Richard Marshall, MD

Thyroid Artery Embolization

Dr. Marshall has been a pioneer in thyroid artery embolization using pressure enabled delivery. He has helped refine the technique through collaboration with other physicians around the United States, including Dr. Juan Camacho who was the first to publish on this technique. He uses three-dimensional imaging to perform an assessment of thyroid blood flow and improve treatment outcomes.  Candidates for thyroid artery embolization are generally patients with benign nodules that cause symptoms of pressure, difficulty swallowing, difficulty breathing or that are visible through the neck.  Patients with inflammatory thyroid disease, such as Graves’ Disease, and hyperthyroidism, including thyroid nodules are candidates for embolization.  All patients are evaluated on an individual basis to determine the best treatment strategy. Patients who are interested in discussing non-surgical, thyroid preserving therapy can contact our nurse navigator at 504-503-4141.  We are happy to provide more information, including second opinions. 

Portal Venous Interventions

Patients with portal vein disease are evaluated in a multidisciplinary setting, including Tulane Hepatology, Transplant Surgery/Hepatobiliary Surgery, Interventional Radiology and Diagnostic Radiology.  Interventional Radiology provides plays an important role in opening and maintaining portal veins in patients who might become candidates for liver transplantation or to improve symptoms.   Dr. Marshall has advanced experience in trans-jugular intrahepatic portosystemic shunts, direct portosystemic shunts, portal vein recanalization, variceal embolization for active bleeding and prevention of bleeding, splenic embolization for low platelets and shunt embolization to manage high ammonia levels.  We are happy to provide more information and second opinions in our outpatient clinic. For more information, please contact our nurse navigator at 504-503-4141. 

Interventional Oncology

With training in advanced cancer treatments at Memorial Sloan Kettering Cancer Center and Weill Cornell University/New York Presbyterian Hospital, Dr. Marshall brings experience and cutting-edge technologies to his patients.  He offers a wide range of technologically advanced treatments, including tumor ablation, Y90 radioembolization and trans-arterial embolization in multiple organs of the body.  High-quality, 3-dimensional imaging is required for optimal targeting and treatment of tumors, along with an evidence-based approach.  To review treatment options in our outpatient clinic, please contact our nurse navigator at 504-503-4141. 

Women’s and Men’s Health

Uterine Artery Embolization

Uterine artery embolization is a common procedure performed to treat uterine fibroids and adenomyosis.  The American College of Gynecology and Obstetrics states, “Uterine artery embolization (UAE) is recommended as an interventional procedure for the treatment of uterine leiomyomas in patients who desire uterine preservation and are counseled about the limited available data on reproductive outcomes.”  Dr. Marshall brings over a decade of experience in providing this procedure to his patients, including offering nerve blocks to improve the patient experience. 

Obstetrics & Gynecology 137(6):p e100-e115, June 2021. | DOI: 10.1097/AOG.0000000000004401

https://www.sirweb.org/for-patients/conditions-and-treatments/uterine-f…

Pelvic Floor Injections

Pelvic floor dysfunction is recognized as major source of pain in women that can be difficult to diagnose and treat.  Dr. Marshall has performed pelvic Botox and pain injections for almost a decade. This procedure is a series of injections with image guidance to target muscles and nerves that are abnormally functioning.  Patients are given anesthesia for the procedure and sent home the same day.  Pelvic injections are part of a multi-faceted approach that includes proper patient selection, counseling, and pelvic floor physical therapy.  Dr. Marshall recognizes the benefits of expert evaluation and an experienced, team-based approach.  He is happy to direct patients to experts in the New Orleans area for their workup or and sequencing of pelvic floor interventions as needed. 

Pelvic Venous Dysfunction Treatment

Diagnosis of pelvic venous dysfunction can be difficult since symptoms are often brushed off or managed temporarily with medications.  However, treatment of the underlying vein disease can re-route blood flow to normal veins that are able to accommodate blood flow.  Dr. Marshall uses a combination of techniques and equipment based on individual patient factors that include anatomy, flow and symptoms. 

Varicocele Embolization

Varicocele is a painful condition that can lead to scrotal pain after standing, poor blood flow to the testicle and fertility problems.  It can be treated surgically with vein ligation or with endovascular (through blood vessels) approach.  In patients who have undergone surgical vein ligation that has failed, or in patents who have experienced recurrence of symptoms, varicocele embolization can treat the underlying cause of symptom development.   

Prostate Artery Embolization

Urinary dysfunction caused by benign prostatic hyperplasia (BPH) can create anxiety over treatment and side effects.  Prostate artery embolization offers minimally invasive, safe and effective reduction in size of the prostate and improved urinary function.   Treatment is performed using 3-dimensinoal imaging guidance in the outpatient setting to reduce blood flow to the enlarged prostate. 

For questions about pelvic pain diagnosis and treatment, please contact our nurse navigator at 504-503-4141.