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Interventional Radiology
Croatia and Interventional Radiology Asst. Prof. Vinko Vidjak MD, PhD Clinical Hospital Merkur Zagreb, Croatia RENAL SONOGRAPHY Ultrasound is a very valuable modality for evaluation of the kidneys. Although CT has superceded ultrasound in renal evaluation in many instances, ultrasound is still a very useful, quick, non-invasive, relatively inexpensive, ubiquitous technique, particularly useful in children. This Core Curriculum teaching slide series was produced by the Jefferson Ultrasound Research and Educational Institute of Thomas Jefferson University through an educational grant from the Open Society Institute , New York. The author of this Core Curriculum module is Oksana H. Baltarowich, M.D.
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CRO = HR Croatia = Hrvatska Inhabitants: 4.3 mill
IR in Croatia, Turkey, Antalya March 2014 Inhabitants: 4.3 mill CRO = HR Croatia = Hrvatska
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Nikola Tesla Tesla = Weber/m²
IR in Croatia, Turkey, Antalya March 2014 Nikola Tesla Tesla = Weber/m²
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Nikola Tesla Tesla = Weber/m²
IR in Croatia, Turkey, Antalya March 2014 Nikola Tesla Tesla = Weber/m²
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Science and Education in Croatia?
IR in Croatia, Turkey, Antalya March 2014 Science and Education in Croatia?
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IR in Croatia, Turkey, Antalya 19-22 March 2014
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IR in Croatia, Turkey, Antalya 19-22 March 2014
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Radiology education and mentorship?
IR in Croatia, Turkey, Antalya March 2014 Radiology education and mentorship?
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Radiology education and mentorship?
IR in Croatia, Turkey, Antalya March 2014 Radiology education and mentorship? 4 University Centers
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Radiology education and mentorship?
IR in Croatia, Turkey, Antalya March 2014 Radiology education and mentorship? 4 University Centers Residency programme harmonised with UEMS/ESR training curriculum
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Radiology education and mentorship?
IR in Croatia, Turkey, Antalya March 2014 Radiology education and mentorship? 4 University Centers Residency programme harmonised with UEMS/ESR training curriculum Oral and practical board exams
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Radiology education and mentorship?
IR in Croatia, Turkey, Antalya March 2014 Radiology education and mentorship? 4 University Centers Residency programme harmonised with UEMS/ESR training curriculum Oral and practical board exams Committee consisting of three examiners
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Croatian Society of Radiology
IR in Croatia, Turkey, Antalya March 2014 Croatian Society of Radiology 316 radiologists + 64 radiology residents 4.4 mill inhabitants: 1 radiologist per inhabitants incl residents 1: inhabitants 1200 radiographers
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IR in Croatia, Turkey, Antalya 19-22 March 2014
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Section of Interventional Radiology- Croatia – sIRcro
IR in Croatia, Turkey, Antalya March 2014 Section of Interventional Radiology- Croatia – sIRcro Officially since 2000.g. Unofficially since 1990.g.
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Section of Interventional Radiology- Croatia – sIRcro
IR in Croatia, Turkey, Antalya March 2014 Section of Interventional Radiology- Croatia – sIRcro Officially since 2000.g. Unofficially since 1990.g. Regular Meetings with International Parcitipation every 2 years since 1986. Cooperation with Slovenia, Austria, Hungary
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Section of Interventional Radiology- Croatia – sIRcro
IR in Croatia, Turkey, Antalya March 2014 Section of Interventional Radiology- Croatia – sIRcro Officially since 2000.g. Unofficially since 1990.g. Regular Meetings with International Parcitipation every 2 years since 1986. Cooperation with Slovenia, Austria, Hungary CIRSE Group Member since 2010
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Section of Interventional Radiology – today
IR in Croatia, Turkey, Antalya March 2014 Section of Interventional Radiology – today 41 radiologists + 7 radiology residents Most radiologists or smaller procedures (punction, drainage) under US control, diagnostic angiography,..
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Section of Interventional Radiology – today
IR in Croatia, Turkey, Antalya March 2014 Section of Interventional Radiology – today 41 radiologists + 7 radiology residents Most radiologists for smaller procedures (punction, drainage) under US control, diagnostic angiography,.. Significant angio therapeutic procedures Neuroradiologic interventions EVAR, TIPS, CAS, BTK, tm embolisation, ..
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Section of Interventional Radiology – today
IR in Croatia, Turkey, Antalya March 2014 Section of Interventional Radiology – today 41 radiologists + 7 radiology residents Most (41 radiologists) for smaller procedures (punction, drainage) under US control, diagnostic angiography,.. Significant angio therapeutic procedures Neuroradiologic interventions EVAR, TIPS, CAS, BTK, tm embolisation, .. - 8 cath labs
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Section of Interventional Radiology – today
IR in Croatia, Turkey, Antalya March 2014 Section of Interventional Radiology – today 41 radiologists + 7 radiology residents Most (41 radiologists) for smaller procedures (punction, drainage) under US control, diagnostic angiography,.. Significant angio therapeutic procedures Neuroradiologic interventions EVAR, TIPS, CAS, BTK, tm embolisation, .. - 8 cath labs - 2 cath labs
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Section of Interventional Radiology – today
IR in Croatia, Turkey, Antalya March 2014 Section of Interventional Radiology – today 41 radiologists + 7 radiology residents Most (41 radiologists) for smaller procedures (punction, drainage) under US control, diagnostic angiography,.. Significant angio therapeutic procedures Neuroradiologic interventions EVAR, TIPS, CAS, BTK, tm embolisation, .. - 8 cath labs - 2 cath labs - 4 cath labs
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IR in Croatia, Turkey, Antalya 19-22 March 2014
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Interventional Radiology – training
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology – training
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Interventional Radiology – training
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology – training Subspecialisation of radiology (general radiology+2 years)
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Interventional Radiology – training
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology – training Subspecialisation of radiology (general radiology+2 years) Subspecialty exam since 2000 (IR, NR, UZV)
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Interventional Radiology – training
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology – training Subspecialisation of radiology (general radiology+2 years) Subspecialty exam since 2000 (IR, NR, UZV) PROGRAM 5 months on nonradiology clinical departments (vasc.,abd.,thorac.,urorad./surgery and oncol) 9 months on vascular IR procedures 8 months non vascular IR procedures
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Interventional Radiology – training
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology – training Subspecialisation of radiology (general radiology+2 years) Subspecialty exam since 2000 (IR, NR, UZV) PROGRAM 5 months on nonradiology clinical departments (vasc.,abd.,thorac.,urorad./surgery and oncol) 9 months on vascular IR procedures 8 months non vascular IR procedures Oral and practical board exams
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Interventional Radiology - training
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology - training
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Interventional Radiology - training
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology - training PROGRAM Nr of procedure and….. vascular IR… PTA (30), stents (20), EVAR (ass),…. TIPSS (10 ass, 2 alone),…… non vascular IR US guided drenaige (40), US guided biopsy (30)…
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IR in Croatia, Turkey, Antalya 19-22 March 2014
IR experience …………….
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IR experience ……………. (… two institutions) 2009.g : 1550 hospital beds
IR in Croatia, Turkey, Antalya March 2014 IR experience ……………. (… two institutions) 2009.g : 1550 hospital beds Annualy more than angio therapeutic procedures Type of procedures: PAD (pta/stenting), PTA/stenting on other arteries, CAS, EVAR, embolisations, reocclusive technics (mechanical, aspiration thrombectomy, thrombolysis),interventional oncology (TACE, RFA...) billiary, urogenital, digestive interventions, CT controlled interventions,....
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IR experience Procedures graph (… two institutions) 2009.g.:
IR in Croatia, Turkey, Antalya March 2014 IR experience Procedures graph (… two institutions) 2009.g.: vascular interventions pts EVAR / TEVAR CAS PTA / stenting SFA PTA / iliac artery stenting BTK Mechanical thrombectomy 15 Embolisation
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IR experience Procedures graph (… two institutions) 2009.g.:
IR in Croatia, Turkey, Antalya March 2014 IR experience Procedures graph (… two institutions) 2009.g.: non vascular interventions pts Billiary Urogenital Esophageal CT / US drainage
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Clinical Hospital Merkur – Zagreb
IR in Croatia, Turkey, Antalya March 2014 Clinical Hospital Merkur – Zagreb Associate Professor Vinko Vidjak, MD, PhD IR experience More than 800 (angio therapeutic + diagnostic) procedures anually Treatment types: PAD (pta/stent), PTA/stent on other arteries, subintim rec., CAS, EVAR, BTK, embolisation, reocclusive techniques (mechanical, aspiration thrombectomy, TIPSS, (thrombolysis), billiary, urogenital, digestive interventions, CTguided drainage,....
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Clinical Hospital Merkur – Zagreb
IR in Croatia, Turkey, Antalya March 2014 Clinical Hospital Merkur – Zagreb Associate Professor Vinko Vidjak, MD, PhD - IR subspecialization mentorship - Ambulatory IR consultations IR experience More than 800 (angio therapeutic + diagnostic) procedures anually Treatment types: PAD (pta/stent), PTA/stent on other arteries, subintim rec., CAS, EVAR, BTK, embolisation, reocclusive techniques (mechanical, aspiration thrombectomy, TIPSS, (thrombolysis), billiary, urogenital, digestive interventions, CTguided drainage,....
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Clinical Hospital Merkur – Zagreb
IR in Croatia, Turkey, Antalya March 2014 Clinical Hospital Merkur – Zagreb Associate Professor Vinko Vidjak, MD, PhD - IR subspecialization mentorship - Ambulatory IR consultations IR experience More than 800 angio therapeutic + diagnostic procedures anually Treatment types: PAD (pta/stent), PTA/stent on other arteries, subintim rec., CAS, EVAR, BTK, embolisation, reocclusive techniques (mechanical, aspiration thrombectomy, TIPSS, (thrombolysis), billiary, urogenital, digestive interventions, CTguided drainage,....
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Experience in organization of IR meetings?
IR in Croatia, Turkey, Antalya March 2014 Experience in organization of IR meetings?
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sIRcro 2009 VII. Meeting of Croatian Interventional Radiologists
IR in Croatia, Turkey, Antalya March 2014 VII. Meeting of Croatian Interventional Radiologists with International Participation sIRcro 2009 Lectures: 80 Lecturers: 57 Participants: 240 Clinical Faculty Okan Akhan Firas Al-Ali Massimiliano Fusaro Antonin Krajina Robert Morgan Zoran Milošević Andrej Schmidt Luc Stockx István Szikora Renan Uflacker Christof Zollickoffer
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Moto: bringing IR closer to clinitians
IR in Croatia, Turkey, Antalya March 2014 VII. Meeting of Croatian Interventional Radiologists with International Participation sIRcro 2009 Moto: bringing IR closer to clinitians Lectures: 80 Lecturers: 57 Participants: 240 Clinical Faculty Okan Akhan Firas Al-Ali Massimiliano Fusaro Antonin Krajina Robert Morgan Zoran Milošević Andrej Schmidt Luc Stockx István Szikora Renan Uflacker Christof Zollickoffer
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IR in Croatia, Turkey, Antalya 19-22 March 2014
VIII. Meeting of Croatian Interventional Radiologists with International Participation sIRcro 2011 International Clinical Faculty Jan Raupach Istvan Battyany Pavel Berden Tomaž Ključevšek Karl-Ludwig Schulte Markus Graf Maria Schoder Dimitrij Kuhelj Andrej Schmidt Zoran Milošević …………… Lectures: 85 Lecturers: 60 Participants: 230
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Moto: bringing IR closer to young radiologists
IR in Croatia, Turkey, Antalya March 2014 VIII. Meeting of Croatian Interventional Radiologists with International Participation sIRcro 2011 Moto: bringing IR closer to young radiologists International Clinical Faculty Jan Raupach Istvan Battyany Pavel Berden Tomaž Ključevšek Karl-Ludwig Schulte Markus Graf Maria Schoder Dimitrij Kuhelj Andrej Schmidt Zoran Milošević …………… Lectures: 85 Lecturers: 60 Participants: 230
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sIRcro 2013 IX. Meeting of Interventional Radiologists
IR in Croatia, Turkey, Antalya March 2014 IX. Meeting of Interventional Radiologists of Croatiawith international participation sIRcro 2013 International Clinical Faculty Andrej Schmidt , Leipzig Hart Zentrum, Germany Jan Raupach, Hradec Králové, The Czech Republic Okan Akhan, Ankara, Turkey Marco Manzi , Abano Terme, Padua, Italy Firas Al Ali , Kalamazoo, USA Zoran Milošević , KBC Ljubljana, Slovenia Antonin Krajina , Hredec Kralove, Czech Republic Raman Uberoi , Oxford, Great Britain Istvan Battany , KB Pesch, Hungary Lectures: 90 Lecturers: 70 Participants: 270
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Moto: hot topics in IR sIRcro 2013
IR in Croatia, Turkey, Antalya March 2014 IX. Meeting of Interventional Radiologists of Croatiawith international participation sIRcro 2013 Moto: hot topics in IR International Clinical Faculty Andrej Schmidt , Leipzig Hart Zentrum, Germany Jan Raupach, Hradec Králové, The Czech Republic Okan Akhan, Ankara, Turkey Marco Manzi , Abano Terme, Padua, Italy Firas Al Ali , Kalamazoo, USA Zoran Milošević , KBC Ljubljana, Slovenia Antonin Krajina , Hredec Kralove, Czech Republic Raman Uberoi , Oxford, Great Britain Istvan Battany , KB Pesch, Hungary Lectures: 90 Lecturers: 70 Participants: 270
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AVS 2010
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IR in Croatia, Turkey, Antalya 19-22 March 2014
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Modul education: I Carotid artery, II Femoral and SFA III BTK
IR in Croatia, Turkey, Antalya March 2014 Modul education: I Carotid artery, II Femoral and SFA III BTK from 2010 part of Crossroads "Centers of exellence"
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Interventional Radiology -Why interest???
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology -Why interest???
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Interventional Radiology -Why interest???
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology -Why interest??? Creative
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Interventional Radiology -Why interest???
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology -Why interest??? Creative Attractive
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Interventional Radiology -Why interest???
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology -Why interest??? Creative Attractive Innovative
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Interventional Radiology -Why interest???
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology -Why interest??? Creative Attractive Innovative Multipotent
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BUT !!! Interventional Radiology -Why interest??? Creative Attractive
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology -Why interest??? Creative Attractive Innovative Multipotent BUT !!!
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Interventional Radiology - problems
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology - problems Low monthly IR limits… for depart. More than 40% IR procedures are not recognized by state healtcare (CAS, DEB, PMTh,….. State directed material reimbursment No working benefits for IR doctors
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Interventional Radiology - consequence
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology - consequence Less and less radiologists on IR IR lose interest in profesion mainly due to financial rectrictions Few centers left Low procedure numbers (education?) Inflow of other clinitians ( vascular surgeons, interventional cardiologists …) into IR
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vs Interventional Radiology
IR in Croatia, Turkey, Antalya March 2014 State healtcare vs Interventional Radiology
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Interventional Radiology – solutions
IR in Croatia, Turkey, Antalya March 2014 Interventional Radiology – solutions EU/CIRSE recomendations for IR Education standardisation Implementation of EBIR as national board exam Centers of IR exellence (2-3 in Croatia) without financial restrictions Independent funding for high price procedures Less goverment control More involment of private healtcare companies
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Thank you for your attention
IR in Croatia, Turkey, Antalya March 2014
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Thank you for your attention
IR in Croatia, Turkey, Antalya March 2014 Welcome sIRcro 2015 …….Trust us, we work also …..
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