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Interventional Neuroradiology Fellowship (St. Michael's Hospital)

Supervisor: Dr. Tom Marotta

The INR fellows at SMH play a key role in the Neurovascular Program, and are provided an opportunity to "run" our busy clinical service with full management responsibilities. This is done with careful supervision from our interventional neuroradiology staff which includes  four experienced individuals with neuroradiology background (Marotta, Montanera, Sarma, Bharatha) and one with neurosurgical background (Spears). 

Interventional clinical material is rich and varied.  Fellows are exposed to the full spectrum of INR cases including  high volumes of complex aneurysms; carotid angioplasty and stenting; intracranial atherosclerosis;  brain and spinal vascular malformations; pre-operative embolizations;  trauma; epistaxis; and stroke interventions. SMH is a designated Stroke center and a designated Trauma hospital. Spinal interventions including vertebral augmentations and  biopsies are also routinely performed. 

SMH has a dedicated biplane flat panel neuroradiology suite with 3D. Imaging is done on 3 up-to-date multi-slice CT scanners.  There are two 1.5 T MRI machines and two 3 T units including a dedicated research scanner. Noninvasive neurovascular studies including the full range of CTA, MRA, perfusion and time resolved MRA studies are performed routinely and efficiently.

The INR fellows, along with the INR staff, participate in a busy weekly neurovascular clinic where patients treated by the service are carefully followed. In addition, the fellows are given the opportunity to lead our weekly "carotid clinic" where patients requiring urgent evaluation regarding carotid revascularization are efficiently triaged and managed.  There is a monthly Neurovascular Conference for discussion of difficult management cases.  Fellows also participate in Neuroscience rounds, Neuroradiology rounds, Neurosurgery rounds and periodic Stroke rounds.

The INR team at SMH also participates in pediatric cases and pediatric neurovascular rounds held quarterly at the HSC in Toronto.For fellows who have neurosurgical training there is an opportunity to be involved in open neurovascular cases in the operating room.

Teaching, clinical research, trial participation, and animal research opportunities are readily available. Fellows receive one day per week of protected research time and are expected to participate in at least one major research project leading to conference presentation and publication per year. Current research interests of the group include intracranial flow diverters, carotid revascularization, imaging and management of cerebral vasospasm, and acute stroke intervention. Dr. Marotta has additional unique experience and opportunities for innovative device evaluations and development.

The Interventional service is fully supported within the hospital environment and has excellent access to Anesthesia. We are well supported within the Medical Imaging department and enjoy a friendly and collaborative relationship with the neurosurgery and neurology services. Our clinical service is supported by a dedicated Nurse Practitioner and two highly experienced and efficient clerical staff.

Depending on the background training of the applicant the INR fellowship may be a one- or two-year program. We accept applications from diagnostic radiologists (who have completed at least one year of neuroradiology fellowship training), as well as from Neurologists (who have completed at least one year of stroke or neurocritical care fellowship) and from neurosurgeons.  The two-year program can be performed at SMH or as a combined program at SMH and another site including TWH.

Neuroscience program link:

http://www.stmichaelshospital.com/neuroscience/

Neuroscience education/training page link:

http://www.stmichaelshospital.com/neuroscience/students.php#neurovascular