What is an Interventional Radiologist?

with John Tomashek, M.D., Interventional Radiologist, Columbia St. Mary’s

Posted: May 1, 2004

John Tomashek, M.D., an interventional radiologist working out of Columbia St. Mary’s, is used to having to explain his area of medicine.

“Most people do not know what IR (interventional radiology) is,” Dr. Tomashek said. “Other doctors refer their patients to me for a specific procedure or to address a specific problem. In general, people do not go to an interventional radiologist on their own.”

John Tomashek, M.D., Interventional Radiologist, Columbia St. Mary's "We work with every specialist in the hospital, and we perform a myriad of procedures just as diverse."

Interventional radiologists are physicians who have specialized in radiology and then have gone on for further training. Interventional radiologists perform minimally invasive, targeted treatments using imaging guidance. These procedures often replace open surgical procedures and are easier on the patient because they involve no large incisions.

Interventional radiologists use X-rays, ultrasound, CAT (computerized axial tomography) scans and MRI (magnetic resonance imaging) to guide small instruments such as needles and catheters through the blood vessels or other pathways to treat or detect disease.

Their specialized training is certified by the American Board of Radiology and recognized by the American Board of Medical Specialties.

Types of treatments
Opening blocked blood vessels, taking biopsies, placing long-term intravenous (IV) lines for cancer and dialysis patients are all common procedures in interventional radiology (IR).

Interventional radiologists have treatments for varicose veins, severe blood clots in the legs, painful or bleeding uterine fibroids and some sources of chronic pelvic pain in women. They offer vertebroplasty and kyphoplasty, which are treatments for painful spine fractures. Some causes of infertility in both women and men can now be treated without surgery by interventional radiologists.

At one time, surgery was required for people who required a feeding tube or a tube to drain an infection, but today these procedures can be done without surgery by an interventional radiologist.

Currently, interventional radiologists work with vascular surgeons while performing aortic stent grafting. This is a less invasive procedure offered to some people with abdominal aortic aneurysm as a safer alternative to conventional surgery.

In some cases, new IR procedures can be used to deliver cancer-fighting therapy directly to the site of the tumor.

The unifying theme that links these unique and diverse therapies is the use of medical image guidance. This allows the IR specialist to perform these procedures more safely and with less recovery time than older treatments.

More uses on the horizon
IR is a rapidly growing area of medicine and has continued to evolve as a specialty for the past 40 years — since the time early founders of the field developed angioplasty. Advances in vascular imaging technology in the last ten years are notable, especially CT and MR angiography. This new generation of angiograms (i.e. X-rays of blood vessels) has given the interventional radiologist the power to study blood vessels from the brain, heart, feet, and everywhere in between, non-invasively.

The patient simply receives an IV, gets the test and goes home. Interventional radiology is changing the landscape of medical diagnosis and treatment from one of surgery and scars to one of outpatient procedures and Band-Aids.

Dr. Tomashek is one of six interventional radiologists working out of Columbia St. Mary’s. These six belong to a larger group of radiologists known as Wisconsin Radiology Specialists, S.C. He and his colleagues are excited to be a part of this burgeoning specialty and anticipate the field will continue to expand in scope.

They look forward to providing the newest IR services to the physicians and patients of Columbia St. Mary’s, with additions of newer venous interventional therapies and radio frequency tumor ablation in the near future. A new state-of-the-art IR suite is under construction at St. Mary’s Ozaukee, which will open this summer.

To learn more about IR, please visit the Society of Interventional Radiology Web site at www.sirweb.org or Wisconsin Radiology Specialists Web site at www.wisconsin-radiology.com.

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