Cross Sectional Interventional Radiology (CSIR) A Guide for Patients

Preparing for the Procedure

One Week Before Your Appointment

Review all of your medications with your primary physician. Your medications may need to be changed before you come in for your procedure. If you are taking medications that affect blood clotting (such as warfarin, coumadin, aspirin, ibuprofen), ask your physician to contact us at 617-525-8751.
If you have diabetes, ask your doctor about how much insulin to take on the morning of your procedure.
If you develop a cold (with cough or fever) or other illness before the procedure, inform us and your primary physician immediately.
Arrange for a companion to pick you up after your procedure. You will not be able to drive or take public transportation after the procedure.
Arrange for a companion to assist you for a day or two after your procedure.

Two Days Before Procedure

Discontinue use of non-steroidal anti-inflammatory medications (e.g., Motrin, Advil) with permission from your referring physician. Arrange for someone to accompany you to the hospital who may drive you home.

Night Before Procedure

Do not eat or drink after midnight on the night prior to your procedure if your procedure is at 11 AM or earlier other than a small cup of water with your morning medications. You may have light breakfast before 7 AM if your procedure is 1:00 PM or later, but be sure not to eat or drink (except for your medications) for six hours prior to your procedure.

Day of Procedure

Arrive at the Hospital one hour before your procedure time. Bring your daily medications in their labeled containers with you.
If you do not have a BWH blue registration card, come in early and obtain one at the Ambulatory Registration desk (ASB-II, 2nd floor) before going to the CSIR unit.
Report with your blue card to the L1 unit as assigned. Your companion may use the waiting room during the procedure.
At this time, you may be asked to drink a substance to outline your intestines.
The Interventional radiologist covering the CSIR service will meet you and answer your questions. You will be asked to sign a form giving your consent for the procedure.
Occasionally emergencies may take priority. If this occurs, please accept our apologies for any delay.

Precautions

Review all of your medications with your primary physician at least 1 week before your procedure. When taking medications that affect blood clotting (such as warfarin, aspirin, Coumadin, ibuprofen), ask your physician to contact us at 617-525-8751.
Your medications may need modification before the study.
If you have diabetes, consult your primary physician regarding the insulin you should take on the morning of your procedure.
If you develop a cold (with cough or fever) or other illness before the procedure, inform us and your primary physician immediately.

Use the Quick Reminder Sheet as a simple checklist to help you remember these steps.

The Procedure Itself

After you change into a hospital gown, the nurse or technologist will place an intravenous line in your arm. This line will enable us to give you fluids and medications to alleviate discomfort or anxiety during the procedure.
Your blood pressure will be taken, and a small probe will be placed on your finger to monitor your blood oxygen level. You will also be attached to a cardiac monitor during the procedure.
Preliminary images will help the Interventional radiologist to plan the procedure. Then the skin will be prepared sterilely and local anesthesia will be administered. For most studies your anesthesia will not put you to sleep because you will need to follow breathing instructions during the procedure.
Then, your interventional radiologist will use the imaging device to guide a needle into your body for purposes of performing the intervention. Typical interventions include biopsy, catheter placement, therapeutic-injection or ablation of solid tumors.

Types of Interventions

Biopsy

A tissue biopsy is performed to identify the type of tissue or fluid comprising your lesion. During imaging, small needles are guided to the lesion. Then a small amount of tissue or fluid is extracted for examination under the microscope. More than one needle pass is made to ensure the removal of sufficient material at the designated sites.

Fluid Drainage

Using imaging guidance, a small needle or catheter is placed through the skin and into the fluid collection to provide drainage to an outside container.

Ablation

After the Procedure

At the Hospital

Although the average procedure time is 30-90 minutes, some require more or less time. The length of recovery time also varies with each procedure. Most outpatients are observed in the Radiology Recovery Room for 2 to 4-6 hours. Rarely patients need to stay overnight after the procedure.
Before discharge, you will be seen again by the care team and a special home-care instruction sheet will be given to you. The sheet includes our telephone number should you need to contact us.

Going Home

If you received sedating medications, do not drive or take public transportation alone following the procedure. Make arrangements to have someone available to accompany you home from the hospital. We will be happy to contact your companion and alert them as to your time of discharge.
For the remainder of the day, you will need to rest.

The Results

Although the average procedure time is 30-90 minutes, some require more or less time. The length of recovery time also varies with each procedure. Most outpatients are observed in the Radiology Recovery Room for 2 to 4-6 hours. Rarely patients need to stay overnight after the procedure.
Before discharge, you will be seen again by the care team and a special home-care instruction sheet will be given to you. The sheet includes our telephone number should you need to contact us.