Interventional Neuroradiology

Fellowship Director: Dr. Dana Iancu, MD, MSc.
Program Administrator: Avril D'Silva

Overall Goals of the Program

This program provides one (or two) years of training in Interventional Neuroradiology. On successful completion, the physician will have the necessary skills to maintain a consulting practice in neuro-interventional radiology.

The training will be clinical (minimum of 12 months) but will also provide training and experience in research (up to one research day per week).

Program objectives are to develop an interventional neuroradiologist who:

  • Has clinical competence in the field of interventional neuroradiology, with expertise in performing diagnostic and interventional neuroradiological procedures. He/she will be able to:
    • Interpret multi-modality neurovascular imaging (CTA, MRA, DSA)
    • Post-process and interpret therapeutic neuro-interventional procedures (coiling, embolization, puncture, nerve block, vertebroplasty, etc.)
    • Serve as a consultant to general practitioners and other specialists such as neurologists, neurosurgeons, head and neck surgeons, spins surgeons, oncologists, physiatrists, anesthesiologists and ophthalmologists.
    • Arrange for supervising and performing complex diagnostic procedures in the sub-specialty.
    • Organise and supervise the pre- and post-operative care of patients treated for neuro-interventional diseases.
  • Has the ability to develop and carry out clinical or basic science research projects in the field of interventional neuroradiology, although it is not expected that the trainee will have the skills to conduct independent sophisticated research on completion of the one- or two-year program.
  • Has interest and ability to teach interventional neuroradiology to undergraduates, postgraduates and colleagues

Year 1

Assuming the trainee is, at the beginning of the program, sufficiently skilled in performing independently the majority of the diagnostic vascular/spinal procedures (for instance, diagnostic cerebral angiography, lumbar puncture, CT-guided biopsy), and following a few weeks of adaptation to the routine of the local supervisors, the first year clinical fellow will focus on performing, under supervision, diagnostic cerebral angiographies, diagnostic spinal angiographies, fluoroscopy-guided procedures (spinal, cranial), and on provided first assist in the coiling, embolization, or stenting of head/neck/spinal vascular conditions, tumors or mass lesions. He/she will learn the indications and technique for performing lumbar puncture, myelography, bone and soft tissue biopsies of the spine, and head and neck. Of note, procedures that are not listed in this document, but can potentially be performed by a neuro-interventionalist, may be added to the skill set during the course of the year to ensure an up-to-date training.

The clinical fellow will assess patients in clinic as well as in-patients at the hospital, prior to and after the procedure(s). He/she will be responsible for verifying the initial results of a variety of tests performed prior to a procedure being booked. The fellow will review the case with the supervising staff and ensure that the appropriate post-operative care is negotiated with the interested parts, including the family of the patients. He/she will function as an important liaison between the supervisor and the family. The trainee will learn indications for, and the appropriate technique of, the aforementioned procedures, and will learn to obtain an informed consent, and to lead pre- and post-procedure care. He/she will be responsible to train the junior diagnostic neuroradiology fellows in performing diagnostic cerebral angiography, diagnostic spinal angiography and other fluoroscopy and CT guided procedures.

Towards the second half of this first year, and depending on the trainee’s ability and learning curve, he/she will be encouraged to take on the lead as first operator on most of the cases, once again under the assistance of a supervisor who will passively guide him/her. The trainee will be encouraged to perform clinical research. Initial projects would include a case report or case series, depending essentially on the level of preparedness of the trainee.

Year 2

This year is offered when the trainee starts the first year of the program at the level of training that requires him/her to learn the basic techniques of catheter and/or needle manipulation in the first year. The second year clinical fellow will continue focus on the aforementioned activities of the first year, in addition to becoming the first operator in most of the procedures that the training program offers. He/she will continue to be responsible for providing training to the diagnostic neuroradiology fellow performing diagnostic cerebral angiography, diagnostic spinal angiography, and other fluoroscopy and CT guided procedures.

Application Deadlines

Academic Year 2019-2021: deadline to apply is September 30, 2017

***Applicants must have proven previous experience with cerebral angiograms or neuro catheter procedures described in their CV. If not, applicant must have completed two years of a diagnostic neuroradiology fellowship to be eligible for the interventional neuroradiology fellowship.

 

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