The Beginnings of the Society of Interventional Radiology (SIR, née SCVIR, SCVR)

Abstract

IT is hard for many of us who were around in the early days of the Society of Cardiovascular Radiology to realize that 30 years have passed since the first organizational meeting at the Massachusetts General Hospital in 1973. The introduction of the percutaneous Seldinger technique represented a major advance in diagnostic imaging. In the very early 1960s, the only way to be trained in percutaneous angiography was to go to Sweden and study at the side of radiologists at Lund or Stockholm or go to Herbert Abrams at Stanford University, Charles Dotter at the University of Oregon, or Kurt Amplatz at the University of Minnesota. All offered fellowships in Cardiovascular/Angiography. The trainees from these fellowships were recruited to various parts of the country, and, slowly, the practice of Cardiovascular/Angiography began to grow. As is true for all fledgling disciplines, there was a need to share experiences, describe some of our complications, and describe new techniques. During the 1960s, all of us immersed catheters in boiling water to give them the right shape, punched the proper number of side holes, and flanged the ends of the catheters so they could be attached to the adapters and injectors. To facilitate the sharing of information, “angio clubs” began to spring up in different parts of the country. On the East coast, we had the Philadelphia, New York, Boston, and Baltimore clubs. The West coast had the Western Angiography Society with members from all the western academic centers. These clubs were also important as a means of educating and alerting each other to the incidence and nature of complications. In the early days, most angiographers performed angiocardiography and selective coronary arteriography in addition to peripheral vascular studies. In 1965, the pharmaceutical company making the most widely used contrast material for selective coronary arteriography decided that the contrast material would be safer if its concentration of sodium was decreased. Those of us performing selective coronary arteriography with use of this new contrast material began noticing a significant increase in the number of procedure-related ventricular fibrillations. This was identified early through the monthly meetings of the angio clubs. The company was notified, the sodium level was brought back to where it was, and the number of ventricular fibrillations decreased. Frank discussions at the angio clubs played a critical role in the early development and acceptance of angiography as a safe diagnostic method. The establishment of the angio clubs fulfilled in part the need for members to share information and to learn from each other. Soon it became obvious that geographic expansion of the citybased angio clubs would be beneficial. Expansion would bring more angiographers together to share the latest advances in the new field. This led to the organization of “regional” meetings. On the East coast, once a year, angiographers from Philadelphia, Baltimore, Boston, and New York gathered in one city on an alternating basis. These regional angio club meetings were wellattended and well-received. Participants found the information and the learning experience extremely valuable. During coffee breaks, comments were often heard and opinions voiced about expanding these meetings beyond cities and regions, possibly to a national level. The seeds for the development of a new national society were planted there and then. The growth of angiography as a diagnostic tool was rapid, and in a very short time angiography was being used to diagnose a large variety of abdominal and thoracic abnormalities. The angiographer was being called on to be available 7 days a week so emergency studies could be performed. The work on catheter control of variceal bleeding and on the angiographic localization and control of gastrointestinal bleeding from arterial sources laid the foundation for the therapeutic applications of angiography for the control of bleeding from the gastrointestinal tract (1–3) and trauma (Fig 1). The specialty rapidly evolved into “interventional radiology” (a term coined by Alex Margulis in his attempt to describe this new field of radiology). Blood flow in vessels could now be increased by placing dilating catheters or expanding baskets across stenotic or occluded vessels and bleeding in the gastrointestinal tract or following trauma could be controlled by means of From the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Address correspondence to S.B., Department of Radiology, 3600 Market Street, Suite 370, Philadelphia, PA 19104; E-mail: baum@oasis.rad.upenn.edu