Clinical practice The evolution
of IR How practice has changed over the past 50 years
T
he various procedures, therapies, techniques and mindsets that embody interventional radiology have had many different names
over the years. Well before the Society of Interventional Radiology, there were angiographers and procedural pioneers, cardiovascular radiologists and clinical cowboys. In the 50 years since the Society of Interventional Radiology was established, the field has seen unparalleled growth in technology, tools and longitudinal care. Today’s IR suite is almost unrecognizable from its roots, according to SIR past presidents, who shared how practice has evolved over their careers.
Tools Steaming guidewires “We had very limited tools when I started,” said Katharine L. Krol, MD, FSIR (2006–2007). “We weren’t
completely without, but catheters were 7 French, very stiff and had limited choice of curves.”
It was not uncommon for IRs to make their own curves, Dr. Krol said, utilizing a good old-fashioned kettle and steam.
“You had a tea kettle that would produce steam, and you would hold the catheter over the steam to
soften it,” said Michael D. Dake, MD, FSIR (2020–2021). “You would shape it with your hands into whatever shape you wanted, and when you removed it from the steam, it would cool in that shape.” As an added bonus, the steam would sterilize the catheter as well.
The problem, Dr. Dake said, is that although steaming would provide more flexibility than commercially shaped catheters, the shaping wouldn’t last long.
“The shape would eventually wear out if you took too long to do your procedure,” he said. “The tools that we have at our disposal are so much more advanced today.”
1973 The birth of a society 50 YEARS OF SIR TIMELINE 6 IRQ | WINTER 2025
Amid the rise of angioplasty, angio clubs and a group of 12 angiographers establish the Society of Cardiovascular Radiology (SCVR) during an organizational meeting at the Massachusetts General Hospital. They invite 48 well-known physicians in the field to join.
1974
Inventing stents Dr. Krol was in training when Andreas Gruentzig, MD, performed the first balloon angioplasty in 1977, and so she went into practice having seen balloon angioplasties, but never having performed one. During her early career, Dr. Krol had a front-row seat to arterial and venous interventions, participating in the stent trials with Julio C. Palmaz, MD, FSIR, to determine safety and efficacy of various stents such as carotid stents, drug-eluting stents and endovascular graft stents.
“All the early TIPS were done with uncovered wall stents,” said James B. Spies, MD, MPH, FSIR
(2014–2015). “And so the introduction of covered stents was a huge step forward because it allowed us to have much better outcomes and lower occlusion rates of TIPS.” Those lower occlusion rates enabled IRs to expand treatment to other areas, such as managing psuedoaneurysms, according to Dr. Spies.
1975 First Annual Scientific Meeting
The first Annual Scientific Meeting is held in Key Largo, FL, organized by Manuel Viamonte, Jr., MD. Learn more about the first meeting and who attended on pg. 20.
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