Image-guided intervention · UK
Interventional radiology, image-guided keyhole procedures — from angioplasty and embolisation to biopsy and ablation.
Interventional radiology (IR) treats problems through pinhole access, guided by X-ray, ultrasound, CT, or MRI. It covers angioplasty and stenting, uterine and prostate artery embolisation, tumour ablation, image-guided biopsy, drainage, and vascular access. Many patients avoid open surgery altogether.
Key facts about interventional radiology
- 01
Image-guided minimally invasive procedures
IR treats through pinhole access, with the imaging kept live throughout. Many patients avoid open surgery.
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Ultrasound, X-ray, CT or MRI guidance
The guiding modality is chosen for the target: ultrasound for vascular access and drainage, X-ray fluoroscopy for angioplasty, CT for biopsy and ablation, MRI for select ablations.
- 03
Delivered by an IR consultant radiologist
Procedures are planned, performed and reported by a consultant interventional radiologist with subspecialty training.
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Common procedures
Angioplasty and stenting, uterine and prostate artery embolisation, tumour ablation, image-guided biopsy, drainage and vascular access.
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Day-case for most procedures
Most IR procedures are performed as day cases under local anaesthesia and sedation, with same-day discharge.
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Multi-disciplinary team-linked
Every case is discussed with the relevant MDT — vascular, oncology, urology or gynaecology — so IR sits inside a joined-up plan.
Where IR fits
One route in an MDT-led plan, not a stand-alone product.
For selected vascular, oncological and gynaecological problems, IR can treat the target through pinhole access and preserve function. It sits alongside surgery, systemic therapy and radiotherapy — the MDT chooses.
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Symptomatic fibroids?
Uterine artery embolisation may shrink fibroids and relieve symptoms without hysterectomy.
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Small liver or kidney tumour?
Image-guided ablation can be curative for well-selected lesions, avoiding major resection.
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Vascular disease or bleeding?
Angioplasty, stenting or targeted embolisation as an alternative to open vascular surgery.
The pathway
From IR consultation to structured follow-up — what happens, in order.
Every IR pathway runs the same seven steps, in the same order.
Phase 1 · Before the procedure
Consultation, imaging, preparation
Phase 2 · Procedure day
Sedation, image-guided intervention
Phase 3 · After
Discharge and surveillance imaging
- 01
Before
Consultant IR consultation
Consultant interventional radiologist review — indication, imaging, alternatives and consent are all covered in one visit.
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Before
Modality-specific preparation
Fasting instructions, anticoagulation review and any bloods or cross-sectional imaging needed for planning.
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Before
IV access and monitoring
Cannula sited, baseline observations, and monitoring set up before the procedure starts.
- 04
Procedure day
Sedation or general anaesthetic
Local anaesthetic with conscious sedation for most cases; general anaesthesia for selected embolisations and ablations.
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Procedure day
Image-guided intervention
The procedure is performed under real-time image guidance — angioplasty, embolisation, ablation, biopsy or drainage as planned.
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Procedure day
Recovery and same-day discharge
A short observation period on the recovery unit, then home the same day for most IR procedures.
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After
Structured follow-up imaging
Imaging follow-up at intervals set by the indication — duplex ultrasound, CT or MRI — with results routed back to your MDT.
What IR treats
The problems interventional radiology solves.
IR answers a specific question: can we reach and treat this target through a pinhole, and preserve everything around it. These are the scenarios where it fits.
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Angioplasty and stenting (arterial, venous)
Balloon dilatation and stent placement to restore flow in narrowed arteries or veins.
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Uterine artery embolisation (fibroids)
Targeted embolisation of the uterine arteries to shrink symptomatic fibroids without hysterectomy.
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Prostate artery embolisation (BPH)
Embolisation of the prostatic arteries to relieve lower-urinary-tract symptoms from benign prostatic hyperplasia.
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Tumour ablation (RFA, microwave, cryoablation)
Percutaneous, image-guided ablation of tumours in the liver, kidney, lung and bone.
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Image-guided biopsy
Precision core biopsy of deep or difficult-to-reach lesions under ultrasound or CT guidance.
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Percutaneous drainage
Image-guided drainage of abscesses, biliary obstruction or fluid collections.
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Central venous access (PICC, port)
Ultrasound and fluoroscopy-guided insertion of PICC lines and implantable ports for long-term therapy.
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Red flag: post-procedure haemorrhage or vascular injury — urgent IR / surgical review
Fresh bleeding, expanding haematoma or a pulsatile access-site lump needs same-day IR and vascular-surgery assessment.
Treatment options and next steps
IR is one of eight routes an MDT weighs up.
What each option on the MDT’s list is actually for.
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Repeat IR intervention
Re-do angioplasty, re-embolisation or repeat ablation when the first procedure hasn’t fully resolved the problem.
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Surgical referral if IR unsuccessful
Open or laparoscopic surgery when IR is not feasible, has failed, or is not the right first-line option.
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Cancer MDT after ablation
Structured discussion with the oncology MDT after tumour ablation — for surveillance, systemic therapy or salvage.
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Structured surveillance imaging
Duplex ultrasound, CT or MRI at defined intervals to detect recurrence, restenosis or complications early.
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Vascular surgery follow-up
Shared vascular-surgery follow-up after angioplasty, stenting or endovascular repair.
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Endovascular aneurysm repair
EVAR or TEVAR — minimally invasive stent-graft repair of abdominal or thoracic aortic aneurysms.
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Chemoembolisation (TACE) for liver cancer
Transarterial chemoembolisation delivering chemotherapy directly to hepatocellular carcinoma or liver metastases.
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Radioembolisation (SIRT) for hepatic metastases
Selective internal radiation therapy with Y-90 microspheres for unresectable liver tumours.
Our vetted UK network
A small panel of centres, we picked them.
IR centres are chosen for MDT integration, procedure volume and follow-up rigour — not for who is easiest to book.
Selection criteria
How we choose every centre in our network.
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Consultant interventional radiologists with subspecialty accreditation
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MDT-reviewed indication before every procedure
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Modern angiography, CT and ultrasound guidance suites
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Structured imaging follow-up with clear escalation pathways
Red flags and what to watch for
When to escalate after an IR procedure.
IR is safe in well-selected patients. The practical points are the complications the consent conversation needs to name and the situations that warrant urgent review.
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Post-procedure haemorrhage
Fresh bleeding after any IR procedure needs urgent assessment — pressure, imaging and, if needed, re-intervention.
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Access-site pseudoaneurysm
A pulsatile, tender lump at the puncture site — typically diagnosed on duplex ultrasound and treated by thrombin injection or repeat compression.
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Contrast anaphylaxis
Rare but recognised — screened at consent, and managed immediately in the IR suite if it occurs.
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Contrast-induced kidney injury
Renal function is checked and hydration optimised before contrast studies, particularly in diabetes and CKD.
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Post-embolisation infarction
Post-embolisation syndrome — pain, fever and inflammatory markers — is expected; true infarction of adjacent tissue is uncommon and imaged if suspected.
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Post-ablation abscess
A collection at the ablation site presenting with fever and pain — diagnosed on cross-sectional imaging and drained percutaneously.
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Stent thrombosis
Sudden return of symptoms after stenting warrants urgent duplex or angiography, with antiplatelet review and possible re-intervention.
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Migrated coil / device
Rare device migration is picked up on follow-up imaging and managed by IR retrieval or surgical referral.
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Recurrent haemoptysis post-embolisation
Recurrent bleeding after bronchial artery embolisation needs repeat imaging and consideration of re-embolisation.
Your IR report
An IR report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and consent
Your details, the MDT-agreed indication, the procedure planned, and the consented risks.
- 02 Technique
Access, guidance and devices
Access site, guidance modality, catheters, wires, balloons, stents, embolic agents or ablation probes used.
- 03 Findings
Anatomy, intervention and completion imaging
Vessel-by-vessel or lesion-by-lesion description, what was treated, and the completion imaging that confirms result.
- 04 Impression
The plan — read this first
Technical result, any complications, medication changes, and the surveillance imaging schedule.
Recognised by major UK insurers
Cover depends on your policy and centre; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about interventional radiology.
Quick answers on what IR is, which imaging guides the procedure, anaesthesia, risks, embolisation and ablation.
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What is interventional radiology?
Interventional radiology (IR) is a medical subspecialty that treats disease through pinhole access using continuous image guidance — X-ray, ultrasound, CT or MRI. It covers angioplasty and stenting, embolisation, tumour ablation, image-guided biopsy, drainage and vascular access.
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Which imaging is used to guide IR procedures?
The modality is chosen for the target: ultrasound for vascular access and drainage, X-ray fluoroscopy for angioplasty and embolisation, CT for biopsy and ablation, and MRI for selected ablations. Many procedures combine two — for example ultrasound-guided puncture followed by fluoroscopic navigation.
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Is IR done under general anaesthetic?
Most IR procedures are done under local anaesthetic with conscious sedation and can be performed as day cases. General anaesthesia is reserved for selected embolisations, complex ablations or paediatric cases.
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What are the common risks?
The main risks are bleeding or bruising at the access site, contrast reactions, contrast-induced kidney injury, pseudoaneurysm, and — depending on the procedure — post-embolisation syndrome, stent thrombosis or post-ablation abscess. All are discussed frankly at consent.
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What is uterine or prostate artery embolisation?
Uterine artery embolisation (UAE) shrinks symptomatic fibroids by blocking their arterial supply, avoiding hysterectomy. Prostate artery embolisation (PAE) relieves lower-urinary-tract symptoms from benign prostatic hyperplasia by embolising the prostatic arteries — an alternative to TURP for selected men.
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How does tumour ablation compare with surgery?
Image-guided ablation — radiofrequency, microwave or cryoablation — can be curative for small, well-selected liver, kidney and lung tumours, and is often chosen when surgery carries higher risk. The MDT decides between ablation, resection and systemic therapy based on tumour size, location and patient fitness.
Sources
Guidelines this page draws on.
- British Society of Interventional Radiology (BSIR).
- European Society of Radiology (ESR).
- Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
- The Royal College of Radiologists.
Last reviewed 2026-07-30. Next review 2027-07-30. Reviewed by Pulse Atlas Editorial Board, . Approximate reading time 6 minutes.
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In practice, in London
The honest picture around interventional radiology in London
With interventional radiology, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Waiting lists on the NHS for interventional radiology vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
Once you’re in the private system for interventional radiology, the pace picks up noticeably. Consultant slots run to time, imaging is usually available in the same building or a short walk away, and the report comes back typed and detailed. It’s the coordination that tends to feel different — one person on the other end of the phone, not a switchboard. For interventional radiology specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
There are a lot of consultants in London who can technically handle interventional radiology. Fewer who do it week in, week out for the exact question you’re bringing. We spend most of our time working out which is which — and being straight when a different test or a different specialist would serve you better. Everything runs to CQC, GMC and Royal College standards; the choice is about fit, not floor.