Interventional Radiology Practice Research Articles

Strategic Initiatives in Interventional Radiology: A New Vision

Interventional radiology is at a crossroads. Two possible futures exist. In one direction, advances in technology are providing exciting opportunities for interventional radiology. Promising new treatments in tumor and cancer therapy, the treatment of fibroids, venous access, and spine interventions, as well as advances in noninvasive vascular imaging, pharmacologic therapies, and peripheral interventions are revitalizing our specialty, attracting significant patient interest and promising tremendous public benefit. In the other direction, interventional radiology is losing market share in vascular interventions to other specialties and suffering a crisis of confidence. One road leads to success, the other to failure. The only problem is that the roads aren’t clearly marked. Which road is which? The burden falls upon all of us, the leaders, staff, and members of the Society to choose the right path, to choose our future, and to make our continued success a reality. Fortunately, we have the tool to create a map; this tool is strategic planning, a business discipline that helps organizations determine and achieve desired futures. Strategic planning can provide direction and help focus organizational activities. Without it, entropy can set in and organizations can fail. Last year, SCVIR launched a strategic planning process to set directions for both the specialty and the Society. It was clearly time; the Society’s thencurrent plan was more than 5 years old—a millennium in today’s rapidly changing world. In addition, the Society and its members were facing increasing challenges from competing specialties, ever-tightening reimbursement, new technologies, evolving practice patterns, and changing consumer expectations. This paper is the first of a series in JVIR to convey a significant depth of information about the strategic plan; to provide an understanding of its foundations, our goals and objectives, and issues that will still need to be debated as the plan moves forward. This first article describes the strategic planning process, the vision, timeline and goals, and early successes of the new plan. Subsequent articles will include the following topics: • Results of strategic plan research: the environmental/economic assessment, leadership, staff and external interviews, and member polling; • Workforce projections and employment market for interventional radiologists; • Becoming “clinical,” and what this will mean for the interventional radiologist; • Practice and volume trends in interventional radiology; • “Branding” of interventional radiology, what our customers are telling us about who we are; • Future of interventional radiology and the implications for training and practice; the report of the SCVIR Specialty Development Task Force; and • A series on innovation and research.

Introduction

It has been a few years since the first issue of Techniques in Vascular and Interventional Radiology on the topic of central venous access was published. In the interim, we have seen further refinements take place in this arena. The benefits of image-guided venous access and device placement have been well established, as demonstrated in numerous scientific contributions by interventional radiologists from around the world. The commitment of interventional radiologists to provide an all-inclusive and reliable venous access and management service has altered practice patterns in many institutions. It is not surprising that the editors of Techniques in Vascular and Interventional Radiology thought it would be timely to revisit the subject, and that they also agreed to add an important non-vascular topic. It has been a privilege to work with a group of contributors who have lent their enthusiastic and unconditional support to this issue of Techniques in Vascular and Interventional Radiology. The authors have done so despite other pressing commitments and have more than met the goal of providing an exciting array of expert advice and opinion in areas important to the daily practice of interventional radiology. Without their timely, diligent contributions, this project would not have been possible. I am truly indebted to all of them. I trust that you, the readers, will find their manuscripts informative and helpful in your daily clinical activities. Last, but not least, I would like to thank Drs. Razavi and Semba for offering me an opportunity to coordinate this issue of Techniques in Vascular and Interventional Radiology. Their trust, helpful suggestions, and patience have made it smooth sailing for me, even though the waters were rough at times. Once again, many thanks!

SCVIR Gold Medal

The SCVIR is proud to announce the awarding of the Society's third Gold Medals to Stanley Baum, MD, and Anders M. Lunderquist, MD. Candidates for the award, the highest honor of the Society, are chosen by the SCVIR Gold Medal Committee and are approved by the SCVIR Executive Council. The Gold Medal is bestowed on those individuals who, in the judgment of the Society, have rendered exceptional service to the field of interventional radiology. Gold Medal recipients exemplify those individuals who have dedicated their talents to advancing the quality of patient care through the practice of interventional radiology and who, by their outstanding achievements, also help ensure the future of the field. The SCVIR is proud to present Gold Medals to these innovative scientists and radiologists whose leadership and dedication have fortified the field of interventional radiology.

The Role of the FDA in the Daily Practice of Interventional Radiology

The Role of the FDA in the Daily Practice of Interventional Radiology

Stents: material, surface texture and design, in theory and practice

Intravascular stenting has become standard practice in cardiology and interventional radiology. As part of their daily routine, interventional therapists have to choose from more than 50 different coronary stents for the optimal treatment of patients. Striking advances in biomedical engineering have triggered the production of numerous new and improved stent models, whose theoretical benefits have not yet been confirmed by large-scale clinical trials. Selecting appropriate stents for individual patients is frequently subject to the personal and, therefore, subjective experience of the interventional therapist. This paper reviews different stent materials and designs used in current trials and clinical practice. The theoretical benefits of individual parameters are discussed and correlated with up-to-date clinical results, particularly with a view to considering their favourable impact on intervention outcomes.

Pediatric Vascular Access

Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices.

Embolization agents: A review

Embolotherapy is an integral part of the practice of interventional radiology. Although many of the embolic agents in common use are well established, advances in microcatheter design, as well as microcatheter-compatible embolic agents, have expanded the role of embolotherapy. This article reviews common embolic agents for use with both standard and microcatheter systems and their roles in embolotherapy.

Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends. A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived from a similar survey of interventional practice in the United States. Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds. This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are used in the United States. Trends toward making interventional radiology a clinical specialty are evident, with 51% of respondents having day case beds, and 30% having inpatient beds.

How to Make a Business Plan for Your Interventional Radiology Practice

How to Make a Business Plan for Your Interventional Radiology Practice

Principles of Gene Therapy as Related to Practice of Interventional Radiology

Principles of Gene Therapy as Related to Practice of Interventional Radiology

Giant Right Atrial Thrombus: A Life-Threatening Complication of Long-term Central Venous Access Catheters

© SCVIR, 1997 THE placement and management of long-term central venous access catheters is now a significant and growing element of interventional radiology practice. An appreciation of the management of complications is essential, particularly when these can be life threatening. Clinically detected catheter-related thrombosis can occur in up to 5% of cases (1); however, the potentially catastrophic complication of massive atrial thrombosis has rarely been described. We describe a case of massive atrial thrombosis that necessitated emergency cardiac surgery in a 40-year-old woman with a Port-A-Cath in situ.

Guidelines Regarding HIV and Other Bloodborne Pathogens in Vascular/Interventional Radiology

CONCERN about human immunodeficiency virus (HIV) and other bloodborne pathogens is rising throughout society as infection becomes more prevalent. Many members of the Society of Interventional Radiology (SIR) have expressed the need for an official statement from the Society that addresses practice issues unique to interventional radiology. As a result, the SIR Subcommittee on HIV and Bloodborne Pathogens was formed to review current knowledge about risk of bloodborne pathogen transmission during interventional radiology procedures, to summarize exposure control regulations and recommendations as they pertain to the practice of interventional radiology and review ways that risk can be reduced, and to formulate a policy for the Society to assist its members in dealing with this complicated subject. LEVEL OF RISK IN INTERVENTIONAL RADIOLOGY

The Future of Private Practice Interventional Radiology: Where We Are Going and Where We're Not

The Future of Private Practice Interventional Radiology: Where We Are Going and Where We're Not

Current Status of Angiography and Interventional Radiology in Japan: Survey Results

Because the practice of interventional radiology in Japan seems very different from that in western countries, a survey was conducted to define practice patterns and the current position of radiologists in the field of vascular and interventional radiology in Japan. During the spring of 1992, a questionnaire was mailed to all institutions to which members of the Japanese Society of Angiography and Interventional Radiology belong. For abdominal, thoracic, and peripheral angiography, more than 50% of procedures were controlled by radiologists. The majority of abdominal embolotherapy (87%) and peripheral angioplasty (70%) procedures were performed by interventional radiologists. On the other hand, 64.3% of neurointerventions, 74% of abscess drainage, and 98% of coronary angioplasty procedures were performed by other specialists. In most institutions, embolotherapy for liver neoplasms was commonly performed by radiologists (97%). Peripheral and renal angioplasty and thrombolysis were performed by 74% of respondents, although less than 10 cases per year were encountered at 81% of institutions. Abscess drainage and biopsy were performed by radiologists in more than 50% of institutions. In other nonvascular interventional procedures, especially lithotripsy, the practice by and experiences of radiologists were very limited. Fifty-seven percent of radiology departments have beds allocated and radiologists serve as attending physicians for interventional purposes. The practice pattern of interventional radiology in Japan is quite different from that in other countries because of differences in patients' diseases, historical backgrounds, number of interventional radiologists, and department organization.

Current Practice of Interventional Radiology

Current Practice of Interventional Radiology

Current Practice of Interventional Radiology

Current practice of interventional radiology , Current practice of interventional radiology , کتابخانه دیجیتالی دانشگاه علوم پزشکی و خدمات درمانی شهید بهشتی

Current Practice of Interventional Radiology

Current Practice of Interventional Radiology

Initial experience with a universal-length copolymer ureteral stent

A universal-length ureteral stent made of a biocompatible copolymer was designed specifically for easy antegrade internal placement. The double-looped distal end of the stent eliminates the need to measure the distance from the ureteropelvic to ureterovesical junction. If additional length is required, a portion of the distal loop is incorporated into the stent shaft. Interventional radiology practices benefit economically, as the universal-length stent is the only size required for the treatment of most ureteral obstructions.

Economic factors affecting practice of interventional radiology in the United States.

HomeRadiologyVol. 172, No. 3 PreviousNext Critical IssuesEconomic Factors Affecting Practice of Interventional Radiology in the United StatesGary S. Dorfman, Arthur C. WaltmanGary S. Dorfman, Arthur C. WaltmanAuthor AffiliationsAddress reprint requests to G.S.D.Gary S. DorfmanArthur C. WaltmanPublished Online:Sep 1 1989https://doi.org/10.1148/172.3.895MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Article HistoryReceived: Nov 8 1988Revision received: Apr 20 1989Accepted: May 11 1989Published in print: Sept 1989 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 172, No. 3 Metrics Altmetric Score PDF download

Developing an interventional radiology practice in a community hospital: the interventional radiologist as an equal partner in patient care.

Development of an interventional radiology practice or section depends first on the commitment and ability of the interventionalist but is also contingent on an appropriate environment. Moreover, the interventionalist must attempt to change long-standing concepts and referral patterns with aggressive dissemination of information. He or she must be an advocate of the procedures offered, as well as their benefits to the patient and the health care system. One must actively include outpatient visits and admissions as part of services offered. Allies in this effort include primary care physicians, internists, hospital administration, and third-party payers. In addition, organized radiology can now offer some assistance through the Society of Cardiovascular and Interventional Radiology and the American College of Radiology. All of these factors will contribute significantly to the success of interventional radiology in both teaching and community hospital settings.