Introduction to IR
Interventional Radiology is a specialty that uses medical imaging in order to perform procedures. IRs use a variety of wires, catheters and other medical equipment to perform procedures through a pinhole incision.
Past, Present and Future
The field of IR has a history of clinical and technical innovation that continues to this day. IR was initially 'angiography' performed for diagnostic purposes. However, Charles Dotter recognised the potential for catheters to be used for intervention. He successfully performed the first angioplasty in 1964.
In the last 50 years, the complexity of procedures has exploded, and IRs became more and more clinically involved. Stents were developed in the late 1960s. IRs began to develop embolisation techniques for bleeding, and thrombolysis to treat clots in the 1970s. The techniques of ablation and chemo-embolisation of tumours was developed in the 80s. By the 90s, there was IR involvement in the majority of body systems.
The innovative spirit of interventional radiologists continues to this day. There has never been a better time to join the field, as IRs are now taking on a more active role in patient management. Developments in robotics, artificial intelligence and personalised medicine promise to further advance the field, and improve what we can do for our patients.
Areas within IR
IR has a role in almost every body system. Like surgery, there are different subspecialty areas of IR that focus on treating different conditions. However, most interventional radiologists have broad training and can perform a wide variety of procedures.
The main areas are:
- Vascular. This mostly deals with peripheral arterial and venous disease and aneurysms.
- Non-vascular. The main areas are hepatobiliary and renal, as well as treating uterine fibroids and enlarged prostates.
- Oncology. The main techniques involved are ablation of tumours using heat or cold, and accessing the blood supply of a tumour to deliver chemotherapy. The majority of work is in liver and renal cancer, but there have been advancements in tumours all over the body.
- Neuro. This mostly deals with acute stroke and aneurysms in the brain.
IR procedures are now essential for emergency care. Emergency interventions include stopping bleeding in major trauma, clot removal in stroke and drainage of infected organs.
Satisfaction rate of IR trainees in 2018 - the second highest of any specialty or subspecialty
Percentage of NHS trusts that have capacity for a 24/7 IR Service
Shortage of interventional radiologists in the UK
Percentage of medical students who feel their knowledge on IR is adequate