Interventional radiology

Interventional radiology

Balloon dilatation of the stenosed internal jugular vein (photo from an X-ray angiograph monitor). While pressure in the balloon is relatively low, stenosis prevents the balloon from inflating in the middle. Further increase in pressure will dilate the narrowing and restore the full blood flow.
MeSH D015642

Interventional radiology (IR), sometimes known as vascular and interventional radiology (VIR), is a medical sub-specialty which provides minimally invasive image-guided diagnosis and treatment of disease. Although the range of procedures performed by interventional radiologists is broad, the unifying concept behind these procedures is the application of image guidance and minimally invasive techniques in order to minimize risk to the patient.

Interventional radiologist
Occupation
Names Doctor, Medical Specialist
Occupation type
 Specialty
Activity sectors
 Medicine
Description
Education required
Fields of
employment
 Hospitals, Clinics
Related jobs
 Radiologist

Training for interventional radiology occurs in the residency portion of medical education, and has gone through developments.

In 2000, the Society of Interventional Radiology (SIR) created a program named "Clinical Pathway in IR", which modified the "Holman Pathway" that was already accepted by the American Board of Radiology to including training in IR; this was accepted by ABR but was not widely adopted. In 2005 SIR proposed and ABR accepted another pathway called "DIRECT (Diagnostic and Interventional Radiology Enhanced Clinical Training) Pathway" to help trainees coming from other specialities learn IR; this too was not widely adopted. In 2006 SIR proposed a pathway resulting in certification in IR as a speciality; this was eventually accepted by the ABR in 2007 and was presented to the American Board of Medical Specialities (ABMS) in 2009, which rejected it because it did not include enough diagnostic radiology (DR) training. The proposal was reworked, at the same time that overall DR training was being revamped, and a new proposal that would lead to a dual DR/IR specialization was presented to the ABMS and was accepted in 2012 and eventually was implemented in 2014.[1][2][3] By 2016 the field had determined that the old IR fellowships would be terminated by 2020.[3]

A handful of programs have offered interventional radiology fellowships that focus on training in the treatment of children.[4]

In Europe the field followed its own pathway; for example in Germany the parallel interventional society began to break free of the DR society there in 2008.[5]

Procedures

Interventional radiologists commonly perform both diagnostic and therapeutic procedures, although diagnostic angiography is becoming less common as the quality and reliability of CT and MRI angiography has allowed for alternative forms of non invasive evaluation.

Diagnostic

Therapeutic

Vascular

Biliary intervention[13]

Catheter placement

Ablative[15][16]

Genitourinary[18]

Pain management


References

  1. ↑ Kaufman, John A. (November 2014). "The Interventional Radiology/Diagnostic Radiology Certificate and Interventional Radiology Residency". Radiology. 273 (2): 318–321. PMID 25340266. doi:10.1148/radiol.14141263.
  2. ↑ Siragusa, DA; Cardella, JF; Hieb, RA; Kaufman, JA; Kim, HS; Nikolic, B; Misra, S; Resnick, SA; Saad, WE; Vatakencherry, G; Wallace, MJ; Society of Interventional, Radiology. (November 2013). "Requirements for training in interventional radiology.". Journal of vascular and interventional radiology : JVIR. 24 (11): 1609–12. PMC 4485607 Freely accessible. PMID 24160820.
  3. 1 2 Di Marco, L; Anderson, MB (February 2016). "The new Interventional Radiology/Diagnostic Radiology dual certificate: "higher standards, better education".". Insights into imaging. 7 (1): 163–5. PMC 4729716 Freely accessible. PMID 26746975.
  4. ↑ The Society for Pediatric Radiology
  5. ↑ Mahnken, AH; Bücker, A; Hohl, C; Berlis, A (April 2017). "White Paper: Curriculum in Interventional Radiology.". RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. 189 (4): 309–311. PMID 28335057. doi:10.1055/s-0043-104773.
  6. ↑ Uberoi, Raman (2009). "4 Imaging". Interventional radiology. Oxford New York: Oxford University Press. p. 49-77. ISBN 978-0-19-157556-3.
  7. ↑ Uberoi, Raman (2009). "19 Biopsy and drainage". Interventional radiology. Oxford New York: Oxford University Press. p. 387-402. ISBN 978-0-19-157556-3.
  8. ↑ Uberoi, Raman (2009). "7 Angioplasty and stenting". Interventional radiology. Oxford New York: Oxford University Press. p. 123-147. ISBN 978-0-19-157556-3.
  9. ↑ Uberoi, Raman (2009). "9 Stentgrafting". Interventional radiology. Oxford New York: Oxford University Press. p. 171-186. ISBN 978-0-19-157556-3.
  10. ↑ Uberoi, Raman (2009). "17 Embolization techniques". Interventional radiology. Oxford New York: Oxford University Press. p. 341-360. ISBN 978-0-19-157556-3.
  11. ↑ Uberoi, Raman (2009). "12 Haemodialysis fistula". Interventional radiology. Oxford New York: Oxford University Press. p. 253-268. ISBN 978-0-19-157556-3.
  12. ↑ Keller, Frederick S.; Farsad, Khashayar; Rösch, Josef (2016). "The Transjugular Intrahepatic Portosystemic Shunt: Technique and Instruments". Techniques in vascular and interventional radiology. Elsevier BV. 19 (1): 2–9. ISSN 1089-2516. PMID 26997084. doi:10.1053/j.tvir.2016.01.001.
  13. ↑ Uberoi, Raman (2009). "13 Hepatobiliary intervention". Interventional radiology. Oxford New York: Oxford University Press. p. 269-282. ISBN 978-0-19-157556-3.
  14. ↑ Uberoi, Raman (2009). "14 Gastro-intestinal intervention". Interventional radiology. Oxford New York: Oxford University Press. p. 290-295. ISBN 978-0-19-157556-3.
  15. ↑ Uberoi, Raman (2009). "18 Tumour ablation". Interventional radiology. Oxford New York: Oxford University Press. p. 361-386. ISBN 978-0-19-157556-3.
  16. ↑ Wah, T.M. (2017). "Image-guided ablation of renal cell carcinoma". Clinical radiology. Elsevier BV. 72 (8): 636–644. ISSN 0009-9260. PMID 28527529. doi:10.1016/j.crad.2017.03.007.
  17. ↑ Percutaneous Tumor Ablation. Thieme Verlag. 2011. ISBN 9781604063066. doi:10.1055/b-0034-81500.
  18. ↑ Uberoi, Raman (2009). "11 Interventional uro-radiology". Interventional radiology. Oxford New York: Oxford University Press. p. 221-225. ISBN 978-0-19-157556-3.
  19. ↑ Uberoi, Raman (2009). "22 Musculoskeletal intervention". Interventional radiology. Oxford New York: Oxford University Press. p. 445. ISBN 978-0-19-157556-3.

Further reading


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