Aortic Aneurysm

An aortic aneurysm is an abnormal bulging or weakness in the wall of the aorta. Aortic aneurysms can occur either in the chest (Thoracic Aortic Aneurysm, TAA) or in the abdomen (Abdominal Aortic Aneurysm, AAA). Aneurysms are typically asymptomatic and can enlarge over time. Risk factors include family history, male gender, smoking, hypertension, and age over 65. Aortic aneurysm ruptures can be life threatening, but fortunately most aneurysms can be repaired using minimally invasive endovascular techniques.

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Symptoms (when present):

  • Pain in the jaw, neck, upper back or chest (TAA)
  • Pulsating enlargement or tender abdominal mass felt by a physician during a physical exam (AAA)
  • Pain in the back or abdomen (AAA)

Diagnosis:

  • Physical exam
  • CT
  • Ultrasound

Treatment:

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Arterial Aneurysm

An aneurysm is an abnormal bulging or weakness in the wall of an artery. Aneurysms can occur in the arteries supplying the kidneys and gut, and arteries supplying the pelvis and legs. Aneurysms are typically asymptomatic, and can enlarge over time. Risk factors include smoking and hypertension. Aneurysm rupture can be life threatening, but fortunately most can be repaired through minimally invasive endovascular techniques.

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Symptoms (when present):

  • Severe pain in the abdomen
  • Low blood pressure
  • Cold leg or foot

Diagnosis:

  • Physical exam
  • CT
  • Ultrasound

Treatment:

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Compression Fractures

Compression fractures occur in the spine when bones and vertebrae become soft and weak. Quite often the cause is osteoporosis, a disease that affects more than 10 million Americans. Osteoporosis is marked by weakened and brittle bones and typically results in height loss and spine curvature. This kind of stress on the bones can cause painful compression fractures and further collapse of the bones. Using minimally-invasive image-guided techniques, cement can be inserted directly into the fracture, creating an internal cast. The goal of such a procedure is pain relief.

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Symptoms:

  • Sudden, severe back pain
  • Worsening of pain when standing or walking
  • Some pain relief when lying down
  • Difficulty and back pain when bending or twisting
  • Loss of height
  • Visible deformity or curvature of the spine

Diagnosis:

  • Physical exam
  • Spinal X-ray
  • CT
  • MRI

Treatment:

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Deep Vein Thrombosis (DVT)

Deep Vein Thrombosis is a serious medical condition that occurs when a blood clot forms in one or more of the body's major deep veins (typically in the legs or pelvis), leading to blockage of blood flow. The result is significant discomfort and risk of serious health complications, like pulmonary embolism (PE), which occurs when a blood clot travels to the lungs. Risk factors include obesity, prolonged sitting, restricted mobility, pregnancy and predisposition to clotting. DVT therapy utilizes minimally invasive ultrasound and live X-ray guidance to remove the blood clot, typically in a single setting.

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Symptoms:

  • Pain
  • Swelling
  • Tenderness
  • Discoloration or redness

Diagnosis:

  • Ultrasound

Treatment:

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Liver Cancer

Surgery is often not an option for liver cancer, and chemotherapy can sometimes be ineffective. Minimally invasive interventional oncology treatments are a viable option for many cases of liver cancer, as well as kidney and lung cancer. These treatments can preserve the affected organ by delivering targeted treatments that can attack the cancer from within. Interventional oncology is often considered in cases where traditional surgery, chemotherapy or radiotherapy have failed or are not considered safe.

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Pelvic Congestion Syndrome

Pelvic Congestion Syndrome results from pelvic venous insufficiency (PVI), where the pelvic veins become enlarged (similar to varicose veins that are common in the lower legs). With PVI, pelvic varicose veins bulge and stretch, causing chronic pelvic pain and a sensation of heaviness in the lower pelvis. Pelvic Congestion Syndrome is treated with pelvic embolization, an outpatient procedure that closes off blood supply to the failing veins and redirects it to normally functioning veins.

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Symptoms:

  • Significant pain and heaviness in lower pelvis
  • Chronic dull and aching pelvic pain
  • Worsening pain with prolonged standing or sitting

Diagnosis:

  • MRI/MRV (venogram)
  • CT

Treatment:

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Peripheral Artery Disease

Peripheral Artery Disease (PAD) is a condition in which the arteries that carry blood to the legs become narrowed or clogged due to accumulation of atherosclerotic plaque. The disease limits blood flow to the tissue of the legs, which can cause pain with exertion. Also referred to as Peripheral Vascular Disease, PAD can occur in anyone; however, it is more common in men and women over the age of 50. Risk factors include smoking, diabetes, high blood pressure or high cholesterol. Most patients with Peripheral Artery Disease can be treated by minimally invasive endovascular methods.

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Symptoms:

  • Cramping pain in legs while walking (relieved by rest)
  • Pain in legs or feet while resting or lying flat
  • Ulcerations or wounds on legs or feet that do not heal
  • Cold and painful legs or feet

Diagnosis:

  • Ankle-Brachial Index (ABI)
  • Vascular Ultrasound
  • CT Angiogram

Treatment:

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Uterine Fibroids

Uterine fibroids are the most common form of noncancerous uterine tumors, affecting 25 - 40% of American women. While not life-threatening, fibroids can cause significant discomfort and heavy menstrual bleeding. Fortunately, hysterectomy is no longer the only option. Charlotte Radiology's interventional radiologists can perform a minimally invasive procedure called Uterine Fibroid Embolization (UFE) that can provide significant and lasting symptomatic relief.

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Symptoms:

  • Heavy, prolonged menstrual periods
  • Pelvic pain, pressure or heaviness
  • Lower back or leg pain
  • Pain during sexual intercourse
  • Bladder pressure
  • Constipation
  • Frequent urination

Diagnosis:

  • Pelvis Exam
  • Ultrasound

Treatment:

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Varicoceles

A varicocele is a cluster of enlarged veins in the scrotum that causes blood to accumulate and increased pressure in the veins. Approximately 10% of all men have varicoceles, with the highest occurrence in younger men. Also, approximately 30% of infertile men have varicoceles. Varicoceles are treated with embolization, during which abnormal veins are permanently closed, redirecting blood through normal venous channels.

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Symptoms:

  • Dull testicular pain, especially after sitting or standing for an extended period
  • Infertility
  • Testicular atrophy, or shrinking of the testicles
  • A palpable lump or visible cluster of veins in the scrotum

Diagnosis:

  • Physical Exam
  • Ultrasound

Treatment:

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Vascular Malformations

Vascular malformations can exist in veins, arteries, capillaries or lymphatic vessels—or a combination of these. Although present at birth, not all vascular malformations are noticed right away. Some become apparent years later. Vascular malformations occur during the development of arteries, but the cause is unknown. Charlotte Radiology's interventional radiologists and the vascular anomalies team at Levine Children's Hospital work together to diagnose, triage and provide treatment plans for many patients with simple to complex vascular malformations.

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