Ultra-Modern Medical Imaging Technology Provides More Choices At Bozeman Deaconess
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Medical Technology at Bozeman Deaconess Hospital in Montana
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This spring, a joint radiology-surgery team performed the first-ever peripheral atherectomy at Bozeman Deaconess Hospital. Frank Rembert, MD, used a “Silverhawk” catheter instrument with a rotating blade, to carve out and remove plaque from a patient with inoperable critical limb ischemia, a disease that causes sharply diminished blood flow to the legs. This is just one of the many catheter-based guided imaging interventions now available at Bozeman Deaconess.
Interventional Radiology
Radiologists diagnose disease by “seeing” it through the use of x-rays, magnetic resonance (MRI), ultrasound and computerized tomography (CT scan). Back in the ‘70s, new medical imaging equipment and miniature medical devices made it possible to treat many medical disorders without surgery. Subsequently, in addition to diagnosing disease during imaging, radiologists began treating patients with interventional procedures.
Interventional radiology can be used to identify abnormalities in the arteries, such as narrowing, blockages, injury and associated tumors. The most common tools in interventional radiology are catheters, small balloons and when needed, stents and filters. For example, the technology can be used for a number of procedures including angioplasty where a balloon is inserted into an artery to open it; stent placement, a procedure where a tiny metallic tubular mesh is placed into an artery to keep it open; and thrombolytic therapy which is essentially blood clot treatment. These are just a few examples of its reach.
Frank Rembert, MD, one of two certified interventional radiologists at Intercity Radiology, says many procedures are cooperative efforts by radiologists and surgeons. “For example, a surgeon might perform a leg bypass procedure and the radiologist places a stent to allow adequate blood flow to the bypass graft and leg,” said Rembert. “Interventional radiology is a primary member of any vascular surgery team. The team includes surgeons, anesthesiologists, operating room staff and intensive care unit and radiology nurses,” says surgeon Garth Olds, MD, FACS. “Peripheral vascular procedures are becoming more common at Bozeman Deaconess and a team approach to these patients is essential.”
Orthopedic surgeons may request a filter placed prior to surgery when a patient has a history of deep vein clotting or pulmonary obstruction. The filter traps clots, preventing obstruction. The radiologist may retrieve the filter following surgery; in other cases they’re left in place. Additionally, radiologists can assist surgeons and gastroenterologists to control bleeding using these catheter-based techniques.
All of the radiologists at Bozeman Deaconess perform many interventional procedures, although Rembert and Daniel Alderman, MD, of Intercity Radiology, who are certified in Interventional Radiology, perform the more specialized treatments. “We have the equipment and staff available to allow us to successfully perform essentially any type of interventional radiology procedure here at Bozeman Deaconess Hospital,” says Alderman.
Radiology Nursing Now Available 24/7
Advances in imaging technology ushered in new life-saving procedures, which in turn, created demand for a new nursing field. When a less invasive interventional radiology procedure is recommended over surgery, often the patient is critically ill. Many are diabetic, which means they are more at risk for problems that call for intervention and more likely to develop problems during a procedure. Others may have allergies or become combative. In the Bozeman Deaconess Radiology department, specially trained radiology nurses assess, stabilize, sedate and monitor these high-risk patients.
“We’re responsible for communicating with patients and their primary care physicians about what lab tests are needed and what medications to stop taking before a procedure,” said Conradine Tompers, RN, BSN, CRN, supervisor of Radiology Nursing. “If a patient is in pain or has anxiety we deliver medications to relax or sedate them. The radiologists rely on us to monitor the patient’s status, being alert for signs of irregular heart rhythms, allergic reactions or contrast dye leaks.” Last year, Tompers earned a Certificate of Radiology Nursing (CRN) by the American Radiological Nurses Association.
In addition to assisting in procedures, radiology nurses—who are on call 24/7—coach patients and provide follow-up care.
“We have a great crew—all topnotch nurses,” Rembert attests. “They know the procedures, what the patient should expect, as well as the imaging modalities we use. Like our radiology technologists, they’re experts at radiation safety and MRI safety.”
For more information about interventional radiology—what’s possible and what medical surveillance needs to be done upfront—contact Dr. Rembert, Dr. Alderman or Conradine Tompers at 585-1035.
Bozeman Deaconess Hospital and Intercity Radiologists stepped into a new era of advanced medical imaging. The new outpatient imaging facility, Advanced Medical Imaging, is located on the first floor of Highland Park 4. This is a joint venture between Bozeman Deaconess and the physicians of Intercity Radiology. The seven-member radiology group now shares their time between Advanced Medical Imaging and the hospital radiology department. Advanced Medical Imaging helps to provide a soothing, relaxing outpatient environment with easy access, convenient hours and parking with the services of Bozeman Deaconess Hospital right next door.
Both inpatient and outpatient radiology equipment was upgraded to feature technology unheard of just five years ago. Two MRI scanners—including a new Philips high field strength wide open bore 1.5T magnet, one of the most advanced in Montana—performs standard brain, spine, bone and body scans four times faster and with greater clarity. “Even more remarkable,” says Jay Jutzy, MD, of Intercity Radiology, “is how the new MRI helps physicians visualize arteries and assess heart function.” This new MRI unit is a short bore magnet that is more spacious than the equipment it replaces. A second new unit is an open MRI to better meet the needs of those who become anxious in unusually close spaces.
The new multi-slice CT scanner is fast. In less than 15 seconds, it takes images that five years ago took more than 10 minutes. The images can be viewed in multiple planes or 3-D, enhancing the radiologist’s ability to read the scan.
Advanced Medical Imaging also offers a Comprehensive Women’s Imaging Center providing screening and diagnostic mammograms, CAD technology, breast ultrasound, stereotactic and ultrasound-guided breast biopsies, bone densitometry (DEXA) and has recently added breast MRI to further enhance patient care. In April of 2006, the mammography department at Advanced Medical Imaging passed a rigorous Federal Inspection (the Food and Drug Administration) with flying colors. The department has also received compliments from many outside facilities such as Duke University, Mayo Clinic and Sally Jobe Breast Center, Denver, Colorado on the high quality of mammography imaging.
Also new is hospital-wide use of an image storage and distribution system called Picture Archiving and Communication System (PACS). “We’re able to read images directly off state-of-the-art computer screens. And, referring doctors now have rapid access to images throughout the hospital and in their offices or even at home,” Jutzy said. “This helps patients receive faster, more efficient care.” Digital imaging not only saves time between diagnosis and treatment, images are more accurate and, unlike hand-held images, do not get damaged or lost. Jutzy says electronic transfer of images and medical reports is fully compliant with patient privacy regulations.
Bozeman Deaconess Hospital and Intercity Radiology, according to Jutzy, are committed to outstanding patient care. Advanced Medical Imaging is committed to ensuring area patients access to the highest quality imaging equipment and techniques available. To schedule an appointment call (406) 556-5201 or visit www.bozemanadvanced.com for more information.
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