Specialities & Procedures

Pelvic vein embolisation (PVE) is a minimally invasive treatment for women with pelvic venous disorder (also known as pelvic congestion), a condition caused by poor drainage of veins within the pelvis.

When these veins do not function properly, blood can pool and create increased pressure, leading to symptoms such as chronic pelvic pain, heaviness, aching discomfort, pain after prolonged standing, or pain during or after intercourse. Some people may also notice visible varicose veins in the pelvis or upper thighs.

PVE works by closing off the abnormal veins using image-guided techniques, allowing blood to reroute through healthy veins and reducing the pressure that causes symptoms. The procedure does not involve surgery and preserves normal pelvic anatomy.

Treatment is usually performed in a staged manner, starting with a diagnostic catheter study to map the veins, followed by embolisation on a separate day if appropriate. Both stages are day-only procedures, performed through a small puncture in the neck under light sedation.

Most patients return home the same day and resume normal activities within a few days. Improvement in symptoms typically occurs gradually over several weeks.

These image-guided procedures are used to assess whether the fallopian tubes are open and, in some cases, to improve tubal function in women experiencing difficulty conceiving.

An HSG is an X-ray test that examines the shape of the uterus and checks whether contrast can pass through the fallopian tubes. If a blockage is identified, additional treatment can often be performed during the same appointment.

A Lipiodol flush is a variation of the HSG that uses an oil-based contrast agent. In selected patients, this has been shown to modestly improve pregnancy rates in the months following the procedure, likely by gently clearing minor debris or mucus from the tubes.

If a tube appears blocked near its opening to the uterus, fallopian tube recanalisation may be performed. This involves carefully reopening the tube using fine catheters and guidewires under continuous X-ray guidance.

These procedures can be performed together in a single sitting, through the cervix, without surgery, and may be done with sedation if desired. Most patients go home the same day and resume normal activities quickly.

Prostate artery embolisation (PAE) is a minimally invasive treatment for men with benign prostatic hypertrophy (BPH) – a common, non-cancerous enlargement of the prostate that can cause urinary symptoms such as weak flow, difficulty starting, frequent urination, urgency, or night-time waking.

As the prostate enlarges, it can compress the urethra and interfere with normal urine flow. PAE works by reducing the blood supply to the enlarged prostate tissue using image-guided techniques, causing the prostate to gradually shrink over time and relieve pressure on the urinary tract.

The procedure is performed without surgery or incisions into the urinary tract. It is usually done as a day-only procedure, through a small puncture in the wrist or groin, under light sedation. Most patients return home the same day and resume normal activities within a few days.

PAE sits between medication and surgery as a treatment option. It can be particularly appealing for men who have persistent symptoms despite medication, wish to avoid surgery, or are concerned about sexual side effects such as retrograde ejaculation. Importantly, having PAE does not prevent future surgical treatments if they are needed later.

Careful assessment and imaging are essential to ensure the procedure is appropriate for each individual, and treatment decisions are made in collaboration with your GP and urologist.

Venous embolisation is a minimally invasive treatment for men with a symptomatic varicocele – a condition caused by abnormal drainage of veins around the testicle, similar to varicose veins.

Many varicoceles cause no symptoms. When they do cause symptoms, men may experience aching or dragging discomfort, a feeling of heaviness in the scrotum (often worse with standing or exercise), or visible enlarged veins.

Varicocele embolisation treats the underlying venous problem by closing off the abnormal veins using image-guided techniques. Blood flow is redirected through healthier veins, reducing pressure and relieving symptoms. The testicle itself is not operated on.

The procedure is performed without surgery, through a small puncture (usually at the base of the neck), under local anaesthetic with or without sedation. It is typically a day-only procedure, with most patients returning to normal activities within a few days.

Vascular access procedures provide safe and reliable access to the bloodstream for medications, treatments, dialysis, or blood sampling. These procedures are commonly required when repeated or long-term intravenous access is needed.

All vascular access procedures are performed using ultrasound and X-ray guidance, which improves accuracy and safety. They are usually done under local anaesthetic, sometimes with light sedation, and most patients go home the same day.

Types of vascular access commonly performed include, implanted venous ports (Port-a-Cath), tunnelled dialysis catheters, and central venous catheters.

Careful planning is undertaken to choose the most appropriate type of access based on the intended use, duration, and individual patient factors. Ongoing line care is usually managed by the referring medical or nursing team.

Genicular artery embolisation (GAE) is a minimally invasive treatment for people with chronic knee pain, most commonly related to knee osteoarthritis.

In arthritis, ongoing inflammation within the knee joint is partly driven by the development of small abnormal blood vessels around the joint lining. GAE works by selectively reducing blood flow to these inflamed areas using image-guided techniques, which can help reduce pain and improve knee function.

The procedure is performed without surgery, usually under local anaesthetic with or without sedation. A small catheter is inserted into an artery in the groin or ankle and guided to the vessels supplying the painful areas of the knee. There are no incisions into the knee itself, and most patients go home the same day.

GAE may be considered for people who continue to have symptoms despite physiotherapy, medications, or injections, and who are not ready for knee replacement surgery. It does not prevent future surgery if this becomes necessary.

An inferior vena cava (IVC) filter is a small device placed inside the body’s main vein to help reduce the risk of blood clots travelling to the lungs. It is most often used when blood-thinning medication cannot be given safely, is ineffective, or needs to be paused temporarily.

IVC filters are inserted using a minimally invasive, image-guided technique, through a small puncture in a vein in the neck or groin, usually under local anaesthetic with or without sedation. Many filters are designed to be temporary and can be removed once the risk of clot migration has passed or anticoagulation can be resumed. Both placement and removal are typically day-only procedures, with most patients returning home the same day.

A radiologically inserted gastrostomy (RIG) is a feeding tube placed through the skin directly into the stomach to allow nutrition, fluids, and medications to be given safely when swallowing is difficult or unsafe.

A RIG may be recommended when medical treatment, neurological conditions, or other illnesses make it hard to maintain adequate nutrition by mouth, or when there is a risk of food or fluid entering the lungs. The decision to place a feeding tube is usually made in collaboration with the treating medical and nutrition teams.

The procedure is performed by an interventional radiologist using X-ray guidance to accurately position the tube. It is done through a small opening in the skin, usually under local anaesthetic with pain relief and light sedation. It is typically a day-only procedure with patients returning home the same day.

An ultrasound-guided biopsy is a minimally invasive procedure used to obtain a small tissue sample from an internal organ such as the liver or kidney, to help diagnose or guide treatment.

Using real-time ultrasound imaging, a biopsy needle is accurately guided into the target area through the skin. This allows tissue to be sampled precisely while minimising disruption to surrounding structures.

These biopsies are most often performed in outpatient radiology clinics under local anaesthetic. In selected cases, Dr Hillhouse can offer these procedures in a theatre setting with anaesthetic support. This may be recommended when:

• The target area is technically challenging to access and requires anaesthetic support to control breathing and help with patient positioning
• If patient comfort or anxiety is a concern
• The patient prefers sedation or anaesthetic assistance

Most biopsies are day-only procedures, and patients usually return home the same day. The bleeding risk of the procedure remains the same regardless of setting it is performed in and will be discussed with you on an individual basis. Please inform the hospital and doctor’s secretary if you are taking blood thinning medications.