Opening the Black Box: How Interventional Radiology Can Help Our Patients in Hospice and Palliative Care (SA504)

Abstract

•Describe indications for four commonly used interventional procedures for patients with serious illness.•Explain the clinical experience of patients undergoing a tunneled catheter placement, kyphoplasty, celiac plexus block, and other common procedures.•Identify the most and least cost-effective procedures that VIR clinicians can perform for four common palliative care conditions. Thanks to rapidly advancing technology, the number of clinical interventions to treat serious illnesses grows each year. Vascular Interventional Radiology (VIR) is at the center of medicine’s procedural growth and has become a vital part of clinicians’ symptom management toolbox. Unfortunately, most clinicians practicing Palliative Care (PC) have had little interaction with VIR providers and, while often understanding the purpose of available procedures, have not seen and cannot explain to patients the experience of undergoing common VIR procedures. How can PC and hospice clinicians understand the complex and ever changing landscape of VIR? In this explanation and demonstration-heavy concurrent session, an academic palliative care and hospice physician with training in business and the Interventional Radiology residency/fellowship program director at a large academic hospital will join together to expose attendees to the ‘how and why’ of VIR. Evidence-based indications for common procedures like gastrostomy and jejunostomy feeding tube placement, thoracic and abdominal drainage catheter placement, kyphoplasty, celiac plexus block, and others will be provided and these procedures will be explained using a combination of hands-on demonstration, video, and illustration. In addition to the clinical aspects of each procedure, the patient experience of undergoing these interventions will be described and samples of the tools and devices being discussed will be circulated through the audience to encourage high-level understanding. Under the Medicare Hospice benefit, hospices must bear the cost of these interventions. We will discuss the relative costs of typical interventions for ascites, pleural effusion, and compression fractures and share strategies to ensure interventions are cost-effective both initially and over time. Remaining current with technological advances is difficult, especially for clinicians who practice outside the acute hospital setting. This concurrent session will shine light in the black box of VIR to improve care for many of our patients.