The practice of Cardiovascular and Interventional Radiology (CVIR) in India began in the early 1970s at a few isolated centers of excellence providing tertiary care. Non-availability of hardware and trained personnel, lack of familiarity with techniques and mismatched facilities were major obstacles to its growth in these early years. Despite individual initiatives, this practice did not gain any momentum until the mid- eighties. Improvements in imaging techniques and their wider availability played a major part in the growth of CVIR in India at this time. The practice of CVIR was initially largely restricted to the vascular radiologists, mainly because of their easier access to the fluoroscopy labs and familiarity with the hardware used in angiography. The next decade saw the emergence, in some centers, of separate divisions within the radiology departments devoted to various facets of CVIR. These became the foci for eventual growth of this sub-specialty in India.
Even though the first organized effort to establish the Indian Society of vascular & Interventional Radiology (ISVIR) was conceived in 1988, the society in its present shape was established on November 7th, 1997 with 28 founder members. Since then, we have come a long way. Today, this society has over 700 members and performs many activities, including creation of a nation-wide network of state branches & zonal chapters, and conducting monthly local, quarterly zonal and annual national level scientific meetings. The Indian society has so far held nine successful annual national meetings. All of them had faculty drawn from various parts of the world and included didactic lectures, symposia, workshops and, in most meetings, live case transmissions, from within and outside India, on topics of current interest and cutting edge technology. It also organizes 2-3 regional CME programs every year on topics of local interest. The society publishes a quarterly newsletter since 1999. It is also engaged in the organization of public awareness programs in different regions on locally relevant subjects. The society conducts short-term postgraduate training fellowships, and provides travel assistance to its members for participating in meetings within the country. It also maintains an interactive website.
We are the only national society in the world to conduct a web-based comprehensive annual national registry of vascular and interventional radiological procedures since 1999. Eight successful annual meetings of the national registry have been held so far. The annual number of procedures performed country wide has grown from under 5,000 in 1999 to over 1 lakh in the last year. The number of centers performing these procedures has grown from 8 institutions at the time of inception of the Indian society to over 100 today. Beginning with this year, ISVIR plans to start disease and technique-specific national registries in addition to its above effort.
The society has also been actively working with the industry to address the issues related to availability, pricing and Governmental policies regarding the custom clearance of various devices. Efforts are also directed towards widening the membership base and affiliation with various international bodies.
CVIR is at cross-roads in India today. There are perpetual shortages of equipment and hardware which is either not available or is mismatched to requirement. Most products are still imported, the prices are steep and not matched to the average per capita income of the Indian households. Indigenization of the hardware technology and their local production is essential to bridge the above gap. We also face turf issues with various other sub-specialties, including those from cardiology, neurology, neuro-surgery, gastro-enterology and vascular surgery. There is also a lack of trained manpower. Most medical colleges in India are still not geared to train radiology post graduates in interventional radiology. The radiology curriculum for post graduate degree needs inclusion of exposure to IR for the latter's optimal development. This factor, along with an increase in public and physician awareness, is the key to handle turf issues that our specialty faces today.
Despite above issues, there is a tremendous scope for the practice of interventional radiology in India. The members perform all state-of-the-art techniques available any where in the world and participate in the cutting edge experimental and clinical research, alone and also in collaboration with other national and international institutes. All forms of IR techniques in various organ systems, including the cardiovascular, hepato-biliary, genito-urinary, neurological, abdominal and musculoskeletal systems and other non-vascular locations are performed at various centers across the country. Some key areas of recent individual and collaborative research include gene therapy in vascular disease, stem cell therapy in various disease states, experimental work on tagged stem cell homing by MRI, synthetic venous valves, newer options in vascular recanalization and evolving concepts in endovascular reconstruction among others. Six tertiary care institutes in India have been identified by the society to provide ISVIR-sponsored training to the residents. CVIR in India is strategically poised for growth at this time.