By: Sammy Cusimano
Drs. Sean O’ Brien and Benjamin Henderson are changing lives each day, utilizing leading-edge methods and equipment that could only have been imagined years ago. Although Drs. O’Brien and Henderson are vastly experienced in diagnostic radiology (for example, reading complex cross-sectional imaging studies), they form a powerful team specializing in interventional radiology. This minimally invasive, image-guided surgical specialty of radiology is procedure-based and covers a wide range of treatments for diseases and conditions, involving every single field of medicine. Dr. Henderson clarifies, “[Interventional radiology] is not to be confused with laparoscopic surgery, which is a less invasive version of open surgery. This is even more minimally-invasive than [laparoscopic surgery].” Countless patients are benefitting by being able to resume normal daily activities in record time. “There are at least several hundred procedures that we do, as opposed to a typical surgeon who has 10-12 set procedures,” states Dr. O’Brien.
What sets the treatment techniques of interventional radiology apart from other surgical methods is the fact that the procedures are image-guided, rather than relying on direct visualization of internal anatomy via a surgical incision or placement of a scope/camera (as in laparoscopic or robotic surgery). Drs. O’Brien and Henderson utilize CT, ultrasound and x-rays to see inside the body and guide them to the area of concern. Many of the procedures are carried out with the use of tiny tubes or catheters, inserted into the body through a very small incision or puncture, which is barely noticeable after the procedure is completed. Patients typically leave with a small bandage covering the tiny incision, and no stitches are required. This minimally invasive method of treatment shortens recovery time significantly. The safety and convenience of the procedures are helping people of all ages return to their normal routine in an astonishingly short amount of time.
Interventional radiology is changing the game in the treatment of tumors. Whereas traditional chemotherapy kills the cancerous cells, along with many healthy cells within the body, the techniques used in interventional radiology can target tumors precisely. Dr. Henderson states, “We are injecting beads that are loaded with chemotherapy directly into the tumor instead of exposing the whole body. This significantly reduces the number of side effects patients experience.” Henderson and O’Brien utilize radiofrequency ablation and microwave ablation as well to target specific tumor sites for eradication. Many large scientific studies confirm that this approach to the treatment of cancer is successful in destroying tumor cells and decreases systemic toxicity from chemotherapy. “From beginning to end, we offer the entire spectrum of oncology-based special procedures, from initial tumor biopsy and diagnosis, to image-guided treatment. For example, we can use microwave ablation to treat a lung lesion, and the patient’s course of therapy will be much shorter than with traditional radiation therapy,” states Dr. O’Brien. This makes the entire process of treating diseases more convenient for the patient, while simultaneously being more cost-effective for the patient and health-care system. The direct treatment of tumors with interventional radiology may be coordinated with traditional chemotherapy and radiation therapy, resulting in lower dosages needed for these treatments.
In addition to the advances in the treatment of tumors using interventional radiology, Drs. O’ Brien and Henderson are also helping women to explore new options in the realm of gynecology. Uterine fibroid embolization employs an arterial catheter placed through a small arterial puncture to ablate uterine fibroids, providing many women with an alternative to a hysterectomy for relief of their symptoms. In addition to preserving their child-bearing potential, Dr. O’Brien states that patients benefit from a much quicker recovery time compared to a hysterectomy; they are able to return home hours after the procedure, and typically resume work and daily activities within about one week.
The earliest interventional radiology procedures involved the circulatory system; over time, the array of devices and techniques available for treatment of blood vessels throughout the body has grown exponentially. With the proper catheters and equipment, Drs. O’ Brien and Henderson are able to open blood vessels as well as close them if needed. For example, the doctors dilate arteries and veins and place stents in vessels when more blood needs to flow; however, if there is internal bleeding, as a result of trauma or surgery for example, they are also able to close a blood vessel to avoid further hemorrhage.
Interventional radiology is also helpful in treating conditions that are visible on the exterior of the body such as varicose veins and swollen legs. Using laser-tipped catheters, the doctors are able to close down the faulty veins. Drs. O’ Brien and Henderson treat conditions at the source with their accurate application of specific catheters.
Treatment of dialysis graft and fistula malfunctions is a subset of vascular interventions that these doctors perform regularly. Many patients with renal failure rely on dialysis to provide life-saving kidney functions; when clots or areas of narrowing form in dialysis access vessels, Henderson and O’Brien dissolve the clot and angioplasty/stent any underlying areas of narrowing in the fistula/graft, allowing the patient to resume dialysis.
Interventional radiology provides an exciting, non-surgical treatment for obesity, a condition affecting over one third of Americans. The goal of these procedures is appetite suppression. “There are new [procedures] on the horizon that are very exciting. There are [methods] of embolizing an artery to the stomach that controls the area that creates appetite,” states Dr. O’Brien. This new procedure targets the cells in the stomach that secrete ghrelin, the hormone that stimulates the desire to eat. This is performed as minimally invasive outpatient procedure, in contrast to traditional bariatric surgery which entails a 2-6 week recovery time.
Just as interventional radiology is helping women in the field of gynecology, there are procedures in this specialty that treat conditions affecting males as well. Symptoms that arise from prostate enlargement as men get older were previously treated with surgery in which the prostate, many times, was completely removed. Drs. O’ Brien and Henderson are actually able to shrink the prostate and alleviate urinary symptoms utilizing catheters. “There is a high success rate of embolizing the prostate until it shrinks so that it is not blocking the urethra, and the symptoms resolve,” explains Dr. O’Brien. Interventional radiology is also extensively utilized in urology for the benefit of both male and female patients in the treatment of kidney stones, providing urologists access to remove stones, and providing kidney-saving drainage (via nephrostomy placement) for patients whose urine flow is blocked by stones, tumors, strictures, etc.
Osteoarthritis is a condition that causes discomfort in the joints due to the breakdown of cartilage and even bone. It is a disease that affects over 20 million people in the United States alone. The method of treating osteoarthritis in interventional radiology involves blocking the arteries that feed blood to the joint spaces where inflammation is occurring. Through the use of catheters, doctors are able to diminish blood flow to the affected joints and treat the body’s inflammatory response at the source to relieve pain. Dr. O’Brien states, “There has been great success in the treatment of osteoarthritis using interventional radiology. When the body is reacting against itself in response to a disease such as this, we are able to prevent the inflammation.”
Appendicitis and Diverticulitis
Drs. O’ Brien and Henderson are also able to help patients by lessening the need for surgery/surgeries when cases of appendicitis and diverticulitis occur. Dr. O’Brien states, “In the case of a ruptured appendix, we are able to insert a very small tube through the skin that completely drains the abscess, alleviating the need for emergent surgery.” Similarly, abscesses related to diverticulitis (inflammatory disease of the colon) can be alleviated through interventional radiology treatment procedures. Often times, treating diverticulitis with surgery is at least a two-part process; however, through the use of interventional radiology, inflammation can be reduced so that only one surgery is needed.
Interventional radiology is changing the medical field each day by making treatment options available that are healing patients at an unprecedented rate, while also enhancing their health and wellness. Dr. Henderson explains, “This efficient method of treating patients is beneficial to the entire medical community. It allows for more availability of rooms in hospitals, less overall cost and better long-term results.” As a united team, Drs. O’Brien and Henderson are bringing the state-of-the-art treatment procedures of interventional radiology to the Gulf South. Dr. O’Brien concludes, “Interventional radiology has always been exciting and new treatments are on the horizon.”