Intervenational Radiology Services of LJR Medical Group - San Diego & Orange County CA.
Interventional & Oncological Services of LJR Medical Group

The Division of Interventional Radiology provides diagnostic and therapeutic services at the Scripps Memorial Hospitals in La Jolla and Encinitas and Scripps Mercy Hospital in Chula Vista.

Interventional & Oncological Services of LJR Medical Group  - San Diego and Orange County CA.

Highlighted Specialty Interventional Procedures

NOTE: If you have a health problem or disease, you should consult your doctor or health care provider directly.

LJR Interventional Radiologists

Ross A. Christensen M.D.
Stephan Bradford Hulse M.D.
Trevor D. Nelson, M.D.
Harold G. Pimenta M.D.
Paul J. Rickards, M.D.
Brian J. Shore, M.D.
Robert R. Varney, M.D.

LJR Clinical Support Staff


Interventional Radiology Services

Aortic Endograft and Stent Grafts

Nephrostomy

Angiography

Neurologic Interventions

Angioplasty

Paracentesis

Arteriovenous grafting

Pelvic Congestion Syndrome Treatment

Arthrography

Positron Emission Tomography (PET)

Biliary drainage & stent grafting

Stroke - Prevention and Treatment

Continuous Ambulatory Peritoneal Dialysis
(CAPD)

Thoracentesis

Catheter embolization

Thrombectomy

Central Catheters

Thrombolysis- arterial and venous

Transjuglar ntrahepatic Portosytemic Shunt
(TIPS)

Chronic pelvic pain interventions

Uterine Fibroid Embolization (UFE)

Cholecystostomy

Varicose Vein treatment

Computed Tomography Angiography (CTA)

Venous Access

Discography

Vertebroplasty

Fallopian tube recannulization

Vascular stent placements

Gastrostomy tube placement

 

Image guided biopsies

Oncological Therapies

Inferior vena cava filter placement

Chemoembolization
Kyphoplasty Radiofrequency Tumor Ablation

Magnetic Resonance Angiography (MRA)

Regional Tumor Therapy

Myelography

SIRT / Yttrium Microsphere Radioembolization

Angiography

(X-ray exam of the blood vessels)

Angiography is an X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems.

An interventional radiologist performs this X-ray procedure, which is also called an angiogram. During the angiogram, the doctor inserts a thin tube (catheter) into the artery through a small nick in the skin about the size of the tip of a pencil. A substance called a contrast agent (X-ray dye) is injected to make the blood vessels visible on the X-ray.

One of the most common reasons for angiograms is to see if there is a blockage or narrowing in a blood vessel that may interfere with the normal flow of blood through the body. In many cases, the interventional radiologist can treat a blocked blood vessel without surgery at the same time the angiogram is performed. Interventional radiologists treat blockages with techniques called angioplasty and thrombolysis. (information provided by the Society of Interventional Radiology)

More information from the Society of Interventional Radiology

Angioplasty

Angioplasty In this technique, the interventional radiologist inserts a very small balloon attached to a thin tube (catheter) into a blood vessel through a small nick in the skin. The catheter is threaded under X-ray guidance to the site of the blocked artery. The balloon is inflated to open the artery.


Balloon
Sometimes, a small metal scaffold / tube, called a stent, is inserted to hold the blood vessel open. (information provided by the Society of Interventional Radiology)

More information from the Society of Interventional Radiology

Aortic Endograft/stent grafts

An aortic aneurysm is a weak area in the aorta, the main blood vessel that carries blood from the heart to the rest of the body. As blood flows through the aorta, the weak area bulges like a balloon and can burst if the balloon gets too big.

A small aneurysm may require no immediate treatment other than "watchful waiting" - checking the aneurysm regularly to be certain it does not grow. If an aneurysm reaches a certain size, however, there is a danger that it will burst and bleed uncontrollably (hemorrhage). In these cases treatment is necessary.

The following information was prepared by the Society of Interventional Radiology (SIR) to provide general information about abdominal aortic aneurysm - the most common type of aortic aneurysm. This site reviews the signs and symptoms, how it is diagnosed, and when it may require treatment.

Treatment of an abdominal aortic aneurysm may require surgery. For some patients, however, a new, non-surgical treatment called "stent-graft repair" can be performed by an interventional radiologist. This site gives an overview of treatment options, and specific information about stent-graft repair, the new, interventional radiology treatment that does not require surgery.


The most common site for an aortic aneurysm is below where the aorta divides to supply blood to the kidneys


Q: What is an aneurysm?

An aneurysm is a weak area in the wall of a blood vessel that bulges like a balloon when blood flows through the vessel. Aneurysms can occur throughout the body, and sometimes they are harmless. But sometimes they are life-threatening. Aneurysm occurs most commonly in the brain (cerebral aneurysm) or the aorta, the main blood vessel that supplies blood to the body. An aortic aneurysm may be in the chest cavity (thoracic aortic aneurysm), but it is most commonly seen in the abdomen (abdominal aortic aneurysm).

Q: What is an abdominal aortic aneurysm (AAA)?

An abdominal aortic aneurysm (AAA) is a weak area in the wall of the abdominal aorta - the artery that carries blood from the heart to the rest of the body. The aorta is the body’s largest blood vessel; when an area is weak, it may bulge like a balloon when blood flows through it. The most common site for an aortic aneurysm to occur is below where the aorta divides to supply blood to the kidneys and above where it divides to supply blood to the pelvis and legs. An aneurysm that occurs in this location is called an abdominal aortic aneurysm. The normal diameter of the aorta is about 1 inch or less. Small aneurysms - less than 2 inches (5 centimeters) rarely rupture and may pose little risk to the patient. If the aneurysm grows larger, however, the risk of rupture and life-threatening bleeding (hemorrhage) increases. In most cases, physicians recommend treating aneurysms that are 5.5 centimeters or greater in diameter.

Q: How Common is AAA?

Abdominal aortic aneurysms occur in from 5 percent to 7 percent of people over the age of 60 in the United States. Males are at least four times more likely to have AAA than females, and some studies have shown the rate in males to be even higher. According to one study, the incidence of AAA has increased three-fold over the past 40 years, making it the 13th leading cause of death in the U.S.The condition accounts for nearly 15,000 deaths each year.

Approximately one in every 250 people over the age of 50 will die of a ruptured AAA. Fortunately, when AAA is diagnosed early it can be successfully treated and rupture is prevented. Depending on the individual, treatment may require surgery. Often, however, the aneurysm can be repaired with a new,interventional radiology technique that does not require open surgery.

Q: What are the symptoms of AAA?

AAA is often a silent disease. Many patients do not experience any symptoms, particularly when the aneurysm is small. If there are symptoms, the most common ones are:

  • intense abdominal pain that may be constant or come and go.
  • pain in the lower back that may radiate to the buttocks, groin or legs
  • the feeling of a "heart beat" or pulse in the abdomen.
  • Fatigue
  • Sometimes, the aneurysm can be felt as a soft mass in the abdomen.
  • If an aneurysm expands rapidly, tears open, or bursts, or if blood leaks along the wall of the blood vessel (aortic dissection), more severe symptoms may develop suddenly. A ruptured aneurysm is life-threatening and requires immediate emergency care.

Symptoms of a ruptured aneurysm may include:

  • severe pain that begins suddenly
  • paleness
  • rapid pulse
  • dry mouth/skin and excessive thirst
  • anxiety
  • nausea and vomiting
  • lightheadedness or fainting
  • excessive sweating or clammy skin
  • shock


Q: Who is at Risk for AAA?

The most common cause of an aortic aneurysm is atherosclerosis (often called "hardening of the arteries"). Atherosclerosis is a gradual process in which cholesterol and scar tissue build up, forming a substance called "plaque" that weakens or damages the walls of the blood vessels and makes them more vulnerable to an aneurysm. Other risk factors are high blood pressure, smoking and a family history of AAA. Less frequently, aneurysms may be caused by connective tissue diseases, inflammation of the blood vessels (vasculitis) and some congenital disorders. Aortic aneurysms most frequently occur in white males between the ages of 50 and 60. (information provided by the Society of Interventional Radiology)