Introduction to clinical interventional radiology.

Within 10 years of Dr. Sven Seldinger's introduction of needle replacement of a catheter in 1953, Dr. Charles Dotter, at the University of Oregon Health Sciences, began to use catheters as surgical instruments. Dr. Dotter said, "The angiographer who enters into the treatment of arterial obstructive disease can now play a key role, if he is prepared and willing to serve as a true clinician, not just as a skilled catheter mechanic. He must accept the responsibility for the direct care of patients before and after the procedure; now see them as patients, not just as blocked arteries." On this prediction time has shown Dr. Dotter to be exactly right. We are on the verge of tremendous growth in peripheral vascular interventions, particularly in the arterial arena. There are several forces within and outside radiology that presaged this transition that will be explored in this issue. But it is clear that all of radiology, not just interventionalists, have finally heeded Dotter's message. In 2004, the American College of Radiology published a "white paper" on interventional radiology clinical practice. The white paper outlined the features and resource needs of interventional radiologists for providing patient care. In this issue we will explore the reasons why in 2004 there is no other way to practice interventional radiology than to practice as a clinical doctor.