1. The Vascular Diagnostic and Intervention Fellowship at The Mount Sinai Hospital

Curriculum

Through our comprehensive curriculum, the Vascular Diagnostic and Intervention Fellowship at The Mount Sinai Hospital provides fellows integrated training in the field of vascular disease, with an emphasis on the diagnosis and management of patients including endovascular interventions.

Fellows gain comprehensive understanding and expertise in peripheral circulatory anatomy, pathophysiology, and the natural history of vascular diseases. They will acquire knowledge and procedural skills in evaluating and managing various vascular conditions including:

  • Acute and chronic arterial occlusion of the lower extremities
  • Atherosclerotic renal artery disease
  • Renal artery denervation
  • Atherosclerotic disease of the brachiocephalic vessels, including the carotid artery and subclavian artery
  • Venous disease
  • Inflammatory vasculitis
  • Procoagulant states
  • Aortic disease

Fellows also develop the technical skills of invasive diagnostic imaging and intervention, including:

  • Diagnostic angiography
  • Angioplasty and stenting
  • Administration of adjunct pharmacotherapy
  • Recognition and management of complications

Inpatient Clinical Consultation

Fellows actively participate in inpatient consultation services, evaluating a variety of vascular diseases, conducting patient history assessments, performing physical examinations, and interpreting non-invasive test data such as ankle brachial index and duplex ultrasound studies. Fellows will integrate patient history, non-invasive study data, and further invasive evaluation to make accurate diagnoses and appropriate clinical decisions. They also engage in discussions with attending physicians on procedural methods and provide written consultations addressing pertinent patient issues.

Outpatient Service

Fellows will actively participate in an outpatient vascular medicine services under the supervision of an attending with the aim to gain insight into evaluation, management, and follow-up of patients with peripheral vascular and cardiovascular diseases. They will develop expertise in managing patients in ambulatory setup including pre and post procedural assessment and management.

Wound Care Management

Fellows have an opportunity to attend wound care clinic headed by John C. Lantis, MD, staying updated on evidence-based practices for skin and wound care management. They will develop skills in accurately assessing, documenting, identifying, and planning comprehensive treatment plans for wound management.

Diagnostic Imaging

Fellows gain knowledge and expertise in vascular imaging techniques such as ankle brachial index ultrasound, CT, and MR. They will have dedicated time to interpret noninvasive modalities with special focus on identifying sites of atherosclerotic obstruction, delineating stenosis severity, and determining suitability for surgery or percutaneous intervention.

Percutaneous Vascular Procedures and Intervention

Fellows develop vascular angiographic and interventional skills under attending physician guidance. They gain expertise in angiography and catheter-based interventions in the peripheral vasculature. Fellows will actively participate in procedural and clinical aspects of interventional cardiology, focusing on procedural care, patient follow-up, and management of vascular disease.

Our fellowship will allow the trainee to gain insight and knowledge in the proper device selection and use of different guiding catheters, guidewires, balloon catheters, and stents. Fellows will learn critical manipulations applied in peripheral vascular interventions including:

  • Aortoiliac intervention
  • Femoral-popliteal intervention
  • Infrapopliteal intervention
  • Renal artery intervention
  • Subclavian and innominate intervention
  • Extracranial carotid artery intervention
  • Venous stenting and ablation procedures
  • Endovascular repair of AAA
  • DVT intervention
  • May Thurner’s syndrome intervention
  • Venous insufficiency management

Vascular Access

The program places special emphasis to train fellows in various techniques for gaining safe and secure vascular access, including the contralateral femoral artery approach, antegrade and retrograde common femoral artery approach, popliteal artery access, and radial and brachial access. Furthermore, fellows will gain exposure to managing large bore access and identifying as well as treating complications such as dissection, thrombosis, spasm, perforation, peripheral vessel occlusion.

Fellows actively participate in dedicated didactic sessions on a weekly basis. The goal of these sessions is to enhance academic learning and keep fellows up to date with the latest literature and advancements in the field of vascular medicine and intervention. Various forms of didactic interactions include:

  • Journal club
  • Case review series
  • Faculty lectures
  • Quality and assessment of cases
  • Discussion of complications
  • Live case participation

Fellows are considered an integral part in the organization of the annual New York Endovascular Summit, held every fall. They are expected to help in the planning and execution of the program and are encouraged to present their research and data at national and international conferences.