Thomas E. Wiley, MD Services

Thomas E. Wiley, MD

Interventional Radiology

Tulsa, Oklahoma

Vascular Intervention

As an Interventional Radiologist with Radiology Consultants of Tulsa in Tulsa, Oklahoma, Thomas E. Wiley, MD treats vascular disease, sometimes called peripheral arterial disease (PAD) or Peripheral Vascular Disease (PVD) Methods used to diagnose and treat vascular disease include: Angiography,stenting, angioplasty, thrombolysis, embolization, inferior vena caval filter placement, and venography. Dr. Wiley is active in the diagnosis and treatment of stroke. Carotid angiography is performed to assess the amount of blockage within the carotid artery and to determine the risk of stroke. High risk patient's often will require surgery for carotid endarterectomy. With the recent FDA approval of the Guidant System for carotid stent treatment of carotid stenosis, we anticipate that we will be able to provide carotid stents as a minimally invasive alternative for some of our patient's in the near future.

Vascular Disease Overview

Peripheral Arterial Disease (PAD)

Angiography

Angioplasty and Stenting

Carotid Stent Placement

Thrombolysis

Catheter Embolization Information

Diagnosis and Treatment of Deep Venous Thrombosis

Deep Venous Thrombosis

Deep vein thrombosis is the formation of clot in the large veins of the body, usually involving the lower extremities (legs). This condition is potentially life threatening if a clot moves from it's original location and lodges in the pulmonary (lung) arteries. Diagnosis is usually accomplished by venography or by ultrasound evaluation of the legs in the radiology department. Treatment most commonly consists of anti-coagulation (use of a blood thinner). However, some patients may benefit by other treatments such as thrombolytic therapy to dissolve the clot. If the patient cannot tolerate blood thinners or has a pulmonary embolus (clot in the lungs) while on a blood thinner, an inferior vena cava filter is placed. Sometimes inferior vena cava filters are also placed in patient's who are at very high risk for pulmonary embolus such as ill patient's who are expected to be at bed rest for a prolonged period of Time.

Inferior Vena Caval Filters

Inferior Vena Cava filters are small metallic structures which are designed to capture clot in the abdomen and prevent potentially life threatening clot from reaching the heart or the lungs. A variety of filters are currently available. Recently a new type of filter has become available which can be removed after the risk of pulmonary embolus has decreased. This filter is called a retrievable filter.

Varicose Vein Treatment

Ten to twenty percent of adult americans suffer from varicose veins (large veins which sometimes bulge at the skin surface often on the legs). These varicosities can lead to medical symptoms of pain, fatigue and discomfort . The varicose veins can lead to other problems (complications). Traditional treatment with compression stockings does not address the underlying problems with the veins. Surgical vein stripping requires several weeks for recovery and the veins often come recur with time. Now we are able to offer treatment with a minimally invasive approach using the laser ablation of the saphenous vein. This procedure is usually very effective for the treatment of varicose veins.

Genitourinary Intervention

Including percutaneous nephrostomy, nephroureteral stents, ureteral double j stent placement, nephrostomy tube and ureteral stent exchange, nephrostograms, varicocele embolization and ureteral dilatation.

Male Fertility and Varicocele Embolization Information

Cancer Diagnosis and Treatment

Cancer Treatment

Cancer can now often be diagnosed without the risk and trauma of open surgery using image guided biopsy through a very small incision in the skin with a small needle. Image directed biopsy is precisely guided with CT, ultrasound, or fluoroscopy.

Needle Biopsy Information

Abscess and Fluid Drainage
	Image guided drainage of abscess and other fluid collections in the abdomen and thorax.

Bile Intervention
	Including transhepatic cholangiography, biliary drainage, bile duct dilatation, and bile stone extraction.

Spine Interventions: Vertebroplasty, Kyphoplasty, and Percutaneous Discectomy

Vertebroplasty and Kyphoplasty

Vertebroplasty is a pain treatment for vertebral compression fractures that fail to respond to conventional medical therapy. The most common reason for a vertebral compression fracture is osteoporosis (decreased bone calcium). Approximately 700,000 vertebral, or spinal bone, fractures occur each year usually in women over the age of 60. One in four women over the age of 50 is likely to suffer a vertebral compression fracture. Vertebroplasty is a minimally invasive technique to stabilize the fracture and decrease the pain associated with the fracture by placing cement in the fractured spinal vertebra. The procedure is safe and effective. Conventional treatment with bed rest is likely to exacerbate osteoporosis and potentially lead to more compression fractures or other complications.

Kyphoplasty is similar to vertebroplasty but involves the use of a balloon in addition to cement in an effort to regain vertebral body height in the fractured vertebra.

More information about Vertebroplasty

Percutaneous Discectomy

Percutaneous discectomy is a minimally invasive method to remove a small piece of a disc from the spine. This treatment is an alternative to more invasive surgery in some patient's with pain in the cervical and lumbar spine related to disc disease (disc herniation or bulges that press on the adjacent nerves or spinal cord).

Learn more about percutaneous discectomy

Facet Blocks and Nerve Blocks

Pain in the spine can often be alleviated by injection of anesthetic sometimes with an anti-inflammatory steroid. These injections can be precisely directed with imaging guidance using fluoroscopy (x-ray) or CT (CAT scan) guidance.

Discography (Discogram)

Discography involves administration of a small amount of iodine contrast into the spinal disc in an effort to determine whether that disc is responsible for the patient's pain or discomfort. The procedure is done using fluoroscopy (x-ray) guidance.

Transjugular Intrahepatic Portosystemic Shunt (TIPS) Placement

Transjugular Intrahepatic Portosystemic Shunt (TIPS) Placement is a treatment for patient's with portal hypertension (increased pressure in the veins of the abdomen) usually caused by cirrhosis (scarring) of the liver. This process can occur from hepatitis, viral infection, alcohol, medications, and genetic reasons. Some patients with recurrent bleeding or ascites (fluid on the abdomen) can benefit from creation of a pathway from the portal vein to the hepatic vein in the liver to decrease the pressure in the portal vein. The MELD classification MELD Classificationcurrently used for liver transplant evaluation can be used to help decide which patients may benefit the most from a TIPS procedure. Read More about this....

Thomas E Wiley, MD 2004