E5199. Beyond the IR Suite: Exploring Interventional Radiology in Nontraditional Settings
  1. Kaesha Thomas; Emory University
  2. Judy Gichoya; Emory University
  3. Peter Park; Emory University
  4. Zachary Bercu; Emory University
  5. Elizabeth Krupinski; Emory University
  6. Janice Newsome; Emory University
The objective of this study was to investigate the feasibility of conducting interventional radiology (IR) procedures using portable fluoroscopic devices in nontraditional settings. The aim was to assess whether such an approach could enhance patient access to IR procedures and potentially improve patient outcomes. Portable fluoroscopic devices may enable safe and effective performance of IR procedures outside the traditional suite, potentially increasing access and improving patient outcomes.

Materials and Methods:
We conducted a systematic search of all procedures performed in a large academic center between 2018 and 2022. Procedures were categorized by type and analyzed as a function of fluoroscopic time and radiation dose for each procedure. Patient characteristics, including BMI category, age, ICU stay, and COVID-19 status were examined to identify factors associated with increased fluoroscopy time and radiation dose. Data analyses were conducted using Python, and a p-value of < 0.05 was considered statistically significant.

During the period, there were 67,924 unique IR procedures performed, which included 393 different types. The three most common procedures were tunneled central venous catheter (CVC) placement (15.8%, 10,714/67,924), diagnostic angiogram (11.9%, 8,115/67,924), and nontunneled CVC placement (7.5%, 5,111/67,924). Only 0.7% (499/67,924) of the procedures were conducted portably. Portable procedures were significantly associated with ICU stay (p = 0.006) and COVID-19 positivity (p = 0.002). The median fluoroscopy time (minutes) for the top three procedures were 1.30 (0.80, 2.23), 13.36 (7.07, 23.88), and 1.08 (0.62, 1.95), respectively. The median radiation doses (mGy) were 5.31 (2.55, 1.55), 463.72 (164.57, 1181.16), and 4.41 (2.06, 9.65). Higher BMI (p = 0.005, < 0.001) and ICU stay (p = < 0.001) were associated with increased fluoroscopy time and radiation dose.

Optimizing portable IR procedures, particularly vascular access, can expand services, including the use of physician extenders, and improve safety when performed by other clinicians. This expansion not only benefits patients by minimizing procedure delays, especially in settings with limited resources, but also contributes to the overall efficiency and effectiveness of the healthcare system. Moreover, the study highlights the relevance of adapting IR practices to nontraditional settings, especially during critical periods like the COVID-19 pandemic.