Overview of the BIDMC IR Section
The Interventional Radiology section has a busy practice (with approximately 9,000 diagnostic and interventional procedures performed each year) supported by 12 full-time, fellowship-trained IR attending physicians.
The IR section prides itself on building strong collaborative relationships with other physician specialists within BIDMC and its affiliates, and strives to provide the best patient care and clinical service possible.
Interventional Radiology Facilities
The main hospital-based facility has a total of 5 available procedural suites. This includes: 3 state-of-the-art angiography suites on the West Campus, in the brand new Klarman Building that opened in March 2023. These suites all include high-resolution digital subtraction angiography, rotational angiography, cone-beam CT, and workstation-based volume-rendered imaging with reconstructions. All rooms have dedicated Interventional Radiology ultrasound equipment. On the East Campus, an advanced angiographic suite, with a new holding area, break room, and reading room opened in 2016. A new fluoroscopy room capable of cone-beam CT opened in the summer of 2022. This is where many procedures ranging in complexity are performed, including superficial venous disease interventions. Additionally, CT-guided procedures are performed in state-of-the-art procedural CT scanners on both the East and West Campuses.
Interventional Radiology has two dedicated complete outpatient IR clinic rooms, complete with examination tables computers and physical exam equipment, on the West Campus close to the IR procedural area. In addition, IR physicians are an integral part of both the Liver Tumor Multidisciplinary Clinic and the Lung Tumor Multidisciplinary Clinic.
Procedures
Our IR physicians perform a wide range of IR procedures, across multiple imaging modalities (both vascular and non-vascular interventions using both fluoroscopy and cross-sectional imaging).
Examples of this include (but are not limited to) the following:
Advanced Biliary Interventions
The IR section has a very busy advanced hepatobiliary practice (including biliary drainages, cholangioplasty, metallic stenting, biopsy, and management of biliary leaks) and collaborates closely with the advanced endoscopy group at BIDMC (which maintains the region’s largest ERCP/EUS practice) and the Pancreatic Cancer Center.
Interventional Oncology
The IR section also has an active Interventional Oncology practice –performing transarterial chemoembolization (with conventional lipiodol and drug-eluting beads) for primary and secondary liver tumors, radioembolization, and CT/US-guided tumor ablation of liver, kidney, lung, bone, adrenal, and soft tissue tumors using various ablation technologies (radiofrequency, microwave systems, and cryoablation). IR also works with 4 other medical specialties in a multidisciplinary single-site liver cancer clinic.
Hepatic Interventions
Our IR physicians work closely with our Liver Transplant Center and as key participants in BIDMC’s Liver Tumor Board/Clinic, and perform advanced hepatic interventions including transjugular intrahepatic portosystemic shunts and associated procedures (TIPS/BRTO), post-transplant interventions (arterial and venous angioplasty/stenting) and liver biopsies (percutaneous and transjugular).
Radial Artery Interventions
We routinely perform transradial arteriography for interventions including radioembolization, chemoembolization and uterine fibroid embolization.
Arterial and Venous Interventions
The IR section performs a wide range of general arterial and venous interventions, including IVC filter placement and retrieval (including complex embedded filters), treatment of DVT (thrombolysis, angioplasty, and stenting), treatment of arterial and venous stenosis (angioplasty and stenting), and treatment of arterial bleeding (such as traumatic and gastrointestinal bleeding). IR physicians also treat pulmonary AVMs, perform bronchial artery embolizations and sclerotherapy of adult venous malformations.
Hemodialysis Care and Vascular Access
Through its partnership with transplant surgery and nephrology, IR physicians perform procedures at the hospital-affiliated outpatient Advanced Vascular Care (AV Care) center, which focuses on managing hemodialysis access care for patients from several different outpatient dialysis centers. This includes tunneled catheter placement/removal, fistulograms, balloon angioplasty, stenting, mechanical thrombectomy/thrombolysis, and venograms. The BIDMC hospital IR practice also performs fistula and dialysis interventions on inpatients and those cases that require higher levels of care.
Endocrine Interventions
The IR section has a busy endocrine-related practice, including performing adrenal vein sampling, ectopic parathyroid angiography and embolization, and benign adrenal adenoma ablation. BIDMC is one of the world’s leading center for minimally invasive treatment of hormonally active benign adrenal tumors.
Urologic Interventions
The IR section performs percutaneous nephrostomies (and nephroureteral stents) and suprapubic catheter placement for acute urinary obstruction, as well as for lithotripsy guidance in the management of urinary stone disease.
Women’s Health
The IR section has an active role in gynecologic interventions, including embolization for the elective treatment of uterine fibroids, pelvic congestion syndrome, and for the emergent treatment of uncontrolled postpartum hemorrhage. We also perform fallopian tube recanalization procedures.
Men’s Health
The IR group has a robust clinical practice in prostate artery embolization, pelvic angiography for the evaluation and treatment of erectile dysfunction and varicocele treatment for infertility or pain.
Enteric Interventions
IR physicians routinely place percutaneous feeding tubes, including primary gastrostomy, gastrojejunostomy, and jejunostomy tube placement and their subsequent management.
Cross-sectional Interventions
IR physicians also staff the cross-sectional IR physician rotation during which they perform routine CT- and US-guided biopsies and drainages (in the chest, abdomen, and pelvis), as well as image-guided palliative pain therapies including celiac plexus neurolysis.
Spine Interventions
IR physicians also perform image-guided treatments for pain, such as facet joint injections and kyphoplasty/sacroplasty.
Superficial Venous Disease
At an offsite outpatient center, the IR section has a comprehensive practice performing patient consults and treating lower extremity superficial venous disease using sclerotherapy and endovenous ablation.
In addition to IR physicians, there are 9 non-procedural advanced practice PA/NPs who manage the outpatient care of our IR patients. The IR practice is also supported by a large group of very competent IR nurses and technologists.
