Acquisition of endovascular skills for obstetrician-gynecologists.

STUDY OBJECTIVE

To identify skills not part of the training of obstetrician-gynecologists that are needed to perform endovascular procedures, especially uterine artery embolization.

DESIGN

Literature review of known skills necessary to perform endovascular procedures.

RESULTS

Important areas of endovascular skills are as follows. Understanding of the modern C-arm image intensifier is basic to performing endovascular procedures safely for the patient, physician, and others in the procedure room. Many states require physicians to obtain a Fluoroscopy Supervisors Permit when doing such interventions. Arteriotomy begins every endovascular procedure. Physicians must understand catheter manipulation and selection, and the use of microcatheters. An understanding of the pelvic arterial anatomy will help the surgeon identify the uterine arteries. Once in the uterine artery, the surgeon must understand how to successfully embolize the artery. As in any surgery, prevention of complications is important as well as management of complications once they arise.

CONCLUSION

Obstetrician-gynecologists should plan on devoting a year for the acquisition of skills needed to perform endovascular procedures. Methods of acquiring such skills include simulator training, animal laboratory procedures, and observation of live procedures. Didactic courses will give physicians an overview of endovascular procedures.