The Interventional and Vascular Radiology section at Vanderbilt is responsible for non-neurological angiographic studies, biliary, GI and GU interventions; percutaneous biopsies and drainages with fluoroscopic, sonographic and/or CT guidance; and CT and MR angiography. The section also provides interventional radiology service for the Vanderbilt Children’s Hospital. The section is staffed by 4 CAQ-accredited vascular/interventional faculty supported by a full complement of dedicated technical and nursing staff. The interventional area has state-of-the-art single and biplane digital angiographic equipment, a recovery room and facilities for short-term admissions.
Our educational mission is to develop outstanding interventional radiologists who are capable of practicing in any environment and are trained to provide the highest level of patient care. The strength of the program is the diversity of its caseload, which encompasses a large volume of both vascular and nonvascular diagnosis and intervention.
About 2,500 special procedures are performed annually in the Cardiovascular Radiology Section. These are principally adult cases, but since the hospital also contains a children's hospital center, a small number of pediatric angiography cases are performed as well. At present, about one-third of all cases are interventional. Besides the standard vascular, diagnostic, and interventional procedures (angioplasty, thrombolysis, embolization, filter insertion, foreign body removal, etc.), the Cardiovascular and Interventional Radiology Section is also responsible for biliary invasive procedures (percutaneous transhepatic cholangiogram, biliary stenting, biliary stricture balloon dilatation, and percutaneous stone removal), interventional uroradiological procedures (percutaneous nephrostomies, uretheral stenting, and intraoperative nephrolithotomy assistance), and percutaneous lung biopsies plus some abscess drainages that are not accessible to CT-guided needling. Additional experience with CT-guided biopsies and abscess drainage is also available. A broad spectrum of embolo-therapy and balloon dilatation is performed. The section maintains a good working relationship with the Department of Surgery. Pulmonary angiography for suspected emboli and caval filter insertion, as necessary, is performed in this section.
An active liver transplant service at Vanderbilt University Hospital has led to the development of considerable hepatic interventional radiology procedures, particularly in the areas of chemoembolization of primary and metastatic tumors and intrahepatic portosystemic shunting (TIPS). Vanderbilt University Hospital is also the Level I trauma referral for all of Middle Tennessee, providing the trainee with considerable experience in angiography for blunt and penetrating injuries.
Presently there are three angiographic suites in the Department of Radiology and Radiological Sciences for cardiovascular procedures and neuroangiography. Cardiovascular procedures are performed in a Philips Poly A angiographic suite with C-arm capabilities for interventional procedures and DVI-S digital imaging. Invasive and non-invasive monitoring devices are utilized during numerous procedures, and an ECG-gated injector pump is available. The second angiography suite is a recently installed state-of-the-art system with ceiling-suspended C-arm, 1024 DSA and additional biplane filming capabilities plus video-recording and optical disk archiving. The third angiographic suite is principally for neuroradiology procedures, containing state-of-the-art Philips biplane 1024 digital angiography with two C-arms, a tilt table, video-recording and optical disc archiving and an additional remote work station. Biplane angiographic filming in this room is utilized for occasional abdominal or thoracic arteriograms performed by the Cardiovascular Section.
Two 1.5 Tesla MRI suites with cine and 3-D capabilities are located adjacent to the angiography section and are available for cardiovascular imaging investigations, both clinical and research oriented. The ultrasound section, with color Doppler vascular imaging, is also adjacent to the angiography section. Positron emission tomography has been installed for cardiovascular and neuroradiological functional and diagnostic imaging. Animal lab facilities with good research support personnel are available. Strong departments of basic science, biomedical engineers and physicists are also available for support in research interests.
The Cardiovascular and Interventional Radiology Section is presently staffed with two attending faculty, two fellows, and one resident who spends a two month rotation in this section. The fellows function as junior staff, and there are ample cases for all. The experienced fourth-year residents take angiographic first-call for night-time emergencies. The cardiovascular fellow is expected to accomplish some meaningful clinical and/or basic science research during the fellowship and is provided the time to accomplish such a task.
Medical licensure in the state of Tennessee and Board eligibility in Diagnostic Radiology are prerequisites for this fellowship.
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