Interventional Neuro

[undecided3yr]

My interest has been piqued by previous threads pertaining to Interventional Neuro. As far as I can tell, it has yet to be accrediated and may be stepping on Rads toes. Just a few questions if anyone has input:

1. Where are these fellowships?
2. Is there a possible fight brewing with interventional rads; thus limiting opportunity until the dust settles?

Thanks

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[Plesso]

http://forums.studentdoctor.net/archive/index.php/t-230537.html

 

[ihateschool]

Hi guys..

great topic and in my opinion an extremely exciting and up and coming opportunity for neurologists that are willing to dedicate themselves to the extra years..

my understanding is that to pursue this one has to continue for another three years of training after finishing their neurology residency so the total is 7 years...

Secondly, UMDNJ is outstanding with Dr. Qureshi, and MIchigan State University is doing some amazing stuff with Dr. Majed nowadays...I feel like that program is going to blossom in the coming year or two and will become one of the premiere programs along of course with UMDNJ...I'm not very familiar with many of the "big name" programs taking Neurology, but i'm sure its a possiblitiy...

The cool thing about this is that it affords a neurologist who enjoys procedural work to essentially be a neuroradiologist/neurosurgeon in a minor sense of course...either way its exciting and I truly believe that Neurology today is where Cardiology was 10-20 years ago and that the entire field is going to be an outstanding place to be in the coming years...

Good luck with everything and hope that info helps

Regards

 

[Astrocyte]

Hi guys..

great topic and in my opinion an extremely exciting and up and coming opportunity for neurologists that are willing to dedicate themselves to the extra years..

my understanding is that to pursue this one has to continue for another three years of training after finishing their neurology residency so the total is 7 years...

Secondly, UMDNJ is outstanding with Dr. Qureshi, and MIchigan State University is doing some amazing stuff with Dr. Majed nowadays...I feel like that program is going to blossom in the coming year or two and will become one of the premiere programs along of course with UMDNJ...I'm not very familiar with many of the "big name" programs taking Neurology, but i'm sure its a possiblitiy...

The cool thing about this is that it affords a neurologist who enjoys procedural work to essentially be a neuroradiologist/neurosurgeon in a minor sense of course...either way its exciting and I truly believe that Neurology today is where Cardiology was 10-20 years ago and that the entire field is going to be an outstanding place to be in the coming years...

Good luck with everything and hope that info helps

Regards

No doubt. But I believe the real breakthrough in stroke therapy will be medical and not surgical. Unlike CAD/MI, recanalization by itself has relatively limited benefit and significant risks, given the short effective time window. Carotid stents have shown to be valuable in only limited number of cases. Stroke is a different beast from MI altogether. Nonetheless, I certainly hope those neurologists who like to do it will have plenty of opportunities.

 

[ihateschool]

Great points Astrocyte...i agree with you that the medical breakthrough's will be the mainstay of stroke regardless of research, simply because the time window is so pervasive...

I do also agree with you that there is a sincere place for endovascular work and hopefully that aspect of the field will accompany the medical aspect leading to what is most important, better patient care and hopefully decreases in morbidity and mortality in post CVA patients.

its our jobs as neurologists to chip in and truly think abotu new and innovative ways to conquer the beast that is Stroke...That is one of the reasons that i love neurology and the fact that its only moderately competitive, it draws in residents that love the neurological system, and truly want to help in its aid...for the most part of course, exceptions always exist

Thanks for the input astrocyte and have a great day
Regards

 

[Docxter]

Great points Astrocyte...i agree with you that the medical breakthrough's will be the mainstay of stroke regardless of research, simply because the time window is so pervasive...

I do also agree with you that there is a sincere place for endovascular work and hopefully that aspect of the field will accompany the medical aspect leading to what is most important, better patient care and hopefully decreases in morbidity and mortality in post CVA patients.

its our jobs as neurologists to chip in and truly think abotu new and innovative ways to conquer the beast that is Stroke...That is one of the reasons that i love neurology and the fact that its only moderately competitive, it draws in residents that love the neurological system, and truly want to help in its aid...for the most part of course, exceptions always exist

Thanks for the input astrocyte and have a great day
Regards

Then stay tuned for the results of the currently ongoing Desmoteplase studies. We have been involved in the ongoing DIAS series studies at our place and it seems promising. Guess we'll have to see when the final phase III results come out.

On a side note, most neurologists, neurosurgeons, and radiologists do not want to do neurointerventions, mainly because of the bad lifestyle. Even most neurosurgery residents don't want to do it when they can have a much better lifestyle and perhaps much more money doing spine, functional, or tumor surgery.

 

[Bonobo]

I think endovascular treatments will be of prime importance in treating stroke in the future. The cerebrovascular system is different than the coronary system, but the basic principles of hemodynamics still holds. Clot removal will still make a difference, especially if we can do it more cleanly in the future. Another big important use of endovascular methods will be providing medications specifically to the brain region affected that might be toxic to other regions of the brain. tPA is one example, of course, and the upcoming IMS-2 trial will hopefully show that giving 1/2 of the tPA endovascularly will allow us to extend the time window and improve morbidity and mortality after stroke. Add neuroprotective agents of various sorts, and endovascular methods will possibly become even more important.

As the population ages, and patients are more often put on aspirin, plavix, and possibly blood thinners for below-the-neck problems, the rates of ICH will also expand quickly. I sense that endovascular treatments here will also be useful in controlling the bleeding *internally* and then shooting of agents to trunk arteries to help protect the surrounding brain tissue.

It is really simply a matter of basic physics: what can be done well systemetically, can be done better locally--where it is needed most.

On turf matters, btw, neurologists are rapidly taking up more and more training spots in interventional. I don't think the turf issues are really there among neurologists, radiologists, and neurosurgeons that much. Those neurologists that are as qualified and demonstrate equal eagerness and determination to enter this field--possibly one of the most demanding in all of medicine--will get spots, and good ones too. I know of neurologists trained at MGH, UCLA, Columbia, and the list goes on. Neurosurgeons really don't care that much because to be good at endovascular techniques, one cannot also compete with other neurosurgeons in performing lucrative surgical procedures--so what was the point of spending a combined 4 years of their life studying spinal surgery? Neuroradiologists will mostly realize the good life in the dark room. The real turf war is with cardiologists trying to do all the carotid stents. This is where we really need to fight--for the sake of the field and patients....

B

 

[Plesso]

another old thread...scroll down:
http://forums.studentdoctor.net/showthread.php?threadid=101422