Interventional Radiology

Interventional radiology procedures are some of the most highly varied group of procedures but what they all have in common is the use of an imaging modality to guide therapy. The amount of time needed to perform these procedures is highly variable and therefore should be discussed with the proceduralist.

Neuroradiology / Interventional vascular

Interventional vascular procedures are becoming more of the standard for managing multiple different vascular procedures which used to have a high morbidity/mortality from surgery. Sometimes, these procedures simply require light sedation as the initial needle puncture is the main painful stimulus and the remainder of the procedure is to simply keep the patient comfortable enough that they do not need to move. When absolute immobility is required (such as in coiling small vessels in the head), then the patient may need general anesthesia to guarantee that they will not move during the procedure. Normally the position is on the back (supine), but this can very based on the needs of the radiologist.

CT-guided therapy

The need for anesthesia services for CT-guided therapy is based on the radiolgists need for immobility during their procedure. With deeper sedation and the more nuanced approach to pain management, patients can tolerate these more complicated and sometimes painful procedures without moving which helps to minimize the amount of radiation and time needed to perform them. These CT-guided biopsies are usually performed with moderate-deep sedation and IV medications. The position is dependant on the needs of the radiologists but is usually either on the back (supine) or on the belly (prone).

Imaging sedation

Some hospital systems provide a mechanism for sedation during imaging (usually MRI). At times, the patient may be too sick, medically complex or anxious to be able to have the imaging study with a small dose of anti-anxiety medication. Anesthesia providers may be requested to provide sedation or general anesthesia for such cases. In particular with these imaging studies, the anesthesia provider is normally physically separated from the patient due to safety concerns (repeated radiation doses or magnetic field interference). The decision to place a breathing device or the medications is very dependant on the specific circumstances and should be discussed with the anesthesia provider.