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Background The COVID-19 pandemic has had an unprecedented effect upon the National Health Service (NHS). Like other specialties, Interventional Radiology (IR) rapidly adapted to the evolving situation. Members of BSIR were surveyed to obtain a snapshot of the experiences of UK IRs in response to COVID-19. An electronic survey was compiled using Google Forms, approved by the BSIR Council Officers and distributed to BSIR members by email on 18 th April 2020. A total of 228 responses were received. The survey was open for a 14-day period and the data analysed in Microsoft Excel 365. The response rate was 29% (228/800). Results Two thirds of respondents work in a Tertiary unit and 33% deliver IR in a District Hospital. 84% have a day-case facility. After the COVID-19 crisis, 81% of respondents were able to maintain 24–7 On-call service. 59% of respondents had been required change their day to day practice to allow the on-call service to continue. 55% of respondents were involved in providing a central line service. Of those questioned, 91% continued to offer endovascular services, 98% genitourinary and 92% hepatobiliary services, although a degree of service reduction was described. 38% have provided IR trainees with additional training material during this pandemic. Conclusions This survey has confirmed that the responses of UK IR departments to the COVID-19 crisis have ensured vital on-call and urgent services have continued, including ongoing availability of most IR sub-specialties. Availability of a day case facility has possibly influenced the positive response.

Twitter is the most used social media platform by medical professionals and has become an effective way to disseminate ideas and information. To evaluate Twitter usage by some of the larger diagnostic radiology (DR) and interventional radiology (IR) societies. Data were collected from the publicly available Twitter analytics platform, Twitonomy™. Data collected included the number of followers, Twitter output, user engagement and changes of these parameters between January 2017 and January 2019. DR societies have the largest number of followers. The IR group increased its number of followers by 5139 (55%) compared with 10013 (18%) by the DR group during the period studied. In both years, the IR group posted more tweets/day compared with the DR group (6.6 vs. 4.7). Although user engagement increased for both IR and DR societies, the IR subgroup had a highly engaged user audience with a similar number of ‘likes’ to the DR group despite their larger Twitter following (DR 65500 vs. IR 14411 in 2019). The IR societies studied experienced comparable Twitter engagement to the larger DR societies. The societies with the smallest number of followers (BSIR and CIRSE) enjoyed the largest relative increase in followers over the study period. IR societies should be encouraged by these results to continue to publicize their work on social media and increase awareness of the specialty.

Mo Al-Qaisi1, David M Nott1, David H King1, Sam Kaddoura2, Mo Hamady31Charing Cross Hospital, London, UK; 2Royal Brompton Hospital, London, UK; 3St. Mary’s Hospital, London, UKAbstract: This illustrated review article gives an evidence-based update on the different modalities used for imaging peripheral vascular disease (duplex ultrasound, computed tomography angiography, magnetic resonance angiography, and digital subtraction angiography). After discussing the latest technological developments for each modality, their limitations are also highlighted. The evidence is presented for the various modalities’ roles in the imaging of peripheral vascular disease, including problem-solving applications. The strengths and weaknesses of each modality are therefore critically appraised, including the salient technological, clinical, and financial aspects. This review allows the general and specialist practitioner to make an informed decision on how best to deploy imaging tests in peripheral vascular disease as part of an evidence-based approach. The article concludes with a rational imaging algorithm for the investigation of peripheral vascular disease.Keywords: imaging, peripheral, vascular, duplex, angiography, arterial&nbsp

Thoracic aortic aneurysms are a relatively uncommon clinical problem; however, their rupture is associated with high mortality and morbidity, with treatment aiming at reducing this risk. Endovascular repair of thoracic aortic aneurysms (TEVAR) has emerged over the last decade as a viable and increasingly preferred alternative to open surgical repair for thoracic aortic disease, which is increasing in prevalence, especially in an aging population. TEVAR has created a new set of challenges and complications not previously encountered with conventional forms of treatment; one such important complication is endoleaks. This Case discusses the pathogenesis, diagnosis, and management of endoleaks as well as some strategies to reduce their incidence. The discussion of this unique clinical entity includes a case-based discussion of some of the clinical and technical challenges encountered.

Aims Patient-specific virtual reality (VR) simulation is a technologic advancement that allows planning and practice of the carotid artery stenting (CAS) procedure before it is performed on the patient. The initial findings are reported, using this novel VR technique as a tool to optimize technical and nontechnical aspects of this complex endovascular procedure. Methods In the angiography suite, the same interventional team performed the VR rehearsal and the actual CAS on the patient. All proceedings were recorded to allow for video analysis of team, technical, and nontechnical skills. Results Analysis of both procedures showed identical use of endovascular tools, similar access strategy, and a high degree of similarity between the angiography images. The total procedure time (24.04 vs 60.44 minutes), fluoroscopy time (11.19 vs 21.04 minutes), and cannulation of the common carotid artery (1.35 vs 9.34) took considerably longer in reality. An extensive questionnaire revealed that all team members found that the rehearsal increased the subjective sense of teamwork (4/5), communication (4/5), and patient safety (4/5). Conclusion A VR procedure rehearsal is a practical and feasible preparatory tool for CAS and shows a high correlation with the real procedure. It has the potential to enhance the technical, nontechnical, and team performance. Further research is needed to evaluate if this technology can lead to improved outcomes for patients.

ObjectivesTo develop weighted error-based, generic and procedure-specific rating scales, to validate these scales for video-based assessment during virtual carotid artery stent (CAS) procedures and correlate them with simulator-derived metrics.MethodsA questionnaire was developed to assess the technique during live CAS procedures. Errors were rated from 1 (unimportant) to 5 (life-threatening) by 28 highly experienced CAS (>50 CAS) physicians. Virtual CAS procedure was performed by 21 interventionalists with varied CAS experience. Fluoroscopy screen and hand movements were video-taped, and simulator-derived metrics recorded. Experienced CAS practitioners then rated the video-taped performances using weighted error, generic and procedure-specific rating scales.ResultsOf the 23 errors assessed, 12 were regarded as moderate (score 3), six serious (score 4) and four life-threatening (score 5). The generic rating scale was able to detect significant differences in performance between inexperienced and experienced CAS operators (score 25 vs. 32 respectively, P