Interventional Radiology in Interventional Radiology in TurkeyTurkeyPast-Present and FuturePast-Present and Futureİzzet Rozanes (EBIR)İzzet Rozanes (EBIR)VKV Koç UniversityVKV Koç UniversitySchool of MedicineSchool of Medicine

18951895

X- Rays were discoveredX- Rays were discovered H.G.Wells wrote his H.G.Wells wrote his

novel novel ““The time machinThe time machinee””

He was inspired by He was inspired by Nicola Tesla 1856-1943 Nicola Tesla 1856-1943 (brilliant inventor, (brilliant inventor, electrical engineer, electrical engineer, mechanical engineer, mechanical engineer, physicist and futurist physicist and futurist

Who was inspired by the Who was inspired by the space-time concept of space-time concept of special relativity by special relativity by Albert EinsteinAlbert Einstein

Fact is thePlace whereFiction has Already been

W.C.RoentgenW.C.Roentgen Born in 1845 Born in 1845 Became a mechanical Became a mechanical

engineer in 1868 engineer in 1868 Became the head of the Became the head of the

“Phys“Physiik Institute” of k Institute” of Würzburg University in Würzburg University in 1879 1879

In 8 NovemberIn 8 November 1895 1895 notices a lumnotices a lumininenesence in enesence in a fluorescence tube while a fluorescence tube while working with cathode ray working with cathode ray tubestubes

Conducts experiments and Conducts experiments and notes that the rays can notes that the rays can penetrate solid objectspenetrate solid objects

Delivers a paper to the Delivers a paper to the secretary of Wurzburg secretary of Wurzburg medical-physics society medical-physics society titled “on a new kind of titled “on a new kind of rays”rays”

W.C.RoentgenW.C.Roentgen

His discovery causes a big His discovery causes a big sensationsensation

All newspapers cover his All newspapers cover his storystory

Receives thReceives the Nobel e Nobel prize prize for for physics in 1901physics in 1901

Does not deliver an Does not deliver an inauguration speech inauguration speech because of his shynessbecause of his shyness

Gives his money prize as a Gives his money prize as a present to his university to present to his university to be used for resbe used for reseearcharch

Dedicates his discovery to Dedicates his discovery to humanityhumanity

Dies in poverty in 1923Dies in poverty in 1923

RadiologyRadiology

1400 scientific 1400 scientific papers are papers are published on X Rays published on X Rays in the first 10 years in the first 10 years

A new speciality of A new speciality of medicine is createdmedicine is created

BJR starts regular BJR starts regular publication in 1905publication in 1905

MeanwhileMeanwhile

The Ottoman The Ottoman empire(1299-1922) and empire(1299-1922) and Modern Turkey (1923-) Modern Turkey (1923-) are not indifferent to are not indifferent to scientific progress scientific progress primarily 2nd to military primarily 2nd to military disadvantagesdisadvantages

““IslahatIslahat”” modernisation modernisation period 1770-1876period 1770-1876

1st constitution 1st constitution ““tanzimattanzimat”” 18391839

First engineering school First engineering school 1791, medical school 1791, medical school 1826, science school 18631826, science school 1863

The republic is a The republic is a modernisation project per modernisation project per sese

1897 Turkish X Greek 1897 Turkish X Greek warwar

Yıldız Military Yıldız Military Hospital-IstanbulHospital-Istanbul

Internist Salih Internist Salih BeyBey

Esat Feyzi 5th Esat Feyzi 5th year studentyear student

Osman 4th year Osman 4th year studentstudent

Crookes tube and Rumkorff coil

From “origin of military radiology: First use of X-rays in OttomanEmpire”A. Tunaci et al 2004

The Turkish Society of The Turkish Society of RadiologyRadiology Is founded in 1924 in IstanbulIs founded in 1924 in Istanbul The Turkish journal of Radiology The Turkish journal of Radiology

started started ““irregularirregular”” publication in 1955 publication in 1955 1st. Turkish Congress of Radiology is 1st. Turkish Congress of Radiology is

held in 1966held in 1966 Aspirations of a younger generation of Aspirations of a younger generation of

dynamic radiologists is not fulfilleddynamic radiologists is not fulfilled The Turkish Society of Diagnostic and The Turkish Society of Diagnostic and

Interventional Radiology is founded in Interventional Radiology is founded in 1991 in Ankara1991 in Ankara

1994, Diagnostic and Interventional 1994, Diagnostic and Interventional Radiology Radiology ““official journal of the Turkish official journal of the Turkish Society of RadiologySociety of Radiology”” starts starts ““regularregular”” ““publicationpublication

2000, Competition has activated the Istanbul 2000, Competition has activated the Istanbul society and following a period of sibling society and following a period of sibling rivalry common sense prevailsrivalry common sense prevails

The Istanbul society becames the National The Istanbul society becames the National Society of Interventional Radiology-TGRDSociety of Interventional Radiology-TGRD

The Ankara society becames the National The Ankara society becames the National Society of Radiology-TRD (approx. 4000 Society of Radiology-TRD (approx. 4000 members presently)members presently)

Charles Theodore Dotter 1920-1985 Charles Theodore Dotter 1920-1985

““renaissance manrenaissance man”” Painter, pilot, car racer accomplished mountaneer, (67 Painter, pilot, car racer accomplished mountaneer, (67

peaks over 3500m), dog enthusiast peaks over 3500m), dog enthusiast Can be credited with having invented Can be credited with having invented ““Interventional Interventional

RadiologyRadiology”” ““Karlovy speech 1963Karlovy speech 1963”” Performed and described PTA with his trainee Judkins Performed and described PTA with his trainee Judkins

in 1964in 1964 Invented catheter delivered stent (1969), first Invented catheter delivered stent (1969), first

thrombolysis (1972) first PTA baloon (1972) first j tip thrombolysis (1972) first PTA baloon (1972) first j tip guide wire, described first graft-stentguide wire, described first graft-stent

Did all this despite 2x CABG and 2x Hodgkin Did all this despite 2x CABG and 2x Hodgkin lymphoma tx by Rxlymphoma tx by Rx

Received the Nobel price for medicine in 1978Received the Nobel price for medicine in 1978

Charles DotterCharles Dotter

“Crazy Charly”

Meanwhile back in Meanwhile back in TurkeyTurkey Turkish Radiogists read the literatureTurkish Radiogists read the literature Follow international conventionsFollow international conventions PTA and stenting procedures are PTA and stenting procedures are

performed in academic centers in performed in academic centers in major Turkish hospitals almost major Turkish hospitals almost simultaneously in early 1980simultaneously in early 1980’’ss

A new generation travels to A new generation travels to ““interventional radiologyinterventional radiology”” training to training to North America and Europe in 1980North America and Europe in 1980’’ and 1990and 1990’’

Meanwhile back in Meanwhile back in TurkeyTurkey They return and a They return and a

new generation of new generation of radiologist radiologist performing almost performing almost exclusively exclusively ““interventional interventional radiologyradiology”” emerges emerges

They train the next They train the next generationgeneration

TGRD founded in TGRD founded in year 2000 is affiliated year 2000 is affiliated with Cirse in 2007with Cirse in 2007

Growing membershipGrowing membership

2009:1042009:104 2010:1342010:134 2011:1872011:187 2012:2222012:222 2013:3502013:350

2014 =380

What we have What we have accomplishedaccomplished We have a democratically run, robust, We have a democratically run, robust,

growing society growing society Most teaching hospitals in Turkey Most teaching hospitals in Turkey

perform the basic interventional perform the basic interventional radiologic proceduresradiologic procedures

Some centers are highly advanced in Some centers are highly advanced in the quality and magnitude of the the quality and magnitude of the procedures they perform procedures they perform

Majority of Majority of ““interventional radiologic interventional radiologic proceduresprocedures”” in Turkey are performed in Turkey are performed by radiologistsby radiologists

What we have not What we have not been able to been able to accomplishaccomplish Interventional Radiology has not been Interventional Radiology has not been

recognised as a speciality or subspecialty by recognised as a speciality or subspecialty by the Health Ministery despite efforts, 2nd to the Health Ministery despite efforts, 2nd to insufficient lobbying powerinsufficient lobbying power

We donWe don’’t have regular training programt have regular training program Few teaching hospitals have fellowship Few teaching hospitals have fellowship

programsprograms Most teaching hospitals in Turkey do not have Most teaching hospitals in Turkey do not have

interventional radiology bedsinterventional radiology beds A substantial number of IR do not have patient A substantial number of IR do not have patient

admitting priviledges in their hospitalsadmitting priviledges in their hospitals

The futureThe future

Minimal invasive Minimal invasive procedures have a procedures have a bright futurebright future

Although we have Although we have lost a lot of lost a lot of procedures we procedures we invented, invented, Interventional Interventional Radiology has Radiology has managed to survive managed to survive 2nd to the ingenuity 2nd to the ingenuity of IR of IR

If I have seen further, it is by standing on the shoulders of giantsIsaac Newton

Thank yourozanesi@yahoo.com+90 5322371695