Interventional neuroradiology
Encyclopedia
Interventional Neuroradiology (INR)/Neurointerventional Surgery (NIS) is an (ACGME) Accreditation Council for Graduate Medical Education
accredited medical subspecialty specializing in minimally invasive image-based technologies and procedures used in diagnosis and treatment of diseases of the head, neck, and spine. While NIS can be ACGME accredited, fewer than 5 programs in the U.S. are actually accredited. First accredited in 2000, there are currently more than 500 individuals in the United States who have an active interest and special competency in this field.
at the University of Lisbon to provide contrasted x-ray angiography in order to diagnose several kinds of nervous diseases, such as tumors, coronary heart disease and arteriovenous malformations. He is usually recognized as one of the pioneers in this field. Moniz performed the first cerebral angiogram in Lisbon in 1927.
In 2007, the specialty changed its name from Interventional Neuroradiology to Neurointerventional Surgery. The American Society of Interventional & Therapeutic Neuroradiology (ASITN) changed its name to Society of Neurointerventional Surgery (SNIS). Others have proposed redefining the field as "endovascular surgical neuroradiology." Closely aligned is the Society for Vascular and Interventional Neurology (SVIN), founded in 2006 to represent a society of persons interested in the innovative treatment of cerebrovascular and other neurological disease recently the Society of Minimally Invasive Neurological Therapeutic procedures (SMINTP), founded in 2009 to represent a society of specialists who gathered from Europe and Middle East to push forward the field in the developing regions by educating juniors and promoting research in this areas.
, Neurosurgery
, or less commonly Neurology
and additional training depending on the given field. Neurologists must complete additional fellowship training in neurovascular disease or neurocritical care in order to qualify to train in a Neurointerventional fellowship. Radiologists usually complete a fellowship in diagnostic neuroradiology prior to a Neurointerventional fellowship.
Neurointerventional fellowships are variable in length, but last from 1-3 years with a focus on the integration of clinical management and performance of endovascular surgeries of the conditions/diseases listed below. Many fellowships require a second year of training which allows participants to further hone their technical skills and assert a greater degree of influence in clinical management of patients with diseases of interest.
Accreditation Council for Graduate Medical Education
The Accreditation Council for Graduate Medical Education is the body responsible for the accreditation for graduate medical training programs for medical doctors in the United States. It is a non-profit private council that evaluates and accredits medical residency and internship programs...
accredited medical subspecialty specializing in minimally invasive image-based technologies and procedures used in diagnosis and treatment of diseases of the head, neck, and spine. While NIS can be ACGME accredited, fewer than 5 programs in the U.S. are actually accredited. First accredited in 2000, there are currently more than 500 individuals in the United States who have an active interest and special competency in this field.
History
The technique that constitutes the basis for angiographic neurointerventions, and thus, interventional neuroradiology, was first developed in 1927 by the Portuguese physician and neurologist Egas MonizEgas Moniz
António Caetano de Abreu Freire Egas Moniz , known as Egas Moniz , was a Portuguese neurologist and the developer of cerebral angiography...
at the University of Lisbon to provide contrasted x-ray angiography in order to diagnose several kinds of nervous diseases, such as tumors, coronary heart disease and arteriovenous malformations. He is usually recognized as one of the pioneers in this field. Moniz performed the first cerebral angiogram in Lisbon in 1927.
In 2007, the specialty changed its name from Interventional Neuroradiology to Neurointerventional Surgery. The American Society of Interventional & Therapeutic Neuroradiology (ASITN) changed its name to Society of Neurointerventional Surgery (SNIS). Others have proposed redefining the field as "endovascular surgical neuroradiology." Closely aligned is the Society for Vascular and Interventional Neurology (SVIN), founded in 2006 to represent a society of persons interested in the innovative treatment of cerebrovascular and other neurological disease recently the Society of Minimally Invasive Neurological Therapeutic procedures (SMINTP), founded in 2009 to represent a society of specialists who gathered from Europe and Middle East to push forward the field in the developing regions by educating juniors and promoting research in this areas.
Training
Preparatory requirements for a fellowship in INR/NIS include successful completion of a residency in RadiologyRadiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...
, Neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
, or less commonly Neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
and additional training depending on the given field. Neurologists must complete additional fellowship training in neurovascular disease or neurocritical care in order to qualify to train in a Neurointerventional fellowship. Radiologists usually complete a fellowship in diagnostic neuroradiology prior to a Neurointerventional fellowship.
Neurointerventional fellowships are variable in length, but last from 1-3 years with a focus on the integration of clinical management and performance of endovascular surgeries of the conditions/diseases listed below. Many fellowships require a second year of training which allows participants to further hone their technical skills and assert a greater degree of influence in clinical management of patients with diseases of interest.
Diseases & Conditions
The following is a list of diseases and conditions typically treated by neurointerventionalists.- Cerebral aneurysmCerebral aneurysmA cerebral or brain aneurysm is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.- Signs and symptoms :...
- Brain arteriovenous malformationArteriovenous malformationArteriovenous malformation or AVM is an abnormal connection between veins and arteries, usually congenital. This pathology is widely known because of its occurrence in the central nervous system, but can appear in any location. An arteriovenous malformation is a vascular anomaly. It is a...
(AVM) - Carotid-cavernous fistulaCarotid-cavernous fistulaA carotid-cavernous fistula results from an abnormal communication between the arterial and venous systems within the cavernous sinus in the skull. It is a type of arteriovenous fistula...
(CCF) - Dural arteriovenous fistulaDural arteriovenous fistulaA dural arteriovenous fistula , also called a dural arteriovenous malformation , is an abnormal direct connection between a meningeal artery and a meningeal vein or dural venous sinus.-Classification:...
- Extracranial (brachiocephalic) atherosclerosisAtherosclerosisAtherosclerosis is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol...
- Extracranial (head and neck) and paraspinal vascular malformations
- Head and neck tumors
- Intracranial atherosclerosisAtherosclerosisAtherosclerosis is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol...
- Juvenile nasopharyngeal tumor
- Meningiomas
- Nosebleeds
- Paragangliomas
- StrokeStrokeA stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
- Spinal vascular malformations
- Traumatic vascular lesions
- VasospasmVasospasmVasospasm refers to a condition in which blood vessels spasm, leading to vasoconstriction. This can lead to tissue ischemia and death . Cerebral vasospasm may arise in the context of subarachnoid hemorrhage. Symptomatic vasospasm or delayed cerebral ischemia is a major contributor to...
- Vertebral body tumors
- Vertebral body compression fractures
External links
- Society for Vascular and Interventional Neurology (SVIN)
- Society of Neurointerventional Surgery (SNIS)
- American Academy of Neurology (AAN)
- American Association of Neurological Surgeons
- Congress of Neurological Surgeons
- American College of Graduate Medical Education (ACGME)
- Interventional Neuroradiology at Johns Hopkins Medicine
- Society of Minimally Invasive Neurological Therapeutic procedures (SMINTP)