Can IR do cardiac caths???

[Triple_AAA]

Lowly 2nd year med student so not trying to start any wars or arguments but I read somewhere about IR doing cardiac caths??? Is this true in the community setting because I have not heard of this before.

I have an interest in DR -> IR (if possible since I'm a DO student) and simply trying to learn as much as I can.

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[scoopdaboop]

Yea. IR is a specialty where your tools will let you do anything, from something like line placement to bringing someone back to life.

 

[Triple_AAA]

Yea. IR is a specialty where your tools will let you do anything, from something like line placement to bringing someone back to life.

Thanks for responding. In what situation(s) would IR handle this as opposed to IC?

 

[CCM-MD]

Yea. IR is a specialty where your tools will let you do anything, from something like line placement to bringing someone back to life.

Um. What? Talk about spreading false information.

OP, I have never heard of an IR performing cardiac cath.

 

[piii]

IRs invented the cardiac cath but don’t do it anymore. Could they if the wanted to? Yes. But the Interventional Cardiology docs would flip a **** because it’s one of the five procedure$ they do.

 

[NDcienporciento100]

Lowly 2nd year med student so not trying to start any wars or arguments but I read somewhere about IR doing cardiac caths??? Is this true in the community setting because I have not heard of this before.

I have an interest in DR -> IR (if possible since I'm a DO student) and simply trying to learn as much as I can.
[/QUOTE
I will clarify. No, IR does not do cardiac Caths.

 

[NDcienporciento100]

IR many years ago did cardiac caths. No longer, Many of the catheters and tools they use to this day are named after radiologist that did it.

 

[NDcienporciento100]

IRs invented the cardiac cath but don’t do it anymore. Could they if the wanted to? Yes. But the Interventional Cardiology docs would flip a **** because it’s one of the five procedure$ they do.

IR did not do the first cardiac catch a cardiologist did.

 

[Smoking Jay Cutler]

Right heart catheterization and pulmonary artery interventions, yes.

 

[Dr G Oogle]

IR did not do the first cardiac catch a cardiologist did.

Technically a urologist did the first cath using a foley

Werner Forssmann - Wikipedia

en.m.wikipedia.org

The Seldinger technique which makes endocascular and any luminal procedure possibly was invented by a radiologist

 

[Clean7795]

It is extremely rare IR will do a cardiac cath for cardiac intervention. I know a FEW places where they do and it is because of lack of adequate coverage from IC. You have to happen to live in one of those rare areas if you're hearing this.

I don't think it is helpful to claim who did what first, because even if many of the initial contributions were from radiologists, cardiology has always been heavily active in the development and furthering of interventional procedures.

 

[NDcienporciento100]

Lol! #medical student education for you folks.
So when someone says cardiac cath in today’s world they mean a coronary catheterization and or Intervention of the heart. Simply slipping a wire into the right atrium ie:central line (which is what the urologist did). Well no need to even go to medical school because a PA can do that lol. They put central lines in all the time. But the first person to put a catheter into a coronary artery was mason sones md IC at Cleavland Clinic on accident. There is know were in the country that even teaches IC to IR’s. Yes we go through The heart all the time to work on the pulmonary artery‘s etc. As far as stenting a coronary no way.

 

[UChicagoIR]

Please refer to the following articles on history:

Interventional radiology: a half century of innovation - PubMed

The evolution of modern interventional radiology began over half century ago with a simple question. Was it possible to use the same diagnostic imaging tools that had revolutionized the practice of medicine to guide the real-time treatment of disease? This disruptive concept led to rapid...

pubmed.ncbi.nlm.nih.gov

The history of cardiac catheterization - PubMed

The evolution of cardiac catheterization has occurred over at least four centuries. One of the first major steps was the description of the circulation of the blood by William Harvey in 1628. The next milestone was the measurement of arterial pressure by Stephen Hales, one century later...

pubmed.ncbi.nlm.nih.gov

Currently IR's are not trained to perform coronary angiography. There are many IRs who used to do coronary caths regularly in their practice but most have retired or are near retirement . I believe a young IR could easily learn to perform a cardiac cath, but I cannot imagine any hospital would credential someone to allow this. Having said this, I know of two interventional radiologists who were asked emergently to assist their cardiology colleagues in embolizing a ruptured coronary artery roughly 10 years ago or so. Take that for what it's worth.

Lol! #medical student education for you folks.
So when someone says cardiac cath in today’s world they mean a coronary catheterization and or Intervention of the heart. Simply slipping a wire into the right atrium ie:central line (which is what the urologist did). Well no need to even go to medical school because a PA can do that lol. They put central lines in all the time. But the first person to put a catheter into a coronary artery was mason sones md IC at Cleavland Clinic on accident. There is know were in the country that even teaches IC to IR’s. Yes we go through The heart all the time to work on the pulmonary artery‘s etc. As far as stenting a coronary no way.

 

[medradthrowaway]

There is no way interventional cards will give IR any slice of this pie.

 

[NDcienporciento100]

There is no way interventional cards will give IR any slice of this pie.

Have have actually already taken the Pie home with them. And I’m ok with it....

 

[Torquer]

This is a ridiculous conversation that I've stumbled upon by accident. But I feel compelled to respond as a Cardiology Fellow and clarify some very strange misconceptions.
- The first ever coronary angiography was performed by a Cardiologist, Mason Sones. Its a fun story, google it.
- It doesn't matter who started it or who 'gets to do it'. What matters is what's best for the patient
- An IC Fellow is a PGY-7 (3 years of IM, 3 years of general cardiology). This training is crucial to understand what patient is appropriate to cath, what patient is too sick, what patient doesn't need a cath, and then to follow up on these patients on the floor.
- IC's don't just 'shoot the pictures' and write 'clinically correlate' at the end of the report. The report is a comprehensive amalgam of hemodynamic and angiographic data along with clinical recommendations.
- With IC getting more and more complex, with the use of IVUS (intravascular ultrasound), IFR, FFR, atherectomy, shockwaves it is imperative to make this a full-time job with rigorous on-the-job learning.

Not to belittle interventional radiologists, they do amazing and impressive work. But when it comes to patient care, coronaries are best left to experts.
Hope this helps!

 

[medradthrowaway]

This is a ridiculous conversation that I've stumbled upon by accident. But I feel compelled to respond as a Cardiology Fellow and clarify some very strange misconceptions.
- The first ever coronary angiography was performed by a Cardiologist, Mason Sones. Its a fun story, google it.
- It doesn't matter who started it or who 'gets to do it'. What matters is what's best for the patient
- An IC Fellow is a PGY-7 (3 years of IM, 3 years of general cardiology). This training is crucial to understand what patient is appropriate to cath, what patient is too sick, what patient doesn't need a cath, and then to follow up on these patients on the floor.
- IC's don't just 'shoot the pictures' and write 'clinically correlate' at the end of the report. The report is a comprehensive amalgam of hemodynamic and angiographic data along with clinical recommendations.
- With IC getting more and more complex, with the use of IVUS (intravascular ultrasound), IFR, FFR, atherectomy, shockwaves it is imperative to make this a full-time job with rigorous on-the-job learning.

Not to belittle interventional radiologists, they do amazing and impressive work. But when it comes to patient care, coronaries are best left to experts.
Hope this helps!

I totally agree. IR has cornered itself into the technical role. It's the same story with neuro interventional. A neurosurg trained neuroir guy can do both IR and open procedures and manage the patient clinically.

 

[Kuratz]

@MQRaza

Agreed. To be fair this question was asked by a 2nd year med student with minimal exposure to IR or probably IC (though asked with good intentions). No IRs are even considering venturing into cardiac management. The only overlap might be in PAD or thoracic aorta.

 

[NDcienporciento100]

I totally agree. IR has cornered itself into the technical role. It's the same story with neuro interventional. A neurosurg trained neuroir guy can do both IR and open procedures and manage the patient clinically.

Neuro IRs

I totally agree. IR has cornered itself into the technical role. It's the same story with neuro interventional. A neurosurg trained neuroir guy can do both IR and open procedures and manage the patient clinically.

Neuro IRs can manage the patient clinically. Although I agree that Neurosurgeons can manage any possible surgical options.
There seems to be a misconception surgeons manage the whole patient. The reality is no one manages the whole patient. When a neurosurgeon does a stroke thrombectomy they send the patient to the ICU and the ICU attending and team manages them medically. Just one example.

 

[scoopdaboop]

Can’t PA’s do caths. Remember seeing some Duke study about PA's doing caths. IMO any of the non-surgical procedures are fairly mid level creep friendly... I mean, all a physician has to do is show them how to do it, then utilize the PA/NP to do 1-2 procedures like already done in GI with colonoscopies to bill more... Sad, but reality. Not saying NP/PA can decide who gets procedures and who don't, because that is above them, and they can't be close to good enough at the full gamut of procedures.

 

[NDcienporciento100]

Can’t PA’s do caths. Remember seeing some Duke study about PA's doing caths. IMO any of the non-surgical procedures are fairly mid level creep friendly... I mean, all a physician has to do is show them how to do it, then utilize the PA/NP to do 1-2 procedures like already done in GI with colonoscopies to bill more... Sad, but reality. Not saying NP/PA can decide who gets procedures and who don't, because that is above them, and they can't be close to good enough at the full gamut of procedures.

Simple procedures central lines etc. nothing complex, certainly not a cardiac cath/Intervention. Just because you see one case go smoothly ie; Stroke can be done in 20 minutes or less in a straight forward case. But what happens when you get a type 3 bovine arch and can’t go straight up the Carotid and you try and try from the groin and nothing works. What are you going to do in that <2% of cases. What happens when you get in the IMA for a GI Bleed and you do your run and you don’t see anything bleeding and it was clearly being fed by an IMA branch on CT. These are decisions that take years of experience and training to understand. Yes PA are great at simple cases but from what I have see when they come across anything that’s not straight forward they are yelling for the doctor.

 

[Tiger100]

To OP:

The answer is No.

But a bigger question is why you narrow down your choices so early. Do all rotations, choose the field that you like the most and go for it.

DR is very cool field. Many people stay in DR after doing a radiology residency.

Keep your options open.

 

[Tiger100]

This is a ridiculous conversation that I've stumbled upon by accident. But I feel compelled to respond as a Cardiology Fellow and clarify some very strange misconceptions.
- The first ever coronary angiography was performed by a Cardiologist, Mason Sones. Its a fun story, google it.
- It doesn't matter who started it or who 'gets to do it'. What matters is what's best for the patient
- An IC Fellow is a PGY-7 (3 years of IM, 3 years of general cardiology). This training is crucial to understand what patient is appropriate to cath, what patient is too sick, what patient doesn't need a cath, and then to follow up on these patients on the floor.
- IC's don't just 'shoot the pictures' and write 'clinically correlate' at the end of the report. The report is a comprehensive amalgam of hemodynamic and angiographic data along with clinical recommendations.
- With IC getting more and more complex, with the use of IVUS (intravascular ultrasound), IFR, FFR, atherectomy, shockwaves it is imperative to make this a full-time job with rigorous on-the-job learning.

Not to belittle interventional radiologists, they do amazing and impressive work. But when it comes to patient care, coronaries are best left to experts.
Hope this helps!

My question is why a Cardiology fellow should come to Radiology forum and make fun of a Radiologist's job?
Do you feel miserable in your current job? Do you wish you could "shoot the pictures" and write "clinically correlate" instead of your current job?

 

[IRorBustguy]

This is a ridiculous conversation that I've stumbled upon by accident. But I feel compelled to respond as a Cardiology Fellow and clarify some very strange misconceptions.
- The first ever coronary angiography was performed by a Cardiologist, Mason Sones. Its a fun story, google it.
- It doesn't matter who started it or who 'gets to do it'. What matters is what's best for the patient
- An IC Fellow is a PGY-7 (3 years of IM, 3 years of general cardiology). This training is crucial to understand what patient is appropriate to cath, what patient is too sick, what patient doesn't need a cath, and then to follow up on these patients on the floor.
- IC's don't just 'shoot the pictures' and write 'clinically correlate' at the end of the report. The report is a comprehensive amalgam of hemodynamic and angiographic data along with clinical recommendations.
- With IC getting more and more complex, with the use of IVUS (intravascular ultrasound), IFR, FFR, atherectomy, shockwaves it is imperative to make this a full-time job with rigorous on-the-job learning.

Not to belittle interventional radiologists, they do amazing and impressive work. But when it comes to patient care, coronaries are best left to experts.
Hope this helps!