The History of Interventional Radiology
Interventional Radiologists Are Minimally Invasive Specialists
The landscape of medicine is constantly changing, and for the past 40 years, interventional radiologists have been responsible for much of the medical innovation and development of the minimally invasive procedures that are commonplace today. Interventional radiologists pioneered modern medicine with the invention of angioplasty and the catheter-delivered stent, which were first used to treat peripheral arterial disease. By using a catheter to open the blocked artery, the procedure allowed an 82-year-old woman, who refused amputation surgery, to keep her gangrene-ravaged left foot. To her surgeons disbelief, her pain ceased, she started walking, and three "irreversibly" gangrenous toes spontaneously sloughed. She left the hospital on her feetboth of them. Charles Dotter, MD, the interventional radiologist that pioneered this technique, is known as the "Father of Interventional Radiology" and was nominated for the Nobel Prize in medicine in 1978.
Angioplasty and stenting revolutionized medicine and led the way for the more widely known applications of coronary artery angioplasty and stenting that revolutionized the practice of cardiology. Today many conditions that once required surgery can be treated nonsurgically by interventional radiologists. Through a small knick in the skin, they use tiny catheters and miniature instruments so small they can be run through a persons network of arteries to treat at the site of illness internally, saving the patient from open invasive surgery. While no treatment is risk free, the risks of interventional procedures are far lower than the risks of open surgery, and are a major advance in medicine for patients.
Some of the more recent advances in interventional radiology include:
- Nonsurgical ablation of tumors to kill cancer without harming the surrounding tissue
- Embolization therapy to stop hemorrhaging or to block the blood supply to a tumor
- Catheter-directed thrombolysis to clear blood clots, preventing disability from deep vein thrombosis and stroke
- Carotid artery angioplasty and stenting to prevent stroke
Interventional Radiology Innovators: Advancing Minimally Invasive Modern Medicine
Hall of Innovation
Over the past 40 years, more than 2,400 patents and patent applications-pioneering modern medicine with the devices and drugs that advance minimally invasive treatments-have been filed by members of the Society of Interventional Radiology. These innovations-from the invention of angioplasty and the catheter-delivered stent, which were both first used to treat peripheral arterial disease in the legs, to drug-coated stents, balloon angioplasty, vena cava filters, catheter delivery systems, aortic endografts, ozone generators and radiofrequency ablation and clot-removing devices of today-continue to shape and change the medical landscape and improve patient care.
SIR's Annual Scientific Meeting celebrated "IR Innovation," highlighting the tremendous interventional radiology advances in patient care and quality of life. The Society honored IR inventors and inventions with a special "Hall of Innovation" at the SIR 2010 Annual Scientific Meeting in Tampa, Fla.
Interventional Radiology Innovators: Advancing Minimally Invasive Modern Medicine: Contributions of Society of Interventional Radiology Members Through Medical Patents, Patent Applications Continue to Alter Medical Landscape to Improve Patient Care (March 16, 2010)
Milestones Pioneered by Interventional Radiologists
1966 Embolization therapy to treat tumors and spinal cord vascular malformations by blocking the blood flow
1967 The Judkins technique of coronary angiography, the technique still most widely used around the world today
1967 Closure of the patent ductus arteriosis, a heart defect in newborns of a vascular opening between the pulmonary artery and the aorta
1967 Selective vasoconstriction infusions for hemorrhage, now commonly used for bleeding ulcers, GI bleeding and arterial bleeding
1969 The catheter-delivered stenting technique and prototype stent
1960-74 Tools for interventions such as heparinized guidewires, contrast injector, disposable catheter needles and see-through film changer
1970s Percutaneous removal of common bile duct stones
1970s Occlusive coils
1972 Selective arterial embolization for GI bleeding, which was adapted to treat massive bleeding in other arteries in the body and to block blood supply to tumors
1973 Embolization for pelvic trauma
1974 Selective arterial thrombolysis for arterial occlusions, now used to treat blood clots, stroke, DVT, etc.
1974 Transhepatic embolization for variceal bleeding
1977-78 Embolization technique for pulmonary arteriovenous malformations and varicoceles
1977-83 Bland- and chemo-embolization for treatment of hepatocellular cancer and disseminated liver metastases
1980 Cryoablation to freeze liver tumors
1980 Development of special tools and devices for biliary manipulation
1980s Biliary stents to allow bile to flow from the liver saving patients from biliary bypass surgery
1981 Embolization technique for spleen trauma
1982 TIPS (transjugular intrahepatic portosystemic shunt) to improve blood flow in damaged livers from conditions such as cirrhosis and hepatitis C
1982 Dilators for interventional urology, percutaneous removal of kidney stones
1983 The balloon-expandable stent (peripheral) used today
1985 Self-expandable stents
1990 Percutaneous extraction of gallbladder stones
1990 Radiofrequency ablation (RFA) technique for liver tumors
1990s Treatment of bone and kidney tumors by embolization
1990s RFA for soft tissue tumors, i.e., bone, breast, kidney, lung and liver cancer
1991 Abdominal aortic stent grafts
1994 The balloon-expandable coronary stent used today
1997 Intra-arterial delivery of tumor-killing viruses and gene therapy vectors to the liver
1999 Percutaneous delivery of pancreatic islet cells to the liver for transplantation to treat diabetes
1999 Developed the endovenous laser ablation procedure to
treat varicose veins and venous disease
The Birth, Early Years, and
Future of Interventional Radiology.
Josef Rösch, Frederick S. Keller, and John A. Kaufman.
J. Vasc. Interv. Radiol. 2003 14: 841-853.
The Catheter Introducers by Leslie A. Geddes and LaNelle
E. Geddes, copyright 1993 by Cook Group Incorporated, Mobium Press,
The Ship in the Balloon: The Story of Boston Scientific and the Development of Less-Invasive Medicine by Jeffrey L. Rodengen, copyright 2001 by Write Stuff Enterprises, Inc.