Weeks 1 and 2 - Jean C. Cruz

Week 1:

On Tuesday morning, I met with Dr. Gupta. He is a neuro-radiologist at the Weill Hall Neuro Radiology Department. We talked about my research for a while before deciding on a possible topic which should be my focus for the summer. He immediately got me involved by introducing me to his colleagues and staff members. 

Due to the fact that the nature of my thesis (elucidation of the triggers and progression of Alzheimer’s disease) and his day to day work, (interpretations of radiographs, CT, and MRI involving the brain, spine, and the head & neck) don’t have anything in common, we decided that during these next two weeks I should shadow some of his colleagues before we decided on a specific topic for the summer project. We opted shadowing Dr. Bradley Pua, an intervention radiologist at Weill Hall Cornell Medical School. In addition of the general procedures (biopsies, insertions of catheters and IVC filters, etc.), I had the opportunity to watch a thrombolysis and balloon angioplasty/stent procedure. During this procedure Dr. Pua was able to remove the most recent clots using the Trellis System and for the old ones he used the balloon angioplasty system. 

                                                       

                                                        Figure 1. Trellis Peripheral Infusion System

The Trellis Peripheral Infusion System is an isolated thrombolysis catheter with two occluding balloons, drug infusion holes between the balloons, and mechanical drug dispersion capabilities. This pharmaco-mechanical combination provides focused treatment of thrombus within vessel.                    

  Figure 2. Balloon angioplasty mechanism

The balloon angioplasty procedure can open blocked arteries by expanding the inner diameter with a balloon mounted on a thin tube.  

Week 2: 

For the second week, I kept shadowing Dr. Pua and Dr. Sista in the intervention radiology department. Similar to the first week, in addition to watching general procedures, I was able to watch additional uncommon and interesting procedures. During this week we can highlight the tumor embolization procedure. 

                                                         Figure 3. Tumor embolization procedure

Tumor embolization is a procedure that can be performed prior to a planned surgical resection. Embolization shuts down the blood supply to a tumor reducing blood loss during surgical resection. A secondary benefit from embolization can be that tumor margins are more easily identified and a tumor can be removed more completely and with less effort.

In addition to being able to observe some medical interventions during these past two weeks, I was able to attend some of the MD classes, some general meetings, conferences, tumor board discussions, and social events with Dr. Pua. Of all the above activities, the tumor board discussions were probably the most insane ones. In this meeting the physicians were able to go through 20-30 patient records per hour; they were able to identify and determine the tumor type and decide the most convenient treatment for the patients.