People with osteoporosis or bone tumors sometimes develop painful compression fractures of the spine.

Vertebroplasty is an effective pain treatment for compression fractures that also prevents further collapse of the vertebra. Guided by medical imaging, interventional radiologists can inject medical-grade bone cement into the spine to strengthen it.

Some patients experience immediate pain relief after vertebroplasty. Most report that their pain is gone or significantly better within 48 hours.

Studies show vertebroplasty provides long-term relief and has a low complication rate. It is covered by most insurance plans.

Uterine Fibroid Embolization (UFE)

Uterine fibroids are growths that can develop in the wall of the uterus. They are not cancerous. While fibroids do not always cause symptoms, their size and location can lead to problems for some women, including pain and heavy bleeding.

Uterine fibroid embolization cuts off the blood supply to uterine fibroids, causing them to shrink and symptoms to subside. Fibroids eventually die. This procedure can prevent the need for a hysterectomy, allowing patients a much faster recovery.

The same procedure can be used to stop life-threatening postpartum bleeding; in these cases it is known as uterine artery embolization.

Studies have shown that uterine fibroid embolization is safe and effective. The American College of Gynecology states that the procedure is “a safe and effective option” for the treatment of uterine fibroids. Many insurance plans cover it.

Peripheral Arterial Disease (PAD) Evaluation & Treatment

Peripheral arterial disease (PAD) is also known as peripheral vascular disease. It is a relatively common condition that can result from clogged or narrowed arteries. One symptom of PAD is claudication, a pain or weakness in the legs while walking. If left untreated, PAD can cause significant leg pain and eventually gangrene, requiring amputation.

The interventional radiologists and vascular surgeons at VIVA offer simple, painless tests to diagnose PAD. The most important test is called the ankle-brachial index (ABI).

VIVA physicians provide a full range of PAD treatments and can perform the most appropriate procedure for each patient. These procedures encompass the front-line treatments for PAD today, including surgical bypass, angioplasty, stenting, and atherectomy.

Radiofrequency ablation (RFA)

RFA can benefit certain patients with bone, breast, kidney, liver, or lung cancer. Interventional radiologists use RFA to kill tumor cells with heat, while sparing healthy tissue. Depending upon the type of tumor, RFA can help reduce pain, improve quality of life, and provide treatment options for inoperable cancers.


Chemoembolization is an interventional radiology cancer therapy. It can be used for certain liver tumors that are too large to treat with RFA, or that are in locations that cannot be treated with RFA. The procedure can be used in combination with other cancer treatments. Chemoembolization delivers a high dose of chemotherapy drugs directly to the tumor while blocking the arteries feeding the tumor. Depending upon the type of cancer, chemoembolization can help reduce pain and improve quality of life.

Varicose Vein Treatment

The Interventional Radiologists and Vascular Surgeons at Virginia Interventional and Vascular Associates (VIVA) assess which treatments are best for specific patients and offer greater assurances than most other vein centers can provide.

Unsightly varicose veins can be removed using a procedure called ambulatory phlebotomy. Sclerotherapy is also available to treat some varicose veins and smaller spider veins.

These advanced outpatient procedures take less than an hour, allow patients to return to normal activity quickly, and offer a high success rate. The procedures are EndoVenous Laser Treatment (EVLT®) and Radio Frequency Ablation (RFA).

Research shows a success rate of 93%-98% in individuals undergoing EVLT®/RFA

Abdominal Aortic Aneurysm Repair

The abdominal aorta is the largest blood vessel in the abdomen. When an area of the abdominal aorta becomes weak and expands, it is called an abdominal aortic aneurysm. Aneurysms are a serious health risk because they can burst, cause internal bleeding, and can lead to shock or death.

The physicians at RAF & ViVA can perform abdominal ultrasound, CT, and/or MRI to help your doctor diagnose an abdominal aortic aneurysm. Our vascular surgeons will recommend the best treatment option depending upon your condition.

One possible treatment is open aneurysm repair, which replaces the weak portion of the aorta. More than 90 percent of open aneurysm repairs are successful, according to the Society for Vascular Surgery. Another treatment option for some patients is an endovascular stent graft, which is less invasive than open surgery and requires a shorter hospital stay.

Vascular Ultrasound

Vascular ultrasound examinations are noninvasive, painless medical tests. They can detect serious vascular conditions and help doctors determine the best treatment options.

VIVA performs vascular ultrasound tests to evaluate:

  • Upper and lower extremities for peripheral arterial disease (PAD)
  • Carotid arteries for plaque that can cause strokes
  • The abdominal aorta for aneurysms
  • Leg veins for deep vein thrombosis and varicose veins
  • Arm veins for vein thrombosis

VIVA technologists who perform ultrasound tests have passed board exams of the American Registry of Diagnostic Medical Sonographers to become Registered Vascular Technologists (RVTs). VIVA is accredited by the Intersocietal Commission for the Accreditation of Vascular Laboratories. Vascular ultrasounds are interpreted by our board-certified interventional radiologists.

Deep Venous Thrombosis Treatment

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in a deep leg vein. DVT can affect people of all ages but risk factors increase after age 50 and with certain conditions, such as cancer, recent surgery, recent trauma, and extended periods of immobility. Left untreated, DVT can cause permanent leg damage. There is also a risk that the blood clot could break off and travel to the lungs, causing a potentially deadly pulmonary embolism.

Our physicians can diagnose DVT and provide several treatment options used individually or in combination, depending on the patient’s condition:

  • Blood thinning medications to prevent new clots from forming
  • Catheter-directed thrombolysis, a minimally invasive procedure that breaks up the clot but requires a 24-72 hour intensive care hospital stay
  • Isolated pharmacomechanical thrombolysis (IPMT), a newer minimally invasive procedure that breaks up the clot, requiring an overnight hospital stay. VIVA doctors use the Trellis® Peripheral Infusion System to perform the procedure.
  • Inferior vena cava filter, a medical device that is implanted to help prevent pulmonary embolisms

Central venous access catheters

Several types of catheters can be placed into the veins for intermediate or long-term use. These are used to administer medications and for dialysis. For cancer patients, a combination of a port attached to a venous catheter is placed under the skin for the administration of chemotherapy. All of these procedures are minimally invasive and quick.

Management of pleural effusions and ascites

Fluid can accumulate around the lungs, called a pleural effusion. If large enough, these can compress the lung resulting in difficulty breathing. Similarly, fluid can accumulate in the abdomen causing it to distend and be painful. In both instances, this fluid can be quickly and safely drained with a needle under imaging guidance. If necessary, a drainage catheter can be placed.

Nephrostomy tube placement

The drainage pathway of urine from the kidney to the bladder can be blocked by a renal stone or by tumor. A urine drainage catheter can be placed so that urine does not damage the kidneys.


The arteries in our bodies can be evaluated by placing a catheter in them and injecting contrast. The resulting angiograms are used to diagnose areas of narrowing, blockages, aneurysms, tears in the artery walls, and vasculitis. We routinely perform angiograms of the arteries in the brain, neck, chest, abdomen, legs and arms.

Angioplasty and stent placement

Various arteries in our body can become narrowed resulting in decreased blood flow to organs in our body, our brain, and our limbs. This can result in damage to those organs, or loss of a limb. In certain patients, our physicians can decrease the amount of arterial narrowing by balloon angioplasty and/or stent placement.

Dialysis Grafts & Fistulas

Patients with renal failure require dialysis. Often dialysis is performed via vascular grafts and fistulas. Our interventional radiologists and vascular surgeons are highly skilled both in the placement of these grafts & fistulas, as well as keeping them open.


Many masses detected on imaging require a tissue sample to be acquired and sent to pathology for further analysis to determine if they are tumors or benign. In the case of tumors, the tumor type can be determined through this tissue sampling. The results help your team of doctors determine the most appropriate course of treatment for you. In many cases, an open surgical biopsy can be avoided. Using various imaging technologies, biopsies can be obtained via a needle quickly and safely without the need for surgery.

Feeding tube placement

In patients who are unable to eat and swallow food via their mouths, a feeding tube can be placed through the skin into the stomach.

Abscess drainage

An abscess is a collection of infected pus. Using imaging guidance, these abscesses can be drained via a needle. A drainage catheter can be left in place if necessary.