What is interventional radiology?

Interventional radiology (IR) is a medical specialty that treats disease from the inside of the body. Instead of opening the skin to see an organ, we use medical imaging to see it, and we reach it with thin, flexible tubes called catheters, fine wires and needles.

Most IR procedures start with a small puncture in the skin, often at the wrist, the upper thigh or directly over the target. Blood vessels act like a road map that leads to almost any organ. That is how we can stop bleeding, open blocked vessels, shrink tumors, drain infections or take a tissue sample without a surgical incision.

IR touches almost every part of medicine: blood vessels and veins, cancer care, the kidneys and bile ducts, pain and the spine, women's and men's health, and long-term access lines such as ports and PICC lines.

Imaging is how we see what we are doing, in real time. We choose the tool that shows the target best and uses the least radiation.

We keep radiation as low as possible. We use short pulses of X-ray, tight framing on the area we need and ultrasound whenever it does the job. For most procedures the dose is similar to or lower than a few diagnostic CT scans.

IR is not always better than surgery. For some problems surgery is the right answer, and for many there is a choice. Here is how the two approaches usually differ.

Recovery depends on the procedure and on your overall health. Your doctor will explain what to expect for your specific treatment.

Interventional radiologists are medical doctors (MD or DO). After 4 years of medical school, they complete about 6 to 7 more years of training: a year of general clinical medicine, then residency in diagnostic radiology and interventional radiology. Many also complete an extra fellowship year.

That training combines two skills that rarely live in one person: reading medical images like a radiologist, and treating patients with catheters and needles like a proceduralist. In the United States, interventional radiologists are certified by the American Board of Radiology.

Because we often work behind the scenes, many patients have never heard of us. You may meet us when your surgeon, oncologist, primary care doctor or the emergency team asks for help, or you can come to us directly for a consultation.

Before your procedure, we study your scans in detail: where the problem is, which blood vessels supply it, what sits nearby and what the safest path looks like. We plan the entry point, the tools and a backup plan before you arrive.

During the procedure, the room has large screens showing live X-ray or ultrasound, your vital signs and your earlier scans side by side. We compare the live picture with the plan at every step. When we inject contrast, we watch how blood flows. When we place a needle, we confirm its tip is exactly where it should be before we do anything else.

When I look at a scan, I am asking three questions: what is the problem, what is the safest way to reach it, and what could surprise me on the way there. I treat the screen as a window into your body, and I do not move forward until what I see matches what I expect. I also like to show patients their own images afterward, because seeing it makes the whole thing much less mysterious.

Fabio Komlos, MD, interventional radiologist · About Dr. Fabio Komlos

Most IR procedures take 30 to 90 minutes. You are usually awake but relaxed, with the skin numbed so you feel pressure rather than pain. Learn more in our guides on sedation, getting ready and recovery at home.

If you take a blood thinner, tell us early, because it may need to be paused under a plan from us and your prescribing doctor. See blood thinners and procedures.