By Dario Teplisky, MD, and Sergio Sierre, MD, FSIR Winter 2019
Throughout my training, I was always interested in both radiology and children's health. In the last year of my pediatrics residency at Garrahan Hospital, Buenos Aires, Argentina, when I was chief of residents, I had a pediatric patient whose liver was failing and who needed a TIPS procedure. I approached the interventional radiology department to observe the procedure and so my interest in interventional radiology took hold.
Sergio Sierre, MD, FSIR, the IR chief, encouraged me to apply for SIR’s International Scholarship. Because the SIR 2016 Annual Scientific Meeting would include a special session about IR societies from around the world, including Argentina, I was excited when my scholarship application was accepted.
My SIR 2016 experience
Shortly after arriving in Vancouver at SIR 2016, I met with physicians from Ghana, Croatia, China and Greece (to name just a few), all with different backgrounds and experiences but with the same goals: to share and learn and to become better IR doctors.
That first meeting was led by Brian F. Stainken, MD, FSIR, whom I admired because of his exceptional efforts to integrate and enhance IR communities around the world—not an easy task, given the variety of backgrounds and available resources in those different communities.
Every day at the annual meeting, the scholars had informal lunches with distinguished figures of SIR history, offering extraordinary moments of connection and exchange. We filled our minds with the anecdotes, experiences and teachings from these IRs, who were genuinely and profoundly interested in welcoming us, the young scholars, into the diverse SIR community.
I also enjoyed and valued my fellow scholars’ presentations on their experiences, background, difficulties and goals for the future. Learning how IR is performed today in China, Ghana, the U.K., was very educational. While at the meeting, I shared my vision for a public hospital vascular anomalies clinic, the first in Argentina. I received a lot of support from more experienced doctors, and the presentation was greatly accepted by the audience. What most encouraged me to pursue the clinic, though, was listening to other scholars from other parts of the globe sharing their efforts to develop IR in their uniquely difficult environments.
Establishing the clinic
Since that amazing experience, I´ve completed my IR training under the guidance of Dr. Sierre, who developed the only currently available pediatric IR fellowship program in Latin America at Garrahan Hospital.
In 2017, we successfully launched the vascular anomalies clinic at Hospital Garrahan, where we treat any kind of vascular anomaly known in children—arteriovenous, venous, lymphatic and others. We especially take care of patients with complex vascular anomalies syndromes, receiving patients from all over Argentina and neighboring countries like Bolivia, Paraguay and Perú.
Every Friday we see approximately 25 cases. In the last year we've treated almost 600 cases. The work starts the day before, when we review our schedule of cases and which specialist(s) need to see each patient.
Our IR group then examines the patients, from 8–11 a.m., performing an ultrasound if needed. A large group of specialists comes to see the patients: plastic surgeons, hematologists, clinicians, orthopedics specialists, cardiologists, genetics specialists and more if needed. The specialists meet to discuss the complex cases, treatments and follow-up. This interdisciplinary meeting gives the patients, who often come from far away, the opportunity to see all the specialists in the same day. We strive to make the best care available to all of our patients.
We are trying to connect with other vascular anomalies clinics from other countries to share experiences, learn and improve our care. We plan to publish our experiences and develop our own adapted protocols to treat vascular syndromes. In the future, we hope to be able to do all the studies needed, including genetics studies—which, while a very important part of the specialty, are not currently available at our institution. We are also visiting other clinics, getting trained in new techniques and collaborating with other health institutions.
Speaking from my experience, I strongly recommend SIR’s International Scholarship program. I deeply believe it made a profound impact on my career and believe it will continue making a profound impact on patient care around the world.