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Interventional Neuroradiology Fellowship

The Interventional Neuroradiology or Endovascular Surgical Neuroradiology (ESN) Fellowship is a one-year ACGME-accredited clinical program offered under the aegis of the Mallinckrodt Institute of Radiology and the Department of Neurological Surgery at Washington University School of Medicine.

Program Goals and Objectives

There are three primary goals of the ESN Fellowship program:
  1. to provide clinical training encompassing essentially all areas of endovascular surgical neuroradiology
  2. to provide an understanding of disease symptomatology and pathophysiology relating to those disease states that are amenable to treatment with endovascular surgical neuroradiology
  3. to provide an opportunity for a meaningful and productive experience in research

Prerequisites

Key prerequisites for this fellowship can be found at the ACGME web site:

Program Requirements for Graduate Medical Education in Endovascular Surgical Neuroradiology.

Applicants from a neurosurgical background must complete a prerequisite year of diagnostic catheter angiography and imaging training. This can be acquired during residency. One prerequisite for radiology trainees is a year of diagnostic neuroradiology training. If possible, we prefer that this training be done at our institution.

Clinical Service

The Interventional Neuroradiology Service is responsible for all endovascular neurosurgical procedures at Barnes-Jewish and St. Louis Children’s hospitals. There are four full-time neuro-endovascular faculty:

DeWitte T. Cross, III, MD
Akask P. Kansagra, MD
Christopher J. Moran, MD
Joshua W. Osbun, MD

The section and ESN fellowship program is directed by Dr. Cross. 

In terms of technology, we have two dedicated, state-of-the-art flat-panel Siemens Axiom Artis units with 3D capability. We also have the benefit of excellent noninvasive imaging through the Mallinckrodt Institute of Radiology, with multiple MR scanners and multi-ring CT scanners.

Our clinical facilities and personnel are similarly impressive. Outpatients are seen in the Center for Advanced Medicine on the Washington University Medical School Campus. Inpatients generally are cared for in the Neurology/Neurosurgery Intensive Care Unit at Barnes-Jewish Hospital.

The volume of endovascular procedures is large. The Neurovascular Program at Washington University, directed by Dr. Ralph G. Dacey Jr. and attended by the three neuro-endovascular faculty, as well as Drs. Keith Rich, Greg Zipfel and Michael Chicoine, is a major referral center for patients with surgically, radio-surgically or endovascularly amenable cerebrovascular disease.

For the past several years we have performed more than 300 therapeutic neuroendovascular cases annually, with progressive growth each year. The largest fraction of these cases are for the endovascular treatment of cerebral aneurysms, accounting for nearly 150 procedures last year. Other common procedures include AVM embolization and acute stroke intervention. Many of acute stroke interventions are referred by our large Stroke Neurology Service.

More than 1,000 diagnostic spinal and cerebral angiograms are performed each year. Although these are generally performed by diagnostic neuroradiology fellows and radiology residents, some are performed by the ESN fellows.

ESN fellows are expected to participate in the full range of patient care activities. These include initial clinical evaluation, operative management, postoperative patient care and follow-up clinic visits. Over the course of the one-year fellowship, fellows are expected to assume increasing responsibility for each of these facets of patient care.

Research, Teaching and Conferences

In addition to a strong clinical experience, fellows will have the opportunity to teach and supervise residents and medical students. Fellows also will be expected to participate in meaningful research projects within the Department of Neurological Surgery and the Interventional Neuroradiology Service. There are several weekly conferences that we participate in as a service.

Contact Information
To obtain more information or to request an application, please email:

DeWitte T. Cross, III, MD (Program Director): crossdt@wustl.edu

OR

Peggy Winkler (Education Coordinator): winklerp@wustl.edu