Interventional Radiology UK NHS – What Happens?

Imaging of the right kidney using Digital Subtraction Angiography (researchgate.net) or DSA, a technique used for imaging in interventional radiology

I wrote a blog post in April about the LLETZ procedure and my experiences with HPV, colposcopy, smear tests, and eventual excision of the transformation zone – this post was popular and one or two people wrote to me and said they were having the LLETZ and the post helped them understand what would happen.

So, I wondered how many people out there have been booked in for interventional radiology and have no idea what to expect? I figured I could help them out here – I’ve had two procedures under interventional radiology ordered by my hospital treating my endocrine/renal/blood pressure issues, St Bart’s Hospital in London, although the procedures themselves were carried out at the Royal London Hospital, which is part of the St Bart’s network.

Please note that although I am briefly giving accounts of my experiences, I am not giving medical advice or offering any form of education – I’m a patient, a lay person, and anything you need to know must be discussed with your doctor. What I can give you is an honest overview of what you can expect if you’re having this procedure yourself. With that said, I hope you find this useful and I hope it brings you calm to read about somebody else’s experience.

What is interventional radiology?

Interventional radiology is a medical subspecialty that performs various minimally-invasive procedures using medical imaging guidance, such as x-ray fluoroscopy, computed tomography, magnetic resonance imaging, or ultrasound.

https://en.wikipedia.org/wiki/Interventional_radiology

What procedures did I have, and why?

I was recommended for a right-kidney embolisation using interventional radiology because my doctors suspected that a small blood supply to my very damaged kidney (see my 8lb tumour story here) was causing my extremely high blood pressure, which I’ve suffered with since the age of 26. I’m now 30 and still taking three medications a day to control my blood pressure. I’m at risk of stroke and eyesight problems (which I’ve already had a brush with when my high blood pressure was first discovered) and pregnancy for me is considered high-risk, with extra monitoring required and a change of medications. I had a successful embolisation procedure, which sadly did not reduce my blood pressure problems as hoped, and I had a second procedure to investigate other areas which could need embolising, resulting in no need for further treatment as there were no vessels feeding into the kidney.

What happened?

This procedure was treated as a day-stay procedure, but largely went ahead in much the same manner as any other operation on both occasions. I was asked to present myself at Royal London at 7am and await my turn, where I was gowned up and the procedure explained to me. I met with the anaesthetist and consultant who would be carrying out the operation, and I was fitted with a canula in the preparation room. I was then led to the operating theatre where I could hop-up on the bed myself and get comfy. The anaesthetist then fed a line into my cannula and spoke to me while the team busied themselves around the room, all gowned up in scrubs and masks of course. As my second procedure happened during the covid-19 lockdown, I had to wear my mask before and after the procedure.

The anaesthetist then began feeding the (beautiful, beautiful) drugs into my system, watching me and speaking to me to test how sleepy I was getting. The drugs flood through you in a magnificent wave of pure happiness, I assure you – it’s a beautiful fuzzy feeling, so don’t be afraid of it and just enjoy the ride. Everything is very carefully calculated, monitored and controlled by the anaesthetist. My particular procedure required access through a vein in my groin, where a thin wire was fed up through my aorta, through my heart (I believe!) and back down towards the right kidney, going with the blood flow. To the best of my memory that’s how it was done both times, but if you’re a medic, please correct me if I’ve gotten anything wrong there. These can be a little painful and you need to be incredibly still, so naturally it’s best to go under anaesthetic. The anaesthetist put an oxygen mask over my mouth and nose, as levels tend to drop when going under any kind of sedation or anaesthesia. There is no intubation required for this type of sedation and it is all fed in via cannula, allowing the anaesthetist to control your sleep and wake you up if need be. Not long after enjoying the psychedelic wooziness of the drugs in my system, my eyelids started to feel heavy. Eventually I dropped off to sleep as if I was taking a nap on the sofa.

During my first procedure, I was brought awake once or twice in order to breathe in and hold it – this was to allow them to take an accurate X-ray. Once they’d achieved the image, I drifted back to sleep. I do remember bits and pieces of this surgery – I remember feeling as if I’d been abducted by aliens. I woke up several times and saw the doctors gathered together around monitors at one point, and feeding the line into my groin in the next moment, and so on – it happened in snapshots. I often looked at the anaesthetist and he spoke to me and asked if I’m okay, if I was enjoying my intermittent napping. During the second procedure however, I was totally out for the count for the entire procedure. I woke up and asked how long it had been, and was shocked to find I’d been asleep for 1hr 30 minutes!

After both procedures, there was a lot of pressure applied to the site on my groin, as the artery will naturally spout out a lot of blood and needs pressure to help it clot and heal. After both procedures, I was left with a lot of bruising in this area – this is fine and should be expected, especially if you bruise like a peach as I do. As they wheeled me off to the recovery room after my second procedure, unfortunately my leg decided it wasn’t done bleeding and it was pooling out of me – however, I told the nurse and we stopped in the middle of the corridor to apply more pressure and more dressings.

I stayed for a short time in a recovery room (one or two hours) where I was given an electric blanket (on both occasions!), which was a god-send, because after both surgeries, I felt absolutely freezing cold, shivering even. Then, it was 4 hours of bed-rest and dozing off in a general ward/ recovery area. I think I was allowed water and eventually food, but I had to stay laying down because the wound was delicate and needs opportunity to heal properly. Unfortunately on both occasions I needed to pee like you wouldn’t believe, to the point where I just couldn’t hold it. The nurse brought me a bed-pan both times and I had to pee with the curtain pulled around me. I’d never peed so much in my life! Top-tip – if you’re worried about anyone hearing you, ask the nurse to put toilet paper in the bottom of the pan so your pee doesn’t echo against the metal bowl. You will thank me!

After my first procedure I had a morphine drip, which was a delight, and I clicked away until I was enjoying a heady trip. Morphine is a happiness drug for me and I can say for sure that I understand why people get addicted to opiates, though I of course do not condone drug use (or theft or misuse of morphine for that matter!) However, after my second procedure I didn’t need pain relief and so I just basked in post-anaesthesia doziness. Eventually I was allowed to go home, so I washed briefly in the washroom/loo and dressed very groggily in my going-home clothes. During the first procedure I was staying with family, but after the second I elected to recover for a few days at my then-boyfriend’s house (now my fiancΓ©!) and keep away from family in case I’d contracted covid.

Aftercare

Given mine was a day procedure, my aftercare was pyjamas, love, movies, pizza, and a day or two off work spent napping. However, yours may be different and it really depends what you’re having done. My advice is you listen to what the team tells you and don’t deviate from their advice, or do so at your own risk. Remember to relax, rest and recuperate -your body has been through a lot. Anaesthetic can make you feel dozy and groggy for a good few days and I for one napped for England. Eventually I was able to take off the dressing (again, the nurse will advise you about aftercare of your wound – don’t deviate from this or you risk infection) and I had a fair amount of bruising, but I felt no other after-effects.

All in all, I was very happy with my treatment both times and I was once again amazed by the level of care available to us on the NHS. No matter how worried or scared you get, just remember the first-class health service you are receiving and how envied we are the world over. I for one feel nothing but gratitude for the healthcare I’ve received.

I hope if you’re having interventional radiology that you find this blog helpful. Just remember that, as with most things, it’s all in the mind. Stay calm, trust your professionals, and ask questions – lots of questions – if you need to. Consider all your options and work with them. Remember, they want to help you and they wouldn’t offer these procedures unless they absolutely felt it was in your best interests.

Thank you for reading, and I hope your procedures go as smoothly as mine did!

Best wishes,
Ashleigh