Procedures performed during this fellowship include:
- Access-biliary (transhepatic cholangiography, with drain and/or stent placement)
- Urologic (nephrostomy and ureteral stent placement, intraoperative dilation for lithotripsy)
- Enteric (gastro-jejuno- or cecostomy)
- Biopsy or drainage of any body part
- Oncologic interventions (RFA/cryoablation, chemo-, bland-, or radio (Yttrium)- embolization).
- Central venous access (including alternative sites: occluded IJ, collateral veins, IVC)
- Venous interventions (IVC filter placement and removal, SVC or IVC stent placement, transjugular biopsy, and foreign body retrieval)
- Hemodialysis access maintenance (angioplasty, thrombolysis, percutaneous mechanical thrombectomy, stent placement)
- Venous ablation (radiofrequency or sclerotherapy)
- Peripheral vascular disease, as well as diagnostic and therapeutic (embolization) procedures for trauma hemorrhage, GI bleeding, hemoptysis, and symptomatic fibroids
- Vascular malformations (AVM, venous, lymphatic)
The fellow's exposure to peripheral vascular intervention is augmented by integrated rotations with the Vascular Surgery service, where first operator experience is gained in a variety of lower extremity, renal, and carotid revascularization procedures. During the Vascular Surgery rotations, the fellow is also involved in the operating room placement of abdominal and thoracic stent grafts.
The VIR service performs vertebroplasty and discography, and there is an option for more intensive interventional neuroradiology participation, including stroke therapy and intracranial embolization for aneurysms and vascular malformations. Formal rotations on the body imaging services provide experience with MRA and CTA, including coronary CTA. Vascular duplex ultrasound imaging is performed in the Vascular Lab, where the fellow has a dedicated rotation.
Clinical evaluation and management training is provided through participation in the attending staff's clinic time. A full-time nurse practitioner provides invaluable assistance with management of the inpatient clinical service and outpatient follow-up. She shares responsibility for patient workups, admissions, and discharges. There are 1 to 3 Diagnostic Radiology residents on the service.