From the Kinked Wire
From the Kinked Wire Barry Katzen and the renaissance of angioplasty
This transcript is from episode 52 of the Kinked Wire podcast. As SIR celebrates its 50th anniversary, host Roger Tomihama, MD, spoke with longtime IR leader Barry T. Katzen, MD, FSIR, about the early days of interventional radiology.
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This excerpt has been edited and condensed for flow. To hear the full discussion about the growth of his practice, the birth of SIR and more, listen to the podcast at
sirweb.org/kinkedwire.
Roger Tomihama, MD: What initially drew you to interventional radiology? Barry T. Katzen, MD, FSIR: First of all, interventional radiology didn’t actually exist. As a resident in the early 1970s, I spent time studying in Europe and was able to get an ear to the ground of some of the things that were going on there.
Barry T. Katzen, MD, FSIR
For example, in the U.S. at the time, the conventional wisdom among oncology surgeons was that putting a needle into cancer was a bad thing, because you would have what’s called needle tracking—you would just be spreading the cancer. As a result, we weren’t doing needle biopsies, but in the European literature, this was becoming more of a norm. And there were more things happening in Europe, and it was becoming apparent that you could use imaging in a way to accomplish something rather than just make a diagnosis.
Two things came out of this for me: first, it broadened my own horizons about looking for knowledge in different places, and second, it encouraged me to challenge the status quo—which is really at the core of what IR is in many ways.
After spending time in London, learning what we now call a chest intervention, I came home. That’s when New York Hospital did the first percutaneous lung biopsy. It was like doing a heart transplant, there was that level of excitement around it.
32 IRQ | SUMMER 2024
This was the beginning of people starting to follow in Dotter’s footsteps, using the catheter as a surgical instrument. Simultaneously, people at Massachusetts General Hospital, at Penn, were starting to report things like putting drugs in catheters to treat gastrointestinal bleeding, and ultimately putting particulates in as well.
The light bulbs went off for me and I said, that’s really what I’m interested in. There was no name for it at the time. It was just this transition that was occurring between what we would call diagnostic angiographers and what would become interventionalists.
When I finished my residency, the chairman of the department—who I had a tremendous amount of respect for— heard that I was going to move further in angiography and cardiovascular radiology and told me I was making a big mistake, because CT scanning was going to be coming along. That was going to change the landscape and there would be no need for angiography. In those years, angiography was the number one way we diagnosed cancer, by using microangiography and looking at the architecture of different cancers. And I explained to the department head, no, this is different—I’m interested in treatment and therapy, and I think there’s an opportunity here.
RT: So, it sounds like although Dotter pioneered the angioplasty procedure in the U.S., it didn’t take off here but blossomed in Europe.
The
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