COME FORMARE I NEUROINTERVENTISTICOME FORMARE I NEUROINTERVENTISTI

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►Medical SpecialitiesMedical Specialities►The The UEMSUEMS represents more than 50 represents more than 50

medical disciplines through various medical disciplines through various bodies and structures. The most bodies and structures. The most important ones are the 43 Specialist important ones are the 43 Specialist Sections,neuroradiology is one of Sections,neuroradiology is one of thesethese

►Training Charter for Interventional Training Charter for Interventional Neuroradiology”. Neuroradiology”.

► The UEMS Division of NeuroradiologyThe UEMS Division of Neuroradiology ► Interventional Neuroradiology (INR) (endovascular) is an Interventional Neuroradiology (INR) (endovascular) is an

emerging medical activity that has, until now, been practiced emerging medical activity that has, until now, been practiced in Europe (and worldwide) by medical specialists coming from in Europe (and worldwide) by medical specialists coming from

different specialties, but without specific training.different specialties, but without specific training. ► With the development of increasingly complex treatments With the development of increasingly complex treatments ► it is necessary that competent and skilled physicians provide it is necessary that competent and skilled physicians provide

appropriate treatments to patients. Thus, specific training is appropriate treatments to patients. Thus, specific training is necessary for physicians who want to practice INRnecessary for physicians who want to practice INR

►The UEMS Training CharterThe UEMS Training Charter clearly indicates that all clearly indicates that all physicians ( neurologists, neurosurgeons, radiologists and physicians ( neurologists, neurosurgeons, radiologists and neuroradiologists) can be trained in INR, which reflects the neuroradiologists) can be trained in INR, which reflects the current situation in Europe and the rest of the World where current situation in Europe and the rest of the World where INR physicians come from different specialties.INR physicians come from different specialties.

► Revised European Training Charter for Clinical Radiology; Revised European Training Charter for Clinical Radiology; European Society of RadiologyEuropean Society of Radiology. .

The UEMS Training The UEMS Training CharterCharter

► The task force was formed by appointed The task force was formed by appointed representatives from the representatives from the Sections of NeurologySections of Neurology (W (W Grisold), Grisold), NeurosurgeryNeurosurgery (B Richling) and the Division of (B Richling) and the Division of NeuroradiologyNeuroradiology (L Pierot). Representation from the (L Pierot). Representation from the Sections of Sections of CardiologyCardiology (H Mudra) and (H Mudra) and RadiologyRadiology (P (P Pattynama) joined the final meeting of the task force, Pattynama) joined the final meeting of the task force, which was chaired by the President of the Division of which was chaired by the President of the Division of Neuroradiology (O Flodmark). Neuroradiology (O Flodmark).

► The The INR Training CharterINR Training Charter purpose is to define the purpose is to define the training needed to perform only endovascular training needed to perform only endovascular procedures safely. procedures safely.

► Training needed for interventional percutaneous Training needed for interventional percutaneous spinal procedures will be the topic of a separate spinal procedures will be the topic of a separate charter. charter.

►The INR Training Charter [1] text was The INR Training Charter [1] text was finalised in December 2010. finalised in December 2010.

►On 8 October 2011 The On 8 October 2011 The UEMS CouncilUEMS Council gave final approval to the document. gave final approval to the document. Consequently, the Consequently, the INR Training CharterINR Training Charter is is now an official UEMS recommendation now an official UEMS recommendation and is part of the EU legislative and is part of the EU legislative apparatus through the Directive apparatus through the Directive 2005/36/CE 2005/36/CE

► UEMS recommendations for acquiring “Particular qualification” in Endovascular UEMS recommendations for acquiring “Particular qualification” in Endovascular

Interventional Neuroradiology – INR; Interventional Neuroradiology – INR; UEMSUEMS 2011-10-08 2011-10-08. .

FutureFuture

►two significant pieces of the two significant pieces of the framework are still missing: framework are still missing:

►11 rules for visitation of the INR training rules for visitation of the INR training centres centres

►2 2 the development and introduction of the development and introduction of a European examination in INR. a European examination in INR.

►Both fields need to cooperate across Both fields need to cooperate across scientific societies and with the UEMS scientific societies and with the UEMS Institution. Institution.

►Both procedures require the Both procedures require the assistance of a level of competence assistance of a level of competence available only within the scientific available only within the scientific societies while the regulatory societies while the regulatory framework must be in agreement with framework must be in agreement with UEMS standards UEMS standards

►It seems It seems essential essential for the future of for the future of INR that all specialists receive the INR that all specialists receive the same training and that individual same training and that individual specialities do not organise their specialities do not organise their own training (interventional own training (interventional neurology, endovascular neurology, endovascular neurosurgery, interventional neurosurgery, interventional neuroradiology, etc.). neuroradiology, etc.).

►The Training CharterThe Training Charter► is appropriately based on four years full time is appropriately based on four years full time

training including one year of Clinical Neuroscience, training including one year of Clinical Neuroscience, ► one year of Diagnostic Neuroradiology andone year of Diagnostic Neuroradiology and► two years of INR. two years of INR. ► Clinical and Diagnostic Neuroradiology knowledge Clinical and Diagnostic Neuroradiology knowledge

is mandatory to practice INR and, according to the is mandatory to practice INR and, according to the large field of complex procedures included in INR, large field of complex procedures included in INR,

two years training for INR is appropriatetwo years training for INR is appropriate. .

► The knowledge-based objectives are precisely and The knowledge-based objectives are precisely and extensively described and cover the entire extensively described and cover the entire necessary field from basic neurosciences to necessary field from basic neurosciences to therapeutics. therapeutics.

► Important topics like ethics, research, requirement Important topics like ethics, research, requirement for training institutions and certification are also for training institutions and certification are also appropriately described.appropriately described.

►

NEUROINTERVENTISTICANEUROINTERVENTISTICAIN ITALIAIN ITALIA

NEUROINTERVENTISTICANEUROINTERVENTISTICAIN ITALIAIN ITALIA

NEUROINTERVENTISTICANEUROINTERVENTISTICAIN ITALIAIN ITALIA

NEUROINTERVENTISTICANEUROINTERVENTISTICAIN ITALIAIN ITALIA

BUONSENSOBUONSENSO

►TRATTAMENTO ANEURISMI TRATTAMENTO ANEURISMI ►TROMBECTOMIA MECCANICATROMBECTOMIA MECCANICA►HUB REGIONALIHUB REGIONALI

►TRATTAMENTO IN ELEZIONE DI AVM E TRATTAMENTO IN ELEZIONE DI AVM E DAVFDAVF

►CENTRI NAZIONALI DI PROVATA CENTRI NAZIONALI DI PROVATA ESPERIENZAESPERIENZA

COME FORMARE I NEUROINTERVENTISTICOME FORMARE I NEUROINTERVENTISTI

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► UEMSUEMS is the one and only representation of medical specialists is the one and only representation of medical specialists for the European Commission and Parliament.for the European Commission and Parliament.

► The definition of a specialty in UEMS is defined by its training The definition of a specialty in UEMS is defined by its training requirements.requirements.

► Thus, producing a Training Charter became the first issue for Thus, producing a Training Charter became the first issue for the newly established Division of Neuroradiology, supported the newly established Division of Neuroradiology, supported by the Section of Radiology.by the Section of Radiology.

► Although most interventional neuroradiological Although most interventional neuroradiological endovascular procedures in Europe are performed endovascular procedures in Europe are performed by neuroradiologists, a significant number are by neuroradiologists, a significant number are performed by neurosurgeons and interventional performed by neurosurgeons and interventional radiologists and, to a lesser degree, cardiologists radiologists and, to a lesser degree, cardiologists and neurologists. and neurologists.

► It is extremely important to have an It is extremely important to have an INR common training programme for INR common training programme for all interested specialists. all interested specialists.