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Dr VRK Rao
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He earned a national reputation for his devotion to interventional neuroradiology, investing in research and education while teaching at one of the most prestigious medical institutions in India, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Thiruvananthapuram. Renowned radiologist, Dr Vedula Rajani Kanth Rao (VRK Rao) has been at the forefront of important interventional neuroradiology-related developments in India. Famous for his contribution to the birth and growth of interventional radiology at SCTIMST, he is also known for developing biomaterials for therapeutic endovascular neurointervention.
Distinctive work
Throughout his career Dr VRK Rao’s work has been primarily focussed on vascular imaging and interventional radiology. “When I began my career in radiology, indeed there was no specially identified field of interventional neuroradiology. Though some anecdotal procedures were performed by neurosurgeons without image guidance, there was no identity to this discipline in those days, the early 80s,” he says.
Much of his research focused on biomaterials for therapeutic endovascular neurointervention. Also, an astute diagnostic radiologist, his observations and publications on Syringohydromyelia and congenital atlanto-axial dislocation are based on personal experience in investigating these patients over more than a decade. His original observations on the integrity of the acrylic monomers used for embolotherapy received wide attention.
SCTIMST at Thiruvananthapuram is well recognised as a premier referral centre for interventional neuro and vascular radiology. It is here that Dr Rao collaborated with the scientists and engineers to synthesise monomers and particulate materials necessary for therapeutic embolisation. Using home-grown Indian technology he demonstrated the therapeutic usefulness of stainless steel spring coils for intravascular use. This was done at minimal cost, for bringing down the total cost of treatment for the patients as imported implants were prohibitively expensive. “For the first time to my knowledge, our Department of Radiology was given the patient admission rights with provision of two beds in the neurological wards for patients undergoing neurointervention,” Dr Rao remembers. “This was a basic requirement and the beginning of an identity to the new discipline, for which I deeply acknowledge the support from the Head of the Institution, and also for procuring the expensive hardware, while subsidising treatment costs to the patients,” he adds.
Dr Rao established the treatment modality for embolisation of brain and spinal vascular lesions which was not available readily in India. He, along with his colleagues, standardised and perfected the detachable balloon techniques for treatment of carotid-cavernous fistulae and many unusual vascular lesions in other parts of the body, peripheral vascular angioplasty etc., He simultaneously designed studies of vascular stents in animals and long-term patency. “The journey was not smooth however,” Dr Rao says. “The materials were under continuous development. My junior colleagues were always a great support to me,” he recollects. “I remember the late evenings we used to work in the department assembling the catheter systems for the next day’s procedure,” he adds. “My enthusiasm was shared by the nursing staff and technologists, we worked on Sundays and holidays as well with intense involvement to treat patients. I believe this was the key to our carving a discipline of intervention in the Institute that gained acceptance all over,” Dr Rao explains.
During his term at various institutes and hospitals his contributions are duly noted. He perused the feasibility of picture archival and communications (PACS) as well as radiology information systems (RIS) related to automation in patient data and report generation with encouraging results. While in charge of the central referral hospital at Abu Dhabi, he made efforts to introduce and establish vascular interventional radiological services in the United Arab Emirates (UAE), resulting in the treatment of patients from different neighbouring countries as well. At Kasturba Hospital, Manipal, he was involved in quality improvement programme and self-audit of the department functioning in addition to introducing new initiatives with particular emphasis on the interventional radiology programme.
For Dr Rao, achieving excellence in his work in diagnostic radiology, mainly in vascular radiology and interventional neuroradiology, has never been enough. He has always sought to expand and share his knowledge as well as his experience by involving professional bodies and mentoring students.
“Each aspect of intervention was so exciting that I could not wait to share my findings with my colleagues and students. Profound passion for the subject expressed itself through my desire to communicate and share, if you want to call it ‘teaching’” he says.
Career highlights
Dr Rao earned his medical degree in 1970 from Andhra Medical College, Visakhapatnam. He spent the next few years getting his post graduation in radiology from the University of Delhi and Banaras Hindu University.
Dr Rao began his academic career at SCTIMST as an assistant professor in 1977. Over the next 17 years, he held many posts at the institute such as Professor of Radiology and Head of the Department of Imaging Sciences and Interventional Radiology from 1986 to 1993.
Later that year, he moved to Al Jazeira & Central Hospitals, Abu Dhabi as Head of Radiology. He came back to India in 2005, working briefly at Kerala Institute of Medical Sciences (KIMS), Thiruvananthapuram. From 2006 to August 2013 he spent his time at Kasturba Hospital, Manipal as Professor and Head of Radiology and Imaging. Currently, he is the Clinical Director of Radiology & Imaging Services at Krishna Institute of Medical Sciences, Hyderabad where he hopes to continue his clinical work, research and teaching.
He has authored over 116 peer-reviewed scientific articles and four book chapters. He is a member of World Federation of Therapeutic and Interventional Radiology, Member of Academy of Medical Sciences and several other international forums. He was honoured for his life time achievements by Surjeet Singh Barnala, Governor of Tamil Nadu, besides receiving many other accolades by several academic bodies.
His research interests lie in the area of radiology information and management systems as well as in the progress of endovascular management strategies.
Inspiration
He was inspired by the great minds of the time, doyens of radiology from around the world. He was a keen follower of the research done by other doctors whose works were published in reputed journals. “Western literature, available in the professional journals mostly, acted as stimulus. Close interaction with the most willing neurosurgeons at the time was another factor adding to my quest for knowledge,” he reveals.
“It was exciting to read the results of neurointervention by pioneers in France and the US. At a time when it was not possible to have formal training by pioneers in the West, Prof Luc Picard and Jack Moret of France visited my Institute. Meeting them and discussing with them was the first step for me to learn the art of science. Their subsequent visits to India paved the way for the continued growth,” he further adds.
Changing scenario in interventional neuroradiology
Much has changed from the time Dr Rao started giving shape to his thoughts. Now, interventional neuroradiology has a curriculum, and a sizable number of interns opt for the subject. “Over the past two decades, technology has grown by leaps and bounds with availability of a vast array of tools for safe and effective management of patients by interventional techniques. More radiologists are interested in this discipline in the present healthcare delivery,” Dr Rao says.
With optimism he says, “It is interesting to watch the discipline now attracting the neurosurgeons, neurologists and vascular surgeons.”
“With the evolution of a three-year DM programme in neuroradiology (after MD in radiodiagnosis) in premier institutions, and neurointervention as an integral part of the training, today we have qualified and trained neurointerventionalists emerging every year from these national institutions,” he informs. “Advanced Course in Neurointervention is conducted every two years at SRMC, Chennai where experts from international faculty converge and demonstrate live transmission of the procedures,” he adds. “Introspection of current knowledge, skills and outcomes of treatments are extensively discussed over three days every year at Goa during Monsoon Meetings with the aim of dissemination of knowledge. Fellowship and Residency programmes approved by Universities are now available for training in vascular and neurointervention at selected institutions,” he informs.
Loved by all
Dr Rao is very proud of his students who have become successful in their own fields. He remembers with fondness that they are carrying his legacy to not only different parts of India but around the world. “It is very much gratifying to see my students and junior colleagues leading the departments of neurointervention in reputed and premier institutions, such as the Sanjay Gandhi Postgraduate Institute at Lucknow, Kovai Medical Centre at Coimbatore, Sree Rama Chandra Medical College at Chennai and NIMHANS at Bangalore and of course my former Sree Chitra Tirunal Institute at Thiruvananthapuram,” he says. “Each one of them has distinguished themselves professionally, travelled widely and are well known today in the academic sphere. The recent national conference organised at Coimbatore is a testimony to their recognition and excellence of performance. I consider their accomplishments and recognition as my own achievement,” he concludes.