Section 9: Interventional activity under medical imaging in neuroradiology

Interventional procedures under medical imaging in neuroradiology concern diagnostic and therapeutic procedures relating to the cervico-cerebral and medullo-spinal region and which are performed by endovascular or percutaneous means, excluding osteoarticular locations. This does not include thyroid procedures.

For interventional neuroradiology treatment of cancerous lesions, the holder of the authorisation to carry out interventional neuroradiology activity must hold the authorisation mentioned in 18° of article R. 6122-25.

Authorisation to perform interventional neuroradiology is not required from a health establishment or a health cooperation group when it holds an authorisation to perform the surgical care activity mentioned in 2° of article R. 6122-25 and the activity performed is limited to interventional angiography of the cervical vessels.

Interventional activities under medical imaging in neuroradiology are practised in two categories: 1° Category A comprising solely the performance of mechanical thrombectomy and associated diagnostic procedures in the context of acute ischaemic cerebrovascular accident; 2° Option B comprising all interventional neuroradiology activities.

Authorisation for interventional activity under medical imaging in neuroradiology, category A, may only be granted if the holder draws up an agreement with a structure authorised to carry out interventional activity under medical imaging in neuroradiology, category B. The agreement provides in particular for the sharing of professional practices and the arrangements for connecting information systems, in particular to enable images to be shared in real time.

Authorisation may only be granted if the holder has a vascular neurology intensive care unit, as referred to in article R. 6123-34-1, on site twenty-four hours a day, seven days a week, and an intensive care unit on site.

Authorisation for interventional activity under medical imaging in neuroradiology, category A, may only be granted if the holder has access to a neurosurgery unit, where applicable by agreement. Authorisation for interventional activity under medical imaging in neuroradiology, category B, may only be granted if the holder has an on-site neurosurgery unit.

Authorisation may only be granted if the holder has access, on site or by agreement, to medical biology tests and labile blood products within a timeframe that is compatible with the safety of treatment.

Authorisation may only be granted if the holder can provide cerebral and vascular exploration by scanner and MRI, on site, twenty-four hours a day, seven days a week. The holder of the medical imaging interventional activity in neuroradiology in option B has an interventional catheterisation platform on site enabling all diagnostic and therapeutic procedures relating to cerebrovascular pathologies to be carried out.

The holder of the authorisation ensures that patients are diagnosed and treated on a permanent basis, in liaison with the emergency medicine structures mentioned in article R. 6123-1, including via telehealth. This round-the-clock service may be shared by several authorised sites. In this case, an agreement is drawn up between the authorisation holders for each site. When the duty of care is provided for several sites, the agreement referred to…