Skip to main content
SpringerLink
Log in

Ethics and Safety

  • Chapter
  • First Online:
Diagnostic and Interventional Radiology in Gynecological and Obstetric Diseases

  • 292 Accesses

Abstract

Interventional radiology is a relatively new subspecialty of clinical radiology, which has grown in importance over the last 20 years as the range of radiographic procedures has become more invasive and complex. It is increasingly being offered to high-risk patients as an alternative to surgery.

Interventional radiology is continuing to reshape current practice in many specialties of clinical care and the fields of gynecology and obstetrics are no exception.

Ethical and safety issues represent key elements in the field of interventional radiology.

As interventional radiologists have adopted a more “clinical identity,” they have assumed more responsibility in patient management. With this growing role, interventional radiologists have an even greater obligation to understand the ethical challenges specific to their specialty.

Patient safety is of paramount importance in interventional radiology as in all branches of medicine. Potential failures occur throughout successful procedures and are attributed to a spectrum of errors, including equipment unavailability, planning errors, and communication errors. These are mainly preventable by improved preprocedural planning and teamwork.

Interventional care is a longitudinal continuum, beginning with an initial consultation. Advance planning, which starts at that point, is the key to success and provides the cornerstone for a safe procedure and subsequently the desirable outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cazzato RL, de Rubeis G, de Marini P, et al. Interventional radiology outpatient clinics (IROC): clinical impact and patient satisfaction. Cardiovasc Intervent Radiol. 2021;44:118–26. https://doi.org/10.1007/s00270-020-02677-1.

    Article  PubMed  Google Scholar 

  2. White SB. Value in interventional radiology: achieving high quality outcomes at a lower cost. Radiology. 2020;297:482–3. https://doi.org/10.1148/radiol.2020203407.

    Article  PubMed  Google Scholar 

  3. Tsetis D, Uberoi R, Fanelli F, et al. The provision of interventional radiology services in Europe: CIRSE recommendations. Cardiovasc Intervent Radiol. 2016;39:500–6. https://doi.org/10.1007/s00270-016-1299-0.

    Article  PubMed  Google Scholar 

  4. Baum RA, Baum S. Interventional radiology: a half century of innovation. Radiology. 2014;273(2 Suppl):S75–91. https://doi.org/10.1148/radiol.14140534.

    Article  PubMed  Google Scholar 

  5. Velling TE, Brennan FJ, Hall LD, et al. Role of the interventional radiologist in treating obstetric-gynecologic pathology. AJR Am J Roentgenol. 2000;175:1273–8. https://doi.org/10.2214/ajr.175.5.1751273.

    Article  CAS  PubMed  Google Scholar 

  6. Giurazza F, Corvino F, Cangiano G, et al. Transarterial embolization of peripheral high-flow arteriovenous malformation with ethylene vinyl alcohol copolymer (onyx®): single-center 10-year experience. Radiol Med. 2019;124:154–62. https://doi.org/10.1007/s11547-018-0948-6.

    Article  PubMed  Google Scholar 

  7. Coppola M, Pane F, Borzelli A, et al. Traumatic and spontaneous hemothorax due to intercostal arteries hemorrhage: what the interventional radiologist needs to know. J Radiol Rev. 2020;7:300–6. https://doi.org/10.23736/S2723-9284.20.00050-X.

    Article  Google Scholar 

  8. Giurazza F, Corvino F, Borzelli A, et al. Role of interventional radiology in managing gastrointestinal bleedings. J Radiol Rev. 2020;7:173–84. https://doi.org/10.23736/S2723-9284.20.00025-4.

    Article  Google Scholar 

  9. Ganeshan A, Nazir SA, Hon LQ, et al. The role of interventional radiology in obstetric and gynaecology practice. Eur J Radiol. 2010;73:404–11. https://doi.org/10.1016/j.ejrad.2008.11.020.

    Article  PubMed  Google Scholar 

  10. Shanbhogue AK, Menias CO, Lalwani N, et al. Obstetric (nonfetal) complications. Radiol Clin N Am. 2013;51:983–1004. https://doi.org/10.1016/j.rcl.2013.07.012.

    Article  PubMed  Google Scholar 

  11. Niola R, Giurazza F, Torbica A, et al. Predelivery uterine arteries embolization in patients with placental implant anomalies: a cost-effective procedure. Radiol Med. 2017;122:77–9. https://doi.org/10.1007/s11547-016-0690-x.

    Article  PubMed  Google Scholar 

  12. Thabet A, Kalva SP, Liu B, et al. Interventional radiology in pregnancy complications: indications, technique, and methods for minimizing radiation exposure. Radiographics. 2012;32:255–74. https://doi.org/10.1148/rg.321115064.

    Article  PubMed  Google Scholar 

  13. Weston M, Soyer P, Barral M, et al. Role of interventional procedures in obstetrics and gynecology. Radiol Clin N Am. 2020;58:445–62. https://doi.org/10.1016/j.rcl.2019.11.006.

    Article  PubMed  Google Scholar 

  14. Giurazza F, Corvino F, Silvestre M, et al. Role of interventional radiology in obstetric and gynecological diseases. J Radiol Rev. 2020;7:26–38. https://doi.org/10.23736/S2723-9284.20.00253-3.

    Article  Google Scholar 

  15. Di Stasi C, Cina A, Rosella F, et al. Uterine fibroid embolization efficacy and safety: 15 years experience in an elevated turnout rate center. Radiol Med. 2018;123:385–97. https://doi.org/10.1007/s11547-017-0843-6.

    Article  PubMed  Google Scholar 

  16. Silberstein S, Shnayder-Adams MM, Keller EJ, et al. Ethics in interventional radiology: a case-based primer. Cardiovasc Intervent Radiol. 2021;44:1510–7. https://doi.org/10.1007/s00270-021-02894-2.

    Article  PubMed  Google Scholar 

  17. Wong KK, Chu WC. Ethics policies and procedures in imaging and interventional radiology. Australas Phys Eng Sci Med. 2015;38:375–6. https://doi.org/10.1007/s13246-015-0346-5.

    Article  PubMed  Google Scholar 

  18. Bozorghadad S, Newton IG, Perez AW, et al. Research ethics in IR: the intersection between care and progress. J Vasc Interv Radiol. 2020;31:846–8. https://doi.org/10.1016/j.jvir.2020.02.014.

    Article  PubMed  Google Scholar 

  19. Kon AA, Shepard EK, Sederstrom NO, et al. Defining futile and potentially inappropriate interventions: a policy statement from the society of critical care medicine ethics committee. Crit Care Med. 2016;44:1769–74. https://doi.org/10.1097/CCM.0000000000001965.

    Article  PubMed  Google Scholar 

  20. Borgstede JP, Zinninger MD. Radiology and patient safety. Acad Radiol. 2004;11:322–32. https://doi.org/10.1016/s1076-6332(03)00720-7.

    Article  PubMed  Google Scholar 

  21. Angle JF, Nemcek AA Jr, Cohen AM, et al. Quality improvement guidelines for preventing wrong site, wrong procedure, and wrong person errors: application of the joint commission “universal protocol for preventing wrong site, wrong procedure, wrong person surgery” to the practice of interventional radiology. J Vasc Interv Radiol. 2009;20(7 Suppl):S256–62. https://doi.org/10.1016/j.jvir.2009.04.023.

    Article  PubMed  Google Scholar 

  22. Morbi AH, Hamady MS, Riga CV, et al. Reducing error and improving efficiency during vascular interventional radiology: implementation of a preprocedural team rehearsal. Radiology. 2012;264:473–83. https://doi.org/10.1148/radiol.12110530.

    Article  PubMed  Google Scholar 

  23. Koetser IC, de Vries EN, van Delden OM, et al. A checklist to improve patient safety in interventional radiology. Cardiovasc Intervent Radiol. 2013;36:312–9. https://doi.org/10.1007/s00270-012-0395-z.

    Article  PubMed  Google Scholar 

  24. Pressman BD, Roy LT. Developing a culture of safety in an imaging department. J Am Coll Radiol. 2015;12:198–200. https://doi.org/10.1016/j.jacr.2014.07.010.

    Article  PubMed  Google Scholar 

  25. Larson DB, Kruskal JB, Krecke KN, et al. Key concepts of patient safety in radiology. Radiographics. 2015;35:1677–93. https://doi.org/10.1148/rg.2015140277.

    Article  PubMed  Google Scholar 

  26. Baerlocher MO, Kennedy SA, Ward TJ, et al. Society of Interventional Radiology position statement: staffing guidelines for the interventional radiology suite. J Vasc Interv Radiol. 2016;27:618–22. https://doi.org/10.1016/j.jvir.2016.02.010.

    Article  PubMed  Google Scholar 

  27. du Pisanie JL, Dixon R. Building a culture of safety in interventional radiology. Tech Vasc Interv Radiol. 2018;21:198–204. https://doi.org/10.1053/j.tvir.2018.07.012.

    Article  PubMed  Google Scholar 

  28. Bibbolino C, Ferrante Z, Canitano S, et al. Working hypothesis for the drafting of ethical-deontological regulations in radiodiagnostics and interventional radiology. J Radiol Rev. 2020;7:165–72. https://doi.org/10.23736/S2723-9284.20.00013-2.

    Article  Google Scholar 

  29. Keller EJ, Vogelzang RL. Who we are and what we can become: the anthropology of IR and challenges of forming a new specialty. J Vasc Interv Radiol. 2018;29:1703–1704.e2. https://doi.org/10.1016/j.jvir.2018.07.021.

    Article  PubMed  Google Scholar 

  30. Shnayder MM, Keller EJ, Makary MS. COVID-19 ethics: what interventional radiologists need to know. J Vasc Interv Radiol. 2020;31:1720–3. https://doi.org/10.1016/j.jvir.2020.07.003.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Cornelis FH, Monard E, Moulin MA, et al. Sedation and analgesia in interventional radiology: where do we stand, where are we heading and why does it matter? Diagn Interv Imaging. 2019;100:753–62. https://doi.org/10.1016/j.diii.2019.10.002.

    Article  CAS  PubMed  Google Scholar 

  32. Giurazza F, Corvino F, Borzelli A, et al. Interventional radiology in the COVID-19 era: management experience from a tertiary care center in the South of Italy. J Radiol Rev. 2021;8:181–5. https://doi.org/10.23736/S2723-9284.21.00133-0.

    Article  Google Scholar 

  33. Dhansura T, Shaikh N. The parturient in the interventional radiology suite: new frontier in obstetric anaesthesia. Indian J Anaesth. 2017;61:289–94. https://doi.org/10.4103/ija.IJA_438_16.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Romagnoli S, Fanelli F, Barbani F, et al. CIRSE standards of practice on analgesia and sedation for interventional radiology in adults. Cardiovasc Intervent Radiol. 2020;43:1251–60. https://doi.org/10.1007/s00270-020-02536-z.

    Article  PubMed  Google Scholar 

  35. Dauer LT, Thornton RH, Miller DL, et al. Radiation management for interventions using fluoroscopic or computed tomographic guidance during pregnancy: a joint guideline of the Society of Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe with Endorsement by the Canadian Interventional Radiology Association. J Vasc Interv Radiol. 2012;23:19–32. https://doi.org/10.1016/j.jvir.2011.09.007.

    Article  PubMed  Google Scholar 

  36. Niola R, Giurazza F, Nazzaro G, et al. Uterine artery embolization before delivery to prevent postpartum hemorrhage. J Vasc Interv Radiol. 2016;27:376–82. https://doi.org/10.1016/j.jvir.2015.12.006.

    Article  PubMed  Google Scholar 

  37. Bibbolino C, Pittalis S, Schininà V, et al. Hygiene precautions and the transmission of infections in radiology. Radiol Med. 2009;114:111–20. https://doi.org/10.1007/s11547-009-0363-0.

    Article  CAS  PubMed  Google Scholar 

  38. Kohi MP, Fidelman N, Behr S, et al. Periprocedural patient care. Radiographics. 2015;35:1766–78. https://doi.org/10.1148/rg.2015150038.

    Article  PubMed  Google Scholar 

  39. Guideline for hand hygiene in health-care settings. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm.

  40. Guidelines for the prevention of intravascular catheter-related infections, 2011. Centers for Disease Control and Prevention. 2011. http://www.cdc.gov/hicpac/pdf/guide lines/bsi-guidelines-2011.pdf.

  41. Ierardi AM, Wood BJ, Gaudino C, et al. How to handle a COVID-19 patient in the angiographic suite. Cardiovasc Intervent Radiol. 2020;43:820–6. https://doi.org/10.1007/s00270-020-02476-8.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Taslakian B, Georges Sebaaly M, Al-Kutoubi A. Patient evaluation and preparation in vascular and interventional radiology: what every interventional radiologist should know (part 1: patient assessment and laboratory tests). Cardiovasc Intervent Radiol. 2016;39:325–33. https://doi.org/10.1007/s00270-015-1228-7.

    Article  PubMed  Google Scholar 

  43. Brook OR, Kruskal JB, Eisenberg RL, et al. Root cause analysis: learning from adverse safety events. Radiographics. 2015;35:1655–67. https://doi.org/10.1148/rg.2015150067.

    Article  PubMed  Google Scholar 

  44. de Vries EN, Ramrattan MA, Smorenburg SM, et al. The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care. 2008;17:216–23. https://doi.org/10.1136/qshc.2007.023622.

    Article  PubMed  Google Scholar 

  45. Duncan JR. Strategies for improving safety and quality in interventional radiology. J Vasc Interv Radiol. 2008;19:3–7. https://doi.org/10.1016/j.jvir.2007.09.026.

    Article  PubMed  Google Scholar 

  46. Mafeld S, Musing E, Conway A, et al. Avoiding and managing error in interventional radiology practice: tips and tools. Can Assoc Radiol J. 2020;71:528–35. https://doi.org/10.1177/0846537119899215.

    Article  PubMed  Google Scholar 

  47. Pinto A, Brunese L, Pinto F, et al. The concept of error and malpractice in radiology. Semin Ultrasound CT MR. 2012;33:275–9. https://doi.org/10.1053/j.sult.2012.01.009.

    Article  PubMed  Google Scholar 

  48. Carrafiello G, Floridi C, Pellegrino C, et al. Errors and malpractice in interventional radiology. Semin Ultrasound CT MR. 2012;33:371–5. https://doi.org/10.1053/j.sult.2012.01.008.

    Article  PubMed  Google Scholar 

  49. Mafeld S, Oreopoulos G, Musing ELS, et al. Sources of error in interventional radiology: how, why, and when. Can Assoc Radiol J. 2020;71:518–27. https://doi.org/10.1177/0846537119899226.

    Article  PubMed  Google Scholar 

  50. Keller EJ. Reflect and remember: the ethics of complications in interventional radiology. Semin Intervent Radiol. 2019;36:104–7. https://doi.org/10.1055/s-0039-1688423.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Siewert B, Hochman MG. Improving safety through human factors engineering. Radiographics. 2015;35:1694–705. https://doi.org/10.1148/rg.2015150107.

    Article  PubMed  Google Scholar 

  52. Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360:491–9. https://doi.org/10.1056/NEJMsa0810119.

    Article  CAS  PubMed  Google Scholar 

  53. Corso R, Vacirca F, Patelli C, et al. Use of “time-out” checklist in interventional radiology procedures as a tool to enhance patient safety. Radiol Med. 2014;119:828–34. https://doi.org/10.1007/s11547-014-0397-9.

    Article  PubMed  Google Scholar 

  54. Lee MJ, Fanelli F, Haage P, et al. Patient safety in interventional radiology: a CIRSE IR checklist. Cardiovasc Intervent Radiol. 2012;35:244–6. https://doi.org/10.1007/s00270-011-0289-5.

    Article  CAS  PubMed  Google Scholar 

  55. Cashman JN, Ng L. The management of peri- and postprocedural pain in interventional radiology: a narrative review. Pain Manag. 2017;7:523–35. https://doi.org/10.2217/pmt-2017-0024.

    Article  PubMed  Google Scholar 

  56. Maingard J, Kok HK, Ranatunga D, et al. The future of interventional and neurointerventional radiology: learning lessons from the past. Br J Radiol. 2017;90(1080):20170473. https://doi.org/10.1259/bjr.20170473.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Patel IJ, Davidson JC, Nikolic B, et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol. 2012;23:727–36. https://doi.org/10.1016/j.jvir.2012.02.012.

    Article  PubMed  Google Scholar 

  58. Schenker MP, Martin R, Shyn PB, et al. Interventional radiology and anesthesia. Anesthesiol Clin. 2009;27:87–94. https://doi.org/10.1016/j.anclin.2008.10.012.

    Article  PubMed  Google Scholar 

  59. Kompanje EJO, van Dijck JTJM, Chalos V, et al. Informed consent procedures for emergency interventional research in patients with traumatic brain injury and ischaemic stroke. Lancet Neurol. 2020;19:1033–42. https://doi.org/10.1016/S1474-4422(20)30276-3.

    Article  PubMed  Google Scholar 

  60. Miller DL, Balter S, Wagner LK, et al. Quality improvement guidelines for recording patient radiation dose in the medical record. J Vasc Interv Radiol. 2009;20(7 Suppl):S200–7. https://doi.org/10.1016/j.jvir.2009.04.005.

    Article  PubMed  Google Scholar 

  61. Zener R, Johnson P, Wiseman D, et al. Informed consent for radiation in interventional radiology procedures. Can Assoc Radiol J. 2018;69:30–7. https://doi.org/10.1016/j.carj.2017.07.002.

    Article  PubMed  Google Scholar 

  62. Torresin A, Evans S, Lizio D, et al. Practical recommendations for the application of DE 59/2013. Radiol Med. 2019;124:721–7. https://doi.org/10.1007/s11547-019-01031-x.

    Article  PubMed  Google Scholar 

  63. Mavroforou A, Giannoukas A, Mavrophoros D, et al. Physicians’ liability in interventional radiology and endovascular therapy. Eur J Radiol. 2003;46:240–3. https://doi.org/10.1016/s0720-048x(02)00192-4.

    Article  PubMed  Google Scholar 

  64. O’Dwyer HM, Lyon SM, Fotheringham T, et al. Informed consent for interventional radiology procedures: a survey detailing current European practice. Cardiovasc Intervent Radiol. 2003;26:428–33. https://doi.org/10.1007/s00270-003-0058-1.

    Article  PubMed  Google Scholar 

  65. Pomara C, Pascale N, Maglietta F, et al. Use of contrast media in diagnostic imaging: medico-legal considerations. Radiol Med. 2015;120:802–9. https://doi.org/10.1007/s11547-015-0549-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Peralta F, Wong CA. Interventional radiology in the pregnant patient for obstetric and nonobstetric indications: organizational, anesthetic, and procedural issues. Curr Opin Anaesthesiol. 2013;26:450–5. https://doi.org/10.1097/ACO.0b013e3283625e89.

    Article  CAS  PubMed  Google Scholar 

  67. Itri JN. Patient-centered radiology. Radiographics. 2015;35:1835–46. https://doi.org/10.1148/rg.2015150110.

    Article  PubMed  Google Scholar 

  68. Ripley BA, Tiffany D, Lehmann LS, et al. Improving the informed consent conversation: a standardized checklist that is patient centered, quality driven, and legally sound. J Vasc Interv Radiol. 2015;26:1639–46. https://doi.org/10.1016/j.jvir.2015.06.007.

    Article  PubMed  Google Scholar 

  69. Pinto A, Giurazza F, Califano T, et al. Interventional radiology in gynecology and obstetric practice: safety issues. Semin Ultrasound CT MR. 2021;42:104–12. https://doi.org/10.1053/j.sult.2020.09.004.

    Article  PubMed  Google Scholar 

  70. Hill GQ, Ryu RK. A primer to understanding the elements of medical malpractice. Semin Intervent Radiol. 2019;36:117–9. https://doi.org/10.1055/s-0039-1688425.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Support Health Services, Unit of Radiology, CTO Hospital, Azienda Ospedaliera dei Colli, Naples, Italy

    Antonio Pinto, Raffaella Capasso, Franco Guida, Claudia Rossi, Sabrina Segreto & Daniela Vecchione

Authors
  1. Antonio Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Raffaella Capasso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Franco Guida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudia Rossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sabrina Segreto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Daniela Vecchione
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Vascular and Interventional Radiology Department, Ospedale Antonio Cardarelli, Naples, Italy

    Raffaella Niola

  2. Radiology Department, Azienda Ospedaliera Dei Colli-CTO, Naples, Italy

    Antonio Pinto

  3. Vascular and Interventional Radiology Department, Ospedale Antonio Cardarelli, Naples, Italy

    Francesco Giurazza

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pinto, A., Capasso, R., Guida, F., Rossi, C., Segreto, S., Vecchione, D. (2023). Ethics and Safety. In: Niola, R., Pinto, A., Giurazza, F. (eds) Diagnostic and Interventional Radiology in Gynecological and Obstetric Diseases. Springer, Cham. https://doi.org/10.1007/978-3-031-11910-1_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-11910-1_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-11909-5

  • Online ISBN: 978-3-031-11910-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation