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Croatia and Interventional Radiology Asst. Prof. Vinko Vidjak MD, PhD Clinical Hospital Merkur Zagreb, Croatia.

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Presentation on theme: "Croatia and Interventional Radiology Asst. Prof. Vinko Vidjak MD, PhD Clinical Hospital Merkur Zagreb, Croatia."— Presentation transcript:

1 Croatia and Interventional Radiology Asst. Prof. Vinko Vidjak MD, PhD Clinical Hospital Merkur Zagreb, Croatia

2 Inhabitants: 4.3 mill CRO = HR Croatia = Hrvatska IR in Croatia, Turkey, Antalya March 2014

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6 Nikola Tesla Tesla = Weber/m² IR in Croatia, Turkey, Antalya March 2014

7 Nikola Tesla Tesla = Weber/m² IR in Croatia, Turkey, Antalya March 2014

8 Science and Education in Croatia? IR in Croatia, Turkey, Antalya March 2014

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11 Radiology education and mentorship? IR in Croatia, Turkey, Antalya March 2014

12 Radiology education and mentorship? 4 University Centers IR in Croatia, Turkey, Antalya March 2014

13 Radiology education and mentorship? 4 University Centers Residency programme harmonised with UEMS/ESR training curriculum IR in Croatia, Turkey, Antalya March 2014

14 Radiology education and mentorship? 4 University Centers Residency programme harmonised with UEMS/ESR training curriculum Oral and practical board exams IR in Croatia, Turkey, Antalya March 2014

15 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 IR in Croatia, Turkey, Antalya March 2014

16 Croatian Society of Radiology 316 radiologists + 64 radiology residents 4.4 mill inhabitants: 1 radiologist per inhabitants incl residents 1: inhabitants 1200 radiographers IR in Croatia, Turkey, Antalya March 2014

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18 Section of Interventional Radiology- Croatia – sIRcro Officially since 2000.g. Unofficially since 1990.g. IR in Croatia, Turkey, Antalya March 2014

19 Section of Interventional Radiology- Croatia – sIRcro Officially since 2000.g. Unofficially since 1990.g. IR in Croatia, Turkey, Antalya March 2014 Regular Meetings with International Parcitipation every 2 years since Cooperation with Slovenia, Austria, Hungary

20 Section of Interventional Radiology- Croatia – sIRcro Officially since 2000.g. Unofficially since 1990.g. IR in Croatia, Turkey, Antalya March 2014 Regular Meetings with International Parcitipation every 2 years since Cooperation with Slovenia, Austria, Hungary CIRSE Group Member since 2010

21 Section of Interventional Radiology – today 41 radiologists + 7 radiology residents Most radiologists or smaller procedures (punction, drainage) under US control, diagnostic angiography,.. IR in Croatia, Turkey, Antalya March 2014

22 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,.. IR in Croatia, Turkey, Antalya March 2014

23 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,.. IR in Croatia, Turkey, Antalya March cath labs

24 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,.. IR in Croatia, Turkey, Antalya March cath labs - 2 cath labs

25 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,.. IR in Croatia, Turkey, Antalya March cath labs - 2 cath labs - 4 cath labs

26 IR in Croatia, Turkey, Antalya March 2014

27 Interventional Radiology – training IR in Croatia, Turkey, Antalya March 2014

28 Interventional Radiology – training Subspecialisation of radiology (general radiology+2 years) IR in Croatia, Turkey, Antalya March 2014

29 Interventional Radiology – training Subspecialisation of radiology (general radiology+2 years) Subspecialty exam since 2000 (IR, NR, UZV) IR in Croatia, Turkey, Antalya March 2014

30 Interventional Radiology – training 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 Subspecialisation of radiology (general radiology+2 years) Subspecialty exam since 2000 (IR, NR, UZV) IR in Croatia, Turkey, Antalya March 2014

31 Interventional Radiology – training 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 Subspecialisation of radiology (general radiology+2 years) Subspecialty exam since 2000 (IR, NR, UZV) Oral and practical board exams IR in Croatia, Turkey, Antalya March 2014

32 Interventional Radiology - training IR in Croatia, Turkey, Antalya March 2014

33 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)… IR in Croatia, Turkey, Antalya March 2014

34 IR experience ……………. IR in Croatia, Turkey, Antalya March 2014

35 IR experience ……………. IR in Croatia, Turkey, Antalya March 2014 (… 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,....

36 IR experience Procedures graph (… two institutions) 2009.g.: vascular interventionspts 1.EVAR / TEVAR32 2.CAS43 3.PTA / stenting SFA206 4.PTA / iliac artery stenting140 5.BTK84 6.Mechanical thrombectomy15 7.Embolisation 90 IR in Croatia, Turkey, Antalya March 2014

37 IR experience Procedures graph (… two institutions) 2009.g.: non vascular interventionspts 1. Billiary80 2. Urogenital30 3. Esophageal20 4. CT / US drainage150 IR in Croatia, Turkey, Antalya March 2014

38 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,.... IR in Croatia, Turkey, Antalya March 2014

39 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, IR subspecialization mentorship - Ambulatory IR consultations IR in Croatia, Turkey, Antalya March 2014

40 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, IR subspecialization mentorship - Ambulatory IR consultations IR in Croatia, Turkey, Antalya March 2014

41 Experience in organization of IR meetings? IR in Croatia, Turkey, Antalya March 2014

42 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 Lectures: 80 Lecturers: 57 Participants:240 VII. Meeting of Croatian Interventional Radiologists with International Participation sIRcro 2009 IR in Croatia, Turkey, Antalya March 2014

43 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 Lectures: 80 Lecturers: 57 Participants:240 VII. Meeting of Croatian Interventional Radiologists with International Participation sIRcro 2009 Moto: bringing IR closer to clinitians IR in Croatia, Turkey, Antalya March 2014

44 International Clinical Faculty Jan Raupach Istvan Battyany Pavel Berden Tomaž Ključevšek Karl-Ludwig Schulte Markus Graf Maria Schoder Dimitrij Kuhelj Andrej Schmidt Zoran Milošević …………… VIII. Meeting of Croatian Interventional Radiologists with International Participation sIRcro 2011 Lectures: 85 Lecturers: 60 Participants:230 IR in Croatia, Turkey, Antalya March 2014

45 International Clinical Faculty Jan Raupach Istvan Battyany Pavel Berden Tomaž Ključevšek Karl-Ludwig Schulte Markus Graf Maria Schoder Dimitrij Kuhelj Andrej Schmidt Zoran Milošević …………… VIII. Meeting of Croatian Interventional Radiologists with International Participation sIRcro 2011 Lectures: 85 Lecturers: 60 Participants:230 Moto: bringing IR closer to young radiologists IR in Croatia, Turkey, Antalya March 2014

46 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 IX. Meeting of Interventional Radiologists of Croatiawith international participation sIRcro 2013 Lectures: 90 Lecturers: 70 Participants:270 IR in Croatia, Turkey, Antalya March 2014

47 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 IX. Meeting of Interventional Radiologists of Croatiawith international participation sIRcro 2013 Lectures: 90 Lecturers: 70 Participants:270 Moto: hot topics in IR IR in Croatia, Turkey, Antalya March 2014

48 AVS 2010

49 IR in Croatia, Turkey, Antalya March 2014

50 Modul education: I Carotid artery, II Femoral and SFA III BTK from 2010 part of Crossroads "Centers of exellence" IR in Croatia, Turkey, Antalya March 2014

51 Interventional Radiology -Why interest??? IR in Croatia, Turkey, Antalya March 2014

52 Interventional Radiology -Why interest??? Creative IR in Croatia, Turkey, Antalya March 2014

53 Interventional Radiology -Why interest??? Creative Attractive IR in Croatia, Turkey, Antalya March 2014

54 Interventional Radiology -Why interest??? Creative Attractive Innovative IR in Croatia, Turkey, Antalya March 2014

55 Interventional Radiology -Why interest??? Multipotent Creative Attractive Innovative IR in Croatia, Turkey, Antalya March 2014

56 Interventional Radiology -Why interest??? BUT !!! Multipotent Creative Attractive Innovative IR in Croatia, Turkey, Antalya March 2014

57 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 IR in Croatia, Turkey, Antalya March 2014

58 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 IR in Croatia, Turkey, Antalya March 2014

59 State healtcare vs Interventional Radiology IR in Croatia, Turkey, Antalya March 2014

60 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 IR in Croatia, Turkey, Antalya March 2014

61 Thank you for your attention

62 IR in Croatia, Turkey, Antalya March 2014 Thank you for your attention Welcome sIRcro 2015 …….Trust us, we work also …..


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