Living in lead: the evolution of interventional radiology

Since its advent in 1964, the field of interventional radiology (IR) has evolved from a specialty that historically served other physicians to one with the ability to treat a range of diseases and patients on its own. Successful use of percutaneous transluminal angioplasty (PTA) to restore blood flow through stenotic vessels in 1964 demonstrated the ability of IR techniques to treat disease, thereby avoiding open surgical interventions such as endarterectomy and bypass grafting. Since then, IR has further transformed into a specialty with a range of clinical applications, including some that are considered the gold standard in their field today. Percutaneous coronary intervention (PCI) is the first-line treatment for acute myocardial infarctions and similarly has applications in the prevention of coronary artery disease. IR has emerged as a valuable tool in acute settings, including embolisation of upper and lower gastrointestinal bleeds, diverticular diseases, and cases of massive blood loss or haemodynamic instability where both conservative and endoscopic treatments have failed. Furthermore, chemo-, radio-, and bland trans-arterial embolisation have revolutionised hepatocellular carcinoma treatment, offering an additional treatment option for select patients who are deemed inoperable. The impact that IR has had on the field of medicine to date is nothing short of remarkable; however, as one of the ‘youngest’ medical specialties, it is just getting started. The possibilities for discovery and invention within this field may yield an ever-expanding role for IR in the prevention and treatment of numerous disorders.