A new interventional radiology suite gets patients home faster

On January 4, 2022, 83-year-old William Baker felt enormous pressure in his abdomen and ran to the bathroom, where a startling amount of blood poured from his body. His wife drove him directly to the emergency department at Oak Valley Health’s Markham Stouffville Hospital (MSH). He nearly passed out from blood loss as he waited to be triaged. 

Baker underwent numerous tests until a colonoscopy showed the bleeding had stopped. Seemingly stable, he was discharged, but a few hours later, the bleeding started again, forcing Baker to return to the hospital. Moments after being brought into MSH’s emergency department, he bled out and lost consciousness. “I didn’t know what happened until I woke up all wired up and attached to an IV and monitor,” he recalls. 

It turned out to be colonic diverticular bleeding, a type of hemorrhage where the artery that supplies blood to the ascending colon ruptures. While the bleeding often stops on its own, if the vessel does not clot by itself, as in Baker’s case, it becomes an emergency requiring immediate medical attention, often handled by interventional radiologists. 

Less invasive, more precise

Interventional radiology (IR) uses real-time imaging like ultrasound, CT, MRI or X-ray fluorography to help guide small instruments, such as wires and catheters, through the body to diagnose and treat medical issues. “We’re like plumbers looking for a leak,” explains Dr. Ramez Hanna, an interventional radiologist at MSH. “We send a tiny camera in to look for the source of the leak, and then we can go back in and patch it up.”

IR is far less invasive than typical surgery, employing mild sedation and local anaesthetic, rather than general anaesthetic. The IR team creates a small incision, which is less traumatic for the patient and results in shorter hospital stays and faster recovery times. 

With Baker, the interventional radiologist performed an embolization, which involved putting a tiny wire coil into the ruptured blood vessel to stop the bleed. Michael Wilson, a medical radiation technologist and IR technical specialist at the hospital, and his team used ultrasound as a visual guide to insert a catheter into the femoral artery. 

From there, they used fluoroscopy-–a kind of live X-ray-–and contrast injections to locate the ruptured vessel. It was an intricate process that required directing progressively smaller wires into the nearby vessels to find the damaged one. The procedure took more than two hours but was ultimately successful. 

Redesigning IR

Had Baker’s emergency occurred just three months later, he would have been sent to the hospital’s new 2,465-square-foot IR suite. The suite, which opened in April 2022, boasts the new GE Allia IGS 7, a hulking but surprisingly nimble imaging system mounted on a laser-guided robotic arm. 

The C-shaped piece of equipment is not tethered to the floor or ceiling. Instead, its long arm reaches across the room and can be adjusted to any position around the surgical table, enhancing imaging precision by extending the angles at which images can be taken. “The difference is the image quality,” notes Wilson. “The new IR suite makes it much easier for the doctors to identify the vessels, potentially shortening the time the patient is on the table.”

Preparation and recovery occur just steps from the procedure room rather than down the hall, reducing transportation time. “It’s also got a lot of really incredible features,” says Dr. Hanna, such as reducing the amount of radiation so doctors can use the machine for longer.

Although the government funds many aspects of the healthcare experience, equipment replacements, technology advancements and other upgrades are largely thanks to community donations. The construction of the new IR suite, for instance, was made possible by the generosity of MSH’s donors, especially Betty Miller and Family, and the important work of the MSH Foundation.

The number of patients treated in the IR has jumped to 2,000 annually, up from around 1,200. “This room has given us tremendous capabilities, and it’s getting used a lot,” says Dr. Hanna. In fact, one of the first patients to use the suite was in and out in a mere 40 minutes.

While the new suite would have fixed Baker up more quickly—it was still the hospital’s expert IR team that is the star of these stories. Baker knew the procedure worked—he couldn’t feel anything, but he was awake enough to know that his doctors had found the culprit vessel and performed the embolization. After a few hours of recovery and a blood transfusion, he was released the following day. “Since then,” he says, “my life has been completely back to normal.” 

For more information about Markham Stouffville Hospital Foundation, visit mshf.on.ca.