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Medical student (MS) interventional radiology (IR) symposium: raising awareness and interest in pursuing IR residency
S186
Scientific e-Posters
measured and recorded procedure and fluoroscopy time with both approaches. Results: Procedure and fluoroscopy time was reduced by reducing number of catheter and guide wire exchanges. Average procedure time with standard angioplasty versus Chameleon™ was 101 seconds versus 16.5 seconds which represents an 89% reduction. Average fluoroscopy time with standard angioplasty versus Chameleon was 16 seconds versus 6.6 seconds which represents a 60% reduction in fluoroscopy time. The differences were statistically significant (po0.05). Conclusions: Proximal injection angioplasty balloon catheter reduces catheter exchanges and guide wire removals and eliminates the need for manual compression reflux angiography. This technique seamlessly reduces patient and personnel radiation exposure by reducing fluoroscopy time.
Abstract No. 432 Bovine carotid artery arteriovenous (AV) conduits: outcome of percutaneous thrombectomy procedures
Scientific e-Posters
S. Sun1, A. Forauer2, C. Simpkins2; 1Geisel School of Medicine, Dartmouth College, Hanover, NH; 2DartmouthHitchcock Medical Center, Lebanon, NH Purpose: Bovine carotid artery (BCA) can be used as a surgical conduit for creation of AV accesses in patients whose veins are not suitable for AV fistula creation or have exhausted existing potential AV accesses. BCA conduits are reported to have reduced infectious complications and possibly improved access patency. We evaluated the outcomes of percutaneous interventions in BCA hemodialysis (HD) conduits. Materials: Over a 48-month period, all patients undergoing AV access creation using BCA were identified. Basic demographic data was collected (gender, age, BMI, and causes of chronic kidney disease). AV access specific information included location of the access, subsequent interventions, procedural outcome, and access abandonment. All access interventions, both percutaneous and surgical, were identified and reviewed. Results: 28 BCA AV accesses for HD were created in 27 patients (14 F, 13 M; mean age, 58.8 yrs; range 26-80). Mean BMI at the time of creation was 31. Medical comorbidities contributing to CKD included diabetes (n = 18), hypertension (n = 25), and polycystic kidney disease (n = 10), SLE and RA (1 each). 19 accesses were created in the upper extremity and nine in the lower extremity. Two BCA conduit infections occurred (20 days and 4 months following creation). Primary patency at 3, 6, and 12 months was 36%, 26%, and 0% respectively. Thrombectomy procedures represented 72% (33/46) of percutaneous interventions; the remainder of procedures were PTA. The secondary patency (after the first thrombotic event) was 47%, 33%, and 18% at 1, 3, and 6 months respectively. Twelve patients (44%) underwent multiple thrombectomy procedures: 2 (n = 5), 3 (n = 5) and 5 (n = 2). The average post thrombectomy patency was 47 days (range 5-221; median = 26). Conclusions: While exhibiting a low risk of infectious complications, AV conduits created using BCA demonstrate low patency rates and a large percentage of patients undergo multiple thrombectomy procedures.
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JVIR
Abstract No. 433 Medical student (MS) interventional radiology (IR) symposium: raising awareness and interest in pursuing IR residency J. Buethe1, J. Farrell1, S. Partovi1, T. Bochnakova1, M. Robbin1, J. McDaniel2, P. Kang3, B. Kapoor4, S. Tavri1, I. Patel1; 1University Hospitals Cleveland Medical Center, Cleveland, OH; 2N/A, Akron, OH; 3N/A, Pepper Pike, OH; 4 Cleveland Clinic, Cleveland, OH Purpose: To determine if MS IR symposium can raise awareness and interest in pursuing IR residency and to identify preferred ways of gaining exposure to IR among MS. Materials: Following IRB approval, 1 day MS IR symposium consisting of lectures, panel discussions, and hands-on IR simulation was held at a major academic institution on 2/26/ 2016. All MS from 10 regional medical schools were invited. Recruited MS underwent a web-based pre-symposium survey: demographics, prior exposure and interest in IR using 5-point Likert scales, and 8 question quiz assessing the knowledge of IR training pathway, IR procedures, and its role within the multi-disciplinary patient care. Post-symposium survey assessed overall experience, interest in IR, 8 question quiz, and preferred methods of gaining exposure to IR using 5-point Likert scales. Paired t-tests were used for statistical analysis. Results: A total of 65 MS (60% male; MS1-43%, 2-23%, 322%, 4-12%) from 8 schools were recruited. While only 30% considered IR as a top 3 residency choice, 97% felt strongly or very strongly in regards to learning more about IR. Of the 8 schools represented, 3 offer an IR elective (n ¼ 20), and the mean exposure to IR was 1.7/5(SD 0.7) among all MS. There was 14% improvement in mean quiz scores from pre-to postsymposium (P ¼ 0.004). Following the IR symposium, 95% demonstrated greater interest in IR. Mean post-symposium survey Likert scores were as follows: interest in IR (4.4); desire to use simulators during training (4.9); usefulness of simulators during IR residency (5); medical student exposure to IR (4.9); and utility of an IR symposium as introduction to IR (4.9). 100% thought it would be beneficial to integrate IR lectures and electives into the medical school curriculum, and 95% agreed that simulation experience was the best way to gain exposure to IR during the symposium. Conclusions: This study underscores the knowledge deficit in IR training pathway and clinical IR career among MS despite interest in IR. MS preferred incorporating IR lectures, electives, and simulation training into the curriculum. Additional targeted projects such as IR symposium may improve exposure and recruitment of MS.
Abstract No. 434 Assessing the depth and quality of interventional radiology resources on the web: are we answering patients’ questions in the digital age? J. Martin1, J. Martin1; 1University of Toronto, Toronto, ON Purpose: The purpose of this investigation was to objectively evaluate the presence of IR resources online, and measure the
Scientific e-Posters
measured and recorded procedure and fluoroscopy time with both approaches. Results: Procedure and fluoroscopy time was reduced by reducing number of catheter and guide wire exchanges. Average procedure time with standard angioplasty versus Chameleon™ was 101 seconds versus 16.5 seconds which represents an 89% reduction. Average fluoroscopy time with standard angioplasty versus Chameleon was 16 seconds versus 6.6 seconds which represents a 60% reduction in fluoroscopy time. The differences were statistically significant (po0.05). Conclusions: Proximal injection angioplasty balloon catheter reduces catheter exchanges and guide wire removals and eliminates the need for manual compression reflux angiography. This technique seamlessly reduces patient and personnel radiation exposure by reducing fluoroscopy time.
Abstract No. 432 Bovine carotid artery arteriovenous (AV) conduits: outcome of percutaneous thrombectomy procedures
Scientific e-Posters
S. Sun1, A. Forauer2, C. Simpkins2; 1Geisel School of Medicine, Dartmouth College, Hanover, NH; 2DartmouthHitchcock Medical Center, Lebanon, NH Purpose: Bovine carotid artery (BCA) can be used as a surgical conduit for creation of AV accesses in patients whose veins are not suitable for AV fistula creation or have exhausted existing potential AV accesses. BCA conduits are reported to have reduced infectious complications and possibly improved access patency. We evaluated the outcomes of percutaneous interventions in BCA hemodialysis (HD) conduits. Materials: Over a 48-month period, all patients undergoing AV access creation using BCA were identified. Basic demographic data was collected (gender, age, BMI, and causes of chronic kidney disease). AV access specific information included location of the access, subsequent interventions, procedural outcome, and access abandonment. All access interventions, both percutaneous and surgical, were identified and reviewed. Results: 28 BCA AV accesses for HD were created in 27 patients (14 F, 13 M; mean age, 58.8 yrs; range 26-80). Mean BMI at the time of creation was 31. Medical comorbidities contributing to CKD included diabetes (n = 18), hypertension (n = 25), and polycystic kidney disease (n = 10), SLE and RA (1 each). 19 accesses were created in the upper extremity and nine in the lower extremity. Two BCA conduit infections occurred (20 days and 4 months following creation). Primary patency at 3, 6, and 12 months was 36%, 26%, and 0% respectively. Thrombectomy procedures represented 72% (33/46) of percutaneous interventions; the remainder of procedures were PTA. The secondary patency (after the first thrombotic event) was 47%, 33%, and 18% at 1, 3, and 6 months respectively. Twelve patients (44%) underwent multiple thrombectomy procedures: 2 (n = 5), 3 (n = 5) and 5 (n = 2). The average post thrombectomy patency was 47 days (range 5-221; median = 26). Conclusions: While exhibiting a low risk of infectious complications, AV conduits created using BCA demonstrate low patency rates and a large percentage of patients undergo multiple thrombectomy procedures.
’
JVIR
Abstract No. 433 Medical student (MS) interventional radiology (IR) symposium: raising awareness and interest in pursuing IR residency J. Buethe1, J. Farrell1, S. Partovi1, T. Bochnakova1, M. Robbin1, J. McDaniel2, P. Kang3, B. Kapoor4, S. Tavri1, I. Patel1; 1University Hospitals Cleveland Medical Center, Cleveland, OH; 2N/A, Akron, OH; 3N/A, Pepper Pike, OH; 4 Cleveland Clinic, Cleveland, OH Purpose: To determine if MS IR symposium can raise awareness and interest in pursuing IR residency and to identify preferred ways of gaining exposure to IR among MS. Materials: Following IRB approval, 1 day MS IR symposium consisting of lectures, panel discussions, and hands-on IR simulation was held at a major academic institution on 2/26/ 2016. All MS from 10 regional medical schools were invited. Recruited MS underwent a web-based pre-symposium survey: demographics, prior exposure and interest in IR using 5-point Likert scales, and 8 question quiz assessing the knowledge of IR training pathway, IR procedures, and its role within the multi-disciplinary patient care. Post-symposium survey assessed overall experience, interest in IR, 8 question quiz, and preferred methods of gaining exposure to IR using 5-point Likert scales. Paired t-tests were used for statistical analysis. Results: A total of 65 MS (60% male; MS1-43%, 2-23%, 322%, 4-12%) from 8 schools were recruited. While only 30% considered IR as a top 3 residency choice, 97% felt strongly or very strongly in regards to learning more about IR. Of the 8 schools represented, 3 offer an IR elective (n ¼ 20), and the mean exposure to IR was 1.7/5(SD 0.7) among all MS. There was 14% improvement in mean quiz scores from pre-to postsymposium (P ¼ 0.004). Following the IR symposium, 95% demonstrated greater interest in IR. Mean post-symposium survey Likert scores were as follows: interest in IR (4.4); desire to use simulators during training (4.9); usefulness of simulators during IR residency (5); medical student exposure to IR (4.9); and utility of an IR symposium as introduction to IR (4.9). 100% thought it would be beneficial to integrate IR lectures and electives into the medical school curriculum, and 95% agreed that simulation experience was the best way to gain exposure to IR during the symposium. Conclusions: This study underscores the knowledge deficit in IR training pathway and clinical IR career among MS despite interest in IR. MS preferred incorporating IR lectures, electives, and simulation training into the curriculum. Additional targeted projects such as IR symposium may improve exposure and recruitment of MS.
Abstract No. 434 Assessing the depth and quality of interventional radiology resources on the web: are we answering patients’ questions in the digital age? J. Martin1, J. Martin1; 1University of Toronto, Toronto, ON Purpose: The purpose of this investigation was to objectively evaluate the presence of IR resources online, and measure the