CIRSE Clinical Practice Manual

Abstract

Background: Interventional radiology (IR) has come a long way to a nowadays UEMS-CESMA endorsed clinical specialty. Over the last decades IR became an essential part of modern medicine, delivering minimally invasive patient-focused care.

Purpose: To provide principles for delivering high quality of care in IR.

Methods: Systematic description of clinical skills, principles of practice, organizational standards and infrastructure needed for the provision of professional IR services.

Results: There are IR procedures for almost all body parts and organs, covering a broad range of medical conditions. In many cases IR procedures are the mainstay of therapy, e.g. in the treatment of hepatocellular carcinoma. In parallel the specialty moved from the delivery of a procedure towards taking care for a patient's condition with the interventional radiologists taking ultimate responsibility for the patient's outcomes.

Conclusions: The evolution from a technical specialty to a clinical specialty goes along with changing demands on how clinical care in IR is provided. The CIRSE Clinical Practice Manual provides interventional radiologist with a starting point for developing his or her IR practice as a clinician.

Keywords: Clinical practice; Interventional radiology; Patient care; Practice development; Quality standards.

Fig. 1

The IR process with the interventional radiologist taking responsibility for a patient through the entire clinical process

Fig. 2

Exemplified win–win situation where IR provides various services for clinical partners, which enables them to increase their portfolio. Examples include TIPS after initial endoscopy to prevent re-bleeding, image-guided tissue sampling, freeing OR capacities for the surgical department by implanting ports or PICC lines, enabling more complex surgical procedures by providing pre- and post-surgical support services, etc. Ultimately, offering such a broad portfolio will increase the number of patients referred to the hospital and specifically attract patients with more complex diseases, leading to a higher case-mix-index so that eventually all departments profit by increasing their revenue

Fig. 3

A SWOT analysis covering Strengths, Weaknesses, Opportunities and Threats of a typical IR business on one glance, an essential tool in most business plans

Fig. 4

CIRSE patient safety checklist covering all phases of an intervention