[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Radiology](https://durgical.com/en/radiology/) › [Nuclear medicine and interventional radiology](https://durgical.com/en/radiology/areas/nuclear/) › Interventional radiology: what it can do

# Interventional radiology: what it can do

- Modality

Interventional radiologists use ultrasound, CT or X-ray guidance to treat and sample inside the body through a needle or a thin tube instead of open surgery.

Updated Nov 13, 2026

## Key points

- Interventional radiology: image-guided, minimally invasive diagnosis and treatment through a needle or catheter.
- Seldinger technique: needle, guidewire, dilator, then catheter or drain over the wire.
- Abscess drainage plus antibiotics is first-line for accessible collections.
- Lung biopsy: pneumothorax is the commonest complication.
- Fibroid embolisation keeps the uterus; post-embolisation syndrome is expected.

## What it is

Interventional radiology performs minimally invasive procedures under image guidance. Through a needle puncture of the skin, or through an artery or vein, the radiologist can drain collections, take biopsies, open or block vessels and place tubes and lines, usually under local anaesthesia and sedation and with a shorter recovery than surgery. Ultrasound is used for superficial targets and real-time needle guidance without radiation; CT for deep targets such as the lung or a retroperitoneal collection; fluoroscopy and angiography for vessels, bile ducts and the urinary tract. Three classic examples are percutaneous abscess drainage, CT-guided lung biopsy and uterine fibroid embolisation.

## Key facts

- Percutaneous drainage is first-line for most well-defined, accessible intra-abdominal abscesses, together with antibiotics and source control.
- Pneumothorax is the commonest complication of CT-guided lung biopsy; most are small and need only observation, a minority need a chest tube.
- After uterine fibroid embolisation, pain, fever and nausea in the first days (post-embolisation syndrome) are expected, not necessarily infection.
- A safe window (a path that avoids bowel, vessels and pleura where possible) is planned on the images before every puncture.

## How the image is made

- Guidance: ultrasound (real time, no radiation, bedside), CT (deep or difficult windows, lung) or fluoroscopy with contrast (vessels, ducts, drains).
- Access: a needle into the target, then a guidewire, then dilators and a catheter or drain passed over the wire (Seldinger technique); or a direct trocar puncture for large superficial collections.
- Vascular access: usually the common femoral or radial artery for arterial work; veins for central lines, filters and portal procedures.
- Embolisation: particles, coils, plugs or liquid agents are delivered through a catheter to block a bleeding or diseased vessel.
- Revascularisation: balloon angioplasty and stents open narrowed or blocked arteries and veins.

## What it is good for

- Drainage: intra-abdominal, pelvic, liver and other abscesses; obstructed kidneys (nephrostomy) and bile ducts (percutaneous biliary drainage); pleural collections.
- Biopsy: lung, liver, kidney, bone, lymph node and other masses with ultrasound or CT guidance, usually with a core needle for histology.
- Bleeding: angiography and embolisation in trauma (spleen, liver, pelvis), gastrointestinal bleeding, haemoptysis and postpartum haemorrhage.
- Uterine fibroid embolisation: both uterine arteries are embolised so fibroids shrink, keeping the uterus.
- Oncology: tumour ablation and chemoembolisation of liver tumours; vascular access: central lines, PICCs and ports.

## Limitations and risks

- Bleeding risk: coagulation tests and platelets are checked, and anticoagulant and antiplatelet drugs are managed according to the procedure's bleeding risk.
- Drainage may fail in multiloculated collections, phlegmon without liquid, or thick debris; then repositioning, more drains or surgery are considered.
- Lung biopsy risk rises with emphysema, deep or small lesions, and long needle paths; haemoptysis and, rarely, air embolism can occur.
- Fibroid embolisation is not chosen when malignancy is suspected or in pregnancy; desire for future pregnancy needs a discussion of options; possible effects on ovarian function are explained.
- Contrast and radiation: angiographic procedures use iodinated contrast and fluoroscopy, so kidney function, allergies and pregnancy are checked.

## Next step

- Refer with the question, the images and recent results (blood count, coagulation, kidney function); state the anticoagulants and antiplatelet drugs.
- Discuss with interventional radiology early in a bleeding patient who may be a candidate for embolisation, while resuscitation continues.
- After a drain: record the output daily, flush as instructed, and ask for repeat imaging if output stays high, fever persists or output stops suddenly.
- After lung biopsy: a chest X-ray as per local protocol; breathlessness or chest pain needs an urgent repeat X-ray and a senior review.

## Test yourself

Think of the answer, then tap the question to see it.

## What are the steps of the Seldinger technique?

Puncture the target with a needle, pass a guidewire through it, remove the needle, dilate the tract and pass the catheter or drain over the wire.

## What is the commonest complication of a CT-guided lung biopsy?

Pneumothorax; most are small and resolve with observation, and a minority need a chest tube.

## A woman has pelvic pain, low fever and nausea the day after uterine fibroid embolisation. What is the likely explanation?

Post-embolisation syndrome, an expected inflammatory reaction to the ischaemic fibroids; infection is considered if symptoms worsen or persist.

## Which checks are needed before most interventional procedures?

A clear indication, blood count and coagulation, a plan for anticoagulant and antiplatelet drugs, kidney function and allergies if contrast is used, pregnancy status and informed consent.

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## Connections

## Related 6

- [Ultrasound: echogenicity, probes, Doppler and artefacts](https://durgical.com/en/radiology/ultrasound-echogenicity-probes-doppler-and-artefacts/)
- [CT: windows, Hounsfield units and contrast phases](https://durgical.com/en/radiology/ct-windows-hounsfield-units-and-contrast-phases/)
- [Iodinated contrast: reactions and the kidney](https://durgical.com/en/radiology/iodinated-contrast-reactions-and-the-kidney/)
- [Pneumothorax on the chest X-ray](https://durgical.com/en/radiology/pneumothorax-on-the-chest-x-ray/)
- [Pelvic ultrasound in gynaecology: cysts, fibroids, torsion](https://durgical.com/en/radiology/pelvic-ultrasound-in-gynaecology-cysts-fibroids-torsion/)
- [Nuclear medicine and PET: how they work](https://durgical.com/en/radiology/nuclear-medicine-and-pet-how-they-work/)

## Related conditions 5

- [Intra-abdominal abscess](https://durgical.com/en/conditions/intra-abdominal-abscess/)
- [Pyogenic liver abscess](https://durgical.com/en/conditions/pyogenic-liver-abscess/)
- [Uterine fibroids (leiomyomas)](https://durgical.com/en/conditions/uterine-fibroids/)
- [Lung cancer](https://durgical.com/en/conditions/lung-cancer/)
- [Solitary pulmonary nodule](https://durgical.com/en/conditions/solitary-pulmonary-nodule/)

[← All of radiology](https://durgical.com/en/radiology/)

Educational content; it does not replace a radiologist's report and is not a clinical instruction. Each study is ordered on the patient's assessment and your institution's protocols.

Sources: [Percutaneous Abscess Drainage](https://www.ncbi.nlm.nih.gov/books/NBK564356/) (StatPearls (NCBI Bookshelf), 2025); [Percutaneous Lung Lesion Biopsy](https://www.ncbi.nlm.nih.gov/books/NBK513290/) (StatPearls (NCBI Bookshelf), 2025); [Uterine Fibroid Embolization](https://www.ncbi.nlm.nih.gov/books/NBK519016/) (StatPearls (NCBI Bookshelf), 2025).

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Representative model, for educational purposes only.

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