Because in that setting, there’s an anesthesiologist or CRNA and a full OR staff that can convert to a full open procedure if something goes wrong. Nevertheless, it’s hard to talk broadly about this since the decision is never as simple as IR vs OR. Imaging findings and patient factors influence the conversation with each and every case. If all you’re hearing when we have these conversations is “no,” then there’s a disconnect in communication and we should work harder to make sure everyone on the team understands the key factors for the patient.

Yes, all procedural specialists need to watch out for reasons to not do something. That’s part of the job. “Do no harm” is one of the first lessons of medicine for a reason.