ABC | Volume 114, Nº1, January 2019

Statement Position Statement of the Brazilian Cardiology Society and the Brazilian Society of Hemodynamics and Interventional Cardiology on Training Centers and Professional Certification in Hemodynamics and Interventional Cardiology – 2020 Arq Bras Cardiol. 2020; 114(1):137-193 6.3.2.3. Interventions in Renal Arteries 6.3.2.3.1. Basic Knowledge • Natural history of the disease. • Differentiation of conduct based on the clinic and anatomy. • Diagnostic exams required for image interpretation. • Indications for invasive intervention. • How to conduct follow-up. 6.3.2.3.2. Interventional Cardiologists’ Abilities • Definition of best vascular access. • Selection of introducers, sheaths, guides, and catheters. • Selection of balloons and stents. • Mastery of management of complications by means of rescue of occlusions or perforations with embolotherapy techniques. 6.3.2.4. Interventions in Carotid Arteries and Vessels of the Base 6.3.2.4.1. Basic Knowledge • Natural history of the disease. • Differentiation of conduct based on the clinic and extra- and intracranial vascular anatomy. • Diagnostic exams required for image interpretation. • Indications for invasive intervention. • How to conduct follow-up. 6.3.2.4.2. Interventional Cardiologists’ Abilities • Definition of best vascular access. • Selection of introducers, sheaths, guides, and catheters. • Selective, atraumatic catheterization of the vessels of the base. • Selection of the form of cerebral protection, filters, or proximal protection, balloons, and stents. • Mastery of management of local complications by means of rescue of intracranial occlusions by local thrombolysis and retriever devices. 6.3.2.5. Embolotherapy 6.3.2.5.1. Basic Knowledge • Identification of which conditions of vascular complications require endovascular intervention for occlusion of the target vessel. • Diagnostic exams required for image interpretation. • Indications for invasive intervention. • How to conduct follow-up. 6.3.2.5.2. Interventional Cardiologists’ Abilities • Definition of best vascular access. • Selection of introducers, sheaths, guides, and catheters. • Selective, atraumatic catheterization of target vessels. • Correct selection of embolization agent for every necessity. • Mastery of the use of microcatheters, microguides, coils, particles, plugs, Onyx, and biological glue. 6.3.2.6. Venous Diseases 6.3.2.6.1. Basic Knowledge • Venous diseases treatable by endovascular treatment, such as thromboses, central occlusions, stenoses, May-Thurner syndrome, and nutcracker syndrome, among others. • Diagnostic exams required for image interpretation. • Indications for invasive intervention. • How to conduct follow-up. 6.3.2.6.2. Interventional Cardiologists’ Abilities • Selection of introducers, sheaths, guides, and catheters based on the condition to be handled. • Selection of balloons and stents. • Knowledge of techniques for chemical and mechanical thrombolysis; indications andmanagement of vena cava filters. Regarding procedures whose indications and degrees of evidence have fluctuated over the past years, such as pulmonary branch angioplasty and renal denervation, it is necessary for trainees and interventional cardiologists who are already qualified to stay continuously updated. Finally, interventional cardiologists are encouraged to have knowledge and training for the use of mechanical thrombectomy in the case of an acute ischemic stroke, which may result from both percutaneous procedures performed and separate events, whose limited therapeutic window makes transfer to another center difficult. 7. Final Considerations The great advance recently observed in interventional cardiology is limited not only to percutaneous treatment of the coronary artery disease, but also to the treatment of congenital heart diseases, the extracardiac vascular bed and, above all, structural heart diseases. Establishment and maintenance of training centers are fundamental in order to guarantee that new interventionists acquire the abilities necessary to carry out interventional treatment of diseases that are included in this vast and complex area of cardiology practice, with excellence. In this manner, the SBHCI must assume the coordination of actions and norms that provide for the certification of training centers and new interventionists. The SBHCI must also act as a facilitator of continued medical education in the area of interventional cardiology, with the objective of providing society with professionals whose abilities and responsibilities adequately meet the population’s expectations. This entire process should be periodically revised, and any eventual adaptations should be published in the form of guidelines or recommendations. 157