Paola Devis
- Assistant Clinical Professor, Medical Imaging - (Clinical Series Track)
- (520) 792-1450
- AHSC, Rm. 20
- pdevis@arizona.edu
Biography
I started working with the University of Arizona Medical Imaging Department in 2010, at a time of big transitions and changes. I was making a conscious decision to take on the challenge of re-building the Division of Interventional Radiology early in my career as an Interventional Radiologist. At the time I arrived, the Interventional Radiology Division had been reduced to a service providing mostly central line placements and biopsies. The Interventional Radiology fellowship was cited on multiple issues by the ACGME as the volume and variety of procedures performed could not support the training of fellows and the Interventional Radiology curriculum had not been updated in a very long time. Other clinical care divisions within the hospital such as Oncology, Trauma, Transplant services and General Surgery were not supported adequately by Interventional Radiology.
I saw all these issues as a great challenge and as an opportunity to positively impact the Interventional Radiology Division, the Department of Medical Imaging and the University Medical Center (UMC, now Banner University Hospital-Tucson). From the moment I began working as an assistant professor, I was very interested in expanding the role of Interventional Radiology within UMC. I introduced new and different interventional radiology procedures and provided further clinical assistance to other clinical services. This enriched the experience of our fellows, our rotating residents and medical students. I also assisted in creating a new Interventional Radiology curriculum and a strong didactic program.
During my time at Banner, I started the Interventional Oncology Program and set up a dedicated Interventional Radiology Clinic with emphasis on Interventional Oncology. We offered all available Inerventional Oncology procedures and were the first in Southern AZ to establish a Y90 program to offer selective transarterial radiation therapy. I performed the first Y90 procedure in Southern AZ while at Banner University Hospital.
In 2017 I transitioned to the Southern Arizona VA Medical center, where I continue to provide these services. I started the VA Interventional Oncology IR clinic and also set up the Y90 program, to offer all these services to our veterans. This is where I am based today.
At the VA, I serve as the University of Arizona Interventional Radiology Residency and Interventional Radiology Independant and Integrated Program site director.
In 2022 I came back part time/per diem to Banner, with the Body Imaging department, where I am part of the faculty and participate in Diagnostic Radiology resident training.
Degrees
- M.D. Medicine
- Universidad de Rosario, Bogota, Colombia
Work Experience
- American College of Radiology (2017 - Ongoing)
- Southerner Arizona Veterans Health Administration (2017 - Ongoing)
- University of AZ (2010 - 2017)
- Veterans Affairs Hospital VAMC (2006 - 2010)
- Hospital San Antonio (1998 - 1999)
Awards
- University of Miami William J Harrington Program for Latin American Students, Externship
- University of Miami, Summer 1998
- Class Representative for the Medical School Academic Committee
- Spring 1995
- Teacher Assistant of Pathology, Colegio Mayor de Nuestra Sra. Del Rosario, awarded to two top students in each class
- Colegio Mayor de Nuestra Sra. Del Rosario, Summer 1994
- Chief Resident Diagnostic Radiology Residency
- Spring 2004
Licensure & Certification
- Diagnostic Radiology, American Board of Radiology (2006)
- Dual Certificate of Interventional Radiology/Diagnostic Radiology, American Board of Radiology (2015)
- Certificate of added Qualification in Vascular and Interventional Radiology, American Board of Radiology (2008)
- USMLE 1, 2, 3, ECFMG Certified (1999)
Interests
Research
As stated before, since my appointment my focus was directed towards re-building the Interventional Radiology Division and its Fellowship Program as well as, re-building and establishing new interdisciplinary relationships. Most of my efforts were spent expanding the role of Interventional Radiology within this hospital and offering new clinical services at the University Medical Center (now BUMC-T) and within the Southern Arizona Community. Recently, with the addition of two full time Interventional Radiologists, the clinical workload has been able to be distributed and this has allowed some time for collaborations and clinical research. The increase in volume and variety of cases experienced in the few years since my appointment is resulting in a meaningful data base that continues to grow and will soon allow us to become more productive with clinical research projects.With new found flexibility on my schedule, I have been able to become involved in several projects. I am one of the two principal investigators on a Grant submitted to the Merck Investigator Studies Program (co-p.i. Lee Cranmer, MD/PhD): “Phase I Dose Escalation Study of Selective Intra-arterial Hepatic Infusion of Pembrolizumab for the Treatment of Solid Hepatic Metastasis” and I was a co-investigator on a Grant that was submitted by Interventional Radiology to the State of Arizona (p.i. Dr. Stacey Black): “Gastric Artery Embolization for Weight Loss – A Minimally Invasive Alternative to Bariatric Surgery”. I was a co-author on an abstract and poster presented at the Society of Interventional Radiology Meeting 2014 and another presented at the Society of Interventional Radiology Meeting 2015. I have submitted abstracts with our residents and fellows for the Society of Interventional Radiology Meeting 2016 and for the American Roentgen Ray Society Meeting 2016. I have also co-authored several case reports with residents and students and I am currently collaborating in clinical research with the Department of Medical Oncology, with the Department of Surgery and with the Division of Body Imaging within the Department of Medical Imaging. The Division of Interventional Radiology is currently collecting prospective data on Interventional Oncology cases with the expectation to publish our results and experience on the treatment of certain tumors for which conventional therapies such as chemotherapy and surgery are not good options.Having built a superb clinical and teaching program, while maintaining active scholarly involvement, and with the participation of my newly recruited colleagues, I anticipate more time to dedicate to research commitments and publications in the upcoming years. In order to be competitive on a national level, and with the recent growth of my Division, we have applied for the new ACGME accredited Interventional Radiology Residency, and our division is currently undergoing review. My future plans include the continued development of the Division of Interventional Radiology with an increased presence within the Banner University Medical Center and the Southern Arizona community, while providing research opportunities for our students, residents, fellows, and faculty. My goal is to use our efforts and expertise Body Imaging within the Department of Medical Imaging. The Division of Interventional Radiology is currently collecting prospective data on Interventional Oncology cases with the expectation to publish our results and experience on the treatment of certain tumors for which conventional therapies such as chemotherapy and surgery are not good options.Having built a superb clinical and teaching program, while maintaining active scholarly involvement, and with the participation of my newly recruited colleagues, I anticipate more time to dedicate to research commitments and publications in the upcoming years. In order to be competitive on a national level, and with the recent growth of my Division, we have applied for the new ACGME accredited Interventional Radiology Residency, and our division is currently undergoing review. My future plans include the continued development of the Division of Interventional Radiology with an increased presence within the Banner University Medical Center and the Southern Arizona community, while providing research opportunities for our students, residents, fellows, and faculty. My goal is to use our efforts and expertise to increase national awareness of The University of Arizona Interventional Radiology Program. Personally, I would like to be more active nationally and with the Medical College and Society of Interventional Radiology and would also like to be able to take the time to accept invitations to lecture at other institutions.
Teaching
My objective for teaching students, residents, and fellows is to inspire them with a joy for lifelong learning and to empower them to help their patients and future students. I strive to produce clinicians who will be kind, compassionate and correct, with cutting-edge clinical competence. My ultimate goal is to produce the kind of physician that I would like to care for me or my loved ones, if we became critically ill or injured. I strive to train future leaders within the field of Interventional Radiology who will convey the above attributes to their trainees, with good humor and encouragement. My philosophy on teaching is simple; I teach others as I would like to be taught.For the improvement of resident and fellow education, I created the new Interventional Radiology curriculum, which includes a series of bimonthly didactic lectures that I present. These cover all the essentials of Interventional Radiology. They are fellowship level lectures where the attendance of IR fellows and Radiology Residents is required. Aside from this, once a month, I am in charge of the resident/fellow interesting case conference, where residents/fellows present cases in which they participated during their rotation. These cases are discussed with a current literature review on the subject. I also created the Interventional Radiology board review for the senior radiology residents to prepare them for the radiology boards. I continuously update and redesign this based on feedback from the groups of residents who have taken the new radiology core exams. This comprehensive Interventional Radiology review is covered in a total of 5h (usually split in 2-3 review sessions). It covers all the main IR topics to prepare the residents for "the core exam".With the breadth of new cases stemming from re-established interdisciplinary relationships that started after my appointment, the volume and variety of procedures performed by Interventional Radiology increased significantly. This added to the establishment of the dedicated Interventional Radiology Clinic (an ACGME requirement for fellowship training), the re-design of the IR curriculum and the establishment of the mandatory didactic lectures and case conferences, the Interventional Radiology Fellowship at the University of Arizona went from nearly closed, to an increase from 1 to 2 ACGME accredited fellows. This following the last ACGME review, which took place on October 2014.As part of my commitment to the University of Arizona medical students, I am involved in mentoring shadowing students that have specific interest in my subspecialty. We have 1 or 2 such students a year, that will spend an entire month with us, and a handful of students each month, that include us for one week as part of their general radiology rotations. When we do have interested students, I make sure to involve them in cases, have them participate in case discussions and assign them a topic to prepare and present to the staff as part of their rotation. We had a second year student that spent the summer of 2014 shadowing me and working on a research project. She prepared a poster with one of our residents to present at the Interventional Radiology Society meeting. Also, in anticipation of the expected upcoming separation between the Diagnostic Radiology Residency and the Interventional Radiology Residency, I have started a series of medical student lectures through the University of Arizona Medical Student Radiology Interest group, to raise awareness and increase interest among the medical students about our specialty/subspecialty.Additional academic duties have included, taking part in the secondary screener program 2014-15, evaluating applications to the University of Arizona Medical School and, most recently, I was chosen by my peers to participate in the selection committee for the Diagnostic Radiology and the Interventional Radiology Residency programs, starting this fall. My success as a teacher depends on the success of my students. My immediate rewards as a teacher stem from the day-to-day successes of my students, such as when they achieve new understanding, when they perform a procedure for the first time, or when they sit down to spend time with their patients and families to comfort and counsel them. My longer-term rewards include the success of making my students enthusiastic about a life dedicated to Interventional Radiology. Since my arrival, the top residents of each class have chosen a career in IR and since 2013 most have chosen to stay in our fellowship program, those that don’t stay have matched in excellent IR programs such as the Mallinckrodt Institute of Radiology, for the last 2 years in a row.
Courses
No activities entered.
Scholarly Contributions
Books
- Devis, P., & Arif, H. (2020). The Ultimate guide to point of care ultrasound guided procedures. chapter title- Ultrasound-guided Percutaneous Drainage Procedures: Springer.
Chapters
- Devis, P., & Arif, H. (2017). The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. In The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures.
- Situ-lacasse, E., Situ-lacasse, E., Javedani, P., Devis, P., Devis, P., Arif Tiwari, H., & Arif-tiwari, H. (2020). Ultrasound-Guided Percutaneous Drainage Procedures. In The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. Springer, Cham. doi:10.1007/978-3-030-28267-7_11More infoUltrasound-guided procedures, especially those that are for needle guidance, are all based on the learned skill of being able to track the needle tip the entire time, while it is in the patient under ultrasound imaging. By learning this critical skill, the physician should feel confident in the successful completion of both simple and more complicated, invasive procedures. Ultrasound-guided percutaneous drainage or aspiration of abnormal fluid collections is becoming standard of care in current clinical practice. Ultrasound guidance has led to reduced morbidity and mortality and decrease in length of stay and healthcare costs. Ultrasound-guided percutaneous drainage is minimally invasive and relatively inexpensive and has several advantages over CT including real-time guidance and lack of radiation.
- Situ-LaCasse, E., Javedani, P., Devis, P., & Arif-Tiwari, H. (2019). Ultrasound-Guided Percutaneous Drainage Procedures. In The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. Springer Nature.
Journals/Publications
- Devis, P. (2021). Covid-19 and Renal Infarct: To be or not to be on anticoagulation. Clinical Nephrology Case Studies, 9, 117-122.
- Sherman, N. C., Williams, K. N., Hennemeyer, C. T., Devis, P., Chehab, M., Joseph, B., & Tang, A. L. (2022). Authors' response to "The diameter of the gelatin sponge affects the outcome of pelvic internal iliac artery embolization". The journal of trauma and acute care surgery.
- Devis, P. (2015). 2015 SIR Abstract : Systematic MRI Characterization of Tissue Outcomes Following IRE of Hepatic Tumors. Journal of Vasular and Interventional Radiology, 26(2):S60-61.
- Devis, P. (2016). Hepatic Cirrhosis - Letter to the Editor. New England Journal of Medicine.
- Devis, P. (2017). Man lured with alcohol, takes bait and gets caught- A cautionary fish tale. The American Surgeon.
- Sherman, N. C., Williams, K. N., Hennemeyer, C. T., Devis, P., Chehab, M., Joseph, B., & Tang, A. L. (2021). Effects of nonselective internal iliac artery angioembolization on pelvic venous flow in the swine model. The journal of trauma and acute care surgery, 91(2), 318-324.More infoPelvic angioembolization (AE) is a mainstay in the treatment algorithm for pelvic hemorrhage from pelvic fractures. Nonselective AE refers to embolization of the bilateral internal iliac arteries (IIAs) proximally rather than embolization of their tributaries distally. The aim of this study was to quantify the effect of nonselective pelvic AE on pelvic venous flow in a swine model. We hypothesized that internal iliac vein (IIV) flow following IIA AE is reduced by half.
- Takamatsu, C., Devis, P., & Tolouian, R. (2021). COVID-19 and renal infarct: To be or not to be on anticoagulation. Clinical nephrology. Case studies, 9, 117-122.More infoWe present a unique case of a male veteran with a history of Castleman disease, presenting with multiple arterial and venous vascular thromboses in the setting of recent Coronavirus (COVID-19)-disease diagnosis. We explore this patient's morbidity related to thrombotic complications of his COVID-19 diagnosis that were potentially avoidable with a comprehensive outpatient evaluation of his risk for thrombosis, as well as the initiation of anticoagulation and/or antiplatelet therapy given his high risk. Our case highlights the need for a standardized clinical workup of patients in the outpatient setting for risk assessment of vascular thrombosis associated with COVID-19 infection to direct medical management, in order to minimize adverse outcomes, complications requiring inpatient admission, and the need for additional yet limited medical resources and interventions. We propose a minimum of low-dose aspirin 81 mg daily as a reasonable approach for outpatient clinicians to consider, based on their best clinical judgement, when managing mild COVID-19, while other options, such as novel oral anticoagulants, are undergoing further investigation.
- Vercruysse, G. A., Bauman, Z. M., Devis, P., & Hennemeyer, C. T. (2018). Man lured with alcohol, takes bait and gets caught - A cautionary fish tale.. The American Surgeon, 84.
- Vercruysse, G. A., Bauman, Z. M., Hennemeyer, C. T., Devis, P., & Rhee, P. M. (2018). Man Lured with Alcohol, Takes Bait, and Gets Caught: A Cautionary Fish Tale. The American surgeon, 84(2), e85-e86.
- Devis, P. (2017). Coccidioidomycosis Mimicking Peritoneal Carcinomatosis: Case report Applied Radiology. Applied Radiology: 2017;46(4):28-29. April 03, 2017, 46(4): 28-29.
- Devis, P., & Knuttinen, G. (2017). Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management.. Cardiovasc Diagn Ther, 7(Suppl 3), S309-S319. doi:10.21037
- Devis, P., & Knuttinen, M. G. (2017). Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management. Cardiovascular diagnosis and therapy, 7(Suppl 3), S309-S319.More infoDeep venous thrombosis (DVT) during pregnancy is associated with high mortality, morbidity, and costs. Pulmonary embolism (PE), its most feared complication, is the leading cause of maternal death in the developed world. DVT can also result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. Women are up to 5 times more likely to develop DVT when pregnant. The current standard of care for this condition is anticoagulation. This review discusses the epidemiology, pathogenesis, prophylaxis and diagnosis of DVT during pregnancy, and then focuses on endovascular treatment modalities. Inferior vena cava (IVC) filter placement and pharmacomechanical catheter directed thrombolysis (PCDT) in the pregnant patient are discussed, as well as patient selection criteria, and complications.
- Devis, P. (2016). Segmental arterial mediolysis and fibromuscular dysplasia: What comes first, the chicken or the egg?. Cardiovascular Pathology, 25(2):113-5.
- Hall, E. T., Gibson, B. A., Hennemeyer, C. T., Devis, P., Black, S., & Larsen, B. T. (2016). Segmental arterial mediolysis and fibromuscular dysplasia: what comes first, the chicken or the egg?. Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology, 25(2), 113-5.More infoSegmental arterial mediolysis (SAM) is a rare vasculopathy characterized by lysis of the outer media in splanchnic arteries and formation of dissecting pseudoaneurysms that may spontaneously rupture, leading to massive and often fatal intraabdominal hemorrhage. The pathogenesis of SAM is poorly understood. Healed SAM lesions closely resemble fibromuscular dysplasia (FMD), leading some authors to postulate that SAM represents a precursor to FMD despite distinct clinical differences between these two disorders. Herein, we present a 61-year-old woman with fatal SAM who showed histologic features in her aorta suggesting the opposite pathogenetic relationship, with an unclassified "FMD-like" arteriopathy preceding development of SAM.
- Devis, P., Woodhead, G. J., Kalb, B., Black, S., & Krupinski, E. (2015). Systematic MRI Characterization of Tissue Outcomes Following IRE of Hepatic Tumors. JVIR - Journal of Vascular and Interventional Radiology.More infoFebruary 2015Volume 26, Issue 2, Supplement, Pages S60–S61
- Devis, P., & John, S. G. (2013). Case Report: Migration of Fractured PICC Line, Southwest Journal of Pulmonary Critical Care. 2013; 7 (5). Southwest Journal of Pulmonary and Critical Care., 2013;7(5)304-304 DOI 10.13175/swjpcc151-13.
- Devis, P., Iwanik, D., & Aikens, C. (2005). Metastatic Adenocarcinoma Presenting as Monoarticular Arthritis of the Knee. AJR. American journal of roentgenology, 184(3 Suppl), S107-9.
Presentations
- Devis, P. (2017, February). Endovascular management of Visceral Arterial Aneurysms and Pseudo-aneurysms. The University of Arizona Medical Imaging Grand Rounds.
- Devis, P. (2017, February). “Endovascular management of Visceral Arterial Aneurysms and Pseudoaneurysms”. Vascular Surgery Teaching Conference, The University of Arizona College of Medicine Tucson, Sarver Heart Center.
Poster Presentations
- Devis, P. (2016, Fall). Winner - Best Poster Award - "Denever peritoneo-venous shunt: as essential tool in the managment of malignant ascites". SIR 41st Annual Scientific Meeting.
Reviews
- Devis, P., & Knuttien, G. (2017. DVT in pregnancy: Incidence, Treatment and Outcomes; Review article Journal: Thrombosis.
Case Studies
- Devis, P. (2016. Gastro Intestinal Basidiobolomycosis: A case report and review of the literature.(p. 000).
- Devis, P. (2017. Gastrointestinal Basidiobolomycosis(pp ID # s4024).
- Devis, P., Lee, J., & Kramer, J. (2017. Management of Portal Vein stenosis following liver transplant.(pp TBD).
Others
- Devis, P., Tang, A., Williams, K., & Sherman, N. (2017, May). IRB approved Animal study, May 2017: aims to quantify the degree of pelvic venous flow reduction following unilateral and bilateral internal iliac artery embolization in Swine. Study in collaboration between IR and the division of Trauma Surgery: Data was collected and is currently being analyzed..