Fellowship Overview

The Interventional radiology section at the Hospital of the University of Pennsylvania offers 7-8 fellowship positions per year. The year-long fellowship consists of one week rotations at HUP and The Children's Hospital of Philadelphia. The Philadelphia VA hospital and the Presbyterian Hospital of Philadelphia are covered in one month rotations . Four weeks are spent in a GU rotation with HUP's dedicated GU interventionalists and four weeks in a dedicated Research/Stent-Graft rotation during which the fellow is able to pursue clinical or laboratory based research and participate first-hand in HUPs very active stent-graft program.

Clinical Work

The fellowship offers exposure to a broad variety of cases. Fellows gain expertise in vascular diagnostic and therapeutic procedures, such as peripheral arteriography, angioplasty, stenting, thrombolysis, and abdominal, thoracic and peripheral venography as well as pulmonary angiography. We are extremely active in therapeutic procedures ranging from artery embolization and angioplasty and stenting to venous angioplasty, stenting and filter placement. Like most successful IR practices a large part of our work revolves around the dialysis patient. Unusual modalities such as lymphangiography and percutaneous sympathectomy are also performed. Non vascular interventional procedures cover the liver and biliary tract, GI. tract (percutaneous gastrostomies and percutaneous jejunostomies) as well as the GU tract and portal system. We have a thriving Chemoembolization Program as well as a Uterine Fibroid Embolization Program. We are integrally involved in abdominal and thoracic aortic stent-grafts (about 200 a year) with the fellows participating along with the interventional radiologist, surgeon, and vascular surgery fellow.
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Our caseload is more than adequate to give all fellows extensive experience in the above mentioned areas. Over the past year we have treated over 7,500 patients at the Hospital of the University of Pennsylvania alone. Although a majority of time is spent in an academic university hospital setting at HUP, candidates are exposed to more of a community radiology setting at the VA and Presbyterian Hospitals. Case volume at the Veteran's Medical Center is approximately 15-20 cases per week and at the Presbyterian Medical Center approximately 30-40 cases per week. A unique feature of the program is experience in interventional pediatric radiology at the world-famous Children's Hospital of Philadelphia, where our fellows gain experience in routine peripheral pediatric procedures, as well as in diagnostic neuroangiography under the guidance of two dedicated pediatric interventionalists.

History

The HUP Interventional Radiology section has long been regarded as a leader in the field of Interventional Radiology. Past section members have included such leaders and early interventional radiology innovators as Gordon McLean and Ernest Ring. Transhepatic Biliary drainage procedures were developed here as well as percutaneous image guided fluid drainage and angioplasty.

Current Staff

Currently, the staff includes Scott Trerotola (Section Chief and international authority on dialysis access procedures), Stan Cope (inventor of the Cope loop catheter, fellow of SCVIR); Michael Soulen (councilor for professional practice of SCVIR, specializing in image guided cancer therapies such as chemoembolization and radio-frequency ablation); Richard Shlanksy-Goldberg who has developed a successful uterine artery embolization program, and David Freiman( angioplasty and stents), the Fellowship Director. The section also includes a number of younger faculty (Timothy Clark, Jeffrey Solomon, Andrew Kwak, Max Itkin and Bill Stavropulos, Catherine Tuite, Aalpen Patel, Jeffrey Mondschein) with active research interests in MRI/MRA, dialysis intervention, and economic outcomes.

Physical Facilities

We currently have five interventional rooms and a small procedure room with a C-arm at HUP. A new nine-bed holding area has recently opened and two additional procedure rooms are planned over the next few years. Ultrasound is currently available in all of the interventional suites. Newly installed Vascular Lab equipment is available for clinical use and training. A digital workstation for reviewing studies such as CT scans and MRIs from other parts of the department is also available in the Interventional Reading Room.
The Fellows have an office with carrels, lockers, desks, and 2 computers.
At the Presbyterian Medical Center there are two rooms, one of which was installed in October 1999. There are also two rooms at the VA, one of which was opened in 2003.
A large medical research library is located adjacent to HUP. All four affiliated hospitals are within easy walking distance of one another, and all lie adjacent to or on the campus of the University of Pennsylvania with all the resources, activities, and facilities that one expects at a world-class research University.

Educational Resources and Conferences

Teaching consists numerous conferences and rounds. Weekly conferences include a didactic lecture, vascular imaging (MRA and CTA), and a combined vascular surgery conference. There are monthly Morbidity and Mortality and Research conferences. Each day we review the previous day's cases so everyone gets to se and learn from all the cases. board rounds where the cases from the previous day are discussed. All fellows participate in research with a mentor within the program and most present one or more papers at SCVIR. Although the main responsibility for the Fellows is patient care, research is an integral part of our program. Preparation of scientific material for presentation at national meetings is expected and is strongly supported by the attending staff and ancillary research personnel. Both clinical and animal research is performed at the University of Pennsylvania. A two suite research area which we will share with Cardiology is currently in the late stages of planning and should be available by March 2002. All fellows also receive a stipend to present at the annual SCVIR meeting. The department reimburses expenses for any conference at which a fellow presents a paper as first author. The section presents several annual CME courses which fellows are encouraged to attend, including one in Philadelphia's Rittenhouse Square. There is an annual IR section retreat at a resort on the Chesapeake Bay which all attending staff and fellows attend.

To see more information: The Hospital of the University of Pennsylvania

This article is reposted with thanks to The Hospital of the University of Pennsylvania.