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INTRODUCTION

The purpose of this chapter is to provide a basic guide for the approach to interventional procedures and the patient issues that are common to all interventional procedures. Available procedures and the organization within the radiology department in a particular hospital will reflect the patient population being treated and professional collaborations through which specialized procedures are performed. The American College of Radiology website provides evidence-based guidance for a wide variety of procedures through Interventional Radiology Practice Parameters developed in collaboration with medical specialty societies. Practice parameters are continually reviewed and updated to respond to new issues and health care developments.

INTERVENTIONAL RADIOLOGY PROCEDURES DURING HOSPITALIZATION

The performance of minimally invasive diagnostic and therapeutic procedures has increased dramatically in the 21st century. Such procedures contribute significantly to decrease in length of stay and successful shift of care to the outpatient setting. Central venous catheter placement, thoracentesis, and paracentesis are straightforward procedures that may be organized through one or more divisions within the department of radiology. In some institutions, these will be performed by thoracic radiologists, abdominal radiologists, and angio-interventional radiologists while in other institutions all three will be performed by radiologists in a single interventional radiology division. Many procedures that have previously required open surgery may now be performed in angiography and other specialized radiology suites. The organization of service lines varies among hospitals as will the frequency with which individual procedures are performed. Learn how the service or services are organized in your institution and what procedures are offered. In this introduction, we will present issues that are common to the widest variety of procedures and also examples of how the service may be organized. Minimally invasive procedures are performed in radiology suites using very similar guidelines and procedures to those used for surgery. Inpatient acuity will generally prioritize patients for care although hospitalized patients often require more preparation and coordination for the safe performance of procedures.

ORGANIZATION OF SERVICES

Interventional services may be provided by one group of radiologists who are prepared to perform procedures in a variety of locations, including angiographic suite, ultrasound, and specialized CT and MR suites. In a hospital with strong modality-based organization of services, the radiologists may specialize in performance of procedures within a particular modality such as US, CT, or angiography. If your hospital has subspecialty groups of radiologists who are dedicated to specific organ systems, the interventional services may be performed by the radiologists who also perform and interpret diagnostic procedures in the same organ system regardless of the modality chosen for the procedure.

RADIOLOGY CONSULTATION

Consultation with radiology is as fundamental as consultation with surgery prior to selection and performance of any procedure. The radiologist with whom you normally consult can advise you regarding the organization of services within your hospital. The radiologist who will perform the procedure is best able to ...

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