Innovation and Improvisation - Wednesday August 11th

A busy day in the Dotter intervention rooms where I got to see two types of intervention that I had never seen before. I won't bore you all with the details but the cases, both performed by Fred Keller, nicely summed up the Dotter ethos.

Adrenal vein sampling is a notoriously fiddly procedure which requires insertion of catheters directly into the (tiny) veins which drain the adrenal glands. FK is an expert at this and, as previously described, shapes his own catheters over a boiling flask rather than using expensive pre-shaped catheters.

A selection of pre-shaped vascular catheters

Afterwards he performed a Balloon-occluded Retrograde Transvenous Obliteration (BRTO) - a rare and complex procedure for abnormal bleeding vessels in the stomach - something that I am unlikely to ever see again (until I'm asked to do one!)

The Dotter Research Lab - Tuesday August 10th

The Dotter institute was founded in 1990 with a mission statement to develop a multidisciplinary program in interventional radiology with emphasis on research, education and patient care. In addition to the creation of the Dotter Institute itself (essentially a rebranding of the interventional radiology department of OHSU) a research lab was created to allow for the development of new IR techniques.

The Dotter Research Lab

The lab was originally housed in a small disused fire station at the edge of the OHSU campus site. In the last 20 years countless new IR technologies and techniques have been imagined and developed here. The original lab has been extensively expanded and redesigned and now incorporates the animal research lab, a conference centre and museum in a pretty chalet style building.

Visiting fellows can opt to spend a supervised afternoon in the lab practicing any IR techniques they choose. So after a quick visit to the museum I arrived in the lab with Fred Keller where my patient (lets call her "Bacon") was under general anaesthetic and ready to go.

I spent the afternoon performing a TIPS procedure and practicing caval filter deployment and retrieval techniques on Bacon under the supervision of one of the best interventional radiologists in the world. Which seemed to be time well spent.

Afterwards Bacon was sent to live on a farm...