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Cardiovascular and Interventional Radiological Society of Europe Interventional Radiology Curriculum for Medical Students C RSEInterventional Radiology Curriculum for Medical Students Introduction It has been recognized that the teaching of radiology in medical schools is vital both for the education of medical students as well as for the future practice of medicine irrespective of their specialty. In addition, it is important that medical students comprehend the increasing role of interventional radiology in hospital medicine. CIRSE has published a curriculum of interventional radiology for medical students, to provide guidance on the learning outcomes required to prepare medical students for their role during ResidencyYears and subsequent life-long learning. This curriculum presupposes that clinical radiology will be taught as a continuous strand throughout the undergraduate medical years. Ideally, interventional radiology teaching should be delivered as part of the clinical radiology teaching programme. The curriculum does not specify forms of delivery. It is felt that this should be left to schools to determine, depending on local circumstances. This curriculum is limited to material that is essential and justifiable. It focuses on common acute clinical problems. Rare clinical conditions are included where their identification can help avoid a potentially serious outcome. It is recommended that the students’interventional radiology curriculum should impart knowledge of: · The basis of interventional radiology and its historical context · Image guidance for interventional procedures · Knowledge of radiation protection guidelines for interventional procedures · Knowledge of the legislation relating to the use of interventional radiology in clinical practice Cardiovascular and Interventional Radiological Society of Europe 1Interventional Radiology Curriculum for Medical Students SuggestedCoreSyllabus On completion of the program the student should demonstrate knowledge and recognition of the subjects listed below. VASCULAR INTERVENTIONAL RADIOLOGY Peripheral Arterial Disease Acute limb ischemia · Atherosclerosis · Clinical presentation (pathology, risk factors, genetics, drug management) · Classification of ischemia · How to diagnose · Treatment strategies: thrombectomy / thrombolysis / (non-invasive imaging, duplex US, CTA, MRA) mechanical / pharmacomechanical · Angioplasty - how it works and where it is applied Claudication and critical limb ischemia Aneurysmal disease – abdominal aorta · Clinical presentation of each condition and significance · Clinical presentation – rupture risk · When and how to image · EVAR (indications – tools – success rates, complications) · The role of IR in treatment · EVAR in ruptured AAAs · Longterm EVAR surveillance – how to treat endoleaks Aneurysmal disease – thoracic aorta and other complications · Clinical presentation – rupture risk · Surgical vs.TEVAR SPECIFIC CASE SCENARIOS A patient with a carotid stenosis A patient with hemoptysis · Cerebrovascular risk associated with carotid bifurcation dis- · When to call the Interventional Radiologist? ease (how to select a patient for treatment?When to treat? · What imaging modality will help identify the bleeding site and What is CEA?What is CAS? cause? · Carotid stenting: stent, cerebral protection devices · What is bronchial artery embolization? A young patient with sudden onset of hypertension Acirrhoticpatientwithvaricealbleedingorintractableascites · The pathophysiology of renovascular hypertension, · How is the diagnosis of portal HTN established fibromuscular dysplasia. · When isTIPS indicated? · How to image the renal arteries; US vs. MR vs. CTA vs. DSA · How is theTIPS performed? · PTA for FMD? · What are the results and complications? A patient with pulmonary embolism A young man with varicocele · How to image the pulmonary arteries? · How to image the scrotum · How to prevent PE; prophylaxis with medications · What is the significance of varicocele? · Indications for IVC filters? · How and when to embolize? A patient with acute limb swelling and pain A woman with uterine fibroids · What is DVT? · Clinical presentation of fibroids · Imaging with US, CT venography and contrast venography · Why is Uterine Artery Embolization (UAE) a very good treatment · Common treatment option? · When are thrombolysis and adjunctive treatments indicated? · How is UAE performed? A patient with GI Bleeding A catastrophic event at childbirth · What are the etiologies? · What is Post Partum Hemorrhage (PPH)? · Modalities of treatment: endoscopy first · When is the risk for PPH high? · How to image if the first option fails: · What is the IR’s role in PPH? nuclear medicine vs. MDCT · When to embolize and how? Trauma · How to image the severely injured patient · Embolization of solid organs · Embolization for pelvic arterial bleeding Cardiovascular and Interventional Radiological Society of Europe 2Interventional Radiology Curriculum for Medical Students NON-VASCULAR INTERVENTIONAL RADIOLOGY Image-guided percutaneous biopsies Interventional Radiology for the GI tract · Biopsies of thyroid, breast, and other superficial organs · Percutaneous gastrostomy · Lung and mediastinum · Esophageal and colonic stents · Liver and pelvis SPECIFIC CASE SCENARIOS How to manage the patient with obstructive uropathy How to manage the jaundiced patient · Percutaneous nephrostomy and ureteric stenting · List the more common causes of obstructive jaundice · How to define the level and etiology of obstruction A patient with post-operative fluid collection and sepsis · When is percutaneous intervention indicated? · How to image abdominal collections · When and how to drain abdominal and pelvic abscesses INTERVENTIONAL RADIOLOGICAL ONCOLOGY How to ensure venous access for chemotherapy Liver metastases · What is a PICC line? · How to select patients for ablation / or transcatheter · What is a venous port and why should this be performed by treatment an IR? · What is a Hickman catheter? How to treat renal carcinoma · When is ablation indicated? Hepatocellular carcinoma · What is the role of embolization for RCC? · Imaging diagnosis · Patient selection for surgery, ablation, chemoembolization / When and how to treat lung masses radioembolization · RFA and other ablative techniques MUSCULOSKELETAL INTERVENTIONAL RADIOLOGY · When and how to perform an image guided biopsy of · When and how to perform percutaneous image guided muscles and bones vertebral augmentation techniques (vertebroplasty, · When and how to image a patient with back pain and kyphoplasty) neuralgias · When and how to perform percutaneous image-guided · When and how to perform percutaneous image guided ablation of bone or soft tissue lesions (benign and decompression of intervertebral discs malignant) Cardiovascular and Interventional Radiological Society of Europe 3CIRSE Central Office Neutorgasse 9 1010Vienna, AUSTRIA Tel: + 43 1 904 2003 Fax: + 43 1 904 2003 30 Email: office@cirse.org www.cirse.org © All rights reserved by CIRSE Cardiovascular and Interventional Radiological Society of Europe / 2012 GraphX by L O O P. 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