Introduction to IR

Abstract

Interventional Radiology (IR) began with an act of faith, when Charles Dotter performed the first percutaneous transluminal angioplasty (PTA) (which he originally described as “percutaneous transfemoral catheter dilation”) in 1964 (Dotter and Judkins 1964). This was in the face of severe opposition from the establishment and at the time he was labelled a maverick. However, today quite rightly he is seen to be a visionary and a pioneer. He demonstrated that major surgical treatments could be done in a much less invasive and safer way. He built on the existing technologies: percutaneous selective catheter angiography using the Seldinger technique (Seldinger 1953). Although this had existed for some time prior to this, nobody up until this point had made the leap from performing diagnostic procedures to treating the disease at the same time. In its infancy, angioplasty was performed using coaxial or dilating catheters. The major problem with this technique was that the hole created in the artery had to be large (the same as the diameter that the vessel was to be dilated), limiting the size of the vessel that could be treated and resulting in a high number of complications related to the puncture site.