Our Services

Rochester Radiology offers state-of-the-art imaging studies as well as minimally invasive image-guided procedures and treatments for various health conditions. Our physicians are subspecialized experts and perform a variety of exams and procedures.

We strive to educate, inform & prepare our patients for the exam or procedure they plan to undergo.

  • X-Ray

    Diagnostic Imaging
    • X-Ray
    • Pediatric X-Ray
    • Osteoporosis Screening (DEXA)

    What is x-ray imaging?

    X-ray, or plain film radiograph, is the oldest and most common type of imaging. It provides valuable information by capturing a detailed image on digital film using a small dose of radiation. It is a non-invasive exam that involves exposing a part of the body to invisible x-rays, allowing highly detailed pictures of internal structures to be produced.

    Why is this exam done?

    X-ray is usually the best initial test to evaluate for many problems, as it is performed quickly and uses only a tiny amount of radiation. Typically, x-rays are used for imaging of:

    • the chest for pneumonia or fluid
    • bones for fractures
    • the abdomen for kidney stones

    What will happen during the exam?

    A radiology technologist will escort you into a special room where he or she will take the images. Multiple images are often needed to achieve the best results and ensure proper evaluation.

    What are the risks and benefits?

    You will be exposed to a small dose of radiation during your exam, which in general are negligible as isolated exposure. However, the benefits outweigh the potential risk.

    Please inform the technologist if you are pregnant or think there is a possibility you may be pregnant.

    For children, and whenever else possible, lower doses of radiation are used. Shielding is also provided to parts of the body not being imaged.

    How should I prepare?

    No preparation is needed. You only need to bring your referral/prescription.

    Please inform the technologist if you are pregnant or think you might be pregnant.

    Be sure to take all prescribed medications as scheduled.

    Any special instructions for after my test?

    There are no special instructions or limitations after your x-ray is taken.

  • Pediatric X-Ray

    Diagnostic Imaging

    X-rays are painless and commonly used procedures. They do not require any special preparation. During the exam, your child will need to remain still as the technologist adjusts the image recording plate against the area to be tested. Wearing a lead apron to limit radiation exposure, your child's x-ray will be taken once the technologist activates the x-ray machine.

    Please also see our X-Ray page for additional information on the procedure.

  • Osteoporosis Screening (DEXA)

    Diagnostic Imaging

    What is Osteoporosis?

    Osteoporosis refers to thinning of the bones. This condition can occur in men and women of all ages.

    What is DEXA?

    DEXA stands for Dual Energy X-ray Absorptiometry. It is a fast and simple, non-invasive procedure used to measure bone mineral density (BMD). BMD measurements can help to determine your particular bone status and prediction of fracture risk.

    A DEXA scan uses a special x-ray unit to image for BMD and requires an extremely small dose of radiation, less than 1/20 the amount in a chest x-ray.

    How should I prepare for the exam?

    Please do not take any calcium supplements the day of the exam. For the exam, you will not need to remove any clothing, but we do suggest wearing comfortable clothing and avoiding any items containing metal.

    What can I expect during the exam?

    Your lower back and hip will be x-rayed. The procedure takes about 30 minutes, including time for you to ask questions.

    What can I expect after the exam?

    Once the radiologist evaluates your BMD as compared to individuals who are similar in age, weight, sex and ethnic background, your results will be sent to your physician for further review.

    Will a DEXA scan be covered by my insurance?

    Some insurance companies may require prior approval for a DEXA scan. Please check with your insurance company to determine if prior approval is required. If so, you can arrange this through your primary care physician.

  • CT

    Computed Tomography
    • CT
    • CT Angiography
    • Coronary CT Angiography
    • CT Colonography
    • CT Enterography
    • CT Virtual Colonoscopy

    What is CT Imaging?

    CT, or computed tomography, combines a special spinning x-ray scanner with sophisticated computers to produce multiple images of the inside of the body. Instead of creating a two-dimensional image as an x-ray does (like a photograph), a CT scan creates both 2-D and 3-D models of the imaged portion of the body, which can then be looked at in various ways.

    Newer state-of-the-art CT scanners, such as the ones used in our facility, are so sophisticated that they can capture incredible detail in milliseconds, allowing the ability to recreate a beating heart image or a 3-D model of the colon. Our state-of-the-art software now allows us to use less radiation than other typicals scanners while performing these exams.

    Why is this exam done?

    CT scans are done for a much higher level of detail and can be used to image almost any part of the body. They are performed fairly quickly (ranging from 10 seconds for a head CT to a few minutes for more advanced body scans).

    What will happen during the exam?

    One of our highly skilled technologist will help position you on the CT examination table, which is an open ring around the table (unlike an MRI). The table will move through the scanner to determine the correct starting position for the exam. The table will then move slowly through the machine as the CT scan is performed. (You may be asked to hold your breath during the exam.)

    You may have an IV so as to administer IV contrast, which greatly enhances the images obtained. While you will be alone in the exam room during the actual scan, you will be able to see and hear the technologist at all times.

    What are the risks and benefits?

    Excessive exposure to radiation can be harmful, but the exposure during a CT scan is minimal and the benefits of an accurate diagnosis far outweigh the risk. Moreover, our state-of-the-art software now allows us to use less radiation than other typicals scanners while performing these exams.It is important to inform your doctor of any recent illnesses or medical conditions as some conditions may increase the risk of an adverse effect.

    Women should always inform their physician and the technologist if they are pregnant or may be pregnant. Nursing mothers should wait 24 hours after receiving contrast before resuming breast-feeding. Allergic reaction to contrast (mild or severe) is also a rare but possible risk. Our team is well-prepared to deal with such reactions should the need arise.

    How should I prepare for my test?

    Do not eat or drink for 2 hours prior to the exam. You will need to bring your prescription. When you arrive, you will be asked to fill out a questionnaire in order to confirm that all necessary precautions have been taken.

    Please inform the technologist if you are pregnant or think you might be pregnant, if you have kidney disease or are diabetic, or if you are allergic to the IV contrast.

    Take all of your prescribed medications as scheduled unless otherwise instructed. You may be asked to drink a liquid that allows us to obtain better imaging of your GI system.

    Any special instructions for after my test?

    After a CT exam, you can return to your normal activities.

  • CT Virtual Colonoscopy

    Computed Tomography

    What is CT Virtual Colonoscopy?

    CT Virtual Colonoscopy is a safe, non-invasive procedure to identify growths (polyps) in the colon. Polyps have been shown to be the precursor of many cancers in the colon and rectum (colorectal cancer), and the goal of CT Virtual Colonoscopy is to find these potentially dangerous polyps before they can cause a serious problem.

    CT Virtual Colonoscopy is an alternative to conventional colonoscopy, which requires the introduction of a long tube into the rectum and is then advanced through the entire colon. Unlike optical colonoscopy, virtual colonoscopy is a minimally invasive procedure and requires no sedation. While conventional colonoscopy takes two or more hours to perform, virtual colonoscopy can be completed within a half-hour and is a far more comfortable procedure.

    Who should have a CT Virtual Colonoscopy?

    Colorectal cancer is the second leading cause of cancer-related deaths in the United States. According to guidelines endorsed by the American Cancer Society and other national groups, screening for colorectal cancer utilizing a technique that examines the entire colon is recommended for individuals beginning at age 50. Screening is recommended beginning at age 40 for individuals at high risk for colon cancer, including those with:

    • Personal or family history of colon cancer
    • Personal history of ovarian, endometrial or breast cancer
    • History of chronic ulcerative colitis or Crohn's disease

    Potential reasons for having a CT Colonography exam are an incomplete optical colonoscopy, low-to-average risk patients who prefer not to have a colonoscopy, and frail patients and others who are unable to tolerate a colonoscopy.

    How do I prepare and what can I expect before, during and after my CT Virtual Colonoscopy?

    In order to obtain the best images, bowel preparation is required. The preparation is similar to that required for conventional colonoscopy.

    In addition, it is necessary to distend the colon for the best images. After you enter the examination room and are placed on the CT examination table, the nurse or technologist will insert a small plastic tip into the rectum. Air is slowly pumped through the tube to inflate the colon.

    Two scans are performed, one while lying on your back, the other while lying on your stomach. The actual time of each scan is 20 seconds. There is a three-minute pause between the two scans to allow the computer to process the many images acquired. You will be asked to hold your breath for up to 20 seconds. You should remain as still as possible to produce the clearest images. After the second scan, your examination is complete. Total examination time, from the moment you enter the scan room until completion, is approximately 15 minutes.

  • Ultrasound

    Ultrasound
    • Abdominal
    • Pelvic Ultrasound
    • Vascular and Doppler Ultrasound
    • Thyroid Ultrasound
    • Testicular Ultrasound
    • Pediatric Renal Ultrasound
    • Sonoelasticity
    • Musculoskeletal Ultrasound
    • Ultrasound-Guided Prostate Biopsy

    What is ultrasound imaging?

    Ultrasound is a diagnostic imaging technique that uses high-frequency sound waves which are invisible and inaudible to human in order to produce images. There is absolutely no radiation involved in ultrasound.

    Why is this exam done?

    Ultrasound provides real-time imaging of many abdominal tissues and organs using a painless and non-invasive method. It is especially sensitive in evaluating abdominal organs such as the gallbladder for gallstones, the liver, the spleen, and the kidneys. Ultrasound also provides the best imaging of the pelvic organs such as the bladder, thyroid gland, uterus, and ovaries. The carotid arteries of the neck and the veins of the legs are also commonly studied through ultrasound.

    What will happen during the exam?

    An ultrasound technician or sonographer will meet you and take you into a private ultrasound suite. A small ultrasound probe is placed over the area to be imaged and high-frequency sound waves are used to create images of body tissues. Once all the appropriate images are obtained, the images are reviewed with a board-certified radiologist to ensure no further imaging is needed. Again, this procedure is painless and radiation-free.

    What are the risks and benefits?

    There are no known risks to ultrasound imaging. There is no radiation used in ultrasound imaging.

    How should I prepare for my test?

    You will need to bring your prescription. You may be asked not to urinate for a few hours prior to the procedure for certain exams.

  • Women's Imaging

    Women's Imaging
    • Digital Mammography
    • Needle Biopsy of the Breast
    • Breast Ultrasound
    • Breast MRI

    What is a Breast Imaging?

    Breast imaging includes exams including mammagrophy, needle biopsy of the breast, preoperative needle localization, breast ultrasound and breast MRI. While each procedure offers specific diagnostic information, breast imaging overall is essential to the prevention, diagnosis, and treatment of any abnormality in the breast.

  • Digital Mammography

    Women's Imaging

    What is a mammogram?

    A mammogram is a test performed using safe, low-dose x-ray that films the internal tissue of the breast, often able to detect breast cancer as early as two years before a lump can ever be felt, at which time it is more than 90 percent curable. As the most commonly used procedure for early detection, mammograms are recommended to be performed in women every year beginning at age 40.

    What will happen during the exam?

    The technologist will call you in to a private section of the office. They will then bring you in to a mammography suite and position your breast on the detector of the mammography machine. A special device will then gently compress (or flatten) your breast to spread the tissue and produce a more uniform thickness. You may feel a sensation of pressure or tightness as the breast is being compressed. Once the technologist takes x-rays of your breast in different positions, the procedure is repeated from the other breast. The entire procedure usually takes about 30 minutes.

    What are the risks and benefits?

    Mammography is a safe procedure with minimal exposure to radiation. The benefits of frequent mammograms, especially in women over age 40, can help reduce the number of deaths caused by breast cancer through early detection.

    How should I prepare for my test?

    We ask that our patients refrain from wearing deodorant or powder the day of the exam as such products leave a residue on the machine that may interfere with the images. No dietary restrictions exist. We also suggest that women consider scheduling the exam with their menstrual cycle in mind to avoid times of breast tenderness.

    Any special instructions for after my test?

    If you are pregnant or suspect you may be pregnant, please discuss this procedure with your physician before making your appointment.

  • Breast Ultrasound

    Women's Imaging

    What is breast ultrasound?

    Breast ultrasound is a non-invasive procedure used to evaluate specific areas of concern, which can often be felt by the patient or physician as a lump or tender area of the breast. While this procedure does not replace mammography, it is often helpful to assist in the diagnosis process.

  • Needle Biopsy of the Breast

    Women's Imaging

    What is a needle biopsy of the breast?

    As the only definitive way to confirm if breast tissue is malignant or benign, needle biopsy is safe and minimally invasive. The procedure is used to retrieve a sample from an abnormal breast lesion by obtaining small amounts of breast tissue through a needle. The tissue is then studied by a pathologist to generate a diagnosis.

    There are various needle biopsy methods, including ultrasound-guided biopsy (for highly visible lesions on an ultrasound), stereotactic (for more conspicuous lesions), and MR-guided biopsy (guided in real-time by MRI for potential lesions not visible by mammogram or ultrasound).

  • Breast MRI

    Women's Imaging

    What is Breast MRI?

    Breast MRI is a sophisticated technology that uses a computer, magnetic field, and radio waves instead of traditional mammography to produce images of the breast. It is a non-invasive procedure that is used in conjunction with screening and diagnostic mammography, providing valuable information for the detection of breast disease.

  • Fluoroscopic Imaging

    Fluoroscopic Imaging
    • Esophogram
    • Upper Gastrointestinal Exam (UGI)
    • Pediatric Upper Gastrointestinal Exam (Pediatric UGI)
    • Small Bowel Series
    • Barium Enema (BE)
    • Intravenous Pyelogram (IVP)
    • Pediatric Voiding Cystourethrogram (VCUG)
    • Cystography

    What is fluoroscopy? Why is this exam done?

    Fluoroscopy is the term used for continuous, or moving, x-ray imaging. If you think of an x-ray as a digital photo, fluoroscopy is like a digital movie. The technique of fluoroscopy is used for a series of exams, mostly used to evaluate the GI system (esophagus, stomach, bowel, and colon) or the genitourinary system (kidneys, ureters, and bladder). For GI tests, fluoroscopy uses barium as a contrast agent, either after drinking it or after administering through a tube in the rectum. For fluoroscopic exams of the bladder, contrast is gently used through a Foley catheter. Types of studies that use fluoroscopy include esophogram, upper GI series, small bowel series, barium enema, IVP, VCUG, and cystography.

    What are the risks and benefits?

    Excessive exposure to radiation can be harmful, but the exposure during a fluoroscopy exam is generally minimal and the benefits of an accurate diagnosis far outweigh the risk. Moreover, we use every safety precaution to use the least possible amount of radiation, especially for children. It is important to inform your doctor of any recent illnesses or medical conditions as some conditions may increase the risk of an adverse effect.

    Women should always inform their physician and the technologist if they are pregnant or may be pregnant. Nursing mothers should wait 24 hours after receiving IV contrast before resuming breast-feeding. Allergic reaction to contrast (mild or severe) is also a rare but possible risk. Our team is well-prepared to deal with such reactions should the need arise.

  • Barium Enema(BE)

    Fluoroscopic Imaging

    What is a barium enema (BE)?

    A barium enema is a common method of diagnosing problems in the colon (large intestine). The barium enema exam uses barium sulfate (a thick, chalky liquid) and a fluoroscope, which is like an x-ray video camera, to take pictures of your colon. It is a safe procedure and our staff will do everything possible to make you comfortable during the exam.

    How should I prepare for my exam?

    Before your barium enema, you must consume a diet of only clear liquid for 24 hours preceding your appointment. This includes fruit juices (no pulp), soda, tea or coffee (without cream), broth, popsicles, Italian ices, hard candy, and JELL-O. You should try to consume an 8 oz. glass of water every hour for 10 hours the day before your appointment as well.

    You must also:

    • Take Citrate of Magnesia (10 oz.) 24 hours prior to the exam
    • Take 3 tablets (5 mg each) of Dulcolax the evening prior to the exam after dinner
    • Tap water enemas two hours before the exam (1 pint to 1 quart) until returns are clear
    • Do not eat or drink the morning of the exam
    • Do not smoke or chew gum the morning of the exam

    What can I expect during the exam?

    The x-ray technologist will position you on your side on the examining table. The technologist will then insert a lubricated enema tube into your rectum. As the barium enters your colon, you may have cramps and feel a strong urge to use the bathroom.

    As the barium fills your colon, the radiologist takes x-ray pictures. The radiologist may reposition you or push on your abdomen to make sure that all the loops of your colon fill with barium. The technologist will put air into your rectum to make the colon more visible. This may give you a cramping feeling, but this feeling is normal and will go away.

    The entire procedure usually takes about an hour.

    What can I expect after the exam?

    Once the exam is completed, you will be allowed go to the bathroom and expel the barium. The remaining barium usually passes out in small amounts over the next few days. You will be able to resume your regular or prescribed diet and medications. Eating normally and drinking plenty of fluids will help remove the barium from your system.

    It is normal for barium to give a whitish color to your bowel movements for a day or two. Watch for signs of constipation. If you have not had a bowel movement two or three days following your barium examination, it may be necessary to take a laxative.

    Rochester Radiology will send the results of your exam to your physician so that he or she can make a diagnosis and explain to you what the findings mean.

  • Intravenous Pyelogram (IVP)

    Fluoroscopic Imaging

    What is Intravenous Pyelogram (IVP)?

    IVP uses x-rays and an injection fluid (contrast media) to diagnose abnormalities or blockages that may occur in the kidneys, ureter, and/or bladder and to check for normal kidney growth and function.

    If you are pregnant or suspect you may be pregnant, discuss this with your physician before undergoing this procedure.

    A contrast solution will be used in your exam, so be sure to let your physician know if you have any allergies. If you are a diabetic, please inform our office at the time your appointment is scheduled.

    And lastly, be sure to bring with you a complete list of all medications that you are currently taking.

    How should I prepare for the exam?

    Before your IVP:

    • Take 3 tablets (5 mg. each) of Dulcolax, OR 10 OZ. OF Citrate of Magnesia, the night before the exam.
    • Do not eat or drink anything after 10:00 pm the night before the exam.

    What can I expect during the exam?

    After changing into an examining gown and completing a medical history form, the technolopgist will position you on the examining table where the nurse will inject the contrast solution into a vein in your arm. As the contrast solution filters through your kidneys and into your bladder, the technologist takes x-ray pictures from various angles.

    The entire procedure usually takes about 45 to 60 minutes.

    What can I expect after the exam?

    After the radiologist evaluates the results of your IVP exam, Rochester Radiology will send the information to your referring physician in order for him or her to make a diagnosis and review next steps with you.

  • Joint Imaging and Procedures

    Orthopedic Imaging and Procedures
    • Conventional Arthrography
    • CT Arthrography
    • MR Arthrography
    • Diagnostic and Therapeutic Joint Injections
    • Joint Aspiration
     

    What are these arthrography?

    Joint arthrography involves imaging the internal joint structures after injecting a contrast agent into the joint. After the injection, imaging can be obtained with conventional radiographs (conventional arthrography), CT (computed tomography arthrography), or MRI (magnetic resonance imaging arthrography)

    Diagnostic and therapeutic joint injections usually involve injecting an anesthetic and a steroid. The anesthetic is used to confirm that your symptoms are actually coming from the joint injected. The steroid is used to decrease any inflammation which may be associated with the joint. The injections do not reverse the arthritis but provide diagnostic and therapeutic effects.

    Joint aspirations are performed in a similar manner, but rather than injecting into the joint, fluid is removed from the joint. Your referring physician will usually specify what tests should be performed on any aspirated fluid, such as those to evaluate for possible infection, crystal arthropathy, or other reasons.

    All of these procedures are performed by an attending radiologist with special fellowship training in musculoskeletal imaging and musculoskeletal procedures.

    How should I prepare for the exam?

    Do not eat or drink for 2 hours prior to the exam. You will need to bring your prescription.

    Please inform the technologist if you are pregnant or think you might be pregnant, or if you are allergic to the IV contrast.

    Take all of your prescribed medications as scheduled unless otherwise instructed.

    What can I expect during the exam?

    After changing into an examining gown, the technologist will position you on the examining table, and briefly explain the procedure. The radiologist will also tell you about the procedure. Scout images of the involved joint may be obtained. The joint will be cleansed and marked under fluoroscopy and local anesthesia will be given prior to entering the joint with a small needle. Additional images will be obtained as necessary.

    The actual procedure usually takes about 10 minutes, but sterile set-up and preparation may take 20 to 30 minutes.

    What can I expect after the exam?

    After the radiologist evaluates the results of your exam, Rochester Radiology will send the information to your referring physician in order for him or her to make a diagnosis and review next steps with you. If you are having further imaging with CT or MRI, a separate report will be issued for that portion of the diagnostic procedure.

    You may experience a mild fullness sensation from the injected medications, minimal discomfort from the injection itself, or you may feel symptomatic relief after the procedure. If your symptoms are actually referred from elsewhere, such as the spine, muscles, or bursitis, you may notice no change in your symptoms. You should avoid heavy lifting for 24 hours until the fluid is resorbed naturally.

    Although rare, if you experience any signs of infection such as redness, swelling, or fever, please contact your referring physician, primary physician, or call our office directly.

    If you have had a therapeutic injection and experienced symptomatic relief, you should be aware that the duration of relief is variable. Your referring physician may suggest repeating the injection in the future depending on your specific situation.

  • Pediatric Imaging

    Pediatric Imaging
    Image Gently
    • Pediatric X-Ray, CT, and MRI
    • Pediatric Renal Ultrasound
    • Pediatric Upper Gastrointestinal Exam (Pediatric UGI)
    • Pediatric Retrograde Vesicoureterogram (VCUG)

    Pediatric Imaging

    Our staff takes special care in imaging our young patients. Our radiologists and staff have pledged to Image Gently, taking precautions to minimize radiation exposure and to promote radiation protection in the imaging of children. Our radiologists are happy to answer any questions or concerns about pediatric studies.

  • PET/CT

    Nuclear Medicine

    What is PET/CT Imaging?

    Before the Exam

    • Prior approval is required by most insurance companies for a PET/CT scan. This is arranged by your physician requesting the scan.
    • You will be asked not to eat anything for six hours before the exam. You may drink plenty of water in preparation for the exam, but not other beverages such as coffee, tea, diet or regular soda, juice or milk.
    • You may take regular medications with water if you do not need to take them with food. Pain medication, if needed, should be arranged for in advance of the study.
    • For Diabetic Patients: Take your usual medications except for injected regular insulin. Bring regular insulin for injection with you and food to eat following the exam.
    • If you are anxious about the exam, your physician may prescribe a sedative to help calm you. If so, you should bring someone with you to drive you home.
    • Wear comfortable clothing such as sweatpants or pull-on pants and tops. Please leave all valuables at home.
    • Before the exam, we will check your blood sugar to make sure it will not interfere with your exam results.
    • It is very important that you arrive on time in order to receive the proper dose of radioactive tracer used in your exam.
    • If you are pregnant or suspect that you may be, or if you are nursing, be sure to discuss this with your physician before undergoing this procedure. On the day of the exam, remember to dress in comfortable clothing.

    During the Exam

    A PET/CT scan is a simple procedure. First, a compound familiar to the human body (such as glucose sugar) is tagged with a signal-emitting tracer. You will be injected with this tracer and asked to rest quietly for 1/2 - 1 hour while the radioactive compound is distributed throughout your body. The glucose is attracted to cells with increased metabolism, such as cancer cells. Next, the examining table on which you are resting passes through the PET/CT scanner while a scan is made. It records the signals the tracers emit as they journey through the body and collect in the organs targeted for examination. A computer then translates the signals into images that show normal or abnormal organ function. These images are then interpreted by a specially trained radiologist who will prepare a report for your physician.

    The entire procedure typically takes from two to three hours, depending on the PET/CT study requested.

    After the Exam

    You should not experience any side effects from the tracer, but because the tracer is radioactive, you should not plan to travel within 48 hours of your exam, including air travel or crossing an international border. Otherwise you may resume your normal activities.

    Your physician will receive the radiologist's report from the exam, allowing you and your physician to consider appropriate follow-up and treatment.

    We encourage you to contact us at any time to discuss your questions and concerns.

  • Magnetic Resonance Imaging

    Magnetic Resonance Imaging
    • MRI
    • MRA (MR Angiography)
    • Breast MRI
    • Cardiac MRI
  • MRI

    Magnetic Resonance Imaging

    What is Magnetic Resonance Imaging (MRI)?

    MRI uses a large magnet, radio waves, and a computer to view soft tissue hidden from view by bone.

    Why is this exam done?

    Scans of the brain, head and neck, spine, abdomen and pelvis, and musculoskeletal system allow the radiologist to detect injuries and abnormalities, diagnose numerous conditions, and monitor the success of treatment. With MRI scans, it may be possible to identify and, therefore, treat conditions in their early stages.

    What will happen during the exam?

    The technologist will position you on the scanning table, and offer you pillows and blankets to make you feel comfortable and relaxed. The technologist may also place a surface coil around the part of the body to be scanned.

    The nurse or physician may give you an intravenous injection halfway through the exam if a contrast agent is needed to enhance the images. While you lie flat on a table, it will be moved into the opening of the MRI system.

    During the exam, you must remain still. You and the technologist, now in an adjoining room capturing the images on a computer screen, can talk to each other throughout the exam. If you experience any unpleasant feelings, just alert the technologist. Remember, the technologist can see and hear you at all times.

    If the noises associated with the MRI system make you uncomfortable, headphones playing a favorite tape or CD and earplugs are available. You will find the exam to be painless and safe.

    The entire procedure takes from 1/2 to 1 hour, depending on the test.

    What are the risks and benefits?

    Because certain conditions interfere with MRI scans, be sure to alert RDI if you have any of the following: pacemaker, surgical brain clip, vena cava filter, metallic foreign body in the eye, metallic heart valve, neurostimulator, neurosurgical aneurysm clip, ear implant, eye implant (other than cataract) or stent. In addition, alert your physician and RDI if you may be pregnant or have specific questions or concerns.

    How should I prepare for my test?

    When you go for your appointment, consider wearing a sweatshirt and sweatpants or other clothing that does not have zippers or metal fasteners, since these interfere with MRI scans. Also, please plan to arrive and check in with the receptionist 15 minutes before your appointment is scheduled.

    RDI has two MRI systems. Although both systems are designed for patient comfort, any scan can cause some anxiety, so be sure to let your physician and RDI know if you think you may be claustrophobic. The physician may want to prescribe a sedative, and the exam will likely be scheduled on the MRI system with the wider patient opening. You will have the option of listening to a tape or CD during the exam, so feel free to bring a favorite recording along, or make your selection from a variety available at RDI.

    Any special instructions for after my test?

    If no additional radiological tests are scheduled, you will be able to dress and leave the facility. You can resume your usual activity. There should be no side effects.

    Once the technologist prepares your images, the radiologist will read the images and dictate a report that will be sent to your referring physician within 2-3 days. If the actual MRI images are needed, please allow 1-2 days notice.

  • Advanced Therapies at Rochester Radiology

    Advanced Therapies

    Dr. Jonathan Broder, Dr. Atul Gupta, Dr. Raj Pyne, and Dr. Michael Rivero

    The cutting edge of medicine.

    Advanced Therapies is a division of Rochester Radiology dedicated to the field of Vascular and Interventional Radiology. This field utilizes state-of-the-art images to guide our highly trained specialists, called interventional radiologists, to perform minimally invasive procedures. Many of these procedures are performed through the tiniest of nicks in the skin - without surgical incisions - allowing for interventions which, only a few years ago, would have required open surgeries and the risks that often accompany them.

    Common procedures performed by our board-certified interventional radiologists include:

    To schedule a consultation at Advanced Therapies, call 585.339.2080

  • Interventional Radiology Procedures

    Interventional Radiology Procedures
    • Uterine Fibroid Embolization
    • Balloon Kyphyplasty
    • Chemoembolization
    • Varicose Vein Ablation (EVLT) ? link to "Varicose Vein Treatment" page
    • Cryoablation of Tumors
    • Radiofrequency Ablation (RFA) of Tumors
    • AVM and Venous Malformation Embolization
    • Angioplasty and Vascular Stenting
    • Renal Artery Stenting
    • Arterial Stenting for Mesenteric Ischemia
    • Varicocele Embolization
    • Pelvic Congestion Syndrome
    • Peripheral Arterial Aneurysm Coiling
    • DVT Clot Lysis
    • IVC Filter Placement and Retrieval
    • Transjugulars Portosystemic Shunt (TIPS)
    • Adrenal Vein Sampling
    • Tunneled Pleural Effusion and Abdominal Ascites Catheter Placement
    • Y-90 Radioembolization
    • CT-Guided Biopsy and Abscess Drainage
  • Uterine Fibroid Embolization

    Interventional Radiology Procedures

    This situation is analogous to what a fibroid does to the uterus. Fibroids, also called leiomyomas, are benign growths that occur in the muscular wall of the uterus. Similar to weeds that destroy a garden, fibroids can grow rapidly and cause symptoms including heavy menstrual bleeding, pelvic or back pain, bloating, and bladder or bowel pressure causing urinary frequency or constipation.

    Uterine Fibroid Embolization

    Image provided by the Society of Interventional
    Radiology, www.SIRweb.org ©2004

    Are fibroids common?

    Fibroids are exceedingly common in women over 35, with up to 50% of all women in this age range having them. They range in size from smaller than a pea to as large as a football, causing the uterus to grow to the size of a five to six month pregnancy.

    What causes fibroids?

    Fibroids are hormonally driven and can grow rapidly during periods of elevated hormone states, such as during pregnancy, and conversely, may start to decrease in size after menopause.

    Will my fibroids require treatment?

    Typically, only 10-20% of fibroids are large enough to cause symptoms that require treatment; however, that still amounts to approximately 5-10% of all American women, many of whom do not realize the cause of these non-specific symptoms.

    What kind of treatment is available?

    There are multiple options for fibroids. Surgical removal (called myomectomy) of one or a few accessible fibroids may be the best option for women with mild symptoms. For a uterus overrun with large fibroids that cause severe symptoms, women may choose removal of the entire uterus, called hysterectomy. In fact, uterine fibroids are the most frequent indication for hysterectomy in premenopausal women.

    Other hormone-based options, albeit less definitive, also exist and include hormone therapy to shrink the fibroids, versus waiting for menopause to naturally decrease hormone levels for the same result.

    The final option is the medical version of weedkilling, called uterine artery embolization. Small particles are introduced into the uterine blood supply, which are preferentially taken up by the vascular fibroids and ultimately kill their own blood supply.

    What is Uterine Artery Embolization (UAE)?

    Uterine artery embolization (UAE) is an alternative to surgery for uterine fibroids. The non-surgical procedure is performed by interventional radiologists to treat all fibroids present in a symptomatic uterus, regardless of number or location.

    Under local anesthesia, a tiny catheter is introduced into the common femoral artery in the groin and advanced under fluoroscopic guidance into the uterine artery. There, tiny particles - smaller than grains of sand - are released. These particles are then preferentially taken up by the parasitic, vascular fibroids which tend to steal the uterine blood supply. With success rates routinely shown up to 94%, it has become a mainstay of fibroid treatment.

    The procedure usually takes less than one hour, is performed with conscious sedation rather than general anesthesia, and is done as an outpatient procedure or as an overnight observation.

    What are the risks and benefits?

    UAE can also be used to control heavy uterine bleeding for reasons other than fibroids, such as emergently in cases of postpartum obstetrical hemorrhage. The effects of UAE on fertility have long been a question mark. Although many women preserve their fertility and have children after UAE, there are no scientific studies proving this. However, fibroids themselves are a cause of infertility in younger women, and a hysterectomy obviously eliminates any chance of preserving fertility, thus making UAE a viable option for many.

  • Balloon Kyphoplasty

    Interventional Radiology Procedures

    What is balloon kyphoplasty?

    Balloon kyphoplasty is a minimally invasive procedure for stabilizing spinal fractures. The procedure aims to stabilize the fracture, alleviate the back pain, correct angular vertebral deformity, and restore vertebral body height.

    As opposed to an open surgery, it is done through two tiny nicks in the back. It can be performed as an outpatient procedure without general anesthesia, and requires minimal recovery. In fact, the goal is for most bedbound patients (who were previously unable to walk because of pain) to attempt walking hours after the procedure in our recovery area.

    How is the balloon kyphoplasty performed?

    Balloon kyphoplasty is performed by an interventional radiologist, who is a physician with expertise in minimally invasive procedures using imaging guidance. It is performed in an Angiography Suite that looks like an operating room, but has a small tube over it, which provides real-time x-ray imaging for the procedure.

    Treatment for each vertebral compression fracture level typically takes less than one hour. Multiple fractures can be treated simultaneously, usually up to 3 levels in one procedure, except in special circumstances.

    It can be performed on an inpatient or outpatient basis and is usually performed with conscious sedation or simple local analgesia only (lidocaine injection in the skin). It rarely requires general anesthesia. Your physician will discuss which options are appropriate for you.

    What actually takes place during the procedure?

    The procedure involves placing a metal cannula (about the size and diameter of a pencil) into the vertebral body to be treated using careful image guidance. Once the cannula is placed, the inner stylet is removed and a small balloon is advanced through the hollow trocar. The balloon is carefully inflated under visualization, creating a cavity in the bone and condensing the bone around it, while trying to restore height to the vertebral body (reducing the fracture).

    Finally, a special 'bone cement' called polymethylmethacrylate (PMMA) is injected into the bone. Injecting the bone cement has three purposes:

    1. As it hardens, it fixates the fractured portions of the bone. (Fractured bone movement is what causes the pain.)

    2. It solidifies the structural rigidity of this portion of the spine that was acting as the "weak link in the chain".

    3. The heat given off as the cement hardens has been hypothesized to burn tiny little nerve endings, which in turn reduces the pain.

    How does balloon kyphoplasty differ from vertebroplasty?

    Balloon kyphoplasty is similar to vertebroplasty; however, vertebroplast does not include balloon inflation as a way to create a cavity prior to injection of the bone cement. Instead, the bone cement is directly injected into the bone after the cannula is placed. As no cavity is created, the bone cement injected needs to be thinner and under pressure, which equates to more risk for cement to leak out of the bone. In addition, no balloon inflation reduces the chance of restoration of height of the vertebral body.

    Is balloon kyphoplasty covered by insurance?

    In general, kyphoplasty is covered by insurance providers. However, each provider has different requirements, such as a trial a of conservative therapy with rest, pain medications and/or a back brace prior to undergoing this procedure. Consult with your health insurance provider for further information.

    How long will it take me to recover?

    Balloon kyphoplasty is generally performed as an outpatient procedure. Following the procedure, you are transferred to the Interventional Radiology recovery area for four hours for observation. After your sedation completely wears off, (usually within two hours) you will be asked to attempt walking if your pain has already subjectively improved. Your interventional radiologist will have a specific post-operative recovery/exercise plan to help you return to your normal daily life as quickly as possible.

    Patients usually report relief from pain and are able to walk and move about soon after the procedure. Your doctor will schedule a follow-up visit and explain limitations, if any, on your activity.

    Following a balloon kyphoplasty, you may notice a rapid improvement of some or all of your symptoms -- including pain -- while other symptoms may improve more gradually. You will work closely with your physician to determine the appropriate recovery protocol for you, and follow his or her instructions closely to optimize the healing process.

    What are the potential risks or complications of this procedure?

    Although the complication rate for balloon kyphoplasty is very low, as with most other surgical and minimally invasive procedures, serious adverse events can occur, some of which can be fatal. The following are the minor and major serious risks.

    Minor risks and complications are more common than severe and may include, but are not limited to: bleeding/small hematoma on back, minor skin infection at site of injection, leakage of a small amount of "cement" into the adjacent disc space, and lack of pain relief despite successful technique during the procedure.

    In more rare instances, major risks and complications may occur. These include: cement embolism (leakage of the cement out of the vertebral body and migration to the lungs); paralysis (due to spinal cord damage as a result of the placement of the cannula); leakage of bone cement into the spinal canal and/or surrounding nerves (may also result in paralysis); severe infection of the vertebral body, disc space or spinal canal; bleeding/hematoma in or surrounding the spinal canal, thus compromising the spinal cord.

    Does having a balloon kyphoplasty increase my risk for more vertebral fractures?

    No.

  • Chemoembolization

    Interventional Radiology Procedures

    What is chemoembolization?

    Chemoembolization is a minimally invasive procedure performed by an interventional radiologist that directly targets tumors in the liver. It works by complimentary means, first injecting chemotherapy directly into the tumor, and then stopping the blood supply to the tumor. This double-injury method causes cell destruction of the tumor while sparing normal liver tissue and reducing side effects of chemotherapy elsewhere in the body. Sometimes, a third injury technique is added for certain cases, in which the tumor is ablated using either a freezing (cryoablation) or heating (radiofrequency ablation) method.

    How is the chemoembolization performed?

    You will initially come in for a consultation in our office to fully discuss the problem and all the treatment options to ensure that this is the right treatment for you. Prior to your procedure, labs and a special type of CT called a CT angiography will be performed to evaluate and map the tumor and all the arteries leading to it.

    On the day of the procedure, you will be prepped in the pre-procedure area and brought to the interventional radiology suite. Under local anesthesia, a tiny catheter (tube) is introduced into an artery in the groin and advanced under image guidance into the livery artery that feeds the tumor. There, tiny particles - smaller than grains of sand - are released. These tiny particles have a specific chemotherapy attached to them tailored to the specific type of tumor. These particles are then preferentially taken up by the liver tumors which tend to steal the normal liver blood supply. Chemoembolization has become a mainstay of liver tumor treatment over the past 20 years. The procedure usually takes less than 1-2 hours, is performed with conscious sedation rather than general anesthesia, and usually only requires an overnight stay for observation.

    How long will it take me to recover?

    Chemoembolization is a minimally invasive procedure, with no surgical incision, therefore greatly reducing the time needed for recovery. Recovery from the catheterization usually involves 4 hours of bedrest in the recovery area keeping the legs straight. Recovery for the chemoembolization of the tumor usually involves overnight observation for post-embolization syndrome. This includes abdominal pain and cramping, nausea, fever, and malaise. Many patients state that this recovery, which usually only lasts overnight, is similar to the flu. We keep patients overnight to ensure they are comfortable and provide any medications that they may need until the post-embolization syndrome resolves.

    What are the potential risks or complications of this procedure?

    The risks of the chemoembolization include risk of bleeding, clot, and infection. Non-target embolization refers to particles being injected into an unintended area, but is rare if being performed by an experienced physician. Liver failure is also a possible complication, which is why labs will be drawn and full medical history explored during your initial consultation to ensure you are a proper candidate.

  • Varicose Vein Treatment

    Varicose Vein Treatment

    Advanced Therapies Vein Institute

    • Endovenous Laser Ablation (EVLT) for Varicose Veins
    • Ambulatory Microphlebectomy
    • Ultrasound-Guided Sclerotherapy
    • Cosmetic Sclerotherapy for Spider Veins
  • Endovenous Laser Ablation (EVLT) for Varicose Veins

    Varicose Vein Treatment

    What are varicose veins?

    Veins are the blood vessels that bring blood from the organs and limbs back to the heart. There are two sets of veins in the legs: the important veins are called deep veins which carry nearly all the blood, while the others are called superficial veins (so named because they are closer to the skin) and carry only a minimal amount blood but cause nearly all the problems associated with varicose veins. Because of gravity, veins in the legs literally have a difficult uphill battle in returning the blood to the heart . The leg veins actually work by squeezing blood upwards whenever muscles are contracted, while valves in the vein keep the blood from flowing backwards, or refluxing, back down to the feet.

    However, sometimes these valves weaken and don't close properly, thus allowing blood to reflux. This occurs for many reasons, and the valves in the superficial veins are especially prone to this failure. When that blood refluxes back down, it fills in and pools into veins near the skin which become elongated, rope-like, bulged, and thickened. These enlarged, swollen vessels are known as varicose veins and are a direct result of increased pressure from reflux. A common cause of varicose veins in the legs is reflux in the main superficial thigh vein called the great saphenous vein (GSV), which leads to pooling in the visible varicose vein below.

    How common are varicose veins?

    Chronic venous insufficiency of the legs is one of the most common conditions affecting people of all backgrounds. Approximately half of the U.S. population has venous disease: 50 to 55% of women and 40 to 45% of men. Of these, up to 25% of women and 15% of men will have visible varicose veins. Varicose veins affect 1 out of 2 people age 50 and over and up to 25% of all adults.

    What symptoms accompany varicose veins?

    Symptoms may include sharp or dull pain in the legs, leg heaviness, restlessness in the legs, skin color changes/darkening of skin (especially around the ankles), leg/ankle swelling, bulging veins, small "spider veins" (sometimes blue in color), "charley horses" (or severe cramping), hardening of the skin, easy bruising and in severe cases, chronic wounds or "ulcers" on the legs. Some may experience symptoms without any visible varicose veins.

    What are the risk factors for varicose veins?

    Risk factors include older age, female gender, prior pregnancy, family history, prior trauma or surgery to leg, and occupation or lifestyle that involves standing for long periods of time.

    What is EVLT?

    Varicose veins as a clinical entity can be traced back as early as the fifth century BC. Forefathers of medicine such as Hippocrates described the disease and attempted to thwart its progress. Throughout the centuries, major open surgical treatments have given way to latest, state-of-the-art minimally invasive approaches in the past decade.

    Up until recently, the only treatment option available for venous insufficiency was a major surgery called vein stripping, an invasive procedure with a long recovery that tended to fail after a few years. Over the past decade, a revolutionary new treatment has been developed by interventional radiologists, doctors who are experts in imaging and specialize in minimally invasive treatments.

    This new treatment, called endovenous laser ablation (EVLT), is an outpatient procedure performed using ultrasound imaging guidance. Instead of pulling the vein out as is done in vein stripping, the problematic vein is gently heat sealed shut from the inside using a sophisticated laser tip, all through an opening in the skin not much larger than needed for a typical IV. After applying local anesthetic to the vein and getting venous access, the interventional radiologist inserts a catheter, a thin tube about the size of a strand of spaghetti, into the vein and uses ultrasound to expertly guide it up the vein in the leg to an exact location. After numbing the area around the vein, laser energy is then applied to the inside of the vein, heating the vein and sealing it closed. By closing the problematic vein which is the source of the reflux, the twisted and varicosed branch veins closest to the skin also shrink and improve in appearance. Once the diseased veins are closed, the blood is rerouted to normal, healthy deep veins and the pain and symptoms start to disappear.

    EVLT takes roughly 45 minutes and is performed as an outpatient procedure using local anesthesia. It involves minimal pain, no scarring, quick recovery and immediate return to normal routines.

    What are the benefits of EVLT?

    EVLT is minimally invasive, requiring no surgical incision or visible scars, and is generally performed as an outpatient procedure. With a high success rate up to 97% and a low recurrence compared to surgery, EVLT is extremely safe and requires minimal recovery time. Patients are often encouraged to walk and resume normal activities the same day.

    What do I need to do to prepare for EVLT?

    To prepare for EVLT, patients must not shave their legs or apply moisturizer the day of treatment. However, it is important to wash the leg with antibacterial soap the morning of the procedure.

    It is also important to wear loose-fitting pants and loose shoes to allow room for thick bandages and compression garments. You must also bring your prescription Class II stockings with you. Failure to do so will require your appointment to be rescheduled for a later date.

    What can I expect during the procedure?

    A sonographer will first perform a limited ultrasound. You will be asked to stand for five minutes, after which your varicosities will be marked using a VeinLite marker.

    The EVLT tube, or catheter, will be inserted into the vein under ultrasound control, and the tip is positioned at the top of the vein. Once the laser tip is confirmed in place and the device is turned on, the laser is slowly retracted over 2-3 minutes, a process which the patient generally does not feel. Compression is then applied by a combination of bandages and compression garments.

    You may need to return later to complete treatment with ultrasound-guided sclerotherapy of the residual varicosities.

    Are there any limitations or restrictions following EVLT?

    After your procedure, you will wear compression stockings for two weeks. With the exception of heavy exercise, you will be encouraged to walk immediately and can resume all normal activity. If you experience minor soreness and bruising, you can take over-the-counter medication as needed. Periodic ultrasound examinations will confirm that the vein remains closed.

    What can I expect following EVLT?

    You may experience mild pain for several days following the procedure, which is usually improved by walking or by taking over the counter pain medication. (Note: Do not take Ibuprofen, as it may interfere with the vein closing.) You may also experience some inflammation and bruising around the treated areas.

    What are the possible complications of EVLT?

    Complications are rare, but can occur even when the procedure is technically successful. Such complications include severe bruising, prolonged redness and/or tenderness around the puncture sites or over the treated vein, infection of the puncture site (thrombophlebitis), clots extending into the important deep veins (deep vein thrombosis), and burning of the skin.

  • Ambulatory Microphlebectomy

    Varicose Vein Treatment

    In conjunction with EVLT, a minimally invasive surgical technique called ambulatory microphlebectomy is commonly used to complete treatment of varicose veins. After EVLT treats the source problem, the varicose veins (which are bulging and dilated) are then removed using a tiny nick.

    The blade used for this procedure is the same scalpel used for eye surgeries, and therefore is relatively painless after lidocaine administration. It also generally leaves no scars. The abnormal vein is then removed through this tiny incision(s) using special tools. The procedure is done under local anesthesia and typically takes only a few minutes. Recovery is rapid, and most patients do not need to interrupt regular activity after the procedure.

  • Ultrasound-Guided Sclerotherapy

    Varicose Vein Treatment

    Ultrasound-guided sclerotherapy is a technique for closing troublesome incompetent refluxing veins and varicosities. With this treatment, a chemical irritant called a sclerosant is injected into the vein to be treated, rather than heating it closed. It causes the inner lining of the targeted vein to become irritated and the vein then closes.

    This can be used in conjunction with or in place of EVLT. This is especially useful in situations where the veins are too close to the skin to be heat sealed (risk of burn), too tortuous (many turns and bends), or too numerous for a single laser treatment to be successful. This very specialized treatment is used in complex cases, often for patients who previously had a vein stripping that failed.

    Advanced Therapies at Rochester Radiology is one of the only practices in the area to provide this treatment.

  • Cosmetic Sclerotherapy for Spider Veins

    Varicose Vein Treatment

    What is cosmetic sclerotherapy?

    Cosmetic sclerotherapy is a nonsurgical treatment for unwanted spider veins. Using a very fine needle, a medication called a sclerosant is directly injected in to the spider veins, causing the lining of injected veins to become irritated. Over time, the veins close down and the body absorbs these nonfunctioning vessels. Sclerotherapy has been performed for decades and is very safe.

    At our office, we use a sclerosant called Sotradecol (Sodium Tetradecyl Sulfate or STS), an agent which is recognized and used around the world, and is FDA-approved in the U.S. Some people may have had saline injections before for sclerotherapy. Although Sotradecol is more expensive, we use it exclusively as saline sclerotherapy results are not as successful and long lasting as Sotradecol; moreover, saline injections are painful, whereas Sotradecol injections are nearly painless.

    Many people also have larger varicose veins associated with underlying reflux (or backflow) in their main superficial veins. This is usually associated with pain, aching, restlessness, heaviness, and swelling of the legs. At the initial consultation, we will screen for these underlying conditions as well.

    How effective is cosmetic sclerotherapy?

    It is important to understand the benefits and limitations of spider vein treatment. Spider veins will not disappear immediately on the day of treatment because the treatment is based on a controlled injury to the vein wall over time. The majority of patients who have sclerotherapy will see improvement and have satisfying results. Successfully treated spider veins generally respond to treatment in 3-6 weeks by starting to disappear or lighten. However, many patients may need between 2-5 sessions to treat spider veins successfully.

    The key to understanding why some spider veins tend to recur depends on whether there is underlying disease, call feeder vessels. Only when the underlying problem is solved by stopping the feeder vessels can the spider veins be properly treated. At Advanced Therapies, we use state-of-the-art technology which is able to show how and where the feeder vessels lead to the spider veins. These feeder vessels are then injected, stopping the source of the problem. Then, and only then, can the spider veins be properly sclerosed.

    How do I know if I am a candidate for cosmetic sclerotherapy?

    At your initial consultation, you will meet with one of our Interventional Radiologists, who are board-certified physicians and vascular specialists trained in minimally invasive procedures, especially in vein treatments. They will determine by history and ultrasound if you simply need injection treatment or if there is a underlying problem. Only after ensuring that no underlying problem is present will we proceed to start the cosmetic sclerotherapy for your spider veins.

    You are not eligible for sclerotherapy if you are pregnant, breastfeeding, or are bed ridden. If you recently gave birth, you must wait at least three months after delivery before you can be considered for the procedure. If you have had a blood clot in the past, your eligibility will be determined on an individual basis, and will depend on the leg and the cause of the clot.

    Will my insurance cover sclerotherapy?

    Cosmetic sclerotherapy is considered to be a cosmetic procedure and is therefore usually a self-pay. Insurance companies do not provide coverage for sclerotherapy when it is performed for cosmetic reasons. It is also usually not covered for mild pain or tenderness associated with the spider veins. Rarely, some insurance companies do cover sclerotherapy for extenuating circumstances and extensive disease, but again this is not common.

    What are the most common side effects of cosmetic sclerotherapy?

    Common side effects include itching, bruising with some pain, transient hyperpigmentation (brownish discoloration along the course of the vessel), sloughing (less than 1% of patients report small ulcerations at the injection site), blood accumulation in the treated vessel, telangieactic matting (development of new blood vessels in the treated area), and some times, patients experience an allergic reaction to the sclerosing agent that is used.

    How do I prepare for my sclerotherapy?

    Do no take aspirin, ibuprofen, or other anti-inflammatory medications for 48 hours before and after sclerotherapy. These medications may interfere with the action of the sclerosing agent or increase bleeding. Tylenol is permitted.

    Steroids such as Prednisone also decrease the effectiveness of the sclerosing agent, and if possible should be discontinued 48 hours prior to the sclerotherapy, only if deemed safe by your physician. Also, Tetracycline and Minocin (both antibiotics), may cause a staining or hyperpigmentation of the skin if taken 7 to 10 days before or after sclerotherapy. Ask your doctor about alternative antibiotics if required during that time frame. Finally, do not apply lotion to your leg the day of the procedure and bring your compression stocking with you.

    How many treatments will be needed?

    The number of treatments needed to clear or improve the condition differs from patient to patient and depends on the number of varicose and spider veins present. Some patients only need one treatment.

    While sclerotherapy is safe and highly effective, most patients need between two and five treatments to clear or improve unsightly veins. A small minority of patients do not improve even after multiple treatments.

    What can I expect after the treatment?

    A sclerotherapy session generally lasts 20-30 minutes. Following the injection, you will wear a 20-30 mm Hg (Grade 1) compression stocking over the treated area. You may resume your regular activities, including work, and are encouraged to walk immediately after the procedure. You must wear the compression stocking for 48 consecutive hours following the treatment. After that, wash the injection sites with mild soap and lukewarm water as needed.

    Following the procedure, avoid aspirin, ibuprofen, and other anti-inflammatory medications for 48 hours. Tylenol can be used if pain relief is needed. You must also avoid hot baths, saunas and extensive hot showers for seven days. You must also not apply hot compresses or any other form of heat to the injected areas.

    It is extremely important to avoid direct exposure to sunlight (including sun tanning and tanning beds) for 14 days following your procedure to prevent hyperpigmentation (brown spots) from developing on your skin.