Matthew Herp
Extreme IR is returning to SIR 2024—so plan your flights accordingly.
The session, which started as a grueling 17-mile hike up a mountain with lectures along the way, has morphed into a perennial favorite of the SIR Annual Scientific Meeting. For 4 hours, attendees are treated to the highs and lows of real-life interventional radiology cases.
Extreme IR, which was created by Ziv J Haskal, MD, FSIR, was born from the spirit of vanguard innovation that propelled the early days of IR. While the field has become more focused on clinical care and research, Dr. Haskal says that extreme spirit is still part of IR’s DNA—and this session reflects that.
“Part of IR is developing and doing new procedures that perhaps may have not been done before,” Dr. Haskal says. “And most people, regardless of practice type, will find themselves at some point saying, ‘I haven’t been in this situation before.’ That’s the purpose of Extreme IR—to share those unknown experiences. As IRs, we do so much of our work in isolation. But if someone in the crowd finds themselves in an extreme situation, maybe they’ll recall a case they heard at this session, and even if it’s not the exact same, they may be able to analogize and find their way through.”
This open dialogue about complications is crucial not only for learning, but for creating community, Dr. Haskal said.
“If you have a devastating complication and you’re in a small practice—like many of us—you may not have an opportunity to talk to others about it,” he said. “And that can create a moral injury.”
Often in these situations, Dr. Haskal will ask the crowd to raise their hand if they’ve experienced something similar. It can be stunning, he said, for those who look around and realize they’re not alone.
“That’s a very important aspect of M&M conferences as well,” he said. “Obviously we want to prevent complications and bad outcomes, but we also need to deal with the fact that even in our best situations, we’re doing extremely difficult things and complications will occur. We have to prepare ourselves, as well as our patients and our families.”
Though the content is often serious, the format of Extreme IR brings a degree of levity that gets the adrenaline pumping.
“We all have a short attention span by nature and by specialty, so we do this fast,” Dr. Haskal said.
This year, Dr. Haskal said he has prioritized bringing together a diverse portfolio of cases from across IR. There will be approximately 30–40 presentations, each under 6 minutes, featuring faculty of all levels—from established luminaries to medical students.
“The quick pace and endless procession is what helps Extreme IR capture lightning in a bottle,” Dr. Haskal said. He feels that excitement is what makes the lessons presented stick with attendees.
“A lot of our education focuses on short, concise, lectures or presentations, and we all walk away feeling elevated and engaged,” Dr. Haskal said. “But the truth is, it’s water washing over us.”
A key flaw of adult scientific education, he said, is that it’s very hard to retain the information learned. What makes these lessons stick is an emotional event or adrenaline spike that can bring you back to the moment.
“You always remember the near miss or the huge win,” he said. “So Extreme IR is designed to try to underpin our education with those emotional moments that will make the lesson stick.”
There are some cases that attendees still remember, even years later—like an IR having to use water pump pliers to remove a pin that went awry during a vertebroplasty.
“There’s one case we’re including this year from a presenter in India that is so extraordinary, it’s going to leave people with a giant question mark and an open mouth,” Dr. Haskal said.
The Extreme IR format has expanded over the years, from a regular column within the Journal of Interventional Radiology to a recently published book that contains hundreds of cases, collated by Dr. Haskal. Copies of Extreme IR: Extraordinary Cases in Interventional Radiology and Endovascular Therapies (which features the aforementioned water pump pliers case on the cover) will be presented to participants with the most engaging cases at this year’s session.
Be sure to plan ahead so you don’t miss the adrenaline—Extreme IR will take place on Saturday, March 22 from 1–5 p.m. MT.
“Book your flights to come early!” Dr. Haskal said. “And be ready to be amazed.”
Visit sirmeeting.org to see the full line up of panelists for this year’s session.
