EDITORIAL

",ho should do
interventional

radiology?
PeterCorr

MBChB, FFRAD(D)SA, FRCR, M Med(UC7)

Department of Radiology,
University of Natal

With rapid technical advances in interventional techniques over the last five
years the role of the interventional radiologist in patient management is changing.
The whole new speciality of "minimally invasive surgery" is developing led by the
increased use of direct endoscopic techniques and is encroaching on many of the
procedures that have been developed in part by the interventional radiologist. This
is seen particularly in vascular and neurovascular interventional procedures where
vascular surgeons, cardiologists and neurosurgeons are developing interest in
endovascular therapy. The cross-over between radiology, cardiology and surgery
has a number of important implications in training, skills development and ac-
creditation both internationally and in the South African context.

Training in interventional radiology in North America usually entails a 12 month
fellowship for general body intervention and 24 months for neurointervention. In
the United Kingdom, the Royal College of Radiologists recommends a minimum
of 12 months of full time post fellowship training in a recognised centre, of which
there are 12 in the UK. In South Africa there is no training course although some
departments have excellent registrar rotations in interventional radiology.

Development of interventional radiology is dependent on communication to
both clinical colleagues and our own radiology colleagues of the benefits and appli-
cations of interventional techniques to patient management. From personal expe-
rience, convincing one's surgical colleagues of the advantages of interventional ra-
diology can be a long and arduous process. The Society ofInterventional Radiology
has been formed locally and should be able to focus attention and improve educa-
tion in this very important speciality.

Who should perform it? This is a very contentious question in Europe and
North America; however in South Africa where we have a significant skills short-
age, perhaps the most honest local answer is: "The most capable skilled specialist
available". To develop interventional skills, it is very important to understand the
disease process and clinical problems that the surgeon faces in patient manage-
ment. Only by working in a team environment where there is a healthy collegial
relationship between the radiologist and surgeon, will interventional radiology de-
velop and prosper. The radiologist must be available 24 hours a day and must be
prepared to be involved with management of the complications related to the
procedures.

We need, as radiologists, to be aware of not only the rapid developments in this
exciting field but also the added responsibilities to ensure that we do not lose our
potential to contribute to patient care.

The Editor

2 SAJOURNAL OF RADIOLOGY. June 1997