Interventional radiology – Wikipedia

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.

Interventional radiology (IR), sometimes known as vascular and interventional radiology (VIR), is a medical 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.

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 in 2008.[5] In the UK, interventional radiology was approved as a sub-specialty of clinical radiology in 2010.[6][7] While many countries have an interventional radiology society, there is also the European-wide Cardiovascular and Interventional Radiological Society of Europe, whose aim is to support teaching, science, research and clinical practice in the field by hosting meetings, educational workshops and promoting patient safety initiatives. Furthermore, the Society provides an examination, the European Board of Interventional Radiology (EBIR), which is a highly valuable qualification in interventional radiology based on the European Curriculum and Syllabus for IR.

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.

Vascular

Biliary intervention[15]

Catheter placement

Ablative[17][18]

Genitourinary[20]

Pain management

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Interventional radiology - Wikipedia