Urinary, Gynecological, and Liver Conditions
Benign Prostate Hyperplasia (BPH)
An enlarged prostate gland, known as benign prostate hyperplasia, or BPH, is a common non-cancerous benign tumor found in men. While it does not pose serious danger, it can make it difficult to urinate, increase the frequency of urination, and cause pain or discomfort.
At Mount Sinai, we take a multidisciplinary approach in the diagnosis and treatment of prostate enlargement with our urology team working in tandem with interventional radiologists. When appropriate, we perform Prostate Artery Embolization (PAE) to reduce the size of the prostate.
With PAE, a Mount Sinai interventional radiologist inserts a thin tube, or catheter, into an artery in the patient’s wrist or groin. Then the physician inserts tiny glass beads to seal off the arteries that supply blood to the prostate. After the procedure, with less blood flowing to the prostate, it quickly shrinks in size and symptoms lessen.
End-Stage Renal Disease/Hemodialysis
For patients requiring dialysis to treat their kidney disease, our team of interventional radiologists and vascular specialists provides advanced treatment for creating and maintaining access to the vessels required for hemodialysis. At Mount Sinai, we use a range of diagnostic and treatment procedures for our ESRD patients, including the following:
- Fistulagrams & Interventions — These are a type of X-ray to detect blood flow irregularities that occur in the dialysis access point. Such irregularities, like blood clots or narrowing of the vessels, can prevent you from getting dialysis, so fistulagrams are an essential tool to detect problems. When a fistula becomes blocked by clots or scarring, our interventional radiologists and vascular specialists can re-open the vessels using devices like tiny balloons, rigid tubes called stents, or by manually removing debris through a procedure called thrombectomy.
- Dialysis Catheter Management — Instead of using a fistula to access the blood stream, some patients have catheters inserted into their blood vessels to facilitate dialysis. However, the access point of the catheter can become infected, or the blood vessels can become occluded, or blocked. In these cases, our vascular specialists work to ensure the access point stays healthy and dialysis is not interrupted.
- Kidney Biopsy — Not necessarily only for ESRD patients, Mount Sinai’s interventional radiologists perform CT-guided biopsies by inserting a thin biopsy needle through the skin and then, using a special device, harvest a small sample of renal tissue from the kidney. A pathologist then examines the tissue under a microscope to determine if the kidney is healthy or not.
Liver Disease
One of the liver’s jobs is to filter blood. As a result, the liver is highly vascular, which means it has a lot of blood vessels. That makes the liver an ideal organ for treating diseases and conditions using interventional radiology and vascular procedures. At Mount Sinai, our team consists of experts in the field of minimally invasive therapies for liver disease. We provide liver biopsies, relief from abdominal fluid build-up (ascites), and treatment of varices, or swollen veins.
- Paracentesis — One of the body’s natural responses to injury or disease is to produce excess fluid. However, this excess fluid in the abdominal cavity, known as paracentesis, can cause discomfort and make it difficult to breathe. Mount Sinai’s interventional radiologists use image guidance to insert a needle into the abdomen – without damaging any organs – to remove the excess fluid.
- Percutaneous Biopsy and Transjugular Liver Biopsy — Since the liver is a common site for cancer to appear when it has spread from another part of the body, we frequently have to biopsy liver tissue to determine if lesions that appear on CT scans or other imaging studies are cancerous. We also use liver biopsies to diagnose other liver conditions, including cirrhosis and bleeding problems. Mount Sinai’s interventional radiologists and vascular specialists can remove liver tissue for biopsies in two ways, both using image guidance. With percutaneous biopsy, our physicians insert a needle through the abdominal wall to access the liver. To reach deeper parts of the liver, we use transjugular liver biopsy. With this method, your Mount Sinai specialist inserts a flexible needle through the jugular vein in the neck all the way to the main vein in the liver, the hepatic vein, where he or she can remove a tissue sample.
- Transjugular Intrahepatic Portosystemic Shunt (TIPS) Placement — Patients who have increased blood pressure in the portal vein, which is the vein that carries blood from digestive organs to the liver, may require a transjugular intrahepatic portosystemic shunt (TIPS) to ensure adequate blood reaches the liver. In this procedure, using image guidance, Mount Sinai’s interventional radiologists and vascular specialists access the liver through the jugular vein. Then, our physicians use a shunt, which is like a tunnel, to connect the portal vein to the hepatic vein, which takes blood away from the liver. They also insert a rigid tube, or stent, to keep the shunt open so blood can flow freely.
- Balloon Retrograde Transvenous Obliteration (BRTO) of Shunts and Varices — Swollen veins in and around the liver can lead to dangerous bleeding or rupture. Our Mount Sinai interventional radiologists and vascular specialists use this advanced procedure to seal off blood vessels to prevent possible bleeding.