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 surgeon’s disbelief, her pain ceased, she started walking, and three "irreversibly" gangrenous toes spontaneously sloughed. She left the hospital on her feet—both 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 person’s 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

IGI 50: Celebrating the 50th Anniversary of Angioplasty

On July 23-24, 2014, the SIR-endorsed meeting, Image-guided Intervention: The Next 50 Years (IGI 50) meeting, took place in Portland, Oregon. This two-day, cross-disciplinary, international, interactive, high-level conference commemorated the 50th anniversary of angioplasty and featured many SIR members as faculty and discussion on the future of imaged-guided interventions. View the IGI-50 Album.

Celebrating 50 Years of Life-saving Angioplasty

Charles  Dotter
It was 50 years ago on Jan. 16, 2104 that Charles Dotter, the father of interventional radiology, performed the first angioplasty. Today, millions of individuals get this medical intervention annually.

 

 

 

Dr. Charles T. Dotter

SIR Leaders Comment on Historic Occasion and Significance to Patients

“Dr. Dotter’s innovation of opening an artery—not with surgery but rather with a minimally invasive image-guided procedure—was not only a seminal event in the nascent field of Interventional Radiology but in all of medicine in general. It was a cornerstone of the explosion in minimally invasive procedures that have been introduced over the 50 years since his discovery. Minimally invasive procedures have saved countless lives and literally millions of man years of time away from work or from the activities of daily living. Charles Dotter was one of the visionaries who helped pioneer the minimally invasive revolution in medicine that continues today.”

—SIR President Scott C. Goodwin, M.D., FSIR
Hasso Brothers Professor and Chair of the Department of Radiological Sciences at the University of California, Irvine

 

“In combination with advancements in imaging and medical device technology, Dotter’s work showed that with the use of imaging-guidance, you could employ cutting-edge technology to treat diseases without the cutting.  Less became more.“

—SIR Secretary Alan H. Matsumoto, M.D., FSIR
Director, Vascular and Interventional Radiology, University of Virginia Health System, Charlottesville

 

“As seen with many vanguard moves, logic is often greeted with resistance and cries of heresy. The era surrounding the Dotter angioplasty may be a distant memory; however, that procedure provided the logic and fundament for much—if not all—of modern interventional therapy. Imagine how many years of innovation and less invasive care we—and our patients—might have missed without Dotter’s giant step?”

—Ziv J Haskal, M.D., FSIR
Editor, Journal of Vascular and Interventional Radiology
Professor of Radiology, Department of Radiology and Medical Imaging, University of Virginia School of Medicine

 

In Historic 2014, Future of Image-guided Interventions to Be Discussed in Portland

By John Kaufman
Director, Dotter Interventional Institute and Frederick S. Keller Professor of Interventional Radiology, Oregon Health and Science University Hospital, Portland

On January 16, 1964, Charles Dotter (who was then chairman of radiology at the University of Oregon Medical School) performed the first recorded angioplasty in the world when he used progressively larger catheters to dilate a distal superficial femoral artery stenosis. The patient was an elderly woman with rest pain and gangrenous toes who had only been offered amputation of her foot. 

Her rest pain abated, her toes auto-amputated, and she kept her foot until her death two years later from a myocardial infarction. Dotter had suggested that angiographic catheters could be used as surgical instruments the previous year during a lecture in the then Czechoslovakia  … when he dilated that stenosis, he initiated an era of innovation and invention in image-guided intervention that has changed the patient experience, altered how medicine is practiced, led to the creation of new industries, and improved our understanding of many diseases.

Read more

Learn More About Angioplasty and Interventional Radiology

What is angioplasty?

What is an interventional radiologist?

Read About Interventional Radiology in the News

Interventional radiology treatments are working to help women with uterine fibroids, treat liver cancer, save lives by removing dangerous blood clots and more.

Follow the Society of Interventional Radiology on social media.

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)

Hall of Innovation: 439 IRs. 2,492 Patents. IR Is Innovation.

Milestones Pioneered by Interventional Radiologists

1964 Angioplasty

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

1970’s Percutaneous removal of common bile duct stones

1970’s 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

1980’s 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

1990’s Treatment of bone and kidney tumors by embolization

1990’s 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

Resources

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, Chicago.

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.