The Birth, Early Years, and Future of Interventional Radiology
Section snippets
THE BIRTH OF INTERVENTIONAL RADIOLOGY
Interventional radiology developed from diagnostic angiography and from the innovative minds and technical skills of many angiographers. Charles Dotter (Fig 1) (1) conceived interventional radiology in the early 1960s and first officially spoke about it on June 19, 1963, at the Czechoslovak Radiological Congress in Karlovy Vary. In his more than 1 hour presentation, “Cardiac catheterization and angiographic techniques of the future,” he discussed, among other topics, catheter biopsy, controlled
THE EARLY YEARS OF INTERVENTIONAL RADIOLOGY
The most exciting years of our professional lives were from the late 1960s to the mid 1980s. Dotter's papers, his lectures, and, later, daily work with him were constant inspirations to us that changed our orientation from diagnostic angiographers to interventionalists. We can still hear his voice telling us that, whenever examining the patient, we must not only concentrate on improving diagnoses, but we must also always think about potential ways to percutaneously treat whatever we find. We
EARLY HIGHLIGHTS IN PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY
After a few successful procedures, Dotter started an aggressive campaign to recruit patients and gain recognition for PTA. His referrals were mainly from general practitioners and occasionally from internists. Surgeons were not interested in nonsurgical treatment of atheromatous disease and were adamantly opposed to PTA. Dotter's articles in local newspapers and his radio and TV interviews were effective in attracting patients interested in this new procedure. These patients were admitted to
LOCAL THROMBOLYSIS
Dotter introduced catheter-directed thrombolysis in 1972 at the annual meeting of the Radiological Society of North America in Chicago. The origins of the procedure were the treatment of complications of angiography and PTA. Thrombotic occlusions occasionally occurred at the catheter entrance or dilation sites because of the large size of diagnostic coronary catheters (8 F) and coaxial dilation catheters (12 F). Dotter wanted to treat these complications with interventional techniques rather
EXPANDABLE STENTS
Dotter started the era of intravascular stent placement in 1969 with the introduction of a transluminally placed coil spring endarterial tube graft Fig 8) (16). Frustrated with the frequently occurring occlusions of a recanalized SFA, he tried to find a percutaneous method to keep the artery open. Of several different types of percutaneously introduced tubings, only the uncoated coil spring tubular prostheses stayed open in canine SFAs. Two of three 1-cm-long coil springs remained patent on
ACUTE GASTROINTESTINAL BLEEDING
Angiographic diagnosis and treatment of acute gastrointestinal bleeding (AGIB) was pioneered by Stanley Baum and Moreye Nusbaum in the 1960s. First, they showed in 1963 that selective visceral cut-film arteriography was capable of demonstrating extravasation at rates as low as 0.5 mL/sec (29). Then, in 1967, after they found in animal experiments that vasoconstrictive infusion of the superior mesenteric artery could reduce portal hypertension (30), they started to use continuous low-dose
TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTS
The TIPS technique was developed in canine experiments at the University of California Los Angeles in the late 1960s by Rösch (Fig 15) (38). A modified transeptal Ross needle was used for entrance of the portal vein from a hepatic vein and coaxial Teflon catheters as large as 18 F were used for dilation of the hepatic puncture tract. Rigid Teflon tubing was used in the first animals for the shunt connection. The idea to create TIPS in the early years of interventional radiology was enhanced by
FUTURE OF INTERVENTIONAL RADIOLOGY
The three authors of this article have close to 100 years of collective angiographic and interventional radiology practice and experience. During that time, we have seen almost everything in interventional radiology. Some of us have witnessed and participated in the original introduction of basic procedures that define the specialty, what many would call the “golden days.” Over time, the enthusiastic introduction of new devices and methods resulted in continuously increasing numbers of patients
References (52)
- et al.
Selective arterial drug infusions in the treatment of acute gastrointestinal bleeding
Gastroenterology
(1970) - et al.
Transjugular intrahepatic portacaval shunt: an experimental work
Am J Surg
(1971) Interventional radiology 2000 and beyond: back from the brink. The 1999 Charles T. Dotter Lecture
J Vasc Interv Radiol
(1999)Charles Dotter: interventional radiologist
Radiology
(1989)Cardiac catheterization and angiographic techniques of the future
Cesk Radiol
(1965)- et al.
Transluminal treatment of atherosclerotic obstructions: description of a new technique and preliminary report of its applications
Circulation
(1964) - et al.
The nonsurgical treatment of ileofemoral arteriosclerotic obstructions
Radiology
(1966) - et al.
Nichtoperative, transluminale behandlung der arteriosklerotischen verschlussaffektionen
Fortschr Rontgenstr
(1968) Interventional diagnostic radiology—a new subspecialty (Editorial)
AJR Am J Roentgenol
(1967)- et al.
Intravasale recanalisation inoperabler arterieller obliterationen
Zentralbl Chir
(1967)
Erste egebnisse mit der katheter-rekanalisation nach dotter bei arterieller verschlusskrankenheit
Fortschr Rontgenstr
Mechanische bchandlung von beckenarterienstenosen mit der perkutanen kathetertechnik
Verh Dtsch Kreislaufforsch
Ein neuer korsett-balloon-katheter zur transluminalen recanalisation nach dotter unter besonderer berücksichtigung von oblitera-tionen an den beckenarterien
Radiol Diagn
Percutane Recanalization chronischer arterieller verschlüsse mit einem neuen dilatationskatheter
Dtsch Med Wochenschr
Percutane dilatation von koronarstenoses. Beschreibung eines neuen kathetersystem
Klin Wochenschr
Selective clot lysis with low-dose streptokinase
Radiology
Low dose streptokinase in the treatment of arterial occlusions
AJR Am J Roentgenol
Low-dose fibrinolytic therapy: results and new concepts
Radiology
Thrombolysis of peripheral arterial and graft occlusions: improved results using highdose urokinase
AJR Am J Roentgenol
Transluminally-placed coilspring endarterial tube grafts: longterm patency in canine popliteal artery
Invest Radiol
Transluminal implantation of intravascular “double-helix” spiral prostheses: technical and biological considerations
ESAO Proc
Radiological follow-up of transluminally inserted vascular endoprostheses: an experimental study using expanding spirals
Radiology
Transluminal expandable nitinol coil stent grafting: preliminary report
Radiology
Nonsurgical placement of arterial endoprostheses: a new technique using nitinol wire
Radiology
The Rabkin nitinol coil stent: a five-year experience
Percutaneous endovascular stents: an experimental evaluation
Radiology
Cited by (105)
Public Awareness of Interventional Radiology: Population-Based Analysis of the Current State of and Pathways for Improvement
2023, Journal of Vascular and Interventional RadiologyThe IDEAL framework
2023, Translational Interventional RadiologyMaximizing Angioplasty Results in Peripheral Interventions
2022, Techniques in Vascular and Interventional RadiologyCitation Excerpt :The field of Interventional Radiology is said to have begun in 1964, when an 82-year-old woman with critical limb ischemia and gangrene of the lower extremity refused amputation. Dotter successfully restored circulation to her leg by percutaneously dilating a localized stenosis of the superficial femoral artery using a Teflon catheter introduced over a guide wire (or ‘wire guide’ as it was called then).3,4 Dotter's technique, initially called “percutaneous transfemoral catheter dilatation” involved opening blood vessels by use of coaxial dilation catheters.
Liquid embolic agents for interventional embolization
2022, ChemPhysMaterPrecision interventional radiology
2021, Journal of Interventional MedicineAnomalous origin of the middle colic artery from the ileocecal artery affecting laparoscopic ascending colon cancer resection
2021, Radiology Case ReportsCitation Excerpt :However, an intraoperative vascular evaluation is necessary in cases where preoperative multidetector-row CT cannot be performed, such as in patients with kidney dysfunction. In recent years, modalities such as indocyanine green (ICG) have been widely used for the intraoperative evaluation of the intestinal blood flow [26–30] Although ICG was not used in the present case, it may have been useful for assessing the residual intestinal blood flow had we performed common trunk ligation, which would have allowed us to ligate the common trunk and perform en bloc dissection of the regional lymph nodes without damaging the mesentery. Thus, preoperative and intraoperative vascular assessments are necessary in order to perform surgery safely.