Lots of NIR trained people don’t do it anymore for various reasons. Reasons include being displaced by neurosurgery and not wanting to move, insufficient financial incentive from the hospital to cover the grueling call, and aging out / not being able to withstand the grueling call.
Lots of fellowships are popping up at lower-tier institutions resulting in too many trained people for too few spots. These are popping up to help offload work onto fellows to give attendings better lifestyles, at the expense of the job pool.
My frank opinion is that if you’re really interested in neuro vascular intervention, become a body IR person, work at a stroke center, and see if you can help offload stroke call from the people where you’re working. Odds are if you hang around long enough they’ll eventually be cool with it because of how unpleasant the call is. However, If you want to embolize AVMs or stent carotids (outpatient, scheduled, weekday work), you have your work cut out for you. Some people I know got attending offers simultaneous with fellowship application, which I think would be a reasonable path. But I don’t think this is typical.