Minimally Invasive Procedures

Marc S. Schwartzberg, M.D., Interventional Radiologist

Marc S. Schwartzberg, M.D., Interventional Radiologist

Lake Medical Imaging provides minimally invasive procedures which often replace traditional surgery.

Venous Ablation / Varicose Veins

Venous ablation is a minimally invasive treatment done in our office using imaging guidance. After applying local anesthetic to the vein, one of our Interventional Radiologists insert a thin catheter, about the size of a strand of spaghetti, into the vein and guide it up the greater saphenous vein in the thigh. Then laser energy is applied to the inside of the vein. This heats the vein and seals the vein closed. By closing the greater saphenous vein, the twisted and varicosed branch veins, which are close to the skin, shrink and leg appearance improves. Once the diseased vein is closed, other healthy veins take over to carry blood from the leg, re-establishing normal flow.

Benefits of Venous Ablation Treatment

The treatment takes less than an hour and provides immediate relief of symptoms. The patient can return immediately to normal activity with little or no pain (there may be minor soreness or bruising, which can be treated with over-the-counter pain relievers). Because the procedure does not require a surgical incision, just a nick in the skin about the size of a pencil tip, there are no scars or stitches. Traditionally, surgical ligation or vein stripping was the treatment for varicose veins, but these procedures can be quite painful and often have a long recovery time. The success rate for venous ablation is substantially higher than that for surgery (meaning the recurrence rate is low); in fact, the success rate for venous ablation ranges from 93% to 95%.

Sclerotherapy/Spider Veins

Sclerotherapy is the most common treatment for spider veins. The procedure takes about 30 minutes, during which time a solution called a “sclerosing agent” is injected into the veins. This causes the inter lining of the vein to stick together, which results in scar tissue that acts like a ‘glue’ to seal off the unwanted veins. There are few side effects, such as bruising around the injection site, or temporary discoloration of a light brown color along the vein; the patient can, however, return to normal activity immediately.

How many treatments will it take?

The number of treatments depends on the individual. One or possibly more treatments, depending on the extent of the spider veins. The average number of treatments needed is usually three.

Diagnostic Injections & Pain Management

The Interventional Radiologists at Lake Medical Imaging are specialists in the field of diagnostic injections and pain management, and serve as valued consultants to your doctor. Because of their education, experience, and skill, our radiologists will assure that your procedure is performed quickly and precisely. Treatments are obtained only by referral from your physician. Diagnostic injections and pain management procedures are ordered by your physician for diagnosis and/or therapeutic treatment of pain in most joints of the body and in all areas of the spine (lumbar, thoracic, and cervical). In some cases, the spinal injection procedure will be used in combination with other imaging exams, such as CT and MRI. We offer a variety of injection and pain management procedures. Therefore a technologist will contact you before your exam to give you your specific instructions on your procedure.

Please note that, due to the effects of some medications, you may need to have someone drive you home after the exam.

Our technologist will give you information and instructions on potential after-effects from the local anesthetic and medications used with your procedure. The total appointment time for most of our procedures is 30 to 60 minutes.

Specialized Injection Procedures Performed at Lake Medical Imaging:

  • Facet Joint and Nerve Injections
  • Arthrography/MRI Arthrography
  • Epidural Steroid Injections
  • Sacro-Iliac Joint Injections
  • Nerve Root Blocks
  • Myelography

Image-Guided Needle Biopsy

In many cases, tissue samples can be obtained without open surgery by utilizing interventional radiology techniques. Nearly all biopsies performed by Interventional Radiologists are “image guided needle biopsies.” This means that a needle is placed into an area of abnormality directly through the skin. The needle placement is confirmed with the use of a variety of equipment used by the radiologists including ultrasound (used most often), CT or X-ray fluoroscopy.

Needle biopsies are almost always performed as an outpatient with a short (one hour) observation period after.

Paracentesis and Thoracentesis

Patients with a variety of illnesses may develop an area of excessive fluid in a body cavity, such as the abdomen or chest. The fluid can be drained by inserting a thin tube (catheter) through a small nick in the skin. In an effort to determine the cause of the fluid build-up or to relieve the symptoms of the excess fluid, Interventional Radiologists insert a small tube (less than 1/12 of an inch in diameter) through the skin after numbing the skin with a local anesthetic. The fluid may be sent to the laboratory for analysis.

The patient experiences immediate relief of most of the symptoms and is released home after a short (one hour or less) observation period.

Vascular Access Procedures

A vascular access procedure is designed for patients who need intravenous (IV) access for a considerable time, longer than 7 to 10 days. A simple IV set-up is effective in the short term, but is far from ideal when, for instance, a patient needs a course of chemotherapy, several weeks of IV antibiotic treatment, or long-term IV feeding.

A vascular access catheter is a long, thin tube that is placed in a branch vein in the arm, in the neck, or just beneath the collarbone. The tube is then threaded into a major vein in the chest. In many conditions, having this type of tube inserted provides a simple and painless means of drawing blood or delivering drugs, nutrients or both. In this way, the patient is spared the discomfort and stress of repeated needle sticks.

These so-called central catheters can remain in place for several weeks or even months.