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Techniques in Vascular and Interventional Radiology

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https://read.qxmd.com/read/30765076/high-fidelity-endovascular-simulation
#1
Ayush Amin, Jason Salsamendi, Thomas Sullivan
With the ongoing changes in graduate medical education, emphasis has been placed on simulation models to increase clinical exposure and optimize learning. In specific, high-fidelity simulation presents as a potential option for procedural-skill development in interventional radiology. With improved haptic, visual, and tactile dynamics, high-fidelity endovascular simulators have gained increasing support from trainees and certified interventionalists alike. The 2 most common high-fidelity endovascular simulators utilized today are the Procedicus VIST and ANGIO Mentor, which contain notable differences in technical features, case availability, and cost...
March 2019: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30765075/simulation-based-training-for-interventional-radiology-and-opportunities-for-improving-the-educational-paradigm
#2
Zoe A Miller, Ayush Amin, Joanthan Tu, Ana Echenique, Ronald S Winokur
The current model for medical education is based on the Master-Apprentice model which was adopted into practice over a century ago. Since then, there have been many changes in healthcare and the environment in which trainees learn, practice and become proficient in procedural and critical thinking skills. The current model for medical education has however, not changed considerably in this time frame, resulting in significant limitations to trainee education. Simulator-based training is a technique which can minimize the limitations of the apprenticeship model by mitigating the effect of time constraints, increased emphasis on patient safety and satisfaction and nonstandardization of Interventional Radiology (IR) curricula...
March 2019: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30765074/multidisciplinary-team-training-simulation-in-interventional-radiology
#3
Kimberly Scherer, Ronald S Winokur
Efficient teamwork and communication is critical for the delivery of safe and high quality patient care. Studies have shown that medical errors can occur as a result of poor communication. Simulation scenarios can help improve communication and teamwork, therefore decreasing errors and improving team morale. Simulation is best employed through a multidisciplinary approach, including all members of the team involved in the patient's care. Team simulation can be difficult to plan and execute, therefore we will review the steps to planning an effective multidisciplinary team simulation, as well as the barriers to overcome when implementing these programs...
March 2019: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30765073/tools-for-simulation-low-budget-and-no-budget
#4
Benjamin J May, Joe K Khoury, Ronald S Winokur
Interventional Radiology (IR) incorporates a unique set of technical skills such as ultrasound-guided needle placement, inferior vena cava filter placement, and wire/catheter exchange, which are not easily attained in other aspects of medical training. Simple, low cost models can allow medical students and residents to attain these skills in a low risk setting. These simulated tasks will ultimately combine to improve preparedness of trainees during patient procedures allowing them to advance more quickly through the training paradigm without patient risk...
March 2019: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30765072/simulation-based-training-of-the-nurse-practitioner-in-interventional-radiology
#5
Ana Echenique, Evelyn P Wempe
Advanced practice registered nurses, such as Nurse Practitioners (NPs), can be found working in a variety of settings. Niche practices, such as Interventional Radiology, are highly specialized areas and are often specialties in which few NPs get to orient through during their graduate nursing program clinical rotations. For the NP transitioning into an Interventional Radiology practice, formal on-the-job orientation and training can assist in gaining specialty-based knowledge and competencies in performing interventional procedures...
March 2019: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30765071/ablation-planning-software-for-optimizing-treatment-challenges-techniques-and-applications
#6
Gray R Lyons, Bradley B Pua
Percutaneous ablation can deliver effective anticancer therapy with minimal side effects; however, undertreatment can lead to disease recurrence and overtreatment can lead to unnecessary complications. Ablation planning software can support the procedure during the planning, treatment, and follow-up phases. In this review, 2 examples of microwave ablation software are described with attention to how the software can influence procedural choices. In the future, ablation software will entail larger source datasets and more refined algorithms to better model the in vivo ablation zone...
March 2019: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30765070/three-dimensional-printing-for-procedure-rehearsal-simulation-planning-in-interventional-radiology
#7
Doyoung Chang, Srini Tummala, Dax Sotero, Eric Tong, Luai Mustafa, Moawiah Mustafa, William F Browne, Ronald S Winokur
With the advances in affordable three-dimensional (3D) printing technology, 3D reconstruction and patient-specific 3D printed models are establishing a crucial role in the field of medicine for both educational purposes and procedural planning. 3D printed models provide physicians with increased 3D perception and tactile feedback, and enable a team-based approach to operational planning. However, performing an effective 3D reconstruction requires an in-depth understanding of the software features to accurately segment and reconstruct the human anatomy of interest from preacquired image data from multiple modalities such as computer tomography, 3D angiography and magnetic resonance imaging, and the different 3D printers/materials available in the market today...
March 2019: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30765069/climbing-the-mountain-value-of-simulation-in-interventional-radiology-training
#8
Kumar Shah, Ronald S Winokur
No abstract text is available yet for this article.
March 2019: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545508/aviation-and-procedural-medicine
#9
J Bayne Selby, Anthony Thompson
Aviation and medicine are two complex fields involving many interdependent steps where problems can occur. When they inevitably do the outcome can be catastrophic, leading to injury or even loss of life. While both professions have made great strides to reduce error and improve safety, we would suggest medicine can still learn much from the approach aviation has developed. We will show how pilots spend a significant amount of time on planning and early recognition of impending challenges, utilize the concept of crew resource management routinely, and stay much focused during each specific mission...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545507/how-to-get-out-of-trouble-during-prostatic-artery-embolization
#10
REVIEW
Ari J Isaacson, Rachel L Piechowiak, Charles Nutting, Sandeep Bagla
Prostatic artery embolization can be an extremely challenging procedure often giving the operator the sense of "being in trouble." This feeling can occur during different stages of the procedure including initial identification of the prostatic artery, catheterization of the prostatic artery, and prevention of non-target ischemia via extra-prostatic anastomoses during embolization. This brief guide provides techniques developed from prior experience with these frustrating situations that could potentially help the prostatic artery embolization operator "get out of trouble...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545506/portal-venous-interventions-how-to-recognize-avoid-or-get-out-of-trouble-in-transjugular-intrahepatic-portosystemic-shunt-tips-balloon-occlusion-sclerosis-ie-brto-and-portal-vein-embolization-pve
#11
REVIEW
Trevor M Downing, Sarah N Khan, Rodrick C Zvavanjanja, Zagum Bhatti, Anil K Pillai, Stephen T Kee
Portal venous interventions comprise a large portion of many Interventional Radiology practices today, and remain some of the more technically challenging cases in one's repertoire of procedures. The patients upon whom these procedures are performed are often critically ill, have decompensated disease, or are burdened with comorbid conditions such that they are poor surgical candidates. This leaves them with few options outside the care of Interventional Radiology. Some portal venous interventions, such as transjugular intrahepatic portosystemic shunt, have an established history of excellent clinical success with numerous technical advancements over the years helping to improve outcomes...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545505/image-guided-nephrostomy-interventions-how-to-recognize-avoid-or-get-out-of-trouble
#12
REVIEW
Steven J Krohmer, Anil K Pillai, Carlos J Guevara, Brian Lee Bones, Kevin W Dickey
Image-guided percutaneous nephrostomy is a relatively safe and successful procedure for access to the renal collecting system for multiple purposes including relief of urinary obstruction, urinary diversion, access for endourologic procedures, and diagnostic testing. Although placing a percutaneous nephrostomy catheter is most times straightforward, providing immediate benefit for the patient and satisfaction for the practitioner, there can be situations that make the procedure more difficult or risky. A thorough review of the patient's imaging and medical record will help to set a path for success...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545504/percutaneous-gastrostomy-how-to-recognize-avoid-or-get-out-of-trouble
#13
Peter Bream, Steven J Krohmer, Anil K Pillai, Brian Lee Bones Md, Kevin W Dickey
Placement of gastrostomy tubes can be done with different techniques. The radiologic-guided tube placement relies on image guidance for safe placement of the tube. A thorough knowledge of the immediate and delayed hazards is essential. This article outlines the potential complications and how to recognize, avoid, and treat them. Several clinical examples are included. Key Words: gastrostomy, complication, feeding tubes, image guidance.
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545503/image-guided-biliary-interventions-how-to-recognize-avoid-or-get-out-of-trouble
#14
REVIEW
Steven J Krohmer, Anil K Pillai, Carlos J Guevara, Brian Lee Bones, Kevin W Dickey
Percutaneous biliary interventions have a well-established role in the management of hepatobiliary diseases. Good outcomes include recognizing and avoiding complications. This section will cover the "standard" technique of percutaneous biliary drainage, pearls to decrease the risk of problems, and approaches to treat those complications in patients undergoing percutaneous transhepatic cholangiography and percutaneous transhepatic biliary drainage.
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545502/how-to-recognize-avoid-or-get-out-of-trouble-in-pediatric-interventional-radiology
#15
Sudhen B Desai, Kamlesh U Kukreja
The average clinical practice of most interventional radiologists focuses on the care of adults (for practical purposes, defined as most patients over age 15). However, an increasing number of pediatric patients are being referred to Interventional Radiologists for evaluation and possible treatment. In some cases, these patients may not require significant deviation from the normal procedures of the lab (e.g., a 160 pound 14-year-old), although they may be designated as a pediatric patient by the anesthesia support team...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545501/percutaneous-venous-interventions-in-the-pulmonary-vascular-central-and-peripheral-venous-systems-how-to-recognize-avoid-and-treat-complications
#16
Michael J Miller, LeAnn S Stokes, Rayan Abboud, Zagum Bhatti, Anil K Pillai
Endovascular treatment of venous disease encompasses a broad range of interventions. Both central and peripheral venous interventions can range from the simple to the complex which increases the need for proper patient selection, procedural planning and technical proficiency. The following article will discuss the importance of avoiding, recognizing and addressing complications associated with venous interventions. Our goal is to raise awareness and educate to help the reader improve performance.
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545500/interventional-oncology-keeping-out-of-trouble-in-ablation-techniques
#17
John Smirniotopoulos, Wayne Cheng, Steven Krohmer, Stephen Kee, Bradley Pua
Interventional radiologists provide an essential role in the therapy and management of cancer patients. Computed-tomography (CT) guided percutaneous procedures have enabled interventionalists to treat multiple solid organ malignancies with minimal risk, however, certain lesions may present challenges to physicians due to a difficult approach, or their close proximity to other vital structures. The following presents a brief summary of tips and tricks the interventionalist may use to provide their patients with safe and effective therapy...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545499/interventional-oncology-optimizing-transarterial-therapies-for-the-treatment-of-hepatic-malignancy
#18
REVIEW
Brian E Kouri
The rapidly evolving field of interventional oncology comprises both diagnostic and therapeutic procedures for the treatment of various malignancies. With respect to the liver, the most commonly utilized therapeutic procedures include thermal tumor ablation and transarterial embolization. Transarterial embolization techniques include bland embolization, chemoembolization and radioembolization. To safely and effectively perform these transarterial therapies, the interventional radiologist must have a thorough understanding of relevant arterial anatomy and proficiency in optimally delivering the pertinent embolic agent...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545498/building-a-culture-of-safety-in-interventional-radiology
#19
Johannes Lourens du Pisanie, Robert Dixon
Safety in medicine is a pressing issue. It has been shown that deaths due to medical error range from 98,000 to 400,000 per year in the United States. Since this issue was broached in 1999, a variety of clinical and institutional safety interventions have been pioneered; however, the medical community has realized that without a strong institutional safety culture, the efficacy of these interventions is limited. Changing culture is often a long and difficult process. Just as the wider medical community slowly moves towards the practice of safety culture, interventional radiology must uphold a culture of safety along with its other core tenets throughout its continued evolution...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30545497/introduction
#20
EDITORIAL
Kevin W Dickey
No abstract text is available yet for this article.
December 2018: Techniques in Vascular and Interventional Radiology
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