Ayman Al Sibaie is a consultant interventional radiologist currently working at Rashid Hospital (Dubai, UAE), and has been the president of the Pan Arab Interventional Radiology Society (PAIRS) since 2019. Interventional News interviewed him to delve into his practice in Dubai, to get his take on how interventional radiology (IR) practice varies between the Middle East-North African (MENA) region and the Western world, and his perspective on PAIRS’ work, having been president for the past four years.
IN: Would you be able to provide some insight into your background and IR training?
I am originally Syrian and have German nationality. I studied medicine in Germany and graduated from Friedrich Schiller University Medical School (Jena, Germany) in 1992. Then I did my radiology residency in the same university hospital and finished my postgraduate studies in 1997. I have been in love with IR since the very beginning and I worked as an interventional radiologist in many German cities like Jena and Gera before becoming a consultant of IR in 1998. In 2005, I decided to go to Dubai to start a new career there.
IN: How was it starting a new IR career in Dubai?
It was far from an easy ride. When I first came to Dubai there was nothing—IR was rather a new specialty so I had to start from scratch. The infrastructure was good and the hospital authorities were willing to do anything to help the patients, however I had to talk to companies from my connections in Germany to get the tools. I then started recruiting residents who could help me with cases, and talking to doctors from other specialties to send patients. Fortunately, after 18 years, I can definitely say we have a practice in Dubai that is not at all inferior to those in Europe and the USA.
IN: What is your special interest within IR?
Practising IR in the MENA region requires you to cover a wide spectrum of procedures. For example, the hospital I work in is a trauma centre—one of the biggest emergency and trauma centres in the Middle East—that has different specialties like neuro and vascular, and I am the only IR consultant. This means I have to cover almost all IR procedures, including for aneurysms, arteriovenous malformations, stroke, the aorta, critical limb ischaemia, pulmonary embolism and deep vein thrombosis. Also emergency embolization for bronchial, gastrointestinal bleeds, and renal, as well as elective embolization for uterine fibroids, prostate, and varicose vein management.
IN: What are the key differences in IR practice between the MENA region and Europe?
There are substantial differences on many levels. For example, the regulations are much more flexible in our region, allowing us to use a wide range of supplies from all over the world. There is a lot of variation in diseases in my region due to the difference in weather and our younger population, not to mention the difference in health insurance coverage and a bigger private sector with self-payors in the MENA region compared to in the Western hemisphere.
I would also like to add that there is huge heterogeneity in my region when it comes to IR, from countries with a remarkably advanced IR practice like UAE, Egypt and Saudi Arabia, to countries with no access to IR services at all. Even if there is IR provision in a country, it will tend to be centralised in the major cities, depriving the rural areas. So, in a country like Egypt, of 120 million people, with a high-volume IR practice, almost 90% of trained interventional radiologists are in Cairo.
IN: Talking now about PAIRS, how much progress have you seen in the past few years with the society? What are the challenges, and for the specialty overall? What is your vision for the future?
In 2018, PAIRS had 30 active members. In 2023, we now have more than 1,000. In 2014, the annual meeting was attended by 150 people, whereas in 2023 it was attended by 4,300 people. Now, we are collaborating with all the big IR societies and meetings worldwide like the Cardiovascular and Interventional Radiological Society of Europe, Leipzig Interventional Course, Global Embolization Symposium Technologies, as well as being the regional hub for the different national societies in the MENA region.
As for my vision (although this vision belongs to the whole of the current board), I remember having an eight-hour board meeting in Dubai in the holy month of Ramadan in 2019, when we planned for the years ahead. Our main goal was to transform PAIRS from a successful annual meeting to a fully functioning multicommittee society, working to face challenges, and help doctors and patients in the region to access IR. If you look now, we have a decent website with a big academy, housing hundreds of lectures accessible to all members. We have the Arab Journal of Interventional Radiology growing every day led by Mohammad Arabi as editor-in-chief; we also have the educational committee led by Refaat Salman doing dozens of webinars, which has also started our hands-on courses.
The board has a vision of investing in the younger generation, so we formed the very active residents, fellows and students (RFS) committee led by Rana Khafagy, who initiated the Global IR Juniors Summit organised in collaboration with the Society of Interventional Radiology RFS, the European Trainees Forum, and the British Society of Interventional Radiology. It will be its fourth year in PAIRS next year, and the RFS committee has been also working on the PAIRS IR curriculum, which will be published by the 2024 annual meeting.
Regarding PAIRS’s vision to further promote IR training in the region and to recruit more and more young minds to join IR, PAIRS initiated the #I_AM_ PAIRS IR awareness campaign led by our secretary Karim Abd El Tawab, and it took place in six medical schools in Egypt, Morocco, Saudi Arabia, Tunisia, UAE, and Syria, with almost 1,000 total attendees. Finally, we have the Women in IR committee headed by Noha Guzaiz (King Abdullah Medical City, Makkah, Saudi Arabia), which is dedicated to boosting numbers of female interventional radiologists in the region. Five or six years ago, none of these committees even existed.
IN: What advice do you have for interventional radiologists just starting out?
My advice would be this: you are an interventional radiologist, so you are a hero, as every day you will save lives and can treat disease all over the body. The important thing you have to learn is when not to do cases, where to stop and say “I should not do this case” or “there is a better option for this patient”. As long as you are developing your clinical skills, you should concentrate on making the best decisions for your patients.
