Cardiovascular and Interventional Radiological Society of Europe
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Science for people
Science for people
ProgrammeTopic highlightsHow to establish and how to run an outpatient clinic

How to establish and how to run an outpatient clinic

We spoke to Dr. Cazzato to learn more about his presentation at CIRSE 2022.

Watch his lecture in the session, “IR going clinical.”

Since its origins in the 1960s, interventional radiology (IR) has developed continually, with a growing number and variety of percutaneous image-guided procedures performed in the vascular and extra-vascular fields. Nevertheless, interventionalists have traditionally suffered from limited exposure to patients both before and after the IR treatment. To overcome such a huge limitation for a subspecialty clearly pretending to have a “clinical soul,” interventionalists have started to run IR clinics with overnight patient admissions and IR outpatient clinics (IROC) to counsel patients. The privilege of running an IR ward is unfortunately still limited to very few IR centers; this probably happens due to the substantial needs an IR ward requires. On the other hand, running an IROC is far more practical and financially sustainable compared to a ward, and this may somehow explain the rapid flourishing of IROCs in the last few years. In fact, an IROC needs no more than secretarial services and access to an outpatient office.


To understand how an IROC works and understand the main factors impacting its success, a retrospective analysis of the IROC facility at the University Hospital of Strasbourg (France) was recently performed. The first surprising result was that the total number of consultations steadily increased from the first to the last year of the study period (from 693 consultations performed in 2011 to 1595 consultations performed in 2019, which accounts for an increased rate of 130%). The rate of unattended consultations remained stable throughout the entire study period (around 7%). Interestingly, for the 2018-2019 period, the cumulative procedure conversion rate, namely the rate of first consultations subsequently resulting in an IR procedure, was higher than 85%. In the end, a pool of 159 patients was surveyed to evaluate their satisfaction with the IROC; 99.2% of responders highly appreciated their IROC experience. When asked what the main aspects they took into account to evaluate their IROC experience, the quality of secretarial and medical services came out as the two main factors.


Overall, these results point out that:

  • Once the IROC is started, the tendency is for a rapid growth of consultations and interventions being performed, which means that an increased workload is expected for the entire IR department; this should be anticipated and supported by local administrations;
  • interventionalists are clearly succeeding in establishing the clinical character of IR, as witnessed by the high procedure conversion rate;
  • with patients mainly paying attention to the quality of secretarial and medical services received in the IROC, it seems adapted to set up dedicated training allowing these professional figures to acquire all the soft skills required for a beneficial relationship with patients.


In conclusion, IROC definitively represents another success story within the recent bright history of IR, since it significantly contributes to affirming the clinical role of interventionalists. Nevertheless, running an IROC needs supportive local administrations, given the expected increased workload for the IR department. Moreover, dedicated training for the interventionalists and secretaries should be set up to maximize the development of all the soft skills required to establish a beneficial relationship with patients.


Roberto Luigi Cazzato


University Hospital Strasbourg, Strasbourg/FR


Dr. Roberto Luigi Cazzato completed his IR training at the University Hospital of Strasbourg in Strasbourg, France, where he now serves as an associate professor of radiology and interventional radiology. An author of numerous peer-reviewed papers, his main area of clinical interest is extra-vascular interventional oncology. A CIRSE Fellow and active member, Dr. Cazzato has spoken during several European School of Radiology courses, helped author multiple Academy courses, spoken at many CIRSE meetings and currently the Chairperson of CIRSE's European Trainee Forum.