Treatments & conditions.

Leg circulation & diabetic foot

Reduced blood flow to the legs can cause pain when walking, wounds that do not heal, or pain at rest. In selected cases, angioplasty or stenting can improve blood flow through narrowed or blocked arteries, including below the knee and ankle.

Assessment considers symptoms, scans, wound care, diabetes management and other treatment options. Complex limb-threatening disease is usually managed with a multidisciplinary team.

Varicose veins

Varicose veins may cause aching, heaviness, swelling or skin change. A duplex ultrasound helps identify the veins responsible and guides a treatment plan.

Options may include endovenous laser ablation, ultrasound-guided foam sclerotherapy or microsclerotherapy. Recovery, compression and possible further treatment are discussed before a decision is made.

Varicocele & pelvic conditions

Embolisation uses imaging and a catheter to close selected abnormal blood vessels. It can be an option for some people with a varicocele or certain pelvic vascular conditions.

Whether it is suitable depends on the diagnosis, symptoms, imaging and the alternatives available. Your consultation will cover expected benefits, limitations and risks.

Port-a-Caths & central venous access

Repeated infusions, chemotherapy or long-term medicines can be difficult through ordinary arm veins. A Port-a-Cath (an implanted venous port) sits beneath the skin and connects to a central vein, allowing the clinical team to give treatment and, when appropriate, take blood.

Depending on the treatment plan, image-guided options also include PICC lines and tunnelled central venous catheters. Assessment covers the most suitable device, its position and expected duration, with placement, exchange or removal discussed as appropriate. The referring treatment team remains involved in choosing and caring for the device.

We discuss practical care and possible complications, including infection, bleeding, clotting or device blockage, before proceeding. Availability depends on the hospital and clinical circumstances.

Tumour-directed treatments

For selected tumours, image-guided ablation places a probe into a lesion to treat it with heat or cold. Techniques may include microwave or radiofrequency ablation and cryoablation. Kidney and lung tumours are important examples; other sites may be considered depending on the case.

Embolisation treats a tumour or tumour-related bleeding by targeting its blood supply through a catheter. The choice depends on tumour type, location, stage and overall treatment goals.

These interventions are considered alongside surgery, radiotherapy and systemic treatments through the relevant cancer multidisciplinary team. A referral and review of imaging are needed before suitability, risks and expected benefit can be discussed.

Relieving symptoms & blockages

Image-guided procedures can sometimes help with symptoms or complications of cancer, alongside care from the oncology and palliative care teams. The aim may be to relieve pain, restore drainage or help a patient continue other treatment.

• Pain: selected nerve blocks or neurolysis, and image-guided treatment of painful bone lesions.
• Blocked bile ducts: percutaneous biliary drainage or stenting when appropriate.
• Blocked urinary tract: nephrostomy drainage and selected ureteric stent procedures.
• Fluid collections: image-guided placement or exchange of drains where clinically indicated.

The best approach depends on the cause of symptoms, anatomy, expected benefit and other available treatments. Some patients need urgent hospital assessment rather than a routine private appointment.