Interventional radiology (IR) was officially born on January 16, 1964, when Charles Dotter performed the first arterial angioplasty at the Department of Radiology at Oregon Health and Science University (Portland, USA). We still can see the prescription Dotter received from the referring physician, which stated: “VISUALISE BUT DO NOT TRY TO FIX!!!” Roberto Luigi Cazzato speaks to Interventional News about the emergence of IR outpatient clinics (IROCs) and his view that IR hospitalisation clinics (IRHCs) will soon begin being established too.
The above phrase summarises what interventionalists are—dreaming souls looking for innovation. For this reason, it is not surprising that in the last few decades, IR has evolved so rapidly that today, at least one type of IR procedure can be done on any and every organ. Moreover, devices and imaging guidance are becoming so sophisticated and precise that new interventions and clinical outcomes are presented yearly. Therefore, as interventional radiologists, we are succeeding in providing innovation in healthcare.
Our willingness for innovation is not only due to our love for novelty and technology. In our minds, innovation has a purpose, and it is a noble one—to serve our patients! For this reason, we stay in close contact with patients before and after interventional procedures.
It is not a surprise that in the last decade, IR initiatives intended to increase contact with our patients and improve their care have flourished. From this perspective, two main measures can be adopted: the IROC for consulting patients before and after the intervention; and on the other side, the IRHC, which provides hospital beds for patients undergoing challenging interventions.
Both of these solutions are desirable for the development of our specialty. However, the clinical, administrative, and financial input to establish IROCs versus IRHCs differs— it is much less costly to establish an IROC compared to an IRHC. In the last decade, newly built IROCs have flourished, with IRHCs less of a priority. The creation of IROCs is the first step, but we are confident that IRHCs will soon become more common.
In the meantime, we can analyse the performance of the IROC so far. In a paper published in CardioVascular and Interventional Radiology (CVIR), the addition of an IROC at the University Hospital of Strasbourg (Strasbourg, France) has had a positive effect on patient care. The results have been quite surprising:
The total number of consultations steadily increased from the first to the last year of the study period (from 693 consultations performed in 2011, to 1595 consultations performed in 2019, which accounts for an increase of 130%); the rate of unattended consultations remained stable throughout the entire study period (around 7%); in the 2018–2019 period, the cumulative procedure conversion rate, namely, the rate of first consultations that led to an IR procedure, was higher than 85%; among the 159 patients being surveyed to evaluate their satisfaction with the IROC, 99.2% highly appreciated their IROC experience, and pointed out that the main aspects they took into account to evaluate their IROC experience were the quality of secretarial and medical services.
These results represent another successful chapter for IR in its so far short, but bright, history. This study points out that as interventional radiologists, we are succeeding in taking care of our patients and that our clinical role is being affirmed, which may pave the way to establishing IRHCs in the near future.
Nevertheless, with patients looking for high-quality secretarial and medical services, these results also show that specific training is required for the employees involved in running the IROC.
The entire IR community is becoming increasingly interested and focused on developing this topic; for this reason, the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) dedicated a lecture to ‘How to establish and run an outpatient clinic’ at its annual meeting (10–14 September, Barcelona, Spain).
Roberto Luigi Cazzato is associate professor at the Department of Interventional Radiology, University Hospital of Strasbourg (Strasbourg, France).
Disclosures: The author declared no relevant disclosures.
