New Suite Enhances Pediatric Interventional Radiology

This summer, Children’s Hospital Los Angeles celebrated the opening of its new Interventional Radiology Suite. Upgraded with the latest technology, the state-of-the-art suite is improving patient care—and features equipment not found at any other pediatric hospital.

Interventional radiology uses image-guided procedures to diagnose and treat a variety of conditions in a minimally invasive fashion, often helping children to avoid open surgery. Fluoroscopy and CT scanning are commonly used, but CHLA is the first children’s hospital in the country to have a machine that combines these two capabilities.

“Fluoroscopy gives you a real-time view, while CT gives you a 3D view, but not in real time,” says Joseph Miller, MD, MS, Director of Interventional Radiology and Co-Director of the Vascular Anomalies Center at Children’s Hospital Los Angeles. “The ability to combine these two technologies in one machine will enable us to pick up on subtle but clinically consequential findings that otherwise would be very challenging to see.”

In addition, the two-room suite includes a biplane angiography machine, which allows interventional radiologists to take X-ray video during procedures.

“The new technology in our suite is allowing us to do more delicate procedures safer and faster—with less anesthesia time—while minimizing radiation doses for both patients and staff,” Dr. Miller says.

Intervening in the brain

The suite is also supporting specialized interventional radiology procedures for children with neurological conditions. These include placing stents into arteries in the event of a stroke or brain aneurysm, removing blood clots, and closing off arteriovenous malformations (AVMs) in the brain and spinal cord.

“The arteries in the brain are extremely small and very delicate, especially in a small child,” Dr. Miller says. “The suite’s advanced imaging capabilities allow our team to safely intervene to treat complex conditions and AVMs in these patients.”

Those cerebrovascular interventions are delivered through a close partnership between CHLA and the USC Neurorevascularization Center. The collaboration involves pediatric and adult neurosurgeons, neurologists and interventional radiologists, among other specialists.

“These complex cerebrovascular disorders are very rare in children,” says Jason Chu, MD, MSc, a pediatric neurosurgeon at Children’s Hospital Los Angeles. “Our collaborative approach allows us to fully assess these conditions and provide the most advanced treatment for children. This new suite is an essential part of that care.”

Fostering innovation

The Interventional Radiology Program at CHLA is among the few in the Western U.S. with a dedicated Board-certified interventional radiologist who specializes in treating children.

The program works closely with specialists across the hospital and provides a range of procedures, including angiograms, biopsies, cerebral arteriograms to evaluate blood vessels in and near the brain, cryoablation, sclerotherapy and vascular access (implanting a central line to support the delivery of medications and dialysis).

Dr. Miller adds that the new suite is also creating opportunities for research and innovation.

“We are actively working with the manufacturer to apply combined fluoroscopy-CT technology in novel ways that we hope will enhance clinical information with minimal radiation exposure,” he says. “Because of this new suite, we can now start pushing the boundaries of diagnosis and therapy for these conditions. It really opens the door to advancing care for patients.”