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Nonvascular Catheter or Needle Placement

Providing essential treatment access

Interventional radiologists may place tubes or catheters in places other than blood vessels to allow infusion care in various areas or systems of the body.  These nonvascular placements, which often take advantage of ultrasound or other forms of imaging guidance, include:

Radiologists are an essential part of the care team any time that imaging guidance is needed to place access into the body. 

feeding tubes.  The specialists implant these tubes by making an incision through the skin and into the stomach or intestine.  These tubes are gastrostomy (stomach access) tubes, gastrojejunostomy tubes (stomach and intestines access), or jejunostomy tubes (intestine access).  The tubes are placed under x-ray guidance and secured in place with an external port. Nutrition may be infused directly into the digestive system via these tubes, in a process called enteral feeding.

chemotherapy tubes.  Patients can sometimes benefit from having chemotherapy infused directly into the spaces within their body.  Most commonly in such cases, specialists will infuse chemotherapy drugs into the pelvis to treat cancer (most often ovarian cancer) that has metastasized into the spaces between the organs.  Interventionalists can use image guidance to carefully places tubes, in a tunneled position under the skin, for this intraperitioneal chemotherapy, which is delivered by an cancer specialist.

chemotherapy injection.  Interventionalists may also inject chemotherapy into areas of the body through needles via a skin puncture.  Most often this is for purposes of placing chemotherapy drugs into the cerebrospinal fluid, which immediately surrounds the spine and brain (in the intrathecal space) bathing and protecting the central nervous system.  Injecting intrathecal chemotherapy into the spinal canal, for a patients whose cancer had invaded the central nervous system, means that the needle must puncture the lumbar area, the space in between the bones of the lower back.   The cancer team may repeat these lumbar punctures to deliver intrathecal chemotherapy for a number of cycles, over a number of weeks or months.This kind of chemotherapy may also be delivered into the ventricle of the brain or using a special reservoir.