New Privilege List - DI / Radiation Oncology - Sutter Medical Center

Sutter Medical Center, Sacramento
Department Of Diagnostic Imaging & Radiation Oncology - Delineation Of Privileges
NAME:
Request Privilege Appointment Requirements Proctoring Required
Peripheral Transluminal Angioplasty - Continued
[ ] Hepatic Artery Chemoembolization
Sub-selective catheterization of the hepatic artery, or
its branches, with subsequent infusion of
chemotherapeutic agents and/or embolic agents (under
fluoroscopic guidance) with immediate removal of the
catheter after the procedure has been performed.
[ ] Peripheral and Visceral Arteriography (noncoronary/non-cerebral
diagnostic angiography)
(This privilege is shared with another department)
(Continued on next page)
preceptorship of a senior qualified physician and
the performance of at least 100 peripheral
angiograms and 50 peripheral angioplasty
procedures.
Applicants will be required to provide such
documentation from the Director of Fellowship
training or by letter from primary hospital where
he/she has been practicing for the previous two years:
1. Fellowship training in Interventional Radiology
OR
2. Selective catheterization of the hepatic artery and
performance of diagnostic Arteriography in at
least ten (10) cases
AND
3. Evidence of performance of Hepatic Artery
Chemoembolization under supervision of a
physician experienced in the procedure in at least
five (5) cases.
1. Evidence of training and competency by
certification, or admissible for certification by the
American Board of Radiology, Cardiovascular
Disease by the American Board of Internal Medicine
or Vascular Surgery by the American Board of
Surgery.
– AND –
2 Documentation from the training program that the
training program included concentrated training and
experience in angiography including at least 50 noncoronary
arteriographic procedures performed
proficiently and successfully.
-OR – In the absence of residency training in
this procedure, documentation of successful
completion of 100 non-coronary angiographic
procedures from a Joint Commission accredited
hospital within the past three years is required. This
documentation must also include a letter of reference
from a physician who is familiar with the applicant’s
NONE
Five (5) non-cerebral
peripheral angiography
procedures.
Reappointment
Requirements
Two (2) procedures
within prior two
year period
Twenty (20) noncoronary,
noncerebral
peripheral
and visceral
arteriography
procedures.
Number
Performed
Page 8 of 17
Note: Approval is subject to the terms of the hospital's exclusive contract for Radiology services, i.e., approval is for second opinion consultations only, it being understood that the
hospital's contracting Radiologists are primarily responsible for these services.