Current IR Practice in Brazil

By Dr. Vinicius Fornazari

Interventional Radiologist From São Paulo - BRAZIL
Director RAINTER Medical Institute







Medicine has gone through several breakthroughs (pharmacological, nuclear and technological), and at this moment, we believe that we are experiencing the latest in modern medicine, interventional radiology (IR). In Brazil, it is not different.

The Brazilian Society of Interventional Radiology and Endovascular Surgery (SOBRICE) is a Brazilian entity that regulates and establishes the rights and duties of specialists in IR in Brazil and for this purpose, it has 16 IR training centers (IRTC) accredited, active and inspected annually, distributed in private and public services, without the need for tutorials on other specialties.

For the accreditation of a IRTC it is necessary to comply with the minimum requirements, such as infrastructure (table 1), under the supervision of specialist doctors and also SOBRICE certified board.

The training program lasts 5,760 hours over 2 years, full time. Theoretical activities should fill 10 to 20% of the workload, and the remaining 80% cover work in inpatient, outpatient, emergency room/emergency units, and the performance of percutaneous and endovascular interventional procedures. At the end of the training period, fellows must be able to carry out the procedures required in the syllabus (table 2), and must submit a scientific manuscript on a interventional topic. Quarterly they will be to an assessment of theoretical and technical skills, in addition to the global evaluation of attitudes, including knowledge, dedication and professionalism towards the team and patients.

Brazil is a country with a continental dimension, with a vast social, economic and cultural diversity. There are currently 397 specialist doctors SOBRICE Board Certified, however the vast majority are concentrated in the more developed regions of the country, mainly the southeastern region, specifically the São Paulo state.

We can say that the Brazilian IR in development areas is equivalent to the other world references, however, we have a long and hard work to be able to explore the internal social and economic frontiers of more remote places.


Minimum infrastructure requirements required in interventional radiology training centers (table 1)


1. Ultrasonography equipment with at least 1 (one) weekly period dedicated to carrying out guided procedures.
2. Computed tomography equipment with at least 1 (one) weekly period dedicated to guided procedures.
3. Specialized and up-to-date material in adequate quality and variety, to enable carrying out diagnostic and therapeutic interventional procedures.
4. Hospital unit with a specific Interventional Radiology ward or beds in a general ward for hospitalization of patients assisted by the Interventional Radiology team, with at least one (one) bed for each roommate.
5. Hospital unit that provides urgent and emergency care.
6. Hospital unit or radiological clinic capable of performing Doppler ultrasonography, computed tomography angiography and magnetic resonance angiography.
7. Outpatient care unit for cases assisted by the Interventional Radiology team.
8. Meeting room with audiovisual material.
9. Library and/or access to virtual libraries.


Interventional procedures that must be feasible during training (table 2)


Patient safety

Knowledge of the most used drugs

Physics of Radiation, Magnetic Resonance and Ultrasound


Ultrasonography with Doppler

Computed Tomography Angiography

Magnetic MRI

Digital subtraction angiography


Blood collection by selective catheterization

Liver and spleen biopsy and abdomino-pelvic structures

Biopsy of renal, adrenal and retroperitoneal structures

Biopsy of the musculoskeletal system

Lung and mediastinal biopsy

Thoracocentesis, paracentesis and puncture of collections

Fine needle aspiration punctures of cervical structures

Drainage of abscesses and collections

Percutaneous ablation of liver, kidney, adrenal, lung and bone tumors

Percutaneous gastrointestinal interventions: gastrostomy, jejunostomy, intestinal stent

Hepatobiliary percutaneous interventions: biliary drainage, cholecystostomy, stent cholangioplasty


Percutaneous genitourinary interventions: nephrostomy, cystostomy, ureteral catheter implantation

Atherosclerotic Diseases: angioplasty and endovascular stent implantation
Aortic aneurysmal disease, aortic dissection, aortic stent implantation

Difficult Vascular Access, semi-implantable and fully implantable catheters

Deep venous thrombosis, pulmonary thromboembolism, arterial or venous thrombolysis of limbs, vena cava filter implantation and pulmonary thrombectomy

Embolization in trauma

Research and embolization of digestive bleeding

Uterine fibroids, adenomyosis, gynecological tumors and uterine artery embolization

Benign prostatic hyperplasia and embolization of the prostatic arteries

Hepatocellular carcinoma, liver metastasis, TACE and tumor embolization

Arteriovenous and pulmonary fistulas, aneurysms and pseudoaneurysms of the pulmonary arteries, infectious processes, pulmonary and hemoptysis embolization

Embolization of peripartum bleeding

Periuterine embolization and varicocele

Peripheral vascular malformations: embolization and sclerotherapy

Pediatric procedures

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