Questions about Neurointerventionalists

[samsoccer7]

1. What's the difference between diagnostic neuroradiologists and neurointerventionalists? Some fellowship sites say "We have 3 diagnostic nr's and 1 neurointervent. on staff....?"

2. Is doing JUST a neuroradiology fellowship after regular DR good enough? Or do you have to do vascular/interventional AND neuroradiology? I keep reading mixed info on this. Some 1 yr neuro fellowships say they also teach interventional procedures, so this question piggy-backs #1.

3. Do you think the # of neurointerventionalists will increase at all over the next 5-10 yrs? (which is good, b/c you can share more call but still do enough procedures and make bank).

4. Is there anybody here who contemplated neurosurgery before realizing they'd actually like to take a vacation now and then, and became (or is becoming) a neurointerventionalist instead?

Thanks everybody, you guys are really helping me out. And if anybody cares to send me a private message, feel free.

P.S. I think I can get a DR spot somewhere, so posts about "just get a DR spot first then worry about it" will not help anyone reading this post.

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[Voxel]

Diagnostic neuroradiologists perform diagnostic procedures... ie diagnostic cerebral and spinal angiograms, spinal biopsies, ct and regular myelograms. NeuroInterventional Radiology is a 1-2 year fellowship after diagnostic radiology.

If you really want to become an neurointerventional radiologist you would need to complete a fellowship in NIR after regular neuroradiology fellowship (or sometimes via VIR this route can be more difficult to secure). No place that I know of will let you go from DR to NIR fellowship without doing neuroradiology DR fellowship first.

At some places you can structure your 2 year neuroradiology fellowship to be 1 year DR and 1 year NIR. VIR can perform NIR procedures usually after a 1 or 2 year fellowship in NIR.

It should be noted that many of the "diagnostic angiograms" are being replaced by MRA and more recently CTA. I have seen Cerebral and Carotid CTAs and I think they are as good if not better than cerebral/carotid angiograms because they can be rotated 360 degree space via a vitrea workstation. The images are amazing. And with the risk of diagnostic angiograms being around 1% stroke risk (or so I'm told), in this day and age I wouldn't really let someone do a diagnostic cerebral angiogram on my friends (unless it was during an interventional case).

If all you want to do is NIR and some radiology, you have to weigh the different paths to getting there ie neurosurgery vs diagnostic rads. You have to be able to complete either and all that this entails. Also you would not be doing "surgery", but minimally invasive procedures if you go the DR route.

 

[samsoccer7]

Thanks Voxel... to clarify:
If you do a neuroradiology fellowship, either 1 or 2 yrs, then you CANNOT do interventional in practice? If so, then how can I find programs that have interventional neuroradiology fellowships? A lot of websites say their neuroradiology fellowships include training in interventional, but you seem to be saying you have to do an ADDITIONAL year or so after neuroradiology to practice interventional. Am I right? I know NYU has an interventional neuroradiology fellowship that's not ACGME, but that's the only one I've seen so far.

 

[samsoccer7]

^

 

[Voxel]

In some institutions you can structure the 1st year to be diagnostic nuerorad and the 2nd year to be NIR.