Advances in Radiology and Imaging Lead to Medical Breakthroughs in the Field

By Julie Laviolette - South Florida Hospital News

New advances in radiology and imaging have led to a medical breakthrough in the way doctors are now able to locate and treat veins and arteries

The Vein Viewer™, which became available in June, is a new technology that uses infrared light to image red blood cells, allowing a video camera to capture the images through a computer and project them onto a patient’s skin. This device allows healthcare providers to quickly and accurately map a patient’s veins, regardless of age, gender, body type or skin tone. It is particularly beneficial for patients with hard-to-find veins, including blood donors, children and cancer patients whose veins have been weakened by chemotherapy.

"It’s a breakthrough technology that allows you to see veins that you wouldn’t see with the naked eye," said Dr. William Julien, an endovascular surgeon and President of South Florida Vascular Associates in Margate. Dr. Julien was one of six doctors in the country and the first in South Florida to acquire the technology.

In his practice, the Vein Viewer™ has been successfully used to guide the physicians while they perform sclerotherapy, a procedure where spider veins are eliminated by injecting them with caustic chemicals.

"Without this sophisticated viewing technology, physicians can only see the veins on the surface," Dr. Julien said. "If you want to destroy the veins that are at the root of the spider veins, it’s a bit of a problem because you can’t see them with the naked eye, but you can see them with the Vein Viewer™."

It’s like being Superman and having X-ray vision, he said.

Dr. Julien said hospitals could benefit from this technology for inserting I.V.s, drawing blood, administering chemotherapy or even identifying good-quality veins in dialysis patients. Because the Vein Viewer™ illuminates the position of the target area, doctors know exactly where to access a vein, alleviating multiple needle sticks that can cause stress, bruising and discomfort for the patient.

"Its uses are quite dramatic for the patient", says Dr. Julien. The Vein Viewer™ is even being used to help wounded soldiers in the battle field by shortening the time it takes to insert an IV. There’s even talk of Homeland Security one day using it as an identification system, since no two persons’ veins are alike.
"Because this technology is so new, we are still determining the full extent of all of its uses in the medical community," Dr. Julien said.

A nother recent technological advance in imaging and radiology relates to carotid artery stenting, a procedure which is utilized to prevent strokes.

In addition to preventing strokes, "There’s new information that the carotid artery stenting procedure may actually improve executive brain functions such as memory and mental acuity," Dr. Julien said.

During the procedure, an angioplasty balloon and then a stent are used to widen the carotid artery narrowed by plaque. Prior to the angioplasty, a tiny filter is placed in the carotid artery to capture any particles that are unintentionally dislodged during the procedure. The final step is to remove the filter along with any trapped debris.

"Filtering takes place because there was a concern that the particles were causing a subtle deterioration in mental function," Dr. Julien said. "Instead, they found, in a statistically significant number of people, that there were increased mental functions. Colors were brighter. Memory was sharper."

Dr. Julien said the Food and Drug Administration has approved carotid artery stenting for use only in high-risk patients.

"These new findings indicate that if you have a patient with reduced mental function, they may have a narrowing of the carotid artery that no one may be aware of and can be screened for it," he said. "If there is depression or dementia in the elderly, there are many possible causes, but it may be caused by stenosis, a narrowing of the carotid artery, and carotid stenting may help that."

Dr. Julien said advances in image guided technology are reducing instances when patients have to go "under the knife."

"Endovascular surgery is guided by imaging, and advancements in imaging techniques are nearing us to the day where people won’t necessarily have to be subjected to major surgery," he said. "If you don’t have to cut people open, it means faster surgery, less pain for the patient and faster recovery time."

Dr. William Julien is a board certified interventional radiologist with a full-time endovascular practice. He is president of South Florida Vascular Associates in Margate and is on staff at Northwest Medical Center. Dr. Julien can be reached at (954) 975-6161 or www.southfloridavascular.com. www.southfloridavascular.com.