Standards of practice for peripheral and visceral embolisation published


The joint guidelines on standards of practice for embolisation as defined by the Society of Interventional Radiology (SIR), Cardiovascular and Interventional Radiological Society of Europe (CIRSE), and Canadian Interventional Radiology Association (CIRA), were published in the April issue of JVIR (Golzarian et al, April 2010, Vol. 21, Issue 4, pp 436–441).

Marc Sapoval, France, one of the directors of GEST USA, presented some key points on the document at GEST USA 2010. “The guidelines document is a training standard designed to define the way people who are performing embolisation should be trained,” he said.

Sapoval told Interventional News, “In summary, this document covers the clinical, technical and imaging training needed to perform embolisation. On top of that, there is a clear definition of imaging training needed to perform this technically and clinically demanding, minimally invasive procedure. The focus is to ensure that everybody who actually performs embolisation has an appropriate level of training that covers, at least, full imaging training such as radiology certification.

Sapoval shared an excerpt from the document at GEST USA 2010 which read: “Embolisation has grown dramatically in scope and complexity over the past three decades, and with this growth, there is now a need to define standards for those practising in this field including: Appropriate training with monitoring of outcomes; provision of pre-, intra- and post-procedural patient care; and the performance of technical aspects of the procedure.”

He told delegates, “If you have no idea of 3D imaging, or disease conditions other than in your own field, there is a real danger that you will treat an image rather than a patient. Without adequate knowledge and training, there is a high risk that you will apply the wrong technique to the wrong patient. This can result in high complication/failure rates and ultimately, if performed inappropriately, poor acceptance of the technique. The skill needed for embolisation is much more than just using a catheter. We have spent hours discussing the use of embolisation materials. To perform embolisation, we need skills, knowledge and mastery over the equipment, including state-of-the-art imaging capabilities, knowledge of anatomy and radiation protection. High quality fluoroscopy is a must to see very small wires. Mobile C-arms are not appropriate for this intervention.

“Please use this document. It will soon be published in local languages, and I think it will be the basis for clinical privilege if we use it appropriately,” he said.