I nt er ve nt iona l Radiolo gy a nd Anesthesia Matthew P. Schenker, MD a , Ramon Martin, MD b , Paul B. Shyn, MD c , Richard A. Baum, MD a, * During the past the decade interventional radiology (IR) has evolved from a referral- based to a clinically based specialty. Longitudinal care now is provided to patients before,during,and after procedures. This paradigm shift has resulted in dramatic increases in the scope and volume of practice and in the complexity of patients under- going image-guided procedures. The need for anesthesia and procedural sedation outside the operating room (OR) continues to grow as the number of minimally invasive procedures proliferates and the complexity of cases undertaken outside the OR increases. The division of Angiog- raphy and Interventional Radiology at Brigham and Women’s Hospital has witnessed a greater than fourfold increase in the number of cases requiring procedural sedation during the 5-year period ending in April 2008, with a concomitant growth in the numbe of cases requiring monitored anesthesia care (MAC) or general anesthesia (GA). This trend is likely to accelerate as the population ages and minimally invasive procedures continue to supplement or replace traditional open surgeries. How are medical specialists to address this burgeoning need for procedural seda- tion in a safe and effective manner? Anesthesiologists are well equipped to deliver anesthesia and procedural sedation by virtue of their specialty training and broad experience in a numberof settings.These settings include the OR,emergency room, ICU, pain clinic, and other procedural areas. The availability of anesthesiologists will become more limited as the demand for their expertise grows. How, then, can this a Division of Angiography and InterventionalRadiology,Department of Radiology,Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA b Department of Anesthesiology,Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA c Division of Abdominal Imaging and Intervention, Department of Radiology,Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA * Corresponding author. Division of Angiography and Interventional Radiology, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115. E-mail address: rbaum@partners.org (R.A. Baum). KEYWORDS Anesthesia Interventional radiology Quality assurance Sedation Angiography Anesthesiology Clin 27 (2009) 87–94 doi:10.1016/j.anclin.2008.10.012 anesthesiology.theclinics.com 1932-2275/08/$ – see front matter ª 2009 Elsevier Inc. All rights reserved.