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Clinical Practice (Guidelines and Statements)
IR BLEEDING RISK GUIDANCE
Dear BSIR members,
Please find attached the BSIR bleeding risk guidance document.
This has been jointly produced by the BSIR Safety & Quality Committee in conjunction with the British Society of Haematology.
This is intended as an easy to use guide for IR teams.
The HEMSTOP screening questionnaire is designed to act as a pre-procedural screening tool rather than simply performing routine clotting screens on all patients, and has been widely supported by the British Society of Haematology. This is used by other surgical specialties and pre-operative assessment teams and we hope that this will guide future radiological practice in the UK.
The second half of the document is designed to guide the temporary cessation and restarting of an anticoagulant or antiplatelet medication for an IR procedure. This is a complex area to summarise and therefore intended to be used as a general guide for radiology teams, but may require engagement with referring or specialist teams when managing complex patients or for those patients who require bridging protocols.
We hope that this will be a useful guide for daily practice, streamlining processes in an attempt to avoid unnecessary tests, and we are keen to distribute this to the BSIR membership.
Many thanks
Best wishes
Dr Raj Das and Dr Clare Bent on behalf of the BSIR Safety and Quality Subcommittee
Any comments or correspondence please send to : raj.das@stgeorges.nhs.uk and Clare.Bent@uhd.nhs.uk
IR BLEEDING RISK GUIDANCE FINAL BSIR BSH 2022
IR Statement - POIRS
The Provision of Interventional Radiology Services (POIRS) has been revised, and the second edition is due to be published this summer (2019). A statement has been released by the Royal College of Radiologists (RCR) and British Society of Interventional Radiology (BSIR), to introduce the POIRS document, identify the benchmarks for Interventional Radiology and to highlight the competencies of interventional radiologists in patient management, both in an inpatient and outpatient scenario, obtained as part of their subspecialty training.
Medtronic Valiant Navion™ Thoracic Stent Graft System Recall
Medtronic valiant Navion surveillance advice
Navion Letter to patients_Template
Urgent Field Safety Notice Medtronic Valiant Navion™ Thoracic Stent Graft System Recall
Transjugular Intrahepatic Portosystemic Stent-Shunt (TIPSS)
Guidance management of gas embolism
Please click HERE to view Management of Patients With Gas Embolism
Provision of interventional radiology services, Second edition Sept 2019
Please click here to view the Provision of interventional radiology services, Second edition, Sept 2019.
Global Vascular Guidelines
Please click HERE to view the Global Vascular Guidelines CLTI Guideline Published in June 2019
NICE Guidance for Prostate Artery Embolisation (PAE)
NICE Guidance for Prostate Artery Embolisation (PAE)
BIAS Report - Fourth Iliac Angioplasty Study Report 2018
BIAS Report - Fourth Iliac Angioplasty Study Report 2018
Foreword
My thanks to the many people who have contributed to the British Iliac Angioplasty and Stenting (BIAS) registry. The BSIR is very proud to have instigated and supported this project, which is now in its fourth (and nal) report stage. BIAS has been one of the vanguard registries in the United Kingdom. This report joins its three predecessors, and is not only useful for its content, but is also a tribute to all those BSIR members who have taken the time to complete data entry. The society realises that much of this has been given freely, and often in individuals’ spare time. As President, on behalf of The Society, I thank you all for that.
BIAS is (to the best of The Society’s knowledge) the largest iliac artery endovascular intervention registry worldwide, with over 13,000 patients entered over its 16 years of operation. It demonstrates the commitment of the British Interventional Radiology community to ensuring that this index procedure for vascular interventional radiology is delivered safely and is benchmarked for future delivery. We can see that patients experience good outcomes at follow up, which is key. BIAS also provides us with excellent longitudinal information about the way services are delivered, for example the ever-increasing use of day-case facilities.
The BSIR’s rich history in supporting and developing registries is an enviable one. Going forward, The Society encourages members to continue to contribute to the National Vascular Registry (which has taken over the role of documenting iliac intervention from BIAS, as well allowing the recording of more distal peripheral interventions). At the same time, we ask members to consider other areas where data submission by Interventional Radiologists into new registries might establish benchmarks for safe and efective practice. Anyone with enthusiasm and ideas for future registries is encouraged to contact the Registries and Audit Committee via the BSIR website (www.BSIR.org). Many congratulations and thanks to you all. Trevor Cleveland President, British Society of Interventional Radiology.
Many congratulations and thanks to you all.
Trevor Cleveland
President, British Society of Interventional Radiology
BIAS Registry
8000+ cases entered since last publication (BIAS III, 2008) 13000+ cases altogether. Largest registry of iliac intervention worldwide as far as I know 50+ cases per week at peak recruitment in 2013. Substantially better recruitment so far compared with NVR. Follow up data excellent - 97% for most data points. Very low complication rates High success rates. read more..
Mechanical Thrombectory for Ischaemic Stroke
Training to deliver mechanical thrombectomy
In order to achieve the desired delivery of a 24/7 service in MT across England, the number of operators capable of contributing to MT services needs to expand more rapidly than will be achieved by current INR trainee numbers. This means training other specialists to perform MT.
The British Society of Neuroradiologists (BSNR) has produced “Training guidance for mechanical thrombectomy” (Lenthall R, McConachie N, White P, Clifton A, Rowland-Hill C. BSNR training guidance for mechanical thrombectomy. Clin Radiol 2017; 72(2): 175.e11–175.e18.) which details the training that will be required for practitioners from different clinical backgrounds to achieve the necessary skills and experience to effectively contribute to the acute stroke service. This guidance will underpin all routes to increasing the workforce.
https://www.rcr.ac.uk/clinical-radiology/being-consultant/mechanical-thrombectomy-ischaemic-stroke
BSIR statement - Obtaining informed consent after the Montgomery ruling
Obtaining informed consent after the Montgomery ruling - please see BSIR statement attachment below, available to view and print.
BSIR statement - Obtaining informed consent after the Montgomery ruling
Training of Existing Consultants in Interventional Radiology
Training of Existing Consultants in Interventional Radiology - please see BSIR statement attachment below, available to view and print.
Training of Existing Consultants in Interventional Radiology
NHS Reference Cost Collection 2016/17
NHS have now published this year’s reference cost collection (2016/17 costs) all the spreadsheets and supporting documentation can be found HERE
BSIR Statement on UFE
NICE Guidance CG147 update
Updates on national tariff related publications from NHS Improvement
Enquiries and frequently asked questions
NHS Improvement now publish the queries they receive on the national tariff. The 2016/17 enquiries log now updated with questions and FAQs up to January and this can be found here:
https://www.gov.uk/government/publications/nhs-national-tariff-payment-system-201617
NHS Improvement have also launched the 2017/19 document with a selection of FAQs, that document can be found here:
https://improvement.nhs.uk/resources/national-tariff-1719/
Tariff doc corrections
NHS Improvement have updated a number of documents on the 2017/19 webpage due to small errors. The main national tariff has had a date correction made in paragraphs 271 and 272 (relating to MFF recalculation). They have corrected a column header issue on the MFF page of the national prices spreadsheet and further to feedback have removed the non-mandatory price for adult hearing services from the non-mandatory prices spreadsheet. The documents can all be found here:
https://improvement.nhs.uk/resources/national-tariff-1719/
Reference cost collection guidance.
NHS Improvement have now published the reference cost guidance for 2017, it can be accessed here:
https://improvement.nhs.uk/resources/approved-costing-guidance/
Whole population budget webinars.
Following NHS Improvement latest webinar on new payment approaches, a page as been set up to bring all of the webinars on the subject together. This will be added in the next month or so with further material.
https://improvement.nhs.uk/resources/whole-population-budgets/
Letter to members and medical directors re IR data submission to NVR 2016
Please see below a position statement from the BSIR about time allocation (in job planning) and administrative support for IR data entry into NVR. We hope that members may find this useful in negotiations with trust management over these issues.
Yours faithfully,
Chris Hammond
Chair: BSIR R&A Committee
Letter to members and medical directors re IR data submission to NVR 2016
Benchmarking Consent in Nephrostomy
Please see below a survey of nephrostomy outcomes (also performed earlier in 2016), which we hope may aid you in benchmarking your practice and assisting in consent processes.
Chris Hammond
Chair: BSIR R&A Committee
