Dr. Frederick Johnson Physician

Prostate Artery Embolization, or PAE is a minimally invasive treatment that helps improve lower urinary tract symptoms caused by a benign prostate hyperplasia, also known as BPH. BPH is an enlargement of the prostate gland and is the most common benign tumor found in men. The Likelihood of developing an enlarged prostate increases with age. A small catheter is then inserted into your artery through a tiny incision in either your groin or wrist. The interventional radiologist will then guide the catheter into the vessels that supply blood to your prostate. Once the catheter is in position, an arteriogram is done to map the blood vessels feeding the prostate. Tiny round particles are injected through the catheter and into the blood vessels that feed your prostate, which reduce the blood supply.

As the prostate gets larger, it will constrict or partly block the urethra, causing lower urinary tract symptoms such as:

• Urinary frequency

• Inability to urinate

• Incomplete emptying of bladder

• Incontinence

• Straining to urinate or weak urine stream

In most cases, relief begins to occur within a few days as the prostate shrinks, relieving pressure on the urethra which improves symptoms.

Carotid artery stenosis is a term that describes a blockage in the main artery to the brain, which is the carotid artery. The carotid artery is located in the neck. These arteries deliver oxygenated blood from the heart to the brain. The blockage results from plaque buildup, just like blockages in the coronary arteries of the heart, or the peripheral arteries in the legs. Narrowing or blockages of the carotid arteries can cause a stroke and should be treated immediately. The risk factors for developing carotid artery stenosis includes smoking and high cholesterol.

Research has shown that fixing the blockage in the artery can decrease chances of having a stroke. Most physicians will begin discussing fixing the blockage once it reaches a 60% - 70% blockage. Patients that are at a high risk for surgery will need carotid stenting. These high-risk factors include patients with blockage in a site that has already been opened surgically in the past, patients with advanced heart and lung disease, and patients who have received radiation to the neck for cancer treatment.

The physician inserts a small catheter in the groin through the blockage and opens a filter above the blockage to catch any plaque that may break off during the procedure. The blockage is then opened with a small metal coil (stent). The stent helps prop the artery open and decreases the chance of it narrowing again.

Therasphere is a liver cancer treatment that is made up of microscopic glass spheres containing a radioactive element yttrium-90. Yttrium-90 emits radiation into the tissue within 0.5 inches of the glass spheres. The radioactive glass spheres are delivered to the tumor through a catheter. The glass spheres deposit in the microscopic arteries of the tumor and remain permanently there. The radiation emitted beings to treat the tumor by shrinking it.

Side effects:

• Fatigue

• Mild abdominal discomfort

• Nausea

• Vomiting

• Fever

Kyphoplasty is used to treat painful compression fractures in the spine. Most people blame aging as the cause of back pain however the true cause may be a vertebral compression fracture due to osteoporosis. Prior to the procedure, your primary care physician will do a physical exam and order x-rays or other imaging such as MRI, CT, or bone scan. These test help determine the location of the fractured vertebrae and how recent the fracture occurred. This will determine if this treatment option is best for you. Kyphoplasty is performed while you are awake but sedated. Your back is numbed by a local anesthetic. Using x-ray guidance, a balloon is inserted into the fractured vertebrae through a small incision. The balloon is then inflated to create a cavity space in the bone. Once the balloons is deflated and withdrawn, the cavity is filled with bone cement. This can restore the damaged vertebrae height and may also relieve the pain. This is an outpatient procedure. The balloon kyphoplasty procedure has been reported to provide patients with significant improvements in pain, mobility, and the ability to perform daily tasks.

Contact your doctor if you experience one or more of these symptoms below:

• Sharp, sudden back pain

• Pain increase during standing or walking

• Laying on the back makes pain less intense

• Limited spinal mobility due to pain

• Do not respond to non-surgical treatment (bed rest, ice packs, and/or pain medications.

Peripheral arterial disease (PAD) in the lower extremities is the narrowing or blockage of vessels that carry blood from the heart to the legs. It is primarily caused by the buildup of fatty plaque in the arteries, which is called atherosclerosis.

Angiography is used to diagnose blockages and other blood vessel problems. One specific type called a peripheral angiogram is used to help our physicians find narrowed or blocked areas in one or more arteries that supply blood to your legs. In some cases, angioplasty or stent placement may be necessary to treat peripheral artery disease that causes claudication or rest pain.

Symptoms:

• Claudication

• Cool extremities

• Ulcerations

Risk Factors:

• Tobacco usage

• Diabetes

• High blood pressure

• Family history of PAD

• High cholesterol

Uterine Fibroid Embolization, or UFE, is becoming a routine alternative to hysterectomy for treatment of symptomatic uterine fibroids. UFE is performed by an interventional radiologist, who uses x-ray imaging to guide a thin tube through your groin area into the uterine artery. Thousands of tiny particles are injected into the blood vessels that lead to the fibroids. The particles block blood flow, which causes the fibroids to shrink. It is clinically proven to reduce the major symptoms of fibroids. Some of the common signs and symptoms of fibroids are heavy menstrual cycles, pelvic pressure/pain, and frequent urination. If you need treatment for fibroid symptoms and want to avoid major surgery, UFE may be right for you. We believe it is very important to talk to your gynecologist about this alternative to hysterectomy. Your gynecologist can provide a referral to our office. Drs. Johnson, Yokley and Ram have extensive experience performing this procedure treating hundreds of women with symptomatic uterine fibroids.