Virtual Reality as an Anxiolytic and Analgesic in Interventional Radiology Procedures: An Evidence-Based Review and Practical Framework.

PURPOSE: To evaluate the clinical efficacy, mechanisms, and feasibility of immersive virtual reality (VR) as a non-pharmacological anxiolytic and analgesic in interventional radiology (IR). METHODS: A literature search for a narrative review was conducted on June 7, 2026, across MEDLINE, EMBASE, and Web of Science. Prospective pilot studies and randomized controlled trials that evaluated VR as an intraprocedural anxiolytic or analgesic modality during percutaneous or endovascular interventions were included. RESULTS: Analysis of 9 clinical trials demonstrated substantial reductions in procedural distress. In a randomized controlled trial involving 120 patients undergoing peripheral arterial angioplasty, VR was associated with significant improvements in patient-reported intraprocedural pain (visual analog scale: 6.23 ± 0.91 vs. 8.03 ± 0.94; p < 0.001) and anxiety (State-Trait Anxiety Inventory-6-Item: 47.60 ± 7.42 vs. 67.97 ± 9.95; p  < 0.001). Furthermore, combining VR with guided breathing during percutaneous transhepatic biliary drainage reduces post-procedural opioid consumption (20.25 vs. 56.61 morphine milligram equivalents, p = 0.044). CONCLUSIONS: VR is an effective, sedation-sparing digital tool for short, simple IR procedures. Application in complex, long endovascular cases remains investigational.