Cath Lab I: Review and Introductory

• Primary and Secondary Prevention in ASCVD
• Comparative Diagnostic Techniques in Vascular Disease
  • Clinical
  • Doppler
  • Ultrasound
  • CT Angiography
  • MR Angiography
• Comparison of Treatment Modalities for Peripheral arterial disease: Medical vs Interventional vs Surgical
• Treatment modalities for renal hypertension: Medical treatment. Percutaneous intervention
• Comparison of Treatment Modalities for Carotid artery disease: Medical vs Interventional vs Surgical
• Treatment approach to acute limb ischemia
• Antithrombotic therapy
• Overview of Pre-procedural, Post-procedural and Long-term Follow-up Care of the Vascular Patient

Cath Lab II: The Laboratory and Basic Science

• The Laboratory
  • Cath Lab Equipment
  • Radiation Physics
  • Radiation Biology and Safety
  • OSHA Invasive Lab Safety
  • Computer Software and Applications in Clinical Practice
• Basic Science
  • Vascular Biology
    • Endothelial Physiology
    • Plaque Composition/Response to Injury
    • Soluble Mediators
    • Restenosis Pathophysiology (clinical, animal models)
  • Platelets and the Coagulation Cascade
  • Basic Clinical Pharmacology
  • Gene Therapy

Cath Lab III: Interventional Diagnostic Modalities

• Lower Extremity Angiography:
  • Normal and Abnormal/Variant Anatomy
  • Intravascular Ultrasound
• Carotid Angiography:
  • Normal and Abnormal/Variant Anatomy
  • Intravascular Ultrasound
• Carotid Angiography:
  • Normal and Abnormal/Variant Anatomy
  • Pressure Gradient
  • Intravascular Ultrasound
• Vascular Access
  • Femoral Access
  • Radial and Brachial Access

Cath Lab IV: Interventional Therapeutic Modalities

These modalities will apply differently to the lower extremity, renal/mesenteric arteries and carotid arteries.

• Selection of Catheter Revascularization Modality
• Angioplasty Balloons
• Stents and Stenting (Including Restenosis)
• Directional Atherectomy
• Rotational Atherectomy
• Intravascular Laser
• Regional/Local Drug Administration
• Use of distal protection devices

Cath Lab V: Emergency Care

• Complications of Percutaneous Interventions: Diagnosis and Management
  • Arterial Dissection
  • Acute Closure/Thrombosis
  • Acute Spasm
  • Vessel Perforation
  • Distal Embolization
  • No-Reflow/Slow Reflow
  • Bleeding Complications
• Vascular Access Complication
  • Retroperitoneal Bleeding
  • Pseudoaneurysm
• Basic and Advanced Cardiopulmonary Resuscitation
  • Pharmacologic Hemodynamic Support
  • Arrhythmia Diagnosis and Management (Temporary Pacing Techniques, Drugs, DCCV)
  • Airway Management and Artificial Ventilation
• Emergency Procedures for the Interventional Patient
  • Emergency Bypass Surgery

Cath Lab VI: Adjunctive Pharmacologic Modalities

• Pharmacology (pharmacokinetics, pharmacodynamics, applied therapeutics)
  • Antiplatelet and GP IIB/IIIA Inhibitory Drugs
  • Heparins and Thrombin Inhibitors
  • Thrombolytic Drugs
  • Procoagulant Drugs
  • Vasodilators (Oral, Intravenous, Intracoronary)
  • Hypolipidemic Agents
  • Contrast Agents
  • Adverse Drug Events: Prevention, Identification, and Management

VII: Research and Quality Improvement Projects

Due to the 1 year duration of the fellowship, the fellow could choose either a research project or a quality improvement project during their fellowship. In addition, the fellow will be exposed to basic research concepts:

• Clinical Trial Designs
• Meta-Analysis
• Registry, Case-Control, and Cohort Studies
• Medical Statistics
  • Basic Principles
  • Populations and Distributions
  • Univariate Analysis
  • Multivariate Analysis
• Ethics in Clinical Research
• Cost Analysis Research

VIII: Elective 4 Weeks

Fellow may choose from any of the electives. MR, CT, and Vascular Surgery if desired.

Structural

The fellow is expected to participate in and master the following procedures:

• Transcatheter Aortic Valve Replacement (Valve in Native Aortic Valve and Valve in Valve)
• Transcatheter Mitral Valve Replacement (Valve in Valve and Valve in Ring)
• Aortic and Mitral Valvuloplasty
• Mitral Clip
• Interatrial Septal Puncture
• PFO and ASD Closure
• Ventricular Septal Defect Closure
• Tricuspid Valve Intervention and Balloon Expandable Valve in the IVC
• Complex Coronary Intervention
• Coronary Intervention for Chronic Total Occulusion Lesions
• Peripheral Vascular Intervention
• Alcohol Septal Ablations
• IntraCardiac Echocardiography (ICE)

Research

Active participation in research is highly encouraged. Fellows have the opportunity to participate in ongoing research projects while encouraged to initiate their own scholarly ideas. In-depth guidance and counseling are provided by faculty well-versed in the area of research. Training spans the spectrum from constructing study protocols, to enrolling patients, to gathering and analyzing data, to writing abstracts and manuscripts.

The University of Florida College of Medicine – Jacksonville encourages resident/fellow research through the availability of Dean’s Fund Research Awards and an annual Research Day, with residents and fellows from all disciplines presenting their work. Well-designed studies conducted in collaboration with the faculty have resulted in residents and fellows presenting their research at regional, national and international meetings.