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Innovation at Work congRress news CIRSE 2012 - Lisbon Saturday, September 15, 2012 Michael J. Lee CIRSE President InnovatIon at Work ... Welcome to CIRSE 2012, a congress Robert Morgan dedicated to excellence in IR! This is Scientific Programme neatly encapsulated by our slogan Committee Chairman “Innovation, Education, Inter ven - tion.” Innovation is the key build - ing block of the discipline, which from its earliest days has been cha rac ter ised by inspired new ap proaches to treating acute and chronic diseases. Paulo Almeida Local Host Committee Chairman The birth of IR Excellence and Innovation Continuing the Legacy of Innovation 1963 was an important year for radiology, due Dotter and like-minded radiologists continued In recognition of the continuing importance of As can be seen by the growing list of topics to a speech made at the first Czechoslovak Ra - to explore the possibilities of angioplasty, and innovative approaches to IR, Prof. Rolf Günther covered at every CIRSE meeting, innovation is diologic Congress by a certain Charles Dotter. to overcome the clinical obstacles presented. has established an Award for Excellence and still going strong, and has broadened the disci - The meeting, held at Karlovy Vary, was a large Doctors such as Melvin Judkins, Josef Rösch, Innovation, which will be presented at today’s pline to cover all manner of interventions, from international event, and the many delegates Stanley Baum, Sidney Wallace and Caesare Award Ceremony (see page 3) . This year, the the original vascular interventions, to encom - present listened in awe as Dotter explained his Gianturco, and many others besides, were all to award goes to Dr. Amman Bolia and Prof. pass stroke, trauma, kidney and musculoskele - vision of the future of radiology: “The angio - bring their own innovative ideas to the table. Jim Reekers, for their work in developing tal interventions, all the way to the most fast- graphic catheter can be more than a tool for subintimal angioplasty. moving field of all: oncology. passive means for diagnostic observation; Dr. Judkins was the one who would make the used with imagination, it can become an angioplasty truly minimally invasive, as he de - Subintimal angioplasty came into being in Innovation continues to be the bread-and-but - important surgical instrument.” vised and perfected the transfemoral approach, January 1987, following Dr. Bolia’s unintention - ter of every good IR, and this can express itself which was to largely replace the surgical cut- al recanalisation of a long popliteal occlusion in small ways – most usually, in the off-label His words turned out to be more than wishful downs of the brachial artery which had been through a dissection channel, while simultane - use of devices. While often having excellent thinking, and in January of the following year, used for early interventions. Dr. Rösch and ously in Amsterdam, the same approach was be - outcomes for patients in very dire situations, Dotter had the opportunity to try his theory. Dr. Baum in Los Angeles were to apply the ing developed independently by Jim Reekers. this practice is not without risks, and IRs can 82-year-old Laura Shaw presented with a non- ideas behind angioplasty to GI and biliary disor - According to Dr. Bolia, “the greatest discovery learn more about how to minimise complica - healing ulcer and gangrenous toes. The recom - ders, while Anders Lunderquist in Sweden was in relation to the technique was the ‘loop’, for it tions and protect themselves from legal action mendation to amputate the foot was flatly re - exploring the use of IR in pancreatic tumours. was with the help of the loop, with which one by attending today’s Medico-legal issues and IR fused, and her surgeon figured if she was refus - could not only extend the dissection through Session in Auditorium 2. ing surgery, Dotter might as well have a look at New applications were continually being consi - the length of a long occlusion, but also make a her. The reason for the injury was established dered, and new devices were designed. Many re-entry distally into a patent lumen. Therefore, Every year at CIRSE, we showcase the latest to be an ideal lesion on which to perform per - IRs adapted existing catheters and guidewires the real innovation was the discovery of the advances. Some of these prove to be major cutaneous angioplasty, and she agreed to try it. themselves, but some more well-known IRs, such loop.” advances, such as irreversible electroporation; Within minutes of the procedure, her foot was as Charles Dotter, entered into partnership with others are small improvements, or alternatives warm, blood flowed easily, her pain disappear - companies like Cook Medical. Others, such as For over 25 years, the technique has been that expand the indications to include previ - ed within a week, and the ulcer soon healed. Kurt Amplatz, were eventually to set up their own re fined and perfected with the help of hydro - ously disqualified sub-sections of patients. But She died 3 years later of an unrelated heart companies to produce their tailor-made devices. philic and ‘J’ wires, to the point that TASC D all innovations, large and small, help drive for - complaint, with both feet still intact. lesions previously thought to be the domain of ward not only IR, but patient care as a whole. Gaining public acceptance bypass surgery can now be dealt with using Growing as a specialty subintimal angioplasty. It has also been used in The continued need for innovation is best But from the public’s perspective, the arrival of many other occlusions, such as flush superficial explained by the great pioneer, Dr. Josef Rösch: This new therapy built on the previous innova - a Swiss cardiologist, Andreas Grüntzig, was artery occlusions (SFA), long tibial occlusions, “Present day interventionalists have a more tions that had led to diagnostic angiography, what really brought interventional radiological reconstitution of bifurcations and trifurcations defined clinical practice, with numerous estab - notably the pioneering work of Sven Seldinger. procedures into the open. Grüntzig had adapt - and iliac occlusions, and has led to many spin- lished techniques, tools and devices to select He was the first to crack the conundrum of how ed Dotter’s techniques, and had developed the off inventions. from. Despite this, interventionalists should to safely and successfully introduce a catheter first balloon catheter capable of dilating peri - always be thinking about potential improve - into a blood vessel – a puzzle that radiologists pheral arteries. In February 1978, the Lancet The technique has a steep learning curve, and ments in present procedures or developing had worked on since 1940. In 1952, a flash of published the impressive results from his first many find it difficult to perform. Prof. Reekers new techniques. An innovative, creative mind inspiration urged Seldinger to try a new arrange - five balloon cases, and the medical world suggests that further innovation may hold the must be an integral part of every ment of the tried and failed needle-catheter- responded with unprecedented warmth. His key: “To overcome this hurdle, we have now interventionalist.” guidewire combination: needle-wire-remove high profile and technical developments added developed a device for subintimal recanalisa - needle-catheter. This deceptively simple break - momentum to the progress of interventional tion with some engineers in Delft, which will through was to revolutionise radiology. procedures. make this technique available for all IRs”. Cardiovascular and Interventional Radiological Society of Europe C RSE coIngRress opening Ceremony and awards 3 news opening Ceremony and awards – 14:30, auditorium 1 Welcome to CIrSE 2012, the largest Ir con - Gold Medal Excellence and Innovation Pedro Burmester | Piano gress of the year! once again, we have made every effort to put together a broad scientif - Peter Mueller ic programme, covering the whole spectrum Boston, MA/US of Ir, and featuring some of the world’s most inspiring researchers and lecturers. But we also strive to honour those who have served the discipline well over their careers, and who have made staggering contributions to the field of interventional radiology. Amman Bolia Jim Reekers Join us today at 14:30 in Auditorium 1 for our Laudation: Andy Adam Opening Ceremony and Awards, with enter - tainment provided by the internationally Peter Mueller completed his medical training at The R.W. Günther Award for Excellence and In no - Internationally acclaimed pianist Pedro Burmester renowned piano soloist, Pedro Burmester. the University of Cincinnati, Ohio, USA, and his vation in IR celebrates one of the key aspects of studied with the great Helena Sá e Costa, grad - residency in radiology at Massachusetts Gene ral interventional radiology – that of innovation. It is uating from the Conservatory of Porto in 1981 Hospital, Department of Radiology, Boston, USA. privately funded by the R.W. Günther Foundation. with astonishing full marks. Later, he moved to Welcome Address In 1978 he started his interventional career in the United States, attending master-classes of the GI radiology section of Massachusetts This award was presented for the first time at the legendary pianists Vladimir Ashkenazy, Jörg Michael J. Lee, CIRSE President General Hospital, joining a team that was to last year’s Annual Meeting, and will this year be Demus, Karl Engel and Tatiana Nikolayeva. Paulo Almeida, CIRSE 2012 Local Host Committee develop a number of non-vascular radiology awarded to Dr. Amman Bolia and Prof. Jim Chairman procedures which are now considered routine, Reekers for their ground-breaking work in While still very young, he won awards in seve ral Robert Morgan, CIRSE 2012 Scientific Programme such as percutaneous biopsy, abscess drainage, subintimal angioplasty, a novel technique dis - competitions, including the Prix Moreira de Sá, Committee Chairman cholecystostomy, gastrostomy, biliary drainage, covered in 1988, which has also been referred second prize at the International Piano benign biliary drainage and percutaneous to as “temporary percutaneous bypass” (see Competition Vianna da Motta, and the jury ablation of liver and renal tumours.
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