What is interventional ? refused amputation. Following this, despite 2. Opening up of blocked tubes (, , , or IR, is a new scepticism from his surgical colleagues, the bile ducts, ureters, fallopian tubes etc) specialty that has been responsible for leg pain ceased, she started walking and her 3. Stopping from any cause major recent medical advancement. It is at leg improved. Dr Charles Dotter was (gastrointestinal bleeding, obstetric and the forefront of medical technology and nominated for the Nobel Prize in in gynaecological bleeding, traumatic bleeding, innovation. Although IR is less well known 1978. bleeding after , brain , by GPs, IR is typically referred to as the The term ‘interventional radiology’, however, vascular malformations) by occluding the specialist’s ‘specialist’. It is responsible for was not conceived until March 1967 when an vessels with embolisation image-guided minimally invasive American radiologist, Alexander Margulis, 4. Destroying tumours in the liver, lung, kidney procedures and you may have described it in an edition of the American by delivering local chemotherapy, thought more usually carried out by Journal of Roentgenology. embolisation or ablation techniques (such as surgeons. What skills do interventional radiologists cryotherapy and ) IR is a minimally invasive alternative to (IRs) have? 5. Minimally invasive treatments of thoracic and open surgery that uses radiological image IRs have expertise in guiding small needles, abdominal aneurysms guidance (X-rays, , CT and MRI) and other medical equipment into to aid treatment. In many circumstances, 6. Preoperative embolisation to improve the the body through tiny (5–10 mm) incisions in safety of surgery. surgery can be avoided and the risks to the the skin to treat disease. The treatments patient can be lowered with faster recovery performed are truly minimally invasive. Patient safety times. IR can also be used as an adjuvant However, the basic skills of an IR are still IRs pioneered the safe and high-quality to surgery and combined procedures with image interpretation and, therefore, core procedures and standards for performing surgeons can optimise patient care. diagnostic radiology is at the of minimally invasive therapies, with a When did IR start? interventional radiology training. This concentration on patient safety. IR developed in diagnostic in combined skill has meant that there is hardly IRs are specialists of radiology, who have the 1960s, after the any area of medicine where IR has completed further education and training in was described by Dr Sven-Ivar Seldinger in not had an impact on patient management. diagnostic radiology and interventional 1953. The technique described used a What can IR treat? radiology including radiation safety, radiation hollow needle and guide wire to access a You maybe surprised to know the extent of physics, the biological effects of radiation, vessel. therapies now performed predominantly by injury prevention and clinical practice. An American radiologist, Dr Charles Dotter, IRs. Traditionally surgeons performed a lot of What are the advantages of IR? altered the course of cardiovascular these procedures, although a significant IR therapies are minimally invasive and interventional radiology in 1964 and is amount of treatments are new and typically only require a short stay in hospital. considered the father of IR. He modified the innovative. A significant number of these procedures are Seldinger technique for therapeutic Virtually all body parts and systems can be performed as day cases. General purposes. On 16 January 1964, IR was born treated using IR techniques. However, broad anaesthesia is usually not required. Risk, when Dotter percutaneously dilated a tight categories of treatments available include: pain and recovery time are usually reduced stenosis of a femoral , using a plastic compared with conventional surgery. tube (), in an 82-year-old lady with 1. Draining of fluid collections (abscesses, painful leg ischaemia and who dilated kidneys, pleural effusions) Can we be referred directly to an IR?  1980s Biliary The answer is yes. IR is a progressive  1982 Transjugular intrahepatic specialty and is developing at a fantastic portosystemic shunts (TIPS) speed. Most IRs offer direct referrals from  1983 development of balloon expandable your GP with no need to be seen by another stents specialist (traditionally a surgeon). IRs often run outpatient and have access to  1990s Treatment of bone and kidney day-case beds if you need a simple tumours by embolisation procedure. IRs typically work as part of a  1990 Radiofrequency ablation of liver multidisciplinary team within , so tumours are able to refer you to another team member if it is appropriate. IRs are happy to  1991 Endovascular grafts to treat aortic aneurysms British Society of Interventional discuss patient management with your GP if Radiology they need advice.  1995 Uterine artery embolisation to treat fibroids (UAE) Milestones of IR Best kept secret You may be surprised to learn of the  1999 Endovascular laser (EVLT) advancements in medicine that have been to treat . primarily down to IR innovation. You may Interventional radiology not even have known that IR had been involved. Contact: ‘Minimally invasive specialists’ Here are a few milestones of IR British Society of Interventional Radiology www.bsir.org  1964  1966 Embolisation of spinal tumour  1967 Judkins technique for coronary angiography  1969 Prototype catheter delivered stent This leaflet has been prepared by the British Society of Interventional Radiology (BSIR) and the Clinical Radiology Patients’ Liaison Group (CRPLG) of The Royal College of Radiologists. Approved by the Board of the Faculty of Clinical  1970s Embolisation coils Radiology: 25 February 2011  1972 Embolisation of bleeding gut © The British Society of Interventional Radiology (BSIR) 2011.Permission is granted to modify and/or re-produce these leaflets for purposes relating to the Information  1973 Embolisation of pelvic bleeding improvement of provided that the source is acknowledged and that none of the material is used for commercial gain. If modified, the BSIR and RCR secondary to trauma logos should not be reproduced. The material may not be used for any other purpose without prior consent from the Society. Endorsed by  1974 Selective arterial Legal notice  1977 Embolisation of pulmonary Please remember that this leaflet is intended as general information only. It is not definitive, and the RCR and the BSIR cannot accept any legal liability arising from arteriovenous malformations its use. We aim to make the information as up to date and accurate as possible, but please be warned that it is always subject to change. Please therefore always check specific advice on the procedure or any concerns you may have with your  1978 Embolisation of doctor.