Interventional Radiology in Greece

Elias N Brountzos, EBIRHead IR Division

Attikon University Hospital2nd Dept of Radiology, School of Medicine

National and Kapodistrian University of Athens.

Subspecialisation of Interventional Radiology in Europe2009

Interventional Radiology in Greece2012

Republic’s Gazette 3 April 2012:• Interventional Radiology is

established as having subspecialty status within Diagnostic Radiology.

• The content of IR are image-guided procedures both diagnostic and therapeutic which are minimally invasive.

• Such treatments involve peripheral PTA, percutaneous aneurysm management, tumor ablation, etc.

IR in Greece

• Subspecialty of Radiology

• Area of expertise: Image-guided minimal invasive diagnostic or therapeutic medical procedures

• With the exception of coronary and neuro-interventional procedures.

IR training in Greece during DR residency

Current Radiology curriculum• 5 year training.• Interventional Radiology:

mandatory 6-months rotation.

• In some University Hospitals: 3-years IR training.

New Radiology Curriculum• Harmonization with ESR.• 3-years of core knowledge.• 2-years of specialization.

2-years of IR subspecialization within Radiology training.

Subspeciality IR training in Greece

• Board certified Radiologists can apply for Subspecialty.

• Time of training: 2 years. • 16 months theoretical and clinical training in the

field of vascular IR.• 8 months theoretical and clinical training in non

vascular IR.

Subspeciality IR training in GreeceTraining centres:

• Tertiary Hospitals with ≥200 beds covering all the clinical specialties (internal medicine, surgery, oncology, vascular surgery, Intensive Care Unit, etc.)

• With angiography unit, CT, MRI, U/S

Subspeciality IR training in Greece

Selection of applicants:

• Radiology title

• CV

• Personal interview at the selected cites

Subspeciality IR accreditation in GreeceTitle of IR subspecialty

• Acquired after written and oral examinations• IR logbook (150 diagnostic and 100 therapeutic

vascular and non vascular procedures as first of second operator. At least 50 diagnostic and 30 therapeutic procedures as a first operator)

• IR Publications

IR Certificate

Issued by the Greek Ministry of Health

• is important to develop an IR curriculum to ensure that every trainee is trained to a set standard and assessed before they are accredited as specialists. This is particularly important when interventional radiologists cross European borders, and a set curriculum offers a means of ensuring quality control and competency,”

IR procedures in Greece

Late 70s: first stepsToday: all kinds of vascular, non vascular and

emergency IR procedures

INTERVENTIONAL RADIOLOGY IN GREECE (by Prof D Kelekis)

1993 : Foundation of Society of Interventional Radiology 1970: Intraarterial Angiography 1971: Selective angiography of renal and splachnic vessels 1979: Selective embolization of juvenile fibroadenoma 1979: PTA of renal artery 1980: PTA of iliac arteries 1982: Chemoembolization of tumors 1984: Embolization of internal iliac arteries for hemorrhage 1986: Intraarterial thrombolysis 1996: Radiofrequency Ablation 1997: Endovascular Treatment of Abdominal Aneurysms 2004:Chemoembolization with DEB 2009: Microwave Ablation

IR procedures in GreeceEmergency IR

• Trauma centres in the majority of the major Greek hospitals performing endovascular embolization/stenting procedures

• TIPS

• Emergency EVAR- TEVAR network under development

Vascular IR

• PAD (IC, CLI, ALI)

• EVAR-TEVAR

• Dialysis access maintenance

• Venous disease (DVT, Varicose veins)

Non Vascular IR

• Musculoskeletal

• Obstructive uropathy

• Biliary disease

• Image-guided biopsies/drainages

Interventional Oncology

• RFA• TACE• GI/biliary stenting• Supportive care: Port/PICC,pain management

• SIRT currently available in Athens

In all major hospitals

Research

Experimental protocols• Animal labs investigating new

IR devices and techniques.

• Development of various animal models for PAD, cancer, angiogenesis, uropathy, ect.

• Multi-disciplinary experimental protocols (vascular surgeons, urologists, interventional cardiologists, etc.)

Academia of Athens

Clinical Investigation

• Multiple high-impact IR publications in major peer-review journals

• Pioneer work in HCC (TACE) , PAD (infrapopliteal drug-eluting stents), musculoskeletal disease (vertebroplasty) and dialysis access (drug-coated balloons) treatment

• Continuously growing participation in multi-centre trials.

International recognition

• Society of Interventional Radiology (USA) Gold Medal. In 2012.

IR division 2nd Dept of RadiologyAttikon University Hospital

IR in GreeceCIRSE Group member

• Greek Society of Interventional Radiology

www.epemvatiki.gr

• Post-graduate course (MSc) in IR at the University of Athens

CIRSE Group member

Thinks to do…

• Establish a truly clinically oriented IR specialty –within Radiology.

• Create an IR department in every hospital.• Change the Radiology residency curriculum

towards an IR module after a core diagnostic knowledge.

• Attract enthusiastic young physicians who want to be Irs!!