Cardiovascular Radiology History

Clinical arteriography was largely developed by the Portuguese investigators, Moniz and Dos Santos, in the late 1920s, and for about 25 years it proved to be an interesting but not widely applied technique. A major reason for this was that in other translumbar aortography and direct puncture carotid arteriography it was necessary to expose the artery and do an arteriotomy. All of this changed in 1953 when Sven Seldinger described his percutaneous approach to the vascular system.

The state of arteriographic activity in 1953 was reflected in the fact that there were 10 articles on arteriography in Acta Radiologica, five in the American Journal of Roentgenology, and 11 in Radiology. However, interest in arteriography throughout the world increased very rapidly, and the attendees at the 1961 meeting of the Radiological Society of North America were captivated by the advanced arteriograms, particularly the selective abdominal visceral studies, shown by a group of Swedish investigators. Interest in arteriography soared, and in 1973 there were 38 arteriography articles in Acta Radiologica, 19 in the American Journal of Roentgenology, and 68 in Radiology. Arteriography had become a widely used tool not only in the major medical centers but in community hospitals as well. Numerous radiologists in academic centers were devoting most of their professional efforts, clinical and investigational, to the study of cardiovascular disease.

Activity in the field of arteriography was such that a number of individuals felt that there was a place for an organization devoted to the study of the radiological aspects of cardiovascular disease. Two parallel efforts developed in this area. One was conceived as a broadly based organization for those with an interest in cardiovascular radiology, and the other was to be a more narrowly focused organization in which membership would be restricted to the most active individuals in the investigational aspects of cardiovascular radiology. The idea for the latter organization was Stanley Baum's, and an organizational meeting was held late in the summer of 1973 in his office at Massachusetts General Hospital. Those in attendance were enthusiastic about the proposed society, and a follow up meeting was held at the time of the 1973 RSNA meeting in Chicago. Subsequently, at the 1974 meeting of the Association of University Radiologists at New York University, a larger group of individuals who had been invited by the original nucleus, met and the Society of Cardiovascular Radiology was formed. As best as I have been able to determine, no minutes exist to record what occurred at this meeting. However, I was present and have some recollection of the events. Stan Baum was elected President by acclamation, and Chris Athanasoulis was made Secretary-Treasurer. The idea was to have two officers in the same department to facilitate the organizational activity which would be taking place.

On November 19, 1974 Chris and Stan sent a letter to members of the Society, stating that a meeting would be held at the Ocean Reef Club in Key Largo, Florida. They indicated that the facilities there were excellent for the type of meeting that was contemplated. Manny Viamonte had arranged for a members' rate; accommodations for a family of four cost approximately $50 a day. Stewart Reuter was Chairman of the Program Committee.

1975
The meeting was held on January 30 to February 2, 1975. There were numerous presentations by the 24 members who were present, and also by Dr. Anders Lünderquist of the University of Lünd, who was a guest.

It was brought up that the Europeans, under the aegis of Drs. Boijsen, Lünderquist, Hernandez and Rossi, were forming a similar society. Stan Baum and Anders Lünderquist indicated their view that the two societies should be separate. Anders suggested that we have joint meetings, and that it should be feasible for members of one society to attend the meetings of the other.

A membership fee of $30 was initiated in order to raise funds to have the Society incorporated. The Membership Committee, comprised of Mort Bosniak, Chairman, Arnie Chait, Klaus Bron, Andy Crummy and Joe Bookstein, recommended the following criteria for membership:

That the candidate:

1. Spend 50 percent or more of his/her time doing or supervising cardiovascular procedures.
2. Be at least three years past residency,
3. Have made significant published contributions on cardiovascular subjects,
4. Show continuing interest in cardiovascular radiology by current work in the field (papers, lectures, etc.), and
5. Have demonstrated interest and ability in cardiovascular radiology such that two members of the Society were willing to support the nomination in writing.

These criteria precipitated discussion about the size of the Society, a subject which would be debated annually. There was considerable concern that adoption of the criteria suggested by the Membership Committee would result in 200 or 300 members. There was a consensus that the original intent was to have a relatively small membership in order to foster interchange of information in somewhat intimate circumstances. A rather spirited consideration of the issue followed. Klaus Ranninger spoke vociferously about the need to keep the membership small. Bob White, Doug Adams and Tom Meaney spoke in favor of changing the bylaws so that the number of members would be restricted, recognizing that the bylaws could be modified to increase the number should this be deemed desirable. The Society then voted that membership be limited to 75 individuals, and the recommendations of the Membership Committee were unanimously accepted.

There was then a consideration of what the relationship between the North American Society of Cardiac Radiology and the Society of Cardiovascular Radiology should be. The discussion finally resulted in the following proposal being voted: "Resolved, that the North American Society of Cardiovascular Radiology will consist of a Division of Cardiac Radiology and a Division of Vascular Radiology. Each Division will have its own membership, bylaws and officers, and remain financially independent of the other division. An Executive Committee of the NASCVR will be composed of an equal number of officers from the two divisions."

It was then voted that the present officers and members of the Executive Committee remain in their respective posts for an additional year: Stan Baum as President, Chris Athanasoulis Secretary-Treasurer, and Ruben Koehler as President-elect. It was decided that a postgraduate course would be held in conjunction with the next meeting. The idea of holding a postgraduate course was advanced on two bases: 1) That since the majority of individuals involved in the Society were intimately involved in the pedagogical process, the Society could put on an outstanding course because it would have access to the best faculty, and 2) that some money could be raised in order to support the efforts of the Society.

1976
The Second Scientific Session and the First Postgraduate Course of the Society of Cardiovascular Radiology was held at the El Conquistador Hotel and Club in Las Corvas, Puerto Rico. The Conquistador was a beautiful hotel located in a particularly picturesque part of northeastern Puerto Rico. The physical appointments and surroundings were lovely. However, the hotel had gone into receivership and, perhaps as a cause or maybe as a result of this action, the poor service in the hotel dining rooms, overbooking, etc. made for great difficulty for members and attendees at the course. There was a major misgiving about what had occurred and whether we would ever be able to conduct a second course because of the problems encountered by a number of people.

The course had one unique feature, which was very enthusiastically received, and it in part made up for a number of inconveniences, which had been experienced. Tom Meaney gave a detailed seminar on how to play craps. The didactic session was then followed by a "hands on" demonstration in the hotel casino. While no official critique sheets were obtained, the consensus was that the Probability Seminar was an outstanding success.

The Secretary reported that the roster showed 47 active members. One hundred and sixty-one people registered for the course, plus 14 residents and two nonpaying members, for a total of 177 attendees.

Issues that would remain focal points over the years were again brought up. A possible merger with the North American Society of Cardiac Radiology was again discussed, with a small group contending that if radiologists did not continue to participate in cardiac radiology it would be lost to non-radiologists, and that "turf" was an important aspect. Setting criteria for training programs in cardiovascular radiology was considered, and a committee was appointed to look into this matter.

The possibility of having the Society affiliate with a journal was brought up. Klaus Ranninger indicated that planning was under way for publication of a new journal, Cardiovascular Radiology. Stan Baum stated his view that a new journal would detract from material being submitted to existing radiology journals. Ken Fellows noted that a similar effort to establish a journal, Pediatric Radiology, had not gained much support among pediatric radiologists. Ruben Koehler and Herb Abrams stated that they were not enthusiastic about the idea of the Society becoming involved with the proposed journal.

Some activity in the political arena had been undertaken during the year. The Society through Stan Baum had contacted some congressmen and the FDA about Parke Davis Company's discontinuing production of Vasopressin. There was discussion about a directive from the Social Security Administration that catheters and guidewires be for one time use only. The consensus was that the great impetus for this action had come from the manufacturer who, not surprisingly, would benefit financially from this. One of the questions raised was regarding the statement "Discard after single use". Did this refer to using it on one patient, or just inserting it into the patient once?

This was the first year that new members were admitted to the Society. The ten individuals were Scott Boley, Harvey Goldstein, Eugene Jacobson, Vincent Chuang, Donald Harrington, Richard Kittridge, Francis Ruzicka, Arthur Waltman, Thomas Sos and Warren Widrich. These ten had been voted in on recommendation of the Membership Committee from a total of 39 nominations. As usual, the impact of admitting a large number of individuals to the Society, which had an upper limit of 75 members, was looked at askance by some.

1977
The members' meeting was held at Newport Beach, California and attended by 38 members. Subsequently the course was held at the Century Plaza Hotel in Los Angeles and was well received by the 190 registrants. There was concern that the costs were fairly high in expensive and highly-unionized Los Angeles, but the course organization was improved and the hotel was better than the Conquistador, so there was considerable satisfaction. New members elected were Ernest Ring, Martin Goldman, Theron Ovitt, James LePage and Manuel Madayag. Helen Redman asked to become a corresponding member and Israel Steinberg was elected a consulting member. The following officers were elected: Stewart Reuter, President; Mort Bosniak, President-elect; Bill Casarella remained Secretary-Treasurer for his second year.

1978
The meeting and course returned to the East in accord with the idea that it would be alternated between coasts. The members' meeting was held at Point Clear, Alabama with 46 members attending, and the course was held in New Orleans. Five new members were elected: Dick Hawkins, Charles Tegtmeyer, Frank Miller, Irv Johnsrud and Kim Cho.

Herb Abrams reported that Springer-Verlag planned to sponsor a journal, Cardiovascular Radiology. He suggested that the two American and two European cardiovascular radiology societies jointly sponsor the journal. Sponsorship would include an announcement of each society's proceedings, but no commitment to purchase a journal or publish articles in it. Stewart Reuter suggested that a committee be named to study the situation and make recommendations. New officers elected were Mort Bosniak, President, Bill Casarella, President-elect, and Andrew Crummy, Secretary-Treasurer.

1979
The annual meeting and course were held at the Cerromar Beach Hotel in Puerto Rico in March, 1979. The course with a large attendance was generally viewed to be a success, and Society members were quite pleased with the progress and stature of the course as a teaching endeavor. Once again, membership was of considerable concern. Murray Baron was Chairman of the Membership Committee, and he brought up a discussion of the five-year rule. It was the opinion of the Membership Committee that a requirement for having to submit a bibliography every five years should be retained. The idea was that this would encourage members who were no longer active in the field to become corresponding or emeritus members. The major thrust was that no action would be initiated by the Membership Committee, but rather the decision as to whether one would remain qualified would be left to the individual member.

What had now become the annual discussion as to who qualified for membership was pursued at some length. It was suggested that the new President appoint a committee to look into the definition of "membership", with particular emphasis on whether an individual had to be a radiologist. There were currently two non-radiologist members.

The following individuals were elected to membership: Raul Pereiras, Charles Higgins, Gerald Wolf. The bylaws were changed so that there would be orderly progression of officers. The Secretary-Treasurer would automatically advance to President-elect and then to the office of President.

Bill Casarella was elected President, Tom Meaney President-elect and Andrew Crummy re-elected Secretary-Treasurer. Mark Wholey was appointed Program Chairman.

Following the 1975 meeting, the Society of Cardiovascular Radiology had been incorporated in the State of Illinois as a tax exempt organization. However, the attorneys had neglected to advise the Society that it was necessary to pursue this matter with the Internal Revenue Service and become registered with them as a tax-exempt organization. How to remedy this failure was being pursued with attorneys in Chicago. This was an important concern of the Society because the course was raising substantial sums of money, some of which was from exhibitors at the annual meeting.

The possibility of having an official journal was raised, and the two considerations were the Journal of Cardiovascular Radiology and the American Journal of Roentgenology. A vote was taken, the outcome of which indicated that both the Journal of Cardiovascular Radiology and the American Journal of Roentgenology should be made official journals. Subsequently the Journal of Cardiovascular Radiology endorsed the proposal and the American Journal of Roentgenology did not, so that no official journal was accepted.

A motion was made by the Secretary-Treasurer to change the name of the Society to the "Society of Cardiovascular and Interventional Radiology". The motion was defeated. The sentiment seemed to be that the basis of the Society was angiography, and that other aspects of interventional radiology such as a biliary tree or urinary tract were peripheral to our major thrust. It was felt at that time that there was no utility in the use of the word "interventionalist" and that we accrued no advantage in claiming "turf".

1980
The annual course and members' meeting were held in Phoenix and Scottsdale, Arizona in February 1980. A discussion of the official journal was undertaken. The American Journal of Roentgenology indicated that they were unwilling to be affiliated in a dual sponsorship as an official journal. Thus the Executive Committee was unable to implement the motion that had been passed at the previous meeting. After several motions and numerous votes, a motion was made to approach the American Journal of Roentgenology as to the possibility of being the official journal of the Society. A motion was passed.

A Registry Committee consisting of Charles Tegtmeyer, Frank Miller and Ernie Ring was appointed. They were asked to organize, as soon as possible, a registry of protocols which could be distributed to members and submitted to the American College of Radiology for computer processing. The primary purpose of this was to have a registry for percutaneous transluminal angioplasty.

Our problems with status as a tax-exempt organization had not yet been resolved. The attorneys were still in the process of preparing the proper income tax returns to be submitted with an application for approval as a tax-exempt organization. At the time of the meeting, inquiries for additional information had been received from the Internal Revenue Service.

Earlier in the previous year, several members had traveled to Dublin to attend the meeting of the European Society of Cardiovascular Radiology. Those who attended the meeting thought it was very successful. A preliminary communication had been received from Anders Lünderquist relative to the possibility of holding the 1981 course in Orlando, Florida in conjunction with the European College of Angiology.

Steve Kaufman was elected to membership. The fact that only one person was elected was met with dismay by many. This resulted, again, in extensive discussion as to why only one member was elected and what could be done about the situation. After spirited debate President Bill Casarella instructed the Membership Committee to look into this matter and consider the possibility of a mail ballot. The procedure was changed, and Klem Barth, Vic Millan and Jim Anderson (Ph.D.) were elected to membership.

There was a consensus that the Society was fulfilling its intended role as a vehicle for exchange of scientific information in a pleasant atmosphere conducive to informal discussion. Nevertheless, some members were concerned that the group stood for elitism, in that the number of angiographers had increased substantially and many well-qualified people were excluded.

Tom Meaney was elected President, Andrew Crummy President-elect, and Mark Wholey Secretary-Treasurer. Gene Klatte was appointed Program Chairman.

1981
The members' meeting was held at Innisbrook, Tarpon Springs, Florida March 12-15, followed by the course in Orlando. These were held in conjunction with the European Society of Cardiovascular Radiology.

It was voted that a registry for PTA be implemented for one year. There was considerable enthusiasm for the possibility of a registry but there was concern about the funding of it, whether there would be sufficient numbers to make it meaningful, and an underlying concern (generally expressed in private) as to who the authors would be if any of the material were to be published.

Final approval of formal affiliation between the Society of Cardiovascular Radiology and the American Journal of Roentgenology was made, with Charles Tegtmeyer appointed by the Society to be the Editor-pro-tem.

Charles Tegtmeyer was appointed Program Chairman for the meeting to be held at the Hilton Hotel, Palm Springs, California. Officers elected were Andrew Crummy, President, Mark Wholey President-elect, and John Doppman Secretary-Treasurer.

The course had 301 registrants, 44 Society of Cardiovascular Radiology faculty, five European Congress of Angiology faculty, nine European Congress of Angiography registrants, one guest speaker, and 50 representatives from industry.

The number of membership positions was expanded from 75 to 100.

The possibility of having a joint meeting with the European Society in Dubrovnik, Yugoslavia was raised, and there was substantial interest.

It was announced that difficulties with the IRS had been resolved, and we had been granted tax-exempt status.

1982
The registry for percutaneous transluminal angioplasty had not been a success. The participation had not been very enthusiastic, expense had been considerable and a motion by Charles Dotter to discontinue the registry was approved.

As usual, membership was considered to be a problem. There was lively discussion about the policy regarding new members, the high rejection rate, and the recurrent failure to elect many new members. The Membership Committee reported 22 nominees had met the standard for acceptance in the Society, and only three were elected to membership. A motion to direct the Membership Committee to reevaluate the protocol for membership was approved.

There was discussion about limiting the nomination for Secretary-Treasurer to one person. The idea was that there was some embarrassment at being nominated for the position and losing. However, the motion did not carry.

Charles Tegtmeyer reported that only 10 of 42 presentations at the members' meeting were submitted as abstracts to the AJR. A motion was made and carried that the Society not submit abstracts of the members' meeting to the journal. This move ended the official journal status with the American Journal of Roentgenology.

The course, which was held in Palm Springs, California, had 280 registrants, 38 Society of Cardiovascular Radiology members and 80 representatives of industry.

As the course grew larger and the number of commercial exhibits increased, it became more and more difficult for the Secretary-Treasurer to handle all the planning. Therefore, arrangements were made to retain Educational Resource Associates to organize the course. The action turned out to be disastrous. It was extremely expensive and the overall services provided to the group were not very good. Despite this negative experience we were able to realize a $5,000 profit so the financial integrity of the Society was preserved.

1983
Once again, membership was the primary concern. The Membership Committee had reported that 24 nominees had met the standards for acceptance and six were elected to membership. The continuing experience of having a large number of qualified applicants being unable to become members of the Society prompted a change in the bylaws.

The members' meeting and the course were held at the Marriott Hotel in Fort Lauderdale, Florida. Educational Resource Associates had been dropped as the meeting coordinator, and they were replaced by Pam Gaudio of Pittsburgh, Pennsylvania. This was the beginning of a very salubrious relationship. Pam was extraordinarily helpful at a time when the size of the course was rapidly expanding and some expertise in management was sorely needed. She continued to be most helpful until 1988, when she retired from the position because of family obligations.

The Rules Committee, Tom Sos, Chairman, Don Harrington and Charles Higgins, had submitted by mail a proposed revision in the voting procedures for members. The change was in Article III, Section 3 (F) and read, "After the second ballot, those candidates who receive the affirmative vote of at least two-thirds of the members present will be ranked in accordance with the number of votes received. From this group, and starting with those who received the most votes, candidates will also be declared elected to the Society to fill up, but not to exceed, one-half of the available vacancies." This motion was passed by a show of hands.

Subsequently, six new members were added to the Society.

Plans to participate in the meeting in Dubrovnik, Yugoslavia with the European Society of Cardiovascular Radiology were reviewed.

A motion to change the name of the Society to "Society of Cardiovascular and Interventional Radiology" was approved. This reflected a change in attitude from 1979, when a similar proposal had been defeated.

Pressures form within and without radiology as to who would perform certain interventional procedures came up for extended discussion. It was recognized that non-radiologists had great interest in doing interventions, and it was the strong feeling of the membership that these procedures were best done by cardiovascular radiologists who had a special interest and training in the use of guidewires, catheters and the like. The possibility of thwarting non-radiologists from doing interventional radiology procedures by having a politically strong Society was raised.

The consideration to extend our membership by having a two-tiered Society, much like the American College of Radiology, was advanced. The current members would be made Fellows, and a new category of members would include those individuals who had angiographic-interventional radiology fellowships and were now spending a major portion of their time performing angiography. In addition to having a larger membership, which would provide additional political strength, it was also expressed that there was a need at the community level to have some means of acknowledging those radiologists who were performing angiography and interventional procedures and having "turf" battles with non-radiologists attempting to get privileges. Tom Sos and Ernie Ring volunteered to work with the Executive Committee to examine the possibility of this new type of Society membership.

1984
The annual meeting was held at the Silverado Country Club in Napa Valley, California, followed by the course which was held in San Francisco.

Note was made that the Society's name had been changed to the Society of Cardiovascular and Interventional Radiology.

It was recognized that having the members' meeting and course in separate locations consumed a considerable amount of time which could be better used to conduct the business meeting. Therefore, a change in format was adopted, and in the future both sessions would be held in a single location.

It was announced that 34 members had attended the meeting in Dubrovnik, Yugoslavia held in conjunction with the European College of Angiography and European Society of Cardiovascular and Interventional Radiology. The consensus was that it was a great success.

A motion was made and unanimously and enthusiastically approved that we initiate a named lecture honoring Charlie Dotter. A committee would be named to select the first incumbent.

The Society had 19 positions open for active members, and there had been 23 nominees who met the standards considered acceptable by the Membership Committee. Six new members were elected, making a total of 87 active members and six associate members. The annual discussion of the size of the Society and its nature was undertaken. The possibility of having a two-tiered Society, as well as expanding membership to 150 or other numbers, was discussed at length. John Doppman, Robert White and Ernest Ring strongly advocated expansion of the Society. The motion had become so familiar, that is, to have the Executive Committee study the problem and report back to the membership, was passed. The idea was that two or three alternative solutions for expansion of membership would be brought to the Society. Written suggestions to the Executive Committee were encouraged.

The Society decided to undertake a brochure that would list the fellowship programs which were available in cardiovascular and interventional radiology. There was some reservation about this in that it could be construed as an endorsement.

1985
The annual meeting and course were held at the Hyatt Regency Grand Cypress at Orlando, Florida. Registration for the course exceeded 300. It was apparent that the Society course was the leading one in cardiovascular and interventional radiology in the country. This was reflected by the large registration and by an increase in the number of commercial exhibitors. The ongoing polemic about the direction the Society was taking as regards to membership was continued. The discussion was somewhat more organized than on previous occasions in that four members were asked to present views, not necessarily reflecting their own, on the various types of expansion:

1. Stay the same size -- Andrew Crummy
2. Enlarge by 26-75 -Stewart Reuter
3. Enlarge to include all radiologists who have completed fellowships and are practicing cardiovascular and interventional radiology 50 percent of the time, one category of membership - William Casarella
4. Enlarge to include all radiologists who have completed fellowships and are practicing cardiovascular-interventional radiology 50 percent of the time, two categories of membership - John Doppman.

A number of advisory ballots were taken as to the type of change that should be made. On the basis of these, the consensus appeared to be to expand the Society to accept all qualified applicants. President Bob White indicated that the Executive Committee should now come back to the membership with some written suggestions to review. A change in the locations of the meeting was officially made, in that the Society would hold a West Coast meeting only one in three years due to the high expenses on the West Coast. The idea of rotating between only three different cities was considered. The Charles Dotter Lecture, which had been established the year before, had been endowed with $25,000 by William Cook of Cook, Inc. The first lecturer was Eberhard Zeitler, of Nüremberg, West Germany, Charlie's longtime friend.

1986
The meeting was held at the Marriott Harbor Beach Resort in Fort Lauderdale, Florida. President Charles Tegtmeyer reported that the Society had a substantial amount of money in the bank and was doing well, and anticipated that the attendance would be over 350. Again, interest in exhibiting at the course by commercial enterprises was up.

The major business activity was the possibility of expanding membership. Of course, this was no surprise, this issue having escalated every year since the beginning and having reached a crescendo in 1985. Bob White indicated that last year's discussion was not whether to enlarge but to enlarge and to identify the way to do it in an orderly fashion.

Two committees had been appointed by President Charles Tegtmeyer to check into proposed methods for expansion. The committee for a one-tiered expansion consisted of Drs. Reuter, Waltman, Tegtmeyer and White; the two-tiered committee was comprised of Drs. Katzen, Ring, Sos and Tegtmeyer. Two proposals had been drafted and submitted to the Rules Committee, the members of which were Stan Baum, Bill Casarella and Andy Crummy. These drafts were distributed to the membership 30 days prior to the meeting.

The reports of both the committees were presented, and as usual a lengthy and spirited discussion followed. Eventually a vote was taken and a two-tiered structure for the Society was adopted.

The Membership Committee reported that 28 nominees had met the requirements for membership, and subsequently 13 new members were elected.

It was recognized that the current bylaws read that we were a society of angiographers who do interventional radiology. There was some feeling that the name of the Society should be changed, from the "Society of Cardiovascular and Interventional Radiology" to the "Society of Cardiovascular and/or Interventional Radiology". An advisory and non-binding vote was taken, and the idea that members were angiographers who do interventional radiology rather interventional radiologists was supported 44 to 20.

There was lengthy discussion about the use of non-ionic contrast agents. Gerry Wolf discussed an editorial which would be forthcoming in Radiology. No consensus developed as to how to address this because it was largely an economic and liability problem.

1987
There was a dialogue on a number of issues, including contrast agents and "turf". As was anticipated, the major source of concern were the actions that the Executive Committee, led by Tom Sos, had taken in the past year to implement changing the Society into a two-tiered organization. With the proposed change the Society, the number of members was projected to reach 700 and perhaps 900 very rapidly.

The Society at this point was in a solid financial position. However, its method of funding would have to be changed. Heretofore the Society funds were generated by tuition from the course and fees from the commercial exhibitors. It was apparent that because of the change in membership it would be necessary to have dues, because many of the tuition-paying attendees at the course would now be members of the Society.

Barry Katzen outlined some proposals for activities for the Society which included hiring a full time executive director, as well as contracting with the American College of Radiology for organizational services. It was estimated that the overall budget would be in excess of $350,000 a year, and this would include operation of the course, the meeting, and salaries of the executive director. A proposal to fix dues at $250 a year was accepted. The Society was now headed in an entirely new direction.

Eric Martin had been chairman of the Membership Committee, which had done a prodigious amount of work. It was reported that there were now 532 members, including 113 Fellows.

1988
The meeting and course were held in Orlando, Florida at the Hyatt Grand Cypress. Judy Fielden, who had been appointed executive director, and Gary Price, director of government relations, were introduced to the Society. The membership had increased to 747 members. This, for the second year in a row, represented an extraordinary amount of work for the Membership Committee. Not only was it the volume, but the necessity to pass through some "uncharted waters" in attempting to come to proper conclusions on the large number of people who had applied for membership.

Ernie Ring of the Executive Committee recommended a bylaws change which would include a "by-invitation" qualification for membership. In this way individuals from a variety of backgrounds, which otherwise did not fit the criteria for membership, could be eligible for membership. These individuals could subsequently become Fellows, since all members are eligible for Fellowship after one year. Prior to this time, a surgeon and two physiologists had become members of the Society and were current Fellows. The idea of having non-angiographer members was a marked departure from the sentiment of the Society in past years, but certainly was in concert with the change in the direction the Society was taking.

The initiation of the two-tiered system and expansion of the membership to almost 800 people was in stark contrast to the first meeting held in Key Largo in 1975. This attested to the success of the Society, both as a scientific and pedagogical institution. The Society course had become widely recognized as the premier course in the cardiovascular and interventional radiology arena. The enthusiasm of the commercial interests to display their wares at the course was testimony to the success of the endeavor.

One other matter that had been debated over the years was the possibility of having the Society of Cardiovascular and Interventional Radiology affiliate with a journal or have a journal of its own. A committee with Chris Athanasoulis as chairman, members Stan Baum, Bill Casarella, John Doppman and Andy Crummy had been appointed by President Art Waltman to consider the matter. The committee recommended that the Society affiliate with Radiology. There was discussion as to the merits of this, and it was pointed out that Stanley Siegelman, who is the editor of Radiology and a Fellow of the Society, had met with the committee and indicated that he was enthusiastic about this and willing to discuss details of such an affiliation with the necessary committees at the Radiological Society of North America. A minority report was made suggesting that the Society found its own journal.

There was much discussion, and various other alternatives were raised. An advisory ballot was held to determine whether the Society should affiliate with Radiology, and a clear-cut majority was in favor.

In March 1989 a special series "RSNA-SCVIR" of Radiology was published in Volume 170. The series contained 191 pages which followed the general format of Radiology. All of the articles, book reviews, general editorials, and news items were specifically related to cardiovascular and interventional radiology. In addition, abstracts of the 1989 SCVIR meeting were published. The editor for the special series was Gary J. Becker, who was assisted by Ernie Ring, Barry Katzen, Daniel Picus, Charles Tegtmeyer and Art Waltman. They are to be commended for an excellent job. The publication fulfills the desire of the Society to have an identifiable printed forum in which items related to the business of the Society, as well as its scientific aspects, could be promulgated.

It was decided that the Fellows' meeting would continue as before, to be followed by a members' meeting at which the business of the Society would be conducted with the input and vote of the entire membership. It was recognized that, whereas in the past only Fellows had presented at the course, it would be desirable to open up participation to all members.

The change in the size of the Society, the number of people desiring to become members and Fellows, the size of the budget, the hiring of full time staff, the success of the course, and the concerns of the Fellows to preserve the intimacy of their small scientific meeting, all attest to the success of the Society. Not all agree with the changes, but few would fail to acknowledge that it is a robust Society with the opportunity to be both scientifically and politically influential in the arena of cardiovascular and interventional radiology. While the original objectives of the Society have been fulfilled, additional ones have been added. Prospects for the future are excellent.