Mercedes Pérez Lafuente, head of the Interventional Radiology Unit at the Vall d’Hebron Hospital in Barcelona and a member of the Spanish Society of Medical Radiology (SERAM).
The Royal Decree on Specialties, approved last July, can turn this situation around. “Work is being done on the creation of the Specific Training Areas (ACEs), specifically, in the ACE of Interventional Radiology. Regulated and paid training will facilitate the hiring of personnel to create or promote Intervention units, which have specialized professionals, ”he details. But nothing has been established yet, and he anticipates that if the bases of these areas are not clear and delimited, there is a risk of intrusion from other spatialities.
Interventional Radiology today not a specialtybut the training is limited to three months of rotation during the four years of specialization and, if one of the limited places is obtained, to a program that offers the Spanish Society of Interventional Radiology (served). The doctor explains that many other professionals choose to go to other countries for their training or that it is even not unusual for the professionals themselves to have to train other colleagues who join the unit due to lack of subspecialization.
This is even more pronounced, he stresses, in the area of Pediatric interventionism. Pérez Lafuente adds that, in the case of the smallest patients, to this lack of opportunities for training we must add the centralization of complex pediatric pathology in referral hospitals. This has positive and negative aspects at the same time. On the one hand, it offers “excellent” training and provides greater experience for the management of low-incidence pediatric pathologies. On the other hand, this means that there are few centers enabled for it. “There are few hospitals with an Interventional Radiology Service trained to treat this patient profile and logically there are few centers with the capacity to train pediatric interventional radiologists”, he emphasizes.
The specialist ensures that there are huge differences between adult and child patients, from specific pathologies of the child that do not exist in older people, going through different hemodynamic responses depending on age and ending with different possibilities of complications. In addition, the contrast dose fluctuates depending on the patient’s weight, which is why he defends that Pediatric Interventionism should be carried out by experts. “First you have to be a good adult interventional radiologist to later train in Pediatrics”, he thinks. To obtain the necessary knowledge, some health professionals opt for specific training in pediatric centers in countries such as the United States or Canada.
The present and future situation of the area in Spain
Pérez Lafuente, who won the prize for the profession from the Spanish Society of Medical Radiology (SERAM) last November, details that, as a consequence of the lower demand for procedures in the pediatric field, compared to Interventionism in adults , there has been less interest on the part of the industry in the technological development of materials suitable for the size and age of children. “We have had to reinvent ourselves by adapting the materials already used in adults. Fortunately, in some areas, progress has been made by giant steps, ”he details. Some of these materials, such as microcatheters, stents or microguides, have been of great help in pediatric procedures and have resulted in an increase in the number and type of procedures that physicians perform, without the weight or pressure Age is an impediment.
In Spain, the situation is similar to that of other European countries, defend. The difference can lie in the size of pediatric centers and, therefore, the volume of patients treated. Regarding the number of Spanish radiologists with the relevant education, the specific physician who Very few are adequately trained to manage complex pediatric pathologies.
As for the near future, Interventional Radiology has positioned itself in the therapeutic algorithms for adult patient pathologies and Pediatric Interventionism is following the same evaluation. “Due to its less invasiveness Regarding open surgery, It is already considered as part of current therapeutic strategies”, he details.
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