Doing Dr. Dotter proud: interventional radiology gets a department of its own

Dr. John Kaufman to serve as inaugural department chair

June 28, 2017

Dr. John KaufmanThe Charles T. Dotter Department of Interventional Radiology will achieve full-fledged departmental status in the OHSU School of Medicine July 1, another historical landmark of transformative change in a medical field pioneered at OHSU. John Kaufman, M.D., M.S., institute director and Frederick S. Keller Chair of Interventional Radiology, will serve as inaugural chair of the Department of Interventional Radiology. Reka Laakso will be department administrator.

"Creating a new department is a big decision. And in the case of interventional radiology, I could not be more thrilled to bring the Dotter Interventional Institute's new status across the finish line," said Interim Dean John Hunter. "Its departmental status recognizes not only the legitimacy of the discipline and its essential function in diagnosis and cure, it honors the legacy of OHSU and Charles Dotter as a birthplace for work that has transformed medicine."

In the late 1950s, doctors and researchers were just beginning to develop invasive approaches using X-ray to enhance their ability to diagnose disease. Charles T. Dotter, M.D., chair of the Department of Diagnostic Radiology, OHSU School of Medicine, wanted to not only diagnose blockages in blood vessels with X-ray guided techniques, but treat them as well.

In 1964 on the 11th floor of OHSU Hospital, Dr. Dotter used a guidewire and Teflon catheters inserted percutaneously into the femoral artery to open a blocked artery in a woman's leg, guided by a live X-ray viewed on a TV monitor. The world's first angioplasty procedure saved the elderly woman's gangrenous left foot and spawned the practice of image-guided interventions.

Dr. Charles Dotter in 1962Because there were no tools for these procedures, Dr. Dotter often created his own. He would heat and shape sterile Teflon tubing into specialized catheters for procedural use. At a conference in Chicago, so the story goes, he borrowed a blow torch and raw materials from a fledgling medical equipment salesman named Bill Cook and fashioned catheters in his hotel room that Cook then sold at the conference the next day. Cook Medical, still family-owned, has grown into one of the nation's largest minimally invasive medical equipment companies.

Bill Cook gave back after Dr. Dotter's death in 1985 with a generous grant to OHSU to, in 1990, create the Dotter Interventional Institute, a freestanding division in the OHSU School of Medicine separate from the Department of Radiology. Josef Rösch, M.D., who joined Dr. Dotter in 1970, was the first director of the institute, followed by Frederick Keller, M.D., Cook Professor of Interventional Therapy, OHSU School of Medicine, who led from 1993 to 2012. In addition to angioplasty, OHSU has pioneered many other commonly used interventional tools and techniques. One of the most important was developed by Dr. Rösch: the TIPS procedure (trans-jugular intrahepatic portosystemic shunt) that revolutionized the treatment of some of the complications of severe liver disease. Many hundreds of thousands of people are treated each year with procedures originated at OHSU.

In 2012, the American Board of Medical Specialties recognized interventional radiology as a primary specialty of medicine. Not long after, OHSU began a discussion about elevating the Dotter Interventional Institute to departmental status.

"This is a huge step as it acknowledges the importance of image-guided intervention in medicine and positions OHSU at the leading edge worldwide," said Dr. Kaufman. "The field has grown such that we can now fulfill Josef Rösch's and Bill Cook's vision and become a department."

The shift in status is budget neutral; Dotter already had its own budget, faculty and space. But with a department, OHSU becomes better-positioned to attract new top faculty, students and grants, Dr. Kaufman said. He noted that they are still working on how to incorporate Charles Dotter's name into the department name in order to continue the tribute to Dr. Dotter's legacy.

Among those celebrating interventional radiology's change in status is the department from which it came 27 years ago.

"Granting interventional radiology full department status is another visionary and progressive step for OHSU," said Fergus Coakley, M.D., professor and chair of diagnostic radiology, OHSU School of Medicine. "Making interventional radiology a department not only shows that OHSU recognizes the special status and importance of the specialty, it projects OHSU's commitment to continuing our record of excellence in the practice and teaching of interventional radiology."

Pictured (top): Dr. John Kaufman; (bottom) Dr. Charles Dotter with a patient in 1962.