The
endovascular surgical neuroradiology (ESN) or interventional neuroradiology
fellowship is a one-year ACGME-accredited clinical program offered under
the aegis of the Mallinckrodt Institute of Radiology and the Department
of Neurological Surgery at Washington University School of Medicine.
There
are three primary goals of the Endovascular Surgical Neuroradiology (ESN)
fellowship program. These goals are:
1.to
provide clinical training encompassing essentially all areas of endovascular
surgical neuroradiology
2.to
provide an understanding of disease symptomatology and pathophysiology
relating to those disease states which are amenable to treatment with endovascular
surgical neuroradiology
3.to
provide an opportunity for a meaningful and productive experience in research
The
key prerequisites for this fellowship can be found at the ACGME web site
(http://www.acgme.org/title:
Program Requirements for Residency Education in Endovascular Surgical Neuroradiology).One
prerequisite is a year of diagnostic neuroradiology training.Successful
applicants for the ESN fellowship will be offered a position in the diagnostic
neuroradiology fellowship for the year prior to ESN training. If possible,
we prefer that this training be done at our institution.
The
Interventional Neuroradiology Service is responsible for all endovascular
neurosurgical procedures at Barnes Jewish and St. Louis Childrens Hospitals
(http://www.nil.wustl.edu/~inr/index.html).There
are three full-time neuro-endovascular faculty: Drs. DeWitte T. Cross,
Colin P. Derdeyn, and Christopher J. Moran.The
section is directed by Dr. Cross and the fellowship program is directed
by Dr. Derdeyn.
In
terms of equipment, we have two dedicated, state-of-the-art Siemens Neurostar
units, with plans to replace one within the upcoming year.We
are performing some cases in the experimental Stereotaxis suite, investigating
the use of magnetic guidance under approved protocols (http://www.stereotaxis.com/neuro.html).We
have the benefit of excellent non-invasive imaging through the Mallinckrodt
Institute of Radiology, with multiple MR scanners and multi-ring CT scanners.
Our
clinical facilities and personnel are similarly impressive.Outpatients
are generally seen in the new, patient-friendly, Center for Advanced Medicine,
on the Washington University Medical School Campus (http://wuphysicians.wustl.edu/page.asp?pageID=33&NavID=6)
.Inpatients are generally cared
for in the Neurology/Neurosurgery Intensive Care Unit (http://www.neuro.wustl.edu/nnicu/),
under the directed of Dr. Michael Diringer.Excellent
neuro-anesthesia is also available for cases that require it.
The
volume of endovascular procedures is large.The
Neurovascular Program at Washington University, directed by Dr. Ralph G.
Dacey, Jr. and attended by the three neuro-endovascular faculty, as well
as Drs. Keith Rich, Robert Grubb, Jr., and Michael Chicoine,is
a major referral center for patients with surgically, radio-surgically
or endovascularly amenable cerebrovascular disease.For
the past several years we have performed over 300 therapeutic neuro-endovascular
cases annually, with progressive growth each year.The
largest fraction of these cases are for the endovascular treatment of cerebral
aneurysms, accounting for nearly 100 procedures last year.Other
common procedures include AVM embolization and carotid angioplasty.Many
of the later are referred by large Stroke Neurology and Vascular Surgery
services.Over 1000 diagnostic spinal
and cerebral angiograms are performed each year.While
these are generally performed by diagnostic neuroradiology fellows and
radiology residents, some are performed by the ESN fellows.
In
addition to endovascular training, the ESN fellows also learn to perform
spinal intervention procedures under the supervision of Drs. Louis Gilula
of the musculoskeletal section and Josh Shimony of neuroradiology.The spine
intervention service performs a large volume of vertebroplasties, as well
as nerve root and epidural injections.
ESN
fellows are expected to participate in the full range of patient care activities.These
include initial clinical evaluation, operative management, post-operative
patient care, and follow up clinic visits.Over
the course of the one-year fellowship, fellows are expected to assume increasing
responsibility for each of these facets of patient care.
In
addition to a strong clinical experience, fellows will also have the opportunity
to teach and supervise residents and medical students and will be expected
to participate in meaningful research projects within the Department of
Neurological Surgery and the Interventional Neuroradiology Service.There
are several weekly conferences that we participate in as a service.
For more information or an application please write or call:
Colin P. Derdeyn. (Program Director)
derdeync@mir.wustl.edu
Pamela R. Jearls (Education Coordinator)
jearlsp@mir.wustl.edu
Interventional Neuroradiology Service
Washington University School of Medicine
Campus Box 8131
510 So. Kingshighway Blvd.
St. Louis, Missouri 63110-1076
Phone: 314/362-5950
Fax: 314/362-4886