Radiology has had a key role in the current movement toward less invasive approaches to both diagnostic and therapeutic procedures. The beginnings of interventional radiology can be traced back to the work of Seldinger, who described the first nonsurgical introduction of a wire and catheter, and to the work of Charles Dotter, who is widely recognized to be the father of interventional radiology. For many years early interventionists were looked at with a peculiar curiosity by our referring physicians. However, our mission was always clear, namely to reduce the level of invasiveness required in accomplishing clinical goals. In the following discussion, the work of these interventional radiologists extends into the entire field of medicine, leading to less invasive efforts in urology, in biliary care, in cardiovascular care, and even directly in the surgical environment. For many in our field, the development of laparoscopic surgery was a direct offshoot of the work of early interventional radiologists.

The following three discussions, by Drs Dion, Wholey, and Black provide some sense of the diverse impact of interventional radiology. From the small, complex, and highly dangerous environment of the intracranial circulation, to the application of stents and angioplasty throughout the rest of the circulation, and finally the use of sophisticated imaging to guide needles and catheters to disparate anatomic locations, a varied group of important clinical applications has been developed.

Perhaps the most difficult question to answer remains, “What is an interventional radiologist?” The discussions that follow demonstrate how difficult it is to provide a clear definition of the interventionist since we virtually cross the entire spectrum of anatomy and pathophysiology of the human body, and interact with all medical specialties. It is clear, however, that interventionists of all disciplines have the same thing in common, namely, the use of imaging to create less invasive access into the body, and to guide instruments for both diagnostic and therapeutic purposes.

As we enter the new millennium, and interventional radiology its fourth decade, it is clear that this field remains one of exciting opportunity and, undoubtedly, of dramatic future development.

Barry T. Katzen, MD
Medical Director
Miami Cardiac & Vascular Institute
Miami, Fla

Endovascular therapy-established, new, and emerging procedures.
By Jacques E. Dion, MD

An interventional radiologist’s perspective on peripheral vascular disease: Where we have been, current treatment, and plans for the future.
By Michael H. Wholey, MD, MBA

Interventional radiology adds a potent new tool to its armamentarium to further ameliorate intervention.
By Steven Black, MD