Association of Vascular and Inter ventional Radiographers
As I come to the end of my • Rewriting policies and procedures – awaiting
term of President, I would Board approval
like to recap what the Board
• Improve membership communication
of Directors and I have
with the Board by utilizing the committee
worked on this past year. We
have made some big strides.
Jaime Nodolf, RT(R)
• Added 10 articles on the website for CEU
• Instituted routine conference calls allowing
• Joined forces with ADVANCE
us to cut most travel
• Changed Past Presidents Formal Dinner The list may not seem long to some, but many
to a Past Presidents Reception decreasing hours were put in to each and everyone. The
expenses thou continuing to acknowledge Board will continue to work on these items and
our historical roots will continue to add more to make this organiza-
tion strive. We have all volunteered our time and
• Solicited funds from vendors for support
energy for this organization and hope that more
• Changed to electronic newsletters, cutting people will follow.
Thank you to all the Board and Committee
• Came up with a new website design, Members for your time and commitment to
waiting for installation this organization.
• Working to improve areas of interest from
Winter 2011 Inside this Issue
Interventional Informer Editor: 2 The Checklist Manifesto 17 BOD & Committees
David S. Douthett, RT(R)(CV) 3 2011 Award of Excellence 19 Shari Ullman Scholarship
4 Press Release Foundation
12100 Sunset Hills Road | Suite 130 5 2011 Annual Meeting 20 Bill SB336
Reston, Virginia 20190 8 CARE Bill 21 Editor’s Message
703-234-4055 | Fax: 703-435-4390 10 Meetings Around the World 27 Gestures
e-mail: email@example.com 11 Chapter Happenings 28 Annual Meeting Schedule
www.avir.org 15 Board of Directors 31 Membership Application
16 New Members 32 What is AVIR?
The Checklist Manifesto—How to Get Things Right
by Atul Gawandy
Reviewed by Karen Finnegan
C hecklists, huddles
and read-backs are
everywhere. They are
one million dead and the factors that led
Dr. Gawandy to the development of the simple
surgery checklist. Atul tells the story of what lead
not just the current buzz up to his decision and many other interesting stories
words that medicine has along the journey to implement the checklist.
adopted to create more Although his stories are entertaining, the lessons to be
work and angst for the learned are very thought provoking.
It seems that a simple checklist is not so simple to
but simple methods to
design. They have to help with memory recall and
insure patient safety.
clearly set out the minimum steps necessary in a
process while being usable and filled out quickly.
have been early adap-
One benefit that the checklist also accomplished
tors of the checklists, such as the airline industry,
was making the conglomerate of professionals in the
the construction industry, disaster recovery and the
operating room act more as a cohesive team. This
restaurant business, but healthcare is just starting
also seemed to have a positive effect on the outcome
to realize the impact a simple checklist can have on
because everyone felt more accountable not only to the
patient but to the rest of the team.
Why is medicine plagued with errors? Dr. Gawandy,
In IR and anywhere else that central lines are placed
a surgeon at the Brigham and Women’s Hospital in
in the hospital where I work, we use the checklist
Boston, believes the answer is simple; “the volume
for preventing central line associated blood stream
and the complexity of knowledge today has exceeded
infections. Our hospital went from the state’s worst
our ability as individuals to properly deliver it to the
infection rate to only 1-2 a month. That made most
people consistently, correctly and safely”. He believes
of us a believer but we still do not like the idea
that the medical professionals train longer, specialize
of a checklist for a procedure that we do multiple
more, use ever-advancing technologies and still they
times a day. More than twenty of The World Health
experience avoidable failures. It is his premise that
Organization countries have adopted the surgical
health care can do better by using the simplest of
checklist as the standard of care and their results
methods: the checklist.
are compelling that the simple checklist can make a
The surgeon, Dr. Gawandy is challenged by the difference.
World Health Organization to develop a global
I recommend this book for anyone who still doubts
program to reduce avoidable deaths and harm from
the value of the checklist, or who feels foolish by
surgery. The caveat was there was no money for
having to do the checklist and especially anyone who
research nor implementation and only 193 member
likes to hear “war” stories about surgical and other
countries needed to benefit from his discovery. This
book looks at the worldwide problem of unsafe
surgery that leaves seven million disabled and at least
2 | Winter 2011 | Interventional Informer
HEIDI APFEL: 2011 Award of Excellence Recipient
Melissa Post, MBA, CRA, RT(MR)(CV)(CT), FAVIR
Don’t worry when you are not recognized,
but strive to be worthy of recognition.
This year, I am honored to write an article on the 2011 Award of Excellence Recipient, Heidi Apfel.
In the last Newsletter, we discussed having pride and Heidi is a natural fit for this award. She is also one
the amount of sweat equity it takes to feel proud. whom the AVIRdesires to represent this organiza-
Working hard and being an integral part of some- tion (subliminal plea for you to assume an office
thing positive is worthy of recognition. role). We are grateful for Heidi’s dedication to the
IRfield and proud to welcome her in to the Award
It is required to be nominated by your peers to of Excellence family.
receive the recognition: Award of Excellence. Upon
the receipt of many such nominations, it became Those she joins are:
clear that Heidi is worthy of recognition. Let me tell
you why: 1997 – Richard Cless
1998 – Gara Colelli
“Her Success is a testament to her excellent 1999 – David Hall
work ethic, commitment to patients and
their families, dedication to the team and 2000 – Gene Maziarski
her organizational and technical skills” 2001 – Marie Schodle
2002 – Sharon Misler
“Heidi has an immense knowledge of IR and
is our ‘go-to’ person” 2003 – Leona Benson
2004 – Sandra Dixon & Amber Mitchell
“She is a self-starter whom her colleagues and
2005 – Viki Allenbach
MD staff hold in the highest esteem...”
2006 – Jaime Nodolf
“She… actively takes on the role of mentor for 2007 – Patricia Crane
new and beginning technologists with in the
section” 2008 – Rebecca Lassiter
2009 – John Mancera
“…always lends a hand and… goes above 2010 – Stephan Haug
“…she is a highly professional and Congratulations!
Interventional Informer | Winter 2011 | 3
Contact: Mike Bederka | Phone: 610-278-1400, x1128 | Email: firstname.lastname@example.org
Website: www.advanceweb.com/imaging | Address: 2900 Horizon Drive, King of Prussia, PA 19406
ADVANCE Forms Alliance with the Association
of Vascular and Interventional Radiographers
King of Prussia, PA—ADVANCE for Imaging & Radiation Oncology, the leading informational resource for
healthcare professionals in the imaging and radiation oncology fields, has partnered with the Association
of Vascular and Interventional Radiographers (AVIR).
This partnership will enable ADVANCE and the AVIR to take advantage of various cross-promotional
opportunities and work together to educate the imaging community throughout 2011. AVIR will contribute
a regular column to ADVANCE for Imaging & Radiation Oncology and collaborate on two joint educational
All qualified members of the AVIR will be eligible to receive a free print and digital subscription to
ADVANCE for Imaging & Radiation Oncology. AVIR members will also get a chance to sign up to receive
free weekly e-newsletters from ADVANCE, which offer timely news and original articles not available in
the print magazine
The AVIR is made up of interventional technologists, interventional radiology nurses, cardiovascular
technologists, radiology physician assistants (RPAs), vendor representatives and other associated
ADVANCE for Imaging & Radiation Oncology provides 98,900* allied healthcare professionals with
cutting edge practical and technical information regarding the imaging and radiation oncology fields,
including vascular and interventional radiography. Via a bimonthly print magazine, a weekly e-newsletter,
a website that is updated on a daily basis and special focus issues on women's health, radiation
oncology, PACS/IT and more, ADVANCE keeps imaging and radiation oncology professionals constantly
up to date with the latest news, articles and multimedia content.
ADVANCE for Imaging & Radiation Oncology is published by Merion Matters. Merion Matters is based in King of
Prussia, Pennsylvania, and proudly serves millions of nursing and allied healthcare professionals nationwide. Since
1985, the company has provided the healthcare community with print magazines, websites, e-newsletters, in-person
and virtual events, custom communications and promotional services, a popular healthcare shop and more.
**98,900 calculated from ADVANCE Readership Report run 2/3/11. ADVANCE Readership Report references the following subscription options: total
number of unique print subscribers, digital print edition subscribers and e-newsletter subscribers. Subscribers do not overlap.
4 | Winter 2011 | Interventional Informer
AVIR ANNUAL SCIENTIFIC MEETING 03.26-30.11
McCormick Place Convention Center | Chicago, Illinois | Held in Conjunction with SIR
Joni Schott, Program Chair
The AVIR Annual Scientific meeting is scheduled for March 26-30th,
2011 in Chicago, IL. Chicago is the perfect city for a large meeting
because of its offerings. There is something for everyone. We are excited
about the diverse, well-rounded program that is planned for this year.
The meeting will be conducted at the McCormick Place Convention Center. The
McCormick Center is an amazing complex. RSNA holds their annual meeting at
McCormick. The floor plan is very well designed as far as meeting space, transpor-
tation options, restaurants and shopping. The AVIR meeting will be held in the new
West Building. Buses will run to and from the hotels throughout the day and are
scheduled for every thirty minutes.
Interventional Informer | Winter 2011 | 5
AVIR ANNUAL SCIENTIFIC MEETING (continued)
The program committee has been busy on the
meeting plans and details. We will try some new
concepts that include two panel discussions/
presentations. The program includes a nice variety
of educations sessions. Topics will include neuroin-
terventions, ablations, venous and arterial disease
and treatment, patient care, musculoskeletal proce-
dures, IR veterinary care, UAE, and new procedures
and technology on the horizon. Dr. Buddy Connors
will be presenting this years Gold Medal Lecture.
As many of you know, Dr. Connors is an excellent
speaker and advocate for technologist and nurse
The pre-meeting workshops include a half day PICC
workshop and a half day ARRT registry review.
The SIR plans are progressing as well. Highlights
this year include oncology and palliative care, liver
tumor therapy, carotid/stroke interventions, women’s
health, embolics, lung tumor therapy, nanotech-
nology, renal tumor therapy, biliary interventions,
vascular imaging, hemodialysis, and peripheral arte-
rial interventions. The SIR program includes plenary,
symposia, categorical course, workshops and scien-
The meeting hotels are all within the same general
vicinity. Chicago is known for Michigan Avenue
or the Magnificent Mile, which is truly a shopping
extravaganza. Some of Chicago’s tourist sights
include Wrigley Field, Millennium Park, Lincoln Park
Zoo, Frank Lloyd Wright’s home and studio, John
G. Shedd Aquarium, the Art Institute, the Museum
of Science and Industry, and the Field Museum.
The restaurant selection is phenomenal and as
far as night life, there are many options including
Broadway shows, Navy Pier, comedy clubs, and
many musical venues.
PLEASE JOIN US IN CHICAGO!
AVIR ANNUAL SCIENTIFIC MEETING SPONSORS
GOLD MEDAL SPONSORS
SILVER MEDAL SPONSORS
Interventional Informer | Winter 2011 | 7
The American Registry of Radiologic Technologists
Editor: For more information on this two-page article,
contact Christopher Cook – phone (651) 681-3199;
fax (651) 687-0349; e-mail email@example.com www.arrt.org
CARE Bill: Building Awareness and Momentum
(March 4, 2011) — The CARE bill was featured in a February 28 New York Times article that
called attention to the patient-safety proposal as a way to improve the quality of medical imaging
exams and radiation therapy procedures.
The article explained that the Consistency, Accuracy, Responsibility and Excellence (CARE)
in Medical Imaging and Radiation Therapy bill would establish educational and certification
standards for personnel who perform exams and procedures that use medical radiation.
The bill has the support of 26 national organizations representing more than a half million
The article was the latest in a 13-month New York Times series on radiation overdose errors and
continued the conversation, hopefully leading towards movement forward by legislators in
passing the bill in the near future.
―In the bigger picture, healthcare requires a continuous quality improvement process,‖ said Jerry
B. Reid, Ph.D., executive director of the American Registry of Radiologic Technologists
(ARRT). ―We believe that passing the CARE bill would be a large step forward towards
achieving the best possible safety and quality.‖
―In addition to standards for personnel who perform exams, procedures, and use medical
radiation, we believe that quality and safety improvement requires a multi-disciplinary
approach,‖ Reid continued. ―It often depends on sound policy and procedure wherever care is
delivered, transparent oversight, properly programmed and maintained technology, committed
healthcare teams, and engaged patients and families.‖
The Registered Technologist (R.T.) credential is one important component of quality and safety
in a working partnership with practice and facility accreditors and state regulators, physicians,
and hospital, clinic and imaging center leaders across the country.
The ARRT’s mission is to promote the highest possible standards for patient care by recognizing
qualified individuals in medical imaging, interventional procedures, and radiation therapy. The
ARRT credentialing process is based in a multi-faceted Equation for Excellence. Education, plus
ethics, plus examination equals excellence – is a comprehensive process in which technologists
earn a credential and then maintain their qualifications so that they are able to safely provide
patient care throughout their career.
8 | Winter 2011 | Interventional Informer
Once qualified through successful completion of education, experience, and examination, the
equation for excellence requires individuals to live by ethical standards and always act in the best
interest of their patients. Continuing education is required to ensure the most current knowledge
and skill in an ever-advancing healthcare environment.
Peace of mind by helping reduce the possibility of misdiagnosis or treatment errors; helping
improve outcomes through better images, treatment and procedure quality; helping create
efficiencies that bring increased safety, added value and decreased healthcare costs; and helping
deliver exceptional patient experiences through well-rounded education, ethics and engagement
in the profession – that’s the value of credentialed technologists.
Visit The New York Times to read the latest in the series. For more information on the CARE bill
or to take action by letting your local legislators know why you support it, visit the American
Society of Radiologic Technologists website to find tools on who to contact in your area.
The American Registry of Radiologic Technologists promotes high standards of patient care by
recognizing qualified individuals in medical imaging, interventional procedures, and radiation
therapy. Headquartered in St. Paul, Minn., ARRT evaluates, certifies, and annually registers
more than a quarter-of-a-million radiologic technologists across the United States. For more
information, visit www.arrt.org.
WANT TO CONTACT THE ARRT?
online: www.arrt.org | phone: 651-687-0048
Concern about: Quinnipiac University
extension 8540 Education & Registration Hamden, CT
extension 8580 Ethics
extension 8560 Examination & Certification Ohio State University
extension 8530 Psychometrics
University of Medicine/Dentistry
ARRT – Recognized Radiologist Assistant of New Jersey
University of Arkansas for
Little Rock, AR
University of North Carolina at Chapel Hill
Chapel Hill, NC
Loma Linda University
Virginia Commonwealth University
Loma Linda, CA
Midwestern State University
Weber State University
Wichita Falls, TX
Interventional Informer | Winter 2011 | 9
MEETINGS AROUND THE WORLD
MEETING FOCUS WEBSITE LOCATION DATE
36th SIRAnnual Meeting Pe r i p h e ra l SIR w w w. S I R m eet ing. org C hi c ago, I L M arc h 26–31, 2011
21st Annual AVIRScientific Meeting Pe r i p h e ra l AV I R w w w. av ir. org C hi c ago, I L M arc h 26–31, 2011
2011 Mid-Atlantic Vascular and Pe r i p h e ra l c om os el e@ s ent ara. c om V i rgi nia B eac h, VA A pr i l 1–2, 2011
Venous Symposium in New York Pe r i p h e ra l VS w w w. venous s y m pos ium . N ew Yor k , N Y A pr i l 8, 9 2011
c om / 2011/ index . ht m l
33rd Charing Cross International w w w. c x s y m pos i um . c om London, U K A pr i l 9–12, 2011
Symposium: Vascular & Endovascular
New Advances in Cardiovascular & w w w. s avealegs aveahear t . c om S an Juan, P R M ay 6–7, 2011
International Vein Congress (IVC): Pe r i p h e ra l IVC w w w. iv c m iam i. c om M iam i B eac h, F L M ay 12- 14, 2011
Society for Vascular Medicine Pe r i p h e ra l w w w. vas c ular m ed. org B os t on, M A June 2 –4, 2011
2011 Vascular Annual Meeting Pe r i p h e ra l w w w. vas c ularweb. org C hi c ago, I L June 1 6–19, 2011
Complex Cardiovascular Catheter Pe r i p h e ra l / C3 w w w. c 3c onferenc e. net O r l ando, F L June 2 6–30, 2011
For Professionals Available in
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Phone: 800 432 5347 – Fax: 800 849-0946 – Email: Venosan@venosanusa.com
10 | Winter 2011 | Interventional Informer
Below are the most current contacts for the active AVIR Chapters. The AVIR is dedicated to developing new and
supporting existing state and regional chapters. From my experience with AVIR, activities at the Chapter level
are rewarding and a great resource for networking, both locally and nationally.
North Carolina Chapter of AVIR Lone Star State Chapter
Diane Koenigshofer MPH, BSRT-R(CV), FAVIR Alan Seeley RT (R)(VI)
Diane has about 350 people on our mailing lists for meetings and firstname.lastname@example.org
average about 60 attendees per meeting. They hold 1 Saturday
seminar a year and try to provide 8 CEs. North Texas Chapter
The next meeting will be in the Fall of 2011 in the Chapel Hill area. Sven Phillips RT (R)(VI)
Orange County California Chapter (OCAVIR)
Brett Thiebolt (R) Sven Phillips is starting a Vascular
email@example.com Interventional Certification program in
This Chapter has approximately 65 active members, and are a affiliation with Brookhaven College in
combination of RT’s, CVT’s and RN’s. OCAVIR and LAAVIR September 2011. The program will offer
held a joint Endovascular Symposium in 2009. 40 associates 31 hours college credit and provide clin-
attended the meeting. 7 CEU’s were given approved for both ARRT ical sites for technologists. The program
and AACN. 12 vendors participated. is 10 months in length and will allow the
Plans are to set up another Vascular students to sit for the VI exam. As the
Symposium for 2011 with the help NTAVIR Chairman, he hopes to partner
of the newly resurrected Orange with Alan Seeley this year to conduct a
County Angio Club. Dates to be Texas meeting. Their last meeting drew
approximately 40 plus attendees and
Northern California Chapter offered 6 CE’s. Sven is our newly elected
Darlene Crockett RT (CV) Director-at –Large, Congratulations.
Happy RT’s and RN’s Darlene held a meeting in SE Wisconsin Chapter
Old Sacramento, California in Julie Malkowski
November 2010, 32 technologists firstname.lastname@example.org
and nurses attended to receive 8
CEU’s. The NorCal Chapter is Julie Chairs the SEW-AVIR chapter in
hoping to do the same this year as Wisconsin. The chapter has been around
well. for a long time, at least 15years if not
more. Julie has been involved with it for
Jenelle, Glenda Barham, and Los Angeles Chapter the last 10 years. They offer 12 credits
Darlene Crockett Jeane Rhoten RT (R)(CV) a year if you are an AVIR member by
email@example.com having an all day 8 CEU meeting in the
Seattle AVIR spring and 4 other 1 hour talks during
Leona Benson RT (R)(CV) FAVIR the rest of the year. This year’s meetings
firstname.lastname@example.org are still to be announced.
www.seattleavir.com Baltimore Chapter
Sharon Misler RT (R)(CV) FAVIR
Dr. A. Lee presents Cardiology email@example.com
Interventional Informer | Winter 2011 | 11
Steve Haug and Anita Bell Dr. Mark Levy discusses AVIR Past President Jeff Kins
present at VI Review Atherectomy at GWL talks with Bard Vendors
Virginia Chapter VAAVIR Buckeye State Chapter (Ohio)
Rita Howard RT (R)(CV) Jamie Hiott RT (R) (CV)(M)(CT)(VI)
Christopher Shaver RT (R) South Carolina (SCAVIR)
firstname.lastname@example.org John Furtek RT (R)
The Virginia Chapter is the largest of all the active email@example.com
chapters, totaling over 100 members. Last year www.scavir.org
they held an 7 CE VI Review Course in May at
Richmond and an 8 CE Conference in November SCAVIR recently held The Sanctuary of Endovascular
in Williamsburg. Over 110 technologists and nurses Therapy (SET) at the Sanctuary Resort, Kiawah Island,
attended the two events combined. This year, plans are Feb 24-26. Future meeting details can be found at
to have the annual conference in October at the Great www.setmeeting.org
Wolf Lodge in Williamsburg, Va. Contact Rita and Metro Atlanta Chapter
Chris for further details. Thomas Staton RT (R) (CV)
New York Capital AVIR firstname.lastname@example.org
Kevin Brown RT (R) Great Lakes Chapter (Michigan)
kbxrayyahoo.com Michelle Denomme
Previously Chaired by Israel Rasaswamy, who will email@example.com
relocating to the Miami area. Kevin Brown will be Rocky Mountain Chapter
the point of contact in the central New York region.
Erik Stein RT (R)
This chapter features educational sessions combined
with regional Angio Clubs. Their last meeting was in firstname.lastname@example.org
November 2010, and featured presentation by local Erik has been involved with the Rocky Mountain
vascular surgeons. Chapte for a few years,. They plan on a regional
NE Connecticut AVIR meeting this fall/winter. Dates are to be announced.
This region will undoubtedly draw from the
Meredith Gaiter-Brown BSN, RT (R)(CV)(MR)(M)
surrounding states. Look for updates/notices regarding
email@example.com this event.
Meredith expressed her concerns for the past lack of
interest by regional members, but would like to see
the chapter active once again. Interested individuals
in that region are encouraged to contact her to assist
promoting renewed interest in the educational process.
12 | Winter 2011 | Interventional Informer
Per-Diem and Travel Assignments: notices, even Facebook notices can increase your atten-
Are you interested in travel work? Being in the situa- dance, and spark more interest. Contact the AVIR
tion myself, I’ve often encountered job offerings that office or any board member for assistance.
I could not commit to for various reasons. But what Why are Chapters so important?
if , as an AVIR member, you could select to be noti- At the grassroots level, Chapters help foster local
fied if a position became available in a city,region or and regional educational opportunities and increase
state you desired? The AVIR website has dozens of the overall visibility of the AVIR. Membership had
positions posted for both permanent institution and decreased over the last few years, which could be due
for travel assignments as well. It’s easy as posting a to the national economy, and the restructure of the
resume on the AVIR website Career section. Go there membership term. Several Chapters faded into obscu-
today to explore your future possibilities. The AVIR rity. But there has been a resurgence, new members,
has relationships with permanent, travel and per-diem renewing members, and most important new Chapter
companies that can put you in the right job at the interest. A Chapter’s activities enables its members,
right time for the right pay! and vice versa. Every technologist needs to obtain
Future Chapter Contacts CE’s to maintain their respective certification, why not
Miami, Florida achieve this goal, offer networking opportunities and
industry exposure? Providing education is a win-win
Israel Rasaswamy RT (R) (CV) for everyone involved.
firstname.lastname@example.org Getting local physicians involved, speaking on
Tampa, Florida current therapies and procedures, enhances not only
Christopher Sheridan RT (R) (VI) an Institution’s image, but also exposes attendees to
innovations and techniques to take back to their own
email@example.com practices. Talk to your interventional radiologists
New York City, New York about supporting the AVIR and its activities, whether
Rennie Mohabir RT (R) it’s providing a lecture locally, regionally or assisting
staff members in attending the Annual Meeting.
How Can You Start a Chapter in your
Living close to these metropolitan areas? Contact the
State or Region?
above individuals to express your support and ideas.
Active Chapters need active members. The following Depending on where you live, there may be a
areas and regions need active chapters. Chapter already, but you can still be involved. The
Chapter listings have been updated with current
contact information, so feel free to e-mail the Chapter
• Pennsylvania Representative in your area or region to inquire about
• Massachusetts upcoming meetings or events. New interests in New
York City and Tampa, Florida are also listed, along
with their respective contacts.
If you live in these areas, there are numerous
The process of starting a Chapter has a few require-
AVIRmembers who will benefit from organized
ments. Evaluating interest amongst your peers,
educational activities , such as those an active Chapter
whether within your institution, city or region is
can provide. Are you interested in joining the AVIR
a first step. Networking this interest through the
or getting involved in rewarding Chapter activities?
AVIR and industry sponsors can help promote an
Contact your area/regional Chapter representative. It’s
increased awareness, and potential members. The
a great way to start!!
AVIR has Chapter Committee , lead by the Director
Involved in a Chapter and need better exposure, let at Large, to help facilitate your needs. Reviewing
the AVIR help you by getting the word out about the AVIR Chapter manual will also be necessary, as
upcoming events. Email blasts and website events there are reporting requirements, CE application, and
Interventional Informer | Winter 2011 | 13
sponsorship information essential in having successful Chapter Manual, and find the contacts of those who
events. Selecting leadership, and organizing formal can help you be a success. The current website (www.
or informal meetings to discuss possible events and avir.org) is being upgraded in the very near future The
delegating the tasks that go along with AVIR spon- AVIR is also hosted on Facebook, where meetings and
sored CE presentations is important. Communicating events are posted, as well as blogs regarding practice
those discussions and events to your constituents is and industry ideas. Visit us there as well.
important as well. Visit the AVIR website to access the
As I mentioned before, AVIR membership reached its lowest period in In the Summer 2010 newsletter,
the last decade in 2010, several factors I feel there are 2 major contribu- We published a state by state break-
tors to this. down, Membership vs Specialties,
The Economy, plain and simple. Job market, home values, gas prices, using that membership data, and
etc. All affect how we see value in our daily lives. The AVIR wants to comparing it to February 2011, we
give you more bang for your buck, by offering educational opportuni- are seeing increases, some big, some
ties (in various formats) and promoting the profession world-wide. small, but increases. Here’s the
breakdown, as of February 2011.
Membership renewal period, in mid 2009, the renewal went from, July Keep in mind that memberships
1 to Jan 1, and a sharp decline happened as a result. Some members just can trickle in week to week, so
didn’t renew. If you know somebody like this. Please remind them. while these are accurate to February,
the numbers could be higher by
AV I R AV I R AV I R AV I R this printing.
State/Country 2010 2 0 11 State/Country 2010 2 0 11
ALABAMA NEVADA 5 I am pleased to say that there were
ALASKA NEW HAMPSHIRE 3 3 not any areas that decreased in
ARIZONA 12 15 NEW JERSEY 17 20 census. There are still areas where
ARKANSAS NEW MEXICO 2 2
membership is needed, mostly
CALIFORNIA 60 68 NEW YORK 33 37
COLORADO 13 15 NORTH CAROLINA 35 43 in the Great Plains states. In that
CONNECTICUT 13 15 NORTH DAKOTA 1 1 regard, members are needed every-
DELAWARE 2 3 OHIO 15 21 where. Our membership even
DIST OF COL OKLAHOMA 4 5 stretches out to areas as far as Saudi
FLORIDA 22 26 OREGON 8 8
GEORGIA 18 20 PENNSYLVANIA 50 59
Arabia, Hong Kong and Uraguay
HAWAII 3 3 PUERTO RICO 1 1 and Canada as well. Increasing
IDAHO 3 3 RHODE ISLAND 8 8 our membership numbers, allows
ILLINOIS 16 27 SOUTH CAROLINA 12 14 the AVIR to offer different on-line
INDIANA 10 12 SOUTH DAKOTA
IOWA 2 2 TENNESSEE 2 2
educational opportunities, as well
KANSAS 3 3 TEXAS 17 22 as plan and develop regional meet-
KENTUCKY 2 2 UTAH 6 7 ings as well as the Annual Meeting
LOUISIANA 3 3 VERMONT 1 1 with SIR and ARIN. Help promote
MAINE 6 6 VIRGINIA 83 107
the AVIR, in your labs and
MARYLAND 29 31 WASHINGTON 16 20
MASSACHUSETTS 18 29 WEST VIRGINIA 1 1 amongst your peers. Thank you for
MICHIGAN 29 31 WISCONSIN 34 39 your continued support.
MINNESOTA 7 9 WYOMING
MISSISSIPPI 4 5 CANADA 5 5
MISSOURI 5 7 OTHER 3 4
MONTANA Total 641 776
NEBRASKA 4 6 21%
14 | Winter 2011 | Interventional Informer
From left to right: Jeffrey Kins, David S. Douthett, Karen Finnegan, Melissa Post, Jaime Nodolf, Tony Walton, Joni Schott,
Dana Bridges, and Bill Greear
2010-2011 AVIR Board of Directors
Jaime Nodolf, RT(R) William “Tony” Walton RT(R)
President Director at Large
3121 Prospect Drive 8398 Windsor Drive
Sun Prairie, WI 53590-7010 Mechanicsville, VA 23111
Work Phone: (608) 890-6994 Work Phone: (804) 828-6986
Home Phone: (608) 332-4425 Work Fax: (804) 828-7926
Email: firstname.lastname@example.org Cell Phone: (804) 244-1792
Jeffrey Kins, RT(R)(VI)
Immediate Past President David S. Douthett, RT(R)(CV)
4201 White Heron Pt. Publications Chair
Portsmouth, VA 23703-5359 1304 Murray Drive
Work Phone: (757) 886-6520 Chesapeake, VA 23322
Home Phone: (757) 686-9578 Work Phone: (800) 447-7585 x1271
Email: email@example.com Fax: (757) 482-0473
Home Phone: (757) 482-5722
Melissa Post, MBA, CRA, RT(MR)(CV)(CT), Email: firstname.lastname@example.org
Vice President Dana Bridges, RN
1706 Cumberland Ct Associate Representative
Waunakee, WI 53597 1509 Fox Hollow Rd.
Work Phone: (608) 262-7549 Greensboro, NC 27410
Home Phone: (608) 335-3868 Work Phone: (336) 312-0095
Email: email@example.com Home Phone: (336) 856-7790
Bill Greear, MHA, MBA, RT(R), (CV)
Secretary/Treasurer Joni Schott, MBA, RT (R)(CT)
11926 Red Sorrel Lane Program Co-Chair
Huntersville, NC 28078 W3209 Schaefer Rd
Work phone: (704)-304-5867 Belleville, WI 53508-9660
Fax: (704)-304-5197 Work Phone: (608) 263-4099
Home Phone: 704-947-7002 Fax: (608) 263-8297
Email: Bill.firstname.lastname@example.org Home Phone: (609) 424-6901
Leona J. Benson, RT(R)(CV),
FAVIR Karen Finnegan, MS, RT(R)(CV), FAVIR
Web Site Chair Past Presidents Chair
20519 14th Drive, SE 1321 Elm Road
Bothell, WA 98012 Baltimore, MD 21227
Work Phone: (425) 261-4145 Work Phone: (410) 328-3694
Fax: (425) 261-4149 Fax: (410) 328-2213
Cell Phone: (425) 772-6673 Home Phone: (410) 242-9242
Email: email@example.com Email: firstname.lastname@example.org
Interventional Informer | Winter 2011 | 15
OUR NEWEST MEMBERS
ACTIVE MEMBERS CLINICAL ASSOCIATE MEMBERS
Jennifer Barrett Greenville, NC Pamela Mansfield Wilmington, DE
Meagan Beauchamp Boston, MA Darlene Messer Garfield Heights, OH
Tari Ann Bocook Gahanna, OH Gina Smith Owasso, OK
Alex Bruce Boston, MA James Williams Bellevue, WA
Lynda Campbell Tallmadge, OH Ryan Zewatsky Norfolk, VA
Heather Carver Farmington, UT
Wade Cobb Union City, CA CORPORATE ASSOCIATE MEMBERS
Jonathan Craig Morton, MS Katherine Duncan Chapel Hill, NC
Kenneth Doud Bourbonnais, IL
Stefanie Feyka Pittsburgh, PA STUDENT MEMBERS
Lori Hart Three Rivers, MI Daniel Heiser Gainesville, VA
Jaclyn Heiser Yulee, FL Megan LeBel Charlottesville, VA
Jacqueline Huldt Grand Island, NE Bethany McCollough Charlottesville, VA
Harold Hulings Gillett, PA Amhelia McCracken Waynesboro, VA
Joy Jacob Skokie, IL Brian Sharp Earlysville, VA
Stephan Johnson Selkirk, NY
Holly Keenan Plymouth, WI
Stephen Kelbach Euclid, OH
Karen Keyes Hampden, MA
Jodi King Sheboygan, WI
Matthew Lee Janesville, WI
Mark Lingad Waukegan, IL
Thomas Lukas Renton, WA
Matthew McGill Easthampton, MA
EXCELLENCE is a talent or quality
Patrice Moe Bloomington, MN which is unusually good and so surpasses
Heather Nemeth Mount Pleasant, SC
ordinary standards. It is also an aimed for
Sherri Nixon Champaign, IL
Michael Owiesny Saint Clair Shores, MI standard of performance. Actual studies
Nicole Price Leesburg, VA have shown that the most important way
Roberta Rehor La Grange, IL
Gordon Remchuk West Chazy, NY to achieve excellent performance in our
Kathy Schiavina West Springfield, MA profession is to practice. Achievement of
Laura Sears Duluth, GA
Lorie Shafer Colorado Springs, CO excellence in this field commonly requires
Christopher Sheridan Lutz, FL approximately 10 years of dedication,
Kari Smith Kankakee, IL
Raina Thrower Kinston, NC comprising about 10,000 hours of effort.
Sarah Umiker Salado, TX
Amy Warburton Bourbonnais, IL
Linda Weiland Warrenville, IL
Dennis Windsor Bloomington, IN
16 | Winter 2011 | Interventional Informer
AVIR Board of Directors & Committees
Jeffrey Kins, RT(R)(VI), Immediate Past President,Nominating Committee Chair
Our Board of Directors consists of President-Elect, Secretary/ Treasurer, Director-at-Large, and Associate
Representative. A requirement to be nominated for a Board position consists of being a current AVIR
member and must have served on an AVIR committee for at least one (1) year. The following are a brief
explanation of some of the responsibilities and commitments.
President-Elect: Three (3) year commitment. and conference calls. Jamie Nodolf after 5 years on
the board will move into the Past President slot.
Vice President: this is a voting position. Your She has a wealth of experience with most every
first year responsibilities would include being position on our board of directors.
the Chair of the Education Committee, Chair
of the Fellowship Committee, and a member of Secretary/Treasurer: One (1) year commitment.
the Finance Committee. You also shall attend This is a voting position. Your responsibilities
all Board Meetings and conference calls, write include chairing the Finance Committee and the
newsletter articles, work closely with President for Membership Committee. You will work closely
a smooth transition, and stand in for President with the home office on all Financial Reports,
whenever needed. This year we have voted in write newsletter articles, present a Finance report
Tony Walton, whom comes with great creden- at Annual Business Meeting, and attend all Board
tials and also spend the last year working as Meetings and conference calls. This year Bill Greer
Director-at-Large. was re-elected and is looking to continue on his
mission to create a solvent organization.
President: this position is a non-voting position
(unless there is a tie). Your second year responsibili- Director-at-Large: One (1) year commitment.
ties would include being the Chair of the Ethics This is a voting position. Your responsibilities
and Judicial Committee, a member of the Finance include being the Chair of Chapters Committee,
Committee, a correspondent with all external orga- a member of the Education Committee and the
nizations, and presidential correspondence. You are Finance Committee, assist with local chapter
responsible for writing the “Presidents Message” for committees by answering questions and corre-
the newsletter, work with Immediate Past President sponding with local chapter members. You will
on projects thus enabling a smooth transition. write newsletter articles, present the Director-at-
You conduct the Annual Business Meeting and are Large report at Annual Business Meeting, and
responsible for the agenda for all of the Board of attend all Board Meetings and conference calls.
Director meetings and conference calls. This year This year we welcome in Sven Phillips as the we
Missy Post will step up as our new President as she get representation from all over.
transition out of VP.
Associate Representative: One (1) year commit-
Past President: this is a voting position. Your third ment. This is a non-voting position and your
and last year of commitment include being the responsibilities would include Chairing the Associate
Chair of the Nominating Committee, a member Representative Committee and attend all Board
of the Finance Committee, and are responsible Meetings and conference calls. This position repre-
for the AVIR External Liaisons. You will write sents non-RT members. Dana Bridges will be this
newsletter articles, work with President on projects year’s Associate Representative.
from previous years, and attend all Board Meetings
Interventional Informer | Winter 2011 | 17
The previous commitments might of seemed a Finance Committee: Seeks contributions from
bit more than what you were capable of at this outside sources to fund the projects of the
time; so, there are Committees that need a strong Association.
representation of members. Please consider joining
Chapter Committee: Members are known as
one or more of these committees. It is a great way
Chapter Liaisons. Each Chapter Liaison is assigned
to be involved in the decisions of the association.
a regional area where they shall be responsible
Nominating Committee: Prepares the ballot for
for helping new chapters get started or helping
the general election.
existing chapters with problems and/or questions.
Ethics/Judicial Committee: Considers any ethical
This committee is chaired by the Director-at-
or judicial question regarding the policies of the
Large. All local chapter liaisons must submit a
Association or Local Chapters or actions of the
bi-monthly report on the activities for the past
members of the Association.
two months and future activities of their assigned
Education Committee: Responsible for policies chapters.
concerning continuing education programs; for
Annual Program Committee: Plans and conducts
reviewing and approving the educational program
the Annual and Regional Meetings of the
of meetings/seminars endorsed by the national
Association; and for assisting other organizations,
including local chapters, in planning the content Publications Committee: Develops and imple-
of educational meetings/seminars in which the ments policies and guidelines regarding the
Association will be endorsing (e.g. Regional AVIR relationship between the Association and
Meetings). publishers of professional journals and other
publications in the field of Cardiovascular and
Fellowship Committee: Reviews applications for
Interventional Radiology. The committee over-
admission as a Fellow of the AVIRand elects as
sees the newsletter and other publications of the
Fellows those applicants who satisfy the relevant
criteria. Fellowship Committee members are
required to have AVIR Fellowship status. Associate Members Committee: Reviews asso-
ciate member concerns and supervises associate
Award of Excellence Committee: Reviews nomina-
membership recruitment. Committee members
tions for the Award of Excellence and elects the
shall have associate membership status.
most qualified nominee who satisfies the relevant
criteria. Award of excellence committee members Web Site Committee: Reviews and recommends
shall be recipient’s of the Award of Excellence. to the AVIRBoard content to be placed on AVIR
Membership Committee: Reviews membership
concerns and supervises membership recruitment
efforts. Committee Members should include the
Associate Member Representative.
18 | Winter 2011 | Interventional Informer
Shari Ullman Scholarship Foundation
David Douthett RT R CV
T his is the second year since the AVIR renamed
the Gold Medal Lecture in honor of Shari
Ullman. After Board approval, the AVIR presented
Technologists wanting to participate would submit
an essay with specific criteria (topic to be deter-
mined) which would be reviewed by a committee.
this honor to Shari two years ago and she was The technologist chosen would have all expenses
really touched. In fact to quote Shar: “this means paid to attend the Annual Meeting. The expenses
the world to me.” The first annual Shari Ullman would include registration to the AVIR Annual
Gold Medal Award was given at our 19th Annual meeting, coach airfare and hotel for four nights.
Meeting in San Diego. Unfortunately, Shari past
Shari Ullman Scholarship Fund had its initial
away before she could present the first Gold Medal
kick-off at the 20th Annual Meeting in San
Award named in her honor. However, Shari’s
Diego. Many contributors have come forward
family was able to attend the first awarding of the
and we were hoping to be able to start this last
Shari Ullman Gold Medal Lecturer Award to Dr.
year to award this; however the funds in the
John Aruny. A duplicate crystal was presented to
Foundation would not support that at this time.
her family, in remembrance of Shari. This year it
Please help us fulfill this Scholarship by making
is being presented to Dr Buddy Conners, a great
your donation. We are super close and with
supporter, champion and contributes and helps this
just a little more, next year we can award this
organization move forward just as it was meant to
scholarship and send our first deserving active
be as the “Shari Ullman Gold Medal Award”.
member off to San Francisco to the 22nd AVIR
Several of the Past Presidents have suggested that Annual Scientific Meeting.
a fitting way to honor Shari’s many contributions
The AVIR will be accepting donations for the
to the AVIR would be to set-up a scholarship to be
Shari Ullman scholarship fund which help create
given to a deserving active member to attend the
Annual Meeting. Although there is much planning
to be done, an initial approach has been suggested.
Editors Award Winner Newsletter Advertising Rates
and Production Schedule
AVIRwould like to acknowledge the following
Type Dimensions (inches) Ad Rate
writer for their publication in the past issue.
Classified Ad 1 column inch $ 125.00
Karen Finnegan, “ When Hospitals 1/8 page black/white ad 2¼ x 3¾ $ 225.00
Should Fly” 1/4 page black/white ad 4½ x 3¾ $ 425.00
Attention All Writers 1/2 page black/white ad 4½ x 7½ $ 800.00
Full page black/white ad 9 x 7½ $ 1,500.00
The Interventional Informer is offering $100 to the
best article. This is awarded four (4) times a year. Full page color ad 9 x 7½ $ 2,000.00
The articles should be originals. No limit in size,
Issue Close Date Pub Date
but they must pertain to Interventional Radiology.
Just submit your article with name and address for 2011 Winter Jan 20, 2011 Feb 20, 2011
the AVIRBoard of Directors to review. 2011 Spring April 20, 2011 May 20, 2011
Best of luck! Full payment must accompany ad order.
Interventional Informer | Winter 2011 | 19
We Thought You Would Want to Know About This One…
Donald F. Haydon CAE
A bill, SB336, has been filed in New Mexico
to amend the New Mexico Medical Imaging
Licensure law that was passed in March of 2009.
The next stop in the New Mexico process is the
Senate Judiciary Committee (where it could go
on the calendar as early as tomorrow) a link to the
SB336, as originally drafted, would provide New Mexico Senate Judiciary Committee follows:
exemption from the provisions of the medical http://www.nmlegis.gov/lcs/committeedisplay.
imaging licensure law to three nursing specialty aspx?CommitteeCode=SJC If supported within
groups including the Certified Registered Nurse the Judiciary Committee, then it would then go
Anesthetists (CRNA), advanced practice nurses to the full Senate and then over to the House for
and nurse midwives. Those of us within the consideration. Things can move very quickly in
ultrasound professional community were working New Mexico, and having members contact both
on a more reasoned approach to exemption for members of the reference committees, as well as
these nursing groups based on a ‘Point of Care’ their own state representative and senator, is a step
approach when the bill (last week) passed out of worth considering.
the Public Affairs Committee in a much more
Our objective in providing this information is to:
onerous form, and with a recommendation to
the New Mexico legislature to “Do Pass” the bill. • Create a awareness among the national medical
The Public Affairs Committee passed amendment imaging community about the threat now
language that would allow all nurses to provide all posed by NM SB336
medical imaging services.
• Encourage the medical imaging professional
Compounding the problem is the speed at which associations and related organizations to engage
the New Mexico legislature moves; they only have their local membership constituency/registrants
a 60 day session and there is just about half that in creating a timely oppositional response to
time left in this current session. We experienced SB336
the warp speed review problem when we were
first involved with the proposed medical imaging There are other statutory and regulatory issues
licensure law in 2009. It is not a exaggeration to pending in other states (e.g. West Virginia,
say that the legislative calendar in New Mexico Oregon) and having SB336 passed in its recently
makes it very difficult to provide for informed amended form could create a troublesome prec-
decision-making based on comprehensive infor- edent. We hope you found this information to be
mation assemblage. helpful.
The professional ultrasound organizations have all Donald F. Haydon CAE
either issued, or will shortly, member alerts for a Chief Executive Officer
‘Call to Action’ in New Mexico. The take away Society of Diagnostic Medical Sonography
message in these alerts is a simple one, this bill Plano, Texas
should not be passed. We have also encouraged email@example.com
our respective members to engage their physician
partners in taking this bill to task with the appro-
priate New Mexico legislators.
20 | Winter 2011 | Interventional Informer
e d i t o r ’s m e s s a g e
Around the World with What is new and What should not be New!
David S Douthett RT R CV
Like last issue I am going around and getting clips ARGON Medical Devices, Inc. (Athens, TX)
of new items that are hitting the news and hence announced today that it has entered into a
forth being brought around to everybody in the definitive license agreement with Rex Medical, LP
lab, that will listen. (Conshohocken, PA) to market and distribute the
Option retrievable inferior vena cava filter.
Merit Medical Systems, Inc. has announced that
it has received 510(k) clearance from the US Food PAD CAN INCREASE CAD?
and Drug Administration for its ASAP thrombus In the Journal of the American College of
aspiration catheter. The company stated that the Cardiology, Ayman A. Hussein, MD, et al
device, which has been available in Europe, will be published findings from an analysis that sought to
launched immediately in the United States. characterize the progression of coronary athero-
sclerosis in patients with concomitant peripheral
According to the company, the ASAP aspiration
arterial disease (PAD) (2011;57:1220–1225).
catheter kit is designed for the quick removal
PAD is associated with adverse cardiovascular
of fresh, soft emboli and thrombus from vessels
outcomes; however, the impact of concomitant
of the arterial system. The ASAP kit contains a
PAD on coronary atherosclerosis progression in
dual-lumen rapid exchange catheter with related
patients with coronary artery disease has not been
accessories. The ASAP is a single-extrusion, 100%
well established, the investigators noted.
wire-braided, kink-resistant catheter with a large
aspiration lumen to facilitate quick aspiration. The investigators concluded that patients with
concomitant PAD were found to have a higher
incidence of extensive and calcified coronary
Teleflex Incorporated (Limerick, PA) announced
atherosclerosis, constrictive arterial remodeling,
that its Arrow NextStep antegrade chronic hemo-
and greater disease progression. These changes
dialysis catheter has received market clearance
likely contribute to adverse cardiovascular
from the US Food and Drug Administration. The
outcomes. The benefit for all patients in achieving
company expects to launch the product in the
low levels of low-density lipoprotein cholesterol
United States later this year.
supports the need for intensive lipid lowering in
According to the Teleflex, the Arrow NextStep patients with PAD, the investigators concluded.
catheter is indicated for use in adult patients. It is
designed to attain long-term vascular access for
hemodialysis and apheresis. The device provides
AHA: HOSPITAL COSTS RISE 5%
ease of insertion and sustained high flow. The ports
IN LAST DECADE
are reversed to match the heart’s natural blood flow Factors such as labor expenditures, shortfalls in
dynamics and are significantly separated to enhance reimbursement and health IT related costs are
flow and minimize recirculation. The venous port major drivers in hospital price increases over the
releases blood into the superior vena cava. The arte- past decade. Hospital costs have increased by
rial port draws blood from the right atrium. Side almost 5 percent per year from 2000 to 2009,
holes on the tip of the catheter are designed to pull according to a report published this month
blood from all sides of the catheter. that was sponsored by the American Hospital
Interventional Informer | Winter 2011 | 21
e d i t o r ’s m e s s a g e
ENDOVASCULAR TREATMENT “Patients do not necessarily want to know whether
FOR MULTIPLE SCLEROSIS the stent I have put in is patent or not. They want
Zamboni explained that, though multiple sclerosis to know about their limb preservation, they want
is an inflammatory neurodegenerative disease of to know about their pain control, they want to
the central nervous system of unknown origin know about their maintenance of mobility and
– widely considered to be autoimmune in nature – function and they want to know about wound
it is strongly associated with chronic cerebrospinal healing. . So I am suggesting here that all of us
venous insufficiency. look beyond the coronary paradigm when we start
dealing with below-the-knee study designs.
This link was supported by Zamboni’s recent
study of 65 patients affected by clinically defined There were patient vs. physician-centered
multiple sclerosis, along with 235 “healthy” outcomes and that lessons learned from the
control subjects. Though this study left open the surgical literature had shown that graft patency
question as to whether venous stenoses are the is equated with a successful clinical outcome and
cause or product of multiple sclerosis. amputation-free survival.
“I cannot answer this at the moment,” said “However, graft patency and its association with
Zamboni. “The interesting thing, though, is that other ‘patient-centric’ outcomes such as symptom
when you can treat the stenosis, you have, in time, relief, wound healing and mobility are poorly
an improvement in those patients. Especially in correlated and these are very complex patients,”
the first phase.”
Patency is only part of the answer. Looking to the
Zamboni’s current, ongoing study is exploring the literature, it is highlighted that in a 2007 study
effects of endovascular treatment for stenosed jugular (Taylor et al, Journal of American College of
and azygous veins in a cohort of 100 multiple scle- Surgery) which set out to determine success after
rosis patients, with follow-up to one year. bypass for critical limb ischemia, clinical success
was defined as achieving all of the following: graft
“I think that this is really promising,” he said. “I
patency to the point of wound healing, limb
have good cooperation with the neurologists in
salvage at one year, maintenance of ambulatory
my country. And I think that this could be prom-
status at one year and survival for six months.
ising if neurologists and vascular people work back
to back on this. The results of this study which enrolled 331
patients with Rutherford class 3–6 lesion, showed
that graft patency and limb salvage at three years
ExPENSIVE TECHNOLOGIES was 73%, but the total clinical success when
SHOULD YIELD BETTER PATIENT- combining all four of the parameters was only 44%.
Krishna Rocha-Singh, Prairie Vascular Institute “For below-the-knee lesions, expensive tech-
nologies should yield better patient-relevant
Interventions using coronary drug-eluting stents outcomes—perhaps an adequate percutaneous
below the knee in claudicants (Rutherford category transluminal angioplasty result alone is sufficient.
2 to 3) is a new, emerging study inclusion criteria. Although an important element, in the USA,
You can do trials in patients with ischemic limbs payers will not reimburse for ‘stent patency’. We
while excluding Rutherford Category 6 patients must challenge each other to promote rigorous
trial designs to advance this field beyond tech-
Coronary drug-eluting stents have superior binary nology-driven surrogates,” Rocha-Singh said.
patency rates compared to percutaneous translu-
minal angioplasty/bare metal stents in patients
with so-called “ischemic limbs” with mean lesion
lengths less than 3cm.
22 | Winter 2011 | Interventional Informer
e d i t o r ’s m e s s a g e
assessed for the primary endpoint at six months.
Investigators found that office-based blood pres-
sure measurements in the renal denervation group
decreased by 32/12mmHg (+/- 23/1mmHg, baseline
of 178/96mmHg; p
Between-group differences in blood pressure at six
months were 33/11mmHg (p
At six months, 84% of the subjects receiving renal
denervation had a decrease in systolic blood pres-
sure of 10mmHg or more versus 35% of 51 controls
RENAL DENERVATION REDUCES (pThere were no major procedure-related or device-
TREATMENT-RESISTANT HYPERTENSION, related complications.
SYMPLICITY HTN-2 TRIAL SHOWS
New data presented at the American Heart Dierk Scheinert, Leipzig, Germany, who presented
Association Scientific Sessions show that renal dener- these results at the LINC annual meeting noted that
vation significantly reduces blood pressure in patients there were no serious device- or procedure-related
with treatment-resistant hypertension. Murray Esler, adverse events in the 52 patients. There was one femoral
Baker IDI Heart and Diabetes Institute, Melbourne, artery pseudoaneurysm treated with manual compres-
Australia, presented results from the Symplicity sion; one post-procedural drop in blood pressure
HTN-2 trial. The results were simultaneously resulting in a reduction in medication; one urinary tract
published online in The Lancet. infection; one prolonged hospitalisation for evaluation
of paraesthesias and one back pain treated with pain
Elser told delegates that “Activation of renal sympathetic medications which resolved after one month.
nerves is key to pathogenesis of essential hypertension.”
The proprietary radiofrequency generator used in the “Six month renal imaging in 43 patients showed no
procedure is automatic, operates on low power and has vascular abnormality at any radiofrequency treatment
built-in safety algorithms. site. One magnetic resonance angiography indicates
possible progression of a pre-existing stenosis unre-
Investigators set out to assess effectiveness and safety of lated to radiofrequency treatment with no further
catheter-based renal denervation for reduction of blood therapy warranted,” he said.
pressure in patients with treatment-resistant hypertension.
There were no changes in measured renal function
Symplicity HTN-2 is a multicentre, prospective, with denervation, which suggests that the procedure
randomised trial. Between 9 June 2009 and 15 itself and associated hemodynamic changes have no
January 2010, Esler et al randomised 106 patients deleterious effects on the kidneys.
who had a baseline systolic blood pressure of
160mmHg or more (≥150mmHg for patients with
type 2 diabetes), despite taking three or more anti- IS RENAL ARTERY REVASCULARISATION
hypertensive drugs in a one-to-one ratio to undergo A DEAD DUCK?
renal denervation (n=52) with previous treatment or Nicholas Chalmers
to maintain previous treatment alone (control group,
n=54) at 24 participating centres. The primary effec- After ASTRAL, is there a role for renal artery interven-
tiveness endpoint was change in supine office-based tion? Nicholas Chalmers and Michael Jaff will try to
measurement of systolic blood pressure at six months. convince CX33 delegates wit arguments in favour and
Primary analysis included all patients remaining in against revascularisation of the renal arteries in the
follow-up at six months. debate ‘Renal artery revascularisation is a dead duck’.
CX33 will seek consensus whether there is any justi-
Forty nine (94%) of 52 patients who underwent fication for renal artery intervention and whether the
renal denervation and 51 (94%) of 54 controls were CORAL trial adds valuable data to this discussion.
Interventional Informer | Winter 2011 | 23
e d i t o r ’s m e s s a g e
Chalmers, consultant vascular radiologist, Manchester clinical indication and have no other explanation for
Royal Infirmary, Manchester, UK, will speak for the their resistant hypertension and/or kidney disease.
motion. “The outcome of the ASTRAL trial is a “Patients must have failed maximal medical therapy
reduction in the grey area of uncertainty surrounding and should have viable renal parenchyma. During the
treatment of renal artery stenosis. We now know procedure assessment of hemodynamic factors such
that, with very few exceptions, atherosclerotic renal as the fractional flow reserve and hyperemic systolic
artery stenosis can be managed conservatively,” he gradient may help direct treatment further.
told Vascular News. He will tell the CX audience that
isolated case reports demonstrate the benefit of renal “Admittedly, in a real world situation, endovascular
artery intervention. However, he will say, these cases renal artery stent revascularisation is not without
are not representative of the vast majority of athero- risk. Therefore it should be emphasised that proce-
sclerotic renal artery stenosis. dural expertise is critical to minimise periprocedural
complications. Advances in embolic protection device
“Historically, several uncontrolled cohort studies have technology may further reduce risk of renal athero-
claimed to demonstrate that intervention preserves or matous embolisation. By carefully selecting patients,
improves renal function in these patients. However, in predictable, clinically meaningful and beneficial long-
the absence of a control group, these claims are weak. term results can be anticipated.
Several small controlled trials failed to show benefit,
but were underpowered to do so,” he said.
Coronary CT angiography
The ASTRAL trial is a large randomised trial involving study rules out coronary
806 patients with renal artery stenosis. It has, as yet, artery disease in a 58-year-
demonstrated no benefit from intervention in terms old asymptomatic man with
of blood pressure control or preservation of renal multiple cardiovascular risk
function. factors. Image source: U.
Joseph Schoepf, Medical
“Critics have claimed that the negative outcome of University of South
ASTRAL is due to the operators’ lack of experience Carolina, Charleston
and skill resulting in a high complication rate. In other
words, those individuals who benefitted from inter-
vention were balanced by those who were harmed by AIM: LOW-DOSE CCTA RIVALS ANGIO FOR
it. This theory is not supported by the data: analysis CAD DETECTION
of change in serum creatinine shows no evidence of Low-dose coronary CT angiography (CCTA)
either benefit or harm compared with conservative suggested that the sensitivity of the technique rivals
treatment in the great majority,” Chalmers said. catheter-based angiography and may offer an alterna-
tive to invasive angiography in ruling out coronary
Speaking against the motion that renal artery revas-
artery disease in symptomatic patients, according to
cularisation is a dead duck, Michael Jaff, cardiologist,
a meta-analysis of 16 studies published March 15 in
Massachusetts General Hospital, Boston, USA,
Annals of Internal Medicine.
will argue that publications that failed to show a
therapeutic advantage for renal artery stenting had Although 2.3 million CCTA studies are performed
significant methodological flaws which prevent annually in the U.S., the noninvasive exam is associ-
conclusions from being drawn. ated with an effective radiation dose of 12 millisievert
[mSv], which has sparked concerns among physicians
“Although renal artery interventions should not
and patients. Prospective ECG gating, also known
be used for all patients with hypertension and an
as step-and-shoot or sequential mode, cuts dose up
incidental finding of renal artery stenosis, there is
to 80 percent by limiting radiation application to a
retrospective and prospective data to support its use
predefined point in the cardiac cycle. However, some
in appropriately selected patients,” Jaff said. He added
physicians have voiced concerns about the potential
that patients should be chosen for endovascular renal
reduced diagnostic quality of the resulting dataset
artery stent revascularisation only if they have a clear
24 | Winter 2011 | Interventional Informer
The Placement and Retrieval of IVC Filters
James F. Benenati, MD, provides his insight on the SIR guidelines regarding IVC filter use and
reminds us that patient follow-up and appropriate retrieval are tantamount to success
What are the major issues surrounding the use How have these issues come to light?
of inferior vena cava (IVC) filters in the current
practice of preventing pulmonary embolism (PE)? These issues have come to light by looking at the
overall use of a product. This type of information
IVC filters are very important tools for physicians is easily attainable, and it has become apparent
treating patients with deep venous thrombosis and that the number of filters being placed annually is
PE. There is very good evidence that these filters rising sharply. There may be good reasons for this
are effective in certain patient populations. One and proper indications; I’m not stating that we are
of the issues that has arisen recently is that IVC doing something wrong. I’m stating that we need
filters tend to be overused and that the indica- to take a very close look at what we are doing and
tions for the filters are starting to be expanded and have very good followup with our patients. It may
stretched into areas where we don’t have a lot of be that this is all very appropriate, but we need to
evidence to justify their use. Importantly, there have better follow-up and control of our patients.
may be some situations in which you can’t wait
for level I evidence. If something makes very good When is a retrievable device preferred over
a permanent device?
sense and it is believed that it may be best medical
practice, it may be appropriate to use a device with A retrievable device is favorable over a perma-
an expanded indication. We do not want to deny nent device when a patient’s risk of having PE
patients a treatment that could possibly help them. is limited to a short period of time. Patients
who may be at high risk in a temporary situa-
Any implantable device carries some risk with it,
tion, as, for example, those who possibly have a
and if you are placing filters too liberally, you are
clot in their leg and are undergoing surgery or
putting some patients at risk either without benefit
are exposed to certain risk factors that may be
or with limited or unproven benefit. More and
limited in time. When they are out of the period
more retrievable filters are being used. Filter use
of risk, the filter should come out.
in this country is increasing quickly, and one of
the problems is that a majority of the temporary To what degree are the current devices of concern
filters are not being retrieved. Retrievable filters are as to how they are used and monitored?
often being used as permanent devices, and many
patients are not being followed closely enough There are a variety of devices available. They are
with these devices. We must be cautious and make all different, and the data on them are different.
sure that if someone receives a temporary filter, the They all tend to work pretty well. Some of the
filter is removed when the patient’s risk of PE has filters seem to be more problematic than others,
passed. We need better follow-up in this country,
and that is exactly what the US Food and Drug
Administration suggested in their warning letter in
Interventional Informer | Winter 2011 | 25
and those need to be examined more closely. Some What is the ideal timing and nature of follow-up for
filters tend to migrate more than others or tilt, patients in whom an IVC filter has been placed?
bend, and fracture in the vena cava. It is prob-
The ideal timing and follow-up depend on the
ably best dealt with by a postmarket trial—not a
indication for the filter and the patient’s clinical
registry—to look at the use and the safety profiles
status. A filter that is being placed permanently
of the filters, either individually or all-inclusive.
with no chance of coming out might not require
Some of the responsibility falls to the manufac-
close follow-up. A patient who has an opportu-
turers to be aware of whether their devices are
nity to have the filter removed needs appropriate
problematic, and if they are, it is their responsi-
follow-up as determined by the implanting
bility to issue warnings, report problems to the US
physician at the time the device is placed. It’s
Food and Drug Administration, and either modify
the responsibility of the implanting physician to
the devices or pull them from the market.
bring the patient back at an appropriate time for
What is the Society of Interventional Radiology follow-up.
(SIR) recommending within their guidelines
specifically pertaining to the education of What types of imaging equipment should every
both interventionists and hospital staff who center have available?
are involved in implanting, monitoring, and Implanting filters requires good-quality imaging
retrieving filters? equipment with the ability to record and store
The SIR recommends all interventionists be prop- permanent images and the ability to perform imaging
erly trained through accredited fellowships. To runs. Documentation of location of placement and
place a filter, one must have adequate training; patency of the vena cava must be recorded.
this is attained by properly accredited fellowship How much or how often is continuing medical
training or post-fellowship educational activities education (CME) required for interventionists who
that provide adequate training in imaging and are placing these devices?
This skill set needed to perform IVC filter place-
One must understand all the indications and risks ment requires specific training in the venous
of placing the filter, and physicians are obligated system. This should be obtained during fellowship
to obtain informed consent and explain these training. CME is vital in all areas of intervention
procedures to their patients along with risks, and should occur frequently. Specific CME in
complications, and alternative therapeutic options. venous interventions should be obtained periodi-
In the appropriate setting, when a filter can be cally in order to be qualified to place IVC filters.
removed, the patient should be followed closely,
seen back by the implanting physician, and have
the filter removed at the first available time that
the patient is out of the window of risk for PE.
26 | Winter 2011 | Interventional Informer
Never ever passed these things along and I am not I asked him if he wanted to play a little football
starting now, I am just going to share this story with my friends. He said yes..
with thousands and hope that the good gesture just
We hung out all weekend and the more I got to
Start! We all know or knew someone like this!!
know Kyle, the more I liked him, and my friends
One day, when I was a freshman in high school, thought the same of him. Monday morning came,
I saw a kid from my class was walking home and there was Kyle with the huge stack of books
from school. His name was Kyle. again. I stopped him and said, ‘Boy, you are gonna
really build some serious muscles with this pile of
It looked like he was carrying all of his books. books everyday!’ He just laughed and handed me
I thought to myself, ‘Why would anyone bring half the books.
home all his books on a Friday? He must really
be a nerd.’ Over the next four years, Kyle and I became best
friends... When we were seniors we began to think
I had quite a weekend planned (parties and a about college. Kyle decided on Georgetown and I
football game with my friends tomorrow after- was going to Duke. I knew that we would always be
noon), so I shrugged my shoulders and went on. friends, that the miles would never be a problem.
As I was walking, I saw a bunch of kids running
toward him. He was going to be a doctor and I was going for
business on a football scholarship.. Kyle was vale-
They ran at him, knocking all his books out of dictorian of our class. I teased him all the time
his arms and tripping him so he landed in the about being a nerd.
dirt. His glasses went flying, and I saw them
land in the grass about ten feet from him... He He had to prepare a speech for graduation. I was so
looked up and I saw this terrible sadness in his glad it wasn’t me having to get up there and speak
eyes. My heart went out to him. So, I jogged
Graduation day, I saw Kyle. He looked great.
over to him as he crawled around looking for his
He was one of those guys that really found himself
glasses, and I saw a tear in his eye.
during high school. He filled out and actually
As I handed him his glasses, I said, ‘Those guys looked good in glasses. He had more dates than I
are jerks.’ They really should get lives. ‘ He had and all the girls loved him. Boy, sometimes I
looked at me and said, ‘Hey thanks!’ There was a was jealous!
big smile on his face. It was one of those smiles
Today was one of those days.
that showed real gratitude. I helped him pick up
his books, and asked him where he lived… I could see that he was nervous about his speech.
So, I smacked him on the back and said, ‘Hey, big
As it turned out, he lived near me, so I asked
guy, you’ll be great!’ He looked at me with one of
him why I had never seen him before.. He said
those looks (the really grateful one) and smiled. ‘
he had gone to private school before now. I
Thanks,’ he said.
would have never hung out with a private school
kid before. We talked all the way home, and I As he started his speech, he cleared his throat, and
carried some of his books. He turned out to be a began ‘Graduation is a time to thank those who
pretty cool kid. helped you make it through those tough years.
continued page 30
Interventional Informer | Winter 2011 | 27
AVIR ANNUAL SCIENTIFIC MEETING 03.26-30.11
McCormick Place Convention Center | Chicago, Illinois | Held in Conjunction with SIR
AGENDA Saturday, MarCh 26, 2011
Hyatt Regency cHicago
gold level, east toweR, Room columbus H
ADNEGA 8:00 AM–8:30 AM Continental Breakfast
8:30 AM–11:45 AM PICC Workshop
PROGRAM SUBJECT TO CHANGE 12:45 PM–4:00 PM CIT Exam Review
SuNday, MarCh 27, 2011
mccoRmick Place convention centeR
west building, FouRtH FlooR, Room w475
7:00 AM–8:00 AM Continental Breakfast
8:00 AM–8:15 AM Presidents’ Welcome
8:15 AM–9:15 AM Ablation 101: An Introduction to Percutaneous
Radiofrequency Ablation and Cryoablation
9:15 AM–10:15 AM DVT / Venous Interventions
10:15 AM–10:30 AM Break
10:30 AM–11:30 AM The Management of Renal Artery Stenosis
11:30 AM–1:00 PM Imaging Device Symposium, Room W476
Sponsored by Cook Medical
1:00 PM–2:00 PM Interventional Treatment of Venous Disease in the Legs
2:00 PM–3:00 PM From Zero to HeRO: An IR Survival Guide to HeRO
3:00 PM–3:15 PM Break
3:15 PM–4:15 PM Renal Ablation
MoNday, MarCh 28, 2011
mccoRmick Place convention centeR
west building, FouRtH FlooR, Room w475
7:30 AM–8:00 AM Continental Breakfast
8:00 AM–9:00 AM Panel: Acute Stroke and Intervention
9:00 AM–10:00 AM Vascular Anomolies-Embolization
10:00 AM–10:30 AM AVIR Business Meeting
10:30 AM–11:30 AM Carotid Artery Stenting: What You Need To Know
11:30 AM–1:00 PM Imaging Device Symposium, Room W476
28 | Winter 2011 | Interventional Informer
AGENDA Concurrent Sessions
1:00 PM–2:00 PM Gold Metal Lecture
ADNEGA 2:00 PM–3:00 PM Peripheral Artery Disease
3:00 PM–3:15 PM Break
PROGRAM SUBJECT TO CHANGE 3:15 PM–4:15 PM Spine Interventions
4:15 PM–5:15 PM Veterinarian IR Medicine-Oncology
1:00 PM–2:00 PM Interventional Coding I: Vascular Family
2:00 PM–3:00 PM Interventional Coding II: Interventions
3:00 PM–3:15 PM Break
3:15 PM–4:15 PM GI Bleed
4:15 PM–5:15 PM Hybrid OR/Angio Suites
tuESday, MarCh 29, 2011
mccoRmick Place convention centeR
west building, FouRtH FlooR, Room w475
7:30 AM–8:00 AM Continental Breakfast
8:00 AM–9:00 AM Panel: Management of Renal Artery Stenosis
9:00 AM–10:00 AM Venous Interventions
10:00 AM–10:30 AM Break
10:30 AM–11:30 AM Dural Sinus Stent Placement for Advanced
Pseudotumor with Papilledema:
A Disease Treatable with Interventional Techniques
11:30 AM–1:00 PM Imaging Device Symposium, Room W476
Sponsored by Space TRAX
1:00 PM–2:00 PM Extreme IR: The Show Goes On
2:00 PM–3:00 PM Pain Management-Spinal and Joint Interventions
3:00 PM–3:15 PM Break
3:15 PM–4:15 PM Interesting Cases Across Species From Fish to Lions
4:15 PM–5:15 PM Status and Controversies of UFE
1:00 PM–2:00 PM Yttrium 90 Radioembolization for Liver Malignancies
2:00 PM–3:00 PM Peripheral Artery Disease
3:00 PM–3:15 PM Break
3:15 PM–4:15 PM Endovascular Repair of AAA’s
4:15 PM–5:15 PM Diagnosis and Treatment of Shoulder, Chest,
Abdomen, Pelvis, and Buttock Vascular Malformations
Interventional Informer | Winter 2011 | 29
AGENDA WEdNESday, MarCh 30, 2011
mccoRmick Place convention centeR
ADNEGA west building, FouRtH FlooR, Room w475
7:30 AM–8:00 AM Continental Breakfast
PROGRAM SUBJECT TO CHANGE 8:00 AM–9:00 AM TACE and Portal Vein Embolization
9:00 AM–10:00 AM Pelvic Congestion and Fallopian Tube
Recanalization and Post-Partum Hemorrhage
10:00 AM–10:30 AM Break
10:30 AM–11:30 AM Cosmetic IR
11:30 AM–1:00 PM Imaging Device Symposium, Room W476
Sponsored by Siemens
1:00 PM–2:00 PM Pediatric Vascular Procedures
2:00 PM–3:00 PM Irreversible Electroporation
3:00 PM–3:15 PM Break
3:15 PM-4:15 PM The History of IR: From 1896 -2010 “In Constant
4:15 PM–5:15 PM Oncological Interventions
continued from page 25
Your parents, your teachers, your siblings, maybe a Mom and dad looking at me and smiling that same
coach...but mostly your friends...I am here to tell all grateful smile.
of you that being a friend to someone is the best gift
Not until that moment did I realize it’s depth.
you can give them. I am going to tell you a story.’
Never underestimate the power of your actions..
I just looked at my friend with disbelief as he told
the first day we met. With one small gesture you can change a person’s life..
He had planned to kill himself over the weekend. For better or for worse.....
He talked of how he had cleaned out his locker God puts us all in each others lives to impact one
so his Mom wouldn’t have to do it later and was another in some way. Look for God in others.
carrying his stuff home. He looked hard at me and
gave me a little smile. ‘Friends are angels who lift us to our feet when our
wings have trouble remembering how to fly.’
‘Thankfully, I was saved. My friend saved me
from doing the unspeakable...’ I heard the gasp go There is no beginning or end.. Yesterday is history.
through the crowd as this handsome, popular boy Tomorrow is a mystery. Today is a gift.
told us all about his weakest moment. I saw his
30 | Winter 2011 | Interventional Informer
ASSOCIATION OF VASCULAR AND/OR INTERVENTIONAL RADIOGRAPHERS
12100 Sunset Hills Road, Suite 130, Reston, Virginia 20190 | 703.234.4055 | Fax 703.435.4390 | Email: firstname.lastname@example.org
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mACTIVE — $ 75/yr * mCLINICAL ASSOCIATE — $ 65/yr mCORPORATE ASSOCIATE — $ 65/yr
mSTUDENT — $ 45/yr mINTERNATIONAL — $85/yr *ACTIVE – Submit ARRT certification or Canadian equivalent
NAME mMr mMrs mMs FIRST M.I. LAST GENERATION (JR., SR., II, III)
Preferred Address mHome mWork
CITY STATE ZIP
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WHAT IS AVIR?
The Association of Vascular and Interventional Radiographers (AVIR) is the national organization of
healthcare professionals within Vascular and Interventional Radiology and involved in standard of care
issues, continuing education and related concerns.
Who Can Become a Member of AVIR? Why Is Joining AVIR Important?
ACTIVE: Radiographers with a primary focus in Vascular The AVIRis dedicated to you and is a powerful advocate
and/or Interventional Radiology. Active members must be for the special interest and concerns of healthcare
ARRT registered or have Canadian equivalent. Submit copy professionals working in Vascular and Interventional
of certification with application. Radiology. We acknowledge the importance of continuing
Dues are $75 per year. education, establishing high standards of practice and care,
certifying Vascular and/or Interventional Radiographers,
ASSOCIATE: Related healthcare professionals working and establishing a nationwide network for obtaining
with or having a special interest in Vascular and/or information and/or employment opportunities.
Interventional Radiology, including Nurses, Medical/
Cardiovascular Technologies and Commercial Company What Opportunities Does AVIR Offer?
Representatives. • Professional growth
Dues are $65 per year. • Society of Interventional Radiographers (SIR)
STUDENT: Students in certified programs for Vascular Annual Meeting
and/or Interventional Radiographers. • Exchange of information and ideas
Dues are $45 per year. • AVIR Annual Meeting
• Continuing education opportunities
INTERNATIONAL: Healthcare professionals working • Quarterly newsletter
or having special interest in CIT and who reside outside • Local chapter involvement
of the United States and Canada. This category includes, • National membership directory
but is not limited to, medical technologists, radiologic
technologists, registered nurses, licensed practical nurses,
Physicians and commercial company representatives. The Association of Vascular and
Dues are $85 per year. Interventional Radiographers (AVIR)
12100 Sunset Hills Road, Suite 130
All Memberships are renewable annually each January. Reston, VA 20190
Join AVIR today... and become an influential force in the future of health care policies!
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Available for Category A CE Credits
Access the AVIRWebsite www.avir.org
Articles and tests are posted under Members Only
Mail or fax the completed test to AVIR
12100 Sunset Hills Road
Suite 130 Reston, Virginia 20190
FAX 703.435.4390 PHONE 703.234.4055 E-MAIL email@example.com
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