Exploring new horizons in IR By Roger T. Tomihama, MD Spring 2021


"You cannot swim for new horizons until you have courage to lose sight of the shore." —WILLIAM FAULKNER


P


erhaps nothing more apropos could be said of both interventional radiology and this supplement to SIR’s IR Quarterly magazine. As a specialty, our mantra has always been to redefine the boundaries of image-guided therapy. For over 50 years, IR has demonstrated the courage to “lose sight” of the historical acceptance of the limitations of the medical field and to “swim for the new horizons” of high-quality patient care through emerging technology, innovation and continued excellence.


Though IR was born out a creative spirit that utilized on-table innovation and in-the-moment problem-solving to push boundaries, as the specialty has evolved, its practitioners have increased their emphasis on the scientific method: The identification and formulation of a problem, the gathering of data through observation and investigation, and the formulation and testing of hypotheses.


Throughout that process, SIR and SIR Foundation have worked with the community to advance scientific knowledge, increasing the number of proficient investigators and generating innovative therapies that lead to improved patient care and quality of life. By showcasing tomorrow’s treatments at the Annual Scientific Meeting, publishing forward-thinking research in the Journal of Vascular and Interventional Radiology, establishing grant and award programs to help fund research and conducting multidisciplinary Research Consensus Panels to help prioritize that research, SIR, SIR Foundation and the specialty have demonstrated dedication to nurturing the expansion and improvement of innovative, minimally invasive, image-guided therapies from inception to ubiquitous clinical utilization. SIR’s recent virtual 2021 Annual Scientific Meeting further showed how much the specialty is pushing boundaries and solidifying knowledge through rigorous scientific study.


This supplement highlights clear examples of this type of avant-garde, research- driven, evidence-based work being performed by numerous IRs in recent years.


• On page 4, Sandeep Bagla, MD, shares his work in genicular artery embolization in the decreasing pain and disability resulting from osteoarthritis-related knee pain— an exciting area of growth in for interventional radiology with possible application for other inflammatory musculoskeletal conditions as well.


• On page 7, Frank Yuan, MD, and Clifford R. Weiss, MD, FSIR, discuss the potential of bariatric embolization in treating obesity, the outcomes of the recent SIR Foundation RCP on the treatment, and the next steps forward.


• On page 12, read the perspectives of Jacob Dayan, MD, and Joseph P. Erinjeri, MD, PhD, on the current state of adjunctive immunotherapy in liver-directed therapy for hepatocellular carcinoma.


• On page 15, David S. Shin, MD, et al write about recent advances in venous reconstruction, exploring superficial venous disease management, thrombectomy and venous reconstruction and more.


Alongside these articles on emerging techniques, you’ll find a timeline celebrating the evolution and landmarks that form the backstory and context of these treatments of tomorrow—from the first angioplasty to the approval of interventional radiology as a primary specialty. But IR is never done evolving—so within this supplement you’ll also find predictions from the community of what comes next for the culture and science of IR.


We hope you enjoy this supplement, and want to hear your thoughts on the future of IR. Start the conversation on SIR Connect, tweet us at @SIRSpecialists, and email us anytime with ideas for future IRQ supplements or anything else you’d like to see covered at irq@sirweb.org.


SUPPLEMENT | SUPPORTED BY BOSTON SCIENTIFIC


sirweb.org/irq | 3


4 Genicular artery embolization 7


Bariatric embolization 12


TACE and immunotherapy for intermediate-stage HCC


15 The venous revolution PLUS HISTORY OF IR TIMELINE


Spring 2021


SUPPLEMENT EDITORIAL BOARD Jaimin D. Shah, MD, editor Barbara Nickel Hamilton, MD Roger T. Tomihama, MD


STAFF CONSULTANT Brian Haefs


EDITORIAL MANAGER Hope Racine


GRAPHIC DESIGN bluehousedc.com


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Archived IR Quarterly articles, issues and additional content can be found at sirweb.org/irq.


The views and opinions of authors and advertisers expressed herein are not necessarily those of the Society of Interventional Radiology. The society does not endorse any companies or products.


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