dr. Sriharsha Athreya found himself seeing many patients from Niagara during his time as an interventional radiologist in Hamilton.
So when a vacancy arose in Niagara Health’s Interventional Radiology Department in late 2017, Dr. Athreya not to apply. He saw it as an opportunity to bring more comprehensive care closer to home to so many Niagara patients.
“I thought, ‘We see a lot of people from Niagara. I could help there,’” Dr. Athreya recalls. “I knew Niagara Health was welcoming, making progress and bringing change locally for patients.”
Interventional radiology (IR) is a specialty of radiology and uses medical imaging, including CT scans, fluoroscopy, MRI, and ultrasound, to guide minimally invasive surgical procedures that diagnose and treat a variety of conditions. IR procedures include biopsies, insertion of picc lines, angioplasty or stents to unblock blood vessels, and treating cancers with tumor ablation or by chemoembolization, which restricts a tumor’s blood supply.
At the time of Dr. Athreya, there were two interventional radiologists on the ward who were hard at work serving the patients during limited hours. If patients required the care of an interventional radiologist at night for conditions such as postpartum hemorrhage or abscess drainage, they had to be transferred from Niagara.
Shortly after Dr. Athreya made the move to Niagara Health, he was promoted to chief of interventional radiology. The department added other fellowship-trained interventional radiologists, diagnostic imaging nurses and medical radiation technologists, and momentum grew to offer more services with the support of Dr. Julian Dobranowski, Niagara Health Chief of Diagnostic Imaging, and Mike Sharma, Diagnostics Director.
Part of Niagara Health’s Interventional Radiology team. The department now has four fellowship-trained interventional radiologists, medical radiation technologists and nurses. Together, they assist patients during their procedures and aid in recovery and discharge.
Becoming a world-class healthcare center
In 2019, the department, led by Dr. Athreya and with funding from Cancer Care Ontario, to offer image-guided tumor ablation, making Niagara Health one of the few hospitals in Ontario to offer the service. This low-risk pinhole procedure, performed under conscious sedation, is used to treat small tumors in the kidneys, lungs, or liver by using a superfine probe to burn or freeze the cancer cells. Patients are discharged from the hospital the same day.
“This is an evidence-based, targeted treatment for cancer tumors, especially those under four centimeters,” says Dr. Athreya. “Previously, there were only a few centers in Ontario that did this, including Toronto, Hamilton and London. Now we can proudly say that we offer this treatment locally.”
During a routine ultrasound in 2019, doctors discovered a small tumor on Fern Gow’s right kidney. Fern, a retired registered nurse living in Niagara Falls, was given the choice of surgery, which would require removal of part of her kidney, or tumor ablation via IR.
She chose the latter after meeting Dr. Athreya and researching the work he had previously done in the field.
“He was so approachable and very informative. I decided to go for it,” recalls Fern. “The program is great for people like me who don’t want surgery and prefer something less invasive. I was delighted to have this done here in Niagara through a remarkably high-quality program by highly qualified professionals. If I had to go to Hamilton it would have been more difficult.”
November marks three years since Fern underwent the 60-minute procedure, which left her with minimal pain and minimal recovery. She has been cancer free ever since.
“I’m still here,” she says. “I hope it continues like this.”
From left to right: medical radiation technologists Carly Mascia, Brayden Shaw, Sarah Robb, Christopher Provias, Tiffany Sagloski, and Dr. Sriharsha Athreya gather around a CT machine, which is used in some procedures performed by the Interventional Radiology Department.
Thanks to the dedication of Dr. Athreya and the IR team, the department now has four fellowship-trained interventional radiologists, medical radiation technologists and nurses. Together, they assist patients during their procedures and aid in recovery and discharge.
The team also created a streamlined system to manage appointments and optimize patient care, including letting patients know in advance what to expect on the day of their procedure. This ensures that appointments run on time and any cancellations are completed quickly to avoid backlogs. The follow-up after the procedure is coordinated by the IR outpatient clinic.
Interventional radiologists are now available 24/7, eliminating the need to send patients to other hospitals outside office hours for IR treatments. The program was expanded to treat patients at the Niagara Falls site two days a week, which has helped reduce wait times for certain IR procedures.
“The work of the entire Interventional Radiology team has been commendable, especially during the COVID pandemic, and I am grateful to all of them,” said Dr. athreya. “Now we can provide image-guided cancer treatment in Niagara that is minimally invasive, safe, and the recovery time is just a few days with no long-term effect on the organ function of the lung, liver or kidneys. By offering these services locally, it also awakens trust with clinicians and patients, we are committed to patient-centered care.”
Providing patient-centered care close to home
The work of Dr. Athreya and the IR team have hit almost every program in the hospital.
From left to right: Diagnostic Medical Sonographers, Amanda Ouwendyk, Vanessa Vaicius and Marisa Boccia are part of the Interventional Radiology team.
They are ‘a tremendous asset’, providing timely access to biopsies and placing lines and ports to treat patients and relieve pain, says Dr Michael Levesque, Head of Oncology. dr. Athreya also regularly contacts the Walker Family Cancer Center team to find out what it takes to improve services and continue to provide quality healthcare.
“There was a person like Dr. Athreya and other practitioners to nurture and build a program. They all believe in providing services to patients in Niagara that you can find elsewhere,” said Dr. Levesque. “They want the program to be as good as possible. We want people to come here because our program is world-class, not just because it’s close to home.”
IR is also key in the care of dialysis patients. The department performs critical vascular surgeries and procedures, including angioplasties to keep the arteries and veins of dialysis patients open when fistulas begin to fail. These are “patient lifelines that dialysis can use to cleanse their blood,” says Dr. Danny Lagrotteria, head of the Nephrology Department. So are the long-term hemodialysis catheters the IR team uses using fluoroscopy, a type of medical imaging that uses real-time moving X-ray images inside a patient’s body.
“They do a lot for vascular access to support dialysis care,” says Dr. Lagroterria. “Without them and the success of that program, we would have to send patients to Hamilton. The availability of IR here has done a lot to improve patients’ quality of life.”