Interventional Radiology - Current and Future
Interventional Radiology - Current and Future
Anyone who goes through radiological training will be largely based in a central unit that has its own particular caseload and case mix. While training to perform a wide range of procedures, be those either angiographic or in solid organs, trainees will learn all about the different types and applications of angiographic and therapeutic catheters and why certain shapes or designs might or might not be appropriate in a given situation. Each doctor will have a background in general training related to the application of devices, from different types of catheters and guidewires, moving on to different types of balloons and stents or the materials needed for embolization procedures. There is a large bank of shared knowledge and then a lot of it comes down to personal preference. An interventional radiologist that has many years of experience will have a basic kit of several catheters that they commonly use and will keep other things in reserve for more difficult or unexpected situations. There is not a prescription that says you must always use 'this catheter' to do 'this procedure' but there is a lot of experience that directs us as to when to use certain devices and at the same time, specialists will have their own chosen devices that they prefer over others.
When it comes down to issues such as choosing one stent over another, there is some science in it as some devices will work better in certain anatomical areas and in the presence of certain types of lesions, but a lot of this is not terribly well supported by good randomized data. Devices are carefully developed and tested, but often the clinical research behind them is not thorough enough to be conclusive. Partly, this is owing to the speed with which interventional devices are being developed and brought to the market. Before one product has been thoroughly evaluated, a newer generation or alternative is already available and we move on. However, despite the lack of randomized data, there is a substantial evidence base from cohort and observational studies that supports the enhanced outcomes that we can achieve by using these modern interventional devices.
There Are Many Various Catheters & Devices That an Interventional Radiologist Might Use During a Procedure. How Do Radiologists Determine What Equipment Is Most Appropriate & Most Effective for Each Procedure?
Anyone who goes through radiological training will be largely based in a central unit that has its own particular caseload and case mix. While training to perform a wide range of procedures, be those either angiographic or in solid organs, trainees will learn all about the different types and applications of angiographic and therapeutic catheters and why certain shapes or designs might or might not be appropriate in a given situation. Each doctor will have a background in general training related to the application of devices, from different types of catheters and guidewires, moving on to different types of balloons and stents or the materials needed for embolization procedures. There is a large bank of shared knowledge and then a lot of it comes down to personal preference. An interventional radiologist that has many years of experience will have a basic kit of several catheters that they commonly use and will keep other things in reserve for more difficult or unexpected situations. There is not a prescription that says you must always use 'this catheter' to do 'this procedure' but there is a lot of experience that directs us as to when to use certain devices and at the same time, specialists will have their own chosen devices that they prefer over others.
When it comes down to issues such as choosing one stent over another, there is some science in it as some devices will work better in certain anatomical areas and in the presence of certain types of lesions, but a lot of this is not terribly well supported by good randomized data. Devices are carefully developed and tested, but often the clinical research behind them is not thorough enough to be conclusive. Partly, this is owing to the speed with which interventional devices are being developed and brought to the market. Before one product has been thoroughly evaluated, a newer generation or alternative is already available and we move on. However, despite the lack of randomized data, there is a substantial evidence base from cohort and observational studies that supports the enhanced outcomes that we can achieve by using these modern interventional devices.
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