BackTable Vascular & Interventional https://www.backtable.com/ en All rights reserved The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Listen on BackTable.com or on the streaming platform of your choice. You can also visit www.BackTable.com to browse our open access, physician-catered knowledge center for all things vascular and interventional; now featuring practice tools, procedure walkthroughs, and expert guidance on more than 40 endovascular procedures. https://megaphone.imgix.net/podcasts/d2317f46-1baf-11ec-976f-f3375cc9dd88/image/BT-Endovascular-Favicon-Square-3000.png?ixlib=rails-4.3.1&max-w=3000&max-h=3000&fit=crop&auto=format,compress BackTable Vascular & Interventional https://www.backtable.com/ no episodic The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. BackTable The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Listen on BackTable.com or on the streaming platform of your choice. You can also visit www.BackTable.com to browse our open access, physician-catered knowledge center for all things vascular and interventional; now featuring practice tools, procedure walkthroughs, and expert guidance on more than 40 endovascular procedures. The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Listen on BackTable.com or on the streaming platform of your choice. You can also visit www.BackTable.com to browse our open access, physician-catered knowledge center for all things vascular and interventional; now featuring practice tools, procedure walkthroughs, and expert guidance on more than 40 endovascular procedures.

]]> BackTable Inc. aaron@backtable.com https://feeds.megaphone.fm/BTL2696346991 Ep. 635 Methodical Approach to Adrenal Vein Sampling with Dr. Zoe Miller Your guide to better planning, access, and sampling. In this episode of the BackTable Podcast, we revisit every IR’s favorite procedure with Dr. Zoe Miller, Assistant Professor of Clinical Interventional Radiology and Associate Program Director at the University of Miami. Together with host Dr. Ally Baheti, Dr. Miller walks through a methodical approach to adrenal vein sampling to help you overcome common procedural challenges and reliably point your patients towards the proper therapies. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:26 - Preprocedural Workup Basics06:21 - Planning CT Utility and Protocol08:46 - Access Strategy10:36 - Procedure Day Preparation12:12 - Catheters and Side Holes15:44 - Adrenal Vein Selection Techniques18:50 - Troubleshooting Right Adrenal Vein Selection24:34 - Sample Acquisition Coordination27:38 - Aspiration Flow Optimization29:34 - Preventing Reintervention and Vessel Damage34:06 - Post-Procedure Follow-Up35:46 - AVS in Cushing Syndrome39:38 - Mentorship and Sourcing Knowledge39:25 - Closing Remarks --- More about this episode The physicians outline the key aspects of the pre-procedural workup, from setting expectations with patients to the utility of CT in operative planning. Dr. Miller provides a detailed exploration of strategies and tools for achieving safe access of the adrenal veins, particularly on the right side, and obtaining adequate samples. She emphasizes the importance of collaboration, both within the IR team and with other specialists, to ensure maximal procedural yield and to ultimately provide patients with valuable guidance in their treatment. The episode concludes with a discussion of the challenges presented by co-secreting tumors in hormone level assessment as well as the value of seeking out data and the experiences of mentors in developing your own best practices as an IR. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app Fri, 17 Apr 2026 07:00:00 -0000 full BackTable Your guide to better planning, access, and sampling. In this episode of the BackTable Podcast, we revisit every IR’s favorite procedure with Dr. Zoe Miller, Assistant Professor of Clinical Interventional Radiology and Associate Program Director at the University of Miami. Together with host Dr. Ally Baheti, Dr. Miller walks through a methodical approach to adrenal vein sampling to help you overcome common procedural challenges and reliably point your patients towards the proper therapies. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:26 - Preprocedural Workup Basics06:21 - Planning CT Utility and Protocol08:46 - Access Strategy10:36 - Procedure Day Preparation12:12 - Catheters and Side Holes15:44 - Adrenal Vein Selection Techniques18:50 - Troubleshooting Right Adrenal Vein Selection24:34 - Sample Acquisition Coordination27:38 - Aspiration Flow Optimization29:34 - Preventing Reintervention and Vessel Damage34:06 - Post-Procedure Follow-Up35:46 - AVS in Cushing Syndrome39:38 - Mentorship and Sourcing Knowledge39:25 - Closing Remarks --- More about this episode The physicians outline the key aspects of the pre-procedural workup, from setting expectations with patients to the utility of CT in operative planning. Dr. Miller provides a detailed exploration of strategies and tools for achieving safe access of the adrenal veins, particularly on the right side, and obtaining adequate samples. She emphasizes the importance of collaboration, both within the IR team and with other specialists, to ensure maximal procedural yield and to ultimately provide patients with valuable guidance in their treatment. The episode concludes with a discussion of the challenges presented by co-secreting tumors in hormone level assessment as well as the value of seeking out data and the experiences of mentors in developing your own best practices as an IR. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app Your guide to better planning, access, and sampling. In this episode of the BackTable Podcast, we revisit every IR’s favorite procedure with Dr. Zoe Miller, Assistant Professor of Clinical Interventional Radiology and Associate Program Director at the University of Miami. Together with host Dr. Ally Baheti, Dr. Miller walks through a methodical approach to adrenal vein sampling to help you overcome common procedural challenges and reliably point your patients towards the proper therapies.


---


Get the BackTable app
https://www.backtable.com/app


---


Timestamps


00:00 - Introduction
02:26 - Preprocedural Workup Basics
06:21 - Planning CT Utility and Protocol
08:46 - Access Strategy
10:36 - Procedure Day Preparation
12:12 - Catheters and Side Holes
15:44 - Adrenal Vein Selection Techniques
18:50 - Troubleshooting Right Adrenal Vein Selection
24:34 - Sample Acquisition Coordination
27:38 - Aspiration Flow Optimization
29:34 - Preventing Reintervention and Vessel Damage
34:06 - Post-Procedure Follow-Up
35:46 - AVS in Cushing Syndrome
39:38 - Mentorship and Sourcing Knowledge
39:25 - Closing Remarks


---


More about this episode


The physicians outline the key aspects of the pre-procedural workup, from setting expectations with patients to the utility of CT in operative planning. Dr. Miller provides a detailed exploration of strategies and tools for achieving safe access of the adrenal veins, particularly on the right side, and obtaining adequate samples. She emphasizes the importance of collaboration, both within the IR team and with other specialists, to ensure maximal procedural yield and to ultimately provide patients with valuable guidance in their treatment. The episode concludes with a discussion of the challenges presented by co-secreting tumors in hormone level assessment as well as the value of seeking out data and the experiences of mentors in developing your own best practices as an IR.


---


BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.


Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


► https://www.backtable.com/app

]]> 2579 Ep. 634 Understanding Intravascular Lithotripsy in the OBL with Dr. Nicholas Petruzzi What do the 2026 coding changes mean for the financial viability of IVL in the OBL? In this episode of the BackTable Podcast, host Dr. Ally Baheti sits down with Dr. Nicholas Petruzzi to break down how intravascular lithotripsy fits into OBL workflows, and how upcoming lower-extremity revascularization coding updates may impact outpatient economics. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Shockwave Medicalhttps://shockwavemedical.com/ --- Timestamps 00:00 - Introduction02:35 - 2026 Coding Changes Overview05:18 - Where IVL Codes Apply06:35 - Iliac Reimbursement Impact08:50 - IVL vs. Atherectomy11:54 - BTK Reality and Future14:44 - When IVL Is Not Ideal16:05 - Catheters and Setup Basics17:50 - Sizing and Technique Tips23:01 - Javelin Forward Emitter26:25 - Wrap Up --- More about this episode The episode starts with a walkthrough of the key 2026 coding updates, including territory-based coding, new IVL add-on codes for aorto-iliac and fem-pop segments, the introduction of below-the-ankle codes, and the shift toward ‘simple’ versus ‘complex’ designations. From there, the conversation focuses on where IVL makes sense clinically and operationally, particularly as an alternative or complement to atherectomy, with discussion of low embolization risk seen in the DISRUPT PAD trial and the potential to avoid distal protection in select cases. Dr. Petruzzi shares how he approaches IVL in the lab, including catheter selection, sizing, low-pressure technique, and repositioning strategies. They also touch on workflow considerations in the OBL and preview newer concepts like the forward-emitting Javelin device for heavily calcified lesions and situations where device exchange is limited. --- Resources DISRUPT PAD III RCThttps://shockwavemedical.com/en-eu/clinical-evidence/pad-iii-rct/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app Tue, 14 Apr 2026 07:00:00 -0000 full BackTable What do the 2026 coding changes mean for the financial viability of IVL in the OBL? In this episode of the BackTable Podcast, host Dr. Ally Baheti sits down with Dr. Nicholas Petruzzi to break down how intravascular lithotripsy fits into OBL workflows, and how upcoming lower-extremity revascularization coding updates may impact outpatient economics. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Shockwave Medicalhttps://shockwavemedical.com/ --- Timestamps 00:00 - Introduction02:35 - 2026 Coding Changes Overview05:18 - Where IVL Codes Apply06:35 - Iliac Reimbursement Impact08:50 - IVL vs. Atherectomy11:54 - BTK Reality and Future14:44 - When IVL Is Not Ideal16:05 - Catheters and Setup Basics17:50 - Sizing and Technique Tips23:01 - Javelin Forward Emitter26:25 - Wrap Up --- More about this episode The episode starts with a walkthrough of the key 2026 coding updates, including territory-based coding, new IVL add-on codes for aorto-iliac and fem-pop segments, the introduction of below-the-ankle codes, and the shift toward ‘simple’ versus ‘complex’ designations. From there, the conversation focuses on where IVL makes sense clinically and operationally, particularly as an alternative or complement to atherectomy, with discussion of low embolization risk seen in the DISRUPT PAD trial and the potential to avoid distal protection in select cases. Dr. Petruzzi shares how he approaches IVL in the lab, including catheter selection, sizing, low-pressure technique, and repositioning strategies. They also touch on workflow considerations in the OBL and preview newer concepts like the forward-emitting Javelin device for heavily calcified lesions and situations where device exchange is limited. --- Resources DISRUPT PAD III RCThttps://shockwavemedical.com/en-eu/clinical-evidence/pad-iii-rct/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app What do the 2026 coding changes mean for the financial viability of IVL in the OBL? In this episode of the BackTable Podcast, host Dr. Ally Baheti sits down with Dr. Nicholas Petruzzi to break down how intravascular lithotripsy fits into OBL workflows, and how upcoming lower-extremity revascularization coding updates may impact outpatient economics.


---


Get the BackTable app
https://www.backtable.com/app


---


This podcast is supported by


Shockwave Medical
https://shockwavemedical.com/


---


Timestamps


00:00 - Introduction
02:35 - 2026 Coding Changes Overview
05:18 - Where IVL Codes Apply
06:35 - Iliac Reimbursement Impact
08:50 - IVL vs. Atherectomy
11:54 - BTK Reality and Future
14:44 - When IVL Is Not Ideal
16:05 - Catheters and Setup Basics
17:50 - Sizing and Technique Tips
23:01 - Javelin Forward Emitter
26:25 - Wrap Up


---


More about this episode


The episode starts with a walkthrough of the key 2026 coding updates, including territory-based coding, new IVL add-on codes for aorto-iliac and fem-pop segments, the introduction of below-the-ankle codes, and the shift toward ‘simple’ versus ‘complex’ designations. From there, the conversation focuses on where IVL makes sense clinically and operationally, particularly as an alternative or complement to atherectomy, with discussion of low embolization risk seen in the DISRUPT PAD trial and the potential to avoid distal protection in select cases.


Dr. Petruzzi shares how he approaches IVL in the lab, including catheter selection, sizing, low-pressure technique, and repositioning strategies. They also touch on workflow considerations in the OBL and preview newer concepts like the forward-emitting Javelin device for heavily calcified lesions and situations where device exchange is limited.


---


Resources


DISRUPT PAD III RCT
https://shockwavemedical.com/en-eu/clinical-evidence/pad-iii-rct/


---


BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.


Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


► https://www.backtable.com/app

]]> 1582 Ep. 633 Pelvic Venous Disease: Causes, Symptoms and Treatments with Dr. Deepak Sudheendra How do you differentiate between iliac vein compression, gonadal vein reflux, and Nutcracker syndrome in patients with chronic pelvic pain? Dr. Deepak Sudheendra, director and interventional radiologist at 360 Vascular Institute, joins host Dr. Ally Baheti to share his approach to evaluating and managing pelvic venous disease (PVD). --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:43 - PVD Demand at Penn06:42 - Approach & Algorithm12:08 - Variation in Iliac Vein Compression15:58 - Treatment Approaches19:20 - Important Ultrasounds22:15 - Intra-Procedural Workflow31:14 - Iliac Vein Stenting and Avoiding Complications36:31 - Gonadal Vein Embolization and Working with Patients42:20 - Iliac Vein Embolization and Post-Op Care --- More about this episode Dr. Sudheendra's clinical algorithm for diagnosing PVD emphasizes the importance of patient history and specific symptoms over isolated cross-sectional imaging findings. He shares his approach to the pre-procedural workup, highlighting the necessity of a standing venous reflux ultrasound to rule out superficial venous insufficiency. Beyond the technical steps, Dr. Sudheendra emphasizes the "soft skills" of managing a venous practice: counseling patients on conservative treatments like pelvic floor therapy, explicitly setting expectations about postoperative back pain, and avoiding unnecessary bilateral stents in young women. Dr. Sudheendra details his intra-procedural workflow for diagnosing and treating PVD, providing a look into his unique preference for right internal jugular (IJ) vein access to perform venograms and place iliac vein stents. He explains how this approach allows him to consistently check inflow from the lower extremities, and shares his techniques for performing gonadal vein embolizations and accurately sizing iliac vein stents to prevent lifelong complications. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app Fri, 10 Apr 2026 07:00:00 -0000 full BackTable How do you differentiate between iliac vein compression, gonadal vein reflux, and Nutcracker syndrome in patients with chronic pelvic pain? Dr. Deepak Sudheendra, director and interventional radiologist at 360 Vascular Institute, joins host Dr. Ally Baheti to share his approach to evaluating and managing pelvic venous disease (PVD). --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:43 - PVD Demand at Penn06:42 - Approach & Algorithm12:08 - Variation in Iliac Vein Compression15:58 - Treatment Approaches19:20 - Important Ultrasounds22:15 - Intra-Procedural Workflow31:14 - Iliac Vein Stenting and Avoiding Complications36:31 - Gonadal Vein Embolization and Working with Patients42:20 - Iliac Vein Embolization and Post-Op Care --- More about this episode Dr. Sudheendra's clinical algorithm for diagnosing PVD emphasizes the importance of patient history and specific symptoms over isolated cross-sectional imaging findings. He shares his approach to the pre-procedural workup, highlighting the necessity of a standing venous reflux ultrasound to rule out superficial venous insufficiency. Beyond the technical steps, Dr. Sudheendra emphasizes the "soft skills" of managing a venous practice: counseling patients on conservative treatments like pelvic floor therapy, explicitly setting expectations about postoperative back pain, and avoiding unnecessary bilateral stents in young women. Dr. Sudheendra details his intra-procedural workflow for diagnosing and treating PVD, providing a look into his unique preference for right internal jugular (IJ) vein access to perform venograms and place iliac vein stents. He explains how this approach allows him to consistently check inflow from the lower extremities, and shares his techniques for performing gonadal vein embolizations and accurately sizing iliac vein stents to prevent lifelong complications. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app How do you differentiate between iliac vein compression, gonadal vein reflux, and Nutcracker syndrome in patients with chronic pelvic pain? Dr. Deepak Sudheendra, director and interventional radiologist at 360 Vascular Institute, joins host Dr. Ally Baheti to share his approach to evaluating and managing pelvic venous disease (PVD).

---

Get the BackTable app

https://www.backtable.com/app

---

Timestamps

00:00 - Introduction
01:43 - PVD Demand at Penn
06:42 - Approach & Algorithm
12:08 - Variation in Iliac Vein Compression
15:58 - Treatment Approaches
19:20 - Important Ultrasounds
22:15 - Intra-Procedural Workflow
31:14 - Iliac Vein Stenting and Avoiding Complications
36:31 - Gonadal Vein Embolization and Working with Patients
42:20 - Iliac Vein Embolization and Post-Op Care

---

More about this episode

Dr. Sudheendra's clinical algorithm for diagnosing PVD emphasizes the importance of patient history and specific symptoms over isolated cross-sectional imaging findings. He shares his approach to the pre-procedural workup, highlighting the necessity of a standing venous reflux ultrasound to rule out superficial venous insufficiency. Beyond the technical steps, Dr. Sudheendra emphasizes the "soft skills" of managing a venous practice: counseling patients on conservative treatments like pelvic floor therapy, explicitly setting expectations about postoperative back pain, and avoiding unnecessary bilateral stents in young women.

Dr. Sudheendra details his intra-procedural workflow for diagnosing and treating PVD, providing a look into his unique preference for right internal jugular (IJ) vein access to perform venograms and place iliac vein stents. He explains how this approach allows him to consistently check inflow from the lower extremities, and shares his techniques for performing gonadal vein embolizations and accurately sizing iliac vein stents to prevent lifelong complications.

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

]]> 2943 Ep. 631 Advancements in Carotid Stenting with Dr. Adnan Siddiqui Clean lumen club! This week, BackTable meets you at the carotid bifurcation to discuss all things carotid angioplasty and stenting. Interventional neuroradiologist and cerebrovascular surgeon Dr. Adnan Siddiqui, Vice Chairman of the University of Buffalo’s Department of Neurosurgery, joins host Dr. Sameh Sayfo to discuss the evolution and current state of carotid disease treatment. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Terumohttps://www.terumois.com/ --- Timestamps 00:00 - Introduction02:48 - From Aspirin to Endarterectomy03:47 - Rise of Carotid Stenting06:46 - CREST-2 and CMS Coverage09:57 - Management of Severe Asymptomatic Carotid Stenosis 15:35 - New Stent Designs Explained17:56 - Five Tips for New Operators20:08 - Case Selection Algorithm22:04 - Learning Curve and Mentorship28:27 - What’s Next: IVL and Outpatient31:24 - Managing Complications Safely35:05 - Closing and Credits --- More about this episode Dr. Siddiqui details the history of carotid stenosis treatment, charting its path and progression from medical therapy to endarterectomy and modern stenting approaches. He includes how recent trial data and updated CMS reimbursements have influenced practice and generated recent developments such as second generation stent technology. Dr. Siddiqui shares perspectives on patient selection, operator learning curve, complication preparedness, and the importance of structured training and proctoring as technology and techniques continue to improve. The physicians close by overviewing future directions for the carotid space such as IVL and how to approach management of procedural complications. --- Resources Dr. Adnan Siddiqui provider profilehttps://www.ubns.com/physicians/dr-adnan-h-siddiqui/ Carotid Endarterectomy for Asymptomatic Carotid Stenosis: Asymptomatic Carotid Surgery Trial (ACAS)https://www.ahajournals.org/doi/10.1161/01.str.0000141706.50170.a7 Asymptomatic Carotid Surgery Trial (ACST-2)https://www.acc.org/latest-in-cardiology/clinical-trials/2021/08/25/23/24/acst2 Protected Carotid-Artery Stenting versus Endarterectomy in High-Risk Patients (SAPPHIRE trial)https://www.nejm.org/doi/full/10.1056/NEJMoa040127 Medical Management and Revascularization for Asymptomatic Carotid Stenosis (CREST-2 trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2508800 The North American Symptomatic Carotid Endarterectomy Trial (NASCET trial)https://www.ahajournals.org/doi/10.1161/01.str.30.9.1751 Tue, 07 Apr 2026 07:00:00 -0000 full BackTable Clean lumen club! This week, BackTable meets you at the carotid bifurcation to discuss all things carotid angioplasty and stenting. Interventional neuroradiologist and cerebrovascular surgeon Dr. Adnan Siddiqui, Vice Chairman of the University of Buffalo’s Department of Neurosurgery, joins host Dr. Sameh Sayfo to discuss the evolution and current state of carotid disease treatment. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Terumohttps://www.terumois.com/ --- Timestamps 00:00 - Introduction02:48 - From Aspirin to Endarterectomy03:47 - Rise of Carotid Stenting06:46 - CREST-2 and CMS Coverage09:57 - Management of Severe Asymptomatic Carotid Stenosis 15:35 - New Stent Designs Explained17:56 - Five Tips for New Operators20:08 - Case Selection Algorithm22:04 - Learning Curve and Mentorship28:27 - What’s Next: IVL and Outpatient31:24 - Managing Complications Safely35:05 - Closing and Credits --- More about this episode Dr. Siddiqui details the history of carotid stenosis treatment, charting its path and progression from medical therapy to endarterectomy and modern stenting approaches. He includes how recent trial data and updated CMS reimbursements have influenced practice and generated recent developments such as second generation stent technology. Dr. Siddiqui shares perspectives on patient selection, operator learning curve, complication preparedness, and the importance of structured training and proctoring as technology and techniques continue to improve. The physicians close by overviewing future directions for the carotid space such as IVL and how to approach management of procedural complications. --- Resources Dr. Adnan Siddiqui provider profilehttps://www.ubns.com/physicians/dr-adnan-h-siddiqui/ Carotid Endarterectomy for Asymptomatic Carotid Stenosis: Asymptomatic Carotid Surgery Trial (ACAS)https://www.ahajournals.org/doi/10.1161/01.str.0000141706.50170.a7 Asymptomatic Carotid Surgery Trial (ACST-2)https://www.acc.org/latest-in-cardiology/clinical-trials/2021/08/25/23/24/acst2 Protected Carotid-Artery Stenting versus Endarterectomy in High-Risk Patients (SAPPHIRE trial)https://www.nejm.org/doi/full/10.1056/NEJMoa040127 Medical Management and Revascularization for Asymptomatic Carotid Stenosis (CREST-2 trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2508800 The North American Symptomatic Carotid Endarterectomy Trial (NASCET trial)https://www.ahajournals.org/doi/10.1161/01.str.30.9.1751 Clean lumen club! This week, BackTable meets you at the carotid bifurcation to discuss all things carotid angioplasty and stenting. Interventional neuroradiologist and cerebrovascular surgeon Dr. Adnan Siddiqui, Vice Chairman of the University of Buffalo’s Department of Neurosurgery, joins host Dr. Sameh Sayfo to discuss the evolution and current state of carotid disease treatment.


---

Get the BackTable app

https://www.backtable.com/app

---

This podcast is supported by

Terumo
https://www.terumois.com/

---

Timestamps

00:00 - Introduction
02:48 - From Aspirin to Endarterectomy
03:47 - Rise of Carotid Stenting
06:46 - CREST-2 and CMS Coverage
09:57 - Management of Severe Asymptomatic Carotid Stenosis
15:35 - New Stent Designs Explained
17:56 - Five Tips for New Operators
20:08 - Case Selection Algorithm
22:04 - Learning Curve and Mentorship
28:27 - What’s Next: IVL and Outpatient
31:24 - Managing Complications Safely
35:05 - Closing and Credits

---

More about this episode

Dr. Siddiqui details the history of carotid stenosis treatment, charting its path and progression from medical therapy to endarterectomy and modern stenting approaches. He includes how recent trial data and updated CMS reimbursements have influenced practice and generated recent developments such as second generation stent technology. Dr. Siddiqui shares perspectives on patient selection, operator learning curve, complication preparedness, and the importance of structured training and proctoring as technology and techniques continue to improve. The physicians close by overviewing future directions for the carotid space such as IVL and how to approach management of procedural complications.

---

Resources

Dr. Adnan Siddiqui provider profile
https://www.ubns.com/physicians/dr-adnan-h-siddiqui/
Carotid Endarterectomy for Asymptomatic Carotid Stenosis: Asymptomatic


Carotid Surgery Trial (ACAS)
https://www.ahajournals.org/doi/10.1161/01.str.0000141706.50170.a7

Asymptomatic Carotid Surgery Trial (ACST-2)
https://www.acc.org/latest-in-cardiology/clinical-trials/2021/08/25/23/24/acst2

Protected Carotid-Artery Stenting versus Endarterectomy in High-Risk Patients (SAPPHIRE trial)
https://www.nejm.org/doi/full/10.1056/NEJMoa040127

Medical Management and Revascularization for Asymptomatic Carotid Stenosis (CREST-2 trial)
https://www.nejm.org/doi/full/10.1056/NEJMoa2508800

The North American Symptomatic Carotid Endarterectomy Trial (NASCET trial)
https://www.ahajournals.org/doi/10.1161/01.str.30.9.1751

]]> 2224 Ep. 630 Trauma Embolization Techniques Using Vascular Plugs with Dr. Nima Kokabi, Dr. Brian Funaki, and Dr. Alex Villalobos As interventional radiology cements its position as a primary clinical responder for acute arterial hemorrhage, what if you could achieve rapid and durable arterial occlusion with a single, highly deliverable device? In this episode of the BackTable Podcast, Dr. Alex Villalobos (UNC), Dr. Nima Kokabi (UNC), and Dr. Brian Funaki (UChicago) join host Dr. Kavi Krishnasamy to explore the shifting paradigms of arterial embolization in a case-based discussion highlighting modern vascular plug technologies.--- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Okami Medicalhttps://okamimedical.com/ --- Timestamps 00:00 - Introduction01:24 - Trauma Activation Workflow06:42 - Empiric Arterial Embolization Indications10:40 - Embolic Agent Preferences and Value Analysis17:18 - Embolics on the Shelf19:32 - LOBO Plug Use Cases20:58 - Case 1: Abdominal Wall Hematoma23:54 - LOBO Advantages, Cost, and Microcatheter Compatibility26:33 - Alternative Access Approaches30:31 - LOBO Sizing and Trackability35:26 - Pusher Wire Features38:20 - Delivery Catheter Requirements43:41 - Case 2: Retroperitoneal Bleed45:15 - LOBO Deployment Technique49:41 - Case 3: Splenic Trauma53:51 - Occlusion Time and Adjunct Embolics57:07 - Closing Remarks --- More about this episode The panel begins by discussing the range of embolic options and combinations at their disposal, sharing their preferences and treatment algorithms in various clinical scenarios. In particular, they emphasize the need for tools that provide immediate, predictable occlusion without the technical burden and cost of needing to deploy multiple embolic agents. The physicians go on to focus on Okami Medical’s LOBO vascular plug as a primary solution for rapid vessel occlusion, highlighting the micro-pore architecture and unique deliverability through microcatheters that make it advantageous for precise positioning and reliable embolization. Exploring its use in cases including rectus sheath hematomas, retroperitoneal bleeding, and splenic trauma, the physicians detail the technical nuances of sizing and positioning the LOBO as well as the long-term advantages of its artifact-free design. This episode ultimately underscores a growing preference for streamlined arterial embolization workflows that prioritize rapid stasis and clinical predictability while leveraging the strengths of a multimodal embolic toolkit. Fri, 03 Apr 2026 07:00:00 -0000 full BackTable As interventional radiology cements its position as a primary clinical responder for acute arterial hemorrhage, what if you could achieve rapid and durable arterial occlusion with a single, highly deliverable device? In this episode of the BackTable Podcast, Dr. Alex Villalobos (UNC), Dr. Nima Kokabi (UNC), and Dr. Brian Funaki (UChicago) join host Dr. Kavi Krishnasamy to explore the shifting paradigms of arterial embolization in a case-based discussion highlighting modern vascular plug technologies.--- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Okami Medicalhttps://okamimedical.com/ --- Timestamps 00:00 - Introduction01:24 - Trauma Activation Workflow06:42 - Empiric Arterial Embolization Indications10:40 - Embolic Agent Preferences and Value Analysis17:18 - Embolics on the Shelf19:32 - LOBO Plug Use Cases20:58 - Case 1: Abdominal Wall Hematoma23:54 - LOBO Advantages, Cost, and Microcatheter Compatibility26:33 - Alternative Access Approaches30:31 - LOBO Sizing and Trackability35:26 - Pusher Wire Features38:20 - Delivery Catheter Requirements43:41 - Case 2: Retroperitoneal Bleed45:15 - LOBO Deployment Technique49:41 - Case 3: Splenic Trauma53:51 - Occlusion Time and Adjunct Embolics57:07 - Closing Remarks --- More about this episode The panel begins by discussing the range of embolic options and combinations at their disposal, sharing their preferences and treatment algorithms in various clinical scenarios. In particular, they emphasize the need for tools that provide immediate, predictable occlusion without the technical burden and cost of needing to deploy multiple embolic agents. The physicians go on to focus on Okami Medical’s LOBO vascular plug as a primary solution for rapid vessel occlusion, highlighting the micro-pore architecture and unique deliverability through microcatheters that make it advantageous for precise positioning and reliable embolization. Exploring its use in cases including rectus sheath hematomas, retroperitoneal bleeding, and splenic trauma, the physicians detail the technical nuances of sizing and positioning the LOBO as well as the long-term advantages of its artifact-free design. This episode ultimately underscores a growing preference for streamlined arterial embolization workflows that prioritize rapid stasis and clinical predictability while leveraging the strengths of a multimodal embolic toolkit. As interventional radiology cements its position as a primary clinical responder for acute arterial hemorrhage, what if you could achieve rapid and durable arterial occlusion with a single, highly deliverable device? In this episode of the BackTable Podcast, Dr. Alex Villalobos (UNC), Dr. Nima Kokabi (UNC), and Dr. Brian Funaki (UChicago) join host Dr. Kavi Krishnasamy to explore the shifting paradigms of arterial embolization in a case-based discussion highlighting modern vascular plug technologies.
---


Get the BackTable app

https://www.backtable.com/app

---

This podcast is supported by

Okami Medical
https://okamimedical.com/


---

Timestamps

00:00 - Introduction
01:24 - Trauma Activation Workflow
06:42 - Empiric Arterial Embolization Indications
10:40 - Embolic Agent Preferences and Value Analysis
17:18 - Embolics on the Shelf
19:32 - LOBO Plug Use Cases
20:58 - Case 1: Abdominal Wall Hematoma
23:54 - LOBO Advantages, Cost, and Microcatheter Compatibility
26:33 - Alternative Access Approaches
30:31 - LOBO Sizing and Trackability
35:26 - Pusher Wire Features
38:20 - Delivery Catheter Requirements
43:41 - Case 2: Retroperitoneal Bleed
45:15 - LOBO Deployment Technique
49:41 - Case 3: Splenic Trauma
53:51 - Occlusion Time and Adjunct Embolics
57:07 - Closing Remarks

---

More about this episode

The panel begins by discussing the range of embolic options and combinations at their disposal, sharing their preferences and treatment algorithms in various clinical scenarios. In particular, they emphasize the need for tools that provide immediate, predictable occlusion without the technical burden and cost of needing to deploy multiple embolic agents. The physicians go on to focus on Okami Medical’s LOBO vascular plug as a primary solution for rapid vessel occlusion, highlighting the micro-pore architecture and unique deliverability through microcatheters that make it advantageous for precise positioning and reliable embolization. Exploring its use in cases including rectus sheath hematomas, retroperitoneal bleeding, and splenic trauma, the physicians detail the technical nuances of sizing and positioning the LOBO as well as the long-term advantages of its artifact-free design. This episode ultimately underscores a growing preference for streamlined arterial embolization workflows that prioritize rapid stasis and clinical predictability while leveraging the strengths of a multimodal embolic toolkit.

]]> 3542 Ep. 629 Optimizing Prostate Treatment with Embolization Strategies with Dr. Art Rastinehad and Dr. Don Garbett From consult to catheter, success in prostate artery embolization is shaped by a series of decisions that directly impact patient outcomes. In the third installment of our 2026 PAE University series, Dr. Chris Beck is joined again by Dr. Art Rastinehad and Dr. Don Garbett to discuss patient selection, procedural strategies, and practical case-based learnings in prostate artery embolization. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Guerbet. --- Timestamps 00:00 - Introduction03:33 - Typical Referrals and Patient Workup06:08 - Prostate Sizes and Bladder Necks12:33 - Radial Versus Femoral Access16:38 - Ipsilateral Crossing Techniques17:02 - Preferred Microcatheters20:32 - Troubleshooting Techniques with Microwires22:35 - Intra-arterial Medications and Checkpoints26:01 - Protecting Penile Collaterals29:47 - Evolution of PAE Technique32:20 - Liquid Embolics and Dilution Strategies37:48 - Bead Sizing Considerations39:59 - Managing Symptoms Post-PAE48:33 - Repeat PAE Procedures52:49 - Managing No-Flow After Injection57:06 - Case Studies --- More about this episode The discussion begins with consultation frameworks, focusing on imaging modalities and symptom scoring systems used to determine candidacy for PAE. Scenarios in which PAE may be less suitable, such as patients with high bladder neck anatomy, are also addressed alongside alternative management considerations. The conversation then transitions to procedural planning, including arterial access (radial versus femoral), workflow efficiencies to reduce operator fatigue, and preferred device selection such as microcatheters, microwires, and adjunctive vasodilators.Technical challenges encountered during PAE are explored in detail, including management of collateral vessels and avoidance of non-target embolization through techniques such as coil protection and flow modulation. The role of liquid embolics is also discussed, with emphasis on dilution strategies that vary based on operator technique. Post-procedural care is then reviewed, including assessment of symptom response, expectations for clinical outcomes, and criteria for repeat embolization in select patients. The episode concludes with three case studies highlighting procedural decision-making in complex scenarios, emphasizing recognition of anatomic variants and strategies to address intra-procedural challenges. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app Tue, 31 Mar 2026 07:00:00 -0000 full BackTable From consult to catheter, success in prostate artery embolization is shaped by a series of decisions that directly impact patient outcomes. In the third installment of our 2026 PAE University series, Dr. Chris Beck is joined again by Dr. Art Rastinehad and Dr. Don Garbett to discuss patient selection, procedural strategies, and practical case-based learnings in prostate artery embolization. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Guerbet. --- Timestamps 00:00 - Introduction03:33 - Typical Referrals and Patient Workup06:08 - Prostate Sizes and Bladder Necks12:33 - Radial Versus Femoral Access16:38 - Ipsilateral Crossing Techniques17:02 - Preferred Microcatheters20:32 - Troubleshooting Techniques with Microwires22:35 - Intra-arterial Medications and Checkpoints26:01 - Protecting Penile Collaterals29:47 - Evolution of PAE Technique32:20 - Liquid Embolics and Dilution Strategies37:48 - Bead Sizing Considerations39:59 - Managing Symptoms Post-PAE48:33 - Repeat PAE Procedures52:49 - Managing No-Flow After Injection57:06 - Case Studies --- More about this episode The discussion begins with consultation frameworks, focusing on imaging modalities and symptom scoring systems used to determine candidacy for PAE. Scenarios in which PAE may be less suitable, such as patients with high bladder neck anatomy, are also addressed alongside alternative management considerations. The conversation then transitions to procedural planning, including arterial access (radial versus femoral), workflow efficiencies to reduce operator fatigue, and preferred device selection such as microcatheters, microwires, and adjunctive vasodilators.Technical challenges encountered during PAE are explored in detail, including management of collateral vessels and avoidance of non-target embolization through techniques such as coil protection and flow modulation. The role of liquid embolics is also discussed, with emphasis on dilution strategies that vary based on operator technique. Post-procedural care is then reviewed, including assessment of symptom response, expectations for clinical outcomes, and criteria for repeat embolization in select patients. The episode concludes with three case studies highlighting procedural decision-making in complex scenarios, emphasizing recognition of anatomic variants and strategies to address intra-procedural challenges. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app From consult to catheter, success in prostate artery embolization is shaped by a series of decisions that directly impact patient outcomes. In the third installment of our 2026 PAE University series, Dr. Chris Beck is joined again by Dr. Art Rastinehad and Dr. Don Garbett to discuss patient selection, procedural strategies, and practical case-based learnings in prostate artery embolization.


---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by an educational grant from Guerbet.

---

Timestamps

00:00 - Introduction
03:33 - Typical Referrals and Patient Workup
06:08 - Prostate Sizes and Bladder Necks
12:33 - Radial Versus Femoral Access
16:38 - Ipsilateral Crossing Techniques
17:02 - Preferred Microcatheters
20:32 - Troubleshooting Techniques with Microwires
22:35 - Intra-arterial Medications and Checkpoints
26:01 - Protecting Penile Collaterals
29:47 - Evolution of PAE Technique
32:20 - Liquid Embolics and Dilution Strategies
37:48 - Bead Sizing Considerations
39:59 - Managing Symptoms Post-PAE
48:33 - Repeat PAE Procedures
52:49 - Managing No-Flow After Injection
57:06 - Case Studies

---

More about this episode

The discussion begins with consultation frameworks, focusing on imaging modalities and symptom scoring systems used to determine candidacy for PAE. Scenarios in which PAE may be less suitable, such as patients with high bladder neck anatomy, are also addressed alongside alternative management considerations. The conversation then transitions to procedural planning, including arterial access (radial versus femoral), workflow efficiencies to reduce operator fatigue, and preferred device selection such as microcatheters, microwires, and adjunctive vasodilators.
Technical challenges encountered during PAE are explored in detail, including management of collateral vessels and avoidance of non-target embolization through techniques such as coil protection and flow modulation. The role of liquid embolics is also discussed, with emphasis on dilution strategies that vary based on operator technique. Post-procedural care is then reviewed, including assessment of symptom response, expectations for clinical outcomes, and criteria for repeat embolization in select patients.

The episode concludes with three case studies highlighting procedural decision-making in complex scenarios, emphasizing recognition of anatomic variants and strategies to address intra-procedural challenges.

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

]]> 3931 Ep. 628 Techniques for Managing Biliary Drain Complications with Dr. Ahsun Riaz Patients and IRs alike dread the persistent cycles of malfunction and repeated procedures that often accompany biliary drains. What can you do to keep patients off the doorstep of reintervention? In this episode of the BackTable Podcast, Dr. Ahsun Riaz of Northwestern Medicine joins host Dr. Michael Barraza to walk through strategies for preventing and managing complications of percutaneous biliary drain placement. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:51 - Complication Rates and Associated Factors06:09 - PTC in Non-Dilated Biliary Systems11:00 - Techniques for Access and Drain Placement15:10 - Drain Flushing, Capping, and Ideal Positioning17:48 - External versus Internal-External Biliary Drains20:42 - Managing Pericatheter Leakage23:01 - Life Expectancy and Stenting Malignant Strictures26:32 - Tract Maturation and Minimizing Access Sites28:56 - Addressing Unresolving Hyperbilirubinemia34:52 - Managing Bloody Drain Output38:12 - Approach to Dislodged Drains39:40 - Drain-Associated Pain and Exchange Timing42:49 - Strategy for Benign Biliary Strictures45:18 - Final Thoughts and Closing Remarks --- More about this episode The discussion begins with a look at the data on biliary drain-related adverse events, emphasizing the need to bring down the high rates of complications that may take a toll on patients' quality of life. Dr. Riaz stresses the importance of employing techniques at initial drain placement, such as placing left-sided drains where appropriate and minimizing biliary pressure buildup, to reduce the starting risk of malfunction. The physicians go on to share their algorithms for approaching various scenarios, from pericatheter leakage and drain dislodgement to unresolving hyperbilirubinemia, pointing out the factors and observations that should influence treatment approaches during planning and intraprocedurally. Finally, the physicians address the evolving landscape of long-term biliary management, assessing potential drainage strategies as survival rates improve in hepatobiliary malignancies, and underscore the critical importance of collaboration with gastroenterologists and surgeons to ensure cohesive, goals-of-care-centered management. --- Resources Adverse Events After Percutaneous Transhepatic Biliary Drainage: A 10-Year Retrospective Analysishttps://doi.org/10.1016/j.jvir.2024.12.022 Fri, 27 Mar 2026 07:00:00 -0000 full BackTable Patients and IRs alike dread the persistent cycles of malfunction and repeated procedures that often accompany biliary drains. What can you do to keep patients off the doorstep of reintervention? In this episode of the BackTable Podcast, Dr. Ahsun Riaz of Northwestern Medicine joins host Dr. Michael Barraza to walk through strategies for preventing and managing complications of percutaneous biliary drain placement. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:51 - Complication Rates and Associated Factors06:09 - PTC in Non-Dilated Biliary Systems11:00 - Techniques for Access and Drain Placement15:10 - Drain Flushing, Capping, and Ideal Positioning17:48 - External versus Internal-External Biliary Drains20:42 - Managing Pericatheter Leakage23:01 - Life Expectancy and Stenting Malignant Strictures26:32 - Tract Maturation and Minimizing Access Sites28:56 - Addressing Unresolving Hyperbilirubinemia34:52 - Managing Bloody Drain Output38:12 - Approach to Dislodged Drains39:40 - Drain-Associated Pain and Exchange Timing42:49 - Strategy for Benign Biliary Strictures45:18 - Final Thoughts and Closing Remarks --- More about this episode The discussion begins with a look at the data on biliary drain-related adverse events, emphasizing the need to bring down the high rates of complications that may take a toll on patients' quality of life. Dr. Riaz stresses the importance of employing techniques at initial drain placement, such as placing left-sided drains where appropriate and minimizing biliary pressure buildup, to reduce the starting risk of malfunction. The physicians go on to share their algorithms for approaching various scenarios, from pericatheter leakage and drain dislodgement to unresolving hyperbilirubinemia, pointing out the factors and observations that should influence treatment approaches during planning and intraprocedurally. Finally, the physicians address the evolving landscape of long-term biliary management, assessing potential drainage strategies as survival rates improve in hepatobiliary malignancies, and underscore the critical importance of collaboration with gastroenterologists and surgeons to ensure cohesive, goals-of-care-centered management. --- Resources Adverse Events After Percutaneous Transhepatic Biliary Drainage: A 10-Year Retrospective Analysishttps://doi.org/10.1016/j.jvir.2024.12.022 Patients and IRs alike dread the persistent cycles of malfunction and repeated procedures that often accompany biliary drains. What can you do to keep patients off the doorstep of reintervention? In this episode of the BackTable Podcast, Dr. Ahsun Riaz of Northwestern Medicine joins host Dr. Michael Barraza to walk through strategies for preventing and managing complications of percutaneous biliary drain placement.


---


Get the BackTable app


https://www.backtable.com/app


---


Timestamps


00:00 - Introduction
01:51 - Complication Rates and Associated Factors
06:09 - PTC in Non-Dilated Biliary Systems
11:00 - Techniques for Access and Drain Placement
15:10 - Drain Flushing, Capping, and Ideal Positioning
17:48 - External versus Internal-External Biliary Drains
20:42 - Managing Pericatheter Leakage
23:01 - Life Expectancy and Stenting Malignant Strictures
26:32 - Tract Maturation and Minimizing Access Sites
28:56 - Addressing Unresolving Hyperbilirubinemia
34:52 - Managing Bloody Drain Output
38:12 - Approach to Dislodged Drains
39:40 - Drain-Associated Pain and Exchange Timing
42:49 - Strategy for Benign Biliary Strictures
45:18 - Final Thoughts and Closing Remarks


---


More about this episode


The discussion begins with a look at the data on biliary drain-related adverse events, emphasizing the need to bring down the high rates of complications that may take a toll on patients' quality of life. Dr. Riaz stresses the importance of employing techniques at initial drain placement, such as placing left-sided drains where appropriate and minimizing biliary pressure buildup, to reduce the starting risk of malfunction. The physicians go on to share their algorithms for approaching various scenarios, from pericatheter leakage and drain dislodgement to unresolving hyperbilirubinemia, pointing out the factors and observations that should influence treatment approaches during planning and intraprocedurally. Finally, the physicians address the evolving landscape of long-term biliary management, assessing potential drainage strategies as survival rates improve in hepatobiliary malignancies, and underscore the critical importance of collaboration with gastroenterologists and surgeons to ensure cohesive, goals-of-care-centered management.


---


Resources


Adverse Events After Percutaneous Transhepatic Biliary Drainage: A 10-Year Retrospective Analysis
https://doi.org/10.1016/j.jvir.2024.12.022

]]> 2850 Ep. 627 Radial Access for Peripheral Interventions: Techniques & Considerations with Dr. Shailendra Singh Radial roots, peripheral reach! Radial to peripheral (R2P) access is the focus of this week’s episode with interventional cardiologist Dr. Shailendra Singh (Pennsylvania’s Lehigh Valley Heart and Vascular Institute) and dual hosts Hady Lichaa and Sameh Sayfo. The conversation focuses on key techniques, pre-procedure planning and imaging, and ideal case selection for those new to the R2P approach. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Terumo https://www.terumois.com/ --- Timestamps 00:00 - Introduction04:42 - Radial-to-Peripheral: Right vs Left Radial10:18 - Ultrasound and Pedal Access Applications17:10 - Ideal Cases When Starting Radial to Peripheral25:59 - Impactful Radial Success Stories29:38 - Managing Radial Spasm 35:22 - Left Radial Workflow42:00 - Shelf Setup Essentials48:43 - Renal Mesenteric Access55:37 - Safe Sheath Removal01:01:10 - Training and Courses01:04:48 - Closing Thoughts --- More about this episode Dr. Singh shares how he began incorporating radial-to-peripheral procedures into his practice after fellowship and how his experience with radial coronary access translated naturally to peripheral interventions. The group reviews access strategy, including right versus left radial selection, along with techniques for preventing and managing radial spasm. They also touch on staff workflow and training when introducing R2P into the lab. The episode closes with practical insights on case selection for operators new to the approach, the role of pedal access in selected CTO cases, and strategies for safe sheath removal and hemostasis. --- Resources Dr. Shailendra Singh’s Provider Profile https://www.lvhn.org/doctors/shailendra-singh Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Tue, 24 Mar 2026 07:00:00 -0000 full BackTable Radial roots, peripheral reach! Radial to peripheral (R2P) access is the focus of this week’s episode with interventional cardiologist Dr. Shailendra Singh (Pennsylvania’s Lehigh Valley Heart and Vascular Institute) and dual hosts Hady Lichaa and Sameh Sayfo. The conversation focuses on key techniques, pre-procedure planning and imaging, and ideal case selection for those new to the R2P approach. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Terumo https://www.terumois.com/ --- Timestamps 00:00 - Introduction04:42 - Radial-to-Peripheral: Right vs Left Radial10:18 - Ultrasound and Pedal Access Applications17:10 - Ideal Cases When Starting Radial to Peripheral25:59 - Impactful Radial Success Stories29:38 - Managing Radial Spasm 35:22 - Left Radial Workflow42:00 - Shelf Setup Essentials48:43 - Renal Mesenteric Access55:37 - Safe Sheath Removal01:01:10 - Training and Courses01:04:48 - Closing Thoughts --- More about this episode Dr. Singh shares how he began incorporating radial-to-peripheral procedures into his practice after fellowship and how his experience with radial coronary access translated naturally to peripheral interventions. The group reviews access strategy, including right versus left radial selection, along with techniques for preventing and managing radial spasm. They also touch on staff workflow and training when introducing R2P into the lab. The episode closes with practical insights on case selection for operators new to the approach, the role of pedal access in selected CTO cases, and strategies for safe sheath removal and hemostasis. --- Resources Dr. Shailendra Singh’s Provider Profile https://www.lvhn.org/doctors/shailendra-singh Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Radial roots, peripheral reach! Radial to peripheral (R2P) access is the focus of this week’s episode with interventional cardiologist Dr. Shailendra Singh (Pennsylvania’s Lehigh Valley Heart and Vascular Institute) and dual hosts Hady Lichaa and Sameh Sayfo. The conversation focuses on key techniques, pre-procedure planning and imaging, and ideal case selection for those new to the R2P approach.


---


Get the BackTable app
https://www.backtable.com/app


---


This podcast is supported by


Terumo


https://www.terumois.com/


---


Timestamps


00:00 - Introduction
04:42 - Radial-to-Peripheral: Right vs Left Radial
10:18 - Ultrasound and Pedal Access Applications
17:10 - Ideal Cases When Starting Radial to Peripheral
25:59 - Impactful Radial Success Stories
29:38 - Managing Radial Spasm
35:22 - Left Radial Workflow
42:00 - Shelf Setup Essentials
48:43 - Renal Mesenteric Access
55:37 - Safe Sheath Removal
01:01:10 - Training and Courses
01:04:48 - Closing Thoughts


---


More about this episode


Dr. Singh shares how he began incorporating radial-to-peripheral procedures into his practice after fellowship and how his experience with radial coronary access translated naturally to peripheral interventions. The group reviews access strategy, including right versus left radial selection, along with techniques for preventing and managing radial spasm. They also touch on staff workflow and training when introducing R2P into the lab. The episode closes with practical insights on case selection for operators new to the approach, the role of pedal access in selected CTO cases, and strategies for safe sheath removal and hemostasis.


---


Resources


Dr. Shailendra Singh’s Provider Profile
https://www.lvhn.org/doctors/shailendra-singh


Dr. Sameh Sayfo’s Provider Profile
https://www.bswhealth.com/physician/sameh-sayf


Dr. Hady Lichaa’s Provider Profile
https://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa

]]> 4074 Ep. 626 Single Stick Vascular Access: Techniques & Benefits Explained with Dr. Kevin Wong With the single-stick technique proving to be an effective addition to the venous line placement toolkit, what is stopping IRs from venturing beyond the traditional dual-incision approach? In this episode of the BackTable Podcast, pediatric interventional radiologist Dr. Kevin Wong of USA Health joins host Dr. Ally Baheti to review the single-stick technique for central venous access, a method widely utilized in pediatric practice. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:35 - Origins of Single-Stick Access03:10 - Setup and Bending the Needle07:17 - Tunneling to the IJ10:06 - Line Positioning and Measurement14:45 - Wire Handling Considerations18:55 - Clinical Advantages of Single-Stick Access21:27 - Femoral Single-Stick Tips23:41 - Common Mistakes and Pitfalls27:39 - Needle-Free Lidocaine Administration30:48 - Closing Remarks --- More about this episode Delving into the origins, technical nuances, and clinical advantages, the physicians explore how the single-stick technique can reduce the risk of infection and minimize interference with other lines and tubing to improve patient care. The discussion provides a detailed technical breakdown of the procedure, offering a masterclass on navigating the curves up the neck as well as the equipment selection and sizing necessary to facilitate the process. With the aid of visual slides and demonstrations, Dr. Wong steps us through the specifics of bending the access needle, maneuvering tools to adapt to anatomical configurations, and handling ultrasound movement to confirm and maintain a safe trajectory throughout the procedure. The conversation emphasizes the tactile “feel” and attention to forces acting on the wire that are required to appropriately position the catheter.Recognizing the logistical constraints that make it challenging for attendings to regularly adopt alternative procedural techniques, this episode serves as an accessible primer for clinicians looking to broaden their options for venous access with this effective, patient-centric technique. Fri, 20 Mar 2026 07:00:00 -0000 full BackTable With the single-stick technique proving to be an effective addition to the venous line placement toolkit, what is stopping IRs from venturing beyond the traditional dual-incision approach? In this episode of the BackTable Podcast, pediatric interventional radiologist Dr. Kevin Wong of USA Health joins host Dr. Ally Baheti to review the single-stick technique for central venous access, a method widely utilized in pediatric practice. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:35 - Origins of Single-Stick Access03:10 - Setup and Bending the Needle07:17 - Tunneling to the IJ10:06 - Line Positioning and Measurement14:45 - Wire Handling Considerations18:55 - Clinical Advantages of Single-Stick Access21:27 - Femoral Single-Stick Tips23:41 - Common Mistakes and Pitfalls27:39 - Needle-Free Lidocaine Administration30:48 - Closing Remarks --- More about this episode Delving into the origins, technical nuances, and clinical advantages, the physicians explore how the single-stick technique can reduce the risk of infection and minimize interference with other lines and tubing to improve patient care. The discussion provides a detailed technical breakdown of the procedure, offering a masterclass on navigating the curves up the neck as well as the equipment selection and sizing necessary to facilitate the process. With the aid of visual slides and demonstrations, Dr. Wong steps us through the specifics of bending the access needle, maneuvering tools to adapt to anatomical configurations, and handling ultrasound movement to confirm and maintain a safe trajectory throughout the procedure. The conversation emphasizes the tactile “feel” and attention to forces acting on the wire that are required to appropriately position the catheter.Recognizing the logistical constraints that make it challenging for attendings to regularly adopt alternative procedural techniques, this episode serves as an accessible primer for clinicians looking to broaden their options for venous access with this effective, patient-centric technique. With the single-stick technique proving to be an effective addition to the venous line placement toolkit, what is stopping IRs from venturing beyond the traditional dual-incision approach? In this episode of the BackTable Podcast, pediatric interventional radiologist Dr. Kevin Wong of USA Health joins host Dr. Ally Baheti to review the single-stick technique for central venous access, a method widely utilized in pediatric practice.


---


Get the BackTable app


https://www.backtable.com/app


---


Timestamps


00:00 - Introduction
01:35 - Origins of Single-Stick Access
03:10 - Setup and Bending the Needle
07:17 - Tunneling to the IJ
10:06 - Line Positioning and Measurement
14:45 - Wire Handling Considerations
18:55 - Clinical Advantages of Single-Stick Access
21:27 - Femoral Single-Stick Tips
23:41 - Common Mistakes and Pitfalls
27:39 - Needle-Free Lidocaine Administration
30:48 - Closing Remarks


---


More about this episode


Delving into the origins, technical nuances, and clinical advantages, the physicians explore how the single-stick technique can reduce the risk of infection and minimize interference with other lines and tubing to improve patient care. The discussion provides a detailed technical breakdown of the procedure, offering a masterclass on navigating the curves up the neck as well as the equipment selection and sizing necessary to facilitate the process. With the aid of visual slides and demonstrations, Dr. Wong steps us through the specifics of bending the access needle, maneuvering tools to adapt to anatomical configurations, and handling ultrasound movement to confirm and maintain a safe trajectory throughout the procedure. The conversation emphasizes the tactile “feel” and attention to forces acting on the wire that are required to appropriately position the catheter.
Recognizing the logistical constraints that make it challenging for attendings to regularly adopt alternative procedural techniques, this episode serves as an accessible primer for clinicians looking to broaden their options for venous access with this effective, patient-centric technique.

]]> 1984 Ep. 625 Managing Acute Arterial Thrombosis: Devices & Approaches with Dr. Shang Loh and Dr. Khanjan Nagarsheth The advent of newer thrombectomy devices has turned what were once hours-long surgical cutdowns into endovascular cases that last under an hour. In this episode of BackTable, host Dr. Sabeen Dhand is joined by Dr. Shang Loh from the University of Pennsylvania and Dr. Khanjan Nagarsheth from the University of Maryland to discuss the evolution of arterial thrombectomy devices and modern techniques for acute arterial occlusions. --- This podcast is supported by: Inari Medicalhttps://www.inarimedical.com/artix-system --- SYNPOSIS The episode highlights major technological advancements over the past decade, including the development of mechanical and computer-assisted thrombectomy systems. The physicians review key features of newer devices, such as the ability to combine aspiration with stent retrievers, the use of PTFE baskets to reduce distal embolization, and the advantage of maintaining wire access throughout the case. They share strategies for managing specific cases, including acute femoral-popliteal occlusions with distal reconstitution, intraoperative ischemic pain due to flow arrest, trauma-related thrombosis, and cases complicated by extensive calcification and chronic vascular disease. As vascular surgeons, they also discuss the ongoing role of open approaches, outlining when surgical cutdown is indicated and where they prefer endovascular first. The conversation further explores challenges such as acute limb ischemia, stent thrombosis, and visceral artery thrombosis, emphasizing the importance of staying current with rapidly evolving technologies to improve procedural efficiency and patient outcomes. --- TIMESTAMPS 00:00 - Introduction02:04 - Evolution of Arterial Thrombosis Treatment04:11 - New Devices and Techniques10:42 - Case Studies and Practical Applications24:26 - Techniques and Devices for Thrombectomy25:33 - Managing Flow and Patient Safety27:25 - Surgical vs. Endovascular Approaches29:25 - Dealing with Complications and Failures37:50 - Visceral Thrombosis and Advanced Techniques41:09 - Future of Thrombectomy Devices44:27 - Closing Remarks Tue, 17 Mar 2026 07:00:00 -0000 full BackTable The advent of newer thrombectomy devices has turned what were once hours-long surgical cutdowns into endovascular cases that last under an hour. In this episode of BackTable, host Dr. Sabeen Dhand is joined by Dr. Shang Loh from the University of Pennsylvania and Dr. Khanjan Nagarsheth from the University of Maryland to discuss the evolution of arterial thrombectomy devices and modern techniques for acute arterial occlusions. --- This podcast is supported by: Inari Medicalhttps://www.inarimedical.com/artix-system --- SYNPOSIS The episode highlights major technological advancements over the past decade, including the development of mechanical and computer-assisted thrombectomy systems. The physicians review key features of newer devices, such as the ability to combine aspiration with stent retrievers, the use of PTFE baskets to reduce distal embolization, and the advantage of maintaining wire access throughout the case. They share strategies for managing specific cases, including acute femoral-popliteal occlusions with distal reconstitution, intraoperative ischemic pain due to flow arrest, trauma-related thrombosis, and cases complicated by extensive calcification and chronic vascular disease. As vascular surgeons, they also discuss the ongoing role of open approaches, outlining when surgical cutdown is indicated and where they prefer endovascular first. The conversation further explores challenges such as acute limb ischemia, stent thrombosis, and visceral artery thrombosis, emphasizing the importance of staying current with rapidly evolving technologies to improve procedural efficiency and patient outcomes. --- TIMESTAMPS 00:00 - Introduction02:04 - Evolution of Arterial Thrombosis Treatment04:11 - New Devices and Techniques10:42 - Case Studies and Practical Applications24:26 - Techniques and Devices for Thrombectomy25:33 - Managing Flow and Patient Safety27:25 - Surgical vs. Endovascular Approaches29:25 - Dealing with Complications and Failures37:50 - Visceral Thrombosis and Advanced Techniques41:09 - Future of Thrombectomy Devices44:27 - Closing Remarks The advent of newer thrombectomy devices has turned what were once hours-long surgical cutdowns into endovascular cases that last under an hour. In this episode of BackTable, host Dr. Sabeen Dhand is joined by Dr. Shang Loh from the University of Pennsylvania and Dr. Khanjan Nagarsheth from the University of Maryland to discuss the evolution of arterial thrombectomy devices and modern techniques for acute arterial occlusions.

---

This podcast is supported by:

Inari Medical
https://www.inarimedical.com/artix-system

---

SYNPOSIS

The episode highlights major technological advancements over the past decade, including the development of mechanical and computer-assisted thrombectomy systems. The physicians review key features of newer devices, such as the ability to combine aspiration with stent retrievers, the use of PTFE baskets to reduce distal embolization, and the advantage of maintaining wire access throughout the case.

They share strategies for managing specific cases, including acute femoral-popliteal occlusions with distal reconstitution, intraoperative ischemic pain due to flow arrest, trauma-related thrombosis, and cases complicated by extensive calcification and chronic vascular disease. As vascular surgeons, they also discuss the ongoing role of open approaches, outlining when surgical cutdown is indicated and where they prefer endovascular first. The conversation further explores challenges such as acute limb ischemia, stent thrombosis, and visceral artery thrombosis, emphasizing the importance of staying current with rapidly evolving technologies to improve procedural efficiency and patient outcomes.


---

TIMESTAMPS

00:00 - Introduction
02:04 - Evolution of Arterial Thrombosis Treatment
04:11 - New Devices and Techniques
10:42 - Case Studies and Practical Applications
24:26 - Techniques and Devices for Thrombectomy
25:33 - Managing Flow and Patient Safety
27:25 - Surgical vs. Endovascular Approaches
29:25 - Dealing with Complications and Failures
37:50 - Visceral Thrombosis and Advanced Techniques
41:09 - Future of Thrombectomy Devices
44:27 - Closing Remarks

]]> 2705 Ep. 624 Integrating Spinal Cord Stimulation in Vascular Disease Management for CLTI with Dr. Mary Costantino and Jill Sommerset Chronic limb-threatening ischemia (CLTI) represents the most advanced stage of peripheral artery disease. While many patients can be treated with endovascular or surgical revascularization, a subset of individuals remain ‘no-option’ candidates when conventional therapies fail or distal targets are absent. In this episode of BackTable, host Dr. Ally Baheti speaks with Dr. Mary Costantino, interventional radiologist at Advanced Vascular Centers, and Jill Sommerset, vascular technologist and Director of Clinical Education and Training at Aveera Medical, about the emerging role of spinal cord stimulation (SCS) as a potential therapy for patients with no-option CLTI. --- SYNPOSIS This episode explores where spinal cord stimulation may fit within the treatment landscape for advanced CLTI, particularly for patients who are not candidates for revascularization or deep venous arterialization (DVA). Dr. Costantino describes how interest in the therapy developed through multidisciplinary collaboration and early physiologic observations using pedal acceleration time (PAT) measured with duplex ultrasound alongside angiography. A representative case highlights immediate, setting-dependent improvements in PAT following stimulation, and the group reviews early trends from a small patient cohort suggesting improved distal perfusion in individuals with severe infrapopliteal disease. The conversation also addresses practical barriers to adoption, including site-of-service and reimbursement challenges and the difficulty of implanting permanent stimulators in patients with active wounds. Jill Sommerset adds perspective from the vascular lab, discussing ultrasound-based methods to quantify physiologic changes after DVA and how similar perfusion metrics may help evaluate spinal cord stimulation. The episode concludes with a discussion of the potential role of neuromodulation in this population and the need for larger datasets to better define its clinical impact. --- TIMESTAMPS00:00 - Introduction02:02 - Why CLTI Needs Options06:25 - First No Option Case11:06 - Trial Turns Flow On14:38 - Timing and Reimbursement19:59 - Early Results and Adoption22:45 - How Spinal Cord Stimulation Might Improve Flow26:46 - Patient Selection and Access30:24 - Treatment Algorithm and Timing32:37 - Quality of Life and Mobility37:57 - Implant Delays and Coordination39:41 - Data --- RESOURCES Paper on Maturation after DVAhttps://www.sciencedirect.com/science/article/pii/S1078588426000523 Fri, 13 Mar 2026 07:00:00 -0000 full BackTable Chronic limb-threatening ischemia (CLTI) represents the most advanced stage of peripheral artery disease. While many patients can be treated with endovascular or surgical revascularization, a subset of individuals remain ‘no-option’ candidates when conventional therapies fail or distal targets are absent. In this episode of BackTable, host Dr. Ally Baheti speaks with Dr. Mary Costantino, interventional radiologist at Advanced Vascular Centers, and Jill Sommerset, vascular technologist and Director of Clinical Education and Training at Aveera Medical, about the emerging role of spinal cord stimulation (SCS) as a potential therapy for patients with no-option CLTI. --- SYNPOSIS This episode explores where spinal cord stimulation may fit within the treatment landscape for advanced CLTI, particularly for patients who are not candidates for revascularization or deep venous arterialization (DVA). Dr. Costantino describes how interest in the therapy developed through multidisciplinary collaboration and early physiologic observations using pedal acceleration time (PAT) measured with duplex ultrasound alongside angiography. A representative case highlights immediate, setting-dependent improvements in PAT following stimulation, and the group reviews early trends from a small patient cohort suggesting improved distal perfusion in individuals with severe infrapopliteal disease. The conversation also addresses practical barriers to adoption, including site-of-service and reimbursement challenges and the difficulty of implanting permanent stimulators in patients with active wounds. Jill Sommerset adds perspective from the vascular lab, discussing ultrasound-based methods to quantify physiologic changes after DVA and how similar perfusion metrics may help evaluate spinal cord stimulation. The episode concludes with a discussion of the potential role of neuromodulation in this population and the need for larger datasets to better define its clinical impact. --- TIMESTAMPS00:00 - Introduction02:02 - Why CLTI Needs Options06:25 - First No Option Case11:06 - Trial Turns Flow On14:38 - Timing and Reimbursement19:59 - Early Results and Adoption22:45 - How Spinal Cord Stimulation Might Improve Flow26:46 - Patient Selection and Access30:24 - Treatment Algorithm and Timing32:37 - Quality of Life and Mobility37:57 - Implant Delays and Coordination39:41 - Data --- RESOURCES Paper on Maturation after DVAhttps://www.sciencedirect.com/science/article/pii/S1078588426000523 Chronic limb-threatening ischemia (CLTI) represents the most advanced stage of peripheral artery disease. While many patients can be treated with endovascular or surgical revascularization, a subset of individuals remain ‘no-option’ candidates when conventional therapies fail or distal targets are absent. In this episode of BackTable, host Dr. Ally Baheti speaks with Dr. Mary Costantino, interventional radiologist at Advanced Vascular Centers, and Jill Sommerset, vascular technologist and Director of Clinical Education and Training at Aveera Medical, about the emerging role of spinal cord stimulation (SCS) as a potential therapy for patients with no-option CLTI.


---


SYNPOSIS


This episode explores where spinal cord stimulation may fit within the treatment landscape for advanced CLTI, particularly for patients who are not candidates for revascularization or deep venous arterialization (DVA). Dr. Costantino describes how interest in the therapy developed through multidisciplinary collaboration and early physiologic observations using pedal acceleration time (PAT) measured with duplex ultrasound alongside angiography. A representative case highlights immediate, setting-dependent improvements in PAT following stimulation, and the group reviews early trends from a small patient cohort suggesting improved distal perfusion in individuals with severe infrapopliteal disease. The conversation also addresses practical barriers to adoption, including site-of-service and reimbursement challenges and the difficulty of implanting permanent stimulators in patients with active wounds. Jill Sommerset adds perspective from the vascular lab, discussing ultrasound-based methods to quantify physiologic changes after DVA and how similar perfusion metrics may help evaluate spinal cord stimulation. The episode concludes with a discussion of the potential role of neuromodulation in this population and the need for larger datasets to better define its clinical impact.


---


TIMESTAMPS
00:00 - Introduction
02:02 - Why CLTI Needs Options
06:25 - First No Option Case
11:06 - Trial Turns Flow On
14:38 - Timing and Reimbursement
19:59 - Early Results and Adoption
22:45 - How Spinal Cord Stimulation Might Improve Flow
26:46 - Patient Selection and Access
30:24 - Treatment Algorithm and Timing
32:37 - Quality of Life and Mobility
37:57 - Implant Delays and Coordination
39:41 - Data


---


RESOURCES


Paper on Maturation after DVA
https://www.sciencedirect.com/science/article/pii/S1078588426000523

]]> 2513 Ep. 623 CLTI: Lithotripsy and Endovascular Techniques for Below the Knee Interventions with Dr. Paul Foley Below-the-knee (BTK) arterial disease remains one of the more challenging areas in vascular care, particularly in patients with chronic limb-threatening ischemia (CLTI), where heavy calcification complicates endovascular treatment. As new calcium-modifying technologies emerge, an important question remains: what evidence supports their use in BTK interventions? In this episode of BackTable Vascular & Interventional, host Dr. Sabeen Dhand speaks with vascular surgeon Dr. Paul Foley of Doylestown Health about the Disrupt BTK II clinical trial from Shockwave Medical, which evaluates the performance of peripheral intravascular lithotripsy (IVL) in heavily calcified BTK disease. --- This podcast is supported by: Shockwave Medicalhttps://shockwavemedical.com/ --- SYNPOSIS Dr. Foley begins by outlining his training and the evolution of his vascular surgery practice, setting the stage for a broader discussion on how BTK interventions have changed over the past decade. The conversation explores shifts in access strategies, procedural approaches, and the unique characteristics of calcification encountered in CLTI. Because BTK calcium differs from calcification seen elsewhere in the peripheral vasculature, imaging and device selection play a particularly important role when planning IVL-based therapies. Dr. Foley reviews the design and outcomes of the Disrupt BTK II trial, where devices such as the Shockwave M5+ and S4 catheters were used to modify calcified plaque, demonstrating encouraging safety and performance signals. The discussion then turns to emerging technologies, including Shockwave’s Javelin catheter, designed to deliver focused pressure waves to fracture dense calcium within peripheral arteries. Dr. Foley describes how the device fits into BTK workflows, including technique considerations and its use alongside adjunctive therapies such as balloon angioplasty. The episode also addresses the ongoing skepticism surrounding IVL in BTK disease, emphasizing the need for careful patient selection, procedural precision, and continued multidisciplinary collaboration as the field works to refine treatment strategies and improve outcomes for patients with peripheral artery disease (PAD). --- TIMESTAMPS 00:00 - Introduction08:20 - Evolution of Below-the-Knee Treatments11:10 - Differences in BTK Calcification13:13 - Imaging and Technology in BTK Interventions15:18 - Disrupt BTK II Trial Data and Results23:17 - Introduction to the Javelin Device26:39 - Technique Considerations with Javelin28:36 - Comparing Javelin and E831:17 - Future Directions for Lithotripsy Technology35:30 - Skepticism Around IVL in BTK Disease38:47 - Final Thoughts --- RESOURCES Disrupt BTK II Trialhttps://www.jvascsurg.org/article/S0741-5214(24)02063-9/fulltext Tue, 10 Mar 2026 07:00:00 -0000 full BackTable Below-the-knee (BTK) arterial disease remains one of the more challenging areas in vascular care, particularly in patients with chronic limb-threatening ischemia (CLTI), where heavy calcification complicates endovascular treatment. As new calcium-modifying technologies emerge, an important question remains: what evidence supports their use in BTK interventions? In this episode of BackTable Vascular & Interventional, host Dr. Sabeen Dhand speaks with vascular surgeon Dr. Paul Foley of Doylestown Health about the Disrupt BTK II clinical trial from Shockwave Medical, which evaluates the performance of peripheral intravascular lithotripsy (IVL) in heavily calcified BTK disease. --- This podcast is supported by: Shockwave Medicalhttps://shockwavemedical.com/ --- SYNPOSIS Dr. Foley begins by outlining his training and the evolution of his vascular surgery practice, setting the stage for a broader discussion on how BTK interventions have changed over the past decade. The conversation explores shifts in access strategies, procedural approaches, and the unique characteristics of calcification encountered in CLTI. Because BTK calcium differs from calcification seen elsewhere in the peripheral vasculature, imaging and device selection play a particularly important role when planning IVL-based therapies. Dr. Foley reviews the design and outcomes of the Disrupt BTK II trial, where devices such as the Shockwave M5+ and S4 catheters were used to modify calcified plaque, demonstrating encouraging safety and performance signals. The discussion then turns to emerging technologies, including Shockwave’s Javelin catheter, designed to deliver focused pressure waves to fracture dense calcium within peripheral arteries. Dr. Foley describes how the device fits into BTK workflows, including technique considerations and its use alongside adjunctive therapies such as balloon angioplasty. The episode also addresses the ongoing skepticism surrounding IVL in BTK disease, emphasizing the need for careful patient selection, procedural precision, and continued multidisciplinary collaboration as the field works to refine treatment strategies and improve outcomes for patients with peripheral artery disease (PAD). --- TIMESTAMPS 00:00 - Introduction08:20 - Evolution of Below-the-Knee Treatments11:10 - Differences in BTK Calcification13:13 - Imaging and Technology in BTK Interventions15:18 - Disrupt BTK II Trial Data and Results23:17 - Introduction to the Javelin Device26:39 - Technique Considerations with Javelin28:36 - Comparing Javelin and E831:17 - Future Directions for Lithotripsy Technology35:30 - Skepticism Around IVL in BTK Disease38:47 - Final Thoughts --- RESOURCES Disrupt BTK II Trialhttps://www.jvascsurg.org/article/S0741-5214(24)02063-9/fulltext Below-the-knee (BTK) arterial disease remains one of the more challenging areas in vascular care, particularly in patients with chronic limb-threatening ischemia (CLTI), where heavy calcification complicates endovascular treatment. As new calcium-modifying technologies emerge, an important question remains: what evidence supports their use in BTK interventions? In this episode of BackTable Vascular & Interventional, host Dr. Sabeen Dhand speaks with vascular surgeon Dr. Paul Foley of Doylestown Health about the Disrupt BTK II clinical trial from Shockwave Medical, which evaluates the performance of peripheral intravascular lithotripsy (IVL) in heavily calcified BTK disease.


---


This podcast is supported by:


Shockwave Medical
https://shockwavemedical.com/


---


SYNPOSIS


Dr. Foley begins by outlining his training and the evolution of his vascular surgery practice, setting the stage for a broader discussion on how BTK interventions have changed over the past decade. The conversation explores shifts in access strategies, procedural approaches, and the unique characteristics of calcification encountered in CLTI. Because BTK calcium differs from calcification seen elsewhere in the peripheral vasculature, imaging and device selection play a particularly important role when planning IVL-based therapies. Dr. Foley reviews the design and outcomes of the Disrupt BTK II trial, where devices such as the Shockwave M5+ and S4 catheters were used to modify calcified plaque, demonstrating encouraging safety and performance signals.


The discussion then turns to emerging technologies, including Shockwave’s Javelin catheter, designed to deliver focused pressure waves to fracture dense calcium within peripheral arteries. Dr. Foley describes how the device fits into BTK workflows, including technique considerations and its use alongside adjunctive therapies such as balloon angioplasty. The episode also addresses the ongoing skepticism surrounding IVL in BTK disease, emphasizing the need for careful patient selection, procedural precision, and continued multidisciplinary collaboration as the field works to refine treatment strategies and improve outcomes for patients with peripheral artery disease (PAD).


---


TIMESTAMPS


00:00 - Introduction
08:20 - Evolution of Below-the-Knee Treatments
11:10 - Differences in BTK Calcification
13:13 - Imaging and Technology in BTK Interventions
15:18 - Disrupt BTK II Trial Data and Results
23:17 - Introduction to the Javelin Device
26:39 - Technique Considerations with Javelin
28:36 - Comparing Javelin and E8
31:17 - Future Directions for Lithotripsy Technology
35:30 - Skepticism Around IVL in BTK Disease
38:47 - Final Thoughts


---


RESOURCES


Disrupt BTK II Trial
https://www.jvascsurg.org/article/S0741-5214(24)02063-9/fulltext

]]> 2624 Ep. 622 Intratumoral Immunotherapy Injections for Melanoma with Dr. Jennifer McQuade and Dr. Rahul Sheth When standard-of-care checkpoint blockade fails in metastatic melanoma, how can oncologists and interventional radiologists join forces to turn around patient outcomes? In this episode of the BackTable Podcast, medical oncologist Dr. Jennifer McQuade and interventional radiologist Dr. Rahul Sheth join host Dr. Tyler Sandow to discuss the growing evidence for intratumoral oncolytics as a therapeutic strategy for frontline immunotherapy-refractory melanoma and the interdisciplinary work that is required for successful implementation in practice. --- SYNPOSIS The physicians review how engineered viral vectors, particularly RP1, complement checkpoint blockade through direct tumor lysis and immune activation, and summarize the IGNYTE trial data supporting their use in patients with metastatic melanoma refractory to anti-PD-1 and anti-CTLA-4 agents. The discussion then shifts to practical administration, highlighting the central role of interventional radiology in delivering these therapies to visceral and deep-seated lesions under image guidance. The doctors go on to address the nuances of patient and lesion selection, injection technique, and response assessment, including the importance of recognizing pseudo-progression. They place particular emphasis on the need for multidisciplinary collaboration and stakeholder buy-in efforts on the part of IRs seeking to integrate intratumoral oncolytic injections into their scope of practice. The episode concludes with a forward-looking discussion on the potential for expansion of oncolytic platforms into other solid tumors, underscoring this field as a growing, IR-forward frontier in cancer treatment. --- TIMESTAMPS 00:00 - Introduction02:28 - Immunotherapy Basics06:51 - How Oncolytic Viruses Work11:01 - IGNYTE Trials and Why IR Matters18:14 - T-VEC vs RP1 Indications and Logistics21:57 - Physician Communication and Multidisciplinary Treatment23:06 - RP1 Protocol and Administration Techniques30:28 - RP1 Safety Profile32:46 - Follow-Up Imaging and Response Assessment35:44 - Future Applications Beyond Melanoma41:42 - Final Thoughts and Closing Remarks --- RESOURCESWong MK, et al. RP1 Combined With Nivolumab in Advance Anti-PD-1-Failed Melanoma (IGNYTE). J Clin Oncol. 2025;43(33):3589-3599.https://doi.org/10.1200/jco-25-01346 IGNYTE-3 Trialhttps://clinicaltrials.gov/study/NCT06264180 Fri, 06 Mar 2026 08:00:00 -0000 full BackTable When standard-of-care checkpoint blockade fails in metastatic melanoma, how can oncologists and interventional radiologists join forces to turn around patient outcomes? In this episode of the BackTable Podcast, medical oncologist Dr. Jennifer McQuade and interventional radiologist Dr. Rahul Sheth join host Dr. Tyler Sandow to discuss the growing evidence for intratumoral oncolytics as a therapeutic strategy for frontline immunotherapy-refractory melanoma and the interdisciplinary work that is required for successful implementation in practice. --- SYNPOSIS The physicians review how engineered viral vectors, particularly RP1, complement checkpoint blockade through direct tumor lysis and immune activation, and summarize the IGNYTE trial data supporting their use in patients with metastatic melanoma refractory to anti-PD-1 and anti-CTLA-4 agents. The discussion then shifts to practical administration, highlighting the central role of interventional radiology in delivering these therapies to visceral and deep-seated lesions under image guidance. The doctors go on to address the nuances of patient and lesion selection, injection technique, and response assessment, including the importance of recognizing pseudo-progression. They place particular emphasis on the need for multidisciplinary collaboration and stakeholder buy-in efforts on the part of IRs seeking to integrate intratumoral oncolytic injections into their scope of practice. The episode concludes with a forward-looking discussion on the potential for expansion of oncolytic platforms into other solid tumors, underscoring this field as a growing, IR-forward frontier in cancer treatment. --- TIMESTAMPS 00:00 - Introduction02:28 - Immunotherapy Basics06:51 - How Oncolytic Viruses Work11:01 - IGNYTE Trials and Why IR Matters18:14 - T-VEC vs RP1 Indications and Logistics21:57 - Physician Communication and Multidisciplinary Treatment23:06 - RP1 Protocol and Administration Techniques30:28 - RP1 Safety Profile32:46 - Follow-Up Imaging and Response Assessment35:44 - Future Applications Beyond Melanoma41:42 - Final Thoughts and Closing Remarks --- RESOURCESWong MK, et al. RP1 Combined With Nivolumab in Advance Anti-PD-1-Failed Melanoma (IGNYTE). J Clin Oncol. 2025;43(33):3589-3599.https://doi.org/10.1200/jco-25-01346 IGNYTE-3 Trialhttps://clinicaltrials.gov/study/NCT06264180 When standard-of-care checkpoint blockade fails in metastatic melanoma, how can oncologists and interventional radiologists join forces to turn around patient outcomes? In this episode of the BackTable Podcast, medical oncologist Dr. Jennifer McQuade and interventional radiologist Dr. Rahul Sheth join host Dr. Tyler Sandow to discuss the growing evidence for intratumoral oncolytics as a therapeutic strategy for frontline immunotherapy-refractory melanoma and the interdisciplinary work that is required for successful implementation in practice.


---


SYNPOSIS


The physicians review how engineered viral vectors, particularly RP1, complement checkpoint blockade through direct tumor lysis and immune activation, and summarize the IGNYTE trial data supporting their use in patients with metastatic melanoma refractory to anti-PD-1 and anti-CTLA-4 agents. The discussion then shifts to practical administration, highlighting the central role of interventional radiology in delivering these therapies to visceral and deep-seated lesions under image guidance. The doctors go on to address the nuances of patient and lesion selection, injection technique, and response assessment, including the importance of recognizing pseudo-progression. They place particular emphasis on the need for multidisciplinary collaboration and stakeholder buy-in efforts on the part of IRs seeking to integrate intratumoral oncolytic injections into their scope of practice. The episode concludes with a forward-looking discussion on the potential for expansion of oncolytic platforms into other solid tumors, underscoring this field as a growing, IR-forward frontier in cancer treatment.


---


TIMESTAMPS


00:00 - Introduction
02:28 - Immunotherapy Basics
06:51 - How Oncolytic Viruses Work
11:01 - IGNYTE Trials and Why IR Matters
18:14 - T-VEC vs RP1 Indications and Logistics
21:57 - Physician Communication and Multidisciplinary Treatment
23:06 - RP1 Protocol and Administration Techniques
30:28 - RP1 Safety Profile
32:46 - Follow-Up Imaging and Response Assessment
35:44 - Future Applications Beyond Melanoma
41:42 - Final Thoughts and Closing Remarks


---


RESOURCES
Wong MK, et al. RP1 Combined With Nivolumab in Advance Anti-PD-1-Failed Melanoma (IGNYTE). J Clin Oncol. 2025;43(33):3589-3599.
https://doi.org/10.1200/jco-25-01346


IGNYTE-3 Trial
https://clinicaltrials.gov/study/NCT06264180

]]> 2700 Ep. 621 Techniques for Liver Metastases Ablation: Planning & Execution with Dr. Jonas Redmond With data increasingly positioning thermal ablation as a viable alternative to surgery for select liver metastases, the demands on the interventional oncologist have never been higher. Mastering the nuances of patient selection and precise margin assessment is now essential for ensuring effective disease control locally. In this episode of the BackTable Podcast, interventional radiologist Dr. Jonas Redmond of UC San Diego Health joins host Dr. Sabeen Dhand to discuss the current state of microwave ablation (MWA) in the management of oligometastatic liver disease, focusing on tumor assessment, preprocedural planning, and the integration of local and systemic therapies. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS The conversation delves into the complexities of timing systemic versus local ablative therapies and explores questions surrounding adequate treatment margins. Dr. Redmond goes on to emphasize the need for operators to approach procedures with a high level of adaptability, advocating for interdisciplinary preprocedural planning and thoughtful modality selection. Exploring the complications that could arise from injury to adjacent viscera, the physicians speak to the critical importance of rigorous intraprocedural reassessment and discuss how modern software and robotics are transforming procedural precision and safety. Framing these MWA pearls within the context of recent clinical trials like COLLISION and ACCLAIM, the episode underscores the transition of interventional oncology from providing palliative services to increasingly curative solutions that may offer better prospects for patients with metastatic disease. --- TIMESTAMPS 00:00 - Introduction04:30 - Role of Local Therapy in Systemic Disease09:49 - Patient Selection and Treatment Modalities13:15 - Challenging Lesion Characteristics and Locations19:56 - Y-90 Radioembolization versus Microwave Ablation23:04 - Intraoperative Ablation and Combining Locoregional Modalities29:36 - Complications of Microwave Ablation in the Liver36:43 - Future of Ablation and Liver Metastases Treatment39:25 - Final Thoughts and Closing Remarks --- RESOURCES UC San Diego Health. Cryoablation and Arterial Infusion of SD-101 in Combination with Durvalumab and Tremelimumab.https://clinicaltrials.ucsd.edu/trial/NCT06710223 COLLISION trialhttps://clinicaltrials.gov/study/NCT03088150 ACCLAIM trialhttps://clinicaltrials.gov/study/NCT05265169 Tue, 03 Mar 2026 08:00:00 -0000 full BackTable With data increasingly positioning thermal ablation as a viable alternative to surgery for select liver metastases, the demands on the interventional oncologist have never been higher. Mastering the nuances of patient selection and precise margin assessment is now essential for ensuring effective disease control locally. In this episode of the BackTable Podcast, interventional radiologist Dr. Jonas Redmond of UC San Diego Health joins host Dr. Sabeen Dhand to discuss the current state of microwave ablation (MWA) in the management of oligometastatic liver disease, focusing on tumor assessment, preprocedural planning, and the integration of local and systemic therapies. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS The conversation delves into the complexities of timing systemic versus local ablative therapies and explores questions surrounding adequate treatment margins. Dr. Redmond goes on to emphasize the need for operators to approach procedures with a high level of adaptability, advocating for interdisciplinary preprocedural planning and thoughtful modality selection. Exploring the complications that could arise from injury to adjacent viscera, the physicians speak to the critical importance of rigorous intraprocedural reassessment and discuss how modern software and robotics are transforming procedural precision and safety. Framing these MWA pearls within the context of recent clinical trials like COLLISION and ACCLAIM, the episode underscores the transition of interventional oncology from providing palliative services to increasingly curative solutions that may offer better prospects for patients with metastatic disease. --- TIMESTAMPS 00:00 - Introduction04:30 - Role of Local Therapy in Systemic Disease09:49 - Patient Selection and Treatment Modalities13:15 - Challenging Lesion Characteristics and Locations19:56 - Y-90 Radioembolization versus Microwave Ablation23:04 - Intraoperative Ablation and Combining Locoregional Modalities29:36 - Complications of Microwave Ablation in the Liver36:43 - Future of Ablation and Liver Metastases Treatment39:25 - Final Thoughts and Closing Remarks --- RESOURCES UC San Diego Health. Cryoablation and Arterial Infusion of SD-101 in Combination with Durvalumab and Tremelimumab.https://clinicaltrials.ucsd.edu/trial/NCT06710223 COLLISION trialhttps://clinicaltrials.gov/study/NCT03088150 ACCLAIM trialhttps://clinicaltrials.gov/study/NCT05265169 With data increasingly positioning thermal ablation as a viable alternative to surgery for select liver metastases, the demands on the interventional oncologist have never been higher. Mastering the nuances of patient selection and precise margin assessment is now essential for ensuring effective disease control locally. In this episode of the BackTable Podcast, interventional radiologist Dr. Jonas Redmond of UC San Diego Health joins host Dr. Sabeen Dhand to discuss the current state of microwave ablation (MWA) in the management of oligometastatic liver disease, focusing on tumor assessment, preprocedural planning, and the integration of local and systemic therapies.


---


This podcast is supported by:


Varian IntelliBlate
https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions


---


SYNPOSIS


The conversation delves into the complexities of timing systemic versus local ablative therapies and explores questions surrounding adequate treatment margins. Dr. Redmond goes on to emphasize the need for operators to approach procedures with a high level of adaptability, advocating for interdisciplinary preprocedural planning and thoughtful modality selection. Exploring the complications that could arise from injury to adjacent viscera, the physicians speak to the critical importance of rigorous intraprocedural reassessment and discuss how modern software and robotics are transforming procedural precision and safety. Framing these MWA pearls within the context of recent clinical trials like COLLISION and ACCLAIM, the episode underscores the transition of interventional oncology from providing palliative services to increasingly curative solutions that may offer better prospects for patients with metastatic disease.


---


TIMESTAMPS


00:00 - Introduction
04:30 - Role of Local Therapy in Systemic Disease
09:49 - Patient Selection and Treatment Modalities
13:15 - Challenging Lesion Characteristics and Locations
19:56 - Y-90 Radioembolization versus Microwave Ablation
23:04 - Intraoperative Ablation and Combining Locoregional Modalities
29:36 - Complications of Microwave Ablation in the Liver
36:43 - Future of Ablation and Liver Metastases Treatment
39:25 - Final Thoughts and Closing Remarks


---


RESOURCES


UC San Diego Health. Cryoablation and Arterial Infusion of SD-101 in Combination with Durvalumab and Tremelimumab.
https://clinicaltrials.ucsd.edu/trial/NCT06710223


COLLISION trial
https://clinicaltrials.gov/study/NCT03088150


ACCLAIM trial
https://clinicaltrials.gov/study/NCT05265169

]]> 2744 Ep. 620 Ergonomic Strategies for Radiologists: Preventing Back & Neck Pain with Dr. Keith Horton Better habits start now. Poor ergonomics in the angio suite lead to cumulative neck and back injuries, absenteeism, presenteeism, and even early retirement. This episode of the BackTable Podcast offers a guide on on how to improve your ergonomics in the the cath lab, featuring interventional radiologist Dr. Keith Horton and host Dr. Ally Baheti. --- SYNPOSIS Dr. Horton and Dr. Baheti discuss common setup mistakes (especially monitor and ultrasound placement), practical positioning guidance (neutral posture, monitor height/angle, table height at elbow level), lead considerations (two-piece vs one-piece, refitting with body changes, costs vs. injury), and procedural stressors from longer, more complex cases. Horton also reviews evidence and standards (including SIR guidance), highlights surgical ergonomics programs like Duke’s education-and-leadership model with scheduled microbreaks, and describes emerging mitigations such as augmented reality guidance, robotics, and “zero-gravity” lead systems, emphasizing that strain prevention and intentional setup are essential for career longevity. --- TIMESTAMPS 00:00 - Introduction01:43 - Defining Ergonomics04:52 - Common Setup Mistakes07:31 - Neutral Posture Basics09:02 - Lead Fit And Support12:33 - Fighting Bad Room Design14:46 - Augmented Reality Workflow17:11 - Leadless Shielding Options20:53 - Repetitive Strain Tactics25:06 - Future Tech On Horizon27:56 - Maternity Lead Frustrations30:22 - Why Incentives Misalign32:45 - When Ergonomics Fails33:59 - Duke Program Blueprint37:02 - Tools Monitor Table Setup39:05 - Microbreaks That Stick42:46 - Room Setup Realities47:08 - Reminders and Wrap Up Fri, 27 Feb 2026 08:00:00 -0000 full BackTable Better habits start now. Poor ergonomics in the angio suite lead to cumulative neck and back injuries, absenteeism, presenteeism, and even early retirement. This episode of the BackTable Podcast offers a guide on on how to improve your ergonomics in the the cath lab, featuring interventional radiologist Dr. Keith Horton and host Dr. Ally Baheti. --- SYNPOSIS Dr. Horton and Dr. Baheti discuss common setup mistakes (especially monitor and ultrasound placement), practical positioning guidance (neutral posture, monitor height/angle, table height at elbow level), lead considerations (two-piece vs one-piece, refitting with body changes, costs vs. injury), and procedural stressors from longer, more complex cases. Horton also reviews evidence and standards (including SIR guidance), highlights surgical ergonomics programs like Duke’s education-and-leadership model with scheduled microbreaks, and describes emerging mitigations such as augmented reality guidance, robotics, and “zero-gravity” lead systems, emphasizing that strain prevention and intentional setup are essential for career longevity. --- TIMESTAMPS 00:00 - Introduction01:43 - Defining Ergonomics04:52 - Common Setup Mistakes07:31 - Neutral Posture Basics09:02 - Lead Fit And Support12:33 - Fighting Bad Room Design14:46 - Augmented Reality Workflow17:11 - Leadless Shielding Options20:53 - Repetitive Strain Tactics25:06 - Future Tech On Horizon27:56 - Maternity Lead Frustrations30:22 - Why Incentives Misalign32:45 - When Ergonomics Fails33:59 - Duke Program Blueprint37:02 - Tools Monitor Table Setup39:05 - Microbreaks That Stick42:46 - Room Setup Realities47:08 - Reminders and Wrap Up Better habits start now. Poor ergonomics in the angio suite lead to cumulative neck and back injuries, absenteeism, presenteeism, and even early retirement. This episode of the BackTable Podcast offers a guide on on how to improve your ergonomics in the the cath lab, featuring interventional radiologist Dr. Keith Horton and host Dr. Ally Baheti.


---


SYNPOSIS


Dr. Horton and Dr. Baheti discuss common setup mistakes (especially monitor and ultrasound placement), practical positioning guidance (neutral posture, monitor height/angle, table height at elbow level), lead considerations (two-piece vs one-piece, refitting with body changes, costs vs. injury), and procedural stressors from longer, more complex cases. Horton also reviews evidence and standards (including SIR guidance), highlights surgical ergonomics programs like Duke’s education-and-leadership model with scheduled microbreaks, and describes emerging mitigations such as augmented reality guidance, robotics, and “zero-gravity” lead systems, emphasizing that strain prevention and intentional setup are essential for career longevity.


---


TIMESTAMPS


00:00 - Introduction
01:43 - Defining Ergonomics
04:52 - Common Setup Mistakes
07:31 - Neutral Posture Basics
09:02 - Lead Fit And Support
12:33 - Fighting Bad Room Design
14:46 - Augmented Reality Workflow
17:11 - Leadless Shielding Options
20:53 - Repetitive Strain Tactics
25:06 - Future Tech On Horizon
27:56 - Maternity Lead Frustrations
30:22 - Why Incentives Misalign
32:45 - When Ergonomics Fails
33:59 - Duke Program Blueprint
37:02 - Tools Monitor Table Setup
39:05 - Microbreaks That Stick
42:46 - Room Setup Realities
47:08 - Reminders and Wrap Up

]]> 3014 Ep. 619 Clinical Insights: Managing LUTs in BPH Patients with Dr. Art Rastinehad Prostate artery embolization may be performed by interventional radiologists, but its indications are rooted in urologic evaluation. In the second installment of our 2026 PAE University Series, Dr. Chris Beck is joined by Dr. Art Rastinehad of Northwell Health, a urologist with formal interventional radiology training, to share how his dual background informs both when to offer PAE and how to execute it thoughtfully. --- This podcast is supported by an educational grant from Guerbet. --- SYNPOSIS Dr. Rastinehad discusses his path from urology into IR and how that combined training shapes his current hybrid practice. He outlines a practical BPH consult framework grounded in urologic evaluation, emphasizing appropriate imaging, careful patient selection, and the importance of ruling out malignancy before proceeding with embolization. From his perspective, durable outcomes begin with disciplined workup and clear counseling around expectations, including sexual side effects and alternative treatment options. The conversation then turns to procedural strategy. Dr. Rastinehad reviews anatomic considerations, large-gland and technically challenging cases, and his experience incorporating liquid embolics into PAE. He compares glue and particles, detailing workflow decisions, medication strategy, and post-procedure management. Throughout, he highlights scenarios where PAE may not be the most appropriate intervention and how other BPH tools may better serve the patient. The episode concludes with a discussion of the future of PAE, including questions of training, collaboration between specialties, and reimbursement; underscoring the value of cross-specialty insight in contemporary BPH care. --- TIMESTAMPS 00:00 - Introduction01:26 - Interventional Urologist with IR Roots04:13 - Leaving Urology for IR: Fellowship Life, Case Volume & Mentors08:45 - Building a Hybrid Urology/IR Practice14:32 - PAE Benefits, Sexual Side Effects & Why MRI Matters17:39 - BPH Consult Playbook22:17 - Anatomy Deep Dive24:27 - Edge Cases & Big Glands28:24 - Why Glue?35:39 - Glue vs Particles39:40 - Post-PAE Follow-Up41:28 - Antibiotics and Medications46:18 - Tough Cases50:53 - The Future of PAE --- RESOURCES Early Outcomes of Prostatic Artery Embolization using n-Butyl Cyanoacrylate Liquid Embolic Agent: A Safety and Feasibility Studyhttps://pubmed.ncbi.nlm.nih.gov/39074551/ Dr. Rastinehad’s Websitehttps://drrastinehad.com/ Tue, 24 Feb 2026 08:00:00 -0000 full BackTable Prostate artery embolization may be performed by interventional radiologists, but its indications are rooted in urologic evaluation. In the second installment of our 2026 PAE University Series, Dr. Chris Beck is joined by Dr. Art Rastinehad of Northwell Health, a urologist with formal interventional radiology training, to share how his dual background informs both when to offer PAE and how to execute it thoughtfully. --- This podcast is supported by an educational grant from Guerbet. --- SYNPOSIS Dr. Rastinehad discusses his path from urology into IR and how that combined training shapes his current hybrid practice. He outlines a practical BPH consult framework grounded in urologic evaluation, emphasizing appropriate imaging, careful patient selection, and the importance of ruling out malignancy before proceeding with embolization. From his perspective, durable outcomes begin with disciplined workup and clear counseling around expectations, including sexual side effects and alternative treatment options. The conversation then turns to procedural strategy. Dr. Rastinehad reviews anatomic considerations, large-gland and technically challenging cases, and his experience incorporating liquid embolics into PAE. He compares glue and particles, detailing workflow decisions, medication strategy, and post-procedure management. Throughout, he highlights scenarios where PAE may not be the most appropriate intervention and how other BPH tools may better serve the patient. The episode concludes with a discussion of the future of PAE, including questions of training, collaboration between specialties, and reimbursement; underscoring the value of cross-specialty insight in contemporary BPH care. --- TIMESTAMPS 00:00 - Introduction01:26 - Interventional Urologist with IR Roots04:13 - Leaving Urology for IR: Fellowship Life, Case Volume & Mentors08:45 - Building a Hybrid Urology/IR Practice14:32 - PAE Benefits, Sexual Side Effects & Why MRI Matters17:39 - BPH Consult Playbook22:17 - Anatomy Deep Dive24:27 - Edge Cases & Big Glands28:24 - Why Glue?35:39 - Glue vs Particles39:40 - Post-PAE Follow-Up41:28 - Antibiotics and Medications46:18 - Tough Cases50:53 - The Future of PAE --- RESOURCES Early Outcomes of Prostatic Artery Embolization using n-Butyl Cyanoacrylate Liquid Embolic Agent: A Safety and Feasibility Studyhttps://pubmed.ncbi.nlm.nih.gov/39074551/ Dr. Rastinehad’s Websitehttps://drrastinehad.com/ Prostate artery embolization may be performed by interventional radiologists, but its indications are rooted in urologic evaluation. In the second installment of our 2026 PAE University Series, Dr. Chris Beck is joined by Dr. Art Rastinehad of Northwell Health, a urologist with formal interventional radiology training, to share how his dual background informs both when to offer PAE and how to execute it thoughtfully.


---


This podcast is supported by an educational grant from Guerbet.


---


SYNPOSIS


Dr. Rastinehad discusses his path from urology into IR and how that combined training shapes his current hybrid practice. He outlines a practical BPH consult framework grounded in urologic evaluation, emphasizing appropriate imaging, careful patient selection, and the importance of ruling out malignancy before proceeding with embolization. From his perspective, durable outcomes begin with disciplined workup and clear counseling around expectations, including sexual side effects and alternative treatment options.


The conversation then turns to procedural strategy. Dr. Rastinehad reviews anatomic considerations, large-gland and technically challenging cases, and his experience incorporating liquid embolics into PAE. He compares glue and particles, detailing workflow decisions, medication strategy, and post-procedure management. Throughout, he highlights scenarios where PAE may not be the most appropriate intervention and how other BPH tools may better serve the patient.


The episode concludes with a discussion of the future of PAE, including questions of training, collaboration between specialties, and reimbursement; underscoring the value of cross-specialty insight in contemporary BPH care.


---


TIMESTAMPS


00:00 - Introduction
01:26 - Interventional Urologist with IR Roots
04:13 - Leaving Urology for IR: Fellowship Life, Case Volume & Mentors
08:45 - Building a Hybrid Urology/IR Practice
14:32 - PAE Benefits, Sexual Side Effects & Why MRI Matters
17:39 - BPH Consult Playbook
22:17 - Anatomy Deep Dive
24:27 - Edge Cases & Big Glands
28:24 - Why Glue?
35:39 - Glue vs Particles
39:40 - Post-PAE Follow-Up
41:28 - Antibiotics and Medications
46:18 - Tough Cases
50:53 - The Future of PAE


---


RESOURCES


Early Outcomes of Prostatic Artery Embolization using n-Butyl Cyanoacrylate Liquid Embolic Agent: A Safety and Feasibility Study
https://pubmed.ncbi.nlm.nih.gov/39074551/


Dr. Rastinehad’s Website
https://drrastinehad.com/

]]> 3416 Ep. 618 How to Manage Advanced DVA Cases: Techniques & Tips with Dr. Kumar Madassery How do experienced operators approach the most technically demanding aspects of deep venous arterialization (DVA)? In this episode of BackTable, host Dr. Sabeen Dhand sits down with Dr. Kumar Madassery for a detailed discussion of procedural strategy, technical decision-making, and real-world troubleshooting in DVA. --- SYNPOSIS Dr. Madassery walks through his approach from pre-procedure planning to final scaffolding. The conversation begins with imaging review, patient selection, and anesthesia considerations, emphasizing how preparation influences technical success. They then examine venous mapping and access strategy, with specific attention to femoral and tibial disease patterns and how these anatomic variables shape crossing techniques.This episode also covers wire and catheter selection, techniques for creating the arteriovenous anastomosis, balloon sizing, valve management, and stent scaffolding. Throughout, Dr. Madassery shares practical solutions to common access challenges and highlights decision points that can determine procedural durability. The discussion closes with reflections on clinical management, operator fatigue, and the value of professional networks when navigating complex limb salvage cases. --- TIMESTAMPS 00:00 - Introduction03:08 - Pre-Procedure Imaging and Setup05:01 - Venous Access and Mapping07:27 - Anesthesia and Patient Preparation12:29 - Femoral and Tibial Disease Considerations23:17 - Crossing Techniques and Tools27:16 - Venous Access Challenges and Solutions35:54 - Creating the Anastomosis37:03 - Balloon Sizing and Scaffolding Techniques38:26 - Navigating Venous Access Challenges39:56 - Wire and Catheter Strategies42:08 - Dealing with Valves and Anastomosis44:16 - Proximal vs. Distal DVA Approaches47:01 - Scaffolding and Stent Techniques50:06 - Clinical Management and Case Fatigue01:01:10 - Networking and Seeking Advice01:05:41 - Concluding Thoughts and Future Directions Fri, 20 Feb 2026 08:00:00 -0000 full BackTable How do experienced operators approach the most technically demanding aspects of deep venous arterialization (DVA)? In this episode of BackTable, host Dr. Sabeen Dhand sits down with Dr. Kumar Madassery for a detailed discussion of procedural strategy, technical decision-making, and real-world troubleshooting in DVA. --- SYNPOSIS Dr. Madassery walks through his approach from pre-procedure planning to final scaffolding. The conversation begins with imaging review, patient selection, and anesthesia considerations, emphasizing how preparation influences technical success. They then examine venous mapping and access strategy, with specific attention to femoral and tibial disease patterns and how these anatomic variables shape crossing techniques.This episode also covers wire and catheter selection, techniques for creating the arteriovenous anastomosis, balloon sizing, valve management, and stent scaffolding. Throughout, Dr. Madassery shares practical solutions to common access challenges and highlights decision points that can determine procedural durability. The discussion closes with reflections on clinical management, operator fatigue, and the value of professional networks when navigating complex limb salvage cases. --- TIMESTAMPS 00:00 - Introduction03:08 - Pre-Procedure Imaging and Setup05:01 - Venous Access and Mapping07:27 - Anesthesia and Patient Preparation12:29 - Femoral and Tibial Disease Considerations23:17 - Crossing Techniques and Tools27:16 - Venous Access Challenges and Solutions35:54 - Creating the Anastomosis37:03 - Balloon Sizing and Scaffolding Techniques38:26 - Navigating Venous Access Challenges39:56 - Wire and Catheter Strategies42:08 - Dealing with Valves and Anastomosis44:16 - Proximal vs. Distal DVA Approaches47:01 - Scaffolding and Stent Techniques50:06 - Clinical Management and Case Fatigue01:01:10 - Networking and Seeking Advice01:05:41 - Concluding Thoughts and Future Directions How do experienced operators approach the most technically demanding aspects of deep venous arterialization (DVA)? In this episode of BackTable, host Dr. Sabeen Dhand sits down with Dr. Kumar Madassery for a detailed discussion of procedural strategy, technical decision-making, and real-world troubleshooting in DVA.


---


SYNPOSIS


Dr. Madassery walks through his approach from pre-procedure planning to final scaffolding. The conversation begins with imaging review, patient selection, and anesthesia considerations, emphasizing how preparation influences technical success. They then examine venous mapping and access strategy, with specific attention to femoral and tibial disease patterns and how these anatomic variables shape crossing techniques.
This episode also covers wire and catheter selection, techniques for creating the arteriovenous anastomosis, balloon sizing, valve management, and stent scaffolding. Throughout, Dr. Madassery shares practical solutions to common access challenges and highlights decision points that can determine procedural durability. The discussion closes with reflections on clinical management, operator fatigue, and the value of professional networks when navigating complex limb salvage cases.


---


TIMESTAMPS


00:00 - Introduction
03:08 - Pre-Procedure Imaging and Setup
05:01 - Venous Access and Mapping
07:27 - Anesthesia and Patient Preparation
12:29 - Femoral and Tibial Disease Considerations
23:17 - Crossing Techniques and Tools
27:16 - Venous Access Challenges and Solutions
35:54 - Creating the Anastomosis
37:03 - Balloon Sizing and Scaffolding Techniques
38:26 - Navigating Venous Access Challenges
39:56 - Wire and Catheter Strategies
42:08 - Dealing with Valves and Anastomosis
44:16 - Proximal vs. Distal DVA Approaches
47:01 - Scaffolding and Stent Techniques
50:06 - Clinical Management and Case Fatigue
01:01:10 - Networking and Seeking Advice
01:05:41 - Concluding Thoughts and Future Directions

]]> 4185 Ep. 617 Cybersecurity Essentials for Medical Professionals with Didier Jourdain Think your medical practice is safe from hackers? Learn why humans, rather than software, are often the weakest link in patient data protection. In this episode of the BackTable Podcast, host Dr. Chris Beck delves into the critical topic of cybersecurity in healthcare with Didier Jourdain, a certified Information Systems Security Professional (CISSP). --- SYNPOSIS Didier discusses his recently approved paper, 'Cybersecurity for Interventional Radiologists: A Clinical Imperative for Protecting Patient Data and Imaging Systems,' and shares his extensive background in software and application security, penetration testing, and cybersecurity risk governance. The conversation covers key issues such as phishing, ransomware, third-party vendor risks, and the vulnerabilities of the Internet of Medical Things (IOMT). Didier emphasizes the importance of education, tabletop exercises, and comprehensive third-party risk management strategies to enhance cybersecurity resilience in both hospital systems and independent physician practices. --- TIMESTAMPS00:00 - Introduction04:03 - Cybersecurity in Healthcare: A Clinical Imperative16:07 - Mitigating Cybersecurity Risks20:23 - Password Management and Best Practices27:33 - The Role of IT in Cybersecurity31:04 - Internet of Medical Things (IoMT) Vulnerabilities39:17 - Top Cybersecurity Recommendations for Physicians Tue, 17 Feb 2026 08:00:00 -0000 full BackTable Think your medical practice is safe from hackers? Learn why humans, rather than software, are often the weakest link in patient data protection. In this episode of the BackTable Podcast, host Dr. Chris Beck delves into the critical topic of cybersecurity in healthcare with Didier Jourdain, a certified Information Systems Security Professional (CISSP). --- SYNPOSIS Didier discusses his recently approved paper, 'Cybersecurity for Interventional Radiologists: A Clinical Imperative for Protecting Patient Data and Imaging Systems,' and shares his extensive background in software and application security, penetration testing, and cybersecurity risk governance. The conversation covers key issues such as phishing, ransomware, third-party vendor risks, and the vulnerabilities of the Internet of Medical Things (IOMT). Didier emphasizes the importance of education, tabletop exercises, and comprehensive third-party risk management strategies to enhance cybersecurity resilience in both hospital systems and independent physician practices. --- TIMESTAMPS00:00 - Introduction04:03 - Cybersecurity in Healthcare: A Clinical Imperative16:07 - Mitigating Cybersecurity Risks20:23 - Password Management and Best Practices27:33 - The Role of IT in Cybersecurity31:04 - Internet of Medical Things (IoMT) Vulnerabilities39:17 - Top Cybersecurity Recommendations for Physicians Think your medical practice is safe from hackers? Learn why humans, rather than software, are often the weakest link in patient data protection. In this episode of the BackTable Podcast, host Dr. Chris Beck delves into the critical topic of cybersecurity in healthcare with Didier Jourdain, a certified Information Systems Security Professional (CISSP).


---


SYNPOSIS


Didier discusses his recently approved paper, 'Cybersecurity for Interventional Radiologists: A Clinical Imperative for Protecting Patient Data and Imaging Systems,' and shares his extensive background in software and application security, penetration testing, and cybersecurity risk governance. The conversation covers key issues such as phishing, ransomware, third-party vendor risks, and the vulnerabilities of the Internet of Medical Things (IOMT). Didier emphasizes the importance of education, tabletop exercises, and comprehensive third-party risk management strategies to enhance cybersecurity resilience in both hospital systems and independent physician practices.


---


TIMESTAMPS
00:00 - Introduction
04:03 - Cybersecurity in Healthcare: A Clinical Imperative
16:07 - Mitigating Cybersecurity Risks
20:23 - Password Management and Best Practices
27:33 - The Role of IT in Cybersecurity
31:04 - Internet of Medical Things (IoMT) Vulnerabilities
39:17 - Top Cybersecurity Recommendations for Physicians

]]> 2912 Ep. 616 Exploring Unique Outpatient Models in Interventional Radiology with Dr. Richard Daniels How can patients receive more consistent interventional radiology care amid a national shortage of IR physicians? That question led Dr. Rick Daniels to develop a new outpatient practice model centered on recruiting independent IRs to provide long-term, fractional coverage for groups in need. In this episode of the BackTable Podcast hosted by Dr. Aaron Fritts, Dr. Daniels outlines the thinking behind this approach and how it aims to expand access to IR services in outpatient settings. --- SYNPOSIS The conversation examines the evolving landscape of IR practice, including the challenges associated with transitioning between practice settings and building sustainable outpatient service lines. Dr. Daniels walks through the development of his model, with particular attention to identifying and supporting outpatient embolization opportunities. The discussion also explores the consortium-style structure for independent IRs, emphasizing long-term alignment, professional autonomy, and scalability at a national level. Operational considerations such as technology partnerships, documentation workflows, and targeted marketing strategies offer a practical look at what it takes to make this model work. --- TIMESTAMPS 00:00 - Introduction03:49 - Evolution of an Independent IR Practice05:30 - Challenges and Opportunities in Outpatient IR09:58 - Building Service Lines and Marketing Strategies18:34 - Forming a National IR Group25:21 - Balancing Business and Healthcare25:37 - Evaluating and Correcting Site Performance28:16 - Expanding Geographical Reach30:45 - Recruitment and Retention Challenges38:07 - The Importance of Tech-Doc Teams42:35 - Future Goals and Recruitment Efforts45:58 - Conclusion Fri, 13 Feb 2026 08:00:00 -0000 full BackTable How can patients receive more consistent interventional radiology care amid a national shortage of IR physicians? That question led Dr. Rick Daniels to develop a new outpatient practice model centered on recruiting independent IRs to provide long-term, fractional coverage for groups in need. In this episode of the BackTable Podcast hosted by Dr. Aaron Fritts, Dr. Daniels outlines the thinking behind this approach and how it aims to expand access to IR services in outpatient settings. --- SYNPOSIS The conversation examines the evolving landscape of IR practice, including the challenges associated with transitioning between practice settings and building sustainable outpatient service lines. Dr. Daniels walks through the development of his model, with particular attention to identifying and supporting outpatient embolization opportunities. The discussion also explores the consortium-style structure for independent IRs, emphasizing long-term alignment, professional autonomy, and scalability at a national level. Operational considerations such as technology partnerships, documentation workflows, and targeted marketing strategies offer a practical look at what it takes to make this model work. --- TIMESTAMPS 00:00 - Introduction03:49 - Evolution of an Independent IR Practice05:30 - Challenges and Opportunities in Outpatient IR09:58 - Building Service Lines and Marketing Strategies18:34 - Forming a National IR Group25:21 - Balancing Business and Healthcare25:37 - Evaluating and Correcting Site Performance28:16 - Expanding Geographical Reach30:45 - Recruitment and Retention Challenges38:07 - The Importance of Tech-Doc Teams42:35 - Future Goals and Recruitment Efforts45:58 - Conclusion How can patients receive more consistent interventional radiology care amid a national shortage of IR physicians? That question led Dr. Rick Daniels to develop a new outpatient practice model centered on recruiting independent IRs to provide long-term, fractional coverage for groups in need. In this episode of the BackTable Podcast hosted by Dr. Aaron Fritts, Dr. Daniels outlines the thinking behind this approach and how it aims to expand access to IR services in outpatient settings.


---


SYNPOSIS


The conversation examines the evolving landscape of IR practice, including the challenges associated with transitioning between practice settings and building sustainable outpatient service lines. Dr. Daniels walks through the development of his model, with particular attention to identifying and supporting outpatient embolization opportunities. The discussion also explores the consortium-style structure for independent IRs, emphasizing long-term alignment, professional autonomy, and scalability at a national level. Operational considerations such as technology partnerships, documentation workflows, and targeted marketing strategies offer a practical look at what it takes to make this model work.


---


TIMESTAMPS


00:00 - Introduction
03:49 - Evolution of an Independent IR Practice
05:30 - Challenges and Opportunities in Outpatient IR
09:58 - Building Service Lines and Marketing Strategies
18:34 - Forming a National IR Group
25:21 - Balancing Business and Healthcare
25:37 - Evaluating and Correcting Site Performance
28:16 - Expanding Geographical Reach
30:45 - Recruitment and Retention Challenges
38:07 - The Importance of Tech-Doc Teams
42:35 - Future Goals and Recruitment Efforts
45:58 - Conclusion

]]> 3006 Ep. 615 Exploring Intravascular Lithotripsy in Below the Knee CLTI with Dr. Constantino Peña As new calcium-modifying technologies expand the repertoire of below-the-knee (BTK) arterial disease interventions, how should your treatment algorithm evolve, and what endpoints matter most? In this episode of the BackTable Podcast, Dr. Constantino Peña of the Baptist Health Miami Cardiac and Vascular Institute joins Dr. Sabeen Dhand to discuss the latest advancements in BTK chronic limb-threatening ischemia (CLTI) therapies and the push to improve on current vessel preparation outcomes. --- This podcast is supported by: Shockwave Medicalhttps://shockwavemedical.com/ --- SYNPOSIS The physicians discuss the evolution of tibial arterial therapies, the challenges presented by heavily calcified lesions, and the impact of new tools, particularly the Shockwave E8 intravascular lithotripsy (IVL) device, on procedural considerations and endpoints. Dr. Peña shares his treatment algorithms and offers practical advice on selecting the right tools for each unique case. The episode closes with speculation on the future of treatment options and technologies for BTK disease, and the growing need for robust data to guide patient-specific treatment. --- TIMESTAMPS 00:00 - Introduction02:11 - Understanding Tibial Disease and Treatment Evolution07:22 - Advancements in Tibial Disease Treatment and the Role of IVL15:31 - Techniques for Effective IVL Sizing and Usage 21:28 - Challenges and Innovations in Tibial Disease Management26:48 - Innovations in Stent Technology30:43 - Combining IVL with Adjunct Therapies32:13 - Addressing Misconceptions in Tibial Treatment37:54 - Advancements in Intravascular Lithotripsy40:59 - Future of Vascular Treatments43:42 - Final Thoughts Tue, 10 Feb 2026 08:00:00 -0000 full BackTable As new calcium-modifying technologies expand the repertoire of below-the-knee (BTK) arterial disease interventions, how should your treatment algorithm evolve, and what endpoints matter most? In this episode of the BackTable Podcast, Dr. Constantino Peña of the Baptist Health Miami Cardiac and Vascular Institute joins Dr. Sabeen Dhand to discuss the latest advancements in BTK chronic limb-threatening ischemia (CLTI) therapies and the push to improve on current vessel preparation outcomes. --- This podcast is supported by: Shockwave Medicalhttps://shockwavemedical.com/ --- SYNPOSIS The physicians discuss the evolution of tibial arterial therapies, the challenges presented by heavily calcified lesions, and the impact of new tools, particularly the Shockwave E8 intravascular lithotripsy (IVL) device, on procedural considerations and endpoints. Dr. Peña shares his treatment algorithms and offers practical advice on selecting the right tools for each unique case. The episode closes with speculation on the future of treatment options and technologies for BTK disease, and the growing need for robust data to guide patient-specific treatment. --- TIMESTAMPS 00:00 - Introduction02:11 - Understanding Tibial Disease and Treatment Evolution07:22 - Advancements in Tibial Disease Treatment and the Role of IVL15:31 - Techniques for Effective IVL Sizing and Usage 21:28 - Challenges and Innovations in Tibial Disease Management26:48 - Innovations in Stent Technology30:43 - Combining IVL with Adjunct Therapies32:13 - Addressing Misconceptions in Tibial Treatment37:54 - Advancements in Intravascular Lithotripsy40:59 - Future of Vascular Treatments43:42 - Final Thoughts As new calcium-modifying technologies expand the repertoire of below-the-knee (BTK) arterial disease interventions, how should your treatment algorithm evolve, and what endpoints matter most? In this episode of the BackTable Podcast, Dr. Constantino Peña of the Baptist Health Miami Cardiac and Vascular Institute joins Dr. Sabeen Dhand to discuss the latest advancements in BTK chronic limb-threatening ischemia (CLTI) therapies and the push to improve on current vessel preparation outcomes.


---


This podcast is supported by:


Shockwave Medical
https://shockwavemedical.com/


---


SYNPOSIS


The physicians discuss the evolution of tibial arterial therapies, the challenges presented by heavily calcified lesions, and the impact of new tools, particularly the Shockwave E8 intravascular lithotripsy (IVL) device, on procedural considerations and endpoints. Dr. Peña shares his treatment algorithms and offers practical advice on selecting the right tools for each unique case. The episode closes with speculation on the future of treatment options and technologies for BTK disease, and the growing need for robust data to guide patient-specific treatment.


---


TIMESTAMPS


00:00 - Introduction
02:11 - Understanding Tibial Disease and Treatment Evolution
07:22 - Advancements in Tibial Disease Treatment and the Role of IVL
15:31 - Techniques for Effective IVL Sizing and Usage
21:28 - Challenges and Innovations in Tibial Disease Management
26:48 - Innovations in Stent Technology
30:43 - Combining IVL with Adjunct Therapies
32:13 - Addressing Misconceptions in Tibial Treatment
37:54 - Advancements in Intravascular Lithotripsy
40:59 - Future of Vascular Treatments
43:42 - Final Thoughts

]]> 3053 Ep. 614 Interventional Radiology’s Evolution: Insights from Dr. Ernest Ring Have you ever wondered what it was like to be in the room when the first pelvic embolization was performed or how the TIPS procedure was pioneered? Dr. Ernie Ring, a legendary figure from UCSF and a true forefather of Interventional Radiology, joins host Dr. Peder Horner to recount the early days of the specialty. Dr. Ring shares fascinating stories from his training at Massachusetts General Hospital under Dr. Stanley Baum, where he witnessed the birth of transformative techniques using angiographic catheters to treat life-threatening bleeding. --- SYNPOSIS From improvising the use of autologous blood clot and thrombin to stop massive hemorrhages to his pivotal role in developing the TIPS procedure and specialized biliary catheters, Dr. Ring’s career is loaded with innovation. The conversation explores the "cowboy" era of IR, the evolution of essential tools like the glide wire, and the critical importance of maintaining a "high-touch" clinical practice in the face of emerging technologies like AI. Dr. Ring also reflects on his later transition into hospital leadership as Chief Medical Officer, where he applied his problem-solving mindset to institutional quality and safety. --- TIMESTAMPS 00:00 - Introduction01:58 - Upbringing from Detroit to Mass Gen 06:55 - Early IR with an Embo Case13:50 - Trailblazing Cases in IR16:17 - Penn and Innovation20:00 - Polarizing Procedures24:13 - IR Device Innovation33:00 - Dotter’s Separation from Diagnostics37:30 - Fear Finds Cowboys39:08 - AI and Robotics40:08 - Fun Hobbies Fri, 06 Feb 2026 08:00:00 -0000 full BackTable Have you ever wondered what it was like to be in the room when the first pelvic embolization was performed or how the TIPS procedure was pioneered? Dr. Ernie Ring, a legendary figure from UCSF and a true forefather of Interventional Radiology, joins host Dr. Peder Horner to recount the early days of the specialty. Dr. Ring shares fascinating stories from his training at Massachusetts General Hospital under Dr. Stanley Baum, where he witnessed the birth of transformative techniques using angiographic catheters to treat life-threatening bleeding. --- SYNPOSIS From improvising the use of autologous blood clot and thrombin to stop massive hemorrhages to his pivotal role in developing the TIPS procedure and specialized biliary catheters, Dr. Ring’s career is loaded with innovation. The conversation explores the "cowboy" era of IR, the evolution of essential tools like the glide wire, and the critical importance of maintaining a "high-touch" clinical practice in the face of emerging technologies like AI. Dr. Ring also reflects on his later transition into hospital leadership as Chief Medical Officer, where he applied his problem-solving mindset to institutional quality and safety. --- TIMESTAMPS 00:00 - Introduction01:58 - Upbringing from Detroit to Mass Gen 06:55 - Early IR with an Embo Case13:50 - Trailblazing Cases in IR16:17 - Penn and Innovation20:00 - Polarizing Procedures24:13 - IR Device Innovation33:00 - Dotter’s Separation from Diagnostics37:30 - Fear Finds Cowboys39:08 - AI and Robotics40:08 - Fun Hobbies Have you ever wondered what it was like to be in the room when the first pelvic embolization was performed or how the TIPS procedure was pioneered? Dr. Ernie Ring, a legendary figure from UCSF and a true forefather of Interventional Radiology, joins host Dr. Peder Horner to recount the early days of the specialty. Dr. Ring shares fascinating stories from his training at Massachusetts General Hospital under Dr. Stanley Baum, where he witnessed the birth of transformative techniques using angiographic catheters to treat life-threatening bleeding.

---

SYNPOSIS

From improvising the use of autologous blood clot and thrombin to stop massive hemorrhages to his pivotal role in developing the TIPS procedure and specialized biliary catheters, Dr. Ring’s career is loaded with innovation. The conversation explores the "cowboy" era of IR, the evolution of essential tools like the glide wire, and the critical importance of maintaining a "high-touch" clinical practice in the face of emerging technologies like AI. Dr. Ring also reflects on his later transition into hospital leadership as Chief Medical Officer, where he applied his problem-solving mindset to institutional quality and safety.

---

TIMESTAMPS

00:00 - Introduction
01:58 - Upbringing from Detroit to Mass Gen
06:55 - Early IR with an Embo Case
13:50 - Trailblazing Cases in IR
16:17 - Penn and Innovation
20:00 - Polarizing Procedures
24:13 - IR Device Innovation
33:00 - Dotter’s Separation from Diagnostics
37:30 - Fear Finds Cowboys
39:08 - AI and Robotics
40:08 - Fun Hobbies

]]> 3074 Ep. 613 Microwave Ablation in Renal Tumors with Dr. Steven Huang You’re about to biopsy a renal lesion; should you ablate at the same time? In this episode of the BackTable Podcast, host Michael Barraza talks with Dr. Steven Huang from MD Anderson Cancer Center about building an efficient and effective renal biopsy and ablation service line. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS Dr. Huang first covers referral patterns and the typical pathway that patients take to end up in his clinic. The discussion covers the types of lesions he treats, imaging requirements, and criteria for patient eligibility. He emphasizes the importance of shared decision making when deciding between active surveillance, interventional treatment, and partial nephrectomy. Dr. Huang explains his preferred procedural approach and ablation modalities, including cryo, microwave (MWA), and radiofrequency ablation (RFA). He shares his experiences with challenging cases and integrating new technologies like histotripsy and the Siemens interventional package. They also discuss the possibility of a preoperative embolization for larger lesions that could be susceptible to the heat sink effect. Both experts emphasize the importance of collaboration with urologists and ensuring patient safety and expectations. They also touch on the future of the field, discussing the use of AI and robotics. --- TIMESTAMPS 00:00 - Introduction 02:17 - Training Programs at MD Anderson03:23 - Referral Patterns for Renal Ablations07:25 - Patient Management and Virtual Consultations10:59 - Ablation Techniques and Device Selection26:44 - Challenges and Complications27:25 - Approach to Lesions Near Renal Vasculature28:02 - Patient Expectations and Urologist Collaboration33:26 - Post-Procedure Care and Patient Recovery35:30 - Managing Recurrences and Multiple RCCs47:17 - Closing Remarks Tue, 03 Feb 2026 08:00:00 -0000 full BackTable You’re about to biopsy a renal lesion; should you ablate at the same time? In this episode of the BackTable Podcast, host Michael Barraza talks with Dr. Steven Huang from MD Anderson Cancer Center about building an efficient and effective renal biopsy and ablation service line. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS Dr. Huang first covers referral patterns and the typical pathway that patients take to end up in his clinic. The discussion covers the types of lesions he treats, imaging requirements, and criteria for patient eligibility. He emphasizes the importance of shared decision making when deciding between active surveillance, interventional treatment, and partial nephrectomy. Dr. Huang explains his preferred procedural approach and ablation modalities, including cryo, microwave (MWA), and radiofrequency ablation (RFA). He shares his experiences with challenging cases and integrating new technologies like histotripsy and the Siemens interventional package. They also discuss the possibility of a preoperative embolization for larger lesions that could be susceptible to the heat sink effect. Both experts emphasize the importance of collaboration with urologists and ensuring patient safety and expectations. They also touch on the future of the field, discussing the use of AI and robotics. --- TIMESTAMPS 00:00 - Introduction 02:17 - Training Programs at MD Anderson03:23 - Referral Patterns for Renal Ablations07:25 - Patient Management and Virtual Consultations10:59 - Ablation Techniques and Device Selection26:44 - Challenges and Complications27:25 - Approach to Lesions Near Renal Vasculature28:02 - Patient Expectations and Urologist Collaboration33:26 - Post-Procedure Care and Patient Recovery35:30 - Managing Recurrences and Multiple RCCs47:17 - Closing Remarks You’re about to biopsy a renal lesion; should you ablate at the same time? In this episode of the BackTable Podcast, host Michael Barraza talks with Dr. Steven Huang from MD Anderson Cancer Center about building an efficient and effective renal biopsy and ablation service line.


---


This podcast is supported by:


Varian IntelliBlate
https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions


---


SYNPOSIS


Dr. Huang first covers referral patterns and the typical pathway that patients take to end up in his clinic. The discussion covers the types of lesions he treats, imaging requirements, and criteria for patient eligibility. He emphasizes the importance of shared decision making when deciding between active surveillance, interventional treatment, and partial nephrectomy. Dr. Huang explains his preferred procedural approach and ablation modalities, including cryo, microwave (MWA), and radiofrequency ablation (RFA). He shares his experiences with challenging cases and integrating new technologies like histotripsy and the Siemens interventional package. They also discuss the possibility of a preoperative embolization for larger lesions that could be susceptible to the heat sink effect. Both experts emphasize the importance of collaboration with urologists and ensuring patient safety and expectations. They also touch on the future of the field, discussing the use of AI and robotics.


---


TIMESTAMPS


00:00 - Introduction
02:17 - Training Programs at MD Anderson
03:23 - Referral Patterns for Renal Ablations
07:25 - Patient Management and Virtual Consultations
10:59 - Ablation Techniques and Device Selection
26:44 - Challenges and Complications
27:25 - Approach to Lesions Near Renal Vasculature
28:02 - Patient Expectations and Urologist Collaboration
33:26 - Post-Procedure Care and Patient Recovery
35:30 - Managing Recurrences and Multiple RCCs
47:17 - Closing Remarks

]]> 3019 Ep. 612 Interventional Radiology in Military Medicine with Dr. John York What does day-to-day interventional radiology look like in the military? Here’s a firsthand account. Dr. John York, interventional radiologist at University of California San Diego with 37 years of active duty in the Navy joins host Dr. Ally Baheti to share his experiences and perspectives on being an interventional radiologist in the military. --- SYNPOSIS Dr. York recounts his path to the military and how it ultimately led him to interventional radiology. He reflects on his deployments to Afghanistan and Djibouti, highlighting the clinical complexity, operational challenges, and fulfilling aspects of delivering image-guided care in high-acuity environments. Dr. York recounts several remarkable cases from his deployments, including the management of a vertebral artery aneurysm. He underscores how strong foundational training enables creative problem-solving in resource-limited settings. Dr. York also shares his experience as senior medical officer on the USS Theodore Roosevelt during the initial COVID-19 outbreak, offering insight into the clinical, operational, and administrative challenges he faced. He highlights how adaptability and creative problem-solving are essential to managing complex cases in dynamic environments. --- TIMESTAMPS 00:00 - Introduction02:53 - Journey to Medicine: From Naval Academy to Medical School05:55 - Choosing Interventional Radiology08:11 - Military Medical Experience: Portsmouth and Beyond11:38 - First Deployment: Challenges and Adaptations14:38 - Case Studies: Trauma and Innovation in Afghanistan26:15 - A Unique Procedure in a Combat Zone28:49 - Transitioning Back to Civilian Life31:07 - Challenges in Combat Zones34:22 - Deployment in Djibouti38:25 - COVID-19 on the USS Theodore Roosevelt45:50 - Reflections on Military Service Fri, 30 Jan 2026 08:00:00 -0000 full BackTable What does day-to-day interventional radiology look like in the military? Here’s a firsthand account. Dr. John York, interventional radiologist at University of California San Diego with 37 years of active duty in the Navy joins host Dr. Ally Baheti to share his experiences and perspectives on being an interventional radiologist in the military. --- SYNPOSIS Dr. York recounts his path to the military and how it ultimately led him to interventional radiology. He reflects on his deployments to Afghanistan and Djibouti, highlighting the clinical complexity, operational challenges, and fulfilling aspects of delivering image-guided care in high-acuity environments. Dr. York recounts several remarkable cases from his deployments, including the management of a vertebral artery aneurysm. He underscores how strong foundational training enables creative problem-solving in resource-limited settings. Dr. York also shares his experience as senior medical officer on the USS Theodore Roosevelt during the initial COVID-19 outbreak, offering insight into the clinical, operational, and administrative challenges he faced. He highlights how adaptability and creative problem-solving are essential to managing complex cases in dynamic environments. --- TIMESTAMPS 00:00 - Introduction02:53 - Journey to Medicine: From Naval Academy to Medical School05:55 - Choosing Interventional Radiology08:11 - Military Medical Experience: Portsmouth and Beyond11:38 - First Deployment: Challenges and Adaptations14:38 - Case Studies: Trauma and Innovation in Afghanistan26:15 - A Unique Procedure in a Combat Zone28:49 - Transitioning Back to Civilian Life31:07 - Challenges in Combat Zones34:22 - Deployment in Djibouti38:25 - COVID-19 on the USS Theodore Roosevelt45:50 - Reflections on Military Service What does day-to-day interventional radiology look like in the military? Here’s a firsthand account. Dr. John York, interventional radiologist at University of California San Diego with 37 years of active duty in the Navy joins host Dr. Ally Baheti to share his experiences and perspectives on being an interventional radiologist in the military.


---


SYNPOSIS


Dr. York recounts his path to the military and how it ultimately led him to interventional radiology. He reflects on his deployments to Afghanistan and Djibouti, highlighting the clinical complexity, operational challenges, and fulfilling aspects of delivering image-guided care in high-acuity environments. Dr. York recounts several remarkable cases from his deployments, including the management of a vertebral artery aneurysm. He underscores how strong foundational training enables creative problem-solving in resource-limited settings.

Dr. York also shares his experience as senior medical officer on the USS Theodore Roosevelt during the initial COVID-19 outbreak, offering insight into the clinical, operational, and administrative challenges he faced. He highlights how adaptability and creative problem-solving are essential to managing complex cases in dynamic environments.


---


TIMESTAMPS


00:00 - Introduction
02:53 - Journey to Medicine: From Naval Academy to Medical School
05:55 - Choosing Interventional Radiology
08:11 - Military Medical Experience: Portsmouth and Beyond
11:38 - First Deployment: Challenges and Adaptations
14:38 - Case Studies: Trauma and Innovation in Afghanistan
26:15 - A Unique Procedure in a Combat Zone
28:49 - Transitioning Back to Civilian Life
31:07 - Challenges in Combat Zones
34:22 - Deployment in Djibouti
38:25 - COVID-19 on the USS Theodore Roosevelt
45:50 - Reflections on Military Service

]]> 3069 Ep. 611 Challenges in Prostate Artery Embolization with Dr. Rajasekhara Ayyagari Are balloon occlusion microcatheters your new best friend for prostate artery embolization (PAE)? In this episode of BackTable, Dr. Raj Ayyagari, interventional radiologist at Boston Medical Center, joins Dr. Ally Baheti to tackle complex clinical and technical challenges in PAE. --- This podcast is supported by an educational grant from Guerbet. --- SYNPOSIS Dr. Ayyagari shares his unique journey from urology to interventional radiology and his experience building successful PAE service lines at multiple institutions. He walks through a series of challenging cases involving intraprostatic penile arteries, perivesicular collaterals, and internal pudendal collaterals used to treat bilateral hemi-prostates. The discussion highlights the role of balloon occlusion microcatheters such as the Sniper, his transition from 100–300 micron particles to glue embolization, and scenarios where coil protection is essential to prevent nontarget embolization. He also covers post-procedural management, the importance of setting expectations around suprapubic tube removal, and why thorough patient and provider counseling is critical for optimal care. --- TIMESTAMPS 00:00 - Introduction 02:14 - Building a Practice in Prostate Artery Embolization08:19 - Case Studies and Techniques in Prostate Artery Embolization23:16 - Challenges in Embolization Techniques23:47 - Step-by-Step Guide to Embolizing a Hemi Prostate25:24 - Choosing the Right Beads for Embolization29:10 - Transitioning to Liquid Embolics35:38 - Setting Patient Expectations and Pre-Procedure Evaluation40:17 - Post-Procedure Care and Medications44:06 - Conclusion and Final Thoughts Tue, 27 Jan 2026 08:00:00 -0000 full BackTable Are balloon occlusion microcatheters your new best friend for prostate artery embolization (PAE)? In this episode of BackTable, Dr. Raj Ayyagari, interventional radiologist at Boston Medical Center, joins Dr. Ally Baheti to tackle complex clinical and technical challenges in PAE. --- This podcast is supported by an educational grant from Guerbet. --- SYNPOSIS Dr. Ayyagari shares his unique journey from urology to interventional radiology and his experience building successful PAE service lines at multiple institutions. He walks through a series of challenging cases involving intraprostatic penile arteries, perivesicular collaterals, and internal pudendal collaterals used to treat bilateral hemi-prostates. The discussion highlights the role of balloon occlusion microcatheters such as the Sniper, his transition from 100–300 micron particles to glue embolization, and scenarios where coil protection is essential to prevent nontarget embolization. He also covers post-procedural management, the importance of setting expectations around suprapubic tube removal, and why thorough patient and provider counseling is critical for optimal care. --- TIMESTAMPS 00:00 - Introduction 02:14 - Building a Practice in Prostate Artery Embolization08:19 - Case Studies and Techniques in Prostate Artery Embolization23:16 - Challenges in Embolization Techniques23:47 - Step-by-Step Guide to Embolizing a Hemi Prostate25:24 - Choosing the Right Beads for Embolization29:10 - Transitioning to Liquid Embolics35:38 - Setting Patient Expectations and Pre-Procedure Evaluation40:17 - Post-Procedure Care and Medications44:06 - Conclusion and Final Thoughts Are balloon occlusion microcatheters your new best friend for prostate artery embolization (PAE)? In this episode of BackTable, Dr. Raj Ayyagari, interventional radiologist at Boston Medical Center, joins Dr. Ally Baheti to tackle complex clinical and technical challenges in PAE.


---


This podcast is supported by an educational grant from Guerbet.


---


SYNPOSIS


Dr. Ayyagari shares his unique journey from urology to interventional radiology and his experience building successful PAE service lines at multiple institutions. He walks through a series of challenging cases involving intraprostatic penile arteries, perivesicular collaterals, and internal pudendal collaterals used to treat bilateral hemi-prostates. The discussion highlights the role of balloon occlusion microcatheters such as the Sniper, his transition from 100–300 micron particles to glue embolization, and scenarios where coil protection is essential to prevent nontarget embolization. He also covers post-procedural management, the importance of setting expectations around suprapubic tube removal, and why thorough patient and provider counseling is critical for optimal care.


---


TIMESTAMPS


00:00 - Introduction
02:14 - Building a Practice in Prostate Artery Embolization
08:19 - Case Studies and Techniques in Prostate Artery Embolization
23:16 - Challenges in Embolization Techniques
23:47 - Step-by-Step Guide to Embolizing a Hemi Prostate
25:24 - Choosing the Right Beads for Embolization
29:10 - Transitioning to Liquid Embolics
35:38 - Setting Patient Expectations and Pre-Procedure Evaluation
40:17 - Post-Procedure Care and Medications
44:06 - Conclusion and Final Thoughts

]]> 2841 Ep. 610 Interventional Radiology in UAE: Current Practices with Dr. Jamal Alkoteesh Have you ever considered taking a sabbatical to practice Interventional Radiology in the Middle East? In this episode, Dr. Jamal AlKoteesh, the Chairman of Clinical Imaging at SEHA and the "Godfather of IR" in the United Arab Emirates, joins host Dr. Sabeen Dhand to discuss the rapid evolution and current state of IR in the Gulf region. --- SYNPOSIS Dr. AlKoteesh shares his journey from training in the UK to establishing the IR specialty in Abu Dhabi over the last 18 years. He details the unique practice environment in UAE government hospitals, where the lack of strict sub-specialization requires IRs to maintain a versatile skillset—handling everything from thyroid FNAs and UFE to complex neurovascular thrombectomies. The conversation highlights the significant government investment in healthcare technology, which allows physicians access to the latest tools—such as the Siemens Artis Icono with integrated RapidAI for stroke—often before they are widely available in other markets. Dr. AlKoteesh also provides a practical guide for US physicians interested in working abroad, covering the licensing timeline, tax-free income, and the high demand for Western-trained physicians. --- TIMESTAMPS 00:00 - Introduction01:39 - Building IR in UAE05:23 - UAE Healthcare System Overview07:54 - IR Residency and Staffing13:15 - Access to Latest Devices15:15 - Compensation and Lifestyle17:58 - PAIRS Conference Overview20:45 - Licensing and Relocation Guide21:39 - Liability and Language Barriers26:33 - Launching Stroke Interventions Fri, 23 Jan 2026 08:00:00 -0000 full BackTable Have you ever considered taking a sabbatical to practice Interventional Radiology in the Middle East? In this episode, Dr. Jamal AlKoteesh, the Chairman of Clinical Imaging at SEHA and the "Godfather of IR" in the United Arab Emirates, joins host Dr. Sabeen Dhand to discuss the rapid evolution and current state of IR in the Gulf region. --- SYNPOSIS Dr. AlKoteesh shares his journey from training in the UK to establishing the IR specialty in Abu Dhabi over the last 18 years. He details the unique practice environment in UAE government hospitals, where the lack of strict sub-specialization requires IRs to maintain a versatile skillset—handling everything from thyroid FNAs and UFE to complex neurovascular thrombectomies. The conversation highlights the significant government investment in healthcare technology, which allows physicians access to the latest tools—such as the Siemens Artis Icono with integrated RapidAI for stroke—often before they are widely available in other markets. Dr. AlKoteesh also provides a practical guide for US physicians interested in working abroad, covering the licensing timeline, tax-free income, and the high demand for Western-trained physicians. --- TIMESTAMPS 00:00 - Introduction01:39 - Building IR in UAE05:23 - UAE Healthcare System Overview07:54 - IR Residency and Staffing13:15 - Access to Latest Devices15:15 - Compensation and Lifestyle17:58 - PAIRS Conference Overview20:45 - Licensing and Relocation Guide21:39 - Liability and Language Barriers26:33 - Launching Stroke Interventions Have you ever considered taking a sabbatical to practice Interventional Radiology in the Middle East? In this episode, Dr. Jamal AlKoteesh, the Chairman of Clinical Imaging at SEHA and the "Godfather of IR" in the United Arab Emirates, joins host Dr. Sabeen Dhand to discuss the rapid evolution and current state of IR in the Gulf region.


---


SYNPOSIS


Dr. AlKoteesh shares his journey from training in the UK to establishing the IR specialty in Abu Dhabi over the last 18 years. He details the unique practice environment in UAE government hospitals, where the lack of strict sub-specialization requires IRs to maintain a versatile skillset—handling everything from thyroid FNAs and UFE to complex neurovascular thrombectomies.


The conversation highlights the significant government investment in healthcare technology, which allows physicians access to the latest tools—such as the Siemens Artis Icono with integrated RapidAI for stroke—often before they are widely available in other markets. Dr. AlKoteesh also provides a practical guide for US physicians interested in working abroad, covering the licensing timeline, tax-free income, and the high demand for Western-trained physicians.


---


TIMESTAMPS


00:00 - Introduction
01:39 - Building IR in UAE
05:23 - UAE Healthcare System Overview
07:54 - IR Residency and Staffing
13:15 - Access to Latest Devices
15:15 - Compensation and Lifestyle
17:58 - PAIRS Conference Overview
20:45 - Licensing and Relocation Guide
21:39 - Liability and Language Barriers
26:33 - Launching Stroke Interventions

]]> 2180 Ep. 609 Chronic Venous Disease Diagnosis & Management Strategies with Dr. Steven Abramowitz Tue, 20 Jan 2026 08:00:00 -0000 full BackTable 3094 Ep. 608 Interventional Radiology Global Survey: Training & Awareness with Dr. Justin Guan and Dr. Constantinos Sofocleous Patient access to interventional radiology services remains highly variable worldwide, reflecting global differences in training opportunities and infrastructure. Drawing on responses from more than 1,260 interventional radiologists worldwide, Dr. Justin Guan and Dr. Constantinos Sofocleous unpack the findings of a large international survey, highlighting where IR is advancing, where it remains fragmented, and what the data suggest about the future direction of the specialty. --- SYNPOSIS Key points of the episode involve the collaborative efforts put into this survey, how data was collected, and major findings from the respondents. These findings involve challenges with IR training, the significance of public awareness, and the need for standardized training programs. The discussion also covers the efforts required to promote IR globally, especially at global summits, and the potential steps to address these findings. Finally, the episode highlights the importance of developing region-specific programs and the ongoing efforts to elevate IR practices worldwide. --- TIMESTAMPS 00:00 - Introduction01:57 - Global IR Network and Survey Introduction10:30 - Survey Insights and Results19:26 - Challenges in IR Training and Awareness23:33 - Future Directions and Initiatives36:06 - Conclusion and Final Thoughts --- RESOURCES Results of a Global Survey on the State of Interventional Radiology 2024: https://pubmed.ncbi.nlm.nih.gov/39793699/ Fri, 16 Jan 2026 08:00:00 -0000 full BackTable Patient access to interventional radiology services remains highly variable worldwide, reflecting global differences in training opportunities and infrastructure. Drawing on responses from more than 1,260 interventional radiologists worldwide, Dr. Justin Guan and Dr. Constantinos Sofocleous unpack the findings of a large international survey, highlighting where IR is advancing, where it remains fragmented, and what the data suggest about the future direction of the specialty. --- SYNPOSIS Key points of the episode involve the collaborative efforts put into this survey, how data was collected, and major findings from the respondents. These findings involve challenges with IR training, the significance of public awareness, and the need for standardized training programs. The discussion also covers the efforts required to promote IR globally, especially at global summits, and the potential steps to address these findings. Finally, the episode highlights the importance of developing region-specific programs and the ongoing efforts to elevate IR practices worldwide. --- TIMESTAMPS 00:00 - Introduction01:57 - Global IR Network and Survey Introduction10:30 - Survey Insights and Results19:26 - Challenges in IR Training and Awareness23:33 - Future Directions and Initiatives36:06 - Conclusion and Final Thoughts --- RESOURCES Results of a Global Survey on the State of Interventional Radiology 2024: https://pubmed.ncbi.nlm.nih.gov/39793699/ Patient access to interventional radiology services remains highly variable worldwide, reflecting global differences in training opportunities and infrastructure. Drawing on responses from more than 1,260 interventional radiologists worldwide, Dr. Justin Guan and Dr. Constantinos Sofocleous unpack the findings of a large international survey, highlighting where IR is advancing, where it remains fragmented, and what the data suggest about the future direction of the specialty.


---


SYNPOSIS


Key points of the episode involve the collaborative efforts put into this survey, how data was collected, and major findings from the respondents. These findings involve challenges with IR training, the significance of public awareness, and the need for standardized training programs. The discussion also covers the efforts required to promote IR globally, especially at global summits, and the potential steps to address these findings. Finally, the episode highlights the importance of developing region-specific programs and the ongoing efforts to elevate IR practices worldwide.


---


TIMESTAMPS


00:00 - Introduction
01:57 - Global IR Network and Survey Introduction
10:30 - Survey Insights and Results
19:26 - Challenges in IR Training and Awareness
23:33 - Future Directions and Initiatives
36:06 - Conclusion and Final Thoughts


---


RESOURCES


Results of a Global Survey on the State of Interventional Radiology 2024: https://pubmed.ncbi.nlm.nih.gov/39793699/

]]> 2376 Ep. 607 Interventional Radiology Coding & Compliance Essentials with Dr. David Zielske Are you getting paid for the work you do? In this episode of the BackTable Podcast, interventional radiology coding expert Dr. David Zielske joins host Dr. Ally Baheti to share practical tips for billing and coding in interventional radiology, focusing on accurate, efficient, and compliant revenue capture. --- SYNPOSIS Dr. Zielske shares his path to becoming a coding expert, highlighting why precise documentation is essential to accurate medical billing. Drawing from personal experience, he breaks down the most common coding pitfalls physicians face and how to avoid them. He highlights the importance of early training in coding and billing during residency and fellowship, reviews key coding updates effective January 2026, and offers guidance on modifier usage. --- TIMESTAMPS 00:00 - Introduction01:34 - The Importance of Accurate Coding and Documentation04:03 - Common Coding Errors and Compliance Issues07:09 - Detailed Coding Guidelines and Best Practices26:20 - Modifiers and Their Proper Use33:53 - Interventional Radiology vs Diagnostic Radiology35:18 - Discussing ENM Billing and Procedural Focus35:45 - Commonly Missed Codes in Dialysis Circuit Interventions37:04 - Balloon Fibrin Sheath Disruption and Thrombectomy37:51 - Importance of Accurate Documentation for Vascular Access40:55 - Moderate Sedation and Ultrasound Guidance42:33 - Selective Imaging and Urinary Access Coding44:48 - Ablations and Biopsies: Guidance and Coding46:53 - Drainages and Intravascular Lithotripsy50:19 - 2026 Coding Changes and Physician Documentation01:00:29 - Resources and Education for Physicians Tue, 13 Jan 2026 08:00:00 -0000 full BackTable Are you getting paid for the work you do? In this episode of the BackTable Podcast, interventional radiology coding expert Dr. David Zielske joins host Dr. Ally Baheti to share practical tips for billing and coding in interventional radiology, focusing on accurate, efficient, and compliant revenue capture. --- SYNPOSIS Dr. Zielske shares his path to becoming a coding expert, highlighting why precise documentation is essential to accurate medical billing. Drawing from personal experience, he breaks down the most common coding pitfalls physicians face and how to avoid them. He highlights the importance of early training in coding and billing during residency and fellowship, reviews key coding updates effective January 2026, and offers guidance on modifier usage. --- TIMESTAMPS 00:00 - Introduction01:34 - The Importance of Accurate Coding and Documentation04:03 - Common Coding Errors and Compliance Issues07:09 - Detailed Coding Guidelines and Best Practices26:20 - Modifiers and Their Proper Use33:53 - Interventional Radiology vs Diagnostic Radiology35:18 - Discussing ENM Billing and Procedural Focus35:45 - Commonly Missed Codes in Dialysis Circuit Interventions37:04 - Balloon Fibrin Sheath Disruption and Thrombectomy37:51 - Importance of Accurate Documentation for Vascular Access40:55 - Moderate Sedation and Ultrasound Guidance42:33 - Selective Imaging and Urinary Access Coding44:48 - Ablations and Biopsies: Guidance and Coding46:53 - Drainages and Intravascular Lithotripsy50:19 - 2026 Coding Changes and Physician Documentation01:00:29 - Resources and Education for Physicians Are you getting paid for the work you do? In this episode of the BackTable Podcast, interventional radiology coding expert Dr. David Zielske joins host Dr. Ally Baheti to share practical tips for billing and coding in interventional radiology, focusing on accurate, efficient, and compliant revenue capture.


---


SYNPOSIS


Dr. Zielske shares his path to becoming a coding expert, highlighting why precise documentation is essential to accurate medical billing. Drawing from personal experience, he breaks down the most common coding pitfalls physicians face and how to avoid them. He highlights the importance of early training in coding and billing during residency and fellowship, reviews key coding updates effective January 2026, and offers guidance on modifier usage.


---


TIMESTAMPS


00:00 - Introduction
01:34 - The Importance of Accurate Coding and Documentation
04:03 - Common Coding Errors and Compliance Issues
07:09 - Detailed Coding Guidelines and Best Practices
26:20 - Modifiers and Their Proper Use
33:53 - Interventional Radiology vs Diagnostic Radiology
35:18 - Discussing ENM Billing and Procedural Focus
35:45 - Commonly Missed Codes in Dialysis Circuit Interventions
37:04 - Balloon Fibrin Sheath Disruption and Thrombectomy
37:51 - Importance of Accurate Documentation for Vascular Access
40:55 - Moderate Sedation and Ultrasound Guidance
42:33 - Selective Imaging and Urinary Access Coding
44:48 - Ablations and Biopsies: Guidance and Coding
46:53 - Drainages and Intravascular Lithotripsy
50:19 - 2026 Coding Changes and Physician Documentation
01:00:29 - Resources and Education for Physicians

]]> 3975 Ep. 606 Building a Case Video Library with Dr. Rusty Hofmann The modes and methods of medical education have changed drastically in the past decade. Social media, podcasts (like this one), and other on-demand learning formats have fundamentally shifted how healthcare professionals stay up to date and advance their practice. So what’s next? Dr. Rusty Hofmann, former chief of interventional radiology at Stanford, current Chief of Industry Partnerships for Stanford Healthcare, and Medical Director of Cardiac and Interventional Services at Stanford, joins host Dr. Aaron Fritts to discuss how he’s redefining the future of personalized learning. --- SYNPOSISDr. Hofmann shares an update on his company, Grand Rounds—now called Included Health—a personalized healthcare platform delivering virtual primary and specialty care to millions of Americans. Dr. Hofmann reflects on the journey behind Included Health and introduces his latest venture, Wysdom, a next-generation learning platform reimagining medical education through short, TikTok-style videos created by clinicians, for clinicians. He dives into the innovation of building a peer-reviewed, clinician-driven video library centered on real-world clinical cases. He discusses both the challenges and transformative potential of technology in medical education, spanning learners from trainees to seasoned clinicians. The episode concludes with his perspective on what’s next—and where the company is ultimately headed. --- TIMESTAMPS 00:00 - Introduction03:23 - Grand Rounds and Included Health05:29 - Challenges in Healthcare and Entrepreneurship12:28 - The Evolution of Medical Education16:37 - Creating and Sharing Medical Content20:52 - Curation and Organization of Medical Content27:41 - Morning Rounds: A Social Media Platform for Healthcare Professionals30:08 - Educational Content and Industry Collaboration35:08 - Creating Engaging and Practical Medical Videos40:55 - The Future of Medical Education48:18 - Final Thoughts and Reflections --- RESOURCES VI Episode 100https://www.backtable.com/shows/vi/podcasts/100/why-dr-rusty-hofmann-built-an-innovative-digital-health-company Wysdom Websitehttps://www.medicalwysdom.ai/home Sun, 11 Jan 2026 08:00:00 -0000 full BackTable The modes and methods of medical education have changed drastically in the past decade. Social media, podcasts (like this one), and other on-demand learning formats have fundamentally shifted how healthcare professionals stay up to date and advance their practice. So what’s next? Dr. Rusty Hofmann, former chief of interventional radiology at Stanford, current Chief of Industry Partnerships for Stanford Healthcare, and Medical Director of Cardiac and Interventional Services at Stanford, joins host Dr. Aaron Fritts to discuss how he’s redefining the future of personalized learning. --- SYNPOSISDr. Hofmann shares an update on his company, Grand Rounds—now called Included Health—a personalized healthcare platform delivering virtual primary and specialty care to millions of Americans. Dr. Hofmann reflects on the journey behind Included Health and introduces his latest venture, Wysdom, a next-generation learning platform reimagining medical education through short, TikTok-style videos created by clinicians, for clinicians. He dives into the innovation of building a peer-reviewed, clinician-driven video library centered on real-world clinical cases. He discusses both the challenges and transformative potential of technology in medical education, spanning learners from trainees to seasoned clinicians. The episode concludes with his perspective on what’s next—and where the company is ultimately headed. --- TIMESTAMPS 00:00 - Introduction03:23 - Grand Rounds and Included Health05:29 - Challenges in Healthcare and Entrepreneurship12:28 - The Evolution of Medical Education16:37 - Creating and Sharing Medical Content20:52 - Curation and Organization of Medical Content27:41 - Morning Rounds: A Social Media Platform for Healthcare Professionals30:08 - Educational Content and Industry Collaboration35:08 - Creating Engaging and Practical Medical Videos40:55 - The Future of Medical Education48:18 - Final Thoughts and Reflections --- RESOURCES VI Episode 100https://www.backtable.com/shows/vi/podcasts/100/why-dr-rusty-hofmann-built-an-innovative-digital-health-company Wysdom Websitehttps://www.medicalwysdom.ai/home The modes and methods of medical education have changed drastically in the past decade. Social media, podcasts (like this one), and other on-demand learning formats have fundamentally shifted how healthcare professionals stay up to date and advance their practice. So what’s next? Dr. Rusty Hofmann, former chief of interventional radiology at Stanford, current Chief of Industry Partnerships for Stanford Healthcare, and Medical Director of Cardiac and Interventional Services at Stanford, joins host Dr. Aaron Fritts to discuss how he’s redefining the future of personalized learning.


---


SYNPOSIS
Dr. Hofmann shares an update on his company, Grand Rounds—now called Included Health—a personalized healthcare platform delivering virtual primary and specialty care to millions of Americans. Dr. Hofmann reflects on the journey behind Included Health and introduces his latest venture, Wysdom, a next-generation learning platform reimagining medical education through short, TikTok-style videos created by clinicians, for clinicians. He dives into the innovation of building a peer-reviewed, clinician-driven video library centered on real-world clinical cases. He discusses both the challenges and transformative potential of technology in medical education, spanning learners from trainees to seasoned clinicians. The episode concludes with his perspective on what’s next—and where the company is ultimately headed.


---


TIMESTAMPS


00:00 - Introduction
03:23 - Grand Rounds and Included Health
05:29 - Challenges in Healthcare and Entrepreneurship
12:28 - The Evolution of Medical Education
16:37 - Creating and Sharing Medical Content
20:52 - Curation and Organization of Medical Content
27:41 - Morning Rounds: A Social Media Platform for Healthcare Professionals
30:08 - Educational Content and Industry Collaboration
35:08 - Creating Engaging and Practical Medical Videos
40:55 - The Future of Medical Education
48:18 - Final Thoughts and Reflections


---


RESOURCES


VI Episode 100
https://www.backtable.com/shows/vi/podcasts/100/why-dr-rusty-hofmann-built-an-innovative-digital-health-company

Wysdom Website
https://www.medicalwysdom.ai/home

]]> 3167 Ep. 605 Advanced Surgical Approaches in Lung Cancer Management with Dr. Scott Atay and Dr. Scott Oh Is the open thoracotomy becoming outdated as robotic surgery and advanced ablation techniques take center stage in lung cancer treatment? In the final discussion of the 2025 NSCLC Creator Weekend™ series, our virtual tumor board of interventional radiologists and pulmonologists from leading medical institutions discuss recent surgical and interventional advancements in the treatment of lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The conversation covers the contemporary role of PET scans, endobronchial ultrasound (EBUS), mediastinal staging, and the importance of perioperative systemic therapy. The doctors explore surgical and non-surgical methods for treating lung cancer, including lymph node dissection, criteria for resection, and the advantages of minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgeries.A key focus of this episode is the decision-making process for treating multifocal lung cancers while preserving lung function, and the use of combined therapies like ablation and radiation. The episode concludes with a detailed case study illustrating the long-term management of a patient with multiple lung adenocarcinomas over several years, highlighting the multidisciplinary approach required in such complex scenarios. --- TIMESTAMPS 00:00 - Introduction10:07 - Patient Selection and Comorbid Conditions27:29 - Surgical Margins and Resection Strategies42:11 - Understanding Upstaging in Cancer Treatment53:27 - Technical and Clinical Resectability56:13 - Case Study: Managing Multifocal Lung Cancer01:11:41 - Long-Term Outcomes and Treatment Strategies --- RESOURCES CALGB 140503 Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa2212083 JCOG0802 Trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02333-3/abstract Fri, 09 Jan 2026 08:00:00 -0000 full BackTable Is the open thoracotomy becoming outdated as robotic surgery and advanced ablation techniques take center stage in lung cancer treatment? In the final discussion of the 2025 NSCLC Creator Weekend™ series, our virtual tumor board of interventional radiologists and pulmonologists from leading medical institutions discuss recent surgical and interventional advancements in the treatment of lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The conversation covers the contemporary role of PET scans, endobronchial ultrasound (EBUS), mediastinal staging, and the importance of perioperative systemic therapy. The doctors explore surgical and non-surgical methods for treating lung cancer, including lymph node dissection, criteria for resection, and the advantages of minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgeries.A key focus of this episode is the decision-making process for treating multifocal lung cancers while preserving lung function, and the use of combined therapies like ablation and radiation. The episode concludes with a detailed case study illustrating the long-term management of a patient with multiple lung adenocarcinomas over several years, highlighting the multidisciplinary approach required in such complex scenarios. --- TIMESTAMPS 00:00 - Introduction10:07 - Patient Selection and Comorbid Conditions27:29 - Surgical Margins and Resection Strategies42:11 - Understanding Upstaging in Cancer Treatment53:27 - Technical and Clinical Resectability56:13 - Case Study: Managing Multifocal Lung Cancer01:11:41 - Long-Term Outcomes and Treatment Strategies --- RESOURCES CALGB 140503 Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa2212083 JCOG0802 Trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02333-3/abstract Is the open thoracotomy becoming outdated as robotic surgery and advanced ablation techniques take center stage in lung cancer treatment? In the final discussion of the 2025 NSCLC Creator Weekend™ series, our virtual tumor board of interventional radiologists and pulmonologists from leading medical institutions discuss recent surgical and interventional advancements in the treatment of lung cancer.


---


This podcast is supported by an educational grant from Johnson & Johnson and Varian.


---


SYNPOSIS


The conversation covers the contemporary role of PET scans, endobronchial ultrasound (EBUS), mediastinal staging, and the importance of perioperative systemic therapy. The doctors explore surgical and non-surgical methods for treating lung cancer, including lymph node dissection, criteria for resection, and the advantages of minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgeries.
A key focus of this episode is the decision-making process for treating multifocal lung cancers while preserving lung function, and the use of combined therapies like ablation and radiation. The episode concludes with a detailed case study illustrating the long-term management of a patient with multiple lung adenocarcinomas over several years, highlighting the multidisciplinary approach required in such complex scenarios.


---


TIMESTAMPS


00:00 - Introduction
10:07 - Patient Selection and Comorbid Conditions
27:29 - Surgical Margins and Resection Strategies
42:11 - Understanding Upstaging in Cancer Treatment
53:27 - Technical and Clinical Resectability
56:13 - Case Study: Managing Multifocal Lung Cancer
01:11:41 - Long-Term Outcomes and Treatment Strategies


---


RESOURCES


CALGB 140503 Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2212083


JCOG0802 Trial
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02333-3/abstract

]]> 4697 Ep. 604 Mythbusters: Provocative Mesenteric Angiography for GI Bleeds with Dr. Sabeen Dhand A negative angiogram in a patient with recurrent lower GI bleeding often calls for provocative angiography. In this episode of the BackTable Podcast, IR hosts Mike Barraza and Sabeen Dhand team up to talk tools, techniques, and tPA dosing for safe and effective treatment of lower GI bleeds with provocative mesenteric angiography.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISDr. Dhand describes the utility of provocative angiography in recurrent lower GI bleed patients with negative CTA and angiography, addressing common myths and concerns that may contribute to its underutilization. The conversation covers detailed procedure steps for both targeted and untargeted angiography, including access sites, dosing of tPA, and angiographic technique. Dr. Dhand emphasizes the importance of gradual increases in tPA dosage in 2 mg increments, and clear communication with care teams and the patient about the nature of the procedure. He also emphasizes the effectiveness and safety of this procedure by sharing real-world cases.---TIMESTAMPS00:00 - Introduction02:04 - Provocative Angiography for Lower GI Bleeds04:09 - Detailed Protocol for Provocative Angiography11:13 - Technical Details and Best Practices20:07 - Challenges in GI Bleeding Studies22:40 - Selective Embolization Techniques27:44 - Handling Negative Angiograms32:56 - Real-World Case Studies35:15 - Final Thoughts---RESOURCESThiry et al. Provocative Mesenteric Angiography: Outcomes and Standardized Protocol for Management of Recurrent Lower Gastrointestinal Hemorrhagehttps://pubmed.ncbi.nlm.nih.gov/34506023/ Tue, 06 Jan 2026 08:00:00 -0000 full BackTable A negative angiogram in a patient with recurrent lower GI bleeding often calls for provocative angiography. In this episode of the BackTable Podcast, IR hosts Mike Barraza and Sabeen Dhand team up to talk tools, techniques, and tPA dosing for safe and effective treatment of lower GI bleeds with provocative mesenteric angiography.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISDr. Dhand describes the utility of provocative angiography in recurrent lower GI bleed patients with negative CTA and angiography, addressing common myths and concerns that may contribute to its underutilization. The conversation covers detailed procedure steps for both targeted and untargeted angiography, including access sites, dosing of tPA, and angiographic technique. Dr. Dhand emphasizes the importance of gradual increases in tPA dosage in 2 mg increments, and clear communication with care teams and the patient about the nature of the procedure. He also emphasizes the effectiveness and safety of this procedure by sharing real-world cases.---TIMESTAMPS00:00 - Introduction02:04 - Provocative Angiography for Lower GI Bleeds04:09 - Detailed Protocol for Provocative Angiography11:13 - Technical Details and Best Practices20:07 - Challenges in GI Bleeding Studies22:40 - Selective Embolization Techniques27:44 - Handling Negative Angiograms32:56 - Real-World Case Studies35:15 - Final Thoughts---RESOURCESThiry et al. Provocative Mesenteric Angiography: Outcomes and Standardized Protocol for Management of Recurrent Lower Gastrointestinal Hemorrhagehttps://pubmed.ncbi.nlm.nih.gov/34506023/ A negative angiogram in a patient with recurrent lower GI bleeding often calls for provocative angiography. In this episode of the BackTable Podcast, IR hosts Mike Barraza and Sabeen Dhand team up to talk tools, techniques, and tPA dosing for safe and effective treatment of lower GI bleeds with provocative mesenteric angiography.
---
This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
---
SYNPOSIS
Dr. Dhand describes the utility of provocative angiography in recurrent lower GI bleed patients with negative CTA and angiography, addressing common myths and concerns that may contribute to its underutilization. The conversation covers detailed procedure steps for both targeted and untargeted angiography, including access sites, dosing of tPA, and angiographic technique. Dr. Dhand emphasizes the importance of gradual increases in tPA dosage in 2 mg increments, and clear communication with care teams and the patient about the nature of the procedure. He also emphasizes the effectiveness and safety of this procedure by sharing real-world cases.
---
TIMESTAMPS
00:00 - Introduction
02:04 - Provocative Angiography for Lower GI Bleeds
04:09 - Detailed Protocol for Provocative Angiography
11:13 - Technical Details and Best Practices
20:07 - Challenges in GI Bleeding Studies
22:40 - Selective Embolization Techniques
27:44 - Handling Negative Angiograms
32:56 - Real-World Case Studies
35:15 - Final Thoughts
---
RESOURCES
Thiry et al. Provocative Mesenteric Angiography: Outcomes and Standardized Protocol for Management of Recurrent Lower Gastrointestinal Hemorrhage
https://pubmed.ncbi.nlm.nih.gov/34506023/

]]> 2282 Ep. 603 Biopsy and Ablation Decision-Making in Lung Cancer with Dr. Alan Lee, Dr. Scott Oh, Dr. Rob Suh Why might simultaneous ablation and biopsy be the new standard for high-probability lung cancer cases where surgery isn’t an option? In the penultimate episode of the 2025 NSCLC Creator Weekend™ series, our multidisciplinary tumor board panel discusses the intricacies and decision-making processes surrounding biopsy and ablation procedures in thoracic oncology. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Topics include the prioritization of treatment versus tissue acquisition, the nuances of bronchoscopic versus percutaneous biopsies, and the latest advancements in robotic and cryo-biopsy techniques. The experts also share their approaches to managing pneumothorax, the value of multidisciplinary collaboration, and case studies that highlight personalized patient care. Listeners gain valuable insights into the evolving landscape of thoracic oncology procedures and the importance of patient-centered decision-making. --- TIMESTAMPS 00:00 - Introduction04:12 - Cryobiopy vs. Non-Cryobiopsy08:43 - Biopsy and Ablation: Strategies and Considerations15:31 - Post-Therapy Imaging and Follow-Up25:18 - Treatment Options and Patient Decisions27:08 - Evaluating Ablation Techniques28:59 - Managing Lung Cancer Recurrence39:41 - Case Study: Young Male with Ground Glass Nodule43:15 - Concluding Thoughts Fri, 02 Jan 2026 08:00:00 -0000 full BackTable Why might simultaneous ablation and biopsy be the new standard for high-probability lung cancer cases where surgery isn’t an option? In the penultimate episode of the 2025 NSCLC Creator Weekend™ series, our multidisciplinary tumor board panel discusses the intricacies and decision-making processes surrounding biopsy and ablation procedures in thoracic oncology. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Topics include the prioritization of treatment versus tissue acquisition, the nuances of bronchoscopic versus percutaneous biopsies, and the latest advancements in robotic and cryo-biopsy techniques. The experts also share their approaches to managing pneumothorax, the value of multidisciplinary collaboration, and case studies that highlight personalized patient care. Listeners gain valuable insights into the evolving landscape of thoracic oncology procedures and the importance of patient-centered decision-making. --- TIMESTAMPS 00:00 - Introduction04:12 - Cryobiopy vs. Non-Cryobiopsy08:43 - Biopsy and Ablation: Strategies and Considerations15:31 - Post-Therapy Imaging and Follow-Up25:18 - Treatment Options and Patient Decisions27:08 - Evaluating Ablation Techniques28:59 - Managing Lung Cancer Recurrence39:41 - Case Study: Young Male with Ground Glass Nodule43:15 - Concluding Thoughts Why might simultaneous ablation and biopsy be the new standard for high-probability lung cancer cases where surgery isn’t an option? In the penultimate episode of the 2025 NSCLC Creator Weekend™ series, our multidisciplinary tumor board panel discusses the intricacies and decision-making processes surrounding biopsy and ablation procedures in thoracic oncology.


---


This podcast is supported by an educational grant from Johnson & Johnson and Varian.


---


SYNPOSIS


Topics include the prioritization of treatment versus tissue acquisition, the nuances of bronchoscopic versus percutaneous biopsies, and the latest advancements in robotic and cryo-biopsy techniques. The experts also share their approaches to managing pneumothorax, the value of multidisciplinary collaboration, and case studies that highlight personalized patient care. Listeners gain valuable insights into the evolving landscape of thoracic oncology procedures and the importance of patient-centered decision-making.


---


TIMESTAMPS


00:00 - Introduction
04:12 - Cryobiopy vs. Non-Cryobiopsy
08:43 - Biopsy and Ablation: Strategies and Considerations
15:31 - Post-Therapy Imaging and Follow-Up
25:18 - Treatment Options and Patient Decisions
27:08 - Evaluating Ablation Techniques
28:59 - Managing Lung Cancer Recurrence
39:41 - Case Study: Young Male with Ground Glass Nodule
43:15 - Concluding Thoughts

]]> 2421 Ep. 602 Managing Neuroendocrine Tumors in Interventional Radiology with Dr. Daniel DePietro What considerations drive your decision between bland embolization, TACE, and radioembolization in managing neuroendocrine tumors? In this BackTable episode, Dr. Daniel DePietro, interventional radiologist at the University of Pennsylvania joins host Dr. Kavi Krishnasamy for an in-depth discussion on the interventional management of neuroendocrine tumors. --- SYNPOSIS The physicians start by discussing the intricacies of primary and metastatic neuroendocrine tumors, focusing on how treatment decisions are shaped by factors such as symptom burden, extent of disease requiring debulking, and symptom progression despite systemic therapy. Dr. DePietro shares insights from his clinical experience and emphasizes the critical role of interdisciplinary collaboration in optimizing patient outcomes. Dr. DePietro then shares his approach to using Y90 radioembolization in patients with biliary contraindications to TACE or bland embolization—such as those with prior Whipple surgery, sphincterotomy, or biliary stents—where the risk of hepatic abscess with ischemia-based therapies is higher. He also notes that patients who derive less than a year of benefit from prior TACE or bland embolization may be good candidates for radioembolization. The conversation also covers the role of thermal ablation in select patients with solitary lesions, and also touches on several key trials, including the ongoing CapTemY90 study. --- 00:00 - Introduction02:09 - Specialization in Neuroendocrine Tumors06:32 - Patient Selection and Treatment Criteria10:40 - Grading and Treatment of Neuroendocrine Tumors16:09 - Systemic Therapy Options22:22 - Rebiopsy and Its Importance28:01 - Technical Aspects of Local Regional Therapies39:14 - Radioembolization: When and How43:33 - Segmentectomy and Multimodal Approaches45:22 - CapTemY90 Trial and Promising Results49:52 - Hormone Release During Local Regional Therapies53:12 - Combining Radioembolization with PRT56:12 - Thermal Ablation in Neuroendocrine Tumor Patients58:06 - Follow-Up Imaging and Tumor Markers01:02:40 - Updates from Nanets Conference01:05:08 - Collaborating Across Specialties01:07:56 - Managing High Tumor Burden Patients01:13:59 - Treating Carcinoid Heart Disease01:19:37 - Closing Remarks and Acknowledgments --- RESOURCES NETTER-1 Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1607427 REMINET Trialhttps://ascopubs.org/doi/10.1200/JCO.2016.34.15_suppl.TPS4148 CapTemY90 Trialhttps://www.clinicaltrials.gov/study/NCT04339036#contacts-and-locations Tue, 30 Dec 2025 08:00:00 -0000 full BackTable What considerations drive your decision between bland embolization, TACE, and radioembolization in managing neuroendocrine tumors? In this BackTable episode, Dr. Daniel DePietro, interventional radiologist at the University of Pennsylvania joins host Dr. Kavi Krishnasamy for an in-depth discussion on the interventional management of neuroendocrine tumors. --- SYNPOSIS The physicians start by discussing the intricacies of primary and metastatic neuroendocrine tumors, focusing on how treatment decisions are shaped by factors such as symptom burden, extent of disease requiring debulking, and symptom progression despite systemic therapy. Dr. DePietro shares insights from his clinical experience and emphasizes the critical role of interdisciplinary collaboration in optimizing patient outcomes. Dr. DePietro then shares his approach to using Y90 radioembolization in patients with biliary contraindications to TACE or bland embolization—such as those with prior Whipple surgery, sphincterotomy, or biliary stents—where the risk of hepatic abscess with ischemia-based therapies is higher. He also notes that patients who derive less than a year of benefit from prior TACE or bland embolization may be good candidates for radioembolization. The conversation also covers the role of thermal ablation in select patients with solitary lesions, and also touches on several key trials, including the ongoing CapTemY90 study. --- 00:00 - Introduction02:09 - Specialization in Neuroendocrine Tumors06:32 - Patient Selection and Treatment Criteria10:40 - Grading and Treatment of Neuroendocrine Tumors16:09 - Systemic Therapy Options22:22 - Rebiopsy and Its Importance28:01 - Technical Aspects of Local Regional Therapies39:14 - Radioembolization: When and How43:33 - Segmentectomy and Multimodal Approaches45:22 - CapTemY90 Trial and Promising Results49:52 - Hormone Release During Local Regional Therapies53:12 - Combining Radioembolization with PRT56:12 - Thermal Ablation in Neuroendocrine Tumor Patients58:06 - Follow-Up Imaging and Tumor Markers01:02:40 - Updates from Nanets Conference01:05:08 - Collaborating Across Specialties01:07:56 - Managing High Tumor Burden Patients01:13:59 - Treating Carcinoid Heart Disease01:19:37 - Closing Remarks and Acknowledgments --- RESOURCES NETTER-1 Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1607427 REMINET Trialhttps://ascopubs.org/doi/10.1200/JCO.2016.34.15_suppl.TPS4148 CapTemY90 Trialhttps://www.clinicaltrials.gov/study/NCT04339036#contacts-and-locations What considerations drive your decision between bland embolization, TACE, and radioembolization in managing neuroendocrine tumors? In this BackTable episode, Dr. Daniel DePietro, interventional radiologist at the University of Pennsylvania joins host Dr. Kavi Krishnasamy for an in-depth discussion on the interventional management of neuroendocrine tumors.


---

SYNPOSIS

The physicians start by discussing the intricacies of primary and metastatic neuroendocrine tumors, focusing on how treatment decisions are shaped by factors such as symptom burden, extent of disease requiring debulking, and symptom progression despite systemic therapy. Dr. DePietro shares insights from his clinical experience and emphasizes the critical role of interdisciplinary collaboration in optimizing patient outcomes.

Dr. DePietro then shares his approach to using Y90 radioembolization in patients with biliary contraindications to TACE or bland embolization—such as those with prior Whipple surgery, sphincterotomy, or biliary stents—where the risk of hepatic abscess with ischemia-based therapies is higher. He also notes that patients who derive less than a year of benefit from prior TACE or bland embolization may be good candidates for radioembolization.

The conversation also covers the role of thermal ablation in select patients with solitary lesions, and also touches on several key trials, including the ongoing CapTemY90 study.

---




00:00 - Introduction
02:09 - Specialization in Neuroendocrine Tumors
06:32 - Patient Selection and Treatment Criteria
10:40 - Grading and Treatment of Neuroendocrine Tumors
16:09 - Systemic Therapy Options
22:22 - Rebiopsy and Its Importance
28:01 - Technical Aspects of Local Regional Therapies
39:14 - Radioembolization: When and How
43:33 - Segmentectomy and Multimodal Approaches
45:22 - CapTemY90 Trial and Promising Results
49:52 - Hormone Release During Local Regional Therapies
53:12 - Combining Radioembolization with PRT
56:12 - Thermal Ablation in Neuroendocrine Tumor Patients
58:06 - Follow-Up Imaging and Tumor Markers
01:02:40 - Updates from Nanets Conference
01:05:08 - Collaborating Across Specialties
01:07:56 - Managing High Tumor Burden Patients
01:13:59 - Treating Carcinoid Heart Disease
01:19:37 - Closing Remarks and Acknowledgments


---

RESOURCES

NETTER-1 Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1607427

REMINET Trial
https://ascopubs.org/doi/10.1200/JCO.2016.34.15_suppl.TPS4148

CapTemY90 Trial
https://www.clinicaltrials.gov/study/NCT04339036#contacts-and-locations

]]> 5004 Ep. 601 Revenue Cycle Management: Key Strategies for Healthcare Success with Laurie Bouzarelos MHA, CPC, FACHE The ultimate challenge of operating an OBL is staying profitable. In this episode of BackTable, we bring on healthcare administrator Laurie Bouzarelos and interventional radiologist Dr. Mary Costantino to talk through the intricacies of revenue cycle management as an IR managing an OBL. --- SYNPOSIS The conversation covers the full lifecycle of getting paid in an IR practice, from initial patient contact through final claim resolution. Key topics include credentialing, determining medical necessity, coordination of benefits, prior authorizations, and the importance of working with billing and practice management teams experienced in interventional radiology. The episode also examines how EHR and practice management platform selection impacts clinical workflows and reimbursement, and closes with a discussion on payment plans and how emerging technologies, including AI, may shape the future of revenue management in IR-led OBLs. --- TIMESTAMPS 00:00 - Introduction 01:08 - The Importance of Revenue Cycle Management09:29 - The No Surprises Act and Data Transparency12:03 - Professional Societies and Continuing Education17:50 - Credentialing and Taxonomy Codes40:28 - Impact of Insurance Credentialing on Patient Care42:08 - Revenue Cycle Management Walkthrough48:18 - Challenges with Medicare Advantage and Coordination of Benefits54:20 - Covered vs. Non-Covered Services59:03 - Medical Necessity and Insurance Policies01:01:04 - Prior Authorization and Payment Issues01:13:11 - Payment Plans and Compliance01:23:10 - Practice Management Software01:31:10 - AI in Healthcare and Compliance01:38:57 - Final Thoughts --- RESOURCES Medical Group Management Administration (MGMA)https://www.mgma.com/ Fri, 26 Dec 2025 08:00:00 -0000 full BackTable The ultimate challenge of operating an OBL is staying profitable. In this episode of BackTable, we bring on healthcare administrator Laurie Bouzarelos and interventional radiologist Dr. Mary Costantino to talk through the intricacies of revenue cycle management as an IR managing an OBL. --- SYNPOSIS The conversation covers the full lifecycle of getting paid in an IR practice, from initial patient contact through final claim resolution. Key topics include credentialing, determining medical necessity, coordination of benefits, prior authorizations, and the importance of working with billing and practice management teams experienced in interventional radiology. The episode also examines how EHR and practice management platform selection impacts clinical workflows and reimbursement, and closes with a discussion on payment plans and how emerging technologies, including AI, may shape the future of revenue management in IR-led OBLs. --- TIMESTAMPS 00:00 - Introduction 01:08 - The Importance of Revenue Cycle Management09:29 - The No Surprises Act and Data Transparency12:03 - Professional Societies and Continuing Education17:50 - Credentialing and Taxonomy Codes40:28 - Impact of Insurance Credentialing on Patient Care42:08 - Revenue Cycle Management Walkthrough48:18 - Challenges with Medicare Advantage and Coordination of Benefits54:20 - Covered vs. Non-Covered Services59:03 - Medical Necessity and Insurance Policies01:01:04 - Prior Authorization and Payment Issues01:13:11 - Payment Plans and Compliance01:23:10 - Practice Management Software01:31:10 - AI in Healthcare and Compliance01:38:57 - Final Thoughts --- RESOURCES Medical Group Management Administration (MGMA)https://www.mgma.com/ The ultimate challenge of operating an OBL is staying profitable. In this episode of BackTable, we bring on healthcare administrator Laurie Bouzarelos and interventional radiologist Dr. Mary Costantino to talk through the intricacies of revenue cycle management as an IR managing an OBL.


---

SYNPOSIS

The conversation covers the full lifecycle of getting paid in an IR practice, from initial patient contact through final claim resolution. Key topics include credentialing, determining medical necessity, coordination of benefits, prior authorizations, and the importance of working with billing and practice management teams experienced in interventional radiology. The episode also examines how EHR and practice management platform selection impacts clinical workflows and reimbursement, and closes with a discussion on payment plans and how emerging technologies, including AI, may shape the future of revenue management in IR-led OBLs.

---

TIMESTAMPS

00:00 - Introduction
01:08 - The Importance of Revenue Cycle Management
09:29 - The No Surprises Act and Data Transparency
12:03 - Professional Societies and Continuing Education
17:50 - Credentialing and Taxonomy Codes
40:28 - Impact of Insurance Credentialing on Patient Care
42:08 - Revenue Cycle Management Walkthrough
48:18 - Challenges with Medicare Advantage and Coordination of Benefits
54:20 - Covered vs. Non-Covered Services
59:03 - Medical Necessity and Insurance Policies
01:01:04 - Prior Authorization and Payment Issues
01:13:11 - Payment Plans and Compliance
01:23:10 - Practice Management Software
01:31:10 - AI in Healthcare and Compliance
01:38:57 - Final Thoughts

---

RESOURCES

Medical Group Management Administration (MGMA)
https://www.mgma.com/

]]> 6127 Ep. 600 Exploring Artificial Intelligence Utility in Endovascular Procedures with Dr. Emil Cohen OpenEvidence was founded in 2022. In just 3 short years, it has become a household name amongst aspiring and established healthcare providers. AI-based tools are now being used to augment workflows, improve productivity, streamline busy work, and assist with clinical decision making. Is AI coming for our jobs? Time will tell. But in the meantime, you can (and probably should) use it to enhance yours. In this episode of BackTable, computer scientist and interventional radiologist Dr. Emil Cohen joins Dr. Chris Beck to share how he’s integrated AI tools into his IR practice. --- SYNPOSIS Dr. Cohen and Dr. Beck discuss both the advantages and key limitations of AI resources and tools like OpenEvidence and ChatGPT. They also explore application of AI in daily workflows, structured reports, procedural guidance, and predicting outcomes. Dr. Cohen dives into integrating AI to solve clinical problems and enhance existing technology, such as maskless subtraction angiography and rotational cone beam CT. Finally, Dr. Cohen speaks on the claim of AI replacing interventional radiology, informing those that are nervous about artificial intelligence. --- TIMESTAMPS 00:00 - Introduction05:09 - Computer Science and Medicine09:37 - AI Fundamentals for IRs17:59 - Practical Applications of AI in IR28:14 - The Value and Risks of Patient Data31:22 - Developing Advanced Imaging Techniques34:16 - Maskless Subtraction Angiography40:29 - AI in Clinical Problem Solving45:55 - The Future of AI in IR49:51 - Getting Involved with AI and Volunteering53:01 - Final Thoughts and Resources --- RESOURCES No Mask Subtraction with AI:https://www.smartangio.com/bone_subtraction/ Tue, 23 Dec 2025 08:00:00 -0000 full BackTable OpenEvidence was founded in 2022. In just 3 short years, it has become a household name amongst aspiring and established healthcare providers. AI-based tools are now being used to augment workflows, improve productivity, streamline busy work, and assist with clinical decision making. Is AI coming for our jobs? Time will tell. But in the meantime, you can (and probably should) use it to enhance yours. In this episode of BackTable, computer scientist and interventional radiologist Dr. Emil Cohen joins Dr. Chris Beck to share how he’s integrated AI tools into his IR practice. --- SYNPOSIS Dr. Cohen and Dr. Beck discuss both the advantages and key limitations of AI resources and tools like OpenEvidence and ChatGPT. They also explore application of AI in daily workflows, structured reports, procedural guidance, and predicting outcomes. Dr. Cohen dives into integrating AI to solve clinical problems and enhance existing technology, such as maskless subtraction angiography and rotational cone beam CT. Finally, Dr. Cohen speaks on the claim of AI replacing interventional radiology, informing those that are nervous about artificial intelligence. --- TIMESTAMPS 00:00 - Introduction05:09 - Computer Science and Medicine09:37 - AI Fundamentals for IRs17:59 - Practical Applications of AI in IR28:14 - The Value and Risks of Patient Data31:22 - Developing Advanced Imaging Techniques34:16 - Maskless Subtraction Angiography40:29 - AI in Clinical Problem Solving45:55 - The Future of AI in IR49:51 - Getting Involved with AI and Volunteering53:01 - Final Thoughts and Resources --- RESOURCES No Mask Subtraction with AI:https://www.smartangio.com/bone_subtraction/ OpenEvidence was founded in 2022. In just 3 short years, it has become a household name amongst aspiring and established healthcare providers. AI-based tools are now being used to augment workflows, improve productivity, streamline busy work, and assist with clinical decision making. Is AI coming for our jobs? Time will tell. But in the meantime, you can (and probably should) use it to enhance yours. In this episode of BackTable, computer scientist and interventional radiologist Dr. Emil Cohen joins Dr. Chris Beck to share how he’s integrated AI tools into his IR practice.


---


SYNPOSIS


Dr. Cohen and Dr. Beck discuss both the advantages and key limitations of AI resources and tools like OpenEvidence and ChatGPT. They also explore application of AI in daily workflows, structured reports, procedural guidance, and predicting outcomes. Dr. Cohen dives into integrating AI to solve clinical problems and enhance existing technology, such as maskless subtraction angiography and rotational cone beam CT. Finally, Dr. Cohen speaks on the claim of AI replacing interventional radiology, informing those that are nervous about artificial intelligence.


---


TIMESTAMPS


00:00 - Introduction
05:09 - Computer Science and Medicine
09:37 - AI Fundamentals for IRs
17:59 - Practical Applications of AI in IR
28:14 - The Value and Risks of Patient Data
31:22 - Developing Advanced Imaging Techniques
34:16 - Maskless Subtraction Angiography
40:29 - AI in Clinical Problem Solving
45:55 - The Future of AI in IR
49:51 - Getting Involved with AI and Volunteering
53:01 - Final Thoughts and Resources


---


RESOURCES


No Mask Subtraction with AI:
https://www.smartangio.com/bone_subtraction/

]]> 3500 Ep. 599 Lung Ablation: Techniques, Challenges, & Best Practices with Dr. Alan Lee, Dr. Scott Oh, and Dr. Rob Suh Collaboration between interventional radiology and radiation oncology has enabled high-dose brachytherapy in central lung lesions that were previously untreatable. This episode of the 2025 NSCLC Creator Weekend™ series offers a deep dive into recent advancements in lung ablation and brachytherapy techniques for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Key discussion points include ablation zone sizes, confirmation methods for effective treatment, and the integration of different modalities such as microwave and cryoablation. Our tumor board panel also explores the practical and logistic challenges of implementing high-dose brachytherapy, especially for central lesions, and its role in palliative care. Despite the intricate processes and potential complications like pneumothorax, these methods show promising local control rates and provide crucial options for non-operative candidates. --- TIMESTAMPS 00:00 - Introduction and Overview of Lung Ablation07:01 - Microwave Ablation and Ground Glass Attenuation17:53 - Artificial Pneumothorax Techniques27:09 - Technical Aspects and Innovations32:35 - Bronchial Brachytherapy Techniques37:47 - Conclusion and Credits --- RESOURCES 2021 Central Lesion Studyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8186067/ Fri, 19 Dec 2025 08:00:00 -0000 full BackTable Collaboration between interventional radiology and radiation oncology has enabled high-dose brachytherapy in central lung lesions that were previously untreatable. This episode of the 2025 NSCLC Creator Weekend™ series offers a deep dive into recent advancements in lung ablation and brachytherapy techniques for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Key discussion points include ablation zone sizes, confirmation methods for effective treatment, and the integration of different modalities such as microwave and cryoablation. Our tumor board panel also explores the practical and logistic challenges of implementing high-dose brachytherapy, especially for central lesions, and its role in palliative care. Despite the intricate processes and potential complications like pneumothorax, these methods show promising local control rates and provide crucial options for non-operative candidates. --- TIMESTAMPS 00:00 - Introduction and Overview of Lung Ablation07:01 - Microwave Ablation and Ground Glass Attenuation17:53 - Artificial Pneumothorax Techniques27:09 - Technical Aspects and Innovations32:35 - Bronchial Brachytherapy Techniques37:47 - Conclusion and Credits --- RESOURCES 2021 Central Lesion Studyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8186067/ Collaboration between interventional radiology and radiation oncology has enabled high-dose brachytherapy in central lung lesions that were previously untreatable. This episode of the 2025 NSCLC Creator Weekend™ series offers a deep dive into recent advancements in lung ablation and brachytherapy techniques for primary lung cancer.


---


This podcast is supported by an educational grant from Johnson & Johnson and Varian.


---


SYNPOSIS


Key discussion points include ablation zone sizes, confirmation methods for effective treatment, and the integration of different modalities such as microwave and cryoablation. Our tumor board panel also explores the practical and logistic challenges of implementing high-dose brachytherapy, especially for central lesions, and its role in palliative care. Despite the intricate processes and potential complications like pneumothorax, these methods show promising local control rates and provide crucial options for non-operative candidates.


---


TIMESTAMPS


00:00 - Introduction and Overview of Lung Ablation
07:01 - Microwave Ablation and Ground Glass Attenuation
17:53 - Artificial Pneumothorax Techniques
27:09 - Technical Aspects and Innovations
32:35 - Bronchial Brachytherapy Techniques
37:47 - Conclusion and Credits


---


RESOURCES


2021 Central Lesion Study
https://pmc.ncbi.nlm.nih.gov/articles/PMC8186067/

]]> 2421 Ep. 598 Genicular Artery Embolization: Insights & Techniques with Dr. Rachel Piechowiak and Dr. Faraz Khan How is genicular artery embolization reshaping our clinical approach to patients with chronic knee pain? Dr. Rachel Piechowiak and Dr. Faraz Khan, interventional radiologists at IR Centers join Dr. Don Garbett in a deep dive into the current state of Genicular Artery Embolization (GAE). --- SYNPOSIS Dr. Piechowiak and Dr. Khan provide a deep dive on the technical nuances of GAE, covering patient selection, access strategies, and key procedural techniques. The conversation also details complex case scenarios and how to tailor catheters and embolics to navigate challenging anatomy. The doctors then share their structured approach to post-procedure follow-up, underscoring the importance of setting realistic treatment expectations with patients. The episode closes with their perspective on the future of genicular artery embolization, emphasizing the need for robust long-term outcomes data to better define the role of GAE in chronic knee pain management. --- TIMESTAMPS 00:00 - Introduction05:54 - Patient Workup for GAE10:42 - Setting Patient Expectations for GAE16:24 - Procedure Approaches and Techniques30:41 - Understanding Artery Targeting Strategies34:56 - Approaches to Microcatheter Selection38:18 - Choosing the Right Embolic Agents47:43 - Managing Complications and Follow-Ups51:23 - Challenges with Post-TKA Patients54:16 - Future Directions Tue, 16 Dec 2025 08:00:00 -0000 full BackTable How is genicular artery embolization reshaping our clinical approach to patients with chronic knee pain? Dr. Rachel Piechowiak and Dr. Faraz Khan, interventional radiologists at IR Centers join Dr. Don Garbett in a deep dive into the current state of Genicular Artery Embolization (GAE). --- SYNPOSIS Dr. Piechowiak and Dr. Khan provide a deep dive on the technical nuances of GAE, covering patient selection, access strategies, and key procedural techniques. The conversation also details complex case scenarios and how to tailor catheters and embolics to navigate challenging anatomy. The doctors then share their structured approach to post-procedure follow-up, underscoring the importance of setting realistic treatment expectations with patients. The episode closes with their perspective on the future of genicular artery embolization, emphasizing the need for robust long-term outcomes data to better define the role of GAE in chronic knee pain management. --- TIMESTAMPS 00:00 - Introduction05:54 - Patient Workup for GAE10:42 - Setting Patient Expectations for GAE16:24 - Procedure Approaches and Techniques30:41 - Understanding Artery Targeting Strategies34:56 - Approaches to Microcatheter Selection38:18 - Choosing the Right Embolic Agents47:43 - Managing Complications and Follow-Ups51:23 - Challenges with Post-TKA Patients54:16 - Future Directions How is genicular artery embolization reshaping our clinical approach to patients with chronic knee pain? Dr. Rachel Piechowiak and Dr. Faraz Khan, interventional radiologists at IR Centers join Dr. Don Garbett in a deep dive into the current state of Genicular Artery Embolization (GAE).


---


SYNPOSIS


Dr. Piechowiak and Dr. Khan provide a deep dive on the technical nuances of GAE, covering patient selection, access strategies, and key procedural techniques. The conversation also details complex case scenarios and how to tailor catheters and embolics to navigate challenging anatomy. The doctors then share their structured approach to post-procedure follow-up, underscoring the importance of setting realistic treatment expectations with patients. The episode closes with their perspective on the future of genicular artery embolization, emphasizing the need for robust long-term outcomes data to better define the role of GAE in chronic knee pain management.


---


TIMESTAMPS


00:00 - Introduction
05:54 - Patient Workup for GAE
10:42 - Setting Patient Expectations for GAE
16:24 - Procedure Approaches and Techniques
30:41 - Understanding Artery Targeting Strategies
34:56 - Approaches to Microcatheter Selection
38:18 - Choosing the Right Embolic Agents
47:43 - Managing Complications and Follow-Ups
51:23 - Challenges with Post-TKA Patients
54:16 - Future Directions

]]> 3500 Ep. 597 Ablative Treatments & Radiotherapy: The Latest in Lung Cancer Treatment with Dr. Alan Lee, Dr. Scott Oh, and Dr. Rob Suh Why might the standard RECIST criteria fail to accurately track success after tumor ablation, and what should you look for instead? In the 4th installment of the 2025 NSCLC Creator Weekend™ series, hosts Drs. Scott Genshaft and Kavi Krishnasamy are joined by specialists from UCLA and USC to discuss and debate advanced treatment options for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The panel, including interventional radiologists, pulmonologists, and a radiation oncologist, discusses the intricacies of photon versus proton therapies, the physics behind radiation treatment, and the evolving landscape of ablation technologies. The conversation covers the efficacy and limitations of different treatments, patient selection criteria, and the role of newer technologies like electroporation and robotic-assisted bronchoscopy in enhancing precision and outcomes. Additionally, the panel addresses the practical challenges of intraprocedural imaging, the importance of adequate margins, and the complexities of managing local recurrences and radiation-induced toxicities. --- TIMESTAMPS 00:00 - Tumor Ablation and Recurrence Rates12:53 - Advancements in Ablation Technologies23:31 - Bronchoscopic Approaches in Lung Cancer Treatment38:46 - Challenges in Radiation Dose and Delivery49:21 - Ablation and Radiation Margins01:07:19 - Final Thoughts --- RESOURCES Thierry de Baere Paper on Ablation Margins https://pmc.ncbi.nlm.nih.gov/articles/PMC9815739/ Fri, 12 Dec 2025 08:00:00 -0000 full BackTable Why might the standard RECIST criteria fail to accurately track success after tumor ablation, and what should you look for instead? In the 4th installment of the 2025 NSCLC Creator Weekend™ series, hosts Drs. Scott Genshaft and Kavi Krishnasamy are joined by specialists from UCLA and USC to discuss and debate advanced treatment options for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The panel, including interventional radiologists, pulmonologists, and a radiation oncologist, discusses the intricacies of photon versus proton therapies, the physics behind radiation treatment, and the evolving landscape of ablation technologies. The conversation covers the efficacy and limitations of different treatments, patient selection criteria, and the role of newer technologies like electroporation and robotic-assisted bronchoscopy in enhancing precision and outcomes. Additionally, the panel addresses the practical challenges of intraprocedural imaging, the importance of adequate margins, and the complexities of managing local recurrences and radiation-induced toxicities. --- TIMESTAMPS 00:00 - Tumor Ablation and Recurrence Rates12:53 - Advancements in Ablation Technologies23:31 - Bronchoscopic Approaches in Lung Cancer Treatment38:46 - Challenges in Radiation Dose and Delivery49:21 - Ablation and Radiation Margins01:07:19 - Final Thoughts --- RESOURCES Thierry de Baere Paper on Ablation Margins https://pmc.ncbi.nlm.nih.gov/articles/PMC9815739/ Why might the standard RECIST criteria fail to accurately track success after tumor ablation, and what should you look for instead? In the 4th installment of the 2025 NSCLC Creator Weekend™ series, hosts Drs. Scott Genshaft and Kavi Krishnasamy are joined by specialists from UCLA and USC to discuss and debate advanced treatment options for primary lung cancer.


---


This podcast is supported by an educational grant from Johnson & Johnson and Varian.


---


SYNPOSIS


The panel, including interventional radiologists, pulmonologists, and a radiation oncologist, discusses the intricacies of photon versus proton therapies, the physics behind radiation treatment, and the evolving landscape of ablation technologies. The conversation covers the efficacy and limitations of different treatments, patient selection criteria, and the role of newer technologies like electroporation and robotic-assisted bronchoscopy in enhancing precision and outcomes. Additionally, the panel addresses the practical challenges of intraprocedural imaging, the importance of adequate margins, and the complexities of managing local recurrences and radiation-induced toxicities.


---


TIMESTAMPS


00:00 - Tumor Ablation and Recurrence Rates
12:53 - Advancements in Ablation Technologies
23:31 - Bronchoscopic Approaches in Lung Cancer Treatment
38:46 - Challenges in Radiation Dose and Delivery
49:21 - Ablation and Radiation Margins
01:07:19 - Final Thoughts


---


RESOURCES


Thierry de Baere Paper on Ablation Margins https://pmc.ncbi.nlm.nih.gov/articles/PMC9815739/

]]> 4205 Ep. 596 Thrombin Injection for Pseudoaneurysms: Technique & Considerations with Dr. Gabriel Werder Pseudoaneurysms are among the most common complications of vascular access. Here’s a refresher on how to treat them with thrombin injection featuring interventional radiologist Dr. Gabriel Werder from Radiology Associates of Florida. Alongside host Dr. Chris Beck, Dr. Werder outlines both the clinical and procedural approach to thrombin injection for pseudoaneurysms. --- SYNPOSIS This episode covers best practices for thrombin injection procedures, including preferred needle positioning techniques, sedation protocols, ultrasound evaluation, and follow-up care. The physicians discuss recent evidence supporting needle placement at the center of the sac from an inferior approach, and share specific cases that highlight the utility of balloon-assisted thrombin injections. Dr. Werder provides a detailed walkthrough of his technique, including contralateral femoral access, balloon oversizing, and preferences for a post-procedural run-off angiogram. The episode also touches on complex pseudoaneurysms with multiple sacs and learnings from several other unique cases. --- TIMESTAMPS 00:00 - Introduction03:53 - Thrombin Injection Procedural Overview08:14 - Procedure Setup and Execution16:13 - Needle Positioning and Ultrasound Evaluation18:47 - Handling Complex Pseudoaneurysms19:20 - Balloon Occlusion Thrombin Injection19:59 - Case Studies and Practical Insights26:21 - Post-Procedure Care and Follow-Up29:17 - Final Thoughts and Reflections --- RESOURCES Kim et al. “Optimal thrombin injection method for the treatment of femoral artery pseudoaneurysm” - https://www.jthjournal.org/article/S1538-7836(24)00048-5/fulltext Tue, 09 Dec 2025 08:00:00 -0000 full BackTable Pseudoaneurysms are among the most common complications of vascular access. Here’s a refresher on how to treat them with thrombin injection featuring interventional radiologist Dr. Gabriel Werder from Radiology Associates of Florida. Alongside host Dr. Chris Beck, Dr. Werder outlines both the clinical and procedural approach to thrombin injection for pseudoaneurysms. --- SYNPOSIS This episode covers best practices for thrombin injection procedures, including preferred needle positioning techniques, sedation protocols, ultrasound evaluation, and follow-up care. The physicians discuss recent evidence supporting needle placement at the center of the sac from an inferior approach, and share specific cases that highlight the utility of balloon-assisted thrombin injections. Dr. Werder provides a detailed walkthrough of his technique, including contralateral femoral access, balloon oversizing, and preferences for a post-procedural run-off angiogram. The episode also touches on complex pseudoaneurysms with multiple sacs and learnings from several other unique cases. --- TIMESTAMPS 00:00 - Introduction03:53 - Thrombin Injection Procedural Overview08:14 - Procedure Setup and Execution16:13 - Needle Positioning and Ultrasound Evaluation18:47 - Handling Complex Pseudoaneurysms19:20 - Balloon Occlusion Thrombin Injection19:59 - Case Studies and Practical Insights26:21 - Post-Procedure Care and Follow-Up29:17 - Final Thoughts and Reflections --- RESOURCES Kim et al. “Optimal thrombin injection method for the treatment of femoral artery pseudoaneurysm” - https://www.jthjournal.org/article/S1538-7836(24)00048-5/fulltext Pseudoaneurysms are among the most common complications of vascular access. Here’s a refresher on how to treat them with thrombin injection featuring interventional radiologist Dr. Gabriel Werder from Radiology Associates of Florida. Alongside host Dr. Chris Beck, Dr. Werder outlines both the clinical and procedural approach to thrombin injection for pseudoaneurysms.


---


SYNPOSIS


This episode covers best practices for thrombin injection procedures, including preferred needle positioning techniques, sedation protocols, ultrasound evaluation, and follow-up care. The physicians discuss recent evidence supporting needle placement at the center of the sac from an inferior approach, and share specific cases that highlight the utility of balloon-assisted thrombin injections. Dr. Werder provides a detailed walkthrough of his technique, including contralateral femoral access, balloon oversizing, and preferences for a post-procedural run-off angiogram. The episode also touches on complex pseudoaneurysms with multiple sacs and learnings from several other unique cases.


---


TIMESTAMPS


00:00 - Introduction
03:53 - Thrombin Injection Procedural Overview
08:14 - Procedure Setup and Execution
16:13 - Needle Positioning and Ultrasound Evaluation
18:47 - Handling Complex Pseudoaneurysms
19:20 - Balloon Occlusion Thrombin Injection
19:59 - Case Studies and Practical Insights
26:21 - Post-Procedure Care and Follow-Up
29:17 - Final Thoughts and Reflections


---


RESOURCES


Kim et al. “Optimal thrombin injection method for the treatment of femoral artery pseudoaneurysm” - https://www.jthjournal.org/article/S1538-7836(24)00048-5/fulltext

]]> 2030 Ep. 595 Lung Cancer Staging and Systemic Therapies: Recent Advancements with Dr. Karen Reckamp and Dr. Scott Atay How do leading oncologists interpret the abundance of molecular tests, genomic data, and biomarkers to create a lung cancer patient’s treatment plan? In this episode of the 2025 NSCLC Creator Weekend™ series, our tumor board discusses the complexities of lung cancer treatment, including new systemic therapies, lung cancer staging, and the role of molecular diagnostics and liquid biopsies. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The panel, featuring specialists from various institutions, discusses the specifics of sequencing therapies, the impact of targeted and immunotherapies, and the nuances of treating different patient profiles, including non-smokers and those with specific genetic mutations. The conversation also touches on the integration of new staging systems, the benefits of multidisciplinary clinics, and the ongoing evolution of cancer treatment trials. The discussion aims to provide clarity on the latest advancements and future directions in managing lung cancer, emphasizing the importance of tailored treatment plans and the potential of emerging technologies. --- TIMESTAMPS 00:00 - Introduction05:16 - Molecular Diagnostics and Liquid Biopsy21:43 - Targeted Therapy Options27:29 - Managing Toxicities and Treatment Strategies33:13 - Challenges with Immunotherapy in Special Cases34:07 - Lung Transplantation in Cancer Patients48:38 - Multidisciplinary Clinics and Collaboration01:06:29 - Future Directions --- RESOURCES ADAURA Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa2027071 Gomez NSCLChttps://pmc.ncbi.nlm.nih.gov/articles/PMC5143183/ Fri, 05 Dec 2025 08:00:00 -0000 full BackTable How do leading oncologists interpret the abundance of molecular tests, genomic data, and biomarkers to create a lung cancer patient’s treatment plan? In this episode of the 2025 NSCLC Creator Weekend™ series, our tumor board discusses the complexities of lung cancer treatment, including new systemic therapies, lung cancer staging, and the role of molecular diagnostics and liquid biopsies. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The panel, featuring specialists from various institutions, discusses the specifics of sequencing therapies, the impact of targeted and immunotherapies, and the nuances of treating different patient profiles, including non-smokers and those with specific genetic mutations. The conversation also touches on the integration of new staging systems, the benefits of multidisciplinary clinics, and the ongoing evolution of cancer treatment trials. The discussion aims to provide clarity on the latest advancements and future directions in managing lung cancer, emphasizing the importance of tailored treatment plans and the potential of emerging technologies. --- TIMESTAMPS 00:00 - Introduction05:16 - Molecular Diagnostics and Liquid Biopsy21:43 - Targeted Therapy Options27:29 - Managing Toxicities and Treatment Strategies33:13 - Challenges with Immunotherapy in Special Cases34:07 - Lung Transplantation in Cancer Patients48:38 - Multidisciplinary Clinics and Collaboration01:06:29 - Future Directions --- RESOURCES ADAURA Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa2027071 Gomez NSCLChttps://pmc.ncbi.nlm.nih.gov/articles/PMC5143183/ How do leading oncologists interpret the abundance of molecular tests, genomic data, and biomarkers to create a lung cancer patient’s treatment plan? In this episode of the 2025 NSCLC Creator Weekend™ series, our tumor board discusses the complexities of lung cancer treatment, including new systemic therapies, lung cancer staging, and the role of molecular diagnostics and liquid biopsies.


---


This podcast is supported by an educational grant from Johnson & Johnson and Varian.


---


SYNPOSIS


The panel, featuring specialists from various institutions, discusses the specifics of sequencing therapies, the impact of targeted and immunotherapies, and the nuances of treating different patient profiles, including non-smokers and those with specific genetic mutations. The conversation also touches on the integration of new staging systems, the benefits of multidisciplinary clinics, and the ongoing evolution of cancer treatment trials. The discussion aims to provide clarity on the latest advancements and future directions in managing lung cancer, emphasizing the importance of tailored treatment plans and the potential of emerging technologies.


---


TIMESTAMPS


00:00 - Introduction
05:16 - Molecular Diagnostics and Liquid Biopsy
21:43 - Targeted Therapy Options
27:29 - Managing Toxicities and Treatment Strategies
33:13 - Challenges with Immunotherapy in Special Cases
34:07 - Lung Transplantation in Cancer Patients
48:38 - Multidisciplinary Clinics and Collaboration
01:06:29 - Future Directions


---


RESOURCES


ADAURA Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2027071


Gomez NSCLC
https://pmc.ncbi.nlm.nih.gov/articles/PMC5143183/

]]> 4171 Ep. 594 How New Guidelines are Shaping Acute DVT Management with Dr. Steven Abramowitz Are you up to date with the latest guidelines on deep venous thrombosis (DVT) management? Dr. Steven Abramowitz, vascular surgeon at MedStar Health, joins host Dr. Chris Beck for a deep dive into emerging clinical data in DVT management, where they review the evolving indications for mechanical thrombectomy and the implications of studies like the ATTRACT trial, the CLOUT registry, and the ongoing DEFIANCE trial. --- This podcast is supported by: Inari Medicalhttps://www.inarimedical.com/ --- SYNPOSIS Dr. Abramowitz reviews recent data comparing outcomes of mechanical intervention versus lytic-based therapy, outlining how each approach fits into current practice. He underscores the critical role of IVUS in determining treatment endpoints, while noting the ongoing challenge of an absent standardized definition. The conversation also offers practical insights on procedural techniques and the evolving role of anticoagulation, emphasizing the importance of close collaboration and open communication with referring physicians. --- TIMESTAMPS 00:00 - Introduction00:45 - Overview of DVT Management02:50 - New Guidelines for DVT Treatment07:30 - Technical Endpoints in DVT Treatment13:26 - Clout Registry and Its Findings17:57 - Anticoagulation and DVT23:05 - Defining Acute DVT Management27:00 - Evolving Approaches to Acute DVT28:19 - Patient Experience and Quality of Life31:08 - Referring Providers and Data Impact37:01 - Single Session Treatments and Stenting41:07 - Chronic Venous Disease Management --- RESOURCES (ATTRACT) Weinberg I, Vedantham S, Salter A, et al. Relationships between the use of pharmacomechanical catheter-directed thrombolysis, sonographic findings, and clinical outcomes in patients with acute proximal DVT: Results from the ATTRACT Multicenter Randomized Trial. Vasc Med. 2019;24(5):442-451. doi:10.1177/1358863X19862043https://pubmed.ncbi.nlm.nih.gov/31354089/ (CLOUT) Shaikh A, Zybulewski A, Paulisin J, et al. Six-Month Outcomes of Mechanical Thrombectomy for Treating Deep Vein Thrombosis: Analysis from the 500-Patient CLOUT Registry. Cardiovasc Intervent Radiol. 2023;46(11):1571-1580. doi:10.1007/s00270-023-03509-8https://pubmed.ncbi.nlm.nih.gov/37580422/ (DEFIANCE) Abramowitz SD, Marko X, D'Souza D, et al. Rationale and design of the DEFIANCE study: A randomized controlled trial of mechanical thrombectomy versus anticoagulation alone for iliofemoral deep vein thrombosis. Am Heart J. 2025;281:92-102. doi:10.1016/j.ahj.2024.10.016https://pubmed.ncbi.nlm.nih.gov/39491572/ Tue, 02 Dec 2025 08:00:00 -0000 full BackTable Are you up to date with the latest guidelines on deep venous thrombosis (DVT) management? Dr. Steven Abramowitz, vascular surgeon at MedStar Health, joins host Dr. Chris Beck for a deep dive into emerging clinical data in DVT management, where they review the evolving indications for mechanical thrombectomy and the implications of studies like the ATTRACT trial, the CLOUT registry, and the ongoing DEFIANCE trial. --- This podcast is supported by: Inari Medicalhttps://www.inarimedical.com/ --- SYNPOSIS Dr. Abramowitz reviews recent data comparing outcomes of mechanical intervention versus lytic-based therapy, outlining how each approach fits into current practice. He underscores the critical role of IVUS in determining treatment endpoints, while noting the ongoing challenge of an absent standardized definition. The conversation also offers practical insights on procedural techniques and the evolving role of anticoagulation, emphasizing the importance of close collaboration and open communication with referring physicians. --- TIMESTAMPS 00:00 - Introduction00:45 - Overview of DVT Management02:50 - New Guidelines for DVT Treatment07:30 - Technical Endpoints in DVT Treatment13:26 - Clout Registry and Its Findings17:57 - Anticoagulation and DVT23:05 - Defining Acute DVT Management27:00 - Evolving Approaches to Acute DVT28:19 - Patient Experience and Quality of Life31:08 - Referring Providers and Data Impact37:01 - Single Session Treatments and Stenting41:07 - Chronic Venous Disease Management --- RESOURCES (ATTRACT) Weinberg I, Vedantham S, Salter A, et al. Relationships between the use of pharmacomechanical catheter-directed thrombolysis, sonographic findings, and clinical outcomes in patients with acute proximal DVT: Results from the ATTRACT Multicenter Randomized Trial. Vasc Med. 2019;24(5):442-451. doi:10.1177/1358863X19862043https://pubmed.ncbi.nlm.nih.gov/31354089/ (CLOUT) Shaikh A, Zybulewski A, Paulisin J, et al. Six-Month Outcomes of Mechanical Thrombectomy for Treating Deep Vein Thrombosis: Analysis from the 500-Patient CLOUT Registry. Cardiovasc Intervent Radiol. 2023;46(11):1571-1580. doi:10.1007/s00270-023-03509-8https://pubmed.ncbi.nlm.nih.gov/37580422/ (DEFIANCE) Abramowitz SD, Marko X, D'Souza D, et al. Rationale and design of the DEFIANCE study: A randomized controlled trial of mechanical thrombectomy versus anticoagulation alone for iliofemoral deep vein thrombosis. Am Heart J. 2025;281:92-102. doi:10.1016/j.ahj.2024.10.016https://pubmed.ncbi.nlm.nih.gov/39491572/ Are you up to date with the latest guidelines on deep venous thrombosis (DVT) management? Dr. Steven Abramowitz, vascular surgeon at MedStar Health, joins host Dr. Chris Beck for a deep dive into emerging clinical data in DVT management, where they review the evolving indications for mechanical thrombectomy and the implications of studies like the ATTRACT trial, the CLOUT registry, and the ongoing DEFIANCE trial.


---


This podcast is supported by:


Inari Medical
https://www.inarimedical.com/


---


SYNPOSIS


Dr. Abramowitz reviews recent data comparing outcomes of mechanical intervention versus lytic-based therapy, outlining how each approach fits into current practice. He underscores the critical role of IVUS in determining treatment endpoints, while noting the ongoing challenge of an absent standardized definition. The conversation also offers practical insights on procedural techniques and the evolving role of anticoagulation, emphasizing the importance of close collaboration and open communication with referring physicians.


---


TIMESTAMPS


00:00 - Introduction
00:45 - Overview of DVT Management
02:50 - New Guidelines for DVT Treatment
07:30 - Technical Endpoints in DVT Treatment
13:26 - Clout Registry and Its Findings
17:57 - Anticoagulation and DVT
23:05 - Defining Acute DVT Management
27:00 - Evolving Approaches to Acute DVT
28:19 - Patient Experience and Quality of Life
31:08 - Referring Providers and Data Impact
37:01 - Single Session Treatments and Stenting
41:07 - Chronic Venous Disease Management


---


RESOURCES


(ATTRACT) Weinberg I, Vedantham S, Salter A, et al. Relationships between the use of pharmacomechanical catheter-directed thrombolysis, sonographic findings, and clinical outcomes in patients with acute proximal DVT: Results from the ATTRACT Multicenter Randomized Trial. Vasc Med. 2019;24(5):442-451. doi:10.1177/1358863X19862043
https://pubmed.ncbi.nlm.nih.gov/31354089/

(CLOUT) Shaikh A, Zybulewski A, Paulisin J, et al. Six-Month Outcomes of Mechanical Thrombectomy for Treating Deep Vein Thrombosis: Analysis from the 500-Patient CLOUT Registry. Cardiovasc Intervent Radiol. 2023;46(11):1571-1580. doi:10.1007/s00270-023-03509-8
https://pubmed.ncbi.nlm.nih.gov/37580422/

(DEFIANCE) Abramowitz SD, Marko X, D'Souza D, et al. Rationale and design of the DEFIANCE study: A randomized controlled trial of mechanical thrombectomy versus anticoagulation alone for iliofemoral deep vein thrombosis. Am Heart J. 2025;281:92-102. doi:10.1016/j.ahj.2024.10.016
https://pubmed.ncbi.nlm.nih.gov/39491572/

]]> 2864 Ep. 593 Evaluating IR Programs: A Residency Applicant's Guide with Dr. Neil Jain What should you know before applying to an interventional radiology residency program? Get 70 minutes of free advice in this week's episode of BackTable featuring Georgetown IR fellow Dr. Neil Jain and host Dr. Chris Beck, covering everything from building your IR resume to crushing your interviews. SYNPOSIS The conversation starts by covering the essential steps that medical students can take to build their resume prior to the application cycle, including involvement in the medical student sections of SIR, CIRSE, and local symposiums. Dr. Jain highlights the importance of mentorship and research, strategies for obtaining strong letters of recommendation, and effectively navigating both home and away rotations. The discussion also extends to interview preparation, program selection, signaling updates, and the rank list construction. The episode also touches on the SOAP process for unmatched applicants and the avenues to secure a match. Importantly, Dr. Jain emphasizes the significance of fit over prestige and finding a program that aligns with your values and professional goals. --- TIMESTAMPS 00:00 - Introduction03:07 - Building Your Resume for IR10:43 - Away Rotations and Letters of Recommendation 23:54 - Personal Statements: Importance and Tips30:07 - Application Strategies: IR and DR Programs41:48 - Utilizing Signaling in the Application Process44:19 - Evaluating Programs During Interviews49:58 - Letters of Interest and Intent54:33 - The Interview Day Experience01:04:47 - Building Your Rank List01:08:56 - The SOAP Process01:12:50 - Final Advice and Closing Remarks --- RESOURCES 2025 NRMP Match Data https://www.nrmp.org/wp-content/uploads/2025/03/Advance_Data_Tables_2025.pdfSociety of Interventional Radiology Trainee Websitehttps://www.sirweb.org/in-training/ VI 372 - IR Pathways Unveiled: Matching, Training & Beyond https://www.backtable.com/shows/vi/podcasts/372/ir-pathways-unveiled-matching-training-beyond VI 554: Optimizing the IR/DR Curriculum & Experiencehttps://www.backtable.com/shows/vi/podcasts/554/optimizing-the-ir-dr-curriculum-experience Fri, 28 Nov 2025 08:00:00 -0000 full BackTable What should you know before applying to an interventional radiology residency program? Get 70 minutes of free advice in this week's episode of BackTable featuring Georgetown IR fellow Dr. Neil Jain and host Dr. Chris Beck, covering everything from building your IR resume to crushing your interviews. SYNPOSIS The conversation starts by covering the essential steps that medical students can take to build their resume prior to the application cycle, including involvement in the medical student sections of SIR, CIRSE, and local symposiums. Dr. Jain highlights the importance of mentorship and research, strategies for obtaining strong letters of recommendation, and effectively navigating both home and away rotations. The discussion also extends to interview preparation, program selection, signaling updates, and the rank list construction. The episode also touches on the SOAP process for unmatched applicants and the avenues to secure a match. Importantly, Dr. Jain emphasizes the significance of fit over prestige and finding a program that aligns with your values and professional goals. --- TIMESTAMPS 00:00 - Introduction03:07 - Building Your Resume for IR10:43 - Away Rotations and Letters of Recommendation 23:54 - Personal Statements: Importance and Tips30:07 - Application Strategies: IR and DR Programs41:48 - Utilizing Signaling in the Application Process44:19 - Evaluating Programs During Interviews49:58 - Letters of Interest and Intent54:33 - The Interview Day Experience01:04:47 - Building Your Rank List01:08:56 - The SOAP Process01:12:50 - Final Advice and Closing Remarks --- RESOURCES 2025 NRMP Match Data https://www.nrmp.org/wp-content/uploads/2025/03/Advance_Data_Tables_2025.pdfSociety of Interventional Radiology Trainee Websitehttps://www.sirweb.org/in-training/ VI 372 - IR Pathways Unveiled: Matching, Training & Beyond https://www.backtable.com/shows/vi/podcasts/372/ir-pathways-unveiled-matching-training-beyond VI 554: Optimizing the IR/DR Curriculum & Experiencehttps://www.backtable.com/shows/vi/podcasts/554/optimizing-the-ir-dr-curriculum-experience What should you know before applying to an interventional radiology residency program? Get 70 minutes of free advice in this week's episode of BackTable featuring Georgetown IR fellow Dr. Neil Jain and host Dr. Chris Beck, covering everything from building your IR resume to crushing your interviews.




SYNPOSIS


The conversation starts by covering the essential steps that medical students can take to build their resume prior to the application cycle, including involvement in the medical student sections of SIR, CIRSE, and local symposiums. Dr. Jain highlights the importance of mentorship and research, strategies for obtaining strong letters of recommendation, and effectively navigating both home and away rotations. The discussion also extends to interview preparation, program selection, signaling updates, and the rank list construction. The episode also touches on the SOAP process for unmatched applicants and the avenues to secure a match. Importantly, Dr. Jain emphasizes the significance of fit over prestige and finding a program that aligns with your values and professional goals.


---


TIMESTAMPS


00:00 - Introduction
03:07 - Building Your Resume for IR
10:43 - Away Rotations and Letters of Recommendation
23:54 - Personal Statements: Importance and Tips
30:07 - Application Strategies: IR and DR Programs
41:48 - Utilizing Signaling in the Application Process
44:19 - Evaluating Programs During Interviews
49:58 - Letters of Interest and Intent
54:33 - The Interview Day Experience
01:04:47 - Building Your Rank List
01:08:56 - The SOAP Process
01:12:50 - Final Advice and Closing Remarks


---


RESOURCES


2025 NRMP Match Data

https://www.nrmp.org/wp-content/uploads/2025/03/Advance_Data_Tables_2025.pdf
Society of Interventional Radiology Trainee Website
https://www.sirweb.org/in-training/


VI 372 - IR Pathways Unveiled: Matching, Training & Beyond https://www.backtable.com/shows/vi/podcasts/372/ir-pathways-unveiled-matching-training-beyond


VI 554: Optimizing the IR/DR Curriculum & Experience
https://www.backtable.com/shows/vi/podcasts/554/optimizing-the-ir-dr-curriculum-experience

]]> 4608 Ep. 592 Comparing Thermal Ablation Techniques for Liver Lesions with Dr. Jason Hoffmann With the range of interventional modalities that are available for metastatic liver tumors, when should you advocate for thermal ablation at the tumor board? In this episode of BackTable, host Dr. Sabeen Dhand welcomes back Dr. Jason Hoffman, an interventional radiologist from New York University, to discuss tools, techniques, and multidisciplinary collaboration around microwave ablation for liver metastases. --- This podcast is supported by: Varian https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS The physicians discuss benefits and advancements in microwave ablation, the decision-making process behind using microwave ablation for metastatic liver disease, and strategies for advocating for this technology in tumor boards. Dr. Hoffman especially emphasizes the value of educating patients about their options and using thoughtful clinical judgement as an IR. The conversation also covers the utility of software guidance, system fusion with CT machines, temperature monitoring, and the ability to achieve a more spherical ablation zone. --- TIMESTAMPS 00:00 - Introduction04:39 - Practice Growth11:10 - Microwave Ablation Technology12:43 - Multidisciplinary Approach to Liver Metastases26:48 - Microwave Technology and Probe Placement28:42 - Guidance Software and Technological Integration30:40 - Planning and Intraoperative Decisions40:28 - Future of Microwave Ablation48:35 - Conclusion and Final Thoughts Tue, 25 Nov 2025 08:00:00 -0000 full BackTable With the range of interventional modalities that are available for metastatic liver tumors, when should you advocate for thermal ablation at the tumor board? In this episode of BackTable, host Dr. Sabeen Dhand welcomes back Dr. Jason Hoffman, an interventional radiologist from New York University, to discuss tools, techniques, and multidisciplinary collaboration around microwave ablation for liver metastases. --- This podcast is supported by: Varian https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS The physicians discuss benefits and advancements in microwave ablation, the decision-making process behind using microwave ablation for metastatic liver disease, and strategies for advocating for this technology in tumor boards. Dr. Hoffman especially emphasizes the value of educating patients about their options and using thoughtful clinical judgement as an IR. The conversation also covers the utility of software guidance, system fusion with CT machines, temperature monitoring, and the ability to achieve a more spherical ablation zone. --- TIMESTAMPS 00:00 - Introduction04:39 - Practice Growth11:10 - Microwave Ablation Technology12:43 - Multidisciplinary Approach to Liver Metastases26:48 - Microwave Technology and Probe Placement28:42 - Guidance Software and Technological Integration30:40 - Planning and Intraoperative Decisions40:28 - Future of Microwave Ablation48:35 - Conclusion and Final Thoughts With the range of interventional modalities that are available for metastatic liver tumors, when should you advocate for thermal ablation at the tumor board? In this episode of BackTable, host Dr. Sabeen Dhand welcomes back Dr. Jason Hoffman, an interventional radiologist from New York University, to discuss tools, techniques, and multidisciplinary collaboration around microwave ablation for liver metastases.


---


This podcast is supported by:


Varian

https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions


---


SYNPOSIS


The physicians discuss benefits and advancements in microwave ablation, the decision-making process behind using microwave ablation for metastatic liver disease, and strategies for advocating for this technology in tumor boards. Dr. Hoffman especially emphasizes the value of educating patients about their options and using thoughtful clinical judgement as an IR. The conversation also covers the utility of software guidance, system fusion with CT machines, temperature monitoring, and the ability to achieve a more spherical ablation zone.


---


TIMESTAMPS


00:00 - Introduction
04:39 - Practice Growth
11:10 - Microwave Ablation Technology
12:43 - Multidisciplinary Approach to Liver Metastases
26:48 - Microwave Technology and Probe Placement
28:42 - Guidance Software and Technological Integration
30:40 - Planning and Intraoperative Decisions
40:28 - Future of Microwave Ablation
48:35 - Conclusion and Final Thoughts

]]> 3207 Ep. 591 NSCLC Tumor Board Discussion: Considerations for Oligometastatic Disease with Dr. Karen Reckamp, Dr. Scott Atay, Dr. Scott Oh and Dr. Alan Lee When cancer spreads to the brain, what is the best approach: immediate local treatment or systemic immunotherapy first? Part two of the 2025 NSCLC Creator Weekend™ series focuses on a complex case involving a 75-year-old woman with a history of breast malignancy, presenting with new dyspnea and a large mass in the left lower lobe. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Our mock tumor board consists of surgeons, medical oncologists, and radiation oncologists to deliberate and determine the best treatment plan. The specialists explore diagnostic and treatment options, including neoadjuvant chemoimmunotherapy, invasive mediastinal staging, and the potential for surgical resection or radiation therapy. --- TIMESTAMPS 00:00 - Introduction05:01 - Approach to Isolated Brain Metastasis09:09 - Radiation Therapy Considerations12:06 - Imaging and Follow-Up Strategies14:39 - Resectability and Surgical Decisions19:10 - Conclusion --- RESOURCES PACIFIC Clinical Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1709937 Fri, 21 Nov 2025 08:00:00 -0000 full BackTable When cancer spreads to the brain, what is the best approach: immediate local treatment or systemic immunotherapy first? Part two of the 2025 NSCLC Creator Weekend™ series focuses on a complex case involving a 75-year-old woman with a history of breast malignancy, presenting with new dyspnea and a large mass in the left lower lobe. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Our mock tumor board consists of surgeons, medical oncologists, and radiation oncologists to deliberate and determine the best treatment plan. The specialists explore diagnostic and treatment options, including neoadjuvant chemoimmunotherapy, invasive mediastinal staging, and the potential for surgical resection or radiation therapy. --- TIMESTAMPS 00:00 - Introduction05:01 - Approach to Isolated Brain Metastasis09:09 - Radiation Therapy Considerations12:06 - Imaging and Follow-Up Strategies14:39 - Resectability and Surgical Decisions19:10 - Conclusion --- RESOURCES PACIFIC Clinical Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1709937 When cancer spreads to the brain, what is the best approach: immediate local treatment or systemic immunotherapy first? Part two of the 2025 NSCLC Creator Weekend™ series focuses on a complex case involving a 75-year-old woman with a history of breast malignancy, presenting with new dyspnea and a large mass in the left lower lobe.


---


This podcast is supported by an educational grant from Johnson & Johnson and Varian.


---


SYNPOSIS


Our mock tumor board consists of surgeons, medical oncologists, and radiation oncologists to deliberate and determine the best treatment plan. The specialists explore diagnostic and treatment options, including neoadjuvant chemoimmunotherapy, invasive mediastinal staging, and the potential for surgical resection or radiation therapy.


---


TIMESTAMPS


00:00 - Introduction
05:01 - Approach to Isolated Brain Metastasis
09:09 - Radiation Therapy Considerations
12:06 - Imaging and Follow-Up Strategies
14:39 - Resectability and Surgical Decisions
19:10 - Conclusion


---


RESOURCES


PACIFIC Clinical Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1709937

]]> 1303 Ep. 590 Deep Venous Arterialization: Techniques & Outcomes with Dr. Miguel Montero Baker and Dr. Lucas M Ferrer Cardona When conventional revascularization fails, can deep venous arterialization offer a new lifeline to limb salvage? Dr. Lucas Ferrer Cardona, vascular surgeon at Ascension and Dr. Miguel Montero Baker, vascular surgeon and medical director at HOPE Clinical Innovation Center join host Dr. Sabeen Dhand for an insightful discussion on deep venous arterialization (DVA). --- This podcast is supported by: RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS The doctors discuss the progression of deep venous arterialization, highlighting the benefits of open, endovascular, and hybrid approaches. They draw on their personal experiences to share key technical nuances and explore new devices such as the Aveera Boomerang device. They emphasize the critical role of patient selection, family support, and close postoperative surveillance, including weekly wound assessments and monthly ultrasound evaluations. Although currently FDA-approved for no-option chronic limb-threatening ischemia (CLTI), Dr. Baker notes that deep venous arterialization may hold promise even for patients earlier in the disease course.The episode concludes by exploring future directions for deep venous arterialization, highlighting the ongoing need for research to advance limb preservation. --- TIMESTAMPS 00:00 - Introduction03:15 - The Inspiration Behind Their Podcast10:05 - Challenges and Success Stories in Vascular Surgery10:29 - Exploring Deep Venous Arterialization (DVA)25:16 - Hybrid Approaches and Patient Outcomes32:06 - Evolution of Endovascular Techniques37:33 - Patient Selection and Criteria38:52 - Understanding the Biology of Procedures43:57 - Exploring New Techniques and Devices58:52 - Challenges and Considerations01:01:51 - Final Thoughts --- RESOURCES Hybrid superficial venous arterialization and endovascular deep venous arterializationhttps://pubmed.ncbi.nlm.nih.gov/37404577/ Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemiahttps://www.nejm.org/doi/full/10.1056/NEJMoa2212754 Tue, 18 Nov 2025 08:00:00 -0000 full BackTable When conventional revascularization fails, can deep venous arterialization offer a new lifeline to limb salvage? Dr. Lucas Ferrer Cardona, vascular surgeon at Ascension and Dr. Miguel Montero Baker, vascular surgeon and medical director at HOPE Clinical Innovation Center join host Dr. Sabeen Dhand for an insightful discussion on deep venous arterialization (DVA). --- This podcast is supported by: RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS The doctors discuss the progression of deep venous arterialization, highlighting the benefits of open, endovascular, and hybrid approaches. They draw on their personal experiences to share key technical nuances and explore new devices such as the Aveera Boomerang device. They emphasize the critical role of patient selection, family support, and close postoperative surveillance, including weekly wound assessments and monthly ultrasound evaluations. Although currently FDA-approved for no-option chronic limb-threatening ischemia (CLTI), Dr. Baker notes that deep venous arterialization may hold promise even for patients earlier in the disease course.The episode concludes by exploring future directions for deep venous arterialization, highlighting the ongoing need for research to advance limb preservation. --- TIMESTAMPS 00:00 - Introduction03:15 - The Inspiration Behind Their Podcast10:05 - Challenges and Success Stories in Vascular Surgery10:29 - Exploring Deep Venous Arterialization (DVA)25:16 - Hybrid Approaches and Patient Outcomes32:06 - Evolution of Endovascular Techniques37:33 - Patient Selection and Criteria38:52 - Understanding the Biology of Procedures43:57 - Exploring New Techniques and Devices58:52 - Challenges and Considerations01:01:51 - Final Thoughts --- RESOURCES Hybrid superficial venous arterialization and endovascular deep venous arterializationhttps://pubmed.ncbi.nlm.nih.gov/37404577/ Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemiahttps://www.nejm.org/doi/full/10.1056/NEJMoa2212754 When conventional revascularization fails, can deep venous arterialization offer a new lifeline to limb salvage? Dr. Lucas Ferrer Cardona, vascular surgeon at Ascension and Dr. Miguel Montero Baker, vascular surgeon and medical director at HOPE Clinical Innovation Center join host Dr. Sabeen Dhand for an insightful discussion on deep venous arterialization (DVA).


---


This podcast is supported by:


RADPAD® Radiation Protection
https://www.radpad.com/


---


SYNPOSIS


The doctors discuss the progression of deep venous arterialization, highlighting the benefits of open, endovascular, and hybrid approaches. They draw on their personal experiences to share key technical nuances and explore new devices such as the Aveera Boomerang device. They emphasize the critical role of patient selection, family support, and close postoperative surveillance, including weekly wound assessments and monthly ultrasound evaluations. Although currently FDA-approved for no-option chronic limb-threatening ischemia (CLTI), Dr. Baker notes that deep venous arterialization may hold promise even for patients earlier in the disease course.
The episode concludes by exploring future directions for deep venous arterialization, highlighting the ongoing need for research to advance limb preservation.


---


TIMESTAMPS


00:00 - Introduction
03:15 - The Inspiration Behind Their Podcast
10:05 - Challenges and Success Stories in Vascular Surgery
10:29 - Exploring Deep Venous Arterialization (DVA)
25:16 - Hybrid Approaches and Patient Outcomes
32:06 - Evolution of Endovascular Techniques
37:33 - Patient Selection and Criteria
38:52 - Understanding the Biology of Procedures
43:57 - Exploring New Techniques and Devices
58:52 - Challenges and Considerations
01:01:51 - Final Thoughts


---


RESOURCES


Hybrid superficial venous arterialization and endovascular deep venous arterialization
https://pubmed.ncbi.nlm.nih.gov/37404577/

Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia
https://www.nejm.org/doi/full/10.1056/NEJMoa2212754

]]> 3950 Ep. 589 Lung Cancer Tumor Boards: Multidisciplinary Approaches & Best Practices with Dr. Karen Reckamp, Dr. Scott Atay, Dr. Scott Oh, Dr. Alan Lee As lung cancer treatments become more complex, is a collaborative tumor board more essential than ever? We’re kicking off the 2025 NSCLC Creator Weekend™ series with an in-studio panel discussion on the multidisciplinary management of lung cancer. The panel includes experts from medical oncology, thoracic surgery, radiation oncology, and interventional pulmonology from major institutions in Los Angeles. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS They discuss the operation of tumor boards at their respective institutions, the impact of virtual meetings, optimal strategies for mediastinal staging, the management of early-stage lung cancer, and the emerging role of ablation therapy. The conversation dives into the complexities of treating patients with recurrence or metastatic disease, highlighting the importance of collaborative decision-making in navigating these challenging scenarios. The episode emphasizes the critical role of multidisciplinary tumor boards in providing informed, patient-centered care. --- TIMESTAMPS 00:00 - Introduction06:59 - Role of Pulmonologists in Tumor Boards12:08 - Importance of Tissue Diagnosis24:52 - Lung Cancer Screening and Stigma34:01 - Interventional Radiology and Biopsies46:21 - Challenges with Immunotherapy and Radiation53:44 - The Importance of Multidisciplinary Teams54:24 - Final Thoughts --- RESOURCES American Lung Association 2024 Datahttps://www.lung.org/getmedia/12020193-7fb3-46b8-8d78-0e5d9cd8f93c/SOLC-2024.pdf National Lung Screening Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1102873 Checkmate 816https://www.nejm.org/doi/full/10.1056/NEJMoa2202170 PACIFIC Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1709937 Fri, 14 Nov 2025 08:00:00 -0000 full BackTable As lung cancer treatments become more complex, is a collaborative tumor board more essential than ever? We’re kicking off the 2025 NSCLC Creator Weekend™ series with an in-studio panel discussion on the multidisciplinary management of lung cancer. The panel includes experts from medical oncology, thoracic surgery, radiation oncology, and interventional pulmonology from major institutions in Los Angeles. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS They discuss the operation of tumor boards at their respective institutions, the impact of virtual meetings, optimal strategies for mediastinal staging, the management of early-stage lung cancer, and the emerging role of ablation therapy. The conversation dives into the complexities of treating patients with recurrence or metastatic disease, highlighting the importance of collaborative decision-making in navigating these challenging scenarios. The episode emphasizes the critical role of multidisciplinary tumor boards in providing informed, patient-centered care. --- TIMESTAMPS 00:00 - Introduction06:59 - Role of Pulmonologists in Tumor Boards12:08 - Importance of Tissue Diagnosis24:52 - Lung Cancer Screening and Stigma34:01 - Interventional Radiology and Biopsies46:21 - Challenges with Immunotherapy and Radiation53:44 - The Importance of Multidisciplinary Teams54:24 - Final Thoughts --- RESOURCES American Lung Association 2024 Datahttps://www.lung.org/getmedia/12020193-7fb3-46b8-8d78-0e5d9cd8f93c/SOLC-2024.pdf National Lung Screening Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1102873 Checkmate 816https://www.nejm.org/doi/full/10.1056/NEJMoa2202170 PACIFIC Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1709937 As lung cancer treatments become more complex, is a collaborative tumor board more essential than ever? We’re kicking off the 2025 NSCLC Creator Weekend™ series with an in-studio panel discussion on the multidisciplinary management of lung cancer. The panel includes experts from medical oncology, thoracic surgery, radiation oncology, and interventional pulmonology from major institutions in Los Angeles.


---


This podcast is supported by an educational grant from Johnson & Johnson and Varian.


---


SYNPOSIS


They discuss the operation of tumor boards at their respective institutions, the impact of virtual meetings, optimal strategies for mediastinal staging, the management of early-stage lung cancer, and the emerging role of ablation therapy. The conversation dives into the complexities of treating patients with recurrence or metastatic disease, highlighting the importance of collaborative decision-making in navigating these challenging scenarios. The episode emphasizes the critical role of multidisciplinary tumor boards in providing informed, patient-centered care.


---


TIMESTAMPS


00:00 - Introduction
06:59 - Role of Pulmonologists in Tumor Boards
12:08 - Importance of Tissue Diagnosis
24:52 - Lung Cancer Screening and Stigma
34:01 - Interventional Radiology and Biopsies
46:21 - Challenges with Immunotherapy and Radiation
53:44 - The Importance of Multidisciplinary Teams
54:24 - Final Thoughts


---


RESOURCES


American Lung Association 2024 Data
https://www.lung.org/getmedia/12020193-7fb3-46b8-8d78-0e5d9cd8f93c/SOLC-2024.pdf


National Lung Screening Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1102873


Checkmate 816
https://www.nejm.org/doi/full/10.1056/NEJMoa2202170


PACIFIC Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1709937

]]> 3418 Ep. 588 Breast Cryoablation: Techniques, Patient Selection & Outcomes with Dr. Robert Ward As breast imaging is becoming increasingly sensitive, is cryoablation the next frontier for treating small cancers or patients who are poor surgical candidates? Learn from expert Dr. Robert Ward, associate professor and program director of the Breast Imaging Fellowship at Brown University as he provides a contemporary overview of the innovative field of breast cryoablation. --- SYNPOSIS Dr. Ward shares his journey to becoming an expert in breast cryoablation, from his start in residency to his well-developed service line today. He details his experience enrolling patients in the FROST Trial, which is investigating the role of breast cryoablation as an alternative for surgery in patients with early stage invasive breast cancer. The conversation also covers the intricacies of the procedure, patient selection criteria, pre- and post-procedural care, and the significance of receptor positivity and clinical markers in treatment choices. Dr. Ward talks through the challenges in needle positioning prior to ice ball formation and the possibility of treating tumors close to the skin surface given appropriate wound care. The discussion concludes with a future look at how cryoablation could change the current paradigm of breast cancer care. --- TIMESTAMPS 00:00 - Introduction 01:39 - The Rise of Breast Cryoablation06:40 - Challenges and Considerations in Cryoablation07:59 - Patient Referral and Evaluation Process13:35 - Equipment and Techniques for Cryoablation23:29 - Procedure Steps and Needle Positioning26:11 - Post-Procedure Thawing and Patient Expectations28:35 - Post-Procedure Care and Follow-Up34:20 - Future of Cryoablation in Breast Cancer Treatment38:01 - Conclusion --- RESOURCES FROST Trialhttps://clinicaltrials.gov/study/NCT01992250 Brown et al., Strategies to Optimize Success in Breast Cancer Cryoablation, Journal of Vascular and Interventional Radiologyhttps://pubmed.ncbi.nlm.nih.gov/41083146/ Tue, 11 Nov 2025 08:00:00 -0000 full BackTable As breast imaging is becoming increasingly sensitive, is cryoablation the next frontier for treating small cancers or patients who are poor surgical candidates? Learn from expert Dr. Robert Ward, associate professor and program director of the Breast Imaging Fellowship at Brown University as he provides a contemporary overview of the innovative field of breast cryoablation. --- SYNPOSIS Dr. Ward shares his journey to becoming an expert in breast cryoablation, from his start in residency to his well-developed service line today. He details his experience enrolling patients in the FROST Trial, which is investigating the role of breast cryoablation as an alternative for surgery in patients with early stage invasive breast cancer. The conversation also covers the intricacies of the procedure, patient selection criteria, pre- and post-procedural care, and the significance of receptor positivity and clinical markers in treatment choices. Dr. Ward talks through the challenges in needle positioning prior to ice ball formation and the possibility of treating tumors close to the skin surface given appropriate wound care. The discussion concludes with a future look at how cryoablation could change the current paradigm of breast cancer care. --- TIMESTAMPS 00:00 - Introduction 01:39 - The Rise of Breast Cryoablation06:40 - Challenges and Considerations in Cryoablation07:59 - Patient Referral and Evaluation Process13:35 - Equipment and Techniques for Cryoablation23:29 - Procedure Steps and Needle Positioning26:11 - Post-Procedure Thawing and Patient Expectations28:35 - Post-Procedure Care and Follow-Up34:20 - Future of Cryoablation in Breast Cancer Treatment38:01 - Conclusion --- RESOURCES FROST Trialhttps://clinicaltrials.gov/study/NCT01992250 Brown et al., Strategies to Optimize Success in Breast Cancer Cryoablation, Journal of Vascular and Interventional Radiologyhttps://pubmed.ncbi.nlm.nih.gov/41083146/ As breast imaging is becoming increasingly sensitive, is cryoablation the next frontier for treating small cancers or patients who are poor surgical candidates? Learn from expert Dr. Robert Ward, associate professor and program director of the Breast Imaging Fellowship at Brown University as he provides a contemporary overview of the innovative field of breast cryoablation.


---


SYNPOSIS


Dr. Ward shares his journey to becoming an expert in breast cryoablation, from his start in residency to his well-developed service line today. He details his experience enrolling patients in the FROST Trial, which is investigating the role of breast cryoablation as an alternative for surgery in patients with early stage invasive breast cancer.


The conversation also covers the intricacies of the procedure, patient selection criteria, pre- and post-procedural care, and the significance of receptor positivity and clinical markers in treatment choices. Dr. Ward talks through the challenges in needle positioning prior to ice ball formation and the possibility of treating tumors close to the skin surface given appropriate wound care. The discussion concludes with a future look at how cryoablation could change the current paradigm of breast cancer care.


---


TIMESTAMPS


00:00 - Introduction
01:39 - The Rise of Breast Cryoablation
06:40 - Challenges and Considerations in Cryoablation
07:59 - Patient Referral and Evaluation Process
13:35 - Equipment and Techniques for Cryoablation
23:29 - Procedure Steps and Needle Positioning
26:11 - Post-Procedure Thawing and Patient Expectations
28:35 - Post-Procedure Care and Follow-Up
34:20 - Future of Cryoablation in Breast Cancer Treatment
38:01 - Conclusion


---


RESOURCES


FROST Trial
https://clinicaltrials.gov/study/NCT01992250


Brown et al., Strategies to Optimize Success in Breast Cancer Cryoablation, Journal of Vascular and Interventional Radiology
https://pubmed.ncbi.nlm.nih.gov/41083146/

]]> 2473 Ep. 587 Thyroid Artery Embolization: Indications & Outcomes with Dr. Juan Camacho What role does thyroid artery embolization play in contemporary thyroid cancer care? Dr. Juan Camacho, an interventional radiologist from Sarasota, Florida, joins host Dr. Sabeen Dhand to discuss how this emerging technique is reshaping the management of thyroid malignancies. --- SYNPOSIS Dr. Camacho shares his experiences establishing a multidisciplinary team at Memorial Sloan Kettering Cancer Center dedicated to the management of thyroid malignancies, highlighting the critical role of collaboration in the successful implementation of this emerging treatment. He details key procedural techniques, emphasizing the importance of recognizing anatomic variations that can influence technical success. He also examines how arterial supply and lesion location inform procedural planning and decision-making, and outlines his technical approach to thyroid artery embolization, including the use of a radial artery access, catheter selection strategies, and the application of cone-beam CT for procedural optimization. Finally, he reviews his pre- and post-procedural management strategies, including the role of beta blockers in optimizing patient outcomes. The discussion concludes with illustrative case studies demonstrating substantial reductions in thyroid volume and symptomatic relief, notably achieved without post-procedural hypothyroidism. --- TIMESTAMPS 00:00 - Introduction03:31 - Pioneering Thyroid Ablation at Sloan Kettering06:53 - The Need for Thyroid Artery Embolization25:08 - Pre-Procedural Planning32:41 - Embolization Technique and Procedure44:48 - Choosing the Right Catheter for the Job45:43 - Ensuring Patient Comfort and Safety47:09 - High-Stakes Imaging and Safety Protocols47:55 - Innovative Techniques and Case Studies51:02 - Post-Procedure Management and Follow-Up56:30 - Engaging with Endocrinology and Surgeons01:00:00 - Case Studies and Practical Applications Fri, 07 Nov 2025 08:00:00 -0000 full BackTable What role does thyroid artery embolization play in contemporary thyroid cancer care? Dr. Juan Camacho, an interventional radiologist from Sarasota, Florida, joins host Dr. Sabeen Dhand to discuss how this emerging technique is reshaping the management of thyroid malignancies. --- SYNPOSIS Dr. Camacho shares his experiences establishing a multidisciplinary team at Memorial Sloan Kettering Cancer Center dedicated to the management of thyroid malignancies, highlighting the critical role of collaboration in the successful implementation of this emerging treatment. He details key procedural techniques, emphasizing the importance of recognizing anatomic variations that can influence technical success. He also examines how arterial supply and lesion location inform procedural planning and decision-making, and outlines his technical approach to thyroid artery embolization, including the use of a radial artery access, catheter selection strategies, and the application of cone-beam CT for procedural optimization. Finally, he reviews his pre- and post-procedural management strategies, including the role of beta blockers in optimizing patient outcomes. The discussion concludes with illustrative case studies demonstrating substantial reductions in thyroid volume and symptomatic relief, notably achieved without post-procedural hypothyroidism. --- TIMESTAMPS 00:00 - Introduction03:31 - Pioneering Thyroid Ablation at Sloan Kettering06:53 - The Need for Thyroid Artery Embolization25:08 - Pre-Procedural Planning32:41 - Embolization Technique and Procedure44:48 - Choosing the Right Catheter for the Job45:43 - Ensuring Patient Comfort and Safety47:09 - High-Stakes Imaging and Safety Protocols47:55 - Innovative Techniques and Case Studies51:02 - Post-Procedure Management and Follow-Up56:30 - Engaging with Endocrinology and Surgeons01:00:00 - Case Studies and Practical Applications What role does thyroid artery embolization play in contemporary thyroid cancer care? Dr. Juan Camacho, an interventional radiologist from Sarasota, Florida, joins host Dr. Sabeen Dhand to discuss how this emerging technique is reshaping the management of thyroid malignancies.


---


SYNPOSIS


Dr. Camacho shares his experiences establishing a multidisciplinary team at Memorial Sloan Kettering Cancer Center dedicated to the management of thyroid malignancies, highlighting the critical role of collaboration in the successful implementation of this emerging treatment. He details key procedural techniques, emphasizing the importance of recognizing anatomic variations that can influence technical success. He also examines how arterial supply and lesion location inform procedural planning and decision-making, and outlines his technical approach to thyroid artery embolization, including the use of a radial artery access, catheter selection strategies, and the application of cone-beam CT for procedural optimization. Finally, he reviews his pre- and post-procedural management strategies, including the role of beta blockers in optimizing patient outcomes.


The discussion concludes with illustrative case studies demonstrating substantial reductions in thyroid volume and symptomatic relief, notably achieved without post-procedural hypothyroidism.


---


TIMESTAMPS


00:00 - Introduction
03:31 - Pioneering Thyroid Ablation at Sloan Kettering
06:53 - The Need for Thyroid Artery Embolization
25:08 - Pre-Procedural Planning
32:41 - Embolization Technique and Procedure
44:48 - Choosing the Right Catheter for the Job
45:43 - Ensuring Patient Comfort and Safety
47:09 - High-Stakes Imaging and Safety Protocols
47:55 - Innovative Techniques and Case Studies
51:02 - Post-Procedure Management and Follow-Up
56:30 - Engaging with Endocrinology and Surgeons
01:00:00 - Case Studies and Practical Applications

]]> 4534 Ep. 586 Bronchial Artery Embolization: Techniques, Outcomes & Complications to Avoid with Dr. Alex Lam A patient presents to the ER with hemoptysis. When is bronchial artery embolization (BAE) the right call, and what can you do to tip the odds of procedural success in your favor? In this episode of the BackTable Podcast, interventional radiologist Dr. Alexander Lam of UCSF shares his approach to bronchial artery embolization with host Dr. Ally Baheti.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISThe conversation covers why patients are referred for this procedure, the typical causes of bronchial artery hypertrophy, and Dr. Lam's preferred techniques for embolization, including the use of glue over traditional particles. Dr. Lam emphasizes the importance of multidisciplinary collaboration, detailed pre-procedure preparations, and recognizing potential complications.---TIMESTAMPS00:00 - Introduction01:45 - Patient Evaluation04:22 - Causes of Bronchial Hypertrophy09:03 - Procedure Setup10:35 - Catheter Selection and Techniques13:35 - Embolic Choices and Techniques19:39 - Understanding Different Types of Glue22:48 - Continuous Push Technique24:38 - Managing Complications and Success Rates28:14 - Postoperative Instructions and Follow-Up29:00 - Handling Difficult Bronchial Artery Selections34:02 - Final Thoughts Tue, 04 Nov 2025 08:00:00 -0000 full BackTable A patient presents to the ER with hemoptysis. When is bronchial artery embolization (BAE) the right call, and what can you do to tip the odds of procedural success in your favor? In this episode of the BackTable Podcast, interventional radiologist Dr. Alexander Lam of UCSF shares his approach to bronchial artery embolization with host Dr. Ally Baheti.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISThe conversation covers why patients are referred for this procedure, the typical causes of bronchial artery hypertrophy, and Dr. Lam's preferred techniques for embolization, including the use of glue over traditional particles. Dr. Lam emphasizes the importance of multidisciplinary collaboration, detailed pre-procedure preparations, and recognizing potential complications.---TIMESTAMPS00:00 - Introduction01:45 - Patient Evaluation04:22 - Causes of Bronchial Hypertrophy09:03 - Procedure Setup10:35 - Catheter Selection and Techniques13:35 - Embolic Choices and Techniques19:39 - Understanding Different Types of Glue22:48 - Continuous Push Technique24:38 - Managing Complications and Success Rates28:14 - Postoperative Instructions and Follow-Up29:00 - Handling Difficult Bronchial Artery Selections34:02 - Final Thoughts A patient presents to the ER with hemoptysis. When is bronchial artery embolization (BAE) the right call, and what can you do to tip the odds of procedural success in your favor? In this episode of the BackTable Podcast, interventional radiologist Dr. Alexander Lam of UCSF shares his approach to bronchial artery embolization with host Dr. Ally Baheti.
---
This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
---
SYNPOSIS
The conversation covers why patients are referred for this procedure, the typical causes of bronchial artery hypertrophy, and Dr. Lam's preferred techniques for embolization, including the use of glue over traditional particles. Dr. Lam emphasizes the importance of multidisciplinary collaboration, detailed pre-procedure preparations, and recognizing potential complications.
---
TIMESTAMPS
00:00 - Introduction
01:45 - Patient Evaluation
04:22 - Causes of Bronchial Hypertrophy
09:03 - Procedure Setup
10:35 - Catheter Selection and Techniques
13:35 - Embolic Choices and Techniques
19:39 - Understanding Different Types of Glue
22:48 - Continuous Push Technique
24:38 - Managing Complications and Success Rates
28:14 - Postoperative Instructions and Follow-Up
29:00 - Handling Difficult Bronchial Artery Selections
34:02 - Final Thoughts

]]> 2278 Ep. 585 CPT Code Updates for the OBL with Dr. Goke Akinwande With the annual trend of fluctuating reimbursement rates, have you been on the fence about turning your OBL into an ASC? Make sure your OBL is prepared for the surprising changes in coding coming in 2026. In this episode, Dr. Mary Costantino partners with fellow OBL owner Dr. Goke Akinwande and revenue cycle management expert Laurie Bouzarelos to review the new CPT code changes and how they translate to OBL and ASC reimbursement.---SYNPOSISDr. Akinwande discusses many positive takeaways after diving into the recent Medicare documents, and highlights key shifts. He believes these changes to add-on codes and territories means one thing: CLI is being heard. The upcoming code changes improve delineation of vascular territories, differentiating between "simple" (stenosis) and "complex" (CTO) procedures. These changes are aimed at rewarding physicians performing the difficult CLI work while decreasing reimbursement for more straightforward cases.Beyond the CPT code specifics, the conversation also covers real-world implications for OBL owners. Dr. Akinwande explains why these changes might narrow the reimbursement gap between OBLs and ASCs, prompting him to warn against ASC conversion. Laurie Bouzarelos provides guidance on implementation, stressing the importance of updating charge masters, reviewing payer contracts for "gap fill" clauses, and monitoring payments once the new codes go live. The episode ends with a discussion on obstacles in billing, collections, and the need for physicians to master the business side of their practice to ensure financial success.---TIMESTAMPS00:00 - Introduction04:37 - 2026 CPT Changes Overview07:18 - Simple vs. Complex Codes13:16 - Key Add-on Codes19:52 - OBL vs. ASC Conversion?24:56 - IVL Reimbursement Trends29:18 - Update Your Charge Master41:41 - Pricing & Medicare Year46:39 - Billing & Collections Reality Tue, 28 Oct 2025 07:00:00 -0000 full BackTable With the annual trend of fluctuating reimbursement rates, have you been on the fence about turning your OBL into an ASC? Make sure your OBL is prepared for the surprising changes in coding coming in 2026. In this episode, Dr. Mary Costantino partners with fellow OBL owner Dr. Goke Akinwande and revenue cycle management expert Laurie Bouzarelos to review the new CPT code changes and how they translate to OBL and ASC reimbursement.---SYNPOSISDr. Akinwande discusses many positive takeaways after diving into the recent Medicare documents, and highlights key shifts. He believes these changes to add-on codes and territories means one thing: CLI is being heard. The upcoming code changes improve delineation of vascular territories, differentiating between "simple" (stenosis) and "complex" (CTO) procedures. These changes are aimed at rewarding physicians performing the difficult CLI work while decreasing reimbursement for more straightforward cases.Beyond the CPT code specifics, the conversation also covers real-world implications for OBL owners. Dr. Akinwande explains why these changes might narrow the reimbursement gap between OBLs and ASCs, prompting him to warn against ASC conversion. Laurie Bouzarelos provides guidance on implementation, stressing the importance of updating charge masters, reviewing payer contracts for "gap fill" clauses, and monitoring payments once the new codes go live. The episode ends with a discussion on obstacles in billing, collections, and the need for physicians to master the business side of their practice to ensure financial success.---TIMESTAMPS00:00 - Introduction04:37 - 2026 CPT Changes Overview07:18 - Simple vs. Complex Codes13:16 - Key Add-on Codes19:52 - OBL vs. ASC Conversion?24:56 - IVL Reimbursement Trends29:18 - Update Your Charge Master41:41 - Pricing & Medicare Year46:39 - Billing & Collections Reality With the annual trend of fluctuating reimbursement rates, have you been on the fence about turning your OBL into an ASC? Make sure your OBL is prepared for the surprising changes in coding coming in 2026. In this episode, Dr. Mary Costantino partners with fellow OBL owner Dr. Goke Akinwande and revenue cycle management expert Laurie Bouzarelos to review the new CPT code changes and how they translate to OBL and ASC reimbursement.
---
SYNPOSIS
Dr. Akinwande discusses many positive takeaways after diving into the recent Medicare documents, and highlights key shifts. He believes these changes to add-on codes and territories means one thing: CLI is being heard. The upcoming code changes improve delineation of vascular territories, differentiating between "simple" (stenosis) and "complex" (CTO) procedures. These changes are aimed at rewarding physicians performing the difficult CLI work while decreasing reimbursement for more straightforward cases.
Beyond the CPT code specifics, the conversation also covers real-world implications for OBL owners. Dr. Akinwande explains why these changes might narrow the reimbursement gap between OBLs and ASCs, prompting him to warn against ASC conversion. Laurie Bouzarelos provides guidance on implementation, stressing the importance of updating charge masters, reviewing payer contracts for "gap fill" clauses, and monitoring payments once the new codes go live. The episode ends with a discussion on obstacles in billing, collections, and the need for physicians to master the business side of their practice to ensure financial success.
---
TIMESTAMPS
00:00 - Introduction
04:37 - 2026 CPT Changes Overview
07:18 - Simple vs. Complex Codes
13:16 - Key Add-on Codes
19:52 - OBL vs. ASC Conversion?
24:56 - IVL Reimbursement Trends
29:18 - Update Your Charge Master
41:41 - Pricing & Medicare Year
46:39 - Billing & Collections Reality

]]> 4336 Ep. 584 Middle Meningeal Artery Embolization: Procedure & Rationale with Dr. Paul Gulotta Is meningeal artery embolization the key to ending the cycle of chronic subdural hematomas? In this episode of the Back Table Podcast, Dr. Paul Gullota from Ochsner Health joins host Michael Barraza to share his technical insights on middle meningeal artery embolization, including patient workup, procedure technique, and post-operative care.---SYNPOSISThe episode begins with a discussion on the evolving role of middle meningeal artery embolization in preventing chronic subdural recurrence. The doctors talk through patient selection and procedural planning for middle meningeal artery embolization, emphasizing the importance of assessing collateral pathways and hemorrhage laterality. Dr. Gullota shares his access techniques, microcatheter and embolic options, and the critical role of teamwork with neurosurgery. He also shares his approach to navigating complex vascular anatomy as well as ensuring appropriate patient follow up.---TIMESTAMPS00:00 - Introduction03:12 - Middle Meningeal Artery Embolization: Rationale and Process04:17 - Patient Evaluation and Procedure Steps06:09 - Outpatient Procedures and Billing07:06 - Candidates for Embolization Post-Evacuation07:56 - Unilateral vs. Bilateral Embolization10:34 - Procedure Techniques and Tools19:48 - Post-Procedure Care and Follow-Up21:35 - Final Thoughts and Conclusion Fri, 24 Oct 2025 07:00:00 -0000 full BackTable Is meningeal artery embolization the key to ending the cycle of chronic subdural hematomas? In this episode of the Back Table Podcast, Dr. Paul Gullota from Ochsner Health joins host Michael Barraza to share his technical insights on middle meningeal artery embolization, including patient workup, procedure technique, and post-operative care.---SYNPOSISThe episode begins with a discussion on the evolving role of middle meningeal artery embolization in preventing chronic subdural recurrence. The doctors talk through patient selection and procedural planning for middle meningeal artery embolization, emphasizing the importance of assessing collateral pathways and hemorrhage laterality. Dr. Gullota shares his access techniques, microcatheter and embolic options, and the critical role of teamwork with neurosurgery. He also shares his approach to navigating complex vascular anatomy as well as ensuring appropriate patient follow up.---TIMESTAMPS00:00 - Introduction03:12 - Middle Meningeal Artery Embolization: Rationale and Process04:17 - Patient Evaluation and Procedure Steps06:09 - Outpatient Procedures and Billing07:06 - Candidates for Embolization Post-Evacuation07:56 - Unilateral vs. Bilateral Embolization10:34 - Procedure Techniques and Tools19:48 - Post-Procedure Care and Follow-Up21:35 - Final Thoughts and Conclusion Is meningeal artery embolization the key to ending the cycle of chronic subdural hematomas? In this episode of the Back Table Podcast, Dr. Paul Gullota from Ochsner Health joins host Michael Barraza to share his technical insights on middle meningeal artery embolization, including patient workup, procedure technique, and post-operative care.
---
SYNPOSIS
The episode begins with a discussion on the evolving role of middle meningeal artery embolization in preventing chronic subdural recurrence. The doctors talk through patient selection and procedural planning for middle meningeal artery embolization, emphasizing the importance of assessing collateral pathways and hemorrhage laterality. Dr. Gullota shares his access techniques, microcatheter and embolic options, and the critical role of teamwork with neurosurgery. He also shares his approach to navigating complex vascular anatomy as well as ensuring appropriate patient follow up.
---
TIMESTAMPS
00:00 - Introduction
03:12 - Middle Meningeal Artery Embolization: Rationale and Process
04:17 - Patient Evaluation and Procedure Steps
06:09 - Outpatient Procedures and Billing
07:06 - Candidates for Embolization Post-Evacuation
07:56 - Unilateral vs. Bilateral Embolization
10:34 - Procedure Techniques and Tools
19:48 - Post-Procedure Care and Follow-Up
21:35 - Final Thoughts and Conclusion

]]> 1617 Ep. 583 Managing Type II Endoleaks: Techniques & Tools with Dr. Matthew Givens From longitudinal monitoring to complex interventions, type II endoleaks often require an individualized approach. In this episode of BackTable, host Dr. Sabeen Dhand welcomes Dr. Matt Givens, Chief of Interventional Radiology at the New Orleans VA and faculty at Louisiana State University Health, to discuss the intricacies of type II endoleak management and repair techniques.---SYNPOSISThe conversation begins with a walkthrough of Dr. Givens’s firstline operative approach, which involves entering the inferior mesenteric artery and choosing a microcatheter that allows for entry into the sac and nidus. The doctors cover nuances in choosing and planning transarterial, translumbar, and transcaval approaches. Dr. Givens also details his embolics of choice, his preferred tools for direct sac puncture, and the rationale behind his embolization endpoints.---TIMESTAMPS00:00 - Introduction 08:12 - Imaging and Follow-Up Protocols16:27 - Transarterial Techniques for Endoleak Management33:45 - Techniques for Targeting and Embolization35:34 - Challenges and Solutions in Embolization36:57 - Transcaval and Translumbar Approaches39:09 - Complications and Case Studies53:58 - Building a Collaborative Practice56:09 - Conclusion Tue, 21 Oct 2025 07:00:00 -0000 full BackTable From longitudinal monitoring to complex interventions, type II endoleaks often require an individualized approach. In this episode of BackTable, host Dr. Sabeen Dhand welcomes Dr. Matt Givens, Chief of Interventional Radiology at the New Orleans VA and faculty at Louisiana State University Health, to discuss the intricacies of type II endoleak management and repair techniques.---SYNPOSISThe conversation begins with a walkthrough of Dr. Givens’s firstline operative approach, which involves entering the inferior mesenteric artery and choosing a microcatheter that allows for entry into the sac and nidus. The doctors cover nuances in choosing and planning transarterial, translumbar, and transcaval approaches. Dr. Givens also details his embolics of choice, his preferred tools for direct sac puncture, and the rationale behind his embolization endpoints.---TIMESTAMPS00:00 - Introduction 08:12 - Imaging and Follow-Up Protocols16:27 - Transarterial Techniques for Endoleak Management33:45 - Techniques for Targeting and Embolization35:34 - Challenges and Solutions in Embolization36:57 - Transcaval and Translumbar Approaches39:09 - Complications and Case Studies53:58 - Building a Collaborative Practice56:09 - Conclusion From longitudinal monitoring to complex interventions, type II endoleaks often require an individualized approach. In this episode of BackTable, host Dr. Sabeen Dhand welcomes Dr. Matt Givens, Chief of Interventional Radiology at the New Orleans VA and faculty at Louisiana State University Health, to discuss the intricacies of type II endoleak management and repair techniques.
---
SYNPOSIS
The conversation begins with a walkthrough of Dr. Givens’s firstline operative approach, which involves entering the inferior mesenteric artery and choosing a microcatheter that allows for entry into the sac and nidus. The doctors cover nuances in choosing and planning transarterial, translumbar, and transcaval approaches. Dr. Givens also details his embolics of choice, his preferred tools for direct sac puncture, and the rationale behind his embolization endpoints.
---
TIMESTAMPS
00:00 - Introduction
08:12 - Imaging and Follow-Up Protocols
16:27 - Transarterial Techniques for Endoleak Management
33:45 - Techniques for Targeting and Embolization
35:34 - Challenges and Solutions in Embolization
36:57 - Transcaval and Translumbar Approaches
39:09 - Complications and Case Studies
53:58 - Building a Collaborative Practice
56:09 - Conclusion

]]> 3599 Ep. 582 PERT Consortium Recap: New Developments in PE with Dr. Jonathan Paul and Dr. Osman Ahmed PERT Consortium 2025 gives interventionalists the reins to tackle even the toughest saddle pulmonary embolisms. In this episode of the BackTable Podcast, host Dr. Aaron Fritts welcomes interventional radiologist Dr. Osman Ahmed and interventional cardiologist Dr. Jonathan Paul to discuss their experiences at the annual PERT Consortium in San Diego, and offer their perspectives on the latest developments in pulmonary embolism (PE) treatment.---SYNPOSISThe doctors delve into advancements and trials within the PE treatment space, including new devices and clinical studies that are set to shape the future of pulmonary embolism care. The conversation highlights the value of collaboration between interventional specialties, the safety and efficacy of various PE interventions, and the growing trend of using combined therapies. They also provide updates on their ongoing innovation with Flow Medical, describing their philosophy and motivation for developing a new device for PE treatment that incorporates real-time pulmonary artery pressures, mean systolic and diastolic pressures, and a potential for AI utilization in the future. ---TIMESTAMPS00:00 - Introduction01:23 - PERT Consortium Highlights02:11 - Emerging Clinical Trials and Innovations03:59 - Thrombectomy Devices and Market Trends12:37 - Flow Medical: Origin and Updates19:37 - Advanced Data Tracking in Cardiology20:45 - Remote Monitoring and Mobile Integration22:45 - Cardiologists’ Data-Driven Approach23:10 - Upcoming Studies and Data Insights24:10 - Interventional Radiology and Cardiology Collaboration25:07 - Access to Care and Procedure Adoption27:32 - Final Thoughts---RESOURCESPulmonary Embolism Response Team (PERT) Consortiumhttps://pertconsortium.org/ Flow Medicalhttps://www.flowmedical.co/ PEERLESS RCThttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.072364RESCUE-IIhttps://www.jacc.org/doi/10.1016/j.jacadv.2025.101789 PEERLESS II https://www.jscai.org/article/S2772-9303(24)01053-6/fulltextPulmonary Embolism - Thrombus Removal With Catheter-Directed Therapy (PE-TRACT)https://clinicaltrials.gov/study/NCT05591118 The HI-PEITHO Studyhttps://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/hi-peitho.htmlPRAGUE-26https://eurointervention.pcronline.com/article/design-and-rationale-of-prague-26-a-multicentre-randomised-trial-of-catheter-directed-thrombolysis-for-intermediate-high-risk-acute-pulmonary-embolism Pulmonary Embolism - Thrombus Removal With Catheter-Directed Therapy (PE-TRACT)https://clinicaltrials.gov/study/NCT05591118 Aaron Fritts, MDhttps://www.backtable.com/shows/vi/contributors/dr-aaron-fritts Osman Ahmed, MDhttps://jointvascular.com/team/osman-ahmed-m-d-fcirse/ Jonathan Paul, MDhttps://www.uchicagomedicine.org/find-a-physician/physician/jonathan-d-paul Fri, 17 Oct 2025 07:00:00 -0000 full BackTable PERT Consortium 2025 gives interventionalists the reins to tackle even the toughest saddle pulmonary embolisms. In this episode of the BackTable Podcast, host Dr. Aaron Fritts welcomes interventional radiologist Dr. Osman Ahmed and interventional cardiologist Dr. Jonathan Paul to discuss their experiences at the annual PERT Consortium in San Diego, and offer their perspectives on the latest developments in pulmonary embolism (PE) treatment.---SYNPOSISThe doctors delve into advancements and trials within the PE treatment space, including new devices and clinical studies that are set to shape the future of pulmonary embolism care. The conversation highlights the value of collaboration between interventional specialties, the safety and efficacy of various PE interventions, and the growing trend of using combined therapies. They also provide updates on their ongoing innovation with Flow Medical, describing their philosophy and motivation for developing a new device for PE treatment that incorporates real-time pulmonary artery pressures, mean systolic and diastolic pressures, and a potential for AI utilization in the future. ---TIMESTAMPS00:00 - Introduction01:23 - PERT Consortium Highlights02:11 - Emerging Clinical Trials and Innovations03:59 - Thrombectomy Devices and Market Trends12:37 - Flow Medical: Origin and Updates19:37 - Advanced Data Tracking in Cardiology20:45 - Remote Monitoring and Mobile Integration22:45 - Cardiologists’ Data-Driven Approach23:10 - Upcoming Studies and Data Insights24:10 - Interventional Radiology and Cardiology Collaboration25:07 - Access to Care and Procedure Adoption27:32 - Final Thoughts---RESOURCESPulmonary Embolism Response Team (PERT) Consortiumhttps://pertconsortium.org/ Flow Medicalhttps://www.flowmedical.co/ PEERLESS RCThttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.072364RESCUE-IIhttps://www.jacc.org/doi/10.1016/j.jacadv.2025.101789 PEERLESS II https://www.jscai.org/article/S2772-9303(24)01053-6/fulltextPulmonary Embolism - Thrombus Removal With Catheter-Directed Therapy (PE-TRACT)https://clinicaltrials.gov/study/NCT05591118 The HI-PEITHO Studyhttps://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/hi-peitho.htmlPRAGUE-26https://eurointervention.pcronline.com/article/design-and-rationale-of-prague-26-a-multicentre-randomised-trial-of-catheter-directed-thrombolysis-for-intermediate-high-risk-acute-pulmonary-embolism Pulmonary Embolism - Thrombus Removal With Catheter-Directed Therapy (PE-TRACT)https://clinicaltrials.gov/study/NCT05591118 Aaron Fritts, MDhttps://www.backtable.com/shows/vi/contributors/dr-aaron-fritts Osman Ahmed, MDhttps://jointvascular.com/team/osman-ahmed-m-d-fcirse/ Jonathan Paul, MDhttps://www.uchicagomedicine.org/find-a-physician/physician/jonathan-d-paul PERT Consortium 2025 gives interventionalists the reins to tackle even the toughest saddle pulmonary embolisms. In this episode of the BackTable Podcast, host Dr. Aaron Fritts welcomes interventional radiologist Dr. Osman Ahmed and interventional cardiologist Dr. Jonathan Paul to discuss their experiences at the annual PERT Consortium in San Diego, and offer their perspectives on the latest developments in pulmonary embolism (PE) treatment.
---
SYNPOSIS
The doctors delve into advancements and trials within the PE treatment space, including new devices and clinical studies that are set to shape the future of pulmonary embolism care. The conversation highlights the value of collaboration between interventional specialties, the safety and efficacy of various PE interventions, and the growing trend of using combined therapies. They also provide updates on their ongoing innovation with Flow Medical, describing their philosophy and motivation for developing a new device for PE treatment that incorporates real-time pulmonary artery pressures, mean systolic and diastolic pressures, and a potential for AI utilization in the future.
---
TIMESTAMPS
00:00 - Introduction
01:23 - PERT Consortium Highlights
02:11 - Emerging Clinical Trials and Innovations
03:59 - Thrombectomy Devices and Market Trends
12:37 - Flow Medical: Origin and Updates
19:37 - Advanced Data Tracking in Cardiology
20:45 - Remote Monitoring and Mobile Integration
22:45 - Cardiologists’ Data-Driven Approach
23:10 - Upcoming Studies and Data Insights
24:10 - Interventional Radiology and Cardiology Collaboration
25:07 - Access to Care and Procedure Adoption
27:32 - Final Thoughts
---
RESOURCES
Pulmonary Embolism Response Team (PERT) Consortium
https://pertconsortium.org/
Flow Medical
https://www.flowmedical.co/
PEERLESS RCT
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.072364
RESCUE-II
https://www.jacc.org/doi/10.1016/j.jacadv.2025.101789
PEERLESS II
https://www.jscai.org/article/S2772-9303(24)01053-6/fulltext
Pulmonary Embolism - Thrombus Removal With Catheter-Directed Therapy (PE-TRACT)
https://clinicaltrials.gov/study/NCT05591118
The HI-PEITHO Study
https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/hi-peitho.html
PRAGUE-26
https://eurointervention.pcronline.com/article/design-and-rationale-of-prague-26-a-multicentre-randomised-trial-of-catheter-directed-thrombolysis-for-intermediate-high-risk-acute-pulmonary-embolism
Pulmonary Embolism - Thrombus Removal With Catheter-Directed Therapy (PE-TRACT)
https://clinicaltrials.gov/study/NCT05591118
Aaron Fritts, MD
https://www.backtable.com/shows/vi/contributors/dr-aaron-fritts
Osman Ahmed, MD
https://jointvascular.com/team/osman-ahmed-m-d-fcirse/
Jonathan Paul, MD
https://www.uchicagomedicine.org/find-a-physician/physician/jonathan-d-paul

]]> 1819 Ep. 581 IR Physicians as Key Decision-Makers in Health Systems with Dr. Howard Chrisman From the angio suite to the boardroom, what qualities of an interventional radiologist translate into pioneering leadership? Tune in to hear from Dr. Howard Chrisman, the President and CEO of Northwestern Medicine, as he discusses his journey with hosts Dr. Sabeen Dhand and Dr. Aaron Fritts.---SYNPOSISDr. Chrisman shares his inspiring journey from a student with an initial interest in veterinary medicine to a leader in interventional radiology (IR) and healthcare administration. He recounts his pivotal experiences, including his mentorship under prominent IRs, his decision to pursue an MBA, and the importance of building trust and fostering relationships within clinical and administrative realms. He details his learnings in developing self-awareness, being open to multiple viewpoints, and amplifying your voice as an IR. The discussion touches on the future of interventional radiology, the impact of artificial intelligence on the field, and the essential qualities for leadership in healthcare. Dr. Chrisman also reflects on the significance of learning from mistakes and the role of mentorship in his career, emphasizing the value of collaboration and empathy in achieving success.---TIMESTAMPS00:00 - Introduction 03:21 - Mentorship and Career Development09:55 - Balancing Bias and Decision Making18:32 - Building Trust and Value in Healthcare23:13 - The Future of Radiology and AI Integration28:48 - The Role of MBAs in Healthcare32:24 - Reflections on Leadership and Career35:43 - Conclusion and Final Thoughts Tue, 14 Oct 2025 07:00:00 -0000 full BackTable From the angio suite to the boardroom, what qualities of an interventional radiologist translate into pioneering leadership? Tune in to hear from Dr. Howard Chrisman, the President and CEO of Northwestern Medicine, as he discusses his journey with hosts Dr. Sabeen Dhand and Dr. Aaron Fritts.---SYNPOSISDr. Chrisman shares his inspiring journey from a student with an initial interest in veterinary medicine to a leader in interventional radiology (IR) and healthcare administration. He recounts his pivotal experiences, including his mentorship under prominent IRs, his decision to pursue an MBA, and the importance of building trust and fostering relationships within clinical and administrative realms. He details his learnings in developing self-awareness, being open to multiple viewpoints, and amplifying your voice as an IR. The discussion touches on the future of interventional radiology, the impact of artificial intelligence on the field, and the essential qualities for leadership in healthcare. Dr. Chrisman also reflects on the significance of learning from mistakes and the role of mentorship in his career, emphasizing the value of collaboration and empathy in achieving success.---TIMESTAMPS00:00 - Introduction 03:21 - Mentorship and Career Development09:55 - Balancing Bias and Decision Making18:32 - Building Trust and Value in Healthcare23:13 - The Future of Radiology and AI Integration28:48 - The Role of MBAs in Healthcare32:24 - Reflections on Leadership and Career35:43 - Conclusion and Final Thoughts From the angio suite to the boardroom, what qualities of an interventional radiologist translate into pioneering leadership? Tune in to hear from Dr. Howard Chrisman, the President and CEO of Northwestern Medicine, as he discusses his journey with hosts Dr. Sabeen Dhand and Dr. Aaron Fritts.
---
SYNPOSIS
Dr. Chrisman shares his inspiring journey from a student with an initial interest in veterinary medicine to a leader in interventional radiology (IR) and healthcare administration. He recounts his pivotal experiences, including his mentorship under prominent IRs, his decision to pursue an MBA, and the importance of building trust and fostering relationships within clinical and administrative realms. He details his learnings in developing self-awareness, being open to multiple viewpoints, and amplifying your voice as an IR. The discussion touches on the future of interventional radiology, the impact of artificial intelligence on the field, and the essential qualities for leadership in healthcare. Dr. Chrisman also reflects on the significance of learning from mistakes and the role of mentorship in his career, emphasizing the value of collaboration and empathy in achieving success.
---
TIMESTAMPS
00:00 - Introduction
03:21 - Mentorship and Career Development
09:55 - Balancing Bias and Decision Making
18:32 - Building Trust and Value in Healthcare
23:13 - The Future of Radiology and AI Integration
28:48 - The Role of MBAs in Healthcare
32:24 - Reflections on Leadership and Career
35:43 - Conclusion and Final Thoughts

]]> 2374 Ep. 580 How to Manage Portal Vein Thrombosis with Dr. Vijay Ramalingam When a patient presents with portal vein thrombosis (PVT), how do you decide between anticoagulation, intervention, and adjunct therapies? In this episode, Dr. Vijay Ramalingam, vascular and interventional radiologist from Beth Israel Deaconess Medical Center, joins Backtable host Dr. Chris Beck to share his approach to evaluation and management of both acute and chronic PVT.---SYNPOSISThe discussion begins with an overview of the Splanchnic Vein Thrombosis Multidisciplinary Clinic at Beth Israel– a collaboration between Interventional Radiology, Hepatology/Gastroenterology, Surgery and Hematology. Dr. Ramalingam details the clinic's workflow, from initial case conference to the comprehensive single-day patient workup that includes imaging, lab work, and consultations with all three specialties. He shares his algorithm for treatment decisions, breaking down the distinct management pathways for patients with and without cirrhosis, and for those with acute vs. chronic thrombosis.Finally, Dr. Ramalingam details his portal vein recanalization technique during procedure, providing a step-by-step guide to his preferred dual-access approach for complex cases, including his method for trans-splenic access and his trick on how to safely close the splenic tract. He also explains when it’s appropriate to use adjunctive therapies like suction thrombectomy and catheter-directed lysis, and describes preliminary data showing that their comprehensive approach leads to a change in management for about 40% of patients.---TIMESTAMPS00:00 - Introduction05:35 - Splanchnic Vein Thrombosis Multidisciplinary Clinic22:24 - Multidisciplinary Approach26:17 - PVT Classification38:47 - Treatment Evaluation and Intervention44:21 - Alternative Treatment Options for PVT49:00 - Procedural Techniques59:53 - Adjunct Techniques and Case Studies01:02:58 - Review of Preliminary Data & Final Thoughts Fri, 10 Oct 2025 07:00:00 -0000 full BackTable When a patient presents with portal vein thrombosis (PVT), how do you decide between anticoagulation, intervention, and adjunct therapies? In this episode, Dr. Vijay Ramalingam, vascular and interventional radiologist from Beth Israel Deaconess Medical Center, joins Backtable host Dr. Chris Beck to share his approach to evaluation and management of both acute and chronic PVT.---SYNPOSISThe discussion begins with an overview of the Splanchnic Vein Thrombosis Multidisciplinary Clinic at Beth Israel– a collaboration between Interventional Radiology, Hepatology/Gastroenterology, Surgery and Hematology. Dr. Ramalingam details the clinic's workflow, from initial case conference to the comprehensive single-day patient workup that includes imaging, lab work, and consultations with all three specialties. He shares his algorithm for treatment decisions, breaking down the distinct management pathways for patients with and without cirrhosis, and for those with acute vs. chronic thrombosis.Finally, Dr. Ramalingam details his portal vein recanalization technique during procedure, providing a step-by-step guide to his preferred dual-access approach for complex cases, including his method for trans-splenic access and his trick on how to safely close the splenic tract. He also explains when it’s appropriate to use adjunctive therapies like suction thrombectomy and catheter-directed lysis, and describes preliminary data showing that their comprehensive approach leads to a change in management for about 40% of patients.---TIMESTAMPS00:00 - Introduction05:35 - Splanchnic Vein Thrombosis Multidisciplinary Clinic22:24 - Multidisciplinary Approach26:17 - PVT Classification38:47 - Treatment Evaluation and Intervention44:21 - Alternative Treatment Options for PVT49:00 - Procedural Techniques59:53 - Adjunct Techniques and Case Studies01:02:58 - Review of Preliminary Data & Final Thoughts When a patient presents with portal vein thrombosis (PVT), how do you decide between anticoagulation, intervention, and adjunct therapies? In this episode, Dr. Vijay Ramalingam, vascular and interventional radiologist from Beth Israel Deaconess Medical Center, joins Backtable host Dr. Chris Beck to share his approach to evaluation and management of both acute and chronic PVT.
---
SYNPOSIS
The discussion begins with an overview of the Splanchnic Vein Thrombosis Multidisciplinary Clinic at Beth Israel– a collaboration between Interventional Radiology, Hepatology/Gastroenterology, Surgery and Hematology. Dr. Ramalingam details the clinic's workflow, from initial case conference to the comprehensive single-day patient workup that includes imaging, lab work, and consultations with all three specialties. He shares his algorithm for treatment decisions, breaking down the distinct management pathways for patients with and without cirrhosis, and for those with acute vs. chronic thrombosis.
Finally, Dr. Ramalingam details his portal vein recanalization technique during procedure, providing a step-by-step guide to his preferred dual-access approach for complex cases, including his method for trans-splenic access and his trick on how to safely close the splenic tract. He also explains when it’s appropriate to use adjunctive therapies like suction thrombectomy and catheter-directed lysis, and describes preliminary data showing that their comprehensive approach leads to a change in management for about 40% of patients.
---
TIMESTAMPS
00:00 - Introduction
05:35 - Splanchnic Vein Thrombosis Multidisciplinary Clinic
22:24 - Multidisciplinary Approach
26:17 - PVT Classification
38:47 - Treatment Evaluation and Intervention
44:21 - Alternative Treatment Options for PVT
49:00 - Procedural Techniques
59:53 - Adjunct Techniques and Case Studies
01:02:58 - Review of Preliminary Data & Final Thoughts

]]> 4213 Ep. 579 How to Manage Vascular Anomalies: From Hemangioma to AVM with Dr. Clifford Weiss This week’s episode is a masterclass on vascular anomaly treatment. Brush up on your malformations with Dr. Cliff Weiss, the Director of the Vascular Anomaly Center at Johns Hopkins. He shares next-level techniques, precision diagnostics, and his 'gold standard' approach to alcohol sclerotherapy. --- This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS The episode begins with the most vital component of patient care: establishing a correct diagnosis through proper classification. Dr. Weiss shares his philosophy that “MRI is a conversation” - not just an image, detailing the specific MRI protocols to confidently make a diagnosis over 90% of the time. He then shares an overview of the classification system, differentiating vascular tumors like hemangiomas from high-flow and low-flow vascular malformations. Dr. Weiss explores a wide array of treatment strategies tailored to each diagnosis. He walks through his techniques for treating low-flow malformations with sclerotherapy—using agents like alcohol, doxycycline, and bleomycin based on a lesion’s location and characteristics—and his use of cryoablation for vascular tumors. He then dives into the creative and high-stakes approaches for treating AVMs, comparing transvenous and transarterial embolization with agents like Onyx and coils, before concluding with his predictions on the future of IR in the field. --- TIMESTAMPS 00:00 - Introduction 02:36 - Vascular Anomaly Center at Johns Hopkins06:33 - Vascular Anomaly & Malformation Diagnosis with Imaging09:04 - Classifying Vascular Anomalies15:55 - Vascular Tumors18:46 - Low-Flow Malformations27:58 - Needle Placement29:56 - Retro-orbital & ENT Malformations32:44 - AVM Treatment Strategy40:41 - Following up with Patients Tue, 07 Oct 2025 07:00:00 -0000 full BackTable This week’s episode is a masterclass on vascular anomaly treatment. Brush up on your malformations with Dr. Cliff Weiss, the Director of the Vascular Anomaly Center at Johns Hopkins. He shares next-level techniques, precision diagnostics, and his 'gold standard' approach to alcohol sclerotherapy. --- This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS The episode begins with the most vital component of patient care: establishing a correct diagnosis through proper classification. Dr. Weiss shares his philosophy that “MRI is a conversation” - not just an image, detailing the specific MRI protocols to confidently make a diagnosis over 90% of the time. He then shares an overview of the classification system, differentiating vascular tumors like hemangiomas from high-flow and low-flow vascular malformations. Dr. Weiss explores a wide array of treatment strategies tailored to each diagnosis. He walks through his techniques for treating low-flow malformations with sclerotherapy—using agents like alcohol, doxycycline, and bleomycin based on a lesion’s location and characteristics—and his use of cryoablation for vascular tumors. He then dives into the creative and high-stakes approaches for treating AVMs, comparing transvenous and transarterial embolization with agents like Onyx and coils, before concluding with his predictions on the future of IR in the field. --- TIMESTAMPS 00:00 - Introduction 02:36 - Vascular Anomaly Center at Johns Hopkins06:33 - Vascular Anomaly & Malformation Diagnosis with Imaging09:04 - Classifying Vascular Anomalies15:55 - Vascular Tumors18:46 - Low-Flow Malformations27:58 - Needle Placement29:56 - Retro-orbital & ENT Malformations32:44 - AVM Treatment Strategy40:41 - Following up with Patients This week’s episode is a masterclass on vascular anomaly treatment. Brush up on your malformations with Dr. Cliff Weiss, the Director of the Vascular Anomaly Center at Johns Hopkins. He shares next-level techniques, precision diagnostics, and his 'gold standard' approach to alcohol sclerotherapy.

---

This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/

---

SYNPOSIS

The episode begins with the most vital component of patient care: establishing a correct diagnosis through proper classification. Dr. Weiss shares his philosophy that “MRI is a conversation” - not just an image, detailing the specific MRI protocols to confidently make a diagnosis over 90% of the time. He then shares an overview of the classification system, differentiating vascular tumors like hemangiomas from high-flow and low-flow vascular malformations.

Dr. Weiss explores a wide array of treatment strategies tailored to each diagnosis. He walks through his techniques for treating low-flow malformations with sclerotherapy—using agents like alcohol, doxycycline, and bleomycin based on a lesion’s location and characteristics—and his use of cryoablation for vascular tumors. He then dives into the creative and high-stakes approaches for treating AVMs, comparing transvenous and transarterial embolization with agents like Onyx and coils, before concluding with his predictions on the future of IR in the field.

---

TIMESTAMPS

00:00 - Introduction
02:36 - Vascular Anomaly Center at Johns Hopkins
06:33 - Vascular Anomaly & Malformation Diagnosis with Imaging
09:04 - Classifying Vascular Anomalies
15:55 - Vascular Tumors
18:46 - Low-Flow Malformations
27:58 - Needle Placement
29:56 - Retro-orbital & ENT Malformations
32:44 - AVM Treatment Strategy
40:41 - Following up with Patients

]]> 2890 Ep. 578 Navigating Disability after a Life-Changing Event with Dr. Nicholas Hanson What happens when the doctor suddenly becomes the patient? In this episode of the BackTable podcast, host Dr. Ally Baheti interviews Dr. Nicholas Hanson, an interventional and diagnostic radiologist from Oregon, about a life-changing event that dramatically altered his career.---SYNPOSISDr. Hanson describes the circumstances surrounding a severe car accident that resulted in a traumatic brain injury and subsequent medical complications, including the discovery of a heart aneurysm. He shares the challenges of his recovery, his struggle with insurance companies, and the emotional and professional toll of his experiences. Dr. Hanson provides valuable insights into the importance of disability insurance and the often overwhelming process of navigating healthcare systems. The discussion also touches on the ongoing debate about the separation of interventional radiology from diagnostic radiology and how sudden life events can impact one's career in medicine.---TIMESTAMPS00:00 - Introduction01:19 - The Life-Changing Event09:28 - Navigating Insurance and Disability16:39 - The Future of IR and Career Advice21:50 - Struggles with Disconnection28:56 - The Road to Recovery35:20 - Reflecting on the Journey37:42 - Closing Thoughts and Future Hopes Fri, 03 Oct 2025 07:00:00 -0000 full BackTable What happens when the doctor suddenly becomes the patient? In this episode of the BackTable podcast, host Dr. Ally Baheti interviews Dr. Nicholas Hanson, an interventional and diagnostic radiologist from Oregon, about a life-changing event that dramatically altered his career.---SYNPOSISDr. Hanson describes the circumstances surrounding a severe car accident that resulted in a traumatic brain injury and subsequent medical complications, including the discovery of a heart aneurysm. He shares the challenges of his recovery, his struggle with insurance companies, and the emotional and professional toll of his experiences. Dr. Hanson provides valuable insights into the importance of disability insurance and the often overwhelming process of navigating healthcare systems. The discussion also touches on the ongoing debate about the separation of interventional radiology from diagnostic radiology and how sudden life events can impact one's career in medicine.---TIMESTAMPS00:00 - Introduction01:19 - The Life-Changing Event09:28 - Navigating Insurance and Disability16:39 - The Future of IR and Career Advice21:50 - Struggles with Disconnection28:56 - The Road to Recovery35:20 - Reflecting on the Journey37:42 - Closing Thoughts and Future Hopes What happens when the doctor suddenly becomes the patient? In this episode of the BackTable podcast, host Dr. Ally Baheti interviews Dr. Nicholas Hanson, an interventional and diagnostic radiologist from Oregon, about a life-changing event that dramatically altered his career.
---
SYNPOSIS
Dr. Hanson describes the circumstances surrounding a severe car accident that resulted in a traumatic brain injury and subsequent medical complications, including the discovery of a heart aneurysm. He shares the challenges of his recovery, his struggle with insurance companies, and the emotional and professional toll of his experiences. Dr. Hanson provides valuable insights into the importance of disability insurance and the often overwhelming process of navigating healthcare systems. The discussion also touches on the ongoing debate about the separation of interventional radiology from diagnostic radiology and how sudden life events can impact one's career in medicine.
---
TIMESTAMPS
00:00 - Introduction
01:19 - The Life-Changing Event
09:28 - Navigating Insurance and Disability
16:39 - The Future of IR and Career Advice
21:50 - Struggles with Disconnection
28:56 - The Road to Recovery
35:20 - Reflecting on the Journey
37:42 - Closing Thoughts and Future Hopes

]]> 2494 Ep. 577 Microwave Ablation for Liver Tumors: Techniques & Outcomes with Dr. Driss Raissi Is microwave ablation only for simple liver tumors, or can it be a versatile ‘Swiss Army knife’ for a wide range of complex cases? In this episode, Dr. Driss Raissi of the University of Kentucky returns to BackTable to join host Dr. Chris Beck for a deep dive into advanced and unconventional microwave ablation techniques. They cover strategies for tackling a wide range of cases, from desmoid tumors to enterocutaneous fistulas.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISDr. Raissi shares his ‘pre-burn’ technique that desiccates tissue and reduces complications like capsular burst and bleeding. He elaborates on his method for tackling large liver tumors with a single probe through overlapping ablations, needle placement techniques and his ‘lung seal technique’ to prevent pneumothorax. Dr. Raissi also shares how his previous experience in the ICU promotes close communication with anesthesiologists and how he ups his ablation game through collaboration, optimizing conditions for safe and effective ablation.The episode explores a series of unique, real-world applications beyond the usual scope of IRs. Dr. Raissi walks us through his novel approach to challenging cases, including cauterization of enterocutaneous fistulas, endometriomas and desmoid tumors. He also compares using microwave or cryoablation for renal cell carcinoma, explaining thought processes based on lesion location and the need for speed and simplicity. The discussion provides an overview of ablation physics and careful techniques that expand treatment possibilities for IR patients.---TIMESTAMPS00:00 - Introduction 04:08 - Advanced Techniques for Liver Tumor Ablation06:06 - Pre-Burning Ablation and Ablating a Range of Lesions16:38 - Lung Ablation22:00 - Partnering with Anesthesia28:53 - Managing Postoperative Pain and Nerve Injuries29:42 - Treating Enterocutaneous Fistulas, Endometriomas & Desmoid Tumors38:49 - Adrenal Gland Ablation: A Case Study44:50 - Microwave vs. Cryoablation for Renal Cell Carcinoma49:06 - Preventing Pneumothorax in Lung Ablation Tue, 30 Sep 2025 07:00:00 -0000 full BackTable Is microwave ablation only for simple liver tumors, or can it be a versatile ‘Swiss Army knife’ for a wide range of complex cases? In this episode, Dr. Driss Raissi of the University of Kentucky returns to BackTable to join host Dr. Chris Beck for a deep dive into advanced and unconventional microwave ablation techniques. They cover strategies for tackling a wide range of cases, from desmoid tumors to enterocutaneous fistulas.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISDr. Raissi shares his ‘pre-burn’ technique that desiccates tissue and reduces complications like capsular burst and bleeding. He elaborates on his method for tackling large liver tumors with a single probe through overlapping ablations, needle placement techniques and his ‘lung seal technique’ to prevent pneumothorax. Dr. Raissi also shares how his previous experience in the ICU promotes close communication with anesthesiologists and how he ups his ablation game through collaboration, optimizing conditions for safe and effective ablation.The episode explores a series of unique, real-world applications beyond the usual scope of IRs. Dr. Raissi walks us through his novel approach to challenging cases, including cauterization of enterocutaneous fistulas, endometriomas and desmoid tumors. He also compares using microwave or cryoablation for renal cell carcinoma, explaining thought processes based on lesion location and the need for speed and simplicity. The discussion provides an overview of ablation physics and careful techniques that expand treatment possibilities for IR patients.---TIMESTAMPS00:00 - Introduction 04:08 - Advanced Techniques for Liver Tumor Ablation06:06 - Pre-Burning Ablation and Ablating a Range of Lesions16:38 - Lung Ablation22:00 - Partnering with Anesthesia28:53 - Managing Postoperative Pain and Nerve Injuries29:42 - Treating Enterocutaneous Fistulas, Endometriomas & Desmoid Tumors38:49 - Adrenal Gland Ablation: A Case Study44:50 - Microwave vs. Cryoablation for Renal Cell Carcinoma49:06 - Preventing Pneumothorax in Lung Ablation Is microwave ablation only for simple liver tumors, or can it be a versatile ‘Swiss Army knife’ for a wide range of complex cases? In this episode, Dr. Driss Raissi of the University of Kentucky returns to BackTable to join host Dr. Chris Beck for a deep dive into advanced and unconventional microwave ablation techniques. They cover strategies for tackling a wide range of cases, from desmoid tumors to enterocutaneous fistulas.
---
This podcast is supported by:
Medtronic Emprint
https://www.medtronic.com/emprint
---
SYNPOSIS
Dr. Raissi shares his ‘pre-burn’ technique that desiccates tissue and reduces complications like capsular burst and bleeding. He elaborates on his method for tackling large liver tumors with a single probe through overlapping ablations, needle placement techniques and his ‘lung seal technique’ to prevent pneumothorax. Dr. Raissi also shares how his previous experience in the ICU promotes close communication with anesthesiologists and how he ups his ablation game through collaboration, optimizing conditions for safe and effective ablation.
The episode explores a series of unique, real-world applications beyond the usual scope of IRs. Dr. Raissi walks us through his novel approach to challenging cases, including cauterization of enterocutaneous fistulas, endometriomas and desmoid tumors. He also compares using microwave or cryoablation for renal cell carcinoma, explaining thought processes based on lesion location and the need for speed and simplicity. The discussion provides an overview of ablation physics and careful techniques that expand treatment possibilities for IR patients.
---
TIMESTAMPS
00:00 - Introduction
04:08 - Advanced Techniques for Liver Tumor Ablation
06:06 - Pre-Burning Ablation and Ablating a Range of Lesions
16:38 - Lung Ablation
22:00 - Partnering with Anesthesia
28:53 - Managing Postoperative Pain and Nerve Injuries
29:42 - Treating Enterocutaneous Fistulas, Endometriomas & Desmoid Tumors
38:49 - Adrenal Gland Ablation: A Case Study
44:50 - Microwave vs. Cryoablation for Renal Cell Carcinoma
49:06 - Preventing Pneumothorax in Lung Ablation

]]> 3209 Ep. 576 Biliary Endoscopy Techniques: Managing Strictures & Drains with Dr. Ahsun Riaz So you’ve placed the biliary drain—are your patients getting the follow up that they need? In this episode, Dr. Ahsun Riaz from Northwestern University joins host, Dr. Christopher Beck, for a deep dive into biliary strictures—how to manage them effectively and navigate the potential complications of this challenging chronic condition.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISDr. Riaz takes us inside his journey of building a specialized hepatobiliary service at Northwestern, highlighting innovative practices like endoscopic techniques and radiofrequency ablation. He unpacks the nuances of distinguishing benign from malignant strictures, shares technical pearls for patient management, and emphasizes the power of collaboration with Gastroenterology to improve long-term patient outcomes. He outlines key technical considerations, including the use of the Hudson loop and strategic equipment selection to address intra-procedural challenges. He further emphasizes the importance of comprehensive patient care—ensuring appropriate follow-up, minimizing drain duration, and prioritizing quality of life as essential components of optimal management.---TIMESTAMPS00:00 - Introduction01:28 - Biliary Drain Management04:18 - Approach to Biliary Strictures19:20 - Endoscopic Evaluation and Techniques27:53 - Practical Tips and Experiences with Endoscopy30:39 - Post-Procedure Follow-Up and Patient Outcomes31:16 - Learning from the Hudson Roof Technique32:48 - Innovations in Benign Stricture Management36:48 - Endobiliary Ablation: Equipment and Procedure40:23 - The Double Dragon Technique Explained46:02 - Considerations for Malignant Biliary Stenting52:37 - Future Innovations and Collaborative Care Fri, 26 Sep 2025 07:00:00 -0000 full BackTable So you’ve placed the biliary drain—are your patients getting the follow up that they need? In this episode, Dr. Ahsun Riaz from Northwestern University joins host, Dr. Christopher Beck, for a deep dive into biliary strictures—how to manage them effectively and navigate the potential complications of this challenging chronic condition.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISDr. Riaz takes us inside his journey of building a specialized hepatobiliary service at Northwestern, highlighting innovative practices like endoscopic techniques and radiofrequency ablation. He unpacks the nuances of distinguishing benign from malignant strictures, shares technical pearls for patient management, and emphasizes the power of collaboration with Gastroenterology to improve long-term patient outcomes. He outlines key technical considerations, including the use of the Hudson loop and strategic equipment selection to address intra-procedural challenges. He further emphasizes the importance of comprehensive patient care—ensuring appropriate follow-up, minimizing drain duration, and prioritizing quality of life as essential components of optimal management.---TIMESTAMPS00:00 - Introduction01:28 - Biliary Drain Management04:18 - Approach to Biliary Strictures19:20 - Endoscopic Evaluation and Techniques27:53 - Practical Tips and Experiences with Endoscopy30:39 - Post-Procedure Follow-Up and Patient Outcomes31:16 - Learning from the Hudson Roof Technique32:48 - Innovations in Benign Stricture Management36:48 - Endobiliary Ablation: Equipment and Procedure40:23 - The Double Dragon Technique Explained46:02 - Considerations for Malignant Biliary Stenting52:37 - Future Innovations and Collaborative Care So you’ve placed the biliary drain—are your patients getting the follow up that they need? In this episode, Dr. Ahsun Riaz from Northwestern University joins host, Dr. Christopher Beck, for a deep dive into biliary strictures—how to manage them effectively and navigate the potential complications of this challenging chronic condition.
---
This podcast is supported by:
Medtronic Emprint
https://www.medtronic.com/emprint
---
SYNPOSIS
Dr. Riaz takes us inside his journey of building a specialized hepatobiliary service at Northwestern, highlighting innovative practices like endoscopic techniques and radiofrequency ablation. He unpacks the nuances of distinguishing benign from malignant strictures, shares technical pearls for patient management, and emphasizes the power of collaboration with Gastroenterology to improve long-term patient outcomes. He outlines key technical considerations, including the use of the Hudson loop and strategic equipment selection to address intra-procedural challenges. He further emphasizes the importance of comprehensive patient care—ensuring appropriate follow-up, minimizing drain duration, and prioritizing quality of life as essential components of optimal management.
---
TIMESTAMPS
00:00 - Introduction
01:28 - Biliary Drain Management
04:18 - Approach to Biliary Strictures
19:20 - Endoscopic Evaluation and Techniques
27:53 - Practical Tips and Experiences with Endoscopy
30:39 - Post-Procedure Follow-Up and Patient Outcomes
31:16 - Learning from the Hudson Roof Technique
32:48 - Innovations in Benign Stricture Management
36:48 - Endobiliary Ablation: Equipment and Procedure
40:23 - The Double Dragon Technique Explained
46:02 - Considerations for Malignant Biliary Stenting
52:37 - Future Innovations and Collaborative Care

]]> 3504 Ep. 575 Physician Employment Models: Exploring Benefits & Challenges with Dr. Ryan Trojan Could hospital employment be your path to practicing 100% interventional radiology (IR)? In this episode of BackTable, host Dr. Ally Baheti sits down with Dr. Ryan Trojan, an interventional radiologist at INTEGRIS Health in Oklahoma City, to discuss the pros and cons of hospital employment contracts in IR.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISThe physicians take a deep dive into the evolving employment models in the IR landscape. Dr. Trojan shares his journey from a private IR-DR blended practice to becoming directly employed by a hospital, highlighting the financial challenges, contract negotiations, and administrative dynamics along the way. He explains the growing loss of IR talent to lucrative diagnostic contracts and emphasizes the importance of advocating for IR’s value to hospital systems, from decreasing length of stay to supporting ECMO, trauma, and transplant services. The discussion covers financial security, administrative support, and the benefits of having aligned goals with the hospital in order to grow an IR practice. Dr. Trojan also addresses common misconceptions about IR and private practice, detailing how the landscape is likely to change over the coming years, and offers advice on navigating employment contracts. ---TIMESTAMPS00:00 - Introduction03:02 - Transition to Hospital Employment12:15 - Advocating for IR’s Value16:07 - Contract Structures and Compensation Models25:07 - Benefits and Downsides of the Employed Model28:27 - Negotiating Contracts and Fair Market Value41:12 - Conclusion---RESOURCESDr. Trojan’s contact information:ryan.trojan@integrishealth.org Tue, 23 Sep 2025 07:00:00 -0000 full BackTable Could hospital employment be your path to practicing 100% interventional radiology (IR)? In this episode of BackTable, host Dr. Ally Baheti sits down with Dr. Ryan Trojan, an interventional radiologist at INTEGRIS Health in Oklahoma City, to discuss the pros and cons of hospital employment contracts in IR.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISThe physicians take a deep dive into the evolving employment models in the IR landscape. Dr. Trojan shares his journey from a private IR-DR blended practice to becoming directly employed by a hospital, highlighting the financial challenges, contract negotiations, and administrative dynamics along the way. He explains the growing loss of IR talent to lucrative diagnostic contracts and emphasizes the importance of advocating for IR’s value to hospital systems, from decreasing length of stay to supporting ECMO, trauma, and transplant services. The discussion covers financial security, administrative support, and the benefits of having aligned goals with the hospital in order to grow an IR practice. Dr. Trojan also addresses common misconceptions about IR and private practice, detailing how the landscape is likely to change over the coming years, and offers advice on navigating employment contracts. ---TIMESTAMPS00:00 - Introduction03:02 - Transition to Hospital Employment12:15 - Advocating for IR’s Value16:07 - Contract Structures and Compensation Models25:07 - Benefits and Downsides of the Employed Model28:27 - Negotiating Contracts and Fair Market Value41:12 - Conclusion---RESOURCESDr. Trojan’s contact information:ryan.trojan@integrishealth.org Could hospital employment be your path to practicing 100% interventional radiology (IR)? In this episode of BackTable, host Dr. Ally Baheti sits down with Dr. Ryan Trojan, an interventional radiologist at INTEGRIS Health in Oklahoma City, to discuss the pros and cons of hospital employment contracts in IR.
---
This podcast is supported by:
Medtronic Emprint
https://www.medtronic.com/emprint
---
SYNPOSIS
The physicians take a deep dive into the evolving employment models in the IR landscape. Dr. Trojan shares his journey from a private IR-DR blended practice to becoming directly employed by a hospital, highlighting the financial challenges, contract negotiations, and administrative dynamics along the way. He explains the growing loss of IR talent to lucrative diagnostic contracts and emphasizes the importance of advocating for IR’s value to hospital systems, from decreasing length of stay to supporting ECMO, trauma, and transplant services. The discussion covers financial security, administrative support, and the benefits of having aligned goals with the hospital in order to grow an IR practice. Dr. Trojan also addresses common misconceptions about IR and private practice, detailing how the landscape is likely to change over the coming years, and offers advice on navigating employment contracts.
---
TIMESTAMPS
00:00 - Introduction
03:02 - Transition to Hospital Employment
12:15 - Advocating for IR’s Value
16:07 - Contract Structures and Compensation Models
25:07 - Benefits and Downsides of the Employed Model
28:27 - Negotiating Contracts and Fair Market Value
41:12 - Conclusion
---
RESOURCES
Dr. Trojan’s contact information:
ryan.trojan@integrishealth.org

]]> 2655 Ep. 574 MRI Guided Interventions: Techniques, Benefits, & Clinical Applications with Dr. Clifford Weiss and Dr. David Woodrum Should MRI-guided interventions be on your radar? Find out why the future of interventional radiology might lie in MRI guidance with experts Dr. Clifford Weiss from Johns Hopkins University and Dr. David Woodrum from the Mayo Clinic.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISThe physicians join host Dr. Chris Beck to explore the benefits of MRI guided procedures, including superior imaging capabilities and reduced radiation exposure. Dr. Weiss and Dr. Woodrum detail the challenges and barriers to adoption, like the intricate set up needed to protect equipment from a strong magnetic field. They highlight the significant technological advancements and collaborations between MRI and device companies that are set to make MRI guided interventions more accessible and practical for everyday use. They also discuss the reimbursement paradigm for MRI guided biopsies and how similar the algorithm is to CT guided procedures.The episode closes with unique insights for young physicians on training opportunities and the promising future of MRI guided interventions for trainees looking to bring a different approach to their future practices.---TIMESTAMPS00:00 - Introduction05:13 - The Advantages of MRI in Interventional Radiology13:44 - Technical Insights and Challenges of MRI Guided Procedures18:46 - Future Prospects and Industry Developments in MRI Guided Interventions31:01- Development of Hybrid MRI Rooms48:19 - Economic Considerations and Reimbursement52:33 - Community Support for MRI Interventions56:41 - Conclusion and Final Thoughts---RESOURCESInternational Society for Magnetic Resonance in Imaging:https://www.ismrm.org/ Fri, 19 Sep 2025 07:00:00 -0000 full BackTable Should MRI-guided interventions be on your radar? Find out why the future of interventional radiology might lie in MRI guidance with experts Dr. Clifford Weiss from Johns Hopkins University and Dr. David Woodrum from the Mayo Clinic.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISThe physicians join host Dr. Chris Beck to explore the benefits of MRI guided procedures, including superior imaging capabilities and reduced radiation exposure. Dr. Weiss and Dr. Woodrum detail the challenges and barriers to adoption, like the intricate set up needed to protect equipment from a strong magnetic field. They highlight the significant technological advancements and collaborations between MRI and device companies that are set to make MRI guided interventions more accessible and practical for everyday use. They also discuss the reimbursement paradigm for MRI guided biopsies and how similar the algorithm is to CT guided procedures.The episode closes with unique insights for young physicians on training opportunities and the promising future of MRI guided interventions for trainees looking to bring a different approach to their future practices.---TIMESTAMPS00:00 - Introduction05:13 - The Advantages of MRI in Interventional Radiology13:44 - Technical Insights and Challenges of MRI Guided Procedures18:46 - Future Prospects and Industry Developments in MRI Guided Interventions31:01- Development of Hybrid MRI Rooms48:19 - Economic Considerations and Reimbursement52:33 - Community Support for MRI Interventions56:41 - Conclusion and Final Thoughts---RESOURCESInternational Society for Magnetic Resonance in Imaging:https://www.ismrm.org/ Should MRI-guided interventions be on your radar? Find out why the future of interventional radiology might lie in MRI guidance with experts Dr. Clifford Weiss from Johns Hopkins University and Dr. David Woodrum from the Mayo Clinic.
---
This podcast is supported by:
Medtronic Emprint
https://www.medtronic.com/emprint
---
SYNPOSIS
The physicians join host Dr. Chris Beck to explore the benefits of MRI guided procedures, including superior imaging capabilities and reduced radiation exposure. Dr. Weiss and Dr. Woodrum detail the challenges and barriers to adoption, like the intricate set up needed to protect equipment from a strong magnetic field. They highlight the significant technological advancements and collaborations between MRI and device companies that are set to make MRI guided interventions more accessible and practical for everyday use. They also discuss the reimbursement paradigm for MRI guided biopsies and how similar the algorithm is to CT guided procedures.
The episode closes with unique insights for young physicians on training opportunities and the promising future of MRI guided interventions for trainees looking to bring a different approach to their future practices.
---
TIMESTAMPS
00:00 - Introduction
05:13 - The Advantages of MRI in Interventional Radiology
13:44 - Technical Insights and Challenges of MRI Guided Procedures
18:46 - Future Prospects and Industry Developments in MRI Guided Interventions
31:01- Development of Hybrid MRI Rooms
48:19 - Economic Considerations and Reimbursement
52:33 - Community Support for MRI Interventions
56:41 - Conclusion and Final Thoughts
---
RESOURCES
International Society for Magnetic Resonance in Imaging:
https://www.ismrm.org/

]]> 3634 Ep. 573 BackTable Tricks Competition 2025 What tricks do you have up your sleeve to help you get through tough cases? In this special episode of the BackTable Podcast, Drs. Ally Baheti, Mike Barraza, and Chris Beck spotlight the most creative and practical pearls from the 2025 BackTable Tips & Tricks competition, showcasing standout submissions and clever techniques shared by their peers. --- SYNPOSIS Guests include leading interventional radiologists like Dr. Aaron Fischman from Mount Sinai, who reveals his unique wire-shaping method—bending it like a question mark to navigate challenging, angulated vessels during prostate artery embolization. From Jefferson, Dr. Sean Maratto walks us through his innovative retrograde approach to placing double J stents. And from Ochsner Health, Dr. Tyler Sandow brings invaluable guidance on achieving direct portal vein access for TIPS. --- TIMESTAMPS 00:00 - Introduction 03:30 - Favorite Tips and Tricks06:11 - Practical Techniques and Personal Experiences15:41 - A Humbling Experience with Phil Banov16:02 - The Bumper Stitch Technique17:55 - Direct Portal Access for TIPS19:35 - Navigating Challenging Cases24:11 - Radial vs. Femoral Access Debate27:33 - Innovative Techniques and Tricks29:36 - Final Thoughts and Gratitude Mon, 15 Sep 2025 07:00:00 -0000 full BackTable What tricks do you have up your sleeve to help you get through tough cases? In this special episode of the BackTable Podcast, Drs. Ally Baheti, Mike Barraza, and Chris Beck spotlight the most creative and practical pearls from the 2025 BackTable Tips & Tricks competition, showcasing standout submissions and clever techniques shared by their peers. --- SYNPOSIS Guests include leading interventional radiologists like Dr. Aaron Fischman from Mount Sinai, who reveals his unique wire-shaping method—bending it like a question mark to navigate challenging, angulated vessels during prostate artery embolization. From Jefferson, Dr. Sean Maratto walks us through his innovative retrograde approach to placing double J stents. And from Ochsner Health, Dr. Tyler Sandow brings invaluable guidance on achieving direct portal vein access for TIPS. --- TIMESTAMPS 00:00 - Introduction 03:30 - Favorite Tips and Tricks06:11 - Practical Techniques and Personal Experiences15:41 - A Humbling Experience with Phil Banov16:02 - The Bumper Stitch Technique17:55 - Direct Portal Access for TIPS19:35 - Navigating Challenging Cases24:11 - Radial vs. Femoral Access Debate27:33 - Innovative Techniques and Tricks29:36 - Final Thoughts and Gratitude What tricks do you have up your sleeve to help you get through tough cases? In this special episode of the BackTable Podcast, Drs. Ally Baheti, Mike Barraza, and Chris Beck spotlight the most creative and practical pearls from the 2025 BackTable Tips & Tricks competition, showcasing standout submissions and clever techniques shared by their peers.


---


SYNPOSIS

Guests include leading interventional radiologists like Dr. Aaron Fischman from Mount Sinai, who reveals his unique wire-shaping method—bending it like a question mark to navigate challenging, angulated vessels during prostate artery embolization. From Jefferson, Dr. Sean Maratto walks us through his innovative retrograde approach to placing double J stents. And from Ochsner Health, Dr. Tyler Sandow brings invaluable guidance on achieving direct portal vein access for TIPS.

---

TIMESTAMPS

00:00 - Introduction
03:30 - Favorite Tips and Tricks
06:11 - Practical Techniques and Personal Experiences
15:41 - A Humbling Experience with Phil Banov
16:02 - The Bumper Stitch Technique
17:55 - Direct Portal Access for TIPS
19:35 - Navigating Challenging Cases
24:11 - Radial vs. Femoral Access Debate
27:33 - Innovative Techniques and Tricks
29:36 - Final Thoughts and Gratitude

]]> 1975 Ep. 572 How to Perform Mesocaval Shunts: Techniques & Outcomes with Dr. Omar Chohan and Dr. Harris Chengazi Before the advent of TIPS, mesocaval shunts were considered a less popular option for managing portal hypertension. But today, could they serve as a lifeline when no other choices remain? This week on BackTable, Drs. Omar Chohan and Harris Chengazi (Great Lakes Medical Imaging) join host Dr. Chris Beck to discuss the evolving role of endovascular mesocaval shunts, covering patient selection, clinical decision-making, and technical pearls. --- SYNPOSIS In this episode, the hosts delve into the specialized procedure of meso-caval shunts, focusing on its applications for patients with portal hypertension who have no other viable options. This discussion includes detailed case studies, such as one involving a woman with autoimmune hepatitis and another with pancreatic cancer, showcasing the practical challenges and innovative solutions in creating these shunts. In each case, they detail the rationale for patient selection, difficult anatomy, procedural steps, and resolution of symptoms like recurrent ascites and variceal bleeding. The episode emphasizes the importance of pre-procedure planning, collaboration, and precise imaging, utilizing advanced tools like the 4D CT scanner. The conversation also highlights the compassionate motivation behind these complex procedures, aimed at improving patients' quality of life. --- TIMESTAMPS 00:00 - Introduction 03:07 - Historical Context and Indications06:49 - Case 1: Patient with Refractory Ascites34:00 - Case 2: Recurrent GI Bleeding41:16 - Case 3: TIPS Consult - Pancreatic Cancer and Duodenal Varices47:44 - Lessons, Pearls, and Tips56:13 - Final Thoughts --- RESOURCES A Case Series of Dr. Chengazi's Mesocaval Shunts on X:https://x.com/chengazimd/status/1966337167879438571 Episode 573 Portal Hypertension Treatment Strategies:https://www.backtable.com/shows/vi/podcasts/473/portal-hypertension-treatment-strategies-ir-hepatology-perspectives TIPS University Freshman Year:https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup TIPS University Sophomore Year:https://www.backtable.com/shows/vi/podcasts/124/tips-university-sophomore-year-basic-procedure-technique TIPS University Junior Year:https://www.backtable.com/shows/vi/podcasts/125/tips-university-junior-year-advanced-techniques-ice-splenic-access TIPS University Senior Year:https://www.backtable.com/shows/vi/podcasts/126/tips-university-senior-year-gunsight-technique-splenic-closure Fri, 12 Sep 2025 07:00:00 -0000 full BackTable Before the advent of TIPS, mesocaval shunts were considered a less popular option for managing portal hypertension. But today, could they serve as a lifeline when no other choices remain? This week on BackTable, Drs. Omar Chohan and Harris Chengazi (Great Lakes Medical Imaging) join host Dr. Chris Beck to discuss the evolving role of endovascular mesocaval shunts, covering patient selection, clinical decision-making, and technical pearls. --- SYNPOSIS In this episode, the hosts delve into the specialized procedure of meso-caval shunts, focusing on its applications for patients with portal hypertension who have no other viable options. This discussion includes detailed case studies, such as one involving a woman with autoimmune hepatitis and another with pancreatic cancer, showcasing the practical challenges and innovative solutions in creating these shunts. In each case, they detail the rationale for patient selection, difficult anatomy, procedural steps, and resolution of symptoms like recurrent ascites and variceal bleeding. The episode emphasizes the importance of pre-procedure planning, collaboration, and precise imaging, utilizing advanced tools like the 4D CT scanner. The conversation also highlights the compassionate motivation behind these complex procedures, aimed at improving patients' quality of life. --- TIMESTAMPS 00:00 - Introduction 03:07 - Historical Context and Indications06:49 - Case 1: Patient with Refractory Ascites34:00 - Case 2: Recurrent GI Bleeding41:16 - Case 3: TIPS Consult - Pancreatic Cancer and Duodenal Varices47:44 - Lessons, Pearls, and Tips56:13 - Final Thoughts --- RESOURCES A Case Series of Dr. Chengazi's Mesocaval Shunts on X:https://x.com/chengazimd/status/1966337167879438571 Episode 573 Portal Hypertension Treatment Strategies:https://www.backtable.com/shows/vi/podcasts/473/portal-hypertension-treatment-strategies-ir-hepatology-perspectives TIPS University Freshman Year:https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup TIPS University Sophomore Year:https://www.backtable.com/shows/vi/podcasts/124/tips-university-sophomore-year-basic-procedure-technique TIPS University Junior Year:https://www.backtable.com/shows/vi/podcasts/125/tips-university-junior-year-advanced-techniques-ice-splenic-access TIPS University Senior Year:https://www.backtable.com/shows/vi/podcasts/126/tips-university-senior-year-gunsight-technique-splenic-closure Before the advent of TIPS, mesocaval shunts were considered a less popular option for managing portal hypertension. But today, could they serve as a lifeline when no other choices remain? This week on BackTable, Drs. Omar Chohan and Harris Chengazi (Great Lakes Medical Imaging) join host Dr. Chris Beck to discuss the evolving role of endovascular mesocaval shunts, covering patient selection, clinical decision-making, and technical pearls.


---

SYNPOSIS

In this episode, the hosts delve into the specialized procedure of meso-caval shunts, focusing on its applications for patients with portal hypertension who have no other viable options. This discussion includes detailed case studies, such as one involving a woman with autoimmune hepatitis and another with pancreatic cancer, showcasing the practical challenges and innovative solutions in creating these shunts. In each case, they detail the rationale for patient selection, difficult anatomy, procedural steps, and resolution of symptoms like recurrent ascites and variceal bleeding. The episode emphasizes the importance of pre-procedure planning, collaboration, and precise imaging, utilizing advanced tools like the 4D CT scanner. The conversation also highlights the compassionate motivation behind these complex procedures, aimed at improving patients' quality of life.


---

TIMESTAMPS

00:00 - Introduction
03:07 - Historical Context and Indications
06:49 - Case 1: Patient with Refractory Ascites
34:00 - Case 2: Recurrent GI Bleeding
41:16 - Case 3: TIPS Consult - Pancreatic Cancer and Duodenal Varices
47:44 - Lessons, Pearls, and Tips
56:13 - Final Thoughts

---

RESOURCES

A Case Series of Dr. Chengazi's Mesocaval Shunts on X:
https://x.com/chengazimd/status/1966337167879438571

Episode 573 Portal Hypertension Treatment Strategies:
https://www.backtable.com/shows/vi/podcasts/473/portal-hypertension-treatment-strategies-ir-hepatology-perspectives

TIPS University Freshman Year:
https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup

TIPS University Sophomore Year:
https://www.backtable.com/shows/vi/podcasts/124/tips-university-sophomore-year-basic-procedure-technique

TIPS University Junior Year:
https://www.backtable.com/shows/vi/podcasts/125/tips-university-junior-year-advanced-techniques-ice-splenic-access

TIPS University Senior Year:
https://www.backtable.com/shows/vi/podcasts/126/tips-university-senior-year-gunsight-technique-splenic-closure

]]> 4432 Ep. 571 Independent IR Practices: Key Strategies for Success with Dr. Kartik Kansagra and Dr. Harout Dermendjian What does it really take to break away from the hospital system and build your own interventional radiology practice?---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISIn this episode, host Dr. Ally Baheti interviews Dr. Kartik Kansagra and Dr. Harout Dermendjian, independent interventional radiologists from California and founders of EVS LA. They share their journey in establishing and growing an independent IR practice, discussing their training at Kaiser Sunset, the steps they took to develop their own practice, and the challenges they faced along the way. Emphasizing the importance of training, clinician communication, and balancing inpatient and outpatient services, they offer valuable insights and advice for new IR professionals considering a similar path.---TIMESTAMPS00:00 – Introduction and opening remarks01:23 – Early training and transition08:54 – Clinical vs. non-clinical IR practice differences13:05 – Achieving parity with other interventional specialties17:47 – Building insurance contracts and following up with patients24:31 – Setting boundaries and documenting clinical decisions34:32 – Final advice and closing words from the guests Tue, 09 Sep 2025 07:00:00 -0000 full BackTable What does it really take to break away from the hospital system and build your own interventional radiology practice?---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISIn this episode, host Dr. Ally Baheti interviews Dr. Kartik Kansagra and Dr. Harout Dermendjian, independent interventional radiologists from California and founders of EVS LA. They share their journey in establishing and growing an independent IR practice, discussing their training at Kaiser Sunset, the steps they took to develop their own practice, and the challenges they faced along the way. Emphasizing the importance of training, clinician communication, and balancing inpatient and outpatient services, they offer valuable insights and advice for new IR professionals considering a similar path.---TIMESTAMPS00:00 – Introduction and opening remarks01:23 – Early training and transition08:54 – Clinical vs. non-clinical IR practice differences13:05 – Achieving parity with other interventional specialties17:47 – Building insurance contracts and following up with patients24:31 – Setting boundaries and documenting clinical decisions34:32 – Final advice and closing words from the guests What does it really take to break away from the hospital system and build your own interventional radiology practice?
---
This podcast is supported by:
Medtronic Emprint
https://www.medtronic.com/emprint
---
SYNPOSIS
In this episode, host Dr. Ally Baheti interviews Dr. Kartik Kansagra and Dr. Harout Dermendjian, independent interventional radiologists from California and founders of EVS LA. They share their journey in establishing and growing an independent IR practice, discussing their training at Kaiser Sunset, the steps they took to develop their own practice, and the challenges they faced along the way. Emphasizing the importance of training, clinician communication, and balancing inpatient and outpatient services, they offer valuable insights and advice for new IR professionals considering a similar path.
---
TIMESTAMPS
00:00 – Introduction and opening remarks
01:23 – Early training and transition
08:54 – Clinical vs. non-clinical IR practice differences
13:05 – Achieving parity with other interventional specialties
17:47 – Building insurance contracts and following up with patients
24:31 – Setting boundaries and documenting clinical decisions
34:32 – Final advice and closing words from the guests

]]> 2319 Introducing Backtable Cardiology Mon, 08 Sep 2025 07:00:00 -0000 trailer BackTable 85 Ep. 570 Exploring Atherectomy’s Role Below the Knee with Dr. Anahita Dua Below the knee atherectomy is a hot topic right now in the vascular community. Why is it so controversial? Dr. Anahita Dua, vascular surgeon at Mass General, joins host Dr. Sabeen Dhand to explore the utility of this technique and the pressing need for more Level I evidence in this space. --- This podcast is supported by:AngioDynamicshttps://www.auryon-system.com/ --- SYNPOSIS The conversation dives into the controversial role of below-the-knee atherectomy in limb salvage, an area where data has long been debated. Dr. Dua, principal investigator of the AMBITION BTK Trial—the first randomized controlled trial comparing below-the-knee atherectomy to angioplasty alone—introduces the trial and explains how it fits into the current body of literature. Together, the doctors review past evidence, current practice, and the future outlook for tibial interventions. Dr. Dua outlines the wide range of techniques and clinical strategies used to manage PAD, and stresses the importance of physician engagement with the NIH and research community to establish stronger, evidence-based protocols. She also shares her candid thoughts on the most overrated and underrated devices in tibial intervention, highlighting atherectomy’s potential role in vessel preparation before below-the-knee treatment. --- TIMESTAMPS 00:00 - Introduction04:55 - Current State of Evidence and Challenges10:54 - Heterogeneity in PAD Treatment14:26 - Need for National Metrics and Standardization20:51 - AMBITION BTK Trial and Importance27:23 - Potential Outcomes and Implications30:18 - Trial Design34:56 - Advice for Practitioners37:36 - Underrated and Overrated Devices41:50 - Conclusion --- RESOURCES AMBITION BTK Trial:https://www.angiodynamics.com/studies/ambition-btk/ Fri, 05 Sep 2025 07:00:00 -0000 full BackTable Below the knee atherectomy is a hot topic right now in the vascular community. Why is it so controversial? Dr. Anahita Dua, vascular surgeon at Mass General, joins host Dr. Sabeen Dhand to explore the utility of this technique and the pressing need for more Level I evidence in this space. --- This podcast is supported by:AngioDynamicshttps://www.auryon-system.com/ --- SYNPOSIS The conversation dives into the controversial role of below-the-knee atherectomy in limb salvage, an area where data has long been debated. Dr. Dua, principal investigator of the AMBITION BTK Trial—the first randomized controlled trial comparing below-the-knee atherectomy to angioplasty alone—introduces the trial and explains how it fits into the current body of literature. Together, the doctors review past evidence, current practice, and the future outlook for tibial interventions. Dr. Dua outlines the wide range of techniques and clinical strategies used to manage PAD, and stresses the importance of physician engagement with the NIH and research community to establish stronger, evidence-based protocols. She also shares her candid thoughts on the most overrated and underrated devices in tibial intervention, highlighting atherectomy’s potential role in vessel preparation before below-the-knee treatment. --- TIMESTAMPS 00:00 - Introduction04:55 - Current State of Evidence and Challenges10:54 - Heterogeneity in PAD Treatment14:26 - Need for National Metrics and Standardization20:51 - AMBITION BTK Trial and Importance27:23 - Potential Outcomes and Implications30:18 - Trial Design34:56 - Advice for Practitioners37:36 - Underrated and Overrated Devices41:50 - Conclusion --- RESOURCES AMBITION BTK Trial:https://www.angiodynamics.com/studies/ambition-btk/ Below the knee atherectomy is a hot topic right now in the vascular community. Why is it so controversial? Dr. Anahita Dua, vascular surgeon at Mass General, joins host Dr. Sabeen Dhand to explore the utility of this technique and the pressing need for more Level I evidence in this space.

---

This podcast is supported by:
AngioDynamics
https://www.auryon-system.com/

---

SYNPOSIS

The conversation dives into the controversial role of below-the-knee atherectomy in limb salvage, an area where data has long been debated. Dr. Dua, principal investigator of the AMBITION BTK Trial—the first randomized controlled trial comparing below-the-knee atherectomy to angioplasty alone—introduces the trial and explains how it fits into the current body of literature.

Together, the doctors review past evidence, current practice, and the future outlook for tibial interventions. Dr. Dua outlines the wide range of techniques and clinical strategies used to manage PAD, and stresses the importance of physician engagement with the NIH and research community to establish stronger, evidence-based protocols. She also shares her candid thoughts on the most overrated and underrated devices in tibial intervention, highlighting atherectomy’s potential role in vessel preparation before below-the-knee treatment.

---

TIMESTAMPS

00:00 - Introduction
04:55 - Current State of Evidence and Challenges
10:54 - Heterogeneity in PAD Treatment
14:26 - Need for National Metrics and Standardization
20:51 - AMBITION BTK Trial and Importance
27:23 - Potential Outcomes and Implications
30:18 - Trial Design
34:56 - Advice for Practitioners
37:36 - Underrated and Overrated Devices
41:50 - Conclusion

---

RESOURCES

AMBITION BTK Trial:
https://www.angiodynamics.com/studies/ambition-btk/

]]> 2783 Ep. 569 Advances & Challenges in Carotid Artery Stenting with Dr. Wayne Olan From new techniques to evolving best practices–are you up to date with the latest developments in carotid artery stenting? In this episode, Dr. Wayne Olan, Interventional Neuroradiologist and the director of Minimally Invasive Neurosurgery at George Washington University joins Dr. Michael Barraza for a discussion on the latest innovations and evolving techniques in carotid artery stenting. --- This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS Dr. Olan opens the conversation with a historical perspective on the evolution of carotid stenting, tracing advancements from early techniques to modern devices. He then talks through referral patterns, noting that the majority originate from cardiologists. Dr. Olan emphasizes the importance of meticulous periprocedural planning and comprehensive post-procedural management. Central to this discussion is the critical role of antiplatelet therapy, including strategies for addressing Plavix non-responders, such as the use of Integrilin. The discussions also covers advanced techniques in carotid artery stenting, including the utilization of the Aptus sheath and the Contego stent system. He underscores the importance of mastering the available tools, understanding patient-specific factors, meticulous procedural planning, and always maintaining a contingency plan. He concludes the discussion by exploring emerging trends and the future potential of outpatient carotid stenting. --- TIMESTAMPS 00:00 - Introduction02:44 - The Importance of Stroke Intervention07:16 - Carotid Stenting: Evolution and Techniques13:29 - Challenges and Collaborations in Carotid Interventions16:17 - Technical Insights and Best Practices25:24 - Choosing the Right Wire for Carotid Procedures25:53 - Anticoagulation and Filter Wire Techniques28:30 - Managing Stent Placement and Distal Protection30:54 - Handling Carotid Bifurcation and Skull Base Lesions38:43 Dealing with Tandem Occlusions42:06 - Future Trends in Outpatient Procedures44:43 - Addressing Re-stenosis and Vertebral Lesions45:44 - Conclusion and Final Thoughts Tue, 02 Sep 2025 07:00:00 -0000 full BackTable From new techniques to evolving best practices–are you up to date with the latest developments in carotid artery stenting? In this episode, Dr. Wayne Olan, Interventional Neuroradiologist and the director of Minimally Invasive Neurosurgery at George Washington University joins Dr. Michael Barraza for a discussion on the latest innovations and evolving techniques in carotid artery stenting. --- This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS Dr. Olan opens the conversation with a historical perspective on the evolution of carotid stenting, tracing advancements from early techniques to modern devices. He then talks through referral patterns, noting that the majority originate from cardiologists. Dr. Olan emphasizes the importance of meticulous periprocedural planning and comprehensive post-procedural management. Central to this discussion is the critical role of antiplatelet therapy, including strategies for addressing Plavix non-responders, such as the use of Integrilin. The discussions also covers advanced techniques in carotid artery stenting, including the utilization of the Aptus sheath and the Contego stent system. He underscores the importance of mastering the available tools, understanding patient-specific factors, meticulous procedural planning, and always maintaining a contingency plan. He concludes the discussion by exploring emerging trends and the future potential of outpatient carotid stenting. --- TIMESTAMPS 00:00 - Introduction02:44 - The Importance of Stroke Intervention07:16 - Carotid Stenting: Evolution and Techniques13:29 - Challenges and Collaborations in Carotid Interventions16:17 - Technical Insights and Best Practices25:24 - Choosing the Right Wire for Carotid Procedures25:53 - Anticoagulation and Filter Wire Techniques28:30 - Managing Stent Placement and Distal Protection30:54 - Handling Carotid Bifurcation and Skull Base Lesions38:43 Dealing with Tandem Occlusions42:06 - Future Trends in Outpatient Procedures44:43 - Addressing Re-stenosis and Vertebral Lesions45:44 - Conclusion and Final Thoughts From new techniques to evolving best practices–are you up to date with the latest developments in carotid artery stenting? In this episode, Dr. Wayne Olan, Interventional Neuroradiologist and the director of Minimally Invasive Neurosurgery at George Washington University joins Dr. Michael Barraza for a discussion on the latest innovations and evolving techniques in carotid artery stenting.


---

This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/

---

SYNPOSIS

Dr. Olan opens the conversation with a historical perspective on the evolution of carotid stenting, tracing advancements from early techniques to modern devices. He then talks through referral patterns, noting that the majority originate from cardiologists. Dr. Olan emphasizes the importance of meticulous periprocedural planning and comprehensive post-procedural management. Central to this discussion is the critical role of antiplatelet therapy, including strategies for addressing Plavix non-responders, such as the use of Integrilin.

The discussions also covers advanced techniques in carotid artery stenting, including the utilization of the Aptus sheath and the Contego stent system. He underscores the importance of mastering the available tools, understanding patient-specific factors, meticulous procedural planning, and always maintaining a contingency plan. He concludes the discussion by exploring emerging trends and the future potential of outpatient carotid stenting.

---

TIMESTAMPS

00:00 - Introduction
02:44 - The Importance of Stroke Intervention
07:16 - Carotid Stenting: Evolution and Techniques
13:29 - Challenges and Collaborations in Carotid Interventions
16:17 - Technical Insights and Best Practices
25:24 - Choosing the Right Wire for Carotid Procedures
25:53 - Anticoagulation and Filter Wire Techniques
28:30 - Managing Stent Placement and Distal Protection
30:54 - Handling Carotid Bifurcation and Skull Base Lesions
38:43 Dealing with Tandem Occlusions
42:06 - Future Trends in Outpatient Procedures
44:43 - Addressing Re-stenosis and Vertebral Lesions
45:44 - Conclusion and Final Thoughts

]]> 2957 Ep. 568 Understanding CON Laws: Effects on Rural Cardiovascular Care with Dr. Ash Sastry and Dr. Sree Nair What does it really take to bring cutting-edge vascular care to the most underserved corners of the rural South? In this episode of the BackTable Podcast, host Dr. Ally Baheti welcomes interventional cardiologist Dr. Ash Sastry and interventional radiologist Dr. Sree Nair to discuss the financial and regulatory side of providing care to underserved rural populations in North Carolina, Virginia, and Georgia. --- SYNPOSIS The doctors delve into the operations and challenges of running an office-based lab (OBL) and the potential transition to an ambulatory surgical center (ASC). This episode covers topics like certificate of need (CON) laws, reimbursement issues, and the importance of multidisciplinary collaboration. The conversation offers insights into the practical and regulatory hurdles faced in delivering high-quality vascular care in rural settings. --- TIMESTAMPS 00:00 - Introduction02:14 - Challenges in Rural Healthcare09:00 - Understanding Certificate of Need (CON) Laws11:30 - The Financial Struggles of OBLs19:58 - Advocacy and Legislative Efforts27:53 - Future Prospects and Final Thoughts Fri, 29 Aug 2025 07:00:00 -0000 full BackTable What does it really take to bring cutting-edge vascular care to the most underserved corners of the rural South? In this episode of the BackTable Podcast, host Dr. Ally Baheti welcomes interventional cardiologist Dr. Ash Sastry and interventional radiologist Dr. Sree Nair to discuss the financial and regulatory side of providing care to underserved rural populations in North Carolina, Virginia, and Georgia. --- SYNPOSIS The doctors delve into the operations and challenges of running an office-based lab (OBL) and the potential transition to an ambulatory surgical center (ASC). This episode covers topics like certificate of need (CON) laws, reimbursement issues, and the importance of multidisciplinary collaboration. The conversation offers insights into the practical and regulatory hurdles faced in delivering high-quality vascular care in rural settings. --- TIMESTAMPS 00:00 - Introduction02:14 - Challenges in Rural Healthcare09:00 - Understanding Certificate of Need (CON) Laws11:30 - The Financial Struggles of OBLs19:58 - Advocacy and Legislative Efforts27:53 - Future Prospects and Final Thoughts What does it really take to bring cutting-edge vascular care to the most underserved corners of the rural South? In this episode of the BackTable Podcast, host Dr. Ally Baheti welcomes interventional cardiologist Dr. Ash Sastry and interventional radiologist Dr. Sree Nair to discuss the financial and regulatory side of providing care to underserved rural populations in North Carolina, Virginia, and Georgia.


---

SYNPOSIS

The doctors delve into the operations and challenges of running an office-based lab (OBL) and the potential transition to an ambulatory surgical center (ASC). This episode covers topics like certificate of need (CON) laws, reimbursement issues, and the importance of multidisciplinary collaboration. The conversation offers insights into the practical and regulatory hurdles faced in delivering high-quality vascular care in rural settings.

---

TIMESTAMPS

00:00 - Introduction
02:14 - Challenges in Rural Healthcare
09:00 - Understanding Certificate of Need (CON) Laws
11:30 - The Financial Struggles of OBLs
19:58 - Advocacy and Legislative Efforts
27:53 - Future Prospects and Final Thoughts

]]> 2149 Ep. 567 How to Manage Biliary Strictures with Dr. Premal Trivedi What piques your clinical suspicion for biliary structure? And when is interventional endoscopy the preferred approach? Fine tune your diagnostic and treatment algorithm with Dr. Premal Trivedi from the University of Colorado and host Dr. Christopher Beck as they go in-depth on the management of biliary strictures.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISThe doctors first break down the signs and clinical picture that alert them to a possible biliary stricture. Dr. Trivedi then explains the steps of his workup and preferred imaging, and also describes his threshold to pursue percutaneous transhepatic cholangiography (PTC), especially in diffuse conditions like primary sclerosing cholangitis. Dr. Trivedi also walks through his procedural steps for PTC and drain placement, covering his best practices and typical intraoperative decision making.Dr. Trivedi then explains the role of angioplasty over the course of longitudinal treatment, balloon choice, and his upper limit of catheter upsizing. The doctors also delve into the role of interventional endoscopy and tackling complications such as bleeding and tube leakage. The conversation offers valuable insights for trainees and practitioners alike, and highlights future advancements in biliary interventions.---TIMESTAMPS00:00 - Introduction06:19 - Approach to Biliary Strictures08:10 - Workup and Imaging for Biliary Strictures20:41 - Accessing the Biliary System27:14 - Crossing the Obstruction: Next Steps33:22 - Endoscopic Evaluation and Its Role47:14 - Complications and Pain Management53:40 - Future of Biliary Management54:55 - Conclusion and Final Thoughts Tue, 26 Aug 2025 07:00:00 -0000 full BackTable What piques your clinical suspicion for biliary structure? And when is interventional endoscopy the preferred approach? Fine tune your diagnostic and treatment algorithm with Dr. Premal Trivedi from the University of Colorado and host Dr. Christopher Beck as they go in-depth on the management of biliary strictures.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISThe doctors first break down the signs and clinical picture that alert them to a possible biliary stricture. Dr. Trivedi then explains the steps of his workup and preferred imaging, and also describes his threshold to pursue percutaneous transhepatic cholangiography (PTC), especially in diffuse conditions like primary sclerosing cholangitis. Dr. Trivedi also walks through his procedural steps for PTC and drain placement, covering his best practices and typical intraoperative decision making.Dr. Trivedi then explains the role of angioplasty over the course of longitudinal treatment, balloon choice, and his upper limit of catheter upsizing. The doctors also delve into the role of interventional endoscopy and tackling complications such as bleeding and tube leakage. The conversation offers valuable insights for trainees and practitioners alike, and highlights future advancements in biliary interventions.---TIMESTAMPS00:00 - Introduction06:19 - Approach to Biliary Strictures08:10 - Workup and Imaging for Biliary Strictures20:41 - Accessing the Biliary System27:14 - Crossing the Obstruction: Next Steps33:22 - Endoscopic Evaluation and Its Role47:14 - Complications and Pain Management53:40 - Future of Biliary Management54:55 - Conclusion and Final Thoughts What piques your clinical suspicion for biliary structure? And when is interventional endoscopy the preferred approach? Fine tune your diagnostic and treatment algorithm with Dr. Premal Trivedi from the University of Colorado and host Dr. Christopher Beck as they go in-depth on the management of biliary strictures.
---
This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
---
SYNPOSIS
The doctors first break down the signs and clinical picture that alert them to a possible biliary stricture. Dr. Trivedi then explains the steps of his workup and preferred imaging, and also describes his threshold to pursue percutaneous transhepatic cholangiography (PTC), especially in diffuse conditions like primary sclerosing cholangitis. Dr. Trivedi also walks through his procedural steps for PTC and drain placement, covering his best practices and typical intraoperative decision making.
Dr. Trivedi then explains the role of angioplasty over the course of longitudinal treatment, balloon choice, and his upper limit of catheter upsizing. The doctors also delve into the role of interventional endoscopy and tackling complications such as bleeding and tube leakage. The conversation offers valuable insights for trainees and practitioners alike, and highlights future advancements in biliary interventions.
---
TIMESTAMPS
00:00 - Introduction
06:19 - Approach to Biliary Strictures
08:10 - Workup and Imaging for Biliary Strictures
20:41 - Accessing the Biliary System
27:14 - Crossing the Obstruction: Next Steps
33:22 - Endoscopic Evaluation and Its Role
47:14 - Complications and Pain Management
53:40 - Future of Biliary Management
54:55 - Conclusion and Final Thoughts

]]> 3465 Ep. 566 Navigating the Private Equity Practice Setting with Dr. Oleksandra Kutsenko As new graduates enter the workforce, what are the key differences between academic, private, and hybrid practice models? Dr. Oleksandra Kutsenko, Chief of Interventional Radiology at Red Rock Radiology Associates, joins host Dr. Ally Baheti to discuss her experiences working in a private equity group in Nevada.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISDr. Kanko discusses her career trajectory, her experiences with private equity, and the benefits and challenges of working in such a setting. She highlights the value of stepping into leadership roles, cultivating a versatile skill set, and navigating the complexities of working within a large, multifaceted organization like Radiology Partners. The conversation covers day-to-day operations, educational opportunities, and her perspective on balancing clinical work with administrative responsibilities. She emphasizes the importance of investing early in one’s career to build credibility and establish a lasting presence.---TIMESTAMPS00:00 - Introduction01:50 - Career Journey and Challenges03:15 - Private Practice vs. Academics07:11 - Daily Life as an Interventional Radiologist12:19 - Involvement with RAD Partners13:42 - Educational Tools and AI in Radiology24:08 - Clinic Operations and RVU Discussion31:59 - Advice for Trainees and Career Insights33:13 - Conclusion and Final Thoughts Fri, 22 Aug 2025 07:00:00 -0000 full BackTable As new graduates enter the workforce, what are the key differences between academic, private, and hybrid practice models? Dr. Oleksandra Kutsenko, Chief of Interventional Radiology at Red Rock Radiology Associates, joins host Dr. Ally Baheti to discuss her experiences working in a private equity group in Nevada.---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISDr. Kanko discusses her career trajectory, her experiences with private equity, and the benefits and challenges of working in such a setting. She highlights the value of stepping into leadership roles, cultivating a versatile skill set, and navigating the complexities of working within a large, multifaceted organization like Radiology Partners. The conversation covers day-to-day operations, educational opportunities, and her perspective on balancing clinical work with administrative responsibilities. She emphasizes the importance of investing early in one’s career to build credibility and establish a lasting presence.---TIMESTAMPS00:00 - Introduction01:50 - Career Journey and Challenges03:15 - Private Practice vs. Academics07:11 - Daily Life as an Interventional Radiologist12:19 - Involvement with RAD Partners13:42 - Educational Tools and AI in Radiology24:08 - Clinic Operations and RVU Discussion31:59 - Advice for Trainees and Career Insights33:13 - Conclusion and Final Thoughts As new graduates enter the workforce, what are the key differences between academic, private, and hybrid practice models? Dr. Oleksandra Kutsenko, Chief of Interventional Radiology at Red Rock Radiology Associates, joins host Dr. Ally Baheti to discuss her experiences working in a private equity group in Nevada.
---
This podcast is supported by:
Medtronic Emprint
https://www.medtronic.com/emprint
---
SYNPOSIS
Dr. Kanko discusses her career trajectory, her experiences with private equity, and the benefits and challenges of working in such a setting. She highlights the value of stepping into leadership roles, cultivating a versatile skill set, and navigating the complexities of working within a large, multifaceted organization like Radiology Partners. The conversation covers day-to-day operations, educational opportunities, and her perspective on balancing clinical work with administrative responsibilities. She emphasizes the importance of investing early in one’s career to build credibility and establish a lasting presence.
---
TIMESTAMPS
00:00 - Introduction
01:50 - Career Journey and Challenges
03:15 - Private Practice vs. Academics
07:11 - Daily Life as an Interventional Radiologist
12:19 - Involvement with RAD Partners
13:42 - Educational Tools and AI in Radiology
24:08 - Clinic Operations and RVU Discussion
31:59 - Advice for Trainees and Career Insights
33:13 - Conclusion and Final Thoughts

]]> 2181 Ep. 565 Resorbable Embolics in MSK Embolizations with Dr. Keerthi Prasad Resorbable embolics are gaining traction in musculoskeletal interventions, but what are the key technical considerations? Dr. Keerthi Prasad, interventional radiologist at the Centers for Pain Control and Vein Care joins host Dr. Ally Baheti to share practical insights when using resorbable embolics in MSK interventions.---This podcast is supported by:OBL Marketinghttps://www.oblmarketing.com---SYNPOSISDr. Prasad opens the conversation with an overview of embolic agents used in MSK interventions—including Imipenem, Lipiodol, and Nexsphere-F—and shares practical insights into technique selection. He explores the nuances of working with various resorbable embolics, highlighting clinical cases from his personal experience. The discussion also highlights Dr. Prasad’s innovative approach to establishing an outpatient-based lab (OBL) focused on musculoskeletal interventions. Additionally, Dr. Prasad also offers insight into the expanding role of resorbable embolics in treating conditions such as knee arthritis, plantar fasciitis, and adhesive capsulitis. The episode ends with a call to broaden access to this evolving treatment.---TIMESTAMPS00:00 - Introduction01:55 - Outpatient Embolization and MSK Procedures04:20 - Resorbable Embolics in Joint Embolization04:52 - Available Resorbable Embolics in the US07:57 - Technical Insights on Using Resorbable Embolics15:18 - Patient Outcomes and Long-Term Durability22:24 - Future of MSK Embolization Techniques24:05 - Exploring New Applications for Resorbable Embolics27:30 - Innovative Procedures and Techniques37:00 - Final Thoughts and Advice for Practitioners Tue, 19 Aug 2025 07:00:00 -0000 full BackTable Resorbable embolics are gaining traction in musculoskeletal interventions, but what are the key technical considerations? Dr. Keerthi Prasad, interventional radiologist at the Centers for Pain Control and Vein Care joins host Dr. Ally Baheti to share practical insights when using resorbable embolics in MSK interventions.---This podcast is supported by:OBL Marketinghttps://www.oblmarketing.com---SYNPOSISDr. Prasad opens the conversation with an overview of embolic agents used in MSK interventions—including Imipenem, Lipiodol, and Nexsphere-F—and shares practical insights into technique selection. He explores the nuances of working with various resorbable embolics, highlighting clinical cases from his personal experience. The discussion also highlights Dr. Prasad’s innovative approach to establishing an outpatient-based lab (OBL) focused on musculoskeletal interventions. Additionally, Dr. Prasad also offers insight into the expanding role of resorbable embolics in treating conditions such as knee arthritis, plantar fasciitis, and adhesive capsulitis. The episode ends with a call to broaden access to this evolving treatment.---TIMESTAMPS00:00 - Introduction01:55 - Outpatient Embolization and MSK Procedures04:20 - Resorbable Embolics in Joint Embolization04:52 - Available Resorbable Embolics in the US07:57 - Technical Insights on Using Resorbable Embolics15:18 - Patient Outcomes and Long-Term Durability22:24 - Future of MSK Embolization Techniques24:05 - Exploring New Applications for Resorbable Embolics27:30 - Innovative Procedures and Techniques37:00 - Final Thoughts and Advice for Practitioners Resorbable embolics are gaining traction in musculoskeletal interventions, but what are the key technical considerations? Dr. Keerthi Prasad, interventional radiologist at the Centers for Pain Control and Vein Care joins host Dr. Ally Baheti to share practical insights when using resorbable embolics in MSK interventions.
---
This podcast is supported by:
OBL Marketing
https://www.oblmarketing.com
---
SYNPOSIS
Dr. Prasad opens the conversation with an overview of embolic agents used in MSK interventions—including Imipenem, Lipiodol, and Nexsphere-F—and shares practical insights into technique selection. He explores the nuances of working with various resorbable embolics, highlighting clinical cases from his personal experience. The discussion also highlights Dr. Prasad’s innovative approach to establishing an outpatient-based lab (OBL) focused on musculoskeletal interventions. Additionally, Dr. Prasad also offers insight into the expanding role of resorbable embolics in treating conditions such as knee arthritis, plantar fasciitis, and adhesive capsulitis. The episode ends with a call to broaden access to this evolving treatment.
---
TIMESTAMPS
00:00 - Introduction
01:55 - Outpatient Embolization and MSK Procedures
04:20 - Resorbable Embolics in Joint Embolization
04:52 - Available Resorbable Embolics in the US
07:57 - Technical Insights on Using Resorbable Embolics
15:18 - Patient Outcomes and Long-Term Durability
22:24 - Future of MSK Embolization Techniques
24:05 - Exploring New Applications for Resorbable Embolics
27:30 - Innovative Procedures and Techniques
37:00 - Final Thoughts and Advice for Practitioners

]]> 2466 Ep. 564 Pressure-Enabled Drug Delivery in HCC & Metastatic Liver Lesions with Dr. Zach Berman Can you manipulate blood flow in the tumor microenvironment to optimize drug delivery? In this episode of the BackTable Podcast, interventional oncologist Dr. Zachary Berman (UC San Diego) joins host Dr. Christopher Beck to discuss real-world applications of pressure-enabled drug delivery in locoregional liver-directed therapies like TACE and Y90.---This podcast is supported by:TriSalus Life Scienceshttp://trinavinfusion.com/---SYNPOSISThe conversation begins with an overview of the tumor microvascular environment, focusing on the abnormal nature of the new vessels that feed tumors. They then discuss the genesis of pressure-enabled drug delivery and the theory behind its efficacy. Dr. Berman explains the TriNav catheter’s micro-valve design, its anti-reflux properties, and how these features enhance tumor drug delivery. He walks through his own procedure technique, comparing and contrasting it to standard embolization, and details the utility of pressure-enabled drug delivery in lobar radioembolization and larger tumors. They also explore the benefits of both balloon occlusion and microvalve catheters.Real-world cases—including neuroendocrine tumors, segmental HCC, and more—illustrate the thought process around when to use specialized technologies. The episode wraps up with a discussion of the future implications for this technology in other pathologies, cost considerations, and the potential for enhancing drug delivery with innovative approaches.---TIMESTAMPS00:00 - Introduction01:39 - The Tumor Microenvironment06:59 - Pressure-Enabled Drug Delivery Explained09:37 - Technical Aspects of Pressure-Enabled Catheters21:48 - Case 1: Grade 3 Neuroendocrine Tumor34:06 - Case 2: Hepatocellular Carcinoma with Tumor and Vein36:01 - Case 3: TACE for Segmental HCC in Decompensated Cirrhosis38:58 - Case 4: Large Heterogenous Cholangiocarcinoma40:40 - Case 5: Lobar Neuroendocrine Tumor42:38 - Case 6: Segmental HCC with Central Necrosis47:52 - Best Practices and Technical Considerations57:52 - Future Directions in Pressure-Directed Embolotherapy59:48 - Conclusion and Final Thoughts---RESOURCESJVIR 2024 Jaroch et al.:https://pubmed.ncbi.nlm.nih.gov/38969336/ Tue, 12 Aug 2025 07:00:00 -0000 full BackTable Can you manipulate blood flow in the tumor microenvironment to optimize drug delivery? In this episode of the BackTable Podcast, interventional oncologist Dr. Zachary Berman (UC San Diego) joins host Dr. Christopher Beck to discuss real-world applications of pressure-enabled drug delivery in locoregional liver-directed therapies like TACE and Y90.---This podcast is supported by:TriSalus Life Scienceshttp://trinavinfusion.com/---SYNPOSISThe conversation begins with an overview of the tumor microvascular environment, focusing on the abnormal nature of the new vessels that feed tumors. They then discuss the genesis of pressure-enabled drug delivery and the theory behind its efficacy. Dr. Berman explains the TriNav catheter’s micro-valve design, its anti-reflux properties, and how these features enhance tumor drug delivery. He walks through his own procedure technique, comparing and contrasting it to standard embolization, and details the utility of pressure-enabled drug delivery in lobar radioembolization and larger tumors. They also explore the benefits of both balloon occlusion and microvalve catheters.Real-world cases—including neuroendocrine tumors, segmental HCC, and more—illustrate the thought process around when to use specialized technologies. The episode wraps up with a discussion of the future implications for this technology in other pathologies, cost considerations, and the potential for enhancing drug delivery with innovative approaches.---TIMESTAMPS00:00 - Introduction01:39 - The Tumor Microenvironment06:59 - Pressure-Enabled Drug Delivery Explained09:37 - Technical Aspects of Pressure-Enabled Catheters21:48 - Case 1: Grade 3 Neuroendocrine Tumor34:06 - Case 2: Hepatocellular Carcinoma with Tumor and Vein36:01 - Case 3: TACE for Segmental HCC in Decompensated Cirrhosis38:58 - Case 4: Large Heterogenous Cholangiocarcinoma40:40 - Case 5: Lobar Neuroendocrine Tumor42:38 - Case 6: Segmental HCC with Central Necrosis47:52 - Best Practices and Technical Considerations57:52 - Future Directions in Pressure-Directed Embolotherapy59:48 - Conclusion and Final Thoughts---RESOURCESJVIR 2024 Jaroch et al.:https://pubmed.ncbi.nlm.nih.gov/38969336/ Can you manipulate blood flow in the tumor microenvironment to optimize drug delivery? In this episode of the BackTable Podcast, interventional oncologist Dr. Zachary Berman (UC San Diego) joins host Dr. Christopher Beck to discuss real-world applications of pressure-enabled drug delivery in locoregional liver-directed therapies like TACE and Y90.
---
This podcast is supported by:
TriSalus Life Sciences
http://trinavinfusion.com/
---
SYNPOSIS
The conversation begins with an overview of the tumor microvascular environment, focusing on the abnormal nature of the new vessels that feed tumors. They then discuss the genesis of pressure-enabled drug delivery and the theory behind its efficacy. Dr. Berman explains the TriNav catheter’s micro-valve design, its anti-reflux properties, and how these features enhance tumor drug delivery. He walks through his own procedure technique, comparing and contrasting it to standard embolization, and details the utility of pressure-enabled drug delivery in lobar radioembolization and larger tumors. They also explore the benefits of both balloon occlusion and microvalve catheters.
Real-world cases—including neuroendocrine tumors, segmental HCC, and more—illustrate the thought process around when to use specialized technologies. The episode wraps up with a discussion of the future implications for this technology in other pathologies, cost considerations, and the potential for enhancing drug delivery with innovative approaches.
---
TIMESTAMPS
00:00 - Introduction
01:39 - The Tumor Microenvironment
06:59 - Pressure-Enabled Drug Delivery Explained
09:37 - Technical Aspects of Pressure-Enabled Catheters
21:48 - Case 1: Grade 3 Neuroendocrine Tumor
34:06 - Case 2: Hepatocellular Carcinoma with Tumor and Vein
36:01 - Case 3: TACE for Segmental HCC in Decompensated Cirrhosis
38:58 - Case 4: Large Heterogenous Cholangiocarcinoma
40:40 - Case 5: Lobar Neuroendocrine Tumor
42:38 - Case 6: Segmental HCC with Central Necrosis
47:52 - Best Practices and Technical Considerations
57:52 - Future Directions in Pressure-Directed Embolotherapy
59:48 - Conclusion and Final Thoughts
---
RESOURCES
JVIR 2024 Jaroch et al.:
https://pubmed.ncbi.nlm.nih.gov/38969336/

]]> 3558 Ep. 563 Techniques for Effective Vessel Prep with Dr. Jay Mathews and Dr. Michael Siah The toolbox for vessel preparation is rapidly expanding. Are you keeping up? In this episode, host Dr. Sabeen Dhand is joined by Dr. Jay Mathews, interventional cardiologist (Manatee Memorial Hospital) and Dr. Michael Siah, vascular surgeon (UT Southwestern), to explore the latest innovations and strategies in vessel prep. --- This podcast is supported by: Cagent Vascularhttps://cagentvascular.com/ --- SYNPOSIS The discussion opens with a look at new additions to their practice over the past few years, including bioresorbable scaffolds for below-the-knee interventions and retrievable stent technologies. Both experts emphasize the role of imaging—particularly CT angiography and IVUS—and discuss how renal disease impacts their use of contrast during diagnosis and intervention. They then walk through how they assess vessels on angiography or IVUS to decide when and where to use specialty tools. From intravascular lithotripsy for managing dense calcification to serration angioplasty, the conversation highlights how the doctors decide to use specialty balloons and devices. The episode also touches on the practical challenges of balancing device cost with treatment effectiveness. The physicians break down the latest specialty balloons and devices and touch on their own experiences with them. To close, the guests share what emerging technologies they’re most excited about and how these devices could change their day-to-day practice. Whether you’re in IR, cardiology, or vascular surgery, this episode offers a valuable roadmap to the current and future state of vessel preparation. --- TIMESTAMPS 0:00 - Introduction4:07 - New Changes in Techniques14:57 - Vessel Characteristics on Angiogram18:10 - Approaches to Above-the-Knee vs. Below-the-Knee Disease23:48 - Latest Specialty Balloons46:14 - New Devices on the Horizon50:58 - Words of Advice and Final Thoughts --- RESOURCES POINT FORCE Registry: ​​https://evtoday.com/news/cagent-initiates-point-force-registry-of-serranator-pta-catheter?c4src=news Tue, 05 Aug 2025 07:00:00 -0000 full BackTable The toolbox for vessel preparation is rapidly expanding. Are you keeping up? In this episode, host Dr. Sabeen Dhand is joined by Dr. Jay Mathews, interventional cardiologist (Manatee Memorial Hospital) and Dr. Michael Siah, vascular surgeon (UT Southwestern), to explore the latest innovations and strategies in vessel prep. --- This podcast is supported by: Cagent Vascularhttps://cagentvascular.com/ --- SYNPOSIS The discussion opens with a look at new additions to their practice over the past few years, including bioresorbable scaffolds for below-the-knee interventions and retrievable stent technologies. Both experts emphasize the role of imaging—particularly CT angiography and IVUS—and discuss how renal disease impacts their use of contrast during diagnosis and intervention. They then walk through how they assess vessels on angiography or IVUS to decide when and where to use specialty tools. From intravascular lithotripsy for managing dense calcification to serration angioplasty, the conversation highlights how the doctors decide to use specialty balloons and devices. The episode also touches on the practical challenges of balancing device cost with treatment effectiveness. The physicians break down the latest specialty balloons and devices and touch on their own experiences with them. To close, the guests share what emerging technologies they’re most excited about and how these devices could change their day-to-day practice. Whether you’re in IR, cardiology, or vascular surgery, this episode offers a valuable roadmap to the current and future state of vessel preparation. --- TIMESTAMPS 0:00 - Introduction4:07 - New Changes in Techniques14:57 - Vessel Characteristics on Angiogram18:10 - Approaches to Above-the-Knee vs. Below-the-Knee Disease23:48 - Latest Specialty Balloons46:14 - New Devices on the Horizon50:58 - Words of Advice and Final Thoughts --- RESOURCES POINT FORCE Registry: ​​https://evtoday.com/news/cagent-initiates-point-force-registry-of-serranator-pta-catheter?c4src=news The toolbox for vessel preparation is rapidly expanding. Are you keeping up? In this episode, host Dr. Sabeen Dhand is joined by Dr. Jay Mathews, interventional cardiologist (Manatee Memorial Hospital) and Dr. Michael Siah, vascular surgeon (UT Southwestern), to explore the latest innovations and strategies in vessel prep.


---


This podcast is supported by:


Cagent Vascular
https://cagentvascular.com/


---


SYNPOSIS


The discussion opens with a look at new additions to their practice over the past few years, including bioresorbable scaffolds for below-the-knee interventions and retrievable stent technologies. Both experts emphasize the role of imaging—particularly CT angiography and IVUS—and discuss how renal disease impacts their use of contrast during diagnosis and intervention. They then walk through how they assess vessels on angiography or IVUS to decide when and where to use specialty tools. From intravascular lithotripsy for managing dense calcification to serration angioplasty, the conversation highlights how the doctors decide to use specialty balloons and devices. The episode also touches on the practical challenges of balancing device cost with treatment effectiveness. The physicians break down the latest specialty balloons and devices and touch on their own experiences with them. To close, the guests share what emerging technologies they’re most excited about and how these devices could change their day-to-day practice. Whether you’re in IR, cardiology, or vascular surgery, this episode offers a valuable roadmap to the current and future state of vessel preparation.


---


TIMESTAMPS


0:00 - Introduction
4:07 - New Changes in Techniques
14:57 - Vessel Characteristics on Angiogram
18:10 - Approaches to Above-the-Knee vs. Below-the-Knee Disease
23:48 - Latest Specialty Balloons
46:14 - New Devices on the Horizon
50:58 - Words of Advice and Final Thoughts


---


RESOURCES


POINT FORCE Registry: ​​https://evtoday.com/news/cagent-initiates-point-force-registry-of-serranator-pta-catheter?c4src=news

]]> 3384 Ep. 562 IR as a Business Engine: Scaling High-Acuity Care in Private Practice with Dr. Harris Chengazi What are the key elements of a robust interventional radiology practice, and how can IRs effectively demonstrate their value to hospitals? Guest, Dr. Harris Chengazi, interventional radiologist at Great Lakes Medical Imaging, joins host Dr. Sabeen Dhand to explore the core strategies behind developing a successful and sustainable clinical IR practice. --- This podcast is supported by: RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS Dr. Chengazi reflects on formative experiences from the early stages of his career, highlighting the importance of joining a group that shares your vision for a clinical interventional radiology (IR) practice. He underscores the unique value IR offers hospitals—particularly through longitudinal patient care, which not only enhances reimbursement opportunities but also strengthens interdisciplinary collaboration and drives outpatient referrals.He shares insights on balancing complex cases with essential procedures, while underscoring the importance of clear communication and articulating IR’s value to hospital leadership. He also highlights the critical need for physicians to understand the business side of medicine—including coding, billing, and reimbursement—in order to effectively advocate for the specialty. He concludes the episode with a compelling message on the importance of taking ownership of both our patients and the future of our profession. --- TIMESTAMPS00:00 - Introduction and Overview01:55 - Building a Private Practice05:22 - Challenges and Successes24:58 - The Value of Complex Cases in Medical Practice27:00 - Improving Hospital Efficiency Through IR Services29:18 - Involvement of IR in Hospital Administration31:26 - Building a Successful IR Practice36:14 -The Financial Dynamics of IR and DR Practices41:14 -The Essential Role of IR in Hospital Operations Fri, 01 Aug 2025 07:00:00 -0000 full BackTable What are the key elements of a robust interventional radiology practice, and how can IRs effectively demonstrate their value to hospitals? Guest, Dr. Harris Chengazi, interventional radiologist at Great Lakes Medical Imaging, joins host Dr. Sabeen Dhand to explore the core strategies behind developing a successful and sustainable clinical IR practice. --- This podcast is supported by: RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS Dr. Chengazi reflects on formative experiences from the early stages of his career, highlighting the importance of joining a group that shares your vision for a clinical interventional radiology (IR) practice. He underscores the unique value IR offers hospitals—particularly through longitudinal patient care, which not only enhances reimbursement opportunities but also strengthens interdisciplinary collaboration and drives outpatient referrals.He shares insights on balancing complex cases with essential procedures, while underscoring the importance of clear communication and articulating IR’s value to hospital leadership. He also highlights the critical need for physicians to understand the business side of medicine—including coding, billing, and reimbursement—in order to effectively advocate for the specialty. He concludes the episode with a compelling message on the importance of taking ownership of both our patients and the future of our profession. --- TIMESTAMPS00:00 - Introduction and Overview01:55 - Building a Private Practice05:22 - Challenges and Successes24:58 - The Value of Complex Cases in Medical Practice27:00 - Improving Hospital Efficiency Through IR Services29:18 - Involvement of IR in Hospital Administration31:26 - Building a Successful IR Practice36:14 -The Financial Dynamics of IR and DR Practices41:14 -The Essential Role of IR in Hospital Operations What are the key elements of a robust interventional radiology practice, and how can IRs effectively demonstrate their value to hospitals? Guest, Dr. Harris Chengazi, interventional radiologist at Great Lakes Medical Imaging, joins host Dr. Sabeen Dhand to explore the core strategies behind developing a successful and sustainable clinical IR practice.


---


This podcast is supported by:


RADPAD® Radiation Protection
https://www.radpad.com/


---


SYNPOSIS


Dr. Chengazi reflects on formative experiences from the early stages of his career, highlighting the importance of joining a group that shares your vision for a clinical interventional radiology (IR) practice. He underscores the unique value IR offers hospitals—particularly through longitudinal patient care, which not only enhances reimbursement opportunities but also strengthens interdisciplinary collaboration and drives outpatient referrals.
He shares insights on balancing complex cases with essential procedures, while underscoring the importance of clear communication and articulating IR’s value to hospital leadership. He also highlights the critical need for physicians to understand the business side of medicine—including coding, billing, and reimbursement—in order to effectively advocate for the specialty. He concludes the episode with a compelling message on the importance of taking ownership of both our patients and the future of our profession.


---


TIMESTAMPS
00:00 - Introduction and Overview
01:55 - Building a Private Practice
05:22 - Challenges and Successes
24:58 - The Value of Complex Cases in Medical Practice
27:00 - Improving Hospital Efficiency Through IR Services
29:18 - Involvement of IR in Hospital Administration
31:26 - Building a Successful IR Practice
36:14 -The Financial Dynamics of IR and DR Practices
41:14 -The Essential Role of IR in Hospital Operations

]]> 3264 Ep. 561 Dosimetry University VI: Challenging Case Review with Dr. Tyler Sandow and Dr. Zach Berman When is Y90 the right treatment for metastatic disease? Join Drs. Tyler Sandow, Zach Berman and host Kavi Krishnasamy in the conclusion of Dosimetry University where they discuss the complexities of treating different variations of metastatic disease and review how they’ve approached complicated cases with Y90. --- SYNPOSIS The interventional oncologists first outline the types of metastases that they treat, including colorectal, lung, cholangiocarcinoma, breast, gastric, RCC, and melanoma. The doctors then discuss the potential for Y90 to provide palliative relief by reducing tumor-related pain. The conversation also covers key differences between treating liver-dominant and liver-only disease, along with their algorithm for patients not on systemic chemotherapy.The episode then covers advanced concepts in Y90, such as sub-ablative dosing, the possibility of creating an abscopal effect, and how radiation thresholds change depending on treatment goals. They outline their approach to partition dosimetry, using SPECT/CT to calculate tumor-to-normal ratios, and explain how they modify particle counts and microsphere activity, using flow augmentation based on tumor vascularity. Additional discussion includes the impact of mutation status, prior lines of chemotherapy, and tumor response criteria like RECIST 1.1 and mRECIST. The experts conclude with a case series that illustrates decision-making around when to consider Y90, thermal ablation, TACE, or alternative approaches—even in complex cases like sphincter of Oddi dysfunction. The session underscores the nuanced nature of advanced dosimetric techniques and the evolving landscape of interventional oncology. --- TIMESTAMPS 00:00 - Introduction 01:30 - Types of Metastases Treated with Y9002:50 - Liver-Dominant vs. Liver-Only Disease 07:20 - Sub-Ablative Dosing and the Abscopal Effect09:55 - Tips for Partition Dosimetry 15:30 - Clinical Factors in Treatment Planning23:50 - Choosing Ablation, Resection, or Y90 for mCRC30:27 - Case Series: Colorectal Metastases, Biliary Complications, and more46:00 - Final Thoughts: The Evolving Field --- RESOURCES RECIST 1.1 and mRECIST Criteria:https://pmc.ncbi.nlm.nih.gov/articles/PMC9161105/ COLLISION Trial:https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501 BackTable Episode on COLLISION Trial:https://www.youtube.com/watch?v=NQLKcv1BRVM FOXFIRE, SIRFLOX, FOXFIRE-Global:https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30457-6/fulltext Tue, 29 Jul 2025 07:00:00 -0000 full BackTable When is Y90 the right treatment for metastatic disease? Join Drs. Tyler Sandow, Zach Berman and host Kavi Krishnasamy in the conclusion of Dosimetry University where they discuss the complexities of treating different variations of metastatic disease and review how they’ve approached complicated cases with Y90. --- SYNPOSIS The interventional oncologists first outline the types of metastases that they treat, including colorectal, lung, cholangiocarcinoma, breast, gastric, RCC, and melanoma. The doctors then discuss the potential for Y90 to provide palliative relief by reducing tumor-related pain. The conversation also covers key differences between treating liver-dominant and liver-only disease, along with their algorithm for patients not on systemic chemotherapy.The episode then covers advanced concepts in Y90, such as sub-ablative dosing, the possibility of creating an abscopal effect, and how radiation thresholds change depending on treatment goals. They outline their approach to partition dosimetry, using SPECT/CT to calculate tumor-to-normal ratios, and explain how they modify particle counts and microsphere activity, using flow augmentation based on tumor vascularity. Additional discussion includes the impact of mutation status, prior lines of chemotherapy, and tumor response criteria like RECIST 1.1 and mRECIST. The experts conclude with a case series that illustrates decision-making around when to consider Y90, thermal ablation, TACE, or alternative approaches—even in complex cases like sphincter of Oddi dysfunction. The session underscores the nuanced nature of advanced dosimetric techniques and the evolving landscape of interventional oncology. --- TIMESTAMPS 00:00 - Introduction 01:30 - Types of Metastases Treated with Y9002:50 - Liver-Dominant vs. Liver-Only Disease 07:20 - Sub-Ablative Dosing and the Abscopal Effect09:55 - Tips for Partition Dosimetry 15:30 - Clinical Factors in Treatment Planning23:50 - Choosing Ablation, Resection, or Y90 for mCRC30:27 - Case Series: Colorectal Metastases, Biliary Complications, and more46:00 - Final Thoughts: The Evolving Field --- RESOURCES RECIST 1.1 and mRECIST Criteria:https://pmc.ncbi.nlm.nih.gov/articles/PMC9161105/ COLLISION Trial:https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501 BackTable Episode on COLLISION Trial:https://www.youtube.com/watch?v=NQLKcv1BRVM FOXFIRE, SIRFLOX, FOXFIRE-Global:https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30457-6/fulltext When is Y90 the right treatment for metastatic disease? Join Drs. Tyler Sandow, Zach Berman and host Kavi Krishnasamy in the conclusion of Dosimetry University where they discuss the complexities of treating different variations of metastatic disease and review how they’ve approached complicated cases with Y90.


---


SYNPOSIS


The interventional oncologists first outline the types of metastases that they treat, including colorectal, lung, cholangiocarcinoma, breast, gastric, RCC, and melanoma. The doctors then discuss the potential for Y90 to provide palliative relief by reducing tumor-related pain. The conversation also covers key differences between treating liver-dominant and liver-only disease, along with their algorithm for patients not on systemic chemotherapy.
The episode then covers advanced concepts in Y90, such as sub-ablative dosing, the possibility of creating an abscopal effect, and how radiation thresholds change depending on treatment goals.

They outline their approach to partition dosimetry, using SPECT/CT to calculate tumor-to-normal ratios, and explain how they modify particle counts and microsphere activity, using flow augmentation based on tumor vascularity. Additional discussion includes the impact of mutation status, prior lines of chemotherapy, and tumor response criteria like RECIST 1.1 and mRECIST.


The experts conclude with a case series that illustrates decision-making around when to consider Y90, thermal ablation, TACE, or alternative approaches—even in complex cases like sphincter of Oddi dysfunction. The session underscores the nuanced nature of advanced dosimetric techniques and the evolving landscape of interventional oncology.


---


TIMESTAMPS


00:00 - Introduction
01:30 - Types of Metastases Treated with Y90
02:50 - Liver-Dominant vs. Liver-Only Disease
07:20 - Sub-Ablative Dosing and the Abscopal Effect
09:55 - Tips for Partition Dosimetry
15:30 - Clinical Factors in Treatment Planning
23:50 - Choosing Ablation, Resection, or Y90 for mCRC
30:27 - Case Series: Colorectal Metastases, Biliary Complications, and more
46:00 - Final Thoughts: The Evolving Field


---


RESOURCES


RECIST 1.1 and mRECIST Criteria:
https://pmc.ncbi.nlm.nih.gov/articles/PMC9161105/


COLLISION Trial:
https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501


BackTable Episode on COLLISION Trial:
https://www.youtube.com/watch?v=NQLKcv1BRVM


FOXFIRE, SIRFLOX, FOXFIRE-Global:
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30457-6/fulltext

]]> 2995 Ep. 560 Biliary Endoscopy Techniques for Gallstones with Dr. John Smirniotopoulos Symptomatic gallstones that can’t be treated with surgery? Interventional radiology can help. In this episode of BackTable, Dr. John Smirniotopoulos, IR at MedStar Health, joins Dr. Michael Barraza to share the latest advancements and techniques in biliary endoscopy. --- SYNPOSIS Dr. Smirniotopoulos reflects on his early work with cholangioscopy at Cornell, highlighting ongoing innovation and evolving tools. The conversation covers the practical aspects of patient selection, procedural steps, and overcoming technical challenges. Dr. Smirniotopoulos shares his personal experiences managing small and large biliary stones, emphasizing the important role of selecting appropriate equipment to navigate procedural challenges. Dr. Smirniotopoulos also highlights the collaborative role of surgeons and gastroenterologists throughout patient management. He also provides insights into the management of biliary strictures and emphasizes the importance of accurate billing and coding. The episode concludes with advice for clinicians seeking to integrate these techniques into their practice. --- TIMESTAMPS 00:00 - Introduction01:09 - Early Experiences with Biliary Endoscopy03:35 - Procedure Techniques and Tools05:36 - Patient Selection and Case Studies11:01 - Advanced Techniques and Equipment14:02 - Patient Management and Follow-Up18:21 - Technical Considerations and Best Practices20:14 - Managing Stones in the Gallbladder35:42 - Collaborating with Surgeons and GI Teams37:59 - Advice for New Practitioners Fri, 25 Jul 2025 07:00:00 -0000 full BackTable Symptomatic gallstones that can’t be treated with surgery? Interventional radiology can help. In this episode of BackTable, Dr. John Smirniotopoulos, IR at MedStar Health, joins Dr. Michael Barraza to share the latest advancements and techniques in biliary endoscopy. --- SYNPOSIS Dr. Smirniotopoulos reflects on his early work with cholangioscopy at Cornell, highlighting ongoing innovation and evolving tools. The conversation covers the practical aspects of patient selection, procedural steps, and overcoming technical challenges. Dr. Smirniotopoulos shares his personal experiences managing small and large biliary stones, emphasizing the important role of selecting appropriate equipment to navigate procedural challenges. Dr. Smirniotopoulos also highlights the collaborative role of surgeons and gastroenterologists throughout patient management. He also provides insights into the management of biliary strictures and emphasizes the importance of accurate billing and coding. The episode concludes with advice for clinicians seeking to integrate these techniques into their practice. --- TIMESTAMPS 00:00 - Introduction01:09 - Early Experiences with Biliary Endoscopy03:35 - Procedure Techniques and Tools05:36 - Patient Selection and Case Studies11:01 - Advanced Techniques and Equipment14:02 - Patient Management and Follow-Up18:21 - Technical Considerations and Best Practices20:14 - Managing Stones in the Gallbladder35:42 - Collaborating with Surgeons and GI Teams37:59 - Advice for New Practitioners Symptomatic gallstones that can’t be treated with surgery? Interventional radiology can help. In this episode of BackTable, Dr. John Smirniotopoulos, IR at MedStar Health, joins Dr. Michael Barraza to share the latest advancements and techniques in biliary endoscopy.


---


SYNPOSIS


Dr. Smirniotopoulos reflects on his early work with cholangioscopy at Cornell, highlighting ongoing innovation and evolving tools. The conversation covers the practical aspects of patient selection, procedural steps, and overcoming technical challenges. Dr. Smirniotopoulos shares his personal experiences managing small and large biliary stones, emphasizing the important role of selecting appropriate equipment to navigate procedural challenges.


Dr. Smirniotopoulos also highlights the collaborative role of surgeons and gastroenterologists throughout patient management. He also provides insights into the management of biliary strictures and emphasizes the importance of accurate billing and coding. The episode concludes with advice for clinicians seeking to integrate these techniques into their practice.


---


TIMESTAMPS


00:00 - Introduction
01:09 - Early Experiences with Biliary Endoscopy
03:35 - Procedure Techniques and Tools
05:36 - Patient Selection and Case Studies
11:01 - Advanced Techniques and Equipment
14:02 - Patient Management and Follow-Up
18:21 - Technical Considerations and Best Practices
20:14 - Managing Stones in the Gallbladder
35:42 - Collaborating with Surgeons and GI Teams
37:59 - Advice for New Practitioners

]]> 2640 Ep. 559 Dosimetry University V: Case Review on Dose Optimization Strategies with Dr. Tyler Sandow and Dr. Zach Berman The balance between targeting tumor and sparing healthy liver is delicate. How do the experts do it? In this case-based review, Drs. Zach Berman (UC San Diego) and Tyler Sandow (Ochsner Health) join host Dr. Kavi Krishnasamy to walk us through real-world scenarios and share how they approach Y90 dose optimization. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS First, the doctors review a case of HCC and discuss key lab values, like albumin, and their role in planning. They also break down how they manipulate variables like microsphere activity, perfusion density, and total dose to deliver a tumor dose of around 1,100 Gy. The doctors also challenge the standard perfused dose of 400 Gy for large tumors and share when they feel comfortable pushing beyond it. Next, they discuss nuances in treating portal vein tumor invasion and what decides which Vp classifications can be treated with Y90 or combination immunotherapy. A subsequent case involving a large central HCC tumor explores the risks of biliary stricture from high radiation and the challenge of missing tumor margins with overly selective catheterization. In the last case, the doctors discuss different scenarios in multifocal HCC liver lesions. Overall, the conversation explores different approaches based on tumor size, location, and patient liver function, and highlights the importance of multidisciplinary collaboration in optimizing patient outcomes. --- TIMESTAMPS 00:00 - Introduction and Case Overview01:28 - Patient Case Study - Hep C and Alcoholic Cirrhosis02:05 - Evaluating Liver Function and Treatment Approach04:50 - Tumor Dose and Perfusion Density15:49 - Portal Vein Tumor Invasion21:42 - Case Study: Large Central HCC Tumor Treatment22:19 - Challenges in Treating Large Central Tumors22:48 - Dosimetry Considerations and Biliary Strictures27:24 - Case Study: Assorted Multifocal HCC Lesions Scenarios Tue, 22 Jul 2025 07:00:00 -0000 full BackTable The balance between targeting tumor and sparing healthy liver is delicate. How do the experts do it? In this case-based review, Drs. Zach Berman (UC San Diego) and Tyler Sandow (Ochsner Health) join host Dr. Kavi Krishnasamy to walk us through real-world scenarios and share how they approach Y90 dose optimization. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS First, the doctors review a case of HCC and discuss key lab values, like albumin, and their role in planning. They also break down how they manipulate variables like microsphere activity, perfusion density, and total dose to deliver a tumor dose of around 1,100 Gy. The doctors also challenge the standard perfused dose of 400 Gy for large tumors and share when they feel comfortable pushing beyond it. Next, they discuss nuances in treating portal vein tumor invasion and what decides which Vp classifications can be treated with Y90 or combination immunotherapy. A subsequent case involving a large central HCC tumor explores the risks of biliary stricture from high radiation and the challenge of missing tumor margins with overly selective catheterization. In the last case, the doctors discuss different scenarios in multifocal HCC liver lesions. Overall, the conversation explores different approaches based on tumor size, location, and patient liver function, and highlights the importance of multidisciplinary collaboration in optimizing patient outcomes. --- TIMESTAMPS 00:00 - Introduction and Case Overview01:28 - Patient Case Study - Hep C and Alcoholic Cirrhosis02:05 - Evaluating Liver Function and Treatment Approach04:50 - Tumor Dose and Perfusion Density15:49 - Portal Vein Tumor Invasion21:42 - Case Study: Large Central HCC Tumor Treatment22:19 - Challenges in Treating Large Central Tumors22:48 - Dosimetry Considerations and Biliary Strictures27:24 - Case Study: Assorted Multifocal HCC Lesions Scenarios The balance between targeting tumor and sparing healthy liver is delicate. How do the experts do it? In this case-based review, Drs. Zach Berman (UC San Diego) and Tyler Sandow (Ochsner Health) join host Dr. Kavi Krishnasamy to walk us through real-world scenarios and share how they approach Y90 dose optimization.


---


This podcast is supported by:


Sirtex
https://www.sirtex.com/


Medtronic Emprint
https://www.medtronic.com/emprint


---


SYNPOSIS


First, the doctors review a case of HCC and discuss key lab values, like albumin, and their role in planning. They also break down how they manipulate variables like microsphere activity, perfusion density, and total dose to deliver a tumor dose of around 1,100 Gy. The doctors also challenge the standard perfused dose of 400 Gy for large tumors and share when they feel comfortable pushing beyond it.
Next, they discuss nuances in treating portal vein tumor invasion and what decides which Vp classifications can be treated with Y90 or combination immunotherapy. A subsequent case involving a large central HCC tumor explores the risks of biliary stricture from high radiation and the challenge of missing tumor margins with overly selective catheterization. In the last case, the doctors discuss different scenarios in multifocal HCC liver lesions. Overall, the conversation explores different approaches based on tumor size, location, and patient liver function, and highlights the importance of multidisciplinary collaboration in optimizing patient outcomes.


---


TIMESTAMPS


00:00 - Introduction and Case Overview
01:28 - Patient Case Study - Hep C and Alcoholic Cirrhosis
02:05 - Evaluating Liver Function and Treatment Approach
04:50 - Tumor Dose and Perfusion Density
15:49 - Portal Vein Tumor Invasion
21:42 - Case Study: Large Central HCC Tumor Treatment
22:19 - Challenges in Treating Large Central Tumors
22:48 - Dosimetry Considerations and Biliary Strictures
27:24 - Case Study: Assorted Multifocal HCC Lesions Scenarios

]]> 2374 Ep. 558 Advancements in Stroke Thrombectomy: Techniques & Training with Dr. Blaise Baxter and Dr. James Milburn Are your current stroke interventions in line with the latest clinical data? Dr. Blaise Baxter, interventional radiologist at Sutter Health, and Dr. Jim Milburn, interventional neuroradiologist at the Ochsner Health, join host Dr. Michael Barraza to discuss the latest advancements in stroke interventions. --- This podcast is supported by: Imperative Carehttps://imperativecare.com/stroke/zoom-stroke-solution/ --- SYNPOSIS The episode begins with a discussion on the different pathways to becoming a neurointerventionalist, emphasizing why interventional radiologists are uniquely equipped for this transition. They dive into cutting-edge stroke interventions, sharing key takeaways from major trials on large core and medium vessel occlusions. Dr. Baxter and Dr. Milburn highlight the HERMES trial, which showed that endovascular thrombectomy led to beneficial effects on patients with anterior circulation occlusion. They then cover the BAOCHE trial, which showed better functional outcomes with thrombectomy over medical therapy. Milburn and Baxter also share their perspectives on the shifting role of perfusion imaging and why the field may be moving beyond it. To close the discussion, the doctors underscore the powerful impact of rehabilitation in driving patient recovery, and stress the ongoing need for innovation and improved training in the field of neurointerventional radiology. --- TIMESTAMPS 00:00 - Introduction06:18 - Training and Certification in Neurointervention13:11- Large Core Trials and Their Impact19:42 - CT Perfusion and Treatment Decisions29:45 - Understanding Stroke Scale Scores and ICAD30:31 - Thrombectomy Trials and Treatment Strategies34:48 - Challenges in Randomizing Patients for Trials44:25 - Advancements in Robotics and Stroke Treatment51:37 - Future Directions in Stroke Rehabilitation53:11 - Global Thrombectomy Adoption and Training --- RESOURCES Hermes trial: Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723-1731. doi:10.1016/S0140-6736(16)00163-X BAOCH trial: Jovin TG, Li C, Wu L, et al. Trial of Thrombectomy 6 to 24 Hours after Stroke Due to Basilar-Artery Occlusion. N Engl J Med. 2022;387(15):1373-1384. doi:10.1056/NEJMoa2207576 Fri, 18 Jul 2025 07:00:00 -0000 full BackTable Are your current stroke interventions in line with the latest clinical data? Dr. Blaise Baxter, interventional radiologist at Sutter Health, and Dr. Jim Milburn, interventional neuroradiologist at the Ochsner Health, join host Dr. Michael Barraza to discuss the latest advancements in stroke interventions. --- This podcast is supported by: Imperative Carehttps://imperativecare.com/stroke/zoom-stroke-solution/ --- SYNPOSIS The episode begins with a discussion on the different pathways to becoming a neurointerventionalist, emphasizing why interventional radiologists are uniquely equipped for this transition. They dive into cutting-edge stroke interventions, sharing key takeaways from major trials on large core and medium vessel occlusions. Dr. Baxter and Dr. Milburn highlight the HERMES trial, which showed that endovascular thrombectomy led to beneficial effects on patients with anterior circulation occlusion. They then cover the BAOCHE trial, which showed better functional outcomes with thrombectomy over medical therapy. Milburn and Baxter also share their perspectives on the shifting role of perfusion imaging and why the field may be moving beyond it. To close the discussion, the doctors underscore the powerful impact of rehabilitation in driving patient recovery, and stress the ongoing need for innovation and improved training in the field of neurointerventional radiology. --- TIMESTAMPS 00:00 - Introduction06:18 - Training and Certification in Neurointervention13:11- Large Core Trials and Their Impact19:42 - CT Perfusion and Treatment Decisions29:45 - Understanding Stroke Scale Scores and ICAD30:31 - Thrombectomy Trials and Treatment Strategies34:48 - Challenges in Randomizing Patients for Trials44:25 - Advancements in Robotics and Stroke Treatment51:37 - Future Directions in Stroke Rehabilitation53:11 - Global Thrombectomy Adoption and Training --- RESOURCES Hermes trial: Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723-1731. doi:10.1016/S0140-6736(16)00163-X BAOCH trial: Jovin TG, Li C, Wu L, et al. Trial of Thrombectomy 6 to 24 Hours after Stroke Due to Basilar-Artery Occlusion. N Engl J Med. 2022;387(15):1373-1384. doi:10.1056/NEJMoa2207576 Are your current stroke interventions in line with the latest clinical data? Dr. Blaise Baxter, interventional radiologist at Sutter Health, and Dr. Jim Milburn, interventional neuroradiologist at the Ochsner Health, join host Dr. Michael Barraza to discuss the latest advancements in stroke interventions.


---


This podcast is supported by:


Imperative Care
https://imperativecare.com/stroke/zoom-stroke-solution/


---


SYNPOSIS


The episode begins with a discussion on the different pathways to becoming a neurointerventionalist, emphasizing why interventional radiologists are uniquely equipped for this transition. They dive into cutting-edge stroke interventions, sharing key takeaways from major trials on large core and medium vessel occlusions. Dr. Baxter and Dr. Milburn highlight the HERMES trial, which showed that endovascular thrombectomy led to beneficial effects on patients with anterior circulation occlusion. They then cover the BAOCHE trial, which showed better functional outcomes with thrombectomy over medical therapy.


Milburn and Baxter also share their perspectives on the shifting role of perfusion imaging and why the field may be moving beyond it. To close the discussion, the doctors underscore the powerful impact of rehabilitation in driving patient recovery, and stress the ongoing need for innovation and improved training in the field of neurointerventional radiology.


---


TIMESTAMPS


00:00 - Introduction
06:18 - Training and Certification in Neurointervention
13:11- Large Core Trials and Their Impact
19:42 - CT Perfusion and Treatment Decisions
29:45 - Understanding Stroke Scale Scores and ICAD
30:31 - Thrombectomy Trials and Treatment Strategies
34:48 - Challenges in Randomizing Patients for Trials
44:25 - Advancements in Robotics and Stroke Treatment
51:37 - Future Directions in Stroke Rehabilitation
53:11 - Global Thrombectomy Adoption and Training


---


RESOURCES


Hermes trial: Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723-1731. doi:10.1016/S0140-6736(16)00163-X


BAOCH trial: Jovin TG, Li C, Wu L, et al. Trial of Thrombectomy 6 to 24 Hours after Stroke Due to Basilar-Artery Occlusion. N Engl J Med. 2022;387(15):1373-1384. doi:10.1056/NEJMoa2207576

]]> 3590 Ep. 557 Proving Your Worth to the Hospital: Economics of Hospital Based IR with Dr. Matt Hawkins How can interventional radiologists turn their unique capabilities into revenue? Dr. Matt Hawkins, interventional radiologist and Health Policy and Economics councilor at the Society of Interventional Radiology (SIR), joins host Dr. Ally Baheti to discuss how interventional radiologists can prove (and get paid for) the value that they bring to hospitals. --- This podcast is supported by: Medtronic Emprinthttps://www.medtronic.com/emprint RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS The doctors discuss key physician reimbursement models, including the Hospital Outpatient Prospective Payment System (HOPPS) for hospital outpatient and Diagnosis-Related Groups (DRGs) for hospital inpatient, as well as strategies for negotiating subsidies. Dr. Hawkins covers key strategies for proving the value of IR to hospitals, emphasizing the importance of moving beyond work RVUs and focusing on the technical revenue generated for hospitals. The discussion underscores the critical role that IR plays in trauma, transplant, and cancer care. Lastly, Dr. Hawkins highlights SIR’s economic initiative emphasizing the importance of accurate documentation and coding in order to turn our clinical impact into measurable value. --- TIMESTAMPS 00:00 - Introduction01:58 - Understanding Professional and Technical Reimbursement04:49 - Hospital Reimbursement Structures07:59 - Quantifying Value and Negotiating Contracts15:55 - Economic Arguments for IR in Trauma, Transplant, and Cancer23:01 - The Importance of IR Leadership in Mixed IRDR Groups25:13 - Challenges and Strategies for Independent IR Practices28:41 - Maximizing Revenue Through Evaluation and Management (E&M)36:40 - Navigating Coding and Documentation for Better Negotiation38:54 - Financial Literacy and Business Strategies Tue, 15 Jul 2025 07:00:00 -0000 full BackTable How can interventional radiologists turn their unique capabilities into revenue? Dr. Matt Hawkins, interventional radiologist and Health Policy and Economics councilor at the Society of Interventional Radiology (SIR), joins host Dr. Ally Baheti to discuss how interventional radiologists can prove (and get paid for) the value that they bring to hospitals. --- This podcast is supported by: Medtronic Emprinthttps://www.medtronic.com/emprint RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS The doctors discuss key physician reimbursement models, including the Hospital Outpatient Prospective Payment System (HOPPS) for hospital outpatient and Diagnosis-Related Groups (DRGs) for hospital inpatient, as well as strategies for negotiating subsidies. Dr. Hawkins covers key strategies for proving the value of IR to hospitals, emphasizing the importance of moving beyond work RVUs and focusing on the technical revenue generated for hospitals. The discussion underscores the critical role that IR plays in trauma, transplant, and cancer care. Lastly, Dr. Hawkins highlights SIR’s economic initiative emphasizing the importance of accurate documentation and coding in order to turn our clinical impact into measurable value. --- TIMESTAMPS 00:00 - Introduction01:58 - Understanding Professional and Technical Reimbursement04:49 - Hospital Reimbursement Structures07:59 - Quantifying Value and Negotiating Contracts15:55 - Economic Arguments for IR in Trauma, Transplant, and Cancer23:01 - The Importance of IR Leadership in Mixed IRDR Groups25:13 - Challenges and Strategies for Independent IR Practices28:41 - Maximizing Revenue Through Evaluation and Management (E&M)36:40 - Navigating Coding and Documentation for Better Negotiation38:54 - Financial Literacy and Business Strategies How can interventional radiologists turn their unique capabilities into revenue? Dr. Matt Hawkins, interventional radiologist and Health Policy and Economics councilor at the Society of Interventional Radiology (SIR), joins host Dr. Ally Baheti to discuss how interventional radiologists can prove (and get paid for) the value that they bring to hospitals.


---


This podcast is supported by:


Medtronic Emprint
https://www.medtronic.com/emprint


RADPAD® Radiation Protection
https://www.radpad.com/


---


SYNPOSIS


The doctors discuss key physician reimbursement models, including the Hospital Outpatient Prospective Payment System (HOPPS) for hospital outpatient and Diagnosis-Related Groups (DRGs) for hospital inpatient, as well as strategies for negotiating subsidies. Dr. Hawkins covers key strategies for proving the value of IR to hospitals, emphasizing the importance of moving beyond work RVUs and focusing on the technical revenue generated for hospitals. The discussion underscores the critical role that IR plays in trauma, transplant, and cancer care. Lastly, Dr. Hawkins highlights SIR’s economic initiative emphasizing the importance of accurate documentation and coding in order to turn our clinical impact into measurable value.


---


TIMESTAMPS


00:00 - Introduction
01:58 - Understanding Professional and Technical Reimbursement
04:49 - Hospital Reimbursement Structures
07:59 - Quantifying Value and Negotiating Contracts
15:55 - Economic Arguments for IR in Trauma, Transplant, and Cancer
23:01 - The Importance of IR Leadership in Mixed IRDR Groups
25:13 - Challenges and Strategies for Independent IR Practices
28:41 - Maximizing Revenue Through Evaluation and Management (E&M)
36:40 - Navigating Coding and Documentation for Better Negotiation
38:54 - Financial Literacy and Business Strategies

]]> 2579 Ep. 556 Dosimetry University IV: Optimizing Radiation Segmentectomy with Dr. Nima Kokabi and Dr. Tyler Sandow Radiation segmentectomy: who, when, how? Interventional oncologists Dr. Nima Kokabi, Dr. Tyler Sandow, and Dr. Kavi Krishnasamy continue their in-studio discussion on all things Y90 in Part 4 of Dosimetry University, focusing on specific applications of radiation segmentectomy. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS This session kicks off with a discussion on the curative potential of Y90, comparing it to other curative modalities like resection. The doctors discuss the importance of achieving a complete pathological necrosis (CPN) with Y90 for better survival outcomes, especially in the context of liver transplantation. The conversation also covers personalized approaches for treating liver-dominant metastatic cancers using Y90, and strategic considerations when choosing between techniques like radiation lobectomy, thermal ablation, and chemoembolization. The interventional oncologists explore the viability of radiation segmentectomy in treating small lesions and discuss data supporting its efficacy. Real-world clinical cases are examined to highlight the practical application of these therapies, their impact on overall survival, and the intricacies of dosimetry and patient selection. --- TIMESTAMPS 00:00 - Introduction01:07 - Ablative Y90 Curative Outcomes and Survival Rates02:16 - Radiation Segmentectomy vs. Ablation09:22 - Case Study: Metastatic Colorectal Cancer18:06 - Tumor Distinction on Cone Beam CT19:58 - Case Study: 77-Year-Old Female with Breast and Colorectal Cancer21:09 - Challenges and Techniques in Selective Radiation Segmentectomy24:28 - Avastin and Y9028:16 - Case Study: 53-Year-Old Male with Metastatic Colorectal Cancer29:40 - Radiation Lobectomy and Hypertrophy Strategies32:37 - Approaches for Metastatic and HCC Patients Tue, 08 Jul 2025 07:00:00 -0000 full BackTable Radiation segmentectomy: who, when, how? Interventional oncologists Dr. Nima Kokabi, Dr. Tyler Sandow, and Dr. Kavi Krishnasamy continue their in-studio discussion on all things Y90 in Part 4 of Dosimetry University, focusing on specific applications of radiation segmentectomy. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS This session kicks off with a discussion on the curative potential of Y90, comparing it to other curative modalities like resection. The doctors discuss the importance of achieving a complete pathological necrosis (CPN) with Y90 for better survival outcomes, especially in the context of liver transplantation. The conversation also covers personalized approaches for treating liver-dominant metastatic cancers using Y90, and strategic considerations when choosing between techniques like radiation lobectomy, thermal ablation, and chemoembolization. The interventional oncologists explore the viability of radiation segmentectomy in treating small lesions and discuss data supporting its efficacy. Real-world clinical cases are examined to highlight the practical application of these therapies, their impact on overall survival, and the intricacies of dosimetry and patient selection. --- TIMESTAMPS 00:00 - Introduction01:07 - Ablative Y90 Curative Outcomes and Survival Rates02:16 - Radiation Segmentectomy vs. Ablation09:22 - Case Study: Metastatic Colorectal Cancer18:06 - Tumor Distinction on Cone Beam CT19:58 - Case Study: 77-Year-Old Female with Breast and Colorectal Cancer21:09 - Challenges and Techniques in Selective Radiation Segmentectomy24:28 - Avastin and Y9028:16 - Case Study: 53-Year-Old Male with Metastatic Colorectal Cancer29:40 - Radiation Lobectomy and Hypertrophy Strategies32:37 - Approaches for Metastatic and HCC Patients Radiation segmentectomy: who, when, how? Interventional oncologists Dr. Nima Kokabi, Dr. Tyler Sandow, and Dr. Kavi Krishnasamy continue their in-studio discussion on all things Y90 in Part 4 of Dosimetry University, focusing on specific applications of radiation segmentectomy.

---


This podcast is supported by:


Sirtex
https://www.sirtex.com/


Medtronic Emprint
https://www.medtronic.com/emprint


---


SYNPOSIS


This session kicks off with a discussion on the curative potential of Y90, comparing it to other curative modalities like resection. The doctors discuss the importance of achieving a complete pathological necrosis (CPN) with Y90 for better survival outcomes, especially in the context of liver transplantation. The conversation also covers personalized approaches for treating liver-dominant metastatic cancers using Y90, and strategic considerations when choosing between techniques like radiation lobectomy, thermal ablation, and chemoembolization.


The interventional oncologists explore the viability of radiation segmentectomy in treating small lesions and discuss data supporting its efficacy. Real-world clinical cases are examined to highlight the practical application of these therapies, their impact on overall survival, and the intricacies of dosimetry and patient selection.


---


TIMESTAMPS


00:00 - Introduction
01:07 - Ablative Y90 Curative Outcomes and Survival Rates
02:16 - Radiation Segmentectomy vs. Ablation
09:22 - Case Study: Metastatic Colorectal Cancer
18:06 - Tumor Distinction on Cone Beam CT
19:58 - Case Study: 77-Year-Old Female with Breast and Colorectal Cancer
21:09 - Challenges and Techniques in Selective Radiation Segmentectomy
24:28 - Avastin and Y90
28:16 - Case Study: 53-Year-Old Male with Metastatic Colorectal Cancer
29:40 - Radiation Lobectomy and Hypertrophy Strategies
32:37 - Approaches for Metastatic and HCC Patients

]]> 2207 Ep. 555 Dosimetry University Part III: Optimizing Single-Session Treatments with Dr. Nima Kokabi and Dr. Tyler Sandow Will single session Y90 become the standard of care for HCC and oligo-metastatic disease? Tune in to our third installment of Dosimetry University with interventional oncologists Drs. Tyler Sandow, Nima Kokabi, and Kavi Krishnasamy as they share their experiences and best practices in single session Y90 treatment. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The doctors discuss the application and workflow of single session Y90 therapy for primary and oligo-metastatic liver tumors. They discuss the latest data from various institutions, emphasizing reduced lung dose, lower time to treatment, improved cost-efficiency, and the advantageous safety profile associated with single session treatment. The discussion also covers ideal patient selection based on tumor location and vascular characteristics, the importance of cone beam CT, and how to identify red-flag features of vascular enhancement. Our panel then reviews key technical considerations for single session success, including the use of flow-modifying microcatheters, gelfoam, and strategies for flow redirection. The episode concludes with a case discussion to explore the best strategy for a large liver tumor, detailing the specifics of each treatment and the potential role of combined therapies to achieve better long-term outcomes. --- TIMESTAMPS 00:00 - Introduction 00:47 - Single Session Y90: Workflow and Benefits03:52 - Patient Selection04:31 - Tumor Location and Preferred Techniques14:31 - Reperfusion and Redirection Techniques 26:16 - Case Study: Large Tumor Treatment37:01 - Long-Term Outcomes and Surgical Considerations Tue, 01 Jul 2025 07:00:00 -0000 full BackTable Will single session Y90 become the standard of care for HCC and oligo-metastatic disease? Tune in to our third installment of Dosimetry University with interventional oncologists Drs. Tyler Sandow, Nima Kokabi, and Kavi Krishnasamy as they share their experiences and best practices in single session Y90 treatment. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The doctors discuss the application and workflow of single session Y90 therapy for primary and oligo-metastatic liver tumors. They discuss the latest data from various institutions, emphasizing reduced lung dose, lower time to treatment, improved cost-efficiency, and the advantageous safety profile associated with single session treatment. The discussion also covers ideal patient selection based on tumor location and vascular characteristics, the importance of cone beam CT, and how to identify red-flag features of vascular enhancement. Our panel then reviews key technical considerations for single session success, including the use of flow-modifying microcatheters, gelfoam, and strategies for flow redirection. The episode concludes with a case discussion to explore the best strategy for a large liver tumor, detailing the specifics of each treatment and the potential role of combined therapies to achieve better long-term outcomes. --- TIMESTAMPS 00:00 - Introduction 00:47 - Single Session Y90: Workflow and Benefits03:52 - Patient Selection04:31 - Tumor Location and Preferred Techniques14:31 - Reperfusion and Redirection Techniques 26:16 - Case Study: Large Tumor Treatment37:01 - Long-Term Outcomes and Surgical Considerations Will single session Y90 become the standard of care for HCC and oligo-metastatic disease? Tune in to our third installment of Dosimetry University with interventional oncologists Drs. Tyler Sandow, Nima Kokabi, and Kavi Krishnasamy as they share their experiences and best practices in single session Y90 treatment.


---


This podcast is supported by:


Sirtex
https://www.sirtex.com/


Medtronic Emprint
https://www.medtronic.com/emprint


---


SYNPOSIS

The doctors discuss the application and workflow of single session Y90 therapy for primary and oligo-metastatic liver tumors. They discuss the latest data from various institutions, emphasizing reduced lung dose, lower time to treatment, improved cost-efficiency, and the advantageous safety profile associated with single session treatment. The discussion also covers ideal patient selection based on tumor location and vascular characteristics, the importance of cone beam CT, and how to identify red-flag features of vascular enhancement.

Our panel then reviews key technical considerations for single session success, including the use of flow-modifying microcatheters, gelfoam, and strategies for flow redirection. The episode concludes with a case discussion to explore the best strategy for a large liver tumor, detailing the specifics of each treatment and the potential role of combined therapies to achieve better long-term outcomes.

---

TIMESTAMPS

00:00 - Introduction
00:47 - Single Session Y90: Workflow and Benefits
03:52 - Patient Selection
04:31 - Tumor Location and Preferred Techniques
14:31 - Reperfusion and Redirection Techniques
26:16 - Case Study: Large Tumor Treatment
37:01 - Long-Term Outcomes and Surgical Considerations

]]> 3117 Ep. 554 Optimizing the IR/DR Curriculum and Experience with Dr. Gregg Khodorov and Dr. Nicole Lamparello So you’re going to be an IR resident–what exactly did you sign up for? Find out with Dr. Neil Jain, an integrated IR resident at Georgetown as he hosts a discussion on optimizing integrated IR residency programs with Dr. Nicole Lamparello, an Assistant Professor of Clinical Radiology at Weill Cornell Medicine, and Dr. Gregg Khodorov, a PGY-5 resident at Thomas Jefferson University Hospital. The conversation covers a comprehensive range of topics, including optimal rotation schedules, early IR exposure, consult services, and the benefits of structured clinics. --- This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The doctors first discuss the nuances of choosing a surgical, medicine, or transitional intern year, and the electives that best prepare junior trainees for a career in IR. They then discuss the optimal balance between diagnostic and interventional training in DR years, and the best way to keep junior trainees involved in IR throughout their residency. The conversation moves on to the different structures of the consult service at each of the speakers’ programs and what this means for training quality and patient care. The doctors then break down what the last year of IR residency looks like, and the residents detail what they would like to see in order to prepare best for attending life. They explore exposure to private practice, subspecialty clinic, and elective time; sharing innovative practices from their own institutions and emphasizing the importance of mentorship, integration, and resident retention. The episode also addresses the challenges and potential solutions for resident attrition within the integrated IR residency track. --- TIMESTAMPS 0:00 - Host Introductions3:34 - PGY1: Medicine, Surgery or Transitional Intern Year?15:41 - PGY2-PGY4: Diagnostic Radiology Years24:46 - IR Clinic Training Throughout IR/DR Curriculum27:49 - IR Consult Service Structure38:23 - PGY5: Credentialing in Nuclear Medicine and Mammography43:58 - PGY6: Preparing for Attending Life53:00 - Minimizing Attrition Rate Fri, 27 Jun 2025 07:00:00 -0000 full BackTable So you’re going to be an IR resident–what exactly did you sign up for? Find out with Dr. Neil Jain, an integrated IR resident at Georgetown as he hosts a discussion on optimizing integrated IR residency programs with Dr. Nicole Lamparello, an Assistant Professor of Clinical Radiology at Weill Cornell Medicine, and Dr. Gregg Khodorov, a PGY-5 resident at Thomas Jefferson University Hospital. The conversation covers a comprehensive range of topics, including optimal rotation schedules, early IR exposure, consult services, and the benefits of structured clinics. --- This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The doctors first discuss the nuances of choosing a surgical, medicine, or transitional intern year, and the electives that best prepare junior trainees for a career in IR. They then discuss the optimal balance between diagnostic and interventional training in DR years, and the best way to keep junior trainees involved in IR throughout their residency. The conversation moves on to the different structures of the consult service at each of the speakers’ programs and what this means for training quality and patient care. The doctors then break down what the last year of IR residency looks like, and the residents detail what they would like to see in order to prepare best for attending life. They explore exposure to private practice, subspecialty clinic, and elective time; sharing innovative practices from their own institutions and emphasizing the importance of mentorship, integration, and resident retention. The episode also addresses the challenges and potential solutions for resident attrition within the integrated IR residency track. --- TIMESTAMPS 0:00 - Host Introductions3:34 - PGY1: Medicine, Surgery or Transitional Intern Year?15:41 - PGY2-PGY4: Diagnostic Radiology Years24:46 - IR Clinic Training Throughout IR/DR Curriculum27:49 - IR Consult Service Structure38:23 - PGY5: Credentialing in Nuclear Medicine and Mammography43:58 - PGY6: Preparing for Attending Life53:00 - Minimizing Attrition Rate So you’re going to be an IR resident–what exactly did you sign up for? Find out with Dr. Neil Jain, an integrated IR resident at Georgetown as he hosts a discussion on optimizing integrated IR residency programs with Dr. Nicole Lamparello, an Assistant Professor of Clinical Radiology at Weill Cornell Medicine, and Dr. Gregg Khodorov, a PGY-5 resident at Thomas Jefferson University Hospital. The conversation covers a comprehensive range of topics, including optimal rotation schedules, early IR exposure, consult services, and the benefits of structured clinics.


---


This podcast is supported by:
Medtronic Emprint
https://www.medtronic.com/emprint


---


SYNPOSIS


The doctors first discuss the nuances of choosing a surgical, medicine, or transitional intern year, and the electives that best prepare junior trainees for a career in IR. They then discuss the optimal balance between diagnostic and interventional training in DR years, and the best way to keep junior trainees involved in IR throughout their residency.


The conversation moves on to the different structures of the consult service at each of the speakers’ programs and what this means for training quality and patient care. The doctors then break down what the last year of IR residency looks like, and the residents detail what they would like to see in order to prepare best for attending life. They explore exposure to private practice, subspecialty clinic, and elective time; sharing innovative practices from their own institutions and emphasizing the importance of mentorship, integration, and resident retention. The episode also addresses the challenges and potential solutions for resident attrition within the integrated IR residency track.


---


TIMESTAMPS


0:00 - Host Introductions
3:34 - PGY1: Medicine, Surgery or Transitional Intern Year?
15:41 - PGY2-PGY4: Diagnostic Radiology Years
24:46 - IR Clinic Training Throughout IR/DR Curriculum
27:49 - IR Consult Service Structure
38:23 - PGY5: Credentialing in Nuclear Medicine and Mammography
43:58 - PGY6: Preparing for Attending Life
53:00 - Minimizing Attrition Rate

]]> 3926 Ep. 553 Dosimetry University Part II: Understanding Partition and Voxel-Based Approaches with Dr. Tyler Sandow and Dr. Nima Kokabi BSA, MIRD, or voxel-based dosimetry? Join us for part 2 of Dosimetry University where interventional oncologists Dr. Tyler Sandow, Dr. Nima Kokabi, and Dr. Kavi Krishnasamy explore and debate the critical nuances of a successful Y90 procedure, covering dosing methods, lung shunt management, and when to incorporate other therapeutic approaches. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The episode begins with a discussion on methodologies for calculating lung shunt fractions using planar imaging versus SPECT CT. The physicians highlight the implications of various dosimetry models, including BSA (Body Surface Area), MIRD (Medical Internal Radiation Dose), and voxel-based dosimetry for determining prescribed activity. Drawing on their clinical experience, they address the management of high lung shunt fraction cases and the application of therapeutic strategies like TACE (Transarterial Chemoembolization) and SBRT (Stereotactic Body Radiotherapy). The conversation also covers the roles of cryoablation and microwave ablation in treating centrally located lesions. The episode concludes with a case study emphasizing the importance of individualized dosimetry planning. --- TIMESTAMPS 00:00 - Introduction01:05 - Lung Shunt Calculation Methods06:42 - BSA, MIRD, and Voxel-Based Dosimetry16:03 - High Lung Shunt Management30:02 - Case Study: Liver Tumor Treatment34:10 - Cryo vs Microwave: A Safer Option?35:42 - Y-90 Procedure: Imaging and Techniques43:35 - Dosimetry and Dose Calculations51:10 - Post-Treatment Analysis and Outcomes57:51 - Transplant Considerations and Aggressive Treatments58:18 - Conclusion and Final Thoughts Tue, 24 Jun 2025 07:00:00 -0000 full BackTable BSA, MIRD, or voxel-based dosimetry? Join us for part 2 of Dosimetry University where interventional oncologists Dr. Tyler Sandow, Dr. Nima Kokabi, and Dr. Kavi Krishnasamy explore and debate the critical nuances of a successful Y90 procedure, covering dosing methods, lung shunt management, and when to incorporate other therapeutic approaches. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The episode begins with a discussion on methodologies for calculating lung shunt fractions using planar imaging versus SPECT CT. The physicians highlight the implications of various dosimetry models, including BSA (Body Surface Area), MIRD (Medical Internal Radiation Dose), and voxel-based dosimetry for determining prescribed activity. Drawing on their clinical experience, they address the management of high lung shunt fraction cases and the application of therapeutic strategies like TACE (Transarterial Chemoembolization) and SBRT (Stereotactic Body Radiotherapy). The conversation also covers the roles of cryoablation and microwave ablation in treating centrally located lesions. The episode concludes with a case study emphasizing the importance of individualized dosimetry planning. --- TIMESTAMPS 00:00 - Introduction01:05 - Lung Shunt Calculation Methods06:42 - BSA, MIRD, and Voxel-Based Dosimetry16:03 - High Lung Shunt Management30:02 - Case Study: Liver Tumor Treatment34:10 - Cryo vs Microwave: A Safer Option?35:42 - Y-90 Procedure: Imaging and Techniques43:35 - Dosimetry and Dose Calculations51:10 - Post-Treatment Analysis and Outcomes57:51 - Transplant Considerations and Aggressive Treatments58:18 - Conclusion and Final Thoughts BSA, MIRD, or voxel-based dosimetry? Join us for part 2 of Dosimetry University where interventional oncologists Dr. Tyler Sandow, Dr. Nima Kokabi, and Dr. Kavi Krishnasamy explore and debate the critical nuances of a successful Y90 procedure, covering dosing methods, lung shunt management, and when to incorporate other therapeutic approaches.


---


This podcast is supported by:


Sirtex
https://www.sirtex.com/


Medtronic Emprint
https://www.medtronic.com/emprint


---


SYNPOSIS


The episode begins with a discussion on methodologies for calculating lung shunt fractions using planar imaging versus SPECT CT. The physicians highlight the implications of various dosimetry models, including BSA (Body Surface Area), MIRD (Medical Internal Radiation Dose), and voxel-based dosimetry for determining prescribed activity. Drawing on their clinical experience, they address the management of high lung shunt fraction cases and the application of therapeutic strategies like TACE (Transarterial Chemoembolization) and SBRT (Stereotactic Body Radiotherapy). The conversation also covers the roles of cryoablation and microwave ablation in treating centrally located lesions. The episode concludes with a case study emphasizing the importance of individualized dosimetry planning.


---


TIMESTAMPS


00:00 - Introduction
01:05 - Lung Shunt Calculation Methods
06:42 - BSA, MIRD, and Voxel-Based Dosimetry
16:03 - High Lung Shunt Management
30:02 - Case Study: Liver Tumor Treatment
34:10 - Cryo vs Microwave: A Safer Option?
35:42 - Y-90 Procedure: Imaging and Techniques
43:35 - Dosimetry and Dose Calculations
51:10 - Post-Treatment Analysis and Outcomes
57:51 - Transplant Considerations and Aggressive Treatments
58:18 - Conclusion and Final Thoughts

]]> 3678 Ep. 552 Dosimetry University Part I: Treatment Planning with Dr. Tyler Sandow and Dr. Nima Kokabi Dosimetry University is now in session! First up—how do you plan your Y90 treatments and what can you do in the planning phase to maximize efficacy? Find out in Part I of BackTable’s Dosimetry University series featuring interventional oncologists Dr. Nima Kokabi from the University of North Carolina Chapel Hill and Dr. Tyler Sandow from Ochsner Health. This episode is hosted by Dr. Kavi Krishnasamy and recorded live in the BackTable studio. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Sponsor This podcast is supported by: Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The doctors first discuss the structure of their Y90 service lines, including the impact of multidisciplinary tumor boards and clinics on time to treatment for liver cancer patients. They then talk through their technical preferences—whether to use glass or resin, preferred dosimetry guidelines and apps, and the dosimetry softwares that they use in treatment planning. The doctors also discuss the utility of the T2N ratio, advanced imaging like cone beam CT, and angiographic targeting software—emphasizing how these tools can help achieve the delicate balance of preserving normal tissue while treating as much tumor as possible. This episode also highlights the importance of collaboration between academic and private practices to optimize patient care and treatment outcomes. --- TIMESTAMPS 00:00 - Introduction and Overview02:21 - Multidisciplinary Clinics and Tumor Boards13:12 - Dosimetry Guidelines and Practices27:46 - Nuances in Tumor Dosage and Segmentectomy32:00 - Angiographic Targeting Software33:18 - Cone Beam CT Techniques48:33 - Anesthesia, Access, and Catheters Tue, 17 Jun 2025 07:00:00 -0000 full BackTable Dosimetry University is now in session! First up—how do you plan your Y90 treatments and what can you do in the planning phase to maximize efficacy? Find out in Part I of BackTable’s Dosimetry University series featuring interventional oncologists Dr. Nima Kokabi from the University of North Carolina Chapel Hill and Dr. Tyler Sandow from Ochsner Health. This episode is hosted by Dr. Kavi Krishnasamy and recorded live in the BackTable studio. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Sponsor This podcast is supported by: Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The doctors first discuss the structure of their Y90 service lines, including the impact of multidisciplinary tumor boards and clinics on time to treatment for liver cancer patients. They then talk through their technical preferences—whether to use glass or resin, preferred dosimetry guidelines and apps, and the dosimetry softwares that they use in treatment planning. The doctors also discuss the utility of the T2N ratio, advanced imaging like cone beam CT, and angiographic targeting software—emphasizing how these tools can help achieve the delicate balance of preserving normal tissue while treating as much tumor as possible. This episode also highlights the importance of collaboration between academic and private practices to optimize patient care and treatment outcomes. --- TIMESTAMPS 00:00 - Introduction and Overview02:21 - Multidisciplinary Clinics and Tumor Boards13:12 - Dosimetry Guidelines and Practices27:46 - Nuances in Tumor Dosage and Segmentectomy32:00 - Angiographic Targeting Software33:18 - Cone Beam CT Techniques48:33 - Anesthesia, Access, and Catheters Dosimetry University is now in session! First up—how do you plan your Y90 treatments and what can you do in the planning phase to maximize efficacy? Find out in Part I of BackTable’s Dosimetry University series featuring interventional oncologists Dr. Nima Kokabi from the University of North Carolina Chapel Hill and Dr. Tyler Sandow from Ochsner Health. This episode is hosted by Dr. Kavi Krishnasamy and recorded live in the BackTable studio.


---


This podcast is supported by:


Sirtex
https://www.sirtex.com/


Sponsor


This podcast is supported by:


Medtronic Emprint
https://www.medtronic.com/emprint


---


SYNPOSIS


The doctors first discuss the structure of their Y90 service lines, including the impact of multidisciplinary tumor boards and clinics on time to treatment for liver cancer patients. They then talk through their technical preferences—whether to use glass or resin, preferred dosimetry guidelines and apps, and the dosimetry softwares that they use in treatment planning. The doctors also discuss the utility of the T2N ratio, advanced imaging like cone beam CT, and angiographic targeting software—emphasizing how these tools can help achieve the delicate balance of preserving normal tissue while treating as much tumor as possible. This episode also highlights the importance of collaboration between academic and private practices to optimize patient care and treatment outcomes.


---


TIMESTAMPS


00:00 - Introduction and Overview
02:21 - Multidisciplinary Clinics and Tumor Boards
13:12 - Dosimetry Guidelines and Practices
27:46 - Nuances in Tumor Dosage and Segmentectomy
32:00 - Angiographic Targeting Software
33:18 - Cone Beam CT Techniques
48:33 - Anesthesia, Access, and Catheters

]]> 3312 Ep. 551 Independent IR Practice: Opportunities and Challenges with Dr. Waqaar Diwan What would you do if your IR/DR practice underwent major ownership and staffing changes just one week after signing your first attending contract? In this episode of BackTable, Dr. Waqaar Diwan joins host Dr. Michael Barraza to share his experience facing exactly that challenge—and how it led to the eventual development of his own independent IR practice.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/OBL Marketinghttps://oblmarketing.com/Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISDr. Diwan discusses how he navigated the unexpected transition of ownership and staffing changes, and ultimately secured a hospital contract that allowed him to perform IR procedures full-time. Since then, he has been building an independent IR practice with the support of his partner and a growing team. Dr. Diwan shares his goals for the practice, including staffing and equipment logistics, strategic planning, and patient outreach. He emphasizes the importance of leveraging personal and professional networks to guide his business development. He also outlines key differences between independent IR practices and combined IR/DR models. These include the need for greater investment in the outpatient experience, actively seeking referrals, and navigating hospital politics without the backing of a larger department. His top advice for building a referral base is to first earn trust—by excelling in straightforward cases and ensuring strong outcomes—and to market the practice directly to potential referring providers. Overall, Dr. Diwan encourages early-career interventional radiologists to know their worth. He notes that in the real world, IRs are often seen as providers of “catch-all” services, making it crucial to ensure fair compensation. He stresses the importance of striking a balance between self-advocacy and humility, all while staying focused on serving patients.---TIMESTAMPS00:00 - Introduction 01:42 - Navigating Contracts and Restructuring8:07 - Upcoming Goals for His IR Group14:00 - Strategic Planning and Marketing20:16 - Compensation and Finances of Independent IR27:38 - Future Plans and Market Trends29:48 Advice for New Interventional Radiologists---RESOURCESMinimally Invasive Specialists of Texas: https://www.mist-health.com/ Tue, 10 Jun 2025 07:00:00 -0000 full BackTable What would you do if your IR/DR practice underwent major ownership and staffing changes just one week after signing your first attending contract? In this episode of BackTable, Dr. Waqaar Diwan joins host Dr. Michael Barraza to share his experience facing exactly that challenge—and how it led to the eventual development of his own independent IR practice.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/OBL Marketinghttps://oblmarketing.com/Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISDr. Diwan discusses how he navigated the unexpected transition of ownership and staffing changes, and ultimately secured a hospital contract that allowed him to perform IR procedures full-time. Since then, he has been building an independent IR practice with the support of his partner and a growing team. Dr. Diwan shares his goals for the practice, including staffing and equipment logistics, strategic planning, and patient outreach. He emphasizes the importance of leveraging personal and professional networks to guide his business development. He also outlines key differences between independent IR practices and combined IR/DR models. These include the need for greater investment in the outpatient experience, actively seeking referrals, and navigating hospital politics without the backing of a larger department. His top advice for building a referral base is to first earn trust—by excelling in straightforward cases and ensuring strong outcomes—and to market the practice directly to potential referring providers. Overall, Dr. Diwan encourages early-career interventional radiologists to know their worth. He notes that in the real world, IRs are often seen as providers of “catch-all” services, making it crucial to ensure fair compensation. He stresses the importance of striking a balance between self-advocacy and humility, all while staying focused on serving patients.---TIMESTAMPS00:00 - Introduction 01:42 - Navigating Contracts and Restructuring8:07 - Upcoming Goals for His IR Group14:00 - Strategic Planning and Marketing20:16 - Compensation and Finances of Independent IR27:38 - Future Plans and Market Trends29:48 Advice for New Interventional Radiologists---RESOURCESMinimally Invasive Specialists of Texas: https://www.mist-health.com/ What would you do if your IR/DR practice underwent major ownership and staffing changes just one week after signing your first attending contract? In this episode of BackTable, Dr. Waqaar Diwan joins host Dr. Michael Barraza to share his experience facing exactly that challenge—and how it led to the eventual development of his own independent IR practice.
---
This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
OBL Marketing
https://oblmarketing.com/
Medtronic Emprint
https://www.medtronic.com/emprint
---
SYNPOSIS
Dr. Diwan discusses how he navigated the unexpected transition of ownership and staffing changes, and ultimately secured a hospital contract that allowed him to perform IR procedures full-time. Since then, he has been building an independent IR practice with the support of his partner and a growing team.


Dr. Diwan shares his goals for the practice, including staffing and equipment logistics, strategic planning, and patient outreach. He emphasizes the importance of leveraging personal and professional networks to guide his business development.


He also outlines key differences between independent IR practices and combined IR/DR models. These include the need for greater investment in the outpatient experience, actively seeking referrals, and navigating hospital politics without the backing of a larger department. His top advice for building a referral base is to first earn trust—by excelling in straightforward cases and ensuring strong outcomes—and to market the practice directly to potential referring providers.


Overall, Dr. Diwan encourages early-career interventional radiologists to know their worth. He notes that in the real world, IRs are often seen as providers of “catch-all” services, making it crucial to ensure fair compensation. He stresses the importance of striking a balance between self-advocacy and humility, all while staying focused on serving patients.
---
TIMESTAMPS
00:00 - Introduction
01:42 - Navigating Contracts and Restructuring
8:07 - Upcoming Goals for His IR Group
14:00 - Strategic Planning and Marketing
20:16 - Compensation and Finances of Independent IR
27:38 - Future Plans and Market Trends
29:48 Advice for New Interventional Radiologists
---
RESOURCES
Minimally Invasive Specialists of Texas:
https://www.mist-health.com/

]]> 2185 Ep. 550 Percutaneous Transesophageal Gastrostomy: Indications and Procedure Insights with Lisa Rotellini-Coltvet and Dr. Alex Wallace What do you do when conventional gastric tubes are not an option? In this week’s episode of BackTable, host Dr. Ally Baheti speaks with interventional radiologist Dr. Alex Wallace and physician assistant Lisa Rotellini-Colvet from the Mayo Clinic in Arizona about the percutaneous transesophageal gastrostomy (PTEG) procedure. The discussion explores how PTEG offers a transformative solution for patients who are not candidates for traditional transabdominal gastrostomy access. Suitable candidates for PTEG include individuals with malignancies, peritoneal carcinomatosis, prior gastrectomies, or ascites. --- This podcast is supported by: Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS Dr. Wallace and Lisa provide valuable insights on the benefits of early patient selection, thorough pre-procedural evaluation, step-by-step procedural guidance, and key considerations for post-procedural care. They also highlight the critical role of patient and staff education in achieving successful outcomes. The episode features real-world experiences, including a powerful story of a patient who benefited from her PTEG for over 560 days. Our guests advocate for increased awareness of PTEG and its early consideration in patients with advanced abdominal cancers, emphasizing its potential to greatly improve quality of life. --- TIMESTAMPS 00:00 - Introduction01:38 - History and Explanation of PTEG08:12 - Pre-Procedure Evaluation11:48 - Procedural Walkthrough20:46 - Post-Procedure Care and Suction Management24:45 - Exchange Process and Troubleshooting30:11 - Patient Education and Staff Training35:54 - Improved Quality of Life for Patients --- RESOURCES Percutaneous Transesophageal Gastrostomy: Procedural Technique and Outcomes (Rotellini-Coltvet, Wallace et al, 2023):https://pubmed.ncbi.nlm.nih.gov/37419279/ Fri, 06 Jun 2025 07:00:00 -0000 full BackTable What do you do when conventional gastric tubes are not an option? In this week’s episode of BackTable, host Dr. Ally Baheti speaks with interventional radiologist Dr. Alex Wallace and physician assistant Lisa Rotellini-Colvet from the Mayo Clinic in Arizona about the percutaneous transesophageal gastrostomy (PTEG) procedure. The discussion explores how PTEG offers a transformative solution for patients who are not candidates for traditional transabdominal gastrostomy access. Suitable candidates for PTEG include individuals with malignancies, peritoneal carcinomatosis, prior gastrectomies, or ascites. --- This podcast is supported by: Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS Dr. Wallace and Lisa provide valuable insights on the benefits of early patient selection, thorough pre-procedural evaluation, step-by-step procedural guidance, and key considerations for post-procedural care. They also highlight the critical role of patient and staff education in achieving successful outcomes. The episode features real-world experiences, including a powerful story of a patient who benefited from her PTEG for over 560 days. Our guests advocate for increased awareness of PTEG and its early consideration in patients with advanced abdominal cancers, emphasizing its potential to greatly improve quality of life. --- TIMESTAMPS 00:00 - Introduction01:38 - History and Explanation of PTEG08:12 - Pre-Procedure Evaluation11:48 - Procedural Walkthrough20:46 - Post-Procedure Care and Suction Management24:45 - Exchange Process and Troubleshooting30:11 - Patient Education and Staff Training35:54 - Improved Quality of Life for Patients --- RESOURCES Percutaneous Transesophageal Gastrostomy: Procedural Technique and Outcomes (Rotellini-Coltvet, Wallace et al, 2023):https://pubmed.ncbi.nlm.nih.gov/37419279/ What do you do when conventional gastric tubes are not an option? In this week’s episode of BackTable, host Dr. Ally Baheti speaks with interventional radiologist Dr. Alex Wallace and physician assistant Lisa Rotellini-Colvet from the Mayo Clinic in Arizona about the percutaneous transesophageal gastrostomy (PTEG) procedure. The discussion explores how PTEG offers a transformative solution for patients who are not candidates for traditional transabdominal gastrostomy access. Suitable candidates for PTEG include individuals with malignancies, peritoneal carcinomatosis, prior gastrectomies, or ascites.


---


This podcast is supported by:


Medtronic Emprint
https://www.medtronic.com/emprint


---


SYNPOSIS


Dr. Wallace and Lisa provide valuable insights on the benefits of early patient selection, thorough pre-procedural evaluation, step-by-step procedural guidance, and key considerations for post-procedural care. They also highlight the critical role of patient and staff education in achieving successful outcomes. The episode features real-world experiences, including a powerful story of a patient who benefited from her PTEG for over 560 days.


Our guests advocate for increased awareness of PTEG and its early consideration in patients with advanced abdominal cancers, emphasizing its potential to greatly improve quality of life.


---


TIMESTAMPS


00:00 - Introduction
01:38 - History and Explanation of PTEG
08:12 - Pre-Procedure Evaluation
11:48 - Procedural Walkthrough
20:46 - Post-Procedure Care and Suction Management
24:45 - Exchange Process and Troubleshooting
30:11 - Patient Education and Staff Training
35:54 - Improved Quality of Life for Patients


---


RESOURCES


Percutaneous Transesophageal Gastrostomy: Procedural Technique and Outcomes (Rotellini-Coltvet, Wallace et al, 2023):
https://pubmed.ncbi.nlm.nih.gov/37419279/

]]> 2506 Ep. 549 Liquid Embolics: Practical Applications and Techniques with Dr. Gary Siskin Liquid embolics are a relatively new addition to the interventional radiology toolkit—how well do you understand the technical considerations that come with using these agents? Get up to speed in this episode of the BackTable Podcast where Dr. Gary Siskin, Chair of Radiology at Albany Medical Center, shares his expertise. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/us/ --- SYNPOSIS Dr. Siskin provides expert insights into the use of liquid embolic agents, including Onyx and LAVA, with a focus on their practical applications, techniques for safe and effective deployment, and the critical role they play in treating complex cases which range from peripheral and traumatic hemorrhage to portal vein embolization. He highlights the importance of understanding the viscosity and flow characteristics of various liquid embolic agents, providing expert guidance on ensuring optimal catheter positioning, case selection, and avoidance of common pitfalls. Additionally, he shares strategies for tailoring injection speed based on vessel caliber to mitigate reflux. The episode ends with final thoughts on best practices and future directions for the technology. --- TIMESTAMPS 00:00 - Introduction02:09 - Historical Perspective on Liquid Embolics06:37 - Practical Applications and Techniques16:14 - Handling Catheters and Reflux Concerns22:38 - Trauma Embolization26:53 - Visibility and Injection Techniques29:06 - Catheter Compatibility and Vessel Size32:53 - Best Practices and Common Mistakes45:55 - Final Thoughts and Advice --- RESOURCES Arslan B, Razavi MK, Siskin G, et al. The LAVA Study: A Prospective, Multicenter, Single-Arm Study of a Liquid Embolic System for Treatment of Peripheral Arterial Hemorrhage. J Vasc Interv Radiol. 2025;36(3):436-445.e2. doi:10.1016/j.jvir.2024.11.005 Onyx Liquid Embolic System: https://europe.medtronic.com/xd-en/healthcare-professionals/products/cardiovascular/peripheral-embolization/onyx-liquid-embolic-system.html LAVA Liquid Embolic System:https://www.sirtex.com/us/products/lava-liquid-embolic-system/product-information/ Tue, 03 Jun 2025 07:00:00 -0000 full BackTable Liquid embolics are a relatively new addition to the interventional radiology toolkit—how well do you understand the technical considerations that come with using these agents? Get up to speed in this episode of the BackTable Podcast where Dr. Gary Siskin, Chair of Radiology at Albany Medical Center, shares his expertise. Liquid embolics are a relatively new addition to the interventional radiology toolkit—how well do you understand the technical considerations that come with using these agents? Get up to speed in this episode of the BackTable Podcast where Dr. Gary Siskin, Chair of Radiology at Albany Medical Center, shares his expertise. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/us/ --- SYNPOSIS Dr. Siskin provides expert insights into the use of liquid embolic agents, including Onyx and LAVA, with a focus on their practical applications, techniques for safe and effective deployment, and the critical role they play in treating complex cases which range from peripheral and traumatic hemorrhage to portal vein embolization. He highlights the importance of understanding the viscosity and flow characteristics of various liquid embolic agents, providing expert guidance on ensuring optimal catheter positioning, case selection, and avoidance of common pitfalls. Additionally, he shares strategies for tailoring injection speed based on vessel caliber to mitigate reflux. The episode ends with final thoughts on best practices and future directions for the technology. --- TIMESTAMPS 00:00 - Introduction02:09 - Historical Perspective on Liquid Embolics06:37 - Practical Applications and Techniques16:14 - Handling Catheters and Reflux Concerns22:38 - Trauma Embolization26:53 - Visibility and Injection Techniques29:06 - Catheter Compatibility and Vessel Size32:53 - Best Practices and Common Mistakes45:55 - Final Thoughts and Advice --- RESOURCES Arslan B, Razavi MK, Siskin G, et al. The LAVA Study: A Prospective, Multicenter, Single-Arm Study of a Liquid Embolic System for Treatment of Peripheral Arterial Hemorrhage. J Vasc Interv Radiol. 2025;36(3):436-445.e2. doi:10.1016/j.jvir.2024.11.005 Onyx Liquid Embolic System: https://europe.medtronic.com/xd-en/healthcare-professionals/products/cardiovascular/peripheral-embolization/onyx-liquid-embolic-system.html LAVA Liquid Embolic System:https://www.sirtex.com/us/products/lava-liquid-embolic-system/product-information/ Liquid embolics are a relatively new addition to the interventional radiology toolkit—how well do you understand the technical considerations that come with using these agents? Get up to speed in this episode of the BackTable Podcast where Dr. Gary Siskin, Chair of Radiology at Albany Medical Center, shares his expertise.


---


This podcast is supported by:


Sirtex
https://www.sirtex.com/us/


---


SYNPOSIS


Dr. Siskin provides expert insights into the use of liquid embolic agents, including Onyx and LAVA, with a focus on their practical applications, techniques for safe and effective deployment, and the critical role they play in treating complex cases which range from peripheral and traumatic hemorrhage to portal vein embolization. He highlights the importance of understanding the viscosity and flow characteristics of various liquid embolic agents, providing expert guidance on ensuring optimal catheter positioning, case selection, and avoidance of common pitfalls. Additionally, he shares strategies for tailoring injection speed based on vessel caliber to mitigate reflux. The episode ends with final thoughts on best practices and future directions for the technology.


---


TIMESTAMPS


00:00 - Introduction
02:09 - Historical Perspective on Liquid Embolics
06:37 - Practical Applications and Techniques
16:14 - Handling Catheters and Reflux Concerns
22:38 - Trauma Embolization
26:53 - Visibility and Injection Techniques
29:06 - Catheter Compatibility and Vessel Size
32:53 - Best Practices and Common Mistakes
45:55 - Final Thoughts and Advice


---


RESOURCES


Arslan B, Razavi MK, Siskin G, et al. The LAVA Study: A Prospective, Multicenter, Single-Arm Study of a Liquid Embolic System for Treatment of Peripheral Arterial Hemorrhage. J Vasc Interv Radiol. 2025;36(3):436-445.e2. doi:10.1016/j.jvir.2024.11.005


Onyx Liquid Embolic System:
https://europe.medtronic.com/xd-en/healthcare-professionals/products/cardiovascular/peripheral-embolization/onyx-liquid-embolic-system.html


LAVA Liquid Embolic System:
https://www.sirtex.com/us/products/lava-liquid-embolic-system/product-information/

]]> 3059 Ep. 548 Winding Down Neuwave: Impact on Interventional Radiology with Dr. Joshua Kuban It’s official — NeuWave is exiting the market. In this episode, Dr. Christopher Beck hosts a conversation with Dr. Josh Kuban, an interventional radiologist at MD Anderson Cancer Center, to discuss the impact that NeuWave's microwave tumor ablation technology has had on the field of interventional oncology and the recent announcement of its discontinuation, scheduled for March 2026. --- This podcast is supported by: Medtronic Emprint --- SYNPOSIS Dr. Kuban reflects on NeuWave’s innovative beginnings in microwave ablation, which expanded to include four distinct systems and advanced ablation confirmation software. At its peak, the company held over 50% of the microwave ablation market and played a pivotal role in reshaping interventional radiology's view of the safety and effectiveness of this treatment approach. He also shares how NeuWave’s departure will affect his practice and outlines the steps he’s taking to prepare his team for the transition to alternative devices. The discussion broadens to the current landscape of microwave ablation, spotlighting emerging players in ablation confirmation software and robotic technologies. --- TIMESTAMPS 00:00 - Introduction2:14 - Overview of Neuwave’s Rise7:01 - Decision to Discontinue 14:56 - Navigating the Switch Different Technologies 21:54 - Buyback Program24:33 - Forecasting New Developments --- RESOURCES BackTable IND Ep. 23- Approach the Problem with Vision: Part I of the Neuwave Story : https://www.backtable.com/shows/industry/podcasts/23/approach-the-problem-with-vision-part-i-of-the-neuwave-story BackTable IND Ep. 24- Trials and Tribulations: Part II of the Neuwave Story: https://www.backtable.com/shows/industry/podcasts/24/trials-tribulations-part-ii-of-the-neuwave-story BackTable IND Ep. 25- Next Level Stuff, the Exit: Part III of the Neuwave Story:https://www.backtable.com/shows/industry/podcasts/25/next-level-stuff-the-exit-part-iii-of-the-neuwave-story Johnson & Johnson Press Release Regarding Discontinuation of NeuWave:https://www.medline.com/media/assets/pdf/vendor-list/Disco_notice.pdfMedTronic Emprint Ablation: https://www.medtronic.com/covidien/en-gb/products/ablation-systems/emprint-ablation-system.html Varian MicroThermX Ablation: https://www.varian.com/products/interventional-oncology/microthermx Safety and Effectiveness of Microwave Ablation of Liver Tumors: Initial Real-World Results from the Multinational NeuWave Observational Liver Ablation (NOLA) Registry (Odisio, 2025):https://pubmed.ncbi.nlm.nih.gov/39848330/ Fri, 30 May 2025 07:00:00 -0000 full BackTable It’s official — NeuWave is exiting the market. In this episode, Dr. Christopher Beck hosts a conversation with Dr. Josh Kuban, an interventional radiologist at MD Anderson Cancer Center, to discuss the impact that NeuWave's microwave tumor ablation technology has had on the field of interventional oncology and the recent announcement of its discontinuation, scheduled for March 2026. --- This podcast is supported by: Medtronic Emprint --- SYNPOSIS Dr. Kuban reflects on NeuWave’s innovative beginnings in microwave ablation, which expanded to include four distinct systems and advanced ablation confirmation software. At its peak, the company held over 50% of the microwave ablation market and played a pivotal role in reshaping interventional radiology's view of the safety and effectiveness of this treatment approach. He also shares how NeuWave’s departure will affect his practice and outlines the steps he’s taking to prepare his team for the transition to alternative devices. The discussion broadens to the current landscape of microwave ablation, spotlighting emerging players in ablation confirmation software and robotic technologies. --- TIMESTAMPS 00:00 - Introduction2:14 - Overview of Neuwave’s Rise7:01 - Decision to Discontinue 14:56 - Navigating the Switch Different Technologies 21:54 - Buyback Program24:33 - Forecasting New Developments --- RESOURCES BackTable IND Ep. 23- Approach the Problem with Vision: Part I of the Neuwave Story : https://www.backtable.com/shows/industry/podcasts/23/approach-the-problem-with-vision-part-i-of-the-neuwave-story BackTable IND Ep. 24- Trials and Tribulations: Part II of the Neuwave Story: https://www.backtable.com/shows/industry/podcasts/24/trials-tribulations-part-ii-of-the-neuwave-story BackTable IND Ep. 25- Next Level Stuff, the Exit: Part III of the Neuwave Story:https://www.backtable.com/shows/industry/podcasts/25/next-level-stuff-the-exit-part-iii-of-the-neuwave-story Johnson & Johnson Press Release Regarding Discontinuation of NeuWave:https://www.medline.com/media/assets/pdf/vendor-list/Disco_notice.pdfMedTronic Emprint Ablation: https://www.medtronic.com/covidien/en-gb/products/ablation-systems/emprint-ablation-system.html Varian MicroThermX Ablation: https://www.varian.com/products/interventional-oncology/microthermx Safety and Effectiveness of Microwave Ablation of Liver Tumors: Initial Real-World Results from the Multinational NeuWave Observational Liver Ablation (NOLA) Registry (Odisio, 2025):https://pubmed.ncbi.nlm.nih.gov/39848330/ It’s official — NeuWave is exiting the market. In this episode, Dr. Christopher Beck hosts a conversation with Dr. Josh Kuban, an interventional radiologist at MD Anderson Cancer Center, to discuss the impact that NeuWave's microwave tumor ablation technology has had on the field of interventional oncology and the recent announcement of its discontinuation, scheduled for March 2026.


---


This podcast is supported by:


Medtronic Emprint


---


SYNPOSIS


Dr. Kuban reflects on NeuWave’s innovative beginnings in microwave ablation, which expanded to include four distinct systems and advanced ablation confirmation software. At its peak, the company held over 50% of the microwave ablation market and played a pivotal role in reshaping interventional radiology's view of the safety and effectiveness of this treatment approach.


He also shares how NeuWave’s departure will affect his practice and outlines the steps he’s taking to prepare his team for the transition to alternative devices. The discussion broadens to the current landscape of microwave ablation, spotlighting emerging players in ablation confirmation software and robotic technologies.


---


TIMESTAMPS


00:00 - Introduction
2:14 - Overview of Neuwave’s Rise
7:01 - Decision to Discontinue
14:56 - Navigating the Switch Different Technologies
21:54 - Buyback Program
24:33 - Forecasting New Developments


---


RESOURCES


BackTable IND Ep. 23- Approach the Problem with Vision: Part I of the Neuwave Story : https://www.backtable.com/shows/industry/podcasts/23/approach-the-problem-with-vision-part-i-of-the-neuwave-story


BackTable IND Ep. 24- Trials and Tribulations: Part II of the Neuwave Story: https://www.backtable.com/shows/industry/podcasts/24/trials-tribulations-part-ii-of-the-neuwave-story


BackTable IND Ep. 25- Next Level Stuff, the Exit: Part III of the Neuwave Story:
https://www.backtable.com/shows/industry/podcasts/25/next-level-stuff-the-exit-part-iii-of-the-neuwave-story


Johnson & Johnson Press Release Regarding Discontinuation of NeuWave:
https://www.medline.com/media/assets/pdf/vendor-list/Disco_notice.pdf
MedTronic Emprint Ablation: https://www.medtronic.com/covidien/en-gb/products/ablation-systems/emprint-ablation-system.html


Varian MicroThermX Ablation:
https://www.varian.com/products/interventional-oncology/microthermx


Safety and Effectiveness of Microwave Ablation of Liver Tumors: Initial Real-World Results from the Multinational NeuWave Observational Liver Ablation (NOLA) Registry (Odisio, 2025):
https://pubmed.ncbi.nlm.nih.gov/39848330/

]]> 1916 Ep. 547 Intratumoral Oncolytic Treatments for Metastatic Melanoma: A Multidisciplinary Approach with Dr. Riad Salem and Dr. Sunandana Chandra Making strides against melanoma: how can medical oncologists and interventional oncologists join forces to deliver smarter, patient-centered care? In this episode of BackTable, Dr. Tyler Sandow,hosts Dr. Sunandana Chandra, medical oncologist at Northwestern, and Dr. Riad Salem, interventional oncologist at Northwestern, to discuss the evolving management of advanced melanoma. --- This podcast is supported by an educational grant from Replimune. --- SYNPOSIS The doctors open the episode with an overview of melanoma and recent advances in its treatment, highlighting key trials such as DREAMseq and CheckMate 067. The discussion explores the shift from medical oncologist as solo primary providers to a dynamic, multidisciplinary approach to advanced cancer care—emphasizing cutting-edge treatments like immunotherapy and intratumoral oncolytic viruses. Dr. Salem shares practical insights on the procedural techniques of administering intratumoral oncolytics like Replimune, emphasizing the importance of thorough documentation and patient-centered care. The doctors also provide an overview of the ongoing IGNYTE-3 Trial, a Phase 3 study assessing the safety and efficacy of the oncolytic immunotherapy RP1 in combination with nivolumab for the treatment of advanced melanoma. The episode underscores the transformative potential of innovative melanoma treatments and the crucial role of integrated, team-based approaches in improving cancer patient outcomes. --- TIMESTAMPS 00:00 - Introduction03:48 - The Evolution of Melanoma Treatment: From Chemotherapy to Immunotherapy14:05 - The Role of Oncolytic Viruses in Melanoma Treatment20:14 - Interventional Radiology’s Role in Cancer Treatment27:00 - Collaborative Approach to Cancer Care32:53 - Hyper Documentation and Communication Efficiency44:47 - Future of Intratumoral Oncolytics48:10 - Multidisciplinary Approach in Advanced Cancer Management51:46 - Conclusion and Final Thoughts --- RESOURCES DREAMseq Trial: Atkins MB, Lee SJ, Chmielowski B, et al. Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma: The DREAMseq Trial-ECOG-ACRIN EA6134. J Clin Oncol. 2023;41(2):186-197. doi:10.1200/JCO.22.01763 CheckMate 067 trial: Wolchok JD, Chiarion-Sileni V, Rutkowski P, et al. Final, 10-Year Outcomes with Nivolumab plus Ipilimumab in Advanced Melanoma. N Engl J Med. 2025;392(1):11-22. doi:10.1056/NEJMoa2407417 Tue, 27 May 2025 07:00:00 -0000 full BackTable Making strides against melanoma: how can medical oncologists and interventional oncologists join forces to deliver smarter, patient-centered care? In this episode of BackTable, Dr. Tyler Sandow, hosts Dr. Sunandana Chandra, medical oncologist at Northwestern, and Dr. Riad Salem, interventional oncologist at Northwestern to discuss the evolving management of advanced melanoma. Making strides against melanoma: how can medical oncologists and interventional oncologists join forces to deliver smarter, patient-centered care? In this episode of BackTable, Dr. Tyler Sandow,hosts Dr. Sunandana Chandra, medical oncologist at Northwestern, and Dr. Riad Salem, interventional oncologist at Northwestern, to discuss the evolving management of advanced melanoma. --- This podcast is supported by an educational grant from Replimune. --- SYNPOSIS The doctors open the episode with an overview of melanoma and recent advances in its treatment, highlighting key trials such as DREAMseq and CheckMate 067. The discussion explores the shift from medical oncologist as solo primary providers to a dynamic, multidisciplinary approach to advanced cancer care—emphasizing cutting-edge treatments like immunotherapy and intratumoral oncolytic viruses. Dr. Salem shares practical insights on the procedural techniques of administering intratumoral oncolytics like Replimune, emphasizing the importance of thorough documentation and patient-centered care. The doctors also provide an overview of the ongoing IGNYTE-3 Trial, a Phase 3 study assessing the safety and efficacy of the oncolytic immunotherapy RP1 in combination with nivolumab for the treatment of advanced melanoma. The episode underscores the transformative potential of innovative melanoma treatments and the crucial role of integrated, team-based approaches in improving cancer patient outcomes. --- TIMESTAMPS 00:00 - Introduction03:48 - The Evolution of Melanoma Treatment: From Chemotherapy to Immunotherapy14:05 - The Role of Oncolytic Viruses in Melanoma Treatment20:14 - Interventional Radiology’s Role in Cancer Treatment27:00 - Collaborative Approach to Cancer Care32:53 - Hyper Documentation and Communication Efficiency44:47 - Future of Intratumoral Oncolytics48:10 - Multidisciplinary Approach in Advanced Cancer Management51:46 - Conclusion and Final Thoughts --- RESOURCES DREAMseq Trial: Atkins MB, Lee SJ, Chmielowski B, et al. Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma: The DREAMseq Trial-ECOG-ACRIN EA6134. J Clin Oncol. 2023;41(2):186-197. doi:10.1200/JCO.22.01763 CheckMate 067 trial: Wolchok JD, Chiarion-Sileni V, Rutkowski P, et al. Final, 10-Year Outcomes with Nivolumab plus Ipilimumab in Advanced Melanoma. N Engl J Med. 2025;392(1):11-22. doi:10.1056/NEJMoa2407417 Making strides against melanoma: how can medical oncologists and interventional oncologists join forces to deliver smarter, patient-centered care? In this episode of BackTable, Dr. Tyler Sandow,hosts Dr. Sunandana Chandra, medical oncologist at Northwestern, and Dr. Riad Salem, interventional oncologist at Northwestern, to discuss the evolving management of advanced melanoma.


---


This podcast is supported by an educational grant from Replimune.


---


SYNPOSIS


The doctors open the episode with an overview of melanoma and recent advances in its treatment, highlighting key trials such as DREAMseq and CheckMate 067. The discussion explores the shift from medical oncologist as solo primary providers to a dynamic, multidisciplinary approach to advanced cancer care—emphasizing cutting-edge treatments like immunotherapy and intratumoral oncolytic viruses.


Dr. Salem shares practical insights on the procedural techniques of administering intratumoral oncolytics like Replimune, emphasizing the importance of thorough documentation and patient-centered care. The doctors also provide an overview of the ongoing IGNYTE-3 Trial, a Phase 3 study assessing the safety and efficacy of the oncolytic immunotherapy RP1 in combination with nivolumab for the treatment of advanced melanoma.

The episode underscores the transformative potential of innovative melanoma treatments and the crucial role of integrated, team-based approaches in improving cancer patient outcomes.


---


TIMESTAMPS


00:00 - Introduction
03:48 - The Evolution of Melanoma Treatment: From Chemotherapy to Immunotherapy
14:05 - The Role of Oncolytic Viruses in Melanoma Treatment
20:14 - Interventional Radiology’s Role in Cancer Treatment
27:00 - Collaborative Approach to Cancer Care
32:53 - Hyper Documentation and Communication Efficiency
44:47 - Future of Intratumoral Oncolytics
48:10 - Multidisciplinary Approach in Advanced Cancer Management
51:46 - Conclusion and Final Thoughts


---


RESOURCES


DREAMseq Trial: Atkins MB, Lee SJ, Chmielowski B, et al. Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma: The DREAMseq Trial-ECOG-ACRIN EA6134. J Clin Oncol. 2023;41(2):186-197. doi:10.1200/JCO.22.01763

CheckMate 067 trial: Wolchok JD, Chiarion-Sileni V, Rutkowski P, et al. Final, 10-Year Outcomes with Nivolumab plus Ipilimumab in Advanced Melanoma. N Engl J Med. 2025;392(1):11-22. doi:10.1056/NEJMoa2407417

]]> 3315 Ep. 546 IR Practice Development: Residency to Real-World with Dr. Quinn Meisinger Fri, 23 May 2025 07:00:00 -0000 full BackTable 3660 Ep. 545 Outpatient PAE- Tips and Tricks from a High Volume Operator with Dr. Stephen "Andy" Vartanian Bringing Prostate Artery Embolization (PAE) to the OBL setting means balancing cost efficiency, quality care, and a high procedure volume. What should you know and how can you get started? This week, host Dr. Ally Baheti explores outpatient PAE with Dr. Stephen “Andy” Vartanian, an independent interventional radiologist and medical director of PrecisionIR.---SYNPOSISThe doctors discuss Dr. Vartanian’s unique career path and extensive experience with prostate artery embolization (PAE). They discuss his approach to the procedure, best practices, and how he was able to set himself up for success in the transition to an OBL. Dr. Vartanian shares insights into patient workup, collaboration with urologists, and his perspective on the financial and operational challenges of managing an independent practice. The doctors then touch on other outpatient procedures like uterine fibroid embolization (UFE) and genicular artery embolization (GAE) and the difficulties in patient acquisition for these treatments. This episode offers a unique look into factors to consider when optimizing your practice patterns for PAE in an OBL setting.---TIMESTAMPS00:00 - Introduction05:38 - OBL Setting and PAE10:02 - Approach to PAE, Techniques, and Tools21:38 - Post-Procedure Care and Managing Patient Expectations25:32 - Advice to IRs Interested in PAE27:37 - Challenges and Strategies in Uterine Fibroid Embolization (UFE)33:14 - Running an OBL: Insights and Experiences36:40 - Future Plans and Business Reflections---RESOURCESPrecisionIR: https://myprecisionir.com/ Tue, 20 May 2025 07:00:00 -0000 full BackTable Bringing Prostate Artery Embolization (PAE) to the OBL setting means balancing cost efficiency, quality care, and a high procedure volume. What should you know and how can you get started? This week, host Dr. Ally Baheti explores outpatient PAE with Dr. Stephen “Andy” Vartanian, an independent interventional radiologist and medical director of PrecisionIR. Bringing Prostate Artery Embolization (PAE) to the OBL setting means balancing cost efficiency, quality care, and a high procedure volume. What should you know and how can you get started? This week, host Dr. Ally Baheti explores outpatient PAE with Dr. Stephen “Andy” Vartanian, an independent interventional radiologist and medical director of PrecisionIR.---SYNPOSISThe doctors discuss Dr. Vartanian’s unique career path and extensive experience with prostate artery embolization (PAE). They discuss his approach to the procedure, best practices, and how he was able to set himself up for success in the transition to an OBL. Dr. Vartanian shares insights into patient workup, collaboration with urologists, and his perspective on the financial and operational challenges of managing an independent practice. The doctors then touch on other outpatient procedures like uterine fibroid embolization (UFE) and genicular artery embolization (GAE) and the difficulties in patient acquisition for these treatments. This episode offers a unique look into factors to consider when optimizing your practice patterns for PAE in an OBL setting.---TIMESTAMPS00:00 - Introduction05:38 - OBL Setting and PAE10:02 - Approach to PAE, Techniques, and Tools21:38 - Post-Procedure Care and Managing Patient Expectations25:32 - Advice to IRs Interested in PAE27:37 - Challenges and Strategies in Uterine Fibroid Embolization (UFE)33:14 - Running an OBL: Insights and Experiences36:40 - Future Plans and Business Reflections---RESOURCESPrecisionIR: https://myprecisionir.com/ Bringing Prostate Artery Embolization (PAE) to the OBL setting means balancing cost efficiency, quality care, and a high procedure volume. What should you know and how can you get started? This week, host Dr. Ally Baheti explores outpatient PAE with Dr. Stephen “Andy” Vartanian, an independent interventional radiologist and medical director of PrecisionIR.
---
SYNPOSIS
The doctors discuss Dr. Vartanian’s unique career path and extensive experience with prostate artery embolization (PAE). They discuss his approach to the procedure, best practices, and how he was able to set himself up for success in the transition to an OBL. Dr. Vartanian shares insights into patient workup, collaboration with urologists, and his perspective on the financial and operational challenges of managing an independent practice. The doctors then touch on other outpatient procedures like uterine fibroid embolization (UFE) and genicular artery embolization (GAE) and the difficulties in patient acquisition for these treatments. This episode offers a unique look into factors to consider when optimizing your practice patterns for PAE in an OBL setting.
---
TIMESTAMPS
00:00 - Introduction
05:38 - OBL Setting and PAE
10:02 - Approach to PAE, Techniques, and Tools
21:38 - Post-Procedure Care and Managing Patient Expectations
25:32 - Advice to IRs Interested in PAE
27:37 - Challenges and Strategies in Uterine Fibroid Embolization (UFE)
33:14 - Running an OBL: Insights and Experiences
36:40 - Future Plans and Business Reflections
---
RESOURCES
PrecisionIR: https://myprecisionir.com/

]]> 2477 Ep. 544 Inside the RVS Update Committee (RUC) Process with Dr. Amar Rewari and Dr. Curtis Lee Anderson How is reimbursement decided? Have an inside look from the committee itself as we unpack exactly how a new CPT (Current Procedural Terminology) code is created, assessed, and ultimately valued for physician Medicare reimbursement. In this episode of BackTable, Dr. Sabeen Dhand is joined by radiation oncologist Dr. Amar Rewari and interventional radiologist Dr. Curtis Anderson, both of whom sit on the RVS Update Committee (RUC).---SYNPOSISThe conversation covers who participates in the RUC, the preparation it takes to propose a new CPT code, and what it’s like to collaborate with physicians from all specialties. They discuss the confidential yet crucial role of the RUC in determining physician work and practice expenses, advocacy efforts, and the impact of healthcare policies on reimbursement. The doctors stress the importance of physician engagement—especially through member surveys—and share how providers can get involved. The guests also touch on their personal journeys and motivations within the RUC and introduce Dr. Rewari’s podcast, ‘Value Health Voices’, which focuses on healthcare policy and economics.---TIMESTAMPS00:00 - Introduction and Importance of Surveys01:18 - Understanding the RVS Update Committee (RUC)6:36 - How Does a New CPT Code Get Introduced?09:44 - Challenges and Dynamics within the RUC20:52 - Health Value Voices Podcast22:51 - Transparency in Healthcare Policy24:39 - Future of Healthcare Payments29:00 - Getting Involved in Healthcare Policy33:43- Final Thoughts and Call to Action---RESOURCESHealth Value Voices Podcast: https://open.spotify.com/show/0cxnf4Il3QK3cvFFKxwPWL?si=212d084a09034cf2 Fri, 16 May 2025 07:00:00 -0000 full BackTable How is reimbursement decided? Have an inside look from the committee itself as we unpack exactly how a new CPT (Current Procedural Terminology) code is created, assessed, and ultimately valued for physician Medicare reimbursement. In this episode of BackTable, Dr. Sabeen Dhand is joined by radiation oncologist Dr. Amar Rewari and interventional radiologist Dr. Curtis Anderson, both of whom sit on the RVS Update Committee (RUC). How is reimbursement decided? Have an inside look from the committee itself as we unpack exactly how a new CPT (Current Procedural Terminology) code is created, assessed, and ultimately valued for physician Medicare reimbursement. In this episode of BackTable, Dr. Sabeen Dhand is joined by radiation oncologist Dr. Amar Rewari and interventional radiologist Dr. Curtis Anderson, both of whom sit on the RVS Update Committee (RUC).---SYNPOSISThe conversation covers who participates in the RUC, the preparation it takes to propose a new CPT code, and what it’s like to collaborate with physicians from all specialties. They discuss the confidential yet crucial role of the RUC in determining physician work and practice expenses, advocacy efforts, and the impact of healthcare policies on reimbursement. The doctors stress the importance of physician engagement—especially through member surveys—and share how providers can get involved. The guests also touch on their personal journeys and motivations within the RUC and introduce Dr. Rewari’s podcast, ‘Value Health Voices’, which focuses on healthcare policy and economics.---TIMESTAMPS00:00 - Introduction and Importance of Surveys01:18 - Understanding the RVS Update Committee (RUC)6:36 - How Does a New CPT Code Get Introduced?09:44 - Challenges and Dynamics within the RUC20:52 - Health Value Voices Podcast22:51 - Transparency in Healthcare Policy24:39 - Future of Healthcare Payments29:00 - Getting Involved in Healthcare Policy33:43- Final Thoughts and Call to Action---RESOURCESHealth Value Voices Podcast: https://open.spotify.com/show/0cxnf4Il3QK3cvFFKxwPWL?si=212d084a09034cf2 How is reimbursement decided? Have an inside look from the committee itself as we unpack exactly how a new CPT (Current Procedural Terminology) code is created, assessed, and ultimately valued for physician Medicare reimbursement. In this episode of BackTable, Dr. Sabeen Dhand is joined by radiation oncologist Dr. Amar Rewari and interventional radiologist Dr. Curtis Anderson, both of whom sit on the RVS Update Committee (RUC).
---
SYNPOSIS
The conversation covers who participates in the RUC, the preparation it takes to propose a new CPT code, and what it’s like to collaborate with physicians from all specialties. They discuss the confidential yet crucial role of the RUC in determining physician work and practice expenses, advocacy efforts, and the impact of healthcare policies on reimbursement. The doctors stress the importance of physician engagement—especially through member surveys—and share how providers can get involved. The guests also touch on their personal journeys and motivations within the RUC and introduce Dr. Rewari’s podcast, ‘Value Health Voices’, which focuses on healthcare policy and economics.
---
TIMESTAMPS
00:00 - Introduction and Importance of Surveys
01:18 - Understanding the RVS Update Committee (RUC)
6:36 - How Does a New CPT Code Get Introduced?
09:44 - Challenges and Dynamics within the RUC
20:52 - Health Value Voices Podcast
22:51 - Transparency in Healthcare Policy
24:39 - Future of Healthcare Payments
29:00 - Getting Involved in Healthcare Policy
33:43- Final Thoughts and Call to Action
---
RESOURCES
Health Value Voices Podcast: https://open.spotify.com/show/0cxnf4Il3QK3cvFFKxwPWL?si=212d084a09034cf2

]]> 2236 Ep. 543 Metastatic Colorectal Cancer: Discussion on the COLLISION Trial with Dr. Martijn Meijerink Is minimally invasive ablation the future of metastatic cancer care? We now have the results of the COLLISION Trial, which investigates the non-inferiority of thermal ablation compared to surgical resection. How will these findings change treatment paradigms and practice patterns around metastatic colorectal cancer? In this week’s episode of BackTable, interventional radiologist Dr. Chris Beck discusses the impact and implications of the COLLISION Trial with principal investigator Dr. Martijn Meijerink from Amsterdam UMC.---SYNPOSISThe doctors explore the COLLISION Trial’s design, results, complication rates, and future directions. They also cover best practices for ablation techniques and the potential for interventional oncology to enter a “golden era.” Finally, Dr. Meijerink highlights the importance of standardizing intervention quality and being present in tumor boards to ensure optimal patient care.---TIMESTAMPS00:00 - Introduction 03:21 - Understanding Metastatic Colorectal Cancer and IR’s Role05:18 - Introduction to the COLLISION Trial07:40 - Radiofrequency vs Microwave Ablation and Technological Advancements09:02 - Trial Design and Patient Eligibility16:20 - Ablation Techniques and Approaches22:05 - Trial Results and Analysis30:19 - Impact on Guidelines and Practice39:44 - Best Practices in Thermal Ablation43:27 - Future Directions in Interventional Oncology---RESOURCES“Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial.” (Meijerink, 2024)https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501 Tue, 13 May 2025 07:00:00 -0000 full BackTable Is minimally invasive ablation the future of metastatic cancer care? We now have the results of the COLLISION Trial, which investigates the non-inferiority of thermal ablation compared to surgical resection. How will these findings change treatment paradigms and practice patterns around metastatic colorectal cancer? In this week’s episode of BackTable, interventional radiologist Dr. Chris Beck discusses the impact and implications of the COLLISION Trial with principal investigator Dr. Martijn Meijerink from Amsterdam UMC. Is minimally invasive ablation the future of metastatic cancer care? We now have the results of the COLLISION Trial, which investigates the non-inferiority of thermal ablation compared to surgical resection. How will these findings change treatment paradigms and practice patterns around metastatic colorectal cancer? In this week’s episode of BackTable, interventional radiologist Dr. Chris Beck discusses the impact and implications of the COLLISION Trial with principal investigator Dr. Martijn Meijerink from Amsterdam UMC.---SYNPOSISThe doctors explore the COLLISION Trial’s design, results, complication rates, and future directions. They also cover best practices for ablation techniques and the potential for interventional oncology to enter a “golden era.” Finally, Dr. Meijerink highlights the importance of standardizing intervention quality and being present in tumor boards to ensure optimal patient care.---TIMESTAMPS00:00 - Introduction 03:21 - Understanding Metastatic Colorectal Cancer and IR’s Role05:18 - Introduction to the COLLISION Trial07:40 - Radiofrequency vs Microwave Ablation and Technological Advancements09:02 - Trial Design and Patient Eligibility16:20 - Ablation Techniques and Approaches22:05 - Trial Results and Analysis30:19 - Impact on Guidelines and Practice39:44 - Best Practices in Thermal Ablation43:27 - Future Directions in Interventional Oncology---RESOURCES“Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial.” (Meijerink, 2024)https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501 Is minimally invasive ablation the future of metastatic cancer care? We now have the results of the COLLISION Trial, which investigates the non-inferiority of thermal ablation compared to surgical resection. How will these findings change treatment paradigms and practice patterns around metastatic colorectal cancer? In this week’s episode of BackTable, interventional radiologist Dr. Chris Beck discusses the impact and implications of the COLLISION Trial with principal investigator Dr. Martijn Meijerink from Amsterdam UMC.
---
SYNPOSIS
The doctors explore the COLLISION Trial’s design, results, complication rates, and future directions. They also cover best practices for ablation techniques and the potential for interventional oncology to enter a “golden era.” Finally, Dr. Meijerink highlights the importance of standardizing intervention quality and being present in tumor boards to ensure optimal patient care.
---
TIMESTAMPS
00:00 - Introduction
03:21 - Understanding Metastatic Colorectal Cancer and IR’s Role
05:18 - Introduction to the COLLISION Trial
07:40 - Radiofrequency vs Microwave Ablation and Technological Advancements
09:02 - Trial Design and Patient Eligibility
16:20 - Ablation Techniques and Approaches
22:05 - Trial Results and Analysis
30:19 - Impact on Guidelines and Practice
39:44 - Best Practices in Thermal Ablation
43:27 - Future Directions in Interventional Oncology
---
RESOURCES
“Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial.” (Meijerink, 2024)
https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501

]]> 2938 Ep. 542 Navigating Early Career in Interventional Radiology with Dr. Christopher Zarour and Dr. Kavi Devulapalli As graduating residents step into the IR job market, the big question remains: What truly makes a great first job? Dr. Subhash Gutti hosts guest Dr. Kavi Devulapalli (Image Guided Solutions of Missouri) and Dr. Christopher Zarour (Huron Valley Radiology in Ann Arbor) as they share early career advice and job search strategies.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISThe doctors begin by highlighting different practice models and emphasize the significance of knowing what type of IR you are - an imager, a surgeon, or dynamic blend of both. They share their personal experiences navigating their early careers and underscore the pivotal role of establishing a robust clinical practice and taking full ownership of the patient. They also explore strategies for practice growth, including availability and network referrals. The episode ends with valuable advice on navigating the early stages of one's career, drawn from personal experiences.---TIMESTAMPS00:00 - Introduction01:16 - Early Career Advice and Job Search04:50 - Exploring the Job Market09:46 - What Makes a Good First Job?14:33 - Challenges in the First Job28:27 - Strategies for Building a Clinical Practice36:56 - Understanding the Business Side of Medicine48:49 - Final Advice for New Graduates Fri, 09 May 2025 07:00:00 -0000 full BackTable As graduating residents step into the IR job market, the big question remains: What truly makes a great first job? Dr. Subhash Gutti hosts guest Dr. Kavi Devulapalli (Image Guided Solutions of Missouri), and Dr. Christopher Zarour (Trinity Health) as they share early career advice and job search strategies. As graduating residents step into the IR job market, the big question remains: What truly makes a great first job? Dr. Subhash Gutti hosts guest Dr. Kavi Devulapalli (Image Guided Solutions of Missouri) and Dr. Christopher Zarour (Huron Valley Radiology in Ann Arbor) as they share early career advice and job search strategies.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISThe doctors begin by highlighting different practice models and emphasize the significance of knowing what type of IR you are - an imager, a surgeon, or dynamic blend of both. They share their personal experiences navigating their early careers and underscore the pivotal role of establishing a robust clinical practice and taking full ownership of the patient. They also explore strategies for practice growth, including availability and network referrals. The episode ends with valuable advice on navigating the early stages of one's career, drawn from personal experiences.---TIMESTAMPS00:00 - Introduction01:16 - Early Career Advice and Job Search04:50 - Exploring the Job Market09:46 - What Makes a Good First Job?14:33 - Challenges in the First Job28:27 - Strategies for Building a Clinical Practice36:56 - Understanding the Business Side of Medicine48:49 - Final Advice for New Graduates As graduating residents step into the IR job market, the big question remains: What truly makes a great first job? Dr. Subhash Gutti hosts guest Dr. Kavi Devulapalli (Image Guided Solutions of Missouri) and Dr. Christopher Zarour (Huron Valley Radiology in Ann Arbor) as they share early career advice and job search strategies.
---
This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
---
SYNPOSIS
The doctors begin by highlighting different practice models and emphasize the significance of knowing what type of IR you are - an imager, a surgeon, or dynamic blend of both. They share their personal experiences navigating their early careers and underscore the pivotal role of establishing a robust clinical practice and taking full ownership of the patient. They also explore strategies for practice growth, including availability and network referrals. The episode ends with valuable advice on navigating the early stages of one's career, drawn from personal experiences.
---
TIMESTAMPS
00:00 - Introduction
01:16 - Early Career Advice and Job Search
04:50 - Exploring the Job Market
09:46 - What Makes a Good First Job?
14:33 - Challenges in the First Job
28:27 - Strategies for Building a Clinical Practice
36:56 - Understanding the Business Side of Medicine
48:49 - Final Advice for New Graduates

]]> 3563 Ep. 541 Treatment of Acute Portal Vein Thrombosis with Dr. Ben May To TIPS or not to TIPS? More than ever, younger patients are presenting with acute portal vein thrombosis (PVT) that requires intervention beyond anticoagulation alone. These patients need safe, effective options that offer long-term resolution and a good quality of life after treatment. In this episode of the BackTable Podcast, Dr. Benjamin May, Interventional Radiologist at Weill Cornell Medicine, discusses the evolving treatment landscape for acute PVT.---SYNPOSISDr. May shares insights into the changing interventional approaches, highlights the utility of tools such as suction thrombectomy devices, and explains how his best practices have developed over time. He emphasizes the continued importance of anticoagulation therapy, explores the potential complications and outcomes of various interventions, and discusses how thrombus location and characteristics influence his clinical decisions. With real-world scenarios and a step-by-step walkthrough of his decision-making process, Dr. May offers a comprehensive look at modern strategies for managing acute portal vein thrombosis.---TIMESTAMPS00:00 - Introduction 05:46 - Diagnosing Portal Vein Thrombosis10:52 - Management Options for Acute PVT and What is Safest?21:09 - Choosing an Intervention Approach26:19 - Tackling Large Bore Thrombectomy32:37 - Learnings and Tips for Successful Thrombectomy39:50 - Impact of Thrombus Location on Intervention Approach 45:01 - Post-Care and Follow-Up49:46 - Final Thoughts and Encouragement---RESOURCES“Transjugular Intrahepatic Portosystemic Shunt and Thrombectomy (TIPS-Thrombectomy) for Symptomatic Acute Noncirrhotic Portal Vein Thrombosis” (Shalvoy, 2023)https://www.jvir.org/article/S1051-0443(23)00341-X/abstract Tue, 06 May 2025 07:00:00 -0000 full BackTable To TIPS or not to TIPS? More than ever, younger patients are presenting with acute portal vein thrombosis (PVT) that requires intervention beyond anticoagulation alone. These patients need safe, effective options that offer long-term resolution and a good quality of life after treatment. In this episode of the BackTable Podcast, Dr. Benjamin May, Interventional Radiologist at Weill Cornell Medicine, discusses the evolving treatment landscape for acute PVT. To TIPS or not to TIPS? More than ever, younger patients are presenting with acute portal vein thrombosis (PVT) that requires intervention beyond anticoagulation alone. These patients need safe, effective options that offer long-term resolution and a good quality of life after treatment. In this episode of the BackTable Podcast, Dr. Benjamin May, Interventional Radiologist at Weill Cornell Medicine, discusses the evolving treatment landscape for acute PVT.---SYNPOSISDr. May shares insights into the changing interventional approaches, highlights the utility of tools such as suction thrombectomy devices, and explains how his best practices have developed over time. He emphasizes the continued importance of anticoagulation therapy, explores the potential complications and outcomes of various interventions, and discusses how thrombus location and characteristics influence his clinical decisions. With real-world scenarios and a step-by-step walkthrough of his decision-making process, Dr. May offers a comprehensive look at modern strategies for managing acute portal vein thrombosis.---TIMESTAMPS00:00 - Introduction 05:46 - Diagnosing Portal Vein Thrombosis10:52 - Management Options for Acute PVT and What is Safest?21:09 - Choosing an Intervention Approach26:19 - Tackling Large Bore Thrombectomy32:37 - Learnings and Tips for Successful Thrombectomy39:50 - Impact of Thrombus Location on Intervention Approach 45:01 - Post-Care and Follow-Up49:46 - Final Thoughts and Encouragement---RESOURCES“Transjugular Intrahepatic Portosystemic Shunt and Thrombectomy (TIPS-Thrombectomy) for Symptomatic Acute Noncirrhotic Portal Vein Thrombosis” (Shalvoy, 2023)https://www.jvir.org/article/S1051-0443(23)00341-X/abstract To TIPS or not to TIPS? More than ever, younger patients are presenting with acute portal vein thrombosis (PVT) that requires intervention beyond anticoagulation alone. These patients need safe, effective options that offer long-term resolution and a good quality of life after treatment. In this episode of the BackTable Podcast, Dr. Benjamin May, Interventional Radiologist at Weill Cornell Medicine, discusses the evolving treatment landscape for acute PVT.
---
SYNPOSIS
Dr. May shares insights into the changing interventional approaches, highlights the utility of tools such as suction thrombectomy devices, and explains how his best practices have developed over time. He emphasizes the continued importance of anticoagulation therapy, explores the potential complications and outcomes of various interventions, and discusses how thrombus location and characteristics influence his clinical decisions. With real-world scenarios and a step-by-step walkthrough of his decision-making process, Dr. May offers a comprehensive look at modern strategies for managing acute portal vein thrombosis.
---
TIMESTAMPS
00:00 - Introduction
05:46 - Diagnosing Portal Vein Thrombosis
10:52 - Management Options for Acute PVT and What is Safest?
21:09 - Choosing an Intervention Approach
26:19 - Tackling Large Bore Thrombectomy
32:37 - Learnings and Tips for Successful Thrombectomy
39:50 - Impact of Thrombus Location on Intervention Approach
45:01 - Post-Care and Follow-Up
49:46 - Final Thoughts and Encouragement
---
RESOURCES
“Transjugular Intrahepatic Portosystemic Shunt and Thrombectomy (TIPS-Thrombectomy) for Symptomatic Acute Noncirrhotic Portal Vein Thrombosis” (Shalvoy, 2023)
https://www.jvir.org/article/S1051-0443(23)00341-X/abstract

]]> 3214 Ep. 540 Dolor Crónico Femenino: Varices Pélvicas con Dr. Gloria Salazar En este episodio de BackTable, la radióloga intervencionista Dra. Sara Lojo Lendoiro y la Dra. Gloria Salazar discuten los desafíos y las barreras para diagnosticar y tratar el dolor pélvico crónico y las varices pélvicas en mujeres.---SYNPOSISPrimero, abordan la ausencia de diagnóstico y el estereotipo que estigmatiza a las mujeres con problemas psiquiátricos. Dra. Salazar comparte su trayectoria personal desde Brasil hasta su posición de profesora asociada de radiología en la University of North Carolina, y su trabajo centrado en mejorar la salud de la mujer. También se habla sobre la necesidad de colaboración multidisciplinar, la investigación futura para entender mejor la fisiopatología, y cómo la educación y una mayor conciencia pueden mejorar el diagnóstico y tratamiento de estas patologías. Además, destacan la importancia de considerar el impacto económico y social de no tratar adecuadamente estas condiciones en mujeres activas y trabajadoras.---TIMESTAMPS00:00 - Presentación de la Dra. Gloria Salazar 06:25 - Desafíos en el Diagnóstico de la Salud de la Mujer 08:08 - Comprendiendo las Varices Pélvicas y el Dolor Pélvico Crónico 22:23 - Técnicas de Diagnóstico y Desafíos 36:19 - Evaluación del Dolor Pélvico y los Síntomas en las Piernas 41:46 - Variaciones Anatómicas y Técnicas de Diagnóstico 50:40 - La Importancia de los Equipos Multidisciplinarios 58:59 - Direcciones Futuras en la Investigación de las Venas Pélvicas 01:09:50 - Reflexiones Finales y Colaboraciones Futuras Sat, 03 May 2025 06:00:00 -0000 full BackTable En este episodio de BackTable, la radióloga intervencionista Dra. Sara Lojo Lendoiro y la Dra. Gloria Salazar discuten los desafíos y las barreras para diagnosticar y tratar el dolor pélvico crónico y las varices pélvicas en mujeres. En este episodio de BackTable, la radióloga intervencionista Dra. Sara Lojo Lendoiro y la Dra. Gloria Salazar discuten los desafíos y las barreras para diagnosticar y tratar el dolor pélvico crónico y las varices pélvicas en mujeres.---SYNPOSISPrimero, abordan la ausencia de diagnóstico y el estereotipo que estigmatiza a las mujeres con problemas psiquiátricos. Dra. Salazar comparte su trayectoria personal desde Brasil hasta su posición de profesora asociada de radiología en la University of North Carolina, y su trabajo centrado en mejorar la salud de la mujer. También se habla sobre la necesidad de colaboración multidisciplinar, la investigación futura para entender mejor la fisiopatología, y cómo la educación y una mayor conciencia pueden mejorar el diagnóstico y tratamiento de estas patologías. Además, destacan la importancia de considerar el impacto económico y social de no tratar adecuadamente estas condiciones en mujeres activas y trabajadoras.---TIMESTAMPS00:00 - Presentación de la Dra. Gloria Salazar 06:25 - Desafíos en el Diagnóstico de la Salud de la Mujer 08:08 - Comprendiendo las Varices Pélvicas y el Dolor Pélvico Crónico 22:23 - Técnicas de Diagnóstico y Desafíos 36:19 - Evaluación del Dolor Pélvico y los Síntomas en las Piernas 41:46 - Variaciones Anatómicas y Técnicas de Diagnóstico 50:40 - La Importancia de los Equipos Multidisciplinarios 58:59 - Direcciones Futuras en la Investigación de las Venas Pélvicas 01:09:50 - Reflexiones Finales y Colaboraciones Futuras En este episodio de BackTable, la radióloga intervencionista Dra. Sara Lojo Lendoiro y la Dra. Gloria Salazar discuten los desafíos y las barreras para diagnosticar y tratar el dolor pélvico crónico y las varices pélvicas en mujeres.
---
SYNPOSIS
Primero, abordan la ausencia de diagnóstico y el estereotipo que estigmatiza a las mujeres con problemas psiquiátricos. Dra. Salazar comparte su trayectoria personal desde Brasil hasta su posición de profesora asociada de radiología en la University of North Carolina, y su trabajo centrado en mejorar la salud de la mujer. También se habla sobre la necesidad de colaboración multidisciplinar, la investigación futura para entender mejor la fisiopatología, y cómo la educación y una mayor conciencia pueden mejorar el diagnóstico y tratamiento de estas patologías. Además, destacan la importancia de considerar el impacto económico y social de no tratar adecuadamente estas condiciones en mujeres activas y trabajadoras.
---
TIMESTAMPS
00:00 - Presentación de la Dra. Gloria Salazar
06:25 - Desafíos en el Diagnóstico de la Salud de la Mujer
08:08 - Comprendiendo las Varices Pélvicas y el Dolor Pélvico Crónico
22:23 - Técnicas de Diagnóstico y Desafíos
36:19 - Evaluación del Dolor Pélvico y los Síntomas en las Piernas
41:46 - Variaciones Anatómicas y Técnicas de Diagnóstico
50:40 - La Importancia de los Equipos Multidisciplinarios
58:59 - Direcciones Futuras en la Investigación de las Venas Pélvicas
01:09:50 - Reflexiones Finales y Colaboraciones Futuras

]]> 4434 Ep. 539 The Future of the IR-DR Relationship with Dr. Saher Sabri and Dr. Mark Lessne Is it time for interventional radiology to sever ties with diagnostic radiology and define its own future? Dr. Ally Baheti hosts Dr. Mark Lessne, interventional radiologist at Charlotte Radiology and Dr. Saher Sabri, Chief of Interventional Radiology at MedStar Health, to discuss the evolving relationship between interventional radiology (IR) and diagnostic radiology (DR). --- SYNPOSISThe doctors begin the discussion by asking a critical question: 'What defines an interventional radiologist?' They delve into the different practice patterns of IRs, exploring both the opportunities and challenges in interventional radiology forging its own path, independent of diagnostic radiology. The doctors share their thoughts on the financial implications, sustainability of the specialty, and the importance of establishing a clinical and longitudinal practice. The discussion concludes with the notion that an organic separation is likely inevitable, although the timing remains uncertain. --- TIMESTAMPS 00:00 - Introduction03:45 - Challenges in IR Practice12:23 - Financial Models and Sustainability16:13 - The Role of SIR in Supporting IRs34:29 - Defining IR Standards35:28 - SIR’s Role38:29 - Future of IR and DR58:36 - Final Thoughts and Call to Action Fri, 02 May 2025 07:00:00 -0000 full BackTable Is it time for interventional radiology to sever ties with diagnostic radiology and define its own future? Dr. Ally Baheti hosts Dr. Mark Lessne, interventional radiologist at Charlotte Radiology and Dr. Saher Sabri, Chief of Interventional Radiology at MedStar Health, to discuss the evolving relationship between interventional radiology (IR) and diagnostic radiology (DR). --- SYNPOSISThe doctors begin the discussion by asking a critical question: 'What defines an interventional radiologist?' They delve into the different practice patterns of IRs, exploring both the opportunities and challenges in interventional radiology forging its own path, independent of diagnostic radiology. The doctors share their thoughts on the financial implications, sustainability of the specialty, and the importance of establishing a clinical and longitudinal practice. The discussion concludes with the notion that an organic separation is likely inevitable, although the timing remains uncertain. --- TIMESTAMPS 00:00 - Introduction03:45 - Challenges in IR Practice12:23 - Financial Models and Sustainability16:13 - The Role of SIR in Supporting IRs34:29 - Defining IR Standards35:28 - SIR’s Role38:29 - Future of IR and DR58:36 - Final Thoughts and Call to Action Is it time for interventional radiology to sever ties with diagnostic radiology and define its own future? Dr. Ally Baheti hosts Dr. Mark Lessne, interventional radiologist at Charlotte Radiology and Dr. Saher Sabri, Chief of Interventional Radiology at MedStar Health, to discuss the evolving relationship between interventional radiology (IR) and diagnostic radiology (DR).


---


SYNPOSIS
The doctors begin the discussion by asking a critical question: 'What defines an interventional radiologist?' They delve into the different practice patterns of IRs, exploring both the opportunities and challenges in interventional radiology forging its own path, independent of diagnostic radiology. The doctors share their thoughts on the financial implications, sustainability of the specialty, and the importance of establishing a clinical and longitudinal practice. The discussion concludes with the notion that an organic separation is likely inevitable, although the timing remains uncertain.


---


TIMESTAMPS


00:00 - Introduction
03:45 - Challenges in IR Practice
12:23 - Financial Models and Sustainability
16:13 - The Role of SIR in Supporting IRs
34:29 - Defining IR Standards
35:28 - SIR’s Role
38:29 - Future of IR and DR
58:36 - Final Thoughts and Call to Action

]]> 3899 Ep. 538 Immunotherapy and TACE in HCC Treatment with Dr. Julius Chapiro and Dr. Richard Finn There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field.---This podcast is supported by an educational grant from Guerbet.---SYNPOSISThe doctors highlight the importance of high quality clinical data and the pivotal studies shaping current best practices. They explore the role of the different players on the multidisciplinary team and compare the oncologic and radiologic perspectives. Additionally, they discuss the synergy between TACE and immunotherapy, the criteria for selecting appropriate treatments, and the ongoing need for research and collaboration.---TIMESTAMPS00:00 - Introduction 03:35 - HCC from an Oncologic Perspective 05:33 - Radiological Perspective on Liver Cancer06:50 - Referral Patterns and Organizing a Multidisciplinary Approach18:01 - Explaining TACE and Variations in the Procedure27:27 - Choosing the Right Procedure for HCC36:13 - Making a Decision on Medical Treatment Candidacy 42:23 - Importance of Data Driven HCC Treatment, Practical Insights, and Studies to Know55:30 - Planning an Approach for a TACE Procedure01:02:26 - Final Thoughts and Future Prospects in Liver Cancer Treatment---RESOURCESBarcelona Staging System:https://www.ncbi.nlm.nih.gov/books/NBK569796/table/Ch3-t0001/TRACE Trial:https://pubs.rsna.org/doi/full/10.1148/radiol.211806PREMIERE Trial:https://www.gastrojournal.org/article/S0016-5085(16)34971-X/fulltextEMERALD-1 Trial:https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432LEAP O12 Study:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02575-3/abstract Tue, 29 Apr 2025 06:00:00 -0000 full BackTable There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field. There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field.---This podcast is supported by an educational grant from Guerbet.---SYNPOSISThe doctors highlight the importance of high quality clinical data and the pivotal studies shaping current best practices. They explore the role of the different players on the multidisciplinary team and compare the oncologic and radiologic perspectives. Additionally, they discuss the synergy between TACE and immunotherapy, the criteria for selecting appropriate treatments, and the ongoing need for research and collaboration.---TIMESTAMPS00:00 - Introduction 03:35 - HCC from an Oncologic Perspective 05:33 - Radiological Perspective on Liver Cancer06:50 - Referral Patterns and Organizing a Multidisciplinary Approach18:01 - Explaining TACE and Variations in the Procedure27:27 - Choosing the Right Procedure for HCC36:13 - Making a Decision on Medical Treatment Candidacy 42:23 - Importance of Data Driven HCC Treatment, Practical Insights, and Studies to Know55:30 - Planning an Approach for a TACE Procedure01:02:26 - Final Thoughts and Future Prospects in Liver Cancer Treatment---RESOURCESBarcelona Staging System:https://www.ncbi.nlm.nih.gov/books/NBK569796/table/Ch3-t0001/TRACE Trial:https://pubs.rsna.org/doi/full/10.1148/radiol.211806PREMIERE Trial:https://www.gastrojournal.org/article/S0016-5085(16)34971-X/fulltextEMERALD-1 Trial:https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432LEAP O12 Study:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02575-3/abstract There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field.
---
This podcast is supported by an educational grant from Guerbet.
---
SYNPOSIS
The doctors highlight the importance of high quality clinical data and the pivotal studies shaping current best practices. They explore the role of the different players on the multidisciplinary team and compare the oncologic and radiologic perspectives. Additionally, they discuss the synergy between TACE and immunotherapy, the criteria for selecting appropriate treatments, and the ongoing need for research and collaboration.
---
TIMESTAMPS
00:00 - Introduction
03:35 - HCC from an Oncologic Perspective
05:33 - Radiological Perspective on Liver Cancer
06:50 - Referral Patterns and Organizing a Multidisciplinary Approach
18:01 - Explaining TACE and Variations in the Procedure
27:27 - Choosing the Right Procedure for HCC
36:13 - Making a Decision on Medical Treatment Candidacy
42:23 - Importance of Data Driven HCC Treatment, Practical Insights, and Studies to Know
55:30 - Planning an Approach for a TACE Procedure
01:02:26 - Final Thoughts and Future Prospects in Liver Cancer Treatment
---
RESOURCES
Barcelona Staging System:
https://www.ncbi.nlm.nih.gov/books/NBK569796/table/Ch3-t0001/
TRACE Trial:
https://pubs.rsna.org/doi/full/10.1148/radiol.211806
PREMIERE Trial:
https://www.gastrojournal.org/article/S0016-5085(16)34971-X/fulltext
EMERALD-1 Trial:
https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432
LEAP O12 Study:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02575-3/abstract

]]> 4117 Ep. 537 Keeping It Lean in the OBL with Dr. Mary Costantino What is the key to running an efficient OBL? Dr. Mary Costantino, medical director of Advanced Vascular Centers, joins host Dr. Ally Baheti to share some of the key ingredients in keeping it lean in OBL. --- SYNPOSIS The doctors delve into strategies in running a cost-effective OBL while upholding clinical excellence. Dr. Costantino shares her personal insights and experiences in minimizing unnecessary costs while maintaining regulatory compliance, high-performing team, and outstanding patient care. She also underscores the importance of having a clear leadership vision and remaining at the forefront of patient care to proactively identify challenges and develop effective solutions to address them. Lastly, she shares her thoughts on navigating the challenges of balancing personal and professional responsibilities in the growing field of outpatient vascular care. --- TIMESTAMPS 00:00 - Introduction 01:46 - Expanding Practices and Partnerships 06:24 - Navigating Regulatory Requirements 12:26 - Building a Lean and Valuable Team 35:01 - Leadership 39:54 - Opportunity Cost in Practice Management 44:32 - Employee Growth and Retention Strategies 46:49 - Building and Maintaining a Successful Practice 01:06:54 - The Financial Wheel and Its Impact on Small Businesses Fri, 25 Apr 2025 14:43:00 -0000 full BackTable What is the key to running an efficient OBL? Dr. Mary Costantino, medical director of Advanced Vascular Centers, joins host Dr. Ally Baheti to share some of the key ingredients in keeping it lean in OBL. --- SYNPOSIS The doctors delve into strategies in running a cost-effective OBL while upholding clinical excellence. Dr. Costantino shares her personal insights and experiences in minimizing unnecessary costs while maintaining regulatory compliance, high-performing team, and outstanding patient care. She also underscores the importance of having a clear leadership vision and remaining at the forefront of patient care to proactively identify challenges and develop effective solutions to address them. Lastly, she shares her thoughts on navigating the challenges of balancing personal and professional responsibilities in the growing field of outpatient vascular care. --- TIMESTAMPS 00:00 - Introduction 01:46 - Expanding Practices and Partnerships 06:24 - Navigating Regulatory Requirements 12:26 - Building a Lean and Valuable Team 35:01 - Leadership 39:54 - Opportunity Cost in Practice Management 44:32 - Employee Growth and Retention Strategies 46:49 - Building and Maintaining a Successful Practice 01:06:54 - The Financial Wheel and Its Impact on Small Businesses What is the key to running an efficient OBL? Dr. Mary Costantino, medical director of Advanced Vascular Centers, joins host Dr. Ally Baheti to share some of the key ingredients in keeping it lean in OBL.


---


SYNPOSIS


The doctors delve into strategies in running a cost-effective OBL while upholding clinical excellence. Dr. Costantino shares her personal insights and experiences in minimizing unnecessary costs while maintaining regulatory compliance, high-performing team, and outstanding patient care. She also underscores the importance of having a clear leadership vision and remaining at the forefront of patient care to proactively identify challenges and develop effective solutions to address them. Lastly, she shares her thoughts on navigating the challenges of balancing personal and professional responsibilities in the growing field of outpatient vascular care.


---


TIMESTAMPS


00:00 - Introduction

01:46 - Expanding Practices and Partnerships

06:24 - Navigating Regulatory Requirements

12:26 - Building a Lean and Valuable Team

35:01 - Leadership

39:54 - Opportunity Cost in Practice Management

44:32 - Employee Growth and Retention Strategies

46:49 - Building and Maintaining a Successful Practice

01:06:54 - The Financial Wheel and Its Impact on Small Businesses

]]> 4303 Ep. 536 Multidisciplinary Approaches to Renal Cancer Care with Dr. Louis Hinshaw and Dr. Jason Abel This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors. ---This podcast is supported by:NeuWave Microwave Ablation Systemshttps://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems---SYNPOSISTheir discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration.---TIMESTAMPS00:00 - Introduction04:04 - Collaboration Between Urologists and Interventional Radiologists05:58 - Advancements in Ablation10:05 - Patient Selection15:19 - Technical Considerations26:57 - Post-Ablation Surveillance and Recurrence Management33:19 - Conclusion Wed, 23 Apr 2025 06:00:00 -0000 full BackTable This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors. This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors. ---This podcast is supported by:NeuWave Microwave Ablation Systemshttps://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems---SYNPOSISTheir discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration.---TIMESTAMPS00:00 - Introduction04:04 - Collaboration Between Urologists and Interventional Radiologists05:58 - Advancements in Ablation10:05 - Patient Selection15:19 - Technical Considerations26:57 - Post-Ablation Surveillance and Recurrence Management33:19 - Conclusion This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors.
---
This podcast is supported by:
NeuWave Microwave Ablation Systems
https://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems
---
SYNPOSIS
Their discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration.
---
TIMESTAMPS
00:00 - Introduction
04:04 - Collaboration Between Urologists and Interventional Radiologists
05:58 - Advancements in Ablation
10:05 - Patient Selection
15:19 - Technical Considerations
26:57 - Post-Ablation Surveillance and Recurrence Management
33:19 - Conclusion

]]> 2436 Ep. 535 Genicular Artery Embolization: Current Controversies and Insights with Dr. Sid Padia and Dr. Osman Ahmed Who is the ultimate candidate for GAE, which technical approach is best, and how do you set your patients up for success? Tune into this week’s episode of BackTable to hear from interventional radiologists Dr. Osman Ahmed (University of Chicago Medicine) and Dr. Siddharth Padia (UCLA Health) as they discuss everything from patient selection to follow-up care, covering pre-procedure imaging, access, embolics, technical challenges, clinical data, and the future of genicular artery embolization. --- SYNPOSIS Dr. Ahmed and Dr. Padia debate their approaches to patient selection criteria, the use of MRI and cone beam CT, permanent vs. resorbable embolic materials, how many arteries to embolize, and the relevance of pain metrics post GAE. They also delve into follow-up considerations and the potential for GAE as a long term treatment. --- TIMESTAMPS 00:00 Introduction 01:08 MRI for Patient Selection in GAE 08:53 Access Techniques: Femoral vs. Pedal 17:07 Cone Beam CT in GAE Procedures 27:20 Embolization Strategies 39:30 Challenges and Complications in Embolization 44:50 Follow-Up and Pain Metrics in Clinical Practice and Research 01:06:30 Repeat GAE Procedures: When and Why? 01:11:13 Post-Total Knee Replacement and GAE 01:21:01 Advice for IRs Looking to do GAE 01:24:32 Conclusion and Final Thoughts --- RESOURCES GENESIS Trial: https://pubmed.ncbi.nlm.nih.gov/33474601/ Landers et al Trial: https://pubmed.ncbi.nlm.nih.gov/37051829/ Tue, 22 Apr 2025 06:00:00 -0000 full BackTable Who is the ultimate candidate for GAE, which technical approach is best, and how do you set your patients up for success? Tune into this week’s episode of BackTable to hear from interventional radiologists Dr. Osman Ahmed (University of Chicago Medicine) and Dr. Siddharth Padia (UCLA Health) as they discuss everything from patient selection to follow-up care, covering pre-procedure imaging, access, embolics, technical challenges, clinical data, and the future of genicular artery embolization. Who is the ultimate candidate for GAE, which technical approach is best, and how do you set your patients up for success? Tune into this week’s episode of BackTable to hear from interventional radiologists Dr. Osman Ahmed (University of Chicago Medicine) and Dr. Siddharth Padia (UCLA Health) as they discuss everything from patient selection to follow-up care, covering pre-procedure imaging, access, embolics, technical challenges, clinical data, and the future of genicular artery embolization. --- SYNPOSIS Dr. Ahmed and Dr. Padia debate their approaches to patient selection criteria, the use of MRI and cone beam CT, permanent vs. resorbable embolic materials, how many arteries to embolize, and the relevance of pain metrics post GAE. They also delve into follow-up considerations and the potential for GAE as a long term treatment. --- TIMESTAMPS 00:00 Introduction 01:08 MRI for Patient Selection in GAE 08:53 Access Techniques: Femoral vs. Pedal 17:07 Cone Beam CT in GAE Procedures 27:20 Embolization Strategies 39:30 Challenges and Complications in Embolization 44:50 Follow-Up and Pain Metrics in Clinical Practice and Research 01:06:30 Repeat GAE Procedures: When and Why? 01:11:13 Post-Total Knee Replacement and GAE 01:21:01 Advice for IRs Looking to do GAE 01:24:32 Conclusion and Final Thoughts --- RESOURCES GENESIS Trial: https://pubmed.ncbi.nlm.nih.gov/33474601/ Landers et al Trial: https://pubmed.ncbi.nlm.nih.gov/37051829/ Who is the ultimate candidate for GAE, which technical approach is best, and how do you set your patients up for success? Tune into this week’s episode of BackTable to hear from interventional radiologists Dr. Osman Ahmed (University of Chicago Medicine) and Dr. Siddharth Padia (UCLA Health) as they discuss everything from patient selection to follow-up care, covering pre-procedure imaging, access, embolics, technical challenges, clinical data, and the future of genicular artery embolization.


---


SYNPOSIS


Dr. Ahmed and Dr. Padia debate their approaches to patient selection criteria, the use of MRI and cone beam CT, permanent vs. resorbable embolic materials, how many arteries to embolize, and the relevance of pain metrics post GAE. They also delve into follow-up considerations and the potential for GAE as a long term treatment.


---


TIMESTAMPS


00:00 Introduction

01:08 MRI for Patient Selection in GAE

08:53 Access Techniques: Femoral vs. Pedal

17:07 Cone Beam CT in GAE Procedures

27:20 Embolization Strategies

39:30 Challenges and Complications in Embolization

44:50 Follow-Up and Pain Metrics in Clinical Practice and Research

01:06:30 Repeat GAE Procedures: When and Why?

01:11:13 Post-Total Knee Replacement and GAE

01:21:01 Advice for IRs Looking to do GAE

01:24:32 Conclusion and Final Thoughts



---


RESOURCES


GENESIS Trial: https://pubmed.ncbi.nlm.nih.gov/33474601/

Landers et al Trial: https://pubmed.ncbi.nlm.nih.gov/37051829/

]]> 5334 Ep. 534 What’s a Good Job? Looking at the Diagnostic Job Market with Dr. Ned Holman and Dr. Mike Romeo Are you thinking about pursuing a new diagnostic radiology gig? Get the download on the current job market, how to evaluate different compensation models, and what to look out for when considering your next job offer in this week’s episode of BackTable, featuring guests Dr. Ned Holman (Neuroradiologist at Alaska Imaging) and Dr. Mike Romeo (Radiologist and President of West Reading Radiology). --- SYNPOSIS The doctors begin by exploring various employment models, including private practice, academic positions, and hybrid arrangements that combine elements of both. They share valuable insights on job transparency and the significance of leveraging professional connections to gain honest, firsthand perspectives on potential employers. They also provide advice on key questions to ask during job interviews and strategies for negotiating contracts. The doctors conclude by sharing tips to help make informed decisions to ensure job satisfaction and professional growth. --- TIMESTAMPS 00:00 - Introduction 04:30 - Employment Models 06:32 - Compensation Structures 08:43 - Evaluating Job Offers 19:05 - Red Flags in Employment 27:13 - Private Equity Jobs: Pros and Cons 31:36 - Navigating Job Boards and Resources 42:03 - Final Advice for Job Seekers Fri, 18 Apr 2025 06:00:00 -0000 full BackTable Are you thinking about pursuing a new diagnostic radiology gig? Get the download on the current job market, how to evaluate different compensation models, and what to look out for when considering your next job offer in this week’s episode of BackTable, featuring guests Dr. Ned Holman (Neuroradiologist at Alaska Imaging) and Dr. Mike Romeo (Radiologist and President of West Reading Radiology). Are you thinking about pursuing a new diagnostic radiology gig? Get the download on the current job market, how to evaluate different compensation models, and what to look out for when considering your next job offer in this week’s episode of BackTable, featuring guests Dr. Ned Holman (Neuroradiologist at Alaska Imaging) and Dr. Mike Romeo (Radiologist and President of West Reading Radiology). --- SYNPOSIS The doctors begin by exploring various employment models, including private practice, academic positions, and hybrid arrangements that combine elements of both. They share valuable insights on job transparency and the significance of leveraging professional connections to gain honest, firsthand perspectives on potential employers. They also provide advice on key questions to ask during job interviews and strategies for negotiating contracts. The doctors conclude by sharing tips to help make informed decisions to ensure job satisfaction and professional growth. --- TIMESTAMPS 00:00 - Introduction 04:30 - Employment Models 06:32 - Compensation Structures 08:43 - Evaluating Job Offers 19:05 - Red Flags in Employment 27:13 - Private Equity Jobs: Pros and Cons 31:36 - Navigating Job Boards and Resources 42:03 - Final Advice for Job Seekers Are you thinking about pursuing a new diagnostic radiology gig? Get the download on the current job market, how to evaluate different compensation models, and what to look out for when considering your next job offer in this week’s episode of BackTable, featuring guests Dr. Ned Holman (Neuroradiologist at Alaska Imaging) and Dr. Mike Romeo (Radiologist and President of West Reading Radiology).



---


SYNPOSIS


The doctors begin by exploring various employment models, including private practice, academic positions, and hybrid arrangements that combine elements of both. They share valuable insights on job transparency and the significance of leveraging professional connections to gain honest, firsthand perspectives on potential employers. They also provide advice on key questions to ask during job interviews and strategies for negotiating contracts. The doctors conclude by sharing tips to help make informed decisions to ensure job satisfaction and professional growth.


---


TIMESTAMPS


00:00 - Introduction

04:30 - Employment Models

06:32 - Compensation Structures

08:43 - Evaluating Job Offers

19:05 - Red Flags in Employment

27:13 - Private Equity Jobs: Pros and Cons

31:36 - Navigating Job Boards and Resources

42:03 - Final Advice for Job Seekers

]]> 2798 Ep. 533 Physician’s Guide to Financial Literacy and Investment Strategies with Dr. Jim Dahle The road towards financial literacy and financial freedom does not need to be a solo, do-it-yourself, figure it out as it goes type of journey. Guest Dr. Jim Dahle (practicing emergency medicine physician and Founder of the White Coat Investor) joins host Dr. Chris Beck to help better illuminate the process of becoming financially literate and securing financial freedom for physicians and others in similar professional arenas. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Dahle begins the episode by driving home how sound and solid financial education coupled with early, prudent financial behaviors can be worth millions over a career. The doctors discuss writing investment plans, goal setting, and understanding of asset allocation to ensure long-term financial success. Dr. Dahle also delves into the Mega Backdoor Roth IRA, practical tips for handling savings and expenses, as well as how to integrate real estate into your investment portfolio. The episode concludes with helpful resources, programs, and conferences available through the White Coat Investor. --- TIMESTAMPS 00:00 - Introduction 04:30 - Savings Tips and Strategies 13:22 - Retirement Goals and Savings Targets 28:20 - Real Estate as an Investment 32:30 - Mega Backdoor Roth IRA 42:59 - Advice for New High-Income Earners 46:09 - Teaching Financial Literacy to Kids 48:15 - Addressing Physician Burnout 53:53 - Common Financial Mistakes by Doctors 58:11 - White Coat Investor Book Giveaway Program --- RESOURCES White Coat Investor: https://www.whitecoatinvestor.com BackTable VI Episode #194 - Financial Basics from the White Coat Investor with Dr. James Dahle: https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor White Coat Investor Champions Program (For Students): https://www.whitecoatinvestor.com/wci-champions/ Tue, 15 Apr 2025 06:00:00 -0000 full BackTable The road towards financial literacy and financial freedom does not need to be a solo, do-it-yourself, figure it out as it goes type of journey. Guest Dr. Jim Dahle (practicing emergency medicine physician and Founder of the White Coat Investor) joins host Dr. Chris Beck to help better illuminate the process of becoming financially literate and securing financial freedom for physicians and others in similar professional arenas. The road towards financial literacy and financial freedom does not need to be a solo, do-it-yourself, figure it out as it goes type of journey. Guest Dr. Jim Dahle (practicing emergency medicine physician and Founder of the White Coat Investor) joins host Dr. Chris Beck to help better illuminate the process of becoming financially literate and securing financial freedom for physicians and others in similar professional arenas. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Dahle begins the episode by driving home how sound and solid financial education coupled with early, prudent financial behaviors can be worth millions over a career. The doctors discuss writing investment plans, goal setting, and understanding of asset allocation to ensure long-term financial success. Dr. Dahle also delves into the Mega Backdoor Roth IRA, practical tips for handling savings and expenses, as well as how to integrate real estate into your investment portfolio. The episode concludes with helpful resources, programs, and conferences available through the White Coat Investor. --- TIMESTAMPS 00:00 - Introduction 04:30 - Savings Tips and Strategies 13:22 - Retirement Goals and Savings Targets 28:20 - Real Estate as an Investment 32:30 - Mega Backdoor Roth IRA 42:59 - Advice for New High-Income Earners 46:09 - Teaching Financial Literacy to Kids 48:15 - Addressing Physician Burnout 53:53 - Common Financial Mistakes by Doctors 58:11 - White Coat Investor Book Giveaway Program --- RESOURCES White Coat Investor: https://www.whitecoatinvestor.com BackTable VI Episode #194 - Financial Basics from the White Coat Investor with Dr. James Dahle: https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor White Coat Investor Champions Program (For Students): https://www.whitecoatinvestor.com/wci-champions/ The road towards financial literacy and financial freedom does not need to be a solo, do-it-yourself, figure it out as it goes type of journey. Guest Dr. Jim Dahle (practicing emergency medicine physician and Founder of the White Coat Investor) joins host Dr. Chris Beck to help better illuminate the process of becoming financially literate and securing financial freedom for physicians and others in similar professional arenas.


---


This podcast is supported by:


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


Dr. Dahle begins the episode by driving home how sound and solid financial education coupled with early, prudent financial behaviors can be worth millions over a career. The doctors discuss writing investment plans, goal setting, and understanding of asset allocation to ensure long-term financial success. Dr. Dahle also delves into the Mega Backdoor Roth IRA, practical tips for handling savings and expenses, as well as how to integrate real estate into your investment portfolio. The episode concludes with helpful resources, programs, and conferences available through the White Coat Investor.


---


TIMESTAMPS


00:00 - Introduction

04:30 - Savings Tips and Strategies

13:22 - Retirement Goals and Savings Targets

28:20 - Real Estate as an Investment

32:30 - Mega Backdoor Roth IRA

42:59 - Advice for New High-Income Earners

46:09 - Teaching Financial Literacy to Kids

48:15 - Addressing Physician Burnout

53:53 - Common Financial Mistakes by Doctors

58:11 - White Coat Investor Book Giveaway Program



---


RESOURCES


White Coat Investor:

https://www.whitecoatinvestor.com


BackTable VI Episode #194 - Financial Basics from the White Coat Investor with Dr. James Dahle:

https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor


White Coat Investor Champions Program (For Students):

https://www.whitecoatinvestor.com/wci-champions/

]]> 3745 Ep. 532 OBL Site of Service Update with Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki Navigating the intricate world of medical billing can be challenging, and knowing the steps needed to ensure fair reimbursement can be even more challenging. Guests Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki (private practice interventional radiologists) join host Dr. Ally Baheti to discuss how IRs in the OBL setting can legislatively rally behind the office-based facility concept and improve physician reimbursement in the light of developments addressed at the recent OEIS meeting. --- SYNPOSIS Dr. Wiechmann and Dr. Niedzwiecki begin the episode by defining several key-terms and processes in physician reimbursement in the outpatient setting to help orient us to the issue at hand. After explaining why and how reimbursement for more advanced procedures in the OBL setting has been lagging behind, the doctors introduce the concept of creating an office-based facility concept. This would help stabilize payments for complex procedures done in the OBL space. The episode concludes with emphasis on more physician involvement and advocacy in pushing reform forward, underscoring how a unified effort is essential for long-lasting, meaningful change. --- TIMESTAMPS 00:00 - Introduction 01:42 - Medicare Physician Fee Schedule 05:46 - Challenges with Current Reimbursement Models 11:28 - Proposing the Office-Based Facility Concept 17:58 - Legislative Efforts and Congressional Involvement 26:53 - Call to Action: How You Can Help 36:40 - Conclusion --- RESOURCES Outpatient Endovascular and Interventional Society: https://oeisweb.com Tue, 08 Apr 2025 06:00:00 -0000 full BackTable Navigating the intricate world of medical billing can be challenging, and knowing the steps needed to ensure fair reimbursement can be even more challenging. Guests Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki (private practice interventional radiologists) join host Dr. Ally Baheti to discuss how IRs in the OBL setting can legislatively rally behind the office-based facility concept and improve physician reimbursement in the light of developments addressed at the recent OEIS meeting. Navigating the intricate world of medical billing can be challenging, and knowing the steps needed to ensure fair reimbursement can be even more challenging. Guests Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki (private practice interventional radiologists) join host Dr. Ally Baheti to discuss how IRs in the OBL setting can legislatively rally behind the office-based facility concept and improve physician reimbursement in the light of developments addressed at the recent OEIS meeting. --- SYNPOSIS Dr. Wiechmann and Dr. Niedzwiecki begin the episode by defining several key-terms and processes in physician reimbursement in the outpatient setting to help orient us to the issue at hand. After explaining why and how reimbursement for more advanced procedures in the OBL setting has been lagging behind, the doctors introduce the concept of creating an office-based facility concept. This would help stabilize payments for complex procedures done in the OBL space. The episode concludes with emphasis on more physician involvement and advocacy in pushing reform forward, underscoring how a unified effort is essential for long-lasting, meaningful change. --- TIMESTAMPS 00:00 - Introduction 01:42 - Medicare Physician Fee Schedule 05:46 - Challenges with Current Reimbursement Models 11:28 - Proposing the Office-Based Facility Concept 17:58 - Legislative Efforts and Congressional Involvement 26:53 - Call to Action: How You Can Help 36:40 - Conclusion --- RESOURCES Outpatient Endovascular and Interventional Society: https://oeisweb.com Navigating the intricate world of medical billing can be challenging, and knowing the steps needed to ensure fair reimbursement can be even more challenging. Guests Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki (private practice interventional radiologists) join host Dr. Ally Baheti to discuss how IRs in the OBL setting can legislatively rally behind the office-based facility concept and improve physician reimbursement in the light of developments addressed at the recent OEIS meeting.



---


SYNPOSIS


Dr. Wiechmann and Dr. Niedzwiecki begin the episode by defining several key-terms and processes in physician reimbursement in the outpatient setting to help orient us to the issue at hand. After explaining why and how reimbursement for more advanced procedures in the OBL setting has been lagging behind, the doctors introduce the concept of creating an office-based facility concept. This would help stabilize payments for complex procedures done in the OBL space. The episode concludes with emphasis on more physician involvement and advocacy in pushing reform forward, underscoring how a unified effort is essential for long-lasting, meaningful change.


---


TIMESTAMPS


00:00 - Introduction

01:42 - Medicare Physician Fee Schedule

05:46 - Challenges with Current Reimbursement Models

11:28 - Proposing the Office-Based Facility Concept

17:58 - Legislative Efforts and Congressional Involvement

26:53 - Call to Action: How You Can Help

36:40 - Conclusion



---


RESOURCES


Outpatient Endovascular and Interventional Society:

https://oeisweb.com

]]> 2514 Ep. 531 Ten Commandments for Female Interventional Radiologists with Dr. Maureen Kohi What are the 10 Commandments of Being a Female Interventional Radiologist? Guest Dr. Maureen Kohi (Chair of Radiology at University of North Carolina Chapel Hill) sits down with host Dr. Ally Baheti to discuss the details of her popular lecture topic and how these 10 rules are actually applicable to all current and future interventional radiologists. --- SYNPOSIS Dr. Kohi begins by going through each of the 10 points - offering detailed advice throughout, while also acknowledging nuances and challenges women and men can encounter in medicine and best approaches. Dr. Kohi also speaks on how to build and navigate strong relationships with industry. The episode concludes with several more pearls of wisdom as Dr. Kohi shares the last of the 10 commandments. --- TIMESTAMPS 00:00 - Introduction 01:08 - 10 Commandments of Being a Female IR 23:06 - Importance of Involvement in Professional Societies 24:46 - Childcare Concerns in Professional Settings 28:58 - Making the Leadership Leap 35:24 - Navigating Gender Bias in Professional Environments 41:51 - Prioritizing Health, Family, and Personal Fulfillment --- RESOURCES From Good to Great (Book): https://a.co/d/gXWW1Qp Start With Why (Book): https://a.co/d/hgaadIt Fri, 04 Apr 2025 06:00:00 -0000 full BackTable What are the 10 Commandments of Being a Female Interventional Radiologist? Guest Dr. Maureen Kohi (Chair of Radiology at University of North Carolina Chapel Hill) sits down with host Dr. Ally Baheti to discuss the details of her popular lecture topic and how these 10 rules are actually applicable to all current and future interventional radiologists. What are the 10 Commandments of Being a Female Interventional Radiologist? Guest Dr. Maureen Kohi (Chair of Radiology at University of North Carolina Chapel Hill) sits down with host Dr. Ally Baheti to discuss the details of her popular lecture topic and how these 10 rules are actually applicable to all current and future interventional radiologists. --- SYNPOSIS Dr. Kohi begins by going through each of the 10 points - offering detailed advice throughout, while also acknowledging nuances and challenges women and men can encounter in medicine and best approaches. Dr. Kohi also speaks on how to build and navigate strong relationships with industry. The episode concludes with several more pearls of wisdom as Dr. Kohi shares the last of the 10 commandments. --- TIMESTAMPS 00:00 - Introduction 01:08 - 10 Commandments of Being a Female IR 23:06 - Importance of Involvement in Professional Societies 24:46 - Childcare Concerns in Professional Settings 28:58 - Making the Leadership Leap 35:24 - Navigating Gender Bias in Professional Environments 41:51 - Prioritizing Health, Family, and Personal Fulfillment --- RESOURCES From Good to Great (Book): https://a.co/d/gXWW1Qp Start With Why (Book): https://a.co/d/hgaadIt What are the 10 Commandments of Being a Female Interventional Radiologist? Guest Dr. Maureen Kohi (Chair of Radiology at University of North Carolina Chapel Hill) sits down with host Dr. Ally Baheti to discuss the details of her popular lecture topic and how these 10 rules are actually applicable to all current and future interventional radiologists.


---


SYNPOSIS


Dr. Kohi begins by going through each of the 10 points - offering detailed advice throughout, while also acknowledging nuances and challenges women and men can encounter in medicine and best approaches. Dr. Kohi also speaks on how to build and navigate strong relationships with industry. The episode concludes with several more pearls of wisdom as Dr. Kohi shares the last of the 10 commandments.


---


TIMESTAMPS


00:00 - Introduction

01:08 - 10 Commandments of Being a Female IR

23:06 - Importance of Involvement in Professional Societies

24:46 - Childcare Concerns in Professional Settings

28:58 - Making the Leadership Leap

35:24 - Navigating Gender Bias in Professional Environments

41:51 - Prioritizing Health, Family, and Personal Fulfillment


---


RESOURCES


From Good to Great (Book):

https://a.co/d/gXWW1Qp


Start With Why (Book):

https://a.co/d/hgaadIt

]]> 2823 Ep. 530 Evolution of IR: A Conversation with Dr. Barry Katzen In honor of the 50th annual meeting of the Society of Interventional Radiology (SIR) in Nashville, let’s take it back to the beginning of IR and review how the field became what it is today. Guest host Dr. Andrew Niekamp (interventional radiologist at Miami Vascular) sits down with esteemed guest Dr. Barry Katzen, who began his training at the advent of IR, to discuss the origins and development of the field since its inception. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors discuss challenges and innovations that shaped IR’s growth, and the importance of clinical practice and patient-centered care. Dr. Katzen shares insights from his extensive career, including his early involvement in advancing image-guided therapies, his role in founding Miami Cardiac & Vascular Institute, and strategies to overcome turf-wars and complacency in medicine. Dr. Katzen emphasizes the need for continuous innovation and dedication towards improving patient outcomes in the evolving landscape of IR. The episode concludes with Dr. Katzen’s advice for future and early-career IRs. --- TIMESTAMPS 00:00 - Introduction 03:39 - Early Innovations and Training in Europe 09:08 - Founding the Miami Cardiac and Vascular Institute 17:13 - Challenges and Innovations 25:24 - Importance of Clinical Responsibility 34:07 - Birth of a Specialty 40:35 - Advice for Future Interventional Radiologists 43:29 - Conclusion Tue, 01 Apr 2025 06:00:00 -0000 full BackTable In honor of the 50th annual meeting of the Society of Interventional Radiology (SIR) in Nashville, let’s take it back to the beginning of IR and review how the field became what it is today. Guest host Dr. Andrew Niekamp (interventional radiologist at Miami Vascular) sits down with esteemed guest Dr. Barry Katzen, who began his training at the advent of IR, to discuss the origins and development of the field since its inception. In honor of the 50th annual meeting of the Society of Interventional Radiology (SIR) in Nashville, let’s take it back to the beginning of IR and review how the field became what it is today. Guest host Dr. Andrew Niekamp (interventional radiologist at Miami Vascular) sits down with esteemed guest Dr. Barry Katzen, who began his training at the advent of IR, to discuss the origins and development of the field since its inception. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors discuss challenges and innovations that shaped IR’s growth, and the importance of clinical practice and patient-centered care. Dr. Katzen shares insights from his extensive career, including his early involvement in advancing image-guided therapies, his role in founding Miami Cardiac & Vascular Institute, and strategies to overcome turf-wars and complacency in medicine. Dr. Katzen emphasizes the need for continuous innovation and dedication towards improving patient outcomes in the evolving landscape of IR. The episode concludes with Dr. Katzen’s advice for future and early-career IRs. --- TIMESTAMPS 00:00 - Introduction 03:39 - Early Innovations and Training in Europe 09:08 - Founding the Miami Cardiac and Vascular Institute 17:13 - Challenges and Innovations 25:24 - Importance of Clinical Responsibility 34:07 - Birth of a Specialty 40:35 - Advice for Future Interventional Radiologists 43:29 - Conclusion In honor of the 50th annual meeting of the Society of Interventional Radiology (SIR) in Nashville, let’s take it back to the beginning of IR and review how the field became what it is today. Guest host Dr. Andrew Niekamp (interventional radiologist at Miami Vascular) sits down with esteemed guest Dr. Barry Katzen, who began his training at the advent of IR, to discuss the origins and development of the field since its inception.


---


This podcast is supported by:


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


The doctors discuss challenges and innovations that shaped IR’s growth, and the importance of clinical practice and patient-centered care. Dr. Katzen shares insights from his extensive career, including his early involvement in advancing image-guided therapies, his role in founding Miami Cardiac & Vascular Institute, and strategies to overcome turf-wars and complacency in medicine. Dr. Katzen emphasizes the need for continuous innovation and dedication towards improving patient outcomes in the evolving landscape of IR. The episode concludes with Dr. Katzen’s advice for future and early-career IRs.


---


TIMESTAMPS


00:00 - Introduction

03:39 - Early Innovations and Training in Europe

09:08 - Founding the Miami Cardiac and Vascular Institute

17:13 - Challenges and Innovations

25:24 - Importance of Clinical Responsibility

34:07 - Birth of a Specialty

40:35 - Advice for Future Interventional Radiologists

43:29 - Conclusion

]]> 2801 Ep. 529 Building a Social Media Presence in IR with Dr. Gustavo Elias Is social media an effective patient acquisition tool for interventional radiologists? In a word: absolutely. Learn how to reach more patients in this week’s BackTable Podcast, where Dr. Gustavo Elias joins Dr. Ally Baheti to discuss the benefits he has seen with social media, and the content strategies that he uses in his medical practice. --- SYNPOSIS The episode begins with Dr. Elias sharing his journey of overcoming initial reservations around posting content. The doctors emphasize the importance of individuality and passion in showing what IR can offer to the public in easily-digestible ways. Dr. Elias then discusses the impact of social media on patient engagement, and shares practical tips for physicians who are looking to enhance their online presence. Dr. Elias also touches on optimal posting schedules, collaboration tips, and balancing professionalism with approachability. --- TIMESTAMPS 00:00 - Introduction 04:02 - Social Media for Interventional Radiologists 08:56 - Building a Social Media Presence 19:24 - Optimal Posting Strategies 21:58 - Collaborations and Platforms 25:27 - Conclusion Fri, 28 Mar 2025 06:00:00 -0000 full BackTable Is social media an effective patient acquisition tool for interventional radiologists? In a word: absolutely. Learn how to reach more patients in this week’s BackTable Podcast, where Dr. Gustavo Elias joins Dr. Ally Baheti to discuss the benefits he has seen with social media, and the content strategies that he uses in his medical practice. Is social media an effective patient acquisition tool for interventional radiologists? In a word: absolutely. Learn how to reach more patients in this week’s BackTable Podcast, where Dr. Gustavo Elias joins Dr. Ally Baheti to discuss the benefits he has seen with social media, and the content strategies that he uses in his medical practice. --- SYNPOSIS The episode begins with Dr. Elias sharing his journey of overcoming initial reservations around posting content. The doctors emphasize the importance of individuality and passion in showing what IR can offer to the public in easily-digestible ways. Dr. Elias then discusses the impact of social media on patient engagement, and shares practical tips for physicians who are looking to enhance their online presence. Dr. Elias also touches on optimal posting schedules, collaboration tips, and balancing professionalism with approachability. --- TIMESTAMPS 00:00 - Introduction 04:02 - Social Media for Interventional Radiologists 08:56 - Building a Social Media Presence 19:24 - Optimal Posting Strategies 21:58 - Collaborations and Platforms 25:27 - Conclusion Is social media an effective patient acquisition tool for interventional radiologists? In a word: absolutely. Learn how to reach more patients in this week’s BackTable Podcast, where Dr. Gustavo Elias joins Dr. Ally Baheti to discuss the benefits he has seen with social media, and the content strategies that he uses in his medical practice.


---


SYNPOSIS


The episode begins with Dr. Elias sharing his journey of overcoming initial reservations around posting content. The doctors emphasize the importance of individuality and passion in showing what IR can offer to the public in easily-digestible ways. Dr. Elias then discusses the impact of social media on patient engagement, and shares practical tips for physicians who are looking to enhance their online presence. Dr. Elias also touches on optimal posting schedules, collaboration tips, and balancing professionalism with approachability.


---


TIMESTAMPS


00:00 - Introduction

04:02 - Social Media for Interventional Radiologists

08:56 - Building a Social Media Presence

19:24 - Optimal Posting Strategies

21:58 - Collaborations and Platforms

25:27 - Conclusion

]]> 1775 Ep. 528 Approach to Microwave Liver Ablations with Dr. Asad Baig Let’s talk liver ablations. This week’s episode of the BackTable Podcast provides a thorough review of modern microwave ablation methods, tools, and tech, featuring Dr. Asad Baig (interventional radiologist at Columbia University) and host Dr. Michael Barraza. --- This podcast is supported by an educational grant from Medtronic . --- SYNPOSIS Dr. Baig shares practical advice on how to become a key contributor at your tumor board and how to position your skillset as an interventional radiologist. He talks through his microwave ablation procedure technique, highlighting the role of ablation zone visualization software. The doctors go on to discuss a variety of ablation approaches, needle placement, intra- and post-operative imaging, and tips for dealing with challenging tumor locations. The episode concludes with Dr. Baig summarizing best practices for ensuring safe and effective ablations, and underscoring the importance of solid patient-physician communication throughout care. --- TIMESTAMPS 00:00 - Introduction 08:28 - Microwave Ablation Techniques 12:54 - Collaborative Approach in Tumor Boards 23:30 - Combined Ablation Cases and Techniques 36:12 - Challenging Liver Ablations 45:56 - Tips for Safe and Effective Ablations 50:07 - Balancing Biopsy and Ablation 01:00:34 - Conclusion --- RESOURCES The Emprint™ Ablation System with Thermosphere™ Technology: One of the Newer Next-Generation Microwave Ablation Technologies: https://pmc.ncbi.nlm.nih.gov/articles/PMC4640908/ Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria: https://pubmed.ncbi.nlm.nih.gov/24628534/ Percutaneous microwave ablation of hepatic lesions near the heart: https://pubmed.ncbi.nlm.nih.gov/34805581/ Microwave Ablation of Hepatic Tumors Abutting the Diaphragm Is Safe and Effective: https://ajronline.org/doi/10.2214/AJR.14.12879 Tue, 25 Mar 2025 06:00:00 -0000 full BackTable Let’s talk liver ablations. This week’s episode of the BackTable Podcast provides a thorough review of modern microwave ablation methods, tools, and tech, featuring Dr. Asad Baig (interventional radiologist at Columbia University) and host Dr. Michael Barraza. Let’s talk liver ablations. This week’s episode of the BackTable Podcast provides a thorough review of modern microwave ablation methods, tools, and tech, featuring Dr. Asad Baig (interventional radiologist at Columbia University) and host Dr. Michael Barraza. --- This podcast is supported by an educational grant from Medtronic . --- SYNPOSIS Dr. Baig shares practical advice on how to become a key contributor at your tumor board and how to position your skillset as an interventional radiologist. He talks through his microwave ablation procedure technique, highlighting the role of ablation zone visualization software. The doctors go on to discuss a variety of ablation approaches, needle placement, intra- and post-operative imaging, and tips for dealing with challenging tumor locations. The episode concludes with Dr. Baig summarizing best practices for ensuring safe and effective ablations, and underscoring the importance of solid patient-physician communication throughout care. --- TIMESTAMPS 00:00 - Introduction 08:28 - Microwave Ablation Techniques 12:54 - Collaborative Approach in Tumor Boards 23:30 - Combined Ablation Cases and Techniques 36:12 - Challenging Liver Ablations 45:56 - Tips for Safe and Effective Ablations 50:07 - Balancing Biopsy and Ablation 01:00:34 - Conclusion --- RESOURCES The Emprint™ Ablation System with Thermosphere™ Technology: One of the Newer Next-Generation Microwave Ablation Technologies: https://pmc.ncbi.nlm.nih.gov/articles/PMC4640908/ Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria: https://pubmed.ncbi.nlm.nih.gov/24628534/ Percutaneous microwave ablation of hepatic lesions near the heart: https://pubmed.ncbi.nlm.nih.gov/34805581/ Microwave Ablation of Hepatic Tumors Abutting the Diaphragm Is Safe and Effective: https://ajronline.org/doi/10.2214/AJR.14.12879 Let’s talk liver ablations. This week’s episode of the BackTable Podcast provides a thorough review of modern microwave ablation methods, tools, and tech, featuring Dr. Asad Baig (interventional radiologist at Columbia University) and host Dr. Michael Barraza.




---


This podcast is supported by an educational grant from Medtronic .


---


SYNPOSIS


Dr. Baig shares practical advice on how to become a key contributor at your tumor board and how to position your skillset as an interventional radiologist. He talks through his microwave ablation procedure technique, highlighting the role of ablation zone visualization software. The doctors go on to discuss a variety of ablation approaches, needle placement, intra- and post-operative imaging, and tips for dealing with challenging tumor locations. The episode concludes with Dr. Baig summarizing best practices for ensuring safe and effective ablations, and underscoring the importance of solid patient-physician communication throughout care.



---


TIMESTAMPS


00:00 - Introduction

08:28 - Microwave Ablation Techniques

12:54 - Collaborative Approach in Tumor Boards

23:30 - Combined Ablation Cases and Techniques

36:12 - Challenging Liver Ablations

45:56 - Tips for Safe and Effective Ablations

50:07 - Balancing Biopsy and Ablation

01:00:34 - Conclusion



---


RESOURCES


The Emprint™ Ablation System with Thermosphere™ Technology: One of the Newer Next-Generation Microwave Ablation Technologies:

https://pmc.ncbi.nlm.nih.gov/articles/PMC4640908/


Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria:

https://pubmed.ncbi.nlm.nih.gov/24628534/


Percutaneous microwave ablation of hepatic lesions near the heart:

https://pubmed.ncbi.nlm.nih.gov/34805581/


Microwave Ablation of Hepatic Tumors Abutting the Diaphragm Is Safe and Effective:

https://ajronline.org/doi/10.2214/AJR.14.12879

]]> 3811 Ep. 527 Managing Hereditary Hemorrhagic Telangiectasia and Pulmonary AVMs with Dr. Clifford Weiss Targeted, image-guided interventions can make a big difference for patients with hereditary hemorrhagic telangiectasia (HHT). Learn how in this week’s BackTable episode featuring Dr. Clifford R. Weiss (Director of the Johns Hopkins Vascular Anomalies Center and HHT Center of Excellence) and host Dr. Michael Barraza. --- SYNPOSIS Dr. Weiss delves into the complexities and multisystem nature of HHT, emphasizing the significance of early diagnosis and multidisciplinary care. He goes on to explain the clinical criteria for diagnosing HHT, the role of genetic and imaging screenings, and the evolving approaches to treating pulmonary arteriovenous malformations (AVMs) in adults and children. The doctors discuss the potential impact of anti-angiogenic medications on the future management of HHT. The episode closes with a nod to the pivotal role that HHT Centers of Excellence play, and the ongoing dedication to improving patient outcomes through collaborative care and innovative research. --- TIMESTAMPS 00:00 - Introduction 03:57 - Diagnosing and Screening for Hereditary Hemorrhagic Telangiectasia (HHT) 07:37 - Treatment Approaches for HHT 12:12 - Embolization Techniques and Safety Measures 19:02 - Future of HHT Treatment and Research 22:30 - Conclusion and Final Thoughts --- RESOURCES The Johns Hopkins Hereditary Hemorrhagic Telangiectasia (HHT) Center of Excellence: https://www.hopkinsmedicine.org/interventional-radiology/hht Fri, 21 Mar 2025 06:00:00 -0000 full BackTable Targeted, image-guided interventions can make a big difference for patients with hereditary hemorrhagic telangiectasia (HHT). Learn how in this week’s BackTable episode featuring Dr. Clifford R. Weiss (Director of the Johns Hopkins Vascular Anomalies Center and HHT Center of Excellence) and host Dr. Michael Barraza. Targeted, image-guided interventions can make a big difference for patients with hereditary hemorrhagic telangiectasia (HHT). Learn how in this week’s BackTable episode featuring Dr. Clifford R. Weiss (Director of the Johns Hopkins Vascular Anomalies Center and HHT Center of Excellence) and host Dr. Michael Barraza. --- SYNPOSIS Dr. Weiss delves into the complexities and multisystem nature of HHT, emphasizing the significance of early diagnosis and multidisciplinary care. He goes on to explain the clinical criteria for diagnosing HHT, the role of genetic and imaging screenings, and the evolving approaches to treating pulmonary arteriovenous malformations (AVMs) in adults and children. The doctors discuss the potential impact of anti-angiogenic medications on the future management of HHT. The episode closes with a nod to the pivotal role that HHT Centers of Excellence play, and the ongoing dedication to improving patient outcomes through collaborative care and innovative research. --- TIMESTAMPS 00:00 - Introduction 03:57 - Diagnosing and Screening for Hereditary Hemorrhagic Telangiectasia (HHT) 07:37 - Treatment Approaches for HHT 12:12 - Embolization Techniques and Safety Measures 19:02 - Future of HHT Treatment and Research 22:30 - Conclusion and Final Thoughts --- RESOURCES The Johns Hopkins Hereditary Hemorrhagic Telangiectasia (HHT) Center of Excellence: https://www.hopkinsmedicine.org/interventional-radiology/hht Targeted, image-guided interventions can make a big difference for patients with hereditary hemorrhagic telangiectasia (HHT). Learn how in this week’s BackTable episode featuring Dr. Clifford R. Weiss (Director of the Johns Hopkins Vascular Anomalies Center and HHT Center of Excellence) and host Dr. Michael Barraza.


---


SYNPOSIS


Dr. Weiss delves into the complexities and multisystem nature of HHT, emphasizing the significance of early diagnosis and multidisciplinary care. He goes on to explain the clinical criteria for diagnosing HHT, the role of genetic and imaging screenings, and the evolving approaches to treating pulmonary arteriovenous malformations (AVMs) in adults and children. The doctors discuss the potential impact of anti-angiogenic medications on the future management of HHT. The episode closes with a nod to the pivotal role that HHT Centers of Excellence play, and the ongoing dedication to improving patient outcomes through collaborative care and innovative research.




---


TIMESTAMPS


00:00 - Introduction

03:57 - Diagnosing and Screening for Hereditary Hemorrhagic Telangiectasia (HHT)

07:37 - Treatment Approaches for HHT

12:12 - Embolization Techniques and Safety Measures

19:02 - Future of HHT Treatment and Research

22:30 - Conclusion and Final Thoughts



---


RESOURCES


The Johns Hopkins Hereditary Hemorrhagic Telangiectasia (HHT) Center of Excellence:

https://www.hopkinsmedicine.org/interventional-radiology/hht

]]> 1627 Ep. 526 Radiology Private Equity Update with Dr. Ben White Teleradiology, artificial intelligence, and private equity takeovers—how do we navigate these rapid changes in the radiology landscape? In this episode, our co-hosts Dr. Ally Baheti and Dr. Mike Barraza bring Dr. Ben White back to the show to provide an update on the current radiology job market and share his insights on reclaiming value for the profession. Dr. White begins by reflecting on the changes since his last appearance with us in 2022, focusing primarily on the ongoing shortage of radiologists, which has lasted longer than anticipated during the pandemic, and the explosion of teleradiology. --- SYNPOSIS Today’s radiologists are more mobile than ever, with remote work options and the appeal of sensationalized job postings. Dr. White also discusses the instability of more established practices, particularly when legacy partners depart after fulfilling their contractual obligations. In response, many practices are refinancing their debt, which has led to a decrease in practice acquisitions. Dr. White believes that large-scale healthcare operations often result in increased inefficiency and reduced agility. The downstream effects include the commoditization of teleradiologists, concerns about decreased quality of reads, a limited scope of practice for procedures, reduced access to imaging for smaller hospitals, longer wait times, and more unstable locum staffing. The doctors also speculate about the future division of radiology into different service tiers, depending on the level of access each hospital has to radiologists. Finally, Dr. White highlights his Independent Radiology job board, which lists open positions from physician-owned practices. His goal in creating the website is to address the pain points of other job advertisement sites, where misleading postings are common. He wants radiologists to consider joining a team of physicians, rather than simply accepting a job. His advice to all radiologists is to expect uncertainty in the job market and to remain flexible. --- TIMESTAMPS 00:00 - Current Radiology Job Market 07:43 - Updates on Private Equity in Radiology 16:26 - Role of Artificial Intelligence 22:46 - Growing Imaging Volume and Efficiency 26:51 - Challenges in Radiology Staffing 36:49 - Independent Radiology Job Board 50:07 - Future of Radiology and Final Thoughts --- RESOURCES BackTable VI Ep. 277- Private Equity and the Radiology Job Environment with Dr. Ben White: https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment Independent Radiology Job Board: https://www.independentradiology.com/ Tue, 18 Mar 2025 06:00:00 -0000 full BackTable Teleradiology, artificial intelligence, and private equity takeovers—how do we navigate these rapid changes in the radiology landscape? In this episode, our co-hosts Dr. Ally Baheti and Dr. Mike Barraza bring Dr. Ben White back to the show to provide an update on the current radiology job market and share his insights on reclaiming value for the profession. Dr. White begins by reflecting on the changes since his last appearance with us in 2022, focusing primarily on the ongoing shortage of radiologists, which has lasted longer than anticipated during the pandemic, and the explosion of teleradiology. Teleradiology, artificial intelligence, and private equity takeovers—how do we navigate these rapid changes in the radiology landscape? In this episode, our co-hosts Dr. Ally Baheti and Dr. Mike Barraza bring Dr. Ben White back to the show to provide an update on the current radiology job market and share his insights on reclaiming value for the profession. Dr. White begins by reflecting on the changes since his last appearance with us in 2022, focusing primarily on the ongoing shortage of radiologists, which has lasted longer than anticipated during the pandemic, and the explosion of teleradiology. --- SYNPOSIS Today’s radiologists are more mobile than ever, with remote work options and the appeal of sensationalized job postings. Dr. White also discusses the instability of more established practices, particularly when legacy partners depart after fulfilling their contractual obligations. In response, many practices are refinancing their debt, which has led to a decrease in practice acquisitions. Dr. White believes that large-scale healthcare operations often result in increased inefficiency and reduced agility. The downstream effects include the commoditization of teleradiologists, concerns about decreased quality of reads, a limited scope of practice for procedures, reduced access to imaging for smaller hospitals, longer wait times, and more unstable locum staffing. The doctors also speculate about the future division of radiology into different service tiers, depending on the level of access each hospital has to radiologists. Finally, Dr. White highlights his Independent Radiology job board, which lists open positions from physician-owned practices. His goal in creating the website is to address the pain points of other job advertisement sites, where misleading postings are common. He wants radiologists to consider joining a team of physicians, rather than simply accepting a job. His advice to all radiologists is to expect uncertainty in the job market and to remain flexible. --- TIMESTAMPS 00:00 - Current Radiology Job Market 07:43 - Updates on Private Equity in Radiology 16:26 - Role of Artificial Intelligence 22:46 - Growing Imaging Volume and Efficiency 26:51 - Challenges in Radiology Staffing 36:49 - Independent Radiology Job Board 50:07 - Future of Radiology and Final Thoughts --- RESOURCES BackTable VI Ep. 277- Private Equity and the Radiology Job Environment with Dr. Ben White: https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment Independent Radiology Job Board: https://www.independentradiology.com/ Teleradiology, artificial intelligence, and private equity takeovers—how do we navigate these rapid changes in the radiology landscape? In this episode, our co-hosts Dr. Ally Baheti and Dr. Mike Barraza bring Dr. Ben White back to the show to provide an update on the current radiology job market and share his insights on reclaiming value for the profession. Dr. White begins by reflecting on the changes since his last appearance with us in 2022, focusing primarily on the ongoing shortage of radiologists, which has lasted longer than anticipated during the pandemic, and the explosion of teleradiology.



---


SYNPOSIS


Today’s radiologists are more mobile than ever, with remote work options and the appeal of sensationalized job postings. Dr. White also discusses the instability of more established practices, particularly when legacy partners depart after fulfilling their contractual obligations. In response, many practices are refinancing their debt, which has led to a decrease in practice acquisitions.


Dr. White believes that large-scale healthcare operations often result in increased inefficiency and reduced agility. The downstream effects include the commoditization of teleradiologists, concerns about decreased quality of reads, a limited scope of practice for procedures, reduced access to imaging for smaller hospitals, longer wait times, and more unstable locum staffing. The doctors also speculate about the future division of radiology into different service tiers, depending on the level of access each hospital has to radiologists.


Finally, Dr. White highlights his Independent Radiology job board, which lists open positions from physician-owned practices. His goal in creating the website is to address the pain points of other job advertisement sites, where misleading postings are common. He wants radiologists to consider joining a team of physicians, rather than simply accepting a job. His advice to all radiologists is to expect uncertainty in the job market and to remain flexible.



---


TIMESTAMPS


00:00 - Current Radiology Job Market

07:43 - Updates on Private Equity in Radiology

16:26 - Role of Artificial Intelligence

22:46 - Growing Imaging Volume and Efficiency

26:51 - Challenges in Radiology Staffing

36:49 - Independent Radiology Job Board

50:07 - Future of Radiology and Final Thoughts



---


RESOURCES


BackTable VI Ep. 277- Private Equity and the Radiology Job Environment with Dr. Ben White:

https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment


Independent Radiology Job Board:

https://www.independentradiology.com/

]]> 4028 Ep. 525 Principles to Practice: An HCC Tumor Board Do you ever wish you could be a fly on the wall at a tumor board meeting? In this episode of BackTable, we’re excited to give you an insider’s view of the real case discussions that take place during hepatocellular carcinoma (HCC) tumor boards. Host Dr. Zach Berman sits down with a multidisciplinary team, including Drs. Adam Burgoyne (medical oncologist), Heather Patton (hepatologist), Siddharth Padia (interventional radiologist), and Gabriel Schnickel (transplant and hepatobiliary surgeon). Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125743 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The team walks through a range of diverse HCC cases, reviewing patient histories, imaging, and treatment options. They cover eight cases in total, each featuring patients with varying treatment histories, comorbidities, liver function, and lesion characteristics. For the full educational experience, we recommend watching the video format on our YouTube channel. --- TIMESTAMPS 00:00 - Introduction 00:47 - Case 1: Small Lesion in a Young Patient 05:01 - Case 2: Moderate Sized Lesion in an Older Patient 11:10 - Case 3: Multifocal HCC with Dominant Lesion 21:09 - Case 4: Dominant Lesion with Portal Hypertension 32:08 - Case 5: Ruptured Solitary Lesion 34:34 - Case 6: Rupture with Multifocal Lesions 44:08 - Case 7: Portal Vein Invasion 52:12 - Case 8: Metastatic HCC After Transplant --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 14 Mar 2025 06:00:00 -0000 full BackTable Do you ever wish you could be a fly on the wall at a tumor board meeting? In this episode of BackTable, we’re excited to give you an insider’s view of the real case discussions that take place during hepatocellular carcinoma (HCC) tumor boards. Host Dr. Zach Berman sits down with a multidisciplinary team, including Drs. Adam Burgoyne (medical oncologist), Heather Patton (hepatologist), Siddharth Padia (interventional radiologist), and Gabriel Schnickel (transplant and hepatobiliary surgeon). Do you ever wish you could be a fly on the wall at a tumor board meeting? In this episode of BackTable, we’re excited to give you an insider’s view of the real case discussions that take place during hepatocellular carcinoma (HCC) tumor boards. Host Dr. Zach Berman sits down with a multidisciplinary team, including Drs. Adam Burgoyne (medical oncologist), Heather Patton (hepatologist), Siddharth Padia (interventional radiologist), and Gabriel Schnickel (transplant and hepatobiliary surgeon). Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125743 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The team walks through a range of diverse HCC cases, reviewing patient histories, imaging, and treatment options. They cover eight cases in total, each featuring patients with varying treatment histories, comorbidities, liver function, and lesion characteristics. For the full educational experience, we recommend watching the video format on our YouTube channel. --- TIMESTAMPS 00:00 - Introduction 00:47 - Case 1: Small Lesion in a Young Patient 05:01 - Case 2: Moderate Sized Lesion in an Older Patient 11:10 - Case 3: Multifocal HCC with Dominant Lesion 21:09 - Case 4: Dominant Lesion with Portal Hypertension 32:08 - Case 5: Ruptured Solitary Lesion 34:34 - Case 6: Rupture with Multifocal Lesions 44:08 - Case 7: Portal Vein Invasion 52:12 - Case 8: Metastatic HCC After Transplant --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Do you ever wish you could be a fly on the wall at a tumor board meeting? In this episode of BackTable, we’re excited to give you an insider’s view of the real case discussions that take place during hepatocellular carcinoma (HCC) tumor boards. Host Dr. Zach Berman sits down with a multidisciplinary team, including Drs. Adam Burgoyne (medical oncologist), Heather Patton (hepatologist), Siddharth Padia (interventional radiologist), and Gabriel Schnickel (transplant and hepatobiliary surgeon).


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125743


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


The team walks through a range of diverse HCC cases, reviewing patient histories, imaging, and treatment options. They cover eight cases in total, each featuring patients with varying treatment histories, comorbidities, liver function, and lesion characteristics. For the full educational experience, we recommend watching the video format on our YouTube channel.


---


TIMESTAMPS


00:00 - Introduction

00:47 - Case 1: Small Lesion in a Young Patient

05:01 - Case 2: Moderate Sized Lesion in an Older Patient

11:10 - Case 3: Multifocal HCC with Dominant Lesion

21:09 - Case 4: Dominant Lesion with Portal Hypertension

32:08 - Case 5: Ruptured Solitary Lesion

34:34 - Case 6: Rupture with Multifocal Lesions

44:08 - Case 7: Portal Vein Invasion

52:12 - Case 8: Metastatic HCC After Transplant


---


RESOURCES


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 3570 Ep. 524 Collaborative Oncology: Surgeon’s Perspective and Role in Locoregional Therapy with Dr. Robert Martin Medical, surgical, radiation, and interventional oncology all play vital roles in delivering care to patients battling liver cancer. How do we optimize outcomes when so many specialties have something to offer the same patient? The answer is collaborative oncology. Dr. Robert Martin (Director of Surgical Oncology, University of Louisville) and pioneer in liver-directed therapies, joins host Dr. Sabeen Dhand to discuss a collaborative approach to oncology and recent advances in locoregional therapy. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Martin discusses the importance of a growth mindset in advancing medical techniques and fostering collaborations between specialists. He then shares insights into minimally invasive procedures, such as microwave ablation and irreversible electroporation (IRE). The doctors also touch on the evolution of liver cancer treatments, emphasizing the significance of clinical trials on the horizon. To conclude, Dr. Martin encourages young professionals in surgery and interventional radiology to stay open-minded, be life-long learners, and find synergistic ways to integrate new technologies into patient care. --- TIMESTAMPS 00:00 - Introduction 02:31 - Dr. Martin’s Background and Career Path 06:18 - Evolution of Liver Directed Therapies 10:12 - Collaboration Between Specialties 18:34 - Clinical Trials and Emerging Therapies 36:08 - Advice for Young Professionals 39:15 - Conclusion --- RESOURCES Radioembolization Oncology Trial Utilizing Transarterial Eye90 (ROUTE 90) for the Treatment of HCC: https://clinicaltrials.gov/study/NCT05953337?term=NCT05953337&rank=1 Intratumoral Injection of IP-001 Following Thermal Ablation in Patients With CRC, NSCLC, and STS (INJECTABL-1): https://clinicaltrials.gov/study/NCT05688280 Immunophotonics, CIRSE, and Next Research Announce Innovative Phase 2/3 Clinical Trial: INJECTABL-3: https://immunophotonics.com/news/immunophotonics-cirse-and-next-research-announce-innovative-phase-2-3-clinical-trial-injectabl-3/ Tue, 11 Mar 2025 06:00:00 -0000 full BackTable Medical, surgical, radiation, and interventional oncology all play vital roles in delivering care to patients battling liver cancer. How do we optimize outcomes when so many specialties have something to offer the same patient? The answer is collaborative oncology. Dr. Robert Martin (Director of Surgical Oncology, University of Louisville) and pioneer in liver-directed therapies, joins host Dr. Sabeen Dhand to discuss a collaborative approach to oncology and recent advances in locoregional therapy. Medical, surgical, radiation, and interventional oncology all play vital roles in delivering care to patients battling liver cancer. How do we optimize outcomes when so many specialties have something to offer the same patient? The answer is collaborative oncology. Dr. Robert Martin (Director of Surgical Oncology, University of Louisville) and pioneer in liver-directed therapies, joins host Dr. Sabeen Dhand to discuss a collaborative approach to oncology and recent advances in locoregional therapy. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Martin discusses the importance of a growth mindset in advancing medical techniques and fostering collaborations between specialists. He then shares insights into minimally invasive procedures, such as microwave ablation and irreversible electroporation (IRE). The doctors also touch on the evolution of liver cancer treatments, emphasizing the significance of clinical trials on the horizon. To conclude, Dr. Martin encourages young professionals in surgery and interventional radiology to stay open-minded, be life-long learners, and find synergistic ways to integrate new technologies into patient care. --- TIMESTAMPS 00:00 - Introduction 02:31 - Dr. Martin’s Background and Career Path 06:18 - Evolution of Liver Directed Therapies 10:12 - Collaboration Between Specialties 18:34 - Clinical Trials and Emerging Therapies 36:08 - Advice for Young Professionals 39:15 - Conclusion --- RESOURCES Radioembolization Oncology Trial Utilizing Transarterial Eye90 (ROUTE 90) for the Treatment of HCC: https://clinicaltrials.gov/study/NCT05953337?term=NCT05953337&rank=1 Intratumoral Injection of IP-001 Following Thermal Ablation in Patients With CRC, NSCLC, and STS (INJECTABL-1): https://clinicaltrials.gov/study/NCT05688280 Immunophotonics, CIRSE, and Next Research Announce Innovative Phase 2/3 Clinical Trial: INJECTABL-3: https://immunophotonics.com/news/immunophotonics-cirse-and-next-research-announce-innovative-phase-2-3-clinical-trial-injectabl-3/ Medical, surgical, radiation, and interventional oncology all play vital roles in delivering care to patients battling liver cancer. How do we optimize outcomes when so many specialties have something to offer the same patient? The answer is collaborative oncology. Dr. Robert Martin (Director of Surgical Oncology, University of Louisville) and pioneer in liver-directed therapies, joins host Dr. Sabeen Dhand to discuss a collaborative approach to oncology and recent advances in locoregional therapy.


---


This podcast is supported by:


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


Dr. Martin discusses the importance of a growth mindset in advancing medical techniques and fostering collaborations between specialists. He then shares insights into minimally invasive procedures, such as microwave ablation and irreversible electroporation (IRE). The doctors also touch on the evolution of liver cancer treatments, emphasizing the significance of clinical trials on the horizon. To conclude, Dr. Martin encourages young professionals in surgery and interventional radiology to stay open-minded, be life-long learners, and find synergistic ways to integrate new technologies into patient care.


---


TIMESTAMPS


00:00 - Introduction

02:31 - Dr. Martin’s Background and Career Path

06:18 - Evolution of Liver Directed Therapies

10:12 - Collaboration Between Specialties

18:34 - Clinical Trials and Emerging Therapies

36:08 - Advice for Young Professionals

39:15 - Conclusion



---


RESOURCES


Radioembolization Oncology Trial Utilizing Transarterial Eye90 (ROUTE 90) for the Treatment of HCC:

https://clinicaltrials.gov/study/NCT05953337?term=NCT05953337&rank=1


Intratumoral Injection of IP-001 Following Thermal Ablation in Patients With CRC, NSCLC, and STS (INJECTABL-1):

https://clinicaltrials.gov/study/NCT05688280


Immunophotonics, CIRSE, and Next Research Announce Innovative Phase 2/3 Clinical Trial: INJECTABL-3:

https://immunophotonics.com/news/immunophotonics-cirse-and-next-research-announce-innovative-phase-2-3-clinical-trial-injectabl-3/

]]> 2544 Ep. 523 Getting Started in Interventional Oncology: Tips for Starting your Career Are you seeking to build your reputation and patient base within interventional oncology? In this episode, host Dr. Zachary Berman interviews Dr. Siddarth Padia, Dr. Tyler Sandow, Dr. Kavi Krishnasamy, and Dr. Kevin Burns about their journeys into interventional oncology (IO) and their experiences providing care in different practice settings. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125742 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The doctors begin by discussing how they became interested in interventional oncology, with most of them recognizing opportunities to address unmet needs in the field. Each guest shares insights on the timelines and challenges involved in starting their IO practices, which vary significantly today. For instance, telehealth clinics are particularly viable in private practice IO, thanks to conferencing software and virtual translators. Hybrid care models, which combine in-person and remote consultations, can help overcome patient-level barriers such as time and transportation. The panel also emphasizes how increased clinic availability can significantly drive growth in procedural volume. Finally, they offer advice for starting an IO practice, including the importance of having clinic support staff, building strong relationships with referring physicians, and staying up to date with new technologies. --- TIMESTAMPS 00:00 - Introduction 05:38 - Balancing Career Interests and Expectations 07:10 - Building an Interventional Oncology Practice 13:42 - Gaining Trust from Referring Physicians 17:33 - Importance of Open Communication 19:19 - Comparing Clinic Settings 26:01 - Essential Components of a Clinic 33:28 - Narrowing Your Interventional Practice 40:09 - Introducing New Technology --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 07 Mar 2025 07:00:00 -0000 full BackTable Are you seeking to build your reputation and patient base within interventional oncology? In this episode, host Dr. Zachary Berman interviews Dr. Siddarth Padia, Dr. Tyler Sandow, Dr. Kavi Krishnasamy, and Dr. Kevin Burns about their journeys into interventional oncology (IO) and their experiences providing care in different practice settings. Are you seeking to build your reputation and patient base within interventional oncology? In this episode, host Dr. Zachary Berman interviews Dr. Siddarth Padia, Dr. Tyler Sandow, Dr. Kavi Krishnasamy, and Dr. Kevin Burns about their journeys into interventional oncology (IO) and their experiences providing care in different practice settings. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125742 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The doctors begin by discussing how they became interested in interventional oncology, with most of them recognizing opportunities to address unmet needs in the field. Each guest shares insights on the timelines and challenges involved in starting their IO practices, which vary significantly today. For instance, telehealth clinics are particularly viable in private practice IO, thanks to conferencing software and virtual translators. Hybrid care models, which combine in-person and remote consultations, can help overcome patient-level barriers such as time and transportation. The panel also emphasizes how increased clinic availability can significantly drive growth in procedural volume. Finally, they offer advice for starting an IO practice, including the importance of having clinic support staff, building strong relationships with referring physicians, and staying up to date with new technologies. --- TIMESTAMPS 00:00 - Introduction 05:38 - Balancing Career Interests and Expectations 07:10 - Building an Interventional Oncology Practice 13:42 - Gaining Trust from Referring Physicians 17:33 - Importance of Open Communication 19:19 - Comparing Clinic Settings 26:01 - Essential Components of a Clinic 33:28 - Narrowing Your Interventional Practice 40:09 - Introducing New Technology --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Are you seeking to build your reputation and patient base within interventional oncology? In this episode, host Dr. Zachary Berman interviews Dr. Siddarth Padia, Dr. Tyler Sandow, Dr. Kavi Krishnasamy, and Dr. Kevin Burns about their journeys into interventional oncology (IO) and their experiences providing care in different practice settings.


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125742


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


The doctors begin by discussing how they became interested in interventional oncology, with most of them recognizing opportunities to address unmet needs in the field. Each guest shares insights on the timelines and challenges involved in starting their IO practices, which vary significantly today. For instance, telehealth clinics are particularly viable in private practice IO, thanks to conferencing software and virtual translators. Hybrid care models, which combine in-person and remote consultations, can help overcome patient-level barriers such as time and transportation. The panel also emphasizes how increased clinic availability can significantly drive growth in procedural volume. Finally, they offer advice for starting an IO practice, including the importance of having clinic support staff, building strong relationships with referring physicians, and staying up to date with new technologies.


---


TIMESTAMPS


00:00 - Introduction

05:38 - Balancing Career Interests and Expectations

07:10 - Building an Interventional Oncology Practice

13:42 - Gaining Trust from Referring Physicians

17:33 - Importance of Open Communication

19:19 - Comparing Clinic Settings

26:01 - Essential Components of a Clinic

33:28 - Narrowing Your Interventional Practice

40:09 - Introducing New Technology


---


RESOURCES


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 2720 Ep. 522 Advancements in Treatment of Metastatic Ocular Melanoma with Dr. Altan Ahmed and Dr. Sid Padia Is there a way to treat liver metastasis secondary to uveal melanoma without introducing systemic, treatment-related toxicity? Dr. Altan Ahmed (interventional radiologist at Moffitt Cancer Center) and Dr. Sid Padia (interventional radiologist at UCLA) join guest-host Dr. Kavi Krishnasamy to discuss HEPZATO, a novel device-based treatment for liver metastases from uveal melanoma. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Ahmed and Dr. Padia begin by exploring the design and setup of the HEPZATO clinical trials, while also speaking on patient selection criteria. The doctors then talk through the technical aspects of the intervention. After covering workflow and considerations related to procedure timing and coordination, the doctors go on to discuss drug dosing and optimizing treatment cycles. The episode concludes with current gaps in literature, current and future research aims, and potential future applications of the HEPZATO modality in treating other malignancies such as colorectal cancer. --- TIMESTAMPS 00:00 - Introduction 05:40 - Patient Selection Criteria 09:49 - Workflow 19:17 - Procedure Timing and Coordination 29:39 - Challenges and Considerations in Drug Dosing 32:39 - Optimizing Treatment Cycles and Patient Response 37:56 - Managing Post-Treatment and Adverse Effects 43:43 - Future Research and Gaps in Current Interventions 50:45 - Exploring New Applications for PHP Therapy 55:02 - Conclusion --- RESOURCES Hepzato: https://hepzatokit.com/ FOCUS Trial - Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study: https://pubmed.ncbi.nlm.nih.gov/38704501/ FOCUS phase 3 trial results: Percutaneous hepatic perfusion (PHP) with melphalan for patients with ocular melanoma liver metastases (PHP-OCM-301/301A): https://ascopubs.org/doi/pdf/10.1200/JCO.2022.40.16_suppl.9510 Combining Melphalan Percutaneous Hepatic Perfusion with Ipilimumab Plus Nivolumab in Advanced Uveal Melanoma: First Safety and Efficacy Data from the Phase Ib Part of the Chopin Trial: https://pubmed.ncbi.nlm.nih.gov/36624292/ Troponin Elevation in Patients Undergoing Percutaneous Hepatic Perfusion for Metastatic Uveal Melanoma: https://pmc.ncbi.nlm.nih.gov/articles/PMC11010739/ Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Ocular Melanoma Metastases Confined to the Liver: A Prospective Phase II Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC7801354/ Southampton group - Quality of life after melphalan percutaneous hepatic perfusion for patients with metastatic uveal melanoma: https://pmc.ncbi.nlm.nih.gov/articles/PMC10906212/ Leiden group - Quality of Life Analysis of Patients Treated with Percutaneous Hepatic Perfusion for Uveal Melanoma Liver Metastases: https://pubmed.ncbi.nlm.nih.gov/38587534/ Tue, 04 Mar 2025 07:00:00 -0000 full BackTable Is there a way to treat liver metastasis secondary to uveal melanoma without introducing systemic, treatment-related toxicity? Dr. Altan Ahmed (interventional radiologist at Moffitt Cancer Center) and Dr. Sid Padia (interventional radiologist at UCLA) join guest-host Dr. Kavi Krishnasamy to discuss HEPZATO, a novel device-based treatment for liver metastases from uveal melanoma. Is there a way to treat liver metastasis secondary to uveal melanoma without introducing systemic, treatment-related toxicity? Dr. Altan Ahmed (interventional radiologist at Moffitt Cancer Center) and Dr. Sid Padia (interventional radiologist at UCLA) join guest-host Dr. Kavi Krishnasamy to discuss HEPZATO, a novel device-based treatment for liver metastases from uveal melanoma. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Ahmed and Dr. Padia begin by exploring the design and setup of the HEPZATO clinical trials, while also speaking on patient selection criteria. The doctors then talk through the technical aspects of the intervention. After covering workflow and considerations related to procedure timing and coordination, the doctors go on to discuss drug dosing and optimizing treatment cycles. The episode concludes with current gaps in literature, current and future research aims, and potential future applications of the HEPZATO modality in treating other malignancies such as colorectal cancer. --- TIMESTAMPS 00:00 - Introduction 05:40 - Patient Selection Criteria 09:49 - Workflow 19:17 - Procedure Timing and Coordination 29:39 - Challenges and Considerations in Drug Dosing 32:39 - Optimizing Treatment Cycles and Patient Response 37:56 - Managing Post-Treatment and Adverse Effects 43:43 - Future Research and Gaps in Current Interventions 50:45 - Exploring New Applications for PHP Therapy 55:02 - Conclusion --- RESOURCES Hepzato: https://hepzatokit.com/ FOCUS Trial - Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study: https://pubmed.ncbi.nlm.nih.gov/38704501/ FOCUS phase 3 trial results: Percutaneous hepatic perfusion (PHP) with melphalan for patients with ocular melanoma liver metastases (PHP-OCM-301/301A): https://ascopubs.org/doi/pdf/10.1200/JCO.2022.40.16_suppl.9510 Combining Melphalan Percutaneous Hepatic Perfusion with Ipilimumab Plus Nivolumab in Advanced Uveal Melanoma: First Safety and Efficacy Data from the Phase Ib Part of the Chopin Trial: https://pubmed.ncbi.nlm.nih.gov/36624292/ Troponin Elevation in Patients Undergoing Percutaneous Hepatic Perfusion for Metastatic Uveal Melanoma: https://pmc.ncbi.nlm.nih.gov/articles/PMC11010739/ Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Ocular Melanoma Metastases Confined to the Liver: A Prospective Phase II Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC7801354/ Southampton group - Quality of life after melphalan percutaneous hepatic perfusion for patients with metastatic uveal melanoma: https://pmc.ncbi.nlm.nih.gov/articles/PMC10906212/ Leiden group - Quality of Life Analysis of Patients Treated with Percutaneous Hepatic Perfusion for Uveal Melanoma Liver Metastases: https://pubmed.ncbi.nlm.nih.gov/38587534/ Is there a way to treat liver metastasis secondary to uveal melanoma without introducing systemic, treatment-related toxicity? Dr. Altan Ahmed (interventional radiologist at Moffitt Cancer Center) and Dr. Sid Padia (interventional radiologist at UCLA) join guest-host Dr. Kavi Krishnasamy to discuss HEPZATO, a novel device-based treatment for liver metastases from uveal melanoma.


---


This podcast is supported by:


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


Dr. Ahmed and Dr. Padia begin by exploring the design and setup of the HEPZATO clinical trials, while also speaking on patient selection criteria. The doctors then talk through the technical aspects of the intervention. After covering workflow and considerations related to procedure timing and coordination, the doctors go on to discuss drug dosing and optimizing treatment cycles. The episode concludes with current gaps in literature, current and future research aims, and potential future applications of the HEPZATO modality in treating other malignancies such as colorectal cancer.


---


TIMESTAMPS


00:00 - Introduction

05:40 - Patient Selection Criteria

09:49 - Workflow

19:17 - Procedure Timing and Coordination

29:39 - Challenges and Considerations in Drug Dosing

32:39 - Optimizing Treatment Cycles and Patient Response

37:56 - Managing Post-Treatment and Adverse Effects

43:43 - Future Research and Gaps in Current Interventions

50:45 - Exploring New Applications for PHP Therapy

55:02 - Conclusion



---


RESOURCES


Hepzato:

https://hepzatokit.com/


FOCUS Trial - Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study:

https://pubmed.ncbi.nlm.nih.gov/38704501/


FOCUS phase 3 trial results: Percutaneous hepatic perfusion (PHP) with melphalan for patients with ocular melanoma liver metastases (PHP-OCM-301/301A):

https://ascopubs.org/doi/pdf/10.1200/JCO.2022.40.16_suppl.9510


Combining Melphalan Percutaneous Hepatic Perfusion with Ipilimumab Plus Nivolumab in Advanced Uveal Melanoma: First Safety and Efficacy Data from the Phase Ib Part of the Chopin Trial:

https://pubmed.ncbi.nlm.nih.gov/36624292/


Troponin Elevation in Patients Undergoing Percutaneous Hepatic Perfusion for Metastatic Uveal Melanoma:

https://pmc.ncbi.nlm.nih.gov/articles/PMC11010739/


Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Ocular Melanoma Metastases Confined to the Liver: A Prospective Phase II Study:

https://pmc.ncbi.nlm.nih.gov/articles/PMC7801354/


Southampton group - Quality of life after melphalan percutaneous hepatic perfusion for patients with metastatic uveal melanoma:

https://pmc.ncbi.nlm.nih.gov/articles/PMC10906212/


Leiden group - Quality of Life Analysis of Patients Treated with Percutaneous Hepatic Perfusion for Uveal Melanoma Liver Metastases:

https://pubmed.ncbi.nlm.nih.gov/38587534/

]]> 3511 Ep. 521 Surgery for HCC: What’s its Role Today? Is surgery truly the "cure" for hepatocellular carcinoma (HCC), and when is it a viable option? In this episode, Dr. Sabeen Dhand leads a roundtable discussion with interventional radiologist Dr. Siddharth Padia and transplant/hepatobiliary surgeons Dr. John Seal and Dr. Gabriel Schnickel, delving into the complexities of surgical treatments for HCC and the evolving landscape of liver resection and transplantation. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125741 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The doctors begin by discussing how they manage patient expectations regarding both palliative and curative treatments, highlighting the risk of recurrent HCC as a new lesion. They then outline key factors that influence their recommendations for liver transplant versus resection, such as the extent of underlying liver disease, the function of the future liver remnant, body habitus, overall health, and organ availability. The surgeons also review various surgical approaches to liver resection and recent advancements in liver transplantation, including living donor transplants and the ability to refer patients for downstaging procedures. Dr. Padia explains the original role of Y90 as a bridging treatment to downstage tumors and promote hypertrophy in the non-diseased liver segments, preparing the organ for surgical resection. However, Y90 treatment can also lead to the formation of adhesions, which may complicate future surgeries. Finally, the doctors discuss strategies to improve care coordination between community physicians and transplant centers to optimize patient outcomes. --- TIMESTAMPS 00:00 - Curative vs. Palliative Treatment 04:03 - Choosing Between Transplantation and Resection 05:47 - Liver Resection Types 07:27 - Bridging Role of Y90 12:14 - Evolving Landscape of Liver Transplantation 20:59 - Patient Counseling in Minimally Invasive Procedures 28:40 - Considerations for Surgery After Y90 33:32 - Coordination Between Specialists 40:08 - Immunotherapy as a Bridge to Transplant --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 28 Feb 2025 07:00:00 -0000 full BackTable The doctors begin by discussing how they manage patient expectations regarding both palliative and curative treatments, highlighting the risk of recurrent HCC as a new lesion. They then outline key factors that influence their recommendations for liver transplant versus resection, such as the extent of underlying liver disease, the function of the future liver remnant, body habitus, overall health, and organ availability. The surgeons also review various surgical approaches to liver resection and recent advancements in liver transplantation, including living donor transplants and the ability to refer patients for downstaging procedures. Is surgery truly the "cure" for hepatocellular carcinoma (HCC), and when is it a viable option? In this episode, Dr. Sabeen Dhand leads a roundtable discussion with interventional radiologist Dr. Siddharth Padia and transplant/hepatobiliary surgeons Dr. John Seal and Dr. Gabriel Schnickel, delving into the complexities of surgical treatments for HCC and the evolving landscape of liver resection and transplantation. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125741 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The doctors begin by discussing how they manage patient expectations regarding both palliative and curative treatments, highlighting the risk of recurrent HCC as a new lesion. They then outline key factors that influence their recommendations for liver transplant versus resection, such as the extent of underlying liver disease, the function of the future liver remnant, body habitus, overall health, and organ availability. The surgeons also review various surgical approaches to liver resection and recent advancements in liver transplantation, including living donor transplants and the ability to refer patients for downstaging procedures. Dr. Padia explains the original role of Y90 as a bridging treatment to downstage tumors and promote hypertrophy in the non-diseased liver segments, preparing the organ for surgical resection. However, Y90 treatment can also lead to the formation of adhesions, which may complicate future surgeries. Finally, the doctors discuss strategies to improve care coordination between community physicians and transplant centers to optimize patient outcomes. --- TIMESTAMPS 00:00 - Curative vs. Palliative Treatment 04:03 - Choosing Between Transplantation and Resection 05:47 - Liver Resection Types 07:27 - Bridging Role of Y90 12:14 - Evolving Landscape of Liver Transplantation 20:59 - Patient Counseling in Minimally Invasive Procedures 28:40 - Considerations for Surgery After Y90 33:32 - Coordination Between Specialists 40:08 - Immunotherapy as a Bridge to Transplant --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Is surgery truly the "cure" for hepatocellular carcinoma (HCC), and when is it a viable option? In this episode, Dr. Sabeen Dhand leads a roundtable discussion with interventional radiologist Dr. Siddharth Padia and transplant/hepatobiliary surgeons Dr. John Seal and Dr. Gabriel Schnickel, delving into the complexities of surgical treatments for HCC and the evolving landscape of liver resection and transplantation.


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125741


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


The doctors begin by discussing how they manage patient expectations regarding both palliative and curative treatments, highlighting the risk of recurrent HCC as a new lesion. They then outline key factors that influence their recommendations for liver transplant versus resection, such as the extent of underlying liver disease, the function of the future liver remnant, body habitus, overall health, and organ availability. The surgeons also review various surgical approaches to liver resection and recent advancements in liver transplantation, including living donor transplants and the ability to refer patients for downstaging procedures.


Dr. Padia explains the original role of Y90 as a bridging treatment to downstage tumors and promote hypertrophy in the non-diseased liver segments, preparing the organ for surgical resection. However, Y90 treatment can also lead to the formation of adhesions, which may complicate future surgeries. Finally, the doctors discuss strategies to improve care coordination between community physicians and transplant centers to optimize patient outcomes.


---


TIMESTAMPS


00:00 - Curative vs. Palliative Treatment

04:03 - Choosing Between Transplantation and Resection

05:47 - Liver Resection Types

07:27 - Bridging Role of Y90

12:14 - Evolving Landscape of Liver Transplantation

20:59 - Patient Counseling in Minimally Invasive Procedures

28:40 - Considerations for Surgery After Y90

33:32 - Coordination Between Specialists

40:08 - Immunotherapy as a Bridge to Transplant


---


RESOURCES


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 2831 Ep. 520 Frontiers in Musculoskeletal Embolization with Dr. Yuji Okuno Musculoskeletal embolization is generating significant excitement in the field of chronic pain management. In this episode, Dr. Jacob Fleming hosts a discussion with Dr. Yuji Okuno from Japan, a pioneer in both basic science and clinical practice within the field of musculoskeletal embolization. --- This podcast is supported by: Medtronic MVP https://www.medtronic.com/mvp --- SYNPOSIS The conversation delves into Dr. Okuno's groundbreaking work using embolization to treat chronic pain from conditions such as frozen shoulder, knee osteoarthritis, plantar fasciitis, and various sports injuries. Dr. Okuno discusses the development of new temporary embolic agents and compares different approaches to embolization treatments, including the innovative use of antibiotics as embolic material. The doctors also cover the intriguing concept of differential recanalization, where abnormal inflammatory vessels are less likely to recanalize than normal vessels after embolic treatment. Identifying hypervascularity through MRI, ultrasound, or angiogram is a crucial step before attempting embolization. Overall, Dr. Okuno offers valuable insights into his clinical practice and the potential for groundbreaking advancements in musculoskeletal care worldwide. --- TIMESTAMPS 00:00 - Introduction 01:54 - Origins of Embolization for Pain 04:15 - Basic Science Research Discoveries and Clinical Trials 09:02 - Temporary Embolic Materials 15:28 - Techniques for Embolization 17:33 - Plantar Fasciitis Treatment 24:04 - Future of Embolization in Sports Injuries 28:11 - Diagnostic Imaging in Embolization 36:10 - Global Expansion and Collaborations Tue, 25 Feb 2025 07:00:00 -0000 full BackTable Musculoskeletal embolization is generating significant excitement in the field of chronic pain management. In this episode, Dr. Jacob Fleming hosts a discussion with Dr. Yuji Okuno from Japan, a pioneer in both basic science and clinical practice within the field of musculoskeletal embolization. Musculoskeletal embolization is generating significant excitement in the field of chronic pain management. In this episode, Dr. Jacob Fleming hosts a discussion with Dr. Yuji Okuno from Japan, a pioneer in both basic science and clinical practice within the field of musculoskeletal embolization. --- This podcast is supported by: Medtronic MVP https://www.medtronic.com/mvp --- SYNPOSIS The conversation delves into Dr. Okuno's groundbreaking work using embolization to treat chronic pain from conditions such as frozen shoulder, knee osteoarthritis, plantar fasciitis, and various sports injuries. Dr. Okuno discusses the development of new temporary embolic agents and compares different approaches to embolization treatments, including the innovative use of antibiotics as embolic material. The doctors also cover the intriguing concept of differential recanalization, where abnormal inflammatory vessels are less likely to recanalize than normal vessels after embolic treatment. Identifying hypervascularity through MRI, ultrasound, or angiogram is a crucial step before attempting embolization. Overall, Dr. Okuno offers valuable insights into his clinical practice and the potential for groundbreaking advancements in musculoskeletal care worldwide. --- TIMESTAMPS 00:00 - Introduction 01:54 - Origins of Embolization for Pain 04:15 - Basic Science Research Discoveries and Clinical Trials 09:02 - Temporary Embolic Materials 15:28 - Techniques for Embolization 17:33 - Plantar Fasciitis Treatment 24:04 - Future of Embolization in Sports Injuries 28:11 - Diagnostic Imaging in Embolization 36:10 - Global Expansion and Collaborations Musculoskeletal embolization is generating significant excitement in the field of chronic pain management. In this episode, Dr. Jacob Fleming hosts a discussion with Dr. Yuji Okuno from Japan, a pioneer in both basic science and clinical practice within the field of musculoskeletal embolization.


---


This podcast is supported by:


Medtronic MVP

https://www.medtronic.com/mvp


---


SYNPOSIS


The conversation delves into Dr. Okuno's groundbreaking work using embolization to treat chronic pain from conditions such as frozen shoulder, knee osteoarthritis, plantar fasciitis, and various sports injuries. Dr. Okuno discusses the development of new temporary embolic agents and compares different approaches to embolization treatments, including the innovative use of antibiotics as embolic material. The doctors also cover the intriguing concept of differential recanalization, where abnormal inflammatory vessels are less likely to recanalize than normal vessels after embolic treatment. Identifying hypervascularity through MRI, ultrasound, or angiogram is a crucial step before attempting embolization.


Overall, Dr. Okuno offers valuable insights into his clinical practice and the potential for groundbreaking advancements in musculoskeletal care worldwide.



---


TIMESTAMPS


00:00 - Introduction

01:54 - Origins of Embolization for Pain

04:15 - Basic Science Research Discoveries and Clinical Trials

09:02 - Temporary Embolic Materials

15:28 - Techniques for Embolization

17:33 - Plantar Fasciitis Treatment

24:04 - Future of Embolization in Sports Injuries

28:11 - Diagnostic Imaging in Embolization

36:10 - Global Expansion and Collaborations

]]> 2384 Ep. 519 Transplantation for HCC: Who, When, and How? The process of liver transplantation involves many complexities, and each patient's path to transplant is unique. To offer insider perspectives on this process, Dr. Zachary Berman sits down with transplant and hepatobiliary surgeon Dr. John Seal, as well as transplant hepatologists Dr. Heather Patton and Dr. Steve Young. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125740 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The panel begins by discussing the multidisciplinary pre-transplant evaluation process, which assesses factors such as liver function, comorbidities, surgical risk, and the availability of psychosocial support. Once a patient is listed for transplant, they enter a system that prioritizes those with the highest Model for End-Stage Liver Disease (MELD) score. During the waiting period, several comorbidities should be carefully monitored. Dr. Seal explores the impact of portal vein hypertension and portal vein thrombosis, explaining how these conditions may necessitate intraoperative thrombectomy or bypass. Dr. Patton and Dr. Young focus on considerations for using anticoagulation in patients with a high baseline bleeding risk and selecting the appropriate anticoagulant for patients listed for transplant. For patients with hepatocellular carcinoma (HCC), eligibility for MELD exception points may depend on factors such as time spent on the waiting list, adherence to the Milan criteria, and the presence of extrahepatic complications of liver disease. The panel also discusses bridging therapies to transplant, including Y90 and TACE. In the peri-transplant phase, they highlight innovations such as living donor transplants, liver perfusion pumps, and the use of hepatitis C- and HIV-positive organs. Finally, the discussion turns to post-transplant considerations, including surgical complications, organ rejection, immunosuppression, predictors of HCC recurrence, and long-term surveillance. --- TIMESTAMPS 00:00 - Introduction 01:16 - Current Landscape of Liver Transplantation 03:22 - Transplant Evaluation Process 09:48 - Timeline from Listing to Transplantion 11:16 - Treating Portal Vein Thrombosis and Hypertension 18:44 - MELD Exception Points 22:05 - Bridging Therapies 25:34 - Peri-Transplant Considerations 30:53 - Post-Transplant Period 37:39 - Repeat Transplantation --- RESOURCES Model for end-stage liver disease (MELD) and allocation of donor livers (Wiesner et al, 2003): https://www.gastrojournal.org/article/S0016-5085%2803%2950022-1/fulltext Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis- Milan Criteria (Mazzaferro et al, 1996): https://pubmed.ncbi.nlm.nih.gov/8594428/ Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database (Mehta et al, 2019): https://pmc.ncbi.nlm.nih.gov/articles/PMC6445634/ CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 21 Feb 2025 07:00:00 -0000 full BackTable The process of liver transplantation involves many complexities, and each patient's path to transplant is unique. To offer insider perspectives on this process, Dr. Zachary Berman sits down with transplant and hepatobiliary surgeon Dr. John Seal, as well as transplant hepatologists Dr. Heather Patton and Dr. Steve Young. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125740 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The panel begins by discussing the multidisciplinary pre-transplant evaluation process, which assesses factors such as liver function, comorbidities, surgical risk, and the availability of psychosocial support. Once a patient is listed for transplant, they enter a system that prioritizes those with the highest Model for End-Stage Liver Disease (MELD) score. During the waiting period, several comorbidities should be carefully monitored. Dr. Seal explores the impact of portal vein hypertension and portal vein thrombosis, explaining how these conditions may necessitate intraoperative thrombectomy or bypass. Dr. Patton and Dr. Young focus on considerations for using anticoagulation in patients with a high baseline bleeding risk and selecting the appropriate anticoagulant for patients listed for transplant. For patients with hepatocellular carcinoma (HCC), eligibility for MELD exception points may depend on factors such as time spent on the waiting list, adherence to the Milan criteria, and the presence of extrahepatic complications of liver disease. The panel also discusses bridging therapies to transplant, including Y90 and TACE. In the peri-transplant phase, they highlight innovations such as living donor transplants, liver perfusion pumps, and the use of hepatitis C- and HIV-positive organs. Finally, the discussion turns to post-transplant considerations, including surgical complications, organ rejection, immunosuppression, predictors of HCC recurrence, and long-term surveillance. --- TIMESTAMPS 00:00 - Introduction 01:16 - Current Landscape of Liver Transplantation 03:22 - Transplant Evaluation Process 09:48 - Timeline from Listing to Transplantion 11:16 - Treating Portal Vein Thrombosis and Hypertension 18:44 - MELD Exception Points 22:05 - Bridging Therapies 25:34 - Peri-Transplant Considerations 30:53 - Post-Transplant Period 37:39 - Repeat Transplantation --- RESOURCES Model for end-stage liver disease (MELD) and allocation of donor livers (Wiesner et al, 2003): https://www.gastrojournal.org/article/S0016-5085%2803%2950022-1/fulltext Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis- Milan Criteria (Mazzaferro et al, 1996): https://pubmed.ncbi.nlm.nih.gov/8594428/ Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database (Mehta et al, 2019): https://pmc.ncbi.nlm.nih.gov/articles/PMC6445634/ CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf The process of liver transplantation involves many complexities, and each patient's path to transplant is unique. To offer insider perspectives on this process, Dr. Zachary Berman sits down with transplant and hepatobiliary surgeon Dr. John Seal, as well as transplant hepatologists Dr. Heather Patton and Dr. Steve Young.


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125740


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


The panel begins by discussing the multidisciplinary pre-transplant evaluation process, which assesses factors such as liver function, comorbidities, surgical risk, and the availability of psychosocial support. Once a patient is listed for transplant, they enter a system that prioritizes those with the highest Model for End-Stage Liver Disease (MELD) score. During the waiting period, several comorbidities should be carefully monitored. Dr. Seal explores the impact of portal vein hypertension and portal vein thrombosis, explaining how these conditions may necessitate intraoperative thrombectomy or bypass. Dr. Patton and Dr. Young focus on considerations for using anticoagulation in patients with a high baseline bleeding risk and selecting the appropriate anticoagulant for patients listed for transplant.


For patients with hepatocellular carcinoma (HCC), eligibility for MELD exception points may depend on factors such as time spent on the waiting list, adherence to the Milan criteria, and the presence of extrahepatic complications of liver disease. The panel also discusses bridging therapies to transplant, including Y90 and TACE. In the peri-transplant phase, they highlight innovations such as living donor transplants, liver perfusion pumps, and the use of hepatitis C- and HIV-positive organs. Finally, the discussion turns to post-transplant considerations, including surgical complications, organ rejection, immunosuppression, predictors of HCC recurrence, and long-term surveillance.


---


TIMESTAMPS


00:00 - Introduction

01:16 - Current Landscape of Liver Transplantation

03:22 - Transplant Evaluation Process

09:48 - Timeline from Listing to Transplantion

11:16 - Treating Portal Vein Thrombosis and Hypertension

18:44 - MELD Exception Points

22:05 - Bridging Therapies

25:34 - Peri-Transplant Considerations

30:53 - Post-Transplant Period

37:39 - Repeat Transplantation


---


RESOURCES


Model for end-stage liver disease (MELD) and allocation of donor livers (Wiesner et al, 2003):

https://www.gastrojournal.org/article/S0016-5085%2803%2950022-1/fulltext


Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis- Milan Criteria (Mazzaferro et al, 1996):

https://pubmed.ncbi.nlm.nih.gov/8594428/


Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database (Mehta et al, 2019):

https://pmc.ncbi.nlm.nih.gov/articles/PMC6445634/


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 2760 Ep. 518 Long-Term Outcomes of Prostatic Artery Embolization (PAE) with Dr. Shivank Bhatia Do we finally have definitive data on the efficacy of prostate artery embolization (PAE)? Dr. Shivank Bhatia (interventional radiologist at University of Miami) joins host Dr. Michael Barraza to discuss the findings from his prospective 1,075 patient study on the long-term outcomes of PAE, the largest longitudinal, single-center, single-operator, prospective study in the United States. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ Medtronic MVP https://www.medtronic.com/mvp --- SYNPOSIS Dr. Bhatia begins by sharing his early years of training, and the steps he took to become an expert in all things PAE. He also covers how he helped build the PAE program at University of Miami, sharing several pearls for young IRs and trainees that are interested in bringing new service lines to their institutions. Dr. Bhatia then talks through the details of the study that he spearheaded, and encourages everyone to tune in - physicians and patients alike. --- TIMESTAMPS 00:00 - Introduction 05:12 - Building a PAE Program 18:55 - PAE Procedure Technicalities 22:30 - Post-Procedure Meds and Care 25:13 - Study Details and Patient Demographics 27:36 - Procedure Time and Technical Success 28:32 - Safety and Efficacy of PAE 38:06 - PSA Levels and Prostate Cancer 40:42 - Urinary Retention and Treatment Prioritization 45:17 - Re-Intervention Rates and Medication Independence --- RESOURCES Pisco et al (2011) - Prostatic arterial embolization to treat benign prostatic hyperplasia: https://pubmed.ncbi.nlm.nih.gov/21195898/ Bhatia et al (2024) - Prostatic Artery Embolization: Mid- to Long-Term Outcomes in 1,075 Patients: https://pubmed.ncbi.nlm.nih.gov/39532156/ Tue, 18 Feb 2025 07:00:00 -0000 full BackTable Do we finally have definitive data on the efficacy of prostate artery embolization (PAE)? Dr. Shivank Bhatia (interventional radiologist at University of Miami) joins host Dr. Michael Barraza to discuss the findings from his prospective 1,075 patient study on the long-term outcomes of PAE, the largest longitudinal, single-center, single-operator, prospective study in the United States. Do we finally have definitive data on the efficacy of prostate artery embolization (PAE)? Dr. Shivank Bhatia (interventional radiologist at University of Miami) joins host Dr. Michael Barraza to discuss the findings from his prospective 1,075 patient study on the long-term outcomes of PAE, the largest longitudinal, single-center, single-operator, prospective study in the United States. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ Medtronic MVP https://www.medtronic.com/mvp --- SYNPOSIS Dr. Bhatia begins by sharing his early years of training, and the steps he took to become an expert in all things PAE. He also covers how he helped build the PAE program at University of Miami, sharing several pearls for young IRs and trainees that are interested in bringing new service lines to their institutions. Dr. Bhatia then talks through the details of the study that he spearheaded, and encourages everyone to tune in - physicians and patients alike. --- TIMESTAMPS 00:00 - Introduction 05:12 - Building a PAE Program 18:55 - PAE Procedure Technicalities 22:30 - Post-Procedure Meds and Care 25:13 - Study Details and Patient Demographics 27:36 - Procedure Time and Technical Success 28:32 - Safety and Efficacy of PAE 38:06 - PSA Levels and Prostate Cancer 40:42 - Urinary Retention and Treatment Prioritization 45:17 - Re-Intervention Rates and Medication Independence --- RESOURCES Pisco et al (2011) - Prostatic arterial embolization to treat benign prostatic hyperplasia: https://pubmed.ncbi.nlm.nih.gov/21195898/ Bhatia et al (2024) - Prostatic Artery Embolization: Mid- to Long-Term Outcomes in 1,075 Patients: https://pubmed.ncbi.nlm.nih.gov/39532156/ Do we finally have definitive data on the efficacy of prostate artery embolization (PAE)? Dr. Shivank Bhatia (interventional radiologist at University of Miami) joins host Dr. Michael Barraza to discuss the findings from his prospective 1,075 patient study on the long-term outcomes of PAE, the largest longitudinal, single-center, single-operator, prospective study in the United States.


---


This podcast is supported by:


RADPAD® Radiation Protection

https://www.radpad.com/


Medtronic MVP



https://www.medtronic.com/mvp



---


SYNPOSIS


Dr. Bhatia begins by sharing his early years of training, and the steps he took to become an expert in all things PAE. He also covers how he helped build the PAE program at University of Miami, sharing several pearls for young IRs and trainees that are interested in bringing new service lines to their institutions. Dr. Bhatia then talks through the details of the study that he spearheaded, and encourages everyone to tune in - physicians and patients alike.


---


TIMESTAMPS


00:00 - Introduction

05:12 - Building a PAE Program

18:55 - PAE Procedure Technicalities

22:30 - Post-Procedure Meds and Care

25:13 - Study Details and Patient Demographics

27:36 - Procedure Time and Technical Success

28:32 - Safety and Efficacy of PAE

38:06 - PSA Levels and Prostate Cancer

40:42 - Urinary Retention and Treatment Prioritization

45:17 - Re-Intervention Rates and Medication Independence



---


RESOURCES


Pisco et al (2011) - Prostatic arterial embolization to treat benign prostatic hyperplasia:

https://pubmed.ncbi.nlm.nih.gov/21195898/


Bhatia et al (2024) - Prostatic Artery Embolization: Mid- to Long-Term Outcomes in 1,075 Patients:

https://pubmed.ncbi.nlm.nih.gov/39532156/

]]> 3327 Ep. 517 Complex HCC Patients and the "Grey Zone": What to Do When You Don’t Know What to Do Treatment of hepatocellular carcinoma (HCC), like that of many other cancers, spans a spectrum from curative to palliative intent. To explore the "grey zone" of treatment goals for intermediate-stage HCC patients, Dr. Sabeen Dhand interviews a panel of experts in the field: medical oncologists Dr. Adam Burgoyne and Dr. Lingling Du, along with interventional radiologists Dr. Kirema Garcia-Reyes and Dr. Zachary Berman. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125739 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The discussion begins with an explanation of the Barcelona-Clinic Liver Cancer (BCLC) staging system. While this system takes into account helpful factors such as liver function, performance status, and tumor burden, it fails to fully capture the true heterogeneity of the HCC patient population. Additional considerations include tumor biology, response to previous treatments, and the location of metastases. The specialists then share their experiences in treating patients with comorbid gastrointestinal cancers and mixed tumors, discuss the benefits of an interventional oncology clinic setting, and highlight virtual opportunities for connecting with tumor boards. They also offer advice on patient education regarding treatment options. --- TIMESTAMPS 00:00 - Introduction to BCLC Staging 03:02 - Impact of Performance Status 06:29 - Predictors of Survival in HCC 09:51 - Palliative versus Curative Treatment Intent 13:55 - Comorbid and Mixed Gastrointestinal Cancers 16:51 - Adverse Effects of Treatment 20:37 - Interventional Oncology in the Clinic Setting 23:06 - Navigating Multiple Provider Viewpoints 28:01 - Complex Case Examples --- RESOURCES BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update (Reig et al, 2022): https://www.journal-of-hepatology.eu/article/S0168-8278(21)02223-6/fulltext CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 14 Feb 2025 07:00:00 -0000 full BackTable Treatment of hepatocellular carcinoma (HCC), like that of many other cancers, spans a spectrum from curative to palliative intent. To explore the "grey zone" of treatment goals for intermediate-stage HCC patients, Dr. Sabeen Dhand interviews a panel of experts in the field: medical oncologists Dr. Adam Burgoyne and Dr. Lingling Du, along with interventional radiologists Dr. Kirema Garcia-Reyes and Dr. Zachary Berman. Treatment of hepatocellular carcinoma (HCC), like that of many other cancers, spans a spectrum from curative to palliative intent. To explore the "grey zone" of treatment goals for intermediate-stage HCC patients, Dr. Sabeen Dhand interviews a panel of experts in the field: medical oncologists Dr. Adam Burgoyne and Dr. Lingling Du, along with interventional radiologists Dr. Kirema Garcia-Reyes and Dr. Zachary Berman. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125739 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The discussion begins with an explanation of the Barcelona-Clinic Liver Cancer (BCLC) staging system. While this system takes into account helpful factors such as liver function, performance status, and tumor burden, it fails to fully capture the true heterogeneity of the HCC patient population. Additional considerations include tumor biology, response to previous treatments, and the location of metastases. The specialists then share their experiences in treating patients with comorbid gastrointestinal cancers and mixed tumors, discuss the benefits of an interventional oncology clinic setting, and highlight virtual opportunities for connecting with tumor boards. They also offer advice on patient education regarding treatment options. --- TIMESTAMPS 00:00 - Introduction to BCLC Staging 03:02 - Impact of Performance Status 06:29 - Predictors of Survival in HCC 09:51 - Palliative versus Curative Treatment Intent 13:55 - Comorbid and Mixed Gastrointestinal Cancers 16:51 - Adverse Effects of Treatment 20:37 - Interventional Oncology in the Clinic Setting 23:06 - Navigating Multiple Provider Viewpoints 28:01 - Complex Case Examples --- RESOURCES BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update (Reig et al, 2022): https://www.journal-of-hepatology.eu/article/S0168-8278(21)02223-6/fulltext CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Treatment of hepatocellular carcinoma (HCC), like that of many other cancers, spans a spectrum from curative to palliative intent. To explore the "grey zone" of treatment goals for intermediate-stage HCC patients, Dr. Sabeen Dhand interviews a panel of experts in the field: medical oncologists Dr. Adam Burgoyne and Dr. Lingling Du, along with interventional radiologists Dr. Kirema Garcia-Reyes and Dr. Zachary Berman.


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125739


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


The discussion begins with an explanation of the Barcelona-Clinic Liver Cancer (BCLC) staging system. While this system takes into account helpful factors such as liver function, performance status, and tumor burden, it fails to fully capture the true heterogeneity of the HCC patient population. Additional considerations include tumor biology, response to previous treatments, and the location of metastases. The specialists then share their experiences in treating patients with comorbid gastrointestinal cancers and mixed tumors, discuss the benefits of an interventional oncology clinic setting, and highlight virtual opportunities for connecting with tumor boards. They also offer advice on patient education regarding treatment options.


---


TIMESTAMPS


00:00 - Introduction to BCLC Staging

03:02 - Impact of Performance Status

06:29 - Predictors of Survival in HCC

09:51 - Palliative versus Curative Treatment Intent

13:55 - Comorbid and Mixed Gastrointestinal Cancers

16:51 - Adverse Effects of Treatment

20:37 - Interventional Oncology in the Clinic Setting

23:06 - Navigating Multiple Provider Viewpoints

28:01 - Complex Case Examples


---


RESOURCES


BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update (Reig et al, 2022):

https://www.journal-of-hepatology.eu/article/S0168-8278(21)02223-6/fulltext


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 2435 Ep. 516 Dialysis Procedures: New Tools for Better Outcomes with Dr. Ari Kramer and Dr. Omar Davis Given the challenges that our dialysis patients face, how can we as providers stay sharp with the latest access techniques to help ensure the best possible outcomes? Dr. Omar Davis (interventional nephrologist) and Dr. Ari Kramer (general surgeon) join host Dr. Chris Beck to discuss advanced approaches to AV access and share their experiences with the FLEX Vessel Prep device. --- This podcast is supported by: VentureMed FLEX Vessel Prep https://www.venturemedgroup.com/ --- SYNPOSIS The doctors begin by describing how they create dialysis access and what they account for during the procedure. They then focus on the role of the FLEX VP system, its benefits, and how they use it in practice, touching on the latest clinical data. Dr. Kramer and Dr. Davis also stress the importance of mental health in dialysis care and share ways that we can better support our patients through difficult diagnoses and treatments. In fact, one of their patients, Fred Hill, authored the book “Dialysis Is Not Your Life,” which offers a unique perspective for patients feeling overburdened by dialysis, and the healthcare providers who treat them. The episode concludes with case presentations and practical guidance on when to use the FLEX Vessel Prep system. --- TIMESTAMPS 00:00 - Introduction 07:00 - AV Access and Procedures 10:58 - Case Walkthrough 14:19 - Balloon Angioplasty and IVUS 24:43 - Flex VP Device and Vessel Prep 35:03 - Algorithm and Reimbursement Challenges 39:51 - Device Usage and Techniques 46:58 - Clinical Data and Outcomes 01:01:59 - Case Studies --- RESOURCES Fred Hill, “Dialysis Is Not Your Life” Founder and Author: https://www.dialysisisnotyourlife.com/meet-founder.php “Dialysis Is Not Your Life” Book: https://www.amazon.com/DIALYSIS-NOT-YOUR-LIFE-Redefine/dp/B09L4XGGNX Novel Device Prior to Balloon Angioplasty for Dysfunctional Arteriovenous Access: Analysis of a Real-World Registry by Race and Sex Cohorts: https://www.openaccessjournals.com/articles/novel-device-prior-to-balloon-angioplasty-for-dysfunctional-arteriovenousaccess-analysis-of-a-realworld-registry-by-race-and-sex-16852.html FLEX Vessel Prep 12 Month AV Registry Data and 12 Month Belong PAD Data Shows Benefit to Micro-incisions Before Balloon or DCB Treatment: https://www.venturemedgroup.com/wp-content/uploads/2022/12/VEITH-Data-FINAL.pdf Angioplasty with novel, easy-to-use, bladed Flex Vessel Prep system “could replace standard of care”: https://www.youtube.com/watch?v=iRpkrURx1mc Surgical AVF Articles Atlas Condensed - sAVF Overview - Creation Maturation and Difficulties: https://docs.google.com/document/d/1f26FT65s03oZjjeZhBVy8auz0h8PTNvX3CWU5Xi_H5c/edit?usp=share_link Surgical AVF Articles Asif A, Early Arteriovenous fistula failure: https://drive.google.com/file/d/1zZEWgxsdBM4MKCQFjw0U04ra_hB9Ey_N/view?usp=share_link Surgical AVF Articles Asif A - Best Vascular Access in the Elderly - Time for Innovation: https://drive.google.com/file/d/1IpH-KnZyfN5Rqm_kxLnERnEJD6vcjAO8/view?usp=sharing Surgical AVF Articles EV Today - Managing Cephalic Arch Stenosis: https://drive.google.com/file/d/17yVd2M706YCtX-xTK6teesgZqzVIgUoN/view?usp=share_link VentureMed 2024 FLEX Vessel Prep System Reimbursement Guide: https://www.venturemedgroup.com/wp-content/uploads/2024/04/MMA-CTO-15690_FlexVesselPrepSystem-BillingGuide_Lv6-003.pdf BackTable VI Podcast Episode #139 - AV Fistula & Graft Maintenance with Dr. Ari Kramer: https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance BackTable VI Podcast Episode #292 - Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More with Dr. Ari Kramer: https://www.backtable.com/shows/vi/podcasts/292/dialysis-interventions-with-drug-coated-balloons-covered-stents-more Tue, 11 Feb 2025 07:00:00 -0000 full BackTable Given the challenges that our dialysis patients face, how can we as providers stay sharp with the latest access techniques to help ensure the best possible outcomes? Dr. Omar Davis (interventional nephrologist) and Dr. Ari Kramer (general surgeon) join host Dr. Chris Beck to discuss advanced approaches to AV access and share their experiences with the FLEX Vessel Prep device. Given the challenges that our dialysis patients face, how can we as providers stay sharp with the latest access techniques to help ensure the best possible outcomes? Dr. Omar Davis (interventional nephrologist) and Dr. Ari Kramer (general surgeon) join host Dr. Chris Beck to discuss advanced approaches to AV access and share their experiences with the FLEX Vessel Prep device. --- This podcast is supported by: VentureMed FLEX Vessel Prep https://www.venturemedgroup.com/ --- SYNPOSIS The doctors begin by describing how they create dialysis access and what they account for during the procedure. They then focus on the role of the FLEX VP system, its benefits, and how they use it in practice, touching on the latest clinical data. Dr. Kramer and Dr. Davis also stress the importance of mental health in dialysis care and share ways that we can better support our patients through difficult diagnoses and treatments. In fact, one of their patients, Fred Hill, authored the book “Dialysis Is Not Your Life,” which offers a unique perspective for patients feeling overburdened by dialysis, and the healthcare providers who treat them. The episode concludes with case presentations and practical guidance on when to use the FLEX Vessel Prep system. --- TIMESTAMPS 00:00 - Introduction 07:00 - AV Access and Procedures 10:58 - Case Walkthrough 14:19 - Balloon Angioplasty and IVUS 24:43 - Flex VP Device and Vessel Prep 35:03 - Algorithm and Reimbursement Challenges 39:51 - Device Usage and Techniques 46:58 - Clinical Data and Outcomes 01:01:59 - Case Studies --- RESOURCES Fred Hill, “Dialysis Is Not Your Life” Founder and Author: https://www.dialysisisnotyourlife.com/meet-founder.php “Dialysis Is Not Your Life” Book: https://www.amazon.com/DIALYSIS-NOT-YOUR-LIFE-Redefine/dp/B09L4XGGNX Novel Device Prior to Balloon Angioplasty for Dysfunctional Arteriovenous Access: Analysis of a Real-World Registry by Race and Sex Cohorts: https://www.openaccessjournals.com/articles/novel-device-prior-to-balloon-angioplasty-for-dysfunctional-arteriovenousaccess-analysis-of-a-realworld-registry-by-race-and-sex-16852.html FLEX Vessel Prep 12 Month AV Registry Data and 12 Month Belong PAD Data Shows Benefit to Micro-incisions Before Balloon or DCB Treatment: https://www.venturemedgroup.com/wp-content/uploads/2022/12/VEITH-Data-FINAL.pdf Angioplasty with novel, easy-to-use, bladed Flex Vessel Prep system “could replace standard of care”: https://www.youtube.com/watch?v=iRpkrURx1mc Surgical AVF Articles Atlas Condensed - sAVF Overview - Creation Maturation and Difficulties: https://docs.google.com/document/d/1f26FT65s03oZjjeZhBVy8auz0h8PTNvX3CWU5Xi_H5c/edit?usp=share_link Surgical AVF Articles Asif A, Early Arteriovenous fistula failure: https://drive.google.com/file/d/1zZEWgxsdBM4MKCQFjw0U04ra_hB9Ey_N/view?usp=share_link Surgical AVF Articles Asif A - Best Vascular Access in the Elderly - Time for Innovation: https://drive.google.com/file/d/1IpH-KnZyfN5Rqm_kxLnERnEJD6vcjAO8/view?usp=sharing Surgical AVF Articles EV Today - Managing Cephalic Arch Stenosis: https://drive.google.com/file/d/17yVd2M706YCtX-xTK6teesgZqzVIgUoN/view?usp=share_link VentureMed 2024 FLEX Vessel Prep System Reimbursement Guide: https://www.venturemedgroup.com/wp-content/uploads/2024/04/MMA-CTO-15690_FlexVesselPrepSystem-BillingGuide_Lv6-003.pdf BackTable VI Podcast Episode #139 - AV Fistula & Graft Maintenance with Dr. Ari Kramer: https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance BackTable VI Podcast Episode #292 - Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More with Dr. Ari Kramer: https://www.backtable.com/shows/vi/podcasts/292/dialysis-interventions-with-drug-coated-balloons-covered-stents-more Given the challenges that our dialysis patients face, how can we as providers stay sharp with the latest access techniques to help ensure the best possible outcomes? Dr. Omar Davis (interventional nephrologist) and Dr. Ari Kramer (general surgeon) join host Dr. Chris Beck to discuss advanced approaches to AV access and share their experiences with the FLEX Vessel Prep device.


---


This podcast is supported by:


VentureMed FLEX Vessel Prep

https://www.venturemedgroup.com/


---


SYNPOSIS


The doctors begin by describing how they create dialysis access and what they account for during the procedure. They then focus on the role of the FLEX VP system, its benefits, and how they use it in practice, touching on the latest clinical data. Dr. Kramer and Dr. Davis also stress the importance of mental health in dialysis care and share ways that we can better support our patients through difficult diagnoses and treatments. In fact, one of their patients, Fred Hill, authored the book “Dialysis Is Not Your Life,” which offers a unique perspective for patients feeling overburdened by dialysis, and the healthcare providers who treat them. The episode concludes with case presentations and practical guidance on when to use the FLEX Vessel Prep system.


---


TIMESTAMPS


00:00 - Introduction

07:00 - AV Access and Procedures

10:58 - Case Walkthrough

14:19 - Balloon Angioplasty and IVUS

24:43 - Flex VP Device and Vessel Prep

35:03 - Algorithm and Reimbursement Challenges

39:51 - Device Usage and Techniques

46:58 - Clinical Data and Outcomes

01:01:59 - Case Studies



---


RESOURCES


Fred Hill, “Dialysis Is Not Your Life” Founder and Author:

https://www.dialysisisnotyourlife.com/meet-founder.php


“Dialysis Is Not Your Life” Book:

https://www.amazon.com/DIALYSIS-NOT-YOUR-LIFE-Redefine/dp/B09L4XGGNX


Novel Device Prior to Balloon Angioplasty for Dysfunctional Arteriovenous Access: Analysis of a Real-World Registry by Race and Sex Cohorts:

https://www.openaccessjournals.com/articles/novel-device-prior-to-balloon-angioplasty-for-dysfunctional-arteriovenousaccess-analysis-of-a-realworld-registry-by-race-and-sex-16852.html


FLEX Vessel Prep 12 Month AV Registry Data and 12 Month Belong PAD Data Shows Benefit to Micro-incisions Before Balloon or DCB Treatment:

https://www.venturemedgroup.com/wp-content/uploads/2022/12/VEITH-Data-FINAL.pdf


Angioplasty with novel, easy-to-use, bladed Flex Vessel Prep system “could replace standard of care”:

https://www.youtube.com/watch?v=iRpkrURx1mc


Surgical AVF Articles Atlas Condensed - sAVF Overview - Creation Maturation and Difficulties:

https://docs.google.com/document/d/1f26FT65s03oZjjeZhBVy8auz0h8PTNvX3CWU5Xi_H5c/edit?usp=share_link


Surgical AVF Articles Asif A, Early Arteriovenous fistula failure:

https://drive.google.com/file/d/1zZEWgxsdBM4MKCQFjw0U04ra_hB9Ey_N/view?usp=share_link


Surgical AVF Articles Asif A - Best Vascular Access in the Elderly - Time for Innovation:

https://drive.google.com/file/d/1IpH-KnZyfN5Rqm_kxLnERnEJD6vcjAO8/view?usp=sharing


Surgical AVF Articles EV Today - Managing Cephalic Arch Stenosis:

https://drive.google.com/file/d/17yVd2M706YCtX-xTK6teesgZqzVIgUoN/view?usp=share_link


VentureMed 2024 FLEX Vessel Prep System Reimbursement Guide:

https://www.venturemedgroup.com/wp-content/uploads/2024/04/MMA-CTO-15690_FlexVesselPrepSystem-BillingGuide_Lv6-003.pdf


BackTable VI Podcast Episode #139 - AV Fistula & Graft Maintenance with Dr. Ari Kramer:

https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance


BackTable VI Podcast Episode #292 - Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More with Dr. Ari Kramer:

https://www.backtable.com/shows/vi/podcasts/292/dialysis-interventions-with-drug-coated-balloons-covered-stents-more

]]> 4392 Ep. 515 Curative Intent Therapies for HCC: Today and Tomorrow For hepatocellular carcinoma (HCC) patients who are not candidates for liver transplant or resection, lesion ablation can be a curative treatment. With multiple ablation options available and still under investigation, it can be challenging to navigate the differences between them. In this episode, Dr. Tyler Sandow hosts a discussion with interventional radiologists Dr. Kirema Garcia-Reyes, Dr. Sabeen Dhand, and Dr. Kevin Burns on the various ablation options for HCC and when to use each one. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125738 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The doctors first discuss Barcelona-Clinic Liver Cancer (BCLC) Stage A patients, where lesion size and location are key factors in deciding between ablation and transarterial therapies. They then compare cryoablation and microwave ablation, highlighting that cryoablation offers better visualization and control of the ablation zone, while microwave ablation is more effective for treating larger lesions. Dr. Burns introduces histotripsy, a noninvasive treatment that uses ultrasound energy to mechanically ablate tumors. He shares his experiences as an early adopter of this technology and discusses how intraoperative cone beam CT can help treat lesions located near critical structures or those poorly visualized on ultrasound. Finally, Dr. Garcia-Reyes and Dr. Berman provide insights into patient selection, pre-procedural imaging, and technical tips for Y90. --- TIMESTAMPS 00:00 - Introduction 02:04 - Ablation vs Y90 in BCLC A Patients 05:58 - Same-Day Y90 15:55 - Y90 for Large Tumors 17:51 - Ideal Cases for Cryoablation 19:38 - Explanation of Histotripsy 32:09 - Procedural Specifics for Histotripsy 38:21 - Technical Tips for Y90 --- RESOURCES Including the Hollow Viscera (Stomach or Bowel) within the Ice Ball during Cryoablation: A Review of Adverse Events (Abramyan et al, 2024): https://www.jvir.org/article/S1051-0443(24)00681-X/abstract CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 07 Feb 2025 07:00:00 -0000 full BackTable For hepatocellular carcinoma (HCC) patients who are not candidates for liver transplant or resection, lesion ablation can be a curative treatment. With multiple ablation options available and still under investigation, it can be challenging to navigate the differences between them. In this episode, Dr. Tyler Sandow hosts a discussion with interventional radiologists Dr. Kirema Garcia-Reyes, Dr. Sabeen Dhand, and Dr. Kevin Burns on the various ablation options for HCC and when to use each one. For hepatocellular carcinoma (HCC) patients who are not candidates for liver transplant or resection, lesion ablation can be a curative treatment. With multiple ablation options available and still under investigation, it can be challenging to navigate the differences between them. In this episode, Dr. Tyler Sandow hosts a discussion with interventional radiologists Dr. Kirema Garcia-Reyes, Dr. Sabeen Dhand, and Dr. Kevin Burns on the various ablation options for HCC and when to use each one. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125738 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The doctors first discuss Barcelona-Clinic Liver Cancer (BCLC) Stage A patients, where lesion size and location are key factors in deciding between ablation and transarterial therapies. They then compare cryoablation and microwave ablation, highlighting that cryoablation offers better visualization and control of the ablation zone, while microwave ablation is more effective for treating larger lesions. Dr. Burns introduces histotripsy, a noninvasive treatment that uses ultrasound energy to mechanically ablate tumors. He shares his experiences as an early adopter of this technology and discusses how intraoperative cone beam CT can help treat lesions located near critical structures or those poorly visualized on ultrasound. Finally, Dr. Garcia-Reyes and Dr. Berman provide insights into patient selection, pre-procedural imaging, and technical tips for Y90. --- TIMESTAMPS 00:00 - Introduction 02:04 - Ablation vs Y90 in BCLC A Patients 05:58 - Same-Day Y90 15:55 - Y90 for Large Tumors 17:51 - Ideal Cases for Cryoablation 19:38 - Explanation of Histotripsy 32:09 - Procedural Specifics for Histotripsy 38:21 - Technical Tips for Y90 --- RESOURCES Including the Hollow Viscera (Stomach or Bowel) within the Ice Ball during Cryoablation: A Review of Adverse Events (Abramyan et al, 2024): https://www.jvir.org/article/S1051-0443(24)00681-X/abstract CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf For hepatocellular carcinoma (HCC) patients who are not candidates for liver transplant or resection, lesion ablation can be a curative treatment. With multiple ablation options available and still under investigation, it can be challenging to navigate the differences between them. In this episode, Dr. Tyler Sandow hosts a discussion with interventional radiologists Dr. Kirema Garcia-Reyes, Dr. Sabeen Dhand, and Dr. Kevin Burns on the various ablation options for HCC and when to use each one.


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125738


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


The doctors first discuss Barcelona-Clinic Liver Cancer (BCLC) Stage A patients, where lesion size and location are key factors in deciding between ablation and transarterial therapies. They then compare cryoablation and microwave ablation, highlighting that cryoablation offers better visualization and control of the ablation zone, while microwave ablation is more effective for treating larger lesions.


Dr. Burns introduces histotripsy, a noninvasive treatment that uses ultrasound energy to mechanically ablate tumors. He shares his experiences as an early adopter of this technology and discusses how intraoperative cone beam CT can help treat lesions located near critical structures or those poorly visualized on ultrasound. Finally, Dr. Garcia-Reyes and Dr. Berman provide insights into patient selection, pre-procedural imaging, and technical tips for Y90.


---


TIMESTAMPS


00:00 - Introduction

02:04 - Ablation vs Y90 in BCLC A Patients

05:58 - Same-Day Y90

15:55 - Y90 for Large Tumors

17:51 - Ideal Cases for Cryoablation

19:38 - Explanation of Histotripsy

32:09 - Procedural Specifics for Histotripsy

38:21 - Technical Tips for Y90


---


RESOURCES


Including the Hollow Viscera (Stomach or Bowel) within the Ice Ball during Cryoablation: A Review of Adverse Events (Abramyan et al, 2024):

https://www.jvir.org/article/S1051-0443(24)00681-X/abstract


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 3203 Ep. 514 Deep Sedation in IR: Intro to Ketamine with Dr. Amy Deipolyi When deep sedation is required, it can be challenging to implement due to the difficulty of scheduling dedicated anesthesia coverage in the IR suite. Dr. Amy Deipolyi (interventional radiologist and Division Chief at Charleston Area Medical Center, WY) joins host Dr. Ally Baheti to explain an alternative approach to deep sedation through the use of ketamine. --- This podcast is supported by: Medtronic Abre Stent https://www.medtronic.com/en-us/healthcare-professionals/products/cardiovascular/deep-venous-stents/abre-venous-self-expanding-stent-system.html --- SYNPOSIS Dr. Deipolyi begins by sharing how she built a dedicated, academic IR program at a level 1 trauma center in West Virginia. The doctors then discuss the advantages of ketamine for deep sedation in the IR suite, and how Dr. Deipolyi gained administrative approval and implemented the change to achieve an alternative approach to deep sedation for interventional procedures. The discussion also includes how ketamine compares to traditional agents such as fentanyl and Versed. The episode concludes with Dr. Deipolyi’s practical advice to fellow IR’s interested in providing their patients deep sedation via ketamine and her ongoing and future research and outreach efforts. --- TIMESTAMPS 00:00 - Introduction 02:04 - Dr. Deipolyi’s Practice 14:32 - Overcoming Hurdles and Gaining Support 20:12 - Application and Patient Experiences 26:01 - Future of Deep Sedation in IR 28:55 - Conclusion Tue, 04 Feb 2025 07:00:00 -0000 full BackTable When deep sedation is required, it can be challenging to implement due to the difficulty of scheduling dedicated anesthesia coverage in the IR suite. Dr. Amy Deipolyi (interventional radiologist and Division Chief at Charleston Area Medical Center, WY) joins host Dr. Ally Baheti to explain an alternative approach to deep sedation through the use of ketamine. When deep sedation is required, it can be challenging to implement due to the difficulty of scheduling dedicated anesthesia coverage in the IR suite. Dr. Amy Deipolyi (interventional radiologist and Division Chief at Charleston Area Medical Center, WY) joins host Dr. Ally Baheti to explain an alternative approach to deep sedation through the use of ketamine. --- This podcast is supported by: Medtronic Abre Stent https://www.medtronic.com/en-us/healthcare-professionals/products/cardiovascular/deep-venous-stents/abre-venous-self-expanding-stent-system.html --- SYNPOSIS Dr. Deipolyi begins by sharing how she built a dedicated, academic IR program at a level 1 trauma center in West Virginia. The doctors then discuss the advantages of ketamine for deep sedation in the IR suite, and how Dr. Deipolyi gained administrative approval and implemented the change to achieve an alternative approach to deep sedation for interventional procedures. The discussion also includes how ketamine compares to traditional agents such as fentanyl and Versed. The episode concludes with Dr. Deipolyi’s practical advice to fellow IR’s interested in providing their patients deep sedation via ketamine and her ongoing and future research and outreach efforts. --- TIMESTAMPS 00:00 - Introduction 02:04 - Dr. Deipolyi’s Practice 14:32 - Overcoming Hurdles and Gaining Support 20:12 - Application and Patient Experiences 26:01 - Future of Deep Sedation in IR 28:55 - Conclusion When deep sedation is required, it can be challenging to implement due to the difficulty of scheduling dedicated anesthesia coverage in the IR suite. Dr. Amy Deipolyi (interventional radiologist and Division Chief at Charleston Area Medical Center, WY) joins host Dr. Ally Baheti to explain an alternative approach to deep sedation through the use of ketamine.


---


This podcast is supported by:


Medtronic Abre Stent

https://www.medtronic.com/en-us/healthcare-professionals/products/cardiovascular/deep-venous-stents/abre-venous-self-expanding-stent-system.html


---


SYNPOSIS


Dr. Deipolyi begins by sharing how she built a dedicated, academic IR program at a level 1 trauma center in West Virginia. The doctors then discuss the advantages of ketamine for deep sedation in the IR suite, and how Dr. Deipolyi gained administrative approval and implemented the change to achieve an alternative approach to deep sedation for interventional procedures. The discussion also includes how ketamine compares to traditional agents such as fentanyl and Versed. The episode concludes with Dr. Deipolyi’s practical advice to fellow IR’s interested in providing their patients deep sedation via ketamine and her ongoing and future research and outreach efforts.


---


TIMESTAMPS


00:00 - Introduction

02:04 - Dr. Deipolyi’s Practice

14:32 - Overcoming Hurdles and Gaining Support

20:12 - Application and Patient Experiences

26:01 - Future of Deep Sedation in IR

28:55 - Conclusion

]]> 2042 Ep. 513 Combination Therapy and Clinical trials for Advanced HCC: What They Really Mean In the past five years, the use of immunotherapeutic agents for advanced cancers has emerged as a promising alternative to tyrosine kinase inhibitors and chemotherapy, making it an exciting time to be practicing oncology. In this episode, Dr. Tyler Sandow interviews oncology experts about the landscape of advanced hepatocellular carcinoma (HCC) and the current state of immunotherapy treatments. He is joined by medical oncologists Dr. Jonathan Mizrah, Dr. Lingling Du, and Dr. Adam Burgoyne, as well as interventional oncologist Dr. Zachary Berman. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125737 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS Drs. Burgoyne and Mizrahi provide a primer on immunotherapy and explain how they communicate the principles of this treatment to their patients. Dr. Du discusses the Imbrave clinical trial and how recent studies have shown improved overall survival when immunotherapeutic agents are used, especially when multiple agents targeting various pathways are employed. When choosing between different regimens, the doctors consider factors such as the patient's underlying liver function, symptom burden, and prior treatments. Importantly, the doctors also discuss contraindications to immunotherapy, including a history of organ transplant, autoimmune disease, and poor performance status—all of which put patients at high risk for deterioration with this treatment. The treatment of patients with poor liver function remains controversial, as underlying cirrhosis may prevent the recovery of liver function. Dr. Berman outlines recent clinical trials studying the effects of transarterial chemoembolization (TACE) combined with immunotherapy. Finally, the doctors discuss the future of HCC treatment and the benefits of continued innovation in both interventional and medical oncology. --- TIMESTAMPS 00:00 - Introduction to Immunotherapy 04:32 - Notable Clinical Trials 13:39 - HCC Etiology and Immunotherapy Outcomes 18:43 - Contraindications for Immunotherapy 23:05 - Adverse Effects from Treatment 25:14 - Combination Therapy 36:22 - Considerations for Immunotherapy Dosing 40:26 - The Future of HCC Treatment --- RESOURCES Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma, IMbrave150 Trial (Finn et al, 2020): https://pubmed.ncbi.nlm.nih.gov/32402160/ Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma, HIMALAYA Trial (Abou-Alfa et al, 2022): https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100070 Nivolumab versus sorafenib in advanced hepatocellular carcinoma (CheckMate 459): a randomised, multicentre, open-label, phase 3 trial (Yau, 2022): https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00604-5/abstract Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): First results from CheckMate 9DW (Galle, 2024): https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA4008 Randomized Phase 3 LEAP-012 Study: Transarterial Chemoembolization With or Without Lenvatinib Plus Pembrolizumab for Intermediate-Stage Hepatocellular Carcinoma Not Amenable to Curative Treatment (Llovet, 2022): https://pubmed.ncbi.nlm.nih.gov/35119481/ EMERALD-1: A phase 3, randomized, placebo-controlled study of transarterial chemoembolization combined with durvalumab with or without bevacizumab in participants with unresectable hepatocellular carcinoma eligible for embolization (Lencioni, 2024): https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432 CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 31 Jan 2025 07:00:00 -0000 full BackTable In the past five years, the use of immunotherapeutic agents for advanced cancers has emerged as a promising alternative to tyrosine kinase inhibitors and chemotherapy, making it an exciting time to be practicing oncology. In this episode, Dr. Tyler Sandow interviews oncology experts about the landscape of advanced hepatocellular carcinoma (HCC) and the current state of immunotherapy treatments. He is joined by medical oncologists Dr. Jonathan Mizrah, Dr. Lingling Du, and Dr. Adam Burgoyne, as well as interventional oncologist Dr. Zachary Berman. In the past five years, the use of immunotherapeutic agents for advanced cancers has emerged as a promising alternative to tyrosine kinase inhibitors and chemotherapy, making it an exciting time to be practicing oncology. In this episode, Dr. Tyler Sandow interviews oncology experts about the landscape of advanced hepatocellular carcinoma (HCC) and the current state of immunotherapy treatments. He is joined by medical oncologists Dr. Jonathan Mizrah, Dr. Lingling Du, and Dr. Adam Burgoyne, as well as interventional oncologist Dr. Zachary Berman. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125737 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS Drs. Burgoyne and Mizrahi provide a primer on immunotherapy and explain how they communicate the principles of this treatment to their patients. Dr. Du discusses the Imbrave clinical trial and how recent studies have shown improved overall survival when immunotherapeutic agents are used, especially when multiple agents targeting various pathways are employed. When choosing between different regimens, the doctors consider factors such as the patient's underlying liver function, symptom burden, and prior treatments. Importantly, the doctors also discuss contraindications to immunotherapy, including a history of organ transplant, autoimmune disease, and poor performance status—all of which put patients at high risk for deterioration with this treatment. The treatment of patients with poor liver function remains controversial, as underlying cirrhosis may prevent the recovery of liver function. Dr. Berman outlines recent clinical trials studying the effects of transarterial chemoembolization (TACE) combined with immunotherapy. Finally, the doctors discuss the future of HCC treatment and the benefits of continued innovation in both interventional and medical oncology. --- TIMESTAMPS 00:00 - Introduction to Immunotherapy 04:32 - Notable Clinical Trials 13:39 - HCC Etiology and Immunotherapy Outcomes 18:43 - Contraindications for Immunotherapy 23:05 - Adverse Effects from Treatment 25:14 - Combination Therapy 36:22 - Considerations for Immunotherapy Dosing 40:26 - The Future of HCC Treatment --- RESOURCES Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma, IMbrave150 Trial (Finn et al, 2020): https://pubmed.ncbi.nlm.nih.gov/32402160/ Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma, HIMALAYA Trial (Abou-Alfa et al, 2022): https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100070 Nivolumab versus sorafenib in advanced hepatocellular carcinoma (CheckMate 459): a randomised, multicentre, open-label, phase 3 trial (Yau, 2022): https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00604-5/abstract Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): First results from CheckMate 9DW (Galle, 2024): https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA4008 Randomized Phase 3 LEAP-012 Study: Transarterial Chemoembolization With or Without Lenvatinib Plus Pembrolizumab for Intermediate-Stage Hepatocellular Carcinoma Not Amenable to Curative Treatment (Llovet, 2022): https://pubmed.ncbi.nlm.nih.gov/35119481/ EMERALD-1: A phase 3, randomized, placebo-controlled study of transarterial chemoembolization combined with durvalumab with or without bevacizumab in participants with unresectable hepatocellular carcinoma eligible for embolization (Lencioni, 2024): https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432 CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf In the past five years, the use of immunotherapeutic agents for advanced cancers has emerged as a promising alternative to tyrosine kinase inhibitors and chemotherapy, making it an exciting time to be practicing oncology. In this episode, Dr. Tyler Sandow interviews oncology experts about the landscape of advanced hepatocellular carcinoma (HCC) and the current state of immunotherapy treatments. He is joined by medical oncologists Dr. Jonathan Mizrah, Dr. Lingling Du, and Dr. Adam Burgoyne, as well as interventional oncologist Dr. Zachary Berman.


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125737


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


Drs. Burgoyne and Mizrahi provide a primer on immunotherapy and explain how they communicate the principles of this treatment to their patients. Dr. Du discusses the Imbrave clinical trial and how recent studies have shown improved overall survival when immunotherapeutic agents are used, especially when multiple agents targeting various pathways are employed. When choosing between different regimens, the doctors consider factors such as the patient's underlying liver function, symptom burden, and prior treatments.


Importantly, the doctors also discuss contraindications to immunotherapy, including a history of organ transplant, autoimmune disease, and poor performance status—all of which put patients at high risk for deterioration with this treatment. The treatment of patients with poor liver function remains controversial, as underlying cirrhosis may prevent the recovery of liver function. Dr. Berman outlines recent clinical trials studying the effects of transarterial chemoembolization (TACE) combined with immunotherapy. Finally, the doctors discuss the future of HCC treatment and the benefits of continued innovation in both interventional and medical oncology.


---


TIMESTAMPS


00:00 - Introduction to Immunotherapy

04:32 - Notable Clinical Trials

13:39 - HCC Etiology and Immunotherapy Outcomes

18:43 - Contraindications for Immunotherapy

23:05 - Adverse Effects from Treatment

25:14 - Combination Therapy

36:22 - Considerations for Immunotherapy Dosing

40:26 - The Future of HCC Treatment


---


RESOURCES


Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma, IMbrave150 Trial (Finn et al, 2020):

https://pubmed.ncbi.nlm.nih.gov/32402160/


Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma, HIMALAYA Trial (Abou-Alfa et al, 2022):

https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100070


Nivolumab versus sorafenib in advanced hepatocellular carcinoma (CheckMate 459): a randomised, multicentre, open-label, phase 3 trial (Yau, 2022):

https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00604-5/abstract


Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): First results from CheckMate 9DW (Galle, 2024):

https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA4008


Randomized Phase 3 LEAP-012 Study: Transarterial Chemoembolization With or Without Lenvatinib Plus Pembrolizumab for Intermediate-Stage Hepatocellular Carcinoma Not Amenable to Curative Treatment (Llovet, 2022):

https://pubmed.ncbi.nlm.nih.gov/35119481/


EMERALD-1: A phase 3, randomized, placebo-controlled study of transarterial chemoembolization combined with durvalumab with or without bevacizumab in participants with unresectable hepatocellular carcinoma eligible for embolization (Lencioni, 2024):

https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 2912 Ep. 512 The "Alzate Maneuver”: Flipping Retrograde Access with Dr. Gregg Alzate Proximity to innovation often gives rise to further innovation. This trend is especially true in interventional radiology. Dr. Gregg Alzate (interventional radiologist in San Diego, California) joins host Dr. Ally Baheti to share his career pearls for early and mid-career IRs, and how he came to pioneer the Alzate Retrograde Antegrade Maneuver (A-RAM). --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Alzate starts by sharing his early influences, including his time with interventional radiology giant Dr. Harold Coons. The doctors also cover the importance of proper vessel access techniques, innovative approaches to limb salvage, and how to address complex chronic total occlusions (CTOs). Dr. Alzate then goes on to give us a thorough walkthrough of the A-RAM. The episode concludes with Dr. Alzate’s closing thoughts on being open to adopt new techniques, the impact of strong mentorship, and importance for consuming and sharing knowledge. --- TIMESTAMPS 00:00 - Introduction 03:05 - Dr. Alzate’s Journey 25:52 - A-RAM Technique 34:26 - CTO’s and Heavy Calcium 40:16 - Moral Injury in Medical Practice 43:35 - Honoring Dr. Harold Coons 46:23 - Closing Thoughts and Reflections --- RESOURCES Ohki, Takao et al. “Long-term results of the Japanese multicenter Viabahn trial of heparin bonded endovascular stent grafts for long and complex lesions in the superficial femoral artery.” Journal of vascular surgery vol. 74,6 (2021): 1958-1967.e2. https://www.jvascsurg.org/article/S0741-5214(21)01011-9/fulltext Kedora, John et al. “Randomized comparison of percutaneous Viabahn stent grafts vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral arterial occlusive disease.” Journal of vascular surgeryvol. 45,1 (2007): 10-6; discussion 16. https://www.jvascsurg.org/article/S0741-5214(06)01612-0/fulltext Tue, 28 Jan 2025 07:00:00 -0000 full BackTable Proximity to innovation often gives rise to further innovation. This trend is especially true in interventional radiology. Dr. Gregg Alzate (interventional radiologist in San Diego, California) joins host Dr. Ally Baheti to share his career pearls for early and mid-career IRs, and how he came to pioneer the Alzate Retrograde Antegrade Maneuver (A-RAM). Proximity to innovation often gives rise to further innovation. This trend is especially true in interventional radiology. Dr. Gregg Alzate (interventional radiologist in San Diego, California) joins host Dr. Ally Baheti to share his career pearls for early and mid-career IRs, and how he came to pioneer the Alzate Retrograde Antegrade Maneuver (A-RAM). --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Alzate starts by sharing his early influences, including his time with interventional radiology giant Dr. Harold Coons. The doctors also cover the importance of proper vessel access techniques, innovative approaches to limb salvage, and how to address complex chronic total occlusions (CTOs). Dr. Alzate then goes on to give us a thorough walkthrough of the A-RAM. The episode concludes with Dr. Alzate’s closing thoughts on being open to adopt new techniques, the impact of strong mentorship, and importance for consuming and sharing knowledge. --- TIMESTAMPS 00:00 - Introduction 03:05 - Dr. Alzate’s Journey 25:52 - A-RAM Technique 34:26 - CTO’s and Heavy Calcium 40:16 - Moral Injury in Medical Practice 43:35 - Honoring Dr. Harold Coons 46:23 - Closing Thoughts and Reflections --- RESOURCES Ohki, Takao et al. “Long-term results of the Japanese multicenter Viabahn trial of heparin bonded endovascular stent grafts for long and complex lesions in the superficial femoral artery.” Journal of vascular surgery vol. 74,6 (2021): 1958-1967.e2. https://www.jvascsurg.org/article/S0741-5214(21)01011-9/fulltext Kedora, John et al. “Randomized comparison of percutaneous Viabahn stent grafts vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral arterial occlusive disease.” Journal of vascular surgeryvol. 45,1 (2007): 10-6; discussion 16. https://www.jvascsurg.org/article/S0741-5214(06)01612-0/fulltext Proximity to innovation often gives rise to further innovation. This trend is especially true in interventional radiology. Dr. Gregg Alzate (interventional radiologist in San Diego, California) joins host Dr. Ally Baheti to share his career pearls for early and mid-career IRs, and how he came to pioneer the Alzate Retrograde Antegrade Maneuver (A-RAM).


---


This podcast is supported by:


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


Dr. Alzate starts by sharing his early influences, including his time with interventional radiology giant Dr. Harold Coons. The doctors also cover the importance of proper vessel access techniques, innovative approaches to limb salvage, and how to address complex chronic total occlusions (CTOs). Dr. Alzate then goes on to give us a thorough walkthrough of the A-RAM. The episode concludes with Dr. Alzate’s closing thoughts on being open to adopt new techniques, the impact of strong mentorship, and importance for consuming and sharing knowledge.


---


TIMESTAMPS


00:00 - Introduction

03:05 - Dr. Alzate’s Journey

25:52 - A-RAM Technique

34:26 - CTO’s and Heavy Calcium

40:16 - Moral Injury in Medical Practice

43:35 - Honoring Dr. Harold Coons

46:23 - Closing Thoughts and Reflections



---


RESOURCES


Ohki, Takao et al. “Long-term results of the Japanese multicenter Viabahn trial of heparin bonded endovascular stent grafts for long and complex lesions in the superficial femoral artery.” Journal of vascular surgery vol. 74,6 (2021): 1958-1967.e2.

https://www.jvascsurg.org/article/S0741-5214(21)01011-9/fulltext


Kedora, John et al. “Randomized comparison of percutaneous Viabahn stent grafts vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral arterial occlusive disease.” Journal of vascular surgeryvol. 45,1 (2007): 10-6; discussion 16.

https://www.jvascsurg.org/article/S0741-5214(06)01612-0/fulltext

]]> 3034 Ep. 511 How to Simplify Dosing: Understanding Y-90 Dosimetry from Simple to Complex Of all the topics covered during interventional radiology training, dosimetry education is often delayed until after IRs enter clinical practice. In this episode, Drs. Tyler Sandow and Sabeen Dhand host a roundtable discussion with experts on the dosimetry fundamentals that all Y90 operators should understand. They are joined by interventional radiologists Drs. Zachary Berman, Kirema Garcia-Reyes, and Siddharth Padia, who provide their expert insights. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125736 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The group agrees that dosimetry is not a one-size-fits-all approach. Dosing strategies depend on factors such as tumor size, perfusion territory, underlying liver function, the choice between glass versus resin spheres, and treatment intent. These considerations are illustrated with real-life case examples. The doctors also explore voxel-based dosimetry, a method for calculating the amount of radiation absorbed by different parts of the tumor. They stress the importance of learning how to perform accurate dosage calculations. Finally, the conversation touches on data from major Y90 trials, current guidelines, and the evolving perspective on Y90 as a potential curative treatment, rather than merely a bridging therapy. --- TIMESTAMPS 00:00 - Introduction 01:59 - Dosimetry Education During Training 05:46 - Benefit of Individualized Dosing 11:01 - Complications from High Doses 15:19 - Dosage Calculation Cases 22:51 - Duration of Response to Y90 25:00 - Dosing Based on Treatment Intent 29:11 - Challenging Case Example 42:31 - Voxel-Based Dosimetry 45:15 - Using Dosimetry Software --- RESOURCES LEGACY Trial (Salem et al, 2021): https://pmc.ncbi.nlm.nih.gov/articles/PMC8596669/ Voxel-based tumor dose correlates to complete pathologic necrosis after transarterial radioembolization for hepatocellular carcinoma (Pianka et al, 2024): https://pubmed.ncbi.nlm.nih.gov/38913189/ RAPY90D Trial (Kappadath et al, 2023): https://jnm.snmjournals.org/content/64/supplement_1/P268 Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group (Salem et al, 2023): https://pubmed.ncbi.nlm.nih.gov/36114872/ International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres (Levillain, 2021): https://link.springer.com/article/10.1007/s00259-020-05163-5) CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 24 Jan 2025 07:00:00 -0000 full BackTable Of all the topics covered during interventional radiology training, dosimetry education is often delayed until after IRs enter clinical practice. In this episode, Drs. Tyler Sandow and Sabeen Dhand host a roundtable discussion with experts on the dosimetry fundamentals that all Y90 operators should understand. They are joined by interventional radiologists Drs. Zachary Berman, Kirema Garcia-Reyes, and Siddharth Padia, who provide their expert insights. Of all the topics covered during interventional radiology training, dosimetry education is often delayed until after IRs enter clinical practice. In this episode, Drs. Tyler Sandow and Sabeen Dhand host a roundtable discussion with experts on the dosimetry fundamentals that all Y90 operators should understand. They are joined by interventional radiologists Drs. Zachary Berman, Kirema Garcia-Reyes, and Siddharth Padia, who provide their expert insights. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125736 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The group agrees that dosimetry is not a one-size-fits-all approach. Dosing strategies depend on factors such as tumor size, perfusion territory, underlying liver function, the choice between glass versus resin spheres, and treatment intent. These considerations are illustrated with real-life case examples. The doctors also explore voxel-based dosimetry, a method for calculating the amount of radiation absorbed by different parts of the tumor. They stress the importance of learning how to perform accurate dosage calculations. Finally, the conversation touches on data from major Y90 trials, current guidelines, and the evolving perspective on Y90 as a potential curative treatment, rather than merely a bridging therapy. --- TIMESTAMPS 00:00 - Introduction 01:59 - Dosimetry Education During Training 05:46 - Benefit of Individualized Dosing 11:01 - Complications from High Doses 15:19 - Dosage Calculation Cases 22:51 - Duration of Response to Y90 25:00 - Dosing Based on Treatment Intent 29:11 - Challenging Case Example 42:31 - Voxel-Based Dosimetry 45:15 - Using Dosimetry Software --- RESOURCES LEGACY Trial (Salem et al, 2021): https://pmc.ncbi.nlm.nih.gov/articles/PMC8596669/ Voxel-based tumor dose correlates to complete pathologic necrosis after transarterial radioembolization for hepatocellular carcinoma (Pianka et al, 2024): https://pubmed.ncbi.nlm.nih.gov/38913189/ RAPY90D Trial (Kappadath et al, 2023): https://jnm.snmjournals.org/content/64/supplement_1/P268 Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group (Salem et al, 2023): https://pubmed.ncbi.nlm.nih.gov/36114872/ International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres (Levillain, 2021): https://link.springer.com/article/10.1007/s00259-020-05163-5) CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Of all the topics covered during interventional radiology training, dosimetry education is often delayed until after IRs enter clinical practice. In this episode, Drs. Tyler Sandow and Sabeen Dhand host a roundtable discussion with experts on the dosimetry fundamentals that all Y90 operators should understand. They are joined by interventional radiologists Drs. Zachary Berman, Kirema Garcia-Reyes, and Siddharth Padia, who provide their expert insights.


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125736


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


The group agrees that dosimetry is not a one-size-fits-all approach. Dosing strategies depend on factors such as tumor size, perfusion territory, underlying liver function, the choice between glass versus resin spheres, and treatment intent. These considerations are illustrated with real-life case examples. The doctors also explore voxel-based dosimetry, a method for calculating the amount of radiation absorbed by different parts of the tumor. They stress the importance of learning how to perform accurate dosage calculations.


Finally, the conversation touches on data from major Y90 trials, current guidelines, and the evolving perspective on Y90 as a potential curative treatment, rather than merely a bridging therapy.


---


TIMESTAMPS


00:00 - Introduction

01:59 - Dosimetry Education During Training

05:46 - Benefit of Individualized Dosing

11:01 - Complications from High Doses

15:19 - Dosage Calculation Cases

22:51 - Duration of Response to Y90

25:00 - Dosing Based on Treatment Intent

29:11 - Challenging Case Example

42:31 - Voxel-Based Dosimetry

45:15 - Using Dosimetry Software


---


RESOURCES


LEGACY Trial (Salem et al, 2021):

https://pmc.ncbi.nlm.nih.gov/articles/PMC8596669/


Voxel-based tumor dose correlates to complete pathologic necrosis after transarterial radioembolization for hepatocellular carcinoma (Pianka et al, 2024):

https://pubmed.ncbi.nlm.nih.gov/38913189/


RAPY90D Trial (Kappadath et al, 2023):

https://jnm.snmjournals.org/content/64/supplement_1/P268


Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group (Salem et al, 2023):

https://pubmed.ncbi.nlm.nih.gov/36114872/


International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres (Levillain, 2021):

https://link.springer.com/article/10.1007/s00259-020-05163-5)


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 3316 Ep. 510 Robotics Revolution in Interventional Radiology with Dr. Sean Tutton and Dr. Raj Narayanan Robot-assisted technology has revolutionized surgical fields such as general surgery and urology—could interventional radiology be the next frontier? In this episode of the BackTable podcast, host Dr. Jacob Fleming explores the transformative potential of robotic-assisted percutaneous biopsies and ablations with experts Dr. Govindarajan “Raj” Narayanan from the Miami Cancer Institute and Dr. Sean Tutton from UC San Diego. --- This podcast is supported by: Quantum Surgical https://www.quantumsurgical.com/ --- SYNPOSIS Dr. Narayanan begins by sharing his initial interest in robotic applications for tumor ablations, aiming to maximize efficiency in his practice. Dr. Tutton then highlights the advantages of robotics for probe placement, especially in challenging cases. The two doctors discuss the logistics of the robotic system, including setup, imaging, and access choices. They also reflect on the learning curve associated with robotics and how it gradually enhances procedural efficiency while reducing mental fatigue. This improvement allows them to take on more complex cases with confidence. Overall, both experts agree that robotics has the potential to democratize minimally invasive procedures, offering new opportunities for skill development and advancement within the field of interventional radiology. --- TIMESTAMPS 00:00 - Introduction to the Podcast 03:30 - Developing an Interest in Robotics 10:44 - Integration of Robotics in the Procedural Suite 13:27 - Logistics of Robot System 18:38 - Planning for Percutaneous Access 22:39 - Future Implications of Robotics on Training Programs 35:51 - Efficiency and Volume Management with Robotics 40:39 - Learning Curves for Robotic Procedures 48:09 - Conclusion and Final Thoughts --- RESOURCES Quantum Surgical Epione Robot: https://www.quantumsurgical.com/epione/ ACCLAIM Trial: https://www.sio-central.org/ACCLAIM-Trial Tue, 21 Jan 2025 07:00:00 -0000 full BackTable Robot-assisted technology has revolutionized surgical fields such as general surgery and urology—could interventional radiology be the next frontier? In this episode of the BackTable podcast, host Dr. Jacob Fleming explores the transformative potential of robotic-assisted percutaneous biopsies and ablations with experts Dr. Govindarajan “Raj” Narayanan from the Miami Cancer Institute and Dr. Sean Tutton from UC San Diego. Robot-assisted technology has revolutionized surgical fields such as general surgery and urology—could interventional radiology be the next frontier? In this episode of the BackTable podcast, host Dr. Jacob Fleming explores the transformative potential of robotic-assisted percutaneous biopsies and ablations with experts Dr. Govindarajan “Raj” Narayanan from the Miami Cancer Institute and Dr. Sean Tutton from UC San Diego. --- This podcast is supported by: Quantum Surgical https://www.quantumsurgical.com/ --- SYNPOSIS Dr. Narayanan begins by sharing his initial interest in robotic applications for tumor ablations, aiming to maximize efficiency in his practice. Dr. Tutton then highlights the advantages of robotics for probe placement, especially in challenging cases. The two doctors discuss the logistics of the robotic system, including setup, imaging, and access choices. They also reflect on the learning curve associated with robotics and how it gradually enhances procedural efficiency while reducing mental fatigue. This improvement allows them to take on more complex cases with confidence. Overall, both experts agree that robotics has the potential to democratize minimally invasive procedures, offering new opportunities for skill development and advancement within the field of interventional radiology. --- TIMESTAMPS 00:00 - Introduction to the Podcast 03:30 - Developing an Interest in Robotics 10:44 - Integration of Robotics in the Procedural Suite 13:27 - Logistics of Robot System 18:38 - Planning for Percutaneous Access 22:39 - Future Implications of Robotics on Training Programs 35:51 - Efficiency and Volume Management with Robotics 40:39 - Learning Curves for Robotic Procedures 48:09 - Conclusion and Final Thoughts --- RESOURCES Quantum Surgical Epione Robot: https://www.quantumsurgical.com/epione/ ACCLAIM Trial: https://www.sio-central.org/ACCLAIM-Trial Robot-assisted technology has revolutionized surgical fields such as general surgery and urology—could interventional radiology be the next frontier? In this episode of the BackTable podcast, host Dr. Jacob Fleming explores the transformative potential of robotic-assisted percutaneous biopsies and ablations with experts Dr. Govindarajan “Raj” Narayanan from the Miami Cancer Institute and Dr. Sean Tutton from UC San Diego.



---


This podcast is supported by:


Quantum Surgical

https://www.quantumsurgical.com/


---


SYNPOSIS


Dr. Narayanan begins by sharing his initial interest in robotic applications for tumor ablations, aiming to maximize efficiency in his practice. Dr. Tutton then highlights the advantages of robotics for probe placement, especially in challenging cases. The two doctors discuss the logistics of the robotic system, including setup, imaging, and access choices. They also reflect on the learning curve associated with robotics and how it gradually enhances procedural efficiency while reducing mental fatigue. This improvement allows them to take on more complex cases with confidence. Overall, both experts agree that robotics has the potential to democratize minimally invasive procedures, offering new opportunities for skill development and advancement within the field of interventional radiology.


---


TIMESTAMPS


00:00 - Introduction to the Podcast

03:30 - Developing an Interest in Robotics

10:44 - Integration of Robotics in the Procedural Suite

13:27 - Logistics of Robot System

18:38 - Planning for Percutaneous Access

22:39 - Future Implications of Robotics on Training Programs

35:51 - Efficiency and Volume Management with Robotics

40:39 - Learning Curves for Robotic Procedures

48:09 - Conclusion and Final Thoughts



---


RESOURCES


Quantum Surgical Epione Robot:

https://www.quantumsurgical.com/epione/


ACCLAIM Trial:

https://www.sio-central.org/ACCLAIM-Trial

]]> 3388 Ep. 509 Multidisciplinary HCC Care: Improving the Patient Experience with Combined Clinic Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator). Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125735 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The team speaks on the value of having multiple specialties weigh in on treatment conversations that are tailored to each patient’s medical history and risk factors, such as underlying cirrhosis and portal hypertension. Deondra highlights the importance of assessing the patient’s understanding of their disease and the role of physician extenders and schedulers in patient education. Dr. Young discusses the value of outreach clinics and streamlining the transplant evaluation process. Finally, Dr. Mizrahi gives advice on building referral networks and establishing early contact with transplant centers. --- TIMESTAMPS 00:00 - Introduction 00:46 - Multidisciplinary Tumor Board 06:00 - Patient Experience in Treatment Pathways 10:10 - Barriers to Treatment 16:03 - Benefits of IR Clinic 19:33 - HCC Screening and Risk Factors 24:08 - Building Referral Networks 30:34 - Strategies for Effective Scheduling 35:43 - The Future of HCC Treatment --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Fri, 17 Jan 2025 16:40:00 -0000 full BackTable Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator). Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator). Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125735 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The team speaks on the value of having multiple specialties weigh in on treatment conversations that are tailored to each patient’s medical history and risk factors, such as underlying cirrhosis and portal hypertension. Deondra highlights the importance of assessing the patient’s understanding of their disease and the role of physician extenders and schedulers in patient education. Dr. Young discusses the value of outreach clinics and streamlining the transplant evaluation process. Finally, Dr. Mizrahi gives advice on building referral networks and establishing early contact with transplant centers. --- TIMESTAMPS 00:00 - Introduction 00:46 - Multidisciplinary Tumor Board 06:00 - Patient Experience in Treatment Pathways 10:10 - Barriers to Treatment 16:03 - Benefits of IR Clinic 19:33 - HCC Screening and Risk Factors 24:08 - Building Referral Networks 30:34 - Strategies for Effective Scheduling 35:43 - The Future of HCC Treatment --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator).


Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125735


---


This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.


---


SYNPOSIS


The team speaks on the value of having multiple specialties weigh in on treatment conversations that are tailored to each patient’s medical history and risk factors, such as underlying cirrhosis and portal hypertension. Deondra highlights the importance of assessing the patient’s understanding of their disease and the role of physician extenders and schedulers in patient education. Dr. Young discusses the value of outreach clinics and streamlining the transplant evaluation process. Finally, Dr. Mizrahi gives advice on building referral networks and establishing early contact with transplant centers.


---


TIMESTAMPS


00:00 - Introduction

00:46 - Multidisciplinary Tumor Board

06:00 - Patient Experience in Treatment Pathways

10:10 - Barriers to Treatment

16:03 - Benefits of IR Clinic

19:33 - HCC Screening and Risk Factors

24:08 - Building Referral Networks

30:34 - Strategies for Effective Scheduling

35:43 - The Future of HCC Treatment


---


RESOURCES


CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

]]> 2732 Introducing Backtable Tumor Board Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator). --- This podcast is supported by an educational grant from: AstraZeneca https://www.astrazeneca.com/our-therapy-areas/oncology.html With additional support from: Boston Scientific https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology.html --- SYNPOSIS The team speaks on the value of having multiple specialties weigh in on treatment conversations that are tailored to each patient’s medical history and risk factors, such as underlying cirrhosis and portal hypertension. Deondra highlights the importance of assessing the patient’s understanding of their disease and the role of physician extenders and schedulers in patient education. Dr. Young discusses the value of outreach clinics and streamlining the transplant evaluation process. Finally, Dr. Mizrahi gives advice on building referral networks and establishing early contact with transplant centers. --- TIMESTAMPS 00:00 - Introduction 00:46 - Multidisciplinary Tumor Board 06:00 - Patient Experience in Treatment Pathways 10:10 - Barriers to Treatment 16:03 - Benefits of IR Clinic 19:33 - HCC Screening and Risk Factors 24:08 - Building Referral Networks 30:34 - Strategies for Effective Scheduling 35:43 - The Future of HCC Treatment Thu, 16 Jan 2025 13:50:00 -0000 trailer BackTable Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator). Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator). --- This podcast is supported by an educational grant from: AstraZeneca https://www.astrazeneca.com/our-therapy-areas/oncology.html With additional support from: Boston Scientific https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology.html --- SYNPOSIS The team speaks on the value of having multiple specialties weigh in on treatment conversations that are tailored to each patient’s medical history and risk factors, such as underlying cirrhosis and portal hypertension. Deondra highlights the importance of assessing the patient’s understanding of their disease and the role of physician extenders and schedulers in patient education. Dr. Young discusses the value of outreach clinics and streamlining the transplant evaluation process. Finally, Dr. Mizrahi gives advice on building referral networks and establishing early contact with transplant centers. --- TIMESTAMPS 00:00 - Introduction 00:46 - Multidisciplinary Tumor Board 06:00 - Patient Experience in Treatment Pathways 10:10 - Barriers to Treatment 16:03 - Benefits of IR Clinic 19:33 - HCC Screening and Risk Factors 24:08 - Building Referral Networks 30:34 - Strategies for Effective Scheduling 35:43 - The Future of HCC Treatment Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator).


---


This podcast is supported by an educational grant from:


AstraZeneca

https://www.astrazeneca.com/our-therapy-areas/oncology.html


With additional support from:


Boston Scientific

https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology.html


---


SYNPOSIS


The team speaks on the value of having multiple specialties weigh in on treatment conversations that are tailored to each patient’s medical history and risk factors, such as underlying cirrhosis and portal hypertension. Deondra highlights the importance of assessing the patient’s understanding of their disease and the role of physician extenders and schedulers in patient education. Dr. Young discusses the value of outreach clinics and streamlining the transplant evaluation process. Finally, Dr. Mizrahi gives advice on building referral networks and establishing early contact with transplant centers.


---


TIMESTAMPS


00:00 - Introduction

00:46 - Multidisciplinary Tumor Board

06:00 - Patient Experience in Treatment Pathways

10:10 - Barriers to Treatment

16:03 - Benefits of IR Clinic

19:33 - HCC Screening and Risk Factors

24:08 - Building Referral Networks

30:34 - Strategies for Effective Scheduling

35:43 - The Future of HCC Treatment

]]> 129 Ep. 508 Advancements in Pulmonary Embolus Intervention Techniques: PEERLESS Trial Insights with Dr. Ripal Gandhi and Dr. Zarina Sharalaya Interventional treatment for pulmonary embolism (PE) has significantly evolved in recent years, largely due to advancements in techniques, knowledge, and device technology. Dr. Zarina Sharalaya (interventional and structural cardiologist) and Dr. Ripal Gandhi (interventional radiologist) join host Dr. Chris Beck to discuss the evolving landscape of PE treatment, comparing large-bore mechanical thrombectomy with catheter-directed thrombolysis and exploring outcomes from the PEERLESS randomized control trial. --- This podcast is supported by: Inari Medical https://cwa.inarimedical.com/inari-learn --- SYNPOSIS Dr. Sharalaya and Dr. Gandhi begin by covering risk stratification and treatment algorithms for their patients with PE. The doctors then go onto discuss the procedure in detail, and best practices and techniques for mechanical thrombectomy. The conversation also focuses on the PEERLESS trial, highlighting how the study showed significant benefits of mechanical thrombectomy, including faster symptom improvement, decreased ICU stay, and reduced readmission rates. Dr. Sharalaya and Dr. Gandhi conclude the episode with a series of case presentations. --- TIMESTAMPS 00:00 - Introduction 08:01 - Pulmonary Embolism Risk Stratification and Treatment Algorithms 14:49 - Procedure Overview 24:25 - Best Practices and Techniques in Thrombectomy 34:31 - Peerless Study Overview and Findings 46:50 - Gender Differences in PE Treatment 47:49 - Future of PE Treatment and Advice 51:55 - Case Presentations and Clinical Insights --- RESOURCES 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): https://pubmed.ncbi.nlm.nih.gov/31504429/ PEERLESS II: A Randomized Controlled Trial of Large-Bore Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism: https://www.jscai.org/article/S2772-9303(24)01053-6/fulltext Large-bore Mechanical Thrombectomy Versus Catheter-directed Thrombolysis in the Management of Intermediate-risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/39470698/ Tue, 14 Jan 2025 07:00:00 -0000 full BackTable Interventional treatment for pulmonary embolism (PE) has significantly evolved in recent years, largely due to advancements in techniques, knowledge, and device technology. Dr. Zarina Sharalya (interventional and structural cardiologist) and Dr. Ripal Gandhi (interventional radiologist) join host Dr. Chris Beck to discuss the evolving landscape of PE treatment, comparing large-bore mechanical thrombectomy with catheter-directed thrombolysis and exploring outcomes from the PEERLESS randomized control trial. Interventional treatment for pulmonary embolism (PE) has significantly evolved in recent years, largely due to advancements in techniques, knowledge, and device technology. Dr. Zarina Sharalaya (interventional and structural cardiologist) and Dr. Ripal Gandhi (interventional radiologist) join host Dr. Chris Beck to discuss the evolving landscape of PE treatment, comparing large-bore mechanical thrombectomy with catheter-directed thrombolysis and exploring outcomes from the PEERLESS randomized control trial. --- This podcast is supported by: Inari Medical https://cwa.inarimedical.com/inari-learn --- SYNPOSIS Dr. Sharalaya and Dr. Gandhi begin by covering risk stratification and treatment algorithms for their patients with PE. The doctors then go onto discuss the procedure in detail, and best practices and techniques for mechanical thrombectomy. The conversation also focuses on the PEERLESS trial, highlighting how the study showed significant benefits of mechanical thrombectomy, including faster symptom improvement, decreased ICU stay, and reduced readmission rates. Dr. Sharalaya and Dr. Gandhi conclude the episode with a series of case presentations. --- TIMESTAMPS 00:00 - Introduction 08:01 - Pulmonary Embolism Risk Stratification and Treatment Algorithms 14:49 - Procedure Overview 24:25 - Best Practices and Techniques in Thrombectomy 34:31 - Peerless Study Overview and Findings 46:50 - Gender Differences in PE Treatment 47:49 - Future of PE Treatment and Advice 51:55 - Case Presentations and Clinical Insights --- RESOURCES 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): https://pubmed.ncbi.nlm.nih.gov/31504429/ PEERLESS II: A Randomized Controlled Trial of Large-Bore Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism: https://www.jscai.org/article/S2772-9303(24)01053-6/fulltext Large-bore Mechanical Thrombectomy Versus Catheter-directed Thrombolysis in the Management of Intermediate-risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/39470698/ Interventional treatment for pulmonary embolism (PE) has significantly evolved in recent years, largely due to advancements in techniques, knowledge, and device technology. Dr. Zarina Sharalaya (interventional and structural cardiologist) and Dr. Ripal Gandhi (interventional radiologist) join host Dr. Chris Beck to discuss the evolving landscape of PE treatment, comparing large-bore mechanical thrombectomy with catheter-directed thrombolysis and exploring outcomes from the PEERLESS randomized control trial.


---


This podcast is supported by:


Inari Medical

https://cwa.inarimedical.com/inari-learn


---


SYNPOSIS


Dr. Sharalaya and Dr. Gandhi begin by covering risk stratification and treatment algorithms for their patients with PE. The doctors then go onto discuss the procedure in detail, and best practices and techniques for mechanical thrombectomy. The conversation also focuses on the PEERLESS trial, highlighting how the study showed significant benefits of mechanical thrombectomy, including faster symptom improvement, decreased ICU stay, and reduced readmission rates. Dr. Sharalaya and Dr. Gandhi conclude the episode with a series of case presentations.


---


TIMESTAMPS


00:00 - Introduction

08:01 - Pulmonary Embolism Risk Stratification and Treatment Algorithms

14:49 - Procedure Overview

24:25 - Best Practices and Techniques in Thrombectomy

34:31 - Peerless Study Overview and Findings

46:50 - Gender Differences in PE Treatment

47:49 - Future of PE Treatment and Advice

51:55 - Case Presentations and Clinical Insights



---


RESOURCES


2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS):

https://pubmed.ncbi.nlm.nih.gov/31504429/


PEERLESS II: A Randomized Controlled Trial of Large-Bore Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism:

https://www.jscai.org/article/S2772-9303(24)01053-6/fulltext


Large-bore Mechanical Thrombectomy Versus Catheter-directed Thrombolysis in the Management of Intermediate-risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial:

https://pubmed.ncbi.nlm.nih.gov/39470698/

]]> 4351 Ep. 507 New Horizons in IR: Private Practice Insights and Strategies with Dr. Mark Wilson Interventional radiology is unique in the way that much of what an IR’s practice looks like is extremely contingent upon their practice setting following training - whether it be community, academic, private, or hybrid. Dr. Mark Wilson joins host Dr. Donald Garbett to discuss his own journey of transitioning from a large, physician owned group to forming his own private IR practice in Spokane, Washington following a major hospital contract shift. --- This podcast is supported by: Medtronic MVP https://www.medtronic.com/mvp --- SYNPOSIS Dr. Wilson shares the emotional impact of the career shift, and the technical aspects of how he was able to succeed following the change, and the details that went into creating his own private IR-only group and securing contracts with local hospitals. The doctors also spend time on the financial dynamics between DR and IR, as well as the true dollar value and impact IR brings to hospitals. The episode concludes with Dr. Wilson’s practical and thorough guide on how one can go about starting up their own IR-only private practice. --- TIMESTAMPS 00:00 - Introduction 03:02 - Forming a New IR Group 04:43 - Impact of Practice Changes 11:02 - IR’s Value to Hospitals 30:49 - Independent IR Practice Set-Up 36:38 - Conclusion --- RESOURCES Karage, 2024. Attrition Rates in Interventional Radiology Integrated Residency Programs: https://pubmed.ncbi.nlm.nih.gov/39586539/ Fri, 10 Jan 2025 08:00:00 -0000 full BackTable Interventional radiology is unique in the way that much of what an IR’s practice looks like is extremely contingent upon their practice setting following training - whether it be community, academic, private, or hybrid. Dr. Mark Wilson joins host Dr. Donald Garbett to discuss his own journey of transitioning from a large, physician owned group to forming his own private IR practice in Spokane, Washington following a major hospital contract shift. Interventional radiology is unique in the way that much of what an IR’s practice looks like is extremely contingent upon their practice setting following training - whether it be community, academic, private, or hybrid. Dr. Mark Wilson joins host Dr. Donald Garbett to discuss his own journey of transitioning from a large, physician owned group to forming his own private IR practice in Spokane, Washington following a major hospital contract shift. --- This podcast is supported by: Medtronic MVP https://www.medtronic.com/mvp --- SYNPOSIS Dr. Wilson shares the emotional impact of the career shift, and the technical aspects of how he was able to succeed following the change, and the details that went into creating his own private IR-only group and securing contracts with local hospitals. The doctors also spend time on the financial dynamics between DR and IR, as well as the true dollar value and impact IR brings to hospitals. The episode concludes with Dr. Wilson’s practical and thorough guide on how one can go about starting up their own IR-only private practice. --- TIMESTAMPS 00:00 - Introduction 03:02 - Forming a New IR Group 04:43 - Impact of Practice Changes 11:02 - IR’s Value to Hospitals 30:49 - Independent IR Practice Set-Up 36:38 - Conclusion --- RESOURCES Karage, 2024. Attrition Rates in Interventional Radiology Integrated Residency Programs: https://pubmed.ncbi.nlm.nih.gov/39586539/ Interventional radiology is unique in the way that much of what an IR’s practice looks like is extremely contingent upon their practice setting following training - whether it be community, academic, private, or hybrid. Dr. Mark Wilson joins host Dr. Donald Garbett to discuss his own journey of transitioning from a large, physician owned group to forming his own private IR practice in Spokane, Washington following a major hospital contract shift.


---


This podcast is supported by:


Medtronic MVP

https://www.medtronic.com/mvp


---


SYNPOSIS


Dr. Wilson shares the emotional impact of the career shift, and the technical aspects of how he was able to succeed following the change, and the details that went into creating his own private IR-only group and securing contracts with local hospitals. The doctors also spend time on the financial dynamics between DR and IR, as well as the true dollar value and impact IR brings to hospitals. The episode concludes with Dr. Wilson’s practical and thorough guide on how one can go about starting up their own IR-only private practice.


---


TIMESTAMPS


00:00 - Introduction

03:02 - Forming a New IR Group

04:43 - Impact of Practice Changes

11:02 - IR’s Value to Hospitals

30:49 - Independent IR Practice Set-Up

36:38 - Conclusion



---


RESOURCES


Karage, 2024. Attrition Rates in Interventional Radiology Integrated Residency Programs:

https://pubmed.ncbi.nlm.nih.gov/39586539/

]]> 2435 Ep. 506 Transfemoral Liver Biopsy: A Novel Approach with Dr. Kapil Wattamwar and Dr. Jacob Cynamon It might be time to rethink your liver biopsy technique. Transfemoral transcaval core-needle liver biopsy has demonstrated key advantages over the transjugular approach and has become increasingly popular in recent years. Interventional radiologists Dr. Jacob Cynamon and Dr. Kapil Wattamwar join host Dr. Sabeen Dhand to discuss the inception and advantages of their novel approach. --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS The doctors start with how they began using the transfemoral transcaval approach, along with the literature they published following adoption of this novel technique shortly thereafter. Dr. Cynamon and Dr. Wattamwar then go on to discuss the technique in detail, providing a thorough step-by-step and pausing to mention key considerations. The episode concludes with the doctors emphasizing the safety and efficacy of the transfemoral transcaval approach, citing specific findings and sharing exemplary cases. --- TIMESTAMPS 00:00 - Introduction 05:47 - Percutaneous vs. Transvenous Biopsies 08:56 - Evolution of Transfemoral Biopsies 12:41 - Comparing Transjugular and Transfemoral Approaches 24:52 - Pre-Procedural Imaging and Sheath Selection 29:23 - Complications and Case Studies 35:46 - Transcaval Biopsy Technique 45:00 - Conclusion --- RESOURCES Cynamon, 2016. Transfemoral Transcaval Core-Needle Liver Biopsy: An Alternative to Transjugular Liver Biopsy: https://pubmed.ncbi.nlm.nih.gov/26723528/ Wattamar, 2020. Transjugular versus Transfemoral Transcaval Liver Biopsy: A Single-Center Experience in 500 Cases: https://pubmed.ncbi.nlm.nih.gov/32798119/ Wattamar, 2022. The Use of the Transfemoral Transcaval Liver Biopsy Technique for Biopsies of Hepatic Masses: https://pubmed.ncbi.nlm.nih.gov/36182256/ Wattamar, 2022. Transcaval Creation of a Portal Vein Target for Transjugular Intrahepatic Portosystemic Shunt in a Patient with Portal Vein Thrombosis: https://pubmed.ncbi.nlm.nih.gov/34448032/ Tue, 07 Jan 2025 08:00:00 -0000 full BackTable It might be time to rethink your liver biopsy technique. Transfemoral transcaval core-needle liver biopsy has demonstrated key advantages over the transjugular approach and has become increasingly popular in recent years. Interventional radiologists Dr. Jacob Cynamon and Dr. Kapil Wattamar join host Dr. Sabeen Dhand to discuss the inception and advantages of their novel approach. It might be time to rethink your liver biopsy technique. Transfemoral transcaval core-needle liver biopsy has demonstrated key advantages over the transjugular approach and has become increasingly popular in recent years. Interventional radiologists Dr. Jacob Cynamon and Dr. Kapil Wattamwar join host Dr. Sabeen Dhand to discuss the inception and advantages of their novel approach. --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS The doctors start with how they began using the transfemoral transcaval approach, along with the literature they published following adoption of this novel technique shortly thereafter. Dr. Cynamon and Dr. Wattamwar then go on to discuss the technique in detail, providing a thorough step-by-step and pausing to mention key considerations. The episode concludes with the doctors emphasizing the safety and efficacy of the transfemoral transcaval approach, citing specific findings and sharing exemplary cases. --- TIMESTAMPS 00:00 - Introduction 05:47 - Percutaneous vs. Transvenous Biopsies 08:56 - Evolution of Transfemoral Biopsies 12:41 - Comparing Transjugular and Transfemoral Approaches 24:52 - Pre-Procedural Imaging and Sheath Selection 29:23 - Complications and Case Studies 35:46 - Transcaval Biopsy Technique 45:00 - Conclusion --- RESOURCES Cynamon, 2016. Transfemoral Transcaval Core-Needle Liver Biopsy: An Alternative to Transjugular Liver Biopsy: https://pubmed.ncbi.nlm.nih.gov/26723528/ Wattamar, 2020. Transjugular versus Transfemoral Transcaval Liver Biopsy: A Single-Center Experience in 500 Cases: https://pubmed.ncbi.nlm.nih.gov/32798119/ Wattamar, 2022. The Use of the Transfemoral Transcaval Liver Biopsy Technique for Biopsies of Hepatic Masses: https://pubmed.ncbi.nlm.nih.gov/36182256/ Wattamar, 2022. Transcaval Creation of a Portal Vein Target for Transjugular Intrahepatic Portosystemic Shunt in a Patient with Portal Vein Thrombosis: https://pubmed.ncbi.nlm.nih.gov/34448032/ It might be time to rethink your liver biopsy technique. Transfemoral transcaval core-needle liver biopsy has demonstrated key advantages over the transjugular approach and has become increasingly popular in recent years. Interventional radiologists Dr. Jacob Cynamon and Dr. Kapil Wattamwar join host Dr. Sabeen Dhand to discuss the inception and advantages of their novel approach.


---


This podcast is supported by:


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


The doctors start with how they began using the transfemoral transcaval approach, along with the literature they published following adoption of this novel technique shortly thereafter. Dr. Cynamon and Dr. Wattamwar then go on to discuss the technique in detail, providing a thorough step-by-step and pausing to mention key considerations. The episode concludes with the doctors emphasizing the safety and efficacy of the transfemoral transcaval approach, citing specific findings and sharing exemplary cases.


---


TIMESTAMPS


00:00 - Introduction

05:47 - Percutaneous vs. Transvenous Biopsies

08:56 - Evolution of Transfemoral Biopsies

12:41 - Comparing Transjugular and Transfemoral Approaches

24:52 - Pre-Procedural Imaging and Sheath Selection

29:23 - Complications and Case Studies

35:46 - Transcaval Biopsy Technique

45:00 - Conclusion



---


RESOURCES


Cynamon, 2016. Transfemoral Transcaval Core-Needle Liver Biopsy: An Alternative to Transjugular Liver Biopsy:

https://pubmed.ncbi.nlm.nih.gov/26723528/


Wattamar, 2020. Transjugular versus Transfemoral Transcaval Liver Biopsy: A Single-Center Experience in 500 Cases:

https://pubmed.ncbi.nlm.nih.gov/32798119/


Wattamar, 2022. The Use of the Transfemoral Transcaval Liver Biopsy Technique for Biopsies of Hepatic Masses:

https://pubmed.ncbi.nlm.nih.gov/36182256/


Wattamar, 2022. Transcaval Creation of a Portal Vein Target for Transjugular Intrahepatic Portosystemic Shunt in a Patient with Portal Vein Thrombosis:

https://pubmed.ncbi.nlm.nih.gov/34448032/

]]> 3192 Ep. 505 Más allá de la Técnica: La Gestión Emocional como Herramienta con Dr. María Luisa Die Trill En este episodio de BackTable, la Dra. María Luisa Die Trill conversa con la Dra. Sara Lojo Lendoiro sobre la gestión emocional y la comunicación con los pacientes. --- SYNPOSIS Se explora la importancia de integrar el sufrimiento como parte de la vida, la necesidad de una formación adecuada en comunicación médico-paciente, y las estrategias para abordar complicaciones y situaciones complejas. Además, se analizan conceptos como la empatía, la escucha activa, y la introspección, para mejorar la relación con los pacientes y con el resto de compañeros del hospital. Finalmente, la Dra. Trill enfatiza la necesidad de centrarse en el bienestar del paciente y en manejar el estrés profesional para poder ofrecer un cuidado de calidad. --- TIMESTAMPS 00:00 - Bienvenida y Comprendiendo la Psicología Oncológica 05:06 Habilidades de Comunicación en la Práctica Médica 10:19 Técnicas Prácticas de Comunicación 22:10 La Importancia de Escuchar 28:18 La Insensibilidad en la Sociedad Moderna 30:49 La Importancia de la Salud Mental en los Profesionales 34:24 La Empatía y la Conexión con los Pacientes 36:22 El Manejo del Estrés en el Personal Sanitario 48:35 El Ego y la Dinámica de Grupo en los Hospitales 52:54 Conclusión y Reflexiones Finales Tue, 31 Dec 2024 08:00:00 -0000 full BackTable En este episodio de BackTable, la Dra. María Luisa Die Trill conversa con la Dra. Sara Lojo Lendoiro sobre la gestión emocional y la comunicación con los pacientes. En este episodio de BackTable, la Dra. María Luisa Die Trill conversa con la Dra. Sara Lojo Lendoiro sobre la gestión emocional y la comunicación con los pacientes. --- SYNPOSIS Se explora la importancia de integrar el sufrimiento como parte de la vida, la necesidad de una formación adecuada en comunicación médico-paciente, y las estrategias para abordar complicaciones y situaciones complejas. Además, se analizan conceptos como la empatía, la escucha activa, y la introspección, para mejorar la relación con los pacientes y con el resto de compañeros del hospital. Finalmente, la Dra. Trill enfatiza la necesidad de centrarse en el bienestar del paciente y en manejar el estrés profesional para poder ofrecer un cuidado de calidad. --- TIMESTAMPS 00:00 - Bienvenida y Comprendiendo la Psicología Oncológica 05:06 Habilidades de Comunicación en la Práctica Médica 10:19 Técnicas Prácticas de Comunicación 22:10 La Importancia de Escuchar 28:18 La Insensibilidad en la Sociedad Moderna 30:49 La Importancia de la Salud Mental en los Profesionales 34:24 La Empatía y la Conexión con los Pacientes 36:22 El Manejo del Estrés en el Personal Sanitario 48:35 El Ego y la Dinámica de Grupo en los Hospitales 52:54 Conclusión y Reflexiones Finales En este episodio de BackTable, la Dra. María Luisa Die Trill conversa con la Dra. Sara

Lojo Lendoiro sobre la gestión emocional y la comunicación con los pacientes.


---


SYNPOSIS


Se explora la importancia de integrar el sufrimiento como parte de la vida, la necesidad

de una formación adecuada en comunicación médico-paciente, y las estrategias para

abordar complicaciones y situaciones complejas. Además, se analizan conceptos como

la empatía, la escucha activa, y la introspección, para mejorar la relación con los

pacientes y con el resto de compañeros del hospital. Finalmente, la Dra. Trill enfatiza la

necesidad de centrarse en el bienestar del paciente y en manejar el estrés profesional

para poder ofrecer un cuidado de calidad.


---


TIMESTAMPS


00:00 - Bienvenida y Comprendiendo la Psicología Oncológica

05:06 Habilidades de Comunicación en la Práctica Médica

10:19 Técnicas Prácticas de Comunicación

22:10 La Importancia de Escuchar

28:18 La Insensibilidad en la Sociedad Moderna

30:49 La Importancia de la Salud Mental en los Profesionales

34:24 La Empatía y la Conexión con los Pacientes

36:22 El Manejo del Estrés en el Personal Sanitario

48:35 El Ego y la Dinámica de Grupo en los Hospitales

52:54 Conclusión y Reflexiones Finales

]]> 3428 Ep. 504 ¿Es la Embolización el Futuro? Hablemos de Emborrhoid con Dr. José Andrés Guirola Ortíz En este episodio del BackTable, Dr. José Andrés Guirola Ortíz, radiólogo intervencionista, aborda la embolización como tratamiento para las hemorroides, mediante la técnica Emborrhoid y comparte su valoración de la embolización como técnica de futuro. --- SYNPOSIS En primer lugar, la Dra. Sara Lojo Lendoiro le invita a explicar qué son las hemorroides y porqué y cuando hay que tratarlas. Además, el Dr. Guirola Ortíz analiza la historia de las hemorroides, sus síntomas y opciones de tratamiento. También se discuten las indicaciones, técnicas y posibles complicaciones de la embolización hemorroidal, así como el futuro de esta técnica dentro de la radiología intervencionista. --- TIMESTAMPS 00:00 - Introducción al BackTable y Dr. Ortíz 01:56 - Entendiendo las Hemorroides: Historia y Conceptos Básicos 03:39 - Síntomas y Causas de las Hemorroides 07:36 - Opciones de Tratamiento para las Hemorroides 12:50 - Explicación de la Técnica de Embolización 19:25 - Complicaciones y Seguimiento 29:05 - Futuro de la Embolización y Conclusión Fri, 27 Dec 2024 08:00:00 -0000 full BackTable En este episodio del BackTable, Dr. José Andrés Guirola Ortíz, radiólogo intervencionista, aborda la embolización como tratamiento para las hemorroides, mediante la técnica Emborrhoid y comparte su valoración de la embolización como técnica de futuro. En este episodio del BackTable, Dr. José Andrés Guirola Ortíz, radiólogo intervencionista, aborda la embolización como tratamiento para las hemorroides, mediante la técnica Emborrhoid y comparte su valoración de la embolización como técnica de futuro. --- SYNPOSIS En primer lugar, la Dra. Sara Lojo Lendoiro le invita a explicar qué son las hemorroides y porqué y cuando hay que tratarlas. Además, el Dr. Guirola Ortíz analiza la historia de las hemorroides, sus síntomas y opciones de tratamiento. También se discuten las indicaciones, técnicas y posibles complicaciones de la embolización hemorroidal, así como el futuro de esta técnica dentro de la radiología intervencionista. --- TIMESTAMPS 00:00 - Introducción al BackTable y Dr. Ortíz 01:56 - Entendiendo las Hemorroides: Historia y Conceptos Básicos 03:39 - Síntomas y Causas de las Hemorroides 07:36 - Opciones de Tratamiento para las Hemorroides 12:50 - Explicación de la Técnica de Embolización 19:25 - Complicaciones y Seguimiento 29:05 - Futuro de la Embolización y Conclusión En este episodio del BackTable, Dr. José Andrés Guirola Ortíz, radiólogo

intervencionista, aborda la embolización como tratamiento para las hemorroides,

mediante la técnica Emborrhoid y comparte su valoración de la embolización como

técnica de futuro.


---


SYNPOSIS


En primer lugar, la Dra. Sara Lojo Lendoiro le invita a explicar qué son las hemorroides

y porqué y cuando hay que tratarlas. Además, el Dr. Guirola Ortíz analiza la historia de

las hemorroides, sus síntomas y opciones de tratamiento. También se discuten las

indicaciones, técnicas y posibles complicaciones de la embolización hemorroidal, así

como el futuro de esta técnica dentro de la radiología intervencionista.


---


TIMESTAMPS


00:00 - Introducción al BackTable y Dr. Ortíz

01:56 - Entendiendo las Hemorroides: Historia y Conceptos Básicos

03:39 - Síntomas y Causas de las Hemorroides

07:36 - Opciones de Tratamiento para las Hemorroides

12:50 - Explicación de la Técnica de Embolización

19:25 - Complicaciones y Seguimiento

29:05 - Futuro de la Embolización y Conclusión

]]> 2110 Ep. 503 Cryoablation: A Patient’s Kidney Cancer Journey with Clinton Lanier For patients with early-stage cancer, minimally invasive image-guided therapies like cryoablation can be both life-altering and life-saving. Patient Clinton Lanier, a kidney cancer survivor who underwent multiple cryoablations, sits down with host Dr. Eric Keller to share his story and raise patient-provider awareness of the positive impacts IR brings. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Clinton shares his personal story of being diagnosed with a kidney tumor during a sailing trip and discovering cryoablation as a treatment option through his own research and advocacy. He discusses the effectiveness and ease of the procedure, the positive impact it has had on his quality of life, and the importance of raising awareness about cryoablation among patients and healthcare providers. --- TIMESTAMPS 00:00 - Introduction 03:56 - First Cryoablation Experience 05:20 - Patient Experience 09:12 - Cryoablation Awareness 14:44 - Conclusion --- RESOURCES The Interventional Initiative: https://theii.org Fri, 20 Dec 2024 08:00:00 -0000 full BackTable For patients with early-stage cancer, minimally invasive image-guided therapies like cryoablation can be both life-altering and life-saving. Patient Clinton Lanier, a kidney cancer survivor who underwent multiple cryoablations, sits down with host Dr. Eric Keller to share his story and raise patient-provider awareness of the positive impacts IR brings. For patients with early-stage cancer, minimally invasive image-guided therapies like cryoablation can be both life-altering and life-saving. Patient Clinton Lanier, a kidney cancer survivor who underwent multiple cryoablations, sits down with host Dr. Eric Keller to share his story and raise patient-provider awareness of the positive impacts IR brings. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Clinton shares his personal story of being diagnosed with a kidney tumor during a sailing trip and discovering cryoablation as a treatment option through his own research and advocacy. He discusses the effectiveness and ease of the procedure, the positive impact it has had on his quality of life, and the importance of raising awareness about cryoablation among patients and healthcare providers. --- TIMESTAMPS 00:00 - Introduction 03:56 - First Cryoablation Experience 05:20 - Patient Experience 09:12 - Cryoablation Awareness 14:44 - Conclusion --- RESOURCES The Interventional Initiative: https://theii.org For patients with early-stage cancer, minimally invasive image-guided therapies like cryoablation can be both life-altering and life-saving. Patient Clinton Lanier, a kidney cancer survivor who underwent multiple cryoablations, sits down with host Dr. Eric Keller to share his story and raise patient-provider awareness of the positive impacts IR brings.


---


This podcast was developed in collaboration with:


Interventional Initiative

https://theii.org/


---


SYNPOSIS


Clinton shares his personal story of being diagnosed with a kidney tumor during a sailing trip and discovering cryoablation as a treatment option through his own research and advocacy. He discusses the effectiveness and ease of the procedure, the positive impact it has had on his quality of life, and the importance of raising awareness about cryoablation among patients and healthcare providers.


---


TIMESTAMPS


00:00 - Introduction

03:56 - First Cryoablation Experience

05:20 - Patient Experience

09:12 - Cryoablation Awareness

14:44 - Conclusion


---


RESOURCES


The Interventional Initiative:

https://theii.org


]]> 1365 Ep. 502 Global Accessibility: Uterine Fibroid Embolization Insights with Dr. Janice Newsome and Dr. Azza Naif How can we make life-changing treatments like uterine fibroid embolization (UFE) more globally accessible? To help answer this question, Dr. Janice Newsome and Dr. Azza Naif share what they’re doing in Tanzania to make UFE a standard option in fibroid care. Dr. Newsome is a Professor at Emory University and Dr. Naif is an IR attending physician at Muhimbili University of Health and Allied Sciences (MUHAS) and a member of the first generation of Tanzanian IR trainees. --- This podcast is supported by: Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SYNPOSIS The doctors focus on patient education, overcoming cultural barriers, training of IR specialists, and the economic aspects of UFE. The discussion highlights the importance of making women’s health treatments accessible worldwide and adapting procedures to fit local resources while maintaining high standards of care. --- TIMESTAMPS 00:00 - Introduction 05:25 - Patient Care in Tanzania 16:28 - Challenges in UFE Adoption 21:38 - Equipment and Techniques for UFE 34:26 - Post-Procedure Follow-Up Care 41:16 - Cost and Accessibility of UFE 47:01 - Future Goals for Fibroid Care --- RESOURCES BackTable VI Podcast Episode #318 - Back on the Road2IR with Dr. Janice Newsome, Dr. Judy Gichoya and Dr. Fabian Laage Gaupp: https://www.backtable.com/shows/vi/podcasts/318/back-on-the-road2ir BackTable VI Podcast Episode #104 - Bringing IR to East Africa: The Road2IR Story with Dr. Fabian Laage Gaupp: https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story Road2IR: https://www.road2ir.org/ Tue, 17 Dec 2024 08:00:00 -0000 full BackTable How can we make life-changing treatments like uterine fibroid embolization (UFE) more globally accessible? To help answer this question, Dr. Janice Newsome and Dr. Azza Naif share what they’re doing in Tanzania to make UFE a standard option in fibroid care. Dr. Newsome is a Professor at Emory University and Dr. Naif is an IR attending physician at Muhimbili University of Health and Allied Sciences (MUHAS) and a member of the first generation of Tanzanian IR trainees. How can we make life-changing treatments like uterine fibroid embolization (UFE) more globally accessible? To help answer this question, Dr. Janice Newsome and Dr. Azza Naif share what they’re doing in Tanzania to make UFE a standard option in fibroid care. Dr. Newsome is a Professor at Emory University and Dr. Naif is an IR attending physician at Muhimbili University of Health and Allied Sciences (MUHAS) and a member of the first generation of Tanzanian IR trainees. --- This podcast is supported by: Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SYNPOSIS The doctors focus on patient education, overcoming cultural barriers, training of IR specialists, and the economic aspects of UFE. The discussion highlights the importance of making women’s health treatments accessible worldwide and adapting procedures to fit local resources while maintaining high standards of care. --- TIMESTAMPS 00:00 - Introduction 05:25 - Patient Care in Tanzania 16:28 - Challenges in UFE Adoption 21:38 - Equipment and Techniques for UFE 34:26 - Post-Procedure Follow-Up Care 41:16 - Cost and Accessibility of UFE 47:01 - Future Goals for Fibroid Care --- RESOURCES BackTable VI Podcast Episode #318 - Back on the Road2IR with Dr. Janice Newsome, Dr. Judy Gichoya and Dr. Fabian Laage Gaupp: https://www.backtable.com/shows/vi/podcasts/318/back-on-the-road2ir BackTable VI Podcast Episode #104 - Bringing IR to East Africa: The Road2IR Story with Dr. Fabian Laage Gaupp: https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story Road2IR: https://www.road2ir.org/ How can we make life-changing treatments like uterine fibroid embolization (UFE) more globally accessible? To help answer this question, Dr. Janice Newsome and Dr. Azza Naif share what they’re doing in Tanzania to make UFE a standard option in fibroid care. Dr. Newsome is a Professor at Emory University and Dr. Naif is an IR attending physician at Muhimbili University of Health and Allied Sciences (MUHAS) and a member of the first generation of Tanzanian IR trainees.


---


This podcast is supported by:


Varian, a Siemens Healthineers company

https://www.varian.com/products/interventional-solutions/embolization-solutions


---


SYNPOSIS


The doctors focus on patient education, overcoming cultural barriers, training of IR specialists, and the economic aspects of UFE. The discussion highlights the importance of making women’s health treatments accessible worldwide and adapting procedures to fit local resources while maintaining high standards of care.


---


TIMESTAMPS


00:00 - Introduction

05:25 - Patient Care in Tanzania

16:28 - Challenges in UFE Adoption

21:38 - Equipment and Techniques for UFE

34:26 - Post-Procedure Follow-Up Care

41:16 - Cost and Accessibility of UFE

47:01 - Future Goals for Fibroid Care


---


RESOURCES


BackTable VI Podcast Episode #318 - Back on the Road2IR with Dr. Janice Newsome, Dr. Judy Gichoya and Dr. Fabian Laage Gaupp:

https://www.backtable.com/shows/vi/podcasts/318/back-on-the-road2ir


BackTable VI Podcast Episode #104 - Bringing IR to East Africa: The Road2IR Story with Dr. Fabian Laage Gaupp:

https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story


Road2IR:

https://www.road2ir.org/

]]> 4213 Ep. 501 Innovative Care Models for Underserved Communities with Dr. Lyssa Ochoa As physicians, we have the unique ability to improve the health and wellbeing of individuals in underserved communities. But even if we possess the drive and the compassion to do so, it can be difficult to know how to take meaningful steps towards addressing local healthcare disparities. In this episode of the BackTable Podcast, Dr. Lyssa Ochoa of the San Antonio Vascular and Endovascular Clinic (SAVE) shares how her clinic improves access to care for underserved patient populations, and how you can emulate her success. --- This podcast is supported by: Philips Image Guided Therapy Solutions https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products --- SYNPOSIS Dr. Ochoa shares her journey from joining a large private practice to founding her own clinic focused on underserved areas in San Antonio. She discusses the importance of addressing social determinants of health, the logistics of running multiple satellite clinics, and her approach to patient care. Dr. Ochoa also emphasizes the need for community engagement and outlines her vision for improving healthcare equity in San Antonio. The conversation highlights the challenges and rewards of providing quality care in economically segregated regions, and offers insights for healthcare providers looking to make a meaningful impact. --- TIMESTAMPS 00:00 - Introduction 03:23 - Addressing Social Determinants of Health 05:20 - Innovative Approaches to Healthcare Delivery 08:46 - Challenges and Strategies in Underserved Areas 15:16 - Building Community Trust and Referrals 22:27 - Advice for New Practitioners 29:42 - Future Vision for Healthcare in San Antonio 32:07 - Resources -- DISCLAIMER Dr. Lyssa Ochoa is a consultant for Philips and was requested to provide their services in preparing and presenting this material for Philips. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations. Tue, 10 Dec 2024 08:00:00 -0000 full BackTable As physicians, we have the unique ability to improve the health and wellbeing of individuals in underserved communities. But even if we possess the drive and the compassion to do so, it can be difficult to know how to take meaningful steps towards addressing local healthcare disparities. In this episode of the BackTable Podcast, Dr. Lisa Ochoa of the San Antonio Vascular and Endovascular Clinic (SAVE) shares how her clinic improves access to care for underserved patient populations, and how you can emulate her success. As physicians, we have the unique ability to improve the health and wellbeing of individuals in underserved communities. But even if we possess the drive and the compassion to do so, it can be difficult to know how to take meaningful steps towards addressing local healthcare disparities. In this episode of the BackTable Podcast, Dr. Lyssa Ochoa of the San Antonio Vascular and Endovascular Clinic (SAVE) shares how her clinic improves access to care for underserved patient populations, and how you can emulate her success. --- This podcast is supported by: Philips Image Guided Therapy Solutions https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products --- SYNPOSIS Dr. Ochoa shares her journey from joining a large private practice to founding her own clinic focused on underserved areas in San Antonio. She discusses the importance of addressing social determinants of health, the logistics of running multiple satellite clinics, and her approach to patient care. Dr. Ochoa also emphasizes the need for community engagement and outlines her vision for improving healthcare equity in San Antonio. The conversation highlights the challenges and rewards of providing quality care in economically segregated regions, and offers insights for healthcare providers looking to make a meaningful impact. --- TIMESTAMPS 00:00 - Introduction 03:23 - Addressing Social Determinants of Health 05:20 - Innovative Approaches to Healthcare Delivery 08:46 - Challenges and Strategies in Underserved Areas 15:16 - Building Community Trust and Referrals 22:27 - Advice for New Practitioners 29:42 - Future Vision for Healthcare in San Antonio 32:07 - Resources -- DISCLAIMER Dr. Lyssa Ochoa is a consultant for Philips and was requested to provide their services in preparing and presenting this material for Philips. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations. As physicians, we have the unique ability to improve the health and wellbeing of individuals in underserved communities. But even if we possess the drive and the compassion to do so, it can be difficult to know how to take meaningful steps towards addressing local healthcare disparities. In this episode of the BackTable Podcast, Dr. Lyssa Ochoa of the San Antonio Vascular and Endovascular Clinic (SAVE) shares how her clinic improves access to care for underserved patient populations, and how you can emulate her success.


---


This podcast is supported by:


Philips Image Guided Therapy Solutions

https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products


---


SYNPOSIS


Dr. Ochoa shares her journey from joining a large private practice to founding her own clinic focused on underserved areas in San Antonio. She discusses the importance of addressing social determinants of health, the logistics of running multiple satellite clinics, and her approach to patient care. Dr. Ochoa also emphasizes the need for community engagement and outlines her vision for improving healthcare equity in San Antonio. The conversation highlights the challenges and rewards of providing quality care in economically segregated regions, and offers insights for healthcare providers looking to make a meaningful impact.


---


TIMESTAMPS


00:00 - Introduction

03:23 - Addressing Social Determinants of Health

05:20 - Innovative Approaches to Healthcare Delivery

08:46 - Challenges and Strategies in Underserved Areas

15:16 - Building Community Trust and Referrals

22:27 - Advice for New Practitioners

29:42 - Future Vision for Healthcare in San Antonio

32:07 - Resources


--


DISCLAIMER


Dr. Lyssa Ochoa is a consultant for Philips and was requested to provide their services in preparing and presenting this material for Philips. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations.

]]> 2147 Ep. 500 Celebrating 500 Episodes of BackTable with the BT Hosts 500 episodes of BackTable calls for a special reunion! The original hosts—Dr. Aaron Fritts, Dr. Chris Beck, Dr. Ally Baheti, Dr. Sabeen Dhand, Dr. Mike Barraza, and producer Kieran Gannon—come together to celebrate by reminiscing about the podcast’s origins and evolution. They discuss the challenges of improving the podcast, share funny behind-the-scenes moments, and highlight their favorite episodes. The team also offers insights into how they choose topics and reflects on their experiences with both virtual and in-person recordings. Finally, they introduce the new BackTable Studio and highlight the upcoming Creator Weekends. --- SYNPOSIS To our BackTable community, thank you for tuning in every week. We look forward to continuing to serve your vascular and interventional education needs! --- TIMESTAMPS 00:00 Introduction 01:43 The Origin Story of Backtable 06:42 From Our Side of the Microphone: Hosting Episodes 25:57 Choosing Topics and Guests 32:55 Introducing the New BackTable Studio 38:27 Favorite Episodes and Memorable Moments 44:02 The Story Behind the Backtable Theme Music 47:49 The Iconic Backtable Hoodies 51:03 Closing Thoughts and Gratitude --- RESOURCES BackTable Special 100th Episode Interview: https://www.backtable.com/shows/vi/podcasts/special/special-100th-episode-interview-with-backtable Fri, 06 Dec 2024 08:00:00 -0000 full BackTable 500 episodes of BackTable calls for a special reunion! The original hosts—Dr. Aaron Fritts, Dr. Chris Beck, Dr. Ally Baheti, Dr. Sabeen Dhand, Dr. Mike Barraza, and producer Kieran Gannon—come together to celebrate by reminiscing about the podcast’s origins and evolution. They discuss the challenges of improving the podcast, share funny behind-the-scenes moments, and highlight their favorite episodes. The team also offers insights into how they choose topics and reflects on their experiences with both virtual and in-person recordings. Finally, they introduce the new BackTable Studio and highlight the upcoming Creator Weekends. 500 episodes of BackTable calls for a special reunion! The original hosts—Dr. Aaron Fritts, Dr. Chris Beck, Dr. Ally Baheti, Dr. Sabeen Dhand, Dr. Mike Barraza, and producer Kieran Gannon—come together to celebrate by reminiscing about the podcast’s origins and evolution. They discuss the challenges of improving the podcast, share funny behind-the-scenes moments, and highlight their favorite episodes. The team also offers insights into how they choose topics and reflects on their experiences with both virtual and in-person recordings. Finally, they introduce the new BackTable Studio and highlight the upcoming Creator Weekends. --- SYNPOSIS To our BackTable community, thank you for tuning in every week. We look forward to continuing to serve your vascular and interventional education needs! --- TIMESTAMPS 00:00 Introduction 01:43 The Origin Story of Backtable 06:42 From Our Side of the Microphone: Hosting Episodes 25:57 Choosing Topics and Guests 32:55 Introducing the New BackTable Studio 38:27 Favorite Episodes and Memorable Moments 44:02 The Story Behind the Backtable Theme Music 47:49 The Iconic Backtable Hoodies 51:03 Closing Thoughts and Gratitude --- RESOURCES BackTable Special 100th Episode Interview: https://www.backtable.com/shows/vi/podcasts/special/special-100th-episode-interview-with-backtable 500 episodes of BackTable calls for a special reunion! The original hosts—Dr. Aaron Fritts, Dr. Chris Beck, Dr. Ally Baheti, Dr. Sabeen Dhand, Dr. Mike Barraza, and producer Kieran Gannon—come together to celebrate by reminiscing about the podcast’s origins and evolution. They discuss the challenges of improving the podcast, share funny behind-the-scenes moments, and highlight their favorite episodes. The team also offers insights into how they choose topics and reflects on their experiences with both virtual and in-person recordings. Finally, they introduce the new BackTable Studio and highlight the upcoming Creator Weekends.


---


SYNPOSIS


To our BackTable community, thank you for tuning in every week. We look forward to continuing to serve your vascular and interventional education needs!


---


TIMESTAMPS


00:00 Introduction

01:43 The Origin Story of Backtable

06:42 From Our Side of the Microphone: Hosting Episodes

25:57 Choosing Topics and Guests

32:55 Introducing the New BackTable Studio

38:27 Favorite Episodes and Memorable Moments

44:02 The Story Behind the Backtable Theme Music

47:49 The Iconic Backtable Hoodies

51:03 Closing Thoughts and Gratitude



---


RESOURCES


BackTable Special 100th Episode Interview: https://www.backtable.com/shows/vi/podcasts/special/special-100th-episode-interview-with-backtable

]]> 3294 Ep. 499 Tips and Tricks for Techs in the OBL with Lake Odom IR technologists are a valuable part of the interventional team due to their technical expertise and hands-on contributions to patient and provider safety. Lake Odom, a seasoned IR tech with over 14 years of experience, sits down with host Dr. Ally Baheti to share his wisdom from his time in hospital-based and outpatient care settings. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Lake begins by describing his unconventional career path, the importance of passion in profession, and how he started his consulting businesses: IR Tech Tips and Image Guided Consultants. Lake also speaks on transitioning from the hospital to the outpatient-based lab (OBL) setting, and highlights key aspects of the tech’s role, including inventory management, patient workflow, and building efficient systems. The significance of understanding the financial intricacies within OBLs, common inefficiencies, and strategies to foster a culture of accountability and teamwork are also discussed. The episode provides valuable insights for IR technologists and other professionals seeking to improve their practices and operate at maximum potential. --- TIMESTAMPS 00:00 - Introduction 06:55 - Image Guided Consultants 12:07 - Improving Practice Efficiency 17:51 - Daily IR Tech Responsibilities 20:56 - Inventory Management and Preparedness 28:03 - Building Trust and Credibility --- RESOURCES BackTable Ep. 130- Technologist Training & Retention with Andrew Struchen and Alisha Hawrylack: https://www.backtable.com/shows/vi/podcasts/130/technologist-training-retention Image Guided Consultants: https://igsconsults.com/ IR Tech Tips Course: https://irtechtips.teachable.com/ Tue, 03 Dec 2024 08:00:00 -0000 full BackTable IR technologists are a valuable part of the interventional team due to their technical expertise and hands-on contributions to patient and provider safety. Lake Odom, a seasoned IR tech with over 14 years of experience, sits down with host Dr. Ally Baheti to share his wisdom from his time in hospital-based and outpatient care settings. IR technologists are a valuable part of the interventional team due to their technical expertise and hands-on contributions to patient and provider safety. Lake Odom, a seasoned IR tech with over 14 years of experience, sits down with host Dr. Ally Baheti to share his wisdom from his time in hospital-based and outpatient care settings. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Lake begins by describing his unconventional career path, the importance of passion in profession, and how he started his consulting businesses: IR Tech Tips and Image Guided Consultants. Lake also speaks on transitioning from the hospital to the outpatient-based lab (OBL) setting, and highlights key aspects of the tech’s role, including inventory management, patient workflow, and building efficient systems. The significance of understanding the financial intricacies within OBLs, common inefficiencies, and strategies to foster a culture of accountability and teamwork are also discussed. The episode provides valuable insights for IR technologists and other professionals seeking to improve their practices and operate at maximum potential. --- TIMESTAMPS 00:00 - Introduction 06:55 - Image Guided Consultants 12:07 - Improving Practice Efficiency 17:51 - Daily IR Tech Responsibilities 20:56 - Inventory Management and Preparedness 28:03 - Building Trust and Credibility --- RESOURCES BackTable Ep. 130- Technologist Training & Retention with Andrew Struchen and Alisha Hawrylack: https://www.backtable.com/shows/vi/podcasts/130/technologist-training-retention Image Guided Consultants: https://igsconsults.com/ IR Tech Tips Course: https://irtechtips.teachable.com/ IR technologists are a valuable part of the interventional team due to their technical expertise and hands-on contributions to patient and provider safety. Lake Odom, a seasoned IR tech with over 14 years of experience, sits down with host Dr. Ally Baheti to share his wisdom from his time in hospital-based and outpatient care settings.


---


This podcast is supported by:


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


Lake begins by describing his unconventional career path, the importance of passion in profession, and how he started his consulting businesses: IR Tech Tips and Image Guided Consultants. Lake also speaks on transitioning from the hospital to the outpatient-based lab (OBL) setting, and highlights key aspects of the tech’s role, including inventory management, patient workflow, and building efficient systems. The significance of understanding the financial intricacies within OBLs, common inefficiencies, and strategies to foster a culture of accountability and teamwork are also discussed. The episode provides valuable insights for IR technologists and other professionals seeking to improve their practices and operate at maximum potential.


---


TIMESTAMPS


00:00 - Introduction

06:55 - Image Guided Consultants

12:07 - Improving Practice Efficiency

17:51 - Daily IR Tech Responsibilities

20:56 - Inventory Management and Preparedness

28:03 - Building Trust and Credibility


---


RESOURCES


BackTable Ep. 130- Technologist Training & Retention with Andrew Struchen and Alisha Hawrylack: https://www.backtable.com/shows/vi/podcasts/130/technologist-training-retention


Image Guided Consultants:

https://igsconsults.com/


IR Tech Tips Course:

https://irtechtips.teachable.com/


]]> 2356 Ep. 498 Advanced Techniques in Cone Beam CT with Dr. Michael Miller Cone Beam CT has become a cornerstone of modern interventional practice. Are you utilizing it to its fullest potential? Dr. Michael Miller joins host Dr. Chris Beck to discuss Cone Beam CT, sharing advanced techniques and clinical pearls. Dr. Miller is an interventional radiologist and Associate Professor of Radiology at Atrium Health, Wake Forest Baptist Hospital, North Carolina. --- This podcast is supported by: GE Healthcare Allia Image Guided Systems https://www.gehealthcare.com/products/interventional-image-guided-systems/allia --- SYNPOSIS Dr. Miller explains the importance of fundamental training and how fundamentals can be scaled across various procedures to improve outcomes, including vascular malformations and endoleaks. Dr. Miller then speaks to best practices that he has learned firsthand through his years of using Cone Beam CT. The doctors also touch on tips for setting up the IR suite and collaborating with anesthesia. --- TIMESTAMPS 00:00 - Introduction 07:22 - Advanced Uses of Cone Beam CT 15:04 - Setup and Best Practices 22:34 - Vascular Malformations 23:32 - Understanding Sclerosant Distribution 26:53 - Trajectory Guidance in Complex Cases 32:45 - Contrast Bolus Timing and Spin Techniques 40:16 - Advice for New Angio Suites --- RESOURCES BackTable VI Podcast Episode #51 - Cone Beam CT Techniques with Dr. Austin Bourgeois: https://www.backtable.com/shows/vi/podcasts/51/cone-beam-ct-techniques Shujaat, S., Alfadley, A., Morgan, N., Jamleh, A., Riaz, M., Aboalela, A.A., Jacobs, R., 2024. Emergence of artificial intelligence for automating cone-beam computed tomography-derived maxillary sinus imaging tasks. A systematic review. Clin Implant Dent Relat Res 26, 899–912. https://doi.org/10.1111/cid.13352 Orth, R.C., Wallace, M.J., Kuo, M.D., Technology Assessment Committee of the Society of Interventional Radiology, 2009. C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 20, S538-544. https://doi.org/10.1016/j.jvir.2009.04.026 Bapst, B., Lagadec, M., Breguet, R., Vilgrain, V., Ronot, M., 2016. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver. Cardiovasc Intervent Radiol 39, 8–20. https://doi.org/10.1007/s00270-015-1180-6 Wallace, M.J., Kuo, M.D., Glaiberman, C., Binkert, C.A., Orth, R.C., Soulez, G., Technology Assessment Committee of the Society of Interventional Radiology, 2008. Three-dimensional C-arm cone-beam CT: applications in the interventional suite. J Vasc Interv Radiol 19, 799–813. https://doi.org/10.1016/j.jvir.2008.02.018 Bm, K., Sm, T., Mj, S., 2023. Cone-Beam CT With Enhanced Needle Guidance and Augmented Fluoroscopy Overlay: Applications in Interventional Radiology. AJR. American journal of roentgenology 221. https://doi.org/10.2214/AJR.22.28712 Kwok, Y.M., Irani, F.G., Tay, K.H., Yang, C.C., Padre, C.G., Tan, B.S., 2013. Effective dose estimates for cone beam computed tomography in interventional radiology. Eur Radiol 23, 3197–3204. https://doi.org/10.1007/s00330-013-2934-7 Tue, 26 Nov 2024 08:00:00 -0000 full BackTable Cone Beam CT has become a cornerstone of modern interventional practice. Are you utilizing it to its fullest potential? Dr. Michael Miller joins host Dr. Chris Beck to discuss Cone Beam CT, sharing advanced techniques and clinical pearls. Dr. Miller is an interventional radiologist and Associate Professor of Radiology at Atrium Health, Wake Forest Baptist Hospital, North Carolina. Cone Beam CT has become a cornerstone of modern interventional practice. Are you utilizing it to its fullest potential? Dr. Michael Miller joins host Dr. Chris Beck to discuss Cone Beam CT, sharing advanced techniques and clinical pearls. Dr. Miller is an interventional radiologist and Associate Professor of Radiology at Atrium Health, Wake Forest Baptist Hospital, North Carolina. --- This podcast is supported by: GE Healthcare Allia Image Guided Systems https://www.gehealthcare.com/products/interventional-image-guided-systems/allia --- SYNPOSIS Dr. Miller explains the importance of fundamental training and how fundamentals can be scaled across various procedures to improve outcomes, including vascular malformations and endoleaks. Dr. Miller then speaks to best practices that he has learned firsthand through his years of using Cone Beam CT. The doctors also touch on tips for setting up the IR suite and collaborating with anesthesia. --- TIMESTAMPS 00:00 - Introduction 07:22 - Advanced Uses of Cone Beam CT 15:04 - Setup and Best Practices 22:34 - Vascular Malformations 23:32 - Understanding Sclerosant Distribution 26:53 - Trajectory Guidance in Complex Cases 32:45 - Contrast Bolus Timing and Spin Techniques 40:16 - Advice for New Angio Suites --- RESOURCES BackTable VI Podcast Episode #51 - Cone Beam CT Techniques with Dr. Austin Bourgeois: https://www.backtable.com/shows/vi/podcasts/51/cone-beam-ct-techniques Shujaat, S., Alfadley, A., Morgan, N., Jamleh, A., Riaz, M., Aboalela, A.A., Jacobs, R., 2024. Emergence of artificial intelligence for automating cone-beam computed tomography-derived maxillary sinus imaging tasks. A systematic review. Clin Implant Dent Relat Res 26, 899–912. https://doi.org/10.1111/cid.13352 Orth, R.C., Wallace, M.J., Kuo, M.D., Technology Assessment Committee of the Society of Interventional Radiology, 2009. C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 20, S538-544. https://doi.org/10.1016/j.jvir.2009.04.026 Bapst, B., Lagadec, M., Breguet, R., Vilgrain, V., Ronot, M., 2016. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver. Cardiovasc Intervent Radiol 39, 8–20. https://doi.org/10.1007/s00270-015-1180-6 Wallace, M.J., Kuo, M.D., Glaiberman, C., Binkert, C.A., Orth, R.C., Soulez, G., Technology Assessment Committee of the Society of Interventional Radiology, 2008. Three-dimensional C-arm cone-beam CT: applications in the interventional suite. J Vasc Interv Radiol 19, 799–813. https://doi.org/10.1016/j.jvir.2008.02.018 Bm, K., Sm, T., Mj, S., 2023. Cone-Beam CT With Enhanced Needle Guidance and Augmented Fluoroscopy Overlay: Applications in Interventional Radiology. AJR. American journal of roentgenology 221. https://doi.org/10.2214/AJR.22.28712 Kwok, Y.M., Irani, F.G., Tay, K.H., Yang, C.C., Padre, C.G., Tan, B.S., 2013. Effective dose estimates for cone beam computed tomography in interventional radiology. Eur Radiol 23, 3197–3204. https://doi.org/10.1007/s00330-013-2934-7 Cone Beam CT has become a cornerstone of modern interventional practice. Are you utilizing it to its fullest potential? Dr. Michael Miller joins host Dr. Chris Beck to discuss Cone Beam CT, sharing advanced techniques and clinical pearls. Dr. Miller is an interventional radiologist and Associate Professor of Radiology at Atrium Health, Wake Forest Baptist Hospital, North Carolina.


---


This podcast is supported by:


GE Healthcare Allia Image Guided Systems

https://www.gehealthcare.com/products/interventional-image-guided-systems/allia


---


SYNPOSIS


Dr. Miller explains the importance of fundamental training and how fundamentals can be scaled across various procedures to improve outcomes, including vascular malformations and endoleaks. Dr. Miller then speaks to best practices that he has learned firsthand through his years of using Cone Beam CT. The doctors also touch on tips for setting up the IR suite and collaborating with anesthesia.


---


TIMESTAMPS


00:00 - Introduction

07:22 - Advanced Uses of Cone Beam CT

15:04 - Setup and Best Practices

22:34 - Vascular Malformations

23:32 - Understanding Sclerosant Distribution

26:53 - Trajectory Guidance in Complex Cases

32:45 - Contrast Bolus Timing and Spin Techniques

40:16 - Advice for New Angio Suites


---


RESOURCES


BackTable VI Podcast Episode #51 - Cone Beam CT Techniques with Dr. Austin Bourgeois:

https://www.backtable.com/shows/vi/podcasts/51/cone-beam-ct-techniques


Shujaat, S., Alfadley, A., Morgan, N., Jamleh, A., Riaz, M., Aboalela, A.A., Jacobs, R., 2024. Emergence of artificial intelligence for automating cone-beam computed tomography-derived maxillary sinus imaging tasks. A systematic review. Clin Implant Dent Relat Res 26, 899–912. https://doi.org/10.1111/cid.13352


Orth, R.C., Wallace, M.J., Kuo, M.D., Technology Assessment Committee of the Society of Interventional Radiology, 2009. C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 20, S538-544. https://doi.org/10.1016/j.jvir.2009.04.026


Bapst, B., Lagadec, M., Breguet, R., Vilgrain, V., Ronot, M., 2016. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver. Cardiovasc Intervent Radiol 39, 8–20. https://doi.org/10.1007/s00270-015-1180-6


Wallace, M.J., Kuo, M.D., Glaiberman, C., Binkert, C.A., Orth, R.C., Soulez, G., Technology Assessment Committee of the Society of Interventional Radiology, 2008. Three-dimensional C-arm cone-beam CT: applications in the interventional suite. J Vasc Interv Radiol 19, 799–813. https://doi.org/10.1016/j.jvir.2008.02.018


Bm, K., Sm, T., Mj, S., 2023. Cone-Beam CT With Enhanced Needle Guidance and Augmented Fluoroscopy Overlay: Applications in Interventional Radiology. AJR. American journal of roentgenology 221. https://doi.org/10.2214/AJR.22.28712


Kwok, Y.M., Irani, F.G., Tay, K.H., Yang, C.C., Padre, C.G., Tan, B.S., 2013. Effective dose estimates for cone beam computed tomography in interventional radiology. Eur Radiol 23, 3197–3204. https://doi.org/10.1007/s00330-013-2934-7

]]> 2985 Ep. 497 Essential Guide to Varicocele Embolization with Dr. John Matson Varicoceles embolization is the least invasive treatment option for varicoceles, making it the favored option for most patients and a staple in the interventional radiologist’s procedural repertoire. Dr. John Matson joins host Dr. Ally Baheti to give us an essential guide to varicocele embolization, serving as an introduction for junior IRs and refresher for the more experienced. Dr. Matson is an Assistant Professor of Interventional Radiology at University of Virginia. --- RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Mattson covers the indications, procedural setup, technique variations, and post-procedure follow-up for treating varicoceles, with specific attention to the different embolic materials used in clinical practice. He also delves into the importance of pre-procedure evaluations, imaging requirements, and managing potential complications. --- TIMESTAMPS 00:00 - Introduction 02:05 - Indications for Varicocele Embolization 06:05 - Procedure Setup and Execution 12:57 - Coil Sizing and Embolic Materials 17:36 - Managing Complications 20:25 - Post-Procedure Care and Follow-Up Fri, 22 Nov 2024 08:00:00 -0000 full BackTable Varicoceles embolization is the least invasive treatment option for varicoceles, making it the favored option for most patients and a staple in the interventional radiologist’s procedural repertoire. Dr. John Matson joins host Dr. Ally Baheti to give us an essential guide to varicocele embolization, serving as an introduction for junior IRs and refresher for the more experienced. Dr. Matson is an Assistant Professor of Interventional Radiology at University of Virginia. Varicoceles embolization is the least invasive treatment option for varicoceles, making it the favored option for most patients and a staple in the interventional radiologist’s procedural repertoire. Dr. John Matson joins host Dr. Ally Baheti to give us an essential guide to varicocele embolization, serving as an introduction for junior IRs and refresher for the more experienced. Dr. Matson is an Assistant Professor of Interventional Radiology at University of Virginia. --- RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Mattson covers the indications, procedural setup, technique variations, and post-procedure follow-up for treating varicoceles, with specific attention to the different embolic materials used in clinical practice. He also delves into the importance of pre-procedure evaluations, imaging requirements, and managing potential complications. --- TIMESTAMPS 00:00 - Introduction 02:05 - Indications for Varicocele Embolization 06:05 - Procedure Setup and Execution 12:57 - Coil Sizing and Embolic Materials 17:36 - Managing Complications 20:25 - Post-Procedure Care and Follow-Up Varicoceles embolization is the least invasive treatment option for varicoceles, making it the favored option for most patients and a staple in the interventional radiologist’s procedural repertoire. Dr. John Matson joins host Dr. Ally Baheti to give us an essential guide to varicocele embolization, serving as an introduction for junior IRs and refresher for the more experienced. Dr. Matson is an Assistant Professor of Interventional Radiology at University of Virginia.


---


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


Dr. Mattson covers the indications, procedural setup, technique variations, and post-procedure follow-up for treating varicoceles, with specific attention to the different embolic materials used in clinical practice. He also delves into the importance of pre-procedure evaluations, imaging requirements, and managing potential complications.


---


TIMESTAMPS


00:00 - Introduction

02:05 - Indications for Varicocele Embolization

06:05 - Procedure Setup and Execution

12:57 - Coil Sizing and Embolic Materials

17:36 - Managing Complications

20:25 - Post-Procedure Care and Follow-Up

]]> 1480 Ep. 496 Ensuring Safety and Quality in ASCs with Kristen Richards Interested in setting up an Ambulatory Surgery Center (ASC) or Outpatient Based Lab (OBL)? Special guest Kristen Richards sits down with host Dr. Aaron Fritts to discuss the importance of establishing and tracking safety and quality metrics in the outpatient space to achieve success. Kristen is Vice President of Ambulatory Care at Cardiovascular Logistics in Chicago, IL. --- This podcast is supported by: Philips Image Guided Therapy Solutions https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products --- SYNPOSIS Kristen shares insights from her experience in the cardiovascular ambulatory space, highlighting the necessity of patient safety, efficient care, and the benefits of outpatient settings over hospital environments. Patient selection, infection control, staff and physician satisfaction, economic drivers, and the future outlook for cardiovascular procedures in ASCs are some of the key topics discussed. Kristen also emphasizes the need for continuous data tracking to demonstrate and improve the quality of care provided in these centers. --- TIMESTAMPS 00:00 - Introduction 06:25 - Benefits of Out-of-Hospital Care 17:47 - Financial Incentives and Ownership Models 18:17 - Technological Advancements and Cost Reduction 25:00 - Considerations for Opening an ASC 31:58 - Importance of Quality Metrics --- RESOURCES BackTable VI Podcast Episode #366 Navigating OBL & ASC Business: Pitfalls to Avoid with Teri Yates https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid BackTable VI Podcast Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates https://www.backtable.com/shows/vi/podcasts/431/obl-or-asc-for-your-private-practice-how-to-decide BackTable VI Podcast Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates https://www.backtable.com/shows/vi/podcasts/486/winning-the-revenue-cycle-game Outpatient Endovascular and Interventional Society (OEIS) 2025 Conference: https://oeisweb.com/ Cardiovascular Business: https://cardiovascularbusiness.com/ SCAI: https://scai.org/ --- DISCLAIMER Kristen Richards is a consultant for Philips. She has been compensated by Philips for their services in preparing and presenting this material. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations. Tue, 19 Nov 2024 08:00:00 -0000 full BackTable Interested in setting up an Ambulatory Surgery Center (ASC) or Outpatient Based Lab (OBL)? Special guest Kristen Richards sits down with host Dr. Aaron Fritts to discuss the importance of establishing and tracking safety and quality metrics in the outpatient space to achieve success. Kristen is Vice President of Ambulatory Care at Cardiovascular Logistics in Chicago, IL. Interested in setting up an Ambulatory Surgery Center (ASC) or Outpatient Based Lab (OBL)? Special guest Kristen Richards sits down with host Dr. Aaron Fritts to discuss the importance of establishing and tracking safety and quality metrics in the outpatient space to achieve success. Kristen is Vice President of Ambulatory Care at Cardiovascular Logistics in Chicago, IL. --- This podcast is supported by: Philips Image Guided Therapy Solutions https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products --- SYNPOSIS Kristen shares insights from her experience in the cardiovascular ambulatory space, highlighting the necessity of patient safety, efficient care, and the benefits of outpatient settings over hospital environments. Patient selection, infection control, staff and physician satisfaction, economic drivers, and the future outlook for cardiovascular procedures in ASCs are some of the key topics discussed. Kristen also emphasizes the need for continuous data tracking to demonstrate and improve the quality of care provided in these centers. --- TIMESTAMPS 00:00 - Introduction 06:25 - Benefits of Out-of-Hospital Care 17:47 - Financial Incentives and Ownership Models 18:17 - Technological Advancements and Cost Reduction 25:00 - Considerations for Opening an ASC 31:58 - Importance of Quality Metrics --- RESOURCES BackTable VI Podcast Episode #366 Navigating OBL & ASC Business: Pitfalls to Avoid with Teri Yates https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid BackTable VI Podcast Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates https://www.backtable.com/shows/vi/podcasts/431/obl-or-asc-for-your-private-practice-how-to-decide BackTable VI Podcast Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates https://www.backtable.com/shows/vi/podcasts/486/winning-the-revenue-cycle-game Outpatient Endovascular and Interventional Society (OEIS) 2025 Conference: https://oeisweb.com/ Cardiovascular Business: https://cardiovascularbusiness.com/ SCAI: https://scai.org/ --- DISCLAIMER Kristen Richards is a consultant for Philips. She has been compensated by Philips for their services in preparing and presenting this material. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations. Interested in setting up an Ambulatory Surgery Center (ASC) or Outpatient Based Lab (OBL)? Special guest Kristen Richards sits down with host Dr. Aaron Fritts to discuss the importance of establishing and tracking safety and quality metrics in the outpatient space to achieve success. Kristen is Vice President of Ambulatory Care at Cardiovascular Logistics in Chicago, IL.


---


This podcast is supported by:


Philips Image Guided Therapy Solutions

https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products


---


SYNPOSIS


Kristen shares insights from her experience in the cardiovascular ambulatory space, highlighting the necessity of patient safety, efficient care, and the benefits of outpatient settings over hospital environments. Patient selection, infection control, staff and physician satisfaction, economic drivers, and the future outlook for cardiovascular procedures in ASCs are some of the key topics discussed. Kristen also emphasizes the need for continuous data tracking to demonstrate and improve the quality of care provided in these centers.


---


TIMESTAMPS


00:00 - Introduction

06:25 - Benefits of Out-of-Hospital Care

17:47 - Financial Incentives and Ownership Models

18:17 - Technological Advancements and Cost Reduction

25:00 - Considerations for Opening an ASC

31:58 - Importance of Quality Metrics



---


RESOURCES


BackTable VI Podcast Episode #366

Navigating OBL & ASC Business: Pitfalls to Avoid with Teri Yates

https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid


BackTable VI Podcast Episode #431

OBL or ASC for Your Private Practice? How to Decide with Teri Yates

https://www.backtable.com/shows/vi/podcasts/431/obl-or-asc-for-your-private-practice-how-to-decide


BackTable VI Podcast Episode #431

OBL or ASC for Your Private Practice? How to Decide with Teri Yates

https://www.backtable.com/shows/vi/podcasts/486/winning-the-revenue-cycle-game


Outpatient Endovascular and Interventional Society (OEIS) 2025 Conference:

https://oeisweb.com/


Cardiovascular Business:

https://cardiovascularbusiness.com/


SCAI:

https://scai.org/


---


DISCLAIMER


Kristen Richards is a consultant for Philips. She has been compensated by Philips for their services in preparing and presenting this material. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations.

]]> 2241 Ep. 495 Microwave Ablation Techniques: Dr. Ed Kim's Approach Is your microwave ablation technique up to date? Dr. Ed Kim sits down with guest-host Dr. Kavi Krishnasamy to explore cutting-edge techniques in tumor ablation, with a focus on hepatocellular carcinoma (HCC) treatment with microwave. Dr. Ed Kim is the Director of Interventional Oncology and Professor of Radiology and Surgery in the Division of Vascular and Interventional Radiology at the Mount Sinai Medical Center. --- This podcast is supported by an educational grant from Varian, a Siemens Healthineers company. --- SYNPOSIS The doctors discuss microwave ablation, radiation segmentectomy, and the decision-making algorithms for choosing appropriate procedures based on lesion characteristics. Dr. Kim touches on the complexities of ablation near the diaphragm and subcapsular lesions, emphasizing the impact of practitioner skill and experience on outcomes. Recent advancements in ablation technologies, software, and device-specific versus device-agnostic applications are also highlighted, along with the importance of post-contrast scans and ultrasound skills. Dr. Kim also delves into emerging technologies such as HistoSonics, augmented reality/virtual reality, and immunotherapy synergies. The doctors underscore the need for a multidisciplinary approach for optimizing patient outcomes and pushing the field toward future innovations. --- TIMESTAMPS 00:00 - Introduction 04:28 - Standardizing Ablation Algorithms 07:51 - Suboptimal Lesion Locations 13:06 - Device Selection and Properties 22:49 - Ablation Planning Software 32:53 - Real-Time Visualization 44:48 - Biopsy and Ablation Techniques 52:14 - Future of Ablation Technology --- RESOURCES Dr. Ed Kim’s Publications: https://scholars.mssm.edu/en/persons/edward-kim ACCLAIM Trial: https://www.sio-central.org/ACCLAIM-Trial A multicenter randomized controlled trial to evaluate the efficacy of surgery versus radiofrequency ablation for small hepatocellular carcinoma (SURF trial): Analysis of overall survival: https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.4093 Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial. https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501 SIR welcomes results of COLLISION Trial, presented at the 2024 ASCO Annual Meeting: https://www.sirweb.org/media-and-pubs/media/news-release-archive/collision-trial-06032024/ HistoSonics: https://histosonics.com/ Tue, 12 Nov 2024 08:00:00 -0000 full BackTable Is your microwave ablation technique up to date? Dr. Ed Kim sits down with guest-host Dr. Kavi Krishnasamy to explore cutting-edge techniques in tumor ablation, with a focus on hepatocellular carcinoma (HCC) treatment with microwave. Dr. Ed Kim is the Director of Interventional Oncology and Professor of Radiology and Surgery in the Division of Vascular and Interventional Radiology at the Mount Sinai Medical Center. Is your microwave ablation technique up to date? Dr. Ed Kim sits down with guest-host Dr. Kavi Krishnasamy to explore cutting-edge techniques in tumor ablation, with a focus on hepatocellular carcinoma (HCC) treatment with microwave. Dr. Ed Kim is the Director of Interventional Oncology and Professor of Radiology and Surgery in the Division of Vascular and Interventional Radiology at the Mount Sinai Medical Center. --- This podcast is supported by an educational grant from Varian, a Siemens Healthineers company. --- SYNPOSIS The doctors discuss microwave ablation, radiation segmentectomy, and the decision-making algorithms for choosing appropriate procedures based on lesion characteristics. Dr. Kim touches on the complexities of ablation near the diaphragm and subcapsular lesions, emphasizing the impact of practitioner skill and experience on outcomes. Recent advancements in ablation technologies, software, and device-specific versus device-agnostic applications are also highlighted, along with the importance of post-contrast scans and ultrasound skills. Dr. Kim also delves into emerging technologies such as HistoSonics, augmented reality/virtual reality, and immunotherapy synergies. The doctors underscore the need for a multidisciplinary approach for optimizing patient outcomes and pushing the field toward future innovations. --- TIMESTAMPS 00:00 - Introduction 04:28 - Standardizing Ablation Algorithms 07:51 - Suboptimal Lesion Locations 13:06 - Device Selection and Properties 22:49 - Ablation Planning Software 32:53 - Real-Time Visualization 44:48 - Biopsy and Ablation Techniques 52:14 - Future of Ablation Technology --- RESOURCES Dr. Ed Kim’s Publications: https://scholars.mssm.edu/en/persons/edward-kim ACCLAIM Trial: https://www.sio-central.org/ACCLAIM-Trial A multicenter randomized controlled trial to evaluate the efficacy of surgery versus radiofrequency ablation for small hepatocellular carcinoma (SURF trial): Analysis of overall survival: https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.4093 Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial. https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501 SIR welcomes results of COLLISION Trial, presented at the 2024 ASCO Annual Meeting: https://www.sirweb.org/media-and-pubs/media/news-release-archive/collision-trial-06032024/ HistoSonics: https://histosonics.com/ Is your microwave ablation technique up to date? Dr. Ed Kim sits down with guest-host Dr. Kavi Krishnasamy to explore cutting-edge techniques in tumor ablation, with a focus on hepatocellular carcinoma (HCC) treatment with microwave. Dr. Ed Kim is the Director of Interventional Oncology and Professor of Radiology and Surgery in the Division of Vascular and Interventional Radiology at the Mount Sinai Medical Center.


---


This podcast is supported by an educational grant from Varian, a Siemens Healthineers company.


---


SYNPOSIS


The doctors discuss microwave ablation, radiation segmentectomy, and the decision-making algorithms for choosing appropriate procedures based on lesion characteristics. Dr. Kim touches on the complexities of ablation near the diaphragm and subcapsular lesions, emphasizing the impact of practitioner skill and experience on outcomes. Recent advancements in ablation technologies, software, and device-specific versus device-agnostic applications are also highlighted, along with the importance of post-contrast scans and ultrasound skills. Dr. Kim also delves into emerging technologies such as HistoSonics, augmented reality/virtual reality, and immunotherapy synergies. The doctors underscore the need for a multidisciplinary approach for optimizing patient outcomes and pushing the field toward future innovations.


---


TIMESTAMPS


00:00 - Introduction

04:28 - Standardizing Ablation Algorithms

07:51 - Suboptimal Lesion Locations

13:06 - Device Selection and Properties

22:49 - Ablation Planning Software

32:53 - Real-Time Visualization

44:48 - Biopsy and Ablation Techniques

52:14 - Future of Ablation Technology


---


RESOURCES


Dr. Ed Kim’s Publications:

https://scholars.mssm.edu/en/persons/edward-kim


ACCLAIM Trial:

https://www.sio-central.org/ACCLAIM-Trial


A multicenter randomized controlled trial to evaluate the efficacy of surgery versus radiofrequency ablation for small hepatocellular carcinoma (SURF trial): Analysis of overall survival:

https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.4093


Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial.

https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501


SIR welcomes results of COLLISION Trial, presented at the 2024 ASCO Annual Meeting:

https://www.sirweb.org/media-and-pubs/media/news-release-archive/collision-trial-06032024/


HistoSonics:

https://histosonics.com/

]]> 3612 Ep. 494 Multidisciplinary Cancer Care: Lynn's Chemoembolization and More with Lynn Lazzaro How do interventional oncologists fit into the bigger picture of multidisciplinary cancer care? Today we hear the patient’s perspective from Lynn Lazzaro, a liver cancer survivor who underwent multiple interventional oncology procedures prior to liver resection and eventual transplant. Lynn sits down with host Dr. Eric Keller to discuss her journey from initial diagnosis to present day. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Lynn provides insights on the importance of patient self-advocacy, seeking second opinions, and the benefits of a multidisciplinary approach when fighting cancer. Lynn encourages patients to be informed, ask questions, and connect with mentors, while also emphasizing the important duty physicians have in humanizing patient care. Her story highlights resilience, the value of teamwork among medical specialists, and the transformative potential of minimally invasive procedures. --- TIMESTAMPS 00:00 - Introduction 02:22 - Multidisciplinary Management 06:59 - Navigating TACE and Support Systems 13:39 - Surgical Interventions and Transplant Journey 19:09 - Reflections and Advice for Patients and Clinicians 26:13 - Conclusion --- RESOURCES The Interventional Initiative: https://theii.org/ The Cholangiocarcinoma Foundation: https://cholangiocarcinoma.org/ Fri, 08 Nov 2024 08:00:00 -0000 full BackTable How do interventional oncologists fit into the bigger picture of multidisciplinary cancer care? Today we hear the patient’s perspective from Lynn Lazzaro, a liver cancer survivor who underwent multiple interventional oncology procedures prior to liver resection and eventual transplant. Lynn sits down with host Dr. Eric Keller to discuss her journey from initial diagnosis to present day. How do interventional oncologists fit into the bigger picture of multidisciplinary cancer care? Today we hear the patient’s perspective from Lynn Lazzaro, a liver cancer survivor who underwent multiple interventional oncology procedures prior to liver resection and eventual transplant. Lynn sits down with host Dr. Eric Keller to discuss her journey from initial diagnosis to present day. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Lynn provides insights on the importance of patient self-advocacy, seeking second opinions, and the benefits of a multidisciplinary approach when fighting cancer. Lynn encourages patients to be informed, ask questions, and connect with mentors, while also emphasizing the important duty physicians have in humanizing patient care. Her story highlights resilience, the value of teamwork among medical specialists, and the transformative potential of minimally invasive procedures. --- TIMESTAMPS 00:00 - Introduction 02:22 - Multidisciplinary Management 06:59 - Navigating TACE and Support Systems 13:39 - Surgical Interventions and Transplant Journey 19:09 - Reflections and Advice for Patients and Clinicians 26:13 - Conclusion --- RESOURCES The Interventional Initiative: https://theii.org/ The Cholangiocarcinoma Foundation: https://cholangiocarcinoma.org/ How do interventional oncologists fit into the bigger picture of multidisciplinary cancer care? Today we hear the patient’s perspective from Lynn Lazzaro, a liver cancer survivor who underwent multiple interventional oncology procedures prior to liver resection and eventual transplant. Lynn sits down with host Dr. Eric Keller to discuss her journey from initial diagnosis to present day.


---


This podcast was developed in collaboration with:


Interventional Initiative

https://theii.org/


---


SYNPOSIS


Lynn provides insights on the importance of patient self-advocacy, seeking second opinions, and the benefits of a multidisciplinary approach when fighting cancer. Lynn encourages patients to be informed, ask questions, and connect with mentors, while also emphasizing the important duty physicians have in humanizing patient care. Her story highlights resilience, the value of teamwork among medical specialists, and the transformative potential of minimally invasive procedures.


---


TIMESTAMPS


00:00 - Introduction

02:22 - Multidisciplinary Management

06:59 - Navigating TACE and Support Systems

13:39 - Surgical Interventions and Transplant Journey

19:09 - Reflections and Advice for Patients and Clinicians

26:13 - Conclusion


---


RESOURCES


The Interventional Initiative:

https://theii.org/


The Cholangiocarcinoma Foundation:

https://cholangiocarcinoma.org/

]]> 1904 Ep. 493 Jillian’s Fight to Restore Blood Flow-A Long COVID Journey How can interventional radiologists help patients with long COVID? Today we hear directly from Jillian Angeline, a long COVID survivor that benefited tremendously from minimally invasive interventional care. Jillian sits down with host Dr. Eric Keller, and shares how interventional radiologist Dr. Brooke Spencer helped get her life back by turning the tide against her long-haul COVID symptoms which had been ongoing for multiple years. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Jillian shares her challenging journey from being an extremely active individual to barely being able to walk, due to persistent inflammation following COVID-19 infection. After seeing numerous physicians across various states and experiencing dismissal and misdiagnosis, Jillian was finally referred to Dr. Spencer at the MIPS Center in Colorado where she underwent a series of venous interventions that significantly helped her. This episode aims to raise awareness about possible life-changing IR options for patients suffering from long COVID, the importance of patient advocacy, and underscores multidisciplinary collaboration amongst medical professionals. --- TIMESTAMPS 00:00 - Introduction 02:33 - Jillian’s Journey 05:11 - Finding Interventional Radiologist, Dr. Brooke Spencer 08:39 - Venous Interventions 16:03 - Road to Healing 32:21 - Advice for Long COVID Patients --- RESOURCES Dr. Brooke Spencer, MD, FSIR Practice: https://mipscenter.com/about-us/dr-e-brooke-spencer-md-fsir/ The Interventional Initiative: https://theii.org/ Fri, 01 Nov 2024 07:00:00 -0000 full BackTable How can interventional radiologists help patients with long COVID? Today we hear directly from Jillian Angeline, a long COVID survivor that benefited tremendously from minimally invasive interventional care. Jillian sits down with host Dr. Eric Keller, and shares how interventional radiologist Dr. Brooke Spencer helped get her life back by turning the tide against her long-haul COVID symptoms which had been ongoing for multiple years. How can interventional radiologists help patients with long COVID? Today we hear directly from Jillian Angeline, a long COVID survivor that benefited tremendously from minimally invasive interventional care. Jillian sits down with host Dr. Eric Keller, and shares how interventional radiologist Dr. Brooke Spencer helped get her life back by turning the tide against her long-haul COVID symptoms which had been ongoing for multiple years. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Jillian shares her challenging journey from being an extremely active individual to barely being able to walk, due to persistent inflammation following COVID-19 infection. After seeing numerous physicians across various states and experiencing dismissal and misdiagnosis, Jillian was finally referred to Dr. Spencer at the MIPS Center in Colorado where she underwent a series of venous interventions that significantly helped her. This episode aims to raise awareness about possible life-changing IR options for patients suffering from long COVID, the importance of patient advocacy, and underscores multidisciplinary collaboration amongst medical professionals. --- TIMESTAMPS 00:00 - Introduction 02:33 - Jillian’s Journey 05:11 - Finding Interventional Radiologist, Dr. Brooke Spencer 08:39 - Venous Interventions 16:03 - Road to Healing 32:21 - Advice for Long COVID Patients --- RESOURCES Dr. Brooke Spencer, MD, FSIR Practice: https://mipscenter.com/about-us/dr-e-brooke-spencer-md-fsir/ The Interventional Initiative: https://theii.org/ How can interventional radiologists help patients with long COVID? Today we hear directly from Jillian Angeline, a long COVID survivor that benefited tremendously from minimally invasive interventional care. Jillian sits down with host Dr. Eric Keller, and shares how interventional radiologist Dr. Brooke Spencer helped get her life back by turning the tide against her long-haul COVID symptoms which had been ongoing for multiple years.


---


This podcast was developed in collaboration with:


Interventional Initiative

https://theii.org/


---


SYNPOSIS


Jillian shares her challenging journey from being an extremely active individual to barely being able to walk, due to persistent inflammation following COVID-19 infection. After seeing numerous physicians across various states and experiencing dismissal and misdiagnosis, Jillian was finally referred to Dr. Spencer at the MIPS Center in Colorado where she underwent a series of venous interventions that significantly helped her. This episode aims to raise awareness about possible life-changing IR options for patients suffering from long COVID, the importance of patient advocacy, and underscores multidisciplinary collaboration amongst medical professionals.


---


TIMESTAMPS


00:00 - Introduction

02:33 - Jillian’s Journey

05:11 - Finding Interventional Radiologist, Dr. Brooke Spencer

08:39 - Venous Interventions

16:03 - Road to Healing

32:21 - Advice for Long COVID Patients


---


RESOURCES


Dr. Brooke Spencer, MD, FSIR Practice:

https://mipscenter.com/about-us/dr-e-brooke-spencer-md-fsir/


The Interventional Initiative:

https://theii.org/

]]> 2359 Ep. 492 Renal Tumor Ablations: Technique and Advancements with Dr. AJ Gunn Looking to enhance your interventional oncology practice with renal tumor ablation? In this episode, host Dr. Don Garbett is joined by Dr. AJ Gunn to discuss the current landscape of renal tumor ablation and Dr. Gunn’s procedural tips for successful outcomes. Dr. Gunn is an interventional radiologist at the University of Alabama at Birmingham, with extensive experience in building service lines, including renal tumor management. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors review various scoring systems to predict the risks associated with renal ablation. Dr. Gunn emphasizes that tumor size is the most consistent predictor of procedural complications, local recurrence, and metastasis. He also discusses ablation techniques and proactive steps to avoid complications, such as hydrodissection and the selection of appropriate ablation technology. He employs cryoablation for central renal tumors and large tumors to minimize damage to the collecting system, while using microwave ablation for smaller peripheral lesions. Additionally, prior literature and his personal experience suggest that preoperative embolization may be beneficial for larger hypervascular tumors. Finally, Dr. Gunn speaks about the ongoing Embolization Before Ablation of Renal Cell Carcinoma (EMBARC) study and the importance of sharing knowledge and experiences within the interventional oncology community. --- TIMESTAMPS 00:00 - Introduction 04:24 - Practice Building Philosophy 09:29 - Importance of Clinical Follow Up 12:17 - Predictive Factors of Ablation Success 23:30 - Renal Ablation Technique 31:41 - Embolization Before Ablation 44:13 - The Future of Renal Tumor Treatments --- RESOURCES Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Safety, Technical Results, and Clinical Outcomes (Gunn et al, 2019): https://pmc.ncbi.nlm.nih.gov/articles/PMC8983093/ Should Renal Mass Biopsy Be Performed prior to or Concomitantly with Thermal Ablation? (Chung et al, 2018): https://pubmed.ncbi.nlm.nih.gov/30075976/ EMBARC Trial: https://med.stanford.edu/ir/clinical-trials/embarc.html Society for Interventional Oncology (SIO) Conference: https://www.sio-central.org/Events/Annual-Scientific-Meeting Tue, 29 Oct 2024 07:00:00 -0000 full BackTable Looking to enhance your interventional oncology practice with renal tumor ablation? In this episode, host Dr. Don Garbett is joined by Dr. AJ Gunn to discuss the current landscape of renal tumor ablation and Dr. Gunn’s procedural tips for successful outcomes. Dr. Gunn is an interventional radiologist at the University of Alabama at Birmingham, with extensive experience in building service lines, including renal tumor management. Looking to enhance your interventional oncology practice with renal tumor ablation? In this episode, host Dr. Don Garbett is joined by Dr. AJ Gunn to discuss the current landscape of renal tumor ablation and Dr. Gunn’s procedural tips for successful outcomes. Dr. Gunn is an interventional radiologist at the University of Alabama at Birmingham, with extensive experience in building service lines, including renal tumor management. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors review various scoring systems to predict the risks associated with renal ablation. Dr. Gunn emphasizes that tumor size is the most consistent predictor of procedural complications, local recurrence, and metastasis. He also discusses ablation techniques and proactive steps to avoid complications, such as hydrodissection and the selection of appropriate ablation technology. He employs cryoablation for central renal tumors and large tumors to minimize damage to the collecting system, while using microwave ablation for smaller peripheral lesions. Additionally, prior literature and his personal experience suggest that preoperative embolization may be beneficial for larger hypervascular tumors. Finally, Dr. Gunn speaks about the ongoing Embolization Before Ablation of Renal Cell Carcinoma (EMBARC) study and the importance of sharing knowledge and experiences within the interventional oncology community. --- TIMESTAMPS 00:00 - Introduction 04:24 - Practice Building Philosophy 09:29 - Importance of Clinical Follow Up 12:17 - Predictive Factors of Ablation Success 23:30 - Renal Ablation Technique 31:41 - Embolization Before Ablation 44:13 - The Future of Renal Tumor Treatments --- RESOURCES Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Safety, Technical Results, and Clinical Outcomes (Gunn et al, 2019): https://pmc.ncbi.nlm.nih.gov/articles/PMC8983093/ Should Renal Mass Biopsy Be Performed prior to or Concomitantly with Thermal Ablation? (Chung et al, 2018): https://pubmed.ncbi.nlm.nih.gov/30075976/ EMBARC Trial: https://med.stanford.edu/ir/clinical-trials/embarc.html Society for Interventional Oncology (SIO) Conference: https://www.sio-central.org/Events/Annual-Scientific-Meeting Looking to enhance your interventional oncology practice with renal tumor ablation? In this episode, host Dr. Don Garbett is joined by Dr. AJ Gunn to discuss the current landscape of renal tumor ablation and Dr. Gunn’s procedural tips for successful outcomes. Dr. Gunn is an interventional radiologist at the University of Alabama at Birmingham, with extensive experience in building service lines, including renal tumor management.


---


This podcast is supported by:


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


The doctors review various scoring systems to predict the risks associated with renal ablation. Dr. Gunn emphasizes that tumor size is the most consistent predictor of procedural complications, local recurrence, and metastasis. He also discusses ablation techniques and proactive steps to avoid complications, such as hydrodissection and the selection of appropriate ablation technology. He employs cryoablation for central renal tumors and large tumors to minimize damage to the collecting system, while using microwave ablation for smaller peripheral lesions. Additionally, prior literature and his personal experience suggest that preoperative embolization may be beneficial for larger hypervascular tumors.


Finally, Dr. Gunn speaks about the ongoing Embolization Before Ablation of Renal Cell Carcinoma (EMBARC) study and the importance of sharing knowledge and experiences within the interventional oncology community.



---


TIMESTAMPS


00:00 - Introduction

04:24 - Practice Building Philosophy

09:29 - Importance of Clinical Follow Up

12:17 - Predictive Factors of Ablation Success

23:30 - Renal Ablation Technique

31:41 - Embolization Before Ablation

44:13 - The Future of Renal Tumor Treatments


---


RESOURCES


Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Safety, Technical Results, and Clinical Outcomes (Gunn et al, 2019):

https://pmc.ncbi.nlm.nih.gov/articles/PMC8983093/


Should Renal Mass Biopsy Be Performed prior to or Concomitantly with Thermal Ablation? (Chung et al, 2018): https://pubmed.ncbi.nlm.nih.gov/30075976/


EMBARC Trial:

https://med.stanford.edu/ir/clinical-trials/embarc.html


Society for Interventional Oncology (SIO) Conference: https://www.sio-central.org/Events/Annual-Scientific-Meeting

]]> 3236 Ep. 491 Surviving Cancer: Suzanne Martin's Radioembolization Journey As providers, we know firsthand how impactful interventional radiology procedures can be. Today, we hear the perspective of Suzanne Martin, a patient who underwent life-saving radioembolization for stage 4 colorectal cancer. Suzanne shares her story with host Dr. Eric Keller, including how things took a positive turn when she was introduced to interventional radiologist Dr. Charles Nutting after initially undergoing ineffective chemotherapy treatment. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Suzanne discusses her role as a motivational speaker and highlights the importance of patient self-advocacy and the collaborative efforts between oncologists and interventional radiologists. This inspiring episode underscores the transformative power of minimally invasive treatments and the significance of hope and teamwork in overcoming cancer. --- TIMESTAMPS 00:00 - Introduction 04:25 - SIR Spheres Procedure 07:10 - Post-Procedure Recovery Experience 09:49 - Long-Term Outcomes and Reflections 17:48 - Advocating for Yourself 19:07 - Finding Support and Hope 23:35 - Advice for Patients and Doctors --- RESOURCES Dr. Charles Nutting Denver Practice: https://www.drnutting.com/ Say Yes to Hope Cancer Support Group: https://www.sayyestohope.org/ Fri, 25 Oct 2024 07:00:00 -0000 full BackTable As providers, we know firsthand how impactful interventional radiology procedures can be. Today, we hear the perspective of Suzanne Martin, a patient who underwent life-saving radioembolization for stage 4 colorectal cancer. Suzanne shares her story with host Dr. Eric Keller, including how things took a positive turn when she was introduced to interventional radiologist Dr. Charles Nutting after initially undergoing ineffective chemotherapy treatment. As providers, we know firsthand how impactful interventional radiology procedures can be. Today, we hear the perspective of Suzanne Martin, a patient who underwent life-saving radioembolization for stage 4 colorectal cancer. Suzanne shares her story with host Dr. Eric Keller, including how things took a positive turn when she was introduced to interventional radiologist Dr. Charles Nutting after initially undergoing ineffective chemotherapy treatment. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Suzanne discusses her role as a motivational speaker and highlights the importance of patient self-advocacy and the collaborative efforts between oncologists and interventional radiologists. This inspiring episode underscores the transformative power of minimally invasive treatments and the significance of hope and teamwork in overcoming cancer. --- TIMESTAMPS 00:00 - Introduction 04:25 - SIR Spheres Procedure 07:10 - Post-Procedure Recovery Experience 09:49 - Long-Term Outcomes and Reflections 17:48 - Advocating for Yourself 19:07 - Finding Support and Hope 23:35 - Advice for Patients and Doctors --- RESOURCES Dr. Charles Nutting Denver Practice: https://www.drnutting.com/ Say Yes to Hope Cancer Support Group: https://www.sayyestohope.org/ As providers, we know firsthand how impactful interventional radiology procedures can be. Today, we hear the perspective of Suzanne Martin, a patient who underwent life-saving radioembolization for stage 4 colorectal cancer. Suzanne shares her story with host Dr. Eric Keller, including how things took a positive turn when she was introduced to interventional radiologist Dr. Charles Nutting after initially undergoing ineffective chemotherapy treatment.


---


This podcast was developed in collaboration with:


Interventional Initiative

https://theii.org/


---


SYNPOSIS


Suzanne discusses her role as a motivational speaker and highlights the importance of patient self-advocacy and the collaborative efforts between oncologists and interventional radiologists. This inspiring episode underscores the transformative power of minimally invasive treatments and the significance of hope and teamwork in overcoming cancer.


---


TIMESTAMPS


00:00 - Introduction

04:25 - SIR Spheres Procedure

07:10 - Post-Procedure Recovery Experience

09:49 - Long-Term Outcomes and Reflections

17:48 - Advocating for Yourself

19:07 - Finding Support and Hope

23:35 - Advice for Patients and Doctors


---


RESOURCES


Dr. Charles Nutting Denver Practice:

https://www.drnutting.com/


Say Yes to Hope Cancer Support Group:

https://www.sayyestohope.org/

]]> 1907 Ep. 490 Uterine Fibroid Embolization: My Algorithm with Dr. Gary Siskin Get a second opinion on your uterine fibroid embolization (UFE) technique. Dr. Gary Siskin joins host Dr. Chris Beck for an in-depth discussion on his approach to uterine fibroid embolization, detailing techniques, tools, and embolic agents. Dr. Siskin is an experienced UFE practitioner, professor, and Chair of the Department of Radiology and Chief of the Division of Vascular & Interventional Radiology at Albany Med Health System in New York. --- This podcast is supported by: Merit Embolotherapy https://www.merit.com/solutions/embolotherapy/ --- SYNPOSIS Dr. Siskin shares his journey and evolution of his specialization in GYN-related interventional radiology procedures. The doctors cover various aspects of fibroid embolization, including its effectiveness compared to surgical options like myomectomy and hysterectomy, the referral and evaluation process, and considerations for fertility preservation. Pain management strategies and postoperative care are also explored, emphasizing the importance of patient education and interdisciplinary collaboration to promote less invasive treatments. --- TIMESTAMPS 00:00 - Introduction 04:45 - Building a Fibroid Practice 08:35 - Workup and Consultation 17:01 - Recurrence and Re-Embolization 20:27 - Pre-Procedural Workup and Technique 30:18 - Embolization Endpoint 36:07 - Accessing the Correct Uterine Artery 48:49 - Post-Procedure Patient Care --- RESOURCES List of Publications by Dr. James B. Spies (PubMed): https://pubmed.ncbi.nlm.nih.gov/?sort=jour&term=Spies+JB&cauthor_id=24436560 Tue, 22 Oct 2024 07:00:00 -0000 full BackTable Get a second opinion on your uterine fibroid embolization (UFE) technique. Dr. Gary Siskin joins host Dr. Chris Beck for an in-depth discussion on his approach to uterine fibroid embolization, detailing techniques, tools, and embolic agents. Dr. Siskin is an experienced UFE practitioner, professor, and Chair of the Department of Radiology and Chief of the Division of Vascular & Interventional Radiology at Albany Med Health System in New York. Get a second opinion on your uterine fibroid embolization (UFE) technique. Dr. Gary Siskin joins host Dr. Chris Beck for an in-depth discussion on his approach to uterine fibroid embolization, detailing techniques, tools, and embolic agents. Dr. Siskin is an experienced UFE practitioner, professor, and Chair of the Department of Radiology and Chief of the Division of Vascular & Interventional Radiology at Albany Med Health System in New York. --- This podcast is supported by: Merit Embolotherapy https://www.merit.com/solutions/embolotherapy/ --- SYNPOSIS Dr. Siskin shares his journey and evolution of his specialization in GYN-related interventional radiology procedures. The doctors cover various aspects of fibroid embolization, including its effectiveness compared to surgical options like myomectomy and hysterectomy, the referral and evaluation process, and considerations for fertility preservation. Pain management strategies and postoperative care are also explored, emphasizing the importance of patient education and interdisciplinary collaboration to promote less invasive treatments. --- TIMESTAMPS 00:00 - Introduction 04:45 - Building a Fibroid Practice 08:35 - Workup and Consultation 17:01 - Recurrence and Re-Embolization 20:27 - Pre-Procedural Workup and Technique 30:18 - Embolization Endpoint 36:07 - Accessing the Correct Uterine Artery 48:49 - Post-Procedure Patient Care --- RESOURCES List of Publications by Dr. James B. Spies (PubMed): https://pubmed.ncbi.nlm.nih.gov/?sort=jour&term=Spies+JB&cauthor_id=24436560 Get a second opinion on your uterine fibroid embolization (UFE) technique. Dr. Gary Siskin joins host Dr. Chris Beck for an in-depth discussion on his approach to uterine fibroid embolization, detailing techniques, tools, and embolic agents. Dr. Siskin is an experienced UFE practitioner, professor, and Chair of the Department of Radiology and Chief of the Division of Vascular & Interventional Radiology at Albany Med Health System in New York.


---


This podcast is supported by:


Merit Embolotherapy

https://www.merit.com/solutions/embolotherapy/


---


SYNPOSIS


Dr. Siskin shares his journey and evolution of his specialization in GYN-related interventional radiology procedures. The doctors cover various aspects of fibroid embolization, including its effectiveness compared to surgical options like myomectomy and hysterectomy, the referral and evaluation process, and considerations for fertility preservation. Pain management strategies and postoperative care are also explored, emphasizing the importance of patient education and interdisciplinary collaboration to promote less invasive treatments.


---


TIMESTAMPS


00:00 - Introduction

04:45 - Building a Fibroid Practice

08:35 - Workup and Consultation

17:01 - Recurrence and Re-Embolization

20:27 - Pre-Procedural Workup and Technique

30:18 - Embolization Endpoint

36:07 - Accessing the Correct Uterine Artery

48:49 - Post-Procedure Patient Care


---


RESOURCES


List of Publications by Dr. James B. Spies (PubMed):

https://pubmed.ncbi.nlm.nih.gov/?sort=jour&term=Spies+JB&cauthor_id=24436560

]]> 3481 Ep. 489 Improving Public Awareness of Interventional Radiology with Dr. Mina Makary Historically, public recognition and understanding of IR has been limited, with a significant portion of patients unaware of interventional procedures and the field as a whole. How can we improve awareness of IR and minimally invasive treatment options? Dr. Mina Makary discusses this and his recent study on public perceptions of IR, with host Dr. Michael Barraza. Dr. Makary is a vascular and interventional radiologist and an Associate Professor of Radiology at The Ohio State University. --- This podcast is supported by: PearsonRavitz https://pearsonravitz.com/backtable --- SYNPOSIS Dr. Makary states that less than half of the public believes IRs are physicians, highlighting a knowledge gap with potentially significant implications for patient care and treatment decisions. The doctors delve into possible solutions to address this issue, including educational interventions targeting both the public and healthcare providers, the potential impact of name recognition on public perception, and methods to enhance IR awareness through media and direct engagement with primary care providers. The episode also emphasizes the need for ongoing research and efforts to improve understanding and recognition of IR to ensure patients have informed medical options. --- TIMESTAMPS 00:00 - Introduction 03:23 - Study Methodology and Findings 08:13 - Challenges and Solutions in IR Awareness 10:23 - Impact of IR Procedures on Public Perception 15:16 - Future Research and Awareness Efforts 23:40 - Conclusions --- RESOURCES 2023 Paper - Public Awareness of Interventional Radiology: Population-Based Analysis of the Current State of and Pathways for Improvement: https://pubmed.ncbi.nlm.nih.gov/36764444/ 2019 Paper - Primary Care Provider Awareness of IR: A Single-Center Analysis: https://pubmed.ncbi.nlm.nih.gov/31235412/ 2024 Paper - Impact of Educational Videos on Patient Understanding of Interventional Radiology Procedures: https://pubmed.ncbi.nlm.nih.gov/39198139/ BackTable VI Podcast Episode #454 - Moral Injury in Interventional Radiology with Dr. Mina Makary and Dr. Jeffrey Chick: https://www.backtable.com/shows/vi/podcasts/454/moral-injury-in-interventional-radiology BackTable VI Podcast Episode #195 - Disclosures of Conflicts of Interest with Dr. Mina Makary: https://www.backtable.com/shows/vi/podcasts/195/disclosures-of-conflicts-of-interest BackTable VI Podcast Episode #62 - Protect Yourself Before You Wreck Yourself with Dr. Mina Makary: https://www.backtable.com/shows/vi/podcasts/62/protect-yourself-before-you-wreck-yourself Fri, 18 Oct 2024 07:00:00 -0000 full BackTable Historically, public recognition and understanding of IR has been limited, with a significant portion of patients unaware of interventional procedures and the field as a whole. How can we improve awareness of IR and minimally invasive treatment options? Dr. Mina Makary discusses this and his recent study on public perceptions of IR, with host Dr. Michael Barraza. Dr. Makary is a vascular and interventional radiologist and an Associate Professor of Radiology at The Ohio State University. Historically, public recognition and understanding of IR has been limited, with a significant portion of patients unaware of interventional procedures and the field as a whole. How can we improve awareness of IR and minimally invasive treatment options? Dr. Mina Makary discusses this and his recent study on public perceptions of IR, with host Dr. Michael Barraza. Dr. Makary is a vascular and interventional radiologist and an Associate Professor of Radiology at The Ohio State University. --- This podcast is supported by: PearsonRavitz https://pearsonravitz.com/backtable --- SYNPOSIS Dr. Makary states that less than half of the public believes IRs are physicians, highlighting a knowledge gap with potentially significant implications for patient care and treatment decisions. The doctors delve into possible solutions to address this issue, including educational interventions targeting both the public and healthcare providers, the potential impact of name recognition on public perception, and methods to enhance IR awareness through media and direct engagement with primary care providers. The episode also emphasizes the need for ongoing research and efforts to improve understanding and recognition of IR to ensure patients have informed medical options. --- TIMESTAMPS 00:00 - Introduction 03:23 - Study Methodology and Findings 08:13 - Challenges and Solutions in IR Awareness 10:23 - Impact of IR Procedures on Public Perception 15:16 - Future Research and Awareness Efforts 23:40 - Conclusions --- RESOURCES 2023 Paper - Public Awareness of Interventional Radiology: Population-Based Analysis of the Current State of and Pathways for Improvement: https://pubmed.ncbi.nlm.nih.gov/36764444/ 2019 Paper - Primary Care Provider Awareness of IR: A Single-Center Analysis: https://pubmed.ncbi.nlm.nih.gov/31235412/ 2024 Paper - Impact of Educational Videos on Patient Understanding of Interventional Radiology Procedures: https://pubmed.ncbi.nlm.nih.gov/39198139/ BackTable VI Podcast Episode #454 - Moral Injury in Interventional Radiology with Dr. Mina Makary and Dr. Jeffrey Chick: https://www.backtable.com/shows/vi/podcasts/454/moral-injury-in-interventional-radiology BackTable VI Podcast Episode #195 - Disclosures of Conflicts of Interest with Dr. Mina Makary: https://www.backtable.com/shows/vi/podcasts/195/disclosures-of-conflicts-of-interest BackTable VI Podcast Episode #62 - Protect Yourself Before You Wreck Yourself with Dr. Mina Makary: https://www.backtable.com/shows/vi/podcasts/62/protect-yourself-before-you-wreck-yourself Historically, public recognition and understanding of IR has been limited, with a significant portion of patients unaware of interventional procedures and the field as a whole. How can we improve awareness of IR and minimally invasive treatment options? Dr. Mina Makary discusses this and his recent study on public perceptions of IR, with host Dr. Michael Barraza. Dr. Makary is a vascular and interventional radiologist and an Associate Professor of Radiology at The Ohio State University.


---


This podcast is supported by:


PearsonRavitz

https://pearsonravitz.com/backtable


---


SYNPOSIS


Dr. Makary states that less than half of the public believes IRs are physicians, highlighting a knowledge gap with potentially significant implications for patient care and treatment decisions. The doctors delve into possible solutions to address this issue, including educational interventions targeting both the public and healthcare providers, the potential impact of name recognition on public perception, and methods to enhance IR awareness through media and direct engagement with primary care providers. The episode also emphasizes the need for ongoing research and efforts to improve understanding and recognition of IR to ensure patients have informed medical options.


---


TIMESTAMPS


00:00 - Introduction

03:23 - Study Methodology and Findings

08:13 - Challenges and Solutions in IR Awareness

10:23 - Impact of IR Procedures on Public Perception

15:16 - Future Research and Awareness Efforts

23:40 - Conclusions


---


RESOURCES


2023 Paper - Public Awareness of Interventional Radiology: Population-Based Analysis of the Current State of and Pathways for Improvement:

https://pubmed.ncbi.nlm.nih.gov/36764444/


2019 Paper - Primary Care Provider Awareness of IR: A Single-Center Analysis:

https://pubmed.ncbi.nlm.nih.gov/31235412/


2024 Paper - Impact of Educational Videos on Patient Understanding of Interventional Radiology Procedures:

https://pubmed.ncbi.nlm.nih.gov/39198139/


BackTable VI Podcast Episode #454 - Moral Injury in Interventional Radiology with Dr. Mina Makary and Dr. Jeffrey Chick:

https://www.backtable.com/shows/vi/podcasts/454/moral-injury-in-interventional-radiology


BackTable VI Podcast Episode #195 - Disclosures of Conflicts of Interest with Dr. Mina Makary:

https://www.backtable.com/shows/vi/podcasts/195/disclosures-of-conflicts-of-interest


BackTable VI Podcast Episode #62 - Protect Yourself Before You Wreck Yourself with Dr. Mina Makary:

https://www.backtable.com/shows/vi/podcasts/62/protect-yourself-before-you-wreck-yourself

]]> 1776 Ep. 488 Ablation Techniques for Acetabular Lesions with Dr. Jason Levy Acetabular lesions present unique challenges for interventionalists due to their location within the pelvis. In this episode of the BackTable Podcast, host Dr. Jacob Fleming interviews Dr. Jason Levy, an experienced practitioner in musculoskeletal interventional oncology based in Atlanta, Georgia, about techniques for ablating acetabular lesions. --- This podcast is supported by an educational grant from Medtronic. --- SYNPOSIS The doctors discuss the unique considerations involved in treating the acetabulum, including its susceptibility to various axial loading, shear, and torsion forces. Dr. Levy prefers to use radiofrequency ablation combined with cement augmentation to enhance joint stability. He outlines the procedural steps and shares his preferred imaging methods. Additionally, he addresses potential complications, such as instability from inadequate cement delivery, cement leakage into the hip joint space, and avascular necrosis. Throughout the episode, the doctors emphasize the importance of collaboration with orthopedic oncologists and staying updated on current research in musculoskeletal interventional oncology.\ --- TIMESTAMPS 00:00 - Introduction 05:11 - Unique Considerations for Acetabular Lesions 09:06 - Collaboration with Orthopedic Oncologists 13:10 - Anatomy and Procedural Steps 24:40 - Preventing Complications 35:25 - Concluding Thoughts --- RESOURCES BackTable MSK Ep. 17- Multidisciplinary Approach to Treating Spinal Metastases with Dr. Jason Levy and Dr. Amir Lavaf: https://www.backtable.com/shows/msk/podcasts/17/multidisciplinary-approach-to-treating-spinal-metastases BackTable VI Ep. 68- RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla: https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases BackTable MSK Ep. 12- Ortho/IR Collaboration in Private Practice: https://www.backtable.com/shows/msk/podcasts/12/ortho-ir-collaboration-in-private-practice Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study): https://pubmed.ncbi.nlm.nih.gov/33129427/ Hip Joint Distraction Technique during Cryoablation of Acetabular Bone Tumor to Prevent Femoral Head Osteonecrosis: https://www.jvir.org/article/S1051-0443(22)01119-8/fulltext Tue, 15 Oct 2024 07:00:00 -0000 full BackTable Acetabular lesions present unique challenges for interventionalists due to their location within the pelvis. In this episode of the BackTable Podcast, host Dr. Jacob Fleming interviews Dr. Jason Levy, an experienced practitioner in musculoskeletal interventional oncology based in Atlanta, Georgia, about techniques for ablating acetabular lesions. Acetabular lesions present unique challenges for interventionalists due to their location within the pelvis. In this episode of the BackTable Podcast, host Dr. Jacob Fleming interviews Dr. Jason Levy, an experienced practitioner in musculoskeletal interventional oncology based in Atlanta, Georgia, about techniques for ablating acetabular lesions. --- This podcast is supported by an educational grant from Medtronic. --- SYNPOSIS The doctors discuss the unique considerations involved in treating the acetabulum, including its susceptibility to various axial loading, shear, and torsion forces. Dr. Levy prefers to use radiofrequency ablation combined with cement augmentation to enhance joint stability. He outlines the procedural steps and shares his preferred imaging methods. Additionally, he addresses potential complications, such as instability from inadequate cement delivery, cement leakage into the hip joint space, and avascular necrosis. Throughout the episode, the doctors emphasize the importance of collaboration with orthopedic oncologists and staying updated on current research in musculoskeletal interventional oncology.\ --- TIMESTAMPS 00:00 - Introduction 05:11 - Unique Considerations for Acetabular Lesions 09:06 - Collaboration with Orthopedic Oncologists 13:10 - Anatomy and Procedural Steps 24:40 - Preventing Complications 35:25 - Concluding Thoughts --- RESOURCES BackTable MSK Ep. 17- Multidisciplinary Approach to Treating Spinal Metastases with Dr. Jason Levy and Dr. Amir Lavaf: https://www.backtable.com/shows/msk/podcasts/17/multidisciplinary-approach-to-treating-spinal-metastases BackTable VI Ep. 68- RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla: https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases BackTable MSK Ep. 12- Ortho/IR Collaboration in Private Practice: https://www.backtable.com/shows/msk/podcasts/12/ortho-ir-collaboration-in-private-practice Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study): https://pubmed.ncbi.nlm.nih.gov/33129427/ Hip Joint Distraction Technique during Cryoablation of Acetabular Bone Tumor to Prevent Femoral Head Osteonecrosis: https://www.jvir.org/article/S1051-0443(22)01119-8/fulltext Acetabular lesions present unique challenges for interventionalists due to their location within the pelvis. In this episode of the BackTable Podcast, host Dr. Jacob Fleming interviews Dr. Jason Levy, an experienced practitioner in musculoskeletal interventional oncology based in Atlanta, Georgia, about techniques for ablating acetabular lesions.


---


This podcast is supported by an educational grant from Medtronic.


---


SYNPOSIS


The doctors discuss the unique considerations involved in treating the acetabulum, including its susceptibility to various axial loading, shear, and torsion forces. Dr. Levy prefers to use radiofrequency ablation combined with cement augmentation to enhance joint stability. He outlines the procedural steps and shares his preferred imaging methods. Additionally, he addresses potential complications, such as instability from inadequate cement delivery, cement leakage into the hip joint space, and avascular necrosis. Throughout the episode, the doctors emphasize the importance of collaboration with orthopedic oncologists and staying updated on current research in musculoskeletal interventional oncology.\


---


TIMESTAMPS


00:00 - Introduction

05:11 - Unique Considerations for Acetabular Lesions

09:06 - Collaboration with Orthopedic Oncologists

13:10 - Anatomy and Procedural Steps

24:40 - Preventing Complications

35:25 - Concluding Thoughts


---


RESOURCES


BackTable MSK Ep. 17- Multidisciplinary Approach to Treating Spinal Metastases with Dr. Jason Levy and Dr. Amir Lavaf:

https://www.backtable.com/shows/msk/podcasts/17/multidisciplinary-approach-to-treating-spinal-metastases


BackTable VI Ep. 68- RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla:

https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases



BackTable MSK Ep. 12- Ortho/IR Collaboration in Private Practice:

https://www.backtable.com/shows/msk/podcasts/12/ortho-ir-collaboration-in-private-practice



Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study):

https://pubmed.ncbi.nlm.nih.gov/33129427/



Hip Joint Distraction Technique during Cryoablation of Acetabular Bone Tumor to Prevent Femoral Head Osteonecrosis:

https://www.jvir.org/article/S1051-0443(22)01119-8/fulltext

]]> 2700 Ep. 487 Musculoskeletal Tumor Embolizations with Dr. Gina Landinez Tumor embolization is a versatile procedure that can provide symptomatic and long-term benefits for patients. In this episode of BackTable MSK, host Dr. Michael Barraza discusses musculoskeletal tumor embolizations with Dr. Gina Landinez from the Miami Cardiac and Vascular Institute, where she is helping to grow the MSK interventions program. --- This podcast is supported by: Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- SYNPOSIS Dr. Landinez explains that the main indications for embolization are preoperative tumor shrinkage and pain palliation. Embolization decreases hemorrhagic risk and procedure time during surgical resection and leads to better surgical margins. Pain palliation can also be achieved due to tumor size reduction and decreased pressure on surrounding nerves and tissue. Dr. Landinez explains that lesions well-suited embolization are hypervascular, large, not sensitive to radiation, and painful. She also describes the risks of off-target skin and muscle embolization and the importance of exercising caution with vertebral tumors. Finally, Dr. Landinez shares valuable practice-building tips about developing relationships with orthopedic surgeons and providing adequate follow up care. --- TIMESTAMPS 00:00 - Introduction 03:51 - Indications for Embolization 08:08 - Building Referral Networks 13:45 - Preoperative Planning 18:34 - Technical Aspects of Embolization 27:25 - Challenges and Considerations 31:23 - Importance of Outpatient Follow Up Fri, 11 Oct 2024 07:00:00 -0000 full BackTable Tumor embolization is a versatile procedure that can provide symptomatic and long-term benefits for patients. In this episode of BackTable MSK, host Dr. Michael Barraza discusses musculoskeletal tumor embolizations with Dr. Gina Landinez from the Miami Cardiac and Vascular Institute, where she is helping to grow the MSK interventions program. Tumor embolization is a versatile procedure that can provide symptomatic and long-term benefits for patients. In this episode of BackTable MSK, host Dr. Michael Barraza discusses musculoskeletal tumor embolizations with Dr. Gina Landinez from the Miami Cardiac and Vascular Institute, where she is helping to grow the MSK interventions program. --- This podcast is supported by: Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- SYNPOSIS Dr. Landinez explains that the main indications for embolization are preoperative tumor shrinkage and pain palliation. Embolization decreases hemorrhagic risk and procedure time during surgical resection and leads to better surgical margins. Pain palliation can also be achieved due to tumor size reduction and decreased pressure on surrounding nerves and tissue. Dr. Landinez explains that lesions well-suited embolization are hypervascular, large, not sensitive to radiation, and painful. She also describes the risks of off-target skin and muscle embolization and the importance of exercising caution with vertebral tumors. Finally, Dr. Landinez shares valuable practice-building tips about developing relationships with orthopedic surgeons and providing adequate follow up care. --- TIMESTAMPS 00:00 - Introduction 03:51 - Indications for Embolization 08:08 - Building Referral Networks 13:45 - Preoperative Planning 18:34 - Technical Aspects of Embolization 27:25 - Challenges and Considerations 31:23 - Importance of Outpatient Follow Up Tumor embolization is a versatile procedure that can provide symptomatic and long-term benefits for patients. In this episode of BackTable MSK, host Dr. Michael Barraza discusses musculoskeletal tumor embolizations with Dr. Gina Landinez from the Miami Cardiac and Vascular Institute, where she is helping to grow the MSK interventions program.


---


This podcast is supported by:


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


---


SYNPOSIS


Dr. Landinez explains that the main indications for embolization are preoperative tumor shrinkage and pain palliation. Embolization decreases hemorrhagic risk and procedure time during surgical resection and leads to better surgical margins. Pain palliation can also be achieved due to tumor size reduction and decreased pressure on surrounding nerves and tissue. Dr. Landinez explains that lesions well-suited embolization are hypervascular, large, not sensitive to radiation, and painful. She also describes the risks of off-target skin and muscle embolization and the importance of exercising caution with vertebral tumors.

Finally, Dr. Landinez shares valuable practice-building tips about developing relationships with orthopedic surgeons and providing adequate follow up care.


---


TIMESTAMPS


00:00 - Introduction

03:51 - Indications for Embolization

08:08 - Building Referral Networks

13:45 - Preoperative Planning

18:34 - Technical Aspects of Embolization

27:25 - Challenges and Considerations

31:23 - Importance of Outpatient Follow Up

]]> 2220 Ep. 486 Winning the Revenue Cycle Game with Teri Yates Is your practice profitable? The success of a private medical practice often hinges on effective revenue cycle management (RCM). In this episode of the BackTable Podcast, private practice consultant Teri Yates and host Dr. Ally Baheti share best practices in revenue cycle management for physicians. Teri Yates is the CEO of Accountable Physician Advisors and President of DocCentric. --- This podcast is supported by:S Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Teri explains the importance of understanding payer rules, the benefits of using professional coders, and managing front desk staff efficiently. The episode includes real-world examples of RCM challenges and solutions, the impact of insurance policies, and the role of cybersecurity. Teri also provides actionable tips for improving collections and navigating recent changes in healthcare reimbursement, especially for outpatient-based labs (OBLs) and ambulatory surgery centers (ASCs). --- TIMESTAMPS 00:00 - Introduction 09:17 - Revenue Cycle Management: Case Scenarios 19:55 - In-House vs. Outsourced Billing 31:51 - Winning Strategies for Physicians 40:55 - Healthcare Cybersecurity 43:52 - Proposed Reimbursement Changes for 2025 48:32 - Telehealth and Legislative Concerns 55:25 - Conclusion --- RESOURCES BackTable VI Podcast - Episode #366 Navigating OBL & ASC Business, Pitfalls to Avoid with Teri Yates: https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid BackTable VI Podcast - Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates: https://www.backtable.com/shows/vi/podcasts/431/obl-or-asc-for-your-private-practice-how-to-decide Accountable Physician Advisors: http://www.accountablephysicianadvisors.com/services DocCentric: https://doccentricasc.com/ G2211 Add-on Code: What It Is and When To Use It: https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/evaluation-management/G2211-what-it-is-and-how-to-use-it.html Tue, 08 Oct 2024 07:00:00 -0000 full BackTable Is your practice profitable? The success of a private medical practice often hinges on effective revenue cycle management (RCM). In this episode of the BackTable Podcast, private practice consultant Teri Yates and host Dr. Ally Baheti share best practices in revenue cycle management for physicians. Teri Yates is the CEO of Accountable Physician Advisors and President of DocCentric. Is your practice profitable? The success of a private medical practice often hinges on effective revenue cycle management (RCM). In this episode of the BackTable Podcast, private practice consultant Teri Yates and host Dr. Ally Baheti share best practices in revenue cycle management for physicians. Teri Yates is the CEO of Accountable Physician Advisors and President of DocCentric. --- This podcast is supported by:S Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Teri explains the importance of understanding payer rules, the benefits of using professional coders, and managing front desk staff efficiently. The episode includes real-world examples of RCM challenges and solutions, the impact of insurance policies, and the role of cybersecurity. Teri also provides actionable tips for improving collections and navigating recent changes in healthcare reimbursement, especially for outpatient-based labs (OBLs) and ambulatory surgery centers (ASCs). --- TIMESTAMPS 00:00 - Introduction 09:17 - Revenue Cycle Management: Case Scenarios 19:55 - In-House vs. Outsourced Billing 31:51 - Winning Strategies for Physicians 40:55 - Healthcare Cybersecurity 43:52 - Proposed Reimbursement Changes for 2025 48:32 - Telehealth and Legislative Concerns 55:25 - Conclusion --- RESOURCES BackTable VI Podcast - Episode #366 Navigating OBL & ASC Business, Pitfalls to Avoid with Teri Yates: https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid BackTable VI Podcast - Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates: https://www.backtable.com/shows/vi/podcasts/431/obl-or-asc-for-your-private-practice-how-to-decide Accountable Physician Advisors: http://www.accountablephysicianadvisors.com/services DocCentric: https://doccentricasc.com/ G2211 Add-on Code: What It Is and When To Use It: https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/evaluation-management/G2211-what-it-is-and-how-to-use-it.html Is your practice profitable? The success of a private medical practice often hinges on effective revenue cycle management (RCM). In this episode of the BackTable Podcast, private practice consultant Teri Yates and host Dr. Ally Baheti share best practices in revenue cycle management for physicians. Teri Yates is the CEO of Accountable Physician Advisors and President of DocCentric.


---


This podcast is supported by:S


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


Teri explains the importance of understanding payer rules, the benefits of using professional coders, and managing front desk staff efficiently. The episode includes real-world examples of RCM challenges and solutions, the impact of insurance policies, and the role of cybersecurity. Teri also provides actionable tips for improving collections and navigating recent changes in healthcare reimbursement, especially for outpatient-based labs (OBLs) and ambulatory surgery centers (ASCs).


---


TIMESTAMPS


00:00 - Introduction

09:17 - Revenue Cycle Management: Case Scenarios

19:55 - In-House vs. Outsourced Billing

31:51 - Winning Strategies for Physicians

40:55 - Healthcare Cybersecurity

43:52 - Proposed Reimbursement Changes for 2025

48:32 - Telehealth and Legislative Concerns

55:25 - Conclusion


---


RESOURCES


BackTable VI Podcast - Episode #366 Navigating OBL & ASC Business, Pitfalls to Avoid with Teri Yates:

https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid



BackTable VI Podcast - Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates:

https://www.backtable.com/shows/vi/podcasts/431/obl-or-asc-for-your-private-practice-how-to-decide


Accountable Physician Advisors:

http://www.accountablephysicianadvisors.com/services


DocCentric:

https://doccentricasc.com/


G2211 Add-on Code: What It Is and When To Use It:

https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/evaluation-management/G2211-what-it-is-and-how-to-use-it.html


]]> 3755 Ep. 485 Mastering Microwave Ablation in HCC Treatment with Dr. Zach Berman Are you up-to-date on microwave ablation for hepatocellular carcinoma (HCC) treatment? Dr. Zachary Berman and host Dr. Michael Barraza discuss this treatment modality. They cover the spectrum of pre-procedure imaging and planning, procedure steps, and tips for navigating difficult cases. Dr. Berman is a hepatobiliary interventional oncologist and Associate Clinical Professor of Radiology at UC San Diego School of Medicine. --- This podcast is supported by an educational grant from Varian, a Siemens Healthineers company. --- SYNPOSIS Dr. Berman highlights the importance of a multidisciplinary approach, referral pathways, and the role of tumor boards in decision-making. The doctors also cover various ablation technologies, pre-procedure embolization, hydrodissection, biopsy considerations, and the incorporation of immunotherapy in ongoing research. Finally, Dr. Berman emphasizes the importance of ultrasound skills and presents some cases. --- TIMESTAMPS 00:00 - Introduction 10:09 - Techniques and Technologies 17:26 - Planning and Performing Ablations 21:35 - Tumor Size and Margins 25:09 - Navigational Software and Skills 30:47 - Hydrodissection Techniques 33:20 - Post-Ablation Imaging and Follow-Up 35:52 - Future of Ablation in IR and Cases --- RESOURCES Liver Imaging Reporting & Data System (LI-RADS®): https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS Liver Cancer Stages (BCLC): https://www.cancer.gov/types/liver/what-is-liver-cancer/stages Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795153/ Microwave ablation compared with radiofrequency ablation for treatment of hepatocellular carcinoma and liver metastases: a systematic review and meta-analysis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698169/ Prospective double-blinded randomized controlled trial of Microwave versus RadioFrequency Ablation for hepatocellular carcinoma (McRFA trial): https://www.hpbonline.org/article/S1365-182X(20)30023-X/fulltext Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial: https://jgo.amegroups.org/article/view/26929/html Surgical microwave ablation for the treatment of hepatocellular carcinoma in 791 operations: https://www.sciencedirect.com/science/article/abs/pii/S1365182X23020002 Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial: https://meetings.asco.org/abstracts-presentations/234189 One-millimeter cancer-free margin is curative for colorectal liver metastases: a propensity score case-match approach: https://pubmed.ncbi.nlm.nih.gov/23732261/ Fri, 04 Oct 2024 07:00:00 -0000 full BackTable Are you up-to-date on microwave ablation for hepatocellular carcinoma (HCC) treatment? Dr. Zachary Berman and host Dr. Michael Barraza discuss this treatment modality. They cover the spectrum of pre-procedure imaging and planning, procedure steps, and tips for navigating difficult cases. Dr. Berman is a hepatobiliary interventional oncologist and Associate Clinical Professor of Radiology at UC San Diego School of Medicine. Are you up-to-date on microwave ablation for hepatocellular carcinoma (HCC) treatment? Dr. Zachary Berman and host Dr. Michael Barraza discuss this treatment modality. They cover the spectrum of pre-procedure imaging and planning, procedure steps, and tips for navigating difficult cases. Dr. Berman is a hepatobiliary interventional oncologist and Associate Clinical Professor of Radiology at UC San Diego School of Medicine. --- This podcast is supported by an educational grant from Varian, a Siemens Healthineers company. --- SYNPOSIS Dr. Berman highlights the importance of a multidisciplinary approach, referral pathways, and the role of tumor boards in decision-making. The doctors also cover various ablation technologies, pre-procedure embolization, hydrodissection, biopsy considerations, and the incorporation of immunotherapy in ongoing research. Finally, Dr. Berman emphasizes the importance of ultrasound skills and presents some cases. --- TIMESTAMPS 00:00 - Introduction 10:09 - Techniques and Technologies 17:26 - Planning and Performing Ablations 21:35 - Tumor Size and Margins 25:09 - Navigational Software and Skills 30:47 - Hydrodissection Techniques 33:20 - Post-Ablation Imaging and Follow-Up 35:52 - Future of Ablation in IR and Cases --- RESOURCES Liver Imaging Reporting & Data System (LI-RADS®): https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS Liver Cancer Stages (BCLC): https://www.cancer.gov/types/liver/what-is-liver-cancer/stages Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795153/ Microwave ablation compared with radiofrequency ablation for treatment of hepatocellular carcinoma and liver metastases: a systematic review and meta-analysis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698169/ Prospective double-blinded randomized controlled trial of Microwave versus RadioFrequency Ablation for hepatocellular carcinoma (McRFA trial): https://www.hpbonline.org/article/S1365-182X(20)30023-X/fulltext Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial: https://jgo.amegroups.org/article/view/26929/html Surgical microwave ablation for the treatment of hepatocellular carcinoma in 791 operations: https://www.sciencedirect.com/science/article/abs/pii/S1365182X23020002 Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial: https://meetings.asco.org/abstracts-presentations/234189 One-millimeter cancer-free margin is curative for colorectal liver metastases: a propensity score case-match approach: https://pubmed.ncbi.nlm.nih.gov/23732261/ Are you up-to-date on microwave ablation for hepatocellular carcinoma (HCC) treatment? Dr. Zachary Berman and host Dr. Michael Barraza discuss this treatment modality. They cover the spectrum of pre-procedure imaging and planning, procedure steps, and tips for navigating difficult cases. Dr. Berman is a hepatobiliary interventional oncologist and Associate Clinical Professor of Radiology at UC San Diego School of Medicine.


---


This podcast is supported by an educational grant from Varian, a Siemens Healthineers company.


---


SYNPOSIS


Dr. Berman highlights the importance of a multidisciplinary approach, referral pathways, and the role of tumor boards in decision-making. The doctors also cover various ablation technologies, pre-procedure embolization, hydrodissection, biopsy considerations, and the incorporation of immunotherapy in ongoing research. Finally, Dr. Berman emphasizes the importance of ultrasound skills and presents some cases.


---


TIMESTAMPS


00:00 - Introduction

10:09 - Techniques and Technologies

17:26 - Planning and Performing Ablations

21:35 - Tumor Size and Margins

25:09 - Navigational Software and Skills

30:47 - Hydrodissection Techniques

33:20 - Post-Ablation Imaging and Follow-Up

35:52 - Future of Ablation in IR and Cases


---


RESOURCES


Liver Imaging Reporting & Data System (LI-RADS®):

https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS


Liver Cancer Stages (BCLC):

https://www.cancer.gov/types/liver/what-is-liver-cancer/stages


Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795153/


Microwave ablation compared with radiofrequency ablation for treatment of hepatocellular carcinoma and liver metastases: a systematic review and meta-analysis:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698169/


Prospective double-blinded randomized controlled trial of Microwave versus RadioFrequency Ablation for hepatocellular carcinoma (McRFA trial):

https://www.hpbonline.org/article/S1365-182X(20)30023-X/fulltext


Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial:

https://jgo.amegroups.org/article/view/26929/html

Surgical microwave ablation for the treatment of hepatocellular carcinoma in 791 operations:

https://www.sciencedirect.com/science/article/abs/pii/S1365182X23020002


Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial:

https://meetings.asco.org/abstracts-presentations/234189


One-millimeter cancer-free margin is curative for colorectal liver metastases: a propensity score case-match approach:

https://pubmed.ncbi.nlm.nih.gov/23732261/

]]> 2401 Ep. 484 Toolbox Essentials for CLI in the OBL with Dr. Kevin Herman Is your critical limb ischemia (CLI) toolbox up to date? Dr. Kevin Herman and host Dr. Sabeen Dhand discuss treating CLI in the outpatient based lab (OBL) and ambulatory surgery center (ASC) settings. Dr. Herman is an interventional radiologist at American Endovascular and Holy Name Hospital in New Jersey. --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Herman discusses the evolution of vascular interventions over the past 15 years, the role of advanced devices like the Wingman catheter and IVUS, and the nuances of tackling complex cases in both hospital and outpatient settings. Additionally, Dr. Herman highlights the business challenges of OBL practices, effective marketing strategies, and the integration of innovative tools such as live-streaming cases for real-time education and consultations. The episode concludes with a detailed case study showcasing a successful treatment of CLI, underscoring the application of advanced techniques and collaborative efforts in management. --- TIMESTAMPS 00:00 - Introduction 06:57 - Balancing Hospital and OBL Work 13:48 - Educational Initiatives and Innovations 17:12 - Strategic Planning and Treatments 26:25 - Crossing Devices and Techniques 32:04 - DEEPER REVEAL Trial 39:33 - Case Presentation: Non-Healing Wound 50:09 - Conclusion --- RESOURCES A Prospective Single-Arm Multicenter StuDy of the BarE TEmporary SPur StEnt System foR the tREatment of Vascular Lesions Located in the infrapoplitEal Arteries beLow the Knee (DEEPER REVEAL) (DEEPER REVEAL): https://clinicaltrials.gov/study/NCT05358353 Wingman Catheter: https://www.reflowmedical.com/wingman/ Tue, 01 Oct 2024 07:00:00 -0000 full BackTable Is your critical limb ischemia (CLI) toolbox up to date? Dr. Kevin Herman and host Dr. Sabeen Dhand discuss treating CLI in the outpatient based lab (OBL) and ambulatory surgery center (ASC) settings. Dr. Herman is an interventional radiologist at American Endovascular and Holy Name Hospital in New Jersey. Is your critical limb ischemia (CLI) toolbox up to date? Dr. Kevin Herman and host Dr. Sabeen Dhand discuss treating CLI in the outpatient based lab (OBL) and ambulatory surgery center (ASC) settings. Dr. Herman is an interventional radiologist at American Endovascular and Holy Name Hospital in New Jersey. --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Herman discusses the evolution of vascular interventions over the past 15 years, the role of advanced devices like the Wingman catheter and IVUS, and the nuances of tackling complex cases in both hospital and outpatient settings. Additionally, Dr. Herman highlights the business challenges of OBL practices, effective marketing strategies, and the integration of innovative tools such as live-streaming cases for real-time education and consultations. The episode concludes with a detailed case study showcasing a successful treatment of CLI, underscoring the application of advanced techniques and collaborative efforts in management. --- TIMESTAMPS 00:00 - Introduction 06:57 - Balancing Hospital and OBL Work 13:48 - Educational Initiatives and Innovations 17:12 - Strategic Planning and Treatments 26:25 - Crossing Devices and Techniques 32:04 - DEEPER REVEAL Trial 39:33 - Case Presentation: Non-Healing Wound 50:09 - Conclusion --- RESOURCES A Prospective Single-Arm Multicenter StuDy of the BarE TEmporary SPur StEnt System foR the tREatment of Vascular Lesions Located in the infrapoplitEal Arteries beLow the Knee (DEEPER REVEAL) (DEEPER REVEAL): https://clinicaltrials.gov/study/NCT05358353 Wingman Catheter: https://www.reflowmedical.com/wingman/ Is your critical limb ischemia (CLI) toolbox up to date? Dr. Kevin Herman and host Dr. Sabeen Dhand discuss treating CLI in the outpatient based lab (OBL) and ambulatory surgery center (ASC) settings. Dr. Herman is an interventional radiologist at American Endovascular and Holy Name Hospital in New Jersey.


---


This podcast is supported by:


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


Dr. Herman discusses the evolution of vascular interventions over the past 15 years, the role of advanced devices like the Wingman catheter and IVUS, and the nuances of tackling complex cases in both hospital and outpatient settings. Additionally, Dr. Herman highlights the business challenges of OBL practices, effective marketing strategies, and the integration of innovative tools such as live-streaming cases for real-time education and consultations. The episode concludes with a detailed case study showcasing a successful treatment of CLI, underscoring the application of advanced techniques and collaborative efforts in management.


---


TIMESTAMPS


00:00 - Introduction

06:57 - Balancing Hospital and OBL Work

13:48 - Educational Initiatives and Innovations

17:12 - Strategic Planning and Treatments

26:25 - Crossing Devices and Techniques

32:04 - DEEPER REVEAL Trial

39:33 - Case Presentation: Non-Healing Wound

50:09 - Conclusion


---


RESOURCES


A Prospective Single-Arm Multicenter StuDy of the BarE TEmporary SPur StEnt System foR the tREatment of Vascular Lesions Located in the infrapoplitEal Arteries beLow the Knee (DEEPER REVEAL) (DEEPER REVEAL):

https://clinicaltrials.gov/study/NCT05358353


Wingman Catheter:

https://www.reflowmedical.com/wingman/

]]> 2556 Ep. 483 Endovascular Innovations: The Ellipsys Story with Dr. Jeff Hull Surgical arteriovenous fistula (AVF) creation has been a mainstay of dialysis care for multiple decades. What does it take to break into such an established space with a new endovascular medical device? In this episode of the BackTable Podcast, Dr. Jeffrey Hull discusses the challenging journey of developing the Ellipsys system for endovascular AVF creation. --- CHECK OUT OUR SPONSOR Medtronic ClosureFast https://www.medtronic.com/closurefast6f --- SYNPOSIS We trace Dr. Hull’s path from the device's initial conception in 2006, through the first-in-human cases in 2013, to regulatory approval and acquisition by Medtronic in 2020. Dr. Hull highlights the roles of key business mentors, the importance of multidisciplinary collaboration with vascular surgery and nephrology, and the impact of investment. He also shares valuable insights on the benefits of having competitors and selecting a well-thought-out exit strategy. Additionally, we explore deep vein arterialization (DVA) as another application of endovascular AVF creation in the context of peripheral arterial disease. --- TIMESTAMPS 00:00 - Introduction 03:05 - The Birth of the Percutaneous AV Fistula Creation 15:04 - First-in-Human Cases 17:58 - Navigating the Startup Journey 21:52 - Identifying Mentors and Investors 27:33 - Competition and Criticism 36:43 - Regulatory Hurdles 44:45 - Acquisition by Medtronic 49:14 - Deep Vein Arterialization for Peripheral Arterial Disease 54:40 - Final Thoughts and Advice --- RESOURCES Avenu Medical: https://avenumedical.com/ Gracz KC et al. Proximal forearm fistula for maintenance hemodialysis (1977): https://pubmed.ncbi.nlm.nih.gov/839655/ Hull JE et al. The Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access (2018): https://pubmed.ncbi.nlm.nih.gov/29275056/ Endovascular Today- Update on Percutaneous AV Fistula Creation (2015): https://evtoday.com/articles/2015-june/update-on-percutaneous-av-fistula-creation Mallios A, Jennings WC. Percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System-the state of the art (2020): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353338/ Fri, 27 Sep 2024 07:00:00 -0000 full BackTable Surgical arteriovenous fistula (AVF) creation has been a mainstay of dialysis care for multiple decades. What does it take to break into such an established space with a new endovascular medical device? In this episode of the BackTable Podcast, Dr. Jeffrey Hull discusses the challenging journey of developing the Ellipsys system for endovascular AVF creation. Surgical arteriovenous fistula (AVF) creation has been a mainstay of dialysis care for multiple decades. What does it take to break into such an established space with a new endovascular medical device? In this episode of the BackTable Podcast, Dr. Jeffrey Hull discusses the challenging journey of developing the Ellipsys system for endovascular AVF creation. --- CHECK OUT OUR SPONSOR Medtronic ClosureFast https://www.medtronic.com/closurefast6f --- SYNPOSIS We trace Dr. Hull’s path from the device's initial conception in 2006, through the first-in-human cases in 2013, to regulatory approval and acquisition by Medtronic in 2020. Dr. Hull highlights the roles of key business mentors, the importance of multidisciplinary collaboration with vascular surgery and nephrology, and the impact of investment. He also shares valuable insights on the benefits of having competitors and selecting a well-thought-out exit strategy. Additionally, we explore deep vein arterialization (DVA) as another application of endovascular AVF creation in the context of peripheral arterial disease. --- TIMESTAMPS 00:00 - Introduction 03:05 - The Birth of the Percutaneous AV Fistula Creation 15:04 - First-in-Human Cases 17:58 - Navigating the Startup Journey 21:52 - Identifying Mentors and Investors 27:33 - Competition and Criticism 36:43 - Regulatory Hurdles 44:45 - Acquisition by Medtronic 49:14 - Deep Vein Arterialization for Peripheral Arterial Disease 54:40 - Final Thoughts and Advice --- RESOURCES Avenu Medical: https://avenumedical.com/ Gracz KC et al. Proximal forearm fistula for maintenance hemodialysis (1977): https://pubmed.ncbi.nlm.nih.gov/839655/ Hull JE et al. The Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access (2018): https://pubmed.ncbi.nlm.nih.gov/29275056/ Endovascular Today- Update on Percutaneous AV Fistula Creation (2015): https://evtoday.com/articles/2015-june/update-on-percutaneous-av-fistula-creation Mallios A, Jennings WC. Percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System-the state of the art (2020): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353338/ Surgical arteriovenous fistula (AVF) creation has been a mainstay of dialysis care for multiple decades. What does it take to break into such an established space with a new endovascular medical device? In this episode of the BackTable Podcast, Dr. Jeffrey Hull discusses the challenging journey of developing the Ellipsys system for endovascular AVF creation.


---


CHECK OUT OUR SPONSOR


Medtronic ClosureFast

https://www.medtronic.com/closurefast6f


---


SYNPOSIS


We trace Dr. Hull’s path from the device's initial conception in 2006, through the first-in-human cases in 2013, to regulatory approval and acquisition by Medtronic in 2020. Dr. Hull highlights the roles of key business mentors, the importance of multidisciplinary collaboration with vascular surgery and nephrology, and the impact of investment. He also shares valuable insights on the benefits of having competitors and selecting a well-thought-out exit strategy. Additionally, we explore deep vein arterialization (DVA) as another application of endovascular AVF creation in the context of peripheral arterial disease.


---


TIMESTAMPS


00:00 - Introduction

03:05 - The Birth of the Percutaneous AV Fistula Creation

15:04 - First-in-Human Cases

17:58 - Navigating the Startup Journey

21:52 - Identifying Mentors and Investors

27:33 - Competition and Criticism

36:43 - Regulatory Hurdles

44:45 - Acquisition by Medtronic

49:14 - Deep Vein Arterialization for Peripheral Arterial Disease

54:40 - Final Thoughts and Advice


---


RESOURCES


Avenu Medical:

https://avenumedical.com/


Gracz KC et al. Proximal forearm fistula for maintenance hemodialysis (1977):

https://pubmed.ncbi.nlm.nih.gov/839655/


Hull JE et al. The Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access (2018):

https://pubmed.ncbi.nlm.nih.gov/29275056/


Endovascular Today- Update on Percutaneous AV Fistula Creation (2015):

https://evtoday.com/articles/2015-june/update-on-percutaneous-av-fistula-creation


Mallios A, Jennings WC. Percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System-the state of the art (2020):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353338/

]]> 3523 Ep. 482 Performing PAE and Practice Building in 2024 with Dr. Jason Hoffman Get caught up on prostate artery embolization (PAE) best practices and learn the ins-and-outs of building a PAE program in 2024. Dr. Jason Hoffmann covers this and more, with host Dr. Michael Barraza. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health. --- CHECK OUT OUR SPONSOR Merit Embolotherapy https://www.merit.com/solutions/embolotherapy/ --- SYNPOSIS The doctors delve into strategies for developing expertise within a practice, coordinating with urologists, and effectively managing patient expectations. Dr. Hoffmann shares insights on leveraging different imaging techniques, equipment choices, and best practices for ensuring post-procedure patient satisfaction. The discussion also touches on the evolution of PAE guidelines, insurance challenges, and the importance of longitudinal care in interventional radiology. --- TIMESTAMPS 00:00 - Introduction 04:12 - Building a BPH Program and PAE Practice 06:28 - Referrals and Relationship with Urology 15:27 - Patient Workup and Setting Expectations 27:10 - SwiftNinja Study: Initial Impressions and Findings 31:43 - Patient Management and Post-Procedure Care 35:37 - Building a Successful PAE Practice 42:19 - Conclusion --- RESOURCES BackTable VI Podcast Episode #445 - Inside the IR Suite: A Clinician's Own Battle with Portal Vein Thrombosis with Dr. Jason Hoffmann: https://www.backtable.com/shows/vi/podcasts/445/inside-the-ir-suite-a-clinicians-own-battle-with-portal-vein-thrombosis AUA Guidelines on Benign Prostatic Hyperplasia (Updated 2023): https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline Use of a steerable microcatheter during superselective angiography: impact on radiation exposure and procedural efficiency: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966367/ Tue, 24 Sep 2024 07:00:00 -0000 full BackTable Get caught up on prostate artery embolization (PAE) best practices and learn the ins-and-outs of building a PAE program in 2024. Dr. Jason Hoffmann covers this and more, with host Dr. Michael Barraza. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health. Get caught up on prostate artery embolization (PAE) best practices and learn the ins-and-outs of building a PAE program in 2024. Dr. Jason Hoffmann covers this and more, with host Dr. Michael Barraza. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health. --- CHECK OUT OUR SPONSOR Merit Embolotherapy https://www.merit.com/solutions/embolotherapy/ --- SYNPOSIS The doctors delve into strategies for developing expertise within a practice, coordinating with urologists, and effectively managing patient expectations. Dr. Hoffmann shares insights on leveraging different imaging techniques, equipment choices, and best practices for ensuring post-procedure patient satisfaction. The discussion also touches on the evolution of PAE guidelines, insurance challenges, and the importance of longitudinal care in interventional radiology. --- TIMESTAMPS 00:00 - Introduction 04:12 - Building a BPH Program and PAE Practice 06:28 - Referrals and Relationship with Urology 15:27 - Patient Workup and Setting Expectations 27:10 - SwiftNinja Study: Initial Impressions and Findings 31:43 - Patient Management and Post-Procedure Care 35:37 - Building a Successful PAE Practice 42:19 - Conclusion --- RESOURCES BackTable VI Podcast Episode #445 - Inside the IR Suite: A Clinician's Own Battle with Portal Vein Thrombosis with Dr. Jason Hoffmann: https://www.backtable.com/shows/vi/podcasts/445/inside-the-ir-suite-a-clinicians-own-battle-with-portal-vein-thrombosis AUA Guidelines on Benign Prostatic Hyperplasia (Updated 2023): https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline Use of a steerable microcatheter during superselective angiography: impact on radiation exposure and procedural efficiency: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966367/ Get caught up on prostate artery embolization (PAE) best practices and learn the ins-and-outs of building a PAE program in 2024. Dr. Jason Hoffmann covers this and more, with host Dr. Michael Barraza. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health.


---


CHECK OUT OUR SPONSOR


Merit Embolotherapy

https://www.merit.com/solutions/embolotherapy/


---


SYNPOSIS


The doctors delve into strategies for developing expertise within a practice, coordinating with urologists, and effectively managing patient expectations. Dr. Hoffmann shares insights on leveraging different imaging techniques, equipment choices, and best practices for ensuring post-procedure patient satisfaction. The discussion also touches on the evolution of PAE guidelines, insurance challenges, and the importance of longitudinal care in interventional radiology.


---


TIMESTAMPS


00:00 - Introduction

04:12 - Building a BPH Program and PAE Practice

06:28 - Referrals and Relationship with Urology

15:27 - Patient Workup and Setting Expectations

27:10 - SwiftNinja Study: Initial Impressions and Findings

31:43 - Patient Management and Post-Procedure Care

35:37 - Building a Successful PAE Practice

42:19 - Conclusion



---


RESOURCES


BackTable VI Podcast Episode #445 - Inside the IR Suite: A Clinician's Own Battle with Portal Vein Thrombosis with Dr. Jason Hoffmann:

https://www.backtable.com/shows/vi/podcasts/445/inside-the-ir-suite-a-clinicians-own-battle-with-portal-vein-thrombosis


AUA Guidelines on Benign Prostatic Hyperplasia (Updated 2023):

https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline


Use of a steerable microcatheter during superselective angiography: impact on radiation exposure and procedural efficiency:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966367/

]]> 3030 Ep. 481 Genicular Artery Embolization: How I Do It with Dr. Osman Ahmed Genicular artery embolization (GAE) is quickly emerging as a treatment option for knee osteoarthritis when other therapies have failed. In this episode of the BackTable Podcast, Dr. Osman Ahmed discusses the origins of GAE and how he employs it in his practice. --- This podcast is supported by an educational grant from Guerbet. --- SYNPOSIS Dr. Ahmed, an interventional radiologist at the University of Chicago, shares details about the procedure, his journey in adopting it, and his thoughts on the current landscape of GAE. Topics include procedural techniques, patient selection, anatomical considerations, potential complications, and the importance of ongoing research in this field. --- TIMESTAMPS 00:00 - Introduction 04:43 - Knee Osteoarthritis and Current Treatments 07:54 - Building a GAE Practice 13:23 - Tools and Procedure: Step-by-Step 25:05 - Post-Procedure Care and Complications 30:26 - Future of GAE and Other Applications 34:03 - Conclusion and Contact Information --- RESOURCES BackTable INN Ep. 46- New Innovations in Treatment of PE: The Flow Medical Story with Founders Dr. Osman Ahmed and Dr. Jonathan Paul: https://www.backtable.com/shows/innovation/podcasts/46/new-innovations-in-treatment-of-pe-the-flow-medical-story BackTable VI Ep. 429- Tackling Upper GI Bleeds: Techniques and Tools with Dr. Osman Ahmed: https://www.backtable.com/shows/vi/podcasts/429/tackling-upper-gi-bleeds-techniques-tools BackTable VI Ep. 447- Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little: https://www.backtable.com/shows/vi/podcasts/447/exploring-gae-clinical-insights-outcomes GEST MSK Conference 2025 (Paris): https://www.gestmsk.com/ Okuno Y et al. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis (2014): https://pubmed.ncbi.nlm.nih.gov/24993956/ Little MW et al. Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS 1) Using Permanent Microspheres: Interim Analysis (2021): https://pubmed.ncbi.nlm.nih.gov/33474601/ Little MW et al. Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial (2023): https://pubmed.ncbi.nlm.nih.gov/37337060/ Correa MP et al.GAUCHO - Trial Genicular Artery Embolization Using Imipenem/Cilastatin vs. Microsphere for Knee Osteoarthritis: A Randomized Controlled Trial (2022): https://pubmed.ncbi.nlm.nih.gov/35304614/ Sapoval M et al. Genicular artery embolization for knee osteoarthritis: Results of the LipioJoint-1 trial (2024): https://pubmed.ncbi.nlm.nih.gov/38102013/ Fri, 20 Sep 2024 07:00:00 -0000 full BackTable Genicular artery embolization (GAE) is quickly emerging as a treatment option for knee osteoarthritis when other therapies have failed. In this episode of the BackTable Podcast, Dr. Osman Ahmed discusses the origins of GAE and how he employs it in his practice. Genicular artery embolization (GAE) is quickly emerging as a treatment option for knee osteoarthritis when other therapies have failed. In this episode of the BackTable Podcast, Dr. Osman Ahmed discusses the origins of GAE and how he employs it in his practice. --- This podcast is supported by an educational grant from Guerbet. --- SYNPOSIS Dr. Ahmed, an interventional radiologist at the University of Chicago, shares details about the procedure, his journey in adopting it, and his thoughts on the current landscape of GAE. Topics include procedural techniques, patient selection, anatomical considerations, potential complications, and the importance of ongoing research in this field. --- TIMESTAMPS 00:00 - Introduction 04:43 - Knee Osteoarthritis and Current Treatments 07:54 - Building a GAE Practice 13:23 - Tools and Procedure: Step-by-Step 25:05 - Post-Procedure Care and Complications 30:26 - Future of GAE and Other Applications 34:03 - Conclusion and Contact Information --- RESOURCES BackTable INN Ep. 46- New Innovations in Treatment of PE: The Flow Medical Story with Founders Dr. Osman Ahmed and Dr. Jonathan Paul: https://www.backtable.com/shows/innovation/podcasts/46/new-innovations-in-treatment-of-pe-the-flow-medical-story BackTable VI Ep. 429- Tackling Upper GI Bleeds: Techniques and Tools with Dr. Osman Ahmed: https://www.backtable.com/shows/vi/podcasts/429/tackling-upper-gi-bleeds-techniques-tools BackTable VI Ep. 447- Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little: https://www.backtable.com/shows/vi/podcasts/447/exploring-gae-clinical-insights-outcomes GEST MSK Conference 2025 (Paris): https://www.gestmsk.com/ Okuno Y et al. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis (2014): https://pubmed.ncbi.nlm.nih.gov/24993956/ Little MW et al. Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS 1) Using Permanent Microspheres: Interim Analysis (2021): https://pubmed.ncbi.nlm.nih.gov/33474601/ Little MW et al. Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial (2023): https://pubmed.ncbi.nlm.nih.gov/37337060/ Correa MP et al.GAUCHO - Trial Genicular Artery Embolization Using Imipenem/Cilastatin vs. Microsphere for Knee Osteoarthritis: A Randomized Controlled Trial (2022): https://pubmed.ncbi.nlm.nih.gov/35304614/ Sapoval M et al. Genicular artery embolization for knee osteoarthritis: Results of the LipioJoint-1 trial (2024): https://pubmed.ncbi.nlm.nih.gov/38102013/ Genicular artery embolization (GAE) is quickly emerging as a treatment option for knee osteoarthritis when other therapies have failed. In this episode of the BackTable Podcast, Dr. Osman Ahmed discusses the origins of GAE and how he employs it in his practice.


---


This podcast is supported by an educational grant from Guerbet.


---


SYNPOSIS


Dr. Ahmed, an interventional radiologist at the University of Chicago, shares details about the procedure, his journey in adopting it, and his thoughts on the current landscape of GAE. Topics include procedural techniques, patient selection, anatomical considerations, potential complications, and the importance of ongoing research in this field.


---


TIMESTAMPS


00:00 - Introduction

04:43 - Knee Osteoarthritis and Current Treatments

07:54 - Building a GAE Practice

13:23 - Tools and Procedure: Step-by-Step

25:05 - Post-Procedure Care and Complications

30:26 - Future of GAE and Other Applications

34:03 - Conclusion and Contact Information



---


RESOURCES


BackTable INN Ep. 46- New Innovations in Treatment of PE: The Flow Medical Story

with Founders Dr. Osman Ahmed and Dr. Jonathan Paul:

https://www.backtable.com/shows/innovation/podcasts/46/new-innovations-in-treatment-of-pe-the-flow-medical-story


BackTable VI Ep. 429- Tackling Upper GI Bleeds: Techniques and Tools with Dr. Osman Ahmed:

https://www.backtable.com/shows/vi/podcasts/429/tackling-upper-gi-bleeds-techniques-tools


BackTable VI Ep. 447- Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little:

https://www.backtable.com/shows/vi/podcasts/447/exploring-gae-clinical-insights-outcomes


GEST MSK Conference 2025 (Paris):

https://www.gestmsk.com/


Okuno Y et al. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis (2014):

https://pubmed.ncbi.nlm.nih.gov/24993956/


Little MW et al. Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS 1) Using Permanent Microspheres: Interim Analysis (2021):

https://pubmed.ncbi.nlm.nih.gov/33474601/


Little MW et al. Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial (2023):

https://pubmed.ncbi.nlm.nih.gov/37337060/


Correa MP et al.GAUCHO - Trial Genicular Artery Embolization Using Imipenem/Cilastatin vs. Microsphere for Knee Osteoarthritis: A Randomized Controlled Trial (2022):

https://pubmed.ncbi.nlm.nih.gov/35304614/


Sapoval M et al. Genicular artery embolization for knee osteoarthritis: Results of the LipioJoint-1 trial (2024):

https://pubmed.ncbi.nlm.nih.gov/38102013/

]]> 2310 Ep. 480 Venous Treatments: How Low Do You Go? with Dr. Adam Raskin Get caught up on the current best practices and guidelines in venous interventions. Dr. Adam Raskin covers this and more, with host Dr. Sabeen Dhand in this discussion of DVT and PE treatments. Dr. Raskin is an interventional cardiologist, medical director of Cardiac ICU, and Co-Director of the PERT program at Mercy Health in Cincinnati, Ohio. --- CHECK OUT OUR SPONSOR Imperative Care https://imperativecare.com/vascular/ --- SYNPOSIS Dr. Raskin shares his comprehensive approach for treating patients with DVT and PE, highlighting recent advancements in thrombectomy systems, as well as underscoring the need for more randomized trials to further build on current venous disease treatment guidelines. The doctors also touch on the significance of accurate diagnostic tools and thorough follow-up to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 10:58 - Approaching DVT & PE Patients 19:04 - Thrombectomy Advancements 24:02 - Iliofemoral Interventions & Standard Practices 26:32 - Accessing Tibial Veins & Clearing Clots 38:59 - Follow-Up & Data Collection 41:09 - Future of Venous Interventions --- RESOURCES The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine: https://www.jvsvenous.org/article/S2213-333X(23)00322-0/fulltext --- DISCLAIMER The Symphony Thrombectomy System is intended for the non-surgical removal of fresh, soft emboli and thrombi from blood vessels. Injection, infusion and/or aspiration of contrast media and other fluids into or from a blood vessel, intended for use in the peripheral vasculature and it is not for use in the pulmonary vasculature. Rx only. Important Safety Information may be found at http://bit.ly/3pAaUlw. Views expressed are those of the speakers and not necessarily those of the sponsor. Certain content in this podcast contains forward-looking statements and no assurance of future results should be relied upon. Brands and trademarks referenced herein are those of their respective owners or holders. Dr. Adam Raskin is a paid consultant of Imperative Care. Tue, 17 Sep 2024 07:00:00 -0000 full BackTable Get caught up on the current best practices and guidelines in venous interventions. Dr. Adam Raskin covers this and more, with host Dr. Sabeen Dhand in this discussion of DVT and PE treatments. Dr. Raskin is an interventional cardiologist, medical director of Cardiac ICU, and Co-Director of the PERT program at Mercy Health in Cincinnati, Ohio. Get caught up on the current best practices and guidelines in venous interventions. Dr. Adam Raskin covers this and more, with host Dr. Sabeen Dhand in this discussion of DVT and PE treatments. Dr. Raskin is an interventional cardiologist, medical director of Cardiac ICU, and Co-Director of the PERT program at Mercy Health in Cincinnati, Ohio. --- CHECK OUT OUR SPONSOR Imperative Care https://imperativecare.com/vascular/ --- SYNPOSIS Dr. Raskin shares his comprehensive approach for treating patients with DVT and PE, highlighting recent advancements in thrombectomy systems, as well as underscoring the need for more randomized trials to further build on current venous disease treatment guidelines. The doctors also touch on the significance of accurate diagnostic tools and thorough follow-up to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 10:58 - Approaching DVT & PE Patients 19:04 - Thrombectomy Advancements 24:02 - Iliofemoral Interventions & Standard Practices 26:32 - Accessing Tibial Veins & Clearing Clots 38:59 - Follow-Up & Data Collection 41:09 - Future of Venous Interventions --- RESOURCES The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine: https://www.jvsvenous.org/article/S2213-333X(23)00322-0/fulltext --- DISCLAIMER The Symphony Thrombectomy System is intended for the non-surgical removal of fresh, soft emboli and thrombi from blood vessels. Injection, infusion and/or aspiration of contrast media and other fluids into or from a blood vessel, intended for use in the peripheral vasculature and it is not for use in the pulmonary vasculature. Rx only. Important Safety Information may be found at http://bit.ly/3pAaUlw. Views expressed are those of the speakers and not necessarily those of the sponsor. Certain content in this podcast contains forward-looking statements and no assurance of future results should be relied upon. Brands and trademarks referenced herein are those of their respective owners or holders. Dr. Adam Raskin is a paid consultant of Imperative Care. Get caught up on the current best practices and guidelines in venous interventions. Dr. Adam Raskin covers this and more, with host Dr. Sabeen Dhand in this discussion of DVT and PE treatments. Dr. Raskin is an interventional cardiologist, medical director of Cardiac ICU, and Co-Director of the PERT program at Mercy Health in Cincinnati, Ohio.


---


CHECK OUT OUR SPONSOR


Imperative Care

https://imperativecare.com/vascular/


---


SYNPOSIS


Dr. Raskin shares his comprehensive approach for treating patients with DVT and PE, highlighting recent advancements in thrombectomy systems, as well as underscoring the need for more randomized trials to further build on current venous disease treatment guidelines. The doctors also touch on the significance of accurate diagnostic tools and thorough follow-up to improve patient outcomes.


---


TIMESTAMPS


00:00 - Introduction

10:58 - Approaching DVT & PE Patients

19:04 - Thrombectomy Advancements

24:02 - Iliofemoral Interventions & Standard Practices

26:32 - Accessing Tibial Veins & Clearing Clots

38:59 - Follow-Up & Data Collection

41:09 - Future of Venous Interventions


---


RESOURCES


The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II

Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine:

https://www.jvsvenous.org/article/S2213-333X(23)00322-0/fulltext


---


DISCLAIMER


The Symphony Thrombectomy System is intended for the non-surgical removal of fresh, soft emboli and thrombi from blood vessels. Injection, infusion and/or aspiration of contrast media and other fluids into or from a blood vessel, intended for use in the peripheral vasculature and it is not for use in the pulmonary vasculature. Rx only. Important Safety Information may be found at http://bit.ly/3pAaUlw.


Views expressed are those of the speakers and not necessarily those of the sponsor. Certain content in this podcast contains forward-looking statements and no assurance of future results should be relied upon. Brands and trademarks referenced herein are those of their respective owners or holders.


Dr. Adam Raskin is a paid consultant of Imperative Care.

]]> 2848 Ep. 479 World of Hurt: A New Film About Medical Malpractice with Viknesh Kasthuri In a society where discussions about medical malpractice are often concealed from the public eye, this episode of BackTable shines a spotlight on the powerful documentary ‘A World of Hurt: How Medical Malpractice Fails Everyone,’ produced by Viknesh Kasthuri, a fourth-year medical student at Brown University. Released earlier this year, the film explores how the American medical malpractice system harms and disconnects patients and providers through three compelling case studies. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS We delve into Viknesh’s motivations and the process behind creating the documentary, discussing the need for improved provider education on lawsuits, effective communication with patients and legal teams, and strategies for coping mentally and emotionally throughout this intensive process. Additionally, Viknesh provides a behind-the-scenes look at documentary production, including filming during the COVID pandemic, creating environments for patients and providers to share their stories, and submitting the documentary to film festivals. --- TIMESTAMPS 00:00 - Introduction 02:40 - Inspiration Behind the Documentary 06:10 - Technical and Legal Aspects of Documentary Production 14:34 - Releasing the Documentary 17:04 - Physician and Patient Responses to Medical Errors 20:27 - Highlighting Communication Resolution Programs 23:04 - Educational Gaps in Medical Training 26:43 - Exploring Systemic Solutions to Management of Medical Errors 30:16 - Final Thoughts and Future Projects --- RESOURCES A World of Hurt Documentary: https://www.youtube.com/watch?v=09IVcL6pACU BackTable VI Ep. 77- Doctors and Litigation: The L Word, with Dr. Gita Pensa: https://www.backtable.com/shows/vi/podcasts/177/doctors-litigation-the-l-word The L Word Podcast with Dr. Gita Pensa: https://doctorsandlitigation.com/podcast-2 BackTable ENT Ep. 90- Coaching Physicians Through the Stress of Malpractice Litigation, with Dr. Gita Pensa: https://www.backtable.com/shows/ent/podcasts/90/coaching-physicians-through-the-stress-of-malpractice-litigation Michigan Model Communication and Resolution Program: https://www.uofmhealth.org/michigan-model-medical-malpractice-and-patient-safety-umhs Fri, 13 Sep 2024 07:00:00 -0000 full BackTable In a society where discussions about medical malpractice are often concealed from the public eye, this episode of BackTable shines a spotlight on the powerful documentary ‘A World of Hurt: How Medical Malpractice Fails Everyone,’ produced by Viknesh Kasthuri, a fourth-year medical student at Brown University. Released earlier this year, the film explores how the American medical malpractice system harms and disconnects patients and providers through three compelling case studies. In a society where discussions about medical malpractice are often concealed from the public eye, this episode of BackTable shines a spotlight on the powerful documentary ‘A World of Hurt: How Medical Malpractice Fails Everyone,’ produced by Viknesh Kasthuri, a fourth-year medical student at Brown University. Released earlier this year, the film explores how the American medical malpractice system harms and disconnects patients and providers through three compelling case studies. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS We delve into Viknesh’s motivations and the process behind creating the documentary, discussing the need for improved provider education on lawsuits, effective communication with patients and legal teams, and strategies for coping mentally and emotionally throughout this intensive process. Additionally, Viknesh provides a behind-the-scenes look at documentary production, including filming during the COVID pandemic, creating environments for patients and providers to share their stories, and submitting the documentary to film festivals. --- TIMESTAMPS 00:00 - Introduction 02:40 - Inspiration Behind the Documentary 06:10 - Technical and Legal Aspects of Documentary Production 14:34 - Releasing the Documentary 17:04 - Physician and Patient Responses to Medical Errors 20:27 - Highlighting Communication Resolution Programs 23:04 - Educational Gaps in Medical Training 26:43 - Exploring Systemic Solutions to Management of Medical Errors 30:16 - Final Thoughts and Future Projects --- RESOURCES A World of Hurt Documentary: https://www.youtube.com/watch?v=09IVcL6pACU BackTable VI Ep. 77- Doctors and Litigation: The L Word, with Dr. Gita Pensa: https://www.backtable.com/shows/vi/podcasts/177/doctors-litigation-the-l-word The L Word Podcast with Dr. Gita Pensa: https://doctorsandlitigation.com/podcast-2 BackTable ENT Ep. 90- Coaching Physicians Through the Stress of Malpractice Litigation, with Dr. Gita Pensa: https://www.backtable.com/shows/ent/podcasts/90/coaching-physicians-through-the-stress-of-malpractice-litigation Michigan Model Communication and Resolution Program: https://www.uofmhealth.org/michigan-model-medical-malpractice-and-patient-safety-umhs In a society where discussions about medical malpractice are often concealed from the public eye, this episode of BackTable shines a spotlight on the powerful documentary ‘A World of Hurt: How Medical Malpractice Fails Everyone,’ produced by Viknesh Kasthuri, a fourth-year medical student at Brown University. Released earlier this year, the film explores how the American medical malpractice system harms and disconnects patients and providers through three compelling case studies.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


We delve into Viknesh’s motivations and the process behind creating the documentary, discussing the need for improved provider education on lawsuits, effective communication with patients and legal teams, and strategies for coping mentally and emotionally throughout this intensive process.

Additionally, Viknesh provides a behind-the-scenes look at documentary production, including filming during the COVID pandemic, creating environments for patients and providers to share their stories, and submitting the documentary to film festivals.


---


TIMESTAMPS


00:00 - Introduction

02:40 - Inspiration Behind the Documentary

06:10 - Technical and Legal Aspects of Documentary Production

14:34 - Releasing the Documentary

17:04 - Physician and Patient Responses to Medical Errors

20:27 - Highlighting Communication Resolution Programs

23:04 - Educational Gaps in Medical Training

26:43 - Exploring Systemic Solutions to Management of Medical Errors

30:16 - Final Thoughts and Future Projects



---


RESOURCES


A World of Hurt Documentary:

https://www.youtube.com/watch?v=09IVcL6pACU


BackTable VI Ep. 77- Doctors and Litigation: The L Word, with Dr. Gita Pensa:

https://www.backtable.com/shows/vi/podcasts/177/doctors-litigation-the-l-word


The L Word Podcast with Dr. Gita Pensa:

https://doctorsandlitigation.com/podcast-2



BackTable ENT Ep. 90- Coaching Physicians Through the Stress of Malpractice Litigation, with Dr. Gita Pensa:

https://www.backtable.com/shows/ent/podcasts/90/coaching-physicians-through-the-stress-of-malpractice-litigation


Michigan Model Communication and Resolution Program:

https://www.uofmhealth.org/michigan-model-medical-malpractice-and-patient-safety-umhs

]]> 2306 Ep. 478 ASC vs. OBL: Legal Insights Explained with Jason Greis Are you interested in starting an ASC or converting your OBL into an ASC, but aren’t sure where to start? We’ve got you covered with this comprehensive overview. Attorney Jason Greis joins guest host and ASC founder Dr. Krishna Mannava to explore the operational, financial, and legal intricacies of starting an ASC. Jason is a Partner of Benesch, Friedlander, Coplan & Aronoff LLP, outside co-counsel to the Renal Physicians Association and OEIS Society, and recognized faculty member of SIR Business Institute. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Jason and Dr. Mannava discuss crucial factors such as structural modifications, financial considerations, legal requirements, Certificate of Need (CON) states, and credentialing processes. The conversation also delves into strategic partnerships with hospitals, the role of ASC management companies, and the involvement of non-physician owners. Additionally, they explain the implications of non-compete clauses, operational challenges, investment structures, and exit strategies. --- TIMESTAMPS 00:00 - Introduction 03:11 - OBL to ASC Conversion 06:08 - Financial and Regulatory Aspects 15:35 - Ownership and Investment Strategies 29:41 - Non-Competes and Legal Risks 34:21 - Specialized Legal Advice and Conclusion --- RESOURCES Vive Vascular: https://www.vivevascular.com/ SIR Business Center: https://irbc.sirweb.org/ Tue, 10 Sep 2024 07:00:00 -0000 full BackTable Are you interested in starting an ASC or converting your OBL into an ASC, but aren’t sure where to start? We’ve got you covered with this comprehensive overview. Attorney Jason Greis joins guest host and ASC founder Dr. Krishna Mannava to explore the operational, financial, and legal intricacies of starting an ASC. Jason is a Partner of Benesch, Friedlander, Coplan & Aronoff LLP, outside co-counsel to the Renal Physicians Association and OEIS Society, and recognized faculty member of SIR Business Institute. Are you interested in starting an ASC or converting your OBL into an ASC, but aren’t sure where to start? We’ve got you covered with this comprehensive overview. Attorney Jason Greis joins guest host and ASC founder Dr. Krishna Mannava to explore the operational, financial, and legal intricacies of starting an ASC. Jason is a Partner of Benesch, Friedlander, Coplan & Aronoff LLP, outside co-counsel to the Renal Physicians Association and OEIS Society, and recognized faculty member of SIR Business Institute. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Jason and Dr. Mannava discuss crucial factors such as structural modifications, financial considerations, legal requirements, Certificate of Need (CON) states, and credentialing processes. The conversation also delves into strategic partnerships with hospitals, the role of ASC management companies, and the involvement of non-physician owners. Additionally, they explain the implications of non-compete clauses, operational challenges, investment structures, and exit strategies. --- TIMESTAMPS 00:00 - Introduction 03:11 - OBL to ASC Conversion 06:08 - Financial and Regulatory Aspects 15:35 - Ownership and Investment Strategies 29:41 - Non-Competes and Legal Risks 34:21 - Specialized Legal Advice and Conclusion --- RESOURCES Vive Vascular: https://www.vivevascular.com/ SIR Business Center: https://irbc.sirweb.org/ Are you interested in starting an ASC or converting your OBL into an ASC, but aren’t sure where to start? We’ve got you covered with this comprehensive overview. Attorney Jason Greis joins guest host and ASC founder Dr. Krishna Mannava to explore the operational, financial, and legal intricacies of starting an ASC. Jason is a Partner of Benesch, Friedlander, Coplan & Aronoff LLP, outside co-counsel to the Renal Physicians Association and OEIS Society, and recognized faculty member of SIR Business Institute.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


Jason and Dr. Mannava discuss crucial factors such as structural modifications, financial considerations, legal requirements, Certificate of Need (CON) states, and credentialing processes. The conversation also delves into strategic partnerships with hospitals, the role of ASC management companies, and the involvement of non-physician owners. Additionally, they explain the implications of non-compete clauses, operational challenges, investment structures, and exit strategies.


---


TIMESTAMPS


00:00 - Introduction

03:11 - OBL to ASC Conversion

06:08 - Financial and Regulatory Aspects

15:35 - Ownership and Investment Strategies

29:41 - Non-Competes and Legal Risks

34:21 - Specialized Legal Advice and Conclusion


---


RESOURCES


Vive Vascular:

https://www.vivevascular.com/


SIR Business Center:

https://irbc.sirweb.org/

]]> 2843 Ep. 477 Building a Successful Lymphangiography Practice with Dr. Bill Majdalany What’s needed to build a successful lymphangiography practice? Dr. Bill Majdalany joins host Dr. Chris Beck to answer this question and to discuss advancements in lymphangiography over the past decade. Dr. Majdalany is the Chief and Vice Chair of Research of Interventional Radiology at University of Vermont. --- CHECK OUT OUR SPONSOR Guerbet --- SYNPOSIS The doctors provide insights on various lymphatic procedures such as thoracic duct embolization, stenting, and recanalization. They also discuss the evolving significance of lymphatic medicine in interventional radiology and its potential applications in treating conditions like ascites and variceal bleeding. The conversation underscores the interconnected nature of the lymphatic system throughout the body, emphasizing the revolutionary potential of lymphangiography in modern medicine. --- TIMESTAMPS 00:00 - Introduction 04:23 - Building a Lymphangiography Practice 08:36 - The Lymphatic Revolution 17:42 - Practical Tips and Equipment for Lymphangiography 30:09 - Advanced Interventions and Tools 48:45 - Future of Lymphatic Interventions 51:23 - Conclusion and Resources --- RESOURCES BackTable VI Podcast Episode #135 - IR Residency Pathways & Getting In! (Part 1) with Dr. Jeff Bodner and Dr. Bill Majdalany: https://www.backtable.com/shows/vi/contributors/dr-bill-majdalany Seminars in Interventional Radiology - Lymphatics: https://www.thieme-connect.com/products/ejournals/issue/10.1055/s-010-49075 Lymphatic Anatomy: https://www.techvir.com/article/S1089-2516(16)30042-7/abstract Tue, 03 Sep 2024 07:00:00 -0000 full BackTable What’s needed to build a successful lymphangiography practice? Dr. Bill Majdalany joins host Dr. Chris Beck to answer this question and to discuss advancements in lymphangiography over the past decade. Dr. Majdalany is the Chief and Vice Chair of Research of Interventional Radiology at University of Vermont. What’s needed to build a successful lymphangiography practice? Dr. Bill Majdalany joins host Dr. Chris Beck to answer this question and to discuss advancements in lymphangiography over the past decade. Dr. Majdalany is the Chief and Vice Chair of Research of Interventional Radiology at University of Vermont. --- CHECK OUT OUR SPONSOR Guerbet --- SYNPOSIS The doctors provide insights on various lymphatic procedures such as thoracic duct embolization, stenting, and recanalization. They also discuss the evolving significance of lymphatic medicine in interventional radiology and its potential applications in treating conditions like ascites and variceal bleeding. The conversation underscores the interconnected nature of the lymphatic system throughout the body, emphasizing the revolutionary potential of lymphangiography in modern medicine. --- TIMESTAMPS 00:00 - Introduction 04:23 - Building a Lymphangiography Practice 08:36 - The Lymphatic Revolution 17:42 - Practical Tips and Equipment for Lymphangiography 30:09 - Advanced Interventions and Tools 48:45 - Future of Lymphatic Interventions 51:23 - Conclusion and Resources --- RESOURCES BackTable VI Podcast Episode #135 - IR Residency Pathways & Getting In! (Part 1) with Dr. Jeff Bodner and Dr. Bill Majdalany: https://www.backtable.com/shows/vi/contributors/dr-bill-majdalany Seminars in Interventional Radiology - Lymphatics: https://www.thieme-connect.com/products/ejournals/issue/10.1055/s-010-49075 Lymphatic Anatomy: https://www.techvir.com/article/S1089-2516(16)30042-7/abstract What’s needed to build a successful lymphangiography practice? Dr. Bill Majdalany joins host Dr. Chris Beck to answer this question and to discuss advancements in lymphangiography over the past decade. Dr. Majdalany is the Chief and Vice Chair of Research of Interventional Radiology at University of Vermont.


---


CHECK OUT OUR SPONSOR


Guerbet



---


SYNPOSIS


The doctors provide insights on various lymphatic procedures such as thoracic duct embolization, stenting, and recanalization. They also discuss the evolving significance of lymphatic medicine in interventional radiology and its potential applications in treating conditions like ascites and variceal bleeding. The conversation underscores the interconnected nature of the lymphatic system throughout the body, emphasizing the revolutionary potential of lymphangiography in modern medicine.


---


TIMESTAMPS


00:00 - Introduction

04:23 - Building a Lymphangiography Practice

08:36 - The Lymphatic Revolution

17:42 - Practical Tips and Equipment for Lymphangiography

30:09 - Advanced Interventions and Tools

48:45 - Future of Lymphatic Interventions

51:23 - Conclusion and Resources



---


RESOURCES


BackTable VI Podcast Episode #135 - IR Residency Pathways & Getting In! (Part 1)

with Dr. Jeff Bodner and Dr. Bill Majdalany:

https://www.backtable.com/shows/vi/contributors/dr-bill-majdalany


Seminars in Interventional Radiology - Lymphatics:

https://www.thieme-connect.com/products/ejournals/issue/10.1055/s-010-49075


Lymphatic Anatomy:

https://www.techvir.com/article/S1089-2516(16)30042-7/abstract


]]> 3325 Ep. 476 Medical Innovations: IR in Space with Dominic Tanzillo and Dr. Richard Moon What is the final frontier of interventional radiology? Dominic Tanzillo and Dr. Richard Moon believe it could be space. Dominic is a 3rd year medical student at Duke University interested in interventional radiology (IR) and space medicine, and Dr. Moon is a Professor at Duke University and an expert in hyperbaric and aerospace medicine. --- CHECK OUT OUR SPONSOR Medtronic DCB https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/drug-coated-balloons.html --- SYNPOSIS Dominic and Dr. Moon cover the potential for IR in deep space missions, focusing on the unique challenges astronauts face, such as altered blood flow, increased clotting risks, and the impacts of microgravity on the human body. The episode dives into NASA’s investments in portable medical technologies, the practicalities of emergency medical procedures in space, and the need for minimally invasive interventions. The significance of IR in diagnosing and managing vascular issues in space is discussed, as well as the broader implications for future Mars missions and long-term space travel. --- TIMESTAMPS 00:00 - Introduction 02:36 - IR in Space 20:04 - Medical Issues Astronauts Face 26:27 - Remote Surgery and Telesurgery 30:45 - Emergency Evacuations in Space 32:32 - More on Space Medicine --- RESOURCES Aerospace Medicine Association: https://www.asma.org/about-asma/careers/aerospace-medicine Translational Research Institute for Space Health: https://www.bcm.edu/academic-centers/space-medicine/translational-research-institute Space Medicine Coursera: https://www.coursera.org/learn/space-medicine-duke What Space Medicine Taught Me About Science Communication | Dominic Tanzillo | TEDxDuke: https://www.youtube.com/watch?v=PBkdvSByneM Dominic Tanzillo: https://dominictanzillo.github.io/ Tue, 27 Aug 2024 07:00:00 -0000 full BackTable What is the final frontier of interventional radiology? Dominic Tanzillo and Dr. Richard Moon believe it could be space. Dominic is a 3rd year medical student at Duke University interested in interventional radiology (IR) and space medicine, and Dr. Moon is a Professor at Duke University and an expert in hyperbaric and aerospace medicine. What is the final frontier of interventional radiology? Dominic Tanzillo and Dr. Richard Moon believe it could be space. Dominic is a 3rd year medical student at Duke University interested in interventional radiology (IR) and space medicine, and Dr. Moon is a Professor at Duke University and an expert in hyperbaric and aerospace medicine. --- CHECK OUT OUR SPONSOR Medtronic DCB https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/drug-coated-balloons.html --- SYNPOSIS Dominic and Dr. Moon cover the potential for IR in deep space missions, focusing on the unique challenges astronauts face, such as altered blood flow, increased clotting risks, and the impacts of microgravity on the human body. The episode dives into NASA’s investments in portable medical technologies, the practicalities of emergency medical procedures in space, and the need for minimally invasive interventions. The significance of IR in diagnosing and managing vascular issues in space is discussed, as well as the broader implications for future Mars missions and long-term space travel. --- TIMESTAMPS 00:00 - Introduction 02:36 - IR in Space 20:04 - Medical Issues Astronauts Face 26:27 - Remote Surgery and Telesurgery 30:45 - Emergency Evacuations in Space 32:32 - More on Space Medicine --- RESOURCES Aerospace Medicine Association: https://www.asma.org/about-asma/careers/aerospace-medicine Translational Research Institute for Space Health: https://www.bcm.edu/academic-centers/space-medicine/translational-research-institute Space Medicine Coursera: https://www.coursera.org/learn/space-medicine-duke What Space Medicine Taught Me About Science Communication | Dominic Tanzillo | TEDxDuke: https://www.youtube.com/watch?v=PBkdvSByneM Dominic Tanzillo: https://dominictanzillo.github.io/ What is the final frontier of interventional radiology? Dominic Tanzillo and Dr. Richard Moon believe it could be space. Dominic is a 3rd year medical student at Duke University interested in interventional radiology (IR) and space medicine, and Dr. Moon is a Professor at Duke University and an expert in hyperbaric and aerospace medicine.


---


CHECK OUT OUR SPONSOR


Medtronic DCB

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/drug-coated-balloons.html


---


SYNPOSIS


Dominic and Dr. Moon cover the potential for IR in deep space missions, focusing on the unique challenges astronauts face, such as altered blood flow, increased clotting risks, and the impacts of microgravity on the human body. The episode dives into NASA’s investments in portable medical technologies, the practicalities of emergency medical procedures in space, and the need for minimally invasive interventions. The significance of IR in diagnosing and managing vascular issues in space is discussed, as well as the broader implications for future Mars missions and long-term space travel.


---


TIMESTAMPS


00:00 - Introduction

02:36 - IR in Space

20:04 - Medical Issues Astronauts Face

26:27 - Remote Surgery and Telesurgery

30:45 - Emergency Evacuations in Space

32:32 - More on Space Medicine


---


RESOURCES


Aerospace Medicine Association:

https://www.asma.org/about-asma/careers/aerospace-medicine


Translational Research Institute for Space Health:

https://www.bcm.edu/academic-centers/space-medicine/translational-research-institute


Space Medicine Coursera:

https://www.coursera.org/learn/space-medicine-duke


What Space Medicine Taught Me About Science Communication | Dominic Tanzillo | TEDxDuke:

https://www.youtube.com/watch?v=PBkdvSByneM


Dominic Tanzillo:

https://dominictanzillo.github.io/

]]> 2286 Ep. 475 Bariatric Embolization for Obesity Management with Dr Cliff Weiss While GLP-1 agonists continue to gain popularity in the medical management of diabetes and obesity, Dr. Cliff Weiss is exploring bariatric arterial embolization (BAE) as an adjunctive therapy to help patients sustain weight loss. Dr. Weiss, the Director of IR Research at Johns Hopkins, joins the show to discuss the techniques and impacts of BAE for obesity treatment. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Weiss outlines his initial research interest in gastric embolization of the fundus to reduce ghrelin production. He began by studying the use of sclerosants for embolization but later shifted to using embolic spheres. BAE involves the targeted embolization of the left gastric artery, with or without the left gastroepiploic artery, using 300-500 micron embolic spheres. Dr. Weiss also employs a dilute mixture of spheres and a vasodilator to achieve distal arterial penetration. He describes the role of BAE in conjunction with existing surgical and pharmaceutical treatments. According to his experience, patients undergoing BAE achieve maximum weight loss 6-9 months after the procedure and can maintain this weight when they follow up in a weight management clinic. Additionally, Dr. Weiss reviews data from BAE studies, including the BEAT Obesity Trial and the recent BEATLES Trial. --- TIMESTAMPS 00:00 - Introduction 03:21 - Early Research and Development of BAE 07:39 - Potential Role of BAE in Obesity Treatment 16:03 - Procedure Details 25:28 - Post-Procedure Care and Patient Management 28:06 - Insights from the BEAT Obesity Trial 33:38 - BEATLES Trial 37:38 - Combination Therapy for Obesity --- RESOURCES BEAT Obesity Trial: https://pubs.rsna.org/doi/full/10.1148/radiol.2019182354 LC Bead/Bead Block: https://www.bostonscientific.com/en-US/products/embolization/lc-bead.html EmboSpheres: https://www.merit.com/product/embosphere-microspheres/ EMBIO Trial: https://bmjopen.bmj.com/content/13/9/e072327 BEATLES Trial: https://www.jvir.org/article/S1051-0443(23)01155-7/fulltext Tue, 20 Aug 2024 07:00:00 -0000 full BackTable While GLP-1 agonists continue to gain popularity in the medical management of diabetes and obesity, Dr. Cliff Weiss is exploring bariatric arterial embolization (BAE) as an adjunctive therapy to help patients sustain weight loss. Dr. Weiss, the Director of IR Research at Johns Hopkins, joins the show to discuss the techniques and impacts of BAE for obesity treatment. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Weiss outlines his initial research interest in gastric embolization of the fundus to reduce ghrelin production. He began by studying the use of sclerosants for embolization but later shifted to using embolic spheres. BAE involves the targeted embolization of the left gastric artery, with or without the left gastroepiploic artery, using 300-500 micron embolic spheres. Dr. Weiss also employs a dilute mixture of spheres and a vasodilator to achieve distal arterial penetration. He describes the role of BAE in conjunction with existing surgical and pharmaceutical treatments. According to his experience, patients undergoing BAE achieve maximum weight loss 6-9 months after the procedure and can maintain this weight when they follow up in a weight management clinic. Additionally, Dr. Weiss reviews data from BAE studies, including the BEAT Obesity Trial and the recent BEATLES Trial. --- TIMESTAMPS 00:00 - Introduction 03:21 - Early Research and Development of BAE 07:39 - Potential Role of BAE in Obesity Treatment 16:03 - Procedure Details 25:28 - Post-Procedure Care and Patient Management 28:06 - Insights from the BEAT Obesity Trial 33:38 - BEATLES Trial 37:38 - Combination Therapy for Obesity --- RESOURCES BEAT Obesity Trial: https://pubs.rsna.org/doi/full/10.1148/radiol.2019182354 LC Bead/Bead Block: https://www.bostonscientific.com/en-US/products/embolization/lc-bead.html EmboSpheres: https://www.merit.com/product/embosphere-microspheres/ EMBIO Trial: https://bmjopen.bmj.com/content/13/9/e072327 BEATLES Trial: https://www.jvir.org/article/S1051-0443(23)01155-7/fulltext While GLP-1 agonists continue to gain popularity in the medical management of diabetes and obesity, Dr. Cliff Weiss is exploring bariatric arterial embolization (BAE) as an adjunctive therapy to help patients sustain weight loss. Dr. Weiss, the Director of IR Research at Johns Hopkins, joins the show to discuss the techniques and impacts of BAE for obesity treatment.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


Dr. Weiss outlines his initial research interest in gastric embolization of the fundus to reduce ghrelin production. He began by studying the use of sclerosants for embolization but later shifted to using embolic spheres. BAE involves the targeted embolization of the left gastric artery, with or without the left gastroepiploic artery, using 300-500 micron embolic spheres. Dr. Weiss also employs a dilute mixture of spheres and a vasodilator to achieve distal arterial penetration.


He describes the role of BAE in conjunction with existing surgical and pharmaceutical treatments. According to his experience, patients undergoing BAE achieve maximum weight loss 6-9 months after the procedure and can maintain this weight when they follow up in a weight management clinic. Additionally, Dr. Weiss reviews data from BAE studies, including the BEAT Obesity Trial and the recent BEATLES Trial.


---


TIMESTAMPS


00:00 - Introduction

03:21 - Early Research and Development of BAE

07:39 - Potential Role of BAE in Obesity Treatment

16:03 - Procedure Details

25:28 - Post-Procedure Care and Patient Management

28:06 - Insights from the BEAT Obesity Trial

33:38 - BEATLES Trial

37:38 - Combination Therapy for Obesity


---


RESOURCES


BEAT Obesity Trial:

https://pubs.rsna.org/doi/full/10.1148/radiol.2019182354


LC Bead/Bead Block:

https://www.bostonscientific.com/en-US/products/embolization/lc-bead.html


EmboSpheres:

https://www.merit.com/product/embosphere-microspheres/


EMBIO Trial:

https://bmjopen.bmj.com/content/13/9/e072327


BEATLES Trial:

https://www.jvir.org/article/S1051-0443(23)01155-7/fulltext

]]> 2800 Ep. 474 Navigating Physician and Industry Relationships with Dr. Adam Tanious How can physicians and industry partners collaborate effectively to enhance patient care? Dr. Adam Tanious, Assistant Professor of Vascular Surgery at the Medical University of South Carolina, joins host Dr. Aaron Fritts to explore strategies for navigating physician-industry relationships. --- SYNPOSIS The doctors share their experiences in partnering with the medical device industry. The conversation covers the benefits of industry partnerships, the challenges of avoiding conflicts of interest, and the critical role of education in preparing new physicians for these interactions. Dr. Tanious also delves into his thought-provoking TED Talk on big business in surgery, and discusses the value of business education for physicians. --- TIMESTAMPS 00:00 - Introduction 02:12 - Medicine and Business 05:01 - Business Knowledge for Physicians 15:05 - Physician-Industry Relationships 27:26 - Industry Relationships in Medical Training 33:08 - Ethical Considerations and Influence in the OR 35:00 - Leveraging Industry Resources for Better Training 43:24 - Future of Medical Technology and Collaboration --- RESOURCES Big Business and Surgery: Who Belongs in Your Operating Room?: https://youtu.be/kksVjF0fI_w?si=LADwqrbXPz3VsFm4 Quantic MBA Program: https://quantic.edu/blog/category/fields-of-study/accounting/ The price of a cup of coffee: https://vascularspecialistonline.com/the-price-of-a-cup-of-coffee/ Fri, 16 Aug 2024 07:00:00 -0000 full BackTable How can physicians and industry partners collaborate effectively to enhance patient care? Dr. Adam Tanious, Assistant Professor of Vascular Surgery at the Medical University of South Carolina, joins host Dr. Aaron Fritts to explore strategies for navigating physician-industry relationships. How can physicians and industry partners collaborate effectively to enhance patient care? Dr. Adam Tanious, Assistant Professor of Vascular Surgery at the Medical University of South Carolina, joins host Dr. Aaron Fritts to explore strategies for navigating physician-industry relationships. --- SYNPOSIS The doctors share their experiences in partnering with the medical device industry. The conversation covers the benefits of industry partnerships, the challenges of avoiding conflicts of interest, and the critical role of education in preparing new physicians for these interactions. Dr. Tanious also delves into his thought-provoking TED Talk on big business in surgery, and discusses the value of business education for physicians. --- TIMESTAMPS 00:00 - Introduction 02:12 - Medicine and Business 05:01 - Business Knowledge for Physicians 15:05 - Physician-Industry Relationships 27:26 - Industry Relationships in Medical Training 33:08 - Ethical Considerations and Influence in the OR 35:00 - Leveraging Industry Resources for Better Training 43:24 - Future of Medical Technology and Collaboration --- RESOURCES Big Business and Surgery: Who Belongs in Your Operating Room?: https://youtu.be/kksVjF0fI_w?si=LADwqrbXPz3VsFm4 Quantic MBA Program: https://quantic.edu/blog/category/fields-of-study/accounting/ The price of a cup of coffee: https://vascularspecialistonline.com/the-price-of-a-cup-of-coffee/ How can physicians and industry partners collaborate effectively to enhance patient care? Dr. Adam Tanious, Assistant Professor of Vascular Surgery at the Medical University of South Carolina, joins host Dr. Aaron Fritts to explore strategies for navigating physician-industry relationships.


---


SYNPOSIS


The doctors share their experiences in partnering with the medical device industry. The conversation covers the benefits of industry partnerships, the challenges of avoiding conflicts of interest, and the critical role of education in preparing new physicians for these interactions. Dr. Tanious also delves into his thought-provoking TED Talk on big business in surgery, and discusses the value of business education for physicians.


---


TIMESTAMPS


00:00 - Introduction

02:12 - Medicine and Business

05:01 - Business Knowledge for Physicians

15:05 - Physician-Industry Relationships

27:26 - Industry Relationships in Medical Training

33:08 - Ethical Considerations and Influence in the OR

35:00 - Leveraging Industry Resources for Better Training

43:24 - Future of Medical Technology and Collaboration


---


RESOURCES


Big Business and Surgery: Who Belongs in Your Operating Room?:

https://youtu.be/kksVjF0fI_w?si=LADwqrbXPz3VsFm4


Quantic MBA Program:

https://quantic.edu/blog/category/fields-of-study/accounting/


The price of a cup of coffee:

https://vascularspecialistonline.com/the-price-of-a-cup-of-coffee/

]]> 3429 Ep. 473 Portal Hypertension Treatment Strategies: IR and Hepatology Perspectives with Dr. Thomas Leventhal and Dr. Siobhan Flanagan The management of portal hypertension has drastically evolved over the years. What are the current best practices? And what’s coming next? Dr. Tom Leventhal and Dr. Siobahn Flanagan from University of Minnesota Medical School join us for an interdisciplinary discussion. Dr. Leventhal is an Associate Professor of Transplant Hepatology and Dr. Siobhan is an Associate Professor of Interventional Radiology. --- CHECK OUT OUR SPONSOR Cook Medical Embolization https://www.cookmedical.com/interventional-radiology/coils-home/cook-products/?utm_source=backtable&utm_medium=digital&utm_campaign=vasc_ir_p_awa_embolization_2024_amer --- SYNPOSIS The doctors discuss current collaborative approaches that are improving portal hypertension patient care, the impact of contemporary clinical practices in transplant hepatology and IR, and the imminent future of portal hypertension treatments. Dr. Leventhal also gives his insight on what could be on the horizon, touching on in-vitro organ creation, xenotransplants, and stem cells phasing out immunosuppression. --- TIMESTAMPS 00:00 - Introduction 06:10 - Managing Portal Hypertension 07:51 - Current Collaborative Practices 10:38 - Patient Referral and Management 15:25 - Initial Workup for Portal Hypertension 19:27 - Role of Biopsy in Diagnosis 24:02 - Patient Scenarios for TIPS Referral 32:04 - Ultrasound and Intracardiac Echocardiography (ICE) in TIPS 38:09 - Clinical Management 52:48 - Future of Transplant and Organ Growth Tue, 13 Aug 2024 07:00:00 -0000 full BackTable The management of portal hypertension has drastically evolved over the years. What are the current best practices? And what’s coming next? Dr. Tom Leventhal and Dr. Siobahn Flanagan from University of Minnesota Medical School join us for an interdisciplinary discussion. Dr. Leventhal is an Associate Professor of Transplant Hepatology and Dr. Siobhan is an Associate Professor of Interventional Radiology. The management of portal hypertension has drastically evolved over the years. What are the current best practices? And what’s coming next? Dr. Tom Leventhal and Dr. Siobahn Flanagan from University of Minnesota Medical School join us for an interdisciplinary discussion. Dr. Leventhal is an Associate Professor of Transplant Hepatology and Dr. Siobhan is an Associate Professor of Interventional Radiology. --- CHECK OUT OUR SPONSOR Cook Medical Embolization https://www.cookmedical.com/interventional-radiology/coils-home/cook-products/?utm_source=backtable&utm_medium=digital&utm_campaign=vasc_ir_p_awa_embolization_2024_amer --- SYNPOSIS The doctors discuss current collaborative approaches that are improving portal hypertension patient care, the impact of contemporary clinical practices in transplant hepatology and IR, and the imminent future of portal hypertension treatments. Dr. Leventhal also gives his insight on what could be on the horizon, touching on in-vitro organ creation, xenotransplants, and stem cells phasing out immunosuppression. --- TIMESTAMPS 00:00 - Introduction 06:10 - Managing Portal Hypertension 07:51 - Current Collaborative Practices 10:38 - Patient Referral and Management 15:25 - Initial Workup for Portal Hypertension 19:27 - Role of Biopsy in Diagnosis 24:02 - Patient Scenarios for TIPS Referral 32:04 - Ultrasound and Intracardiac Echocardiography (ICE) in TIPS 38:09 - Clinical Management 52:48 - Future of Transplant and Organ Growth The management of portal hypertension has drastically evolved over the years. What are the current best practices? And what’s coming next? Dr. Tom Leventhal and Dr. Siobahn Flanagan from University of Minnesota Medical School join us for an interdisciplinary discussion. Dr. Leventhal is an Associate Professor of Transplant Hepatology and Dr. Siobhan is an Associate Professor of Interventional Radiology.


---


CHECK OUT OUR SPONSOR


Cook Medical Embolization

https://www.cookmedical.com/interventional-radiology/coils-home/cook-products/?utm_source=backtable&utm_medium=digital&utm_campaign=vasc_ir_p_awa_embolization_2024_amer


---


SYNPOSIS


The doctors discuss current collaborative approaches that are improving portal hypertension patient care, the impact of contemporary clinical practices in transplant hepatology and IR, and the imminent future of portal hypertension treatments. Dr. Leventhal also gives his insight on what could be on the horizon, touching on in-vitro organ creation, xenotransplants, and stem cells phasing out immunosuppression.


---


TIMESTAMPS


00:00 - Introduction

06:10 - Managing Portal Hypertension

07:51 - Current Collaborative Practices

10:38 - Patient Referral and Management

15:25 - Initial Workup for Portal Hypertension

19:27 - Role of Biopsy in Diagnosis

24:02 - Patient Scenarios for TIPS Referral

32:04 - Ultrasound and Intracardiac Echocardiography (ICE) in TIPS

38:09 - Clinical Management

52:48 - Future of Transplant and Organ Growth

]]> 3559 Ep. 472 All Things Enteral Access Part 2 from Dr. Peter Bream We are back with Part 2 of All Things Enteral Access with Dr. Peter Bream! We discuss various aspects of enteric access and management of complications with G and GJ-tubes. --- SYNPOSIS Dr. Bream provides detailed advice on troubleshooting common issues such as leaking tubes, infections, and clogs. He emphasizes the importance of a multidisciplinary approach in managing special populations, such as patients with ALS and head and neck cancer, and offers guidance for safe and effective procedures. The conversation is rich with practical tips, tricks, and valuable insights that cater to both new and experienced practitioners. --- TIMESTAMPS 00:00 - Introduction 01:47 - Special Populations 07:21 - ALS Patients 09:57 - Head and Neck Cancer Patients 14:05 - Techniques for Gastric Bypass and Altered Anatomy 18:11 - Addressing G-Tube Issues 27:16 - Converting G to GJ-Tubes 31:11 - Advanced Tips and Tricks --- RESOURCES Weighted Tip Extensions Result in Fewer Gastrojejunostomy Tube Migrations and Increase Tube Lifespan: https://www.jvir.org/article/S1051-0443(22)01243-X/abstract Fri, 09 Aug 2024 07:00:00 -0000 full BackTable We are back with Part 2 of All Things Enteral Access with Dr. Peter Bream! We discuss various aspects of enteric access and management of complications with G and GJ-tubes. We are back with Part 2 of All Things Enteral Access with Dr. Peter Bream! We discuss various aspects of enteric access and management of complications with G and GJ-tubes. --- SYNPOSIS Dr. Bream provides detailed advice on troubleshooting common issues such as leaking tubes, infections, and clogs. He emphasizes the importance of a multidisciplinary approach in managing special populations, such as patients with ALS and head and neck cancer, and offers guidance for safe and effective procedures. The conversation is rich with practical tips, tricks, and valuable insights that cater to both new and experienced practitioners. --- TIMESTAMPS 00:00 - Introduction 01:47 - Special Populations 07:21 - ALS Patients 09:57 - Head and Neck Cancer Patients 14:05 - Techniques for Gastric Bypass and Altered Anatomy 18:11 - Addressing G-Tube Issues 27:16 - Converting G to GJ-Tubes 31:11 - Advanced Tips and Tricks --- RESOURCES Weighted Tip Extensions Result in Fewer Gastrojejunostomy Tube Migrations and Increase Tube Lifespan: https://www.jvir.org/article/S1051-0443(22)01243-X/abstract We are back with Part 2 of All Things Enteral Access with Dr. Peter Bream! We discuss various aspects of enteric access and management of complications with G and GJ-tubes.


---


SYNPOSIS


Dr. Bream provides detailed advice on troubleshooting common issues such as leaking tubes, infections, and clogs. He emphasizes the importance of a multidisciplinary approach in managing special populations, such as patients with ALS and head and neck cancer, and offers guidance for safe and effective procedures. The conversation is rich with practical tips, tricks, and valuable insights that cater to both new and experienced practitioners.


---


TIMESTAMPS


00:00 - Introduction

01:47 - Special Populations

07:21 - ALS Patients

09:57 - Head and Neck Cancer Patients

14:05 - Techniques for Gastric Bypass and Altered Anatomy

18:11 - Addressing G-Tube Issues

27:16 - Converting G to GJ-Tubes

31:11 - Advanced Tips and Tricks


---


RESOURCES


Weighted Tip Extensions Result in Fewer Gastrojejunostomy Tube Migrations and Increase Tube Lifespan:

https://www.jvir.org/article/S1051-0443(22)01243-X/abstract

]]> 2332 Ep. 471 All Things Enteral Access Part 1 from Dr. Peter Bream Do you have questions about enteral access? Dr. Peter Bream’s got you covered! In this episode Dr. Bream, former Professor at UNC Chapel Hill School of Medicine and current private practice interventional radiologist, shares his extensive knowledge on enteral access. --- CHECK OUT OUR SPONSOR Medtronic Concerto https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/peripheral-embolization/concerto.html --- SYNPOSIS The discussion covers various insertion techniques, the use of different types of tubes including NG, G, and GJ tubes, and specialized methods like the Balloon-Assisted Gastrostomy (BAG) and Percutaneous Transesophageal Gastrostomy (PTEG). Dr. Bream also provides valuable insights on handling complications, patient preparation, and post-procedure care, making this episode a comprehensive guide for all things enteral access. Be sure to check out Part 2 next. --- TIMESTAMPS 00:00 - Introduction 03:00 - Tubes for Enteral Access 15:48 - Techniques and Personal Experiences 29:59 - Limitations and Techniques for Stroke Patients 30:45 - Patient Comfort and Sedation 37:16 - Complications and Safety Measures 39:14 - Palliative Techniques and Special Cases 49:49 - Post-Procedure Care and Maintenance --- RESOURCES Percutaneous gastrostomy: https://pubmed.ncbi.nlm.nih.gov/6414043/ Retrospective comparison of outcomes and associated complications between large bore radiologically inserted gastrostomy tube types: https://pubmed.ncbi.nlm.nih.gov/30073401/ Single-Step Method for Pull-Type Gastrostomy Tube Placement: https://pubmed.ncbi.nlm.nih.gov/31542269/ Balloon Assisted Gastrostomy (BAG) YouTube Video: https://youtu.be/GuF7BYW2Hm0?si=6xUIDQaQV-ywX1ua IR Playbook: A Comprehensive Introduction to Interventional Radiology (1st edition): https://link.springer.com/book/10.1007/978-3-319-71300-7 IR Playbook: A Comprehensive Introduction to Interventional Radiology Second Edition 2024: https://link.springer.com/book/10.1007/978-3-031-52546-9 Pediatric gastrostomy tubes and techniques: making safer and cleaner choices: https://pubmed.ncbi.nlm.nih.gov/29180216/ Thu, 08 Aug 2024 07:00:00 -0000 full BackTable Do you have questions about enteral access? Dr. Peter Bream’s got you covered! In this episode Dr. Bream, former Professor at UNC Chapel Hill School of Medicine and current private practice interventional radiologist, shares his extensive knowledge on enteral access. Do you have questions about enteral access? Dr. Peter Bream’s got you covered! In this episode Dr. Bream, former Professor at UNC Chapel Hill School of Medicine and current private practice interventional radiologist, shares his extensive knowledge on enteral access. --- CHECK OUT OUR SPONSOR Medtronic Concerto https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/peripheral-embolization/concerto.html --- SYNPOSIS The discussion covers various insertion techniques, the use of different types of tubes including NG, G, and GJ tubes, and specialized methods like the Balloon-Assisted Gastrostomy (BAG) and Percutaneous Transesophageal Gastrostomy (PTEG). Dr. Bream also provides valuable insights on handling complications, patient preparation, and post-procedure care, making this episode a comprehensive guide for all things enteral access. Be sure to check out Part 2 next. --- TIMESTAMPS 00:00 - Introduction 03:00 - Tubes for Enteral Access 15:48 - Techniques and Personal Experiences 29:59 - Limitations and Techniques for Stroke Patients 30:45 - Patient Comfort and Sedation 37:16 - Complications and Safety Measures 39:14 - Palliative Techniques and Special Cases 49:49 - Post-Procedure Care and Maintenance --- RESOURCES Percutaneous gastrostomy: https://pubmed.ncbi.nlm.nih.gov/6414043/ Retrospective comparison of outcomes and associated complications between large bore radiologically inserted gastrostomy tube types: https://pubmed.ncbi.nlm.nih.gov/30073401/ Single-Step Method for Pull-Type Gastrostomy Tube Placement: https://pubmed.ncbi.nlm.nih.gov/31542269/ Balloon Assisted Gastrostomy (BAG) YouTube Video: https://youtu.be/GuF7BYW2Hm0?si=6xUIDQaQV-ywX1ua IR Playbook: A Comprehensive Introduction to Interventional Radiology (1st edition): https://link.springer.com/book/10.1007/978-3-319-71300-7 IR Playbook: A Comprehensive Introduction to Interventional Radiology Second Edition 2024: https://link.springer.com/book/10.1007/978-3-031-52546-9 Pediatric gastrostomy tubes and techniques: making safer and cleaner choices: https://pubmed.ncbi.nlm.nih.gov/29180216/ Do you have questions about enteral access? Dr. Peter Bream’s got you covered! In this episode Dr. Bream, former Professor at UNC Chapel Hill School of Medicine and current private practice interventional radiologist, shares his extensive knowledge on enteral access.


---


CHECK OUT OUR SPONSOR


Medtronic Concerto

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/peripheral-embolization/concerto.html


---


SYNPOSIS


The discussion covers various insertion techniques, the use of different types of tubes including NG, G, and GJ tubes, and specialized methods like the Balloon-Assisted Gastrostomy (BAG) and Percutaneous Transesophageal Gastrostomy (PTEG). Dr. Bream also provides valuable insights on handling complications, patient preparation, and post-procedure care, making this episode a comprehensive guide for all things enteral access. Be sure to check out Part 2 next.


---


TIMESTAMPS


00:00 - Introduction

03:00 - Tubes for Enteral Access

15:48 - Techniques and Personal Experiences

29:59 - Limitations and Techniques for Stroke Patients

30:45 - Patient Comfort and Sedation

37:16 - Complications and Safety Measures

39:14 - Palliative Techniques and Special Cases

49:49 - Post-Procedure Care and Maintenance


---


RESOURCES


Percutaneous gastrostomy:

https://pubmed.ncbi.nlm.nih.gov/6414043/


Retrospective comparison of outcomes and associated complications between large bore radiologically inserted gastrostomy tube types:

https://pubmed.ncbi.nlm.nih.gov/30073401/


Single-Step Method for Pull-Type Gastrostomy Tube Placement:

https://pubmed.ncbi.nlm.nih.gov/31542269/


Balloon Assisted Gastrostomy (BAG) YouTube Video:

https://youtu.be/GuF7BYW2Hm0?si=6xUIDQaQV-ywX1ua


IR Playbook: A Comprehensive Introduction to Interventional Radiology (1st edition):

https://link.springer.com/book/10.1007/978-3-319-71300-7


IR Playbook: A Comprehensive Introduction to Interventional Radiology Second Edition 2024:

https://link.springer.com/book/10.1007/978-3-031-52546-9


Pediatric gastrostomy tubes and techniques: making safer and cleaner choices:

https://pubmed.ncbi.nlm.nih.gov/29180216/

]]> 3579 Ep. 470 Updated Guidance on Paclitaxel-Coated Devices with Dr. Sahil Parikh and Dr. John Park The use of drug-coated balloons (DCBs) for peripheral arterial disease has been controversial in the past. However, new data and updated FDA guidance have helped these devices regain popularity. In this episode of the BackTable Podcast, Dr. Ally Baheti hosts a discussion with Dr. Sahil Parikh, an interventional cardiologist in New York City, and Dr. John Park, a vascular surgeon in Omaha. --- CHECK OUT OUR SPONSOR BD Lutonix https://www.bd.com/en-us/products-and-solutions/products/product-families/lutonix-drug-coated-balloon-pta-catheters --- SYNPOSIS They review the historical controversy surrounding the potential late-mortality risks associated with Paclitaxel-coated devices, discuss more recent literature on the safety and efficacy of DCBs, and examine the implications of the FDA’s updated guidance in 2023. This update was made possible through collaborative efforts across specialties and regulatory bodies to establish best practices for vascular interventions. They also delve into patient selection criteria, lesion characteristics, and practical considerations for choosing between DCBs and other revascularization options. Each provider shares their treatment algorithm for DCB use in peripheral arterial disease. Dr. Park uses DCBs as a first-line treatment for patients with complete occlusions, CLTI symptoms, or lifestyle-limiting claudication, with adjunctive stenting sometimes required afterwards. In his experience, DCBs work best in lesions shorter than 100 mm and are preferable in locations where stenting is not feasible, such as across the knee joint. Dr. Parikh similarly prefers DCBs over plain balloon angioplasty and places stents in longer lesions. He notes that Hunter’s canal is a challenging area to treat with DCBs alone and may require atherectomy or intravascular lithotripsy. He recommends considering drug-eluting stents as a proactive measure to prevent more costly interventions for future restenosis. --- TIMESTAMPS 00:00 - Introduction 02:14 - History of DCB and Controversy 07:46 - Updated Research and 2023 FDA Guidelines 16:44 - Importance of Collaboration and Patient Preference 26:34 - DCB Treatment Algorithms 33:31 - Drug-Eluting Stents 35:46 - Approach for Patients with Claudication 37:22 - DCB Sizing and Dose --- RESOURCES Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials (2018): https://www.ahajournals.org/doi/10.1161/JAHA.118.011245 FDA- Treatment of Peripheral Arterial Disease with Paclitaxel-Coated Balloons and Paclitaxel-Eluting Stents Potentially Associated with Increased Mortality–Letter to Health Care Providers (2018): www.fda.gov/medical-devices/letters-health-care-providers/update-treatment-peripheral-arterial-disease-paclitaxel-coated-balloons-and-paclitaxel-eluting FDA- Paclitaxel-Coated Devices to Treat Peripheral Arterial Disease Unlikely to Increase Risk of Mortality - Letter to Health Care Providers (2023): https://www.fda.gov/medical-devices/letters-health-care-providers/update-paclitaxel-coated-devices-treat-peripheral-arterial-disease-unlikely-increase-risk-mortality Mortality in randomised controlled trials using paclitaxel-coated devices for femoropopliteal interventional procedures: an updated patient-level meta-analysis (2023): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02189-X/abstract Tue, 06 Aug 2024 07:00:00 -0000 full BackTable The use of drug-coated balloons (DCBs) for peripheral arterial disease has been controversial in the past. However, new data and updated FDA guidance have helped these devices regain popularity. In this episode of the BackTable Podcast, Dr. Ally Baheti hosts a discussion with Dr. Sahil Parikh, an interventional cardiologist in New York City, and Dr. John Park, a vascular surgeon in Omaha. The use of drug-coated balloons (DCBs) for peripheral arterial disease has been controversial in the past. However, new data and updated FDA guidance have helped these devices regain popularity. In this episode of the BackTable Podcast, Dr. Ally Baheti hosts a discussion with Dr. Sahil Parikh, an interventional cardiologist in New York City, and Dr. John Park, a vascular surgeon in Omaha. --- CHECK OUT OUR SPONSOR BD Lutonix https://www.bd.com/en-us/products-and-solutions/products/product-families/lutonix-drug-coated-balloon-pta-catheters --- SYNPOSIS They review the historical controversy surrounding the potential late-mortality risks associated with Paclitaxel-coated devices, discuss more recent literature on the safety and efficacy of DCBs, and examine the implications of the FDA’s updated guidance in 2023. This update was made possible through collaborative efforts across specialties and regulatory bodies to establish best practices for vascular interventions. They also delve into patient selection criteria, lesion characteristics, and practical considerations for choosing between DCBs and other revascularization options. Each provider shares their treatment algorithm for DCB use in peripheral arterial disease. Dr. Park uses DCBs as a first-line treatment for patients with complete occlusions, CLTI symptoms, or lifestyle-limiting claudication, with adjunctive stenting sometimes required afterwards. In his experience, DCBs work best in lesions shorter than 100 mm and are preferable in locations where stenting is not feasible, such as across the knee joint. Dr. Parikh similarly prefers DCBs over plain balloon angioplasty and places stents in longer lesions. He notes that Hunter’s canal is a challenging area to treat with DCBs alone and may require atherectomy or intravascular lithotripsy. He recommends considering drug-eluting stents as a proactive measure to prevent more costly interventions for future restenosis. --- TIMESTAMPS 00:00 - Introduction 02:14 - History of DCB and Controversy 07:46 - Updated Research and 2023 FDA Guidelines 16:44 - Importance of Collaboration and Patient Preference 26:34 - DCB Treatment Algorithms 33:31 - Drug-Eluting Stents 35:46 - Approach for Patients with Claudication 37:22 - DCB Sizing and Dose --- RESOURCES Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials (2018): https://www.ahajournals.org/doi/10.1161/JAHA.118.011245 FDA- Treatment of Peripheral Arterial Disease with Paclitaxel-Coated Balloons and Paclitaxel-Eluting Stents Potentially Associated with Increased Mortality–Letter to Health Care Providers (2018): www.fda.gov/medical-devices/letters-health-care-providers/update-treatment-peripheral-arterial-disease-paclitaxel-coated-balloons-and-paclitaxel-eluting FDA- Paclitaxel-Coated Devices to Treat Peripheral Arterial Disease Unlikely to Increase Risk of Mortality - Letter to Health Care Providers (2023): https://www.fda.gov/medical-devices/letters-health-care-providers/update-paclitaxel-coated-devices-treat-peripheral-arterial-disease-unlikely-increase-risk-mortality Mortality in randomised controlled trials using paclitaxel-coated devices for femoropopliteal interventional procedures: an updated patient-level meta-analysis (2023): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02189-X/abstract The use of drug-coated balloons (DCBs) for peripheral arterial disease has been controversial in the past. However, new data and updated FDA guidance have helped these devices regain popularity. In this episode of the BackTable Podcast, Dr. Ally Baheti hosts a discussion with Dr. Sahil Parikh, an interventional cardiologist in New York City, and Dr. John Park, a vascular surgeon in Omaha.


---


CHECK OUT OUR SPONSOR


BD Lutonix

https://www.bd.com/en-us/products-and-solutions/products/product-families/lutonix-drug-coated-balloon-pta-catheters


---


SYNPOSIS


They review the historical controversy surrounding the potential late-mortality risks associated with Paclitaxel-coated devices, discuss more recent literature on the safety and efficacy of DCBs, and examine the implications of the FDA’s updated guidance in 2023. This update was made possible through collaborative efforts across specialties and regulatory bodies to establish best practices for vascular interventions. They also delve into patient selection criteria, lesion characteristics, and practical considerations for choosing between DCBs and other revascularization options. Each provider shares their treatment algorithm for DCB use in peripheral arterial disease.

Dr. Park uses DCBs as a first-line treatment for patients with complete occlusions, CLTI symptoms, or lifestyle-limiting claudication, with adjunctive stenting sometimes required afterwards. In his experience, DCBs work best in lesions shorter than 100 mm and are preferable in locations where stenting is not feasible, such as across the knee joint.

Dr. Parikh similarly prefers DCBs over plain balloon angioplasty and places stents in longer lesions. He notes that Hunter’s canal is a challenging area to treat with DCBs alone and may require atherectomy or intravascular lithotripsy. He recommends considering drug-eluting stents as a proactive measure to prevent more costly interventions for future restenosis.


---


TIMESTAMPS


00:00 - Introduction

02:14 - History of DCB and Controversy

07:46 - Updated Research and 2023 FDA Guidelines

16:44 - Importance of Collaboration and Patient Preference

26:34 - DCB Treatment Algorithms

33:31 - Drug-Eluting Stents

35:46 - Approach for Patients with Claudication

37:22 - DCB Sizing and Dose


---


RESOURCES


Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials (2018):

https://www.ahajournals.org/doi/10.1161/JAHA.118.011245


FDA- Treatment of Peripheral Arterial Disease with Paclitaxel-Coated Balloons and Paclitaxel-Eluting Stents Potentially Associated with Increased Mortality–Letter to Health Care Providers (2018):

www.fda.gov/medical-devices/letters-health-care-providers/update-treatment-peripheral-arterial-disease-paclitaxel-coated-balloons-and-paclitaxel-eluting


FDA- Paclitaxel-Coated Devices to Treat Peripheral Arterial Disease Unlikely to Increase Risk of Mortality - Letter to Health Care Providers (2023): https://www.fda.gov/medical-devices/letters-health-care-providers/update-paclitaxel-coated-devices-treat-peripheral-arterial-disease-unlikely-increase-risk-mortality

Mortality in randomised controlled trials using paclitaxel-coated devices for femoropopliteal interventional procedures: an updated patient-level meta-analysis (2023):

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02189-X/abstract

]]> 2864 Ep. 469 Price Transparency in Healthcare with Dr. Keith Smith Creating an ambulatory surgery center (ASC) with transparent, affordable pricing is possible and can go a long way in protecting our patients’ health, pockets, and futures. Dr. Keith Smith, founder of Oklahoma Surgery Center and the Free Market Medical Association, joins us to explain how to do it. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Smith shares his journey of creating transparent and affordable healthcare pricing, the challenges faced due to government regulations and insurance companies, and the rapid growth of self-funded companies seeking value in medical services. He highlights the importance of simple, honest pricing and the impact of the Free Market Medical Association in connecting buyers and sellers. Dr. Smith also discusses the expansion of his model beyond Oklahoma and into new surgical centers, emphasizing the need for price transparency in healthcare. --- TIMESTAMPS 00:00 - Introduction 05:06 - Challenges & Growth 14:18 - Self-Funding & Price Transparency 16:47 - Free Market Medical Association 21:44 - Government & Price Transparency 26:19 - Expansion & Future Plans --- RESOURCES Oklahoma Surgery Center: https://surgerycenterok.com/ Free Market Medical Association: https://fmma.org/ Fri, 02 Aug 2024 07:00:00 -0000 full BackTable Creating an ambulatory surgery center (ASC) with transparent, affordable pricing is possible and can go a long way in protecting our patients’ health, pockets, and futures. Dr. Keith Smith, founder of Oklahoma Surgery Center and the Free Market Medical Association, joins us to explain how to do it. Creating an ambulatory surgery center (ASC) with transparent, affordable pricing is possible and can go a long way in protecting our patients’ health, pockets, and futures. Dr. Keith Smith, founder of Oklahoma Surgery Center and the Free Market Medical Association, joins us to explain how to do it. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Smith shares his journey of creating transparent and affordable healthcare pricing, the challenges faced due to government regulations and insurance companies, and the rapid growth of self-funded companies seeking value in medical services. He highlights the importance of simple, honest pricing and the impact of the Free Market Medical Association in connecting buyers and sellers. Dr. Smith also discusses the expansion of his model beyond Oklahoma and into new surgical centers, emphasizing the need for price transparency in healthcare. --- TIMESTAMPS 00:00 - Introduction 05:06 - Challenges & Growth 14:18 - Self-Funding & Price Transparency 16:47 - Free Market Medical Association 21:44 - Government & Price Transparency 26:19 - Expansion & Future Plans --- RESOURCES Oklahoma Surgery Center: https://surgerycenterok.com/ Free Market Medical Association: https://fmma.org/ Creating an ambulatory surgery center (ASC) with transparent, affordable pricing is possible and can go a long way in protecting our patients’ health, pockets, and futures. Dr. Keith Smith, founder of Oklahoma Surgery Center and the Free Market Medical Association, joins us to explain how to do it.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


Dr. Smith shares his journey of creating transparent and affordable healthcare pricing, the challenges faced due to government regulations and insurance companies, and the rapid growth of self-funded companies seeking value in medical services. He highlights the importance of simple, honest pricing and the impact of the Free Market Medical Association in connecting buyers and sellers. Dr. Smith also discusses the expansion of his model beyond Oklahoma and into new surgical centers, emphasizing the need for price transparency in healthcare.


---


TIMESTAMPS


00:00 - Introduction

05:06 - Challenges & Growth

14:18 - Self-Funding & Price Transparency

16:47 - Free Market Medical Association

21:44 - Government & Price Transparency

26:19 - Expansion & Future Plans


---


RESOURCES


Oklahoma Surgery Center:

https://surgerycenterok.com/


Free Market Medical Association:

https://fmma.org/

]]> 2382 Ep. 468 Advancements in Laser Atherectomy with Dr. On Topaz How has Laser Atherectomy advanced over the years to treat patients with coronary and peripheral artery disease? Dr. On Topaz, renowned specialist in laser atherectomy, answers exactly that and much more in this week’s episode the BackTable Podcast. Dr. Topaz is an interventional cardiologist and a professor of medicine at Duke University. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SYNPOSIS The doctors begin their discussion by comparing traditional Excimer laser and new Auryon laser technologies. The conversation also covers thrombus management, use of lasers in complex plaques, the latest research studies on laser atherectomy, and future developments in laser technology for varied medical applications. --- TIMESTAMPS 00:00 - Introduction 10:01 - Laser Atherectomy & Thrombus Management 21:59 - Laser Applications in Peripheral Arterial Disease 28:12 - Laser in Interventional Cardiology 41:17 - New Laser Technologies 47:50 - Research Findings and Clinical Trials 59:09 - Future Prospects and Applications --- RESOURCES Book by Dr. On Topaz - Debulking in Cardiovascular Interventions and Revascularization Strategies: https://www.sciencedirect.com/book/9780128214510/debulking-in-cardiovascular-interventions-and-revascularization-strategies Book by Dr. On Topaz - Lasers in Cardiovascular Interventions: https://link.springer.com/content/pdf/10.1007/978-1-4471-5220-0.pdf Book by Dr. On Topaz - Cardiovascular Thrombus: From Pathology and Clinical Presentations to Imaging, Pharmacotherapy and Interventions: https://www.sciencedirect.com/book/9780128126158/cardiovascular-thrombus Paper from Dr. Giancarlo Biamino - The excimer laser: science fiction fantasy or practical tool?: https://pubmed.ncbi.nlm.nih.gov/15760264/ Clinical Trial from Dr. John Bittl - Predictors of outcome of percutaneous excimer laser coronary angioplasty of saphenous vein bypass graft lesions. The Percutaneous Excimer Laser Coronary Angioplasty Registry: https://pubmed.ncbi.nlm.nih.gov/8023778/ Paper from Dr. Warren S. Grundfest - https://journals.lww.com/coronary-artery/citation/1990/07000/laser_angioplasty.4.aspx Paper from Dr. George S. Abela - Abrupt Closure After Pulsed Laser Angioplasty: Spasm or A “Mille-Feuilles” Effect?: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-8183.1992.tb00830.x Solid state, pulsed-wave 355 nm UV laser atherectomy debulking in the treatment of infrainguinal peripheral arterial disease: The Pathfinder Registry: https://pubmed.ncbi.nlm.nih.gov/38566525/ Tue, 30 Jul 2024 07:00:00 -0000 full BackTable How has Laser Atherectomy advanced over the years to treat patients with coronary and peripheral artery disease? Dr. On Topaz, renowned specialist in laser atherectomy, answers exactly that and much more in this week’s episode the BackTable Podcast. Dr. Topaz is an interventional cardiologist and a professor of medicine at Duke University. How has Laser Atherectomy advanced over the years to treat patients with coronary and peripheral artery disease? Dr. On Topaz, renowned specialist in laser atherectomy, answers exactly that and much more in this week’s episode the BackTable Podcast. Dr. Topaz is an interventional cardiologist and a professor of medicine at Duke University. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SYNPOSIS The doctors begin their discussion by comparing traditional Excimer laser and new Auryon laser technologies. The conversation also covers thrombus management, use of lasers in complex plaques, the latest research studies on laser atherectomy, and future developments in laser technology for varied medical applications. --- TIMESTAMPS 00:00 - Introduction 10:01 - Laser Atherectomy & Thrombus Management 21:59 - Laser Applications in Peripheral Arterial Disease 28:12 - Laser in Interventional Cardiology 41:17 - New Laser Technologies 47:50 - Research Findings and Clinical Trials 59:09 - Future Prospects and Applications --- RESOURCES Book by Dr. On Topaz - Debulking in Cardiovascular Interventions and Revascularization Strategies: https://www.sciencedirect.com/book/9780128214510/debulking-in-cardiovascular-interventions-and-revascularization-strategies Book by Dr. On Topaz - Lasers in Cardiovascular Interventions: https://link.springer.com/content/pdf/10.1007/978-1-4471-5220-0.pdf Book by Dr. On Topaz - Cardiovascular Thrombus: From Pathology and Clinical Presentations to Imaging, Pharmacotherapy and Interventions: https://www.sciencedirect.com/book/9780128126158/cardiovascular-thrombus Paper from Dr. Giancarlo Biamino - The excimer laser: science fiction fantasy or practical tool?: https://pubmed.ncbi.nlm.nih.gov/15760264/ Clinical Trial from Dr. John Bittl - Predictors of outcome of percutaneous excimer laser coronary angioplasty of saphenous vein bypass graft lesions. The Percutaneous Excimer Laser Coronary Angioplasty Registry: https://pubmed.ncbi.nlm.nih.gov/8023778/ Paper from Dr. Warren S. Grundfest - https://journals.lww.com/coronary-artery/citation/1990/07000/laser_angioplasty.4.aspx Paper from Dr. George S. Abela - Abrupt Closure After Pulsed Laser Angioplasty: Spasm or A “Mille-Feuilles” Effect?: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-8183.1992.tb00830.x Solid state, pulsed-wave 355 nm UV laser atherectomy debulking in the treatment of infrainguinal peripheral arterial disease: The Pathfinder Registry: https://pubmed.ncbi.nlm.nih.gov/38566525/ How has Laser Atherectomy advanced over the years to treat patients with coronary and peripheral artery disease? Dr. On Topaz, renowned specialist in laser atherectomy, answers exactly that and much more in this week’s episode the BackTable Podcast. Dr. Topaz is an interventional cardiologist and a professor of medicine at Duke University.


---


CHECK OUT OUR SPONSOR


AngioDynamics Auryon System

https://www.auryon-system.com/


---


SYNPOSIS


The doctors begin their discussion by comparing traditional Excimer laser and new Auryon laser technologies. The conversation also covers thrombus management, use of lasers in complex plaques, the latest research studies on laser atherectomy, and future developments in laser technology for varied medical applications.


---


TIMESTAMPS


00:00 - Introduction

10:01 - Laser Atherectomy & Thrombus Management

21:59 - Laser Applications in Peripheral Arterial Disease

28:12 - Laser in Interventional Cardiology

41:17 - New Laser Technologies

47:50 - Research Findings and Clinical Trials

59:09 - Future Prospects and Applications


---


RESOURCES


Book by Dr. On Topaz - Debulking in Cardiovascular Interventions and Revascularization Strategies:

https://www.sciencedirect.com/book/9780128214510/debulking-in-cardiovascular-interventions-and-revascularization-strategies


Book by Dr. On Topaz - Lasers in Cardiovascular Interventions:

https://link.springer.com/content/pdf/10.1007/978-1-4471-5220-0.pdf


Book by Dr. On Topaz - Cardiovascular Thrombus: From Pathology and Clinical Presentations to Imaging, Pharmacotherapy and Interventions:

https://www.sciencedirect.com/book/9780128126158/cardiovascular-thrombus


Paper from Dr. Giancarlo Biamino - The excimer laser: science fiction fantasy or practical tool?:

https://pubmed.ncbi.nlm.nih.gov/15760264/


Clinical Trial from Dr. John Bittl - Predictors of outcome of percutaneous excimer laser coronary angioplasty of saphenous vein bypass graft lesions. The Percutaneous Excimer Laser Coronary Angioplasty Registry:

https://pubmed.ncbi.nlm.nih.gov/8023778/


Paper from Dr. Warren S. Grundfest - https://journals.lww.com/coronary-artery/citation/1990/07000/laser_angioplasty.4.aspx


Paper from Dr. George S. Abela - Abrupt Closure After Pulsed Laser Angioplasty: Spasm or A “Mille-Feuilles” Effect?:

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-8183.1992.tb00830.x


Solid state, pulsed-wave 355 nm UV laser atherectomy debulking in the treatment of infrainguinal peripheral arterial disease: The Pathfinder Registry:

https://pubmed.ncbi.nlm.nih.gov/38566525/

]]> 4086 Ep. 467 Independent IR Practice in Rural America with Dr. Frederick D. Johnson Bringing more interventional radiology to rural America would benefit many patients who currently do not have access to minimally invasive, image guided medicine. In today's episode, Dr. Frederick Johnson, an interventional radiologist practicing in Thomasville, Georgia joins us to discuss the unique dynamics and challenges of setting up and maintaining a successful rural IR practice. --- CHECK OUT OUR SPONSOR Medtronic ClosureFast https://www.medtronic.com/us-en/c/cardiovascular/closurefast-rfa-system.html --- SYNPOSIS Dr. Johnson provides insights into the professional service agreement (PSA) model that allows his practice to maintain autonomy while collaborating with the local hospital. The episode explores the complexities of recruiting to a rural setting, maintaining a broad case mix, ensuring financial stability, and fostering professional satisfaction. The conversation highlights the importance of redefining independence and the benefits of integrating collaboration into IR practices. --- TIMESTAMPS 00:00 - Introduction 02:29 - Dr. Johnson’s Background and Journey 11:46 - Professional Service Agreement (PSA) Explained 18:48 - Daily Operations and Structure 24:19 - Teamwork in Rural Healthcare 30:35 - Recruitment and Growth 33:33 - Compensation and Financial Incentives 42:05 - Benefits of Small Town Living 44:34 - Advice for Aspiring Rural Healthcare Practitioners --- RESOURCES Vita Surgery/Vascular Website: https://vitadr.org/ Fri, 26 Jul 2024 07:00:00 -0000 full BackTable Bringing more interventional radiology to rural America would benefit many patients who currently do not have access to minimally invasive, image guided medicine. In today's episode, Dr. Frederick Johnson, an interventional radiologist practicing in Thomasville, Georgia joins us to discuss the unique dynamics and challenges of setting up and maintaining a successful rural IR practice. Bringing more interventional radiology to rural America would benefit many patients who currently do not have access to minimally invasive, image guided medicine. In today's episode, Dr. Frederick Johnson, an interventional radiologist practicing in Thomasville, Georgia joins us to discuss the unique dynamics and challenges of setting up and maintaining a successful rural IR practice. --- CHECK OUT OUR SPONSOR Medtronic ClosureFast https://www.medtronic.com/us-en/c/cardiovascular/closurefast-rfa-system.html --- SYNPOSIS Dr. Johnson provides insights into the professional service agreement (PSA) model that allows his practice to maintain autonomy while collaborating with the local hospital. The episode explores the complexities of recruiting to a rural setting, maintaining a broad case mix, ensuring financial stability, and fostering professional satisfaction. The conversation highlights the importance of redefining independence and the benefits of integrating collaboration into IR practices. --- TIMESTAMPS 00:00 - Introduction 02:29 - Dr. Johnson’s Background and Journey 11:46 - Professional Service Agreement (PSA) Explained 18:48 - Daily Operations and Structure 24:19 - Teamwork in Rural Healthcare 30:35 - Recruitment and Growth 33:33 - Compensation and Financial Incentives 42:05 - Benefits of Small Town Living 44:34 - Advice for Aspiring Rural Healthcare Practitioners --- RESOURCES Vita Surgery/Vascular Website: https://vitadr.org/ Bringing more interventional radiology to rural America would benefit many patients who currently do not have access to minimally invasive, image guided medicine. In today's episode, Dr. Frederick Johnson, an interventional radiologist practicing in Thomasville, Georgia joins us to discuss the unique dynamics and challenges of setting up and maintaining a successful rural IR practice.


---


CHECK OUT OUR SPONSOR


Medtronic ClosureFast

https://www.medtronic.com/us-en/c/cardiovascular/closurefast-rfa-system.html


---


SYNPOSIS


Dr. Johnson provides insights into the professional service agreement (PSA) model that allows his practice to maintain autonomy while collaborating with the local hospital. The episode explores the complexities of recruiting to a rural setting, maintaining a broad case mix, ensuring financial stability, and fostering professional satisfaction. The conversation highlights the importance of redefining independence and the benefits of integrating collaboration into IR practices.


---


TIMESTAMPS


00:00 - Introduction

02:29 - Dr. Johnson’s Background and Journey

11:46 - Professional Service Agreement (PSA) Explained

18:48 - Daily Operations and Structure

24:19 - Teamwork in Rural Healthcare

30:35 - Recruitment and Growth

33:33 - Compensation and Financial Incentives

42:05 - Benefits of Small Town Living

44:34 - Advice for Aspiring Rural Healthcare Practitioners


---


RESOURCES


Vita Surgery/Vascular Website:

https://vitadr.org/

]]> 3015 Ep. 466 Exploring IR in Australia with Dr. Chris Rogan Ever wonder what it’s like to practice interventional radiology down under? Dr. Chris Rogan joins us on the BackTable Podcast this week to tell us about his IR practice in Australia, with special emphasis on healthcare system and interventional practice model differences between our two countries. --- SYNPOSIS We cover a wide range of topics, including the differences in IR training pathways between Australia and the U.S., the impact of healthcare models on IR practice, and the cooperation between public and private healthcare. We also highlight the urgent need for more IR specialists in Australia. Additionally, the doctors explore the challenges of public awareness, interdisciplinary and global collaboration, and the ongoing efforts by the Interventional Radiology Society of Australasia (IRSA) to promote IR through public outreach and educational strategies. --- TIMESTAMPS 00:00 - Introduction 04:08 - Australia vs. US Healthcare Systems 08:21 - Compensation and Career Mobility 16:52 - IR Public Awareness and Marketing 25:56 - Global Collaboration and Conferences 30:53 - Travel Tips for Australia --- RESOURCES Dr. Chris Rogan’s practice: https://drrogan.com/ Interventional Radiology Society of Australasia (IRSA): https://irsa.com.au/ IRSA 2024 Annual Meeting: https://irsa.com.au/education-events/irsa-annual-scientific-meeting-2024/ Tue, 23 Jul 2024 07:00:00 -0000 full BackTable Ever wonder what it’s like to practice interventional radiology down under? Dr. Chris Rogan joins us on the BackTable Podcast this week to tell us about his IR practice in Australia, with special emphasis on healthcare system and interventional practice model differences between our two countries. Ever wonder what it’s like to practice interventional radiology down under? Dr. Chris Rogan joins us on the BackTable Podcast this week to tell us about his IR practice in Australia, with special emphasis on healthcare system and interventional practice model differences between our two countries. --- SYNPOSIS We cover a wide range of topics, including the differences in IR training pathways between Australia and the U.S., the impact of healthcare models on IR practice, and the cooperation between public and private healthcare. We also highlight the urgent need for more IR specialists in Australia. Additionally, the doctors explore the challenges of public awareness, interdisciplinary and global collaboration, and the ongoing efforts by the Interventional Radiology Society of Australasia (IRSA) to promote IR through public outreach and educational strategies. --- TIMESTAMPS 00:00 - Introduction 04:08 - Australia vs. US Healthcare Systems 08:21 - Compensation and Career Mobility 16:52 - IR Public Awareness and Marketing 25:56 - Global Collaboration and Conferences 30:53 - Travel Tips for Australia --- RESOURCES Dr. Chris Rogan’s practice: https://drrogan.com/ Interventional Radiology Society of Australasia (IRSA): https://irsa.com.au/ IRSA 2024 Annual Meeting: https://irsa.com.au/education-events/irsa-annual-scientific-meeting-2024/ Ever wonder what it’s like to practice interventional radiology down under? Dr. Chris Rogan joins us on the BackTable Podcast this week to tell us about his IR practice in Australia, with special emphasis on healthcare system and interventional practice model differences between our two countries.


---


SYNPOSIS


We cover a wide range of topics, including the differences in IR training pathways between Australia and the U.S., the impact of healthcare models on IR practice, and the cooperation between public and private healthcare. We also highlight the urgent need for more IR specialists in Australia. Additionally, the doctors explore the challenges of public awareness, interdisciplinary and global collaboration, and the ongoing efforts by the Interventional Radiology Society of Australasia (IRSA) to promote IR through public outreach and educational strategies.


---


TIMESTAMPS


00:00 - Introduction

04:08 - Australia vs. US Healthcare Systems

08:21 - Compensation and Career Mobility

16:52 - IR Public Awareness and Marketing

25:56 - Global Collaboration and Conferences

30:53 - Travel Tips for Australia


---


RESOURCES


Dr. Chris Rogan’s practice:

https://drrogan.com/


Interventional Radiology Society of Australasia (IRSA):

https://irsa.com.au/


IRSA 2024 Annual Meeting:

https://irsa.com.au/education-events/irsa-annual-scientific-meeting-2024/

]]> 2320 Ep. 465 Innovations in Superficial Venous Disease Treatment with Dr. Ali Golshan Superficial venous disease can pose significant management challenges, particularly after patients have exhausted conservative and invasive therapies. This week, our host, Dr. Sabeen Dhand, interviews Dr. Ali Golshan, an interventional radiologist and the founder of SOLVEIN. Dr. Golshan discusses the latest advancements in treating superficial venous disease, highlighting both the benefits and complexities of thermal and non-thermal ablation techniques. --- CHECK OUT OUR SPONSOR BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html --- SYNPOSIS Dr. Golshin introduces SOLVEIN, his innovative medical device designed to address these challenges. The conversation also includes practical tips for managing patients with venous insufficiencies, along with insights into the entrepreneurial journey involved in developing a new medical device. --- TIMESTAMPS 00:00 - Introduction 02:02 - Defining Superficial Venous Disease 05:43 - Diagnostic Techniques and Imaging 08:29 - Current Treatment Options for Venous Insufficiency 20:07 - Introducing SOLVEIN 29:42 - FDA Approval Pathway 33:37 - Advice for Aspiring Medical Entrepreneurs --- RESOURCES Dr. Ali Golshan’s Practice: https://www.beachwellnessmd.com/ Fri, 19 Jul 2024 07:00:00 -0000 full BackTable Superficial venous disease can pose significant management challenges, particularly after patients have exhausted conservative and invasive therapies. This week, our host, Dr. Sabeen Dhand, interviews Dr. Ali Golshan, an interventional radiologist and the founder of SOLVEIN. Dr. Golshan discusses the latest advancements in treating superficial venous disease, highlighting both the benefits and complexities of thermal and non-thermal ablation techniques. Superficial venous disease can pose significant management challenges, particularly after patients have exhausted conservative and invasive therapies. This week, our host, Dr. Sabeen Dhand, interviews Dr. Ali Golshan, an interventional radiologist and the founder of SOLVEIN. Dr. Golshan discusses the latest advancements in treating superficial venous disease, highlighting both the benefits and complexities of thermal and non-thermal ablation techniques. --- CHECK OUT OUR SPONSOR BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html --- SYNPOSIS Dr. Golshin introduces SOLVEIN, his innovative medical device designed to address these challenges. The conversation also includes practical tips for managing patients with venous insufficiencies, along with insights into the entrepreneurial journey involved in developing a new medical device. --- TIMESTAMPS 00:00 - Introduction 02:02 - Defining Superficial Venous Disease 05:43 - Diagnostic Techniques and Imaging 08:29 - Current Treatment Options for Venous Insufficiency 20:07 - Introducing SOLVEIN 29:42 - FDA Approval Pathway 33:37 - Advice for Aspiring Medical Entrepreneurs --- RESOURCES Dr. Ali Golshan’s Practice: https://www.beachwellnessmd.com/ Superficial venous disease can pose significant management challenges, particularly after patients have exhausted conservative and invasive therapies. This week, our host, Dr. Sabeen Dhand, interviews Dr. Ali Golshan, an interventional radiologist and the founder of SOLVEIN. Dr. Golshan discusses the latest advancements in treating superficial venous disease, highlighting both the benefits and complexities of thermal and non-thermal ablation techniques.


---


CHECK OUT OUR SPONSOR


BD Advance Clinical Training & Education Program

https://page.bd.com/Advance-Training-Program_Homepage.html


---


SYNPOSIS


Dr. Golshin introduces SOLVEIN, his innovative medical device designed to address these challenges. The conversation also includes practical tips for managing patients with venous insufficiencies, along with insights into the entrepreneurial journey involved in developing a new medical device.


---


TIMESTAMPS


00:00 - Introduction

02:02 - Defining Superficial Venous Disease

05:43 - Diagnostic Techniques and Imaging

08:29 - Current Treatment Options for Venous Insufficiency

20:07 - Introducing SOLVEIN

29:42 - FDA Approval Pathway

33:37 - Advice for Aspiring Medical Entrepreneurs


---


RESOURCES


Dr. Ali Golshan’s Practice:

https://www.beachwellnessmd.com/

]]> 2284 Ep. 464 Minimizing Complications for Challenging Lung Biopsies with Dr. Venkatesh Krishnasamy Dr. Venkatesh Krishnasamy shares techniques and specific cases for challenging lung biopsies, his insights on mentorship, importance of multidisciplinary tumor boards, and the evolution of lung biopsy practices. Dr. Krishnasamy is an interventional radiologist and Director of Interventional Oncology at the University of Alabama Birmingham. --- CHECK OUT OUR SPONSOR Merit Biopsy Solutions https://www.merit.com/solutions/biopsy-solutions/ --- SYNPOSIS The doctors cover practical advice on handling complications like pneumothorax and hemoptysis, and share strategies for optimizing workflows to improve patient outcomes. Dr. Krishnasamy encourages listeners to leverage mentor experience and partake in continued learning to advance their practice. --- TIMESTAMPS 00:00 - Introduction 05:16 - Lung Biopsy Referrals and Multidisciplinary Approach 12:03 - Complex Lung Biopsies 25:43 - Needle Position Verification 27:29 - Importance of Cytopathologist Presence 28:51 - Blood Patching vs. Plug Technique 33:54 - Post-Procedure Protocols 36:15 - Advanced Techniques and Mentorship 44:26 - Handling Hemoptysis During Biopsies 47:50 - Encouragement for Trainees --- RESOURCES Society of Interventional Oncology: https://www.sio-central.org/ BackTable VI Podcast Episode #278 - Minimizing Complications for Lung Biopsies with Dr. Robert Suh: https://www.backtable.com/shows/vi/podcasts/278/minimizing-complications-for-lung-biopsies BackTable VI Podcast Episode #156 - Percutaneous Lung Biopsies: The Basics with Dr. Fred Lee (Part 1 of 2): https://www.backtable.com/shows/vi/podcasts/156/percutaneous-lung-biopsies-the-basics BackTable VI Podcast Episode #157 - Percutaneous Lung Biopsies: Pleural & Parenchymal Blood Patching with Dr. Fred Lee (Part 2 of 2): https://www.backtable.com/shows/vi/podcasts/157/percutaneous-lung-biopsies-pleural-parenchymal-blood-patching Tue, 16 Jul 2024 07:00:00 -0000 full BackTable Dr. Venkatesh Krishnasamy shares techniques and specific cases for challenging lung biopsies, his insights on mentorship, importance of multidisciplinary tumor boards, and the evolution of lung biopsy practices. Dr. Krishnasamy is an interventional radiologist and Director of Interventional Oncology at the University of Alabama Birmingham. Dr. Venkatesh Krishnasamy shares techniques and specific cases for challenging lung biopsies, his insights on mentorship, importance of multidisciplinary tumor boards, and the evolution of lung biopsy practices. Dr. Krishnasamy is an interventional radiologist and Director of Interventional Oncology at the University of Alabama Birmingham. --- CHECK OUT OUR SPONSOR Merit Biopsy Solutions https://www.merit.com/solutions/biopsy-solutions/ --- SYNPOSIS The doctors cover practical advice on handling complications like pneumothorax and hemoptysis, and share strategies for optimizing workflows to improve patient outcomes. Dr. Krishnasamy encourages listeners to leverage mentor experience and partake in continued learning to advance their practice. --- TIMESTAMPS 00:00 - Introduction 05:16 - Lung Biopsy Referrals and Multidisciplinary Approach 12:03 - Complex Lung Biopsies 25:43 - Needle Position Verification 27:29 - Importance of Cytopathologist Presence 28:51 - Blood Patching vs. Plug Technique 33:54 - Post-Procedure Protocols 36:15 - Advanced Techniques and Mentorship 44:26 - Handling Hemoptysis During Biopsies 47:50 - Encouragement for Trainees --- RESOURCES Society of Interventional Oncology: https://www.sio-central.org/ BackTable VI Podcast Episode #278 - Minimizing Complications for Lung Biopsies with Dr. Robert Suh: https://www.backtable.com/shows/vi/podcasts/278/minimizing-complications-for-lung-biopsies BackTable VI Podcast Episode #156 - Percutaneous Lung Biopsies: The Basics with Dr. Fred Lee (Part 1 of 2): https://www.backtable.com/shows/vi/podcasts/156/percutaneous-lung-biopsies-the-basics BackTable VI Podcast Episode #157 - Percutaneous Lung Biopsies: Pleural & Parenchymal Blood Patching with Dr. Fred Lee (Part 2 of 2): https://www.backtable.com/shows/vi/podcasts/157/percutaneous-lung-biopsies-pleural-parenchymal-blood-patching Dr. Venkatesh Krishnasamy shares techniques and specific cases for challenging lung biopsies, his insights on mentorship, importance of multidisciplinary tumor boards, and the evolution of lung biopsy practices. Dr. Krishnasamy is an interventional radiologist and Director of Interventional Oncology at the University of Alabama Birmingham.


---


CHECK OUT OUR SPONSOR


Merit Biopsy Solutions

https://www.merit.com/solutions/biopsy-solutions/


---


SYNPOSIS


The doctors cover practical advice on handling complications like pneumothorax and hemoptysis, and share strategies for optimizing workflows to improve patient outcomes. Dr. Krishnasamy encourages listeners to leverage mentor experience and partake in continued learning to advance their practice.


---


TIMESTAMPS


00:00 - Introduction

05:16 - Lung Biopsy Referrals and Multidisciplinary Approach

12:03 - Complex Lung Biopsies

25:43 - Needle Position Verification

27:29 - Importance of Cytopathologist Presence

28:51 - Blood Patching vs. Plug Technique

33:54 - Post-Procedure Protocols

36:15 - Advanced Techniques and Mentorship

44:26 - Handling Hemoptysis During Biopsies

47:50 - Encouragement for Trainees


---


RESOURCES


Society of Interventional Oncology:

https://www.sio-central.org/


BackTable VI Podcast Episode #278 - Minimizing Complications for Lung Biopsies with Dr. Robert Suh:

https://www.backtable.com/shows/vi/podcasts/278/minimizing-complications-for-lung-biopsies


BackTable VI Podcast Episode #156 - Percutaneous Lung Biopsies: The Basics with Dr. Fred Lee (Part 1 of 2):

https://www.backtable.com/shows/vi/podcasts/156/percutaneous-lung-biopsies-the-basics


BackTable VI Podcast Episode #157 - Percutaneous Lung Biopsies: Pleural & Parenchymal Blood Patching with Dr. Fred Lee (Part 2 of 2):

https://www.backtable.com/shows/vi/podcasts/157/percutaneous-lung-biopsies-pleural-parenchymal-blood-patching

]]> 2498 Ep. 463 Stone Retrieval and Other Advanced Biliary Interventions with Dr. Alexander Vezeridis In this episode, Dr. Alexander Vezeridis discusses advanced biliary interventions; covering stone removal procedures, technical success rates, and practical tips for using Spyglass cholangioscopy, laser lithotripsy, and endobiliary ablation. Dr. Vezeridis is an interventional radiologist, physician-scientist, and Assistant Professor of Radiology at Stanford. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Vezeridis highlights the importance of continuous learning, collaboration with other specialties, and shares his experiences and tips for optimizing patient outcomes. The doctors also touch on innovative approaches such as photodynamic therapy and the use of various tools in managing benign and malignant biliary diseases. --- TIMESTAMPS 00:00 - Introduction 03:25 - Setting Up Spyglass in Your Practice 10:50 - Patient Selection and Procedure Details 24:27 - Stone Fragmentation Techniques 27:35 - Success Rates and Patient Outcomes 35:06 - Endobiliary Ablation Techniques 47:35 - Laser Treatment for Biliary Obstructions 49:18 - Future Innovations --- RESOURCES BackTable VI Podcast Episode #146 - Spyglass Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa: https://www.backtable.com/shows/vi/podcasts/146/spyglass-interventions Spyglass - Boston Scientific: https://www.bostonscientific.com/en-US/medical-specialties/gastroenterology/advancements-cholangioscopy.html Percutaneous Gallstone Removal: Long-term Follow-up (Dr. Hovsepian Paper): https://www.jvir.org/article/S1051-0443(96)70766-2/pdf SIR’s Percutaneous Cholangiopancreatoscopy (PCPS) registry: https://clinicaltrials.gov/study/NCT05210322 StarMed Endoscopic RFA Clinical Articles: https://www.starmedacademy.com/endoscopic-rfa-clinical-articles-elra Habib Endobiliary Ablation Catheter: https://www.bostonscientific.com/en-US/products/rf-ablation/habib-endohpb-bipolar-radiofrequency-catheter.html Interventional Radiology-Operated Choledochoscopic-Guided Radiofrequency Wire and Holmium Laser Ablations May Facilitate Treatment and Long-Term Patency of Benign Biliary Strictures: https://www.jvir.org/article/S1051-0443(18)31535-5/abstract Percutaneous Cholangioscope-Assisted Laser Incision of Severe Benign Hepaticojejunostomy Stenoses: https://pubmed.ncbi.nlm.nih.gov/35504434/ Percutaneous Endoluminal Benign Biliary Laser (PEBBL) (Clinical Trial): https://clinicaltrials.gov/study/NCT05567003 Fri, 12 Jul 2024 07:00:00 -0000 full BackTable In this episode, Dr. Alexander Vezeridis discusses advanced biliary interventions; covering stone removal procedures, technical success rates, and practical tips for using Spyglass cholangioscopy, laser lithotripsy, and endobiliary ablation. Dr. Vezeridis is an interventional radiologist, physician-scientist, and Assistant Professor of Radiology at Stanford. In this episode, Dr. Alexander Vezeridis discusses advanced biliary interventions; covering stone removal procedures, technical success rates, and practical tips for using Spyglass cholangioscopy, laser lithotripsy, and endobiliary ablation. Dr. Vezeridis is an interventional radiologist, physician-scientist, and Assistant Professor of Radiology at Stanford. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Vezeridis highlights the importance of continuous learning, collaboration with other specialties, and shares his experiences and tips for optimizing patient outcomes. The doctors also touch on innovative approaches such as photodynamic therapy and the use of various tools in managing benign and malignant biliary diseases. --- TIMESTAMPS 00:00 - Introduction 03:25 - Setting Up Spyglass in Your Practice 10:50 - Patient Selection and Procedure Details 24:27 - Stone Fragmentation Techniques 27:35 - Success Rates and Patient Outcomes 35:06 - Endobiliary Ablation Techniques 47:35 - Laser Treatment for Biliary Obstructions 49:18 - Future Innovations --- RESOURCES BackTable VI Podcast Episode #146 - Spyglass Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa: https://www.backtable.com/shows/vi/podcasts/146/spyglass-interventions Spyglass - Boston Scientific: https://www.bostonscientific.com/en-US/medical-specialties/gastroenterology/advancements-cholangioscopy.html Percutaneous Gallstone Removal: Long-term Follow-up (Dr. Hovsepian Paper): https://www.jvir.org/article/S1051-0443(96)70766-2/pdf SIR’s Percutaneous Cholangiopancreatoscopy (PCPS) registry: https://clinicaltrials.gov/study/NCT05210322 StarMed Endoscopic RFA Clinical Articles: https://www.starmedacademy.com/endoscopic-rfa-clinical-articles-elra Habib Endobiliary Ablation Catheter: https://www.bostonscientific.com/en-US/products/rf-ablation/habib-endohpb-bipolar-radiofrequency-catheter.html Interventional Radiology-Operated Choledochoscopic-Guided Radiofrequency Wire and Holmium Laser Ablations May Facilitate Treatment and Long-Term Patency of Benign Biliary Strictures: https://www.jvir.org/article/S1051-0443(18)31535-5/abstract Percutaneous Cholangioscope-Assisted Laser Incision of Severe Benign Hepaticojejunostomy Stenoses: https://pubmed.ncbi.nlm.nih.gov/35504434/ Percutaneous Endoluminal Benign Biliary Laser (PEBBL) (Clinical Trial): https://clinicaltrials.gov/study/NCT05567003 In this episode, Dr. Alexander Vezeridis discusses advanced biliary interventions; covering stone removal procedures, technical success rates, and practical tips for using Spyglass cholangioscopy, laser lithotripsy, and endobiliary ablation. Dr. Vezeridis is an interventional radiologist, physician-scientist, and Assistant Professor of Radiology at Stanford.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


Dr. Vezeridis highlights the importance of continuous learning, collaboration with other specialties, and shares his experiences and tips for optimizing patient outcomes. The doctors also touch on innovative approaches such as photodynamic therapy and the use of various tools in managing benign and malignant biliary diseases.


---


TIMESTAMPS


00:00 - Introduction

03:25 - Setting Up Spyglass in Your Practice

10:50 - Patient Selection and Procedure Details

24:27 - Stone Fragmentation Techniques

27:35 - Success Rates and Patient Outcomes

35:06 - Endobiliary Ablation Techniques

47:35 - Laser Treatment for Biliary Obstructions

49:18 - Future Innovations


---


RESOURCES


BackTable VI Podcast Episode #146 - Spyglass Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa:

https://www.backtable.com/shows/vi/podcasts/146/spyglass-interventions


Spyglass - Boston Scientific:

https://www.bostonscientific.com/en-US/medical-specialties/gastroenterology/advancements-cholangioscopy.html


Percutaneous Gallstone Removal: Long-term Follow-up (Dr. Hovsepian Paper):

https://www.jvir.org/article/S1051-0443(96)70766-2/pdf


SIR’s Percutaneous Cholangiopancreatoscopy (PCPS) registry:

https://clinicaltrials.gov/study/NCT05210322


StarMed Endoscopic RFA Clinical Articles:

https://www.starmedacademy.com/endoscopic-rfa-clinical-articles-elra


Habib Endobiliary Ablation Catheter:

https://www.bostonscientific.com/en-US/products/rf-ablation/habib-endohpb-bipolar-radiofrequency-catheter.html


Interventional Radiology-Operated Choledochoscopic-Guided Radiofrequency Wire and Holmium Laser Ablations May Facilitate Treatment and Long-Term Patency of Benign Biliary Strictures:

https://www.jvir.org/article/S1051-0443(18)31535-5/abstract


Percutaneous Cholangioscope-Assisted Laser Incision of Severe Benign Hepaticojejunostomy Stenoses:

https://pubmed.ncbi.nlm.nih.gov/35504434/


Percutaneous Endoluminal Benign Biliary Laser (PEBBL) (Clinical Trial):

https://clinicaltrials.gov/study/NCT05567003

]]> 3291 Ep. 462 IVC Filter Retrieval: Tips and Technique with Dr. Noor Ahmad In this episode of the Back Table Podcast, interventional radiologist Dr. Noor Ahmad discusses his algorithm for complex inferior vena cava (IVC) filter retrievals and reviews several cases that utilize various retrieval tools. --- CHECK OUT OUR SPONSOR Argon Medical http://www.argonmedical.com/ --- SYNPOSIS Dr. Ahmad emphasizes that most patients are referred by physicians with whom he maintains good relationships, and both specialties jointly monitor patients after IVC filters are placed. Generally, it is ideal to remove IVC filters around the 3-month mark, with filters in place for over 6 months posing a higher risk of requiring complex retrieval. For preoperative evaluation, obtaining a history of the filter type and placement date, along with CT scans (non-contrast and venogram), is crucial. Anticoagulation is typically discontinued two days prior to retrieval. During the procedure, moderate sedation and internal jugular access are used. However, complex retrievals may necessitate general anesthesia and access through the femoral vein or dual sites. The initial device employed is usually the CloverSnare to hook and extract the IVC filter. If unsuccessful, Dr. Ahmad proceeds with techniques such as the hangman (modified loop snare), endobronchial forceps, and finally the CavaClear laser sheath. He highlights that particularly challenging cases might require collaboration with colleagues, especially when dual access is needed, possibly requiring rescheduling for general anesthesia availability. Patient safety is emphasized in these scenarios. Lastly, Dr. Ahmad presents past cases with imaging to illustrate various retrieval methods. --- TIMESTAMPS 00:00 - Introduction 03:29 - Referrals and Tracking for Filter Removal 08:49 - Working Up Complex Cases 13:19 - Patient Selection 20:14 - Procedure Walkthrough 23:22 - Different Strategies for Filter Removal 31:23 - Laser Techniques 34:47 - Sheath Sizing 36:06 - Enhancing Patient Safety 43:34 - Cheat Sheet for IVC Filters and Case Studies --- RESOURCES BackTable Ep. 204- Filter Indications and Filter Tracking: Up Your Game with Dr. Stephen Wang: https://www.backtable.com/shows/vi/podcasts/204/filter-indications-filter-tracking-up-your-game BackTable Ep. 339- The Importance of a Multidisciplinary Filter Retrieval Program with Dr. Robert Ryu, Dr. Warren Clements, and Dr. Premal Trivedi: https://www.backtable.com/shows/vi/podcasts/339/the-importance-of-a-multidisciplinary-filter-retrieval-program Tue, 09 Jul 2024 07:00:00 -0000 full BackTable In this episode of the Back Table Podcast, interventional radiologist Dr. Noor Ahmad discusses his algorithm for complex inferior vena cava (IVC) filter retrievals and reviews several cases that utilize various retrieval tools. In this episode of the Back Table Podcast, interventional radiologist Dr. Noor Ahmad discusses his algorithm for complex inferior vena cava (IVC) filter retrievals and reviews several cases that utilize various retrieval tools. --- CHECK OUT OUR SPONSOR Argon Medical http://www.argonmedical.com/ --- SYNPOSIS Dr. Ahmad emphasizes that most patients are referred by physicians with whom he maintains good relationships, and both specialties jointly monitor patients after IVC filters are placed. Generally, it is ideal to remove IVC filters around the 3-month mark, with filters in place for over 6 months posing a higher risk of requiring complex retrieval. For preoperative evaluation, obtaining a history of the filter type and placement date, along with CT scans (non-contrast and venogram), is crucial. Anticoagulation is typically discontinued two days prior to retrieval. During the procedure, moderate sedation and internal jugular access are used. However, complex retrievals may necessitate general anesthesia and access through the femoral vein or dual sites. The initial device employed is usually the CloverSnare to hook and extract the IVC filter. If unsuccessful, Dr. Ahmad proceeds with techniques such as the hangman (modified loop snare), endobronchial forceps, and finally the CavaClear laser sheath. He highlights that particularly challenging cases might require collaboration with colleagues, especially when dual access is needed, possibly requiring rescheduling for general anesthesia availability. Patient safety is emphasized in these scenarios. Lastly, Dr. Ahmad presents past cases with imaging to illustrate various retrieval methods. --- TIMESTAMPS 00:00 - Introduction 03:29 - Referrals and Tracking for Filter Removal 08:49 - Working Up Complex Cases 13:19 - Patient Selection 20:14 - Procedure Walkthrough 23:22 - Different Strategies for Filter Removal 31:23 - Laser Techniques 34:47 - Sheath Sizing 36:06 - Enhancing Patient Safety 43:34 - Cheat Sheet for IVC Filters and Case Studies --- RESOURCES BackTable Ep. 204- Filter Indications and Filter Tracking: Up Your Game with Dr. Stephen Wang: https://www.backtable.com/shows/vi/podcasts/204/filter-indications-filter-tracking-up-your-game BackTable Ep. 339- The Importance of a Multidisciplinary Filter Retrieval Program with Dr. Robert Ryu, Dr. Warren Clements, and Dr. Premal Trivedi: https://www.backtable.com/shows/vi/podcasts/339/the-importance-of-a-multidisciplinary-filter-retrieval-program In this episode of the Back Table Podcast, interventional radiologist Dr. Noor Ahmad discusses his algorithm for complex inferior vena cava (IVC) filter retrievals and reviews several cases that utilize various retrieval tools.


---


CHECK OUT OUR SPONSOR


Argon Medical

http://www.argonmedical.com/


---


SYNPOSIS


Dr. Ahmad emphasizes that most patients are referred by physicians with whom he maintains good relationships, and both specialties jointly monitor patients after IVC filters are placed. Generally, it is ideal to remove IVC filters around the 3-month mark, with filters in place for over 6 months posing a higher risk of requiring complex retrieval. For preoperative evaluation, obtaining a history of the filter type and placement date, along with CT scans (non-contrast and venogram), is crucial. Anticoagulation is typically discontinued two days prior to retrieval.


During the procedure, moderate sedation and internal jugular access are used. However, complex retrievals may necessitate general anesthesia and access through the femoral vein or dual sites. The initial device employed is usually the CloverSnare to hook and extract the IVC filter. If unsuccessful, Dr. Ahmad proceeds with techniques such as the hangman (modified loop snare), endobronchial forceps, and finally the CavaClear laser sheath. He highlights that particularly challenging cases might require collaboration with colleagues, especially when dual access is needed, possibly requiring rescheduling for general anesthesia availability. Patient safety is emphasized in these scenarios. Lastly, Dr. Ahmad presents past cases with imaging to illustrate various retrieval methods.


---


TIMESTAMPS


00:00 - Introduction

03:29 - Referrals and Tracking for Filter Removal

08:49 - Working Up Complex Cases

13:19 - Patient Selection

20:14 - Procedure Walkthrough

23:22 - Different Strategies for Filter Removal

31:23 - Laser Techniques

34:47 - Sheath Sizing

36:06 - Enhancing Patient Safety

43:34 - Cheat Sheet for IVC Filters and Case Studies


---


RESOURCES


BackTable Ep. 204- Filter Indications and Filter Tracking: Up Your Game with Dr. Stephen Wang:

https://www.backtable.com/shows/vi/podcasts/204/filter-indications-filter-tracking-up-your-game


BackTable Ep. 339- The Importance of a Multidisciplinary Filter Retrieval Program with Dr. Robert Ryu, Dr. Warren Clements, and Dr. Premal Trivedi:

https://www.backtable.com/shows/vi/podcasts/339/the-importance-of-a-multidisciplinary-filter-retrieval-program

]]> 2799 Ep. 461 Advanced Radial to Peripheral Interventions with Dr. Sameh Sayfo Dr. Sameh Sayfo discusses advanced techniques in radial to peripheral (R2P) interventions, the importance of having multiple techniques, the role of different devices, troubleshooting tips, and the evolving landscape of R2P interventions. Dr. Sayfo is an interventional cardiologist at the Baylor Heart Hospital, and serves as program director for the endovascular fellowship and pulmonary embolism response team (PERT) program. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SYNPOSIS Dr. Sayfo shares his experience and insights on using various devices, such as the new Auryon laser, for treating peripheral arterial disease (PAD).Additionally, the doctors address the benefits of radial access over traditional femoral approaches, patient selection, and procedural planning. Listeners are encouraged to adopt a flexible approach and learn from each other’s experiences to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 05:24 - Incorporating Radial into Peripheral Practice 11:19 - Right vs. Left Radial Access 20:01 - Room Setup and Procedure Planning 25:13 - Radial vs. Femoral Access 33:01 - Advancements in Laser Atherectomy 41:33 - Laser Atherectomy Tips 45:52 - Advantages of Radial Access in Specific Cases 51:33 - Post-Op Care and Best Practices --- RESOURCES BackTable VI Podcast Episode #30 - Transradial Access Basic to Advanced with Dr. Aaron Fischman: https://www.backtable.com/shows/vi/podcasts/30/transradial-access-basic-to-advanced BackTable VI Podcast Episode #148 - Radial vs. Femoral for Prostate Artery Embolization with Dr. Blake Parsons: https://www.backtable.com/shows/vi/podcasts/148/radial-vs-femoral-for-prostate-artery-embolization BackTable VI Podcast Episode #342 - Radial Access for PAD with Dr. Rami Tadros: https://www.backtable.com/shows/vi/podcasts/342/radial-access-for-pad BackTable VI Podcast Episode #395 - Radial to Peripheral Tools & Technique with Dr. Sameh Sayfo: https://www.backtable.com/shows/vi/podcasts/395/radial-to-peripheral-tools-technique BackTable VI Podcast Episode #443 - Innovative Approaches in Radial to Peripheral Interventions with Dr. Amit Srivastava: https://www.backtable.com/shows/vi/podcasts/443/innovative-approaches-in-radial-to-peripheral-interventions BackTable VI Podcast Episode #390 - Laser Atherectomy: An Overview of the Pathfinder Registry with Dr. Tony Das: https://www.backtable.com/shows/vi/podcasts/390/laser-atherectomy-an-overview-of-the-pathfinder-registry BackTable VI Podcast Episode #408 - Laser BTK Study Insights: Navigating Complex Lesions with Dr. Nicolas Shammas: https://www.backtable.com/shows/vi/podcasts/408/laser-btk-study-insights-navigating-complex-lesions Safety and efficacy of radial artery access for peripheral vascular intervention: a single center experience: https://www.ajconline.org/article/S0002-9149(24)00461-2/abstract Comparative Outcomes of Interventions for Femoropopliteal Chronic Total Occlusion Versus Non-Chronic Total Occlusion Lesions From the Multicenter XLPAD Registry: https://pubmed.ncbi.nlm.nih.gov/37318023/ Prospective, Multi-center, Single-Arm Study of the Auryon Laser System for Treatment of Below-the-Knee Arteries in Patients With Chronic Limb-Threatening Ischemia: 30-Day Results of the Auryon BTK: https://pubmed.ncbi.nlm.nih.gov/38458581/ Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions: https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext Solid state, pulsed-wave 355 nm UV laser atherectomy debulking in the treatment of infrainguinal peripheral arterial disease: The Pathfinder Registry: https://pubmed.ncbi.nlm.nih.gov/38566525/ SCAI Expert Consensus Statement Update on Best Practices for Transradial Angiography and Intervention: https://scai.org/publications/clinical-documents/scai-expert-consensus-statement-update-best-practices-transradial Tue, 02 Jul 2024 07:00:00 -0000 full BackTable Dr. Sameh Sayfo discusses advanced techniques in radial to peripheral (R2P) interventions, the importance of having multiple techniques, the role of different devices, troubleshooting tips, and the evolving landscape of R2P interventions. Dr. Sayfo is an interventional cardiologist at the Baylor Heart Hospital, and serves as program director for the endovascular fellowship and pulmonary embolism response team (PERT) program. Dr. Sameh Sayfo discusses advanced techniques in radial to peripheral (R2P) interventions, the importance of having multiple techniques, the role of different devices, troubleshooting tips, and the evolving landscape of R2P interventions. Dr. Sayfo is an interventional cardiologist at the Baylor Heart Hospital, and serves as program director for the endovascular fellowship and pulmonary embolism response team (PERT) program. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SYNPOSIS Dr. Sayfo shares his experience and insights on using various devices, such as the new Auryon laser, for treating peripheral arterial disease (PAD).Additionally, the doctors address the benefits of radial access over traditional femoral approaches, patient selection, and procedural planning. Listeners are encouraged to adopt a flexible approach and learn from each other’s experiences to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 05:24 - Incorporating Radial into Peripheral Practice 11:19 - Right vs. Left Radial Access 20:01 - Room Setup and Procedure Planning 25:13 - Radial vs. Femoral Access 33:01 - Advancements in Laser Atherectomy 41:33 - Laser Atherectomy Tips 45:52 - Advantages of Radial Access in Specific Cases 51:33 - Post-Op Care and Best Practices --- RESOURCES BackTable VI Podcast Episode #30 - Transradial Access Basic to Advanced with Dr. Aaron Fischman: https://www.backtable.com/shows/vi/podcasts/30/transradial-access-basic-to-advanced BackTable VI Podcast Episode #148 - Radial vs. Femoral for Prostate Artery Embolization with Dr. Blake Parsons: https://www.backtable.com/shows/vi/podcasts/148/radial-vs-femoral-for-prostate-artery-embolization BackTable VI Podcast Episode #342 - Radial Access for PAD with Dr. Rami Tadros: https://www.backtable.com/shows/vi/podcasts/342/radial-access-for-pad BackTable VI Podcast Episode #395 - Radial to Peripheral Tools & Technique with Dr. Sameh Sayfo: https://www.backtable.com/shows/vi/podcasts/395/radial-to-peripheral-tools-technique BackTable VI Podcast Episode #443 - Innovative Approaches in Radial to Peripheral Interventions with Dr. Amit Srivastava: https://www.backtable.com/shows/vi/podcasts/443/innovative-approaches-in-radial-to-peripheral-interventions BackTable VI Podcast Episode #390 - Laser Atherectomy: An Overview of the Pathfinder Registry with Dr. Tony Das: https://www.backtable.com/shows/vi/podcasts/390/laser-atherectomy-an-overview-of-the-pathfinder-registry BackTable VI Podcast Episode #408 - Laser BTK Study Insights: Navigating Complex Lesions with Dr. Nicolas Shammas: https://www.backtable.com/shows/vi/podcasts/408/laser-btk-study-insights-navigating-complex-lesions Safety and efficacy of radial artery access for peripheral vascular intervention: a single center experience: https://www.ajconline.org/article/S0002-9149(24)00461-2/abstract Comparative Outcomes of Interventions for Femoropopliteal Chronic Total Occlusion Versus Non-Chronic Total Occlusion Lesions From the Multicenter XLPAD Registry: https://pubmed.ncbi.nlm.nih.gov/37318023/ Prospective, Multi-center, Single-Arm Study of the Auryon Laser System for Treatment of Below-the-Knee Arteries in Patients With Chronic Limb-Threatening Ischemia: 30-Day Results of the Auryon BTK: https://pubmed.ncbi.nlm.nih.gov/38458581/ Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions: https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext Solid state, pulsed-wave 355 nm UV laser atherectomy debulking in the treatment of infrainguinal peripheral arterial disease: The Pathfinder Registry: https://pubmed.ncbi.nlm.nih.gov/38566525/ SCAI Expert Consensus Statement Update on Best Practices for Transradial Angiography and Intervention: https://scai.org/publications/clinical-documents/scai-expert-consensus-statement-update-best-practices-transradial Dr. Sameh Sayfo discusses advanced techniques in radial to peripheral (R2P) interventions, the importance of having multiple techniques, the role of different devices, troubleshooting tips, and the evolving landscape of R2P interventions. Dr. Sayfo is an interventional cardiologist at the Baylor Heart Hospital, and serves as program director for the endovascular fellowship and pulmonary embolism response team (PERT) program.


---


CHECK OUT OUR SPONSOR


AngioDynamics Auryon System

https://www.auryon-system.com/


---


SYNPOSIS


Dr. Sayfo shares his experience and insights on using various devices, such as the new Auryon laser, for treating peripheral arterial disease (PAD).Additionally, the doctors address the benefits of radial access over traditional femoral approaches, patient selection, and procedural planning. Listeners are encouraged to adopt a flexible approach and learn from each other’s experiences to improve patient outcomes.


---


TIMESTAMPS


00:00 - Introduction

05:24 - Incorporating Radial into Peripheral Practice

11:19 - Right vs. Left Radial Access

20:01 - Room Setup and Procedure Planning

25:13 - Radial vs. Femoral Access

33:01 - Advancements in Laser Atherectomy

41:33 - Laser Atherectomy Tips

45:52 - Advantages of Radial Access in Specific Cases

51:33 - Post-Op Care and Best Practices


---


RESOURCES


BackTable VI Podcast Episode #30 - Transradial Access Basic to Advanced with Dr. Aaron Fischman:

https://www.backtable.com/shows/vi/podcasts/30/transradial-access-basic-to-advanced


BackTable VI Podcast Episode #148 - Radial vs. Femoral for Prostate Artery Embolization with Dr. Blake Parsons:

https://www.backtable.com/shows/vi/podcasts/148/radial-vs-femoral-for-prostate-artery-embolization


BackTable VI Podcast Episode #342 - Radial Access for PAD with Dr. Rami Tadros:

https://www.backtable.com/shows/vi/podcasts/342/radial-access-for-pad


BackTable VI Podcast Episode #395 - Radial to Peripheral Tools & Technique with Dr. Sameh Sayfo:

https://www.backtable.com/shows/vi/podcasts/395/radial-to-peripheral-tools-technique


BackTable VI Podcast Episode #443 - Innovative Approaches in Radial to Peripheral Interventions with Dr. Amit Srivastava:

https://www.backtable.com/shows/vi/podcasts/443/innovative-approaches-in-radial-to-peripheral-interventions


BackTable VI Podcast Episode #390 - Laser Atherectomy: An Overview of the Pathfinder Registry with Dr. Tony Das:

https://www.backtable.com/shows/vi/podcasts/390/laser-atherectomy-an-overview-of-the-pathfinder-registry


BackTable VI Podcast Episode #408 - Laser BTK Study Insights: Navigating Complex Lesions with Dr. Nicolas Shammas:

https://www.backtable.com/shows/vi/podcasts/408/laser-btk-study-insights-navigating-complex-lesions


Safety and efficacy of radial artery access for peripheral vascular intervention: a single center experience:

https://www.ajconline.org/article/S0002-9149(24)00461-2/abstract


Comparative Outcomes of Interventions for Femoropopliteal Chronic Total Occlusion Versus Non-Chronic Total Occlusion Lesions From the Multicenter XLPAD Registry:

https://pubmed.ncbi.nlm.nih.gov/37318023/


Prospective, Multi-center, Single-Arm Study of the Auryon Laser System for Treatment of Below-the-Knee Arteries in Patients With Chronic Limb-Threatening Ischemia: 30-Day Results of the Auryon BTK:

https://pubmed.ncbi.nlm.nih.gov/38458581/


Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions:

https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext


Solid state, pulsed-wave 355 nm UV laser atherectomy debulking in the treatment of infrainguinal peripheral arterial disease: The Pathfinder Registry:

https://pubmed.ncbi.nlm.nih.gov/38566525/


SCAI Expert Consensus Statement Update on Best Practices for Transradial Angiography and Intervention:

https://scai.org/publications/clinical-documents/scai-expert-consensus-statement-update-best-practices-transradial

]]> 3546 Ep. 460 What is POTS and Orthostatic Flow Syndrome? with Dr. Steven Smith Dr. Ally Baheti interviews interventional radiologist Dr. Steven Smith about his insights into venous orthostatic flow dysfunction and its association with multisystem disorders. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Smith details his clinical career and his surprising findings that connect pelvic congestion syndrome with a range of other conditions, such as postural orthostatic tachycardia syndrome (POTS), chronic fatigue syndrome, Ehlers-Danlos syndrome, irritable bowel syndrome (IBS), vulvodynia, interstitial cystitis, and fibromyalgia. For patients with venous manifestations, he pursues treatment with stents or embolization, taking a proactive approach to targeting any abnormal vasculature that he identifies. Additionally, the podcast delves into the physiological basis of POTS and related disorders, which mainly stems from blood pooling in the lower body, leading to sympathetic overactivation. Overall, Dr. Smith emphasizes the significance of collaborating with specialists across different disciplines to advance understanding and treatment of these complex syndromes. --- TIMESTAMPS 00:00 - Introduction 03:11 - Symptom Constellation of Venous Orthostatic Flow Syndrome 12:08 - Pelvic Vein Treatment Algorithm 21:08 - Physiology of Orthostatic Intolerance and Sympathetic Overdrive 27:11 - Patient Selection 33:27 - Need for Research and Collaboration 36:07 - Advocacy for Patients --- RESOURCES BackTable VI Ep. 337- Management of Vulvar Varices with Dr. Brooke Spencer https://www.backtable.com/shows/vi/podcasts/337/management-of-vulvar-varices BackTable VI Ep. 33- Building a Comprehensive Vein Practice with Dr. Brooke Spencer & Dr. Isabel Newton https://www.backtable.com/shows/vi/podcasts/33/building-a-comprehensive-vein-practice An online survey of pelvic congestion support group members regarding comorbid symptoms and syndromes (Smith et al, 2022): https://journals.sagepub.com/doi/abs/10.1177/02683555221112567 Distension of central great vein decreases sympathetic outflow in humans (Cui et al, 2013): https://journals.physiology.org/doi/full/10.1152/ajpheart.00019.2013 Orthostatic intolerance and chronic fatigue syndrome: New light on an old problem (Rowe, 2002): https://www.jpeds.com/article/S0022-3476(02)53209-1/fulltext Fri, 28 Jun 2024 07:00:00 -0000 full BackTable Dr. Ally Baheti interviews interventional radiologist Dr. Steven Smith about his insights into venous orthostatic flow dysfunction and its association with multisystem disorders. Dr. Ally Baheti interviews interventional radiologist Dr. Steven Smith about his insights into venous orthostatic flow dysfunction and its association with multisystem disorders. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Smith details his clinical career and his surprising findings that connect pelvic congestion syndrome with a range of other conditions, such as postural orthostatic tachycardia syndrome (POTS), chronic fatigue syndrome, Ehlers-Danlos syndrome, irritable bowel syndrome (IBS), vulvodynia, interstitial cystitis, and fibromyalgia. For patients with venous manifestations, he pursues treatment with stents or embolization, taking a proactive approach to targeting any abnormal vasculature that he identifies. Additionally, the podcast delves into the physiological basis of POTS and related disorders, which mainly stems from blood pooling in the lower body, leading to sympathetic overactivation. Overall, Dr. Smith emphasizes the significance of collaborating with specialists across different disciplines to advance understanding and treatment of these complex syndromes. --- TIMESTAMPS 00:00 - Introduction 03:11 - Symptom Constellation of Venous Orthostatic Flow Syndrome 12:08 - Pelvic Vein Treatment Algorithm 21:08 - Physiology of Orthostatic Intolerance and Sympathetic Overdrive 27:11 - Patient Selection 33:27 - Need for Research and Collaboration 36:07 - Advocacy for Patients --- RESOURCES BackTable VI Ep. 337- Management of Vulvar Varices with Dr. Brooke Spencer https://www.backtable.com/shows/vi/podcasts/337/management-of-vulvar-varices BackTable VI Ep. 33- Building a Comprehensive Vein Practice with Dr. Brooke Spencer & Dr. Isabel Newton https://www.backtable.com/shows/vi/podcasts/33/building-a-comprehensive-vein-practice An online survey of pelvic congestion support group members regarding comorbid symptoms and syndromes (Smith et al, 2022): https://journals.sagepub.com/doi/abs/10.1177/02683555221112567 Distension of central great vein decreases sympathetic outflow in humans (Cui et al, 2013): https://journals.physiology.org/doi/full/10.1152/ajpheart.00019.2013 Orthostatic intolerance and chronic fatigue syndrome: New light on an old problem (Rowe, 2002): https://www.jpeds.com/article/S0022-3476(02)53209-1/fulltext Dr. Ally Baheti interviews interventional radiologist Dr. Steven Smith about his insights into venous orthostatic flow dysfunction and its association with multisystem disorders.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


Dr. Smith details his clinical career and his surprising findings that connect pelvic congestion syndrome with a range of other conditions, such as postural orthostatic tachycardia syndrome (POTS), chronic fatigue syndrome, Ehlers-Danlos syndrome, irritable bowel syndrome (IBS), vulvodynia, interstitial cystitis, and fibromyalgia. For patients with venous manifestations, he pursues treatment with stents or embolization, taking a proactive approach to targeting any abnormal vasculature that he identifies.


Additionally, the podcast delves into the physiological basis of POTS and related disorders, which mainly stems from blood pooling in the lower body, leading to sympathetic overactivation. Overall, Dr. Smith emphasizes the significance of collaborating with specialists across different disciplines to advance understanding and treatment of these complex syndromes.


---


TIMESTAMPS


00:00 - Introduction

03:11 - Symptom Constellation of Venous Orthostatic Flow Syndrome

12:08 - Pelvic Vein Treatment Algorithm

21:08 - Physiology of Orthostatic Intolerance and Sympathetic Overdrive

27:11 - Patient Selection

33:27 - Need for Research and Collaboration

36:07 - Advocacy for Patients


---


RESOURCES


BackTable VI Ep. 337- Management of Vulvar Varices with Dr. Brooke Spencer

https://www.backtable.com/shows/vi/podcasts/337/management-of-vulvar-varices


BackTable VI Ep. 33- Building a Comprehensive Vein Practice with Dr. Brooke Spencer & Dr. Isabel Newton

https://www.backtable.com/shows/vi/podcasts/33/building-a-comprehensive-vein-practice


An online survey of pelvic congestion support group members regarding comorbid symptoms and syndromes (Smith et al, 2022):

https://journals.sagepub.com/doi/abs/10.1177/02683555221112567


Distension of central great vein decreases sympathetic outflow in humans (Cui et al, 2013):

https://journals.physiology.org/doi/full/10.1152/ajpheart.00019.2013


Orthostatic intolerance and chronic fatigue syndrome: New light on an old problem (Rowe, 2002):

https://www.jpeds.com/article/S0022-3476(02)53209-1/fulltext

]]> 2809 Ep. 459 Transitioning from Academia to Private OBL Practice with Dr. Jafar Golzarian Dr. Jafar Golzarian shares his experiences with co-founding an outpatient-based lab (OBL), obtaining the right equipment, handling staffing, negotiating with insurance companies, and marketing his new practice. Dr. Golzarian is an interventional radiologist at his OBL in Minneapolis, Minnesota and he is the former Division Head and Program Director for the interventional radiology program at the University of Minnesota. --- CHECK OUT OUR SPONSOR GE Healthcare Allia Image Guided Systems https://www.gehealthcare.com/products/interventional-image-guided-systems/allia --- SYNPOSIS Dr. Golzarian emphasizes the importance of having independence and adopting a patient-centered approach. He also offers practical advice for physicians considering similar moves into the private practice sphere. Additionally, Dr. Golzarian talks about the challenges and rewards of focusing on specific embolization procedures and collaborating with industry partners to build a successful practice. --- TIMESTAMPS 00:00 - Introduction 06:06 - Setting Up a New Practice 14:27 - Tips for Marketing 23:40 - Finding the Right Business Partner 30:44 - OBL vs. ASC Status and Reimbursement 32:59 - Industry Support and Device Costs 37:58 - Staffing and Culture 45:25 - Advice for New Practitioners --- RESOURCES BackTable VI Episode #85 - Genicular Artery Embolization for OA with Dr. Jafar Golzarian: https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa BackTable VI Episode #361 - Intra-Arterial & Percutaneous Treatment of Giant Hepatic Hemangiomas with Dr. Jafar Golzarian: https://www.backtable.com/shows/vi/podcasts/361/intra-arterial-percutaneous-treatment-of-giant-hepatic-hemangiomas BackTable VI Episode #447 - Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little: https://www.backtable.com/shows/vi/podcasts/447/exploring-gae-clinical-insights-outcomes GEST MSK Annual Meeting: https://www.gestmsk.com/ Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline: https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline Tue, 25 Jun 2024 07:00:00 -0000 full BackTable Dr. Jafar Golzarian shares his experiences with co-founding an outpatient-based lab (OBL), obtaining the right equipment, handling staffing, negotiating with insurance companies, and marketing his new practice. Dr. Jafar Golzarian shares his experiences with co-founding an outpatient-based lab (OBL), obtaining the right equipment, handling staffing, negotiating with insurance companies, and marketing his new practice. Dr. Golzarian is an interventional radiologist at his OBL in Minneapolis, Minnesota and he is the former Division Head and Program Director for the interventional radiology program at the University of Minnesota. --- CHECK OUT OUR SPONSOR GE Healthcare Allia Image Guided Systems https://www.gehealthcare.com/products/interventional-image-guided-systems/allia --- SYNPOSIS Dr. Golzarian emphasizes the importance of having independence and adopting a patient-centered approach. He also offers practical advice for physicians considering similar moves into the private practice sphere. Additionally, Dr. Golzarian talks about the challenges and rewards of focusing on specific embolization procedures and collaborating with industry partners to build a successful practice. --- TIMESTAMPS 00:00 - Introduction 06:06 - Setting Up a New Practice 14:27 - Tips for Marketing 23:40 - Finding the Right Business Partner 30:44 - OBL vs. ASC Status and Reimbursement 32:59 - Industry Support and Device Costs 37:58 - Staffing and Culture 45:25 - Advice for New Practitioners --- RESOURCES BackTable VI Episode #85 - Genicular Artery Embolization for OA with Dr. Jafar Golzarian: https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa BackTable VI Episode #361 - Intra-Arterial & Percutaneous Treatment of Giant Hepatic Hemangiomas with Dr. Jafar Golzarian: https://www.backtable.com/shows/vi/podcasts/361/intra-arterial-percutaneous-treatment-of-giant-hepatic-hemangiomas BackTable VI Episode #447 - Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little: https://www.backtable.com/shows/vi/podcasts/447/exploring-gae-clinical-insights-outcomes GEST MSK Annual Meeting: https://www.gestmsk.com/ Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline: https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline Dr. Jafar Golzarian shares his experiences with co-founding an outpatient-based lab (OBL), obtaining the right equipment, handling staffing, negotiating with insurance companies, and marketing his new practice. Dr. Golzarian is an interventional radiologist at his OBL in Minneapolis, Minnesota and he is the former Division Head and Program Director for the interventional radiology program at the University of Minnesota.


---


CHECK OUT OUR SPONSOR


GE Healthcare Allia Image Guided Systems

https://www.gehealthcare.com/products/interventional-image-guided-systems/allia


---


SYNPOSIS


Dr. Golzarian emphasizes the importance of having independence and adopting a patient-centered approach. He also offers practical advice for physicians considering similar moves into the private practice sphere. Additionally, Dr. Golzarian talks about the challenges and rewards of focusing on specific embolization procedures and collaborating with industry partners to build a successful practice.


---


TIMESTAMPS


00:00 - Introduction

06:06 - Setting Up a New Practice

14:27 - Tips for Marketing

23:40 - Finding the Right Business Partner

30:44 - OBL vs. ASC Status and Reimbursement

32:59 - Industry Support and Device Costs

37:58 - Staffing and Culture

45:25 - Advice for New Practitioners


---


RESOURCES


BackTable VI Episode #85 - Genicular Artery Embolization for OA with Dr. Jafar Golzarian:

https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa


BackTable VI Episode #361 - Intra-Arterial & Percutaneous Treatment of Giant Hepatic Hemangiomas with Dr. Jafar Golzarian:

https://www.backtable.com/shows/vi/podcasts/361/intra-arterial-percutaneous-treatment-of-giant-hepatic-hemangiomas


BackTable VI Episode #447 - Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little:

https://www.backtable.com/shows/vi/podcasts/447/exploring-gae-clinical-insights-outcomes


GEST MSK Annual Meeting:

https://www.gestmsk.com/


Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline:

https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline

]]> 2951 Ep. 458 AI Scribes: Enhancing Patient and Physician Interaction with Elie Toubiana Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation. --- SYNPOSIS Their conversation covers the capabilities and benefits of using an AI-driven medical scribe that ensures HIPAA compliance, reduces physician burnout, and enhances patient interactions. Elie also shares his insights about the technology’s adaptability across various medical fields. Finally, Dr. Bagrodia and Elie discuss ethical considerations surrounding applications of AI in other aspects of healthcare, such as medical workup and diagnosis. --- TIMESTAMPS 00:00 - Introduction 06:00 - How ScribeMD AI Works 14:14 - Integration with EMR 20:31 - Legal Considerations with AI Technology 26:34 - Cost Implications of AI Scribes 38:46 - Future of AI in Medical Diagnosis 41:45 - Conclusion and Final Thoughts --- RESOURCES ScribeMD.ai https://www.scribemd.ai/ Fri, 21 Jun 2024 07:00:00 -0000 full BackTable Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation. Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation. --- SYNPOSIS Their conversation covers the capabilities and benefits of using an AI-driven medical scribe that ensures HIPAA compliance, reduces physician burnout, and enhances patient interactions. Elie also shares his insights about the technology’s adaptability across various medical fields. Finally, Dr. Bagrodia and Elie discuss ethical considerations surrounding applications of AI in other aspects of healthcare, such as medical workup and diagnosis. --- TIMESTAMPS 00:00 - Introduction 06:00 - How ScribeMD AI Works 14:14 - Integration with EMR 20:31 - Legal Considerations with AI Technology 26:34 - Cost Implications of AI Scribes 38:46 - Future of AI in Medical Diagnosis 41:45 - Conclusion and Final Thoughts --- RESOURCES ScribeMD.ai https://www.scribemd.ai/ Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation.


---


SYNPOSIS


Their conversation covers the capabilities and benefits of using an AI-driven medical scribe that ensures HIPAA compliance, reduces physician burnout, and enhances patient interactions. Elie also shares his insights about the technology’s adaptability across various medical fields. Finally, Dr. Bagrodia and Elie discuss ethical considerations surrounding applications of AI in other aspects of healthcare, such as medical workup and diagnosis.


---


TIMESTAMPS


00:00 - Introduction

06:00 - How ScribeMD AI Works

14:14 - Integration with EMR

20:31 - Legal Considerations with AI Technology

26:34 - Cost Implications of AI Scribes

38:46 - Future of AI in Medical Diagnosis

41:45 - Conclusion and Final Thoughts


---


RESOURCES


ScribeMD.ai

https://www.scribemd.ai/

]]> 2685 Ep. 457 Sacroplasty II: Technique, Pearls, and Training Opportunities with Dr. Doug Beall In this episode of the Back Table MSK podcast, Dr. Jacob Fleming and Dr. Douglas Beall dive into the intricacies of sacroplasty, including considerations for selecting cement volume, efficacy of small versus large needles, and biomechanics of the pelvis. --- CHECK OUT OUR SPONSOR Stryker Interventional Spine https://www.strykerivs.com --- SYNPOSIS The doctors review evidence from the SAKOS trial on pain relief and highlight the complexities of billing. They also emphasize proactive treatments for aging populations suffering from fractures and the need for more training and propagation of sacroplasty techniques. Listeners are encouraged to stay informed about new educational opportunities and advancements in sacroplasty through ongoing updates and courses. --- TIMESTAMPS 00:00 - Introduction 02:33 - Expanding Sacroplasty Training and Curriculum 04:50 - Walkthrough of Sacroplasty Technique 10:36 - Mechanical Stabilization and Cement Volume 21:41 - Choosing Hardware and Needle Size 27:37 - Industry-Sponsored Trials and Bias 32:47 - Navigating Billing and Reimbursement 38:05 - Closing Thoughts on Sacroplasty and Osteoporotic Fractures --- RESOURCES BackTable VI Ep. 51- Sacroplasty: Principles & New Data in the Treatment of Sacral Insufficiency Fractures: https://www.backtable.com/shows/msk/podcasts/51/sacroplasty-i-principles-new-data-in-the-treatment-of-sacral-insufficiency-fractures Seattle Science Foundation Annual Image Guided Interventional Spine Procedures Course: https://ssf.cloud-cme.com/course/courseoverview?P=5&EID=1149 Dr. Doug Beall’s Twitter: @dougbeall Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation: https://www.amazon.com/Vertebral-Augmentation-Comprehensive-Vertebroplasty-Kyphoplasty/dp/1684200156 An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall, 2023): https://www.jvir.org/article/S1051-0443(23)00356-1/fulltext Thu, 20 Jun 2024 07:00:00 -0000 full BackTable Dr. Jacob Fleming and Dr. Douglas Beall dive into the intricacies of sacroplasty, including considerations for selecting cement volume, efficacy of small versus large needles, and biomechanics of the pelvis. In this episode of the Back Table MSK podcast, Dr. Jacob Fleming and Dr. Douglas Beall dive into the intricacies of sacroplasty, including considerations for selecting cement volume, efficacy of small versus large needles, and biomechanics of the pelvis. --- CHECK OUT OUR SPONSOR Stryker Interventional Spine https://www.strykerivs.com --- SYNPOSIS The doctors review evidence from the SAKOS trial on pain relief and highlight the complexities of billing. They also emphasize proactive treatments for aging populations suffering from fractures and the need for more training and propagation of sacroplasty techniques. Listeners are encouraged to stay informed about new educational opportunities and advancements in sacroplasty through ongoing updates and courses. --- TIMESTAMPS 00:00 - Introduction 02:33 - Expanding Sacroplasty Training and Curriculum 04:50 - Walkthrough of Sacroplasty Technique 10:36 - Mechanical Stabilization and Cement Volume 21:41 - Choosing Hardware and Needle Size 27:37 - Industry-Sponsored Trials and Bias 32:47 - Navigating Billing and Reimbursement 38:05 - Closing Thoughts on Sacroplasty and Osteoporotic Fractures --- RESOURCES BackTable VI Ep. 51- Sacroplasty: Principles & New Data in the Treatment of Sacral Insufficiency Fractures: https://www.backtable.com/shows/msk/podcasts/51/sacroplasty-i-principles-new-data-in-the-treatment-of-sacral-insufficiency-fractures Seattle Science Foundation Annual Image Guided Interventional Spine Procedures Course: https://ssf.cloud-cme.com/course/courseoverview?P=5&EID=1149 Dr. Doug Beall’s Twitter: @dougbeall Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation: https://www.amazon.com/Vertebral-Augmentation-Comprehensive-Vertebroplasty-Kyphoplasty/dp/1684200156 An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall, 2023): https://www.jvir.org/article/S1051-0443(23)00356-1/fulltext In this episode of the Back Table MSK podcast, Dr. Jacob Fleming and Dr. Douglas Beall dive into the intricacies of sacroplasty, including considerations for selecting cement volume, efficacy of small versus large needles, and biomechanics of the pelvis.


---


CHECK OUT OUR SPONSOR


Stryker Interventional Spine

https://www.strykerivs.com


---


SYNPOSIS


The doctors review evidence from the SAKOS trial on pain relief and highlight the complexities of billing. They also emphasize proactive treatments for aging populations suffering from fractures and the need for more training and propagation of sacroplasty techniques. Listeners are encouraged to stay informed about new educational opportunities and advancements in sacroplasty through ongoing updates and courses.


---


TIMESTAMPS


00:00 - Introduction

02:33 - Expanding Sacroplasty Training and Curriculum

04:50 - Walkthrough of Sacroplasty Technique

10:36 - Mechanical Stabilization and Cement Volume

21:41 - Choosing Hardware and Needle Size

27:37 - Industry-Sponsored Trials and Bias

32:47 - Navigating Billing and Reimbursement

38:05 - Closing Thoughts on Sacroplasty and Osteoporotic Fractures


---


RESOURCES


BackTable VI Ep. 51- Sacroplasty: Principles & New Data in the Treatment of Sacral Insufficiency Fractures:

https://www.backtable.com/shows/msk/podcasts/51/sacroplasty-i-principles-new-data-in-the-treatment-of-sacral-insufficiency-fractures


Seattle Science Foundation Annual Image Guided Interventional Spine Procedures Course:

https://ssf.cloud-cme.com/course/courseoverview?P=5&EID=1149


Dr. Doug Beall’s Twitter: @dougbeall


Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation:

https://www.amazon.com/Vertebral-Augmentation-Comprehensive-Vertebroplasty-Kyphoplasty/dp/1684200156


An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall, 2023):

https://www.jvir.org/article/S1051-0443(23)00356-1/fulltext

]]> 2499 Ep. 456 Sacroplasty I: Principles and New Data in the Treatment of Sacral Insufficiency Fractures with Dr. Doug Beall Dr. Jacob Fleming and Dr. Douglas Beall discuss the challenges and advancements in treating sacral insufficiency fractures (SIF), the importance of real-world data in evaluating treatment efficacy, and the need to increase awareness of sacral fractures and sacroplasty. --- CHECK OUT OUR SPONSOR Stryker Interventional Spine https://www.strykerivs.com --- SYNPOSIS Dr. Beall emphasizes the underrecognition and undertreatment of sacral insufficiency fractures, pointing out the high mortality and chronic pain rates associated with non-treatment. He urges providers to consider this diagnosis, especially if the patient is describing symptoms of pain with position changes with standing, sitting, and laying, has pubic rami fractures, or reports a history of pelvic radiation. Even with imaging, the diagnosis can remain elusive, since it is not commonly recognized on x-ray and may not show obvious cortical disruption on CT or MRI. We also review the current literature on sacroplasty efficacy in lowering patient-reported pain scores and adverse events associated with treatment versus conservative management. Dr. Beall speaks about the importance of real-world data collection in the form of patient registries and the insight that these resulting studies have on applications of sacroplasty in specific patient populations. --- TIMESTAMPS 00:00 - Introduction 03:01 - Sacral Fractures and Sacroplasty 15:17 - Treatment Options for Sacral Fractures 17:34 - Consequences of Untreated Sacral Fractures 28:32 - Sacroplasty Registry and Current Research 38:08 - Imaging Modalities: CT vs. Fluoroscopy 40:49 - Complications of Sacroplasty: Extravasation 43:21 - Bone Quality and Fracture Healing 45:42 - Growing Awareness of Sacral Fractures and Treatment Options --- RESOURCES Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly (Lourie, 1982): https://pubmed.ncbi.nlm.nih.gov/7097924/ Percutaneous cementoplasty for pelvic bone metastasis (Marcy, 2000): https://pubmed.ncbi.nlm.nih.gov/11094996/ Safety and Efficacy of Sacroplasty for Sacral Fractures: A Systematic Review and Meta-Analysis (Chandra et al, 2019): https://pubmed.ncbi.nlm.nih.gov/31587952/ Percutaneous sacroplasty for osteoporotic sacral insufficiency fractures: a prospective, multicenter, observational pilot study (Frey et al, 2008): https://pubmed.ncbi.nlm.nih.gov/17981097/ Sacroplasty: A Ten-Year Analysis of Prospective Patients Treated with Percutaneous Sacroplasty: Literature Review and Technical Considerations (Frey et al, 2017): https://pubmed.ncbi.nlm.nih.gov/29149151/ Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation (Beall, 2020): https://www.thieme-connect.de/products/ebooks/book/10.1055/b000000226 An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall et al, 2023): https://pubmed.ncbi.nlm.nih.gov/37207812/ Clinical Effect of Balloon Kyphoplasty in Elderly Patients with Multiple Osteoporotic Vertebral Fracture (Liu et al, 2019): ​https://journals.lww.com/njcp/fulltext/2019/22030/clinical_effect_of_balloon_kyphoplasty_in_elderly.1.aspx Wed, 19 Jun 2024 07:00:00 -0000 full BackTable Dr. Jacob Fleming and Dr. Douglas Beall discuss the challenges and advancements in treating sacral insufficiency fractures (SIF), the importance of real-world data in evaluating treatment efficacy, and the need to increase awareness of sacral fractures and sacroplasty. Dr. Jacob Fleming and Dr. Douglas Beall discuss the challenges and advancements in treating sacral insufficiency fractures (SIF), the importance of real-world data in evaluating treatment efficacy, and the need to increase awareness of sacral fractures and sacroplasty. --- CHECK OUT OUR SPONSOR Stryker Interventional Spine https://www.strykerivs.com --- SYNPOSIS Dr. Beall emphasizes the underrecognition and undertreatment of sacral insufficiency fractures, pointing out the high mortality and chronic pain rates associated with non-treatment. He urges providers to consider this diagnosis, especially if the patient is describing symptoms of pain with position changes with standing, sitting, and laying, has pubic rami fractures, or reports a history of pelvic radiation. Even with imaging, the diagnosis can remain elusive, since it is not commonly recognized on x-ray and may not show obvious cortical disruption on CT or MRI. We also review the current literature on sacroplasty efficacy in lowering patient-reported pain scores and adverse events associated with treatment versus conservative management. Dr. Beall speaks about the importance of real-world data collection in the form of patient registries and the insight that these resulting studies have on applications of sacroplasty in specific patient populations. --- TIMESTAMPS 00:00 - Introduction 03:01 - Sacral Fractures and Sacroplasty 15:17 - Treatment Options for Sacral Fractures 17:34 - Consequences of Untreated Sacral Fractures 28:32 - Sacroplasty Registry and Current Research 38:08 - Imaging Modalities: CT vs. Fluoroscopy 40:49 - Complications of Sacroplasty: Extravasation 43:21 - Bone Quality and Fracture Healing 45:42 - Growing Awareness of Sacral Fractures and Treatment Options --- RESOURCES Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly (Lourie, 1982): https://pubmed.ncbi.nlm.nih.gov/7097924/ Percutaneous cementoplasty for pelvic bone metastasis (Marcy, 2000): https://pubmed.ncbi.nlm.nih.gov/11094996/ Safety and Efficacy of Sacroplasty for Sacral Fractures: A Systematic Review and Meta-Analysis (Chandra et al, 2019): https://pubmed.ncbi.nlm.nih.gov/31587952/ Percutaneous sacroplasty for osteoporotic sacral insufficiency fractures: a prospective, multicenter, observational pilot study (Frey et al, 2008): https://pubmed.ncbi.nlm.nih.gov/17981097/ Sacroplasty: A Ten-Year Analysis of Prospective Patients Treated with Percutaneous Sacroplasty: Literature Review and Technical Considerations (Frey et al, 2017): https://pubmed.ncbi.nlm.nih.gov/29149151/ Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation (Beall, 2020): https://www.thieme-connect.de/products/ebooks/book/10.1055/b000000226 An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall et al, 2023): https://pubmed.ncbi.nlm.nih.gov/37207812/ Clinical Effect of Balloon Kyphoplasty in Elderly Patients with Multiple Osteoporotic Vertebral Fracture (Liu et al, 2019): ​https://journals.lww.com/njcp/fulltext/2019/22030/clinical_effect_of_balloon_kyphoplasty_in_elderly.1.aspx Dr. Jacob Fleming and Dr. Douglas Beall discuss the challenges and advancements in treating sacral insufficiency fractures (SIF), the importance of real-world data in evaluating treatment efficacy, and the need to increase awareness of sacral fractures and sacroplasty.


---


CHECK OUT OUR SPONSOR


Stryker Interventional Spine

https://www.strykerivs.com


---


SYNPOSIS


Dr. Beall emphasizes the underrecognition and undertreatment of sacral insufficiency fractures, pointing out the high mortality and chronic pain rates associated with non-treatment. He urges providers to consider this diagnosis, especially if the patient is describing symptoms of pain with position changes with standing, sitting, and laying, has pubic rami fractures, or reports a history of pelvic radiation. Even with imaging, the diagnosis can remain elusive, since it is not commonly recognized on x-ray and may not show obvious cortical disruption on CT or MRI.


We also review the current literature on sacroplasty efficacy in lowering patient-reported pain scores and adverse events associated with treatment versus conservative management. Dr. Beall speaks about the importance of real-world data collection in the form of patient registries and the insight that these resulting studies have on applications of sacroplasty in specific patient populations.


---


TIMESTAMPS


00:00 - Introduction

03:01 - Sacral Fractures and Sacroplasty

15:17 - Treatment Options for Sacral Fractures

17:34 - Consequences of Untreated Sacral Fractures

28:32 - Sacroplasty Registry and Current Research

38:08 - Imaging Modalities: CT vs. Fluoroscopy

40:49 - Complications of Sacroplasty: Extravasation

43:21 - Bone Quality and Fracture Healing

45:42 - Growing Awareness of Sacral Fractures and Treatment Options


---


RESOURCES


Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly (Lourie, 1982):

https://pubmed.ncbi.nlm.nih.gov/7097924/


Percutaneous cementoplasty for pelvic bone metastasis (Marcy, 2000):

https://pubmed.ncbi.nlm.nih.gov/11094996/


Safety and Efficacy of Sacroplasty for Sacral Fractures: A Systematic Review and Meta-Analysis (Chandra et al, 2019):

https://pubmed.ncbi.nlm.nih.gov/31587952/


Percutaneous sacroplasty for osteoporotic sacral insufficiency fractures: a prospective, multicenter, observational pilot study (Frey et al, 2008):

https://pubmed.ncbi.nlm.nih.gov/17981097/


Sacroplasty: A Ten-Year Analysis of Prospective Patients Treated with Percutaneous Sacroplasty: Literature Review and Technical Considerations (Frey et al, 2017):

https://pubmed.ncbi.nlm.nih.gov/29149151/


Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation (Beall, 2020):

https://www.thieme-connect.de/products/ebooks/book/10.1055/b000000226


An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall et al, 2023):

https://pubmed.ncbi.nlm.nih.gov/37207812/


Clinical Effect of Balloon Kyphoplasty in Elderly Patients with Multiple Osteoporotic Vertebral Fracture (Liu et al, 2019):

​https://journals.lww.com/njcp/fulltext/2019/22030/clinical_effect_of_balloon_kyphoplasty_in_elderly.1.aspx

]]> 3122 Ep. 455 Evolving TIPS Procedures Using New Tools and ICE with Dr. Dylan Suttle and Dr. Harris Chengazi Dr. Dylan Suttle and Dr. Harris Chengazi delve into recent advancements in transjugular intrahepatic portosystemic shunt (TIPS) procedures, highlighting the significant reduction in procedural time and improvements in outcomes due to the introduction of Intracardiac Echo (ICE) and the Scorpion Portal Vein Access Series. --- CHECK OUT OUR SPONSOR Argon Medical http://www.argonmedical.com/ --- SYNPOSIS The doctors share their experiences, techniques, and the evolution of their approaches. They emphasize benefits such as high-resolution imaging, cost-effectiveness, and new technologies that make TIPS cases more approachable. --- TIMESTAMPS 00:00 - Introduction 06:17 - Portal Hypertension Clinics 13:17 - Technical Aspects of TIPS Procedures 35:17 - Challenges in Selecting the Right Hepatic Vein 38:48 - Pre-Procedure Planning 39:36 - Puncture Techniques 50:04 - Stent Deployment and Placement 55:35 - Learning Curve of ICE & Advantages 01:07:58 - The Future of TIPS Procedures --- RESOURCES BackTable VI Episode #123 - TIPS University Freshman Year: Referrals and Pre-op Workup with Dr. Emmett Lynskey: https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup BackTable VI Episode #124 - TIPS University Sophomore Year: Basic Procedure Technique with Dr. Emmett Lynskey: https://www.backtable.com/shows/vi/podcasts/124/tips-university-sophomore-year-basic-procedure-technique BackTable VI Episode #125 - TIPS University Junior Year: Advanced Techniques, ICE, and Splenic Access with Dr. Emmett Lynskey: https://www.backtable.com/shows/vi/podcasts/125/tips-university-junior-year-advanced-techniques-ice-splenic-access BackTable VI Episode #126 - TIPS University Senior Year: Gunsight Technique & Splenic Closure with Dr. Emmett Lynskey: https://www.backtable.com/shows/vi/podcasts/126/tips-university-senior-year-gunsight-technique-splenic-closure Dr. Suttle TIPS Technique Video: https://www.youtube.com/watch?v=jYfr_rWe5Ck TIPS prevents further decompensation and improves survival in patients with cirrhosis and portal hypertension in an individual patient data meta-analysis: https://www.journal-of-hepatology.eu/article/S0168-8278(23)00314-8/abstract Intracardiac Echocardiography–Guided TIPS: A Primer for New Operators: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540636/ Tue, 18 Jun 2024 07:00:00 -0000 full BackTable Dr. Dylan Suttle and Dr. Harris Chengazi delve into the advancements in transjugular intrahepatic portosystemic shunt (TIPS) procedures, highlighting the significant reduction in procedural time and improvements in outcomes due to the introduction of Intracardiac Echo (ICE) and the Scorpion Portal Vein Access Series. Dr. Dylan Suttle and Dr. Harris Chengazi delve into recent advancements in transjugular intrahepatic portosystemic shunt (TIPS) procedures, highlighting the significant reduction in procedural time and improvements in outcomes due to the introduction of Intracardiac Echo (ICE) and the Scorpion Portal Vein Access Series. --- CHECK OUT OUR SPONSOR Argon Medical http://www.argonmedical.com/ --- SYNPOSIS The doctors share their experiences, techniques, and the evolution of their approaches. They emphasize benefits such as high-resolution imaging, cost-effectiveness, and new technologies that make TIPS cases more approachable. --- TIMESTAMPS 00:00 - Introduction 06:17 - Portal Hypertension Clinics 13:17 - Technical Aspects of TIPS Procedures 35:17 - Challenges in Selecting the Right Hepatic Vein 38:48 - Pre-Procedure Planning 39:36 - Puncture Techniques 50:04 - Stent Deployment and Placement 55:35 - Learning Curve of ICE & Advantages 01:07:58 - The Future of TIPS Procedures --- RESOURCES BackTable VI Episode #123 - TIPS University Freshman Year: Referrals and Pre-op Workup with Dr. Emmett Lynskey: https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup BackTable VI Episode #124 - TIPS University Sophomore Year: Basic Procedure Technique with Dr. Emmett Lynskey: https://www.backtable.com/shows/vi/podcasts/124/tips-university-sophomore-year-basic-procedure-technique BackTable VI Episode #125 - TIPS University Junior Year: Advanced Techniques, ICE, and Splenic Access with Dr. Emmett Lynskey: https://www.backtable.com/shows/vi/podcasts/125/tips-university-junior-year-advanced-techniques-ice-splenic-access BackTable VI Episode #126 - TIPS University Senior Year: Gunsight Technique & Splenic Closure with Dr. Emmett Lynskey: https://www.backtable.com/shows/vi/podcasts/126/tips-university-senior-year-gunsight-technique-splenic-closure Dr. Suttle TIPS Technique Video: https://www.youtube.com/watch?v=jYfr_rWe5Ck TIPS prevents further decompensation and improves survival in patients with cirrhosis and portal hypertension in an individual patient data meta-analysis: https://www.journal-of-hepatology.eu/article/S0168-8278(23)00314-8/abstract Intracardiac Echocardiography–Guided TIPS: A Primer for New Operators: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540636/ Dr. Dylan Suttle and Dr. Harris Chengazi delve into recent advancements in transjugular intrahepatic portosystemic shunt (TIPS) procedures, highlighting the significant reduction in procedural time and improvements in outcomes due to the introduction of Intracardiac Echo (ICE) and the Scorpion Portal Vein Access Series.


---


CHECK OUT OUR SPONSOR


Argon Medical

http://www.argonmedical.com/


---


SYNPOSIS


The doctors share their experiences, techniques, and the evolution of their approaches. They emphasize benefits such as high-resolution imaging, cost-effectiveness, and new technologies that make TIPS cases more approachable.


---


TIMESTAMPS


00:00 - Introduction

06:17 - Portal Hypertension Clinics

13:17 - Technical Aspects of TIPS Procedures

35:17 - Challenges in Selecting the Right Hepatic Vein

38:48 - Pre-Procedure Planning

39:36 - Puncture Techniques

50:04 - Stent Deployment and Placement

55:35 - Learning Curve of ICE & Advantages

01:07:58 - The Future of TIPS Procedures


---


RESOURCES


BackTable VI Episode #123 - TIPS University Freshman Year: Referrals and Pre-op Workup with Dr. Emmett Lynskey:

https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup


BackTable VI Episode #124 - TIPS University Sophomore Year: Basic Procedure Technique

with Dr. Emmett Lynskey:

https://www.backtable.com/shows/vi/podcasts/124/tips-university-sophomore-year-basic-procedure-technique


BackTable VI Episode #125 - TIPS University Junior Year: Advanced Techniques, ICE, and Splenic Access with Dr. Emmett Lynskey:

https://www.backtable.com/shows/vi/podcasts/125/tips-university-junior-year-advanced-techniques-ice-splenic-access


BackTable VI Episode #126 - TIPS University Senior Year: Gunsight Technique & Splenic Closure with Dr. Emmett Lynskey:

https://www.backtable.com/shows/vi/podcasts/126/tips-university-senior-year-gunsight-technique-splenic-closure


Dr. Suttle TIPS Technique Video:

https://www.youtube.com/watch?v=jYfr_rWe5Ck


TIPS prevents further decompensation and improves survival in patients with cirrhosis and portal hypertension in an individual patient data meta-analysis:

https://www.journal-of-hepatology.eu/article/S0168-8278(23)00314-8/abstract


Intracardiac Echocardiography–Guided TIPS: A Primer for New Operators:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540636/

]]> 4400 Ep. 454 Moral Injury in Interventional Radiology with Dr. Mina Makary and Dr. Jeff Chick In this episode of the BackTable Podcast, host Dr. Ally Baheti discusses the concept of moral injury with Dr. Mina Makary from Ohio State University and Dr. Jeff Chick from the University of Washington. The conversation focuses on their recent study published in Academic Radiology, which employed a survey to analyze prevalence of moral injury, factors contributing to its occurrence, and strategies to address it. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS It is important to distinguish burnout from moral injury, with the former concept more focused on personal resilience, and the latter defined as extrinsic circumstances that lead to disconnection with one’s career. A key finding from the study was the negative correlation between degree of moral injury and quality of life. Respondents’ free text answers identified a variety of factors contributing to moral injury. The doctors also speak about strategies for addressing moral injury such as psychotherapy, spiritual care, and physical exercise. Most importantly, they believe it is crucial to target systemic factors with efforts to increase physician leadership, administrative support, and research in physician wellness. --- TIMESTAMPS 00:00 - Introduction 02:14 - Defining Moral Injury 05:31 - Survey Methodology and Respondent Demographics 07:52 - Key Survey Findings 11:07 - Causes of Moral Injury 12:11 - Personal and Systemic Strategies for Addressing Moral Injury --- RESOURCES Moral Injury Among Interventional Radiologists (Woerner, 2024): https://pubmed.ncbi.nlm.nih.gov/37926643/ Identifying Moral Injury in Healthcare Professionals: The Moral Injury Symptom Scale-HP (Mantri, 2020): https://pubmed.ncbi.nlm.nih.gov/32681398/ Fri, 14 Jun 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Ally Baheti discusses the concept of moral injury with Dr. Mina Makary from Ohio State University and Dr. Jeff Chick from the University of Washington. The conversation focuses on their recent study published in Academic Radiology, which employed a survey to analyze prevalence of moral injury, factors contributing to its occurrence, and strategies to address it. In this episode of the BackTable Podcast, host Dr. Ally Baheti discusses the concept of moral injury with Dr. Mina Makary from Ohio State University and Dr. Jeff Chick from the University of Washington. The conversation focuses on their recent study published in Academic Radiology, which employed a survey to analyze prevalence of moral injury, factors contributing to its occurrence, and strategies to address it. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS It is important to distinguish burnout from moral injury, with the former concept more focused on personal resilience, and the latter defined as extrinsic circumstances that lead to disconnection with one’s career. A key finding from the study was the negative correlation between degree of moral injury and quality of life. Respondents’ free text answers identified a variety of factors contributing to moral injury. The doctors also speak about strategies for addressing moral injury such as psychotherapy, spiritual care, and physical exercise. Most importantly, they believe it is crucial to target systemic factors with efforts to increase physician leadership, administrative support, and research in physician wellness. --- TIMESTAMPS 00:00 - Introduction 02:14 - Defining Moral Injury 05:31 - Survey Methodology and Respondent Demographics 07:52 - Key Survey Findings 11:07 - Causes of Moral Injury 12:11 - Personal and Systemic Strategies for Addressing Moral Injury --- RESOURCES Moral Injury Among Interventional Radiologists (Woerner, 2024): https://pubmed.ncbi.nlm.nih.gov/37926643/ Identifying Moral Injury in Healthcare Professionals: The Moral Injury Symptom Scale-HP (Mantri, 2020): https://pubmed.ncbi.nlm.nih.gov/32681398/ In this episode of the BackTable Podcast, host Dr. Ally Baheti discusses the concept of moral injury with Dr. Mina Makary from Ohio State University and Dr. Jeff Chick from the University of Washington. The conversation focuses on their recent study published in Academic Radiology, which employed a survey to analyze prevalence of moral injury, factors contributing to its occurrence, and strategies to address it.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


It is important to distinguish burnout from moral injury, with the former concept more focused on personal resilience, and the latter defined as extrinsic circumstances that lead to disconnection with one’s career. A key finding from the study was the negative correlation between degree of moral injury and quality of life. Respondents’ free text answers identified a variety of factors contributing to moral injury. The doctors also speak about strategies for addressing moral injury such as psychotherapy, spiritual care, and physical exercise. Most importantly, they believe it is crucial to target systemic factors with efforts to increase physician leadership, administrative support, and research in physician wellness.


---


TIMESTAMPS


00:00 - Introduction

02:14 - Defining Moral Injury

05:31 - Survey Methodology and Respondent Demographics

07:52 - Key Survey Findings

11:07 - Causes of Moral Injury

12:11 - Personal and Systemic Strategies for Addressing Moral Injury


---


RESOURCES


Moral Injury Among Interventional Radiologists (Woerner, 2024):

https://pubmed.ncbi.nlm.nih.gov/37926643/


Identifying Moral Injury in Healthcare Professionals: The Moral Injury Symptom Scale-HP (Mantri, 2020):

https://pubmed.ncbi.nlm.nih.gov/32681398/

]]> 1448 Ep. 453 Thoracentesis Best Practices with Dr. Paul Lewis In this episode, Dr. Paul Lewis discusses best practices for thoracentesis. He shares insights on using image guidance, managing complex effusions, and managing complications such as pneumothorax and hemothorax. Dr. Lewis is an interventional radiologist at the University of Pittsburgh Medical Center. --- CHECK OUT OUR SPONSOR Laborie RenovaRP Centesis System https://www.laborie.com/product/renovarp-products/ --- SYNPOSIS Dr. Lewis also speaks on patient selection, procedural techniques, equipment choices, and other troubleshooting tips. Additionally, the doctors cover procedural nuances such as bilateral thoracentesis and patient positioning and highlight the efficiency of the RenovaRP Centesis System. --- TIMESTAMPS 00:00 - Introduction 06:07 - Thoracentesis Procedure Walkthrough 16:49 - Equipment Used 22:14 - Troubleshooting 30:56 - Post-Procedural Care 36:12 - Complications 48:07 - Helpful Resources --- RESOURCES Prospective comparison between a peristaltic pump and vacuum containers for paracentesis: Time, resources and safety: https://pubmed.ncbi.nlm.nih.gov/38042055/ Paracentesis: Faster and easier using the RenovaRP® pump: https://pubmed.ncbi.nlm.nih.gov/35548901/ Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations: https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext The Impact of Gravity vs Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: The GRAVITAS Multicenter Randomized Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/31711990/ Tue, 11 Jun 2024 07:00:00 -0000 full BackTable In this episode, Dr. Paul Lewis discusses best practices for thoracentesis. He shares insights on using image guidance, managing complex effusions, and managing complications such as pneumothorax and hemothorax. Dr. Lewis is an interventional radiologist at the University of Pittsburgh Medical Center. In this episode, Dr. Paul Lewis discusses best practices for thoracentesis. He shares insights on using image guidance, managing complex effusions, and managing complications such as pneumothorax and hemothorax. Dr. Lewis is an interventional radiologist at the University of Pittsburgh Medical Center. --- CHECK OUT OUR SPONSOR Laborie RenovaRP Centesis System https://www.laborie.com/product/renovarp-products/ --- SYNPOSIS Dr. Lewis also speaks on patient selection, procedural techniques, equipment choices, and other troubleshooting tips. Additionally, the doctors cover procedural nuances such as bilateral thoracentesis and patient positioning and highlight the efficiency of the RenovaRP Centesis System. --- TIMESTAMPS 00:00 - Introduction 06:07 - Thoracentesis Procedure Walkthrough 16:49 - Equipment Used 22:14 - Troubleshooting 30:56 - Post-Procedural Care 36:12 - Complications 48:07 - Helpful Resources --- RESOURCES Prospective comparison between a peristaltic pump and vacuum containers for paracentesis: Time, resources and safety: https://pubmed.ncbi.nlm.nih.gov/38042055/ Paracentesis: Faster and easier using the RenovaRP® pump: https://pubmed.ncbi.nlm.nih.gov/35548901/ Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations: https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext The Impact of Gravity vs Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: The GRAVITAS Multicenter Randomized Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/31711990/ In this episode, Dr. Paul Lewis discusses best practices for thoracentesis. He shares insights on using image guidance, managing complex effusions, and managing complications such as pneumothorax and hemothorax. Dr. Lewis is an interventional radiologist at the University of Pittsburgh Medical Center.


---


CHECK OUT OUR SPONSOR


Laborie RenovaRP Centesis System

https://www.laborie.com/product/renovarp-products/


---


SYNPOSIS


Dr. Lewis also speaks on patient selection, procedural techniques, equipment choices, and other troubleshooting tips. Additionally, the doctors cover procedural nuances such as bilateral thoracentesis and patient positioning and highlight the efficiency of the RenovaRP Centesis System.


---


TIMESTAMPS


00:00 - Introduction

06:07 - Thoracentesis Procedure Walkthrough

16:49 - Equipment Used

22:14 - Troubleshooting

30:56 - Post-Procedural Care

36:12 - Complications

48:07 - Helpful Resources


---


RESOURCES


Prospective comparison between a peristaltic pump and vacuum containers for paracentesis: Time, resources and safety:

https://pubmed.ncbi.nlm.nih.gov/38042055/


Paracentesis: Faster and easier using the RenovaRP® pump:

https://pubmed.ncbi.nlm.nih.gov/35548901/


Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations:

https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext


The Impact of Gravity vs Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: The GRAVITAS Multicenter Randomized Controlled Trial:

https://pubmed.ncbi.nlm.nih.gov/31711990/

]]> 3329 Ep. 452 The 'Woundosome' Concept with Dr. Lorenzo Patrone In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Lorenzo Patrone about his recent multidisciplinary editorial entitled "The 'Woundosome' Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia.” --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Patrone explains his interest in critical limb ischemia (CLI) and describes how he reached out to colleagues around the world with the intention of drafting a paper that summarizes research in below-the-ankle interventions and increases awareness of the woundosome concept. He explains the woundosome concept, which aims to understand how each patient’s foot vasculature influences the effectiveness of below-the-ankle interventions and tissue healing. Understanding each patient’s anatomy, having adequate imaging of the foot, obtaining pedal acceleration times, and using micro-oxygen sensors are strategies to assess wound perfusion, which is integral for treatment planning and prognosis. He illustrates these techniques in a case study of a non-healing wound. Finally, Dr. Patrone shares some technical tips for below-the-ankle interventions, including the benefits of ipsilateral antegrade access, sheath selection, and strategic contrast administration. --- TIMESTAMPS 00:00 - Introduction 02:25 - Multidisciplinary and Global Collaboration 05:59 - Explaining the Woundosome Concept 07:51 - Understanding Wound Perfusion 10:20 - Assessing the Effectiveness of Revascularization 20:09 - Case Example with Pictures 28:07 - Technical Tips for CLI Interventions --- RESOURCES Find Your Algorithm (FYA): https://fya-congress.com/ The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia: https://journals.sagepub.com/doi/10.1177/15266028241231745?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Vascular imaging of the foot: the first step toward endovascular recanalization (Manzi): https://pubmed.ncbi.nlm.nih.gov/21997985/ BASIL-2 Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00462-2/fulltext BackTable VI Ep. 90- Pedal Acceleration Time for Limb Salvage with Jill Sommerset and Dr. Mary Constantino: https://www.backtable.com/shows/vi/podcasts/90/pedal-acceleration-time-for-limb-salvage The First-in-Man "Si Se Puede" Study for the use of micro-oxygen sensors (Montero-Baker): https://pubmed.ncbi.nlm.nih.gov/26004327/ PEDRA Perfusion Monitoring: https://www.pedratech.com/ Armada XT Balloon: https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/peripheral-dilatation-catheters/armada-14.html Fri, 07 Jun 2024 07:00:00 -0000 full BackTable In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Lorenzo Patrone about his recent multidisciplinary editorial entitled "The 'Woundosome' Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia.” In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Lorenzo Patrone about his recent multidisciplinary editorial entitled "The 'Woundosome' Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia.” --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Patrone explains his interest in critical limb ischemia (CLI) and describes how he reached out to colleagues around the world with the intention of drafting a paper that summarizes research in below-the-ankle interventions and increases awareness of the woundosome concept. He explains the woundosome concept, which aims to understand how each patient’s foot vasculature influences the effectiveness of below-the-ankle interventions and tissue healing. Understanding each patient’s anatomy, having adequate imaging of the foot, obtaining pedal acceleration times, and using micro-oxygen sensors are strategies to assess wound perfusion, which is integral for treatment planning and prognosis. He illustrates these techniques in a case study of a non-healing wound. Finally, Dr. Patrone shares some technical tips for below-the-ankle interventions, including the benefits of ipsilateral antegrade access, sheath selection, and strategic contrast administration. --- TIMESTAMPS 00:00 - Introduction 02:25 - Multidisciplinary and Global Collaboration 05:59 - Explaining the Woundosome Concept 07:51 - Understanding Wound Perfusion 10:20 - Assessing the Effectiveness of Revascularization 20:09 - Case Example with Pictures 28:07 - Technical Tips for CLI Interventions --- RESOURCES Find Your Algorithm (FYA): https://fya-congress.com/ The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia: https://journals.sagepub.com/doi/10.1177/15266028241231745?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Vascular imaging of the foot: the first step toward endovascular recanalization (Manzi): https://pubmed.ncbi.nlm.nih.gov/21997985/ BASIL-2 Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00462-2/fulltext BackTable VI Ep. 90- Pedal Acceleration Time for Limb Salvage with Jill Sommerset and Dr. Mary Constantino: https://www.backtable.com/shows/vi/podcasts/90/pedal-acceleration-time-for-limb-salvage The First-in-Man "Si Se Puede" Study for the use of micro-oxygen sensors (Montero-Baker): https://pubmed.ncbi.nlm.nih.gov/26004327/ PEDRA Perfusion Monitoring: https://www.pedratech.com/ Armada XT Balloon: https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/peripheral-dilatation-catheters/armada-14.html In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Lorenzo Patrone about his recent multidisciplinary editorial entitled "The 'Woundosome' Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia.”


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


Dr. Patrone explains his interest in critical limb ischemia (CLI) and describes how he reached out to colleagues around the world with the intention of drafting a paper that summarizes research in below-the-ankle interventions and increases awareness of the woundosome concept.


He explains the woundosome concept, which aims to understand how each patient’s foot vasculature influences the effectiveness of below-the-ankle interventions and tissue healing. Understanding each patient’s anatomy, having adequate imaging of the foot, obtaining pedal acceleration times, and using micro-oxygen sensors are strategies to assess wound perfusion, which is integral for treatment planning and prognosis. He illustrates these techniques in a case study of a non-healing wound.


Finally, Dr. Patrone shares some technical tips for below-the-ankle interventions, including the benefits of ipsilateral antegrade access, sheath selection, and strategic contrast administration.


---


TIMESTAMPS


00:00 - Introduction

02:25 - Multidisciplinary and Global Collaboration

05:59 - Explaining the Woundosome Concept

07:51 - Understanding Wound Perfusion

10:20 - Assessing the Effectiveness of Revascularization

20:09 - Case Example with Pictures

28:07 - Technical Tips for CLI Interventions


---


RESOURCES


Find Your Algorithm (FYA):

https://fya-congress.com/


The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia:

https://journals.sagepub.com/doi/10.1177/15266028241231745?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed


Vascular imaging of the foot: the first step toward endovascular recanalization (Manzi):

https://pubmed.ncbi.nlm.nih.gov/21997985/


BASIL-2 Trial:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00462-2/fulltext


BackTable VI Ep. 90- Pedal Acceleration Time for Limb Salvage with Jill Sommerset and Dr. Mary Constantino:

https://www.backtable.com/shows/vi/podcasts/90/pedal-acceleration-time-for-limb-salvage


The First-in-Man "Si Se Puede" Study for the use of micro-oxygen sensors (Montero-Baker):

https://pubmed.ncbi.nlm.nih.gov/26004327/


PEDRA Perfusion Monitoring:

https://www.pedratech.com/


Armada XT Balloon:

https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/peripheral-dilatation-catheters/armada-14.html

]]> 1809 Ep. 451 Comprehensive DVT Care: CLOUT Study Impacts with Dr. Nicolas Mouawad and Dr. Raja Ramaswamy In this episode of the BackTable Podcast, vascular surgeon Dr. Nicolas Mouawad and interventional radiologist Dr. Raja Ramaswamy share their insights on the changing landscape of deep vein thrombosis (DVT) management, steps of mechanical thrombectomy, and current research on DVT interventions. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SYNPOSIS The guests start by describing their typical referral patterns, noting that most cases come through the emergency department. In terms of workup, it is important to distinguish between acute and chronic DVTs and classify the thrombosis location as either proximal (femoral vein or higher) or distal. Anticoagulation, usually with direct oral anticoagulants, is always started, with efficacy largely determined by patient compliance. Regarding endovascular intervention, thrombolysis may be an effective adjunctive treatment if the clot occurred within a two-week timespan, but it carries a bleeding risk and requires ICU monitoring. On the other hand, mechanical thrombectomy is an option for both acute and chronic clots, allows for intervention in patients with high bleeding risk, and does not require post-procedural hospitalization. Both physicians emphasize that interventions should be employed if there are long-term benefits of avoiding post-thrombotic syndrome and pulmonary embolism. The physicians walk through a typical mechanical thrombectomy procedure, which involves the thrombectomy device, venogram, intravascular ultrasound, and possible stent placement. Finally, they discuss recent data, including the ATTRACT Trial for thrombolytics and the CLOUT Registry and Trial for ClotTriever use. Notably, they mention the DEFIANCE Trial as a current prospective randomized clinical trial for ClotTriever use in the iliofemoral region. --- TIMESTAMPS 00:00 - Introduction 03:48 - DVT Referral Patterns and Treatment Algorithms 08:55 - Choosing an Anticoagulation Regimen 11:01 - DVT Interventions 13:54 - Patient Scenarios and Treatment Decisions 22:29 - Post-Thrombotic Syndrome 26:16 - Mechanical Thrombectomy Technique 35:45 - Postoperative Care 39:09 - The Evolution of Mechanical Thrombectomy 43:38 - ATTRACT Trial 46:20 - CLOUT Trial --- RESOURCES Inari ClotTriever System: https://www.inarimedical.com/clottriever-system ATTRACT Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1615066 CLOUT Trial: https://pubmed.ncbi.nlm.nih.gov/35218955/ DEFIANCE Trial: https://evtoday.com/news/inari-medical-begins-defiance-randomized-clinical-trial-of-clottriever-system-in-dvt Tue, 04 Jun 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, vascular surgeon Dr. Nicolas Mouawad and interventional radiologist Dr. Raja Ramaswamy share their insights on the changing landscape of deep vein thrombosis (DVT) management, steps of mechanical thrombectomy, and current research on DVT interventions. In this episode of the BackTable Podcast, vascular surgeon Dr. Nicolas Mouawad and interventional radiologist Dr. Raja Ramaswamy share their insights on the changing landscape of deep vein thrombosis (DVT) management, steps of mechanical thrombectomy, and current research on DVT interventions. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SYNPOSIS The guests start by describing their typical referral patterns, noting that most cases come through the emergency department. In terms of workup, it is important to distinguish between acute and chronic DVTs and classify the thrombosis location as either proximal (femoral vein or higher) or distal. Anticoagulation, usually with direct oral anticoagulants, is always started, with efficacy largely determined by patient compliance. Regarding endovascular intervention, thrombolysis may be an effective adjunctive treatment if the clot occurred within a two-week timespan, but it carries a bleeding risk and requires ICU monitoring. On the other hand, mechanical thrombectomy is an option for both acute and chronic clots, allows for intervention in patients with high bleeding risk, and does not require post-procedural hospitalization. Both physicians emphasize that interventions should be employed if there are long-term benefits of avoiding post-thrombotic syndrome and pulmonary embolism. The physicians walk through a typical mechanical thrombectomy procedure, which involves the thrombectomy device, venogram, intravascular ultrasound, and possible stent placement. Finally, they discuss recent data, including the ATTRACT Trial for thrombolytics and the CLOUT Registry and Trial for ClotTriever use. Notably, they mention the DEFIANCE Trial as a current prospective randomized clinical trial for ClotTriever use in the iliofemoral region. --- TIMESTAMPS 00:00 - Introduction 03:48 - DVT Referral Patterns and Treatment Algorithms 08:55 - Choosing an Anticoagulation Regimen 11:01 - DVT Interventions 13:54 - Patient Scenarios and Treatment Decisions 22:29 - Post-Thrombotic Syndrome 26:16 - Mechanical Thrombectomy Technique 35:45 - Postoperative Care 39:09 - The Evolution of Mechanical Thrombectomy 43:38 - ATTRACT Trial 46:20 - CLOUT Trial --- RESOURCES Inari ClotTriever System: https://www.inarimedical.com/clottriever-system ATTRACT Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1615066 CLOUT Trial: https://pubmed.ncbi.nlm.nih.gov/35218955/ DEFIANCE Trial: https://evtoday.com/news/inari-medical-begins-defiance-randomized-clinical-trial-of-clottriever-system-in-dvt In this episode of the BackTable Podcast, vascular surgeon Dr. Nicolas Mouawad and interventional radiologist Dr. Raja Ramaswamy share their insights on the changing landscape of deep vein thrombosis (DVT) management, steps of mechanical thrombectomy, and current research on DVT interventions.


---


CHECK OUT OUR SPONSOR


Inari Medical

https://www.inarimedical.com/


---


SYNPOSIS


The guests start by describing their typical referral patterns, noting that most cases come through the emergency department. In terms of workup, it is important to distinguish between acute and chronic DVTs and classify the thrombosis location as either proximal (femoral vein or higher) or distal. Anticoagulation, usually with direct oral anticoagulants, is always started, with efficacy largely determined by patient compliance.


Regarding endovascular intervention, thrombolysis may be an effective adjunctive treatment if the clot occurred within a two-week timespan, but it carries a bleeding risk and requires ICU monitoring. On the other hand, mechanical thrombectomy is an option for both acute and chronic clots, allows for intervention in patients with high bleeding risk, and does not require post-procedural hospitalization. Both physicians emphasize that interventions should be employed if there are long-term benefits of avoiding post-thrombotic syndrome and pulmonary embolism.


The physicians walk through a typical mechanical thrombectomy procedure, which involves the thrombectomy device, venogram, intravascular ultrasound, and possible stent placement. Finally, they discuss recent data, including the ATTRACT Trial for thrombolytics and the CLOUT Registry and Trial for ClotTriever use. Notably, they mention the DEFIANCE Trial as a current prospective randomized clinical trial for ClotTriever use in the iliofemoral region.


---


TIMESTAMPS


00:00 - Introduction

03:48 - DVT Referral Patterns and Treatment Algorithms

08:55 - Choosing an Anticoagulation Regimen

11:01 - DVT Interventions

13:54 - Patient Scenarios and Treatment Decisions

22:29 - Post-Thrombotic Syndrome

26:16 - Mechanical Thrombectomy Technique

35:45 - Postoperative Care

39:09 - The Evolution of Mechanical Thrombectomy

43:38 - ATTRACT Trial

46:20 - CLOUT Trial


---


RESOURCES


Inari ClotTriever System:

https://www.inarimedical.com/clottriever-system


ATTRACT Trial:

https://www.nejm.org/doi/full/10.1056/NEJMoa1615066


CLOUT Trial:

https://pubmed.ncbi.nlm.nih.gov/35218955/


DEFIANCE Trial:

https://evtoday.com/news/inari-medical-begins-defiance-randomized-clinical-trial-of-clottriever-system-in-dvt

]]> 3566 Ep. 450 The Hidden Struggles: Supporting Mental Health in Medicine Together, Not Alone with Dr. Jenanan Vairavamurthy Trigger warning: This episode contains discussions about suicide. In this episode of the BackTable podcast, interventional radiologist Dr. Jenanan Vairavamurthy shares about the tragic loss of his physician brother to suicide and discusses his own mental health journey. He highlights the immense pressures and challenges that medical training and practice impose on providers. --- SYNPOSIS The discussion emphasizes the need for mental health awareness and the importance of creating supportive environments within the medical community. He advocates for open conversations about mental health struggles and urges those in leadership positions to prioritize the well-being of colleagues and trainees. This powerful conversation aims to destigmatize mental health issues in the medical field and encourages medical providers to seek and provide support for each other. --- TIMESTAMPS 00:00 Introduction 04:11 Assessing Personal Mental Health 06:31 Personal Tragedy and Mindset Shift 11:49 The Realities of Wellness in Medicine 21:59 Creating Supportive Environments Within Medicine 25:58 Navigating Personal and Professional Challenges 35:15 Building and Leading Supportive Networks --- RESOURCES Physician Supp​​ort Line: https://www.physiciansupportline.com/ Fri, 31 May 2024 07:00:00 -0000 full BackTable Trigger warning: This episode contains discussions about suicide. In this episode of the BackTable podcast, interventional radiologist Dr. Jenanan Vairavamurthy shares about the tragic loss of his physician brother to suicide and discusses his own mental health journey. He highlights the immense pressures and challenges that medical training and practice impose on providers. Trigger warning: This episode contains discussions about suicide. In this episode of the BackTable podcast, interventional radiologist Dr. Jenanan Vairavamurthy shares about the tragic loss of his physician brother to suicide and discusses his own mental health journey. He highlights the immense pressures and challenges that medical training and practice impose on providers. --- SYNPOSIS The discussion emphasizes the need for mental health awareness and the importance of creating supportive environments within the medical community. He advocates for open conversations about mental health struggles and urges those in leadership positions to prioritize the well-being of colleagues and trainees. This powerful conversation aims to destigmatize mental health issues in the medical field and encourages medical providers to seek and provide support for each other. --- TIMESTAMPS 00:00 Introduction 04:11 Assessing Personal Mental Health 06:31 Personal Tragedy and Mindset Shift 11:49 The Realities of Wellness in Medicine 21:59 Creating Supportive Environments Within Medicine 25:58 Navigating Personal and Professional Challenges 35:15 Building and Leading Supportive Networks --- RESOURCES Physician Supp​​ort Line: https://www.physiciansupportline.com/ Trigger warning: This episode contains discussions about suicide.


In this episode of the BackTable podcast, interventional radiologist Dr. Jenanan Vairavamurthy shares about the tragic loss of his physician brother to suicide and discusses his own mental health journey. He highlights the immense pressures and challenges that medical training and practice impose on providers.


---


SYNPOSIS


The discussion emphasizes the need for mental health awareness and the importance of creating supportive environments within the medical community. He advocates for open conversations about mental health struggles and urges those in leadership positions to prioritize the well-being of colleagues and trainees. This powerful conversation aims to destigmatize mental health issues in the medical field and encourages medical providers to seek and provide support for each other.


---


TIMESTAMPS


00:00 Introduction

04:11 Assessing Personal Mental Health

06:31 Personal Tragedy and Mindset Shift

11:49 The Realities of Wellness in Medicine

21:59 Creating Supportive Environments Within Medicine

25:58 Navigating Personal and Professional Challenges

35:15 Building and Leading Supportive Networks


---


RESOURCES


Physician Supp​​ort Line:

https://www.physiciansupportline.com/

]]> 2631 Ep. 449 Percutaneous Transmural Arterial Bypass: Updates on Technique and Data with Dr. Peter Soukas In this episode, interventional cardiologist Dr. Peter Soukas joins us to discuss percutaneous transmural arterial bypass (PTAB) using the DETOUR system, a novel percutaneous treatment for extensive and complex blockages in the superficial femoral artery (SFA). --- CHECK OUT OUR SPONSOR Endologix https://endologix.com/ --- SYNPOSIS Dr. Soukas shares his extensive experience and insights into PTAB development, benefits, patient selection, and procedural details. The idea behind PTAB is to create an SFA-to-popliteal artery bypass through endovascular means, using a system of overlapping stent grafts within the femoral vein as a conduit. When planning the procedure, it is important to consider the location of reentry into the popliteal artery, avoid calcified zones, and meet femoral vein size criteria. Additionally, we explore the advantages of PTAB over other endovascular options and traditional open surgical bypass, which carry a higher likelihood of restenosis and longer recovery times, respectively. We also discuss the types of training and support available for physicians interested in adopting this technique, cost and reimbursement aspects, and the future direction of PTAB, including ongoing post-market studies. --- TIMESTAMPS 00:00 Introduction 02:38 Dr. Soukas’ Career in Vascular Medicine 05:19 Introduction to PTAB 13:00 Landing Zones 19:37 Stent Graft Sizing 23:14 Patient Selection and Adjunctive Medical Therapy 28:04 Procedural Risks 29:18 Navigating PTAB Implementation 32:20 Opportunities for Learning PTAB --- RESOURCES PTAB with the DETOUR System: https://endologix.com/ptab/detour/ Brown Vascular and Endovascular Fellowship: https://brownmedicine.org/3/cardiology-vascular-endovascular-fellowship/ COMPASS Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1709118 VOYAGER Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2000052 DETOUR 2 Trial: https://www.jvascsurg.org/article/S0741-5214(22)01274-5/fulltext Tue, 28 May 2024 07:00:00 -0000 full BackTable In this episode, interventional cardiologist Dr. Peter Soukas joins us to discuss percutaneous transmural arterial bypass (PTAB) using the DETOUR system, a novel percutaneous treatment for extensive and complex blockages in the superficial femoral artery (SFA). In this episode, interventional cardiologist Dr. Peter Soukas joins us to discuss percutaneous transmural arterial bypass (PTAB) using the DETOUR system, a novel percutaneous treatment for extensive and complex blockages in the superficial femoral artery (SFA). --- CHECK OUT OUR SPONSOR Endologix https://endologix.com/ --- SYNPOSIS Dr. Soukas shares his extensive experience and insights into PTAB development, benefits, patient selection, and procedural details. The idea behind PTAB is to create an SFA-to-popliteal artery bypass through endovascular means, using a system of overlapping stent grafts within the femoral vein as a conduit. When planning the procedure, it is important to consider the location of reentry into the popliteal artery, avoid calcified zones, and meet femoral vein size criteria. Additionally, we explore the advantages of PTAB over other endovascular options and traditional open surgical bypass, which carry a higher likelihood of restenosis and longer recovery times, respectively. We also discuss the types of training and support available for physicians interested in adopting this technique, cost and reimbursement aspects, and the future direction of PTAB, including ongoing post-market studies. --- TIMESTAMPS 00:00 Introduction 02:38 Dr. Soukas’ Career in Vascular Medicine 05:19 Introduction to PTAB 13:00 Landing Zones 19:37 Stent Graft Sizing 23:14 Patient Selection and Adjunctive Medical Therapy 28:04 Procedural Risks 29:18 Navigating PTAB Implementation 32:20 Opportunities for Learning PTAB --- RESOURCES PTAB with the DETOUR System: https://endologix.com/ptab/detour/ Brown Vascular and Endovascular Fellowship: https://brownmedicine.org/3/cardiology-vascular-endovascular-fellowship/ COMPASS Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1709118 VOYAGER Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2000052 DETOUR 2 Trial: https://www.jvascsurg.org/article/S0741-5214(22)01274-5/fulltext In this episode, interventional cardiologist Dr. Peter Soukas joins us to discuss percutaneous transmural arterial bypass (PTAB) using the DETOUR system, a novel percutaneous treatment for extensive and complex blockages in the superficial femoral artery (SFA).


---


CHECK OUT OUR SPONSOR


Endologix

https://endologix.com/


---


SYNPOSIS


Dr. Soukas shares his extensive experience and insights into PTAB development, benefits, patient selection, and procedural details. The idea behind PTAB is to create an SFA-to-popliteal artery bypass through endovascular means, using a system of overlapping stent grafts within the femoral vein as a conduit. When planning the procedure, it is important to consider the location of reentry into the popliteal artery, avoid calcified zones, and meet femoral vein size criteria. Additionally, we explore the advantages of PTAB over other endovascular options and traditional open surgical bypass, which carry a higher likelihood of restenosis and longer recovery times, respectively.


We also discuss the types of training and support available for physicians interested in adopting this technique, cost and reimbursement aspects, and the future direction of PTAB, including ongoing post-market studies.


---


TIMESTAMPS


00:00 Introduction

02:38 Dr. Soukas’ Career in Vascular Medicine

05:19 Introduction to PTAB

13:00 Landing Zones

19:37 Stent Graft Sizing

23:14 Patient Selection and Adjunctive Medical Therapy

28:04 Procedural Risks

29:18 Navigating PTAB Implementation

32:20 Opportunities for Learning PTAB


---


RESOURCES


PTAB with the DETOUR System:

https://endologix.com/ptab/detour/


Brown Vascular and Endovascular Fellowship:

https://brownmedicine.org/3/cardiology-vascular-endovascular-fellowship/


COMPASS Trial:

https://www.nejm.org/doi/full/10.1056/NEJMoa1709118


VOYAGER Trial:

https://www.nejm.org/doi/full/10.1056/NEJMoa2000052


DETOUR 2 Trial:

https://www.jvascsurg.org/article/S0741-5214(22)01274-5/fulltext

]]> 2442 Ep. 448 Below the Ankle Expertise: Distal Pedal Access with Dr. Marta Lobato In this episode, Dr. Marta Lobato explores advanced endovascular techniques in below the knee (BTK) and below the ankle (BTA) interventions for critical limb ischemia (CLI). She introduces various skills that were developed and used by her team, such as the telescopic needle, buddy needle, balloon-assisted puncture, and vasodilation to prevent artery spasm. Dr. Lobato is a vascular surgeon at Hospital de Cruces in Barakaldo, Spain. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS The discussion covers the importance of visualizing the fifth metatarsal for effective lateral views in X-rays, the intricacies of accessing the lateral and medial plantar arteries, and the significance of starting with easier procedures before attempting more complex interventions. Additionally, Dr. Lobato highlights the role of social media in learning about innovative medical practices. --- TIMESTAMPS 00:00 - Introduction 05:54 - Below the Knee and Ankle Interventions 15:35 - Complexities of Zone 2 and 3 Access 23:12 - Buddy Needle Technique for Calcified Arteries 30:12 - Advanced Techniques for Supporting the Wire 34:13 - Vasodilator Use 37:12 - Balloon-Assisted Techniques 41:02 - Advancing Your Endovascular Skills --- RESOURCES Tips and Tricks for Simple and Complex Below-the-Ankle Punctures: https://pubmed.ncbi.nlm.nih.gov/38441118/ Buddy Needle Technique to Facilitate Retrograde Puncture of Heavily Calcified Tibial Vessels: https://pubmed.ncbi.nlm.nih.gov/28587566/ Balloon-Assisted Retrograde Puncture of Distal Vessels in Patients Unsuitable for a Conventional Transpedal Approach: https://pubmed.ncbi.nlm.nih.gov/34989276/ Retrograde Balloon-Assisted Approach to Prevent Distal Embolization During Complex Recanalization Procedures: https://pubmed.ncbi.nlm.nih.gov/36415934/ The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia: https://pubmed.ncbi.nlm.nih.gov/38523459/ New antioxidant therapy for hard-to-heal neuroischaemic diabetic foot ulcers with deep exposure: https://pubmed.ncbi.nlm.nih.gov/37029973/ Percutaneous endovascular arteriovenous fistula creation for hemodialysis access using "off-the-shelf" conventional devices: https://pubmed.ncbi.nlm.nih.gov/33251393/ Fri, 24 May 2024 07:00:00 -0000 full BackTable In this episode, Dr. Marta Lobato explores advanced endovascular techniques in below the knee (BTK) and below the ankle (BTA) interventions for critical limb ischemia (CLI). She introduces various skills that were developed and used by her team, such as the telescopic needle, buddy needle, balloon-assisted puncture, and vasodilation to prevent artery spasm. In this episode, Dr. Marta Lobato explores advanced endovascular techniques in below the knee (BTK) and below the ankle (BTA) interventions for critical limb ischemia (CLI). She introduces various skills that were developed and used by her team, such as the telescopic needle, buddy needle, balloon-assisted puncture, and vasodilation to prevent artery spasm. Dr. Lobato is a vascular surgeon at Hospital de Cruces in Barakaldo, Spain. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS The discussion covers the importance of visualizing the fifth metatarsal for effective lateral views in X-rays, the intricacies of accessing the lateral and medial plantar arteries, and the significance of starting with easier procedures before attempting more complex interventions. Additionally, Dr. Lobato highlights the role of social media in learning about innovative medical practices. --- TIMESTAMPS 00:00 - Introduction 05:54 - Below the Knee and Ankle Interventions 15:35 - Complexities of Zone 2 and 3 Access 23:12 - Buddy Needle Technique for Calcified Arteries 30:12 - Advanced Techniques for Supporting the Wire 34:13 - Vasodilator Use 37:12 - Balloon-Assisted Techniques 41:02 - Advancing Your Endovascular Skills --- RESOURCES Tips and Tricks for Simple and Complex Below-the-Ankle Punctures: https://pubmed.ncbi.nlm.nih.gov/38441118/ Buddy Needle Technique to Facilitate Retrograde Puncture of Heavily Calcified Tibial Vessels: https://pubmed.ncbi.nlm.nih.gov/28587566/ Balloon-Assisted Retrograde Puncture of Distal Vessels in Patients Unsuitable for a Conventional Transpedal Approach: https://pubmed.ncbi.nlm.nih.gov/34989276/ Retrograde Balloon-Assisted Approach to Prevent Distal Embolization During Complex Recanalization Procedures: https://pubmed.ncbi.nlm.nih.gov/36415934/ The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia: https://pubmed.ncbi.nlm.nih.gov/38523459/ New antioxidant therapy for hard-to-heal neuroischaemic diabetic foot ulcers with deep exposure: https://pubmed.ncbi.nlm.nih.gov/37029973/ Percutaneous endovascular arteriovenous fistula creation for hemodialysis access using "off-the-shelf" conventional devices: https://pubmed.ncbi.nlm.nih.gov/33251393/ In this episode, Dr. Marta Lobato explores advanced endovascular techniques in below the knee (BTK) and below the ankle (BTA) interventions for critical limb ischemia (CLI). She introduces various skills that were developed and used by her team, such as the telescopic needle, buddy needle, balloon-assisted puncture, and vasodilation to prevent artery spasm. Dr. Lobato is a vascular surgeon at Hospital de Cruces in Barakaldo, Spain.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


The discussion covers the importance of visualizing the fifth metatarsal for effective lateral views in X-rays, the intricacies of accessing the lateral and medial plantar arteries, and the significance of starting with easier procedures before attempting more complex interventions. Additionally, Dr. Lobato highlights the role of social media in learning about innovative medical practices.


---


TIMESTAMPS


00:00 - Introduction

05:54 - Below the Knee and Ankle Interventions

15:35 - Complexities of Zone 2 and 3 Access

23:12 - Buddy Needle Technique for Calcified Arteries

30:12 - Advanced Techniques for Supporting the Wire

34:13 - Vasodilator Use

37:12 - Balloon-Assisted Techniques

41:02 - Advancing Your Endovascular Skills


---


RESOURCES


Tips and Tricks for Simple and Complex Below-the-Ankle Punctures:

https://pubmed.ncbi.nlm.nih.gov/38441118/


Buddy Needle Technique to Facilitate Retrograde Puncture of Heavily Calcified Tibial Vessels:

https://pubmed.ncbi.nlm.nih.gov/28587566/


Balloon-Assisted Retrograde Puncture of Distal Vessels in Patients Unsuitable for a Conventional Transpedal Approach:

https://pubmed.ncbi.nlm.nih.gov/34989276/


Retrograde Balloon-Assisted Approach to Prevent Distal Embolization During Complex Recanalization Procedures:

https://pubmed.ncbi.nlm.nih.gov/36415934/


The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia:

https://pubmed.ncbi.nlm.nih.gov/38523459/


New antioxidant therapy for hard-to-heal neuroischaemic diabetic foot ulcers with deep exposure:

https://pubmed.ncbi.nlm.nih.gov/37029973/


Percutaneous endovascular arteriovenous fistula creation for hemodialysis access using "off-the-shelf" conventional devices:

https://pubmed.ncbi.nlm.nih.gov/33251393/

]]> 2776 Ep. 447 Exploring GAE: Clinical Insights and Outcomes with Dr. Mark Little In this episode, Dr. Mark Little shares his insights about genicular artery embolization (GAE), implications for patients with knee osteoarthritis, possible applications in other MSK interventions, and the importance of research for advancing the field. Dr. Little is a consultant diagnostic and interventional radiologist at Berkshire Imaging and Visiting Professor at the University of Reading in England. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ --- SYNPOSIS The doctors also discuss challenges and considerations in patient selection, particularly concerning patients with comorbid peripheral arterial disease, and they further emphasize the need for high-quality research and collaboration within the IR community to continue improving MSK embolization practices. --- TIMESTAMPS 00:00 - Introduction 12:28 - Genicular Artery Embolization 24:30 - GENESIS 1 and 2 Studies 41:04 - Future of MSK Embolization --- RESOURCES BackTable VI Episode 27 - Geniculate Artery Embolization for Osteoarthritis with Dr. Sandeep Bagla and Dr. Ari Isaacson: https://www.backtable.com/shows/vi/podcasts/27/geniculate-artery-embolization-for-osteoarthritis BackTable VI Episode 85 - Genicular Artery Embolization for OA with Dr. Jafar Golzarian: https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa GEST MSK Annual Meeting: https://thegestgroup.com/annual-msk-meeting/ GENESIS 1 - Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis: https://pubmed.ncbi.nlm.nih.gov/33474601/ GENESIS 2 - Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/37337060/ Dr. Little Genicular Artery Anatomy Paper - Cadaveric and Angiographic Anatomical Considerations in the Genicular Arterial System: Implications for Genicular Artery Embolisation in Patients with Knee Osteoarthritis: https://pubmed.ncbi.nlm.nih.gov/34657976/ Dr. Sid Padia’s Knee OA Research (UCLA) - Genicular Artery Embolization for the Treatment of Symptomatic Knee Osteoarthritis: https://pubmed.ncbi.nlm.nih.gov/34703964/ Dr. Lars Lönn from Copenhagen Trial - Genicular Artery Embolization as Pain Treatment of Knee Osteoarthritis (GETKO): https://classic.clinicaltrials.gov/ct2/show/NCT05360329 Dr. Anna Martinez from Spain Shoulder Study - Mid-Term Results of Transcatheter Arterial Embolization for Adhesive Capsulitis Resistant to Conservative Treatment: https://pubmed.ncbi.nlm.nih.gov/33135118/ Dr. Anna Martinez from Spain Shoulder Study - Clinical Outcomes of Transcatheter Arterial Embolization for Secondary Stiff Shoulder: https://pubmed.ncbi.nlm.nih.gov/33478903/ Tue, 21 May 2024 07:00:00 -0000 full BackTable In this episode, Dr. Mark Little shares his insights about genicular artery embolization (GAE), implications for patients with knee osteoarthritis, possible applications in other MSK interventions, and the importance of research for advancing the field. In this episode, Dr. Mark Little shares his insights about genicular artery embolization (GAE), implications for patients with knee osteoarthritis, possible applications in other MSK interventions, and the importance of research for advancing the field. Dr. Little is a consultant diagnostic and interventional radiologist at Berkshire Imaging and Visiting Professor at the University of Reading in England. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ --- SYNPOSIS The doctors also discuss challenges and considerations in patient selection, particularly concerning patients with comorbid peripheral arterial disease, and they further emphasize the need for high-quality research and collaboration within the IR community to continue improving MSK embolization practices. --- TIMESTAMPS 00:00 - Introduction 12:28 - Genicular Artery Embolization 24:30 - GENESIS 1 and 2 Studies 41:04 - Future of MSK Embolization --- RESOURCES BackTable VI Episode 27 - Geniculate Artery Embolization for Osteoarthritis with Dr. Sandeep Bagla and Dr. Ari Isaacson: https://www.backtable.com/shows/vi/podcasts/27/geniculate-artery-embolization-for-osteoarthritis BackTable VI Episode 85 - Genicular Artery Embolization for OA with Dr. Jafar Golzarian: https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa GEST MSK Annual Meeting: https://thegestgroup.com/annual-msk-meeting/ GENESIS 1 - Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis: https://pubmed.ncbi.nlm.nih.gov/33474601/ GENESIS 2 - Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/37337060/ Dr. Little Genicular Artery Anatomy Paper - Cadaveric and Angiographic Anatomical Considerations in the Genicular Arterial System: Implications for Genicular Artery Embolisation in Patients with Knee Osteoarthritis: https://pubmed.ncbi.nlm.nih.gov/34657976/ Dr. Sid Padia’s Knee OA Research (UCLA) - Genicular Artery Embolization for the Treatment of Symptomatic Knee Osteoarthritis: https://pubmed.ncbi.nlm.nih.gov/34703964/ Dr. Lars Lönn from Copenhagen Trial - Genicular Artery Embolization as Pain Treatment of Knee Osteoarthritis (GETKO): https://classic.clinicaltrials.gov/ct2/show/NCT05360329 Dr. Anna Martinez from Spain Shoulder Study - Mid-Term Results of Transcatheter Arterial Embolization for Adhesive Capsulitis Resistant to Conservative Treatment: https://pubmed.ncbi.nlm.nih.gov/33135118/ Dr. Anna Martinez from Spain Shoulder Study - Clinical Outcomes of Transcatheter Arterial Embolization for Secondary Stiff Shoulder: https://pubmed.ncbi.nlm.nih.gov/33478903/ In this episode, Dr. Mark Little shares his insights about genicular artery embolization (GAE), implications for patients with knee osteoarthritis, possible applications in other MSK interventions, and the importance of research for advancing the field. Dr. Little is a consultant diagnostic and interventional radiologist at Berkshire Imaging and Visiting Professor at the University of Reading in England.


---


CHECK OUT OUR SPONSOR


Varian, a Siemens Healthineers company

https://www.siemens-healthineers.com/


---


SYNPOSIS


The doctors also discuss challenges and considerations in patient selection, particularly concerning patients with comorbid peripheral arterial disease, and they further emphasize the need for high-quality research and collaboration within the IR community to continue improving MSK embolization practices.


---


TIMESTAMPS


00:00 - Introduction

12:28 - Genicular Artery Embolization

24:30 - GENESIS 1 and 2 Studies

41:04 - Future of MSK Embolization


---


RESOURCES


BackTable VI Episode 27 - Geniculate Artery Embolization for Osteoarthritis with Dr. Sandeep Bagla and Dr. Ari Isaacson:

https://www.backtable.com/shows/vi/podcasts/27/geniculate-artery-embolization-for-osteoarthritis


BackTable VI Episode 85 - Genicular Artery Embolization for OA with Dr. Jafar Golzarian:

https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa

GEST MSK Annual Meeting:

https://thegestgroup.com/annual-msk-meeting/


GENESIS 1 - Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis:

https://pubmed.ncbi.nlm.nih.gov/33474601/


GENESIS 2 - Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial:

https://pubmed.ncbi.nlm.nih.gov/37337060/


Dr. Little Genicular Artery Anatomy Paper - Cadaveric and Angiographic Anatomical Considerations in the Genicular Arterial System: Implications for Genicular Artery Embolisation in Patients with Knee Osteoarthritis:

https://pubmed.ncbi.nlm.nih.gov/34657976/


Dr. Sid Padia’s Knee OA Research (UCLA) - Genicular Artery Embolization for the Treatment of Symptomatic Knee Osteoarthritis:

https://pubmed.ncbi.nlm.nih.gov/34703964/


Dr. Lars Lönn from Copenhagen Trial - Genicular Artery Embolization as Pain Treatment of Knee Osteoarthritis (GETKO):

https://classic.clinicaltrials.gov/ct2/show/NCT05360329


Dr. Anna Martinez from Spain Shoulder Study - Mid-Term Results of Transcatheter Arterial Embolization for Adhesive Capsulitis Resistant to Conservative Treatment:

https://pubmed.ncbi.nlm.nih.gov/33135118/


Dr. Anna Martinez from Spain Shoulder Study - Clinical Outcomes of Transcatheter Arterial Embolization for Secondary Stiff Shoulder:

https://pubmed.ncbi.nlm.nih.gov/33478903/

]]> 3132 Ep. 446 Más Allá del Coil: El Bienestar del Intervencionista con Dr. Anna Alguersuari Cabiscol En este episodio de nuestro podcast, Dra. Anna Alguersuari Cabiscol, una radióloga intervencionista que dejó su especialidad hace cuatro años, comparte su experiencia personal sobre los desafíos relacionados con la salud mental dentro de la profesión médica. --- SYNPOSIS Expone cómo la insatisfacción profesional, el síndrome del impostor y la falta de bienestar mental la llevaron a tomar la decisión drástica de abandonar el intervencionismo. A través de su relato, se discute la relevancia de crear un entorno positivo en el trabajo, invertir en el bienestar mental, y la importancia de enfrentar y superar el estigma asociado con estos temas en el ámbito médico. El episodio también aborda la necesidad de cambiar la percepción del éxito y cómo el apoyo de la comunidad médica y científica es fundamental para mejorar la situación actual. Finalmente, se destaca el rol crucial de los mentores en todas las etapas de la carrera médica para fomentar un equilibrio entre competencia y confianza, así como promover un entorno laboral saludable y respetuoso. --- TIMESTAMPS 00:00 - Bienvenido al podcast 07:16 - Redefiniendo el éxito 10:20 - Los cuatro pilares de una vida y un trabajo significativos 28:36 - Crecimiento personal y la importancia de la tutoría 32:22 - Pensamientos finales Fri, 17 May 2024 07:00:00 -0000 full BackTable Sumérjase en una discusión profunda sobre la salud mental en el intervencionismo médico, en la que expertos comparten sus viajes y conocimientos personales. En este episodio de nuestro podcast, Dra. Anna Alguersuari Cabiscol, una radióloga intervencionista que dejó su especialidad hace cuatro años, comparte su experiencia personal sobre los desafíos relacionados con la salud mental dentro de la profesión médica. --- SYNPOSIS Expone cómo la insatisfacción profesional, el síndrome del impostor y la falta de bienestar mental la llevaron a tomar la decisión drástica de abandonar el intervencionismo. A través de su relato, se discute la relevancia de crear un entorno positivo en el trabajo, invertir en el bienestar mental, y la importancia de enfrentar y superar el estigma asociado con estos temas en el ámbito médico. El episodio también aborda la necesidad de cambiar la percepción del éxito y cómo el apoyo de la comunidad médica y científica es fundamental para mejorar la situación actual. Finalmente, se destaca el rol crucial de los mentores en todas las etapas de la carrera médica para fomentar un equilibrio entre competencia y confianza, así como promover un entorno laboral saludable y respetuoso. --- TIMESTAMPS 00:00 - Bienvenido al podcast 07:16 - Redefiniendo el éxito 10:20 - Los cuatro pilares de una vida y un trabajo significativos 28:36 - Crecimiento personal y la importancia de la tutoría 32:22 - Pensamientos finales En este episodio de nuestro podcast, Dra. Anna Alguersuari Cabiscol, una radióloga intervencionista que dejó su especialidad hace cuatro años, comparte su experiencia personal sobre los desafíos relacionados con la salud mental dentro de la profesión médica.


---


SYNPOSIS


Expone cómo la insatisfacción profesional, el síndrome del impostor y la falta de bienestar mental la llevaron a tomar la decisión drástica de abandonar el intervencionismo. A través de su relato, se discute la relevancia de crear un entorno positivo en el trabajo, invertir en el bienestar mental, y la importancia de enfrentar y superar el estigma asociado con estos temas en el ámbito médico. El episodio también aborda la necesidad de cambiar la percepción del éxito y cómo el apoyo de la comunidad médica y científica es fundamental para mejorar la situación actual.


Finalmente, se destaca el rol crucial de los mentores en todas las etapas de la carrera médica para fomentar un equilibrio entre competencia y confianza, así como promover un entorno laboral saludable y respetuoso.


---


TIMESTAMPS


00:00 - Bienvenido al podcast

07:16 - Redefiniendo el éxito

10:20 - Los cuatro pilares de una vida y un trabajo significativos

28:36 - Crecimiento personal y la importancia de la tutoría

32:22 - Pensamientos finales

]]> 2135 Ep. 445 Inside the IR Suite: A clinician's own battle with Portal Vein Thrombosis with Dr. Jason Hoffmann In this episode, Dr. Jason Hoffmann shares his harrowing personal experience as a patient with massive portal vein thrombosis - recounting the onset of his symptoms, the subsequent diagnosis, treatment, and recovery, all occurring while he was on-call for his own hospital. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Reflecting on how this experience impacted his approach to medicine and patient care, Dr. Hoffmann discusses the importance of empathy, patient education, and building trust. Additionally, he touches upon his personal and family medical history, and how these events have influenced his medical practice and perspective on patient care. --- TIMESTAMPS 00:00 - Introduction 05:55 - Dr. Hoffmann’s IR Practice and Passions 09:23 - Physician’s Experience as a Patient 22:47 - New Perspective on Patient Care 28:53 - Closing Thoughts --- RESOURCES Combating the Health Risks of Sedentary Behavior in the Contemporary Radiology Reading Room: https://pubmed.ncbi.nlm.nih.gov/27057784/ Tue, 14 May 2024 07:00:00 -0000 full BackTable In this episode, Dr. Jason Hoffmann shares his harrowing personal experience as a patient with massive portal vein thrombosis - recounting the onset of his symptoms, the subsequent diagnosis, treatment, and recovery, all occurring while he was on-call for his own hospital. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health. In this episode, Dr. Jason Hoffmann shares his harrowing personal experience as a patient with massive portal vein thrombosis - recounting the onset of his symptoms, the subsequent diagnosis, treatment, and recovery, all occurring while he was on-call for his own hospital. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Reflecting on how this experience impacted his approach to medicine and patient care, Dr. Hoffmann discusses the importance of empathy, patient education, and building trust. Additionally, he touches upon his personal and family medical history, and how these events have influenced his medical practice and perspective on patient care. --- TIMESTAMPS 00:00 - Introduction 05:55 - Dr. Hoffmann’s IR Practice and Passions 09:23 - Physician’s Experience as a Patient 22:47 - New Perspective on Patient Care 28:53 - Closing Thoughts --- RESOURCES Combating the Health Risks of Sedentary Behavior in the Contemporary Radiology Reading Room: https://pubmed.ncbi.nlm.nih.gov/27057784/ In this episode, Dr. Jason Hoffmann shares his harrowing personal experience as a patient with massive portal vein thrombosis - recounting the onset of his symptoms, the subsequent diagnosis, treatment, and recovery, all occurring while he was on-call for his own hospital. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SYNPOSIS


Reflecting on how this experience impacted his approach to medicine and patient care, Dr. Hoffmann discusses the importance of empathy, patient education, and building trust. Additionally, he touches upon his personal and family medical history, and how these events have influenced his medical practice and perspective on patient care.


---


TIMESTAMPS


00:00 - Introduction

05:55 - Dr. Hoffmann’s IR Practice and Passions

09:23 - Physician’s Experience as a Patient

22:47 - New Perspective on Patient Care

28:53 - Closing Thoughts


---


RESOURCES


Combating the Health Risks of Sedentary Behavior in the Contemporary Radiology Reading Room:

https://pubmed.ncbi.nlm.nih.gov/27057784/

]]> 1944 Ep. 444 Género, Embarazo y Exposición a Radiación Ionizante: ¿Dónde Estamos? con Dr. Maite Velazquez En este episodio de BackTable la Dra. Maite Velázquez, hemodinamista del Hospital 12 de Octubre de Madrid, aborda el creciente porcentaje de mujeres que ingresan en el campo de la medicina y, en comparación, el escaso porcentaje de mujeres entre los profesionales que trabajan en entornos con radiación ocupacional, como la radiología vascular intervencionista, hemodinámica o cirugía vascular. Además, se analizan los desafíos existentes alrededor del embarazo de estas profesionales, legislación existente y qué medidas protectoras existen en España y Europa, así como los riesgos reales de radiación para el feto basados en evidencia científica. --- SYNPOSIS La Dra. Velázquez disipa mitos, enfatiza la seguridad existente a la hora de mantener la actividad profesional durante el embarazo con las protecciones adecuadas y destaca la brecha de género y el impacto de la escasez de relevo generacional en estas especialidades. La conversación tiene como objetivo informar y reflejar la evidencia científica existente en cuanto al manejo del embarazo mientras se trabaja en ambientes expuestos a la radiación ionizante. --- TIMESTAMPS 00:00 - Introducción 03:11 - Exposición a la radiación durante el embarazo 07:33 – Evidencia científica y legislación 20:19 - Abordar el impacto profesional del embarazo 26:56 - Combatir conceptos erróneos y promover prácticas seguras 34:59 - Comentarios finales Fri, 10 May 2024 07:00:00 -0000 full BackTable En este episodio de BackTable la Dra. Maite Velázquez, hemodinamista del Hospital 12 de Octubre de Madrid, aborda el creciente porcentaje de mujeres que ingresan en el campo de la medicina y, en comparación, el escaso porcentaje de mujeres entre los profesionales que trabajan en entornos con radiación ocupacional, como la radiología vascular intervencionista, hemodinámica o cirugía vascular. En este episodio de BackTable la Dra. Maite Velázquez, hemodinamista del Hospital 12 de Octubre de Madrid, aborda el creciente porcentaje de mujeres que ingresan en el campo de la medicina y, en comparación, el escaso porcentaje de mujeres entre los profesionales que trabajan en entornos con radiación ocupacional, como la radiología vascular intervencionista, hemodinámica o cirugía vascular. Además, se analizan los desafíos existentes alrededor del embarazo de estas profesionales, legislación existente y qué medidas protectoras existen en España y Europa, así como los riesgos reales de radiación para el feto basados en evidencia científica. --- SYNPOSIS La Dra. Velázquez disipa mitos, enfatiza la seguridad existente a la hora de mantener la actividad profesional durante el embarazo con las protecciones adecuadas y destaca la brecha de género y el impacto de la escasez de relevo generacional en estas especialidades. La conversación tiene como objetivo informar y reflejar la evidencia científica existente en cuanto al manejo del embarazo mientras se trabaja en ambientes expuestos a la radiación ionizante. --- TIMESTAMPS 00:00 - Introducción 03:11 - Exposición a la radiación durante el embarazo 07:33 – Evidencia científica y legislación 20:19 - Abordar el impacto profesional del embarazo 26:56 - Combatir conceptos erróneos y promover prácticas seguras 34:59 - Comentarios finales En este episodio de BackTable la Dra. Maite Velázquez, hemodinamista del Hospital 12 de Octubre de Madrid, aborda el creciente porcentaje de mujeres que ingresan en el campo de la medicina y, en comparación, el escaso porcentaje de mujeres entre los profesionales que trabajan en entornos con radiación ocupacional, como la radiología vascular intervencionista, hemodinámica o cirugía vascular. Además, se analizan los desafíos existentes alrededor del embarazo de estas profesionales, legislación existente y qué medidas protectoras existen en España y Europa, así como los riesgos reales de radiación para el feto basados en evidencia científica.


---


SYNPOSIS


La Dra. Velázquez disipa mitos, enfatiza la seguridad existente a la hora de mantener la actividad profesional durante el embarazo con las protecciones adecuadas y destaca la brecha de género y el impacto de la escasez de relevo generacional en estas especialidades. La conversación tiene como objetivo informar y reflejar la evidencia científica existente en cuanto al manejo del embarazo mientras se trabaja en ambientes expuestos a la radiación ionizante.


---


TIMESTAMPS


00:00 - Introducción

03:11 - Exposición a la radiación durante el embarazo

07:33 – Evidencia científica y legislación

20:19 - Abordar el impacto profesional del embarazo

26:56 - Combatir conceptos erróneos y promover prácticas seguras

34:59 - Comentarios finales

]]> 2361 Ep. 443 Innovative Approaches in Radial to Peripheral Interventions with Dr. Amit Srivastava In this episode, Dr. Amit Srivastava discusses the transformation of peripheral interventional practices through radial access techniques, emphasizing reduced complication rates, the extensive range of devices now available, and the option for same-day discharge. --- CHECK OUT OUR SPONSOR Terumo Interventional Systems https://terumois.com/education --- SYNPOSIS Through a series of real-world examples and discussion on the R2P registry, the doctors illustrate the high success rates and low complications of the transradial approach, debunking common misconceptions, and highlighting the significance of team collaboration in executing these procedures efficiently. Additionally, the conversation covers the evolution of devices suited for R2P, including longer length wires, catheters, and novel training methods like immersive virtual reality courses designed to educate and inspire practitioners to adopt radial access in their endovascular practices. --- TIMESTAMPS 00:00 - Introduction 02:19 - Current Role of Radial Access in Peripheral Interventions 15:08 - Future of Radial Access 21:11 - The R2P Registry 28:44 - Educational Opportunities and Community Support --- RESOURCES TERUMO Transradial Training & Education: https://www.terumois.com/education-training/healthcare-provider-education-programs/transradial-courses.html BT Episode 342 - Radial Access for PAD with Dr. Rami Tadros: https://www.backtable.com/shows/vi/podcasts/342/radial-access-for-pad Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study: https://pubmed.ncbi.nlm.nih.gov/22858390/ Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions (RPI Study): https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext Tue, 07 May 2024 07:00:00 -0000 full BackTable In this episode, Dr. Amit Srivastava discusses the transformation of peripheral interventional practices through radial access techniques, emphasizing reduced complication rates, the extensive range of devices now available, and the option for same-day discharge. In this episode, Dr. Amit Srivastava discusses the transformation of peripheral interventional practices through radial access techniques, emphasizing reduced complication rates, the extensive range of devices now available, and the option for same-day discharge. --- CHECK OUT OUR SPONSOR Terumo Interventional Systems https://terumois.com/education --- SYNPOSIS Through a series of real-world examples and discussion on the R2P registry, the doctors illustrate the high success rates and low complications of the transradial approach, debunking common misconceptions, and highlighting the significance of team collaboration in executing these procedures efficiently. Additionally, the conversation covers the evolution of devices suited for R2P, including longer length wires, catheters, and novel training methods like immersive virtual reality courses designed to educate and inspire practitioners to adopt radial access in their endovascular practices. --- TIMESTAMPS 00:00 - Introduction 02:19 - Current Role of Radial Access in Peripheral Interventions 15:08 - Future of Radial Access 21:11 - The R2P Registry 28:44 - Educational Opportunities and Community Support --- RESOURCES TERUMO Transradial Training & Education: https://www.terumois.com/education-training/healthcare-provider-education-programs/transradial-courses.html BT Episode 342 - Radial Access for PAD with Dr. Rami Tadros: https://www.backtable.com/shows/vi/podcasts/342/radial-access-for-pad Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study: https://pubmed.ncbi.nlm.nih.gov/22858390/ Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions (RPI Study): https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext In this episode, Dr. Amit Srivastava discusses the transformation of peripheral interventional practices through radial access techniques, emphasizing reduced complication rates, the extensive range of devices now available, and the option for same-day discharge.


---


CHECK OUT OUR SPONSOR


Terumo Interventional Systems

https://terumois.com/education


---


SYNPOSIS


Through a series of real-world examples and discussion on the R2P registry, the doctors illustrate the high success rates and low complications of the transradial approach, debunking common misconceptions, and highlighting the significance of team collaboration in executing these procedures efficiently. Additionally, the conversation covers the evolution of devices suited for R2P, including longer length wires, catheters, and novel training methods like immersive virtual reality courses designed to educate and inspire practitioners to adopt radial access in their endovascular practices.


---


TIMESTAMPS


00:00 - Introduction

02:19 - Current Role of Radial Access in Peripheral Interventions

15:08 - Future of Radial Access

21:11 - The R2P Registry

28:44 - Educational Opportunities and Community Support


---


RESOURCES


TERUMO Transradial Training & Education:

https://www.terumois.com/education-training/healthcare-provider-education-programs/transradial-courses.html


BT Episode 342 - Radial Access for PAD with Dr. Rami Tadros:

https://www.backtable.com/shows/vi/podcasts/342/radial-access-for-pad


Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study:

https://pubmed.ncbi.nlm.nih.gov/22858390/


Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions (RPI Study):

https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext

]]> 2357 Ep. 442 The Gender Gap in IR: Progress and Challenges with Dr. Nicole Lamparello In this episode, Dr. Nicole Lamparello discusses the strides and challenges in achieving gender equity in interventional radiology (IR), sharing insights from her research on gender disparities in IR, and revealing how women currently comprise a significantly low percentage of the IR workforce compared to men despite equal numbers of male and female medical students. Dr. Lamparello is an interventional radiologist and serves as the Program Director for Weill Cornell Medicine’s Integrated IR Residency in New York City. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors cover the importance of workplace culture with flexibility for family and maternity needs, mentorship, visibility of female leaders in IR, and strategies for attracting more women to the field. The conversation also touches on the impact of diverse IR professionals on patient outcomes, and how outsourcing personal tasks can help maintain work-life balance. The necessity of early exposure to IR for medical students and addressing specific hurdles for women in IR, such as work-life balance, radiation exposure fears, and lack of female role models are also explored. --- TIMESTAMPS 00:00 - Introduction 05:40 - Addressing Gender Disparity in IR 13:48 - Importance of Physician Workforce Diversity 18:31 - Challenges and Solutions for Gender Equity in IR 25:28 - Work-Life Balance 38:40 - Concluding Thoughts --- RESOURCES The Gender Gap in Interventional Radiology: Barriers, Opportunities, and the Role of the Integrated IR Residency: https://pubmed.ncbi.nlm.nih.gov/36870809/ The IR Trainee Workforce 10 Years after Becoming a Primary Medical Specialty: https://www.jvir.org/article/S1051-0443(23)00651-6/fulltext Lack of exposure and perceived occupational hazards as barriers to entry into IR for women: a survey of 143 female medical students: https://www.jvir.org/article/S1051-0443(16)31526-3/fulltext Untapped Resources: Attaining Equitable Representation for Women in IR: https://www.jvir.org/article/S1051-0443(18)31645-2/fulltext Gender and racial diversity among plenary session speakers at the Society of Abdominal Radiology Annual Meetings: a five-year assessment: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226100/ Bridging the Gender Gap in the Society of IR: A Benchmark Study: https://www.jvir.org/article/S1051-0443(18)31492-1/pdf Fri, 03 May 2024 07:00:00 -0000 full BackTable In this episode, Dr. Nicole Lamparello discusses the strides and challenges in achieving gender equity in interventional radiology (IR), sharing insights from her research on gender disparities in IR, and revealing how women currently comprise a significantly low percentage of the IR workforce compared to men despite equal numbers of male and female medical students. In this episode, Dr. Nicole Lamparello discusses the strides and challenges in achieving gender equity in interventional radiology (IR), sharing insights from her research on gender disparities in IR, and revealing how women currently comprise a significantly low percentage of the IR workforce compared to men despite equal numbers of male and female medical students. Dr. Lamparello is an interventional radiologist and serves as the Program Director for Weill Cornell Medicine’s Integrated IR Residency in New York City. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors cover the importance of workplace culture with flexibility for family and maternity needs, mentorship, visibility of female leaders in IR, and strategies for attracting more women to the field. The conversation also touches on the impact of diverse IR professionals on patient outcomes, and how outsourcing personal tasks can help maintain work-life balance. The necessity of early exposure to IR for medical students and addressing specific hurdles for women in IR, such as work-life balance, radiation exposure fears, and lack of female role models are also explored. --- TIMESTAMPS 00:00 - Introduction 05:40 - Addressing Gender Disparity in IR 13:48 - Importance of Physician Workforce Diversity 18:31 - Challenges and Solutions for Gender Equity in IR 25:28 - Work-Life Balance 38:40 - Concluding Thoughts --- RESOURCES The Gender Gap in Interventional Radiology: Barriers, Opportunities, and the Role of the Integrated IR Residency: https://pubmed.ncbi.nlm.nih.gov/36870809/ The IR Trainee Workforce 10 Years after Becoming a Primary Medical Specialty: https://www.jvir.org/article/S1051-0443(23)00651-6/fulltext Lack of exposure and perceived occupational hazards as barriers to entry into IR for women: a survey of 143 female medical students: https://www.jvir.org/article/S1051-0443(16)31526-3/fulltext Untapped Resources: Attaining Equitable Representation for Women in IR: https://www.jvir.org/article/S1051-0443(18)31645-2/fulltext Gender and racial diversity among plenary session speakers at the Society of Abdominal Radiology Annual Meetings: a five-year assessment: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226100/ Bridging the Gender Gap in the Society of IR: A Benchmark Study: https://www.jvir.org/article/S1051-0443(18)31492-1/pdf In this episode, Dr. Nicole Lamparello discusses the strides and challenges in achieving gender equity in interventional radiology (IR), sharing insights from her research on gender disparities in IR, and revealing how women currently comprise a significantly low percentage of the IR workforce compared to men despite equal numbers of male and female medical students. Dr. Lamparello is an interventional radiologist and serves as the Program Director for Weill Cornell Medicine’s Integrated IR Residency in New York City.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SYNPOSIS


The doctors cover the importance of workplace culture with flexibility for family and maternity needs, mentorship, visibility of female leaders in IR, and strategies for attracting more women to the field. The conversation also touches on the impact of diverse IR professionals on patient outcomes, and how outsourcing personal tasks can help maintain work-life balance. The necessity of early exposure to IR for medical students and addressing specific hurdles for women in IR, such as work-life balance, radiation exposure fears, and lack of female role models are also explored.


---


TIMESTAMPS


00:00 - Introduction

05:40 - Addressing Gender Disparity in IR

13:48 - Importance of Physician Workforce Diversity

18:31 - Challenges and Solutions for Gender Equity in IR

25:28 - Work-Life Balance

38:40 - Concluding Thoughts


---


RESOURCES


The Gender Gap in Interventional Radiology: Barriers, Opportunities, and the Role of the Integrated IR Residency:

https://pubmed.ncbi.nlm.nih.gov/36870809/


The IR Trainee Workforce 10 Years after Becoming a Primary Medical Specialty:

https://www.jvir.org/article/S1051-0443(23)00651-6/fulltext


Lack of exposure and perceived occupational hazards as barriers to entry into IR for women: a survey of 143 female medical students:

https://www.jvir.org/article/S1051-0443(16)31526-3/fulltext


Untapped Resources: Attaining Equitable Representation for Women in IR:

https://www.jvir.org/article/S1051-0443(18)31645-2/fulltext


Gender and racial diversity among plenary session speakers at the Society of Abdominal Radiology Annual Meetings: a five-year assessment:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226100/


Bridging the Gender Gap in the Society of IR: A Benchmark Study:

https://www.jvir.org/article/S1051-0443(18)31492-1/pdf

]]> 2601 Ep. 441 Chilling Solutions: Cryoneurolysis in Clinical Practice with Dr. Aron Chary In this episode, Dr. Aron Chary provides an in-depth look into endovascular and minimally invasive treatments for pain management, specifically focusing on cryoneurolysis. He shares his experience of implementing the technology for both benign and malignant conditions in an independent private practice setting. --- CHECK OUT OUR SPONSOR Boston Scientific Visual ICE Cryoablation System https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html --- SYNPOSIS The discussion covers various aspects, including collaboration with Boston Scientific for the VISUAL ICE cryoablation system, Dr. Chary’s personal journey from academics at Emory to private practice in Memphis, the effectiveness of cryoneurolysis in different areas such as genicular nerve and palliative care, and the operational dynamics between hospital and outpatient settings. The doctors delve into the procedural specifics, patient response, and outcomes with cryoneurolysis, including Dr. Chary’s efforts to navigate insurance and reimbursement challenges. --- TIMESTAMPS 00:00 - Introduction 07:04 - Evolution of Pain Intervention Techniques 11:08 - Building a Pain Intervention Service 16:16 - Versatility of Cryoablation in Pain Management 23:54 - Expectations and the Future of Pain Management Research 31:41 - Cryoneurolysis Insights and Patient Management 42:10 - Techniques in Celiac Cryoneurolysis 52:33 - Pain Management in the Outpatient Setting --- RESOURCES Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol: https://www.jvir.org/article/S1051-0443(20)30349-3/abstract BT VI Episode 199 - Advanced Minimally Invasive Pain Interventions with Dr. David Prologo: https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions BT VI Episode 433 - Kyphoplasty Evolution: Steering Toward Targeted Therapy with Dr. David Prologo: https://www.backtable.com/shows/vi/podcasts/433/kyphoplasty-evolution-steering-toward-targeted-therapy Boston Scientific, VISUAL ICE: https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html Tue, 30 Apr 2024 07:00:00 -0000 full BackTable In this episode, Dr. Aron Chary provides an in-depth look into endovascular and minimally invasive treatments for pain management, specifically focusing on cryoneurolysis. He shares his experience of implementing the technology for both benign and malignant conditions in an independent private practice setting. In this episode, Dr. Aron Chary provides an in-depth look into endovascular and minimally invasive treatments for pain management, specifically focusing on cryoneurolysis. He shares his experience of implementing the technology for both benign and malignant conditions in an independent private practice setting. --- CHECK OUT OUR SPONSOR Boston Scientific Visual ICE Cryoablation System https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html --- SYNPOSIS The discussion covers various aspects, including collaboration with Boston Scientific for the VISUAL ICE cryoablation system, Dr. Chary’s personal journey from academics at Emory to private practice in Memphis, the effectiveness of cryoneurolysis in different areas such as genicular nerve and palliative care, and the operational dynamics between hospital and outpatient settings. The doctors delve into the procedural specifics, patient response, and outcomes with cryoneurolysis, including Dr. Chary’s efforts to navigate insurance and reimbursement challenges. --- TIMESTAMPS 00:00 - Introduction 07:04 - Evolution of Pain Intervention Techniques 11:08 - Building a Pain Intervention Service 16:16 - Versatility of Cryoablation in Pain Management 23:54 - Expectations and the Future of Pain Management Research 31:41 - Cryoneurolysis Insights and Patient Management 42:10 - Techniques in Celiac Cryoneurolysis 52:33 - Pain Management in the Outpatient Setting --- RESOURCES Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol: https://www.jvir.org/article/S1051-0443(20)30349-3/abstract BT VI Episode 199 - Advanced Minimally Invasive Pain Interventions with Dr. David Prologo: https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions BT VI Episode 433 - Kyphoplasty Evolution: Steering Toward Targeted Therapy with Dr. David Prologo: https://www.backtable.com/shows/vi/podcasts/433/kyphoplasty-evolution-steering-toward-targeted-therapy Boston Scientific, VISUAL ICE: https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html In this episode, Dr. Aron Chary provides an in-depth look into endovascular and minimally invasive treatments for pain management, specifically focusing on cryoneurolysis. He shares his experience of implementing the technology for both benign and malignant conditions in an independent private practice setting.


---


CHECK OUT OUR SPONSOR


Boston Scientific Visual ICE Cryoablation System

https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html


---


SYNPOSIS


The discussion covers various aspects, including collaboration with Boston Scientific for the VISUAL ICE cryoablation system, Dr. Chary’s personal journey from academics at Emory to private practice in Memphis, the effectiveness of cryoneurolysis in different areas such as genicular nerve and palliative care, and the operational dynamics between hospital and outpatient settings. The doctors delve into the procedural specifics, patient response, and outcomes with cryoneurolysis, including Dr. Chary’s efforts to navigate insurance and reimbursement challenges.


---


TIMESTAMPS


00:00 - Introduction

07:04 - Evolution of Pain Intervention Techniques

11:08 - Building a Pain Intervention Service

16:16 - Versatility of Cryoablation in Pain Management

23:54 - Expectations and the Future of Pain Management Research

31:41 - Cryoneurolysis Insights and Patient Management

42:10 - Techniques in Celiac Cryoneurolysis

52:33 - Pain Management in the Outpatient Setting


---


RESOURCES


Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol:

https://www.jvir.org/article/S1051-0443(20)30349-3/abstract


BT VI Episode 199 - Advanced Minimally Invasive Pain Interventions with Dr. David Prologo:

https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions


BT VI Episode 433 - Kyphoplasty Evolution: Steering Toward Targeted Therapy with Dr. David Prologo:

https://www.backtable.com/shows/vi/podcasts/433/kyphoplasty-evolution-steering-toward-targeted-therapy


Boston Scientific, VISUAL ICE:

https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html

]]> 3529 Ep. 440 Ultrasound’s Role in Endoleak Monitoring with Dr. David Guez In this episode, Dr. David Guez discusses the advancements in contrast enhanced ultrasound, its application in detecting endoleaks, and his journey of learning and applying this modality from residency to his current practice. Dr. Guez emphasizes ultrasound’s utility in lesion characterization, endoleak monitoring, and sparing patients from more invasive diagnostic procedures. The doctors delve into the specifics of using ultrasound contrast agents, particularly LUMASON and its intravascular utility for real-time monitoring of disease states with superior resolution compared to CT or MRI. Dr. Guez also discusses the potential for contrast enhanced ultrasound in interventional radiology, including diagnosing vascular lesions and augmenting tumor treatments. The conversation highlights the technique’s advantages, its high sensitivity for endoleaks, and potential areas for future research and application. The episode underscores the underutilized potential of contrast enhanced ultrasound in both diagnostic and interventional radiology settings. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:54 - Exploring the Basics of Contrast Enhanced Ultrasound 06:49 - Clinical Applications and Advantages of Contrast Enhanced Ultrasound 09:15 - Contrast Enhanced Ultrasound in Action: Diagnosing Endoleaks 23:52 - Future of Contrast Enhanced Ultrasound in Interventional Radiology 27:02 - Closing Thoughts --- RESOURCES Bracco LUMASON: https://lumason.com/ Nontraditional Uses of US Contrast Agents in Abdominal Imaging and Intervention: https://pubs.rsna.org/doi/full/10.1148/rg.220016 Book written by Andrej Lyshchik, MD, PhD (Thomas Jefferson) - Specialty Imaging: Fundamentals of CEUS: https://www.amazon.com/Specialty-Imaging-Fundamentals-Andrej-Lyshchik/dp/0323625649 Contrast-enhanced Ultrasound Identifies Patent Feeding Vessels in Transarterial Chemoembolization Patients With Residual Tumor Vascularity: https://pubmed.ncbi.nlm.nih.gov/32890324/ Contrast-enhanced ultrasound (CEUS) versus computed tomography angiography (CTA) in detection of endoleaks in post-EVAR patients. Are delayed type II endoleaks being missed? A systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/26191109/ Fri, 26 Apr 2024 07:00:00 -0000 full BackTable In this episode, Dr. David Guez discusses the advancements in contrast enhanced ultrasound, its application in detecting endoleaks, and his journey of learning and applying this modality from residency to his current practice. In this episode, Dr. David Guez discusses the advancements in contrast enhanced ultrasound, its application in detecting endoleaks, and his journey of learning and applying this modality from residency to his current practice. Dr. Guez emphasizes ultrasound’s utility in lesion characterization, endoleak monitoring, and sparing patients from more invasive diagnostic procedures. The doctors delve into the specifics of using ultrasound contrast agents, particularly LUMASON and its intravascular utility for real-time monitoring of disease states with superior resolution compared to CT or MRI. Dr. Guez also discusses the potential for contrast enhanced ultrasound in interventional radiology, including diagnosing vascular lesions and augmenting tumor treatments. The conversation highlights the technique’s advantages, its high sensitivity for endoleaks, and potential areas for future research and application. The episode underscores the underutilized potential of contrast enhanced ultrasound in both diagnostic and interventional radiology settings. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:54 - Exploring the Basics of Contrast Enhanced Ultrasound 06:49 - Clinical Applications and Advantages of Contrast Enhanced Ultrasound 09:15 - Contrast Enhanced Ultrasound in Action: Diagnosing Endoleaks 23:52 - Future of Contrast Enhanced Ultrasound in Interventional Radiology 27:02 - Closing Thoughts --- RESOURCES Bracco LUMASON: https://lumason.com/ Nontraditional Uses of US Contrast Agents in Abdominal Imaging and Intervention: https://pubs.rsna.org/doi/full/10.1148/rg.220016 Book written by Andrej Lyshchik, MD, PhD (Thomas Jefferson) - Specialty Imaging: Fundamentals of CEUS: https://www.amazon.com/Specialty-Imaging-Fundamentals-Andrej-Lyshchik/dp/0323625649 Contrast-enhanced Ultrasound Identifies Patent Feeding Vessels in Transarterial Chemoembolization Patients With Residual Tumor Vascularity: https://pubmed.ncbi.nlm.nih.gov/32890324/ Contrast-enhanced ultrasound (CEUS) versus computed tomography angiography (CTA) in detection of endoleaks in post-EVAR patients. Are delayed type II endoleaks being missed? A systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/26191109/ In this episode, Dr. David Guez discusses the advancements in contrast enhanced ultrasound, its application in detecting endoleaks, and his journey of learning and applying this modality from residency to his current practice.


Dr. Guez emphasizes ultrasound’s utility in lesion characterization, endoleak monitoring, and sparing patients from more invasive diagnostic procedures. The doctors delve into the specifics of using ultrasound contrast agents, particularly LUMASON and its intravascular utility for real-time monitoring of disease states with superior resolution compared to CT or MRI. Dr. Guez also discusses the potential for contrast enhanced ultrasound in interventional radiology, including diagnosing vascular lesions and augmenting tumor treatments. The conversation highlights the technique’s advantages, its high sensitivity for endoleaks, and potential areas for future research and application. The episode underscores the underutilized potential of contrast enhanced ultrasound in both diagnostic and interventional radiology settings.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

03:54 - Exploring the Basics of Contrast Enhanced Ultrasound

06:49 - Clinical Applications and Advantages of Contrast Enhanced Ultrasound

09:15 - Contrast Enhanced Ultrasound in Action: Diagnosing Endoleaks

23:52 - Future of Contrast Enhanced Ultrasound in Interventional Radiology

27:02 - Closing Thoughts


---


RESOURCES


Bracco LUMASON:

https://lumason.com/


Nontraditional Uses of US Contrast Agents in Abdominal Imaging and Intervention:

https://pubs.rsna.org/doi/full/10.1148/rg.220016


Book written by Andrej Lyshchik, MD, PhD (Thomas Jefferson) - Specialty Imaging: Fundamentals of CEUS:

https://www.amazon.com/Specialty-Imaging-Fundamentals-Andrej-Lyshchik/dp/0323625649


Contrast-enhanced Ultrasound Identifies Patent Feeding Vessels in Transarterial Chemoembolization Patients With Residual Tumor Vascularity:

https://pubmed.ncbi.nlm.nih.gov/32890324/


Contrast-enhanced ultrasound (CEUS) versus computed tomography angiography (CTA) in detection of endoleaks in post-EVAR patients. Are delayed type II endoleaks being missed? A systematic review and meta-analysis:

https://pubmed.ncbi.nlm.nih.gov/26191109/

]]> 1945 Ep. 439 Navigating the Aftermath: Change Healthcare’s Cyberattack and Response with Dr. Robert Tahara In this episode, guest host Dr. Krishna Mannava interviews Dr. Bob Tahara about the significant multilevel impacts, ripple effects, and fallout of cyberattacks on the healthcare industry, specifically covering the recent cyberattack that targeted major clearinghouse, Change Healthcare. Dr. Tahara is a vascular surgeon practicing in rural northwest Pennsylvania and President of Outpatient Endovascular Interventional Society (OEIS). Dr. Tahara shares his experiences as a solo vascular surgeon in rural Pennsylvania, highlighting the complexities of modern billing systems, the advantages of hiring a quality billing company, and the challenges posed by the consolidation of clearinghouses. The conversation also delves into the alarming ransomware attack on Change Healthcare, where 6 terabytes of patient data were compromised. This incident exposed vulnerabilities across the healthcare sector, from payment processes to electronic medical and prescription records. The doctors underscore the importance of cybersecurity preparedness, diversification of clearinghouses, and the role of physicians in advocating for more secure and efficient healthcare systems. They also touch on personal hobbies like Kendo to manage stress. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 02:02 - Cyberattack on Change Healthcare: An Overview 06:37 - Impact of the Cyberattack on Healthcare Practices 09:50 - Understanding Clearinghouses in Healthcare Billing 14:30 - Fallout from the Cyber Attack: A Personal Account 16:40 - Navigating the Aftermath: Strategies and Solutions 22:54 - Value of Medical Records and Cybersecurity Measures 29:18 - Action Items and Advocacy for Physicians 35:00 - OEIS 2024 Meeting and Final Thoughts --- RESOURCES OEIS Annual Meeting Schedule 2024: https://oeisweb.com/wp-content/uploads/2024/04/2024-AM-attendee-brochure-v4-FINAL-proof-lowres.pdf BackTable Episode 349 - Cybersecurity for Physicians with Jason Newton, Esq: https://www.backtable.com/shows/vi/podcasts/349/cybersecurity-for-physicians Thu, 25 Apr 2024 07:00:00 -0000 full BackTable In this episode, guest host Dr. Krishna Mannava interviews Dr. Bob Tahara about the significant multilevel impacts, ripple effects, and fallout of cyberattacks on the healthcare industry, specifically covering the recent cyberattack that targeted major clearinghouse, Change Healthcare. In this episode, guest host Dr. Krishna Mannava interviews Dr. Bob Tahara about the significant multilevel impacts, ripple effects, and fallout of cyberattacks on the healthcare industry, specifically covering the recent cyberattack that targeted major clearinghouse, Change Healthcare. Dr. Tahara is a vascular surgeon practicing in rural northwest Pennsylvania and President of Outpatient Endovascular Interventional Society (OEIS). Dr. Tahara shares his experiences as a solo vascular surgeon in rural Pennsylvania, highlighting the complexities of modern billing systems, the advantages of hiring a quality billing company, and the challenges posed by the consolidation of clearinghouses. The conversation also delves into the alarming ransomware attack on Change Healthcare, where 6 terabytes of patient data were compromised. This incident exposed vulnerabilities across the healthcare sector, from payment processes to electronic medical and prescription records. The doctors underscore the importance of cybersecurity preparedness, diversification of clearinghouses, and the role of physicians in advocating for more secure and efficient healthcare systems. They also touch on personal hobbies like Kendo to manage stress. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 02:02 - Cyberattack on Change Healthcare: An Overview 06:37 - Impact of the Cyberattack on Healthcare Practices 09:50 - Understanding Clearinghouses in Healthcare Billing 14:30 - Fallout from the Cyber Attack: A Personal Account 16:40 - Navigating the Aftermath: Strategies and Solutions 22:54 - Value of Medical Records and Cybersecurity Measures 29:18 - Action Items and Advocacy for Physicians 35:00 - OEIS 2024 Meeting and Final Thoughts --- RESOURCES OEIS Annual Meeting Schedule 2024: https://oeisweb.com/wp-content/uploads/2024/04/2024-AM-attendee-brochure-v4-FINAL-proof-lowres.pdf BackTable Episode 349 - Cybersecurity for Physicians with Jason Newton, Esq: https://www.backtable.com/shows/vi/podcasts/349/cybersecurity-for-physicians In this episode, guest host Dr. Krishna Mannava interviews Dr. Bob Tahara about the significant multilevel impacts, ripple effects, and fallout of cyberattacks on the healthcare industry, specifically covering the recent cyberattack that targeted major clearinghouse, Change Healthcare.


Dr. Tahara is a vascular surgeon practicing in rural northwest Pennsylvania and President of Outpatient Endovascular Interventional Society (OEIS). Dr. Tahara shares his experiences as a solo vascular surgeon in rural Pennsylvania, highlighting the complexities of modern billing systems, the advantages of hiring a quality billing company, and the challenges posed by the consolidation of clearinghouses. The conversation also delves into the alarming ransomware attack on Change Healthcare, where 6 terabytes of patient data were compromised. This incident exposed vulnerabilities across the healthcare sector, from payment processes to electronic medical and prescription records. The doctors underscore the importance of cybersecurity preparedness, diversification of clearinghouses, and the role of physicians in advocating for more secure and efficient healthcare systems. They also touch on personal hobbies like Kendo to manage stress.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

02:02 - Cyberattack on Change Healthcare: An Overview

06:37 - Impact of the Cyberattack on Healthcare Practices

09:50 - Understanding Clearinghouses in Healthcare Billing

14:30 - Fallout from the Cyber Attack: A Personal Account

16:40 - Navigating the Aftermath: Strategies and Solutions

22:54 - Value of Medical Records and Cybersecurity Measures

29:18 - Action Items and Advocacy for Physicians

35:00 - OEIS 2024 Meeting and Final Thoughts


---


RESOURCES


OEIS Annual Meeting Schedule 2024:

https://oeisweb.com/wp-content/uploads/2024/04/2024-AM-attendee-brochure-v4-FINAL-proof-lowres.pdf


BackTable Episode 349 - Cybersecurity for Physicians with Jason Newton, Esq:

https://www.backtable.com/shows/vi/podcasts/349/cybersecurity-for-physicians

]]> 2544 Ep. 438 Creative Solutions to OBL Misadventures with Dr. Omar Saleh and Dr. Mike Watts In this episode, Dr. Omar Saleh and Dr. Mike Watts discuss the challenging aspects of vascular interventions in the OBL setting, focusing on ‘oh $#!%’ moments and how to address various complications. Both Dr. Saleh and Dr. Watts are vascular and interventional radiologist, practicing in Southern California and New Jersey, respectively. The doctors share specific, challenging cases they’ve encountered, including device malfunctions and unexpected outcomes during procedures. Additionally, Dr. Saleh and Dr. Watts discuss the advantages of having hybrid OBL and hospital practices, the importance of being prepared for complications by having the right tools and strategies at hand, and interdisciplinary collaboration. The conversation also touches on the value of certain devices and techniques in managing complications effectively and ensuring patient safety. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 04:53 - Creative Solutions for Complex Vascular Cases 16:47 - Hybrid Practice: Balancing OBL and Hospital Work 21:39 - The Pros and Cons of Hybrid OBL-Hospital Practices 30:34 - Navigating Complex Medical Procedures 35:09 - Importance of Preparedness and Resourcefulness in Medical Emergencies 44:38 - Advice for Handling Complicated Medical Cases 49:26 - Concluding Thoughts and Looking Ahead to Future Conferences --- RESOURCES BackTable VI Episode 384 - New Innovations in Closure Devices with Dr. Omar Saleh and Dr. Syed Hussain: https://www.backtable.com/shows/vi/podcasts/384/new-innovations-in-closure-devices BackTable VI Episode 121 - Office-Based Labs (OBLs) & What You Can Do in Them with Dr. Mike Watts: https://www.backtable.com/shows/vi/podcasts/121/office-based-labs-obls-what-you-can-do-in-them BackTable VI Episode 37 - Treating PAD in the OBL with Dr. Mike Watts and Dr. Omar Saleh: https://www.backtable.com/shows/vi/podcasts/37/treating-pad-in-the-obl Tue, 23 Apr 2024 07:00:00 -0000 full BackTable In this episode, Dr. Omar Saleh and Dr. Mike Watts discuss the challenging aspects of vascular interventions in the OBL setting, focusing on ‘oh $#!%’ moments and how to address various complications. Both Dr. Saleh and Dr. Watts are vascular and interventional radiologist, practicing in Southern California and New Jersey, respectively. In this episode, Dr. Omar Saleh and Dr. Mike Watts discuss the challenging aspects of vascular interventions in the OBL setting, focusing on ‘oh $#!%’ moments and how to address various complications. Both Dr. Saleh and Dr. Watts are vascular and interventional radiologist, practicing in Southern California and New Jersey, respectively. The doctors share specific, challenging cases they’ve encountered, including device malfunctions and unexpected outcomes during procedures. Additionally, Dr. Saleh and Dr. Watts discuss the advantages of having hybrid OBL and hospital practices, the importance of being prepared for complications by having the right tools and strategies at hand, and interdisciplinary collaboration. The conversation also touches on the value of certain devices and techniques in managing complications effectively and ensuring patient safety. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 04:53 - Creative Solutions for Complex Vascular Cases 16:47 - Hybrid Practice: Balancing OBL and Hospital Work 21:39 - The Pros and Cons of Hybrid OBL-Hospital Practices 30:34 - Navigating Complex Medical Procedures 35:09 - Importance of Preparedness and Resourcefulness in Medical Emergencies 44:38 - Advice for Handling Complicated Medical Cases 49:26 - Concluding Thoughts and Looking Ahead to Future Conferences --- RESOURCES BackTable VI Episode 384 - New Innovations in Closure Devices with Dr. Omar Saleh and Dr. Syed Hussain: https://www.backtable.com/shows/vi/podcasts/384/new-innovations-in-closure-devices BackTable VI Episode 121 - Office-Based Labs (OBLs) & What You Can Do in Them with Dr. Mike Watts: https://www.backtable.com/shows/vi/podcasts/121/office-based-labs-obls-what-you-can-do-in-them BackTable VI Episode 37 - Treating PAD in the OBL with Dr. Mike Watts and Dr. Omar Saleh: https://www.backtable.com/shows/vi/podcasts/37/treating-pad-in-the-obl In this episode, Dr. Omar Saleh and Dr. Mike Watts discuss the challenging aspects of vascular interventions in the OBL setting, focusing on ‘oh $#!%’ moments and how to address various complications. Both Dr. Saleh and Dr. Watts are vascular and interventional radiologist, practicing in Southern California and New Jersey, respectively.


The doctors share specific, challenging cases they’ve encountered, including device malfunctions and unexpected outcomes during procedures. Additionally, Dr. Saleh and Dr. Watts discuss the advantages of having hybrid OBL and hospital practices, the importance of being prepared for complications by having the right tools and strategies at hand, and interdisciplinary collaboration. The conversation also touches on the value of certain devices and techniques in managing complications effectively and ensuring patient safety.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

04:53 - Creative Solutions for Complex Vascular Cases

16:47 - Hybrid Practice: Balancing OBL and Hospital Work

21:39 - The Pros and Cons of Hybrid OBL-Hospital Practices

30:34 - Navigating Complex Medical Procedures

35:09 - Importance of Preparedness and Resourcefulness in Medical Emergencies

44:38 - Advice for Handling Complicated Medical Cases

49:26 - Concluding Thoughts and Looking Ahead to Future Conferences


---


RESOURCES


BackTable VI Episode 384 - New Innovations in Closure Devices with Dr. Omar Saleh and Dr. Syed Hussain:

https://www.backtable.com/shows/vi/podcasts/384/new-innovations-in-closure-devices


BackTable VI Episode 121 - Office-Based Labs (OBLs) & What You Can Do in Them with Dr. Mike Watts:

https://www.backtable.com/shows/vi/podcasts/121/office-based-labs-obls-what-you-can-do-in-them


BackTable VI Episode 37 - Treating PAD in the OBL with Dr. Mike Watts and Dr. Omar Saleh:

https://www.backtable.com/shows/vi/podcasts/37/treating-pad-in-the-obl

]]> 3255 Ep. 437 Pulmera’s Journey: From Concept to Clinical Impact with Dr. Bryan Hartley In this episode, host Dr. Bryan Hartley takes us on a deep dive into the origin story and mission of Pulmera, a medtech company dedicated to transforming the field of bronchoscopic lung cancer diagnosis by retrofitting existing fluoroscopy machines into cone beam CT-like scanners. Dr. Hartley is a vascular and interventional radiologist and co-founded Pulmera, alongside interventional pulmonologist Dr. Harmeet Bedi at Stanford. Pulmera is developing a novel approach to enhance physicians’ ability to diagnose lung nodules accurately through innovative technology. Dr. Hartley shares insights into the challenges of existing diagnostic methods, the inspiration behind Pulmera, and the technology’s potential to combine the best of 3D imaging and endoscopy techniques. Dr. Hartley discusses the benefits for both patients and physicians, such as improved diagnostic yields and patient outcomes, and introduces an investment opportunity for the BackTable community to be part of this revolutionary project. The episode also explores the broader implications of this technology across various medical specialties beyond pulmonology. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:18 - Personal Journey: From Vanderbilt to Stanford Biodesign 06:11 - Pulmera’s Mission: Enhancing Diagnostic Accuracy in Lung Biopsies 15:02 - Introducing a Game-Changing Technology for Bronchoscopic Procedures 22:09 - Challenges and Breakthroughs in Portable CT Imaging 27:44 - Economic Impact of Enhanced Diagnostic Procedures 29:48 - Building a Team and Securing Funding for Innovation 31:30 - Understanding Investment Opportunities and Equity Financing --- RESOURCES Dr. Bryan Hartley’s email: bryan.hartley@pulmera.com Dr. Bryan Hartley’s cell: 423-432-0612 Pulmera: http://www.pulmera.com/ Stanford Biodesign Fellowship: https://biodesign.stanford.edu/programs/fellowships/innovation-fellowships.html BackTable Innovation Episode #1 - Needs Driven Innovation with Dr. Todd Brinton (Stanford BioDesign): https://www.backtable.com/shows/innovation/podcasts/1/needs-driven-innovation BackTable Innovation Episode #30 - Host Stories with Dr. Bryan Hartley and Dr. Eric Gantwerker (Stanford BioDesign): https://www.backtable.com/shows/innovation/podcasts/30/host-stories BackTable VI Episode #422 - Pathology 101: Solid Advice for Percutaneous Biopsies with Dr. Andrew Sholl: https://www.backtable.com/shows/vi/podcasts/422/pathology-101-solid-advice-for-percutaneous-biopsies Fri, 19 Apr 2024 07:00:00 -0000 full BackTable In this episode, host Dr. Bryan Hartley takes us on a deep dive into the origin story and mission of Pulmera, a medtech company dedicated to transforming the field of bronchoscopic lung cancer diagnosis by retrofitting existing fluoroscopy machines into cone beam CT-like scanners. In this episode, host Dr. Bryan Hartley takes us on a deep dive into the origin story and mission of Pulmera, a medtech company dedicated to transforming the field of bronchoscopic lung cancer diagnosis by retrofitting existing fluoroscopy machines into cone beam CT-like scanners. Dr. Hartley is a vascular and interventional radiologist and co-founded Pulmera, alongside interventional pulmonologist Dr. Harmeet Bedi at Stanford. Pulmera is developing a novel approach to enhance physicians’ ability to diagnose lung nodules accurately through innovative technology. Dr. Hartley shares insights into the challenges of existing diagnostic methods, the inspiration behind Pulmera, and the technology’s potential to combine the best of 3D imaging and endoscopy techniques. Dr. Hartley discusses the benefits for both patients and physicians, such as improved diagnostic yields and patient outcomes, and introduces an investment opportunity for the BackTable community to be part of this revolutionary project. The episode also explores the broader implications of this technology across various medical specialties beyond pulmonology. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:18 - Personal Journey: From Vanderbilt to Stanford Biodesign 06:11 - Pulmera’s Mission: Enhancing Diagnostic Accuracy in Lung Biopsies 15:02 - Introducing a Game-Changing Technology for Bronchoscopic Procedures 22:09 - Challenges and Breakthroughs in Portable CT Imaging 27:44 - Economic Impact of Enhanced Diagnostic Procedures 29:48 - Building a Team and Securing Funding for Innovation 31:30 - Understanding Investment Opportunities and Equity Financing --- RESOURCES Dr. Bryan Hartley’s email: bryan.hartley@pulmera.com Dr. Bryan Hartley’s cell: 423-432-0612 Pulmera: http://www.pulmera.com/ Stanford Biodesign Fellowship: https://biodesign.stanford.edu/programs/fellowships/innovation-fellowships.html BackTable Innovation Episode #1 - Needs Driven Innovation with Dr. Todd Brinton (Stanford BioDesign): https://www.backtable.com/shows/innovation/podcasts/1/needs-driven-innovation BackTable Innovation Episode #30 - Host Stories with Dr. Bryan Hartley and Dr. Eric Gantwerker (Stanford BioDesign): https://www.backtable.com/shows/innovation/podcasts/30/host-stories BackTable VI Episode #422 - Pathology 101: Solid Advice for Percutaneous Biopsies with Dr. Andrew Sholl: https://www.backtable.com/shows/vi/podcasts/422/pathology-101-solid-advice-for-percutaneous-biopsies In this episode, host Dr. Bryan Hartley takes us on a deep dive into the origin story and mission of Pulmera, a medtech company dedicated to transforming the field of bronchoscopic lung cancer diagnosis by retrofitting existing fluoroscopy machines into cone beam CT-like scanners. Dr. Hartley is a vascular and interventional radiologist and co-founded Pulmera, alongside interventional pulmonologist Dr. Harmeet Bedi at Stanford.


Pulmera is developing a novel approach to enhance physicians’ ability to diagnose lung nodules accurately through innovative technology. Dr. Hartley shares insights into the challenges of existing diagnostic methods, the inspiration behind Pulmera, and the technology’s potential to combine the best of 3D imaging and endoscopy techniques. Dr. Hartley discusses the benefits for both patients and physicians, such as improved diagnostic yields and patient outcomes, and introduces an investment opportunity for the BackTable community to be part of this revolutionary project. The episode also explores the broader implications of this technology across various medical specialties beyond pulmonology.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

02:18 - Personal Journey: From Vanderbilt to Stanford Biodesign

06:11 - Pulmera’s Mission: Enhancing Diagnostic Accuracy in Lung Biopsies

15:02 - Introducing a Game-Changing Technology for Bronchoscopic Procedures

22:09 - Challenges and Breakthroughs in Portable CT Imaging

27:44 - Economic Impact of Enhanced Diagnostic Procedures

29:48 - Building a Team and Securing Funding for Innovation

31:30 - Understanding Investment Opportunities and Equity Financing


---


RESOURCES


Dr. Bryan Hartley’s email:

bryan.hartley@pulmera.com


Dr. Bryan Hartley’s cell:

423-432-0612


Pulmera:

http://www.pulmera.com/


Stanford Biodesign Fellowship:

https://biodesign.stanford.edu/programs/fellowships/innovation-fellowships.html


BackTable Innovation Episode #1 - Needs Driven Innovation with Dr. Todd Brinton (Stanford BioDesign):

https://www.backtable.com/shows/innovation/podcasts/1/needs-driven-innovation


BackTable Innovation Episode #30 - Host Stories with Dr. Bryan Hartley and Dr. Eric Gantwerker (Stanford BioDesign):

https://www.backtable.com/shows/innovation/podcasts/30/host-stories


BackTable VI Episode #422 - Pathology 101: Solid Advice for Percutaneous Biopsies with Dr. Andrew Sholl:

https://www.backtable.com/shows/vi/podcasts/422/pathology-101-solid-advice-for-percutaneous-biopsies

]]> 2135 Ep. 436 The Multidisciplinary Approach to Combatting CLI Globally with Dr. Jos van den Berg In this episode, Dr. Jos van den Berg discusses the benefits of joining the Critical Limb Ischemia (CLI) Global Society, including discounts on Amputation Prevention Symposium (AMP) meetings, access to a specialized journal, and participation in Multidisciplinary CLI Network (MCLIN) discussion boards. Dr. van den Berg is an interventional radiologist at University of Bern in Switzerland and Europe Office Chairman and Member of Board of Directors for CLI Global Society. Dr. van den Berg also serves as a reviewer and editorial board member of multiple high-impact scientific journals. With members across the globe, the CLI Global Society emphasizes a multidisciplinary approach to combat CLI, aiming to prevent amputation and death through education, patient advocacy, and awareness about CLI. Dr. van den Berg also sheds light on the complexity of CLI management in Europe due to varied reimbursement systems among countries and the society’s efforts to tackle these challenges. The episode also touches on the society’s future goals, including expanding its global presence and continuing to offer extensive resources and networking opportunities to its members. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 02:08 - Meet Our Guest: Dr. Jos van den Berg 05:42 - Deep Dive into CLI Global Society 07:53 - Exploring the Impact and Initiatives of CLI Global Society 14:42 - Challenges and Differences of CLI Management in Europe 21:08 - Innovations and Future Endeavors in CLI Treatment 23:45 - Closing Thoughts and the Importance of Membership --- RESOURCES CLI Global Society: https://www.cliglobalsociety.org/ Multidisciplinary CLI Network (MCLIN) Global CLI LIVE Meeting (every 2nd Friday of the month, 7am EST): https://www.cliglobalsociety.org/education/mclin/#myaccount AMP CLI Meeting: https://www.hmpglobalevents.com/amptheclimeeting Wed, 17 Apr 2024 07:00:00 -0000 full BackTable In this episode, Dr. Jos van den Berg discusses the benefits of joining the Critical Limb Ischemia (CLI) Global Society, including discounts on Amputation Prevention Symposium (AMP) meetings, access to a specialized journal, and participation in Multidisciplinary CLI Network (MCLIN) discussion boards. In this episode, Dr. Jos van den Berg discusses the benefits of joining the Critical Limb Ischemia (CLI) Global Society, including discounts on Amputation Prevention Symposium (AMP) meetings, access to a specialized journal, and participation in Multidisciplinary CLI Network (MCLIN) discussion boards. Dr. van den Berg is an interventional radiologist at University of Bern in Switzerland and Europe Office Chairman and Member of Board of Directors for CLI Global Society. Dr. van den Berg also serves as a reviewer and editorial board member of multiple high-impact scientific journals. With members across the globe, the CLI Global Society emphasizes a multidisciplinary approach to combat CLI, aiming to prevent amputation and death through education, patient advocacy, and awareness about CLI. Dr. van den Berg also sheds light on the complexity of CLI management in Europe due to varied reimbursement systems among countries and the society’s efforts to tackle these challenges. The episode also touches on the society’s future goals, including expanding its global presence and continuing to offer extensive resources and networking opportunities to its members. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 02:08 - Meet Our Guest: Dr. Jos van den Berg 05:42 - Deep Dive into CLI Global Society 07:53 - Exploring the Impact and Initiatives of CLI Global Society 14:42 - Challenges and Differences of CLI Management in Europe 21:08 - Innovations and Future Endeavors in CLI Treatment 23:45 - Closing Thoughts and the Importance of Membership --- RESOURCES CLI Global Society: https://www.cliglobalsociety.org/ Multidisciplinary CLI Network (MCLIN) Global CLI LIVE Meeting (every 2nd Friday of the month, 7am EST): https://www.cliglobalsociety.org/education/mclin/#myaccount AMP CLI Meeting: https://www.hmpglobalevents.com/amptheclimeeting In this episode, Dr. Jos van den Berg discusses the benefits of joining the Critical Limb Ischemia (CLI) Global Society, including discounts on Amputation Prevention Symposium (AMP) meetings, access to a specialized journal, and participation in Multidisciplinary CLI Network (MCLIN) discussion boards.


Dr. van den Berg is an interventional radiologist at University of Bern in Switzerland and Europe Office Chairman and Member of Board of Directors for CLI Global Society. Dr. van den Berg also serves as a reviewer and editorial board member of multiple high-impact scientific journals.


With members across the globe, the CLI Global Society emphasizes a multidisciplinary approach to combat CLI, aiming to prevent amputation and death through education, patient advocacy, and awareness about CLI. Dr. van den Berg also sheds light on the complexity of CLI management in Europe due to varied reimbursement systems among countries and the society’s efforts to tackle these challenges. The episode also touches on the society’s future goals, including expanding its global presence and continuing to offer extensive resources and networking opportunities to its members.


---


CHECK OUT OUR SPONSORS


BD Advance Clinical Training & Education Program

https://page.bd.com/Advance-Training-Program_Homepage.html


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

02:08 - Meet Our Guest: Dr. Jos van den Berg

05:42 - Deep Dive into CLI Global Society

07:53 - Exploring the Impact and Initiatives of CLI Global Society

14:42 - Challenges and Differences of CLI Management in Europe

21:08 - Innovations and Future Endeavors in CLI Treatment

23:45 - Closing Thoughts and the Importance of Membership


---


RESOURCES


CLI Global Society:

https://www.cliglobalsociety.org/


Multidisciplinary CLI Network (MCLIN) Global CLI LIVE Meeting (every 2nd Friday of the month, 7am EST):

https://www.cliglobalsociety.org/education/mclin/#myaccount


AMP CLI Meeting:

https://www.hmpglobalevents.com/amptheclimeeting

]]> 1714 Ep. 435 SCS for Neuropathy: Clinical Insights and Patient Impact with Dr. Blake Parsons In this episode, Dr. Blake Parsons talks through the role of spinal cord stimulation in treating vascular issues and diabetic neuropathy. He also discusses the growing presence of vascular specialists in clinics, the transition from procedural work to clinical involvement, and the significance of building a strong patient-doctor relationship. The doctors highlight the effectiveness of Nevro 10 kHz therapy in providing long-term pain relief and sensory improvements for patients struggling with painful diabetic neuropathy, even after conventional treatments fail. Additionally, they touch upon reimbursement updates, the rise of outpatient care, and the future of spinal cord stimulation - emphasizing its potential beyond just pain relief to include improvements in patients’ overall quality of life, reducing risks related to diabetic foot wounds, and incidental falls. The need for a multidisciplinary approach in treating vascular and neuropathic conditions is also discussed, along with the role of interventional radiologists in managing these complex cases. --- CHECK OUT OUR SPONSOR Nevro HFX Spinal Cord Stimulator https://www.hfxforpdn.com --- SHOW NOTES 00:00 - Introduction 06:00 - Demystifying Spinal Cord Stimulation for Pain Management 17:11 - Optimizing Patient Care: Trials, Techniques, and Insurance 26:03 - Leveraging Telehealth and Support Teams for Patient Success 30:22 - Challenges and Solutions in Managing Peripheral Neuropathy 35:19 - Collaboration and Referral Dynamics in Vascular and Interventional Radiology 39:19 - Exploring the Future of Neuropathy Treatment and Quality of Life Improvements 43:46 - Addressing the Challenges of Permanent Implant Procedures 48:46 - Role of Technology and AI in Patient Management 56:31 - Concluding Thoughts on Neuropathy Treatment and Practice Dynamics --- RESOURCES Nevro 10 kHz Therapy: https://nevro.com/English/en/providers/HFX-Advanced-Therapies/default.aspx Effect of High-frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy: A Randomized Clinical Trial (JAMA Neurology RCT 2021): https://pubmed.ncbi.nlm.nih.gov/33818600/ Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial (SENZA-PDN RCT 2023): https://pubmed.ncbi.nlm.nih.gov/37536514/ Electrical spinal-cord stimulation for painful diabetic peripheral neuropathy (Lancet RCT 1996): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)02467-1/abstract Tue, 16 Apr 2024 07:00:00 -0000 full BackTable In this episode, Dr. Blake Parsons talks through the role of spinal cord stimulation in treating vascular issues and diabetic neuropathy. He also discusses the growing presence of vascular specialists in clinics, the transition from procedural work to clinical involvement, and the significance of building a strong patient-doctor relationship. In this episode, Dr. Blake Parsons talks through the role of spinal cord stimulation in treating vascular issues and diabetic neuropathy. He also discusses the growing presence of vascular specialists in clinics, the transition from procedural work to clinical involvement, and the significance of building a strong patient-doctor relationship. The doctors highlight the effectiveness of Nevro 10 kHz therapy in providing long-term pain relief and sensory improvements for patients struggling with painful diabetic neuropathy, even after conventional treatments fail. Additionally, they touch upon reimbursement updates, the rise of outpatient care, and the future of spinal cord stimulation - emphasizing its potential beyond just pain relief to include improvements in patients’ overall quality of life, reducing risks related to diabetic foot wounds, and incidental falls. The need for a multidisciplinary approach in treating vascular and neuropathic conditions is also discussed, along with the role of interventional radiologists in managing these complex cases. --- CHECK OUT OUR SPONSOR Nevro HFX Spinal Cord Stimulator https://www.hfxforpdn.com --- SHOW NOTES 00:00 - Introduction 06:00 - Demystifying Spinal Cord Stimulation for Pain Management 17:11 - Optimizing Patient Care: Trials, Techniques, and Insurance 26:03 - Leveraging Telehealth and Support Teams for Patient Success 30:22 - Challenges and Solutions in Managing Peripheral Neuropathy 35:19 - Collaboration and Referral Dynamics in Vascular and Interventional Radiology 39:19 - Exploring the Future of Neuropathy Treatment and Quality of Life Improvements 43:46 - Addressing the Challenges of Permanent Implant Procedures 48:46 - Role of Technology and AI in Patient Management 56:31 - Concluding Thoughts on Neuropathy Treatment and Practice Dynamics --- RESOURCES Nevro 10 kHz Therapy: https://nevro.com/English/en/providers/HFX-Advanced-Therapies/default.aspx Effect of High-frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy: A Randomized Clinical Trial (JAMA Neurology RCT 2021): https://pubmed.ncbi.nlm.nih.gov/33818600/ Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial (SENZA-PDN RCT 2023): https://pubmed.ncbi.nlm.nih.gov/37536514/ Electrical spinal-cord stimulation for painful diabetic peripheral neuropathy (Lancet RCT 1996): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)02467-1/abstract In this episode, Dr. Blake Parsons talks through the role of spinal cord stimulation in treating vascular issues and diabetic neuropathy. He also discusses the growing presence of vascular specialists in clinics, the transition from procedural work to clinical involvement, and the significance of building a strong patient-doctor relationship.


The doctors highlight the effectiveness of Nevro 10 kHz therapy in providing long-term pain relief and sensory improvements for patients struggling with painful diabetic neuropathy, even after conventional treatments fail. Additionally, they touch upon reimbursement updates, the rise of outpatient care, and the future of spinal cord stimulation - emphasizing its potential beyond just pain relief to include improvements in patients’ overall quality of life, reducing risks related to diabetic foot wounds, and incidental falls. The need for a multidisciplinary approach in treating vascular and neuropathic conditions is also discussed, along with the role of interventional radiologists in managing these complex cases.


---


CHECK OUT OUR SPONSOR


Nevro HFX Spinal Cord Stimulator

https://www.hfxforpdn.com


---


SHOW NOTES


00:00 - Introduction

06:00 - Demystifying Spinal Cord Stimulation for Pain Management

17:11 - Optimizing Patient Care: Trials, Techniques, and Insurance

26:03 - Leveraging Telehealth and Support Teams for Patient Success

30:22 - Challenges and Solutions in Managing Peripheral Neuropathy

35:19 - Collaboration and Referral Dynamics in Vascular and Interventional Radiology

39:19 - Exploring the Future of Neuropathy Treatment and Quality of Life Improvements

43:46 - Addressing the Challenges of Permanent Implant Procedures

48:46 - Role of Technology and AI in Patient Management

56:31 - Concluding Thoughts on Neuropathy Treatment and Practice Dynamics


---


RESOURCES


Nevro 10 kHz Therapy:

https://nevro.com/English/en/providers/HFX-Advanced-Therapies/default.aspx


Effect of High-frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy: A Randomized Clinical Trial (JAMA Neurology RCT 2021):

https://pubmed.ncbi.nlm.nih.gov/33818600/


Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial (SENZA-PDN RCT 2023):

https://pubmed.ncbi.nlm.nih.gov/37536514/


Electrical spinal-cord stimulation for painful diabetic peripheral neuropathy (Lancet RCT 1996):

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)02467-1/abstract

]]> 3629 Ep. 434 Biliary Disease: Surgical and IR Insights with Dr. Mark Lessne and Dr. John Martinie In this episode, Dr. Mark Lessne and Dr. John Martinie discuss the importance of multidisciplinary collaboration, patient-centered care, and the role of interventional radiology and surgery in treating benign and malignant biliary diseases. Dr. Lessne is an interventional radiologist at Charlotte Radiology and Dr. Martinie is a hepatobiliary surgeon at Carolinas Medical Center, both located in North Carolina. The doctors explore various scenarios including challenges in biliary decompression, the decision-making process behind choosing the right intervention, and the impact of such diseases on patient care plans and outcomes. Dr. Lessne and Dr. Martinie emphasize the importance of viewing interventional radiologists and gastroenterologists as physicians who not only perform procedures, but also provide comprehensive care and follow-up for their patients. Through their dialogue, it becomes clear that successful treatment of biliary diseases requires a combination of technical skill, thoughtful patient engagement, and collaborative practice among specialists. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:19 - Multidisciplinary Approach to Patient Care 05:31 - Navigating the Complexities of Biliary Disease Workups 10:13 - Collaboration Between Hepatobiliary Surgery and Interventional Radiology 19:33 - Balancing Minimally Invasive Techniques with Surgical Options 30:29 - The Importance of Compassionate Consent and Patient-Centered Care 32:16 - Exploring Advanced Interventions and Team Discussions 36:31 - Considerations and Challenges in Biliary Stenting 45:46 - Role of Interventional Radiology in Patient Care 56:57 - Final Thoughts on Teamwork and Patient Care --- RESOURCES BackTable Ep. 203- Making Informed Consent an Informed Choice with the Interventional Initiative: https://www.backtable.com/shows/vi/podcasts/203/making-informed-consent-an-informed-choice-with-the-interventional-initiative Fri, 12 Apr 2024 07:00:00 -0000 full BackTable In this episode, Dr. Mark Lessne and Dr. John Martinie discuss the importance of multidisciplinary collaboration, patient-centered care, and the role of interventional radiology and surgery in treating benign and malignant biliary diseases. In this episode, Dr. Mark Lessne and Dr. John Martinie discuss the importance of multidisciplinary collaboration, patient-centered care, and the role of interventional radiology and surgery in treating benign and malignant biliary diseases. Dr. Lessne is an interventional radiologist at Charlotte Radiology and Dr. Martinie is a hepatobiliary surgeon at Carolinas Medical Center, both located in North Carolina. The doctors explore various scenarios including challenges in biliary decompression, the decision-making process behind choosing the right intervention, and the impact of such diseases on patient care plans and outcomes. Dr. Lessne and Dr. Martinie emphasize the importance of viewing interventional radiologists and gastroenterologists as physicians who not only perform procedures, but also provide comprehensive care and follow-up for their patients. Through their dialogue, it becomes clear that successful treatment of biliary diseases requires a combination of technical skill, thoughtful patient engagement, and collaborative practice among specialists. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:19 - Multidisciplinary Approach to Patient Care 05:31 - Navigating the Complexities of Biliary Disease Workups 10:13 - Collaboration Between Hepatobiliary Surgery and Interventional Radiology 19:33 - Balancing Minimally Invasive Techniques with Surgical Options 30:29 - The Importance of Compassionate Consent and Patient-Centered Care 32:16 - Exploring Advanced Interventions and Team Discussions 36:31 - Considerations and Challenges in Biliary Stenting 45:46 - Role of Interventional Radiology in Patient Care 56:57 - Final Thoughts on Teamwork and Patient Care --- RESOURCES BackTable Ep. 203- Making Informed Consent an Informed Choice with the Interventional Initiative: https://www.backtable.com/shows/vi/podcasts/203/making-informed-consent-an-informed-choice-with-the-interventional-initiative In this episode, Dr. Mark Lessne and Dr. John Martinie discuss the importance of multidisciplinary collaboration, patient-centered care, and the role of interventional radiology and surgery in treating benign and malignant biliary diseases. Dr. Lessne is an interventional radiologist at Charlotte Radiology and Dr. Martinie is a hepatobiliary surgeon at Carolinas Medical Center, both located in North Carolina.


The doctors explore various scenarios including challenges in biliary decompression, the decision-making process behind choosing the right intervention, and the impact of such diseases on patient care plans and outcomes. Dr. Lessne and Dr. Martinie emphasize the importance of viewing interventional radiologists and gastroenterologists as physicians who not only perform procedures, but also provide comprehensive care and follow-up for their patients. Through their dialogue, it becomes clear that successful treatment of biliary diseases requires a combination of technical skill, thoughtful patient engagement, and collaborative practice among specialists.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

02:19 - Multidisciplinary Approach to Patient Care

05:31 - Navigating the Complexities of Biliary Disease Workups

10:13 - Collaboration Between Hepatobiliary Surgery and Interventional Radiology

19:33 - Balancing Minimally Invasive Techniques with Surgical Options

30:29 - The Importance of Compassionate Consent and Patient-Centered Care

32:16 - Exploring Advanced Interventions and Team Discussions

36:31 - Considerations and Challenges in Biliary Stenting

45:46 - Role of Interventional Radiology in Patient Care

56:57 - Final Thoughts on Teamwork and Patient Care


---


RESOURCES


BackTable Ep. 203- Making Informed Consent an Informed Choice with the Interventional Initiative:

https://www.backtable.com/shows/vi/podcasts/203/making-informed-consent-an-informed-choice-with-the-interventional-initiative

]]> 3720 Ep. 433 Kyphoplasty Evolution: Steering Toward Targeted Therapy with Dr. David Prologo In this episode of the BackTable MSK Podcast, Dr. Dana Dunleavy interviews Dr. David Prologo about his perspective on current advancements in MSK interventions, including steerable spine needles, thermocouples for radiofrequency ablation, and the growing importance of advocacy and longitudinal follow up for patients with chronic pain. Dr. Prologo is an interventional radiologist at Emory University. Dr. Prologo starts by describing the evolution of interventional radiology’s role in MSK interventions. He explains that establishing solid referral networks is crucial to building this service line, and he gives examples of how new interventionalists can highlight their skills to others. Then, he describes a new steerable needle that allows operators to safely enter the vertebral body with a transpedicular approach and subsequently navigate directly to the location of interest. This device is especially useful when lesions are located in tricky areas where the trajectory of a straight needle would have difficulty reaching. He also discusses different devices for bone tumor ablation and his preferred methods for targeting lesions that are located at varying locations in the spine. For lesions below T5, he uses fluoroscopy for better visualization of the axial plane. For lumbar lesions, he emphasizes the importance of correlating and cross-checking vertebral levels with pre-procedural MRI. Dr. Prologo also discusses lessons learned from his extensive experience in spine interventions, especially from prior complications. He explains how thermocouple monitoring can give real time feedback on internal temperature during radiofrequency ablation, the necessity of understanding the ablation zone, and the importance of longitudinal follow up. He cites specific cases of patients struggling with chronic pain and how he advocated for each case. --- CHECK OUT OUR SPONSOR Merit Spine https://www.merit.com/merit-spine/ --- SHOW NOTES 00:00 - Introduction 02:09 - Dr. Prologo’s Career and Leadership Roles 09:52 - Interventional Radiology’s Role in MSK Interventions 13:37 - A Primer for Steerable Vertebral Needles 21:40 - Increasing Standardization and Accessibility of Bone Tumor Ablation 26:37 - Advanced Pain Management in Interventional Radiology’ Book 30:24 - Thermocouples in Radiofrequency Ablation 35:45 - Prior Complications and Importance of Longitudinal Care 44:24 - SIR EDGE 2024 52:31 - Accessing Targets for Basivertebral Nerve Ablation 1:01:17 - The Role of Advocacy in Patient Care --- RESOURCES Osseoflex Steerable Needle: https://www.merit.com/product/osseoflex-sn-steerable-needle/ STAR Tumor Ablation System: https://www.merit.com/product/star-tumor-ablation-system/ Osteocool OsteoCool Radiofrequency Ablation System: https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html OptaBlate Bone Tumor Ablation System: https://providers.strykerivs.com/products/optablate ‘Advanced Pain Management in Interventional Radiology’ by J. David Prologo and Charles E. Ray Jr: https://shop.thieme.com/Advanced-Pain-Management-in-Interventional-Radiology/9781684201402 Ablation zones and weight-bearing bones: points of caution for the palliative interventionalist: https://pubmed.ncbi.nlm.nih.gov/24745905/ SIR EDGE 2024: https://www.sirweb.org/learning-center/meetings/sir-edge/ ‘The Catching Point Transformation’ by J. David Prologo: https://www.catchingpoint.com/ Tue, 09 Apr 2024 07:00:00 -0000 full BackTable In this episode of the BackTable MSK Podcast, Dr. Dana Dunleavy interviews Dr. David Prologo about his perspective on current advancements in MSK interventions, including steerable spine needles, thermocouples for radiofrequency ablation, and the growing importance of advocacy and longitudinal follow up for patients with chronic pain. In this episode of the BackTable MSK Podcast, Dr. Dana Dunleavy interviews Dr. David Prologo about his perspective on current advancements in MSK interventions, including steerable spine needles, thermocouples for radiofrequency ablation, and the growing importance of advocacy and longitudinal follow up for patients with chronic pain. Dr. Prologo is an interventional radiologist at Emory University. Dr. Prologo starts by describing the evolution of interventional radiology’s role in MSK interventions. He explains that establishing solid referral networks is crucial to building this service line, and he gives examples of how new interventionalists can highlight their skills to others. Then, he describes a new steerable needle that allows operators to safely enter the vertebral body with a transpedicular approach and subsequently navigate directly to the location of interest. This device is especially useful when lesions are located in tricky areas where the trajectory of a straight needle would have difficulty reaching. He also discusses different devices for bone tumor ablation and his preferred methods for targeting lesions that are located at varying locations in the spine. For lesions below T5, he uses fluoroscopy for better visualization of the axial plane. For lumbar lesions, he emphasizes the importance of correlating and cross-checking vertebral levels with pre-procedural MRI. Dr. Prologo also discusses lessons learned from his extensive experience in spine interventions, especially from prior complications. He explains how thermocouple monitoring can give real time feedback on internal temperature during radiofrequency ablation, the necessity of understanding the ablation zone, and the importance of longitudinal follow up. He cites specific cases of patients struggling with chronic pain and how he advocated for each case. --- CHECK OUT OUR SPONSOR Merit Spine https://www.merit.com/merit-spine/ --- SHOW NOTES 00:00 - Introduction 02:09 - Dr. Prologo’s Career and Leadership Roles 09:52 - Interventional Radiology’s Role in MSK Interventions 13:37 - A Primer for Steerable Vertebral Needles 21:40 - Increasing Standardization and Accessibility of Bone Tumor Ablation 26:37 - Advanced Pain Management in Interventional Radiology’ Book 30:24 - Thermocouples in Radiofrequency Ablation 35:45 - Prior Complications and Importance of Longitudinal Care 44:24 - SIR EDGE 2024 52:31 - Accessing Targets for Basivertebral Nerve Ablation 1:01:17 - The Role of Advocacy in Patient Care --- RESOURCES Osseoflex Steerable Needle: https://www.merit.com/product/osseoflex-sn-steerable-needle/ STAR Tumor Ablation System: https://www.merit.com/product/star-tumor-ablation-system/ Osteocool OsteoCool Radiofrequency Ablation System: https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html OptaBlate Bone Tumor Ablation System: https://providers.strykerivs.com/products/optablate ‘Advanced Pain Management in Interventional Radiology’ by J. David Prologo and Charles E. Ray Jr: https://shop.thieme.com/Advanced-Pain-Management-in-Interventional-Radiology/9781684201402 Ablation zones and weight-bearing bones: points of caution for the palliative interventionalist: https://pubmed.ncbi.nlm.nih.gov/24745905/ SIR EDGE 2024: https://www.sirweb.org/learning-center/meetings/sir-edge/ ‘The Catching Point Transformation’ by J. David Prologo: https://www.catchingpoint.com/ In this episode of the BackTable MSK Podcast, Dr. Dana Dunleavy interviews Dr. David Prologo about his perspective on current advancements in MSK interventions, including steerable spine needles, thermocouples for radiofrequency ablation, and the growing importance of advocacy and longitudinal follow up for patients with chronic pain. Dr. Prologo is an interventional radiologist at Emory University.


Dr. Prologo starts by describing the evolution of interventional radiology’s role in MSK interventions. He explains that establishing solid referral networks is crucial to building this service line, and he gives examples of how new interventionalists can highlight their skills to others. Then, he describes a new steerable needle that allows operators to safely enter the vertebral body with a transpedicular approach and subsequently navigate directly to the location of interest. This device is especially useful when lesions are located in tricky areas where the trajectory of a straight needle would have difficulty reaching. He also discusses different devices for bone tumor ablation and his preferred methods for targeting lesions that are located at varying locations in the spine. For lesions below T5, he uses fluoroscopy for better visualization of the axial plane. For lumbar lesions, he emphasizes the importance of correlating and cross-checking vertebral levels with pre-procedural MRI.


Dr. Prologo also discusses lessons learned from his extensive experience in spine interventions, especially from prior complications. He explains how thermocouple monitoring can give real time feedback on internal temperature during radiofrequency ablation, the necessity of understanding the ablation zone, and the importance of longitudinal follow up. He cites specific cases of patients struggling with chronic pain and how he advocated for each case.


---


CHECK OUT OUR SPONSOR


Merit Spine

https://www.merit.com/merit-spine/


---


SHOW NOTES


00:00 - Introduction

02:09 - Dr. Prologo’s Career and Leadership Roles

09:52 - Interventional Radiology’s Role in MSK Interventions

13:37 - A Primer for Steerable Vertebral Needles

21:40 - Increasing Standardization and Accessibility of Bone Tumor Ablation

26:37 - Advanced Pain Management in Interventional Radiology’ Book

30:24 - Thermocouples in Radiofrequency Ablation

35:45 - Prior Complications and Importance of Longitudinal Care

44:24 - SIR EDGE 2024

52:31 - Accessing Targets for Basivertebral Nerve Ablation

1:01:17 - The Role of Advocacy in Patient Care


---


RESOURCES


Osseoflex Steerable Needle:

https://www.merit.com/product/osseoflex-sn-steerable-needle/


STAR Tumor Ablation System:

https://www.merit.com/product/star-tumor-ablation-system/


Osteocool OsteoCool Radiofrequency Ablation System:

https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html


OptaBlate Bone Tumor Ablation System:

https://providers.strykerivs.com/products/optablate


‘Advanced Pain Management in Interventional Radiology’ by J. David Prologo and Charles E. Ray Jr:

https://shop.thieme.com/Advanced-Pain-Management-in-Interventional-Radiology/9781684201402


Ablation zones and weight-bearing bones: points of caution for the palliative interventionalist:

https://pubmed.ncbi.nlm.nih.gov/24745905/


SIR EDGE 2024:

https://www.sirweb.org/learning-center/meetings/sir-edge/


‘The Catching Point Transformation’ by J. David Prologo:

https://www.catchingpoint.com/

]]> 4352 Ep. 432 AI in Medicine: Navigating the New Frontier with Confidence with Dr. Matthew Lungren In this episode, Dr. Matthew Lungren discusses the transformative potential of Artificial Intelligence (AI) in healthcare, sharing insights into large language models, deep learning, and machine learning in improving patient care, enhancing clinical workflows, and optimizing medical research. Dr. Lungren is a pediatric diagnostic and interventional radiologist, and the Chief Data Science Officer at Microsoft Health and Life Sciences. He advocates for a future where AI acts as a tool for healthcare professionals, allowing them to devote more time to patient care rather than administrative tasks. Additionally, the discussion explores concerns such as AI’s impact on employment and interactions with insurance companies, while presenting resources for healthcare professionals to engage with and learn about AI technologies actively. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:00 - The Journey to AI Expertise: Dr. Lungren’s Story 05:48 - Decoding AI: From Basics to Large Language Models 13:07 - AI’s Impact on Healthcare and Beyond 15:57 - Exploring AI’s Potential in Content Creation and Clinical Efficiency 20:22 - The Future of AI in Healthcare: Opportunities and Challenges 25:27 - Leveraging AI for Diagnostic Radiology and Beyond 27:42 - The Transformative Potential of Generative AI in Healthcare 33:40 - Addressing Concerns: AI’s Role in Insurance and Patient Advocacy 36:41 - Empowering Healthcare Professionals with AI: Practical Applications and Future Outlook --- RESOURCES Fundamentals of Machine Learning for Healthcare - Stanford University Coursera Course: https://www.coursera.org/learn/fundamental-machine-learning-healthcare Dr. Matt Lungren’s LinkedIn Learning Course on Generative AI: https://www.linkedin.com/learning/an-introduction-to-how-generative-ai-will-transform-healthcare/introduction-to-generative-ai-in-healthcare DeepLearning.AI Website (Professor Andrew Ng): https://www.deeplearning.ai/ Fast.AI Website (Professor Jeremy Howard): https://www.fast.ai/ Professor Jeremy Howard YouTube: https://www.youtube.com/@howardjeremyp/featured Healthcare Information and Management Systems Society (HIMMS) Meeting: https://www.himssconference.com/en/homepage.html Fri, 05 Apr 2024 07:00:00 -0000 full BackTable In this episode, Dr. Matthew Lungren discusses the transformative potential of Artificial Intelligence (AI) in healthcare, sharing insights into large language models, deep learning, and machine learning in improving patient care, enhancing clinical workflows, and optimizing medical research. In this episode, Dr. Matthew Lungren discusses the transformative potential of Artificial Intelligence (AI) in healthcare, sharing insights into large language models, deep learning, and machine learning in improving patient care, enhancing clinical workflows, and optimizing medical research. Dr. Lungren is a pediatric diagnostic and interventional radiologist, and the Chief Data Science Officer at Microsoft Health and Life Sciences. He advocates for a future where AI acts as a tool for healthcare professionals, allowing them to devote more time to patient care rather than administrative tasks. Additionally, the discussion explores concerns such as AI’s impact on employment and interactions with insurance companies, while presenting resources for healthcare professionals to engage with and learn about AI technologies actively. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:00 - The Journey to AI Expertise: Dr. Lungren’s Story 05:48 - Decoding AI: From Basics to Large Language Models 13:07 - AI’s Impact on Healthcare and Beyond 15:57 - Exploring AI’s Potential in Content Creation and Clinical Efficiency 20:22 - The Future of AI in Healthcare: Opportunities and Challenges 25:27 - Leveraging AI for Diagnostic Radiology and Beyond 27:42 - The Transformative Potential of Generative AI in Healthcare 33:40 - Addressing Concerns: AI’s Role in Insurance and Patient Advocacy 36:41 - Empowering Healthcare Professionals with AI: Practical Applications and Future Outlook --- RESOURCES Fundamentals of Machine Learning for Healthcare - Stanford University Coursera Course: https://www.coursera.org/learn/fundamental-machine-learning-healthcare Dr. Matt Lungren’s LinkedIn Learning Course on Generative AI: https://www.linkedin.com/learning/an-introduction-to-how-generative-ai-will-transform-healthcare/introduction-to-generative-ai-in-healthcare DeepLearning.AI Website (Professor Andrew Ng): https://www.deeplearning.ai/ Fast.AI Website (Professor Jeremy Howard): https://www.fast.ai/ Professor Jeremy Howard YouTube: https://www.youtube.com/@howardjeremyp/featured Healthcare Information and Management Systems Society (HIMMS) Meeting: https://www.himssconference.com/en/homepage.html In this episode, Dr. Matthew Lungren discusses the transformative potential of Artificial Intelligence (AI) in healthcare, sharing insights into large language models, deep learning, and machine learning in improving patient care, enhancing clinical workflows, and optimizing medical research.


Dr. Lungren is a pediatric diagnostic and interventional radiologist, and the Chief Data Science Officer at Microsoft Health and Life Sciences. He advocates for a future where AI acts as a tool for healthcare professionals, allowing them to devote more time to patient care rather than administrative tasks. Additionally, the discussion explores concerns such as AI’s impact on employment and interactions with insurance companies, while presenting resources for healthcare professionals to engage with and learn about AI technologies actively.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

03:00 - The Journey to AI Expertise: Dr. Lungren’s Story

05:48 - Decoding AI: From Basics to Large Language Models

13:07 - AI’s Impact on Healthcare and Beyond

15:57 - Exploring AI’s Potential in Content Creation and Clinical Efficiency

20:22 - The Future of AI in Healthcare: Opportunities and Challenges

25:27 - Leveraging AI for Diagnostic Radiology and Beyond

27:42 - The Transformative Potential of Generative AI in Healthcare

33:40 - Addressing Concerns: AI’s Role in Insurance and Patient Advocacy

36:41 - Empowering Healthcare Professionals with AI: Practical Applications and Future Outlook


---


RESOURCES


Fundamentals of Machine Learning for Healthcare - Stanford University Coursera Course: https://www.coursera.org/learn/fundamental-machine-learning-healthcare


Dr. Matt Lungren’s LinkedIn Learning Course on Generative AI:

https://www.linkedin.com/learning/an-introduction-to-how-generative-ai-will-transform-healthcare/introduction-to-generative-ai-in-healthcare


DeepLearning.AI Website (Professor Andrew Ng):

https://www.deeplearning.ai/


Fast.AI Website (Professor Jeremy Howard):

https://www.fast.ai/


Professor Jeremy Howard YouTube:

https://www.youtube.com/@howardjeremyp/featured


Healthcare Information and Management Systems Society (HIMMS) Meeting:

https://www.himssconference.com/en/homepage.html

]]> 2874 Ep. 431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates In this episode of the BackTable Podcast, Teri Yates explores the nuances of choosing between an Office-Based Lab (OBL) and Ambulatory Surgery Center (ASC) for private practices. Teri is the CEO of Accountable Physician Advisors, a consulting firm which specializes in OBLs, ASCs, and hybrid models for private-practice physicians. She is also President of DocCentric, a company focused on supporting physicians building and leading their own ASCs. The discussion includes a comprehensive analysis of the financial, regulatory, and operational considerations for physicians contemplating this decision. This includes insights into reimbursement models, Medicare regulations, and the strategic advantages of each model. The episode also touches on the importance of feasibility studies, partnerships with other specialties, and real estate strategies when developing these facilities. The conversation provides valuable advice for navigating the complexities of ASC development and emphasizes the value of maintaining independence and leveraging physician-owned models for long-term success. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 04:19 - Deep Dive into OBL and ASC: Definitions, Differences, and Decisions 07:26 - Financial Implications of ASC vs. OBL 10:56 - Hybrid Model: Combining OBL and ASC for Flexibility 15:14 - Navigating the Complexities of ASC Development 20:03 - Real Estate Strategies for OBL and ASC Projects 22:50 - Staffing Considerations and Physician Entrepreneur Insights 35:17 - Future of OBL and ASC: Trends and Predictions 39:43 - Closing Thoughts and Resources for Further Learning --- RESOURCES Ambulatory Surgery Center Association: https://www.ascassociation.org/home OEIS Annual Meeting 2024 Las Vegas: https://oeisweb.com/meetings/2024-annual-meeting/ Accountable Physician Advisors (Teri’s consulting firm): http://www.accountablephysicianadvisors.com/services DocCentric: https://doccentricasc.com/ NOON Development Company: https://noondevelopment.com/ BT VI Episode #366 - Navigating OBL & ASC Business: Pitfalls to Avoid with Teri Yates: https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid BT VI Episode #202 - Staffing the OBL with Dr. Krishna Mannava and Kristin Longwell: https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl BT VI Episode #129 - OBL / ASC Business Pearls with Dr. Jim Melton: https://www.backtable.com/shows/vi/podcasts/129/obl-asc-business-pearls BI VI Episode #121 - Office-Based Labs (OBLs) & What You Can Do in Them with Dr. Mike Watts: https://www.backtable.com/shows/vi/podcasts/121/office-based-labs-obls-what-you-can-do-in-them BT VI Episode #42 - Building an Outpatient UFE Practice with Dr. Mary Costantino: https://www.backtable.com/shows/vi/podcasts/36/building-an-outpatient-ufe-practice Tue, 02 Apr 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, Teri Yates explores the nuances of choosing between an Office-Based Lab (OBL) and Ambulatory Surgery Center (ASC) for private practices. In this episode of the BackTable Podcast, Teri Yates explores the nuances of choosing between an Office-Based Lab (OBL) and Ambulatory Surgery Center (ASC) for private practices. Teri is the CEO of Accountable Physician Advisors, a consulting firm which specializes in OBLs, ASCs, and hybrid models for private-practice physicians. She is also President of DocCentric, a company focused on supporting physicians building and leading their own ASCs. The discussion includes a comprehensive analysis of the financial, regulatory, and operational considerations for physicians contemplating this decision. This includes insights into reimbursement models, Medicare regulations, and the strategic advantages of each model. The episode also touches on the importance of feasibility studies, partnerships with other specialties, and real estate strategies when developing these facilities. The conversation provides valuable advice for navigating the complexities of ASC development and emphasizes the value of maintaining independence and leveraging physician-owned models for long-term success. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 04:19 - Deep Dive into OBL and ASC: Definitions, Differences, and Decisions 07:26 - Financial Implications of ASC vs. OBL 10:56 - Hybrid Model: Combining OBL and ASC for Flexibility 15:14 - Navigating the Complexities of ASC Development 20:03 - Real Estate Strategies for OBL and ASC Projects 22:50 - Staffing Considerations and Physician Entrepreneur Insights 35:17 - Future of OBL and ASC: Trends and Predictions 39:43 - Closing Thoughts and Resources for Further Learning --- RESOURCES Ambulatory Surgery Center Association: https://www.ascassociation.org/home OEIS Annual Meeting 2024 Las Vegas: https://oeisweb.com/meetings/2024-annual-meeting/ Accountable Physician Advisors (Teri’s consulting firm): http://www.accountablephysicianadvisors.com/services DocCentric: https://doccentricasc.com/ NOON Development Company: https://noondevelopment.com/ BT VI Episode #366 - Navigating OBL & ASC Business: Pitfalls to Avoid with Teri Yates: https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid BT VI Episode #202 - Staffing the OBL with Dr. Krishna Mannava and Kristin Longwell: https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl BT VI Episode #129 - OBL / ASC Business Pearls with Dr. Jim Melton: https://www.backtable.com/shows/vi/podcasts/129/obl-asc-business-pearls BI VI Episode #121 - Office-Based Labs (OBLs) & What You Can Do in Them with Dr. Mike Watts: https://www.backtable.com/shows/vi/podcasts/121/office-based-labs-obls-what-you-can-do-in-them BT VI Episode #42 - Building an Outpatient UFE Practice with Dr. Mary Costantino: https://www.backtable.com/shows/vi/podcasts/36/building-an-outpatient-ufe-practice In this episode of the BackTable Podcast, Teri Yates explores the nuances of choosing between an Office-Based Lab (OBL) and Ambulatory Surgery Center (ASC) for private practices. Teri is the CEO of Accountable Physician Advisors, a consulting firm which specializes in OBLs, ASCs, and hybrid models for private-practice physicians. She is also President of DocCentric, a company focused on supporting physicians building and leading their own ASCs.


The discussion includes a comprehensive analysis of the financial, regulatory, and operational considerations for physicians contemplating this decision. This includes insights into reimbursement models, Medicare regulations, and the strategic advantages of each model. The episode also touches on the importance of feasibility studies, partnerships with other specialties, and real estate strategies when developing these facilities. The conversation provides valuable advice for navigating the complexities of ASC development and emphasizes the value of maintaining independence and leveraging physician-owned models for long-term success.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

04:19 - Deep Dive into OBL and ASC: Definitions, Differences, and Decisions

07:26 - Financial Implications of ASC vs. OBL

10:56 - Hybrid Model: Combining OBL and ASC for Flexibility

15:14 - Navigating the Complexities of ASC Development

20:03 - Real Estate Strategies for OBL and ASC Projects

22:50 - Staffing Considerations and Physician Entrepreneur Insights

35:17 - Future of OBL and ASC: Trends and Predictions

39:43 - Closing Thoughts and Resources for Further Learning


---


RESOURCES


Ambulatory Surgery Center Association:

https://www.ascassociation.org/home


OEIS Annual Meeting 2024 Las Vegas:

https://oeisweb.com/meetings/2024-annual-meeting/


Accountable Physician Advisors (Teri’s consulting firm):

http://www.accountablephysicianadvisors.com/services


DocCentric:

https://doccentricasc.com/


NOON Development Company:

https://noondevelopment.com/


BT VI Episode #366 - Navigating OBL & ASC Business: Pitfalls to Avoid with Teri Yates:

https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid


BT VI Episode #202 - Staffing the OBL with Dr. Krishna Mannava and Kristin Longwell:

https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl


BT VI Episode #129 - OBL / ASC Business Pearls with Dr. Jim Melton:

https://www.backtable.com/shows/vi/podcasts/129/obl-asc-business-pearls


BI VI Episode #121 - Office-Based Labs (OBLs) & What You Can Do in Them with Dr. Mike Watts:

https://www.backtable.com/shows/vi/podcasts/121/office-based-labs-obls-what-you-can-do-in-them


BT VI Episode #42 - Building an Outpatient UFE Practice with Dr. Mary Costantino:

https://www.backtable.com/shows/vi/podcasts/36/building-an-outpatient-ufe-practice

]]> 2858 Ep. 430 Navigating Insurance Contracts in the OBL Setting with Dr. Deepak Sudheendra and Laurie Bouzarelos In this episode of the BackTable Podcast, host Dr. Ally Baheti interviews Dr. Deepak Sudheendra and Laurie Bouzarelos about the complexities of navigating insurance for procedures performed in vascular and interventional radiology outpatient-based labs (OBLs). Dr. Sudheendra is an interventional radiologist at 360 Vascular Solutions in Dublin, Ohio and Laurie Bouzarelos is the founder and owner of Provider Solutions, a small business which focuses on coaching private practice and business-owning physicians on payor contracting. The conversation illuminates common challenges faced by physicians when negotiating insurance contracts, and it emphasizes the lack of awareness among insurance companies about the roles of IRs and the significance of OBLs. Laurie Bouzarelos shares her expertise on insurance contracting, highlighting the importance of education, strategy, and patient-focused care in achieving favorable contract terms. The episode delves into tactics for contract negotiation, leveraging data for better rates, and the critical role of in-house billing for financial transparency and control. Dr. Sudheendra shares his personal journey and the tenacity required to educate insurance providers about IR and OBLs. He underscores the broader need for healthcare professionals to advocate vigorously for their both patient care standards and their financial interests. The episode also includes practical insights for setting up a fee schedule, understanding market dynamics, and the potential pitfalls in standard contracts. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:14 - Journey of Insurance Contracting: From Confusion to Clarity 10:08 - Art of Negotiation: Laurie’s Unique Coaching Model 19:53 - Leveraging Data for Effective Insurance Negotiations 25:17 - Power of Negotiation: Changing the Game in Insurance Contracting 28:09 - Exploring the Challenges of Physician Negotiations with Insurance Companies 31:54 - Power of Personal Advocacy and Site Visits in Negotiations 36:45 - Navigating Contract Renegotiations and Understanding Fee Schedules 40:56 - Importance of In-House Billing and Vigilant Fee Management 52:16 - Final Advice: The Importance of Negotiation and Understanding Your Business --- RESOURCES Provider Solutions (Laurie Bouzarelos’ company): https://www.providersolutionsconsulting.com/about Fri, 29 Mar 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Ally Baheti interviews Dr. Deepak Sudheendra and Laurie Bouzarelos about the complexities of navigating insurance for procedures performed in vascular and interventional radiology outpatient-based labs (OBLs). In this episode of the BackTable Podcast, host Dr. Ally Baheti interviews Dr. Deepak Sudheendra and Laurie Bouzarelos about the complexities of navigating insurance for procedures performed in vascular and interventional radiology outpatient-based labs (OBLs). Dr. Sudheendra is an interventional radiologist at 360 Vascular Solutions in Dublin, Ohio and Laurie Bouzarelos is the founder and owner of Provider Solutions, a small business which focuses on coaching private practice and business-owning physicians on payor contracting. The conversation illuminates common challenges faced by physicians when negotiating insurance contracts, and it emphasizes the lack of awareness among insurance companies about the roles of IRs and the significance of OBLs. Laurie Bouzarelos shares her expertise on insurance contracting, highlighting the importance of education, strategy, and patient-focused care in achieving favorable contract terms. The episode delves into tactics for contract negotiation, leveraging data for better rates, and the critical role of in-house billing for financial transparency and control. Dr. Sudheendra shares his personal journey and the tenacity required to educate insurance providers about IR and OBLs. He underscores the broader need for healthcare professionals to advocate vigorously for their both patient care standards and their financial interests. The episode also includes practical insights for setting up a fee schedule, understanding market dynamics, and the potential pitfalls in standard contracts. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:14 - Journey of Insurance Contracting: From Confusion to Clarity 10:08 - Art of Negotiation: Laurie’s Unique Coaching Model 19:53 - Leveraging Data for Effective Insurance Negotiations 25:17 - Power of Negotiation: Changing the Game in Insurance Contracting 28:09 - Exploring the Challenges of Physician Negotiations with Insurance Companies 31:54 - Power of Personal Advocacy and Site Visits in Negotiations 36:45 - Navigating Contract Renegotiations and Understanding Fee Schedules 40:56 - Importance of In-House Billing and Vigilant Fee Management 52:16 - Final Advice: The Importance of Negotiation and Understanding Your Business --- RESOURCES Provider Solutions (Laurie Bouzarelos’ company): https://www.providersolutionsconsulting.com/about In this episode of the BackTable Podcast, host Dr. Ally Baheti interviews Dr. Deepak Sudheendra and Laurie Bouzarelos about the complexities of navigating insurance for procedures performed in vascular and interventional radiology outpatient-based labs (OBLs).


Dr. Sudheendra is an interventional radiologist at 360 Vascular Solutions in Dublin, Ohio and Laurie Bouzarelos is the founder and owner of Provider Solutions, a small business which focuses on coaching private practice and business-owning physicians on payor contracting.


The conversation illuminates common challenges faced by physicians when negotiating insurance contracts, and it emphasizes the lack of awareness among insurance companies about the roles of IRs and the significance of OBLs. Laurie Bouzarelos shares her expertise on insurance contracting, highlighting the importance of education, strategy, and patient-focused care in achieving favorable contract terms. The episode delves into tactics for contract negotiation, leveraging data for better rates, and the critical role of in-house billing for financial transparency and control. Dr. Sudheendra shares his personal journey and the tenacity required to educate insurance providers about IR and OBLs. He underscores the broader need for healthcare professionals to advocate vigorously for their both patient care standards and their financial interests. The episode also includes practical insights for setting up a fee schedule, understanding market dynamics, and the potential pitfalls in standard contracts.


---


CHECK OUT OUR SPONSORS


Varian, a Siemens Healthineers company

https://www.siemens-healthineers.com/


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

03:14 - Journey of Insurance Contracting: From Confusion to Clarity

10:08 - Art of Negotiation: Laurie’s Unique Coaching Model

19:53 - Leveraging Data for Effective Insurance Negotiations

25:17 - Power of Negotiation: Changing the Game in Insurance Contracting

28:09 - Exploring the Challenges of Physician Negotiations with Insurance Companies

31:54 - Power of Personal Advocacy and Site Visits in Negotiations

36:45 - Navigating Contract Renegotiations and Understanding Fee Schedules

40:56 - Importance of In-House Billing and Vigilant Fee Management

52:16 - Final Advice: The Importance of Negotiation and Understanding Your Business


---


RESOURCES


Provider Solutions (Laurie Bouzarelos’ company):

https://www.providersolutionsconsulting.com/about

]]> 3493 Ep. 429 Tackling Upper GI Bleeds: Techniques and Tools with Dr. Osman Ahmed In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews Dr. Osman Ahmed about treatment algorithms and new technologies for upper gastrointestinal (GI) bleed embolization. Dr. Ahmed is an interventional radiologist at the University of Chicago. The doctors dive into various embolization techniques, microcatheters, and embolic materials that are ideal for managing upper GI bleeds. Dr. Ahmed highlights the importance of understanding the etiology of bleeding, differences between arterial vs. venous bleeding, and first-line therapies such as endoscopy. Dr. Ahmed also discusses the utilization of new embolic materials like Obsidio Embolic, which is designed specifically for peripheral use, and its advantages in achieving rapid and complete vessel occlusion. Additionally, the doctors cover pre-procedural imaging, procedural techniques, and operator preferences for microcatheters and embolic devices. They emphasize the procedural nuances, operator comfort, and evolving technologies in the management of GI bleeds. --- CHECK OUT OUR SPONSOR Boston Scientific Obsidio Embolics https://www.bostonscientific.com/obsidio --- SHOW NOTES 00:00 - Introduction 03:29 - Discussion on Upper GI Bleeds 06:35 - Pre-Procedure Imaging for Upper GI Bleeds 11:16 - Procedure Walkthrough for Upper GI Embolization 19:51 - Understanding Mesenteric Anatomy 22:50 - Embolization Devices: Coils and More 25:31 - Exploring Obsidio: A New Embolic 32:55 - Post-Procedure Care 34:17 - Case Discussions and Final Thoughts --- RESOURCES Navigating Early Cases with the Obsidio™ Conformable Embolic - GEST 2023 Webinar with Dr. Ahmed: https://thegestgroup.com/webinar-featuring-obsidio/ BackTable VI Episode #179 - Happiness is a Warm Coil: Treating GI Bleeds with Dr. Donald Garbett: https://www.backtable.com/shows/vi/podcasts/179/happiness-is-a-warm-coil-treating-gi-bleeds BackTable VI Episode #216 - Stick It: Glue Embo with Dr. Ziv Haskal: https://www.backtable.com/shows/vi/podcasts/216/stick-it-glue-embo BackTable VI Episode #321 - New Innovations in Lower GI Bleed Embolization with Dr. Kevin Henseler: https://www.backtable.com/shows/vi/podcasts/321/new-innovations-in-lower-gi-bleed-embolization Obsidio - Conformable Embolic: https://www.bostonscientific.com/obsidio Tue, 26 Mar 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews Dr. Osman Ahmed about treatment algorithms and new technologies for upper gastrointestinal (GI) bleed embolization. In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews Dr. Osman Ahmed about treatment algorithms and new technologies for upper gastrointestinal (GI) bleed embolization. Dr. Ahmed is an interventional radiologist at the University of Chicago. The doctors dive into various embolization techniques, microcatheters, and embolic materials that are ideal for managing upper GI bleeds. Dr. Ahmed highlights the importance of understanding the etiology of bleeding, differences between arterial vs. venous bleeding, and first-line therapies such as endoscopy. Dr. Ahmed also discusses the utilization of new embolic materials like Obsidio Embolic, which is designed specifically for peripheral use, and its advantages in achieving rapid and complete vessel occlusion. Additionally, the doctors cover pre-procedural imaging, procedural techniques, and operator preferences for microcatheters and embolic devices. They emphasize the procedural nuances, operator comfort, and evolving technologies in the management of GI bleeds. --- CHECK OUT OUR SPONSOR Boston Scientific Obsidio Embolics https://www.bostonscientific.com/obsidio --- SHOW NOTES 00:00 - Introduction 03:29 - Discussion on Upper GI Bleeds 06:35 - Pre-Procedure Imaging for Upper GI Bleeds 11:16 - Procedure Walkthrough for Upper GI Embolization 19:51 - Understanding Mesenteric Anatomy 22:50 - Embolization Devices: Coils and More 25:31 - Exploring Obsidio: A New Embolic 32:55 - Post-Procedure Care 34:17 - Case Discussions and Final Thoughts --- RESOURCES Navigating Early Cases with the Obsidio™ Conformable Embolic - GEST 2023 Webinar with Dr. Ahmed: https://thegestgroup.com/webinar-featuring-obsidio/ BackTable VI Episode #179 - Happiness is a Warm Coil: Treating GI Bleeds with Dr. Donald Garbett: https://www.backtable.com/shows/vi/podcasts/179/happiness-is-a-warm-coil-treating-gi-bleeds BackTable VI Episode #216 - Stick It: Glue Embo with Dr. Ziv Haskal: https://www.backtable.com/shows/vi/podcasts/216/stick-it-glue-embo BackTable VI Episode #321 - New Innovations in Lower GI Bleed Embolization with Dr. Kevin Henseler: https://www.backtable.com/shows/vi/podcasts/321/new-innovations-in-lower-gi-bleed-embolization Obsidio - Conformable Embolic: https://www.bostonscientific.com/obsidio In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews Dr. Osman Ahmed about treatment algorithms and new technologies for upper gastrointestinal (GI) bleed embolization. Dr. Ahmed is an interventional radiologist at the University of Chicago.


The doctors dive into various embolization techniques, microcatheters, and embolic materials that are ideal for managing upper GI bleeds. Dr. Ahmed highlights the importance of understanding the etiology of bleeding, differences between arterial vs. venous bleeding, and first-line therapies such as endoscopy. Dr. Ahmed also discusses the utilization of new embolic materials like Obsidio Embolic, which is designed specifically for peripheral use, and its advantages in achieving rapid and complete vessel occlusion. Additionally, the doctors cover pre-procedural imaging, procedural techniques, and operator preferences for microcatheters and embolic devices. They emphasize the procedural nuances, operator comfort, and evolving technologies in the management of GI bleeds.


---


CHECK OUT OUR SPONSOR


Boston Scientific Obsidio Embolics

https://www.bostonscientific.com/obsidio


---


SHOW NOTES


00:00 - Introduction

03:29 - Discussion on Upper GI Bleeds

06:35 - Pre-Procedure Imaging for Upper GI Bleeds

11:16 - Procedure Walkthrough for Upper GI Embolization

19:51 - Understanding Mesenteric Anatomy

22:50 - Embolization Devices: Coils and More

25:31 - Exploring Obsidio: A New Embolic

32:55 - Post-Procedure Care

34:17 - Case Discussions and Final Thoughts


---


RESOURCES


Navigating Early Cases with the Obsidio™ Conformable Embolic - GEST 2023 Webinar with Dr. Ahmed:

https://thegestgroup.com/webinar-featuring-obsidio/


BackTable VI Episode #179 - Happiness is a Warm Coil: Treating GI Bleeds with Dr. Donald Garbett:

https://www.backtable.com/shows/vi/podcasts/179/happiness-is-a-warm-coil-treating-gi-bleeds


BackTable VI Episode #216 - Stick It: Glue Embo with Dr. Ziv Haskal:

https://www.backtable.com/shows/vi/podcasts/216/stick-it-glue-embo


BackTable VI Episode #321 - New Innovations in Lower GI Bleed Embolization with Dr. Kevin Henseler:

https://www.backtable.com/shows/vi/podcasts/321/new-innovations-in-lower-gi-bleed-embolization


Obsidio - Conformable Embolic:

https://www.bostonscientific.com/obsidio

]]> 2321 Ep. 428 Radial Access Evolution: Clinical Perspectives and Insights from the RAVI Registry with Dr. Marcelo Guimaraes In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Marcelo Guimaraes about the advantages and implementation of radial access in interventional radiology. Dr. Guimaraes is a vascular and interventional radiologist from the Medical University of South Carolina (MUSC). Dr. Guimaraes shares insights on the adoption of radial access over femoral access, emphasizing its simplicity, safety, and the clear benefits recognized by younger interventionalists. He elaborates on the importance of education, partnership with the industry, and following a standard protocol to build a successful radial access program. The doctors also cover specific topics like the RAVI Registry outcomes, patient preferences for radial access based on a study, the cost-benefit analysis, and handling various challenges such as artery spasms and loops. Dr. Guimaraes advocates for radial access as the default method for embolization therapies, highlighting its efficacy across a range of procedures and patient conditions. --- CHECK OUT OUR SPONSOR Medtronic Concerto https://mobile.twitter.com/mdtvascular --- SHOW NOTES 00:00 - Introduction 02:56 - Insights into MUSC’s Interventional Radiology Program 04:44 - Emergence of Radial Access in Interventional Procedures 07:04 - Challenges and Solutions in Setting Up a Radial Access Program 10:14 - Essential Equipment for Radial Access 22:20 - Addressing Spasm Challenges in Radial Access 30:11 - Patient Preference: Radial vs Femoral Access 32:46 - Safety and Efficacy of Radial Access: The Data 41:11 - Post-procedure Hemostasis Protocol 43:51 - Optimal Radial Artery Access Point and Best Practices --- RESOURCES How To Do The Barbeau Test - BackTable Demo: https://www.backtable.com/shows/vi/demos/how-to-do-the-barbeau-test Comparison of transradial coronary procedures via right radial versus left radial artery approach: A meta-analysis: https://pubmed.ncbi.nlm.nih.gov/27037544/ Transradial Versus Transfemoral Arterial Access in Liver Cancer Embolization: Randomized Trial to Assess Patient Satisfaction (Dr. Guimaraes paper): https://pubmed.ncbi.nlm.nih.gov/29150395/ An Update on Radial Artery Access and Best Practices for Transradial Coronary Angiography and Intervention in Acute Coronary Syndrome: A Scientific Statement From the American Heart Association: https://www.ahajournals.org/doi/full/10.1161/HCV.0000000000000035 The RAVI registry: prospective, multicenter study of radial access in embolization procedures – 30 days follow up: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10828405/ Fri, 22 Mar 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Marcelo Guimaraes about the advantages and implementation of radial access in interventional radiology. In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Marcelo Guimaraes about the advantages and implementation of radial access in interventional radiology. Dr. Guimaraes is a vascular and interventional radiologist from the Medical University of South Carolina (MUSC). Dr. Guimaraes shares insights on the adoption of radial access over femoral access, emphasizing its simplicity, safety, and the clear benefits recognized by younger interventionalists. He elaborates on the importance of education, partnership with the industry, and following a standard protocol to build a successful radial access program. The doctors also cover specific topics like the RAVI Registry outcomes, patient preferences for radial access based on a study, the cost-benefit analysis, and handling various challenges such as artery spasms and loops. Dr. Guimaraes advocates for radial access as the default method for embolization therapies, highlighting its efficacy across a range of procedures and patient conditions. --- CHECK OUT OUR SPONSOR Medtronic Concerto https://mobile.twitter.com/mdtvascular --- SHOW NOTES 00:00 - Introduction 02:56 - Insights into MUSC’s Interventional Radiology Program 04:44 - Emergence of Radial Access in Interventional Procedures 07:04 - Challenges and Solutions in Setting Up a Radial Access Program 10:14 - Essential Equipment for Radial Access 22:20 - Addressing Spasm Challenges in Radial Access 30:11 - Patient Preference: Radial vs Femoral Access 32:46 - Safety and Efficacy of Radial Access: The Data 41:11 - Post-procedure Hemostasis Protocol 43:51 - Optimal Radial Artery Access Point and Best Practices --- RESOURCES How To Do The Barbeau Test - BackTable Demo: https://www.backtable.com/shows/vi/demos/how-to-do-the-barbeau-test Comparison of transradial coronary procedures via right radial versus left radial artery approach: A meta-analysis: https://pubmed.ncbi.nlm.nih.gov/27037544/ Transradial Versus Transfemoral Arterial Access in Liver Cancer Embolization: Randomized Trial to Assess Patient Satisfaction (Dr. Guimaraes paper): https://pubmed.ncbi.nlm.nih.gov/29150395/ An Update on Radial Artery Access and Best Practices for Transradial Coronary Angiography and Intervention in Acute Coronary Syndrome: A Scientific Statement From the American Heart Association: https://www.ahajournals.org/doi/full/10.1161/HCV.0000000000000035 The RAVI registry: prospective, multicenter study of radial access in embolization procedures – 30 days follow up: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10828405/ In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Marcelo Guimaraes about the advantages and implementation of radial access in interventional radiology. Dr. Guimaraes is a vascular and interventional radiologist from the Medical University of South Carolina (MUSC).


Dr. Guimaraes shares insights on the adoption of radial access over femoral access, emphasizing its simplicity, safety, and the clear benefits recognized by younger interventionalists. He elaborates on the importance of education, partnership with the industry, and following a standard protocol to build a successful radial access program. The doctors also cover specific topics like the RAVI Registry outcomes, patient preferences for radial access based on a study, the cost-benefit analysis, and handling various challenges such as artery spasms and loops. Dr. Guimaraes advocates for radial access as the default method for embolization therapies, highlighting its efficacy across a range of procedures and patient conditions.


---


CHECK OUT OUR SPONSOR


Medtronic Concerto

https://mobile.twitter.com/mdtvascular


---


SHOW NOTES


00:00 - Introduction

02:56 - Insights into MUSC’s Interventional Radiology Program

04:44 - Emergence of Radial Access in Interventional Procedures

07:04 - Challenges and Solutions in Setting Up a Radial Access Program

10:14 - Essential Equipment for Radial Access

22:20 - Addressing Spasm Challenges in Radial Access

30:11 - Patient Preference: Radial vs Femoral Access

32:46 - Safety and Efficacy of Radial Access: The Data

41:11 - Post-procedure Hemostasis Protocol

43:51 - Optimal Radial Artery Access Point and Best Practices


---


RESOURCES


How To Do The Barbeau Test - BackTable Demo:

https://www.backtable.com/shows/vi/demos/how-to-do-the-barbeau-test


Comparison of transradial coronary procedures via right radial versus left radial artery approach: A meta-analysis:

https://pubmed.ncbi.nlm.nih.gov/27037544/


Transradial Versus Transfemoral Arterial Access in Liver Cancer Embolization: Randomized Trial to Assess Patient Satisfaction (Dr. Guimaraes paper):

https://pubmed.ncbi.nlm.nih.gov/29150395/


An Update on Radial Artery Access and Best Practices for Transradial Coronary Angiography and Intervention in Acute Coronary Syndrome: A Scientific Statement From the American Heart Association:

https://www.ahajournals.org/doi/full/10.1161/HCV.0000000000000035


The RAVI registry: prospective, multicenter study of radial access in embolization procedures – 30 days follow up:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10828405/

]]> 3136 Ep. 427 TREAT Symposium: Advancing Clinical Education with Live Cases with Dr. Aaron Fischman In this episode of BackTable Podcast, host Dr. Sabeen Dhand interviews guest Dr. Aaron Fischman about the TREAT Symposium and its evolution into TREAT Live, a platform for broadcasting live endovascular cases. Dr. Fischman is a vascular and interventional radiologist at Mount Sinai in New York. Dr. Fischman details the journey from TREAT’s inception as a conference focused on radial interventions to its current form, which includes a monthly live case streaming setup aimed at providing continuous medical education. The discussion covers the strategic shift from annual conferences to monthly live streams due to the pandemic, the logistical challenges and solutions for setting up live broadcasts, and the educational benefits of showcasing live cases, including the potential for offering CME credits. Dr. Fischman also shares insights into the selection of cases and operators, emphasizing the diversity of cases and the future direction of the program. The doctors also underscore the importance of innovation in medical education and the potential of live case broadcasts to enhance learning and improve patient care. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ --- SHOW NOTES 00:00 - Introduction 01:53 - Meet Dr. Aaron Fischman: A Pioneer in Transradial Interventions 02:19 - Evolution of TREAT Symposium: From Concept to Live Cases 06:06 - TREAT Live’s Monthly Case Broadcasts 10:28 - Future of Medical Education: Live Cases and CME Credits 16:32 - Impact and Expansion of TREAT Live --- RESOURCES TREAT Live: https://treatsymposium.com/ BackTable VI Episode #30 - Transradial Access: Basic to Advanced with Dr. Aaron Fischman: https://www.backtable.com/shows/vi/podcasts/30/transradial-access-basic-to-advanced Wed, 20 Mar 2024 07:00:00 -0000 full BackTable In this episode of BackTable Podcast, host Dr. Sabeen Dhand interviews guest Dr. Aaron Fischman about the TREAT Symposium and its evolution into TREAT Live, a platform for broadcasting live endovascular cases. In this episode of BackTable Podcast, host Dr. Sabeen Dhand interviews guest Dr. Aaron Fischman about the TREAT Symposium and its evolution into TREAT Live, a platform for broadcasting live endovascular cases. Dr. Fischman is a vascular and interventional radiologist at Mount Sinai in New York. Dr. Fischman details the journey from TREAT’s inception as a conference focused on radial interventions to its current form, which includes a monthly live case streaming setup aimed at providing continuous medical education. The discussion covers the strategic shift from annual conferences to monthly live streams due to the pandemic, the logistical challenges and solutions for setting up live broadcasts, and the educational benefits of showcasing live cases, including the potential for offering CME credits. Dr. Fischman also shares insights into the selection of cases and operators, emphasizing the diversity of cases and the future direction of the program. The doctors also underscore the importance of innovation in medical education and the potential of live case broadcasts to enhance learning and improve patient care. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ --- SHOW NOTES 00:00 - Introduction 01:53 - Meet Dr. Aaron Fischman: A Pioneer in Transradial Interventions 02:19 - Evolution of TREAT Symposium: From Concept to Live Cases 06:06 - TREAT Live’s Monthly Case Broadcasts 10:28 - Future of Medical Education: Live Cases and CME Credits 16:32 - Impact and Expansion of TREAT Live --- RESOURCES TREAT Live: https://treatsymposium.com/ BackTable VI Episode #30 - Transradial Access: Basic to Advanced with Dr. Aaron Fischman: https://www.backtable.com/shows/vi/podcasts/30/transradial-access-basic-to-advanced In this episode of BackTable Podcast, host Dr. Sabeen Dhand interviews guest Dr. Aaron Fischman about the TREAT Symposium and its evolution into TREAT Live, a platform for broadcasting live endovascular cases. Dr. Fischman is a vascular and interventional radiologist at Mount Sinai in New York.


Dr. Fischman details the journey from TREAT’s inception as a conference focused on radial interventions to its current form, which includes a monthly live case streaming setup aimed at providing continuous medical education. The discussion covers the strategic shift from annual conferences to monthly live streams due to the pandemic, the logistical challenges and solutions for setting up live broadcasts, and the educational benefits of showcasing live cases, including the potential for offering CME credits. Dr. Fischman also shares insights into the selection of cases and operators, emphasizing the diversity of cases and the future direction of the program. The doctors also underscore the importance of innovation in medical education and the potential of live case broadcasts to enhance learning and improve patient care.


---


CHECK OUT OUR SPONSOR


Varian, a Siemens Healthineers company

https://www.siemens-healthineers.com/


---


SHOW NOTES


00:00 - Introduction

01:53 - Meet Dr. Aaron Fischman: A Pioneer in Transradial Interventions

02:19 - Evolution of TREAT Symposium: From Concept to Live Cases

06:06 - TREAT Live’s Monthly Case Broadcasts

10:28 - Future of Medical Education: Live Cases and CME Credits

16:32 - Impact and Expansion of TREAT Live


---


RESOURCES


TREAT Live:

https://treatsymposium.com/


BackTable VI Episode #30 - Transradial Access: Basic to Advanced with Dr. Aaron Fischman:

https://www.backtable.com/shows/vi/podcasts/30/transradial-access-basic-to-advanced

]]> 1292 Ep. 426 Managing Pelvic Venous Disease: From Diagnosis to Treatment with Dr. Neil Khilnani In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews Dr. Neil Khilnani about the management of pelvic venous disorders, focusing on embolization practices for treating conditions such as chronic pelvic pain and pelvic venous syndrome. Dr. Khilnani is an interventional radiologist at Weill Cornell Medicine in New York Presbyterian Hospital. --- CHECK OUT OUR SPONSOR Cook Medical Embolization https://www.cookmedical.com/embobacktable --- SYNPOSIS Dr. Khilnani discusses the significance of identifying and treating venous disorders in patients with chronic pelvic pain. He emphasizes the need for a comprehensive approach that includes detailed patient history, physical exams, and imaging techniques such as ultrasound, CT, and MRI for accurate diagnosis. The doctors also cover the evolution of embolization techniques, including the use of balloon occlusion and sclerosants and they underscore the importance of addressing underlying venous insufficiencies for effective pain management. Additionally, Dr. Khilnani highlights the interconnectedness of various pelvic symptoms and the potential for embolization to alleviate not just pelvic pain, but also related conditions such as painful bladder syndrome and orthostatic hypotension. The doctors acknowledge the ongoing research and the need for collaboration across specialties to improve patient outcomes in pelvic venous disorder. --- TIMESTAMPS 00:00 - Introduction 04:44 - Pelvic Venous Disease 09:20 - Prevalence of Pelvic Venous Disease 13:54 - Challenges in Communication with Referring Doctors 18:32 - Workup and Diagnosis of Pelvic Venous Disorders 30:08 - Treatment Options and Patient Education 36:19 - Role of Social Media in Patient Support Networks 37:04 - Procedure: From Planning to Execution to Post-Intervention 54:07 - Navigating Difficult Anatomy and Potential Complications 01:02:34 - Future of Pelvic Venous Disorders Treatment: Research and Trials --- RESOURCES BackTable VI Episode 389 - Pelvic PT: An Introduction for Interventionalists with Ingrid Harm-Ernandes, PT: https://www.backtable.com/shows/vi/podcasts/389/pelvic-pt-an-introduction-for-interventionalists BackTable VI Episode 337 - Management of Vulvar Varices with Dr. Brooke Spencer: https://www.backtable.com/shows/vi/podcasts/337/management-of-vulvar-varices BackTable VI Episode 101 - Pelvic Congestion Syndrome Part 1: Diagnosis and Planning with Dr. Mark Meissner and Dr. Michael Cumming: https://www.backtable.com/shows/vi/podcasts/101/pelvic-congestion-syndrome-part-1-diagnosis-planning BackTable VI Episode 101 - Pelvic Congestion Syndrome Part 2: Technique and Follow-Up with Dr. Mark Meissner and Dr. Michael Cumming: https://www.backtable.com/shows/vi/podcasts/102/pelvic-congestion-syndrome-part-2-technique-follow-up A standardized ultrasound approach to pelvic congestion syndrome (Labropoulos et al): https://pubmed.ncbi.nlm.nih.gov/27799418/ Comparison of Fibered versus Nonfibered Coils for Venous Embolization in an Ovine Model (White et al): https://pubmed.ncbi.nlm.nih.gov/37105664/ Pelvic Venous Disorders in Women due to Pelvic Varices: Treatment by Embolization: Experience in 520 Patients (De Gregorio et al): https://www.jvir.org/article/S1051-0443(20)30534-0/abstract Improvement in chronic pelvic pain, orthostatic intolerance and interstitial cystitis symptoms after treatment of pelvic vein insufficiency (Smith et al): https://journals.sagepub.com/doi/abs/10.1177/02683555231219737 The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders: https://www.jvsvenous.org/article/S2213-333X(21)00071-8/fulltext Research Priorities in Pelvic Venous Disorders in Women: Recommendations from a Multidisciplinary Research Consensus Panel: https://pubmed.ncbi.nlm.nih.gov/30857986/ Find this episode on BackTable.com for the full list of resources. Tue, 19 Mar 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews Dr. Neil Khilnani about the management of pelvic venous disorders, focusing on embolization practices for treating conditions such as chronic pelvic pain and pelvic venous syndrome. Dr. Khilnani is an interventional radiologist at Weill Cornell Medicine in New York Presbyterian Hospital. --- CHECK OUT OUR SPONSOR Cook Medical Embolization https://www.cookmedical.com/embobacktable --- SYNPOSIS Dr. Khilnani discusses the significance of identifying and treating venous disorders in patients with chronic pelvic pain. He emphasizes the need for a comprehensive approach that includes detailed patient history, physical exams, and imaging techniques such as ultrasound, CT, and MRI for accurate diagnosis. The doctors also cover the evolution of embolization techniques, including the use of balloon occlusion and sclerosants and they underscore the importance of addressing underlying venous insufficiencies for effective pain management. Additionally, Dr. Khilnani highlights the interconnectedness of various pelvic symptoms and the potential for embolization to alleviate not just pelvic pain, but also related conditions such as painful bladder syndrome and orthostatic hypotension. The doctors acknowledge the ongoing research and the need for collaboration across specialties to improve patient outcomes in pelvic venous disorder. --- TIMESTAMPS 00:00 - Introduction 04:44 - Pelvic Venous Disease 09:20 - Prevalence of Pelvic Venous Disease 13:54 - Challenges in Communication with Referring Doctors 18:32 - Workup and Diagnosis of Pelvic Venous Disorders 30:08 - Treatment Options and Patient Education 36:19 - Role of Social Media in Patient Support Networks 37:04 - Procedure: From Planning to Execution to Post-Intervention 54:07 - Navigating Difficult Anatomy and Potential Complications 01:02:34 - Future of Pelvic Venous Disorders Treatment: Research and Trials --- RESOURCES BackTable VI Episode 389 - Pelvic PT: An Introduction for Interventionalists with Ingrid Harm-Ernandes, PT: https://www.backtable.com/shows/vi/podcasts/389/pelvic-pt-an-introduction-for-interventionalists BackTable VI Episode 337 - Management of Vulvar Varices with Dr. Brooke Spencer: https://www.backtable.com/shows/vi/podcasts/337/management-of-vulvar-varices BackTable VI Episode 101 - Pelvic Congestion Syndrome Part 1: Diagnosis and Planning with Dr. Mark Meissner and Dr. Michael Cumming: https://www.backtable.com/shows/vi/podcasts/101/pelvic-congestion-syndrome-part-1-diagnosis-planning BackTable VI Episode 101 - Pelvic Congestion Syndrome Part 2: Technique and Follow-Up with Dr. Mark Meissner and Dr. Michael Cumming: https://www.backtable.com/shows/vi/podcasts/102/pelvic-congestion-syndrome-part-2-technique-follow-up A standardized ultrasound approach to pelvic congestion syndrome (Labropoulos et al): https://pubmed.ncbi.nlm.nih.gov/27799418/ Comparison of Fibered versus Nonfibered Coils for Venous Embolization in an Ovine Model (White et al): https://pubmed.ncbi.nlm.nih.gov/37105664/ Pelvic Venous Disorders in Women due to Pelvic Varices: Treatment by Embolization: Experience in 520 Patients (De Gregorio et al): https://www.jvir.org/article/S1051-0443(20)30534-0/abstract Improvement in chronic pelvic pain, orthostatic intolerance and interstitial cystitis symptoms after treatment of pelvic vein insufficiency (Smith et al): https://journals.sagepub.com/doi/abs/10.1177/02683555231219737 The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders: https://www.jvsvenous.org/article/S2213-333X(21)00071-8/fulltext Research Priorities in Pelvic Venous Disorders in Women: Recommendations from a Multidisciplinary Research Consensus Panel: https://pubmed.ncbi.nlm.nih.gov/30857986/ Find this episode on BackTable.com for the full list of resources. In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews Dr. Neil Khilnani about the management of pelvic venous disorders, focusing on embolization practices for treating conditions such as chronic pelvic pain and pelvic venous syndrome. Dr. Khilnani is an interventional radiologist at Weill Cornell Medicine in New York Presbyterian Hospital.


---


CHECK OUT OUR SPONSOR


Cook Medical Embolization

https://www.cookmedical.com/embobacktable


---


SYNPOSIS


Dr. Khilnani discusses the significance of identifying and treating venous disorders in patients with chronic pelvic pain. He emphasizes the need for a comprehensive approach that includes detailed patient history, physical exams, and imaging techniques such as ultrasound, CT, and MRI for accurate diagnosis. The doctors also cover the evolution of embolization techniques, including the use of balloon occlusion and sclerosants and they underscore the importance of addressing underlying venous insufficiencies for effective pain management. Additionally, Dr. Khilnani highlights the interconnectedness of various pelvic symptoms and the potential for embolization to alleviate not just pelvic pain, but also related conditions such as painful bladder syndrome and orthostatic hypotension. The doctors acknowledge the ongoing research and the need for collaboration across specialties to improve patient outcomes in pelvic venous disorder.


---


TIMESTAMPS


00:00 - Introduction

04:44 - Pelvic Venous Disease

09:20 - Prevalence of Pelvic Venous Disease

13:54 - Challenges in Communication with Referring Doctors

18:32 - Workup and Diagnosis of Pelvic Venous Disorders

30:08 - Treatment Options and Patient Education

36:19 - Role of Social Media in Patient Support Networks

37:04 - Procedure: From Planning to Execution to Post-Intervention

54:07 - Navigating Difficult Anatomy and Potential Complications

01:02:34 - Future of Pelvic Venous Disorders Treatment: Research and Trials


---


RESOURCES


BackTable VI Episode 389 - Pelvic PT: An Introduction for Interventionalists with Ingrid Harm-Ernandes, PT:

https://www.backtable.com/shows/vi/podcasts/389/pelvic-pt-an-introduction-for-interventionalists


BackTable VI Episode 337 - Management of Vulvar Varices with Dr. Brooke Spencer:

https://www.backtable.com/shows/vi/podcasts/337/management-of-vulvar-varices


BackTable VI Episode 101 - Pelvic Congestion Syndrome Part 1: Diagnosis and Planning

with Dr. Mark Meissner and Dr. Michael Cumming:

https://www.backtable.com/shows/vi/podcasts/101/pelvic-congestion-syndrome-part-1-diagnosis-planning


BackTable VI Episode 101 - Pelvic Congestion Syndrome Part 2: Technique and Follow-Up with Dr. Mark Meissner and Dr. Michael Cumming:

https://www.backtable.com/shows/vi/podcasts/102/pelvic-congestion-syndrome-part-2-technique-follow-up


A standardized ultrasound approach to pelvic congestion syndrome (Labropoulos et al):

https://pubmed.ncbi.nlm.nih.gov/27799418/


Comparison of Fibered versus Nonfibered Coils for Venous Embolization in an Ovine Model (White et al):

https://pubmed.ncbi.nlm.nih.gov/37105664/


Pelvic Venous Disorders in Women due to Pelvic Varices: Treatment by Embolization: Experience in 520 Patients (De Gregorio et al):

https://www.jvir.org/article/S1051-0443(20)30534-0/abstract


Improvement in chronic pelvic pain, orthostatic intolerance and interstitial cystitis symptoms after treatment of pelvic vein insufficiency (Smith et al):

https://journals.sagepub.com/doi/abs/10.1177/02683555231219737


The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders:

https://www.jvsvenous.org/article/S2213-333X(21)00071-8/fulltext


Research Priorities in Pelvic Venous Disorders in Women: Recommendations from a Multidisciplinary Research Consensus Panel:

https://pubmed.ncbi.nlm.nih.gov/30857986/


Find this episode on BackTable.com for the full list of resources.

]]> 4246 Ep. 425 Solving for Stent Adjacent Stenosis: The Auxetics Story with Dr. Ramsey Al-Hakim In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ramsey Al-Hakim about the inception and journey of Auxetics, a med-tech company innovating in the vein stent market. Dr. Al-Hakim is the co-founder of Auxetics and the Section Chief of the Division of Interventional Radiology at Scripps Hospital in San Diego, CA. Dr. Al-Hakim covers the initial challenges of understanding the market and securing capital, the clinical significance of addressing stent-adjacent stenosis, and the process of developing a stent with a negative Poisson effect to counteract it. Dr. Al-Hakim highlights Auxetics' approach to combining cutting-edge interventional technologies with world-class imaging tools for enhanced procedural efficiency in venous interventions. The company’s progress through benchtop work, animal testing, and plans for first-in-human studies outside the U.S., aiming for commercialization within the next four to five years, is also outlined. Contributions from key figures in the vascular community and the role of mentorship and perseverance in navigating the complexities of medical device innovation are discussed as well. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:11 - The Market and Problem Solving 12:13 - Journey of Creating a Stent 22:28 - Birth of Auxetics 26:53 - Learning Process and Support from the University 29:16 - Building the Dream Team 33:01 - Starting a Company 36:42 - Challenges and Triumphs of Fundraising 37:44 - Current Status and Future Plans 45:32 - Importance of Community and Mentorship --- RESOURCES Auxetics: https://www.auxeticsinc.com In-stent restenosis and stent compression following stenting for chronic iliofemoral venous obstruction: https://pubmed.ncbi.nlm.nih.gov/34174500/ Venous Stenosis Animal Model Utilizing Endovenous Radiofrequency Ablation: https://pubmed.ncbi.nlm.nih.gov/30717966/ The Messy Middle: Finding Your Way Through the Hardest and Most Crucial Part of Any Bold Venture: https://www.amazon.com/Messy-Middle-Finding-Through-Hardest/dp/0735218072 Fri, 15 Mar 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ramsey Al-Hakim about the inception and journey of Auxetics, a med-tech company innovating in the vein stent market. In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ramsey Al-Hakim about the inception and journey of Auxetics, a med-tech company innovating in the vein stent market. Dr. Al-Hakim is the co-founder of Auxetics and the Section Chief of the Division of Interventional Radiology at Scripps Hospital in San Diego, CA. Dr. Al-Hakim covers the initial challenges of understanding the market and securing capital, the clinical significance of addressing stent-adjacent stenosis, and the process of developing a stent with a negative Poisson effect to counteract it. Dr. Al-Hakim highlights Auxetics' approach to combining cutting-edge interventional technologies with world-class imaging tools for enhanced procedural efficiency in venous interventions. The company’s progress through benchtop work, animal testing, and plans for first-in-human studies outside the U.S., aiming for commercialization within the next four to five years, is also outlined. Contributions from key figures in the vascular community and the role of mentorship and perseverance in navigating the complexities of medical device innovation are discussed as well. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:11 - The Market and Problem Solving 12:13 - Journey of Creating a Stent 22:28 - Birth of Auxetics 26:53 - Learning Process and Support from the University 29:16 - Building the Dream Team 33:01 - Starting a Company 36:42 - Challenges and Triumphs of Fundraising 37:44 - Current Status and Future Plans 45:32 - Importance of Community and Mentorship --- RESOURCES Auxetics: https://www.auxeticsinc.com In-stent restenosis and stent compression following stenting for chronic iliofemoral venous obstruction: https://pubmed.ncbi.nlm.nih.gov/34174500/ Venous Stenosis Animal Model Utilizing Endovenous Radiofrequency Ablation: https://pubmed.ncbi.nlm.nih.gov/30717966/ The Messy Middle: Finding Your Way Through the Hardest and Most Crucial Part of Any Bold Venture: https://www.amazon.com/Messy-Middle-Finding-Through-Hardest/dp/0735218072 In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ramsey Al-Hakim about the inception and journey of Auxetics, a med-tech company innovating in the vein stent market. Dr. Al-Hakim is the co-founder of Auxetics and the Section Chief of the Division of Interventional Radiology at Scripps Hospital in San Diego, CA.


Dr. Al-Hakim covers the initial challenges of understanding the market and securing capital, the clinical significance of addressing stent-adjacent stenosis, and the process of developing a stent with a negative Poisson effect to counteract it. Dr. Al-Hakim highlights Auxetics' approach to combining cutting-edge interventional technologies with world-class imaging tools for enhanced procedural efficiency in venous interventions. The company’s progress through benchtop work, animal testing, and plans for first-in-human studies outside the U.S., aiming for commercialization within the next four to five years, is also outlined. Contributions from key figures in the vascular community and the role of mentorship and perseverance in navigating the complexities of medical device innovation are discussed as well.


---


CHECK OUT OUR SPONSORS


Varian, a Siemens Healthineers company

https://www.siemens-healthineers.com/


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

03:11 - The Market and Problem Solving

12:13 - Journey of Creating a Stent

22:28 - Birth of Auxetics

26:53 - Learning Process and Support from the University

29:16 - Building the Dream Team

33:01 - Starting a Company

36:42 - Challenges and Triumphs of Fundraising

37:44 - Current Status and Future Plans

45:32 - Importance of Community and Mentorship


---


RESOURCES


Auxetics:

https://www.auxeticsinc.com


In-stent restenosis and stent compression following stenting for chronic iliofemoral venous obstruction:

https://pubmed.ncbi.nlm.nih.gov/34174500/


Venous Stenosis Animal Model Utilizing Endovenous Radiofrequency Ablation:

https://pubmed.ncbi.nlm.nih.gov/30717966/


The Messy Middle: Finding Your Way Through the Hardest and Most Crucial Part of Any Bold Venture:

https://www.amazon.com/Messy-Middle-Finding-Through-Hardest/dp/0735218072

]]> 3331 Ep. 424 Acute Limb Ischemia Diagnosis and Treatment with Dr. Dean Ferrera In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Dean Ferrera about treating acute limb ischemia with mechanical thrombectomy. Dr. Ferrera is an interventional cardiologist at Community Care Network in northwestern Indiana. Dr. Ferrera emphasizes the importance of interdisciplinary collaboration, early detection, and selection of appropriate intervention techniques. He also discusses threading issues, bleeding complications, use of lysis, and understanding the nature of clots. He recommends thrombectomy systems such as the Pounce Thrombectomy System for removing thrombus and embolus. Furthermore, Dr. Ferrera highlights the significance of continued learning and mentorship in managing these complex conditions. --- CHECK OUT OUR SPONSOR Surmodics Pounce Thrombectomy https://pouncesystem.com/ --- SHOW NOTES 00:00 - Introduction 04:21 - Patient Presentation and Workup 09:23 - Treatment Options for Acute Limb Ischemia 17:48 - Crossing the Clot and Treatment Options 25:18 - Device Capabilities and Limitations 28:43 - Procedure Steps and Reusability 31:26 - Device Selection and Aspiration Devices 37:07 - Post-Procedure Considerations and Follow-Up 43:16 - Complications and Risk Management --- RESOURCES Pounce Thrombectomy System: https://pouncesystem.com/ Thrombus Structural Composition in Cardiovascular Disease: https://pubmed.ncbi.nlm.nih.gov/34261330/ Tue, 12 Mar 2024 07:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Dean Ferrera about treating acute limb ischemia with mechanical thrombectomy. Dr. Ferrera is an interventional cardiologist at Community Care Network in northwestern Indiana. In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Dean Ferrera about treating acute limb ischemia with mechanical thrombectomy. Dr. Ferrera is an interventional cardiologist at Community Care Network in northwestern Indiana. Dr. Ferrera emphasizes the importance of interdisciplinary collaboration, early detection, and selection of appropriate intervention techniques. He also discusses threading issues, bleeding complications, use of lysis, and understanding the nature of clots. He recommends thrombectomy systems such as the Pounce Thrombectomy System for removing thrombus and embolus. Furthermore, Dr. Ferrera highlights the significance of continued learning and mentorship in managing these complex conditions. --- CHECK OUT OUR SPONSOR Surmodics Pounce Thrombectomy https://pouncesystem.com/ --- SHOW NOTES 00:00 - Introduction 04:21 - Patient Presentation and Workup 09:23 - Treatment Options for Acute Limb Ischemia 17:48 - Crossing the Clot and Treatment Options 25:18 - Device Capabilities and Limitations 28:43 - Procedure Steps and Reusability 31:26 - Device Selection and Aspiration Devices 37:07 - Post-Procedure Considerations and Follow-Up 43:16 - Complications and Risk Management --- RESOURCES Pounce Thrombectomy System: https://pouncesystem.com/ Thrombus Structural Composition in Cardiovascular Disease: https://pubmed.ncbi.nlm.nih.gov/34261330/ In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Dean Ferrera about treating acute limb ischemia with mechanical thrombectomy. Dr. Ferrera is an interventional cardiologist at Community Care Network in northwestern Indiana.


Dr. Ferrera emphasizes the importance of interdisciplinary collaboration, early detection, and selection of appropriate intervention techniques. He also discusses threading issues, bleeding complications, use of lysis, and understanding the nature of clots. He recommends thrombectomy systems such as the Pounce Thrombectomy System for removing thrombus and embolus. Furthermore, Dr. Ferrera highlights the significance of continued learning and mentorship in managing these complex conditions.


---


CHECK OUT OUR SPONSOR


Surmodics Pounce Thrombectomy

https://pouncesystem.com/


---


SHOW NOTES


00:00 - Introduction

04:21 - Patient Presentation and Workup

09:23 - Treatment Options for Acute Limb Ischemia

17:48 - Crossing the Clot and Treatment Options

25:18 - Device Capabilities and Limitations

28:43 - Procedure Steps and Reusability

31:26 - Device Selection and Aspiration Devices

37:07 - Post-Procedure Considerations and Follow-Up

43:16 - Complications and Risk Management


---


RESOURCES


Pounce Thrombectomy System:

https://pouncesystem.com/


Thrombus Structural Composition in Cardiovascular Disease:

https://pubmed.ncbi.nlm.nih.gov/34261330/

]]> 3111 Ep. 423 Next Level Electroporation Therapy: The RadioClash Story with Dr. John Qiao In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. John Qiao about exploration of physicians’ role in medical innovation, particularly among interventional radiologists. Dr. Qiao shares insightful information about the origin of RadioClash and details his journey as an entrepreneur. Through this discussion, Dr. Qiao covers the challenges encountered during the startup phase, the invention of a single-probe electroporation device, and the future applications of this novel medical technology. The episode concludes with broader advice on how to manage the demands of professional work, entrepreneurship, and personal life. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic Concerto https://mobile.twitter.com/mdtvascular --- SHOW NOTES 00:00 - Introduction 02:39 - Dr. Qiao’s Journey into Medicine and Entrepreneurship 11:40 - Birth of Radioclash: A Unique Solution for Cancer Treatment 17:58 - Future of RadioClash: Targeting Metastatic Cancer 25:20 - Future of Electroporation Therapy 35:21 - Challenges of Building a Company 44:37 - Path to Market and Future Plans 47:28 - Balancing Clinical Practice and Entrepreneurship --- RESOURCES RadioClash website: https://www.radioclash.co/ News Article on Dr. John Qiao: https://voyagehouston.com/interview/meet-john-qiao-m-d-of-radioclash-ltd-co/ Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086111/ The Abscopal Effect: A Reemerging Field of Interest: https://ascopost.com/issues/november-25-2018/the-abscopal-effect-a-reemerging-field-of-interest/ BackTable VI Episode #402 - Immunotherapy in HCC: Evolving Treatment Paradigms: https://www.backtable.com/shows/vi/podcasts/402/immunotherapy-in-hcc-evolving-treatment-paradigms Tavo and Pembrolizumab in Patients With Stage III/​IV Melanoma Progressing on Either Pembrolizumab or Nivolumab Treatment (Keynote-695): https://clinicaltrials.gov/study/NCT03132675 PANFIRE-3 Trial: Assessing Safety and Efficacy of Irreversible Electroporation (IRE) + Nivolumab + CpG for Metastatic Pancreatic Cancer: https://classic.clinicaltrials.gov/ct2/show/NCT04612530 Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study) in 100 Patients: https://pubmed.ncbi.nlm.nih.gov/33129427/ The improvement of irreversible electroporation therapy using saline-irrigated electrodes: a theoretical study (Northwestern study): https://pubmed.ncbi.nlm.nih.gov/21728392/ Irreversible electroporation reverses resistance to immune checkpoint blockade in pancreatic cancer: https://www.nature.com/articles/s41467-019-08782-1 Fri, 08 Mar 2024 07:20:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. John Qiao about exploration of physicians’ role in medical innovation, particularly among interventional radiologists. In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. John Qiao about exploration of physicians’ role in medical innovation, particularly among interventional radiologists. Dr. Qiao shares insightful information about the origin of RadioClash and details his journey as an entrepreneur. Through this discussion, Dr. Qiao covers the challenges encountered during the startup phase, the invention of a single-probe electroporation device, and the future applications of this novel medical technology. The episode concludes with broader advice on how to manage the demands of professional work, entrepreneurship, and personal life. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic Concerto https://mobile.twitter.com/mdtvascular --- SHOW NOTES 00:00 - Introduction 02:39 - Dr. Qiao’s Journey into Medicine and Entrepreneurship 11:40 - Birth of Radioclash: A Unique Solution for Cancer Treatment 17:58 - Future of RadioClash: Targeting Metastatic Cancer 25:20 - Future of Electroporation Therapy 35:21 - Challenges of Building a Company 44:37 - Path to Market and Future Plans 47:28 - Balancing Clinical Practice and Entrepreneurship --- RESOURCES RadioClash website: https://www.radioclash.co/ News Article on Dr. John Qiao: https://voyagehouston.com/interview/meet-john-qiao-m-d-of-radioclash-ltd-co/ Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086111/ The Abscopal Effect: A Reemerging Field of Interest: https://ascopost.com/issues/november-25-2018/the-abscopal-effect-a-reemerging-field-of-interest/ BackTable VI Episode #402 - Immunotherapy in HCC: Evolving Treatment Paradigms: https://www.backtable.com/shows/vi/podcasts/402/immunotherapy-in-hcc-evolving-treatment-paradigms Tavo and Pembrolizumab in Patients With Stage III/​IV Melanoma Progressing on Either Pembrolizumab or Nivolumab Treatment (Keynote-695): https://clinicaltrials.gov/study/NCT03132675 PANFIRE-3 Trial: Assessing Safety and Efficacy of Irreversible Electroporation (IRE) + Nivolumab + CpG for Metastatic Pancreatic Cancer: https://classic.clinicaltrials.gov/ct2/show/NCT04612530 Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study) in 100 Patients: https://pubmed.ncbi.nlm.nih.gov/33129427/ The improvement of irreversible electroporation therapy using saline-irrigated electrodes: a theoretical study (Northwestern study): https://pubmed.ncbi.nlm.nih.gov/21728392/ Irreversible electroporation reverses resistance to immune checkpoint blockade in pancreatic cancer: https://www.nature.com/articles/s41467-019-08782-1 In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. John Qiao about exploration of physicians’ role in medical innovation, particularly among interventional radiologists.


Dr. Qiao shares insightful information about the origin of RadioClash and details his journey as an entrepreneur. Through this discussion, Dr. Qiao covers the challenges encountered during the startup phase, the invention of a single-probe electroporation device, and the future applications of this novel medical technology. The episode concludes with broader advice on how to manage the demands of professional work, entrepreneurship, and personal life.


---


CHECK OUT OUR SPONSORS


Reflow Medical

https://www.reflowmedical.com/


Medtronic Concerto

https://mobile.twitter.com/mdtvascular


---


SHOW NOTES


00:00 - Introduction

02:39 - Dr. Qiao’s Journey into Medicine and Entrepreneurship

11:40 - Birth of Radioclash: A Unique Solution for Cancer Treatment

17:58 - Future of RadioClash: Targeting Metastatic Cancer

25:20 - Future of Electroporation Therapy

35:21 - Challenges of Building a Company

44:37 - Path to Market and Future Plans

47:28 - Balancing Clinical Practice and Entrepreneurship


---


RESOURCES


RadioClash website:

https://www.radioclash.co/


News Article on Dr. John Qiao:

https://voyagehouston.com/interview/meet-john-qiao-m-d-of-radioclash-ltd-co/


Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086111/


The Abscopal Effect: A Reemerging Field of Interest:

https://ascopost.com/issues/november-25-2018/the-abscopal-effect-a-reemerging-field-of-interest/


BackTable VI Episode #402 - Immunotherapy in HCC: Evolving Treatment Paradigms:

https://www.backtable.com/shows/vi/podcasts/402/immunotherapy-in-hcc-evolving-treatment-paradigms


Tavo and Pembrolizumab in Patients With Stage III/​IV Melanoma Progressing on Either Pembrolizumab or Nivolumab Treatment (Keynote-695):

https://clinicaltrials.gov/study/NCT03132675


PANFIRE-3 Trial: Assessing Safety and Efficacy of Irreversible Electroporation (IRE) + Nivolumab + CpG for Metastatic Pancreatic Cancer:

https://classic.clinicaltrials.gov/ct2/show/NCT04612530


Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study) in 100 Patients:

https://pubmed.ncbi.nlm.nih.gov/33129427/


The improvement of irreversible electroporation therapy using saline-irrigated electrodes: a theoretical study (Northwestern study):

https://pubmed.ncbi.nlm.nih.gov/21728392/


Irreversible electroporation reverses resistance to immune checkpoint blockade in pancreatic cancer:

https://www.nature.com/articles/s41467-019-08782-1

]]> 3110 Ep. 422 Pathology 101: Solid Advice for Percutaneous Biopsies with Dr. Andrew Sholl In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Andrew Sholl, who demystifies the ins and outs of percutaneous biopsies and their impact on diagnoses. Dr. Scholl is a pathologist at LCMC Health in New Orleans, Louisiana. Dr. Sholl emphasizes the importance of understanding substantial clinical history, as well as obtaining adequate and correctly processed samples. The doctors discuss the varying scenarios faced in pathology, such as instances when larger samples are beneficial and the nuances of differentiating malignancies in certain organs. They also cover detailed tips for conducting biopsies and the process of how pathologists assess patient samples. The overarching message is the importance of communication and collaboration between interventional radiologists and pathologists to ensure the best patient outcomes. --- CHECK OUT OUR SPONSOR Argon BioPince Ultra https://www.argonmedical.com/product/biopince-ultra-full-core-biopsy-instrument/ --- SHOW NOTES 00:00 - Introduction 02:38 - Understanding Pathology Training and Practice 06:07 - Role of Pathology in Medical Diagnosis 18:57 - Importance of Sample Size and Quality in Pathology 26:34 - Next Gen Sequencing and Molecular Markers 29:44 - Biopsy Devices and Their Impact on Diagnosis 37:21 - Using Clinical History in Pathology 43:16 - Challenges and Considerations in Diagnosing Renal and Hepatic Tumors 50:25 - Importance of Communication Between Pathologists and Interventional Radiologists Tue, 05 Mar 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Andrew Sholl, who demystifies the ins and outs of percutaneous biopsies and their impact on diagnoses. Dr. Sholl is a pathologist at LCMC Health in New Orleans, Louisiana. In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Andrew Sholl, who demystifies the ins and outs of percutaneous biopsies and their impact on diagnoses. Dr. Scholl is a pathologist at LCMC Health in New Orleans, Louisiana. Dr. Sholl emphasizes the importance of understanding substantial clinical history, as well as obtaining adequate and correctly processed samples. The doctors discuss the varying scenarios faced in pathology, such as instances when larger samples are beneficial and the nuances of differentiating malignancies in certain organs. They also cover detailed tips for conducting biopsies and the process of how pathologists assess patient samples. The overarching message is the importance of communication and collaboration between interventional radiologists and pathologists to ensure the best patient outcomes. --- CHECK OUT OUR SPONSOR Argon BioPince Ultra https://www.argonmedical.com/product/biopince-ultra-full-core-biopsy-instrument/ --- SHOW NOTES 00:00 - Introduction 02:38 - Understanding Pathology Training and Practice 06:07 - Role of Pathology in Medical Diagnosis 18:57 - Importance of Sample Size and Quality in Pathology 26:34 - Next Gen Sequencing and Molecular Markers 29:44 - Biopsy Devices and Their Impact on Diagnosis 37:21 - Using Clinical History in Pathology 43:16 - Challenges and Considerations in Diagnosing Renal and Hepatic Tumors 50:25 - Importance of Communication Between Pathologists and Interventional Radiologists In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Andrew Sholl, who demystifies the ins and outs of percutaneous biopsies and their impact on diagnoses. Dr. Scholl is a pathologist at LCMC Health in New Orleans, Louisiana.


Dr. Sholl emphasizes the importance of understanding substantial clinical history, as well as obtaining adequate and correctly processed samples. The doctors discuss the varying scenarios faced in pathology, such as instances when larger samples are beneficial and the nuances of differentiating malignancies in certain organs. They also cover detailed tips for conducting biopsies and the process of how pathologists assess patient samples. The overarching message is the importance of communication and collaboration between interventional radiologists and pathologists to ensure the best patient outcomes.


---


CHECK OUT OUR SPONSOR


Argon BioPince Ultra

https://www.argonmedical.com/product/biopince-ultra-full-core-biopsy-instrument/


---


SHOW NOTES


00:00 - Introduction

02:38 - Understanding Pathology Training and Practice

06:07 - Role of Pathology in Medical Diagnosis

18:57 - Importance of Sample Size and Quality in Pathology

26:34 - Next Gen Sequencing and Molecular Markers

29:44 - Biopsy Devices and Their Impact on Diagnosis

37:21 - Using Clinical History in Pathology

43:16 - Challenges and Considerations in Diagnosing Renal and Hepatic Tumors

50:25 - Importance of Communication Between Pathologists and Interventional Radiologists

]]> 3365 Ep. 421 A Deep Dive into Biliary Interventions with Dr. Brian Holly In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Brian Holly about different surgical scenarios relating to biliary interventions. Dr. Holly is a practicing interventional radiologist and Assistant Professor of Radiology and Radiological Sciences at Johns Hopkins University. The doctors delve into various techniques including the usage of ultrasound, managing non-dilated and dilated systems, as well as handling specific clinical scenarios such as malignant obstructions, benign biliary strictures, and postoperative bile leaks. The podcast also briefly discusses the controversial topic of placing internal biliary stents and the challenges faced with managing biliary strictures and leaks. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 01:53 - Discussion on IR Training at Johns Hopkins 04:09 - Overview of Biliary Interventions 08:31 - Challenges and Techniques in Biliary Access 19:28 - Approach to Non-Dilated Collecting System 28:07 - Dealing with Dilated Systems and Obstructions 32:56 - Biopsy Techniques for Malignant CBD Strictures 39:30 - Approach to Benign Biliary Strictures 41:48 - Use of Internal Stents in Biliary Procedures 44:51 - Managing Bleeding in Biliary Procedures --- RESOURCES The Hepaticojejunostomy Technique with Intra-Anastomotic Stent in Biliary Diseases and Its Evolution throughout the Years: A Technical Analysis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846744/ Percutaneous Transhepatic Cholangiography and Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Malignant Biliary Obstruction: https://www.jvir.org/article/S1051-0443(15)00166-9/abstract Fri, 01 Mar 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Brian Holly about different surgical scenarios relating to biliary interventions. Dr. Holly is a practicing interventional radiologist and Assistant Professor of Radiology and Radiological Sciences at Johns Hopkins University. In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Brian Holly about different surgical scenarios relating to biliary interventions. Dr. Holly is a practicing interventional radiologist and Assistant Professor of Radiology and Radiological Sciences at Johns Hopkins University. The doctors delve into various techniques including the usage of ultrasound, managing non-dilated and dilated systems, as well as handling specific clinical scenarios such as malignant obstructions, benign biliary strictures, and postoperative bile leaks. The podcast also briefly discusses the controversial topic of placing internal biliary stents and the challenges faced with managing biliary strictures and leaks. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 01:53 - Discussion on IR Training at Johns Hopkins 04:09 - Overview of Biliary Interventions 08:31 - Challenges and Techniques in Biliary Access 19:28 - Approach to Non-Dilated Collecting System 28:07 - Dealing with Dilated Systems and Obstructions 32:56 - Biopsy Techniques for Malignant CBD Strictures 39:30 - Approach to Benign Biliary Strictures 41:48 - Use of Internal Stents in Biliary Procedures 44:51 - Managing Bleeding in Biliary Procedures --- RESOURCES The Hepaticojejunostomy Technique with Intra-Anastomotic Stent in Biliary Diseases and Its Evolution throughout the Years: A Technical Analysis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846744/ Percutaneous Transhepatic Cholangiography and Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Malignant Biliary Obstruction: https://www.jvir.org/article/S1051-0443(15)00166-9/abstract In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Brian Holly about different surgical scenarios relating to biliary interventions. Dr. Holly is a practicing interventional radiologist and Assistant Professor of Radiology and Radiological Sciences at Johns Hopkins University.


The doctors delve into various techniques including the usage of ultrasound, managing non-dilated and dilated systems, as well as handling specific clinical scenarios such as malignant obstructions, benign biliary strictures, and postoperative bile leaks. The podcast also briefly discusses the controversial topic of placing internal biliary stents and the challenges faced with managing biliary strictures and leaks.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

01:53 - Discussion on IR Training at Johns Hopkins

04:09 - Overview of Biliary Interventions

08:31 - Challenges and Techniques in Biliary Access

19:28 - Approach to Non-Dilated Collecting System

28:07 - Dealing with Dilated Systems and Obstructions

32:56 - Biopsy Techniques for Malignant CBD Strictures

39:30 - Approach to Benign Biliary Strictures

41:48 - Use of Internal Stents in Biliary Procedures

44:51 - Managing Bleeding in Biliary Procedures


---


RESOURCES


The Hepaticojejunostomy Technique with Intra-Anastomotic Stent in Biliary Diseases and Its Evolution throughout the Years: A Technical Analysis:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846744/


Percutaneous Transhepatic Cholangiography and Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Malignant Biliary Obstruction:

https://www.jvir.org/article/S1051-0443(15)00166-9/abstract

]]> 3090 Ep. 420 The Art and Science of Declotting the Dialysis Circuit with Dr. Omar Chohan and Dr. Harris Chengazi In this episode of the Backtable Podcast, host Dr. Chris Beck interviews guests Dr. Omar Chohan and Dr. Harris Chengazi about dialysis fistula declot procedures and their own experiences with various devices and strategies, including usage of pre-procedure ultrasound, heparinization, and closure techniques. Both Dr. Chohan and Dr. Chengazi are interventional radiologists at Great Lakes Medical Imaging in Buffalo, New York. The doctors dive into treatment of anastomosis stenosis, stressing the importance of technique refinement, physical examination, and thoughtful pre-procedure planning. The discussion concludes with an invitation for listeners to share their experiences with the ‘bottle-cap’ hemostasis trick. --- CHECK OUT OUR SPONSOR Argon Cleaner Rotational Thrombectomy System https://www.argonmedical.com/cleaner --- SHOW NOTES 00:00 - Introduction 05:59 - Importance of Problem Solving in Declot Procedures 07:27 - Role of Pre-Procedure Ultrasound 12:00 - Process of Declot Procedures 28:27 - Moving to the Arterial Side: Access and Treatment 32:37 - Wire Management and the Risk of Rupture 41:59 - Art of Closure: Techniques and Considerations 45:53 - When to Quit: Evaluating the Need for Revision or Alternative Treatment 50:24 - Experience and Planning in Successful Fistula Treatment --- RESOURCES BackTable Declot Guide: https://www.backtable.com/shows/vi/topics/procedure/declot BackTable VI Episode #25 - Declots with the Argon Cleaner Device with Dr. Sabeen Dhand: https://www.backtable.com/shows/vi/podcasts/25/declots-with-the-argon-cleaner-device BackTable VI Episode #117 - Successful (and Quick!) Declots for AV Access with Dr. Neghae Mawla: https://www.backtable.com/shows/vi/podcasts/117/successful-quick-declots-for-av-access BackTable VI Episode #139 - AV Fistula & Graft Maintenance with Dr. Ari Kramer: https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance BackTable VI Episode #141 - DEB vs. Balloon Angioplasty Alone for Dysfunctional Hemodialysis Access with Dr. Eric Therasse: https://www.backtable.com/shows/vi/podcasts/141/deb-vs-balloon-angioplasty-alone-for-dysfunctional-hemodialysis-access BackTable VI Episode #292 - Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More Dr. Ari Kramer: https://www.backtable.com/shows/vi/podcasts/292/dialysis-interventions-with-drug-coated-balloons-covered-stents-more Tue, 27 Feb 2024 08:00:00 -0000 full BackTable In this episode of the Backtable Podcast, host Dr. Chris Beck interviews guests Dr. Omar Chohan and Dr. Harris Chengazi about dialysis fistula declot procedures and their own experiences with various devices and strategies, including usage of pre-procedure ultrasound, heparinization, and closure techniques. In this episode of the Backtable Podcast, host Dr. Chris Beck interviews guests Dr. Omar Chohan and Dr. Harris Chengazi about dialysis fistula declot procedures and their own experiences with various devices and strategies, including usage of pre-procedure ultrasound, heparinization, and closure techniques. Both Dr. Chohan and Dr. Chengazi are interventional radiologists at Great Lakes Medical Imaging in Buffalo, New York. The doctors dive into treatment of anastomosis stenosis, stressing the importance of technique refinement, physical examination, and thoughtful pre-procedure planning. The discussion concludes with an invitation for listeners to share their experiences with the ‘bottle-cap’ hemostasis trick. --- CHECK OUT OUR SPONSOR Argon Cleaner Rotational Thrombectomy System https://www.argonmedical.com/cleaner --- SHOW NOTES 00:00 - Introduction 05:59 - Importance of Problem Solving in Declot Procedures 07:27 - Role of Pre-Procedure Ultrasound 12:00 - Process of Declot Procedures 28:27 - Moving to the Arterial Side: Access and Treatment 32:37 - Wire Management and the Risk of Rupture 41:59 - Art of Closure: Techniques and Considerations 45:53 - When to Quit: Evaluating the Need for Revision or Alternative Treatment 50:24 - Experience and Planning in Successful Fistula Treatment --- RESOURCES BackTable Declot Guide: https://www.backtable.com/shows/vi/topics/procedure/declot BackTable VI Episode #25 - Declots with the Argon Cleaner Device with Dr. Sabeen Dhand: https://www.backtable.com/shows/vi/podcasts/25/declots-with-the-argon-cleaner-device BackTable VI Episode #117 - Successful (and Quick!) Declots for AV Access with Dr. Neghae Mawla: https://www.backtable.com/shows/vi/podcasts/117/successful-quick-declots-for-av-access BackTable VI Episode #139 - AV Fistula & Graft Maintenance with Dr. Ari Kramer: https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance BackTable VI Episode #141 - DEB vs. Balloon Angioplasty Alone for Dysfunctional Hemodialysis Access with Dr. Eric Therasse: https://www.backtable.com/shows/vi/podcasts/141/deb-vs-balloon-angioplasty-alone-for-dysfunctional-hemodialysis-access BackTable VI Episode #292 - Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More Dr. Ari Kramer: https://www.backtable.com/shows/vi/podcasts/292/dialysis-interventions-with-drug-coated-balloons-covered-stents-more In this episode of the Backtable Podcast, host Dr. Chris Beck interviews guests Dr. Omar Chohan and Dr. Harris Chengazi about dialysis fistula declot procedures and their own experiences with various devices and strategies, including usage of pre-procedure ultrasound, heparinization, and closure techniques. Both Dr. Chohan and Dr. Chengazi are interventional radiologists at Great Lakes Medical Imaging in Buffalo, New York.


The doctors dive into treatment of anastomosis stenosis, stressing the importance of technique refinement, physical examination, and thoughtful pre-procedure planning. The discussion concludes with an invitation for listeners to share their experiences with the ‘bottle-cap’ hemostasis trick.


---


CHECK OUT OUR SPONSOR


Argon Cleaner Rotational Thrombectomy System

https://www.argonmedical.com/cleaner


---


SHOW NOTES


00:00 - Introduction

05:59 - Importance of Problem Solving in Declot Procedures

07:27 - Role of Pre-Procedure Ultrasound

12:00 - Process of Declot Procedures

28:27 - Moving to the Arterial Side: Access and Treatment

32:37 - Wire Management and the Risk of Rupture

41:59 - Art of Closure: Techniques and Considerations

45:53 - When to Quit: Evaluating the Need for Revision or Alternative Treatment

50:24 - Experience and Planning in Successful Fistula Treatment


---


RESOURCES


BackTable Declot Guide:

https://www.backtable.com/shows/vi/topics/procedure/declot


BackTable VI Episode #25 - Declots with the Argon Cleaner Device with Dr. Sabeen Dhand:

https://www.backtable.com/shows/vi/podcasts/25/declots-with-the-argon-cleaner-device


BackTable VI Episode #117 - Successful (and Quick!) Declots for AV Access with Dr. Neghae Mawla:

https://www.backtable.com/shows/vi/podcasts/117/successful-quick-declots-for-av-access


BackTable VI Episode #139 - AV Fistula & Graft Maintenance with Dr. Ari Kramer:

https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance


BackTable VI Episode #141 - DEB vs. Balloon Angioplasty Alone for Dysfunctional Hemodialysis Access with Dr. Eric Therasse:

https://www.backtable.com/shows/vi/podcasts/141/deb-vs-balloon-angioplasty-alone-for-dysfunctional-hemodialysis-access


BackTable VI Episode #292 - Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More Dr. Ari Kramer:

https://www.backtable.com/shows/vi/podcasts/292/dialysis-interventions-with-drug-coated-balloons-covered-stents-more


]]> 3433 Ep. 419 Experiencing a Pulmonary Embolism and Thrombectomy with Dr. Ilan Rzadkowolsky-Raoli In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ilan Rzadkowolsky-Raoli about his experience of being diagnosed with a large saddle embolus and subsequently being treated by his best friend, Dr. Ripal Gandhi. Dr. Rzadkowolsky-Raoli is an interventional radiologist at Palmetto General Hospital in Miami, Florida. Dr. Rzadkowolsky-Raoli discusses the impact of his diagnosis on his practice, how it has changed the way he approaches and speaks to his patients, and his advice for clinicians. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions Medtronic ClosureFast https://www.medtronic.com/closurefast6f --- SHOW NOTES 00:00 - Introduction 06:18 - Dr. Rzadkowolsky-Raoli’s Personal Journey 09:41 - Diagnosis and Treatment Process 12:18 - Post-Treatment Recovery and Reflections 24:18 - Impact on Practice and Patient Care 31:45 - Final Thoughts and Appreciation --- RESOURCES Pulmonary Embolism Response Team (PERT) Consortium: https://pertconsortium.org/ Inari FlowTriever: https://www.inarimedical.com/flowtriever/ Fri, 23 Feb 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ilan Rzadkowolsky-Raoli about his experience of being diagnosed with a large saddle embolus and subsequently being treated by his best friend, Dr. Ripal Gandhi. In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ilan Rzadkowolsky-Raoli about his experience of being diagnosed with a large saddle embolus and subsequently being treated by his best friend, Dr. Ripal Gandhi. Dr. Rzadkowolsky-Raoli is an interventional radiologist at Palmetto General Hospital in Miami, Florida. Dr. Rzadkowolsky-Raoli discusses the impact of his diagnosis on his practice, how it has changed the way he approaches and speaks to his patients, and his advice for clinicians. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions Medtronic ClosureFast https://www.medtronic.com/closurefast6f --- SHOW NOTES 00:00 - Introduction 06:18 - Dr. Rzadkowolsky-Raoli’s Personal Journey 09:41 - Diagnosis and Treatment Process 12:18 - Post-Treatment Recovery and Reflections 24:18 - Impact on Practice and Patient Care 31:45 - Final Thoughts and Appreciation --- RESOURCES Pulmonary Embolism Response Team (PERT) Consortium: https://pertconsortium.org/ Inari FlowTriever: https://www.inarimedical.com/flowtriever/ In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ilan Rzadkowolsky-Raoli about his experience of being diagnosed with a large saddle embolus and subsequently being treated by his best friend, Dr. Ripal Gandhi. Dr. Rzadkowolsky-Raoli is an interventional radiologist at Palmetto General Hospital in Miami, Florida.


Dr. Rzadkowolsky-Raoli discusses the impact of his diagnosis on his practice, how it has changed the way he approaches and speaks to his patients, and his advice for clinicians.


---


CHECK OUT OUR SPONSORS


Varian, a Siemens Healthineers company

https://www.varian.com/products/interventional-solutions/embolization-solutions


Medtronic ClosureFast

https://www.medtronic.com/closurefast6f


---


SHOW NOTES


00:00 - Introduction

06:18 - Dr. Rzadkowolsky-Raoli’s Personal Journey

09:41 - Diagnosis and Treatment Process

12:18 - Post-Treatment Recovery and Reflections

24:18 - Impact on Practice and Patient Care

31:45 - Final Thoughts and Appreciation


---


RESOURCES


Pulmonary Embolism Response Team (PERT) Consortium:

https://pertconsortium.org/


Inari FlowTriever:

https://www.inarimedical.com/flowtriever/

]]> 2123 Ep. 418 Acute Limb Ischemia: Timing, Technology, and Triage with Dr. Charles Bailey In this episode, host Dr. Sabeen Dhand interviews Dr. Charles Bailey about Limb Alert, a hospital protocol devised to expedite the diagnosis and treatment of patients presenting with acute limb ischemia. Dr. Bailey is a vascular surgeon and the Director of Peripheral Artery Disease (PAD) and Limb Salvage at the University of South Florida. Dr. Bailey explains how the Limb Alert program standardizes the care pathway, rapidly alerts necessary personnel, initiates labs, and prepares the Penumbra Lightning Bolt 7 System for endovascular thrombectomy. The incorporated protocol significantly streamlines patient management, resulting in encouraging survival rates. Dr. Bailey further emphasizes the necessity for modern endovascular trials in acute limb ischemia and proposes a multicenter randomized trial to provide evidence for endovascular treatment. --- CHECK OUT OUR SPONSOR Penumbra Lightning Flash https://www.penumbrainc.com/products/lightning-flash/ --- SHOW NOTES 00:00 - Introduction 02:43 - Dr. Bailey’s Journey to Florida and His Practice 06:43 - Importance of Timely Intervention in Acute Limb Ischemia 21:29 - Role of Debulking in Acute Limb Ischemia 28:20 - Tips and Tricks for Successful Outcomes 31:17 - Impact of the Limb Alert Program 41:19 - Future of Acute Limb Ischemia Treatment 47:40 - The Need for New Randomized Trials --- RESOURCES Acute Limb Ischemia: An Update on Diagnosis and Management: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723825/ Safety and efficacy of mechanical aspiration thrombectomy at 30 days for patients with lower extremity acute limb ischemia - STRIDE Study: https://www.jvascsurg.org/article/S0741-5214(23)02196-1/fulltext Tue, 20 Feb 2024 08:00:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews Dr. Charles Bailey about Limb Alert, a hospital protocol devised to expedite the diagnosis and treatment of patients presenting with acute limb ischemia. Dr. Bailey is a vascular surgeon and the Director of Peripheral Artery Disease (PAD) and Limb Salvage at the University of South Florida. In this episode, host Dr. Sabeen Dhand interviews Dr. Charles Bailey about Limb Alert, a hospital protocol devised to expedite the diagnosis and treatment of patients presenting with acute limb ischemia. Dr. Bailey is a vascular surgeon and the Director of Peripheral Artery Disease (PAD) and Limb Salvage at the University of South Florida. Dr. Bailey explains how the Limb Alert program standardizes the care pathway, rapidly alerts necessary personnel, initiates labs, and prepares the Penumbra Lightning Bolt 7 System for endovascular thrombectomy. The incorporated protocol significantly streamlines patient management, resulting in encouraging survival rates. Dr. Bailey further emphasizes the necessity for modern endovascular trials in acute limb ischemia and proposes a multicenter randomized trial to provide evidence for endovascular treatment. --- CHECK OUT OUR SPONSOR Penumbra Lightning Flash https://www.penumbrainc.com/products/lightning-flash/ --- SHOW NOTES 00:00 - Introduction 02:43 - Dr. Bailey’s Journey to Florida and His Practice 06:43 - Importance of Timely Intervention in Acute Limb Ischemia 21:29 - Role of Debulking in Acute Limb Ischemia 28:20 - Tips and Tricks for Successful Outcomes 31:17 - Impact of the Limb Alert Program 41:19 - Future of Acute Limb Ischemia Treatment 47:40 - The Need for New Randomized Trials --- RESOURCES Acute Limb Ischemia: An Update on Diagnosis and Management: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723825/ Safety and efficacy of mechanical aspiration thrombectomy at 30 days for patients with lower extremity acute limb ischemia - STRIDE Study: https://www.jvascsurg.org/article/S0741-5214(23)02196-1/fulltext In this episode, host Dr. Sabeen Dhand interviews Dr. Charles Bailey about Limb Alert, a hospital protocol devised to expedite the diagnosis and treatment of patients presenting with acute limb ischemia. Dr. Bailey is a vascular surgeon and the Director of Peripheral Artery Disease (PAD) and Limb Salvage at the University of South Florida.


Dr. Bailey explains how the Limb Alert program standardizes the care pathway, rapidly alerts necessary personnel, initiates labs, and prepares the Penumbra Lightning Bolt 7 System for endovascular thrombectomy. The incorporated protocol significantly streamlines patient management, resulting in encouraging survival rates. Dr. Bailey further emphasizes the necessity for modern endovascular trials in acute limb ischemia and proposes a multicenter randomized trial to provide evidence for endovascular treatment.


---


CHECK OUT OUR SPONSOR


Penumbra Lightning Flash

https://www.penumbrainc.com/products/lightning-flash/


---


SHOW NOTES


00:00 - Introduction

02:43 - Dr. Bailey’s Journey to Florida and His Practice

06:43 - Importance of Timely Intervention in Acute Limb Ischemia

21:29 - Role of Debulking in Acute Limb Ischemia

28:20 - Tips and Tricks for Successful Outcomes

31:17 - Impact of the Limb Alert Program

41:19 - Future of Acute Limb Ischemia Treatment

47:40 - The Need for New Randomized Trials


---


RESOURCES


Acute Limb Ischemia: An Update on Diagnosis and Management:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723825/


Safety and efficacy of mechanical aspiration thrombectomy at 30 days for patients with lower extremity acute limb ischemia - STRIDE Study:

https://www.jvascsurg.org/article/S0741-5214(23)02196-1/fulltext

]]> 3164 Ep. 417 IR Training: Perspectives and Expectations with Dr. Thomas P. Sullivan In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Thomas Sullivan about the findings from a recent survey exploring the reasons behind professional job changes among interventional radiologists. Dr. Sullivan is the Assistant Program Director of Diagnostic and Integrated Interventional Radiology Residency programs at Wake Forest University. Dr. Sullivan highlights the importance of mentorship during residency and notes the huge impact of geography and financial compensation in determining job satisfaction and longevity in a role. He also discusses some surprising insights about trainee expectations of future practice settings, the need for a variety in practice caseload, and the desire for about 80% of clinical time to be spent on dedicated IR activities. The conversation also delves into the challenges of equipping residents for rural practice and the potential value of developing a procedural radiology curriculum. Dr. Sullivan anticipates that the survey results will help improve and adapt training paradigms to better align with the evolving landscape of interventional radiology practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:50 - Discussion on IR Training and Practice 04:51 - Survey Discussion and Key Findings 16:47 - Importance of Diagnostic Skills in IR 19:01 - Deciding Factors for First Job After Training 21:04 - Need for Medical Services in Rural Settings 25:23 - Role of Mentorship in Job Seeking 28:21 - Importance of Networking in Career Development 32:37 - Future of IR Training and Practice 38:23 - Role of BackTable in IR Training --- RESOURCES SIR 2024 Monday Session (3:27 PM - 3:36 PM MT): Trainee perceptions of current IR workforce: Are we setting our residents up for failure? With Dr. Thomas Sullivan: https://www.sirmeeting.org/fsPopup.asp?PresentationID=1348792&mode=presInfo Fri, 16 Feb 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Thomas Sullivan about the findings from a recent survey exploring the reasons behind professional job changes among interventional radiologists. Dr. Sullivan is the Assistant Program Director of Diagnostic and Integrated Interventional Radiology Residency programs at Wake Forest University. In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Thomas Sullivan about the findings from a recent survey exploring the reasons behind professional job changes among interventional radiologists. Dr. Sullivan is the Assistant Program Director of Diagnostic and Integrated Interventional Radiology Residency programs at Wake Forest University. Dr. Sullivan highlights the importance of mentorship during residency and notes the huge impact of geography and financial compensation in determining job satisfaction and longevity in a role. He also discusses some surprising insights about trainee expectations of future practice settings, the need for a variety in practice caseload, and the desire for about 80% of clinical time to be spent on dedicated IR activities. The conversation also delves into the challenges of equipping residents for rural practice and the potential value of developing a procedural radiology curriculum. Dr. Sullivan anticipates that the survey results will help improve and adapt training paradigms to better align with the evolving landscape of interventional radiology practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:50 - Discussion on IR Training and Practice 04:51 - Survey Discussion and Key Findings 16:47 - Importance of Diagnostic Skills in IR 19:01 - Deciding Factors for First Job After Training 21:04 - Need for Medical Services in Rural Settings 25:23 - Role of Mentorship in Job Seeking 28:21 - Importance of Networking in Career Development 32:37 - Future of IR Training and Practice 38:23 - Role of BackTable in IR Training --- RESOURCES SIR 2024 Monday Session (3:27 PM - 3:36 PM MT): Trainee perceptions of current IR workforce: Are we setting our residents up for failure? With Dr. Thomas Sullivan: https://www.sirmeeting.org/fsPopup.asp?PresentationID=1348792&mode=presInfo In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Thomas Sullivan about the findings from a recent survey exploring the reasons behind professional job changes among interventional radiologists. Dr. Sullivan is the Assistant Program Director of Diagnostic and Integrated Interventional Radiology Residency programs at Wake Forest University.


Dr. Sullivan highlights the importance of mentorship during residency and notes the huge impact of geography and financial compensation in determining job satisfaction and longevity in a role. He also discusses some surprising insights about trainee expectations of future practice settings, the need for a variety in practice caseload, and the desire for about 80% of clinical time to be spent on dedicated IR activities. The conversation also delves into the challenges of equipping residents for rural practice and the potential value of developing a procedural radiology curriculum. Dr. Sullivan anticipates that the survey results will help improve and adapt training paradigms to better align with the evolving landscape of interventional radiology practice.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

02:50 - Discussion on IR Training and Practice

04:51 - Survey Discussion and Key Findings

16:47 - Importance of Diagnostic Skills in IR

19:01 - Deciding Factors for First Job After Training

21:04 - Need for Medical Services in Rural Settings

25:23 - Role of Mentorship in Job Seeking

28:21 - Importance of Networking in Career Development

32:37 - Future of IR Training and Practice

38:23 - Role of BackTable in IR Training


---


RESOURCES


SIR 2024 Monday Session (3:27 PM - 3:36 PM MT): Trainee perceptions of current IR workforce: Are we setting our residents up for failure? With Dr. Thomas Sullivan:

https://www.sirmeeting.org/fsPopup.asp?PresentationID=1348792&mode=presInfo

]]> 2654 Ep. 416 PAE in the OBL with Dr. Charles Nutting In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Charles Nutting about prostatic artery embolization (PAE) in the outpatient-based lab (OBL) setting. Dr. Nutting is an interventional radiologist at Endovascular Consultants in Lone Tree, Colorado. The doctors discuss procedure techniques, patient selection, follow-up care, and benefits of the OBL environment over the hospital. Dr. Nutting emphasizes that it is important to learn PAE in a hospital setting before transitioning to the OBL. He recommends using consistent equipment to help with the learning process. Dr. Nutting also shares his experience with radiopaque beads in PAE and describes the advantages of seeing the deposition of the beads into the gland. The doctors discuss the potential impact of the 2023 American Urological Association (AUA) Guidelines, which for the first time recognizes PAE for the treatment of symptomatic benign prostatic hyperplasia (BPH), and what this might mean for patient volume and interventional radiology training. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SHOW NOTES 00:00 - Introduction 03:03 - Impact of New AUA Guidelines on PAE 04:48 - Benefits of PAE for Patients 06:37 - Role of Primary Care Physicians in PAE 08:18 - Practice of PAE in the OBL 19:08 - Role of Urodynamic Studies 22:23 - Challenges of Treating Small Glands 26:11 - Procedure Steps and Techniques 34:19 - Post-Procedure Care and Follow-up 38:33 - The Future of Prostate Embolization --- RESOURCES Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023: https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity-matched comparison with transurethral resection of the prostate (the UK-ROPE study): https://pubmed.ncbi.nlm.nih.gov/29645352/ NICE - Prostate artery embolisation for lower urinary tract symptoms caused by benign prostatic hyperplasia: https://www.nice.org.uk/guidance/ipg611 Yttrium-90 Radioembolization in the Office-Based Lab: https://pubmed.ncbi.nlm.nih.gov/32800662/ Role of Urodynamic Studies in Management of Benign Prostatic Obstruction: A Guide for Interventional Radiologists: https://www.jvir.org/article/S1051-0443(16)30520-6/fulltext International Prostate Symptom Score (IPSS): https://www.urologygroup.com/wp-content/uploads/2019/07/IPSS-Form-Before-Tx-_-BPH.pdf Tue, 13 Feb 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Charles Nutting about prostatic artery embolization (PAE) in the outpatient-based lab (OBL) setting. Dr. Nutting is an interventional radiologist at Endovascular Consultants in Lone Tree, Colorado. The doctors discuss procedure techniques, patient selection, follow-up care, and benefits of the OBL environment over the hospital. Dr. Nutting emphasizes that it is important to learn PAE in a hospital setting before transitioning to the OBL. He recommends using consistent equipment to help with the learning process. Dr. Nutting also shares his experience with radiopaque beads in PAE and describes the advantages of seeing the deposition of the beads into the gland. The doctors discuss the potential impact of the 2023 American Urological Association (AUA) Guidelines, which for the first time recognizes PAE for the treatment of symptomatic benign prostatic hyperplasia (BPH), and what this might mean for patient volume and interventional radiology training. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SHOW NOTES 00:00 - Introduction 03:03 - Impact of New AUA Guidelines on PAE 04:48 - Benefits of PAE for Patients 06:37 - Role of Primary Care Physicians in PAE 08:18 - Practice of PAE in the OBL 19:08 - Role of Urodynamic Studies 22:23 - Challenges of Treating Small Glands 26:11 - Procedure Steps and Techniques 34:19 - Post-Procedure Care and Follow-up 38:33 - The Future of Prostate Embolization --- RESOURCES Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023: https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity-matched comparison with transurethral resection of the prostate (the UK-ROPE study): https://pubmed.ncbi.nlm.nih.gov/29645352/ NICE - Prostate artery embolisation for lower urinary tract symptoms caused by benign prostatic hyperplasia: https://www.nice.org.uk/guidance/ipg611 Yttrium-90 Radioembolization in the Office-Based Lab: https://pubmed.ncbi.nlm.nih.gov/32800662/ Role of Urodynamic Studies in Management of Benign Prostatic Obstruction: A Guide for Interventional Radiologists: https://www.jvir.org/article/S1051-0443(16)30520-6/fulltext International Prostate Symptom Score (IPSS): https://www.urologygroup.com/wp-content/uploads/2019/07/IPSS-Form-Before-Tx-_-BPH.pdf In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Charles Nutting about prostatic artery embolization (PAE) in the outpatient-based lab (OBL) setting. Dr. Nutting is an interventional radiologist at Endovascular Consultants in Lone Tree, Colorado. The doctors discuss procedure techniques, patient selection, follow-up care, and benefits of the OBL environment over the hospital.


Dr. Nutting emphasizes that it is important to learn PAE in a hospital setting before transitioning to the OBL. He recommends using consistent equipment to help with the learning process. Dr. Nutting also shares his experience with radiopaque beads in PAE and describes the advantages of seeing the deposition of the beads into the gland. The doctors discuss the potential impact of the 2023 American Urological Association (AUA) Guidelines, which for the first time recognizes PAE for the treatment of symptomatic benign prostatic hyperplasia (BPH), and what this might mean for patient volume and interventional radiology training.


---


CHECK OUT OUR SPONSOR


Varian, a Siemens Healthineers company

https://www.varian.com/products/interventional-solutions/embolization-solutions


---


SHOW NOTES


00:00 - Introduction

03:03 - Impact of New AUA Guidelines on PAE

04:48 - Benefits of PAE for Patients

06:37 - Role of Primary Care Physicians in PAE

08:18 - Practice of PAE in the OBL

19:08 - Role of Urodynamic Studies

22:23 - Challenges of Treating Small Glands

26:11 - Procedure Steps and Techniques

34:19 - Post-Procedure Care and Follow-up

38:33 - The Future of Prostate Embolization


---


RESOURCES


Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023:

https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline


Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity-matched comparison with transurethral resection of the prostate (the UK-ROPE study):

https://pubmed.ncbi.nlm.nih.gov/29645352/


NICE - Prostate artery embolisation for lower urinary tract symptoms caused by benign prostatic hyperplasia:

https://www.nice.org.uk/guidance/ipg611


Yttrium-90 Radioembolization in the Office-Based Lab:

https://pubmed.ncbi.nlm.nih.gov/32800662/


Role of Urodynamic Studies in Management of Benign Prostatic Obstruction: A Guide for Interventional Radiologists:

https://www.jvir.org/article/S1051-0443(16)30520-6/fulltext


International Prostate Symptom Score (IPSS):

https://www.urologygroup.com/wp-content/uploads/2019/07/IPSS-Form-Before-Tx-_-BPH.pdf

]]> 2859 Ep. 415 Thyroid Ablation: Efficacy, Safety, and Procedure Overview with Dr. Gary Tse In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Gary Tse about the innovative technique of thyroid ablation and its role in treating benign thyroid nodules. Dr. Tse is a practicing interventional radiologist at UCLA Health. Dr. Tse highlights the procedural details, patient experiences, potential complications, and follow-up protocols of thyroid ablation. He emphasizes the importance of consistent communication with patients during these procedures, given that the patients are under minimal anesthesia. He explains how interventional radiologists can benefit from embracing this procedure due to their expertise in ultrasound usage, as it leads to reduction in recovery times and complications for patients. Dr. Tse also briefly discusses the future potential of thyroid embolization for larger goiters. He encourages other IR specialists to consider adopting this procedure, which he believes should become a standard of care. --- CHECK OUT OUR SPONSORS Siemens Healthineers https://www.siemens-healthineers.com/ Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SHOW NOTES 00:00 - Introduction 04:03 - Dr. Tse’s Career Journey and Transition to Academics 06:32 - Discussion on Thyroid Interventions 09:15 - Building Referral Patterns for Thyroid Interventions 11:50 - Thyroid Ablation Procedure Overview 21:23 - Post-Ablation Outcomes and Goals 25:52 - Avoiding Complications 32:55 - Post-Procedure Follow-Up 36:14 - Exploring Thyroid Embolization 42:23 - Final Thoughts and Future Prospects --- RESOURCES 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/ Recurrent Laryngeal Nerve Injury in Thermal Ablation of Thyroid Nodules-Risk Factors and Cause Analysis: https://pubmed.ncbi.nlm.nih.gov/35311971/ Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation: https://doi.org/10.3803/EnM.2020.35.2.407 Revisiting Rupture of Benign Thyroid Nodules after Radiofrequency Ablation: Various Types and Imaging Features: https://doi.org/10.3803/EnM.2019.34.4.415 Thyroid arterial embolization to treat Graves' disease: https://pubmed.ncbi.nlm.nih.gov/17354140/ Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients: https://www.jvir.org/article/S1051-0443(21)01212-4/fulltext#%20 Fri, 09 Feb 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Gary Tse about the innovative technique of thyroid ablation and its role in treating benign thyroid nodules. Dr. Tse is a practicing interventional radiologist at UCLA Health. Dr. Tse highlights the procedural details, patient experiences, potential complications, and follow-up protocols of thyroid ablation. He emphasizes the importance of consistent communication with patients during these procedures, given that the patients are under minimal anesthesia. He explains how interventional radiologists can benefit from embracing this procedure due to their expertise in ultrasound usage, as it leads to reduction in recovery times and complications for patients. Dr. Tse also briefly discusses the future potential of thyroid embolization for larger goiters. He encourages other IR specialists to consider adopting this procedure, which he believes should become a standard of care. --- CHECK OUT OUR SPONSORS Siemens Healthineers https://www.siemens-healthineers.com/ Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SHOW NOTES 00:00 - Introduction 04:03 - Dr. Tse’s Career Journey and Transition to Academics 06:32 - Discussion on Thyroid Interventions 09:15 - Building Referral Patterns for Thyroid Interventions 11:50 - Thyroid Ablation Procedure Overview 21:23 - Post-Ablation Outcomes and Goals 25:52 - Avoiding Complications 32:55 - Post-Procedure Follow-Up 36:14 - Exploring Thyroid Embolization 42:23 - Final Thoughts and Future Prospects --- RESOURCES 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/ Recurrent Laryngeal Nerve Injury in Thermal Ablation of Thyroid Nodules-Risk Factors and Cause Analysis: https://pubmed.ncbi.nlm.nih.gov/35311971/ Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation: https://doi.org/10.3803/EnM.2020.35.2.407 Revisiting Rupture of Benign Thyroid Nodules after Radiofrequency Ablation: Various Types and Imaging Features: https://doi.org/10.3803/EnM.2019.34.4.415 Thyroid arterial embolization to treat Graves' disease: https://pubmed.ncbi.nlm.nih.gov/17354140/ Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients: https://www.jvir.org/article/S1051-0443(21)01212-4/fulltext#%20 In this episode of the BackTable Podcast, host Dr. Chris Beck interviews guest Dr. Gary Tse about the innovative technique of thyroid ablation and its role in treating benign thyroid nodules. Dr. Tse is a practicing interventional radiologist at UCLA Health.


Dr. Tse highlights the procedural details, patient experiences, potential complications, and follow-up protocols of thyroid ablation. He emphasizes the importance of consistent communication with patients during these procedures, given that the patients are under minimal anesthesia. He explains how interventional radiologists can benefit from embracing this procedure due to their expertise in ultrasound usage, as it leads to reduction in recovery times and complications for patients. Dr. Tse also briefly discusses the future potential of thyroid embolization for larger goiters. He encourages other IR specialists to consider adopting this procedure, which he believes should become a standard of care.


---


CHECK OUT OUR SPONSORS


Siemens Healthineers

https://www.siemens-healthineers.com/


Varian, a Siemens Healthineers company

https://www.varian.com/products/interventional-solutions/embolization-solutions


---


SHOW NOTES


00:00 - Introduction

04:03 - Dr. Tse’s Career Journey and Transition to Academics

06:32 - Discussion on Thyroid Interventions

09:15 - Building Referral Patterns for Thyroid Interventions

11:50 - Thyroid Ablation Procedure Overview

21:23 - Post-Ablation Outcomes and Goals

25:52 - Avoiding Complications

32:55 - Post-Procedure Follow-Up

36:14 - Exploring Thyroid Embolization

42:23 - Final Thoughts and Future Prospects


---


RESOURCES


2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/

Recurrent Laryngeal Nerve Injury in Thermal Ablation of Thyroid Nodules-Risk Factors and Cause Analysis:

https://pubmed.ncbi.nlm.nih.gov/35311971/


Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation:

https://doi.org/10.3803/EnM.2020.35.2.407


Revisiting Rupture of Benign Thyroid Nodules after Radiofrequency Ablation: Various Types and Imaging Features:

https://doi.org/10.3803/EnM.2019.34.4.415


Thyroid arterial embolization to treat Graves' disease:

https://pubmed.ncbi.nlm.nih.gov/17354140/


Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients:

https://www.jvir.org/article/S1051-0443(21)01212-4/fulltext#%20

]]> 2813 Ep. 414 HeRO Grafts in Dialysis: Techniques, Challenges, and Solutions with Dr. Jason Wagner In this episode, host Dr. Chris Beck interviews Dr. Jason Wagner about his experience with using the Hemodialysis Reliable Outflow (HeRO) graft and the Surfacer system for treating patients with end stage renal disease (ESRD) and limited vascular access options. Dr. Wagner is a practicing vascular surgeon in Sarasota, Florida. Dr. Wagner explains the steps to implant a HeRO endovascular graft, how it provides a durable and reliable outflow for hemodialysis patients, and how it can be used and revised based on the patient’s needs. He also discusses the Surfacer system in obtaining central venous access, its advantages, and the necessity of preoperative imaging. Dr. Wagner emphasizes the critical role of continued learning in utilizing and optimizing these advanced dialysis solutions. The suggestions and other information, which may include Merit products, are for the practitioner’s convenience and for general information purposes only. This information does not constitute medical or legal advice. Before using, refer to the Instructions for Use (IFU) for indications, contraindications, warnings, precautions, and directions for use. --- CHECK OUT OUR SPONSOR Merit HeRO Graft https://www.merit.com/product/merit-hero-graft/ --- SHOW NOTES 00:00 - Introduction 02:25 - Dr. Wagner’s Experience in Vascular Surgery 05:49 - Understanding End-Stage Vascular Access 08:52 - Introduction to the HeRO Graft 16:15 - Implantation of the HeRO Graft 28:38 - The Surfacer: A Game Changer in Vascular Access 31:49 - Potential Risks and Precautions with the Surfacer 33:38 - Using Both HeRO Graft and Surfacer 36:31 - Final Thoughts and Resources on Both Devices --- RESOURCES Think Dialysis Access Course from Merit: https://www.merit.com/education/courses/thinkaccess/ HeRO Graft: Indications, Technique, Outcomes, and Secondary Intervention: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8856774/ KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/ The Surfacer: https://bluegrassvascular.com/surfacer-2/ Tue, 06 Feb 2024 08:00:00 -0000 full BackTable In this episode, host Dr. Chris Beck interviews Dr. Jason Wagner about his experience with using the Hemodialysis Reliable Outflow (HeRO) graft and the Surfacer system for treating patients with end stage renal disease (ESRD) and limited vascular access options. Dr. Wagner is a practicing vascular surgeon in Sarasota, Florida. In this episode, host Dr. Chris Beck interviews Dr. Jason Wagner about his experience with using the Hemodialysis Reliable Outflow (HeRO) graft and the Surfacer system for treating patients with end stage renal disease (ESRD) and limited vascular access options. Dr. Wagner is a practicing vascular surgeon in Sarasota, Florida. Dr. Wagner explains the steps to implant a HeRO endovascular graft, how it provides a durable and reliable outflow for hemodialysis patients, and how it can be used and revised based on the patient’s needs. He also discusses the Surfacer system in obtaining central venous access, its advantages, and the necessity of preoperative imaging. Dr. Wagner emphasizes the critical role of continued learning in utilizing and optimizing these advanced dialysis solutions. The suggestions and other information, which may include Merit products, are for the practitioner’s convenience and for general information purposes only. This information does not constitute medical or legal advice. Before using, refer to the Instructions for Use (IFU) for indications, contraindications, warnings, precautions, and directions for use. --- CHECK OUT OUR SPONSOR Merit HeRO Graft https://www.merit.com/product/merit-hero-graft/ --- SHOW NOTES 00:00 - Introduction 02:25 - Dr. Wagner’s Experience in Vascular Surgery 05:49 - Understanding End-Stage Vascular Access 08:52 - Introduction to the HeRO Graft 16:15 - Implantation of the HeRO Graft 28:38 - The Surfacer: A Game Changer in Vascular Access 31:49 - Potential Risks and Precautions with the Surfacer 33:38 - Using Both HeRO Graft and Surfacer 36:31 - Final Thoughts and Resources on Both Devices --- RESOURCES Think Dialysis Access Course from Merit: https://www.merit.com/education/courses/thinkaccess/ HeRO Graft: Indications, Technique, Outcomes, and Secondary Intervention: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8856774/ KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/ The Surfacer: https://bluegrassvascular.com/surfacer-2/ In this episode, host Dr. Chris Beck interviews Dr. Jason Wagner about his experience with using the Hemodialysis Reliable Outflow (HeRO) graft and the Surfacer system for treating patients with end stage renal disease (ESRD) and limited vascular access options. Dr. Wagner is a practicing vascular surgeon in Sarasota, Florida.


Dr. Wagner explains the steps to implant a HeRO endovascular graft, how it provides a durable and reliable outflow for hemodialysis patients, and how it can be used and revised based on the patient’s needs. He also discusses the Surfacer system in obtaining central venous access, its advantages, and the necessity of preoperative imaging. Dr. Wagner emphasizes the critical role of continued learning in utilizing and optimizing these advanced dialysis solutions.


The suggestions and other information, which may include Merit products, are for the practitioner’s convenience and for general information purposes only. This information does not constitute medical or legal advice. Before using, refer to the Instructions for Use (IFU) for indications, contraindications, warnings, precautions, and directions for use.


---


CHECK OUT OUR SPONSOR


Merit HeRO Graft

https://www.merit.com/product/merit-hero-graft/


---


SHOW NOTES


00:00 - Introduction

02:25 - Dr. Wagner’s Experience in Vascular Surgery

05:49 - Understanding End-Stage Vascular Access

08:52 - Introduction to the HeRO Graft

16:15 - Implantation of the HeRO Graft

28:38 - The Surfacer: A Game Changer in Vascular Access

31:49 - Potential Risks and Precautions with the Surfacer

33:38 - Using Both HeRO Graft and Surfacer

36:31 - Final Thoughts and Resources on Both Devices


---


RESOURCES


Think Dialysis Access Course from Merit:

https://www.merit.com/education/courses/thinkaccess/


HeRO Graft: Indications, Technique, Outcomes, and Secondary Intervention:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8856774/


KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update:

https://pubmed.ncbi.nlm.nih.gov/32778223/


The Surfacer:

https://bluegrassvascular.com/surfacer-2/


]]> 2808 Ep. 413 TBAD Management: Best Practices in Aortic Dissection with Dr. Darren Klass This week on the BackTable Podcast, Dr. Darren Klass shares his experiences in the treatment of aortic dissections. Dr. Klass is an interventional radiologist at the University of British Columbia. Dr. Klass underscores the criticality of intraoperative decision-making, the use of intravascular ultrasound (IVUS), and the importance of taking a multidisciplinary approach. The conversation further explores the nuances of treating acute complicated aortic dissections, stabilizing the intermedial flap, follow-up protocols, and the importance of raising awareness about this high risk disease. --- CHECK OUT OUR SPONSOR Cook Medical Aortic Interventions https://www.cookmedical.com/aorticbacktable --- SHOW NOTES 00:00 - Introduction 07:45 - Identifying and Treating Type B Aortic Dissections 09:35 - Role of Imaging 18:24 - Patient Journey Through Aortic Dissection Treatment 29:35 - Importance of Intravascular Ultrasound 39:01 - Petticoat Technique 47:12 - Role of Lumbar Drains 50:10 - Importance of Follow-ups --- RESOURCES Cook Medical Essential Prescribing Information: https://www.cookmedical.com/patient-resources/aortic-dissection/aortic-dissection-cook-medical-products/ Dr. Darren Klass’ ResearchGate Profile: https://www.researchgate.net/profile/Darren-Klass The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection: https://www.sts.org/sites/default/files/content/TBAD_Guideline_2022.pdf Krukenberg E. Beiträge zur Frage des Aneurysma dissecans. Beitr Patho Anat Allg Pathol. 1920; 67:329-351. (Paper that first described acute intramural hematoma from 1920): https://cir.nii.ac.jp/crid/1571698600607606272 Acute Aortic Dissection and Intramural Hematoma: A Systematic Review: https://pubmed.ncbi.nlm.nih.gov/27533160/ The PETTICOAT Technique for Complicated Acute Stanford Type B Aortic Dissection Using a Tapered Self-Expanding Nitinol Device as Distal Uncovered Stent: https://pubmed.ncbi.nlm.nih.gov/28279721/ Fri, 02 Feb 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews Dr. Darren Klass about his expert insights and experiences in the treatment of aortic dissections. This week on the BackTable Podcast, Dr. Darren Klass shares his experiences in the treatment of aortic dissections. Dr. Klass is an interventional radiologist at the University of British Columbia. Dr. Klass underscores the criticality of intraoperative decision-making, the use of intravascular ultrasound (IVUS), and the importance of taking a multidisciplinary approach. The conversation further explores the nuances of treating acute complicated aortic dissections, stabilizing the intermedial flap, follow-up protocols, and the importance of raising awareness about this high risk disease. --- CHECK OUT OUR SPONSOR Cook Medical Aortic Interventions https://www.cookmedical.com/aorticbacktable --- SHOW NOTES 00:00 - Introduction 07:45 - Identifying and Treating Type B Aortic Dissections 09:35 - Role of Imaging 18:24 - Patient Journey Through Aortic Dissection Treatment 29:35 - Importance of Intravascular Ultrasound 39:01 - Petticoat Technique 47:12 - Role of Lumbar Drains 50:10 - Importance of Follow-ups --- RESOURCES Cook Medical Essential Prescribing Information: https://www.cookmedical.com/patient-resources/aortic-dissection/aortic-dissection-cook-medical-products/ Dr. Darren Klass’ ResearchGate Profile: https://www.researchgate.net/profile/Darren-Klass The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection: https://www.sts.org/sites/default/files/content/TBAD_Guideline_2022.pdf Krukenberg E. Beiträge zur Frage des Aneurysma dissecans. Beitr Patho Anat Allg Pathol. 1920; 67:329-351. (Paper that first described acute intramural hematoma from 1920): https://cir.nii.ac.jp/crid/1571698600607606272 Acute Aortic Dissection and Intramural Hematoma: A Systematic Review: https://pubmed.ncbi.nlm.nih.gov/27533160/ The PETTICOAT Technique for Complicated Acute Stanford Type B Aortic Dissection Using a Tapered Self-Expanding Nitinol Device as Distal Uncovered Stent: https://pubmed.ncbi.nlm.nih.gov/28279721/ This week on the BackTable Podcast, Dr. Darren Klass shares his experiences in the treatment of aortic dissections. Dr. Klass is an interventional radiologist at the University of British Columbia.


Dr. Klass underscores the criticality of intraoperative decision-making, the use of intravascular ultrasound (IVUS), and the importance of taking a multidisciplinary approach. The conversation further explores the nuances of treating acute complicated aortic dissections, stabilizing the intermedial flap, follow-up protocols, and the importance of raising awareness about this high risk disease.


---


CHECK OUT OUR SPONSOR


Cook Medical Aortic Interventions

https://www.cookmedical.com/aorticbacktable


---


SHOW NOTES


00:00 - Introduction

07:45 - Identifying and Treating Type B Aortic Dissections

09:35 - Role of Imaging

18:24 - Patient Journey Through Aortic Dissection Treatment

29:35 - Importance of Intravascular Ultrasound

39:01 - Petticoat Technique

47:12 - Role of Lumbar Drains

50:10 - Importance of Follow-ups


---


RESOURCES


Cook Medical Essential Prescribing Information:

https://www.cookmedical.com/patient-resources/aortic-dissection/aortic-dissection-cook-medical-products/


Dr. Darren Klass’ ResearchGate Profile:

https://www.researchgate.net/profile/Darren-Klass


The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection:

https://www.sts.org/sites/default/files/content/TBAD_Guideline_2022.pdf


Krukenberg E. Beiträge zur Frage des Aneurysma dissecans. Beitr Patho Anat Allg Pathol. 1920; 67:329-351. (Paper that first described acute intramural hematoma from 1920):

https://cir.nii.ac.jp/crid/1571698600607606272


Acute Aortic Dissection and Intramural Hematoma: A Systematic Review:

https://pubmed.ncbi.nlm.nih.gov/27533160/


The PETTICOAT Technique for Complicated Acute Stanford Type B Aortic Dissection Using a Tapered Self-Expanding Nitinol Device as Distal Uncovered Stent:

https://pubmed.ncbi.nlm.nih.gov/28279721/

]]> 3497 Ep. 412 Intervencionismo Pediátrico: No Kits For Peds with Dr. Fernando Gómez Muñoz En este nuevo episodio de BackTable, el Dr. Fernando Gómez Muñoz y la Dra. Sara Lojo Lendoiro profundizan en el complejo y específico campo de la radiología intervencionista pediátrica. Al enfatizar las diferencias existentes entre los pacientes adultos y los niños, el Dr. Gómez Muñoz destaca la necesidad de capacitación y enfoques especializados para el manejo de casos pediátricos, especialmente en términos de variantes propias de la edad del paciente como la volemia o el tamaño de los vasos. Se examinan críticamente los desafíos en los procedimientos intervencionistas, particularmente en relación con las complejidades propias del trabajo con pacientes pediátricos y la dificultad añadida de los materiales necesarios. Además, el Dr Gómez Muñoz comparte su trayectoria profesional, su paso por el Great Ormond Street Hospital de Londres y su continuo aprendizaje de colegas de todo el mundo. En el podcast también se explora la necesidad de una colaboración multidisciplinar y se analiza la relación entre los radiólogos intervencionistas y los cirujanos pediátricos. Se subraya la importancia de una comunicación clara con las familias de los pacientes durante procedimientos o diagnósticos particularmente complejos, afirmando que la atención al paciente comienza con el manejo de las emociones y expectativas de los propios médicos. --- SHOW NOTES 00:00 - Introducción a la radiología intervencionista pediátrica 01:27 - Comprender las diferencias entre pacientes adultos y pediátricos 03:08 - Desafíos en radiología intervencionista pediátrica 08:29 - El papel de la formación y la especialización 13:25 - Cómo afrontar las emergencias médicas pediátricas 19:02 - La importancia del enfoque multidisciplinario en la atención pediátrica 26:23 - El futuro de la radiología intervencionista pediátrica 42:44 - Conclusión: La importancia de la radiología intervencionista pediátrica Wed, 31 Jan 2024 08:00:00 -0000 full BackTable En este nuevo episodio de BackTable, el Dr. Fernando Gómez Muñoz y la Dra. Sara Lojo Lendoiro profundizan en el complejo y específico campo de la radiología intervencionista pediátrica. En este nuevo episodio de BackTable, el Dr. Fernando Gómez Muñoz y la Dra. Sara Lojo Lendoiro profundizan en el complejo y específico campo de la radiología intervencionista pediátrica. Al enfatizar las diferencias existentes entre los pacientes adultos y los niños, el Dr. Gómez Muñoz destaca la necesidad de capacitación y enfoques especializados para el manejo de casos pediátricos, especialmente en términos de variantes propias de la edad del paciente como la volemia o el tamaño de los vasos. Se examinan críticamente los desafíos en los procedimientos intervencionistas, particularmente en relación con las complejidades propias del trabajo con pacientes pediátricos y la dificultad añadida de los materiales necesarios. Además, el Dr Gómez Muñoz comparte su trayectoria profesional, su paso por el Great Ormond Street Hospital de Londres y su continuo aprendizaje de colegas de todo el mundo. En el podcast también se explora la necesidad de una colaboración multidisciplinar y se analiza la relación entre los radiólogos intervencionistas y los cirujanos pediátricos. Se subraya la importancia de una comunicación clara con las familias de los pacientes durante procedimientos o diagnósticos particularmente complejos, afirmando que la atención al paciente comienza con el manejo de las emociones y expectativas de los propios médicos. --- SHOW NOTES 00:00 - Introducción a la radiología intervencionista pediátrica 01:27 - Comprender las diferencias entre pacientes adultos y pediátricos 03:08 - Desafíos en radiología intervencionista pediátrica 08:29 - El papel de la formación y la especialización 13:25 - Cómo afrontar las emergencias médicas pediátricas 19:02 - La importancia del enfoque multidisciplinario en la atención pediátrica 26:23 - El futuro de la radiología intervencionista pediátrica 42:44 - Conclusión: La importancia de la radiología intervencionista pediátrica En este nuevo episodio de BackTable, el Dr. Fernando Gómez Muñoz y la Dra. Sara Lojo Lendoiro profundizan en el complejo y específico campo de la radiología intervencionista pediátrica.


Al enfatizar las diferencias existentes entre los pacientes adultos y los niños, el Dr. Gómez Muñoz destaca la necesidad de capacitación y enfoques especializados para el manejo de casos pediátricos, especialmente en términos de variantes propias de la edad del paciente como la volemia o el tamaño de los vasos. Se examinan críticamente los desafíos en los procedimientos intervencionistas, particularmente en relación con las complejidades propias del trabajo con pacientes pediátricos y la dificultad añadida de los materiales necesarios. Además, el Dr Gómez Muñoz comparte su trayectoria profesional, su paso por el Great Ormond Street Hospital de Londres y su continuo aprendizaje de colegas de todo el mundo.


En el podcast también se explora la necesidad de una colaboración multidisciplinar y se analiza la relación entre los radiólogos intervencionistas y los cirujanos pediátricos. Se subraya la importancia de una comunicación clara con las familias de los pacientes durante procedimientos o diagnósticos particularmente complejos, afirmando que la atención al paciente comienza con el manejo de las emociones y expectativas de los propios médicos.


---


SHOW NOTES


00:00 - Introducción a la radiología intervencionista pediátrica

01:27 - Comprender las diferencias entre pacientes adultos y pediátricos

03:08 - Desafíos en radiología intervencionista pediátrica

08:29 - El papel de la formación y la especialización

13:25 - Cómo afrontar las emergencias médicas pediátricas

19:02 - La importancia del enfoque multidisciplinario en la atención pediátrica

26:23 - El futuro de la radiología intervencionista pediátrica

42:44 - Conclusión: La importancia de la radiología intervencionista pediátrica

]]> 2743 Ep. 411 Innovating Pain Management: The Role of Spinal Cord Stimulators in Outpatient Care with Dr. Douglas Beall In this episode, guest host Dr. Dana Dunleavy and guest Dr. Douglas Beall delve into the transformative potential of neuromodulation in the treatment of chronic pain, particularly for painful diabetic neuropathy (PDN). Dr. Beall is an interventional musculoskeletal radiologist practicing at Oklahoma Spine in Edmond, Oklahoma. Dr. Beall recounts his journey, from his beginnings in the military to his experiences with navigating institutional resistance to his clinical practice, and finally the process of moving to private practice. He discusses the positive impact of spinal cord stimulation on patients with PDN and reflects on its effectiveness in reducing pain and improving neurologic function. He underscores the crucial role of interventional radiologists in managing PDN, while also advocating for the integration of these specialists in pain management clinics. Dr. Beall argues that interventional radiologists possess unique skill sets adept for neuromodulation, which opens up new treatment possibilities in the process. He shares insights on the evolution of spinal cord stimulation technology, reimbursement considerations, and the importance of clinical trials in refining treatment approaches. The episode ends with an invitation for interested physicians to participate in professional forums and learn more about this burgeoning field. --- CHECK OUT OUR SPONSOR Nevro HFX Spinal Cord Stimulator https://www.hfxforpdn.com --- SHOW NOTES 00:00 - Introduction 02:30 - Challenges and Triumphs of a Solo Practice 14:44 - Evolution of Neuromodulation in Practice 17:05 - Impact of Neuromodulation on Painful Diabetic Neuropathy 31:53 - Unique Mechanism of High Frequency Neuromodulation 46:02 - Role of Interventional Radiologists in Neuromodulation 54:11 - Future of Neuromodulation in Interventional Radiology --- RESOURCES Douglas Beall, MD Research Gate Profile: https://www.researchgate.net/scientific-contributions/Douglas-P-Beall-39583252 Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial: https://pubmed.ncbi.nlm.nih.gov/37536514/ High-Frequency 10-kHz Spinal Cord Stimulation Improves Health-Related Quality of Life in Patients With Refractory Painful Diabetic Neuropathy: 12-Month Results From a Randomized Controlled Trial: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256824/ Neuromodulation Interventions for the Treatment of Painful Diabetic Neuropathy: a Systematic Review: https://link.springer.com/article/10.1007/s11916-022-01035-9 High-frequency spinal cord stimulation at 10 kHz for the treatment of painful diabetic neuropathy: design of a multicenter, randomized controlled trial (SENZA-PDN): https://link.springer.com/article/10.1186/s13063-019-4007-y Mon, 29 Jan 2024 08:00:00 -0000 full BackTable In this episode, guest host Dr. Dana Dunleavy and guest Dr. Douglas Beall delve into the transformative potential of neuromodulation in the treatment of chronic pain, particularly for painful diabetic neuropathy (PDN). In this episode, guest host Dr. Dana Dunleavy and guest Dr. Douglas Beall delve into the transformative potential of neuromodulation in the treatment of chronic pain, particularly for painful diabetic neuropathy (PDN). Dr. Beall is an interventional musculoskeletal radiologist practicing at Oklahoma Spine in Edmond, Oklahoma. Dr. Beall recounts his journey, from his beginnings in the military to his experiences with navigating institutional resistance to his clinical practice, and finally the process of moving to private practice. He discusses the positive impact of spinal cord stimulation on patients with PDN and reflects on its effectiveness in reducing pain and improving neurologic function. He underscores the crucial role of interventional radiologists in managing PDN, while also advocating for the integration of these specialists in pain management clinics. Dr. Beall argues that interventional radiologists possess unique skill sets adept for neuromodulation, which opens up new treatment possibilities in the process. He shares insights on the evolution of spinal cord stimulation technology, reimbursement considerations, and the importance of clinical trials in refining treatment approaches. The episode ends with an invitation for interested physicians to participate in professional forums and learn more about this burgeoning field. --- CHECK OUT OUR SPONSOR Nevro HFX Spinal Cord Stimulator https://www.hfxforpdn.com --- SHOW NOTES 00:00 - Introduction 02:30 - Challenges and Triumphs of a Solo Practice 14:44 - Evolution of Neuromodulation in Practice 17:05 - Impact of Neuromodulation on Painful Diabetic Neuropathy 31:53 - Unique Mechanism of High Frequency Neuromodulation 46:02 - Role of Interventional Radiologists in Neuromodulation 54:11 - Future of Neuromodulation in Interventional Radiology --- RESOURCES Douglas Beall, MD Research Gate Profile: https://www.researchgate.net/scientific-contributions/Douglas-P-Beall-39583252 Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial: https://pubmed.ncbi.nlm.nih.gov/37536514/ High-Frequency 10-kHz Spinal Cord Stimulation Improves Health-Related Quality of Life in Patients With Refractory Painful Diabetic Neuropathy: 12-Month Results From a Randomized Controlled Trial: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256824/ Neuromodulation Interventions for the Treatment of Painful Diabetic Neuropathy: a Systematic Review: https://link.springer.com/article/10.1007/s11916-022-01035-9 High-frequency spinal cord stimulation at 10 kHz for the treatment of painful diabetic neuropathy: design of a multicenter, randomized controlled trial (SENZA-PDN): https://link.springer.com/article/10.1186/s13063-019-4007-y In this episode, guest host Dr. Dana Dunleavy and guest Dr. Douglas Beall delve into the transformative potential of neuromodulation in the treatment of chronic pain, particularly for painful diabetic neuropathy (PDN). Dr. Beall is an interventional musculoskeletal radiologist practicing at Oklahoma Spine in Edmond, Oklahoma.


Dr. Beall recounts his journey, from his beginnings in the military to his experiences with navigating institutional resistance to his clinical practice, and finally the process of moving to private practice. He discusses the positive impact of spinal cord stimulation on patients with PDN and reflects on its effectiveness in reducing pain and improving neurologic function. He underscores the crucial role of interventional radiologists in managing PDN, while also advocating for the integration of these specialists in pain management clinics. Dr. Beall argues that interventional radiologists possess unique skill sets adept for neuromodulation, which opens up new treatment possibilities in the process. He shares insights on the evolution of spinal cord stimulation technology, reimbursement considerations, and the importance of clinical trials in refining treatment approaches. The episode ends with an invitation for interested physicians to participate in professional forums and learn more about this burgeoning field.


---


CHECK OUT OUR SPONSOR


Nevro HFX Spinal Cord Stimulator

https://www.hfxforpdn.com


---


SHOW NOTES


00:00 - Introduction

02:30 - Challenges and Triumphs of a Solo Practice

14:44 - Evolution of Neuromodulation in Practice

17:05 - Impact of Neuromodulation on Painful Diabetic Neuropathy

31:53 - Unique Mechanism of High Frequency Neuromodulation

46:02 - Role of Interventional Radiologists in Neuromodulation

54:11 - Future of Neuromodulation in Interventional Radiology


---


RESOURCES


Douglas Beall, MD Research Gate Profile:

https://www.researchgate.net/scientific-contributions/Douglas-P-Beall-39583252


Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial:

https://pubmed.ncbi.nlm.nih.gov/37536514/


High-Frequency 10-kHz Spinal Cord Stimulation Improves Health-Related Quality of Life in Patients With Refractory Painful Diabetic Neuropathy: 12-Month Results From a Randomized Controlled Trial:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256824/


Neuromodulation Interventions for the Treatment of Painful Diabetic Neuropathy: a Systematic Review:

https://link.springer.com/article/10.1007/s11916-022-01035-9


High-frequency spinal cord stimulation at 10 kHz for the treatment of painful diabetic neuropathy: design of a multicenter, randomized controlled trial (SENZA-PDN):

https://link.springer.com/article/10.1186/s13063-019-4007-y

]]> 3949 Ep. 410 True Lumen Re-Entry with Pioneer Plus with Dr. Thomas Davis In this episode of BackTable Podcast, host Dr. Ally Behati invites interventional cardiologist Dr. Thomas Davis, Director of the Cardiac Catheterization Lab at St. John Hospital and Medical Center, to discuss re-entry devices, with a focus on the Pioneer Plus Catheter. Dr. Davis shares his experience in using the Pioneer Plus, an intravascular ultrasound (IVUS) guided re-entry catheter in treating critical limb ischemia (CLI), especially in cases where it is difficult to stay intraluminal. He explains a novel ‘reorientation technique’, which allows proceduralists to remain in the true lumen while treating a chronic total occlusion. Dr. Davis also describes his workflow and decision points about when to reach for the catheter. To finish the episode, he covers post-procedure patient management, imaging follow up, and opportunities to learn more about treatment of peripheral vascular disease. --- CHECK OUT OUR SPONSOR Philips Pioneer Plus https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter --- SHOW NOTES 00:00 Introduction to the Back Table Podcast 02:09 Dr. Davis’ Practice in CLI Treatment 04:18 The Decision to Use the Pioneer Plus Catheter 07:31 The Reorientation Technique for Staying in the True Lumen 11:49 Using Intravascular Ultrasound to Guide Your Wire 17:33 Learning and Troubleshooting with IVUS 21:48 Preparing for Subintimal Work 28:26 Post-Procedural Management and Imaging 30:12 Advice for Proceduralists in the CLI Space --- RESOURCES Pioneer Plus Re-Entry Catheter: https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter Outback Re-Entry Catheter: https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter Enteer Re-Entry Catheter https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/chronic-total-occlusion-devices/enteer.html The Amputation Prevention Symposium (AMP) Meeting: https://www.hmpglobalevents.com/amptheclimeeting Thu, 25 Jan 2024 08:00:00 -0000 full BackTable In this episode of BackTable Podcast, host Dr. Ally Behati invites interventional cardiologist Dr. Thomas Davis, Director of the Cardiac Catheterization Lab at St. John Hospital and Medical Center, to discuss re-entry devices, with a focus on the Pioneer Plus Catheter. In this episode of BackTable Podcast, host Dr. Ally Behati invites interventional cardiologist Dr. Thomas Davis, Director of the Cardiac Catheterization Lab at St. John Hospital and Medical Center, to discuss re-entry devices, with a focus on the Pioneer Plus Catheter. Dr. Davis shares his experience in using the Pioneer Plus, an intravascular ultrasound (IVUS) guided re-entry catheter in treating critical limb ischemia (CLI), especially in cases where it is difficult to stay intraluminal. He explains a novel ‘reorientation technique’, which allows proceduralists to remain in the true lumen while treating a chronic total occlusion. Dr. Davis also describes his workflow and decision points about when to reach for the catheter. To finish the episode, he covers post-procedure patient management, imaging follow up, and opportunities to learn more about treatment of peripheral vascular disease. --- CHECK OUT OUR SPONSOR Philips Pioneer Plus https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter --- SHOW NOTES 00:00 Introduction to the Back Table Podcast 02:09 Dr. Davis’ Practice in CLI Treatment 04:18 The Decision to Use the Pioneer Plus Catheter 07:31 The Reorientation Technique for Staying in the True Lumen 11:49 Using Intravascular Ultrasound to Guide Your Wire 17:33 Learning and Troubleshooting with IVUS 21:48 Preparing for Subintimal Work 28:26 Post-Procedural Management and Imaging 30:12 Advice for Proceduralists in the CLI Space --- RESOURCES Pioneer Plus Re-Entry Catheter: https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter Outback Re-Entry Catheter: https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter Enteer Re-Entry Catheter https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/chronic-total-occlusion-devices/enteer.html The Amputation Prevention Symposium (AMP) Meeting: https://www.hmpglobalevents.com/amptheclimeeting In this episode of BackTable Podcast, host Dr. Ally Behati invites interventional cardiologist Dr. Thomas Davis, Director of the Cardiac Catheterization Lab at St. John Hospital and Medical Center, to discuss re-entry devices, with a focus on the Pioneer Plus Catheter.


Dr. Davis shares his experience in using the Pioneer Plus, an intravascular ultrasound (IVUS) guided re-entry catheter in treating critical limb ischemia (CLI), especially in cases where it is difficult to stay intraluminal. He explains a novel ‘reorientation technique’, which allows proceduralists to remain in the true lumen while treating a chronic total occlusion. Dr. Davis also describes his workflow and decision points about when to reach for the catheter. To finish the episode, he covers post-procedure patient management, imaging follow up, and opportunities to learn more about treatment of peripheral vascular disease.


---


CHECK OUT OUR SPONSOR


Philips Pioneer Plus

https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter


---


SHOW NOTES


00:00 Introduction to the Back Table Podcast

02:09 Dr. Davis’ Practice in CLI Treatment

04:18 The Decision to Use the Pioneer Plus Catheter

07:31 The Reorientation Technique for Staying in the True Lumen

11:49 Using Intravascular Ultrasound to Guide Your Wire

17:33 Learning and Troubleshooting with IVUS

21:48 Preparing for Subintimal Work

28:26 Post-Procedural Management and Imaging

30:12 Advice for Proceduralists in the CLI Space


---


RESOURCES


Pioneer Plus Re-Entry Catheter:

https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter


Outback Re-Entry Catheter:

https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter


Enteer Re-Entry Catheter

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/chronic-total-occlusion-devices/enteer.html


The Amputation Prevention Symposium (AMP) Meeting:

https://www.hmpglobalevents.com/amptheclimeeting

]]> 2119 Ep. 409 Thrombectomy for Large Core Infarctions: Balancing Benefits and Risks with Dr. Fawaz Al-Mufti In this episode of the BackTable Podcast, guest host Dr. Krishna Amuluru interviews Dr. Fawaz Al-Mufti about recent trials on large core strokes and how they may impact practice. Dr. Al-Mufti is a practicing neurointerventionalist and serves as the Associate Chair of Neurology for Research at New York Medical College. Dr. Al-Mufti examines the cost-effectiveness and socioeconomic implications of successful treatment of patients with large core strokes. The doctors highlight various stroke thrombectomy trials including the RESCUE-Japan, SELECT2 Trial, and TENSION trials. The discussion also covers how these findings affect thrombectomy expansion in lower resource settings and the future outlook of endovascular thrombectomy procedures. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:53 - Large Ischemic Core Infarcts 06:06 - The Importance of ASPECTS 11:59 - Large Ischemic Core Trials 23:37 - Socioeconomic Implications of Thrombectomy 38:08 - The Future of Thrombectomy --- RESOURCES Mission Thrombectomy: https://missionthrombectomy.org/ The Alberta Stroke Program Early CT score (ASPECTS): A predictor of mortality in acute ischemic stroke: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515558/ Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomized trials (HERMES Study): https://doi.org/10.1016/S0140-6736(16)00163-X Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging (DEFUSE III Trial): https://www.nejm.org/doi/full/10.1056/nejmoa1713973 Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct (DAWN Trial): https://www.nejm.org/doi/full/10.1056/nejmoa1706442 Endovascular Therapy for Acute Stroke with a Large Ischemic Region (RESCUE-Japan Trial): https://www.nejm.org/doi/full/10.1056/nejmoa2118191 Trial of Endovascular Thrombectomy for Large Ischemic Strokes (SELECT2 Trial): https://www.nejm.org/doi/full/10.1056/NEJMoa2214403 TESLA Trial: Rationale, Protocol, and Design: https://www.ahajournals.org/doi/10.1161/SVIN.122.000787 Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomized trial (TENSION Trial): https://www.sciencedirect.com/science/article/pii/S0140673623020329 Evaluation of acute mechanical revascularization in large stroke (ASPECTS ⩽5) and large vessel occlusion within 7 h of last-seen-well: The LASTE multicenter, randomized, clinical trial protocol: https://pubmed.ncbi.nlm.nih.gov/37462028/ Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct (ANGEL-ASPECT Trial): https://www.nejm.org/doi/full/10.1056/NEJMoa2213379 Acute endovascular stroke therapy (Dr. Mike Chen Review): https://pubmed.ncbi.nlm.nih.gov/20535000/ Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS (European Cost Effectiveness Study): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/ Mechanical Thrombectomy Global Access For Stroke (MT-GLASS): A Mission Thrombectomy (MT-2020 Plus) Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/ Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576630/ Wed, 24 Jan 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, guest host Dr. Krishna Amuluru interviews Dr. Fawaz Al-Mufti about recent trials on large core strokes and how they may impact practice. Dr. Al-Mufti is a practicing neurointerventionalist and serves as the Associate Chair of Neurology for Research at New York Medical College. In this episode of the BackTable Podcast, guest host Dr. Krishna Amuluru interviews Dr. Fawaz Al-Mufti about recent trials on large core strokes and how they may impact practice. Dr. Al-Mufti is a practicing neurointerventionalist and serves as the Associate Chair of Neurology for Research at New York Medical College. Dr. Al-Mufti examines the cost-effectiveness and socioeconomic implications of successful treatment of patients with large core strokes. The doctors highlight various stroke thrombectomy trials including the RESCUE-Japan, SELECT2 Trial, and TENSION trials. The discussion also covers how these findings affect thrombectomy expansion in lower resource settings and the future outlook of endovascular thrombectomy procedures. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:53 - Large Ischemic Core Infarcts 06:06 - The Importance of ASPECTS 11:59 - Large Ischemic Core Trials 23:37 - Socioeconomic Implications of Thrombectomy 38:08 - The Future of Thrombectomy --- RESOURCES Mission Thrombectomy: https://missionthrombectomy.org/ The Alberta Stroke Program Early CT score (ASPECTS): A predictor of mortality in acute ischemic stroke: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515558/ Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomized trials (HERMES Study): https://doi.org/10.1016/S0140-6736(16)00163-X Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging (DEFUSE III Trial): https://www.nejm.org/doi/full/10.1056/nejmoa1713973 Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct (DAWN Trial): https://www.nejm.org/doi/full/10.1056/nejmoa1706442 Endovascular Therapy for Acute Stroke with a Large Ischemic Region (RESCUE-Japan Trial): https://www.nejm.org/doi/full/10.1056/nejmoa2118191 Trial of Endovascular Thrombectomy for Large Ischemic Strokes (SELECT2 Trial): https://www.nejm.org/doi/full/10.1056/NEJMoa2214403 TESLA Trial: Rationale, Protocol, and Design: https://www.ahajournals.org/doi/10.1161/SVIN.122.000787 Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomized trial (TENSION Trial): https://www.sciencedirect.com/science/article/pii/S0140673623020329 Evaluation of acute mechanical revascularization in large stroke (ASPECTS ⩽5) and large vessel occlusion within 7 h of last-seen-well: The LASTE multicenter, randomized, clinical trial protocol: https://pubmed.ncbi.nlm.nih.gov/37462028/ Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct (ANGEL-ASPECT Trial): https://www.nejm.org/doi/full/10.1056/NEJMoa2213379 Acute endovascular stroke therapy (Dr. Mike Chen Review): https://pubmed.ncbi.nlm.nih.gov/20535000/ Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS (European Cost Effectiveness Study): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/ Mechanical Thrombectomy Global Access For Stroke (MT-GLASS): A Mission Thrombectomy (MT-2020 Plus) Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/ Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576630/ In this episode of the BackTable Podcast, guest host Dr. Krishna Amuluru interviews Dr. Fawaz Al-Mufti about recent trials on large core strokes and how they may impact practice. Dr. Al-Mufti is a practicing neurointerventionalist and serves as the Associate Chair of Neurology for Research at New York Medical College.


Dr. Al-Mufti examines the cost-effectiveness and socioeconomic implications of successful treatment of patients with large core strokes. The doctors highlight various stroke thrombectomy trials including the RESCUE-Japan, SELECT2 Trial, and TENSION trials. The discussion also covers how these findings affect thrombectomy expansion in lower resource settings and the future outlook of endovascular thrombectomy procedures.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

02:53 - Large Ischemic Core Infarcts

06:06 - The Importance of ASPECTS

11:59 - Large Ischemic Core Trials

23:37 - Socioeconomic Implications of Thrombectomy

38:08 - The Future of Thrombectomy


---


RESOURCES


Mission Thrombectomy:

https://missionthrombectomy.org/


The Alberta Stroke Program Early CT score (ASPECTS): A predictor of mortality in acute ischemic stroke:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515558/


Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomized trials (HERMES Study):

https://doi.org/10.1016/S0140-6736(16)00163-X


Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging (DEFUSE III Trial):

https://www.nejm.org/doi/full/10.1056/nejmoa1713973


Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct (DAWN Trial):

https://www.nejm.org/doi/full/10.1056/nejmoa1706442


Endovascular Therapy for Acute Stroke with a Large Ischemic Region (RESCUE-Japan Trial):

https://www.nejm.org/doi/full/10.1056/nejmoa2118191


Trial of Endovascular Thrombectomy for Large Ischemic Strokes (SELECT2 Trial):

https://www.nejm.org/doi/full/10.1056/NEJMoa2214403


TESLA Trial: Rationale, Protocol, and Design:

https://www.ahajournals.org/doi/10.1161/SVIN.122.000787


Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomized trial (TENSION Trial):

https://www.sciencedirect.com/science/article/pii/S0140673623020329


Evaluation of acute mechanical revascularization in large stroke (ASPECTS ⩽5) and large vessel occlusion within 7 h of last-seen-well: The LASTE multicenter, randomized, clinical trial protocol:

https://pubmed.ncbi.nlm.nih.gov/37462028/


Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct (ANGEL-ASPECT Trial):

https://www.nejm.org/doi/full/10.1056/NEJMoa2213379


Acute endovascular stroke therapy (Dr. Mike Chen Review):

https://pubmed.ncbi.nlm.nih.gov/20535000/


Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS (European Cost Effectiveness Study):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/


Mechanical Thrombectomy Global Access For Stroke (MT-GLASS): A Mission Thrombectomy (MT-2020 Plus) Study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/


Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576630/

]]> 2787 Ep. 408 Laser BTK Study Insights: Navigating Complex Lesions with Dr. Nicolas Shammas In this episode, host Dr. Aaron Fritts is joined by interventional cardiologists Dr. Sameh Sayfo (Baylor Scott & White in Plano, TX) and Dr. Nicolas Shammas (Cardiovascular Medicine in Davenport, IA) for a discussion about critical limb ischemia (CLI) and the use of lasers in below-the-knee (BTK) treatment. To start, Dr. Shammas explains that infrapopliteal disease is difficult to treat due to the high rate of total occlusions and the high degree of medial calcinosis. Next, he gives an introduction to laser atherectomy for certain plaque locations and morphologies, and he describes previous studies that have shown its efficacy for calcified lesions. Intravascular ultrasound (IVUS) can also help guide vessel sizing, plaque morphology, and appropriate device selection. Dr. Shammas believes that the current atherectomy devices on the market are easy to learn to use and can be incorporated into any CLI program. The doctors discuss the ongoing multicenter study on outcomes of the Auryon laser atherectomy system in CLI patients. Dr. Shammas reviews the study design, proposed endpoints, and current data on 30 day outcomes. We end the episode with advice on building a strong CLI program, which includes multidisciplinary collaboration, advocating for resources, a variety of different tools, and appropriate management of cardiovascular risk factors. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES 00:00 - Introduction 04:18 - Current Treatment Limitations for Infrapopliteal Disease 07:38 - Laser Atherectomy for Calcified Lesions 12:10 - Learning Curve for Laser Atherectomy Devices 15:38 - 30-Day Results of the Auryon BTK Study 23:35 - Technical Approach and Tools for Infrapopliteal Segments 29:00 - Upcoming Developments in CLI Treatment 31:33 - Advice for Building a CLI Program --- RESOURCES Calcium 360 Trial: https://pubmed.ncbi.nlm.nih.gov/22891826/ Auryon Laser Atherectomy System: https://www.angiodynamics.com/product/auryon/ Nexcimer Laser Atherectomy System: https://www.usa.philips.com/healthcare/product/HCIGTDPHLLSRSYSTM/laser-system-hcigtdphllsrsystm 30-Day Results of the Auryon BTK Study: https://www.jacc.org/doi/10.1016/j.jacc.2023.09.194 Midwest Cardiovascular Research Foundation: http://www.mcrfmd.com/ Life-BTK Study: https://www.cardiovascular.abbott/us/en/patients/treatments-therapies/peripheral-artery-disease/life-btk.html Promise II Study: https://www.nejm.org/doi/full/10.1056/NEJMoa2212754 BackTable Ep. 350- Building a CLI Program with Dr. Zola N’Dandu: https://www.backtable.com/shows/vi/podcasts/350/building-a-cli-program Tue, 23 Jan 2024 08:00:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts is joined by interventional cardiologists Dr. Sameh Sayfo (Baylor Scott & White in Plano, TX) and Dr. Nicolas Shammas (Cardiovascular Medicine in Davenport, IA) for a discussion about critical limb ischemia (CLI) and the use of lasers in below-the-knee (BTK) treatment. In this episode, host Dr. Aaron Fritts is joined by interventional cardiologists Dr. Sameh Sayfo (Baylor Scott & White in Plano, TX) and Dr. Nicolas Shammas (Cardiovascular Medicine in Davenport, IA) for a discussion about critical limb ischemia (CLI) and the use of lasers in below-the-knee (BTK) treatment. To start, Dr. Shammas explains that infrapopliteal disease is difficult to treat due to the high rate of total occlusions and the high degree of medial calcinosis. Next, he gives an introduction to laser atherectomy for certain plaque locations and morphologies, and he describes previous studies that have shown its efficacy for calcified lesions. Intravascular ultrasound (IVUS) can also help guide vessel sizing, plaque morphology, and appropriate device selection. Dr. Shammas believes that the current atherectomy devices on the market are easy to learn to use and can be incorporated into any CLI program. The doctors discuss the ongoing multicenter study on outcomes of the Auryon laser atherectomy system in CLI patients. Dr. Shammas reviews the study design, proposed endpoints, and current data on 30 day outcomes. We end the episode with advice on building a strong CLI program, which includes multidisciplinary collaboration, advocating for resources, a variety of different tools, and appropriate management of cardiovascular risk factors. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES 00:00 - Introduction 04:18 - Current Treatment Limitations for Infrapopliteal Disease 07:38 - Laser Atherectomy for Calcified Lesions 12:10 - Learning Curve for Laser Atherectomy Devices 15:38 - 30-Day Results of the Auryon BTK Study 23:35 - Technical Approach and Tools for Infrapopliteal Segments 29:00 - Upcoming Developments in CLI Treatment 31:33 - Advice for Building a CLI Program --- RESOURCES Calcium 360 Trial: https://pubmed.ncbi.nlm.nih.gov/22891826/ Auryon Laser Atherectomy System: https://www.angiodynamics.com/product/auryon/ Nexcimer Laser Atherectomy System: https://www.usa.philips.com/healthcare/product/HCIGTDPHLLSRSYSTM/laser-system-hcigtdphllsrsystm 30-Day Results of the Auryon BTK Study: https://www.jacc.org/doi/10.1016/j.jacc.2023.09.194 Midwest Cardiovascular Research Foundation: http://www.mcrfmd.com/ Life-BTK Study: https://www.cardiovascular.abbott/us/en/patients/treatments-therapies/peripheral-artery-disease/life-btk.html Promise II Study: https://www.nejm.org/doi/full/10.1056/NEJMoa2212754 BackTable Ep. 350- Building a CLI Program with Dr. Zola N’Dandu: https://www.backtable.com/shows/vi/podcasts/350/building-a-cli-program In this episode, host Dr. Aaron Fritts is joined by interventional cardiologists Dr. Sameh Sayfo (Baylor Scott & White in Plano, TX) and Dr. Nicolas Shammas (Cardiovascular Medicine in Davenport, IA) for a discussion about critical limb ischemia (CLI) and the use of lasers in below-the-knee (BTK) treatment.


To start, Dr. Shammas explains that infrapopliteal disease is difficult to treat due to the high rate of total occlusions and the high degree of medial calcinosis. Next, he gives an introduction to laser atherectomy for certain plaque locations and morphologies, and he describes previous studies that have shown its efficacy for calcified lesions. Intravascular ultrasound (IVUS) can also help guide vessel sizing, plaque morphology, and appropriate device selection. Dr. Shammas believes that the current atherectomy devices on the market are easy to learn to use and can be incorporated into any CLI program.


The doctors discuss the ongoing multicenter study on outcomes of the Auryon laser atherectomy system in CLI patients. Dr. Shammas reviews the study design, proposed endpoints, and current data on 30 day outcomes. We end the episode with advice on building a strong CLI program, which includes multidisciplinary collaboration, advocating for resources, a variety of different tools, and appropriate management of cardiovascular risk factors.


---


CHECK OUT OUR SPONSOR


AngioDynamics Auryon System

https://www.auryon-system.com/


---


SHOW NOTES


00:00 - Introduction

04:18 - Current Treatment Limitations for Infrapopliteal Disease

07:38 - Laser Atherectomy for Calcified Lesions

12:10 - Learning Curve for Laser Atherectomy Devices

15:38 - 30-Day Results of the Auryon BTK Study

23:35 - Technical Approach and Tools for Infrapopliteal Segments

29:00 - Upcoming Developments in CLI Treatment

31:33 - Advice for Building a CLI Program


---


RESOURCES


Calcium 360 Trial:

https://pubmed.ncbi.nlm.nih.gov/22891826/


Auryon Laser Atherectomy System:

https://www.angiodynamics.com/product/auryon/


Nexcimer Laser Atherectomy System:

https://www.usa.philips.com/healthcare/product/HCIGTDPHLLSRSYSTM/laser-system-hcigtdphllsrsystm


30-Day Results of the Auryon BTK Study:

https://www.jacc.org/doi/10.1016/j.jacc.2023.09.194


Midwest Cardiovascular Research Foundation:

http://www.mcrfmd.com/


Life-BTK Study:

https://www.cardiovascular.abbott/us/en/patients/treatments-therapies/peripheral-artery-disease/life-btk.html


Promise II Study:

https://www.nejm.org/doi/full/10.1056/NEJMoa2212754


BackTable Ep. 350- Building a CLI Program with Dr. Zola N’Dandu:

https://www.backtable.com/shows/vi/podcasts/350/building-a-cli-program

]]> 2499 Ep. 407 The Evolving Role of Drug Eluting Stents in PAD with Dr. Eric Secemsky In this episode of the BackTable Podcast, host Dr. Sabeen Dhand interviews Dr. Eric Secemsky about the efficacy of drug eluting technologies in vascular interventions, with Dr. Secemsky offering insight into his own practice. Dr. Secemsky is an interventional cardiologist practicing at Beth Israel Deaconess Medical Center in Boston. Dr. Secemsky believes that drug coated technology is a game-changer in the endovascular space since it improves patient outcomes by reducing the risk of needing additional procedures. Dr. Secemsky highlights the importance of various trials such as IMPERIAL and EMINENT, which compare the effectiveness of different stents. He also speaks about the significance of the Cook Medical prediction model to calculate intervention success rates and the role of disease site-specific interventions. Dr. Secemsky ends the podcast by sharing his thoughts about advancements in the near future, including the use of bioabsorbable stents and sirolimus drug-coated balloons. --- CHECK OUT OUR SPONSOR Cook Medical Zilver PTX https://www.cookmedical.com/zilverptxbacktable --- SHOW NOTES 00:00 - Introduction 09:31 - Understanding Drug Coated Balloons and Stents 14:29 - The Paclitaxel Controversy 19:30 - Stenting Algorithm for Fem-Pop Disease 23:55 - Impact of Lithotripsy on Drug Delivery 26:02 - Predictability Models for Revascularization 29:14 - Economic Considerations in Drug Eluting Stent Usage 31:33 - Highlighting Trials on Drug Coated Technology and Drug Eluting Stents 37:08 - Future Technologies: Drug on Stent Grafts and Spot Stenting --- RESOURCES Zilver PTX Cook Prediction Model: https://cooksfa.z13.web.core.windows.net/ Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials: https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011245 Durable Clinical Effectiveness With Paclitaxel-Eluting Stents in the Femoropopliteal Artery: 5-Year Results of the Zilver PTX Randomized Trial: https://pubmed.ncbi.nlm.nih.gov/26969758/ Mortality in randomized controlled trials using paclitaxel-coated devices for femoropopliteal interventional procedures: an updated patient-level meta-analysis: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02189-X/fulltext Outcomes of Stented vs Nonstented Femoropopliteal Lesions Treated With Drug-Coated Balloon Angioplasty: https://pubmed.ncbi.nlm.nih.gov/35179065/ Drug coated balloon improves outcomes of sub-optimal Supera deployment in the intermediate term: https://pubmed.ncbi.nlm.nih.gov/36494491/ Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency: Twelve-Month Results of the DEFINITIVE AR Study: https://pubmed.ncbi.nlm.nih.gov/28916599/ Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial: https://pubmed.ncbi.nlm.nih.gov/34167675/ Efficacy of a Drug-Eluting Stent Versus Bare Metal Stents for Symptomatic Femoropopliteal Peripheral Artery Disease: Primary Results of the EMINENT Randomized Trial: https://pubmed.ncbi.nlm.nih.gov/36254728/ A polymer-coated, paclitaxel-eluting stent (Eluvia) versus a polymer-free, paclitaxel-coated stent (Zilver PTX) for endovascular femoropopliteal intervention (IMPERIAL): a randomized, non-inferiority trial: https://doi.org/10.1016/S0140-6736(18)32262-1 SPORTS Clinical Trial Results Boston Scientific: https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/drug-eluting-stent-drug-coated-balloon/eluvia/sports-rct.html Mon, 22 Jan 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Sabeen Dhand interviews Dr. Eric Secemsky about the efficacy of drug eluting technologies in vascular interventions, with Dr. Secemsky offering insight into his own practice. In this episode of the BackTable Podcast, host Dr. Sabeen Dhand interviews Dr. Eric Secemsky about the efficacy of drug eluting technologies in vascular interventions, with Dr. Secemsky offering insight into his own practice. Dr. Secemsky is an interventional cardiologist practicing at Beth Israel Deaconess Medical Center in Boston. Dr. Secemsky believes that drug coated technology is a game-changer in the endovascular space since it improves patient outcomes by reducing the risk of needing additional procedures. Dr. Secemsky highlights the importance of various trials such as IMPERIAL and EMINENT, which compare the effectiveness of different stents. He also speaks about the significance of the Cook Medical prediction model to calculate intervention success rates and the role of disease site-specific interventions. Dr. Secemsky ends the podcast by sharing his thoughts about advancements in the near future, including the use of bioabsorbable stents and sirolimus drug-coated balloons. --- CHECK OUT OUR SPONSOR Cook Medical Zilver PTX https://www.cookmedical.com/zilverptxbacktable --- SHOW NOTES 00:00 - Introduction 09:31 - Understanding Drug Coated Balloons and Stents 14:29 - The Paclitaxel Controversy 19:30 - Stenting Algorithm for Fem-Pop Disease 23:55 - Impact of Lithotripsy on Drug Delivery 26:02 - Predictability Models for Revascularization 29:14 - Economic Considerations in Drug Eluting Stent Usage 31:33 - Highlighting Trials on Drug Coated Technology and Drug Eluting Stents 37:08 - Future Technologies: Drug on Stent Grafts and Spot Stenting --- RESOURCES Zilver PTX Cook Prediction Model: https://cooksfa.z13.web.core.windows.net/ Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials: https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011245 Durable Clinical Effectiveness With Paclitaxel-Eluting Stents in the Femoropopliteal Artery: 5-Year Results of the Zilver PTX Randomized Trial: https://pubmed.ncbi.nlm.nih.gov/26969758/ Mortality in randomized controlled trials using paclitaxel-coated devices for femoropopliteal interventional procedures: an updated patient-level meta-analysis: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02189-X/fulltext Outcomes of Stented vs Nonstented Femoropopliteal Lesions Treated With Drug-Coated Balloon Angioplasty: https://pubmed.ncbi.nlm.nih.gov/35179065/ Drug coated balloon improves outcomes of sub-optimal Supera deployment in the intermediate term: https://pubmed.ncbi.nlm.nih.gov/36494491/ Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency: Twelve-Month Results of the DEFINITIVE AR Study: https://pubmed.ncbi.nlm.nih.gov/28916599/ Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial: https://pubmed.ncbi.nlm.nih.gov/34167675/ Efficacy of a Drug-Eluting Stent Versus Bare Metal Stents for Symptomatic Femoropopliteal Peripheral Artery Disease: Primary Results of the EMINENT Randomized Trial: https://pubmed.ncbi.nlm.nih.gov/36254728/ A polymer-coated, paclitaxel-eluting stent (Eluvia) versus a polymer-free, paclitaxel-coated stent (Zilver PTX) for endovascular femoropopliteal intervention (IMPERIAL): a randomized, non-inferiority trial: https://doi.org/10.1016/S0140-6736(18)32262-1 SPORTS Clinical Trial Results Boston Scientific: https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/drug-eluting-stent-drug-coated-balloon/eluvia/sports-rct.html In this episode of the BackTable Podcast, host Dr. Sabeen Dhand interviews Dr. Eric Secemsky about the efficacy of drug eluting technologies in vascular interventions, with Dr. Secemsky offering insight into his own practice. Dr. Secemsky is an interventional cardiologist practicing at Beth Israel Deaconess Medical Center in Boston.


Dr. Secemsky believes that drug coated technology is a game-changer in the endovascular space since it improves patient outcomes by reducing the risk of needing additional procedures. Dr. Secemsky highlights the importance of various trials such as IMPERIAL and EMINENT, which compare the effectiveness of different stents. He also speaks about the significance of the Cook Medical prediction model to calculate intervention success rates and the role of disease site-specific interventions. Dr. Secemsky ends the podcast by sharing his thoughts about advancements in the near future, including the use of bioabsorbable stents and sirolimus drug-coated balloons.


---


CHECK OUT OUR SPONSOR


Cook Medical Zilver PTX

https://www.cookmedical.com/zilverptxbacktable


---


SHOW NOTES


00:00 - Introduction

09:31 - Understanding Drug Coated Balloons and Stents

14:29 - The Paclitaxel Controversy

19:30 - Stenting Algorithm for Fem-Pop Disease

23:55 - Impact of Lithotripsy on Drug Delivery

26:02 - Predictability Models for Revascularization

29:14 - Economic Considerations in Drug Eluting Stent Usage

31:33 - Highlighting Trials on Drug Coated Technology and Drug Eluting Stents

37:08 - Future Technologies: Drug on Stent Grafts and Spot Stenting


---


RESOURCES


Zilver PTX Cook Prediction Model:

https://cooksfa.z13.web.core.windows.net/


Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials:

https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011245



Durable Clinical Effectiveness With Paclitaxel-Eluting Stents in the Femoropopliteal Artery: 5-Year Results of the Zilver PTX Randomized Trial:

https://pubmed.ncbi.nlm.nih.gov/26969758/


Mortality in randomized controlled trials using paclitaxel-coated devices for femoropopliteal interventional procedures: an updated patient-level meta-analysis:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02189-X/fulltext


Outcomes of Stented vs Nonstented Femoropopliteal Lesions Treated With Drug-Coated Balloon Angioplasty:

https://pubmed.ncbi.nlm.nih.gov/35179065/


Drug coated balloon improves outcomes of sub-optimal Supera deployment in the intermediate term:

https://pubmed.ncbi.nlm.nih.gov/36494491/


Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency: Twelve-Month Results of the DEFINITIVE AR Study:

https://pubmed.ncbi.nlm.nih.gov/28916599/


Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial:

https://pubmed.ncbi.nlm.nih.gov/34167675/


Efficacy of a Drug-Eluting Stent Versus Bare Metal Stents for Symptomatic Femoropopliteal Peripheral Artery Disease: Primary Results of the EMINENT Randomized Trial:

https://pubmed.ncbi.nlm.nih.gov/36254728/


A polymer-coated, paclitaxel-eluting stent (Eluvia) versus a polymer-free, paclitaxel-coated stent (Zilver PTX) for endovascular femoropopliteal intervention (IMPERIAL): a randomized, non-inferiority trial:

https://doi.org/10.1016/S0140-6736(18)32262-1


SPORTS Clinical Trial Results Boston Scientific:

https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/drug-eluting-stent-drug-coated-balloon/eluvia/sports-rct.html

]]> 2714 Ep. 406 Biodegradable Flow Diverters for Cerebral Aneurysms with Dr. Alim Mitha In this episode of the Back Table Innovation Podcast, host Dr. Diana Velazquez-Pimentel, a radiologist and biomedical engineer, chats with Dr. Alim Mitha about the novel idea of biodegradable flow diverters and the future of interventional neuroradiology. Dr. Mitha is a cerebrovascular, endovascular, and skull base neurosurgeon and biomedical engineer at the University of Calgary. During his neurosurgery residency, Dr. Mitha also completed a master’s degree in biomedical engineering. Afterwards, he pursued additional fellowships in cerebrovascular and skull base surgery, as well as endovascular neurosurgery. Since then, he has started a research lab focused on tissue engineering and biomedical device development. He explains the role of flow diverters and how they are used to guide blood flow away from the intracranial aneurysms. While flow diverters have been applied to treatment of many different types of aneurysms, Dr. Mitha notes that these devices carry thrombogenic risks. During his training, he saw that it was not preferable to deploy a flow diverter in a young patient who would have to remain on antiplatelet therapy for the rest of their life. As a result, Dr. Mitha began to develop a polymer-based biodegradable flow diverter that could be absorbed by the body after the aneurysm had been occluded, in addition to being visible on non-invasive imaging. He explains the process of building a prototype, incorporating a company, joining a start-up incubator, and now performing first in-human-clinical trials. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 Introduction 03:05 Understanding the Role of Flow Diverters 08:17 The Conception of a Biodegradable Flow Diverter 11:35 The Challenges and Successes in Prototyping 13:53 A Path Towards Commercialization 16:10 Considerations for Clinical Adoption 24:00 Developing Skills for Engineering and Entrepreneurship 27:29 First-In-Human Trials and Early Feedback 30:36 Innovating Within the University of Calgary --- RESOURCES University of Calgary Creative Destruction Lab: https://creativedestructionlab.com/locations/calgary/ The Brain Conferences: https://www.fens.org/meetings/the-brain-conferences Wed, 17 Jan 2024 08:00:00 -0000 full BackTable In this episode of the Back Table Innovation Podcast, host Dr. Diana Velazquez-Pimentel, a radiologist and biomedical engineer, chats with Dr. Alim Mitha about the novel idea of biodegradable flow diverters and the future of interventional neuroradiology. In this episode of the Back Table Innovation Podcast, host Dr. Diana Velazquez-Pimentel, a radiologist and biomedical engineer, chats with Dr. Alim Mitha about the novel idea of biodegradable flow diverters and the future of interventional neuroradiology. Dr. Mitha is a cerebrovascular, endovascular, and skull base neurosurgeon and biomedical engineer at the University of Calgary. During his neurosurgery residency, Dr. Mitha also completed a master’s degree in biomedical engineering. Afterwards, he pursued additional fellowships in cerebrovascular and skull base surgery, as well as endovascular neurosurgery. Since then, he has started a research lab focused on tissue engineering and biomedical device development. He explains the role of flow diverters and how they are used to guide blood flow away from the intracranial aneurysms. While flow diverters have been applied to treatment of many different types of aneurysms, Dr. Mitha notes that these devices carry thrombogenic risks. During his training, he saw that it was not preferable to deploy a flow diverter in a young patient who would have to remain on antiplatelet therapy for the rest of their life. As a result, Dr. Mitha began to develop a polymer-based biodegradable flow diverter that could be absorbed by the body after the aneurysm had been occluded, in addition to being visible on non-invasive imaging. He explains the process of building a prototype, incorporating a company, joining a start-up incubator, and now performing first in-human-clinical trials. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 Introduction 03:05 Understanding the Role of Flow Diverters 08:17 The Conception of a Biodegradable Flow Diverter 11:35 The Challenges and Successes in Prototyping 13:53 A Path Towards Commercialization 16:10 Considerations for Clinical Adoption 24:00 Developing Skills for Engineering and Entrepreneurship 27:29 First-In-Human Trials and Early Feedback 30:36 Innovating Within the University of Calgary --- RESOURCES University of Calgary Creative Destruction Lab: https://creativedestructionlab.com/locations/calgary/ The Brain Conferences: https://www.fens.org/meetings/the-brain-conferences In this episode of the Back Table Innovation Podcast, host Dr. Diana Velazquez-Pimentel, a radiologist and biomedical engineer, chats with Dr. Alim Mitha about the novel idea of biodegradable flow diverters and the future of interventional neuroradiology. Dr. Mitha is a cerebrovascular, endovascular, and skull base neurosurgeon and biomedical engineer at the University of Calgary.


During his neurosurgery residency, Dr. Mitha also completed a master’s degree in biomedical engineering. Afterwards, he pursued additional fellowships in cerebrovascular and skull base surgery, as well as endovascular neurosurgery. Since then, he has started a research lab focused on tissue engineering and biomedical device development. He explains the role of flow diverters and how they are used to guide blood flow away from the intracranial aneurysms.


While flow diverters have been applied to treatment of many different types of aneurysms, Dr. Mitha notes that these devices carry thrombogenic risks. During his training, he saw that it was not preferable to deploy a flow diverter in a young patient who would have to remain on antiplatelet therapy for the rest of their life. As a result, Dr. Mitha began to develop a polymer-based biodegradable flow diverter that could be absorbed by the body after the aneurysm had been occluded, in addition to being visible on non-invasive imaging. He explains the process of building a prototype, incorporating a company, joining a start-up incubator, and now performing first in-human-clinical trials.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 Introduction

03:05 Understanding the Role of Flow Diverters

08:17 The Conception of a Biodegradable Flow Diverter

11:35 The Challenges and Successes in Prototyping

13:53 A Path Towards Commercialization

16:10 Considerations for Clinical Adoption

24:00 Developing Skills for Engineering and Entrepreneurship

27:29 First-In-Human Trials and Early Feedback

30:36 Innovating Within the University of Calgary


---


RESOURCES


University of Calgary Creative Destruction Lab:

https://creativedestructionlab.com/locations/calgary/


The Brain Conferences:

https://www.fens.org/meetings/the-brain-conferences

]]> 2377 Ep. 405 Site of Service Differentials with Dr. Michael Cumming In this episode of the BackTable Podcast, host Dr. Ally Baheti interviews Dr. Michael Cumming about the issue of site of service differentials in healthcare. Dr. Cumming is an interventional radiologist and the founder of Vascular and Interventional Experts. They discuss the history and the impact of these differentials, which often result in higher costs for identical services depending on the site they’re carried out in. For example, services offered within hospitals typically cost significantly more than those offered in ambulatory surgery centers or physician offices. The doctors also describe the role of key stakeholders such as lobbyists and industry players, the outcomes of care provided in various settings, and ongoing legislative efforts to address these issues. Finally, they discuss how physicians can advocate for high quality, value-based care. --- CHECK OUT OUR SPONSORS Siemens Healthineers https://www.siemens-healthineers.com/ Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SHOW NOTES 00:00 - Introduction 03:33 - Site of Service and Its Impact on Payment 06:15 - Role of CMS in Determining Payment 09:09 - Role of Advocacy Groups in Site of Service Payments 17:51 - Future of Site of Service Payments 20:17 - Negative Consequences of Site of Service Differentials 24:01 - Closing Remarks and Reflections --- RESOURCES CMS.gov website: https://www.cms.gov/ Preliminary Results of the Outpatient Endovascular and Interventional Society National Registry: https://journals.sagepub.com/doi/10.1177/1526602820949970 Mon, 15 Jan 2024 08:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Ally Baheti interviews Dr. Michael Cumming about the issue of site of service differentials in healthcare. In this episode of the BackTable Podcast, host Dr. Ally Baheti interviews Dr. Michael Cumming about the issue of site of service differentials in healthcare. Dr. Cumming is an interventional radiologist and the founder of Vascular and Interventional Experts. They discuss the history and the impact of these differentials, which often result in higher costs for identical services depending on the site they’re carried out in. For example, services offered within hospitals typically cost significantly more than those offered in ambulatory surgery centers or physician offices. The doctors also describe the role of key stakeholders such as lobbyists and industry players, the outcomes of care provided in various settings, and ongoing legislative efforts to address these issues. Finally, they discuss how physicians can advocate for high quality, value-based care. --- CHECK OUT OUR SPONSORS Siemens Healthineers https://www.siemens-healthineers.com/ Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SHOW NOTES 00:00 - Introduction 03:33 - Site of Service and Its Impact on Payment 06:15 - Role of CMS in Determining Payment 09:09 - Role of Advocacy Groups in Site of Service Payments 17:51 - Future of Site of Service Payments 20:17 - Negative Consequences of Site of Service Differentials 24:01 - Closing Remarks and Reflections --- RESOURCES CMS.gov website: https://www.cms.gov/ Preliminary Results of the Outpatient Endovascular and Interventional Society National Registry: https://journals.sagepub.com/doi/10.1177/1526602820949970 In this episode of the BackTable Podcast, host Dr. Ally Baheti interviews Dr. Michael Cumming about the issue of site of service differentials in healthcare. Dr. Cumming is an interventional radiologist and the founder of Vascular and Interventional Experts.


They discuss the history and the impact of these differentials, which often result in higher costs for identical services depending on the site they’re carried out in. For example, services offered within hospitals typically cost significantly more than those offered in ambulatory surgery centers or physician offices. The doctors also describe the role of key stakeholders such as lobbyists and industry players, the outcomes of care provided in various settings, and ongoing legislative efforts to address these issues. Finally, they discuss how physicians can advocate for high quality, value-based care.


---


CHECK OUT OUR SPONSORS


Siemens Healthineers

https://www.siemens-healthineers.com/


Varian, a Siemens Healthineers company

https://www.varian.com/products/interventional-solutions/embolization-solutions


---


SHOW NOTES


00:00 - Introduction

03:33 - Site of Service and Its Impact on Payment

06:15 - Role of CMS in Determining Payment

09:09 - Role of Advocacy Groups in Site of Service Payments

17:51 - Future of Site of Service Payments

20:17 - Negative Consequences of Site of Service Differentials

24:01 - Closing Remarks and Reflections


---


RESOURCES


CMS.gov website:

https://www.cms.gov/


Preliminary Results of the Outpatient Endovascular and Interventional Society National Registry:

https://journals.sagepub.com/doi/10.1177/1526602820949970

]]> 1693 Ep. 404 Navigation Software for IR Guidance with Dr. Merve Ozen In this episode of the BackTable podcast, host Dr. Ally Baheti interviews interventional radiologist Dr. Merve Ozen about the potential of the Percunav system, an advanced needle guidance technology used in interventional and endovascular procedures. Dr. Ozen is an Assistant Professor of Radiology, Surgery, Obstetrics, and Gynecology at the University of Kentucky. The uniqueness of the Percunav system lies in its 3D ultrasound image fusion and navigation capabilities, which enable doctors to combine the advantages of different imaging techniques including CT, MR, PET, and ultrasound. This allows for more precise and accurate procedures, while reducing radiation exposure. However, the utilization of this technology requires understanding and overcoming the learning curve. Additionally, Dr. Ozen explores the various applications of this technology including biopsies, drain placements and other challenging interventions. --- SHOW NOTES 00:00 - Introduction 02:42 - Clinical Applications of 3D Fusion and Navigation Systems 11:43 - Limitations and Challenges of the Technology 17:30 - Exploring Different Needle Tracking Technologies 18:44 - Future Applications of the Technology 20:17 - Advice for Incorporating the Technology into Practice --- RESOURCES Percunav System: https://www.usa.philips.com/healthcare/product/HCNOCTN150/fusion-and-navigation-image-fusion-and-needle-navigation Fri, 12 Jan 2024 09:00:00 -0000 full BackTable In this episode of the BackTable podcast, host Dr. Ally Baheti interviews interventional radiologist Dr. Merve Ozen about the potential of the Percunav system, an advanced needle guidance technology used in interventional and endovascular procedures. Dr. Ozen is an Assistant Professor of Radiology, Surgery, Obstetrics, and Gynecology at the University of Kentucky. In this episode of the BackTable podcast, host Dr. Ally Baheti interviews interventional radiologist Dr. Merve Ozen about the potential of the Percunav system, an advanced needle guidance technology used in interventional and endovascular procedures. Dr. Ozen is an Assistant Professor of Radiology, Surgery, Obstetrics, and Gynecology at the University of Kentucky. The uniqueness of the Percunav system lies in its 3D ultrasound image fusion and navigation capabilities, which enable doctors to combine the advantages of different imaging techniques including CT, MR, PET, and ultrasound. This allows for more precise and accurate procedures, while reducing radiation exposure. However, the utilization of this technology requires understanding and overcoming the learning curve. Additionally, Dr. Ozen explores the various applications of this technology including biopsies, drain placements and other challenging interventions. --- SHOW NOTES 00:00 - Introduction 02:42 - Clinical Applications of 3D Fusion and Navigation Systems 11:43 - Limitations and Challenges of the Technology 17:30 - Exploring Different Needle Tracking Technologies 18:44 - Future Applications of the Technology 20:17 - Advice for Incorporating the Technology into Practice --- RESOURCES Percunav System: https://www.usa.philips.com/healthcare/product/HCNOCTN150/fusion-and-navigation-image-fusion-and-needle-navigation In this episode of the BackTable podcast, host Dr. Ally Baheti interviews interventional radiologist Dr. Merve Ozen about the potential of the Percunav system, an advanced needle guidance technology used in interventional and endovascular procedures. Dr. Ozen is an Assistant Professor of Radiology, Surgery, Obstetrics, and Gynecology at the University of Kentucky.


The uniqueness of the Percunav system lies in its 3D ultrasound image fusion and navigation capabilities, which enable doctors to combine the advantages of different imaging techniques including CT, MR, PET, and ultrasound. This allows for more precise and accurate procedures, while reducing radiation exposure. However, the utilization of this technology requires understanding and overcoming the learning curve. Additionally, Dr. Ozen explores the various applications of this technology including biopsies, drain placements and other challenging interventions.


---


SHOW NOTES


00:00 - Introduction

02:42 - Clinical Applications of 3D Fusion and Navigation Systems

11:43 - Limitations and Challenges of the Technology

17:30 - Exploring Different Needle Tracking Technologies

18:44 - Future Applications of the Technology

20:17 - Advice for Incorporating the Technology into Practice


---


RESOURCES


Percunav System:

https://www.usa.philips.com/healthcare/product/HCNOCTN150/fusion-and-navigation-image-fusion-and-needle-navigation

]]> 1510 Ep. 403 Intra-Arterial Therapies for Migraine Management with Dr. Adnan Qureshi In this episode, guest-host Dr. Paul Bhogal invites Dr. Adnan Qureshi, an interventional neurologist at the University of Missouri, to share his insights on innovative treatments for migraines. Dr. Qureshi covers his pioneering work in intra-arterial lidocaine injections and their effect on patients with severe migraines. Injections have shown a significant relief in symptoms immediately following treatment. He emphasizes the importance of identifying the right patient group for such treatments and highlights the potential of interventions beyond standard drug therapy. The conversation also explores the role of interventional neuroradiology in treating migraines and the potential development of new medical devices and alternatives to lidocaine. The podcast ends with Dr. Qureshi endorsing the upcoming Brain Conference and encouraging participation. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction and Overview of Migraine Treatment 05:35 - Initial Experiments with Lidocaine Treatment 17:45 - Potential for New Migraine Treatments 18:23 - Procedure for Intra Arterial Injections of Lidocaine 36:41 - Potential for Other Treatments and Future Research --- RESOURCES BRAIN Conference London December 2024 Use code ‘BACKTABLE10’ to register: https://www.millbrook-events.co.uk/event/a68ab951-6a92-4a9a-88ca-3e8dad79d971/summary Dr. Qureshi’s Email Address: qureshi@gmail.com Intra-arterial injection of lidocaine into middle meningeal artery to treat intractable headaches and severe migraine: https://pubmed.ncbi.nlm.nih.gov/34388298/ MIDAS Score: https://headaches.org/wp-content/uploads/2018/02/MIDAS.pdf Chronic headaches and middle meningeal artery embolization: https://pubmed.ncbi.nlm.nih.gov/33888570/ Intra-arterial lidocaine therapy via the middle meningeal artery for migraine headache: Theory, current practice and future directions: https://pubmed.ncbi.nlm.nih.gov/37574789/ Dr. Nathan Manning ResearchGate Profile: https://www.researchgate.net/profile/Nathan-Manning-4 Wed, 10 Jan 2024 08:23:00 -0000 full BackTable In this episode, guest-host Dr. Paul Bhogal invites Dr. Adnan Qureshi, an interventional neurologist at the University of Missouri, to share his insights on innovative treatments for migraines. In this episode, guest-host Dr. Paul Bhogal invites Dr. Adnan Qureshi, an interventional neurologist at the University of Missouri, to share his insights on innovative treatments for migraines. Dr. Qureshi covers his pioneering work in intra-arterial lidocaine injections and their effect on patients with severe migraines. Injections have shown a significant relief in symptoms immediately following treatment. He emphasizes the importance of identifying the right patient group for such treatments and highlights the potential of interventions beyond standard drug therapy. The conversation also explores the role of interventional neuroradiology in treating migraines and the potential development of new medical devices and alternatives to lidocaine. The podcast ends with Dr. Qureshi endorsing the upcoming Brain Conference and encouraging participation. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction and Overview of Migraine Treatment 05:35 - Initial Experiments with Lidocaine Treatment 17:45 - Potential for New Migraine Treatments 18:23 - Procedure for Intra Arterial Injections of Lidocaine 36:41 - Potential for Other Treatments and Future Research --- RESOURCES BRAIN Conference London December 2024 Use code ‘BACKTABLE10’ to register: https://www.millbrook-events.co.uk/event/a68ab951-6a92-4a9a-88ca-3e8dad79d971/summary Dr. Qureshi’s Email Address: qureshi@gmail.com Intra-arterial injection of lidocaine into middle meningeal artery to treat intractable headaches and severe migraine: https://pubmed.ncbi.nlm.nih.gov/34388298/ MIDAS Score: https://headaches.org/wp-content/uploads/2018/02/MIDAS.pdf Chronic headaches and middle meningeal artery embolization: https://pubmed.ncbi.nlm.nih.gov/33888570/ Intra-arterial lidocaine therapy via the middle meningeal artery for migraine headache: Theory, current practice and future directions: https://pubmed.ncbi.nlm.nih.gov/37574789/ Dr. Nathan Manning ResearchGate Profile: https://www.researchgate.net/profile/Nathan-Manning-4 In this episode, guest-host Dr. Paul Bhogal invites Dr. Adnan Qureshi, an interventional neurologist at the University of Missouri, to share his insights on innovative treatments for migraines.


Dr. Qureshi covers his pioneering work in intra-arterial lidocaine injections and their effect on patients with severe migraines. Injections have shown a significant relief in symptoms immediately following treatment. He emphasizes the importance of identifying the right patient group for such treatments and highlights the potential of interventions beyond standard drug therapy. The conversation also explores the role of interventional neuroradiology in treating migraines and the potential development of new medical devices and alternatives to lidocaine. The podcast ends with Dr. Qureshi endorsing the upcoming Brain Conference and encouraging participation.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction and Overview of Migraine Treatment

05:35 - Initial Experiments with Lidocaine Treatment

17:45 - Potential for New Migraine Treatments

18:23 - Procedure for Intra Arterial Injections of Lidocaine

36:41 - Potential for Other Treatments and Future Research


---


RESOURCES


BRAIN Conference London December 2024

Use code ‘BACKTABLE10’ to register:

https://www.millbrook-events.co.uk/event/a68ab951-6a92-4a9a-88ca-3e8dad79d971/summary


Dr. Qureshi’s Email Address:

qureshi@gmail.com


Intra-arterial injection of lidocaine into middle meningeal artery to treat intractable headaches and severe migraine:

https://pubmed.ncbi.nlm.nih.gov/34388298/


MIDAS Score:

https://headaches.org/wp-content/uploads/2018/02/MIDAS.pdf


Chronic headaches and middle meningeal artery embolization:

https://pubmed.ncbi.nlm.nih.gov/33888570/


Intra-arterial lidocaine therapy via the middle meningeal artery for migraine headache: Theory, current practice and future directions:

https://pubmed.ncbi.nlm.nih.gov/37574789/


Dr. Nathan Manning ResearchGate Profile:

https://www.researchgate.net/profile/Nathan-Manning-4

]]> 2741 Ep. 402 Immunotherapy in HCC: Evolving Treatment Paradigms with Dr. Edward Kim and Dr. Terence Gade In this episode, Dr. Tyler Sandow (Ochsner Health) interviews interventional radiologists Dr. Edward Kim (Mount Sinai) and Dr. Terence Gade (University of Pennsylvania) about the future directions of hepatocellular carcinoma (HCC) treatments, specifically focusing on the adoption of precision medicine and multidisciplinary approaches. They delve into various HCC treatments, such as locoregional therapies like transarterial chemoembolization (TACE) and transarterial radioembolization (TARE), as well as the roles of systemic immunotherapies and checkpoint inhibitors. They highlight the importance of sequential order and timing of treatments and the use of imaging biomarkers for individualized cancer care. Throughout the discussion, influential clinical trials in HCC treatment are discussed and summarized. The doctors unanimously agree that as the sphere of interventional oncology is rapidly evolving, the focus should be centered on providing the most effective and patient-specific care with a deep understanding of combination therapies. --- CHECK OUT OUR SPONSOR AstraZeneca https://www.astrazeneca-us.com/ --- SHOW NOTES 00:00 - Introduction 05:45 - The Beginnings of Systemic Therapy for HCC 08:28 - The Role of Immunotherapy in HCC Treatment 11:09 - Multidisciplinary Clinics and Tumor Boards 20:21 - The Society of Interventional Oncology and Treatment Guidelines 24.59 - Choosing Between Locoregional and Combination Therapies 39:17 - The Use of Immunotherapy in Early Stage Patients 42:08 - Current Safety Data for Immunotherapy 48.56 - TACE Drug Choice 53:16 - How to Approach Treatment of Multifocal or Large Tumors 01:00 - Timeline for Imaging to Assess Treatment Response 01:03 - The Future of Immunotherapy and Interventional Oncology --- RESOURCES Society of Interventional Oncology (SIO): https://www.sio-central.org/ Sorafenib in Advanced Hepatocellular Carcinoma (SHARP Trial) https://www.nejm.org/doi/full/10.1056/nejmoa0708857 Efficacy and Safety of Sorafenib in Patients in the Asia-Pacific region with Advanced Hepatocellular Carcinoma: https://pubmed.ncbi.nlm.nih.gov/19095497/ Efficacy and Safety of Nivolumab Plus Ipilimumab in Patients With Advanced Hepatocellular Carcinoma Previously Treated With Sorafenib (CheckMate 040 Trial): https://jamanetwork.com/journals/jamaoncology/fullarticle/2771012 Tremelimumab and Durvalumab as First-line Therapy in Patients with Unresectable Hepatocellular Carcinoma (HIMALAYA Trial): https://ascopubs.org/doi/10.1200/JCO.2022.40.4_suppl.379 Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma (IMbrave 150 Trial): https://www.nejm.org/doi/full/10.1056/nejmoa1915745 Lenvatinib Combined With Transarterial Chemoembolization as First-Line Treatment for Advanced Hepatocellular Carcinoma (LAUNCH Trial): https://ascopubs.org/doi/abs/10.1200/JCO.22.00392 Randomised, Multicentre Prospective Trial of Transarterial Chemoembolisation Plus Sorafenib as Compared with TACE Alone in Patients with Hepatocellular Carcinoma (TACTICS Trial): https://pubmed.ncbi.nlm.nih.gov/31801872/ Uncoupling Immune Trajectories of Response and Adverse Events from Anti-PD-1 Immunotherapy in Hepatocellular Carcinoma: https://pubmed.ncbi.nlm.nih.gov/35430299/ Personalised Versus Standard Dosimetry Approach of Selective Internal Radiation Therapy in Patients with Locally Advanced Hepatocellular Carcinoma (DOSISPHERE-01 Trial): https://pubmed.ncbi.nlm.nih.gov/33166497/ Radiation Segmentectomy for Curative Intent of Unresectable Very Early to Early Stage Hepatocellular Carcinoma (RASER Trial): https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00091-7/fulltext Immunotherapy and Transarterial Radioembolization Combination Treatment for Advanced Hepatocellular Carcinoma: https://journals.lww.com/ajg/abstract/2023/12000/immunotherapy_and_transarterial_radioembolization.23.aspx Find this episode on BackTable.com to see additional resources. Mon, 08 Jan 2024 08:07:00 -0000 full BackTable In this episode, Dr. Tyler Sandow (Ochsner Health) interviews interventional radiologists Dr. Edward Kim (Mount Sinai) and Dr. Terence Gade (University of Pennsylvania) about the future directions of hepatocellular carcinoma (HCC) treatments, specifically focusing on the adoption of precision medicine and multidisciplinary approaches. In this episode, Dr. Tyler Sandow (Ochsner Health) interviews interventional radiologists Dr. Edward Kim (Mount Sinai) and Dr. Terence Gade (University of Pennsylvania) about the future directions of hepatocellular carcinoma (HCC) treatments, specifically focusing on the adoption of precision medicine and multidisciplinary approaches. They delve into various HCC treatments, such as locoregional therapies like transarterial chemoembolization (TACE) and transarterial radioembolization (TARE), as well as the roles of systemic immunotherapies and checkpoint inhibitors. They highlight the importance of sequential order and timing of treatments and the use of imaging biomarkers for individualized cancer care. Throughout the discussion, influential clinical trials in HCC treatment are discussed and summarized. The doctors unanimously agree that as the sphere of interventional oncology is rapidly evolving, the focus should be centered on providing the most effective and patient-specific care with a deep understanding of combination therapies. --- CHECK OUT OUR SPONSOR AstraZeneca https://www.astrazeneca-us.com/ --- SHOW NOTES 00:00 - Introduction 05:45 - The Beginnings of Systemic Therapy for HCC 08:28 - The Role of Immunotherapy in HCC Treatment 11:09 - Multidisciplinary Clinics and Tumor Boards 20:21 - The Society of Interventional Oncology and Treatment Guidelines 24.59 - Choosing Between Locoregional and Combination Therapies 39:17 - The Use of Immunotherapy in Early Stage Patients 42:08 - Current Safety Data for Immunotherapy 48.56 - TACE Drug Choice 53:16 - How to Approach Treatment of Multifocal or Large Tumors 01:00 - Timeline for Imaging to Assess Treatment Response 01:03 - The Future of Immunotherapy and Interventional Oncology --- RESOURCES Society of Interventional Oncology (SIO): https://www.sio-central.org/ Sorafenib in Advanced Hepatocellular Carcinoma (SHARP Trial) https://www.nejm.org/doi/full/10.1056/nejmoa0708857 Efficacy and Safety of Sorafenib in Patients in the Asia-Pacific region with Advanced Hepatocellular Carcinoma: https://pubmed.ncbi.nlm.nih.gov/19095497/ Efficacy and Safety of Nivolumab Plus Ipilimumab in Patients With Advanced Hepatocellular Carcinoma Previously Treated With Sorafenib (CheckMate 040 Trial): https://jamanetwork.com/journals/jamaoncology/fullarticle/2771012 Tremelimumab and Durvalumab as First-line Therapy in Patients with Unresectable Hepatocellular Carcinoma (HIMALAYA Trial): https://ascopubs.org/doi/10.1200/JCO.2022.40.4_suppl.379 Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma (IMbrave 150 Trial): https://www.nejm.org/doi/full/10.1056/nejmoa1915745 Lenvatinib Combined With Transarterial Chemoembolization as First-Line Treatment for Advanced Hepatocellular Carcinoma (LAUNCH Trial): https://ascopubs.org/doi/abs/10.1200/JCO.22.00392 Randomised, Multicentre Prospective Trial of Transarterial Chemoembolisation Plus Sorafenib as Compared with TACE Alone in Patients with Hepatocellular Carcinoma (TACTICS Trial): https://pubmed.ncbi.nlm.nih.gov/31801872/ Uncoupling Immune Trajectories of Response and Adverse Events from Anti-PD-1 Immunotherapy in Hepatocellular Carcinoma: https://pubmed.ncbi.nlm.nih.gov/35430299/ Personalised Versus Standard Dosimetry Approach of Selective Internal Radiation Therapy in Patients with Locally Advanced Hepatocellular Carcinoma (DOSISPHERE-01 Trial): https://pubmed.ncbi.nlm.nih.gov/33166497/ Radiation Segmentectomy for Curative Intent of Unresectable Very Early to Early Stage Hepatocellular Carcinoma (RASER Trial): https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00091-7/fulltext Immunotherapy and Transarterial Radioembolization Combination Treatment for Advanced Hepatocellular Carcinoma: https://journals.lww.com/ajg/abstract/2023/12000/immunotherapy_and_transarterial_radioembolization.23.aspx Find this episode on BackTable.com to see additional resources. In this episode, Dr. Tyler Sandow (Ochsner Health) interviews interventional radiologists Dr. Edward Kim (Mount Sinai) and Dr. Terence Gade (University of Pennsylvania) about the future directions of hepatocellular carcinoma (HCC) treatments, specifically focusing on the adoption of precision medicine and multidisciplinary approaches.


They delve into various HCC treatments, such as locoregional therapies like transarterial chemoembolization (TACE) and transarterial radioembolization (TARE), as well as the roles of systemic immunotherapies and checkpoint inhibitors. They highlight the importance of sequential order and timing of treatments and the use of imaging biomarkers for individualized cancer care.


Throughout the discussion, influential clinical trials in HCC treatment are discussed and summarized. The doctors unanimously agree that as the sphere of interventional oncology is rapidly evolving, the focus should be centered on providing the most effective and patient-specific care with a deep understanding of combination therapies.


---


CHECK OUT OUR SPONSOR


AstraZeneca

https://www.astrazeneca-us.com/


---


SHOW NOTES


00:00 - Introduction

05:45 - The Beginnings of Systemic Therapy for HCC

08:28 - The Role of Immunotherapy in HCC Treatment

11:09 - Multidisciplinary Clinics and Tumor Boards

20:21 - The Society of Interventional Oncology and Treatment Guidelines

24.59 - Choosing Between Locoregional and Combination Therapies

39:17 - The Use of Immunotherapy in Early Stage Patients

42:08 - Current Safety Data for Immunotherapy

48.56 - TACE Drug Choice

53:16 - How to Approach Treatment of Multifocal or Large Tumors

01:00 - Timeline for Imaging to Assess Treatment Response

01:03 - The Future of Immunotherapy and Interventional Oncology


---


RESOURCES


Society of Interventional Oncology (SIO):

https://www.sio-central.org/


Sorafenib in Advanced Hepatocellular Carcinoma (SHARP Trial)

https://www.nejm.org/doi/full/10.1056/nejmoa0708857


Efficacy and Safety of Sorafenib in Patients in the Asia-Pacific region with Advanced Hepatocellular Carcinoma:

https://pubmed.ncbi.nlm.nih.gov/19095497/


Efficacy and Safety of Nivolumab Plus Ipilimumab in Patients With Advanced Hepatocellular Carcinoma Previously Treated With Sorafenib (CheckMate 040 Trial):

https://jamanetwork.com/journals/jamaoncology/fullarticle/2771012


Tremelimumab and Durvalumab as First-line Therapy in Patients with Unresectable Hepatocellular Carcinoma (HIMALAYA Trial):

https://ascopubs.org/doi/10.1200/JCO.2022.40.4_suppl.379


Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma (IMbrave 150 Trial):

https://www.nejm.org/doi/full/10.1056/nejmoa1915745


Lenvatinib Combined With Transarterial Chemoembolization as First-Line Treatment for Advanced Hepatocellular Carcinoma (LAUNCH Trial):

https://ascopubs.org/doi/abs/10.1200/JCO.22.00392


Randomised, Multicentre Prospective Trial of Transarterial Chemoembolisation Plus Sorafenib as Compared with TACE Alone in Patients with Hepatocellular Carcinoma (TACTICS Trial):

https://pubmed.ncbi.nlm.nih.gov/31801872/


Uncoupling Immune Trajectories of Response and Adverse Events from Anti-PD-1 Immunotherapy in Hepatocellular Carcinoma:

https://pubmed.ncbi.nlm.nih.gov/35430299/


Personalised Versus Standard Dosimetry Approach of Selective Internal Radiation Therapy in Patients with Locally Advanced Hepatocellular Carcinoma (DOSISPHERE-01 Trial):

https://pubmed.ncbi.nlm.nih.gov/33166497/


Radiation Segmentectomy for Curative Intent of Unresectable Very Early to Early Stage Hepatocellular Carcinoma (RASER Trial):

https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00091-7/fulltext


Immunotherapy and Transarterial Radioembolization Combination Treatment for Advanced Hepatocellular Carcinoma:

https://journals.lww.com/ajg/abstract/2023/12000/immunotherapy_and_transarterial_radioembolization.23.aspx


Find this episode on BackTable.com to see additional resources.

]]> 4440 Ep. 401 The MOTION Study: Cryoablation for Painful Bone Metastases with Dr. Jack Jennings In this episode of the BackTable Podcast, host Dr. Jacob Fleming and guest Dr. Jack Jennings discuss advancements in interventional oncology, specifically regarding cryoablation for bone metastases. Dr. Jennings is an interventional musculoskeletal radiologist at Washington University School of Medicine and President of the American Society of Spine Radiology. They discuss the results of the MOTION Study, the benefits of industry collaboration, and the future of robotic guidance systems in interventional procedures. They also explain techniques like hydrodissection and pneumodissection in detail. With constant advancements in technology such as guidance navigation systems to reduce pain from bone metastases, it is crucial for interventional radiologists to adapt to these changes. At the end of the episode the doctors give a shout out to the upcoming Society of Interventional Oncology (SIO) 2024 meeting and the enriching opportunities that it offers for interventional radiologists. --- CHECK OUT OUR SPONSOR Boston Scientific Visual ICE Cryoablation System https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html --- SHOW NOTES 00:00 - Introduction 02:25 - Overview of the MOTION Study 04:23 - Benefits and Challenges of Cryoablation 09:37 - Results of the MOTION Study 12:13 - Future of Interventional Oncology 19:38 - Role of Imaging Guidance in Cryoablation 23:07 - Future of Robotic Guidance Systems 31:40 - Importance of Industry Partnerships --- RESOURCES Society of Interventional Oncology Annual Meeting, Long Beach, CA January 25th-29th: https://www.sio-central.org/Events/Annual-Scientific-Meeting/Registration Interventional Oncology MOTION Multicenter Study: https://www.bostonscientific.com/en-EU/medical-specialties/interventional-radiology/interventional-oncology/latest-evidence/motion-study.html Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial: https://pubmed.ncbi.nlm.nih.gov/23065947/ Cryoablation Needles from Boston Scientific: https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice/visual-ice-cryoablation-needles.htm Fri, 05 Jan 2024 09:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Jacob Fleming and guest Dr. Jack Jennings discuss advancements in interventional oncology, specifically regarding cryoablation for bone metastases. In this episode of the BackTable Podcast, host Dr. Jacob Fleming and guest Dr. Jack Jennings discuss advancements in interventional oncology, specifically regarding cryoablation for bone metastases. Dr. Jennings is an interventional musculoskeletal radiologist at Washington University School of Medicine and President of the American Society of Spine Radiology. They discuss the results of the MOTION Study, the benefits of industry collaboration, and the future of robotic guidance systems in interventional procedures. They also explain techniques like hydrodissection and pneumodissection in detail. With constant advancements in technology such as guidance navigation systems to reduce pain from bone metastases, it is crucial for interventional radiologists to adapt to these changes. At the end of the episode the doctors give a shout out to the upcoming Society of Interventional Oncology (SIO) 2024 meeting and the enriching opportunities that it offers for interventional radiologists. --- CHECK OUT OUR SPONSOR Boston Scientific Visual ICE Cryoablation System https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html --- SHOW NOTES 00:00 - Introduction 02:25 - Overview of the MOTION Study 04:23 - Benefits and Challenges of Cryoablation 09:37 - Results of the MOTION Study 12:13 - Future of Interventional Oncology 19:38 - Role of Imaging Guidance in Cryoablation 23:07 - Future of Robotic Guidance Systems 31:40 - Importance of Industry Partnerships --- RESOURCES Society of Interventional Oncology Annual Meeting, Long Beach, CA January 25th-29th: https://www.sio-central.org/Events/Annual-Scientific-Meeting/Registration Interventional Oncology MOTION Multicenter Study: https://www.bostonscientific.com/en-EU/medical-specialties/interventional-radiology/interventional-oncology/latest-evidence/motion-study.html Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial: https://pubmed.ncbi.nlm.nih.gov/23065947/ Cryoablation Needles from Boston Scientific: https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice/visual-ice-cryoablation-needles.htm In this episode of the BackTable Podcast, host Dr. Jacob Fleming and guest Dr. Jack Jennings discuss advancements in interventional oncology, specifically regarding cryoablation for bone metastases. Dr. Jennings is an interventional musculoskeletal radiologist at Washington University School of Medicine and President of the American Society of Spine Radiology.


They discuss the results of the MOTION Study, the benefits of industry collaboration, and the future of robotic guidance systems in interventional procedures. They also explain techniques like hydrodissection and pneumodissection in detail. With constant advancements in technology such as guidance navigation systems to reduce pain from bone metastases, it is crucial for interventional radiologists to adapt to these changes. At the end of the episode the doctors give a shout out to the upcoming Society of Interventional Oncology (SIO) 2024 meeting and the enriching opportunities that it offers for interventional radiologists.


---


CHECK OUT OUR SPONSOR


Boston Scientific Visual ICE Cryoablation System

https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html


---


SHOW NOTES


00:00 - Introduction

02:25 - Overview of the MOTION Study

04:23 - Benefits and Challenges of Cryoablation

09:37 - Results of the MOTION Study

12:13 - Future of Interventional Oncology

19:38 - Role of Imaging Guidance in Cryoablation

23:07 - Future of Robotic Guidance Systems

31:40 - Importance of Industry Partnerships


---


RESOURCES


Society of Interventional Oncology Annual Meeting, Long Beach, CA January 25th-29th:

https://www.sio-central.org/Events/Annual-Scientific-Meeting/Registration


Interventional Oncology MOTION Multicenter Study:

https://www.bostonscientific.com/en-EU/medical-specialties/interventional-radiology/interventional-oncology/latest-evidence/motion-study.html


Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial:

https://pubmed.ncbi.nlm.nih.gov/23065947/


Cryoablation Needles from Boston Scientific:

https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice/visual-ice-cryoablation-needles.htm

]]> 2256 Ep. 400 Intra-Arterial Approaches in Tumor Therapy: Overcoming the Blood-Brain Barrier with Dr. Piotr Walczak and Dr. Prakash Ambady In this episode of the Backtable Podcast, guest host Dr. Paul Bhogal, a consultant interventional neuroradiologist at Royal London Hospital in the UK, and guests Dr. Piotr Walczak and Dr. Prakash Ambady discuss the potential of intra-arterial treatments combined with blood brain barrier (BBB) manipulation in treating various neurological conditions and tumors. The trio of doctors discuss methods such as the use of hyperosmolar mannitol and focused ultrasound to breach the BBB and deliver drugs directly to the brain tissue. Dr. Walczak and Dr. Ambady also highlight their individual research areas, including therapies involving cell delivery and engineered cells. The conversation also covers potential risks and new perspectives in comparison to current techniques such as whole-brain radiation. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 05:44 - Challenges of Treating Glioblastoma Multiforme 12:52 - Understanding the Blood Brain Barrier 18:30 - Strategies to Negate the Blood Brain Barrier 20:52 - Blood Brain Barrier Disruption Using Intra-Arterial Mannitol 26:35 - Infusion Rates and Magnetic Resonance Guidance 33:47 - Role of Radiolabel Studies in Drug Delivery 36:31 - Future of Therapeutic Agents Design 47:54 - Potential of Focused Ultrasound in Drug Delivery 56:10 - Exploring the Use of Cells in Drug Delivery 58:44 - Future of Intra-Arterial Interventions --- RESOURCES Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma: https://pubmed.ncbi.nlm.nih.gov/15758009/ Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-year analysis of the EORTC-NCIC trial: https://pubmed.ncbi.nlm.nih.gov/19269895/ REMOVAL OF RIGHT CEREBRAL HEMISPHERE FOR CERTAIN TUMORS WITH HEMIPLEGIA - PRELIMINARY REPORT: https://jamanetwork.com/journals/jama/article-abstract/254927 Real-Time MRI Guidance for Reproducible Hyperosmolar Opening of the Blood-Brain Barrier in Mice: https://www.researchgate.net/publication/328537972_Real-Time_MRI_Guidance_for_Reproducible_Hyperosmolar_Opening_of_the_Blood-Brain_Barrier_in_Mice Dr. Piotr Walczak ResearchGate Profile: https://www.researchgate.net/profile/Piotr-Walczak-6 Dr. Prakash Ambday ResearchGate Profile: https://www.researchgate.net/profile/Prakash-Ambady Maculopathy Associated With Osmotic Blood- Brain Barrier Disruption and Chemotherapy in Patients With Primary CNS Lymphoma: https://pubmed.ncbi.nlm.nih.gov/32484895/ PET imaging of intra-arterial 89 Zr bevacizumab in mice with and without osmotic opening of the blood-brain barrier: distinct advantage of intra-arterial delivery: 10.2967/jnumed.118.218792 Safety of intra-arterial chemotherapy with or without osmotic blood–brain barrier disruption for the treatment of patients with brain tumors: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307096/ Delivery of chemotherapeutics across the blood-brain barrier: challenges and advances: https://pubmed.ncbi.nlm.nih.gov/25307218/ Wed, 03 Jan 2024 06:00:00 -0000 full BackTable In this episode of the Backtable Podcast, guest host Dr. Paul Bhogal, a consultant interventional neuroradiologist at Royal London Hospital in the UK, and guests Dr. Piotr Walczak and Dr. Prakash Ambady discuss the potential of intra-arterial treatments combined with blood brain barrier (BBB) manipulation in treating various neurological conditions and tumors. In this episode of the Backtable Podcast, guest host Dr. Paul Bhogal, a consultant interventional neuroradiologist at Royal London Hospital in the UK, and guests Dr. Piotr Walczak and Dr. Prakash Ambady discuss the potential of intra-arterial treatments combined with blood brain barrier (BBB) manipulation in treating various neurological conditions and tumors. The trio of doctors discuss methods such as the use of hyperosmolar mannitol and focused ultrasound to breach the BBB and deliver drugs directly to the brain tissue. Dr. Walczak and Dr. Ambady also highlight their individual research areas, including therapies involving cell delivery and engineered cells. The conversation also covers potential risks and new perspectives in comparison to current techniques such as whole-brain radiation. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 05:44 - Challenges of Treating Glioblastoma Multiforme 12:52 - Understanding the Blood Brain Barrier 18:30 - Strategies to Negate the Blood Brain Barrier 20:52 - Blood Brain Barrier Disruption Using Intra-Arterial Mannitol 26:35 - Infusion Rates and Magnetic Resonance Guidance 33:47 - Role of Radiolabel Studies in Drug Delivery 36:31 - Future of Therapeutic Agents Design 47:54 - Potential of Focused Ultrasound in Drug Delivery 56:10 - Exploring the Use of Cells in Drug Delivery 58:44 - Future of Intra-Arterial Interventions --- RESOURCES Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma: https://pubmed.ncbi.nlm.nih.gov/15758009/ Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-year analysis of the EORTC-NCIC trial: https://pubmed.ncbi.nlm.nih.gov/19269895/ REMOVAL OF RIGHT CEREBRAL HEMISPHERE FOR CERTAIN TUMORS WITH HEMIPLEGIA - PRELIMINARY REPORT: https://jamanetwork.com/journals/jama/article-abstract/254927 Real-Time MRI Guidance for Reproducible Hyperosmolar Opening of the Blood-Brain Barrier in Mice: https://www.researchgate.net/publication/328537972_Real-Time_MRI_Guidance_for_Reproducible_Hyperosmolar_Opening_of_the_Blood-Brain_Barrier_in_Mice Dr. Piotr Walczak ResearchGate Profile: https://www.researchgate.net/profile/Piotr-Walczak-6 Dr. Prakash Ambday ResearchGate Profile: https://www.researchgate.net/profile/Prakash-Ambady Maculopathy Associated With Osmotic Blood- Brain Barrier Disruption and Chemotherapy in Patients With Primary CNS Lymphoma: https://pubmed.ncbi.nlm.nih.gov/32484895/ PET imaging of intra-arterial 89 Zr bevacizumab in mice with and without osmotic opening of the blood-brain barrier: distinct advantage of intra-arterial delivery: 10.2967/jnumed.118.218792 Safety of intra-arterial chemotherapy with or without osmotic blood–brain barrier disruption for the treatment of patients with brain tumors: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307096/ Delivery of chemotherapeutics across the blood-brain barrier: challenges and advances: https://pubmed.ncbi.nlm.nih.gov/25307218/ In this episode of the Backtable Podcast, guest host Dr. Paul Bhogal, a consultant interventional neuroradiologist at Royal London Hospital in the UK, and guests Dr. Piotr Walczak and Dr. Prakash Ambady discuss the potential of intra-arterial treatments combined with blood brain barrier (BBB) manipulation in treating various neurological conditions and tumors.


The trio of doctors discuss methods such as the use of hyperosmolar mannitol and focused ultrasound to breach the BBB and deliver drugs directly to the brain tissue. Dr. Walczak and Dr. Ambady also highlight their individual research areas, including therapies involving cell delivery and engineered cells. The conversation also covers potential risks and new perspectives in comparison to current techniques such as whole-brain radiation.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

05:44 - Challenges of Treating Glioblastoma Multiforme

12:52 - Understanding the Blood Brain Barrier

18:30 - Strategies to Negate the Blood Brain Barrier

20:52 - Blood Brain Barrier Disruption Using Intra-Arterial Mannitol

26:35 - Infusion Rates and Magnetic Resonance Guidance

33:47 - Role of Radiolabel Studies in Drug Delivery

36:31 - Future of Therapeutic Agents Design

47:54 - Potential of Focused Ultrasound in Drug Delivery

56:10 - Exploring the Use of Cells in Drug Delivery

58:44 - Future of Intra-Arterial Interventions


---


RESOURCES


Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma:

https://pubmed.ncbi.nlm.nih.gov/15758009/


Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-year analysis of the EORTC-NCIC trial:

https://pubmed.ncbi.nlm.nih.gov/19269895/


REMOVAL OF RIGHT CEREBRAL HEMISPHERE FOR CERTAIN TUMORS WITH HEMIPLEGIA - PRELIMINARY REPORT:

https://jamanetwork.com/journals/jama/article-abstract/254927


Real-Time MRI Guidance for Reproducible Hyperosmolar Opening of the Blood-Brain Barrier in Mice:

https://www.researchgate.net/publication/328537972_Real-Time_MRI_Guidance_for_Reproducible_Hyperosmolar_Opening_of_the_Blood-Brain_Barrier_in_Mice


Dr. Piotr Walczak ResearchGate Profile:

https://www.researchgate.net/profile/Piotr-Walczak-6


Dr. Prakash Ambday ResearchGate Profile:

https://www.researchgate.net/profile/Prakash-Ambady


Maculopathy Associated With Osmotic Blood- Brain Barrier Disruption and Chemotherapy in Patients With Primary CNS Lymphoma:

https://pubmed.ncbi.nlm.nih.gov/32484895/


PET imaging of intra-arterial 89 Zr bevacizumab in mice with and without osmotic opening of the blood-brain barrier: distinct advantage of intra-arterial delivery:

10.2967/jnumed.118.218792


Safety of intra-arterial chemotherapy with or without osmotic blood–brain barrier disruption for the treatment of patients with brain tumors:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307096/


Delivery of chemotherapeutics across the blood-brain barrier: challenges and advances:

https://pubmed.ncbi.nlm.nih.gov/25307218/

]]> 4066 Ep. 399 Pros and Cons of Independence in the OBL with Dr. Mahmood Razavi and Dr. Mark Garcia In this episode of The Backtable Podcast, host Dr. Aaron Fritts and guests Dr. Mahmood Razavi and Dr. Mark Garcia discuss the intricacies of owning and operating an outpatient-based lab (OBL). Dr. Razavi and Dr. Garcia are practicing interventional radiologists at Vascular and Interventional Specialists of Orange County (California) and American Vascular Associates (Florida), respectively. The doctors explore the advantages of OBLs, including autonomy, flexibility, and patient satisfaction. They also delve into the challenges of financial sustainability, decision-making restrictions, and insurance navigation. The conversation revolves around the need for a solid business plan before stepping into OBL operation. This includes awareness of potential regulatory oversight, costs, and patient sources. They also discuss the impact of OBLs on healthcare, and they specifically warn that the lack of evidence-based practices might have adverse effects. The doctors propose solutions such as societal guidelines, required accreditation, and stringent care delivery. --- CHECK OUT OUR SPONSOR Siemens Healthineers https://www.siemens-healthineers.com/ --- SHOW NOTES 00:00 - Introduction 04:26 - Pros and Cons of Owning and Operating in an OBL 11:07 - Financial Aspects and Profitability of OBLs 23:42 - Exploring Alternative Models for OBLs 32:33 - The Role of Societies in Guiding OBL Practices 36:27 - The Future of OBLs: Regulation, Consolidation, and Quality 42:59 - Exit Strategies and Future Considerations for OBLs 50:38 - Final Thoughts on OBLs and the Importance of Quality Care --- RESOURCES Impact of Office Based Laboratories on Physician Practice Patterns and Outcomes after Percutaneous Vascular Interventions for Peripheral Artery Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555658/pdf/nihms-1524412.pdf Mon, 01 Jan 2024 06:00:00 -0000 full BackTable In this episode of The Backtable Podcast, host Dr. Aaron Fritts and guests Dr. Mahmood Razavi and Dr. Mark Garcia discuss the intricacies of owning and operating an outpatient-based lab (OBL). In this episode of The Backtable Podcast, host Dr. Aaron Fritts and guests Dr. Mahmood Razavi and Dr. Mark Garcia discuss the intricacies of owning and operating an outpatient-based lab (OBL). Dr. Razavi and Dr. Garcia are practicing interventional radiologists at Vascular and Interventional Specialists of Orange County (California) and American Vascular Associates (Florida), respectively. The doctors explore the advantages of OBLs, including autonomy, flexibility, and patient satisfaction. They also delve into the challenges of financial sustainability, decision-making restrictions, and insurance navigation. The conversation revolves around the need for a solid business plan before stepping into OBL operation. This includes awareness of potential regulatory oversight, costs, and patient sources. They also discuss the impact of OBLs on healthcare, and they specifically warn that the lack of evidence-based practices might have adverse effects. The doctors propose solutions such as societal guidelines, required accreditation, and stringent care delivery. --- CHECK OUT OUR SPONSOR Siemens Healthineers https://www.siemens-healthineers.com/ --- SHOW NOTES 00:00 - Introduction 04:26 - Pros and Cons of Owning and Operating in an OBL 11:07 - Financial Aspects and Profitability of OBLs 23:42 - Exploring Alternative Models for OBLs 32:33 - The Role of Societies in Guiding OBL Practices 36:27 - The Future of OBLs: Regulation, Consolidation, and Quality 42:59 - Exit Strategies and Future Considerations for OBLs 50:38 - Final Thoughts on OBLs and the Importance of Quality Care --- RESOURCES Impact of Office Based Laboratories on Physician Practice Patterns and Outcomes after Percutaneous Vascular Interventions for Peripheral Artery Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555658/pdf/nihms-1524412.pdf In this episode of The Backtable Podcast, host Dr. Aaron Fritts and guests Dr. Mahmood Razavi and Dr. Mark Garcia discuss the intricacies of owning and operating an outpatient-based lab (OBL). Dr. Razavi and Dr. Garcia are practicing interventional radiologists at Vascular and Interventional Specialists of Orange County (California) and American Vascular Associates (Florida), respectively.


The doctors explore the advantages of OBLs, including autonomy, flexibility, and patient satisfaction. They also delve into the challenges of financial sustainability, decision-making restrictions, and insurance navigation. The conversation revolves around the need for a solid business plan before stepping into OBL operation. This includes awareness of potential regulatory oversight, costs, and patient sources. They also discuss the impact of OBLs on healthcare, and they specifically warn that the lack of evidence-based practices might have adverse effects. The doctors propose solutions such as societal guidelines, required accreditation, and stringent care delivery.


---


CHECK OUT OUR SPONSOR


Siemens Healthineers

https://www.siemens-healthineers.com/


---


SHOW NOTES


00:00 - Introduction

04:26 - Pros and Cons of Owning and Operating in an OBL

11:07 - Financial Aspects and Profitability of OBLs

23:42 - Exploring Alternative Models for OBLs

32:33 - The Role of Societies in Guiding OBL Practices

36:27 - The Future of OBLs: Regulation, Consolidation, and Quality

42:59 - Exit Strategies and Future Considerations for OBLs

50:38 - Final Thoughts on OBLs and the Importance of Quality Care


---


RESOURCES


Impact of Office Based Laboratories on Physician Practice Patterns and Outcomes after Percutaneous Vascular Interventions for Peripheral Artery Disease:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555658/pdf/nihms-1524412.pdf

]]> 3335 Ep. 398 Scheduling Strategies for Clinicians: Flexibility and Transparency with Dr. Brandon St. Amant In this episode of The Backtable Podcast, host Dr. Michael Barraza and guest Dr. Brandon St. Amant have an in-depth discussion about QGenda, an online scheduling solution. Both doctors practice interventional radiology at Radiology Associates in Baton Rouge, Louisiana. They discuss the initial setup process, from rule setting to managing shift assignments and creating transparency among the team. The key points of the conversation include the concept of the ‘holiday schedule’, the ‘buy sell system’ for open shifts, and making ‘longer schedules’ for predictability. The episode emphasizes the ongoing role of the scheduler and the need to build trust when transitioning to an electronic system like QGenda. --- CHECK OUT OUR SPONSORS Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:08 - The Challenges of Manual Scheduling 05:00 - Transition to QGenda 09:34 - The Role of Excel in Scheduling 22:06 - Handling Holiday Schedules 26:50 - Buy-Sell System for Shifts 33:17 - Final Tips for Effective Scheduling --- RESOURCES QGenda: https://www.qgenda.com/ Fri, 29 Dec 2023 06:00:00 -0000 full BackTable In this episode of The Backtable Podcast, host Dr. Michael Barraza and guest Dr. Brandon St. Amant have an in-depth discussion about QGenda, an online scheduling solution. Both doctors practice interventional radiology at Radiology Associates in Baton Rouge, Louisiana. In this episode of The Backtable Podcast, host Dr. Michael Barraza and guest Dr. Brandon St. Amant have an in-depth discussion about QGenda, an online scheduling solution. Both doctors practice interventional radiology at Radiology Associates in Baton Rouge, Louisiana. They discuss the initial setup process, from rule setting to managing shift assignments and creating transparency among the team. The key points of the conversation include the concept of the ‘holiday schedule’, the ‘buy sell system’ for open shifts, and making ‘longer schedules’ for predictability. The episode emphasizes the ongoing role of the scheduler and the need to build trust when transitioning to an electronic system like QGenda. --- CHECK OUT OUR SPONSORS Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:08 - The Challenges of Manual Scheduling 05:00 - Transition to QGenda 09:34 - The Role of Excel in Scheduling 22:06 - Handling Holiday Schedules 26:50 - Buy-Sell System for Shifts 33:17 - Final Tips for Effective Scheduling --- RESOURCES QGenda: https://www.qgenda.com/ In this episode of The Backtable Podcast, host Dr. Michael Barraza and guest Dr. Brandon St. Amant have an in-depth discussion about QGenda, an online scheduling solution. Both doctors practice interventional radiology at Radiology Associates in Baton Rouge, Louisiana.


They discuss the initial setup process, from rule setting to managing shift assignments and creating transparency among the team. The key points of the conversation include the concept of the ‘holiday schedule’, the ‘buy sell system’ for open shifts, and making ‘longer schedules’ for predictability. The episode emphasizes the ongoing role of the scheduler and the need to build trust when transitioning to an electronic system like QGenda.


---


CHECK OUT OUR SPONSORS


Medtronic HawkOne Directional Atherectomy System

https://www.medtronic.com/hawkone


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

03:08 - The Challenges of Manual Scheduling

05:00 - Transition to QGenda

09:34 - The Role of Excel in Scheduling

22:06 - Handling Holiday Schedules

26:50 - Buy-Sell System for Shifts

33:17 - Final Tips for Effective Scheduling


---


RESOURCES


QGenda:

https://www.qgenda.com/

]]> 2394 Ep. 397 Embolización Prostática: ¿Merecemos Estar en las Guías Clínicas? con Dr. Iñigo Insausti Gorbea En este episodio del podcast, el Dr. Iñigo Insausti Gorbea y la Dra. Sara Lojo Lendoiro, se centraron en la técnica de embolización prostática como alternativa mínimamente invasiva para el tratamiento de la hiperplasia benigna de próstata. Se detallaron los criterios de inclusión del paciente para poder realizar este procedimiento, las tasas de éxito y los riesgos potenciales. Además, se destaca la importancia de educar a los urólogos y médicos de atención primaria sobre este procedimiento, abogando por una mayor participación clínica de los intervencionistas en la atención al paciente. El Dr. Insausti también abordó la necesidad de que los radiólogos intervencionistas cuenten con consultas y camas propias, para los pacientes. Por último, en el episodio se habla sobre el futuro potencial de la embolización de próstata, incluida la introducción de materiales de embolización alternativos y la tasa de retratamiento de pacientes a largo plazo, en comparación con las opciones quirúrgicas. --- SHOW NOTES 00:00 - Introducción 01:43 - Comprender la hipertrofia prostática benigna 03:42 - Impacto en la calidad de vida de los pacientes 04:31 - Introducción a la embolización de la próstata. 06:25 - Candidatura del paciente para la embolización 07:29 - Comparación de embolización y cirugía. 11:08 - Riesgos asociados con la embolización de la próstata 14:51 - Tasas de éxito de la embolización de la próstata 24:17 - El futuro de la embolización de la próstata 45:01 - Conclusión y pensamientos finales Wed, 27 Dec 2023 06:00:00 -0000 full BackTable En este episodio del podcast, el Dr. Iñigo Insausti Gorbea y la Dra. Sara Lojo Lendoiro, se centraron en la técnica de embolización prostática como alternativa mínimamente invasiva para el tratamiento de la hiperplasia benigna de próstata. En este episodio del podcast, el Dr. Iñigo Insausti Gorbea y la Dra. Sara Lojo Lendoiro, se centraron en la técnica de embolización prostática como alternativa mínimamente invasiva para el tratamiento de la hiperplasia benigna de próstata. Se detallaron los criterios de inclusión del paciente para poder realizar este procedimiento, las tasas de éxito y los riesgos potenciales. Además, se destaca la importancia de educar a los urólogos y médicos de atención primaria sobre este procedimiento, abogando por una mayor participación clínica de los intervencionistas en la atención al paciente. El Dr. Insausti también abordó la necesidad de que los radiólogos intervencionistas cuenten con consultas y camas propias, para los pacientes. Por último, en el episodio se habla sobre el futuro potencial de la embolización de próstata, incluida la introducción de materiales de embolización alternativos y la tasa de retratamiento de pacientes a largo plazo, en comparación con las opciones quirúrgicas. --- SHOW NOTES 00:00 - Introducción 01:43 - Comprender la hipertrofia prostática benigna 03:42 - Impacto en la calidad de vida de los pacientes 04:31 - Introducción a la embolización de la próstata. 06:25 - Candidatura del paciente para la embolización 07:29 - Comparación de embolización y cirugía. 11:08 - Riesgos asociados con la embolización de la próstata 14:51 - Tasas de éxito de la embolización de la próstata 24:17 - El futuro de la embolización de la próstata 45:01 - Conclusión y pensamientos finales En este episodio del podcast, el Dr. Iñigo Insausti Gorbea y la Dra. Sara Lojo Lendoiro, se centraron en la técnica de embolización prostática como alternativa mínimamente invasiva para el tratamiento de la hiperplasia benigna de próstata.


Se detallaron los criterios de inclusión del paciente para poder realizar este procedimiento, las tasas de éxito y los riesgos potenciales. Además, se destaca la importancia de educar a los urólogos y médicos de atención primaria sobre este procedimiento, abogando por una mayor participación clínica de los intervencionistas en la atención al paciente. El Dr. Insausti también abordó la necesidad de que los radiólogos intervencionistas cuenten con consultas y camas propias, para los pacientes. Por último, en el episodio se habla sobre el futuro potencial de la embolización de próstata, incluida la introducción de materiales de embolización alternativos y la tasa de retratamiento de pacientes a largo plazo, en comparación con las opciones quirúrgicas.


---


SHOW NOTES


00:00 - Introducción

01:43 - Comprender la hipertrofia prostática benigna

03:42 - Impacto en la calidad de vida de los pacientes

04:31 - Introducción a la embolización de la próstata.

06:25 - Candidatura del paciente para la embolización

07:29 - Comparación de embolización y cirugía.

11:08 - Riesgos asociados con la embolización de la próstata

14:51 - Tasas de éxito de la embolización de la próstata

24:17 - El futuro de la embolización de la próstata

45:01 - Conclusión y pensamientos finales

]]> 2969 Ep. 396 How I Perform a Port Removal with Dr. Chris Beck In this episode of the BackTable Podcast, hosts Dr. Aaron Fritts and Dr. Chris Beck discuss their Mediport removal workflows and the common challenges of a port removal procedure. Often seen as a significant milestone for cancer patients who have completed their treatment, successful Mediport removal requires a thorough understanding of the catheter and reservoir removal processes. This discussion covers tips and tricks for removing Mediports with minimal discomfort to the patient, effective anesthesia, careful dissection, and appropriate closure procedures. The hosts also emphasize the importance of preparing for unexpected scenarios such as catheter fractures or infection, and they outline strategies to effectively handle these complications. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 03:06 - Overview of Mediport Removal 13:25 - Mediport Removal Procedure 20:59 - Procedural Challenges and Complications 22:12 - Infected Ports 30:17 - Stuck Ports 33:14 - Fractured Ports Mon, 25 Dec 2023 06:00:00 -0000 full BackTable In this episode of the BackTable Podcast, hosts Dr. Aaron Fritts and Dr. Chris Beck discuss their Mediport removal workflows and the common challenges of a port removal procedure. In this episode of the BackTable Podcast, hosts Dr. Aaron Fritts and Dr. Chris Beck discuss their Mediport removal workflows and the common challenges of a port removal procedure. Often seen as a significant milestone for cancer patients who have completed their treatment, successful Mediport removal requires a thorough understanding of the catheter and reservoir removal processes. This discussion covers tips and tricks for removing Mediports with minimal discomfort to the patient, effective anesthesia, careful dissection, and appropriate closure procedures. The hosts also emphasize the importance of preparing for unexpected scenarios such as catheter fractures or infection, and they outline strategies to effectively handle these complications. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 03:06 - Overview of Mediport Removal 13:25 - Mediport Removal Procedure 20:59 - Procedural Challenges and Complications 22:12 - Infected Ports 30:17 - Stuck Ports 33:14 - Fractured Ports In this episode of the BackTable Podcast, hosts Dr. Aaron Fritts and Dr. Chris Beck discuss their Mediport removal workflows and the common challenges of a port removal procedure.


Often seen as a significant milestone for cancer patients who have completed their treatment, successful Mediport removal requires a thorough understanding of the catheter and reservoir removal processes. This discussion covers tips and tricks for removing Mediports with minimal discomfort to the patient, effective anesthesia, careful dissection, and appropriate closure procedures. The hosts also emphasize the importance of preparing for unexpected scenarios such as catheter fractures or infection, and they outline strategies to effectively handle these complications.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

03:06 - Overview of Mediport Removal

13:25 - Mediport Removal Procedure

20:59 - Procedural Challenges and Complications

22:12 - Infected Ports

30:17 - Stuck Ports

33:14 - Fractured Ports

]]> 2438 Ep. 395 Radial to Peripheral Tools and Technique with Dr. Sameh Sayfo In this episode of the Back Table Podcast, host Dr. Aaron Fritts and Dr. Sameh Sayfo discuss radial to peripheral interventions, also known as R2P. Dr. Sayfo is an interventional cardiologist and the program director of the endovascular fellowship at Baylor Heart Hospital in Plano, Texas. Dr. Sayfo points out the need for research data on the financial impact of these interventions on patients. Dr. Amit P. Amin’s work in 2017, 2018 and 2021 is highlighted for its valuable contribution in this area, specifically in the radial to coronary world. The conversation then veers into the possibilities for radial to peripheral interventions in the coming years. There’s a discussion about the potential financial impact on the healthcare system, and how radial to peripheral interventions may yield a lower length of stay and more same day discharges, which can serve as motivators for more practitioners to adopt this technology. The episode also highlights training, patient selection, complications, bailout techniques and post-procedure care related to radial to peripheral interventions. --- CHECK OUT OUR SPONSORS Surmodics Sublime Radial Access Platform https://sublimeradial.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 04:40 - Discussion on Radial to Peripheral 15:52 - Addressing Hesitations about Radial Approach 25:24 - Crossing Complex Lesions: Challenges and Solutions 28:50 - Need for Research and Equipment Advancement 33:43 - Importance of Landmark Study in Radial to Peripheral 35:23 - Complications to Avoid and Bailout Techniques 40:53 - The Radial Movement and Future Prospects --- RESOURCES From Femoral to Radial Approach in Coronary Intervention: https://pubmed.ncbi.nlm.nih.gov/27401210/ Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial: https://pubmed.ncbi.nlm.nih.gov/34167675/ Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions: https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext Distal Versus Proximal Radial Artery Access for Cardiac Catheterization and Intervention: Design and Rationale of the DIPRA Trial: https://pubmed.ncbi.nlm.nih.gov/33926835/ Costs associated with transradial access and same-day discharge after percutaneous coronary intervention: a systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/34258909/ The Value of Transradial: Impact on Patient Satisfaction and Health Care Economics: https://pubmed.ncbi.nlm.nih.gov/31733737/ Transradial Access for High-Risk Percutaneous Coronary Intervention: Implications of the Risk-Treatment Paradox: https://pubmed.ncbi.nlm.nih.gov/34253050/ Cost of coronary syndrome treated with percutaneous coronary intervention and 30-day unplanned readmission in the United States: https://pubmed.ncbi.nlm.nih.gov/31876371/ Terumo Radial Sheath: https://www.terumois.com/products/access/glidesheath-slender-introducer-sheath.html Cordis Radial Sheath: https://cordis.com/na/products/access/cardiology/rain-sheath-transradial-thin-walled-introducer Surmodic Radial Sheath: https://www.surmodics.com/ Fri, 22 Dec 2023 06:00:00 -0000 full BackTable In this episode of the Back Table Podcast, host Dr. Aaron Fritts and Dr. Sameh Sayfo discuss radial to peripheral interventions, also known as R2P. Dr. Sayfo is an interventional cardiologist and the program director of the endovascular fellowship at Baylor Heart Hospital in Plano, Texas. In this episode of the Back Table Podcast, host Dr. Aaron Fritts and Dr. Sameh Sayfo discuss radial to peripheral interventions, also known as R2P. Dr. Sayfo is an interventional cardiologist and the program director of the endovascular fellowship at Baylor Heart Hospital in Plano, Texas. Dr. Sayfo points out the need for research data on the financial impact of these interventions on patients. Dr. Amit P. Amin’s work in 2017, 2018 and 2021 is highlighted for its valuable contribution in this area, specifically in the radial to coronary world. The conversation then veers into the possibilities for radial to peripheral interventions in the coming years. There’s a discussion about the potential financial impact on the healthcare system, and how radial to peripheral interventions may yield a lower length of stay and more same day discharges, which can serve as motivators for more practitioners to adopt this technology. The episode also highlights training, patient selection, complications, bailout techniques and post-procedure care related to radial to peripheral interventions. --- CHECK OUT OUR SPONSORS Surmodics Sublime Radial Access Platform https://sublimeradial.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 04:40 - Discussion on Radial to Peripheral 15:52 - Addressing Hesitations about Radial Approach 25:24 - Crossing Complex Lesions: Challenges and Solutions 28:50 - Need for Research and Equipment Advancement 33:43 - Importance of Landmark Study in Radial to Peripheral 35:23 - Complications to Avoid and Bailout Techniques 40:53 - The Radial Movement and Future Prospects --- RESOURCES From Femoral to Radial Approach in Coronary Intervention: https://pubmed.ncbi.nlm.nih.gov/27401210/ Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial: https://pubmed.ncbi.nlm.nih.gov/34167675/ Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions: https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext Distal Versus Proximal Radial Artery Access for Cardiac Catheterization and Intervention: Design and Rationale of the DIPRA Trial: https://pubmed.ncbi.nlm.nih.gov/33926835/ Costs associated with transradial access and same-day discharge after percutaneous coronary intervention: a systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/34258909/ The Value of Transradial: Impact on Patient Satisfaction and Health Care Economics: https://pubmed.ncbi.nlm.nih.gov/31733737/ Transradial Access for High-Risk Percutaneous Coronary Intervention: Implications of the Risk-Treatment Paradox: https://pubmed.ncbi.nlm.nih.gov/34253050/ Cost of coronary syndrome treated with percutaneous coronary intervention and 30-day unplanned readmission in the United States: https://pubmed.ncbi.nlm.nih.gov/31876371/ Terumo Radial Sheath: https://www.terumois.com/products/access/glidesheath-slender-introducer-sheath.html Cordis Radial Sheath: https://cordis.com/na/products/access/cardiology/rain-sheath-transradial-thin-walled-introducer Surmodic Radial Sheath: https://www.surmodics.com/ In this episode of the Back Table Podcast, host Dr. Aaron Fritts and Dr. Sameh Sayfo discuss radial to peripheral interventions, also known as R2P. Dr. Sayfo is an interventional cardiologist and the program director of the endovascular fellowship at Baylor Heart Hospital in Plano, Texas.


Dr. Sayfo points out the need for research data on the financial impact of these interventions on patients. Dr. Amit P. Amin’s work in 2017, 2018 and 2021 is highlighted for its valuable contribution in this area, specifically in the radial to coronary world. The conversation then veers into the possibilities for radial to peripheral interventions in the coming years. There’s a discussion about the potential financial impact on the healthcare system, and how radial to peripheral interventions may yield a lower length of stay and more same day discharges, which can serve as motivators for more practitioners to adopt this technology. The episode also highlights training, patient selection, complications, bailout techniques and post-procedure care related to radial to peripheral interventions.


---


CHECK OUT OUR SPONSORS


Surmodics Sublime Radial Access Platform

https://sublimeradial.com/


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

04:40 - Discussion on Radial to Peripheral

15:52 - Addressing Hesitations about Radial Approach

25:24 - Crossing Complex Lesions: Challenges and Solutions

28:50 - Need for Research and Equipment Advancement

33:43 - Importance of Landmark Study in Radial to Peripheral

35:23 - Complications to Avoid and Bailout Techniques

40:53 - The Radial Movement and Future Prospects


---


RESOURCES


From Femoral to Radial Approach in Coronary Intervention:

https://pubmed.ncbi.nlm.nih.gov/27401210/


Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial:

https://pubmed.ncbi.nlm.nih.gov/34167675/


Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions:

https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext


Distal Versus Proximal Radial Artery Access for Cardiac Catheterization and Intervention: Design and Rationale of the DIPRA Trial:

https://pubmed.ncbi.nlm.nih.gov/33926835/


Costs associated with transradial access and same-day discharge after percutaneous coronary intervention: a systematic review and meta-analysis:

https://pubmed.ncbi.nlm.nih.gov/34258909/


The Value of Transradial: Impact on Patient Satisfaction and Health Care Economics:

https://pubmed.ncbi.nlm.nih.gov/31733737/


Transradial Access for High-Risk Percutaneous Coronary Intervention: Implications of the Risk-Treatment Paradox:

https://pubmed.ncbi.nlm.nih.gov/34253050/


Cost of coronary syndrome treated with percutaneous coronary intervention and 30-day unplanned readmission in the United States:

https://pubmed.ncbi.nlm.nih.gov/31876371/


Terumo Radial Sheath:

https://www.terumois.com/products/access/glidesheath-slender-introducer-sheath.html


Cordis Radial Sheath:

https://cordis.com/na/products/access/cardiology/rain-sheath-transradial-thin-walled-introducer


Surmodic Radial Sheath:

https://www.surmodics.com/

]]> 2677 Ep. 394 Cryoneurolysis Pearls and Pitfalls with Dr. Alexa Levey In this episode of the BackTable Podcast, host Dr. Jacob Fleming and Dr. Alexa Levey have an in-depth discussion about the current uses and potential future applications of cryoneurolysis in interventional radiology. Dr. Levey is an interventional radiologist at the Memorial Hermann Health System in Houston, TX. The doctors discuss how cryoneurolysis differs from radiofrequency (RF) ablation, highlighting the increased precision and gentleness to surrounding tissues. Dr. Levey describes the specifics of stellate ganglion procedures and cryoneurolysis techniques. They delve into the importance of research and collaboration in advancing the field, as well as the necessity of being patient-centered. They also address the need for financial discussions in medicine and the prospect for cryoneurolysis as desmoid tumor treatments. Additionally, Dr. Levey shares her journey in building a career as a female in a male-dominated space and emphasizes the importance of physician availability to patients and colleagues. --- CHECK OUT OUR SPONSOR Boston Scientific Visual ICE Cryoablation System https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html --- SHOW NOTES 00:00 - Introduction to RF Ablation and Cryoneurolysis 03:20 - Dr. Alexa Levey’s Journey and Inspiration 07:00 - Building a Pain Practice 14:03 - Advantages of Cryoneurolysis over RF 21:09 - Patient Selection and Planning for Cryoneurolysis 32:02 - Understanding Patient’s Condition and Treatment Options 36:21 - Role of Stellate Ganglion Procedures in PTSD and Anxiety Management 37:48 - Challenges and Impact of Long COVID 41:34 - The Future of Cryoneurolysis in Medical Practice 54:55 - Future of Cryo Treatment in Medical Practice --- RESOURCES Safety and Effectiveness of Stellate Ganglion Cryoablation in Complex Regional Pain Syndrome: https://doi.org/10.1016/j.jvir.2023.09.030 Treating phantom limb pain: cryoablation of the posterior tibial nerve: https://pubmed.ncbi.nlm.nih.gov/35801126/ Stellate Ganglion Block for Psychiatric Disorders: A Systematic Review of the Clinical Research Landscape: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664306/ The Efficacy of the Stellate Ganglion Block as a Treatment Modality for Posttraumatic Stress Disorder Among Active Duty Combat Veterans: A Pilot Program Evaluation: https://pubmed.ncbi.nlm.nih.gov/33242072/ Stellate Ganglion Block in the Treatment of Post-traumatic Stress Disorder: A Review of Historical and Recent Literature: https://pubmed.ncbi.nlm.nih.gov/27739175/ Stellate ganglion block reduces symptoms of Long COVID: A case series: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8653406/ Stellate Ganglion Block Relieves Long COVID-19 Symptoms in 86% of Patients: A Retrospective Cohort Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498998/ Mon, 18 Dec 2023 06:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Jacob Fleming and Dr. Alexa Levey have an in-depth discussion about the current uses and potential future applications of cryoneurolysis in interventional radiology. In this episode of the BackTable Podcast, host Dr. Jacob Fleming and Dr. Alexa Levey have an in-depth discussion about the current uses and potential future applications of cryoneurolysis in interventional radiology. Dr. Levey is an interventional radiologist at the Memorial Hermann Health System in Houston, TX. The doctors discuss how cryoneurolysis differs from radiofrequency (RF) ablation, highlighting the increased precision and gentleness to surrounding tissues. Dr. Levey describes the specifics of stellate ganglion procedures and cryoneurolysis techniques. They delve into the importance of research and collaboration in advancing the field, as well as the necessity of being patient-centered. They also address the need for financial discussions in medicine and the prospect for cryoneurolysis as desmoid tumor treatments. Additionally, Dr. Levey shares her journey in building a career as a female in a male-dominated space and emphasizes the importance of physician availability to patients and colleagues. --- CHECK OUT OUR SPONSOR Boston Scientific Visual ICE Cryoablation System https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html --- SHOW NOTES 00:00 - Introduction to RF Ablation and Cryoneurolysis 03:20 - Dr. Alexa Levey’s Journey and Inspiration 07:00 - Building a Pain Practice 14:03 - Advantages of Cryoneurolysis over RF 21:09 - Patient Selection and Planning for Cryoneurolysis 32:02 - Understanding Patient’s Condition and Treatment Options 36:21 - Role of Stellate Ganglion Procedures in PTSD and Anxiety Management 37:48 - Challenges and Impact of Long COVID 41:34 - The Future of Cryoneurolysis in Medical Practice 54:55 - Future of Cryo Treatment in Medical Practice --- RESOURCES Safety and Effectiveness of Stellate Ganglion Cryoablation in Complex Regional Pain Syndrome: https://doi.org/10.1016/j.jvir.2023.09.030 Treating phantom limb pain: cryoablation of the posterior tibial nerve: https://pubmed.ncbi.nlm.nih.gov/35801126/ Stellate Ganglion Block for Psychiatric Disorders: A Systematic Review of the Clinical Research Landscape: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664306/ The Efficacy of the Stellate Ganglion Block as a Treatment Modality for Posttraumatic Stress Disorder Among Active Duty Combat Veterans: A Pilot Program Evaluation: https://pubmed.ncbi.nlm.nih.gov/33242072/ Stellate Ganglion Block in the Treatment of Post-traumatic Stress Disorder: A Review of Historical and Recent Literature: https://pubmed.ncbi.nlm.nih.gov/27739175/ Stellate ganglion block reduces symptoms of Long COVID: A case series: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8653406/ Stellate Ganglion Block Relieves Long COVID-19 Symptoms in 86% of Patients: A Retrospective Cohort Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498998/ In this episode of the BackTable Podcast, host Dr. Jacob Fleming and Dr. Alexa Levey have an in-depth discussion about the current uses and potential future applications of cryoneurolysis in interventional radiology. Dr. Levey is an interventional radiologist at the Memorial Hermann Health System in Houston, TX.


The doctors discuss how cryoneurolysis differs from radiofrequency (RF) ablation, highlighting the increased precision and gentleness to surrounding tissues. Dr. Levey describes the specifics of stellate ganglion procedures and cryoneurolysis techniques. They delve into the importance of research and collaboration in advancing the field, as well as the necessity of being patient-centered. They also address the need for financial discussions in medicine and the prospect for cryoneurolysis as desmoid tumor treatments. Additionally, Dr. Levey shares her journey in building a career as a female in a male-dominated space and emphasizes the importance of physician availability to patients and colleagues.


---


CHECK OUT OUR SPONSOR


Boston Scientific Visual ICE Cryoablation System

https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html


---


SHOW NOTES


00:00 - Introduction to RF Ablation and Cryoneurolysis

03:20 - Dr. Alexa Levey’s Journey and Inspiration

07:00 - Building a Pain Practice

14:03 - Advantages of Cryoneurolysis over RF

21:09 - Patient Selection and Planning for Cryoneurolysis

32:02 - Understanding Patient’s Condition and Treatment Options

36:21 - Role of Stellate Ganglion Procedures in PTSD and Anxiety Management

37:48 - Challenges and Impact of Long COVID

41:34 - The Future of Cryoneurolysis in Medical Practice

54:55 - Future of Cryo Treatment in Medical Practice


---


RESOURCES


Safety and Effectiveness of Stellate Ganglion Cryoablation in Complex Regional Pain Syndrome:

https://doi.org/10.1016/j.jvir.2023.09.030


Treating phantom limb pain: cryoablation of the posterior tibial nerve:

https://pubmed.ncbi.nlm.nih.gov/35801126/


Stellate Ganglion Block for Psychiatric Disorders: A Systematic Review of the Clinical Research Landscape:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664306/


The Efficacy of the Stellate Ganglion Block as a Treatment Modality for Posttraumatic Stress Disorder Among Active Duty Combat Veterans: A Pilot Program Evaluation:

https://pubmed.ncbi.nlm.nih.gov/33242072/


Stellate Ganglion Block in the Treatment of Post-traumatic Stress Disorder: A Review of Historical and Recent Literature:

https://pubmed.ncbi.nlm.nih.gov/27739175/


Stellate ganglion block reduces symptoms of Long COVID: A case series:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8653406/


Stellate Ganglion Block Relieves Long COVID-19 Symptoms in 86% of Patients: A Retrospective Cohort Study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498998/

]]> 3840 Ep. 393 Peripartum and Postpartum Hemorrhage with Dr. Dan Sheeran In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Daniel Sheeran discuss the management and treatment of peripartum and postpartum hemorrhage. Dr. Sheeran highlights the importance of imaging-based diagnostics, particularly with MRI, to identify the source of bleeding and guide therapy. He also explains the need to employ a variety of techniques tailored towards each individual situation, which may involve utilizing different types of catheters, occlusion balloons, and embolics. He underlines the necessity to balance effective treatment with the preservation of uterine health, especially for women who may wish to have future pregnancies. In severe cases, he mentions the possibility of temporary aortic occlusion. As a final point, Dr. Sheeran argues that Interventional Radiology can play a crucial role in managing these types of cases and potentially avoiding hysterectomies. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:00 - Breakdown of Types of Hemorrhages 03:26 - Understanding Peripartum Hemorrhage 04:05 - Discussion on Postpartum Hemorrhage 07:52 - Technical Details of Balloon Occlusion 08:00 - Procedure for Peripartum Hemorrhage 21:15 - Blood Loss in Medical Procedures 22:48 - Uterine Artery Embolization 27:10 - Post-Procedure Follow Up and Fertility Concerns 30:05 - Technical Points for Newcomers in the Field 36:12 - The Role of REBOA in Treating Postpartum Hemorrhage --- RESOURCES The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276355/ Magnetic Resonance Imaging of Placenta Accreta Spectrum: A Step-by-Step Approach: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817633/ Role of interventional radiology in placenta accreta spectrum (PAS) disorders: https://www.sciencedirect.com/science/article/pii/S1521693421000146 Perioperative temporary occlusion of the internal iliac arteries as prophylaxis in cesarean section at risk of hemorrhage in placenta accreta: https://pubmed.ncbi.nlm.nih.gov/21598085/ Aberrant Ovarian and Uterine Feeding from the Renal Artery at the End of Gestation: Two Cases: https://www.jvir.org/article/S1051-0443(10)00863-8/fulltext Uterine Fundal Blood Supply from an Aberrant Left Ovarian Artery Originating from the Inferior Mesenteric Artery: Implications for Uterine Artery Embolization: https://www.jvir.org/article/S1051-0443(10)00191-0/fulltext Pregnancy success and outcomes after uterine fibroid embolization: updated review of published literature: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948071/ Uterine artery embolisation: fertility, adenomyosis and size – what is the evidence?: https://cvirendovasc.springeropen.com/articles/10.1186/s42155-023-00353-2 Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Proximal Aortic Control in Patients With Severe Hemorrhage and Arrest: https://pubmed.ncbi.nlm.nih.gov/28973104/ Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): https://prytimemedical.com/clinical/reboa/ Resuscitative endovascular balloon occlusion of the aorta (REBOA) for life-threatening postpartum hemorrhage: A nationwide observational study in Japan: https://pubmed.ncbi.nlm.nih.gov/35444149/ Efficacy of resuscitative endovascular balloon occlusion of the aorta (REBOA) for hemorrhage control in patients with abnormally invasive placenta: a historical cohort study: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05649-8 An elective hybrid suite approach to the management of placenta accreta-associated postpartum hemorrhage (PPH): https://www.jvir.org/article/S1051-0443(13)00311-4/fulltext The role of interventional radiology in primary postpartum hemorrhage: https://www.jstage.jst.go.jp/article/jsshp/4/2/4_HRP2015-016/_article Fri, 15 Dec 2023 06:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Daniel Sheeran discuss the management and treatment of peripartum and postpartum hemorrhage. In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Daniel Sheeran discuss the management and treatment of peripartum and postpartum hemorrhage. Dr. Sheeran highlights the importance of imaging-based diagnostics, particularly with MRI, to identify the source of bleeding and guide therapy. He also explains the need to employ a variety of techniques tailored towards each individual situation, which may involve utilizing different types of catheters, occlusion balloons, and embolics. He underlines the necessity to balance effective treatment with the preservation of uterine health, especially for women who may wish to have future pregnancies. In severe cases, he mentions the possibility of temporary aortic occlusion. As a final point, Dr. Sheeran argues that Interventional Radiology can play a crucial role in managing these types of cases and potentially avoiding hysterectomies. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:00 - Breakdown of Types of Hemorrhages 03:26 - Understanding Peripartum Hemorrhage 04:05 - Discussion on Postpartum Hemorrhage 07:52 - Technical Details of Balloon Occlusion 08:00 - Procedure for Peripartum Hemorrhage 21:15 - Blood Loss in Medical Procedures 22:48 - Uterine Artery Embolization 27:10 - Post-Procedure Follow Up and Fertility Concerns 30:05 - Technical Points for Newcomers in the Field 36:12 - The Role of REBOA in Treating Postpartum Hemorrhage --- RESOURCES The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276355/ Magnetic Resonance Imaging of Placenta Accreta Spectrum: A Step-by-Step Approach: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817633/ Role of interventional radiology in placenta accreta spectrum (PAS) disorders: https://www.sciencedirect.com/science/article/pii/S1521693421000146 Perioperative temporary occlusion of the internal iliac arteries as prophylaxis in cesarean section at risk of hemorrhage in placenta accreta: https://pubmed.ncbi.nlm.nih.gov/21598085/ Aberrant Ovarian and Uterine Feeding from the Renal Artery at the End of Gestation: Two Cases: https://www.jvir.org/article/S1051-0443(10)00863-8/fulltext Uterine Fundal Blood Supply from an Aberrant Left Ovarian Artery Originating from the Inferior Mesenteric Artery: Implications for Uterine Artery Embolization: https://www.jvir.org/article/S1051-0443(10)00191-0/fulltext Pregnancy success and outcomes after uterine fibroid embolization: updated review of published literature: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948071/ Uterine artery embolisation: fertility, adenomyosis and size – what is the evidence?: https://cvirendovasc.springeropen.com/articles/10.1186/s42155-023-00353-2 Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Proximal Aortic Control in Patients With Severe Hemorrhage and Arrest: https://pubmed.ncbi.nlm.nih.gov/28973104/ Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): https://prytimemedical.com/clinical/reboa/ Resuscitative endovascular balloon occlusion of the aorta (REBOA) for life-threatening postpartum hemorrhage: A nationwide observational study in Japan: https://pubmed.ncbi.nlm.nih.gov/35444149/ Efficacy of resuscitative endovascular balloon occlusion of the aorta (REBOA) for hemorrhage control in patients with abnormally invasive placenta: a historical cohort study: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05649-8 An elective hybrid suite approach to the management of placenta accreta-associated postpartum hemorrhage (PPH): https://www.jvir.org/article/S1051-0443(13)00311-4/fulltext The role of interventional radiology in primary postpartum hemorrhage: https://www.jstage.jst.go.jp/article/jsshp/4/2/4_HRP2015-016/_article In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Daniel Sheeran discuss the management and treatment of peripartum and postpartum hemorrhage.


Dr. Sheeran highlights the importance of imaging-based diagnostics, particularly with MRI, to identify the source of bleeding and guide therapy. He also explains the need to employ a variety of techniques tailored towards each individual situation, which may involve utilizing different types of catheters, occlusion balloons, and embolics. He underlines the necessity to balance effective treatment with the preservation of uterine health, especially for women who may wish to have future pregnancies. In severe cases, he mentions the possibility of temporary aortic occlusion. As a final point, Dr. Sheeran argues that Interventional Radiology can play a crucial role in managing these types of cases and potentially avoiding hysterectomies.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

03:00 - Breakdown of Types of Hemorrhages

03:26 - Understanding Peripartum Hemorrhage

04:05 - Discussion on Postpartum Hemorrhage

07:52 - Technical Details of Balloon Occlusion

08:00 - Procedure for Peripartum Hemorrhage

21:15 - Blood Loss in Medical Procedures

22:48 - Uterine Artery Embolization

27:10 - Post-Procedure Follow Up and Fertility Concerns

30:05 - Technical Points for Newcomers in the Field

36:12 - The Role of REBOA in Treating Postpartum Hemorrhage


---


RESOURCES


The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276355/


Magnetic Resonance Imaging of Placenta Accreta Spectrum: A Step-by-Step Approach:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817633/


Role of interventional radiology in placenta accreta spectrum (PAS) disorders:

https://www.sciencedirect.com/science/article/pii/S1521693421000146


Perioperative temporary occlusion of the internal iliac arteries as prophylaxis in cesarean section at risk of hemorrhage in placenta accreta:

https://pubmed.ncbi.nlm.nih.gov/21598085/


Aberrant Ovarian and Uterine Feeding from the Renal Artery at the End of Gestation: Two Cases:

https://www.jvir.org/article/S1051-0443(10)00863-8/fulltext


Uterine Fundal Blood Supply from an Aberrant Left Ovarian Artery Originating from the Inferior Mesenteric Artery: Implications for Uterine Artery Embolization:

https://www.jvir.org/article/S1051-0443(10)00191-0/fulltext


Pregnancy success and outcomes after uterine fibroid embolization: updated review of published literature:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948071/


Uterine artery embolisation: fertility, adenomyosis and size – what is the evidence?:

https://cvirendovasc.springeropen.com/articles/10.1186/s42155-023-00353-2


Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Proximal Aortic Control in Patients With Severe Hemorrhage and Arrest:

https://pubmed.ncbi.nlm.nih.gov/28973104/


Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA):

https://prytimemedical.com/clinical/reboa/


Resuscitative endovascular balloon occlusion of the aorta (REBOA) for life-threatening postpartum hemorrhage: A nationwide observational study in Japan:

https://pubmed.ncbi.nlm.nih.gov/35444149/


Efficacy of resuscitative endovascular balloon occlusion of the aorta (REBOA) for hemorrhage control in patients with abnormally invasive placenta: a historical cohort study:

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05649-8


An elective hybrid suite approach to the management of placenta accreta-associated postpartum hemorrhage (PPH):

https://www.jvir.org/article/S1051-0443(13)00311-4/fulltext


The role of interventional radiology in primary postpartum hemorrhage:

https://www.jstage.jst.go.jp/article/jsshp/4/2/4_HRP2015-016/_article

]]> 2501 Ep. 392 How to Maximize Efficiency and Revenue with EMRs and Practice Management Systems with Dr. Paramjit "Romi" Chopra In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Paramjit “Romi” Chopra discuss the processes involved in successful interventional radiology practice management. Dr. Chopra is an interventional radiologist practicing in Chicago, IL. He is the founder and CEO of Midwest Institute for Minimally Invasive Therapies. Dr. Chopra advises young IRs against going solo, and he suggests finding people who’ve done it before, to avoid “reinventing the wheel.” Dr. Chopra emphasizes the importance of adopting a patient-centered approach, building systems, developing business sense, and understanding risk. He shares his own experiences of building systems using Salesforce and explains the concept of ‘omni-channel healthcare delivery’. He particularly discusses the importance of patient, provider, and payer relationships, and he offers solutions for dealing with inherent complications. The episode also covers identifying the right electronic health record and developing an effective inventory management system. --- CHECK OUT OUR SPONSORS Medtronic IN.PACT 018 DCB https://www.medtronic.com/018 Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 05:41 - Shift from Academic Medicine to Entrepreneurship 09:40 - Patient-Centered Care in Interventional Radiology 11:13 - Challenges of Starting an Independent Practice 17:49 - Role of Electronic Health Records (EHRs) in Modern Healthcare 26:15 - Challenges of Implementing EHRs in Interventional Radiology 35:30 - Misconceptions about Outpatient Based Labs (OBLs) 37:01 - Understanding the Payer System 38:19 - Challenge of Insurance Coverage 51:43 - Practice Management Companies --- RESOURCES MIMIT Healthcare: https://mimithealth.com/physicians-executives The E-Myth Revisited: Why Most Small Businesses Don't Work and What to Do About It by Michael E. Gerber: https://a.co/d/2TuGpTn AdvancedMD Cloud Based EMR: https://www.googleadservices.com/pagead/aclk Athena Cloud Based EMR: https://www.athenahealth.com/landing/athenaclinicals CIMSS Management Services Organization (MSO): https://www.cimss.com/ Salesforce: https://www.salesforce.com/ Mon, 11 Dec 2023 06:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Paramjit “Romi” Chopra discuss the processes involved in successful interventional radiology practice management. Dr. Chopra is an interventional radiologist practicing in Chicago, IL. He is the founder and CEO of Midwest Institute for Minimally Invasive Therapies. In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Paramjit “Romi” Chopra discuss the processes involved in successful interventional radiology practice management. Dr. Chopra is an interventional radiologist practicing in Chicago, IL. He is the founder and CEO of Midwest Institute for Minimally Invasive Therapies. Dr. Chopra advises young IRs against going solo, and he suggests finding people who’ve done it before, to avoid “reinventing the wheel.” Dr. Chopra emphasizes the importance of adopting a patient-centered approach, building systems, developing business sense, and understanding risk. He shares his own experiences of building systems using Salesforce and explains the concept of ‘omni-channel healthcare delivery’. He particularly discusses the importance of patient, provider, and payer relationships, and he offers solutions for dealing with inherent complications. The episode also covers identifying the right electronic health record and developing an effective inventory management system. --- CHECK OUT OUR SPONSORS Medtronic IN.PACT 018 DCB https://www.medtronic.com/018 Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 05:41 - Shift from Academic Medicine to Entrepreneurship 09:40 - Patient-Centered Care in Interventional Radiology 11:13 - Challenges of Starting an Independent Practice 17:49 - Role of Electronic Health Records (EHRs) in Modern Healthcare 26:15 - Challenges of Implementing EHRs in Interventional Radiology 35:30 - Misconceptions about Outpatient Based Labs (OBLs) 37:01 - Understanding the Payer System 38:19 - Challenge of Insurance Coverage 51:43 - Practice Management Companies --- RESOURCES MIMIT Healthcare: https://mimithealth.com/physicians-executives The E-Myth Revisited: Why Most Small Businesses Don't Work and What to Do About It by Michael E. Gerber: https://a.co/d/2TuGpTn AdvancedMD Cloud Based EMR: https://www.googleadservices.com/pagead/aclk Athena Cloud Based EMR: https://www.athenahealth.com/landing/athenaclinicals CIMSS Management Services Organization (MSO): https://www.cimss.com/ Salesforce: https://www.salesforce.com/ In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Paramjit “Romi” Chopra discuss the processes involved in successful interventional radiology practice management. Dr. Chopra is an interventional radiologist practicing in Chicago, IL. He is the founder and CEO of Midwest Institute for Minimally Invasive Therapies.


Dr. Chopra advises young IRs against going solo, and he suggests finding people who’ve done it before, to avoid “reinventing the wheel.” Dr. Chopra emphasizes the importance of adopting a patient-centered approach, building systems, developing business sense, and understanding risk. He shares his own experiences of building systems using Salesforce and explains the concept of ‘omni-channel healthcare delivery’. He particularly discusses the importance of patient, provider, and payer relationships, and he offers solutions for dealing with inherent complications. The episode also covers identifying the right electronic health record and developing an effective inventory management system.


---


CHECK OUT OUR SPONSORS


Medtronic IN.PACT 018 DCB

https://www.medtronic.com/018


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


00:00 - Introduction

05:41 - Shift from Academic Medicine to Entrepreneurship

09:40 - Patient-Centered Care in Interventional Radiology

11:13 - Challenges of Starting an Independent Practice

17:49 - Role of Electronic Health Records (EHRs) in Modern Healthcare

26:15 - Challenges of Implementing EHRs in Interventional Radiology

35:30 - Misconceptions about Outpatient Based Labs (OBLs)

37:01 - Understanding the Payer System

38:19 - Challenge of Insurance Coverage

51:43 - Practice Management Companies


---


RESOURCES


MIMIT Healthcare:

https://mimithealth.com/physicians-executives



The E-Myth Revisited: Why Most Small Businesses Don't Work and What to Do About It by Michael E. Gerber:

https://a.co/d/2TuGpTn


AdvancedMD Cloud Based EMR:

https://www.googleadservices.com/pagead/aclk


Athena Cloud Based EMR:

https://www.athenahealth.com/landing/athenaclinicals


CIMSS Management Services Organization (MSO):

https://www.cimss.com/


Salesforce:

https://www.salesforce.com/

]]> 3820 Ep. 391 Building a Prostate Biopsy Service Line with Dr. Jamil Muasher In this episode, Dr. Aaron Fritts and Dr. Jose Silva invite interventional radiologist Dr. Jamil Muasher to highlight the potential that interventional radiologists possess in offering prostate biopsy work alongside Urology colleagues. Given the advancement in MRI guidance, the discussion addresses the opportunity for radiologists to step in and provide crucial expertise to optimize patient outcomes. Dr. Muasher talks about his approach of using an MR imaging to guide the biopsy procedure. He further expresses importance in understanding the grading, reading, interpreting systems like Prostate Imaging-Reporting and Data System (PI-RADS) and significant experience needed for accurate results. The doctors also explain various biopsy procedures, details about post-procedure care and follow-ups, and observations about billing for the services. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 07:29 - Learning to Read Prostate MRI 09:43 - The Role of Radiologists and Grading Systems in Prostate Biopsies 24:00 - Techniques in Prostate Biopsy 31:16 - The Role of Antibiotics in Biopsy 32:34 - The Debate Between Transperineal and Transrectal Biopsy 40:36 - Post-Procedure Care and Follow-Up 45:49 - The Future of Biopsy --- RESOURCES Decipher Prostate Genomic Classifier by Veracyte: https://decipherbio.com/ Fri, 08 Dec 2023 06:00:00 -0000 full BackTable In this episode, Dr. Aaron Fritts and Dr. Jose Silva invite interventional radiologist Dr. Jamil Muasher to highlight the potential that interventional radiologists possess in offering prostate biopsy work alongside Urology colleagues. In this episode, Dr. Aaron Fritts and Dr. Jose Silva invite interventional radiologist Dr. Jamil Muasher to highlight the potential that interventional radiologists possess in offering prostate biopsy work alongside Urology colleagues. Given the advancement in MRI guidance, the discussion addresses the opportunity for radiologists to step in and provide crucial expertise to optimize patient outcomes. Dr. Muasher talks about his approach of using an MR imaging to guide the biopsy procedure. He further expresses importance in understanding the grading, reading, interpreting systems like Prostate Imaging-Reporting and Data System (PI-RADS) and significant experience needed for accurate results. The doctors also explain various biopsy procedures, details about post-procedure care and follow-ups, and observations about billing for the services. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 07:29 - Learning to Read Prostate MRI 09:43 - The Role of Radiologists and Grading Systems in Prostate Biopsies 24:00 - Techniques in Prostate Biopsy 31:16 - The Role of Antibiotics in Biopsy 32:34 - The Debate Between Transperineal and Transrectal Biopsy 40:36 - Post-Procedure Care and Follow-Up 45:49 - The Future of Biopsy --- RESOURCES Decipher Prostate Genomic Classifier by Veracyte: https://decipherbio.com/ In this episode, Dr. Aaron Fritts and Dr. Jose Silva invite interventional radiologist Dr. Jamil Muasher to highlight the potential that interventional radiologists possess in offering prostate biopsy work alongside Urology colleagues.


Given the advancement in MRI guidance, the discussion addresses the opportunity for radiologists to step in and provide crucial expertise to optimize patient outcomes. Dr. Muasher talks about his approach of using an MR imaging to guide the biopsy procedure. He further expresses importance in understanding the grading, reading, interpreting systems like Prostate Imaging-Reporting and Data System (PI-RADS) and significant experience needed for accurate results. The doctors also explain various biopsy procedures, details about post-procedure care and follow-ups, and observations about billing for the services.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

07:29 - Learning to Read Prostate MRI

09:43 - The Role of Radiologists and Grading Systems in Prostate Biopsies

24:00 - Techniques in Prostate Biopsy

31:16 - The Role of Antibiotics in Biopsy

32:34 - The Debate Between Transperineal and Transrectal Biopsy

40:36 - Post-Procedure Care and Follow-Up

45:49 - The Future of Biopsy


---


RESOURCES


Decipher Prostate Genomic Classifier by Veracyte:

https://decipherbio.com/

]]> 3148 Ep. 390 Laser Atherectomy: An Overview of the Pathfinder Registry with Dr. Tony Das In this episode of the BackTable Podcast, host Dr. Chris Beck discusses atherectomy, laser technologies, and their use in vessel treatment with Dr. Tony Das, an interventional cardiologist practicing in Dallas, TX and one of the founding members of the VIVA Vascular Education Course in Las Vegas. Dr. Das shares insights on the PATHFINDER registry, which is a prospective non-randomized, multicenter study to evaluate the performance and outcome of the Auryon laser atherectomy system. Their conversation explores the role of atherectomy in reducing stent usage, decreasing embolization likelihood, enhancing thrombus removal, and uncovering lesions. Dr. Das further provides recommendations for building a successful atherectomy program, utilizing laser technologies, and the importance of having ablative technology in outpatient labs. The doctors forecast future applications for artificial intelligence and remote monitoring. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES 00:00 - Introduction 03:38 - Discussion about Connected Cardiovascular Care Associates 05:09 - Deep Dive into Atherectomy 14:06 - Understanding Laser Atherectomy 23:23 - Discussion on the PATHFINDER Study 34:52 - Advice for Building an Atherectomy Program 38:49 - Future Topics and Closing Remarks --- RESOURCES Connected Cardiovascular Care Associates: https://www.texasc3.com/ Pathfinder Registry Trial: https://www.clinicaltrials.gov/study/NCT04229563#publications Pathfinder Registry Trial Introduction: https://evtoday.com/articles/2021-sept/introduction-to-the-pathfinder-registry-and-complex-endovascular-cases-with-the-auryon-atherectomy-system Limb salvage following laser-assisted angioplasty for critical limb ischemia: results of the LACI multicenter trial: https://pubmed.ncbi.nlm.nih.gov/16445313/ Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: initial results from the EXCITE ISR trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis): https://pubmed.ncbi.nlm.nih.gov/25499305/ Cryoplasty Versus Conventional Balloon Angioplasty of the Femoropopliteal Artery in Diabetic Patients: Long-Term Results from a Prospective Randomized Single-Center Controlled Trial: https://link.springer.com/article/10.1007/s00270-010-9915-x#Abs1 Cryoplasty for the treatment of femoropopliteal arterial disease: results of a prospective, multicenter registry: https://pubmed.ncbi.nlm.nih.gov/16105918/ Auryon Laser from AngioDynamics: https://www.angiodynamics.com/product/auryon/ Philips Laser System: https://www.usa.philips.com/healthcare/product/HCIGTDPHLLSRSYSTM/laser-system-hcigtdphllsrsystm Atherectomy plus drug-coated balloon versus drug-coated balloon only for treatment of femoropopliteal artery lesions: A systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/33478353/ Laser in Infrapopliteal and Popliteal Stenosis 2 Study (LIPS2): Long-Term Outcomes of Laser-Assisted Balloon Angioplasty Versus Balloon Angioplasty for Below Knee Peripheral Arterial Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407062/ Distal embolization during lower extremity endovascular interventions: https://pubmed.ncbi.nlm.nih.gov/28366300/ Shockwave™ Lithoplasty in Combination With Atherectomy in Treating Severe Calcified Femoropopliteal and Iliac Artery Disease: A Single-Center Experience: https://pubmed.ncbi.nlm.nih.gov/32563711/ Mon, 04 Dec 2023 06:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Chris Beck discusses atherectomy, laser technologies, and their use in vessel treatment with Dr. Tony Das, an interventional cardiologist practicing in Dallas, TX and one of the founding members of the VIVA Vascular Education Course in Las Vegas. In this episode of the BackTable Podcast, host Dr. Chris Beck discusses atherectomy, laser technologies, and their use in vessel treatment with Dr. Tony Das, an interventional cardiologist practicing in Dallas, TX and one of the founding members of the VIVA Vascular Education Course in Las Vegas. Dr. Das shares insights on the PATHFINDER registry, which is a prospective non-randomized, multicenter study to evaluate the performance and outcome of the Auryon laser atherectomy system. Their conversation explores the role of atherectomy in reducing stent usage, decreasing embolization likelihood, enhancing thrombus removal, and uncovering lesions. Dr. Das further provides recommendations for building a successful atherectomy program, utilizing laser technologies, and the importance of having ablative technology in outpatient labs. The doctors forecast future applications for artificial intelligence and remote monitoring. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES 00:00 - Introduction 03:38 - Discussion about Connected Cardiovascular Care Associates 05:09 - Deep Dive into Atherectomy 14:06 - Understanding Laser Atherectomy 23:23 - Discussion on the PATHFINDER Study 34:52 - Advice for Building an Atherectomy Program 38:49 - Future Topics and Closing Remarks --- RESOURCES Connected Cardiovascular Care Associates: https://www.texasc3.com/ Pathfinder Registry Trial: https://www.clinicaltrials.gov/study/NCT04229563#publications Pathfinder Registry Trial Introduction: https://evtoday.com/articles/2021-sept/introduction-to-the-pathfinder-registry-and-complex-endovascular-cases-with-the-auryon-atherectomy-system Limb salvage following laser-assisted angioplasty for critical limb ischemia: results of the LACI multicenter trial: https://pubmed.ncbi.nlm.nih.gov/16445313/ Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: initial results from the EXCITE ISR trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis): https://pubmed.ncbi.nlm.nih.gov/25499305/ Cryoplasty Versus Conventional Balloon Angioplasty of the Femoropopliteal Artery in Diabetic Patients: Long-Term Results from a Prospective Randomized Single-Center Controlled Trial: https://link.springer.com/article/10.1007/s00270-010-9915-x#Abs1 Cryoplasty for the treatment of femoropopliteal arterial disease: results of a prospective, multicenter registry: https://pubmed.ncbi.nlm.nih.gov/16105918/ Auryon Laser from AngioDynamics: https://www.angiodynamics.com/product/auryon/ Philips Laser System: https://www.usa.philips.com/healthcare/product/HCIGTDPHLLSRSYSTM/laser-system-hcigtdphllsrsystm Atherectomy plus drug-coated balloon versus drug-coated balloon only for treatment of femoropopliteal artery lesions: A systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/33478353/ Laser in Infrapopliteal and Popliteal Stenosis 2 Study (LIPS2): Long-Term Outcomes of Laser-Assisted Balloon Angioplasty Versus Balloon Angioplasty for Below Knee Peripheral Arterial Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407062/ Distal embolization during lower extremity endovascular interventions: https://pubmed.ncbi.nlm.nih.gov/28366300/ Shockwave™ Lithoplasty in Combination With Atherectomy in Treating Severe Calcified Femoropopliteal and Iliac Artery Disease: A Single-Center Experience: https://pubmed.ncbi.nlm.nih.gov/32563711/ In this episode of the BackTable Podcast, host Dr. Chris Beck discusses atherectomy, laser technologies, and their use in vessel treatment with Dr. Tony Das, an interventional cardiologist practicing in Dallas, TX and one of the founding members of the VIVA Vascular Education Course in Las Vegas.


Dr. Das shares insights on the PATHFINDER registry, which is a prospective non-randomized, multicenter study to evaluate the performance and outcome of the Auryon laser atherectomy system. Their conversation explores the role of atherectomy in reducing stent usage, decreasing embolization likelihood, enhancing thrombus removal, and uncovering lesions. Dr. Das further provides recommendations for building a successful atherectomy program, utilizing laser technologies, and the importance of having ablative technology in outpatient labs. The doctors forecast future applications for artificial intelligence and remote monitoring.


---


CHECK OUT OUR SPONSOR


AngioDynamics Auryon System

https://www.auryon-system.com/


---


SHOW NOTES


00:00 - Introduction

03:38 - Discussion about Connected Cardiovascular Care Associates

05:09 - Deep Dive into Atherectomy

14:06 - Understanding Laser Atherectomy

23:23 - Discussion on the PATHFINDER Study

34:52 - Advice for Building an Atherectomy Program

38:49 - Future Topics and Closing Remarks


---


RESOURCES


Connected Cardiovascular Care Associates:

https://www.texasc3.com/


Pathfinder Registry Trial:

https://www.clinicaltrials.gov/study/NCT04229563#publications


Pathfinder Registry Trial Introduction:

https://evtoday.com/articles/2021-sept/introduction-to-the-pathfinder-registry-and-complex-endovascular-cases-with-the-auryon-atherectomy-system


Limb salvage following laser-assisted angioplasty for critical limb ischemia: results of the LACI multicenter trial:

https://pubmed.ncbi.nlm.nih.gov/16445313/


Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: initial results from the EXCITE ISR trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis):

https://pubmed.ncbi.nlm.nih.gov/25499305/


Cryoplasty Versus Conventional Balloon Angioplasty of the Femoropopliteal Artery in Diabetic Patients: Long-Term Results from a Prospective Randomized Single-Center Controlled Trial:

https://link.springer.com/article/10.1007/s00270-010-9915-x#Abs1


Cryoplasty for the treatment of femoropopliteal arterial disease: results of a prospective, multicenter registry:

https://pubmed.ncbi.nlm.nih.gov/16105918/


Auryon Laser from AngioDynamics:

https://www.angiodynamics.com/product/auryon/


Philips Laser System:

https://www.usa.philips.com/healthcare/product/HCIGTDPHLLSRSYSTM/laser-system-hcigtdphllsrsystm


Atherectomy plus drug-coated balloon versus drug-coated balloon only for treatment of femoropopliteal artery lesions: A systematic review and meta-analysis:

https://pubmed.ncbi.nlm.nih.gov/33478353/


Laser in Infrapopliteal and Popliteal Stenosis 2 Study (LIPS2): Long-Term Outcomes of Laser-Assisted Balloon Angioplasty Versus Balloon Angioplasty for Below Knee Peripheral Arterial Disease:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407062/


Distal embolization during lower extremity endovascular interventions:

https://pubmed.ncbi.nlm.nih.gov/28366300/


Shockwave™ Lithoplasty in Combination With Atherectomy in Treating Severe Calcified Femoropopliteal and Iliac Artery Disease: A Single-Center Experience:

https://pubmed.ncbi.nlm.nih.gov/32563711/

]]> 2626 Ep. 389 Pelvic PT: An Introduction for Interventionalists with Ingrid Harm-Ernandes In this episode of the BackTable Podcast, host Dr. Ally Baheti discusses the relationship between pelvic venous disease and physical therapy with Ingrid Harm-Ernandes, a pelvic floor physical therapist, mentor for Duke University’s Women’s Health Physical Therapy Residency Program, and author of The Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms. Ingrid gives a detailed walkthrough of a physical therapy session, highlighting the importance of holistic and interdisciplinary treatment approaches, as well as patient communication. She shares perspectives on the need for earlier interventions of physical therapy, misconceptions around the pelvic therapy issues, and the significant role of interventional radiologists as part of the treatment team. She also discusses her book which aims to demystify pelvic floor issues and empower both patients and practitioners in treating them. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:25 - Discussion on Pelvic Venous Disease and Physical Therapy 02:36 - Exploring the Role of Physical Therapy in Treating Pelvic Pain 04:41 - Understanding the Challenges in Treating Pelvic Pain 06:51 - Identifying Symptoms of Pelvic Venous Disease 10:06 - The Role of Pelvic PT in Treating Pelvic Venous Disease 15:49 - Finding a Qualified Pelvic PT 22:13 - Improving Synergy between Interventional Radiologists and Pelvic PT 28:39 - Understanding the Musculoskeletal Mystery in Pelvic Floor Symptoms 33:48 - Final Thoughts and Advice for Treating Patients with Pelvic Venous Disease --- RESOURCES The Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms: https://www.pelvicpain.org/resources/marketplace/books/the-musculoskeletal-mystery Fri, 01 Dec 2023 06:00:00 -0000 full BackTable In this episode of the BackTable Podcast, host Dr. Ally Baheti discusses the relationship between pelvic venous disease and physical therapy with Ingrid Harm-Ernandes, a pelvic floor physical therapist, mentor for Duke University’s Women’s Health Physical Therapy Residency Program, and author of The Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms. In this episode of the BackTable Podcast, host Dr. Ally Baheti discusses the relationship between pelvic venous disease and physical therapy with Ingrid Harm-Ernandes, a pelvic floor physical therapist, mentor for Duke University’s Women’s Health Physical Therapy Residency Program, and author of The Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms. Ingrid gives a detailed walkthrough of a physical therapy session, highlighting the importance of holistic and interdisciplinary treatment approaches, as well as patient communication. She shares perspectives on the need for earlier interventions of physical therapy, misconceptions around the pelvic therapy issues, and the significant role of interventional radiologists as part of the treatment team. She also discusses her book which aims to demystify pelvic floor issues and empower both patients and practitioners in treating them. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:25 - Discussion on Pelvic Venous Disease and Physical Therapy 02:36 - Exploring the Role of Physical Therapy in Treating Pelvic Pain 04:41 - Understanding the Challenges in Treating Pelvic Pain 06:51 - Identifying Symptoms of Pelvic Venous Disease 10:06 - The Role of Pelvic PT in Treating Pelvic Venous Disease 15:49 - Finding a Qualified Pelvic PT 22:13 - Improving Synergy between Interventional Radiologists and Pelvic PT 28:39 - Understanding the Musculoskeletal Mystery in Pelvic Floor Symptoms 33:48 - Final Thoughts and Advice for Treating Patients with Pelvic Venous Disease --- RESOURCES The Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms: https://www.pelvicpain.org/resources/marketplace/books/the-musculoskeletal-mystery In this episode of the BackTable Podcast, host Dr. Ally Baheti discusses the relationship between pelvic venous disease and physical therapy with Ingrid Harm-Ernandes, a pelvic floor physical therapist, mentor for Duke University’s Women’s Health Physical Therapy Residency Program, and author of The Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms.


Ingrid gives a detailed walkthrough of a physical therapy session, highlighting the importance of holistic and interdisciplinary treatment approaches, as well as patient communication. She shares perspectives on the need for earlier interventions of physical therapy, misconceptions around the pelvic therapy issues, and the significant role of interventional radiologists as part of the treatment team. She also discusses her book which aims to demystify pelvic floor issues and empower both patients and practitioners in treating them.


---


CHECK OUT OUR SPONSORS


BD Advance Clinical Training & Education Program

https://page.bd.com/Advance-Training-Program_Homepage.html


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


00:00 - Introduction

02:25 - Discussion on Pelvic Venous Disease and Physical Therapy

02:36 - Exploring the Role of Physical Therapy in Treating Pelvic Pain

04:41 - Understanding the Challenges in Treating Pelvic Pain

06:51 - Identifying Symptoms of Pelvic Venous Disease

10:06 - The Role of Pelvic PT in Treating Pelvic Venous Disease

15:49 - Finding a Qualified Pelvic PT

22:13 - Improving Synergy between Interventional Radiologists and Pelvic PT

28:39 - Understanding the Musculoskeletal Mystery in Pelvic Floor Symptoms

33:48 - Final Thoughts and Advice for Treating Patients with Pelvic Venous Disease


---


RESOURCES


The Musculoskeletal Mystery: How to Solve Your Pelvic Floor Symptoms:

https://www.pelvicpain.org/resources/marketplace/books/the-musculoskeletal-mystery

]]> 2298 Ep. 388 Emergent Cases: The Impact of Arterial Sheath Technology with Dr. Rehan Quadri In this episode, host Dr. Aaron Fritts interviews Dr. Rehan Quadri about the impact of intra-procedural arterial monitoring via sheath technology. Dr. Quadri is a practicing interventional radiologist at UT Southwestern in Dallas, Texas. --- CHECK OUT OUR SPONSOR Endophys https://endophys.com/ --- SHOW NOTES Dr. Quadri begins by telling us about a new arterial sheath, the EndoPhys Pressure Sense Arterial Sheath, which enables real-time blood pressure monitoring in a number of different cases and advantages that it offers over arterial lines and cuff monitors. We also discuss specific indications for utilizing this technology, such as trauma, GI bleeds, stroke, fistulas, and other emergent arterial interventions requiring minute-to-minute monitoring. We also breakdown the specs of the sheath, including its setup, calibration, placement, recorded measurements, and the accuracy of the read-outs when compared to those of past technologies. Dr. Quadri speaks on the cost and the overall value of the EndoPhys sheath. He concludes the episode by discussing new advancements in the technology such as improved device warmup times and a radial-specific sheath. --- RESOURCES Endophys Pressure Sense Arterial Sheath: https://endophys.com/ Mon, 27 Nov 2023 06:00:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Rehan Quadri about the impact of intra-procedural arterial monitoring via sheath technology. Dr. Quadri is a practicing interventional radiologist at UT Southwestern in Dallas, Texas. In this episode, host Dr. Aaron Fritts interviews Dr. Rehan Quadri about the impact of intra-procedural arterial monitoring via sheath technology. Dr. Quadri is a practicing interventional radiologist at UT Southwestern in Dallas, Texas. --- CHECK OUT OUR SPONSOR Endophys https://endophys.com/ --- SHOW NOTES Dr. Quadri begins by telling us about a new arterial sheath, the EndoPhys Pressure Sense Arterial Sheath, which enables real-time blood pressure monitoring in a number of different cases and advantages that it offers over arterial lines and cuff monitors. We also discuss specific indications for utilizing this technology, such as trauma, GI bleeds, stroke, fistulas, and other emergent arterial interventions requiring minute-to-minute monitoring. We also breakdown the specs of the sheath, including its setup, calibration, placement, recorded measurements, and the accuracy of the read-outs when compared to those of past technologies. Dr. Quadri speaks on the cost and the overall value of the EndoPhys sheath. He concludes the episode by discussing new advancements in the technology such as improved device warmup times and a radial-specific sheath. --- RESOURCES Endophys Pressure Sense Arterial Sheath: https://endophys.com/ In this episode, host Dr. Aaron Fritts interviews Dr. Rehan Quadri about the impact of intra-procedural arterial monitoring via sheath technology. Dr. Quadri is a practicing interventional radiologist at UT Southwestern in Dallas, Texas.


---


CHECK OUT OUR SPONSOR


Endophys

https://endophys.com/


---


SHOW NOTES


Dr. Quadri begins by telling us about a new arterial sheath, the EndoPhys Pressure Sense Arterial Sheath, which enables real-time blood pressure monitoring in a number of different cases and advantages that it offers over arterial lines and cuff monitors. We also discuss specific indications for utilizing this technology, such as trauma, GI bleeds, stroke, fistulas, and other emergent arterial interventions requiring minute-to-minute monitoring.


We also breakdown the specs of the sheath, including its setup, calibration, placement, recorded measurements, and the accuracy of the read-outs when compared to those of past technologies. Dr. Quadri speaks on the cost and the overall value of the EndoPhys sheath. He concludes the episode by discussing new advancements in the technology such as improved device warmup times and a radial-specific sheath.


---


RESOURCES


Endophys Pressure Sense Arterial Sheath:

https://endophys.com/

]]> 1933 Ep. 387 Beyond BPH: PAE in Prostate Cancer with Dr. Nainesh Parikh In this episode of BackTable, host Dr. Michael Barraza is joined by Dr. Nainesh Parikh from Moffitt Cancer Center. Dr. Parikh has worked extensively on prostate artery embolizations (PAE), having performed around 250 PAEs since joining Moffitt in 2017. The conversation delves into the multifaceted applications of PAE, with a specific focus on its role in prostate cancer. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Parikh outlines the various clinical scenarios where PAE proves beneficial in prostate cancer cases. This includes the potential to shrink the prostate to an optimal size for brachytherapy, decrease volume for operational convenience, and address lower urinary tract symptoms associated with enlarged prostates. Clinical improvement emerges as a major motivator, with Dr. Parikh underscored the importance of ensuring a certain volume reduction before focal therapy, thereby simplifying subsequent treatments. The conversation extends to the role of PAE in managing radiation prostatitis, categorized clinically as chronic prostatitis. While conventional treatments often fall short for this condition, PAE emerges as an effective solution, especially for the 50% of men typically refractory to standard approaches. Dr. Parikh informs patients of the 70-75 percent chance of improvement while acknowledging the challenges in chronic prostatitis patients. The episode explores Dr. Parikh's approach to working up patients for PAE, with most referrals originating from the GU tumor board. Dr. Parikh discusses the gland size threshold for PAE assessment, emphasizing that while larger glands generally ease embolization, he occasionally considers PAE for smaller glands based on clinical context. Challenges associated with chronic prostatitis patients are acknowledged, with a focus on managing expectations due to a lower response rate compared to other PAE patients. Detailed insights into imaging protocols for follow-up are provided. For prostate cancer cases, Dr. Parikh recommends MRI at 6 and 12 weeks post procedure. He notes that there is notable reduction in PSA levels following PAE. Conversely, radiation prostatitis patients do not undergo post-procedural imaging unless PSA levels are detectable. As the episode concludes, Dr. Parikh highlights the future utility of PAE in prostate cancer, particularly in neoadjuvant settings before local or radiation therapy and even post radiation therapy. Fri, 24 Nov 2023 06:00:00 -0000 full BackTable In this episode of BackTable, host Dr. Michael Barraza is joined by Dr. Nainesh Parikh from Moffitt Cancer Center. Dr. Parikh has worked extensively on prostate artery embolizations (PAE), having performed around 250 PAEs since joining Moffitt in 2017. The conversation delves into the multifaceted applications of PAE, with a specific focus on its role in prostate cancer. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Parikh outlines the various clinical scenarios where PAE proves beneficial in prostate cancer cases. This includes the potential to shrink the prostate to an optimal size for brachytherapy, decrease volume for operational convenience, and address lower urinary tract symptoms associated with enlarged prostates. Clinical improvement emerges as a major motivator, with Dr. Parikh underscored the importance of ensuring a certain volume reduction before focal therapy, thereby simplifying subsequent treatments. The conversation extends to the role of PAE in managing radiation prostatitis, categorized clinically as chronic prostatitis. While conventional treatments often fall short for this condition, PAE emerges as an effective solution, especially for the 50% of men typically refractory to standard approaches. Dr. Parikh informs patients of the 70-75 percent chance of improvement while acknowledging the challenges in chronic prostatitis patients. The episode explores Dr. Parikh's approach to working up patients for PAE, with most referrals originating from the GU tumor board. Dr. Parikh discusses the gland size threshold for PAE assessment, emphasizing that while larger glands generally ease embolization, he occasionally considers PAE for smaller glands based on clinical context. Challenges associated with chronic prostatitis patients are acknowledged, with a focus on managing expectations due to a lower response rate compared to other PAE patients. Detailed insights into imaging protocols for follow-up are provided. For prostate cancer cases, Dr. Parikh recommends MRI at 6 and 12 weeks post procedure. He notes that there is notable reduction in PSA levels following PAE. Conversely, radiation prostatitis patients do not undergo post-procedural imaging unless PSA levels are detectable. As the episode concludes, Dr. Parikh highlights the future utility of PAE in prostate cancer, particularly in neoadjuvant settings before local or radiation therapy and even post radiation therapy. In this episode of BackTable, host Dr. Michael Barraza is joined by Dr. Nainesh Parikh from Moffitt Cancer Center. Dr. Parikh has worked extensively on prostate artery embolizations (PAE), having performed around 250 PAEs since joining Moffitt in 2017. The conversation delves into the multifaceted applications of PAE, with a specific focus on its role in prostate cancer.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Dr. Parikh outlines the various clinical scenarios where PAE proves beneficial in prostate cancer cases. This includes the potential to shrink the prostate to an optimal size for brachytherapy, decrease volume for operational convenience, and address lower urinary tract symptoms associated with enlarged prostates. Clinical improvement emerges as a major motivator, with Dr. Parikh underscored the importance of ensuring a certain volume reduction before focal therapy, thereby simplifying subsequent treatments.


The conversation extends to the role of PAE in managing radiation prostatitis, categorized clinically as chronic prostatitis. While conventional treatments often fall short for this condition, PAE emerges as an effective solution, especially for the 50% of men typically refractory to standard approaches. Dr. Parikh informs patients of the 70-75 percent chance of improvement while acknowledging the challenges in chronic prostatitis patients.


The episode explores Dr. Parikh's approach to working up patients for PAE, with most referrals originating from the GU tumor board. Dr. Parikh discusses the gland size threshold for PAE assessment, emphasizing that while larger glands generally ease embolization, he occasionally considers PAE for smaller glands based on clinical context. Challenges associated with chronic prostatitis patients are acknowledged, with a focus on managing expectations due to a lower response rate compared to other PAE patients.


Detailed insights into imaging protocols for follow-up are provided. For prostate cancer cases, Dr. Parikh recommends MRI at 6 and 12 weeks post procedure. He notes that there is notable reduction in PSA levels following PAE. Conversely, radiation prostatitis patients do not undergo post-procedural imaging unless PSA levels are detectable.


As the episode concludes, Dr. Parikh highlights the future utility of PAE in prostate cancer, particularly in neoadjuvant settings before local or radiation therapy and even post radiation therapy.

]]> 3030 Ep. 386 The PERT Approach: Innovating on Acute PE Management with Dr. Robert Lookstein In this episode, host Dr. Chris Beck interviews Dr. Robert Lookstein about the pulmonary embolism response team (PERT) approach for treating acute pulmonary embolisms (PE). Dr. Lookstein is a practicing interventional radiologist in New York City at Mount Sinai Icahn School of Medicine. --- CHECK OUT OUR SPONSOR Penumbra Lightning Flash https://www.penumbrainc.com/products/lightning-flash/ --- SHOW NOTES We begin the episode by learning how Dr. Lookstein became involved in the PE space and how acute PE management has evolved. Dr. Lookstein breaks down the PERT at Mount Sinai, PERTs at other academic institutions, and the core qualities of a strong PERT. He walks us through a typical PE presentation, the process of PERT activation, and the workup with risk stratification. Dr. Lookstein also shares a few physical examination pearls for evaluating patients with PE and teasing out acuity vs. chronicity of presentation . Dr. Lookstein and Dr. Beck discuss endovascular PE interventions - ultrasound accelerated thrombolysis (trade name: EKOS catheter, Boston Scientific), first generation and second generation thrombectomy systems. The doctors also cover how advancements in technology have made these large-bore thrombectomy devices easier to learn about and use. Looking towards the horizon, Dr. Lookstein shares what we can expect from third generation technologies. We highlight how the primary endpoint of the PERT is to relieve the strain and stabilize/preserve the function of the right ventricle, regardless of how much clot is removed/remains. The doctors discuss the possibility of combined treatment algorithms for PE and the clinical data that has guided PERTs (all linked in resources below). To conclude the episode, Dr. Lookstein shares follow-up, longitudinal care, and how to tackle clot-in-transit. --- RESOURCES PERT Consortium: https://pertconsortium.org/ Ultima Trial: https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/ultima.html HI-PEITHO Trial: https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/hi-peitho.html CANARY Trial: https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2022/10/25/19/42/CANARY PE-TRACT Trial: https://evtoday.com/articles/2023-feb/pe-tract-a-closer-look STORM-PE Trial: https://pertconsortium.org/storm-pe-trial/ PEERLESS II Trial: https://ir.inarimedical.com/news-releases/news-release-details/inari-medical-announces-peerless-ii-randomized-controlled-trial Mon, 20 Nov 2023 06:00:00 -0000 full BackTable In this episode, host Dr. Chris Beck interviews Dr. Robert Lookstein about the pulmonary embolism response team (PERT) approach for treating acute pulmonary embolisms (PE). Dr. Lookstein is a practicing interventional radiologist in New York City at Mount Sinai Icahn School of Medicine. In this episode, host Dr. Chris Beck interviews Dr. Robert Lookstein about the pulmonary embolism response team (PERT) approach for treating acute pulmonary embolisms (PE). Dr. Lookstein is a practicing interventional radiologist in New York City at Mount Sinai Icahn School of Medicine. --- CHECK OUT OUR SPONSOR Penumbra Lightning Flash https://www.penumbrainc.com/products/lightning-flash/ --- SHOW NOTES We begin the episode by learning how Dr. Lookstein became involved in the PE space and how acute PE management has evolved. Dr. Lookstein breaks down the PERT at Mount Sinai, PERTs at other academic institutions, and the core qualities of a strong PERT. He walks us through a typical PE presentation, the process of PERT activation, and the workup with risk stratification. Dr. Lookstein also shares a few physical examination pearls for evaluating patients with PE and teasing out acuity vs. chronicity of presentation . Dr. Lookstein and Dr. Beck discuss endovascular PE interventions - ultrasound accelerated thrombolysis (trade name: EKOS catheter, Boston Scientific), first generation and second generation thrombectomy systems. The doctors also cover how advancements in technology have made these large-bore thrombectomy devices easier to learn about and use. Looking towards the horizon, Dr. Lookstein shares what we can expect from third generation technologies. We highlight how the primary endpoint of the PERT is to relieve the strain and stabilize/preserve the function of the right ventricle, regardless of how much clot is removed/remains. The doctors discuss the possibility of combined treatment algorithms for PE and the clinical data that has guided PERTs (all linked in resources below). To conclude the episode, Dr. Lookstein shares follow-up, longitudinal care, and how to tackle clot-in-transit. --- RESOURCES PERT Consortium: https://pertconsortium.org/ Ultima Trial: https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/ultima.html HI-PEITHO Trial: https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/hi-peitho.html CANARY Trial: https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2022/10/25/19/42/CANARY PE-TRACT Trial: https://evtoday.com/articles/2023-feb/pe-tract-a-closer-look STORM-PE Trial: https://pertconsortium.org/storm-pe-trial/ PEERLESS II Trial: https://ir.inarimedical.com/news-releases/news-release-details/inari-medical-announces-peerless-ii-randomized-controlled-trial In this episode, host Dr. Chris Beck interviews Dr. Robert Lookstein about the pulmonary embolism response team (PERT) approach for treating acute pulmonary embolisms (PE). Dr. Lookstein is a practicing interventional radiologist in New York City at Mount Sinai Icahn School of Medicine.


---


CHECK OUT OUR SPONSOR


Penumbra Lightning Flash

https://www.penumbrainc.com/products/lightning-flash/


---


SHOW NOTES


We begin the episode by learning how Dr. Lookstein became involved in the PE space and how acute PE management has evolved. Dr. Lookstein breaks down the PERT at Mount Sinai, PERTs at other academic institutions, and the core qualities of a strong PERT. He walks us through a typical PE presentation, the process of PERT activation, and the workup with risk stratification. Dr. Lookstein also shares a few physical examination pearls for evaluating patients with PE and teasing out acuity vs. chronicity of presentation .


Dr. Lookstein and Dr. Beck discuss endovascular PE interventions - ultrasound accelerated thrombolysis (trade name: EKOS catheter, Boston Scientific), first generation and second generation thrombectomy systems. The doctors also cover how advancements in technology have made these large-bore thrombectomy devices easier to learn about and use. Looking towards the horizon, Dr. Lookstein shares what we can expect from third generation technologies.


We highlight how the primary endpoint of the PERT is to relieve the strain and stabilize/preserve the function of the right ventricle, regardless of how much clot is removed/remains. The doctors discuss the possibility of combined treatment algorithms for PE and the clinical data that has guided PERTs (all linked in resources below). To conclude the episode, Dr. Lookstein shares follow-up, longitudinal care, and how to tackle clot-in-transit.


---


RESOURCES


PERT Consortium:

https://pertconsortium.org/


Ultima Trial:

https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/ultima.html


HI-PEITHO Trial:

https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/hi-peitho.html


CANARY Trial:

https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2022/10/25/19/42/CANARY


PE-TRACT Trial:

https://evtoday.com/articles/2023-feb/pe-tract-a-closer-look


STORM-PE Trial:

https://pertconsortium.org/storm-pe-trial/


PEERLESS II Trial:

https://ir.inarimedical.com/news-releases/news-release-details/inari-medical-announces-peerless-ii-randomized-controlled-trial

]]> 3601 Ep. 385 Early (and Ongoing) Challenges in the OBL with Dr. Don Garbett (Live from WAIS) Fri, 17 Nov 2023 06:00:00 -0000 full BackTable 2593 Ep. 384 New Innovations in Closure Devices with Dr. Omar Saleh and Dr. Syed Hussain In this episode, host Dr. Aaron Fritts interviews vascular surgeon Dr. Syed Hussain and interventional radiologist Dr. Omar Saleh about new innovations in closure devices. --- CHECK OUT OUR SPONSOR Vasorum https://www.vasorum.ie/ --- SHOW NOTES We begin the episode by discussing how closure devices have evolved over recent years and gained popularity in both hospital and OBL settings. Dr. Hussain and Dr. Saleh highlight the logistical advantages associated with a consistent, reliable closure device. Both doctors speak about their patients’ reported experiences and preferences for different types of closure devices and the importance of having a variety of options at hand. Dr. Saleh and Dr. Hussain also introduce the new CELT ACD closure device from Vasorum. We learn how to place a CELT, and Dr. Saleh highlights the ease of deployment and the reliability of results. Dr. Hussain also shares his experience in using the CELT, comparing its deployment to a “mic drop”. Additionally, we discuss if there are any potential drawbacks or special considerations that may exist in using CELT compared to other devices. The doctors cover the time from CELT closure to ambulation/discharge, citing an abstract published in Journal of Vascular Surgery (see resources below). Dr. Hussain and Dr. Saleh also report very few closure-site complications when using CELT, good outcomes with calcified arteries, and ease of bailout options. To conclude the episode, we discuss how physicians can get CELT and other products into their hospital or OBL through the Agency for Healthcare Research and Quality (AHRQ), Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores, and other methods. --- RESOURCES Safety and Efficacy of the CELT ACD Femoral Arteriotomy Closure Device in the Office-based Laboratory: https://www.jvascsurg.org/article/S0741-5214(22)00945-4/fulltext Silent cerebral infarct after cardiac catheterization as detected by diffusion weighted Magnetic Resonance Imaging: a randomized comparison of radial and femoral arterial approaches: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1896179/ Vasorum CELT ACD Closure Device: https://www.vasorum.ie/ Mon, 13 Nov 2023 06:00:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews vascular surgeon Dr. Syed Hussain and interventional radiologist Dr. Omar Saleh about new innovations in closure devices. In this episode, host Dr. Aaron Fritts interviews vascular surgeon Dr. Syed Hussain and interventional radiologist Dr. Omar Saleh about new innovations in closure devices. --- CHECK OUT OUR SPONSOR Vasorum https://www.vasorum.ie/ --- SHOW NOTES We begin the episode by discussing how closure devices have evolved over recent years and gained popularity in both hospital and OBL settings. Dr. Hussain and Dr. Saleh highlight the logistical advantages associated with a consistent, reliable closure device. Both doctors speak about their patients’ reported experiences and preferences for different types of closure devices and the importance of having a variety of options at hand. Dr. Saleh and Dr. Hussain also introduce the new CELT ACD closure device from Vasorum. We learn how to place a CELT, and Dr. Saleh highlights the ease of deployment and the reliability of results. Dr. Hussain also shares his experience in using the CELT, comparing its deployment to a “mic drop”. Additionally, we discuss if there are any potential drawbacks or special considerations that may exist in using CELT compared to other devices. The doctors cover the time from CELT closure to ambulation/discharge, citing an abstract published in Journal of Vascular Surgery (see resources below). Dr. Hussain and Dr. Saleh also report very few closure-site complications when using CELT, good outcomes with calcified arteries, and ease of bailout options. To conclude the episode, we discuss how physicians can get CELT and other products into their hospital or OBL through the Agency for Healthcare Research and Quality (AHRQ), Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores, and other methods. --- RESOURCES Safety and Efficacy of the CELT ACD Femoral Arteriotomy Closure Device in the Office-based Laboratory: https://www.jvascsurg.org/article/S0741-5214(22)00945-4/fulltext Silent cerebral infarct after cardiac catheterization as detected by diffusion weighted Magnetic Resonance Imaging: a randomized comparison of radial and femoral arterial approaches: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1896179/ Vasorum CELT ACD Closure Device: https://www.vasorum.ie/ In this episode, host Dr. Aaron Fritts interviews vascular surgeon Dr. Syed Hussain and interventional radiologist Dr. Omar Saleh about new innovations in closure devices.


---


CHECK OUT OUR SPONSOR


Vasorum

https://www.vasorum.ie/


---


SHOW NOTES


We begin the episode by discussing how closure devices have evolved over recent years and gained popularity in both hospital and OBL settings. Dr. Hussain and Dr. Saleh highlight the logistical advantages associated with a consistent, reliable closure device. Both doctors speak about their patients’ reported experiences and preferences for different types of closure devices and the importance of having a variety of options at hand.


Dr. Saleh and Dr. Hussain also introduce the new CELT ACD closure device from Vasorum. We learn how to place a CELT, and Dr. Saleh highlights the ease of deployment and the reliability of results. Dr. Hussain also shares his experience in using the CELT, comparing its deployment to a “mic drop”. Additionally, we discuss if there are any potential drawbacks or special considerations that may exist in using CELT compared to other devices.


The doctors cover the time from CELT closure to ambulation/discharge, citing an abstract published in Journal of Vascular Surgery (see resources below). Dr. Hussain and Dr. Saleh also report very few closure-site complications when using CELT, good outcomes with calcified arteries, and ease of bailout options. To conclude the episode, we discuss how physicians can get CELT and other products into their hospital or OBL through the Agency for Healthcare Research and Quality (AHRQ), Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores, and other methods.


---


RESOURCES


Safety and Efficacy of the CELT ACD Femoral Arteriotomy Closure Device in the Office-based Laboratory:

https://www.jvascsurg.org/article/S0741-5214(22)00945-4/fulltext


Silent cerebral infarct after cardiac catheterization as detected by diffusion weighted Magnetic Resonance Imaging: a randomized comparison of radial and femoral arterial approaches:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1896179/


Vasorum CELT ACD Closure Device:

https://www.vasorum.ie/

]]> 3313 Ep. 383 Reflections on a Career in Clinical IR with Dr. Alan Matsumoto In this episode of the "History of IR" series on BackTable, Dr. Alan Matsumoto, Chair of the Department of Radiology at the University of Virginia and a fellow of the Society of Interventional Radiology, joins our host Aparna Baheti. Dr. Matsumoto also serves as the Vice Chair of the American College of Radiology's Board of Chancellors. This installment provides a unique perspective on the life and career of Dr. Matsumoto and sheds light on the evolution of interventional radiology. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic Embolization https://www.medtronic.com/embolization --- SHOW NOTES Dr. Matsumoto's journey into IR commenced during his residency in the Department of Radiology at the University of North Carolina. The culture of independence within the department allowed him to gain extensive hands-on experience. Subsequently, after completing a four-year radiology residency followed by a one-year fellowship, Dr. Matsumoto ventured into private practice on the picturesque West Coast of Florida. However, his return to academic medicine was inspired by a profound appreciation for collaborative patient care discussions with referring physicians, marking a departure from the previous norm of merely appeasing them to maintain referral patterns. This transition led him to the University of Virginia, where he partnered with Dr. Tegtmeyer. Dr. Tegtmeyer's meticulous approach in running the IR suite, akin to a surgical suite, cultivated an appreciation for organizational precision and independence. During this conversation, Dr. Matsumoto fondly reminisces about Dr. Tegtmeyer, who emphasized the art of presenting oneself as an IR doctor to patients. He recognizes Dr. Tegtmeyer's passion for renal angioplasty, acknowledging him and Dr. Thoman Sos as pioneers in the field. Dr. Matsumoto also provides valuable insights into the technological landscape of IR in the past, underscoring the absence of contemporary tools like C-arms and pre-shaped catheters. Consequently, IR practitioners had to adapt and innovate, often crafting and modifying instruments, including innovative solutions like using styrofoam for embolizations or shaping catheters with bunsen burners. Furthermore, Dr. Matsumoto delves into the challenges faced by early practitioners, highlighting the need for caution to avoid detractors exploiting mistakes to diminish the value of IR procedures and potentially restrict the scope of IR practice. Balancing the role of a friendly collaborator with technicians and nurses while assuming leadership in the IR suite is a pivotal aspect of his journey. Dr. Matsumoto then elaborates on his pivotal involvement in aortic work in 1998, as he helped establish a core lab and collaborated with device companies along with CT and vascular surgeons. This work allowed him to be a part of the approval process of Medtronic’s AneuRx endograft in 1999, where he testified at the FDA hearing for this groundbreaking product designed to treat AAA’s. The transition to leadership within the department of IR at the University of Virginia marked another significant chapter in Dr. Matsumoto's career. Despite assuming this role unexpectedly after the passing of Dr. Tegtmire, he embraced the challenge. His vision for the department revolves around a heightened focus on clinical operations and streamlining patient responsibilities to enhance efficiency while upholding a culture of excellence. Dr. Matsumoto concludes this episode with valuable insights into strengthening an IR department by effectively promoting and communicating the value of services to the broader medical community. Fri, 10 Nov 2023 06:00:00 -0000 full BackTable In this episode of the "History of IR" series on BackTable, Dr. Alan Matsumoto, Chair of the Department of Radiology at the University of Virginia and a fellow of the Society of Interventional Radiology, joins our host Aparna Baheti. Dr. Matsumoto also serves as the Vice Chair of the American College of Radiology's Board of Chancellors. This installment provides a unique perspective on the life and career of Dr. Matsumoto and sheds light on the evolution of interventional radiology. In this episode of the "History of IR" series on BackTable, Dr. Alan Matsumoto, Chair of the Department of Radiology at the University of Virginia and a fellow of the Society of Interventional Radiology, joins our host Aparna Baheti. Dr. Matsumoto also serves as the Vice Chair of the American College of Radiology's Board of Chancellors. This installment provides a unique perspective on the life and career of Dr. Matsumoto and sheds light on the evolution of interventional radiology. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic Embolization https://www.medtronic.com/embolization --- SHOW NOTES Dr. Matsumoto's journey into IR commenced during his residency in the Department of Radiology at the University of North Carolina. The culture of independence within the department allowed him to gain extensive hands-on experience. Subsequently, after completing a four-year radiology residency followed by a one-year fellowship, Dr. Matsumoto ventured into private practice on the picturesque West Coast of Florida. However, his return to academic medicine was inspired by a profound appreciation for collaborative patient care discussions with referring physicians, marking a departure from the previous norm of merely appeasing them to maintain referral patterns. This transition led him to the University of Virginia, where he partnered with Dr. Tegtmeyer. Dr. Tegtmeyer's meticulous approach in running the IR suite, akin to a surgical suite, cultivated an appreciation for organizational precision and independence. During this conversation, Dr. Matsumoto fondly reminisces about Dr. Tegtmeyer, who emphasized the art of presenting oneself as an IR doctor to patients. He recognizes Dr. Tegtmeyer's passion for renal angioplasty, acknowledging him and Dr. Thoman Sos as pioneers in the field. Dr. Matsumoto also provides valuable insights into the technological landscape of IR in the past, underscoring the absence of contemporary tools like C-arms and pre-shaped catheters. Consequently, IR practitioners had to adapt and innovate, often crafting and modifying instruments, including innovative solutions like using styrofoam for embolizations or shaping catheters with bunsen burners. Furthermore, Dr. Matsumoto delves into the challenges faced by early practitioners, highlighting the need for caution to avoid detractors exploiting mistakes to diminish the value of IR procedures and potentially restrict the scope of IR practice. Balancing the role of a friendly collaborator with technicians and nurses while assuming leadership in the IR suite is a pivotal aspect of his journey. Dr. Matsumoto then elaborates on his pivotal involvement in aortic work in 1998, as he helped establish a core lab and collaborated with device companies along with CT and vascular surgeons. This work allowed him to be a part of the approval process of Medtronic’s AneuRx endograft in 1999, where he testified at the FDA hearing for this groundbreaking product designed to treat AAA’s. The transition to leadership within the department of IR at the University of Virginia marked another significant chapter in Dr. Matsumoto's career. Despite assuming this role unexpectedly after the passing of Dr. Tegtmire, he embraced the challenge. His vision for the department revolves around a heightened focus on clinical operations and streamlining patient responsibilities to enhance efficiency while upholding a culture of excellence. Dr. Matsumoto concludes this episode with valuable insights into strengthening an IR department by effectively promoting and communicating the value of services to the broader medical community. In this episode of the "History of IR" series on BackTable, Dr. Alan Matsumoto, Chair of the Department of Radiology at the University of Virginia and a fellow of the Society of Interventional Radiology, joins our host Aparna Baheti. Dr. Matsumoto also serves as the Vice Chair of the American College of Radiology's Board of Chancellors. This installment provides a unique perspective on the life and career of Dr. Matsumoto and sheds light on the evolution of interventional radiology.


---


CHECK OUT OUR SPONSORS


Reflow Medical

https://www.reflowmedical.com/


Medtronic Embolization

https://www.medtronic.com/embolization


---


SHOW NOTES


Dr. Matsumoto's journey into IR commenced during his residency in the Department of Radiology at the University of North Carolina. The culture of independence within the department allowed him to gain extensive hands-on experience. Subsequently, after completing a four-year radiology residency followed by a one-year fellowship, Dr. Matsumoto ventured into private practice on the picturesque West Coast of Florida. However, his return to academic medicine was inspired by a profound appreciation for collaborative patient care discussions with referring physicians, marking a departure from the previous norm of merely appeasing them to maintain referral patterns. This transition led him to the University of Virginia, where he partnered with Dr. Tegtmeyer. Dr. Tegtmeyer's meticulous approach in running the IR suite, akin to a surgical suite, cultivated an appreciation for organizational precision and independence.


During this conversation, Dr. Matsumoto fondly reminisces about Dr. Tegtmeyer, who emphasized the art of presenting oneself as an IR doctor to patients. He recognizes Dr. Tegtmeyer's passion for renal angioplasty, acknowledging him and Dr. Thoman Sos as pioneers in the field.


Dr. Matsumoto also provides valuable insights into the technological landscape of IR in the past, underscoring the absence of contemporary tools like C-arms and pre-shaped catheters. Consequently, IR practitioners had to adapt and innovate, often crafting and modifying instruments, including innovative solutions like using styrofoam for embolizations or shaping catheters with bunsen burners.


Furthermore, Dr. Matsumoto delves into the challenges faced by early practitioners, highlighting the need for caution to avoid detractors exploiting mistakes to diminish the value of IR procedures and potentially restrict the scope of IR practice. Balancing the role of a friendly collaborator with technicians and nurses while assuming leadership in the IR suite is a pivotal aspect of his journey.


Dr. Matsumoto then elaborates on his pivotal involvement in aortic work in 1998, as he helped establish a core lab and collaborated with device companies along with CT and vascular surgeons. This work allowed him to be a part of the approval process of Medtronic’s AneuRx endograft in 1999, where he testified at the FDA hearing for this groundbreaking product designed to treat AAA’s.


The transition to leadership within the department of IR at the University of Virginia marked another significant chapter in Dr. Matsumoto's career. Despite assuming this role unexpectedly after the passing of Dr. Tegtmire, he embraced the challenge. His vision for the department revolves around a heightened focus on clinical operations and streamlining patient responsibilities to enhance efficiency while upholding a culture of excellence.


Dr. Matsumoto concludes this episode with valuable insights into strengthening an IR department by effectively promoting and communicating the value of services to the broader medical community.

]]> 3106 Ep. 382 Iliofemoral Stenting: Decision-Making and Best Practices Explored with Dr. Kush Desai and Dr. Steven Abramowitz In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. Kush Desai (Northwestern University Feinberg School of Medicine) and vascular surgeon Dr. Steve Abramowitz (MedStar Washington Health Center) about iliofemoral venous stenting. --- CHECK OUT OUR SPONSOR Cook Medical https://www.cookmedical.com/divisions/vascular-division/ --- SHOW NOTES We start this episode by reviewing the evolution of knowledge and treatment of venous disease over recent years. Dr. Desai and Dr. Abramowitz identify referral patterns that connect patients with vascular and interventional physicians, and they emphasize how most patients are diagnosed in primary care pathways rather than in the emergency room. The doctors also underscore the importance of educating referring physicians and patients on the impact of early intervention and how vascular and interventional physicians are well-equipped to provide specialized care and management of venous disease. Dr. Desai and Dr. Abramowitz explain their work-up of patients with deep venous disease. The doctors cover necessary imaging studies and conservative treatments for clinic visits. They also explain their procedural approach, access sites, patient positioning preferences, and more. The doctors share guiding anatomical landmarks and recommendations on tools for crossing, along with their decision-making process in treating post-thrombotic patients. They also discuss best practices in venous stenting and post-operative follow up algorithms. We conclude this episode with important advice on how to avoid dangerous life-threatening outcomes. --- RESOURCES Society of Interventional Radiology Position Statement on the Endovascular Management of Acute Iliofemoral Deep Vein Thrombosis (2023): https://www.sciencedirect.com/science/article/pii/S1051044322013173 A review of the incidence, outcome, and management of venous stent migration: https://www.sciencedirect.com/science/article/abs/pii/S2213333X2100411X Mon, 06 Nov 2023 06:00:00 -0000 full BackTable In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. Kush Desai (Northwestern University Feinberg School of Medicine) and vascular surgeon Dr. Steve Abramowitz (MedStar Washington Health Center) about iliofemoral venous stenting. In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. Kush Desai (Northwestern University Feinberg School of Medicine) and vascular surgeon Dr. Steve Abramowitz (MedStar Washington Health Center) about iliofemoral venous stenting. --- CHECK OUT OUR SPONSOR Cook Medical https://www.cookmedical.com/divisions/vascular-division/ --- SHOW NOTES We start this episode by reviewing the evolution of knowledge and treatment of venous disease over recent years. Dr. Desai and Dr. Abramowitz identify referral patterns that connect patients with vascular and interventional physicians, and they emphasize how most patients are diagnosed in primary care pathways rather than in the emergency room. The doctors also underscore the importance of educating referring physicians and patients on the impact of early intervention and how vascular and interventional physicians are well-equipped to provide specialized care and management of venous disease. Dr. Desai and Dr. Abramowitz explain their work-up of patients with deep venous disease. The doctors cover necessary imaging studies and conservative treatments for clinic visits. They also explain their procedural approach, access sites, patient positioning preferences, and more. The doctors share guiding anatomical landmarks and recommendations on tools for crossing, along with their decision-making process in treating post-thrombotic patients. They also discuss best practices in venous stenting and post-operative follow up algorithms. We conclude this episode with important advice on how to avoid dangerous life-threatening outcomes. --- RESOURCES Society of Interventional Radiology Position Statement on the Endovascular Management of Acute Iliofemoral Deep Vein Thrombosis (2023): https://www.sciencedirect.com/science/article/pii/S1051044322013173 A review of the incidence, outcome, and management of venous stent migration: https://www.sciencedirect.com/science/article/abs/pii/S2213333X2100411X In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. Kush Desai (Northwestern University Feinberg School of Medicine) and vascular surgeon Dr. Steve Abramowitz (MedStar Washington Health Center) about iliofemoral venous stenting.


---


CHECK OUT OUR SPONSOR


Cook Medical

https://www.cookmedical.com/divisions/vascular-division/


---


SHOW NOTES


We start this episode by reviewing the evolution of knowledge and treatment of venous disease over recent years. Dr. Desai and Dr. Abramowitz identify referral patterns that connect patients with vascular and interventional physicians, and they emphasize how most patients are diagnosed in primary care pathways rather than in the emergency room. The doctors also underscore the importance of educating referring physicians and patients on the impact of early intervention and how vascular and interventional physicians are well-equipped to provide specialized care and management of venous disease.


Dr. Desai and Dr. Abramowitz explain their work-up of patients with deep venous disease. The doctors cover necessary imaging studies and conservative treatments for clinic visits. They also explain their procedural approach, access sites, patient positioning preferences, and more.


The doctors share guiding anatomical landmarks and recommendations on tools for crossing, along with their decision-making process in treating post-thrombotic patients. They also discuss best practices in venous stenting and post-operative follow up algorithms. We conclude this episode with important advice on how to avoid dangerous life-threatening outcomes.


---


RESOURCES


Society of Interventional Radiology Position Statement on the Endovascular Management of Acute Iliofemoral Deep Vein Thrombosis (2023):

https://www.sciencedirect.com/science/article/pii/S1051044322013173


A review of the incidence, outcome, and management of venous stent migration:

https://www.sciencedirect.com/science/article/abs/pii/S2213333X2100411X

]]> 3792 Ep. 381 Anesthesia vs. Moderate Sedation: A Spectrum of Care with Dr. Vishal Kumar In this episode, interventional radiologists Dr. Aaron Fritts, Dr. Vishal Kumar, and Dr. Chris Beck discuss types of sedation for IR procedures. --- CHECK OUT OUR SPONSOR Medtronic OBL https://www.medtronic.com/obl --- SHOW NOTES We start the discussion off by dividing the spectrum of patient sedation into three tiers: local anesthesia, moderate sedation with fentanyl and Versed, and deep sedation which encompasses anything beyond fentanyl and Versed. The conversation revolves around the fluidity of this spectrum, underscoring the ease with which patients can transition between these sedation levels, thereby adding layers of complexity to the decision-making process. Chris emphasizes the significance of embracing trauma-informed care, highlighting the potential for IR procedures to be maximally traumatic despite their minimally invasive nature. The doctors emphasize the importance of establishing comprehensive pre-procedural patient education to align expectations about pain management. Procedures that automatically trigger the requirement for an anesthesia team include procedures such as TIPS, tumor ablations, as well as declot procedures more recently. Decisions regarding anesthesia for these procedures are additionally influenced by factors such as the patient's condition, history of methadone exposure, the preference of the IR providers, and the comfort level of nursing staff. Vishal highlights the game-changing concept of having an anesthesia team present for real-time monitoring and the administration of nerve blocks during IR procedures. This collaboration is especially helpful for complex interventions. Vishal advocates for prioritizing patient safety over logistical considerations. He firmly contends IRs should be empowered to decide the level of anesthesia care since they have the most experience with the specific procedures and are best suited to recognize anesthesia needs. The conversation delves into the American Society of Anesthesiologists (ASA) scoring system, which categorizes patients based on their health status from ASA 1 (healthy) to ASA 6 (brain death). While IR procedures usually involve ASA 3 or ASA 4 patients, today’s discussion uncovers the tendency among clinicians to underestimate a patient's ASA classification while overestimating their pain tolerance. The discussion raises critical questions about whether the IR community has grown complacent with moderate sedation in procedures and whether alternative approaches are warranted. --- RESOURCES American Society of Anesthesiologists Classification (ASA) Classification: https://www.ncbi.nlm.nih.gov/books/NBK441940/ Fri, 03 Nov 2023 05:05:00 -0000 full BackTable In this episode, interventional radiologists Dr. Aaron Fritts, Dr. Vishal Kumar, and Dr. Chris Beck discuss types of sedation for IR procedures. In this episode, interventional radiologists Dr. Aaron Fritts, Dr. Vishal Kumar, and Dr. Chris Beck discuss types of sedation for IR procedures. --- CHECK OUT OUR SPONSOR Medtronic OBL https://www.medtronic.com/obl --- SHOW NOTES We start the discussion off by dividing the spectrum of patient sedation into three tiers: local anesthesia, moderate sedation with fentanyl and Versed, and deep sedation which encompasses anything beyond fentanyl and Versed. The conversation revolves around the fluidity of this spectrum, underscoring the ease with which patients can transition between these sedation levels, thereby adding layers of complexity to the decision-making process. Chris emphasizes the significance of embracing trauma-informed care, highlighting the potential for IR procedures to be maximally traumatic despite their minimally invasive nature. The doctors emphasize the importance of establishing comprehensive pre-procedural patient education to align expectations about pain management. Procedures that automatically trigger the requirement for an anesthesia team include procedures such as TIPS, tumor ablations, as well as declot procedures more recently. Decisions regarding anesthesia for these procedures are additionally influenced by factors such as the patient's condition, history of methadone exposure, the preference of the IR providers, and the comfort level of nursing staff. Vishal highlights the game-changing concept of having an anesthesia team present for real-time monitoring and the administration of nerve blocks during IR procedures. This collaboration is especially helpful for complex interventions. Vishal advocates for prioritizing patient safety over logistical considerations. He firmly contends IRs should be empowered to decide the level of anesthesia care since they have the most experience with the specific procedures and are best suited to recognize anesthesia needs. The conversation delves into the American Society of Anesthesiologists (ASA) scoring system, which categorizes patients based on their health status from ASA 1 (healthy) to ASA 6 (brain death). While IR procedures usually involve ASA 3 or ASA 4 patients, today’s discussion uncovers the tendency among clinicians to underestimate a patient's ASA classification while overestimating their pain tolerance. The discussion raises critical questions about whether the IR community has grown complacent with moderate sedation in procedures and whether alternative approaches are warranted. --- RESOURCES American Society of Anesthesiologists Classification (ASA) Classification: https://www.ncbi.nlm.nih.gov/books/NBK441940/ In this episode, interventional radiologists Dr. Aaron Fritts, Dr. Vishal Kumar, and Dr. Chris Beck discuss types of sedation for IR procedures.


---


CHECK OUT OUR SPONSOR


Medtronic OBL

https://www.medtronic.com/obl


---


SHOW NOTES


We start the discussion off by dividing the spectrum of patient sedation into three tiers: local anesthesia, moderate sedation with fentanyl and Versed, and deep sedation which encompasses anything beyond fentanyl and Versed. The conversation revolves around the fluidity of this spectrum, underscoring the ease with which patients can transition between these sedation levels, thereby adding layers of complexity to the decision-making process. Chris emphasizes the significance of embracing trauma-informed care, highlighting the potential for IR procedures to be maximally traumatic despite their minimally invasive nature. The doctors emphasize the importance of establishing comprehensive pre-procedural patient education to align expectations about pain management.


Procedures that automatically trigger the requirement for an anesthesia team include procedures such as TIPS, tumor ablations, as well as declot procedures more recently. Decisions regarding anesthesia for these procedures are additionally influenced by factors such as the patient's condition, history of methadone exposure, the preference of the IR providers, and the comfort level of nursing staff.


Vishal highlights the game-changing concept of having an anesthesia team present for real-time monitoring and the administration of nerve blocks during IR procedures. This collaboration is especially helpful for complex interventions. Vishal advocates for prioritizing patient safety over logistical considerations. He firmly contends IRs should be empowered to decide the level of anesthesia care since they have the most experience with the specific procedures and are best suited to recognize anesthesia needs.


The conversation delves into the American Society of Anesthesiologists (ASA) scoring system, which categorizes patients based on their health status from ASA 1 (healthy) to ASA 6 (brain death). While IR procedures usually involve ASA 3 or ASA 4 patients, today’s discussion uncovers the tendency among clinicians to underestimate a patient's ASA classification while overestimating their pain tolerance. The discussion raises critical questions about whether the IR community has grown complacent with moderate sedation in procedures and whether alternative approaches are warranted.


---


RESOURCES


American Society of Anesthesiologists Classification (ASA) Classification:

https://www.ncbi.nlm.nih.gov/books/NBK441940/

]]> 3084 Ep. 380 Managing Venous Stent Rethrombosis with the RevCore Device with Dr. Steven Abramowitz and Dr. Angelo Marino In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Steven Abramowitz and interventional radiologist Dr. Angelo Marino on managing venous stent rethrombosis with the RevCore device. Steven is the Chair of Vascular Surgery at MedStar Washington Hospital and Angelo is an Assistant Professor of Interventional Radiology at Yale School of Medicine. --- CHECK OUT OUR SPONSOR Inari Medical RevCore https://www.inarimedical.com/revcore/ --- SHOW NOTES We start this episode with Steven and Angelo’s experience in venous interventions and how venous stent rethrombosis presents. The doctors then tell us more about how stent failure can precipitate, inflow and landing zone considerations, and stenting location. Angelo then goes onto introduce the RevCore device. Both Steven and Angelo share their experience in using the RevCore device in venous stent rethrombosis, and their preferred access site(s) when using this tool. They also discuss specific maneuvers, troubleshooting, and other tools they use alongside the RevCore system. We conclude this episode with the doctor’s overall treatment algorithm for venous stent rethrombosis and follow-up plans. --- RESOURCES Inari Medical RevCore Device: https://www.inarimedical.com/revcore/ Mon, 30 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Steven Abramowitz and interventional radiologist Dr. Angelo Marino on managing venous stent rethrombosis with the RevCore device. In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Steven Abramowitz and interventional radiologist Dr. Angelo Marino on managing venous stent rethrombosis with the RevCore device. Steven is the Chair of Vascular Surgery at MedStar Washington Hospital and Angelo is an Assistant Professor of Interventional Radiology at Yale School of Medicine. --- CHECK OUT OUR SPONSOR Inari Medical RevCore https://www.inarimedical.com/revcore/ --- SHOW NOTES We start this episode with Steven and Angelo’s experience in venous interventions and how venous stent rethrombosis presents. The doctors then tell us more about how stent failure can precipitate, inflow and landing zone considerations, and stenting location. Angelo then goes onto introduce the RevCore device. Both Steven and Angelo share their experience in using the RevCore device in venous stent rethrombosis, and their preferred access site(s) when using this tool. They also discuss specific maneuvers, troubleshooting, and other tools they use alongside the RevCore system. We conclude this episode with the doctor’s overall treatment algorithm for venous stent rethrombosis and follow-up plans. --- RESOURCES Inari Medical RevCore Device: https://www.inarimedical.com/revcore/ In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Steven Abramowitz and interventional radiologist Dr. Angelo Marino on managing venous stent rethrombosis with the RevCore device. Steven is the Chair of Vascular Surgery at MedStar Washington Hospital and Angelo is an Assistant Professor of Interventional Radiology at Yale School of Medicine.


---


CHECK OUT OUR SPONSOR


Inari Medical RevCore

https://www.inarimedical.com/revcore/


---


SHOW NOTES


We start this episode with Steven and Angelo’s experience in venous interventions and how venous stent rethrombosis presents. The doctors then tell us more about how stent failure can precipitate, inflow and landing zone considerations, and stenting location. Angelo then goes onto introduce the RevCore device.


Both Steven and Angelo share their experience in using the RevCore device in venous stent rethrombosis, and their preferred access site(s) when using this tool. They also discuss specific maneuvers, troubleshooting, and other tools they use alongside the RevCore system. We conclude this episode with the doctor’s overall treatment algorithm for venous stent rethrombosis and follow-up plans.


---


RESOURCES


Inari Medical RevCore Device:

https://www.inarimedical.com/revcore/

]]> 1678 Ep. 379 Management of HCC: Focus on Radiation Segmentectomy Part 2 with Dr. Juan Gimenez and Dr. Tyler Sandow In this episode, host Dr. Chris Beck continues the discussion on managing hepatocellular carcinoma (HCC) with Dr. Tyler Sandow and Dr. Juan Gimenez, interventional radiologists at Ochsner Health in New Orleans, Louisiana. --- CHECK OUT OUR SPONSOR Boston Scientific TheraSphere https://www.bostonscientific.com/therasphere --- SHOW NOTES We continue the conversation where we left off in Part 1. Tyler and Juan share their thoughts on lobar treatment vs. radiation segmentectomy, selection strategies, and their preferred combination of ablation and Y-90. Tyler also reviews the core tenets of Y-90 treatment and references a handful of major landmark trials and studies. Juan highlights more studies that guide their approach to preoperative mapping and intraoperative delivery of Y-90. Juan emphasizes cone-beam CT and how this technique has significantly evolved over the years. We cover dosimetry software, navigation software, and the calculation of treated tumor volumes. Additionally, Tyler and Juan discuss their change in treatment approach for especially complex cases, which can involve factors such as extrahepatic feeders and difficult treatment locations. We also discuss the redistribution of flow and how underlying liver disease may affect treatment plans. We wrap up Part 2 of our discussion by highlighting the doctors’ current research pursuits. Tyler tells us about exciting new developments in the tumor marker arena, the emerging role of albumin in HCC, and the rising popularity of radiation segmentectomy in metastatic disease. Juan shares a few closing thoughts on the extrahepatic applications of Y-90 and the advantages of using AI in interventional radiology. --- RESOURCES LEGACY Trial: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/legacy-study.html RASER Trial: https://pubmed.ncbi.nlm.nih.gov/35617978/ DOSISPHERE Trial: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/dosisphere-01.html TARGET Study: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/target-study.html Radiation Lobectomy: Preliminary Findings of Hepatic Volumetric Response to Lobar Yttrium-90 Radioembolization: https://link.springer.com/article/10.1245/s10434-009-0454-0 Radiation lobectomy: Time-dependent analysis of future liver remnant volume in unresectable liver cancer as a bridge to resection: https://www.sciencedirect.com/science/article/abs/pii/S0168827813004315 ACR–ABS–ACNM–ASTRO–SIR–SNMMI PRACTICE PARAMETER FOR SELECTIVE INTERNAL RADIATION THERAPY (SIRT) OR RADIOEMBOLIZATION FOR TREATMENT OF LIVER MALIGNANCIES: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/rmbd.pdf Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group: https://pubmed.ncbi.nlm.nih.gov/36114872/ “Simplicit90y” Boston Scientific Dosimetry Software: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/dosage-and-administration.html Fri, 27 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Chris Beck continues the discussion on managing hepatocellular carcinoma (HCC) with Dr. Tyler Sandow and Dr. Juan Gimenez, interventional radiologists at Ochsner Health in New Orleans, Louisiana. In this episode, host Dr. Chris Beck continues the discussion on managing hepatocellular carcinoma (HCC) with Dr. Tyler Sandow and Dr. Juan Gimenez, interventional radiologists at Ochsner Health in New Orleans, Louisiana. --- CHECK OUT OUR SPONSOR Boston Scientific TheraSphere https://www.bostonscientific.com/therasphere --- SHOW NOTES We continue the conversation where we left off in Part 1. Tyler and Juan share their thoughts on lobar treatment vs. radiation segmentectomy, selection strategies, and their preferred combination of ablation and Y-90. Tyler also reviews the core tenets of Y-90 treatment and references a handful of major landmark trials and studies. Juan highlights more studies that guide their approach to preoperative mapping and intraoperative delivery of Y-90. Juan emphasizes cone-beam CT and how this technique has significantly evolved over the years. We cover dosimetry software, navigation software, and the calculation of treated tumor volumes. Additionally, Tyler and Juan discuss their change in treatment approach for especially complex cases, which can involve factors such as extrahepatic feeders and difficult treatment locations. We also discuss the redistribution of flow and how underlying liver disease may affect treatment plans. We wrap up Part 2 of our discussion by highlighting the doctors’ current research pursuits. Tyler tells us about exciting new developments in the tumor marker arena, the emerging role of albumin in HCC, and the rising popularity of radiation segmentectomy in metastatic disease. Juan shares a few closing thoughts on the extrahepatic applications of Y-90 and the advantages of using AI in interventional radiology. --- RESOURCES LEGACY Trial: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/legacy-study.html RASER Trial: https://pubmed.ncbi.nlm.nih.gov/35617978/ DOSISPHERE Trial: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/dosisphere-01.html TARGET Study: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/target-study.html Radiation Lobectomy: Preliminary Findings of Hepatic Volumetric Response to Lobar Yttrium-90 Radioembolization: https://link.springer.com/article/10.1245/s10434-009-0454-0 Radiation lobectomy: Time-dependent analysis of future liver remnant volume in unresectable liver cancer as a bridge to resection: https://www.sciencedirect.com/science/article/abs/pii/S0168827813004315 ACR–ABS–ACNM–ASTRO–SIR–SNMMI PRACTICE PARAMETER FOR SELECTIVE INTERNAL RADIATION THERAPY (SIRT) OR RADIOEMBOLIZATION FOR TREATMENT OF LIVER MALIGNANCIES: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/rmbd.pdf Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group: https://pubmed.ncbi.nlm.nih.gov/36114872/ “Simplicit90y” Boston Scientific Dosimetry Software: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/dosage-and-administration.html In this episode, host Dr. Chris Beck continues the discussion on managing hepatocellular carcinoma (HCC) with Dr. Tyler Sandow and Dr. Juan Gimenez, interventional radiologists at Ochsner Health in New Orleans, Louisiana.


---


CHECK OUT OUR SPONSOR


Boston Scientific TheraSphere

https://www.bostonscientific.com/therasphere


---


SHOW NOTES


We continue the conversation where we left off in Part 1. Tyler and Juan share their thoughts on lobar treatment vs. radiation segmentectomy, selection strategies, and their preferred combination of ablation and Y-90. Tyler also reviews the core tenets of Y-90 treatment and references a handful of major landmark trials and studies.


Juan highlights more studies that guide their approach to preoperative mapping and intraoperative delivery of Y-90. Juan emphasizes cone-beam CT and how this technique has significantly evolved over the years. We cover dosimetry software, navigation software, and the calculation of treated tumor volumes. Additionally, Tyler and Juan discuss their change in treatment approach for especially complex cases, which can involve factors such as extrahepatic feeders and difficult treatment locations. We also discuss the redistribution of flow and how underlying liver disease may affect treatment plans.


We wrap up Part 2 of our discussion by highlighting the doctors’ current research pursuits. Tyler tells us about exciting new developments in the tumor marker arena, the emerging role of albumin in HCC, and the rising popularity of radiation segmentectomy in metastatic disease. Juan shares a few closing thoughts on the extrahepatic applications of Y-90 and the advantages of using AI in interventional radiology.


---


RESOURCES


LEGACY Trial:

https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/legacy-study.html


RASER Trial:

https://pubmed.ncbi.nlm.nih.gov/35617978/


DOSISPHERE Trial:

https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/dosisphere-01.html


TARGET Study:

https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/target-study.html


Radiation Lobectomy: Preliminary Findings of Hepatic Volumetric Response to Lobar Yttrium-90 Radioembolization:

https://link.springer.com/article/10.1245/s10434-009-0454-0


Radiation lobectomy: Time-dependent analysis of future liver remnant volume in unresectable liver cancer as a bridge to resection:

https://www.sciencedirect.com/science/article/abs/pii/S0168827813004315


ACR–ABS–ACNM–ASTRO–SIR–SNMMI PRACTICE PARAMETER FOR SELECTIVE INTERNAL RADIATION THERAPY (SIRT) OR RADIOEMBOLIZATION FOR TREATMENT OF LIVER MALIGNANCIES:

https://www.acr.org/-/media/ACR/Files/Practice-Parameters/rmbd.pdf


Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group:

https://pubmed.ncbi.nlm.nih.gov/36114872/


“Simplicit90y” Boston Scientific Dosimetry Software:

https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/dosage-and-administration.html

]]> 3235 Ep. 378 Setting the Benchmark: Ablation Confirmation Software for Tumors with Dr. Bruno Odisio and Dr. Constantinos Sofocleous In this episode, Dr. Constantinos (Costi) Sofocleous, Dr. Bruno Odisio, and Dr. William Rilling discuss the history of percutaneous liver tumor ablation, takeaways from past and present clinical studies, and the contemporary role of ablation margin confirmation software for optimizing treatment outcomes. --- CHECK OUT OUR SPONSORS NeuWave Microwave Ablation Systems https://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems EDDA Technology https://www.eddatech.com/ --- SHOW NOTES Costi initiates the discussion by highlighting crucial developments in tumor ablation over the last 15 years. He notes that it took time to realize that tumors larger than 3 cm carried higher rates of local failure, primarily due to insufficient margins. Research eventually found that establishing larger margins, preferably 10 mm margins, resulted in significantly lower recurrence rates. In fact, with these margins, ablation outcomes became even more favorable than surgical outcomes. This shift towards personalizing the approach to each tumor has been instrumental in improving patient outcomes. The conversation then transitions to innovation within the realm of ablation. There are fewer prospective studies over ablation as a sole treatment, since ablation is often performed in conjunction with surgery. Additionally, the presence of numerous vendors for ablation technology makes it challenging to conduct comprehensive studies. The doctors also discuss the importance of ablation margins and recurrence. 3D confirmation is correlated with greater control over the procedure. Local recurrence tends to occur in areas where the margin is suboptimal, but the exact standards for what constitutes "suboptimal" margins are yet to be established. Nevertheless, the consensus among experts is that a contrast CT on the day of the ablation and a subsequent 3D evaluation of the images are crucial. This evaluation should be repeated three weeks later to verify the success of the procedure. Costi mentions that at Memorial Sloan Kettering, ablation zone biopsy is an option if necessary, which adds another layer of verification. The discussion also touches on the importance of using a guidance system for ablation. Bruno underlines the significance of always using CT to verify the procedure. He points out that colleagues in Europe have been using stereotactic guidance for many years, revealing that 40% of the time, the ablation application wasn't placed exactly where they thought it would be based on pre-scans. This is where stereotactic technology becomes invaluable. Costi suggests real-time PET as a beneficial tool, but the challenge lies in justifying these additional steps to payers. Minimum imaging requirements and margin confirmation software are essential components of a guidance system.. The episode culminates in a discussion of a significant trial that involves three different industry sponsors - a landmark effort in the field of oncology. The ACCLAIM trial, which began in 2016, sought to conduct a multicenter study but took four years to secure approval and funding. Costi highlights the reasons for its success, emphasizing the potential for reproducible outcomes that could establish ablation as a strong indication in colorectal cancer. The data suggests that margin confirmation software significantly improves margins, and he hopes that this information will lead to increased reimbursement for the use of these crucial software tools. --- RESOURCES ACCLAIM Trial: https://www.sio-central.org/Research-Resources/Research-Grants/ACCLAIM-Trial Wed, 25 Oct 2023 05:05:00 -0000 full BackTable In this episode, Dr. Constantinos (Costi) Sofocleous, Dr. Bruno Odisio, and Dr. William Rilling discuss the history of percutaneous liver tumor ablation, takeaways from past and present clinical studies, and the contemporary role of ablation margin confirmation software for optimizing treatment outcomes. In this episode, Dr. Constantinos (Costi) Sofocleous, Dr. Bruno Odisio, and Dr. William Rilling discuss the history of percutaneous liver tumor ablation, takeaways from past and present clinical studies, and the contemporary role of ablation margin confirmation software for optimizing treatment outcomes. --- CHECK OUT OUR SPONSORS NeuWave Microwave Ablation Systems https://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems EDDA Technology https://www.eddatech.com/ --- SHOW NOTES Costi initiates the discussion by highlighting crucial developments in tumor ablation over the last 15 years. He notes that it took time to realize that tumors larger than 3 cm carried higher rates of local failure, primarily due to insufficient margins. Research eventually found that establishing larger margins, preferably 10 mm margins, resulted in significantly lower recurrence rates. In fact, with these margins, ablation outcomes became even more favorable than surgical outcomes. This shift towards personalizing the approach to each tumor has been instrumental in improving patient outcomes. The conversation then transitions to innovation within the realm of ablation. There are fewer prospective studies over ablation as a sole treatment, since ablation is often performed in conjunction with surgery. Additionally, the presence of numerous vendors for ablation technology makes it challenging to conduct comprehensive studies. The doctors also discuss the importance of ablation margins and recurrence. 3D confirmation is correlated with greater control over the procedure. Local recurrence tends to occur in areas where the margin is suboptimal, but the exact standards for what constitutes "suboptimal" margins are yet to be established. Nevertheless, the consensus among experts is that a contrast CT on the day of the ablation and a subsequent 3D evaluation of the images are crucial. This evaluation should be repeated three weeks later to verify the success of the procedure. Costi mentions that at Memorial Sloan Kettering, ablation zone biopsy is an option if necessary, which adds another layer of verification. The discussion also touches on the importance of using a guidance system for ablation. Bruno underlines the significance of always using CT to verify the procedure. He points out that colleagues in Europe have been using stereotactic guidance for many years, revealing that 40% of the time, the ablation application wasn't placed exactly where they thought it would be based on pre-scans. This is where stereotactic technology becomes invaluable. Costi suggests real-time PET as a beneficial tool, but the challenge lies in justifying these additional steps to payers. Minimum imaging requirements and margin confirmation software are essential components of a guidance system.. The episode culminates in a discussion of a significant trial that involves three different industry sponsors - a landmark effort in the field of oncology. The ACCLAIM trial, which began in 2016, sought to conduct a multicenter study but took four years to secure approval and funding. Costi highlights the reasons for its success, emphasizing the potential for reproducible outcomes that could establish ablation as a strong indication in colorectal cancer. The data suggests that margin confirmation software significantly improves margins, and he hopes that this information will lead to increased reimbursement for the use of these crucial software tools. --- RESOURCES ACCLAIM Trial: https://www.sio-central.org/Research-Resources/Research-Grants/ACCLAIM-Trial In this episode, Dr. Constantinos (Costi) Sofocleous, Dr. Bruno Odisio, and Dr. William Rilling discuss the history of percutaneous liver tumor ablation, takeaways from past and present clinical studies, and the contemporary role of ablation margin confirmation software for optimizing treatment outcomes.


---


CHECK OUT OUR SPONSORS


NeuWave Microwave Ablation Systems

https://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems


EDDA Technology

https://www.eddatech.com/


---


SHOW NOTES


Costi initiates the discussion by highlighting crucial developments in tumor ablation over the last 15 years. He notes that it took time to realize that tumors larger than 3 cm carried higher rates of local failure, primarily due to insufficient margins. Research eventually found that establishing larger margins, preferably 10 mm margins, resulted in significantly lower recurrence rates. In fact, with these margins, ablation outcomes became even more favorable than surgical outcomes. This shift towards personalizing the approach to each tumor has been instrumental in improving patient outcomes.


The conversation then transitions to innovation within the realm of ablation. There are fewer prospective studies over ablation as a sole treatment, since ablation is often performed in conjunction with surgery. Additionally, the presence of numerous vendors for ablation technology makes it challenging to conduct comprehensive studies.


The doctors also discuss the importance of ablation margins and recurrence. 3D confirmation is correlated with greater control over the procedure. Local recurrence tends to occur in areas where the margin is suboptimal, but the exact standards for what constitutes "suboptimal" margins are yet to be established. Nevertheless, the consensus among experts is that a contrast CT on the day of the ablation and a subsequent 3D evaluation of the images are crucial. This evaluation should be repeated three weeks later to verify the success of the procedure. Costi mentions that at Memorial Sloan Kettering, ablation zone biopsy is an option if necessary, which adds another layer of verification.


The discussion also touches on the importance of using a guidance system for ablation. Bruno underlines the significance of always using CT to verify the procedure. He points out that colleagues in Europe have been using stereotactic guidance for many years, revealing that 40% of the time, the ablation application wasn't placed exactly where they thought it would be based on pre-scans. This is where stereotactic technology becomes invaluable. Costi suggests real-time PET as a beneficial tool, but the challenge lies in justifying these additional steps to payers. Minimum imaging requirements and margin confirmation software are essential components of a guidance system..


The episode culminates in a discussion of a significant trial that involves three different industry sponsors - a landmark effort in the field of oncology. The ACCLAIM trial, which began in 2016, sought to conduct a multicenter study but took four years to secure approval and funding. Costi highlights the reasons for its success, emphasizing the potential for reproducible outcomes that could establish ablation as a strong indication in colorectal cancer. The data suggests that margin confirmation software significantly improves margins, and he hopes that this information will lead to increased reimbursement for the use of these crucial software tools.


---


RESOURCES


ACCLAIM Trial:

https://www.sio-central.org/Research-Resources/Research-Grants/ACCLAIM-Trial

]]> 2995 Ep. 377 Management of HCC: Focus on Radiation Segmentectomy Part 1 with Dr. Juan Gimenez and Dr. Tyler Sandow In this episode, host Dr. Chris Beck interviews Dr. Juan Gimenez and Dr. Tyler Sandow. Juan and Tyler are both interventional radiologists in New Orleans, Louisiana who practice at Ochsner Health System - one of the United States’ leading transplant centers. As a result, both doctors have significant experience in Y-90 radiation segmentectomy and other complex procedures for treatment of hepatocellular carcinoma (HCC). --- CHECK OUT OUR SPONSOR Boston Scientific TheraSphere https://www.bostonscientific.com/therasphere --- SHOW NOTES Juan and Tyler start the episode by telling us about how their practice has evolved over the years, their experience on tumor boards, and advice for building strong relations with transplant surgeons. The doctors also tell us about their approach to working-up patients with HCC, the variety of treatment modalities, and overall timeline to transplant. Next we discuss considerations for building an effective interventional oncology service. Taking full ownership at every step of the way is critical to this goal. To conclude the episode, Juan and Tyler discuss the Barcelona Clinic Liver Cancer (BCLC) staging algorithm, their research, and other factors that guide their treatment plan. Stay tuned for Part 2 of this discussion, releasing later this week! --- RESOURCES Premiere and TRACE Trials: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/premiere-trial-and-trace-trial.html Mon, 23 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Chris Beck interviews Dr. Juan Gimenez and Dr. Tyler Sandow. Juan and Tyler are both interventional radiologists in New Orleans, Louisiana who practice at Ochsner Health System - one of the United States’ leading transplant centers. As a result, both doctors have significant experience in Y-90 radiation segmentectomy and other complex procedures for treatment of hepatocellular carcinoma (HCC). In this episode, host Dr. Chris Beck interviews Dr. Juan Gimenez and Dr. Tyler Sandow. Juan and Tyler are both interventional radiologists in New Orleans, Louisiana who practice at Ochsner Health System - one of the United States’ leading transplant centers. As a result, both doctors have significant experience in Y-90 radiation segmentectomy and other complex procedures for treatment of hepatocellular carcinoma (HCC). --- CHECK OUT OUR SPONSOR Boston Scientific TheraSphere https://www.bostonscientific.com/therasphere --- SHOW NOTES Juan and Tyler start the episode by telling us about how their practice has evolved over the years, their experience on tumor boards, and advice for building strong relations with transplant surgeons. The doctors also tell us about their approach to working-up patients with HCC, the variety of treatment modalities, and overall timeline to transplant. Next we discuss considerations for building an effective interventional oncology service. Taking full ownership at every step of the way is critical to this goal. To conclude the episode, Juan and Tyler discuss the Barcelona Clinic Liver Cancer (BCLC) staging algorithm, their research, and other factors that guide their treatment plan. Stay tuned for Part 2 of this discussion, releasing later this week! --- RESOURCES Premiere and TRACE Trials: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/premiere-trial-and-trace-trial.html In this episode, host Dr. Chris Beck interviews Dr. Juan Gimenez and Dr. Tyler Sandow. Juan and Tyler are both interventional radiologists in New Orleans, Louisiana who practice at Ochsner Health System - one of the United States’ leading transplant centers. As a result, both doctors have significant experience in Y-90 radiation segmentectomy and other complex procedures for treatment of hepatocellular carcinoma (HCC).


---


CHECK OUT OUR SPONSOR


Boston Scientific TheraSphere

https://www.bostonscientific.com/therasphere


---


SHOW NOTES


Juan and Tyler start the episode by telling us about how their practice has evolved over the years, their experience on tumor boards, and advice for building strong relations with transplant surgeons. The doctors also tell us about their approach to working-up patients with HCC, the variety of treatment modalities, and overall timeline to transplant.


Next we discuss considerations for building an effective interventional oncology service. Taking full ownership at every step of the way is critical to this goal. To conclude the episode, Juan and Tyler discuss the Barcelona Clinic Liver Cancer (BCLC) staging algorithm, their research, and other factors that guide their treatment plan. Stay tuned for Part 2 of this discussion, releasing later this week!


---


RESOURCES


Premiere and TRACE Trials:

https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/premiere-trial-and-trace-trial.html

]]> 1503 Ep. 376 New Frontiers in Spinal Tumor Ablation and Augmentation with Dr. Dana Dunleavy In this episode, host Dr. Jacob Fleming interviews Dr. Dana Dunleavy about spinal tumor ablation and vertebral augmentation. Dana is an interventional radiologist and Director of Windsong Interventional & Vascular Services. --- CHECK OUT OUR SPONSOR Stryker Interventional Spine https://www.strykerivs.com --- SHOW NOTES Dana begins the discussion by reflecting on his upbringing in a small country town. His parents, his mother a midwife and his father a contractor, shaped his early experiences. His exposure to medicine began through his mother, particularly in witnessing childbirths. As he navigated his way through medical school, he contemplated various specialties, including orthopedic surgery, interventional radiology, and neurosurgery. He discovered incredible mentors in radiology and ultimately found his place in the field of interventional radiology. During his residency at Johns Hopkins, he sought externships in interventional spine and had the opportunity to immerse himself in this field for one month. He underscores the significance of participating in tumor boards and being a valuable contributor to the team in terms of diagnosis and treatment. He also emphasizes the value of calling consults when performing biopsies and the importance of meeting with the patient face-to-face and engaging in a thorough discussion of the treatment plan. Next, Dana delves deeper into the topics of bone tumor ablation and mechanical augmentation. He notes the importance of having a comprehensive understanding of the patient's anatomy and being well-versed in interventional tools. Cement extravasation is a feared complication of vertebral augmentation, so Dana discusses the role of implants as a means to establish structural support and mitigate the risk of cement leakage. In addition, he talks about his approach in combining ablation with mechanical augmentation so that the augmentation provides a structure after the ablation. Lastly, he discusses the use of advanced technology such as cone beam CT in trajectory planning. He shares his hybrid approach to performing bone biopsies, utilizing fluoroscopy during access and cone beam CT to ascertain accurate trajectory. Wed, 18 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Dana Dunleavy about spinal tumor ablation and vertebral augmentation. Dana is an interventional radiologist and Director of Windsong Interventional & Vascular Services. In this episode, host Dr. Jacob Fleming interviews Dr. Dana Dunleavy about spinal tumor ablation and vertebral augmentation. Dana is an interventional radiologist and Director of Windsong Interventional & Vascular Services. --- CHECK OUT OUR SPONSOR Stryker Interventional Spine https://www.strykerivs.com --- SHOW NOTES Dana begins the discussion by reflecting on his upbringing in a small country town. His parents, his mother a midwife and his father a contractor, shaped his early experiences. His exposure to medicine began through his mother, particularly in witnessing childbirths. As he navigated his way through medical school, he contemplated various specialties, including orthopedic surgery, interventional radiology, and neurosurgery. He discovered incredible mentors in radiology and ultimately found his place in the field of interventional radiology. During his residency at Johns Hopkins, he sought externships in interventional spine and had the opportunity to immerse himself in this field for one month. He underscores the significance of participating in tumor boards and being a valuable contributor to the team in terms of diagnosis and treatment. He also emphasizes the value of calling consults when performing biopsies and the importance of meeting with the patient face-to-face and engaging in a thorough discussion of the treatment plan. Next, Dana delves deeper into the topics of bone tumor ablation and mechanical augmentation. He notes the importance of having a comprehensive understanding of the patient's anatomy and being well-versed in interventional tools. Cement extravasation is a feared complication of vertebral augmentation, so Dana discusses the role of implants as a means to establish structural support and mitigate the risk of cement leakage. In addition, he talks about his approach in combining ablation with mechanical augmentation so that the augmentation provides a structure after the ablation. Lastly, he discusses the use of advanced technology such as cone beam CT in trajectory planning. He shares his hybrid approach to performing bone biopsies, utilizing fluoroscopy during access and cone beam CT to ascertain accurate trajectory. In this episode, host Dr. Jacob Fleming interviews Dr. Dana Dunleavy about spinal tumor ablation and vertebral augmentation. Dana is an interventional radiologist and Director of Windsong Interventional & Vascular Services.


---


CHECK OUT OUR SPONSOR


Stryker Interventional Spine

https://www.strykerivs.com


---


SHOW NOTES


Dana begins the discussion by reflecting on his upbringing in a small country town. His parents, his mother a midwife and his father a contractor, shaped his early experiences. His exposure to medicine began through his mother, particularly in witnessing childbirths. As he navigated his way through medical school, he contemplated various specialties, including orthopedic surgery, interventional radiology, and neurosurgery. He discovered incredible mentors in radiology and ultimately found his place in the field of interventional radiology. During his residency at Johns Hopkins, he sought externships in interventional spine and had the opportunity to immerse himself in this field for one month.


He underscores the significance of participating in tumor boards and being a valuable contributor to the team in terms of diagnosis and treatment. He also emphasizes the value of calling consults when performing biopsies and the importance of meeting with the patient face-to-face and engaging in a thorough discussion of the treatment plan.


Next, Dana delves deeper into the topics of bone tumor ablation and mechanical augmentation. He notes the importance of having a comprehensive understanding of the patient's anatomy and being well-versed in interventional tools. Cement extravasation is a feared complication of vertebral augmentation, so Dana discusses the role of implants as a means to establish structural support and mitigate the risk of cement leakage. In addition, he talks about his approach in combining ablation with mechanical augmentation so that the augmentation provides a structure after the ablation.


Lastly, he discusses the use of advanced technology such as cone beam CT in trajectory planning. He shares his hybrid approach to performing bone biopsies, utilizing fluoroscopy during access and cone beam CT to ascertain accurate trajectory.

]]> 3772 Ep. 375 How to Get Independent IR Hospital Privileges with Dr. Bill Julien In this episode, host Dr. Ally Baheti interviews Dr. Bill Julien about strategies to secure independent IR hospital privileges. Bill is an experienced vascular interventional physician at South Florida Vascular Associates. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html Siemens Healthineers https://www.siemens-healthineers.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Bill starts the episode by telling us why it is crucial for vascular and interventional physicians to have hospital privileges. We learn about Bill’s career progression. He discusses the growing pains he faced, how he effectively tackled these challenges, and how he became staff at a number of hospitals. Bill and Ally then unfold Bill’s detailed roadmap for how IRs can join hospital staff. They explore different pathways, and Bill shares his anecdotes and advice throughout. The doctors discuss how many contracts leave little opportunity to build longitudinal care practice, since the majority of time can be dedicated to large volumes of diagnostic reading time and consults for non-complex cases. At the conclusion of this episode, Bill emphasizes the need for SIR and other societies to step in and usher change. He also shares his 13-point action list for what SIR can do to accomplish this and help IRs secure hospital privileges (linked in Resources section). --- RESOURCES SIR Strategic Plan: https://tinyurl.com/SIRstrategicplan SIR Policy Statement: https://tinyurl.com/SIRpolicystatement Dr. Bill Julien’s Clinical Practice Position: https://tinyurl.com/clinicalpracticeposition2 ACR Policy Statement: https://tinyurl.com/ACRpolicystatement Mon, 16 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews Dr. Bill Julien about strategies to secure independent IR hospital privileges. Bill is an experienced vascular interventional physician at South Florida Vascular Associates. In this episode, host Dr. Ally Baheti interviews Dr. Bill Julien about strategies to secure independent IR hospital privileges. Bill is an experienced vascular interventional physician at South Florida Vascular Associates. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html Siemens Healthineers https://www.siemens-healthineers.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Bill starts the episode by telling us why it is crucial for vascular and interventional physicians to have hospital privileges. We learn about Bill’s career progression. He discusses the growing pains he faced, how he effectively tackled these challenges, and how he became staff at a number of hospitals. Bill and Ally then unfold Bill’s detailed roadmap for how IRs can join hospital staff. They explore different pathways, and Bill shares his anecdotes and advice throughout. The doctors discuss how many contracts leave little opportunity to build longitudinal care practice, since the majority of time can be dedicated to large volumes of diagnostic reading time and consults for non-complex cases. At the conclusion of this episode, Bill emphasizes the need for SIR and other societies to step in and usher change. He also shares his 13-point action list for what SIR can do to accomplish this and help IRs secure hospital privileges (linked in Resources section). --- RESOURCES SIR Strategic Plan: https://tinyurl.com/SIRstrategicplan SIR Policy Statement: https://tinyurl.com/SIRpolicystatement Dr. Bill Julien’s Clinical Practice Position: https://tinyurl.com/clinicalpracticeposition2 ACR Policy Statement: https://tinyurl.com/ACRpolicystatement In this episode, host Dr. Ally Baheti interviews Dr. Bill Julien about strategies to secure independent IR hospital privileges. Bill is an experienced vascular interventional physician at South Florida Vascular Associates.


---


CHECK OUT OUR SPONSORS


BD Advance Clinical Training & Education Program

https://page.bd.com/Advance-Training-Program_Homepage.html


Siemens Healthineers

https://www.siemens-healthineers.com/


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Bill starts the episode by telling us why it is crucial for vascular and interventional physicians to have hospital privileges. We learn about Bill’s career progression. He discusses the growing pains he faced, how he effectively tackled these challenges, and how he became staff at a number of hospitals.


Bill and Ally then unfold Bill’s detailed roadmap for how IRs can join hospital staff. They explore different pathways, and Bill shares his anecdotes and advice throughout. The doctors discuss how many contracts leave little opportunity to build longitudinal care practice, since the majority of time can be dedicated to large volumes of diagnostic reading time and consults for non-complex cases.


At the conclusion of this episode, Bill emphasizes the need for SIR and other societies to step in and usher change. He also shares his 13-point action list for what SIR can do to accomplish this and help IRs secure hospital privileges (linked in Resources section).


---


RESOURCES


SIR Strategic Plan:

https://tinyurl.com/SIRstrategicplan


SIR Policy Statement:

https://tinyurl.com/SIRpolicystatement


Dr. Bill Julien’s Clinical Practice Position:

https://tinyurl.com/clinicalpracticeposition2


ACR Policy Statement:

https://tinyurl.com/ACRpolicystatement

]]> 2632 Ep. 374 Independent IR: More Than Locums, It's a Calling with Dr. Ian Wilson and Dr. Kavi Devulapalli In this episode, host Dr. Dana Dunleavy engages in a thought-provoking discussion about independent interventional radiology practice with two esteemed IRs, Dr. Kavi Devulapalli and Dr. Ian Wilson. Together, they discuss the complexities and opportunities in the ever-evolving landscape of IR. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES We start off the discussion with Kavi expanding on early experiences in working a standard DR / IR split that most IRs tend to work in. He elaborates on how this split was not what he, as well as most IRs, intended to practice in when they entered the field. Thus, he then shifted over to the OBL space, a gratifying journey, but one he notes was difficult to navigate due to the intricacies. As Kavi finally transitioned to locum tenens work, he reflects on its appeal, despite the scarcity of opportunities. He notes that locum tenens work is usually in areas with an extreme dearth of IRs, such as rural areas. This conversation also explores the topic of exclusive contracts. Their impact on independent IR practices' access to hospital privileges is also explored, shedding light on the challenges faced by IRs seeking to expand their reach. Ian then notes that his locum tenens work was also in a rural setting, and how he had served this location for an extended period of time due to their lack of retention of IRs. The discussion then reveals a growing trend among physicians, as more and more are turning to locum work due to its exclusive focus on the IR aspect of the job that initially attracted them to this field. It's a mutual demand, as physicians seeking to specialize in IR find locum work to be a well-suited avenue, while areas of healthcare dearth are equally eager to tap into the expertise of these specialists. Both guests emphasize the urgent need for sustainable solutions to address this growing public health crisis in rural areas. This is precisely where organizations like Travelier come into play. Travelier was established by IRs, one of whom is Kavi, with a mission to bridge this critical gap by offering world-class IR services to communities with unmet needs. Their approach involves assembling dedicated physician teams and creating interventional radiology practices that generate revenue while providing viable work solutions for radiologists. This discussion is a testament to the adaptability and innovation that drive the field of IR, characterized by the commitment to improving healthcare access in areas where it is needed the most. It's also a testament to the increasing mutual demand for specialized IR services and the unique opportunities that come with it. --- RESOURCES Travelier: https://travelierir.com Fri, 13 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Dana Dunleavy engages in a thought-provoking discussion about independent interventional radiology practice with two esteemed IRs, Dr. Kavi Devulapalli and Dr. Ian Wilson. Together, they discuss the complexities and opportunities in the ever-evolving landscape of IR. In this episode, host Dr. Dana Dunleavy engages in a thought-provoking discussion about independent interventional radiology practice with two esteemed IRs, Dr. Kavi Devulapalli and Dr. Ian Wilson. Together, they discuss the complexities and opportunities in the ever-evolving landscape of IR. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES We start off the discussion with Kavi expanding on early experiences in working a standard DR / IR split that most IRs tend to work in. He elaborates on how this split was not what he, as well as most IRs, intended to practice in when they entered the field. Thus, he then shifted over to the OBL space, a gratifying journey, but one he notes was difficult to navigate due to the intricacies. As Kavi finally transitioned to locum tenens work, he reflects on its appeal, despite the scarcity of opportunities. He notes that locum tenens work is usually in areas with an extreme dearth of IRs, such as rural areas. This conversation also explores the topic of exclusive contracts. Their impact on independent IR practices' access to hospital privileges is also explored, shedding light on the challenges faced by IRs seeking to expand their reach. Ian then notes that his locum tenens work was also in a rural setting, and how he had served this location for an extended period of time due to their lack of retention of IRs. The discussion then reveals a growing trend among physicians, as more and more are turning to locum work due to its exclusive focus on the IR aspect of the job that initially attracted them to this field. It's a mutual demand, as physicians seeking to specialize in IR find locum work to be a well-suited avenue, while areas of healthcare dearth are equally eager to tap into the expertise of these specialists. Both guests emphasize the urgent need for sustainable solutions to address this growing public health crisis in rural areas. This is precisely where organizations like Travelier come into play. Travelier was established by IRs, one of whom is Kavi, with a mission to bridge this critical gap by offering world-class IR services to communities with unmet needs. Their approach involves assembling dedicated physician teams and creating interventional radiology practices that generate revenue while providing viable work solutions for radiologists. This discussion is a testament to the adaptability and innovation that drive the field of IR, characterized by the commitment to improving healthcare access in areas where it is needed the most. It's also a testament to the increasing mutual demand for specialized IR services and the unique opportunities that come with it. --- RESOURCES Travelier: https://travelierir.com In this episode, host Dr. Dana Dunleavy engages in a thought-provoking discussion about independent interventional radiology practice with two esteemed IRs, Dr. Kavi Devulapalli and Dr. Ian Wilson. Together, they discuss the complexities and opportunities in the ever-evolving landscape of IR.


---


CHECK OUT OUR SPONSOR


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


We start off the discussion with Kavi expanding on early experiences in working a standard DR / IR split that most IRs tend to work in. He elaborates on how this split was not what he, as well as most IRs, intended to practice in when they entered the field. Thus, he then shifted over to the OBL space, a gratifying journey, but one he notes was difficult to navigate due to the intricacies. As Kavi finally transitioned to locum tenens work, he reflects on its appeal, despite the scarcity of opportunities. He notes that locum tenens work is usually in areas with an extreme dearth of IRs, such as rural areas. This conversation also explores the topic of exclusive contracts. Their impact on independent IR practices' access to hospital privileges is also explored, shedding light on the challenges faced by IRs seeking to expand their reach.


Ian then notes that his locum tenens work was also in a rural setting, and how he had served this location for an extended period of time due to their lack of retention of IRs. The discussion then reveals a growing trend among physicians, as more and more are turning to locum work due to its exclusive focus on the IR aspect of the job that initially attracted them to this field. It's a mutual demand, as physicians seeking to specialize in IR find locum work to be a well-suited avenue, while areas of healthcare dearth are equally eager to tap into the expertise of these specialists.


Both guests emphasize the urgent need for sustainable solutions to address this growing public health crisis in rural areas. This is precisely where organizations like Travelier come into play. Travelier was established by IRs, one of whom is Kavi, with a mission to bridge this critical gap by offering world-class IR services to communities with unmet needs. Their approach involves assembling dedicated physician teams and creating interventional radiology practices that generate revenue while providing viable work solutions for radiologists. This discussion is a testament to the adaptability and innovation that drive the field of IR, characterized by the commitment to improving healthcare access in areas where it is needed the most. It's also a testament to the increasing mutual demand for specialized IR services and the unique opportunities that come with it.


---


RESOURCES


Travelier:

https://travelierir.com

]]> 3394 Ep. 373 Sharp Recanalization Using the RF Wire with Dr. Marcelo Guimaraes In this episode, host Dr. Ally Baheti interviews Dr. Marcelo Guimaraes about using radiofrequency wires for sharp recanalization. Marcelo is an interventional radiologist at the Medical University of South Carolina. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Marcelo begins by telling us about the Sniper technique, what RF wires are, and how they are used in sharp recanalization. He provides indications for using RF wires and his general workup and intraoperative flow for recanalization interventions. Marcelo also discusses the use of RF wires for iliocaval occlusions, SVC/upper extremity occlusions, and chronically occluded stents. Marcelo gives a comprehensive explanation of how and why the Sniper technique has evolved over the years. We also cover RF wires’ capabilities in crossing particularly, long occluded segments and the importance of cone-beam CT in complex cases. Ally and Marcelo then discuss applications of IVUS in sharp recanalization. Marcelo also shares his thoughts on possible alternatives to the RF wire and speaks about current and future applications of RF wires in non-vascular cases. Marcelo ends the episode by sharing tips on how to avoid unfavorable outcomes when using an RF wire, which includes his caution against using the Sniper technique in the office-based lab (OBL) setting. --- RESOURCES JVIR Paper from Dr. Marcelo Guimaraes on RF wires in recanalization of central vein occlusions: https://pubmed.ncbi.nlm.nih.gov/22739648/ PowerWire Radiofrequency Guidewire: https://baylismedtech.com/radio-frequency-wires/powerwire-rf-guidewire/ Mon, 09 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews Dr. Marcelo Guimaraes about using radiofrequency wires for sharp recanalization. Marcelo is an interventional radiologist at the Medical University of South Carolina. In this episode, host Dr. Ally Baheti interviews Dr. Marcelo Guimaraes about using radiofrequency wires for sharp recanalization. Marcelo is an interventional radiologist at the Medical University of South Carolina. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Marcelo begins by telling us about the Sniper technique, what RF wires are, and how they are used in sharp recanalization. He provides indications for using RF wires and his general workup and intraoperative flow for recanalization interventions. Marcelo also discusses the use of RF wires for iliocaval occlusions, SVC/upper extremity occlusions, and chronically occluded stents. Marcelo gives a comprehensive explanation of how and why the Sniper technique has evolved over the years. We also cover RF wires’ capabilities in crossing particularly, long occluded segments and the importance of cone-beam CT in complex cases. Ally and Marcelo then discuss applications of IVUS in sharp recanalization. Marcelo also shares his thoughts on possible alternatives to the RF wire and speaks about current and future applications of RF wires in non-vascular cases. Marcelo ends the episode by sharing tips on how to avoid unfavorable outcomes when using an RF wire, which includes his caution against using the Sniper technique in the office-based lab (OBL) setting. --- RESOURCES JVIR Paper from Dr. Marcelo Guimaraes on RF wires in recanalization of central vein occlusions: https://pubmed.ncbi.nlm.nih.gov/22739648/ PowerWire Radiofrequency Guidewire: https://baylismedtech.com/radio-frequency-wires/powerwire-rf-guidewire/ In this episode, host Dr. Ally Baheti interviews Dr. Marcelo Guimaraes about using radiofrequency wires for sharp recanalization. Marcelo is an interventional radiologist at the Medical University of South Carolina.


---


CHECK OUT OUR SPONSORS


BD Advance Clinical Training & Education Program

https://page.bd.com/Advance-Training-Program_Homepage.html


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Marcelo begins by telling us about the Sniper technique, what RF wires are, and how they are used in sharp recanalization. He provides indications for using RF wires and his general workup and intraoperative flow for recanalization interventions. Marcelo also discusses the use of RF wires for iliocaval occlusions, SVC/upper extremity occlusions, and chronically occluded stents.


Marcelo gives a comprehensive explanation of how and why the Sniper technique has evolved over the years. We also cover RF wires’ capabilities in crossing particularly, long occluded segments and the importance of cone-beam CT in complex cases. Ally and Marcelo then discuss applications of IVUS in sharp recanalization.


Marcelo also shares his thoughts on possible alternatives to the RF wire and speaks about current and future applications of RF wires in non-vascular cases. Marcelo ends the episode by sharing tips on how to avoid unfavorable outcomes when using an RF wire, which includes his caution against using the Sniper technique in the office-based lab (OBL) setting.


---


RESOURCES


JVIR Paper from Dr. Marcelo Guimaraes on RF wires in recanalization of central vein occlusions:

https://pubmed.ncbi.nlm.nih.gov/22739648/


PowerWire Radiofrequency Guidewire:

https://baylismedtech.com/radio-frequency-wires/powerwire-rf-guidewire/

]]> 3323 Ep. 372 IR Pathways Unveiled: Matching, Training, and Beyond with Dr. Neil Jain In this episode, host Christopher Beck discusses the current landscape of IR training with Dr. Neil Jain, a fourth-year IR/DR resident at Georgetown University. Neil, who attended medical school in New Jersey, discusses his early desire for a diverse medical career encompassing clinical work, innovation, and mentorship. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES To start the episode off, Neil offers valuable advice on when to decide on interventional radiology as a career path. He emphasizes that the ideal timing varies based on one's portfolio, but he personally found his passion for IR during his first year of medical school, which facilitated building meaningful connections early on. The conversation then explores the different pathways to entering the field of interventional radiology, including integrated, ESIR, and classic routes. Neil provides insights into the pros and cons of each pathway, shedding light on the evolving landscape of residency applications. We then delve into the changing dynamics of application processes, as Neil discusses the nuances of the recent changes and how students can strategically navigate them. He introduces the concept of "signaling" features, gold and silver star preferences, and the importance of proper program selection when applying to IR residency. Neil also offers guidance on away rotations, emphasizing their significance for students aspiring to match into competitive IR programs. He underscores the dedication to IR as a crucial factor in securing a match. Another key factor is mentorship, and Neil highlights how peer and attending mentors as well as the resources provided by the Society of Interventional Radiology (SIR) can play an enormous role in matching into IR. The discussion then shifts to the virtual residency application process, with Neil offering valuable do's and don'ts for applicants. He underscores the importance of creating a proper environment and engaging in hobbies during virtual interviews. He also provides valuable advice on preparing for common interview questions, encouraging applicants to build compelling stories that showcase their clinical understanding. As the field of interventional radiology continues to evolve, Neil emphasizes the importance of staying informed and maintaining close connections with mentors and resources like SIR. Fri, 06 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Christopher Beck discusses the current landscape of IR training with Dr. Neil Jain, a fourth-year IR/DR resident at Georgetown University. Neil, who attended medical school in New Jersey, discusses his early desire for a diverse medical career encompassing clinical work, innovation, and mentorship. In this episode, host Christopher Beck discusses the current landscape of IR training with Dr. Neil Jain, a fourth-year IR/DR resident at Georgetown University. Neil, who attended medical school in New Jersey, discusses his early desire for a diverse medical career encompassing clinical work, innovation, and mentorship. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES To start the episode off, Neil offers valuable advice on when to decide on interventional radiology as a career path. He emphasizes that the ideal timing varies based on one's portfolio, but he personally found his passion for IR during his first year of medical school, which facilitated building meaningful connections early on. The conversation then explores the different pathways to entering the field of interventional radiology, including integrated, ESIR, and classic routes. Neil provides insights into the pros and cons of each pathway, shedding light on the evolving landscape of residency applications. We then delve into the changing dynamics of application processes, as Neil discusses the nuances of the recent changes and how students can strategically navigate them. He introduces the concept of "signaling" features, gold and silver star preferences, and the importance of proper program selection when applying to IR residency. Neil also offers guidance on away rotations, emphasizing their significance for students aspiring to match into competitive IR programs. He underscores the dedication to IR as a crucial factor in securing a match. Another key factor is mentorship, and Neil highlights how peer and attending mentors as well as the resources provided by the Society of Interventional Radiology (SIR) can play an enormous role in matching into IR. The discussion then shifts to the virtual residency application process, with Neil offering valuable do's and don'ts for applicants. He underscores the importance of creating a proper environment and engaging in hobbies during virtual interviews. He also provides valuable advice on preparing for common interview questions, encouraging applicants to build compelling stories that showcase their clinical understanding. As the field of interventional radiology continues to evolve, Neil emphasizes the importance of staying informed and maintaining close connections with mentors and resources like SIR. In this episode, host Christopher Beck discusses the current landscape of IR training with Dr. Neil Jain, a fourth-year IR/DR resident at Georgetown University. Neil, who attended medical school in New Jersey, discusses his early desire for a diverse medical career encompassing clinical work, innovation, and mentorship.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


To start the episode off, Neil offers valuable advice on when to decide on interventional radiology as a career path. He emphasizes that the ideal timing varies based on one's portfolio, but he personally found his passion for IR during his first year of medical school, which facilitated building meaningful connections early on.


The conversation then explores the different pathways to entering the field of interventional radiology, including integrated, ESIR, and classic routes. Neil provides insights into the pros and cons of each pathway, shedding light on the evolving landscape of residency applications.


We then delve into the changing dynamics of application processes, as Neil discusses the nuances of the recent changes and how students can strategically navigate them. He introduces the concept of "signaling" features, gold and silver star preferences, and the importance of proper program selection when applying to IR residency.


Neil also offers guidance on away rotations, emphasizing their significance for students aspiring to match into competitive IR programs. He underscores the dedication to IR as a crucial factor in securing a match. Another key factor is mentorship, and Neil highlights how peer and attending mentors as well as the resources provided by the Society of Interventional Radiology (SIR) can play an enormous role in matching into IR.


The discussion then shifts to the virtual residency application process, with Neil offering valuable do's and don'ts for applicants. He underscores the importance of creating a proper environment and engaging in hobbies during virtual interviews. He also provides valuable advice on preparing for common interview questions, encouraging applicants to build compelling stories that showcase their clinical understanding.


As the field of interventional radiology continues to evolve, Neil emphasizes the importance of staying informed and maintaining close connections with mentors and resources like SIR.

]]> 3654 Ep. 371 Transverse Sinus Stenting for Idiopathic Intracranial Hypertension with Dr. Aaron Bress In this episode, host Dr. Michael Barraza interviews neurointerventional radiologist Dr. Aaron Bress about transverse sinus stenting for benign intracranial hypertension. --- CHECK OUT OUR SPONSORS MicroVention FRED X https://www.fred-x.com/ RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Aaron starts off the discussion by describing his typical patient population that requires stenting. Patients usually present to the clinic experiencing headaches, vision issues, and pulsatile tinnitus. Typically, these patients are female and overweight, and have been referred from headache clinics, neurosurgeons, and ENT specialists. Around 50% of his patients arrive with prior diagnoses and a complete workup already done, and they only require the procedure to be done. For the remaining patients, Aaron starts from scratch, emphasizing meticulous preparation imaging, which includes MRV with contrast. Aaron has a sequential approach for outpatients. He typically conducts diagnostic and treatment processes separately, to ensure that no complicating fistulas are present during interventions. Three months after the procedure, patients are referred for follow-ups with ophthalmologists to verify progress. During the procedure, Aaron starts with a diagnostic angiogram from the groin. During this time, he also obtains pressure measurements using a 27 mm diagnostic microcatheter. He typically measures from superior central sinus and then works his way back. He then obtains an MR venogram, which typically shows bilateral transverse sinus stenosis, and he measures pressure on both sides of the sinus. For him, a significant enough gradient to stent is typically 10 mmHg, however clinical presentation remains a key factor in deciding to stent patients with a lesser gradient. For the treatment procedure, patients are prescribed 75 mg Plavix and baby aspirin for five days before the intervention. On the day of the procedure, general anesthesia is administered, due to its neck-based approach. This approach not only provides better maneuverability, but also avoids complications associated with the heart, given the complexities of navigating the transverse sinus junction. Stent sizing remains highly personalized and tailored to the size of the patient's sinus, with no rigid guidelines in place. Patients typically stay overnight, with clear communication regarding the likelihood of experiencing a headache post-treatment. Following the procedure, they adhere to a six-month regimen of the dual antiplatelet therapy, which improves their recovery and treatment outcomes. Mon, 02 Oct 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Michael Barraza interviews neurointerventional radiologist Dr. Aaron Bress about transverse sinus stenting for benign intracranial hypertension. In this episode, host Dr. Michael Barraza interviews neurointerventional radiologist Dr. Aaron Bress about transverse sinus stenting for benign intracranial hypertension. --- CHECK OUT OUR SPONSORS MicroVention FRED X https://www.fred-x.com/ RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Aaron starts off the discussion by describing his typical patient population that requires stenting. Patients usually present to the clinic experiencing headaches, vision issues, and pulsatile tinnitus. Typically, these patients are female and overweight, and have been referred from headache clinics, neurosurgeons, and ENT specialists. Around 50% of his patients arrive with prior diagnoses and a complete workup already done, and they only require the procedure to be done. For the remaining patients, Aaron starts from scratch, emphasizing meticulous preparation imaging, which includes MRV with contrast. Aaron has a sequential approach for outpatients. He typically conducts diagnostic and treatment processes separately, to ensure that no complicating fistulas are present during interventions. Three months after the procedure, patients are referred for follow-ups with ophthalmologists to verify progress. During the procedure, Aaron starts with a diagnostic angiogram from the groin. During this time, he also obtains pressure measurements using a 27 mm diagnostic microcatheter. He typically measures from superior central sinus and then works his way back. He then obtains an MR venogram, which typically shows bilateral transverse sinus stenosis, and he measures pressure on both sides of the sinus. For him, a significant enough gradient to stent is typically 10 mmHg, however clinical presentation remains a key factor in deciding to stent patients with a lesser gradient. For the treatment procedure, patients are prescribed 75 mg Plavix and baby aspirin for five days before the intervention. On the day of the procedure, general anesthesia is administered, due to its neck-based approach. This approach not only provides better maneuverability, but also avoids complications associated with the heart, given the complexities of navigating the transverse sinus junction. Stent sizing remains highly personalized and tailored to the size of the patient's sinus, with no rigid guidelines in place. Patients typically stay overnight, with clear communication regarding the likelihood of experiencing a headache post-treatment. Following the procedure, they adhere to a six-month regimen of the dual antiplatelet therapy, which improves their recovery and treatment outcomes. In this episode, host Dr. Michael Barraza interviews neurointerventional radiologist Dr. Aaron Bress about transverse sinus stenting for benign intracranial hypertension.


---


CHECK OUT OUR SPONSORS


MicroVention FRED X

https://www.fred-x.com/


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Aaron starts off the discussion by describing his typical patient population that requires stenting. Patients usually present to the clinic experiencing headaches, vision issues, and pulsatile tinnitus. Typically, these patients are female and overweight, and have been referred from headache clinics, neurosurgeons, and ENT specialists. Around 50% of his patients arrive with prior diagnoses and a complete workup already done, and they only require the procedure to be done. For the remaining patients, Aaron starts from scratch, emphasizing meticulous preparation imaging, which includes MRV with contrast.


Aaron has a sequential approach for outpatients. He typically conducts diagnostic and treatment processes separately, to ensure that no complicating fistulas are present during interventions. Three months after the procedure, patients are referred for follow-ups with ophthalmologists to verify progress.


During the procedure, Aaron starts with a diagnostic angiogram from the groin. During this time, he also obtains pressure measurements using a 27 mm diagnostic microcatheter. He typically measures from superior central sinus and then works his way back. He then obtains an MR venogram, which typically shows bilateral transverse sinus stenosis, and he measures pressure on both sides of the sinus. For him, a significant enough gradient to stent is typically 10 mmHg, however clinical presentation remains a key factor in deciding to stent patients with a lesser gradient.


For the treatment procedure, patients are prescribed 75 mg Plavix and baby aspirin for five days before the intervention. On the day of the procedure, general anesthesia is administered, due to its neck-based approach. This approach not only provides better maneuverability, but also avoids complications associated with the heart, given the complexities of navigating the transverse sinus junction. Stent sizing remains highly personalized and tailored to the size of the patient's sinus, with no rigid guidelines in place. Patients typically stay overnight, with clear communication regarding the likelihood of experiencing a headache post-treatment. Following the procedure, they adhere to a six-month regimen of the dual antiplatelet therapy, which improves their recovery and treatment outcomes.

]]> 1929 Ep. 370 Recan In Benign Venous Occlusions with Dr. Minhaj Khaja In this episode, host Ally Baheti interviews Dr. Minhaj Khaja about iliocaval reconstruction. Minhaj is a Clinical Professor of Radiology and Cardiac Surgery and Associate Program Director of Interventional Radiology Residency at the University of Michigan. --- CHECK OUT OUR SPONSOR BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html --- SHOW NOTES Minhaj begins by sharing how deep venous disease typically presents, as well as his clinical workup. He emphasizes the importance of gathering prior imaging, taking a thorough history and comprehensive physical exam, and calculating Villalta scale and Venous Clinical Severity Score (VCSS) for deep venous disease. Minhaj then tells us more about his approach to complex cases. We cover his setup and intra-op workflow in patients with good inflow, poor inflow, and prior chronically occluded stents. Minhaj and Ally also discuss anticoagulation, types of stents, crossing devices/sharp recanalization, and treating inflow via tibial vein access. Minhaj also shares his experience with using arterial re-entry devices for crossing long, occluded venous segments, radiofrequency wires for chronically occluded stents, and the new RevCore mechanical thrombectomy device made specifically for venous stent thrombosis. Ally and Minhaj then conclude the episode by highlighting the components of good follow up for patients. --- RESOURCES C-TRACT Venous Trial: https://clinicaltrials.med.nyu.edu/clinicaltrial/536/c-tract-study;-chronic-venous/ RevCore Mechanical Thrombectomy Device for Venous Stent Thrombosis: https://www.inarimedical.com/revcore/ Venovo Venous Stent: https://www.bd.com/en-us/products-and-solutions/products/product-families/venovo-venous-stent-system Zilver Vena Stent: https://www.cookmedical.com/products/f3af274c-42cc-42cd-a0db-e5715ad57cc4/ Abre Venous Stent: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/deep-venous/abre-venous-stent.html Fri, 29 Sep 2023 05:05:00 -0000 full BackTable In this episode, host Ally Baheti interviews Dr. Minhaj Khaja about iliocaval reconstruction. Minhaj is a Clinical Professor of Radiology and Cardiac Surgery and Associate Program Director of Interventional Radiology Residency at the University of Michigan. In this episode, host Ally Baheti interviews Dr. Minhaj Khaja about iliocaval reconstruction. Minhaj is a Clinical Professor of Radiology and Cardiac Surgery and Associate Program Director of Interventional Radiology Residency at the University of Michigan. --- CHECK OUT OUR SPONSOR BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html --- SHOW NOTES Minhaj begins by sharing how deep venous disease typically presents, as well as his clinical workup. He emphasizes the importance of gathering prior imaging, taking a thorough history and comprehensive physical exam, and calculating Villalta scale and Venous Clinical Severity Score (VCSS) for deep venous disease. Minhaj then tells us more about his approach to complex cases. We cover his setup and intra-op workflow in patients with good inflow, poor inflow, and prior chronically occluded stents. Minhaj and Ally also discuss anticoagulation, types of stents, crossing devices/sharp recanalization, and treating inflow via tibial vein access. Minhaj also shares his experience with using arterial re-entry devices for crossing long, occluded venous segments, radiofrequency wires for chronically occluded stents, and the new RevCore mechanical thrombectomy device made specifically for venous stent thrombosis. Ally and Minhaj then conclude the episode by highlighting the components of good follow up for patients. --- RESOURCES C-TRACT Venous Trial: https://clinicaltrials.med.nyu.edu/clinicaltrial/536/c-tract-study;-chronic-venous/ RevCore Mechanical Thrombectomy Device for Venous Stent Thrombosis: https://www.inarimedical.com/revcore/ Venovo Venous Stent: https://www.bd.com/en-us/products-and-solutions/products/product-families/venovo-venous-stent-system Zilver Vena Stent: https://www.cookmedical.com/products/f3af274c-42cc-42cd-a0db-e5715ad57cc4/ Abre Venous Stent: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/deep-venous/abre-venous-stent.html In this episode, host Ally Baheti interviews Dr. Minhaj Khaja about iliocaval reconstruction. Minhaj is a Clinical Professor of Radiology and Cardiac Surgery and Associate Program Director of Interventional Radiology Residency at the University of Michigan.


---


CHECK OUT OUR SPONSOR


BD Advance Clinical Training & Education Program

https://page.bd.com/Advance-Training-Program_Homepage.html


---


SHOW NOTES


Minhaj begins by sharing how deep venous disease typically presents, as well as his clinical workup. He emphasizes the importance of gathering prior imaging, taking a thorough history and comprehensive physical exam, and calculating Villalta scale and Venous Clinical Severity Score (VCSS) for deep venous disease.


Minhaj then tells us more about his approach to complex cases. We cover his setup and intra-op workflow in patients with good inflow, poor inflow, and prior chronically occluded stents. Minhaj and Ally also discuss anticoagulation, types of stents, crossing devices/sharp recanalization, and treating inflow via tibial vein access.


Minhaj also shares his experience with using arterial re-entry devices for crossing long, occluded venous segments, radiofrequency wires for chronically occluded stents, and the new RevCore mechanical thrombectomy device made specifically for venous stent thrombosis. Ally and Minhaj then conclude the episode by highlighting the components of good follow up for patients.


---


RESOURCES


C-TRACT Venous Trial:

https://clinicaltrials.med.nyu.edu/clinicaltrial/536/c-tract-study;-chronic-venous/


RevCore Mechanical Thrombectomy Device for Venous Stent Thrombosis:

https://www.inarimedical.com/revcore/


Venovo Venous Stent:

https://www.bd.com/en-us/products-and-solutions/products/product-families/venovo-venous-stent-system


Zilver Vena Stent:

https://www.cookmedical.com/products/f3af274c-42cc-42cd-a0db-e5715ad57cc4/


Abre Venous Stent:

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/deep-venous/abre-venous-stent.html

]]> 3523 Ep. 369 Advancing Vascular Medicine: Inside VIVA’s Multidisciplinary Approach with Dr. Maureen Kohi and Dr. Niten Singh In this episode, host Dr. Aaron Fritts interviews Dr. Maureen Kohi and Dr. Niten Singh on the VIVA Foundation’s multidisciplinary approach to advancing vascular medicine. --- CHECK OUT OUR SPONSORS Medtronic ClosureFast https://www.medtronic.com/closurefast6f Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/PO5TFV --- SHOW NOTES Maureen is an interventional radiologist and Professor and Chair of the Department of Radiology at University of North Carolina - Chapel Hill. Niten is a vascular surgeon and Associate Chief of Vascular Surgery at University of Washington. Both serve on the board of directors at VIVA. We begin with how Maureen and Niten became involved at VIVA. They discuss the history and foundations of VIVA. The duo goes on to describe how VIVA has evolved throughout the years. Maureen speaks on how VEINS has become a comprehensive educational meeting for all things venous disease and interventions, which complements VIVA’s arterial focus. Niten and Maureen then explain how VIVA and VEINS have become more than just meetings. They are conglomerates of multiple initiatives for all things vascular driven by the central question of “What is best for the patient?” The duo also sheds light on the unique inner-workings of VIVA, highlighting the foundation’s speedy, nimble, and inclusive approach to the rapidly advancing landscape of vascular and endovascular surgery. We get a special look of what to expect at VIVA & VEINS Annual 2023 Conference at Wynn Las Vegas (October 28th - November 2nd) from Niten and Maureen. We conclude this episode with Maureen and Niten’s thoughts on how we can improve vascular care for our underserved patient populations and what role OBLs will play in this equation going forward. --- RESOURCES VIVA 2023 Annual Conference Registration: https://viva-foundation.org/viva-programming VEINS 2023 Annual Conference Registration: https://viva-foundation.org/veins-programming VIVA Vascular Leaders Forum on Paclitaxel Safety (2019): https://evtoday.com/articles/2019-mar/highlights-from-the-viva-vascular-leaders-forum-on-paclitaxel-safety Wed, 27 Sep 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Maureen Kohi and Dr. Niten Singh on the VIVA Foundation’s multidisciplinary approach to advancing vascular medicine. In this episode, host Dr. Aaron Fritts interviews Dr. Maureen Kohi and Dr. Niten Singh on the VIVA Foundation’s multidisciplinary approach to advancing vascular medicine. --- CHECK OUT OUR SPONSORS Medtronic ClosureFast https://www.medtronic.com/closurefast6f Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/PO5TFV --- SHOW NOTES Maureen is an interventional radiologist and Professor and Chair of the Department of Radiology at University of North Carolina - Chapel Hill. Niten is a vascular surgeon and Associate Chief of Vascular Surgery at University of Washington. Both serve on the board of directors at VIVA. We begin with how Maureen and Niten became involved at VIVA. They discuss the history and foundations of VIVA. The duo goes on to describe how VIVA has evolved throughout the years. Maureen speaks on how VEINS has become a comprehensive educational meeting for all things venous disease and interventions, which complements VIVA’s arterial focus. Niten and Maureen then explain how VIVA and VEINS have become more than just meetings. They are conglomerates of multiple initiatives for all things vascular driven by the central question of “What is best for the patient?” The duo also sheds light on the unique inner-workings of VIVA, highlighting the foundation’s speedy, nimble, and inclusive approach to the rapidly advancing landscape of vascular and endovascular surgery. We get a special look of what to expect at VIVA & VEINS Annual 2023 Conference at Wynn Las Vegas (October 28th - November 2nd) from Niten and Maureen. We conclude this episode with Maureen and Niten’s thoughts on how we can improve vascular care for our underserved patient populations and what role OBLs will play in this equation going forward. --- RESOURCES VIVA 2023 Annual Conference Registration: https://viva-foundation.org/viva-programming VEINS 2023 Annual Conference Registration: https://viva-foundation.org/veins-programming VIVA Vascular Leaders Forum on Paclitaxel Safety (2019): https://evtoday.com/articles/2019-mar/highlights-from-the-viva-vascular-leaders-forum-on-paclitaxel-safety In this episode, host Dr. Aaron Fritts interviews Dr. Maureen Kohi and Dr. Niten Singh on the VIVA Foundation’s multidisciplinary approach to advancing vascular medicine.


---


CHECK OUT OUR SPONSORS


Medtronic ClosureFast

https://www.medtronic.com/closurefast6f


Philips Image Guided Therapy Devices Academy

https://resource.philipseliiteacademy.com


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/PO5TFV


---


SHOW NOTES


Maureen is an interventional radiologist and Professor and Chair of the Department of Radiology at University of North Carolina - Chapel Hill. Niten is a vascular surgeon and Associate Chief of Vascular Surgery at University of Washington. Both serve on the board of directors at VIVA.


We begin with how Maureen and Niten became involved at VIVA. They discuss the history and foundations of VIVA. The duo goes on to describe how VIVA has evolved throughout the years. Maureen speaks on how VEINS has become a comprehensive educational meeting for all things venous disease and interventions, which complements VIVA’s arterial focus.


Niten and Maureen then explain how VIVA and VEINS have become more than just meetings. They are conglomerates of multiple initiatives for all things vascular driven by the central question of “What is best for the patient?” The duo also sheds light on the unique inner-workings of VIVA, highlighting the foundation’s speedy, nimble, and inclusive approach to the rapidly advancing landscape of vascular and endovascular surgery.


We get a special look of what to expect at VIVA & VEINS Annual 2023 Conference at Wynn Las Vegas (October 28th - November 2nd) from Niten and Maureen. We conclude this episode with Maureen and Niten’s thoughts on how we can improve vascular care for our underserved patient populations and what role OBLs will play in this equation going forward.


---


RESOURCES


VIVA 2023 Annual Conference Registration:

https://viva-foundation.org/viva-programming


VEINS 2023 Annual Conference Registration:

https://viva-foundation.org/veins-programming


VIVA Vascular Leaders Forum on Paclitaxel Safety (2019):

https://evtoday.com/articles/2019-mar/highlights-from-the-viva-vascular-leaders-forum-on-paclitaxel-safety

]]> 1913 Ep. 368 The Recent Trend of Insurance Denials for CLI Interventions with Dr. Bret Wiechmann In this episode, host Dr. Aaron Fritts and Dr. Krishna Mannava engage in a discussion with Dr. Bret Wiechmann about a concerning trend in the field—insurance denials for critical limb ischemia (CLI) interventions. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Bret is an IR in Gainesville, Florida with over 26 years of experience and is one of the founders of the Outpatient Endovascular & Interventional Society (OEIS). OEIS was started 10 years ago to advocate for the viability of non-hospital IR services. We start the episode with Bret sharing his staff’s firsthand encounters with pre-authorization challenges for atherectomy procedures.The panel discusses how the recent inflammatory NY Times article regarding the use of atherectomy to treat peripheral artery disease has exacerbated these challenges. The doctors delve into the perplexing use of non-scientific articles as evidence by insurance companies, which are often influenced by third-party recommendations. The disconnect between insurance decisions and patients' actual needs becomes evident, as peer-to-peer reviews usually involve physicians unfamiliar with the specific medical speciality. Next, we explore strategies for navigating the intricacies of insurance approvals, a particularly challenging task as each insurance company has its unique set of requirements for procedure coverage. Evaluating these requirements for each patient not only limits the capabilities of the physician, but also decreases the quality of the patient's care. One strategy that is discussed is compiling a list of different payers and their specific requirements for each procedure, but this takes away valuable time away from a patient’s care. Another strategy includes the intriguing notion of physicians noting the names of insurance companies and peer reviewers on medical records as reasons for denying certain procedures. While promising, the effectiveness of this approach remains uncertain. Furthermore, the episode contemplates the possibility of refusing to work with insurance companies that consistently denying coverage— a bold strategy that warrants careful consideration as it may drop patient volumes. To combat the rising tide of insurance denials, the discussion emphasizes the pivotal role played by organizations like OEIS. It highlights the importance of involving referring physicians in various specialties, patients themselves as well as industry stakeholders manufacturing relevant devices to bring about meaningful change in the insurance approval process. --- RESOURCES New York Times Article: https://www.nytimes.com/2023/07/15/health/atherectomy-peripheral-artery-disease.html OEIS: https://oeisweb.com Mon, 25 Sep 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts and Dr. Krishna Mannava engage in a discussion with Dr. Bret Wiechmann about a concerning trend in the field—insurance denials for critical limb ischemia (CLI) interventions. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Bret is an IR in Gainesville, Florida with over 26 years of experience and is one of the founders of the Outpatient Endovascular & Interventional Society (OEIS). OEIS was started 10 years ago to advocate for the viability of non-hospital IR services. We start the episode with Bret sharing his staff’s firsthand encounters with pre-authorization challenges for atherectomy procedures.The panel discusses how the recent inflammatory NY Times article regarding the use of atherectomy to treat peripheral artery disease has exacerbated these challenges. The doctors delve into the perplexing use of non-scientific articles as evidence by insurance companies, which are often influenced by third-party recommendations. The disconnect between insurance decisions and patients' actual needs becomes evident, as peer-to-peer reviews usually involve physicians unfamiliar with the specific medical speciality. Next, we explore strategies for navigating the intricacies of insurance approvals, a particularly challenging task as each insurance company has its unique set of requirements for procedure coverage. Evaluating these requirements for each patient not only limits the capabilities of the physician, but also decreases the quality of the patient's care. One strategy that is discussed is compiling a list of different payers and their specific requirements for each procedure, but this takes away valuable time away from a patient’s care. Another strategy includes the intriguing notion of physicians noting the names of insurance companies and peer reviewers on medical records as reasons for denying certain procedures. While promising, the effectiveness of this approach remains uncertain. Furthermore, the episode contemplates the possibility of refusing to work with insurance companies that consistently denying coverage— a bold strategy that warrants careful consideration as it may drop patient volumes. To combat the rising tide of insurance denials, the discussion emphasizes the pivotal role played by organizations like OEIS. It highlights the importance of involving referring physicians in various specialties, patients themselves as well as industry stakeholders manufacturing relevant devices to bring about meaningful change in the insurance approval process. --- RESOURCES New York Times Article: https://www.nytimes.com/2023/07/15/health/atherectomy-peripheral-artery-disease.html OEIS: https://oeisweb.com In this episode, host Dr. Aaron Fritts and Dr. Krishna Mannava engage in a discussion with Dr. Bret Wiechmann about a concerning trend in the field—insurance denials for critical limb ischemia (CLI) interventions.


---


CHECK OUT OUR SPONSOR


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


Bret is an IR in Gainesville, Florida with over 26 years of experience and is one of the founders of the Outpatient Endovascular & Interventional Society (OEIS). OEIS was started 10 years ago to advocate for the viability of non-hospital IR services.


We start the episode with Bret sharing his staff’s firsthand encounters with pre-authorization challenges for atherectomy procedures.The panel discusses how the recent inflammatory NY Times article regarding the use of atherectomy to treat peripheral artery disease has exacerbated these challenges. The doctors delve into the perplexing use of non-scientific articles as evidence by insurance companies, which are often influenced by third-party recommendations. The disconnect between insurance decisions and patients' actual needs becomes evident, as peer-to-peer reviews usually involve physicians unfamiliar with the specific medical speciality.


Next, we explore strategies for navigating the intricacies of insurance approvals, a particularly challenging task as each insurance company has its unique set of requirements for procedure coverage. Evaluating these requirements for each patient not only limits the capabilities of the physician, but also decreases the quality of the patient's care. One strategy that is discussed is compiling a list of different payers and their specific requirements for each procedure, but this takes away valuable time away from a patient’s care. Another strategy includes the intriguing notion of physicians noting the names of insurance companies and peer reviewers on medical records as reasons for denying certain procedures. While promising, the effectiveness of this approach remains uncertain. Furthermore, the episode contemplates the possibility of refusing to work with insurance companies that consistently denying coverage— a bold strategy that warrants careful consideration as it may drop patient volumes.


To combat the rising tide of insurance denials, the discussion emphasizes the pivotal role played by organizations like OEIS. It highlights the importance of involving referring physicians in various specialties, patients themselves as well as industry stakeholders manufacturing relevant devices to bring about meaningful change in the insurance approval process.


---


RESOURCES


New York Times Article:

https://www.nytimes.com/2023/07/15/health/atherectomy-peripheral-artery-disease.html


OEIS:

https://oeisweb.com

]]> 3190 Ep. 367 How TV and Radio Still Work to Market Your Practice with Dr. Aaron Kovaleski In this episode, host Dr. Aaron Fritts interviews Dr. Aaron Kovaleski on good old-fashioned TV and radio marketing. Aaron is an interventional radiologist and founder of Endovascular Consultants of Colorado, who has found success in using tried and true methods of advertising to grow his practice. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/pL6Ay0 --- SHOW NOTES We begin with Aaron’s initial dive into marketing, tips that he learned, and surprising discoveries during this endeavor. He discusses differences between TV and radio advertising and ideal promotions to run through each medium. He also notes the importance of supplementing these strategies with a physical presence. Aaron also shares advice for building a marketing budget. He breaks down categories and percentage of funds invested towards his OBL’s TV and radio outreach. Aaron then speaks on how his practice measures the success of their efforts through analytics provided to them by TV and radio stations and CRM technology. We also discuss the time investment and step-by-step approaches for newer OBLs that are new to marketing outreach. We conclude this episode with future directions for marketing and a shoutout for next year’s Outpatient Endovascular and Interventional Society (OEIS) Annual Meeting in Las Vegas (April 25th-27th, 2024), which will have a dedicated session on marketing and practice building led by Aaron. --- RESOURCES Outpatient Endovascular and Interventional Society (OEIS) Annual 2024 Meeting: https://oeisweb.com/meetings/2024-annual-meeting/ Fri, 22 Sep 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Aaron Kovaleski on good old-fashioned TV and radio marketing. Aaron is an interventional radiologist and founder of Endovascular Consultants of Colorado, who has found success in using tried and true methods of advertising to grow his practice. In this episode, host Dr. Aaron Fritts interviews Dr. Aaron Kovaleski on good old-fashioned TV and radio marketing. Aaron is an interventional radiologist and founder of Endovascular Consultants of Colorado, who has found success in using tried and true methods of advertising to grow his practice. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/pL6Ay0 --- SHOW NOTES We begin with Aaron’s initial dive into marketing, tips that he learned, and surprising discoveries during this endeavor. He discusses differences between TV and radio advertising and ideal promotions to run through each medium. He also notes the importance of supplementing these strategies with a physical presence. Aaron also shares advice for building a marketing budget. He breaks down categories and percentage of funds invested towards his OBL’s TV and radio outreach. Aaron then speaks on how his practice measures the success of their efforts through analytics provided to them by TV and radio stations and CRM technology. We also discuss the time investment and step-by-step approaches for newer OBLs that are new to marketing outreach. We conclude this episode with future directions for marketing and a shoutout for next year’s Outpatient Endovascular and Interventional Society (OEIS) Annual Meeting in Las Vegas (April 25th-27th, 2024), which will have a dedicated session on marketing and practice building led by Aaron. --- RESOURCES Outpatient Endovascular and Interventional Society (OEIS) Annual 2024 Meeting: https://oeisweb.com/meetings/2024-annual-meeting/ In this episode, host Dr. Aaron Fritts interviews Dr. Aaron Kovaleski on good old-fashioned TV and radio marketing. Aaron is an interventional radiologist and founder of Endovascular Consultants of Colorado, who has found success in using tried and true methods of advertising to grow his practice.


---


CHECK OUT OUR SPONSOR


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/pL6Ay0


---


SHOW NOTES


We begin with Aaron’s initial dive into marketing, tips that he learned, and surprising discoveries during this endeavor. He discusses differences between TV and radio advertising and ideal promotions to run through each medium. He also notes the importance of supplementing these strategies with a physical presence.


Aaron also shares advice for building a marketing budget. He breaks down categories and percentage of funds invested towards his OBL’s TV and radio outreach. Aaron then speaks on how his practice measures the success of their efforts through analytics provided to them by TV and radio stations and CRM technology. We also discuss the time investment and step-by-step approaches for newer OBLs that are new to marketing outreach.


We conclude this episode with future directions for marketing and a shoutout for next year’s Outpatient Endovascular and Interventional Society (OEIS) Annual Meeting in Las Vegas (April 25th-27th, 2024), which will have a dedicated session on marketing and practice building led by Aaron.


---


RESOURCES


Outpatient Endovascular and Interventional Society (OEIS) Annual 2024 Meeting:

https://oeisweb.com/meetings/2024-annual-meeting/

]]> 1998 Ep. 366 Navigating OBL & ASC Business: Pitfalls to Avoid with Teri Yates In this episode, host Aaron Fritts is joined by Teri Yates, CEO of Accountable Physician Advisors, who offers essential guidance for successfully establishing and managing Office-Based Labs (OBLs). --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Teri started a consulting company after working as a quality and risk officer at a radiology practice for 18 years. As the company rapidly grew, she has worked with many different physician practices and specialities. We start off the discussion by identifying key pitfalls that Teri sees in OBL ventures. First, it is common for physicians to conduct inadequate due diligence about referral sources, which can be a barrier to effective marketing and patient acquisition. Also, it is common for founders to lack a detailed revenue model or a plan for the business. Oftentimes, they will underestimate the capital needed to start the OBL and lack a clear idea about the types of procedures and patients they are catering towards. Another pitfall is not realizing the amount of time investment required. Teri estimates that approximately 10% of a physician's time will be needed to manage the OBL and it is important to take this into account. Finally, a common error is initially hiring individuals not qualified to be administrators, such as family members or trusted individuals. Teri also highlights some of the major reasons physicians consult her company. These challenges often revolve around "people problems," encompassing issues related to both administrative difficulties and employee management. Staffing and retention problems, leading to a significant turnover of employees, are common concerns. She underscores the importance of addressing issues related to physicians themselves, emphasizing that partners must set the tone for the culture within a company. Patient turnover efficiency in OBLs is also a recurring issue. Teri's advice for this issue to closely follow a few patients throughout their entire visit. This will most likely uncover redundancies in the patient experience, many of which the staff might already be aware of, but hesitant to communicate to leadership. As Teri reflects on her experiences, she notes that it typically takes 6-9 months to fully construct and operate an OBL. A comprehensive understanding of healthcare regulations in each state is crucial in the initial development stages. --- RESOURCES Accountable Physician Advisors: https://www.accountablephysicianadvisors.com/ Mon, 18 Sep 2023 05:05:00 -0000 full BackTable In this episode, host Aaron Fritts is joined by Teri Yates, CEO of Accountable Physician Advisors, who offers essential guidance for successfully establishing and managing Office-Based Labs (OBLs). In this episode, host Aaron Fritts is joined by Teri Yates, CEO of Accountable Physician Advisors, who offers essential guidance for successfully establishing and managing Office-Based Labs (OBLs). --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Teri started a consulting company after working as a quality and risk officer at a radiology practice for 18 years. As the company rapidly grew, she has worked with many different physician practices and specialities. We start off the discussion by identifying key pitfalls that Teri sees in OBL ventures. First, it is common for physicians to conduct inadequate due diligence about referral sources, which can be a barrier to effective marketing and patient acquisition. Also, it is common for founders to lack a detailed revenue model or a plan for the business. Oftentimes, they will underestimate the capital needed to start the OBL and lack a clear idea about the types of procedures and patients they are catering towards. Another pitfall is not realizing the amount of time investment required. Teri estimates that approximately 10% of a physician's time will be needed to manage the OBL and it is important to take this into account. Finally, a common error is initially hiring individuals not qualified to be administrators, such as family members or trusted individuals. Teri also highlights some of the major reasons physicians consult her company. These challenges often revolve around "people problems," encompassing issues related to both administrative difficulties and employee management. Staffing and retention problems, leading to a significant turnover of employees, are common concerns. She underscores the importance of addressing issues related to physicians themselves, emphasizing that partners must set the tone for the culture within a company. Patient turnover efficiency in OBLs is also a recurring issue. Teri's advice for this issue to closely follow a few patients throughout their entire visit. This will most likely uncover redundancies in the patient experience, many of which the staff might already be aware of, but hesitant to communicate to leadership. As Teri reflects on her experiences, she notes that it typically takes 6-9 months to fully construct and operate an OBL. A comprehensive understanding of healthcare regulations in each state is crucial in the initial development stages. --- RESOURCES Accountable Physician Advisors: https://www.accountablephysicianadvisors.com/ In this episode, host Aaron Fritts is joined by Teri Yates, CEO of Accountable Physician Advisors, who offers essential guidance for successfully establishing and managing Office-Based Labs (OBLs).


---


CHECK OUT OUR SPONSORS


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


Teri started a consulting company after working as a quality and risk officer at a radiology practice for 18 years. As the company rapidly grew, she has worked with many different physician practices and specialities.


We start off the discussion by identifying key pitfalls that Teri sees in OBL ventures. First, it is common for physicians to conduct inadequate due diligence about referral sources, which can be a barrier to effective marketing and patient acquisition. Also, it is common for founders to lack a detailed revenue model or a plan for the business. Oftentimes, they will underestimate the capital needed to start the OBL and lack a clear idea about the types of procedures and patients they are catering towards. Another pitfall is not realizing the amount of time investment required. Teri estimates that approximately 10% of a physician's time will be needed to manage the OBL and it is important to take this into account. Finally, a common error is initially hiring individuals not qualified to be administrators, such as family members or trusted individuals.


Teri also highlights some of the major reasons physicians consult her company. These challenges often revolve around "people problems," encompassing issues related to both administrative difficulties and employee management. Staffing and retention problems, leading to a significant turnover of employees, are common concerns. She underscores the importance of addressing issues related to physicians themselves, emphasizing that partners must set the tone for the culture within a company. Patient turnover efficiency in OBLs is also a recurring issue. Teri's advice for this issue to closely follow a few patients throughout their entire visit. This will most likely uncover redundancies in the patient experience, many of which the staff might already be aware of, but hesitant to communicate to leadership.


As Teri reflects on her experiences, she notes that it typically takes 6-9 months to fully construct and operate an OBL. A comprehensive understanding of healthcare regulations in each state is crucial in the initial development stages.


---


RESOURCES


Accountable Physician Advisors:

https://www.accountablephysicianadvisors.com/

]]> 2634 Ep. 365 Manejo de las Estenosis Benignas en Vía Biliar: Actualización en Stents Biodegradables con Dr. Eva Criado Paredes En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista a la Dra. Eva Criado, radióloga intervencionista del Hospital Parc Taulí de Sabadell, Barcelona, sobre el manejo de las estenosis benignas en vía biliar y los stents biodegradables. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/zVailz --- SHOW NOTES En primer lugar la Dra. Criado explica la clasificación de las estenosis biliares y las diferentes etiologías de las estenosis benignas, como causas iatrogénicas, procesos autoinmunes, inflamatorio-infecciosos, isquémicos o post-transplante hepático. Es crucial saber reconocer este tipo de estenosis y diagnosticar su etiología, ya que su no reconocimiento, o su tratamiento inadecuado deriva en complicaciones con riesgo vital para los pacientes. Las pruebas de imagen como la ecografía, el TC o la RM y colangioRM juegan un papel importante para la detección de estenosis biliares, su precisión diagnóstica y por tanto para su manejo y la planificación prequirúrgica A continuación la Dra. Criado resume las diferentes alterativas terapéuticas para la estenosis biliar benigna, como la cirugía y los tratamientos mínimamente invasivos, tanto endoscópicos como percutáneos, como son la dilatación y la colocación de stents. Ella enfatiza que la decisión sobre qué método utilizar debe de ser valorada de manera individualizada en función de la etiología, tipo y localización de la estenosis y factores de riesgo de cada paciente. Ambas doctoras destacan el hecho de que no existen unas guías de consenso entre las distintas sociedades que faciliten el manejo estandarizado con protocolos para el manejo de esta patología, lo cual sería muy Valioso. Adicionalmente, la Dra. Criado explica las posibilidades terapéuticas que ofrece la radiología intervencionista: la bilioplastia percutánea o dilatación, así como sus resultados y complicaciones, como la alta tasa de re-estenosis. Posteriormente pasa a evaluar los distintos tipos de stents, y específicamente los stents biodegradables, comentando las tasas de éxito técnico en su colocación, su permeabilidad primaria y la baja tasa de complicaciones que han demostrado en estudios multicéntricos a largo plazo, uno de los cuales es el registro Biella, un registro multicéntrico en el que han participado 11 centros españoles. También realiza un resumen de los diferentes tipos de stents biodegradables que hay hoy en día en el mercado y comenta las principales características mecánicas de los mismos. La Dra Criado concluye el episodio comentando su experiencia personal en el tratamiento de estenosis biliares benignas con stents biodegradables dando una serie de consejos prácticos para la liberación de estos stents y para prevenir complicaciones, así como las principales contraindicaciones y el tipo de seguimiento recomendado. También destaca la importancia de valorar cada caso individualmente y tomar decisiones bajo el marco de un equipo multidisciplinar. Finalmente comparte sus predicciones para el futuro de los stents biodegradables. Fri, 15 Sep 2023 05:05:00 -0000 full BackTable En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista a la Dra. Eva Criado, radióloga intervencionista del Hospital Parc Taulí de Sabadell, Barcelona, sobre el manejo de las estenosis benignas en vía biliar y los stents biodegradables. En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista a la Dra. Eva Criado, radióloga intervencionista del Hospital Parc Taulí de Sabadell, Barcelona, sobre el manejo de las estenosis benignas en vía biliar y los stents biodegradables. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/zVailz --- SHOW NOTES En primer lugar la Dra. Criado explica la clasificación de las estenosis biliares y las diferentes etiologías de las estenosis benignas, como causas iatrogénicas, procesos autoinmunes, inflamatorio-infecciosos, isquémicos o post-transplante hepático. Es crucial saber reconocer este tipo de estenosis y diagnosticar su etiología, ya que su no reconocimiento, o su tratamiento inadecuado deriva en complicaciones con riesgo vital para los pacientes. Las pruebas de imagen como la ecografía, el TC o la RM y colangioRM juegan un papel importante para la detección de estenosis biliares, su precisión diagnóstica y por tanto para su manejo y la planificación prequirúrgica A continuación la Dra. Criado resume las diferentes alterativas terapéuticas para la estenosis biliar benigna, como la cirugía y los tratamientos mínimamente invasivos, tanto endoscópicos como percutáneos, como son la dilatación y la colocación de stents. Ella enfatiza que la decisión sobre qué método utilizar debe de ser valorada de manera individualizada en función de la etiología, tipo y localización de la estenosis y factores de riesgo de cada paciente. Ambas doctoras destacan el hecho de que no existen unas guías de consenso entre las distintas sociedades que faciliten el manejo estandarizado con protocolos para el manejo de esta patología, lo cual sería muy Valioso. Adicionalmente, la Dra. Criado explica las posibilidades terapéuticas que ofrece la radiología intervencionista: la bilioplastia percutánea o dilatación, así como sus resultados y complicaciones, como la alta tasa de re-estenosis. Posteriormente pasa a evaluar los distintos tipos de stents, y específicamente los stents biodegradables, comentando las tasas de éxito técnico en su colocación, su permeabilidad primaria y la baja tasa de complicaciones que han demostrado en estudios multicéntricos a largo plazo, uno de los cuales es el registro Biella, un registro multicéntrico en el que han participado 11 centros españoles. También realiza un resumen de los diferentes tipos de stents biodegradables que hay hoy en día en el mercado y comenta las principales características mecánicas de los mismos. La Dra Criado concluye el episodio comentando su experiencia personal en el tratamiento de estenosis biliares benignas con stents biodegradables dando una serie de consejos prácticos para la liberación de estos stents y para prevenir complicaciones, así como las principales contraindicaciones y el tipo de seguimiento recomendado. También destaca la importancia de valorar cada caso individualmente y tomar decisiones bajo el marco de un equipo multidisciplinar. Finalmente comparte sus predicciones para el futuro de los stents biodegradables. En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista a la Dra. Eva Criado, radióloga intervencionista del Hospital Parc Taulí de Sabadell, Barcelona, sobre el manejo de las estenosis benignas en vía biliar y los stents biodegradables.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/zVailz


---


SHOW NOTES


En primer lugar la Dra. Criado explica la clasificación de las estenosis biliares y las diferentes etiologías de las estenosis benignas, como causas iatrogénicas, procesos autoinmunes, inflamatorio-infecciosos, isquémicos o post-transplante hepático. Es crucial saber reconocer este tipo de estenosis y diagnosticar su etiología, ya que su no reconocimiento, o su tratamiento inadecuado deriva en complicaciones con riesgo vital para los pacientes. Las pruebas de imagen como la ecografía, el TC o la RM y colangioRM juegan un papel importante para la detección de estenosis biliares, su precisión diagnóstica y por tanto para su manejo y la planificación prequirúrgica


A continuación la Dra. Criado resume las diferentes alterativas terapéuticas para la estenosis biliar benigna, como la cirugía y los tratamientos mínimamente invasivos, tanto endoscópicos como percutáneos, como son la dilatación y la colocación de stents. Ella enfatiza que la decisión sobre qué método utilizar debe de ser valorada de manera individualizada en función de la etiología, tipo y localización de la estenosis y factores de riesgo de cada paciente. Ambas doctoras destacan el hecho de que no existen unas guías de consenso entre las distintas sociedades que faciliten el manejo estandarizado con protocolos para el manejo de esta patología, lo cual sería muy Valioso.


Adicionalmente, la Dra. Criado explica las posibilidades terapéuticas que ofrece la radiología intervencionista: la bilioplastia percutánea o dilatación, así como sus resultados y complicaciones, como la alta tasa de re-estenosis. Posteriormente pasa a evaluar los distintos tipos de stents, y específicamente los stents biodegradables, comentando las tasas de éxito técnico en su colocación, su permeabilidad primaria y la baja tasa de complicaciones que han demostrado en estudios multicéntricos a largo plazo, uno de los cuales es el registro Biella, un registro multicéntrico en el que han participado 11 centros españoles. También realiza un resumen de los diferentes tipos de stents biodegradables que hay hoy en día en el mercado y comenta las principales características mecánicas de los mismos.


La Dra Criado concluye el episodio comentando su experiencia personal en el tratamiento de estenosis biliares benignas con stents biodegradables dando una serie de consejos prácticos para la liberación de estos stents y para prevenir complicaciones, así como las principales contraindicaciones y el tipo de seguimiento recomendado. También destaca la importancia de valorar cada caso individualmente y tomar decisiones bajo el marco de un equipo multidisciplinar. Finalmente comparte sus predicciones para el futuro de los stents biodegradables.

]]> 2686 Ep. 364 Percutaneous Transmural Arterial Bypass (PTAB) as a Treatment Option for CTOs with Dr. Sean Lyden In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Sean Lyden about percutaneous transarterial bypass (PTAB) with DETOUR, a new therapy for treating occlusive / stenotic superficial femoral artery (SFA) disease. --- CHECK OUT OUR SPONSOR Endologix https://endologix.com/ --- SHOW NOTES Dr. Sean Lyden serves as the Chairman of Vascular Surgery at Cleveland Clinic. Sean starts off the discussion by conveying the severity of SFA chronic total occlusion (CTO) and walks us through what PTAB therapy is. We then cover the steps and general principles of using the DETOUR technology. Throughout the episode, Sean and Sabeen discuss the structure and key takeaways of both the DETOUR 1 and DETOUR 2 trials, held in Europe and the United States respectively. They also cover major questions, such as DVT and PE risk, patency of femoral vein following DETOUR intervention, and overall device cost. We conclude the episode with future directions of the now FDA-approved DETOUR device, and when and how vascular and interventional physicians can incorporate the new technology into their practice. Sean and Sabeen also contrast prior treatment options with the recent DETOUR trials to highlight how longer calcified / occluded SFA lesions now have a viable, effective, and safe endovascular treatment option. --- RESOURCES PTAB with DETOUR System: https://endologix.com/ptab/detour/ DETOUR 1 Trial: https://pubmed.ncbi.nlm.nih.gov/29327570/ DETOUR 1 Trial, 1 year follow-up results: https://pubmed.ncbi.nlm.nih.gov/32276015/ DETOUR 2 Trial, 12 month results: https://www.jvascsurg.org/article/S0741-5214(22)01274-5/fulltext DETOUR 2 Trial, 24 month results from Vascular Annual Conference Presentation: https://www.dicardiology.com/content/endologix-announces-24-month-results-detour-2-study-2023-vascular-annual-meeting Voyager Trial: https://www.nejm.org/doi/full/10.1056/nejmoa2000052 Compass Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1709118 Mon, 11 Sep 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Sean Lyden about percutaneous transarterial bypass (PTAB) with DETOUR, a new therapy for treating occlusive / stenotic superficial femoral artery (SFA) disease. In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Sean Lyden about percutaneous transarterial bypass (PTAB) with DETOUR, a new therapy for treating occlusive / stenotic superficial femoral artery (SFA) disease. --- CHECK OUT OUR SPONSOR Endologix https://endologix.com/ --- SHOW NOTES Dr. Sean Lyden serves as the Chairman of Vascular Surgery at Cleveland Clinic. Sean starts off the discussion by conveying the severity of SFA chronic total occlusion (CTO) and walks us through what PTAB therapy is. We then cover the steps and general principles of using the DETOUR technology. Throughout the episode, Sean and Sabeen discuss the structure and key takeaways of both the DETOUR 1 and DETOUR 2 trials, held in Europe and the United States respectively. They also cover major questions, such as DVT and PE risk, patency of femoral vein following DETOUR intervention, and overall device cost. We conclude the episode with future directions of the now FDA-approved DETOUR device, and when and how vascular and interventional physicians can incorporate the new technology into their practice. Sean and Sabeen also contrast prior treatment options with the recent DETOUR trials to highlight how longer calcified / occluded SFA lesions now have a viable, effective, and safe endovascular treatment option. --- RESOURCES PTAB with DETOUR System: https://endologix.com/ptab/detour/ DETOUR 1 Trial: https://pubmed.ncbi.nlm.nih.gov/29327570/ DETOUR 1 Trial, 1 year follow-up results: https://pubmed.ncbi.nlm.nih.gov/32276015/ DETOUR 2 Trial, 12 month results: https://www.jvascsurg.org/article/S0741-5214(22)01274-5/fulltext DETOUR 2 Trial, 24 month results from Vascular Annual Conference Presentation: https://www.dicardiology.com/content/endologix-announces-24-month-results-detour-2-study-2023-vascular-annual-meeting Voyager Trial: https://www.nejm.org/doi/full/10.1056/nejmoa2000052 Compass Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1709118 In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Sean Lyden about percutaneous transarterial bypass (PTAB) with DETOUR, a new therapy for treating occlusive / stenotic superficial femoral artery (SFA) disease.


---


CHECK OUT OUR SPONSOR


Endologix

https://endologix.com/


---


SHOW NOTES


Dr. Sean Lyden serves as the Chairman of Vascular Surgery at Cleveland Clinic. Sean starts off the discussion by conveying the severity of SFA chronic total occlusion (CTO) and walks us through what PTAB therapy is. We then cover the steps and general principles of using the DETOUR technology.


Throughout the episode, Sean and Sabeen discuss the structure and key takeaways of both the DETOUR 1 and DETOUR 2 trials, held in Europe and the United States respectively. They also cover major questions, such as DVT and PE risk, patency of femoral vein following DETOUR intervention, and overall device cost.


We conclude the episode with future directions of the now FDA-approved DETOUR device, and when and how vascular and interventional physicians can incorporate the new technology into their practice. Sean and Sabeen also contrast prior treatment options with the recent DETOUR trials to highlight how longer calcified / occluded SFA lesions now have a viable, effective, and safe endovascular treatment option.


---


RESOURCES


PTAB with DETOUR System:

https://endologix.com/ptab/detour/


DETOUR 1 Trial:

https://pubmed.ncbi.nlm.nih.gov/29327570/


DETOUR 1 Trial, 1 year follow-up results:

https://pubmed.ncbi.nlm.nih.gov/32276015/


DETOUR 2 Trial, 12 month results:

https://www.jvascsurg.org/article/S0741-5214(22)01274-5/fulltext


DETOUR 2 Trial, 24 month results from Vascular Annual Conference Presentation:

https://www.dicardiology.com/content/endologix-announces-24-month-results-detour-2-study-2023-vascular-annual-meeting


Voyager Trial:

https://www.nejm.org/doi/full/10.1056/nejmoa2000052


Compass Trial:

https://www.nejm.org/doi/full/10.1056/nejmoa1709118

]]> 2154 Ep. 363 Graduating IR Residents: What Jobs Are They Looking For? with Dr. Pranav Moudgil In this episode, host Dr. Aaron Fritts is joined by Dr. Pranav Moudgil, a new IR graduate who has just completed his first IR job search. Today’s discussion revolves around the job landscape for recent interventional radiology graduates. --- CHECK OUT OUR SPONSOR Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/rhaY4i --- SHOW NOTES The episode begins by introducing Pranav, who hails from Michigan and has recently completed his IR training at Beaumont. His discussion on today’s podcast was influenced by the recurring question he faced during his job hunt: “What do candidates like him seek in their careers?” Pranav's job search began in January of his PGY-5 year, 18 months before his graduation. When compared to his initial expectations of a robust job market, reality both did and did not meet these expectations. Pranav found that while there were a lot of job postings online, he was aware that there were just as many, if not more, word-of-mouth job opportunities. During his early training years, Pranav initially thought that he wanted a 100% IR role, but after getting more exposure to DR, he later realized that he wanted a balanced mix of DR and IR. When searching for jobs, Pranav found that many of his interviews came from listings on the ACR job board. However, after seeing the jobs his peers ended up taking, Pranav realized that personal connections played a significant role in job placement for him and his peers. As we delve into the core aspects of Pranav's job search strategy, he emphasizes the importance of being aware of which factors you value most in a job. Pranav also encourages new grads to evaluate job offers in terms of technical staff support and long-term job satisfaction. He advises job seekers to be vigilant for red flags during negotiations and emphasizes the importance of clear communication. The topic of locums tenens work also gets brought up during this discussion, as a means to explore diverse job opportunities before committing to a permanent position. Overalll, for a new IR graduate, Pranav recommends engaging in candid discussions about pay and structural aspects with mentors, understanding personal priorities, and evaluating job offers with a discerning perspective. --- RESOURCES ACR Job Listings: https://jobs.acr.org/ Fri, 08 Sep 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts is joined by Dr. Pranav Moudgil, a new IR graduate who has just completed his first IR job search. Today’s discussion revolves around the job landscape for recent interventional radiology graduates. In this episode, host Dr. Aaron Fritts is joined by Dr. Pranav Moudgil, a new IR graduate who has just completed his first IR job search. Today’s discussion revolves around the job landscape for recent interventional radiology graduates. --- CHECK OUT OUR SPONSOR Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/rhaY4i --- SHOW NOTES The episode begins by introducing Pranav, who hails from Michigan and has recently completed his IR training at Beaumont. His discussion on today’s podcast was influenced by the recurring question he faced during his job hunt: “What do candidates like him seek in their careers?” Pranav's job search began in January of his PGY-5 year, 18 months before his graduation. When compared to his initial expectations of a robust job market, reality both did and did not meet these expectations. Pranav found that while there were a lot of job postings online, he was aware that there were just as many, if not more, word-of-mouth job opportunities. During his early training years, Pranav initially thought that he wanted a 100% IR role, but after getting more exposure to DR, he later realized that he wanted a balanced mix of DR and IR. When searching for jobs, Pranav found that many of his interviews came from listings on the ACR job board. However, after seeing the jobs his peers ended up taking, Pranav realized that personal connections played a significant role in job placement for him and his peers. As we delve into the core aspects of Pranav's job search strategy, he emphasizes the importance of being aware of which factors you value most in a job. Pranav also encourages new grads to evaluate job offers in terms of technical staff support and long-term job satisfaction. He advises job seekers to be vigilant for red flags during negotiations and emphasizes the importance of clear communication. The topic of locums tenens work also gets brought up during this discussion, as a means to explore diverse job opportunities before committing to a permanent position. Overalll, for a new IR graduate, Pranav recommends engaging in candid discussions about pay and structural aspects with mentors, understanding personal priorities, and evaluating job offers with a discerning perspective. --- RESOURCES ACR Job Listings: https://jobs.acr.org/ In this episode, host Dr. Aaron Fritts is joined by Dr. Pranav Moudgil, a new IR graduate who has just completed his first IR job search. Today’s discussion revolves around the job landscape for recent interventional radiology graduates.


---


CHECK OUT OUR SPONSOR


Philips Image Guided Therapy Devices Academy

https://resource.philipseliiteacademy.com


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/rhaY4i


---


SHOW NOTES


The episode begins by introducing Pranav, who hails from Michigan and has recently completed his IR training at Beaumont. His discussion on today’s podcast was influenced by the recurring question he faced during his job hunt: “What do candidates like him seek in their careers?”


Pranav's job search began in January of his PGY-5 year, 18 months before his graduation. When compared to his initial expectations of a robust job market, reality both did and did not meet these expectations. Pranav found that while there were a lot of job postings online, he was aware that there were just as many, if not more, word-of-mouth job opportunities.


During his early training years, Pranav initially thought that he wanted a 100% IR role, but after getting more exposure to DR, he later realized that he wanted a balanced mix of DR and IR. When searching for jobs, Pranav found that many of his interviews came from listings on the ACR job board. However, after seeing the jobs his peers ended up taking, Pranav realized that personal connections played a significant role in job placement for him and his peers.


As we delve into the core aspects of Pranav's job search strategy, he emphasizes the importance of being aware of which factors you value most in a job. Pranav also encourages new grads to evaluate job offers in terms of technical staff support and long-term job satisfaction. He advises job seekers to be vigilant for red flags during negotiations and emphasizes the importance of clear communication.


The topic of locums tenens work also gets brought up during this discussion, as a means to explore diverse job opportunities before committing to a permanent position. Overalll, for a new IR graduate, Pranav recommends engaging in candid discussions about pay and structural aspects with mentors, understanding personal priorities, and evaluating job offers with a discerning perspective.


---


RESOURCES


ACR Job Listings:

https://jobs.acr.org/

]]> 2800 Ep. 362 Catheter Shapes: Basic to Challenging Cases with Dr. Kumar Madassery and Dr. Shelly Bhanot In this episode, host Dr. Aaron Fritts interviews interventional radiologists Dr. Kumar Madassery and Dr. Shelly Bhanot about catheter shapes and when to use each type in basic and challenging cases. --- CHECK OUT OUR SPONSOR Cook Medical https://www.cookmedical.com/vascularaccessbacktable --- SHOW NOTES Kumar serves as an Associate Professor and Director of Peripheral Vascular Interventions/Critical Limb Ischemia and Shelly is a PGY-6 IR resident at Rush University Medical Center in Chicago, IL. Kumar and Shelly walk us through a number of different catheters and techniques, along with tips that they have learned from their experiences in the cath lab. They pair complex and challenging anatomy with catheter types, and they describe their reasoning behind different approaches. After going through case-based examples, both Kumar and Shelly share advice on how trainees can become more familiar with tools on the back table. These include observing supply shelves, asking questions, and learning from IR techs and device representatives. We conclude the episode by emphasizing the power of teaching and how experience is a big factor in becoming more and more familiar with all the catheters that are available to our specialty. Disclaimer: The content, information, opinions and viewpoints contained in this presentation are for educational purposes only. Some opinions expressed may represent those of the speaker and are based on their own clinical experience in their practice. This information is not meant or intended to serve as a substitute for a healthcare professional’s clinical training, experience or judgment. Guest speakers are paid consultants of Cook Medical. Always refer to the Instructions for Use for complete prescribing information including indications for use, warnings, precautions, adverse events and deployment/use instructions. Mon, 04 Sep 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews interventional radiologists Dr. Kumar Madassery and Dr. Shelly Bhanot about catheter shapes and when to use each type in basic and challenging cases. In this episode, host Dr. Aaron Fritts interviews interventional radiologists Dr. Kumar Madassery and Dr. Shelly Bhanot about catheter shapes and when to use each type in basic and challenging cases. --- CHECK OUT OUR SPONSOR Cook Medical https://www.cookmedical.com/vascularaccessbacktable --- SHOW NOTES Kumar serves as an Associate Professor and Director of Peripheral Vascular Interventions/Critical Limb Ischemia and Shelly is a PGY-6 IR resident at Rush University Medical Center in Chicago, IL. Kumar and Shelly walk us through a number of different catheters and techniques, along with tips that they have learned from their experiences in the cath lab. They pair complex and challenging anatomy with catheter types, and they describe their reasoning behind different approaches. After going through case-based examples, both Kumar and Shelly share advice on how trainees can become more familiar with tools on the back table. These include observing supply shelves, asking questions, and learning from IR techs and device representatives. We conclude the episode by emphasizing the power of teaching and how experience is a big factor in becoming more and more familiar with all the catheters that are available to our specialty. Disclaimer: The content, information, opinions and viewpoints contained in this presentation are for educational purposes only. Some opinions expressed may represent those of the speaker and are based on their own clinical experience in their practice. This information is not meant or intended to serve as a substitute for a healthcare professional’s clinical training, experience or judgment. Guest speakers are paid consultants of Cook Medical. Always refer to the Instructions for Use for complete prescribing information including indications for use, warnings, precautions, adverse events and deployment/use instructions. In this episode, host Dr. Aaron Fritts interviews interventional radiologists Dr. Kumar Madassery and Dr. Shelly Bhanot about catheter shapes and when to use each type in basic and challenging cases.


---


CHECK OUT OUR SPONSOR


Cook Medical

https://www.cookmedical.com/vascularaccessbacktable


---


SHOW NOTES


Kumar serves as an Associate Professor and Director of Peripheral Vascular Interventions/Critical Limb Ischemia and Shelly is a PGY-6 IR resident at Rush University Medical Center in Chicago, IL.


Kumar and Shelly walk us through a number of different catheters and techniques, along with tips that they have learned from their experiences in the cath lab. They pair complex and challenging anatomy with catheter types, and they describe their reasoning behind different approaches.


After going through case-based examples, both Kumar and Shelly share advice on how trainees can become more familiar with tools on the back table. These include observing supply shelves, asking questions, and learning from IR techs and device representatives.


We conclude the episode by emphasizing the power of teaching and how experience is a big factor in becoming more and more familiar with all the catheters that are available to our specialty.


Disclaimer: The content, information, opinions and viewpoints contained in this presentation are for educational purposes only. Some opinions expressed may represent those of the speaker and are based on their own clinical experience in their practice. This information is not meant or intended to serve as a substitute for a healthcare professional’s clinical training, experience or judgment. Guest speakers are paid consultants of Cook Medical. Always refer to the Instructions for Use for complete prescribing information including indications for use, warnings, precautions, adverse events and deployment/use instructions.

]]> 3700 Ep. 361 Intra-Arterial and Percutaneous Treatment of Giant Hepatic Hemangiomas with Dr. Jafar Golzarian In this episode, our host Michael Barazza interviews Dr. Jafar Golzarian, interventional radiologist at the University of Minnesota, about intra-arterial and percutaneous treatment of giant hepatic hemangiomas. --- SHOW NOTES We start this episode off by highlighting the Global Embolization Symposium and Technologies (GEST) initiative that Jafar co-founded in 2007. Over time, GEST has evolved into a highly acclaimed conference, drawing an international audience of thousands of participants for its webinars. We then dive into cutting edge treatments of liver hemangiomas. Jafar discussed how he was introduced to a novel approach in 2014 when one of his friends, Dr. Shahram Akhlaghpoor, sent him a paper with his results from using transarterial bleomycin-lipiodol embolization (B/LE) to treat symptomatic giant hepatic hemangiomas. Another friend of Jafar’s shared an inventive approach in shifting perspectives to view hepatic hemangiomas as low-grade venous malformations and using percutaneous injections for treatment. Then, Jafar discusses the specifics of his approach to hepatic hemangiomas and how he usually only treats hemangiomas that are large, cause pain and discomfort, or exert pressure on vital structures such as the portal vein or bile duct. Jafar notes that the patient demographic that presents with hemangiomas are typically women aged 30 to 50, and they can be self-referred or referred by hepatobiliary surgeons. In regards to treatment, Jafar prefers either 30, 45, or 60 units of bleomycin, favoring the latter for hemangiomas exceeding 10 cm. He prefers percutaneous access if feasible, but he resorts to chemoembolization in cases when insurance coverage presents issues. Minor post-treatment symptoms post-treatment include abdominal pain and occasional nausea, with extremely rare compilations being pulmonary fibrosis or allergic reactions to the bleomycin. Jafar notes that imaging at 1, 3, and 6 months post-treatment guides assessment of treatment effectiveness of, with substantial change best evaluated at the 6-month mark. Jafar’s treatment has garnered high patient satisfaction, with very few patients requiring return for further therapy after the 6 months. He notes that when surgeons are shown the before and after imaging of the treatment of hemangiomas, they become big advocates of these procedures. --- RESOURCES Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma: https://pubmed.ncbi.nlm.nih.gov/29922860/ Fri, 01 Sep 2023 05:05:00 -0000 full BackTable In this episode, our host Michael Barazza interviews Dr. Jafar Golzarian, interventional radiologist at the University of Minnesota, about intra-arterial and percutaneous treatment of giant hepatic hemangiomas. In this episode, our host Michael Barazza interviews Dr. Jafar Golzarian, interventional radiologist at the University of Minnesota, about intra-arterial and percutaneous treatment of giant hepatic hemangiomas. --- SHOW NOTES We start this episode off by highlighting the Global Embolization Symposium and Technologies (GEST) initiative that Jafar co-founded in 2007. Over time, GEST has evolved into a highly acclaimed conference, drawing an international audience of thousands of participants for its webinars. We then dive into cutting edge treatments of liver hemangiomas. Jafar discussed how he was introduced to a novel approach in 2014 when one of his friends, Dr. Shahram Akhlaghpoor, sent him a paper with his results from using transarterial bleomycin-lipiodol embolization (B/LE) to treat symptomatic giant hepatic hemangiomas. Another friend of Jafar’s shared an inventive approach in shifting perspectives to view hepatic hemangiomas as low-grade venous malformations and using percutaneous injections for treatment. Then, Jafar discusses the specifics of his approach to hepatic hemangiomas and how he usually only treats hemangiomas that are large, cause pain and discomfort, or exert pressure on vital structures such as the portal vein or bile duct. Jafar notes that the patient demographic that presents with hemangiomas are typically women aged 30 to 50, and they can be self-referred or referred by hepatobiliary surgeons. In regards to treatment, Jafar prefers either 30, 45, or 60 units of bleomycin, favoring the latter for hemangiomas exceeding 10 cm. He prefers percutaneous access if feasible, but he resorts to chemoembolization in cases when insurance coverage presents issues. Minor post-treatment symptoms post-treatment include abdominal pain and occasional nausea, with extremely rare compilations being pulmonary fibrosis or allergic reactions to the bleomycin. Jafar notes that imaging at 1, 3, and 6 months post-treatment guides assessment of treatment effectiveness of, with substantial change best evaluated at the 6-month mark. Jafar’s treatment has garnered high patient satisfaction, with very few patients requiring return for further therapy after the 6 months. He notes that when surgeons are shown the before and after imaging of the treatment of hemangiomas, they become big advocates of these procedures. --- RESOURCES Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma: https://pubmed.ncbi.nlm.nih.gov/29922860/ In this episode, our host Michael Barazza interviews Dr. Jafar Golzarian, interventional radiologist at the University of Minnesota, about intra-arterial and percutaneous treatment of giant hepatic hemangiomas.


---


SHOW NOTES


We start this episode off by highlighting the Global Embolization Symposium and Technologies (GEST) initiative that Jafar co-founded in 2007. Over time, GEST has evolved into a highly acclaimed conference, drawing an international audience of thousands of participants for its webinars.


We then dive into cutting edge treatments of liver hemangiomas. Jafar discussed how he was introduced to a novel approach in 2014 when one of his friends, Dr. Shahram Akhlaghpoor, sent him a paper with his results from using transarterial bleomycin-lipiodol embolization (B/LE) to treat symptomatic giant hepatic hemangiomas. Another friend of Jafar’s shared an inventive approach in shifting perspectives to view hepatic hemangiomas as low-grade venous malformations and using percutaneous injections for treatment.


Then, Jafar discusses the specifics of his approach to hepatic hemangiomas and how he usually only treats hemangiomas that are large, cause pain and discomfort, or exert pressure on vital structures such as the portal vein or bile duct. Jafar notes that the patient demographic that presents with hemangiomas are typically women aged 30 to 50, and they can be self-referred or referred by hepatobiliary surgeons.


In regards to treatment, Jafar prefers either 30, 45, or 60 units of bleomycin, favoring the latter for hemangiomas exceeding 10 cm. He prefers percutaneous access if feasible, but he resorts to chemoembolization in cases when insurance coverage presents issues. Minor post-treatment symptoms post-treatment include abdominal pain and occasional nausea, with extremely rare compilations being pulmonary fibrosis or allergic reactions to the bleomycin. Jafar notes that imaging at 1, 3, and 6 months post-treatment guides assessment of treatment effectiveness of, with substantial change best evaluated at the 6-month mark.


Jafar’s treatment has garnered high patient satisfaction, with very few patients requiring return for further therapy after the 6 months. He notes that when surgeons are shown the before and after imaging of the treatment of hemangiomas, they become big advocates of these procedures.


---


RESOURCES


Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma:

https://pubmed.ncbi.nlm.nih.gov/29922860/

]]> 2393 Ep. 360 Stroke Thrombectomy in Special Populations with Dr. Fawaz Al-Mufti In this episode, guest host and neurointerventional surgeon Dr. Krishna Amuluru interviews triple-boarded neurointerventional surgeon, neurointensivist, and neurologist Dr. Fawaz Al-Mufti about stroke thrombectomy in special populations. --- CHECK OUT OUR SPONSOR MicroVention FRED X https://www.fred-x.com/ --- SHOW NOTES Fawaz serves as an Associate Professor, Director of Neuroendovascular Surgery Fellowship & Neurocritical-Care Unit, Assistant Dean of GME research, and Vice-Chair of Neurology research at New York Medical College, Westchester Medical Center. First, we define the special populations that have been excluded from stroke thrombectomy randomized controlled trials (RCTs). These populations include octogenarian, nonagenarian, pediatric, and pregnant patients. Fawaz then recaps the landmark trials that have shaped the field of neuroendovascular surgery, beginning with the handful that were published in 2015/2016. Approaching mechanical stroke thrombectomy in patients in their 80s and 90s and the lack of existing RCT literature is also discussed. Switching gears, Fawaz then speaks on caring for pediatric patients with large-vessel occlusion (LVO). Krishna and Fawaz cover the relative rarity of pediatric LVOs, significant differences in adult vs. pediatric stroke, and what literature exists to help guide decision-making in this patient population. Krishna then asks Fawaz about mechanical stroke thrombectomy in pregnant patients. They also cover existing literature, etiologies, and their approaches to intervention. To conclude the episode, Fawaz and Krishna speak on the purposes, applications, extrapolations, and limitations of randomized-controlled trials. --- RESOURCES SVIN 2023 Annual Meeting: https://www.svin.org/i4a/pages/index.cfm?pageid=3625 IMS-III Trial 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214300 Mr. Clean Study: https://www.nejm.org/doi/full/10.1056/nejmoa1411587 REVASCAT Study: https://www.nejm.org/doi/full/10.1056/nejmoa1503780 EXTEND-IA Study: https://www.nejm.org/doi/full/10.1056/nejmoa1414792 ESCAPE Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1414905 SWIFT PRIME Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1415061 HERMES Registry: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00351-2/fulltext?rss%3Dyes Thrombolysis in Pediatric Stroke Study (TIPS): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342311/ Delay to Diagnosis in Acute Pediatric Arterial Ischemic Stroke Study: https://www.ahajournals.org/doi/10.1161/strokeaha.108.519066#:~:text=Analysis%20of%20Delay%20in%20Arterial,and%2020%25%20within%206%20hours. Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke Study: https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.036361 Recanalization Treatments for Pediatric Acute Ischemic Stroke in France (Kids-Clot): https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796278 Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke: The Save ChildS Study: https://pubmed.ncbi.nlm.nih.gov/31609380/ Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee: https://jnis.bmj.com/content/14/10/1033 O-039 diameters of large vessels in children and compatibility with adult interventional stroke devices: children are not little adults: https://jnis.bmj.com/content/7/Suppl_1/A21.1 Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and Clinical Outcomes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660626/#bib28 WEB Device from Microvention TERUMO: https://www.microvention.com/products/web-family Mon, 28 Aug 2023 05:05:00 -0000 full BackTable In this episode, guest host and neurointerventional surgeon Dr. Krishna Amuluru interviews triple-boarded neurointerventional surgeon, neurointensivist, and neurologist Dr. Fawaz Al-Mufti about stroke thrombectomy in special populations. In this episode, guest host and neurointerventional surgeon Dr. Krishna Amuluru interviews triple-boarded neurointerventional surgeon, neurointensivist, and neurologist Dr. Fawaz Al-Mufti about stroke thrombectomy in special populations. --- CHECK OUT OUR SPONSOR MicroVention FRED X https://www.fred-x.com/ --- SHOW NOTES Fawaz serves as an Associate Professor, Director of Neuroendovascular Surgery Fellowship & Neurocritical-Care Unit, Assistant Dean of GME research, and Vice-Chair of Neurology research at New York Medical College, Westchester Medical Center. First, we define the special populations that have been excluded from stroke thrombectomy randomized controlled trials (RCTs). These populations include octogenarian, nonagenarian, pediatric, and pregnant patients. Fawaz then recaps the landmark trials that have shaped the field of neuroendovascular surgery, beginning with the handful that were published in 2015/2016. Approaching mechanical stroke thrombectomy in patients in their 80s and 90s and the lack of existing RCT literature is also discussed. Switching gears, Fawaz then speaks on caring for pediatric patients with large-vessel occlusion (LVO). Krishna and Fawaz cover the relative rarity of pediatric LVOs, significant differences in adult vs. pediatric stroke, and what literature exists to help guide decision-making in this patient population. Krishna then asks Fawaz about mechanical stroke thrombectomy in pregnant patients. They also cover existing literature, etiologies, and their approaches to intervention. To conclude the episode, Fawaz and Krishna speak on the purposes, applications, extrapolations, and limitations of randomized-controlled trials. --- RESOURCES SVIN 2023 Annual Meeting: https://www.svin.org/i4a/pages/index.cfm?pageid=3625 IMS-III Trial 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214300 Mr. Clean Study: https://www.nejm.org/doi/full/10.1056/nejmoa1411587 REVASCAT Study: https://www.nejm.org/doi/full/10.1056/nejmoa1503780 EXTEND-IA Study: https://www.nejm.org/doi/full/10.1056/nejmoa1414792 ESCAPE Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1414905 SWIFT PRIME Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1415061 HERMES Registry: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00351-2/fulltext?rss%3Dyes Thrombolysis in Pediatric Stroke Study (TIPS): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342311/ Delay to Diagnosis in Acute Pediatric Arterial Ischemic Stroke Study: https://www.ahajournals.org/doi/10.1161/strokeaha.108.519066#:~:text=Analysis%20of%20Delay%20in%20Arterial,and%2020%25%20within%206%20hours. Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke Study: https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.036361 Recanalization Treatments for Pediatric Acute Ischemic Stroke in France (Kids-Clot): https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796278 Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke: The Save ChildS Study: https://pubmed.ncbi.nlm.nih.gov/31609380/ Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee: https://jnis.bmj.com/content/14/10/1033 O-039 diameters of large vessels in children and compatibility with adult interventional stroke devices: children are not little adults: https://jnis.bmj.com/content/7/Suppl_1/A21.1 Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and Clinical Outcomes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660626/#bib28 WEB Device from Microvention TERUMO: https://www.microvention.com/products/web-family In this episode, guest host and neurointerventional surgeon Dr. Krishna Amuluru interviews triple-boarded neurointerventional surgeon, neurointensivist, and neurologist Dr. Fawaz Al-Mufti about stroke thrombectomy in special populations.


---


CHECK OUT OUR SPONSOR


MicroVention FRED X

https://www.fred-x.com/


---


SHOW NOTES


Fawaz serves as an Associate Professor, Director of Neuroendovascular Surgery Fellowship & Neurocritical-Care Unit, Assistant Dean of GME research, and Vice-Chair of Neurology research at New York Medical College, Westchester Medical Center.


First, we define the special populations that have been excluded from stroke thrombectomy randomized controlled trials (RCTs). These populations include octogenarian, nonagenarian, pediatric, and pregnant patients.


Fawaz then recaps the landmark trials that have shaped the field of neuroendovascular surgery, beginning with the handful that were published in 2015/2016. Approaching mechanical stroke thrombectomy in patients in their 80s and 90s and the lack of existing RCT literature is also discussed.


Switching gears, Fawaz then speaks on caring for pediatric patients with large-vessel occlusion (LVO). Krishna and Fawaz cover the relative rarity of pediatric LVOs, significant differences in adult vs. pediatric stroke, and what literature exists to help guide decision-making in this patient population.


Krishna then asks Fawaz about mechanical stroke thrombectomy in pregnant patients. They also cover existing literature, etiologies, and their approaches to intervention. To conclude the episode, Fawaz and Krishna speak on the purposes, applications, extrapolations, and limitations of randomized-controlled trials.


---


RESOURCES


SVIN 2023 Annual Meeting:

https://www.svin.org/i4a/pages/index.cfm?pageid=3625


IMS-III Trial 2013:

https://www.nejm.org/doi/full/10.1056/nejmoa1214300


Mr. Clean Study:

https://www.nejm.org/doi/full/10.1056/nejmoa1411587


REVASCAT Study:

https://www.nejm.org/doi/full/10.1056/nejmoa1503780


EXTEND-IA Study:

https://www.nejm.org/doi/full/10.1056/nejmoa1414792


ESCAPE Trial:

https://www.nejm.org/doi/full/10.1056/nejmoa1414905


SWIFT PRIME Trial:

https://www.nejm.org/doi/full/10.1056/nejmoa1415061


HERMES Registry:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00351-2/fulltext?rss%3Dyes


Thrombolysis in Pediatric Stroke Study (TIPS):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342311/


Delay to Diagnosis in Acute Pediatric Arterial Ischemic Stroke Study:

https://www.ahajournals.org/doi/10.1161/strokeaha.108.519066#:~:text=Analysis%20of%20Delay%20in%20Arterial,and%2020%25%20within%206%20hours.


Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke Study:

https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.036361


Recanalization Treatments for Pediatric Acute Ischemic Stroke in France (Kids-Clot):

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796278


Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke: The Save ChildS Study:

https://pubmed.ncbi.nlm.nih.gov/31609380/


Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee:

https://jnis.bmj.com/content/14/10/1033


O-039 diameters of large vessels in children and compatibility with adult interventional stroke devices: children are not little adults:

https://jnis.bmj.com/content/7/Suppl_1/A21.1


Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and Clinical Outcomes:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660626/#bib28


WEB Device from Microvention TERUMO:

https://www.microvention.com/products/web-family

]]> 2872 Ep. 359 ¿A Qué Nos Referimos Cuando Hablamos de Multidisciplinariedad? con Dr. Alberto Alonso En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista al Dr. Alberto Alonso, radiólogo intervencionista en la Clínica Universidad de Navarra, sobre la importancia del trabajo multidisciplinar e interdisciplinar en la Radiología intervencionista. --- SHOW NOTES El Dr. Alonso introduce el término de interdisciplinariedad, que ocurre cuando distintas especialidades trabajan de manera combinada para interconectarse y potenciar las ventajas de cada una, con un objetivo común. El Dr Alonso defiende que todas las disciplinas son finitas, y debido a ello, existen puntos ciegos y una ausencia de alternativas si se depende solamente de una especialidad. Fomentar el trabajo en equipo con otras especialidades es importante para los radiólogos intervencionistas porque puede ayudarles, no solo con los procedimientos técnicos, sino también con la parte clínica. En este episodio, se enfatiza la importancia del análisis de los resultados de los procedimientos a corto y largo plazo. Para Alonso, ser autocrítico es importante y recomienda que se elimine la subjetividad en la medida de lo posible. Menciona que los errores y los malosentendidos entre las diferentes especialidades ocurren si no existe comunicación y confianza entre los distintos especialistas: es necesario que nos centremos en el factor humano, más que la reputación o el ego, para construir las relaciones personales, dejando atrás el narcisismo existente en la medicina. Finalmente, se resumen algunos escenarios en los que la interdisciplinariedad puede mejorar el manejo de los pacientes, siendo especialmente importante en pacientes complejos como pacientes pediátricos y oncológicos. El Dr. Alonso termina el episodio animando a los oyentes a fomentar la comunicación con el resto de las especialidades, promover la autocrítica y evaluar los resultados obtenidos, así como impulsar el trabajo interdisciplinar en las diferentes unidades de radiología intervencionista. Fri, 25 Aug 2023 05:05:00 -0000 full BackTable En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista al Dr. Alberto Alonso, radiólogo intervencionista en la Clínica Universidad de Navarra, sobre la importancia del trabajo multidisciplinar e interdisciplinar en la Radiología intervencionista. En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista al Dr. Alberto Alonso, radiólogo intervencionista en la Clínica Universidad de Navarra, sobre la importancia del trabajo multidisciplinar e interdisciplinar en la Radiología intervencionista. --- SHOW NOTES El Dr. Alonso introduce el término de interdisciplinariedad, que ocurre cuando distintas especialidades trabajan de manera combinada para interconectarse y potenciar las ventajas de cada una, con un objetivo común. El Dr Alonso defiende que todas las disciplinas son finitas, y debido a ello, existen puntos ciegos y una ausencia de alternativas si se depende solamente de una especialidad. Fomentar el trabajo en equipo con otras especialidades es importante para los radiólogos intervencionistas porque puede ayudarles, no solo con los procedimientos técnicos, sino también con la parte clínica. En este episodio, se enfatiza la importancia del análisis de los resultados de los procedimientos a corto y largo plazo. Para Alonso, ser autocrítico es importante y recomienda que se elimine la subjetividad en la medida de lo posible. Menciona que los errores y los malosentendidos entre las diferentes especialidades ocurren si no existe comunicación y confianza entre los distintos especialistas: es necesario que nos centremos en el factor humano, más que la reputación o el ego, para construir las relaciones personales, dejando atrás el narcisismo existente en la medicina. Finalmente, se resumen algunos escenarios en los que la interdisciplinariedad puede mejorar el manejo de los pacientes, siendo especialmente importante en pacientes complejos como pacientes pediátricos y oncológicos. El Dr. Alonso termina el episodio animando a los oyentes a fomentar la comunicación con el resto de las especialidades, promover la autocrítica y evaluar los resultados obtenidos, así como impulsar el trabajo interdisciplinar en las diferentes unidades de radiología intervencionista. En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista al Dr. Alberto Alonso, radiólogo intervencionista en la Clínica Universidad de Navarra, sobre la importancia del trabajo multidisciplinar e interdisciplinar en la Radiología intervencionista.


---


SHOW NOTES


El Dr. Alonso introduce el término de interdisciplinariedad, que ocurre cuando distintas especialidades trabajan de manera combinada para interconectarse y potenciar las ventajas de cada una, con un objetivo común. El Dr Alonso defiende que todas las disciplinas son finitas, y debido a ello, existen puntos ciegos y una ausencia de alternativas si se depende solamente de una especialidad. Fomentar el trabajo en equipo con otras especialidades es importante para los radiólogos intervencionistas porque puede ayudarles, no solo con los procedimientos técnicos, sino también con la parte clínica.


En este episodio, se enfatiza la importancia del análisis de los resultados de los procedimientos a corto y largo plazo. Para Alonso, ser autocrítico es importante y recomienda que se elimine la subjetividad en la medida de lo posible. Menciona que los errores y los malosentendidos entre las diferentes especialidades ocurren si no existe comunicación y confianza entre los distintos especialistas: es necesario que nos centremos en el factor humano, más que la reputación o el ego, para construir las relaciones personales, dejando atrás el narcisismo existente en la medicina.


Finalmente, se resumen algunos escenarios en los que la interdisciplinariedad puede mejorar el manejo de los pacientes, siendo especialmente importante en pacientes complejos como pacientes pediátricos y oncológicos. El Dr. Alonso termina el episodio animando a los oyentes a fomentar la comunicación con el resto de las especialidades, promover la autocrítica y evaluar los resultados obtenidos, así como impulsar el trabajo interdisciplinar en las diferentes unidades de radiología intervencionista.

]]> 2417 Ep. 358 IR/NIR Neurosurgery Collaboration: Expanding the Blueprint with Dr. Wayne Olan In this episode, guest host and interventional radiologist Dr. Dana Dunleavy interviews neurointerventional radiologist Dr. Wayne Olan about growing neuroIR and IR through a neurosurgery department. Wayne serves as the Director of Interventional and Endovascular Neurosurgery at George Washington University Medical Center. --- CHECK OUT OUR SPONSOR MicroVention FRED X https://www.fred-x.com/ --- SHOW NOTES First, Wayne tells us more about his training, journey in academia, and role in building robust neuroIR and IR service lines through his leadership of the neurosurgery department at his institution. Wayne also shares how powerful being involved in interdisciplinary clinics can be in growing the scale, reach, and impact of minimally-invasive image guided interventions. These collaborations include neuroIR/neurosurgery for neuro clinic and IR/ gynecology for fibroid clinic. Dana and Wayne then discuss how neuroIR and IR has evolved over the years, highlighting watershed moments and key innovations. They discuss sacroiliac joint interventions in detail and how MSK has become one of IR’s newest subspecialties. Wayne shares his history of playing and coaching lacrosse, and he also tells us about the Q-Collar and his role in serving on the company’s board of medical advisors. The device has been shown to protect the athletes’ brains from concussive and subconcussive impacts by increasing internal jugular vein pressure. We conclude the episode with some parting wisdom from Wayne regarding career paths, navigating reimbursements and insurance as a neuroIR or IR, and finding joy and purpose at and outside of work. --- RESOURCES SI-Bone, iFuse TORQ Device: https://si-bone.com/providers/solutions/trauma/ifuse-torq SI-Bone, iFuse Triangle Device: https://si-bone.com/providers/solutions/ifuse Stryker, Spine Jack Device: https://www.stryker.com/us/en/interventional-spine/products/spinejack-system.html Q-Collar Company web-page: https://q30.com/ Q-Collar Studies / Research Briefing: https://q30.com/pages/fda-reviewed Boston University CTE Clinic: https://www.bu.edu/cte/ Wed, 23 Aug 2023 05:05:00 -0000 full BackTable In this episode, guest host and interventional radiologist Dr. Dana Dunleavy interviews neurointerventional radiologist Dr. Wayne Olan about growing neuroIR and IR through a neurosurgery department. Wayne serves as the Director of Interventional and Endovascular Neurosurgery at George Washington University Medical Center. In this episode, guest host and interventional radiologist Dr. Dana Dunleavy interviews neurointerventional radiologist Dr. Wayne Olan about growing neuroIR and IR through a neurosurgery department. Wayne serves as the Director of Interventional and Endovascular Neurosurgery at George Washington University Medical Center. --- CHECK OUT OUR SPONSOR MicroVention FRED X https://www.fred-x.com/ --- SHOW NOTES First, Wayne tells us more about his training, journey in academia, and role in building robust neuroIR and IR service lines through his leadership of the neurosurgery department at his institution. Wayne also shares how powerful being involved in interdisciplinary clinics can be in growing the scale, reach, and impact of minimally-invasive image guided interventions. These collaborations include neuroIR/neurosurgery for neuro clinic and IR/ gynecology for fibroid clinic. Dana and Wayne then discuss how neuroIR and IR has evolved over the years, highlighting watershed moments and key innovations. They discuss sacroiliac joint interventions in detail and how MSK has become one of IR’s newest subspecialties. Wayne shares his history of playing and coaching lacrosse, and he also tells us about the Q-Collar and his role in serving on the company’s board of medical advisors. The device has been shown to protect the athletes’ brains from concussive and subconcussive impacts by increasing internal jugular vein pressure. We conclude the episode with some parting wisdom from Wayne regarding career paths, navigating reimbursements and insurance as a neuroIR or IR, and finding joy and purpose at and outside of work. --- RESOURCES SI-Bone, iFuse TORQ Device: https://si-bone.com/providers/solutions/trauma/ifuse-torq SI-Bone, iFuse Triangle Device: https://si-bone.com/providers/solutions/ifuse Stryker, Spine Jack Device: https://www.stryker.com/us/en/interventional-spine/products/spinejack-system.html Q-Collar Company web-page: https://q30.com/ Q-Collar Studies / Research Briefing: https://q30.com/pages/fda-reviewed Boston University CTE Clinic: https://www.bu.edu/cte/ In this episode, guest host and interventional radiologist Dr. Dana Dunleavy interviews neurointerventional radiologist Dr. Wayne Olan about growing neuroIR and IR through a neurosurgery department. Wayne serves as the Director of Interventional and Endovascular Neurosurgery at George Washington University Medical Center.


---


CHECK OUT OUR SPONSOR


MicroVention FRED X

https://www.fred-x.com/


---


SHOW NOTES


First, Wayne tells us more about his training, journey in academia, and role in building robust neuroIR and IR service lines through his leadership of the neurosurgery department at his institution. Wayne also shares how powerful being involved in interdisciplinary clinics can be in growing the scale, reach, and impact of minimally-invasive image guided interventions. These collaborations include neuroIR/neurosurgery for neuro clinic and IR/ gynecology for fibroid clinic.


Dana and Wayne then discuss how neuroIR and IR has evolved over the years, highlighting watershed moments and key innovations. They discuss sacroiliac joint interventions in detail and how MSK has become one of IR’s newest subspecialties.


Wayne shares his history of playing and coaching lacrosse, and he also tells us about the Q-Collar and his role in serving on the company’s board of medical advisors. The device has been shown to protect the athletes’ brains from concussive and subconcussive impacts by increasing internal jugular vein pressure.


We conclude the episode with some parting wisdom from Wayne regarding career paths, navigating reimbursements and insurance as a neuroIR or IR, and finding joy and purpose at and outside of work.


---


RESOURCES


SI-Bone, iFuse TORQ Device:

https://si-bone.com/providers/solutions/trauma/ifuse-torq


SI-Bone, iFuse Triangle Device:

https://si-bone.com/providers/solutions/ifuse


Stryker, Spine Jack Device:

https://www.stryker.com/us/en/interventional-spine/products/spinejack-system.html


Q-Collar Company web-page:

https://q30.com/


Q-Collar Studies / Research Briefing:

https://q30.com/pages/fda-reviewed


Boston University CTE Clinic:

https://www.bu.edu/cte/

]]> 4361 Ep. 357 Techs and Tools: The Difference a Great Tech Can Make on Practice and Patients with Lake Odom and Chas Sanders In this episode, host Aaron Fritts is joined by Lake Odom and Chas Sanders. Lake is an IR technologist with over a decade of experience, and Chas is the founder and CEO of MARGIN, a company that handles supply chain and outpatient OBLs and ASCs. They focus on the vital role that techs play in maintaining the culture, workflow, and efficiency in an office-based lab (OBL). --- CHECK OUT OUR SPONSOR Siemens Healthineers https://www.siemens-healthineers.com/ --- SHOW NOTES The episode starts with a discussion on what a team lead should be looking for when hiring a IR or cath lab tech. Lake notes that experience and teamwork skills are essential. However, the willingness to learn can also make up for the lack of experience, especially because experience in one office does not always translate to another practice, since every practice has different needs and procedures. Positive work culture and fair compensation are crucial to employee retention. While the physician plays a large role in defining the culture in a practice, it is also important that IR techs are trusted with the responsibility of maintaining the culture, as their roles are very patient-facing and key in practice efficiency. In the discussion of paying techs on a salary versus an hourly system, Lake notes how a salaried tech is more likely to feel like a part of the team and is more invested in the success of the practice. As the discussion shifts to increasing the efficiency and profitability of a practice, Chas discusses how cost awareness is key. It is vital that the physician engages the techs in this conversation, since they are the ones who order tools. The guests wrap up the episode by emphasizing how putting trust in the techs is crucial to the efficiency and profitability of each practice, as they will be the biggest advocates of the practice to the patients. Mon, 21 Aug 2023 20:21:57 -0000 full BackTable In this episode, host Aaron Fritts is joined by Lake Odom and Chas Sanders. Lake is an IR technologist with over a decade of experience, and Chas is the founder and CEO of MARGIN, a company that handles supply chain and outpatient OBLs and ASCs. They focus on the vital role that techs play in maintaining the culture, workflow, and efficiency in an office-based lab (OBL). In this episode, host Aaron Fritts is joined by Lake Odom and Chas Sanders. Lake is an IR technologist with over a decade of experience, and Chas is the founder and CEO of MARGIN, a company that handles supply chain and outpatient OBLs and ASCs. They focus on the vital role that techs play in maintaining the culture, workflow, and efficiency in an office-based lab (OBL). --- CHECK OUT OUR SPONSOR Siemens Healthineers https://www.siemens-healthineers.com/ --- SHOW NOTES The episode starts with a discussion on what a team lead should be looking for when hiring a IR or cath lab tech. Lake notes that experience and teamwork skills are essential. However, the willingness to learn can also make up for the lack of experience, especially because experience in one office does not always translate to another practice, since every practice has different needs and procedures. Positive work culture and fair compensation are crucial to employee retention. While the physician plays a large role in defining the culture in a practice, it is also important that IR techs are trusted with the responsibility of maintaining the culture, as their roles are very patient-facing and key in practice efficiency. In the discussion of paying techs on a salary versus an hourly system, Lake notes how a salaried tech is more likely to feel like a part of the team and is more invested in the success of the practice. As the discussion shifts to increasing the efficiency and profitability of a practice, Chas discusses how cost awareness is key. It is vital that the physician engages the techs in this conversation, since they are the ones who order tools. The guests wrap up the episode by emphasizing how putting trust in the techs is crucial to the efficiency and profitability of each practice, as they will be the biggest advocates of the practice to the patients. In this episode, host Aaron Fritts is joined by Lake Odom and Chas Sanders. Lake is an IR technologist with over a decade of experience, and Chas is the founder and CEO of MARGIN, a company that handles supply chain and outpatient OBLs and ASCs. They focus on the vital role that techs play in maintaining the culture, workflow, and efficiency in an office-based lab (OBL).


---


CHECK OUT OUR SPONSOR


Siemens Healthineers

https://www.siemens-healthineers.com/


---


SHOW NOTES


The episode starts with a discussion on what a team lead should be looking for when hiring a IR or cath lab tech. Lake notes that experience and teamwork skills are essential. However, the willingness to learn can also make up for the lack of experience, especially because experience in one office does not always translate to another practice, since every practice has different needs and procedures.


Positive work culture and fair compensation are crucial to employee retention. While the physician plays a large role in defining the culture in a practice, it is also important that IR techs are trusted with the responsibility of maintaining the culture, as their roles are very patient-facing and key in practice efficiency. In the discussion of paying techs on a salary versus an hourly system, Lake notes how a salaried tech is more likely to feel like a part of the team and is more invested in the success of the practice.


As the discussion shifts to increasing the efficiency and profitability of a practice, Chas discusses how cost awareness is key. It is vital that the physician engages the techs in this conversation, since they are the ones who order tools. The guests wrap up the episode by emphasizing how putting trust in the techs is crucial to the efficiency and profitability of each practice, as they will be the biggest advocates of the practice to the patients.

]]> 2993 Ep. 356 Digital Marketing Strategies with Dr. Eric DePopas In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Eric DePopas about digital marketing strategies for physicians. Eric is the Co-Founder and Chief Medical Officer of Helped, a company designed to connect patients to IR physicians. --- CHECK OUT OUR SPONSORS Siemens Healthineers https://www.siemens-healthineers.com/ Medtronic Ellipsys Vascular Access System https://www.medtronic.com/ellipsys --- SHOW NOTES To begin the episode, Eric shares his motivations behind starting Helped and the unique story of sharing this undertaking with his brother and co-founder Kevin DePopas. He discusses his uphill battle of marketing IR services and building a strong patient base. Eric also covers differences between digital versus in-person marketing. He emphasizes that the digital world is not a substitute for boots on the ground, and he underscores the importance of building word of mouth through strong clinical work and regularly interacting with referring physicians. Eric also shares valuable digital marketing takeaways and questions to ask marketing agencies. Then, Eric breaks down paid-search (Google), paid-social (Facebook, Instagram, TikTok), and radio marketing strategies. Aaron and Eric discuss how to approach the bottom of the marketing funnel (where potential patients become treated patients), and how to engage and guide patients with interactive online quizzes. Finally, the doctors examine the value of customer relation management systems (CRMS). Eric explains how CRMS is a high fidelity approach to assessing patient knowledge and how it is a key component in building a truly robust funnel. The episode concludes with Eric giving parting advice and encouragement for physicians in the marketing world. --- RESOURCES Helped Website: https://www.tryhelped.com/patient-home Fri, 18 Aug 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Eric DePopas about digital marketing strategies for physicians. Eric is the Co-Founder and Chief Medical Officer of Helped, a company designed to connect patients to IR physicians. In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Eric DePopas about digital marketing strategies for physicians. Eric is the Co-Founder and Chief Medical Officer of Helped, a company designed to connect patients to IR physicians. --- CHECK OUT OUR SPONSORS Siemens Healthineers https://www.siemens-healthineers.com/ Medtronic Ellipsys Vascular Access System https://www.medtronic.com/ellipsys --- SHOW NOTES To begin the episode, Eric shares his motivations behind starting Helped and the unique story of sharing this undertaking with his brother and co-founder Kevin DePopas. He discusses his uphill battle of marketing IR services and building a strong patient base. Eric also covers differences between digital versus in-person marketing. He emphasizes that the digital world is not a substitute for boots on the ground, and he underscores the importance of building word of mouth through strong clinical work and regularly interacting with referring physicians. Eric also shares valuable digital marketing takeaways and questions to ask marketing agencies. Then, Eric breaks down paid-search (Google), paid-social (Facebook, Instagram, TikTok), and radio marketing strategies. Aaron and Eric discuss how to approach the bottom of the marketing funnel (where potential patients become treated patients), and how to engage and guide patients with interactive online quizzes. Finally, the doctors examine the value of customer relation management systems (CRMS). Eric explains how CRMS is a high fidelity approach to assessing patient knowledge and how it is a key component in building a truly robust funnel. The episode concludes with Eric giving parting advice and encouragement for physicians in the marketing world. --- RESOURCES Helped Website: https://www.tryhelped.com/patient-home In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Eric DePopas about digital marketing strategies for physicians. Eric is the Co-Founder and Chief Medical Officer of Helped, a company designed to connect patients to IR physicians.


---


CHECK OUT OUR SPONSORS


Siemens Healthineers

https://www.siemens-healthineers.com/


Medtronic Ellipsys Vascular Access System

https://www.medtronic.com/ellipsys


---


SHOW NOTES


To begin the episode, Eric shares his motivations behind starting Helped and the unique story of sharing this undertaking with his brother and co-founder Kevin DePopas. He discusses his uphill battle of marketing IR services and building a strong patient base.


Eric also covers differences between digital versus in-person marketing. He emphasizes that the digital world is not a substitute for boots on the ground, and he underscores the importance of building word of mouth through strong clinical work and regularly interacting with referring physicians. Eric also shares valuable digital marketing takeaways and questions to ask marketing agencies.


Then, Eric breaks down paid-search (Google), paid-social (Facebook, Instagram, TikTok), and radio marketing strategies. Aaron and Eric discuss how to approach the bottom of the marketing funnel (where potential patients become treated patients), and how to engage and guide patients with interactive online quizzes.


Finally, the doctors examine the value of customer relation management systems (CRMS). Eric explains how CRMS is a high fidelity approach to assessing patient knowledge and how it is a key component in building a truly robust funnel. The episode concludes with Eric giving parting advice and encouragement for physicians in the marketing world.


---


RESOURCES


Helped Website:

https://www.tryhelped.com/patient-home

]]> 3459 Ep. 355 Update on EndoAVF Creation with Dr. Neghae Mawla In this episode, interventional nephrologist Dr. Neghae Mawla discusses endovascular AV fistula creation with our host Dr. Christopher Beck. --- CHECK OUT OUR SPONSOR BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html --- SHOW NOTES We start off the episode by discussing Neghae’s current practice at Dallas Nephrology Associates, where most of his patient referrals come from his partners. Patients who come to see Neghae receive a standard vein mapping via ultrasound to determine whether they should receive an endovascular or a surgical procedure. If patients’ veins fit certain specifications, such as superficial location (cephalic, median cubital), large enough size (2-2.5 mm) and presence of large perforating veins (2 mm), then they are better candidates for an endovascular approach. However, these rules do not perfectly predict fistula success. Neghae noticed that even if patients fit the above criteria, their fistulas don’t always mature correctly. With experience, he began to take into consideration the brachial vein size as well. While this is not part of the official vein mapping criteria, he has seen that if the brachial vein is significantly larger than the superficial veins, it could have a competitive outflow and hinder the maturation of the fistula. The conversation then shifts to the types of devices used to create the anastomosis for the fistulas, WavelinQ and Ellipsys. Neghae notes that while most patients do well with either device, some patients do better with one over the other. Thus, he suggests that physicians are trained on both devices if possible, to guarantee the best outcomes. To end the episode, Neghae reflects on his previous decade of experience with endovascular AV fistulas and shares wisdom about failures and successes that he has learned from. --- RESOURCES ASDIN White Paper: Management of cephalic arch stenosis endorsed by the American Society of Diagnostic and Interventional Nephrology: https://cdn.ymaws.com/www.asdin.org/resource/resmgr/positionpaper/Cephalic_Arch.pdf ASDIN White Paper: Patient selection, education, and cannulation of percutaneous arteriovenous fistulae: https://cdn.ymaws.com/www.asdin.org/resource/resmgr/positionpaper/ASDIN_EndoAVF.pdf ASDIN Certification ink: https://www.asdin.org/page/pAVFCert Mon, 14 Aug 2023 05:05:00 -0000 full BackTable In this episode, interventional nephrologist Dr. Neghae Mawla discusses with our host Dr. Christopher Beck about endovascular AV fistula creation. In this episode, interventional nephrologist Dr. Neghae Mawla discusses endovascular AV fistula creation with our host Dr. Christopher Beck. --- CHECK OUT OUR SPONSOR BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html --- SHOW NOTES We start off the episode by discussing Neghae’s current practice at Dallas Nephrology Associates, where most of his patient referrals come from his partners. Patients who come to see Neghae receive a standard vein mapping via ultrasound to determine whether they should receive an endovascular or a surgical procedure. If patients’ veins fit certain specifications, such as superficial location (cephalic, median cubital), large enough size (2-2.5 mm) and presence of large perforating veins (2 mm), then they are better candidates for an endovascular approach. However, these rules do not perfectly predict fistula success. Neghae noticed that even if patients fit the above criteria, their fistulas don’t always mature correctly. With experience, he began to take into consideration the brachial vein size as well. While this is not part of the official vein mapping criteria, he has seen that if the brachial vein is significantly larger than the superficial veins, it could have a competitive outflow and hinder the maturation of the fistula. The conversation then shifts to the types of devices used to create the anastomosis for the fistulas, WavelinQ and Ellipsys. Neghae notes that while most patients do well with either device, some patients do better with one over the other. Thus, he suggests that physicians are trained on both devices if possible, to guarantee the best outcomes. To end the episode, Neghae reflects on his previous decade of experience with endovascular AV fistulas and shares wisdom about failures and successes that he has learned from. --- RESOURCES ASDIN White Paper: Management of cephalic arch stenosis endorsed by the American Society of Diagnostic and Interventional Nephrology: https://cdn.ymaws.com/www.asdin.org/resource/resmgr/positionpaper/Cephalic_Arch.pdf ASDIN White Paper: Patient selection, education, and cannulation of percutaneous arteriovenous fistulae: https://cdn.ymaws.com/www.asdin.org/resource/resmgr/positionpaper/ASDIN_EndoAVF.pdf ASDIN Certification ink: https://www.asdin.org/page/pAVFCert In this episode, interventional nephrologist Dr. Neghae Mawla discusses endovascular AV fistula creation with our host Dr. Christopher Beck.


---


CHECK OUT OUR SPONSOR


BD Advance Clinical Training & Education Program

https://page.bd.com/Advance-Training-Program_Homepage.html


---


SHOW NOTES


We start off the episode by discussing Neghae’s current practice at Dallas Nephrology Associates, where most of his patient referrals come from his partners. Patients who come to see Neghae receive a standard vein mapping via ultrasound to determine whether they should receive an endovascular or a surgical procedure. If patients’ veins fit certain specifications, such as superficial location (cephalic, median cubital), large enough size (2-2.5 mm) and presence of large perforating veins (2 mm), then they are better candidates for an endovascular approach.


However, these rules do not perfectly predict fistula success. Neghae noticed that even if patients fit the above criteria, their fistulas don’t always mature correctly. With experience, he began to take into consideration the brachial vein size as well. While this is not part of the official vein mapping criteria, he has seen that if the brachial vein is significantly larger than the superficial veins, it could have a competitive outflow and hinder the maturation of the fistula.


The conversation then shifts to the types of devices used to create the anastomosis for the fistulas, WavelinQ and Ellipsys. Neghae notes that while most patients do well with either device, some patients do better with one over the other. Thus, he suggests that physicians are trained on both devices if possible, to guarantee the best outcomes. To end the episode, Neghae reflects on his previous decade of experience with endovascular AV fistulas and shares wisdom about failures and successes that he has learned from.


---


RESOURCES


ASDIN White Paper: Management of cephalic arch stenosis endorsed by the American Society of Diagnostic and Interventional Nephrology:

https://cdn.ymaws.com/www.asdin.org/resource/resmgr/positionpaper/Cephalic_Arch.pdf


ASDIN White Paper: Patient selection, education, and cannulation of percutaneous arteriovenous fistulae:

https://cdn.ymaws.com/www.asdin.org/resource/resmgr/positionpaper/ASDIN_EndoAVF.pdf


ASDIN Certification ink:

https://www.asdin.org/page/pAVFCert

]]> 4286 Ep. 354 Discussing Social Media Ethics with Dr. Eric Keller In this episode, co-hosts Dr. Aaron Fritts, Dr. Michael Barraza, and Dr. Eric J. Keller discuss social media ethics in medicine. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES To kick-off the episode, the three IR physicians discuss “clot porn” and all the debate associated with posting case-related findings (clots, imaging, etc) on social media with device/company name visible. Dr. Keller, who has a strong background in medical ethics, shares his thoughts on the matter and underscores the 6 pitfalls of medical social media: patient privacy, patient dignity, information accuracy, conflict of interest, justice inequity, and interprofessional respect. From Dr. Keller, we learn that the crux of the matter tends to circle back to two central issues– how the case is shared and intentions behind sharing. Additionally, Dr. Keller shares unique data on the relation between how often a medical device company is mentioned in social media posts, how often physicians are compensated for their public endorsements, and whether or not conflict of interests are disclosed. Dr. Barraza and Dr. Keller then compare TikTok, Instagram, and Twitter’s roles and potentials in medicine. The trio discuss Twitter’s past, present, and future influences on medical research, networking, innovation, and education. They also consider the need for more clear, comprehensive social media posting guidelines issued by specialty societies and ideas for patient consent forms over social media posting. To wrap up the episode, the doctors discuss interprofessionalism, dealing with social media trolls/negativity, and personal vs. professional accounts. Dr. Keller notes that 85% of the general public turns to social media networks to seek healthcare information, which highlights the online presence of physicians and how they are often held to a higher ethical standard on social media platforms. For listeners wanting to learn more about social media ethics in medicine, the annual Western Angiographic Interventional Society (WAIS) in Palm Springs, California (October 7-11, 2023) will have dedicated medical social media ethics panels and discussions built into programming. Be sure to register and attend! Link to the WAIS webpage below. --- RESOURCES Western Angio Interventional Symposium 2023 Schedule: https://www.westernangio.org/ Western Angio Interventional Symposium 2023 Registration: https://www.westernangio.org/event-5048807 Link to Thomas Webb study: https://www.jvir.org/article/S1051-0443(22)01727-4/fulltext CMS Sunshine Database: https://openpaymentsdata.cms.gov/ Fri, 11 Aug 2023 05:05:00 -0000 full BackTable In this episode, co-hosts Dr. Aaron Fritts, Dr. Michael Barraza, and Dr. Eric J. Keller discuss social media ethics in medicine. In this episode, co-hosts Dr. Aaron Fritts, Dr. Michael Barraza, and Dr. Eric J. Keller discuss social media ethics in medicine. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES To kick-off the episode, the three IR physicians discuss “clot porn” and all the debate associated with posting case-related findings (clots, imaging, etc) on social media with device/company name visible. Dr. Keller, who has a strong background in medical ethics, shares his thoughts on the matter and underscores the 6 pitfalls of medical social media: patient privacy, patient dignity, information accuracy, conflict of interest, justice inequity, and interprofessional respect. From Dr. Keller, we learn that the crux of the matter tends to circle back to two central issues– how the case is shared and intentions behind sharing. Additionally, Dr. Keller shares unique data on the relation between how often a medical device company is mentioned in social media posts, how often physicians are compensated for their public endorsements, and whether or not conflict of interests are disclosed. Dr. Barraza and Dr. Keller then compare TikTok, Instagram, and Twitter’s roles and potentials in medicine. The trio discuss Twitter’s past, present, and future influences on medical research, networking, innovation, and education. They also consider the need for more clear, comprehensive social media posting guidelines issued by specialty societies and ideas for patient consent forms over social media posting. To wrap up the episode, the doctors discuss interprofessionalism, dealing with social media trolls/negativity, and personal vs. professional accounts. Dr. Keller notes that 85% of the general public turns to social media networks to seek healthcare information, which highlights the online presence of physicians and how they are often held to a higher ethical standard on social media platforms. For listeners wanting to learn more about social media ethics in medicine, the annual Western Angiographic Interventional Society (WAIS) in Palm Springs, California (October 7-11, 2023) will have dedicated medical social media ethics panels and discussions built into programming. Be sure to register and attend! Link to the WAIS webpage below. --- RESOURCES Western Angio Interventional Symposium 2023 Schedule: https://www.westernangio.org/ Western Angio Interventional Symposium 2023 Registration: https://www.westernangio.org/event-5048807 Link to Thomas Webb study: https://www.jvir.org/article/S1051-0443(22)01727-4/fulltext CMS Sunshine Database: https://openpaymentsdata.cms.gov/ In this episode, co-hosts Dr. Aaron Fritts, Dr. Michael Barraza, and Dr. Eric J. Keller discuss social media ethics in medicine.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


To kick-off the episode, the three IR physicians discuss “clot porn” and all the debate associated with posting case-related findings (clots, imaging, etc) on social media with device/company name visible. Dr. Keller, who has a strong background in medical ethics, shares his thoughts on the matter and underscores the 6 pitfalls of medical social media: patient privacy, patient dignity, information accuracy, conflict of interest, justice inequity, and interprofessional respect.


From Dr. Keller, we learn that the crux of the matter tends to circle back to two central issues– how the case is shared and intentions behind sharing. Additionally, Dr. Keller shares unique data on the relation between how often a medical device company is mentioned in social media posts, how often physicians are compensated for their public endorsements, and whether or not conflict of interests are disclosed.


Dr. Barraza and Dr. Keller then compare TikTok, Instagram, and Twitter’s roles and potentials in medicine. The trio discuss Twitter’s past, present, and future influences on medical research, networking, innovation, and education. They also consider the need for more clear, comprehensive social media posting guidelines issued by specialty societies and ideas for patient consent forms over social media posting.


To wrap up the episode, the doctors discuss interprofessionalism, dealing with social media trolls/negativity, and personal vs. professional accounts. Dr. Keller notes that 85% of the general public turns to social media networks to seek healthcare information, which highlights the online presence of physicians and how they are often held to a higher ethical standard on social media platforms.


For listeners wanting to learn more about social media ethics in medicine, the annual Western Angiographic Interventional Society (WAIS) in Palm Springs, California (October 7-11, 2023) will have dedicated medical social media ethics panels and discussions built into programming. Be sure to register and attend! Link to the WAIS webpage below.


---


RESOURCES


Western Angio Interventional Symposium 2023 Schedule:

https://www.westernangio.org/


Western Angio Interventional Symposium 2023 Registration:

https://www.westernangio.org/event-5048807


Link to Thomas Webb study:

https://www.jvir.org/article/S1051-0443(22)01727-4/fulltext


CMS Sunshine Database:

https://openpaymentsdata.cms.gov/

]]> 2792 Ep. 353 MicroCT for PAD: What You Need to Know with Dr. John Rundback In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback about analysis of arterial calcifications using microCT. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES Dr. Rundback starts by describing the basic differences between microCT and current imaging techniques. MicroCT is a non-destructive imaging method where the x-ray source is stationary but the subject is on a rotating stage. This method can create 3D imaging with a 3 to 5 micron resolution. On the other hand, in traditional CT imaging, the subject is stationary and the x-ray source rotates, which gives a 3 to 5 millimeter resolution. Then, the episode shifts to a discussion on Dr. Rundback’s recent study, in which he used microCT to evaluate the treatment effect of medial arterial calcification in below knee interventions after Auryon laser atherectomy. For this study, arteries were dissected out of cadavers with cardiac risk factors. These artery segments were then subject to different energies from the Auryon laser. MicroCT was performed before and after the procedure to analyze the degree of calcification. These trials have shown that atherectomy using the Auryon laser could increase compliance of the treated arteries. MicroCT has also helped expand knowledge about different types of calcification and how atherectomy differentially impacts them. --- RESOURCES Treatment effect of medial arterial calcification in below-knee after Auryon laser atherectomy using micro-CT and histologic evaluation: https://pubmed.ncbi.nlm.nih.gov/37400346/ Auryon Atherectomy Device: https://www.angiodynamics.com/product/auryon/ Mon, 07 Aug 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback about analysis of arterial calcifications using microCT. In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback about analysis of arterial calcifications using microCT. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES Dr. Rundback starts by describing the basic differences between microCT and current imaging techniques. MicroCT is a non-destructive imaging method where the x-ray source is stationary but the subject is on a rotating stage. This method can create 3D imaging with a 3 to 5 micron resolution. On the other hand, in traditional CT imaging, the subject is stationary and the x-ray source rotates, which gives a 3 to 5 millimeter resolution. Then, the episode shifts to a discussion on Dr. Rundback’s recent study, in which he used microCT to evaluate the treatment effect of medial arterial calcification in below knee interventions after Auryon laser atherectomy. For this study, arteries were dissected out of cadavers with cardiac risk factors. These artery segments were then subject to different energies from the Auryon laser. MicroCT was performed before and after the procedure to analyze the degree of calcification. These trials have shown that atherectomy using the Auryon laser could increase compliance of the treated arteries. MicroCT has also helped expand knowledge about different types of calcification and how atherectomy differentially impacts them. --- RESOURCES Treatment effect of medial arterial calcification in below-knee after Auryon laser atherectomy using micro-CT and histologic evaluation: https://pubmed.ncbi.nlm.nih.gov/37400346/ Auryon Atherectomy Device: https://www.angiodynamics.com/product/auryon/ In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback about analysis of arterial calcifications using microCT.


---


CHECK OUT OUR SPONSOR


AngioDynamics Auryon System

https://www.auryon-system.com/


---


SHOW NOTES


Dr. Rundback starts by describing the basic differences between microCT and current imaging techniques. MicroCT is a non-destructive imaging method where the x-ray source is stationary but the subject is on a rotating stage. This method can create 3D imaging with a 3 to 5 micron resolution. On the other hand, in traditional CT imaging, the subject is stationary and the x-ray source rotates, which gives a 3 to 5 millimeter resolution.


Then, the episode shifts to a discussion on Dr. Rundback’s recent study, in which he used microCT to evaluate the treatment effect of medial arterial calcification in below knee interventions after Auryon laser atherectomy. For this study, arteries were dissected out of cadavers with cardiac risk factors. These artery segments were then subject to different energies from the Auryon laser. MicroCT was performed before and after the procedure to analyze the degree of calcification. These trials have shown that atherectomy using the Auryon laser could increase compliance of the treated arteries. MicroCT has also helped expand knowledge about different types of calcification and how atherectomy differentially impacts them.


---


RESOURCES


Treatment effect of medial arterial calcification in below-knee after Auryon laser atherectomy using micro-CT and histologic evaluation:

https://pubmed.ncbi.nlm.nih.gov/37400346/


Auryon Atherectomy Device:

https://www.angiodynamics.com/product/auryon/

]]> 1963 Ep. 352 Early Career Challenges with Dr. Sean Maratto and Dr. Junjian Huang In this episode, host Dr. Aaron Fritts interviews Dr. Junjian Huang & Dr. Sean Maratto on navigating early-career changes. Both Dr. Huang and Dr. Maratto touch on a range of their early-career experiences and offer their advice, insights, and realizations. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/9clNvR --- SHOW NOTES The trio begin by discussing the responsibilities of stepping up as new attendings and dive into all that goes into maintaining and building new service-lines. Both Dr. Huang and Dr. Maratto underscore the importance of being as available as possible, taking every brick and mortar case with enthusiasm and drive, and truly getting to know your referring physicians. These actions go a long way in successfully establishing and expanding IR service-lines. Dr. Huang and Dr. Maratto also speak on the nuances of cultural awareness and sensitivity, as every region, hospital, and/or practice does not operate in the same fashion. Both early-career physicians convey the gravity of quickly adapting to the cultural norms of a new workplace and becoming comfortable in new environments. Dr. Maratto adds how conflict resolution is a mainstay throughout all career stages and highlights leadership and clear communication as vital qualities. We then hear about the ins-and-outs of early-career mentorship from both physicians. Dr. Huang states how some of the most pivotal mentors can be from different fields, to always search for mentors, and to even make mentors through industry. Dr. Maratto shares how it is important to have mentors for both professional and emotional support and to always pay it forward to the next-generation of physicians and trainees. Dr. Fritts, Dr. Huang, and Dr. Maratto share a real-time mentorship moment and have a conversation on how becoming an attending can be accompanied by extremely important life milestones such as getting married, starting a family, buying a house, and more. We conclude the episode by discussing some challenges new attendings can face, such as navigating the business-side of medicine and becoming confident in marketing, insurance, and billing. Both early-career physicians agree how these tasks should not be delegated, as they are very worth knowing. Dr. Juang and Dr. Maratto leave us with important parting advice on what they wish they were told when they finished training and became attending physicians. --- RESOURCES Early Career Section (ECS) of SIR: https://www.sirweb.org/member-central/volunteer/early-career-section2/ Fri, 04 Aug 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Junjian Huang & Dr. Sean Maratto on navigating early-career changes. Both Dr. Huang and Dr. Maratto touch on a range of their early-career experiences and offer their advice, insights, and realizations. In this episode, host Dr. Aaron Fritts interviews Dr. Junjian Huang & Dr. Sean Maratto on navigating early-career changes. Both Dr. Huang and Dr. Maratto touch on a range of their early-career experiences and offer their advice, insights, and realizations. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/9clNvR --- SHOW NOTES The trio begin by discussing the responsibilities of stepping up as new attendings and dive into all that goes into maintaining and building new service-lines. Both Dr. Huang and Dr. Maratto underscore the importance of being as available as possible, taking every brick and mortar case with enthusiasm and drive, and truly getting to know your referring physicians. These actions go a long way in successfully establishing and expanding IR service-lines. Dr. Huang and Dr. Maratto also speak on the nuances of cultural awareness and sensitivity, as every region, hospital, and/or practice does not operate in the same fashion. Both early-career physicians convey the gravity of quickly adapting to the cultural norms of a new workplace and becoming comfortable in new environments. Dr. Maratto adds how conflict resolution is a mainstay throughout all career stages and highlights leadership and clear communication as vital qualities. We then hear about the ins-and-outs of early-career mentorship from both physicians. Dr. Huang states how some of the most pivotal mentors can be from different fields, to always search for mentors, and to even make mentors through industry. Dr. Maratto shares how it is important to have mentors for both professional and emotional support and to always pay it forward to the next-generation of physicians and trainees. Dr. Fritts, Dr. Huang, and Dr. Maratto share a real-time mentorship moment and have a conversation on how becoming an attending can be accompanied by extremely important life milestones such as getting married, starting a family, buying a house, and more. We conclude the episode by discussing some challenges new attendings can face, such as navigating the business-side of medicine and becoming confident in marketing, insurance, and billing. Both early-career physicians agree how these tasks should not be delegated, as they are very worth knowing. Dr. Juang and Dr. Maratto leave us with important parting advice on what they wish they were told when they finished training and became attending physicians. --- RESOURCES Early Career Section (ECS) of SIR: https://www.sirweb.org/member-central/volunteer/early-career-section2/ In this episode, host Dr. Aaron Fritts interviews Dr. Junjian Huang & Dr. Sean Maratto on navigating early-career changes. Both Dr. Huang and Dr. Maratto touch on a range of their early-career experiences and offer their advice, insights, and realizations.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/9clNvR


---


SHOW NOTES


The trio begin by discussing the responsibilities of stepping up as new attendings and dive into all that goes into maintaining and building new service-lines. Both Dr. Huang and Dr. Maratto underscore the importance of being as available as possible, taking every brick and mortar case with enthusiasm and drive, and truly getting to know your referring physicians. These actions go a long way in successfully establishing and expanding IR service-lines.


Dr. Huang and Dr. Maratto also speak on the nuances of cultural awareness and sensitivity, as every region, hospital, and/or practice does not operate in the same fashion. Both early-career physicians convey the gravity of quickly adapting to the cultural norms of a new workplace and becoming comfortable in new environments. Dr. Maratto adds how conflict resolution is a mainstay throughout all career stages and highlights leadership and clear communication as vital qualities.


We then hear about the ins-and-outs of early-career mentorship from both physicians. Dr. Huang states how some of the most pivotal mentors can be from different fields, to always search for mentors, and to even make mentors through industry. Dr. Maratto shares how it is important to have mentors for both professional and emotional support and to always pay it forward to the next-generation of physicians and trainees.


Dr. Fritts, Dr. Huang, and Dr. Maratto share a real-time mentorship moment and have a conversation on how becoming an attending can be accompanied by extremely important life milestones such as getting married, starting a family, buying a house, and more.


We conclude the episode by discussing some challenges new attendings can face, such as navigating the business-side of medicine and becoming confident in marketing, insurance, and billing. Both early-career physicians agree how these tasks should not be delegated, as they are very worth knowing. Dr. Juang and Dr. Maratto leave us with important parting advice on what they wish they were told when they finished training and became attending physicians.


---


RESOURCES


Early Career Section (ECS) of SIR:

https://www.sirweb.org/member-central/volunteer/early-career-section2/

]]> 3157 Ep. 351 Discussing the Recent NYT Article with Dr. Frank Arko and Dr. Saher Sabri In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Saher Sabri and vascular surgeon Dr. Frank Arko about their perspectives on a July 2023 New York Times article about the ethics of peripheral arterial disease (PAD) treatment in outpatient based labs (OBLs) and ambulatory surgery centers (ASCs). --- SHOW NOTES Dr. Arko emphasizes the importance of approaching articles as an unbiased reader. He acknowledges that sensationalism in the news is common, and while bad actors do exist, he personally knows talented OBL/ASC practitioners. He also notes that the article fails to mention that the majority of these practitioners follow society guidelines to provide appropriate and effective treatment for their patients, rather than prioritizing financial gain. He believes that most non-surgical specialists have the clinical insight to know when patients would be better candidates for open bypasses as opposed to endovascular interventions. Dr. Arko describes the split response to the article within vascular surgeons on social media, based on their personal philosophies of open versus endovascular interventions for PAD. Dr. Sabri believes that PAD and critical limb-threatening ischemia (CLTI) are not very well known by the general public, this article was a missed opportunity to bring attention to these conditions and disparities in treatments depending on patients’ geographic locations and ethnicities. The article may have the effect of scaring patients away from seeking treatment for PAD and CLTI, as well as receiving care at OBLs, which were originally founded to make interventions more efficient and patient-friendly. Additionally, the article could foster divisiveness between vascular surgeons, interventional radiologists, and interventional cardiologists and as a result, increase barriers to collaboration. It is important to differentiate between PAD and CLTI and the stage at which patients present to medical care. Limb salvage rates and decisions to intervene and/or amputate are multifactorial and are not as straightforward as the article may imply. Both doctors agree that specialty societies share the responsibility of monitoring their members for overuse of interventions. In terms of rebates and volume discounts from device companies, the doctors discuss the ethics of cost savings that benefit a hospital system versus savings that benefit a physician-owned OBL. Dr. Arko recognizes that financing an OBL with device company partnerships can be a smart business decision if devices are used appropriately and only when indicated. He speaks about the need for societies to support more randomized control trials that compare the effectiveness of each atherectomy device. We also discuss implications for insurance coverage of PAD/CLTI interventions. Dr. Sabri believes that it is unfortunate when insurance companies become the decision-maker of patient treatments. --- RESOURCES “They Lost Their Legs. Doctors and Health Giants Profited” (NY Times, July 2023 article): https://www.nytimes.com/2023/07/15/health/atherectomy-peripheral-artery-disease.html BEST-CLI: https://www.bestcli.com/ “Blocked Artery in Your Leg? Here’s What You Should Know” (ProPublica, June 2023 article) https://www.propublica.org/article/what-to-know-about-peripheral-artery-disease Outpatient Endovascular Interventional Society (OEIS): https://oeisweb.com/ Society of Vascular Surgery (SVS) Position Statement: https://vascular.org/news-advocacy/articles-press-releases/svs-response-new-york-times-article-overuse-interventions Wed, 02 Aug 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Saher Sabri and vascular surgeon Dr. Frank Arko about their perspectives on a July 2023 New York Times article about the ethics of peripheral arterial disease (PAD) treatment in outpatient based labs (OBLs) and ambulatory surgery centers (ASCs). In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Saher Sabri and vascular surgeon Dr. Frank Arko about their perspectives on a July 2023 New York Times article about the ethics of peripheral arterial disease (PAD) treatment in outpatient based labs (OBLs) and ambulatory surgery centers (ASCs). --- SHOW NOTES Dr. Arko emphasizes the importance of approaching articles as an unbiased reader. He acknowledges that sensationalism in the news is common, and while bad actors do exist, he personally knows talented OBL/ASC practitioners. He also notes that the article fails to mention that the majority of these practitioners follow society guidelines to provide appropriate and effective treatment for their patients, rather than prioritizing financial gain. He believes that most non-surgical specialists have the clinical insight to know when patients would be better candidates for open bypasses as opposed to endovascular interventions. Dr. Arko describes the split response to the article within vascular surgeons on social media, based on their personal philosophies of open versus endovascular interventions for PAD. Dr. Sabri believes that PAD and critical limb-threatening ischemia (CLTI) are not very well known by the general public, this article was a missed opportunity to bring attention to these conditions and disparities in treatments depending on patients’ geographic locations and ethnicities. The article may have the effect of scaring patients away from seeking treatment for PAD and CLTI, as well as receiving care at OBLs, which were originally founded to make interventions more efficient and patient-friendly. Additionally, the article could foster divisiveness between vascular surgeons, interventional radiologists, and interventional cardiologists and as a result, increase barriers to collaboration. It is important to differentiate between PAD and CLTI and the stage at which patients present to medical care. Limb salvage rates and decisions to intervene and/or amputate are multifactorial and are not as straightforward as the article may imply. Both doctors agree that specialty societies share the responsibility of monitoring their members for overuse of interventions. In terms of rebates and volume discounts from device companies, the doctors discuss the ethics of cost savings that benefit a hospital system versus savings that benefit a physician-owned OBL. Dr. Arko recognizes that financing an OBL with device company partnerships can be a smart business decision if devices are used appropriately and only when indicated. He speaks about the need for societies to support more randomized control trials that compare the effectiveness of each atherectomy device. We also discuss implications for insurance coverage of PAD/CLTI interventions. Dr. Sabri believes that it is unfortunate when insurance companies become the decision-maker of patient treatments. --- RESOURCES “They Lost Their Legs. Doctors and Health Giants Profited” (NY Times, July 2023 article): https://www.nytimes.com/2023/07/15/health/atherectomy-peripheral-artery-disease.html BEST-CLI: https://www.bestcli.com/ “Blocked Artery in Your Leg? Here’s What You Should Know” (ProPublica, June 2023 article) https://www.propublica.org/article/what-to-know-about-peripheral-artery-disease Outpatient Endovascular Interventional Society (OEIS): https://oeisweb.com/ Society of Vascular Surgery (SVS) Position Statement: https://vascular.org/news-advocacy/articles-press-releases/svs-response-new-york-times-article-overuse-interventions In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Saher Sabri and vascular surgeon Dr. Frank Arko about their perspectives on a July 2023 New York Times article about the ethics of peripheral arterial disease (PAD) treatment in outpatient based labs (OBLs) and ambulatory surgery centers (ASCs).


---


SHOW NOTES


Dr. Arko emphasizes the importance of approaching articles as an unbiased reader. He acknowledges that sensationalism in the news is common, and while bad actors do exist, he personally knows talented OBL/ASC practitioners. He also notes that the article fails to mention that the majority of these practitioners follow society guidelines to provide appropriate and effective treatment for their patients, rather than prioritizing financial gain. He believes that most non-surgical specialists have the clinical insight to know when patients would be better candidates for open bypasses as opposed to endovascular interventions. Dr. Arko describes the split response to the article within vascular surgeons on social media, based on their personal philosophies of open versus endovascular interventions for PAD.


Dr. Sabri believes that PAD and critical limb-threatening ischemia (CLTI) are not very well known by the general public, this article was a missed opportunity to bring attention to these conditions and disparities in treatments depending on patients’ geographic locations and ethnicities. The article may have the effect of scaring patients away from seeking treatment for PAD and CLTI, as well as receiving care at OBLs, which were originally founded to make interventions more efficient and patient-friendly. Additionally, the article could foster divisiveness between vascular surgeons, interventional radiologists, and interventional cardiologists and as a result, increase barriers to collaboration.


It is important to differentiate between PAD and CLTI and the stage at which patients present to medical care. Limb salvage rates and decisions to intervene and/or amputate are multifactorial and are not as straightforward as the article may imply. Both doctors agree that specialty societies share the responsibility of monitoring their members for overuse of interventions.


In terms of rebates and volume discounts from device companies, the doctors discuss the ethics of cost savings that benefit a hospital system versus savings that benefit a physician-owned OBL. Dr. Arko recognizes that financing an OBL with device company partnerships can be a smart business decision if devices are used appropriately and only when indicated. He speaks about the need for societies to support more randomized control trials that compare the effectiveness of each atherectomy device. We also discuss implications for insurance coverage of PAD/CLTI interventions. Dr. Sabri believes that it is unfortunate when insurance companies become the decision-maker of patient treatments.


---


RESOURCES


“They Lost Their Legs. Doctors and Health Giants Profited” (NY Times, July 2023 article):

https://www.nytimes.com/2023/07/15/health/atherectomy-peripheral-artery-disease.html


BEST-CLI:

https://www.bestcli.com/


“Blocked Artery in Your Leg? Here’s What You Should Know” (ProPublica, June 2023 article)

https://www.propublica.org/article/what-to-know-about-peripheral-artery-disease


Outpatient Endovascular Interventional Society (OEIS):

https://oeisweb.com/


Society of Vascular Surgery (SVS) Position Statement:

https://vascular.org/news-advocacy/articles-press-releases/svs-response-new-york-times-article-overuse-interventions

]]> 3449 Ep. 350 Building a CLI program with Dr. Zola N’Dandu In this episode, host Dr. Michael Barraza interviews Dr. Zola N’Dandu, an interventional cardiologist at Ochsner Medical Center in Louisiana, about building a successful critical limb ischemia (CLI) program. --- CHECK OUT OUR SPONSORS Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205 Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. N’Dandu’s current practice is about 65% peripheral artery disease, with a focus on critical limb ischemia. He discusses how he developed his current CLI focus by traveling and attending conferences, after his formal training. It was during one of these conferences that Dr. N’Dandu was inspired to further get involved with the patients in the wound care center at Ochsner. This interest led to the start of his CLI team. The episode then shifts towards Dr. N’Dandu’s process of building his CLI team. His commitment to this endeavor helped bring more like-minded people to his team. Having a centralized and committed team has helped Dr. N’Dandu streamline his patient visits, reduce the number of appointments needed for each patient, and greatly decrease the burden on the patients. Dr. N’Dandu then discusses the evolution of CLI in the last decade and how there are now more medications, therapies, and data available to support patient care. Procedural advancements have also been immensely helpful. Things like radial-to-pedal, 3rd and 4th generation stents, proliferative therapy with stents, drug-coated balloons, and bio-absorbable stents are all advancements in CLI treatment. Additionally, obtaining more data on each therapy will help refine the treatment algorithm for CLI. As the conversation shifts towards aspects that still need to evolve in CLI treatment, Dr. N’Dandu emphasizes that our treatment of no-option-CLI patients needs to change. One of the treatments that he uses for these patients is deep vein arterialization, a technique that was first discovered in 1912 but still has more potential for growth. DVA involves shunting arterial blood to the veins, which works for CLI, as studies show that it increases angiogenesis and perfusion of the tissue. As Dr. N’Dandu discusses the specifics of his DVA technique, he emphasizes that new advancements are being made every day, so it is crucial to have a cohesive team that can follow up with patients. Mon, 31 Jul 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Michael Barraza interviews Dr. Zola N’Dandu, an interventional cardiologist at Ochsner Medical Center in Louisiana, about building a successful critical limb ischemia (CLI) program. In this episode, host Dr. Michael Barraza interviews Dr. Zola N’Dandu, an interventional cardiologist at Ochsner Medical Center in Louisiana, about building a successful critical limb ischemia (CLI) program. --- CHECK OUT OUR SPONSORS Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205 Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. N’Dandu’s current practice is about 65% peripheral artery disease, with a focus on critical limb ischemia. He discusses how he developed his current CLI focus by traveling and attending conferences, after his formal training. It was during one of these conferences that Dr. N’Dandu was inspired to further get involved with the patients in the wound care center at Ochsner. This interest led to the start of his CLI team. The episode then shifts towards Dr. N’Dandu’s process of building his CLI team. His commitment to this endeavor helped bring more like-minded people to his team. Having a centralized and committed team has helped Dr. N’Dandu streamline his patient visits, reduce the number of appointments needed for each patient, and greatly decrease the burden on the patients. Dr. N’Dandu then discusses the evolution of CLI in the last decade and how there are now more medications, therapies, and data available to support patient care. Procedural advancements have also been immensely helpful. Things like radial-to-pedal, 3rd and 4th generation stents, proliferative therapy with stents, drug-coated balloons, and bio-absorbable stents are all advancements in CLI treatment. Additionally, obtaining more data on each therapy will help refine the treatment algorithm for CLI. As the conversation shifts towards aspects that still need to evolve in CLI treatment, Dr. N’Dandu emphasizes that our treatment of no-option-CLI patients needs to change. One of the treatments that he uses for these patients is deep vein arterialization, a technique that was first discovered in 1912 but still has more potential for growth. DVA involves shunting arterial blood to the veins, which works for CLI, as studies show that it increases angiogenesis and perfusion of the tissue. As Dr. N’Dandu discusses the specifics of his DVA technique, he emphasizes that new advancements are being made every day, so it is crucial to have a cohesive team that can follow up with patients. In this episode, host Dr. Michael Barraza interviews Dr. Zola N’Dandu, an interventional cardiologist at Ochsner Medical Center in Louisiana, about building a successful critical limb ischemia (CLI) program.


---


CHECK OUT OUR SPONSORS


Boston Scientific Lab Agent

https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. N’Dandu’s current practice is about 65% peripheral artery disease, with a focus on critical limb ischemia. He discusses how he developed his current CLI focus by traveling and attending conferences, after his formal training. It was during one of these conferences that Dr. N’Dandu was inspired to further get involved with the patients in the wound care center at Ochsner. This interest led to the start of his CLI team.


The episode then shifts towards Dr. N’Dandu’s process of building his CLI team. His commitment to this endeavor helped bring more like-minded people to his team. Having a centralized and committed team has helped Dr. N’Dandu streamline his patient visits, reduce the number of appointments needed for each patient, and greatly decrease the burden on the patients.


Dr. N’Dandu then discusses the evolution of CLI in the last decade and how there are now more medications, therapies, and data available to support patient care. Procedural advancements have also been immensely helpful. Things like radial-to-pedal, 3rd and 4th generation stents, proliferative therapy with stents, drug-coated balloons, and bio-absorbable stents are all advancements in CLI treatment. Additionally, obtaining more data on each therapy will help refine the treatment algorithm for CLI.


As the conversation shifts towards aspects that still need to evolve in CLI treatment, Dr. N’Dandu emphasizes that our treatment of no-option-CLI patients needs to change. One of the treatments that he uses for these patients is deep vein arterialization, a technique that was first discovered in 1912 but still has more potential for growth. DVA involves shunting arterial blood to the veins, which works for CLI, as studies show that it increases angiogenesis and perfusion of the tissue. As Dr. N’Dandu discusses the specifics of his DVA technique, he emphasizes that new advancements are being made every day, so it is crucial to have a cohesive team that can follow up with patients.

]]> 2100 Ep. 349 Cybersecurity for Physicians with Jason Newton, Esq In this episode, host Dr. Aaron Fritts interviews Jason Newton - an attorney with 14 years of private practice defense experience and current General Counsel at Curi - about cybersecurity in medicine and healthcare. --- SHOW NOTES Jason begins by introducing how he became an expert in cybersecurity law. Dr. Fritts and Jason then segue to the present day threats of ransomware in healthcare, beginning with a birds eye view and progressively getting more granular. They cover the topics of staffing shortage, how threat-actors are akin to present-day pirates, and the chief risk of ransomware. We learn that healthcare is the most common target of ransomware from threat-actors and how “big fish” are not only the main targets, meaning many smaller health entities are also under real threat. Jason explains well documented reports which detail the intense interest in health information of several US targets such as government leaders, military personnel, celebrities, and popular athletes. Dr. Fritts and Jason underscore how money is the central driving force behind ransomware attacks on healthcare. Jason also takes a deep dive into how threat-actors engage in social engineering to ensure their success. Troubling enough, Jason also shares how threat-actors (on average) have already infiltrated health systems 66 days prior to the day the breach has been discovered. Essentially health systems will only see threat-actors when these hackers want to be seen and demand ransom. ChatGPT, AI, and deep-fake technology is also discussed and how it can be used by threat-actors to bolster their ransomware attacks on healthcare. Jason also mentions the need for health systems to invest in cybersecurity insurance and the inverse relation between “secure” and “easy”. Health systems’ responsibility to secure their data is paramount to mitigating and avoiding ransomware. Jason highlights the necessity of training, the fact that people can be the weakest link in security, and how it is critical for everyone to approach their email inbox with a “no-trust” policy. Anti-phishing software can also be a very helpful addition to health systems looking to bolster their cybersecurity. Mr. Newton supplies some helpful training, consultation, and investigation resources from the Cybersecurity and Infrastructure Security Agency. While we hope this discussion may be helpful, there are no guarantees that the information and resources shared will prevent and/or mitigate bad outcomes, and no guarantees or endorsements are made. Although Jason is an attorney, he cannot and does not offer legal advice to external parties and an attorney-client relationship is not established with listeners of this podcast. Please contact your personal or corporate attorney if you require legal advice. --- RESOURCES Cybersecurity and Infrastructure Security Agency website: https://www.cisa.gov/resources-tools Fri, 28 Jul 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Jason Newton - an attorney with 14 years of private practice defense experience and current General Counsel at Curi - about cybersecurity in medicine and healthcare. In this episode, host Dr. Aaron Fritts interviews Jason Newton - an attorney with 14 years of private practice defense experience and current General Counsel at Curi - about cybersecurity in medicine and healthcare. --- SHOW NOTES Jason begins by introducing how he became an expert in cybersecurity law. Dr. Fritts and Jason then segue to the present day threats of ransomware in healthcare, beginning with a birds eye view and progressively getting more granular. They cover the topics of staffing shortage, how threat-actors are akin to present-day pirates, and the chief risk of ransomware. We learn that healthcare is the most common target of ransomware from threat-actors and how “big fish” are not only the main targets, meaning many smaller health entities are also under real threat. Jason explains well documented reports which detail the intense interest in health information of several US targets such as government leaders, military personnel, celebrities, and popular athletes. Dr. Fritts and Jason underscore how money is the central driving force behind ransomware attacks on healthcare. Jason also takes a deep dive into how threat-actors engage in social engineering to ensure their success. Troubling enough, Jason also shares how threat-actors (on average) have already infiltrated health systems 66 days prior to the day the breach has been discovered. Essentially health systems will only see threat-actors when these hackers want to be seen and demand ransom. ChatGPT, AI, and deep-fake technology is also discussed and how it can be used by threat-actors to bolster their ransomware attacks on healthcare. Jason also mentions the need for health systems to invest in cybersecurity insurance and the inverse relation between “secure” and “easy”. Health systems’ responsibility to secure their data is paramount to mitigating and avoiding ransomware. Jason highlights the necessity of training, the fact that people can be the weakest link in security, and how it is critical for everyone to approach their email inbox with a “no-trust” policy. Anti-phishing software can also be a very helpful addition to health systems looking to bolster their cybersecurity. Mr. Newton supplies some helpful training, consultation, and investigation resources from the Cybersecurity and Infrastructure Security Agency. While we hope this discussion may be helpful, there are no guarantees that the information and resources shared will prevent and/or mitigate bad outcomes, and no guarantees or endorsements are made. Although Jason is an attorney, he cannot and does not offer legal advice to external parties and an attorney-client relationship is not established with listeners of this podcast. Please contact your personal or corporate attorney if you require legal advice. --- RESOURCES Cybersecurity and Infrastructure Security Agency website: https://www.cisa.gov/resources-tools In this episode, host Dr. Aaron Fritts interviews Jason Newton - an attorney with 14 years of private practice defense experience and current General Counsel at Curi - about cybersecurity in medicine and healthcare.


---


SHOW NOTES


Jason begins by introducing how he became an expert in cybersecurity law. Dr. Fritts and Jason then segue to the present day threats of ransomware in healthcare, beginning with a birds eye view and progressively getting more granular. They cover the topics of staffing shortage, how threat-actors are akin to present-day pirates, and the chief risk of ransomware.


We learn that healthcare is the most common target of ransomware from threat-actors and how “big fish” are not only the main targets, meaning many smaller health entities are also under real threat. Jason explains well documented reports which detail the intense interest in health information of several US targets such as government leaders, military personnel, celebrities, and popular athletes.


Dr. Fritts and Jason underscore how money is the central driving force behind ransomware attacks on healthcare. Jason also takes a deep dive into how threat-actors engage in social engineering to ensure their success. Troubling enough, Jason also shares how threat-actors (on average) have already infiltrated health systems 66 days prior to the day the breach has been discovered. Essentially health systems will only see threat-actors when these hackers want to be seen and demand ransom.


ChatGPT, AI, and deep-fake technology is also discussed and how it can be used by threat-actors to bolster their ransomware attacks on healthcare. Jason also mentions the need for health systems to invest in cybersecurity insurance and the inverse relation between “secure” and “easy”. Health systems’ responsibility to secure their data is paramount to mitigating and avoiding ransomware.


Jason highlights the necessity of training, the fact that people can be the weakest link in security, and how it is critical for everyone to approach their email inbox with a “no-trust” policy. Anti-phishing software can also be a very helpful addition to health systems looking to bolster their cybersecurity. Mr. Newton supplies some helpful training, consultation, and investigation resources from the Cybersecurity and Infrastructure Security Agency.


While we hope this discussion may be helpful, there are no guarantees that the information and resources shared will prevent and/or mitigate bad outcomes, and no guarantees or endorsements are made. Although Jason is an attorney, he cannot and does not offer legal advice to external parties and an attorney-client relationship is not established with listeners of this podcast. Please contact your personal or corporate attorney if you require legal advice.


---


RESOURCES


Cybersecurity and Infrastructure Security Agency website:

https://www.cisa.gov/resources-tools

]]> 2301 Ep. 348 The Legends: an Interview with Dr. Thomas Sos In this episode, we delve into the career of Dr. Thomas Sos, a renowned figure in the field of Interventional Radiology (IR), and the triumphs and challenges he faced in the formative years of interventional radiology. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES The episode starts with an introduction to Dr. Sos, whose accomplishments include serving as SIR President from 1986-1987, receiving the SIR Gold Medalist in 2009, authoring 140 publications and 60+ book chapters, as well as winning the SIR Foundations in Leadership and Innovation award this past year. Dr. Sos reflects on his educational journey, starting with his medical degree from Harvard and continuing with diagnostic radiology residency and an IR fellowship at Cornell. As one of Cornell's first IR fellows, he discusses the intensity of his early training and his reasons for choosing this specialty. His fellowship years coincided with the formation of SIR and the rapid evolution of the field, offering him a chance to be part of its groundbreaking developments. He then traces his professional path, highlighting his work at Cornell and Brigham, his role as the youngest IR progressor at Cornell, and his position as the Divisional Chief of Cardiovascular IR. An important turning point in his career was a coronary angioplasty course in Zurich, Switzerland, which led to his collaboration with cardiothoracic surgeons and cardiologists. He remains an active participant in major conferences to share knowledge about angioplasty. Then, Dr. Sos discusses his shifting focus to peripheral vascular disease. As his work in IR began to draw attention, surgeons started acknowledging the growing influence of IR in medicine. This realization resulted in more surgeons learning about angioplasty and a collaboration between SIR and the Society for Vascular Surgery (SVS). Mon, 24 Jul 2023 05:05:00 -0000 full BackTable In this episode, we delve into the career of Dr. Thomas Sos, a renowned figure in the field of Interventional Radiology (IR), and the triumphs and challenges he faced in the formative years of interventional radiology. In this episode, we delve into the career of Dr. Thomas Sos, a renowned figure in the field of Interventional Radiology (IR), and the triumphs and challenges he faced in the formative years of interventional radiology. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES The episode starts with an introduction to Dr. Sos, whose accomplishments include serving as SIR President from 1986-1987, receiving the SIR Gold Medalist in 2009, authoring 140 publications and 60+ book chapters, as well as winning the SIR Foundations in Leadership and Innovation award this past year. Dr. Sos reflects on his educational journey, starting with his medical degree from Harvard and continuing with diagnostic radiology residency and an IR fellowship at Cornell. As one of Cornell's first IR fellows, he discusses the intensity of his early training and his reasons for choosing this specialty. His fellowship years coincided with the formation of SIR and the rapid evolution of the field, offering him a chance to be part of its groundbreaking developments. He then traces his professional path, highlighting his work at Cornell and Brigham, his role as the youngest IR progressor at Cornell, and his position as the Divisional Chief of Cardiovascular IR. An important turning point in his career was a coronary angioplasty course in Zurich, Switzerland, which led to his collaboration with cardiothoracic surgeons and cardiologists. He remains an active participant in major conferences to share knowledge about angioplasty. Then, Dr. Sos discusses his shifting focus to peripheral vascular disease. As his work in IR began to draw attention, surgeons started acknowledging the growing influence of IR in medicine. This realization resulted in more surgeons learning about angioplasty and a collaboration between SIR and the Society for Vascular Surgery (SVS). In this episode, we delve into the career of Dr. Thomas Sos, a renowned figure in the field of Interventional Radiology (IR), and the triumphs and challenges he faced in the formative years of interventional radiology.


---


CHECK OUT OUR SPONSOR


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


The episode starts with an introduction to Dr. Sos, whose accomplishments include serving as SIR President from 1986-1987, receiving the SIR Gold Medalist in 2009, authoring 140 publications and 60+ book chapters, as well as winning the SIR Foundations in Leadership and Innovation award this past year.


Dr. Sos reflects on his educational journey, starting with his medical degree from Harvard and continuing with diagnostic radiology residency and an IR fellowship at Cornell. As one of Cornell's first IR fellows, he discusses the intensity of his early training and his reasons for choosing this specialty. His fellowship years coincided with the formation of SIR and the rapid evolution of the field, offering him a chance to be part of its groundbreaking developments. He then traces his professional path, highlighting his work at Cornell and Brigham, his role as the youngest IR progressor at Cornell, and his position as the Divisional Chief of Cardiovascular IR.


An important turning point in his career was a coronary angioplasty course in Zurich, Switzerland, which led to his collaboration with cardiothoracic surgeons and cardiologists. He remains an active participant in major conferences to share knowledge about angioplasty.


Then, Dr. Sos discusses his shifting focus to peripheral vascular disease. As his work in IR began to draw attention, surgeons started acknowledging the growing influence of IR in medicine. This realization resulted in more surgeons learning about angioplasty and a collaboration between SIR and the Society for Vascular Surgery (SVS).

]]> 5710 Ep. 347 Alternatives to Private Equity in Radiology- Staying Independent with Dr. Ted Wen and Dhruv Chopra In this episode, co-hosts Drs. Ally Baheti and Mike Barraza interview Dr. Ted Wen of Texas Radiology Associates and Dhruv Chopra of Collaborative Imaging about perspectives and helpful technology when managing an independent radiology practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Wen shares reasons why he and his colleagues chose to keep their practice independent. The fast-growing group spent eight years doing due diligence about private equity (PE) to decide if that was the right model for them. Dr. Wen met with PE firms around the country to explore the process of transitioning into PE practice ownership and its implications for current colleagues and future physician hires. Selling to PE would disproportionately benefit senior partners, who were ready to be bought out, over junior partners who would not qualify for the same deal. Additionally PE management could have the power to raise minimum RVU requirements and enforce highly restrictive noncompetes. Texas Radiology Associates ultimately decided that in order to compete in the radiology marketplace as an independent practice, they needed to make significant investments in technology to better serve their patients. They started to connect with Collaborative Imaging to pursue this mission. Dhruv notes that PE has the potential to bring in financial support, strategic relationships, and pathways to growth, but he also warns the audience that not all PE contracts are transparent nor designed to benefit physicians. Workflow, staffing, and collaboration with referring doctors can be extremely difficult when firms value cost savings and RVUs over patient care. All of these stressors have negatively impacted the radiology burnout rate. Dhruv describes the start of Collaborative Imaging, in 2018, as an attempt to integrate a revenue cycle management (RCM) system with radiology workflow at Texas Radiology Associates. This provided a cost-efficient solution that frees up funds to invest in other areas of the practice. Collaborative Imaging is currently working on an AI-driven system to notify patients of actionable findings that come up in their imaging. They are also exploring technology that will adapt the style of radiology reports to different referrers’ preferences. Both guests discuss the common inefficiencies that independent radiology practices face, including RCM, clarification over patients’ payment plans, and office wait times. Collaborative Imaging is working with practices around the country to build solutions. Radiology groups can contribute a percentage of their revenue into Collaborative Imaging and receive dividends, or they can license the RCM solution. --- RESOURCES Ep. 277- Private Equity and the Radiology Job Environment with Dr. Ben White: https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment Texas Radiology Associates: https://texasradiology.com/ Collaborative Imaging: https://collaborativeimaging.com/ Fri, 21 Jul 2023 05:05:00 -0000 full BackTable In this episode, co-hosts Drs. Ally Baheti and Mike Barraza interview Dr. Ted Wen of Texas Radiology Associates and Dhruv Chopra of Collaborative Imaging about perspectives and helpful technology when managing an independent radiology practice. In this episode, co-hosts Drs. Ally Baheti and Mike Barraza interview Dr. Ted Wen of Texas Radiology Associates and Dhruv Chopra of Collaborative Imaging about perspectives and helpful technology when managing an independent radiology practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Wen shares reasons why he and his colleagues chose to keep their practice independent. The fast-growing group spent eight years doing due diligence about private equity (PE) to decide if that was the right model for them. Dr. Wen met with PE firms around the country to explore the process of transitioning into PE practice ownership and its implications for current colleagues and future physician hires. Selling to PE would disproportionately benefit senior partners, who were ready to be bought out, over junior partners who would not qualify for the same deal. Additionally PE management could have the power to raise minimum RVU requirements and enforce highly restrictive noncompetes. Texas Radiology Associates ultimately decided that in order to compete in the radiology marketplace as an independent practice, they needed to make significant investments in technology to better serve their patients. They started to connect with Collaborative Imaging to pursue this mission. Dhruv notes that PE has the potential to bring in financial support, strategic relationships, and pathways to growth, but he also warns the audience that not all PE contracts are transparent nor designed to benefit physicians. Workflow, staffing, and collaboration with referring doctors can be extremely difficult when firms value cost savings and RVUs over patient care. All of these stressors have negatively impacted the radiology burnout rate. Dhruv describes the start of Collaborative Imaging, in 2018, as an attempt to integrate a revenue cycle management (RCM) system with radiology workflow at Texas Radiology Associates. This provided a cost-efficient solution that frees up funds to invest in other areas of the practice. Collaborative Imaging is currently working on an AI-driven system to notify patients of actionable findings that come up in their imaging. They are also exploring technology that will adapt the style of radiology reports to different referrers’ preferences. Both guests discuss the common inefficiencies that independent radiology practices face, including RCM, clarification over patients’ payment plans, and office wait times. Collaborative Imaging is working with practices around the country to build solutions. Radiology groups can contribute a percentage of their revenue into Collaborative Imaging and receive dividends, or they can license the RCM solution. --- RESOURCES Ep. 277- Private Equity and the Radiology Job Environment with Dr. Ben White: https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment Texas Radiology Associates: https://texasradiology.com/ Collaborative Imaging: https://collaborativeimaging.com/ In this episode, co-hosts Drs. Ally Baheti and Mike Barraza interview Dr. Ted Wen of Texas Radiology Associates and Dhruv Chopra of Collaborative Imaging about perspectives and helpful technology when managing an independent radiology practice.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Dr. Wen shares reasons why he and his colleagues chose to keep their practice independent. The fast-growing group spent eight years doing due diligence about private equity (PE) to decide if that was the right model for them. Dr. Wen met with PE firms around the country to explore the process of transitioning into PE practice ownership and its implications for current colleagues and future physician hires. Selling to PE would disproportionately benefit senior partners, who were ready to be bought out, over junior partners who would not qualify for the same deal. Additionally PE management could have the power to raise minimum RVU requirements and enforce highly restrictive noncompetes. Texas Radiology Associates ultimately decided that in order to compete in the radiology marketplace as an independent practice, they needed to make significant investments in technology to better serve their patients. They started to connect with Collaborative Imaging to pursue this mission.


Dhruv notes that PE has the potential to bring in financial support, strategic relationships, and pathways to growth, but he also warns the audience that not all PE contracts are transparent nor designed to benefit physicians. Workflow, staffing, and collaboration with referring doctors can be extremely difficult when firms value cost savings and RVUs over patient care. All of these stressors have negatively impacted the radiology burnout rate. Dhruv describes the start of Collaborative Imaging, in 2018, as an attempt to integrate a revenue cycle management (RCM) system with radiology workflow at Texas Radiology Associates. This provided a cost-efficient solution that frees up funds to invest in other areas of the practice. Collaborative Imaging is currently working on an AI-driven system to notify patients of actionable findings that come up in their imaging. They are also exploring technology that will adapt the style of radiology reports to different referrers’ preferences.


Both guests discuss the common inefficiencies that independent radiology practices face, including RCM, clarification over patients’ payment plans, and office wait times. Collaborative Imaging is working with practices around the country to build solutions. Radiology groups can contribute a percentage of their revenue into Collaborative Imaging and receive dividends, or they can license the RCM solution.


---


RESOURCES


Ep. 277- Private Equity and the Radiology Job Environment with Dr. Ben White:

https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment


Texas Radiology Associates:

https://texasradiology.com/


Collaborative Imaging:

https://collaborativeimaging.com/

]]> 3097 Ep. 346 Genicular Nerve Ablation with Dr. John Smirniotopoulos In this episode, host Dr. Michael Barazza interviews Dr. John Smirniotopoulos about genicular nerve ablation, an innovative treatment option for the management of osteoarthritis. --- CHECK OUT OUR SPONSORS OBL Marketing https://oblmarketing.com/ Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202 --- SHOW NOTES Dr. John Smirniotopoulos is an assistant professor of clinical radiology in the IR department at MedStar Georgetown University and MedStar Washington Hospital Center in DC. He developed the idea of genicular nerve ablation after consulting with his orthopedic colleagues at Georgetown about various pain interventions. He then formulated a treatment algorithm that begins with a conservative approach, using a nerve block for ablation. If the initial response is limited, a second ablation can be performed within six months. However, if the patient experiences only a short-term response, genicular artery embolization may be considered. Genicular nerve ablation proves to be a valuable therapy for patients who are not yet ready for knee replacements or need to postpone the procedure due to factors like high BMI or recent organ transplant. The therapy uses fluoroscopy or ultrasound to target four trunks of nerves, including the superomedial genicular, superolateral, inferomedial, and the suprapatellar nerves. The procedure is done under conscious sedation, and Dr. Smirniotopoulos aims for 50% pain reduction with his patients which is usually reached at six weeks. Dr. Smirniotopoulos and his team recently conducted a study to evaluate the outcomes of genicular nerve ablation. The results indicated a significant reduction in both the WOMAC score, which measures pain and functionality, and the Visual Analogue Scale (VAS) score, which is a subjective measure of pain. Surprisingly, they discovered that age over 50 was the biggest predictor of positive outcomes, contrary to their initial expectation that BMI would play a more significant role. They attribute this finding to a higher prevalence of advanced OA in the older age group. Additionally, patients under 50 may have more sports-related injuries such as meniscal tears, leading them to return to high-intensity activities sooner than older patients. Dr. Smirniotopoulos has also seen success in performing nerve ablation in the hip, shoulder, SI, and intervertebral joints. This wide application of the procedure makes it a valuable and versatile treatment option for patients. --- RESOURCES Genicular Nerve Radiofrequency Ablation: Is There a Predictor of Outcomes?: https://www.jvir.org/article/S1051-0443(22)01597-4/fulltext Wed, 19 Jul 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Michael Barazza interviews Dr. John Smirniotopoulos about genicular nerve ablation, an innovative treatment option for the management of osteoarthritis. In this episode, host Dr. Michael Barazza interviews Dr. John Smirniotopoulos about genicular nerve ablation, an innovative treatment option for the management of osteoarthritis. --- CHECK OUT OUR SPONSORS OBL Marketing https://oblmarketing.com/ Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202 --- SHOW NOTES Dr. John Smirniotopoulos is an assistant professor of clinical radiology in the IR department at MedStar Georgetown University and MedStar Washington Hospital Center in DC. He developed the idea of genicular nerve ablation after consulting with his orthopedic colleagues at Georgetown about various pain interventions. He then formulated a treatment algorithm that begins with a conservative approach, using a nerve block for ablation. If the initial response is limited, a second ablation can be performed within six months. However, if the patient experiences only a short-term response, genicular artery embolization may be considered. Genicular nerve ablation proves to be a valuable therapy for patients who are not yet ready for knee replacements or need to postpone the procedure due to factors like high BMI or recent organ transplant. The therapy uses fluoroscopy or ultrasound to target four trunks of nerves, including the superomedial genicular, superolateral, inferomedial, and the suprapatellar nerves. The procedure is done under conscious sedation, and Dr. Smirniotopoulos aims for 50% pain reduction with his patients which is usually reached at six weeks. Dr. Smirniotopoulos and his team recently conducted a study to evaluate the outcomes of genicular nerve ablation. The results indicated a significant reduction in both the WOMAC score, which measures pain and functionality, and the Visual Analogue Scale (VAS) score, which is a subjective measure of pain. Surprisingly, they discovered that age over 50 was the biggest predictor of positive outcomes, contrary to their initial expectation that BMI would play a more significant role. They attribute this finding to a higher prevalence of advanced OA in the older age group. Additionally, patients under 50 may have more sports-related injuries such as meniscal tears, leading them to return to high-intensity activities sooner than older patients. Dr. Smirniotopoulos has also seen success in performing nerve ablation in the hip, shoulder, SI, and intervertebral joints. This wide application of the procedure makes it a valuable and versatile treatment option for patients. --- RESOURCES Genicular Nerve Radiofrequency Ablation: Is There a Predictor of Outcomes?: https://www.jvir.org/article/S1051-0443(22)01597-4/fulltext In this episode, host Dr. Michael Barazza interviews Dr. John Smirniotopoulos about genicular nerve ablation, an innovative treatment option for the management of osteoarthritis.


---


CHECK OUT OUR SPONSORS


OBL Marketing

https://oblmarketing.com/


Boston Scientific Nextlab

https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202


---


SHOW NOTES


Dr. John Smirniotopoulos is an assistant professor of clinical radiology in the IR department at MedStar Georgetown University and MedStar Washington Hospital Center in DC. He developed the idea of genicular nerve ablation after consulting with his orthopedic colleagues at Georgetown about various pain interventions. He then formulated a treatment algorithm that begins with a conservative approach, using a nerve block for ablation. If the initial response is limited, a second ablation can be performed within six months. However, if the patient experiences only a short-term response, genicular artery embolization may be considered.


Genicular nerve ablation proves to be a valuable therapy for patients who are not yet ready for knee replacements or need to postpone the procedure due to factors like high BMI or recent organ transplant. The therapy uses fluoroscopy or ultrasound to target four trunks of nerves, including the superomedial genicular, superolateral, inferomedial, and the suprapatellar nerves. The procedure is done under conscious sedation, and Dr. Smirniotopoulos aims for 50% pain reduction with his patients which is usually reached at six weeks.


Dr. Smirniotopoulos and his team recently conducted a study to evaluate the outcomes of genicular nerve ablation. The results indicated a significant reduction in both the WOMAC score, which measures pain and functionality, and the Visual Analogue Scale (VAS) score, which is a subjective measure of pain. Surprisingly, they discovered that age over 50 was the biggest predictor of positive outcomes, contrary to their initial expectation that BMI would play a more significant role. They attribute this finding to a higher prevalence of advanced OA in the older age group. Additionally, patients under 50 may have more sports-related injuries such as meniscal tears, leading them to return to high-intensity activities sooner than older patients. Dr. Smirniotopoulos has also seen success in performing nerve ablation in the hip, shoulder, SI, and intervertebral joints. This wide application of the procedure makes it a valuable and versatile treatment option for patients.


---


RESOURCES


Genicular Nerve Radiofrequency Ablation: Is There a Predictor of Outcomes?:

https://www.jvir.org/article/S1051-0443(22)01597-4/fulltext

]]> 3000 Ep. 345 Carotid Interventions with Dr. Ankur Aggarwal Mon, 17 Jul 2023 05:05:00 -0000 full BackTable 2292 Ep. 344 SIR Global IR Training Network with Dr. Justin Guan In this episode, Dr. Michael Barraza interviews Dr. Justin Guan about the SIR Global IR training network. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Guan starts the episode by discussing the IR program at the Cleveland Clinic, where the large case volume enables their trainees to get their pick about what types of cases they want to do. Dr. Guan then mentions his recent trip to Seoul, Korea for the Asia Pacific IR conference and discusses how he learned about new IR techniques that have not made their way into the mainstream yet. Dr. Guan highlights how the SIR Global training network was created due to a need for an entity that could globally spread IR education. He believes that there are insufficient training opportunities worldwide, and even within the countries that have these opportunities, there is a huge variation in IR training. Then, Dr. Guan highlights initiatives that the SIR Global training network is trying to implement and their current challenges. These challenges include insufficient IR services worldwide, a lack of public awareness about IR procedures, and a lack of data about differences in IR training across different countries. One initiative aimed to address these challenges is the Global IR Juniors summits, which recently got approval to be held at the SIR conference. At this summit, IRs from around the world discuss what updates and new research from their respective IR societies.. Dr. Guan also discusses how they are currently working on the Global Training Network, which will be a database of different IR physicians to provide opportunities for observership and mentorship and it will serve as a hub for a clinical exchange of IR knowledge worldwide. --- RESOURCES Public Awareness of Interventional Radiology: Population-Based Analysis of the Current State of and Pathways for Improvement: https://www.jvir.org/article/S1051-0443(23)00122-7/fulltext Global Assessment of the Status of Interventional Radiology: https://www.surveymonkey.com/r/ZBVFXQ8 Fri, 14 Jul 2023 05:05:00 -0000 full BackTable In this episode, Dr. Michael Baraza interviews Dr. Justin Guan, an interventional radiologist at the Cleveland Clinic, about the SIR Global IR training network. In this episode, Dr. Michael Barraza interviews Dr. Justin Guan about the SIR Global IR training network. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Guan starts the episode by discussing the IR program at the Cleveland Clinic, where the large case volume enables their trainees to get their pick about what types of cases they want to do. Dr. Guan then mentions his recent trip to Seoul, Korea for the Asia Pacific IR conference and discusses how he learned about new IR techniques that have not made their way into the mainstream yet. Dr. Guan highlights how the SIR Global training network was created due to a need for an entity that could globally spread IR education. He believes that there are insufficient training opportunities worldwide, and even within the countries that have these opportunities, there is a huge variation in IR training. Then, Dr. Guan highlights initiatives that the SIR Global training network is trying to implement and their current challenges. These challenges include insufficient IR services worldwide, a lack of public awareness about IR procedures, and a lack of data about differences in IR training across different countries. One initiative aimed to address these challenges is the Global IR Juniors summits, which recently got approval to be held at the SIR conference. At this summit, IRs from around the world discuss what updates and new research from their respective IR societies.. Dr. Guan also discusses how they are currently working on the Global Training Network, which will be a database of different IR physicians to provide opportunities for observership and mentorship and it will serve as a hub for a clinical exchange of IR knowledge worldwide. --- RESOURCES Public Awareness of Interventional Radiology: Population-Based Analysis of the Current State of and Pathways for Improvement: https://www.jvir.org/article/S1051-0443(23)00122-7/fulltext Global Assessment of the Status of Interventional Radiology: https://www.surveymonkey.com/r/ZBVFXQ8 In this episode, Dr. Michael Barraza interviews Dr. Justin Guan about the SIR Global IR training network.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Dr. Guan starts the episode by discussing the IR program at the Cleveland Clinic, where the large case volume enables their trainees to get their pick about what types of cases they want to do. Dr. Guan then mentions his recent trip to Seoul, Korea for the Asia Pacific IR conference and discusses how he learned about new IR techniques that have not made their way into the mainstream yet. Dr. Guan highlights how the SIR Global training network was created due to a need for an entity that could globally spread IR education. He believes that there are insufficient training opportunities worldwide, and even within the countries that have these opportunities, there is a huge variation in IR training.


Then, Dr. Guan highlights initiatives that the SIR Global training network is trying to implement and their current challenges. These challenges include insufficient IR services worldwide, a lack of public awareness about IR procedures, and a lack of data about differences in IR training across different countries. One initiative aimed to address these challenges is the Global IR Juniors summits, which recently got approval to be held at the SIR conference. At this summit, IRs from around the world discuss what updates and new research from their respective IR societies.. Dr. Guan also discusses how they are currently working on the Global Training Network, which will be a database of different IR physicians to provide opportunities for observership and mentorship and it will serve as a hub for a clinical exchange of IR knowledge worldwide.


---


RESOURCES


Public Awareness of Interventional Radiology: Population-Based Analysis of the Current State of and Pathways for Improvement:

https://www.jvir.org/article/S1051-0443(23)00122-7/fulltext


Global Assessment of the Status of Interventional Radiology:

https://www.surveymonkey.com/r/ZBVFXQ8

]]> 1163 Ep. 343 Microwave Ablation: A Powerful but Underused Modality for Treatment of Spine Tumors with Dr. Majid Khan In this episode, Dr. Jacob Fleming interviews Dr. Majid Khan, a spine interventionalist and expert in neuroimaging, about microwave ablation, a new treatment modality that has garnered significant attention. --- CHECK OUT OUR SPONSOR Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205 --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/1YOW1H --- SHOW NOTES Dr. Khan completed his radiology residency in New York and his fellowship in neuroradiology at John Hopkins. As he progressed in the field, he observed a significant shift in spinal care towards interventional methods and began to study these techniques, which included radiofrequency ablation (RFA) and cryoablation for treating spinal tumors. However, when he treated cases of prostate cancer spine metastases, he realized that RFA was challenging, due to the high bone impedance of osteoblastic lesions. This obstacle piqued his interest in microwave ablation, an alternative technique that employs an electromagnetic wave to induce rapid oscillation of hydrogen atoms in water molecules. This oscillation generates frictional heat, leading to coagulative tumor necrosis. Unlike RFA, microwave ablation significantly reduces bone impedance, making it a promising solution for these cases. Dr. Khan cautions that special care must be taken when operating in areas near nerves due to the elevated temperatures. To ensure safety, he recommends the use of a probe within the frequency range of 900 MHz to 1.2 GHz and the incorporation of thermocouplers as a safeguard during the ablation process. Furthermore, Dr. Khan delves into the indications for ablation based on the extent of tumor metastasis. In cases of oligometastatic disease, he advises a more aggressive treatment approach by extending the ablation zone beyond the actual tumor size. On the other hand, when dealing with diffusely metastatic disease, the primary goal of treatment shifts towards pain reduction. The two conclude their discussion with Dr. Khan’s advice for physicians planning to utilize microwave ablation. He advises them to approach their initial 5-10 cases judiciously, in an effort to minimize the risk of complications that may adversely impact their self-confidence. Having adequate self confidence enhances the likelihood of achieving successful outcomes. For those looking for a valuable resource in the field, Dr. Khan has recently published a comprehensive textbook that features contributions from experts in the field. --- RESOURCES “Assessing long-term locoregional control of spinal osseous metastases after microwave ablation”: https://pubmed.ncbi.nlm.nih.gov/35963064/ Vertebral Augmentation: https://shop.thieme.com/Vertebral-Augmentation/9781684200153 Image Guided Interventions of the Spine https://link.springer.com/book/10.1007/978-3-030-80079-6 Wed, 12 Jul 2023 05:05:00 -0000 full BackTable In this episode, Dr. Jacob Fleming interviews Dr. Majid Khan, a spine interventionalist and expert in neuroimaging, about microwave ablation, a new treatment modality that has garnered significant attention. In this episode, Dr. Jacob Fleming interviews Dr. Majid Khan, a spine interventionalist and expert in neuroimaging, about microwave ablation, a new treatment modality that has garnered significant attention. --- CHECK OUT OUR SPONSOR Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205 --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/1YOW1H --- SHOW NOTES Dr. Khan completed his radiology residency in New York and his fellowship in neuroradiology at John Hopkins. As he progressed in the field, he observed a significant shift in spinal care towards interventional methods and began to study these techniques, which included radiofrequency ablation (RFA) and cryoablation for treating spinal tumors. However, when he treated cases of prostate cancer spine metastases, he realized that RFA was challenging, due to the high bone impedance of osteoblastic lesions. This obstacle piqued his interest in microwave ablation, an alternative technique that employs an electromagnetic wave to induce rapid oscillation of hydrogen atoms in water molecules. This oscillation generates frictional heat, leading to coagulative tumor necrosis. Unlike RFA, microwave ablation significantly reduces bone impedance, making it a promising solution for these cases. Dr. Khan cautions that special care must be taken when operating in areas near nerves due to the elevated temperatures. To ensure safety, he recommends the use of a probe within the frequency range of 900 MHz to 1.2 GHz and the incorporation of thermocouplers as a safeguard during the ablation process. Furthermore, Dr. Khan delves into the indications for ablation based on the extent of tumor metastasis. In cases of oligometastatic disease, he advises a more aggressive treatment approach by extending the ablation zone beyond the actual tumor size. On the other hand, when dealing with diffusely metastatic disease, the primary goal of treatment shifts towards pain reduction. The two conclude their discussion with Dr. Khan’s advice for physicians planning to utilize microwave ablation. He advises them to approach their initial 5-10 cases judiciously, in an effort to minimize the risk of complications that may adversely impact their self-confidence. Having adequate self confidence enhances the likelihood of achieving successful outcomes. For those looking for a valuable resource in the field, Dr. Khan has recently published a comprehensive textbook that features contributions from experts in the field. --- RESOURCES “Assessing long-term locoregional control of spinal osseous metastases after microwave ablation”: https://pubmed.ncbi.nlm.nih.gov/35963064/ Vertebral Augmentation: https://shop.thieme.com/Vertebral-Augmentation/9781684200153 Image Guided Interventions of the Spine https://link.springer.com/book/10.1007/978-3-030-80079-6 In this episode, Dr. Jacob Fleming interviews Dr. Majid Khan, a spine interventionalist and expert in neuroimaging, about microwave ablation, a new treatment modality that has garnered significant attention.


---


CHECK OUT OUR SPONSOR


Boston Scientific Lab Agent

https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/1YOW1H


---


SHOW NOTES


Dr. Khan completed his radiology residency in New York and his fellowship in neuroradiology at John Hopkins. As he progressed in the field, he observed a significant shift in spinal care towards interventional methods and began to study these techniques, which included radiofrequency ablation (RFA) and cryoablation for treating spinal tumors. However, when he treated cases of prostate cancer spine metastases, he realized that RFA was challenging, due to the high bone impedance of osteoblastic lesions. This obstacle piqued his interest in microwave ablation, an alternative technique that employs an electromagnetic wave to induce rapid oscillation of hydrogen atoms in water molecules. This oscillation generates frictional heat, leading to coagulative tumor necrosis. Unlike RFA, microwave ablation significantly reduces bone impedance, making it a promising solution for these cases.


Dr. Khan cautions that special care must be taken when operating in areas near nerves due to the elevated temperatures. To ensure safety, he recommends the use of a probe within the frequency range of 900 MHz to 1.2 GHz and the incorporation of thermocouplers as a safeguard during the ablation process. Furthermore, Dr. Khan delves into the indications for ablation based on the extent of tumor metastasis. In cases of oligometastatic disease, he advises a more aggressive treatment approach by extending the ablation zone beyond the actual tumor size. On the other hand, when dealing with diffusely metastatic disease, the primary goal of treatment shifts towards pain reduction.


The two conclude their discussion with Dr. Khan’s advice for physicians planning to utilize microwave ablation. He advises them to approach their initial 5-10 cases judiciously, in an effort to minimize the risk of complications that may adversely impact their self-confidence. Having adequate self confidence enhances the likelihood of achieving successful outcomes. For those looking for a valuable resource in the field, Dr. Khan has recently published a comprehensive textbook that features contributions from experts in the field.


---


RESOURCES


“Assessing long-term locoregional control of spinal osseous metastases after microwave ablation”:

https://pubmed.ncbi.nlm.nih.gov/35963064/


Vertebral Augmentation:

https://shop.thieme.com/Vertebral-Augmentation/9781684200153


Image Guided Interventions of the Spine

https://link.springer.com/book/10.1007/978-3-030-80079-6

]]> 4199 Ep. 342 Radial Access for PAD with Dr. Rami Tadros In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Rami Tadros about advantages and indications for radial access in PAD treatment and the current selection of radial access devices. --- CHECK OUT OUR SPONSOR Surmodics Sublime Radial Access Platform https://sublimeradial.com/ --- SHOW NOTES Dr. Rami Tadros is a vascular surgeon and Site Director of Endovascular Aortic Surgery at Mount Sinai Hospital. Dr. Tadros begins by discussing how often he uses radial access in his practice, how current wire and catheter technology limits the potential of radial access, and how evolution of these devices (such as increased length and improved sizing for transradial tools) is on the horizon. Dr. Tadros also discusses the indications and specific advantages for radial access. He describes his device preferences, workflow, and workarounds for radial access. The doctors then take a deeper dive into lengths and sizing of the tools that are currently on the market. They offer some insight on maximizing distance while still maintaining pushability and taking into account the variety of patient anatomy. There is also a brief discussion on pedal access, risks associated with it, and closure complications. Dr. Tadros covers specific clinical vignettes for treating PAD with radial access. There are limitations of the currently available devices, so it is important to plan for distal embolization and bailout stents. We conclude the episode with some guidance for radial access. We review the required tools, the importance of confirming patency of the palmar arch, and the Barbeau test to inform radial access. Dr. Tadros also highlights the use of verapamil, heparin, and nitroglycerin to minimize the risk of vessel spasm. --- RESOURCES Dr. Rami Tadros Twitter: https://twitter.com/VascMD Mon, 10 Jul 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Rami Tadros about advantages and indications for radial access in PAD treatment and the current selection of radial access devices. In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Rami Tadros about advantages and indications for radial access in PAD treatment and the current selection of radial access devices. --- CHECK OUT OUR SPONSOR Surmodics Sublime Radial Access Platform https://sublimeradial.com/ --- SHOW NOTES Dr. Rami Tadros is a vascular surgeon and Site Director of Endovascular Aortic Surgery at Mount Sinai Hospital. Dr. Tadros begins by discussing how often he uses radial access in his practice, how current wire and catheter technology limits the potential of radial access, and how evolution of these devices (such as increased length and improved sizing for transradial tools) is on the horizon. Dr. Tadros also discusses the indications and specific advantages for radial access. He describes his device preferences, workflow, and workarounds for radial access. The doctors then take a deeper dive into lengths and sizing of the tools that are currently on the market. They offer some insight on maximizing distance while still maintaining pushability and taking into account the variety of patient anatomy. There is also a brief discussion on pedal access, risks associated with it, and closure complications. Dr. Tadros covers specific clinical vignettes for treating PAD with radial access. There are limitations of the currently available devices, so it is important to plan for distal embolization and bailout stents. We conclude the episode with some guidance for radial access. We review the required tools, the importance of confirming patency of the palmar arch, and the Barbeau test to inform radial access. Dr. Tadros also highlights the use of verapamil, heparin, and nitroglycerin to minimize the risk of vessel spasm. --- RESOURCES Dr. Rami Tadros Twitter: https://twitter.com/VascMD In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Rami Tadros about advantages and indications for radial access in PAD treatment and the current selection of radial access devices.


---


CHECK OUT OUR SPONSOR


Surmodics Sublime Radial Access Platform

https://sublimeradial.com/


---


SHOW NOTES


Dr. Rami Tadros is a vascular surgeon and Site Director of Endovascular Aortic Surgery at Mount Sinai Hospital. Dr. Tadros begins by discussing how often he uses radial access in his practice, how current wire and catheter technology limits the potential of radial access, and how evolution of these devices (such as increased length and improved sizing for transradial tools) is on the horizon.


Dr. Tadros also discusses the indications and specific advantages for radial access. He describes his device preferences, workflow, and workarounds for radial access. The doctors then take a deeper dive into lengths and sizing of the tools that are currently on the market. They offer some insight on maximizing distance while still maintaining pushability and taking into account the variety of patient anatomy. There is also a brief discussion on pedal access, risks associated with it, and closure complications.


Dr. Tadros covers specific clinical vignettes for treating PAD with radial access. There are limitations of the currently available devices, so it is important to plan for distal embolization and bailout stents.


We conclude the episode with some guidance for radial access. We review the required tools, the importance of confirming patency of the palmar arch, and the Barbeau test to inform radial access. Dr. Tadros also highlights the use of verapamil, heparin, and nitroglycerin to minimize the risk of vessel spasm.


---


RESOURCES


Dr. Rami Tadros Twitter:

https://twitter.com/VascMD

]]> 2716 Ep. 341 Design Thinking in Healthcare with Dr. Gregg Khodorov In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Gregg Khodorov about design thinking to improve healthcare outcomes, getting involved with innovation as a trainee, and ways to successfully advocate for idea implementation. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/88AWhz --- SHOW NOTES Dr. Khodorov was introduced to design thinking when he was pursuing his MBA before medical school. Design thinking revolves around the idea of human-centered design, and it is useful when thinking about healthcare outcomes. The process involves a combination of the scientific process and creative elements. In medical school, Dr. Khodorov led a student organization that taught innovation concepts and encouraged his classmates to explore the entrepreneurship space. The doctors review examples of good and bad designs, such as pill packs instead of orange pill bottles, the confusing EpiPen drug delivery system, the automated voice system on AEDs, and instructions for scrub machines. Then, they focus on design projects that Dr. Khodorov has been working on during his residency. During his intern year, he introduced design thinking to surgical didactic conferences. As an IR resident, he has embarked on collaboration projects with industrial design students to improve the angio suite. One of these improvements was ceiling-mounted lighting that improves visibility during procedures. Dr. Khodorov believes that valuable insights can be offered by people outside of medicine, since they often question the status quo of healthcare and can generate ideas to solve efficiency and safety problems. He notes that it is important to judge two specific characteristics of each idea– effort and impact. The best ideas are the ones with the lowest effort and the highest impact. The next step is to convince stakeholders to accept and invest in the idea. It is helpful to find key performance indicators, forecast numerical outcomes, and identify mentors who will champion the idea. Pitching an idea as a quality improvement initiative is a great way to get dedicated time to work on the project, although it is important to pay attention to institutional policies about intellectual property. Throughout the episode, Dr. Khodorov shares some of his favorite innovation resources, including conferences, workshops and books. --- RESOURCES Health Design Lab: https://www.healthdesignlab.com/ Health Design Thinking: https://www.amazon.com/Health-Design-Thinking-Creating-Products/dp/0262539136 Google Ventures: https://www.gv.com/ This is Service Design Doing: https://www.thisisservicedesigndoing.com/ Fri, 07 Jul 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Gregg Khodorov about design thinking to improve healthcare outcomes, getting involved with innovation as a trainee, and ways to successfully advocate for idea implementation. In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Gregg Khodorov about design thinking to improve healthcare outcomes, getting involved with innovation as a trainee, and ways to successfully advocate for idea implementation. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/88AWhz --- SHOW NOTES Dr. Khodorov was introduced to design thinking when he was pursuing his MBA before medical school. Design thinking revolves around the idea of human-centered design, and it is useful when thinking about healthcare outcomes. The process involves a combination of the scientific process and creative elements. In medical school, Dr. Khodorov led a student organization that taught innovation concepts and encouraged his classmates to explore the entrepreneurship space. The doctors review examples of good and bad designs, such as pill packs instead of orange pill bottles, the confusing EpiPen drug delivery system, the automated voice system on AEDs, and instructions for scrub machines. Then, they focus on design projects that Dr. Khodorov has been working on during his residency. During his intern year, he introduced design thinking to surgical didactic conferences. As an IR resident, he has embarked on collaboration projects with industrial design students to improve the angio suite. One of these improvements was ceiling-mounted lighting that improves visibility during procedures. Dr. Khodorov believes that valuable insights can be offered by people outside of medicine, since they often question the status quo of healthcare and can generate ideas to solve efficiency and safety problems. He notes that it is important to judge two specific characteristics of each idea– effort and impact. The best ideas are the ones with the lowest effort and the highest impact. The next step is to convince stakeholders to accept and invest in the idea. It is helpful to find key performance indicators, forecast numerical outcomes, and identify mentors who will champion the idea. Pitching an idea as a quality improvement initiative is a great way to get dedicated time to work on the project, although it is important to pay attention to institutional policies about intellectual property. Throughout the episode, Dr. Khodorov shares some of his favorite innovation resources, including conferences, workshops and books. --- RESOURCES Health Design Lab: https://www.healthdesignlab.com/ Health Design Thinking: https://www.amazon.com/Health-Design-Thinking-Creating-Products/dp/0262539136 Google Ventures: https://www.gv.com/ This is Service Design Doing: https://www.thisisservicedesigndoing.com/ In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Gregg Khodorov about design thinking to improve healthcare outcomes, getting involved with innovation as a trainee, and ways to successfully advocate for idea implementation.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/88AWhz


---


SHOW NOTES


Dr. Khodorov was introduced to design thinking when he was pursuing his MBA before medical school. Design thinking revolves around the idea of human-centered design, and it is useful when thinking about healthcare outcomes. The process involves a combination of the scientific process and creative elements. In medical school, Dr. Khodorov led a student organization that taught innovation concepts and encouraged his classmates to explore the entrepreneurship space. The doctors review examples of good and bad designs, such as pill packs instead of orange pill bottles, the confusing EpiPen drug delivery system, the automated voice system on AEDs, and instructions for scrub machines.


Then, they focus on design projects that Dr. Khodorov has been working on during his residency. During his intern year, he introduced design thinking to surgical didactic conferences. As an IR resident, he has embarked on collaboration projects with industrial design students to improve the angio suite. One of these improvements was ceiling-mounted lighting that improves visibility during procedures. Dr. Khodorov believes that valuable insights can be offered by people outside of medicine, since they often question the status quo of healthcare and can generate ideas to solve efficiency and safety problems. He notes that it is important to judge two specific characteristics of each idea– effort and impact. The best ideas are the ones with the lowest effort and the highest impact.


The next step is to convince stakeholders to accept and invest in the idea. It is helpful to find key performance indicators, forecast numerical outcomes, and identify mentors who will champion the idea. Pitching an idea as a quality improvement initiative is a great way to get dedicated time to work on the project, although it is important to pay attention to institutional policies about intellectual property. Throughout the episode, Dr. Khodorov shares some of his favorite innovation resources, including conferences, workshops and books.


---


RESOURCES


Health Design Lab:

https://www.healthdesignlab.com/


Health Design Thinking:

https://www.amazon.com/Health-Design-Thinking-Creating-Products/dp/0262539136


Google Ventures:

https://www.gv.com/


This is Service Design Doing:

https://www.thisisservicedesigndoing.com/

]]> 2604 Ep. 340 Awake Spine Surgery with Dr. Alok Sharan In this episode, Dr. Jacob Fleming interviews Dr. Alok Sharan about low back awake spinal surgery. This innovative approach offers patients a more pleasant surgical experience compared to traditional surgery under general anesthesia. Not only does it provide better patient outcomes, but it also reduces the need for opioid pain medication and allows for improved mobility after the procedure. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/3kWFrM --- SHOW NOTES Dr. Sharan began his career in academic medicine at Montefiore, where he gained valuable experience in caring for individuals with severe back problems requiring spine surgery. During his time at Montefiore, Dr. Sharan recognized the changing landscape of healthcare and decided to pursue a healthcare MBA. This unique combination of medical expertise and business knowledge led him to transition to private practice. Dr. Sharan explains that awake spinal surgery offers several benefits for patients undergoing spine procedures. It enables patients to mobilize and recover from surgery more quickly, leading to faster overall recovery times and decreased risk of delirium. Additionally, patients have the opportunity to return home on the same day as the surgery, promoting a more convenient and comfortable experience. Awake spinal surgery also helps reduce the reliance on narcotics for pain management, with patients typically only needing narcotics for around four days compared to the usual four to six weeks with surgeries performed under general anesthesia. Due to the improvement in patient outcomes and the tremendous cost-efficiency of the procedure, awake spinal surgery is an appealing option for individuals requiring spinal fusions and other procedures. Dr. Sharan's entrepreneurial drive has led him to create a comprehensive preoperative education program. His patients are provided with virtual reality headsets to simulate and experience the day of surgery and the actual surgical procedure. The aim is to alleviate any fears or anxieties the patients may have prior to undergoing surgery by immersing them in a realistic virtual environment. This approach helps to prepare patients mentally and emotionally, ensuring a smoother and more comfortable surgical experience. Dr. Sharan is now sharing his techniques with surgeons around the world and anticipates this technique being implemented in many fields in the future. --- RESOURCES Awake Spinal Fusion: https://awakespinalfusion.com Doc Social: https://doc.social Dr. Sharan’s LinkedIn: https://www.linkedin.com/in/alok-sharan-6a612610/ Wed, 05 Jul 2023 05:05:00 -0000 full BackTable In this episode, Dr. Jacob Fleming interviews Dr. Alok Sharan about low back awake spinal surgery. This innovative approach offers patients a more pleasant surgical experience compared to traditional surgery under general anesthesia. Not only does it provide better patient outcomes, but it also reduces the need for opioid pain medication and allows for improved mobility after the procedure. In this episode, Dr. Jacob Fleming interviews Dr. Alok Sharan about low back awake spinal surgery. This innovative approach offers patients a more pleasant surgical experience compared to traditional surgery under general anesthesia. Not only does it provide better patient outcomes, but it also reduces the need for opioid pain medication and allows for improved mobility after the procedure. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/3kWFrM --- SHOW NOTES Dr. Sharan began his career in academic medicine at Montefiore, where he gained valuable experience in caring for individuals with severe back problems requiring spine surgery. During his time at Montefiore, Dr. Sharan recognized the changing landscape of healthcare and decided to pursue a healthcare MBA. This unique combination of medical expertise and business knowledge led him to transition to private practice. Dr. Sharan explains that awake spinal surgery offers several benefits for patients undergoing spine procedures. It enables patients to mobilize and recover from surgery more quickly, leading to faster overall recovery times and decreased risk of delirium. Additionally, patients have the opportunity to return home on the same day as the surgery, promoting a more convenient and comfortable experience. Awake spinal surgery also helps reduce the reliance on narcotics for pain management, with patients typically only needing narcotics for around four days compared to the usual four to six weeks with surgeries performed under general anesthesia. Due to the improvement in patient outcomes and the tremendous cost-efficiency of the procedure, awake spinal surgery is an appealing option for individuals requiring spinal fusions and other procedures. Dr. Sharan's entrepreneurial drive has led him to create a comprehensive preoperative education program. His patients are provided with virtual reality headsets to simulate and experience the day of surgery and the actual surgical procedure. The aim is to alleviate any fears or anxieties the patients may have prior to undergoing surgery by immersing them in a realistic virtual environment. This approach helps to prepare patients mentally and emotionally, ensuring a smoother and more comfortable surgical experience. Dr. Sharan is now sharing his techniques with surgeons around the world and anticipates this technique being implemented in many fields in the future. --- RESOURCES Awake Spinal Fusion: https://awakespinalfusion.com Doc Social: https://doc.social Dr. Sharan’s LinkedIn: https://www.linkedin.com/in/alok-sharan-6a612610/ In this episode, Dr. Jacob Fleming interviews Dr. Alok Sharan about low back awake spinal surgery. This innovative approach offers patients a more pleasant surgical experience compared to traditional surgery under general anesthesia. Not only does it provide better patient outcomes, but it also reduces the need for opioid pain medication and allows for improved mobility after the procedure.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/3kWFrM


---


SHOW NOTES


Dr. Sharan began his career in academic medicine at Montefiore, where he gained valuable experience in caring for individuals with severe back problems requiring spine surgery. During his time at Montefiore, Dr. Sharan recognized the changing landscape of healthcare and decided to pursue a healthcare MBA. This unique combination of medical expertise and business knowledge led him to transition to private practice.


Dr. Sharan explains that awake spinal surgery offers several benefits for patients undergoing spine procedures. It enables patients to mobilize and recover from surgery more quickly, leading to faster overall recovery times and decreased risk of delirium. Additionally, patients have the opportunity to return home on the same day as the surgery, promoting a more convenient and comfortable experience. Awake spinal surgery also helps reduce the reliance on narcotics for pain management, with patients typically only needing narcotics for around four days compared to the usual four to six weeks with surgeries performed under general anesthesia. Due to the improvement in patient outcomes and the tremendous cost-efficiency of the procedure, awake spinal surgery is an appealing option for individuals requiring spinal fusions and other procedures.


Dr. Sharan's entrepreneurial drive has led him to create a comprehensive preoperative education program. His patients are provided with virtual reality headsets to simulate and experience the day of surgery and the actual surgical procedure. The aim is to alleviate any fears or anxieties the patients may have prior to undergoing surgery by immersing them in a realistic virtual environment. This approach helps to prepare patients mentally and emotionally, ensuring a smoother and more comfortable surgical experience. Dr. Sharan is now sharing his techniques with surgeons around the world and anticipates this technique being implemented in many fields in the future.


---


RESOURCES


Awake Spinal Fusion:

https://awakespinalfusion.com


Doc Social:

https://doc.social


Dr. Sharan’s LinkedIn:

https://www.linkedin.com/in/alok-sharan-6a612610/

]]> 3047 Ep. 339 The Importance of a Multidisciplinary Filter Retrieval Team with Dr. Warren Clements and Dr. Premal Trivedi In this episode, guest host Dr. Robert Ryu interviews Dr. Warren Clements and Dr. Premal Trivedi about the current state of IVC filter retrievals, obstacles to increasing retrieval rates, and their experiences with implementing programs to increase IVC filter retrieval rates within their respective healthcare systems. --- CHECK OUT OUR SPONSOR Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205 --- SHOW NOTES Dr. Clements begins the discussion by giving an overview of his recent paper published in CVIR, which explores a novel multidisciplinary approach to IVC filter retrievals. He introduces key features of the Australian healthcare system that contribute to their strengths and challenges with IVC filter retrievals. Dr. Clements emphasizes the positive correlation between maintaining an active database of all IVC filter patients and increased retrieval rates. He discusses the limitations of their previous approach towards IVC filter retrievals, which relied on referring physicians and an automatic retrieval referral system. This passive model posed issues with timing and led to a lower retrieval rate. He also highlights the differences in governmental oversight and filter utilization between Australia and the US, emphasizing the importance of aiming for a 100% retrieval rate. The new approach at his hospital involves a multidisciplinary team, which has resulted in retrieval rates going from 53% to 74% . Next, Dr. Trivedi discusses his recent paper, which is also focused on quality improvement surrounding IVC filter retrieval. He describes his health system’s previous passive approach that relied on a follow-up list of all patients with IVC filters. The list was checked monthly, and letters were sent to patients providing the status of their filters along with educational material. However, since 2016, they have adopted an active methodology, which relies on the IR team actively evaluating the list of patients with an IVC filter and verifying whether retrieval is appropriate in each case. This active approach engages referring doctors and schedules retrievals as needed. Implementing this new methodology has resulted in an increase in IVC retrieval rates from 49% to 61%. The doctors discuss the significant number of filters placed before 2010 that still need to be retrieved. They emphasize the need for a central dedicated team to take responsibility for filter follow-up and retrieval, and they highlight potential role of AI in automating the process and addressing issues related to patients who are lost to follow-up. Finally, they discuss the future of filter retrieval. Both Dr. Clements and Dr. Trivedi stress the importance of knowing the IVC retrieval rate to set goals accordingly. Dr. Clements shares his team's goal of reducing median dwell time to less than 150 days and the benefits of establishing a national registry. Dr. Trivedi emphasizes the need for incremental goals and celebrating small wins on the path towards increasing overall filter retrieval rates. He also discusses the importance of aligning economic and health incentives and leveraging existing AI technology. They all agree that achieving a 100% filter retrieval rate requires a collaborative effort within a multidisciplinary team. --- RESOURCES “Improving the rate of inferior vena cava filter retrieval through multidisciplinary engagement” by Clements et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958400/ “Inferior Vena Cava Filter Retrieval Rates Associated With Passive and Active Surveillance Strategies Adopted by Implanting Physicians” By Trivedi and Ryu et al: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802524 Mon, 03 Jul 2023 05:05:00 -0000 full BackTable In this episode, guest host Dr. Robert Ryu interviews Dr. Warren Clements and Dr. Premal Trivedi about the current state of IVC filter retrievals, obstacles to increasing retrieval rates, and their experiences with implementing programs to increase IVC filter retrieval rates within their respective healthcare systems. In this episode, guest host Dr. Robert Ryu interviews Dr. Warren Clements and Dr. Premal Trivedi about the current state of IVC filter retrievals, obstacles to increasing retrieval rates, and their experiences with implementing programs to increase IVC filter retrieval rates within their respective healthcare systems. --- CHECK OUT OUR SPONSOR Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205 --- SHOW NOTES Dr. Clements begins the discussion by giving an overview of his recent paper published in CVIR, which explores a novel multidisciplinary approach to IVC filter retrievals. He introduces key features of the Australian healthcare system that contribute to their strengths and challenges with IVC filter retrievals. Dr. Clements emphasizes the positive correlation between maintaining an active database of all IVC filter patients and increased retrieval rates. He discusses the limitations of their previous approach towards IVC filter retrievals, which relied on referring physicians and an automatic retrieval referral system. This passive model posed issues with timing and led to a lower retrieval rate. He also highlights the differences in governmental oversight and filter utilization between Australia and the US, emphasizing the importance of aiming for a 100% retrieval rate. The new approach at his hospital involves a multidisciplinary team, which has resulted in retrieval rates going from 53% to 74% . Next, Dr. Trivedi discusses his recent paper, which is also focused on quality improvement surrounding IVC filter retrieval. He describes his health system’s previous passive approach that relied on a follow-up list of all patients with IVC filters. The list was checked monthly, and letters were sent to patients providing the status of their filters along with educational material. However, since 2016, they have adopted an active methodology, which relies on the IR team actively evaluating the list of patients with an IVC filter and verifying whether retrieval is appropriate in each case. This active approach engages referring doctors and schedules retrievals as needed. Implementing this new methodology has resulted in an increase in IVC retrieval rates from 49% to 61%. The doctors discuss the significant number of filters placed before 2010 that still need to be retrieved. They emphasize the need for a central dedicated team to take responsibility for filter follow-up and retrieval, and they highlight potential role of AI in automating the process and addressing issues related to patients who are lost to follow-up. Finally, they discuss the future of filter retrieval. Both Dr. Clements and Dr. Trivedi stress the importance of knowing the IVC retrieval rate to set goals accordingly. Dr. Clements shares his team's goal of reducing median dwell time to less than 150 days and the benefits of establishing a national registry. Dr. Trivedi emphasizes the need for incremental goals and celebrating small wins on the path towards increasing overall filter retrieval rates. He also discusses the importance of aligning economic and health incentives and leveraging existing AI technology. They all agree that achieving a 100% filter retrieval rate requires a collaborative effort within a multidisciplinary team. --- RESOURCES “Improving the rate of inferior vena cava filter retrieval through multidisciplinary engagement” by Clements et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958400/ “Inferior Vena Cava Filter Retrieval Rates Associated With Passive and Active Surveillance Strategies Adopted by Implanting Physicians” By Trivedi and Ryu et al: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802524 In this episode, guest host Dr. Robert Ryu interviews Dr. Warren Clements and Dr. Premal Trivedi about the current state of IVC filter retrievals, obstacles to increasing retrieval rates, and their experiences with implementing programs to increase IVC filter retrieval rates within their respective healthcare systems.


---


CHECK OUT OUR SPONSOR


Boston Scientific Lab Agent

https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent/contact.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-labagent-hci&utm_content=n-backtable-n-backtable_site_labagent_1_2023&cid=n10013205


---


SHOW NOTES


Dr. Clements begins the discussion by giving an overview of his recent paper published in CVIR, which explores a novel multidisciplinary approach to IVC filter retrievals. He introduces key features of the Australian healthcare system that contribute to their strengths and challenges with IVC filter retrievals. Dr. Clements emphasizes the positive correlation between maintaining an active database of all IVC filter patients and increased retrieval rates. He discusses the limitations of their previous approach towards IVC filter retrievals, which relied on referring physicians and an automatic retrieval referral system. This passive model posed issues with timing and led to a lower retrieval rate. He also highlights the differences in governmental oversight and filter utilization between Australia and the US, emphasizing the importance of aiming for a 100% retrieval rate. The new approach at his hospital involves a multidisciplinary team, which has resulted in retrieval rates going from 53% to 74% .


Next, Dr. Trivedi discusses his recent paper, which is also focused on quality improvement surrounding IVC filter retrieval. He describes his health system’s previous passive approach that relied on a follow-up list of all patients with IVC filters. The list was checked monthly, and letters were sent to patients providing the status of their filters along with educational material. However, since 2016, they have adopted an active methodology, which relies on the IR team actively evaluating the list of patients with an IVC filter and verifying whether retrieval is appropriate in each case. This active approach engages referring doctors and schedules retrievals as needed. Implementing this new methodology has resulted in an increase in IVC retrieval rates from 49% to 61%.


The doctors discuss the significant number of filters placed before 2010 that still need to be retrieved. They emphasize the need for a central dedicated team to take responsibility for filter follow-up and retrieval, and they highlight potential role of AI in automating the process and addressing issues related to patients who are lost to follow-up.


Finally, they discuss the future of filter retrieval. Both Dr. Clements and Dr. Trivedi stress the importance of knowing the IVC retrieval rate to set goals accordingly. Dr. Clements shares his team's goal of reducing median dwell time to less than 150 days and the benefits of establishing a national registry. Dr. Trivedi emphasizes the need for incremental goals and celebrating small wins on the path towards increasing overall filter retrieval rates. He also discusses the importance of aligning economic and health incentives and leveraging existing AI technology. They all agree that achieving a 100% filter retrieval rate requires a collaborative effort within a multidisciplinary team.


---


RESOURCES


“Improving the rate of inferior vena cava filter retrieval through multidisciplinary engagement” by Clements et al:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958400/


“Inferior Vena Cava Filter Retrieval Rates Associated With Passive and Active Surveillance Strategies Adopted by Implanting Physicians” By Trivedi and Ryu et al:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802524

]]> 2888 Ep. 338 Surgical Options for Lymphedema with Dr. Kuldeep Singh In this episode, host Dr. Aparna Baheti interviews Dr. Kuldeep Singh who breaks down the three stages of lymphedema, their respective medical and surgical treatment options, all while sharing key insights he has developed through years of experience in treating and caring for patients with lymphedema at a high level throughout the episode. --- CHECK OUT OUR SPONSORS Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Kuldeep is a Vascular Surgeon, the Director of Limb Salvage Surgery, and Program Director at Zucker School of Medicine at North Wall Hospital in Staten Island. He begins by recounting the first time he was approached by a patient suffering from Stage 3 lower extremity lymphedema, along with his initial thought process/treatment plan for the patient. He then goes on to speak on several similarities/challenges he has encountered through treating a number of patients with lymphedema, including managing/treating psychological body dysmorphia in most patients after successful surgical treatment of lymphedema. Kuldeep underscores the gravity and risks associated with moving forward with the Charles procedure (which is also known as lymphedema debulking operation), how such a surgical option should only be considered for patients with Stage 3 lymphedema, and how to encourage and promote consistent pre-operative care. Kuldeep goes onto discuss the operation itself in detail - explaining how the surgery is best done as a team (Vascular (dissecting soft tissue and placing Wound VAC for 1 week to promote formation of granulation tissue), Plastics (skin grafting/reconstruction after 1 week), and Pathology), working within the fascial plane (differentiating fascia, muscle, and fat), dealing with calcified fat effectively, difficulty of identifying fascia in setting of lymphedema, and working near the ankle (avoiding iatrogenic injury of anterior and posterior tibial arteries and achilles tendon). We wrap up the episode by discussing postoperative course: admitting the patient into Burn ICU after each step of the procedure, reapplying Wound VAC after Vascular and Plastic portions, and only discharging the patient from Burn ICU to a rehab facility after evidence of good graft uptake. --- RESOURCES Limb Salvage for “Hopeless” Lymphedema: Reviving the Charles Procedure by Singh et al. DOI: https://doi.org/10.1016/j.jvs.2019.01.021 Fri, 30 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aparna Baheti interviews Dr. Kuldeep Singh who breaks down the three stages of lymphedema, their respective medical and surgical treatment options, all while sharing key insights he has developed through years of experience in treating and caring for patients with lymphedema at a high level throughout the episode. In this episode, host Dr. Aparna Baheti interviews Dr. Kuldeep Singh who breaks down the three stages of lymphedema, their respective medical and surgical treatment options, all while sharing key insights he has developed through years of experience in treating and caring for patients with lymphedema at a high level throughout the episode. --- CHECK OUT OUR SPONSORS Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Kuldeep is a Vascular Surgeon, the Director of Limb Salvage Surgery, and Program Director at Zucker School of Medicine at North Wall Hospital in Staten Island. He begins by recounting the first time he was approached by a patient suffering from Stage 3 lower extremity lymphedema, along with his initial thought process/treatment plan for the patient. He then goes on to speak on several similarities/challenges he has encountered through treating a number of patients with lymphedema, including managing/treating psychological body dysmorphia in most patients after successful surgical treatment of lymphedema. Kuldeep underscores the gravity and risks associated with moving forward with the Charles procedure (which is also known as lymphedema debulking operation), how such a surgical option should only be considered for patients with Stage 3 lymphedema, and how to encourage and promote consistent pre-operative care. Kuldeep goes onto discuss the operation itself in detail - explaining how the surgery is best done as a team (Vascular (dissecting soft tissue and placing Wound VAC for 1 week to promote formation of granulation tissue), Plastics (skin grafting/reconstruction after 1 week), and Pathology), working within the fascial plane (differentiating fascia, muscle, and fat), dealing with calcified fat effectively, difficulty of identifying fascia in setting of lymphedema, and working near the ankle (avoiding iatrogenic injury of anterior and posterior tibial arteries and achilles tendon). We wrap up the episode by discussing postoperative course: admitting the patient into Burn ICU after each step of the procedure, reapplying Wound VAC after Vascular and Plastic portions, and only discharging the patient from Burn ICU to a rehab facility after evidence of good graft uptake. --- RESOURCES Limb Salvage for “Hopeless” Lymphedema: Reviving the Charles Procedure by Singh et al. DOI: https://doi.org/10.1016/j.jvs.2019.01.021 In this episode, host Dr. Aparna Baheti interviews Dr. Kuldeep Singh who breaks down the three stages of lymphedema, their respective medical and surgical treatment options, all while sharing key insights he has developed through years of experience in treating and caring for patients with lymphedema at a high level throughout the episode.


---


CHECK OUT OUR SPONSORS


Medtronic HawkOne Directional Atherectomy System

https://www.medtronic.com/hawkone


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


Dr. Kuldeep is a Vascular Surgeon, the Director of Limb Salvage Surgery, and Program Director at Zucker School of Medicine at North Wall Hospital in Staten Island. He begins by recounting the first time he was approached by a patient suffering from Stage 3 lower extremity lymphedema, along with his initial thought process/treatment plan for the patient. He then goes on to speak on several similarities/challenges he has encountered through treating a number of patients with lymphedema, including managing/treating psychological body dysmorphia in most patients after successful surgical treatment of lymphedema.


Kuldeep underscores the gravity and risks associated with moving forward with the Charles procedure (which is also known as lymphedema debulking operation), how such a surgical option should only be considered for patients with Stage 3 lymphedema, and how to encourage and promote consistent pre-operative care.


Kuldeep goes onto discuss the operation itself in detail - explaining how the surgery is best done as a team (Vascular (dissecting soft tissue and placing Wound VAC for 1 week to promote formation of granulation tissue), Plastics (skin grafting/reconstruction after 1 week), and Pathology), working within the fascial plane (differentiating fascia, muscle, and fat), dealing with calcified fat effectively, difficulty of identifying fascia in setting of lymphedema, and working near the ankle (avoiding iatrogenic injury of anterior and posterior tibial arteries and achilles tendon).


We wrap up the episode by discussing postoperative course: admitting the patient into Burn ICU after each step of the procedure, reapplying Wound VAC after Vascular and Plastic portions, and only discharging the patient from Burn ICU to a rehab facility after evidence of good graft uptake.


---


RESOURCES


Limb Salvage for “Hopeless” Lymphedema: Reviving the Charles Procedure by Singh et al.

DOI: https://doi.org/10.1016/j.jvs.2019.01.021

]]> 2676 Ep. 337 Management of Vulvar Varices with Dr. Brooke Spencer In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Brooke Spencer about management of pelvic venous disease, endovascular therapies for pelvic varices, and important considerations for treating patients with complex and chronic pain. --- CHECK OUT OUR SPONSOR Boston Scientific Drug Elution https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_portfolio_1_2023&cid=n10012334 --- SHOW NOTES Dr. Spencer serves as the CEO and medical director of Minimally Invasive Procedure Specialists in Denver, CO. Her patients commonly get referred from OB/GYNs for chronic pelvic pain that is refractory to laparoscopic surgery and undiagnosed. She notes that collaborative relationships with women's health specialists and pelvic pain physical therapists are necessary for adequate patient outreach. Classifying cases by the location and nature of the vessel abnormality (i.e. compressive, obstructive, varicose, reflux, congenital) allows her to think about the best treatment for each patient. Targeting proximal veins can improve back and groin pain, dyspareunia, and heavy periods. Iliac vein stenting can improve compressive symptoms 50% of the time. On the other hand, isolated labial pain is best treated by directly targeting labial varices. Perineal ultrasound is a helpful way to locate some varicosities, but Dr. Spencer prefers MRI and digital subtraction venography to get a comprehensive venous picture and correlate symptoms with imaging. Next, the doctors discuss embolization and foam sclerotherapy. Through her experience, Dr. Spencer has seen sclerotherapy work better in varices with slower outflow and coil embolization work better for varices with more rapid flow. She prefers oversized floppy coils to minimize the risk of migration. With both treatments, there can be significant insurance barriers. It is important to utilize preauthorization specialists and be aware of what the patient’s insurance will cover, in order to better frame a conversation about treatment options. After the procedure, maximal pain relief can be achieved anywhere between 3 to 6 months. During this period, it is important to counsel patients over adjunct therapies such as pelvic floor therapy, steroids, and puncture aspiration to remove trapped blood. Overall, Dr. Spencer wants IRs to keep in mind that the chronic pain population has faced many misdiagnoses and insurance barriers, so they might harbor mistrust of the healthcare system. It is crucial to acknowledge their feelings and understand their anatomy in order to manage their expectations. --- RESOURCES Pelvic Guru: https://pelvicguru.com/ Efficacy of Endovascular Treatment for Pelvic Congestion Syndrome: https://pubmed.ncbi.nlm.nih.gov/27318059/ International Pelvic Pain Society: https://www.pelvicpain.org/ “The Way Out” book: https://www.amazon.com/Way-Out-Revolutionary-Scientifically-Approach/dp/059308683X Mon, 26 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Brooke Spencer about management of pelvic venous disease, endovascular therapies for pelvic varices, and important considerations for treating patients with complex and chronic pain. In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Brooke Spencer about management of pelvic venous disease, endovascular therapies for pelvic varices, and important considerations for treating patients with complex and chronic pain. --- CHECK OUT OUR SPONSOR Boston Scientific Drug Elution https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_portfolio_1_2023&cid=n10012334 --- SHOW NOTES Dr. Spencer serves as the CEO and medical director of Minimally Invasive Procedure Specialists in Denver, CO. Her patients commonly get referred from OB/GYNs for chronic pelvic pain that is refractory to laparoscopic surgery and undiagnosed. She notes that collaborative relationships with women's health specialists and pelvic pain physical therapists are necessary for adequate patient outreach. Classifying cases by the location and nature of the vessel abnormality (i.e. compressive, obstructive, varicose, reflux, congenital) allows her to think about the best treatment for each patient. Targeting proximal veins can improve back and groin pain, dyspareunia, and heavy periods. Iliac vein stenting can improve compressive symptoms 50% of the time. On the other hand, isolated labial pain is best treated by directly targeting labial varices. Perineal ultrasound is a helpful way to locate some varicosities, but Dr. Spencer prefers MRI and digital subtraction venography to get a comprehensive venous picture and correlate symptoms with imaging. Next, the doctors discuss embolization and foam sclerotherapy. Through her experience, Dr. Spencer has seen sclerotherapy work better in varices with slower outflow and coil embolization work better for varices with more rapid flow. She prefers oversized floppy coils to minimize the risk of migration. With both treatments, there can be significant insurance barriers. It is important to utilize preauthorization specialists and be aware of what the patient’s insurance will cover, in order to better frame a conversation about treatment options. After the procedure, maximal pain relief can be achieved anywhere between 3 to 6 months. During this period, it is important to counsel patients over adjunct therapies such as pelvic floor therapy, steroids, and puncture aspiration to remove trapped blood. Overall, Dr. Spencer wants IRs to keep in mind that the chronic pain population has faced many misdiagnoses and insurance barriers, so they might harbor mistrust of the healthcare system. It is crucial to acknowledge their feelings and understand their anatomy in order to manage their expectations. --- RESOURCES Pelvic Guru: https://pelvicguru.com/ Efficacy of Endovascular Treatment for Pelvic Congestion Syndrome: https://pubmed.ncbi.nlm.nih.gov/27318059/ International Pelvic Pain Society: https://www.pelvicpain.org/ “The Way Out” book: https://www.amazon.com/Way-Out-Revolutionary-Scientifically-Approach/dp/059308683X In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Brooke Spencer about management of pelvic venous disease, endovascular therapies for pelvic varices, and important considerations for treating patients with complex and chronic pain.


---


CHECK OUT OUR SPONSOR


Boston Scientific Drug Elution

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_portfolio_1_2023&cid=n10012334


---


SHOW NOTES


Dr. Spencer serves as the CEO and medical director of Minimally Invasive Procedure Specialists in Denver, CO. Her patients commonly get referred from OB/GYNs for chronic pelvic pain that is refractory to laparoscopic surgery and undiagnosed. She notes that collaborative relationships with women's health specialists and pelvic pain physical therapists are necessary for adequate patient outreach. Classifying cases by the location and nature of the vessel abnormality (i.e. compressive, obstructive, varicose, reflux, congenital) allows her to think about the best treatment for each patient. Targeting proximal veins can improve back and groin pain, dyspareunia, and heavy periods. Iliac vein stenting can improve compressive symptoms 50% of the time. On the other hand, isolated labial pain is best treated by directly targeting labial varices. Perineal ultrasound is a helpful way to locate some varicosities, but Dr. Spencer prefers MRI and digital subtraction venography to get a comprehensive venous picture and correlate symptoms with imaging.


Next, the doctors discuss embolization and foam sclerotherapy. Through her experience, Dr. Spencer has seen sclerotherapy work better in varices with slower outflow and coil embolization work better for varices with more rapid flow. She prefers oversized floppy coils to minimize the risk of migration. With both treatments, there can be significant insurance barriers. It is important to utilize preauthorization specialists and be aware of what the patient’s insurance will cover, in order to better frame a conversation about treatment options.


After the procedure, maximal pain relief can be achieved anywhere between 3 to 6 months. During this period, it is important to counsel patients over adjunct therapies such as pelvic floor therapy, steroids, and puncture aspiration to remove trapped blood. Overall, Dr. Spencer wants IRs to keep in mind that the chronic pain population has faced many misdiagnoses and insurance barriers, so they might harbor mistrust of the healthcare system. It is crucial to acknowledge their feelings and understand their anatomy in order to manage their expectations.


---


RESOURCES


Pelvic Guru:

https://pelvicguru.com/


Efficacy of Endovascular Treatment for Pelvic Congestion Syndrome:

https://pubmed.ncbi.nlm.nih.gov/27318059/


International Pelvic Pain Society:

https://www.pelvicpain.org/


“The Way Out” book:

https://www.amazon.com/Way-Out-Revolutionary-Scientifically-Approach/dp/059308683X

]]> 2695 Ep. 336 My Algorithm for Below the Knee CLI with Dr. Peter Soukas In this episode, host Dr. Christopher Beck interviews Dr. Peter Soukas about his algorithm for below the knee (BTK) critical limb ischemia (CLI) interventions as well as his implementation of new evidence-based guidance. --- CHECK OUT OUR SPONSOR Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone --- SHOW NOTES Dr. Soukas serves as the director of vascular medicine, the interventional peripheral vascular lab, and the endovascular medicine fellowship at Brown University in Providence, RI. In addition, he holds the position of associate professor of medicine at The Warren Alpert Medical School at Brown University. Dr. Soukas began his career as an interventional cardiologist. Over the course of his 13-year tenure in Providence, he has dedicated his career to the treatment of CLI and BTK disease. Prior to any interventional work, Dr. Soukas follows a comprehensive work-up including an ankle-brachial index (ABI), arterial duplex, and evaluating kidney function for safe administration of contrast. For a majority of cases, he uses the common femoral artery as the access point, but prefers to prep multiple access sites in the event of needing both anterograde and retrograde, or pedal, access. He discusses the use of the chronic total occlusion crossing approach based on plaque cap morphology (CTOP) classification on angiogram in determining the need for a retrograde approach. The type I morphology is characterized by the convexity of the plaque pointing away and is often treated successfully by an anterograde approach alone, as CTOP types II, III, and IV benefited from the addition of retrograde tibiopedal access. Once access is gained and the plaque morphology is evaluated using angiography, it becomes crucial to address any issues with the inflow to the affected vessel. This step ensures proper blood flow and provides a stable foundation for further interventions. Intravascular ultrasound is then used to assess the size and extent of the plaque, and then depending on the amount of calcification, either intravascular lithotripsy or calcium modifying technology can be used. Scoring balloons with low pressure may also be used for vessels that are moderately calcified and have been shown to have low rates of recoil and dissection. The main initiative of the procedure is to provide blood flow to the target angiosome which is dependent on the location of the wound. During his last remarks, Dr. Soukas comments on the future of BTK interventions, including Paclitaxel vs Sirolimus eluting stents, the use of self-expanding stents, and LimFlow, a minimally invasive technology that creates a channel between an artery and vein allowing the vein to provide blood flow to the foot. With the increasing prevalence of critical limb-threatening ischemia (CLTI) and high 12-month mortality rates in patients with amputations, Dr. Soukas ends the discussion by emphasizing how revascularization should be the preferred initial approach in treating CLTI due to the potential benefits it offers in terms of limb preservation and mortality reduction, urging practitioners to educate patients in being aggressive in their care. --- RESOURCES CTOP article: https://evtoday.com/articles/2018-may/using-plaque-cap-morphology-to-determine-cto-crossing-approach Disrupt PAD III Observational study: https://pubmed.ncbi.nlm.nih.gov/34380334/ PRELUDE BTK Study: https://pubmed.ncbi.nlm.nih.gov/34802313/ Intravascular Ultrasound study: https://www.jacc.org/doi/10.1016/j.jcin.2022.01.001 Intravascular US in Medicare Beneficiaries: https://pubmed.ncbi.nlm.nih.gov/35998803/ PROMISE II study: https://limflow.com/us/clinical-evidence/promise-ii-study-results/ Fri, 23 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Christopher Beck interviews Dr. Peter Soukas about his algorithm for below the knee (BTK) critical limb ischemia (CLI) interventions as well as his implementation of new evidence-based guidance. In this episode, host Dr. Christopher Beck interviews Dr. Peter Soukas about his algorithm for below the knee (BTK) critical limb ischemia (CLI) interventions as well as his implementation of new evidence-based guidance. --- CHECK OUT OUR SPONSOR Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone --- SHOW NOTES Dr. Soukas serves as the director of vascular medicine, the interventional peripheral vascular lab, and the endovascular medicine fellowship at Brown University in Providence, RI. In addition, he holds the position of associate professor of medicine at The Warren Alpert Medical School at Brown University. Dr. Soukas began his career as an interventional cardiologist. Over the course of his 13-year tenure in Providence, he has dedicated his career to the treatment of CLI and BTK disease. Prior to any interventional work, Dr. Soukas follows a comprehensive work-up including an ankle-brachial index (ABI), arterial duplex, and evaluating kidney function for safe administration of contrast. For a majority of cases, he uses the common femoral artery as the access point, but prefers to prep multiple access sites in the event of needing both anterograde and retrograde, or pedal, access. He discusses the use of the chronic total occlusion crossing approach based on plaque cap morphology (CTOP) classification on angiogram in determining the need for a retrograde approach. The type I morphology is characterized by the convexity of the plaque pointing away and is often treated successfully by an anterograde approach alone, as CTOP types II, III, and IV benefited from the addition of retrograde tibiopedal access. Once access is gained and the plaque morphology is evaluated using angiography, it becomes crucial to address any issues with the inflow to the affected vessel. This step ensures proper blood flow and provides a stable foundation for further interventions. Intravascular ultrasound is then used to assess the size and extent of the plaque, and then depending on the amount of calcification, either intravascular lithotripsy or calcium modifying technology can be used. Scoring balloons with low pressure may also be used for vessels that are moderately calcified and have been shown to have low rates of recoil and dissection. The main initiative of the procedure is to provide blood flow to the target angiosome which is dependent on the location of the wound. During his last remarks, Dr. Soukas comments on the future of BTK interventions, including Paclitaxel vs Sirolimus eluting stents, the use of self-expanding stents, and LimFlow, a minimally invasive technology that creates a channel between an artery and vein allowing the vein to provide blood flow to the foot. With the increasing prevalence of critical limb-threatening ischemia (CLTI) and high 12-month mortality rates in patients with amputations, Dr. Soukas ends the discussion by emphasizing how revascularization should be the preferred initial approach in treating CLTI due to the potential benefits it offers in terms of limb preservation and mortality reduction, urging practitioners to educate patients in being aggressive in their care. --- RESOURCES CTOP article: https://evtoday.com/articles/2018-may/using-plaque-cap-morphology-to-determine-cto-crossing-approach Disrupt PAD III Observational study: https://pubmed.ncbi.nlm.nih.gov/34380334/ PRELUDE BTK Study: https://pubmed.ncbi.nlm.nih.gov/34802313/ Intravascular Ultrasound study: https://www.jacc.org/doi/10.1016/j.jcin.2022.01.001 Intravascular US in Medicare Beneficiaries: https://pubmed.ncbi.nlm.nih.gov/35998803/ PROMISE II study: https://limflow.com/us/clinical-evidence/promise-ii-study-results/ In this episode, host Dr. Christopher Beck interviews Dr. Peter Soukas about his algorithm for below the knee (BTK) critical limb ischemia (CLI) interventions as well as his implementation of new evidence-based guidance.


---


CHECK OUT OUR SPONSOR


Medtronic HawkOne Directional Atherectomy System

https://www.medtronic.com/hawkone


---


SHOW NOTES


Dr. Soukas serves as the director of vascular medicine, the interventional peripheral vascular lab, and the endovascular medicine fellowship at Brown University in Providence, RI. In addition, he holds the position of associate professor of medicine at The Warren Alpert Medical School at Brown University. Dr. Soukas began his career as an interventional cardiologist. Over the course of his 13-year tenure in Providence, he has dedicated his career to the treatment of CLI and BTK disease.


Prior to any interventional work, Dr. Soukas follows a comprehensive work-up including an ankle-brachial index (ABI), arterial duplex, and evaluating kidney function for safe administration of contrast. For a majority of cases, he uses the common femoral artery as the access point, but prefers to prep multiple access sites in the event of needing both anterograde and retrograde, or pedal, access. He discusses the use of the chronic total occlusion crossing approach based on plaque cap morphology (CTOP) classification on angiogram in determining the need for a retrograde approach. The type I morphology is characterized by the convexity of the plaque pointing away and is often treated successfully by an anterograde approach alone, as CTOP types II, III, and IV benefited from the addition of retrograde tibiopedal access. Once access is gained and the plaque morphology is evaluated using angiography, it becomes crucial to address any issues with the inflow to the affected vessel. This step ensures proper blood flow and provides a stable foundation for further interventions. Intravascular ultrasound is then used to assess the size and extent of the plaque, and then depending on the amount of calcification, either intravascular lithotripsy or calcium modifying technology can be used. Scoring balloons with low pressure may also be used for vessels that are moderately calcified and have been shown to have low rates of recoil and dissection. The main initiative of the procedure is to provide blood flow to the target angiosome which is dependent on the location of the wound.


During his last remarks, Dr. Soukas comments on the future of BTK interventions, including Paclitaxel vs Sirolimus eluting stents, the use of self-expanding stents, and LimFlow, a minimally invasive technology that creates a channel between an artery and vein allowing the vein to provide blood flow to the foot. With the increasing prevalence of critical limb-threatening ischemia (CLTI) and high 12-month mortality rates in patients with amputations, Dr. Soukas ends the discussion by emphasizing how revascularization should be the preferred initial approach in treating CLTI due to the potential benefits it offers in terms of limb preservation and mortality reduction, urging practitioners to educate patients in being aggressive in their care.


---


RESOURCES


CTOP article:

https://evtoday.com/articles/2018-may/using-plaque-cap-morphology-to-determine-cto-crossing-approach


Disrupt PAD III Observational study:

https://pubmed.ncbi.nlm.nih.gov/34380334/


PRELUDE BTK Study:

https://pubmed.ncbi.nlm.nih.gov/34802313/


Intravascular Ultrasound study:

https://www.jacc.org/doi/10.1016/j.jcin.2022.01.001


Intravascular US in Medicare Beneficiaries:

https://pubmed.ncbi.nlm.nih.gov/35998803/


PROMISE II study:

https://limflow.com/us/clinical-evidence/promise-ii-study-results/

]]> 3833 Ep. 335 Transcranial Focused Ultrasound: Next Generation Imagine-Guided Therapy of the Brain with Dr. Bhavya Shah In this episode, host Dr. Jacob Fleming interviews one of his attendings Dr. Bhavya Shah about the remarkable features of focused ultrasound technology and its applications. They discuss its dynamic nature, allowing for a wide range of applications. --- SHOW NOTES Dr. Bhavya Shah is a neuroradiologist at UT Southwestern in Dallas, TX and the director of their transcranial-focused ultrasound lab. While in residency at Boston MIT, he studied the radiology applications for nerve regeneration and expanded his scope of practice during his fellowship at Stanford. Dr. Bhavya Shah explains the use of low intensity focused ultrasound (LIFU) and high intensity focused ultrasound (HIFU), particularly in the context of movement disorders including essential tremor and Parkinson’s disease. LIFU is used to identify the appropriate targets in the brain in relation to the disease and may be used to alter how neurons behave. In contrast, high intensity focused ultrasound (HIFU) is utilized to ablate and destroy tissues typically after the localization of the intended treatment area. Dr. Shah developed a way to identify targets in the brain for treatment with focused ultrasound with the use of four-tract tractography in cadavers. Using this technology, the brain can be thinly sliced into sections which could then be registered off an MRI back to the path using block face photography, allowing the identification of white matter tracts that enter and leave the thalamus. With these tracts identified, neuroradiologists can first stimulate the localized area with LIFU to confirm the location, then ablate using HIFU. The procedure lasts approximately 30-45 minutes as the patient remains awake. Remarkably, patients with essential tremor usually experience benefit immediately following the procedure as patients with Parkinson’s have symptom improvement within days to weeks. After two hours of observation, patients are discharged assuming no side effects. Side effects are uncommon but can include numbness and tingling around the mouth or fingertips as well as muscle weakness. Beyond its use for movement disorders, the adaptable nature of focused ultrasound technology shows promise for a broad range of applications, particularly for the use of neuropsychiatric conditions. Dr. Shah offers the potential for the use of HIFU as a wearable device that delivers constant stimulation modulated by biofeedback, potentially eliminating the need for MRI for the procedure. Dr. Shah and Dr. Fleming end the discussion with how radiology has evolved over the years and the importance of keeping an open mind working in a multidisciplinary team. They emphasize the gravity of patient engagement and the central goal of medicine and improving the standard of care should always be aimed at benefiting the patient. --- RESOURCES MRI–Guided Focused Ultrasound Thalamotomy for Essential Tremor: https://thejns.org/view/journals/j-neurosurg/138/4/article-p1028.xml Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson’s Disease: https://www.nejm.org/doi/10.1056/NEJMoa2202721 Long-term effects of bilateral subthalamic nucleus deep brain stimulation on gait disorders in Parkinson's disease: a clinical-instrumental study https://pubmed.ncbi.nlm.nih.gov/37208527/ Magnetic Resonance Image Guided Focused Ultrasound Thalamotomy. A Single Center Experience With 160 Procedures: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894664/ Wed, 21 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews one of his attendings Dr. Bhavya Shah about the remarkable features of focused ultrasound technology and its applications. They discuss its dynamic nature, allowing for a wide range of applications. In this episode, host Dr. Jacob Fleming interviews one of his attendings Dr. Bhavya Shah about the remarkable features of focused ultrasound technology and its applications. They discuss its dynamic nature, allowing for a wide range of applications. --- SHOW NOTES Dr. Bhavya Shah is a neuroradiologist at UT Southwestern in Dallas, TX and the director of their transcranial-focused ultrasound lab. While in residency at Boston MIT, he studied the radiology applications for nerve regeneration and expanded his scope of practice during his fellowship at Stanford. Dr. Bhavya Shah explains the use of low intensity focused ultrasound (LIFU) and high intensity focused ultrasound (HIFU), particularly in the context of movement disorders including essential tremor and Parkinson’s disease. LIFU is used to identify the appropriate targets in the brain in relation to the disease and may be used to alter how neurons behave. In contrast, high intensity focused ultrasound (HIFU) is utilized to ablate and destroy tissues typically after the localization of the intended treatment area. Dr. Shah developed a way to identify targets in the brain for treatment with focused ultrasound with the use of four-tract tractography in cadavers. Using this technology, the brain can be thinly sliced into sections which could then be registered off an MRI back to the path using block face photography, allowing the identification of white matter tracts that enter and leave the thalamus. With these tracts identified, neuroradiologists can first stimulate the localized area with LIFU to confirm the location, then ablate using HIFU. The procedure lasts approximately 30-45 minutes as the patient remains awake. Remarkably, patients with essential tremor usually experience benefit immediately following the procedure as patients with Parkinson’s have symptom improvement within days to weeks. After two hours of observation, patients are discharged assuming no side effects. Side effects are uncommon but can include numbness and tingling around the mouth or fingertips as well as muscle weakness. Beyond its use for movement disorders, the adaptable nature of focused ultrasound technology shows promise for a broad range of applications, particularly for the use of neuropsychiatric conditions. Dr. Shah offers the potential for the use of HIFU as a wearable device that delivers constant stimulation modulated by biofeedback, potentially eliminating the need for MRI for the procedure. Dr. Shah and Dr. Fleming end the discussion with how radiology has evolved over the years and the importance of keeping an open mind working in a multidisciplinary team. They emphasize the gravity of patient engagement and the central goal of medicine and improving the standard of care should always be aimed at benefiting the patient. --- RESOURCES MRI–Guided Focused Ultrasound Thalamotomy for Essential Tremor: https://thejns.org/view/journals/j-neurosurg/138/4/article-p1028.xml Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson’s Disease: https://www.nejm.org/doi/10.1056/NEJMoa2202721 Long-term effects of bilateral subthalamic nucleus deep brain stimulation on gait disorders in Parkinson's disease: a clinical-instrumental study https://pubmed.ncbi.nlm.nih.gov/37208527/ Magnetic Resonance Image Guided Focused Ultrasound Thalamotomy. A Single Center Experience With 160 Procedures: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894664/ In this episode, host Dr. Jacob Fleming interviews one of his attendings Dr. Bhavya Shah about the remarkable features of focused ultrasound technology and its applications. They discuss its dynamic nature, allowing for a wide range of applications.


---


SHOW NOTES


Dr. Bhavya Shah is a neuroradiologist at UT Southwestern in Dallas, TX and the director of their transcranial-focused ultrasound lab. While in residency at Boston MIT, he studied the radiology applications for nerve regeneration and expanded his scope of practice during his fellowship at Stanford. Dr. Bhavya Shah explains the use of low intensity focused ultrasound (LIFU) and high intensity focused ultrasound (HIFU), particularly in the context of movement disorders including essential tremor and Parkinson’s disease. LIFU is used to identify the appropriate targets in the brain in relation to the disease and may be used to alter how neurons behave. In contrast, high intensity focused ultrasound (HIFU) is utilized to ablate and destroy tissues typically after the localization of the intended treatment area.


Dr. Shah developed a way to identify targets in the brain for treatment with focused ultrasound with the use of four-tract tractography in cadavers. Using this technology, the brain can be thinly sliced into sections which could then be registered off an MRI back to the path using block face photography, allowing the identification of white matter tracts that enter and leave the thalamus. With these tracts identified, neuroradiologists can first stimulate the localized area with LIFU to confirm the location, then ablate using HIFU. The procedure lasts approximately 30-45 minutes as the patient remains awake. Remarkably, patients with essential tremor usually experience benefit immediately following the procedure as patients with Parkinson’s have symptom improvement within days to weeks. After two hours of observation, patients are discharged assuming no side effects. Side effects are uncommon but can include numbness and tingling around the mouth or fingertips as well as muscle weakness.


Beyond its use for movement disorders, the adaptable nature of focused ultrasound technology shows promise for a broad range of applications, particularly for the use of neuropsychiatric conditions. Dr. Shah offers the potential for the use of HIFU as a wearable device that delivers constant stimulation modulated by biofeedback, potentially eliminating the need for MRI for the procedure. Dr. Shah and Dr. Fleming end the discussion with how radiology has evolved over the years and the importance of keeping an open mind working in a multidisciplinary team. They emphasize the gravity of patient engagement and the central goal of medicine and improving the standard of care should always be aimed at benefiting the patient.


---


RESOURCES


MRI–Guided Focused Ultrasound Thalamotomy for Essential Tremor:

https://thejns.org/view/journals/j-neurosurg/138/4/article-p1028.xml


Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson’s Disease:

https://www.nejm.org/doi/10.1056/NEJMoa2202721


Long-term effects of bilateral subthalamic nucleus deep brain stimulation on gait disorders in Parkinson's disease: a clinical-instrumental study

https://pubmed.ncbi.nlm.nih.gov/37208527/


Magnetic Resonance Image Guided Focused Ultrasound Thalamotomy. A Single Center Experience With 160 Procedures:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894664/

]]> 2856 Ep. 334 New Balloon Technologies for CLI with Dr. Peter Soukas In this episode, host Dr. Aaron Fritts interviews Dr. Peter Soukas taking a deep dive into novel balloon technologies, appropriate uses below the knee, and how these new balloons are highly effective in treating patients with critical limb ischemia (CLI). Dr. Soukas explains how these new balloon technologies can minimize the risk of dissections (therefore decreasing the need for bailout stents), create effective lumen gain in concentric and eccentric calcified lesions with minimal recoil, and keep pressures low compared to legacy products. --- CHECK OUT OUR SPONSOR Cagent Vascular Serranator https://www.cagentvascular.com --- SHOW NOTES Dr. Soukas is an Interventional Cardiologist who is the Founder and Director of the Brown Vascular and Endovascular Medicine Fellowship program, serves as the Director of the Interventional PV Lab at the Lifespan Cardiovascular Institute of Brown, and an Associate Professor of Medicine at the Warren Alpert School of Medicine. We begin by discussing the treatment of CLI, particularly with new below the knee balloon angioplasty devices like the Cagent Serranator and how balloon tech has evolved over time. These new technologies allow for 1000x more force than previous balloon models through unique serration technology at significantly lesser pressures, minimizing the risk of barotrauma and iatrogenic lumen dissections, while allowing for effective luminal gain, and showing success in treating CLI even when calcified lesions are present. What’s more is that there is now a variety of serration balloon lengths available, which was definitely a huge shortcoming in prior scoring balloons with limited sizing. While IVL is the preferred option in terms of treating concentric (360°) calcified lesions, new serration balloons are cheaper and show success in treating both concentric and eccentric calcified lesions with minimal recoil. Dr. Soukas and Dr. Fritts also go on to discuss how using IVUS is critical in visualizing the size, shape, and depth of possible calcifications but also important in picking the correctly sized serration-balloon to get the job done. Dr. Soukas also explains how the serration balloon technology is easily deployable, tracks very well within vasculature, and can even be used below the ankle if needed (with some pre-dilation of the lumen) stating that if the IVUS can fit, usually so can the serration balloon. To wrap up the episode we underscore how important it is to have the right tools in our toolbox to treat patients with CLI, getting as much “red gold” down to the foot as possible to avoid loss of the limb, and a few papers our listeners can check out to learn more about serration balloons (find linked in Resources below). --- RESOURCES CagentVascular.com Prospective Study of Serration Angioplasty in the Infrapopliteal Arteries Using the Serranator Device: PRELUDE BTK Study DOI: 10.1177/15266028211059917 Standard Balloon Angioplasty Versus Serranator Serration Balloon Angioplasty for the Treatment of Below-the-Knee Artery Occlusive Disease: A Single-Center Subanalysis From the PRELUDE-BTK Prospective Study DOI: 10.1177/15266028221134891 PRELUDE Prospective Study of the Serranator Device in the Treatment of Atherosclerotic Lesions in the Superficial Femoral and Popliteal Arteries DOI: 10.1177/1526602818820787 Mon, 19 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Peter Soukas taking a deep dive into novel balloon technologies, appropriate uses below the knee, and how these new balloons are highly effective in treating patients with critical limb ischemia (CLI). In this episode, host Dr. Aaron Fritts interviews Dr. Peter Soukas taking a deep dive into novel balloon technologies, appropriate uses below the knee, and how these new balloons are highly effective in treating patients with critical limb ischemia (CLI). Dr. Soukas explains how these new balloon technologies can minimize the risk of dissections (therefore decreasing the need for bailout stents), create effective lumen gain in concentric and eccentric calcified lesions with minimal recoil, and keep pressures low compared to legacy products. --- CHECK OUT OUR SPONSOR Cagent Vascular Serranator https://www.cagentvascular.com --- SHOW NOTES Dr. Soukas is an Interventional Cardiologist who is the Founder and Director of the Brown Vascular and Endovascular Medicine Fellowship program, serves as the Director of the Interventional PV Lab at the Lifespan Cardiovascular Institute of Brown, and an Associate Professor of Medicine at the Warren Alpert School of Medicine. We begin by discussing the treatment of CLI, particularly with new below the knee balloon angioplasty devices like the Cagent Serranator and how balloon tech has evolved over time. These new technologies allow for 1000x more force than previous balloon models through unique serration technology at significantly lesser pressures, minimizing the risk of barotrauma and iatrogenic lumen dissections, while allowing for effective luminal gain, and showing success in treating CLI even when calcified lesions are present. What’s more is that there is now a variety of serration balloon lengths available, which was definitely a huge shortcoming in prior scoring balloons with limited sizing. While IVL is the preferred option in terms of treating concentric (360°) calcified lesions, new serration balloons are cheaper and show success in treating both concentric and eccentric calcified lesions with minimal recoil. Dr. Soukas and Dr. Fritts also go on to discuss how using IVUS is critical in visualizing the size, shape, and depth of possible calcifications but also important in picking the correctly sized serration-balloon to get the job done. Dr. Soukas also explains how the serration balloon technology is easily deployable, tracks very well within vasculature, and can even be used below the ankle if needed (with some pre-dilation of the lumen) stating that if the IVUS can fit, usually so can the serration balloon. To wrap up the episode we underscore how important it is to have the right tools in our toolbox to treat patients with CLI, getting as much “red gold” down to the foot as possible to avoid loss of the limb, and a few papers our listeners can check out to learn more about serration balloons (find linked in Resources below). --- RESOURCES CagentVascular.com Prospective Study of Serration Angioplasty in the Infrapopliteal Arteries Using the Serranator Device: PRELUDE BTK Study DOI: 10.1177/15266028211059917 Standard Balloon Angioplasty Versus Serranator Serration Balloon Angioplasty for the Treatment of Below-the-Knee Artery Occlusive Disease: A Single-Center Subanalysis From the PRELUDE-BTK Prospective Study DOI: 10.1177/15266028221134891 PRELUDE Prospective Study of the Serranator Device in the Treatment of Atherosclerotic Lesions in the Superficial Femoral and Popliteal Arteries DOI: 10.1177/1526602818820787 In this episode, host Dr. Aaron Fritts interviews Dr. Peter Soukas taking a deep dive into novel balloon technologies, appropriate uses below the knee, and how these new balloons are highly effective in treating patients with critical limb ischemia (CLI). Dr. Soukas explains how these new balloon technologies can minimize the risk of dissections (therefore decreasing the need for bailout stents), create effective lumen gain in concentric and eccentric calcified lesions with minimal recoil, and keep pressures low compared to legacy products.


---


CHECK OUT OUR SPONSOR


Cagent Vascular Serranator

https://www.cagentvascular.com


---


SHOW NOTES


Dr. Soukas is an Interventional Cardiologist who is the Founder and Director of the Brown Vascular and Endovascular Medicine Fellowship program, serves as the Director of the Interventional PV Lab at the Lifespan Cardiovascular Institute of Brown, and an Associate Professor of Medicine at the Warren Alpert School of Medicine. We begin by discussing the treatment of CLI, particularly with new below the knee balloon angioplasty devices like the Cagent Serranator and how balloon tech has evolved over time.


These new technologies allow for 1000x more force than previous balloon models through unique serration technology at significantly lesser pressures, minimizing the risk of barotrauma and iatrogenic lumen dissections, while allowing for effective luminal gain, and showing success in treating CLI even when calcified lesions are present. What’s more is that there is now a variety of serration balloon lengths available, which was definitely a huge shortcoming in prior scoring balloons with limited sizing. While IVL is the preferred option in terms of treating concentric (360°) calcified lesions, new serration balloons are cheaper and show success in treating both concentric and eccentric calcified lesions with minimal recoil.


Dr. Soukas and Dr. Fritts also go on to discuss how using IVUS is critical in visualizing the size, shape, and depth of possible calcifications but also important in picking the correctly sized serration-balloon to get the job done. Dr. Soukas also explains how the serration balloon technology is easily deployable, tracks very well within vasculature, and can even be used below the ankle if needed (with some pre-dilation of the lumen) stating that if the IVUS can fit, usually so can the serration balloon.


To wrap up the episode we underscore how important it is to have the right tools in our toolbox to treat patients with CLI, getting as much “red gold” down to the foot as possible to avoid loss of the limb, and a few papers our listeners can check out to learn more about serration balloons (find linked in Resources below).


---


RESOURCES


CagentVascular.com


Prospective Study of Serration Angioplasty in the Infrapopliteal Arteries Using the Serranator Device: PRELUDE BTK Study

DOI: 10.1177/15266028211059917


Standard Balloon Angioplasty Versus Serranator Serration Balloon Angioplasty for the Treatment of Below-the-Knee Artery Occlusive Disease: A Single-Center Subanalysis From the PRELUDE-BTK Prospective Study

DOI: 10.1177/15266028221134891


PRELUDE Prospective Study of the Serranator Device in the Treatment of Atherosclerotic Lesions in the Superficial Femoral and Popliteal Arteries

DOI: 10.1177/1526602818820787

]]> 1390 Ep. 333 Empowering Patients Through Image Sharing: The PocketHealth Story with Rishi Nayyar In this episode, host Dr. Bryan Hartley interviews Rishi Nayyar, co-founder and CEO of PocketHealth, the first patient-centered medical image exchange platform. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES PocketHealth is a subscription-based image sharing service that allows patients to store, access, and share their medical imaging with providers across different health systems. Rishi and his brother Harsh developed the idea for this service after realizing how antiquated and frustrating it was for patients to physically carry their CDs to different physician offices. Additionally, with the sheer volume of medical images ordered today and the cost of data storage, hospitals usually delete images after a certain period of time. First, the Nayyar brothers conducted their own market research by calling hundreds of local hospitals and clinics and asking them about their image exchange process. This process confirmed that the status quo of image exchange was a burdensome process for patients and inspired them to configure a patient-centered service. The second stage of their entrepreneurial pursuit was to figure out how the service would be paid for. The founders realized that patients were willing to pay a small subscription fee (instead of paying for CDs) to safely indefinitely store and virtually send their own and their family members’ images to healthcare providers using a link or QR code. Overtime, insurance companies have become willing to reimburse this subscription fee. This payment model allows hospitals and clinics to participate in image exchange at no cost, and has been a key factor in encouraging widespread adoption as well as enabling the growth of their enterprise image sharing business. Rishi highlights the fact that he had the advantage of being an outsider to healthcare when he first started the company, which helped him recognize issues with the current system instead of just accepting the standard processes. He shared the same perspectives as patients who were interacting with the system as non-health experts. PocketHealth’s success in the last eight years has propelled it to take on new challenges, such as patient education within radiology reports. Finally, Rishi gives advice to budding entrepreneurs. He encourages them to pick a problem that they don’t mind grinding at, since there is a large initial time and effort requirement needed to convince people to adopt their product. Additionally, the innovation journey is long, so to manage one’s psyche, it is wise to set short term achievable benchmarks and reflect on day-to-day progress. --- RESOURCES PocketHealth: https://www.pockethealth.com/ Fri, 16 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Bryan Hartley interviews Rishi Nayyar, co-founder and CEO of PocketHealth, the first patient-centered medical image exchange platform. In this episode, host Dr. Bryan Hartley interviews Rishi Nayyar, co-founder and CEO of PocketHealth, the first patient-centered medical image exchange platform. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES PocketHealth is a subscription-based image sharing service that allows patients to store, access, and share their medical imaging with providers across different health systems. Rishi and his brother Harsh developed the idea for this service after realizing how antiquated and frustrating it was for patients to physically carry their CDs to different physician offices. Additionally, with the sheer volume of medical images ordered today and the cost of data storage, hospitals usually delete images after a certain period of time. First, the Nayyar brothers conducted their own market research by calling hundreds of local hospitals and clinics and asking them about their image exchange process. This process confirmed that the status quo of image exchange was a burdensome process for patients and inspired them to configure a patient-centered service. The second stage of their entrepreneurial pursuit was to figure out how the service would be paid for. The founders realized that patients were willing to pay a small subscription fee (instead of paying for CDs) to safely indefinitely store and virtually send their own and their family members’ images to healthcare providers using a link or QR code. Overtime, insurance companies have become willing to reimburse this subscription fee. This payment model allows hospitals and clinics to participate in image exchange at no cost, and has been a key factor in encouraging widespread adoption as well as enabling the growth of their enterprise image sharing business. Rishi highlights the fact that he had the advantage of being an outsider to healthcare when he first started the company, which helped him recognize issues with the current system instead of just accepting the standard processes. He shared the same perspectives as patients who were interacting with the system as non-health experts. PocketHealth’s success in the last eight years has propelled it to take on new challenges, such as patient education within radiology reports. Finally, Rishi gives advice to budding entrepreneurs. He encourages them to pick a problem that they don’t mind grinding at, since there is a large initial time and effort requirement needed to convince people to adopt their product. Additionally, the innovation journey is long, so to manage one’s psyche, it is wise to set short term achievable benchmarks and reflect on day-to-day progress. --- RESOURCES PocketHealth: https://www.pockethealth.com/ In this episode, host Dr. Bryan Hartley interviews Rishi Nayyar, co-founder and CEO of PocketHealth, the first patient-centered medical image exchange platform.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


PocketHealth is a subscription-based image sharing service that allows patients to store, access, and share their medical imaging with providers across different health systems. Rishi and his brother Harsh developed the idea for this service after realizing how antiquated and frustrating it was for patients to physically carry their CDs to different physician offices. Additionally, with the sheer volume of medical images ordered today and the cost of data storage, hospitals usually delete images after a certain period of time. First, the Nayyar brothers conducted their own market research by calling hundreds of local hospitals and clinics and asking them about their image exchange process. This process confirmed that the status quo of image exchange was a burdensome process for patients and inspired them to configure a patient-centered service.


The second stage of their entrepreneurial pursuit was to figure out how the service would be paid for. The founders realized that patients were willing to pay a small subscription fee (instead of paying for CDs) to safely indefinitely store and virtually send their own and their family members’ images to healthcare providers using a link or QR code. Overtime, insurance companies have become willing to reimburse this subscription fee. This payment model allows hospitals and clinics to participate in image exchange at no cost, and has been a key factor in encouraging widespread adoption as well as enabling the growth of their enterprise image sharing business.


Rishi highlights the fact that he had the advantage of being an outsider to healthcare when he first started the company, which helped him recognize issues with the current system instead of just accepting the standard processes. He shared the same perspectives as patients who were interacting with the system as non-health experts. PocketHealth’s success in the last eight years has propelled it to take on new challenges, such as patient education within radiology reports.


Finally, Rishi gives advice to budding entrepreneurs. He encourages them to pick a problem that they don’t mind grinding at, since there is a large initial time and effort requirement needed to convince people to adopt their product. Additionally, the innovation journey is long, so to manage one’s psyche, it is wise to set short term achievable benchmarks and reflect on day-to-day progress.


---


RESOURCES


PocketHealth:

https://www.pockethealth.com/

]]> 3489 Ep. 332 El Futuro de MSK: Embolizaciones Musculoesqueletas con Dr. Ana Fernandez Martinez En este episodio de BackTable, las Dras. Gina Landinez y Ana María Fernández Martínez hablan sobre el intervencionismo musculoesquelético y las técnicas para la embolización del hombre rígido. --- SHOW NOTES La Dra. Fernández Martínez explica su trayectoria en el campo de intervencionismo musculoesquelético y la oportunidad de entrenarse en Japón. Luego entra en detalles técnicos, describiendo cómo obtiene acceso usando su microcatéter para entrar a las articulaciones que quiere tratar. Explica que estas arterias son de un calibre muy pequeño, así que necesita herramientas diferentes para los procedimientos esqueléticos. También, ella describe el efecto que tiene la embolización en las fibras nerviosas y la inflamación para restaurar la vascular normal. Adicionalmente, las doctoras explican quienes son los pacientes ideales para la embolización de un hombro rígido. Dra. Fernández Martínez distingue síntomas de un hombro rígido, como la limitación de la vida diaria y la movilidad, y hace la distinción entre esta patología y la artritis. Habla también del tiempo ideal para la embolización para optimizar los resultados y la importancia de la rehabilitación con la fisioterapia. Próximo, la doctora explica los beneficios inmediatos y a largo plazo que ve en sus pacientes. Usualmente, se pueden ver los efectos de la embolización tres meses después del procedimiento si el paciente participa en la fisioterapia, y el máximo beneficio ocurre a los seis meses. Repetición del procedimiento es posible también. Finalmente, las doctoras hablan sobre las complicaciones de la embolización, que incluyen un hematoma en la zona de punción. Dra. Fernandez Martinez termina el episodio alentando a sus colegas radiólogos intervencionistas a explorar la embolización musculoesquelética. Wed, 14 Jun 2023 05:05:00 -0000 full BackTable En este episodio de BackTable, las Dras. Gina Landinez y Ana María Fernández Martínez hablan sobre el intervencionismo musculoesquelético y las técnicas para la embolización del hombre rígido. En este episodio de BackTable, las Dras. Gina Landinez y Ana María Fernández Martínez hablan sobre el intervencionismo musculoesquelético y las técnicas para la embolización del hombre rígido. --- SHOW NOTES La Dra. Fernández Martínez explica su trayectoria en el campo de intervencionismo musculoesquelético y la oportunidad de entrenarse en Japón. Luego entra en detalles técnicos, describiendo cómo obtiene acceso usando su microcatéter para entrar a las articulaciones que quiere tratar. Explica que estas arterias son de un calibre muy pequeño, así que necesita herramientas diferentes para los procedimientos esqueléticos. También, ella describe el efecto que tiene la embolización en las fibras nerviosas y la inflamación para restaurar la vascular normal. Adicionalmente, las doctoras explican quienes son los pacientes ideales para la embolización de un hombro rígido. Dra. Fernández Martínez distingue síntomas de un hombro rígido, como la limitación de la vida diaria y la movilidad, y hace la distinción entre esta patología y la artritis. Habla también del tiempo ideal para la embolización para optimizar los resultados y la importancia de la rehabilitación con la fisioterapia. Próximo, la doctora explica los beneficios inmediatos y a largo plazo que ve en sus pacientes. Usualmente, se pueden ver los efectos de la embolización tres meses después del procedimiento si el paciente participa en la fisioterapia, y el máximo beneficio ocurre a los seis meses. Repetición del procedimiento es posible también. Finalmente, las doctoras hablan sobre las complicaciones de la embolización, que incluyen un hematoma en la zona de punción. Dra. Fernandez Martinez termina el episodio alentando a sus colegas radiólogos intervencionistas a explorar la embolización musculoesquelética. En este episodio de BackTable, las Dras. Gina Landinez y Ana María Fernández Martínez hablan sobre el intervencionismo musculoesquelético y las técnicas para la embolización del hombre rígido.


---


SHOW NOTES


La Dra. Fernández Martínez explica su trayectoria en el campo de intervencionismo musculoesquelético y la oportunidad de entrenarse en Japón. Luego entra en detalles técnicos, describiendo cómo obtiene acceso usando su microcatéter para entrar a las articulaciones que quiere tratar. Explica que estas arterias son de un calibre muy pequeño, así que necesita herramientas diferentes para los procedimientos esqueléticos. También, ella describe el efecto que tiene la embolización en las fibras nerviosas y la inflamación para restaurar la vascular normal.


Adicionalmente, las doctoras explican quienes son los pacientes ideales para la embolización de un hombro rígido. Dra. Fernández Martínez distingue síntomas de un hombro rígido, como la limitación de la vida diaria y la movilidad, y hace la distinción entre esta patología y la artritis. Habla también del tiempo ideal para la embolización para optimizar los resultados y la importancia de la rehabilitación con la fisioterapia. Próximo, la doctora explica los beneficios inmediatos y a largo plazo que ve en sus pacientes. Usualmente, se pueden ver los efectos de la embolización tres meses después del procedimiento si el paciente participa en la fisioterapia, y el máximo beneficio ocurre a los seis meses. Repetición del procedimiento es posible también.


Finalmente, las doctoras hablan sobre las complicaciones de la embolización, que incluyen un hematoma en la zona de punción. Dra. Fernandez Martinez termina el episodio alentando a sus colegas radiólogos intervencionistas a explorar la embolización musculoesquelética.


]]> 2841 Ep. 331 EVUS to IVUS: a Continuous Spectrum with Dr. Jill Sommerset and Dr. Fadi Saab In this episode, host Dr. Ally Baheti interviews Jill Sommerset and Dr. Fadi Saab about EVUS and IVUS in peripheral arterial cases, including when to use each, how to train an interventional sonographer, and what adding ultrasound in a case can do for patient safety. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Jill Sommerset is the director of ultrasound at Advanced Vascular in Portland, OR and Hope Clinical Innovation Center in Houston, TX, and chair of the SVU annual conference. Dr. Fadi Saab is an interventional cardiologist and associate professor at Michigan State University. He begins by introducing what intravascular ultrasound (IVUS) and extravascular ultrasound (EVUS) are. EVUS is looking from the outside in, and can be used to measure vessel width, hemodynamics, and cross chronic total occlusions (CTOs). IVUS is looking from inside a vessel towards the outside of the body, and can be helpful for viewing the extent of arterial disease and discerning the exact plaque anatomy. Dr. Saab always has a specially trained interventional sonographer involved in the case and in the room for critical limb ischemia (CLI) cases. He values them not only for obtaining access, but also to provide greater safety to the patient. He considers them a core member of the team. He notes the importance of training an ultrasonographer who is good when working under pressure, can interact with multiple personality types, and most importantly, someone willing to learn, be engaged in the case, and willing to put themselves out there in this foreign environment. Jill says it took her around 4 months to feel comfortable working in the cath lab, and for other members of the team to get used to her presence during cases. She describes her work as a dance with the physician. When a wire or catheter is being exchanged, Jill is always scanning and thinking ahead, and she is always ready to check for dissections after balloon angioplasty. Most arterial cases can benefit from the addition of EVUS. Jill says the only time EVUS is not as helpful is when the CTO cap morphology shows a rock hard plaque that casts shadows on the screen. Dr. Saab says he uses EVUS for crossing CTOs, patient safety, and looking at complications. He usually introduces IVUS after he crosses a lesion to look at plaque in a more granular way and understand it’s anatomy. Jill adds that she uses IVUS to help the physician cross a CTO sometimes, but notes that it is important for the tech to hold the probe still and not move in this scenario. The two end by restating the value that EVUS and IVUS add to the procedure, especially because angiography misses a lot of plaque burden that can be seen with IVUS. They recommend finding ultrasonographers interested in working in the cath lab, and taking the responsibility as physicians to mentor them and make them feel like an invaluable member of the treatment team. --- RESOURCES CTOP Paper: https://assets.bmctoday.net/evtoday/pdfs/et0518_F5_Saab.pdf Mon, 12 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews Jill Sommerset and Dr. Fadi Saab about EVUS and IVUS in peripheral arterial cases, including when to use each, how to train an interventional sonographer, and what adding ultrasound in a case can do for patient safety. In this episode, host Dr. Ally Baheti interviews Jill Sommerset and Dr. Fadi Saab about EVUS and IVUS in peripheral arterial cases, including when to use each, how to train an interventional sonographer, and what adding ultrasound in a case can do for patient safety. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Jill Sommerset is the director of ultrasound at Advanced Vascular in Portland, OR and Hope Clinical Innovation Center in Houston, TX, and chair of the SVU annual conference. Dr. Fadi Saab is an interventional cardiologist and associate professor at Michigan State University. He begins by introducing what intravascular ultrasound (IVUS) and extravascular ultrasound (EVUS) are. EVUS is looking from the outside in, and can be used to measure vessel width, hemodynamics, and cross chronic total occlusions (CTOs). IVUS is looking from inside a vessel towards the outside of the body, and can be helpful for viewing the extent of arterial disease and discerning the exact plaque anatomy. Dr. Saab always has a specially trained interventional sonographer involved in the case and in the room for critical limb ischemia (CLI) cases. He values them not only for obtaining access, but also to provide greater safety to the patient. He considers them a core member of the team. He notes the importance of training an ultrasonographer who is good when working under pressure, can interact with multiple personality types, and most importantly, someone willing to learn, be engaged in the case, and willing to put themselves out there in this foreign environment. Jill says it took her around 4 months to feel comfortable working in the cath lab, and for other members of the team to get used to her presence during cases. She describes her work as a dance with the physician. When a wire or catheter is being exchanged, Jill is always scanning and thinking ahead, and she is always ready to check for dissections after balloon angioplasty. Most arterial cases can benefit from the addition of EVUS. Jill says the only time EVUS is not as helpful is when the CTO cap morphology shows a rock hard plaque that casts shadows on the screen. Dr. Saab says he uses EVUS for crossing CTOs, patient safety, and looking at complications. He usually introduces IVUS after he crosses a lesion to look at plaque in a more granular way and understand it’s anatomy. Jill adds that she uses IVUS to help the physician cross a CTO sometimes, but notes that it is important for the tech to hold the probe still and not move in this scenario. The two end by restating the value that EVUS and IVUS add to the procedure, especially because angiography misses a lot of plaque burden that can be seen with IVUS. They recommend finding ultrasonographers interested in working in the cath lab, and taking the responsibility as physicians to mentor them and make them feel like an invaluable member of the treatment team. --- RESOURCES CTOP Paper: https://assets.bmctoday.net/evtoday/pdfs/et0518_F5_Saab.pdf In this episode, host Dr. Ally Baheti interviews Jill Sommerset and Dr. Fadi Saab about EVUS and IVUS in peripheral arterial cases, including when to use each, how to train an interventional sonographer, and what adding ultrasound in a case can do for patient safety.


---


CHECK OUT OUR SPONSORS


Philips Image Guided Therapy Devices Academy

https://resource.philipseliiteacademy.com


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


Jill Sommerset is the director of ultrasound at Advanced Vascular in Portland, OR and Hope Clinical Innovation Center in Houston, TX, and chair of the SVU annual conference. Dr. Fadi Saab is an interventional cardiologist and associate professor at Michigan State University. He begins by introducing what intravascular ultrasound (IVUS) and extravascular ultrasound (EVUS) are. EVUS is looking from the outside in, and can be used to measure vessel width, hemodynamics, and cross chronic total occlusions (CTOs). IVUS is looking from inside a vessel towards the outside of the body, and can be helpful for viewing the extent of arterial disease and discerning the exact plaque anatomy.


Dr. Saab always has a specially trained interventional sonographer involved in the case and in the room for critical limb ischemia (CLI) cases. He values them not only for obtaining access, but also to provide greater safety to the patient. He considers them a core member of the team. He notes the importance of training an ultrasonographer who is good when working under pressure, can interact with multiple personality types, and most importantly, someone willing to learn, be engaged in the case, and willing to put themselves out there in this foreign environment. Jill says it took her around 4 months to feel comfortable working in the cath lab, and for other members of the team to get used to her presence during cases. She describes her work as a dance with the physician. When a wire or catheter is being exchanged, Jill is always scanning and thinking ahead, and she is always ready to check for dissections after balloon angioplasty.


Most arterial cases can benefit from the addition of EVUS. Jill says the only time EVUS is not as helpful is when the CTO cap morphology shows a rock hard plaque that casts shadows on the screen. Dr. Saab says he uses EVUS for crossing CTOs, patient safety, and looking at complications. He usually introduces IVUS after he crosses a lesion to look at plaque in a more granular way and understand it’s anatomy. Jill adds that she uses IVUS to help the physician cross a CTO sometimes, but notes that it is important for the tech to hold the probe still and not move in this scenario. The two end by restating the value that EVUS and IVUS add to the procedure, especially because angiography misses a lot of plaque burden that can be seen with IVUS. They recommend finding ultrasonographers interested in working in the cath lab, and taking the responsibility as physicians to mentor them and make them feel like an invaluable member of the treatment team.


---


RESOURCES


CTOP Paper:

https://assets.bmctoday.net/evtoday/pdfs/et0518_F5_Saab.pdf

]]> 3401 Ep. 330 Early Days and Evolution of the TIPS Procedure with Dr. Richard Saxon In this episode, guest host Dr. Isabel Newton interviews Dr. Richard Saxon about his innovative approach of using stent grafts for transjugular intrahepatic portosystemic shunting (TIPS), the creation of the Viatorr endoprosthesis, and medical ethics of experimental technology. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202 --- SHOW NOTES As an IR fellow, Dr. Saxon was surrounded by constant innovation at the Dotter Institute. He saw the takeoff of TIPS as a last treatment option for patients with liver failure, who were suffering from major variceal bleeding. He recounts the early days of TIPS as extremely technically challenging and arduous, since the methods and devices had not yet been refined. Dr. Saxon spent a significant amount of time performing TIPS revision procedures, which led him to explore the underlying pathology of biliary duct injury and subsequent stent thrombosis. These experiences led him to develop a stent graft for TIPS, which was first tested in swine models and eventually became the Viatorr endoprosthesis. Dr. Saxon highlights the supportive people and environment at the Dotter Institute as a major factor in fueling TIPS improvement. Additionally, during this era, innovative ideas were able to flourish with less influence of medical-legal or intellectual property disputes. In today’s clinical setting, TIPS has become a good option for patients with intractable variceal bleeding, but it is no longer the only option. Dr. Newton emphasizes that patient selection is a crucial part of ensuring that IRs continue to practice safely and effectively. The doctors discuss hepatic encephalopathy, another complication of TIPS that requires careful patient screening, adequate follow up, and collaboration with the medicine side of liver disease treatment. Finally, Dr. Saxon reflects on his career in translational research. A large part of his success has come from recognizing where his passions lie, what his current work environment can support, and maintaining a constant drive to improve procedures and clinical care. --- RESOURCES Gore Viatorr TIPS Endoprosthesis: https://www.goremedical.com/products/viatorr/resource-library Stent-Grafts for Revision of TIPS Stenoses and Occlusions: A Clinical Pilot Study: https://www.jvir.org/article/S1051-0443(97)70606-7/fulltext Barry Uchida on the BackTable Podcast: https://www.backtable.com/shows/vi/podcasts/122/history-of-the-tips-procedure-an-interview-with-barry-uchida Fri, 09 Jun 2023 05:05:00 -0000 full BackTable In this episode, guest host Dr. Isabel Newton interviews Dr. Richard Saxon about his innovative approach of using stent grafts for transjugular intrahepatic portosystemic shunting (TIPS), the creation of the Viatorr endoprosthesis, and medical ethics of experimental technology. In this episode, guest host Dr. Isabel Newton interviews Dr. Richard Saxon about his innovative approach of using stent grafts for transjugular intrahepatic portosystemic shunting (TIPS), the creation of the Viatorr endoprosthesis, and medical ethics of experimental technology. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202 --- SHOW NOTES As an IR fellow, Dr. Saxon was surrounded by constant innovation at the Dotter Institute. He saw the takeoff of TIPS as a last treatment option for patients with liver failure, who were suffering from major variceal bleeding. He recounts the early days of TIPS as extremely technically challenging and arduous, since the methods and devices had not yet been refined. Dr. Saxon spent a significant amount of time performing TIPS revision procedures, which led him to explore the underlying pathology of biliary duct injury and subsequent stent thrombosis. These experiences led him to develop a stent graft for TIPS, which was first tested in swine models and eventually became the Viatorr endoprosthesis. Dr. Saxon highlights the supportive people and environment at the Dotter Institute as a major factor in fueling TIPS improvement. Additionally, during this era, innovative ideas were able to flourish with less influence of medical-legal or intellectual property disputes. In today’s clinical setting, TIPS has become a good option for patients with intractable variceal bleeding, but it is no longer the only option. Dr. Newton emphasizes that patient selection is a crucial part of ensuring that IRs continue to practice safely and effectively. The doctors discuss hepatic encephalopathy, another complication of TIPS that requires careful patient screening, adequate follow up, and collaboration with the medicine side of liver disease treatment. Finally, Dr. Saxon reflects on his career in translational research. A large part of his success has come from recognizing where his passions lie, what his current work environment can support, and maintaining a constant drive to improve procedures and clinical care. --- RESOURCES Gore Viatorr TIPS Endoprosthesis: https://www.goremedical.com/products/viatorr/resource-library Stent-Grafts for Revision of TIPS Stenoses and Occlusions: A Clinical Pilot Study: https://www.jvir.org/article/S1051-0443(97)70606-7/fulltext Barry Uchida on the BackTable Podcast: https://www.backtable.com/shows/vi/podcasts/122/history-of-the-tips-procedure-an-interview-with-barry-uchida In this episode, guest host Dr. Isabel Newton interviews Dr. Richard Saxon about his innovative approach of using stent grafts for transjugular intrahepatic portosystemic shunting (TIPS), the creation of the Viatorr endoprosthesis, and medical ethics of experimental technology.


---


CHECK OUT OUR SPONSORS


Philips Image Guided Therapy Devices Academy

https://resource.philipseliiteacademy.com


Boston Scientific Nextlab

https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202


---


SHOW NOTES


As an IR fellow, Dr. Saxon was surrounded by constant innovation at the Dotter Institute. He saw the takeoff of TIPS as a last treatment option for patients with liver failure, who were suffering from major variceal bleeding. He recounts the early days of TIPS as extremely technically challenging and arduous, since the methods and devices had not yet been refined. Dr. Saxon spent a significant amount of time performing TIPS revision procedures, which led him to explore the underlying pathology of biliary duct injury and subsequent stent thrombosis. These experiences led him to develop a stent graft for TIPS, which was first tested in swine models and eventually became the Viatorr endoprosthesis. Dr. Saxon highlights the supportive people and environment at the Dotter Institute as a major factor in fueling TIPS improvement. Additionally, during this era, innovative ideas were able to flourish with less influence of medical-legal or intellectual property disputes.


In today’s clinical setting, TIPS has become a good option for patients with intractable variceal bleeding, but it is no longer the only option. Dr. Newton emphasizes that patient selection is a crucial part of ensuring that IRs continue to practice safely and effectively. The doctors discuss hepatic encephalopathy, another complication of TIPS that requires careful patient screening, adequate follow up, and collaboration with the medicine side of liver disease treatment.


Finally, Dr. Saxon reflects on his career in translational research. A large part of his success has come from recognizing where his passions lie, what his current work environment can support, and maintaining a constant drive to improve procedures and clinical care.


---


RESOURCES


Gore Viatorr TIPS Endoprosthesis:

https://www.goremedical.com/products/viatorr/resource-library


Stent-Grafts for Revision of TIPS Stenoses and Occlusions: A Clinical Pilot Study:

https://www.jvir.org/article/S1051-0443(97)70606-7/fulltext


Barry Uchida on the BackTable Podcast:

https://www.backtable.com/shows/vi/podcasts/122/history-of-the-tips-procedure-an-interview-with-barry-uchida

]]> 3990 Ep. 329 OBLs, Past, Present, and Future with Dr. Bill Julien In this episode, host Dr. Aparna Baheti interviews Dr. Bill Julien about the evolution of the outpatient based lab (OBL), its role in expanding patient access to IR care, and its relationship with other IR practice models around the country. --- CHECK OUT OUR SPONSORS Boston Scientific Ranger DCB https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/ranger.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_ranger_1_2023&cid=n10012340 Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Julien is one of the initial OBL founders in the United States. In 2001, he started his current practice, South Florida Vascular Associates in an effort to practice independent IR. At this time, he struggled to get hospital privileges due to exclusive diagnostic radiology contracts, so he placed a C-arm in his office out of necessity. Eventually, he built a formal angio suite. As a result, patients enjoyed the efficiency and comfort of office based procedures, and he enjoyed physician autonomy and freedom from hospital politics. Dr. Julien notes that overtime, CMS has recognized the value of an office-based intervention and saw that IRs could practice high-quality care at a lower price point with higher patient satisfaction, leading to improved Medicare reimbursements. Since the conception of his OBL, Dr. Julien has seen practice structures change, especially with the influence of venture capital firms and the pressure to generate RVUs. Additionally, though some voices have pushed for more IR involvement in the clinical sphere, there has not been much progress made in advocating for IR hospital privileges. This is a significant barrier to independent IR practices, since some states require that an IR has hospital privileges before opening an OBL. Dr. Julien says that this dilemma is unique to IR, since other specialties, such as vascular surgery and cardiology, are not affected by exclusive contracts to the same extent. He believes that IR societies and leading voices should actively challenge the legal basis of these contracts and support interventionalists who want to stay independent. We highlight recent SIR and ACR position statements on this topic. Finally, Dr. Julien offers advice to IRs who are seeking to enter the OBL setting. He encourages them to perform and learn from as many procedures as possible, find ways to develop and maintain clinical skills, identify mentors, and ensure that their restrictive covenants are not too stringent. --- RESOURCES South Florida Vascular Associates: https://www.southfloridavascular.com/ Outpatient Endovascular and Interventional Society (OEIS): https://oeisweb.com/ SIR Position Statement on Exclusive Contracts: https://www.sirweb.org/globalassets/aasociety-of-interventional-radiology-home-page/practice-resources/standards_pdfs/exclusive_contracts_policy_final_approved_9-21-15.pdf ACR Position Statement on Exclusive Contracts: https://www.acr.org/-/media/ACR/Files/About-ACR/2022-2023-Digest-of-Council-Actions.pdf Line Monkey MD- “The IR Startup:” https://linemonkeymd.com/the-ir-startup/ Line Monkey MD- “Pseudoexclusive Radiology Contracts:” https://linemonkeymd.com/pseudoexclusive-radiology-contracts-our-downfall/#comment-2087 Mon, 05 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aparna Baheti interviews Dr. Bill Julien about the evolution of the outpatient based lab (OBL), its role in expanding patient access to IR care, and its relationship with other IR practice models around the country. In this episode, host Dr. Aparna Baheti interviews Dr. Bill Julien about the evolution of the outpatient based lab (OBL), its role in expanding patient access to IR care, and its relationship with other IR practice models around the country. --- CHECK OUT OUR SPONSORS Boston Scientific Ranger DCB https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/ranger.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_ranger_1_2023&cid=n10012340 Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Julien is one of the initial OBL founders in the United States. In 2001, he started his current practice, South Florida Vascular Associates in an effort to practice independent IR. At this time, he struggled to get hospital privileges due to exclusive diagnostic radiology contracts, so he placed a C-arm in his office out of necessity. Eventually, he built a formal angio suite. As a result, patients enjoyed the efficiency and comfort of office based procedures, and he enjoyed physician autonomy and freedom from hospital politics. Dr. Julien notes that overtime, CMS has recognized the value of an office-based intervention and saw that IRs could practice high-quality care at a lower price point with higher patient satisfaction, leading to improved Medicare reimbursements. Since the conception of his OBL, Dr. Julien has seen practice structures change, especially with the influence of venture capital firms and the pressure to generate RVUs. Additionally, though some voices have pushed for more IR involvement in the clinical sphere, there has not been much progress made in advocating for IR hospital privileges. This is a significant barrier to independent IR practices, since some states require that an IR has hospital privileges before opening an OBL. Dr. Julien says that this dilemma is unique to IR, since other specialties, such as vascular surgery and cardiology, are not affected by exclusive contracts to the same extent. He believes that IR societies and leading voices should actively challenge the legal basis of these contracts and support interventionalists who want to stay independent. We highlight recent SIR and ACR position statements on this topic. Finally, Dr. Julien offers advice to IRs who are seeking to enter the OBL setting. He encourages them to perform and learn from as many procedures as possible, find ways to develop and maintain clinical skills, identify mentors, and ensure that their restrictive covenants are not too stringent. --- RESOURCES South Florida Vascular Associates: https://www.southfloridavascular.com/ Outpatient Endovascular and Interventional Society (OEIS): https://oeisweb.com/ SIR Position Statement on Exclusive Contracts: https://www.sirweb.org/globalassets/aasociety-of-interventional-radiology-home-page/practice-resources/standards_pdfs/exclusive_contracts_policy_final_approved_9-21-15.pdf ACR Position Statement on Exclusive Contracts: https://www.acr.org/-/media/ACR/Files/About-ACR/2022-2023-Digest-of-Council-Actions.pdf Line Monkey MD- “The IR Startup:” https://linemonkeymd.com/the-ir-startup/ Line Monkey MD- “Pseudoexclusive Radiology Contracts:” https://linemonkeymd.com/pseudoexclusive-radiology-contracts-our-downfall/#comment-2087 In this episode, host Dr. Aparna Baheti interviews Dr. Bill Julien about the evolution of the outpatient based lab (OBL), its role in expanding patient access to IR care, and its relationship with other IR practice models around the country.


---


CHECK OUT OUR SPONSORS


Boston Scientific Ranger DCB

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/ranger.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_ranger_1_2023&cid=n10012340


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


Dr. Julien is one of the initial OBL founders in the United States. In 2001, he started his current practice, South Florida Vascular Associates in an effort to practice independent IR. At this time, he struggled to get hospital privileges due to exclusive diagnostic radiology contracts, so he placed a C-arm in his office out of necessity. Eventually, he built a formal angio suite. As a result, patients enjoyed the efficiency and comfort of office based procedures, and he enjoyed physician autonomy and freedom from hospital politics. Dr. Julien notes that overtime, CMS has recognized the value of an office-based intervention and saw that IRs could practice high-quality care at a lower price point with higher patient satisfaction, leading to improved Medicare reimbursements.


Since the conception of his OBL, Dr. Julien has seen practice structures change, especially with the influence of venture capital firms and the pressure to generate RVUs. Additionally, though some voices have pushed for more IR involvement in the clinical sphere, there has not been much progress made in advocating for IR hospital privileges. This is a significant barrier to independent IR practices, since some states require that an IR has hospital privileges before opening an OBL. Dr. Julien says that this dilemma is unique to IR, since other specialties, such as vascular surgery and cardiology, are not affected by exclusive contracts to the same extent. He believes that IR societies and leading voices should actively challenge the legal basis of these contracts and support interventionalists who want to stay independent. We highlight recent SIR and ACR position statements on this topic.


Finally, Dr. Julien offers advice to IRs who are seeking to enter the OBL setting. He encourages them to perform and learn from as many procedures as possible, find ways to develop and maintain clinical skills, identify mentors, and ensure that their restrictive covenants are not too stringent.


---


RESOURCES


South Florida Vascular Associates:

https://www.southfloridavascular.com/


Outpatient Endovascular and Interventional Society (OEIS):

https://oeisweb.com/


SIR Position Statement on Exclusive Contracts:

https://www.sirweb.org/globalassets/aasociety-of-interventional-radiology-home-page/practice-resources/standards_pdfs/exclusive_contracts_policy_final_approved_9-21-15.pdf


ACR Position Statement on Exclusive Contracts:

https://www.acr.org/-/media/ACR/Files/About-ACR/2022-2023-Digest-of-Council-Actions.pdf


Line Monkey MD- “The IR Startup:”

https://linemonkeymd.com/the-ir-startup/


Line Monkey MD- “Pseudoexclusive Radiology Contracts:”

https://linemonkeymd.com/pseudoexclusive-radiology-contracts-our-downfall/#comment-2087

]]> 3216 Ep. 328 Adrenal Vein Sampling with Dr, Fritz Angle In this episode, host Dr. Aparna Baheti interviews Dr. Fritz Angle about adrenal vein sampling, including indications, workup, and his technique for accessing the right adrenal vein. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Fritz Angle is the Director of Interventional Radiology at the University of Virginia. He frequently performs adrenal vein sampling for primary hyperaldosteronism, and has developed a specific technique. The patient is usually referred from an endocrinologist or primary care doctor. The IR should review the labs to verify the aldosterone-to-renin ratio is greater than 20. Additionally, it is important to review medications and stop all potassium sparing diuretics at least two weeks before the procedure. If they haven’t had a CT scan, the IR should order one to assess the position of the right adrenal vein, the hardest to access due to its variable anatomy.  The morning of the procedure, Dr. Angle always checks a potassium level to know whether to give potassium supplements. He gets dual femoral access, so that he can obtain both non-stimulated and ACTH-stimulated samples. He obtains the sample from the left adrenal vein first. For the right side, he starts with a C2 catheter, to which he adds side holes using a biopsy needle. The left adrenal vein is almost always one vertebral body above the right renal vein, so he begins here, with the catheter pointing directly posterior. He searches around the entire back wall of the IVC by puffing contrast and rotating the catheter. He moves up and down by half a vertebral level. If he still cannot locate it, he begins looking to the left and right. When injecting, it is important to be gentle. To do this, he inserts an 014 wire through his catheter, then does a dry scan to see if the vein is pointing toward the liver or the right adrenal gland. If the vein is injected too hard, it can cause a venous infarct and adrenal insufficiency. The right adrenal vein forms an upside down Y shape. Dr. Angle draws two sets each from the right and left adrenal veins and two peripheral samples.  To interpret results, look for a cortisol of 2-3x greater (3-4x greater in stimulated samples) compared to the peripheral blood to confirm correct placement in the adrenal veins. Once you correct aldosterone levels to cortisol levels, the aldosterone-to-cortisol ratio should be about 5x greater on one side (compared to the other side) to confirm the diagnosis and lateralize the hyperaldosteronism to one side. About 2 ⁄ 3 cases lateralize, but Dr. Angle has found many patients’ symptoms are actually due to bilateral adrenal hyperplasia. Finally, Dr. Angle emphasizes that this is an easy, safe procedure that all IRs should offer. Fri, 02 Jun 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aparna Baheti interviews Dr. Fritz Angle about adrenal vein sampling, including indications, workup, and his technique for accessing the right adrenal vein. In this episode, host Dr. Aparna Baheti interviews Dr. Fritz Angle about adrenal vein sampling, including indications, workup, and his technique for accessing the right adrenal vein. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Fritz Angle is the Director of Interventional Radiology at the University of Virginia. He frequently performs adrenal vein sampling for primary hyperaldosteronism, and has developed a specific technique. The patient is usually referred from an endocrinologist or primary care doctor. The IR should review the labs to verify the aldosterone-to-renin ratio is greater than 20. Additionally, it is important to review medications and stop all potassium sparing diuretics at least two weeks before the procedure. If they haven’t had a CT scan, the IR should order one to assess the position of the right adrenal vein, the hardest to access due to its variable anatomy.  The morning of the procedure, Dr. Angle always checks a potassium level to know whether to give potassium supplements. He gets dual femoral access, so that he can obtain both non-stimulated and ACTH-stimulated samples. He obtains the sample from the left adrenal vein first. For the right side, he starts with a C2 catheter, to which he adds side holes using a biopsy needle. The left adrenal vein is almost always one vertebral body above the right renal vein, so he begins here, with the catheter pointing directly posterior. He searches around the entire back wall of the IVC by puffing contrast and rotating the catheter. He moves up and down by half a vertebral level. If he still cannot locate it, he begins looking to the left and right. When injecting, it is important to be gentle. To do this, he inserts an 014 wire through his catheter, then does a dry scan to see if the vein is pointing toward the liver or the right adrenal gland. If the vein is injected too hard, it can cause a venous infarct and adrenal insufficiency. The right adrenal vein forms an upside down Y shape. Dr. Angle draws two sets each from the right and left adrenal veins and two peripheral samples.  To interpret results, look for a cortisol of 2-3x greater (3-4x greater in stimulated samples) compared to the peripheral blood to confirm correct placement in the adrenal veins. Once you correct aldosterone levels to cortisol levels, the aldosterone-to-cortisol ratio should be about 5x greater on one side (compared to the other side) to confirm the diagnosis and lateralize the hyperaldosteronism to one side. About 2 ⁄ 3 cases lateralize, but Dr. Angle has found many patients’ symptoms are actually due to bilateral adrenal hyperplasia. Finally, Dr. Angle emphasizes that this is an easy, safe procedure that all IRs should offer. In this episode, host Dr. Aparna Baheti interviews Dr. Fritz Angle about adrenal vein sampling, including indications, workup, and his technique for accessing the right adrenal vein.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Dr. Fritz Angle is the Director of Interventional Radiology at the University of Virginia. He frequently performs adrenal vein sampling for primary hyperaldosteronism, and has developed a specific technique. The patient is usually referred from an endocrinologist or primary care doctor. The IR should review the labs to verify the aldosterone-to-renin ratio is greater than 20. Additionally, it is important to review medications and stop all potassium sparing diuretics at least two weeks before the procedure. If they haven’t had a CT scan, the IR should order one to assess the position of the right adrenal vein, the hardest to access due to its variable anatomy. 


The morning of the procedure, Dr. Angle always checks a potassium level to know whether to give potassium supplements. He gets dual femoral access, so that he can obtain both non-stimulated and ACTH-stimulated samples. He obtains the sample from the left adrenal vein first. For the right side, he starts with a C2 catheter, to which he adds side holes using a biopsy needle. The left adrenal vein is almost always one vertebral body above the right renal vein, so he begins here, with the catheter pointing directly posterior. He searches around the entire back wall of the IVC by puffing contrast and rotating the catheter. He moves up and down by half a vertebral level. If he still cannot locate it, he begins looking to the left and right. When injecting, it is important to be gentle. To do this, he inserts an 014 wire through his catheter, then does a dry scan to see if the vein is pointing toward the liver or the right adrenal gland. If the vein is injected too hard, it can cause a venous infarct and adrenal insufficiency. The right adrenal vein forms an upside down Y shape. Dr. Angle draws two sets each from the right and left adrenal veins and two peripheral samples. 


To interpret results, look for a cortisol of 2-3x greater (3-4x greater in stimulated samples) compared to the peripheral blood to confirm correct placement in the adrenal veins. Once you correct aldosterone levels to cortisol levels, the aldosterone-to-cortisol ratio should be about 5x greater on one side (compared to the other side) to confirm the diagnosis and lateralize the hyperaldosteronism to one side. About 2 ⁄ 3 cases lateralize, but Dr. Angle has found many patients’ symptoms are actually due to bilateral adrenal hyperplasia. Finally, Dr. Angle emphasizes that this is an easy, safe procedure that all IRs should offer.

]]> 2223 Ep. 327 Building a Pain Interventions Service Line with Dr. Stephen Hunt In this episode, host Dr. Michael Barraza interviews Dr. Stephen Hunt about building a pain practice, including his nerve ablation technique, how to obtain referrals, and why it is one of the most rewarding procedures that he does. --- SHOW NOTES We begin by discussing what caused Dr. Hunt to start building a pain service. He was treating many patients with lung cancer, and he saw so many patients toward the end of their life. What they wanted was to reduce their suffering due to pain. He saw what was being offered for them, which was opioids, but this caused them to be disconnected from their families at such an important time in their life. He knew he could offer nerve blocks and ablation, so he began educating himself. As he learned about different blocks, he adapted them to create his own technique. Pretty soon, word got out that he was doing this, and he started getting referrals from oncologists. Soon after this, thoracic surgeons and breast surgeons began referring to him for post-thoracotomy and post-mastectomy pain. Next, radiation oncologists referred their patients with radiation necrosis of the ribs, and orthopedic surgeons referred patients to him for pain from musculoskeletal metastases. For his technique, he often starts with a test block using bupivacaine and triamcinolone, which prolongs the effect of the bupivacaine and provides relief for around two weeks. For the ablation, he does the block in the same way, waits 15 minutes, and then injects ethanol to ablate the nerve. Some tips he has learned for celiac ablation are to ablate the retrocrural splanchnic nerves, because they feed into the celiac, and you will get a better result. Other areas he commonly ablates are intercostal nerves. For these, to avoid devastating paralysis from damage to the spinal cord, he always orients his needle lateral and stays at least two inches away from the spine. He advises those new in pain interventions to remember your anatomy. In radiology, we learn it all, and if you remember these nerves, you will be able to help a lot of people with their pain and decrease their suffering, making an enormous impact on someone’s quality of life. --- RESOURCES PIGI Lab: https://www.med.upenn.edu/pigilab/ Twitter: @PigiLab @md_rogue Mon, 29 May 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Michael Barraza interviews Dr. Stephen Hunt about building a pain practice, including his nerve ablation technique, how to obtain referrals, and why it is one of the most rewarding procedures that he does. --- SHOW NOTES We begin by discussing what caused Dr. Hunt to start building a pain service. He was treating many patients with lung cancer, and he saw so many patients toward the end of their life. What they wanted was to reduce their suffering due to pain. He saw what was being offered for them, which was opioids, but this caused them to be disconnected from their families at such an important time in their life. He knew he could offer nerve blocks and ablation, so he began educating himself. As he learned about different blocks, he adapted them to create his own technique. Pretty soon, word got out that he was doing this, and he started getting referrals from oncologists. Soon after this, thoracic surgeons and breast surgeons began referring to him for post-thoracotomy and post-mastectomy pain. Next, radiation oncologists referred their patients with radiation necrosis of the ribs, and orthopedic surgeons referred patients to him for pain from musculoskeletal metastases. For his technique, he often starts with a test block using bupivacaine and triamcinolone, which prolongs the effect of the bupivacaine and provides relief for around two weeks. For the ablation, he does the block in the same way, waits 15 minutes, and then injects ethanol to ablate the nerve. Some tips he has learned for celiac ablation are to ablate the retrocrural splanchnic nerves, because they feed into the celiac, and you will get a better result. Other areas he commonly ablates are intercostal nerves. For these, to avoid devastating paralysis from damage to the spinal cord, he always orients his needle lateral and stays at least two inches away from the spine. He advises those new in pain interventions to remember your anatomy. In radiology, we learn it all, and if you remember these nerves, you will be able to help a lot of people with their pain and decrease their suffering, making an enormous impact on someone’s quality of life. --- RESOURCES PIGI Lab: https://www.med.upenn.edu/pigilab/ Twitter: @PigiLab @md_rogue In this episode, host Dr. Michael Barraza interviews Dr. Stephen Hunt about building a pain practice, including his nerve ablation technique, how to obtain referrals, and why it is one of the most rewarding procedures that he does.


---


SHOW NOTES


We begin by discussing what caused Dr. Hunt to start building a pain service. He was treating many patients with lung cancer, and he saw so many patients toward the end of their life. What they wanted was to reduce their suffering due to pain. He saw what was being offered for them, which was opioids, but this caused them to be disconnected from their families at such an important time in their life. He knew he could offer nerve blocks and ablation, so he began educating himself. As he learned about different blocks, he adapted them to create his own technique.


Pretty soon, word got out that he was doing this, and he started getting referrals from oncologists. Soon after this, thoracic surgeons and breast surgeons began referring to him for post-thoracotomy and post-mastectomy pain. Next, radiation oncologists referred their patients with radiation necrosis of the ribs, and orthopedic surgeons referred patients to him for pain from musculoskeletal metastases.


For his technique, he often starts with a test block using bupivacaine and triamcinolone, which prolongs the effect of the bupivacaine and provides relief for around two weeks. For the ablation, he does the block in the same way, waits 15 minutes, and then injects ethanol to ablate the nerve. Some tips he has learned for celiac ablation are to ablate the retrocrural splanchnic nerves, because they feed into the celiac, and you will get a better result. Other areas he commonly ablates are intercostal nerves. For these, to avoid devastating paralysis from damage to the spinal cord, he always orients his needle lateral and stays at least two inches away from the spine. He advises those new in pain interventions to remember your anatomy. In radiology, we learn it all, and if you remember these nerves, you will be able to help a lot of people with their pain and decrease their suffering, making an enormous impact on someone’s quality of life.


---


RESOURCES


PIGI Lab:

https://www.med.upenn.edu/pigilab/


Twitter:

@PigiLab

@md_rogue

]]> 1988 Ep. 326 Healthcare Policy and Advocacy with Dr. Anahita Dua In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Anahita Dua on the importance of political advocacy in healthcare, including why she created a PAC, the importance of healthcare workers in Congress, and how you can get involved. --- CHECK OUT OUR SPONSORS Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1_2023&cid=n10012337 Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Dua is a vascular surgeon at Massachusetts General Hospital, associate professor of surgery at Harvard Medical School, co-director of the Peripheral Arterial Disease Center, Clinical Director of Research, the Director of the Vascular Lab and the Associate Director of the Wound Care Center. Her passion is limb salvage, and she performs open and endovascular techniques. She was born in Scotland, grew up in Wisconsin, completed medical school in the UK followed by general surgery residency at the Medical College of Wisconsin, vascular surgery fellowship at Stanford, a post-doctoral research fellowship at UT Houston, and finally an MBA and Masters in trauma sciences. She is also a wife, mom of two, and recently created a political action committee (PAC). Before creating a PAC, she initially considered running for Congress. She was tired of seeing injustices both on the healthcare side with her patients, as well as in her own family. She bought a bulletproof backpack for her daughter after a school shooting near where they live, and since that day, she has not stopped fighting for change. Instead of running for Congress herself, she decided to create a PAC with the goal of getting 10 people in Congress who shared her ideas about the change needed in this country. She raised money, surpassed her goal, and got two people in Congress in just one month. She knew she had to pick a side to get anywhere with the current state of politics in this country, so she decided to support someone only if they were a healthcare worker and a Democrat. She chose candidates based on their policies and their personality. She spoke with each one to get a sense of who they were, and she was looking for people who were intelligent, nimble, and who she would trust to babysit her kids. She then called a list of colleagues, informed them who she was supporting, and asked for their financial support. Dr. Dua hopes to have an impact on healthcare reform by creating advice specific to diseases such as diabetes. There is no standardization for limb problems, and this leads to disparities in care, with staggeringly unequal rates of amputations among different racial and socioeconomic groups. She aims to develop a standard of care that is implemented federally to improve limb care and reduce amputations. --- RESOURCES Healthcare for Action: www.healthcareforaction.com Fri, 26 May 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Anahita Dua on the importance of political advocacy in healthcare, including why she created a PAC, the importance of healthcare workers in Congress, and how you can get involved. In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Anahita Dua on the importance of political advocacy in healthcare, including why she created a PAC, the importance of healthcare workers in Congress, and how you can get involved. --- CHECK OUT OUR SPONSORS Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1_2023&cid=n10012337 Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Dua is a vascular surgeon at Massachusetts General Hospital, associate professor of surgery at Harvard Medical School, co-director of the Peripheral Arterial Disease Center, Clinical Director of Research, the Director of the Vascular Lab and the Associate Director of the Wound Care Center. Her passion is limb salvage, and she performs open and endovascular techniques. She was born in Scotland, grew up in Wisconsin, completed medical school in the UK followed by general surgery residency at the Medical College of Wisconsin, vascular surgery fellowship at Stanford, a post-doctoral research fellowship at UT Houston, and finally an MBA and Masters in trauma sciences. She is also a wife, mom of two, and recently created a political action committee (PAC). Before creating a PAC, she initially considered running for Congress. She was tired of seeing injustices both on the healthcare side with her patients, as well as in her own family. She bought a bulletproof backpack for her daughter after a school shooting near where they live, and since that day, she has not stopped fighting for change. Instead of running for Congress herself, she decided to create a PAC with the goal of getting 10 people in Congress who shared her ideas about the change needed in this country. She raised money, surpassed her goal, and got two people in Congress in just one month. She knew she had to pick a side to get anywhere with the current state of politics in this country, so she decided to support someone only if they were a healthcare worker and a Democrat. She chose candidates based on their policies and their personality. She spoke with each one to get a sense of who they were, and she was looking for people who were intelligent, nimble, and who she would trust to babysit her kids. She then called a list of colleagues, informed them who she was supporting, and asked for their financial support. Dr. Dua hopes to have an impact on healthcare reform by creating advice specific to diseases such as diabetes. There is no standardization for limb problems, and this leads to disparities in care, with staggeringly unequal rates of amputations among different racial and socioeconomic groups. She aims to develop a standard of care that is implemented federally to improve limb care and reduce amputations. --- RESOURCES Healthcare for Action: www.healthcareforaction.com In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Anahita Dua on the importance of political advocacy in healthcare, including why she created a PAC, the importance of healthcare workers in Congress, and how you can get involved.


---


CHECK OUT OUR SPONSORS


Boston Scientific Eluvia Drug-Eluting Stent

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1_2023&cid=n10012337


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. Dua is a vascular surgeon at Massachusetts General Hospital, associate professor of surgery at Harvard Medical School, co-director of the Peripheral Arterial Disease Center, Clinical Director of Research, the Director of the Vascular Lab and the Associate Director of the Wound Care Center. Her passion is limb salvage, and she performs open and endovascular techniques. She was born in Scotland, grew up in Wisconsin, completed medical school in the UK followed by general surgery residency at the Medical College of Wisconsin, vascular surgery fellowship at Stanford, a post-doctoral research fellowship at UT Houston, and finally an MBA and Masters in trauma sciences. She is also a wife, mom of two, and recently created a political action committee (PAC).


Before creating a PAC, she initially considered running for Congress. She was tired of seeing injustices both on the healthcare side with her patients, as well as in her own family. She bought a bulletproof backpack for her daughter after a school shooting near where they live, and since that day, she has not stopped fighting for change. Instead of running for Congress herself, she decided to create a PAC with the goal of getting 10 people in Congress who shared her ideas about the change needed in this country. She raised money, surpassed her goal, and got two people in Congress in just one month.


She knew she had to pick a side to get anywhere with the current state of politics in this country, so she decided to support someone only if they were a healthcare worker and a Democrat. She chose candidates based on their policies and their personality. She spoke with each one to get a sense of who they were, and she was looking for people who were intelligent, nimble, and who she would trust to babysit her kids. She then called a list of colleagues, informed them who she was supporting, and asked for their financial support. Dr. Dua hopes to have an impact on healthcare reform by creating advice specific to diseases such as diabetes. There is no standardization for limb problems, and this leads to disparities in care, with staggeringly unequal rates of amputations among different racial and socioeconomic groups. She aims to develop a standard of care that is implemented federally to improve limb care and reduce amputations.


---


RESOURCES


Healthcare for Action:

www.healthcareforaction.com

]]> 2591 Ep. 325 Recovering From a Major Injury as a Proceduralist with Dr. Deepak Sudheendra In this episode, host Dr. Ally Baheti interviews Dr. Deepak Sudheendra about obstacles that he has faced while practicing medicine, including dealing with a career-threatening injury, redefining boundaries between clinical and home responsibilities, and navigating a transition from a surgical to radiology residency. --- CHECK OUT OUR SPONSORS Medtronic Ellipsys Vascular Access System https://www.medtronic.com/ellipsys RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Sudheendra has recently returned to his clinical IR practice. He had taken one year off to recover from a traumatic fall that resulted in multiple fractures and loss of function in his left hand and arm. The recovery process was physically arduous, requiring intensive physical and occupational therapy multiple times a week to re-learn basic functions. As an IR that was 100% procedural, Dr. Sudheendra faced a lot of uncertainty about whether he would ever be able to return to performing complex procedures. Additionally, he faced the stress of battling with insurance companies for his rightful disability insurance payments. The paperwork process required him to submit case logs and attestations from co-workers to prove his prior case volume. Through this experience, Dr. Sudheendra is able to give disability insurance advice for young physicians and graduating trainees. Buying an insurance plan before residency or fellowship ends will allow the trainee to pay a lower premium than if they were attendings. It is important to read the fine print in the contracts that are offered and consider buying both short-term and long-term insurance, since there is no way to predict the timing and severity of a future injury. Additionally, buying into multiple plans can lower the total annual premium, but it comes with the added stress of having to deal with multiple companies when an injury does occur. As Dr. Sudheendra returned to clinical practice, he started with locums in community hospitals. He found that easing back into simple IR procedures allowed him to not only gain his confidence back, but also invest more time into his family. His next endeavor is opening his own office-based lab (OBL) focused on vascular interventions. To end the episode, we discuss Dr. Sundheendra’s perspective on navigating his career. He originally started in a cardiothoracic surgery residency, but decided to leave the field to pursue interventional radiology. This switch was not simple, and it required years of researching and advocating for himself to different residency programs. On this journey, he was able to attain his diagnostic radiology residency and interventional radiology fellowship positions through persistence and networking. Overall, Dr. Sudheendra advises procedurally-oriented medical students and early trainees to expose themselves to all related subspecialty areas, think about new developments in those fields, and imagine how the field might change in the course of their careers. --- RESOURCES Dr. Deepak Sudheendra Website: https://www.gethealthyveins.com/ Dr. Deepak Sudheendra Twitter: https://twitter.com/Dr_Sudi/with_replies Physician Moms Group on Facebook: https://www.facebook.com/groups/PhysicianMomsGroup/ Mon, 22 May 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews Dr. Deepak Sudheendra about obstacles that he has faced while practicing medicine, including dealing with a career-threatening injury, redefining boundaries between clinical and home responsibilities, and navigating a transition from a surgical to radiology residency. In this episode, host Dr. Ally Baheti interviews Dr. Deepak Sudheendra about obstacles that he has faced while practicing medicine, including dealing with a career-threatening injury, redefining boundaries between clinical and home responsibilities, and navigating a transition from a surgical to radiology residency. --- CHECK OUT OUR SPONSORS Medtronic Ellipsys Vascular Access System https://www.medtronic.com/ellipsys RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Sudheendra has recently returned to his clinical IR practice. He had taken one year off to recover from a traumatic fall that resulted in multiple fractures and loss of function in his left hand and arm. The recovery process was physically arduous, requiring intensive physical and occupational therapy multiple times a week to re-learn basic functions. As an IR that was 100% procedural, Dr. Sudheendra faced a lot of uncertainty about whether he would ever be able to return to performing complex procedures. Additionally, he faced the stress of battling with insurance companies for his rightful disability insurance payments. The paperwork process required him to submit case logs and attestations from co-workers to prove his prior case volume. Through this experience, Dr. Sudheendra is able to give disability insurance advice for young physicians and graduating trainees. Buying an insurance plan before residency or fellowship ends will allow the trainee to pay a lower premium than if they were attendings. It is important to read the fine print in the contracts that are offered and consider buying both short-term and long-term insurance, since there is no way to predict the timing and severity of a future injury. Additionally, buying into multiple plans can lower the total annual premium, but it comes with the added stress of having to deal with multiple companies when an injury does occur. As Dr. Sudheendra returned to clinical practice, he started with locums in community hospitals. He found that easing back into simple IR procedures allowed him to not only gain his confidence back, but also invest more time into his family. His next endeavor is opening his own office-based lab (OBL) focused on vascular interventions. To end the episode, we discuss Dr. Sundheendra’s perspective on navigating his career. He originally started in a cardiothoracic surgery residency, but decided to leave the field to pursue interventional radiology. This switch was not simple, and it required years of researching and advocating for himself to different residency programs. On this journey, he was able to attain his diagnostic radiology residency and interventional radiology fellowship positions through persistence and networking. Overall, Dr. Sudheendra advises procedurally-oriented medical students and early trainees to expose themselves to all related subspecialty areas, think about new developments in those fields, and imagine how the field might change in the course of their careers. --- RESOURCES Dr. Deepak Sudheendra Website: https://www.gethealthyveins.com/ Dr. Deepak Sudheendra Twitter: https://twitter.com/Dr_Sudi/with_replies Physician Moms Group on Facebook: https://www.facebook.com/groups/PhysicianMomsGroup/ In this episode, host Dr. Ally Baheti interviews Dr. Deepak Sudheendra about obstacles that he has faced while practicing medicine, including dealing with a career-threatening injury, redefining boundaries between clinical and home responsibilities, and navigating a transition from a surgical to radiology residency.


---


CHECK OUT OUR SPONSORS


Medtronic Ellipsys Vascular Access System

https://www.medtronic.com/ellipsys


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Dr. Sudheendra has recently returned to his clinical IR practice. He had taken one year off to recover from a traumatic fall that resulted in multiple fractures and loss of function in his left hand and arm. The recovery process was physically arduous, requiring intensive physical and occupational therapy multiple times a week to re-learn basic functions. As an IR that was 100% procedural, Dr. Sudheendra faced a lot of uncertainty about whether he would ever be able to return to performing complex procedures. Additionally, he faced the stress of battling with insurance companies for his rightful disability insurance payments. The paperwork process required him to submit case logs and attestations from co-workers to prove his prior case volume.


Through this experience, Dr. Sudheendra is able to give disability insurance advice for young physicians and graduating trainees. Buying an insurance plan before residency or fellowship ends will allow the trainee to pay a lower premium than if they were attendings. It is important to read the fine print in the contracts that are offered and consider buying both short-term and long-term insurance, since there is no way to predict the timing and severity of a future injury. Additionally, buying into multiple plans can lower the total annual premium, but it comes with the added stress of having to deal with multiple companies when an injury does occur.


As Dr. Sudheendra returned to clinical practice, he started with locums in community hospitals. He found that easing back into simple IR procedures allowed him to not only gain his confidence back, but also invest more time into his family. His next endeavor is opening his own office-based lab (OBL) focused on vascular interventions.


To end the episode, we discuss Dr. Sundheendra’s perspective on navigating his career. He originally started in a cardiothoracic surgery residency, but decided to leave the field to pursue interventional radiology. This switch was not simple, and it required years of researching and advocating for himself to different residency programs. On this journey, he was able to attain his diagnostic radiology residency and interventional radiology fellowship positions through persistence and networking. Overall, Dr. Sudheendra advises procedurally-oriented medical students and early trainees to expose themselves to all related subspecialty areas, think about new developments in those fields, and imagine how the field might change in the course of their careers.


---


RESOURCES


Dr. Deepak Sudheendra Website:

https://www.gethealthyveins.com/


Dr. Deepak Sudheendra Twitter:

https://twitter.com/Dr_Sudi/with_replies


Physician Moms Group on Facebook:

https://www.facebook.com/groups/PhysicianMomsGroup/

]]> 3669 Ep. 324 Embolization for Treatment of Hemorrhoids with Dr. Alex Pavidapha In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Alex Pavidapha give a primer on the emerging field of hemorrhoidal artery embolization (HAE), including patient presentations and referrals, treatment algorithms, procedural steps, and follow up care. --- CHECK OUT OUR SPONSOR Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202 --- SHOW NOTES To start. Dr. Pavidapha describes the typical patient presenting with hemorrhoids. This is a prevalent condition that peaks at the ages of 45-65 and in the pregnant population. There are a variety of treatment options ranging from banding, hemorrhoidectomy, and cryotherapy; however, many patients may experience recurrence after these treatments or they may not be suitable candidates for surgery. Next, we discuss the current landscape of HAE. This treatment is a good option for patients who have failed other treatment options. The majority of Dr. Pavidapha’s patients come from referrals by gastroenterologists, although some come based on their own research on the web. It is important that all patients have a colonoscopy before HAE, to rule out the possibility of colon cancer. Additionally, a full history and rectal exam should be performed, since the choice to treat can be guided by the patient’s symptom severity and the degree of internal hemorrhoid prolapse. It is also advisable to identify extremely painful external hemorrhoids, since these can be addressed with conservative measures. Dr. Pavidapha notes that patient counseling is extremely important, since hemorrhoids have a high risk of recurrence and bowel habits play a large part in this. In terms of procedural risks, he counsels patients about standard risks of bleeding and infection, recurrence, mild pain in the few days after the procedure, and although it is rare, non-target embolization of skin or other organs. During the procedure, Dr. Pavidapha prefers femoral access, since this is the easiest way to select the internal mesenteric artery. He does a base catheter run here to visualize the superior rectal arteries. These vessels are the most commonly involved in internal hemorrhoids, and if they are feeding the hemorrhoid, he will inject 500 micron beads and then follow with embolic coils. Next, he navigates through the internal iliac and pudendal arteries to arrive at the middle rectal arteries for another run. If they also supply the hemorrhoids, he will embolize them. The inferior rectal arteries are usually not involved in hemorrhoid formation, embolization of them carries a high risk of skin necrosis. Treatment of inferior rectal arteries is usually avoided. It is important to know typical anatomy very well so you can determine targets for embolization and recognize whether a patient has variant anatomy. Finally, Dr. Pavidapha sees his patients for follow-up at 1 month, 4 months, and 1 year to check for symptomatic improvement, primarily decreased bleeding. If bleeding has worsened, the patient most likely needs a repeat procedure to identify new blood vessels supplying the hemorrhoid. To IRs who are interested in starting an HAE service line, Dr. Pavidapha advises them to read the existing literature about hemorrhoids and HAE and be able to show clinical outcomes data to gastroenterologists. Overall, patients with recurrent hemorrhoids are typically an underserved population and have the potential to benefit from this novel procedure. --- RESOURCES Ep. 319 - How to Collaborate with GI on a New Outpatient Service Line: https://www.backtable.com/shows/vi/podcasts/319/how-to-collaborate-with-gi-on-a-new-outpatient-service-line Outcomes of Hemorrhoidal Artery Embolization from a Multidisciplinary Outpatient Interventional Center: https://pubmed.ncbi.nlm.nih.gov/36736822/ The STREAM Meeting: ​​https://www.thestreammeeting.com/ Fri, 19 May 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Alex Pavidapha give a primer on the emerging field of hemorrhoidal artery embolization (HAE), including patient presentations and referrals, treatment algorithms, procedural steps, and follow up care. In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Alex Pavidapha give a primer on the emerging field of hemorrhoidal artery embolization (HAE), including patient presentations and referrals, treatment algorithms, procedural steps, and follow up care. --- CHECK OUT OUR SPONSOR Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202 --- SHOW NOTES To start. Dr. Pavidapha describes the typical patient presenting with hemorrhoids. This is a prevalent condition that peaks at the ages of 45-65 and in the pregnant population. There are a variety of treatment options ranging from banding, hemorrhoidectomy, and cryotherapy; however, many patients may experience recurrence after these treatments or they may not be suitable candidates for surgery. Next, we discuss the current landscape of HAE. This treatment is a good option for patients who have failed other treatment options. The majority of Dr. Pavidapha’s patients come from referrals by gastroenterologists, although some come based on their own research on the web. It is important that all patients have a colonoscopy before HAE, to rule out the possibility of colon cancer. Additionally, a full history and rectal exam should be performed, since the choice to treat can be guided by the patient’s symptom severity and the degree of internal hemorrhoid prolapse. It is also advisable to identify extremely painful external hemorrhoids, since these can be addressed with conservative measures. Dr. Pavidapha notes that patient counseling is extremely important, since hemorrhoids have a high risk of recurrence and bowel habits play a large part in this. In terms of procedural risks, he counsels patients about standard risks of bleeding and infection, recurrence, mild pain in the few days after the procedure, and although it is rare, non-target embolization of skin or other organs. During the procedure, Dr. Pavidapha prefers femoral access, since this is the easiest way to select the internal mesenteric artery. He does a base catheter run here to visualize the superior rectal arteries. These vessels are the most commonly involved in internal hemorrhoids, and if they are feeding the hemorrhoid, he will inject 500 micron beads and then follow with embolic coils. Next, he navigates through the internal iliac and pudendal arteries to arrive at the middle rectal arteries for another run. If they also supply the hemorrhoids, he will embolize them. The inferior rectal arteries are usually not involved in hemorrhoid formation, embolization of them carries a high risk of skin necrosis. Treatment of inferior rectal arteries is usually avoided. It is important to know typical anatomy very well so you can determine targets for embolization and recognize whether a patient has variant anatomy. Finally, Dr. Pavidapha sees his patients for follow-up at 1 month, 4 months, and 1 year to check for symptomatic improvement, primarily decreased bleeding. If bleeding has worsened, the patient most likely needs a repeat procedure to identify new blood vessels supplying the hemorrhoid. To IRs who are interested in starting an HAE service line, Dr. Pavidapha advises them to read the existing literature about hemorrhoids and HAE and be able to show clinical outcomes data to gastroenterologists. Overall, patients with recurrent hemorrhoids are typically an underserved population and have the potential to benefit from this novel procedure. --- RESOURCES Ep. 319 - How to Collaborate with GI on a New Outpatient Service Line: https://www.backtable.com/shows/vi/podcasts/319/how-to-collaborate-with-gi-on-a-new-outpatient-service-line Outcomes of Hemorrhoidal Artery Embolization from a Multidisciplinary Outpatient Interventional Center: https://pubmed.ncbi.nlm.nih.gov/36736822/ The STREAM Meeting: ​​https://www.thestreammeeting.com/ In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Alex Pavidapha give a primer on the emerging field of hemorrhoidal artery embolization (HAE), including patient presentations and referrals, treatment algorithms, procedural steps, and follow up care.


---


CHECK OUT OUR SPONSOR


Boston Scientific Nextlab

https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1_2023&cid=n10013202


---


SHOW NOTES


To start. Dr. Pavidapha describes the typical patient presenting with hemorrhoids. This is a prevalent condition that peaks at the ages of 45-65 and in the pregnant population. There are a variety of treatment options ranging from banding, hemorrhoidectomy, and cryotherapy; however, many patients may experience recurrence after these treatments or they may not be suitable candidates for surgery. Next, we discuss the current landscape of HAE. This treatment is a good option for patients who have failed other treatment options. The majority of Dr. Pavidapha’s patients come from referrals by gastroenterologists, although some come based on their own research on the web. It is important that all patients have a colonoscopy before HAE, to rule out the possibility of colon cancer. Additionally, a full history and rectal exam should be performed, since the choice to treat can be guided by the patient’s symptom severity and the degree of internal hemorrhoid prolapse. It is also advisable to identify extremely painful external hemorrhoids, since these can be addressed with conservative measures. Dr. Pavidapha notes that patient counseling is extremely important, since hemorrhoids have a high risk of recurrence and bowel habits play a large part in this. In terms of procedural risks, he counsels patients about standard risks of bleeding and infection, recurrence, mild pain in the few days after the procedure, and although it is rare, non-target embolization of skin or other organs.


During the procedure, Dr. Pavidapha prefers femoral access, since this is the easiest way to select the internal mesenteric artery. He does a base catheter run here to visualize the superior rectal arteries. These vessels are the most commonly involved in internal hemorrhoids, and if they are feeding the hemorrhoid, he will inject 500 micron beads and then follow with embolic coils. Next, he navigates through the internal iliac and pudendal arteries to arrive at the middle rectal arteries for another run. If they also supply the hemorrhoids, he will embolize them. The inferior rectal arteries are usually not involved in hemorrhoid formation, embolization of them carries a high risk of skin necrosis. Treatment of inferior rectal arteries is usually avoided. It is important to know typical anatomy very well so you can determine targets for embolization and recognize whether a patient has variant anatomy.


Finally, Dr. Pavidapha sees his patients for follow-up at 1 month, 4 months, and 1 year to check for symptomatic improvement, primarily decreased bleeding. If bleeding has worsened, the patient most likely needs a repeat procedure to identify new blood vessels supplying the hemorrhoid.


To IRs who are interested in starting an HAE service line, Dr. Pavidapha advises them to read the existing literature about hemorrhoids and HAE and be able to show clinical outcomes data to gastroenterologists. Overall, patients with recurrent hemorrhoids are typically an underserved population and have the potential to benefit from this novel procedure.


---


RESOURCES


Ep. 319 - How to Collaborate with GI on a New Outpatient Service Line:

https://www.backtable.com/shows/vi/podcasts/319/how-to-collaborate-with-gi-on-a-new-outpatient-service-line

Outcomes of Hemorrhoidal Artery Embolization from a Multidisciplinary Outpatient Interventional Center:

https://pubmed.ncbi.nlm.nih.gov/36736822/


The STREAM Meeting:

​​https://www.thestreammeeting.com/

]]> 2517 Ep. 323 El Camino Evolucionario de Francisco Carnevale: La Chispa que Encendió la Embolización de la Próstata En los confines de la medicina, a veces es necesario un espíritu intrépido para desafiar las prácticas establecidas y abrir nuevos horizontes. El reconocido doctor Francisco Carnevale, una figura emblemática en el campo de la radiologia intervencionista, personifica a la perfección esta audacia. Su historia es la epopeya de un hombre que tuvo la inquietud de explorar la embolización de la próstata, un enfoque innovador en el tratamiento de la hiperplasia prostática. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Como un faro de curiosidad intelectual, el Dr. Carnevale se aventuró en el mundo desconocido de la embolización de la próstata. Con pasión y determinación, navegó a través de los océanos de investigación médica, desafiando la ortodoxia y enfrentando el escepticismo. Fue un viaje lleno de obstáculos y dificultades, pero cada paso que dio fue impulsado por la convicción de que estaba abriendo puertas a nuevas posibilidades de tratamiento. Su dedicación inquebrantable dio frutos. El Dr. Carnevale no solo superó los desafíos técnicos asociados con la embolización de la próstata, sino que también cosechó resultados impresionantes. Sus intervenciones se convirtieron en un éxito rotundo, aliviando el sufrimiento de muchos pacientes y mejorando su calidad de vida. Sus habilidades quirúrgicas y su enfoque innovador se ganaron el reconocimiento de sus colegas, quienes lo consideran un líder en el campo de la urología.Además de sus logros clínicos, el Dr. Carnevale ha dejado una huella imborrable en la comunidad médica a través de sus numerosas investigaciones y publicaciones. Sus contribuciones han ayudado a sentar las bases científicas de la embolización de la próstata, inspirando a otros profesionales a seguir su ejemplo y continuar expandiendo los límites del conocimiento médico. En resumen, la historia del Dr. Francisco Carnevale es una historia de coraje, determinación y éxito. Su viaje desde la inquietud inicial hasta convertirse en un modelo a seguir en investigación y publicaciones es un testimonio de la pasión y el espíritu de vanguardia que impulsa la medicina moderna. Su legado perdurará, iluminando el camino para las generaciones futuras de profesionales de la salud y dejando un impacto duradero en la comunidad médica. Wed, 17 May 2023 05:05:00 -0000 full BackTable En los confines de la medicina, a veces es necesario un espíritu intrépido para desafiar las prácticas establecidas y abrir nuevos horizontes. El reconocido doctor Francisco Carnevale, una figura emblemática en el campo de la radiologia intervencionista, personifica a la perfección esta audacia. Su historia es la epopeya de un hombre que tuvo la inquietud de explorar la embolización de la próstata, un enfoque innovador en el tratamiento de la hiperplasia prostática. En los confines de la medicina, a veces es necesario un espíritu intrépido para desafiar las prácticas establecidas y abrir nuevos horizontes. El reconocido doctor Francisco Carnevale, una figura emblemática en el campo de la radiologia intervencionista, personifica a la perfección esta audacia. Su historia es la epopeya de un hombre que tuvo la inquietud de explorar la embolización de la próstata, un enfoque innovador en el tratamiento de la hiperplasia prostática. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Como un faro de curiosidad intelectual, el Dr. Carnevale se aventuró en el mundo desconocido de la embolización de la próstata. Con pasión y determinación, navegó a través de los océanos de investigación médica, desafiando la ortodoxia y enfrentando el escepticismo. Fue un viaje lleno de obstáculos y dificultades, pero cada paso que dio fue impulsado por la convicción de que estaba abriendo puertas a nuevas posibilidades de tratamiento. Su dedicación inquebrantable dio frutos. El Dr. Carnevale no solo superó los desafíos técnicos asociados con la embolización de la próstata, sino que también cosechó resultados impresionantes. Sus intervenciones se convirtieron en un éxito rotundo, aliviando el sufrimiento de muchos pacientes y mejorando su calidad de vida. Sus habilidades quirúrgicas y su enfoque innovador se ganaron el reconocimiento de sus colegas, quienes lo consideran un líder en el campo de la urología.Además de sus logros clínicos, el Dr. Carnevale ha dejado una huella imborrable en la comunidad médica a través de sus numerosas investigaciones y publicaciones. Sus contribuciones han ayudado a sentar las bases científicas de la embolización de la próstata, inspirando a otros profesionales a seguir su ejemplo y continuar expandiendo los límites del conocimiento médico. En resumen, la historia del Dr. Francisco Carnevale es una historia de coraje, determinación y éxito. Su viaje desde la inquietud inicial hasta convertirse en un modelo a seguir en investigación y publicaciones es un testimonio de la pasión y el espíritu de vanguardia que impulsa la medicina moderna. Su legado perdurará, iluminando el camino para las generaciones futuras de profesionales de la salud y dejando un impacto duradero en la comunidad médica. En los confines de la medicina, a veces es necesario un espíritu intrépido para desafiar las prácticas establecidas y abrir nuevos horizontes. El reconocido doctor Francisco Carnevale, una figura emblemática en el campo de la radiologia intervencionista, personifica a la perfección esta audacia. Su historia es la epopeya de un hombre que tuvo la inquietud de explorar la embolización de la próstata, un enfoque innovador en el tratamiento de la hiperplasia prostática.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Como un faro de curiosidad intelectual, el Dr. Carnevale se aventuró en el mundo desconocido de la embolización de la próstata. Con pasión y determinación, navegó a través de los océanos de investigación médica, desafiando la ortodoxia y enfrentando el escepticismo. Fue un viaje lleno de obstáculos y dificultades, pero cada paso que dio fue impulsado por la convicción de que estaba abriendo puertas a nuevas posibilidades de tratamiento.


Su dedicación inquebrantable dio frutos. El Dr. Carnevale no solo superó los desafíos técnicos asociados con la embolización de la próstata, sino que también cosechó resultados impresionantes. Sus intervenciones se convirtieron en un éxito rotundo, aliviando el sufrimiento de muchos pacientes y mejorando su calidad de vida. Sus habilidades quirúrgicas y su enfoque innovador se ganaron el reconocimiento de sus colegas, quienes lo consideran un líder en el campo de la urología.Además de sus logros clínicos, el Dr. Carnevale ha dejado una huella imborrable en la comunidad médica a través de sus numerosas investigaciones y publicaciones. Sus contribuciones han ayudado a sentar las bases científicas de la embolización de la próstata, inspirando a otros profesionales a seguir su ejemplo y continuar expandiendo los límites del conocimiento médico.


En resumen, la historia del Dr. Francisco Carnevale es una historia de coraje, determinación y éxito. Su viaje desde la inquietud inicial hasta convertirse en un modelo a seguir en investigación y publicaciones es un testimonio de la pasión y el espíritu de vanguardia que impulsa la medicina moderna. Su legado perdurará, iluminando el camino para las generaciones futuras de profesionales de la salud y dejando un impacto duradero en la comunidad médica.

]]> 3010 Ep. 322 Renal Trauma Embolizations with Dr. Nima Kokabi In this episode, host Dr. Chris Beck interviews Dr. Nima Kokabi about renal trauma embolizations, including imaging workup, embolization technique, and a warning on renal biopsies. --- CHECK OUT OUR SPONSOR Boston Scientific Embold Fibered Coils https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html --- SHOW NOTES Dr. Kokabi was born in Iran, then moved to Canada where he grew up. He attended medical school in Australia due to the shortage of English speaking medical schools in Canada. After his medical training, he was interested in IR, and came to Yale for a fellowship. He then joined Emory as an attending, where he serves one of the largest trauma hospitals in the country. IR and trauma surgery have a close relationship at Emory, and Dr. Kokabi notes they rely more and more on IR for trauma management, even for things such as penetrating trauma, which is traditionally handled by surgery. Most IR consults for kidney injury are iatrogenic from non-target renal biopsies in a nephrology office. The rules for getting access to a kidney that IRs are trained in are generally not followed by nephrology, and only some have ultrasound guidance for their biopsies. Other consults for bleeding from kidney injury are post-op from a partial nephrectomy or from blunt trauma. To work it up, he gets a 2 phase arterial and venous CT. All kidney injuries are evaluated and reported using the American Association for the Surgery of Trauma (AAST) grading scale. If there is an active bleed, they will go to IR for embolization. If the injury is severe, and there is no parenchymal enhancement, this indicates either the artery or both the artery and vein were transected, and this patient requires surgery. In cases where there is only a small pseudo-aneurysm or a perinephric hematoma, these patients can be monitored with repeat imaging. For the embolization, Dr. Kokabi uses radial access. For his microcatheter, he likes the True Select. He always uses coils in the kidney, while in the liver, he uses gel foam. Some of his colleagues use glue for the kidney. He prefers detachable Embold coils, which are fiber coils with a nitinol pusher, so they don’t kink when being pushed very fast, and can be adjusted if positioning is unsatisfactory. When he is finished, he injects first through the microcatheter and then again through the base catheter to ensure he hasn’t missed any bleeding. He generally follows patients in the hospital for 1-2 days, before signing off. His parting advice to trainees and anyone doing kidney biopsies is to exercise caution, because although it is just a biopsy, it can cause life-threatening bleeding. --- RESOURCES AAST Kidney Injury Scale: https://radiopaedia.org/articles/aast-kidney-injury-scale Mon, 15 May 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Chris Beck interviews Dr. Nima Kokabi about renal trauma embolizations, including imaging workup, embolization technique, and a warning on renal biopsies. In this episode, host Dr. Chris Beck interviews Dr. Nima Kokabi about renal trauma embolizations, including imaging workup, embolization technique, and a warning on renal biopsies. --- CHECK OUT OUR SPONSOR Boston Scientific Embold Fibered Coils https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html --- SHOW NOTES Dr. Kokabi was born in Iran, then moved to Canada where he grew up. He attended medical school in Australia due to the shortage of English speaking medical schools in Canada. After his medical training, he was interested in IR, and came to Yale for a fellowship. He then joined Emory as an attending, where he serves one of the largest trauma hospitals in the country. IR and trauma surgery have a close relationship at Emory, and Dr. Kokabi notes they rely more and more on IR for trauma management, even for things such as penetrating trauma, which is traditionally handled by surgery. Most IR consults for kidney injury are iatrogenic from non-target renal biopsies in a nephrology office. The rules for getting access to a kidney that IRs are trained in are generally not followed by nephrology, and only some have ultrasound guidance for their biopsies. Other consults for bleeding from kidney injury are post-op from a partial nephrectomy or from blunt trauma. To work it up, he gets a 2 phase arterial and venous CT. All kidney injuries are evaluated and reported using the American Association for the Surgery of Trauma (AAST) grading scale. If there is an active bleed, they will go to IR for embolization. If the injury is severe, and there is no parenchymal enhancement, this indicates either the artery or both the artery and vein were transected, and this patient requires surgery. In cases where there is only a small pseudo-aneurysm or a perinephric hematoma, these patients can be monitored with repeat imaging. For the embolization, Dr. Kokabi uses radial access. For his microcatheter, he likes the True Select. He always uses coils in the kidney, while in the liver, he uses gel foam. Some of his colleagues use glue for the kidney. He prefers detachable Embold coils, which are fiber coils with a nitinol pusher, so they don’t kink when being pushed very fast, and can be adjusted if positioning is unsatisfactory. When he is finished, he injects first through the microcatheter and then again through the base catheter to ensure he hasn’t missed any bleeding. He generally follows patients in the hospital for 1-2 days, before signing off. His parting advice to trainees and anyone doing kidney biopsies is to exercise caution, because although it is just a biopsy, it can cause life-threatening bleeding. --- RESOURCES AAST Kidney Injury Scale: https://radiopaedia.org/articles/aast-kidney-injury-scale In this episode, host Dr. Chris Beck interviews Dr. Nima Kokabi about renal trauma embolizations, including imaging workup, embolization technique, and a warning on renal biopsies.


---


CHECK OUT OUR SPONSOR


Boston Scientific Embold Fibered Coils

https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html


---


SHOW NOTES


Dr. Kokabi was born in Iran, then moved to Canada where he grew up. He attended medical school in Australia due to the shortage of English speaking medical schools in Canada. After his medical training, he was interested in IR, and came to Yale for a fellowship. He then joined Emory as an attending, where he serves one of the largest trauma hospitals in the country. IR and trauma surgery have a close relationship at Emory, and Dr. Kokabi notes they rely more and more on IR for trauma management, even for things such as penetrating trauma, which is traditionally handled by surgery.


Most IR consults for kidney injury are iatrogenic from non-target renal biopsies in a nephrology office. The rules for getting access to a kidney that IRs are trained in are generally not followed by nephrology, and only some have ultrasound guidance for their biopsies. Other consults for bleeding from kidney injury are post-op from a partial nephrectomy or from blunt trauma. To work it up, he gets a 2 phase arterial and venous CT. All kidney injuries are evaluated and reported using the American Association for the Surgery of Trauma (AAST) grading scale. If there is an active bleed, they will go to IR for embolization. If the injury is severe, and there is no parenchymal enhancement, this indicates either the artery or both the artery and vein were transected, and this patient requires surgery. In cases where there is only a small pseudo-aneurysm or a perinephric hematoma, these patients can be monitored with repeat imaging.


For the embolization, Dr. Kokabi uses radial access. For his microcatheter, he likes the True Select. He always uses coils in the kidney, while in the liver, he uses gel foam. Some of his colleagues use glue for the kidney. He prefers detachable Embold coils, which are fiber coils with a nitinol pusher, so they don’t kink when being pushed very fast, and can be adjusted if positioning is unsatisfactory. When he is finished, he injects first through the microcatheter and then again through the base catheter to ensure he hasn’t missed any bleeding. He generally follows patients in the hospital for 1-2 days, before signing off. His parting advice to trainees and anyone doing kidney biopsies is to exercise caution, because although it is just a biopsy, it can cause life-threatening bleeding.


---


RESOURCES


AAST Kidney Injury Scale:

https://radiopaedia.org/articles/aast-kidney-injury-scale

]]> 2691 Ep. 321 New Innovations in Lower GI Bleed Embolization with Dr. Kevin Henseler In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Kevin Henseler discuss his treatment algorithm and new technologies for embolization of GI bleeds. --- CHECK OUT OUR SPONSOR Boston Scientific Obsidio Embolic https://www.bostonscientific.com/obsidio --- SHOW NOTES Dr. Henseler starts by differentiating between lower and upper GI bleeds. Upper GI bleeds tend to be more life-threatening and are most commonly caused by esophageal varices or duodenal ulcers, and many of these consults come from the endoscopy suite. These upper GI bleeds also have a higher risk of recurrence. On the other hand, lower GI bleeds can be more indolent. CTA is the most efficient way to assess the source of GI bleeding. It provides valuable information about the vascular territory, including localization of bleeding, planning where to inject during angiography, and variant anatomy. If CTA is negative for bleeding, Dr. Henseler does not move onto angiography. He monitors the patient for further signs of intermittent bleeding and may re-image or intervene the following day. If CTA does show bleeding, Dr. Henseler moves onto angiography and embolization. He finds that there are few contraindications to angiography. Relative contraindications include renal insufficiency, which is a small tradeoff for a lifesaving procedure, and contrast allergy, which can be addressed with a preprocedural steroid dose. When it comes to methods of embolization, detachable coils have been a mainstay. While they are more expensive than pushable coils, detachable coils allow for more exact placement and increased safety and more IRs are being trained to use these now. Dr. Henseler also discusses the use of embolic particles, which carry risks of end-organ damage and ischemia, as well as embolic glue, which can be difficult to use if the operator does not have sufficient training. Then, we shift gears to discuss Obsidio, a new injectable solid that is soon to be commercially available. It exists as a liquid when it is in its pressurized form within the microcatheter; however, it immediately solidifies in the vessel as soon as the injection ceases. Obsidio is made of radio-opaque tantalum so it is visible on CT, stays permanently in the vessel, and can be used in conjunction with coils if desired. Additionally, its cohesive properties decrease the risk of abdominal extravasation and it can be used with any catheter. --- RESOURCES Dr. Kevin Henseler LinkedIn: https://www.linkedin.com/in/kevin-henseler-364832231/ CTA for Lower GI Bleeds: https://www.youtube.com/watch?v=UWEf_sAUGKU Ep. 179- Happiness is a Warm Coil: Treating GI Bleeds: https://www.backtable.com/shows/vi/podcasts/179/happiness-is-a-warm-coil-treating-gi-bleeds Ep. 216- Stick It: Glue Embo: https://www.backtable.com/shows/vi/podcasts/216/stick-it-glue-embo Fri, 12 May 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Kevin Henseler discuss his treatment algorithm and new technologies for embolization of GI bleeds. In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Kevin Henseler discuss his treatment algorithm and new technologies for embolization of GI bleeds. --- CHECK OUT OUR SPONSOR Boston Scientific Obsidio Embolic https://www.bostonscientific.com/obsidio --- SHOW NOTES Dr. Henseler starts by differentiating between lower and upper GI bleeds. Upper GI bleeds tend to be more life-threatening and are most commonly caused by esophageal varices or duodenal ulcers, and many of these consults come from the endoscopy suite. These upper GI bleeds also have a higher risk of recurrence. On the other hand, lower GI bleeds can be more indolent. CTA is the most efficient way to assess the source of GI bleeding. It provides valuable information about the vascular territory, including localization of bleeding, planning where to inject during angiography, and variant anatomy. If CTA is negative for bleeding, Dr. Henseler does not move onto angiography. He monitors the patient for further signs of intermittent bleeding and may re-image or intervene the following day. If CTA does show bleeding, Dr. Henseler moves onto angiography and embolization. He finds that there are few contraindications to angiography. Relative contraindications include renal insufficiency, which is a small tradeoff for a lifesaving procedure, and contrast allergy, which can be addressed with a preprocedural steroid dose. When it comes to methods of embolization, detachable coils have been a mainstay. While they are more expensive than pushable coils, detachable coils allow for more exact placement and increased safety and more IRs are being trained to use these now. Dr. Henseler also discusses the use of embolic particles, which carry risks of end-organ damage and ischemia, as well as embolic glue, which can be difficult to use if the operator does not have sufficient training. Then, we shift gears to discuss Obsidio, a new injectable solid that is soon to be commercially available. It exists as a liquid when it is in its pressurized form within the microcatheter; however, it immediately solidifies in the vessel as soon as the injection ceases. Obsidio is made of radio-opaque tantalum so it is visible on CT, stays permanently in the vessel, and can be used in conjunction with coils if desired. Additionally, its cohesive properties decrease the risk of abdominal extravasation and it can be used with any catheter. --- RESOURCES Dr. Kevin Henseler LinkedIn: https://www.linkedin.com/in/kevin-henseler-364832231/ CTA for Lower GI Bleeds: https://www.youtube.com/watch?v=UWEf_sAUGKU Ep. 179- Happiness is a Warm Coil: Treating GI Bleeds: https://www.backtable.com/shows/vi/podcasts/179/happiness-is-a-warm-coil-treating-gi-bleeds Ep. 216- Stick It: Glue Embo: https://www.backtable.com/shows/vi/podcasts/216/stick-it-glue-embo In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Kevin Henseler discuss his treatment algorithm and new technologies for embolization of GI bleeds.


---


CHECK OUT OUR SPONSOR


Boston Scientific Obsidio Embolic

https://www.bostonscientific.com/obsidio


---


SHOW NOTES


Dr. Henseler starts by differentiating between lower and upper GI bleeds. Upper GI bleeds tend to be more life-threatening and are most commonly caused by esophageal varices or duodenal ulcers, and many of these consults come from the endoscopy suite. These upper GI bleeds also have a higher risk of recurrence. On the other hand, lower GI bleeds can be more indolent. CTA is the most efficient way to assess the source of GI bleeding. It provides valuable information about the vascular territory, including localization of bleeding, planning where to inject during angiography, and variant anatomy. If CTA is negative for bleeding, Dr. Henseler does not move onto angiography. He monitors the patient for further signs of intermittent bleeding and may re-image or intervene the following day.


If CTA does show bleeding, Dr. Henseler moves onto angiography and embolization. He finds that there are few contraindications to angiography. Relative contraindications include renal insufficiency, which is a small tradeoff for a lifesaving procedure, and contrast allergy, which can be addressed with a preprocedural steroid dose.


When it comes to methods of embolization, detachable coils have been a mainstay. While they are more expensive than pushable coils, detachable coils allow for more exact placement and increased safety and more IRs are being trained to use these now. Dr. Henseler also discusses the use of embolic particles, which carry risks of end-organ damage and ischemia, as well as embolic glue, which can be difficult to use if the operator does not have sufficient training. Then, we shift gears to discuss Obsidio, a new injectable solid that is soon to be commercially available. It exists as a liquid when it is in its pressurized form within the microcatheter; however, it immediately solidifies in the vessel as soon as the injection ceases. Obsidio is made of radio-opaque tantalum so it is visible on CT, stays permanently in the vessel, and can be used in conjunction with coils if desired. Additionally, its cohesive properties decrease the risk of abdominal extravasation and it can be used with any catheter.


---


RESOURCES


Dr. Kevin Henseler LinkedIn:

https://www.linkedin.com/in/kevin-henseler-364832231/


CTA for Lower GI Bleeds:

https://www.youtube.com/watch?v=UWEf_sAUGKU


Ep. 179- Happiness is a Warm Coil: Treating GI Bleeds:

https://www.backtable.com/shows/vi/podcasts/179/happiness-is-a-warm-coil-treating-gi-bleeds


Ep. 216- Stick It: Glue Embo:

https://www.backtable.com/shows/vi/podcasts/216/stick-it-glue-embo

]]> 2995 Ep. 320 Appropriate Use of IVUS in Lower Extremity Interventions: Expert Consensus with Dr. Eric Secemsky In this episode, host Dr. Sabeen Dhand interviews interventional cardiologist Dr. Eric Secemsky about the role of intravascular ultrasound in lower extremity interventions, and how he published a consensus document to standardize its use across specialties and provide a framework for new users. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Secemsky practices at BIDMC in Boston. His passions are pulmonary embolism intervention and intravascular ultrasound (IVUS) for peripheral vascular disease. He began using IVUS for coronary interventions, and then began incorporating it in arterial and venous peripheral interventions. The goal is to make procedures durable in the endovascular world, and IVUS is key for that. In the coronaries, there is a standardized way that all cardiologists use IVUS for. First, they cross the lesion with the wire, then use IVUS to measure lesion length and vessel diameter for stent sizing. They also evaluate plaque composition, which informs whether to use a plaque modifying device before stenting. They then balloon, stent, and use IVUS again to evaluate stent position and check for dissections. Dr. Secemsky measures an arterial lumen by identifying the 3 layers of the vessel wall, and finding the black stripe behind the intima, which corresponds to the elastic membrane. Dr. Secemsky tells us about a consensus article he published in the Journal of the American College of Cardiology. He collaborated with some colleagues to form a 12 person steering committee composed of interventional cardiology, interventional radiology, vascular surgery and vascular medicine specialists. The goal was to consolidate information from all these specialties to provide a single standardized document. This document can be used for those wanting to incorporate IVUS into their practice, but don’t know where to begin. They established levels of evidence regarding where IVUS is most appropriate. They found that tibial arterial intervention has the highest support for use of IVUS across specialties. Furthermore, they established that the best practice for IVUS is to use it three times per case, for pre-intervention, middle-run and post-run. Using IVUS is safe, and offers so much information to make case a more efficient. In addition, you cut down on device utilization, contrast use and radiation exposure, while improving patient outcomes by getting better luminal gain and improved durability of your intervention. --- RESOURCES JACC Consensus Article: https://pubmed.ncbi.nlm.nih.gov/35926922/ Mon, 08 May 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews interventional cardiologist Dr. Eric Secemsky about the role of intravascular ultrasound in lower extremity interventions, and how he published a consensus document to standardize its use across specialties and provide a framework for new users. In this episode, host Dr. Sabeen Dhand interviews interventional cardiologist Dr. Eric Secemsky about the role of intravascular ultrasound in lower extremity interventions, and how he published a consensus document to standardize its use across specialties and provide a framework for new users. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Secemsky practices at BIDMC in Boston. His passions are pulmonary embolism intervention and intravascular ultrasound (IVUS) for peripheral vascular disease. He began using IVUS for coronary interventions, and then began incorporating it in arterial and venous peripheral interventions. The goal is to make procedures durable in the endovascular world, and IVUS is key for that. In the coronaries, there is a standardized way that all cardiologists use IVUS for. First, they cross the lesion with the wire, then use IVUS to measure lesion length and vessel diameter for stent sizing. They also evaluate plaque composition, which informs whether to use a plaque modifying device before stenting. They then balloon, stent, and use IVUS again to evaluate stent position and check for dissections. Dr. Secemsky measures an arterial lumen by identifying the 3 layers of the vessel wall, and finding the black stripe behind the intima, which corresponds to the elastic membrane. Dr. Secemsky tells us about a consensus article he published in the Journal of the American College of Cardiology. He collaborated with some colleagues to form a 12 person steering committee composed of interventional cardiology, interventional radiology, vascular surgery and vascular medicine specialists. The goal was to consolidate information from all these specialties to provide a single standardized document. This document can be used for those wanting to incorporate IVUS into their practice, but don’t know where to begin. They established levels of evidence regarding where IVUS is most appropriate. They found that tibial arterial intervention has the highest support for use of IVUS across specialties. Furthermore, they established that the best practice for IVUS is to use it three times per case, for pre-intervention, middle-run and post-run. Using IVUS is safe, and offers so much information to make case a more efficient. In addition, you cut down on device utilization, contrast use and radiation exposure, while improving patient outcomes by getting better luminal gain and improved durability of your intervention. --- RESOURCES JACC Consensus Article: https://pubmed.ncbi.nlm.nih.gov/35926922/ In this episode, host Dr. Sabeen Dhand interviews interventional cardiologist Dr. Eric Secemsky about the role of intravascular ultrasound in lower extremity interventions, and how he published a consensus document to standardize its use across specialties and provide a framework for new users.


---


CHECK OUT OUR SPONSORS


Philips Image Guided Therapy Devices Academy

https://resource.philipseliiteacademy.com


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


Dr. Secemsky practices at BIDMC in Boston. His passions are pulmonary embolism intervention and intravascular ultrasound (IVUS) for peripheral vascular disease. He began using IVUS for coronary interventions, and then began incorporating it in arterial and venous peripheral interventions. The goal is to make procedures durable in the endovascular world, and IVUS is key for that.


In the coronaries, there is a standardized way that all cardiologists use IVUS for. First, they cross the lesion with the wire, then use IVUS to measure lesion length and vessel diameter for stent sizing. They also evaluate plaque composition, which informs whether to use a plaque modifying device before stenting. They then balloon, stent, and use IVUS again to evaluate stent position and check for dissections. Dr. Secemsky measures an arterial lumen by identifying the 3 layers of the vessel wall, and finding the black stripe behind the intima, which corresponds to the elastic membrane.


Dr. Secemsky tells us about a consensus article he published in the Journal of the American College of Cardiology. He collaborated with some colleagues to form a 12 person steering committee composed of interventional cardiology, interventional radiology, vascular surgery and vascular medicine specialists. The goal was to consolidate information from all these specialties to provide a single standardized document. This document can be used for those wanting to incorporate IVUS into their practice, but don’t know where to begin. They established levels of evidence regarding where IVUS is most appropriate. They found that tibial arterial intervention has the highest support for use of IVUS across specialties. Furthermore, they established that the best practice for IVUS is to use it three times per case, for pre-intervention, middle-run and post-run. Using IVUS is safe, and offers so much information to make case a more efficient. In addition, you cut down on device utilization, contrast use and radiation exposure, while improving patient outcomes by getting better luminal gain and improved durability of your intervention.


---


RESOURCES


JACC Consensus Article:

https://pubmed.ncbi.nlm.nih.gov/35926922/

]]> 1827 Ep. 319 How to Collaborate with GI on a New Outpatient Service Line with Dr. Jerry Tan and Dr. Sandeep Bagla Fri, 05 May 2023 05:05:00 -0000 full BackTable 1902 Ep. 318 Back on the Road2IR with Dr. Janice Newsome, Dr. Judy Gichoya and Dr. Fabian Laage Gaupp In this episode, Dr. Isabel Newton hosts a panel discussion on updates about Road2IR, an international consortium aimed at increasing access to IR procedures and education in East Africa and beyond. She is joined by Drs. Fabian Laage Gaupp, Judy Gichoya, and Janice Newsome. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SuvZJb --- SHOW NOTES We start by reviewing the origin story of Road2IR. In 2017, Dr. Laage Gaupp had been a second-year diagnostic radiology resident when he traveled to Tanzania for an IR readiness assessment. He found that most of the infrastructure to support IR procedures were already in place; however, there was no formal training program. From there, he and other Road2IR co-founders launched East Africa’s first IR training program, as a collaborative effort between Muhimbili University of Health and Allied Sciences (MUHAS), Yale Radiology, Emory Radiology, and many other partner institutions. Since then, graduates of the training program have gone on to become professors of IR in Tanzania as well as other countries. The early years of the program required a lot of flexibility and patience, due to the limited amount of resources. It was necessary to start with simple procedures like core needle biopsies, abscess drainages, and nephrostomy tubes. Additionally, Dr. Gichoya emphasizes that these ordinary procedures can make a drastic difference in a patient’s life and even impact entire families. Being able to perform and teach a full spectrum of minimally invasive, life-saving procedures energizes her and other faculty members who donate their time and energy. Dr. Newsome has served as the program director for the MUHAS IR program, and she speaks about the challenges that arose during the COVID pandemic, in terms of healthcare policy in Tanzania, as well as restrictions for university faculty travel in the United States. Through the height of the pandemic, the training program persisted with virtual oral examinations, meetings, and lectures. The logistics of travel, equipment, and education are still major challenges today, and they are addressed by a dedicated team of individuals with common goals. Finally, we cover the concept of reverse innovation, aspects of healthcare in under-resourced settings that can inform the U.S. healthcare system. These include lessons in building local service lines, avoiding turf wars, and embracing technology. --- RESOURCES Road2IR: https://www.road2ir.org/ Ep. 104- Bringing IR to East Africa: The Road2IR Story with Dr. Faabian Laage Gaupp: https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story Wed, 03 May 2023 05:05:00 -0000 full BackTable In this episode, Dr. Isabel Newton hosts a panel discussion on updates about Road2IR, an international consortium aimed at increasing access to IR procedures and education in East Africa and beyond. She is joined by Drs. Fabian Laage Gaupp, Judy Gichoya, and Janice Newsome. In this episode, Dr. Isabel Newton hosts a panel discussion on updates about Road2IR, an international consortium aimed at increasing access to IR procedures and education in East Africa and beyond. She is joined by Drs. Fabian Laage Gaupp, Judy Gichoya, and Janice Newsome. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SuvZJb --- SHOW NOTES We start by reviewing the origin story of Road2IR. In 2017, Dr. Laage Gaupp had been a second-year diagnostic radiology resident when he traveled to Tanzania for an IR readiness assessment. He found that most of the infrastructure to support IR procedures were already in place; however, there was no formal training program. From there, he and other Road2IR co-founders launched East Africa’s first IR training program, as a collaborative effort between Muhimbili University of Health and Allied Sciences (MUHAS), Yale Radiology, Emory Radiology, and many other partner institutions. Since then, graduates of the training program have gone on to become professors of IR in Tanzania as well as other countries. The early years of the program required a lot of flexibility and patience, due to the limited amount of resources. It was necessary to start with simple procedures like core needle biopsies, abscess drainages, and nephrostomy tubes. Additionally, Dr. Gichoya emphasizes that these ordinary procedures can make a drastic difference in a patient’s life and even impact entire families. Being able to perform and teach a full spectrum of minimally invasive, life-saving procedures energizes her and other faculty members who donate their time and energy. Dr. Newsome has served as the program director for the MUHAS IR program, and she speaks about the challenges that arose during the COVID pandemic, in terms of healthcare policy in Tanzania, as well as restrictions for university faculty travel in the United States. Through the height of the pandemic, the training program persisted with virtual oral examinations, meetings, and lectures. The logistics of travel, equipment, and education are still major challenges today, and they are addressed by a dedicated team of individuals with common goals. Finally, we cover the concept of reverse innovation, aspects of healthcare in under-resourced settings that can inform the U.S. healthcare system. These include lessons in building local service lines, avoiding turf wars, and embracing technology. --- RESOURCES Road2IR: https://www.road2ir.org/ Ep. 104- Bringing IR to East Africa: The Road2IR Story with Dr. Faabian Laage Gaupp: https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story In this episode, Dr. Isabel Newton hosts a panel discussion on updates about Road2IR, an international consortium aimed at increasing access to IR procedures and education in East Africa and beyond. She is joined by Drs. Fabian Laage Gaupp, Judy Gichoya, and Janice Newsome.


---


CHECK OUT OUR SPONSORS


Reflow Medical

https://www.reflowmedical.com/


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SuvZJb


---


SHOW NOTES


We start by reviewing the origin story of Road2IR. In 2017, Dr. Laage Gaupp had been a second-year diagnostic radiology resident when he traveled to Tanzania for an IR readiness assessment. He found that most of the infrastructure to support IR procedures were already in place; however, there was no formal training program. From there, he and other Road2IR co-founders launched East Africa’s first IR training program, as a collaborative effort between Muhimbili University of Health and Allied Sciences (MUHAS), Yale Radiology, Emory Radiology, and many other partner institutions. Since then, graduates of the training program have gone on to become professors of IR in Tanzania as well as other countries.


The early years of the program required a lot of flexibility and patience, due to the limited amount of resources. It was necessary to start with simple procedures like core needle biopsies, abscess drainages, and nephrostomy tubes. Additionally, Dr. Gichoya emphasizes that these ordinary procedures can make a drastic difference in a patient’s life and even impact entire families. Being able to perform and teach a full spectrum of minimally invasive, life-saving procedures energizes her and other faculty members who donate their time and energy.


Dr. Newsome has served as the program director for the MUHAS IR program, and she speaks about the challenges that arose during the COVID pandemic, in terms of healthcare policy in Tanzania, as well as restrictions for university faculty travel in the United States. Through the height of the pandemic, the training program persisted with virtual oral examinations, meetings, and lectures. The logistics of travel, equipment, and education are still major challenges today, and they are addressed by a dedicated team of individuals with common goals.


Finally, we cover the concept of reverse innovation, aspects of healthcare in under-resourced settings that can inform the U.S. healthcare system. These include lessons in building local service lines, avoiding turf wars, and embracing technology.


---


RESOURCES


Road2IR:

https://www.road2ir.org/


Ep. 104- Bringing IR to East Africa: The Road2IR Story with Dr. Faabian Laage Gaupp:

https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story

]]> 4006 Ep. 317 A Lifetime of IR Innovation and Curiosity with Dr. Harold Coons In this episode, guest host Dr. Peder Horner interviews Dr. Harold Coons about the history of IR, his contributions to the field, where the field is headed, and his advice for trainees and early career IRs. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Coons attended Pomona College, where he studied math. He then realized he didn’t want to be a nuclear scientist in the Sputnik era, which was where most opportunities were at the time. He decided to attend medical school at UCLA instead. As a medical student, he saw how happy the radiologists were, so he decided to choose it as a specialty. He had the opportunity to do a carotid arteriogram one day when everyone else was busy. He considered himself a maverick and someone who was always ready to take on a challenge. He then experienced a moment that changed his life, when Czech radiologist Josef Rösch came to UCLA to visit from the University of Oregon where he was working with Charles Dotter. Dr. Coons saw Dr. Rösch direct puncture the spleen for a spleen portogram, and it took him only 15 seconds. This was incredible to him, and after that, Dr. Coons followed him around whenever he did procedures. They teamed up, Dr. Coons volunteering to be the nurse, because no nurses liked working with Rösch. Coons shaped catheters for him at a steam kettle, watched him do the first TIPS on a dog, and did the first arterial embolization with clotted venous blood under the direction of Dr. Rösch. After his stint in the Airforce at a hospital in San Antonio, where he honed his embolization skills, he returned to San Diego. He was then working in private practice as the only IR in San Diego. One year, he heard about a meeting at Massachusetts General, so he submitted 6 papers on things he had been doing recently. All his papers were accepted, so he went to the meeting. At his first presentation, the leader of the meeting announced to the audience that he had accepted these papers to expose Coons as a fraud, because these techniques were nothing any academic had ever heard of. He did his presentation, and everyone in the audience, including the meeting leader, believed what he was doing was indeed real. He apologized to Coons and invited him to the speakers dinner, where he sat next to Kurt Amplatz and Plinio Rossi. Rossi convinced him to start publishing his ideas to get the credit he deserved, and to have something to show his children. Dr. Coons was forced to retire early in 1996 due to radiation exposure, but has been an avid innovator, educator, and international speaker since then. His passion for IR and excitement for the future of the field is contagious to all who have the pleasure of hearing him speak. Mon, 01 May 2023 05:05:00 -0000 full BackTable In this episode, guest host Dr. Peder Horner interviews Dr. Harold Coons about the history of IR, his contributions to the field, where the field is headed, and his advice for trainees and early career IRs. In this episode, guest host Dr. Peder Horner interviews Dr. Harold Coons about the history of IR, his contributions to the field, where the field is headed, and his advice for trainees and early career IRs. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Coons attended Pomona College, where he studied math. He then realized he didn’t want to be a nuclear scientist in the Sputnik era, which was where most opportunities were at the time. He decided to attend medical school at UCLA instead. As a medical student, he saw how happy the radiologists were, so he decided to choose it as a specialty. He had the opportunity to do a carotid arteriogram one day when everyone else was busy. He considered himself a maverick and someone who was always ready to take on a challenge. He then experienced a moment that changed his life, when Czech radiologist Josef Rösch came to UCLA to visit from the University of Oregon where he was working with Charles Dotter. Dr. Coons saw Dr. Rösch direct puncture the spleen for a spleen portogram, and it took him only 15 seconds. This was incredible to him, and after that, Dr. Coons followed him around whenever he did procedures. They teamed up, Dr. Coons volunteering to be the nurse, because no nurses liked working with Rösch. Coons shaped catheters for him at a steam kettle, watched him do the first TIPS on a dog, and did the first arterial embolization with clotted venous blood under the direction of Dr. Rösch. After his stint in the Airforce at a hospital in San Antonio, where he honed his embolization skills, he returned to San Diego. He was then working in private practice as the only IR in San Diego. One year, he heard about a meeting at Massachusetts General, so he submitted 6 papers on things he had been doing recently. All his papers were accepted, so he went to the meeting. At his first presentation, the leader of the meeting announced to the audience that he had accepted these papers to expose Coons as a fraud, because these techniques were nothing any academic had ever heard of. He did his presentation, and everyone in the audience, including the meeting leader, believed what he was doing was indeed real. He apologized to Coons and invited him to the speakers dinner, where he sat next to Kurt Amplatz and Plinio Rossi. Rossi convinced him to start publishing his ideas to get the credit he deserved, and to have something to show his children. Dr. Coons was forced to retire early in 1996 due to radiation exposure, but has been an avid innovator, educator, and international speaker since then. His passion for IR and excitement for the future of the field is contagious to all who have the pleasure of hearing him speak. In this episode, guest host Dr. Peder Horner interviews Dr. Harold Coons about the history of IR, his contributions to the field, where the field is headed, and his advice for trainees and early career IRs.


---


CHECK OUT OUR SPONSORS


BD Advance Clinical Training & Education Program

https://page.bd.com/Advance-Training-Program_Homepage.html


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


Dr. Coons attended Pomona College, where he studied math. He then realized he didn’t want to be a nuclear scientist in the Sputnik era, which was where most opportunities were at the time. He decided to attend medical school at UCLA instead. As a medical student, he saw how happy the radiologists were, so he decided to choose it as a specialty. He had the opportunity to do a carotid arteriogram one day when everyone else was busy. He considered himself a maverick and someone who was always ready to take on a challenge.


He then experienced a moment that changed his life, when Czech radiologist Josef Rösch came to UCLA to visit from the University of Oregon where he was working with Charles Dotter. Dr. Coons saw Dr. Rösch direct puncture the spleen for a spleen portogram, and it took him only 15 seconds. This was incredible to him, and after that, Dr. Coons followed him around whenever he did procedures. They teamed up, Dr. Coons volunteering to be the nurse, because no nurses liked working with Rösch. Coons shaped catheters for him at a steam kettle, watched him do the first TIPS on a dog, and did the first arterial embolization with clotted venous blood under the direction of Dr. Rösch.


After his stint in the Airforce at a hospital in San Antonio, where he honed his embolization skills, he returned to San Diego. He was then working in private practice as the only IR in San Diego. One year, he heard about a meeting at Massachusetts General, so he submitted 6 papers on things he had been doing recently. All his papers were accepted, so he went to the meeting. At his first presentation, the leader of the meeting announced to the audience that he had accepted these papers to expose Coons as a fraud, because these techniques were nothing any academic had ever heard of. He did his presentation, and everyone in the audience, including the meeting leader, believed what he was doing was indeed real. He apologized to Coons and invited him to the speakers dinner, where he sat next to Kurt Amplatz and Plinio Rossi. Rossi convinced him to start publishing his ideas to get the credit he deserved, and to have something to show his children. Dr. Coons was forced to retire early in 1996 due to radiation exposure, but has been an avid innovator, educator, and international speaker since then. His passion for IR and excitement for the future of the field is contagious to all who have the pleasure of hearing him speak.

]]> 3202 Ep. 316 Basivertebral Nerve Ablation with Dr. Olivier Clerk-Lamalice In this episode, Dr. Jacob Fleming interviews Dr. Olivier Clerk-Lamalice about basivertebral nerve ablation for vertebrogenic back pain, including indications, procedure technique and exciting tech on the horizon in minimally invasive spine interventions. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Clerk-Lamalice trained in Canada, first in engineering, and then medicine and diagnostic radiology at the Université de Sherbrooke in Calgary. He then completed a neuroradiology fellowship at Harvard, and a fellowship in interventional pain at The Spine Fracture Institute in Oklahoma City with Dr. Douglas Beall. Furthermore, he obtained his credentials as a fellow of interventional pain practice (FIPP), which is a widely recognized international designation. He now works at a comprehensive outpatient radiology center, where he practices both diagnostic and interventional radiology daily. They offer intrathecal drug administration, spinal cord stimulators, vertebral augmentation, Spine Jack, disc augmentation, nucleolysis, and various nerve blocks and ablations in and out of the spine. Their goal was to create a one stop shop for patients to come for consultation, imaging, expert advice and treatment. Next, we discuss vertebrogenic back pain and the basivertebral nerve (BVN). The BVN is a nonmyelinated, intraosseous nerve, while most other peripheral nerves are myelinated, meaning they can regenerate. The BVN cannot, so ablation of this nerve is a permanent treatment. It is located within the central portion of the vertebral body midway between the superior and inferior end plates, one third ventral to the posterior wall of the vertebral body. On a sagittal T2 sequence on MRI, there is a triangle at the posterior aspect at the midpoint of the vertebral body called the basivertebral canal, which contains the nerve, artery and vein. The BVN is responsible for vertebrogenic back pain, which is a form of anterior column pain characterized by low back pain worsened by flexion and sitting. It is diagnosed via MRI using the Modic classifications. Modic type 1 (edematous), and type 2 (fibrofatty end plate) changes can be seen in this disease. It can be difficult to distinguish vertebrogenic from discogenic pain due to the fact that the sinuvertebral nerve (SVN), responsible for discogenic pain, crosses paths with the BVN. However, with MRI and an anesthetic discogram, it is possible to determine the etiology and choose the right treatment. Finally, we discuss the steps of the procedure. Dr. Clerk-Lamalice uses an 8 gauge needle via a transpedicular approach, as is common for other spine procedures. He ensures the probe is positioned in the center of the vertebral body, parallel to the endplates. The nerve is ablated for 15 minutes at 85 C. The procedure takes 45 minutes, which includes an epidural steroid injection to bridge pain control during the periprocedural period. Patients usually go home within one hour after the procedure, and begin to experience the results within a couple days. There have been two trials for BVN ablation, which have made this intervention the most minimally invasive and evidence-based treatment for vertebrogenic pain. These studies indicated 25% of patients had a 50% reduction in pain, while 75% of patients had a 75% reduction of pain. Within that 75%, 30% reported being almost entirely pain free. To date, the study has followed participants to 8 years, and the results show the treatment is durable. --- RESOURCES Ep 210: Modern Vertebral Augmentation https://www.backtable.com/shows/vi/podcasts/210/modern-vertebral-augmentation Ep 94: Spine Interventions https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Relievent device for BVN ablation: https://www.relievant.com/intracept/procedure-details/ Find this episode on backtable.com to view the full list of resources. Fri, 28 Apr 2023 05:05:00 -0000 full BackTable In this episode, Dr. Jacob Fleming interviews Dr. Olivier Clerk-Lamalice about basivertebral nerve ablation for vertebrogenic back pain, including indications, procedure technique and exciting tech on the horizon in minimally invasive spine interventions. In this episode, Dr. Jacob Fleming interviews Dr. Olivier Clerk-Lamalice about basivertebral nerve ablation for vertebrogenic back pain, including indications, procedure technique and exciting tech on the horizon in minimally invasive spine interventions. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Clerk-Lamalice trained in Canada, first in engineering, and then medicine and diagnostic radiology at the Université de Sherbrooke in Calgary. He then completed a neuroradiology fellowship at Harvard, and a fellowship in interventional pain at The Spine Fracture Institute in Oklahoma City with Dr. Douglas Beall. Furthermore, he obtained his credentials as a fellow of interventional pain practice (FIPP), which is a widely recognized international designation. He now works at a comprehensive outpatient radiology center, where he practices both diagnostic and interventional radiology daily. They offer intrathecal drug administration, spinal cord stimulators, vertebral augmentation, Spine Jack, disc augmentation, nucleolysis, and various nerve blocks and ablations in and out of the spine. Their goal was to create a one stop shop for patients to come for consultation, imaging, expert advice and treatment. Next, we discuss vertebrogenic back pain and the basivertebral nerve (BVN). The BVN is a nonmyelinated, intraosseous nerve, while most other peripheral nerves are myelinated, meaning they can regenerate. The BVN cannot, so ablation of this nerve is a permanent treatment. It is located within the central portion of the vertebral body midway between the superior and inferior end plates, one third ventral to the posterior wall of the vertebral body. On a sagittal T2 sequence on MRI, there is a triangle at the posterior aspect at the midpoint of the vertebral body called the basivertebral canal, which contains the nerve, artery and vein. The BVN is responsible for vertebrogenic back pain, which is a form of anterior column pain characterized by low back pain worsened by flexion and sitting. It is diagnosed via MRI using the Modic classifications. Modic type 1 (edematous), and type 2 (fibrofatty end plate) changes can be seen in this disease. It can be difficult to distinguish vertebrogenic from discogenic pain due to the fact that the sinuvertebral nerve (SVN), responsible for discogenic pain, crosses paths with the BVN. However, with MRI and an anesthetic discogram, it is possible to determine the etiology and choose the right treatment. Finally, we discuss the steps of the procedure. Dr. Clerk-Lamalice uses an 8 gauge needle via a transpedicular approach, as is common for other spine procedures. He ensures the probe is positioned in the center of the vertebral body, parallel to the endplates. The nerve is ablated for 15 minutes at 85 C. The procedure takes 45 minutes, which includes an epidural steroid injection to bridge pain control during the periprocedural period. Patients usually go home within one hour after the procedure, and begin to experience the results within a couple days. There have been two trials for BVN ablation, which have made this intervention the most minimally invasive and evidence-based treatment for vertebrogenic pain. These studies indicated 25% of patients had a 50% reduction in pain, while 75% of patients had a 75% reduction of pain. Within that 75%, 30% reported being almost entirely pain free. To date, the study has followed participants to 8 years, and the results show the treatment is durable. --- RESOURCES Ep 210: Modern Vertebral Augmentation https://www.backtable.com/shows/vi/podcasts/210/modern-vertebral-augmentation Ep 94: Spine Interventions https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Relievent device for BVN ablation: https://www.relievant.com/intracept/procedure-details/ Find this episode on backtable.com to view the full list of resources. In this episode, Dr. Jacob Fleming interviews Dr. Olivier Clerk-Lamalice about basivertebral nerve ablation for vertebrogenic back pain, including indications, procedure technique and exciting tech on the horizon in minimally invasive spine interventions.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Dr. Clerk-Lamalice trained in Canada, first in engineering, and then medicine and diagnostic radiology at the Université de Sherbrooke in Calgary. He then completed a neuroradiology fellowship at Harvard, and a fellowship in interventional pain at The Spine Fracture Institute in Oklahoma City with Dr. Douglas Beall. Furthermore, he obtained his credentials as a fellow of interventional pain practice (FIPP), which is a widely recognized international designation. He now works at a comprehensive outpatient radiology center, where he practices both diagnostic and interventional radiology daily. They offer intrathecal drug administration, spinal cord stimulators, vertebral augmentation, Spine Jack, disc augmentation, nucleolysis, and various nerve blocks and ablations in and out of the spine. Their goal was to create a one stop shop for patients to come for consultation, imaging, expert advice and treatment.


Next, we discuss vertebrogenic back pain and the basivertebral nerve (BVN). The BVN is a nonmyelinated, intraosseous nerve, while most other peripheral nerves are myelinated, meaning they can regenerate. The BVN cannot, so ablation of this nerve is a permanent treatment. It is located within the central portion of the vertebral body midway between the superior and inferior end plates, one third ventral to the posterior wall of the vertebral body. On a sagittal T2 sequence on MRI, there is a triangle at the posterior aspect at the midpoint of the vertebral body called the basivertebral canal, which contains the nerve, artery and vein. The BVN is responsible for vertebrogenic back pain, which is a form of anterior column pain characterized by low back pain worsened by flexion and sitting. It is diagnosed via MRI using the Modic classifications. Modic type 1 (edematous), and type 2 (fibrofatty end plate) changes can be seen in this disease. It can be difficult to distinguish vertebrogenic from discogenic pain due to the fact that the sinuvertebral nerve (SVN), responsible for discogenic pain, crosses paths with the BVN. However, with MRI and an anesthetic discogram, it is possible to determine the etiology and choose the right treatment.


Finally, we discuss the steps of the procedure. Dr. Clerk-Lamalice uses an 8 gauge needle via a transpedicular approach, as is common for other spine procedures. He ensures the probe is positioned in the center of the vertebral body, parallel to the endplates. The nerve is ablated for 15 minutes at 85 C. The procedure takes 45 minutes, which includes an epidural steroid injection to bridge pain control during the periprocedural period. Patients usually go home within one hour after the procedure, and begin to experience the results within a couple days. There have been two trials for BVN ablation, which have made this intervention the most minimally invasive and evidence-based treatment for vertebrogenic pain. These studies indicated 25% of patients had a 50% reduction in pain, while 75% of patients had a 75% reduction of pain. Within that 75%, 30% reported being almost entirely pain free. To date, the study has followed participants to 8 years, and the results show the treatment is durable.


---


RESOURCES


Ep 210: Modern Vertebral Augmentation

https://www.backtable.com/shows/vi/podcasts/210/modern-vertebral-augmentation


Ep 94: Spine Interventions

https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions


Relievent device for BVN ablation:

https://www.relievant.com/intracept/procedure-details/


Find this episode on backtable.com to view the full list of resources.

]]> 3609 Ep. 315 Arterial Thrombectomy with Dr. Alexander Ushinsky In this episode, host Dr. Chris Beck interviews Dr. Alexander Ushinsky about his standard workup and treatment when performing arterial thrombectomy in acute limb ischemia (ALI). --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES In the past three years, Dr. Ushinksy has focused on building up peripheral vasculature service lines at the Mallinckrodt Institute of Radiology at Washington University in St. Louis. He has acquired skills not only in treatment of ALI, but also in building referral bases and collaborating with vascular surgeons and cardiologists. To begin, we review important aspects of a focused history and physical exam. It is crucial to assess whether the patient has underlying peripheral arterial disease (PAD), other thromboembolic diseases, or underlying coagulopathies. Different etiologies of thrombus could require additional consultation with hematologists and cardiologists. Additionally, timing of symptom onset is important to consider when planning interventions in an on-call setting. Dr. Ushinsky relies on extremity pulse exams using bedside doppler and the Rutherford Classification System for ALI to ascertain whether intervention can be helpful. In cases of Rutherford class 1-2a, intervention is usually warranted. Cases that fall into class 2b may or may not require intervention, and cases in class 3 and beyond usually do not gain benefit from intervention since lower extremity paralysis and clot burden is so severe. With regards to types of interventions, Dr. Ushinsky highlights two common IR procedures– lysis catheter placement and endovascular thrombectomy. In the past, lysis catheters were the only available endovascular treatment. We walk through catheter placement, noting that in order to gain maximum benefit, the catheter should be placed across the entirety of the thrombus, with holes proximal and distal to the lesion, so that tPA can be infused throughout the clot and have appropriate inflow and outflow tracts. Good candidates for lysis catheter placement include patients who have extensive clot burden in small vessels and those who have underlying CLI that can be definitively addressed in a later procedure. A major difference between lytic catheter placement and thrombectomy is that patients receiving lytic therapy require admission to the ICU for close monitoring and frequent neurovascular checks. Next, we pivot to discussion about newer thrombectomy devices. Dr. Ushinsky describes pros and cons of common devices that are used in his practice and types of cases that would benefit from each one. Thrombectomy is useful if there is a low clot burden that can be addressed in a single session. Additionally, this procedure is more appropriate than lysis catheter placement if the patient is elderly, has had recent surgery, or is otherwise a poor candidate for systemic tPA. Dr. Ushinsky always performs a diagnostic angiogram at the beginning of the case and a completion angiogram to confirm that the lesion has been fully treated. Overall, he believes that the best intervention for a patient is the one that the practitioner feels the most adept at and can safely perform. --- RESOURCES Rutherford Acute Limb Ischemia Classification System: https://www.jvascsurg.org/article/S0741-5214(97)70045-4/fulltext#secd69653256e1488 Boston Scientific AngioJet Thrombectomy System: https://www.bostonscientific.com/en-US/products/thrombectomy-systems/angiojet-thrombectomy-system.html Penumbra Indigo Thrombectomy System: https://www.penumbrainc.com/peripheral-device/indigo-system/ AngioDynamics Auryon Thrombectomy System: https://www.angiodynamics.com/product/auryon/ Rotarex Excisional Atherectomy System: https://www.bd.com/en-us/products-and-solutions/products/product-families/rotarex-rotational-excisional-atherectomy-system Pounce Thrombectomy System: https://pouncesystem.com/ Find this episode on BackTable.com to see the full list of resources. Mon, 24 Apr 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Chris Beck interviews Dr. Alexander Ushinsky about his standard workup and treatment when performing arterial thrombectomy in acute limb ischemia (ALI). In this episode, host Dr. Chris Beck interviews Dr. Alexander Ushinsky about his standard workup and treatment when performing arterial thrombectomy in acute limb ischemia (ALI). --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System https://www.auryon-system.com/ --- SHOW NOTES In the past three years, Dr. Ushinksy has focused on building up peripheral vasculature service lines at the Mallinckrodt Institute of Radiology at Washington University in St. Louis. He has acquired skills not only in treatment of ALI, but also in building referral bases and collaborating with vascular surgeons and cardiologists. To begin, we review important aspects of a focused history and physical exam. It is crucial to assess whether the patient has underlying peripheral arterial disease (PAD), other thromboembolic diseases, or underlying coagulopathies. Different etiologies of thrombus could require additional consultation with hematologists and cardiologists. Additionally, timing of symptom onset is important to consider when planning interventions in an on-call setting. Dr. Ushinsky relies on extremity pulse exams using bedside doppler and the Rutherford Classification System for ALI to ascertain whether intervention can be helpful. In cases of Rutherford class 1-2a, intervention is usually warranted. Cases that fall into class 2b may or may not require intervention, and cases in class 3 and beyond usually do not gain benefit from intervention since lower extremity paralysis and clot burden is so severe. With regards to types of interventions, Dr. Ushinsky highlights two common IR procedures– lysis catheter placement and endovascular thrombectomy. In the past, lysis catheters were the only available endovascular treatment. We walk through catheter placement, noting that in order to gain maximum benefit, the catheter should be placed across the entirety of the thrombus, with holes proximal and distal to the lesion, so that tPA can be infused throughout the clot and have appropriate inflow and outflow tracts. Good candidates for lysis catheter placement include patients who have extensive clot burden in small vessels and those who have underlying CLI that can be definitively addressed in a later procedure. A major difference between lytic catheter placement and thrombectomy is that patients receiving lytic therapy require admission to the ICU for close monitoring and frequent neurovascular checks. Next, we pivot to discussion about newer thrombectomy devices. Dr. Ushinsky describes pros and cons of common devices that are used in his practice and types of cases that would benefit from each one. Thrombectomy is useful if there is a low clot burden that can be addressed in a single session. Additionally, this procedure is more appropriate than lysis catheter placement if the patient is elderly, has had recent surgery, or is otherwise a poor candidate for systemic tPA. Dr. Ushinsky always performs a diagnostic angiogram at the beginning of the case and a completion angiogram to confirm that the lesion has been fully treated. Overall, he believes that the best intervention for a patient is the one that the practitioner feels the most adept at and can safely perform. --- RESOURCES Rutherford Acute Limb Ischemia Classification System: https://www.jvascsurg.org/article/S0741-5214(97)70045-4/fulltext#secd69653256e1488 Boston Scientific AngioJet Thrombectomy System: https://www.bostonscientific.com/en-US/products/thrombectomy-systems/angiojet-thrombectomy-system.html Penumbra Indigo Thrombectomy System: https://www.penumbrainc.com/peripheral-device/indigo-system/ AngioDynamics Auryon Thrombectomy System: https://www.angiodynamics.com/product/auryon/ Rotarex Excisional Atherectomy System: https://www.bd.com/en-us/products-and-solutions/products/product-families/rotarex-rotational-excisional-atherectomy-system Pounce Thrombectomy System: https://pouncesystem.com/ Find this episode on BackTable.com to see the full list of resources. In this episode, host Dr. Chris Beck interviews Dr. Alexander Ushinsky about his standard workup and treatment when performing arterial thrombectomy in acute limb ischemia (ALI).


---


CHECK OUT OUR SPONSOR


AngioDynamics Auryon System

https://www.auryon-system.com/


---


SHOW NOTES


In the past three years, Dr. Ushinksy has focused on building up peripheral vasculature service lines at the Mallinckrodt Institute of Radiology at Washington University in St. Louis. He has acquired skills not only in treatment of ALI, but also in building referral bases and collaborating with vascular surgeons and cardiologists. To begin, we review important aspects of a focused history and physical exam. It is crucial to assess whether the patient has underlying peripheral arterial disease (PAD), other thromboembolic diseases, or underlying coagulopathies. Different etiologies of thrombus could require additional consultation with hematologists and cardiologists. Additionally, timing of symptom onset is important to consider when planning interventions in an on-call setting. Dr. Ushinsky relies on extremity pulse exams using bedside doppler and the Rutherford Classification System for ALI to ascertain whether intervention can be helpful. In cases of Rutherford class 1-2a, intervention is usually warranted. Cases that fall into class 2b may or may not require intervention, and cases in class 3 and beyond usually do not gain benefit from intervention since lower extremity paralysis and clot burden is so severe.


With regards to types of interventions, Dr. Ushinsky highlights two common IR procedures– lysis catheter placement and endovascular thrombectomy. In the past, lysis catheters were the only available endovascular treatment. We walk through catheter placement, noting that in order to gain maximum benefit, the catheter should be placed across the entirety of the thrombus, with holes proximal and distal to the lesion, so that tPA can be infused throughout the clot and have appropriate inflow and outflow tracts. Good candidates for lysis catheter placement include patients who have extensive clot burden in small vessels and those who have underlying CLI that can be definitively addressed in a later procedure. A major difference between lytic catheter placement and thrombectomy is that patients receiving lytic therapy require admission to the ICU for close monitoring and frequent neurovascular checks.


Next, we pivot to discussion about newer thrombectomy devices. Dr. Ushinsky describes pros and cons of common devices that are used in his practice and types of cases that would benefit from each one. Thrombectomy is useful if there is a low clot burden that can be addressed in a single session. Additionally, this procedure is more appropriate than lysis catheter placement if the patient is elderly, has had recent surgery, or is otherwise a poor candidate for systemic tPA. Dr. Ushinsky always performs a diagnostic angiogram at the beginning of the case and a completion angiogram to confirm that the lesion has been fully treated. Overall, he believes that the best intervention for a patient is the one that the practitioner feels the most adept at and can safely perform.


---


RESOURCES


Rutherford Acute Limb Ischemia Classification System:

https://www.jvascsurg.org/article/S0741-5214(97)70045-4/fulltext#secd69653256e1488


Boston Scientific AngioJet Thrombectomy System:

https://www.bostonscientific.com/en-US/products/thrombectomy-systems/angiojet-thrombectomy-system.html


Penumbra Indigo Thrombectomy System:

https://www.penumbrainc.com/peripheral-device/indigo-system/


AngioDynamics Auryon Thrombectomy System:

https://www.angiodynamics.com/product/auryon/


Rotarex Excisional Atherectomy System:

https://www.bd.com/en-us/products-and-solutions/products/product-families/rotarex-rotational-excisional-atherectomy-system


Pounce Thrombectomy System:

https://pouncesystem.com/


Find this episode on BackTable.com to see the full list of resources.

]]> 3692 Ep. 314 Tunneled Pleural and Peritoneal Catheters with Dr. Ally Baheti and Dr. Chris Beck In this week’s episode. Dr. Aaron Fritts interviews co-hosts and IRs Dr. Ally Baheti and Dr. Chris Beck about indications, procedural steps, and patient education for tunneled pleural and peritoneal catheters. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/7zVIlO --- SHOW NOTES First, we review indications for tunneled catheters, the most common ones being malignancies. Since tunneled catheters are known to carry a risk of infection, their placement is often used as a palliative care measure. In addition to malignancies, they can also be used to improve symptoms in patients with congestive heart failure, cirrhosis, pancreatitis, autoimmune diseases, and chylothorax. Dr. Baheti emphasizes the importance of establishing chronicity and recurrence of the effusions before placing the tunneled catheter. For example, some patients with ascites could better benefit from a TIPS procedure rather than a peritoneal catheter. Dr. Beck gives us advice for placing pleural tunneled catheters. He positions the patient to ensure the best access point, using a cloth roll underneath the ipsilateral hip and having the patient raise the ipsilateral arm. He also uses lidocaine injections for pain control and he makes a gentle curve to get a smooth angle of the catheter. Dr. Baheti shares her own experiences with pleural tunneled catheter placement. She tunnels along the intercostal space and angles the needle into the posterior space to achieve a smooth angle. She also chooses the biggest fluid pocket to drain, where the fluid is at least 5 cm. She emphasizes that pre-procedural planning and the final location of the catheter tip has a large influence on whether or not the catheter can successfully drain fluid. Throughout a patient’s care, clear communication with insurance, the patient, and the home caretakers are very important. Finally, Dr. Fritts says that the most important part about the procedure is counseling the pt. Realistically, it is hard for physicians to find time to explain the specific instructions of home care, so it is important to delegate at least one person on the medical team to do this. --- RESOURCES PleurX Drainage System: https://www.bd.com/en-us/products-and-solutions/products/product-families/pleurx-pleural-catheter-system Fri, 21 Apr 2023 05:05:00 -0000 full BackTable In this week’s episode. Dr. Aaron Fritts interviews co-hosts and IRs Dr. Ally Baheti and Dr. Chris Beck about indications, procedural steps, and patient education for tunneled pleural and peritoneal catheters. In this week’s episode. Dr. Aaron Fritts interviews co-hosts and IRs Dr. Ally Baheti and Dr. Chris Beck about indications, procedural steps, and patient education for tunneled pleural and peritoneal catheters. --- CHECK OUT OUR SPONSOR Philips SymphonySuite https://www.philips.com/symphonysuite --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/7zVIlO --- SHOW NOTES First, we review indications for tunneled catheters, the most common ones being malignancies. Since tunneled catheters are known to carry a risk of infection, their placement is often used as a palliative care measure. In addition to malignancies, they can also be used to improve symptoms in patients with congestive heart failure, cirrhosis, pancreatitis, autoimmune diseases, and chylothorax. Dr. Baheti emphasizes the importance of establishing chronicity and recurrence of the effusions before placing the tunneled catheter. For example, some patients with ascites could better benefit from a TIPS procedure rather than a peritoneal catheter. Dr. Beck gives us advice for placing pleural tunneled catheters. He positions the patient to ensure the best access point, using a cloth roll underneath the ipsilateral hip and having the patient raise the ipsilateral arm. He also uses lidocaine injections for pain control and he makes a gentle curve to get a smooth angle of the catheter. Dr. Baheti shares her own experiences with pleural tunneled catheter placement. She tunnels along the intercostal space and angles the needle into the posterior space to achieve a smooth angle. She also chooses the biggest fluid pocket to drain, where the fluid is at least 5 cm. She emphasizes that pre-procedural planning and the final location of the catheter tip has a large influence on whether or not the catheter can successfully drain fluid. Throughout a patient’s care, clear communication with insurance, the patient, and the home caretakers are very important. Finally, Dr. Fritts says that the most important part about the procedure is counseling the pt. Realistically, it is hard for physicians to find time to explain the specific instructions of home care, so it is important to delegate at least one person on the medical team to do this. --- RESOURCES PleurX Drainage System: https://www.bd.com/en-us/products-and-solutions/products/product-families/pleurx-pleural-catheter-system In this week’s episode. Dr. Aaron Fritts interviews co-hosts and IRs Dr. Ally Baheti and Dr. Chris Beck about indications, procedural steps, and patient education for tunneled pleural and peritoneal catheters.


---


CHECK OUT OUR SPONSOR


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/7zVIlO


---


SHOW NOTES


First, we review indications for tunneled catheters, the most common ones being malignancies. Since tunneled catheters are known to carry a risk of infection, their placement is often used as a palliative care measure. In addition to malignancies, they can also be used to improve symptoms in patients with congestive heart failure, cirrhosis, pancreatitis, autoimmune diseases, and chylothorax. Dr. Baheti emphasizes the importance of establishing chronicity and recurrence of the effusions before placing the tunneled catheter. For example, some patients with ascites could better benefit from a TIPS procedure rather than a peritoneal catheter.


Dr. Beck gives us advice for placing pleural tunneled catheters. He positions the patient to ensure the best access point, using a cloth roll underneath the ipsilateral hip and having the patient raise the ipsilateral arm. He also uses lidocaine injections for pain control and he makes a gentle curve to get a smooth angle of the catheter.

Dr. Baheti shares her own experiences with pleural tunneled catheter placement. She tunnels along the intercostal space and angles the needle into the posterior space to achieve a smooth angle. She also chooses the biggest fluid pocket to drain, where the fluid is at least 5 cm. She emphasizes that pre-procedural planning and the final location of the catheter tip has a large influence on whether or not the catheter can successfully drain fluid.


Throughout a patient’s care, clear communication with insurance, the patient, and the home caretakers are very important. Finally, Dr. Fritts says that the most important part about the procedure is counseling the pt. Realistically, it is hard for physicians to find time to explain the specific instructions of home care, so it is important to delegate at least one person on the medical team to do this.


---


RESOURCES


PleurX Drainage System:

https://www.bd.com/en-us/products-and-solutions/products/product-families/pleurx-pleural-catheter-system

]]> 2760 Ep. 313 Augmented Reality: Clinical Use Scenarios and Latest Technologies with Dr. Chuck Martin and Dr. Stephen Hunt In this panel episode recorded at SIR 2023, Drs. Stephen Hunt, Chuck Martin, and Gaurav Gadodia update us on current applications and future directions of augmented reality in interventional radiology. --- CHECK OUT OUR SPONSORS Medtronic Ellipsys Vascular Access System https://www.medtronic.com/ellipsys Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/voyqG5 --- SHOW NOTES Dr. Hunt explains the differences between virtual reality (VR), augmented reality (AR), and mixed reality (MR) since there is increasing levels of overlap between virtual and real worlds with each category . He notes that all three are being explored in surgical fields, especially orthopedics and neurosurgery. Within IR, augmented reality can be used to adjust images and subtract out respiratory motion, making biopsies and ablations safer and more effective. Dr. Hunt became interested in AR when his PIGI Lab at the University of Pennsylvania needed 3D models to access liver tumors in experimental mice. Additionally, AR is a useful tool for planning difficult procedures and teaching interventional procedures to trainees across the globe. Dr. Martin speaks about the intersection of medicine and industry. He directs research studies for Mediview, a company focused on bringing AR into medical imaging. Dr. Martin speaks about the important role that industry plays in commercializing an invention and getting it into operators’ hands. As larger companies enter the AR space, accessibility and user interfaces will improve. Additionally, the shift towards AR product development can guide future FDA regulations. Dr. Gadodia’s engineering background made him excited to enter the AR space as resident at the Cleveland Clinic. He highlights applications of AR in the non-academic setting. Using a headset could increase procedural efficiency and access to care. Finally, we discuss major shifts in industry and medicine that favor the increasing use of AR, such as industry’s need for clinician input in product development, the multitude of startups working on the same issues, and the overarching goal of patient safety. --- RESOURCES Ep. 7- Lung Tumor Ablation with Dr. Stephen Hunt: https://www.backtable.com/shows/vi/podcasts/7/lung-tumor-ablation Ep. 53- International IR Volunteer Work with Dr. Stephen Hunt: https://www.backtable.com/shows/vi/podcasts/53/international-ir-volunteer-work Mediview: https://mediview.com/ Microsoft HoloLens: https://www.microsoft.com/en-us/hololens Penn Image-Guided Interventions (PIGI) Lab: https://www.med.upenn.edu/pigilab/ Wed, 19 Apr 2023 05:05:00 -0000 full BackTable In this panel episode recorded at SIR 2023, Drs. Stephen Hunt, Chuck Martin, and Gaurav Gadodia update us on current applications and future directions of augmented reality in interventional radiology. In this panel episode recorded at SIR 2023, Drs. Stephen Hunt, Chuck Martin, and Gaurav Gadodia update us on current applications and future directions of augmented reality in interventional radiology. --- CHECK OUT OUR SPONSORS Medtronic Ellipsys Vascular Access System https://www.medtronic.com/ellipsys Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/voyqG5 --- SHOW NOTES Dr. Hunt explains the differences between virtual reality (VR), augmented reality (AR), and mixed reality (MR) since there is increasing levels of overlap between virtual and real worlds with each category . He notes that all three are being explored in surgical fields, especially orthopedics and neurosurgery. Within IR, augmented reality can be used to adjust images and subtract out respiratory motion, making biopsies and ablations safer and more effective. Dr. Hunt became interested in AR when his PIGI Lab at the University of Pennsylvania needed 3D models to access liver tumors in experimental mice. Additionally, AR is a useful tool for planning difficult procedures and teaching interventional procedures to trainees across the globe. Dr. Martin speaks about the intersection of medicine and industry. He directs research studies for Mediview, a company focused on bringing AR into medical imaging. Dr. Martin speaks about the important role that industry plays in commercializing an invention and getting it into operators’ hands. As larger companies enter the AR space, accessibility and user interfaces will improve. Additionally, the shift towards AR product development can guide future FDA regulations. Dr. Gadodia’s engineering background made him excited to enter the AR space as resident at the Cleveland Clinic. He highlights applications of AR in the non-academic setting. Using a headset could increase procedural efficiency and access to care. Finally, we discuss major shifts in industry and medicine that favor the increasing use of AR, such as industry’s need for clinician input in product development, the multitude of startups working on the same issues, and the overarching goal of patient safety. --- RESOURCES Ep. 7- Lung Tumor Ablation with Dr. Stephen Hunt: https://www.backtable.com/shows/vi/podcasts/7/lung-tumor-ablation Ep. 53- International IR Volunteer Work with Dr. Stephen Hunt: https://www.backtable.com/shows/vi/podcasts/53/international-ir-volunteer-work Mediview: https://mediview.com/ Microsoft HoloLens: https://www.microsoft.com/en-us/hololens Penn Image-Guided Interventions (PIGI) Lab: https://www.med.upenn.edu/pigilab/ In this panel episode recorded at SIR 2023, Drs. Stephen Hunt, Chuck Martin, and Gaurav Gadodia update us on current applications and future directions of augmented reality in interventional radiology.


---


CHECK OUT OUR SPONSORS


Medtronic Ellipsys Vascular Access System

https://www.medtronic.com/ellipsys


Reflow Medical

https://www.reflowmedical.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/voyqG5


---


SHOW NOTES


Dr. Hunt explains the differences between virtual reality (VR), augmented reality (AR), and mixed reality (MR) since there is increasing levels of overlap between virtual and real worlds with each category . He notes that all three are being explored in surgical fields, especially orthopedics and neurosurgery. Within IR, augmented reality can be used to adjust images and subtract out respiratory motion, making biopsies and ablations safer and more effective. Dr. Hunt became interested in AR when his PIGI Lab at the University of Pennsylvania needed 3D models to access liver tumors in experimental mice. Additionally, AR is a useful tool for planning difficult procedures and teaching interventional procedures to trainees across the globe.


Dr. Martin speaks about the intersection of medicine and industry. He directs research studies for Mediview, a company focused on bringing AR into medical imaging. Dr. Martin speaks about the important role that industry plays in commercializing an invention and getting it into operators’ hands. As larger companies enter the AR space, accessibility and user interfaces will improve. Additionally, the shift towards AR product development can guide future FDA regulations.


Dr. Gadodia’s engineering background made him excited to enter the AR space as resident at the Cleveland Clinic. He highlights applications of AR in the non-academic setting. Using a headset could increase procedural efficiency and access to care.


Finally, we discuss major shifts in industry and medicine that favor the increasing use of AR, such as industry’s need for clinician input in product development, the multitude of startups working on the same issues, and the overarching goal of patient safety.


---


RESOURCES


Ep. 7- Lung Tumor Ablation with Dr. Stephen Hunt:

https://www.backtable.com/shows/vi/podcasts/7/lung-tumor-ablation


Ep. 53- International IR Volunteer Work with Dr. Stephen Hunt:

https://www.backtable.com/shows/vi/podcasts/53/international-ir-volunteer-work


Mediview:

https://mediview.com/


Microsoft HoloLens:

https://www.microsoft.com/en-us/hololens


Penn Image-Guided Interventions (PIGI) Lab:

https://www.med.upenn.edu/pigilab/

]]> 3377 Ep. 312 Which Dissections Matter, and How to Treat Them with Dr. John Phillips In this multidisciplinary episode, guest host and vascular surgeon Dr. Krishna Mannava interviews interventional cardiologist Dr. John Phillips about when and how he treats dissections after balloon angioplasty in peripheral vasculature. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Since arterial dissection is a known and common complication of balloon inflation, Dr. Phillips emphasizes the importance of distinguishing between dissections that are flow-limiting and need to be treated, and those that are not flow-limiting. The dissection can be evaluated by measuring pressure gradients and intravascular ultrasound (IVUS). If the dissection flap arc is greater than 180 degrees, Dr. Phillips generally considers it to be flow-limiting. Next, he will determine plaque composition in the area of the dissection. If it is calcified or long, he will deploy a woven nitinol stent. If he needs to target a more specific area that is not calcified, he will use the Tack Endovascular System. The doctors discuss more details about the Tack system. It is a scaffold system that was created specifically for use in dissections after balloon angioplasty in narrowed vessels. The deployment of multiple small devices contributes to an overall lower metal burden than a stent would introduce. The system also has an adaptive and overlapping sizing platform to address dissection in different vessels in the same procedure. Since the Tacks are only meant to scaffold the dissection flap, they do not exert as much radial force as a stent does. This is the reason why Dr. Phillips generally avoids using it in heavily calcified areas. Dr. Phillips also answers submitted audience questions regarding the indications, technique, billing, and education opportunities for the Tack system. Overall, he encourages practitioners to get in touch with their local sales representatives for more information, and brings up the possibility of remote proctoring in the future. In terms of follow up care after balloon angioplasty and Tack placement, Dr. Phillips prescribes dual antiplatelet therapy for three months and possible switches to monotherapy afterwards. This is the same regimen as he prescribes for patients with stents. Additionally, surveillance duplex appears similar in patients with Tacks and stents. --- RESOURCES Tack Dissection Repair Device: https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device Dr. John Phillips Twitter: https://twitter.com/midohiovascular Mon, 17 Apr 2023 05:05:00 -0000 full BackTable In this multidisciplinary episode, guest host and vascular surgeon Dr. Krishna Mannava interviews interventional cardiologist Dr. John Phillips about when and how he treats dissections after balloon angioplasty in peripheral vasculature. In this multidisciplinary episode, guest host and vascular surgeon Dr. Krishna Mannava interviews interventional cardiologist Dr. John Phillips about when and how he treats dissections after balloon angioplasty in peripheral vasculature. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Since arterial dissection is a known and common complication of balloon inflation, Dr. Phillips emphasizes the importance of distinguishing between dissections that are flow-limiting and need to be treated, and those that are not flow-limiting. The dissection can be evaluated by measuring pressure gradients and intravascular ultrasound (IVUS). If the dissection flap arc is greater than 180 degrees, Dr. Phillips generally considers it to be flow-limiting. Next, he will determine plaque composition in the area of the dissection. If it is calcified or long, he will deploy a woven nitinol stent. If he needs to target a more specific area that is not calcified, he will use the Tack Endovascular System. The doctors discuss more details about the Tack system. It is a scaffold system that was created specifically for use in dissections after balloon angioplasty in narrowed vessels. The deployment of multiple small devices contributes to an overall lower metal burden than a stent would introduce. The system also has an adaptive and overlapping sizing platform to address dissection in different vessels in the same procedure. Since the Tacks are only meant to scaffold the dissection flap, they do not exert as much radial force as a stent does. This is the reason why Dr. Phillips generally avoids using it in heavily calcified areas. Dr. Phillips also answers submitted audience questions regarding the indications, technique, billing, and education opportunities for the Tack system. Overall, he encourages practitioners to get in touch with their local sales representatives for more information, and brings up the possibility of remote proctoring in the future. In terms of follow up care after balloon angioplasty and Tack placement, Dr. Phillips prescribes dual antiplatelet therapy for three months and possible switches to monotherapy afterwards. This is the same regimen as he prescribes for patients with stents. Additionally, surveillance duplex appears similar in patients with Tacks and stents. --- RESOURCES Tack Dissection Repair Device: https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device Dr. John Phillips Twitter: https://twitter.com/midohiovascular In this multidisciplinary episode, guest host and vascular surgeon Dr. Krishna Mannava interviews interventional cardiologist Dr. John Phillips about when and how he treats dissections after balloon angioplasty in peripheral vasculature.


---


CHECK OUT OUR SPONSORS


Philips Image Guided Therapy Devices Academy

https://resource.philipseliiteacademy.com


Philips SymphonySuite

https://www.philips.com/symphonysuite


---


SHOW NOTES


Since arterial dissection is a known and common complication of balloon inflation, Dr. Phillips emphasizes the importance of distinguishing between dissections that are flow-limiting and need to be treated, and those that are not flow-limiting. The dissection can be evaluated by measuring pressure gradients and intravascular ultrasound (IVUS). If the dissection flap arc is greater than 180 degrees, Dr. Phillips generally considers it to be flow-limiting. Next, he will determine plaque composition in the area of the dissection. If it is calcified or long, he will deploy a woven nitinol stent. If he needs to target a more specific area that is not calcified, he will use the Tack Endovascular System.


The doctors discuss more details about the Tack system. It is a scaffold system that was created specifically for use in dissections after balloon angioplasty in narrowed vessels. The deployment of multiple small devices contributes to an overall lower metal burden than a stent would introduce. The system also has an adaptive and overlapping sizing platform to address dissection in different vessels in the same procedure. Since the Tacks are only meant to scaffold the dissection flap, they do not exert as much radial force as a stent does. This is the reason why Dr. Phillips generally avoids using it in heavily calcified areas. Dr. Phillips also answers submitted audience questions regarding the indications, technique, billing, and education opportunities for the Tack system. Overall, he encourages practitioners to get in touch with their local sales representatives for more information, and brings up the possibility of remote proctoring in the future.


In terms of follow up care after balloon angioplasty and Tack placement, Dr. Phillips prescribes dual antiplatelet therapy for three months and possible switches to monotherapy afterwards. This is the same regimen as he prescribes for patients with stents. Additionally, surveillance duplex appears similar in patients with Tacks and stents.


---


RESOURCES


Tack Dissection Repair Device:

https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device


Dr. John Phillips Twitter:

https://twitter.com/midohiovascular

]]> 2294 Ep. 311 Working with Industry with Dr. Gregory Makris In this episode, Dr. Aaron Fritts interviews Dr. Gregory Makris about making the transition to industry, including how to market yourself, and how to maintain your clinical and technical skills while working in industry. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SFBnOQ --- SHOW NOTES Dr. Makris is from Greece, and he did his initial training there. He then continued his training in vascular medicine in London, and has been working there ever since. Over the past year, he has been working for Bayer Pharmaceuticals in vascular therapeutics as director, and global clinical lead. He has a hybrid work environment where he works virtually for Bayer, and travels frequently, but still maintains a clinical position at his practice one day a week. He wanted to do this because he enjoys practicing IR and wanted to maintain his clinical and technical skills. Next, we discuss how he decided to get into industry, particularly pharmaceuticals. He never envisioned he would join industry while training. A decade ago, there was a bad reputation about physicians who left medicine to join industry. People often remarked these physicians were soulless or had joined the dark side. Now, there is much less criticism, and there are growing numbers of physicians choosing to partner with industry. Dr. Makris was working as an attending when he started getting more exposed to industry at conferences. He started to imagine a role in medical device innovation, and with a background in research, he knew he had expertise that would be useful to industry as a physician scientist. Somewhat surprisingly, an opportunity came up with Bayer in pharmaceuticals. It was a global role, and involved clinical and research development of vascular medications, which was appealing to him as an IR with a PhD in vascular medicine and someone passionate about global outreach. He also sensed he was ready for a new challenge in his career, so he accepted the role. He recommends being very honest with yourself about your abilities and your limitations when starting out in a new role in industry. Additionally, you should be open to learning new roles, and be flexible with time and travel. Dr. Makris says that the best way to maintain a clinical role is to have a frank conversation with your practice and explain what you can offer them and how to work out a deal that benefits both parties. Most practices will be willing to keep you on part time. If they are not, there are numerous opportunities to stay in medicine, whether through locums or reaching out to other practices that need help. Dr. Makris ends by saying that as a physician, there are many ways to have career satisfaction and work-life balance, while still contributing to healthcare and helping patients. He sees his new role as an opportunity to contribute to the bigger picture, which is advancing healthcare and medical standards. --- RESOURCES Ep 128: Device Innovation with Dr. Atul Gupta https://www.backtable.com/shows/vi/podcasts Ep 57: Practicing IR in the UK with Dr. Gregory Makris https://www.backtable.com/shows/vi/podcasts/57/practicing-ir-in-the-uk Linked In: https://www.linkedin.com/in/gregory-makris-m-d-ph-d-dic-frcr-22118660/?originalSubdomain=uk Twitter: @GregMakris23 Fri, 14 Apr 2023 05:05:00 -0000 full BackTable In this episode, Dr. Aaron Fritts interviews Dr. Gregory Makris about making the transition to industry, including how to market yourself, and how to maintain your clinical and technical skills while working in industry. In this episode, Dr. Aaron Fritts interviews Dr. Gregory Makris about making the transition to industry, including how to market yourself, and how to maintain your clinical and technical skills while working in industry. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SFBnOQ --- SHOW NOTES Dr. Makris is from Greece, and he did his initial training there. He then continued his training in vascular medicine in London, and has been working there ever since. Over the past year, he has been working for Bayer Pharmaceuticals in vascular therapeutics as director, and global clinical lead. He has a hybrid work environment where he works virtually for Bayer, and travels frequently, but still maintains a clinical position at his practice one day a week. He wanted to do this because he enjoys practicing IR and wanted to maintain his clinical and technical skills. Next, we discuss how he decided to get into industry, particularly pharmaceuticals. He never envisioned he would join industry while training. A decade ago, there was a bad reputation about physicians who left medicine to join industry. People often remarked these physicians were soulless or had joined the dark side. Now, there is much less criticism, and there are growing numbers of physicians choosing to partner with industry. Dr. Makris was working as an attending when he started getting more exposed to industry at conferences. He started to imagine a role in medical device innovation, and with a background in research, he knew he had expertise that would be useful to industry as a physician scientist. Somewhat surprisingly, an opportunity came up with Bayer in pharmaceuticals. It was a global role, and involved clinical and research development of vascular medications, which was appealing to him as an IR with a PhD in vascular medicine and someone passionate about global outreach. He also sensed he was ready for a new challenge in his career, so he accepted the role. He recommends being very honest with yourself about your abilities and your limitations when starting out in a new role in industry. Additionally, you should be open to learning new roles, and be flexible with time and travel. Dr. Makris says that the best way to maintain a clinical role is to have a frank conversation with your practice and explain what you can offer them and how to work out a deal that benefits both parties. Most practices will be willing to keep you on part time. If they are not, there are numerous opportunities to stay in medicine, whether through locums or reaching out to other practices that need help. Dr. Makris ends by saying that as a physician, there are many ways to have career satisfaction and work-life balance, while still contributing to healthcare and helping patients. He sees his new role as an opportunity to contribute to the bigger picture, which is advancing healthcare and medical standards. --- RESOURCES Ep 128: Device Innovation with Dr. Atul Gupta https://www.backtable.com/shows/vi/podcasts Ep 57: Practicing IR in the UK with Dr. Gregory Makris https://www.backtable.com/shows/vi/podcasts/57/practicing-ir-in-the-uk Linked In: https://www.linkedin.com/in/gregory-makris-m-d-ph-d-dic-frcr-22118660/?originalSubdomain=uk Twitter: @GregMakris23 In this episode, Dr. Aaron Fritts interviews Dr. Gregory Makris about making the transition to industry, including how to market yourself, and how to maintain your clinical and technical skills while working in industry.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SFBnOQ


---


SHOW NOTES


Dr. Makris is from Greece, and he did his initial training there. He then continued his training in vascular medicine in London, and has been working there ever since. Over the past year, he has been working for Bayer Pharmaceuticals in vascular therapeutics as director, and global clinical lead. He has a hybrid work environment where he works virtually for Bayer, and travels frequently, but still maintains a clinical position at his practice one day a week. He wanted to do this because he enjoys practicing IR and wanted to maintain his clinical and technical skills.


Next, we discuss how he decided to get into industry, particularly pharmaceuticals. He never envisioned he would join industry while training. A decade ago, there was a bad reputation about physicians who left medicine to join industry. People often remarked these physicians were soulless or had joined the dark side. Now, there is much less criticism, and there are growing numbers of physicians choosing to partner with industry. Dr. Makris was working as an attending when he started getting more exposed to industry at conferences. He started to imagine a role in medical device innovation, and with a background in research, he knew he had expertise that would be useful to industry as a physician scientist. Somewhat surprisingly, an opportunity came up with Bayer in pharmaceuticals. It was a global role, and involved clinical and research development of vascular medications, which was appealing to him as an IR with a PhD in vascular medicine and someone passionate about global outreach. He also sensed he was ready for a new challenge in his career, so he accepted the role.


He recommends being very honest with yourself about your abilities and your limitations when starting out in a new role in industry. Additionally, you should be open to learning new roles, and be flexible with time and travel. Dr. Makris says that the best way to maintain a clinical role is to have a frank conversation with your practice and explain what you can offer them and how to work out a deal that benefits both parties. Most practices will be willing to keep you on part time. If they are not, there are numerous opportunities to stay in medicine, whether through locums or reaching out to other practices that need help. Dr. Makris ends by saying that as a physician, there are many ways to have career satisfaction and work-life balance, while still contributing to healthcare and helping patients. He sees his new role as an opportunity to contribute to the bigger picture, which is advancing healthcare and medical standards.


---


RESOURCES


Ep 128: Device Innovation with Dr. Atul Gupta

https://www.backtable.com/shows/vi/podcasts


Ep 57: Practicing IR in the UK with Dr. Gregory Makris

https://www.backtable.com/shows/vi/podcasts/57/practicing-ir-in-the-uk


Linked In:

https://www.linkedin.com/in/gregory-makris-m-d-ph-d-dic-frcr-22118660/?originalSubdomain=uk



Twitter:

@GregMakris23

]]> 2908 Ep. 310 Intravascular Lithotripsy for Fem-Pop Disease in the ASC with Amanda Stanley and Dr. Jim Melton In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton and Amanda Stanley about intravascular lithotripsy in the ASC, including reimbursement trends, patient selection and the future of the device. --- CHECK OUT OUR SPONSOR Shockwave Medical https://shockwavemedical.com/?utm_source=Backtable-Podcast&utm_campaign=Backtable-Podcast --- SHOW NOTES We begin by discussing Amanda’s role in the practice. She is an ex OR nurse and has been clinical director for their original hybrid ASC/OBL in Oklahoma City for 8 years. She has taken on many roles over the years, the most recent being COO. Some of her functions under this title include clinical revenue cycle management (RCM), payer negotiation, credentialing and accreditation. Since partnering with a private equity firm, she has also been collaborating with others in ASCs they have acquired around the country. Dr. Melton states that intravascular lithotripsy (IVL) reimburses very well in the outpatient space, but that this is only true in the ambulatory surgery center (ASC) and does not translate to outpatient based labs (OBLs). Medicare pays for all associated Shockwave intravascular lithotripsy CPT codes, commercial insurance does not. They found in their practice that by using the Medicare fee schedule, they could prove to their local commercial insurance providers that it was worth paying for, and they are now getting it approved via both parties. Specifically, C9765, which is for IVL, percutaneous transluminal angioplasty (PTA) and stenting, pays $5000 more than the code that is just for PTA and stenting. Lastly, we go over sizing and patient selection. In the ASC, he most commonly uses the 5.5, 6 and 7, which all go through a 5-6 Fr slender sheath in the foot. If you use an 8 then you’ll need a 7 Fr sheath, and if you use a size 9, 10, or 12, you’ll need an 8 Fr sheath. Dr. Melton emphasizes the importance of selecting the right patients for the ASC and hospital. In those with significant comorbidities or a femoral artery that will need a size 9, 10 or 12 balloon, he tends to do these in the hospital. He finds that he places a stent more often than not after IVL and PTA because of what he sees using intravascular ultrasound (IVUS). He shares a tip for using the current IVL balloon. Because it emits the strongest sonic pressure impulse at the center of the balloon, he uses IVUS to mark the most calcified segment, then targets this area with the center of the balloon. He remarks that the newer version, coming out soon, has a shorter balloon and emits the same strength across its entire length, allowing you to skip this step. --- RESOURCES Ep. 287 OBL/ASC Reimbursement Update January 2023 https://www.backtable.com/shows/vi/podcasts/287/obl-asc-reimbursement-update-jan-2023 Mon, 10 Apr 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton and Amanda Stanley about intravascular lithotripsy in the ASC, including reimbursement trends, patient selection and the future of the device. In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton and Amanda Stanley about intravascular lithotripsy in the ASC, including reimbursement trends, patient selection and the future of the device. --- CHECK OUT OUR SPONSOR Shockwave Medical https://shockwavemedical.com/?utm_source=Backtable-Podcast&utm_campaign=Backtable-Podcast --- SHOW NOTES We begin by discussing Amanda’s role in the practice. She is an ex OR nurse and has been clinical director for their original hybrid ASC/OBL in Oklahoma City for 8 years. She has taken on many roles over the years, the most recent being COO. Some of her functions under this title include clinical revenue cycle management (RCM), payer negotiation, credentialing and accreditation. Since partnering with a private equity firm, she has also been collaborating with others in ASCs they have acquired around the country. Dr. Melton states that intravascular lithotripsy (IVL) reimburses very well in the outpatient space, but that this is only true in the ambulatory surgery center (ASC) and does not translate to outpatient based labs (OBLs). Medicare pays for all associated Shockwave intravascular lithotripsy CPT codes, commercial insurance does not. They found in their practice that by using the Medicare fee schedule, they could prove to their local commercial insurance providers that it was worth paying for, and they are now getting it approved via both parties. Specifically, C9765, which is for IVL, percutaneous transluminal angioplasty (PTA) and stenting, pays $5000 more than the code that is just for PTA and stenting. Lastly, we go over sizing and patient selection. In the ASC, he most commonly uses the 5.5, 6 and 7, which all go through a 5-6 Fr slender sheath in the foot. If you use an 8 then you’ll need a 7 Fr sheath, and if you use a size 9, 10, or 12, you’ll need an 8 Fr sheath. Dr. Melton emphasizes the importance of selecting the right patients for the ASC and hospital. In those with significant comorbidities or a femoral artery that will need a size 9, 10 or 12 balloon, he tends to do these in the hospital. He finds that he places a stent more often than not after IVL and PTA because of what he sees using intravascular ultrasound (IVUS). He shares a tip for using the current IVL balloon. Because it emits the strongest sonic pressure impulse at the center of the balloon, he uses IVUS to mark the most calcified segment, then targets this area with the center of the balloon. He remarks that the newer version, coming out soon, has a shorter balloon and emits the same strength across its entire length, allowing you to skip this step. --- RESOURCES Ep. 287 OBL/ASC Reimbursement Update January 2023 https://www.backtable.com/shows/vi/podcasts/287/obl-asc-reimbursement-update-jan-2023 In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton and Amanda Stanley about intravascular lithotripsy in the ASC, including reimbursement trends, patient selection and the future of the device.


---


CHECK OUT OUR SPONSOR


Shockwave Medical

https://shockwavemedical.com/?utm_source=Backtable-Podcast&utm_campaign=Backtable-Podcast


---


SHOW NOTES


We begin by discussing Amanda’s role in the practice. She is an ex OR nurse and has been clinical director for their original hybrid ASC/OBL in Oklahoma City for 8 years. She has taken on many roles over the years, the most recent being COO. Some of her functions under this title include clinical revenue cycle management (RCM), payer negotiation, credentialing and accreditation. Since partnering with a private equity firm, she has also been collaborating with others in ASCs they have acquired around the country.


Dr. Melton states that intravascular lithotripsy (IVL) reimburses very well in the outpatient space, but that this is only true in the ambulatory surgery center (ASC) and does not translate to outpatient based labs (OBLs). Medicare pays for all associated Shockwave intravascular lithotripsy CPT codes, commercial insurance does not. They found in their practice that by using the Medicare fee schedule, they could prove to their local commercial insurance providers that it was worth paying for, and they are now getting it approved via both parties. Specifically, C9765, which is for IVL, percutaneous transluminal angioplasty (PTA) and stenting, pays $5000 more than the code that is just for PTA and stenting.


Lastly, we go over sizing and patient selection. In the ASC, he most commonly uses the 5.5, 6 and 7, which all go through a 5-6 Fr slender sheath in the foot. If you use an 8 then you’ll need a 7 Fr sheath, and if you use a size 9, 10, or 12, you’ll need an 8 Fr sheath. Dr. Melton emphasizes the importance of selecting the right patients for the ASC and hospital. In those with significant comorbidities or a femoral artery that will need a size 9, 10 or 12 balloon, he tends to do these in the hospital. He finds that he places a stent more often than not after IVL and PTA because of what he sees using intravascular ultrasound (IVUS). He shares a tip for using the current IVL balloon. Because it emits the strongest sonic pressure impulse at the center of the balloon, he uses IVUS to mark the most calcified segment, then targets this area with the center of the balloon. He remarks that the newer version, coming out soon, has a shorter balloon and emits the same strength across its entire length, allowing you to skip this step.


---


RESOURCES


Ep. 287 OBL/ASC Reimbursement Update January 2023

https://www.backtable.com/shows/vi/podcasts/287/obl-asc-reimbursement-update-jan-2023

]]> 1554 Ep. 309 Physician Finances and Perspectives on Private Equity with Dr. Tarang Patel In this episode, host Dr. Aparna Baheti interviews Dr. Tarang Patel, diagnostic radiologist and creator of the Doctor Money Matters Podcast, about private equity in radiology, from why to get in to how to get out. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES After getting out of the air force, Dr. Patel didn’t know what to do with the significant salary increase he was given. He had a lot of questions and wanted to learn how to manage his finances as a physician. In 2015, he created a website, which soon developed into a podcast. In doing this, his goal was to speak with guests who were experts in aspects of physician finance so that he could learn. He was also interested in disseminating the information with others, because he knew many physicians had similar questions about finance. Next, we discuss the private equity (PE) landscape, specifically in Phoenix, where Dr. Patel practices. He is a hospital employee and has never been part of a PE owned practice, but knows many in Phoenix who went through the Rad Partners buyout there. He explains the evolution of the Rad Partners deal. There were three dominant radiology groups that employed over 100 radiologists. They were approached by Rad Partners and decided to sell and become one large group. This resulted in one dominant radiology group in all of Phoenix. These physicians were all locked into a 5 year contract, which ended in late 2022. At this time, there was a mass exodus of radiologists from this group due to their dissatisfaction with the way the practice was run or how their contracts ended up playing out. Dr. Patel explains how they were able to attract so many people by incentivizing the deal with a heavy cash to share ratio. This gave providers a sense of a guarantee, which a higher share buyout would not have provided. This is because the PE company ascribes value to the shares, and it is unknown at onset whether they will financially profit in the long run. Dr. Patel further explains that joining a PE owned practice is generally a bad deal for young radiologists, because they are offered lower salaries and don’t get any buyout. This has resulted in PE companies failing to hire young doctors. Additionally, many older doctors near retirement use a PE deal as a way to get a large cash payout, work for a few more years, and retire. Dr. Patel believes that due to hiring difficulties and the high debt burden of many PE companies, they will start to close practices, which will open up the market for new practice models. He believes the radiology landscape will be vastly different in 5 years than it is now. Dr. Patel ends by saying you should never trust an offer that advertises low risk and high return. Additionally, for young radiologists looking for jobs out of training, he urges you not to follow the highest offer, but rather find the practice you enjoy going to work at everyday, even if the pay is lower. In the end, you will make the money, and it is worth enjoying your job and your colleagues. --- RESOURCES Ep. 287 OBL/ASC Reimbursement Update January 2023 https://www.backtable.com/shows/vi/podcasts/287/obl-asc-reimbursement-update-jan-2023 Fri, 07 Apr 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aparna Baheti interviews Dr. Tarang Patel, diagnostic radiologist and creator of the Doctor Money Matters Podcast, about private equity in radiology, from why to get in to how to get out. In this episode, host Dr. Aparna Baheti interviews Dr. Tarang Patel, diagnostic radiologist and creator of the Doctor Money Matters Podcast, about private equity in radiology, from why to get in to how to get out. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES After getting out of the air force, Dr. Patel didn’t know what to do with the significant salary increase he was given. He had a lot of questions and wanted to learn how to manage his finances as a physician. In 2015, he created a website, which soon developed into a podcast. In doing this, his goal was to speak with guests who were experts in aspects of physician finance so that he could learn. He was also interested in disseminating the information with others, because he knew many physicians had similar questions about finance. Next, we discuss the private equity (PE) landscape, specifically in Phoenix, where Dr. Patel practices. He is a hospital employee and has never been part of a PE owned practice, but knows many in Phoenix who went through the Rad Partners buyout there. He explains the evolution of the Rad Partners deal. There were three dominant radiology groups that employed over 100 radiologists. They were approached by Rad Partners and decided to sell and become one large group. This resulted in one dominant radiology group in all of Phoenix. These physicians were all locked into a 5 year contract, which ended in late 2022. At this time, there was a mass exodus of radiologists from this group due to their dissatisfaction with the way the practice was run or how their contracts ended up playing out. Dr. Patel explains how they were able to attract so many people by incentivizing the deal with a heavy cash to share ratio. This gave providers a sense of a guarantee, which a higher share buyout would not have provided. This is because the PE company ascribes value to the shares, and it is unknown at onset whether they will financially profit in the long run. Dr. Patel further explains that joining a PE owned practice is generally a bad deal for young radiologists, because they are offered lower salaries and don’t get any buyout. This has resulted in PE companies failing to hire young doctors. Additionally, many older doctors near retirement use a PE deal as a way to get a large cash payout, work for a few more years, and retire. Dr. Patel believes that due to hiring difficulties and the high debt burden of many PE companies, they will start to close practices, which will open up the market for new practice models. He believes the radiology landscape will be vastly different in 5 years than it is now. Dr. Patel ends by saying you should never trust an offer that advertises low risk and high return. Additionally, for young radiologists looking for jobs out of training, he urges you not to follow the highest offer, but rather find the practice you enjoy going to work at everyday, even if the pay is lower. In the end, you will make the money, and it is worth enjoying your job and your colleagues. --- RESOURCES Ep. 287 OBL/ASC Reimbursement Update January 2023 https://www.backtable.com/shows/vi/podcasts/287/obl-asc-reimbursement-update-jan-2023 In this episode, host Dr. Aparna Baheti interviews Dr. Tarang Patel, diagnostic radiologist and creator of the Doctor Money Matters Podcast, about private equity in radiology, from why to get in to how to get out.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


After getting out of the air force, Dr. Patel didn’t know what to do with the significant salary increase he was given. He had a lot of questions and wanted to learn how to manage his finances as a physician. In 2015, he created a website, which soon developed into a podcast. In doing this, his goal was to speak with guests who were experts in aspects of physician finance so that he could learn. He was also interested in disseminating the information with others, because he knew many physicians had similar questions about finance.


Next, we discuss the private equity (PE) landscape, specifically in Phoenix, where Dr. Patel practices. He is a hospital employee and has never been part of a PE owned practice, but knows many in Phoenix who went through the Rad Partners buyout there. He explains the evolution of the Rad Partners deal. There were three dominant radiology groups that employed over 100 radiologists. They were approached by Rad Partners and decided to sell and become one large group. This resulted in one dominant radiology group in all of Phoenix. These physicians were all locked into a 5 year contract, which ended in late 2022. At this time, there was a mass exodus of radiologists from this group due to their dissatisfaction with the way the practice was run or how their contracts ended up playing out. Dr. Patel explains how they were able to attract so many people by incentivizing the deal with a heavy cash to share ratio. This gave providers a sense of a guarantee, which a higher share buyout would not have provided. This is because the PE company ascribes value to the shares, and it is unknown at onset whether they will financially profit in the long run.


Dr. Patel further explains that joining a PE owned practice is generally a bad deal for young radiologists, because they are offered lower salaries and don’t get any buyout. This has resulted in PE companies failing to hire young doctors. Additionally, many older doctors near retirement use a PE deal as a way to get a large cash payout, work for a few more years, and retire. Dr. Patel believes that due to hiring difficulties and the high debt burden of many PE companies, they will start to close practices, which will open up the market for new practice models. He believes the radiology landscape will be vastly different in 5 years than it is now. Dr. Patel ends by saying you should never trust an offer that advertises low risk and high return. Additionally, for young radiologists looking for jobs out of training, he urges you not to follow the highest offer, but rather find the practice you enjoy going to work at everyday, even if the pay is lower. In the end, you will make the money, and it is worth enjoying your job and your colleagues.


---


RESOURCES


Ep. 287 OBL/ASC Reimbursement Update January 2023

https://www.backtable.com/shows/vi/podcasts/287/obl-asc-reimbursement-update-jan-2023

]]> 2762 Ep. 308 When Providers Become Patients: Testicular Cancer and Beyond with Dr. William Flanary aka Dr. Glaucomflecken In this episode of BackTable, Dr. Bagrodia interviews Dr. William Flanary, a physician-comedian popularly known as Dr. Glaucomflecken, about lessons he has learned as a two-time testicular cancer survivor and the importance of humor in medicine. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/VJvXZx --- SHOW NOTES First, Dr. Glaucomflecken shares about his first diagnosis of testicular cancer. During his third year of medical school he felt a lump in his testicle, which led to a quick workup, diagnosis, and a full orchiectomy. The diagnosis was emotionally difficult, as he was in his mid-twenties and healthy. He returned to comedy, a skill he had developed in high school and college, to cope with his diagnosis. This time, however, he started to practice medical-based comedy with his new experiences as a medical student. He recounts other discussions he had about his cancer, such as fertility, the possibility of chemotherapy, and active surveillance. Four years after his first orchiectomy, he received his second diagnosis of testicular cancer during his last year of residency. He recounts feeling distraught and overwhelmed, as questions about fertility, hormone replacement, medical expenses, and postponing residency became more serious. He decided to have a full orchiectomy and testosterone replacement therapy, which solved his issues with fatigue and irritability. Additionally, his wife got him involved in testicular cancer support groups and foundations, including one called First Descents, an organization that encourages young adults with cancer to explore the outdoors. He notes that young patients are often overlooked in cancer support groups and encourages cancer patients to find their support networks outside of friends and family as well. Then, Dr. Flanary discusses his experience with suffering from cardiac arrest in 2020, which led to his wife doing ten minutes of chest compressions to keep him alive. He reflects on this event and concludes that it taught him how to be a better physician to his patients by making sure he involves patients’ families and encouraging him to address medical insurance issues directly. Finally, Dr. Flanary discusses how he uses humor to advocate and educate patients on social media. He notes that comedy can stimulate conversation and debate and encourages physicians to have social media presence. --- RESOURCES Knock Knock Hi Podcast https://podcasts.apple.com/us/podcast/knock-knock-hi-with-the-glaucomfleckens/id1659572053 First Descents https://firstdescents.org/ Wed, 05 Apr 2023 05:05:00 -0000 full BackTable In this episode of BackTable, Dr. Bagrodia interviews Dr. William Flanary, a physician-comedian popularly known as Dr. Glaucomflecken, about lessons he has learned as a two-time testicular cancer survivor and the importance of humor in medicine. In this episode of BackTable, Dr. Bagrodia interviews Dr. William Flanary, a physician-comedian popularly known as Dr. Glaucomflecken, about lessons he has learned as a two-time testicular cancer survivor and the importance of humor in medicine. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/VJvXZx --- SHOW NOTES First, Dr. Glaucomflecken shares about his first diagnosis of testicular cancer. During his third year of medical school he felt a lump in his testicle, which led to a quick workup, diagnosis, and a full orchiectomy. The diagnosis was emotionally difficult, as he was in his mid-twenties and healthy. He returned to comedy, a skill he had developed in high school and college, to cope with his diagnosis. This time, however, he started to practice medical-based comedy with his new experiences as a medical student. He recounts other discussions he had about his cancer, such as fertility, the possibility of chemotherapy, and active surveillance. Four years after his first orchiectomy, he received his second diagnosis of testicular cancer during his last year of residency. He recounts feeling distraught and overwhelmed, as questions about fertility, hormone replacement, medical expenses, and postponing residency became more serious. He decided to have a full orchiectomy and testosterone replacement therapy, which solved his issues with fatigue and irritability. Additionally, his wife got him involved in testicular cancer support groups and foundations, including one called First Descents, an organization that encourages young adults with cancer to explore the outdoors. He notes that young patients are often overlooked in cancer support groups and encourages cancer patients to find their support networks outside of friends and family as well. Then, Dr. Flanary discusses his experience with suffering from cardiac arrest in 2020, which led to his wife doing ten minutes of chest compressions to keep him alive. He reflects on this event and concludes that it taught him how to be a better physician to his patients by making sure he involves patients’ families and encouraging him to address medical insurance issues directly. Finally, Dr. Flanary discusses how he uses humor to advocate and educate patients on social media. He notes that comedy can stimulate conversation and debate and encourages physicians to have social media presence. --- RESOURCES Knock Knock Hi Podcast https://podcasts.apple.com/us/podcast/knock-knock-hi-with-the-glaucomfleckens/id1659572053 First Descents https://firstdescents.org/ In this episode of BackTable, Dr. Bagrodia interviews Dr. William Flanary, a physician-comedian popularly known as Dr. Glaucomflecken, about lessons he has learned as a two-time testicular cancer survivor and the importance of humor in medicine.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/VJvXZx


---


SHOW NOTES


First, Dr. Glaucomflecken shares about his first diagnosis of testicular cancer. During his third year of medical school he felt a lump in his testicle, which led to a quick workup, diagnosis, and a full orchiectomy. The diagnosis was emotionally difficult, as he was in his mid-twenties and healthy. He returned to comedy, a skill he had developed in high school and college, to cope with his diagnosis. This time, however, he started to practice medical-based comedy with his new experiences as a medical student. He recounts other discussions he had about his cancer, such as fertility, the possibility of chemotherapy, and active surveillance.


Four years after his first orchiectomy, he received his second diagnosis of testicular cancer during his last year of residency. He recounts feeling distraught and overwhelmed, as questions about fertility, hormone replacement, medical expenses, and postponing residency became more serious. He decided to have a full orchiectomy and testosterone replacement therapy, which solved his issues with fatigue and irritability. Additionally, his wife got him involved in testicular cancer support groups and foundations, including one called First Descents, an organization that encourages young adults with cancer to explore the outdoors. He notes that young patients are often overlooked in cancer support groups and encourages cancer patients to find their support networks outside of friends and family as well.


Then, Dr. Flanary discusses his experience with suffering from cardiac arrest in 2020, which led to his wife doing ten minutes of chest compressions to keep him alive. He reflects on this event and concludes that it taught him how to be a better physician to his patients by making sure he involves patients’ families and encouraging him to address medical insurance issues directly.


Finally, Dr. Flanary discusses how he uses humor to advocate and educate patients on social media. He notes that comedy can stimulate conversation and debate and encourages physicians to have social media presence.


---


RESOURCES


Knock Knock Hi Podcast

https://podcasts.apple.com/us/podcast/knock-knock-hi-with-the-glaucomfleckens/id1659572053


First Descents

https://firstdescents.org/

]]> 3528 Ep. 307 IR Locums Update with Dr. Kavi Devulapalli and Dr. Vishal Kadakia In the second part of our IR Locums series, guest host Dr. Shamit Desai interviews Drs. Kavi Devulapalli and Vishal Kadakia, reuniting at SIR 2023, to discuss the process of finding and negotiating locum tenens opportunities. They each provide an update on their clinical practice and perspectives about the job market in the last year. --- CHECK OUT OUR SPONSORS Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Devalupalli begins by describing the choices that IRs can make about networking, whether they prefer to personally search for locums opportunities, or whether they work with a staffing agency. Through conversations with people in the staffing industry, he has learned that their margins are around 30-40% of an IR’s daily rate. Deciding whether or not to use a staffing agency is up to the physician and their networking needs, but there are an abundance of direct ways to connect with jobs through online communities, conferences, and device representatives. Having more personal contact with employers and practice owners can also provide more information about each site’s work environment, case load, case variety, and expectations. Dr. Kadakia notes that some clients have signed exclusive locums contracts, so they are prohibited from working with physicians that do not go through the staffing agency. He also talks about national groups establishing locums departments to staff different branches in need of extra help, and how this could be an alternative to staffing agencies. Dr. Devalupalli mainly works with physician-owned practices and he emphasizes the value of speaking directly to practice owners. This is a good way to build trust and reduce bureaucratic inefficiencies. Dr. Kadakia shares a personal marketing tip: He creates a one-page introduction to his skills and reviews, which succinctly lets clients know what he can offer. Next, we discuss the changing job market as demand for IRs is increasing and trainee interest in locums is growing. IR training primarily occurs within a hospital-based setting, so it would be an easier transition for early career IRs to do inpatient locums, as opposed to starting in an OBL setting. Overtime, as one proves their skills, confidence, and efficiency, it will become easier to find outpatient opportunities. Finally, the doctors discuss the importance of transparency around contracts and fees. They give concrete examples of price floors and necessary terms to define in locums contracts. Both doctors also speak about being open to variability in rates based on the need for travel, case and payer mix, and call schedule. --- RESOURCES Ep. 225- Approaches to IR Locums: https://www.backtable.com/shows/vi/podcasts/225/approaches-to-ir-locums Ep. 218- Building a Skillset Outside of Training: https://www.backtable.com/shows/vi/podcasts/218/building-a-skillset-outside-of-training Line Monkey MD Blog: https://linemonkeymd.com/ Outpatient Endovascular and Interventional Society (OEIS): https://oeisweb.com/ Mon, 03 Apr 2023 05:05:00 -0000 full BackTable In the second part of our IR Locums series, guest host Dr. Shamit Desai interviews Drs. Kavi Devulapalli and Vishal Kadakia, reuniting at SIR 2023, to discuss the process of finding and negotiating locum tenens opportunities. They each provide an update on their clinical practice and perspectives about the job market in the last year. In the second part of our IR Locums series, guest host Dr. Shamit Desai interviews Drs. Kavi Devulapalli and Vishal Kadakia, reuniting at SIR 2023, to discuss the process of finding and negotiating locum tenens opportunities. They each provide an update on their clinical practice and perspectives about the job market in the last year. --- CHECK OUT OUR SPONSORS Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Devalupalli begins by describing the choices that IRs can make about networking, whether they prefer to personally search for locums opportunities, or whether they work with a staffing agency. Through conversations with people in the staffing industry, he has learned that their margins are around 30-40% of an IR’s daily rate. Deciding whether or not to use a staffing agency is up to the physician and their networking needs, but there are an abundance of direct ways to connect with jobs through online communities, conferences, and device representatives. Having more personal contact with employers and practice owners can also provide more information about each site’s work environment, case load, case variety, and expectations. Dr. Kadakia notes that some clients have signed exclusive locums contracts, so they are prohibited from working with physicians that do not go through the staffing agency. He also talks about national groups establishing locums departments to staff different branches in need of extra help, and how this could be an alternative to staffing agencies. Dr. Devalupalli mainly works with physician-owned practices and he emphasizes the value of speaking directly to practice owners. This is a good way to build trust and reduce bureaucratic inefficiencies. Dr. Kadakia shares a personal marketing tip: He creates a one-page introduction to his skills and reviews, which succinctly lets clients know what he can offer. Next, we discuss the changing job market as demand for IRs is increasing and trainee interest in locums is growing. IR training primarily occurs within a hospital-based setting, so it would be an easier transition for early career IRs to do inpatient locums, as opposed to starting in an OBL setting. Overtime, as one proves their skills, confidence, and efficiency, it will become easier to find outpatient opportunities. Finally, the doctors discuss the importance of transparency around contracts and fees. They give concrete examples of price floors and necessary terms to define in locums contracts. Both doctors also speak about being open to variability in rates based on the need for travel, case and payer mix, and call schedule. --- RESOURCES Ep. 225- Approaches to IR Locums: https://www.backtable.com/shows/vi/podcasts/225/approaches-to-ir-locums Ep. 218- Building a Skillset Outside of Training: https://www.backtable.com/shows/vi/podcasts/218/building-a-skillset-outside-of-training Line Monkey MD Blog: https://linemonkeymd.com/ Outpatient Endovascular and Interventional Society (OEIS): https://oeisweb.com/ In the second part of our IR Locums series, guest host Dr. Shamit Desai interviews Drs. Kavi Devulapalli and Vishal Kadakia, reuniting at SIR 2023, to discuss the process of finding and negotiating locum tenens opportunities. They each provide an update on their clinical practice and perspectives about the job market in the last year.


---


CHECK OUT OUR SPONSORS


Medtronic HawkOne Directional Atherectomy System

https://www.medtronic.com/hawkone


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. Devalupalli begins by describing the choices that IRs can make about networking, whether they prefer to personally search for locums opportunities, or whether they work with a staffing agency. Through conversations with people in the staffing industry, he has learned that their margins are around 30-40% of an IR’s daily rate. Deciding whether or not to use a staffing agency is up to the physician and their networking needs, but there are an abundance of direct ways to connect with jobs through online communities, conferences, and device representatives. Having more personal contact with employers and practice owners can also provide more information about each site’s work environment, case load, case variety, and expectations. Dr. Kadakia notes that some clients have signed exclusive locums contracts, so they are prohibited from working with physicians that do not go through the staffing agency. He also talks about national groups establishing locums departments to staff different branches in need of extra help, and how this could be an alternative to staffing agencies.


Dr. Devalupalli mainly works with physician-owned practices and he emphasizes the value of speaking directly to practice owners. This is a good way to build trust and reduce bureaucratic inefficiencies. Dr. Kadakia shares a personal marketing tip: He creates a one-page introduction to his skills and reviews, which succinctly lets clients know what he can offer.


Next, we discuss the changing job market as demand for IRs is increasing and trainee interest in locums is growing. IR training primarily occurs within a hospital-based setting, so it would be an easier transition for early career IRs to do inpatient locums, as opposed to starting in an OBL setting. Overtime, as one proves their skills, confidence, and efficiency, it will become easier to find outpatient opportunities.


Finally, the doctors discuss the importance of transparency around contracts and fees. They give concrete examples of price floors and necessary terms to define in locums contracts. Both doctors also speak about being open to variability in rates based on the need for travel, case and payer mix, and call schedule.


---


RESOURCES


Ep. 225- Approaches to IR Locums:

https://www.backtable.com/shows/vi/podcasts/225/approaches-to-ir-locums


Ep. 218- Building a Skillset Outside of Training:

https://www.backtable.com/shows/vi/podcasts/218/building-a-skillset-outside-of-training


Line Monkey MD Blog:

https://linemonkeymd.com/


Outpatient Endovascular and Interventional Society (OEIS):

https://oeisweb.com/

]]> 3857 Ep. 306 Physician Side Gigs with Dr. Nisha Mehta In this episode, Dr. Aaron Fritts interviews Dr. Nisha Mehta, a radiologist and founder of the Physician Side Gigs online community. --- CHECK OUT OUR SPONSORS Medtronic AV DCB https://www.medtronic.com/avdata Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Mehta traces her journey from being a radiologist between jobs to managing and advocating for one of the largest grassroots physician communities, with more than 162,000 online members. She started Physician Side Gigs as a private Facebook group with a few doctors to get advice on managing finances for her paid writing and speaking engagements. Overtime, the size and scope of the group grew so much that there was a branch point where a separate group, Physician Community, formed. Both groups remain active today– while Physician Side Gig still centers around business and personal finance education, Physician Community is more free flowing and fosters a variety of conversations about the healthcare environment, clinical practice, and physician advocacy. This advocacy really came into the spotlight during the peak of COVID-19, when members of the online community collaborated to create a list of physician demands for the federal government and were successful in securing $70 billion for physicians in a stimulus package. Dr. Mehta cites the lack of bureaucracy in the group as factors that helped contribute to this outcome. The groups’ goals are to provide members with peer support and bridge them to opportunities to pursue other interests and revenue streams. We also discuss Dr. Mehta’s personal career trajectory and how her priorities shifted throughout the years. In the beginning stages of Physician Side Gigs, she was able to balance a full time clinical practice and manage the online group in her free time. However, as the group grew in audience and partnerships, she re-evaluated her priorities and saw that fostering the community gave her more energy and allowed her to make more impact than her clinical practice did. She now practices radiology on a per diem basis and devotes most of her time to Physician Side Gigs and physician advocacy. She has also hired staff members to help moderate the group and ensure that it remains a safe and supportive environment. Finally, Dr. Mehta speaks about physician autonomy. The decision to pursue a side gig is not always based on revenue maximization. Instead, side gigs can be a way for physicians to dedicate time to pursuing their non-clinical interests and prevent burnout. Her biggest advice for doctors is to be intentional about what they want their lives to look like, and to not get caught up in others’ expectations for them. In the long run, having career autonomy can extend career longevity and allow physicians to navigate their lives on their own terms. --- RESOURCES Physician Side Gigs Website: https://www.physiciansidegigs.com/ Ep. 194 (VI)- Financial Basics with the White Coat Investor: https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor Ep. 277 (VI)- Private Equity and the Radiology Job Environment with Ben White: https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment Ep. 27 (INN)- Physician Underdog with LOUD Capital Founder Navin Goyal: https://www.backtable.com/shows/innovation/podcasts/27/physician-underdog Fri, 31 Mar 2023 05:05:00 -0000 full BackTable In this episode, Dr. Aaron Fritts interviews Dr. Nisha Mehta, a radiologist and founder of the Physician Side Gigs online community. In this episode, Dr. Aaron Fritts interviews Dr. Nisha Mehta, a radiologist and founder of the Physician Side Gigs online community. --- CHECK OUT OUR SPONSORS Medtronic AV DCB https://www.medtronic.com/avdata Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Mehta traces her journey from being a radiologist between jobs to managing and advocating for one of the largest grassroots physician communities, with more than 162,000 online members. She started Physician Side Gigs as a private Facebook group with a few doctors to get advice on managing finances for her paid writing and speaking engagements. Overtime, the size and scope of the group grew so much that there was a branch point where a separate group, Physician Community, formed. Both groups remain active today– while Physician Side Gig still centers around business and personal finance education, Physician Community is more free flowing and fosters a variety of conversations about the healthcare environment, clinical practice, and physician advocacy. This advocacy really came into the spotlight during the peak of COVID-19, when members of the online community collaborated to create a list of physician demands for the federal government and were successful in securing $70 billion for physicians in a stimulus package. Dr. Mehta cites the lack of bureaucracy in the group as factors that helped contribute to this outcome. The groups’ goals are to provide members with peer support and bridge them to opportunities to pursue other interests and revenue streams. We also discuss Dr. Mehta’s personal career trajectory and how her priorities shifted throughout the years. In the beginning stages of Physician Side Gigs, she was able to balance a full time clinical practice and manage the online group in her free time. However, as the group grew in audience and partnerships, she re-evaluated her priorities and saw that fostering the community gave her more energy and allowed her to make more impact than her clinical practice did. She now practices radiology on a per diem basis and devotes most of her time to Physician Side Gigs and physician advocacy. She has also hired staff members to help moderate the group and ensure that it remains a safe and supportive environment. Finally, Dr. Mehta speaks about physician autonomy. The decision to pursue a side gig is not always based on revenue maximization. Instead, side gigs can be a way for physicians to dedicate time to pursuing their non-clinical interests and prevent burnout. Her biggest advice for doctors is to be intentional about what they want their lives to look like, and to not get caught up in others’ expectations for them. In the long run, having career autonomy can extend career longevity and allow physicians to navigate their lives on their own terms. --- RESOURCES Physician Side Gigs Website: https://www.physiciansidegigs.com/ Ep. 194 (VI)- Financial Basics with the White Coat Investor: https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor Ep. 277 (VI)- Private Equity and the Radiology Job Environment with Ben White: https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment Ep. 27 (INN)- Physician Underdog with LOUD Capital Founder Navin Goyal: https://www.backtable.com/shows/innovation/podcasts/27/physician-underdog In this episode, Dr. Aaron Fritts interviews Dr. Nisha Mehta, a radiologist and founder of the Physician Side Gigs online community.


---


CHECK OUT OUR SPONSORS


Medtronic AV DCB

https://www.medtronic.com/avdata


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. Mehta traces her journey from being a radiologist between jobs to managing and advocating for one of the largest grassroots physician communities, with more than 162,000 online members. She started Physician Side Gigs as a private Facebook group with a few doctors to get advice on managing finances for her paid writing and speaking engagements. Overtime, the size and scope of the group grew so much that there was a branch point where a separate group, Physician Community, formed. Both groups remain active today– while Physician Side Gig still centers around business and personal finance education, Physician Community is more free flowing and fosters a variety of conversations about the healthcare environment, clinical practice, and physician advocacy. This advocacy really came into the spotlight during the peak of COVID-19, when members of the online community collaborated to create a list of physician demands for the federal government and were successful in securing $70 billion for physicians in a stimulus package. Dr. Mehta cites the lack of bureaucracy in the group as factors that helped contribute to this outcome. The groups’ goals are to provide members with peer support and bridge them to opportunities to pursue other interests and revenue streams.


We also discuss Dr. Mehta’s personal career trajectory and how her priorities shifted throughout the years. In the beginning stages of Physician Side Gigs, she was able to balance a full time clinical practice and manage the online group in her free time. However, as the group grew in audience and partnerships, she re-evaluated her priorities and saw that fostering the community gave her more energy and allowed her to make more impact than her clinical practice did. She now practices radiology on a per diem basis and devotes most of her time to Physician Side Gigs and physician advocacy. She has also hired staff members to help moderate the group and ensure that it remains a safe and supportive environment.


Finally, Dr. Mehta speaks about physician autonomy. The decision to pursue a side gig is not always based on revenue maximization. Instead, side gigs can be a way for physicians to dedicate time to pursuing their non-clinical interests and prevent burnout. Her biggest advice for doctors is to be intentional about what they want their lives to look like, and to not get caught up in others’ expectations for them. In the long run, having career autonomy can extend career longevity and allow physicians to navigate their lives on their own terms.


---


RESOURCES


Physician Side Gigs Website:

https://www.physiciansidegigs.com/


Ep. 194 (VI)- Financial Basics with the White Coat Investor:

https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor


Ep. 277 (VI)- Private Equity and the Radiology Job Environment with Ben White:

https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment


Ep. 27 (INN)- Physician Underdog with LOUD Capital Founder Navin Goyal:

https://www.backtable.com/shows/innovation/podcasts/27/physician-underdog

]]> 3161 Ep. 305 Tools for Crossing Challenging CTO's with Dr. Jihad Mustapha In this episode, host Dr. Sabeen Dhand interviews Dr. Jihad Mustapha, interventional cardiologist, about new technology for treating CLI, including CTOP classification, CTO crossing techniques, and reentry devices. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Jihad Mustapha is an interventional cardiologist who practices at Advanced Cardiovascular in Grand Rapids, MI. He used to perform the entire scope of interventional cardiology, until finding his passion in critical limb ischemia and dedicating his career to treating this complex disease. Advanced Cardiovascular has grown, and now includes a dedicated interventional cardiology department and a PAD/CLI specific department. The basic principle for treating chronic total occlusions is to approach them from the best direction. This generally starts with an up and over technique to do the initial planning angiography. Dr. Mustapha then uses the wire and catheter technique, but limits his efforts to 5 minutes. If he can’t cross, he tries a new method. If he can cross but can’t reenter distally, then there are multiple methods to turn to, including reentry devices like the Outback and Pioneer. He emphasizes that when using reentry devices, you must measure the CTO and enter just after it ends, allowing no more than 1-2 mm of space between the cap and your reentry point. If it is impossible to reenter at that level, you should not use a reentry device and should turn to another method. The Chronic Total Occlusion crossing approach based on Plaque cap morphology (CTOP) classification is helpful when deciding how to safely approach a CTO or which technique to turn to, and Dr. Mustapha uses it in all his cases. Next, we discuss pedal access. Dr. Mustapha acknowledges he hasn’t used reentry devices for years now, due to the fact that pedal access is so much quicker and works just as well. If a CTO has a complex CTOP classification, he doesn’t even try anterograde first, he just goes directly to pedal access and crosses retrograde. When he uses the retrograde approach to cross the CTO cap, he often finds the occlusion is not as long as he expects it to be, and also that he is intraluminal much more often than he initially anticipates. For long chronic total occlusions (CTOs), he starts with pedal access, crosses the CTO plaque cap, and continues through the occlusion, stopping just before the reentry point. If it pops through the cap, he then uses the tibiopedal artery minimally invasive retrograde revascularization (TAMI) technique, but if it does not, he comes anterograde and uses the flossing technique. Finally, we discuss how to use the Wingman device, as well as tips for using the Jenali and modified Schmidt techniques. Finally, we discuss new devices coming soon in the CLI arena. Dr. Mustapha is excited about companies that are creating a 2-in-1 device that allows you to cross the CTO and then use it as a reentry device. Dr. Mustapha parts by telling listeners that CTOs are never friendly, whether long, short, calcified, or non-calcified, but as long as you anticipate this and go into a case expecting surprises, you’ll do well. --- RESOURCES Ep. 60: Building a Limb Salvage Program https://www.backtable.com/shows/vi/podcasts/60/building-a-limb-salvage-program CTOP Paper: https://capbuster.com/wp-content/uploads/2021/03/Chronic-Total-Occlusion-Crossing-Approach-Based-on-Plaque-Cap-Morphology-The-CTOP-Classification.pdf Tibial Pedal Access Paper: https://www.openaccessjournals.com/articles/tibialpedal-arterial-access--retrograde-interventions-for-advanced-peripheral-arterial-disease--critical-limb-ischemia.html Jenali Scoring System: https://evtoday.com/pdfs/et0910_Feature_mustapha.pdf Find this episode on backtable.com to view the full list of resources mentioned in this episode. Mon, 27 Mar 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews Dr. Jihad Mustapha, interventional cardiologist, about new technology for treating CLI, including CTOP classification, CTO crossing techniques, and reentry devices. In this episode, host Dr. Sabeen Dhand interviews Dr. Jihad Mustapha, interventional cardiologist, about new technology for treating CLI, including CTOP classification, CTO crossing techniques, and reentry devices. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Jihad Mustapha is an interventional cardiologist who practices at Advanced Cardiovascular in Grand Rapids, MI. He used to perform the entire scope of interventional cardiology, until finding his passion in critical limb ischemia and dedicating his career to treating this complex disease. Advanced Cardiovascular has grown, and now includes a dedicated interventional cardiology department and a PAD/CLI specific department. The basic principle for treating chronic total occlusions is to approach them from the best direction. This generally starts with an up and over technique to do the initial planning angiography. Dr. Mustapha then uses the wire and catheter technique, but limits his efforts to 5 minutes. If he can’t cross, he tries a new method. If he can cross but can’t reenter distally, then there are multiple methods to turn to, including reentry devices like the Outback and Pioneer. He emphasizes that when using reentry devices, you must measure the CTO and enter just after it ends, allowing no more than 1-2 mm of space between the cap and your reentry point. If it is impossible to reenter at that level, you should not use a reentry device and should turn to another method. The Chronic Total Occlusion crossing approach based on Plaque cap morphology (CTOP) classification is helpful when deciding how to safely approach a CTO or which technique to turn to, and Dr. Mustapha uses it in all his cases. Next, we discuss pedal access. Dr. Mustapha acknowledges he hasn’t used reentry devices for years now, due to the fact that pedal access is so much quicker and works just as well. If a CTO has a complex CTOP classification, he doesn’t even try anterograde first, he just goes directly to pedal access and crosses retrograde. When he uses the retrograde approach to cross the CTO cap, he often finds the occlusion is not as long as he expects it to be, and also that he is intraluminal much more often than he initially anticipates. For long chronic total occlusions (CTOs), he starts with pedal access, crosses the CTO plaque cap, and continues through the occlusion, stopping just before the reentry point. If it pops through the cap, he then uses the tibiopedal artery minimally invasive retrograde revascularization (TAMI) technique, but if it does not, he comes anterograde and uses the flossing technique. Finally, we discuss how to use the Wingman device, as well as tips for using the Jenali and modified Schmidt techniques. Finally, we discuss new devices coming soon in the CLI arena. Dr. Mustapha is excited about companies that are creating a 2-in-1 device that allows you to cross the CTO and then use it as a reentry device. Dr. Mustapha parts by telling listeners that CTOs are never friendly, whether long, short, calcified, or non-calcified, but as long as you anticipate this and go into a case expecting surprises, you’ll do well. --- RESOURCES Ep. 60: Building a Limb Salvage Program https://www.backtable.com/shows/vi/podcasts/60/building-a-limb-salvage-program CTOP Paper: https://capbuster.com/wp-content/uploads/2021/03/Chronic-Total-Occlusion-Crossing-Approach-Based-on-Plaque-Cap-Morphology-The-CTOP-Classification.pdf Tibial Pedal Access Paper: https://www.openaccessjournals.com/articles/tibialpedal-arterial-access--retrograde-interventions-for-advanced-peripheral-arterial-disease--critical-limb-ischemia.html Jenali Scoring System: https://evtoday.com/pdfs/et0910_Feature_mustapha.pdf Find this episode on backtable.com to view the full list of resources mentioned in this episode. In this episode, host Dr. Sabeen Dhand interviews Dr. Jihad Mustapha, interventional cardiologist, about new technology for treating CLI, including CTOP classification, CTO crossing techniques, and reentry devices.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. Jihad Mustapha is an interventional cardiologist who practices at Advanced Cardiovascular in Grand Rapids, MI. He used to perform the entire scope of interventional cardiology, until finding his passion in critical limb ischemia and dedicating his career to treating this complex disease. Advanced Cardiovascular has grown, and now includes a dedicated interventional cardiology department and a PAD/CLI specific department.


The basic principle for treating chronic total occlusions is to approach them from the best direction. This generally starts with an up and over technique to do the initial planning angiography. Dr. Mustapha then uses the wire and catheter technique, but limits his efforts to 5 minutes. If he can’t cross, he tries a new method. If he can cross but can’t reenter distally, then there are multiple methods to turn to, including reentry devices like the Outback and Pioneer. He emphasizes that when using reentry devices, you must measure the CTO and enter just after it ends, allowing no more than 1-2 mm of space between the cap and your reentry point. If it is impossible to reenter at that level, you should not use a reentry device and should turn to another method. The Chronic Total Occlusion crossing approach based on Plaque cap morphology (CTOP) classification is helpful when deciding how to safely approach a CTO or which technique to turn to, and Dr. Mustapha uses it in all his cases.


Next, we discuss pedal access. Dr. Mustapha acknowledges he hasn’t used reentry devices for years now, due to the fact that pedal access is so much quicker and works just as well. If a CTO has a complex CTOP classification, he doesn’t even try anterograde first, he just goes directly to pedal access and crosses retrograde. When he uses the retrograde approach to cross the CTO cap, he often finds the occlusion is not as long as he expects it to be, and also that he is intraluminal much more often than he initially anticipates. For long chronic total occlusions (CTOs), he starts with pedal access, crosses the CTO plaque cap, and continues through the occlusion, stopping just before the reentry point. If it pops through the cap, he then uses the tibiopedal artery minimally invasive retrograde revascularization (TAMI) technique, but if it does not, he comes anterograde and uses the flossing technique.


Finally, we discuss how to use the Wingman device, as well as tips for using the Jenali and modified Schmidt techniques. Finally, we discuss new devices coming soon in the CLI arena. Dr. Mustapha is excited about companies that are creating a 2-in-1 device that allows you to cross the CTO and then use it as a reentry device. Dr. Mustapha parts by telling listeners that CTOs are never friendly, whether long, short, calcified, or non-calcified, but as long as you anticipate this and go into a case expecting surprises, you’ll do well.


---


RESOURCES


Ep. 60: Building a Limb Salvage Program

https://www.backtable.com/shows/vi/podcasts/60/building-a-limb-salvage-program


CTOP Paper:

https://capbuster.com/wp-content/uploads/2021/03/Chronic-Total-Occlusion-Crossing-Approach-Based-on-Plaque-Cap-Morphology-The-CTOP-Classification.pdf


Tibial Pedal Access Paper:

https://www.openaccessjournals.com/articles/tibialpedal-arterial-access--retrograde-interventions-for-advanced-peripheral-arterial-disease--critical-limb-ischemia.html


Jenali Scoring System:

https://evtoday.com/pdfs/et0910_Feature_mustapha.pdf


Find this episode on backtable.com to view the full list of resources mentioned in this episode.

]]> 2782 Ep. 304 Código TEP: ¿Lo Hacemos Posible? con Sara Lojo y Juan Jose Ciampi Dopazo En este episodio de BackTable VI, Dr. Pilar Bayona Molano, Dr. Juan Ciampi, y Dr. Sara Lojo Lendoiro discuten el manejo de embolia pulmonar para pacientes con niveles de riesgos diferentes. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/CxjlQ7 --- SHOW NOTES Primero, Dr. Ciampi explica que un equipo multidisciplinario es más importante en el manejo del paciente con una embolia pulmonar. Si el paciente tiene un riesgo bajo o intermedio, el médico hará una primera valoración y puede darle la anticoagulación. Para pacientes con riesgo alto, el equipo necesita ser preparado para activar los códigos y empezar la intervención endovascular. Entonces, Dra. Lendoiro nota la importancia de evaluar los marcadores de laboratorio y considerar las comorbilidades y calidad de vida de cada paciente. Dr. Ciampi añade que hay un riesgo alto de desarrollar hipotensión. Por eso, el paciente podría necesitar vasopresores y también una ecografía para evaluar la función del ventrículo derecho. Entonces, los doctores discuten las técnicas de la trombectomía endovascular. Dr. Ciampi explica que usa la vía femoral ante todo, pero los radiólogos intervencionistas deben usar la técnica con que tenían la mayor experiencia. Enfatiza la importancia de remover la mayor cantidad de trombo posible. Adicionalmente, Dra. Lendoiro explica la necesidad del monitoreo continuo del paciente debido al hecho de que el estatus del paciente puede cambiar de momento a momento. Hay muchas complicaciones posibles durante el procedimiento, como la presencia de materia oclusiva y perforación vascular, que pueden tener consecuencias fatales. También discuten los materiales que usan durante las trombectomias, incluso el uso de la máquina de ultrasonido. Finalmente, los doctores discuten cómo pueden educar al público y a las especialidades médicas sobre las embolias pulmonares. Dr. Ciampi recomienda a los estudiantes interesados en esta condición leer las pautas médicas y observar intervencionistas. Dra. Lendoiro las anima desarrollar buenas relaciones con colegas de especialidades diferentes para practicar trabajar en un grupo multidisciplinario. Fri, 24 Mar 2023 05:05:00 -0000 full BackTable En este episodio de BackTable VI, Dr. Pilar Bayona Molano, Dr. Juan Ciampi, y Dr. Sara Lojo Lendoiro discuten el manejo de embolia pulmonar para pacientes con niveles de riesgos diferentes. En este episodio de BackTable VI, Dr. Pilar Bayona Molano, Dr. Juan Ciampi, y Dr. Sara Lojo Lendoiro discuten el manejo de embolia pulmonar para pacientes con niveles de riesgos diferentes. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/CxjlQ7 --- SHOW NOTES Primero, Dr. Ciampi explica que un equipo multidisciplinario es más importante en el manejo del paciente con una embolia pulmonar. Si el paciente tiene un riesgo bajo o intermedio, el médico hará una primera valoración y puede darle la anticoagulación. Para pacientes con riesgo alto, el equipo necesita ser preparado para activar los códigos y empezar la intervención endovascular. Entonces, Dra. Lendoiro nota la importancia de evaluar los marcadores de laboratorio y considerar las comorbilidades y calidad de vida de cada paciente. Dr. Ciampi añade que hay un riesgo alto de desarrollar hipotensión. Por eso, el paciente podría necesitar vasopresores y también una ecografía para evaluar la función del ventrículo derecho. Entonces, los doctores discuten las técnicas de la trombectomía endovascular. Dr. Ciampi explica que usa la vía femoral ante todo, pero los radiólogos intervencionistas deben usar la técnica con que tenían la mayor experiencia. Enfatiza la importancia de remover la mayor cantidad de trombo posible. Adicionalmente, Dra. Lendoiro explica la necesidad del monitoreo continuo del paciente debido al hecho de que el estatus del paciente puede cambiar de momento a momento. Hay muchas complicaciones posibles durante el procedimiento, como la presencia de materia oclusiva y perforación vascular, que pueden tener consecuencias fatales. También discuten los materiales que usan durante las trombectomias, incluso el uso de la máquina de ultrasonido. Finalmente, los doctores discuten cómo pueden educar al público y a las especialidades médicas sobre las embolias pulmonares. Dr. Ciampi recomienda a los estudiantes interesados en esta condición leer las pautas médicas y observar intervencionistas. Dra. Lendoiro las anima desarrollar buenas relaciones con colegas de especialidades diferentes para practicar trabajar en un grupo multidisciplinario. En este episodio de BackTable VI, Dr. Pilar Bayona Molano, Dr. Juan Ciampi, y Dr. Sara Lojo Lendoiro discuten el manejo de embolia pulmonar para pacientes con niveles de riesgos diferentes.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/CxjlQ7


---


SHOW NOTES


Primero, Dr. Ciampi explica que un equipo multidisciplinario es más importante en el manejo del paciente con una embolia pulmonar. Si el paciente tiene un riesgo bajo o intermedio, el médico hará una primera valoración y puede darle la anticoagulación. Para pacientes con riesgo alto, el equipo necesita ser preparado para activar los códigos y empezar la intervención endovascular. Entonces, Dra. Lendoiro nota la importancia de evaluar los marcadores de laboratorio y considerar las comorbilidades y calidad de vida de cada paciente. Dr. Ciampi añade que hay un riesgo alto de desarrollar hipotensión. Por eso, el paciente podría necesitar vasopresores y también una ecografía para evaluar la función del ventrículo derecho.


Entonces, los doctores discuten las técnicas de la trombectomía endovascular. Dr. Ciampi explica que usa la vía femoral ante todo, pero los radiólogos intervencionistas deben usar la técnica con que tenían la mayor experiencia. Enfatiza la importancia de remover la mayor cantidad de trombo posible. Adicionalmente, Dra. Lendoiro explica la necesidad del monitoreo continuo del paciente debido al hecho de que el estatus del paciente puede cambiar de momento a momento. Hay muchas complicaciones posibles durante el procedimiento, como la presencia de materia oclusiva y perforación vascular, que pueden tener consecuencias fatales. También discuten los materiales que usan durante las trombectomias, incluso el uso de la máquina de ultrasonido.


Finalmente, los doctores discuten cómo pueden educar al público y a las especialidades médicas sobre las embolias pulmonares. Dr. Ciampi recomienda a los estudiantes interesados en esta condición leer las pautas médicas y observar intervencionistas. Dra. Lendoiro las anima desarrollar buenas relaciones con colegas de especialidades diferentes para practicar trabajar en un grupo multidisciplinario.

]]> 2070 Ep. 303 Why Do I Need a Physician Coach? with Dr. Elsie Koh In this episode, host Dr. Aaron Fritts interviews Dr. Elsie Koh about physician coaching and leadership training, including the difference between mentorship and coaching, how to break through common barriers, and how to empower yourself to realize your potential. --- CHECK OUT OUR SPONSORS Medtronic AV DCB https://www.medtronic.com/avdata Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Elsie Koh is an interventional radiologist and founder of Lead Physician, a physician specific coaching company. She trained in coaching at the Proctor Gallagher Institute (PGI), the International Coaching Federation (ICF), and received an Executive Master in Healthcare Leadership at Brown University. After working for only two years out of fellowship, she became the medical director of a surgery center. She had no experience in leadership, and due to her own insecurity and modeling after what she had seen in her medical training, she failed at this position. She was given feedback at a work event, which changed the trajectory of her career. After this occurred, she began reading self-help and personal development books. She sought out the PGI institute, and ended up training in their program to become a coach. Through this difficult experience, she realized other physicians could benefit from this type of guidance. Next, Dr. Koh explains the difference between mentorship and coaching. Mentorship is having someone tell you what to do, or modeling a behavior or career path that you want to emulate. Coaching allows a person to discover more of themselves, become aware of their blind spots, and learn what makes them unique. We discuss some of the most common barriers she sees among physicians that prevent them from seeking out coaching. She believes many hesitate because they don’t believe it will work for them. Many physicians simply don’t know what coaching involves and what their goals should be. Sometimes cost is prohibitive, mostly due to the fact that people are not used to investing in themselves in this way. Many physicians lack the confidence to admit they don’t know how to do something, such as start a company or be a successful leader. At Lead Physician, they have the advantage of only coaching physicians, which helps clients let their guard down, because they are around like-minded thinkers. Dr. Koh likes group coaching sessions because it allows people to build off each other's inspiration, and yields greater idea sharing than one-on-one sessions. --- RESOURCES Ep. 194: Financial Basics from the White Coat Investor https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor BackTable Innovation Ep 27: Physician Underdog https://www.backtable.com/shows/innovation/podcasts/27/physician-underdog Contact Dr. Elsie Koh: info@drelsiekoh.com Lead Physician: https://www.leadphysician.org Elsie Koh TED Talk: https://www.youtube.com/watch?v=hX19-7VRRfI Mon, 20 Mar 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Elsie Koh about physician coaching and leadership training, including the difference between mentorship and coaching, how to break through common barriers, and how to empower yourself to realize your potential. In this episode, host Dr. Aaron Fritts interviews Dr. Elsie Koh about physician coaching and leadership training, including the difference between mentorship and coaching, how to break through common barriers, and how to empower yourself to realize your potential. --- CHECK OUT OUR SPONSORS Medtronic AV DCB https://www.medtronic.com/avdata Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Elsie Koh is an interventional radiologist and founder of Lead Physician, a physician specific coaching company. She trained in coaching at the Proctor Gallagher Institute (PGI), the International Coaching Federation (ICF), and received an Executive Master in Healthcare Leadership at Brown University. After working for only two years out of fellowship, she became the medical director of a surgery center. She had no experience in leadership, and due to her own insecurity and modeling after what she had seen in her medical training, she failed at this position. She was given feedback at a work event, which changed the trajectory of her career. After this occurred, she began reading self-help and personal development books. She sought out the PGI institute, and ended up training in their program to become a coach. Through this difficult experience, she realized other physicians could benefit from this type of guidance. Next, Dr. Koh explains the difference between mentorship and coaching. Mentorship is having someone tell you what to do, or modeling a behavior or career path that you want to emulate. Coaching allows a person to discover more of themselves, become aware of their blind spots, and learn what makes them unique. We discuss some of the most common barriers she sees among physicians that prevent them from seeking out coaching. She believes many hesitate because they don’t believe it will work for them. Many physicians simply don’t know what coaching involves and what their goals should be. Sometimes cost is prohibitive, mostly due to the fact that people are not used to investing in themselves in this way. Many physicians lack the confidence to admit they don’t know how to do something, such as start a company or be a successful leader. At Lead Physician, they have the advantage of only coaching physicians, which helps clients let their guard down, because they are around like-minded thinkers. Dr. Koh likes group coaching sessions because it allows people to build off each other's inspiration, and yields greater idea sharing than one-on-one sessions. --- RESOURCES Ep. 194: Financial Basics from the White Coat Investor https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor BackTable Innovation Ep 27: Physician Underdog https://www.backtable.com/shows/innovation/podcasts/27/physician-underdog Contact Dr. Elsie Koh: info@drelsiekoh.com Lead Physician: https://www.leadphysician.org Elsie Koh TED Talk: https://www.youtube.com/watch?v=hX19-7VRRfI In this episode, host Dr. Aaron Fritts interviews Dr. Elsie Koh about physician coaching and leadership training, including the difference between mentorship and coaching, how to break through common barriers, and how to empower yourself to realize your potential.


---


CHECK OUT OUR SPONSORS


Medtronic AV DCB

https://www.medtronic.com/avdata


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. Elsie Koh is an interventional radiologist and founder of Lead Physician, a physician specific coaching company. She trained in coaching at the Proctor Gallagher Institute (PGI), the International Coaching Federation (ICF), and received an Executive Master in Healthcare Leadership at Brown University. After working for only two years out of fellowship, she became the medical director of a surgery center. She had no experience in leadership, and due to her own insecurity and modeling after what she had seen in her medical training, she failed at this position. She was given feedback at a work event, which changed the trajectory of her career.


After this occurred, she began reading self-help and personal development books. She sought out the PGI institute, and ended up training in their program to become a coach. Through this difficult experience, she realized other physicians could benefit from this type of guidance. Next, Dr. Koh explains the difference between mentorship and coaching. Mentorship is having someone tell you what to do, or modeling a behavior or career path that you want to emulate. Coaching allows a person to discover more of themselves, become aware of their blind spots, and learn what makes them unique.


We discuss some of the most common barriers she sees among physicians that prevent them from seeking out coaching. She believes many hesitate because they don’t believe it will work for them. Many physicians simply don’t know what coaching involves and what their goals should be. Sometimes cost is prohibitive, mostly due to the fact that people are not used to investing in themselves in this way. Many physicians lack the confidence to admit they don’t know how to do something, such as start a company or be a successful leader. At Lead Physician, they have the advantage of only coaching physicians, which helps clients let their guard down, because they are around like-minded thinkers. Dr. Koh likes group coaching sessions because it allows people to build off each other's inspiration, and yields greater idea sharing than one-on-one sessions.


---


RESOURCES


Ep. 194: Financial Basics from the White Coat Investor

https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor


BackTable Innovation Ep 27: Physician Underdog

https://www.backtable.com/shows/innovation/podcasts/27/physician-underdog


Contact Dr. Elsie Koh:

info@drelsiekoh.com


Lead Physician:

https://www.leadphysician.org


Elsie Koh TED Talk:

https://www.youtube.com/watch?v=hX19-7VRRfI

]]> 2162 Ep. 302 Treating Cerebral Aneurysms with Dr. Aaron Bress In this episode, neurointerventional radiologists Dr. Sabeen Dhand and Aaron Bress discuss treatment decisions and devices used in the endovascular treatment of cerebral aneurysms. --- CHECK OUT OUR SPONSORS MicroVention FRED X https://www.microvention.com/emea/product/fred-x RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- SHOW NOTES Dr. Bress starts by describing the patient selection process for treatment of ruptured and unruptured aneurysms, which involves collaboration with critical care and neurosurgery teams. CTA is needed for evaluation of the quality and location of the aneurysm. He notes that it is important to check for parenchymal hemorrhage and mass effects since this warrants further consultation with neurosurgery. Generally, his practice will treat an unruptured aneurysm if it is 4mm or larger. The decision to treat also depends on the patient’s preferences and their personal evaluations of the risks regarding non-treatment as well as risks of intervention. The major complications of interventions on unruptured aneurysms include rupture and stroke, which can range in severity. Other complications include aneurysm enlargement due to compaction of coils into the sac and introduction of thrombus into the parent vessel. To prevent this, Dr. Bress administers intraprocedural heparin and and prescribes antiplatelet agents. Dr. Bress emphasizes that complications are inevitable and it is important for IRs to develop this mindset while also taking ownership of outcomes and building rapport with patients. Next, we discuss new endovascular technology and techniques used in the treatment of aneurysms. These include the use of flow diverters, stent or balloon-assisted coiling, and Woven EndoBridge (WEB). Each tool can be used based on different indications, and it is this creative problem solving that keeps Dr. Dhand and Dr. Bress engaged in the field. Finally, the doctors present different pathways that trainees can use to enter the endovascular neurointerventional space. They can start from neurosurgery, neuroradiology, and neurology and go on to pursue further training. --- RESOURCES Rapid AI: https://www.rapidai.com/stroke Viz.ai: https://www.viz.ai/ Fri, 17 Mar 2023 05:05:00 -0000 full BackTable In this episode, neurointerventional radiologists Dr. Sabeen Dhand and Aaron Bress discuss treatment decisions and devices used in the endovascular treatment of cerebral aneurysms. In this episode, neurointerventional radiologists Dr. Sabeen Dhand and Aaron Bress discuss treatment decisions and devices used in the endovascular treatment of cerebral aneurysms. --- CHECK OUT OUR SPONSORS MicroVention FRED X https://www.microvention.com/emea/product/fred-x RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- SHOW NOTES Dr. Bress starts by describing the patient selection process for treatment of ruptured and unruptured aneurysms, which involves collaboration with critical care and neurosurgery teams. CTA is needed for evaluation of the quality and location of the aneurysm. He notes that it is important to check for parenchymal hemorrhage and mass effects since this warrants further consultation with neurosurgery. Generally, his practice will treat an unruptured aneurysm if it is 4mm or larger. The decision to treat also depends on the patient’s preferences and their personal evaluations of the risks regarding non-treatment as well as risks of intervention. The major complications of interventions on unruptured aneurysms include rupture and stroke, which can range in severity. Other complications include aneurysm enlargement due to compaction of coils into the sac and introduction of thrombus into the parent vessel. To prevent this, Dr. Bress administers intraprocedural heparin and and prescribes antiplatelet agents. Dr. Bress emphasizes that complications are inevitable and it is important for IRs to develop this mindset while also taking ownership of outcomes and building rapport with patients. Next, we discuss new endovascular technology and techniques used in the treatment of aneurysms. These include the use of flow diverters, stent or balloon-assisted coiling, and Woven EndoBridge (WEB). Each tool can be used based on different indications, and it is this creative problem solving that keeps Dr. Dhand and Dr. Bress engaged in the field. Finally, the doctors present different pathways that trainees can use to enter the endovascular neurointerventional space. They can start from neurosurgery, neuroradiology, and neurology and go on to pursue further training. --- RESOURCES Rapid AI: https://www.rapidai.com/stroke Viz.ai: https://www.viz.ai/ In this episode, neurointerventional radiologists Dr. Sabeen Dhand and Aaron Bress discuss treatment decisions and devices used in the endovascular treatment of cerebral aneurysms.


---


CHECK OUT OUR SPONSORS


MicroVention FRED X

https://www.microvention.com/emea/product/fred-x


RapidAI

http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor


---


SHOW NOTES


Dr. Bress starts by describing the patient selection process for treatment of ruptured and unruptured aneurysms, which involves collaboration with critical care and neurosurgery teams. CTA is needed for evaluation of the quality and location of the aneurysm. He notes that it is important to check for parenchymal hemorrhage and mass effects since this warrants further consultation with neurosurgery. Generally, his practice will treat an unruptured aneurysm if it is 4mm or larger. The decision to treat also depends on the patient’s preferences and their personal evaluations of the risks regarding non-treatment as well as risks of intervention.


The major complications of interventions on unruptured aneurysms include rupture and stroke, which can range in severity. Other complications include aneurysm enlargement due to compaction of coils into the sac and introduction of thrombus into the parent vessel. To prevent this, Dr. Bress administers intraprocedural heparin and and prescribes antiplatelet agents. Dr. Bress emphasizes that complications are inevitable and it is important for IRs to develop this mindset while also taking ownership of outcomes and building rapport with patients.


Next, we discuss new endovascular technology and techniques used in the treatment of aneurysms. These include the use of flow diverters, stent or balloon-assisted coiling, and Woven EndoBridge (WEB). Each tool can be used based on different indications, and it is this creative problem solving that keeps Dr. Dhand and Dr. Bress engaged in the field.


Finally, the doctors present different pathways that trainees can use to enter the endovascular neurointerventional space. They can start from neurosurgery, neuroradiology, and neurology and go on to pursue further training.


---


RESOURCES


Rapid AI:

https://www.rapidai.com/stroke


Viz.ai:

https://www.viz.ai/

]]> 2254 Ep. 301 New Technologies for Treatment of Cerebral Aneurysms with Dr. David Altschul and Dr. Omar Tanweer In this episode, host Dr. Sabeen Dhand speaks with neurosurgeons Drs. David Altschul and Omar Tanweer about updates on cerebral aneurysms, including device innovation, risk stratification, and the importance of the doctor-patient relationship in decision-making. --- CHECK OUT OUR SPONSOR MicroVention FRED X https://www.microvention.com/emea/product/fred-x --- SHOW NOTES Dr. Omar Tanweer is the director of cerebrovascular and endovascular neurosurgery at Baylor College of Medicine. He works in a multidisciplinary group of neurologists, radiologists, and neurosurgeons. He trained at NYU and has been at Baylor for 2 years, where he does 100% neurovascular work. Dr. David Altschul is also from New York and is the division chief of neurovascular surgery at Montefiore. He completed an endovascular fellowship in Manhattan and has now been back at Monteriore since 2014. Both physicians have an 80 to 20 endovascular to open case ratio. In the case of ruptured cerebral aneurysms, Dr. Altschul describes a rule of threes. Around one third of patients pass away before reaching a hospital, another third arrive with significant neurologic deficits, the final third simply endure a headache. The severity of symptoms on presentation is generally predictive of outcome. They use the Hunt and Hess score, as well as the Modified Fisher Scale in their workup. They will generally only put in a ventriculostomy if a patient is lethargic and has a Hunt and Hess grade of at least 3. Both physicians use viz.ai to review their aneurysm cases at their home institutions, as well as at all local referring hospitals, as they are all connected via the viz platform. For unruptured aneurysms, they implement the PHASES score and rely on patient preference. Some patients are comfortable monitoring the growth of very small aneurysms, while others prefer the risk of treating it over the risk of monitoring due to the fear of having a known aneurysm. The two agree that developing a good doctor-patient relationship is important in these cases, because getting to know your patient can help you decide which of these small aneurysms to treat. Finally, we discuss new technology in the treatment of cerebral aneurysms. Coils have improved by becoming smaller, containing biologic agents, and coming in different shapes. Dr. Tanweer discusses the difference between balloon and stent assisted techniques. Balloon assisted is great for wide neck aneurysms or patients who can’t be on dual anti-platelet therapy (DAPT) and are better in the case of re-rupture. Stent assisted, when tolerated, increases efficacy and reduces recurrence by keeping coils in place, as well as providing a scaffold for endothelial cells to heal across. The Flow Diverter, a vessel preservation device, is less porous and good for internal carotid and anterior circulation aneurysms. The downside is that it requires DAPT. There is also the Web device, an intrasaccular device that diverts flow across the metal in the aneurysm and at the base of the neck, but does not leave any metal in the normal part of the artery. These are mainly used for wide neck bifurcation aneurysms at the internal carotid, basilar, anterior communicating, and middle cerebral artery bifurcations. --- RESOURCES Twitter: @DavidAltschulMD @omar_tanweer Viz.aneurysm: https://www.viz.ai/aneurysm Mon, 13 Mar 2023 05:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand speaks with neurosurgeons Drs. David Altschul and Omar Tanweer about updates on cerebral aneurysms, including device innovation, risk stratification, and the importance of the doctor-patient relationship in decision-making. In this episode, host Dr. Sabeen Dhand speaks with neurosurgeons Drs. David Altschul and Omar Tanweer about updates on cerebral aneurysms, including device innovation, risk stratification, and the importance of the doctor-patient relationship in decision-making. --- CHECK OUT OUR SPONSOR MicroVention FRED X https://www.microvention.com/emea/product/fred-x --- SHOW NOTES Dr. Omar Tanweer is the director of cerebrovascular and endovascular neurosurgery at Baylor College of Medicine. He works in a multidisciplinary group of neurologists, radiologists, and neurosurgeons. He trained at NYU and has been at Baylor for 2 years, where he does 100% neurovascular work. Dr. David Altschul is also from New York and is the division chief of neurovascular surgery at Montefiore. He completed an endovascular fellowship in Manhattan and has now been back at Monteriore since 2014. Both physicians have an 80 to 20 endovascular to open case ratio. In the case of ruptured cerebral aneurysms, Dr. Altschul describes a rule of threes. Around one third of patients pass away before reaching a hospital, another third arrive with significant neurologic deficits, the final third simply endure a headache. The severity of symptoms on presentation is generally predictive of outcome. They use the Hunt and Hess score, as well as the Modified Fisher Scale in their workup. They will generally only put in a ventriculostomy if a patient is lethargic and has a Hunt and Hess grade of at least 3. Both physicians use viz.ai to review their aneurysm cases at their home institutions, as well as at all local referring hospitals, as they are all connected via the viz platform. For unruptured aneurysms, they implement the PHASES score and rely on patient preference. Some patients are comfortable monitoring the growth of very small aneurysms, while others prefer the risk of treating it over the risk of monitoring due to the fear of having a known aneurysm. The two agree that developing a good doctor-patient relationship is important in these cases, because getting to know your patient can help you decide which of these small aneurysms to treat. Finally, we discuss new technology in the treatment of cerebral aneurysms. Coils have improved by becoming smaller, containing biologic agents, and coming in different shapes. Dr. Tanweer discusses the difference between balloon and stent assisted techniques. Balloon assisted is great for wide neck aneurysms or patients who can’t be on dual anti-platelet therapy (DAPT) and are better in the case of re-rupture. Stent assisted, when tolerated, increases efficacy and reduces recurrence by keeping coils in place, as well as providing a scaffold for endothelial cells to heal across. The Flow Diverter, a vessel preservation device, is less porous and good for internal carotid and anterior circulation aneurysms. The downside is that it requires DAPT. There is also the Web device, an intrasaccular device that diverts flow across the metal in the aneurysm and at the base of the neck, but does not leave any metal in the normal part of the artery. These are mainly used for wide neck bifurcation aneurysms at the internal carotid, basilar, anterior communicating, and middle cerebral artery bifurcations. --- RESOURCES Twitter: @DavidAltschulMD @omar_tanweer Viz.aneurysm: https://www.viz.ai/aneurysm In this episode, host Dr. Sabeen Dhand speaks with neurosurgeons Drs. David Altschul and Omar Tanweer about updates on cerebral aneurysms, including device innovation, risk stratification, and the importance of the doctor-patient relationship in decision-making.


---


CHECK OUT OUR SPONSOR


MicroVention FRED X

https://www.microvention.com/emea/product/fred-x


---


SHOW NOTES


Dr. Omar Tanweer is the director of cerebrovascular and endovascular neurosurgery at Baylor College of Medicine. He works in a multidisciplinary group of neurologists, radiologists, and neurosurgeons. He trained at NYU and has been at Baylor for 2 years, where he does 100% neurovascular work. Dr. David Altschul is also from New York and is the division chief of neurovascular surgery at Montefiore. He completed an endovascular fellowship in Manhattan and has now been back at Monteriore since 2014. Both physicians have an 80 to 20 endovascular to open case ratio.


In the case of ruptured cerebral aneurysms, Dr. Altschul describes a rule of threes. Around one third of patients pass away before reaching a hospital, another third arrive with significant neurologic deficits, the final third simply endure a headache. The severity of symptoms on presentation is generally predictive of outcome. They use the Hunt and Hess score, as well as the Modified Fisher Scale in their workup. They will generally only put in a ventriculostomy if a patient is lethargic and has a Hunt and Hess grade of at least 3. Both physicians use viz.ai to review their aneurysm cases at their home institutions, as well as at all local referring hospitals, as they are all connected via the viz platform. For unruptured aneurysms, they implement the PHASES score and rely on patient preference. Some patients are comfortable monitoring the growth of very small aneurysms, while others prefer the risk of treating it over the risk of monitoring due to the fear of having a known aneurysm. The two agree that developing a good doctor-patient relationship is important in these cases, because getting to know your patient can help you decide which of these small aneurysms to treat.


Finally, we discuss new technology in the treatment of cerebral aneurysms. Coils have improved by becoming smaller, containing biologic agents, and coming in different shapes. Dr. Tanweer discusses the difference between balloon and stent assisted techniques. Balloon assisted is great for wide neck aneurysms or patients who can’t be on dual anti-platelet therapy (DAPT) and are better in the case of re-rupture. Stent assisted, when tolerated, increases efficacy and reduces recurrence by keeping coils in place, as well as providing a scaffold for endothelial cells to heal across. The Flow Diverter, a vessel preservation device, is less porous and good for internal carotid and anterior circulation aneurysms. The downside is that it requires DAPT. There is also the Web device, an intrasaccular device that diverts flow across the metal in the aneurysm and at the base of the neck, but does not leave any metal in the normal part of the artery. These are mainly used for wide neck bifurcation aneurysms at the internal carotid, basilar, anterior communicating, and middle cerebral artery bifurcations.


---


RESOURCES


Twitter:

@DavidAltschulMD

@omar_tanweer


Viz.aneurysm:

https://www.viz.ai/aneurysm

]]> 2400 Ep. 300 Which Medical Device, a Tool to Help you Choose with Dr. Philip Haslam In this episode, co-hosts Dr. Aaron Fritts and Dr. Diana Velazquez-Pimentel interview Dr. Phil Haslam, founder of Which Medical Device and current president of BSIR, about the process of creating a resource bank of medical devices that spans multiple specialties. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SfFu13 --- SHOW NOTES Dr. Haslam began his career as a clinician in medicine, but always knew he wanted to do radiology, specifically interventional radiology. In the UK, you have to train in either medicine or surgery before subspecialty training. He had been an IR consultant for around 8 years when he suddenly couldn’t find the right t-fasteners for a gastrostomy tube placement. He searched the internet for alternatives, but realized it was very cumbersome to complete such a search. Around this same time, he was getting into photography and frequented the website DP Review, which was a way to browse different lenses and parts for cameras, with ratings and information about the pieces. Inspired by this website, he thought a similar website for IR devices would be helpful to clinicians who practice in different environments and are required to know different devices. He began by finding a local web developer and used his own money to pay for the initial website development. He then began loading products he had used, specifically devices he liked or didn’t like. He started telling colleagues about the website, and the word spread fast. What he found difficult was not traction to the website, but getting members to contribute to content, such as writing device ratings or uploading instructional videos. After a couple years, he decided to branch outside of IR into other device heavy specialties like cardiothoracics and orthopedics. He asked colleagues from other specialties to contribute as editors. Dr. Haslam believes the high traction in the IR device section is due to his frequent attendance of conferences, as well as his relationships with industry. Finally, we discuss future goals for Which Medical Device. Dr. Haslam hopes to upload more instructional videos to the website and the YouTube page. Additionally, he plans to bolster his editorial board to include even more specialties. He encourages people to engage by suggesting new devices for the website; they can do so via the home page of the website. He will add more in-depth reviews and device comparisons, as well as launch a device of the month column. --- RESOURCES Website: https://www.whichmedicaldevice.com YouTube Channel: https://www.youtube.com/channel/UCYnn3mCZGfgbUJmmehopcnw Email: phil@whichmedicaldevice.com British Society of Interventional Radiology: https://www.bsir.org Fri, 10 Mar 2023 06:05:00 -0000 full BackTable In this episode, co-hosts Dr. Aaron Fritts and Dr. Diana Velazquez-Pimentel interview Dr. Phil Haslam, founder of Which Medical Device and current president of BSIR, about the process of creating a resource bank of medical devices that spans multiple specialties. In this episode, co-hosts Dr. Aaron Fritts and Dr. Diana Velazquez-Pimentel interview Dr. Phil Haslam, founder of Which Medical Device and current president of BSIR, about the process of creating a resource bank of medical devices that spans multiple specialties. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SfFu13 --- SHOW NOTES Dr. Haslam began his career as a clinician in medicine, but always knew he wanted to do radiology, specifically interventional radiology. In the UK, you have to train in either medicine or surgery before subspecialty training. He had been an IR consultant for around 8 years when he suddenly couldn’t find the right t-fasteners for a gastrostomy tube placement. He searched the internet for alternatives, but realized it was very cumbersome to complete such a search. Around this same time, he was getting into photography and frequented the website DP Review, which was a way to browse different lenses and parts for cameras, with ratings and information about the pieces. Inspired by this website, he thought a similar website for IR devices would be helpful to clinicians who practice in different environments and are required to know different devices. He began by finding a local web developer and used his own money to pay for the initial website development. He then began loading products he had used, specifically devices he liked or didn’t like. He started telling colleagues about the website, and the word spread fast. What he found difficult was not traction to the website, but getting members to contribute to content, such as writing device ratings or uploading instructional videos. After a couple years, he decided to branch outside of IR into other device heavy specialties like cardiothoracics and orthopedics. He asked colleagues from other specialties to contribute as editors. Dr. Haslam believes the high traction in the IR device section is due to his frequent attendance of conferences, as well as his relationships with industry. Finally, we discuss future goals for Which Medical Device. Dr. Haslam hopes to upload more instructional videos to the website and the YouTube page. Additionally, he plans to bolster his editorial board to include even more specialties. He encourages people to engage by suggesting new devices for the website; they can do so via the home page of the website. He will add more in-depth reviews and device comparisons, as well as launch a device of the month column. --- RESOURCES Website: https://www.whichmedicaldevice.com YouTube Channel: https://www.youtube.com/channel/UCYnn3mCZGfgbUJmmehopcnw Email: phil@whichmedicaldevice.com British Society of Interventional Radiology: https://www.bsir.org In this episode, co-hosts Dr. Aaron Fritts and Dr. Diana Velazquez-Pimentel interview Dr. Phil Haslam, founder of Which Medical Device and current president of BSIR, about the process of creating a resource bank of medical devices that spans multiple specialties.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/SfFu13


---


SHOW NOTES


Dr. Haslam began his career as a clinician in medicine, but always knew he wanted to do radiology, specifically interventional radiology. In the UK, you have to train in either medicine or surgery before subspecialty training. He had been an IR consultant for around 8 years when he suddenly couldn’t find the right t-fasteners for a gastrostomy tube placement. He searched the internet for alternatives, but realized it was very cumbersome to complete such a search. Around this same time, he was getting into photography and frequented the website DP Review, which was a way to browse different lenses and parts for cameras, with ratings and information about the pieces. Inspired by this website, he thought a similar website for IR devices would be helpful to clinicians who practice in different environments and are required to know different devices.


He began by finding a local web developer and used his own money to pay for the initial website development. He then began loading products he had used, specifically devices he liked or didn’t like. He started telling colleagues about the website, and the word spread fast. What he found difficult was not traction to the website, but getting members to contribute to content, such as writing device ratings or uploading instructional videos. After a couple years, he decided to branch outside of IR into other device heavy specialties like cardiothoracics and orthopedics. He asked colleagues from other specialties to contribute as editors. Dr. Haslam believes the high traction in the IR device section is due to his frequent attendance of conferences, as well as his relationships with industry.


Finally, we discuss future goals for Which Medical Device. Dr. Haslam hopes to upload more instructional videos to the website and the YouTube page. Additionally, he plans to bolster his editorial board to include even more specialties. He encourages people to engage by suggesting new devices for the website; they can do so via the home page of the website. He will add more in-depth reviews and device comparisons, as well as launch a device of the month column.


---


RESOURCES


Website:

https://www.whichmedicaldevice.com


YouTube Channel:

https://www.youtube.com/channel/UCYnn3mCZGfgbUJmmehopcnw


Email:

phil@whichmedicaldevice.com


British Society of Interventional Radiology:

https://www.bsir.org

]]> 2494 Ep. 299 Robotics in Interventional Oncology with Lucien Blondel In this episode, host Aaron Fritts interviews engineer Lucien Blondel, co-founder and CTO of Quantum Surgical. We discuss robotic applications for interventional oncology procedures and the Epione robot’s impacts on workflow and accuracy. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Lucien first started innovating with robotics in the orthopedics, then neurosurgery fields. He has worked in startups and large corporations. Now, he is focused on interventional oncology. The catalyst for his idea came when his former startup was acquired. Lucien chose to create a company with three other co-founders and then explore. Quantum Surgical’s mission is to democratize minimally invasive cancer treatment through pre-planning, advanced robotic assistance, and tumor ablation confirmation. Lucien started by obtaining the broad vision of the market. He noticed a clear unmet need: There was a proven clinical technique, but outcomes were very operator-dependent. Quantum Surgical’s Epione robot could help alleviate this gap. Higher accuracy can lead to decreased invasiveness and more patient comfort in the outpatient setting. The first application for Quantum Surgical was pre planning software for interventional oncology procedures. He noticed that operators had difficulty visualizing masses for ablation. The robotic image vision software allows merging of CT and MRI images. Additionally, it can provide 3D modeling of ablation zones, map out needle trajectories, and confirm ablation by comparing pre-procedure and post-procedure imaging. Lucien emphasizes that the Epione robot can provide multiple functionalities for the same procedure, reducing the need to utilize different devices. The built-in features are programmed to adjust to patient movements and allow the physician to choose the safest path for needle placement. Finally, we discuss implications of robotics for workflow. Doctors can be more efficient in reviewing images, placing needles, and confirming ablation zones. Epione also reduces the need to obtain images during the procedure. At the moment, Epione is primarily focused on ablation of liver and kidney tumors. However, Lucien envisions the technology expanding to tumor biopsies, especially those that are located in high risk areas. Quantum Surgical is also looking into machine learning and prediction of local tumor progression. --- RESOURCES Quantum Surgical: https://www.quantumsurgical.com/epione/ Less Invasive Podcast: https://podcasts.apple.com/us/podcast/less-invasive/id1604673690 ROSA One Robot: https://www.zimmerbiomet.com/en/products-and-solutions/zb-edge/robotics/rosa-brain.html Wed, 08 Mar 2023 06:05:00 -0000 full BackTable In this episode, host Aaron Fritts interviews engineer Lucien Blondel, co-founder and CTO of Quantum Surgical. We discuss robotic applications for interventional oncology procedures and the Epione robot’s impacts on workflow and accuracy. In this episode, host Aaron Fritts interviews engineer Lucien Blondel, co-founder and CTO of Quantum Surgical. We discuss robotic applications for interventional oncology procedures and the Epione robot’s impacts on workflow and accuracy. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Lucien first started innovating with robotics in the orthopedics, then neurosurgery fields. He has worked in startups and large corporations. Now, he is focused on interventional oncology. The catalyst for his idea came when his former startup was acquired. Lucien chose to create a company with three other co-founders and then explore. Quantum Surgical’s mission is to democratize minimally invasive cancer treatment through pre-planning, advanced robotic assistance, and tumor ablation confirmation. Lucien started by obtaining the broad vision of the market. He noticed a clear unmet need: There was a proven clinical technique, but outcomes were very operator-dependent. Quantum Surgical’s Epione robot could help alleviate this gap. Higher accuracy can lead to decreased invasiveness and more patient comfort in the outpatient setting. The first application for Quantum Surgical was pre planning software for interventional oncology procedures. He noticed that operators had difficulty visualizing masses for ablation. The robotic image vision software allows merging of CT and MRI images. Additionally, it can provide 3D modeling of ablation zones, map out needle trajectories, and confirm ablation by comparing pre-procedure and post-procedure imaging. Lucien emphasizes that the Epione robot can provide multiple functionalities for the same procedure, reducing the need to utilize different devices. The built-in features are programmed to adjust to patient movements and allow the physician to choose the safest path for needle placement. Finally, we discuss implications of robotics for workflow. Doctors can be more efficient in reviewing images, placing needles, and confirming ablation zones. Epione also reduces the need to obtain images during the procedure. At the moment, Epione is primarily focused on ablation of liver and kidney tumors. However, Lucien envisions the technology expanding to tumor biopsies, especially those that are located in high risk areas. Quantum Surgical is also looking into machine learning and prediction of local tumor progression. --- RESOURCES Quantum Surgical: https://www.quantumsurgical.com/epione/ Less Invasive Podcast: https://podcasts.apple.com/us/podcast/less-invasive/id1604673690 ROSA One Robot: https://www.zimmerbiomet.com/en/products-and-solutions/zb-edge/robotics/rosa-brain.html In this episode, host Aaron Fritts interviews engineer Lucien Blondel, co-founder and CTO of Quantum Surgical. We discuss robotic applications for interventional oncology procedures and the Epione robot’s impacts on workflow and accuracy.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Lucien first started innovating with robotics in the orthopedics, then neurosurgery fields. He has worked in startups and large corporations. Now, he is focused on interventional oncology. The catalyst for his idea came when his former startup was acquired. Lucien chose to create a company with three other co-founders and then explore. Quantum Surgical’s mission is to democratize minimally invasive cancer treatment through pre-planning, advanced robotic assistance, and tumor ablation confirmation. Lucien started by obtaining the broad vision of the market. He noticed a clear unmet need: There was a proven clinical technique, but outcomes were very operator-dependent. Quantum Surgical’s Epione robot could help alleviate this gap. Higher accuracy can lead to decreased invasiveness and more patient comfort in the outpatient setting.


The first application for Quantum Surgical was pre planning software for interventional oncology procedures. He noticed that operators had difficulty visualizing masses for ablation. The robotic image vision software allows merging of CT and MRI images. Additionally, it can provide 3D modeling of ablation zones, map out needle trajectories, and confirm ablation by comparing pre-procedure and post-procedure imaging. Lucien emphasizes that the Epione robot can provide multiple functionalities for the same procedure, reducing the need to utilize different devices. The built-in features are programmed to adjust to patient movements and allow the physician to choose the safest path for needle placement.


Finally, we discuss implications of robotics for workflow. Doctors can be more efficient in reviewing images, placing needles, and confirming ablation zones. Epione also reduces the need to obtain images during the procedure. At the moment, Epione is primarily focused on ablation of liver and kidney tumors. However, Lucien envisions the technology expanding to tumor biopsies, especially those that are located in high risk areas. Quantum Surgical is also looking into machine learning and prediction of local tumor progression.


---


RESOURCES


Quantum Surgical:

https://www.quantumsurgical.com/epione/


Less Invasive Podcast:

https://podcasts.apple.com/us/podcast/less-invasive/id1604673690


ROSA One Robot:

https://www.zimmerbiomet.com/en/products-and-solutions/zb-edge/robotics/rosa-brain.html

]]> 2781 Ep. 298 New Innovations in the Treatment of PE: The Flow Medical Story with Founders Dr. Osman Ahmed and Dr. Jonathan Paul In this episode, host Dr. Aaron Fritts interviews FLOW Medical cofounders Dr. Osman Ahmed and Dr. Jonathan Paul about how they built a company with the goal of designing a data-driven thrombolytic device that can deliver personalized care for patients with pulmonary embolism. --- CHECK OUT OUR SPONSOR RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/KikSeM --- SHOW NOTES Dr. Paul, interventional cardiologist, begins by explaining how he and Dr. Ahmed, interventional radiologist, came to work together. Dr. Ahmed came to the University of Chicago shortly after Dr. Paul started a pulmonary embolism response team (PERT) program. Dr. Ahmed, through his IR training, had experience with PE/VTE. They met and decided to combine their knowledge to build the program together. They both saw a need for new catheter directed thrombolytic (CDT) devices in their respective fields. The landscape of thrombectomy device innovation was booming, but they did not see the same innovation happening for CDT. After they both received the COVID vaccine, they were eating at Panera and drew out the idea for their device on a napkin. Neither of them had prior engineering experience and didn’t know how to proceed after this, so they relied on the University of Chicago’s entrepreneurial programs as a starting place. They then did market research and used their own internal research funding to subcontract with an engineering firm. They have been working on the design prototype since, and are conducting animal studies to trial the device. Once they reach design freeze, they will start the regulatory process and NIH 510(k) submission. They also have an NIH SBIR grant for small businesses doing innovative research. They plan to have the device on market in mid 2024. The goal for their device is to make it a catheter that can provide real-time feedback to minimize the complications of both too little or too much thrombolytic therapy. They are installing a sensor on the device that displays how much of the clot is lysed and allows for personalized PE treatment. They hope to incorporate AI into their data management, which they will use to tailor treatment in future patients. --- RESOURCES FLOW Medical: https://www.flowmedical.co Mon, 06 Mar 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews FLOW Medical cofounders Dr. Osman Ahmed and Dr. Jonathan Paul about how they built a company with the goal of designing a data-driven thrombolytic device that can deliver personalized care for patients with pulmonary embolism. In this episode, host Dr. Aaron Fritts interviews FLOW Medical cofounders Dr. Osman Ahmed and Dr. Jonathan Paul about how they built a company with the goal of designing a data-driven thrombolytic device that can deliver personalized care for patients with pulmonary embolism. --- CHECK OUT OUR SPONSOR RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/KikSeM --- SHOW NOTES Dr. Paul, interventional cardiologist, begins by explaining how he and Dr. Ahmed, interventional radiologist, came to work together. Dr. Ahmed came to the University of Chicago shortly after Dr. Paul started a pulmonary embolism response team (PERT) program. Dr. Ahmed, through his IR training, had experience with PE/VTE. They met and decided to combine their knowledge to build the program together. They both saw a need for new catheter directed thrombolytic (CDT) devices in their respective fields. The landscape of thrombectomy device innovation was booming, but they did not see the same innovation happening for CDT. After they both received the COVID vaccine, they were eating at Panera and drew out the idea for their device on a napkin. Neither of them had prior engineering experience and didn’t know how to proceed after this, so they relied on the University of Chicago’s entrepreneurial programs as a starting place. They then did market research and used their own internal research funding to subcontract with an engineering firm. They have been working on the design prototype since, and are conducting animal studies to trial the device. Once they reach design freeze, they will start the regulatory process and NIH 510(k) submission. They also have an NIH SBIR grant for small businesses doing innovative research. They plan to have the device on market in mid 2024. The goal for their device is to make it a catheter that can provide real-time feedback to minimize the complications of both too little or too much thrombolytic therapy. They are installing a sensor on the device that displays how much of the clot is lysed and allows for personalized PE treatment. They hope to incorporate AI into their data management, which they will use to tailor treatment in future patients. --- RESOURCES FLOW Medical: https://www.flowmedical.co In this episode, host Dr. Aaron Fritts interviews FLOW Medical cofounders Dr. Osman Ahmed and Dr. Jonathan Paul about how they built a company with the goal of designing a data-driven thrombolytic device that can deliver personalized care for patients with pulmonary embolism.


---


CHECK OUT OUR SPONSOR


RapidAI

http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/KikSeM


---


SHOW NOTES


Dr. Paul, interventional cardiologist, begins by explaining how he and Dr. Ahmed, interventional radiologist, came to work together. Dr. Ahmed came to the University of Chicago shortly after Dr. Paul started a pulmonary embolism response team (PERT) program. Dr. Ahmed, through his IR training, had experience with PE/VTE. They met and decided to combine their knowledge to build the program together. They both saw a need for new catheter directed thrombolytic (CDT) devices in their respective fields. The landscape of thrombectomy device innovation was booming, but they did not see the same innovation happening for CDT.


After they both received the COVID vaccine, they were eating at Panera and drew out the idea for their device on a napkin. Neither of them had prior engineering experience and didn’t know how to proceed after this, so they relied on the University of Chicago’s entrepreneurial programs as a starting place. They then did market research and used their own internal research funding to subcontract with an engineering firm. They have been working on the design prototype since, and are conducting animal studies to trial the device. Once they reach design freeze, they will start the regulatory process and NIH 510(k) submission. They also have an NIH SBIR grant for small businesses doing innovative research. They plan to have the device on market in mid 2024.


The goal for their device is to make it a catheter that can provide real-time feedback to minimize the complications of both too little or too much thrombolytic therapy. They are installing a sensor on the device that displays how much of the clot is lysed and allows for personalized PE treatment. They hope to incorporate AI into their data management, which they will use to tailor treatment in future patients.


---


RESOURCES


FLOW Medical:

https://www.flowmedical.co

]]> 2344 Ep. 297 Flipping a Hospital-Based IR Practice with Dr. Sebouh Gueyikian In this episode, our host Ally Baheti speaks with interventional radiologist Dr. Sebouh Gueyikian about elevating the scope of IR procedures and leadership techniques to lead successful change within an IR/DR practice. --- CHECK OUT OUR SPONSOR Boston Scientific Ranger DCB https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/ranger.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_ranger_1_2023&cid=n10012340 --- SHOW NOTES Dr. Gueyikian first discusses his career path, from his academic training, to building an IR department in a suburban hospital, to having a chief role within a multicenter practice. All of these roles were taken on in the efforts to grow different IR practices. With each job transition, he notes that it is important to not only pay attention to who was asking him to change the department, but also who had the power to allocate resources and support for his changes. Discrepant goals between diagnostic radiology (DR) partners and hospital administrators present frustrating situations, so it is recommended to outline these challenges before signing on. Additionally, Dr. Gueyikian speaks about the importance of defining boundaries for your IR service. For example, simple procedures that can be done under basic fluoroscopy do not make the best use of the IR suite, so they should be performed at bedside or within the DR setting. Prioritizing IR time and space for complex procedures ensures that resources are being put to good use and fight burnout among IRs and staff. In terms of increasing efficiency. Dr. Gueyikian ensures that there are pre-procedural protocols that can be widely disseminated. He says that it is important to establish mutual expectations for lab tests and supplies needed before each type of procedure, in order to enhance patient safety and job satisfaction for everyone on the team. Additionally, advance communication with colleagues about scheduling cases for each day can help ensure that workload is fairly distributed. Finally, we discuss ways to negotiate with resistors to change, whether these are DRs, hospital administrators, or referring specialists. Dr. Gueyikian highlights the utility of re-framing clinical errors as opportunities for change. Addressing the gaps in the status quo, while also making the effort to understand resistors’ concerns, can increase support for your ideas. Fri, 03 Mar 2023 06:05:00 -0000 full BackTable In this episode, our host Ally Baheti speaks with interventional radiologist Dr. Sebouh Gueyikian about elevating the scope of IR procedures and leadership techniques to lead successful change within an IR/DR practice. In this episode, our host Ally Baheti speaks with interventional radiologist Dr. Sebouh Gueyikian about elevating the scope of IR procedures and leadership techniques to lead successful change within an IR/DR practice. --- CHECK OUT OUR SPONSOR Boston Scientific Ranger DCB https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/ranger.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_ranger_1_2023&cid=n10012340 --- SHOW NOTES Dr. Gueyikian first discusses his career path, from his academic training, to building an IR department in a suburban hospital, to having a chief role within a multicenter practice. All of these roles were taken on in the efforts to grow different IR practices. With each job transition, he notes that it is important to not only pay attention to who was asking him to change the department, but also who had the power to allocate resources and support for his changes. Discrepant goals between diagnostic radiology (DR) partners and hospital administrators present frustrating situations, so it is recommended to outline these challenges before signing on. Additionally, Dr. Gueyikian speaks about the importance of defining boundaries for your IR service. For example, simple procedures that can be done under basic fluoroscopy do not make the best use of the IR suite, so they should be performed at bedside or within the DR setting. Prioritizing IR time and space for complex procedures ensures that resources are being put to good use and fight burnout among IRs and staff. In terms of increasing efficiency. Dr. Gueyikian ensures that there are pre-procedural protocols that can be widely disseminated. He says that it is important to establish mutual expectations for lab tests and supplies needed before each type of procedure, in order to enhance patient safety and job satisfaction for everyone on the team. Additionally, advance communication with colleagues about scheduling cases for each day can help ensure that workload is fairly distributed. Finally, we discuss ways to negotiate with resistors to change, whether these are DRs, hospital administrators, or referring specialists. Dr. Gueyikian highlights the utility of re-framing clinical errors as opportunities for change. Addressing the gaps in the status quo, while also making the effort to understand resistors’ concerns, can increase support for your ideas. In this episode, our host Ally Baheti speaks with interventional radiologist Dr. Sebouh Gueyikian about elevating the scope of IR procedures and leadership techniques to lead successful change within an IR/DR practice.


---


CHECK OUT OUR SPONSOR


Boston Scientific Ranger DCB

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/ranger.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_ranger_1_2023&cid=n10012340


---


SHOW NOTES


Dr. Gueyikian first discusses his career path, from his academic training, to building an IR department in a suburban hospital, to having a chief role within a multicenter practice. All of these roles were taken on in the efforts to grow different IR practices. With each job transition, he notes that it is important to not only pay attention to who was asking him to change the department, but also who had the power to allocate resources and support for his changes. Discrepant goals between diagnostic radiology (DR) partners and hospital administrators present frustrating situations, so it is recommended to outline these challenges before signing on. Additionally, Dr. Gueyikian speaks about the importance of defining boundaries for your IR service. For example, simple procedures that can be done under basic fluoroscopy do not make the best use of the IR suite, so they should be performed at bedside or within the DR setting. Prioritizing IR time and space for complex procedures ensures that resources are being put to good use and fight burnout among IRs and staff.


In terms of increasing efficiency. Dr. Gueyikian ensures that there are pre-procedural protocols that can be widely disseminated. He says that it is important to establish mutual expectations for lab tests and supplies needed before each type of procedure, in order to enhance patient safety and job satisfaction for everyone on the team. Additionally, advance communication with colleagues about scheduling cases for each day can help ensure that workload is fairly distributed.


Finally, we discuss ways to negotiate with resistors to change, whether these are DRs, hospital administrators, or referring specialists. Dr. Gueyikian highlights the utility of re-framing clinical errors as opportunities for change. Addressing the gaps in the status quo, while also making the effort to understand resistors’ concerns, can increase support for your ideas.

]]> 3336 Ep. 296 Building an Ambulatory Surgery Center with Dr. Sean Hislop In this episode, cohosts Dr. Aaron Fritts and Dr. Krishna Mannava interview vascular surgeon Dr. Sean Hislop about building an ambulatory surgery center, including where to purchase property, how to plan your build, and how to prepare for expansion. --- CHECK OUT OUR SPONSOR Medtronic OBL https://www.medtronic.com/obl --- SHOW NOTES We begin by discussing Dr. Hislop’s current practice in Charleston, South Carolina. He is part of a group of eight vascular surgeons, and is also chief of vascular surgery at a local hospital. Their group has 8 offices, 2 of which are outpatient based labs (OBLs). They are currently working on building an ambulatory surgery center (ASC) that is projected to open in April 2023. Dr. Hislop describes how ownership of the ASC was determined. Five interested partners in their group used their personal funds (5 equal parts) and in turn all 5 are on the board of directors. They keep 100% of their profits and work with a local banker that they have built a trusted relationship with from their prior experience with OBLs. To plan for future expansion, each partner will devote a certain percentage of their shares which will go into a pot to provide shares for future partners to buy in. When it came to deciding where to buy property and build their ASC, they factored in weather, price, and proximity to patients. They did market research to evaluate where to build that would be close to their target patient population. They were able to find an affordable property in an area with a high concentration of retirees. Their LLC leased the land, and their practice leased space from the building owner. They built out one procedure room with a portable 9900 OEC C-arm, 4 prep and 4 recovery bays where patients can stay for up to 48 hours. South Carolina is a certificate of need (CON) state, meaning they had to apply for a CON to do all their procedures. Their current CON is procedure specific, not specialty specific, though it does not currently include coronary interventions. This allows them to bring in interventional cardiologists, interventional radiologists or podiatrists in the future. Lastly, Dr. Hislop talks about the hiring process in the ASC. Throughout the COVID-19 pandemic, there has been a huge surge in travel nursing, which has caused retention problems throughout the country. Dr. Hislop remarks that he has recently seen the tides shift back towards normal employment. He believes that in order to recruit and retain high quality staff, it is vital to understand the market and offer competitive salaries. Some of the benefits to working at an ASC instead of a hospital is the lack of nights, weekends, and call coverage. For Dr. Hislop and his partners, they believe that efficiency and work satisfaction are more important than a big financial outcome, which is why they are passionate about building this ASC. They believe it will provide a much better patient experience while also keeping physicians and staff happy. --- RESOURCES Ep. 193: Managing Supplies in your Outpatient Facility https://www.backtable.com/shows/vi/podcasts/193/managing-supplies-in-your-outpatient-facility Ep. 202: Staffing the OBL https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl Mon, 27 Feb 2023 06:05:00 -0000 full BackTable In this episode, cohosts Dr. Aaron Fritts and Dr. Krishna Mannava interview vascular surgeon Dr. Sean Hislop about building an ambulatory surgery center, including where to purchase property, how to plan your build, and how to prepare for expansion. In this episode, cohosts Dr. Aaron Fritts and Dr. Krishna Mannava interview vascular surgeon Dr. Sean Hislop about building an ambulatory surgery center, including where to purchase property, how to plan your build, and how to prepare for expansion. --- CHECK OUT OUR SPONSOR Medtronic OBL https://www.medtronic.com/obl --- SHOW NOTES We begin by discussing Dr. Hislop’s current practice in Charleston, South Carolina. He is part of a group of eight vascular surgeons, and is also chief of vascular surgery at a local hospital. Their group has 8 offices, 2 of which are outpatient based labs (OBLs). They are currently working on building an ambulatory surgery center (ASC) that is projected to open in April 2023. Dr. Hislop describes how ownership of the ASC was determined. Five interested partners in their group used their personal funds (5 equal parts) and in turn all 5 are on the board of directors. They keep 100% of their profits and work with a local banker that they have built a trusted relationship with from their prior experience with OBLs. To plan for future expansion, each partner will devote a certain percentage of their shares which will go into a pot to provide shares for future partners to buy in. When it came to deciding where to buy property and build their ASC, they factored in weather, price, and proximity to patients. They did market research to evaluate where to build that would be close to their target patient population. They were able to find an affordable property in an area with a high concentration of retirees. Their LLC leased the land, and their practice leased space from the building owner. They built out one procedure room with a portable 9900 OEC C-arm, 4 prep and 4 recovery bays where patients can stay for up to 48 hours. South Carolina is a certificate of need (CON) state, meaning they had to apply for a CON to do all their procedures. Their current CON is procedure specific, not specialty specific, though it does not currently include coronary interventions. This allows them to bring in interventional cardiologists, interventional radiologists or podiatrists in the future. Lastly, Dr. Hislop talks about the hiring process in the ASC. Throughout the COVID-19 pandemic, there has been a huge surge in travel nursing, which has caused retention problems throughout the country. Dr. Hislop remarks that he has recently seen the tides shift back towards normal employment. He believes that in order to recruit and retain high quality staff, it is vital to understand the market and offer competitive salaries. Some of the benefits to working at an ASC instead of a hospital is the lack of nights, weekends, and call coverage. For Dr. Hislop and his partners, they believe that efficiency and work satisfaction are more important than a big financial outcome, which is why they are passionate about building this ASC. They believe it will provide a much better patient experience while also keeping physicians and staff happy. --- RESOURCES Ep. 193: Managing Supplies in your Outpatient Facility https://www.backtable.com/shows/vi/podcasts/193/managing-supplies-in-your-outpatient-facility Ep. 202: Staffing the OBL https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl In this episode, cohosts Dr. Aaron Fritts and Dr. Krishna Mannava interview vascular surgeon Dr. Sean Hislop about building an ambulatory surgery center, including where to purchase property, how to plan your build, and how to prepare for expansion.


---


CHECK OUT OUR SPONSOR


Medtronic OBL

https://www.medtronic.com/obl


---


SHOW NOTES


We begin by discussing Dr. Hislop’s current practice in Charleston, South Carolina. He is part of a group of eight vascular surgeons, and is also chief of vascular surgery at a local hospital. Their group has 8 offices, 2 of which are outpatient based labs (OBLs). They are currently working on building an ambulatory surgery center (ASC) that is projected to open in April 2023. Dr. Hislop describes how ownership of the ASC was determined. Five interested partners in their group used their personal funds (5 equal parts) and in turn all 5 are on the board of directors. They keep 100% of their profits and work with a local banker that they have built a trusted relationship with from their prior experience with OBLs. To plan for future expansion, each partner will devote a certain percentage of their shares which will go into a pot to provide shares for future partners to buy in.


When it came to deciding where to buy property and build their ASC, they factored in weather, price, and proximity to patients. They did market research to evaluate where to build that would be close to their target patient population. They were able to find an affordable property in an area with a high concentration of retirees. Their LLC leased the land, and their practice leased space from the building owner. They built out one procedure room with a portable 9900 OEC C-arm, 4 prep and 4 recovery bays where patients can stay for up to 48 hours. South Carolina is a certificate of need (CON) state, meaning they had to apply for a CON to do all their procedures. Their current CON is procedure specific, not specialty specific, though it does not currently include coronary interventions. This allows them to bring in interventional cardiologists, interventional radiologists or podiatrists in the future.


Lastly, Dr. Hislop talks about the hiring process in the ASC. Throughout the COVID-19 pandemic, there has been a huge surge in travel nursing, which has caused retention problems throughout the country. Dr. Hislop remarks that he has recently seen the tides shift back towards normal employment. He believes that in order to recruit and retain high quality staff, it is vital to understand the market and offer competitive salaries. Some of the benefits to working at an ASC instead of a hospital is the lack of nights, weekends, and call coverage. For Dr. Hislop and his partners, they believe that efficiency and work satisfaction are more important than a big financial outcome, which is why they are passionate about building this ASC. They believe it will provide a much better patient experience while also keeping physicians and staff happy.


---


RESOURCES


Ep. 193: Managing Supplies in your Outpatient Facility

https://www.backtable.com/shows/vi/podcasts/193/managing-supplies-in-your-outpatient-facility


Ep. 202: Staffing the OBL

https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl

]]> 2725 Ep. 295 Building an OBL Within an IR/DR Group Part 2 with Dr. Don Garbett and Dr. Nicholas Petruzzi In the second part of this series, host Ally Baheti interviews interventional radiologists Donald Garbett and Nicholas Petruzzi about starting their outpatient based labs (OBLs) within a combined IR/DR group. They discuss the rewards of having an outpatient practice and how they navigate challenges that arise during the practice-building journey. --- CHECK OUT OUR SPONSORS BD Rotarex Atherectomy System https://www.bd.com/rotarex Surmodics Sublime Radial Access Platform https://sublimeradial.com/ --- SHOW NOTES We begin by discussing real estate decisions and the construction process. Dr. Petruzzi, started his first two OBLs within the same space as his group’s existing imaging center. While this was cost effective, it also sacrificed the ability to have an ideal layout. As he built more practice locations, he acquired new real estate. Dr. Garbett purchased and re-purposed a property that had previously been a plastic surgery practice. He notes that supply issues are common, and construction usually takes longer than expected. Additionally, the doctors talk about navigating different vendor relationships. They both agree that there is a certain number of vendors that strikes a balance between an appropriate variety of devices and negotiating power with each vendor. They also discuss their choice in EMR provider and different functions that are important to streamlining workflow. Next, we shift to talking about marketing a new practice. Early in the practice lifetime, they emphasize that in-person marketing directed towards referrers is the best way to form long-lasting relationships. Dr. Petruzzi has since hired a marketing team that has specific knowledge of patient populations. His practice’s participation in clinical trials also provides a marketing edge, since patients can have access to novel treatments. One of the biggest challenges to building a practice is finding and training staff. Dr. Garbett highlights the need to communicate with the nursing team prior to initiating procedures. Communication of expectations, sedation level, and post-operative care guidelines can help ensure that a procedure runs smoothly. Dr. Petruzzi relies on procedure and transfer protocols to standardize patient care and manage urgent and emergent events. Finally, both doctors speak about the multidisciplinary nature of their practices. Dr. Petruzzi’s OBL is a collaboration between IR and vascular surgery, while Dr. Garbett’s OBL synthesizes IR, MSK radiology, and physical therapy. --- RESOURCES Building an OBL Within an IR/DR Group, Part 1: https://www.backtable.com/shows/vi/podcasts/213/building-an-obl-within-an-ir-dr-group Atlantic Medical Imaging: https://www.atlanticmedicalimaging.com/ ReNew Institute: https://reneweugene.com/ SIR Practice Development Resources https://www.sirweb.org/practice-resources/practice-development-new/ Outpatient Endovascular & Interventional Society (OEIS): https://oeisweb.com/ Nicholas Petruzzi Twitter: https://twitter.com/mdpetruzzi Donald Garbett Twitter: https://twitter.com/DonGarbettMD Fri, 24 Feb 2023 08:28:00 -0000 full BackTable In the second part of this series, host Ally Baheti interviews interventional radiologists Donald Garbett and Nicholas Petruzzi about starting their outpatient based labs (OBLs) within a combined IR/DR group. They discuss the rewards of having an outpatient practice and how they navigate challenges that arise during the practice-building journey. In the second part of this series, host Ally Baheti interviews interventional radiologists Donald Garbett and Nicholas Petruzzi about starting their outpatient based labs (OBLs) within a combined IR/DR group. They discuss the rewards of having an outpatient practice and how they navigate challenges that arise during the practice-building journey. --- CHECK OUT OUR SPONSORS BD Rotarex Atherectomy System https://www.bd.com/rotarex Surmodics Sublime Radial Access Platform https://sublimeradial.com/ --- SHOW NOTES We begin by discussing real estate decisions and the construction process. Dr. Petruzzi, started his first two OBLs within the same space as his group’s existing imaging center. While this was cost effective, it also sacrificed the ability to have an ideal layout. As he built more practice locations, he acquired new real estate. Dr. Garbett purchased and re-purposed a property that had previously been a plastic surgery practice. He notes that supply issues are common, and construction usually takes longer than expected. Additionally, the doctors talk about navigating different vendor relationships. They both agree that there is a certain number of vendors that strikes a balance between an appropriate variety of devices and negotiating power with each vendor. They also discuss their choice in EMR provider and different functions that are important to streamlining workflow. Next, we shift to talking about marketing a new practice. Early in the practice lifetime, they emphasize that in-person marketing directed towards referrers is the best way to form long-lasting relationships. Dr. Petruzzi has since hired a marketing team that has specific knowledge of patient populations. His practice’s participation in clinical trials also provides a marketing edge, since patients can have access to novel treatments. One of the biggest challenges to building a practice is finding and training staff. Dr. Garbett highlights the need to communicate with the nursing team prior to initiating procedures. Communication of expectations, sedation level, and post-operative care guidelines can help ensure that a procedure runs smoothly. Dr. Petruzzi relies on procedure and transfer protocols to standardize patient care and manage urgent and emergent events. Finally, both doctors speak about the multidisciplinary nature of their practices. Dr. Petruzzi’s OBL is a collaboration between IR and vascular surgery, while Dr. Garbett’s OBL synthesizes IR, MSK radiology, and physical therapy. --- RESOURCES Building an OBL Within an IR/DR Group, Part 1: https://www.backtable.com/shows/vi/podcasts/213/building-an-obl-within-an-ir-dr-group Atlantic Medical Imaging: https://www.atlanticmedicalimaging.com/ ReNew Institute: https://reneweugene.com/ SIR Practice Development Resources https://www.sirweb.org/practice-resources/practice-development-new/ Outpatient Endovascular & Interventional Society (OEIS): https://oeisweb.com/ Nicholas Petruzzi Twitter: https://twitter.com/mdpetruzzi Donald Garbett Twitter: https://twitter.com/DonGarbettMD In the second part of this series, host Ally Baheti interviews interventional radiologists Donald Garbett and Nicholas Petruzzi about starting their outpatient based labs (OBLs) within a combined IR/DR group. They discuss the rewards of having an outpatient practice and how they navigate challenges that arise during the practice-building journey.


---


CHECK OUT OUR SPONSORS


BD Rotarex Atherectomy System

https://www.bd.com/rotarex


Surmodics Sublime Radial Access Platform

https://sublimeradial.com/


---


SHOW NOTES


We begin by discussing real estate decisions and the construction process. Dr. Petruzzi, started his first two OBLs within the same space as his group’s existing imaging center. While this was cost effective, it also sacrificed the ability to have an ideal layout. As he built more practice locations, he acquired new real estate. Dr. Garbett purchased and re-purposed a property that had previously been a plastic surgery practice. He notes that supply issues are common, and construction usually takes longer than expected. Additionally, the doctors talk about navigating different vendor relationships. They both agree that there is a certain number of vendors that strikes a balance between an appropriate variety of devices and negotiating power with each vendor. They also discuss their choice in EMR provider and different functions that are important to streamlining workflow.


Next, we shift to talking about marketing a new practice. Early in the practice lifetime, they emphasize that in-person marketing directed towards referrers is the best way to form long-lasting relationships. Dr. Petruzzi has since hired a marketing team that has specific knowledge of patient populations. His practice’s participation in clinical trials also provides a marketing edge, since patients can have access to novel treatments.


One of the biggest challenges to building a practice is finding and training staff. Dr. Garbett highlights the need to communicate with the nursing team prior to initiating procedures. Communication of expectations, sedation level, and post-operative care guidelines can help ensure that a procedure runs smoothly. Dr. Petruzzi relies on procedure and transfer protocols to standardize patient care and manage urgent and emergent events. Finally, both doctors speak about the multidisciplinary nature of their practices. Dr. Petruzzi’s OBL is a collaboration between IR and vascular surgery, while Dr. Garbett’s OBL synthesizes IR, MSK radiology, and physical therapy.


---


RESOURCES


Building an OBL Within an IR/DR Group, Part 1:

https://www.backtable.com/shows/vi/podcasts/213/building-an-obl-within-an-ir-dr-group


Atlantic Medical Imaging:

https://www.atlanticmedicalimaging.com/


ReNew Institute:

https://reneweugene.com/


SIR Practice Development Resources

https://www.sirweb.org/practice-resources/practice-development-new/


Outpatient Endovascular & Interventional Society (OEIS):

https://oeisweb.com/


Nicholas Petruzzi Twitter:

https://twitter.com/mdpetruzzi


Donald Garbett Twitter:

https://twitter.com/DonGarbettMD

]]> 3205 Ep. 294 How to Implement Advanced Vascular Ultrasound Techniques in Your Practice with Dr. Mary Costantino and Dr. Miguel Montero-Baker In this episode, guest host and vascular technologist Jill Sommerset interviews Dr. Mary Costantino (interventional radiologist) and Dr. Miguel Montero-Baker (vascular surgeon) about their perspectives on an ultrasound-first approach to diagnosing and planning treatment for critical limb-threatening ischemia (CLTI). --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Boston Scientific Drug Elution https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_portfolio_1_2023&cid=n10012334 --- SHOW NOTES To begin, each doctor shares how ultrasound fits into their practice philosophy. Dr. Costantino is the sole practitioner in her outpatient-based catheterization lab, and she finds that ultrasound provides an opportunity for her to connect with patients and communicate their diagnoses and options in a straightforward manner. She also recognizes the value of investing in advanced ultrasound training for her vascular technologists and for herself, so the practice can function cohesively and focus on providing patient-centered care. On the other hand, Dr. Montero-Baker speaks about the utility of ultrasound in practices across the globe, particularly in resource-limited settings. Additionally, he describes the need for the longitudinal follow up needed to fight this chronic disease process, as well as the need to manage holistic aspects of CTLI such as proper nutrition, wound care, and orthotics. He is currently building a clinical center that will provide these aspects. We take a moment to reflect on the power of social media as a unifying force for a like-minded “global tribe” of vascular specialists. All three guests can recall numerous instances in which they were inspired by another practitioner, or they were contacted and asked for advice by others. Dr. Costantino adds that social media has helped her realize that there is a strong need for collaboration between interventional radiologists and vascular surgeons, in order to generate treatment options and provide quality patient care. She speaks about the importance of learning from and trusting other specialties. To wrap up the episode, we examine how innovation in ultrasound technology has largely stagnated with the advent of other imaging modalities and opportunities to better incorporate ultrasound into CLTI care. Dr. Costantino encourages vascular specialists to seek out ultrasound training and let patient symptoms and quality of life guide treatment decisions. Dr. Montero-Baker believes that change is required on the systemic level and he advocates for a move towards value-based care. --- RESOURCES Ep. 90- Pedal Acceleration Time for Limb Salvage: https://www.backtable.com/shows/vi/podcasts/90/pedal-acceleration-time-for-limb-salvage Ep. 229- Ultrasound Series: First Line Imaging for CLTI: https://www.backtable.com/shows/vi/podcasts/229/ultrasound-series-first-line-imaging-for-clti Ep. 241- Emerging Techniques of Advanced Ultrasound in No Option CLTI Patients: https://www.backtable.com/shows/vi/podcasts/241/emerging-techniques-of-advanced-ultrasound-in-no-options-clti-patients Ep. 155- The Butterfly Story: https://www.backtable.com/shows/vi/podcasts/155/the-butterfly-story Advanced Vascular Centers: https://advancedvascularcenters.com/ Jill Sommerset Twitter: https://twitter.com/JillSommerset Mary Costantino Twitter: https://twitter.com/drcostantino1 Miguel Montero-Baker Twitter: https://twitter.com/monteromiguel Society for Vascular Ultrasound (SVU): https://www.svu.org/ American Vein and Lymphatic Society (ALVS): https://www.myavls.org/ Wed, 22 Feb 2023 06:05:00 -0000 full BackTable In this episode, guest host and vascular technologist Jill Sommerset interviews Dr. Mary Costantino (interventional radiologist) and Dr. Miguel Montero-Baker (vascular surgeon) about their perspectives on an ultrasound-first approach to diagnosing and planning treatment for critical limb-threatening ischemia (CLTI). In this episode, guest host and vascular technologist Jill Sommerset interviews Dr. Mary Costantino (interventional radiologist) and Dr. Miguel Montero-Baker (vascular surgeon) about their perspectives on an ultrasound-first approach to diagnosing and planning treatment for critical limb-threatening ischemia (CLTI). --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Boston Scientific Drug Elution https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_portfolio_1_2023&cid=n10012334 --- SHOW NOTES To begin, each doctor shares how ultrasound fits into their practice philosophy. Dr. Costantino is the sole practitioner in her outpatient-based catheterization lab, and she finds that ultrasound provides an opportunity for her to connect with patients and communicate their diagnoses and options in a straightforward manner. She also recognizes the value of investing in advanced ultrasound training for her vascular technologists and for herself, so the practice can function cohesively and focus on providing patient-centered care. On the other hand, Dr. Montero-Baker speaks about the utility of ultrasound in practices across the globe, particularly in resource-limited settings. Additionally, he describes the need for the longitudinal follow up needed to fight this chronic disease process, as well as the need to manage holistic aspects of CTLI such as proper nutrition, wound care, and orthotics. He is currently building a clinical center that will provide these aspects. We take a moment to reflect on the power of social media as a unifying force for a like-minded “global tribe” of vascular specialists. All three guests can recall numerous instances in which they were inspired by another practitioner, or they were contacted and asked for advice by others. Dr. Costantino adds that social media has helped her realize that there is a strong need for collaboration between interventional radiologists and vascular surgeons, in order to generate treatment options and provide quality patient care. She speaks about the importance of learning from and trusting other specialties. To wrap up the episode, we examine how innovation in ultrasound technology has largely stagnated with the advent of other imaging modalities and opportunities to better incorporate ultrasound into CLTI care. Dr. Costantino encourages vascular specialists to seek out ultrasound training and let patient symptoms and quality of life guide treatment decisions. Dr. Montero-Baker believes that change is required on the systemic level and he advocates for a move towards value-based care. --- RESOURCES Ep. 90- Pedal Acceleration Time for Limb Salvage: https://www.backtable.com/shows/vi/podcasts/90/pedal-acceleration-time-for-limb-salvage Ep. 229- Ultrasound Series: First Line Imaging for CLTI: https://www.backtable.com/shows/vi/podcasts/229/ultrasound-series-first-line-imaging-for-clti Ep. 241- Emerging Techniques of Advanced Ultrasound in No Option CLTI Patients: https://www.backtable.com/shows/vi/podcasts/241/emerging-techniques-of-advanced-ultrasound-in-no-options-clti-patients Ep. 155- The Butterfly Story: https://www.backtable.com/shows/vi/podcasts/155/the-butterfly-story Advanced Vascular Centers: https://advancedvascularcenters.com/ Jill Sommerset Twitter: https://twitter.com/JillSommerset Mary Costantino Twitter: https://twitter.com/drcostantino1 Miguel Montero-Baker Twitter: https://twitter.com/monteromiguel Society for Vascular Ultrasound (SVU): https://www.svu.org/ American Vein and Lymphatic Society (ALVS): https://www.myavls.org/ In this episode, guest host and vascular technologist Jill Sommerset interviews Dr. Mary Costantino (interventional radiologist) and Dr. Miguel Montero-Baker (vascular surgeon) about their perspectives on an ultrasound-first approach to diagnosing and planning treatment for critical limb-threatening ischemia (CLTI).


---


CHECK OUT OUR SPONSORS


Reflow Medical

https://www.reflowmedical.com/


Boston Scientific Drug Elution

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_portfolio_1_2023&cid=n10012334


---


SHOW NOTES


To begin, each doctor shares how ultrasound fits into their practice philosophy. Dr. Costantino is the sole practitioner in her outpatient-based catheterization lab, and she finds that ultrasound provides an opportunity for her to connect with patients and communicate their diagnoses and options in a straightforward manner. She also recognizes the value of investing in advanced ultrasound training for her vascular technologists and for herself, so the practice can function cohesively and focus on providing patient-centered care. On the other hand, Dr. Montero-Baker speaks about the utility of ultrasound in practices across the globe, particularly in resource-limited settings. Additionally, he describes the need for the longitudinal follow up needed to fight this chronic disease process, as well as the need to manage holistic aspects of CTLI such as proper nutrition, wound care, and orthotics. He is currently building a clinical center that will provide these aspects.


We take a moment to reflect on the power of social media as a unifying force for a like-minded “global tribe” of vascular specialists. All three guests can recall numerous instances in which they were inspired by another practitioner, or they were contacted and asked for advice by others. Dr. Costantino adds that social media has helped her realize that there is a strong need for collaboration between interventional radiologists and vascular surgeons, in order to generate treatment options and provide quality patient care. She speaks about the importance of learning from and trusting other specialties.


To wrap up the episode, we examine how innovation in ultrasound technology has largely stagnated with the advent of other imaging modalities and opportunities to better incorporate ultrasound into CLTI care. Dr. Costantino encourages vascular specialists to seek out ultrasound training and let patient symptoms and quality of life guide treatment decisions. Dr. Montero-Baker believes that change is required on the systemic level and he advocates for a move towards value-based care.


---


RESOURCES


Ep. 90- Pedal Acceleration Time for Limb Salvage:

https://www.backtable.com/shows/vi/podcasts/90/pedal-acceleration-time-for-limb-salvage


Ep. 229- Ultrasound Series: First Line Imaging for CLTI:

https://www.backtable.com/shows/vi/podcasts/229/ultrasound-series-first-line-imaging-for-clti


Ep. 241- Emerging Techniques of Advanced Ultrasound in No Option CLTI Patients:

https://www.backtable.com/shows/vi/podcasts/241/emerging-techniques-of-advanced-ultrasound-in-no-options-clti-patients


Ep. 155- The Butterfly Story:

https://www.backtable.com/shows/vi/podcasts/155/the-butterfly-story


Advanced Vascular Centers:

https://advancedvascularcenters.com/


Jill Sommerset Twitter:

https://twitter.com/JillSommerset


Mary Costantino Twitter:

https://twitter.com/drcostantino1


Miguel Montero-Baker Twitter:

https://twitter.com/monteromiguel


Society for Vascular Ultrasound (SVU):

https://www.svu.org/


American Vein and Lymphatic Society (ALVS):

https://www.myavls.org/

]]> 3639 Ep. 293 Advanced Pelvic Venous Duplex: Utility of Vascular Ultrasound with Dr. Kathleen Gibson In this episode, guest host and vascular technologist Jill Sommerset interviews Dr. Kathleen Gibson, vascular surgeon and president of the American Vein and Lymphatic Society, about the role of RVTs and venous ultrasound in the diagnosis and treatment of pelvic venous disorders. --- CHECK OUT OUR SPONSORS Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1_2023&cid=n10012337 --- SHOW NOTES We begin by discussing Dr. Gibson's career. She was the first woman to complete a vascular surgery fellowship, which was in 2001. Her training, like most, was very arterial focused at the time. She then moved into the private practice space while still completing clinical research. She began to realize that more of her patients had venous disease than arterial. For example, she saw many more patients with varicose veins than abdominal aortic aneurysms. Pelvic venous disorders (PeVD) in particular, remain poorly studied and understood. She became interested in this patient population because she saw many women present with pelvic pain and varicose veins after multiple targeted saphenous vein treatments. She realized this was because the source of the problem, the pelvic veins, were being left untreated. Dr. Gibson developed a varicose vein classification that is being disseminated around the world, and has been translated into multiple languages. It is called the SVP Classifier (Symptoms-Varices-Pathophysiology). It was developed to be used in conjunction with CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classification for venous disease. There is an app available, as well as a workbook that can be used to claim CME. It is a tool that can aid providers and vascular technologists alike when working up PeVD. Lastly, Dr. Gibson reviews her workup of a patient with pelvic pain. Before undergoing ultrasound and vascular workup, it is important to think of other causes of pelvic pain in women of certain ages. In young women, she always ensures patients have seen a gynecologist, as endometriosis is the most common cause of pelvic pain in this group. If they are post-menopausal and present with new onset pain, she also has the patient see a gynecologist to rule out malignancy. Finally, if the patient is postpartum, she loops in a pelvic floor physical therapist because myofascial pain from pregnancy can mimic pain from PeVD. For the vascular workup, she begins with an ultrasound performed by a vascular technologist. She meets with the patient to discuss symptomatology and impacts on quality of life. If PeVD is found on US but the patient has minimal pelvic symptoms, she does not pursue treatment. She treats the patient, not the imaging. If symptoms are bad enough, she will move forward with stenting (for obstruction) or embolization (for varicosities). For embolization patients, there is no routine follow up unless there is a complaint. For stenting in NIVL (non-thrombotic iliac vein lesion) patients, she follows patients with annual US for a couple years. For post-thrombotic stenting she sees patients for US every 6 months, and then annually, as re-thrombosis is always a concern in these patients. --- RESOURCES American Vein and Lymphatic Society: https://www.myavls.org Society for Vascular Ultrasound: https://www.svu.org SVP Classifier App: https://www.myavls.org/svp-classification.html Pelvic ultrasound technique paper: https://journals.sagepub.com/doi/abs/10.1177/0268355516677135?journalCode=phla UIP 2023: https://www.myavls.org/annual-congress-2023.html Twitter: @JillSommerset @KathleenGibson6 Mon, 20 Feb 2023 06:05:00 -0000 full BackTable In this episode, guest host and vascular technologist Jill Sommerset interviews Dr. Kathleen Gibson, vascular surgeon and president of the American Vein and Lymphatic Society, about the role of RVTs and venous ultrasound in the diagnosis and treatment of pelvic venous disorders. In this episode, guest host and vascular technologist Jill Sommerset interviews Dr. Kathleen Gibson, vascular surgeon and president of the American Vein and Lymphatic Society, about the role of RVTs and venous ultrasound in the diagnosis and treatment of pelvic venous disorders. --- CHECK OUT OUR SPONSORS Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1_2023&cid=n10012337 --- SHOW NOTES We begin by discussing Dr. Gibson's career. She was the first woman to complete a vascular surgery fellowship, which was in 2001. Her training, like most, was very arterial focused at the time. She then moved into the private practice space while still completing clinical research. She began to realize that more of her patients had venous disease than arterial. For example, she saw many more patients with varicose veins than abdominal aortic aneurysms. Pelvic venous disorders (PeVD) in particular, remain poorly studied and understood. She became interested in this patient population because she saw many women present with pelvic pain and varicose veins after multiple targeted saphenous vein treatments. She realized this was because the source of the problem, the pelvic veins, were being left untreated. Dr. Gibson developed a varicose vein classification that is being disseminated around the world, and has been translated into multiple languages. It is called the SVP Classifier (Symptoms-Varices-Pathophysiology). It was developed to be used in conjunction with CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classification for venous disease. There is an app available, as well as a workbook that can be used to claim CME. It is a tool that can aid providers and vascular technologists alike when working up PeVD. Lastly, Dr. Gibson reviews her workup of a patient with pelvic pain. Before undergoing ultrasound and vascular workup, it is important to think of other causes of pelvic pain in women of certain ages. In young women, she always ensures patients have seen a gynecologist, as endometriosis is the most common cause of pelvic pain in this group. If they are post-menopausal and present with new onset pain, she also has the patient see a gynecologist to rule out malignancy. Finally, if the patient is postpartum, she loops in a pelvic floor physical therapist because myofascial pain from pregnancy can mimic pain from PeVD. For the vascular workup, she begins with an ultrasound performed by a vascular technologist. She meets with the patient to discuss symptomatology and impacts on quality of life. If PeVD is found on US but the patient has minimal pelvic symptoms, she does not pursue treatment. She treats the patient, not the imaging. If symptoms are bad enough, she will move forward with stenting (for obstruction) or embolization (for varicosities). For embolization patients, there is no routine follow up unless there is a complaint. For stenting in NIVL (non-thrombotic iliac vein lesion) patients, she follows patients with annual US for a couple years. For post-thrombotic stenting she sees patients for US every 6 months, and then annually, as re-thrombosis is always a concern in these patients. --- RESOURCES American Vein and Lymphatic Society: https://www.myavls.org Society for Vascular Ultrasound: https://www.svu.org SVP Classifier App: https://www.myavls.org/svp-classification.html Pelvic ultrasound technique paper: https://journals.sagepub.com/doi/abs/10.1177/0268355516677135?journalCode=phla UIP 2023: https://www.myavls.org/annual-congress-2023.html Twitter: @JillSommerset @KathleenGibson6 In this episode, guest host and vascular technologist Jill Sommerset interviews Dr. Kathleen Gibson, vascular surgeon and president of the American Vein and Lymphatic Society, about the role of RVTs and venous ultrasound in the diagnosis and treatment of pelvic venous disorders.


---


CHECK OUT OUR SPONSORS


Medtronic Abre Venous Stent

https://www.medtronic.com/abrevenous


Boston Scientific Eluvia Drug-Eluting Stent

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1_2023&cid=n10012337


---


SHOW NOTES


We begin by discussing Dr. Gibson's career. She was the first woman to complete a vascular surgery fellowship, which was in 2001. Her training, like most, was very arterial focused at the time. She then moved into the private practice space while still completing clinical research. She began to realize that more of her patients had venous disease than arterial. For example, she saw many more patients with varicose veins than abdominal aortic aneurysms. Pelvic venous disorders (PeVD) in particular, remain poorly studied and understood. She became interested in this patient population because she saw many women present with pelvic pain and varicose veins after multiple targeted saphenous vein treatments. She realized this was because the source of the problem, the pelvic veins, were being left untreated.


Dr. Gibson developed a varicose vein classification that is being disseminated around the world, and has been translated into multiple languages. It is called the SVP Classifier (Symptoms-Varices-Pathophysiology). It was developed to be used in conjunction with CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classification for venous disease. There is an app available, as well as a workbook that can be used to claim CME. It is a tool that can aid providers and vascular technologists alike when working up PeVD.


Lastly, Dr. Gibson reviews her workup of a patient with pelvic pain. Before undergoing ultrasound and vascular workup, it is important to think of other causes of pelvic pain in women of certain ages. In young women, she always ensures patients have seen a gynecologist, as endometriosis is the most common cause of pelvic pain in this group. If they are post-menopausal and present with new onset pain, she also has the patient see a gynecologist to rule out malignancy. Finally, if the patient is postpartum, she loops in a pelvic floor physical therapist because myofascial pain from pregnancy can mimic pain from PeVD. For the vascular workup, she begins with an ultrasound performed by a vascular technologist. She meets with the patient to discuss symptomatology and impacts on quality of life. If PeVD is found on US but the patient has minimal pelvic symptoms, she does not pursue treatment. She treats the patient, not the imaging. If symptoms are bad enough, she will move forward with stenting (for obstruction) or embolization (for varicosities). For embolization patients, there is no routine follow up unless there is a complaint. For stenting in NIVL (non-thrombotic iliac vein lesion) patients, she follows patients with annual US for a couple years. For post-thrombotic stenting she sees patients for US every 6 months, and then annually, as re-thrombosis is always a concern in these patients.


---


RESOURCES


American Vein and Lymphatic Society:

https://www.myavls.org


Society for Vascular Ultrasound:

https://www.svu.org


SVP Classifier App:

https://www.myavls.org/svp-classification.html


Pelvic ultrasound technique paper:

https://journals.sagepub.com/doi/abs/10.1177/0268355516677135?journalCode=phla


UIP 2023:

https://www.myavls.org/annual-congress-2023.html


Twitter:

@JillSommerset

@KathleenGibson6

]]> 2509 Ep. 292 Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More with Dr. Ari Kramer In this episode, Dr. Chris Beck interviews vascular access surgeon Dr. Ari Kramer about his management of arteriovenous (AV) access for dialysis patients. We cover his preferred imaging for identifying and deciding to treat stenoses, the protracted angioplasty technique, and the evolution of research in drug coated balloons (DCB) and stent grafts. --- CHECK OUT OUR SPONSORS Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral BD Rotarex Atherectomy System https://www.bd.com/rotarex --- SHOW NOTES Dr. Kramer starts by describing his vascular access practice. He is the sole operator within a hospital-based practice where he creates and maintains AV access. When evaluating a patient for possible intervention, duplex ultrasound, physical exam findings, patient history, and information from the dialysis center all play roles in determining whether the patient is eligible for a fistulagram. Dr. Kramer offers fistulagram tips: he obtains access above the arterial anastomosis in order to avoid occlusion of outflow, and he first shoots contrast into the venous tract first and works his way up to the arterial system. Depending on the findings of the fistulagram, stenotic lesions in the venous outflow tract can be treated. Dr. Kramer generally treats the lesion if the stenosis limits flow by more than 50%. Additionally, he treats any lesion resulting in a luminal diameter of 2mm or less. In an AV fistula circuit, Dr. Kramer describes his procedure, which is largely informed by the most current clinical trials. He first employs the FLEX Vessel Prep system to reduce circumferential fibromuscular tension. Next, he performs protracted plain old balloon angioplasty (POBA) for 90 seconds. This helps Then, he re-images the vessel to ensure there was no injury and utilizes a DCB to deliver paclitaxel. We discuss the clinical trials outcomes of the two current DCBs that have been approved for use in AV management, IN.PACT and Lutonix. Dr. Kramer also notes the significant cost of DCBs and lack of access to treatment for the most at-risk patients. He encourages clinicians to unite to advocate for increased reimbursement for this treatment that has been proven to show the highest standard of care. Additionally, we address treatment of non-autogenous AV circuits with stent grafts. Dr. Kramer prefers self-expanding covered stents, such as Viabahn or Covera, since they are conformable and resistant to kinks. Overall, Dr. Kramer emphasizes the importance of the operator staying up to date on clinical trials that show data for diverse tools with various indications, knowing their own skill and comfort, and incorporating the best treatments based on their patient and practice context. --- RESOURCES Ep. 139 AV Fistula Graft Management: https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance FLEX Vessel Prep System: https://www.venturemedgroup.com/ KDOQI Clinical Practice Guideline for Vascular Access, 2019 Update: https://www.ajkd.org/article/S0272-6386(19)31137-0/fulltext Fahrtash, F., Kairaitis, L., Gruenewald, S., Spicer, T., Sidrak, H., Fletcher, J., Allen, R., & Swinnen, J. (2011). Defining a significant stenosis in an autologous radio-cephalic arteriovenous fistula for hemodialysis. Seminars in dialysis, 24(2), 231–238. Haskal, Z. J., et al. (2010). "Stent graft versus balloon angioplasty for failing dialysis-access grafts." New England Journal of Medicine 362(6): 494-503. Bard Peripheral Vascular. Covera vascular covered stent instructions for use. Rev.4 / 08-18. http://www.bardpv.com/eifu/uploads/BAWB05872R4-Covera-Vascular-Covered-Stent-IFU.pdf. The Fight Doctors: https://thefightdoctors.com/about/ Find this episode on BackTable.com for all resources mentioned in this podcast, including references to journal articles. Fri, 17 Feb 2023 06:05:00 -0000 full BackTable In this episode, Dr. Chris Beck interviews vascular access surgeon Dr. Ari Kramer about his management of arteriovenous (AV) access for dialysis patients. We cover his preferred imaging for identifying and deciding to treat stenoses, the protracted angioplasty technique, and the evolution of research in drug coated balloons (DCB) and stent grafts. In this episode, Dr. Chris Beck interviews vascular access surgeon Dr. Ari Kramer about his management of arteriovenous (AV) access for dialysis patients. We cover his preferred imaging for identifying and deciding to treat stenoses, the protracted angioplasty technique, and the evolution of research in drug coated balloons (DCB) and stent grafts. --- CHECK OUT OUR SPONSORS Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral BD Rotarex Atherectomy System https://www.bd.com/rotarex --- SHOW NOTES Dr. Kramer starts by describing his vascular access practice. He is the sole operator within a hospital-based practice where he creates and maintains AV access. When evaluating a patient for possible intervention, duplex ultrasound, physical exam findings, patient history, and information from the dialysis center all play roles in determining whether the patient is eligible for a fistulagram. Dr. Kramer offers fistulagram tips: he obtains access above the arterial anastomosis in order to avoid occlusion of outflow, and he first shoots contrast into the venous tract first and works his way up to the arterial system. Depending on the findings of the fistulagram, stenotic lesions in the venous outflow tract can be treated. Dr. Kramer generally treats the lesion if the stenosis limits flow by more than 50%. Additionally, he treats any lesion resulting in a luminal diameter of 2mm or less. In an AV fistula circuit, Dr. Kramer describes his procedure, which is largely informed by the most current clinical trials. He first employs the FLEX Vessel Prep system to reduce circumferential fibromuscular tension. Next, he performs protracted plain old balloon angioplasty (POBA) for 90 seconds. This helps Then, he re-images the vessel to ensure there was no injury and utilizes a DCB to deliver paclitaxel. We discuss the clinical trials outcomes of the two current DCBs that have been approved for use in AV management, IN.PACT and Lutonix. Dr. Kramer also notes the significant cost of DCBs and lack of access to treatment for the most at-risk patients. He encourages clinicians to unite to advocate for increased reimbursement for this treatment that has been proven to show the highest standard of care. Additionally, we address treatment of non-autogenous AV circuits with stent grafts. Dr. Kramer prefers self-expanding covered stents, such as Viabahn or Covera, since they are conformable and resistant to kinks. Overall, Dr. Kramer emphasizes the importance of the operator staying up to date on clinical trials that show data for diverse tools with various indications, knowing their own skill and comfort, and incorporating the best treatments based on their patient and practice context. --- RESOURCES Ep. 139 AV Fistula Graft Management: https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance FLEX Vessel Prep System: https://www.venturemedgroup.com/ KDOQI Clinical Practice Guideline for Vascular Access, 2019 Update: https://www.ajkd.org/article/S0272-6386(19)31137-0/fulltext Fahrtash, F., Kairaitis, L., Gruenewald, S., Spicer, T., Sidrak, H., Fletcher, J., Allen, R., & Swinnen, J. (2011). Defining a significant stenosis in an autologous radio-cephalic arteriovenous fistula for hemodialysis. Seminars in dialysis, 24(2), 231–238. Haskal, Z. J., et al. (2010). "Stent graft versus balloon angioplasty for failing dialysis-access grafts." New England Journal of Medicine 362(6): 494-503. Bard Peripheral Vascular. Covera vascular covered stent instructions for use. Rev.4 / 08-18. http://www.bardpv.com/eifu/uploads/BAWB05872R4-Covera-Vascular-Covered-Stent-IFU.pdf. The Fight Doctors: https://thefightdoctors.com/about/ Find this episode on BackTable.com for all resources mentioned in this podcast, including references to journal articles. In this episode, Dr. Chris Beck interviews vascular access surgeon Dr. Ari Kramer about his management of arteriovenous (AV) access for dialysis patients. We cover his preferred imaging for identifying and deciding to treat stenoses, the protracted angioplasty technique, and the evolution of research in drug coated balloons (DCB) and stent grafts.


---


CHECK OUT OUR SPONSORS


Medtronic Chocolate PTA Balloon

https://www.medtronic.com/peripheral


BD Rotarex Atherectomy System

https://www.bd.com/rotarex


---


SHOW NOTES


Dr. Kramer starts by describing his vascular access practice. He is the sole operator within a hospital-based practice where he creates and maintains AV access. When evaluating a patient for possible intervention, duplex ultrasound, physical exam findings, patient history, and information from the dialysis center all play roles in determining whether the patient is eligible for a fistulagram. Dr. Kramer offers fistulagram tips: he obtains access above the arterial anastomosis in order to avoid occlusion of outflow, and he first shoots contrast into the venous tract first and works his way up to the arterial system. Depending on the findings of the fistulagram, stenotic lesions in the venous outflow tract can be treated. Dr. Kramer generally treats the lesion if the stenosis limits flow by more than 50%. Additionally, he treats any lesion resulting in a luminal diameter of 2mm or less.


In an AV fistula circuit, Dr. Kramer describes his procedure, which is largely informed by the most current clinical trials. He first employs the FLEX Vessel Prep system to reduce circumferential fibromuscular tension. Next, he performs protracted plain old balloon angioplasty (POBA) for 90 seconds. This helps Then, he re-images the vessel to ensure there was no injury and utilizes a DCB to deliver paclitaxel. We discuss the clinical trials outcomes of the two current DCBs that have been approved for use in AV management, IN.PACT and Lutonix. Dr. Kramer also notes the significant cost of DCBs and lack of access to treatment for the most at-risk patients. He encourages clinicians to unite to advocate for increased reimbursement for this treatment that has been proven to show the highest standard of care.


Additionally, we address treatment of non-autogenous AV circuits with stent grafts. Dr. Kramer prefers self-expanding covered stents, such as Viabahn or Covera, since they are conformable and resistant to kinks. Overall, Dr. Kramer emphasizes the importance of the operator staying up to date on clinical trials that show data for diverse tools with various indications, knowing their own skill and comfort, and incorporating the best treatments based on their patient and practice context.


---


RESOURCES


Ep. 139 AV Fistula Graft Management:

https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance


FLEX Vessel Prep System:

https://www.venturemedgroup.com/


KDOQI Clinical Practice Guideline for Vascular Access, 2019 Update:

https://www.ajkd.org/article/S0272-6386(19)31137-0/fulltext


Fahrtash, F., Kairaitis, L., Gruenewald, S., Spicer, T., Sidrak, H., Fletcher, J., Allen, R., & Swinnen, J. (2011). Defining a significant stenosis in an autologous radio-cephalic arteriovenous fistula for hemodialysis. Seminars in dialysis, 24(2), 231–238.


Haskal, Z. J., et al. (2010). "Stent graft versus balloon angioplasty for failing dialysis-access grafts." New England Journal of Medicine 362(6): 494-503.


Bard Peripheral Vascular. Covera vascular covered stent instructions for use. Rev.4 / 08-18.

http://www.bardpv.com/eifu/uploads/BAWB05872R4-Covera-Vascular-Covered-Stent-IFU.pdf.


The Fight Doctors:

https://thefightdoctors.com/about/


Find this episode on BackTable.com for all resources mentioned in this podcast, including references to journal articles.

]]> 3952 Ep. 291 Percutaneous Creation of a Distal Deep Venous Arterialization (dDVA) with Dr. August Ysa In this episode, host Dr. Sabeen Dhand interviews Dr. August Ysa, vascular surgeon in Spain, about distal deep venous arterialization, including indications, patient selection, and how to perform his gunsight technique. --- CHECK OUT OUR SPONSORS Viz.ai https://www.viz.ai/ BD Rotarex Atherectomy System https://www.bd.com/rotarex Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES We begin by discussing his training and background. Initially trained in Barcelona before moving to Bilbao as a young vascular surgeon. He came to the US briefly to train at Montefiore and Houston Methodist. When attending the LINNC in Europe one year he saw a live endovascular case, which is when he decided to devote his career to peripheral arterial disease (PAD), specifically below the knee (BTK) and below the ankle (BTA) interventions. He currently works with Dr. Marta Lobato, and they have done around 25 combined deep venous arterializations (DVAs) in their practice. They love this technique because it gives someone previously faced with amputation a new chance. It is a technique to reroute blood flow to get oxygen to a wound and promote wound healing. There are two types of DVA: proximal DVA, which is done closer to the origin of the posterior tibial artery (PTA), and distal DVA, which is at the level of the ankle, and usually also involves the PTA. Thus far, it is unknown which technique is better in terms of limb salvage, and data shows both techniques yield 60-70% limb salvage rates. One advantage to distal DVA is lower rates of post-DVA storm, a type of ischemic steal syndrome. Availability of devices and lower cost also make distal DVA more appealing. DVA is never the first option, traditional recanalization techniques are always explored first. Wounds that are not candidates for DVA are large infected wounds or areas of necrotic tissue. This is because it takes 6-8 weeks to establish the newly created connection, and if the wound is already past the point of healing, DVA will not help. Other reasons DVA can fail is due to choosing the wrong candidates. Mean wound healing time after DVA is 4-7 months, so patients need to be able to commit to close follow up and wound care, and they must have the social support to be compliant with frequent clinic visits. Finally, Dr. Ysa explains his venous arterialization simplification technique (VAST). Before the procedure, he always does a venous ultrasound to rule out prior DVT and evaluate the status of the main veins of the foot. He uses two snares via the gunsight approach, which most IRs are familiar with from TIPS procedures. It involves overlapping two snares and then performing a through and through puncture from the PTA to the posterior tibial vein (PTV). The PTA is generally used over the anterior tibial or the peroneal artery due to its robust connections with the lateral plantar and the plantar arch. He then performs balloon angioplasty (BA) on the PTV. He initially uses the PTA for sizing, but generally goes bigger, between 4-5mm. For valves, he usually does regular BA but will sometimes use a cutting balloon. Two weeks post-DVA he gets an ultrasound, and at one month he gets an angiogram to evaluate the new tract. He has his patients take a single antiplatelet and a blood thinner after the procedure. He considers DVA to have failed if there is progression of wound necrosis. --- RESOURCES Dr. Ysa LinkedIn: https://www.linkedin.com/in/august-ysa-56a99a174/ YouTube DVA Webinar with Dr. Ysa and Dra. Lobato: https://www.youtube.com/watch?v=kDW5Rg5g49I Ep. 93 - DVA for CLI with Dr. Fadi Saab: https://www.backtable.com/shows/vi/podcasts/93/deep-venous-arterialization-for-cli Live Interventional Neuroradiology, Neurology and Neurosurgery Course (LINNC): https://www.linnc.com Patterns of Failure in DVA Paper: https://www.clijournal.com/article/patterns-failure-deep-venous-arterialization-and-implications-management Mon, 13 Feb 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews Dr. August Ysa, vascular surgeon in Spain, about distal deep venous arterialization, including indications, patient selection, and how to perform his gunsight technique. In this episode, host Dr. Sabeen Dhand interviews Dr. August Ysa, vascular surgeon in Spain, about distal deep venous arterialization, including indications, patient selection, and how to perform his gunsight technique. --- CHECK OUT OUR SPONSORS Viz.ai https://www.viz.ai/ BD Rotarex Atherectomy System https://www.bd.com/rotarex Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES We begin by discussing his training and background. Initially trained in Barcelona before moving to Bilbao as a young vascular surgeon. He came to the US briefly to train at Montefiore and Houston Methodist. When attending the LINNC in Europe one year he saw a live endovascular case, which is when he decided to devote his career to peripheral arterial disease (PAD), specifically below the knee (BTK) and below the ankle (BTA) interventions. He currently works with Dr. Marta Lobato, and they have done around 25 combined deep venous arterializations (DVAs) in their practice. They love this technique because it gives someone previously faced with amputation a new chance. It is a technique to reroute blood flow to get oxygen to a wound and promote wound healing. There are two types of DVA: proximal DVA, which is done closer to the origin of the posterior tibial artery (PTA), and distal DVA, which is at the level of the ankle, and usually also involves the PTA. Thus far, it is unknown which technique is better in terms of limb salvage, and data shows both techniques yield 60-70% limb salvage rates. One advantage to distal DVA is lower rates of post-DVA storm, a type of ischemic steal syndrome. Availability of devices and lower cost also make distal DVA more appealing. DVA is never the first option, traditional recanalization techniques are always explored first. Wounds that are not candidates for DVA are large infected wounds or areas of necrotic tissue. This is because it takes 6-8 weeks to establish the newly created connection, and if the wound is already past the point of healing, DVA will not help. Other reasons DVA can fail is due to choosing the wrong candidates. Mean wound healing time after DVA is 4-7 months, so patients need to be able to commit to close follow up and wound care, and they must have the social support to be compliant with frequent clinic visits. Finally, Dr. Ysa explains his venous arterialization simplification technique (VAST). Before the procedure, he always does a venous ultrasound to rule out prior DVT and evaluate the status of the main veins of the foot. He uses two snares via the gunsight approach, which most IRs are familiar with from TIPS procedures. It involves overlapping two snares and then performing a through and through puncture from the PTA to the posterior tibial vein (PTV). The PTA is generally used over the anterior tibial or the peroneal artery due to its robust connections with the lateral plantar and the plantar arch. He then performs balloon angioplasty (BA) on the PTV. He initially uses the PTA for sizing, but generally goes bigger, between 4-5mm. For valves, he usually does regular BA but will sometimes use a cutting balloon. Two weeks post-DVA he gets an ultrasound, and at one month he gets an angiogram to evaluate the new tract. He has his patients take a single antiplatelet and a blood thinner after the procedure. He considers DVA to have failed if there is progression of wound necrosis. --- RESOURCES Dr. Ysa LinkedIn: https://www.linkedin.com/in/august-ysa-56a99a174/ YouTube DVA Webinar with Dr. Ysa and Dra. Lobato: https://www.youtube.com/watch?v=kDW5Rg5g49I Ep. 93 - DVA for CLI with Dr. Fadi Saab: https://www.backtable.com/shows/vi/podcasts/93/deep-venous-arterialization-for-cli Live Interventional Neuroradiology, Neurology and Neurosurgery Course (LINNC): https://www.linnc.com Patterns of Failure in DVA Paper: https://www.clijournal.com/article/patterns-failure-deep-venous-arterialization-and-implications-management In this episode, host Dr. Sabeen Dhand interviews Dr. August Ysa, vascular surgeon in Spain, about distal deep venous arterialization, including indications, patient selection, and how to perform his gunsight technique.


---


CHECK OUT OUR SPONSORS


Viz.ai

https://www.viz.ai/


BD Rotarex Atherectomy System

https://www.bd.com/rotarex


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


We begin by discussing his training and background. Initially trained in Barcelona before moving to Bilbao as a young vascular surgeon. He came to the US briefly to train at Montefiore and Houston Methodist. When attending the LINNC in Europe one year he saw a live endovascular case, which is when he decided to devote his career to peripheral arterial disease (PAD), specifically below the knee (BTK) and below the ankle (BTA) interventions. He currently works with Dr. Marta Lobato, and they have done around 25 combined deep venous arterializations (DVAs) in their practice. They love this technique because it gives someone previously faced with amputation a new chance. It is a technique to reroute blood flow to get oxygen to a wound and promote wound healing. There are two types of DVA: proximal DVA, which is done closer to the origin of the posterior tibial artery (PTA), and distal DVA, which is at the level of the ankle, and usually also involves the PTA. Thus far, it is unknown which technique is better in terms of limb salvage, and data shows both techniques yield 60-70% limb salvage rates. One advantage to distal DVA is lower rates of post-DVA storm, a type of ischemic steal syndrome. Availability of devices and lower cost also make distal DVA more appealing. DVA is never the first option, traditional recanalization techniques are always explored first.


Wounds that are not candidates for DVA are large infected wounds or areas of necrotic tissue. This is because it takes 6-8 weeks to establish the newly created connection, and if the wound is already past the point of healing, DVA will not help. Other reasons DVA can fail is due to choosing the wrong candidates. Mean wound healing time after DVA is 4-7 months, so patients need to be able to commit to close follow up and wound care, and they must have the social support to be compliant with frequent clinic visits.


Finally, Dr. Ysa explains his venous arterialization simplification technique (VAST). Before the procedure, he always does a venous ultrasound to rule out prior DVT and evaluate the status of the main veins of the foot. He uses two snares via the gunsight approach, which most IRs are familiar with from TIPS procedures. It involves overlapping two snares and then performing a through and through puncture from the PTA to the posterior tibial vein (PTV). The PTA is generally used over the anterior tibial or the peroneal artery due to its robust connections with the lateral plantar and the plantar arch. He then performs balloon angioplasty (BA) on the PTV. He initially uses the PTA for sizing, but generally goes bigger, between 4-5mm. For valves, he usually does regular BA but will sometimes use a cutting balloon. Two weeks post-DVA he gets an ultrasound, and at one month he gets an angiogram to evaluate the new tract. He has his patients take a single antiplatelet and a blood thinner after the procedure. He considers DVA to have failed if there is progression of wound necrosis.


---


RESOURCES


Dr. Ysa LinkedIn:

https://www.linkedin.com/in/august-ysa-56a99a174/


YouTube DVA Webinar with Dr. Ysa and Dra. Lobato:

https://www.youtube.com/watch?v=kDW5Rg5g49I


Ep. 93 - DVA for CLI with Dr. Fadi Saab:

https://www.backtable.com/shows/vi/podcasts/93/deep-venous-arterialization-for-cli


Live Interventional Neuroradiology, Neurology and Neurosurgery Course (LINNC):

https://www.linnc.com


Patterns of Failure in DVA Paper:

https://www.clijournal.com/article/patterns-failure-deep-venous-arterialization-and-implications-management

]]> 3640 Ep. 290 SVC Sharp Recanalizations with Dr. Abdulaziz Alharbi In this episode, Dr. Aaron Fritts interviews interventional radiologist Dr. Abdulaziz Alharbi of the Ministry of National Guard Health Affairs in Saudi Arabia. They discuss Dr. Alharbi’s approach to planning and performing sharp recanalization of the superior vena cava (SVC) for dialysis, transplant, and cancer patients. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/sJLY3K --- SHOW NOTES Dr. Alharbi starts by describing how patients get referred to him, mainly due to end stage renal disease, chronic obstruction, and the need for dialysis access. Additionally, some patients seek access for central lines, and others have acute obstructions due to malignancies. Depending on the patient’s clinical condition, comorbidities, upcoming medical procedures, and anatomy, he will then decide if the patient is an appropriate candidate for SVC recanalization and obtain a CT scan. This imaging guides further decision-making on whether to access the obstruction from the internal jugular or brachiocephalic vein. The CT also helps him think about potential complications, such as cardiac tamponade in an obstruction close to the heart and pulmonary edema in all recanalizations. These risks are communicated to each patient accordingly. Prior to starting the procedure, Dr. Alharbi ensures that there are multiple access sites prepared, including neck, bilateral arms, and femoral access. He also ensures that there are tools that he is comfortable using and a support team in place. A colleague will usually help him by obtaining femoral access and placing a target snare distal to the obstruction. Dr. Alharbi walks us through a typical case. First he slowly advances a Chiba needle towards the target. His choice in sheath length depends on the length of the occlusion and the access point. A longer occlusion accessed through the brachiocephalic vein requires a longer sheath than a short occlusion accessed through the internal jugular vein. Next, we discuss stent sizing. Dr. Alharbi notes that it is preferable to oversize, to prevent stagnation of flow. In short occlusions, he uses bare self-expandable stents. In longer occlusions or cancer patients, he uses covered stents since there is more precise deployment. The post-procedure anticoagulation regimen usually includes heparin and an antiplatelet agent for 2-3 weeks. Then, patients are switched to apixaban for 6 months. Beyond this, patients are either taken off of anticoagulation if they are asymptomatic and there is good SVC inflow, or reverted back to their preexisting anticoagulation regimen that they had due to other comorbidities. --- RESOURCES PAIRS 2023: https://pairscongress.com/ Dr. Abdulaziz Alharbi Twitter: https://twitter.com/DrAlHarbiA_Aziz Fri, 10 Feb 2023 06:05:00 -0000 full BackTable In this episode, Dr. Aaron Fritts interviews interventional radiologist Dr. Abdulaziz Alharbi of the Ministry of National Guard Health Affairs in Saudi Arabia. They discuss Dr. Alharbi’s approach to planning and performing sharp recanalization of the superior vena cava (SVC) for dialysis, transplant, and cancer patients. In this episode, Dr. Aaron Fritts interviews interventional radiologist Dr. Abdulaziz Alharbi of the Ministry of National Guard Health Affairs in Saudi Arabia. They discuss Dr. Alharbi’s approach to planning and performing sharp recanalization of the superior vena cava (SVC) for dialysis, transplant, and cancer patients. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/sJLY3K --- SHOW NOTES Dr. Alharbi starts by describing how patients get referred to him, mainly due to end stage renal disease, chronic obstruction, and the need for dialysis access. Additionally, some patients seek access for central lines, and others have acute obstructions due to malignancies. Depending on the patient’s clinical condition, comorbidities, upcoming medical procedures, and anatomy, he will then decide if the patient is an appropriate candidate for SVC recanalization and obtain a CT scan. This imaging guides further decision-making on whether to access the obstruction from the internal jugular or brachiocephalic vein. The CT also helps him think about potential complications, such as cardiac tamponade in an obstruction close to the heart and pulmonary edema in all recanalizations. These risks are communicated to each patient accordingly. Prior to starting the procedure, Dr. Alharbi ensures that there are multiple access sites prepared, including neck, bilateral arms, and femoral access. He also ensures that there are tools that he is comfortable using and a support team in place. A colleague will usually help him by obtaining femoral access and placing a target snare distal to the obstruction. Dr. Alharbi walks us through a typical case. First he slowly advances a Chiba needle towards the target. His choice in sheath length depends on the length of the occlusion and the access point. A longer occlusion accessed through the brachiocephalic vein requires a longer sheath than a short occlusion accessed through the internal jugular vein. Next, we discuss stent sizing. Dr. Alharbi notes that it is preferable to oversize, to prevent stagnation of flow. In short occlusions, he uses bare self-expandable stents. In longer occlusions or cancer patients, he uses covered stents since there is more precise deployment. The post-procedure anticoagulation regimen usually includes heparin and an antiplatelet agent for 2-3 weeks. Then, patients are switched to apixaban for 6 months. Beyond this, patients are either taken off of anticoagulation if they are asymptomatic and there is good SVC inflow, or reverted back to their preexisting anticoagulation regimen that they had due to other comorbidities. --- RESOURCES PAIRS 2023: https://pairscongress.com/ Dr. Abdulaziz Alharbi Twitter: https://twitter.com/DrAlHarbiA_Aziz In this episode, Dr. Aaron Fritts interviews interventional radiologist Dr. Abdulaziz Alharbi of the Ministry of National Guard Health Affairs in Saudi Arabia. They discuss Dr. Alharbi’s approach to planning and performing sharp recanalization of the superior vena cava (SVC) for dialysis, transplant, and cancer patients.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/sJLY3K


---


SHOW NOTES


Dr. Alharbi starts by describing how patients get referred to him, mainly due to end stage renal disease, chronic obstruction, and the need for dialysis access. Additionally, some patients seek access for central lines, and others have acute obstructions due to malignancies. Depending on the patient’s clinical condition, comorbidities, upcoming medical procedures, and anatomy, he will then decide if the patient is an appropriate candidate for SVC recanalization and obtain a CT scan. This imaging guides further decision-making on whether to access the obstruction from the internal jugular or brachiocephalic vein. The CT also helps him think about potential complications, such as cardiac tamponade in an obstruction close to the heart and pulmonary edema in all recanalizations. These risks are communicated to each patient accordingly.


Prior to starting the procedure, Dr. Alharbi ensures that there are multiple access sites prepared, including neck, bilateral arms, and femoral access. He also ensures that there are tools that he is comfortable using and a support team in place. A colleague will usually help him by obtaining femoral access and placing a target snare distal to the obstruction.


Dr. Alharbi walks us through a typical case. First he slowly advances a Chiba needle towards the target. His choice in sheath length depends on the length of the occlusion and the access point. A longer occlusion accessed through the brachiocephalic vein requires a longer sheath than a short occlusion accessed through the internal jugular vein. Next, we discuss stent sizing. Dr. Alharbi notes that it is preferable to oversize, to prevent stagnation of flow. In short occlusions, he uses bare self-expandable stents. In longer occlusions or cancer patients, he uses covered stents since there is more precise deployment.


The post-procedure anticoagulation regimen usually includes heparin and an antiplatelet agent for 2-3 weeks. Then, patients are switched to apixaban for 6 months. Beyond this, patients are either taken off of anticoagulation if they are asymptomatic and there is good SVC inflow, or reverted back to their preexisting anticoagulation regimen that they had due to other comorbidities.


---


RESOURCES


PAIRS 2023:

https://pairscongress.com/


Dr. Abdulaziz Alharbi Twitter:

https://twitter.com/DrAlHarbiA_Aziz

]]> 3499 Ep. 289 Treating Clot in Transit with Dr. Rehan Quadri In this episode, host Dr. Michael Barraza interviews Dr. Rehan Quadri, interventional radiologist, about the definition, indications and techniques for treating clot in transit.  We begin by defining and describing when to treat clot in transit. Traditionally, the definition is the washing machine mobile clot in the right atrium (RA) or right ventricle (RV). In these situations, the next place for the clot to travel is the pulmonary artery (PA). Mortality in these cases can reach as high as 30%, which is why these cases are considered emergencies. There is another category of clot in transit where a clot is partially adhered to a vessel wall, catheter, or heart valve. They are most commonly diagnosed via an echocardiogram, or found incidentally on a CT angiogram. They commonly present as catheter malfunction with symptoms resembling SVC syndrome. Dr. Quadri explains his usual method for retrieving clot in transit, though he notes each case is complex and different depending on the etiology and the overall status of the patient. In general, unless there is a massive PE, he treats the clot in transit before the PE. He always ensures with the preoperative echocardiogram that there is no interatrial shunt or patent foramen ovale (PFO). At the beginning of the case he checks PA and RA pressures.  He uses a 24 French Inari Flowtriever with FLEX technology, which helps with tough angles. He uses ICE guidance in all clot in transit cases. To help with orientation when using the ICE catheter, he recommends pointing it anteriorly while entering the RA, then using the Eustachian ridge, an echogenic line in the RA, to confirm you are in the RA and indicating that you should see the tricuspid valve as you advance. He uses the FlowSaver device, and always has 2 units of blood in the room just in case. At the end of the case, he remeasures the PA pressures, then injects through the Inari sheath to verify that there is no residual before finally doing a pulmonary arteriogram. He sends all the clots to pathology, and has seen that the morphology is usually mixed, with some organized fibrin in addition to acute thrombus. Mon, 06 Feb 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Michael Barraza interviews Dr. Rehan Quadri, interventional radiologist, about the definition, indications and techniques for treating clot in transit. In this episode, host Dr. Michael Barraza interviews Dr. Rehan Quadri, interventional radiologist, about the definition, indications and techniques for treating clot in transit.  We begin by defining and describing when to treat clot in transit. Traditionally, the definition is the washing machine mobile clot in the right atrium (RA) or right ventricle (RV). In these situations, the next place for the clot to travel is the pulmonary artery (PA). Mortality in these cases can reach as high as 30%, which is why these cases are considered emergencies. There is another category of clot in transit where a clot is partially adhered to a vessel wall, catheter, or heart valve. They are most commonly diagnosed via an echocardiogram, or found incidentally on a CT angiogram. They commonly present as catheter malfunction with symptoms resembling SVC syndrome. Dr. Quadri explains his usual method for retrieving clot in transit, though he notes each case is complex and different depending on the etiology and the overall status of the patient. In general, unless there is a massive PE, he treats the clot in transit before the PE. He always ensures with the preoperative echocardiogram that there is no interatrial shunt or patent foramen ovale (PFO). At the beginning of the case he checks PA and RA pressures.  He uses a 24 French Inari Flowtriever with FLEX technology, which helps with tough angles. He uses ICE guidance in all clot in transit cases. To help with orientation when using the ICE catheter, he recommends pointing it anteriorly while entering the RA, then using the Eustachian ridge, an echogenic line in the RA, to confirm you are in the RA and indicating that you should see the tricuspid valve as you advance. He uses the FlowSaver device, and always has 2 units of blood in the room just in case. At the end of the case, he remeasures the PA pressures, then injects through the Inari sheath to verify that there is no residual before finally doing a pulmonary arteriogram. He sends all the clots to pathology, and has seen that the morphology is usually mixed, with some organized fibrin in addition to acute thrombus. In this episode, host Dr. Michael Barraza interviews Dr. Rehan Quadri, interventional radiologist, about the definition, indications and techniques for treating clot in transit. 


We begin by defining and describing when to treat clot in transit. Traditionally, the definition is the washing machine mobile clot in the right atrium (RA) or right ventricle (RV). In these situations, the next place for the clot to travel is the pulmonary artery (PA). Mortality in these cases can reach as high as 30%, which is why these cases are considered emergencies. There is another category of clot in transit where a clot is partially adhered to a vessel wall, catheter, or heart valve. They are most commonly diagnosed via an echocardiogram, or found incidentally on a CT angiogram. They commonly present as catheter malfunction with symptoms resembling SVC syndrome.


Dr. Quadri explains his usual method for retrieving clot in transit, though he notes each case is complex and different depending on the etiology and the overall status of the patient. In general, unless there is a massive PE, he treats the clot in transit before the PE. He always ensures with the preoperative echocardiogram that there is no interatrial shunt or patent foramen ovale (PFO). At the beginning of the case he checks PA and RA pressures. 


He uses a 24 French Inari Flowtriever with FLEX technology, which helps with tough angles. He uses ICE guidance in all clot in transit cases. To help with orientation when using the ICE catheter, he recommends pointing it anteriorly while entering the RA, then using the Eustachian ridge, an echogenic line in the RA, to confirm you are in the RA and indicating that you should see the tricuspid valve as you advance. He uses the FlowSaver device, and always has 2 units of blood in the room just in case. At the end of the case, he remeasures the PA pressures, then injects through the Inari sheath to verify that there is no residual before finally doing a pulmonary arteriogram. He sends all the clots to pathology, and has seen that the morphology is usually mixed, with some organized fibrin in addition to acute thrombus.

]]> 2063 Ep. 288 Treating the Pregnant Patient with Dr. Nikki Keefe In this episode, our host Dr. Ally Baheti interviews interventional radiologist Dr. Nikki Keefe about safety considerations for pregnant and breastfeeding IR patients. Dr. Keefe’s personal experience with pregnancy during her IR training sparked her interest in this topic. A lot of IR patients are pregnant or breastfeeding, so it is important to be cognizant of radiation and medication exposures and how they should be altered. She emphasizes the importance of establishing a protocol when these patients present. We review radiation doses of various IR procedures and risk stratification based on gestational age. At each stage of pregnancy, there are different risks of disruptions in organogenesis, effects on neural tube development, and predisposition to cancer. Elective procedures should usually be deferred until after delivery. The most common and necessary procedures performed in pregnant patients are PICC line placement, nephrostomy tube, and treatment of postpartum hemorrhage. Dr. Keefe also shares her tips for minimizing fluoroscopy time and deciding between different diagnostic imaging modalities that present both maternal and fetal radiation risks. Next, we discuss medication safety. Iodinated contrast is safe to give during pregnancy, while gadolinium is not. Sedation with opioids is generally safe, but their sustained use or administration around the perinatal period can cause neonatal withdrawal symptoms. Benzodiazepines can also be used for amnesia and anxiety reduction, and midazolam has a good safety profile and long half life. However, abnormally extended use of benzodiazepines can cause floppy infant syndrome (sedation, muscle laxity, failure to suckle). Dr. Keefe notes that pregnant patients have to start on higher doses than the standard, since they have higher blood volume and increased renal clearance of these medications. Lovenox is the safest known anticoagulant for pregnant women. Additionally, fetal heart monitoring should be performed before and after the procedure. Finally, we talk about specific cases of patient positioning when placing nephrostomy tubes, transhepatic access for gallbladder tubes, treatment of visceral artery aneurysms before pregnancy, and selection of  imaging modalities to detect pulmonary embolism. Fri, 03 Feb 2023 06:05:00 -0000 full BackTable In this episode, our host Dr. Ally Baheti interviews interventional radiologist Dr. Nikki Keefe about safety considerations for pregnant and breastfeeding IR patients. In this episode, our host Dr. Ally Baheti interviews interventional radiologist Dr. Nikki Keefe about safety considerations for pregnant and breastfeeding IR patients. Dr. Keefe’s personal experience with pregnancy during her IR training sparked her interest in this topic. A lot of IR patients are pregnant or breastfeeding, so it is important to be cognizant of radiation and medication exposures and how they should be altered. She emphasizes the importance of establishing a protocol when these patients present. We review radiation doses of various IR procedures and risk stratification based on gestational age. At each stage of pregnancy, there are different risks of disruptions in organogenesis, effects on neural tube development, and predisposition to cancer. Elective procedures should usually be deferred until after delivery. The most common and necessary procedures performed in pregnant patients are PICC line placement, nephrostomy tube, and treatment of postpartum hemorrhage. Dr. Keefe also shares her tips for minimizing fluoroscopy time and deciding between different diagnostic imaging modalities that present both maternal and fetal radiation risks. Next, we discuss medication safety. Iodinated contrast is safe to give during pregnancy, while gadolinium is not. Sedation with opioids is generally safe, but their sustained use or administration around the perinatal period can cause neonatal withdrawal symptoms. Benzodiazepines can also be used for amnesia and anxiety reduction, and midazolam has a good safety profile and long half life. However, abnormally extended use of benzodiazepines can cause floppy infant syndrome (sedation, muscle laxity, failure to suckle). Dr. Keefe notes that pregnant patients have to start on higher doses than the standard, since they have higher blood volume and increased renal clearance of these medications. Lovenox is the safest known anticoagulant for pregnant women. Additionally, fetal heart monitoring should be performed before and after the procedure. Finally, we talk about specific cases of patient positioning when placing nephrostomy tubes, transhepatic access for gallbladder tubes, treatment of visceral artery aneurysms before pregnancy, and selection of  imaging modalities to detect pulmonary embolism. In this episode, our host Dr. Ally Baheti interviews interventional radiologist Dr. Nikki Keefe about safety considerations for pregnant and breastfeeding IR patients.

Dr. Keefe’s personal experience with pregnancy during her IR training sparked her interest in this topic. A lot of IR patients are pregnant or breastfeeding, so it is important to be cognizant of radiation and medication exposures and how they should be altered. She emphasizes the importance of establishing a protocol when these patients present.

We review radiation doses of various IR procedures and risk stratification based on gestational age. At each stage of pregnancy, there are different risks of disruptions in organogenesis, effects on neural tube development, and predisposition to cancer. Elective procedures should usually be deferred until after delivery. The most common and necessary procedures performed in pregnant patients are PICC line placement, nephrostomy tube, and treatment of postpartum hemorrhage. Dr. Keefe also shares her tips for minimizing fluoroscopy time and deciding between different diagnostic imaging modalities that present both maternal and fetal radiation risks.

Next, we discuss medication safety. Iodinated contrast is safe to give during pregnancy, while gadolinium is not. Sedation with opioids is generally safe, but their sustained use or administration around the perinatal period can cause neonatal withdrawal symptoms. Benzodiazepines can also be used for amnesia and anxiety reduction, and midazolam has a good safety profile and long half life. However, abnormally extended use of benzodiazepines can cause floppy infant syndrome (sedation, muscle laxity, failure to suckle). Dr. Keefe notes that pregnant patients have to start on higher doses than the standard, since they have higher blood volume and increased renal clearance of these medications. Lovenox is the safest known anticoagulant for pregnant women. Additionally, fetal heart monitoring should be performed before and after the procedure.

Finally, we talk about specific cases of patient positioning when placing nephrostomy tubes, transhepatic access for gallbladder tubes, treatment of visceral artery aneurysms before pregnancy, and selection of  imaging modalities to detect pulmonary embolism.



]]> 1670 Ep. 287 OBL/ASC Reimbursement Update Jan 2023 with Dr. Jim Melton and Dr. Blake Parson In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton, vascular surgeon, and Dr. Blake Parsons, interventional radiologist, about progress in the OBL and ASC space, including reimbursement updates, partnering with a private equity firm, and value based care. --- CHECK OUT OUR SPONSOR Surmodics Pounce Thrombectomy https://pouncesystem.com/ --- SHOW NOTES We begin by discussing new developments in Dr. Melton’s and Dr. Parson’s practice. Over the past year, they have partnered with a private equity firm, Assured Healthcare Partners to create Heart and Vascular Partners (HVP). They now cover Oklahoma City, Colorado Springs, Denver, Pueblo, and parts of Illinois and Indiana. They employ mostly hospital based physicians’ ready to start their own office based lab (OBL) or ambulatory surgery center (ASC). The physicians under HVP are cardiologists, vascular surgeons, and interventional radiologists. The two discuss the advantages of aligning with a private equity firm. For them, it provided the scale and capability to provide value-based care when it becomes widely adopted. Additionally, the payer has a much lower cost for the service in the outpatient space versus the hospital. All the physicians in HVP maintain local control over their practices, which was one of their main goals when they decided to partner with a firm. Next, we cover reimbursement cuts and the trends in OBLs and ASCs. On the arterial side of business, they are seeing that OBLs are down 10-15% in reimbursement rates, whereas ASCs are up 3-30%. For iliac interventions in the ASC, they have seen a 30-50% increase in balloon angioplasty and stenting, and up to a 60% increase for Shockwave. On the embolization side, arterial and venous reimbursement has dropped in the OBL by 7-8% and increased in the ASC by 3-30%. Alternatively, the CPT code for embolization for end organ ischemia (UFE, PAE) is still well reimbursed in the OBL. They caution listeners on genicular artery embolization and cryoneurolysis due to the risk of not getting it reimbursed and having to pay money back. --- RESOURCES Heart and Vascular Partners: https://heartandvascularpartners.com Mon, 30 Jan 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton, vascular surgeon, and Dr. Blake Parsons, interventional radiologist, about progress in the OBL and ASC space, including reimbursement updates, partnering with a private equity firm, and value based care. In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton, vascular surgeon, and Dr. Blake Parsons, interventional radiologist, about progress in the OBL and ASC space, including reimbursement updates, partnering with a private equity firm, and value based care. --- CHECK OUT OUR SPONSOR Surmodics Pounce Thrombectomy https://pouncesystem.com/ --- SHOW NOTES We begin by discussing new developments in Dr. Melton’s and Dr. Parson’s practice. Over the past year, they have partnered with a private equity firm, Assured Healthcare Partners to create Heart and Vascular Partners (HVP). They now cover Oklahoma City, Colorado Springs, Denver, Pueblo, and parts of Illinois and Indiana. They employ mostly hospital based physicians’ ready to start their own office based lab (OBL) or ambulatory surgery center (ASC). The physicians under HVP are cardiologists, vascular surgeons, and interventional radiologists. The two discuss the advantages of aligning with a private equity firm. For them, it provided the scale and capability to provide value-based care when it becomes widely adopted. Additionally, the payer has a much lower cost for the service in the outpatient space versus the hospital. All the physicians in HVP maintain local control over their practices, which was one of their main goals when they decided to partner with a firm. Next, we cover reimbursement cuts and the trends in OBLs and ASCs. On the arterial side of business, they are seeing that OBLs are down 10-15% in reimbursement rates, whereas ASCs are up 3-30%. For iliac interventions in the ASC, they have seen a 30-50% increase in balloon angioplasty and stenting, and up to a 60% increase for Shockwave. On the embolization side, arterial and venous reimbursement has dropped in the OBL by 7-8% and increased in the ASC by 3-30%. Alternatively, the CPT code for embolization for end organ ischemia (UFE, PAE) is still well reimbursed in the OBL. They caution listeners on genicular artery embolization and cryoneurolysis due to the risk of not getting it reimbursed and having to pay money back. --- RESOURCES Heart and Vascular Partners: https://heartandvascularpartners.com In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton, vascular surgeon, and Dr. Blake Parsons, interventional radiologist, about progress in the OBL and ASC space, including reimbursement updates, partnering with a private equity firm, and value based care.


---


CHECK OUT OUR SPONSOR


Surmodics Pounce Thrombectomy

https://pouncesystem.com/


---


SHOW NOTES


We begin by discussing new developments in Dr. Melton’s and Dr. Parson’s practice. Over the past year, they have partnered with a private equity firm, Assured Healthcare Partners to create Heart and Vascular Partners (HVP). They now cover Oklahoma City, Colorado Springs, Denver, Pueblo, and parts of Illinois and Indiana. They employ mostly hospital based physicians’ ready to start their own office based lab (OBL) or ambulatory surgery center (ASC). The physicians under HVP are cardiologists, vascular surgeons, and interventional radiologists.


The two discuss the advantages of aligning with a private equity firm. For them, it provided the scale and capability to provide value-based care when it becomes widely adopted. Additionally, the payer has a much lower cost for the service in the outpatient space versus the hospital. All the physicians in HVP maintain local control over their practices, which was one of their main goals when they decided to partner with a firm.


Next, we cover reimbursement cuts and the trends in OBLs and ASCs. On the arterial side of business, they are seeing that OBLs are down 10-15% in reimbursement rates, whereas ASCs are up 3-30%. For iliac interventions in the ASC, they have seen a 30-50% increase in balloon angioplasty and stenting, and up to a 60% increase for Shockwave. On the embolization side, arterial and venous reimbursement has dropped in the OBL by 7-8% and increased in the ASC by 3-30%. Alternatively, the CPT code for embolization for end organ ischemia (UFE, PAE) is still well reimbursed in the OBL. They caution listeners on genicular artery embolization and cryoneurolysis due to the risk of not getting it reimbursed and having to pay money back.


---


RESOURCES


Heart and Vascular Partners:

https://heartandvascularpartners.com

]]> 2210 Ep. 286 Minimally Invasive Thyroid Interventions with Dr. Jawad Hussain and Dr. Alan Alper Sag In this episode, our host Dr.Michael Barraza interviews Drs. Jawad Hussain and Alan Sag about how they implemented thyroid artery embolization into their respective private and academic practices. --- CHECK OUT OUR SPONSOR Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/GXgzcZ --- SHOW NOTES Dr. Hussain discusses how he started doing thyroid embolizations. It was born out of a need to replace thyroid RFA, since the thyroid RFA generator was not yet approved in his health system. At Duke, Dr. Sag collaborated with endocrinologists and endocrine surgeons to address a need to treat non-surgical candidates with bulk symptoms. These symptoms can include supine dyspnea, dysphagia, and aspiration risk. Together, they developed an institutional protocol for post-procedural management. Dr. Sag emphasizes that everything an IR needs to perform a goiter embolization is probably already available to them. Next, the doctors describe how they implemented thyroid embolization in their respective practices. Dr. Sag approached his institution’s weekly tumor board of endocrine specialists to introduce the concept. When talking to non-surgical patients, he offers thyroid embolization as a palliation alternative to tracheostomy and percutaneous gastrostomy as airway protection for patients with aspiration risks. Dr. Hussain describes patients with TR-3 and TR-4 nodules who require repeat FNA. Embolization can be a valuable option for them, since it is a quick outpatient procedure with minimal side effects. Additionally, he communicates to patients that IRs have experience with applying transcatheter embolizations in different spaces in the body and sets the expectation that shrinkage will be a gradual process. Both doctors emphasize the importance of informed consent in a relatively new palliative procedure. In terms of the research landscape for thyroid embolization, Dr. Hussain says that publishing a large retrospective multicenter study would revolutionize the procedure, since it could show efficacy and safety. Dr. Sag believes that RFA and embolization are complementary technologies that can be used in different scenarios. Dr. Hussain shares his treatment algorithm, which includes getting a CTA after each consultation, to map out variable anatomy and select hypertrophied vessels. Deep cannulation is key to preventing reflux and non-target embolization. Additionally, he does a two week follow up for post-procedural symptoms and a 2 month imaging appointment. Dr. Sag describes a joint clinic with endocrine surgeons. Every patient gets a visit from each service on the same day, and the doctors are able to convene and make joint decisions based on patient and goiter factors. He recommends getting a cone beam CTA to rule out anastamoses to aerodigestive structures and the cervical spinal cord. In his embolization, he uses 300-500 micron Embospheres and leaves at least one quadrant untreated to spare some thyroid and parathyroid glands. He also administers decadron and a medrol dose pack. Lab follow-up happens at day 7, when most thyroid hormone peaks occur. If patients are still experiencing symptoms after two months, Dr. Sag will consider repeating the embolization. --- RESOURCES Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients (Yilmaz et al): https://pubmed.ncbi.nlm.nih.gov/34256121/ ACR TI-RADS: https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/TI-RADS 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/ Fri, 27 Jan 2023 00:05:00 -0000 full BackTable In this episode, our host Dr. Michael Barraza interviews Drs. Jawad Hussain and Alan Sag about how they implemented thyroid artery embolization into their respective private and academic practices. In this episode, our host Dr.Michael Barraza interviews Drs. Jawad Hussain and Alan Sag about how they implemented thyroid artery embolization into their respective private and academic practices. --- CHECK OUT OUR SPONSOR Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/GXgzcZ --- SHOW NOTES Dr. Hussain discusses how he started doing thyroid embolizations. It was born out of a need to replace thyroid RFA, since the thyroid RFA generator was not yet approved in his health system. At Duke, Dr. Sag collaborated with endocrinologists and endocrine surgeons to address a need to treat non-surgical candidates with bulk symptoms. These symptoms can include supine dyspnea, dysphagia, and aspiration risk. Together, they developed an institutional protocol for post-procedural management. Dr. Sag emphasizes that everything an IR needs to perform a goiter embolization is probably already available to them. Next, the doctors describe how they implemented thyroid embolization in their respective practices. Dr. Sag approached his institution’s weekly tumor board of endocrine specialists to introduce the concept. When talking to non-surgical patients, he offers thyroid embolization as a palliation alternative to tracheostomy and percutaneous gastrostomy as airway protection for patients with aspiration risks. Dr. Hussain describes patients with TR-3 and TR-4 nodules who require repeat FNA. Embolization can be a valuable option for them, since it is a quick outpatient procedure with minimal side effects. Additionally, he communicates to patients that IRs have experience with applying transcatheter embolizations in different spaces in the body and sets the expectation that shrinkage will be a gradual process. Both doctors emphasize the importance of informed consent in a relatively new palliative procedure. In terms of the research landscape for thyroid embolization, Dr. Hussain says that publishing a large retrospective multicenter study would revolutionize the procedure, since it could show efficacy and safety. Dr. Sag believes that RFA and embolization are complementary technologies that can be used in different scenarios. Dr. Hussain shares his treatment algorithm, which includes getting a CTA after each consultation, to map out variable anatomy and select hypertrophied vessels. Deep cannulation is key to preventing reflux and non-target embolization. Additionally, he does a two week follow up for post-procedural symptoms and a 2 month imaging appointment. Dr. Sag describes a joint clinic with endocrine surgeons. Every patient gets a visit from each service on the same day, and the doctors are able to convene and make joint decisions based on patient and goiter factors. He recommends getting a cone beam CTA to rule out anastamoses to aerodigestive structures and the cervical spinal cord. In his embolization, he uses 300-500 micron Embospheres and leaves at least one quadrant untreated to spare some thyroid and parathyroid glands. He also administers decadron and a medrol dose pack. Lab follow-up happens at day 7, when most thyroid hormone peaks occur. If patients are still experiencing symptoms after two months, Dr. Sag will consider repeating the embolization. --- RESOURCES Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients (Yilmaz et al): https://pubmed.ncbi.nlm.nih.gov/34256121/ ACR TI-RADS: https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/TI-RADS 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/ In this episode, our host Dr.Michael Barraza interviews Drs. Jawad Hussain and Alan Sag about how they implemented thyroid artery embolization into their respective private and academic practices.


---


CHECK OUT OUR SPONSOR


Medtronic Chocolate PTA Balloon

https://www.medtronic.com/peripheral


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/GXgzcZ


---


SHOW NOTES


Dr. Hussain discusses how he started doing thyroid embolizations. It was born out of a need to replace thyroid RFA, since the thyroid RFA generator was not yet approved in his health system. At Duke, Dr. Sag collaborated with endocrinologists and endocrine surgeons to address a need to treat non-surgical candidates with bulk symptoms. These symptoms can include supine dyspnea, dysphagia, and aspiration risk. Together, they developed an institutional protocol for post-procedural management. Dr. Sag emphasizes that everything an IR needs to perform a goiter embolization is probably already available to them.


Next, the doctors describe how they implemented thyroid embolization in their respective practices. Dr. Sag approached his institution’s weekly tumor board of endocrine specialists to introduce the concept. When talking to non-surgical patients, he offers thyroid embolization as a palliation alternative to tracheostomy and percutaneous gastrostomy as airway protection for patients with aspiration risks. Dr. Hussain describes patients with TR-3 and TR-4 nodules who require repeat FNA. Embolization can be a valuable option for them, since it is a quick outpatient procedure with minimal side effects. Additionally, he communicates to patients that IRs have experience with applying transcatheter embolizations in different spaces in the body and sets the expectation that shrinkage will be a gradual process. Both doctors emphasize the importance of informed consent in a relatively new palliative procedure. In terms of the research landscape for thyroid embolization, Dr. Hussain says that publishing a large retrospective multicenter study would revolutionize the procedure, since it could show efficacy and safety. Dr. Sag believes that RFA and embolization are complementary technologies that can be used in different scenarios.


Dr. Hussain shares his treatment algorithm, which includes getting a CTA after each consultation, to map out variable anatomy and select hypertrophied vessels. Deep cannulation is key to preventing reflux and non-target embolization. Additionally, he does a two week follow up for post-procedural symptoms and a 2 month imaging appointment. Dr. Sag describes a joint clinic with endocrine surgeons. Every patient gets a visit from each service on the same day, and the doctors are able to convene and make joint decisions based on patient and goiter factors. He recommends getting a cone beam CTA to rule out anastamoses to aerodigestive structures and the cervical spinal cord. In his embolization, he uses 300-500 micron Embospheres and leaves at least one quadrant untreated to spare some thyroid and parathyroid glands. He also administers decadron and a medrol dose pack. Lab follow-up happens at day 7, when most thyroid hormone peaks occur. If patients are still experiencing symptoms after two months, Dr. Sag will consider repeating the embolization.


---


RESOURCES


Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients (Yilmaz et al):

https://pubmed.ncbi.nlm.nih.gov/34256121/


ACR TI-RADS:

https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/TI-RADS


2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/

]]> 2722 Ep. 285 TIPS with ICE Guidance with Dr. Merve Ozen In this episode, host Dr. Aparna Baheti interviews Dr. Merve Ozen, interventional radiologist, about how to integrate ICE for TIPS, including why she uses a vampire stick, her needle preference, and tips for single operators. --- CHECK OUT OUR SPONSOR Medtronic VenaSeal https://www.medtronic.com/venaseal --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/nfh4bj --- SHOW NOTES Dr. Ozen begins by discussing the challenges she faced when introducing this new technique into her practice at the University of Kentucky. She faced pushback from administration about procedure time and anesthesia time. She now does all her TIPS with intracardiac echocardiography (ICE) guidance, but she keeps CO2 available in case of device malfunction, which would cause her to revert to the traditional method of CO2 angiography. It takes time to learn how to navigate the ICE probe, also called intravascular ultrasound (IVUS), but it helps with complicated cases like thrombosed portal veins and Budd-Chiari syndrome. She uses the “vampire stick” technique, which is a side by side internal jugular access technique for the TIPS needle and the US probe. She puts her TIPS access more medial, which makes it more stable, and places her ICE access more lateral. After getting access, she spends time understanding the anatomy in the liver. Prior CT is useful for getting information about patient specific anatomy. She then uses ICE to view the portal vein and hepatic vein on the same plane, then she advances the needle with one stick. Dr. Ozen prefers a Rösch-Uchida needle versus a Colapinto because she feels she can better visualize it with ICE. One thing she recommends spending time on is understanding where to start introducing your needle. If there is clot or liver stuck in the needle and preventing blood return, she recommends flushing the needle, or advancing it and then pulling back gently. She ends by stating that learning how to operate the ICE probe is a steep learning curve, but one that every IR should invest time in. It cuts down on anesthesia and fluoroscopy time, and provides a level of safety that is simply not achievable with traditional methods. --- RESOURCES ARRS 2022 Abstract on ICE TIPS: https://apps.arrs.org/AbstractsAM22Open/Main/Abstract/E2038 Mon, 23 Jan 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Aparna Baheti interviews Dr. Merve Ozen, interventional radiologist, about how to integrate ICE for TIPS, including why she uses a vampire stick, her needle preference, and tips for single operators. In this episode, host Dr. Aparna Baheti interviews Dr. Merve Ozen, interventional radiologist, about how to integrate ICE for TIPS, including why she uses a vampire stick, her needle preference, and tips for single operators. --- CHECK OUT OUR SPONSOR Medtronic VenaSeal https://www.medtronic.com/venaseal --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/nfh4bj --- SHOW NOTES Dr. Ozen begins by discussing the challenges she faced when introducing this new technique into her practice at the University of Kentucky. She faced pushback from administration about procedure time and anesthesia time. She now does all her TIPS with intracardiac echocardiography (ICE) guidance, but she keeps CO2 available in case of device malfunction, which would cause her to revert to the traditional method of CO2 angiography. It takes time to learn how to navigate the ICE probe, also called intravascular ultrasound (IVUS), but it helps with complicated cases like thrombosed portal veins and Budd-Chiari syndrome. She uses the “vampire stick” technique, which is a side by side internal jugular access technique for the TIPS needle and the US probe. She puts her TIPS access more medial, which makes it more stable, and places her ICE access more lateral. After getting access, she spends time understanding the anatomy in the liver. Prior CT is useful for getting information about patient specific anatomy. She then uses ICE to view the portal vein and hepatic vein on the same plane, then she advances the needle with one stick. Dr. Ozen prefers a Rösch-Uchida needle versus a Colapinto because she feels she can better visualize it with ICE. One thing she recommends spending time on is understanding where to start introducing your needle. If there is clot or liver stuck in the needle and preventing blood return, she recommends flushing the needle, or advancing it and then pulling back gently. She ends by stating that learning how to operate the ICE probe is a steep learning curve, but one that every IR should invest time in. It cuts down on anesthesia and fluoroscopy time, and provides a level of safety that is simply not achievable with traditional methods. --- RESOURCES ARRS 2022 Abstract on ICE TIPS: https://apps.arrs.org/AbstractsAM22Open/Main/Abstract/E2038 In this episode, host Dr. Aparna Baheti interviews Dr. Merve Ozen, interventional radiologist, about how to integrate ICE for TIPS, including why she uses a vampire stick, her needle preference, and tips for single operators.


---


CHECK OUT OUR SPONSOR


Medtronic VenaSeal

https://www.medtronic.com/venaseal


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/nfh4bj


---


SHOW NOTES


Dr. Ozen begins by discussing the challenges she faced when introducing this new technique into her practice at the University of Kentucky. She faced pushback from administration about procedure time and anesthesia time. She now does all her TIPS with intracardiac echocardiography (ICE) guidance, but she keeps CO2 available in case of device malfunction, which would cause her to revert to the traditional method of CO2 angiography.


It takes time to learn how to navigate the ICE probe, also called intravascular ultrasound (IVUS), but it helps with complicated cases like thrombosed portal veins and Budd-Chiari syndrome. She uses the “vampire stick” technique, which is a side by side internal jugular access technique for the TIPS needle and the US probe. She puts her TIPS access more medial, which makes it more stable, and places her ICE access more lateral.


After getting access, she spends time understanding the anatomy in the liver. Prior CT is useful for getting information about patient specific anatomy. She then uses ICE to view the portal vein and hepatic vein on the same plane, then she advances the needle with one stick. Dr. Ozen prefers a Rösch-Uchida needle versus a Colapinto because she feels she can better visualize it with ICE. One thing she recommends spending time on is understanding where to start introducing your needle. If there is clot or liver stuck in the needle and preventing blood return, she recommends flushing the needle, or advancing it and then pulling back gently. She ends by stating that learning how to operate the ICE probe is a steep learning curve, but one that every IR should invest time in. It cuts down on anesthesia and fluoroscopy time, and provides a level of safety that is simply not achievable with traditional methods.


---


RESOURCES


ARRS 2022 Abstract on ICE TIPS:

https://apps.arrs.org/AbstractsAM22Open/Main/Abstract/E2038

]]> 1715 Ep. 284 Ortho/IR Collaboration in Private Practice with Dr. Daniel Lerman and Dr. Anthony Brown In this episode, host Jacob Fleming interviews interventional radiologist Tony Brown and orthopedic oncologist Daniel Lerman about their multidisciplinary IR/orthopedics practice and innovative techniques for pelvic fixation in metastatic cancer patients. --- CHECK OUT OUR SPONSOR Viz.ai https://www.viz.ai/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Bp4tmV --- SHOW NOTES The guests recount their first case together, a “no option” patient in which they collaborated on a tripod fixation of an acetabulum, using a combination of screw placement and cementoplasty. They realized that they were both invested in improving minimally invasive fixation and helping patients with pain management and daily functioning. Their collaboration blossomed into a joint practice of MSK interventional oncology that offers biomechanics knowledge of orthopedic surgery and the precise image guidance of interventional radiology. With the rise of systemic cancer therapies, more patients are living with metastatic bone disease, and this new treatment paradigm could offer them a true joint reconstruction and stable fixation. Overtime, they have streamlined the technique to make their cases more efficient and precise. Despite their advances, Dr. Brown notes that MSK interventional oncology still has a long way to go. In the community, pelvic fractures usually go untreated. He speaks about the importance of outreach to radiation oncologists and orthopedic surgeons and letting them know about new methods of pelvic fixation. Dr. Brown encourages IRs who are curious about MSK interventions to get in contact with colleagues who are already doing innovative techniques and device companies that offer classes. Additionally, there is a need for innovation in instrumentation. Most pelvic intervention tools have been adopted from spine tools; however pelvic anatomy and pelvic lesions are vastly different. Dr. Lerman highlights the uniqueness of each patient’s disease, tumor, and bone lysis. He believes that there is a need to elucidate why different patients respond to different types of constructs. --- RESOURCES Institute for Limb Preservation: https://www.limbpreservationcolorado.com/ Musculoskeletal Tumor Society (MSTS): http://msts.org/ Fri, 20 Jan 2023 06:05:00 -0000 full BackTable In this episode, host Jacob Fleming interviews interventional radiologist Tony Brown and orthopedic oncologist Daniel Lerman about their multidisciplinary IR/orthopedics practice and innovative techniques for pelvic fixation in metastatic cancer patients. In this episode, host Jacob Fleming interviews interventional radiologist Tony Brown and orthopedic oncologist Daniel Lerman about their multidisciplinary IR/orthopedics practice and innovative techniques for pelvic fixation in metastatic cancer patients. --- CHECK OUT OUR SPONSOR Viz.ai https://www.viz.ai/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Bp4tmV --- SHOW NOTES The guests recount their first case together, a “no option” patient in which they collaborated on a tripod fixation of an acetabulum, using a combination of screw placement and cementoplasty. They realized that they were both invested in improving minimally invasive fixation and helping patients with pain management and daily functioning. Their collaboration blossomed into a joint practice of MSK interventional oncology that offers biomechanics knowledge of orthopedic surgery and the precise image guidance of interventional radiology. With the rise of systemic cancer therapies, more patients are living with metastatic bone disease, and this new treatment paradigm could offer them a true joint reconstruction and stable fixation. Overtime, they have streamlined the technique to make their cases more efficient and precise. Despite their advances, Dr. Brown notes that MSK interventional oncology still has a long way to go. In the community, pelvic fractures usually go untreated. He speaks about the importance of outreach to radiation oncologists and orthopedic surgeons and letting them know about new methods of pelvic fixation. Dr. Brown encourages IRs who are curious about MSK interventions to get in contact with colleagues who are already doing innovative techniques and device companies that offer classes. Additionally, there is a need for innovation in instrumentation. Most pelvic intervention tools have been adopted from spine tools; however pelvic anatomy and pelvic lesions are vastly different. Dr. Lerman highlights the uniqueness of each patient’s disease, tumor, and bone lysis. He believes that there is a need to elucidate why different patients respond to different types of constructs. --- RESOURCES Institute for Limb Preservation: https://www.limbpreservationcolorado.com/ Musculoskeletal Tumor Society (MSTS): http://msts.org/ In this episode, host Jacob Fleming interviews interventional radiologist Tony Brown and orthopedic oncologist Daniel Lerman about their multidisciplinary IR/orthopedics practice and innovative techniques for pelvic fixation in metastatic cancer patients.


---


CHECK OUT OUR SPONSOR


Viz.ai

https://www.viz.ai/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Bp4tmV


---


SHOW NOTES


The guests recount their first case together, a “no option” patient in which they collaborated on a tripod fixation of an acetabulum, using a combination of screw placement and cementoplasty. They realized that they were both invested in improving minimally invasive fixation and helping patients with pain management and daily functioning. Their collaboration blossomed into a joint practice of MSK interventional oncology that offers biomechanics knowledge of orthopedic surgery and the precise image guidance of interventional radiology. With the rise of systemic cancer therapies, more patients are living with metastatic bone disease, and this new treatment paradigm could offer them a true joint reconstruction and stable fixation. Overtime, they have streamlined the technique to make their cases more efficient and precise.


Despite their advances, Dr. Brown notes that MSK interventional oncology still has a long way to go. In the community, pelvic fractures usually go untreated. He speaks about the importance of outreach to radiation oncologists and orthopedic surgeons and letting them know about new methods of pelvic fixation. Dr. Brown encourages IRs who are curious about MSK interventions to get in contact with colleagues who are already doing innovative techniques and device companies that offer classes. Additionally, there is a need for innovation in instrumentation. Most pelvic intervention tools have been adopted from spine tools; however pelvic anatomy and pelvic lesions are vastly different. Dr. Lerman highlights the uniqueness of each patient’s disease, tumor, and bone lysis. He believes that there is a need to elucidate why different patients respond to different types of constructs.


---


RESOURCES


Institute for Limb Preservation:

https://www.limbpreservationcolorado.com/


Musculoskeletal Tumor Society (MSTS):

http://msts.org/

]]> 3740 Ep. 283 Interspinous Spacers for Spinal Stenosis Part 2 with Dr. Luigi Manfre In this episode, host Dr. Jacob Fleming interviews Dr. Luigi Manfrè, spine interventional neuroradiologist and chair of the European Society of Neuroradiology about treatment of spinal stenosis and spondylolisthesis using interspinous fusion spacers. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Dr9Ojz --- SHOW NOTES Dr. Manfrè reviews his technique for interspinous spacer placement. He uses local anesthesia which he administers with a spinal needle. He adjusts the angulation and entry point using CT, then inserts the guide wire. When he has it positioned between two spinous processes, and when the wire abuts the facet, this is the end point of the guide wire. He then uses soft tissue dilators through a 5mm incision before placing a spacer over the spacer delivery system. He usually places 8-12mm spacers, occasionally using 14mm spacers. One of the main pitfalls that happens when placing spacers is oversizing. Dr. Manfrè believes that this is a more common phenomenon in open surgical decompression due to patient placement in the operating room. Patients are often placed prone with a pillow beneath their abdomen to flex the lumbar spine and aid in exposure and insertion of spacers. However, this causes measurements to be greater than they are in natural spine mechanics. Next, we discuss the historical idea that interspinous spacers induce an unnatural lumbar kyphosis. New research suggests this is not the case. In fact, spacers restore the natural alignment of the spine without inducing kyphosis. Additionally, in patients with stenosis at multiple levels, the addition of a spacer at the worst level improves the morphology of the entire spine. He usually only places one spacer for his patients, and rarely will place two. New unpublished research by Dr. Manfrè on upright MRI shows that spacers placed for patients with spinal stenosis cause expansion of the dural sac by up to 70% by the next day. What’s more, in patients with both stenosis and listhesis, placement of a fusion spacer to correct both the stenosis and the instability result in disappearance of listhesis on MR the day after the procedure. --- RESOURCES Dr. Manfrè Website: https://www.manfreluigi.com/index.html Manfrè Articles: https://jnis.bmj.com/content/12/7/673.abstract https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511561/ https://journals.sagepub.com/doi/abs/10.15274/INR-2014-10052 ESNR Hands On Spine Course: https://www.esnr.org/en/spine-interventional-neuroradiology-full-hands-on-course/about-catania/ New Procedures in Spinal Interventional Neuroradiology: https://www.springer.com/series/13394 Wed, 18 Jan 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Luigi Manfrè, spine interventional neuroradiologist and chair of the European Society of Neuroradiology about treatment of spinal stenosis and spondylolisthesis using interspinous fusion spacers. In this episode, host Dr. Jacob Fleming interviews Dr. Luigi Manfrè, spine interventional neuroradiologist and chair of the European Society of Neuroradiology about treatment of spinal stenosis and spondylolisthesis using interspinous fusion spacers. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Dr9Ojz --- SHOW NOTES Dr. Manfrè reviews his technique for interspinous spacer placement. He uses local anesthesia which he administers with a spinal needle. He adjusts the angulation and entry point using CT, then inserts the guide wire. When he has it positioned between two spinous processes, and when the wire abuts the facet, this is the end point of the guide wire. He then uses soft tissue dilators through a 5mm incision before placing a spacer over the spacer delivery system. He usually places 8-12mm spacers, occasionally using 14mm spacers. One of the main pitfalls that happens when placing spacers is oversizing. Dr. Manfrè believes that this is a more common phenomenon in open surgical decompression due to patient placement in the operating room. Patients are often placed prone with a pillow beneath their abdomen to flex the lumbar spine and aid in exposure and insertion of spacers. However, this causes measurements to be greater than they are in natural spine mechanics. Next, we discuss the historical idea that interspinous spacers induce an unnatural lumbar kyphosis. New research suggests this is not the case. In fact, spacers restore the natural alignment of the spine without inducing kyphosis. Additionally, in patients with stenosis at multiple levels, the addition of a spacer at the worst level improves the morphology of the entire spine. He usually only places one spacer for his patients, and rarely will place two. New unpublished research by Dr. Manfrè on upright MRI shows that spacers placed for patients with spinal stenosis cause expansion of the dural sac by up to 70% by the next day. What’s more, in patients with both stenosis and listhesis, placement of a fusion spacer to correct both the stenosis and the instability result in disappearance of listhesis on MR the day after the procedure. --- RESOURCES Dr. Manfrè Website: https://www.manfreluigi.com/index.html Manfrè Articles: https://jnis.bmj.com/content/12/7/673.abstract https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511561/ https://journals.sagepub.com/doi/abs/10.15274/INR-2014-10052 ESNR Hands On Spine Course: https://www.esnr.org/en/spine-interventional-neuroradiology-full-hands-on-course/about-catania/ New Procedures in Spinal Interventional Neuroradiology: https://www.springer.com/series/13394 In this episode, host Dr. Jacob Fleming interviews Dr. Luigi Manfrè, spine interventional neuroradiologist and chair of the European Society of Neuroradiology about treatment of spinal stenosis and spondylolisthesis using interspinous fusion spacers.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Dr9Ojz


---


SHOW NOTES


Dr. Manfrè reviews his technique for interspinous spacer placement. He uses local anesthesia which he administers with a spinal needle. He adjusts the angulation and entry point using CT, then inserts the guide wire. When he has it positioned between two spinous processes, and when the wire abuts the facet, this is the end point of the guide wire. He then uses soft tissue dilators through a 5mm incision before placing a spacer over the spacer delivery system. He usually places 8-12mm spacers, occasionally using 14mm spacers.


One of the main pitfalls that happens when placing spacers is oversizing. Dr. Manfrè believes that this is a more common phenomenon in open surgical decompression due to patient placement in the operating room. Patients are often placed prone with a pillow beneath their abdomen to flex the lumbar spine and aid in exposure and insertion of spacers. However, this causes measurements to be greater than they are in natural spine mechanics.


Next, we discuss the historical idea that interspinous spacers induce an unnatural lumbar kyphosis. New research suggests this is not the case. In fact, spacers restore the natural alignment of the spine without inducing kyphosis. Additionally, in patients with stenosis at multiple levels, the addition of a spacer at the worst level improves the morphology of the entire spine. He usually only places one spacer for his patients, and rarely will place two. New unpublished research by Dr. Manfrè on upright MRI shows that spacers placed for patients with spinal stenosis cause expansion of the dural sac by up to 70% by the next day. What’s more, in patients with both stenosis and listhesis, placement of a fusion spacer to correct both the stenosis and the instability result in disappearance of listhesis on MR the day after the procedure.


---


RESOURCES


Dr. Manfrè Website:

https://www.manfreluigi.com/index.html


Manfrè Articles:

https://jnis.bmj.com/content/12/7/673.abstract

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511561/

https://journals.sagepub.com/doi/abs/10.15274/INR-2014-10052


ESNR Hands On Spine Course:

https://www.esnr.org/en/spine-interventional-neuroradiology-full-hands-on-course/about-catania/


New Procedures in Spinal Interventional Neuroradiology:

https://www.springer.com/series/13394

]]> 2963 Ep. 282 Interspinous Spacers for Spinal Stenosis Part I with Dr. Luigi Manfre In this episode, host Dr. Jacob Fleming interviews Dr. Luigi Manfrè, interventional radiologist and chair of the European Society of Neuroradiology about how he treats lumbar spinal stenosis using spinoplasty and minimally invasive placement of interspinous spacers. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Syf8sW --- SHOW NOTES Dr. Manfrè discusses his background and how he arrived at his current practice in Catania, Italy. His journey in medicine began with the intention of becoming an ophthalmologist. He then realized he didn’t want to pursue this path, and was told by a teacher he would be studying neuroradiology. He despised neuroradiology prior to this, but soon fell in love “at first sight”. He then went to Toronto to study under pioneers of pediatric neuroradiology. He dabbled in vascular IR before finally finding interventional spine. It began with injections for pain but he soon realized the potential of this field. At the time, surgery was becoming more minimally invasive, and as a radiologist, he knew he could leverage this momentum due to this unique background in radiology that his surgeon colleagues did not have. Dr. Manfrè believed he could apply the same treatments that conventional spine surgeons were doing in a faster, more precise and less aggressive manner. Spine surgeons were beginning to place interspinous spacers for spinal stenosis, and he was interested in placing these using CT and fluoroscopy guidance. He selects his patients very precisely, because it is important to him to not be using a device on the wrong patient. He endorses collaboration with neurosurgeons and orthopedic surgeons and practices this frequently, often referring patients within his network of collaborators. He selects patients for interspinous spacer placement who have genetic lumbar spinal stenosis causing ligamentous compression of nerves. His technique involves a combination of CT and fluoroscopy as it has been shown that using CT for procedural planning has been shown to reduce patient radiation exposure by 90%. He then uses fluoroscopy to insert the dilater over the guide wire, put in the spacer and open the spacer, which takes around 20 seconds of fluoro time. The interspinous spacer is a device that is placed in between two spinous processes to slow the progression of spinal stenosis and neurologic injury. The spacer cannot undo any prior neurologic injury, however, due to the progressive nature of this disease process. Surgical placement of a spacer is aggressive, involving general anesthesia in older patients with comorbidities, opening of the spinal canal, and laminectomy, which causes ligamentous instability that requires repair. It can be a three hour procedure, which involves extensive recovery and rehab. Dr. Manfrè places a spacer in 3 minutes, uses local anesthesia and midazolam, a 5mm incision, and no rehab. The primary reason for failure of the procedure is spinous process fracture and bone remodeling. He began performing spinoplasty, a procedure in which he injects 1cc of Polymethyl methacrylate (PMMA) in the adjacent posterior arch to determine if this would impact the success of the spacers. He now routinely performs spinoplasty 2 months prior to spacer placement and has enjoyed very low failure rates since implementation of this technique. --- RESOURCES Dr. Manfrè Website: https://www.manfreluigi.com/index.html Manfrè Articles: https://jnis.bmj.com/content/12/7/673.abstract https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511561/ https://journals.sagepub.com/doi/abs/10.15274/INR-2014-10052 Mon, 16 Jan 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Luigi Manfrè, interventional radiologist and chair of the European Society of Neuroradiology about how he treats lumbar spinal stenosis using spinoplasty and minimally invasive placement of interspinous spacers. In this episode, host Dr. Jacob Fleming interviews Dr. Luigi Manfrè, interventional radiologist and chair of the European Society of Neuroradiology about how he treats lumbar spinal stenosis using spinoplasty and minimally invasive placement of interspinous spacers. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Syf8sW --- SHOW NOTES Dr. Manfrè discusses his background and how he arrived at his current practice in Catania, Italy. His journey in medicine began with the intention of becoming an ophthalmologist. He then realized he didn’t want to pursue this path, and was told by a teacher he would be studying neuroradiology. He despised neuroradiology prior to this, but soon fell in love “at first sight”. He then went to Toronto to study under pioneers of pediatric neuroradiology. He dabbled in vascular IR before finally finding interventional spine. It began with injections for pain but he soon realized the potential of this field. At the time, surgery was becoming more minimally invasive, and as a radiologist, he knew he could leverage this momentum due to this unique background in radiology that his surgeon colleagues did not have. Dr. Manfrè believed he could apply the same treatments that conventional spine surgeons were doing in a faster, more precise and less aggressive manner. Spine surgeons were beginning to place interspinous spacers for spinal stenosis, and he was interested in placing these using CT and fluoroscopy guidance. He selects his patients very precisely, because it is important to him to not be using a device on the wrong patient. He endorses collaboration with neurosurgeons and orthopedic surgeons and practices this frequently, often referring patients within his network of collaborators. He selects patients for interspinous spacer placement who have genetic lumbar spinal stenosis causing ligamentous compression of nerves. His technique involves a combination of CT and fluoroscopy as it has been shown that using CT for procedural planning has been shown to reduce patient radiation exposure by 90%. He then uses fluoroscopy to insert the dilater over the guide wire, put in the spacer and open the spacer, which takes around 20 seconds of fluoro time. The interspinous spacer is a device that is placed in between two spinous processes to slow the progression of spinal stenosis and neurologic injury. The spacer cannot undo any prior neurologic injury, however, due to the progressive nature of this disease process. Surgical placement of a spacer is aggressive, involving general anesthesia in older patients with comorbidities, opening of the spinal canal, and laminectomy, which causes ligamentous instability that requires repair. It can be a three hour procedure, which involves extensive recovery and rehab. Dr. Manfrè places a spacer in 3 minutes, uses local anesthesia and midazolam, a 5mm incision, and no rehab. The primary reason for failure of the procedure is spinous process fracture and bone remodeling. He began performing spinoplasty, a procedure in which he injects 1cc of Polymethyl methacrylate (PMMA) in the adjacent posterior arch to determine if this would impact the success of the spacers. He now routinely performs spinoplasty 2 months prior to spacer placement and has enjoyed very low failure rates since implementation of this technique. --- RESOURCES Dr. Manfrè Website: https://www.manfreluigi.com/index.html Manfrè Articles: https://jnis.bmj.com/content/12/7/673.abstract https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511561/ https://journals.sagepub.com/doi/abs/10.15274/INR-2014-10052 In this episode, host Dr. Jacob Fleming interviews Dr. Luigi Manfrè, interventional radiologist and chair of the European Society of Neuroradiology about how he treats lumbar spinal stenosis using spinoplasty and minimally invasive placement of interspinous spacers.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/Syf8sW


---


SHOW NOTES


Dr. Manfrè discusses his background and how he arrived at his current practice in Catania, Italy. His journey in medicine began with the intention of becoming an ophthalmologist. He then realized he didn’t want to pursue this path, and was told by a teacher he would be studying neuroradiology. He despised neuroradiology prior to this, but soon fell in love “at first sight”. He then went to Toronto to study under pioneers of pediatric neuroradiology. He dabbled in vascular IR before finally finding interventional spine. It began with injections for pain but he soon realized the potential of this field. At the time, surgery was becoming more minimally invasive, and as a radiologist, he knew he could leverage this momentum due to this unique background in radiology that his surgeon colleagues did not have.


Dr. Manfrè believed he could apply the same treatments that conventional spine surgeons were doing in a faster, more precise and less aggressive manner. Spine surgeons were beginning to place interspinous spacers for spinal stenosis, and he was interested in placing these using CT and fluoroscopy guidance. He selects his patients very precisely, because it is important to him to not be using a device on the wrong patient. He endorses collaboration with neurosurgeons and orthopedic surgeons and practices this frequently, often referring patients within his network of collaborators. He selects patients for interspinous spacer placement who have genetic lumbar spinal stenosis causing ligamentous compression of nerves.


His technique involves a combination of CT and fluoroscopy as it has been shown that using CT for procedural planning has been shown to reduce patient radiation exposure by 90%. He then uses fluoroscopy to insert the dilater over the guide wire, put in the spacer and open the spacer, which takes around 20 seconds of fluoro time. The interspinous spacer is a device that is placed in between two spinous processes to slow the progression of spinal stenosis and neurologic injury. The spacer cannot undo any prior neurologic injury, however, due to the progressive nature of this disease process. Surgical placement of a spacer is aggressive, involving general anesthesia in older patients with comorbidities, opening of the spinal canal, and laminectomy, which causes ligamentous instability that requires repair. It can be a three hour procedure, which involves extensive recovery and rehab. Dr. Manfrè places a spacer in 3 minutes, uses local anesthesia and midazolam, a 5mm incision, and no rehab. The primary reason for failure of the procedure is spinous process fracture and bone remodeling. He began performing spinoplasty, a procedure in which he injects 1cc of Polymethyl methacrylate (PMMA) in the adjacent posterior arch to determine if this would impact the success of the spacers. He now routinely performs spinoplasty 2 months prior to spacer placement and has enjoyed very low failure rates since implementation of this technique.


---


RESOURCES


Dr. Manfrè Website:

https://www.manfreluigi.com/index.html


Manfrè Articles:

https://jnis.bmj.com/content/12/7/673.abstract

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511561/

https://journals.sagepub.com/doi/abs/10.15274/INR-2014-10052

]]> 3829 Ep. 281 Training in Open vs Endovascular Techniques with Neurosurgeon Dr. Pascal Jabbour In this episode, our host Dr. Sabeen Dhand interviews Dr. Pascal Jabbour, Division Chief of Neurovascular Surgery & Endovascular Neurosurgery at Jefferson University. We discuss the current training landscape for vascular neurosurgery, the open versus endovascular debate, and Dr. Jabbour’s perspective on multispecialty collaboration in vascular neurology. --- CHECK OUT OUR SPONSORS MicroVention FRED X https://www.microvention.com/emea/product/fred-x RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- SHOW NOTES Dr. Jabbour starts the episode by recounting his time in residency and how his mentor inspired him to pursue a vascular neurosurgery fellowship. It is becoming increasingly common for neurosurgery residency programs to require their trainees to complete a rotation in vascular neurosurgery. He also speaks more about the residency program at Jefferson and different community hospitals that Jefferson is affiliated with. Having affiliates across a wide geographic area helps his department better serve the community by saving time and reducing the need to transfer patients. Next, Dr. Jabbour describes his own practice, which incorporates both endovascular and open procedures. He emphasizes that there is little benefit from debating superiority between the two methods, since neurosurgeons should focus on the disease process and select the method that best serves each patient. Training in both methods is a necessity. Finally, we cover the topic of collaboration between neurosurgeons, interventional neuroradiologists, neuroradiologists, and neurologists. Each specialty brings something different to the table, whether it is procedural skill, knowledge of anatomy, or expertise in disease processes. Dr. Jabbour encourages physicians to look past turf wars and recognize the importance of cross training and building a strong overall vascular team. --- RESOURCES Twitter: @PascalJabbourMD Society of Neurointerventional Surgery (SNIS): https://www.snisonline.org/ AANS/CNS Cerebrovascular (CV) Section: https://cvsection.org/ --- MicroVention Disclaimer: For complete indications, contraindications, potential complications, warnings, precautions, and instructions, see instructions for use provided in the device. FRED X is intended for healthcare professional use only and by prescription only. Federal law restricts this device to sale by or on the order of a physician. Fri, 13 Jan 2023 06:05:00 -0000 full BackTable In this episode, our host Dr. Sabeen Dhand interviews Dr. Pascal Jabbour, Division Chief of Neurovascular Surgery & Endovascular Neurosurgery at Jefferson University. We discuss the current training landscape for vascular neurosurgery, the open versus endovascular debate, and Dr. Jabbour’s perspective on multispecialty collaboration in vascular neurology. --- CHECK OUT OUR SPONSORS MicroVention FRED X https://www.microvention.com/emea/product/fred-x RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- SHOW NOTES Dr. Jabbour starts the episode by recounting his time in residency and how his mentor inspired him to pursue a vascular neurosurgery fellowship. It is becoming increasingly common for neurosurgery residency programs to require their trainees to complete a rotation in vascular neurosurgery. He also speaks more about the residency program at Jefferson and different community hospitals that Jefferson is affiliated with. Having affiliates across a wide geographic area helps his department better serve the community by saving time and reducing the need to transfer patients. Next, Dr. Jabbour describes his own practice, which incorporates both endovascular and open procedures. He emphasizes that there is little benefit from debating superiority between the two methods, since neurosurgeons should focus on the disease process and select the method that best serves each patient. Training in both methods is a necessity. Finally, we cover the topic of collaboration between neurosurgeons, interventional neuroradiologists, neuroradiologists, and neurologists. Each specialty brings something different to the table, whether it is procedural skill, knowledge of anatomy, or expertise in disease processes. Dr. Jabbour encourages physicians to look past turf wars and recognize the importance of cross training and building a strong overall vascular team. --- RESOURCES Twitter: @PascalJabbourMD Society of Neurointerventional Surgery (SNIS): https://www.snisonline.org/ AANS/CNS Cerebrovascular (CV) Section: https://cvsection.org/ --- MicroVention Disclaimer: For complete indications, contraindications, potential complications, warnings, precautions, and instructions, see instructions for use provided in the device. FRED X is intended for healthcare professional use only and by prescription only. Federal law restricts this device to sale by or on the order of a physician. In this episode, our host Dr. Sabeen Dhand interviews Dr. Pascal Jabbour, Division Chief of Neurovascular Surgery & Endovascular Neurosurgery at Jefferson University. We discuss the current training landscape for vascular neurosurgery, the open versus endovascular debate, and Dr. Jabbour’s perspective on multispecialty collaboration in vascular neurology.


---


CHECK OUT OUR SPONSORS


MicroVention FRED X

https://www.microvention.com/emea/product/fred-x


RapidAI

http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor


---


SHOW NOTES


Dr. Jabbour starts the episode by recounting his time in residency and how his mentor inspired him to pursue a vascular neurosurgery fellowship. It is becoming increasingly common for neurosurgery residency programs to require their trainees to complete a rotation in vascular neurosurgery. He also speaks more about the residency program at Jefferson and different community hospitals that Jefferson is affiliated with. Having affiliates across a wide geographic area helps his department better serve the community by saving time and reducing the need to transfer patients.


Next, Dr. Jabbour describes his own practice, which incorporates both endovascular and open procedures. He emphasizes that there is little benefit from debating superiority between the two methods, since neurosurgeons should focus on the disease process and select the method that best serves each patient. Training in both methods is a necessity.


Finally, we cover the topic of collaboration between neurosurgeons, interventional neuroradiologists, neuroradiologists, and neurologists. Each specialty brings something different to the table, whether it is procedural skill, knowledge of anatomy, or expertise in disease processes. Dr. Jabbour encourages physicians to look past turf wars and recognize the importance of cross training and building a strong overall vascular team.


---


RESOURCES


Twitter:

@PascalJabbourMD


Society of Neurointerventional Surgery (SNIS):

https://www.snisonline.org/


AANS/CNS Cerebrovascular (CV) Section:

https://cvsection.org/


---


MicroVention Disclaimer: For complete indications, contraindications, potential complications, warnings, precautions, and instructions, see instructions for use provided in the device. FRED X is intended for healthcare professional use only and by prescription only. Federal law restricts this device to sale by or on the order of a physician.

]]> 2011 Ep. 280 Current Controversies in Prostatic Artery Embolization with Dr. Sam Mouli In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. Samdeep Mouli about controversies in prostate artery embolization, including technique, durability, and how we can leverage the data to unite IRs and establish PAE as standard of care. --- CHECK OUT OUR SPONSOR Boston Scientific Embold Fibered Coils https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html --- SHOW NOTES Dr. Mouli discusses his role as director of translational research in interventional radiology at Northwestern. He reviews the most recent major data on PAE. There have been two major papers, one from a Portuguese group and another from a Brazilian group. The take home points from these papers are regarding the durability of symptoms and the safety profile of PAE. The biggest positive of PAE is that it is the safest among all minimally invasive surgeries. Dr. Mouli argues that PAE should be pursued as first line treatment for benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTs). Another upside of PAE is that it doesn’t prevent patients from undergoing any other medical or surgical intervention in the future. One of the barriers to PAE becoming first line therapy is that there is currently no standardization among operators. Everyone still does it differently, whether by using different microcatheters, particle sizes, or other technical factors. This gives urologists ground to stand on when they argue against PAE. Dr. Mouli feels IRs should approach BPH with the same rigor that urologists do. He believes we need to use the long-term data to prove that PAE is safe, durable and yields better sexual outcomes than TURP or other minimally invasive surgical procedures. This can be accomplished via publishing guidelines for IRs. He believes a good starting place is to only use 300-500 micron particles for de-novo PAE cases. It has been proven this size is safe and results in very low non-target embolization compared to the 100-300 micron size, which more commonly causes this complication and results in more sexual dysfunction. Dr. Mouli says urologists are pushing for surgical intervention before exhausting medical management and argues that IRs should do the same. He believes offering PAE early is in the best interest of patients, because waiting to fail medical management can cause further complications. Dr. Mouli does not get pre-procedure vascular imaging or MRI. This is because he uses intra-procedure cone beam CT. He does this as part of his procedure to map out collaterals and other blood supply to the prostate. He then targets these arteries with coils before using particle embolization on the prostate gland itself. He does this because his goal is to match the 5 year success rate demonstrated in recent studies of over 80 percent, with a less than 20% recurrence rate. He ends by stating that the long-term data show a 10-30% re-treatment rate across all treatment modalities. Knowing this, he feels even stronger that PAE should be the first line therapy, considering it is the least invasive option, it is safe and has the lowest rates of sexual dysfunction. If patients prefer more invasive procedures in the future, they can still go that route, or they can elect for repeat PAE as needed. --- RESOURCES Triago Bilhim Paper: https://link.springer.com/article/10.1007/s00270-022-03199-8 Francisco Carnevale Paper: https://pubmed.ncbi.nlm.nih.gov/33308534/ UK-ROPE Study: https://pubmed.ncbi.nlm.nih.gov/29645352/ Mon, 09 Jan 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. Samdeep Mouli about controversies in prostate artery embolization, including technique, durability, and how we can leverage the data to unite IRs and establish PAE as standard of care. In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. Samdeep Mouli about controversies in prostate artery embolization, including technique, durability, and how we can leverage the data to unite IRs and establish PAE as standard of care. --- CHECK OUT OUR SPONSOR Boston Scientific Embold Fibered Coils https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html --- SHOW NOTES Dr. Mouli discusses his role as director of translational research in interventional radiology at Northwestern. He reviews the most recent major data on PAE. There have been two major papers, one from a Portuguese group and another from a Brazilian group. The take home points from these papers are regarding the durability of symptoms and the safety profile of PAE. The biggest positive of PAE is that it is the safest among all minimally invasive surgeries. Dr. Mouli argues that PAE should be pursued as first line treatment for benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTs). Another upside of PAE is that it doesn’t prevent patients from undergoing any other medical or surgical intervention in the future. One of the barriers to PAE becoming first line therapy is that there is currently no standardization among operators. Everyone still does it differently, whether by using different microcatheters, particle sizes, or other technical factors. This gives urologists ground to stand on when they argue against PAE. Dr. Mouli feels IRs should approach BPH with the same rigor that urologists do. He believes we need to use the long-term data to prove that PAE is safe, durable and yields better sexual outcomes than TURP or other minimally invasive surgical procedures. This can be accomplished via publishing guidelines for IRs. He believes a good starting place is to only use 300-500 micron particles for de-novo PAE cases. It has been proven this size is safe and results in very low non-target embolization compared to the 100-300 micron size, which more commonly causes this complication and results in more sexual dysfunction. Dr. Mouli says urologists are pushing for surgical intervention before exhausting medical management and argues that IRs should do the same. He believes offering PAE early is in the best interest of patients, because waiting to fail medical management can cause further complications. Dr. Mouli does not get pre-procedure vascular imaging or MRI. This is because he uses intra-procedure cone beam CT. He does this as part of his procedure to map out collaterals and other blood supply to the prostate. He then targets these arteries with coils before using particle embolization on the prostate gland itself. He does this because his goal is to match the 5 year success rate demonstrated in recent studies of over 80 percent, with a less than 20% recurrence rate. He ends by stating that the long-term data show a 10-30% re-treatment rate across all treatment modalities. Knowing this, he feels even stronger that PAE should be the first line therapy, considering it is the least invasive option, it is safe and has the lowest rates of sexual dysfunction. If patients prefer more invasive procedures in the future, they can still go that route, or they can elect for repeat PAE as needed. --- RESOURCES Triago Bilhim Paper: https://link.springer.com/article/10.1007/s00270-022-03199-8 Francisco Carnevale Paper: https://pubmed.ncbi.nlm.nih.gov/33308534/ UK-ROPE Study: https://pubmed.ncbi.nlm.nih.gov/29645352/ In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. Samdeep Mouli about controversies in prostate artery embolization, including technique, durability, and how we can leverage the data to unite IRs and establish PAE as standard of care.


---


CHECK OUT OUR SPONSOR


Boston Scientific Embold Fibered Coils

https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html


---


SHOW NOTES


Dr. Mouli discusses his role as director of translational research in interventional radiology at Northwestern. He reviews the most recent major data on PAE. There have been two major papers, one from a Portuguese group and another from a Brazilian group. The take home points from these papers are regarding the durability of symptoms and the safety profile of PAE. The biggest positive of PAE is that it is the safest among all minimally invasive surgeries. Dr. Mouli argues that PAE should be pursued as first line treatment for benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTs). Another upside of PAE is that it doesn’t prevent patients from undergoing any other medical or surgical intervention in the future.


One of the barriers to PAE becoming first line therapy is that there is currently no standardization among operators. Everyone still does it differently, whether by using different microcatheters, particle sizes, or other technical factors. This gives urologists ground to stand on when they argue against PAE. Dr. Mouli feels IRs should approach BPH with the same rigor that urologists do. He believes we need to use the long-term data to prove that PAE is safe, durable and yields better sexual outcomes than TURP or other minimally invasive surgical procedures. This can be accomplished via publishing guidelines for IRs. He believes a good starting place is to only use 300-500 micron particles for de-novo PAE cases. It has been proven this size is safe and results in very low non-target embolization compared to the 100-300 micron size, which more commonly causes this complication and results in more sexual dysfunction.


Dr. Mouli says urologists are pushing for surgical intervention before exhausting medical management and argues that IRs should do the same. He believes offering PAE early is in the best interest of patients, because waiting to fail medical management can cause further complications. Dr. Mouli does not get pre-procedure vascular imaging or MRI. This is because he uses intra-procedure cone beam CT. He does this as part of his procedure to map out collaterals and other blood supply to the prostate. He then targets these arteries with coils before using particle embolization on the prostate gland itself. He does this because his goal is to match the 5 year success rate demonstrated in recent studies of over 80 percent, with a less than 20% recurrence rate. He ends by stating that the long-term data show a 10-30% re-treatment rate across all treatment modalities. Knowing this, he feels even stronger that PAE should be the first line therapy, considering it is the least invasive option, it is safe and has the lowest rates of sexual dysfunction. If patients prefer more invasive procedures in the future, they can still go that route, or they can elect for repeat PAE as needed.


---


RESOURCES


Triago Bilhim Paper:

https://link.springer.com/article/10.1007/s00270-022-03199-8


Francisco Carnevale Paper:

https://pubmed.ncbi.nlm.nih.gov/33308534/


UK-ROPE Study:

https://pubmed.ncbi.nlm.nih.gov/29645352/

]]> 2507 Ep. 279 Dissecting Wire Senses with Dr. Hady Lichaa In this episode, host Ally Baheti interviews interventional cardiologist Dr. Hady Lichaa of Ascension St. Thomas Heart about wire senses, including ways to build tactile and visual skills, selection of workhorse and specialty wires, and the do’s and don’ts of crossing lesions. --- CHECK OUT OUR SPONSORS Surmodics Pounce Thrombectomy https://pouncesystem.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Lichaa starts by outlining four different components of wire senses: visual sense, tactile sense, IVUS, and the digital subtraction angiography (DSA) roadmap. First, visual aspects are a combination of 2D wire sliding and looping, 3D rotation, and the course of the wire relative to the vessel architecture. By combining these visual cues, the operator can determine if the wire is inside the true lumen, within the vessel wall, or entirely outside of the vessel. The next factor is tactile sense. Each type of wire strikes a balance between resistance to rotation / advancement and torque transmission. This balance is determined by wire characteristics such as core material, tapers, tip design, and coating. Dr. Lichaa encourages operators to test out different wires and focus on mastering their favorite workhorse wires. Additionally, there are specialty wires that can be employed in certain cases, such as CTO wires with heavy tip, tapered tip wires to enter microchannels, and supportive wires for the use of other equipment. Additionally, we discuss how intravascular ultrasound (IVUS) leads to safer outcomes because it allows the operator to confirm that they are in the true lumen and measure vessel size before deploying stents or balloons. DSA can also help determine location and help map out different strategies if a first option fails. Finally, Dr. Lichaa lists some helpful tips for new operators. We highlight the importance of mastering your favorite wires, having backup plans, communicating with staff, and keeping calm in the angio suite. --- RESOURCES Abbott Command Wire: https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/guide-wires/workhorse/hi-torque-command.html ASAHI Gladius Wire: https://asahi-inteccusa-medical.com/product/asahi-gladius-014/ ASAHI CONFIANZA Pro: https://asahi-inteccusa-medical.com/product/confianza-pro-series/ Terumo NAVICROSS Support Catheter: https://www.terumois.com/products/catheters/navicross.html Teleplex Turnpike Catheter: https://www.teleflex.com/usa/en/product-areas/interventional/coronary-interventions/turnpike-catheters/index.html ACT ONE Technology: https://medical.asahi-intecc.com/en/technologies Philips Pioneer Reentry Catheter: https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter Cordis OUTBACK Reentry Catheter: https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter Fri, 06 Jan 2023 06:05:00 -0000 full BackTable In this episode, host Ally Baheti interviews interventional cardiologist Dr. Hady Lichaa of Ascension St. Thomas Heart about wire senses, including ways to build tactile and visual skills, selection of workhorse and specialty wires, and the do’s and don’ts of crossing lesions. In this episode, host Ally Baheti interviews interventional cardiologist Dr. Hady Lichaa of Ascension St. Thomas Heart about wire senses, including ways to build tactile and visual skills, selection of workhorse and specialty wires, and the do’s and don’ts of crossing lesions. --- CHECK OUT OUR SPONSORS Surmodics Pounce Thrombectomy https://pouncesystem.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Lichaa starts by outlining four different components of wire senses: visual sense, tactile sense, IVUS, and the digital subtraction angiography (DSA) roadmap. First, visual aspects are a combination of 2D wire sliding and looping, 3D rotation, and the course of the wire relative to the vessel architecture. By combining these visual cues, the operator can determine if the wire is inside the true lumen, within the vessel wall, or entirely outside of the vessel. The next factor is tactile sense. Each type of wire strikes a balance between resistance to rotation / advancement and torque transmission. This balance is determined by wire characteristics such as core material, tapers, tip design, and coating. Dr. Lichaa encourages operators to test out different wires and focus on mastering their favorite workhorse wires. Additionally, there are specialty wires that can be employed in certain cases, such as CTO wires with heavy tip, tapered tip wires to enter microchannels, and supportive wires for the use of other equipment. Additionally, we discuss how intravascular ultrasound (IVUS) leads to safer outcomes because it allows the operator to confirm that they are in the true lumen and measure vessel size before deploying stents or balloons. DSA can also help determine location and help map out different strategies if a first option fails. Finally, Dr. Lichaa lists some helpful tips for new operators. We highlight the importance of mastering your favorite wires, having backup plans, communicating with staff, and keeping calm in the angio suite. --- RESOURCES Abbott Command Wire: https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/guide-wires/workhorse/hi-torque-command.html ASAHI Gladius Wire: https://asahi-inteccusa-medical.com/product/asahi-gladius-014/ ASAHI CONFIANZA Pro: https://asahi-inteccusa-medical.com/product/confianza-pro-series/ Terumo NAVICROSS Support Catheter: https://www.terumois.com/products/catheters/navicross.html Teleplex Turnpike Catheter: https://www.teleflex.com/usa/en/product-areas/interventional/coronary-interventions/turnpike-catheters/index.html ACT ONE Technology: https://medical.asahi-intecc.com/en/technologies Philips Pioneer Reentry Catheter: https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter Cordis OUTBACK Reentry Catheter: https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter In this episode, host Ally Baheti interviews interventional cardiologist Dr. Hady Lichaa of Ascension St. Thomas Heart about wire senses, including ways to build tactile and visual skills, selection of workhorse and specialty wires, and the do’s and don’ts of crossing lesions.


---


CHECK OUT OUR SPONSORS


Surmodics Pounce Thrombectomy

https://pouncesystem.com/


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. Lichaa starts by outlining four different components of wire senses: visual sense, tactile sense, IVUS, and the digital subtraction angiography (DSA) roadmap. First, visual aspects are a combination of 2D wire sliding and looping, 3D rotation, and the course of the wire relative to the vessel architecture. By combining these visual cues, the operator can determine if the wire is inside the true lumen, within the vessel wall, or entirely outside of the vessel.


The next factor is tactile sense. Each type of wire strikes a balance between resistance to rotation / advancement and torque transmission. This balance is determined by wire characteristics such as core material, tapers, tip design, and coating. Dr. Lichaa encourages operators to test out different wires and focus on mastering their favorite workhorse wires. Additionally, there are specialty wires that can be employed in certain cases, such as CTO wires with heavy tip, tapered tip wires to enter microchannels, and supportive wires for the use of other equipment.


Additionally, we discuss how intravascular ultrasound (IVUS) leads to safer outcomes because it allows the operator to confirm that they are in the true lumen and measure vessel size before deploying stents or balloons. DSA can also help determine location and help map out different strategies if a first option fails.


Finally, Dr. Lichaa lists some helpful tips for new operators. We highlight the importance of mastering your favorite wires, having backup plans, communicating with staff, and keeping calm in the angio suite.


---


RESOURCES


Abbott Command Wire:

https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/guide-wires/workhorse/hi-torque-command.html


ASAHI Gladius Wire:

https://asahi-inteccusa-medical.com/product/asahi-gladius-014/


ASAHI CONFIANZA Pro:

https://asahi-inteccusa-medical.com/product/confianza-pro-series/


Terumo NAVICROSS Support Catheter:

https://www.terumois.com/products/catheters/navicross.html


Teleplex Turnpike Catheter:

https://www.teleflex.com/usa/en/product-areas/interventional/coronary-interventions/turnpike-catheters/index.html


ACT ONE Technology:

https://medical.asahi-intecc.com/en/technologies


Philips Pioneer Reentry Catheter:

https://www.usa.philips.com/healthcare/product/HCIGTDPPLUS/pioneer-plus-ivus-guided-re-entry-catheter


Cordis OUTBACK Reentry Catheter:

https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter

]]> 2971 Ep. 278 Minimizing Complications for Lung Biopsies with Dr. Robert Suh In this episode, host Dr. Chris Beck interviews chest and interventional radiologist Dr. Robert Suh about his lung biopsy technique, including how he approaches pain management, and his take on the best way to seal the biopsy tract to prevent air leaks. --- CHECK OUT OUR SPONSOR AngioDynamics BioSentry https://www.angiodynamics.com/product/biosentry-tract-sealant-system/ --- SHOW NOTES Dr. Suh begins by telling us about his background and current practice at UCLA. He was trained in interventional radiology but did a second fellowship in chest radiology due to the job market at the time. At UCLA they have a very organ-specific practice, and Dr. Suh has spent his whole career on chest and lung imaging and procedures. He splits his time between procedures, triage and planning, clinic and administrative days. Before a lung biopsy, Dr. Suh sees the patient when they arrive and reviews their procedure. He ends the patient meeting by putting the ball back into their court by coaching them on their breathing. He tells them to take a small breath in and hold it. He has them concentrate on this while on the table which gives them more control in an unfamiliar environment. He uses mild or moderate sedation, and feels that the most important part of pain management is properly numbing the parietal pleura as it is somatically innervated. To do this, he brings a 19 gauge coaxial needle up to the extrapleural space, which looks like a black band of fat, and administers at least 10cc of lidocaine or bupivacaine. Once the parietal pleura is numb, the procedure goes much better because the needle is not tugging on the pleura with each breath. For subpleural lesions, he prefers a tangential approach, which crosses more lung parenchyma but yields a better sample than the shorter perpendicular approach. If a target is inaccessible, he first tries to reposition the patient and does not hesitate to consult interventional pulmonology to discuss alternative approaches. Dr. Suh discusses how he previously used blood patches at the end of the biopsy to seal the tract, and why he changed his technique. He now exclusively uses BioSentry, a hydrogel polymer that functions similarly to a blood patch. After deploying the BioSentry through the introducer needle he waits 3-5 minutes, checks for pneumothorax development, and if there is no pneumothorax he sends patients home within 30 minutes without doing a post-biopsy chest x-ray. --- RESOURCES MD Anderson Study: https://pubmed.ncbi.nlm.nih.gov/15673500/ Memorial Sloan Study: https://pubmed.ncbi.nlm.nih.gov/30480487/ AngioDynamics BioSentry: https://www.angiodynamics.com/product/biosentry-tract-sealant-system/ Mon, 02 Jan 2023 06:05:00 -0000 full BackTable In this episode, host Dr. Chris Beck interviews chest and interventional radiologist Dr. Robert Suh about his lung biopsy technique, including how he approaches pain management, and his take on the best way to seal the biopsy tract to prevent air leaks. In this episode, host Dr. Chris Beck interviews chest and interventional radiologist Dr. Robert Suh about his lung biopsy technique, including how he approaches pain management, and his take on the best way to seal the biopsy tract to prevent air leaks. --- CHECK OUT OUR SPONSOR AngioDynamics BioSentry https://www.angiodynamics.com/product/biosentry-tract-sealant-system/ --- SHOW NOTES Dr. Suh begins by telling us about his background and current practice at UCLA. He was trained in interventional radiology but did a second fellowship in chest radiology due to the job market at the time. At UCLA they have a very organ-specific practice, and Dr. Suh has spent his whole career on chest and lung imaging and procedures. He splits his time between procedures, triage and planning, clinic and administrative days. Before a lung biopsy, Dr. Suh sees the patient when they arrive and reviews their procedure. He ends the patient meeting by putting the ball back into their court by coaching them on their breathing. He tells them to take a small breath in and hold it. He has them concentrate on this while on the table which gives them more control in an unfamiliar environment. He uses mild or moderate sedation, and feels that the most important part of pain management is properly numbing the parietal pleura as it is somatically innervated. To do this, he brings a 19 gauge coaxial needle up to the extrapleural space, which looks like a black band of fat, and administers at least 10cc of lidocaine or bupivacaine. Once the parietal pleura is numb, the procedure goes much better because the needle is not tugging on the pleura with each breath. For subpleural lesions, he prefers a tangential approach, which crosses more lung parenchyma but yields a better sample than the shorter perpendicular approach. If a target is inaccessible, he first tries to reposition the patient and does not hesitate to consult interventional pulmonology to discuss alternative approaches. Dr. Suh discusses how he previously used blood patches at the end of the biopsy to seal the tract, and why he changed his technique. He now exclusively uses BioSentry, a hydrogel polymer that functions similarly to a blood patch. After deploying the BioSentry through the introducer needle he waits 3-5 minutes, checks for pneumothorax development, and if there is no pneumothorax he sends patients home within 30 minutes without doing a post-biopsy chest x-ray. --- RESOURCES MD Anderson Study: https://pubmed.ncbi.nlm.nih.gov/15673500/ Memorial Sloan Study: https://pubmed.ncbi.nlm.nih.gov/30480487/ AngioDynamics BioSentry: https://www.angiodynamics.com/product/biosentry-tract-sealant-system/ In this episode, host Dr. Chris Beck interviews chest and interventional radiologist Dr. Robert Suh about his lung biopsy technique, including how he approaches pain management, and his take on the best way to seal the biopsy tract to prevent air leaks.


---


CHECK OUT OUR SPONSOR


AngioDynamics BioSentry

https://www.angiodynamics.com/product/biosentry-tract-sealant-system/


---


SHOW NOTES


Dr. Suh begins by telling us about his background and current practice at UCLA. He was trained in interventional radiology but did a second fellowship in chest radiology due to the job market at the time. At UCLA they have a very organ-specific practice, and Dr. Suh has spent his whole career on chest and lung imaging and procedures. He splits his time between procedures, triage and planning, clinic and administrative days.


Before a lung biopsy, Dr. Suh sees the patient when they arrive and reviews their procedure. He ends the patient meeting by putting the ball back into their court by coaching them on their breathing. He tells them to take a small breath in and hold it. He has them concentrate on this while on the table which gives them more control in an unfamiliar environment. He uses mild or moderate sedation, and feels that the most important part of pain management is properly numbing the parietal pleura as it is somatically innervated. To do this, he brings a 19 gauge coaxial needle up to the extrapleural space, which looks like a black band of fat, and administers at least 10cc of lidocaine or bupivacaine. Once the parietal pleura is numb, the procedure goes much better because the needle is not tugging on the pleura with each breath. For subpleural lesions, he prefers a tangential approach, which crosses more lung parenchyma but yields a better sample than the shorter perpendicular approach. If a target is inaccessible, he first tries to reposition the patient and does not hesitate to consult interventional pulmonology to discuss alternative approaches.


Dr. Suh discusses how he previously used blood patches at the end of the biopsy to seal the tract, and why he changed his technique. He now exclusively uses BioSentry, a hydrogel polymer that functions similarly to a blood patch. After deploying the BioSentry through the introducer needle he waits 3-5 minutes, checks for pneumothorax development, and if there is no pneumothorax he sends patients home within 30 minutes without doing a post-biopsy chest x-ray.


---


RESOURCES


MD Anderson Study:

https://pubmed.ncbi.nlm.nih.gov/15673500/


Memorial Sloan Study:

https://pubmed.ncbi.nlm.nih.gov/30480487/


AngioDynamics BioSentry:

https://www.angiodynamics.com/product/biosentry-tract-sealant-system/

]]> 2804 Ep. 277 Private Equity and the Radiology Job Environment with Dr. Ben White In this episode, co-hosts Drs. Ally Baheti and Mike Barraza interview diagnostic radiologist and blogger Dr. Ben White, who speaks about private equity (PE) ownership of radiology practices, the nationwide radiologist shortage, and advice for navigating job offers. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/D3g0nd --- SHOW NOTES Dr. White starts the episode by sharing his passion for writing, especially regarding topics that have affected his journey in medicine. His blog features topics that are useful for both trainees and physicians. His current practice structure is an independent diagnostic radiology practice, which is fully owned by physician partners. He thinks that this “priva-demics” job is well-suited to his interest in teaching residents and medical students. He also enjoys the autonomy that the practice has in staffing– it can remain non-bureaucratic and flexible to address patient care. Next, Dr. White explains the factors driving the rise of PE buyouts of radiology practices, including the pros and cons of becoming a PE-owned practice. During a buyout, radiologists are offered more cash and stocks upfront in exchange for a loss of practice autonomy and a cap on future salaries. While PE firms usually advertise buyout as an opportunity to strengthen the practice with more resources, obtain help with debt payment, and eliminate inefficiencies, these benefits may not come to fruition in the long term. Additionally, radiologists may leave practices if they are not satisfied with PE management and priorities, which result in staffing shortages. Buyouts also affect independent radiology practices, since PE-owned practices are able to offer higher salaries for less work, which artificially inflate salaries across the radiology market. Dr. White fears that smaller practices and hospitals will lose their radiology workforces and will be forced to shed low-paying contracts and cease to provide imaging services for patient populations who need medical care the most. Additionally, there is unavoidable friction that arises when third party employers come between the patient-physician relationship. Finally, Dr. White gives advice to radiologists about approaching each job prospect with a holistic perspective, including job factors that cannot be measured. He encourages early career radiologists to identify their values and ask themselves if they view their next job as simply a short term stop, or if they want to set up roots for the long term. This distinction can help guide them in making career decisions. --- RESOURCES American Radiology Associates: https://www.americanrad.com/ Dr. Ben White’s Blog: https://www.benwhite.com/ Strategic Radiology: https://www.strategicradiology.org/ Fri, 30 Dec 2022 06:05:00 -0000 full BackTable In this episode, co-hosts Drs. Ally Baheti and Mike Barraza interview diagnostic radiologist and blogger Dr. Ben White, who speaks about private equity (PE) ownership of radiology practices, the nationwide radiologist shortage, and advice for navigating job offers. In this episode, co-hosts Drs. Ally Baheti and Mike Barraza interview diagnostic radiologist and blogger Dr. Ben White, who speaks about private equity (PE) ownership of radiology practices, the nationwide radiologist shortage, and advice for navigating job offers. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/D3g0nd --- SHOW NOTES Dr. White starts the episode by sharing his passion for writing, especially regarding topics that have affected his journey in medicine. His blog features topics that are useful for both trainees and physicians. His current practice structure is an independent diagnostic radiology practice, which is fully owned by physician partners. He thinks that this “priva-demics” job is well-suited to his interest in teaching residents and medical students. He also enjoys the autonomy that the practice has in staffing– it can remain non-bureaucratic and flexible to address patient care. Next, Dr. White explains the factors driving the rise of PE buyouts of radiology practices, including the pros and cons of becoming a PE-owned practice. During a buyout, radiologists are offered more cash and stocks upfront in exchange for a loss of practice autonomy and a cap on future salaries. While PE firms usually advertise buyout as an opportunity to strengthen the practice with more resources, obtain help with debt payment, and eliminate inefficiencies, these benefits may not come to fruition in the long term. Additionally, radiologists may leave practices if they are not satisfied with PE management and priorities, which result in staffing shortages. Buyouts also affect independent radiology practices, since PE-owned practices are able to offer higher salaries for less work, which artificially inflate salaries across the radiology market. Dr. White fears that smaller practices and hospitals will lose their radiology workforces and will be forced to shed low-paying contracts and cease to provide imaging services for patient populations who need medical care the most. Additionally, there is unavoidable friction that arises when third party employers come between the patient-physician relationship. Finally, Dr. White gives advice to radiologists about approaching each job prospect with a holistic perspective, including job factors that cannot be measured. He encourages early career radiologists to identify their values and ask themselves if they view their next job as simply a short term stop, or if they want to set up roots for the long term. This distinction can help guide them in making career decisions. --- RESOURCES American Radiology Associates: https://www.americanrad.com/ Dr. Ben White’s Blog: https://www.benwhite.com/ Strategic Radiology: https://www.strategicradiology.org/ In this episode, co-hosts Drs. Ally Baheti and Mike Barraza interview diagnostic radiologist and blogger Dr. Ben White, who speaks about private equity (PE) ownership of radiology practices, the nationwide radiologist shortage, and advice for navigating job offers.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/D3g0nd

---


SHOW NOTES


Dr. White starts the episode by sharing his passion for writing, especially regarding topics that have affected his journey in medicine. His blog features topics that are useful for both trainees and physicians. His current practice structure is an independent diagnostic radiology practice, which is fully owned by physician partners. He thinks that this “priva-demics” job is well-suited to his interest in teaching residents and medical students. He also enjoys the autonomy that the practice has in staffing– it can remain non-bureaucratic and flexible to address patient care.


Next, Dr. White explains the factors driving the rise of PE buyouts of radiology practices, including the pros and cons of becoming a PE-owned practice. During a buyout, radiologists are offered more cash and stocks upfront in exchange for a loss of practice autonomy and a cap on future salaries. While PE firms usually advertise buyout as an opportunity to strengthen the practice with more resources, obtain help with debt payment, and eliminate inefficiencies, these benefits may not come to fruition in the long term. Additionally, radiologists may leave practices if they are not satisfied with PE management and priorities, which result in staffing shortages. Buyouts also affect independent radiology practices, since PE-owned practices are able to offer higher salaries for less work, which artificially inflate salaries across the radiology market. Dr. White fears that smaller practices and hospitals will lose their radiology workforces and will be forced to shed low-paying contracts and cease to provide imaging services for patient populations who need medical care the most. Additionally, there is unavoidable friction that arises when third party employers come between the patient-physician relationship.


Finally, Dr. White gives advice to radiologists about approaching each job prospect with a holistic perspective, including job factors that cannot be measured. He encourages early career radiologists to identify their values and ask themselves if they view their next job as simply a short term stop, or if they want to set up roots for the long term. This distinction can help guide them in making career decisions.


---


RESOURCES


American Radiology Associates:

https://www.americanrad.com/


Dr. Ben White’s Blog:

https://www.benwhite.com/


Strategic Radiology:

https://www.strategicradiology.org/

]]> 3354 Ep. 276 Chiba Needle Technique for Tough CTO's with Dr. Michael Cumming In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Michael Cumming about his Chiba needle technique for difficult CTOs, including how to perform the technique safely and how to approach complications. --- CHECK OUT OUR SPONSORS Surmodics Sublime Radial Access Platform https://sublimeradial.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Cumming is one of three interventional radiologists at a private practice OBL in Minneapolis, MN. He treats patients with significant vascular disease, and has developed an approach to tackle heavily calcified chronic total occlusions (CTOs). He first used this technique on a patient with superficial femoral artery (SFA) CTOs, rest pain at night and short distance claudication. The patient was a poor candidate for surgical bypass. He began the case using the conventional technique (glide wire) but after failing twice because the wire wasn’t stiff enough, he asked for a Chiba needle. He used extravascular ultrasound (EVUS) and got part of the way through the SFA occlusion, but couldn’t completely cross the lesion because the needle was too short. He then went looking for a longer needle, and found a 65cm Chiba on the Cook website. Dr. Cumming explains his escalation algorithm, which he uses in every revascularization case. He starts with glide wire (straight or angled), and if he gets to the point where the wire loops on itself, rather than advancing the wire and risking subintimal reentry, he stops. It is important to him to remain true lumen if possible. Next, he tries the back end of the glide wire. Third, he puts an anchoring balloon in and tries again with the back end of the glide wire. If none of these options work, he will either try his Chiba technique or try a retrograde approach from a tibial artery. If he spends more than 5 minutes on any of these steps, he moves on to the next step. He emphasizes the importance of having a plan ahead of time, rather than trying to figure out your next steps mid procedure. For the Chiba technique, Dr. Cumming uses the 65cm Chiba (with or without stylet) through a 40cm Kumpe catheter. He advances it over an 018 nitinol or stainless steel wire. He shapes the Chiba needle based on whether he is trying to cross a lesion or enter the ostium of an artery. Using fluoroscopy, often in the orthogonal plane, he advances the needle by spinning it. Using this technique is relatively safe if you know where you are in the vessel and go slowly. Nevertheless, he says complications will still occur due to the severity of vascular disease. If the needle or wire goes extraluminal or perforates the artery causing heavier bleeding, he always has a plan. He uses balloons to try to tamponade the bleed, and occasionally injects thrombin to the area using a spinal needle. The most dangerous complication is heavy extravasation below the knee in the calf compartments that can lead to compartment syndrome. --- RESOURCES Twitter: @drcumming LinkedIn: https://www.linkedin.com/in/drmichaelcumming Chiba needle: https://www.cookmedical.com/products/ir_dchn_webds/ Mon, 26 Dec 2022 06:05:00 -0000 full BackTable In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Michael Cumming about his Chiba needle technique for difficult CTOs, including how to perform the technique safely and how to approach complications. In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Michael Cumming about his Chiba needle technique for difficult CTOs, including how to perform the technique safely and how to approach complications. --- CHECK OUT OUR SPONSORS Surmodics Sublime Radial Access Platform https://sublimeradial.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Cumming is one of three interventional radiologists at a private practice OBL in Minneapolis, MN. He treats patients with significant vascular disease, and has developed an approach to tackle heavily calcified chronic total occlusions (CTOs). He first used this technique on a patient with superficial femoral artery (SFA) CTOs, rest pain at night and short distance claudication. The patient was a poor candidate for surgical bypass. He began the case using the conventional technique (glide wire) but after failing twice because the wire wasn’t stiff enough, he asked for a Chiba needle. He used extravascular ultrasound (EVUS) and got part of the way through the SFA occlusion, but couldn’t completely cross the lesion because the needle was too short. He then went looking for a longer needle, and found a 65cm Chiba on the Cook website. Dr. Cumming explains his escalation algorithm, which he uses in every revascularization case. He starts with glide wire (straight or angled), and if he gets to the point where the wire loops on itself, rather than advancing the wire and risking subintimal reentry, he stops. It is important to him to remain true lumen if possible. Next, he tries the back end of the glide wire. Third, he puts an anchoring balloon in and tries again with the back end of the glide wire. If none of these options work, he will either try his Chiba technique or try a retrograde approach from a tibial artery. If he spends more than 5 minutes on any of these steps, he moves on to the next step. He emphasizes the importance of having a plan ahead of time, rather than trying to figure out your next steps mid procedure. For the Chiba technique, Dr. Cumming uses the 65cm Chiba (with or without stylet) through a 40cm Kumpe catheter. He advances it over an 018 nitinol or stainless steel wire. He shapes the Chiba needle based on whether he is trying to cross a lesion or enter the ostium of an artery. Using fluoroscopy, often in the orthogonal plane, he advances the needle by spinning it. Using this technique is relatively safe if you know where you are in the vessel and go slowly. Nevertheless, he says complications will still occur due to the severity of vascular disease. If the needle or wire goes extraluminal or perforates the artery causing heavier bleeding, he always has a plan. He uses balloons to try to tamponade the bleed, and occasionally injects thrombin to the area using a spinal needle. The most dangerous complication is heavy extravasation below the knee in the calf compartments that can lead to compartment syndrome. --- RESOURCES Twitter: @drcumming LinkedIn: https://www.linkedin.com/in/drmichaelcumming Chiba needle: https://www.cookmedical.com/products/ir_dchn_webds/ In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Michael Cumming about his Chiba needle technique for difficult CTOs, including how to perform the technique safely and how to approach complications.


---


CHECK OUT OUR SPONSORS


Surmodics Sublime Radial Access Platform

https://sublimeradial.com/


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. Cumming is one of three interventional radiologists at a private practice OBL in Minneapolis, MN. He treats patients with significant vascular disease, and has developed an approach to tackle heavily calcified chronic total occlusions (CTOs). He first used this technique on a patient with superficial femoral artery (SFA) CTOs, rest pain at night and short distance claudication. The patient was a poor candidate for surgical bypass. He began the case using the conventional technique (glide wire) but after failing twice because the wire wasn’t stiff enough, he asked for a Chiba needle. He used extravascular ultrasound (EVUS) and got part of the way through the SFA occlusion, but couldn’t completely cross the lesion because the needle was too short. He then went looking for a longer needle, and found a 65cm Chiba on the Cook website.


Dr. Cumming explains his escalation algorithm, which he uses in every revascularization case. He starts with glide wire (straight or angled), and if he gets to the point where the wire loops on itself, rather than advancing the wire and risking subintimal reentry, he stops. It is important to him to remain true lumen if possible. Next, he tries the back end of the glide wire. Third, he puts an anchoring balloon in and tries again with the back end of the glide wire. If none of these options work, he will either try his Chiba technique or try a retrograde approach from a tibial artery. If he spends more than 5 minutes on any of these steps, he moves on to the next step. He emphasizes the importance of having a plan ahead of time, rather than trying to figure out your next steps mid procedure.


For the Chiba technique, Dr. Cumming uses the 65cm Chiba (with or without stylet) through a 40cm Kumpe catheter. He advances it over an 018 nitinol or stainless steel wire. He shapes the Chiba needle based on whether he is trying to cross a lesion or enter the ostium of an artery. Using fluoroscopy, often in the orthogonal plane, he advances the needle by spinning it. Using this technique is relatively safe if you know where you are in the vessel and go slowly. Nevertheless, he says complications will still occur due to the severity of vascular disease. If the needle or wire goes extraluminal or perforates the artery causing heavier bleeding, he always has a plan. He uses balloons to try to tamponade the bleed, and occasionally injects thrombin to the area using a spinal needle. The most dangerous complication is heavy extravasation below the knee in the calf compartments that can lead to compartment syndrome.


---


RESOURCES


Twitter:

@drcumming


LinkedIn:

https://www.linkedin.com/in/drmichaelcumming


Chiba needle:

https://www.cookmedical.com/products/ir_dchn_webds/

]]> 2342 Ep. 275 E&M Coding Part 2 with Dr. Ryan Trojan In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Ryan Trojan about recent changes to the AMA’s evaluation and management (E&M) coding in the inpatient and outpatient settings. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/WXMItA --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Trojan reflects on changes in his practice since his first BackTable interview in March 2021. Onboarding a nurse practitioner made a large difference in being able to bill for follow up visits. Dr. Trojan also notes that some complex procedures require prior consultation, while other simple procedures do not. This categorization depends on the practice structure. Next, we discuss the 2021 changes to outpatient E&M coding, which will also be reflected in 2023 changes to inpatient coding. These changes place more emphasis on time-based billing and allows physicians to bill for telehealth time with patients before / after / during their visit, as opposed to only face-to-face visits. Dr. Trojan relies on time-based billing more than component-based billing, since time spent with the patient reflects the complexities and comorbidities of each patient’s case. His initial appointment codes typically fall in the level 4 or 5 categories, which indicate moderate or high complexity. Follow up codes usually qualify as level 3, which indicates low complexity. Finally, Dr. Trojan responds to questions from the audience about understanding global periods, billing for diagnostic and interventional service within the same practice, and billing for consults. Overall, he emphasizes the importance of documenting patient encounters and coding to capture revenue and recognize IR contributions to patient care. --- RESOURCES Episode 116- E&M Coding 101: https://www.backtable.com/shows/vi/podcasts/116/evaluation-management-em-coding-101 AMA 2022 E&M Guidelines: https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management Email: ryan.trojan@integrisok.com Fri, 23 Dec 2022 06:05:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Ryan Trojan about recent changes to the AMA’s evaluation and management (E&M) coding in the inpatient and outpatient settings. In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Ryan Trojan about recent changes to the AMA’s evaluation and management (E&M) coding in the inpatient and outpatient settings. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/WXMItA --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES Dr. Trojan reflects on changes in his practice since his first BackTable interview in March 2021. Onboarding a nurse practitioner made a large difference in being able to bill for follow up visits. Dr. Trojan also notes that some complex procedures require prior consultation, while other simple procedures do not. This categorization depends on the practice structure. Next, we discuss the 2021 changes to outpatient E&M coding, which will also be reflected in 2023 changes to inpatient coding. These changes place more emphasis on time-based billing and allows physicians to bill for telehealth time with patients before / after / during their visit, as opposed to only face-to-face visits. Dr. Trojan relies on time-based billing more than component-based billing, since time spent with the patient reflects the complexities and comorbidities of each patient’s case. His initial appointment codes typically fall in the level 4 or 5 categories, which indicate moderate or high complexity. Follow up codes usually qualify as level 3, which indicates low complexity. Finally, Dr. Trojan responds to questions from the audience about understanding global periods, billing for diagnostic and interventional service within the same practice, and billing for consults. Overall, he emphasizes the importance of documenting patient encounters and coding to capture revenue and recognize IR contributions to patient care. --- RESOURCES Episode 116- E&M Coding 101: https://www.backtable.com/shows/vi/podcasts/116/evaluation-management-em-coding-101 AMA 2022 E&M Guidelines: https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management Email: ryan.trojan@integrisok.com In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Ryan Trojan about recent changes to the AMA’s evaluation and management (E&M) coding in the inpatient and outpatient settings.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/WXMItA


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


Dr. Trojan reflects on changes in his practice since his first BackTable interview in March 2021. Onboarding a nurse practitioner made a large difference in being able to bill for follow up visits. Dr. Trojan also notes that some complex procedures require prior consultation, while other simple procedures do not. This categorization depends on the practice structure.


Next, we discuss the 2021 changes to outpatient E&M coding, which will also be reflected in 2023 changes to inpatient coding. These changes place more emphasis on time-based billing and allows physicians to bill for telehealth time with patients before / after / during their visit, as opposed to only face-to-face visits. Dr. Trojan relies on time-based billing more than component-based billing, since time spent with the patient reflects the complexities and comorbidities of each patient’s case. His initial appointment codes typically fall in the level 4 or 5 categories, which indicate moderate or high complexity. Follow up codes usually qualify as level 3, which indicates low complexity.


Finally, Dr. Trojan responds to questions from the audience about understanding global periods, billing for diagnostic and interventional service within the same practice, and billing for consults. Overall, he emphasizes the importance of documenting patient encounters and coding to capture revenue and recognize IR contributions to patient care.


---


RESOURCES


Episode 116- E&M Coding 101:

https://www.backtable.com/shows/vi/podcasts/116/evaluation-management-em-coding-101


AMA 2022 E&M Guidelines:

https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management


Email:

ryan.trojan@integrisok.com

]]> 2004 Ep. 274 Peritoneal Dialysis Catheters with Dr. Satyaki Banerjee In this episode, host Dr. Aparna Baheti interviews interventional nephrologist Dr. Satyaki Banerjee about peritoneal dialysis, including indications, placement technique, and tips for preventing complications. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/Sc3ac2 --- SHOW NOTES Dr. Banerjee is an interventional nephrologist at a private practice OBL in Albuquerque, NM. He has completed around 750 PD catheter placements to date. Indications for PD include patients with renal failure and a glomerular filtration rate (GFR) less than 15%. Regardless of the etiology of renal failure (i.e. hypertension, diabetes), or symptoms (i.e. uremia, volume overload), PD, like hemodialysis (HD), is an option. PD is becoming increasingly popular due to patients’ ability to do it from home rather than at a dialysis clinic 3 days per week. It also empowers patients to manage their own health. Though obesity used to be a contraindication for PD, it no longer is, and Dr. Banerjee frequently places PDs in patients with a BMI of 40. The only contraindication is an abdominal wall with extensive scarring that prevents the location of a clear window. Next, Dr. Banerjee overviews his PD workup. He does a consultation that includes an ultrasound of the abdominal wall (to verify the absence of a hernia or diastasis recti), discussion of risks, and review of post-procedure instructions. The night before, he gives his patients 60mL of lactulose after a liquid diet that evening. Before the procedure, he ensures his patients' bowel and bladder are empty, and places a foley catheter if there is concern for bladder obstruction. He holds Coumadin and Eliquis for 2 days prior to the procedure, and Aspirin and Plavix the day of. His goal for INR is less than 1.5. If they are hyperkalemic, he gives Lokelma, a new powder medication, which he prefers over Kayexalate. He measures the patient's beltline, and where they wear their pants, and always asks if they would prefer the catheter on their right or left. Dr. Banerjee discusses his method for placing PD catheters. He uses a triple prep of chlorhexidine, iodine, and ChloraPrep. He starts by doing a scout x-ray to mark the pelvic rim. He accesses the peritoneum from a paraumbilical approach, just lateral to the spine, and always goes through the rectus muscle. He injects lidocaine until he reaches the posterior rectus sheath, where he switches to contrast. He likes to see a spider web dissipation of contrast to confirm he is intraperitoneal. He prefers a stiff glide for his wire, and an 18 French peel away. After introducing the wire, if it forms the classic loop around the pelvis, then he proceeds to serial dilation. PD catheters are different than PleurX catheters because they have a swan neck and a double cuff. The deep cuff must be in or on the rectus muscle, and the swan neck should be hanging over the rectus. He uses a Vicryl purse-string suture to anchor the deep cuff. He tunnels about 2 inches away from the deep cuff, with the superficial cuff ending in the subcutaneous fascia. He infuses antibiotics through the catheter, usually vancomycin and cefepime. His PD patients can start dialysis the day after the procedure. He then sees his patients one week later for a dressing change and 2 weeks later for a second dressing change and to review home instructions with the PD nurse. Mon, 19 Dec 2022 06:05:00 -0000 full BackTable In this episode, host Dr. Aparna Baheti interviews interventional nephrologist Dr. Satyaki Banerjee about peritoneal dialysis, including indications, placement technique, and tips for preventing complications. In this episode, host Dr. Aparna Baheti interviews interventional nephrologist Dr. Satyaki Banerjee about peritoneal dialysis, including indications, placement technique, and tips for preventing complications. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/Sc3ac2 --- SHOW NOTES Dr. Banerjee is an interventional nephrologist at a private practice OBL in Albuquerque, NM. He has completed around 750 PD catheter placements to date. Indications for PD include patients with renal failure and a glomerular filtration rate (GFR) less than 15%. Regardless of the etiology of renal failure (i.e. hypertension, diabetes), or symptoms (i.e. uremia, volume overload), PD, like hemodialysis (HD), is an option. PD is becoming increasingly popular due to patients’ ability to do it from home rather than at a dialysis clinic 3 days per week. It also empowers patients to manage their own health. Though obesity used to be a contraindication for PD, it no longer is, and Dr. Banerjee frequently places PDs in patients with a BMI of 40. The only contraindication is an abdominal wall with extensive scarring that prevents the location of a clear window. Next, Dr. Banerjee overviews his PD workup. He does a consultation that includes an ultrasound of the abdominal wall (to verify the absence of a hernia or diastasis recti), discussion of risks, and review of post-procedure instructions. The night before, he gives his patients 60mL of lactulose after a liquid diet that evening. Before the procedure, he ensures his patients' bowel and bladder are empty, and places a foley catheter if there is concern for bladder obstruction. He holds Coumadin and Eliquis for 2 days prior to the procedure, and Aspirin and Plavix the day of. His goal for INR is less than 1.5. If they are hyperkalemic, he gives Lokelma, a new powder medication, which he prefers over Kayexalate. He measures the patient's beltline, and where they wear their pants, and always asks if they would prefer the catheter on their right or left. Dr. Banerjee discusses his method for placing PD catheters. He uses a triple prep of chlorhexidine, iodine, and ChloraPrep. He starts by doing a scout x-ray to mark the pelvic rim. He accesses the peritoneum from a paraumbilical approach, just lateral to the spine, and always goes through the rectus muscle. He injects lidocaine until he reaches the posterior rectus sheath, where he switches to contrast. He likes to see a spider web dissipation of contrast to confirm he is intraperitoneal. He prefers a stiff glide for his wire, and an 18 French peel away. After introducing the wire, if it forms the classic loop around the pelvis, then he proceeds to serial dilation. PD catheters are different than PleurX catheters because they have a swan neck and a double cuff. The deep cuff must be in or on the rectus muscle, and the swan neck should be hanging over the rectus. He uses a Vicryl purse-string suture to anchor the deep cuff. He tunnels about 2 inches away from the deep cuff, with the superficial cuff ending in the subcutaneous fascia. He infuses antibiotics through the catheter, usually vancomycin and cefepime. His PD patients can start dialysis the day after the procedure. He then sees his patients one week later for a dressing change and 2 weeks later for a second dressing change and to review home instructions with the PD nurse. In this episode, host Dr. Aparna Baheti interviews interventional nephrologist Dr. Satyaki Banerjee about peritoneal dialysis, including indications, placement technique, and tips for preventing complications.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/Sc3ac2

---


SHOW NOTES


Dr. Banerjee is an interventional nephrologist at a private practice OBL in Albuquerque, NM. He has completed around 750 PD catheter placements to date. Indications for PD include patients with renal failure and a glomerular filtration rate (GFR) less than 15%. Regardless of the etiology of renal failure (i.e. hypertension, diabetes), or symptoms (i.e. uremia, volume overload), PD, like hemodialysis (HD), is an option. PD is becoming increasingly popular due to patients’ ability to do it from home rather than at a dialysis clinic 3 days per week. It also empowers patients to manage their own health. Though obesity used to be a contraindication for PD, it no longer is, and Dr. Banerjee frequently places PDs in patients with a BMI of 40. The only contraindication is an abdominal wall with extensive scarring that prevents the location of a clear window.


Next, Dr. Banerjee overviews his PD workup. He does a consultation that includes an ultrasound of the abdominal wall (to verify the absence of a hernia or diastasis recti), discussion of risks, and review of post-procedure instructions. The night before, he gives his patients 60mL of lactulose after a liquid diet that evening. Before the procedure, he ensures his patients' bowel and bladder are empty, and places a foley catheter if there is concern for bladder obstruction. He holds Coumadin and Eliquis for 2 days prior to the procedure, and Aspirin and Plavix the day of. His goal for INR is less than 1.5. If they are hyperkalemic, he gives Lokelma, a new powder medication, which he prefers over Kayexalate. He measures the patient's beltline, and where they wear their pants, and always asks if they would prefer the catheter on their right or left.


Dr. Banerjee discusses his method for placing PD catheters. He uses a triple prep of chlorhexidine, iodine, and ChloraPrep. He starts by doing a scout x-ray to mark the pelvic rim. He accesses the peritoneum from a paraumbilical approach, just lateral to the spine, and always goes through the rectus muscle. He injects lidocaine until he reaches the posterior rectus sheath, where he switches to contrast. He likes to see a spider web dissipation of contrast to confirm he is intraperitoneal. He prefers a stiff glide for his wire, and an 18 French peel away. After introducing the wire, if it forms the classic loop around the pelvis, then he proceeds to serial dilation. PD catheters are different than PleurX catheters because they have a swan neck and a double cuff. The deep cuff must be in or on the rectus muscle, and the swan neck should be hanging over the rectus. He uses a Vicryl purse-string suture to anchor the deep cuff. He tunnels about 2 inches away from the deep cuff, with the superficial cuff ending in the subcutaneous fascia. He infuses antibiotics through the catheter, usually vancomycin and cefepime. His PD patients can start dialysis the day after the procedure. He then sees his patients one week later for a dressing change and 2 weeks later for a second dressing change and to review home instructions with the PD nurse.

]]> 2875 Ep. 273 Disc Disease and Intradiscal Therapies with Dr. Edward Yoon In this episode, host Dr. Jacob Fleming interviews Dr. Edward Yoon, interventional MSK radiologist and Chief of IR at the Hospital for Special Surgery. The doctors discuss novel intradiscal therapies to treat anterior column pain, as well as where the field of spine interventions is heading. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/teT47L --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Yoon outlines his path to his current specialty area. His interest in orthopedics and minimally invasive techniques led him to pursue fellowships in MSK radiology and spine intervention. He highlights how MSK IR is emerging as a cousin to orthopedic surgery, in the same way that VIR is related to vascular surgery. With nine different specialties practicing interventional pain and spine procedures, Dr. Yoon believes that IRs can differentiate themselves by taking ownership of follow up care and complications management. He emphasizes the importance of building a practice instead of waiting for patients to be referred to you. He also highlights the need to collaborate with colleagues in different specialties (orthopedics, PMR, pain management) to educate them about novel IR techniques and patient populations that could benefit from these. Next, the doctors discuss the leading cause of low axial chronic back pain: stable discogenic pain. Though there has not been a proven treatment to halt degenerative disc disease, there are a few therapies that could help patients with painful symptoms. Dr. Yoon describes his use of anesthetic discogram as a diagnostic and therapeutic tool for discogenic back pain. His injectant is a mix of lidocaine and dexamethasone, and he observes if the patient experiences pain relief. Due to literature that links discograms with accelerated disc degeneration, discograms are less commonly performed today. However, Dr. Yoon believes that many younger patients already have degenerated discs when they present for evaluation and every interventional procedure poses some risk that can reasonably be evaluated in collaboration with the patient. Alongside imaging, he evaluates patient symptoms, the most common being midline back pain that gets worse with flexion or axial loading. Dr. Yoon also offers tips for reading spine MRIs, which include adopting a systematic approach, noting important incidental findings, and correlating findings with patient symptoms. Finally, Dr. Yoon highlights some exciting therapies that are currently under investigation. The VIA Disc procedure involves an allographic injection of ground up nucleus pulposus into the disc. From the VAST Trial, there is data showing that treatment responders experience pain reduction and improved functioning. Autologous injection options include platelet rich plasma (PRP) and bone marrow aspirate concentrate (BMAC). Spinal modic changes could be treated with basivertebral nerve ablation (BVNA), which is a good option that is low-risk and does not preclude the possibility of future interventions. All of these therapies come with the caveat of unreliable insurance coverage, since many private payers are hesitant about approving them. The disconnect between evidence-based therapies, patient needs, and insurance coverage needs to be addressed if these therapies are to become mainstream. --- RESOURCES VAST Clinical Trial: https://pubmed.ncbi.nlm.nih.gov/34554689/ VIA Disc NP: https://gotviadisc.com/ Owestry Disability Index (ODI): https://www.aaos.org/quality/research-resources/patient-reported-outcome-measures/spine/ SMART Trial: https://pubmed.ncbi.nlm.nih.gov/32451777/ INTRACEPT Trial: https://www.nassopenaccess.org/article/S2666-5484(21)00041-X/fulltext Fri, 16 Dec 2022 06:05:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Edward Yoon, interventional MSK radiologist and Chief of IR at the Hospital for Special Surgery. The doctors discuss novel intradiscal therapies to treat anterior column pain, as well as where the field of spine interventions is heading. In this episode, host Dr. Jacob Fleming interviews Dr. Edward Yoon, interventional MSK radiologist and Chief of IR at the Hospital for Special Surgery. The doctors discuss novel intradiscal therapies to treat anterior column pain, as well as where the field of spine interventions is heading. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/teT47L --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Yoon outlines his path to his current specialty area. His interest in orthopedics and minimally invasive techniques led him to pursue fellowships in MSK radiology and spine intervention. He highlights how MSK IR is emerging as a cousin to orthopedic surgery, in the same way that VIR is related to vascular surgery. With nine different specialties practicing interventional pain and spine procedures, Dr. Yoon believes that IRs can differentiate themselves by taking ownership of follow up care and complications management. He emphasizes the importance of building a practice instead of waiting for patients to be referred to you. He also highlights the need to collaborate with colleagues in different specialties (orthopedics, PMR, pain management) to educate them about novel IR techniques and patient populations that could benefit from these. Next, the doctors discuss the leading cause of low axial chronic back pain: stable discogenic pain. Though there has not been a proven treatment to halt degenerative disc disease, there are a few therapies that could help patients with painful symptoms. Dr. Yoon describes his use of anesthetic discogram as a diagnostic and therapeutic tool for discogenic back pain. His injectant is a mix of lidocaine and dexamethasone, and he observes if the patient experiences pain relief. Due to literature that links discograms with accelerated disc degeneration, discograms are less commonly performed today. However, Dr. Yoon believes that many younger patients already have degenerated discs when they present for evaluation and every interventional procedure poses some risk that can reasonably be evaluated in collaboration with the patient. Alongside imaging, he evaluates patient symptoms, the most common being midline back pain that gets worse with flexion or axial loading. Dr. Yoon also offers tips for reading spine MRIs, which include adopting a systematic approach, noting important incidental findings, and correlating findings with patient symptoms. Finally, Dr. Yoon highlights some exciting therapies that are currently under investigation. The VIA Disc procedure involves an allographic injection of ground up nucleus pulposus into the disc. From the VAST Trial, there is data showing that treatment responders experience pain reduction and improved functioning. Autologous injection options include platelet rich plasma (PRP) and bone marrow aspirate concentrate (BMAC). Spinal modic changes could be treated with basivertebral nerve ablation (BVNA), which is a good option that is low-risk and does not preclude the possibility of future interventions. All of these therapies come with the caveat of unreliable insurance coverage, since many private payers are hesitant about approving them. The disconnect between evidence-based therapies, patient needs, and insurance coverage needs to be addressed if these therapies are to become mainstream. --- RESOURCES VAST Clinical Trial: https://pubmed.ncbi.nlm.nih.gov/34554689/ VIA Disc NP: https://gotviadisc.com/ Owestry Disability Index (ODI): https://www.aaos.org/quality/research-resources/patient-reported-outcome-measures/spine/ SMART Trial: https://pubmed.ncbi.nlm.nih.gov/32451777/ INTRACEPT Trial: https://www.nassopenaccess.org/article/S2666-5484(21)00041-X/fulltext In this episode, host Dr. Jacob Fleming interviews Dr. Edward Yoon, interventional MSK radiologist and Chief of IR at the Hospital for Special Surgery. The doctors discuss novel intradiscal therapies to treat anterior column pain, as well as where the field of spine interventions is heading.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/teT47L


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Dr. Yoon outlines his path to his current specialty area. His interest in orthopedics and minimally invasive techniques led him to pursue fellowships in MSK radiology and spine intervention. He highlights how MSK IR is emerging as a cousin to orthopedic surgery, in the same way that VIR is related to vascular surgery. With nine different specialties practicing interventional pain and spine procedures, Dr. Yoon believes that IRs can differentiate themselves by taking ownership of follow up care and complications management. He emphasizes the importance of building a practice instead of waiting for patients to be referred to you. He also highlights the need to collaborate with colleagues in different specialties (orthopedics, PMR, pain management) to educate them about novel IR techniques and patient populations that could benefit from these.


Next, the doctors discuss the leading cause of low axial chronic back pain: stable discogenic pain. Though there has not been a proven treatment to halt degenerative disc disease, there are a few therapies that could help patients with painful symptoms. Dr. Yoon describes his use of anesthetic discogram as a diagnostic and therapeutic tool for discogenic back pain. His injectant is a mix of lidocaine and dexamethasone, and he observes if the patient experiences pain relief. Due to literature that links discograms with accelerated disc degeneration, discograms are less commonly performed today. However, Dr. Yoon believes that many younger patients already have degenerated discs when they present for evaluation and every interventional procedure poses some risk that can reasonably be evaluated in collaboration with the patient. Alongside imaging, he evaluates patient symptoms, the most common being midline back pain that gets worse with flexion or axial loading. Dr. Yoon also offers tips for reading spine MRIs, which include adopting a systematic approach, noting important incidental findings, and correlating findings with patient symptoms.


Finally, Dr. Yoon highlights some exciting therapies that are currently under investigation. The VIA Disc procedure involves an allographic injection of ground up nucleus pulposus into the disc. From the VAST Trial, there is data showing that treatment responders experience pain reduction and improved functioning. Autologous injection options include platelet rich plasma (PRP) and bone marrow aspirate concentrate (BMAC). Spinal modic changes could be treated with basivertebral nerve ablation (BVNA), which is a good option that is low-risk and does not preclude the possibility of future interventions. All of these therapies come with the caveat of unreliable insurance coverage, since many private payers are hesitant about approving them. The disconnect between evidence-based therapies, patient needs, and insurance coverage needs to be addressed if these therapies are to become mainstream.


---


RESOURCES


VAST Clinical Trial:

https://pubmed.ncbi.nlm.nih.gov/34554689/


VIA Disc NP:

https://gotviadisc.com/


Owestry Disability Index (ODI):

https://www.aaos.org/quality/research-resources/patient-reported-outcome-measures/spine/


SMART Trial:

https://pubmed.ncbi.nlm.nih.gov/32451777/


INTRACEPT Trial:

https://www.nassopenaccess.org/article/S2666-5484(21)00041-X/fulltext

]]> 4275 Ep. 272 Creating Culture Through Leadership and Mentoring with Dr. Christopher Kane In this episode, Dr. Bagrodia discusses cultivating a healthy culture inside and outside of the operating room with Dr. Chris Kane, Dean of Clinical Affairs at UCSD and CEO of the UCSD Physician Group. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rVQG40 --- SHOW NOTES First, the doctors discuss the definition of culture, which Dr. Kane defines as the norms of behavior and relationships within an organization. Culture can include dress code, meeting rules, and punctuality. Most of the time, institutional culture is established in an unspoken way. Dr. Kane emphasizes the importance of having a conscious strategy to create a healthy culture and reiterates that trust is a crucial foundation for motivating cultural changes. Next, the doctors discuss helping team members find meaning in their work. Dr. Kane recommends that surgeons share patient gratitude with their other colleagues who are not frontline medical workers. He acknowledges his staff’s contributions during meetings and expresses his gratitude through written notes. He also recommends communication training for everybody on his team. Then, he shares tips for assessing organizational culture. He believes that it is most important to ask team members what they think the overarching goal of the institution is and to assess the attrition rate through exit surveys. He emphasizes that behavioral norms matter most, as department leaders often lead by example. One detrimental practice is favoritism, which Dr. Kane regards as disrespectful to other team members. Additionally, he shares his personal experiences with changing cultures at different institutions and utilizing change management theories. Finally, Dr. Kane shares general leadership advice. He highlights the importance of creating a patient-centered environment, leading by influence rather than authority, and the power of positivity. Wed, 14 Dec 2022 06:00:00 -0000 full BackTable In this episode, Dr. Bagrodia discusses cultivating a healthy culture inside and outside of the operating room with Dr. Chris Kane, Dean of Clinical Affairs at UCSD and CEO of the UCSD Physician Group. In this episode, Dr. Bagrodia discusses cultivating a healthy culture inside and outside of the operating room with Dr. Chris Kane, Dean of Clinical Affairs at UCSD and CEO of the UCSD Physician Group. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rVQG40 --- SHOW NOTES First, the doctors discuss the definition of culture, which Dr. Kane defines as the norms of behavior and relationships within an organization. Culture can include dress code, meeting rules, and punctuality. Most of the time, institutional culture is established in an unspoken way. Dr. Kane emphasizes the importance of having a conscious strategy to create a healthy culture and reiterates that trust is a crucial foundation for motivating cultural changes. Next, the doctors discuss helping team members find meaning in their work. Dr. Kane recommends that surgeons share patient gratitude with their other colleagues who are not frontline medical workers. He acknowledges his staff’s contributions during meetings and expresses his gratitude through written notes. He also recommends communication training for everybody on his team. Then, he shares tips for assessing organizational culture. He believes that it is most important to ask team members what they think the overarching goal of the institution is and to assess the attrition rate through exit surveys. He emphasizes that behavioral norms matter most, as department leaders often lead by example. One detrimental practice is favoritism, which Dr. Kane regards as disrespectful to other team members. Additionally, he shares his personal experiences with changing cultures at different institutions and utilizing change management theories. Finally, Dr. Kane shares general leadership advice. He highlights the importance of creating a patient-centered environment, leading by influence rather than authority, and the power of positivity. In this episode, Dr. Bagrodia discusses cultivating a healthy culture inside and outside of the operating room with Dr. Chris Kane, Dean of Clinical Affairs at UCSD and CEO of the UCSD Physician Group.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rVQG40


---


SHOW NOTES


First, the doctors discuss the definition of culture, which Dr. Kane defines as the norms of behavior and relationships within an organization. Culture can include dress code, meeting rules, and punctuality. Most of the time, institutional culture is established in an unspoken way. Dr. Kane emphasizes the importance of having a conscious strategy to create a healthy culture and reiterates that trust is a crucial foundation for motivating cultural changes.


Next, the doctors discuss helping team members find meaning in their work. Dr. Kane recommends that surgeons share patient gratitude with their other colleagues who are not frontline medical workers. He acknowledges his staff’s contributions during meetings and expresses his gratitude through written notes. He also recommends communication training for everybody on his team. Then, he shares tips for assessing organizational culture. He believes that it is most important to ask team members what they think the overarching goal of the institution is and to assess the attrition rate through exit surveys. He emphasizes that behavioral norms matter most, as department leaders often lead by example. One detrimental practice is favoritism, which Dr. Kane regards as disrespectful to other team members. Additionally, he shares his personal experiences with changing cultures at different institutions and utilizing change management theories.


Finally, Dr. Kane shares general leadership advice. He highlights the importance of creating a patient-centered environment, leading by influence rather than authority, and the power of positivity.

]]> 3453 Ep. 271 How Can AI Help with Acute Aortic Emergencies? with Dr. Ben Starnes In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Benjamin Starnes about artificial intelligence in aortic intervention, from aneurysm detection to procedural planning and coordination of aortic aneurysm surveillance. --- CHECK OUT OUR SPONSOR Viz.ai https://www.viz.ai/ --- SHOW NOTES Dr. Starnes is a vascular surgeon at the University of Washington. He is one of the first adopters of artificial intelligence (AI) in aortic intervention. He uses Viz.ai to help coordinate care for aortic dissections and ruptured aortic aneurysms. He began to implement this due to frustration with an outdated workflow. He serves a large patient population in Washington, Alaska, Idaho, Montana, and Wyoming. With different hospital systems and antiquated methods of communication, he realized it was very inefficient to evaluate a patient from some of these locations, and then have them transferred to Seattle for surgical repair. Dr. Starnes overviews the outdated workflow that’s prevalent in aortic emergency care. If there is a ruptured aortic aneurysm or aortic dissection, he would first get a call from an ER physician who ordered the imaging. The transfer center wouild be contacted, and then he had to find a desktop to view images from the outside facility. If there was no way to view the images due to incompatible PACS, he had to use a screenshot of an image sent by a provider at that hospital. After reviewing the imaging, he would decide whether to accept the transfer. If a patient is transferred, he would do the procedure and then hand off the patient to the ICU team, who was rarely (never) aware of this transfer until the patient arrived in their unit. After starting to use Viz.ai, this process has been streamlined. Dr. Starnes modeled the AI platform he uses for aortic emergencies in a similar way that AI stroke alert platforms already function. He now gets an alert on his phone, he is able to view good-quality images on his phone wherever he is, decide on the next steps, and communicate with members of the team in a HIPAA-compliant fashion all via the user-friendly interface. He uses AI software to detect ruptures and dissections and reports that it is very accurate. Dr. Starnes and colleagues at the University of Washington do over 350 aortic cases per year. The implementation of AI has helped them work more efficiently and has improved patient outcomes by cutting down the time from diagnosis to intervention. He hopes that machines can be trained to measure the aneurysm size for stent graft selection and manage elective aortas by integrating surveillance, follow-up, and elective repair. He also is very hopeful that AI will be able to identify many genetic aortopathies due to the integration of genetics and AI. --- RESOURCES Viz AI: https://www.viz.ai Mon, 12 Dec 2022 06:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Benjamin Starnes about artificial intelligence in aortic intervention, from aneurysm detection to procedural planning and coordination of aortic aneurysm surveillance. In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Benjamin Starnes about artificial intelligence in aortic intervention, from aneurysm detection to procedural planning and coordination of aortic aneurysm surveillance. --- CHECK OUT OUR SPONSOR Viz.ai https://www.viz.ai/ --- SHOW NOTES Dr. Starnes is a vascular surgeon at the University of Washington. He is one of the first adopters of artificial intelligence (AI) in aortic intervention. He uses Viz.ai to help coordinate care for aortic dissections and ruptured aortic aneurysms. He began to implement this due to frustration with an outdated workflow. He serves a large patient population in Washington, Alaska, Idaho, Montana, and Wyoming. With different hospital systems and antiquated methods of communication, he realized it was very inefficient to evaluate a patient from some of these locations, and then have them transferred to Seattle for surgical repair. Dr. Starnes overviews the outdated workflow that’s prevalent in aortic emergency care. If there is a ruptured aortic aneurysm or aortic dissection, he would first get a call from an ER physician who ordered the imaging. The transfer center wouild be contacted, and then he had to find a desktop to view images from the outside facility. If there was no way to view the images due to incompatible PACS, he had to use a screenshot of an image sent by a provider at that hospital. After reviewing the imaging, he would decide whether to accept the transfer. If a patient is transferred, he would do the procedure and then hand off the patient to the ICU team, who was rarely (never) aware of this transfer until the patient arrived in their unit. After starting to use Viz.ai, this process has been streamlined. Dr. Starnes modeled the AI platform he uses for aortic emergencies in a similar way that AI stroke alert platforms already function. He now gets an alert on his phone, he is able to view good-quality images on his phone wherever he is, decide on the next steps, and communicate with members of the team in a HIPAA-compliant fashion all via the user-friendly interface. He uses AI software to detect ruptures and dissections and reports that it is very accurate. Dr. Starnes and colleagues at the University of Washington do over 350 aortic cases per year. The implementation of AI has helped them work more efficiently and has improved patient outcomes by cutting down the time from diagnosis to intervention. He hopes that machines can be trained to measure the aneurysm size for stent graft selection and manage elective aortas by integrating surveillance, follow-up, and elective repair. He also is very hopeful that AI will be able to identify many genetic aortopathies due to the integration of genetics and AI. --- RESOURCES Viz AI: https://www.viz.ai In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Benjamin Starnes about artificial intelligence in aortic intervention, from aneurysm detection to procedural planning and coordination of aortic aneurysm surveillance.


---


CHECK OUT OUR SPONSOR


Viz.ai

https://www.viz.ai/


---


SHOW NOTES


Dr. Starnes is a vascular surgeon at the University of Washington. He is one of the first adopters of artificial intelligence (AI) in aortic intervention. He uses Viz.ai to help coordinate care for aortic dissections and ruptured aortic aneurysms. He began to implement this due to frustration with an outdated workflow. He serves a large patient population in Washington, Alaska, Idaho, Montana, and Wyoming. With different hospital systems and antiquated methods of communication, he realized it was very inefficient to evaluate a patient from some of these locations, and then have them transferred to Seattle for surgical repair.


Dr. Starnes overviews the outdated workflow that’s prevalent in aortic emergency care. If there is a ruptured aortic aneurysm or aortic dissection, he would first get a call from an ER physician who ordered the imaging. The transfer center wouild be contacted, and then he had to find a desktop to view images from the outside facility. If there was no way to view the images due to incompatible PACS, he had to use a screenshot of an image sent by a provider at that hospital. After reviewing the imaging, he would decide whether to accept the transfer. If a patient is transferred, he would do the procedure and then hand off the patient to the ICU team, who was rarely (never) aware of this transfer until the patient arrived in their unit.


After starting to use Viz.ai, this process has been streamlined. Dr. Starnes modeled the AI platform he uses for aortic emergencies in a similar way that AI stroke alert platforms already function. He now gets an alert on his phone, he is able to view good-quality images on his phone wherever he is, decide on the next steps, and communicate with members of the team in a HIPAA-compliant fashion all via the user-friendly interface. He uses AI software to detect ruptures and dissections and reports that it is very accurate. Dr. Starnes and colleagues at the University of Washington do over 350 aortic cases per year. The implementation of AI has helped them work more efficiently and has improved patient outcomes by cutting down the time from diagnosis to intervention. He hopes that machines can be trained to measure the aneurysm size for stent graft selection and manage elective aortas by integrating surveillance, follow-up, and elective repair. He also is very hopeful that AI will be able to identify many genetic aortopathies due to the integration of genetics and AI.


---


RESOURCES


Viz AI:

https://www.viz.ai

]]> 2046 Ep. 270 Treatment Algorithms for Splenic Artery Embolizations with Dr. Chris Grilli In this episode, Dr. Aaron Fritts interviews Dr. Chris Grilli of Christiana Health about his treatment algorithms and procedural tips for splenic embolization as a treatment for splenic trauma, hypersplenism, and splenic artery aneurysm. --- CHECK OUT OUR SPONSOR Boston Scientific Embold Fibered Coils https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html --- SHOW NOTES Dr. Grilli explains that the most common indication for splenic embolization is trauma. He walks us through different trauma guidelines for grading splenic trauma. At his institution, if only a small portion of parenchyma is involved, the patient is monitored. If significant trauma and vascular injury is present and the patient is mostly stable, the patient gets referred to IR. Dr. Grilli notes that the decision to refer to IR or trauma surgery is also institutionally dependent. Across most institutions, it is more common to monitor pediatric splenic trauma rather than intervene. Next. Dr. Grilli walks us through an embolization for splenic trauma. He will most often opt for femoral access, unless there is underlying pathology or very large body habitus. He uses a 5Fr sheath and then navigates to the splenic artery with a C2 angiographic catheter. Then, he performs angiography to visualize the bleed, decide if he wants to embolize proximally or distally, and chooses his embolic agent. The doctors discuss pros and cons of using plugs, coils, and liquid embolics. Coils can induce stasis more quickly than a plug can. There are also coils with different materials and mechanisms of deployment. Dr. Grilli notes that an angiographic run at the end of an ideal case would show that the embolic device has obstructed flow in the main artery and the spleen is now being perfused by collaterals. Finally, we address non-traumatic indications for splenic embolization. In hypersplenism, oncologists will refer patients to IR to address platelet sequestration. Dr. Grilli says that these cases require embolization of segmental branches of the splenic artery, in the effort to kill off 40-70% of the spleen. This procedure could introduce significant adverse effects that must be discussed with the patient beforehand. In embolization of splenic artery aneurysms, Dr. Grilli prefers to use long packing coils or covered stents. --- RESOURCES ChristianaCare IR Residency: https://residency.christianacare.org/vascular-interventional-radiology AAST Spleen Injury Scale: https://www.aast.org/resources-detail/injury-scoring-scale#spleen WSES Classification and Guidelines for Splenic Trauma: https://pubmed.ncbi.nlm.nih.gov/28828034/ Cobra 2 (C2) Catheter: https://meritoem.com/product-category/catheters-extrusions/diagnostic-peripheral/performa-impress/cobra-2/ Sarah Catheter: https://www.terumois.com/products/catheters/optitorque.html Penumbra Pod Device: https://www.penumbrainc.com/peripheral-device/pod/ Embold Fibered Coil: https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html Interlock Coil: https://www.bostonscientific.com/en-US/products/embolization/interlock-and-idc-detachable-embolization-coils.html Management of Hypersplenism by Partial Splenic Embolization With Ethylene Vinyl Alcohol Copolymer (Onyx): https://www.ajronline.org/doi/full/10.2214/AJR.10.4401?mobileUi=0 MYNXGRIP Closure Device: https://cordis.com/na/products/close/endovascular/mynxgrip-vascular-closure-device AngioSeal Closure Device: https://www.terumois.com/products/closure/angio-seal-vascular-closure-devices/angio-seal.html CELT Closure Device: https://www.veryanmed.com/usa/products/celt-acd-vascular-closure-device/ Fri, 09 Dec 2022 06:05:00 -0000 full BackTable In this episode, Dr. Aaron Fritts interviews Dr. Chris Grilli of Christiana Health about his treatment algorithms and procedural tips for splenic embolization as a treatment for splenic trauma, hypersplenism, and splenic artery aneurysm. In this episode, Dr. Aaron Fritts interviews Dr. Chris Grilli of Christiana Health about his treatment algorithms and procedural tips for splenic embolization as a treatment for splenic trauma, hypersplenism, and splenic artery aneurysm. --- CHECK OUT OUR SPONSOR Boston Scientific Embold Fibered Coils https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html --- SHOW NOTES Dr. Grilli explains that the most common indication for splenic embolization is trauma. He walks us through different trauma guidelines for grading splenic trauma. At his institution, if only a small portion of parenchyma is involved, the patient is monitored. If significant trauma and vascular injury is present and the patient is mostly stable, the patient gets referred to IR. Dr. Grilli notes that the decision to refer to IR or trauma surgery is also institutionally dependent. Across most institutions, it is more common to monitor pediatric splenic trauma rather than intervene. Next. Dr. Grilli walks us through an embolization for splenic trauma. He will most often opt for femoral access, unless there is underlying pathology or very large body habitus. He uses a 5Fr sheath and then navigates to the splenic artery with a C2 angiographic catheter. Then, he performs angiography to visualize the bleed, decide if he wants to embolize proximally or distally, and chooses his embolic agent. The doctors discuss pros and cons of using plugs, coils, and liquid embolics. Coils can induce stasis more quickly than a plug can. There are also coils with different materials and mechanisms of deployment. Dr. Grilli notes that an angiographic run at the end of an ideal case would show that the embolic device has obstructed flow in the main artery and the spleen is now being perfused by collaterals. Finally, we address non-traumatic indications for splenic embolization. In hypersplenism, oncologists will refer patients to IR to address platelet sequestration. Dr. Grilli says that these cases require embolization of segmental branches of the splenic artery, in the effort to kill off 40-70% of the spleen. This procedure could introduce significant adverse effects that must be discussed with the patient beforehand. In embolization of splenic artery aneurysms, Dr. Grilli prefers to use long packing coils or covered stents. --- RESOURCES ChristianaCare IR Residency: https://residency.christianacare.org/vascular-interventional-radiology AAST Spleen Injury Scale: https://www.aast.org/resources-detail/injury-scoring-scale#spleen WSES Classification and Guidelines for Splenic Trauma: https://pubmed.ncbi.nlm.nih.gov/28828034/ Cobra 2 (C2) Catheter: https://meritoem.com/product-category/catheters-extrusions/diagnostic-peripheral/performa-impress/cobra-2/ Sarah Catheter: https://www.terumois.com/products/catheters/optitorque.html Penumbra Pod Device: https://www.penumbrainc.com/peripheral-device/pod/ Embold Fibered Coil: https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html Interlock Coil: https://www.bostonscientific.com/en-US/products/embolization/interlock-and-idc-detachable-embolization-coils.html Management of Hypersplenism by Partial Splenic Embolization With Ethylene Vinyl Alcohol Copolymer (Onyx): https://www.ajronline.org/doi/full/10.2214/AJR.10.4401?mobileUi=0 MYNXGRIP Closure Device: https://cordis.com/na/products/close/endovascular/mynxgrip-vascular-closure-device AngioSeal Closure Device: https://www.terumois.com/products/closure/angio-seal-vascular-closure-devices/angio-seal.html CELT Closure Device: https://www.veryanmed.com/usa/products/celt-acd-vascular-closure-device/ In this episode, Dr. Aaron Fritts interviews Dr. Chris Grilli of Christiana Health about his treatment algorithms and procedural tips for splenic embolization as a treatment for splenic trauma, hypersplenism, and splenic artery aneurysm.


---


CHECK OUT OUR SPONSOR


Boston Scientific Embold Fibered Coils

https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html


---


SHOW NOTES


Dr. Grilli explains that the most common indication for splenic embolization is trauma. He walks us through different trauma guidelines for grading splenic trauma. At his institution, if only a small portion of parenchyma is involved, the patient is monitored. If significant trauma and vascular injury is present and the patient is mostly stable, the patient gets referred to IR. Dr. Grilli notes that the decision to refer to IR or trauma surgery is also institutionally dependent. Across most institutions, it is more common to monitor pediatric splenic trauma rather than intervene.


Next. Dr. Grilli walks us through an embolization for splenic trauma. He will most often opt for femoral access, unless there is underlying pathology or very large body habitus. He uses a 5Fr sheath and then navigates to the splenic artery with a C2 angiographic catheter. Then, he performs angiography to visualize the bleed, decide if he wants to embolize proximally or distally, and chooses his embolic agent.


The doctors discuss pros and cons of using plugs, coils, and liquid embolics. Coils can induce stasis more quickly than a plug can. There are also coils with different materials and mechanisms of deployment. Dr. Grilli notes that an angiographic run at the end of an ideal case would show that the embolic device has obstructed flow in the main artery and the spleen is now being perfused by collaterals.


Finally, we address non-traumatic indications for splenic embolization. In hypersplenism, oncologists will refer patients to IR to address platelet sequestration. Dr. Grilli says that these cases require embolization of segmental branches of the splenic artery, in the effort to kill off 40-70% of the spleen. This procedure could introduce significant adverse effects that must be discussed with the patient beforehand. In embolization of splenic artery aneurysms, Dr. Grilli prefers to use long packing coils or covered stents.


---


RESOURCES


ChristianaCare IR Residency:

https://residency.christianacare.org/vascular-interventional-radiology


AAST Spleen Injury Scale:

https://www.aast.org/resources-detail/injury-scoring-scale#spleen


WSES Classification and Guidelines for Splenic Trauma:

https://pubmed.ncbi.nlm.nih.gov/28828034/


Cobra 2 (C2) Catheter:

https://meritoem.com/product-category/catheters-extrusions/diagnostic-peripheral/performa-impress/cobra-2/


Sarah Catheter:

https://www.terumois.com/products/catheters/optitorque.html


Penumbra Pod Device:

https://www.penumbrainc.com/peripheral-device/pod/


Embold Fibered Coil:

https://www.bostonscientific.com/en-US/products/embolization/embold-detachable-coil-system.html


Interlock Coil:

https://www.bostonscientific.com/en-US/products/embolization/interlock-and-idc-detachable-embolization-coils.html


Management of Hypersplenism by Partial Splenic Embolization With Ethylene Vinyl Alcohol Copolymer (Onyx):

https://www.ajronline.org/doi/full/10.2214/AJR.10.4401?mobileUi=0


MYNXGRIP Closure Device:

https://cordis.com/na/products/close/endovascular/mynxgrip-vascular-closure-device


AngioSeal Closure Device:

https://www.terumois.com/products/closure/angio-seal-vascular-closure-devices/angio-seal.html


CELT Closure Device:

https://www.veryanmed.com/usa/products/celt-acd-vascular-closure-device/

]]> 2834 Ep. 269 Innovating on Educational Meetings (on site at Paris Vascular Insights) with Dr. Lorenzo Patrone and Dr. Isabelle Van Herzeele In this episode, guest host Dr. Lorenzo Patrone interviews vascular surgeon Dr. Isabelle Van Herzeele about the current state of vascular skills education and the future of vascular conferences. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic IN.PACT 018 DCB https://www.medtronic.com/018 --- SHOW NOTES The doctors are on site at Paris Vascular Insights, a conference where interactivity is built into every session. Dr. Van Herzeele speaks about the importance of offering hands-on skills workshops in addition to traditional lectures. She believes that interactive learning is essential for all trainees. Additionally, skill development involves collaboration between industry and clinicians. She also emphasizes the importance of brief case-based lectures that spark discussion and encourage audience members to ask questions. The doctors mention the difficulties involved with encouraging audience participation, such as language barriers and fear of judgment. To address these challenges, it is important to create a safe environment that is conducive to learning, since clarification in a training session would yield better patient outcomes. Dr. Van Herzeele also discusses the experience of women in vascular surgery. She recognizes the importance of a support system, which includes family and flexible training methods. One important training modality is virtual simulation. Online modules and skills kits can provide a way for all trainees, but especially women, to learn new skills or keep up with surgical and endovascular skills when they are not able to be in the hospital. She stresses that simulation is a complement and preparation for real life training, not a substitute. Finally, the doctors discuss education in the open surgery and endovascular fields. As vascular procedures are becoming more innovative and diverse, proceduralists have started to subspecialize to lean more heavily on endovascular or open procedures, depending on where they train. Dr. Van Heerzeele believes that vascular surgeons can specialize; however, they should maintain both sets of skills and be able to take call and perform the appropriate procedure in the event of an emergency. Additionally, collaborations between physicians in all vascular fields and different vascular care centers are necessary to ensure the best patient care. --- RESOURCES Paris Vascular Insights: https://parisvascularinsights.com/ VEITH Symposium: https://www.veithsymposium.org/index.php Society of Vascular Surgery (SVS) Women’s Section: https://vascular.org/vascular-specialists/networking/svs-womens-section European Vascular Course: https://vascular-course.com/ European Society for Vascular Surgery (ESVS): https://esvs.org/ Wed, 07 Dec 2022 06:05:00 -0000 full BackTable In this episode, guest host Dr. Lorenzo Patrone interviews vascular surgeon Dr. Isabelle Van Herzeele about the current state of vascular skills education and the future of vascular conferences. In this episode, guest host Dr. Lorenzo Patrone interviews vascular surgeon Dr. Isabelle Van Herzeele about the current state of vascular skills education and the future of vascular conferences. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic IN.PACT 018 DCB https://www.medtronic.com/018 --- SHOW NOTES The doctors are on site at Paris Vascular Insights, a conference where interactivity is built into every session. Dr. Van Herzeele speaks about the importance of offering hands-on skills workshops in addition to traditional lectures. She believes that interactive learning is essential for all trainees. Additionally, skill development involves collaboration between industry and clinicians. She also emphasizes the importance of brief case-based lectures that spark discussion and encourage audience members to ask questions. The doctors mention the difficulties involved with encouraging audience participation, such as language barriers and fear of judgment. To address these challenges, it is important to create a safe environment that is conducive to learning, since clarification in a training session would yield better patient outcomes. Dr. Van Herzeele also discusses the experience of women in vascular surgery. She recognizes the importance of a support system, which includes family and flexible training methods. One important training modality is virtual simulation. Online modules and skills kits can provide a way for all trainees, but especially women, to learn new skills or keep up with surgical and endovascular skills when they are not able to be in the hospital. She stresses that simulation is a complement and preparation for real life training, not a substitute. Finally, the doctors discuss education in the open surgery and endovascular fields. As vascular procedures are becoming more innovative and diverse, proceduralists have started to subspecialize to lean more heavily on endovascular or open procedures, depending on where they train. Dr. Van Heerzeele believes that vascular surgeons can specialize; however, they should maintain both sets of skills and be able to take call and perform the appropriate procedure in the event of an emergency. Additionally, collaborations between physicians in all vascular fields and different vascular care centers are necessary to ensure the best patient care. --- RESOURCES Paris Vascular Insights: https://parisvascularinsights.com/ VEITH Symposium: https://www.veithsymposium.org/index.php Society of Vascular Surgery (SVS) Women’s Section: https://vascular.org/vascular-specialists/networking/svs-womens-section European Vascular Course: https://vascular-course.com/ European Society for Vascular Surgery (ESVS): https://esvs.org/ In this episode, guest host Dr. Lorenzo Patrone interviews vascular surgeon Dr. Isabelle Van Herzeele about the current state of vascular skills education and the future of vascular conferences.


---


CHECK OUT OUR SPONSORS


Reflow Medical

https://www.reflowmedical.com/


Medtronic IN.PACT 018 DCB

https://www.medtronic.com/018


---


SHOW NOTES


The doctors are on site at Paris Vascular Insights, a conference where interactivity is built into every session. Dr. Van Herzeele speaks about the importance of offering hands-on skills workshops in addition to traditional lectures. She believes that interactive learning is essential for all trainees. Additionally, skill development involves collaboration between industry and clinicians. She also emphasizes the importance of brief case-based lectures that spark discussion and encourage audience members to ask questions. The doctors mention the difficulties involved with encouraging audience participation, such as language barriers and fear of judgment. To address these challenges, it is important to create a safe environment that is conducive to learning, since clarification in a training session would yield better patient outcomes.


Dr. Van Herzeele also discusses the experience of women in vascular surgery. She recognizes the importance of a support system, which includes family and flexible training methods. One important training modality is virtual simulation. Online modules and skills kits can provide a way for all trainees, but especially women, to learn new skills or keep up with surgical and endovascular skills when they are not able to be in the hospital. She stresses that simulation is a complement and preparation for real life training, not a substitute.


Finally, the doctors discuss education in the open surgery and endovascular fields. As vascular procedures are becoming more innovative and diverse, proceduralists have started to subspecialize to lean more heavily on endovascular or open procedures, depending on where they train. Dr. Van Heerzeele believes that vascular surgeons can specialize; however, they should maintain both sets of skills and be able to take call and perform the appropriate procedure in the event of an emergency. Additionally, collaborations between physicians in all vascular fields and different vascular care centers are necessary to ensure the best patient care.


---


RESOURCES


Paris Vascular Insights:

https://parisvascularinsights.com/


VEITH Symposium:

https://www.veithsymposium.org/index.php


Society of Vascular Surgery (SVS) Women’s Section:

https://vascular.org/vascular-specialists/networking/svs-womens-section


European Vascular Course:

https://vascular-course.com/


European Society for Vascular Surgery (ESVS):

https://esvs.org/

]]> 1376 Ep. 268 Atherectomy Basics with Dr. Omar Saleh and Dr. Srini Tummala In this episode, host Dr. Sabeen Dhand interviews Drs. Srini Tummala and Omar Saleh about atherectomy in peripheral arterial disease, including indications, technique, and device selection. --- CHECK OUT OUR SPONSORS BD Rotarex Atherectomy System https://www.bd.com/rotarex Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES We begin by overviewing the definition of atherectomy and the types of devices. Atherectomy is a procedure that involves the removal of plaque or thrombus and is categorized as a vessel preparation procedure. It is often done before angioplasty and stenting. The goal of the procedure is to obtain luminal gain, meaning that the diameter of the lumen of an artery becomes closer to its original size. There are a variety of devices that allow for different techniques in atherectomy, including rotational, orbital, laser, and directional. They all offer a degree of plaque modification or debulking of the lesion to improve outcomes for angioplasty with or without stenting. Next, we discuss indications for atherectomy. Both Dr. Saleh and Dr. Tummala begin a peripheral arterial case by doing a full lower extremity angiogram to guide their next steps. They also rely heavily on intravascular ultrasound (IVUS), as this helps determine if the lesion is made of thrombus, calcified, or soft plaque. The type of plaque they find via IVUS as well as the primary location of the plaque will determine which device they will proceed with. There is some controversy regarding atherectomy in regard to its indications and efficacy, mostly due to the lack of randomized control trials and overall data scarcity. Despite this, both Dr. Saleh and Dr. Tummala use atherectomy as vessel prep when they plan on treating a lesion with percutaneous transluminal angioplasty (PTA), either alone or followed by a stent. Finally, we discuss each operator’s advice for those new to atherectomy or treating peripheral arterial disease (PAD), their most used devices, and their thoughts on performing atherectomy in the subintimal plane (outside of the true vessel lumen). Both operators frequently use rotational excisional atherectomy devices and orbital devices. The specific device varies depending on their setting (OBL vs. hospital), but they recommend choosing a couple of devices and learning how to use them well. When it comes to atherectomy in the subintimal space, both Dr. Tummala and Dr. Saleh recommend against doing this, as it is not an indication for any of the devices, and it risks complications such as the device getting stuck. To avoid doing atherectomy in the subintimal plane, they IVUS as far down the vessel as they can to determine if there are any segments that are subintimal. In legs with only a single runoff vessel or no runoff, they are more conservative with atherectomy due to the risk of embolizing smaller vessels and causing even worse flow to the extremity. --- RESOURCES Liberty 360 Trial: https://csi360.com/clinical-evidence/liberty-360/ BD Rotarex Rotational Atherectomy System: bd.com/rotarex Mon, 05 Dec 2022 06:05:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews Drs. Srini Tummala and Omar Saleh about atherectomy in peripheral arterial disease, including indications, technique, and device selection. In this episode, host Dr. Sabeen Dhand interviews Drs. Srini Tummala and Omar Saleh about atherectomy in peripheral arterial disease, including indications, technique, and device selection. --- CHECK OUT OUR SPONSORS BD Rotarex Atherectomy System https://www.bd.com/rotarex Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES We begin by overviewing the definition of atherectomy and the types of devices. Atherectomy is a procedure that involves the removal of plaque or thrombus and is categorized as a vessel preparation procedure. It is often done before angioplasty and stenting. The goal of the procedure is to obtain luminal gain, meaning that the diameter of the lumen of an artery becomes closer to its original size. There are a variety of devices that allow for different techniques in atherectomy, including rotational, orbital, laser, and directional. They all offer a degree of plaque modification or debulking of the lesion to improve outcomes for angioplasty with or without stenting. Next, we discuss indications for atherectomy. Both Dr. Saleh and Dr. Tummala begin a peripheral arterial case by doing a full lower extremity angiogram to guide their next steps. They also rely heavily on intravascular ultrasound (IVUS), as this helps determine if the lesion is made of thrombus, calcified, or soft plaque. The type of plaque they find via IVUS as well as the primary location of the plaque will determine which device they will proceed with. There is some controversy regarding atherectomy in regard to its indications and efficacy, mostly due to the lack of randomized control trials and overall data scarcity. Despite this, both Dr. Saleh and Dr. Tummala use atherectomy as vessel prep when they plan on treating a lesion with percutaneous transluminal angioplasty (PTA), either alone or followed by a stent. Finally, we discuss each operator’s advice for those new to atherectomy or treating peripheral arterial disease (PAD), their most used devices, and their thoughts on performing atherectomy in the subintimal plane (outside of the true vessel lumen). Both operators frequently use rotational excisional atherectomy devices and orbital devices. The specific device varies depending on their setting (OBL vs. hospital), but they recommend choosing a couple of devices and learning how to use them well. When it comes to atherectomy in the subintimal space, both Dr. Tummala and Dr. Saleh recommend against doing this, as it is not an indication for any of the devices, and it risks complications such as the device getting stuck. To avoid doing atherectomy in the subintimal plane, they IVUS as far down the vessel as they can to determine if there are any segments that are subintimal. In legs with only a single runoff vessel or no runoff, they are more conservative with atherectomy due to the risk of embolizing smaller vessels and causing even worse flow to the extremity. --- RESOURCES Liberty 360 Trial: https://csi360.com/clinical-evidence/liberty-360/ BD Rotarex Rotational Atherectomy System: bd.com/rotarex In this episode, host Dr. Sabeen Dhand interviews Drs. Srini Tummala and Omar Saleh about atherectomy in peripheral arterial disease, including indications, technique, and device selection.


---


CHECK OUT OUR SPONSORS


BD Rotarex Atherectomy System

https://www.bd.com/rotarex


Reflow Medical

https://www.reflowmedical.com/


---


SHOW NOTES


We begin by overviewing the definition of atherectomy and the types of devices. Atherectomy is a procedure that involves the removal of plaque or thrombus and is categorized as a vessel preparation procedure. It is often done before angioplasty and stenting. The goal of the procedure is to obtain luminal gain, meaning that the diameter of the lumen of an artery becomes closer to its original size. There are a variety of devices that allow for different techniques in atherectomy, including rotational, orbital, laser, and directional. They all offer a degree of plaque modification or debulking of the lesion to improve outcomes for angioplasty with or without stenting.


Next, we discuss indications for atherectomy. Both Dr. Saleh and Dr. Tummala begin a peripheral arterial case by doing a full lower extremity angiogram to guide their next steps. They also rely heavily on intravascular ultrasound (IVUS), as this helps determine if the lesion is made of thrombus, calcified, or soft plaque. The type of plaque they find via IVUS as well as the primary location of the plaque will determine which device they will proceed with. There is some controversy regarding atherectomy in regard to its indications and efficacy, mostly due to the lack of randomized control trials and overall data scarcity. Despite this, both Dr. Saleh and Dr. Tummala use atherectomy as vessel prep when they plan on treating a lesion with percutaneous transluminal angioplasty (PTA), either alone or followed by a stent.


Finally, we discuss each operator’s advice for those new to atherectomy or treating peripheral arterial disease (PAD), their most used devices, and their thoughts on performing atherectomy in the subintimal plane (outside of the true vessel lumen). Both operators frequently use rotational excisional atherectomy devices and orbital devices. The specific device varies depending on their setting (OBL vs. hospital), but they recommend choosing a couple of devices and learning how to use them well. When it comes to atherectomy in the subintimal space, both Dr. Tummala and Dr. Saleh recommend against doing this, as it is not an indication for any of the devices, and it risks complications such as the device getting stuck. To avoid doing atherectomy in the subintimal plane, they IVUS as far down the vessel as they can to determine if there are any segments that are subintimal. In legs with only a single runoff vessel or no runoff, they are more conservative with atherectomy due to the risk of embolizing smaller vessels and causing even worse flow to the extremity.


---


RESOURCES


Liberty 360 Trial:

https://csi360.com/clinical-evidence/liberty-360/


BD Rotarex Rotational Atherectomy System:

bd.com/rotarex

]]> 3220 Ep. 267 Treatment Algorithms for Severe Venous Disease with Dr. Raghu Kolluri In this episode, Dr. Aaron Fritts interviews Dr. Raghy Kolluri, the system medical director of Vascular Medicine at OhioHealth, about his workup and treatment algorithm for severe venous disease. --- CHECK OUT OUR SPONSOR Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- SHOW NOTES To start, Dr. Kolluri reviews the CEAP (Clinical, Etiological, Anatomical, Physiological) classification of venous disorders and describes how patients commonly get referred to his practice. The majority of his patients fall into the C4 through C6 category (presenting with skin changes, lipodermatosclerosis, and/or recurrent ulcerations) and get referred by podiatrists and wound care clinics. Dr. Kolluri feels that treating severe venous disease is very rewarding because he has the opportunity to manage outcomes from a vascular and overall clinical standpoint. Next, Dr. Kolluri walks through a typical workup. He emphasizes the importance of taking a thorough history, with special focus on past DVT, trauma, and foreign body placement (stents, filters, DeWeese clips). These characteristics could be evidence for deep venous disease. On the other hand, a venous ulcer with a more benign history signifies superficial venous disease. An ultrasound venous insufficiency study, as well as CT venogram, will determine location and severity of disease. If both superficial and deep venous disease are present, Dr. Kolluri will first address the deep disease. He outlines Varithena, radiofrequency ablation, endovascular laser ablation, and foam sclerotherapy as treatment options. Varithena and foam sclerotherapy are endovascular options for patients with tortuous veins. However, Varithena should not be used in patients at high risk for venous thromboembolism, as there is less precise control over treatment. Most commonly, Dr. Kolluri relies on radiofrequency ablation. He also describes his method for laser ablation and foam sclerotherapy with sodium tetradecyl sulfate. Additionally, Dr. Kolluri shares his innovative Sclerotherapy-Assisted Phlebectomy (SAP) technique and how it increases accuracy and minimizes blood loss. He emphasizes that phlebectomy of the saphenous vein should not be overused, as it can preclude the possibility of future bypasses. Overall, his background in thrombosis and anticoagulation helps him customize treatment for each individual patient. The doctors focus on a central theme that venous insufficiency is a chronic and progressive disease, and continued follow up is essential. This involves management of co-existing conditions like lymphedema, peripheral arterial disease (PAD), and infected ulcers. Collaboration with other medical and surgical specialties, occupational therapists, and the patients themselves is essential for ensuring that patients can make appropriate lifestyle changes and follow up throughout their disease course. Finally, Dr. Kolluri shares insight on the push to make vascular medicine an ABIM-certified specialty. --- RESOURCES Ep. 111- Underutilization of Foam Sclerotherapy: https://www.backtable.com/shows/vi/podcasts/111/underutilization-of-foam-sclerotherapy CEAP Classification of Venous Disorders: https://www.ncbi.nlm.nih.gov/books/NBK557410/ Incidence of and risk factors for iliocaval venous obstruction in patients with active or healed venous leg ulcers: https://www.jvascsurg.org/article/S0741-5214(10)02617-0/fulltext American Vein and Lymphatic Society (AVLS): https://www.myavls.org/annual-congress-2022.html Foam Sclerotherapy Augmented Phlebectomy (SAP) Procedure for Varicose Veins: Report of a Novel Technique: https://www.ejvesreports.com/article/S2405-6553(18)30044-6/fulltext OSU Lymphedema Center: https://cancer.osu.edu/for-patients-and-caregivers/learn-about-cancers-and-treatments/specialized-treatment-clinics-and-centers/lymphedema-center-of-excellence The clinical characteristics of lower extremity lymphedema in 440 patients: https://pubmed.ncbi.nlm.nih.gov/31992537/ Fri, 02 Dec 2022 06:05:00 -0000 full BackTable In this episode, Dr. Aaron Fritts interviews Dr. Raghy Kolluri, the system medical director of Vascular Medicine at OhioHealth, about his workup and treatment algorithm for severe venous disease. In this episode, Dr. Aaron Fritts interviews Dr. Raghy Kolluri, the system medical director of Vascular Medicine at OhioHealth, about his workup and treatment algorithm for severe venous disease. --- CHECK OUT OUR SPONSOR Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- SHOW NOTES To start, Dr. Kolluri reviews the CEAP (Clinical, Etiological, Anatomical, Physiological) classification of venous disorders and describes how patients commonly get referred to his practice. The majority of his patients fall into the C4 through C6 category (presenting with skin changes, lipodermatosclerosis, and/or recurrent ulcerations) and get referred by podiatrists and wound care clinics. Dr. Kolluri feels that treating severe venous disease is very rewarding because he has the opportunity to manage outcomes from a vascular and overall clinical standpoint. Next, Dr. Kolluri walks through a typical workup. He emphasizes the importance of taking a thorough history, with special focus on past DVT, trauma, and foreign body placement (stents, filters, DeWeese clips). These characteristics could be evidence for deep venous disease. On the other hand, a venous ulcer with a more benign history signifies superficial venous disease. An ultrasound venous insufficiency study, as well as CT venogram, will determine location and severity of disease. If both superficial and deep venous disease are present, Dr. Kolluri will first address the deep disease. He outlines Varithena, radiofrequency ablation, endovascular laser ablation, and foam sclerotherapy as treatment options. Varithena and foam sclerotherapy are endovascular options for patients with tortuous veins. However, Varithena should not be used in patients at high risk for venous thromboembolism, as there is less precise control over treatment. Most commonly, Dr. Kolluri relies on radiofrequency ablation. He also describes his method for laser ablation and foam sclerotherapy with sodium tetradecyl sulfate. Additionally, Dr. Kolluri shares his innovative Sclerotherapy-Assisted Phlebectomy (SAP) technique and how it increases accuracy and minimizes blood loss. He emphasizes that phlebectomy of the saphenous vein should not be overused, as it can preclude the possibility of future bypasses. Overall, his background in thrombosis and anticoagulation helps him customize treatment for each individual patient. The doctors focus on a central theme that venous insufficiency is a chronic and progressive disease, and continued follow up is essential. This involves management of co-existing conditions like lymphedema, peripheral arterial disease (PAD), and infected ulcers. Collaboration with other medical and surgical specialties, occupational therapists, and the patients themselves is essential for ensuring that patients can make appropriate lifestyle changes and follow up throughout their disease course. Finally, Dr. Kolluri shares insight on the push to make vascular medicine an ABIM-certified specialty. --- RESOURCES Ep. 111- Underutilization of Foam Sclerotherapy: https://www.backtable.com/shows/vi/podcasts/111/underutilization-of-foam-sclerotherapy CEAP Classification of Venous Disorders: https://www.ncbi.nlm.nih.gov/books/NBK557410/ Incidence of and risk factors for iliocaval venous obstruction in patients with active or healed venous leg ulcers: https://www.jvascsurg.org/article/S0741-5214(10)02617-0/fulltext American Vein and Lymphatic Society (AVLS): https://www.myavls.org/annual-congress-2022.html Foam Sclerotherapy Augmented Phlebectomy (SAP) Procedure for Varicose Veins: Report of a Novel Technique: https://www.ejvesreports.com/article/S2405-6553(18)30044-6/fulltext OSU Lymphedema Center: https://cancer.osu.edu/for-patients-and-caregivers/learn-about-cancers-and-treatments/specialized-treatment-clinics-and-centers/lymphedema-center-of-excellence The clinical characteristics of lower extremity lymphedema in 440 patients: https://pubmed.ncbi.nlm.nih.gov/31992537/ In this episode, Dr. Aaron Fritts interviews Dr. Raghy Kolluri, the system medical director of Vascular Medicine at OhioHealth, about his workup and treatment algorithm for severe venous disease.


---


CHECK OUT OUR SPONSOR


Medtronic Abre Venous Stent

https://www.medtronic.com/abrevenous


---


SHOW NOTES


To start, Dr. Kolluri reviews the CEAP (Clinical, Etiological, Anatomical, Physiological) classification of venous disorders and describes how patients commonly get referred to his practice. The majority of his patients fall into the C4 through C6 category (presenting with skin changes, lipodermatosclerosis, and/or recurrent ulcerations) and get referred by podiatrists and wound care clinics. Dr. Kolluri feels that treating severe venous disease is very rewarding because he has the opportunity to manage outcomes from a vascular and overall clinical standpoint.


Next, Dr. Kolluri walks through a typical workup. He emphasizes the importance of taking a thorough history, with special focus on past DVT, trauma, and foreign body placement (stents, filters, DeWeese clips). These characteristics could be evidence for deep venous disease. On the other hand, a venous ulcer with a more benign history signifies superficial venous disease. An ultrasound venous insufficiency study, as well as CT venogram, will determine location and severity of disease. If both superficial and deep venous disease are present, Dr. Kolluri will first address the deep disease.


He outlines Varithena, radiofrequency ablation, endovascular laser ablation, and foam sclerotherapy as treatment options. Varithena and foam sclerotherapy are endovascular options for patients with tortuous veins. However, Varithena should not be used in patients at high risk for venous thromboembolism, as there is less precise control over treatment. Most commonly, Dr. Kolluri relies on radiofrequency ablation. He also describes his method for laser ablation and foam sclerotherapy with sodium tetradecyl sulfate. Additionally, Dr. Kolluri shares his innovative Sclerotherapy-Assisted Phlebectomy (SAP) technique and how it increases accuracy and minimizes blood loss. He emphasizes that phlebectomy of the saphenous vein should not be overused, as it can preclude the possibility of future bypasses. Overall, his background in thrombosis and anticoagulation helps him customize treatment for each individual patient.


The doctors focus on a central theme that venous insufficiency is a chronic and progressive disease, and continued follow up is essential. This involves management of co-existing conditions like lymphedema, peripheral arterial disease (PAD), and infected ulcers. Collaboration with other medical and surgical specialties, occupational therapists, and the patients themselves is essential for ensuring that patients can make appropriate lifestyle changes and follow up throughout their disease course. Finally, Dr. Kolluri shares insight on the push to make vascular medicine an ABIM-certified specialty.


---


RESOURCES


Ep. 111- Underutilization of Foam Sclerotherapy:

https://www.backtable.com/shows/vi/podcasts/111/underutilization-of-foam-sclerotherapy


CEAP Classification of Venous Disorders:

https://www.ncbi.nlm.nih.gov/books/NBK557410/


Incidence of and risk factors for iliocaval venous obstruction in patients with active or healed venous leg ulcers:

https://www.jvascsurg.org/article/S0741-5214(10)02617-0/fulltext


American Vein and Lymphatic Society (AVLS):

https://www.myavls.org/annual-congress-2022.html


Foam Sclerotherapy Augmented Phlebectomy (SAP) Procedure for Varicose Veins: Report of a Novel Technique:

https://www.ejvesreports.com/article/S2405-6553(18)30044-6/fulltext


OSU Lymphedema Center:

https://cancer.osu.edu/for-patients-and-caregivers/learn-about-cancers-and-treatments/specialized-treatment-clinics-and-centers/lymphedema-center-of-excellence


The clinical characteristics of lower extremity lymphedema in 440 patients:

https://pubmed.ncbi.nlm.nih.gov/31992537/

]]> 3490 Ep. 266 Practice Building in a Traditional IR/DR Practice with Dr. David Johnson In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. David Johnson about practice building in an IR/DR group, including factors that make a good job, and how he formed one of the largest PAE practices in the Southeast. --- CHECK OUT OUR SPONSOR Viz.ai https://www.viz.ai/ --- SHOW NOTES Dr. Johnson found his current job, his first out of fellowship, via a job board. His wife, an ER physician, was looking for a job at the same time, which complicated their search slightly. They ultimately found their current positions by being flexible and understanding that no job is perfect. Dr. Johnson believes that when searching for a job, “you can't let the best be the enemy of the good.” What he was looking for in a job was a practice where he could do a lot of IR in a situation where he could build the IR practice that he wanted. He notes that this is something you should try to find out beforehand during the job search because, at some practices, it’s very difficult to change the way things work and the types of procedures they do. One of the most important things to consider and something he recommends to anyone looking for an IR job is the potential for growth. He cautions that this is a long game you must be ready to play. You can't expect to come in and change or build a practice in 2-3 years. After he found his footing and established himself in his new job, he began to grow his practice by finding out what the need was in his community. He started by marketing multiple service lines and seeing which would stick. He did this so that he could feel things out and see which physicians ended up referring to him, and which didn’t. It can be hard to balance practice building while in a combined DR/IR practice due to your DR responsibilities, due to quotas and RVUs. He says that you need to keep your mind on the long game in this situation. He did this by talking to at least one clinician every day about a patient he could help in some way. He figured that if he did this for two years, he would slowly get his name out and build a referral base. Most of these calls were low yield, but it paid dividends for him in the long run. About 1-2 years in, he began getting calls from physicians that he had talked to asking if he could do something for a patient. Finally, Dr. Johnson speaks on how he approached prostate artery embolization (PAE), a procedure that previously didn’t exist in Fort Myers, FL, and used it to turn his practice into one of the biggest PAE centers in the Southeast. He thought of the procedure as a challenge, which he was looking for, and he knew there was a need in the community, so it was something he realized could grow. He didn’t know how to do PAE, but he turned to the STREAM Meeting to learn the technique. He stresses that this was not a fast process. It took 18 months from when he attended STREAM to when he got his first patient on the table. His first patients were self-referred. He built referrals by doing the procedure well and garnering good outcomes. Importantly, he provided good consults and follow-ups, always making sure to include a follow-up with their urologist to whom they reported the good results. To help his clinic run successfully, he had to hold himself accountable to ensure things got done. He relies heavily on digital reminders as well as a great medical assistant who does most of his scheduling. For his PAE patients, who often experience post-PAE syndrome, it is important to him to be available for them; he doesn't want them to feel abandoned. He gives them his cell phone and tells them to call him day or night. It is important to him to be more than just the technician. He wants to be there for them, to be the first person they call, to be their physician. He also believes closing the loop with referring providers is crucial to maintain rapport and a strong stream of new referrals. --- RESOURCES STREAM Meeting: https://www.thestreammeeting.com Mon, 28 Nov 2022 06:05:00 -0000 full BackTable In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. David Johnson about practice building in an IR/DR group, including factors that make a good job, and how he formed one of the largest PAE practices in the Southeast. In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. David Johnson about practice building in an IR/DR group, including factors that make a good job, and how he formed one of the largest PAE practices in the Southeast. --- CHECK OUT OUR SPONSOR Viz.ai https://www.viz.ai/ --- SHOW NOTES Dr. Johnson found his current job, his first out of fellowship, via a job board. His wife, an ER physician, was looking for a job at the same time, which complicated their search slightly. They ultimately found their current positions by being flexible and understanding that no job is perfect. Dr. Johnson believes that when searching for a job, “you can't let the best be the enemy of the good.” What he was looking for in a job was a practice where he could do a lot of IR in a situation where he could build the IR practice that he wanted. He notes that this is something you should try to find out beforehand during the job search because, at some practices, it’s very difficult to change the way things work and the types of procedures they do. One of the most important things to consider and something he recommends to anyone looking for an IR job is the potential for growth. He cautions that this is a long game you must be ready to play. You can't expect to come in and change or build a practice in 2-3 years. After he found his footing and established himself in his new job, he began to grow his practice by finding out what the need was in his community. He started by marketing multiple service lines and seeing which would stick. He did this so that he could feel things out and see which physicians ended up referring to him, and which didn’t. It can be hard to balance practice building while in a combined DR/IR practice due to your DR responsibilities, due to quotas and RVUs. He says that you need to keep your mind on the long game in this situation. He did this by talking to at least one clinician every day about a patient he could help in some way. He figured that if he did this for two years, he would slowly get his name out and build a referral base. Most of these calls were low yield, but it paid dividends for him in the long run. About 1-2 years in, he began getting calls from physicians that he had talked to asking if he could do something for a patient. Finally, Dr. Johnson speaks on how he approached prostate artery embolization (PAE), a procedure that previously didn’t exist in Fort Myers, FL, and used it to turn his practice into one of the biggest PAE centers in the Southeast. He thought of the procedure as a challenge, which he was looking for, and he knew there was a need in the community, so it was something he realized could grow. He didn’t know how to do PAE, but he turned to the STREAM Meeting to learn the technique. He stresses that this was not a fast process. It took 18 months from when he attended STREAM to when he got his first patient on the table. His first patients were self-referred. He built referrals by doing the procedure well and garnering good outcomes. Importantly, he provided good consults and follow-ups, always making sure to include a follow-up with their urologist to whom they reported the good results. To help his clinic run successfully, he had to hold himself accountable to ensure things got done. He relies heavily on digital reminders as well as a great medical assistant who does most of his scheduling. For his PAE patients, who often experience post-PAE syndrome, it is important to him to be available for them; he doesn't want them to feel abandoned. He gives them his cell phone and tells them to call him day or night. It is important to him to be more than just the technician. He wants to be there for them, to be the first person they call, to be their physician. He also believes closing the loop with referring providers is crucial to maintain rapport and a strong stream of new referrals. --- RESOURCES STREAM Meeting: https://www.thestreammeeting.com In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. David Johnson about practice building in an IR/DR group, including factors that make a good job, and how he formed one of the largest PAE practices in the Southeast.


---


CHECK OUT OUR SPONSOR


Viz.ai

https://www.viz.ai/


---


SHOW NOTES


Dr. Johnson found his current job, his first out of fellowship, via a job board. His wife, an ER physician, was looking for a job at the same time, which complicated their search slightly. They ultimately found their current positions by being flexible and understanding that no job is perfect. Dr. Johnson believes that when searching for a job, “you can't let the best be the enemy of the good.” What he was looking for in a job was a practice where he could do a lot of IR in a situation where he could build the IR practice that he wanted. He notes that this is something you should try to find out beforehand during the job search because, at some practices, it’s very difficult to change the way things work and the types of procedures they do. One of the most important things to consider and something he recommends to anyone looking for an IR job is the potential for growth. He cautions that this is a long game you must be ready to play. You can't expect to come in and change or build a practice in 2-3 years.


After he found his footing and established himself in his new job, he began to grow his practice by finding out what the need was in his community. He started by marketing multiple service lines and seeing which would stick. He did this so that he could feel things out and see which physicians ended up referring to him, and which didn’t. It can be hard to balance practice building while in a combined DR/IR practice due to your DR responsibilities, due to quotas and RVUs. He says that you need to keep your mind on the long game in this situation. He did this by talking to at least one clinician every day about a patient he could help in some way. He figured that if he did this for two years, he would slowly get his name out and build a referral base. Most of these calls were low yield, but it paid dividends for him in the long run. About 1-2 years in, he began getting calls from physicians that he had talked to asking if he could do something for a patient.


Finally, Dr. Johnson speaks on how he approached prostate artery embolization (PAE), a procedure that previously didn’t exist in Fort Myers, FL, and used it to turn his practice into one of the biggest PAE centers in the Southeast. He thought of the procedure as a challenge, which he was looking for, and he knew there was a need in the community, so it was something he realized could grow. He didn’t know how to do PAE, but he turned to the STREAM Meeting to learn the technique. He stresses that this was not a fast process. It took 18 months from when he attended STREAM to when he got his first patient on the table. His first patients were self-referred. He built referrals by doing the procedure well and garnering good outcomes. Importantly, he provided good consults and follow-ups, always making sure to include a follow-up with their urologist to whom they reported the good results. To help his clinic run successfully, he had to hold himself accountable to ensure things got done. He relies heavily on digital reminders as well as a great medical assistant who does most of his scheduling. For his PAE patients, who often experience post-PAE syndrome, it is important to him to be available for them; he doesn't want them to feel abandoned. He gives them his cell phone and tells them to call him day or night. It is important to him to be more than just the technician. He wants to be there for them, to be the first person they call, to be their physician. He also believes closing the loop with referring providers is crucial to maintain rapport and a strong stream of new referrals.


---


RESOURCES


STREAM Meeting:

https://www.thestreammeeting.com

]]> 3036 Ep. 265 The TheraSphere Story with Dr. Riad Salem and Peter Pattison In this crossover episode between BackTable VI and BackTable Innovation, Dr. Chris Beck interviews Dr. Riad Salem (Chief of Interventional Radiology at Northwestern University) and Peter Pattison (President of Interventional Oncology at Boston Scientific) about how TheraSpheres for Y90 radioembolization became a mainstay in the IR toolkit for HCC and where the technology is heading next. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PvWJlD --- SHOW NOTES To begin, Peter outlines how the original concept of TheraSpheres began at the University of Missouri, as a collaboration between Drs. Delbert Day and Gary Ehrhardt, who combined their ceramic and nuclear chemistry expertises to create radioactive glass beads and published a paper in 1987. After animal and human testing, the product was licensed to the company Nordion, where Peter worked. The product was given a humanitarian device exemption (HDE) from the FDA, which allowed TheraSpheres to be used for investigational purposes. In the late 1990s, Dr. Salem was in his early interventional oncology career and heard about TheraSpheres. He recognized the enormous potential that this technology had to ensure known amounts of radioactive doses were delivered to the tumor and minimize adverse effects. In fact, he noticed that his Y90 patients had less pain, post-embolization syndrome, and hospitalization than his transarterial chemoembolization (TACE) patients. In the mid 2000s, he collected and submitted data to various conferences and journals, but he was met with criticism from the IR world, which was more comfortable with TACE, since it was the current standard of care. In 2011, Nordion decided to run a clinical trial, EPOCH, which eventually showed that the addition of TARE to systemic therapy for colorectal metastases to the liver led to longer progression free survival. Dr. Riad has focused his efforts on training more IRs on the methodology of Y90, since this was an important step to increasing adoption and minimizing missteps with the new technology. He believes that the advent of Y90 has resulted in better angiography, since IRs are more cognizant of off-target embolization. Dr. Salem also petitioned at the US Nuclear Regulatory Committee to allow IRs to become the authorized users for Y90 injection and advocated to add TARE to the National Comprehensive Cancer Network guidelines for liver cancer. Both of these developments allowed TARE to become more widely adopted. Finally, Peter discusses the competition that TheraSpheres has faced from TACE and SIRSpheres (resin-based radioembolization). He shares exciting new developments that have occurred since acquisition by Boston Scientific. These include exploration for the extra-hepatic use of TheraSpheres in glioblastoma and prostate cancer. --- RESOURCES BackTable Ep. 223- Portal Vein Recan #ReCanDoIt with Dr. Riad Salem: https://www.backtable.com/shows/vi/podcasts/223/portal-vein-recan-recandoit Therapeutic Use of 90Y Microspheres: https://pubmed.ncbi.nlm.nih.gov/3667306/ A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/1327493/ Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up: https://pubmed.ncbi.nlm.nih.gov/7931662/ Humanitarian Device Exemption: https://www.fda.gov/medical-devices/premarket-submissions-selecting-and-preparing-correct-submission/humanitarian-device-exemption EPOCH Trial: https://ascopubs.org/doi/full/10.1200/JCO.21.01839 Radioembolization with 90Yttrium Microspheres: A State-of-the-Art Brachytherapy Treatment for Primary and Secondary Liver Malignancies: https://www.jvir.org/article/S1051-0443(07)60901-4/fulltext Fri, 25 Nov 2022 06:05:00 -0000 full BackTable In this crossover episode between BackTable VI and BackTable Innovation, Dr. Chris Beck interviews Dr. Riad Salem (Chief of Interventional Radiology at Northwestern University) and Peter Pattison (President of Interventional Oncology at Boston Scientific) about how TheraSpheres for Y90 radioembolization became a mainstay in the IR toolkit for HCC and where the technology is heading next. In this crossover episode between BackTable VI and BackTable Innovation, Dr. Chris Beck interviews Dr. Riad Salem (Chief of Interventional Radiology at Northwestern University) and Peter Pattison (President of Interventional Oncology at Boston Scientific) about how TheraSpheres for Y90 radioembolization became a mainstay in the IR toolkit for HCC and where the technology is heading next. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PvWJlD --- SHOW NOTES To begin, Peter outlines how the original concept of TheraSpheres began at the University of Missouri, as a collaboration between Drs. Delbert Day and Gary Ehrhardt, who combined their ceramic and nuclear chemistry expertises to create radioactive glass beads and published a paper in 1987. After animal and human testing, the product was licensed to the company Nordion, where Peter worked. The product was given a humanitarian device exemption (HDE) from the FDA, which allowed TheraSpheres to be used for investigational purposes. In the late 1990s, Dr. Salem was in his early interventional oncology career and heard about TheraSpheres. He recognized the enormous potential that this technology had to ensure known amounts of radioactive doses were delivered to the tumor and minimize adverse effects. In fact, he noticed that his Y90 patients had less pain, post-embolization syndrome, and hospitalization than his transarterial chemoembolization (TACE) patients. In the mid 2000s, he collected and submitted data to various conferences and journals, but he was met with criticism from the IR world, which was more comfortable with TACE, since it was the current standard of care. In 2011, Nordion decided to run a clinical trial, EPOCH, which eventually showed that the addition of TARE to systemic therapy for colorectal metastases to the liver led to longer progression free survival. Dr. Riad has focused his efforts on training more IRs on the methodology of Y90, since this was an important step to increasing adoption and minimizing missteps with the new technology. He believes that the advent of Y90 has resulted in better angiography, since IRs are more cognizant of off-target embolization. Dr. Salem also petitioned at the US Nuclear Regulatory Committee to allow IRs to become the authorized users for Y90 injection and advocated to add TARE to the National Comprehensive Cancer Network guidelines for liver cancer. Both of these developments allowed TARE to become more widely adopted. Finally, Peter discusses the competition that TheraSpheres has faced from TACE and SIRSpheres (resin-based radioembolization). He shares exciting new developments that have occurred since acquisition by Boston Scientific. These include exploration for the extra-hepatic use of TheraSpheres in glioblastoma and prostate cancer. --- RESOURCES BackTable Ep. 223- Portal Vein Recan #ReCanDoIt with Dr. Riad Salem: https://www.backtable.com/shows/vi/podcasts/223/portal-vein-recan-recandoit Therapeutic Use of 90Y Microspheres: https://pubmed.ncbi.nlm.nih.gov/3667306/ A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/1327493/ Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up: https://pubmed.ncbi.nlm.nih.gov/7931662/ Humanitarian Device Exemption: https://www.fda.gov/medical-devices/premarket-submissions-selecting-and-preparing-correct-submission/humanitarian-device-exemption EPOCH Trial: https://ascopubs.org/doi/full/10.1200/JCO.21.01839 Radioembolization with 90Yttrium Microspheres: A State-of-the-Art Brachytherapy Treatment for Primary and Secondary Liver Malignancies: https://www.jvir.org/article/S1051-0443(07)60901-4/fulltext In this crossover episode between BackTable VI and BackTable Innovation, Dr. Chris Beck interviews Dr. Riad Salem (Chief of Interventional Radiology at Northwestern University) and Peter Pattison (President of Interventional Oncology at Boston Scientific) about how TheraSpheres for Y90 radioembolization became a mainstay in the IR toolkit for HCC and where the technology is heading next.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PvWJlD


---


SHOW NOTES


To begin, Peter outlines how the original concept of TheraSpheres began at the University of Missouri, as a collaboration between Drs. Delbert Day and Gary Ehrhardt, who combined their ceramic and nuclear chemistry expertises to create radioactive glass beads and published a paper in 1987. After animal and human testing, the product was licensed to the company Nordion, where Peter worked. The product was given a humanitarian device exemption (HDE) from the FDA, which allowed TheraSpheres to be used for investigational purposes.


In the late 1990s, Dr. Salem was in his early interventional oncology career and heard about TheraSpheres. He recognized the enormous potential that this technology had to ensure known amounts of radioactive doses were delivered to the tumor and minimize adverse effects. In fact, he noticed that his Y90 patients had less pain, post-embolization syndrome, and hospitalization than his transarterial chemoembolization (TACE) patients. In the mid 2000s, he collected and submitted data to various conferences and journals, but he was met with criticism from the IR world, which was more comfortable with TACE, since it was the current standard of care.


In 2011, Nordion decided to run a clinical trial, EPOCH, which eventually showed that the addition of TARE to systemic therapy for colorectal metastases to the liver led to longer progression free survival.


Dr. Riad has focused his efforts on training more IRs on the methodology of Y90, since this was an important step to increasing adoption and minimizing missteps with the new technology. He believes that the advent of Y90 has resulted in better angiography, since IRs are more cognizant of off-target embolization. Dr. Salem also petitioned at the US Nuclear Regulatory Committee to allow IRs to become the authorized users for Y90 injection and advocated to add TARE to the National Comprehensive Cancer Network guidelines for liver cancer. Both of these developments allowed TARE to become more widely adopted.


Finally, Peter discusses the competition that TheraSpheres has faced from TACE and SIRSpheres (resin-based radioembolization). He shares exciting new developments that have occurred since acquisition by Boston Scientific. These include exploration for the extra-hepatic use of TheraSpheres in glioblastoma and prostate cancer.


---


RESOURCES


BackTable Ep. 223- Portal Vein Recan #ReCanDoIt with Dr. Riad Salem:

https://www.backtable.com/shows/vi/podcasts/223/portal-vein-recan-recandoit


Therapeutic Use of 90Y Microspheres:

https://pubmed.ncbi.nlm.nih.gov/3667306/


A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma:

https://pubmed.ncbi.nlm.nih.gov/1327493/


Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up:

https://pubmed.ncbi.nlm.nih.gov/7931662/


Humanitarian Device Exemption:

https://www.fda.gov/medical-devices/premarket-submissions-selecting-and-preparing-correct-submission/humanitarian-device-exemption


EPOCH Trial:

https://ascopubs.org/doi/full/10.1200/JCO.21.01839


Radioembolization with 90Yttrium Microspheres: A State-of-the-Art Brachytherapy Treatment for Primary and Secondary Liver Malignancies:

https://www.jvir.org/article/S1051-0443(07)60901-4/fulltext

]]> 3751 Ep. 264 The Halo Effect with Dr. Sandeep Bagla In this episode, cohosts Dr. Aparna Baheti and Dr. Aaron Fritts interview interventional radiologist Dr. Sandeep Bagla about “The Halo Effect”, including how to recognize when you are being subjected to bias, and how to critically evaluate bad outcomes to improve your practice and enhance patient safety. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/FSZCxF --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- SHOW NOTES Dr. Bagla begins by describing the halo effect. The halo effect describes the tendency for people to overestimate the value of individual positive attributes when evaluating the whole. Thiis can happen when we form our opinions of people, techniques, and even medical devices. The opposite is also true, named the horn effect, where we tend to overestimate negative attributes. They are both forms of bias. In interventional radiology, the halo effect can impact case outcomes by contributing to operator tunnel vision and the reluctance to waver from the desired way of executing a procedure. For Dr. Bagla, the idea of the halo effect came about while working with new colleagues, many of whom do things differently than he did. He realized that in IR, physicians do things a certain way because that’s how they learned in training, whether it really is the safest and best way, or just the most familiar. He also sees the horn effect occur often when people start using a new device. If the device doesn’t work well for them the first time, many often refuse to use it in the future based on that first experience. He summarizes by noting that in IR, there are so many opportunities to become biased, whether through the halo effect or the horn effect. Lastly, Dr. Bagla reviews how he works to avoid these inherent biases. The first step in overcoming this bias is to understand its presence. Next, you must stop and realize that what you are doing is not working, whether due to the procedural approach, the device, or the way you are using the device. Dr. Bagla believes we must be critical of ourselves and try to think outside of our preferred wire, catheter, or device. In order to do this, you must go through the steps and review your checklist in order to determine which step the problem occurred at. Only by doing this can you avoid falling victim to these biases that are so prevalent in medicine. --- RESOURCES BackTable Episode 195: Disclosures of Conflicts of Interest https://www.backtable.com/shows/vi/podcasts/195/disclosures-of-conflicts-of-interest Mon, 21 Nov 2022 06:05:00 -0000 full BackTable In this episode, cohosts Dr. Aparna Baheti and Dr. Aaron Fritts interview interventional radiologist Dr. Sandeep Bagla about “The Halo Effect”, including how to recognize when you are being subjected to bias, and how to critically evaluate bad outcomes to improve your practice and enhance patient safety. In this episode, cohosts Dr. Aparna Baheti and Dr. Aaron Fritts interview interventional radiologist Dr. Sandeep Bagla about “The Halo Effect”, including how to recognize when you are being subjected to bias, and how to critically evaluate bad outcomes to improve your practice and enhance patient safety. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/FSZCxF --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- SHOW NOTES Dr. Bagla begins by describing the halo effect. The halo effect describes the tendency for people to overestimate the value of individual positive attributes when evaluating the whole. Thiis can happen when we form our opinions of people, techniques, and even medical devices. The opposite is also true, named the horn effect, where we tend to overestimate negative attributes. They are both forms of bias. In interventional radiology, the halo effect can impact case outcomes by contributing to operator tunnel vision and the reluctance to waver from the desired way of executing a procedure. For Dr. Bagla, the idea of the halo effect came about while working with new colleagues, many of whom do things differently than he did. He realized that in IR, physicians do things a certain way because that’s how they learned in training, whether it really is the safest and best way, or just the most familiar. He also sees the horn effect occur often when people start using a new device. If the device doesn’t work well for them the first time, many often refuse to use it in the future based on that first experience. He summarizes by noting that in IR, there are so many opportunities to become biased, whether through the halo effect or the horn effect. Lastly, Dr. Bagla reviews how he works to avoid these inherent biases. The first step in overcoming this bias is to understand its presence. Next, you must stop and realize that what you are doing is not working, whether due to the procedural approach, the device, or the way you are using the device. Dr. Bagla believes we must be critical of ourselves and try to think outside of our preferred wire, catheter, or device. In order to do this, you must go through the steps and review your checklist in order to determine which step the problem occurred at. Only by doing this can you avoid falling victim to these biases that are so prevalent in medicine. --- RESOURCES BackTable Episode 195: Disclosures of Conflicts of Interest https://www.backtable.com/shows/vi/podcasts/195/disclosures-of-conflicts-of-interest In this episode, cohosts Dr. Aparna Baheti and Dr. Aaron Fritts interview interventional radiologist Dr. Sandeep Bagla about “The Halo Effect”, including how to recognize when you are being subjected to bias, and how to critically evaluate bad outcomes to improve your practice and enhance patient safety.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/FSZCxF


---


CHECK OUT OUR SPONSORS


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


Accountable Revenue Cycle Solutions

https://www.accountablerevcycle.com/


---


SHOW NOTES


Dr. Bagla begins by describing the halo effect. The halo effect describes the tendency for people to overestimate the value of individual positive attributes when evaluating the whole. Thiis can happen when we form our opinions of people, techniques, and even medical devices. The opposite is also true, named the horn effect, where we tend to overestimate negative attributes. They are both forms of bias. In interventional radiology, the halo effect can impact case outcomes by contributing to operator tunnel vision and the reluctance to waver from the desired way of executing a procedure.


For Dr. Bagla, the idea of the halo effect came about while working with new colleagues, many of whom do things differently than he did. He realized that in IR, physicians do things a certain way because that’s how they learned in training, whether it really is the safest and best way, or just the most familiar. He also sees the horn effect occur often when people start using a new device. If the device doesn’t work well for them the first time, many often refuse to use it in the future based on that first experience. He summarizes by noting that in IR, there are so many opportunities to become biased, whether through the halo effect or the horn effect.


Lastly, Dr. Bagla reviews how he works to avoid these inherent biases. The first step in overcoming this bias is to understand its presence. Next, you must stop and realize that what you are doing is not working, whether due to the procedural approach, the device, or the way you are using the device. Dr. Bagla believes we must be critical of ourselves and try to think outside of our preferred wire, catheter, or device. In order to do this, you must go through the steps and review your checklist in order to determine which step the problem occurred at. Only by doing this can you avoid falling victim to these biases that are so prevalent in medicine.


---


RESOURCES


BackTable Episode 195: Disclosures of Conflicts of Interest

https://www.backtable.com/shows/vi/podcasts/195/disclosures-of-conflicts-of-interest

]]> 3740 Ep. 263 How I Perform Renal Biopsies with Chris and Aaron In this next installment of our Back to the Basics series, Drs. Aaron Fritts and Chris Beck discuss their techniques, considerations, and tips for ensuring safe and high quality renal biopsies. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/bYgmZk --- CHECK OUT OUR SPONSORS Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES First, the doctors discuss indications and contraindications for biopsy. In the outpatient setting, the doctors have noticed that proteinuria is the most common reason for referral, followed by lupus nephritis. For inpatients, acute unexplained kidney failure is an additional indication. It is important to talk with nephrologists to weigh the risks and benefits of renal biopsy, especially if the patient has a coagulopathy, is experiencing uncontrolled hypertension, or is too unstable to lay prone on the table. The SIR Guidelines app is a useful tool to risk stratify patients. In terms of imaging, CT or ultrasound can be used, although they each have unique advantages. Ultrasound allows for real-time guidance and the ability to use the probe to hold pressure on the kidney to prevent bleeding. On the other hand, CT allows for better imaging in patients with larger body habitus and allows the patients to lay prone. Dr. Fritts emphasizes that the best imaging modality is the one that the operator is most comfortable with, since this will ensure maximal safety for the patient. One helpful tip when planning a biopsy is to avoid needle entry into the paraspinal muscles, since this could change the trajectory of the needle and cause pain. Both doctors prefer to use moderate sedation if the patient can tolerate it. This sedation usually has the added benefit of facilitating an intra-procedural blood pressure dip, which protects against bleeding when biopsying hypertensive patients. Since sedation can alter breathing patterns, starting sedation early (before scanning the patient) can be helpful in establishing a steady breathing pattern before the procedure starts. Dr. Beck also recommends checking blood pressure while the patient is in pre-operative care, in order to predict whether or not they might require additional intra-procedural antihypertensive medications such as hydralazine, labetalol, or clonidine. Since blood pressure control is a cornerstone of a safe procedure, each doctor has their own safety threshold for blood pressure. Then, the doctors discuss different types and sizes of biopsy needles. While a 16G needle can obtain better diagnostic samples, the 18G needle might have a lower risk of bleeding complications. The doctors also share their preferred brands of needles. The episode concludes with tips for surveilling patients in the post-procedural period and dealing with bleeding complications. Dr. Beck describes his protocol for re-scanning patients to check for large hematomas and keeping them under observation for at least three hours. If there is a large hematoma, emergency embolization must be performed. --- RESOURCES SIR Guidelines App: https://apps.apple.com/us/app/sir-guidelines/id1552455529 SIR Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions: https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext 18G BioPince Biopsy Needle: https://www.argonmedical.com/products/biopince-full-core-biopsy-instrument Bard Mission Biopsy Needle: https://www.bd.com/en-us/products-and-solutions/products/product-families/mission-disposable-core-biopsy-instrument Temno Biopsy Needle: https://www.merit.com/peripheral-intervention/biopsy/soft-tissue-biopsy/temno-evolution-biopsy-device/ Fri, 18 Nov 2022 06:05:00 -0000 full BackTable In this next installment of our Back to the Basics series, Drs. Aaron Fritts and Chris Beck discuss their techniques, considerations, and tips for ensuring safe and high quality renal biopsies. In this next installment of our Back to the Basics series, Drs. Aaron Fritts and Chris Beck discuss their techniques, considerations, and tips for ensuring safe and high quality renal biopsies. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/bYgmZk --- CHECK OUT OUR SPONSORS Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES First, the doctors discuss indications and contraindications for biopsy. In the outpatient setting, the doctors have noticed that proteinuria is the most common reason for referral, followed by lupus nephritis. For inpatients, acute unexplained kidney failure is an additional indication. It is important to talk with nephrologists to weigh the risks and benefits of renal biopsy, especially if the patient has a coagulopathy, is experiencing uncontrolled hypertension, or is too unstable to lay prone on the table. The SIR Guidelines app is a useful tool to risk stratify patients. In terms of imaging, CT or ultrasound can be used, although they each have unique advantages. Ultrasound allows for real-time guidance and the ability to use the probe to hold pressure on the kidney to prevent bleeding. On the other hand, CT allows for better imaging in patients with larger body habitus and allows the patients to lay prone. Dr. Fritts emphasizes that the best imaging modality is the one that the operator is most comfortable with, since this will ensure maximal safety for the patient. One helpful tip when planning a biopsy is to avoid needle entry into the paraspinal muscles, since this could change the trajectory of the needle and cause pain. Both doctors prefer to use moderate sedation if the patient can tolerate it. This sedation usually has the added benefit of facilitating an intra-procedural blood pressure dip, which protects against bleeding when biopsying hypertensive patients. Since sedation can alter breathing patterns, starting sedation early (before scanning the patient) can be helpful in establishing a steady breathing pattern before the procedure starts. Dr. Beck also recommends checking blood pressure while the patient is in pre-operative care, in order to predict whether or not they might require additional intra-procedural antihypertensive medications such as hydralazine, labetalol, or clonidine. Since blood pressure control is a cornerstone of a safe procedure, each doctor has their own safety threshold for blood pressure. Then, the doctors discuss different types and sizes of biopsy needles. While a 16G needle can obtain better diagnostic samples, the 18G needle might have a lower risk of bleeding complications. The doctors also share their preferred brands of needles. The episode concludes with tips for surveilling patients in the post-procedural period and dealing with bleeding complications. Dr. Beck describes his protocol for re-scanning patients to check for large hematomas and keeping them under observation for at least three hours. If there is a large hematoma, emergency embolization must be performed. --- RESOURCES SIR Guidelines App: https://apps.apple.com/us/app/sir-guidelines/id1552455529 SIR Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions: https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext 18G BioPince Biopsy Needle: https://www.argonmedical.com/products/biopince-full-core-biopsy-instrument Bard Mission Biopsy Needle: https://www.bd.com/en-us/products-and-solutions/products/product-families/mission-disposable-core-biopsy-instrument Temno Biopsy Needle: https://www.merit.com/peripheral-intervention/biopsy/soft-tissue-biopsy/temno-evolution-biopsy-device/ In this next installment of our Back to the Basics series, Drs. Aaron Fritts and Chris Beck discuss their techniques, considerations, and tips for ensuring safe and high quality renal biopsies.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/bYgmZk


---


CHECK OUT OUR SPONSORS


Laurel Road for Doctors

https://www.laurelroad.com/healthcare-banking/


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


First, the doctors discuss indications and contraindications for biopsy. In the outpatient setting, the doctors have noticed that proteinuria is the most common reason for referral, followed by lupus nephritis. For inpatients, acute unexplained kidney failure is an additional indication. It is important to talk with nephrologists to weigh the risks and benefits of renal biopsy, especially if the patient has a coagulopathy, is experiencing uncontrolled hypertension, or is too unstable to lay prone on the table. The SIR Guidelines app is a useful tool to risk stratify patients.


In terms of imaging, CT or ultrasound can be used, although they each have unique advantages. Ultrasound allows for real-time guidance and the ability to use the probe to hold pressure on the kidney to prevent bleeding. On the other hand, CT allows for better imaging in patients with larger body habitus and allows the patients to lay prone. Dr. Fritts emphasizes that the best imaging modality is the one that the operator is most comfortable with, since this will ensure maximal safety for the patient. One helpful tip when planning a biopsy is to avoid needle entry into the paraspinal muscles, since this could change the trajectory of the needle and cause pain.


Both doctors prefer to use moderate sedation if the patient can tolerate it. This sedation usually has the added benefit of facilitating an intra-procedural blood pressure dip, which protects against bleeding when biopsying hypertensive patients. Since sedation can alter breathing patterns, starting sedation early (before scanning the patient) can be helpful in establishing a steady breathing pattern before the procedure starts. Dr. Beck also recommends checking blood pressure while the patient is in pre-operative care, in order to predict whether or not they might require additional intra-procedural antihypertensive medications such as hydralazine, labetalol, or clonidine. Since blood pressure control is a cornerstone of a safe procedure, each doctor has their own safety threshold for blood pressure.


Then, the doctors discuss different types and sizes of biopsy needles. While a 16G needle can obtain better diagnostic samples, the 18G needle might have a lower risk of bleeding complications. The doctors also share their preferred brands of needles.


The episode concludes with tips for surveilling patients in the post-procedural period and dealing with bleeding complications. Dr. Beck describes his protocol for re-scanning patients to check for large hematomas and keeping them under observation for at least three hours. If there is a large hematoma, emergency embolization must be performed.


---


RESOURCES


SIR Guidelines App:

https://apps.apple.com/us/app/sir-guidelines/id1552455529


SIR Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions:

https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext


18G BioPince Biopsy Needle: https://www.argonmedical.com/products/biopince-full-core-biopsy-instrument


Bard Mission Biopsy Needle:

https://www.bd.com/en-us/products-and-solutions/products/product-families/mission-disposable-core-biopsy-instrument


Temno Biopsy Needle:

https://www.merit.com/peripheral-intervention/biopsy/soft-tissue-biopsy/temno-evolution-biopsy-device/

]]> 4333 Ep. 262 IR/OB Collaboration in Treating Post Partum Hemorrhage with Dr. Roxane Rampersad and Dr. Anthony Shanks On this episode, BackTable VI host Dr. Christopher Beck shares the mic with two Maternal Fetal Medicine (MFM) specialists, Drs. Roxane Rampersad at Washington University and Tony Shanks at Indiana University, to discuss cross-specialty management of postpartum hemorrhage (PPH) between OBGYN and interventional radiology (IR). The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/ASxPdP Thu, 17 Nov 2022 06:05:00 -0000 full BackTable On this episode, BackTable VI host Dr. Christopher Beck shares the mic with two Maternal Fetal Medicine (MFM) specialists, Drs. Roxane Rampersad at Washington University and Tony Shanks at Indiana University, to discuss cross-specialty management of postpartum hemorrhage (PPH) between OBGYN and interventional radiology (IR). On this episode, BackTable VI host Dr. Christopher Beck shares the mic with two Maternal Fetal Medicine (MFM) specialists, Drs. Roxane Rampersad at Washington University and Tony Shanks at Indiana University, to discuss cross-specialty management of postpartum hemorrhage (PPH) between OBGYN and interventional radiology (IR). The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/ASxPdP On this episode, BackTable VI host Dr. Christopher Beck shares the mic with two Maternal Fetal Medicine (MFM) specialists, Drs. Roxane Rampersad at Washington University and Tony Shanks at Indiana University, to discuss cross-specialty management of postpartum hemorrhage (PPH) between OBGYN and interventional radiology (IR).


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/ASxPdP

]]> 3133 Ep. 261 Essentials of a Multidisciplinary Team for PE with Dr. Rohit Amin In this episode, host Dr. Aaron Fritts interviews interventional cardiologist Dr. Rohit Amin about his private practice PE response team, including his treatment algorithm, follow-up protocol, and how he believes AI can contribute to PE care. --- CHECK OUT OUR SPONSOR RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- SHOW NOTES Dr. Amin trained at Ochsner Clinic in New Orleans, and now works in private practice in Pensacola, Florida. He and a partner decided to start a PE response team (PERT) to better serve patients in the area and expand their practice. It took a lot of groundwork. They had to pitch it to administration and raise awareness, which they did by hosting CME such as grand rounds. They struggled to get a pulmonologist on board in 2013 when there was less clinical data and guidelines. Next, we discuss how the PERT algorithm functions in his private practice. An ER doctor or hospitalist evaluates the patient first. If the CT shows proximal thrombus, the PERT is notified. If it is a massive PE or submassive with clinical severity, he does thrombectomy promptly. If there is no elevated troponin and normal hemodynamics, the patient gets admitted and evaluated with a stat echo and venous doppler. Dr. Amin’s practice prefers an echo with PE protocol to risk stratify RV dysfunction - i.e. RV size, tricuspid annular plane systolic excursion (TAPSE). He also evaluates pulmonary artery (PA) pressure, PA saturation, and cardiac index which are important clinical factors that determine the optimal route of intervention. For patients with submassive PE who get admitted overnight, he gives all patients a heparinoid, preferably lovenox over heparin. He sees the patient in the morning and if the clot is submassive or proximal, he does a thrombectomy that day. Lastly, we cover the importance of treating PE and how Dr. Amin approaches longitudinal follow up. Dr. Amin refers to the ICOPER trial that showed that the 30 day mortality for submassive PE is 15%, higher than that of NSTEMIs. If a PE is left untreated or if treatment is significantly delayed, a patient can develop post-PE syndrome or chronic thromboembolic pulmonary hypertension (CTEPH), which significantly worsen morbidity and mortality. Dr. Amin treats his PE / DVT patients with one week of lovenox before transitioning to a direct oral anticoagulant (DOAC). He sees them in the office in one month and gets an echo at 3 months. He then sees patients semi-annually or annually for 3-5 years. --- RESOURCES BackTable Episode 196: https://www.backtable.com/shows/vi/podcasts/196/building-a-pe-response-team PERT Consortium: https://pertconsortium.org ICOPER Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)07534-5/fulltext Mon, 14 Nov 2022 06:05:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews interventional cardiologist Dr. Rohit Amin about his private practice PE response team, including his treatment algorithm, follow-up protocol, and how he believes AI can contribute to PE care. In this episode, host Dr. Aaron Fritts interviews interventional cardiologist Dr. Rohit Amin about his private practice PE response team, including his treatment algorithm, follow-up protocol, and how he believes AI can contribute to PE care. --- CHECK OUT OUR SPONSOR RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- SHOW NOTES Dr. Amin trained at Ochsner Clinic in New Orleans, and now works in private practice in Pensacola, Florida. He and a partner decided to start a PE response team (PERT) to better serve patients in the area and expand their practice. It took a lot of groundwork. They had to pitch it to administration and raise awareness, which they did by hosting CME such as grand rounds. They struggled to get a pulmonologist on board in 2013 when there was less clinical data and guidelines. Next, we discuss how the PERT algorithm functions in his private practice. An ER doctor or hospitalist evaluates the patient first. If the CT shows proximal thrombus, the PERT is notified. If it is a massive PE or submassive with clinical severity, he does thrombectomy promptly. If there is no elevated troponin and normal hemodynamics, the patient gets admitted and evaluated with a stat echo and venous doppler. Dr. Amin’s practice prefers an echo with PE protocol to risk stratify RV dysfunction - i.e. RV size, tricuspid annular plane systolic excursion (TAPSE). He also evaluates pulmonary artery (PA) pressure, PA saturation, and cardiac index which are important clinical factors that determine the optimal route of intervention. For patients with submassive PE who get admitted overnight, he gives all patients a heparinoid, preferably lovenox over heparin. He sees the patient in the morning and if the clot is submassive or proximal, he does a thrombectomy that day. Lastly, we cover the importance of treating PE and how Dr. Amin approaches longitudinal follow up. Dr. Amin refers to the ICOPER trial that showed that the 30 day mortality for submassive PE is 15%, higher than that of NSTEMIs. If a PE is left untreated or if treatment is significantly delayed, a patient can develop post-PE syndrome or chronic thromboembolic pulmonary hypertension (CTEPH), which significantly worsen morbidity and mortality. Dr. Amin treats his PE / DVT patients with one week of lovenox before transitioning to a direct oral anticoagulant (DOAC). He sees them in the office in one month and gets an echo at 3 months. He then sees patients semi-annually or annually for 3-5 years. --- RESOURCES BackTable Episode 196: https://www.backtable.com/shows/vi/podcasts/196/building-a-pe-response-team PERT Consortium: https://pertconsortium.org ICOPER Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)07534-5/fulltext In this episode, host Dr. Aaron Fritts interviews interventional cardiologist Dr. Rohit Amin about his private practice PE response team, including his treatment algorithm, follow-up protocol, and how he believes AI can contribute to PE care.


---


CHECK OUT OUR SPONSOR


RapidAI

http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor


---


SHOW NOTES


Dr. Amin trained at Ochsner Clinic in New Orleans, and now works in private practice in Pensacola, Florida. He and a partner decided to start a PE response team (PERT) to better serve patients in the area and expand their practice. It took a lot of groundwork. They had to pitch it to administration and raise awareness, which they did by hosting CME such as grand rounds. They struggled to get a pulmonologist on board in 2013 when there was less clinical data and guidelines.


Next, we discuss how the PERT algorithm functions in his private practice. An ER doctor or hospitalist evaluates the patient first. If the CT shows proximal thrombus, the PERT is notified. If it is a massive PE or submassive with clinical severity, he does thrombectomy promptly. If there is no elevated troponin and normal hemodynamics, the patient gets admitted and evaluated with a stat echo and venous doppler. Dr. Amin’s practice prefers an echo with PE protocol to risk stratify RV dysfunction - i.e. RV size, tricuspid annular plane systolic excursion (TAPSE). He also evaluates pulmonary artery (PA) pressure, PA saturation, and cardiac index which are important clinical factors that determine the optimal route of intervention. For patients with submassive PE who get admitted overnight, he gives all patients a heparinoid, preferably lovenox over heparin. He sees the patient in the morning and if the clot is submassive or proximal, he does a thrombectomy that day.


Lastly, we cover the importance of treating PE and how Dr. Amin approaches longitudinal follow up. Dr. Amin refers to the ICOPER trial that showed that the 30 day mortality for submassive PE is 15%, higher than that of NSTEMIs. If a PE is left untreated or if treatment is significantly delayed, a patient can develop post-PE syndrome or chronic thromboembolic pulmonary hypertension (CTEPH), which significantly worsen morbidity and mortality. Dr. Amin treats his PE / DVT patients with one week of lovenox before transitioning to a direct oral anticoagulant (DOAC). He sees them in the office in one month and gets an echo at 3 months. He then sees patients semi-annually or annually for 3-5 years.


---


RESOURCES


BackTable Episode 196:

https://www.backtable.com/shows/vi/podcasts/196/building-a-pe-response-team


PERT Consortium:

https://pertconsortium.org


ICOPER Trial:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)07534-5/fulltext

]]> 3634 Ep. 260 SAFARI Procedure with Dr. Luke Wilkins In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Luke Wilkins about his approach to the subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique for crossing challenging chronic total occlusions (CTO) in critical limb ischemia (CLI) patients. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ BD Rotarex Atherectomy System https://www.bd.com/rotarex --- SHOW NOTES Dr. WIlkins gives us the basic indication for the procedure, which is when the lesion is unable to be crossed from a purely antegrade approach and other re-entry devices have failed. Dr. Wilkins will always attempt to use an Outback wire and an Enteer balloon before performing the SAFARI technique. There are multiple factors that influence the decision to use SAFARI, such as lesion location, level of calcification, and size of the true lumen at the re-entry point. Next, Dr. Wilkins walks us through a typical SAFARI. He normally establishes retrograde access in the dorsalis pedis or posterior tibial artery using a 4 cm micropuncture needle and an exchange length Nitrex wire. He uses telescoping catheters from the antegrade direction. When the antegrade and retrograde approaches enter the same subintimal plane, the 2 devices can connect and the lesion can be crossed. If it is challenging to achieve the same intimal plane for both devices, the gunsight approach of overlapping snares can be utilized. After the lesion is crossed, normal angioplasty and stenting can occur. Dr. Wilkins gives advice on how to make the procedure efficient. In occlusions that are longer than 1 cm, he always makes sure that the foot is prepped before the case starts. He also emphasizes the importance of knowing when to try a different technique and notes that this intuition comes from experience. Finally, we discuss patency rates for SAFARI patients, which have been relatively high. This technique has made a large impact on limb salvage in a patient population that previously had no other non-surgical options. --- RESOURCES Rotarex Atherectomy System: https://www.bd.com/en-us/products-and-solutions/products/product-families/rotarex-rotational-excisional-atherectomy-system Outback Re-Entry Catheter: https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter Enteer Re-Entry Catheter/Balloon: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/chronic-total-occlusion-devices/enteer/indications-safety-warnings.html Nitrex Wire: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/guidewires/nitrex.html CXI Catheter: https://www.cookmedical.com/products/di_cxi_webds/ Outcome and Distal Access Patency in Subintimal Arterial Flossing with Antegrade-Retrograde Intervention for Chronic Total Occlusions in Lower Extremity Critical Limb Ischemia: https://www.jvir.org/article/S1051-0443(19)31033-4/fulltext Fri, 11 Nov 2022 06:00:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Luke Wilkins about his approach to the subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique for crossing challenging chronic total occlusions (CTO) in critical limb ischemia (CLI) patients. In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Luke Wilkins about his approach to the subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique for crossing challenging chronic total occlusions (CTO) in critical limb ischemia (CLI) patients. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ BD Rotarex Atherectomy System https://www.bd.com/rotarex --- SHOW NOTES Dr. WIlkins gives us the basic indication for the procedure, which is when the lesion is unable to be crossed from a purely antegrade approach and other re-entry devices have failed. Dr. Wilkins will always attempt to use an Outback wire and an Enteer balloon before performing the SAFARI technique. There are multiple factors that influence the decision to use SAFARI, such as lesion location, level of calcification, and size of the true lumen at the re-entry point. Next, Dr. Wilkins walks us through a typical SAFARI. He normally establishes retrograde access in the dorsalis pedis or posterior tibial artery using a 4 cm micropuncture needle and an exchange length Nitrex wire. He uses telescoping catheters from the antegrade direction. When the antegrade and retrograde approaches enter the same subintimal plane, the 2 devices can connect and the lesion can be crossed. If it is challenging to achieve the same intimal plane for both devices, the gunsight approach of overlapping snares can be utilized. After the lesion is crossed, normal angioplasty and stenting can occur. Dr. Wilkins gives advice on how to make the procedure efficient. In occlusions that are longer than 1 cm, he always makes sure that the foot is prepped before the case starts. He also emphasizes the importance of knowing when to try a different technique and notes that this intuition comes from experience. Finally, we discuss patency rates for SAFARI patients, which have been relatively high. This technique has made a large impact on limb salvage in a patient population that previously had no other non-surgical options. --- RESOURCES Rotarex Atherectomy System: https://www.bd.com/en-us/products-and-solutions/products/product-families/rotarex-rotational-excisional-atherectomy-system Outback Re-Entry Catheter: https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter Enteer Re-Entry Catheter/Balloon: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/chronic-total-occlusion-devices/enteer/indications-safety-warnings.html Nitrex Wire: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/guidewires/nitrex.html CXI Catheter: https://www.cookmedical.com/products/di_cxi_webds/ Outcome and Distal Access Patency in Subintimal Arterial Flossing with Antegrade-Retrograde Intervention for Chronic Total Occlusions in Lower Extremity Critical Limb Ischemia: https://www.jvir.org/article/S1051-0443(19)31033-4/fulltext In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Luke Wilkins about his approach to the subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique for crossing challenging chronic total occlusions (CTO) in critical limb ischemia (CLI) patients.


---


CHECK OUT OUR SPONSORS


Reflow Medical

https://www.reflowmedical.com/


BD Rotarex Atherectomy System

https://www.bd.com/rotarex


---


SHOW NOTES


Dr. WIlkins gives us the basic indication for the procedure, which is when the lesion is unable to be crossed from a purely antegrade approach and other re-entry devices have failed. Dr. Wilkins will always attempt to use an Outback wire and an Enteer balloon before performing the SAFARI technique. There are multiple factors that influence the decision to use SAFARI, such as lesion location, level of calcification, and size of the true lumen at the re-entry point.


Next, Dr. Wilkins walks us through a typical SAFARI. He normally establishes retrograde access in the dorsalis pedis or posterior tibial artery using a 4 cm micropuncture needle and an exchange length Nitrex wire. He uses telescoping catheters from the antegrade direction. When the antegrade and retrograde approaches enter the same subintimal plane, the 2 devices can connect and the lesion can be crossed. If it is challenging to achieve the same intimal plane for both devices, the gunsight approach of overlapping snares can be utilized. After the lesion is crossed, normal angioplasty and stenting can occur.


Dr. Wilkins gives advice on how to make the procedure efficient. In occlusions that are longer than 1 cm, he always makes sure that the foot is prepped before the case starts. He also emphasizes the importance of knowing when to try a different technique and notes that this intuition comes from experience.


Finally, we discuss patency rates for SAFARI patients, which have been relatively high. This technique has made a large impact on limb salvage in a patient population that previously had no other non-surgical options.


---


RESOURCES


Rotarex Atherectomy System:

https://www.bd.com/en-us/products-and-solutions/products/product-families/rotarex-rotational-excisional-atherectomy-system


Outback Re-Entry Catheter:

https://cordis.com/na/products/cross/endovascular/outback-elite-re-entry-catheter


Enteer Re-Entry Catheter/Balloon:

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/chronic-total-occlusion-devices/enteer/indications-safety-warnings.html


Nitrex Wire:

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/guidewires/nitrex.html


CXI Catheter:

https://www.cookmedical.com/products/di_cxi_webds/


Outcome and Distal Access Patency in Subintimal Arterial Flossing with Antegrade-Retrograde Intervention for Chronic Total Occlusions in Lower Extremity Critical Limb Ischemia:

https://www.jvir.org/article/S1051-0443(19)31033-4/fulltext

]]> 2444 Ep. 259 Building an IR Department From Scratch with Dr. Doug Hidlay In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. Doug Hidlay about how he has built a solo IR practice in rural Virginia, including how he got equipment, employees and referrals to build a busy and diverse practice. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/TOy6WC --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- SHOW NOTES Dr. Hidlay begins by discussing how he was recruited out of fellowship into a medical group in Virginia. They offered him the opportunity to build an entire IR practice and do the kinds of procedures that he wanted to bring with whatever skills he had from his residency at Brown and fellowship at the University of Washington. He is employed by a hospital group where he does about 30% diagnostic radiology, runs his own clinic and sees consults. He was hired to prioritize IR, and feels very supported by his diagnostic colleagues to do so. We discuss what he learned through this process, and what he wished he would have known. He says the biggest surprises were from his own naivete, having gone straight into this position out of fellowship. The administration was up front with him and told him to expect to have to build this practice from scratch. When he started, he had 6 FTEs including himself, a scheduler, 3 techs and 3 nurses. He started off doing about 10 paracenteses, a couple lung biopsies and some thyroid biopsies per week. He attributes his success to showing up consistently. He asked for time to talk at every local practice and grand rounds. He met with surgeons, hospitalists, and primary care doctors to tell them what he could do, with the idea that even if they didn’t remember, they would have his number and could reach him at any time. What he didn’t realize was how much of a need there was. He soon became overwhelmed by the demand, and realized he was in over his head, doing 12-18 cases daily with the same support staff. As for acquiring equipment to do procedures, Dr. Hidlay feels he was fortunate to have administration who were willing to believe him when he said he needed certain equipment. When it came to training staff, he often worked with them at the backtable and taught them how to use the image intensifier (II) controls to help them ‘learn by doing’. He started out on call 24/7, while his 3 techs and nurses were on call every 3 days. He slowly adjusted this as it was unsustainable for all, and has more staff now. By volume, he still mostly does light IR and feels that if he didn’t accept these cases he would never have built trust and made connections to referring providers. He also has a kyphoplasty service, a venous thromboembolism (VTE) service, and also does a sizeable volume of renal ablations, chemoembolizations, and emergent bleeds. He is hoping to bring on two more IRs to round out his practice and meet the community demand. --- RESOURCES BackTable Episode 221: Building a Musculoskeletal Interventional Oncology Service with Dr. Alan Sag https://www.backtable.com/shows/vi/podcasts/221/building-a-musculoskeletal-interventional-oncology-service Doug Hidlay Twitter: @DHidlayVIR Mon, 07 Nov 2022 06:00:00 -0000 full BackTable In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. Doug Hidlay about how he has built a solo IR practice in rural Virginia, including how he got equipment, employees and referrals to build a busy and diverse practice. In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. Doug Hidlay about how he has built a solo IR practice in rural Virginia, including how he got equipment, employees and referrals to build a busy and diverse practice. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/TOy6WC --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- SHOW NOTES Dr. Hidlay begins by discussing how he was recruited out of fellowship into a medical group in Virginia. They offered him the opportunity to build an entire IR practice and do the kinds of procedures that he wanted to bring with whatever skills he had from his residency at Brown and fellowship at the University of Washington. He is employed by a hospital group where he does about 30% diagnostic radiology, runs his own clinic and sees consults. He was hired to prioritize IR, and feels very supported by his diagnostic colleagues to do so. We discuss what he learned through this process, and what he wished he would have known. He says the biggest surprises were from his own naivete, having gone straight into this position out of fellowship. The administration was up front with him and told him to expect to have to build this practice from scratch. When he started, he had 6 FTEs including himself, a scheduler, 3 techs and 3 nurses. He started off doing about 10 paracenteses, a couple lung biopsies and some thyroid biopsies per week. He attributes his success to showing up consistently. He asked for time to talk at every local practice and grand rounds. He met with surgeons, hospitalists, and primary care doctors to tell them what he could do, with the idea that even if they didn’t remember, they would have his number and could reach him at any time. What he didn’t realize was how much of a need there was. He soon became overwhelmed by the demand, and realized he was in over his head, doing 12-18 cases daily with the same support staff. As for acquiring equipment to do procedures, Dr. Hidlay feels he was fortunate to have administration who were willing to believe him when he said he needed certain equipment. When it came to training staff, he often worked with them at the backtable and taught them how to use the image intensifier (II) controls to help them ‘learn by doing’. He started out on call 24/7, while his 3 techs and nurses were on call every 3 days. He slowly adjusted this as it was unsustainable for all, and has more staff now. By volume, he still mostly does light IR and feels that if he didn’t accept these cases he would never have built trust and made connections to referring providers. He also has a kyphoplasty service, a venous thromboembolism (VTE) service, and also does a sizeable volume of renal ablations, chemoembolizations, and emergent bleeds. He is hoping to bring on two more IRs to round out his practice and meet the community demand. --- RESOURCES BackTable Episode 221: Building a Musculoskeletal Interventional Oncology Service with Dr. Alan Sag https://www.backtable.com/shows/vi/podcasts/221/building-a-musculoskeletal-interventional-oncology-service Doug Hidlay Twitter: @DHidlayVIR In this episode, host Dr. Michael Barraza interviews interventional radiologist Dr. Doug Hidlay about how he has built a solo IR practice in rural Virginia, including how he got equipment, employees and referrals to build a busy and diverse practice.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/TOy6WC


---


CHECK OUT OUR SPONSORS


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


Accountable Revenue Cycle Solutions

https://www.accountablerevcycle.com/


---


SHOW NOTES


Dr. Hidlay begins by discussing how he was recruited out of fellowship into a medical group in Virginia. They offered him the opportunity to build an entire IR practice and do the kinds of procedures that he wanted to bring with whatever skills he had from his residency at Brown and fellowship at the University of Washington. He is employed by a hospital group where he does about 30% diagnostic radiology, runs his own clinic and sees consults. He was hired to prioritize IR, and feels very supported by his diagnostic colleagues to do so.


We discuss what he learned through this process, and what he wished he would have known. He says the biggest surprises were from his own naivete, having gone straight into this position out of fellowship. The administration was up front with him and told him to expect to have to build this practice from scratch. When he started, he had 6 FTEs including himself, a scheduler, 3 techs and 3 nurses. He started off doing about 10 paracenteses, a couple lung biopsies and some thyroid biopsies per week. He attributes his success to showing up consistently. He asked for time to talk at every local practice and grand rounds. He met with surgeons, hospitalists, and primary care doctors to tell them what he could do, with the idea that even if they didn’t remember, they would have his number and could reach him at any time. What he didn’t realize was how much of a need there was. He soon became overwhelmed by the demand, and realized he was in over his head, doing 12-18 cases daily with the same support staff.


As for acquiring equipment to do procedures, Dr. Hidlay feels he was fortunate to have administration who were willing to believe him when he said he needed certain equipment. When it came to training staff, he often worked with them at the backtable and taught them how to use the image intensifier (II) controls to help them ‘learn by doing’. He started out on call 24/7, while his 3 techs and nurses were on call every 3 days. He slowly adjusted this as it was unsustainable for all, and has more staff now. By volume, he still mostly does light IR and feels that if he didn’t accept these cases he would never have built trust and made connections to referring providers. He also has a kyphoplasty service, a venous thromboembolism (VTE) service, and also does a sizeable volume of renal ablations, chemoembolizations, and emergent bleeds. He is hoping to bring on two more IRs to round out his practice and meet the community demand.


---


RESOURCES


BackTable Episode 221: Building a Musculoskeletal Interventional Oncology Service with Dr. Alan Sag

https://www.backtable.com/shows/vi/podcasts/221/building-a-musculoskeletal-interventional-oncology-service


Doug Hidlay Twitter:

@DHidlayVIR

]]> 2752 Ep. 258 GEST Hot Topic: Learn MSK Embolization in Paris! with Dr. Marc Sapoval In this episode, host Dr. Aaron Fritts interviews Dr. Marc Sapoval about practicing IR in France, the origins of the Global Embolization Oncology Symposium Technologies (GEST) Conference, and an upcoming conference in MSK embolization. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/PX6J62 --- CHECK OUT OUR SPONSORS Global Embolization Oncology Symposium Technologies (GEST) Conference https://thegestgroup.com/ Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES First, Dr. Sapoval gives an overview of the French IR landscape. He outlines the training pathway, which is a four year radiology program with an additional two years of IR specialization. He also describes his role at an academic hospital. Dr. Sapoval says that in his country, collaboration with other endovascular specialists depends on both interpersonal relationships and business incentives. For the remainder of the interview, we talk about how GEST began and where it is today. In 2007, Drs. Marc Sapoval, Jafar Golzarian, and Ziv Haskal started the first GEST conference in Barcelona, after they realized the need for a specific meeting geared towards embolization. This inaugural meeting turned out to be a success, with attendance reaching much higher numbers than they had originally anticipated. Since then, GEST annual meetings have taken place throughout Europe and the United States. In recent years, it has found a permanent home in New York City. Dr. Sapoval introduces a new smaller conference series called GEST Hot Topics. An upcoming conference in this series focuses on MSK interventions, and it will be held in Paris on January 20-21, 2023. He emphasizes that it is an incredible opportunity to be part of a new field of IR. He highlights speakers who currently lead research efforts in MSK embolization and encourages all listeners to register and attend GEST Hot Topics: MSK Embolization. --- RESOURCES GEST Hot Topic: MSK Embolization: https://thegestgroup.com/gest-msk-2023-paris/ GEST Annual Conference 2023: https://annual.thegestgroup.com/GEST23/Public/mainhall.aspx Fri, 04 Nov 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Marc Sapoval about practicing IR in France, the origins of the Global Embolization Oncology Symposium Technologies (GEST) Conference, and an upcoming conference in MSK embolization. In this episode, host Dr. Aaron Fritts interviews Dr. Marc Sapoval about practicing IR in France, the origins of the Global Embolization Oncology Symposium Technologies (GEST) Conference, and an upcoming conference in MSK embolization. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/PX6J62 --- CHECK OUT OUR SPONSORS Global Embolization Oncology Symposium Technologies (GEST) Conference https://thegestgroup.com/ Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES First, Dr. Sapoval gives an overview of the French IR landscape. He outlines the training pathway, which is a four year radiology program with an additional two years of IR specialization. He also describes his role at an academic hospital. Dr. Sapoval says that in his country, collaboration with other endovascular specialists depends on both interpersonal relationships and business incentives. For the remainder of the interview, we talk about how GEST began and where it is today. In 2007, Drs. Marc Sapoval, Jafar Golzarian, and Ziv Haskal started the first GEST conference in Barcelona, after they realized the need for a specific meeting geared towards embolization. This inaugural meeting turned out to be a success, with attendance reaching much higher numbers than they had originally anticipated. Since then, GEST annual meetings have taken place throughout Europe and the United States. In recent years, it has found a permanent home in New York City. Dr. Sapoval introduces a new smaller conference series called GEST Hot Topics. An upcoming conference in this series focuses on MSK interventions, and it will be held in Paris on January 20-21, 2023. He emphasizes that it is an incredible opportunity to be part of a new field of IR. He highlights speakers who currently lead research efforts in MSK embolization and encourages all listeners to register and attend GEST Hot Topics: MSK Embolization. --- RESOURCES GEST Hot Topic: MSK Embolization: https://thegestgroup.com/gest-msk-2023-paris/ GEST Annual Conference 2023: https://annual.thegestgroup.com/GEST23/Public/mainhall.aspx In this episode, host Dr. Aaron Fritts interviews Dr. Marc Sapoval about practicing IR in France, the origins of the Global Embolization Oncology Symposium Technologies (GEST) Conference, and an upcoming conference in MSK embolization.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/PX6J62

---


CHECK OUT OUR SPONSORS


Global Embolization Oncology Symposium Technologies (GEST) Conference

https://thegestgroup.com/


Laurel Road for Doctors

https://www.laurelroad.com/healthcare-banking/


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


First, Dr. Sapoval gives an overview of the French IR landscape. He outlines the training pathway, which is a four year radiology program with an additional two years of IR specialization. He also describes his role at an academic hospital. Dr. Sapoval says that in his country, collaboration with other endovascular specialists depends on both interpersonal relationships and business incentives.


For the remainder of the interview, we talk about how GEST began and where it is today. In 2007, Drs. Marc Sapoval, Jafar Golzarian, and Ziv Haskal started the first GEST conference in Barcelona, after they realized the need for a specific meeting geared towards embolization. This inaugural meeting turned out to be a success, with attendance reaching much higher numbers than they had originally anticipated. Since then, GEST annual meetings have taken place throughout Europe and the United States. In recent years, it has found a permanent home in New York City.


Dr. Sapoval introduces a new smaller conference series called GEST Hot Topics. An upcoming conference in this series focuses on MSK interventions, and it will be held in Paris on January 20-21, 2023. He emphasizes that it is an incredible opportunity to be part of a new field of IR. He highlights speakers who currently lead research efforts in MSK embolization and encourages all listeners to register and attend GEST Hot Topics: MSK Embolization.


---


RESOURCES


GEST Hot Topic: MSK Embolization:

https://thegestgroup.com/gest-msk-2023-paris/


GEST Annual Conference 2023:

https://annual.thegestgroup.com/GEST23/Public/mainhall.aspx

]]> 2049 Ep. 257 Microwave Ablation for Liver Lesions with Dr. Josh Kuban In this episode, Dr. Chris Beck interviews Interventional Radiologist Dr. Josh Kuban about his liver tumor ablation practice at MD Anderson Cancer Center, including how it's evolved over time with newer technologies. They also discuss patient workup for liver tumors, treatment with microwave ablation, and post-procedure follow up. Dr. Kuban shares why he uses microwave ablation technology, and the advantages of ablation confirmation software for these procedures. --- CHECK OUT OUR SPONSOR NeuWave Microwave Ablation Systems https://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems --- SHOW NOTES We begin by discussing how Dr. Kuban started to get involved in interventional oncology and tumor ablation. He started off doing a broad base of vascular procedures. When he came to MD Anderson, he began building close relationships with oncologists which led him to become focused on ablation, primarily of liver and lung lesions. For liver tumors, Dr. Kuban primarily uses microwave ablation, while in the lung, he does cryoablation. The benefits of microwave ablation are the efficiency of the procedure compared to the time it takes to perform cryoablation. He generally does multiprobe ablations, which allows him to treat the tumor more aggressively from the beginning. He is able to do this confidently by taking advantage of ablation confirmation (AC) software. He always starts with a pre-procedure CT which he uploads to the AC software. He then compares his pre-image to his probe image which helps target the lesion intraoperatively. After ablating, he does another scan that has arterial and venous phases to look for bleeding. The AC software then takes the pre-scan and post-scan and merges them to show the ablation zone. Lastly, we discuss the impact that AC software has had on Dr. Kuban’s practice. When Dr. Kuban approaches a liver ablation case, his goal is to get the entire tumor in a single procedure, and he believes that he has to be able to see the margins in order to effectively ablate them. The software allows him to see the treatment effect in real time and provide more complete treatment the first time. After using this software, his recurrence rates have been very low, and he is confident that if a recurrence does happen, it is not due to incomplete ablation. He also emphasizes the effects that AC software has had on practice building. Because of this software, he is able to show images of cases to referring providers. --- DISCLAIMER Dr. Josh Kuban is presenting on behalf of Ethicon. The presentation reflects the opinions of the individual presenter, and the steps described may not encompass the complete steps of the procedure. Additionally, other surgeons may prefer different techniques, approaches, etc., as individual surgeon experience in his/her clinical practice, as well as patient needs, may dictate variation in procedure steps. Accordingly, results from any case studies reported in this presentation may not be predictive of results in other cases. Before using any medical device, review all labeling, including without limitation; the Instructions For Use (IFU), and relevant package inserts with particular attention to indications, contradindications, warnings and precautions, and steps for use of the device(s). Dr. Josh Kuban is compensated by and presenting on behalf of Ethicon and must present information in accordance with applicable regulatory requirements. The NeuWave™ Ablation System and Accessories are indicated for the ablation (coagulation) of soft tissue in percutaneous, open surgical and in conjunction with laparoscopic surgical settings, including the partial or complete ablation of non-resectable liver tumors. The NeuWave™ Microwave Ablation System and Accessories are not indicated for use in cardiac procedures. The system is designed for facility use and should only be used under the orders of a clinician. Mon, 31 Oct 2022 05:00:00 -0000 full BackTable In this episode, Dr. Chris Beck interviews Interventional Radiologist Dr. Josh Kuban about his liver tumor ablation practice at MD Anderson Cancer Center, including how it's evolved over time with newer technologies. They also discuss patient workup for liver tumors, treatment with microwave ablation, and post-procedure follow up. Dr. Kuban shares why he uses microwave ablation technology, and the advantages of ablation confirmation software for these procedures. In this episode, Dr. Chris Beck interviews Interventional Radiologist Dr. Josh Kuban about his liver tumor ablation practice at MD Anderson Cancer Center, including how it's evolved over time with newer technologies. They also discuss patient workup for liver tumors, treatment with microwave ablation, and post-procedure follow up. Dr. Kuban shares why he uses microwave ablation technology, and the advantages of ablation confirmation software for these procedures. --- CHECK OUT OUR SPONSOR NeuWave Microwave Ablation Systems https://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems --- SHOW NOTES We begin by discussing how Dr. Kuban started to get involved in interventional oncology and tumor ablation. He started off doing a broad base of vascular procedures. When he came to MD Anderson, he began building close relationships with oncologists which led him to become focused on ablation, primarily of liver and lung lesions. For liver tumors, Dr. Kuban primarily uses microwave ablation, while in the lung, he does cryoablation. The benefits of microwave ablation are the efficiency of the procedure compared to the time it takes to perform cryoablation. He generally does multiprobe ablations, which allows him to treat the tumor more aggressively from the beginning. He is able to do this confidently by taking advantage of ablation confirmation (AC) software. He always starts with a pre-procedure CT which he uploads to the AC software. He then compares his pre-image to his probe image which helps target the lesion intraoperatively. After ablating, he does another scan that has arterial and venous phases to look for bleeding. The AC software then takes the pre-scan and post-scan and merges them to show the ablation zone. Lastly, we discuss the impact that AC software has had on Dr. Kuban’s practice. When Dr. Kuban approaches a liver ablation case, his goal is to get the entire tumor in a single procedure, and he believes that he has to be able to see the margins in order to effectively ablate them. The software allows him to see the treatment effect in real time and provide more complete treatment the first time. After using this software, his recurrence rates have been very low, and he is confident that if a recurrence does happen, it is not due to incomplete ablation. He also emphasizes the effects that AC software has had on practice building. Because of this software, he is able to show images of cases to referring providers. --- DISCLAIMER Dr. Josh Kuban is presenting on behalf of Ethicon. The presentation reflects the opinions of the individual presenter, and the steps described may not encompass the complete steps of the procedure. Additionally, other surgeons may prefer different techniques, approaches, etc., as individual surgeon experience in his/her clinical practice, as well as patient needs, may dictate variation in procedure steps. Accordingly, results from any case studies reported in this presentation may not be predictive of results in other cases. Before using any medical device, review all labeling, including without limitation; the Instructions For Use (IFU), and relevant package inserts with particular attention to indications, contradindications, warnings and precautions, and steps for use of the device(s). Dr. Josh Kuban is compensated by and presenting on behalf of Ethicon and must present information in accordance with applicable regulatory requirements. The NeuWave™ Ablation System and Accessories are indicated for the ablation (coagulation) of soft tissue in percutaneous, open surgical and in conjunction with laparoscopic surgical settings, including the partial or complete ablation of non-resectable liver tumors. The NeuWave™ Microwave Ablation System and Accessories are not indicated for use in cardiac procedures. The system is designed for facility use and should only be used under the orders of a clinician. In this episode, Dr. Chris Beck interviews Interventional Radiologist Dr. Josh Kuban about his liver tumor ablation practice at MD Anderson Cancer Center, including how it's evolved over time with newer technologies. They also discuss patient workup for liver tumors, treatment with microwave ablation, and post-procedure follow up. Dr. Kuban shares why he uses microwave ablation technology, and the advantages of ablation confirmation software for these procedures.


---


CHECK OUT OUR SPONSOR


NeuWave Microwave Ablation Systems

https://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems


---


SHOW NOTES


We begin by discussing how Dr. Kuban started to get involved in interventional oncology and tumor ablation. He started off doing a broad base of vascular procedures. When he came to MD Anderson, he began building close relationships with oncologists which led him to become focused on ablation, primarily of liver and lung lesions.


For liver tumors, Dr. Kuban primarily uses microwave ablation, while in the lung, he does cryoablation. The benefits of microwave ablation are the efficiency of the procedure compared to the time it takes to perform cryoablation. He generally does multiprobe ablations, which allows him to treat the tumor more aggressively from the beginning. He is able to do this confidently by taking advantage of ablation confirmation (AC) software. He always starts with a pre-procedure CT which he uploads to the AC software. He then compares his pre-image to his probe image which helps target the lesion intraoperatively. After ablating, he does another scan that has arterial and venous phases to look for bleeding. The AC software then takes the pre-scan and post-scan and merges them to show the ablation zone.


Lastly, we discuss the impact that AC software has had on Dr. Kuban’s practice. When Dr. Kuban approaches a liver ablation case, his goal is to get the entire tumor in a single procedure, and he believes that he has to be able to see the margins in order to effectively ablate them. The software allows him to see the treatment effect in real time and provide more complete treatment the first time. After using this software, his recurrence rates have been very low, and he is confident that if a recurrence does happen, it is not due to incomplete ablation. He also emphasizes the effects that AC software has had on practice building. Because of this software, he is able to show images of cases to referring providers.


---


DISCLAIMER


Dr. Josh Kuban is presenting on behalf of Ethicon. The presentation reflects the opinions of the individual presenter, and the steps described may not encompass the complete steps of the procedure. Additionally, other surgeons may prefer different techniques, approaches, etc., as individual surgeon experience in his/her clinical practice, as well as patient needs, may dictate variation in procedure steps. Accordingly, results from any case studies reported in this presentation may not be predictive of results in other cases.


Before using any medical device, review all labeling, including without limitation; the Instructions For Use (IFU), and relevant package inserts with particular attention to indications, contradindications, warnings and precautions, and steps for use of the device(s).


Dr. Josh Kuban is compensated by and presenting on behalf of Ethicon and must present information in accordance with applicable regulatory requirements.


The NeuWave™ Ablation System and Accessories are indicated for the ablation (coagulation) of soft tissue in percutaneous, open surgical and in conjunction with laparoscopic surgical settings, including the partial or complete ablation of non-resectable liver tumors. The NeuWave™ Microwave Ablation System and Accessories are not indicated for use in cardiac procedures. The system is designed for facility use and should only be used under the orders of a clinician.

]]> 1455 Ep. 256 Origins of TACE with Drs. Michael Soulen and Nicholas Fidelman In this episode, guest host Dr. Nicholas Fidelman interviews Dr. Michael Solen, a key player in the development and widespread adoption of transarterial chemoembolization (TACE). The doctors discuss how TACE became a major therapeutic option for liver tumors, his preferred method of TACE dosage and management, and exciting new frontiers in chemoembolization. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/ --- SHOW NOTES Dr. Soulen recalls his first ever TACE patient, who was a patient self-referring for a rare neuroendocrine tumor. As an IR fellow at the University of Pennsylvania, Dr. Soulen recognized the opportunity to incorporate clinic time into his IR practice. His push for clinical management of IR patients resulted in successful medical and financial outcomes, which also led his hospital to establishing an interventional oncology clinic. He emphasizes that a clinic presence is crucial to participating in tumor boards and being able to accept outside referrals. Next, we delve into the history of the CAM (cisplatin, adriamycin, mitomycin) conventional TACE cocktail, which Dr. Soulen developed alongside medical oncologists and pharmacists. These chemotherapeutics, combined with lipiodol and followed by particle embolics, make up the most widely used TACE protocol in the United States. Dr. Soulen reviews his preferred ratios and mixing method for maximal efficacy. He discusses his current RETNET trial that directly compares treatment of neuroendocrine tumors with conventional TACE versus bland embolization in terms of progression free survival, toxic side effects, and patient quality of life. Additionally, we address the high prevalence of post-embolization syndrome and SIR consensus guidelines for its management. Since chemoembolization is a highly emetogenic therapy, Dr. Soulen uses an oncology evidence-based combination of Benadryl, Zofran, and Decadron. He administers PRN pain medication on an individual patient basis. Furthermore, we discuss post-TACE management, specifically length of hospital stay. While all patients used to be admitted for overnight monitoring, this has shifted to mostly same-day discharges. This change has allowed the hospital to conserve resources and decrease costs. Finally, Dr. Soulen shares his perspective on new developments in interventional oncology. He highlights a need to identify TACE drugs that specifically target intratumoral hypoxic response mechanisms. He also compares transarterial radioembolization (TARE) to TACE, noting that the former has not shown superiority to systemic therapy in research trials. However, there are possibilities that TARE or TACE could be useful to slow tumor progression in radiation lobectomy or as immunostimulants for combination therapy with immune checkpoint inhibitors and CAR-T cell therapy. --- RESOURCES RETNET Trial: https://clinicaltrials.gov/ct2/show/NCT02724540 Transcatheter oily chemoembolization of hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/2536946/ Prospective Randomized Study of Doxorubicin-Eluting-Bead Embolization in the Treatment of Hepatocellular Carcinoma: Results of the PRECISION V Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816794/ Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/24937669/ Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion: https://pubmed.ncbi.nlm.nih.gov/26390875/ Outpatient Transarterial Chemoembolization of Hepatocellular Carcinoma: Review of a Same-Day Discharge Strategy: https://pubmed.ncbi.nlm.nih.gov/29478795/ Phase I Trial on Arterial Embolization with Hypoxia Activated Tirapazamine for Unresectable Hepatocellular Carcinoma: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8139681/ Fri, 28 Oct 2022 05:00:00 -0000 full BackTable In this episode, guest host Dr. Nicholas Fidelman interviews Dr. Michael Solen, a key player in the development and widespread adoption of transarterial chemoembolization (TACE). The doctors discuss how TACE became a major therapeutic option for liver tumors, his preferred method of TACE dosage and management, and exciting new frontiers in chemoembolization. In this episode, guest host Dr. Nicholas Fidelman interviews Dr. Michael Solen, a key player in the development and widespread adoption of transarterial chemoembolization (TACE). The doctors discuss how TACE became a major therapeutic option for liver tumors, his preferred method of TACE dosage and management, and exciting new frontiers in chemoembolization. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/ --- SHOW NOTES Dr. Soulen recalls his first ever TACE patient, who was a patient self-referring for a rare neuroendocrine tumor. As an IR fellow at the University of Pennsylvania, Dr. Soulen recognized the opportunity to incorporate clinic time into his IR practice. His push for clinical management of IR patients resulted in successful medical and financial outcomes, which also led his hospital to establishing an interventional oncology clinic. He emphasizes that a clinic presence is crucial to participating in tumor boards and being able to accept outside referrals. Next, we delve into the history of the CAM (cisplatin, adriamycin, mitomycin) conventional TACE cocktail, which Dr. Soulen developed alongside medical oncologists and pharmacists. These chemotherapeutics, combined with lipiodol and followed by particle embolics, make up the most widely used TACE protocol in the United States. Dr. Soulen reviews his preferred ratios and mixing method for maximal efficacy. He discusses his current RETNET trial that directly compares treatment of neuroendocrine tumors with conventional TACE versus bland embolization in terms of progression free survival, toxic side effects, and patient quality of life. Additionally, we address the high prevalence of post-embolization syndrome and SIR consensus guidelines for its management. Since chemoembolization is a highly emetogenic therapy, Dr. Soulen uses an oncology evidence-based combination of Benadryl, Zofran, and Decadron. He administers PRN pain medication on an individual patient basis. Furthermore, we discuss post-TACE management, specifically length of hospital stay. While all patients used to be admitted for overnight monitoring, this has shifted to mostly same-day discharges. This change has allowed the hospital to conserve resources and decrease costs. Finally, Dr. Soulen shares his perspective on new developments in interventional oncology. He highlights a need to identify TACE drugs that specifically target intratumoral hypoxic response mechanisms. He also compares transarterial radioembolization (TARE) to TACE, noting that the former has not shown superiority to systemic therapy in research trials. However, there are possibilities that TARE or TACE could be useful to slow tumor progression in radiation lobectomy or as immunostimulants for combination therapy with immune checkpoint inhibitors and CAR-T cell therapy. --- RESOURCES RETNET Trial: https://clinicaltrials.gov/ct2/show/NCT02724540 Transcatheter oily chemoembolization of hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/2536946/ Prospective Randomized Study of Doxorubicin-Eluting-Bead Embolization in the Treatment of Hepatocellular Carcinoma: Results of the PRECISION V Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816794/ Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/24937669/ Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion: https://pubmed.ncbi.nlm.nih.gov/26390875/ Outpatient Transarterial Chemoembolization of Hepatocellular Carcinoma: Review of a Same-Day Discharge Strategy: https://pubmed.ncbi.nlm.nih.gov/29478795/ Phase I Trial on Arterial Embolization with Hypoxia Activated Tirapazamine for Unresectable Hepatocellular Carcinoma: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8139681/ In this episode, guest host Dr. Nicholas Fidelman interviews Dr. Michael Solen, a key player in the development and widespread adoption of transarterial chemoembolization (TACE). The doctors discuss how TACE became a major therapeutic option for liver tumors, his preferred method of TACE dosage and management, and exciting new frontiers in chemoembolization.


---


CHECK OUT OUR SPONSOR


Varian, a Siemens Healthineers company

https://www.varian.com/


---


SHOW NOTES


Dr. Soulen recalls his first ever TACE patient, who was a patient self-referring for a rare neuroendocrine tumor. As an IR fellow at the University of Pennsylvania, Dr. Soulen recognized the opportunity to incorporate clinic time into his IR practice. His push for clinical management of IR patients resulted in successful medical and financial outcomes, which also led his hospital to establishing an interventional oncology clinic. He emphasizes that a clinic presence is crucial to participating in tumor boards and being able to accept outside referrals.


Next, we delve into the history of the CAM (cisplatin, adriamycin, mitomycin) conventional TACE cocktail, which Dr. Soulen developed alongside medical oncologists and pharmacists. These chemotherapeutics, combined with lipiodol and followed by particle embolics, make up the most widely used TACE protocol in the United States. Dr. Soulen reviews his preferred ratios and mixing method for maximal efficacy. He discusses his current RETNET trial that directly compares treatment of neuroendocrine tumors with conventional TACE versus bland embolization in terms of progression free survival, toxic side effects, and patient quality of life.


Additionally, we address the high prevalence of post-embolization syndrome and SIR consensus guidelines for its management. Since chemoembolization is a highly emetogenic therapy, Dr. Soulen uses an oncology evidence-based combination of Benadryl, Zofran, and Decadron. He administers PRN pain medication on an individual patient basis. Furthermore, we discuss post-TACE management, specifically length of hospital stay. While all patients used to be admitted for overnight monitoring, this has shifted to mostly same-day discharges. This change has allowed the hospital to conserve resources and decrease costs.


Finally, Dr. Soulen shares his perspective on new developments in interventional oncology. He highlights a need to identify TACE drugs that specifically target intratumoral hypoxic response mechanisms. He also compares transarterial radioembolization (TARE) to TACE, noting that the former has not shown superiority to systemic therapy in research trials. However, there are possibilities that TARE or TACE could be useful to slow tumor progression in radiation lobectomy or as immunostimulants for combination therapy with immune checkpoint inhibitors and CAR-T cell therapy.


---


RESOURCES


RETNET Trial:

https://clinicaltrials.gov/ct2/show/NCT02724540


Transcatheter oily chemoembolization of hepatocellular carcinoma:

https://pubmed.ncbi.nlm.nih.gov/2536946/


Prospective Randomized Study of Doxorubicin-Eluting-Bead Embolization in the Treatment of Hepatocellular Carcinoma: Results of the PRECISION V Study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816794/


Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma:

https://pubmed.ncbi.nlm.nih.gov/24937669/


Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion:

https://pubmed.ncbi.nlm.nih.gov/26390875/


Outpatient Transarterial Chemoembolization of Hepatocellular Carcinoma: Review of a Same-Day Discharge Strategy:

https://pubmed.ncbi.nlm.nih.gov/29478795/


Phase I Trial on Arterial Embolization with Hypoxia Activated Tirapazamine for Unresectable Hepatocellular Carcinoma:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8139681/

]]> 3413 Ep. 255 History of Ablative Procedures with Drs. Luigi Solbiati and Steven Raman In this episode, guest host Dr. Steven Raman interviews a founding father of percutaneous tumor ablation, Dr. Luigi Solbiati about the development of this revolutionary treatment, new therapies that have stemmed from it, and his vision for the future of interventional oncology. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/ --- SHOW NOTES Dr. Solbiati was a radiologist at the General Hospital of Busto Arsizio when he developed an interest in cancer in the 1980s. He traveled to the UK to learn about CT and ultrasound imaging. Upon his return to Italy, he combined this knowledge with his hospital’s department of pathology to obtain the first liver and abdominal ultrasound-guided biopsies for non-palpable lesions. Dr. Solbiati notes that in most of the world, ultrasound is personally performed by medical doctors, and it is an important skill to have. Next, we discover how Dr. Solbiati came to treat the first parathyroid adenoma using percutaneous ethanol injection. After Dr. Solbiati had performed a parathyroid tumor biopsy, the treatment team realized that her serum PTH levels had completely normalized due to compression of the overactive parenchyma. Inspired by this result, Dr. Solbiati researched past literature and saw the success of ethanol injection to cause sclerosis of liver and renal cysts. Since the patient was not a surgical candidate, she was willing to undergo ethanol injection, which was eventually successful. Dr. Solbiati explains that parathyroid tumors are hypervasculated and encapsulated, so they are able to contain ethanol and prevent diffusion. Additionally, the use of ultrasound made it possible for operators to visualize the amount of liquid ethanol entering a solid tumor. Overtime, Dr. Solbiati began to work with Dr. Tito Livraghi to inject ethanol and chemotherapeutics for hepatocellular carcinoma lesions. The outcomes from their initial studies are still used as benchmarks for locoregional therapies today. Their research gained publicity from scientific and non-scientific media, which came with both positive and negative reactions. Dr. Solbiati emphasizes the importance of collaboration with surgeons and other interventionalists to combine surgical, intravascular, and percutaneous therapies. Additionally, he also played a key role in the testing of cool-tip radiofrequency ablation. Dr. Solbiati highlights the significance of percutaneous ablation in advancing health equity. Ethanol and radiofrequency ablation are relatively cost-efficient and safe, which allows for higher quality of cancer treatment in resource-limited settings. He looks toward the future of interventional oncology as the “fourth pillar” of cancer care (in addition to medical, surgical, and radiation oncological treatments), the growing use of augmented reality for percutaneous procedures, and the increasing rate of combination therapy with immunologic agents. --- RESOURCES Percutaneous ethanol injection of parathyroid tumors under US guidance: treatment for secondary hyperparathyroidism (Radiology, 1985): https://pubmed.ncbi.nlm.nih.gov/3889999/ Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes (RSNA, 1997): https://pubs.rsna.org/doi/10.1148/radiology.205.2.9356616 Wed, 26 Oct 2022 05:00:00 -0000 full BackTable In this episode, guest host Dr. Steven Raman interviews a founding father of percutaneous tumor ablation, Dr. Luigi Solbiati about the development of this revolutionary treatment, new therapies that have stemmed from it, and his vision for the future of interventional oncology. In this episode, guest host Dr. Steven Raman interviews a founding father of percutaneous tumor ablation, Dr. Luigi Solbiati about the development of this revolutionary treatment, new therapies that have stemmed from it, and his vision for the future of interventional oncology. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/ --- SHOW NOTES Dr. Solbiati was a radiologist at the General Hospital of Busto Arsizio when he developed an interest in cancer in the 1980s. He traveled to the UK to learn about CT and ultrasound imaging. Upon his return to Italy, he combined this knowledge with his hospital’s department of pathology to obtain the first liver and abdominal ultrasound-guided biopsies for non-palpable lesions. Dr. Solbiati notes that in most of the world, ultrasound is personally performed by medical doctors, and it is an important skill to have. Next, we discover how Dr. Solbiati came to treat the first parathyroid adenoma using percutaneous ethanol injection. After Dr. Solbiati had performed a parathyroid tumor biopsy, the treatment team realized that her serum PTH levels had completely normalized due to compression of the overactive parenchyma. Inspired by this result, Dr. Solbiati researched past literature and saw the success of ethanol injection to cause sclerosis of liver and renal cysts. Since the patient was not a surgical candidate, she was willing to undergo ethanol injection, which was eventually successful. Dr. Solbiati explains that parathyroid tumors are hypervasculated and encapsulated, so they are able to contain ethanol and prevent diffusion. Additionally, the use of ultrasound made it possible for operators to visualize the amount of liquid ethanol entering a solid tumor. Overtime, Dr. Solbiati began to work with Dr. Tito Livraghi to inject ethanol and chemotherapeutics for hepatocellular carcinoma lesions. The outcomes from their initial studies are still used as benchmarks for locoregional therapies today. Their research gained publicity from scientific and non-scientific media, which came with both positive and negative reactions. Dr. Solbiati emphasizes the importance of collaboration with surgeons and other interventionalists to combine surgical, intravascular, and percutaneous therapies. Additionally, he also played a key role in the testing of cool-tip radiofrequency ablation. Dr. Solbiati highlights the significance of percutaneous ablation in advancing health equity. Ethanol and radiofrequency ablation are relatively cost-efficient and safe, which allows for higher quality of cancer treatment in resource-limited settings. He looks toward the future of interventional oncology as the “fourth pillar” of cancer care (in addition to medical, surgical, and radiation oncological treatments), the growing use of augmented reality for percutaneous procedures, and the increasing rate of combination therapy with immunologic agents. --- RESOURCES Percutaneous ethanol injection of parathyroid tumors under US guidance: treatment for secondary hyperparathyroidism (Radiology, 1985): https://pubmed.ncbi.nlm.nih.gov/3889999/ Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes (RSNA, 1997): https://pubs.rsna.org/doi/10.1148/radiology.205.2.9356616 In this episode, guest host Dr. Steven Raman interviews a founding father of percutaneous tumor ablation, Dr. Luigi Solbiati about the development of this revolutionary treatment, new therapies that have stemmed from it, and his vision for the future of interventional oncology.


---


CHECK OUT OUR SPONSOR


Varian, a Siemens Healthineers company

https://www.varian.com/


---


SHOW NOTES


Dr. Solbiati was a radiologist at the General Hospital of Busto Arsizio when he developed an interest in cancer in the 1980s. He traveled to the UK to learn about CT and ultrasound imaging. Upon his return to Italy, he combined this knowledge with his hospital’s department of pathology to obtain the first liver and abdominal ultrasound-guided biopsies for non-palpable lesions. Dr. Solbiati notes that in most of the world, ultrasound is personally performed by medical doctors, and it is an important skill to have.


Next, we discover how Dr. Solbiati came to treat the first parathyroid adenoma using percutaneous ethanol injection. After Dr. Solbiati had performed a parathyroid tumor biopsy, the treatment team realized that her serum PTH levels had completely normalized due to compression of the overactive parenchyma. Inspired by this result, Dr. Solbiati researched past literature and saw the success of ethanol injection to cause sclerosis of liver and renal cysts. Since the patient was not a surgical candidate, she was willing to undergo ethanol injection, which was eventually successful. Dr. Solbiati explains that parathyroid tumors are hypervasculated and encapsulated, so they are able to contain ethanol and prevent diffusion. Additionally, the use of ultrasound made it possible for operators to visualize the amount of liquid ethanol entering a solid tumor.


Overtime, Dr. Solbiati began to work with Dr. Tito Livraghi to inject ethanol and chemotherapeutics for hepatocellular carcinoma lesions. The outcomes from their initial studies are still used as benchmarks for locoregional therapies today. Their research gained publicity from scientific and non-scientific media, which came with both positive and negative reactions. Dr. Solbiati emphasizes the importance of collaboration with surgeons and other interventionalists to combine surgical, intravascular, and percutaneous therapies. Additionally, he also played a key role in the testing of cool-tip radiofrequency ablation.


Dr. Solbiati highlights the significance of percutaneous ablation in advancing health equity. Ethanol and radiofrequency ablation are relatively cost-efficient and safe, which allows for higher quality of cancer treatment in resource-limited settings. He looks toward the future of interventional oncology as the “fourth pillar” of cancer care (in addition to medical, surgical, and radiation oncological treatments), the growing use of augmented reality for percutaneous procedures, and the increasing rate of combination therapy with immunologic agents.


---


RESOURCES


Percutaneous ethanol injection of parathyroid tumors under US guidance: treatment for secondary hyperparathyroidism (Radiology, 1985):

https://pubmed.ncbi.nlm.nih.gov/3889999/


Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes (RSNA, 1997):

https://pubs.rsna.org/doi/10.1148/radiology.205.2.9356616

]]> 2632 Ep 254 Who is SIO? Past, Present and Future of Our Society with Drs. Bill Rilling, Sarah White, and Sean Tutton In this episode, guest host Dr. Sean Tutton interviews Dr. Bill Rilling and Dr. Sarah White about the history of the Society of Interventional Oncology (SIO), their current research and volunteer involvement, and future directions of the society. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/ --- SHOW NOTES We begin by discussing how the Society of Interventional Oncology (SIO) began. It started as the World Conference of Interventional Oncology (WCIO), but was formed into an official society with the goal to become the fourth pillar of oncology care, in addition to surgical oncology, medical oncology and radiation oncology. At the time of its inception, the group asked themselves whether interventional oncology would be bettered by the addition of a professional membership society, and there was a thoughtful and unified decision that it would be. Next, we discuss what goes into forming a society? When asking people to become members, pay money and give their time, they will expect some return on their investment. It's important to have a formal society, as it greatly advances the field forward. The ability to focus resources and effort completely on what you're passionate about is what having SIO allows. At SIO, we want people to be members of both SIR and SIO, it should be both, not one or the other. Finally, we talk about some of the current research funded by SIO. SIO fulfills the research aspect of the society by creating data, currently via the Ablation with Confirmation of Colorectal Liver Metastasis (ACCLAIM) Trial. This trial uses software to determine post-treatment margins in percutaneous microwave ablation for colorectal metastasis of the liver. With this trial, they hope to prove that this procedure results in high rates of clear margins, which will make it a minimally invasive alternative to surgical resection. Future research efforts will likely focus on coupling locoregional therapy with targeted immunotherapy. They aim to start treating new cancers, develop further partnerships with industry and pharma, and continue to produce quality data on response rates to promote interventional oncology as the well respected and accepted fourth pillar of oncology. --- RESOURCES SIO: www.sio-central.org ACCLAIM Trial: www.sio-central.org/p/cm/ld/fid=809 Mon, 24 Oct 2022 05:00:00 -0000 full BackTable In this episode, guest host Dr. Sean Tutton interviews Dr. Bill Rilling and Dr. Sarah White about the history of the Society of Interventional Oncology (SIO), their current research and volunteer involvement, and future directions of the society. In this episode, guest host Dr. Sean Tutton interviews Dr. Bill Rilling and Dr. Sarah White about the history of the Society of Interventional Oncology (SIO), their current research and volunteer involvement, and future directions of the society. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/ --- SHOW NOTES We begin by discussing how the Society of Interventional Oncology (SIO) began. It started as the World Conference of Interventional Oncology (WCIO), but was formed into an official society with the goal to become the fourth pillar of oncology care, in addition to surgical oncology, medical oncology and radiation oncology. At the time of its inception, the group asked themselves whether interventional oncology would be bettered by the addition of a professional membership society, and there was a thoughtful and unified decision that it would be. Next, we discuss what goes into forming a society? When asking people to become members, pay money and give their time, they will expect some return on their investment. It's important to have a formal society, as it greatly advances the field forward. The ability to focus resources and effort completely on what you're passionate about is what having SIO allows. At SIO, we want people to be members of both SIR and SIO, it should be both, not one or the other. Finally, we talk about some of the current research funded by SIO. SIO fulfills the research aspect of the society by creating data, currently via the Ablation with Confirmation of Colorectal Liver Metastasis (ACCLAIM) Trial. This trial uses software to determine post-treatment margins in percutaneous microwave ablation for colorectal metastasis of the liver. With this trial, they hope to prove that this procedure results in high rates of clear margins, which will make it a minimally invasive alternative to surgical resection. Future research efforts will likely focus on coupling locoregional therapy with targeted immunotherapy. They aim to start treating new cancers, develop further partnerships with industry and pharma, and continue to produce quality data on response rates to promote interventional oncology as the well respected and accepted fourth pillar of oncology. --- RESOURCES SIO: www.sio-central.org ACCLAIM Trial: www.sio-central.org/p/cm/ld/fid=809 In this episode, guest host Dr. Sean Tutton interviews Dr. Bill Rilling and Dr. Sarah White about the history of the Society of Interventional Oncology (SIO), their current research and volunteer involvement, and future directions of the society.


---


CHECK OUT OUR SPONSOR


Varian, a Siemens Healthineers company

https://www.varian.com/


---


SHOW NOTES


We begin by discussing how the Society of Interventional Oncology (SIO) began. It started as the World Conference of Interventional Oncology (WCIO), but was formed into an official society with the goal to become the fourth pillar of oncology care, in addition to surgical oncology, medical oncology and radiation oncology. At the time of its inception, the group asked themselves whether interventional oncology would be bettered by the addition of a professional membership society, and there was a thoughtful and unified decision that it would be.


Next, we discuss what goes into forming a society? When asking people to become members, pay money and give their time, they will expect some return on their investment. It's important to have a formal society, as it greatly advances the field forward. The ability to focus resources and effort completely on what you're passionate about is what having SIO allows. At SIO, we want people to be members of both SIR and SIO, it should be both, not one or the other.


Finally, we talk about some of the current research funded by SIO. SIO fulfills the research aspect of the society by creating data, currently via the Ablation with Confirmation of Colorectal Liver Metastasis (ACCLAIM) Trial. This trial uses software to determine post-treatment margins in percutaneous microwave ablation for colorectal metastasis of the liver. With this trial, they hope to prove that this procedure results in high rates of clear margins, which will make it a minimally invasive alternative to surgical resection. Future research efforts will likely focus on coupling locoregional therapy with targeted immunotherapy. They aim to start treating new cancers, develop further partnerships with industry and pharma, and continue to produce quality data on response rates to promote interventional oncology as the well respected and accepted fourth pillar of oncology.


---


RESOURCES


SIO:

www.sio-central.org


ACCLAIM Trial:

www.sio-central.org/p/cm/ld/fid=809

]]> 2411 Ep. 253 How I Place Nephrostomy Tubes with Dr. Aaron Fritts In this back to the basics episode, Dr. Christopher Beck interviews Dr. Aaron Fritts about his standard procedure for nephrostomy tube placement, preferred tools, and troubleshooting tips. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/yEfEUY --- SHOW NOTES Dr. Fritts says that most of his referrals come from urology, and patients need treatment for hydronephrosis, kidney stones, and pre-operative access for lithotripsy. He goes over his workup, which can be expedited in emergency cases. He checks for normal coagulation tests and anticoagulation medications, since bleeding is the most common and dangerous complication of the procedure. Both doctors prefer to use CT imaging to map out the procedure, identify stone burden, and decide which calyx to access. It is important to use CT to make note of and avoid the colon (lateral) and paraspinal muscles (medial) when choosing an access site. Dr. Fritts also marks the access site before the patient gets prepped for the procedure, in order to ensure that the correct area is cleaned. Patients are usually under moderate sedation with versed and fentanyl. Then the doctors walk through a typical nephrostomy tube placement under ultrasound guidance. They emphasize that lidocaine needs to be injected all the way down to the cortex to maximize patient comfort and decrease the likelihood of patient movement during the procedure. Then, the needle is inserted into a calyx. While it is standard to access the lower pole to minimize bleeding risk, Dr. Beck sometimes prefers mid-pole access since this provides a shorter distance from skin to target and a more favorable angle to enter the ureter from the renal pelvis. The upper pole is generally avoided due to risk of diaphragmatic puncture, but it can be accessed if a stone is present there. Dr. Beck shares a tip about injecting saline to plump up the calyces and allow for better access. Dr. Fritts describes the two-stick technique that was primarily used before ultrasound access was available. He also recommends communicating with urologists in lithotripsy patients to identify optimal access sites for each patient’s lithotripsy. If the wire is placed directly on top of the stone and you have difficulty maneuvering the wire around the stone, you can inject saline to dilate the system and obtain a better angle for the wire. Finally, the doctors talk about drain selection, which is usually an 8Fr or 10Fr. The drain is secured with stitches, and possibly a bumper stitch. Pyonephrosis patients are usually kept inpatient, while other patients can get discharged after two hours. It is important to watch for hematuria and distinguish between mildly red venous blood from minor procedural trauma (which will subside) and bright red blood from arterial damage. --- RESOURCES SIR Now: https://sirnow.sirweb.org/ Ep. 97- Nephrostomy Tube Placement with Dr. David Feld: https://www.backtable.com/shows/vi/podcasts/97/nephrostomy-tube-placement-basic-to-advanced Diuretic agent and normal saline infusion technique for ultrasound-guided percutaneous nephrostomies in nondilated pelvicaliceal systems: https://pubmed.ncbi.nlm.nih.gov/22893420/ Bumper Stitch for Drainage Tube Securement: https://www.jvir.org/article/S1051-0443(11)01353-4/pdf Fri, 21 Oct 2022 05:00:00 -0000 full BackTable In this back to the basics episode, Dr. Christopher Beck interviews Dr. Aaron Fritts about his standard procedure for nephrostomy tube placement, preferred tools, and troubleshooting tips. In this back to the basics episode, Dr. Christopher Beck interviews Dr. Aaron Fritts about his standard procedure for nephrostomy tube placement, preferred tools, and troubleshooting tips. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/yEfEUY --- SHOW NOTES Dr. Fritts says that most of his referrals come from urology, and patients need treatment for hydronephrosis, kidney stones, and pre-operative access for lithotripsy. He goes over his workup, which can be expedited in emergency cases. He checks for normal coagulation tests and anticoagulation medications, since bleeding is the most common and dangerous complication of the procedure. Both doctors prefer to use CT imaging to map out the procedure, identify stone burden, and decide which calyx to access. It is important to use CT to make note of and avoid the colon (lateral) and paraspinal muscles (medial) when choosing an access site. Dr. Fritts also marks the access site before the patient gets prepped for the procedure, in order to ensure that the correct area is cleaned. Patients are usually under moderate sedation with versed and fentanyl. Then the doctors walk through a typical nephrostomy tube placement under ultrasound guidance. They emphasize that lidocaine needs to be injected all the way down to the cortex to maximize patient comfort and decrease the likelihood of patient movement during the procedure. Then, the needle is inserted into a calyx. While it is standard to access the lower pole to minimize bleeding risk, Dr. Beck sometimes prefers mid-pole access since this provides a shorter distance from skin to target and a more favorable angle to enter the ureter from the renal pelvis. The upper pole is generally avoided due to risk of diaphragmatic puncture, but it can be accessed if a stone is present there. Dr. Beck shares a tip about injecting saline to plump up the calyces and allow for better access. Dr. Fritts describes the two-stick technique that was primarily used before ultrasound access was available. He also recommends communicating with urologists in lithotripsy patients to identify optimal access sites for each patient’s lithotripsy. If the wire is placed directly on top of the stone and you have difficulty maneuvering the wire around the stone, you can inject saline to dilate the system and obtain a better angle for the wire. Finally, the doctors talk about drain selection, which is usually an 8Fr or 10Fr. The drain is secured with stitches, and possibly a bumper stitch. Pyonephrosis patients are usually kept inpatient, while other patients can get discharged after two hours. It is important to watch for hematuria and distinguish between mildly red venous blood from minor procedural trauma (which will subside) and bright red blood from arterial damage. --- RESOURCES SIR Now: https://sirnow.sirweb.org/ Ep. 97- Nephrostomy Tube Placement with Dr. David Feld: https://www.backtable.com/shows/vi/podcasts/97/nephrostomy-tube-placement-basic-to-advanced Diuretic agent and normal saline infusion technique for ultrasound-guided percutaneous nephrostomies in nondilated pelvicaliceal systems: https://pubmed.ncbi.nlm.nih.gov/22893420/ Bumper Stitch for Drainage Tube Securement: https://www.jvir.org/article/S1051-0443(11)01353-4/pdf In this back to the basics episode, Dr. Christopher Beck interviews Dr. Aaron Fritts about his standard procedure for nephrostomy tube placement, preferred tools, and troubleshooting tips.


---


CHECK OUT OUR SPONSOR


Reflow Medical

https://www.reflowmedical.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/yEfEUY


---


SHOW NOTES


Dr. Fritts says that most of his referrals come from urology, and patients need treatment for hydronephrosis, kidney stones, and pre-operative access for lithotripsy. He goes over his workup, which can be expedited in emergency cases. He checks for normal coagulation tests and anticoagulation medications, since bleeding is the most common and dangerous complication of the procedure. Both doctors prefer to use CT imaging to map out the procedure, identify stone burden, and decide which calyx to access. It is important to use CT to make note of and avoid the colon (lateral) and paraspinal muscles (medial) when choosing an access site. Dr. Fritts also marks the access site before the patient gets prepped for the procedure, in order to ensure that the correct area is cleaned. Patients are usually under moderate sedation with versed and fentanyl.


Then the doctors walk through a typical nephrostomy tube placement under ultrasound guidance. They emphasize that lidocaine needs to be injected all the way down to the cortex to maximize patient comfort and decrease the likelihood of patient movement during the procedure. Then, the needle is inserted into a calyx. While it is standard to access the lower pole to minimize bleeding risk, Dr. Beck sometimes prefers mid-pole access since this provides a shorter distance from skin to target and a more favorable angle to enter the ureter from the renal pelvis. The upper pole is generally avoided due to risk of diaphragmatic puncture, but it can be accessed if a stone is present there. Dr. Beck shares a tip about injecting saline to plump up the calyces and allow for better access.


Dr. Fritts describes the two-stick technique that was primarily used before ultrasound access was available. He also recommends communicating with urologists in lithotripsy patients to identify optimal access sites for each patient’s lithotripsy. If the wire is placed directly on top of the stone and you have difficulty maneuvering the wire around the stone, you can inject saline to dilate the system and obtain a better angle for the wire.


Finally, the doctors talk about drain selection, which is usually an 8Fr or 10Fr. The drain is secured with stitches, and possibly a bumper stitch. Pyonephrosis patients are usually kept inpatient, while other patients can get discharged after two hours. It is important to watch for hematuria and distinguish between mildly red venous blood from minor procedural trauma (which will subside) and bright red blood from arterial damage.


---


RESOURCES


SIR Now:

https://sirnow.sirweb.org/


Ep. 97- Nephrostomy Tube Placement with Dr. David Feld:

https://www.backtable.com/shows/vi/podcasts/97/nephrostomy-tube-placement-basic-to-advanced


Diuretic agent and normal saline infusion technique for ultrasound-guided percutaneous nephrostomies in nondilated pelvicaliceal systems:

https://pubmed.ncbi.nlm.nih.gov/22893420/


Bumper Stitch for Drainage Tube Securement:

https://www.jvir.org/article/S1051-0443(11)01353-4/pdf

]]> 5251 Ep. 252 How I Place Gastrostomy Tubes with Dr. Chris Beck In this episode, Dr. Aaron Fritts interviews Dr. Christopher Beck about gastrostomy tubes, including the evolution of his method, tips for patients who pull their tubes out, and why g-tubes are such a controversial topic in IR. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/B9TbcW --- SHOW NOTES We begin by discussing indications and contraindications for gastrostomy tubes. Frequent indications are stroke patients, head and neck cancer patients, and trauma patients. Contraindications include uncorrectable coagulopathy, ascites, peritoneal carcinomatosis, or something interposed between the abdominal wall and the stomach, such as liver or bowel. Dr. Beck prefers having imaging to review, which most patients have. If no prior imaging is available, he will get a non-contrast CT abdomen the day of the procedure. He likes all his patients to drink barium for visualization of bowel during the procedure, but will not cancel the procedure if they didn’t drink it, as the insufflation should move bowel out of the way and there should be enough bowel gas to identify and avoid the bowel. Next, Dr. Beck reviews the details of his method. He likes to use monitored anesthesia care (MAC), because frequently he has patients with bad Mallampati scores. Additionally, anesthesia is very helpful with NG placement. Furthermore, it makes the procedure much more comfortable for the patient. He always checks liver margins with ultrasound prior to starting the procedure. He always gives 1 mg glucagon before insufflation and antibiotics per the SIR Guidelines App. As for equipment, he uses t-fasteners from Avanos, a dilator set, and a 20Fr G-tube. He used to start with 16Fr but found he frequently had to size up to a 20Fr. He uses a 24Fr peel away sheath. For the procedure, he insufflates, marks his entry point with a hemostat, and then numbs in all 3 spots where he will place his gastropexies. He uses 1/2 syringe of contrast for his gastropexy placement. He uses 2 t-tags, and prefers the C-arm in RAO rather than AP during this step. For G-tube placement, he aims 20 degrees toward the pylorus, and always makes sure he sees wire touching two walls of the stomach to ensure he is intraluminal. He uses sterile water to inflate the balloon rather than saline or contrast. Lastly, he always makes sure to get a good final image to confirm placement in the stomach. For post-care, on inpatients he rounds the next morning, checking that the tube flushes and then clears it for use. For outpatients, he recommends no feeding (via G or NG) for three hours and a consult with a dietician before discharge. After this, the patient can receive nutrition via NG. If the patient has no peritoneal signs, the G-tube can be used the next day. For tube management, he exchanges the tube every 6 months or sooner if there is an issue, such as the tube being pulled out or becoming clogged beyond the point of a bedside fix. --- RESOURCES BackTable YouTube Gastrostomy Tube Demo: https://www.youtube.com/watch?v=17ep0AEkKqs Early Initiation of Enteral Feeding: https://pubmed.ncbi.nlm.nih.gov/24674218/ SIR Guidelines App: https://apps.apple.com/us/app/sir-guidelines/id1552455529 Mon, 17 Oct 2022 05:00:00 -0000 full BackTable In this episode, Dr. Aaron Fritts interviews Dr. Christopher Beck about gastrostomy tubes, including the evolution of his method, tips for patients who pull their tubes out, and why g-tubes are such a controversial topic in IR. In this episode, Dr. Aaron Fritts interviews Dr. Christopher Beck about gastrostomy tubes, including the evolution of his method, tips for patients who pull their tubes out, and why g-tubes are such a controversial topic in IR. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/B9TbcW --- SHOW NOTES We begin by discussing indications and contraindications for gastrostomy tubes. Frequent indications are stroke patients, head and neck cancer patients, and trauma patients. Contraindications include uncorrectable coagulopathy, ascites, peritoneal carcinomatosis, or something interposed between the abdominal wall and the stomach, such as liver or bowel. Dr. Beck prefers having imaging to review, which most patients have. If no prior imaging is available, he will get a non-contrast CT abdomen the day of the procedure. He likes all his patients to drink barium for visualization of bowel during the procedure, but will not cancel the procedure if they didn’t drink it, as the insufflation should move bowel out of the way and there should be enough bowel gas to identify and avoid the bowel. Next, Dr. Beck reviews the details of his method. He likes to use monitored anesthesia care (MAC), because frequently he has patients with bad Mallampati scores. Additionally, anesthesia is very helpful with NG placement. Furthermore, it makes the procedure much more comfortable for the patient. He always checks liver margins with ultrasound prior to starting the procedure. He always gives 1 mg glucagon before insufflation and antibiotics per the SIR Guidelines App. As for equipment, he uses t-fasteners from Avanos, a dilator set, and a 20Fr G-tube. He used to start with 16Fr but found he frequently had to size up to a 20Fr. He uses a 24Fr peel away sheath. For the procedure, he insufflates, marks his entry point with a hemostat, and then numbs in all 3 spots where he will place his gastropexies. He uses 1/2 syringe of contrast for his gastropexy placement. He uses 2 t-tags, and prefers the C-arm in RAO rather than AP during this step. For G-tube placement, he aims 20 degrees toward the pylorus, and always makes sure he sees wire touching two walls of the stomach to ensure he is intraluminal. He uses sterile water to inflate the balloon rather than saline or contrast. Lastly, he always makes sure to get a good final image to confirm placement in the stomach. For post-care, on inpatients he rounds the next morning, checking that the tube flushes and then clears it for use. For outpatients, he recommends no feeding (via G or NG) for three hours and a consult with a dietician before discharge. After this, the patient can receive nutrition via NG. If the patient has no peritoneal signs, the G-tube can be used the next day. For tube management, he exchanges the tube every 6 months or sooner if there is an issue, such as the tube being pulled out or becoming clogged beyond the point of a bedside fix. --- RESOURCES BackTable YouTube Gastrostomy Tube Demo: https://www.youtube.com/watch?v=17ep0AEkKqs Early Initiation of Enteral Feeding: https://pubmed.ncbi.nlm.nih.gov/24674218/ SIR Guidelines App: https://apps.apple.com/us/app/sir-guidelines/id1552455529 In this episode, Dr. Aaron Fritts interviews Dr. Christopher Beck about gastrostomy tubes, including the evolution of his method, tips for patients who pull their tubes out, and why g-tubes are such a controversial topic in IR.


---


CHECK OUT OUR SPONSOR


Laurel Road for Doctors

https://www.laurelroad.com/healthcare-banking/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/B9TbcW


---


SHOW NOTES


We begin by discussing indications and contraindications for gastrostomy tubes. Frequent indications are stroke patients, head and neck cancer patients, and trauma patients. Contraindications include uncorrectable coagulopathy, ascites, peritoneal carcinomatosis, or something interposed between the abdominal wall and the stomach, such as liver or bowel. Dr. Beck prefers having imaging to review, which most patients have. If no prior imaging is available, he will get a non-contrast CT abdomen the day of the procedure. He likes all his patients to drink barium for visualization of bowel during the procedure, but will not cancel the procedure if they didn’t drink it, as the insufflation should move bowel out of the way and there should be enough bowel gas to identify and avoid the bowel.


Next, Dr. Beck reviews the details of his method. He likes to use monitored anesthesia care (MAC), because frequently he has patients with bad Mallampati scores. Additionally, anesthesia is very helpful with NG placement. Furthermore, it makes the procedure much more comfortable for the patient. He always checks liver margins with ultrasound prior to starting the procedure. He always gives 1 mg glucagon before insufflation and antibiotics per the SIR Guidelines App. As for equipment, he uses t-fasteners from Avanos, a dilator set, and a 20Fr G-tube. He used to start with 16Fr but found he frequently had to size up to a 20Fr. He uses a 24Fr peel away sheath. For the procedure, he insufflates, marks his entry point with a hemostat, and then numbs in all 3 spots where he will place his gastropexies. He uses 1/2 syringe of contrast for his gastropexy placement. He uses 2 t-tags, and prefers the C-arm in RAO rather than AP during this step. For G-tube placement, he aims 20 degrees toward the pylorus, and always makes sure he sees wire touching two walls of the stomach to ensure he is intraluminal. He uses sterile water to inflate the balloon rather than saline or contrast. Lastly, he always makes sure to get a good final image to confirm placement in the stomach.


For post-care, on inpatients he rounds the next morning, checking that the tube flushes and then clears it for use. For outpatients, he recommends no feeding (via G or NG) for three hours and a consult with a dietician before discharge. After this, the patient can receive nutrition via NG. If the patient has no peritoneal signs, the G-tube can be used the next day. For tube management, he exchanges the tube every 6 months or sooner if there is an issue, such as the tube being pulled out or becoming clogged beyond the point of a bedside fix.


---


RESOURCES


BackTable YouTube Gastrostomy Tube Demo:

https://www.youtube.com/watch?v=17ep0AEkKqs


Early Initiation of Enteral Feeding:

https://pubmed.ncbi.nlm.nih.gov/24674218/


SIR Guidelines App:

https://apps.apple.com/us/app/sir-guidelines/id1552455529

]]> 4234 Ep. 251 Race and AI in Radiology with Dr. Judy Gichoya In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Judy Gichoya about her recent paper on artificial intelligence (AI) and the use of a deep learning model to recognize patients’ self-described racial identity, based on radiology images. --- CHECK OUT OUR SPONSORS Medtronic Concerto https://mobile.twitter.com/mdtvascular Viz.ai https://www.viz.ai/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XIPsKR --- SHOW NOTES Dr. Gichoya had started by tackling the original problem of bias in diagnoses for chest X-rays, since it has always been difficult to tell whether something is a real diagnosis, or simply just a finding. Her team built a deep learning model; however, they saw that it did not work well for black patients. With further investigation, they discovered that their model had learned signals that correlated with self-identified race. Intrigued by this finding, Dr. Gichoya and her team sought to identify the factors that the model used when making its race determination. Because AI is black box in nature, the methods by which the algorithm learns remains largely unknown. When tested in other imaging modalities (mammogram, chest CT, spine imaging), the model still showed high accuracy. Additionally, the model retained accuracy when different information was eliminated from the images (ex. age, disease distributions, bone densities). The model was also able to predict race in healthy patients, showing that it did not rely on patterns of disease prevalence in specific ethnic groups. Next, we spoke about the implications of this research in developing risk scores. Deep learning models are able to look at factors that humans are not trained or able to see. Dr. Gichoya highlights the model’s potential effectiveness in predicting osteoarthritis risk in black patients. We also look at applications in opportunistic screening and information about social determinants of health. For example, most patients presenting with chest pain often get chest CTs. Dr. Gichoya thinks that these images can be used by the model to learn about patients’ environmental exposures, like pollution. We finish the episode with a discussion on the changing landscape of IR and how AI can be used as an assistive technology. Interventional cardiologists are already using AI to dictate their procedural reports in real-time. In the interventional oncology space, AI could help integrate imaging and pathology findings to determine personalized treatment courses. All of these applications depend on researchers’ ability to market their findings to peers and the public, Dr. Gichoya gives tips on how to do this. --- RESOURCES AI recognition of patient race in medical imaging: a modelling study: https://www.thelancet.com/journals/landig/article/PIIS2589-7500(22)00063-2/fulltext Fri, 14 Oct 2022 05:00:00 -0000 full BackTable In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Judy Gichoya about her recent paper on artificial intelligence (AI) and the use of a deep learning model to recognize patients’ self-described racial identity, based on radiology images. In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Judy Gichoya about her recent paper on artificial intelligence (AI) and the use of a deep learning model to recognize patients’ self-described racial identity, based on radiology images. --- CHECK OUT OUR SPONSORS Medtronic Concerto https://mobile.twitter.com/mdtvascular Viz.ai https://www.viz.ai/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XIPsKR --- SHOW NOTES Dr. Gichoya had started by tackling the original problem of bias in diagnoses for chest X-rays, since it has always been difficult to tell whether something is a real diagnosis, or simply just a finding. Her team built a deep learning model; however, they saw that it did not work well for black patients. With further investigation, they discovered that their model had learned signals that correlated with self-identified race. Intrigued by this finding, Dr. Gichoya and her team sought to identify the factors that the model used when making its race determination. Because AI is black box in nature, the methods by which the algorithm learns remains largely unknown. When tested in other imaging modalities (mammogram, chest CT, spine imaging), the model still showed high accuracy. Additionally, the model retained accuracy when different information was eliminated from the images (ex. age, disease distributions, bone densities). The model was also able to predict race in healthy patients, showing that it did not rely on patterns of disease prevalence in specific ethnic groups. Next, we spoke about the implications of this research in developing risk scores. Deep learning models are able to look at factors that humans are not trained or able to see. Dr. Gichoya highlights the model’s potential effectiveness in predicting osteoarthritis risk in black patients. We also look at applications in opportunistic screening and information about social determinants of health. For example, most patients presenting with chest pain often get chest CTs. Dr. Gichoya thinks that these images can be used by the model to learn about patients’ environmental exposures, like pollution. We finish the episode with a discussion on the changing landscape of IR and how AI can be used as an assistive technology. Interventional cardiologists are already using AI to dictate their procedural reports in real-time. In the interventional oncology space, AI could help integrate imaging and pathology findings to determine personalized treatment courses. All of these applications depend on researchers’ ability to market their findings to peers and the public, Dr. Gichoya gives tips on how to do this. --- RESOURCES AI recognition of patient race in medical imaging: a modelling study: https://www.thelancet.com/journals/landig/article/PIIS2589-7500(22)00063-2/fulltext In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Judy Gichoya about her recent paper on artificial intelligence (AI) and the use of a deep learning model to recognize patients’ self-described racial identity, based on radiology images.


---


CHECK OUT OUR SPONSORS


Medtronic Concerto

https://mobile.twitter.com/mdtvascular


Viz.ai

https://www.viz.ai/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XIPsKR


---


SHOW NOTES


Dr. Gichoya had started by tackling the original problem of bias in diagnoses for chest X-rays, since it has always been difficult to tell whether something is a real diagnosis, or simply just a finding. Her team built a deep learning model; however, they saw that it did not work well for black patients. With further investigation, they discovered that their model had learned signals that correlated with self-identified race.


Intrigued by this finding, Dr. Gichoya and her team sought to identify the factors that the model used when making its race determination. Because AI is black box in nature, the methods by which the algorithm learns remains largely unknown. When tested in other imaging modalities (mammogram, chest CT, spine imaging), the model still showed high accuracy. Additionally, the model retained accuracy when different information was eliminated from the images (ex. age, disease distributions, bone densities). The model was also able to predict race in healthy patients, showing that it did not rely on patterns of disease prevalence in specific ethnic groups.


Next, we spoke about the implications of this research in developing risk scores. Deep learning models are able to look at factors that humans are not trained or able to see. Dr. Gichoya highlights the model’s potential effectiveness in predicting osteoarthritis risk in black patients. We also look at applications in opportunistic screening and information about social determinants of health. For example, most patients presenting with chest pain often get chest CTs. Dr. Gichoya thinks that these images can be used by the model to learn about patients’ environmental exposures, like pollution.


We finish the episode with a discussion on the changing landscape of IR and how AI can be used as an assistive technology. Interventional cardiologists are already using AI to dictate their procedural reports in real-time. In the interventional oncology space, AI could help integrate imaging and pathology findings to determine personalized treatment courses. All of these applications depend on researchers’ ability to market their findings to peers and the public, Dr. Gichoya gives tips on how to do this.


---


RESOURCES


AI recognition of patient race in medical imaging: a modelling study:

https://www.thelancet.com/journals/landig/article/PIIS2589-7500(22)00063-2/fulltext

]]> 2056 Ep. 250 The Evolution of Trauma Care in Interventional Radiology with Dr. Mark Wilson In this episode, Dr. Vishal Kumar interviews Dr. Mark Wilson, vice chair and professor of radiology and biomedical imaging at UCSF, and chief of diagnostic and interventional radiology at the Zuckerberg San Francisco General Hospital and Trauma Center about the evolution of trauma care in interventional radiology, translational research, and the impact of mentorship and student outreach. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/0RPqzN --- SHOW NOTES We begin by discussing how Dr. Wilson discovered radiology, and how he has come to be a leader in IR. He started out with an interest in psychiatry, and became involved in research on psychiatric brain imaging. As he delved deeper into biomedical imaging, his fascination grew. With help from his mentor, he began publishing, which motivated him to further pursue his passion for research. He learned about IR, and then got into UCSF for his radiology residency. Being at the frontier of innovations, Dr. Wilson has been involved in research on MR guided interventions, remote navigation, and percutaneous venous chemo filters. He says these projects have reinforced that radiology and research isn’t done in a vacuum. He depends on his collaborators in material science, chemistry, and other fields to successfully innovate. One thing he loves about the research lab is the student involvement, and getting to see high school and college students get their name on a paper. This is one area of student outreach that has an incredible impact and shapes future leaders in radiology and medicine. Finally, we discuss how Dr. Wilson spearheaded the role of radiology within the hospital infrastructure when they created the new SF General Hospital, the Zuckerberg San Francisco General Hospital and Trauma Center. He collaborated with hospital leadership and architects, as well as emergency medicine, surgery, anesthesia and nursing to build a state of the art trauma care center to serve the people of San Francisco. It fulfills its goal of bringing the services to the patient to deliver better and more efficient care. From CT scanners in the ED, to a hybrid trauma OR, this new center is one of the leading IR and trauma centers in the world. --- RESOURCES The History of the Zuckerberg San Francisco General Hospital and Trauma Center: https://zuckerbergsanfranciscogeneral.org/about-us/our-history/ Mon, 10 Oct 2022 05:00:00 -0000 full BackTable In this episode, Dr. Vishal Kumar interviews Dr. Mark Wilson, vice chair and professor of radiology and biomedical imaging at UCSF, and chief of diagnostic and interventional radiology at the Zuckerberg San Francisco General Hospital and Trauma Center about the evolution of trauma care in interventional radiology, translational research, and the impact of mentorship and student outreach. In this episode, Dr. Vishal Kumar interviews Dr. Mark Wilson, vice chair and professor of radiology and biomedical imaging at UCSF, and chief of diagnostic and interventional radiology at the Zuckerberg San Francisco General Hospital and Trauma Center about the evolution of trauma care in interventional radiology, translational research, and the impact of mentorship and student outreach. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/0RPqzN --- SHOW NOTES We begin by discussing how Dr. Wilson discovered radiology, and how he has come to be a leader in IR. He started out with an interest in psychiatry, and became involved in research on psychiatric brain imaging. As he delved deeper into biomedical imaging, his fascination grew. With help from his mentor, he began publishing, which motivated him to further pursue his passion for research. He learned about IR, and then got into UCSF for his radiology residency. Being at the frontier of innovations, Dr. Wilson has been involved in research on MR guided interventions, remote navigation, and percutaneous venous chemo filters. He says these projects have reinforced that radiology and research isn’t done in a vacuum. He depends on his collaborators in material science, chemistry, and other fields to successfully innovate. One thing he loves about the research lab is the student involvement, and getting to see high school and college students get their name on a paper. This is one area of student outreach that has an incredible impact and shapes future leaders in radiology and medicine. Finally, we discuss how Dr. Wilson spearheaded the role of radiology within the hospital infrastructure when they created the new SF General Hospital, the Zuckerberg San Francisco General Hospital and Trauma Center. He collaborated with hospital leadership and architects, as well as emergency medicine, surgery, anesthesia and nursing to build a state of the art trauma care center to serve the people of San Francisco. It fulfills its goal of bringing the services to the patient to deliver better and more efficient care. From CT scanners in the ED, to a hybrid trauma OR, this new center is one of the leading IR and trauma centers in the world. --- RESOURCES The History of the Zuckerberg San Francisco General Hospital and Trauma Center: https://zuckerbergsanfranciscogeneral.org/about-us/our-history/ In this episode, Dr. Vishal Kumar interviews Dr. Mark Wilson, vice chair and professor of radiology and biomedical imaging at UCSF, and chief of diagnostic and interventional radiology at the Zuckerberg San Francisco General Hospital and Trauma Center about the evolution of trauma care in interventional radiology, translational research, and the impact of mentorship and student outreach.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/0RPqzN


---


SHOW NOTES


We begin by discussing how Dr. Wilson discovered radiology, and how he has come to be a leader in IR. He started out with an interest in psychiatry, and became involved in research on psychiatric brain imaging. As he delved deeper into biomedical imaging, his fascination grew. With help from his mentor, he began publishing, which motivated him to further pursue his passion for research. He learned about IR, and then got into UCSF for his radiology residency.


Being at the frontier of innovations, Dr. Wilson has been involved in research on MR guided interventions, remote navigation, and percutaneous venous chemo filters. He says these projects have reinforced that radiology and research isn’t done in a vacuum. He depends on his collaborators in material science, chemistry, and other fields to successfully innovate. One thing he loves about the research lab is the student involvement, and getting to see high school and college students get their name on a paper. This is one area of student outreach that has an incredible impact and shapes future leaders in radiology and medicine.


Finally, we discuss how Dr. Wilson spearheaded the role of radiology within the hospital infrastructure when they created the new SF General Hospital, the Zuckerberg San Francisco General Hospital and Trauma Center. He collaborated with hospital leadership and architects, as well as emergency medicine, surgery, anesthesia and nursing to build a state of the art trauma care center to serve the people of San Francisco. It fulfills its goal of bringing the services to the patient to deliver better and more efficient care. From CT scanners in the ED, to a hybrid trauma OR, this new center is one of the leading IR and trauma centers in the world.


---


RESOURCES


The History of the Zuckerberg San Francisco General Hospital and Trauma Center:

https://zuckerbergsanfranciscogeneral.org/about-us/our-history/

]]> 2785 Ep. 249 Plumbers, Scientists and Educators: Is It Possible to Fit It All In and Have a Life? with Dr. Lorenzo Patrone In this episode, BackTable is on location in Barcelona for CIRSE 2022! Dr. Aaron Fritts conducts a live video interview with interventional radiologist Dr. Lorenzo Patrone. They discuss their experiences with balancing clinical, academic, and family responsibilities, as well as differences in the American and European physician work environments and the use of social media in medicine. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral --- SHOW NOTES Dr. Patrone recounts his entry into the European IR speaking circuit. Through networking, he continues to meet speakers, learn from their experiences, and gain effective communication and presentation skills. He speaks about normalizing the feeling of imposter syndrome, especially when being invited to speak among IR founders and luminaries. He emphasizes personal growth and identifying where your passion and talent overlaps with lecture content. Dr. Patrone highlights the fact that the field of IR revolves around three different aspects: First, the pioneering phase to innovate new procedures, then the research/evidence phase to demonstrate reproducible results, and finally, the education phase to disseminate knowledge and inspire new generations of IRs. It is common for IRs to feel overwhelmed when trying to commit to all of these fields. Instead of trying to master all aspects of the job, Dr. Patrone recommends that clinicians find different angles of their jobs and hone in the aspects that make them enthusiastic to come to work. Personally, he prioritizes clinical care and teaching. We discuss how time is the ultimate luxury, and how to avoid over-commitment and burnout. We also consider societal gender roles and talk about unjust extra pressures faced by female physicians. Then, we look at some key differences between a physician career in the US, versus one in Europe. Dr. Patrone comments on the pay gap, training pathway, and overall philosophy of the Italian and British healthcare systems. Finally, we discuss benefits and misuses of social media within the medical community. Dr. Patrone emphasizes that social media should be used as a tool to teach and inspire, rather than a platform to criticize individuals or specialties. Regarding case-based posts and feedback, he highlights the point that every clinician could have a different but valid approach to each case, based on the practice setting and operator skill. He also encourages other posters to talk about case complications, which can provide enormous educational value for learners. Fri, 07 Oct 2022 05:00:00 -0000 full BackTable In this episode, BackTable is on location in Barcelona for CIRSE 2022! Dr. Aaron Fritts conducts a live video interview with interventional radiologist Dr. Lorenzo Patrone. They discuss their experiences with balancing clinical, academic, and family responsibilities, as well as differences in the American and European physician work environments and the use of social media in medicine. In this episode, BackTable is on location in Barcelona for CIRSE 2022! Dr. Aaron Fritts conducts a live video interview with interventional radiologist Dr. Lorenzo Patrone. They discuss their experiences with balancing clinical, academic, and family responsibilities, as well as differences in the American and European physician work environments and the use of social media in medicine. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral --- SHOW NOTES Dr. Patrone recounts his entry into the European IR speaking circuit. Through networking, he continues to meet speakers, learn from their experiences, and gain effective communication and presentation skills. He speaks about normalizing the feeling of imposter syndrome, especially when being invited to speak among IR founders and luminaries. He emphasizes personal growth and identifying where your passion and talent overlaps with lecture content. Dr. Patrone highlights the fact that the field of IR revolves around three different aspects: First, the pioneering phase to innovate new procedures, then the research/evidence phase to demonstrate reproducible results, and finally, the education phase to disseminate knowledge and inspire new generations of IRs. It is common for IRs to feel overwhelmed when trying to commit to all of these fields. Instead of trying to master all aspects of the job, Dr. Patrone recommends that clinicians find different angles of their jobs and hone in the aspects that make them enthusiastic to come to work. Personally, he prioritizes clinical care and teaching. We discuss how time is the ultimate luxury, and how to avoid over-commitment and burnout. We also consider societal gender roles and talk about unjust extra pressures faced by female physicians. Then, we look at some key differences between a physician career in the US, versus one in Europe. Dr. Patrone comments on the pay gap, training pathway, and overall philosophy of the Italian and British healthcare systems. Finally, we discuss benefits and misuses of social media within the medical community. Dr. Patrone emphasizes that social media should be used as a tool to teach and inspire, rather than a platform to criticize individuals or specialties. Regarding case-based posts and feedback, he highlights the point that every clinician could have a different but valid approach to each case, based on the practice setting and operator skill. He also encourages other posters to talk about case complications, which can provide enormous educational value for learners. In this episode, BackTable is on location in Barcelona for CIRSE 2022! Dr. Aaron Fritts conducts a live video interview with interventional radiologist Dr. Lorenzo Patrone. They discuss their experiences with balancing clinical, academic, and family responsibilities, as well as differences in the American and European physician work environments and the use of social media in medicine.


---


CHECK OUT OUR SPONSORS


Reflow Medical

https://www.reflowmedical.com/


Medtronic Chocolate PTA Balloon

https://www.medtronic.com/peripheral


---


SHOW NOTES


Dr. Patrone recounts his entry into the European IR speaking circuit. Through networking, he continues to meet speakers, learn from their experiences, and gain effective communication and presentation skills. He speaks about normalizing the feeling of imposter syndrome, especially when being invited to speak among IR founders and luminaries. He emphasizes personal growth and identifying where your passion and talent overlaps with lecture content.


Dr. Patrone highlights the fact that the field of IR revolves around three different aspects: First, the pioneering phase to innovate new procedures, then the research/evidence phase to demonstrate reproducible results, and finally, the education phase to disseminate knowledge and inspire new generations of IRs. It is common for IRs to feel overwhelmed when trying to commit to all of these fields. Instead of trying to master all aspects of the job, Dr. Patrone recommends that clinicians find different angles of their jobs and hone in the aspects that make them enthusiastic to come to work. Personally, he prioritizes clinical care and teaching. We discuss how time is the ultimate luxury, and how to avoid over-commitment and burnout. We also consider societal gender roles and talk about unjust extra pressures faced by female physicians.


Then, we look at some key differences between a physician career in the US, versus one in Europe. Dr. Patrone comments on the pay gap, training pathway, and overall philosophy of the Italian and British healthcare systems.


Finally, we discuss benefits and misuses of social media within the medical community. Dr. Patrone emphasizes that social media should be used as a tool to teach and inspire, rather than a platform to criticize individuals or specialties. Regarding case-based posts and feedback, he highlights the point that every clinician could have a different but valid approach to each case, based on the practice setting and operator skill. He also encourages other posters to talk about case complications, which can provide enormous educational value for learners.

]]> 3202 Ep. 248 Staff Culture with Dr. Peder Horner (on location at CIRSE) In this episode, Dr. Aaron Fritts interviews Dr. Peder Horner about the impact of staff culture on patient care, how to manage bad players, and how to maintain an active role in shaping a healthy work culture. --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/49cHUg --- SHOW NOTES We begin by discussing why staff culture is important. In IR, many people are coming out of a toxic training program and are now expected to be department leaders. We take after our mentors, and we pick up both good and bad habits. So where does healthy staff culture start? Dr. Horner explains that it starts from the top. You have to play an active role in molding the culture, otherwise it will remain toxic or simply be uninspiring. Next, we ask Dr. Horner how he inspires his staff. He shares many values as a parent and a leader. If he is tired and as a result doesn’t smile while at work, it can set the mood for a case, similarly to how it can add up and impact a home relationship on a day to day basis. When employees have negative feelings at work, this results in worse patient care. Lastly, we talk about how to maintain culture once you have a good team onboard. Dr. Horner believes in checking in frequently by asking his techs and nurses how they are doing. He prioritizes their career growth and mobility, which he says may lose him employees over time, but in turn makes people enjoy coming to work because they feel like they are improving and advancing. He says you must be selfless as a leader. If you expect everything to stay static, you’re doing your staff and patients a disservice. Even a great team, if left static, will not go far. He encourages personal and professional development among his staff which is a huge part of the culture of growth he believes in. --- RESOURCES Harvard Business Review: https://hbr.org Paper on Work Culture and Patient Care: https://asqblog.com/2015/02/25/barsade-oneill-2014-whats-love-got-to-do-with-it-a-longitudinal-study-of-the-culture-of-companionate-love-and-employee-and-client-outcomes-in-a-long-term-care-setting/ Mon, 03 Oct 2022 05:00:00 -0000 full BackTable In this episode, Dr. Aaron Fritts interviews Dr. Peder Horner about the impact of staff culture on patient care, how to manage bad players, and how to maintain an active role in shaping a healthy work culture. In this episode, Dr. Aaron Fritts interviews Dr. Peder Horner about the impact of staff culture on patient care, how to manage bad players, and how to maintain an active role in shaping a healthy work culture. --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/49cHUg --- SHOW NOTES We begin by discussing why staff culture is important. In IR, many people are coming out of a toxic training program and are now expected to be department leaders. We take after our mentors, and we pick up both good and bad habits. So where does healthy staff culture start? Dr. Horner explains that it starts from the top. You have to play an active role in molding the culture, otherwise it will remain toxic or simply be uninspiring. Next, we ask Dr. Horner how he inspires his staff. He shares many values as a parent and a leader. If he is tired and as a result doesn’t smile while at work, it can set the mood for a case, similarly to how it can add up and impact a home relationship on a day to day basis. When employees have negative feelings at work, this results in worse patient care. Lastly, we talk about how to maintain culture once you have a good team onboard. Dr. Horner believes in checking in frequently by asking his techs and nurses how they are doing. He prioritizes their career growth and mobility, which he says may lose him employees over time, but in turn makes people enjoy coming to work because they feel like they are improving and advancing. He says you must be selfless as a leader. If you expect everything to stay static, you’re doing your staff and patients a disservice. Even a great team, if left static, will not go far. He encourages personal and professional development among his staff which is a huge part of the culture of growth he believes in. --- RESOURCES Harvard Business Review: https://hbr.org Paper on Work Culture and Patient Care: https://asqblog.com/2015/02/25/barsade-oneill-2014-whats-love-got-to-do-with-it-a-longitudinal-study-of-the-culture-of-companionate-love-and-employee-and-client-outcomes-in-a-long-term-care-setting/ In this episode, Dr. Aaron Fritts interviews Dr. Peder Horner about the impact of staff culture on patient care, how to manage bad players, and how to maintain an active role in shaping a healthy work culture.


---


CHECK OUT OUR SPONSORS


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


Accountable Revenue Cycle Solutions

https://www.accountablerevcycle.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/49cHUg


---


SHOW NOTES


We begin by discussing why staff culture is important. In IR, many people are coming out of a toxic training program and are now expected to be department leaders. We take after our mentors, and we pick up both good and bad habits. So where does healthy staff culture start? Dr. Horner explains that it starts from the top. You have to play an active role in molding the culture, otherwise it will remain toxic or simply be uninspiring.


Next, we ask Dr. Horner how he inspires his staff. He shares many values as a parent and a leader. If he is tired and as a result doesn’t smile while at work, it can set the mood for a case, similarly to how it can add up and impact a home relationship on a day to day basis. When employees have negative feelings at work, this results in worse patient care.


Lastly, we talk about how to maintain culture once you have a good team onboard. Dr. Horner believes in checking in frequently by asking his techs and nurses how they are doing. He prioritizes their career growth and mobility, which he says may lose him employees over time, but in turn makes people enjoy coming to work because they feel like they are improving and advancing. He says you must be selfless as a leader. If you expect everything to stay static, you’re doing your staff and patients a disservice. Even a great team, if left static, will not go far. He encourages personal and professional development among his staff which is a huge part of the culture of growth he believes in.


---


RESOURCES


Harvard Business Review:

https://hbr.org


Paper on Work Culture and Patient Care:

https://asqblog.com/2015/02/25/barsade-oneill-2014-whats-love-got-to-do-with-it-a-longitudinal-study-of-the-culture-of-companionate-love-and-employee-and-client-outcomes-in-a-long-term-care-setting/

]]> 2990 Ep. 247 Teaming up on Trauma, Gun Violence, and Addressing Trauma Care Deserts with Dr. Andre Campbell In this episode, Dr. Vishal Kumar interviews trauma surgeon Dr. Andre Campbell about his career path and policy interests, including gun safety, nationwide access to trauma care, and diversity and inclusion within surgical subspecialties. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oKVBfW --- SHOW NOTES Dr. Campbell starts the conversation by explaining how he was exposed to early mentorship, which guided him towards pursuing his interest in medicine. He outlines his journey, including his childhood in the Bronx, medical school at UCSF, and residency training. Dr. Andre emphasizes the importance of mentorship at all stages of one’s career. He personally became interested in medicine due to a sixth-grade teacher who sparked his interest in science. Next, we discuss his journey of choosing trauma surgery as a specialty. He found it difficult to decide between medicine and surgery, so he first completed a medicine residency, and then applied to match into surgery afterwards. Dr. Campbell found himself gravitating towards ICU and trauma care, which led him to specialize in trauma surgery. He currently performs trauma, acute care, and elective surgery. Dr. Campbell also talks about the importance of allowing himself to feel the pain of trauma patients and their families, instead of keeping a distance. With every patient loss, he steps back and thinks about lessons that he could learn and how he could do better next time. Then, we shift to a conversation on gun violence, a health emergency in 2022. The incidence of gun violence has rebounded to a higher level than it was before the COVID-19 pandemic started. Dr. Campbell has served as an advocate for gun control, and he highlights the fact that shootings happen every day, but it is only high profile mass shootings that get media attention. He emphasizes that as healthcare providers “staying in our lane” means taking a stance on firearm laws, since our jobs are centered around taking care of injured people. He also talks about respecting gun owners and the complex role that guns play in American culture and symbolism. Dr. Campbell highlights recent progress being made with laws requiring stricter background checks, allocating more funds for hospital based violence intervention programs and psychiatric care, and continuing efforts for gun safety research. We look at the role of Level One trauma centers in providing care for the US population, including people who live in “trauma deserts” with no easy access to a trauma center. Dr. Campbell speaks about the benefits of implementing a nationwide trauma system. Finally, Dr. Campbell shares his observations about increasing diversity within surgical subspecialties. Again, he notes that mentorship is a large factor, as well as intentional initiatives to build supportive environments for underrepresented minorities. Fri, 30 Sep 2022 05:00:00 -0000 full BackTable In this episode, Dr. Vishal Kumar interviews trauma surgeon Dr. Andre Campbell about his career path and policy interests, including gun safety, nationwide access to trauma care, and diversity and inclusion within surgical subspecialties. In this episode, Dr. Vishal Kumar interviews trauma surgeon Dr. Andre Campbell about his career path and policy interests, including gun safety, nationwide access to trauma care, and diversity and inclusion within surgical subspecialties. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oKVBfW --- SHOW NOTES Dr. Campbell starts the conversation by explaining how he was exposed to early mentorship, which guided him towards pursuing his interest in medicine. He outlines his journey, including his childhood in the Bronx, medical school at UCSF, and residency training. Dr. Andre emphasizes the importance of mentorship at all stages of one’s career. He personally became interested in medicine due to a sixth-grade teacher who sparked his interest in science. Next, we discuss his journey of choosing trauma surgery as a specialty. He found it difficult to decide between medicine and surgery, so he first completed a medicine residency, and then applied to match into surgery afterwards. Dr. Campbell found himself gravitating towards ICU and trauma care, which led him to specialize in trauma surgery. He currently performs trauma, acute care, and elective surgery. Dr. Campbell also talks about the importance of allowing himself to feel the pain of trauma patients and their families, instead of keeping a distance. With every patient loss, he steps back and thinks about lessons that he could learn and how he could do better next time. Then, we shift to a conversation on gun violence, a health emergency in 2022. The incidence of gun violence has rebounded to a higher level than it was before the COVID-19 pandemic started. Dr. Campbell has served as an advocate for gun control, and he highlights the fact that shootings happen every day, but it is only high profile mass shootings that get media attention. He emphasizes that as healthcare providers “staying in our lane” means taking a stance on firearm laws, since our jobs are centered around taking care of injured people. He also talks about respecting gun owners and the complex role that guns play in American culture and symbolism. Dr. Campbell highlights recent progress being made with laws requiring stricter background checks, allocating more funds for hospital based violence intervention programs and psychiatric care, and continuing efforts for gun safety research. We look at the role of Level One trauma centers in providing care for the US population, including people who live in “trauma deserts” with no easy access to a trauma center. Dr. Campbell speaks about the benefits of implementing a nationwide trauma system. Finally, Dr. Campbell shares his observations about increasing diversity within surgical subspecialties. Again, he notes that mentorship is a large factor, as well as intentional initiatives to build supportive environments for underrepresented minorities. In this episode, Dr. Vishal Kumar interviews trauma surgeon Dr. Andre Campbell about his career path and policy interests, including gun safety, nationwide access to trauma care, and diversity and inclusion within surgical subspecialties.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oKVBfW


---


SHOW NOTES


Dr. Campbell starts the conversation by explaining how he was exposed to early mentorship, which guided him towards pursuing his interest in medicine. He outlines his journey, including his childhood in the Bronx, medical school at UCSF, and residency training. Dr. Andre emphasizes the importance of mentorship at all stages of one’s career. He personally became interested in medicine due to a sixth-grade teacher who sparked his interest in science.


Next, we discuss his journey of choosing trauma surgery as a specialty. He found it difficult to decide between medicine and surgery, so he first completed a medicine residency, and then applied to match into surgery afterwards. Dr. Campbell found himself gravitating towards ICU and trauma care, which led him to specialize in trauma surgery. He currently performs trauma, acute care, and elective surgery.


Dr. Campbell also talks about the importance of allowing himself to feel the pain of trauma patients and their families, instead of keeping a distance. With every patient loss, he steps back and thinks about lessons that he could learn and how he could do better next time.


Then, we shift to a conversation on gun violence, a health emergency in 2022. The incidence of gun violence has rebounded to a higher level than it was before the COVID-19 pandemic started. Dr. Campbell has served as an advocate for gun control, and he highlights the fact that shootings happen every day, but it is only high profile mass shootings that get media attention. He emphasizes that as healthcare providers “staying in our lane” means taking a stance on firearm laws, since our jobs are centered around taking care of injured people. He also talks about respecting gun owners and the complex role that guns play in American culture and symbolism. Dr. Campbell highlights recent progress being made with laws requiring stricter background checks, allocating more funds for hospital based violence intervention programs and psychiatric care, and continuing efforts for gun safety research. We look at the role of Level One trauma centers in providing care for the US population, including people who live in “trauma deserts” with no easy access to a trauma center. Dr. Campbell speaks about the benefits of implementing a nationwide trauma system.


Finally, Dr. Campbell shares his observations about increasing diversity within surgical subspecialties. Again, he notes that mentorship is a large factor, as well as intentional initiatives to build supportive environments for underrepresented minorities.

]]> 3174 Ep. 246 Ultrasound Guided MSK Interventions with Dr. Jason Cox In this episode, guest host Dr. Jacob Fleming interviews Dr. Jason Cox about musculoskeletal interventions and how he uses ultrasound for diagnosis and intervention in his full spectrum musculoskeletal practice. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/ZHCWxF --- SHOW NOTES We begin by discussing Dr. Cox’s path to MSK intervention. During his interventional training at University of Missouri, the musculoskeletal radiology program was rebuilt, and ultrasound was incorporated heavily. He used his ultrasound skills from vascular intervention in IR to learn musculoskeletal anatomy on ultrasound. He was drawn to MSK radiology due to the mechanical aspect of MSK work and the integration of visual spatial awareness and hand eye coordination involved in MSK ultrasound. He started out by learning steroid injections for sports injuries, commonly rotator cuff injuries. He now does around 20 diagnostic or interventional ultrasound procedures each day in his clinic. He opened his clinic with a partner, and did it slowly while still working at his prior job. He started working at his new clinic on his vacation days until he could build up the clientele to leave his prior job. One of the biggest challenges in opening his MSK radiology clinic was finding a sonographer able to do the complex MSK cases he was doing. The most common procedure Dr. Cox does at his clinic is ultrasound guided carpal tunnel release. He also does tendon barbotage for hydroxyapatite deposition disease for the rotator cuff tendons. His practice has grown largely due to the number of patients that are referred because they cannot get an MRI. He reads his ultrasound exams like an MRI report, with a high level of detail, differential diagnosis and recommendations. --- RESOURCES Institute for Advanced Medical Education: https://www.iame.com Linked In: https://www.linkedin.com/in/jasoncoxmd Ultrasound First Clinic: https://ultrasound-first.com European Society of Musculoskeletal Radiology: https://www.essr.org Mon, 26 Sep 2022 05:00:00 -0000 full BackTable In this episode, guest host Dr. Jacob Fleming interviews Dr. Jason Cox about musculoskeletal interventions and how he uses ultrasound for diagnosis and intervention in his full spectrum musculoskeletal practice. In this episode, guest host Dr. Jacob Fleming interviews Dr. Jason Cox about musculoskeletal interventions and how he uses ultrasound for diagnosis and intervention in his full spectrum musculoskeletal practice. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/ZHCWxF --- SHOW NOTES We begin by discussing Dr. Cox’s path to MSK intervention. During his interventional training at University of Missouri, the musculoskeletal radiology program was rebuilt, and ultrasound was incorporated heavily. He used his ultrasound skills from vascular intervention in IR to learn musculoskeletal anatomy on ultrasound. He was drawn to MSK radiology due to the mechanical aspect of MSK work and the integration of visual spatial awareness and hand eye coordination involved in MSK ultrasound. He started out by learning steroid injections for sports injuries, commonly rotator cuff injuries. He now does around 20 diagnostic or interventional ultrasound procedures each day in his clinic. He opened his clinic with a partner, and did it slowly while still working at his prior job. He started working at his new clinic on his vacation days until he could build up the clientele to leave his prior job. One of the biggest challenges in opening his MSK radiology clinic was finding a sonographer able to do the complex MSK cases he was doing. The most common procedure Dr. Cox does at his clinic is ultrasound guided carpal tunnel release. He also does tendon barbotage for hydroxyapatite deposition disease for the rotator cuff tendons. His practice has grown largely due to the number of patients that are referred because they cannot get an MRI. He reads his ultrasound exams like an MRI report, with a high level of detail, differential diagnosis and recommendations. --- RESOURCES Institute for Advanced Medical Education: https://www.iame.com Linked In: https://www.linkedin.com/in/jasoncoxmd Ultrasound First Clinic: https://ultrasound-first.com European Society of Musculoskeletal Radiology: https://www.essr.org In this episode, guest host Dr. Jacob Fleming interviews Dr. Jason Cox about musculoskeletal interventions and how he uses ultrasound for diagnosis and intervention in his full spectrum musculoskeletal practice.


---


CHECK OUT OUR SPONSOR


Laurel Road for Doctors

https://www.laurelroad.com/healthcare-banking/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/ZHCWxF


---


SHOW NOTES


We begin by discussing Dr. Cox’s path to MSK intervention. During his interventional training at University of Missouri, the musculoskeletal radiology program was rebuilt, and ultrasound was incorporated heavily. He used his ultrasound skills from vascular intervention in IR to learn musculoskeletal anatomy on ultrasound. He was drawn to MSK radiology due to the mechanical aspect of MSK work and the integration of visual spatial awareness and hand eye coordination involved in MSK ultrasound.


He started out by learning steroid injections for sports injuries, commonly rotator cuff injuries. He now does around 20 diagnostic or interventional ultrasound procedures each day in his clinic. He opened his clinic with a partner, and did it slowly while still working at his prior job. He started working at his new clinic on his vacation days until he could build up the clientele to leave his prior job. One of the biggest challenges in opening his MSK radiology clinic was finding a sonographer able to do the complex MSK cases he was doing.


The most common procedure Dr. Cox does at his clinic is ultrasound guided carpal tunnel release. He also does tendon barbotage for hydroxyapatite deposition disease for the rotator cuff tendons. His practice has grown largely due to the number of patients that are referred because they cannot get an MRI. He reads his ultrasound exams like an MRI report, with a high level of detail, differential diagnosis and recommendations.


---


RESOURCES


Institute for Advanced Medical Education:

https://www.iame.com


Linked In:

https://www.linkedin.com/in/jasoncoxmd


Ultrasound First Clinic:

https://ultrasound-first.com


European Society of Musculoskeletal Radiology:

https://www.essr.org

]]> 3737 Ep. 245 Y90 in the OBL with Dr. Jayson Brower In this episode, host Dr. Ally Baheti interviews Dr. Jayson Brower about building a Y90 service line in his outpatient based lab (OBL). --- CHECK OUT OUR SPONSOR Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent.html --- SHOW NOTES First, Dr. Brower describes the IR/DR makeup of his practice and partnerships with surrounding hospitals. Inland Imaging’s collaboration with the Providence healthcare system was formed to provide quality outpatient imaging and avoid duplication and competition of services. Over time, they added interventional services, including interventional oncology procedures, to their joint venture. The decision to move Y90 from the hospital to the outpatient setting was spurred by the need in the community, availability of more modern imaging equipment, and patient convenience. In 2019, it was not very common to perform Y90 in an OBL. Dr. Brower outlines the steps he took to move these services, starting with building consensus within the group. Next, he explained the benefits of the OBL to the hospital administration, which include freeing up time in the hospital for true emergencies and providing care for patients who prefer the OBL setting. Then, the group proactively reached out to payers and secured written agreements that they would provide coverage. After securing these agreements, they drafted pro formas, searched for adequate sites, and contacted vendors. Since each state has different regulations for “hot labs” that use radioactive materials, Dr. Brower recommends working with your radiation safety officer to help walk you through the regulations. His OBL has a “mini hot lab” that allows him to draw up the Sirtex dose that he prescribes. Nuclear medicine technicians assist in transporting the radioactive material. Patients have pre-Y90 SPECT mapping close by, at another center. --- RESOURCES Inland Imaging Interventional Radiology: https://interventional.inlandimaging.com/ OEIS: https://oeisweb.com/ Radioactive Material (RAM) License: https://dpbh.nv.gov/Reg/RAM/dta/Licensing/Radioactive_Material_Program_(RAM)_-_Licensing/ Fri, 23 Sep 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Ally Baheti interviews Dr. Jayson Brower about building a Y90 service line in his outpatient based lab (OBL). In this episode, host Dr. Ally Baheti interviews Dr. Jayson Brower about building a Y90 service line in his outpatient based lab (OBL). --- CHECK OUT OUR SPONSOR Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent.html --- SHOW NOTES First, Dr. Brower describes the IR/DR makeup of his practice and partnerships with surrounding hospitals. Inland Imaging’s collaboration with the Providence healthcare system was formed to provide quality outpatient imaging and avoid duplication and competition of services. Over time, they added interventional services, including interventional oncology procedures, to their joint venture. The decision to move Y90 from the hospital to the outpatient setting was spurred by the need in the community, availability of more modern imaging equipment, and patient convenience. In 2019, it was not very common to perform Y90 in an OBL. Dr. Brower outlines the steps he took to move these services, starting with building consensus within the group. Next, he explained the benefits of the OBL to the hospital administration, which include freeing up time in the hospital for true emergencies and providing care for patients who prefer the OBL setting. Then, the group proactively reached out to payers and secured written agreements that they would provide coverage. After securing these agreements, they drafted pro formas, searched for adequate sites, and contacted vendors. Since each state has different regulations for “hot labs” that use radioactive materials, Dr. Brower recommends working with your radiation safety officer to help walk you through the regulations. His OBL has a “mini hot lab” that allows him to draw up the Sirtex dose that he prescribes. Nuclear medicine technicians assist in transporting the radioactive material. Patients have pre-Y90 SPECT mapping close by, at another center. --- RESOURCES Inland Imaging Interventional Radiology: https://interventional.inlandimaging.com/ OEIS: https://oeisweb.com/ Radioactive Material (RAM) License: https://dpbh.nv.gov/Reg/RAM/dta/Licensing/Radioactive_Material_Program_(RAM)_-_Licensing/ In this episode, host Dr. Ally Baheti interviews Dr. Jayson Brower about building a Y90 service line in his outpatient based lab (OBL).


---


CHECK OUT OUR SPONSOR


Boston Scientific Lab Agent

https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent.html


---


SHOW NOTES


First, Dr. Brower describes the IR/DR makeup of his practice and partnerships with surrounding hospitals. Inland Imaging’s collaboration with the Providence healthcare system was formed to provide quality outpatient imaging and avoid duplication and competition of services. Over time, they added interventional services, including interventional oncology procedures, to their joint venture.


The decision to move Y90 from the hospital to the outpatient setting was spurred by the need in the community, availability of more modern imaging equipment, and patient convenience. In 2019, it was not very common to perform Y90 in an OBL. Dr. Brower outlines the steps he took to move these services, starting with building consensus within the group. Next, he explained the benefits of the OBL to the hospital administration, which include freeing up time in the hospital for true emergencies and providing care for patients who prefer the OBL setting. Then, the group proactively reached out to payers and secured written agreements that they would provide coverage. After securing these agreements, they drafted pro formas, searched for adequate sites, and contacted vendors.


Since each state has different regulations for “hot labs” that use radioactive materials, Dr. Brower recommends working with your radiation safety officer to help walk you through the regulations. His OBL has a “mini hot lab” that allows him to draw up the Sirtex dose that he prescribes. Nuclear medicine technicians assist in transporting the radioactive material. Patients have pre-Y90 SPECT mapping close by, at another center.


---


RESOURCES


Inland Imaging Interventional Radiology:

https://interventional.inlandimaging.com/


OEIS:

https://oeisweb.com/


Radioactive Material (RAM) License:

https://dpbh.nv.gov/Reg/RAM/dta/Licensing/Radioactive_Material_Program_(RAM)_-_Licensing/

]]> 2560 Ep. 244 Learning an OBL Practice Before Going All In with Dr. Ali Alikhani In this episode, host Dr. Aaron Fritts interviews Dr. Ali Alikhani about his solo outpatient IR practice, how he leveraged his sales background in the OBL setting, and marketing advice for IRs in an outpatient practice. --- CHECK OUT OUR SPONSORS Medtronic IN.PACT 018 DCB https://www.medtronic.com/018 Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 --- SHOW NOTES Dr. Alikhani started working at an OBL three years out of fellowship. He became the solo practitioner at an outpatient center that had recently lost its physician to retirement. The practice is OBL based, and had a medical director and staff that flew him around to get trained for his first role. This OBL was part of a company that owns around 70 labs around the country. He primarily does embolization; his favorite procedures include uterine fibroid, prostatic artery, and genicular artery embolization. He works as a W2 employee, but there are 1099 locums IRs who are able to cover him for vacation. Due to his background in marketing, he had a strong interest in building up this OBL and diversifying its services. He works with a marketing team including one employee who has worked at this company for 10 years and is very comfortable going to marketing meetings on her own. She helps plan which meetings he needs to attend, and gives Dr. Alikhani weekly reports on who she has met with during the past week. Together, they are building up the practice. Despite this strong marketing team, Dr. Alikhani still only works 60% at this OBL and has to work 40% at a separate OBL due to lack of patients. It takes time to build relationships with referring providers and build a large patient base. Dr. Alikhani speaks on the responsibilities of being a solo IR at an OBL. It is a great responsibility that requires planning, teamwork and a willingness to make mistakes and learn. It is a stressful adjustment from hospital work, but it can also be a very rewarding shift with the right team in place. He recommends early career IRs to start out at an established OBL that knows how to run the business. Learn from this, and then open your own center if this is something you find yourself capable of and willing to do. Mon, 19 Sep 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Ali Alikhani about his solo outpatient IR practice, how he leveraged his sales background in the OBL setting, and marketing advice for IRs in an outpatient practice. In this episode, host Dr. Aaron Fritts interviews Dr. Ali Alikhani about his solo outpatient IR practice, how he leveraged his sales background in the OBL setting, and marketing advice for IRs in an outpatient practice. --- CHECK OUT OUR SPONSORS Medtronic IN.PACT 018 DCB https://www.medtronic.com/018 Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 --- SHOW NOTES Dr. Alikhani started working at an OBL three years out of fellowship. He became the solo practitioner at an outpatient center that had recently lost its physician to retirement. The practice is OBL based, and had a medical director and staff that flew him around to get trained for his first role. This OBL was part of a company that owns around 70 labs around the country. He primarily does embolization; his favorite procedures include uterine fibroid, prostatic artery, and genicular artery embolization. He works as a W2 employee, but there are 1099 locums IRs who are able to cover him for vacation. Due to his background in marketing, he had a strong interest in building up this OBL and diversifying its services. He works with a marketing team including one employee who has worked at this company for 10 years and is very comfortable going to marketing meetings on her own. She helps plan which meetings he needs to attend, and gives Dr. Alikhani weekly reports on who she has met with during the past week. Together, they are building up the practice. Despite this strong marketing team, Dr. Alikhani still only works 60% at this OBL and has to work 40% at a separate OBL due to lack of patients. It takes time to build relationships with referring providers and build a large patient base. Dr. Alikhani speaks on the responsibilities of being a solo IR at an OBL. It is a great responsibility that requires planning, teamwork and a willingness to make mistakes and learn. It is a stressful adjustment from hospital work, but it can also be a very rewarding shift with the right team in place. He recommends early career IRs to start out at an established OBL that knows how to run the business. Learn from this, and then open your own center if this is something you find yourself capable of and willing to do. In this episode, host Dr. Aaron Fritts interviews Dr. Ali Alikhani about his solo outpatient IR practice, how he leveraged his sales background in the OBL setting, and marketing advice for IRs in an outpatient practice.


---


CHECK OUT OUR SPONSORS


Medtronic IN.PACT 018 DCB

https://www.medtronic.com/018


Boston Scientific Nextlab

https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040


---


SHOW NOTES


Dr. Alikhani started working at an OBL three years out of fellowship. He became the solo practitioner at an outpatient center that had recently lost its physician to retirement. The practice is OBL based, and had a medical director and staff that flew him around to get trained for his first role. This OBL was part of a company that owns around 70 labs around the country. He primarily does embolization; his favorite procedures include uterine fibroid, prostatic artery, and genicular artery embolization. He works as a W2 employee, but there are 1099 locums IRs who are able to cover him for vacation.


Due to his background in marketing, he had a strong interest in building up this OBL and diversifying its services. He works with a marketing team including one employee who has worked at this company for 10 years and is very comfortable going to marketing meetings on her own. She helps plan which meetings he needs to attend, and gives Dr. Alikhani weekly reports on who she has met with during the past week. Together, they are building up the practice. Despite this strong marketing team, Dr. Alikhani still only works 60% at this OBL and has to work 40% at a separate OBL due to lack of patients. It takes time to build relationships with referring providers and build a large patient base.


Dr. Alikhani speaks on the responsibilities of being a solo IR at an OBL. It is a great responsibility that requires planning, teamwork and a willingness to make mistakes and learn. It is a stressful adjustment from hospital work, but it can also be a very rewarding shift with the right team in place. He recommends early career IRs to start out at an established OBL that knows how to run the business. Learn from this, and then open your own center if this is something you find yourself capable of and willing to do.

]]> 3167 Ep. 243 Better Abscess Drainage with Dr. John Pavlus In this episode, our hosts Drs. Michael Barraza and Aaron Fritts interview Dr. John Pavlus about his methods of drain placement, monitoring, and removal, as well as his vision to design an ideal drainage system. --- CHECK OUT OUR SPONSOR Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5KfOLv --- SHOW NOTES In this episode, our hosts Drs. Michael Barraza and Aaron Fritts interview Dr. John Pavlus about his methods of drain placement, monitoring, and removal, as well as his vision to design an ideal drainage system. Dr. Pavlus became interested in abscess drains when he noticed that across different institutions had very different indications, types, and methods of putting in drains. Dr. Pavlus prefers to place drains under ultrasound guidance, and he will also obtain a CT image afterwards to ensure the drain is in place. The doctors discuss their favorite guidewires to use: Dr. Pavlus prefers the Coons wire and Dr. Barraza prefers the Amplatz wire. For deep pelvic cul-de-sac abscesses, Dr. Pavlus describes how he obtains transgluteal access and uses a Hawkins needle. Liver abscesses can be challenging, due to their variety of drainage contents (hematoma, bile, necrotic material), and increased time of drainage. We also discuss the debate between suction bulbs and gravity drainage bags, noting that research studies and personal experiences have not shown significant differences in the rate of fistula formation with either method. One exception is post-operative spinal drainage, where using suction could confer the risk of removing CSF. To assess when a drain needs to be removed, Dr. Pavlus monitors the output and obtains a CT. He prefers to take ownership of drain care and remove drains that he originally placed, but if needed, he also collaborates with trauma surgeons to ensure that drains and sutures are removed properly. Dr. Pavlus also recognizes the need to standardize follow up care for drains. Dr. Barraza describes a workflow for drain checks at his fellowship site, which included daily rounds and a standardized checklist for each patient. Finally, Dr. Pavlus speaks about his ongoing mission to design an ideal drainage system for various dwell times, viscosity of contents, and catheter sizes. Fri, 16 Sep 2022 05:00:00 -0000 full BackTable In this episode, our hosts Drs. Michael Barraza and Aaron Fritts interview Dr. John Pavlus about his methods of drain placement, monitoring, and removal, as well as his vision to design an ideal drainage system. In this episode, our hosts Drs. Michael Barraza and Aaron Fritts interview Dr. John Pavlus about his methods of drain placement, monitoring, and removal, as well as his vision to design an ideal drainage system. --- CHECK OUT OUR SPONSOR Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5KfOLv --- SHOW NOTES In this episode, our hosts Drs. Michael Barraza and Aaron Fritts interview Dr. John Pavlus about his methods of drain placement, monitoring, and removal, as well as his vision to design an ideal drainage system. Dr. Pavlus became interested in abscess drains when he noticed that across different institutions had very different indications, types, and methods of putting in drains. Dr. Pavlus prefers to place drains under ultrasound guidance, and he will also obtain a CT image afterwards to ensure the drain is in place. The doctors discuss their favorite guidewires to use: Dr. Pavlus prefers the Coons wire and Dr. Barraza prefers the Amplatz wire. For deep pelvic cul-de-sac abscesses, Dr. Pavlus describes how he obtains transgluteal access and uses a Hawkins needle. Liver abscesses can be challenging, due to their variety of drainage contents (hematoma, bile, necrotic material), and increased time of drainage. We also discuss the debate between suction bulbs and gravity drainage bags, noting that research studies and personal experiences have not shown significant differences in the rate of fistula formation with either method. One exception is post-operative spinal drainage, where using suction could confer the risk of removing CSF. To assess when a drain needs to be removed, Dr. Pavlus monitors the output and obtains a CT. He prefers to take ownership of drain care and remove drains that he originally placed, but if needed, he also collaborates with trauma surgeons to ensure that drains and sutures are removed properly. Dr. Pavlus also recognizes the need to standardize follow up care for drains. Dr. Barraza describes a workflow for drain checks at his fellowship site, which included daily rounds and a standardized checklist for each patient. Finally, Dr. Pavlus speaks about his ongoing mission to design an ideal drainage system for various dwell times, viscosity of contents, and catheter sizes. In this episode, our hosts Drs. Michael Barraza and Aaron Fritts interview Dr. John Pavlus about his methods of drain placement, monitoring, and removal, as well as his vision to design an ideal drainage system.


---


CHECK OUT OUR SPONSOR


Medtronic Abre Venous Stent

https://www.medtronic.com/abrevenous


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5KfOLv


---


SHOW NOTES


In this episode, our hosts Drs. Michael Barraza and Aaron Fritts interview Dr. John Pavlus about his methods of drain placement, monitoring, and removal, as well as his vision to design an ideal drainage system.


Dr. Pavlus became interested in abscess drains when he noticed that across different institutions had very different indications, types, and methods of putting in drains. Dr. Pavlus prefers to place drains under ultrasound guidance, and he will also obtain a CT image afterwards to ensure the drain is in place. The doctors discuss their favorite guidewires to use: Dr. Pavlus prefers the Coons wire and Dr. Barraza prefers the Amplatz wire.


For deep pelvic cul-de-sac abscesses, Dr. Pavlus describes how he obtains transgluteal access and uses a Hawkins needle. Liver abscesses can be challenging, due to their variety of drainage contents (hematoma, bile, necrotic material), and increased time of drainage. We also discuss the debate between suction bulbs and gravity drainage bags, noting that research studies and personal experiences have not shown significant differences in the rate of fistula formation with either method. One exception is post-operative spinal drainage, where using suction could confer the risk of removing CSF.


To assess when a drain needs to be removed, Dr. Pavlus monitors the output and obtains a CT. He prefers to take ownership of drain care and remove drains that he originally placed, but if needed, he also collaborates with trauma surgeons to ensure that drains and sutures are removed properly. Dr. Pavlus also recognizes the need to standardize follow up care for drains. Dr. Barraza describes a workflow for drain checks at his fellowship site, which included daily rounds and a standardized checklist for each patient.


Finally, Dr. Pavlus speaks about his ongoing mission to design an ideal drainage system for various dwell times, viscosity of contents, and catheter sizes.

]]> 2978 Ep. 242 Image-Guided Headache Interventions with Dan Nguyen In this episode, guest host Dr. Jacob Fleming interviews Dr. Dan Nguyen about MSK and neurologic pain interventions, specifically how he evaluates and treats different types of headaches at his practice. --- CHECK OUT OUR SPONSORS Athletic Greens https://www.athleticgreens.com/backtablevi RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Lt1TRq --- SHOW NOTES Dr. Nguyen left academia and the East Coast 6 years ago, where he trained in neurointerventional radiology and pain intervention to open his own practice in Oklahoma City after visiting Dr. Beall. He now has a clinic where he sees musculoskeletal and neurologic pain patients. He enjoys the long term relationships he has built with many patients in his practice. He still does a degree of diagnostic work so as not to lose his skills. Next, Dr. Nguyen discusses how he evaluates and treats headaches as a neurological pain interventionalist. Understanding the neuroanatomy of the face is key. He tries to understand the presentation of the patient’s headaches, whether it is located above the eyebrow, near the ear or at the jaw. He treats cervicogenic headache, trigeminal neuralgia and occipital neuralgia with a diagnostic block, radiofrequency ablation and neuromodulation. He also treats migrainous headaches. After determining whether the pain is musculogenic or neurogenic, he does a trigger point injection or a test injection of the nerve, followed by RFA and neuromodulation. Dr. Nguyen tells us his approach to trigeminal neuralgia workup. There are three branches, and the Gasserian ganglion (trigeminal ganglion) lies deep to the foramen ovale. To approach it, he usually tries to target the most peripheral nerve branch. For V1, he evaluates the supraorbital, supratrochlear nerves, which you can see with ultrasound. For V2, he evaluates the infraorbital with ultrasound. The foramen rotundundum requires CT guidance to access. For V3 he evaluates the mental and alveolar nerves or the foramen ovale. He does diagnostic blocks, and if this provides relief to the patient they discuss radiofrequency ablation. He advises operators to take the longest path to the nerve to ensure the ablative needle is fully buried under the skin to avoid burns. He also discusses the rare outcome of anesthesia dolorosa which can cause facial numbness and pain after ablation of the Gasserian ganglion. He says that for most of his patients, they accept this potential risk due to the more likely possibility of relief from the excruciating pain they experience with trigeminal neuralgia. --- RESOURCES Dr. Nguyen Twitter: @neuroradiology Narouze: Interventional Management of Head and Face Pain https://link.springer.com/book/10.1007/978-1-4614-8951-1 American Society of Spine Radiology: https://assrannualmeeting.org American Society of Neuroradiology: https://www.asnr.org/annualmeeting/ Mon, 12 Sep 2022 05:00:00 -0000 full BackTable In this episode, guest host Dr. Jacob Fleming interviews Dr. Dan Nguyen about MSK and neurologic pain interventions, specifically how he evaluates and treats different types of headaches at his practice. In this episode, guest host Dr. Jacob Fleming interviews Dr. Dan Nguyen about MSK and neurologic pain interventions, specifically how he evaluates and treats different types of headaches at his practice. --- CHECK OUT OUR SPONSORS Athletic Greens https://www.athleticgreens.com/backtablevi RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Lt1TRq --- SHOW NOTES Dr. Nguyen left academia and the East Coast 6 years ago, where he trained in neurointerventional radiology and pain intervention to open his own practice in Oklahoma City after visiting Dr. Beall. He now has a clinic where he sees musculoskeletal and neurologic pain patients. He enjoys the long term relationships he has built with many patients in his practice. He still does a degree of diagnostic work so as not to lose his skills. Next, Dr. Nguyen discusses how he evaluates and treats headaches as a neurological pain interventionalist. Understanding the neuroanatomy of the face is key. He tries to understand the presentation of the patient’s headaches, whether it is located above the eyebrow, near the ear or at the jaw. He treats cervicogenic headache, trigeminal neuralgia and occipital neuralgia with a diagnostic block, radiofrequency ablation and neuromodulation. He also treats migrainous headaches. After determining whether the pain is musculogenic or neurogenic, he does a trigger point injection or a test injection of the nerve, followed by RFA and neuromodulation. Dr. Nguyen tells us his approach to trigeminal neuralgia workup. There are three branches, and the Gasserian ganglion (trigeminal ganglion) lies deep to the foramen ovale. To approach it, he usually tries to target the most peripheral nerve branch. For V1, he evaluates the supraorbital, supratrochlear nerves, which you can see with ultrasound. For V2, he evaluates the infraorbital with ultrasound. The foramen rotundundum requires CT guidance to access. For V3 he evaluates the mental and alveolar nerves or the foramen ovale. He does diagnostic blocks, and if this provides relief to the patient they discuss radiofrequency ablation. He advises operators to take the longest path to the nerve to ensure the ablative needle is fully buried under the skin to avoid burns. He also discusses the rare outcome of anesthesia dolorosa which can cause facial numbness and pain after ablation of the Gasserian ganglion. He says that for most of his patients, they accept this potential risk due to the more likely possibility of relief from the excruciating pain they experience with trigeminal neuralgia. --- RESOURCES Dr. Nguyen Twitter: @neuroradiology Narouze: Interventional Management of Head and Face Pain https://link.springer.com/book/10.1007/978-1-4614-8951-1 American Society of Spine Radiology: https://assrannualmeeting.org American Society of Neuroradiology: https://www.asnr.org/annualmeeting/ In this episode, guest host Dr. Jacob Fleming interviews Dr. Dan Nguyen about MSK and neurologic pain interventions, specifically how he evaluates and treats different types of headaches at his practice.


---


CHECK OUT OUR SPONSORS


Athletic Greens

https://www.athleticgreens.com/backtablevi


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Lt1TRq


---


SHOW NOTES


Dr. Nguyen left academia and the East Coast 6 years ago, where he trained in neurointerventional radiology and pain intervention to open his own practice in Oklahoma City after visiting Dr. Beall. He now has a clinic where he sees musculoskeletal and neurologic pain patients. He enjoys the long term relationships he has built with many patients in his practice. He still does a degree of diagnostic work so as not to lose his skills.


Next, Dr. Nguyen discusses how he evaluates and treats headaches as a neurological pain interventionalist. Understanding the neuroanatomy of the face is key. He tries to understand the presentation of the patient’s headaches, whether it is located above the eyebrow, near the ear or at the jaw. He treats cervicogenic headache, trigeminal neuralgia and occipital neuralgia with a diagnostic block, radiofrequency ablation and neuromodulation. He also treats migrainous headaches. After determining whether the pain is musculogenic or neurogenic, he does a trigger point injection or a test injection of the nerve, followed by RFA and neuromodulation.


Dr. Nguyen tells us his approach to trigeminal neuralgia workup. There are three branches, and the Gasserian ganglion (trigeminal ganglion) lies deep to the foramen ovale. To approach it, he usually tries to target the most peripheral nerve branch. For V1, he evaluates the supraorbital, supratrochlear nerves, which you can see with ultrasound. For V2, he evaluates the infraorbital with ultrasound. The foramen rotundundum requires CT guidance to access. For V3 he evaluates the mental and alveolar nerves or the foramen ovale. He does diagnostic blocks, and if this provides relief to the patient they discuss radiofrequency ablation. He advises operators to take the longest path to the nerve to ensure the ablative needle is fully buried under the skin to avoid burns. He also discusses the rare outcome of anesthesia dolorosa which can cause facial numbness and pain after ablation of the Gasserian ganglion. He says that for most of his patients, they accept this potential risk due to the more likely possibility of relief from the excruciating pain they experience with trigeminal neuralgia.


---


RESOURCES


Dr. Nguyen Twitter:

@neuroradiology


Narouze: Interventional Management of Head and Face Pain

https://link.springer.com/book/10.1007/978-1-4614-8951-1


American Society of Spine Radiology:

https://assrannualmeeting.org


American Society of Neuroradiology:

https://www.asnr.org/annualmeeting/

]]> 3532 Ep. 241 Emerging Techniques of Advanced Ultrasound in No Options CLTI Patients with Dr. Miguel Montero-Baker In this episode, guest host Jill Sommerset interviews vascular surgeon Dr. Miguel Montero-Baker about his evolving use of ultrasound throughout his career in caring for critical limb-threatening ischemia (CLTI) patients. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/BK45bf --- SHOW NOTES Dr. Montero-Baker starts by outlining his journey from training in Costa Rica, Germany, and Arizona, to building a multidisciplinary limb salvage center at Methodist Houston. Despite his geographic relocations, he is still very involved in endovascular education in Latin America through HENDOLAT, an online community and annual conference. Next, we delve into the uses for ultrasound during the workup stages for CLTI. Dr. Montero-Baker highlights the information that ultrasound can provide: locating the region and extent of disease, pursuing an open versus endovascular treatment approach, and the tools you will need. He points out that a lot of institutions currently only rely on pulse volume recording (PVR), ankle brachial index (ABI), and toe brachial index (TBI), and do not have access to a robust vascular lab for full ultrasounds. Dr. Montero-Baker discusses some hurdles preventing the widespread implementation of ultrasound, such as additional cost and variability in operators. However, he believes that ultrasound can be a phenomenal tool if practices can invest the time to train vascular technologists and implement its use. We frame the ultrasound conversation around incentives for each party: the technologist can achieve higher job satisfaction and further subspecialize, the treating physician can have a better understanding of each patient’s disease and management, and the institution can minimize extended stays and readmissions. Additionally, ultrasound is very useful when institutions are facing the global contrast shortage or treating patients with renal disease. Finally, we look at the pathophysiology of diabetic and chronic renal failure patients who have extreme below the knee and below the ankle disease. These patients with medial artery calcification patterns have very few treatment options and high limb loss rates. Dr. Montero-Baker describes a new method of pedal venous access for deep vein arterialization. --- RESOURCES BackTable en Espanol- Enfermedad Arterial Periférica y Salvamento de Extremidades en la Comunidad Latino Americana: https://www.backtable.com/shows/vi/podcasts/%20v/enfermedad-arterial-periferica-y-salvamento-de-extremidades-en-la-comunidad-latino-americana Dr. Miguel Montero-Baker’s Twitter: https://twitter.com/monteromiguel HENDOLAT: https://hendolat.com/ Society for Vascular Ultrasound: Fri, 09 Sep 2022 05:00:00 -0000 full BackTable In this episode, guest host Jill Sommerset interviews vascular surgeon Dr. Miguel Montero-Baker about his evolving use of ultrasound throughout his career in caring for critical limb-threatening ischemia (CLTI) patients. In this episode, guest host Jill Sommerset interviews vascular surgeon Dr. Miguel Montero-Baker about his evolving use of ultrasound throughout his career in caring for critical limb-threatening ischemia (CLTI) patients. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/BK45bf --- SHOW NOTES Dr. Montero-Baker starts by outlining his journey from training in Costa Rica, Germany, and Arizona, to building a multidisciplinary limb salvage center at Methodist Houston. Despite his geographic relocations, he is still very involved in endovascular education in Latin America through HENDOLAT, an online community and annual conference. Next, we delve into the uses for ultrasound during the workup stages for CLTI. Dr. Montero-Baker highlights the information that ultrasound can provide: locating the region and extent of disease, pursuing an open versus endovascular treatment approach, and the tools you will need. He points out that a lot of institutions currently only rely on pulse volume recording (PVR), ankle brachial index (ABI), and toe brachial index (TBI), and do not have access to a robust vascular lab for full ultrasounds. Dr. Montero-Baker discusses some hurdles preventing the widespread implementation of ultrasound, such as additional cost and variability in operators. However, he believes that ultrasound can be a phenomenal tool if practices can invest the time to train vascular technologists and implement its use. We frame the ultrasound conversation around incentives for each party: the technologist can achieve higher job satisfaction and further subspecialize, the treating physician can have a better understanding of each patient’s disease and management, and the institution can minimize extended stays and readmissions. Additionally, ultrasound is very useful when institutions are facing the global contrast shortage or treating patients with renal disease. Finally, we look at the pathophysiology of diabetic and chronic renal failure patients who have extreme below the knee and below the ankle disease. These patients with medial artery calcification patterns have very few treatment options and high limb loss rates. Dr. Montero-Baker describes a new method of pedal venous access for deep vein arterialization. --- RESOURCES BackTable en Espanol- Enfermedad Arterial Periférica y Salvamento de Extremidades en la Comunidad Latino Americana: https://www.backtable.com/shows/vi/podcasts/%20v/enfermedad-arterial-periferica-y-salvamento-de-extremidades-en-la-comunidad-latino-americana Dr. Miguel Montero-Baker’s Twitter: https://twitter.com/monteromiguel HENDOLAT: https://hendolat.com/ Society for Vascular Ultrasound: In this episode, guest host Jill Sommerset interviews vascular surgeon Dr. Miguel Montero-Baker about his evolving use of ultrasound throughout his career in caring for critical limb-threatening ischemia (CLTI) patients.


---


CHECK OUT OUR SPONSOR


Boston Scientific Eluvia Drug-Eluting Stent

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/BK45bf


---


SHOW NOTES


Dr. Montero-Baker starts by outlining his journey from training in Costa Rica, Germany, and Arizona, to building a multidisciplinary limb salvage center at Methodist Houston. Despite his geographic relocations, he is still very involved in endovascular education in Latin America through HENDOLAT, an online community and annual conference.


Next, we delve into the uses for ultrasound during the workup stages for CLTI. Dr. Montero-Baker highlights the information that ultrasound can provide: locating the region and extent of disease, pursuing an open versus endovascular treatment approach, and the tools you will need. He points out that a lot of institutions currently only rely on pulse volume recording (PVR), ankle brachial index (ABI), and toe brachial index (TBI), and do not have access to a robust vascular lab for full ultrasounds. Dr. Montero-Baker discusses some hurdles preventing the widespread implementation of ultrasound, such as additional cost and variability in operators.


However, he believes that ultrasound can be a phenomenal tool if practices can invest the time to train vascular technologists and implement its use. We frame the ultrasound conversation around incentives for each party: the technologist can achieve higher job satisfaction and further subspecialize, the treating physician can have a better understanding of each patient’s disease and management, and the institution can minimize extended stays and readmissions. Additionally, ultrasound is very useful when institutions are facing the global contrast shortage or treating patients with renal disease.


Finally, we look at the pathophysiology of diabetic and chronic renal failure patients who have extreme below the knee and below the ankle disease. These patients with medial artery calcification patterns have very few treatment options and high limb loss rates. Dr. Montero-Baker describes a new method of pedal venous access for deep vein arterialization.


---


RESOURCES


BackTable en Espanol- Enfermedad Arterial Periférica y Salvamento de Extremidades en la Comunidad Latino Americana:

https://www.backtable.com/shows/vi/podcasts/%20v/enfermedad-arterial-periferica-y-salvamento-de-extremidades-en-la-comunidad-latino-americana


Dr. Miguel Montero-Baker’s Twitter:

https://twitter.com/monteromiguel


HENDOLAT:

https://hendolat.com/


Society for Vascular Ultrasound:

]]> 3112 Ep. 240 Changing VIR Training Paradigms with Dr. Zaeem Billah, Dr. Kartik Kansagra, and Dr. Geogy Vatakencherry In this episode, guest host Dr. Donald Garbett interviews Drs. Geogy Vatakencherry, Zaeem Billah, and Kartik Kansagra about the IR integrated residency, how it’s evolving, and what students should be doing to prepare for this rigorous training program. --- CHECK OUT OUR SPONSOR Medtronic IN.PACT 018 DCB https://www.medtronic.com/018 --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5RwqRC --- SHOW NOTES We begin by discussing the VIR program at Kaiser LA. As the program director, Dr. Vatakencherry discusses how he built his residency program and how it has evolved since the inception of the integrated iR residencies. One integral part of this program is weekly continuity clinic, starting in your first year. Dr. Kansagra brought up the idea to Dr. Vatakencherry after noticing that other surgical specialties and interventional cardiology were doing this. This model allows residents to develop longitudinal relationships with patients, understand disease progression and the importance of preventive care and nonoperative management. Next, Dr. Billah discusses his training at Kaiser LA, as a resident in the first year of the new integrated IR residency. They have a categorical program, with a surgery intern year included. He highly suggests that all IR residents should do a surgery year due to its similarity to IR and the skills it provides you. Whether on DR, ICU or IR, all IR residents have daily IR conferences. ICU training begins in the first year, which includes MICU, SICU and CCU rotations. In the PGY-5 year, they get consecutive rotations in stroke neurology and neurointervention. Finally we discuss the future of the VIR integrated residency. Dr. Vatakencherry believes that clinic time is quintessential during IR residency to understand the nuances of “should vs. could” when it comes to operative intervention. In clinic, not only do you see what you do well but more importantly, you see what you don't do well and how you can fix that. This clinical experience cannot be replicated in a year of fellowship. Lastly, Dr. Vatakencherry gives some extremely pertinent advice to fourth year medical students applying to IR integrated residency. Mon, 05 Sep 2022 05:00:00 -0000 full BackTable In this episode, guest host Dr. Donald Garbett interviews Drs. Geogy Vatakencherry, Zaeem Billah, and Kartik Kansagra about the IR integrated residency, how it’s evolving, and what students should be doing to prepare for this rigorous training program. In this episode, guest host Dr. Donald Garbett interviews Drs. Geogy Vatakencherry, Zaeem Billah, and Kartik Kansagra about the IR integrated residency, how it’s evolving, and what students should be doing to prepare for this rigorous training program. --- CHECK OUT OUR SPONSOR Medtronic IN.PACT 018 DCB https://www.medtronic.com/018 --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5RwqRC --- SHOW NOTES We begin by discussing the VIR program at Kaiser LA. As the program director, Dr. Vatakencherry discusses how he built his residency program and how it has evolved since the inception of the integrated iR residencies. One integral part of this program is weekly continuity clinic, starting in your first year. Dr. Kansagra brought up the idea to Dr. Vatakencherry after noticing that other surgical specialties and interventional cardiology were doing this. This model allows residents to develop longitudinal relationships with patients, understand disease progression and the importance of preventive care and nonoperative management. Next, Dr. Billah discusses his training at Kaiser LA, as a resident in the first year of the new integrated IR residency. They have a categorical program, with a surgery intern year included. He highly suggests that all IR residents should do a surgery year due to its similarity to IR and the skills it provides you. Whether on DR, ICU or IR, all IR residents have daily IR conferences. ICU training begins in the first year, which includes MICU, SICU and CCU rotations. In the PGY-5 year, they get consecutive rotations in stroke neurology and neurointervention. Finally we discuss the future of the VIR integrated residency. Dr. Vatakencherry believes that clinic time is quintessential during IR residency to understand the nuances of “should vs. could” when it comes to operative intervention. In clinic, not only do you see what you do well but more importantly, you see what you don't do well and how you can fix that. This clinical experience cannot be replicated in a year of fellowship. Lastly, Dr. Vatakencherry gives some extremely pertinent advice to fourth year medical students applying to IR integrated residency. In this episode, guest host Dr. Donald Garbett interviews Drs. Geogy Vatakencherry, Zaeem Billah, and Kartik Kansagra about the IR integrated residency, how it’s evolving, and what students should be doing to prepare for this rigorous training program.


---


CHECK OUT OUR SPONSOR


Medtronic IN.PACT 018 DCB

https://www.medtronic.com/018


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5RwqRC


---


SHOW NOTES


We begin by discussing the VIR program at Kaiser LA. As the program director, Dr. Vatakencherry discusses how he built his residency program and how it has evolved since the inception of the integrated iR residencies. One integral part of this program is weekly continuity clinic, starting in your first year. Dr. Kansagra brought up the idea to Dr. Vatakencherry after noticing that other surgical specialties and interventional cardiology were doing this. This model allows residents to develop longitudinal relationships with patients, understand disease progression and the importance of preventive care and nonoperative management.


Next, Dr. Billah discusses his training at Kaiser LA, as a resident in the first year of the new integrated IR residency. They have a categorical program, with a surgery intern year included. He highly suggests that all IR residents should do a surgery year due to its similarity to IR and the skills it provides you. Whether on DR, ICU or IR, all IR residents have daily IR conferences. ICU training begins in the first year, which includes MICU, SICU and CCU rotations. In the PGY-5 year, they get consecutive rotations in stroke neurology and neurointervention.


Finally we discuss the future of the VIR integrated residency. Dr. Vatakencherry believes that clinic time is quintessential during IR residency to understand the nuances of “should vs. could” when it comes to operative intervention. In clinic, not only do you see what you do well but more importantly, you see what you don't do well and how you can fix that. This clinical experience cannot be replicated in a year of fellowship. Lastly, Dr. Vatakencherry gives some extremely pertinent advice to fourth year medical students applying to IR integrated residency.

]]> 4012 Ep. 239 Medicinal Cannabis: The Current State with PureVita Labs Founder Dr. Jason Iannuccilli In this episode, our host Dr. Aaron Fritts and Dr. Jason Iannuccilli dive into the history, science, and future directions of medical cannabis. We discuss Dr. Iannuccilli’s founding vision for PureVita Labs, a company focused on developing standardized testing for cannabis products and ensuring consumer safety. --- CHECK OUT OUR SPONSOR Athletic Greens https://www.athleticgreens.com/backtablevi --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/A8oPKA --- SHOW NOTES Dr. Iannuccilli starts by describing his former interventional oncology practice in Rhode Island. His interest in medical marijuana grew as he frequently found himself in conversations with terminal cancer patients who sought his medical advice to navigate the variety of products. As he learned more about this craft industry, he realized that there could be significant variations between each product type, brand, and even within each batch. With co-founders Dr. Jonathan Martin and Dr. Stuart Procter, he started the entrepreneurial journey of building a laboratory that uses innovative techniques to test and label products with accuracy. The team hopes to continue growing their services and eventually through artificial intelligence, build a platform that can recommend products to each individual consumer that will ensure them a predictable experience based on their desired therapeutic outcome. Throughout this episode, we discuss social stereotypes and political challenges that the cannabis industry has faced in the past decades. We move past the mistaken idea that active ingredients of marijuana always cause mental dullness and lethargy, and we bring the conversation down to a molecular level to discuss CB1 receptors and anti-inflammatory benefits, and pain relief. Finally, the doctors discuss fundraising for a nontraditional business pursuit. Dr. Iannuccilli shares how the vape crisis was a pivotal point– it served as a wake-up call for consumers and investors, leading to higher recognition of the importance of more stringent and standardized product testing. PureVita Labs has started to fundraise through friends and family with convertible notes, which are structured loans with set interest rates that allow the investor to either pull out their initial investment plus interest, or roll that value into equity once the company has established its valuation. --- RESOURCES Pure Vita Labs: https://purevitalabs.com/ The Bartholomewtown Podcast- Ep. 101, “Inside RI Cannabis” https://btown.buzzsprout.com/163601/11221697-inside-ri-cannabis-presented-by-purevita-labs-cannabis-101-part-1 WHOOP: https://www.whoop.com/ The Peter Attia Drive Podcast: https://peterattiamd.com/podcast/ Fri, 02 Sep 2022 05:00:00 -0000 full BackTable In this episode, our host Dr. Aaron Fritts and Dr. Jason Iannuccilli dive into the history, science, and future directions of medical cannabis. We discuss Dr. Iannuccilli’s founding vision for PureVita Labs, a company focused on developing standardized testing for cannabis products and ensuring consumer safety. In this episode, our host Dr. Aaron Fritts and Dr. Jason Iannuccilli dive into the history, science, and future directions of medical cannabis. We discuss Dr. Iannuccilli’s founding vision for PureVita Labs, a company focused on developing standardized testing for cannabis products and ensuring consumer safety. --- CHECK OUT OUR SPONSOR Athletic Greens https://www.athleticgreens.com/backtablevi --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/A8oPKA --- SHOW NOTES Dr. Iannuccilli starts by describing his former interventional oncology practice in Rhode Island. His interest in medical marijuana grew as he frequently found himself in conversations with terminal cancer patients who sought his medical advice to navigate the variety of products. As he learned more about this craft industry, he realized that there could be significant variations between each product type, brand, and even within each batch. With co-founders Dr. Jonathan Martin and Dr. Stuart Procter, he started the entrepreneurial journey of building a laboratory that uses innovative techniques to test and label products with accuracy. The team hopes to continue growing their services and eventually through artificial intelligence, build a platform that can recommend products to each individual consumer that will ensure them a predictable experience based on their desired therapeutic outcome. Throughout this episode, we discuss social stereotypes and political challenges that the cannabis industry has faced in the past decades. We move past the mistaken idea that active ingredients of marijuana always cause mental dullness and lethargy, and we bring the conversation down to a molecular level to discuss CB1 receptors and anti-inflammatory benefits, and pain relief. Finally, the doctors discuss fundraising for a nontraditional business pursuit. Dr. Iannuccilli shares how the vape crisis was a pivotal point– it served as a wake-up call for consumers and investors, leading to higher recognition of the importance of more stringent and standardized product testing. PureVita Labs has started to fundraise through friends and family with convertible notes, which are structured loans with set interest rates that allow the investor to either pull out their initial investment plus interest, or roll that value into equity once the company has established its valuation. --- RESOURCES Pure Vita Labs: https://purevitalabs.com/ The Bartholomewtown Podcast- Ep. 101, “Inside RI Cannabis” https://btown.buzzsprout.com/163601/11221697-inside-ri-cannabis-presented-by-purevita-labs-cannabis-101-part-1 WHOOP: https://www.whoop.com/ The Peter Attia Drive Podcast: https://peterattiamd.com/podcast/ In this episode, our host Dr. Aaron Fritts and Dr. Jason Iannuccilli dive into the history, science, and future directions of medical cannabis. We discuss Dr. Iannuccilli’s founding vision for PureVita Labs, a company focused on developing standardized testing for cannabis products and ensuring consumer safety.


---


CHECK OUT OUR SPONSOR


Athletic Greens

https://www.athleticgreens.com/backtablevi


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/A8oPKA


---


SHOW NOTES


Dr. Iannuccilli starts by describing his former interventional oncology practice in Rhode Island. His interest in medical marijuana grew as he frequently found himself in conversations with terminal cancer patients who sought his medical advice to navigate the variety of products. As he learned more about this craft industry, he realized that there could be significant variations between each product type, brand, and even within each batch. With co-founders Dr. Jonathan Martin and Dr. Stuart Procter, he started the entrepreneurial journey of building a laboratory that uses innovative techniques to test and label products with accuracy. The team hopes to continue growing their services and eventually through artificial intelligence, build a platform that can recommend products to each individual consumer that will ensure them a predictable experience based on their desired therapeutic outcome.


Throughout this episode, we discuss social stereotypes and political challenges that the cannabis industry has faced in the past decades. We move past the mistaken idea that active ingredients of marijuana always cause mental dullness and lethargy, and we bring the conversation down to a molecular level to discuss CB1 receptors and anti-inflammatory benefits, and pain relief.


Finally, the doctors discuss fundraising for a nontraditional business pursuit. Dr. Iannuccilli shares how the vape crisis was a pivotal point– it served as a wake-up call for consumers and investors, leading to higher recognition of the importance of more stringent and standardized product testing. PureVita Labs has started to fundraise through friends and family with convertible notes, which are structured loans with set interest rates that allow the investor to either pull out their initial investment plus interest, or roll that value into equity once the company has established its valuation.


---


RESOURCES


Pure Vita Labs:

https://purevitalabs.com/


The Bartholomewtown Podcast- Ep. 101, “Inside RI Cannabis”

https://btown.buzzsprout.com/163601/11221697-inside-ri-cannabis-presented-by-purevita-labs-cannabis-101-part-1


WHOOP:

https://www.whoop.com/


The Peter Attia Drive Podcast:

https://peterattiamd.com/podcast/

]]> 4331 Ep. 238 Pain and Veins: A Unique OBL Practice with Dr. Keerthi Prasad In this episode, guest host Dr. Shamit Desai interviews Dr. Keerthi Prasad about his path to starting an IR practice alongside interventional pain specialists. --- CHECK OUT OUR SPONSORS Medtronic VenaSeal https://www.medtronic.com/venaseal Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent.html --- SHOW NOTES This unique collaboration started after Dr. Prasad finished fellowship. He describes the support and investment that his anesthesiologist partners provided in helping him launch IR service lines in their existing practice. On the pain management side, he primarily performs vertebral augmentation, DRG stimulation, and nerve blocks. He has also expanded his services into vein care, since venous disease is often concomitant with PAD, wound care, and pain. Dr. Prasad emphasizes the value of focusing on specific procedures and disease states in order to provide the best and most up to date clinical care possible. This can also set you apart from other competitors and help patients identify you as their vascular specialist. Dr. Prasad delves into the infrastructure of their centers. Their high volume of patients requires close coordination of all office and medical staff. To retain highly trained medical staff, he recommends investing in their training, minimizing office politics, and granting sufficient autonomy. Since 2016, the Centers for Pain Control and Vein Care has expanded to multiple locations in northwest Indiana. Dr. Prasad closes the episode by speaking about practice marketing and forming new referral networks. He emphasizes the importance of identifying if there is a true clinical need to perform each procedure and following up with patients and referring doctors. --- RESOURCES Centers for Pain Control and Vein Care: https://www.discover-cpc.com/ Mon, 29 Aug 2022 05:00:00 -0000 full BackTable In this episode, guest host Dr. Shamit Desai interviews Dr. Keerthi Prasad about his path to starting an IR practice alongside interventional pain specialists. In this episode, guest host Dr. Shamit Desai interviews Dr. Keerthi Prasad about his path to starting an IR practice alongside interventional pain specialists. --- CHECK OUT OUR SPONSORS Medtronic VenaSeal https://www.medtronic.com/venaseal Boston Scientific Lab Agent https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent.html --- SHOW NOTES This unique collaboration started after Dr. Prasad finished fellowship. He describes the support and investment that his anesthesiologist partners provided in helping him launch IR service lines in their existing practice. On the pain management side, he primarily performs vertebral augmentation, DRG stimulation, and nerve blocks. He has also expanded his services into vein care, since venous disease is often concomitant with PAD, wound care, and pain. Dr. Prasad emphasizes the value of focusing on specific procedures and disease states in order to provide the best and most up to date clinical care possible. This can also set you apart from other competitors and help patients identify you as their vascular specialist. Dr. Prasad delves into the infrastructure of their centers. Their high volume of patients requires close coordination of all office and medical staff. To retain highly trained medical staff, he recommends investing in their training, minimizing office politics, and granting sufficient autonomy. Since 2016, the Centers for Pain Control and Vein Care has expanded to multiple locations in northwest Indiana. Dr. Prasad closes the episode by speaking about practice marketing and forming new referral networks. He emphasizes the importance of identifying if there is a true clinical need to perform each procedure and following up with patients and referring doctors. --- RESOURCES Centers for Pain Control and Vein Care: https://www.discover-cpc.com/ In this episode, guest host Dr. Shamit Desai interviews Dr. Keerthi Prasad about his path to starting an IR practice alongside interventional pain specialists.


---


CHECK OUT OUR SPONSORS


Medtronic VenaSeal

https://www.medtronic.com/venaseal


Boston Scientific Lab Agent

https://www.bostonscientific.com/en-US/customer-service/ordering/lab-agent.html


---


SHOW NOTES


This unique collaboration started after Dr. Prasad finished fellowship. He describes the support and investment that his anesthesiologist partners provided in helping him launch IR service lines in their existing practice. On the pain management side, he primarily performs vertebral augmentation, DRG stimulation, and nerve blocks. He has also expanded his services into vein care, since venous disease is often concomitant with PAD, wound care, and pain. Dr. Prasad emphasizes the value of focusing on specific procedures and disease states in order to provide the best and most up to date clinical care possible. This can also set you apart from other competitors and help patients identify you as their vascular specialist.


Dr. Prasad delves into the infrastructure of their centers. Their high volume of patients requires close coordination of all office and medical staff. To retain highly trained medical staff, he recommends investing in their training, minimizing office politics, and granting sufficient autonomy.


Since 2016, the Centers for Pain Control and Vein Care has expanded to multiple locations in northwest Indiana. Dr. Prasad closes the episode by speaking about practice marketing and forming new referral networks. He emphasizes the importance of identifying if there is a true clinical need to perform each procedure and following up with patients and referring doctors.


---


RESOURCES


Centers for Pain Control and Vein Care:

https://www.discover-cpc.com/

]]> 2519 Ep. 237 Endovascular Treatment of Stroke Training: An Update with Dr. Martin Radvany and Dr. Venu Vadlamudi In this episode, guest host Dr. Venu Vadlamudi interviews Dr. Martin Radvany about where neurointerventional training stands in 2022, including stroke training for residents, barriers that IRs face in finding training after residency, and future directions of stroke care. --- CHECK OUT OUR SPONSOR RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/s3zGTV --- SHOW NOTES We begin by discussing stroke training in neurointerventional radiology. The Society of Interventional Radiology (SIR) has been prioritizing stroke training for IRs for years, with their former Clots Course and current Stroke Course, with Dr. Vadlamudi and Dr. Radvany as the directors of the course. This course occurs at the annual SIR meetings. Courses such as these are necessary because many residents aren’t trained in neurointervention but when they get out in the community the need is there and their employers often expect them to be able to provide stroke care. Dr. Vadlamudi hopes to grow the stroke course and eventually break away from the annual SIR meeting into it’s own free-standing course, such as has been done with the Y90 course. Next, we cover some of the barriers to IRs getting involved in stroke care. Often, practitioners with years of experience want or need to start performing neuroendovascular interventions but didn’t get a lot of experience in their training. Industry support is an important area that requires some growth to be able to support this pathway for IRs already in practice. Simulators are also a key aspect in training, and we discuss the possibilities of leveraging this for stroke training. By bringing patient specific anatomy into the simulator, anyone could use this to train in stroke thrombectomy and be able to practice with a patient's unique anatomy before performing the actual case. Finally, we discuss what trainees should expect going forward in IR residency and neuro fellowship. Interventional radiology is becoming very clinical, and it is important for trainees to focus on this. Spend the time in the ICU and on the floor. Knowing how to take care of your patients is essential in IR; we need to do more than just master the procedures. There are many ways to get training in stroke intervention. Mentorship at all levels is important and encouraged to push the field forward. --- RESOURCES Outcomes of Stroke Thrombectomy Performed by Interventional Radiologists versus Neurointerventional Physicians: https://pubmed.ncbi.nlm.nih.gov/35150837/ Fri, 26 Aug 2022 05:00:00 -0000 full BackTable In this episode, guest host Dr. Venu Vadlamudi interviews Dr. Martin Radvany about where neurointerventional training stands in 2022, including stroke training for residents, barriers that IRs face in finding training after residency, and future directions of stroke care. In this episode, guest host Dr. Venu Vadlamudi interviews Dr. Martin Radvany about where neurointerventional training stands in 2022, including stroke training for residents, barriers that IRs face in finding training after residency, and future directions of stroke care. --- CHECK OUT OUR SPONSOR RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/s3zGTV --- SHOW NOTES We begin by discussing stroke training in neurointerventional radiology. The Society of Interventional Radiology (SIR) has been prioritizing stroke training for IRs for years, with their former Clots Course and current Stroke Course, with Dr. Vadlamudi and Dr. Radvany as the directors of the course. This course occurs at the annual SIR meetings. Courses such as these are necessary because many residents aren’t trained in neurointervention but when they get out in the community the need is there and their employers often expect them to be able to provide stroke care. Dr. Vadlamudi hopes to grow the stroke course and eventually break away from the annual SIR meeting into it’s own free-standing course, such as has been done with the Y90 course. Next, we cover some of the barriers to IRs getting involved in stroke care. Often, practitioners with years of experience want or need to start performing neuroendovascular interventions but didn’t get a lot of experience in their training. Industry support is an important area that requires some growth to be able to support this pathway for IRs already in practice. Simulators are also a key aspect in training, and we discuss the possibilities of leveraging this for stroke training. By bringing patient specific anatomy into the simulator, anyone could use this to train in stroke thrombectomy and be able to practice with a patient's unique anatomy before performing the actual case. Finally, we discuss what trainees should expect going forward in IR residency and neuro fellowship. Interventional radiology is becoming very clinical, and it is important for trainees to focus on this. Spend the time in the ICU and on the floor. Knowing how to take care of your patients is essential in IR; we need to do more than just master the procedures. There are many ways to get training in stroke intervention. Mentorship at all levels is important and encouraged to push the field forward. --- RESOURCES Outcomes of Stroke Thrombectomy Performed by Interventional Radiologists versus Neurointerventional Physicians: https://pubmed.ncbi.nlm.nih.gov/35150837/ In this episode, guest host Dr. Venu Vadlamudi interviews Dr. Martin Radvany about where neurointerventional training stands in 2022, including stroke training for residents, barriers that IRs face in finding training after residency, and future directions of stroke care.


---


CHECK OUT OUR SPONSOR


RapidAI

http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/s3zGTV


---


SHOW NOTES


We begin by discussing stroke training in neurointerventional radiology. The Society of Interventional Radiology (SIR) has been prioritizing stroke training for IRs for years, with their former Clots Course and current Stroke Course, with Dr. Vadlamudi and Dr. Radvany as the directors of the course. This course occurs at the annual SIR meetings. Courses such as these are necessary because many residents aren’t trained in neurointervention but when they get out in the community the need is there and their employers often expect them to be able to provide stroke care. Dr. Vadlamudi hopes to grow the stroke course and eventually break away from the annual SIR meeting into it’s own free-standing course, such as has been done with the Y90 course.


Next, we cover some of the barriers to IRs getting involved in stroke care. Often, practitioners with years of experience want or need to start performing neuroendovascular interventions but didn’t get a lot of experience in their training. Industry support is an important area that requires some growth to be able to support this pathway for IRs already in practice. Simulators are also a key aspect in training, and we discuss the possibilities of leveraging this for stroke training. By bringing patient specific anatomy into the simulator, anyone could use this to train in stroke thrombectomy and be able to practice with a patient's unique anatomy before performing the actual case.


Finally, we discuss what trainees should expect going forward in IR residency and neuro fellowship. Interventional radiology is becoming very clinical, and it is important for trainees to focus on this. Spend the time in the ICU and on the floor. Knowing how to take care of your patients is essential in IR; we need to do more than just master the procedures. There are many ways to get training in stroke intervention. Mentorship at all levels is important and encouraged to push the field forward.


---


RESOURCES


Outcomes of Stroke Thrombectomy Performed by Interventional Radiologists versus Neurointerventional Physicians:

https://pubmed.ncbi.nlm.nih.gov/35150837/

]]> 3320 Ep. 236 Building a Cross-Specialty Vascular Practice with Dr. Chad Laurich and Dr. Neal Khurana In this episode, host Dr. Aaron Fritts interviews Drs. Chad Laurich and Neal Khurana about how they looked past traditional competition between IR and vascular surgery to build a multidisciplinary practice to meet market need and provide comprehensive patient care for an underserved community in South Dakota. --- CHECK OUT OUR SPONSORS Viz.ai https://www.viz.ai/ Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 --- SHOW NOTES We begin by discussing how Dr. Khurana joined Dr. Laurich at his practice in South Dakota. When Dr. Laurich opened his solo practice, he realized there was a lack of medical care in the community and he knew he would not be able to meet the demand on his own. He decided he wanted to bring an IR to his group due to his respect for IR and the breadth of procedural and clinical knowledge they would bring. He knew that their combined skills would provide better patient care than hiring another vascular surgeon. Next, we discuss the concept of collaboration over competition in vascular surgery and interventional radiology. Dr. Khurana advises that in order to enter into a partnership such as this, you have to understand that you are not the only one able to do endovascular work, that there are vascular surgery and interventional cardiology colleagues who are extremely talented in vascular intervention. All egos must be put aside, and you must never forget that the goal is to help the patient. Dr. Khurana joined Dr. Laurich with this mindset and an eagerness to learn as much as he could to benefit their community. Dr. Laurich and Dr. Khurana hope this collaborative model grows in popularity among all endovascular specialists. The OBL model affords physician autonomy, excellence in patient care, and provides an out from the burnout caused by the hospital grind. What ends up happening at a well designed and operated OBL is that everyone wins: physicians, patients and staff. This VS-IR powerhouse hopes to provide master courses in the future for physicians to learn how to master certain diseases or procedures that they need to run a successful multidisciplinary endovascular OBL. --- RESOURCES Ep. 129: OBL/ASC Business Pearls: https://www.backtable.com/shows/vi/podcasts/129/obl-asc-business-pearls Ep. 205: Update on Reimbursement Cuts for the OBL/ASC: https://www.backtable.com/shows/vi/podcasts/205/update-on-reimbursement-cuts-for-the-obl-asc Mon, 22 Aug 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Drs. Chad Laurich and Neal Khurana about how they looked past traditional competition between IR and vascular surgery to build a multidisciplinary practice to meet market need and provide comprehensive patient care for an underserved community in South Dakota. In this episode, host Dr. Aaron Fritts interviews Drs. Chad Laurich and Neal Khurana about how they looked past traditional competition between IR and vascular surgery to build a multidisciplinary practice to meet market need and provide comprehensive patient care for an underserved community in South Dakota. --- CHECK OUT OUR SPONSORS Viz.ai https://www.viz.ai/ Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 --- SHOW NOTES We begin by discussing how Dr. Khurana joined Dr. Laurich at his practice in South Dakota. When Dr. Laurich opened his solo practice, he realized there was a lack of medical care in the community and he knew he would not be able to meet the demand on his own. He decided he wanted to bring an IR to his group due to his respect for IR and the breadth of procedural and clinical knowledge they would bring. He knew that their combined skills would provide better patient care than hiring another vascular surgeon. Next, we discuss the concept of collaboration over competition in vascular surgery and interventional radiology. Dr. Khurana advises that in order to enter into a partnership such as this, you have to understand that you are not the only one able to do endovascular work, that there are vascular surgery and interventional cardiology colleagues who are extremely talented in vascular intervention. All egos must be put aside, and you must never forget that the goal is to help the patient. Dr. Khurana joined Dr. Laurich with this mindset and an eagerness to learn as much as he could to benefit their community. Dr. Laurich and Dr. Khurana hope this collaborative model grows in popularity among all endovascular specialists. The OBL model affords physician autonomy, excellence in patient care, and provides an out from the burnout caused by the hospital grind. What ends up happening at a well designed and operated OBL is that everyone wins: physicians, patients and staff. This VS-IR powerhouse hopes to provide master courses in the future for physicians to learn how to master certain diseases or procedures that they need to run a successful multidisciplinary endovascular OBL. --- RESOURCES Ep. 129: OBL/ASC Business Pearls: https://www.backtable.com/shows/vi/podcasts/129/obl-asc-business-pearls Ep. 205: Update on Reimbursement Cuts for the OBL/ASC: https://www.backtable.com/shows/vi/podcasts/205/update-on-reimbursement-cuts-for-the-obl-asc In this episode, host Dr. Aaron Fritts interviews Drs. Chad Laurich and Neal Khurana about how they looked past traditional competition between IR and vascular surgery to build a multidisciplinary practice to meet market need and provide comprehensive patient care for an underserved community in South Dakota.


---


CHECK OUT OUR SPONSORS


Viz.ai

https://www.viz.ai/


Boston Scientific Nextlab

https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040


---


SHOW NOTES


We begin by discussing how Dr. Khurana joined Dr. Laurich at his practice in South Dakota. When Dr. Laurich opened his solo practice, he realized there was a lack of medical care in the community and he knew he would not be able to meet the demand on his own. He decided he wanted to bring an IR to his group due to his respect for IR and the breadth of procedural and clinical knowledge they would bring. He knew that their combined skills would provide better patient care than hiring another vascular surgeon.


Next, we discuss the concept of collaboration over competition in vascular surgery and interventional radiology. Dr. Khurana advises that in order to enter into a partnership such as this, you have to understand that you are not the only one able to do endovascular work, that there are vascular surgery and interventional cardiology colleagues who are extremely talented in vascular intervention. All egos must be put aside, and you must never forget that the goal is to help the patient. Dr. Khurana joined Dr. Laurich with this mindset and an eagerness to learn as much as he could to benefit their community.


Dr. Laurich and Dr. Khurana hope this collaborative model grows in popularity among all endovascular specialists. The OBL model affords physician autonomy, excellence in patient care, and provides an out from the burnout caused by the hospital grind. What ends up happening at a well designed and operated OBL is that everyone wins: physicians, patients and staff. This VS-IR powerhouse hopes to provide master courses in the future for physicians to learn how to master certain diseases or procedures that they need to run a successful multidisciplinary endovascular OBL.


---


RESOURCES


Ep. 129: OBL/ASC Business Pearls:

https://www.backtable.com/shows/vi/podcasts/129/obl-asc-business-pearls


Ep. 205: Update on Reimbursement Cuts for the OBL/ASC:

https://www.backtable.com/shows/vi/podcasts/205/update-on-reimbursement-cuts-for-the-obl-asc

]]> 3210 Ep. 235 The Right Job for You with STAT Careers Founders Drs. Kasie and Rockford Adkins In this episode, our host Dr. Aaron Fritts interviews physician-entrepreneur couple Drs. Kasie and Rockford Adkins about the path to starting their healthcare recruiting platform, STAT Careers. --- CHECK OUT OUR SPONSORS RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor Athletic Greens https://www.athleticgreens.com/backtablevi --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/7oM8rH --- SHOW NOTES Our guests describe their firsthand experiences with job searching in IR and Mohs surgery. Completing fellowship programs at different times and moving to different cities made it difficult to negotiate hiring contracts. Dr. Kasie Adkins recounts her frustration with the high cost of third party recruiters and a lack of transparency about pay and job structure during the application process. She also highlights the need to level the playing field for skilled physicians who are underrepresented in certain specialties. To learn more about pain points in hiring and retention of healthcare professionals, the doctors reached out to their hospital administrators and colleagues. They compiled this market research into an online web application that matches candidates to positions. STAT Careers allows candidates to filter positions based on factors such as skill set, call schedule, and location, free of charge. Each employer can build a custom template for each position that lists specific characteristics and responsibilities. The founders outline their growth trajectory, from building their initial algorithm, to hiring full time employees, to seeking international opportunities. Currently, they are developing ways to better match applicants to positions based on culture fit. We close the episode by discussing the importance of learning from retention rates and remaining transparent to optimize team function. --- RESOURCES STAT Careers: https://statcareers.com/?utm_source=Backtable&utm_medium=Podcast&utm_campaign=A+better+job+for+you The Staggering Costs of Physician Turnover: https://www.todayshospitalist.com/staggering-costs-physician-turnover/ Physician Turnover: A Costly Problem: https://go.gale.com/ps/i.do?p=AONE&u=googlescholar&id=GALE%7CA414692555&v=2.1&it=r&sid=AONE&asid=53fcd53a The Cost of Nurse Turnover: https://www.beckershospitalreview.com/finance/the-cost-of-nurse-turnover-by-the-numbers.html Beyond perception: the role of gender across marketing scholars’ careers, in reply to Galak and Kahn (2021): https://link.springer.com/article/10.1007/s11002-021-09585-5 VA National Teleradiology Program: Email VHANTPRecruitment@va.gov Episode 110- When That First Physician Job Isn’t a Good Fit: https://www.backtable.com/shows/vi/podcasts/110/when-that-first-physician-job-isnt-a-good-fit Episode 201- Jobs: The Good, The Bad, and The Snugly: https://www.backtable.com/shows/vi/podcasts/201/jobs-the-good-the-bad-the-snugly Episode 202- Staffing the OBL: https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl Fri, 19 Aug 2022 05:00:00 -0000 full BackTable In this episode, our host Dr. Aaron Fritts interviews physician-entrepreneur couple Drs. Kasie and Rockford Adkins about the path to starting their healthcare recruiting platform, STAT Careers. In this episode, our host Dr. Aaron Fritts interviews physician-entrepreneur couple Drs. Kasie and Rockford Adkins about the path to starting their healthcare recruiting platform, STAT Careers. --- CHECK OUT OUR SPONSORS RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor Athletic Greens https://www.athleticgreens.com/backtablevi --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/7oM8rH --- SHOW NOTES Our guests describe their firsthand experiences with job searching in IR and Mohs surgery. Completing fellowship programs at different times and moving to different cities made it difficult to negotiate hiring contracts. Dr. Kasie Adkins recounts her frustration with the high cost of third party recruiters and a lack of transparency about pay and job structure during the application process. She also highlights the need to level the playing field for skilled physicians who are underrepresented in certain specialties. To learn more about pain points in hiring and retention of healthcare professionals, the doctors reached out to their hospital administrators and colleagues. They compiled this market research into an online web application that matches candidates to positions. STAT Careers allows candidates to filter positions based on factors such as skill set, call schedule, and location, free of charge. Each employer can build a custom template for each position that lists specific characteristics and responsibilities. The founders outline their growth trajectory, from building their initial algorithm, to hiring full time employees, to seeking international opportunities. Currently, they are developing ways to better match applicants to positions based on culture fit. We close the episode by discussing the importance of learning from retention rates and remaining transparent to optimize team function. --- RESOURCES STAT Careers: https://statcareers.com/?utm_source=Backtable&utm_medium=Podcast&utm_campaign=A+better+job+for+you The Staggering Costs of Physician Turnover: https://www.todayshospitalist.com/staggering-costs-physician-turnover/ Physician Turnover: A Costly Problem: https://go.gale.com/ps/i.do?p=AONE&u=googlescholar&id=GALE%7CA414692555&v=2.1&it=r&sid=AONE&asid=53fcd53a The Cost of Nurse Turnover: https://www.beckershospitalreview.com/finance/the-cost-of-nurse-turnover-by-the-numbers.html Beyond perception: the role of gender across marketing scholars’ careers, in reply to Galak and Kahn (2021): https://link.springer.com/article/10.1007/s11002-021-09585-5 VA National Teleradiology Program: Email VHANTPRecruitment@va.gov Episode 110- When That First Physician Job Isn’t a Good Fit: https://www.backtable.com/shows/vi/podcasts/110/when-that-first-physician-job-isnt-a-good-fit Episode 201- Jobs: The Good, The Bad, and The Snugly: https://www.backtable.com/shows/vi/podcasts/201/jobs-the-good-the-bad-the-snugly Episode 202- Staffing the OBL: https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl In this episode, our host Dr. Aaron Fritts interviews physician-entrepreneur couple Drs. Kasie and Rockford Adkins about the path to starting their healthcare recruiting platform, STAT Careers.


---


CHECK OUT OUR SPONSORS


RapidAI

http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor


Athletic Greens

https://www.athleticgreens.com/backtablevi


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/7oM8rH


---


SHOW NOTES


Our guests describe their firsthand experiences with job searching in IR and Mohs surgery. Completing fellowship programs at different times and moving to different cities made it difficult to negotiate hiring contracts. Dr. Kasie Adkins recounts her frustration with the high cost of third party recruiters and a lack of transparency about pay and job structure during the application process. She also highlights the need to level the playing field for skilled physicians who are underrepresented in certain specialties.


To learn more about pain points in hiring and retention of healthcare professionals, the doctors reached out to their hospital administrators and colleagues. They compiled this market research into an online web application that matches candidates to positions. STAT Careers allows candidates to filter positions based on factors such as skill set, call schedule, and location, free of charge. Each employer can build a custom template for each position that lists specific characteristics and responsibilities.


The founders outline their growth trajectory, from building their initial algorithm, to hiring full time employees, to seeking international opportunities. Currently, they are developing ways to better match applicants to positions based on culture fit. We close the episode by discussing the importance of learning from retention rates and remaining transparent to optimize team function.


---


RESOURCES


STAT Careers:

https://statcareers.com/?utm_source=Backtable&utm_medium=Podcast&utm_campaign=A+better+job+for+you


The Staggering Costs of Physician Turnover:

https://www.todayshospitalist.com/staggering-costs-physician-turnover/


Physician Turnover: A Costly Problem:

https://go.gale.com/ps/i.do?p=AONE&u=googlescholar&id=GALE%7CA414692555&v=2.1&it=r&sid=AONE&asid=53fcd53a


The Cost of Nurse Turnover:

https://www.beckershospitalreview.com/finance/the-cost-of-nurse-turnover-by-the-numbers.html


Beyond perception: the role of gender across marketing scholars’ careers, in reply to Galak and Kahn (2021):

https://link.springer.com/article/10.1007/s11002-021-09585-5


VA National Teleradiology Program:

Email VHANTPRecruitment@va.gov


Episode 110- When That First Physician Job Isn’t a Good Fit:

https://www.backtable.com/shows/vi/podcasts/110/when-that-first-physician-job-isnt-a-good-fit


Episode 201- Jobs: The Good, The Bad, and The Snugly:

https://www.backtable.com/shows/vi/podcasts/201/jobs-the-good-the-bad-the-snugly


Episode 202- Staffing the OBL:

https://www.backtable.com/shows/vi/podcasts/202/staffing-the-obl

]]> 3699 Ep. 234 Veterinary IR with Dr. Chris Thomson In this episode, cohosts Dr. Michael Barraza and Dr. Aaron Fritts interview Dr. Chris Thomson, veterinary surgeon and interventional radiologist about how he learned veterinary IR, his area of focus in interventional oncology, and the future of the specialty. --- CHECK OUT OUR SPONSOR Athletic Greens https://www.athleticgreens.com/backtablevi --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/7O0Ic5 --- SHOW NOTES Dr. Thomson begins by taking us through his training. During his residency at the University of Minnesota, Shamar Young taught him embolizations and interventional oncology at the medical school and the veterinary school there. He then adapted it to dogs. He then did a surgical oncology fellowship at Colorado State which grew his passion for practicing interventional oncology. There is no training specifically for IR; you train in your specialty of cardiology or oncology, then go on to learn IR skills later in practice. In the interventional oncology world, Dr. Thomson does prostate artery embolizations for prostate tumors, chemoembolizations, and caval and urethral stents for malignant obstructions. He primarily treats cats and dogs, but occasionally he will help out with an intervention for an animal at the San Diego Zoo. He recently helped do renal sclerotherapy for a dik-dik to treat idiopathic renal hematuria. Dr. Thomson discusses some of the challenges he faces with the different sizes of animals he treats. The size of the animal and the size of the equipment often don’t match up well which poses many technical difficulties for the operator. We end by discussing the future of veterinary IR. In the cardiovascular IR world, veterinary specialists are beginning to do endovascular valve replacements. In the interventional oncology world, radiofrequency ablation and cementoplasty for appendicular bone tumors is the next big procedure that will impact many patients. Dr. Thomson is excited about being able to provide this minimally invasive treatment for his cat and dog patients as it will prevent many amputations and allow his patients to receive chemotherapy while retaining the highest quality of life possible. Mon, 15 Aug 2022 05:00:00 -0000 full BackTable In this episode, cohosts Dr. Michael Barraza and Dr. Aaron Fritts interview Dr. Chris Thomson, veterinary surgeon and interventional radiologist about how he learned veterinary IR, his area of focus in interventional oncology, and the future of the specialty. In this episode, cohosts Dr. Michael Barraza and Dr. Aaron Fritts interview Dr. Chris Thomson, veterinary surgeon and interventional radiologist about how he learned veterinary IR, his area of focus in interventional oncology, and the future of the specialty. --- CHECK OUT OUR SPONSOR Athletic Greens https://www.athleticgreens.com/backtablevi --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/7O0Ic5 --- SHOW NOTES Dr. Thomson begins by taking us through his training. During his residency at the University of Minnesota, Shamar Young taught him embolizations and interventional oncology at the medical school and the veterinary school there. He then adapted it to dogs. He then did a surgical oncology fellowship at Colorado State which grew his passion for practicing interventional oncology. There is no training specifically for IR; you train in your specialty of cardiology or oncology, then go on to learn IR skills later in practice. In the interventional oncology world, Dr. Thomson does prostate artery embolizations for prostate tumors, chemoembolizations, and caval and urethral stents for malignant obstructions. He primarily treats cats and dogs, but occasionally he will help out with an intervention for an animal at the San Diego Zoo. He recently helped do renal sclerotherapy for a dik-dik to treat idiopathic renal hematuria. Dr. Thomson discusses some of the challenges he faces with the different sizes of animals he treats. The size of the animal and the size of the equipment often don’t match up well which poses many technical difficulties for the operator. We end by discussing the future of veterinary IR. In the cardiovascular IR world, veterinary specialists are beginning to do endovascular valve replacements. In the interventional oncology world, radiofrequency ablation and cementoplasty for appendicular bone tumors is the next big procedure that will impact many patients. Dr. Thomson is excited about being able to provide this minimally invasive treatment for his cat and dog patients as it will prevent many amputations and allow his patients to receive chemotherapy while retaining the highest quality of life possible. In this episode, cohosts Dr. Michael Barraza and Dr. Aaron Fritts interview Dr. Chris Thomson, veterinary surgeon and interventional radiologist about how he learned veterinary IR, his area of focus in interventional oncology, and the future of the specialty.


---


CHECK OUT OUR SPONSOR


Athletic Greens

https://www.athleticgreens.com/backtablevi


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/7O0Ic5


---


SHOW NOTES


Dr. Thomson begins by taking us through his training. During his residency at the University of Minnesota, Shamar Young taught him embolizations and interventional oncology at the medical school and the veterinary school there. He then adapted it to dogs. He then did a surgical oncology fellowship at Colorado State which grew his passion for practicing interventional oncology. There is no training specifically for IR; you train in your specialty of cardiology or oncology, then go on to learn IR skills later in practice.


In the interventional oncology world, Dr. Thomson does prostate artery embolizations for prostate tumors, chemoembolizations, and caval and urethral stents for malignant obstructions. He primarily treats cats and dogs, but occasionally he will help out with an intervention for an animal at the San Diego Zoo. He recently helped do renal sclerotherapy for a dik-dik to treat idiopathic renal hematuria. Dr. Thomson discusses some of the challenges he faces with the different sizes of animals he treats. The size of the animal and the size of the equipment often don’t match up well which poses many technical difficulties for the operator.


We end by discussing the future of veterinary IR. In the cardiovascular IR world, veterinary specialists are beginning to do endovascular valve replacements. In the interventional oncology world, radiofrequency ablation and cementoplasty for appendicular bone tumors is the next big procedure that will impact many patients. Dr. Thomson is excited about being able to provide this minimally invasive treatment for his cat and dog patients as it will prevent many amputations and allow his patients to receive chemotherapy while retaining the highest quality of life possible.

]]> 2587 Ep. 233 Desmoid Tumors: IR's Role in Diagnosis and Management with Dr. Jack Jennings In this episode, host Dr. Jacob Fleming interviews Dr. Jack Jennings about cryoablation, multidisciplinary care, and practice building for the treatment of desmoid tumors. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/aNJOCP --- SHOW NOTES First, Dr. Jennings describes the typical presentation of desmoid tumors, also known as “aggressive fibromatosis.” These are neoplasms of fibrous connective tissue, but unlike sarcomas, they do not metastasize to other parts of the body. We quickly review characteristic imaging findings such as hypointense T1 and T2 signals. In the last decade, sorafenib (tyrosine kinase inhibitor) was established as a therapy for desmoid tumors. However, since sorafenib has failed to show significant efficacy, there has been exploration into other treatments such as surgical resection and cryoablation. Dr. Jennings encourages IRs to attend sarcoma tumor boards to learn about desmoid cases and opportunities to perform cryoablations when desmoids cannot be surgically resected. In extra-abdominal desmoids, cryoablation is ideal, since the interventionist can see the low attenuation ice ball forming and sculpt ablation zones to match irregular desmoid shapes. Dr. Jennings recommends forming a 10mm ablation margin around the tumor. Additionally, he discusses both active and passive thermal protection techniques for surrounding tissues. He utilizes carbon dioxide, hydropneumodissection, and motor/somatosensory evoked potentials to keep non-target tissues out of the ablation zone. The bowel and nerves (especially in the extremities) are critically important to avoid. For post-procedural care, Dr. Jennings emphasizes that pain is very common, due to large inflammatory responses. He usually admits patients overnight to monitor pain levels and give IV Decadron. Patients are then sent home with Medrol Dosepak. We also talk about the importance of informed consent about pain and potential nerve injuries. Finally, we discuss how IRs can be advocates for patients with desmoids. Dr. Jennings believes that preemptive measures can go a long way when talking to third party payers. He will usually include current National Comprehensive Cancer Network (NCCN) guidelines and current cryoablation papers in his clinic notes to support his recommendations. He also encourages IRs to collaborate with oncologists, surgeons, and radiation oncologists to craft the best treatment plan for their patients. --- RESOURCES Washington University MSK Interventions: https://www.mir.wustl.edu/education/subspecialty-programs/musculoskeletal-imaging-and-interventions/ Neuroanatomic Considerations in Percutaneous Tumor Ablation: https://pubs.rsna.org/doi/10.1148/rg.334125141 Anatomically Based Guidelines for Core Needle Biopsy of Bone Tumors: Implications for Limb-sparing Surgery: https://pubs.rsna.org/doi/10.1148/rg.271065092 National Comprehensive Cancer Network (NCCN) Guidelines for Soft Tissue Sarcomas (including Desmoid Tumors): https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1464 Society for Interventional Oncology (SIO): http://www.sio-central.org/ Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011449/ Fri, 12 Aug 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Jack Jennings about cryoablation, multidisciplinary care, and practice building for the treatment of desmoid tumors. In this episode, host Dr. Jacob Fleming interviews Dr. Jack Jennings about cryoablation, multidisciplinary care, and practice building for the treatment of desmoid tumors. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/aNJOCP --- SHOW NOTES First, Dr. Jennings describes the typical presentation of desmoid tumors, also known as “aggressive fibromatosis.” These are neoplasms of fibrous connective tissue, but unlike sarcomas, they do not metastasize to other parts of the body. We quickly review characteristic imaging findings such as hypointense T1 and T2 signals. In the last decade, sorafenib (tyrosine kinase inhibitor) was established as a therapy for desmoid tumors. However, since sorafenib has failed to show significant efficacy, there has been exploration into other treatments such as surgical resection and cryoablation. Dr. Jennings encourages IRs to attend sarcoma tumor boards to learn about desmoid cases and opportunities to perform cryoablations when desmoids cannot be surgically resected. In extra-abdominal desmoids, cryoablation is ideal, since the interventionist can see the low attenuation ice ball forming and sculpt ablation zones to match irregular desmoid shapes. Dr. Jennings recommends forming a 10mm ablation margin around the tumor. Additionally, he discusses both active and passive thermal protection techniques for surrounding tissues. He utilizes carbon dioxide, hydropneumodissection, and motor/somatosensory evoked potentials to keep non-target tissues out of the ablation zone. The bowel and nerves (especially in the extremities) are critically important to avoid. For post-procedural care, Dr. Jennings emphasizes that pain is very common, due to large inflammatory responses. He usually admits patients overnight to monitor pain levels and give IV Decadron. Patients are then sent home with Medrol Dosepak. We also talk about the importance of informed consent about pain and potential nerve injuries. Finally, we discuss how IRs can be advocates for patients with desmoids. Dr. Jennings believes that preemptive measures can go a long way when talking to third party payers. He will usually include current National Comprehensive Cancer Network (NCCN) guidelines and current cryoablation papers in his clinic notes to support his recommendations. He also encourages IRs to collaborate with oncologists, surgeons, and radiation oncologists to craft the best treatment plan for their patients. --- RESOURCES Washington University MSK Interventions: https://www.mir.wustl.edu/education/subspecialty-programs/musculoskeletal-imaging-and-interventions/ Neuroanatomic Considerations in Percutaneous Tumor Ablation: https://pubs.rsna.org/doi/10.1148/rg.334125141 Anatomically Based Guidelines for Core Needle Biopsy of Bone Tumors: Implications for Limb-sparing Surgery: https://pubs.rsna.org/doi/10.1148/rg.271065092 National Comprehensive Cancer Network (NCCN) Guidelines for Soft Tissue Sarcomas (including Desmoid Tumors): https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1464 Society for Interventional Oncology (SIO): http://www.sio-central.org/ Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011449/ In this episode, host Dr. Jacob Fleming interviews Dr. Jack Jennings about cryoablation, multidisciplinary care, and practice building for the treatment of desmoid tumors.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/aNJOCP


---


SHOW NOTES


First, Dr. Jennings describes the typical presentation of desmoid tumors, also known as “aggressive fibromatosis.” These are neoplasms of fibrous connective tissue, but unlike sarcomas, they do not metastasize to other parts of the body. We quickly review characteristic imaging findings such as hypointense T1 and T2 signals. In the last decade, sorafenib (tyrosine kinase inhibitor) was established as a therapy for desmoid tumors. However, since sorafenib has failed to show significant efficacy, there has been exploration into other treatments such as surgical resection and cryoablation.


Dr. Jennings encourages IRs to attend sarcoma tumor boards to learn about desmoid cases and opportunities to perform cryoablations when desmoids cannot be surgically resected. In extra-abdominal desmoids, cryoablation is ideal, since the interventionist can see the low attenuation ice ball forming and sculpt ablation zones to match irregular desmoid shapes. Dr. Jennings recommends forming a 10mm ablation margin around the tumor. Additionally, he discusses both active and passive thermal protection techniques for surrounding tissues. He utilizes carbon dioxide, hydropneumodissection, and motor/somatosensory evoked potentials to keep non-target tissues out of the ablation zone. The bowel and nerves (especially in the extremities) are critically important to avoid.


For post-procedural care, Dr. Jennings emphasizes that pain is very common, due to large inflammatory responses. He usually admits patients overnight to monitor pain levels and give IV Decadron. Patients are then sent home with Medrol Dosepak. We also talk about the importance of informed consent about pain and potential nerve injuries.


Finally, we discuss how IRs can be advocates for patients with desmoids. Dr. Jennings believes that preemptive measures can go a long way when talking to third party payers. He will usually include current National Comprehensive Cancer Network (NCCN) guidelines and current cryoablation papers in his clinic notes to support his recommendations. He also encourages IRs to collaborate with oncologists, surgeons, and radiation oncologists to craft the best treatment plan for their patients.


---


RESOURCES


Washington University MSK Interventions:

https://www.mir.wustl.edu/education/subspecialty-programs/musculoskeletal-imaging-and-interventions/


Neuroanatomic Considerations in Percutaneous Tumor Ablation:

https://pubs.rsna.org/doi/10.1148/rg.334125141


Anatomically Based Guidelines for Core Needle Biopsy of Bone Tumors: Implications for Limb-sparing Surgery:

https://pubs.rsna.org/doi/10.1148/rg.271065092


National Comprehensive Cancer Network (NCCN) Guidelines for Soft Tissue Sarcomas (including Desmoid Tumors):

https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1464


Society for Interventional Oncology (SIO):

http://www.sio-central.org/


Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011449/

]]> 4047 Ep. 232 Palliative Care in IR with Dr. Sean Tutton In this episode, host Dr. Eric Keller interviews Dr. Sean Tutton about palliative care as an interventionalist, how he became interested in palliative care, and why he believes it is a crucial aspect of patient care in interventional radiology. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/OYDxfn --- SHOW NOTES The role of palliative care is to talk with patients about their goals, make them comfortable, optimize medical management, help patients understand their diagnosis, and coordinate care. Though palliative care involvement does not mean a patient is close to death, many palliative care patients will enroll in hospice at some point. Once in hospice, life-prolonging therapies are no longer pursued. Hospice care is a benefit of Medicare. It has support such as home care, and it can be expensive but is covered by the government. Due to this, there are guidelines that need to be adhered to. Frequently, palliative interventional pain procedures such as a celiac plexus block or neurolysis may not be covered so patients may have to come off hospice to get the procedure, then go back on. Next, we talk about how an IR can start to incorporate these ideals and practices into their daily work. Dr. Tutton emphasizes that you don’t need to do the fellowship. You can start rounding with palliative care, go to their conferences, and establish relationships. Having residents and fellows rotate with palliative care is a great way for future IRs to learn how to practice with a palliative care mindset, and also to educate palliative care on the minimally invasive options that IR can offer to patients such as nerve blocks and ablations. By adopting palliative care ideals as an interventionalist, you can help your patients achieve better pain control, improve their cognition and reduce narcotics use. Dr. Tutton recommends all IRs understand the medical management of post-op pain for any procedure they perform. He provides a standard medication regimen for a patient having an ablation. He uses Tylenol 1g pre-op and gabapentin 300-600mg 48-72hrs before the procedure and intraoperative steroids and NSAIDs such as Decadron 8-10mg and Toradol 10-30mg. All of these have level 1 data, help reduce narcotic requirements, and help with post-op nausea and pain. He discharges patients on a Medrol dose pack, ibuprofen, Tylenol, and gabapentin for a couple of days. Doing a nerve block can help as well, he frequently does ankle, digital, intercostal, and hypogastric blocks for his MSK and palliative interventions. --- RESOURCES Ep.199: Advanced Minimally Invasive Pain Interventions with Dr. Prologo https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions Ep. 68: RF Ablation for Bone Metastases with Dr. Levy and Dr. Bagla https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases Mon, 08 Aug 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Eric Keller interviews Dr. Sean Tutton about palliative care as an interventionalist, how he became interested in palliative care, and why he believes it is a crucial aspect of patient care in interventional radiology. In this episode, host Dr. Eric Keller interviews Dr. Sean Tutton about palliative care as an interventionalist, how he became interested in palliative care, and why he believes it is a crucial aspect of patient care in interventional radiology. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/OYDxfn --- SHOW NOTES The role of palliative care is to talk with patients about their goals, make them comfortable, optimize medical management, help patients understand their diagnosis, and coordinate care. Though palliative care involvement does not mean a patient is close to death, many palliative care patients will enroll in hospice at some point. Once in hospice, life-prolonging therapies are no longer pursued. Hospice care is a benefit of Medicare. It has support such as home care, and it can be expensive but is covered by the government. Due to this, there are guidelines that need to be adhered to. Frequently, palliative interventional pain procedures such as a celiac plexus block or neurolysis may not be covered so patients may have to come off hospice to get the procedure, then go back on. Next, we talk about how an IR can start to incorporate these ideals and practices into their daily work. Dr. Tutton emphasizes that you don’t need to do the fellowship. You can start rounding with palliative care, go to their conferences, and establish relationships. Having residents and fellows rotate with palliative care is a great way for future IRs to learn how to practice with a palliative care mindset, and also to educate palliative care on the minimally invasive options that IR can offer to patients such as nerve blocks and ablations. By adopting palliative care ideals as an interventionalist, you can help your patients achieve better pain control, improve their cognition and reduce narcotics use. Dr. Tutton recommends all IRs understand the medical management of post-op pain for any procedure they perform. He provides a standard medication regimen for a patient having an ablation. He uses Tylenol 1g pre-op and gabapentin 300-600mg 48-72hrs before the procedure and intraoperative steroids and NSAIDs such as Decadron 8-10mg and Toradol 10-30mg. All of these have level 1 data, help reduce narcotic requirements, and help with post-op nausea and pain. He discharges patients on a Medrol dose pack, ibuprofen, Tylenol, and gabapentin for a couple of days. Doing a nerve block can help as well, he frequently does ankle, digital, intercostal, and hypogastric blocks for his MSK and palliative interventions. --- RESOURCES Ep.199: Advanced Minimally Invasive Pain Interventions with Dr. Prologo https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions Ep. 68: RF Ablation for Bone Metastases with Dr. Levy and Dr. Bagla https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases In this episode, host Dr. Eric Keller interviews Dr. Sean Tutton about palliative care as an interventionalist, how he became interested in palliative care, and why he believes it is a crucial aspect of patient care in interventional radiology.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/OYDxfn


---


SHOW NOTES


The role of palliative care is to talk with patients about their goals, make them comfortable, optimize medical management, help patients understand their diagnosis, and coordinate care. Though palliative care involvement does not mean a patient is close to death, many palliative care patients will enroll in hospice at some point. Once in hospice, life-prolonging therapies are no longer pursued. Hospice care is a benefit of Medicare. It has support such as home care, and it can be expensive but is covered by the government. Due to this, there are guidelines that need to be adhered to. Frequently, palliative interventional pain procedures such as a celiac plexus block or neurolysis may not be covered so patients may have to come off hospice to get the procedure, then go back on.


Next, we talk about how an IR can start to incorporate these ideals and practices into their daily work. Dr. Tutton emphasizes that you don’t need to do the fellowship. You can start rounding with palliative care, go to their conferences, and establish relationships. Having residents and fellows rotate with palliative care is a great way for future IRs to learn how to practice with a palliative care mindset, and also to educate palliative care on the minimally invasive options that IR can offer to patients such as nerve blocks and ablations. By adopting palliative care ideals as an interventionalist, you can help your patients achieve better pain control, improve their cognition and reduce narcotics use.


Dr. Tutton recommends all IRs understand the medical management of post-op pain for any procedure they perform. He provides a standard medication regimen for a patient having an ablation. He uses Tylenol 1g pre-op and gabapentin 300-600mg 48-72hrs before the procedure and intraoperative steroids and NSAIDs such as Decadron 8-10mg and Toradol 10-30mg. All of these have level 1 data, help reduce narcotic requirements, and help with post-op nausea and pain. He discharges patients on a Medrol dose pack, ibuprofen, Tylenol, and gabapentin for a couple of days. Doing a nerve block can help as well, he frequently does ankle, digital, intercostal, and hypogastric blocks for his MSK and palliative interventions.


---


RESOURCES


Ep.199: Advanced Minimally Invasive Pain Interventions with Dr. Prologo

https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions


Ep. 68: RF Ablation for Bone Metastases with Dr. Levy and Dr. Bagla

https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases

]]> 3092 Ep. 231 Bullying in Vascular Training and Practice with Dr. Rachael Forsythe and Dr. Konstantinos Stavroulakis In this episode, host Dr. Aaron Fritts interviews Dr. Rachael Forsythe and Dr. Konstantinos Stravapoulas about their Research Collaborative for Peripheral Arterial Disease (RCPAD) survey on bullying in the European vascular workplace, and overall trends in reported bullying incidents. --- CHECK OUT OUR SPONSOR Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- SHOW NOTES We start the episode by learning about the RCPAD goals to enhance research collaboration between European vascular departments. The workplace bullying online survey is one of the RCPAD’s current projects. This survey was disseminated via social media and society mailing lists, and it received a total of 586 medical practitioners in vascular specialties. Next, we review major findings from the survey. Workplace harassment was experienced at all levels, starting from trainees and continuing in consultants/attendings. 43% of respondents had experienced bullying, harassment, undermining behaviors within the last 12 months, and 75% had witnessed colleagues experiencing these. Many respondents wrote about specific themes of harassment, including gender, pregnancy status, ethnicity, sexuality, and religion. Dr. Forsythe references annual data collected by the trainee-centered Rouleaux Club, which shows an upward trend in reported bullying towards trainees. Dr. Stravapoulas highlights the importance of providing good role models who display ethical behaviors in the OR, since the training period is such a malleable time. We end the episode with a discussion about how increasing diversity in vascular departments can help expose colleagues to people of different backgrounds and hopefully decrease fear and judgment of the unknown. --- RESOURCES Research Collaborative on Peripheral Arterial Disease (RCPAD): https://www.rcpad.org/ Vascupedia: https://vascupedia.com/ Rouleaux Club: http://rouleauxclub.com/ ACC Health Policy Statement Outlines Strategies to Address Bias, Discrimination, Bullying and Harassment in the Workplace: https://www.acc.org/latest-in-cardiology/articles/2022/03/17/16/16/acc-hps-outlines-strategies-to-address-bias-discrimination-bullying-harassment Workplace Bullying Among Surgeons—the Perfect Crime: https://journals.lww.com/annalsofsurgery/FullText/2019/01000/Workplace_Bullying_Among_Surgeons_the_Perfect.11.aspx BackTable Urology Ep. 24: Operate with Zen with Dr. Phil Pierorazio: https://www.backtable.com/shows/urology/podcasts/24/operate-with-zen Audible Bleeding Podcast: https://www.audiblebleeding.com/ Fri, 05 Aug 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Rachael Forsythe and Dr. Konstantinos Stravapoulas about their Research Collaborative for Peripheral Arterial Disease (RCPAD) survey on bullying in the European vascular workplace, and overall trends in reported bullying incidents. In this episode, host Dr. Aaron Fritts interviews Dr. Rachael Forsythe and Dr. Konstantinos Stravapoulas about their Research Collaborative for Peripheral Arterial Disease (RCPAD) survey on bullying in the European vascular workplace, and overall trends in reported bullying incidents. --- CHECK OUT OUR SPONSOR Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- SHOW NOTES We start the episode by learning about the RCPAD goals to enhance research collaboration between European vascular departments. The workplace bullying online survey is one of the RCPAD’s current projects. This survey was disseminated via social media and society mailing lists, and it received a total of 586 medical practitioners in vascular specialties. Next, we review major findings from the survey. Workplace harassment was experienced at all levels, starting from trainees and continuing in consultants/attendings. 43% of respondents had experienced bullying, harassment, undermining behaviors within the last 12 months, and 75% had witnessed colleagues experiencing these. Many respondents wrote about specific themes of harassment, including gender, pregnancy status, ethnicity, sexuality, and religion. Dr. Forsythe references annual data collected by the trainee-centered Rouleaux Club, which shows an upward trend in reported bullying towards trainees. Dr. Stravapoulas highlights the importance of providing good role models who display ethical behaviors in the OR, since the training period is such a malleable time. We end the episode with a discussion about how increasing diversity in vascular departments can help expose colleagues to people of different backgrounds and hopefully decrease fear and judgment of the unknown. --- RESOURCES Research Collaborative on Peripheral Arterial Disease (RCPAD): https://www.rcpad.org/ Vascupedia: https://vascupedia.com/ Rouleaux Club: http://rouleauxclub.com/ ACC Health Policy Statement Outlines Strategies to Address Bias, Discrimination, Bullying and Harassment in the Workplace: https://www.acc.org/latest-in-cardiology/articles/2022/03/17/16/16/acc-hps-outlines-strategies-to-address-bias-discrimination-bullying-harassment Workplace Bullying Among Surgeons—the Perfect Crime: https://journals.lww.com/annalsofsurgery/FullText/2019/01000/Workplace_Bullying_Among_Surgeons_the_Perfect.11.aspx BackTable Urology Ep. 24: Operate with Zen with Dr. Phil Pierorazio: https://www.backtable.com/shows/urology/podcasts/24/operate-with-zen Audible Bleeding Podcast: https://www.audiblebleeding.com/ In this episode, host Dr. Aaron Fritts interviews Dr. Rachael Forsythe and Dr. Konstantinos Stravapoulas about their Research Collaborative for Peripheral Arterial Disease (RCPAD) survey on bullying in the European vascular workplace, and overall trends in reported bullying incidents.


---


CHECK OUT OUR SPONSOR


Medtronic Abre Venous Stent

https://www.medtronic.com/abrevenous


---


SHOW NOTES


We start the episode by learning about the RCPAD goals to enhance research collaboration between European vascular departments. The workplace bullying online survey is one of the RCPAD’s current projects. This survey was disseminated via social media and society mailing lists, and it received a total of 586 medical practitioners in vascular specialties.


Next, we review major findings from the survey. Workplace harassment was experienced at all levels, starting from trainees and continuing in consultants/attendings. 43% of respondents had experienced bullying, harassment, undermining behaviors within the last 12 months, and 75% had witnessed colleagues experiencing these. Many respondents wrote about specific themes of harassment, including gender, pregnancy status, ethnicity, sexuality, and religion.


Dr. Forsythe references annual data collected by the trainee-centered Rouleaux Club, which shows an upward trend in reported bullying towards trainees. Dr. Stravapoulas highlights the importance of providing good role models who display ethical behaviors in the OR, since the training period is such a malleable time. We end the episode with a discussion about how increasing diversity in vascular departments can help expose colleagues to people of different backgrounds and hopefully decrease fear and judgment of the unknown.


---


RESOURCES


Research Collaborative on Peripheral Arterial Disease (RCPAD):

https://www.rcpad.org/


Vascupedia:

https://vascupedia.com/


Rouleaux Club:

http://rouleauxclub.com/


ACC Health Policy Statement Outlines Strategies to Address Bias, Discrimination, Bullying and Harassment in the Workplace:

https://www.acc.org/latest-in-cardiology/articles/2022/03/17/16/16/acc-hps-outlines-strategies-to-address-bias-discrimination-bullying-harassment


Workplace Bullying Among Surgeons—the Perfect Crime:

https://journals.lww.com/annalsofsurgery/FullText/2019/01000/Workplace_Bullying_Among_Surgeons_the_Perfect.11.aspx


BackTable Urology Ep. 24: Operate with Zen with Dr. Phil Pierorazio:

https://www.backtable.com/shows/urology/podcasts/24/operate-with-zen


Audible Bleeding Podcast:

https://www.audiblebleeding.com/

]]> 1802 Ep. 230 The Physician's MBA - Is It Worth It, and Where to Start with Dr. Aneesa Majid and Dr. Roger Tomihama In this episode, host Dr. Aaron Fritts interviews Dr. Aneesa Majid and Dr. Roger Tomihama about how an MBA can benefit physicians and their career goals, and how they both went about getting their MBAs as mid career interventional radiologists. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/OrwQwd --- CHECK OUT OUR SPONSOR Athletic Greens https://www.athleticgreens.com/backtablevi --- SHOW NOTES We begin by discussing the paths these physicians took to get their MBAs, and what their individual goals were for this extra degree. Dr. Aneesa Majid works at VIR Chicago and is the CEO of Zipdata, a biotech company working to get rid of fax machines in health care. She completed her MBA at Kellogg before her move into the biotech industry. Dr. Roger Tomihama is an associate professor of interventional radiology at Loma Linda, a former navy doctor, and is just starting his MBA program at Wharton. They discuss the different types of MBAs, including the traditional MBA path and the healthcare specific MBA. They both recommend IRs do the traditional track because it opens up many more networks outside of the physician community, and allows you to develop a business mindset, which may be more limited in a group of physicians only. Dr. Tomihama recommends talking with both physicians and non physicians who have done MBAs to better understand the culture and the expectations before signing up. It is important to do your research about which institution is best for your goals, as well as looking at specific program criteria. For example, some institutions don’t require physicians to take the GMAT before applying. Finally, we discuss how physicians can grow their business knowledge without getting an MBA. Many IRs need a better understanding of business especially if they are interested in starting an OBL. Dr. Majid and Dr. Tomihama recommend educational material provided on Coursera or AAPL as ways to gain important information without the huge time and monetary investment of an MBA, which is not feasible for all physicians, especially those who want to maintain their clinical IR practice. --- RESOURCES Coursera: https://www.coursera.org American Association of Physician Leadership: https://www.physicianleaders.org Mon, 01 Aug 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Aaron Fritts interviews Dr. Aneesa Majid and Dr. Roger Tomihama about how an MBA can benefit physicians and their career goals, and how they both went about getting their MBAs as mid career interventional radiologists. In this episode, host Dr. Aaron Fritts interviews Dr. Aneesa Majid and Dr. Roger Tomihama about how an MBA can benefit physicians and their career goals, and how they both went about getting their MBAs as mid career interventional radiologists. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/OrwQwd --- CHECK OUT OUR SPONSOR Athletic Greens https://www.athleticgreens.com/backtablevi --- SHOW NOTES We begin by discussing the paths these physicians took to get their MBAs, and what their individual goals were for this extra degree. Dr. Aneesa Majid works at VIR Chicago and is the CEO of Zipdata, a biotech company working to get rid of fax machines in health care. She completed her MBA at Kellogg before her move into the biotech industry. Dr. Roger Tomihama is an associate professor of interventional radiology at Loma Linda, a former navy doctor, and is just starting his MBA program at Wharton. They discuss the different types of MBAs, including the traditional MBA path and the healthcare specific MBA. They both recommend IRs do the traditional track because it opens up many more networks outside of the physician community, and allows you to develop a business mindset, which may be more limited in a group of physicians only. Dr. Tomihama recommends talking with both physicians and non physicians who have done MBAs to better understand the culture and the expectations before signing up. It is important to do your research about which institution is best for your goals, as well as looking at specific program criteria. For example, some institutions don’t require physicians to take the GMAT before applying. Finally, we discuss how physicians can grow their business knowledge without getting an MBA. Many IRs need a better understanding of business especially if they are interested in starting an OBL. Dr. Majid and Dr. Tomihama recommend educational material provided on Coursera or AAPL as ways to gain important information without the huge time and monetary investment of an MBA, which is not feasible for all physicians, especially those who want to maintain their clinical IR practice. --- RESOURCES Coursera: https://www.coursera.org American Association of Physician Leadership: https://www.physicianleaders.org In this episode, host Dr. Aaron Fritts interviews Dr. Aneesa Majid and Dr. Roger Tomihama about how an MBA can benefit physicians and their career goals, and how they both went about getting their MBAs as mid career interventional radiologists.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/OrwQwd

---


CHECK OUT OUR SPONSOR


Athletic Greens

https://www.athleticgreens.com/backtablevi


---


SHOW NOTES


We begin by discussing the paths these physicians took to get their MBAs, and what their individual goals were for this extra degree. Dr. Aneesa Majid works at VIR Chicago and is the CEO of Zipdata, a biotech company working to get rid of fax machines in health care. She completed her MBA at Kellogg before her move into the biotech industry. Dr. Roger Tomihama is an associate professor of interventional radiology at Loma Linda, a former navy doctor, and is just starting his MBA program at Wharton.


They discuss the different types of MBAs, including the traditional MBA path and the healthcare specific MBA. They both recommend IRs do the traditional track because it opens up many more networks outside of the physician community, and allows you to develop a business mindset, which may be more limited in a group of physicians only. Dr. Tomihama recommends talking with both physicians and non physicians who have done MBAs to better understand the culture and the expectations before signing up. It is important to do your research about which institution is best for your goals, as well as looking at specific program criteria. For example, some institutions don’t require physicians to take the GMAT before applying.


Finally, we discuss how physicians can grow their business knowledge without getting an MBA. Many IRs need a better understanding of business especially if they are interested in starting an OBL. Dr. Majid and Dr. Tomihama recommend educational material provided on Coursera or AAPL as ways to gain important information without the huge time and monetary investment of an MBA, which is not feasible for all physicians, especially those who want to maintain their clinical IR practice.


---


RESOURCES


Coursera:

https://www.coursera.org


American Association of Physician Leadership:

https://www.physicianleaders.org

]]> 4326 Ep. 229 Ultrasound Series: First Line Imaging for CLTI with Dr. Mary Costantino In this episode, guest host and vascular technologist Jill Sommerset interviews interventional radiologist Dr. Mary Costantino about the use of advanced arterial ultrasound in the setting of chronic limb-threatening ischemia (CLTI), especially in pre-procedural mapping. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES Jill and Dr. Costantino describe the workflow at their practice and discuss how ultrasound findings can be translated to drawings that help with interventional planning. Dr. Costantino says that ultrasound is traditionally seen as a mundane part of radiology training, but it can be extremely useful if it is operated and interpreted by a skilled technologist. In fact, Dr. Costantino often relies solely on ultrasound to map CLTI patients, instead of diagnostic angiograms. She believes that ultrasound can provide more information about blood flow characteristics and cap morphology. Dr. Costantino also favors ultrasound over TBI and ABI measurements, since the latter values are usually inaccurate in diabetic patients. We look at examples of successful cases where ultrasound results affected access points, how the cath lab setup, and the overall efficiency of the procedures. Jill highlights the use of ultrasound in the immediate post-procedural period. This often shows immediate improvement in pedal acceleration time (PAT). Patients are also followed up after two weeks to ensure that the PAT is sustainable. To end the episode, Jill discusses the current state of complex arterial duplex education. She recognizes the need for more technologists to be trained in this modality. Additionally, Jill describes how ultrasound findings can be used in the context of multidisciplinary limb salvage meetings in which interventional radiologists, interventional cardiologists, vascular surgeons, and podiatrists engage in cases together. Jill believes that the first step to integrating advanced ultrasound is to invest in training for vascular technologists. --- RESOURCES Advanced Vascular Centers: https://advancedvascularcenters.com/ Society for Vascular Ultrasound (SVU): https://www.svu.org/ HENDOLAT: https://www.hendolat.com/ Fri, 29 Jul 2022 05:00:00 -0000 full BackTable In this episode, guest host and vascular technologist Jill Sommerset interviews interventional radiologist Dr. Mary Costantino about the use of advanced arterial ultrasound in the setting of chronic limb-threatening ischemia (CLTI), especially in pre-procedural mapping. In this episode, guest host and vascular technologist Jill Sommerset interviews interventional radiologist Dr. Mary Costantino about the use of advanced arterial ultrasound in the setting of chronic limb-threatening ischemia (CLTI), especially in pre-procedural mapping. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES Jill and Dr. Costantino describe the workflow at their practice and discuss how ultrasound findings can be translated to drawings that help with interventional planning. Dr. Costantino says that ultrasound is traditionally seen as a mundane part of radiology training, but it can be extremely useful if it is operated and interpreted by a skilled technologist. In fact, Dr. Costantino often relies solely on ultrasound to map CLTI patients, instead of diagnostic angiograms. She believes that ultrasound can provide more information about blood flow characteristics and cap morphology. Dr. Costantino also favors ultrasound over TBI and ABI measurements, since the latter values are usually inaccurate in diabetic patients. We look at examples of successful cases where ultrasound results affected access points, how the cath lab setup, and the overall efficiency of the procedures. Jill highlights the use of ultrasound in the immediate post-procedural period. This often shows immediate improvement in pedal acceleration time (PAT). Patients are also followed up after two weeks to ensure that the PAT is sustainable. To end the episode, Jill discusses the current state of complex arterial duplex education. She recognizes the need for more technologists to be trained in this modality. Additionally, Jill describes how ultrasound findings can be used in the context of multidisciplinary limb salvage meetings in which interventional radiologists, interventional cardiologists, vascular surgeons, and podiatrists engage in cases together. Jill believes that the first step to integrating advanced ultrasound is to invest in training for vascular technologists. --- RESOURCES Advanced Vascular Centers: https://advancedvascularcenters.com/ Society for Vascular Ultrasound (SVU): https://www.svu.org/ HENDOLAT: https://www.hendolat.com/ In this episode, guest host and vascular technologist Jill Sommerset interviews interventional radiologist Dr. Mary Costantino about the use of advanced arterial ultrasound in the setting of chronic limb-threatening ischemia (CLTI), especially in pre-procedural mapping.


---


CHECK OUT OUR SPONSOR


Boston Scientific Eluvia Drug-Eluting Stent

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043


---


SHOW NOTES


Jill and Dr. Costantino describe the workflow at their practice and discuss how ultrasound findings can be translated to drawings that help with interventional planning. Dr. Costantino says that ultrasound is traditionally seen as a mundane part of radiology training, but it can be extremely useful if it is operated and interpreted by a skilled technologist. In fact, Dr. Costantino often relies solely on ultrasound to map CLTI patients, instead of diagnostic angiograms. She believes that ultrasound can provide more information about blood flow characteristics and cap morphology. Dr. Costantino also favors ultrasound over TBI and ABI measurements, since the latter values are usually inaccurate in diabetic patients.


We look at examples of successful cases where ultrasound results affected access points, how the cath lab setup, and the overall efficiency of the procedures.


Jill highlights the use of ultrasound in the immediate post-procedural period. This often shows immediate improvement in pedal acceleration time (PAT). Patients are also followed up after two weeks to ensure that the PAT is sustainable.


To end the episode, Jill discusses the current state of complex arterial duplex education. She recognizes the need for more technologists to be trained in this modality. Additionally, Jill describes how ultrasound findings can be used in the context of multidisciplinary limb salvage meetings in which interventional radiologists, interventional cardiologists, vascular surgeons, and podiatrists engage in cases together. Jill believes that the first step to integrating advanced ultrasound is to invest in training for vascular technologists.


---


RESOURCES


Advanced Vascular Centers:

https://advancedvascularcenters.com/


Society for Vascular Ultrasound (SVU):

https://www.svu.org/


HENDOLAT:

https://www.hendolat.com/

]]> 2312 Ep. 228 DC’ing FB’s with EP: A Collaborative Approach to Complex Foreign Body Retrievals with Dr. Kyle Cooper and Dr. Tahmeed Contractor In this episode, host Dr. Michael Barraza interviews Dr. Kyle Cooper, interventional radiologist and Dr. Tahmeed Contractor, electrophysiologist about how IR and EP work together at their institution, including how they perform complex pacer lead removals, and how the have embraced collaboration over competition. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SHOW NOTES The doctors begin by discussing how they began working together. It was somewhat by chance that they started to work so closely, because the EP and the IR labs are directly across from each other at Loma Linda, where they work. They both began finding patients that had overlapping problems requiring intervention by both specialties, such as someone who needed a pacer lead out who also had an occluded AV fistula on the same side. Their relationship developed further due to the nature of the complexity of some of the EP cases. They often have to remove multiple pacer leads that were placed in the patient over 30 years ago. When these devices were created, they were not designed to be removed, so it is often quite difficult to do. Furthermore, because they are mostly plastic, not metal, they often break during removal. When this happens, it is not uncommon to have to call IR to help retrieve the piece. Though a cardiothoracic surgeon is usually always scrubbed into EP cases, open heart surgery is only done if all else fails. The two discuss how this collaboration has allowed them both to learn new skills. Dr. Contractor now does many lead extractions and will only call Dr. Cooper if there is a complication. Similarly, Dr. Cooper says he has learned many techniques from Dr. Contractor such as how to use intracardiac echo (ICE), or more commonly called intravascular ultrasound (IVUS) in IR for many more procedures than he was previously able to. Some of the challenges they have encountered is reimbursement and scheduling. With EP, CT surgery and IR are all in the room and helping, it complicates who gets paid. In general, IR bills for any venoplasty done during the procedure, and EP and CT surgery bill for the rest. Mon, 25 Jul 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Michael Barraza interviews Dr. Kyle Cooper, interventional radiologist and Dr. Tahmeed Contractor, electrophysiologist about how IR and EP work together at their institution, including how they perform complex pacer lead removals, and how the have embraced collaboration over competition. In this episode, host Dr. Michael Barraza interviews Dr. Kyle Cooper, interventional radiologist and Dr. Tahmeed Contractor, electrophysiologist about how IR and EP work together at their institution, including how they perform complex pacer lead removals, and how the have embraced collaboration over competition. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SHOW NOTES The doctors begin by discussing how they began working together. It was somewhat by chance that they started to work so closely, because the EP and the IR labs are directly across from each other at Loma Linda, where they work. They both began finding patients that had overlapping problems requiring intervention by both specialties, such as someone who needed a pacer lead out who also had an occluded AV fistula on the same side. Their relationship developed further due to the nature of the complexity of some of the EP cases. They often have to remove multiple pacer leads that were placed in the patient over 30 years ago. When these devices were created, they were not designed to be removed, so it is often quite difficult to do. Furthermore, because they are mostly plastic, not metal, they often break during removal. When this happens, it is not uncommon to have to call IR to help retrieve the piece. Though a cardiothoracic surgeon is usually always scrubbed into EP cases, open heart surgery is only done if all else fails. The two discuss how this collaboration has allowed them both to learn new skills. Dr. Contractor now does many lead extractions and will only call Dr. Cooper if there is a complication. Similarly, Dr. Cooper says he has learned many techniques from Dr. Contractor such as how to use intracardiac echo (ICE), or more commonly called intravascular ultrasound (IVUS) in IR for many more procedures than he was previously able to. Some of the challenges they have encountered is reimbursement and scheduling. With EP, CT surgery and IR are all in the room and helping, it complicates who gets paid. In general, IR bills for any venoplasty done during the procedure, and EP and CT surgery bill for the rest. In this episode, host Dr. Michael Barraza interviews Dr. Kyle Cooper, interventional radiologist and Dr. Tahmeed Contractor, electrophysiologist about how IR and EP work together at their institution, including how they perform complex pacer lead removals, and how the have embraced collaboration over competition.


---


CHECK OUT OUR SPONSOR


Inari Medical

https://www.inarimedical.com/


---


SHOW NOTES


The doctors begin by discussing how they began working together. It was somewhat by chance that they started to work so closely, because the EP and the IR labs are directly across from each other at Loma Linda, where they work. They both began finding patients that had overlapping problems requiring intervention by both specialties, such as someone who needed a pacer lead out who also had an occluded AV fistula on the same side.


Their relationship developed further due to the nature of the complexity of some of the EP cases. They often have to remove multiple pacer leads that were placed in the patient over 30 years ago. When these devices were created, they were not designed to be removed, so it is often quite difficult to do. Furthermore, because they are mostly plastic, not metal, they often break during removal. When this happens, it is not uncommon to have to call IR to help retrieve the piece. Though a cardiothoracic surgeon is usually always scrubbed into EP cases, open heart surgery is only done if all else fails.


The two discuss how this collaboration has allowed them both to learn new skills. Dr. Contractor now does many lead extractions and will only call Dr. Cooper if there is a complication. Similarly, Dr. Cooper says he has learned many techniques from Dr. Contractor such as how to use intracardiac echo (ICE), or more commonly called intravascular ultrasound (IVUS) in IR for many more procedures than he was previously able to. Some of the challenges they have encountered is reimbursement and scheduling. With EP, CT surgery and IR are all in the room and helping, it complicates who gets paid. In general, IR bills for any venoplasty done during the procedure, and EP and CT surgery bill for the rest.

]]> 3094 Ep. 227 The Pregnant Interventionalist: with Dr Barbara Hamilton and Dr Aarti Luhar Host Aparna Baheti interviews Barbara Hamilton and Aarti Luhar about navigating training and early career during a pregnancy. They discuss factors to consider such as scheduling, parental leave policies, radiation exposure risks, and childcare. --- CHECK OUT OUR SPONSORS Athletic Greens https://www.athleticgreens.com/backtablevi Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- SHOW NOTES Our guests start by sharing their paths to motherhood. Dr. Luhar was pregnant as a diagnostic radiology trainee, while Dr. Hamilton was pregnant as an attending. We talk about the benefits of being part of a large department or group during maternity leave, due to more flexibility of scheduling changes and availability of coverage. Both of our guests recommend that IRs reach out to their HR departments as soon as they feel comfortable sharing their pregnancy news. Establishing contact with the department is a helpful way to clarify parental leave policies, specifically if one qualifies for parental leave and how long the leave can be. Additionally, Dr. Luhar encourages listeners to reach out to colleagues who have been pregnant before, since they can be a valuable resource for insights on the granular details of practicing IR while pregnant. In terms of radiation as an occupational exposure, Dr. Hamilton did not change her caseload during pregnancy. She shares her preference to wear extra radiation protection around her waist. Dr. Luhar reached out to her hospital’s radiation physicist for guidance. She received the advice to use standard radiation protection and follow the principle of ALARA (as low as reasonably achievable). Additionally, we discuss the risks of pathogen exposure and needle sticks. Both doctors agree that having supportive staff and colleagues can make the pregnancy process more manageable. Additionally, we discuss unexpected challenges during pregnancy. Dr. Hamilton describes her experience with the risk of premature labor and bedrest. Dr. Luhar recounts the struggle of scheduling prenatal appointments and dealing with pregnancy complications while working a full caseload. We close the episode by giving advice for evaluating the culture of your work environment, relying on support systems that are in place, and not being afraid to ask important questions. --- RESOURCES Dr. Barbara Hamilton Twitter: @TSuperheroine Dr. Barbara Hamilton Instagram: @TiredSuperheroine SIR Pregnancy Toolkit: https://www.sirweb.org/practice-resources/toolkits/pregnancy-toolkit/ Fri, 22 Jul 2022 05:00:00 -0000 full BackTable Host Aparna Baheti interviews Barbara Hamilton and Aarti Luhar about navigating training and early career during a pregnancy. They discuss factors to consider such as scheduling, parental leave policies, radiation exposure risks, and childcare. Host Aparna Baheti interviews Barbara Hamilton and Aarti Luhar about navigating training and early career during a pregnancy. They discuss factors to consider such as scheduling, parental leave policies, radiation exposure risks, and childcare. --- CHECK OUT OUR SPONSORS Athletic Greens https://www.athleticgreens.com/backtablevi Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- SHOW NOTES Our guests start by sharing their paths to motherhood. Dr. Luhar was pregnant as a diagnostic radiology trainee, while Dr. Hamilton was pregnant as an attending. We talk about the benefits of being part of a large department or group during maternity leave, due to more flexibility of scheduling changes and availability of coverage. Both of our guests recommend that IRs reach out to their HR departments as soon as they feel comfortable sharing their pregnancy news. Establishing contact with the department is a helpful way to clarify parental leave policies, specifically if one qualifies for parental leave and how long the leave can be. Additionally, Dr. Luhar encourages listeners to reach out to colleagues who have been pregnant before, since they can be a valuable resource for insights on the granular details of practicing IR while pregnant. In terms of radiation as an occupational exposure, Dr. Hamilton did not change her caseload during pregnancy. She shares her preference to wear extra radiation protection around her waist. Dr. Luhar reached out to her hospital’s radiation physicist for guidance. She received the advice to use standard radiation protection and follow the principle of ALARA (as low as reasonably achievable). Additionally, we discuss the risks of pathogen exposure and needle sticks. Both doctors agree that having supportive staff and colleagues can make the pregnancy process more manageable. Additionally, we discuss unexpected challenges during pregnancy. Dr. Hamilton describes her experience with the risk of premature labor and bedrest. Dr. Luhar recounts the struggle of scheduling prenatal appointments and dealing with pregnancy complications while working a full caseload. We close the episode by giving advice for evaluating the culture of your work environment, relying on support systems that are in place, and not being afraid to ask important questions. --- RESOURCES Dr. Barbara Hamilton Twitter: @TSuperheroine Dr. Barbara Hamilton Instagram: @TiredSuperheroine SIR Pregnancy Toolkit: https://www.sirweb.org/practice-resources/toolkits/pregnancy-toolkit/ Host Aparna Baheti interviews Barbara Hamilton and Aarti Luhar about navigating training and early career during a pregnancy. They discuss factors to consider such as scheduling, parental leave policies, radiation exposure risks, and childcare.


---


CHECK OUT OUR SPONSORS


Athletic Greens

https://www.athleticgreens.com/backtablevi


Medtronic Abre Venous Stent

https://www.medtronic.com/abrevenous


---


SHOW NOTES


Our guests start by sharing their paths to motherhood. Dr. Luhar was pregnant as a diagnostic radiology trainee, while Dr. Hamilton was pregnant as an attending. We talk about the benefits of being part of a large department or group during maternity leave, due to more flexibility of scheduling changes and availability of coverage. Both of our guests recommend that IRs reach out to their HR departments as soon as they feel comfortable sharing their pregnancy news. Establishing contact with the department is a helpful way to clarify parental leave policies, specifically if one qualifies for parental leave and how long the leave can be. Additionally, Dr. Luhar encourages listeners to reach out to colleagues who have been pregnant before, since they can be a valuable resource for insights on the granular details of practicing IR while pregnant.


In terms of radiation as an occupational exposure, Dr. Hamilton did not change her caseload during pregnancy. She shares her preference to wear extra radiation protection around her waist. Dr. Luhar reached out to her hospital’s radiation physicist for guidance. She received the advice to use standard radiation protection and follow the principle of ALARA (as low as reasonably achievable). Additionally, we discuss the risks of pathogen exposure and needle sticks. Both doctors agree that having supportive staff and colleagues can make the pregnancy process more manageable.


Additionally, we discuss unexpected challenges during pregnancy. Dr. Hamilton describes her experience with the risk of premature labor and bedrest. Dr. Luhar recounts the struggle of scheduling prenatal appointments and dealing with pregnancy complications while working a full caseload. We close the episode by giving advice for evaluating the culture of your work environment, relying on support systems that are in place, and not being afraid to ask important questions.


---


RESOURCES


Dr. Barbara Hamilton Twitter:

@TSuperheroine


Dr. Barbara Hamilton Instagram:

@TiredSuperheroine


SIR Pregnancy Toolkit:

https://www.sirweb.org/practice-resources/toolkits/pregnancy-toolkit/

]]> 3518 Ep. 226 Better Neck Health with Dr. Gerry Mattia In this special crossover BackTable episode, Dr. Aaron Fritts and Dr. Julie Wei talk with Dr. Gerry Mattia, Chiropractor and Director of Rehabilitation of ViscoGen Clinic in Orlando, Florida. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/UmeBWU --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES First, Dr. Mattia recounts his journey to becoming a chiropractor, beginning with his medical history of aortic stenosis fixed by a chiropractor, his decision to enter chiropractic school, and starting his independent practice after graduation. Then, he explains how he deals with patients presenting with degenerative disc disease with spinal stenosis, which was the issue he resolved in Dr. Wei. A herniated disc is the most common cause of degenerative disc disease. The standard chiropractic treatment is cervical decompression to help the disc restore itself. Dr. Mattia also uses a level 4 laser to rehydrate the disc. For optimal results, he recommends that patients see him 4 times a week for 6 to 8 weeks in order to fully lift the pressure off of the brachial plexus. He notes that good chiropractors will use the correct formulas and appropriate technology while adjusting the patient gently. Next, the doctors delve into why many physicians are wary of chiropractors, which is rooted in a 1988 legal case that prohibited doctors from referring their patients to chiropractors. Dr. Mattia encourages physicians to seek therapy before medical issues develop into very severe conditions. Additionally, Dr. Wei notes that medical culture often encourages physicians to put the health of their patients before theirs. Then, Dr. Mattia discusses how younger people and surgeons can improve their neck health. He notes that excessive cell phone use can reverse the cervical curve, causing people to lose their normal lordotic curve, a structure which usually prevents compression. He also recommends strengthening the muscles in the neck and shoulders, sleeping with a cervical pillow, and going to a good chiropractor to get routine adjustments. Dr. Wei recommends avoiding slouching and adjusting screens to eye-level in OR. Both Dr. Wei and Dr. Mattia agree that maintaining a healthy body weight will have positive benefits on spinal health. Finally, Dr. Mattia recommends which qualities to focus on when finding a good chiropractor. He recommends looking for an experienced, passionate family practice chiropractor. As a word of caution, he warns listeners to never let a chiropractor adjust them without reviewing their X-ray imaging first. Tue, 19 Jul 2022 05:00:00 -0000 full BackTable In this special crossover BackTable episode, Dr. Aaron Fritts and Dr. Julie Wei talk with Dr. Gerry Mattia, Chiropractor and Director of Rehabilitation of ViscoGen Clinic in Orlando, Florida. In this special crossover BackTable episode, Dr. Aaron Fritts and Dr. Julie Wei talk with Dr. Gerry Mattia, Chiropractor and Director of Rehabilitation of ViscoGen Clinic in Orlando, Florida. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/UmeBWU --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES First, Dr. Mattia recounts his journey to becoming a chiropractor, beginning with his medical history of aortic stenosis fixed by a chiropractor, his decision to enter chiropractic school, and starting his independent practice after graduation. Then, he explains how he deals with patients presenting with degenerative disc disease with spinal stenosis, which was the issue he resolved in Dr. Wei. A herniated disc is the most common cause of degenerative disc disease. The standard chiropractic treatment is cervical decompression to help the disc restore itself. Dr. Mattia also uses a level 4 laser to rehydrate the disc. For optimal results, he recommends that patients see him 4 times a week for 6 to 8 weeks in order to fully lift the pressure off of the brachial plexus. He notes that good chiropractors will use the correct formulas and appropriate technology while adjusting the patient gently. Next, the doctors delve into why many physicians are wary of chiropractors, which is rooted in a 1988 legal case that prohibited doctors from referring their patients to chiropractors. Dr. Mattia encourages physicians to seek therapy before medical issues develop into very severe conditions. Additionally, Dr. Wei notes that medical culture often encourages physicians to put the health of their patients before theirs. Then, Dr. Mattia discusses how younger people and surgeons can improve their neck health. He notes that excessive cell phone use can reverse the cervical curve, causing people to lose their normal lordotic curve, a structure which usually prevents compression. He also recommends strengthening the muscles in the neck and shoulders, sleeping with a cervical pillow, and going to a good chiropractor to get routine adjustments. Dr. Wei recommends avoiding slouching and adjusting screens to eye-level in OR. Both Dr. Wei and Dr. Mattia agree that maintaining a healthy body weight will have positive benefits on spinal health. Finally, Dr. Mattia recommends which qualities to focus on when finding a good chiropractor. He recommends looking for an experienced, passionate family practice chiropractor. As a word of caution, he warns listeners to never let a chiropractor adjust them without reviewing their X-ray imaging first. In this special crossover BackTable episode, Dr. Aaron Fritts and Dr. Julie Wei talk with Dr. Gerry Mattia, Chiropractor and Director of Rehabilitation of ViscoGen Clinic in Orlando, Florida.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/UmeBWU

---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


First, Dr. Mattia recounts his journey to becoming a chiropractor, beginning with his medical history of aortic stenosis fixed by a chiropractor, his decision to enter chiropractic school, and starting his independent practice after graduation. Then, he explains how he deals with patients presenting with degenerative disc disease with spinal stenosis, which was the issue he resolved in Dr. Wei. A herniated disc is the most common cause of degenerative disc disease. The standard chiropractic treatment is cervical decompression to help the disc restore itself. Dr. Mattia also uses a level 4 laser to rehydrate the disc. For optimal results, he recommends that patients see him 4 times a week for 6 to 8 weeks in order to fully lift the pressure off of the brachial plexus. He notes that good chiropractors will use the correct formulas and appropriate technology while adjusting the patient gently.


Next, the doctors delve into why many physicians are wary of chiropractors, which is rooted in a 1988 legal case that prohibited doctors from referring their patients to chiropractors. Dr. Mattia encourages physicians to seek therapy before medical issues develop into very severe conditions. Additionally, Dr. Wei notes that medical culture often encourages physicians to put the health of their patients before theirs.


Then, Dr. Mattia discusses how younger people and surgeons can improve their neck health. He notes that excessive cell phone use can reverse the cervical curve, causing people to lose their normal lordotic curve, a structure which usually prevents compression. He also recommends strengthening the muscles in the neck and shoulders, sleeping with a cervical pillow, and going to a good chiropractor to get routine adjustments. Dr. Wei recommends avoiding slouching and adjusting screens to eye-level in OR. Both Dr. Wei and Dr. Mattia agree that maintaining a healthy body weight will have positive benefits on spinal health.


Finally, Dr. Mattia recommends which qualities to focus on when finding a good chiropractor. He recommends looking for an experienced, passionate family practice chiropractor. As a word of caution, he warns listeners to never let a chiropractor adjust them without reviewing their X-ray imaging first.

]]> 3074 Ep. 225 Approaches to IR Locums with Dr. Kavi Devulapalli and Dr. Vishal Kadakia Dr. Shamit Desai talks with Dr. Kavi Devulapalli and Dr. Vishal Kadakia about Locums work, including the current market and opportunities, different practice models, navigating finances and taxes, and how to organize your life around this unique practice style. Meet the locums chameleon! --- CHECK OUT OUR SPONSOR Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- SHOW NOTES To start off, we discuss what locums means for each of these clinicians, including inpatient vs outpatient work. Most locums opportunities are in mid-sized cities and smaller cities, due to increased demand in these areas. Locums work is a way for IRs to take control of their practices, making it a very appealing work model. The ratio of IR to DR for each of these clinicians ranges from 70:30 up to 90:10. Employers need locums to prevent burnout of their FTE employees, and to reduce call in areas where IRs are overworked. Employers also look to locums to build service lines and bring in procedures that aren’t currently being done at their institutions. It is a rewarding opportunity for both employer and employee. Next, we review job expectations and the difference between inpatient and outpatient locums work. There are generally two types of clients, one needing someone to fill the role of a person who works at FTE, and another where the IR department is made up of a roster of rotating locums providers. Being in locums, you get exposure to so many different people, and practices and you get to expand your network. This opens up many opportunities that you would not get at one location. Some of the downsides are the need to constantly adapt, use equipment you are not as familiar with, and work with staff who do not know your preferences or even glove size. However, you get to build your schedule, and you have the power to work where you want when you want. Finally, we discuss some of the contracts, reimbursement, and insurance details. The three discuss the differences between being a W2 employee versus a 1099 employee, comparing what happens with health insurance and retirement. They also discuss the pros and cons of a 1099 versus owning an LLC versus starting an S corporation. All three physicians highly recommend researching these and speaking to a lawyer about your best options until you fully understand these concepts. They discuss licensure, credentialing and malpractice insurance, as well as whether they recommend using an agency for these as a locums. Lastly, they discuss reimbursement, including models such as a flat rate for a week versus a deconstructed model that consists of a daily rate, a call rate, and an overtime rate. --- RESOURCES Kavi Devulapalli Profiles Twitter: @linemonkeymd Blog: https://linemonkeymd.com Vishal Kadakia Profiles LinkedIn: https://www.linkedin.com/in/theirdoc Mon, 18 Jul 2022 05:00:00 -0000 full BackTable Dr. Shamit Desai talks with Dr. Kavi Devulapalli and Dr. Vishal Kadakia about Locums work, including the current market and opportunities, different practice models, navigating finances and taxes, and how to organize your life around this unique practice style. Meet the locums chameleon! Dr. Shamit Desai talks with Dr. Kavi Devulapalli and Dr. Vishal Kadakia about Locums work, including the current market and opportunities, different practice models, navigating finances and taxes, and how to organize your life around this unique practice style. Meet the locums chameleon! --- CHECK OUT OUR SPONSOR Medtronic Abre Venous Stent https://www.medtronic.com/abrevenous --- SHOW NOTES To start off, we discuss what locums means for each of these clinicians, including inpatient vs outpatient work. Most locums opportunities are in mid-sized cities and smaller cities, due to increased demand in these areas. Locums work is a way for IRs to take control of their practices, making it a very appealing work model. The ratio of IR to DR for each of these clinicians ranges from 70:30 up to 90:10. Employers need locums to prevent burnout of their FTE employees, and to reduce call in areas where IRs are overworked. Employers also look to locums to build service lines and bring in procedures that aren’t currently being done at their institutions. It is a rewarding opportunity for both employer and employee. Next, we review job expectations and the difference between inpatient and outpatient locums work. There are generally two types of clients, one needing someone to fill the role of a person who works at FTE, and another where the IR department is made up of a roster of rotating locums providers. Being in locums, you get exposure to so many different people, and practices and you get to expand your network. This opens up many opportunities that you would not get at one location. Some of the downsides are the need to constantly adapt, use equipment you are not as familiar with, and work with staff who do not know your preferences or even glove size. However, you get to build your schedule, and you have the power to work where you want when you want. Finally, we discuss some of the contracts, reimbursement, and insurance details. The three discuss the differences between being a W2 employee versus a 1099 employee, comparing what happens with health insurance and retirement. They also discuss the pros and cons of a 1099 versus owning an LLC versus starting an S corporation. All three physicians highly recommend researching these and speaking to a lawyer about your best options until you fully understand these concepts. They discuss licensure, credentialing and malpractice insurance, as well as whether they recommend using an agency for these as a locums. Lastly, they discuss reimbursement, including models such as a flat rate for a week versus a deconstructed model that consists of a daily rate, a call rate, and an overtime rate. --- RESOURCES Kavi Devulapalli Profiles Twitter: @linemonkeymd Blog: https://linemonkeymd.com Vishal Kadakia Profiles LinkedIn: https://www.linkedin.com/in/theirdoc Dr. Shamit Desai talks with Dr. Kavi Devulapalli and Dr. Vishal Kadakia about Locums work, including the current market and opportunities, different practice models, navigating finances and taxes, and how to organize your life around this unique practice style. Meet the locums chameleon!


---


CHECK OUT OUR SPONSOR


Medtronic Abre Venous Stent

https://www.medtronic.com/abrevenous


---


SHOW NOTES


To start off, we discuss what locums means for each of these clinicians, including inpatient vs outpatient work. Most locums opportunities are in mid-sized cities and smaller cities, due to increased demand in these areas. Locums work is a way for IRs to take control of their practices, making it a very appealing work model. The ratio of IR to DR for each of these clinicians ranges from 70:30 up to 90:10. Employers need locums to prevent burnout of their FTE employees, and to reduce call in areas where IRs are overworked. Employers also look to locums to build service lines and bring in procedures that aren’t currently being done at their institutions. It is a rewarding opportunity for both employer and employee.


Next, we review job expectations and the difference between inpatient and outpatient locums work. There are generally two types of clients, one needing someone to fill the role of a person who works at FTE, and another where the IR department is made up of a roster of rotating locums providers. Being in locums, you get exposure to so many different people, and practices and you get to expand your network. This opens up many opportunities that you would not get at one location. Some of the downsides are the need to constantly adapt, use equipment you are not as familiar with, and work with staff who do not know your preferences or even glove size. However, you get to build your schedule, and you have the power to work where you want when you want.


Finally, we discuss some of the contracts, reimbursement, and insurance details. The three discuss the differences between being a W2 employee versus a 1099 employee, comparing what happens with health insurance and retirement. They also discuss the pros and cons of a 1099 versus owning an LLC versus starting an S corporation. All three physicians highly recommend researching these and speaking to a lawyer about your best options until you fully understand these concepts. They discuss licensure, credentialing and malpractice insurance, as well as whether they recommend using an agency for these as a locums. Lastly, they discuss reimbursement, including models such as a flat rate for a week versus a deconstructed model that consists of a daily rate, a call rate, and an overtime rate.


---


RESOURCES


Kavi Devulapalli Profiles

Twitter: @linemonkeymd

Blog: https://linemonkeymd.com


Vishal Kadakia Profiles

LinkedIn: https://www.linkedin.com/in/theirdoc

]]> 6025 Finding Your Place Within Structural Competency with Kelly Knight, PhD In this episode, our guest host Dr. Vishal Kumar interviews medical anthropologist and social scientist Dr. Kelly Knight of UCSF. They discuss the meaning of structural competency, methods for incorporating this concept into medical education, and how it can be applied to alleviate physician burnout. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/4GAyUy --- SHOW NOTES Dr. Knight starts by defining structural competency as the recognition of the underlying policies, systems, and hierarchies that produce social determinants of health. While these structures may sometimes be invisible, they have a large impact on health outcomes. Examination of these factors allows us to think about interventions that can make healthcare more equitable. Next, we highlight effective ways to integrate structural competency into medical education. Dr. Knight shares information about national shared curricula that are designed with the flexibility for each institution to modify the content according to their community’s needs. Finally, we examine redlining as an example of structural violence, signifying intentional disinvestment in marginalized communities. Dr. Knight believes that change starts with an initial acknowledgement and recognition of policies that make populations vulnerable to illness. She also encourages individual healthcare providers to take action by developing interpersonal communication skills, strategizing ways to make the clinical space more focused on healing, and working with elected individuals to create equity at a policy level. All of these efforts may allow for healthcare providers to reconnect with their original motivation to help patients and have a protective effect against burnout. --- RESOURCES Structural Competency Working Group: https://www.structcomp.org/ Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians: https://pubmed.ncbi.nlm.nih.gov/27896692/ Mountains Beyond Mountains: The Quest of Dr. Paul Farmer: https://www.amazon.com/Mountains-Beyond-Tracy-Kidder/dp/0812973011 The REPAIR Project: https://repair.ucsf.edu/home Do No Harm Coalition: https://www.donoharmcoalition.org/ UCSF Health Equity Collaborative: https://thecollaborative.ucsf.edu/training-health-equity-collaborative Fri, 15 Jul 2022 05:00:00 -0000 full BackTable In this episode, our guest host Dr. Vishal Kumar interviews medical anthropologist and social scientist Dr. Kelly Knight of UCSF. They discuss the meaning of structural competency, methods for incorporating this concept into medical education, and how it can be applied to alleviate physician burnout. In this episode, our guest host Dr. Vishal Kumar interviews medical anthropologist and social scientist Dr. Kelly Knight of UCSF. They discuss the meaning of structural competency, methods for incorporating this concept into medical education, and how it can be applied to alleviate physician burnout. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/4GAyUy --- SHOW NOTES Dr. Knight starts by defining structural competency as the recognition of the underlying policies, systems, and hierarchies that produce social determinants of health. While these structures may sometimes be invisible, they have a large impact on health outcomes. Examination of these factors allows us to think about interventions that can make healthcare more equitable. Next, we highlight effective ways to integrate structural competency into medical education. Dr. Knight shares information about national shared curricula that are designed with the flexibility for each institution to modify the content according to their community’s needs. Finally, we examine redlining as an example of structural violence, signifying intentional disinvestment in marginalized communities. Dr. Knight believes that change starts with an initial acknowledgement and recognition of policies that make populations vulnerable to illness. She also encourages individual healthcare providers to take action by developing interpersonal communication skills, strategizing ways to make the clinical space more focused on healing, and working with elected individuals to create equity at a policy level. All of these efforts may allow for healthcare providers to reconnect with their original motivation to help patients and have a protective effect against burnout. --- RESOURCES Structural Competency Working Group: https://www.structcomp.org/ Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians: https://pubmed.ncbi.nlm.nih.gov/27896692/ Mountains Beyond Mountains: The Quest of Dr. Paul Farmer: https://www.amazon.com/Mountains-Beyond-Tracy-Kidder/dp/0812973011 The REPAIR Project: https://repair.ucsf.edu/home Do No Harm Coalition: https://www.donoharmcoalition.org/ UCSF Health Equity Collaborative: https://thecollaborative.ucsf.edu/training-health-equity-collaborative In this episode, our guest host Dr. Vishal Kumar interviews medical anthropologist and social scientist Dr. Kelly Knight of UCSF. They discuss the meaning of structural competency, methods for incorporating this concept into medical education, and how it can be applied to alleviate physician burnout.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/4GAyUy


---


SHOW NOTES


Dr. Knight starts by defining structural competency as the recognition of the underlying policies, systems, and hierarchies that produce social determinants of health. While these structures may sometimes be invisible, they have a large impact on health outcomes. Examination of these factors allows us to think about interventions that can make healthcare more equitable.


Next, we highlight effective ways to integrate structural competency into medical education. Dr. Knight shares information about national shared curricula that are designed with the flexibility for each institution to modify the content according to their community’s needs.


Finally, we examine redlining as an example of structural violence, signifying intentional disinvestment in marginalized communities. Dr. Knight believes that change starts with an initial acknowledgement and recognition of policies that make populations vulnerable to illness. She also encourages individual healthcare providers to take action by developing interpersonal communication skills, strategizing ways to make the clinical space more focused on healing, and working with elected individuals to create equity at a policy level. All of these efforts may allow for healthcare providers to reconnect with their original motivation to help patients and have a protective effect against burnout.


---


RESOURCES


Structural Competency Working Group:

https://www.structcomp.org/


Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians:

https://pubmed.ncbi.nlm.nih.gov/27896692/


Mountains Beyond Mountains: The Quest of Dr. Paul Farmer:

https://www.amazon.com/Mountains-Beyond-Tracy-Kidder/dp/0812973011


The REPAIR Project:

https://repair.ucsf.edu/home


Do No Harm Coalition:

https://www.donoharmcoalition.org/


UCSF Health Equity Collaborative:

https://thecollaborative.ucsf.edu/training-health-equity-collaborative

]]> 2409 Ep. 224 The Legends: An Interview with Dr. Kathy Krol In this episode, host Dr. Mary Costantino interviews Dr. Kathy Krol, interventional radiologist and former SIR president about the evolution of interventional radiology, her various leadership roles, and the growth of women in IR. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SHOW NOTES We begin by discussing how Dr. Krol entered the field of radiology and subsequently became involved in special procedures in radiology, before the beginning of interventional radiology. At the time, there was only a 7 French stiff wire, a J wire, or a straight wire. She recalls how the introduction of two key instruments, the glide wire, and the stent, changed the entire practice and scope of the types of interventions radiologists could do. Next, Dr. Krol talks about her involvement with SIR (Society of Interventional Radiology). She first joined a meeting at a hotel in San Francisco, where she was the only woman in the room, and repeatedly mistaken for a nurse. At the time, the society had recently allowed women to join, and since joining, she has never missed a SIR annual business meeting. During her time as the president of SIR, in 2006, some of the main issues were preserving IR as its own field among vascular surgery and interventional cardiology, forming an independent IR residency, and forming the idea of the outpatient-based lab (OBL) as a new space for IRs to work in. Dr. Krol shares stories of her struggles as a woman in IR as well as in leadership positions. She began in radiology, where she had to work hard to learn procedures, and then even harder to prove to colleagues that she was capable. She was often mistaken for a tech or a nurse and resorted to wearing suits instead of dresses while in the IR suite performing procedures. She often had to take whatever role was given, but she used this to her advantage. One such instance is when she wanted to volunteer for SIR, they put her in coding and billing which was not her interest. She turned this around and became so invested in it that she has now helped create nearly all the CPT codes that exist for IR today. Mon, 11 Jul 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Mary Costantino interviews Dr. Kathy Krol, interventional radiologist and former SIR president about the evolution of interventional radiology, her various leadership roles, and the growth of women in IR. In this episode, host Dr. Mary Costantino interviews Dr. Kathy Krol, interventional radiologist and former SIR president about the evolution of interventional radiology, her various leadership roles, and the growth of women in IR. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SHOW NOTES We begin by discussing how Dr. Krol entered the field of radiology and subsequently became involved in special procedures in radiology, before the beginning of interventional radiology. At the time, there was only a 7 French stiff wire, a J wire, or a straight wire. She recalls how the introduction of two key instruments, the glide wire, and the stent, changed the entire practice and scope of the types of interventions radiologists could do. Next, Dr. Krol talks about her involvement with SIR (Society of Interventional Radiology). She first joined a meeting at a hotel in San Francisco, where she was the only woman in the room, and repeatedly mistaken for a nurse. At the time, the society had recently allowed women to join, and since joining, she has never missed a SIR annual business meeting. During her time as the president of SIR, in 2006, some of the main issues were preserving IR as its own field among vascular surgery and interventional cardiology, forming an independent IR residency, and forming the idea of the outpatient-based lab (OBL) as a new space for IRs to work in. Dr. Krol shares stories of her struggles as a woman in IR as well as in leadership positions. She began in radiology, where she had to work hard to learn procedures, and then even harder to prove to colleagues that she was capable. She was often mistaken for a tech or a nurse and resorted to wearing suits instead of dresses while in the IR suite performing procedures. She often had to take whatever role was given, but she used this to her advantage. One such instance is when she wanted to volunteer for SIR, they put her in coding and billing which was not her interest. She turned this around and became so invested in it that she has now helped create nearly all the CPT codes that exist for IR today. In this episode, host Dr. Mary Costantino interviews Dr. Kathy Krol, interventional radiologist and former SIR president about the evolution of interventional radiology, her various leadership roles, and the growth of women in IR.


---


CHECK OUT OUR SPONSOR


Inari Medical

https://www.inarimedical.com/


---


SHOW NOTES


We begin by discussing how Dr. Krol entered the field of radiology and subsequently became involved in special procedures in radiology, before the beginning of interventional radiology. At the time, there was only a 7 French stiff wire, a J wire, or a straight wire. She recalls how the introduction of two key instruments, the glide wire, and the stent, changed the entire practice and scope of the types of interventions radiologists could do.


Next, Dr. Krol talks about her involvement with SIR (Society of Interventional Radiology). She first joined a meeting at a hotel in San Francisco, where she was the only woman in the room, and repeatedly mistaken for a nurse. At the time, the society had recently allowed women to join, and since joining, she has never missed a SIR annual business meeting. During her time as the president of SIR, in 2006, some of the main issues were preserving IR as its own field among vascular surgery and interventional cardiology, forming an independent IR residency, and forming the idea of the outpatient-based lab (OBL) as a new space for IRs to work in.


Dr. Krol shares stories of her struggles as a woman in IR as well as in leadership positions. She began in radiology, where she had to work hard to learn procedures, and then even harder to prove to colleagues that she was capable. She was often mistaken for a tech or a nurse and resorted to wearing suits instead of dresses while in the IR suite performing procedures. She often had to take whatever role was given, but she used this to her advantage. One such instance is when she wanted to volunteer for SIR, they put her in coding and billing which was not her interest. She turned this around and became so invested in it that she has now helped create nearly all the CPT codes that exist for IR today.

]]> 4768 Ep. 223 Portal Vein Recan #Recandoit with Dr. Riad Salem In this episode, our host Dr. Chris Beck interviews interventional radiologist Dr. Riad Salem about indications, technique, and cross-specialty collaboration in portal vein recanalization in the cirrhotic patient population. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/M2xtKL Fri, 08 Jul 2022 05:00:00 -0000 full BackTable In this episode, our host Dr. Chris Beck interviews interventional radiologist Dr. Riad Salem about indications, technique, and cross-specialty collaboration in portal vein recanalization in the cirrhotic patient population. In this episode, our host Dr. Chris Beck interviews interventional radiologist Dr. Riad Salem about indications, technique, and cross-specialty collaboration in portal vein recanalization in the cirrhotic patient population. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/M2xtKL In this episode, our host Dr. Chris Beck interviews interventional radiologist Dr. Riad Salem about indications, technique, and cross-specialty collaboration in portal vein recanalization in the cirrhotic patient population.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/M2xtKL

]]> 2778 Ep. 222 New Tools for TIPS with Dr. George Behrens In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. George Behrens about how he built a robust multidisciplinary portal hypertension clinic in a community hospital, tips for common challenges during a TIPS, and post-TIPS management. --- CHECK OUT OUR SPONSOR Argon Medical Scorpion Portal Vein Access Series https://www.argonmedical.com/scorpion --- SHOW NOTES We begin by discussing Dr. Behrens portal hypertension practice. He sees patients in conjunction with hepatology and transplant surgery. The model of his clinic is the opposite of the standard practice. The specialists come to the community hospital, and their clinic gets referrals from tertiary hospitals in Chicago. This took years to build, and they received enormous pushback. This model encompasses patient-centered care because it removes many of the barriers that patients face to travel into Chicago for the workup and management plan of portal hypertension. In this clinic, they also evaluate the underlying cause of cirrhosis including more uncommon causes such as hemochromatosis, Wilson disease, and alpha 1 antitrypsin deficiency. Next, Dr. Behrens details the typical procedure and provides tips for commonly encountered challenges during a TIPS (transjugular intrahepatic portosystemic shunt). He does all TIPS under general anesthesia. He drains ascites, then uses a multipurpose catheter to enter the hepatic vein, without a preference for which hepatic vein he is in. He uses a Launcher AL 11 1 ½ or 2 if he is having difficulty entering a hepatic vein. He then does a CO2 portogram. Next, he advances the cannula into the hepatic veins, unsheathes the cannula, then brings it back to about 2cm from the pedicle, close to the ostium of the hepatic vein. He discusses the differences in technique between the Rösch-Uchida and the Scorpion. He likes to place his stent with the proximal portion where the diaphragm crosses the right atrium and the distal part at the entry site of the portal vein. He uses a VIATORR stent, and always dilates to 8mmHg first, then re-measures pressures. His general rule for dilation is less than 12mmHg for bleeding and less than 8mmHg for ascites. Dr. Behrens discusses follow-up for patients and post-procedure care. All patients are started on rifaximin 2 weeks prior to TIPS. If ascites drained was 4L or more, he gives 100g albumin and 20mg Lasix. He measures pressures via a right heart cath before and after the procedure. Depending on the MELD, he may send patients to the floor or home same day, while others go to the ICU. He starts all patients on lactulose and zinc 220mg BID the day of the procedure. He advises all patients against using PPIs due to the increased risk of encephalopathy. He maintains pre-procedure Lasix and spironolactone dosing for the first 3 months. At one month, patients get a TIPS US with velocities, CMP, CBC, and INR. At 3 months they get cross-sectional imaging and repeat labs. He starts managing diuretics at 3 months. After this, he sees patients every 6 months and screens for hepatocellular carcinoma. --- RESOURCES Argon Scorpion: https://www.argonmedical.com/products/scorpion Cook Rösch-Uchida: https://www.cookmedical.com/products/ir_rups_webds/ Gore VIATORR: https://www.goremedical.com/products/viatorr Medtronic Launcher: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/catheters/launcher.html MELD score: https://www.mdcalc.com/calc/78/meld-score-model-end-stage-liver-disease-12-older Mon, 04 Jul 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. George Behrens about how he built a robust multidisciplinary portal hypertension clinic in a community hospital, tips for common challenges during a TIPS, and post-TIPS management. In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. George Behrens about how he built a robust multidisciplinary portal hypertension clinic in a community hospital, tips for common challenges during a TIPS, and post-TIPS management. --- CHECK OUT OUR SPONSOR Argon Medical Scorpion Portal Vein Access Series https://www.argonmedical.com/scorpion --- SHOW NOTES We begin by discussing Dr. Behrens portal hypertension practice. He sees patients in conjunction with hepatology and transplant surgery. The model of his clinic is the opposite of the standard practice. The specialists come to the community hospital, and their clinic gets referrals from tertiary hospitals in Chicago. This took years to build, and they received enormous pushback. This model encompasses patient-centered care because it removes many of the barriers that patients face to travel into Chicago for the workup and management plan of portal hypertension. In this clinic, they also evaluate the underlying cause of cirrhosis including more uncommon causes such as hemochromatosis, Wilson disease, and alpha 1 antitrypsin deficiency. Next, Dr. Behrens details the typical procedure and provides tips for commonly encountered challenges during a TIPS (transjugular intrahepatic portosystemic shunt). He does all TIPS under general anesthesia. He drains ascites, then uses a multipurpose catheter to enter the hepatic vein, without a preference for which hepatic vein he is in. He uses a Launcher AL 11 1 ½ or 2 if he is having difficulty entering a hepatic vein. He then does a CO2 portogram. Next, he advances the cannula into the hepatic veins, unsheathes the cannula, then brings it back to about 2cm from the pedicle, close to the ostium of the hepatic vein. He discusses the differences in technique between the Rösch-Uchida and the Scorpion. He likes to place his stent with the proximal portion where the diaphragm crosses the right atrium and the distal part at the entry site of the portal vein. He uses a VIATORR stent, and always dilates to 8mmHg first, then re-measures pressures. His general rule for dilation is less than 12mmHg for bleeding and less than 8mmHg for ascites. Dr. Behrens discusses follow-up for patients and post-procedure care. All patients are started on rifaximin 2 weeks prior to TIPS. If ascites drained was 4L or more, he gives 100g albumin and 20mg Lasix. He measures pressures via a right heart cath before and after the procedure. Depending on the MELD, he may send patients to the floor or home same day, while others go to the ICU. He starts all patients on lactulose and zinc 220mg BID the day of the procedure. He advises all patients against using PPIs due to the increased risk of encephalopathy. He maintains pre-procedure Lasix and spironolactone dosing for the first 3 months. At one month, patients get a TIPS US with velocities, CMP, CBC, and INR. At 3 months they get cross-sectional imaging and repeat labs. He starts managing diuretics at 3 months. After this, he sees patients every 6 months and screens for hepatocellular carcinoma. --- RESOURCES Argon Scorpion: https://www.argonmedical.com/products/scorpion Cook Rösch-Uchida: https://www.cookmedical.com/products/ir_rups_webds/ Gore VIATORR: https://www.goremedical.com/products/viatorr Medtronic Launcher: https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/catheters/launcher.html MELD score: https://www.mdcalc.com/calc/78/meld-score-model-end-stage-liver-disease-12-older In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. George Behrens about how he built a robust multidisciplinary portal hypertension clinic in a community hospital, tips for common challenges during a TIPS, and post-TIPS management.


---


CHECK OUT OUR SPONSOR


Argon Medical Scorpion Portal Vein Access Series

https://www.argonmedical.com/scorpion


---


SHOW NOTES


We begin by discussing Dr. Behrens portal hypertension practice. He sees patients in conjunction with hepatology and transplant surgery. The model of his clinic is the opposite of the standard practice. The specialists come to the community hospital, and their clinic gets referrals from tertiary hospitals in Chicago. This took years to build, and they received enormous pushback. This model encompasses patient-centered care because it removes many of the barriers that patients face to travel into Chicago for the workup and management plan of portal hypertension. In this clinic, they also evaluate the underlying cause of cirrhosis including more uncommon causes such as hemochromatosis, Wilson disease, and alpha 1 antitrypsin deficiency.


Next, Dr. Behrens details the typical procedure and provides tips for commonly encountered challenges during a TIPS (transjugular intrahepatic portosystemic shunt). He does all TIPS under general anesthesia. He drains ascites, then uses a multipurpose catheter to enter the hepatic vein, without a preference for which hepatic vein he is in. He uses a Launcher AL 11 1 ½ or 2 if he is having difficulty entering a hepatic vein. He then does a CO2 portogram. Next, he advances the cannula into the hepatic veins, unsheathes the cannula, then brings it back to about 2cm from the pedicle, close to the ostium of the hepatic vein. He discusses the differences in technique between the Rösch-Uchida and the Scorpion. He likes to place his stent with the proximal portion where the diaphragm crosses the right atrium and the distal part at the entry site of the portal vein. He uses a VIATORR stent, and always dilates to 8mmHg first, then re-measures pressures. His general rule for dilation is less than 12mmHg for bleeding and less than 8mmHg for ascites.


Dr. Behrens discusses follow-up for patients and post-procedure care. All patients are started on rifaximin 2 weeks prior to TIPS. If ascites drained was 4L or more, he gives 100g albumin and 20mg Lasix. He measures pressures via a right heart cath before and after the procedure. Depending on the MELD, he may send patients to the floor or home same day, while others go to the ICU. He starts all patients on lactulose and zinc 220mg BID the day of the procedure. He advises all patients against using PPIs due to the increased risk of encephalopathy. He maintains pre-procedure Lasix and spironolactone dosing for the first 3 months. At one month, patients get a TIPS US with velocities, CMP, CBC, and INR. At 3 months they get cross-sectional imaging and repeat labs. He starts managing diuretics at 3 months. After this, he sees patients every 6 months and screens for hepatocellular carcinoma.


---


RESOURCES


Argon Scorpion:

https://www.argonmedical.com/products/scorpion


Cook Rösch-Uchida:

https://www.cookmedical.com/products/ir_rups_webds/


Gore VIATORR:

https://www.goremedical.com/products/viatorr


Medtronic Launcher:

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/catheters/launcher.html


MELD score:

https://www.mdcalc.com/calc/78/meld-score-model-end-stage-liver-disease-12-older

]]> 4221 Ep. 221 Building a Musculoskeletal Interventional Oncology Service with Dr. Alan Sag Dr. Jacob Fleming talks with Dr. Alan Alper Sag about building a musculoskeletal (MSK) interventions practice at Duke University Medical Center, collaborating with other specialists, and future predictions for MSK IR. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/o00BlF  --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES In this episode, our host Dr. Jacob Fleming interviews Dr. Alan Sag about building a musculoskeletal (MSK) interventions practice at Duke University Medical Center, collaborating with other specialists, and future predictions for MSK IR. Dr. Sag starts the episode by sharing his unique experience abroad. His first job was centered around helping to build an IR practice at a teaching hospital in Istanbul. This process helped him discover that the key to practice building was forming foundational cross-specialty relationships. These eventually led to more patient referrals and a higher level of care coordination. When he transitioned to an academic position, Dr. Sag first saw an unmet need in bone cryoablation. He recognized that IR procedures could be powerful alternatives to opioid escalation. A key turning point for his department came when a local TV station covered one of his patient’s stories, and he saw a large increase in referrals. Dr. Sag emphasizes that it was important to ensure that the practice was set up with enough resources to accomodate a large volume of patients. Additionally, it was crucial to recognize when to say “no” to patients when a procedure was contraindicated for them. This patient-first approach also showed referring doctors that he was independently and objectively assessing patients, which helps with trust-building. As we move onto discussing multidisciplinary care, Dr. Sag says that learning another specialty’s vocabulary can greatly enhance your communication and show your desire to collaborate. He encourages IRs to be flexible and learn which conditions are important to the referring doctors. When working with anesthesiology and PM&R, IRs can offer their services to enhance their pain palliation efforts. When working with oncologists, this pain palliation can allow cancer patients to continue participating in clinical trials. Finally, we discuss the next frontiers of MSK interventions. Dr Sag is excited by the prospect of standardization of MSK training, internally cemented screws, and vertebral body stents. --- RESOURCES Dr. Alan Sag Twitter: https://twitter.com/AlanAlperMD?s=20&t=8RGQsroHPZ9Vyc-0lpkiVQ Bone Cryoablation Media Coverage: https://www.wral.com/komen-s-kohl-tries-tumor-freezing-therapy-in-ongoing-cancer-fight/18974441/ Duke Center for Brain & Spine Metastasis: http://dukecancerinstitute.org/DCBSM SpineJack System: https://strykerivs.com/products/families/spinejack-system Society of Interventional Oncology (SIO): http://www.sio-central.org/ SIO’s “Language of Oncology” Course: http://www.sio-central.org/p/cm/ld/fid=385 Visible Body Anatomy Atlas: https://www.visiblebody.com/anatomy-and-physiology-apps/human-anatomy-atlas e-Anatomy Atlas: https://www.imaios.com/en/e-Anatomy Ep. 199- Advanced Minimally Invasive Pain Interventions: https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions Fri, 01 Jul 2022 05:00:00 -0000 full BackTable Dr. Jacob Fleming talks with Dr. Alan Alper Sag about building a musculoskeletal (MSK) interventions practice at Duke University Medical Center, collaborating with other specialists, and future predictions for MSK IR. Dr. Jacob Fleming talks with Dr. Alan Alper Sag about building a musculoskeletal (MSK) interventions practice at Duke University Medical Center, collaborating with other specialists, and future predictions for MSK IR. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/o00BlF  --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES In this episode, our host Dr. Jacob Fleming interviews Dr. Alan Sag about building a musculoskeletal (MSK) interventions practice at Duke University Medical Center, collaborating with other specialists, and future predictions for MSK IR. Dr. Sag starts the episode by sharing his unique experience abroad. His first job was centered around helping to build an IR practice at a teaching hospital in Istanbul. This process helped him discover that the key to practice building was forming foundational cross-specialty relationships. These eventually led to more patient referrals and a higher level of care coordination. When he transitioned to an academic position, Dr. Sag first saw an unmet need in bone cryoablation. He recognized that IR procedures could be powerful alternatives to opioid escalation. A key turning point for his department came when a local TV station covered one of his patient’s stories, and he saw a large increase in referrals. Dr. Sag emphasizes that it was important to ensure that the practice was set up with enough resources to accomodate a large volume of patients. Additionally, it was crucial to recognize when to say “no” to patients when a procedure was contraindicated for them. This patient-first approach also showed referring doctors that he was independently and objectively assessing patients, which helps with trust-building. As we move onto discussing multidisciplinary care, Dr. Sag says that learning another specialty’s vocabulary can greatly enhance your communication and show your desire to collaborate. He encourages IRs to be flexible and learn which conditions are important to the referring doctors. When working with anesthesiology and PM&R, IRs can offer their services to enhance their pain palliation efforts. When working with oncologists, this pain palliation can allow cancer patients to continue participating in clinical trials. Finally, we discuss the next frontiers of MSK interventions. Dr Sag is excited by the prospect of standardization of MSK training, internally cemented screws, and vertebral body stents. --- RESOURCES Dr. Alan Sag Twitter: https://twitter.com/AlanAlperMD?s=20&t=8RGQsroHPZ9Vyc-0lpkiVQ Bone Cryoablation Media Coverage: https://www.wral.com/komen-s-kohl-tries-tumor-freezing-therapy-in-ongoing-cancer-fight/18974441/ Duke Center for Brain & Spine Metastasis: http://dukecancerinstitute.org/DCBSM SpineJack System: https://strykerivs.com/products/families/spinejack-system Society of Interventional Oncology (SIO): http://www.sio-central.org/ SIO’s “Language of Oncology” Course: http://www.sio-central.org/p/cm/ld/fid=385 Visible Body Anatomy Atlas: https://www.visiblebody.com/anatomy-and-physiology-apps/human-anatomy-atlas e-Anatomy Atlas: https://www.imaios.com/en/e-Anatomy Ep. 199- Advanced Minimally Invasive Pain Interventions: https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions Dr. Jacob Fleming talks with Dr. Alan Alper Sag about building a musculoskeletal (MSK) interventions practice at Duke University Medical Center, collaborating with other specialists, and future predictions for MSK IR.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/o00BlF



---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


In this episode, our host Dr. Jacob Fleming interviews Dr. Alan Sag about building a musculoskeletal (MSK) interventions practice at Duke University Medical Center, collaborating with other specialists, and future predictions for MSK IR.


Dr. Sag starts the episode by sharing his unique experience abroad. His first job was centered around helping to build an IR practice at a teaching hospital in Istanbul. This process helped him discover that the key to practice building was forming foundational cross-specialty relationships. These eventually led to more patient referrals and a higher level of care coordination.


When he transitioned to an academic position, Dr. Sag first saw an unmet need in bone cryoablation. He recognized that IR procedures could be powerful alternatives to opioid escalation. A key turning point for his department came when a local TV station covered one of his patient’s stories, and he saw a large increase in referrals. Dr. Sag emphasizes that it was important to ensure that the practice was set up with enough resources to accomodate a large volume of patients. Additionally, it was crucial to recognize when to say “no” to patients when a procedure was contraindicated for them. This patient-first approach also showed referring doctors that he was independently and objectively assessing patients, which helps with trust-building.


As we move onto discussing multidisciplinary care, Dr. Sag says that learning another specialty’s vocabulary can greatly enhance your communication and show your desire to collaborate. He encourages IRs to be flexible and learn which conditions are important to the referring doctors. When working with anesthesiology and PM&R, IRs can offer their services to enhance their pain palliation efforts. When working with oncologists, this pain palliation can allow cancer patients to continue participating in clinical trials.


Finally, we discuss the next frontiers of MSK interventions. Dr Sag is excited by the prospect of standardization of MSK training, internally cemented screws, and vertebral body stents.


---


RESOURCES


Dr. Alan Sag Twitter:

https://twitter.com/AlanAlperMD?s=20&t=8RGQsroHPZ9Vyc-0lpkiVQ


Bone Cryoablation Media Coverage:

https://www.wral.com/komen-s-kohl-tries-tumor-freezing-therapy-in-ongoing-cancer-fight/18974441/


Duke Center for Brain & Spine Metastasis:

http://dukecancerinstitute.org/DCBSM


SpineJack System:

https://strykerivs.com/products/families/spinejack-system


Society of Interventional Oncology (SIO):

http://www.sio-central.org/


SIO’s “Language of Oncology” Course:

http://www.sio-central.org/p/cm/ld/fid=385


Visible Body Anatomy Atlas:

https://www.visiblebody.com/anatomy-and-physiology-apps/human-anatomy-atlas


e-Anatomy Atlas:

https://www.imaios.com/en/e-Anatomy


Ep. 199- Advanced Minimally Invasive Pain Interventions:

https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions

]]> 3361 Ep. 220 STREAM 5th Anniversary: Stronger Than Ever! with Dr. Ari Isaacson and Dr. Sandeep Bagla STREAM Meeting Founders Ari Isaacson and Sandeep Bagla tell us about what to expect at the next meeting in September, including PAE and GAE practice building tips, as well learn about new embolization procedures such as adhesive capsulitis and thyroid arterial embolization. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/CIj1ey --- SHOW NOTES In this episode, host Dr. Aaron Fritts and interventional radiologists Drs. Ari Isaacson and Sandeep Bagla discuss new programming for their upcoming STREAM Conference in September 2022. See our “Resources” section below for a special promotion code for BackTable listeners! As they enter their fifth year of hosting the STREAM, the doctors describe the conference’s evolution beyond procedural teaching of prostate artery embolization (PAE). This year, they will focus more programming on practical factors such as decision-making strategies, malpractice considerations (with both plaintiff and defense attorneys), and new frontiers of embolization. They highlight the increased efforts for cross-specialty collaboration, since the conference will include sessions on genicular artery, shoulder, and hemorrhoid embolization. Finally, we share more ways to learn about PAE. Our guests describe opportunities to shadow at Prostate Centers USA and request to be proctored for initial cases. --- RESOURCES The STREAM Meeting: https://www.thestreammeeting.com/ Promotion Code for 25% off registration for the STREAM Meeting: BACKTABLE22 Prostate Centers USA: https://www.prostatecentersusa.com/ Wed, 29 Jun 2022 05:00:00 -0000 full BackTable STREAM Meeting Founders Ari Isaacson and Sandeep Bagla tell us about what to expect at the next meeting in September, including PAE and GAE practice building tips, as well learn about new embolization procedures such as adhesive capsulitis and thyroid arterial embolization. STREAM Meeting Founders Ari Isaacson and Sandeep Bagla tell us about what to expect at the next meeting in September, including PAE and GAE practice building tips, as well learn about new embolization procedures such as adhesive capsulitis and thyroid arterial embolization. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/CIj1ey --- SHOW NOTES In this episode, host Dr. Aaron Fritts and interventional radiologists Drs. Ari Isaacson and Sandeep Bagla discuss new programming for their upcoming STREAM Conference in September 2022. See our “Resources” section below for a special promotion code for BackTable listeners! As they enter their fifth year of hosting the STREAM, the doctors describe the conference’s evolution beyond procedural teaching of prostate artery embolization (PAE). This year, they will focus more programming on practical factors such as decision-making strategies, malpractice considerations (with both plaintiff and defense attorneys), and new frontiers of embolization. They highlight the increased efforts for cross-specialty collaboration, since the conference will include sessions on genicular artery, shoulder, and hemorrhoid embolization. Finally, we share more ways to learn about PAE. Our guests describe opportunities to shadow at Prostate Centers USA and request to be proctored for initial cases. --- RESOURCES The STREAM Meeting: https://www.thestreammeeting.com/ Promotion Code for 25% off registration for the STREAM Meeting: BACKTABLE22 Prostate Centers USA: https://www.prostatecentersusa.com/ STREAM Meeting Founders Ari Isaacson and Sandeep Bagla tell us about what to expect at the next meeting in September, including PAE and GAE practice building tips, as well learn about new embolization procedures such as adhesive capsulitis and thyroid arterial embolization.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/CIj1ey

---


SHOW NOTES


In this episode, host Dr. Aaron Fritts and interventional radiologists Drs. Ari Isaacson and Sandeep Bagla discuss new programming for their upcoming STREAM Conference in September 2022.


See our “Resources” section below for a special promotion code for BackTable listeners!


As they enter their fifth year of hosting the STREAM, the doctors describe the conference’s evolution beyond procedural teaching of prostate artery embolization (PAE). This year, they will focus more programming on practical factors such as decision-making strategies, malpractice considerations (with both plaintiff and defense attorneys), and new frontiers of embolization. They highlight the increased efforts for cross-specialty collaboration, since the conference will include sessions on genicular artery, shoulder, and hemorrhoid embolization.


Finally, we share more ways to learn about PAE. Our guests describe opportunities to shadow at Prostate Centers USA and request to be proctored for initial cases.


---


RESOURCES


The STREAM Meeting:

https://www.thestreammeeting.com/

Promotion Code for 25% off registration for the STREAM Meeting: BACKTABLE22


Prostate Centers USA:

https://www.prostatecentersusa.com/

]]> 1762 Ep. 219 Building an Endoleak Service Line with Dr. David Kim Mon, 27 Jun 2022 05:00:00 -0000 full BackTable 2460 Ep. 218 Building a Skillset Outside of Training with Dr. Shamit Desai We talk with Dr. Shamit Desai about resources and tips for endovascular and interventional specialists to continue building clinical and procedural skills beyond training. --- CHECK OUT OUR SPONSORS RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor Medtronic AV DCB https://www.medtronic.com/avdata --- SHOW NOTES In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Shamit Desai discuss resources and tips for IRs to continue building clinical and procedural skills beyond residency and fellowship training. The doctors start by recognizing that every training program has specific focuses, which influence the skills that IRs have when they first emerge from the program. With the breadth of IR procedures available today, there are many service lines that are not addressed in formal training. However, Dr. Desai believes that any graduating IR has a foundation of proficient catheter skills and they have the potential to learn most image guided procedures. Dr. Desai emphasizes that a big part of building a new skill set is having the support to learn the skills and let it flourish. He recounts his path to learning how to treat kyphoplasty and PAD and the integral role that IR mentors and device companies played in helping him develop knowledge and confidence. Dr. Desai also advises listeners to branch out into reading journals from other specialties. WIth PAD, he highly recommends learning from the Journal of Vascular Surgery (JVS), which can provide valuable perspective on clinical management. We also highlight national conferences that are tailored specifically to educate on certain procedures. Additionally, Dr. Desai emphasizes that it is important for each IR to identify their true passion. Passion fuels the drive to learn as much as possible about a procedure, which leads to better outcomes for patients. It is also important to have clinical infrastructure in place before marketing the service line to patients and referrers, in order to create a quality patient experience. --- RESOURCES Ep. 198- Privademics and Advantages of Lesser Known Community Programs with Dr. Shamit Desai and Dr. Saud Ahmed: https://www.backtable.com/shows/vi/podcasts/198/privademics-advantages-of-lesser-known-community-programs Ep. 210- Modern Vertebral Augmentation with Dr. Doug Beall: https://www.backtable.com/shows/vi/podcasts/210/modern-vertebral-augmentation Vertebral Augmentation by Dr. Douglas Beall: https://www.amazon.com/Vertebral-Augmentation-Comprehensive-Vertebroplasty-Kyphoplasty/dp/1684200156 Medtronic OsteoCool System: https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html Vascupedia: https://vascupedia.com/ Dr. Srini Tummala’s YouTube Channel: https://www.youtube.com/c/DrTummalasVascularChannel?app=desktop Journal of Vascular Surgery (JVS): https://www.jvascsurg.org/ SIR Y90 Course: https://www.sirweb.org/learning-center/meetings/y-90-the-complete-course/ SIR LEARN Conference: https://www.sirweb.org/learning-center/meetings/2022-learn-and-active-meeting/ AMP (Amputation Prevention) Symposium: https://www.amptheclimeeting.com/ NCVH (New Cardiovascular Horizons) Conference: https://ncvh.org/meeting/ncvh-2022/ OEIS (Outpatient Endovascular and Interventional Society) Conference: https://oeisociety.com/ Fri, 24 Jun 2022 05:00:00 -0000 full BackTable We talk with Dr. Shamit Desai about resources and tips for endovascular and interventional specialists to continue building clinical and procedural skills beyond training. We talk with Dr. Shamit Desai about resources and tips for endovascular and interventional specialists to continue building clinical and procedural skills beyond training. --- CHECK OUT OUR SPONSORS RapidAI http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor Medtronic AV DCB https://www.medtronic.com/avdata --- SHOW NOTES In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Shamit Desai discuss resources and tips for IRs to continue building clinical and procedural skills beyond residency and fellowship training. The doctors start by recognizing that every training program has specific focuses, which influence the skills that IRs have when they first emerge from the program. With the breadth of IR procedures available today, there are many service lines that are not addressed in formal training. However, Dr. Desai believes that any graduating IR has a foundation of proficient catheter skills and they have the potential to learn most image guided procedures. Dr. Desai emphasizes that a big part of building a new skill set is having the support to learn the skills and let it flourish. He recounts his path to learning how to treat kyphoplasty and PAD and the integral role that IR mentors and device companies played in helping him develop knowledge and confidence. Dr. Desai also advises listeners to branch out into reading journals from other specialties. WIth PAD, he highly recommends learning from the Journal of Vascular Surgery (JVS), which can provide valuable perspective on clinical management. We also highlight national conferences that are tailored specifically to educate on certain procedures. Additionally, Dr. Desai emphasizes that it is important for each IR to identify their true passion. Passion fuels the drive to learn as much as possible about a procedure, which leads to better outcomes for patients. It is also important to have clinical infrastructure in place before marketing the service line to patients and referrers, in order to create a quality patient experience. --- RESOURCES Ep. 198- Privademics and Advantages of Lesser Known Community Programs with Dr. Shamit Desai and Dr. Saud Ahmed: https://www.backtable.com/shows/vi/podcasts/198/privademics-advantages-of-lesser-known-community-programs Ep. 210- Modern Vertebral Augmentation with Dr. Doug Beall: https://www.backtable.com/shows/vi/podcasts/210/modern-vertebral-augmentation Vertebral Augmentation by Dr. Douglas Beall: https://www.amazon.com/Vertebral-Augmentation-Comprehensive-Vertebroplasty-Kyphoplasty/dp/1684200156 Medtronic OsteoCool System: https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html Vascupedia: https://vascupedia.com/ Dr. Srini Tummala’s YouTube Channel: https://www.youtube.com/c/DrTummalasVascularChannel?app=desktop Journal of Vascular Surgery (JVS): https://www.jvascsurg.org/ SIR Y90 Course: https://www.sirweb.org/learning-center/meetings/y-90-the-complete-course/ SIR LEARN Conference: https://www.sirweb.org/learning-center/meetings/2022-learn-and-active-meeting/ AMP (Amputation Prevention) Symposium: https://www.amptheclimeeting.com/ NCVH (New Cardiovascular Horizons) Conference: https://ncvh.org/meeting/ncvh-2022/ OEIS (Outpatient Endovascular and Interventional Society) Conference: https://oeisociety.com/ We talk with Dr. Shamit Desai about resources and tips for endovascular and interventional specialists to continue building clinical and procedural skills beyond training.


---


CHECK OUT OUR SPONSORS


RapidAI

http://rapidai.com/?utm_campaign=Evergreen&utm_source=Online&utm_medium=podcast&utm_term=Backtable&utm_content=Sponsor


Medtronic AV DCB

https://www.medtronic.com/avdata


---


SHOW NOTES


In this episode, host Dr. Aaron Fritts and interventional radiologist Dr. Shamit Desai discuss resources and tips for IRs to continue building clinical and procedural skills beyond residency and fellowship training.


The doctors start by recognizing that every training program has specific focuses, which influence the skills that IRs have when they first emerge from the program. With the breadth of IR procedures available today, there are many service lines that are not addressed in formal training. However, Dr. Desai believes that any graduating IR has a foundation of proficient catheter skills and they have the potential to learn most image guided procedures.


Dr. Desai emphasizes that a big part of building a new skill set is having the support to learn the skills and let it flourish. He recounts his path to learning how to treat kyphoplasty and PAD and the integral role that IR mentors and device companies played in helping him develop knowledge and confidence. Dr. Desai also advises listeners to branch out into reading journals from other specialties. WIth PAD, he highly recommends learning from the Journal of Vascular Surgery (JVS), which can provide valuable perspective on clinical management. We also highlight national conferences that are tailored specifically to educate on certain procedures.


Additionally, Dr. Desai emphasizes that it is important for each IR to identify their true passion. Passion fuels the drive to learn as much as possible about a procedure, which leads to better outcomes for patients. It is also important to have clinical infrastructure in place before marketing the service line to patients and referrers, in order to create a quality patient experience.


---


RESOURCES


Ep. 198- Privademics and Advantages of Lesser Known Community Programs with Dr. Shamit Desai and Dr. Saud Ahmed:

https://www.backtable.com/shows/vi/podcasts/198/privademics-advantages-of-lesser-known-community-programs


Ep. 210- Modern Vertebral Augmentation with Dr. Doug Beall:

https://www.backtable.com/shows/vi/podcasts/210/modern-vertebral-augmentation


Vertebral Augmentation by Dr. Douglas Beall:

https://www.amazon.com/Vertebral-Augmentation-Comprehensive-Vertebroplasty-Kyphoplasty/dp/1684200156


Medtronic OsteoCool System:

https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html


Vascupedia:

https://vascupedia.com/


Dr. Srini Tummala’s YouTube Channel:

https://www.youtube.com/c/DrTummalasVascularChannel?app=desktop


Journal of Vascular Surgery (JVS):

https://www.jvascsurg.org/


SIR Y90 Course:

https://www.sirweb.org/learning-center/meetings/y-90-the-complete-course/


SIR LEARN Conference:

https://www.sirweb.org/learning-center/meetings/2022-learn-and-active-meeting/


AMP (Amputation Prevention) Symposium:

https://www.amptheclimeeting.com/


NCVH (New Cardiovascular Horizons) Conference:

https://ncvh.org/meeting/ncvh-2022/


OEIS (Outpatient Endovascular and Interventional Society) Conference:

https://oeisociety.com/

]]> 2762 Ep. 217 Building a Comprehensive Women’s Health Practice: Collaboration with GYN with Dr. Mark Hoffman and Dr. Merve Ozen Dr. Merve Ozen, interventional radiologist, and Dr. Mark Hoffman, minimally invasive gynecologic surgeon (MIGS), discuss how collaboration between IR and gynecologic surgery provides comprehensive medical, surgical, and interventional treatment options for women suffering from uterine fibroids, pelvic congestion syndrome and other causes of chronic pelvic pain. --- CHECK OUT OUR SPONSORS Athletic Greens https://www.athleticgreens.com/backtablevi Medtronic AV DCB https://www.medtronic.com/avdata --- SHOW NOTES In this episode, host Dr. Aparna Baheti interviews Dr. Merve Ozen, interventional radiologist, and Dr. Mark Hoffman, minimally invasive gynecologic surgeon (MIGS) about how collaboration between IR and gynecologic surgery provides comprehensive medical, surgical, and interventional treatment options for women suffering from uterine fibroids, pelvic congestion syndrome and other causes of chronic pelvic pain. Drs. Hoffmann and Ozen began a combined clinic after a discussion between their two departments. Though IRs were enthusiastic about performing uterine fibroid embolization (UFE), they were not able to due to a lack of referring gynecologists. Dr. Hoffman was interested in this collaboration, and he knew a very supportive and motivated nurse who wanted to lead this initiative. He says that despite pushback from other MIGs in his department, he had a supportive department chair who allowed the project to go forward. Next, Dr. Ozen describes a day in their collaborative clinic. She begins by reviewing imaging and patients for the day, ordering new imaging if needed, and discussing patients with Dr. Hoffman. They each see their patients which takes about 45 minutes per visit due to the complexity of chronic pelvic pain and the many potential causes and contributing factors. Some patients require meeting with both physicians to discuss all options. They see four to five patients each day. Every day runs differently depending on the patients and their individual needs, but it runs smoothly due to the supportive nursing staff. Dr. Hoffman discusses medical management including birth control pills, which are often a first-line option or an option for someone who wants the least invasive treatment. He also offers hysterectomy (laparoscopic, robotic, vaginal, abdominal) for women who wish to never have more uterine bleeding, and myomectomy, with hysteroscopic myomectomy being the most minimally invasive and allowing patients to go home the same day after recovering from anesthesia. Dr. Ozen discusses UFE and treatments for other causes of pelvic pain. She does hypogastric nerve blocks for pain, ovarian vein embolization for pelvic congestion syndrome, and cryoablation for chronic pelvic pain. She has also been able to treat some unique ectopic pregnancies that Dr. Hoffman has seen, including a cervical and an abdominal ectopic pregnancy which provided lifesaving treatment without invasive surgical evacuation. --- RESOURCES BackTable Ep. 199: Advanced Minimially Invasive Pain Interventions with Dr. Prologo: https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions Non-surgical management of abdominal ectopic pregnancy with uterine artery embolization: https://pubmed.ncbi.nlm.nih.gov/35321265/ Mon, 20 Jun 2022 05:00:00 -0000 full BackTable Dr. Merve Ozen, interventional radiologist, and Dr. Mark Hoffman, minimally invasive gynecologic surgeon (MIGS), discuss how collaboration between IR and gynecologic surgery provides comprehensive medical, surgical, and interventional treatment options for women suffering from uterine fibroids, pelvic congestion syndrome and other causes of chronic pelvic pain. Dr. Merve Ozen, interventional radiologist, and Dr. Mark Hoffman, minimally invasive gynecologic surgeon (MIGS), discuss how collaboration between IR and gynecologic surgery provides comprehensive medical, surgical, and interventional treatment options for women suffering from uterine fibroids, pelvic congestion syndrome and other causes of chronic pelvic pain. --- CHECK OUT OUR SPONSORS Athletic Greens https://www.athleticgreens.com/backtablevi Medtronic AV DCB https://www.medtronic.com/avdata --- SHOW NOTES In this episode, host Dr. Aparna Baheti interviews Dr. Merve Ozen, interventional radiologist, and Dr. Mark Hoffman, minimally invasive gynecologic surgeon (MIGS) about how collaboration between IR and gynecologic surgery provides comprehensive medical, surgical, and interventional treatment options for women suffering from uterine fibroids, pelvic congestion syndrome and other causes of chronic pelvic pain. Drs. Hoffmann and Ozen began a combined clinic after a discussion between their two departments. Though IRs were enthusiastic about performing uterine fibroid embolization (UFE), they were not able to due to a lack of referring gynecologists. Dr. Hoffman was interested in this collaboration, and he knew a very supportive and motivated nurse who wanted to lead this initiative. He says that despite pushback from other MIGs in his department, he had a supportive department chair who allowed the project to go forward. Next, Dr. Ozen describes a day in their collaborative clinic. She begins by reviewing imaging and patients for the day, ordering new imaging if needed, and discussing patients with Dr. Hoffman. They each see their patients which takes about 45 minutes per visit due to the complexity of chronic pelvic pain and the many potential causes and contributing factors. Some patients require meeting with both physicians to discuss all options. They see four to five patients each day. Every day runs differently depending on the patients and their individual needs, but it runs smoothly due to the supportive nursing staff. Dr. Hoffman discusses medical management including birth control pills, which are often a first-line option or an option for someone who wants the least invasive treatment. He also offers hysterectomy (laparoscopic, robotic, vaginal, abdominal) for women who wish to never have more uterine bleeding, and myomectomy, with hysteroscopic myomectomy being the most minimally invasive and allowing patients to go home the same day after recovering from anesthesia. Dr. Ozen discusses UFE and treatments for other causes of pelvic pain. She does hypogastric nerve blocks for pain, ovarian vein embolization for pelvic congestion syndrome, and cryoablation for chronic pelvic pain. She has also been able to treat some unique ectopic pregnancies that Dr. Hoffman has seen, including a cervical and an abdominal ectopic pregnancy which provided lifesaving treatment without invasive surgical evacuation. --- RESOURCES BackTable Ep. 199: Advanced Minimially Invasive Pain Interventions with Dr. Prologo: https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions Non-surgical management of abdominal ectopic pregnancy with uterine artery embolization: https://pubmed.ncbi.nlm.nih.gov/35321265/ Dr. Merve Ozen, interventional radiologist, and Dr. Mark Hoffman, minimally invasive gynecologic surgeon (MIGS), discuss how collaboration between IR and gynecologic surgery provides comprehensive medical, surgical, and interventional treatment options for women suffering from uterine fibroids, pelvic congestion syndrome and other causes of chronic pelvic pain.


---


CHECK OUT OUR SPONSORS


Athletic Greens

https://www.athleticgreens.com/backtablevi


Medtronic AV DCB

https://www.medtronic.com/avdata


---


SHOW NOTES


In this episode, host Dr. Aparna Baheti interviews Dr. Merve Ozen, interventional radiologist, and Dr. Mark Hoffman, minimally invasive gynecologic surgeon (MIGS) about how collaboration between IR and gynecologic surgery provides comprehensive medical, surgical, and interventional treatment options for women suffering from uterine fibroids, pelvic congestion syndrome and other causes of chronic pelvic pain.


Drs. Hoffmann and Ozen began a combined clinic after a discussion between their two departments. Though IRs were enthusiastic about performing uterine fibroid embolization (UFE), they were not able to due to a lack of referring gynecologists. Dr. Hoffman was interested in this collaboration, and he knew a very supportive and motivated nurse who wanted to lead this initiative. He says that despite pushback from other MIGs in his department, he had a supportive department chair who allowed the project to go forward.


Next, Dr. Ozen describes a day in their collaborative clinic. She begins by reviewing imaging and patients for the day, ordering new imaging if needed, and discussing patients with Dr. Hoffman. They each see their patients which takes about 45 minutes per visit due to the complexity of chronic pelvic pain and the many potential causes and contributing factors. Some patients require meeting with both physicians to discuss all options. They see four to five patients each day. Every day runs differently depending on the patients and their individual needs, but it runs smoothly due to the supportive nursing staff.


Dr. Hoffman discusses medical management including birth control pills, which are often a first-line option or an option for someone who wants the least invasive treatment. He also offers hysterectomy (laparoscopic, robotic, vaginal, abdominal) for women who wish to never have more uterine bleeding, and myomectomy, with hysteroscopic myomectomy being the most minimally invasive and allowing patients to go home the same day after recovering from anesthesia. Dr. Ozen discusses UFE and treatments for other causes of pelvic pain. She does hypogastric nerve blocks for pain, ovarian vein embolization for pelvic congestion syndrome, and cryoablation for chronic pelvic pain. She has also been able to treat some unique ectopic pregnancies that Dr. Hoffman has seen, including a cervical and an abdominal ectopic pregnancy which provided lifesaving treatment without invasive surgical evacuation.


---


RESOURCES


BackTable Ep. 199: Advanced Minimially Invasive Pain Interventions with Dr. Prologo:

https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions


Non-surgical management of abdominal ectopic pregnancy with uterine artery embolization:

https://pubmed.ncbi.nlm.nih.gov/35321265/

]]> 2857 Police Presence in Medical Spaces with Dr. Jamal Jefferson In this episode of our Health Equity Series, guest host Dr. Vishal Kumar interviews emergency medicine resident Dr. Jamal Jefferson about the presence of law enforcement in emergency rooms and challenges with patient privacy and trust in the healthcare system. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/1zdevF --- SHOW NOTES In this episode, guest host Dr. Vishal Kumar interviews emergency medicine resident Dr. Jamal Jefferson about the presence of law enforcement in emergency rooms and its effects on patient privacy and trust in the healthcare system. Dr. Jefferson explains the role that the emergency department plays in his community. He outlines its medical role, as well as its extension into “social emergency medicine.” This term refers to the fact that the ED can be an important access point to services that could improve social determinants of health. Overall the ED often sees community members in their most vulnerable states, and it has the opportunity to track trends in community needs. Next, the doctors discuss how healthcare providers can be unknowingly complicit in further injustices to their patients. Dr. Jefferson urges physicians to think about the ramifications of their actions. For example, using a 5150 code to place a patient on psychiatric hold could affect court decisions and child custody outcomes in the future. Furthermore, when patient belongings are being itemized in a public space such as the ED, this routine procedure could trigger a downstream search/seizure, interrogation, and detainment of the patient. Dr. Jefferson emphasizes the importance of being an active participant in protecting patient privacy. In his patient encounters, he separates the police from the doctor-patient relationship and dispels the idea that the medical team will report protected health information to the police. He explicitly lets patients know that the preceding events that brought them to the hospital do not have an impact on how he will treat them. Additionally, the negative experience of a single patient will send a ripple effect through the community. The patient’s friends and family members may trust the ED less, which delays care and increases morbidity and mortality. Finally, the doctors highlight important research and court rulings over the criminalization of patients. --- RESOURCES A National Evaluation of the Effect of Trauma-Center Care on Mortality: https://www.nejm.org/doi/full/10.1056/nejmsa052049 Police Brutality and Black Health: Setting the Agenda for Public Health Scholars: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388955/ Policing the Emergency Room (Harvard Law Review): https://harvardlawreview.org/2021/06/policing-the-emergency-room/ Weapons Use Among Hospital Security Personnel: https://cdn.ymaws.com/www.iahss.org/resource/collection/48907176-3B11-4B24-A7C0-FF756143C7DE/2014_Weapons_use_among_hosptial_security_personnel.pdf Ferguson vs. Charleston: https://supreme.justia.com/cases/federal/us/532/67/ #WhiteCoatsForBlackLives — Addressing Physicians’ Complicity in Criminalizing Communities: https://www.nejm.org/doi/full/10.1056/NEJMp2023305 Fri, 17 Jun 2022 05:00:00 -0000 full BackTable In this episode of our Health Equity Series, guest host Dr. Vishal Kumar interviews emergency medicine resident Dr. Jamal Jefferson about the presence of law enforcement in emergency rooms and challenges with patient privacy and trust in the healthcare system. In this episode of our Health Equity Series, guest host Dr. Vishal Kumar interviews emergency medicine resident Dr. Jamal Jefferson about the presence of law enforcement in emergency rooms and challenges with patient privacy and trust in the healthcare system. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/1zdevF --- SHOW NOTES In this episode, guest host Dr. Vishal Kumar interviews emergency medicine resident Dr. Jamal Jefferson about the presence of law enforcement in emergency rooms and its effects on patient privacy and trust in the healthcare system. Dr. Jefferson explains the role that the emergency department plays in his community. He outlines its medical role, as well as its extension into “social emergency medicine.” This term refers to the fact that the ED can be an important access point to services that could improve social determinants of health. Overall the ED often sees community members in their most vulnerable states, and it has the opportunity to track trends in community needs. Next, the doctors discuss how healthcare providers can be unknowingly complicit in further injustices to their patients. Dr. Jefferson urges physicians to think about the ramifications of their actions. For example, using a 5150 code to place a patient on psychiatric hold could affect court decisions and child custody outcomes in the future. Furthermore, when patient belongings are being itemized in a public space such as the ED, this routine procedure could trigger a downstream search/seizure, interrogation, and detainment of the patient. Dr. Jefferson emphasizes the importance of being an active participant in protecting patient privacy. In his patient encounters, he separates the police from the doctor-patient relationship and dispels the idea that the medical team will report protected health information to the police. He explicitly lets patients know that the preceding events that brought them to the hospital do not have an impact on how he will treat them. Additionally, the negative experience of a single patient will send a ripple effect through the community. The patient’s friends and family members may trust the ED less, which delays care and increases morbidity and mortality. Finally, the doctors highlight important research and court rulings over the criminalization of patients. --- RESOURCES A National Evaluation of the Effect of Trauma-Center Care on Mortality: https://www.nejm.org/doi/full/10.1056/nejmsa052049 Police Brutality and Black Health: Setting the Agenda for Public Health Scholars: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388955/ Policing the Emergency Room (Harvard Law Review): https://harvardlawreview.org/2021/06/policing-the-emergency-room/ Weapons Use Among Hospital Security Personnel: https://cdn.ymaws.com/www.iahss.org/resource/collection/48907176-3B11-4B24-A7C0-FF756143C7DE/2014_Weapons_use_among_hosptial_security_personnel.pdf Ferguson vs. Charleston: https://supreme.justia.com/cases/federal/us/532/67/ #WhiteCoatsForBlackLives — Addressing Physicians’ Complicity in Criminalizing Communities: https://www.nejm.org/doi/full/10.1056/NEJMp2023305 In this episode of our Health Equity Series, guest host Dr. Vishal Kumar interviews emergency medicine resident Dr. Jamal Jefferson about the presence of law enforcement in emergency rooms and challenges with patient privacy and trust in the healthcare system.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/1zdevF

---


SHOW NOTES


In this episode, guest host Dr. Vishal Kumar interviews emergency medicine resident Dr. Jamal Jefferson about the presence of law enforcement in emergency rooms and its effects on patient privacy and trust in the healthcare system.


Dr. Jefferson explains the role that the emergency department plays in his community. He outlines its medical role, as well as its extension into “social emergency medicine.” This term refers to the fact that the ED can be an important access point to services that could improve social determinants of health. Overall the ED often sees community members in their most vulnerable states, and it has the opportunity to track trends in community needs.


Next, the doctors discuss how healthcare providers can be unknowingly complicit in further injustices to their patients. Dr. Jefferson urges physicians to think about the ramifications of their actions. For example, using a 5150 code to place a patient on psychiatric hold could affect court decisions and child custody outcomes in the future. Furthermore, when patient belongings are being itemized in a public space such as the ED, this routine procedure could trigger a downstream search/seizure, interrogation, and detainment of the patient.


Dr. Jefferson emphasizes the importance of being an active participant in protecting patient privacy. In his patient encounters, he separates the police from the doctor-patient relationship and dispels the idea that the medical team will report protected health information to the police. He explicitly lets patients know that the preceding events that brought them to the hospital do not have an impact on how he will treat them. Additionally, the negative experience of a single patient will send a ripple effect through the community. The patient’s friends and family members may trust the ED less, which delays care and increases morbidity and mortality.


Finally, the doctors highlight important research and court rulings over the criminalization of patients.


---


RESOURCES


A National Evaluation of the Effect of Trauma-Center Care on Mortality:

https://www.nejm.org/doi/full/10.1056/nejmsa052049


Police Brutality and Black Health: Setting the Agenda for Public Health Scholars:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388955/


Policing the Emergency Room (Harvard Law Review):

https://harvardlawreview.org/2021/06/policing-the-emergency-room/


Weapons Use Among Hospital Security Personnel:

https://cdn.ymaws.com/www.iahss.org/resource/collection/48907176-3B11-4B24-A7C0-FF756143C7DE/2014_Weapons_use_among_hosptial_security_personnel.pdf


Ferguson vs. Charleston:

https://supreme.justia.com/cases/federal/us/532/67/


#WhiteCoatsForBlackLives — Addressing Physicians’ Complicity in Criminalizing Communities:

https://www.nejm.org/doi/full/10.1056/NEJMp2023305

]]> 2726 Ep. 216 Stick It — Glue Embo with Dr. Ziv Haskal In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Ziv Haskal about the use of glue in peripheral applications. They discuss how to prepare and inject glue for portal vein embolization, type 2 endoleaks, and Dr. Haskal’s glue bullet technique. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Ziv Haskal talks us through the use of glue in peripheral applications. He discusses how to prepare and inject glue for portal vein embolization, how to do the same for type 2 endoleaks, and also shares his glue bullet technique. Glue is only approved for neurointerventional procedures in the US, though there are many off-label uses where glue is the superior embolic. The benefit of glue is the power it gives to the operator. By manipulating the oil to glue ratio and thus the viscosity, the operator has control of how far the glue will travel when injected which makes it a very versatile liquid embolic. Dr. Haskal commonly uses glue for portal vein, bronchial, lumbar and intercostal embolizations as well as in coagulopathic patients. Dr. Haskal advises that one of the easiest places to start using glue is portal vein embolization. To prepare glue for a procedure, Dr. Haskal separates it from the rest of the back table, and always uses new gloves and a separate set of equipment. For a portal vein embolization, Dr. Haskal runs a microcatheter paraxially alongside the safety wire and makes U-turns into portal vein branches that he is targeting. For treating renal pseudoaneurysm or for finishing a coil embolization, Dr. Haskal uses the glue bullet method, which involves loading a syringe with dextrose and only a tiny amount of glue at the top of the syringe. Regarding complications of glue, Dr. Haskal says that though many fear the glue solidifying and causing the catheter to get stuck in a vessel, the likelihood of this is near zero because the glue does not harden fast enough for this to happen. The most common complication is over embolization and downstream spillage, which can be problematic in end organ supply vessels. Finally, Dr. Haskel explains his technique for when the glue starts solidifying around the catheter which creates a glue tail catheter is drawn back. --- RESOURCES Glue for Type 2 Endoleak: https://www.jvir.org/article/S1051-0443(18)30849-2/fulltext Global Embolization and Symposium Technologies (GEST): https://www.gestweb.org Mon, 13 Jun 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Ziv Haskal about the use of glue in peripheral applications. They discuss how to prepare and inject glue for portal vein embolization, type 2 endoleaks, and Dr. Haskal’s glue bullet technique. In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Ziv Haskal about the use of glue in peripheral applications. They discuss how to prepare and inject glue for portal vein embolization, type 2 endoleaks, and Dr. Haskal’s glue bullet technique. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Ziv Haskal talks us through the use of glue in peripheral applications. He discusses how to prepare and inject glue for portal vein embolization, how to do the same for type 2 endoleaks, and also shares his glue bullet technique. Glue is only approved for neurointerventional procedures in the US, though there are many off-label uses where glue is the superior embolic. The benefit of glue is the power it gives to the operator. By manipulating the oil to glue ratio and thus the viscosity, the operator has control of how far the glue will travel when injected which makes it a very versatile liquid embolic. Dr. Haskal commonly uses glue for portal vein, bronchial, lumbar and intercostal embolizations as well as in coagulopathic patients. Dr. Haskal advises that one of the easiest places to start using glue is portal vein embolization. To prepare glue for a procedure, Dr. Haskal separates it from the rest of the back table, and always uses new gloves and a separate set of equipment. For a portal vein embolization, Dr. Haskal runs a microcatheter paraxially alongside the safety wire and makes U-turns into portal vein branches that he is targeting. For treating renal pseudoaneurysm or for finishing a coil embolization, Dr. Haskal uses the glue bullet method, which involves loading a syringe with dextrose and only a tiny amount of glue at the top of the syringe. Regarding complications of glue, Dr. Haskal says that though many fear the glue solidifying and causing the catheter to get stuck in a vessel, the likelihood of this is near zero because the glue does not harden fast enough for this to happen. The most common complication is over embolization and downstream spillage, which can be problematic in end organ supply vessels. Finally, Dr. Haskel explains his technique for when the glue starts solidifying around the catheter which creates a glue tail catheter is drawn back. --- RESOURCES Glue for Type 2 Endoleak: https://www.jvir.org/article/S1051-0443(18)30849-2/fulltext Global Embolization and Symposium Technologies (GEST): https://www.gestweb.org In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Ziv Haskal about the use of glue in peripheral applications. They discuss how to prepare and inject glue for portal vein embolization, type 2 endoleaks, and Dr. Haskal’s glue bullet technique.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


Dr. Ziv Haskal talks us through the use of glue in peripheral applications. He discusses how to prepare and inject glue for portal vein embolization, how to do the same for type 2 endoleaks, and also shares his glue bullet technique.


Glue is only approved for neurointerventional procedures in the US, though there are many off-label uses where glue is the superior embolic. The benefit of glue is the power it gives to the operator. By manipulating the oil to glue ratio and thus the viscosity, the operator has control of how far the glue will travel when injected which makes it a very versatile liquid embolic. Dr. Haskal commonly uses glue for portal vein, bronchial, lumbar and intercostal embolizations as well as in coagulopathic patients.


Dr. Haskal advises that one of the easiest places to start using glue is portal vein embolization. To prepare glue for a procedure, Dr. Haskal separates it from the rest of the back table, and always uses new gloves and a separate set of equipment. For a portal vein embolization, Dr. Haskal runs a microcatheter paraxially alongside the safety wire and makes U-turns into portal vein branches that he is targeting. For treating renal pseudoaneurysm or for finishing a coil embolization, Dr. Haskal uses the glue bullet method, which involves loading a syringe with dextrose and only a tiny amount of glue at the top of the syringe.


Regarding complications of glue, Dr. Haskal says that though many fear the glue solidifying and causing the catheter to get stuck in a vessel, the likelihood of this is near zero because the glue does not harden fast enough for this to happen. The most common complication is over embolization and downstream spillage, which can be problematic in end organ supply vessels. Finally, Dr. Haskel explains his technique for when the glue starts solidifying around the catheter which creates a glue tail catheter is drawn back.


---


RESOURCES


Glue for Type 2 Endoleak:

https://www.jvir.org/article/S1051-0443(18)30849-2/fulltext


Global Embolization and Symposium Technologies (GEST):

https://www.gestweb.org

]]> 2050 Ep. 215 Radiologist as Spine and Pain Specialist with Dr. John Michels Jacob Fleming interviews interventional pain specialist and former Super Bowl champion John S. Michels about his journey into the subspecialty, pathways for getting involved in interventional pain management, and his philosophy on comprehensive patient care. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/1DSmJG --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews interventional pain specialist and former Super Bowl champion Dr. John Michels about his journey into the subspecialty, pathways for getting involved in interventional pain management, and his philosophy on comprehensive patient care. Dr. Michels describes his first career as an NFL player with the Green Bay Packers and how it taught him to be comfortable with external pressures and delayed gratification. He recounts the knee injury that led to an early retirement from the field, as well as interactions with radiologists, surgeons, and rehabilitation specialists that got him thinking about entering the field of medicine. He ended up pursuing a diagnostic residency at Baylor University, and then an additional interventional pain fellowship at the University of California at Irvine. Throughout his training, he recognizes that there is great synergistic benefit when specialists team up to provide multidisciplinary care and teach each other different skills. For example, he refined his physical exam skills by working with a PM&R physician, and he also taught other physicians how to read imaging. Dr. Michels believes that the most gratifying part of his career is the opportunity to diagnose, treat, and follow up with patients. In his Dallas-based independent OBL, he splits his time between clinic and procedural days. He enjoys seeing the impact that his interventions have on patients, and he is committed to providing alternatives to opioid use. Dr. Michels encourages more radiologists to explore the field of interventional pain, which is now recognized as a radiology subspecialty by the American Board of Radiology. Overall, when imaging is combined with physical examination and history-taking, the patient will enjoy the benefits of better diagnosis and care. --- RESOURCES Dr. John Michel’s Website: https://www.johnmichelsmd.com/ Interventional Spine & Pain: http://www.spinedallas.com/ ABR Pain Medicine Subspecialty: https://www.theabr.org/radiation-oncology/subspecialties/pain-medicine UC Irvine Pain Fellowship: https://anesthesiology.uci.edu/education-fellowships-pain-medicine.shtml Fri, 10 Jun 2022 05:00:00 -0000 full BackTable Dr. Jacob Fleming interviews interventional pain specialist and former Super Bowl champion Dr. John Michels about his journey into the subspecialty, pathways for getting involved in interventional pain management, and his philosophy on comprehensive patient care. Jacob Fleming interviews interventional pain specialist and former Super Bowl champion John S. Michels about his journey into the subspecialty, pathways for getting involved in interventional pain management, and his philosophy on comprehensive patient care. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/1DSmJG --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews interventional pain specialist and former Super Bowl champion Dr. John Michels about his journey into the subspecialty, pathways for getting involved in interventional pain management, and his philosophy on comprehensive patient care. Dr. Michels describes his first career as an NFL player with the Green Bay Packers and how it taught him to be comfortable with external pressures and delayed gratification. He recounts the knee injury that led to an early retirement from the field, as well as interactions with radiologists, surgeons, and rehabilitation specialists that got him thinking about entering the field of medicine. He ended up pursuing a diagnostic residency at Baylor University, and then an additional interventional pain fellowship at the University of California at Irvine. Throughout his training, he recognizes that there is great synergistic benefit when specialists team up to provide multidisciplinary care and teach each other different skills. For example, he refined his physical exam skills by working with a PM&R physician, and he also taught other physicians how to read imaging. Dr. Michels believes that the most gratifying part of his career is the opportunity to diagnose, treat, and follow up with patients. In his Dallas-based independent OBL, he splits his time between clinic and procedural days. He enjoys seeing the impact that his interventions have on patients, and he is committed to providing alternatives to opioid use. Dr. Michels encourages more radiologists to explore the field of interventional pain, which is now recognized as a radiology subspecialty by the American Board of Radiology. Overall, when imaging is combined with physical examination and history-taking, the patient will enjoy the benefits of better diagnosis and care. --- RESOURCES Dr. John Michel’s Website: https://www.johnmichelsmd.com/ Interventional Spine & Pain: http://www.spinedallas.com/ ABR Pain Medicine Subspecialty: https://www.theabr.org/radiation-oncology/subspecialties/pain-medicine UC Irvine Pain Fellowship: https://anesthesiology.uci.edu/education-fellowships-pain-medicine.shtml Jacob Fleming interviews interventional pain specialist and former Super Bowl champion John S. Michels about his journey into the subspecialty, pathways for getting involved in interventional pain management, and his philosophy on comprehensive patient care.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/1DSmJG


---


SHOW NOTES


In this episode, host Dr. Jacob Fleming interviews interventional pain specialist and former Super Bowl champion Dr. John Michels about his journey into the subspecialty, pathways for getting involved in interventional pain management, and his philosophy on comprehensive patient care.


Dr. Michels describes his first career as an NFL player with the Green Bay Packers and how it taught him to be comfortable with external pressures and delayed gratification. He recounts the knee injury that led to an early retirement from the field, as well as interactions with radiologists, surgeons, and rehabilitation specialists that got him thinking about entering the field of medicine. He ended up pursuing a diagnostic residency at Baylor University, and then an additional interventional pain fellowship at the University of California at Irvine.


Throughout his training, he recognizes that there is great synergistic benefit when specialists team up to provide multidisciplinary care and teach each other different skills. For example, he refined his physical exam skills by working with a PM&R physician, and he also taught other physicians how to read imaging.


Dr. Michels believes that the most gratifying part of his career is the opportunity to diagnose, treat, and follow up with patients. In his Dallas-based independent OBL, he splits his time between clinic and procedural days. He enjoys seeing the impact that his interventions have on patients, and he is committed to providing alternatives to opioid use. Dr. Michels encourages more radiologists to explore the field of interventional pain, which is now recognized as a radiology subspecialty by the American Board of Radiology. Overall, when imaging is combined with physical examination and history-taking, the patient will enjoy the benefits of better diagnosis and care.


---


RESOURCES


Dr. John Michel’s Website:

https://www.johnmichelsmd.com/


Interventional Spine & Pain:

http://www.spinedallas.com/


ABR Pain Medicine Subspecialty:

https://www.theabr.org/radiation-oncology/subspecialties/pain-medicine


UC Irvine Pain Fellowship:

https://anesthesiology.uci.edu/education-fellowships-pain-medicine.shtml

]]> 3604 Ep. 214 Building a GAE Practice in the OBL with Dr. David Wood Dr. David Wood, interventional radiologist and chief medical officer of Advantage IR, tells us about his experiences with geniculate artery embolization (GAE) practice building in the office-based lab (OBL). --- CHECK OUT OUR SPONSOR Athletic Greens https://www.athleticgreens.com/backtablevi --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oIF49Q --- SHOW NOTES In this episode, host Dr. Michael Barraza interviews Dr. David Wood, interventional radiologist and chief medical officer of Advantage IR, about building office based labs (OBLs), the untapped potential of the geniculate artery embolization (GAE) market, and how to build patient referrals for new OBLs. We begin by discussing why Dr. Wood chose to do geniculate artery embolization (GAE) in his OBLs. He says that GAE makes a great procedure for an office setting because it is relatively easy, only requiring a C arm with digital subtraction angiography (DSA). It is also a quick procedure with little side effects and low rates of complications. He says that patients who get GAE are a unique patient population because they know they have arthritis, and have exhausted conservative measures or declined treatment options that they have been offered, which are often quite invasive. Dr. Wood says his GAE patients are mostly self-referred. He has marketing liaisons for local clinics, but what he has found most effective is TV commercials in English and Spanish, because this reaches the populations that need the most help. His patient population for GAEs consists mostly of self referred patients, as well as referrals from PCPs and occasionally orthopedic or sports medicine providers. Regarding how Dr. Wood evaluates which patients to treat, he says that he began by using the point of maximal tenderness as described by Sandeep Bagla and required MRI before patient selection. He now uses primarily X-ray and only treats pain rated at least 5 out of 10. He does not do GAE in patients who have had knee surgery or with a history of significant PAD or calcification seen on preoperative X-ray. He generally tells patients they can expect up to a 70% improvement of pain after geniculate artery embolization. --- RESOURCES BackTable Ep. 27: Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson https://www.backtable.com/shows/vi/podcasts/27/geniculate-artery-embolization-for-osteoarthritis BackTable Ep. 85: Genicular Artery Embolization for OA with Dr. Jafar Golzarian https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa Bagla GAE Publication: https://pubmed.ncbi.nlm.nih.gov/31837946/ Padia GAE Publication: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542160/ Mon, 06 Jun 2022 05:00:00 -0000 full BackTable Dr. David Wood, interventional radiologist and chief medical officer of Advantage IR, tells us about his experiences with geniculate artery embolization (GAE) practice building in the office-based lab (OBL). Dr. David Wood, interventional radiologist and chief medical officer of Advantage IR, tells us about his experiences with geniculate artery embolization (GAE) practice building in the office-based lab (OBL). --- CHECK OUT OUR SPONSOR Athletic Greens https://www.athleticgreens.com/backtablevi --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oIF49Q --- SHOW NOTES In this episode, host Dr. Michael Barraza interviews Dr. David Wood, interventional radiologist and chief medical officer of Advantage IR, about building office based labs (OBLs), the untapped potential of the geniculate artery embolization (GAE) market, and how to build patient referrals for new OBLs. We begin by discussing why Dr. Wood chose to do geniculate artery embolization (GAE) in his OBLs. He says that GAE makes a great procedure for an office setting because it is relatively easy, only requiring a C arm with digital subtraction angiography (DSA). It is also a quick procedure with little side effects and low rates of complications. He says that patients who get GAE are a unique patient population because they know they have arthritis, and have exhausted conservative measures or declined treatment options that they have been offered, which are often quite invasive. Dr. Wood says his GAE patients are mostly self-referred. He has marketing liaisons for local clinics, but what he has found most effective is TV commercials in English and Spanish, because this reaches the populations that need the most help. His patient population for GAEs consists mostly of self referred patients, as well as referrals from PCPs and occasionally orthopedic or sports medicine providers. Regarding how Dr. Wood evaluates which patients to treat, he says that he began by using the point of maximal tenderness as described by Sandeep Bagla and required MRI before patient selection. He now uses primarily X-ray and only treats pain rated at least 5 out of 10. He does not do GAE in patients who have had knee surgery or with a history of significant PAD or calcification seen on preoperative X-ray. He generally tells patients they can expect up to a 70% improvement of pain after geniculate artery embolization. --- RESOURCES BackTable Ep. 27: Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson https://www.backtable.com/shows/vi/podcasts/27/geniculate-artery-embolization-for-osteoarthritis BackTable Ep. 85: Genicular Artery Embolization for OA with Dr. Jafar Golzarian https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa Bagla GAE Publication: https://pubmed.ncbi.nlm.nih.gov/31837946/ Padia GAE Publication: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542160/ Dr. David Wood, interventional radiologist and chief medical officer of Advantage IR, tells us about his experiences with geniculate artery embolization (GAE) practice building in the office-based lab (OBL).


---


CHECK OUT OUR SPONSOR


Athletic Greens

https://www.athleticgreens.com/backtablevi


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oIF49Q


---


SHOW NOTES


In this episode, host Dr. Michael Barraza interviews Dr. David Wood, interventional radiologist and chief medical officer of Advantage IR, about building office based labs (OBLs), the untapped potential of the geniculate artery embolization (GAE) market, and how to build patient referrals for new OBLs.


We begin by discussing why Dr. Wood chose to do geniculate artery embolization (GAE) in his OBLs. He says that GAE makes a great procedure for an office setting because it is relatively easy, only requiring a C arm with digital subtraction angiography (DSA). It is also a quick procedure with little side effects and low rates of complications. He says that patients who get GAE are a unique patient population because they know they have arthritis, and have exhausted conservative measures or declined treatment options that they have been offered, which are often quite invasive.


Dr. Wood says his GAE patients are mostly self-referred. He has marketing liaisons for local clinics, but what he has found most effective is TV commercials in English and Spanish, because this reaches the populations that need the most help. His patient population for GAEs consists mostly of self referred patients, as well as referrals from PCPs and occasionally orthopedic or sports medicine providers.


Regarding how Dr. Wood evaluates which patients to treat, he says that he began by using the point of maximal tenderness as described by Sandeep Bagla and required MRI before patient selection. He now uses primarily X-ray and only treats pain rated at least 5 out of 10. He does not do GAE in patients who have had knee surgery or with a history of significant PAD or calcification seen on preoperative X-ray. He generally tells patients they can expect up to a 70% improvement of pain after geniculate artery embolization.


---


RESOURCES


BackTable Ep. 27: Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson

https://www.backtable.com/shows/vi/podcasts/27/geniculate-artery-embolization-for-osteoarthritis


BackTable Ep. 85: Genicular Artery Embolization for OA with Dr. Jafar Golzarian

https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa


Bagla GAE Publication:

https://pubmed.ncbi.nlm.nih.gov/31837946/


Padia GAE Publication:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542160/

]]> 4111 Ep. 213 Building an OBL Within an IR/DR Group with Dr. Don Garbett and Dr. Nicholas Petruzzi Dr. Aparna Baheti talks with Nicholas Petruzzi and Donald Garbett about their experiences in building an office-based lab (OBL) within their existing IR/DR practices. Learn how they campaigned and collaborated to get their colleagues on board, and the unique challenges of building and operating an OBL. --- CHECK OUT OUR SPONSOR Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 --- SHOW NOTES In this episode, host Dr. Ally Baheti interviews interventional radiologists Dr. Nick Petruzzi and Dr. Don Garbett about their own experiences with pitching and building an office-based lab (OBL) within their existing practices. First, each doctor describes how they arrived at the idea of an OBL. For Dr. Garbett, the main motivation was a drive to follow up with patients. On the other hand, Dr. Petruzzi was frustrated by the lack of adequate equipment and bureaucratic steps that his hospital required him to follow to request more equipment. Next, we shift to a discussion about how each of them got their practice partners to philosophically and financially buy into the OBL idea. Both doctors wrote and presented pro formas to delineate the net benefits. Additionally, Dr. Petruzzi proved that an OBL would be profitable by doing a few cases with trial periods for different C-arms. Dr. Garbett worked with his practice’s revenue cycle manager and accountant to verify his financial projections. Both emphasize the importance of group culture and the value of colleagues who are open-minded to expansion. Finally, we talk about unforeseen obstacles that have risen on their OBL journeys so far. Dr. Petruzzi describes his conversations with hospital systems, in which he had to advocate for IRs to be listed as referring doctors. Dr. Garbett cites concerns about billing and coding, which can be very complex for a third-party group to handle. We end with updates from each guest about the current status of their OBL and their next steps. --- RESOURCES Vascular Institute of Atlantic Medical Imaging: https://www.vi-ami.com/ Radiology Associates: https://www.rapc.com/ Fri, 03 Jun 2022 05:00:00 -0000 full BackTable Dr. Aparna Baheti talks with Nicholas Petruzzi and Donald Garbett about their experiences in building an office-based lab (OBL) within their existing IR/DR practices. Learn how they campaigned and collaborated to get their colleagues on board, and the unique challenges of building and operating an OBL. Dr. Aparna Baheti talks with Nicholas Petruzzi and Donald Garbett about their experiences in building an office-based lab (OBL) within their existing IR/DR practices. Learn how they campaigned and collaborated to get their colleagues on board, and the unique challenges of building and operating an OBL. --- CHECK OUT OUR SPONSOR Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 --- SHOW NOTES In this episode, host Dr. Ally Baheti interviews interventional radiologists Dr. Nick Petruzzi and Dr. Don Garbett about their own experiences with pitching and building an office-based lab (OBL) within their existing practices. First, each doctor describes how they arrived at the idea of an OBL. For Dr. Garbett, the main motivation was a drive to follow up with patients. On the other hand, Dr. Petruzzi was frustrated by the lack of adequate equipment and bureaucratic steps that his hospital required him to follow to request more equipment. Next, we shift to a discussion about how each of them got their practice partners to philosophically and financially buy into the OBL idea. Both doctors wrote and presented pro formas to delineate the net benefits. Additionally, Dr. Petruzzi proved that an OBL would be profitable by doing a few cases with trial periods for different C-arms. Dr. Garbett worked with his practice’s revenue cycle manager and accountant to verify his financial projections. Both emphasize the importance of group culture and the value of colleagues who are open-minded to expansion. Finally, we talk about unforeseen obstacles that have risen on their OBL journeys so far. Dr. Petruzzi describes his conversations with hospital systems, in which he had to advocate for IRs to be listed as referring doctors. Dr. Garbett cites concerns about billing and coding, which can be very complex for a third-party group to handle. We end with updates from each guest about the current status of their OBL and their next steps. --- RESOURCES Vascular Institute of Atlantic Medical Imaging: https://www.vi-ami.com/ Radiology Associates: https://www.rapc.com/ Dr. Aparna Baheti talks with Nicholas Petruzzi and Donald Garbett about their experiences in building an office-based lab (OBL) within their existing IR/DR practices. Learn how they campaigned and collaborated to get their colleagues on board, and the unique challenges of building and operating an OBL.


---


CHECK OUT OUR SPONSOR


Boston Scientific Nextlab

https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040


---


SHOW NOTES


In this episode, host Dr. Ally Baheti interviews interventional radiologists Dr. Nick Petruzzi and Dr. Don Garbett about their own experiences with pitching and building an office-based lab (OBL) within their existing practices.


First, each doctor describes how they arrived at the idea of an OBL. For Dr. Garbett, the main motivation was a drive to follow up with patients. On the other hand, Dr. Petruzzi was frustrated by the lack of adequate equipment and bureaucratic steps that his hospital required him to follow to request more equipment.


Next, we shift to a discussion about how each of them got their practice partners to philosophically and financially buy into the OBL idea. Both doctors wrote and presented pro formas to delineate the net benefits. Additionally, Dr. Petruzzi proved that an OBL would be profitable by doing a few cases with trial periods for different C-arms. Dr. Garbett worked with his practice’s revenue cycle manager and accountant to verify his financial projections. Both emphasize the importance of group culture and the value of colleagues who are open-minded to expansion.


Finally, we talk about unforeseen obstacles that have risen on their OBL journeys so far. Dr. Petruzzi describes his conversations with hospital systems, in which he had to advocate for IRs to be listed as referring doctors. Dr. Garbett cites concerns about billing and coding, which can be very complex for a third-party group to handle. We end with updates from each guest about the current status of their OBL and their next steps.


---


RESOURCES


Vascular Institute of Atlantic Medical Imaging:

https://www.vi-ami.com/


Radiology Associates:

https://www.rapc.com/

]]> 3100 Ep. 212 New Tools to Treat Severe Distal Femoropopliteal Disease with Dr. John Rundback In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators. --- CHECK OUT OUR SPONSOR Veryan BioMimics 3D® Vascular Stent System https://www.veryanmed.com/usa/products/biomimics-3d-vascular-stent-system/ --- SHOW NOTES In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators. We begin by discussing peripheral arterial disease (PAD) pathophysiology, specifically in the challenging areas around the adductor canal (Hunter’s canal). Dr. Rundback describes how the femoral artery has twists and turns around this area and that it can experience compressive forces up to 15-20% during motions such as flexion of the knee. Due to this being the most dynamic location of the femoral artery, this is often where plaque rupture will happen, resulting in critical limb ischemia (CLI) and requiring urgent intervention. The two discuss how traditional rigid stents do not work well in this area due to the dynamic nature of the region and the fact that the artery is tortuous and can cause rigid stents to fracture or cause intimal hyperplasia due to turbulent flow. Drug coated balloon (DCB) angioplasty generally does not work for this region due to poor durability. They discuss the utility of the Tack device, a scaffold with minimal metal which is better suited for focal dissections. Dr. Rundback emphasizes the importance of intravascular ultrasound (IVUS) during all distal femoropopliteal cases due to the complexity of the region and patient-to-patient variation. He uses IVUS to choose which device and what size to use because measuring on angiography is not accurate in these cases. Finally, they discuss the Supera and BioMimics stents, including the indications, benefits, and ease of deployment of each. Dr. Rundback says that Supera, a woven nitinol stent, gives it the benefit of thermal memory. The difficulty with this stent is the need for aggressive vessel preparation and plaque modification, generally requiring lengthy angioplasty and possibly atherectomy. The BioMimics stent can rotate, curve, and shorten, which is optimal for this region to maintain swirling or helical blood flow rather than causing turbulent flow. The BioMimics stent is also very easy to deploy, and Dr. Rundback generally chooses this stent in locations where he can’t adequately prep the vessel. --- RESOURCES BioMimics 3D stent: https://www.veryanmed.com/international/products/biomimics-3d-vascular-stent-system/ Supera™ Stent: https://www.cardiovascular.abbott/int/en/hcp/products/peripheral-intervention/supera-stent-system/overview.html Tack device: https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device Mon, 30 May 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators. In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators. --- CHECK OUT OUR SPONSOR Veryan BioMimics 3D® Vascular Stent System https://www.veryanmed.com/usa/products/biomimics-3d-vascular-stent-system/ --- SHOW NOTES In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators. We begin by discussing peripheral arterial disease (PAD) pathophysiology, specifically in the challenging areas around the adductor canal (Hunter’s canal). Dr. Rundback describes how the femoral artery has twists and turns around this area and that it can experience compressive forces up to 15-20% during motions such as flexion of the knee. Due to this being the most dynamic location of the femoral artery, this is often where plaque rupture will happen, resulting in critical limb ischemia (CLI) and requiring urgent intervention. The two discuss how traditional rigid stents do not work well in this area due to the dynamic nature of the region and the fact that the artery is tortuous and can cause rigid stents to fracture or cause intimal hyperplasia due to turbulent flow. Drug coated balloon (DCB) angioplasty generally does not work for this region due to poor durability. They discuss the utility of the Tack device, a scaffold with minimal metal which is better suited for focal dissections. Dr. Rundback emphasizes the importance of intravascular ultrasound (IVUS) during all distal femoropopliteal cases due to the complexity of the region and patient-to-patient variation. He uses IVUS to choose which device and what size to use because measuring on angiography is not accurate in these cases. Finally, they discuss the Supera and BioMimics stents, including the indications, benefits, and ease of deployment of each. Dr. Rundback says that Supera, a woven nitinol stent, gives it the benefit of thermal memory. The difficulty with this stent is the need for aggressive vessel preparation and plaque modification, generally requiring lengthy angioplasty and possibly atherectomy. The BioMimics stent can rotate, curve, and shorten, which is optimal for this region to maintain swirling or helical blood flow rather than causing turbulent flow. The BioMimics stent is also very easy to deploy, and Dr. Rundback generally chooses this stent in locations where he can’t adequately prep the vessel. --- RESOURCES BioMimics 3D stent: https://www.veryanmed.com/international/products/biomimics-3d-vascular-stent-system/ Supera™ Stent: https://www.cardiovascular.abbott/int/en/hcp/products/peripheral-intervention/supera-stent-system/overview.html Tack device: https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators.


---


CHECK OUT OUR SPONSOR


Veryan BioMimics 3D® Vascular Stent System

https://www.veryanmed.com/usa/products/biomimics-3d-vascular-stent-system/


---


SHOW NOTES


In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators.


We begin by discussing peripheral arterial disease (PAD) pathophysiology, specifically in the challenging areas around the adductor canal (Hunter’s canal). Dr. Rundback describes how the femoral artery has twists and turns around this area and that it can experience compressive forces up to 15-20% during motions such as flexion of the knee. Due to this being the most dynamic location of the femoral artery, this is often where plaque rupture will happen, resulting in critical limb ischemia (CLI) and requiring urgent intervention.


The two discuss how traditional rigid stents do not work well in this area due to the dynamic nature of the region and the fact that the artery is tortuous and can cause rigid stents to fracture or cause intimal hyperplasia due to turbulent flow. Drug coated balloon (DCB) angioplasty generally does not work for this region due to poor durability. They discuss the utility of the Tack device, a scaffold with minimal metal which is better suited for focal dissections. Dr. Rundback emphasizes the importance of intravascular ultrasound (IVUS) during all distal femoropopliteal cases due to the complexity of the region and patient-to-patient variation. He uses IVUS to choose which device and what size to use because measuring on angiography is not accurate in these cases.


Finally, they discuss the Supera and BioMimics stents, including the indications, benefits, and ease of deployment of each. Dr. Rundback says that Supera, a woven nitinol stent, gives it the benefit of thermal memory. The difficulty with this stent is the need for aggressive vessel preparation and plaque modification, generally requiring lengthy angioplasty and possibly atherectomy. The BioMimics stent can rotate, curve, and shorten, which is optimal for this region to maintain swirling or helical blood flow rather than causing turbulent flow. The BioMimics stent is also very easy to deploy, and Dr. Rundback generally chooses this stent in locations where he can’t adequately prep the vessel.


---


RESOURCES


BioMimics 3D stent:

https://www.veryanmed.com/international/products/biomimics-3d-vascular-stent-system/


Supera™ Stent:

https://www.cardiovascular.abbott/int/en/hcp/products/peripheral-intervention/supera-stent-system/overview.html


Tack device:

https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device

]]> 2192 Ep. 211 Extraspinal Augmentation and the Future of Vertebral Augmentation with Dr. Doug Beall In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about extravertebral augmentation, new technology in interventional spine, and intrathecal drug pumps. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XssSys --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about extravertebral augmentation, new technology in interventional spine, and intrathecal drug pumps. This is the final installment of our 4-part BackTable VI series on osteoporosis treatment. We begin by discussing insufficiency fractures outside of the vertebral body. Dr. Beall discusses how he has treated insufficiency fractures of the pelvis, sacrum, acetabulum, tibia, and calcaneus. He prefers to use a combination of rebar screws and cement, and he enjoys finding innovative solutions for patients without good options for pain relief. He discusses how he recently used this technique for an SI joint fusion. Next, we discuss two exciting innovations that will propel the field of interventional spine forward in the coming years. First, they discuss disc augmentation with hydrogels such as PVA (polyvinyl alcohol), PEG (polyethylene glycol), and PVP (polyvinyl povidone) which can be used to augment the annulus and nucleus without any requirement for ablation or regeneration. Secondly, Dr. Beall discusses the possibilities of interspinous process devices such as the Minuteman® fusion device. He hopes that technology is moving from spacers (the current method) to anterior column support. He believes that this is possible via Kambin’s Triangle (the space between the exiting nerve root, superior articular process, and transverse process). Finally, we discuss Dr. Beall’s newest book, ‘Intrathecal Pump Drug Delivery’. He attributes the small number of IRs doing this procedure to a lack of familiarity and a “how-to guide”. For this reason, he published his book, which includes types of medications used in intrathecal pumps, medication concentrations, trialing doses, and how the pump is used. He welcomes all IRs interested in learning how to incorporate intrathecal pumps into their practice to reach out to him and follow him on social media to keep up to date on training courses and webinars about this topic. --- RESOURCES Dr. Douglas Beall LinkedIn: https://www.linkedin.com/in/douglas-beall-604ba68 Dr. Douglas Beall Twitter: @DougBeall Minuteman® interspinous-interlaminar fusion device: https://spinalsimplicity.com/minuteman/ Douglas Beall Books: Intrathecal Pump Drug Delivery Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation Thu, 26 May 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about extravertebral augmentation, new technology in interventional spine, and intrathecal drug pumps. In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about extravertebral augmentation, new technology in interventional spine, and intrathecal drug pumps. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XssSys --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about extravertebral augmentation, new technology in interventional spine, and intrathecal drug pumps. This is the final installment of our 4-part BackTable VI series on osteoporosis treatment. We begin by discussing insufficiency fractures outside of the vertebral body. Dr. Beall discusses how he has treated insufficiency fractures of the pelvis, sacrum, acetabulum, tibia, and calcaneus. He prefers to use a combination of rebar screws and cement, and he enjoys finding innovative solutions for patients without good options for pain relief. He discusses how he recently used this technique for an SI joint fusion. Next, we discuss two exciting innovations that will propel the field of interventional spine forward in the coming years. First, they discuss disc augmentation with hydrogels such as PVA (polyvinyl alcohol), PEG (polyethylene glycol), and PVP (polyvinyl povidone) which can be used to augment the annulus and nucleus without any requirement for ablation or regeneration. Secondly, Dr. Beall discusses the possibilities of interspinous process devices such as the Minuteman® fusion device. He hopes that technology is moving from spacers (the current method) to anterior column support. He believes that this is possible via Kambin’s Triangle (the space between the exiting nerve root, superior articular process, and transverse process). Finally, we discuss Dr. Beall’s newest book, ‘Intrathecal Pump Drug Delivery’. He attributes the small number of IRs doing this procedure to a lack of familiarity and a “how-to guide”. For this reason, he published his book, which includes types of medications used in intrathecal pumps, medication concentrations, trialing doses, and how the pump is used. He welcomes all IRs interested in learning how to incorporate intrathecal pumps into their practice to reach out to him and follow him on social media to keep up to date on training courses and webinars about this topic. --- RESOURCES Dr. Douglas Beall LinkedIn: https://www.linkedin.com/in/douglas-beall-604ba68 Dr. Douglas Beall Twitter: @DougBeall Minuteman® interspinous-interlaminar fusion device: https://spinalsimplicity.com/minuteman/ Douglas Beall Books: Intrathecal Pump Drug Delivery Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about extravertebral augmentation, new technology in interventional spine, and intrathecal drug pumps.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XssSys


---


SHOW NOTES


In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about extravertebral augmentation, new technology in interventional spine, and intrathecal drug pumps. This is the final installment of our 4-part BackTable VI series on osteoporosis treatment.


We begin by discussing insufficiency fractures outside of the vertebral body. Dr. Beall discusses how he has treated insufficiency fractures of the pelvis, sacrum, acetabulum, tibia, and calcaneus. He prefers to use a combination of rebar screws and cement, and he enjoys finding innovative solutions for patients without good options for pain relief. He discusses how he recently used this technique for an SI joint fusion.


Next, we discuss two exciting innovations that will propel the field of interventional spine forward in the coming years. First, they discuss disc augmentation with hydrogels such as PVA (polyvinyl alcohol), PEG (polyethylene glycol), and PVP (polyvinyl povidone) which can be used to augment the annulus and nucleus without any requirement for ablation or regeneration. Secondly, Dr. Beall discusses the possibilities of interspinous process devices such as the Minuteman® fusion device. He hopes that technology is moving from spacers (the current method) to anterior column support. He believes that this is possible via Kambin’s Triangle (the space between the exiting nerve root, superior articular process, and transverse process).


Finally, we discuss Dr. Beall’s newest book, ‘Intrathecal Pump Drug Delivery’. He attributes the small number of IRs doing this procedure to a lack of familiarity and a “how-to guide”. For this reason, he published his book, which includes types of medications used in intrathecal pumps, medication concentrations, trialing doses, and how the pump is used. He welcomes all IRs interested in learning how to incorporate intrathecal pumps into their practice to reach out to him and follow him on social media to keep up to date on training courses and webinars about this topic.


---


RESOURCES


Dr. Douglas Beall LinkedIn:

https://www.linkedin.com/in/douglas-beall-604ba68


Dr. Douglas Beall Twitter: @DougBeall


Minuteman® interspinous-interlaminar fusion device:

https://spinalsimplicity.com/minuteman/


Douglas Beall Books:

Intrathecal Pump Drug Delivery

Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation

]]> 3143 Ep. 210 Modern Vertebral Augmentation with Dr. Doug Beall In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PdIxV5 --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes. This is the third installment of our 4-part BackTable VI series on osteoporosis treatment. Dr. Beall begins by discussing the newest technique in the treatment of vertebral compression fractures, screw-assisted vertebral augmentation, with emphasis on how it can decrease the excessive vertebral motion induced by a fracture. He uses the three-column approach (anterior, middle, and posterior column) using SpineJack in the front and pedicle screws in the back. They also discuss vertebral body stents and shaped balloons, two emerging technologies that will be available soon. Next, they discuss complications in kyphoplasty and vertebral body augmentation. Dr. Beall shares how to recognize various types of cement extravasation. Importantly, if the cement starts to form a lenticular shape, stop injecting because continued injection will cause the cement to enter the spinal canal. The lenticular, biconvex shape that occurs with this pattern is due to the anterior epidural ligaments and midline anterior epidural ligament. He says to let the cement harden in the anterior epidural space once you reach the basivertebral plexus, and then continue injecting. Extravasation, to some degree, is normal, and recognizing where it is going is the key to avoiding complications. We end by discussing how to improve outcomes. Dr. Beall says that injecting more cement is the best way to produce better outcomes. Lastly, he adds that filling the cleft is the best way to achieve the greatest degree of pain reduction, which ultimately is what indicates a successful outcome. --- RESOURCES Dr. Douglas Beall Twitter: @DougBeall BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall: https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Cianfoni publication on Stent-Screw-Assisted Internal Fixation (SAIF): https://jnis.bmj.com/content/11/6/603 Venmans publication on Pulmonary Emboli during Vertebroplasty: www.ajnr.org/content/29/10/1983 Wed, 25 May 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes. In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PdIxV5 --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes. This is the third installment of our 4-part BackTable VI series on osteoporosis treatment. Dr. Beall begins by discussing the newest technique in the treatment of vertebral compression fractures, screw-assisted vertebral augmentation, with emphasis on how it can decrease the excessive vertebral motion induced by a fracture. He uses the three-column approach (anterior, middle, and posterior column) using SpineJack in the front and pedicle screws in the back. They also discuss vertebral body stents and shaped balloons, two emerging technologies that will be available soon. Next, they discuss complications in kyphoplasty and vertebral body augmentation. Dr. Beall shares how to recognize various types of cement extravasation. Importantly, if the cement starts to form a lenticular shape, stop injecting because continued injection will cause the cement to enter the spinal canal. The lenticular, biconvex shape that occurs with this pattern is due to the anterior epidural ligaments and midline anterior epidural ligament. He says to let the cement harden in the anterior epidural space once you reach the basivertebral plexus, and then continue injecting. Extravasation, to some degree, is normal, and recognizing where it is going is the key to avoiding complications. We end by discussing how to improve outcomes. Dr. Beall says that injecting more cement is the best way to produce better outcomes. Lastly, he adds that filling the cleft is the best way to achieve the greatest degree of pain reduction, which ultimately is what indicates a successful outcome. --- RESOURCES Dr. Douglas Beall Twitter: @DougBeall BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall: https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Cianfoni publication on Stent-Screw-Assisted Internal Fixation (SAIF): https://jnis.bmj.com/content/11/6/603 Venmans publication on Pulmonary Emboli during Vertebroplasty: www.ajnr.org/content/29/10/1983 In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PdIxV5


---


SHOW NOTES


In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes. This is the third installment of our 4-part BackTable VI series on osteoporosis treatment.


Dr. Beall begins by discussing the newest technique in the treatment of vertebral compression fractures, screw-assisted vertebral augmentation, with emphasis on how it can decrease the excessive vertebral motion induced by a fracture. He uses the three-column approach (anterior, middle, and posterior column) using SpineJack in the front and pedicle screws in the back. They also discuss vertebral body stents and shaped balloons, two emerging technologies that will be available soon.


Next, they discuss complications in kyphoplasty and vertebral body augmentation. Dr. Beall shares how to recognize various types of cement extravasation. Importantly, if the cement starts to form a lenticular shape, stop injecting because continued injection will cause the cement to enter the spinal canal. The lenticular, biconvex shape that occurs with this pattern is due to the anterior epidural ligaments and midline anterior epidural ligament. He says to let the cement harden in the anterior epidural space once you reach the basivertebral plexus, and then continue injecting. Extravasation, to some degree, is normal, and recognizing where it is going is the key to avoiding complications.


We end by discussing how to improve outcomes. Dr. Beall says that injecting more cement is the best way to produce better outcomes. Lastly, he adds that filling the cleft is the best way to achieve the greatest degree of pain reduction, which ultimately is what indicates a successful outcome.


---


RESOURCES


Dr. Douglas Beall Twitter:

@DougBeall


BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall:

https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions


Cianfoni publication on Stent-Screw-Assisted Internal Fixation (SAIF):

https://jnis.bmj.com/content/11/6/603


Venmans publication on Pulmonary Emboli during Vertebroplasty:

www.ajnr.org/content/29/10/1983

]]> 2128 Ep. 209 Primer on Medical Treatment of Osteoporosis and Non-surgical Management with Dr. Doug Beall In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about current osteoporosis diagnosis criteria, his treatment algorithm, and recent data showing efficacy of osteoanabolic agents and vertebroplasty. --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oQMiwe --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about current osteoporosis diagnosis criteria, his treatment algorithm, and recent data showing efficacy of osteoanabolic agents and vertebroplasty. This is the second installment of our 4-part BackTable VI series on osteoporosis treatment. As we continue our conversation from Ep. 208, Dr. Beall outlines his typical follow up protocol for his patients. This includes DEXA scans in the first and second years, prescriptions for antiresorptive and/or osteoanabolic agents, and possible Romosozumab injections. Dr. Beall emphasizes that thoroughness is key to treating the disease process, and each encounter is a reimbursable event that can benefit both the patient and the practice. Next, we shift to talking about the American Association of Clinical Endocrinologists (AACE) diagnostic criteria for osteoporosis. Dr. Beall highlights the fact that there are 4 categories that encompass information about DEXA (T-scores), FRAX scores, and fragility fractures. Sole reliance on DEXA score cutoffs can lead to under-diagnosis and increased mortality risk for patients. Notably, any past fragility fracture in a postmenopausal woman is sufficient for an osteoporosis diagnosis. Dr. Beall shares that 82% of patients with fragility fractures do not have T-scores in the osteoporotic range. On the other hand, there are confounding factors that can give a falsely elevated T-score. As we shift to discussing medications for osteoporosis, Dr. Beall emphasizes the need to consider the order in which they are prescribed. He advocates for initially using osteo anabolics (specifically a PTH analog) for 2 years to build up bone mineral density, and then maintaining that density with antiresorptives afterwards. He notes that with the risk of bisphosphonate side effects like osteonecrosis of the jaw and atypical femur fracture, it is unwise to prescribe these antiresorptives as an initial treatment. Finally, we begin the conversation about vertebroplasty and recent trials proving its efficacy in reducing pain and improving function for patients. Tune in to our next 2 installments to learn about Dr. Beall’s clinical pearls for vertebral augmentation! --- RESOURCES Dr. Douglas Beall Twitter: @DougBeall BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall: https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Comparison of thoracolumbosacral orthosis and no orthosis for the treatment of thoracolumbar burst fractures: interim analysis of a multicenter randomized clinical equivalence trial (2009): https://pubmed.ncbi.nlm.nih.gov/19769510/ Comparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace: a prospective randomized controlled non-inferiority trial (2014): https://pubmed.ncbi.nlm.nih.gov/25471910/ The efficacy of conservative treatment of osteoporotic compression fractures on acute pain relief: a systematic review with meta-analysis (2015): https://pubmed.ncbi.nlm.nih.gov/25725810/ Clinical effect of balloon kyphoplasty in elderly patients with multiple osteoporotic vertebral fracture (2019): https://pubmed.ncbi.nlm.nih.gov/30837413/ Tue, 24 May 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about current osteoporosis diagnosis criteria, his treatment algorithm, and recent data showing efficacy of osteoanabolic agents and vertebroplasty. In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about current osteoporosis diagnosis criteria, his treatment algorithm, and recent data showing efficacy of osteoanabolic agents and vertebroplasty. --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oQMiwe --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about current osteoporosis diagnosis criteria, his treatment algorithm, and recent data showing efficacy of osteoanabolic agents and vertebroplasty. This is the second installment of our 4-part BackTable VI series on osteoporosis treatment. As we continue our conversation from Ep. 208, Dr. Beall outlines his typical follow up protocol for his patients. This includes DEXA scans in the first and second years, prescriptions for antiresorptive and/or osteoanabolic agents, and possible Romosozumab injections. Dr. Beall emphasizes that thoroughness is key to treating the disease process, and each encounter is a reimbursable event that can benefit both the patient and the practice. Next, we shift to talking about the American Association of Clinical Endocrinologists (AACE) diagnostic criteria for osteoporosis. Dr. Beall highlights the fact that there are 4 categories that encompass information about DEXA (T-scores), FRAX scores, and fragility fractures. Sole reliance on DEXA score cutoffs can lead to under-diagnosis and increased mortality risk for patients. Notably, any past fragility fracture in a postmenopausal woman is sufficient for an osteoporosis diagnosis. Dr. Beall shares that 82% of patients with fragility fractures do not have T-scores in the osteoporotic range. On the other hand, there are confounding factors that can give a falsely elevated T-score. As we shift to discussing medications for osteoporosis, Dr. Beall emphasizes the need to consider the order in which they are prescribed. He advocates for initially using osteo anabolics (specifically a PTH analog) for 2 years to build up bone mineral density, and then maintaining that density with antiresorptives afterwards. He notes that with the risk of bisphosphonate side effects like osteonecrosis of the jaw and atypical femur fracture, it is unwise to prescribe these antiresorptives as an initial treatment. Finally, we begin the conversation about vertebroplasty and recent trials proving its efficacy in reducing pain and improving function for patients. Tune in to our next 2 installments to learn about Dr. Beall’s clinical pearls for vertebral augmentation! --- RESOURCES Dr. Douglas Beall Twitter: @DougBeall BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall: https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Comparison of thoracolumbosacral orthosis and no orthosis for the treatment of thoracolumbar burst fractures: interim analysis of a multicenter randomized clinical equivalence trial (2009): https://pubmed.ncbi.nlm.nih.gov/19769510/ Comparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace: a prospective randomized controlled non-inferiority trial (2014): https://pubmed.ncbi.nlm.nih.gov/25471910/ The efficacy of conservative treatment of osteoporotic compression fractures on acute pain relief: a systematic review with meta-analysis (2015): https://pubmed.ncbi.nlm.nih.gov/25725810/ Clinical effect of balloon kyphoplasty in elderly patients with multiple osteoporotic vertebral fracture (2019): https://pubmed.ncbi.nlm.nih.gov/30837413/ In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about current osteoporosis diagnosis criteria, his treatment algorithm, and recent data showing efficacy of osteoanabolic agents and vertebroplasty.


---


CHECK OUT OUR SPONSOR


DI4MDs

Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/oQMiwe


---


SHOW NOTES


In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about current osteoporosis diagnosis criteria, his treatment algorithm, and recent data showing efficacy of osteoanabolic agents and vertebroplasty. This is the second installment of our 4-part BackTable VI series on osteoporosis treatment.

As we continue our conversation from Ep. 208, Dr. Beall outlines his typical follow up protocol for his patients. This includes DEXA scans in the first and second years, prescriptions for antiresorptive and/or osteoanabolic agents, and possible Romosozumab injections. Dr. Beall emphasizes that thoroughness is key to treating the disease process, and each encounter is a reimbursable event that can benefit both the patient and the practice.


Next, we shift to talking about the American Association of Clinical Endocrinologists (AACE) diagnostic criteria for osteoporosis. Dr. Beall highlights the fact that there are 4 categories that encompass information about DEXA (T-scores), FRAX scores, and fragility fractures. Sole reliance on DEXA score cutoffs can lead to under-diagnosis and increased mortality risk for patients. Notably, any past fragility fracture in a postmenopausal woman is sufficient for an osteoporosis diagnosis. Dr. Beall shares that 82% of patients with fragility fractures do not have T-scores in the osteoporotic range. On the other hand, there are confounding factors that can give a falsely elevated T-score.


As we shift to discussing medications for osteoporosis, Dr. Beall emphasizes the need to consider the order in which they are prescribed. He advocates for initially using osteo anabolics (specifically a PTH analog) for 2 years to build up bone mineral density, and then maintaining that density with antiresorptives afterwards. He notes that with the risk of bisphosphonate side effects like osteonecrosis of the jaw and atypical femur fracture, it is unwise to prescribe these antiresorptives as an initial treatment.


Finally, we begin the conversation about vertebroplasty and recent trials proving its efficacy in reducing pain and improving function for patients. Tune in to our next 2 installments to learn about Dr. Beall’s clinical pearls for vertebral augmentation!


---


RESOURCES


Dr. Douglas Beall Twitter:

@DougBeall


BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall:

https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions


Comparison of thoracolumbosacral orthosis and no orthosis for the treatment of thoracolumbar burst fractures: interim analysis of a multicenter randomized clinical equivalence trial (2009):

https://pubmed.ncbi.nlm.nih.gov/19769510/


Comparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace: a prospective randomized controlled non-inferiority trial (2014):

https://pubmed.ncbi.nlm.nih.gov/25471910/


The efficacy of conservative treatment of osteoporotic compression fractures on acute pain relief: a systematic review with meta-analysis (2015):

https://pubmed.ncbi.nlm.nih.gov/25725810/


Clinical effect of balloon kyphoplasty in elderly patients with multiple osteoporotic vertebral fracture (2019):

https://pubmed.ncbi.nlm.nih.gov/30837413/

]]> 2795 Ep. 208 Why We Need to Be Treating Osteoporosis for Our Compression Fracture Patients with Dr. Doug Beall In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/xVGPFx --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. This is the first installment of our 4-part BackTable VI series on osteoporosis treatment. Dr. Beall starts by stating his mission: he not only performs vertebral augmentation; he also offers DXA scans and T-score analysis, prescribes osteoanabolic agents, and follows up with patients over time. Dr. Beall cites data showing that both vertebral augmentation and osteoporosis medications can improve patients’ quality of life and significantly reduce mortality. Even with newer osteoanabolic agents like Teriparatide, Abaloparatide, and Romosozumab being approved for treatment, osteoporosis screening rates have dropped in recent years. This is a pressing concern, since osteoporosis is a growing societal burden, given the increasing population of elderly patients. Furthermore, treatment of osteoporosis allows patients to regain mobility, which reduces comorbidities. We finish this episode by discussing how IRs have the potential to learn about osteoanabolic medications, counsel patients, and take ownership of this disease process. --- RESOURCES Dr. Douglas Beall Twitter: @DougBeall BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall: https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Number Needed to Treat with Vertebral Augmentation to Save a Life: http://www.ajnr.org/content/early/2019/12/19/ajnr.A6367 Risk of Mortality Following Clinical Fractures: https://pubmed.ncbi.nlm.nih.gov/11069188/ Prospective and Multicenter Evaluation of Outcomes for Quality of Life and Activities of Daily Living for Balloon Kyphoplasty in the Treatment of Vertebral Compression Fractures: The EVOLVE Trial: https://journals.lww.com/neurosurgery/Fulltext/2019/01000/Prospective_and_Multicenter_Evaluation_of_Outcomes.20.aspx Mon, 23 May 2022 05:00:00 -0000 full BackTable In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/xVGPFx --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. This is the first installment of our 4-part BackTable VI series on osteoporosis treatment. Dr. Beall starts by stating his mission: he not only performs vertebral augmentation; he also offers DXA scans and T-score analysis, prescribes osteoanabolic agents, and follows up with patients over time. Dr. Beall cites data showing that both vertebral augmentation and osteoporosis medications can improve patients’ quality of life and significantly reduce mortality. Even with newer osteoanabolic agents like Teriparatide, Abaloparatide, and Romosozumab being approved for treatment, osteoporosis screening rates have dropped in recent years. This is a pressing concern, since osteoporosis is a growing societal burden, given the increasing population of elderly patients. Furthermore, treatment of osteoporosis allows patients to regain mobility, which reduces comorbidities. We finish this episode by discussing how IRs have the potential to learn about osteoanabolic medications, counsel patients, and take ownership of this disease process. --- RESOURCES Dr. Douglas Beall Twitter: @DougBeall BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall: https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Number Needed to Treat with Vertebral Augmentation to Save a Life: http://www.ajnr.org/content/early/2019/12/19/ajnr.A6367 Risk of Mortality Following Clinical Fractures: https://pubmed.ncbi.nlm.nih.gov/11069188/ Prospective and Multicenter Evaluation of Outcomes for Quality of Life and Activities of Daily Living for Balloon Kyphoplasty in the Treatment of Vertebral Compression Fractures: The EVOLVE Trial: https://journals.lww.com/neurosurgery/Fulltext/2019/01000/Prospective_and_Multicenter_Evaluation_of_Outcomes.20.aspx In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease.


---


CHECK OUT OUR SPONSOR


Laurel Road for Doctors

https://www.laurelroad.com/healthcare-banking/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/xVGPFx


---


SHOW NOTES


In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. This is the first installment of our 4-part BackTable VI series on osteoporosis treatment.


Dr. Beall starts by stating his mission: he not only performs vertebral augmentation; he also offers DXA scans and T-score analysis, prescribes osteoanabolic agents, and follows up with patients over time. Dr. Beall cites data showing that both vertebral augmentation and osteoporosis medications can improve patients’ quality of life and significantly reduce mortality.


Even with newer osteoanabolic agents like Teriparatide, Abaloparatide, and Romosozumab being approved for treatment, osteoporosis screening rates have dropped in recent years. This is a pressing concern, since osteoporosis is a growing societal burden, given the increasing population of elderly patients. Furthermore, treatment of osteoporosis allows patients to regain mobility, which reduces comorbidities. We finish this episode by discussing how IRs have the potential to learn about osteoanabolic medications, counsel patients, and take ownership of this disease process.


---


RESOURCES


Dr. Douglas Beall Twitter:

@DougBeall


BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall:

https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions


Number Needed to Treat with Vertebral Augmentation to Save a Life:

http://www.ajnr.org/content/early/2019/12/19/ajnr.A6367

Risk of Mortality Following Clinical Fractures:

https://pubmed.ncbi.nlm.nih.gov/11069188/


Prospective and Multicenter Evaluation of Outcomes for Quality of Life and Activities of Daily Living for Balloon Kyphoplasty in the Treatment of Vertebral Compression Fractures: The EVOLVE Trial:

https://journals.lww.com/neurosurgery/Fulltext/2019/01000/Prospective_and_Multicenter_Evaluation_of_Outcomes.20.aspx

]]> 1952 Edición Esp: Transplante de Higado: Nuestro Rol como Radiólogos Intervencionistas con Dr. Pilar Bayona y Dr. Alejandro Mejia En este episodio de BackTable, Dra. Gina Landinez habla con el Dr. Alejandro Mejia, cirujano trasplante de Methodist Dallas, y la Dra. Pilar Bayona, radiologista intervencionista de UT Southwestern, sobre la colaboración entre los cirujanos trasplantes y los radiólogos intervencionistas durante los trasplantes de hígados. Hablan sobre el papel de los radiólogos intervencionistas durante los periodos críticos de trasplante: el preoperatorio, el perioperatorio, y el postoperatorio. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/rkKX8a --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ Fri, 20 May 2022 05:00:00 -0000 full BackTable Dra. Gina Landinez habla con el Dr. Alejandro Mejia, cirujano trasplante de Methodist Dallas, y la Dra. Pilar Bayona, radiologista intervencionista de UT Southwestern, sobre la colaboración entre los cirujanos trasplantes y los radiólogos intervencionistas durante los trasplantes de hígados. Hablan sobre el papel de los radiólogos intervencionistas durante los periodos críticos de trasplante: el preoperatorio, el perioperatorio, y el postoperatorio. En este episodio de BackTable, Dra. Gina Landinez habla con el Dr. Alejandro Mejia, cirujano trasplante de Methodist Dallas, y la Dra. Pilar Bayona, radiologista intervencionista de UT Southwestern, sobre la colaboración entre los cirujanos trasplantes y los radiólogos intervencionistas durante los trasplantes de hígados. Hablan sobre el papel de los radiólogos intervencionistas durante los periodos críticos de trasplante: el preoperatorio, el perioperatorio, y el postoperatorio. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/rkKX8a --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ En este episodio de BackTable, Dra. Gina Landinez habla con el Dr. Alejandro Mejia, cirujano trasplante de Methodist Dallas, y la Dra. Pilar Bayona, radiologista intervencionista de UT Southwestern, sobre la colaboración entre los cirujanos trasplantes y los radiólogos intervencionistas durante los trasplantes de hígados. Hablan sobre el papel de los radiólogos intervencionistas durante los periodos críticos de trasplante: el preoperatorio, el perioperatorio, y el postoperatorio.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/rkKX8a


---


CHECK OUT OUR SPONSOR


Laurel Road for Doctors

https://www.laurelroad.com/healthcare-banking/

]]> 2936 Ep. 207 The Man Behind the Sheath: How Dr. Gary Ansel went from almost TV repairman to Endovascular Innovator We talk with interventional cardiologist Dr. Gary Ansel about his career in medical device innovation, including the development of the Ansel Guiding Sheath and the Pounce Thrombectomy System (which was recently acquired by Surmodics, Inc.). --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/3y4ysO --- SHOW NOTES In this episode, our host Dr. Bryan Hartley interviews interventional cardiologist Dr. Gary Ansel about his career in medical device innovation, including the development of the Ansel Guiding Sheath and the Pounce Thrombectomy System (which was recently acquired by Surmodics). Dr. Ansel describes his early career and how he identified a clinical need within the realm of renal stenting. His collaboration with Cook Medical evolved into a guiding sheath that has now become widely popular. Dr. Ansel stresses the importance of ensuring that a device has a value proposition for all stakeholders– patients, doctors, hospitals, and payers. The added cost of a new device must provide overall benefits to the procedure. Next, we discuss Dr. Ansel’s development of a percutaneous thrombectomy system over the course of twelve years, multiple patent applications, and various obstacles. Throughout this process, Dr. Ansel highlights the benefits of having the expertise of a knowledgeable business team. He also tells new entrepreneurs to focus on de-risking their ideas with patents and early sales, in order to make their offerings more attractive to potential investors and acquirers. --- RESOURCES Ansel Guiding Sheath: https://www.cookmedical.com/products/dfdfc483-b37b-49f2-8a78-937bf16ae831/ Pounce Thrombectomy System: https://pouncesystem.com/ Mon, 16 May 2022 05:00:00 -0000 full BackTable In this episode, our host Dr. Bryan Hartley interviews interventional cardiologist Dr. Gary Ansel about his career in medical device innovation, including the development of the Ansel Guiding Sheath and the Pounce Thrombectomy System (which was recently acquired by Surmodics). We talk with interventional cardiologist Dr. Gary Ansel about his career in medical device innovation, including the development of the Ansel Guiding Sheath and the Pounce Thrombectomy System (which was recently acquired by Surmodics, Inc.). --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/3y4ysO --- SHOW NOTES In this episode, our host Dr. Bryan Hartley interviews interventional cardiologist Dr. Gary Ansel about his career in medical device innovation, including the development of the Ansel Guiding Sheath and the Pounce Thrombectomy System (which was recently acquired by Surmodics). Dr. Ansel describes his early career and how he identified a clinical need within the realm of renal stenting. His collaboration with Cook Medical evolved into a guiding sheath that has now become widely popular. Dr. Ansel stresses the importance of ensuring that a device has a value proposition for all stakeholders– patients, doctors, hospitals, and payers. The added cost of a new device must provide overall benefits to the procedure. Next, we discuss Dr. Ansel’s development of a percutaneous thrombectomy system over the course of twelve years, multiple patent applications, and various obstacles. Throughout this process, Dr. Ansel highlights the benefits of having the expertise of a knowledgeable business team. He also tells new entrepreneurs to focus on de-risking their ideas with patents and early sales, in order to make their offerings more attractive to potential investors and acquirers. --- RESOURCES Ansel Guiding Sheath: https://www.cookmedical.com/products/dfdfc483-b37b-49f2-8a78-937bf16ae831/ Pounce Thrombectomy System: https://pouncesystem.com/ We talk with interventional cardiologist Dr. Gary Ansel about his career in medical device innovation, including the development of the Ansel Guiding Sheath and the Pounce Thrombectomy System (which was recently acquired by Surmodics, Inc.).


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/3y4ysO


---


SHOW NOTES


In this episode, our host Dr. Bryan Hartley interviews interventional cardiologist Dr. Gary Ansel about his career in medical device innovation, including the development of the Ansel Guiding Sheath and the Pounce Thrombectomy System (which was recently acquired by Surmodics).


Dr. Ansel describes his early career and how he identified a clinical need within the realm of renal stenting. His collaboration with Cook Medical evolved into a guiding sheath that has now become widely popular. Dr. Ansel stresses the importance of ensuring that a device has a value proposition for all stakeholders– patients, doctors, hospitals, and payers. The added cost of a new device must provide overall benefits to the procedure.


Next, we discuss Dr. Ansel’s development of a percutaneous thrombectomy system over the course of twelve years, multiple patent applications, and various obstacles. Throughout this process, Dr. Ansel highlights the benefits of having the expertise of a knowledgeable business team. He also tells new entrepreneurs to focus on de-risking their ideas with patents and early sales, in order to make their offerings more attractive to potential investors and acquirers.


---


RESOURCES


Ansel Guiding Sheath:

https://www.cookmedical.com/products/dfdfc483-b37b-49f2-8a78-937bf16ae831/


Pounce Thrombectomy System:

https://pouncesystem.com/

]]> 3379 Optimizing LGBTQ+ Care with Shane Snowdon As part of our Health Equity Series Dr. Vishal Kumar talks with Shane Snowdon about current challenges in healthcare for LGTBQ+ patients, how we can improve communication, reduce fear and misunderstanding, and be a true patient advocate, starting with our own education. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/moP2eJ --- SHOW NOTES In this episode, guest host Dr. Vishal Kumar and educator/advocate Shane Snowdon discuss unique barriers to care for LGBTQ+ individuals, as well as strategies for healthcare providers can create nonjudgemental environments for this community. Shane starts by outlining the history of LGBTQ+ healthcare in the United States, noting that it first came to public attention in the midst of the HIV/AIDS epidemic of the 1980s. In the 2020s, the major concerns for LGBTQ+ health access have been centered around gender-affirming care for youths and adults. Shane emphasizes that the process of coming out to healthcare providers empowers LGTBQ+ individuals to “claim an identity that they had been taught to dispense and conceal.” The concern is that when they become known as LGBTQ+, will the provider and system treat them and their families with the respect and care with which they treat people who do not identify as LGBTQ+? Shane says that discrimination in healthcare makes it more likely for patients to delay their screenings and follow up appointments, leading to less engagement in care and worse medical outcomes. Next, we shift to discuss specific patient-provider communication techniques. Shane addresses the fact that there will be moments when providers make the mistake of misgendering patients. Shane advises providers to acknowledge the mistake in the moment, apologize, and affirm the patient’s self identity. This well-meaning approach can help build trust and give the provider an opportunity to specify the patient’s preferred identifiers in the electronic health record. Furthermore, we discuss the unique role of the radiologist in providing LGBTQ+ care, as it is often radiologists who learn that someone is transgender, through imaging. Radiologists can reach out to the patient in a sensitive and respectful way and notify their colleagues of the need for clarification in the electronic medical record. Finally, we discuss healthcare systems and the need for foundational policies, integrated education about LGBTQ+ patients across all healthcare topics, and adequate resources for LGBTQ+ staff and patients. Shane highlights the Healthcare Equality Index, a specific tool that healthcare systems can use to self-assess their level of health equity and learn additional strategies to make their care more LGBTQ+-friendly. --- RESOURCES Healthcare Equality Index: https://www.hrc.org/resources/healthcare-equality-index Transgender Patients: What Radiologists Need to Know: https://pubmed.ncbi.nlm.nih.gov/29629811/ Physicians as Political Pawns– The Texas Directive on Gender-Affirming Care and Other Moves: https://www.nejm.org/doi/full/10.1056/NEJMp2203746 Affordable Care Act, Section 1557: https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html The Trevor Project: https://www.thetrevorproject.org/ Gender Spectrum: https://genderspectrum.org/ The Joint Commission’s LGBTQ+ Field Guide: https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/health-equity/lgbtfieldguide_web_linked_verpdf.pdf?db=web&hash=FD725DC02CFE6E4F21A35EBD839BBE97&hash=FD725DC02CFE6E4F21A35EBD839BBE97 Transgender and Gender Diverse Health Care: The Fenway Guide: https://www.amazon.com/Transgender-Gender-Diverse-Health-Care-ebook/dp/B09648R5HG Fri, 13 May 2022 05:00:00 -0000 full BackTable As part of our Health Equity Series Dr. Vishal Kumar talks with Shane Snowdon about current challenges in healthcare for LGTBQ+ patients, how we can improve communication, reduce fear and misunderstanding, and be a true patient advocate, starting with our own education. As part of our Health Equity Series Dr. Vishal Kumar talks with Shane Snowdon about current challenges in healthcare for LGTBQ+ patients, how we can improve communication, reduce fear and misunderstanding, and be a true patient advocate, starting with our own education. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/moP2eJ --- SHOW NOTES In this episode, guest host Dr. Vishal Kumar and educator/advocate Shane Snowdon discuss unique barriers to care for LGBTQ+ individuals, as well as strategies for healthcare providers can create nonjudgemental environments for this community. Shane starts by outlining the history of LGBTQ+ healthcare in the United States, noting that it first came to public attention in the midst of the HIV/AIDS epidemic of the 1980s. In the 2020s, the major concerns for LGBTQ+ health access have been centered around gender-affirming care for youths and adults. Shane emphasizes that the process of coming out to healthcare providers empowers LGTBQ+ individuals to “claim an identity that they had been taught to dispense and conceal.” The concern is that when they become known as LGBTQ+, will the provider and system treat them and their families with the respect and care with which they treat people who do not identify as LGBTQ+? Shane says that discrimination in healthcare makes it more likely for patients to delay their screenings and follow up appointments, leading to less engagement in care and worse medical outcomes. Next, we shift to discuss specific patient-provider communication techniques. Shane addresses the fact that there will be moments when providers make the mistake of misgendering patients. Shane advises providers to acknowledge the mistake in the moment, apologize, and affirm the patient’s self identity. This well-meaning approach can help build trust and give the provider an opportunity to specify the patient’s preferred identifiers in the electronic health record. Furthermore, we discuss the unique role of the radiologist in providing LGBTQ+ care, as it is often radiologists who learn that someone is transgender, through imaging. Radiologists can reach out to the patient in a sensitive and respectful way and notify their colleagues of the need for clarification in the electronic medical record. Finally, we discuss healthcare systems and the need for foundational policies, integrated education about LGBTQ+ patients across all healthcare topics, and adequate resources for LGBTQ+ staff and patients. Shane highlights the Healthcare Equality Index, a specific tool that healthcare systems can use to self-assess their level of health equity and learn additional strategies to make their care more LGBTQ+-friendly. --- RESOURCES Healthcare Equality Index: https://www.hrc.org/resources/healthcare-equality-index Transgender Patients: What Radiologists Need to Know: https://pubmed.ncbi.nlm.nih.gov/29629811/ Physicians as Political Pawns– The Texas Directive on Gender-Affirming Care and Other Moves: https://www.nejm.org/doi/full/10.1056/NEJMp2203746 Affordable Care Act, Section 1557: https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html The Trevor Project: https://www.thetrevorproject.org/ Gender Spectrum: https://genderspectrum.org/ The Joint Commission’s LGBTQ+ Field Guide: https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/health-equity/lgbtfieldguide_web_linked_verpdf.pdf?db=web&hash=FD725DC02CFE6E4F21A35EBD839BBE97&hash=FD725DC02CFE6E4F21A35EBD839BBE97 Transgender and Gender Diverse Health Care: The Fenway Guide: https://www.amazon.com/Transgender-Gender-Diverse-Health-Care-ebook/dp/B09648R5HG As part of our Health Equity Series Dr. Vishal Kumar talks with Shane Snowdon about current challenges in healthcare for LGTBQ+ patients, how we can improve communication, reduce fear and misunderstanding, and be a true patient advocate, starting with our own education.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/moP2eJ


---


SHOW NOTES


In this episode, guest host Dr. Vishal Kumar and educator/advocate Shane Snowdon discuss unique barriers to care for LGBTQ+ individuals, as well as strategies for healthcare providers can create nonjudgemental environments for this community.


Shane starts by outlining the history of LGBTQ+ healthcare in the United States, noting that it first came to public attention in the midst of the HIV/AIDS epidemic of the 1980s. In the 2020s, the major concerns for LGBTQ+ health access have been centered around gender-affirming care for youths and adults. Shane emphasizes that the process of coming out to healthcare providers empowers LGTBQ+ individuals to “claim an identity that they had been taught to dispense and conceal.” The concern is that when they become known as LGBTQ+, will the provider and system treat them and their families with the respect and care with which they treat people who do not identify as LGBTQ+? Shane says that discrimination in healthcare makes it more likely for patients to delay their screenings and follow up appointments, leading to less engagement in care and worse medical outcomes.


Next, we shift to discuss specific patient-provider communication techniques. Shane addresses the fact that there will be moments when providers make the mistake of misgendering patients. Shane advises providers to acknowledge the mistake in the moment, apologize, and affirm the patient’s self identity. This well-meaning approach can help build trust and give the provider an opportunity to specify the patient’s preferred identifiers in the electronic health record. Furthermore, we discuss the unique role of the radiologist in providing LGBTQ+ care, as it is often radiologists who learn that someone is transgender, through imaging. Radiologists can reach out to the patient in a sensitive and respectful way and notify their colleagues of the need for clarification in the electronic medical record.


Finally, we discuss healthcare systems and the need for foundational policies, integrated education about LGBTQ+ patients across all healthcare topics, and adequate resources for LGBTQ+ staff and patients. Shane highlights the Healthcare Equality Index, a specific tool that healthcare systems can use to self-assess their level of health equity and learn additional strategies to make their care more LGBTQ+-friendly.


---


RESOURCES


Healthcare Equality Index:

https://www.hrc.org/resources/healthcare-equality-index


Transgender Patients: What Radiologists Need to Know:

https://pubmed.ncbi.nlm.nih.gov/29629811/


Physicians as Political Pawns– The Texas Directive on Gender-Affirming Care and Other Moves:

https://www.nejm.org/doi/full/10.1056/NEJMp2203746


Affordable Care Act, Section 1557:

https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html


The Trevor Project:

https://www.thetrevorproject.org/


Gender Spectrum:

https://genderspectrum.org/


The Joint Commission’s LGBTQ+ Field Guide:

https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/health-equity/lgbtfieldguide_web_linked_verpdf.pdf?db=web&hash=FD725DC02CFE6E4F21A35EBD839BBE97&hash=FD725DC02CFE6E4F21A35EBD839BBE97


Transgender and Gender Diverse Health Care: The Fenway Guide:

https://www.amazon.com/Transgender-Gender-Diverse-Health-Care-ebook/dp/B09648R5HG

]]> 3266 Ep. 206 Improving Workflow Efficiency: Starting with Paracentesis with Dr. Karen Brown Dr. Karen Brown explains how she improved paracentesis workflow by creating a service that has shortened procedure time, decreased hospital length of stay, and improved patient and referring provider satisfaction. --- CHECK OUT OUR SPONSOR GI Supply RenovaRP Paracentesis Pump https://www.gi-supply.com/products/paracentesis-management/renovarp-pump/ --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews Dr. Karen Brown, Section Chief for Interventional Radiology at the University of Utah about how she improved workflow by creating a paracentesis service that has shortened procedure time, decreased hospital length of stay, and improved patient and referring provider satisfaction. Dr. Brown begins by reviewing the standard workflow for performing paracentesis before implementing her new program. She says paracentesis used to be done in a procedure room, and would often take quite long, delaying other procedures that were a better use of the room. Though a simple procedure, paracentesis can take quite some time to fully drain the ascites. Dr. Brown and colleagues conducted a trial that compared standard wall suction to the Renova pump. Patients preferred Renova due to less capturing of bowel and adjusting of the catheter. They found that by using the Renova pump, they could cut the procedure time down by almost half. She says that hiring an advanced practice provider (APP) that was designated to paracentesis was key to improving the efficiency of the daily IR workflow. The other advantage to Renova is its portability. She says that this helped her get paracenteses out of procedure rooms because the APP can now do paracenteses anywhere, even at the bedside for an inpatient. We end by discussing recommendations for IRs who are interested in improving efficiency in their practices. Dr. Brown says that the key is to make the case to administrators or purchasers that procedure room time is money. By speeding up the process for paracentesis, she has also been able to increase the number of paracenteses they do per year and decrease hospital length of stay for patients who are waiting for a paracentesis before discharge, which has saved both time and money. --- RESOURCES Dr. Brown’s publication in Diagnosic and Interventional Radiology: https://www.dirjournal.org/en/paracentesis-faster-and-easier-using-the-renovarp-pump-132424 RenovaRP® Paracentesis Pump: https://www.gi-supply.com/products/paracentesis-management/renovarp-pump/ Mon, 09 May 2022 05:00:00 -0000 full BackTable Dr. Karen Brown explains how she improved paracentesis workflow by creating a service that has shortened procedure time, decreased hospital length of stay, and improved patient and referring provider satisfaction. Dr. Karen Brown explains how she improved paracentesis workflow by creating a service that has shortened procedure time, decreased hospital length of stay, and improved patient and referring provider satisfaction. --- CHECK OUT OUR SPONSOR GI Supply RenovaRP Paracentesis Pump https://www.gi-supply.com/products/paracentesis-management/renovarp-pump/ --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews Dr. Karen Brown, Section Chief for Interventional Radiology at the University of Utah about how she improved workflow by creating a paracentesis service that has shortened procedure time, decreased hospital length of stay, and improved patient and referring provider satisfaction. Dr. Brown begins by reviewing the standard workflow for performing paracentesis before implementing her new program. She says paracentesis used to be done in a procedure room, and would often take quite long, delaying other procedures that were a better use of the room. Though a simple procedure, paracentesis can take quite some time to fully drain the ascites. Dr. Brown and colleagues conducted a trial that compared standard wall suction to the Renova pump. Patients preferred Renova due to less capturing of bowel and adjusting of the catheter. They found that by using the Renova pump, they could cut the procedure time down by almost half. She says that hiring an advanced practice provider (APP) that was designated to paracentesis was key to improving the efficiency of the daily IR workflow. The other advantage to Renova is its portability. She says that this helped her get paracenteses out of procedure rooms because the APP can now do paracenteses anywhere, even at the bedside for an inpatient. We end by discussing recommendations for IRs who are interested in improving efficiency in their practices. Dr. Brown says that the key is to make the case to administrators or purchasers that procedure room time is money. By speeding up the process for paracentesis, she has also been able to increase the number of paracenteses they do per year and decrease hospital length of stay for patients who are waiting for a paracentesis before discharge, which has saved both time and money. --- RESOURCES Dr. Brown’s publication in Diagnosic and Interventional Radiology: https://www.dirjournal.org/en/paracentesis-faster-and-easier-using-the-renovarp-pump-132424 RenovaRP® Paracentesis Pump: https://www.gi-supply.com/products/paracentesis-management/renovarp-pump/ Dr. Karen Brown explains how she improved paracentesis workflow by creating a service that has shortened procedure time, decreased hospital length of stay, and improved patient and referring provider satisfaction.


---


CHECK OUT OUR SPONSOR


GI Supply RenovaRP Paracentesis Pump

https://www.gi-supply.com/products/paracentesis-management/renovarp-pump/


---


SHOW NOTES


In this episode, host Dr. Aaron Fritts interviews Dr. Karen Brown, Section Chief for Interventional Radiology at the University of Utah about how she improved workflow by creating a paracentesis service that has shortened procedure time, decreased hospital length of stay, and improved patient and referring provider satisfaction.


Dr. Brown begins by reviewing the standard workflow for performing paracentesis before implementing her new program. She says paracentesis used to be done in a procedure room, and would often take quite long, delaying other procedures that were a better use of the room. Though a simple procedure, paracentesis can take quite some time to fully drain the ascites.


Dr. Brown and colleagues conducted a trial that compared standard wall suction to the Renova pump. Patients preferred Renova due to less capturing of bowel and adjusting of the catheter. They found that by using the Renova pump, they could cut the procedure time down by almost half. She says that hiring an advanced practice provider (APP) that was designated to paracentesis was key to improving the efficiency of the daily IR workflow. The other advantage to Renova is its portability. She says that this helped her get paracenteses out of procedure rooms because the APP can now do paracenteses anywhere, even at the bedside for an inpatient.


We end by discussing recommendations for IRs who are interested in improving efficiency in their practices. Dr. Brown says that the key is to make the case to administrators or purchasers that procedure room time is money. By speeding up the process for paracentesis, she has also been able to increase the number of paracenteses they do per year and decrease hospital length of stay for patients who are waiting for a paracentesis before discharge, which has saved both time and money.


---


RESOURCES


Dr. Brown’s publication in Diagnosic and Interventional Radiology:

https://www.dirjournal.org/en/paracentesis-faster-and-easier-using-the-renovarp-pump-132424


RenovaRP® Paracentesis Pump:

https://www.gi-supply.com/products/paracentesis-management/renovarp-pump/

]]> 1830 Ep. 205 Update on Reimbursement Cuts for the OBL/ASC with Dr. Jim Melton and Dr. Blake Parsons In this episode Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons give us the lay of the land on recent reimbursement cuts in the OBL/ASC space, including peripheral artery disease treatments and embolization procedures, as well as projections of what to expect in the next few years. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Blake Parsons and vascular surgeon Dr. Jim Melton about navigating recent Medicaid reimbursement cuts in their hybrid Office Based Lab (OBL) and Ambulatory Surgery Center (ASC), CardioVascular Health Clinic. This episode largely follows a question and answer format, where our guests respond to previously-submitted audience questions. The guests start by outlining recent vascular surgery and interventional radiology reimbursement cuts from 2022, as well as sharing information on future cuts through 2026. Most cuts are PAD-focused, but they also include pain management procedures like kyphoplasty. Dr. Parsons advises IRs to think about diversifying their practices to encompass procedures outside of PAD. He summarizes the average profits generated in various types of IR cases. He also predicts that there will be more reimbursement cuts on embolization cases, as prostate and geniculate embolizations become more popular. To protect profit margins by means of cost reduction, the doctors negotiate with vendor pricing and try to leverage disposables against capital. Dr. Melton describes the current political landscape and physician advocacy efforts. While industry has started to position themselves to help advocate for OBLs and ASCs, Dr. Melton believes that industry and physicians should be more politically active. He encourages physicians to get involved with their medical societies and reach out to local representatives and senators in order to highlight the benefits of patient care in an OBL/ASC setting– faster recovery, lower risk of infection, and overall lower cost for the healthcare system. --- RESOURCES CardioVascular Health Clinic: https://cvhealthclinic.com/ SIRPAC: https://www.sirweb.org/advocacy/sirpac/ OEIS: https://oeisociety.com/ Fri, 06 May 2022 05:00:00 -0000 full BackTable In this episode Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons give us the lay of the land on recent reimbursement cuts in the OBL/ASC space, including peripheral artery disease treatments and embolization procedures, as well as projections of what to expect in the next few years. In this episode Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons give us the lay of the land on recent reimbursement cuts in the OBL/ASC space, including peripheral artery disease treatments and embolization procedures, as well as projections of what to expect in the next few years. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Blake Parsons and vascular surgeon Dr. Jim Melton about navigating recent Medicaid reimbursement cuts in their hybrid Office Based Lab (OBL) and Ambulatory Surgery Center (ASC), CardioVascular Health Clinic. This episode largely follows a question and answer format, where our guests respond to previously-submitted audience questions. The guests start by outlining recent vascular surgery and interventional radiology reimbursement cuts from 2022, as well as sharing information on future cuts through 2026. Most cuts are PAD-focused, but they also include pain management procedures like kyphoplasty. Dr. Parsons advises IRs to think about diversifying their practices to encompass procedures outside of PAD. He summarizes the average profits generated in various types of IR cases. He also predicts that there will be more reimbursement cuts on embolization cases, as prostate and geniculate embolizations become more popular. To protect profit margins by means of cost reduction, the doctors negotiate with vendor pricing and try to leverage disposables against capital. Dr. Melton describes the current political landscape and physician advocacy efforts. While industry has started to position themselves to help advocate for OBLs and ASCs, Dr. Melton believes that industry and physicians should be more politically active. He encourages physicians to get involved with their medical societies and reach out to local representatives and senators in order to highlight the benefits of patient care in an OBL/ASC setting– faster recovery, lower risk of infection, and overall lower cost for the healthcare system. --- RESOURCES CardioVascular Health Clinic: https://cvhealthclinic.com/ SIRPAC: https://www.sirweb.org/advocacy/sirpac/ OEIS: https://oeisociety.com/ In this episode Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons give us the lay of the land on recent reimbursement cuts in the OBL/ASC space, including peripheral artery disease treatments and embolization procedures, as well as projections of what to expect in the next few years.


---


CHECK OUT OUR SPONSOR


Boston Scientific Eluvia Drug-Eluting Stent

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043


---


SHOW NOTES


In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Blake Parsons and vascular surgeon Dr. Jim Melton about navigating recent Medicaid reimbursement cuts in their hybrid Office Based Lab (OBL) and Ambulatory Surgery Center (ASC), CardioVascular Health Clinic. This episode largely follows a question and answer format, where our guests respond to previously-submitted audience questions.


The guests start by outlining recent vascular surgery and interventional radiology reimbursement cuts from 2022, as well as sharing information on future cuts through 2026. Most cuts are PAD-focused, but they also include pain management procedures like kyphoplasty. Dr. Parsons advises IRs to think about diversifying their practices to encompass procedures outside of PAD. He summarizes the average profits generated in various types of IR cases. He also predicts that there will be more reimbursement cuts on embolization cases, as prostate and geniculate embolizations become more popular. To protect profit margins by means of cost reduction, the doctors negotiate with vendor pricing and try to leverage disposables against capital.


Dr. Melton describes the current political landscape and physician advocacy efforts. While industry has started to position themselves to help advocate for OBLs and ASCs, Dr. Melton believes that industry and physicians should be more politically active. He encourages physicians to get involved with their medical societies and reach out to local representatives and senators in order to highlight the benefits of patient care in an OBL/ASC setting– faster recovery, lower risk of infection, and overall lower cost for the healthcare system.


---


RESOURCES


CardioVascular Health Clinic:

https://cvhealthclinic.com/


SIRPAC:

https://www.sirweb.org/advocacy/sirpac/


OEIS:

https://oeisociety.com/

]]> 2248 Ep. 204 Filter Indications and Filter Tracking...Up Your Game with Dr. Stephen Wang We talk with interventional radiologist Dr. Stephen Wang about building an IVC filter retrieval program, the current guidelines on filter placement, and how to minimize the complications of filters. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/nBihBQ --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- SHOW NOTES In this episode, host Dr. Christopher Beck interviews interventional radiologist Dr. Stephen Wang. They discuss building an IVC filter retrieval program, the current guidelines on filter placement, and the long-term risks of IVC filters. We start by discussing the joint consensus published in JVIR in 2020, a collaboration between vascular, cardiology, and IR societies. Dr. Wang notes that the main indication for placement of an IVC filter is an acute deep venous thrombosis (DVT) or pulmonary embolism (PE) in someone with a contraindication to anticoagulation. He says that they often collaborate with hematology to provide the best patient care, and they have even collaborated with hematology to set up a filter clinic. Next, they touch on the long-term risks of IVC filters. They discuss the PREPIC-1 and PREPIC-2 studies which were studies looking at mortality and risk reduction in patients with IVC filters. These studies demonstrated a low level of evidence that IVC filters being placed were actually working. Even more compelling, the risk of putting in filters often outweighs the benefit. Dr. Wang says that for a filter that is in for longer than five years, there is a 13% risk of partial or complete inferior vena cava (IVC) thrombosis. Additionally, at five years, 70% of filters perforated outside of the IVC and were touching or perforating a retroperitoneal structure. Finally, they discuss the filter retrieval program that Dr. Wang built at Kaiser. Important aspects of the process were educating primary care doctors, coordinating with critical care and hematology, and involving the anticoagulation clinic. He says he created a current procedural terminology (CPT) code-based list and hired a physician extender as filter lead to monitor and update the list. He was able to get his EPIC team on board by creating a safety net based on a procedural code. Ultimately, he raised the IVC filter retrieval rate from 38% in Northern California to 54% after his grand rounds and up to 80% after integrating his program into EPIC which allowed a provider to click a single button that would notify the patient that they were due to come in for their IVC filter retrieval. --- RESOURCES SIR Clinical Practice Guidelines for IVC Filters: https://www.jvir.org/article/S1051-0443(20)30531-5/fulltext PREPIC-1: https://www.nejm.org/doi/full/10.1056/NEJM199802123380701 PREPIC-2: https://jamanetwork.com/journals/jama/fullarticle/2279714 Dr. Wang’s paper: Long-term complications of inferior vena cava filters: https://www.jvsvenous.org/article/S2213-333X(16)30148-2/fulltext Mon, 02 May 2022 05:00:00 -0000 full BackTable We talk with interventional radiologist Dr. Stephen Wang about building an IVC filter retrieval program, the current guidelines on filter placement, and how to minimize the complications of filters. We talk with interventional radiologist Dr. Stephen Wang about building an IVC filter retrieval program, the current guidelines on filter placement, and how to minimize the complications of filters. The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/nBihBQ --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- SHOW NOTES In this episode, host Dr. Christopher Beck interviews interventional radiologist Dr. Stephen Wang. They discuss building an IVC filter retrieval program, the current guidelines on filter placement, and the long-term risks of IVC filters. We start by discussing the joint consensus published in JVIR in 2020, a collaboration between vascular, cardiology, and IR societies. Dr. Wang notes that the main indication for placement of an IVC filter is an acute deep venous thrombosis (DVT) or pulmonary embolism (PE) in someone with a contraindication to anticoagulation. He says that they often collaborate with hematology to provide the best patient care, and they have even collaborated with hematology to set up a filter clinic. Next, they touch on the long-term risks of IVC filters. They discuss the PREPIC-1 and PREPIC-2 studies which were studies looking at mortality and risk reduction in patients with IVC filters. These studies demonstrated a low level of evidence that IVC filters being placed were actually working. Even more compelling, the risk of putting in filters often outweighs the benefit. Dr. Wang says that for a filter that is in for longer than five years, there is a 13% risk of partial or complete inferior vena cava (IVC) thrombosis. Additionally, at five years, 70% of filters perforated outside of the IVC and were touching or perforating a retroperitoneal structure. Finally, they discuss the filter retrieval program that Dr. Wang built at Kaiser. Important aspects of the process were educating primary care doctors, coordinating with critical care and hematology, and involving the anticoagulation clinic. He says he created a current procedural terminology (CPT) code-based list and hired a physician extender as filter lead to monitor and update the list. He was able to get his EPIC team on board by creating a safety net based on a procedural code. Ultimately, he raised the IVC filter retrieval rate from 38% in Northern California to 54% after his grand rounds and up to 80% after integrating his program into EPIC which allowed a provider to click a single button that would notify the patient that they were due to come in for their IVC filter retrieval. --- RESOURCES SIR Clinical Practice Guidelines for IVC Filters: https://www.jvir.org/article/S1051-0443(20)30531-5/fulltext PREPIC-1: https://www.nejm.org/doi/full/10.1056/NEJM199802123380701 PREPIC-2: https://jamanetwork.com/journals/jama/fullarticle/2279714 Dr. Wang’s paper: Long-term complications of inferior vena cava filters: https://www.jvsvenous.org/article/S2213-333X(16)30148-2/fulltext We talk with interventional radiologist Dr. Stephen Wang about building an IVC filter retrieval program, the current guidelines on filter placement, and how to minimize the complications of filters.


The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/nBihBQ

---


CHECK OUT OUR SPONSOR


DI4MDs

Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637.


---


SHOW NOTES


In this episode, host Dr. Christopher Beck interviews interventional radiologist Dr. Stephen Wang. They discuss building an IVC filter retrieval program, the current guidelines on filter placement, and the long-term risks of IVC filters.


We start by discussing the joint consensus published in JVIR in 2020, a collaboration between vascular, cardiology, and IR societies. Dr. Wang notes that the main indication for placement of an IVC filter is an acute deep venous thrombosis (DVT) or pulmonary embolism (PE) in someone with a contraindication to anticoagulation. He says that they often collaborate with hematology to provide the best patient care, and they have even collaborated with hematology to set up a filter clinic.


Next, they touch on the long-term risks of IVC filters. They discuss the PREPIC-1 and PREPIC-2 studies which were studies looking at mortality and risk reduction in patients with IVC filters. These studies demonstrated a low level of evidence that IVC filters being placed were actually working. Even more compelling, the risk of putting in filters often outweighs the benefit. Dr. Wang says that for a filter that is in for longer than five years, there is a 13% risk of partial or complete inferior vena cava (IVC) thrombosis. Additionally, at five years, 70% of filters perforated outside of the IVC and were touching or perforating a retroperitoneal structure.


Finally, they discuss the filter retrieval program that Dr. Wang built at Kaiser. Important aspects of the process were educating primary care doctors, coordinating with critical care and hematology, and involving the anticoagulation clinic. He says he created a current procedural terminology (CPT) code-based list and hired a physician extender as filter lead to monitor and update the list. He was able to get his EPIC team on board by creating a safety net based on a procedural code. Ultimately, he raised the IVC filter retrieval rate from 38% in Northern California to 54% after his grand rounds and up to 80% after integrating his program into EPIC which allowed a provider to click a single button that would notify the patient that they were due to come in for their IVC filter retrieval.


---


RESOURCES


SIR Clinical Practice Guidelines for IVC Filters:

https://www.jvir.org/article/S1051-0443(20)30531-5/fulltext


PREPIC-1:

https://www.nejm.org/doi/full/10.1056/NEJM199802123380701


PREPIC-2:

https://jamanetwork.com/journals/jama/fullarticle/2279714


Dr. Wang’s paper: Long-term complications of inferior vena cava filters:

https://www.jvsvenous.org/article/S2213-333X(16)30148-2/fulltext

]]> 2831 Ep. 203 Making Informed Consent an Informed Choice with the Interventional Initiative with Dr. Isabel Newton, Margaret Simon, MSN, and Susan Jackson, MBA Eric J. Keller talks with Isabel Newton, Susan Jackson and Margaret Simor from the Interventional Initiative about informed consent and helping patients make informed choices with newly developed Patient Decision Aids! --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/HzAYsS --- SHOW NOTES In this episode, our host Dr. Eric Keller interviews a panel of leaders from the Interventional Initiative, a not-for-profit organization devoted to raising awareness of minimally invasive image-guided procedures (MIIPs) among patients and referring clinicians. Our guests are interventional radiologists Drs. Susan Jackson and Isabel Newton and nurse and hospital administrator Margaret Simor. We start by discussing the origins of the Interventional Initiative, which started in 2015. After recognizing the public’s knowledge gap within interventional radiology procedures, the team decided to embark on a docuseries project to capture the impact that the field of IR could have on patients’ lives. This docuseries, entitled “Without a Scalpel,” is available on many streaming platforms. The series follows interventional radiologists and their patients in a variety of procedures and medical settings. Presenting new information within a film format has created a welcoming introduction to the field for both patients and physicians. Next, we shift to discussing the Interventional Initiative’s most recent project, a collection of patient decision aids. These materials are unique because they are specifically crafted to meet health literacy levels in the general public. They also provide statistics and graphics that clearly communicate benefits, risks, and alternatives to IR procedures. Ms. Simor, speaking from the experience of an IR nurse, recognizes the knowledge gaps that patients struggle with when giving informed consent. She looks forward to sharing the decision aids with other providers. Dr. Jackson advocates for presenting the decision aids in a variety of formats (paper, online, app-based, EHR-accessible) so that they are most available to as many people as possible. Dr. Newton describes the success of early clinical trials, which show that using the patient decision aids enriches physician-patient conversations, enhances patient autonomy, and even makes patients perceive that they spent more time with the physician. She encourages anyone who is interested in helping beta test the decision aid to reach out to the Interventional Initiative. --- RESOURCES The Interventional Initiative: https://www.theii.org/ The Interventional Initiative Twitter: @Interventional2 Without a Scalpel Docuseries: https://www.theii.org/the-docuseries Fri, 29 Apr 2022 05:00:00 -0000 full BackTable In this episode, Eric Keller talks with Isabel Newton, Susan Jackson and Margaret Simor from The Interventional Initiative about informed consent and helping patients make informed choices with newly developed Patient Decision Aids! Eric J. Keller talks with Isabel Newton, Susan Jackson and Margaret Simor from the Interventional Initiative about informed consent and helping patients make informed choices with newly developed Patient Decision Aids! --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/HzAYsS --- SHOW NOTES In this episode, our host Dr. Eric Keller interviews a panel of leaders from the Interventional Initiative, a not-for-profit organization devoted to raising awareness of minimally invasive image-guided procedures (MIIPs) among patients and referring clinicians. Our guests are interventional radiologists Drs. Susan Jackson and Isabel Newton and nurse and hospital administrator Margaret Simor. We start by discussing the origins of the Interventional Initiative, which started in 2015. After recognizing the public’s knowledge gap within interventional radiology procedures, the team decided to embark on a docuseries project to capture the impact that the field of IR could have on patients’ lives. This docuseries, entitled “Without a Scalpel,” is available on many streaming platforms. The series follows interventional radiologists and their patients in a variety of procedures and medical settings. Presenting new information within a film format has created a welcoming introduction to the field for both patients and physicians. Next, we shift to discussing the Interventional Initiative’s most recent project, a collection of patient decision aids. These materials are unique because they are specifically crafted to meet health literacy levels in the general public. They also provide statistics and graphics that clearly communicate benefits, risks, and alternatives to IR procedures. Ms. Simor, speaking from the experience of an IR nurse, recognizes the knowledge gaps that patients struggle with when giving informed consent. She looks forward to sharing the decision aids with other providers. Dr. Jackson advocates for presenting the decision aids in a variety of formats (paper, online, app-based, EHR-accessible) so that they are most available to as many people as possible. Dr. Newton describes the success of early clinical trials, which show that using the patient decision aids enriches physician-patient conversations, enhances patient autonomy, and even makes patients perceive that they spent more time with the physician. She encourages anyone who is interested in helping beta test the decision aid to reach out to the Interventional Initiative. --- RESOURCES The Interventional Initiative: https://www.theii.org/ The Interventional Initiative Twitter: @Interventional2 Without a Scalpel Docuseries: https://www.theii.org/the-docuseries Eric J. Keller talks with Isabel Newton, Susan Jackson and Margaret Simor from the Interventional Initiative about informed consent and helping patients make informed choices with newly developed Patient Decision Aids!


---


CHECK OUT OUR SPONSOR


DI4MDs

Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/HzAYsS


---


SHOW NOTES


In this episode, our host Dr. Eric Keller interviews a panel of leaders from the Interventional Initiative, a not-for-profit organization devoted to raising awareness of minimally invasive image-guided procedures (MIIPs) among patients and referring clinicians. Our guests are interventional radiologists Drs. Susan Jackson and Isabel Newton and nurse and hospital administrator Margaret Simor.


We start by discussing the origins of the Interventional Initiative, which started in 2015. After recognizing the public’s knowledge gap within interventional radiology procedures, the team decided to embark on a docuseries project to capture the impact that the field of IR could have on patients’ lives. This docuseries, entitled “Without a Scalpel,” is available on many streaming platforms. The series follows interventional radiologists and their patients in a variety of procedures and medical settings. Presenting new information within a film format has created a welcoming introduction to the field for both patients and physicians.


Next, we shift to discussing the Interventional Initiative’s most recent project, a collection of patient decision aids. These materials are unique because they are specifically crafted to meet health literacy levels in the general public. They also provide statistics and graphics that clearly communicate benefits, risks, and alternatives to IR procedures. Ms. Simor, speaking from the experience of an IR nurse, recognizes the knowledge gaps that patients struggle with when giving informed consent. She looks forward to sharing the decision aids with other providers. Dr. Jackson advocates for presenting the decision aids in a variety of formats (paper, online, app-based, EHR-accessible) so that they are most available to as many people as possible.


Dr. Newton describes the success of early clinical trials, which show that using the patient decision aids enriches physician-patient conversations, enhances patient autonomy, and even makes patients perceive that they spent more time with the physician. She encourages anyone who is interested in helping beta test the decision aid to reach out to the Interventional Initiative.


---


RESOURCES


The Interventional Initiative:

https://www.theii.org/


The Interventional Initiative Twitter:

@Interventional2


Without a Scalpel Docuseries:

https://www.theii.org/the-docuseries

]]> 3026 Ep. 202 Staffing the OBL with Dr. Krishna Mannava and Kristin Longwell Vascular Surgeon Krishna Mannava and Vive Vascular VP of Operations Kristin Longwell give advice on staffing the OBL/ASC based on their experiences over the last few years, including the essentials positions to start with, whether or not to use consulting firms, and sourcing your staff. --- CHECK OUT OUR SPONSOR Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews vascular surgeon Dr. Krishna Mannava and Kristin Longwell, vascular technologist and VP of operations and from Vive Vascular. They discuss staffing in the office based lab, cultivating company culture, and how to recruit and retain good employees. We begin by discussing where to start with staffing when building your office based lab (OBL). First, you must determine what needs to be in house and what will be outsourced. They had help from a consulting firm that helped with hiring, the interview process, and establishing human resources policies. They began with two registered nurses (RNs), two radiologic technologists (RTs), one ultrasound technologist and one front desk operator. Dr. Mannava says he needs one RN to run a room and one for pre and post op. Similarly, he needs one RT to run the C-arm, and one helping tableside. Out of house needs are extensive and include billing, legal, IT, housekeeping, web development, and purchasing. Next, they discuss some challenges of running an OBL. They approached growth by maintaining open communication with their employees. All employees are hourly and have concrete schedules. Many are willing to work outside of their job definition to help out wherever needed during a day. Every afternoon, they have one RN and one RT work late, and they rotate through this schedule so everyone can maintain work life balance. Finally, they discuss company culture. Dr. Mannava explains that one year into their venture, they had a company retreat to revamp their mission which helped personalize it and was empowering for the employees. He believes that employees are customers, and he wants his employees to feel valued and excited about work. This helps with retention and ultimately saves money by avoiding high turnover. Kristen implemented a daily huddle, weekly updates, monthly operational meetings and annual retreats to keep employees engaged and ensure staff are all on the same page. Dr. Mannava ends by saying that he tries to instill a sense of gratitude at his workplace and he believes that it is his job to promote the work culture he wants in a top down fashion. --- RESOURCES VIVE Vascular https://www.vivevascular.com Outpatient Endovascular and Interventional Society (OEIS) 2022: https://oeisociety.com/meetings/2022-annual-meeting/ Mon, 25 Apr 2022 05:00:00 -0000 full BackTable Vascular Surgeon Krishna Mannava and Vive Vascular VP of Operations Kristin Longwell give advice on staffing the OBL/ASC based on their experiences over the last few years, including the essentials positions to start with, whether or not to use consulting firms, and sourcing your staff. Vascular Surgeon Krishna Mannava and Vive Vascular VP of Operations Kristin Longwell give advice on staffing the OBL/ASC based on their experiences over the last few years, including the essentials positions to start with, whether or not to use consulting firms, and sourcing your staff. --- CHECK OUT OUR SPONSOR Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews vascular surgeon Dr. Krishna Mannava and Kristin Longwell, vascular technologist and VP of operations and from Vive Vascular. They discuss staffing in the office based lab, cultivating company culture, and how to recruit and retain good employees. We begin by discussing where to start with staffing when building your office based lab (OBL). First, you must determine what needs to be in house and what will be outsourced. They had help from a consulting firm that helped with hiring, the interview process, and establishing human resources policies. They began with two registered nurses (RNs), two radiologic technologists (RTs), one ultrasound technologist and one front desk operator. Dr. Mannava says he needs one RN to run a room and one for pre and post op. Similarly, he needs one RT to run the C-arm, and one helping tableside. Out of house needs are extensive and include billing, legal, IT, housekeeping, web development, and purchasing. Next, they discuss some challenges of running an OBL. They approached growth by maintaining open communication with their employees. All employees are hourly and have concrete schedules. Many are willing to work outside of their job definition to help out wherever needed during a day. Every afternoon, they have one RN and one RT work late, and they rotate through this schedule so everyone can maintain work life balance. Finally, they discuss company culture. Dr. Mannava explains that one year into their venture, they had a company retreat to revamp their mission which helped personalize it and was empowering for the employees. He believes that employees are customers, and he wants his employees to feel valued and excited about work. This helps with retention and ultimately saves money by avoiding high turnover. Kristen implemented a daily huddle, weekly updates, monthly operational meetings and annual retreats to keep employees engaged and ensure staff are all on the same page. Dr. Mannava ends by saying that he tries to instill a sense of gratitude at his workplace and he believes that it is his job to promote the work culture he wants in a top down fashion. --- RESOURCES VIVE Vascular https://www.vivevascular.com Outpatient Endovascular and Interventional Society (OEIS) 2022: https://oeisociety.com/meetings/2022-annual-meeting/ Vascular Surgeon Krishna Mannava and Vive Vascular VP of Operations Kristin Longwell give advice on staffing the OBL/ASC based on their experiences over the last few years, including the essentials positions to start with, whether or not to use consulting firms, and sourcing your staff.


---


CHECK OUT OUR SPONSOR


Boston Scientific Nextlab

https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040


---


SHOW NOTES


In this episode, host Dr. Aaron Fritts interviews vascular surgeon Dr. Krishna Mannava and Kristin Longwell, vascular technologist and VP of operations and from Vive Vascular. They discuss staffing in the office based lab, cultivating company culture, and how to recruit and retain good employees.


We begin by discussing where to start with staffing when building your office based lab (OBL). First, you must determine what needs to be in house and what will be outsourced. They had help from a consulting firm that helped with hiring, the interview process, and establishing human resources policies. They began with two registered nurses (RNs), two radiologic technologists (RTs), one ultrasound technologist and one front desk operator. Dr. Mannava says he needs one RN to run a room and one for pre and post op. Similarly, he needs one RT to run the C-arm, and one helping tableside. Out of house needs are extensive and include billing, legal, IT, housekeeping, web development, and purchasing.


Next, they discuss some challenges of running an OBL. They approached growth by maintaining open communication with their employees. All employees are hourly and have concrete schedules. Many are willing to work outside of their job definition to help out wherever needed during a day. Every afternoon, they have one RN and one RT work late, and they rotate through this schedule so everyone can maintain work life balance.


Finally, they discuss company culture. Dr. Mannava explains that one year into their venture, they had a company retreat to revamp their mission which helped personalize it and was empowering for the employees. He believes that employees are customers, and he wants his employees to feel valued and excited about work. This helps with retention and ultimately saves money by avoiding high turnover. Kristen implemented a daily huddle, weekly updates, monthly operational meetings and annual retreats to keep employees engaged and ensure staff are all on the same page. Dr. Mannava ends by saying that he tries to instill a sense of gratitude at his workplace and he believes that it is his job to promote the work culture he wants in a top down fashion.


---


RESOURCES


VIVE Vascular

https://www.vivevascular.com


Outpatient Endovascular and Interventional Society (OEIS) 2022:

https://oeisociety.com/meetings/2022-annual-meeting/

]]> 3605 Historical Origins of Health Inequities with Dante King Dr. Vishal Kumar talks with special guest Dante D. King about some of the historical origins of health inequities, and persistent biases we see in our healthcare settings today. *Trigger Warning: Sexual assault is mentioned from 9:29-17:30. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/selDZM --- SHOW NOTES In this episode, guest host Dr. Vishal Kumar interviews educator and author Dante King about America’s history of black subjugation and persistent biases in our healthcare settings today. First, Mr. King gives examples of historical case law and statutes that disenfranchised African Americans and placed them in derogatory and undignified positions. Some examples include the Fugitive Slave Act (1850), as well as various state laws that sought to claim ownership over black people and make sexually assault of black women legally permissible. A key court decision, Geroge v. State (1872) had ruled that rape was only considered a crime when committed against white women. We follow this thread of dehumanization of black women through modern day medicine, in which the maternal mortality rate reflects significantly higher rates in African American women. Dr. Kumar highlights recent studies that show the presence of implicit bias, as well as its intergenerational effects. He notes that privilege involves more than just perks and benefits; it encompasses the lack of barriers and obstacles in society. He also encourages listeners to realize that healthcare providers deny the benefit of the doubt to certain populations, which results in harmful under-intervention or over-intervention. --- RESOURCES Dante King Website: https://www.danteking.com/ Dante King Twitter: https://twitter.com/danteking2020 The 400 Year Holocaust: https://www.amazon.com/400-Year-Holocaust-Americas-Psychopathic-Sociopathic-ebook/dp/B09Q9C43Z9 The Human Doctor Podcast: https://podcasts.apple.com/us/podcast/the-human-doctor/id1571000871 Yale Preschool Study: https://medicine.yale.edu/childstudy/zigler/publications/Preschool Implicit Bias Policy Brief_final_9_26_276766_5379_v1.pdf Race and Intergenerational Economic Opportunity Study: http://www.equality-of-opportunity.org/assets/documents/race_paper.pdf Fri, 22 Apr 2022 05:00:00 -0000 full BackTable Dr. Vishal Kumar talks with special guest Dante D. King about some of the historical origins of health inequities, and persistent biases we see in our healthcare settings today. *Trigger Warning: Sexual assault is mentioned from 9:29-17:30. Dr. Vishal Kumar talks with special guest Dante D. King about some of the historical origins of health inequities, and persistent biases we see in our healthcare settings today. *Trigger Warning: Sexual assault is mentioned from 9:29-17:30. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/selDZM --- SHOW NOTES In this episode, guest host Dr. Vishal Kumar interviews educator and author Dante King about America’s history of black subjugation and persistent biases in our healthcare settings today. First, Mr. King gives examples of historical case law and statutes that disenfranchised African Americans and placed them in derogatory and undignified positions. Some examples include the Fugitive Slave Act (1850), as well as various state laws that sought to claim ownership over black people and make sexually assault of black women legally permissible. A key court decision, Geroge v. State (1872) had ruled that rape was only considered a crime when committed against white women. We follow this thread of dehumanization of black women through modern day medicine, in which the maternal mortality rate reflects significantly higher rates in African American women. Dr. Kumar highlights recent studies that show the presence of implicit bias, as well as its intergenerational effects. He notes that privilege involves more than just perks and benefits; it encompasses the lack of barriers and obstacles in society. He also encourages listeners to realize that healthcare providers deny the benefit of the doubt to certain populations, which results in harmful under-intervention or over-intervention. --- RESOURCES Dante King Website: https://www.danteking.com/ Dante King Twitter: https://twitter.com/danteking2020 The 400 Year Holocaust: https://www.amazon.com/400-Year-Holocaust-Americas-Psychopathic-Sociopathic-ebook/dp/B09Q9C43Z9 The Human Doctor Podcast: https://podcasts.apple.com/us/podcast/the-human-doctor/id1571000871 Yale Preschool Study: https://medicine.yale.edu/childstudy/zigler/publications/Preschool Implicit Bias Policy Brief_final_9_26_276766_5379_v1.pdf Race and Intergenerational Economic Opportunity Study: http://www.equality-of-opportunity.org/assets/documents/race_paper.pdf Dr. Vishal Kumar talks with special guest Dante D. King about some of the historical origins of health inequities, and persistent biases we see in our healthcare settings today. *Trigger Warning: Sexual assault is mentioned from 9:29-17:30.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/selDZM


---


SHOW NOTES


In this episode, guest host Dr. Vishal Kumar interviews educator and author Dante King about America’s history of black subjugation and persistent biases in our healthcare settings today.


First, Mr. King gives examples of historical case law and statutes that disenfranchised African Americans and placed them in derogatory and undignified positions. Some examples include the Fugitive Slave Act (1850), as well as various state laws that sought to claim ownership over black people and make sexually assault of black women legally permissible. A key court decision, Geroge v. State (1872) had ruled that rape was only considered a crime when committed against white women. We follow this thread of dehumanization of black women through modern day medicine, in which the maternal mortality rate reflects significantly higher rates in African American women.


Dr. Kumar highlights recent studies that show the presence of implicit bias, as well as its intergenerational effects. He notes that privilege involves more than just perks and benefits; it encompasses the lack of barriers and obstacles in society. He also encourages listeners to realize that healthcare providers deny the benefit of the doubt to certain populations, which results in harmful under-intervention or over-intervention.


---


RESOURCES


Dante King Website:

https://www.danteking.com/


Dante King Twitter:

https://twitter.com/danteking2020


The 400 Year Holocaust:

https://www.amazon.com/400-Year-Holocaust-Americas-Psychopathic-Sociopathic-ebook/dp/B09Q9C43Z9


The Human Doctor Podcast:

https://podcasts.apple.com/us/podcast/the-human-doctor/id1571000871


Yale Preschool Study:

https://medicine.yale.edu/childstudy/zigler/publications/Preschool Implicit Bias Policy Brief_final_9_26_276766_5379_v1.pdf


Race and Intergenerational Economic Opportunity Study:

http://www.equality-of-opportunity.org/assets/documents/race_paper.pdf

]]> 2507 Ep. 201 Jobs: The Good, the Bad and the Snugly with Dr. Reza Rajebi and Dr. Kavi Devulapalli We talk with Dr. Reza Rajebi and Dr. Kavi Devulapalli about what constitutes a good job in interventional radiology, how to spot red flags when you're job searching, and when to pivot in your career. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/gTvtfF --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews interventional radiologists Drs. Reza Rajebi and Kavi Devulapalli about what constitutes a good job versus a bad job in interventional radiology including red flags to look for, the importance of mentorship and when to pivot in your career. The three begin by discussing their training and various jobs they have held. Dr. Devulapalli took the first job he got out of residency, then worked with an interventional cardiologist building a multidisciplinary OBL. Now he does locums and teleradiology from home. Dr. Rajebi started in academics, then transitioned to private practice at a traditional IR and DR group. He is now at an OBL, now doing a mix of locums. Dr. Fritts currently does locums and DR in Dallas. They discuss what makes an ideal IR job, as well as what leads to job dissatisfaction. They agree that the people you work with are the most important aspect of a good job. Supportive colleagues who share your vision and a pathway for professional growth are also key requirements. Job dissatisfaction in IR is often due to lack of autonomy, inability to build your practice, private equity buyouts such as paths to partnership, and politics such as hospital contracts. They discuss how to spot red flags when job hunting. Dr. Rajebi advises to be aware of false promises, to do robust research, and to ask like minded people what they think of the position. They end by discussing when to pivot in a job you are unhappy with. Dr. Rajebi says not to pivot until you are sure you will get 3 out of 4 things that make an ideal job: location, salary, job satisfaction, and work life balance. Dr. Devulapalli shares his experience with job dissatisfaction and advice on mentorship, noting that you should not pivot too early or too often. He says that the moment you start having negative feelings about your job is when mentorship really matters. He advises to give it a year and use that time to reflect in order to pivot and find a better opportunity. --- RESOURCES Dr. Kavi Devulapalli’s blog: https://linemonkeymd.com/ Dr. Reza Rajebi’s paper on issues for the early career IR: https://pubmed.ncbi.nlm.nih.gov/33726963/ Mon, 18 Apr 2022 05:00:00 -0000 full BackTable We talk with Dr. Reza Rajebi and Dr. Kavi Devulapalli about what constitutes a good job in interventional radiology, how to spot red flags when you're job searching, and when to pivot in your career. We talk with Dr. Reza Rajebi and Dr. Kavi Devulapalli about what constitutes a good job in interventional radiology, how to spot red flags when you're job searching, and when to pivot in your career. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/gTvtfF --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews interventional radiologists Drs. Reza Rajebi and Kavi Devulapalli about what constitutes a good job versus a bad job in interventional radiology including red flags to look for, the importance of mentorship and when to pivot in your career. The three begin by discussing their training and various jobs they have held. Dr. Devulapalli took the first job he got out of residency, then worked with an interventional cardiologist building a multidisciplinary OBL. Now he does locums and teleradiology from home. Dr. Rajebi started in academics, then transitioned to private practice at a traditional IR and DR group. He is now at an OBL, now doing a mix of locums. Dr. Fritts currently does locums and DR in Dallas. They discuss what makes an ideal IR job, as well as what leads to job dissatisfaction. They agree that the people you work with are the most important aspect of a good job. Supportive colleagues who share your vision and a pathway for professional growth are also key requirements. Job dissatisfaction in IR is often due to lack of autonomy, inability to build your practice, private equity buyouts such as paths to partnership, and politics such as hospital contracts. They discuss how to spot red flags when job hunting. Dr. Rajebi advises to be aware of false promises, to do robust research, and to ask like minded people what they think of the position. They end by discussing when to pivot in a job you are unhappy with. Dr. Rajebi says not to pivot until you are sure you will get 3 out of 4 things that make an ideal job: location, salary, job satisfaction, and work life balance. Dr. Devulapalli shares his experience with job dissatisfaction and advice on mentorship, noting that you should not pivot too early or too often. He says that the moment you start having negative feelings about your job is when mentorship really matters. He advises to give it a year and use that time to reflect in order to pivot and find a better opportunity. --- RESOURCES Dr. Kavi Devulapalli’s blog: https://linemonkeymd.com/ Dr. Reza Rajebi’s paper on issues for the early career IR: https://pubmed.ncbi.nlm.nih.gov/33726963/ We talk with Dr. Reza Rajebi and Dr. Kavi Devulapalli about what constitutes a good job in interventional radiology, how to spot red flags when you're job searching, and when to pivot in your career.


---


CHECK OUT OUR SPONSOR


Laurel Road for Doctors

https://www.laurelroad.com/healthcare-banking/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/gTvtfF


---


SHOW NOTES


In this episode, host Dr. Aaron Fritts interviews interventional radiologists Drs. Reza Rajebi and Kavi Devulapalli about what constitutes a good job versus a bad job in interventional radiology including red flags to look for, the importance of mentorship and when to pivot in your career.


The three begin by discussing their training and various jobs they have held. Dr. Devulapalli took the first job he got out of residency, then worked with an interventional cardiologist building a multidisciplinary OBL. Now he does locums and teleradiology from home. Dr. Rajebi started in academics, then transitioned to private practice at a traditional IR and DR group. He is now at an OBL, now doing a mix of locums. Dr. Fritts currently does locums and DR in Dallas.


They discuss what makes an ideal IR job, as well as what leads to job dissatisfaction. They agree that the people you work with are the most important aspect of a good job. Supportive colleagues who share your vision and a pathway for professional growth are also key requirements. Job dissatisfaction in IR is often due to lack of autonomy, inability to build your practice, private equity buyouts such as paths to partnership, and politics such as hospital contracts. They discuss how to spot red flags when job hunting. Dr. Rajebi advises to be aware of false promises, to do robust research, and to ask like minded people what they think of the position.


They end by discussing when to pivot in a job you are unhappy with. Dr. Rajebi says not to pivot until you are sure you will get 3 out of 4 things that make an ideal job: location, salary, job satisfaction, and work life balance. Dr. Devulapalli shares his experience with job dissatisfaction and advice on mentorship, noting that you should not pivot too early or too often. He says that the moment you start having negative feelings about your job is when mentorship really matters. He advises to give it a year and use that time to reflect in order to pivot and find a better opportunity.


---


RESOURCES


Dr. Kavi Devulapalli’s blog:

https://linemonkeymd.com/


Dr. Reza Rajebi’s paper on issues for the early career IR:

https://pubmed.ncbi.nlm.nih.gov/33726963/

]]> 3717 Ep. 200 PAD Stenting Algorithm with Dr. Luke Wilkins We talk with Dr. Luke Wilkins about his stenting algorithm for treating peripheral artery disease, including a step by step discussion of the decision tree when deciding whether or not to stent. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES In this episode, our host Dr. Aparna Baheti interviews interventional radiologist Dr. Luke Wilkins about his treatment algorithm for Peripheral Arterial Disease (PAD). This algorithm is linked below, under “Resources.” Dr. Wilkins starts by explaining his treatment decisions for non-occlusive lesions. If the lesion is less than 10 cm he prefers to use directional atherectomy and percutaneous transluminal angioplasty (PTA). However, if the lesion is greater than 10 cm, directional atherectomy poses the risk of distal embolization, so he will only perform PTA. In both cases, he recommends using IVUS to evaluate the efficacy of the treatment and then proceeding with a drug-coated balloon (DCB) to prevent re-stenosis. On the other hand, if the disease is occlusive, Dr. Wilkins first attempts to cross the lesion. This can be achieved by going through microchannels with a guidewire or boring through the occlusion with a crossing device. If the lesion is unable to be crossed, he attempts subintimal recanalization. We discuss spontaneous re-entry into the true lumen, as well as re-entry devices like the Outback and the Pioneer catheters. We also take a detour into the Subintimal Arterial Flossing with Anterograde-Retrograde Intervention (SAFARI) technique that can be used if re-entry is challenging. After crossing is complete, Dr. Wilkins evaluates vessel diameter. In his experience, vessels that are wider than 5 mm have better stent patency, so he will place a drug eluting stent. In vessels of smaller diameters, Dr. Wilkins relies on other approaches such as interwoven stents with smaller diameters, directional atherectomy, and Tacks (to treat dissection flaps). Finally, Dr. Wilkins discusses medical management and follow-up care for PAD patients. He recommends dual antiplatelet therapy, smoking cessation, and if claudication was an initial concern, patient education on the importance of walking. He follows up with patients in 1, 6, and 9 months, and then annually. During each follow up appointment, he checks ABI, PVR, and arterial duplex for clinical improvement. --- RESOURCES PAD Stenting Algorithm Decision Tree: https://www.backtable.com/shows/vi/podcasts/200/pad-stenting-algorithm TASC Guidelines: https://journals.sagepub.com/doi/10.1177/1358863X15597877?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Articles Mentioned: Schneider PA, Laird JR, Doros G, Gao Q, Ansel G, Brodmann M, Micari A, Shishehbor MH, Tepe G, Zeller T. Mortality not correlated with paclitaxel exposure: an independent patient-level meta-analysis of a drug-coated balloon. Journal of the American College of Cardiology. 2019 May 28;73(20):2550-63.   Secemsky EA, Kundi H, Weinberg I, Jaff MR, Krawisz A, Parikh SA, Beckman JA, Mustapha J, Rosenfield K, Yeh RW. Association of survival with femoropopliteal artery revascularization with drug-coated devices. JAMA cardiology. 2019 Apr 1;4(4):332-40.   Freisinger E, Koeppe J, Gerss J, Goerlich D, Malyar NM, Marschall U, Faldum A, Reinecke H. Mortality after use of paclitaxel-based devices in peripheral arteries: a real-world safety analysis. European heart journal. 2020 Oct 7;41(38):3732-9. Fri, 15 Apr 2022 05:00:00 -0000 full BackTable We talk with Dr. Luke Wilkins about his stenting algorithm for treating peripheral artery disease, including a step by step discussion of the decision tree when deciding whether or not to stent. We talk with Dr. Luke Wilkins about his stenting algorithm for treating peripheral artery disease, including a step by step discussion of the decision tree when deciding whether or not to stent. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES In this episode, our host Dr. Aparna Baheti interviews interventional radiologist Dr. Luke Wilkins about his treatment algorithm for Peripheral Arterial Disease (PAD). This algorithm is linked below, under “Resources.” Dr. Wilkins starts by explaining his treatment decisions for non-occlusive lesions. If the lesion is less than 10 cm he prefers to use directional atherectomy and percutaneous transluminal angioplasty (PTA). However, if the lesion is greater than 10 cm, directional atherectomy poses the risk of distal embolization, so he will only perform PTA. In both cases, he recommends using IVUS to evaluate the efficacy of the treatment and then proceeding with a drug-coated balloon (DCB) to prevent re-stenosis. On the other hand, if the disease is occlusive, Dr. Wilkins first attempts to cross the lesion. This can be achieved by going through microchannels with a guidewire or boring through the occlusion with a crossing device. If the lesion is unable to be crossed, he attempts subintimal recanalization. We discuss spontaneous re-entry into the true lumen, as well as re-entry devices like the Outback and the Pioneer catheters. We also take a detour into the Subintimal Arterial Flossing with Anterograde-Retrograde Intervention (SAFARI) technique that can be used if re-entry is challenging. After crossing is complete, Dr. Wilkins evaluates vessel diameter. In his experience, vessels that are wider than 5 mm have better stent patency, so he will place a drug eluting stent. In vessels of smaller diameters, Dr. Wilkins relies on other approaches such as interwoven stents with smaller diameters, directional atherectomy, and Tacks (to treat dissection flaps). Finally, Dr. Wilkins discusses medical management and follow-up care for PAD patients. He recommends dual antiplatelet therapy, smoking cessation, and if claudication was an initial concern, patient education on the importance of walking. He follows up with patients in 1, 6, and 9 months, and then annually. During each follow up appointment, he checks ABI, PVR, and arterial duplex for clinical improvement. --- RESOURCES PAD Stenting Algorithm Decision Tree: https://www.backtable.com/shows/vi/podcasts/200/pad-stenting-algorithm TASC Guidelines: https://journals.sagepub.com/doi/10.1177/1358863X15597877?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Articles Mentioned: Schneider PA, Laird JR, Doros G, Gao Q, Ansel G, Brodmann M, Micari A, Shishehbor MH, Tepe G, Zeller T. Mortality not correlated with paclitaxel exposure: an independent patient-level meta-analysis of a drug-coated balloon. Journal of the American College of Cardiology. 2019 May 28;73(20):2550-63.   Secemsky EA, Kundi H, Weinberg I, Jaff MR, Krawisz A, Parikh SA, Beckman JA, Mustapha J, Rosenfield K, Yeh RW. Association of survival with femoropopliteal artery revascularization with drug-coated devices. JAMA cardiology. 2019 Apr 1;4(4):332-40.   Freisinger E, Koeppe J, Gerss J, Goerlich D, Malyar NM, Marschall U, Faldum A, Reinecke H. Mortality after use of paclitaxel-based devices in peripheral arteries: a real-world safety analysis. European heart journal. 2020 Oct 7;41(38):3732-9. We talk with Dr. Luke Wilkins about his stenting algorithm for treating peripheral artery disease, including a step by step discussion of the decision tree when deciding whether or not to stent.


---


CHECK OUT OUR SPONSOR


Boston Scientific Eluvia Drug-Eluting Stent

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043


---


SHOW NOTES


In this episode, our host Dr. Aparna Baheti interviews interventional radiologist Dr. Luke Wilkins about his treatment algorithm for Peripheral Arterial Disease (PAD). This algorithm is linked below, under “Resources.”


Dr. Wilkins starts by explaining his treatment decisions for non-occlusive lesions. If the lesion is less than 10 cm he prefers to use directional atherectomy and percutaneous transluminal angioplasty (PTA). However, if the lesion is greater than 10 cm, directional atherectomy poses the risk of distal embolization, so he will only perform PTA. In both cases, he recommends using IVUS to evaluate the efficacy of the treatment and then proceeding with a drug-coated balloon (DCB) to prevent re-stenosis.


On the other hand, if the disease is occlusive, Dr. Wilkins first attempts to cross the lesion. This can be achieved by going through microchannels with a guidewire or boring through the occlusion with a crossing device. If the lesion is unable to be crossed, he attempts subintimal recanalization. We discuss spontaneous re-entry into the true lumen, as well as re-entry devices like the Outback and the Pioneer catheters. We also take a detour into the Subintimal Arterial Flossing with Anterograde-Retrograde Intervention (SAFARI) technique that can be used if re-entry is challenging. After crossing is complete, Dr. Wilkins evaluates vessel diameter. In his experience, vessels that are wider than 5 mm have better stent patency, so he will place a drug eluting stent. In vessels of smaller diameters, Dr. Wilkins relies on other approaches such as interwoven stents with smaller diameters, directional atherectomy, and Tacks (to treat dissection flaps).


Finally, Dr. Wilkins discusses medical management and follow-up care for PAD patients. He recommends dual antiplatelet therapy, smoking cessation, and if claudication was an initial concern, patient education on the importance of walking. He follows up with patients in 1, 6, and 9 months, and then annually. During each follow up appointment, he checks ABI, PVR, and arterial duplex for clinical improvement.


---


RESOURCES


PAD Stenting Algorithm Decision Tree:

https://www.backtable.com/shows/vi/podcasts/200/pad-stenting-algorithm


TASC Guidelines:

https://journals.sagepub.com/doi/10.1177/1358863X15597877?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed


Articles Mentioned:

Schneider PA, Laird JR, Doros G, Gao Q, Ansel G, Brodmann M, Micari A, Shishehbor MH, Tepe G, Zeller T. Mortality not correlated with paclitaxel exposure: an independent patient-level meta-analysis of a drug-coated balloon. Journal of the American College of Cardiology. 2019 May 28;73(20):2550-63.

 

Secemsky EA, Kundi H, Weinberg I, Jaff MR, Krawisz A, Parikh SA, Beckman JA, Mustapha J, Rosenfield K, Yeh RW. Association of survival with femoropopliteal artery revascularization with drug-coated devices. JAMA cardiology. 2019 Apr 1;4(4):332-40.

 

Freisinger E, Koeppe J, Gerss J, Goerlich D, Malyar NM, Marschall U, Faldum A, Reinecke H. Mortality after use of paclitaxel-based devices in peripheral arteries: a real-world safety analysis. European heart journal. 2020 Oct 7;41(38):3732-9.

]]> 2210 Ep. 199 Advanced Minimally Invasive Pain Interventions with Dr. David Prologo We talk with interventional radiologist Dr. David Prologo about minimally invasive pain interventions, multidisciplinary pain management, and how he built a successful pain practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/GzA4Iu --- SHOW NOTES In this episode, host Dr. Michael Barraza interviews Dr. David Prologo, director of interventional radiology at Emory about minimally invasive pain interventions, multidisciplinary pain management, and how he created a booming practice that is well known by patients and providers nationally. Dr. Prologo begins by discussing his training in obesity medicine and how his interests in pain management developed. He discusses his book, The Catching Point, which explores weight loss culture and the fault of society and medical providers in placing the blame on patients and the new options available in IR for weight loss. He says his interest in pain management was similar to his interest in obesity medicine. He was curious about how he could use his tools and skills as an IR to treat obesity and pain with minimally invasive procedures. Next, they discuss how IR fits into the multidisciplinary team that plays a role in pain management. He explains that the combination of technology and an IRs position in the hospital makes them ideal for the job. He says a key is to maintain relationships with all other specialties by focusing initially on procedures that other specialties don't perform, in order to build rapport. He also notes that the procedures he performs result in rapid pain reduction and greatly decrease length of stay which is a huge incentive for hospitals and other specialties to seek out IR and make referrals. Finally, the two discuss the types of patients Dr. Prologo treats, and the procedures he does. He divides patient population into neoplastic versus non neoplastic pain, and spine versus non spine pain. He sees 90% of patients in clinic for procedure planning. Dr. Prologo emphasizes the importance of advocating for patients and continuing to see them even if they do not need an IR procedure. He discusses his 8, 3, 3, 3 method for percutaneous cryoneurolysis and discusses the various outcomes he is able to achieve in pain reduction. Dr. Prologo minimizes non responders by doing test blocks, understanding central desensitization, and selecting patients for procedures appropriately. --- RESOURCES Interventional Cryoneurolysis: An Illustrative Approach: https://pubmed.ncbi.nlm.nih.gov/33308581/ Focused Cryo: https://gra.org/company/213/Focused_Cryo.html Nantes criteria for pudendal neuralgia: https://pubmed.ncbi.nlm.nih.gov/17828787/ The Catching Point https://www.catchingpoint.com David Prologo Website: https://www.drprologo.com/about Mon, 11 Apr 2022 05:00:00 -0000 full BackTable We talk with interventional radiologist Dr. David Prologo about minimally invasive pain interventions, multidisciplinary pain management, and how he built a successful pain practice. We talk with interventional radiologist Dr. David Prologo about minimally invasive pain interventions, multidisciplinary pain management, and how he built a successful pain practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/GzA4Iu --- SHOW NOTES In this episode, host Dr. Michael Barraza interviews Dr. David Prologo, director of interventional radiology at Emory about minimally invasive pain interventions, multidisciplinary pain management, and how he created a booming practice that is well known by patients and providers nationally. Dr. Prologo begins by discussing his training in obesity medicine and how his interests in pain management developed. He discusses his book, The Catching Point, which explores weight loss culture and the fault of society and medical providers in placing the blame on patients and the new options available in IR for weight loss. He says his interest in pain management was similar to his interest in obesity medicine. He was curious about how he could use his tools and skills as an IR to treat obesity and pain with minimally invasive procedures. Next, they discuss how IR fits into the multidisciplinary team that plays a role in pain management. He explains that the combination of technology and an IRs position in the hospital makes them ideal for the job. He says a key is to maintain relationships with all other specialties by focusing initially on procedures that other specialties don't perform, in order to build rapport. He also notes that the procedures he performs result in rapid pain reduction and greatly decrease length of stay which is a huge incentive for hospitals and other specialties to seek out IR and make referrals. Finally, the two discuss the types of patients Dr. Prologo treats, and the procedures he does. He divides patient population into neoplastic versus non neoplastic pain, and spine versus non spine pain. He sees 90% of patients in clinic for procedure planning. Dr. Prologo emphasizes the importance of advocating for patients and continuing to see them even if they do not need an IR procedure. He discusses his 8, 3, 3, 3 method for percutaneous cryoneurolysis and discusses the various outcomes he is able to achieve in pain reduction. Dr. Prologo minimizes non responders by doing test blocks, understanding central desensitization, and selecting patients for procedures appropriately. --- RESOURCES Interventional Cryoneurolysis: An Illustrative Approach: https://pubmed.ncbi.nlm.nih.gov/33308581/ Focused Cryo: https://gra.org/company/213/Focused_Cryo.html Nantes criteria for pudendal neuralgia: https://pubmed.ncbi.nlm.nih.gov/17828787/ The Catching Point https://www.catchingpoint.com David Prologo Website: https://www.drprologo.com/about We talk with interventional radiologist Dr. David Prologo about minimally invasive pain interventions, multidisciplinary pain management, and how he built a successful pain practice.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/GzA4Iu


---


SHOW NOTES


In this episode, host Dr. Michael Barraza interviews Dr. David Prologo, director of interventional radiology at Emory about minimally invasive pain interventions, multidisciplinary pain management, and how he created a booming practice that is well known by patients and providers nationally.


Dr. Prologo begins by discussing his training in obesity medicine and how his interests in pain management developed. He discusses his book, The Catching Point, which explores weight loss culture and the fault of society and medical providers in placing the blame on patients and the new options available in IR for weight loss. He says his interest in pain management was similar to his interest in obesity medicine. He was curious about how he could use his tools and skills as an IR to treat obesity and pain with minimally invasive procedures.


Next, they discuss how IR fits into the multidisciplinary team that plays a role in pain management. He explains that the combination of technology and an IRs position in the hospital makes them ideal for the job. He says a key is to maintain relationships with all other specialties by focusing initially on procedures that other specialties don't perform, in order to build rapport. He also notes that the procedures he performs result in rapid pain reduction and greatly decrease length of stay which is a huge incentive for hospitals and other specialties to seek out IR and make referrals.


Finally, the two discuss the types of patients Dr. Prologo treats, and the procedures he does. He divides patient population into neoplastic versus non neoplastic pain, and spine versus non spine pain. He sees 90% of patients in clinic for procedure planning. Dr. Prologo emphasizes the importance of advocating for patients and continuing to see them even if they do not need an IR procedure. He discusses his 8, 3, 3, 3 method for percutaneous cryoneurolysis and discusses the various outcomes he is able to achieve in pain reduction. Dr. Prologo minimizes non responders by doing test blocks, understanding central desensitization, and selecting patients for procedures appropriately.


---


RESOURCES


Interventional Cryoneurolysis: An Illustrative Approach: https://pubmed.ncbi.nlm.nih.gov/33308581/


Focused Cryo:

https://gra.org/company/213/Focused_Cryo.html


Nantes criteria for pudendal neuralgia:

https://pubmed.ncbi.nlm.nih.gov/17828787/


The Catching Point

https://www.catchingpoint.com


David Prologo Website:

https://www.drprologo.com/about

]]> 4179 Ep. 198 Privademics and Advantages of Lesser Known Community Programs with Dr. Shamit Desai & Dr. Saud Ahmed Interventional radiologists Dr. Shamit Desai and Dr. Saud Ahmed discuss the advantages of community training programs including practice building, resident and attending relationships, and diversity of job opportunities after training. --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Bxnlqq --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews Dr. Shamit Desai and Dr. Saud Ahmed, interventional radiologists at Franciscan St. James, about advantages of community training programs including practice building, resident and attending relationships, and diversity of job opportunities after training. The three begin by discussing current IR training pathways, and what Franciscan St. James offers. Dr. Ahmed is the PD for the early specialization in interventional radiology (ESIR) spot at their program, which has been running for three years. They have 3-4 radiology residents per year, and the diagnostic radiology residency is well established. There are no fellows there, which allows residents ample hands-on experience from the beginning of residency, and facetime with attendings. Next, we discuss the advantages that a small community hospital affords. At their institution, both the IR department as well as the radiology residents have the opportunity to build rapport and trust with referring providers. This is how they are able to build the practice base that is often taken for granted at an academic institution. The community hospital also gives residents more clinical experience; they are taking the IR consults as first years, collaborating on clinical management and rounding with attendings. Lastly, we discuss the benefit of an ESIR program compared to the integrated IR pathway. They discuss how the diagnostic radiology training is uncompromised which prepares trainees very well for job opportunities after training. They argue that having trained in a community setting makes you more marketable when applying for jobs, especially in private practice. The residents at St. James are prepared to go into practice with a broad diagnostic and interventional skill set, but also understand how to be efficient with procedures and build a practice, which is a huge advantage that is simply not taught at academic institutions. --- RESOURCES Franciscan St. James Radiology: https://www.franciscanradiology.com SIR ESIR Program List: https://www.sirweb.org/learning-center/ir-residency/esir/ SIR Integrated IR Program List: https://www.sirweb.org/learning-center/ir-residency/integrated/ Mon, 04 Apr 2022 05:00:00 -0000 full BackTable Interventional radiologists Dr. Shamit Desai and Dr. Saud Ahmed discuss the advantages of community training programs including practice building, resident and attending relationships, and diversity of job opportunities after training. Interventional radiologists Dr. Shamit Desai and Dr. Saud Ahmed discuss the advantages of community training programs including practice building, resident and attending relationships, and diversity of job opportunities after training. --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Bxnlqq --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews Dr. Shamit Desai and Dr. Saud Ahmed, interventional radiologists at Franciscan St. James, about advantages of community training programs including practice building, resident and attending relationships, and diversity of job opportunities after training. The three begin by discussing current IR training pathways, and what Franciscan St. James offers. Dr. Ahmed is the PD for the early specialization in interventional radiology (ESIR) spot at their program, which has been running for three years. They have 3-4 radiology residents per year, and the diagnostic radiology residency is well established. There are no fellows there, which allows residents ample hands-on experience from the beginning of residency, and facetime with attendings. Next, we discuss the advantages that a small community hospital affords. At their institution, both the IR department as well as the radiology residents have the opportunity to build rapport and trust with referring providers. This is how they are able to build the practice base that is often taken for granted at an academic institution. The community hospital also gives residents more clinical experience; they are taking the IR consults as first years, collaborating on clinical management and rounding with attendings. Lastly, we discuss the benefit of an ESIR program compared to the integrated IR pathway. They discuss how the diagnostic radiology training is uncompromised which prepares trainees very well for job opportunities after training. They argue that having trained in a community setting makes you more marketable when applying for jobs, especially in private practice. The residents at St. James are prepared to go into practice with a broad diagnostic and interventional skill set, but also understand how to be efficient with procedures and build a practice, which is a huge advantage that is simply not taught at academic institutions. --- RESOURCES Franciscan St. James Radiology: https://www.franciscanradiology.com SIR ESIR Program List: https://www.sirweb.org/learning-center/ir-residency/esir/ SIR Integrated IR Program List: https://www.sirweb.org/learning-center/ir-residency/integrated/ Interventional radiologists Dr. Shamit Desai and Dr. Saud Ahmed discuss the advantages of community training programs including practice building, resident and attending relationships, and diversity of job opportunities after training.


---


CHECK OUT OUR SPONSOR


DI4MDs

Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Bxnlqq


---


SHOW NOTES


In this episode, host Dr. Aaron Fritts interviews Dr. Shamit Desai and Dr. Saud Ahmed, interventional radiologists at Franciscan St. James, about advantages of community training programs including practice building, resident and attending relationships, and diversity of job opportunities after training.


The three begin by discussing current IR training pathways, and what Franciscan St. James offers. Dr. Ahmed is the PD for the early specialization in interventional radiology (ESIR) spot at their program, which has been running for three years. They have 3-4 radiology residents per year, and the diagnostic radiology residency is well established. There are no fellows there, which allows residents ample hands-on experience from the beginning of residency, and facetime with attendings.


Next, we discuss the advantages that a small community hospital affords. At their institution, both the IR department as well as the radiology residents have the opportunity to build rapport and trust with referring providers. This is how they are able to build the practice base that is often taken for granted at an academic institution. The community hospital also gives residents more clinical experience; they are taking the IR consults as first years, collaborating on clinical management and rounding with attendings.


Lastly, we discuss the benefit of an ESIR program compared to the integrated IR pathway. They discuss how the diagnostic radiology training is uncompromised which prepares trainees very well for job opportunities after training. They argue that having trained in a community setting makes you more marketable when applying for jobs, especially in private practice. The residents at St. James are prepared to go into practice with a broad diagnostic and interventional skill set, but also understand how to be efficient with procedures and build a practice, which is a huge advantage that is simply not taught at academic institutions.



---


RESOURCES


Franciscan St. James Radiology:

https://www.franciscanradiology.com


SIR ESIR Program List:

https://www.sirweb.org/learning-center/ir-residency/esir/


SIR Integrated IR Program List:

https://www.sirweb.org/learning-center/ir-residency/integrated/

]]> 2901 Ep. 197 CERAB Technique for Aortoiliac Disease with Dr. Martin Schroeder Vascular surgeon Dr. Martin Schroeder discusses the Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) technique for treating aortoiliac disease, including patient workup, procedure steps, and pitfalls to avoid with stent placement. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/08Esyf --- SHOW NOTES In this episode, vascular surgeon Dr. Martin Schroeder and our host Dr. Sabeen Dhand discuss the CERAB (Covered Endovascular Reconstruction of Aortic Bifurcation) procedure with all of its steps, including planning, arterial access, recanalization, reconstruction. First, Dr. Schroeder emphasizes that CERAB is ideal for patients with TASC C and TASC D lesions. For planning purposes, he prefers CT angiogram to MRI, since CT is better at showing calcifications and previous stents. At this stage, he measures the intraluminal area. Next, he gains percutaneous ultrasound-guided groin access, and he uses a ProGlide preclose system. He takes an endovascular measurement of the aortic diameter and places a covered stent above the aortic bifurcation. Generally, Dr. Schroeder says that it is ideal to stent below the inferior mesenteric artery, but it can be covered if needed. He flares the proximal end of the stent in order to oppose the graft onto the aorta, create a seal, and prevent a Type I endoleak. Finally, Dr. Schroeder reviews the placement of the iliac stents, the last step in creating a new aortic bifurcation. He shares his 15/15 rule: aortic stent placed 15mm above the aortic bifurcation, and iliac stents placed 15mm within the aortic stent. His general CERAB tips include advancing the sheath before uncovering the stent, making sure that you are always in the intimal space, and staying calm and focused. --- RESOURCES Vascupedia CERAB Webinar: https://vascupedia.com/video/the-cerab-technique-from-a-to-z-part-1/ VBX Stent: https://www.goremedical.com/products/vbx Fri, 01 Apr 2022 05:00:00 -0000 full BackTable Vascular surgeon Dr. Martin Schroeder discusses the Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) technique for treating aortoiliac disease, including patient workup, procedure steps, and pitfalls to avoid with stent placement. Vascular surgeon Dr. Martin Schroeder discusses the Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) technique for treating aortoiliac disease, including patient workup, procedure steps, and pitfalls to avoid with stent placement. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/08Esyf --- SHOW NOTES In this episode, vascular surgeon Dr. Martin Schroeder and our host Dr. Sabeen Dhand discuss the CERAB (Covered Endovascular Reconstruction of Aortic Bifurcation) procedure with all of its steps, including planning, arterial access, recanalization, reconstruction. First, Dr. Schroeder emphasizes that CERAB is ideal for patients with TASC C and TASC D lesions. For planning purposes, he prefers CT angiogram to MRI, since CT is better at showing calcifications and previous stents. At this stage, he measures the intraluminal area. Next, he gains percutaneous ultrasound-guided groin access, and he uses a ProGlide preclose system. He takes an endovascular measurement of the aortic diameter and places a covered stent above the aortic bifurcation. Generally, Dr. Schroeder says that it is ideal to stent below the inferior mesenteric artery, but it can be covered if needed. He flares the proximal end of the stent in order to oppose the graft onto the aorta, create a seal, and prevent a Type I endoleak. Finally, Dr. Schroeder reviews the placement of the iliac stents, the last step in creating a new aortic bifurcation. He shares his 15/15 rule: aortic stent placed 15mm above the aortic bifurcation, and iliac stents placed 15mm within the aortic stent. His general CERAB tips include advancing the sheath before uncovering the stent, making sure that you are always in the intimal space, and staying calm and focused. --- RESOURCES Vascupedia CERAB Webinar: https://vascupedia.com/video/the-cerab-technique-from-a-to-z-part-1/ VBX Stent: https://www.goremedical.com/products/vbx Vascular surgeon Dr. Martin Schroeder discusses the Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) technique for treating aortoiliac disease, including patient workup, procedure steps, and pitfalls to avoid with stent placement.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/08Esyf


---


SHOW NOTES


In this episode, vascular surgeon Dr. Martin Schroeder and our host Dr. Sabeen Dhand discuss the CERAB (Covered Endovascular Reconstruction of Aortic Bifurcation) procedure with all of its steps, including planning, arterial access, recanalization, reconstruction.

First, Dr. Schroeder emphasizes that CERAB is ideal for patients with TASC C and TASC D lesions. For planning purposes, he prefers CT angiogram to MRI, since CT is better at showing calcifications and previous stents. At this stage, he measures the intraluminal area.

Next, he gains percutaneous ultrasound-guided groin access, and he uses a ProGlide preclose system. He takes an endovascular measurement of the aortic diameter and places a covered stent above the aortic bifurcation. Generally, Dr. Schroeder says that it is ideal to stent below the inferior mesenteric artery, but it can be covered if needed. He flares the proximal end of the stent in order to oppose the graft onto the aorta, create a seal, and prevent a Type I endoleak.

Finally, Dr. Schroeder reviews the placement of the iliac stents, the last step in creating a new aortic bifurcation. He shares his 15/15 rule: aortic stent placed 15mm above the aortic bifurcation, and iliac stents placed 15mm within the aortic stent. His general CERAB tips include advancing the sheath before uncovering the stent, making sure that you are always in the intimal space, and staying calm and focused.



---


RESOURCES


Vascupedia CERAB Webinar: https://vascupedia.com/video/the-cerab-technique-from-a-to-z-part-1/


VBX Stent:

https://www.goremedical.com/products/vbx

]]> 2224 Ep. 196 Building a PE Response Team with Dr. Carin Gonsalves We talk with Interventional Radiologist Dr. Carin Gonsalves about how her practice built a multidisciplinary Pulmonary Embolism (PE) Response team, including where to start, developing efficient workflows, and obtaining the equipment you need for success. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SHOW NOTES In this episode, hosts Dr. Michael Barraza and Dr. Aaron Fritts interview Dr. Carin Gonsalves, interventional radiologist, about building a pulmonary embolism response team (PERT) and the evolution of pulmonary embolism (PE) treatment including large bore suction thrombectomy devices and the importance of multidisciplinary effort in care of patients with PEs. Dr. Gonsalves discusses how she came to be Division Director of the PERT program at Jefferson University, and her collaborations with Geno Merli, cofounder of the PERT Consortium. Her interest in advancing PE treatment stemmed from her years of performing pulmonary arteriography and catheter directed thrombolysis before the inception of suction thrombectomy devices. She discusses the difficulty she had in obtaining these new devices, and how after 11 months of discussions, the hospital agreed to purchase the necessary equipment to enable the PE response team. She discusses how the PERT is activated when a patient presents with suspected PE. Her team is comprised of five subspecialties including IR, Pulmonary Critical Care, Vascular Surgery, Cardiothoracic Surgery, and Cardiology. She emphasizes how having a group of experts improves patient care by cutting down on critical decision time. She enjoys sharing the responsibility of evaluating treatment approaches based on the current literature and the diversity of experience in the group. Finally, we discuss advances in technology for treatment of PE. Dr. Gonsalves enjoys the ease of use and wide range of clots she can treat including acute, subacute and chronic. These devices have been game changers for PE; many patients are poor surgical candidates and have contraindications to thrombolysis. They end by discussing novel uses of these devices that Dr. Gonsalves performs including removal of clot in transit (mobile clot in the IVC, SVC, RA or RV) and vegetations on the tricuspid valve or a pacemaker lead. --- RESOURCES The PERT Consortium: https://pertconsortium.org Inari PEERLESS RCT: https://www.inarimedical.com/peerless/ Inari FlowTriever: https://www.inarimedical.com/flowtriever/ Inari ClotTriever: https://www.inarimedical.com/clottriever-int/ Inari FlowSaver: https://www.inarimedical.com/flowsaver/ AngioVac: https://www.angiovac.com Mon, 28 Mar 2022 05:00:00 -0000 full BackTable We talk with Interventional Radiologist Dr. Carin Gonsalves about how her practice built a multidisciplinary Pulmonary Embolism (PE) Response team, including where to start, developing efficient workflows, and obtaining the equipment you need for success. We talk with Interventional Radiologist Dr. Carin Gonsalves about how her practice built a multidisciplinary Pulmonary Embolism (PE) Response team, including where to start, developing efficient workflows, and obtaining the equipment you need for success. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SHOW NOTES In this episode, hosts Dr. Michael Barraza and Dr. Aaron Fritts interview Dr. Carin Gonsalves, interventional radiologist, about building a pulmonary embolism response team (PERT) and the evolution of pulmonary embolism (PE) treatment including large bore suction thrombectomy devices and the importance of multidisciplinary effort in care of patients with PEs. Dr. Gonsalves discusses how she came to be Division Director of the PERT program at Jefferson University, and her collaborations with Geno Merli, cofounder of the PERT Consortium. Her interest in advancing PE treatment stemmed from her years of performing pulmonary arteriography and catheter directed thrombolysis before the inception of suction thrombectomy devices. She discusses the difficulty she had in obtaining these new devices, and how after 11 months of discussions, the hospital agreed to purchase the necessary equipment to enable the PE response team. She discusses how the PERT is activated when a patient presents with suspected PE. Her team is comprised of five subspecialties including IR, Pulmonary Critical Care, Vascular Surgery, Cardiothoracic Surgery, and Cardiology. She emphasizes how having a group of experts improves patient care by cutting down on critical decision time. She enjoys sharing the responsibility of evaluating treatment approaches based on the current literature and the diversity of experience in the group. Finally, we discuss advances in technology for treatment of PE. Dr. Gonsalves enjoys the ease of use and wide range of clots she can treat including acute, subacute and chronic. These devices have been game changers for PE; many patients are poor surgical candidates and have contraindications to thrombolysis. They end by discussing novel uses of these devices that Dr. Gonsalves performs including removal of clot in transit (mobile clot in the IVC, SVC, RA or RV) and vegetations on the tricuspid valve or a pacemaker lead. --- RESOURCES The PERT Consortium: https://pertconsortium.org Inari PEERLESS RCT: https://www.inarimedical.com/peerless/ Inari FlowTriever: https://www.inarimedical.com/flowtriever/ Inari ClotTriever: https://www.inarimedical.com/clottriever-int/ Inari FlowSaver: https://www.inarimedical.com/flowsaver/ AngioVac: https://www.angiovac.com We talk with Interventional Radiologist Dr. Carin Gonsalves about how her practice built a multidisciplinary Pulmonary Embolism (PE) Response team, including where to start, developing efficient workflows, and obtaining the equipment you need for success.


---


CHECK OUT OUR SPONSOR


Inari Medical

https://www.inarimedical.com/


---


SHOW NOTES


In this episode, hosts Dr. Michael Barraza and Dr. Aaron Fritts interview Dr. Carin Gonsalves, interventional radiologist, about building a pulmonary embolism response team (PERT) and the evolution of pulmonary embolism (PE) treatment including large bore suction thrombectomy devices and the importance of multidisciplinary effort in care of patients with PEs.


Dr. Gonsalves discusses how she came to be Division Director of the PERT program at Jefferson University, and her collaborations with Geno Merli, cofounder of the PERT Consortium. Her interest in advancing PE treatment stemmed from her years of performing pulmonary arteriography and catheter directed thrombolysis before the inception of suction thrombectomy devices. She discusses the difficulty she had in obtaining these new devices, and how after 11 months of discussions, the hospital agreed to purchase the necessary equipment to enable the PE response team.


She discusses how the PERT is activated when a patient presents with suspected PE. Her team is comprised of five subspecialties including IR, Pulmonary Critical Care, Vascular Surgery, Cardiothoracic Surgery, and Cardiology. She emphasizes how having a group of experts improves patient care by cutting down on critical decision time. She enjoys sharing the responsibility of evaluating treatment approaches based on the current literature and the diversity of experience in the group.


Finally, we discuss advances in technology for treatment of PE. Dr. Gonsalves enjoys the ease of use and wide range of clots she can treat including acute, subacute and chronic. These devices have been game changers for PE; many patients are poor surgical candidates and have contraindications to thrombolysis. They end by discussing novel uses of these devices that Dr. Gonsalves performs including removal of clot in transit (mobile clot in the IVC, SVC, RA or RV) and vegetations on the tricuspid valve or a pacemaker lead.


---


RESOURCES


The PERT Consortium: https://pertconsortium.org

Inari PEERLESS RCT: https://www.inarimedical.com/peerless/

Inari FlowTriever: https://www.inarimedical.com/flowtriever/

Inari ClotTriever: https://www.inarimedical.com/clottriever-int/

Inari FlowSaver: https://www.inarimedical.com/flowsaver/

AngioVac: https://www.angiovac.com

]]> 2350 Ep. 195 Disclosures of Conflicts of Interest with Dr. Mina Makary Our hosts Dr. Aparna Baheti and Dr. Michael Barraza talk with Dr. Mina Makary about what constitutes a conflict of interest, and how we can reduce bias in research without stifling innovation. Reflect on how this Podcast applies to your day-to-day and engage to earn AMA PRA Category 1 Credit(s)™ via point-of-care learning activities here: https://earnc.me/WV7gzp --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES In this episode, our hosts Dr. Ally Behati and Dr. Michael Barraza interview Dr. Mina Makary about his recent article with the Applied Ethics in IR Working Group about physician conflicts of interest and disclosures in image-guided research publications. Dr. Makary walks us through the study design. The analysis over one year of JVIR articles had two goals. Firstly, the study aimed to assess the prevalence of disclosures in US-based IR research. Additionally, the researchers inspected the level of agreement between disclosed financial relationships and open payment data for top-cited image-guided procedure research. Since 2013, the open payment data has been available on the CMS Open Payment database. Key results showed that disclosures were reported in 29% of JVIR publications in 2019. When comparing reported versus actual financial relationships, it was found that 97% of researchers failed to disclose at least one active financial relationship. Furthermore, there was an average of $58k in undisclosed payments for each publication. Finally, we discuss important takeaways from this study. While industry support is a necessary driver of IR device innovation and practice building, it can influence research agendas. Dr. Makary advises all IRs to be cognizant of the underreporting of financial relationships and how this could make authors implicitly or explicitly biased in their research. He advocates for the construction of an open global registry that automatically links payment information to research disclosures. --- RESOURCES Potential Bias in Image-Guided Procedure Research: A Retrospective Analysis of Disclosed Conflicts of Interest and Open Payment Records: https://pubmed.ncbi.nlm.nih.gov/34756998/ In Science We Trust? (A response to the above study): https://www.jvir.org/article/S1051-0443(21)01446-9/fulltext CMS Open Payments Database: https://openpaymentsdata.cms.gov/ Fri, 25 Mar 2022 05:00:00 -0000 full BackTable Aparna Baheti and J. Michael Barraza Jr. talk with Dr Mina Makary about what constitutes a conflict of interest, and how we can reduce bias in research without stifling innovation. Our hosts Dr. Aparna Baheti and Dr. Michael Barraza talk with Dr. Mina Makary about what constitutes a conflict of interest, and how we can reduce bias in research without stifling innovation. Reflect on how this Podcast applies to your day-to-day and engage to earn AMA PRA Category 1 Credit(s)™ via point-of-care learning activities here: https://earnc.me/WV7gzp --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES In this episode, our hosts Dr. Ally Behati and Dr. Michael Barraza interview Dr. Mina Makary about his recent article with the Applied Ethics in IR Working Group about physician conflicts of interest and disclosures in image-guided research publications. Dr. Makary walks us through the study design. The analysis over one year of JVIR articles had two goals. Firstly, the study aimed to assess the prevalence of disclosures in US-based IR research. Additionally, the researchers inspected the level of agreement between disclosed financial relationships and open payment data for top-cited image-guided procedure research. Since 2013, the open payment data has been available on the CMS Open Payment database. Key results showed that disclosures were reported in 29% of JVIR publications in 2019. When comparing reported versus actual financial relationships, it was found that 97% of researchers failed to disclose at least one active financial relationship. Furthermore, there was an average of $58k in undisclosed payments for each publication. Finally, we discuss important takeaways from this study. While industry support is a necessary driver of IR device innovation and practice building, it can influence research agendas. Dr. Makary advises all IRs to be cognizant of the underreporting of financial relationships and how this could make authors implicitly or explicitly biased in their research. He advocates for the construction of an open global registry that automatically links payment information to research disclosures. --- RESOURCES Potential Bias in Image-Guided Procedure Research: A Retrospective Analysis of Disclosed Conflicts of Interest and Open Payment Records: https://pubmed.ncbi.nlm.nih.gov/34756998/ In Science We Trust? (A response to the above study): https://www.jvir.org/article/S1051-0443(21)01446-9/fulltext CMS Open Payments Database: https://openpaymentsdata.cms.gov/ Our hosts Dr. Aparna Baheti and Dr. Michael Barraza talk with Dr. Mina Makary about what constitutes a conflict of interest, and how we can reduce bias in research without stifling innovation.


Reflect on how this Podcast applies to your day-to-day and engage to earn AMA PRA Category 1 Credit(s)™ via point-of-care learning activities here: https://earnc.me/WV7gzp


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


SHOW NOTES


In this episode, our hosts Dr. Ally Behati and Dr. Michael Barraza interview Dr. Mina Makary about his recent article with the Applied Ethics in IR Working Group about physician conflicts of interest and disclosures in image-guided research publications.


Dr. Makary walks us through the study design. The analysis over one year of JVIR articles had two goals. Firstly, the study aimed to assess the prevalence of disclosures in US-based IR research. Additionally, the researchers inspected the level of agreement between disclosed financial relationships and open payment data for top-cited image-guided procedure research. Since 2013, the open payment data has been available on the CMS Open Payment database.


Key results showed that disclosures were reported in 29% of JVIR publications in 2019. When comparing reported versus actual financial relationships, it was found that 97% of researchers failed to disclose at least one active financial relationship. Furthermore, there was an average of $58k in undisclosed payments for each publication.


Finally, we discuss important takeaways from this study. While industry support is a necessary driver of IR device innovation and practice building, it can influence research agendas. Dr. Makary advises all IRs to be cognizant of the underreporting of financial relationships and how this could make authors implicitly or explicitly biased in their research. He advocates for the construction of an open global registry that automatically links payment information to research disclosures.



---


RESOURCES


Potential Bias in Image-Guided Procedure Research: A Retrospective Analysis of Disclosed Conflicts of Interest and Open Payment Records:

https://pubmed.ncbi.nlm.nih.gov/34756998/


In Science We Trust? (A response to the above study):

https://www.jvir.org/article/S1051-0443(21)01446-9/fulltext


CMS Open Payments Database:

https://openpaymentsdata.cms.gov/

]]> 1811 How We Talk About Race, and the Language of Oppression with Tawny Newsome and Elaine Martin Dr. Vishal Kumar invites Tawny Newsome and Elaine Martin to the show to discuss how we talk about race, and the language of oppression. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rnCu1p --- SHOW NOTES We begin by discussing the JAMA tweet from 2021, reading “No physician is racist, so how can there be structural racism in health care?”. Newsome relates this to arguments she hears often from the tech industry stating that algorithms and computers cannot be racist. She adds that humans created the programs and wrote the medical journals, which means that biases will be present, and that neither computers nor physicians are entirely objective, and both can indeed be racist. Next, the three discuss the power of language, and the critical relationship of language and the biases we hold. Elaine Martin speaks to her experience as a nurse in San Francisco, and what she notices about the language that is used when interacting with patients. She reflects on how medical providers' choice of language can be dismissive or hurtful to patients. She shares experiences from her family members interactions with medical providers, and how she has learned to communicate with patients differently based on these experiences. They discuss a New York Times article by Rachel Gross about the linguistic origins of the pudendal nerve and its ties to patients with pudendal neuralgia who feel shame due to their condition. Finally, our guests give advice to current medical trainees. They discuss how we can examine our current structures and systems and change them where we identify problems. They express their hope that future generations of medical providers will take the time to examine their biases and dismantle harmful and dismissive treatment of marginalized groups. --- RESOURCES Tawny Newsome's Instagram, Twitter: @trondynewman, Subscribe to Tawny's podcasts: @suboptimalpods Yo, Is This Racist? Instagram, Twitter: @yoisthisracist Elaine Martin LinkedIn: https://www.linkedin.com/in/elaine-martin-4b618128/ JAMA: https://jamanetwork.com/journals/jama Taking the 'Shame Part' Out of Female Anatomy by Rachel Gross: https://www.nytimes.com/2021/09/21/science/pudendum-women-anatomy.html Vishal Kumar, MD: https://radiology.ucsf.edu/people/vishal-kumar Mon, 21 Mar 2022 05:00:00 -0000 full BackTable Dr. Vishal Kumar invites Tawny Newsome and Elaine Martin to the show to discuss how we talk about race, and the language of oppression. Dr. Vishal Kumar invites Tawny Newsome and Elaine Martin to the show to discuss how we talk about race, and the language of oppression. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rnCu1p --- SHOW NOTES We begin by discussing the JAMA tweet from 2021, reading “No physician is racist, so how can there be structural racism in health care?”. Newsome relates this to arguments she hears often from the tech industry stating that algorithms and computers cannot be racist. She adds that humans created the programs and wrote the medical journals, which means that biases will be present, and that neither computers nor physicians are entirely objective, and both can indeed be racist. Next, the three discuss the power of language, and the critical relationship of language and the biases we hold. Elaine Martin speaks to her experience as a nurse in San Francisco, and what she notices about the language that is used when interacting with patients. She reflects on how medical providers' choice of language can be dismissive or hurtful to patients. She shares experiences from her family members interactions with medical providers, and how she has learned to communicate with patients differently based on these experiences. They discuss a New York Times article by Rachel Gross about the linguistic origins of the pudendal nerve and its ties to patients with pudendal neuralgia who feel shame due to their condition. Finally, our guests give advice to current medical trainees. They discuss how we can examine our current structures and systems and change them where we identify problems. They express their hope that future generations of medical providers will take the time to examine their biases and dismantle harmful and dismissive treatment of marginalized groups. --- RESOURCES Tawny Newsome's Instagram, Twitter: @trondynewman, Subscribe to Tawny's podcasts: @suboptimalpods Yo, Is This Racist? Instagram, Twitter: @yoisthisracist Elaine Martin LinkedIn: https://www.linkedin.com/in/elaine-martin-4b618128/ JAMA: https://jamanetwork.com/journals/jama Taking the 'Shame Part' Out of Female Anatomy by Rachel Gross: https://www.nytimes.com/2021/09/21/science/pudendum-women-anatomy.html Vishal Kumar, MD: https://radiology.ucsf.edu/people/vishal-kumar Dr. Vishal Kumar invites Tawny Newsome and Elaine Martin to the show to discuss how we talk about race, and the language of oppression.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rnCu1p


---


SHOW NOTES


We begin by discussing the JAMA tweet from 2021, reading “No physician is racist, so how can there be structural racism in health care?”. Newsome relates this to arguments she hears often from the tech industry stating that algorithms and computers cannot be racist. She adds that humans created the programs and wrote the medical journals, which means that biases will be present, and that neither computers nor physicians are entirely objective, and both can indeed be racist.


Next, the three discuss the power of language, and the critical relationship of language and the biases we hold. Elaine Martin speaks to her experience as a nurse in San Francisco, and what she notices about the language that is used when interacting with patients. She reflects on how medical providers' choice of language can be dismissive or hurtful to patients. She shares experiences from her family members interactions with medical providers, and how she has learned to communicate with patients differently based on these experiences. They discuss a New York Times article by Rachel Gross about the linguistic origins of the pudendal nerve and its ties to patients with pudendal neuralgia who feel shame due to their condition.


Finally, our guests give advice to current medical trainees. They discuss how we can examine our current structures and systems and change them where we identify problems. They express their hope that future generations of medical providers will take the time to examine their biases and dismantle harmful and dismissive treatment of marginalized groups.


---


RESOURCES


Tawny Newsome's Instagram, Twitter: @trondynewman,

Subscribe to Tawny's podcasts: @suboptimalpods

Yo, Is This Racist? Instagram, Twitter: @yoisthisracist

Elaine Martin LinkedIn: https://www.linkedin.com/in/elaine-martin-4b618128/

JAMA: https://jamanetwork.com/journals/jama

Taking the 'Shame Part' Out of Female Anatomy by Rachel Gross: https://www.nytimes.com/2021/09/21/science/pudendum-women-anatomy.html

Vishal Kumar, MD: https://radiology.ucsf.edu/people/vishal-kumar

]]> 2116 Ep. 194 Financial Basics from the White Coat Investor with Dr. James Dahle Special guest The White Coat Investor James M. Dahle talks with Christopher Beck about where physicians can start when it comes to financial literacy, including common financial mistakes docs make when start practicing, a primer on mortgage rates, and tips on insurance. --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- SHOW NOTES In this episode, White Coat Investor founder Dr. James Dahle and our host Dr. Chris Beck discuss strategies for physicians seeking to manage their personal finances and gain financial freedom. First, Dr. Dahle explains the reasoning behind the famous quote, “live like a resident.” He explains that for an early career physician, their greatest wealth-building tool is their income. The income jump from residency to attending years can be extremely useful for quickly paying off student loans. Then, he moves on to discuss another way to resolve student debt, the Public Service Loan Forgiveness (PSLF) program. This option is ideal for physicians who have spent a significant amount of time working for a nonprofit institution (for example, during training and in academic medicine). Dr. Dahle advises all physicians to reflect on their priorities when deciding where to allocate their assets. Possible categories could include retirement funds, 529 college savings funds, payment of high-interest debt, and emergency funds. We talk about the power of having a written plan to stay on track with financial goals and prevent ourselves from making rash decisions. Next, we discuss different financial vehicles that can provide benefits for physicians. The “back door Roth IRA” strategy allows for yearly contributions to a tax-free retirement fund, even when a physician’s income exceeds the maximum limit for the conventional Roth IRA. Additionally, the funds in a Health Savings Account (HSA) can be used for investment, and then withdrawn at a later date, penalty-free. Dr. Dahle explains the difference between fixed rate and variable rate mortgages, noting that the latter is better for short-term loans because interest rates are unlikely to dramatically increase from year to year. Finally, Dr. Dahle covers the advantages of buying disability insurance as a way to protect physician income, especially for those working in procedural specialties. --- RESOURCES White Coat Investor: https://www.whitecoatinvestor.com/ White Coat Investor Podcast: https://www.whitecoatinvestor.com/wci-podcast/ White Coat Investor Email: editor@whitecoatinvestor.com Passive Income MD: https://passiveincomemd.com/ Physician on FIRE: https://www.physicianonfire.com/ Fri, 18 Mar 2022 05:00:00 -0000 full BackTable Special guest The White Coat Investor James M. Dahle talks with Christopher Beck about where physicians can start when it comes to financial literacy, including common financial mistakes docs make when start practicing, a primer on mortgage rates, and tips on insurance. Special guest The White Coat Investor James M. Dahle talks with Christopher Beck about where physicians can start when it comes to financial literacy, including common financial mistakes docs make when start practicing, a primer on mortgage rates, and tips on insurance. --- CHECK OUT OUR SPONSOR DI4MDs Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637. --- SHOW NOTES In this episode, White Coat Investor founder Dr. James Dahle and our host Dr. Chris Beck discuss strategies for physicians seeking to manage their personal finances and gain financial freedom. First, Dr. Dahle explains the reasoning behind the famous quote, “live like a resident.” He explains that for an early career physician, their greatest wealth-building tool is their income. The income jump from residency to attending years can be extremely useful for quickly paying off student loans. Then, he moves on to discuss another way to resolve student debt, the Public Service Loan Forgiveness (PSLF) program. This option is ideal for physicians who have spent a significant amount of time working for a nonprofit institution (for example, during training and in academic medicine). Dr. Dahle advises all physicians to reflect on their priorities when deciding where to allocate their assets. Possible categories could include retirement funds, 529 college savings funds, payment of high-interest debt, and emergency funds. We talk about the power of having a written plan to stay on track with financial goals and prevent ourselves from making rash decisions. Next, we discuss different financial vehicles that can provide benefits for physicians. The “back door Roth IRA” strategy allows for yearly contributions to a tax-free retirement fund, even when a physician’s income exceeds the maximum limit for the conventional Roth IRA. Additionally, the funds in a Health Savings Account (HSA) can be used for investment, and then withdrawn at a later date, penalty-free. Dr. Dahle explains the difference between fixed rate and variable rate mortgages, noting that the latter is better for short-term loans because interest rates are unlikely to dramatically increase from year to year. Finally, Dr. Dahle covers the advantages of buying disability insurance as a way to protect physician income, especially for those working in procedural specialties. --- RESOURCES White Coat Investor: https://www.whitecoatinvestor.com/ White Coat Investor Podcast: https://www.whitecoatinvestor.com/wci-podcast/ White Coat Investor Email: editor@whitecoatinvestor.com Passive Income MD: https://passiveincomemd.com/ Physician on FIRE: https://www.physicianonfire.com/ Special guest The White Coat Investor James M. Dahle talks with Christopher Beck about where physicians can start when it comes to financial literacy, including common financial mistakes docs make when start practicing, a primer on mortgage rates, and tips on insurance.


---


CHECK OUT OUR SPONSOR


DI4MDs

Protect your most valuable asset, the skill and ability to practice your medical specialty. Be prepared by establishing a specialty specific disability insurance policy from the experts at DI4MDs. Contact them today at www.Di4MDS.com or call 888-934-4637.


---


SHOW NOTES


In this episode, White Coat Investor founder Dr. James Dahle and our host Dr. Chris Beck discuss strategies for physicians seeking to manage their personal finances and gain financial freedom.


First, Dr. Dahle explains the reasoning behind the famous quote, “live like a resident.” He explains that for an early career physician, their greatest wealth-building tool is their income. The income jump from residency to attending years can be extremely useful for quickly paying off student loans. Then, he moves on to discuss another way to resolve student debt, the Public Service Loan Forgiveness (PSLF) program. This option is ideal for physicians who have spent a significant amount of time working for a nonprofit institution (for example, during training and in academic medicine).


Dr. Dahle advises all physicians to reflect on their priorities when deciding where to allocate their assets. Possible categories could include retirement funds, 529 college savings funds, payment of high-interest debt, and emergency funds. We talk about the power of having a written plan to stay on track with financial goals and prevent ourselves from making rash decisions.


Next, we discuss different financial vehicles that can provide benefits for physicians. The “back door Roth IRA” strategy allows for yearly contributions to a tax-free retirement fund, even when a physician’s income exceeds the maximum limit for the conventional Roth IRA. Additionally, the funds in a Health Savings Account (HSA) can be used for investment, and then withdrawn at a later date, penalty-free. Dr. Dahle explains the difference between fixed rate and variable rate mortgages, noting that the latter is better for short-term loans because interest rates are unlikely to dramatically increase from year to year. Finally, Dr. Dahle covers the advantages of buying disability insurance as a way to protect physician income, especially for those working in procedural specialties.


---


RESOURCES


White Coat Investor:

https://www.whitecoatinvestor.com/


White Coat Investor Podcast:

https://www.whitecoatinvestor.com/wci-podcast/


White Coat Investor Email:

editor@whitecoatinvestor.com


Passive Income MD:

https://passiveincomemd.com/


Physician on FIRE:

https://www.physicianonfire.com/

]]> 3653 Ep. 193 Managing Supplies in your Outpatient Facility with Dr. Krishna Mannava and Chas Sanders Vascular surgeon Krishna Mannava and Chas Sanders (founder of MARGIN) discuss their approach to choosing which disposables and devices to stock up on in the outpatient facility, and how to plan for supply chain issues. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/M9ARhf --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews Dr. Krishna Mannava, vascular surgeon and owner of Vive Vascular and Chas Sanders, founder and CEO of MARGIN, LLC about supply chain in an office-based lab (OBL), focusing on disposables and how to pivot amidst impending reimbursement cuts. The three start by discussing how Dr. Mannava chose to source equipment when building his OBL. He was introduced to Chas Sanders of MARGIN through his advisory firm as they were looking at ways to approach vendors and build inventory. Chas advises against all inclusive packages with one company. Dr. Mannava states that MARGIN has not only helped him get good deals on equipment, but they have mediated relationships with companies and sales reps which has been crucial for him. Next, they discuss supply chain issues and the impact on healthcare and Vive Vascular. Chas believes the best way to offset this is by not putting all your eggs in one basket. For an OBL, it is better to have a surplus of disposables and throw some out rather than cancel a surgery due to a backorder or recall. Chas shares his thoughts on Management Service Organizations (MSOs) for shared resources, stating that while they can be helpful with sourcing and pricing of supplies, an MSO takes around 10% of revenue which for many OBLs means paying for more than you need. They also discuss the future of multispecialty endovascular centers, and the potential for physician collaboration. Finally, they discuss reimbursement cuts and how to compensate for this loss. Chas recommends reassessing products, evaluating procedure mix and looking at capacity, as these can all be adjusted to improve profits. Dr. Mannava adds that front desk personnel can help by ensuring insurance, coding and charges are accurate. --- RESOURCES Vive Vascular: https://www.vivevascular.com MARGIN, LLC: https://www.margin.care Mon, 14 Mar 2022 04:00:00 -0000 full BackTable Vascular surgeon Krishna Mannava and Chas Sanders (founder of MARGIN) discuss their approach to choosing which disposables and devices to stock up on in the outpatient facility, and how to plan for supply chain issues. Vascular surgeon Krishna Mannava and Chas Sanders (founder of MARGIN) discuss their approach to choosing which disposables and devices to stock up on in the outpatient facility, and how to plan for supply chain issues. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/M9ARhf --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews Dr. Krishna Mannava, vascular surgeon and owner of Vive Vascular and Chas Sanders, founder and CEO of MARGIN, LLC about supply chain in an office-based lab (OBL), focusing on disposables and how to pivot amidst impending reimbursement cuts. The three start by discussing how Dr. Mannava chose to source equipment when building his OBL. He was introduced to Chas Sanders of MARGIN through his advisory firm as they were looking at ways to approach vendors and build inventory. Chas advises against all inclusive packages with one company. Dr. Mannava states that MARGIN has not only helped him get good deals on equipment, but they have mediated relationships with companies and sales reps which has been crucial for him. Next, they discuss supply chain issues and the impact on healthcare and Vive Vascular. Chas believes the best way to offset this is by not putting all your eggs in one basket. For an OBL, it is better to have a surplus of disposables and throw some out rather than cancel a surgery due to a backorder or recall. Chas shares his thoughts on Management Service Organizations (MSOs) for shared resources, stating that while they can be helpful with sourcing and pricing of supplies, an MSO takes around 10% of revenue which for many OBLs means paying for more than you need. They also discuss the future of multispecialty endovascular centers, and the potential for physician collaboration. Finally, they discuss reimbursement cuts and how to compensate for this loss. Chas recommends reassessing products, evaluating procedure mix and looking at capacity, as these can all be adjusted to improve profits. Dr. Mannava adds that front desk personnel can help by ensuring insurance, coding and charges are accurate. --- RESOURCES Vive Vascular: https://www.vivevascular.com MARGIN, LLC: https://www.margin.care Vascular surgeon Krishna Mannava and Chas Sanders (founder of MARGIN) discuss their approach to choosing which disposables and devices to stock up on in the outpatient facility, and how to plan for supply chain issues.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/M9ARhf


---


SHOW NOTES


In this episode, host Dr. Aaron Fritts interviews Dr. Krishna Mannava, vascular surgeon and owner of Vive Vascular and Chas Sanders, founder and CEO of MARGIN, LLC about supply chain in an office-based lab (OBL), focusing on disposables and how to pivot amidst impending reimbursement cuts.


The three start by discussing how Dr. Mannava chose to source equipment when building his OBL. He was introduced to Chas Sanders of MARGIN through his advisory firm as they were looking at ways to approach vendors and build inventory. Chas advises against all inclusive packages with one company. Dr. Mannava states that MARGIN has not only helped him get good deals on equipment, but they have mediated relationships with companies and sales reps which has been crucial for him.


Next, they discuss supply chain issues and the impact on healthcare and Vive Vascular. Chas believes the best way to offset this is by not putting all your eggs in one basket. For an OBL, it is better to have a surplus of disposables and throw some out rather than cancel a surgery due to a backorder or recall. Chas shares his thoughts on Management Service Organizations (MSOs) for shared resources, stating that while they can be helpful with sourcing and pricing of supplies, an MSO takes around 10% of revenue which for many OBLs means paying for more than you need. They also discuss the future of multispecialty endovascular centers, and the potential for physician collaboration.


Finally, they discuss reimbursement cuts and how to compensate for this loss. Chas recommends reassessing products, evaluating procedure mix and looking at capacity, as these can all be adjusted to improve profits. Dr. Mannava adds that front desk personnel can help by ensuring insurance, coding and charges are accurate.



---


RESOURCES


Vive Vascular:

https://www.vivevascular.com


MARGIN, LLC:

https://www.margin.care

]]> 3059 Edición Esp: Enfermedad Arterial Periférica y Salvamento de Extremidades en la Comunidad Latino Americana con Dr. Miguel Montero-Baker En este episodio de BackTable Español, Dra. Gina Landinez entrevista a Dr. Miguel Montero-Baker sobre la enfermidad arterial periférica y salvamento de extremidades en la comunidad latinoamericana. In this episode of BackTable Español, Dr. Gina Landinez interviews Dr. Miguel Montero about peripheral arterial disease and limb salvage in the Latin American community. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/nKsjxN --- SHOW NOTES Los dos doctores discuten el camino de Dr. Montero-Baker a convirtirse en un Cirujano vascular enfocado en el salvamento de extremidades, su experiencia de construir un centro de preservación, y diferencias culturales entre los pacientes latinoamericanos y estadounidenses. Además Dr. Montero-Baker comparte sus consejos sobre sus técnicas, su equipo preferido, y como superó los retos institucionales para empezar un programa del salvamento extremidad. Finalmente, él enfatiza la importancia de la prevención y la educación del paciente sobre la enfermedad arterial periférica. The two doctors discuss Dr. Montero's path to becoming an interventional radiologist focused on limb salvage, his experience building a preservation center, and cultural differences between Latin American and US patients. Additionally, Dr. Montero shares his advice on his techniques, his preferred equipment, and how he overcame institutional challenges to start a limb salvage program. Finally, he emphasizes the importance of prevention and patient education about peripheral arterial disease. Fri, 11 Mar 2022 05:00:00 -0000 full BackTable En este episodio de BackTable Español, Dra. Gina Landinez entrevista a Dr. Miguel Montero-Baker sobre la enfermidad arterial periférica y salvamento de extremidades en la comunidad latinoamericana. En este episodio de BackTable Español, Dra. Gina Landinez entrevista a Dr. Miguel Montero-Baker sobre la enfermidad arterial periférica y salvamento de extremidades en la comunidad latinoamericana. In this episode of BackTable Español, Dr. Gina Landinez interviews Dr. Miguel Montero about peripheral arterial disease and limb salvage in the Latin American community. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/nKsjxN --- SHOW NOTES Los dos doctores discuten el camino de Dr. Montero-Baker a convirtirse en un Cirujano vascular enfocado en el salvamento de extremidades, su experiencia de construir un centro de preservación, y diferencias culturales entre los pacientes latinoamericanos y estadounidenses. Además Dr. Montero-Baker comparte sus consejos sobre sus técnicas, su equipo preferido, y como superó los retos institucionales para empezar un programa del salvamento extremidad. Finalmente, él enfatiza la importancia de la prevención y la educación del paciente sobre la enfermedad arterial periférica. The two doctors discuss Dr. Montero's path to becoming an interventional radiologist focused on limb salvage, his experience building a preservation center, and cultural differences between Latin American and US patients. Additionally, Dr. Montero shares his advice on his techniques, his preferred equipment, and how he overcame institutional challenges to start a limb salvage program. Finally, he emphasizes the importance of prevention and patient education about peripheral arterial disease. En este episodio de BackTable Español, Dra. Gina Landinez entrevista a Dr. Miguel Montero-Baker sobre la enfermidad arterial periférica y salvamento de extremidades en la comunidad latinoamericana.


In this episode of BackTable Español, Dr. Gina Landinez interviews Dr. Miguel Montero about peripheral arterial disease and limb salvage in the Latin American community.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/nKsjxN


---


SHOW NOTES


Los dos doctores discuten el camino de Dr. Montero-Baker a convirtirse en un Cirujano vascular enfocado en el salvamento de extremidades, su experiencia de construir un centro de preservación, y diferencias culturales entre los pacientes latinoamericanos y estadounidenses. Además Dr. Montero-Baker comparte sus consejos sobre sus técnicas, su equipo preferido, y como superó los retos institucionales para empezar un programa del salvamento extremidad. Finalmente, él enfatiza la importancia de la prevención y la educación del paciente sobre la enfermedad arterial periférica.


The two doctors discuss Dr. Montero's path to becoming an interventional radiologist focused on limb salvage, his experience building a preservation center, and cultural differences between Latin American and US patients. Additionally, Dr. Montero shares his advice on his techniques, his preferred equipment, and how he overcame institutional challenges to start a limb salvage program. Finally, he emphasizes the importance of prevention and patient education about peripheral arterial disease.

]]> 3822 Ep. 192 Going All In on the OBL and Finding Your Ikigai with Dr. John Lipman In this episode we talk with Dr. John Lipman about his journey to going solo and opening an Outpatient Based Lab (OBL) dedicated to minimally invasive women's interventions, including Uterine Fibroid Embolization (UFE). John also gives us advice on the importance of finding your Ikigai in practice, the secret to a long and happy career! --- CHECK OUT OUR SPONSORS Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- SHOW NOTES In this episode, interventional radiologist Dr. John Lipman joins host Dr. Aaron Fritts to discuss how he came to be one of the first IRs to own an office-based lab (OBL) and how he decided to specialize in uterine fibroid embolization (UFE). Dr. Lipman begins by discussing his path to independent practice. After training at Georgetown, Brigham and Women’s and Yale, he worked in a private practice in Atlanta. In 2004, after 14 years and a growing desire to be an independent IR, he found a hospital to partner with where he could work independently. He started with professional fees only before landing a 50/50 joint venture deal with the hospital. He installed an MRI and angio suite and used a retired ER for his recovery rooms. In 2015 he opened his OBL, the Atlanta Fibroid Center. He was able to lease equipment and buy the real estate with loans and capital he had from his prior practice. He decided to specialize in uterine fibroid embolization for his practice rather than performing a variety of procedures. He says that ultimately, he decided to specialize in what he was most passionate about. The two discuss how Dr. Lipman received enormous pushback and criticism from many who thought opening a center that only offered one procedure was impossible. He used the antagonism as fuel, and after consulting women's groups in Atlanta he opened an OBL that focused on quality and privacy. Dr. Lipman ends by discussing how OBLs are the future of medicine and that they are a method for physicians to take back ownership of medicine from hospital administrators and recover the patient physician relationship. --- RESOURCES Outpatient Endovascular and Interventional Society: https://oeisociety.com Atlanta Fibroid Center: https://atlii.com/ Mon, 07 Mar 2022 05:00:00 -0000 full BackTable In this episode we talk with John Lipman, MD, FSIR about his journey to going solo and opening an Outpatient Based Lab (OBL) dedicated to minimally invasive women's interventions, including Uterine Fibroid Embolization (UFE). John also gives us advice on the importance of finding your Ikigai in practice, the secret to a long and happy career! In this episode we talk with Dr. John Lipman about his journey to going solo and opening an Outpatient Based Lab (OBL) dedicated to minimally invasive women's interventions, including Uterine Fibroid Embolization (UFE). John also gives us advice on the importance of finding your Ikigai in practice, the secret to a long and happy career! --- CHECK OUT OUR SPONSORS Boston Scientific Nextlab https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040 Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- SHOW NOTES In this episode, interventional radiologist Dr. John Lipman joins host Dr. Aaron Fritts to discuss how he came to be one of the first IRs to own an office-based lab (OBL) and how he decided to specialize in uterine fibroid embolization (UFE). Dr. Lipman begins by discussing his path to independent practice. After training at Georgetown, Brigham and Women’s and Yale, he worked in a private practice in Atlanta. In 2004, after 14 years and a growing desire to be an independent IR, he found a hospital to partner with where he could work independently. He started with professional fees only before landing a 50/50 joint venture deal with the hospital. He installed an MRI and angio suite and used a retired ER for his recovery rooms. In 2015 he opened his OBL, the Atlanta Fibroid Center. He was able to lease equipment and buy the real estate with loans and capital he had from his prior practice. He decided to specialize in uterine fibroid embolization for his practice rather than performing a variety of procedures. He says that ultimately, he decided to specialize in what he was most passionate about. The two discuss how Dr. Lipman received enormous pushback and criticism from many who thought opening a center that only offered one procedure was impossible. He used the antagonism as fuel, and after consulting women's groups in Atlanta he opened an OBL that focused on quality and privacy. Dr. Lipman ends by discussing how OBLs are the future of medicine and that they are a method for physicians to take back ownership of medicine from hospital administrators and recover the patient physician relationship. --- RESOURCES Outpatient Endovascular and Interventional Society: https://oeisociety.com Atlanta Fibroid Center: https://atlii.com/ In this episode we talk with Dr. John Lipman about his journey to going solo and opening an Outpatient Based Lab (OBL) dedicated to minimally invasive women's interventions, including Uterine Fibroid Embolization (UFE). John also gives us advice on the importance of finding your Ikigai in practice, the secret to a long and happy career!


---


CHECK OUT OUR SPONSORS


Boston Scientific Nextlab

https://www.bostonscientific.com/en-US/nextlab.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-nextlab-hci&utm_content=n-backtable-n-backtable_site_nextlab_1&cid=n10008040


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


Accountable Revenue Cycle Solutions

https://www.accountablerevcycle.com/


---


SHOW NOTES


In this episode, interventional radiologist Dr. John Lipman joins host Dr. Aaron Fritts to discuss how he came to be one of the first IRs to own an office-based lab (OBL) and how he decided to specialize in uterine fibroid embolization (UFE).


Dr. Lipman begins by discussing his path to independent practice. After training at Georgetown, Brigham and Women’s and Yale, he worked in a private practice in Atlanta. In 2004, after 14 years and a growing desire to be an independent IR, he found a hospital to partner with where he could work independently. He started with professional fees only before landing a 50/50 joint venture deal with the hospital. He installed an MRI and angio suite and used a retired ER for his recovery rooms.


In 2015 he opened his OBL, the Atlanta Fibroid Center. He was able to lease equipment and buy the real estate with loans and capital he had from his prior practice. He decided to specialize in uterine fibroid embolization for his practice rather than performing a variety of procedures. He says that ultimately, he decided to specialize in what he was most passionate about.


The two discuss how Dr. Lipman received enormous pushback and criticism from many who thought opening a center that only offered one procedure was impossible. He used the antagonism as fuel, and after consulting women's groups in Atlanta he opened an OBL that focused on quality and privacy. Dr. Lipman ends by discussing how OBLs are the future of medicine and that they are a method for physicians to take back ownership of medicine from hospital administrators and recover the patient physician relationship.


---


RESOURCES


Outpatient Endovascular and Interventional Society:

https://oeisociety.com


Atlanta Fibroid Center:

https://atlii.com/

]]> 2356 Ep. 191 Novel Techniques for Arterial Thrombectomy: Large Bore and Beyond with Dr. S. Jay Mathews In this episode, Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist S. Jay Mathews about novel techniques for arterial thrombectomy, including a discussion on using large bore devices, a variety of technique tips and tricks, and what's on the horizon for new devices/techniques. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES In this episode, interventional cardiologist Dr. S. Jay Mathews and our host Dr. Sabeen Dhand discuss various devices used in arterial thrombectomy, including large bore aspiration catheters, the preclose system, separators, and stentrievers. Dr. Mathews clarifies the definition of “large bore” as a catheter that is 8 Fr or larger. He notes these devices face some resistance in the interventional community, due the belief that arteries may be size prohibitive. However, he notes that the pre-close systems make arterial closure very feasible. Large bore catheters are able to achieve higher aspiration force compared to smaller catheters. Dr. Mathews prefers to use the Lightning 7 or 12 systems from Penumbra because of their angled/atraumatic catheter tips and their flexibility in navigation. In cases of highly organized thrombus, Dr. Mathews may use separators to break up the clot into smaller and more manageable parts. He also speaks about using filters to capture the clot, but always in conjunction with aspiration, to prevent distal embolization. The doctors also discuss the role of thrombolysis. Although thrombolysis procedure time is shorter than that of thrombectomy, patients remain ischemic for longer, leading to more reperfusion symptoms. Before placing a lysis catheter, Dr. Mathews recommends re-establishing some flow and creating a channel for more effective delivery of tPA. Finally, we talk about new research in thrombus morphology and how this will affect future innovation in ultrasonic energy and nano-magnetic particles. --- RESOURCES Penumbra Lightning Catheter: https://www.penumbrainc.com/indigo-lightning/ Noninvasive thrombectomy of graft by nano-magnetic ablating particles: https://www.nature.com/articles/s41598-021-86291-2 Fri, 04 Mar 2022 06:00:00 -0000 full BackTable In this episode, Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist S. Jay Mathews, MD, MS, FACC about novel techniques for arterial thrombectomy, including a discussion on using large bore devices, a variety of technique tips and tricks, and what's on the horizon. In this episode, Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist S. Jay Mathews about novel techniques for arterial thrombectomy, including a discussion on using large bore devices, a variety of technique tips and tricks, and what's on the horizon for new devices/techniques. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES In this episode, interventional cardiologist Dr. S. Jay Mathews and our host Dr. Sabeen Dhand discuss various devices used in arterial thrombectomy, including large bore aspiration catheters, the preclose system, separators, and stentrievers. Dr. Mathews clarifies the definition of “large bore” as a catheter that is 8 Fr or larger. He notes these devices face some resistance in the interventional community, due the belief that arteries may be size prohibitive. However, he notes that the pre-close systems make arterial closure very feasible. Large bore catheters are able to achieve higher aspiration force compared to smaller catheters. Dr. Mathews prefers to use the Lightning 7 or 12 systems from Penumbra because of their angled/atraumatic catheter tips and their flexibility in navigation. In cases of highly organized thrombus, Dr. Mathews may use separators to break up the clot into smaller and more manageable parts. He also speaks about using filters to capture the clot, but always in conjunction with aspiration, to prevent distal embolization. The doctors also discuss the role of thrombolysis. Although thrombolysis procedure time is shorter than that of thrombectomy, patients remain ischemic for longer, leading to more reperfusion symptoms. Before placing a lysis catheter, Dr. Mathews recommends re-establishing some flow and creating a channel for more effective delivery of tPA. Finally, we talk about new research in thrombus morphology and how this will affect future innovation in ultrasonic energy and nano-magnetic particles. --- RESOURCES Penumbra Lightning Catheter: https://www.penumbrainc.com/indigo-lightning/ Noninvasive thrombectomy of graft by nano-magnetic ablating particles: https://www.nature.com/articles/s41598-021-86291-2 In this episode, Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist S. Jay Mathews about novel techniques for arterial thrombectomy, including a discussion on using large bore devices, a variety of technique tips and tricks, and what's on the horizon for new devices/techniques.


---


CHECK OUT OUR SPONSOR


Boston Scientific Eluvia Drug-Eluting Stent

https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043


---


SHOW NOTES


In this episode, interventional cardiologist Dr. S. Jay Mathews and our host Dr. Sabeen Dhand discuss various devices used in arterial thrombectomy, including large bore aspiration catheters, the preclose system, separators, and stentrievers.


Dr. Mathews clarifies the definition of “large bore” as a catheter that is 8 Fr or larger. He notes these devices face some resistance in the interventional community, due the belief that arteries may be size prohibitive. However, he notes that the pre-close systems make arterial closure very feasible. Large bore catheters are able to achieve higher aspiration force compared to smaller catheters. Dr. Mathews prefers to use the Lightning 7 or 12 systems from Penumbra because of their angled/atraumatic catheter tips and their flexibility in navigation.


In cases of highly organized thrombus, Dr. Mathews may use separators to break up the clot into smaller and more manageable parts. He also speaks about using filters to capture the clot, but always in conjunction with aspiration, to prevent distal embolization.


The doctors also discuss the role of thrombolysis. Although thrombolysis procedure time is shorter than that of thrombectomy, patients remain ischemic for longer, leading to more reperfusion symptoms. Before placing a lysis catheter, Dr. Mathews recommends re-establishing some flow and creating a channel for more effective delivery of tPA.


Finally, we talk about new research in thrombus morphology and how this will affect future innovation in ultrasonic energy and nano-magnetic particles.


---


RESOURCES


Penumbra Lightning Catheter:

https://www.penumbrainc.com/indigo-lightning/


Noninvasive thrombectomy of graft by nano-magnetic ablating particles:

https://www.nature.com/articles/s41598-021-86291-2

]]> 2183 Ep. 190 What Makes a Good Sales Rep-Physician Relationship? With Aaron Weeks The episode begins by discussing the training of a sales rep, which includes learning customer relations, procedure and product details as well as the disease states and anatomy of procedures. Aaron Weeks discusses how a key aspect of sales is understanding product compatibility and knowing what alternatives are available. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/pl1jCp --- SHOW NOTES In this episode, Aaron Weeks, program manager at Cook Medical joins host Dr. Aaron Fritts to discuss what it takes to become a sales rep, qualities of a good sales rep, and how to establish customer rapport. The episode begins by discussing the training of a sales rep, which includes learning customer relations, procedure and product details as well as the disease states and anatomy of procedures. Aaron Weeks discusses how a key aspect of sales is understanding product compatibility and knowing what alternatives are available. The speakers discuss degrees and pay next, and Weeks clarifies that an MBA is not a requirement. He says around half of IR sales reps now were previously techs or nurses because they know the procedures well, making them great trainees and knowledgeable reps. Pay is variable, but often starts as a base salary when training, with quotas or other incentives added later on. Next, the speakers discuss what qualities make a good sales rep and pitfalls to avoid on the job. Weeks notes the importance of emotional intelligence and being able to read the room. He notes that those who are easily frustrated or trying to make a quick sale will not be as successful. The speakers agree that one of the biggest strengths of a good sales rep is knowing their product's limitations and when to step away. The speakers touch on the difficulties that COVID has placed on the job. Weeks discusses how he stays up to date on current products and techniques being used for the procedures he covers. He says podcasts, virtual society meetings and other digital media outlets have played a key role in this aspect of his job. --- RESOURCES JVIR Website: https://www.jvir.org Salesforce Website: https://www.salesforce.com Cook Medical Website: https://www.cookmedical.com Aaron Weeks Linkedin: https://www.linkedin.com/in/aaron-weeks-753bb1 Mon, 28 Feb 2022 06:00:00 -0000 full BackTable In this episode, Aaron Weeks, program manager at Cook Medical joins host Dr. Aaron Fritts to discuss what it takes to become a sales rep, qualities of a good sales rep, and how to establish customer rapport. The episode begins by discussing the training of a sales rep, which includes learning customer relations, procedure and product details as well as the disease states and anatomy of procedures. Aaron Weeks discusses how a key aspect of sales is understanding product compatibility and knowing what alternatives are available. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/pl1jCp --- SHOW NOTES In this episode, Aaron Weeks, program manager at Cook Medical joins host Dr. Aaron Fritts to discuss what it takes to become a sales rep, qualities of a good sales rep, and how to establish customer rapport. The episode begins by discussing the training of a sales rep, which includes learning customer relations, procedure and product details as well as the disease states and anatomy of procedures. Aaron Weeks discusses how a key aspect of sales is understanding product compatibility and knowing what alternatives are available. The speakers discuss degrees and pay next, and Weeks clarifies that an MBA is not a requirement. He says around half of IR sales reps now were previously techs or nurses because they know the procedures well, making them great trainees and knowledgeable reps. Pay is variable, but often starts as a base salary when training, with quotas or other incentives added later on. Next, the speakers discuss what qualities make a good sales rep and pitfalls to avoid on the job. Weeks notes the importance of emotional intelligence and being able to read the room. He notes that those who are easily frustrated or trying to make a quick sale will not be as successful. The speakers agree that one of the biggest strengths of a good sales rep is knowing their product's limitations and when to step away. The speakers touch on the difficulties that COVID has placed on the job. Weeks discusses how he stays up to date on current products and techniques being used for the procedures he covers. He says podcasts, virtual society meetings and other digital media outlets have played a key role in this aspect of his job. --- RESOURCES JVIR Website: https://www.jvir.org Salesforce Website: https://www.salesforce.com Cook Medical Website: https://www.cookmedical.com Aaron Weeks Linkedin: https://www.linkedin.com/in/aaron-weeks-753bb1 The episode begins by discussing the training of a sales rep, which includes learning customer relations, procedure and product details as well as the disease states and anatomy of procedures. Aaron Weeks discusses how a key aspect of sales is understanding product compatibility and knowing what alternatives are available.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/pl1jCp


---


SHOW NOTES


In this episode, Aaron Weeks, program manager at Cook Medical joins host Dr. Aaron Fritts to discuss what it takes to become a sales rep, qualities of a good sales rep, and how to establish customer rapport.


The episode begins by discussing the training of a sales rep, which includes learning customer relations, procedure and product details as well as the disease states and anatomy of procedures. Aaron Weeks discusses how a key aspect of sales is understanding product compatibility and knowing what alternatives are available.


The speakers discuss degrees and pay next, and Weeks clarifies that an MBA is not a requirement. He says around half of IR sales reps now were previously techs or nurses because they know the procedures well, making them great trainees and knowledgeable reps. Pay is variable, but often starts as a base salary when training, with quotas or other incentives added later on.


Next, the speakers discuss what qualities make a good sales rep and pitfalls to avoid on the job. Weeks notes the importance of emotional intelligence and being able to read the room. He notes that those who are easily frustrated or trying to make a quick sale will not be as successful. The speakers agree that one of the biggest strengths of a good sales rep is knowing their product's limitations and when to step away.


The speakers touch on the difficulties that COVID has placed on the job. Weeks discusses how he stays up to date on current products and techniques being used for the procedures he covers. He says podcasts, virtual society meetings and other digital media outlets have played a key role in this aspect of his job.



---


RESOURCES


JVIR Website: https://www.jvir.org


Salesforce Website: https://www.salesforce.com


Cook Medical Website: https://www.cookmedical.com


Aaron Weeks Linkedin: https://www.linkedin.com/in/aaron-weeks-753bb1

]]> 2713 Centering the Conversation Around Health Equity with Dr. Ayanna Bennett In this episode Dr. Kumar and Dr. Bennett discuss various levels of racism found in healthcare, and share allegories of racism as outlined by Dr. Camara P. Jones, including the gardeners tale. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Y1eaX6 --- SHOW NOTES In this episode, guest host Dr. Vishal Kumar interviews Dr. Ayanna Bennett about how to train ourselves to recognize perpetuated health disparities within the medical system and how we can actively work to dismantle them. The doctors first talk about understanding racism on an institutional level, which results in a “machine” that selectively delivers better and worse aspects of healthcare to different populations. Dr. Bennett emphasizes that every disease process shows race disparities not because of inherent biological differences in racial groups, but because of unequal frequencies and quality of contact with healthcare systems. Throughout the episode, they reference the allegories of Dr. Camara Jones, a physician-epidemiologist and civil rights activist. These allegories provide a framework for discussing nature vs. nurture for health outcomes and also privilege defined as the lack of barriers to entry. In terms of actionable steps that providers can take toward reducing health inequity, Dr. Bennett encourages us to learn and engage with the communities that they serve. She advises us to be “counter-stereotypical” and show interest in patients’ lives outside of the healthcare setting. Finally, she calls us to analyze the impact that our institutions have on maintaining the health of the community as a whole, rather than solely focusing on individual patients. --- RESOURCES The Gardener’s Tale Allegory by Dr. Camara Jones: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446334/ Tedx Talk by Dr. Camara Jones: https://www.youtube.com/watch?v=GNhcY6fTyBM Fri, 25 Feb 2022 06:00:00 -0000 full BackTable In this episode Dr. Kumar and Dr. Bennett discuss various levels of racism found in healthcare, and share allegories of racism as outlined by Dr. Camara P Jones, including the gardener's tale. In this episode Dr. Kumar and Dr. Bennett discuss various levels of racism found in healthcare, and share allegories of racism as outlined by Dr. Camara P. Jones, including the gardeners tale. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Y1eaX6 --- SHOW NOTES In this episode, guest host Dr. Vishal Kumar interviews Dr. Ayanna Bennett about how to train ourselves to recognize perpetuated health disparities within the medical system and how we can actively work to dismantle them. The doctors first talk about understanding racism on an institutional level, which results in a “machine” that selectively delivers better and worse aspects of healthcare to different populations. Dr. Bennett emphasizes that every disease process shows race disparities not because of inherent biological differences in racial groups, but because of unequal frequencies and quality of contact with healthcare systems. Throughout the episode, they reference the allegories of Dr. Camara Jones, a physician-epidemiologist and civil rights activist. These allegories provide a framework for discussing nature vs. nurture for health outcomes and also privilege defined as the lack of barriers to entry. In terms of actionable steps that providers can take toward reducing health inequity, Dr. Bennett encourages us to learn and engage with the communities that they serve. She advises us to be “counter-stereotypical” and show interest in patients’ lives outside of the healthcare setting. Finally, she calls us to analyze the impact that our institutions have on maintaining the health of the community as a whole, rather than solely focusing on individual patients. --- RESOURCES The Gardener’s Tale Allegory by Dr. Camara Jones: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446334/ Tedx Talk by Dr. Camara Jones: https://www.youtube.com/watch?v=GNhcY6fTyBM In this episode Dr. Kumar and Dr. Bennett discuss various levels of racism found in healthcare, and share allegories of racism as outlined by Dr. Camara P. Jones, including the gardeners tale.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Y1eaX6


---


SHOW NOTES


In this episode, guest host Dr. Vishal Kumar interviews Dr. Ayanna Bennett about how to train ourselves to recognize perpetuated health disparities within the medical system and how we can actively work to dismantle them.


The doctors first talk about understanding racism on an institutional level, which results in a “machine” that selectively delivers better and worse aspects of healthcare to different populations. Dr. Bennett emphasizes that every disease process shows race disparities not because of inherent biological differences in racial groups, but because of unequal frequencies and quality of contact with healthcare systems.


Throughout the episode, they reference the allegories of Dr. Camara Jones, a physician-epidemiologist and civil rights activist. These allegories provide a framework for discussing nature vs. nurture for health outcomes and also privilege defined as the lack of barriers to entry.


In terms of actionable steps that providers can take toward reducing health inequity, Dr. Bennett encourages us to learn and engage with the communities that they serve. She advises us to be “counter-stereotypical” and show interest in patients’ lives outside of the healthcare setting. Finally, she calls us to analyze the impact that our institutions have on maintaining the health of the community as a whole, rather than solely focusing on individual patients.


---


RESOURCES


The Gardener’s Tale Allegory by Dr. Camara Jones:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446334/


Tedx Talk by Dr. Camara Jones:

https://www.youtube.com/watch?v=GNhcY6fTyBM

]]> 2849 Ep. 189 Approach to Posterior Circulation Stroke Thrombectomy with Dr. Ansaar Rai Dr. Sabeen Dhand talks with Neurointerventionalist Dr. Ansaar Rai from about his approach to posterior circulation strokes, including patient selection, technique and devices, and pitfalls to avoid. --- CHECK OUT OUR SPONSOR CERENOVUS https://www.jnjmedicaldevices.com/en-US/companies/cerenovus --- SHOW NOTES In this episode, neurointerventional radiologist Dr. Ansaar Rai joins Dr. Sabeen Dhand to discuss posterior circulation stroke, including when to treat with thrombectomy, techniques, and advances in stroke research in recent years. They discuss factors to consider when deciding to treat posterior circulation strokes with thrombectomy. Dr. Rai reports that age is the most important factor, followed by comorbidities and severity of clinical symptoms. He discusses the variability in presentation of basilar artery strokes, ranging from mild ataxia to coma. He treats these aggressively with thrombectomy, especially for young patients. For isolated PCA strokes, he often treats with intra arterial TPA only. Dr. Rai next discusses landmark clinical trials, as well as his own research looking at stroke burden. He found that 2% of all acute ischemic strokes occur in the posterior circulation. Importantly, he postulates that there will never be good posterior circulation trials due to lack of equipoise and difficulty in randomizing to a medical treatment only arm. Dr. Rai uses general anesthesia for posterior circulation strokes. He prefers femoral access, and uses an 8Fr femoral short sheath and a guide catheter (ideally 088), rather than a balloon guide catheter. He then uses an 070 or 072 intermediate aspiration catheter navigated over an 024 microwire (Aristotle) or 027 microcatheter (Duo or XT-27) into the basilar. After trying many techniques, he prefers aspiration using the ADAPT technique. If he has to cross clot, he uses a stent retriever such as Trevo, Embotrap or Solitaire. Due to the delicate vasculature and high risk in posterior circulation thrombectomies, Dr. Rai always uses a J wire, biplane imaging and emphasizes that knowing the anatomy on CT is key to decreasing complications such as dissection or distal embolization. --- RESOURCES ASPECTS score: https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.016745 Route 92 Medical SUMMIT MAX Clinical trial: https://evtoday.com/news/route-92-medicals-monopoint-reperfusion-system-studied-in-pivotal-summit-max-trial#:~:text=According%20to%20Route%2092%20Medical%2C%20SUMMIT%20MAX%20is,sites%20in%20the%20United%20States%20and%20New%20Zealand. The Greater Cincinnati Northern Kentucky Stroke Study: https://www.gcnkss.com MR RESUE trial: https://www.ahajournals.org/doi/full/10.1161/strokeaha.113.001443 IMS3 trial: https://evtoday.com/news/ims-3-substudy-shows-delays-in-stroke-treatment-leads-to-worse-outcomes#:~:text=IMS%203%20was%20a%20multicenter%20international%20trial%20in,received%20tPA%20within%203%20hours%20of%20stroke%20onset. SWIFT PRIME trial: https://evtoday.com/news/covidien-commences-enrollment-for-swift-prime-acute-ischemic-stroke-study#:~:text=The%20SWIFT%20PRIME%20study%20will%20evaluate%20acute%20ischemic,will%20also%20include%20an%20extensive%20health%20economics%20analysis. ADAPT technique trial by Turc: https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.025753 BEST trial: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(19)30395-3/fulltext#:~:text=The%20BEST%20trial%20was%20a%20multicentre%2C%20prospective%2C%20open-label%2C,the%20institutional%20review%20board%20of%20each%20participating%20site. ATTENTION trial: https://pubmed.ncbi.nlm.nih.gov/35102797/ Mon, 21 Feb 2022 06:00:00 -0000 full BackTable In this episode, neurointerventional radiologist Dr. Ansaar Rai joins Dr. Sabeen Dhand to discuss posterior circulation stroke, including when to treat with thrombectomy, techniques, and advances in stroke research in recent years. Dr. Sabeen Dhand talks with Neurointerventionalist Dr. Ansaar Rai from about his approach to posterior circulation strokes, including patient selection, technique and devices, and pitfalls to avoid. --- CHECK OUT OUR SPONSOR CERENOVUS https://www.jnjmedicaldevices.com/en-US/companies/cerenovus --- SHOW NOTES In this episode, neurointerventional radiologist Dr. Ansaar Rai joins Dr. Sabeen Dhand to discuss posterior circulation stroke, including when to treat with thrombectomy, techniques, and advances in stroke research in recent years. They discuss factors to consider when deciding to treat posterior circulation strokes with thrombectomy. Dr. Rai reports that age is the most important factor, followed by comorbidities and severity of clinical symptoms. He discusses the variability in presentation of basilar artery strokes, ranging from mild ataxia to coma. He treats these aggressively with thrombectomy, especially for young patients. For isolated PCA strokes, he often treats with intra arterial TPA only. Dr. Rai next discusses landmark clinical trials, as well as his own research looking at stroke burden. He found that 2% of all acute ischemic strokes occur in the posterior circulation. Importantly, he postulates that there will never be good posterior circulation trials due to lack of equipoise and difficulty in randomizing to a medical treatment only arm. Dr. Rai uses general anesthesia for posterior circulation strokes. He prefers femoral access, and uses an 8Fr femoral short sheath and a guide catheter (ideally 088), rather than a balloon guide catheter. He then uses an 070 or 072 intermediate aspiration catheter navigated over an 024 microwire (Aristotle) or 027 microcatheter (Duo or XT-27) into the basilar. After trying many techniques, he prefers aspiration using the ADAPT technique. If he has to cross clot, he uses a stent retriever such as Trevo, Embotrap or Solitaire. Due to the delicate vasculature and high risk in posterior circulation thrombectomies, Dr. Rai always uses a J wire, biplane imaging and emphasizes that knowing the anatomy on CT is key to decreasing complications such as dissection or distal embolization. --- RESOURCES ASPECTS score: https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.016745 Route 92 Medical SUMMIT MAX Clinical trial: https://evtoday.com/news/route-92-medicals-monopoint-reperfusion-system-studied-in-pivotal-summit-max-trial#:~:text=According%20to%20Route%2092%20Medical%2C%20SUMMIT%20MAX%20is,sites%20in%20the%20United%20States%20and%20New%20Zealand. The Greater Cincinnati Northern Kentucky Stroke Study: https://www.gcnkss.com MR RESUE trial: https://www.ahajournals.org/doi/full/10.1161/strokeaha.113.001443 IMS3 trial: https://evtoday.com/news/ims-3-substudy-shows-delays-in-stroke-treatment-leads-to-worse-outcomes#:~:text=IMS%203%20was%20a%20multicenter%20international%20trial%20in,received%20tPA%20within%203%20hours%20of%20stroke%20onset. SWIFT PRIME trial: https://evtoday.com/news/covidien-commences-enrollment-for-swift-prime-acute-ischemic-stroke-study#:~:text=The%20SWIFT%20PRIME%20study%20will%20evaluate%20acute%20ischemic,will%20also%20include%20an%20extensive%20health%20economics%20analysis. ADAPT technique trial by Turc: https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.025753 BEST trial: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(19)30395-3/fulltext#:~:text=The%20BEST%20trial%20was%20a%20multicentre%2C%20prospective%2C%20open-label%2C,the%20institutional%20review%20board%20of%20each%20participating%20site. ATTENTION trial: https://pubmed.ncbi.nlm.nih.gov/35102797/ Dr. Sabeen Dhand talks with Neurointerventionalist Dr. Ansaar Rai from about his approach to posterior circulation strokes, including patient selection, technique and devices, and pitfalls to avoid.


---


CHECK OUT OUR SPONSOR


CERENOVUS

https://www.jnjmedicaldevices.com/en-US/companies/cerenovus


---


SHOW NOTES


In this episode, neurointerventional radiologist Dr. Ansaar Rai joins Dr. Sabeen Dhand to discuss posterior circulation stroke, including when to treat with thrombectomy, techniques, and advances in stroke research in recent years. They discuss factors to consider when deciding to treat posterior circulation strokes with thrombectomy. Dr. Rai reports that age is the most important factor, followed by comorbidities and severity of clinical symptoms. He discusses the variability in presentation of basilar artery strokes, ranging from mild ataxia to coma. He treats these aggressively with thrombectomy, especially for young patients. For isolated PCA strokes, he often treats with intra arterial TPA only.


Dr. Rai next discusses landmark clinical trials, as well as his own research looking at stroke burden. He found that 2% of all acute ischemic strokes occur in the posterior circulation. Importantly, he postulates that there will never be good posterior circulation trials due to lack of equipoise and difficulty in randomizing to a medical treatment only arm.


Dr. Rai uses general anesthesia for posterior circulation strokes. He prefers femoral access, and uses an 8Fr femoral short sheath and a guide catheter (ideally 088), rather than a balloon guide catheter. He then uses an 070 or 072 intermediate aspiration catheter navigated over an 024 microwire (Aristotle) or 027 microcatheter (Duo or XT-27) into the basilar. After trying many techniques, he prefers aspiration using the ADAPT technique. If he has to cross clot, he uses a stent retriever such as Trevo, Embotrap or Solitaire. Due to the delicate vasculature and high risk in posterior circulation thrombectomies, Dr. Rai always uses a J wire, biplane imaging and emphasizes that knowing the anatomy on CT is key to decreasing complications such as dissection or distal embolization.



---


RESOURCES


ASPECTS score: https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.016745


Route 92 Medical SUMMIT MAX Clinical trial: https://evtoday.com/news/route-92-medicals-monopoint-reperfusion-system-studied-in-pivotal-summit-max-trial#:~:text=According%20to%20Route%2092%20Medical%2C%20SUMMIT%20MAX%20is,sites%20in%20the%20United%20States%20and%20New%20Zealand.


The Greater Cincinnati Northern Kentucky Stroke Study: https://www.gcnkss.com


MR RESUE trial: https://www.ahajournals.org/doi/full/10.1161/strokeaha.113.001443


IMS3 trial: https://evtoday.com/news/ims-3-substudy-shows-delays-in-stroke-treatment-leads-to-worse-outcomes#:~:text=IMS%203%20was%20a%20multicenter%20international%20trial%20in,received%20tPA%20within%203%20hours%20of%20stroke%20onset.


SWIFT PRIME trial: https://evtoday.com/news/covidien-commences-enrollment-for-swift-prime-acute-ischemic-stroke-study#:~:text=The%20SWIFT%20PRIME%20study%20will%20evaluate%20acute%20ischemic,will%20also%20include%20an%20extensive%20health%20economics%20analysis.


ADAPT technique trial by Turc: https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.025753


BEST trial: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(19)30395-3/fulltext#:~:text=The%20BEST%20trial%20was%20a%20multicentre%2C%20prospective%2C%20open-label%2C,the%20institutional%20review%20board%20of%20each%20participating%20site.


ATTENTION trial: https://pubmed.ncbi.nlm.nih.gov/35102797/


]]> 2540 Ep. 188 Deep Dive on Anticoagulation Regimens for Venous Interventions with Dr. Fred Bertino Dr. Fred Bertino educates us on anticoagulation regimens for patients after deep venous interventions. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/NwME1W --- SHOW NOTES In this episode, pediatric interventional radiologist Dr. Fred Bertino joins our host Dr. Chris Beck to discuss new data on anticoagulation regimes before, during, and after venous stenting and/or mechanical thrombectomy. Dr. Bertino starts by reviewing the difference between the compositions of arterial versus venous clots. Arterial clots are formed as a response to endothelial injury and exposure of von Willebrand factor, so these clots are usually platelet-rich. On the other hand, venous clots are formed due to stasis, and these are usually platelet-poor. Therefore, antiplatelet therapy may not be ideal for venous clots. However, Dr. Bertino notes that stent placement can cause endothelial injury at the apposition points of the stent, so the treatment algorithm can become more complex in these cases. The doctors note that there are non-thrombotic diseases that require venous stenting, such as May Thurner syndrome. Dr. Bertino says that addressing this early in the pediatric population can be a safe way to prevent future DVT, as long as children are monitored carefully. Next, Dr. Bertino walks us through his preferred anticoagulation routine for stent placement. Four hours before the procedure, he starts with a dose of Factor Xa inhibitor (apixaban or rivaroxaban) to prevent in-stent thrombosis. The patient is maintained on heparin during the procedure. After the procedure, anticoagulation varies depending on whether a stent was placed, or solely mechanical thrombectomy was performed. Finally, the doctors discuss preferred anticoagulation for special scenarios such as covered stents (which can be more thrombophilic) and patients with malignancies. Dr. Bertino encourages IRs to reach out to their hematology colleagues to stay updated on anticoagulation research, as well as physical and occupational therapists to help patients form long-term DVT prevention plans. --- RESOURCES Find this episode on backtable.com to see the full library of resources mentioned by Dr. Fred Bertino. Fri, 18 Feb 2022 05:00:00 -0000 full BackTable In this episode Dr. Fred Bertino educates us on anticoagulation regimens for patients after deep venous interventions. Dr. Fred Bertino educates us on anticoagulation regimens for patients after deep venous interventions. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/NwME1W --- SHOW NOTES In this episode, pediatric interventional radiologist Dr. Fred Bertino joins our host Dr. Chris Beck to discuss new data on anticoagulation regimes before, during, and after venous stenting and/or mechanical thrombectomy. Dr. Bertino starts by reviewing the difference between the compositions of arterial versus venous clots. Arterial clots are formed as a response to endothelial injury and exposure of von Willebrand factor, so these clots are usually platelet-rich. On the other hand, venous clots are formed due to stasis, and these are usually platelet-poor. Therefore, antiplatelet therapy may not be ideal for venous clots. However, Dr. Bertino notes that stent placement can cause endothelial injury at the apposition points of the stent, so the treatment algorithm can become more complex in these cases. The doctors note that there are non-thrombotic diseases that require venous stenting, such as May Thurner syndrome. Dr. Bertino says that addressing this early in the pediatric population can be a safe way to prevent future DVT, as long as children are monitored carefully. Next, Dr. Bertino walks us through his preferred anticoagulation routine for stent placement. Four hours before the procedure, he starts with a dose of Factor Xa inhibitor (apixaban or rivaroxaban) to prevent in-stent thrombosis. The patient is maintained on heparin during the procedure. After the procedure, anticoagulation varies depending on whether a stent was placed, or solely mechanical thrombectomy was performed. Finally, the doctors discuss preferred anticoagulation for special scenarios such as covered stents (which can be more thrombophilic) and patients with malignancies. Dr. Bertino encourages IRs to reach out to their hematology colleagues to stay updated on anticoagulation research, as well as physical and occupational therapists to help patients form long-term DVT prevention plans. --- RESOURCES Find this episode on backtable.com to see the full library of resources mentioned by Dr. Fred Bertino. Dr. Fred Bertino educates us on anticoagulation regimens for patients after deep venous interventions.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/NwME1W


---


SHOW NOTES


In this episode, pediatric interventional radiologist Dr. Fred Bertino joins our host Dr. Chris Beck to discuss new data on anticoagulation regimes before, during, and after venous stenting and/or mechanical thrombectomy.


Dr. Bertino starts by reviewing the difference between the compositions of arterial versus venous clots. Arterial clots are formed as a response to endothelial injury and exposure of von Willebrand factor, so these clots are usually platelet-rich. On the other hand, venous clots are formed due to stasis, and these are usually platelet-poor. Therefore, antiplatelet therapy may not be ideal for venous clots. However, Dr. Bertino notes that stent placement can cause endothelial injury at the apposition points of the stent, so the treatment algorithm can become more complex in these cases.


The doctors note that there are non-thrombotic diseases that require venous stenting, such as May Thurner syndrome. Dr. Bertino says that addressing this early in the pediatric population can be a safe way to prevent future DVT, as long as children are monitored carefully.


Next, Dr. Bertino walks us through his preferred anticoagulation routine for stent placement. Four hours before the procedure, he starts with a dose of Factor Xa inhibitor (apixaban or rivaroxaban) to prevent in-stent thrombosis. The patient is maintained on heparin during the procedure. After the procedure, anticoagulation varies depending on whether a stent was placed, or solely mechanical thrombectomy was performed.


Finally, the doctors discuss preferred anticoagulation for special scenarios such as covered stents (which can be more thrombophilic) and patients with malignancies. Dr. Bertino encourages IRs to reach out to their hematology colleagues to stay updated on anticoagulation research, as well as physical and occupational therapists to help patients form long-term DVT prevention plans.


---


RESOURCES


Find this episode on backtable.com to see the full library of resources mentioned by Dr. Fred Bertino.

]]> 3163 Ep. 187 Dealing with Exclusive Contracts and Non-Competes with Dr. Preston Smith and Patrick Souter, Esq. Interventional Radiologist Dr. Preston Smith and healthcare attorney Patrick Souter join us to discuss strategies for navigating the legal world of non-compete agreements and exclusive contracts. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/pAxIn5 --- SHOW NOTES First, we review the vocabulary and examples of each type of agreement. Mr. Souter emphasizes that contrary to popular misconceptions, non-compete agreements are enforceable, as long as they are reasonable in scope, geographic location, and time frame. Additionally, he calls attention to “backdoor noncompetes,” which are clauses that, while not officially called “noncompetes,” still restrict a physician’s ability to practice medicine in a certain location. These include non-circumvention and non-solicitation agreements. Dr. Smith advises listeners to be wary of any terms that seem far-reaching or unreasonable, and to have a legal professional review the terms of the agreement. Next, we discuss exclusive contracts between large radiology practices and hospitals. While they are legal, they cannot be entered into for antitrust purposes of trying to prevent others from entering the marketplace. Exclusive contracts can serve as a barrier for independently practicing IRs to gain hospital privileges. Mr. Souter advises independent IRs to speak with hospital CMOs and provide reasonable explanations for why their services would be efficient and necessary for quality patient care. Mon, 14 Feb 2022 05:00:00 -0000 full BackTable Interventional Radiologist Dr. Preston Smith and healthcare attorney Patrick Souter join us to discuss strategies for navigating the legal world of non-compete agreements and exclusive contracts. Interventional Radiologist Dr. Preston Smith and healthcare attorney Patrick Souter join us to discuss strategies for navigating the legal world of non-compete agreements and exclusive contracts. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/pAxIn5 --- SHOW NOTES First, we review the vocabulary and examples of each type of agreement. Mr. Souter emphasizes that contrary to popular misconceptions, non-compete agreements are enforceable, as long as they are reasonable in scope, geographic location, and time frame. Additionally, he calls attention to “backdoor noncompetes,” which are clauses that, while not officially called “noncompetes,” still restrict a physician’s ability to practice medicine in a certain location. These include non-circumvention and non-solicitation agreements. Dr. Smith advises listeners to be wary of any terms that seem far-reaching or unreasonable, and to have a legal professional review the terms of the agreement. Next, we discuss exclusive contracts between large radiology practices and hospitals. While they are legal, they cannot be entered into for antitrust purposes of trying to prevent others from entering the marketplace. Exclusive contracts can serve as a barrier for independently practicing IRs to gain hospital privileges. Mr. Souter advises independent IRs to speak with hospital CMOs and provide reasonable explanations for why their services would be efficient and necessary for quality patient care. Interventional Radiologist Dr. Preston Smith and healthcare attorney Patrick Souter join us to discuss strategies for navigating the legal world of non-compete agreements and exclusive contracts.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/pAxIn5


---


SHOW NOTES


First, we review the vocabulary and examples of each type of agreement. Mr. Souter emphasizes that contrary to popular misconceptions, non-compete agreements are enforceable, as long as they are reasonable in scope, geographic location, and time frame. Additionally, he calls attention to “backdoor noncompetes,” which are clauses that, while not officially called “noncompetes,” still restrict a physician’s ability to practice medicine in a certain location. These include non-circumvention and non-solicitation agreements. Dr. Smith advises listeners to be wary of any terms that seem far-reaching or unreasonable, and to have a legal professional review the terms of the agreement.


Next, we discuss exclusive contracts between large radiology practices and hospitals. While they are legal, they cannot be entered into for antitrust purposes of trying to prevent others from entering the marketplace. Exclusive contracts can serve as a barrier for independently practicing IRs to gain hospital privileges. Mr. Souter advises independent IRs to speak with hospital CMOs and provide reasonable explanations for why their services would be efficient and necessary for quality patient care.

]]> 2909 Ep. 186 Drawing Outside the Lines: Creating a New Practice Paradigm with Dr. Sandeep Bagla We talk with Interventional Radiologist Dr. Sandeep Bagla about the challenges of clinical research in private practice, and the inspiration behind building a new practice paradigm in collaboration with Urology colleagues. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Ogw44h --- SHOW NOTES In this episode, interventional radiologist and entrepreneur Dr. Sandeep Bagla joins our host Dr. Aaron Fritts to discuss the founding and multispecialty focus of Prostate Centers USA, a rapidly expanding network of office based labs (OBLs). Dr. Bagla describes why he decided to shift away from his former private practice and embark on a new venture that would eventually become Prostate Centers USA. Dr. Bagla sought to focus on embolization, a novel area of interventional radiology. He recounts the process of conducting prostate artery embolization clinical trials in a private practice environment, including challenges encountered and lessons learned about changing FDA regulations. Dr. Bagla developed Prostate Centers USA from a vision of collaboration with urologists to provide comprehensive procedural and clinical care. He describes how he pitched his collaborative approach to urologists and how he dealt with pushback. He also describes why the centers’ ownership structures and focused training pathways are attractive to physicians. Finally, Dr. Bagla highlights technologies that allow for ease of communication between the team members, such as task management systems and centralized monitoring systems. --- RESOURCES Ep. 164 Collaborative Approach to Prostate Artery Embolization (PAE) for BPH: https://www.backtable.com/shows/vi/podcasts/164/collaborative-approach-to-prostate-artery-embolization-pae-for-bph Prostate Centers USA: https://www.prostatecentersusa.com/ Outpatient Endovascular and Interventional Society (OEIS) Annual Meeting: https://oeisociety.com/ Fri, 11 Feb 2022 05:00:00 -0000 full BackTable We talk with Interventional Radiologist Dr. Sandeep Bagla about the challenges of clinical research in private practice, and the inspiration behind building a new practice paradigm in collaboration with Urology colleagues. We talk with Interventional Radiologist Dr. Sandeep Bagla about the challenges of clinical research in private practice, and the inspiration behind building a new practice paradigm in collaboration with Urology colleagues. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Ogw44h --- SHOW NOTES In this episode, interventional radiologist and entrepreneur Dr. Sandeep Bagla joins our host Dr. Aaron Fritts to discuss the founding and multispecialty focus of Prostate Centers USA, a rapidly expanding network of office based labs (OBLs). Dr. Bagla describes why he decided to shift away from his former private practice and embark on a new venture that would eventually become Prostate Centers USA. Dr. Bagla sought to focus on embolization, a novel area of interventional radiology. He recounts the process of conducting prostate artery embolization clinical trials in a private practice environment, including challenges encountered and lessons learned about changing FDA regulations. Dr. Bagla developed Prostate Centers USA from a vision of collaboration with urologists to provide comprehensive procedural and clinical care. He describes how he pitched his collaborative approach to urologists and how he dealt with pushback. He also describes why the centers’ ownership structures and focused training pathways are attractive to physicians. Finally, Dr. Bagla highlights technologies that allow for ease of communication between the team members, such as task management systems and centralized monitoring systems. --- RESOURCES Ep. 164 Collaborative Approach to Prostate Artery Embolization (PAE) for BPH: https://www.backtable.com/shows/vi/podcasts/164/collaborative-approach-to-prostate-artery-embolization-pae-for-bph Prostate Centers USA: https://www.prostatecentersusa.com/ Outpatient Endovascular and Interventional Society (OEIS) Annual Meeting: https://oeisociety.com/ We talk with Interventional Radiologist Dr. Sandeep Bagla about the challenges of clinical research in private practice, and the inspiration behind building a new practice paradigm in collaboration with Urology colleagues.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Ogw44h


---


SHOW NOTES


In this episode, interventional radiologist and entrepreneur Dr. Sandeep Bagla joins our host Dr. Aaron Fritts to discuss the founding and multispecialty focus of Prostate Centers USA, a rapidly expanding network of office based labs (OBLs).


Dr. Bagla describes why he decided to shift away from his former private practice and embark on a new venture that would eventually become Prostate Centers USA. Dr. Bagla sought to focus on embolization, a novel area of interventional radiology. He recounts the process of conducting prostate artery embolization clinical trials in a private practice environment, including challenges encountered and lessons learned about changing FDA regulations.


Dr. Bagla developed Prostate Centers USA from a vision of collaboration with urologists to provide comprehensive procedural and clinical care. He describes how he pitched his collaborative approach to urologists and how he dealt with pushback. He also describes why the centers’ ownership structures and focused training pathways are attractive to physicians. Finally, Dr. Bagla highlights technologies that allow for ease of communication between the team members, such as task management systems and centralized monitoring systems.


---


RESOURCES


Ep. 164 Collaborative Approach to Prostate Artery Embolization (PAE) for BPH:

https://www.backtable.com/shows/vi/podcasts/164/collaborative-approach-to-prostate-artery-embolization-pae-for-bph


Prostate Centers USA: https://www.prostatecentersusa.com/


Outpatient Endovascular and Interventional Society (OEIS) Annual Meeting: https://oeisociety.com/

]]> 3381 Ep. 185 Cholecystostomy Tubes with Dr. Chris Beck Co-hosts Dr. Christopher Beck and Dr. Aaron Fritts discuss cholecystostomy tube placement for acute cholecystitis, including the pros and cons of different techniques, and pitfalls to avoid. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QDepym --- SHOW NOTES In this episode, our hosts Dr. Aaron Fritts and Dr. Chris Beck compare their procedural techniques for placing cholecystostomy tubes. They start the conversation by discussing patient workup. Dr. Beck always obtains an ultrasound and sometimes a HIDA scan. He also orders coagulation tests and checks if the patient is on anticoagulation medication in order to stratify the risk of the procedure and counsel the patient accordingly. Next, the doctors discuss pros and cons of transhepatic and transperitoneal approaches. Dr. Fritts usually prefers a transhepatic approach because it minimizes the risk of biliary leaks. He also believes that it is easier to stick the gallbladder in an area where it is affixed to the liver. Dr. Beck emphasizes that the gallbladder is a dynamic organ, so doing this procedure under ultrasound with fluoroscopy will allow real-time visualization of the needle. Finally, they consider different needle and drainage options. There are a variety of needles that can be used, including AccuStick, Yueh, and spinal needles. With drainage, the doctors highlight the differences between drainage bags and JP bulbs, noting that the former relies on drainage of infected bile by gravity, and the latter provides additional vacuum suction. Mon, 07 Feb 2022 05:00:00 -0000 full BackTable Co-hosts Dr. Christopher Beck and Dr. Aaron Fritts discuss cholecystostomy tube placement for acute cholecystitis, including the pros and cons of different techniques, and pitfalls to avoid. Co-hosts Dr. Christopher Beck and Dr. Aaron Fritts discuss cholecystostomy tube placement for acute cholecystitis, including the pros and cons of different techniques, and pitfalls to avoid. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QDepym --- SHOW NOTES In this episode, our hosts Dr. Aaron Fritts and Dr. Chris Beck compare their procedural techniques for placing cholecystostomy tubes. They start the conversation by discussing patient workup. Dr. Beck always obtains an ultrasound and sometimes a HIDA scan. He also orders coagulation tests and checks if the patient is on anticoagulation medication in order to stratify the risk of the procedure and counsel the patient accordingly. Next, the doctors discuss pros and cons of transhepatic and transperitoneal approaches. Dr. Fritts usually prefers a transhepatic approach because it minimizes the risk of biliary leaks. He also believes that it is easier to stick the gallbladder in an area where it is affixed to the liver. Dr. Beck emphasizes that the gallbladder is a dynamic organ, so doing this procedure under ultrasound with fluoroscopy will allow real-time visualization of the needle. Finally, they consider different needle and drainage options. There are a variety of needles that can be used, including AccuStick, Yueh, and spinal needles. With drainage, the doctors highlight the differences between drainage bags and JP bulbs, noting that the former relies on drainage of infected bile by gravity, and the latter provides additional vacuum suction. Co-hosts Dr. Christopher Beck and Dr. Aaron Fritts discuss cholecystostomy tube placement for acute cholecystitis, including the pros and cons of different techniques, and pitfalls to avoid.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QDepym


---


SHOW NOTES


In this episode, our hosts Dr. Aaron Fritts and Dr. Chris Beck compare their procedural techniques for placing cholecystostomy tubes.


They start the conversation by discussing patient workup. Dr. Beck always obtains an ultrasound and sometimes a HIDA scan. He also orders coagulation tests and checks if the patient is on anticoagulation medication in order to stratify the risk of the procedure and counsel the patient accordingly.


Next, the doctors discuss pros and cons of transhepatic and transperitoneal approaches. Dr. Fritts usually prefers a transhepatic approach because it minimizes the risk of biliary leaks. He also believes that it is easier to stick the gallbladder in an area where it is affixed to the liver.

Dr. Beck emphasizes that the gallbladder is a dynamic organ, so doing this procedure under ultrasound with fluoroscopy will allow real-time visualization of the needle.


Finally, they consider different needle and drainage options. There are a variety of needles that can be used, including AccuStick, Yueh, and spinal needles. With drainage, the doctors highlight the differences between drainage bags and JP bulbs, noting that the former relies on drainage of infected bile by gravity, and the latter provides additional vacuum suction.

]]> 2470 Ep. 184 Mentorship: Buzzword or Benefit? With Dr. Robert Vogelzang In this episode, our host Dr. Eric Keller interviews his longtime mentor, interventional radiologist Dr. Bob Vogelzang about the evolution of their mentor mentee relationship overtime and ways to create benefits for both mentors and mentees. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/3QPBiv --- SHOW NOTES A common idea throughout this episode is that no single definition of mentorship exists. Dr. Vogelzang highlights the importance of a flat structure, in which the mentee and the mentor feel comfortable to ask questions and explore an area of shared interest. Dr. Keller emphasizes the reality that mentoring relationships will grow and change with career development and geographic relocation. Overall, both doctors agree that an effective mentoring relationship should be driven by feasible projects that motivate both parties. Fri, 04 Feb 2022 05:00:00 -0000 full BackTable Our host Dr. Eric Keller interviews his longtime mentor, interventional radiologist Dr. Bob Vogelzang about the evolution of their mentor mentee relationship overtime and ways to create benefits for both mentors and mentees. In this episode, our host Dr. Eric Keller interviews his longtime mentor, interventional radiologist Dr. Bob Vogelzang about the evolution of their mentor mentee relationship overtime and ways to create benefits for both mentors and mentees. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/3QPBiv --- SHOW NOTES A common idea throughout this episode is that no single definition of mentorship exists. Dr. Vogelzang highlights the importance of a flat structure, in which the mentee and the mentor feel comfortable to ask questions and explore an area of shared interest. Dr. Keller emphasizes the reality that mentoring relationships will grow and change with career development and geographic relocation. Overall, both doctors agree that an effective mentoring relationship should be driven by feasible projects that motivate both parties. In this episode, our host Dr. Eric Keller interviews his longtime mentor, interventional radiologist Dr. Bob Vogelzang about the evolution of their mentor mentee relationship overtime and ways to create benefits for both mentors and mentees.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/3QPBiv


---


SHOW NOTES


A common idea throughout this episode is that no single definition of mentorship exists. Dr. Vogelzang highlights the importance of a flat structure, in which the mentee and the mentor feel comfortable to ask questions and explore an area of shared interest. Dr. Keller emphasizes the reality that mentoring relationships will grow and change with career development and geographic relocation.


Overall, both doctors agree that an effective mentoring relationship should be driven by feasible projects that motivate both parties.

]]> 2113 Ep. 183 Solid Organ and Pelvic Trauma with Dr. Chris Ingraham Interventional Radiologist Dr. Chris Ingraham discusses his approach to treating solid organ and pelvic trauma, including embolization technique and IR's role in workflow efficiency for better trauma care. --- CHECK OUT OUR SPONSOR Boston Scientific IOE https://www.bostonscientific.com/ioe --- SHOW NOTES In this episode, interventional radiologist Dr. Chris Ingraham and our host Dr. Michael Barraza discuss the role of IR in the trauma setting and approaches to embolization for trauma to the spleen, liver, kidneys, and pelvis. Dr. Ingraham outlines Harborview Medical Center’s workup of trauma patients and describes the collaboration between the emergency, trauma surgery, and interventional radiology departments. Although CT provides more comprehensive imaging, Dr. Ingraham says that taking a patient directly to an angiogram could address the trauma quicker and prevent more complications. He also speaks about empiric embolization, noting that extravasation can be intermittent and not visible on imaging. Overall, Dr. Ingraham recommends over-sizing coils, since patients are usually hypotensive and vasoconstrictive during active bleeding. Vessel diameter will eventually increase as patients are resuscitated. When embolizing the spleen, Dr. Ingraham emphasizes that the goal is to prevent the need for splenectomy, especially in young patients, because of its role in immunologic responses. He advocates for proximal embolization in order to decrease the blood flow into the spleen and allow for splenic lacerations to clot and heal. In liver embolization, Dr. Ingraham notes that there could be a laceration to the liver’s venous system, and embolization of the arterial system could reduce the dual blood supply of the liver. In these patients, there can be a higher risk of necrosis and biliary injury. Finally, we discuss follow up care with pulse exams and monitoring of hemodynamic stability. --- RESOURCES Balloons Up: Reduced Time to Angioembolization: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903099/ SIR Trauma Guidelines, 2020: https://www.jvir.org/article/S1051-0443(19)30952-2/fulltext Mon, 31 Jan 2022 05:00:00 -0000 full BackTable Interventional Radiologist Dr. Chris Ingraham discusses his approach to treating solid organ and pelvic trauma, including embolization technique and IR's role in workflow efficiency for better trauma care. Interventional Radiologist Dr. Chris Ingraham discusses his approach to treating solid organ and pelvic trauma, including embolization technique and IR's role in workflow efficiency for better trauma care. --- CHECK OUT OUR SPONSOR Boston Scientific IOE https://www.bostonscientific.com/ioe --- SHOW NOTES In this episode, interventional radiologist Dr. Chris Ingraham and our host Dr. Michael Barraza discuss the role of IR in the trauma setting and approaches to embolization for trauma to the spleen, liver, kidneys, and pelvis. Dr. Ingraham outlines Harborview Medical Center’s workup of trauma patients and describes the collaboration between the emergency, trauma surgery, and interventional radiology departments. Although CT provides more comprehensive imaging, Dr. Ingraham says that taking a patient directly to an angiogram could address the trauma quicker and prevent more complications. He also speaks about empiric embolization, noting that extravasation can be intermittent and not visible on imaging. Overall, Dr. Ingraham recommends over-sizing coils, since patients are usually hypotensive and vasoconstrictive during active bleeding. Vessel diameter will eventually increase as patients are resuscitated. When embolizing the spleen, Dr. Ingraham emphasizes that the goal is to prevent the need for splenectomy, especially in young patients, because of its role in immunologic responses. He advocates for proximal embolization in order to decrease the blood flow into the spleen and allow for splenic lacerations to clot and heal. In liver embolization, Dr. Ingraham notes that there could be a laceration to the liver’s venous system, and embolization of the arterial system could reduce the dual blood supply of the liver. In these patients, there can be a higher risk of necrosis and biliary injury. Finally, we discuss follow up care with pulse exams and monitoring of hemodynamic stability. --- RESOURCES Balloons Up: Reduced Time to Angioembolization: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903099/ SIR Trauma Guidelines, 2020: https://www.jvir.org/article/S1051-0443(19)30952-2/fulltext Interventional Radiologist Dr. Chris Ingraham discusses his approach to treating solid organ and pelvic trauma, including embolization technique and IR's role in workflow efficiency for better trauma care.


---


CHECK OUT OUR SPONSOR


Boston Scientific IOE

https://www.bostonscientific.com/ioe


---


SHOW NOTES


In this episode, interventional radiologist Dr. Chris Ingraham and our host Dr. Michael Barraza discuss the role of IR in the trauma setting and approaches to embolization for trauma to the spleen, liver, kidneys, and pelvis.


Dr. Ingraham outlines Harborview Medical Center’s workup of trauma patients and describes the collaboration between the emergency, trauma surgery, and interventional radiology departments. Although CT provides more comprehensive imaging, Dr. Ingraham says that taking a patient directly to an angiogram could address the trauma quicker and prevent more complications. He also speaks about empiric embolization, noting that extravasation can be intermittent and not visible on imaging.


Overall, Dr. Ingraham recommends over-sizing coils, since patients are usually hypotensive and vasoconstrictive during active bleeding. Vessel diameter will eventually increase as patients are resuscitated.


When embolizing the spleen, Dr. Ingraham emphasizes that the goal is to prevent the need for splenectomy, especially in young patients, because of its role in immunologic responses. He advocates for proximal embolization in order to decrease the blood flow into the spleen and allow for splenic lacerations to clot and heal.


In liver embolization, Dr. Ingraham notes that there could be a laceration to the liver’s venous system, and embolization of the arterial system could reduce the dual blood supply of the liver. In these patients, there can be a higher risk of necrosis and biliary injury.


Finally, we discuss follow up care with pulse exams and monitoring of hemodynamic stability.


---


RESOURCES


Balloons Up: Reduced Time to Angioembolization:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903099/


SIR Trauma Guidelines, 2020:

https://www.jvir.org/article/S1051-0443(19)30952-2/fulltext

]]> 3574 Ep. 182 Thyroid Nodule Ablation with Dr. Tim Huber Dr. Aparna Baheti talks with Dr. Timothy Huber about performing thyroid nodule ablation procedures, including patient selection, technique pearls and pitfalls, and how to incorporate the procedure into your practice. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QZ9TpA --- SHOW NOTES In this episode, interventional radiologist Dr. Tim Huber and our host Dr. Ally Baheti discuss the process of thyroid nodule radiofrequency ablation, including patient selection, workup, procedural technique, and follow up. Dr. Huber describes the most common indication for ablation, which is the presence of benign thyroid nodules that cause compressive symptoms. These can affect quality of life when they restrict a patient’s ability to swallow, breathe, and speak. He recommends ablation for symptomatic nodules that are over 2 cm in diameter. Dr. Huber also mentions functional nodules as more challenging cases, but still treatable with ablation. Though ablation for thyroid malignancies is rare, it is a field of active and growing research. In his workup, Dr. Huber uses ultrasound to assess nodular composition, vasculature, size, and nearby enlarged lymph nodes. Next, he obtains two benign fine needle aspiration samples and checks TSH levels before proceeding with ablation. During the procedure, he anesthetizes the skin of the neck with lidocaine, and periodically checks in with patients about pain level. Dr. Huber describes his “trans-isthmic approach” that keeps the needle as stable as possible. He exercises caution when ablating near the “danger triangle” containing the recurrent laryngeal nerve which innervates the vocal cords. While ablating posterior to anterior, Dr. Huber tracks echogenic changes on ultrasound. After the procedure, patients are monitored for one hour and then followed up in one month, and then three months over the next year. Dr. Huber warns interventionalists that post-ablation zones may look disfigured on ultrasound, but this will revert back to normal within 3-6 months. --- RESOURCES European Thyroid Association Guidelines: https://www.eurothyroid.com/guidelines/eta_guidelines.html Korean Society of Thyroid Radiology Guidelines: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/ Fri, 28 Jan 2022 05:00:00 -0000 full BackTable Dr. Aparna Baheti talks with Dr. Timothy Huber about performing thyroid nodule ablation procedures, including patient selection, technique pearls and pitfalls, and how to incorporate the procedure into your practice. Dr. Aparna Baheti talks with Dr. Timothy Huber about performing thyroid nodule ablation procedures, including patient selection, technique pearls and pitfalls, and how to incorporate the procedure into your practice. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QZ9TpA --- SHOW NOTES In this episode, interventional radiologist Dr. Tim Huber and our host Dr. Ally Baheti discuss the process of thyroid nodule radiofrequency ablation, including patient selection, workup, procedural technique, and follow up. Dr. Huber describes the most common indication for ablation, which is the presence of benign thyroid nodules that cause compressive symptoms. These can affect quality of life when they restrict a patient’s ability to swallow, breathe, and speak. He recommends ablation for symptomatic nodules that are over 2 cm in diameter. Dr. Huber also mentions functional nodules as more challenging cases, but still treatable with ablation. Though ablation for thyroid malignancies is rare, it is a field of active and growing research. In his workup, Dr. Huber uses ultrasound to assess nodular composition, vasculature, size, and nearby enlarged lymph nodes. Next, he obtains two benign fine needle aspiration samples and checks TSH levels before proceeding with ablation. During the procedure, he anesthetizes the skin of the neck with lidocaine, and periodically checks in with patients about pain level. Dr. Huber describes his “trans-isthmic approach” that keeps the needle as stable as possible. He exercises caution when ablating near the “danger triangle” containing the recurrent laryngeal nerve which innervates the vocal cords. While ablating posterior to anterior, Dr. Huber tracks echogenic changes on ultrasound. After the procedure, patients are monitored for one hour and then followed up in one month, and then three months over the next year. Dr. Huber warns interventionalists that post-ablation zones may look disfigured on ultrasound, but this will revert back to normal within 3-6 months. --- RESOURCES European Thyroid Association Guidelines: https://www.eurothyroid.com/guidelines/eta_guidelines.html Korean Society of Thyroid Radiology Guidelines: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/ Dr. Aparna Baheti talks with Dr. Timothy Huber about performing thyroid nodule ablation procedures, including patient selection, technique pearls and pitfalls, and how to incorporate the procedure into your practice.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QZ9TpA


---


SHOW NOTES


In this episode, interventional radiologist Dr. Tim Huber and our host Dr. Ally Baheti discuss the process of thyroid nodule radiofrequency ablation, including patient selection, workup, procedural technique, and follow up.


Dr. Huber describes the most common indication for ablation, which is the presence of benign thyroid nodules that cause compressive symptoms. These can affect quality of life when they restrict a patient’s ability to swallow, breathe, and speak. He recommends ablation for symptomatic nodules that are over 2 cm in diameter. Dr. Huber also mentions functional nodules as more challenging cases, but still treatable with ablation. Though ablation for thyroid malignancies is rare, it is a field of active and growing research.


In his workup, Dr. Huber uses ultrasound to assess nodular composition, vasculature, size, and nearby enlarged lymph nodes. Next, he obtains two benign fine needle aspiration samples and checks TSH levels before proceeding with ablation. During the procedure, he anesthetizes the skin of the neck with lidocaine, and periodically checks in with patients about pain level. Dr. Huber describes his “trans-isthmic approach” that keeps the needle as stable as possible. He exercises caution when ablating near the “danger triangle” containing the recurrent laryngeal nerve which innervates the vocal cords. While ablating posterior to anterior, Dr. Huber tracks echogenic changes on ultrasound.


After the procedure, patients are monitored for one hour and then followed up in one month, and then three months over the next year. Dr. Huber warns interventionalists that post-ablation zones may look disfigured on ultrasound, but this will revert back to normal within 3-6 months.


---


RESOURCES


European Thyroid Association Guidelines:

https://www.eurothyroid.com/guidelines/eta_guidelines.html


Korean Society of Thyroid Radiology Guidelines:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005940/

]]> 1974 Ep. 181 Surgical Versus Endovascular Management of CFA Disease with Dr. Mazin Foteh Vascular Surgeon Dr. Mazin Foteh and our host Dr. Sabeen Dhand consider various factors that can influence the choice of treatment methods for calcified common femoral artery (CFA) disease, including discussing the pros and cons of an endovascular vs surgical approach. --- CHECK OUT OUR SPONSOR Shockwave Medical https://shockwavemedical.com/?utm_source=CFA-Backtable-Podcast&utm_campaign=Backtable-Podcast --- SHOW NOTES In this episode, vascular surgeon Dr. Mazin Foteh and our host Dr. Sabeen Dhand consider various factors that can influence the choice of treatment methods for common femoral artery (CFA) disease. To start, Dr. Foteh describes risk factors of common femoral disease, such as smoking, renal failure, and diabetes. He notes that CFA lesions are usually calcified and homogenous because they are composed of layers of calcium, lipid, and platelets deposited in fibrin sheaths. He further distinguishes between partially occluded and fully occluded CFA lesions. Dr. Foteh reviews key tips to minimize complications during an open endarterectomy. To maximize exposure, he recommends making a longitudinal incision rather than a medial groin incision. Before closing, he also ensures that he checks 3-4 cm proximal and distal to the CFA and stents the external iliac artery if needed. Dr. Foteh opts for general anesthesia over local anesthesia, in case of unforeseen complications. With an endovascular approach, Dr. Foteh finds that shock wave lithotripsy has been most effective at cracking calcium, changing vessel compliance, and ultimately increasing luminal gain. He uses this technique first, examines the results, and then uses a drug-coated balloon or stent as needed. --- RESOURCES Clinical Trial Investigating the Efficacy of the Supera Peripheral Stent System for the Treatment of the Common Femoral Artery: https://clinicaltrials.gov/ct2/show/NCT02804113 Mon, 24 Jan 2022 05:00:00 -0000 full BackTable Vascular Surgeon Dr. Mazin Foteh and our host Dr. Sabeen Dhand consider various factors that can influence the choice of treatment methods for calcified common femoral artery (CFA) disease, including discussing the pros and cons of an endovascular vs surgical approach. Vascular Surgeon Dr. Mazin Foteh and our host Dr. Sabeen Dhand consider various factors that can influence the choice of treatment methods for calcified common femoral artery (CFA) disease, including discussing the pros and cons of an endovascular vs surgical approach. --- CHECK OUT OUR SPONSOR Shockwave Medical https://shockwavemedical.com/?utm_source=CFA-Backtable-Podcast&utm_campaign=Backtable-Podcast --- SHOW NOTES In this episode, vascular surgeon Dr. Mazin Foteh and our host Dr. Sabeen Dhand consider various factors that can influence the choice of treatment methods for common femoral artery (CFA) disease. To start, Dr. Foteh describes risk factors of common femoral disease, such as smoking, renal failure, and diabetes. He notes that CFA lesions are usually calcified and homogenous because they are composed of layers of calcium, lipid, and platelets deposited in fibrin sheaths. He further distinguishes between partially occluded and fully occluded CFA lesions. Dr. Foteh reviews key tips to minimize complications during an open endarterectomy. To maximize exposure, he recommends making a longitudinal incision rather than a medial groin incision. Before closing, he also ensures that he checks 3-4 cm proximal and distal to the CFA and stents the external iliac artery if needed. Dr. Foteh opts for general anesthesia over local anesthesia, in case of unforeseen complications. With an endovascular approach, Dr. Foteh finds that shock wave lithotripsy has been most effective at cracking calcium, changing vessel compliance, and ultimately increasing luminal gain. He uses this technique first, examines the results, and then uses a drug-coated balloon or stent as needed. --- RESOURCES Clinical Trial Investigating the Efficacy of the Supera Peripheral Stent System for the Treatment of the Common Femoral Artery: https://clinicaltrials.gov/ct2/show/NCT02804113 Vascular Surgeon Dr. Mazin Foteh and our host Dr. Sabeen Dhand consider various factors that can influence the choice of treatment methods for calcified common femoral artery (CFA) disease, including discussing the pros and cons of an endovascular vs surgical approach.


---


CHECK OUT OUR SPONSOR


Shockwave Medical

https://shockwavemedical.com/?utm_source=CFA-Backtable-Podcast&utm_campaign=Backtable-Podcast


---


SHOW NOTES


In this episode, vascular surgeon Dr. Mazin Foteh and our host Dr. Sabeen Dhand consider various factors that can influence the choice of treatment methods for common femoral artery (CFA) disease.


To start, Dr. Foteh describes risk factors of common femoral disease, such as smoking, renal failure, and diabetes. He notes that CFA lesions are usually calcified and homogenous because they are composed of layers of calcium, lipid, and platelets deposited in fibrin sheaths. He further distinguishes between partially occluded and fully occluded CFA lesions.


Dr. Foteh reviews key tips to minimize complications during an open endarterectomy. To maximize exposure, he recommends making a longitudinal incision rather than a medial groin incision. Before closing, he also ensures that he checks 3-4 cm proximal and distal to the CFA and stents the external iliac artery if needed. Dr. Foteh opts for general anesthesia over local anesthesia, in case of unforeseen complications.


With an endovascular approach, Dr. Foteh finds that shock wave lithotripsy has been most effective at cracking calcium, changing vessel compliance, and ultimately increasing luminal gain. He uses this technique first, examines the results, and then uses a drug-coated balloon or stent as needed.


---


RESOURCES


Clinical Trial Investigating the Efficacy of the Supera Peripheral Stent System for the Treatment of the Common Femoral Artery: https://clinicaltrials.gov/ct2/show/NCT02804113

]]> 3014 Ep. 180 Environmental Impact of Interventional Radiology with Dr. Jonathan Gross Interventional Radiologist Dr. Jonathan Gross and host Dr. Aaron Fritts discuss the results from his recent JVIR Media article on the quantifiable environmental impact of operating an interventional radiology practice for one week. Guess how many road trips around the world it equates to!? --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Wg2OuX --- SHOW NOTES In this episode, interventional radiologist Dr. Jonathan Gross and our host Dr. Aaron Fritts discuss the results from Dr. Gross’s recent JVIR article on the quantifiable environmental impact of operating an IR practice for one week. Dr. Gross begins by describing his lifelong interest in environmental sustainability. He developed the idea for this study because he recognized the discordance between his conscientious practices at home and his less sustainable practices in the IR suite. Dr. Gross acclimates us to vocabulary that is used in the article and defines the measurements of “life cycle assessment” and “volume of greenhouse gases.” Many listeners will be surprised to find out that material waste makes up less than 2% of all greenhouse gas emissions in an IR suite. The majority of emissions is actually produced by air conditioning and air exchange systems, which frequently and unnecessarily run when IR suites are not being used. Finally, Dr. Gross shares ways to reduce the environmental impacts of IR, such as installing motion-sensor lights, using re-processed equipment instead of single-use equipment, and streamlining procedure packs. --- RESOURCES The Environmental Impact of Interventional Radiology: An Evaluation of Greenhouse Gas Emissions from an Academic Interventional Radiology Practice: https://pubmed.ncbi.nlm.nih.gov/33794372/ Environmental Impacts of Abdominal Imaging: A Pilot Investigation: https://pubmed.ncbi.nlm.nih.gov/30158086/ Fri, 21 Jan 2022 05:00:00 -0000 full BackTable Interventional Radiologist Dr. Jonathan Gross and host Dr. Aaron Fritts discuss the results from his recent JVIR Media article on the quantifiable environmental impact of operating an interventional radiology practice for one week. Guess how many road trips around the world it equates to!? Interventional Radiologist Dr. Jonathan Gross and host Dr. Aaron Fritts discuss the results from his recent JVIR Media article on the quantifiable environmental impact of operating an interventional radiology practice for one week. Guess how many road trips around the world it equates to!? --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Wg2OuX --- SHOW NOTES In this episode, interventional radiologist Dr. Jonathan Gross and our host Dr. Aaron Fritts discuss the results from Dr. Gross’s recent JVIR article on the quantifiable environmental impact of operating an IR practice for one week. Dr. Gross begins by describing his lifelong interest in environmental sustainability. He developed the idea for this study because he recognized the discordance between his conscientious practices at home and his less sustainable practices in the IR suite. Dr. Gross acclimates us to vocabulary that is used in the article and defines the measurements of “life cycle assessment” and “volume of greenhouse gases.” Many listeners will be surprised to find out that material waste makes up less than 2% of all greenhouse gas emissions in an IR suite. The majority of emissions is actually produced by air conditioning and air exchange systems, which frequently and unnecessarily run when IR suites are not being used. Finally, Dr. Gross shares ways to reduce the environmental impacts of IR, such as installing motion-sensor lights, using re-processed equipment instead of single-use equipment, and streamlining procedure packs. --- RESOURCES The Environmental Impact of Interventional Radiology: An Evaluation of Greenhouse Gas Emissions from an Academic Interventional Radiology Practice: https://pubmed.ncbi.nlm.nih.gov/33794372/ Environmental Impacts of Abdominal Imaging: A Pilot Investigation: https://pubmed.ncbi.nlm.nih.gov/30158086/ Interventional Radiologist Dr. Jonathan Gross and host Dr. Aaron Fritts discuss the results from his recent JVIR Media article on the quantifiable environmental impact of operating an interventional radiology practice for one week. Guess how many road trips around the world it equates to!?


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Wg2OuX


---


SHOW NOTES


In this episode, interventional radiologist Dr. Jonathan Gross and our host Dr. Aaron Fritts discuss the results from Dr. Gross’s recent JVIR article on the quantifiable environmental impact of operating an IR practice for one week.


Dr. Gross begins by describing his lifelong interest in environmental sustainability. He developed the idea for this study because he recognized the discordance between his conscientious practices at home and his less sustainable practices in the IR suite. Dr. Gross acclimates us to vocabulary that is used in the article and defines the measurements of “life cycle assessment” and “volume of greenhouse gases.”


Many listeners will be surprised to find out that material waste makes up less than 2% of all greenhouse gas emissions in an IR suite. The majority of emissions is actually produced by air conditioning and air exchange systems, which frequently and unnecessarily run when IR suites are not being used.


Finally, Dr. Gross shares ways to reduce the environmental impacts of IR, such as installing motion-sensor lights, using re-processed equipment instead of single-use equipment, and streamlining procedure packs.


---


RESOURCES


The Environmental Impact of Interventional Radiology: An Evaluation of Greenhouse Gas Emissions from an Academic Interventional Radiology Practice: https://pubmed.ncbi.nlm.nih.gov/33794372/


Environmental Impacts of Abdominal Imaging: A Pilot Investigation:

https://pubmed.ncbi.nlm.nih.gov/30158086/

]]> 2009 Ep. 179 Happiness is a Warm Coil: Treating GI Bleeds with Dr. Donald Garbett Interventional Radiologist Donald Garbett and our host Sabeen Dhand discuss their standard workups and procedural decision making for GI bleeds, including radial vs. femoral approach and preferred embolics. --- CHECK OUT OUR SPONSOR Boston Scientific IOE https://www.bostonscientific.com/ioe --- SHOW NOTES In this episode, interventional radiologist Dr. Donald Garbett and our host Dr. Sabeen Dhand discuss their standard workups and procedural decision making for GI bleeds. The doctors start by describing the workup. Dr. Garbett says that the majority of his cases are referred from GI, either when GI cannot find the bleed or cannot access the bleed because of excessive bleeding into the GI lumen. Dr. Garbett often uses triple phase CT angiography. He emphasizes the importance of doing triple phase, in order to distinguish between arterial bleeds and varices, as this difference will guide further treatment decisions. In non-emergency situations, Dr. Garbett prefers transradial access. He discusses his use of various embolic agents such as glue and combination of both detachable and pushable coils. Dr. Dhand mentions newer embolics such as Onyx. He adds that he sometimes administers a low dose of glucagon to inhibit bowel movements. Finally, the doctors share various pearls of wisdom for GI embolization, such as the advantages of provocative angiogram, treatment decisions when a patient is crashing, and variceal indications for balloon-occluded retrograde transvenous obliteration (BRTO) and transjugular intrahepatic portosystemic shunt (TIPS). --- RESOURCES Ep. 118 BRTO vs. PARTO in Gastric Variceal Bleeding: https://www.backtable.com/shows/vi/podcasts/47/brto-vs-parto-in-gastric-variceal-bleeding YouTube Video: Embolization and Provocative Angiography in Lower GI Bleeds: https://youtu.be/0MESQkTG6hI Mon, 17 Jan 2022 05:00:00 -0000 full BackTable Interventional Radiologist Donald Garbett and our host Sabeen Dhand discuss their standard workups and procedural decision making for GI bleeds, including radial vs. femoral approach and preferred embolics. Interventional Radiologist Donald Garbett and our host Sabeen Dhand discuss their standard workups and procedural decision making for GI bleeds, including radial vs. femoral approach and preferred embolics. --- CHECK OUT OUR SPONSOR Boston Scientific IOE https://www.bostonscientific.com/ioe --- SHOW NOTES In this episode, interventional radiologist Dr. Donald Garbett and our host Dr. Sabeen Dhand discuss their standard workups and procedural decision making for GI bleeds. The doctors start by describing the workup. Dr. Garbett says that the majority of his cases are referred from GI, either when GI cannot find the bleed or cannot access the bleed because of excessive bleeding into the GI lumen. Dr. Garbett often uses triple phase CT angiography. He emphasizes the importance of doing triple phase, in order to distinguish between arterial bleeds and varices, as this difference will guide further treatment decisions. In non-emergency situations, Dr. Garbett prefers transradial access. He discusses his use of various embolic agents such as glue and combination of both detachable and pushable coils. Dr. Dhand mentions newer embolics such as Onyx. He adds that he sometimes administers a low dose of glucagon to inhibit bowel movements. Finally, the doctors share various pearls of wisdom for GI embolization, such as the advantages of provocative angiogram, treatment decisions when a patient is crashing, and variceal indications for balloon-occluded retrograde transvenous obliteration (BRTO) and transjugular intrahepatic portosystemic shunt (TIPS). --- RESOURCES Ep. 118 BRTO vs. PARTO in Gastric Variceal Bleeding: https://www.backtable.com/shows/vi/podcasts/47/brto-vs-parto-in-gastric-variceal-bleeding YouTube Video: Embolization and Provocative Angiography in Lower GI Bleeds: https://youtu.be/0MESQkTG6hI Interventional Radiologist Donald Garbett and our host Sabeen Dhand discuss their standard workups and procedural decision making for GI bleeds, including radial vs. femoral approach and preferred embolics.


---


CHECK OUT OUR SPONSOR


Boston Scientific IOE

https://www.bostonscientific.com/ioe


---


SHOW NOTES


In this episode, interventional radiologist Dr. Donald Garbett and our host Dr. Sabeen Dhand discuss their standard workups and procedural decision making for GI bleeds.


The doctors start by describing the workup. Dr. Garbett says that the majority of his cases are referred from GI, either when GI cannot find the bleed or cannot access the bleed because of excessive bleeding into the GI lumen. Dr. Garbett often uses triple phase CT angiography. He emphasizes the importance of doing triple phase, in order to distinguish between arterial bleeds and varices, as this difference will guide further treatment decisions.


In non-emergency situations, Dr. Garbett prefers transradial access. He discusses his use of various embolic agents such as glue and combination of both detachable and pushable coils. Dr. Dhand mentions newer embolics such as Onyx. He adds that he sometimes administers a low dose of glucagon to inhibit bowel movements.


Finally, the doctors share various pearls of wisdom for GI embolization, such as the advantages of provocative angiogram, treatment decisions when a patient is crashing, and variceal indications for balloon-occluded retrograde transvenous obliteration (BRTO) and transjugular intrahepatic portosystemic shunt (TIPS).


---


RESOURCES


Ep. 118 BRTO vs. PARTO in Gastric Variceal Bleeding:

https://www.backtable.com/shows/vi/podcasts/47/brto-vs-parto-in-gastric-variceal-bleeding


YouTube Video: Embolization and Provocative Angiography in Lower GI Bleeds:

https://youtu.be/0MESQkTG6hI

]]> 2549 Ep. 178 Challenging Stroke Thrombectomies with Tough Clot with Dr. Matt Gounis and Dr. Hannes Nordmeyer Interventional Neuroradiologist Dr. Hannes Nordmeyer and Biomedical Engineer Dr. Matt Gounis discuss compositions of tough clots, approaches to stroke thrombectomy, and bailout stenting. --- CHECK OUT OUR SPONSOR CERENOVUS https://www.jnjmedicaldevices.com/en-US/companies/cerenovus --- SHOW NOTES In this episode, interventional neuroradiologist Dr. Hannes Nordmeyer, biomedical engineering professor Dr. Matt Gounis, and our host Dr. Michael Barraza discuss compositions of tough clots, approaches for stroke thrombectomy, and bailout stenting. Dr. Nordmeyer believes that interventionalists are still struggling to find the most effective method for pulling clots. He says that the use of double stent retrievers has shown high success rates, but it would be ideal to have one retriever that can work on its own. He describes his equipment setup for a standard large vessel occlusion. Dr. Nordmeyer notes clot location and behavior within the first two passes determines whether or not the operator should continue with the stent retrieval approach or change the approach. Dr. Gounis evaluates various devices by defining “success” as achievement of TICI 3 with the first pass. He comments on the current development of very large bore aspiration catheters, such as the 088 Millipede catheter and the Tenzing catheter. He also emphasizes that the success of the procedure relies largely on the composition of the embolus. Fibrin-rich clots are less likely to integrate with the stent retriever. We discuss Dr. Nordmeyer’s technique, which utilizes a microcatheter and the NIMBUS device to pin and retrieve the challenging clot. We also cover bailout stenting and the benefits of recanalization when clot removal is not possible. --- RESOURCES SWIFT DIRECT Trial: https://www.swift-direct.ch/the-swift-direct-trial/ Preclinical Evaluation of Millipede 088 Intracranial Aspiration Catheter: https://pubmed.ncbi.nlm.nih.gov/32606100/ The Novel Tenzing 7 Delivery Catheter Designed to Deliver Intermediate Catheters to the Face of Embolus Without Crossing: https://jnis.bmj.com/content/13/8/722 Factors Influencing Recanalization After Mechanical Thrombectomy With First-Pass Effect for Acute Ischemic Stroke: https://www.frontiersin.org/articles/10.3389/fneur.2021.628523/full NIMBUS Geometric Clot Extractor: https://www.jnjmedicaldevices.com/en-EMEA/news-events/cerenovus-launches-nimbustm-geometric-clot-extractor-remove-tough-clots Mon, 10 Jan 2022 05:00:00 -0000 full BackTable Interventional Neuroradiologist Dr. Hannes Nordmeyer and Biomedical Engineer Dr. Matt Gounis discuss compositions of tough clots, approaches to stroke thrombectomy, and bailout stenting. Interventional Neuroradiologist Dr. Hannes Nordmeyer and Biomedical Engineer Dr. Matt Gounis discuss compositions of tough clots, approaches to stroke thrombectomy, and bailout stenting. --- CHECK OUT OUR SPONSOR CERENOVUS https://www.jnjmedicaldevices.com/en-US/companies/cerenovus --- SHOW NOTES In this episode, interventional neuroradiologist Dr. Hannes Nordmeyer, biomedical engineering professor Dr. Matt Gounis, and our host Dr. Michael Barraza discuss compositions of tough clots, approaches for stroke thrombectomy, and bailout stenting. Dr. Nordmeyer believes that interventionalists are still struggling to find the most effective method for pulling clots. He says that the use of double stent retrievers has shown high success rates, but it would be ideal to have one retriever that can work on its own. He describes his equipment setup for a standard large vessel occlusion. Dr. Nordmeyer notes clot location and behavior within the first two passes determines whether or not the operator should continue with the stent retrieval approach or change the approach. Dr. Gounis evaluates various devices by defining “success” as achievement of TICI 3 with the first pass. He comments on the current development of very large bore aspiration catheters, such as the 088 Millipede catheter and the Tenzing catheter. He also emphasizes that the success of the procedure relies largely on the composition of the embolus. Fibrin-rich clots are less likely to integrate with the stent retriever. We discuss Dr. Nordmeyer’s technique, which utilizes a microcatheter and the NIMBUS device to pin and retrieve the challenging clot. We also cover bailout stenting and the benefits of recanalization when clot removal is not possible. --- RESOURCES SWIFT DIRECT Trial: https://www.swift-direct.ch/the-swift-direct-trial/ Preclinical Evaluation of Millipede 088 Intracranial Aspiration Catheter: https://pubmed.ncbi.nlm.nih.gov/32606100/ The Novel Tenzing 7 Delivery Catheter Designed to Deliver Intermediate Catheters to the Face of Embolus Without Crossing: https://jnis.bmj.com/content/13/8/722 Factors Influencing Recanalization After Mechanical Thrombectomy With First-Pass Effect for Acute Ischemic Stroke: https://www.frontiersin.org/articles/10.3389/fneur.2021.628523/full NIMBUS Geometric Clot Extractor: https://www.jnjmedicaldevices.com/en-EMEA/news-events/cerenovus-launches-nimbustm-geometric-clot-extractor-remove-tough-clots Interventional Neuroradiologist Dr. Hannes Nordmeyer and Biomedical Engineer Dr. Matt Gounis discuss compositions of tough clots, approaches to stroke thrombectomy, and bailout stenting.


---


CHECK OUT OUR SPONSOR


CERENOVUS

https://www.jnjmedicaldevices.com/en-US/companies/cerenovus


---


SHOW NOTES


In this episode, interventional neuroradiologist Dr. Hannes Nordmeyer, biomedical engineering professor Dr. Matt Gounis, and our host Dr. Michael Barraza discuss compositions of tough clots, approaches for stroke thrombectomy, and bailout stenting.


Dr. Nordmeyer believes that interventionalists are still struggling to find the most effective method for pulling clots. He says that the use of double stent retrievers has shown high success rates, but it would be ideal to have one retriever that can work on its own. He describes his equipment setup for a standard large vessel occlusion. Dr. Nordmeyer notes clot location and behavior within the first two passes determines whether or not the operator should continue with the stent retrieval approach or change the approach.


Dr. Gounis evaluates various devices by defining “success” as achievement of TICI 3 with the first pass. He comments on the current development of very large bore aspiration catheters, such as the 088 Millipede catheter and the Tenzing catheter. He also emphasizes that the success of the procedure relies largely on the composition of the embolus. Fibrin-rich clots are less likely to integrate with the stent retriever. We discuss Dr. Nordmeyer’s technique, which utilizes a microcatheter and the NIMBUS device to pin and retrieve the challenging clot.


We also cover bailout stenting and the benefits of recanalization when clot removal is not possible.


---


RESOURCES


SWIFT DIRECT Trial:

https://www.swift-direct.ch/the-swift-direct-trial/


Preclinical Evaluation of Millipede 088 Intracranial Aspiration Catheter:

https://pubmed.ncbi.nlm.nih.gov/32606100/


The Novel Tenzing 7 Delivery Catheter Designed to Deliver Intermediate Catheters to the Face of Embolus Without Crossing:

https://jnis.bmj.com/content/13/8/722


Factors Influencing Recanalization After Mechanical Thrombectomy With First-Pass Effect for Acute Ischemic Stroke: https://www.frontiersin.org/articles/10.3389/fneur.2021.628523/full


NIMBUS Geometric Clot Extractor:

https://www.jnjmedicaldevices.com/en-EMEA/news-events/cerenovus-launches-nimbustm-geometric-clot-extractor-remove-tough-clots

]]> 2165 Ep. 177 Doctors and Litigation: The L Word with Dr. Gita Pensa Emergency medicine physician and podcast founder Dr. Gita Pensa and our co-hosts Dr. Chris Beck and Dr. Aaron Fritts discuss methods of navigating malpractice lawsuits, maintaining professional identity, and prioritizing mental health. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Mfo9EF --- SHOW NOTES In this episode, emergency medicine physician and podcast founder Dr. Gita Pensa and our co-hosts Dr. Chris Beck and Dr. Aaron Fritts discuss methods of navigating malpractice lawsuits, maintaining professional identity, and prioritizing mental health. Dr. Pensa starts by outlining her personal experience with a twelve year-long malpractice suit, which inspired her to start her own podcast, “Doctors and Litigation: The L Word.” She says that despite the fact that most physicians will face lawsuits in their career, there is a current lack of physician-centered educational resources over malpractice litigation. To combat this, she encourages physicians to share their experiences and learn from one another. The doctors walk through major steps of a lawsuit, starting with the process of getting served with papers. Dr. Pensa emphasizes that it is important to recognize that this step could be used as the first tactical move in a lawsuit and designed to make physicians feel uneasy. The next step after getting served should always be to call the insurance carrier and have them start the process of initiating a claim. Dr. Pensa strongly advises against accessing or editing patient charts after getting served, as these actions are recorded in the EMR and can be used against the physician. Finally, Dr. Pensa discusses the process of deposition and how it serves as both a fact-finding mission and a strategic way to distort a physician’s words. She recommends practicing with lawyers to answer deposition questions clearly and concisely. Throughout the episode, the doctors highlight the importance of maintaining one’s mental health during the litigation process. They advise listeners to seek support from friends, family, colleagues, and professionals, as long as the specific details of the case are not discussed. To close, Dr. Pensa reminds the audience that malpractice lawsuits usually have financial motivations, and they may not be an accurate representation of a physician’s competence or compassion for patients. --- RESOURCES Doctors and Litigation: The L Word: https://doctorsandlitigation.com/ “The Defendant” by Sarah Charles: https://www.amazon.com/Defendant-Sarah-Charles/dp/0394746635 “Adverse Events, Stress, and Litigation” by Sarah Charles: https://www.amazon.com/Adverse-Events-Stress-Litigation-Physicians/dp/0195171489 “How to Survive a Medical Malpractice Lawsuit” by Ilene Brenner: https://www.amazon.com/How-Survive-Medical-Malpractice-Lawsuit-ebook/dp/B005C65X2M “When Good Doctors Get Sued” by Angela Dodge and Steven Fitzer: https://www.amazon.com/When-Good-Doctors-Get-Sued/dp/0977751104 Fri, 07 Jan 2022 05:00:00 -0000 full BackTable Emergency medicine physician and podcast founder Dr. Gita Pensa and our co-hosts Dr. Chris Beck and Dr. Aaron Fritts discuss methods of navigating malpractice lawsuits, maintaining professional identity, and prioritizing mental health. Emergency medicine physician and podcast founder Dr. Gita Pensa and our co-hosts Dr. Chris Beck and Dr. Aaron Fritts discuss methods of navigating malpractice lawsuits, maintaining professional identity, and prioritizing mental health. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Mfo9EF --- SHOW NOTES In this episode, emergency medicine physician and podcast founder Dr. Gita Pensa and our co-hosts Dr. Chris Beck and Dr. Aaron Fritts discuss methods of navigating malpractice lawsuits, maintaining professional identity, and prioritizing mental health. Dr. Pensa starts by outlining her personal experience with a twelve year-long malpractice suit, which inspired her to start her own podcast, “Doctors and Litigation: The L Word.” She says that despite the fact that most physicians will face lawsuits in their career, there is a current lack of physician-centered educational resources over malpractice litigation. To combat this, she encourages physicians to share their experiences and learn from one another. The doctors walk through major steps of a lawsuit, starting with the process of getting served with papers. Dr. Pensa emphasizes that it is important to recognize that this step could be used as the first tactical move in a lawsuit and designed to make physicians feel uneasy. The next step after getting served should always be to call the insurance carrier and have them start the process of initiating a claim. Dr. Pensa strongly advises against accessing or editing patient charts after getting served, as these actions are recorded in the EMR and can be used against the physician. Finally, Dr. Pensa discusses the process of deposition and how it serves as both a fact-finding mission and a strategic way to distort a physician’s words. She recommends practicing with lawyers to answer deposition questions clearly and concisely. Throughout the episode, the doctors highlight the importance of maintaining one’s mental health during the litigation process. They advise listeners to seek support from friends, family, colleagues, and professionals, as long as the specific details of the case are not discussed. To close, Dr. Pensa reminds the audience that malpractice lawsuits usually have financial motivations, and they may not be an accurate representation of a physician’s competence or compassion for patients. --- RESOURCES Doctors and Litigation: The L Word: https://doctorsandlitigation.com/ “The Defendant” by Sarah Charles: https://www.amazon.com/Defendant-Sarah-Charles/dp/0394746635 “Adverse Events, Stress, and Litigation” by Sarah Charles: https://www.amazon.com/Adverse-Events-Stress-Litigation-Physicians/dp/0195171489 “How to Survive a Medical Malpractice Lawsuit” by Ilene Brenner: https://www.amazon.com/How-Survive-Medical-Malpractice-Lawsuit-ebook/dp/B005C65X2M “When Good Doctors Get Sued” by Angela Dodge and Steven Fitzer: https://www.amazon.com/When-Good-Doctors-Get-Sued/dp/0977751104 Emergency medicine physician and podcast founder Dr. Gita Pensa and our co-hosts Dr. Chris Beck and Dr. Aaron Fritts discuss methods of navigating malpractice lawsuits, maintaining professional identity, and prioritizing mental health.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Mfo9EF


---


SHOW NOTES


In this episode, emergency medicine physician and podcast founder Dr. Gita Pensa and our co-hosts Dr. Chris Beck and Dr. Aaron Fritts discuss methods of navigating malpractice lawsuits, maintaining professional identity, and prioritizing mental health.


Dr. Pensa starts by outlining her personal experience with a twelve year-long malpractice suit, which inspired her to start her own podcast, “Doctors and Litigation: The L Word.” She says that despite the fact that most physicians will face lawsuits in their career, there is a current lack of physician-centered educational resources over malpractice litigation. To combat this, she encourages physicians to share their experiences and learn from one another.


The doctors walk through major steps of a lawsuit, starting with the process of getting served with papers. Dr. Pensa emphasizes that it is important to recognize that this step could be used as the first tactical move in a lawsuit and designed to make physicians feel uneasy. The next step after getting served should always be to call the insurance carrier and have them start the process of initiating a claim. Dr. Pensa strongly advises against accessing or editing patient charts after getting served, as these actions are recorded in the EMR and can be used against the physician. Finally, Dr. Pensa discusses the process of deposition and how it serves as both a fact-finding mission and a strategic way to distort a physician’s words. She recommends practicing with lawyers to answer deposition questions clearly and concisely.


Throughout the episode, the doctors highlight the importance of maintaining one’s mental health during the litigation process. They advise listeners to seek support from friends, family, colleagues, and professionals, as long as the specific details of the case are not discussed. To close, Dr. Pensa reminds the audience that malpractice lawsuits usually have financial motivations, and they may not be an accurate representation of a physician’s competence or compassion for patients.


---


RESOURCES


Doctors and Litigation: The L Word:

https://doctorsandlitigation.com/


“The Defendant” by Sarah Charles:

https://www.amazon.com/Defendant-Sarah-Charles/dp/0394746635


“Adverse Events, Stress, and Litigation” by Sarah Charles:

https://www.amazon.com/Adverse-Events-Stress-Litigation-Physicians/dp/0195171489


“How to Survive a Medical Malpractice Lawsuit” by Ilene Brenner:

https://www.amazon.com/How-Survive-Medical-Malpractice-Lawsuit-ebook/dp/B005C65X2M


“When Good Doctors Get Sued” by Angela Dodge and Steven Fitzer:

https://www.amazon.com/When-Good-Doctors-Get-Sued/dp/0977751104

]]> 3807 Ep. 176 Dealing with Complications: Advice From a Mentor with Dr. David Ball Dr. Aaron Fritts talks with mentor Dr. David Ball about dealing with complications throughout our professional career, including why physicians have trouble with it, and advice for what not to do when they happen. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/al4Ow0 --- SHOW NOTES In this episode, interventional radiologist Dr. David Ball and our host Dr. Aaron Fritts discuss the inevitability of unforeseen procedural complications, strategies to navigate patient and family communication, and lessons to take away from these experiences. To start, Dr. Ball recognizes the difficulty involved with addressing complications that cause patient injury, damage to physician reputation, and financial consequences. He emphasizes that it is therapeutic to speak about these outcomes with trainees and colleagues for learning purposes. Dr. Ball shares complications stories from his career and describes key takeaways from each. He describes the benefits of forming good relationships with patients and families prior to starting the case, performing a thorough check of all risk factors before the first puncture, and taking responsibility for complications that arise during the case. Finally, he discusses the balance between taking accountability for complications and being vulnerable to malpractice lawsuits. --- RESOURCES BackTable Episode 154, Complications Survey Results (Podcast): https://www.backtable.com/shows/vi/podcasts/154/discussing-the-complications-survey-results BackTable Episode 154 (Video): https://youtu.be/MuRISnu4gKU Mon, 03 Jan 2022 05:00:00 -0000 full BackTable Dr. Aaron Fritts talks with mentor Dr. David Ball about dealing with complications throughout our professional career, including why physicians have trouble with it, and advice for what not to do when they happen. Dr. Aaron Fritts talks with mentor Dr. David Ball about dealing with complications throughout our professional career, including why physicians have trouble with it, and advice for what not to do when they happen. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/al4Ow0 --- SHOW NOTES In this episode, interventional radiologist Dr. David Ball and our host Dr. Aaron Fritts discuss the inevitability of unforeseen procedural complications, strategies to navigate patient and family communication, and lessons to take away from these experiences. To start, Dr. Ball recognizes the difficulty involved with addressing complications that cause patient injury, damage to physician reputation, and financial consequences. He emphasizes that it is therapeutic to speak about these outcomes with trainees and colleagues for learning purposes. Dr. Ball shares complications stories from his career and describes key takeaways from each. He describes the benefits of forming good relationships with patients and families prior to starting the case, performing a thorough check of all risk factors before the first puncture, and taking responsibility for complications that arise during the case. Finally, he discusses the balance between taking accountability for complications and being vulnerable to malpractice lawsuits. --- RESOURCES BackTable Episode 154, Complications Survey Results (Podcast): https://www.backtable.com/shows/vi/podcasts/154/discussing-the-complications-survey-results BackTable Episode 154 (Video): https://youtu.be/MuRISnu4gKU Dr. Aaron Fritts talks with mentor Dr. David Ball about dealing with complications throughout our professional career, including why physicians have trouble with it, and advice for what not to do when they happen.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/al4Ow0


---


SHOW NOTES


In this episode, interventional radiologist Dr. David Ball and our host Dr. Aaron Fritts discuss the inevitability of unforeseen procedural complications, strategies to navigate patient and family communication, and lessons to take away from these experiences.


To start, Dr. Ball recognizes the difficulty involved with addressing complications that cause patient injury, damage to physician reputation, and financial consequences. He emphasizes that it is therapeutic to speak about these outcomes with trainees and colleagues for learning purposes.


Dr. Ball shares complications stories from his career and describes key takeaways from each. He describes the benefits of forming good relationships with patients and families prior to starting the case, performing a thorough check of all risk factors before the first puncture, and taking responsibility for complications that arise during the case. Finally, he discusses the balance between taking accountability for complications and being vulnerable to malpractice lawsuits.


---


RESOURCES


BackTable Episode 154, Complications Survey Results (Podcast):

https://www.backtable.com/shows/vi/podcasts/154/discussing-the-complications-survey-results


BackTable Episode 154 (Video):

https://youtu.be/MuRISnu4gKU

]]> 1817 Ep. 175 Treating Below the Knee Calcium with Dr. Kumar Madassery CLI fighters Dr. Kumar Madassery and Dr. Sabeen Dhand discuss their approach to treating calcified arteries below the knee, including looking at newer technologies and choosing the appropriate device to effect real durable change to the calcified wall. --- CHECK OUT OUR SPONSOR Shockwave Medical https://shockwavemedical.com/?utm_source=BTK-Backtable-Podcast&utm_campaign=Backtable-Podcast --- SHOW NOTES In this episode, interventional radiologist Dr. Kumar Madassery and our host Dr. Sabeen Dhand discuss atherosclerosis in tibial vessels below the knee and devices for atherectomy, angioplasty, and dissection repair. While non-invasive imaging for calcium is still lacking, Dr. Madassery encourages operators to look for calcium on X-ray and ultrasound. He believes that visualization with ultrasound will improve if there is greater collaboration and standardization across all operators. Next, Dr. Madassery differentiates between intimal and medial calcifications. He notes that medial calcifications usually present as “railroad tracks” in diabetic and end-stage renal failure patients, while intimal calcifications lead to plaque ruptures. Each type is distinguishable with the use of intravascular ultrasound (IVUS). Dr. Madassery walks through his approach to calcified lesions. He says that using angiogram to identify whether a lesion is stenotic or occlusive is a crucial first step. He also emphasizes the importance of having a wire escalation strategy. The doctors highlight orbital and laser atherectomy, scoring balloons, and intravascular lithotripsy (IVL). Finally, Dr. Madassery describes his perspective on arterial dissection, a common complication of balloon angioplasty. The decision to treat dissections is dependent on the operator, but he gives advice on weighing the pros and cons of treating. He speaks about the advantages of using the self-expanding Tack system to stent only specific problematic regions. Mon, 27 Dec 2021 05:00:00 -0000 full BackTable CLI fighters Dr. Kumar Madassery and Dr. Sabeen Dhand discuss their approach to treating calcified arteries below the knee, including looking at newer technologies and choosing the appropriate device to effect real durable change to the calcified wall. CLI fighters Dr. Kumar Madassery and Dr. Sabeen Dhand discuss their approach to treating calcified arteries below the knee, including looking at newer technologies and choosing the appropriate device to effect real durable change to the calcified wall. --- CHECK OUT OUR SPONSOR Shockwave Medical https://shockwavemedical.com/?utm_source=BTK-Backtable-Podcast&utm_campaign=Backtable-Podcast --- SHOW NOTES In this episode, interventional radiologist Dr. Kumar Madassery and our host Dr. Sabeen Dhand discuss atherosclerosis in tibial vessels below the knee and devices for atherectomy, angioplasty, and dissection repair. While non-invasive imaging for calcium is still lacking, Dr. Madassery encourages operators to look for calcium on X-ray and ultrasound. He believes that visualization with ultrasound will improve if there is greater collaboration and standardization across all operators. Next, Dr. Madassery differentiates between intimal and medial calcifications. He notes that medial calcifications usually present as “railroad tracks” in diabetic and end-stage renal failure patients, while intimal calcifications lead to plaque ruptures. Each type is distinguishable with the use of intravascular ultrasound (IVUS). Dr. Madassery walks through his approach to calcified lesions. He says that using angiogram to identify whether a lesion is stenotic or occlusive is a crucial first step. He also emphasizes the importance of having a wire escalation strategy. The doctors highlight orbital and laser atherectomy, scoring balloons, and intravascular lithotripsy (IVL). Finally, Dr. Madassery describes his perspective on arterial dissection, a common complication of balloon angioplasty. The decision to treat dissections is dependent on the operator, but he gives advice on weighing the pros and cons of treating. He speaks about the advantages of using the self-expanding Tack system to stent only specific problematic regions. CLI fighters Dr. Kumar Madassery and Dr. Sabeen Dhand discuss their approach to treating calcified arteries below the knee, including looking at newer technologies and choosing the appropriate device to effect real durable change to the calcified wall.


---


CHECK OUT OUR SPONSOR


Shockwave Medical

https://shockwavemedical.com/?utm_source=BTK-Backtable-Podcast&utm_campaign=Backtable-Podcast


---


SHOW NOTES


In this episode, interventional radiologist Dr. Kumar Madassery and our host Dr. Sabeen Dhand discuss atherosclerosis in tibial vessels below the knee and devices for atherectomy, angioplasty, and dissection repair.


While non-invasive imaging for calcium is still lacking, Dr. Madassery encourages operators to look for calcium on X-ray and ultrasound. He believes that visualization with ultrasound will improve if there is greater collaboration and standardization across all operators. Next, Dr. Madassery differentiates between intimal and medial calcifications. He notes that medial calcifications usually present as “railroad tracks” in diabetic and end-stage renal failure patients, while intimal calcifications lead to plaque ruptures. Each type is distinguishable with the use of intravascular ultrasound (IVUS).


Dr. Madassery walks through his approach to calcified lesions. He says that using angiogram to identify whether a lesion is stenotic or occlusive is a crucial first step. He also emphasizes the importance of having a wire escalation strategy. The doctors highlight orbital and laser atherectomy, scoring balloons, and intravascular lithotripsy (IVL).


Finally, Dr. Madassery describes his perspective on arterial dissection, a common complication of balloon angioplasty. The decision to treat dissections is dependent on the operator, but he gives advice on weighing the pros and cons of treating. He speaks about the advantages of using the self-expanding Tack system to stent only specific problematic regions.

]]> 2376 Ep. 174 Making the Switch: Transitioning from Private Practice to Academics with Dr. Amy Taylor Dr. Aparna Baheti and Dr. Amy Taylor discuss the considerations around returning to academic interventional radiology after starting a career in private practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/v6RYgR --- SHOW NOTES In this episode, interventional radiologist Dr. Amy Taylor and our host Dr. Ally Baheti discuss factors that can facilitate the transition from private practice to academic medicine. Dr. Taylor speaks about the course that her career has taken since she completed her fellowship. She highlights contrasts between the private and academic spheres, noting that each allows freedom in different aspects of the job. She encourages IRs to take sufficient time to evaluate their culture fit in their current roles before deciding to transition. When navigating her transition back into academic medicine, Dr. Taylor notes that her former fellowship attendings provided strong support and advice. She advocates for normalizing conversations about career changes. --- RESOURCES SIR Foundation Research Grants: https://apply.sirfoundation.org/ Mon, 20 Dec 2021 05:00:00 -0000 full BackTable Dr. Aparna Baheti and Dr. Amy Taylor discuss the considerations around returning to academic interventional radiology after starting a career in private practice. Dr. Aparna Baheti and Dr. Amy Taylor discuss the considerations around returning to academic interventional radiology after starting a career in private practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/v6RYgR --- SHOW NOTES In this episode, interventional radiologist Dr. Amy Taylor and our host Dr. Ally Baheti discuss factors that can facilitate the transition from private practice to academic medicine. Dr. Taylor speaks about the course that her career has taken since she completed her fellowship. She highlights contrasts between the private and academic spheres, noting that each allows freedom in different aspects of the job. She encourages IRs to take sufficient time to evaluate their culture fit in their current roles before deciding to transition. When navigating her transition back into academic medicine, Dr. Taylor notes that her former fellowship attendings provided strong support and advice. She advocates for normalizing conversations about career changes. --- RESOURCES SIR Foundation Research Grants: https://apply.sirfoundation.org/ Dr. Aparna Baheti and Dr. Amy Taylor discuss the considerations around returning to academic interventional radiology after starting a career in private practice.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/v6RYgR


---


SHOW NOTES


In this episode, interventional radiologist Dr. Amy Taylor and our host Dr. Ally Baheti discuss factors that can facilitate the transition from private practice to academic medicine.


Dr. Taylor speaks about the course that her career has taken since she completed her fellowship. She highlights contrasts between the private and academic spheres, noting that each allows freedom in different aspects of the job. She encourages IRs to take sufficient time to evaluate their culture fit in their current roles before deciding to transition.


When navigating her transition back into academic medicine, Dr. Taylor notes that her former fellowship attendings provided strong support and advice. She advocates for normalizing conversations about career changes.


---


RESOURCES


SIR Foundation Research Grants: https://apply.sirfoundation.org/

]]> 1674 Ep. 173 IR Residency Interviews: Tips from a Program Director with Dr. Luke Wilkins In this Trainee Focus episode, guest host Sunny Murthy talks with Universtiy of Virginia program director Dr. Luke Wilkins about what it takes to become an interventional radiology resident, including tips on finding the right program fit and how to crush the interview day. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/bNit7I --- SHOW NOTES In this episode, University of Virginia interventional radiology and diagnostic radiology program director Dr. Luke Wilkins and our guest host Sunny Murthy discuss the factors that contribute to a successful IR residency application and interview. With the USMLE Step 1 exam moving towards a pass/fail system, Dr. Wilkins emphasizes that it is important for applicants to distinguish themselves by finding ways to show dedication to the field of IR. We also discuss the benefits of having exposure to different programs prior to the application cycle, whether it is through rotations, virtual communication, or SIR involvement. Dr. Wilkins encourages each applicant to recognize programs that fit best with their personality and learning style. He offers his perspective on good program characteristics to look for, such as flexibility in career preparation and wide case variety. Finally, Dr. Wilkins speaks about how authenticity in the application process can maximize benefits for both applicants and programs. --- RESOURCES SIR Residents, Fellows, Students Section: http://rfs.sirweb.org/ Fri, 17 Dec 2021 05:00:00 -0000 full BackTable In this Trainee Focus episode, guest host Sunny Murthy talks with Universtiy of Virginia program director Dr. Luke Wilkins about what it takes to become an interventional radiology resident, including tips on finding the right program fit and how to crush the interview day. In this Trainee Focus episode, guest host Sunny Murthy talks with Universtiy of Virginia program director Dr. Luke Wilkins about what it takes to become an interventional radiology resident, including tips on finding the right program fit and how to crush the interview day. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/bNit7I --- SHOW NOTES In this episode, University of Virginia interventional radiology and diagnostic radiology program director Dr. Luke Wilkins and our guest host Sunny Murthy discuss the factors that contribute to a successful IR residency application and interview. With the USMLE Step 1 exam moving towards a pass/fail system, Dr. Wilkins emphasizes that it is important for applicants to distinguish themselves by finding ways to show dedication to the field of IR. We also discuss the benefits of having exposure to different programs prior to the application cycle, whether it is through rotations, virtual communication, or SIR involvement. Dr. Wilkins encourages each applicant to recognize programs that fit best with their personality and learning style. He offers his perspective on good program characteristics to look for, such as flexibility in career preparation and wide case variety. Finally, Dr. Wilkins speaks about how authenticity in the application process can maximize benefits for both applicants and programs. --- RESOURCES SIR Residents, Fellows, Students Section: http://rfs.sirweb.org/ In this Trainee Focus episode, guest host Sunny Murthy talks with Universtiy of Virginia program director Dr. Luke Wilkins about what it takes to become an interventional radiology resident, including tips on finding the right program fit and how to crush the interview day.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/bNit7I


---


SHOW NOTES


In this episode, University of Virginia interventional radiology and diagnostic radiology program director Dr. Luke Wilkins and our guest host Sunny Murthy discuss the factors that contribute to a successful IR residency application and interview.


With the USMLE Step 1 exam moving towards a pass/fail system, Dr. Wilkins emphasizes that it is important for applicants to distinguish themselves by finding ways to show dedication to the field of IR. We also discuss the benefits of having exposure to different programs prior to the application cycle, whether it is through rotations, virtual communication, or SIR involvement.


Dr. Wilkins encourages each applicant to recognize programs that fit best with their personality and learning style. He offers his perspective on good program characteristics to look for, such as flexibility in career preparation and wide case variety. Finally, Dr. Wilkins speaks about how authenticity in the application process can maximize benefits for both applicants and programs.


---


RESOURCES


SIR Residents, Fellows, Students Section: http://rfs.sirweb.org/

]]> 1820 Ep. 172 Treating Above the Knee Calcium with Dr. Bryan Fisher CLI fighters Dr. Bryan Fisher and Dr. Sabeen Dhand discuss their approach to treating calcified arteries above the knee, including looking at newer technologies and choosing the appropriate device to effect real durable change to the calcified wall. --- CHECK OUT OUR SPONSOR Shockwave Medical https://shockwavemedical.com/?utm_source=ATK-Backtable-Podcast&utm_campaign=Backtable-Podcast --- SHOW NOTES In this episode, vascular surgeon Dr. Bryan Fisher and our host Dr. Sabeen Dhand discuss treatments, intravascular ultrasound (IVUS), and device selection for calcified lesions above the knee. First, Dr. Fisher discusses common risk factors for above the knee calcifications, including diabetes, end-stage renal disease, and smoking. In his diagnostic workup, he highlights the benefits of using CT for showing atherosclerotic disease, as well as IVUS for viewing intimal and medial calcifications. With intimal calcifications, Dr. Fisher prefers to use an atherectomy device. For severely stenotic regions, he notes that orbital atherectomy can clear the way for other devices to pass through. After atherectomy, he usually performs IVUS to identify the luminal gain and assess the degree of plaque modification. The doctors talk about new frontiers in technology such as intravascular lithotripsy, a technique that has been modified from urological treatment. The intermittent delivery of focal energy cracks calcium deposits and minimizes the risk of vessel rupture. Additionally, they discuss optical coherence tomography and how it can assist in visualizing the results of lithotripsy. Overall, Dr. Fisher believes that angioplasties will likely cause injury to intimal walls, but these effects can be minimized by knowledge of vessel architecture and proper device selection. --- RESOURCES The Surgical Clinic: https://thesurgicalclinics.com/ Shockwave Intravascular Lithotripsy: https://shockwavemedical.com/clinicians/international/peripheral/ Mon, 13 Dec 2021 05:00:00 -0000 full BackTable CLI fighters Dr. Bryan Fisher and Dr. Sabeen Dhand discuss their approach to treating calcified arteries above the knee, including looking at newer technologies and choosing the appropriate device to effect real durable change to the calcified wall. CLI fighters Dr. Bryan Fisher and Dr. Sabeen Dhand discuss their approach to treating calcified arteries above the knee, including looking at newer technologies and choosing the appropriate device to effect real durable change to the calcified wall. --- CHECK OUT OUR SPONSOR Shockwave Medical https://shockwavemedical.com/?utm_source=ATK-Backtable-Podcast&utm_campaign=Backtable-Podcast --- SHOW NOTES In this episode, vascular surgeon Dr. Bryan Fisher and our host Dr. Sabeen Dhand discuss treatments, intravascular ultrasound (IVUS), and device selection for calcified lesions above the knee. First, Dr. Fisher discusses common risk factors for above the knee calcifications, including diabetes, end-stage renal disease, and smoking. In his diagnostic workup, he highlights the benefits of using CT for showing atherosclerotic disease, as well as IVUS for viewing intimal and medial calcifications. With intimal calcifications, Dr. Fisher prefers to use an atherectomy device. For severely stenotic regions, he notes that orbital atherectomy can clear the way for other devices to pass through. After atherectomy, he usually performs IVUS to identify the luminal gain and assess the degree of plaque modification. The doctors talk about new frontiers in technology such as intravascular lithotripsy, a technique that has been modified from urological treatment. The intermittent delivery of focal energy cracks calcium deposits and minimizes the risk of vessel rupture. Additionally, they discuss optical coherence tomography and how it can assist in visualizing the results of lithotripsy. Overall, Dr. Fisher believes that angioplasties will likely cause injury to intimal walls, but these effects can be minimized by knowledge of vessel architecture and proper device selection. --- RESOURCES The Surgical Clinic: https://thesurgicalclinics.com/ Shockwave Intravascular Lithotripsy: https://shockwavemedical.com/clinicians/international/peripheral/ CLI fighters Dr. Bryan Fisher and Dr. Sabeen Dhand discuss their approach to treating calcified arteries above the knee, including looking at newer technologies and choosing the appropriate device to effect real durable change to the calcified wall.


---


CHECK OUT OUR SPONSOR


Shockwave Medical

https://shockwavemedical.com/?utm_source=ATK-Backtable-Podcast&utm_campaign=Backtable-Podcast


---


SHOW NOTES


In this episode, vascular surgeon Dr. Bryan Fisher and our host Dr. Sabeen Dhand discuss treatments, intravascular ultrasound (IVUS), and device selection for calcified lesions above the knee.


First, Dr. Fisher discusses common risk factors for above the knee calcifications, including diabetes, end-stage renal disease, and smoking. In his diagnostic workup, he highlights the benefits of using CT for showing atherosclerotic disease, as well as IVUS for viewing intimal and medial calcifications.


With intimal calcifications, Dr. Fisher prefers to use an atherectomy device. For severely stenotic regions, he notes that orbital atherectomy can clear the way for other devices to pass through. After atherectomy, he usually performs IVUS to identify the luminal gain and assess the degree of plaque modification.


The doctors talk about new frontiers in technology such as intravascular lithotripsy, a technique that has been modified from urological treatment. The intermittent delivery of focal energy cracks calcium deposits and minimizes the risk of vessel rupture. Additionally, they discuss optical coherence tomography and how it can assist in visualizing the results of lithotripsy.


Overall, Dr. Fisher believes that angioplasties will likely cause injury to intimal walls, but these effects can be minimized by knowledge of vessel architecture and proper device selection.


---


RESOURCES


The Surgical Clinic: https://thesurgicalclinics.com/


Shockwave Intravascular Lithotripsy: https://shockwavemedical.com/clinicians/international/peripheral/

]]> 2075 Ep. 171 The Making of a “Good” IR with Dr. Lola Oladini Dr. Eric Keller talks with Dr. Lola Oladini from Stanford Medicine Department of Radiology about what makes optimal training for Interventional Radiologists, including discussion on the variety of strengths of programs across the country, balancing diagnostics with procedural training, and what it means in being a "clinical IR". --- CHECK OUT OUR SPONSOR Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/bOp6I7 --- SHOW NOTES In this episode, interventional radiology residents Dr. Lola Oladini and Dr. Eric Keller discuss ideas to strengthen IR/DR residency training in multiple aspects, including clinical exposure, practice building, and personalization for the learner’s career goals. Dr. Oladini shares preliminary results from her research, which consisted of interviews with various IR stakeholders. She highlights common themes on what interviewees value in a residency program: longitudinal patient care experience, practice-building education, exposure to interdisciplinary collaboration, exposure to clinical decision making, strong diagnostic radiology training, and graduated autonomy. She also shares common concerns that interviewees had about the disconnects between clinical education in residency training and real world practices that may not have the same clinical focus. Additionally, residents spoke about balancing the paradigm between wanting to get early IR exposure and training to be excellent diagnostic radiologists. Finally, the doctors discuss different interpretations of the commonly used term, “clinical IR,” and brainstorm ways that residency programs can involve trainees in patient-centered initiatives and cross-speciality relationship building. --- RESOURCES SIR Residency Essentials: https://www.sirweb.org/learning-center/learning-center/residency-essentials-and-fundamentals/residency-essentials/ Mon, 06 Dec 2021 05:00:00 -0000 full BackTable Dr. Eric Keller talks with Dr. Lola Oladini from Stanford Medicine Department of Radiology about what makes optimal training for Interventional Radiologists, including discussion on the variety of strengths of programs across the country, balancing diagnostics with procedural training, and what it means in being a "clinical IR". Dr. Eric Keller talks with Dr. Lola Oladini from Stanford Medicine Department of Radiology about what makes optimal training for Interventional Radiologists, including discussion on the variety of strengths of programs across the country, balancing diagnostics with procedural training, and what it means in being a "clinical IR". --- CHECK OUT OUR SPONSOR Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/bOp6I7 --- SHOW NOTES In this episode, interventional radiology residents Dr. Lola Oladini and Dr. Eric Keller discuss ideas to strengthen IR/DR residency training in multiple aspects, including clinical exposure, practice building, and personalization for the learner’s career goals. Dr. Oladini shares preliminary results from her research, which consisted of interviews with various IR stakeholders. She highlights common themes on what interviewees value in a residency program: longitudinal patient care experience, practice-building education, exposure to interdisciplinary collaboration, exposure to clinical decision making, strong diagnostic radiology training, and graduated autonomy. She also shares common concerns that interviewees had about the disconnects between clinical education in residency training and real world practices that may not have the same clinical focus. Additionally, residents spoke about balancing the paradigm between wanting to get early IR exposure and training to be excellent diagnostic radiologists. Finally, the doctors discuss different interpretations of the commonly used term, “clinical IR,” and brainstorm ways that residency programs can involve trainees in patient-centered initiatives and cross-speciality relationship building. --- RESOURCES SIR Residency Essentials: https://www.sirweb.org/learning-center/learning-center/residency-essentials-and-fundamentals/residency-essentials/ Dr. Eric Keller talks with Dr. Lola Oladini from Stanford Medicine Department of Radiology about what makes optimal training for Interventional Radiologists, including discussion on the variety of strengths of programs across the country, balancing diagnostics with procedural training, and what it means in being a "clinical IR".


---


CHECK OUT OUR SPONSOR


Medtronic Chocolate PTA Balloon

https://www.medtronic.com/peripheral


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/bOp6I7


---


SHOW NOTES


In this episode, interventional radiology residents Dr. Lola Oladini and Dr. Eric Keller discuss ideas to strengthen IR/DR residency training in multiple aspects, including clinical exposure, practice building, and personalization for the learner’s career goals.


Dr. Oladini shares preliminary results from her research, which consisted of interviews with various IR stakeholders. She highlights common themes on what interviewees value in a residency program: longitudinal patient care experience, practice-building education, exposure to interdisciplinary collaboration, exposure to clinical decision making, strong diagnostic radiology training, and graduated autonomy. She also shares common concerns that interviewees had about the disconnects between clinical education in residency training and real world practices that may not have the same clinical focus. Additionally, residents spoke about balancing the paradigm between wanting to get early IR exposure and training to be excellent diagnostic radiologists.


Finally, the doctors discuss different interpretations of the commonly used term, “clinical IR,” and brainstorm ways that residency programs can involve trainees in patient-centered initiatives and cross-speciality relationship building.


---


RESOURCES


SIR Residency Essentials: https://www.sirweb.org/learning-center/learning-center/residency-essentials-and-fundamentals/residency-essentials/

]]> 2401 Ep. 170 Operate With Zen with Phil Pierorazio Dr. Aditya Bagrodia and Dr. Aaron Fritts talk with Dr. Phillip Pierorazio from Penn Urology about his Operate with Zen podcast and tips for surgeon wellness. They cover Dr. Pierorazio's motivation for starting a wellness podcast, preventing physician burnout, achieving work-life balance, and managing healthy competitiveness. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/A9shzj --- SHOW NOTES In this crossover episode of BackTable Urology and BackTable VI, Dr. Aaron Fritts and Dr. Aditya Bagrodia speak with Dr. Phil Pierorazio about surgeon wellness and his mindfulness podcast, Operate with Zen. First, Dr. Pierorazio discusses his motivation for starting the Operate with Zen podcast. During the pandemic, he crafted a new goal for himself: to be happier in surgery. He defines mindfulness as taking a moment to enjoy his livelihood and being more present at work and at home. Next, the doctors tackle the topic of physician burnout. All three doctors agree that burnout is not a badge of honor and are glad that the culture of medicine is progressing towards one that reprimands toxic attitudes early in training. As for managing work-life balance, Dr. Pierorazio explains that once he started creating boundaries for his work schedule, he expanded what he could do. He encourages other surgeons to trust that their colleagues can handle emergencies, even if the patients are not their own patients. Collaboration with colleagues also leads to healthy competitiveness, a concept in which physicians stop comparing themselves to each other and instead celebrate their fellow colleagues. Dr. Pierorazio recommends channeling toxic competitive energy towards a drive to better a broader institution and patient care. Finally, Dr. Pierorazio shares two of his personal tips for wellness. He avidly journals each day in order to exercise gratitude, reflect on his day, and set priorities for the next day. Finally, he emphasizes the importance of finding a wellness mentor or counselor in order to expand surgeon wellness and talent. Fri, 03 Dec 2021 05:00:00 -0000 full BackTable Dr. Aditya Bagrodia and Dr. Aaron Fritts talk with Dr. Phillip Pierorazio from Penn Urology about his Operate with Zen podcast and tips for surgeon wellness. They cover Dr. Pierorazio's motivation for starting a wellness podcast, preventing physician burnout, achieving work-life balance, and managing healthy competitiveness. Dr. Aditya Bagrodia and Dr. Aaron Fritts talk with Dr. Phillip Pierorazio from Penn Urology about his Operate with Zen podcast and tips for surgeon wellness. They cover Dr. Pierorazio's motivation for starting a wellness podcast, preventing physician burnout, achieving work-life balance, and managing healthy competitiveness. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/A9shzj --- SHOW NOTES In this crossover episode of BackTable Urology and BackTable VI, Dr. Aaron Fritts and Dr. Aditya Bagrodia speak with Dr. Phil Pierorazio about surgeon wellness and his mindfulness podcast, Operate with Zen. First, Dr. Pierorazio discusses his motivation for starting the Operate with Zen podcast. During the pandemic, he crafted a new goal for himself: to be happier in surgery. He defines mindfulness as taking a moment to enjoy his livelihood and being more present at work and at home. Next, the doctors tackle the topic of physician burnout. All three doctors agree that burnout is not a badge of honor and are glad that the culture of medicine is progressing towards one that reprimands toxic attitudes early in training. As for managing work-life balance, Dr. Pierorazio explains that once he started creating boundaries for his work schedule, he expanded what he could do. He encourages other surgeons to trust that their colleagues can handle emergencies, even if the patients are not their own patients. Collaboration with colleagues also leads to healthy competitiveness, a concept in which physicians stop comparing themselves to each other and instead celebrate their fellow colleagues. Dr. Pierorazio recommends channeling toxic competitive energy towards a drive to better a broader institution and patient care. Finally, Dr. Pierorazio shares two of his personal tips for wellness. He avidly journals each day in order to exercise gratitude, reflect on his day, and set priorities for the next day. Finally, he emphasizes the importance of finding a wellness mentor or counselor in order to expand surgeon wellness and talent. Dr. Aditya Bagrodia and Dr. Aaron Fritts talk with Dr. Phillip Pierorazio from Penn Urology about his Operate with Zen podcast and tips for surgeon wellness. They cover Dr. Pierorazio's motivation for starting a wellness podcast, preventing physician burnout, achieving work-life balance, and managing healthy competitiveness.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/A9shzj


---


SHOW NOTES


In this crossover episode of BackTable Urology and BackTable VI, Dr. Aaron Fritts and Dr. Aditya Bagrodia speak with Dr. Phil Pierorazio about surgeon wellness and his mindfulness podcast, Operate with Zen.


First, Dr. Pierorazio discusses his motivation for starting the Operate with Zen podcast. During the pandemic, he crafted a new goal for himself: to be happier in surgery. He defines mindfulness as taking a moment to enjoy his livelihood and being more present at work and at home. Next, the doctors tackle the topic of physician burnout. All three doctors agree that burnout is not a badge of honor and are glad that the culture of medicine is progressing towards one that reprimands toxic attitudes early in training.


As for managing work-life balance, Dr. Pierorazio explains that once he started creating boundaries for his work schedule, he expanded what he could do. He encourages other surgeons to trust that their colleagues can handle emergencies, even if the patients are not their own patients. Collaboration with colleagues also leads to healthy competitiveness, a concept in which physicians stop comparing themselves to each other and instead celebrate their fellow colleagues. Dr. Pierorazio recommends channeling toxic competitive energy towards a drive to better a broader institution and patient care.


Finally, Dr. Pierorazio shares two of his personal tips for wellness. He avidly journals each day in order to exercise gratitude, reflect on his day, and set priorities for the next day. Finally, he emphasizes the importance of finding a wellness mentor or counselor in order to expand surgeon wellness and talent.

]]> 2995 Ep. 169 Fallopian Tube Recanalization with Dr. Renato Abu Hana Dr. Renato Abu Hana walks us through how to perform fallopian tube recanalization for infertility, including patient selection, HSG and recanalization technique, as well as pitfalls to avoid. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/gJb6X6 --- SHOW NOTES In this episode, interventional radiologist Dr. Renato Abu Hana and our host Dr. Chris Beck discuss fallopian tube recanalization procedure and patient counseling. Tubal occlusion is one of the leading causes of infertility, and can be diagnosed with a hysterosalpingogram (HSG), a procedure that uses X-ray to check for blockages. Blockages can be cured by subsequent selective salpingography. Since the HSG can be a sensitive gynecologic examination with little to no sedation, Dr. Hana shares advice on how to explain the procedure to patients and make them feel more comfortable during the exam. Dr. Hana describes his HSG procedure to us. He notes that the initial speculum insertion can be difficult because of differences in cervical anatomy. He also discusses patient positioning, different tool sets, and his method of injection. To address complications and risks, Dr. Hana recommends prescribing antibiotics to prevent post-procedural infection. Additionally, he emphasizes the need to minimize radiation exposure as much as possible in a patient who is trying to become pregnant. Finally, we highlight the benefits of fallopian tube recanalization, which include low risk of complications, potentially large impacts on the patients’ ability to conceive, and medical cost savings (when used as an alternative to in vitro fertilization). Mon, 29 Nov 2021 05:00:00 -0000 full BackTable Dr. Renato Abu Hana walks us through how to perform fallopian tube recanalization for infertility, including patient selection, HSG and recanalization technique, as well as pitfalls to avoid. Dr. Renato Abu Hana walks us through how to perform fallopian tube recanalization for infertility, including patient selection, HSG and recanalization technique, as well as pitfalls to avoid. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/gJb6X6 --- SHOW NOTES In this episode, interventional radiologist Dr. Renato Abu Hana and our host Dr. Chris Beck discuss fallopian tube recanalization procedure and patient counseling. Tubal occlusion is one of the leading causes of infertility, and can be diagnosed with a hysterosalpingogram (HSG), a procedure that uses X-ray to check for blockages. Blockages can be cured by subsequent selective salpingography. Since the HSG can be a sensitive gynecologic examination with little to no sedation, Dr. Hana shares advice on how to explain the procedure to patients and make them feel more comfortable during the exam. Dr. Hana describes his HSG procedure to us. He notes that the initial speculum insertion can be difficult because of differences in cervical anatomy. He also discusses patient positioning, different tool sets, and his method of injection. To address complications and risks, Dr. Hana recommends prescribing antibiotics to prevent post-procedural infection. Additionally, he emphasizes the need to minimize radiation exposure as much as possible in a patient who is trying to become pregnant. Finally, we highlight the benefits of fallopian tube recanalization, which include low risk of complications, potentially large impacts on the patients’ ability to conceive, and medical cost savings (when used as an alternative to in vitro fertilization). Dr. Renato Abu Hana walks us through how to perform fallopian tube recanalization for infertility, including patient selection, HSG and recanalization technique, as well as pitfalls to avoid.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/gJb6X6


---


SHOW NOTES


In this episode, interventional radiologist Dr. Renato Abu Hana and our host Dr. Chris Beck discuss fallopian tube recanalization procedure and patient counseling.


Tubal occlusion is one of the leading causes of infertility, and can be diagnosed with a hysterosalpingogram (HSG), a procedure that uses X-ray to check for blockages. Blockages can be cured by subsequent selective salpingography. Since the HSG can be a sensitive gynecologic examination with little to no sedation, Dr. Hana shares advice on how to explain the procedure to patients and make them feel more comfortable during the exam.


Dr. Hana describes his HSG procedure to us. He notes that the initial speculum insertion can be difficult because of differences in cervical anatomy. He also discusses patient positioning, different tool sets, and his method of injection. To address complications and risks, Dr. Hana recommends prescribing antibiotics to prevent post-procedural infection. Additionally, he emphasizes the need to minimize radiation exposure as much as possible in a patient who is trying to become pregnant.


Finally, we highlight the benefits of fallopian tube recanalization, which include low risk of complications, potentially large impacts on the patients’ ability to conceive, and medical cost savings (when used as an alternative to in vitro fertilization).

]]> 2719 Ep. 168 Debunking Contrast Allergies with Dr. Cullen Ruff We talk with Dr. Cullen Ruff about common misconceptions when it comes to IV contrast and issues with the "contrast allergy", including ways we can improve patient care and clinical workflows by clarifying the true source of these reactions. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/16AayH --- SHOW NOTES In this episode, diagnostic radiologist Dr. Cullen Ruff and our host Dr. Chris Beck discuss the research and patient education surrounding contrast allergies. Dr. Cullen starts the episode by commenting on the history of contrast media, noting that the earlier ionic contrast agents are more allergenic than the more recent non-ionic ones. By knowing the time period during which many radiologists switched to non-ionic agents (around 1985), we can identify during a medical history which of these types caused a patient’s allergic reaction. The doctors discuss current research, which shows that substituting for a different contrast media is more effective than giving steroid premedication and using the allergy-inducing contrast media. Unfortunately, many patients are unable to recall the year when they experienced their allergy or the name of the contrast agent given. This lack of information makes it difficult to administer a substitute contrast media to the patient. To address these workflow inefficiencies, Dr. Cullen advocates for individualized patient education over specific contrast allergies. He believes that taking the time to discuss allergies and giving the patient the name of their allergen, in writing, is essential for future imaging studies. He advises against the use of the vague and nonsensical term of “iodine allergy”, noting that patients are never allergic to the iodine itself, but rather a different component in the iodinated contrast media. Finally, we discuss Dr. Cullen’s book, “Looking Within: Understanding Ourselves Through Human Imaging” in which he shares patient stories and introduces the general public to the retrospective and predictive values of diagnostic imaging. --- RESOURCES “Patients Have a Very Limited Knowledge of Their Contrast Allergies”: https://www.clinicalimaging.org/article/S0899-7071(21)00324-7/fulltext “Prevention of Allergic-like Reactions at Repeat CT: Steroid Pretreatment versus Contrast Material Substitution”: https://pubmed.ncbi.nlm.nih.gov/34342504/ “Iodine Allergy: Common Misperceptions”: https://academic.oup.com/ajhp/article-abstract/78/9/781/6129459 American College of Radiology Manual on Contrast Media, 2021: https://www.acr.org/Clinical-Resources/Contrast-Manual Dr. Cullen’s book, “Looking Within: Understanding Ourselves Through Human Imaging”: https://www.cullenruff.com/books “The Immunology of the Vermiform Appendix: A Review of the Literature”: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011360/ Fri, 26 Nov 2021 05:00:00 -0000 full BackTable We talk with Dr. Cullen Ruff about common misconceptions when it comes to IV contrast and issues with the "contrast allergy", including ways we can improve patient care and clinical workflows by clarifying the true source of these reactions. We talk with Dr. Cullen Ruff about common misconceptions when it comes to IV contrast and issues with the "contrast allergy", including ways we can improve patient care and clinical workflows by clarifying the true source of these reactions. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/16AayH --- SHOW NOTES In this episode, diagnostic radiologist Dr. Cullen Ruff and our host Dr. Chris Beck discuss the research and patient education surrounding contrast allergies. Dr. Cullen starts the episode by commenting on the history of contrast media, noting that the earlier ionic contrast agents are more allergenic than the more recent non-ionic ones. By knowing the time period during which many radiologists switched to non-ionic agents (around 1985), we can identify during a medical history which of these types caused a patient’s allergic reaction. The doctors discuss current research, which shows that substituting for a different contrast media is more effective than giving steroid premedication and using the allergy-inducing contrast media. Unfortunately, many patients are unable to recall the year when they experienced their allergy or the name of the contrast agent given. This lack of information makes it difficult to administer a substitute contrast media to the patient. To address these workflow inefficiencies, Dr. Cullen advocates for individualized patient education over specific contrast allergies. He believes that taking the time to discuss allergies and giving the patient the name of their allergen, in writing, is essential for future imaging studies. He advises against the use of the vague and nonsensical term of “iodine allergy”, noting that patients are never allergic to the iodine itself, but rather a different component in the iodinated contrast media. Finally, we discuss Dr. Cullen’s book, “Looking Within: Understanding Ourselves Through Human Imaging” in which he shares patient stories and introduces the general public to the retrospective and predictive values of diagnostic imaging. --- RESOURCES “Patients Have a Very Limited Knowledge of Their Contrast Allergies”: https://www.clinicalimaging.org/article/S0899-7071(21)00324-7/fulltext “Prevention of Allergic-like Reactions at Repeat CT: Steroid Pretreatment versus Contrast Material Substitution”: https://pubmed.ncbi.nlm.nih.gov/34342504/ “Iodine Allergy: Common Misperceptions”: https://academic.oup.com/ajhp/article-abstract/78/9/781/6129459 American College of Radiology Manual on Contrast Media, 2021: https://www.acr.org/Clinical-Resources/Contrast-Manual Dr. Cullen’s book, “Looking Within: Understanding Ourselves Through Human Imaging”: https://www.cullenruff.com/books “The Immunology of the Vermiform Appendix: A Review of the Literature”: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011360/ We talk with Dr. Cullen Ruff about common misconceptions when it comes to IV contrast and issues with the "contrast allergy", including ways we can improve patient care and clinical workflows by clarifying the true source of these reactions.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/16AayH


---


SHOW NOTES


In this episode, diagnostic radiologist Dr. Cullen Ruff and our host Dr. Chris Beck discuss the research and patient education surrounding contrast allergies.


Dr. Cullen starts the episode by commenting on the history of contrast media, noting that the earlier ionic contrast agents are more allergenic than the more recent non-ionic ones. By knowing the time period during which many radiologists switched to non-ionic agents (around 1985), we can identify during a medical history which of these types caused a patient’s allergic reaction.


The doctors discuss current research, which shows that substituting for a different contrast media is more effective than giving steroid premedication and using the allergy-inducing contrast media. Unfortunately, many patients are unable to recall the year when they experienced their allergy or the name of the contrast agent given. This lack of information makes it difficult to administer a substitute contrast media to the patient.


To address these workflow inefficiencies, Dr. Cullen advocates for individualized patient education over specific contrast allergies. He believes that taking the time to discuss allergies and giving the patient the name of their allergen, in writing, is essential for future imaging studies. He advises against the use of the vague and nonsensical term of “iodine allergy”, noting that patients are never allergic to the iodine itself, but rather a different component in the iodinated contrast media.


Finally, we discuss Dr. Cullen’s book, “Looking Within: Understanding Ourselves Through Human Imaging” in which he shares patient stories and introduces the general public to the retrospective and predictive values of diagnostic imaging.


---


RESOURCES


“Patients Have a Very Limited Knowledge of Their Contrast Allergies”:

https://www.clinicalimaging.org/article/S0899-7071(21)00324-7/fulltext


“Prevention of Allergic-like Reactions at Repeat CT: Steroid Pretreatment versus Contrast Material Substitution”:

https://pubmed.ncbi.nlm.nih.gov/34342504/


“Iodine Allergy: Common Misperceptions”:

https://academic.oup.com/ajhp/article-abstract/78/9/781/6129459


American College of Radiology Manual on Contrast Media, 2021:

https://www.acr.org/Clinical-Resources/Contrast-Manual


Dr. Cullen’s book, “Looking Within: Understanding Ourselves Through Human Imaging”:

https://www.cullenruff.com/books


“The Immunology of the Vermiform Appendix: A Review of the Literature”:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011360/

]]> 3078 Ep. 167 Equipment Decisions When Building an OBL with Dr. Mary Costantino and Dr. Goke Akinwande We talk with Dr. Mary Costantino and Dr. Goke Akinwande about their experiences and advice on making equipment purchase decisions for OBLs and outpatient centers, including pitfalls to avoid. --- CHECK OUT OUR SPONSOR Siemens Healthineers https://www.siemens-healthineers.com/ --- SHOW NOTES In this episode, interventional radiologists Dr. Mary Constantino, Dr. Goke Akinwande, and Dr. Aaron Fritts discuss the process of choosing and financing equipment for office-based labs (OBLs). This episode focuses on three major types of equipment: C-arms or fixed units, disposables, and ultrasound machines. First, the doctors discuss the fundamental differences between mobile C-arms and fixed units. Drs. Constantino and Akinwande agree that while the fixed unit is more ergonomically advantageous, it carries significantly more cost. While a fixed unit must be incorporated into the architectural planning of the OBL, a C-arm can be adapted to an existing space. Both doctors emphasize the importance of vendor support and knowing that they have quick access to technicians in the area. Dr. Constantino provides her perspective on disposables and device partnerships, noting that an IR’s priority should be obtaining the equipment that allows them to operate to the best of their abilities. Dr. Akinwande obtains most of his disposables through consignment inventory in order to minimize waste. Finally, the doctors talk about ultrasound technology and situations where different types may be more appropriate than others. Overall, they emphasize that while the OBL model grants autonomy to IRs, this pursuit introduces a large financial risk that should be carefully considered. --- RESOURCES Midwest Institute for Non-Surgical Therapy: https://www.mintstl.com/ Advanced Vascular Centers: https://www.advancedvascularcenters.com/ Mon, 22 Nov 2021 05:00:00 -0000 full BackTable We talk with Dr. Mary Costantino and Dr. Goke Akinwande about their experiences and advice on making equipment purchase decisions for OBLs and outpatient centers, including pitfalls to avoid. We talk with Dr. Mary Costantino and Dr. Goke Akinwande about their experiences and advice on making equipment purchase decisions for OBLs and outpatient centers, including pitfalls to avoid. --- CHECK OUT OUR SPONSOR Siemens Healthineers https://www.siemens-healthineers.com/ --- SHOW NOTES In this episode, interventional radiologists Dr. Mary Constantino, Dr. Goke Akinwande, and Dr. Aaron Fritts discuss the process of choosing and financing equipment for office-based labs (OBLs). This episode focuses on three major types of equipment: C-arms or fixed units, disposables, and ultrasound machines. First, the doctors discuss the fundamental differences between mobile C-arms and fixed units. Drs. Constantino and Akinwande agree that while the fixed unit is more ergonomically advantageous, it carries significantly more cost. While a fixed unit must be incorporated into the architectural planning of the OBL, a C-arm can be adapted to an existing space. Both doctors emphasize the importance of vendor support and knowing that they have quick access to technicians in the area. Dr. Constantino provides her perspective on disposables and device partnerships, noting that an IR’s priority should be obtaining the equipment that allows them to operate to the best of their abilities. Dr. Akinwande obtains most of his disposables through consignment inventory in order to minimize waste. Finally, the doctors talk about ultrasound technology and situations where different types may be more appropriate than others. Overall, they emphasize that while the OBL model grants autonomy to IRs, this pursuit introduces a large financial risk that should be carefully considered. --- RESOURCES Midwest Institute for Non-Surgical Therapy: https://www.mintstl.com/ Advanced Vascular Centers: https://www.advancedvascularcenters.com/ We talk with Dr. Mary Costantino and Dr. Goke Akinwande about their experiences and advice on making equipment purchase decisions for OBLs and outpatient centers, including pitfalls to avoid.


---


CHECK OUT OUR SPONSOR


Siemens Healthineers

https://www.siemens-healthineers.com/


---


SHOW NOTES


In this episode, interventional radiologists Dr. Mary Constantino, Dr. Goke Akinwande, and Dr. Aaron Fritts discuss the process of choosing and financing equipment for office-based labs (OBLs). This episode focuses on three major types of equipment: C-arms or fixed units, disposables, and ultrasound machines.


First, the doctors discuss the fundamental differences between mobile C-arms and fixed units. Drs. Constantino and Akinwande agree that while the fixed unit is more ergonomically advantageous, it carries significantly more cost. While a fixed unit must be incorporated into the architectural planning of the OBL, a C-arm can be adapted to an existing space. Both doctors emphasize the importance of vendor support and knowing that they have quick access to technicians in the area.


Dr. Constantino provides her perspective on disposables and device partnerships, noting that an IR’s priority should be obtaining the equipment that allows them to operate to the best of their abilities. Dr. Akinwande obtains most of his disposables through consignment inventory in order to minimize waste.


Finally, the doctors talk about ultrasound technology and situations where different types may be more appropriate than others. Overall, they emphasize that while the OBL model grants autonomy to IRs, this pursuit introduces a large financial risk that should be carefully considered.


---


RESOURCES


Midwest Institute for Non-Surgical Therapy: https://www.mintstl.com/


Advanced Vascular Centers: https://www.advancedvascularcenters.com/

]]> 3367 Ep. 166 OBL Practice Building in a Rural Setting, Adventures with Road2IR, and more with Dr. Joe Couvillon Dr. Donald Garbett interviews Dr. Joseph Couvillon about how he helped his group build an OBL practice in a rural setting, including the importance of hitting the pavement and phones to drive awareness with referring docs. Dr. Couvillon also raves about his recent trip to East Africa to help out the Road2IR team. --- CHECK OUT OUR SPONSORS Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- SHOW NOTES In this episode, interventional radiologist Dr. Joe Couvillon and our guest host Dr. Donald Garbett discuss the opportunities and obstacles that arise with building an OBL practice in the Shenandoah Valley and lessons learned from Dr. Couvillon’s trip to Tanzania with Road2IR. Dr. Couvillon recounts the process of building up his referral base for uterine fibroid embolizations (UFEs) in his practice, and shares his current experience in doing the same for peripheral arterial disease (PAD). He employs marketing strategies such as reading noninvasive studies and offering his services, as well as fostering a collaborative approach with cardiologists and vascular surgeons. He also speaks to the importance of reaching out to the referring doctors’ staff (NPs, PAs, and administrative assistants), since they can influence referral patterns. In addition, Dr. Couvillon updates us on his recent trip with Road2IR. He gives his perspective on teaching procedures to IR fellows in Tanzania and being inspired by their enthusiasm and resourcefulness. --- RESOURCES Bringing IR to East Africa: The Road2IR Story: https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story Road2IR: https://www.road2ir.org/ Fri, 19 Nov 2021 05:00:00 -0000 full BackTable Dr. Donald Garbett interviews Dr. Joseph Couvillon about how he helped his group build an OBL practice in a rural setting, including the importance of hitting the pavement and phones to drive awareness with referring docs. Dr. Couvillon also raves about his recent trip to East Africa to help out the Road2IR team. Dr. Donald Garbett interviews Dr. Joseph Couvillon about how he helped his group build an OBL practice in a rural setting, including the importance of hitting the pavement and phones to drive awareness with referring docs. Dr. Couvillon also raves about his recent trip to East Africa to help out the Road2IR team. --- CHECK OUT OUR SPONSORS Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- SHOW NOTES In this episode, interventional radiologist Dr. Joe Couvillon and our guest host Dr. Donald Garbett discuss the opportunities and obstacles that arise with building an OBL practice in the Shenandoah Valley and lessons learned from Dr. Couvillon’s trip to Tanzania with Road2IR. Dr. Couvillon recounts the process of building up his referral base for uterine fibroid embolizations (UFEs) in his practice, and shares his current experience in doing the same for peripheral arterial disease (PAD). He employs marketing strategies such as reading noninvasive studies and offering his services, as well as fostering a collaborative approach with cardiologists and vascular surgeons. He also speaks to the importance of reaching out to the referring doctors’ staff (NPs, PAs, and administrative assistants), since they can influence referral patterns. In addition, Dr. Couvillon updates us on his recent trip with Road2IR. He gives his perspective on teaching procedures to IR fellows in Tanzania and being inspired by their enthusiasm and resourcefulness. --- RESOURCES Bringing IR to East Africa: The Road2IR Story: https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story Road2IR: https://www.road2ir.org/ Dr. Donald Garbett interviews Dr. Joseph Couvillon about how he helped his group build an OBL practice in a rural setting, including the importance of hitting the pavement and phones to drive awareness with referring docs. Dr. Couvillon also raves about his recent trip to East Africa to help out the Road2IR team.


---


CHECK OUT OUR SPONSORS


Accountable Revenue Cycle Solutions

https://www.accountablerevcycle.com/


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


---


SHOW NOTES


In this episode, interventional radiologist Dr. Joe Couvillon and our guest host Dr. Donald Garbett discuss the opportunities and obstacles that arise with building an OBL practice in the Shenandoah Valley and lessons learned from Dr. Couvillon’s trip to Tanzania with Road2IR.


Dr. Couvillon recounts the process of building up his referral base for uterine fibroid embolizations (UFEs) in his practice, and shares his current experience in doing the same for peripheral arterial disease (PAD). He employs marketing strategies such as reading noninvasive studies and offering his services, as well as fostering a collaborative approach with cardiologists and vascular surgeons. He also speaks to the importance of reaching out to the referring doctors’ staff (NPs, PAs, and administrative assistants), since they can influence referral patterns.


In addition, Dr. Couvillon updates us on his recent trip with Road2IR. He gives his perspective on teaching procedures to IR fellows in Tanzania and being inspired by their enthusiasm and resourcefulness.


---


RESOURCES


Bringing IR to East Africa: The Road2IR Story:

https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story


Road2IR: https://www.road2ir.org/

]]> 3397 Ep. 165 Unipedicular vs. Bipedicular Approach for Kyphoplasty with Dr. Thomas Andreshak Interventional radiologist Michael Barraza talks with orthopedic spine surgeon Thomas Andreshak about his approach to vertebral augmentation for compression fractures, including unipedicular vs. bipedicular approach, technique pearls, and post-procedure care. --- CHECK OUT OUR SPONSOR Medtronic Kyphon https://www.medtronic.com/kyphoplasty --- SHOW NOTES In this episode, orthopedic surgeon Dr.Thomas Andreshak and our host Dr. Michael Barraza discuss kyphoplasty technique, including different methods of imaging, approaches, sedation, and follow-up. Dr. Andreshak starts with obtaining a standing X-ray because it allows him to better observe cases of spondylolisthesis. He describes both unipedicular and bipedicular approaches, noting that the unipedicular approach can allow for greater cost savings, less cement used, and lower radiation exposure. The doctors also review the stages of bone healing: hematoma formation, fibrocartilage formation, bony callus formation, and bone remodeling. Dr. Andreshak warns against overfilling the vertebra, which creates stiffness and puts stress on the adjacent endplate. Finally, they discuss follow-up and considerations for future treatment if pain persists. --- RESOURCES Consulting Orthopedic Associates: https://consulting-ortho.com/ Kyphon Assist: https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/vertebral-augmentation/kyphon-assist.html Mon, 15 Nov 2021 05:00:00 -0000 full BackTable Interventional radiologist Michael Barraza talks with orthopedic spine surgeon Thomas Andreshak about his approach to vertebral augmentation for compression fractures, including unipedicular vs. bipedicular approach, technique pearls, and post-procedure care. Interventional radiologist Michael Barraza talks with orthopedic spine surgeon Thomas Andreshak about his approach to vertebral augmentation for compression fractures, including unipedicular vs. bipedicular approach, technique pearls, and post-procedure care. --- CHECK OUT OUR SPONSOR Medtronic Kyphon https://www.medtronic.com/kyphoplasty --- SHOW NOTES In this episode, orthopedic surgeon Dr.Thomas Andreshak and our host Dr. Michael Barraza discuss kyphoplasty technique, including different methods of imaging, approaches, sedation, and follow-up. Dr. Andreshak starts with obtaining a standing X-ray because it allows him to better observe cases of spondylolisthesis. He describes both unipedicular and bipedicular approaches, noting that the unipedicular approach can allow for greater cost savings, less cement used, and lower radiation exposure. The doctors also review the stages of bone healing: hematoma formation, fibrocartilage formation, bony callus formation, and bone remodeling. Dr. Andreshak warns against overfilling the vertebra, which creates stiffness and puts stress on the adjacent endplate. Finally, they discuss follow-up and considerations for future treatment if pain persists. --- RESOURCES Consulting Orthopedic Associates: https://consulting-ortho.com/ Kyphon Assist: https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/vertebral-augmentation/kyphon-assist.html Interventional radiologist Michael Barraza talks with orthopedic spine surgeon Thomas Andreshak about his approach to vertebral augmentation for compression fractures, including unipedicular vs. bipedicular approach, technique pearls, and post-procedure care.


---


CHECK OUT OUR SPONSOR


Medtronic Kyphon

https://www.medtronic.com/kyphoplasty


---


SHOW NOTES


In this episode, orthopedic surgeon Dr.Thomas Andreshak and our host Dr. Michael Barraza discuss kyphoplasty technique, including different methods of imaging, approaches, sedation, and follow-up.


Dr. Andreshak starts with obtaining a standing X-ray because it allows him to better observe cases of spondylolisthesis. He describes both unipedicular and bipedicular approaches, noting that the unipedicular approach can allow for greater cost savings, less cement used, and lower radiation exposure.


The doctors also review the stages of bone healing: hematoma formation, fibrocartilage formation, bony callus formation, and bone remodeling. Dr. Andreshak warns against overfilling the vertebra, which creates stiffness and puts stress on the adjacent endplate. Finally, they discuss follow-up and considerations for future treatment if pain persists.


---


RESOURCES


Consulting Orthopedic Associates:

https://consulting-ortho.com/


Kyphon Assist:

https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/vertebral-augmentation/kyphon-assist.html

]]> 1604 Ep. 164 Collaborative Approach to Prostate Artery Embolization (PAE) for BPH with Dr. Claus Roehrborn and Dr. Sandeep Bagla Urologist Dr. Claus Roehrborn and Interventional Radiologist Dr. Sandeep Bagla discuss the pros and cons of Prostate Artery Embolization (PAE) compared to other Minimally Invasive Surgical Treatments (MISTS) for Benign Prostate Hyperplasia (BPH). They also discuss the importance of a collaborative, multidisciplinary approach when offering these treatment options, including agreeing on the best treatment for the patient. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Daw1w2 --- SHOW NOTES In this episode, urologist Dr. Claus Roehrborn and interventional radiologist Dr. Sandeep Bagla discuss benign prostatic hyperplasia (BPH) and prostate artery embolization (PAE) in the context of counseling patients and cross-specialty collaboration. Dr. Roehrborn starts by reviewing the history of BPH treatment, from medications like alpha-blockers and anticholinergics, to minimally invasive options like UroLift, Rezum, and PAE. He emphasizes that the latter options are growing in popularity, since they provide treatment alternatives for patients who are concerned about side effects from medications, or have not experienced symptom relief from medications. Dr. Sandeep Bagla describes Prostate Cancer USA’s philosophy on IR/Urology partnership and how it can ultimately benefit patients. This model provides the patient with both an IR suite for the PAE procedure and a urology clinic for diagnostic assessment, determination of PAE candidacy, and follow-up assessment. Both doctors describe ideal patients for PAE. These are usually patients with a gland size above 60 g, confirmed bladder function, and a desire to preserve ejaculation function. Contraindications include urinary retention, chronic prostatitis, and heavily calcified glands. Finally, they describe how they manage minor short-term complications such as frequency and dysuria with medication. They track symptom relief using the International Prostate Symptom Score (IPSS), Dr. Bagla notes that the largest drop in IPSS usually occurs about 4-5 weeks post-procedure. Mon, 08 Nov 2021 05:00:00 -0000 full BackTable Urologist Dr. Claus Roehrborn and Interventional Radiologist Dr. Sandeep Bagla discuss the pros and cons of Prostate Artery Embolization (PAE) compared to other Minimally Invasive Surgical Treatments (MISTS) for Benign Prostate Hyperplasia (BPH). They also discuss the importance of a collaborative, multidisciplinary approach when offering these treatment options, including agreeing on the best treatment for the patient. Urologist Dr. Claus Roehrborn and Interventional Radiologist Dr. Sandeep Bagla discuss the pros and cons of Prostate Artery Embolization (PAE) compared to other Minimally Invasive Surgical Treatments (MISTS) for Benign Prostate Hyperplasia (BPH). They also discuss the importance of a collaborative, multidisciplinary approach when offering these treatment options, including agreeing on the best treatment for the patient. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Daw1w2 --- SHOW NOTES In this episode, urologist Dr. Claus Roehrborn and interventional radiologist Dr. Sandeep Bagla discuss benign prostatic hyperplasia (BPH) and prostate artery embolization (PAE) in the context of counseling patients and cross-specialty collaboration. Dr. Roehrborn starts by reviewing the history of BPH treatment, from medications like alpha-blockers and anticholinergics, to minimally invasive options like UroLift, Rezum, and PAE. He emphasizes that the latter options are growing in popularity, since they provide treatment alternatives for patients who are concerned about side effects from medications, or have not experienced symptom relief from medications. Dr. Sandeep Bagla describes Prostate Cancer USA’s philosophy on IR/Urology partnership and how it can ultimately benefit patients. This model provides the patient with both an IR suite for the PAE procedure and a urology clinic for diagnostic assessment, determination of PAE candidacy, and follow-up assessment. Both doctors describe ideal patients for PAE. These are usually patients with a gland size above 60 g, confirmed bladder function, and a desire to preserve ejaculation function. Contraindications include urinary retention, chronic prostatitis, and heavily calcified glands. Finally, they describe how they manage minor short-term complications such as frequency and dysuria with medication. They track symptom relief using the International Prostate Symptom Score (IPSS), Dr. Bagla notes that the largest drop in IPSS usually occurs about 4-5 weeks post-procedure. Urologist Dr. Claus Roehrborn and Interventional Radiologist Dr. Sandeep Bagla discuss the pros and cons of Prostate Artery Embolization (PAE) compared to other Minimally Invasive Surgical Treatments (MISTS) for Benign Prostate Hyperplasia (BPH). They also discuss the importance of a collaborative, multidisciplinary approach when offering these treatment options, including agreeing on the best treatment for the patient.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Daw1w2


---


SHOW NOTES


In this episode, urologist Dr. Claus Roehrborn and interventional radiologist Dr. Sandeep Bagla discuss benign prostatic hyperplasia (BPH) and prostate artery embolization (PAE) in the context of counseling patients and cross-specialty collaboration.


Dr. Roehrborn starts by reviewing the history of BPH treatment, from medications like alpha-blockers and anticholinergics, to minimally invasive options like UroLift, Rezum, and PAE. He emphasizes that the latter options are growing in popularity, since they provide treatment alternatives for patients who are concerned about side effects from medications, or have not experienced symptom relief from medications.


Dr. Sandeep Bagla describes Prostate Cancer USA’s philosophy on IR/Urology partnership and how it can ultimately benefit patients. This model provides the patient with both an IR suite for the PAE procedure and a urology clinic for diagnostic assessment, determination of PAE candidacy, and follow-up assessment.


Both doctors describe ideal patients for PAE. These are usually patients with a gland size above 60 g, confirmed bladder function, and a desire to preserve ejaculation function. Contraindications include urinary retention, chronic prostatitis, and heavily calcified glands.


Finally, they describe how they manage minor short-term complications such as frequency and dysuria with medication. They track symptom relief using the International Prostate Symptom Score (IPSS), Dr. Bagla notes that the largest drop in IPSS usually occurs about 4-5 weeks post-procedure.

]]> 3591 Ep. 163 Treating False Lumen Perfusion in Chronic Aortic Dissections with Dr. Daniel Han Vascular Surgeon Daniel Han discusses management of persistent false lumen perfusion in chronic aortic dissection, including the Knickerbocker Technique. --- CHECK OUT OUR SPONSOR Medtronic IN.PACT Admiral Drug-Coated Balloon https://www.medtronic.com/5yeardcb --- SHOW NOTES In this episode, vascular surgeon Dr. Daniel Han and our host Dr. Sabeen Dhand discuss various techniques involved in repairing chronic aortic dissections, including Thoracic Endovascular Aortic Repair (TEVAR), Knickerbocker, and candy plug. Dr. Han starts by reviewing the differences between a true lumen and a false lumen. False lumens are usually formed by a dominant entry tear in the aortic wall with additional fenestrations present. Since the false lumen lacks the three walls of the aorta, it is more easily perfused and compresses the true lumen. He further subdivides aortic dissection into hyperacute, acute, subacute, and chronic dissections, all depending on the chronicity of the tear. With treatment, the goal is to achieve aortic remodeling and fuse the true and false lumens. Dr. Han notes that the more chronic the dissection, the harder it will be to remodel the aorta back to its original state, since it has already started remodeling in the dissected state. The doctors discuss TEVAR and follow-up results in which Dr. Han would choose to re-intervene. He explains the Knickerbocker technique, in which he uses a balloon to selectively rupture the dissected septum. This establishes contact between the stent graft and the other side of the aorta, effectively creating a physical barrier to retrograde flow in the thoracic aorta. Dr. Han also discusses the candy-plug technique, which results in immediate cessation of blood flow into the thoracic aorta. --- RESOURCES BackTable VI Episode 142: Type B Aortic Dissections with Dr. Frank Arko: https://www.backtable.com/shows/vi/podcasts/142/type-b-aortic-dissections Favorable Impact of Thoracic Endovascular Aortic Repair on Survival of Patients with Acute Uncomplicated Type B Aortic Dissection: https://pubmed.ncbi.nlm.nih.gov/29914833/ Outcomes of Thoracic Endovascular Aortic Repair for Chronic Aortic Dissections: https://pubmed.ncbi.nlm.nih.gov/29157682/ Mon, 01 Nov 2021 04:00:00 -0000 full BackTable Vascular Surgeon Daniel Han discusses management of persistent false lumen perfusion in chronic aortic dissection, including the Knickerbocker Technique. Vascular Surgeon Daniel Han discusses management of persistent false lumen perfusion in chronic aortic dissection, including the Knickerbocker Technique. --- CHECK OUT OUR SPONSOR Medtronic IN.PACT Admiral Drug-Coated Balloon https://www.medtronic.com/5yeardcb --- SHOW NOTES In this episode, vascular surgeon Dr. Daniel Han and our host Dr. Sabeen Dhand discuss various techniques involved in repairing chronic aortic dissections, including Thoracic Endovascular Aortic Repair (TEVAR), Knickerbocker, and candy plug. Dr. Han starts by reviewing the differences between a true lumen and a false lumen. False lumens are usually formed by a dominant entry tear in the aortic wall with additional fenestrations present. Since the false lumen lacks the three walls of the aorta, it is more easily perfused and compresses the true lumen. He further subdivides aortic dissection into hyperacute, acute, subacute, and chronic dissections, all depending on the chronicity of the tear. With treatment, the goal is to achieve aortic remodeling and fuse the true and false lumens. Dr. Han notes that the more chronic the dissection, the harder it will be to remodel the aorta back to its original state, since it has already started remodeling in the dissected state. The doctors discuss TEVAR and follow-up results in which Dr. Han would choose to re-intervene. He explains the Knickerbocker technique, in which he uses a balloon to selectively rupture the dissected septum. This establishes contact between the stent graft and the other side of the aorta, effectively creating a physical barrier to retrograde flow in the thoracic aorta. Dr. Han also discusses the candy-plug technique, which results in immediate cessation of blood flow into the thoracic aorta. --- RESOURCES BackTable VI Episode 142: Type B Aortic Dissections with Dr. Frank Arko: https://www.backtable.com/shows/vi/podcasts/142/type-b-aortic-dissections Favorable Impact of Thoracic Endovascular Aortic Repair on Survival of Patients with Acute Uncomplicated Type B Aortic Dissection: https://pubmed.ncbi.nlm.nih.gov/29914833/ Outcomes of Thoracic Endovascular Aortic Repair for Chronic Aortic Dissections: https://pubmed.ncbi.nlm.nih.gov/29157682/ Vascular Surgeon Daniel Han discusses management of persistent false lumen perfusion in chronic aortic dissection, including the Knickerbocker Technique.


---


CHECK OUT OUR SPONSOR


Medtronic IN.PACT Admiral Drug-Coated Balloon

https://www.medtronic.com/5yeardcb


---


SHOW NOTES


In this episode, vascular surgeon Dr. Daniel Han and our host Dr. Sabeen Dhand discuss various techniques involved in repairing chronic aortic dissections, including Thoracic Endovascular Aortic Repair (TEVAR), Knickerbocker, and candy plug.


Dr. Han starts by reviewing the differences between a true lumen and a false lumen. False lumens are usually formed by a dominant entry tear in the aortic wall with additional fenestrations present. Since the false lumen lacks the three walls of the aorta, it is more easily perfused and compresses the true lumen. He further subdivides aortic dissection into hyperacute, acute, subacute, and chronic dissections, all depending on the chronicity of the tear. With treatment, the goal is to achieve aortic remodeling and fuse the true and false lumens. Dr. Han notes that the more chronic the dissection, the harder it will be to remodel the aorta back to its original state, since it has already started remodeling in the dissected state.


The doctors discuss TEVAR and follow-up results in which Dr. Han would choose to re-intervene. He explains the Knickerbocker technique, in which he uses a balloon to selectively rupture the dissected septum. This establishes contact between the stent graft and the other side of the aorta, effectively creating a physical barrier to retrograde flow in the thoracic aorta. Dr. Han also discusses the candy-plug technique, which results in immediate cessation of blood flow into the thoracic aorta.


---


RESOURCES


BackTable VI Episode 142: Type B Aortic Dissections with Dr. Frank Arko:

https://www.backtable.com/shows/vi/podcasts/142/type-b-aortic-dissections


Favorable Impact of Thoracic Endovascular Aortic Repair on Survival of Patients with Acute Uncomplicated Type B Aortic Dissection: https://pubmed.ncbi.nlm.nih.gov/29914833/


Outcomes of Thoracic Endovascular Aortic Repair for Chronic Aortic Dissections:

https://pubmed.ncbi.nlm.nih.gov/29157682/

]]> 2650 Ep. 162 Endovascular Management of CTEPH with Balloon Pulmonary Angioplasty (BPA) with Dr. Butros and Dr. Tehrani Interventional Cardiologist Behnam Tehrani and Interventional Radiologist Reha Butros from Inova Health System tell us about their team approach to endovascular treatment of chronic thromboembolic pulmonary hypertension (CTEPH) with Balloon Pulmonary Angioplasty (BPA). --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/TCTEY3 --- SHOW NOTES In this episode, interventional radiologist Dr. Reha Butros, interventional cardiologist Dr. Behnam Tehrani, and our host Dr. Michael Barraza discuss chronic thromboembolic pulmonary hypertension (CTEPH) and medical, endovascular, and surgical treatment options for CTEPH. CTEPH affects patients of all different ages and medical histories. While it has been associated with prior pulmonary embolism, it can also arise in patients due to blood clotting disorders and infected pacemakers. Both Dr. Butros and Dr. Tehrani stress the importance of collaborating with pulmonary hypertension experts to identify CTEPH patients before right sided heart failure occurs. CTEPH is diagnosed with dual energy CT, which shows perfusion, and right heart catheterization, which measures blood pressure. The three treatment options discussed are medical management, balloon pulmonary angioplasty (BPA), and pulmonary thromboendarterectomy (PTE). Medical management is discussed as an initial treatment for CTEPH, while PTE can be appropriate for good surgical candidates. Finally, Dr. Butros and Dr. Tehrani present BPA as an appropriate treatment for patients of all ages. BPA over multiple sessions and increasing balloon size has been shown to be effective at promoting pulmonary artery remodeling and dilation. The doctors share their own experiences with learning BPA technique, noting that it has a learning curve, but it is ultimately rewarding when patients’ quality of life is improved. Mon, 25 Oct 2021 04:00:00 -0000 full BackTable Interventional Cardiologist Behnam Tehrani and Interventional Radiologist Reha Butros from Inova Health System tell us about their team approach to endovascular treatment of chronic thromboembolic pulmonary hypertension (CTEPH) with Balloon Pulmonary Angioplasty (BPA). Interventional Cardiologist Behnam Tehrani and Interventional Radiologist Reha Butros from Inova Health System tell us about their team approach to endovascular treatment of chronic thromboembolic pulmonary hypertension (CTEPH) with Balloon Pulmonary Angioplasty (BPA). --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/TCTEY3 --- SHOW NOTES In this episode, interventional radiologist Dr. Reha Butros, interventional cardiologist Dr. Behnam Tehrani, and our host Dr. Michael Barraza discuss chronic thromboembolic pulmonary hypertension (CTEPH) and medical, endovascular, and surgical treatment options for CTEPH. CTEPH affects patients of all different ages and medical histories. While it has been associated with prior pulmonary embolism, it can also arise in patients due to blood clotting disorders and infected pacemakers. Both Dr. Butros and Dr. Tehrani stress the importance of collaborating with pulmonary hypertension experts to identify CTEPH patients before right sided heart failure occurs. CTEPH is diagnosed with dual energy CT, which shows perfusion, and right heart catheterization, which measures blood pressure. The three treatment options discussed are medical management, balloon pulmonary angioplasty (BPA), and pulmonary thromboendarterectomy (PTE). Medical management is discussed as an initial treatment for CTEPH, while PTE can be appropriate for good surgical candidates. Finally, Dr. Butros and Dr. Tehrani present BPA as an appropriate treatment for patients of all ages. BPA over multiple sessions and increasing balloon size has been shown to be effective at promoting pulmonary artery remodeling and dilation. The doctors share their own experiences with learning BPA technique, noting that it has a learning curve, but it is ultimately rewarding when patients’ quality of life is improved. Interventional Cardiologist Behnam Tehrani and Interventional Radiologist Reha Butros from Inova Health System tell us about their team approach to endovascular treatment of chronic thromboembolic pulmonary hypertension (CTEPH) with Balloon Pulmonary Angioplasty (BPA).


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/TCTEY3


---


SHOW NOTES


In this episode, interventional radiologist Dr. Reha Butros, interventional cardiologist Dr. Behnam Tehrani, and our host Dr. Michael Barraza discuss chronic thromboembolic pulmonary hypertension (CTEPH) and medical, endovascular, and surgical treatment options for CTEPH.


CTEPH affects patients of all different ages and medical histories. While it has been associated with prior pulmonary embolism, it can also arise in patients due to blood clotting disorders and infected pacemakers. Both Dr. Butros and Dr. Tehrani stress the importance of collaborating with pulmonary hypertension experts to identify CTEPH patients before right sided heart failure occurs. CTEPH is diagnosed with dual energy CT, which shows perfusion, and right heart catheterization, which measures blood pressure.


The three treatment options discussed are medical management, balloon pulmonary angioplasty (BPA), and pulmonary thromboendarterectomy (PTE). Medical management is discussed as an initial treatment for CTEPH, while PTE can be appropriate for good surgical candidates. Finally, Dr. Butros and Dr. Tehrani present BPA as an appropriate treatment for patients of all ages. BPA over multiple sessions and increasing balloon size has been shown to be effective at promoting pulmonary artery remodeling and dilation. The doctors share their own experiences with learning BPA technique, noting that it has a learning curve, but it is ultimately rewarding when patients’ quality of life is improved.

]]> 2275 Ep. 161 RF Ablation for Painful Spinal Metastases with Dr. Nam Tran Neurosurgeon Dr. Nam Tran from Moffitt Cancer Center talks with us about RF ablation for painful spinal metastases, including patient selection and the importance of a multidisciplinary approach. --- CHECK OUT OUR SPONSOR Medtronic OsteoCool https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html --- SHOW NOTES In this episode, neurosurgeon Dr. Nam Tran and our host Dr. Michael Barraza discuss minimally invasive procedures to treat both primary spine tumors and spine metastases. Dr. Tran describes the flexibility that kyphoplasty and spinal ablation can grant patients who are not suitable candidates for open surgical decompression. These minimally invasive procedures can reduce hospital stays from 4-5 days to just one night. Dr. Tran views ablation not only from a palliative pain reduction perspective, but also from an oncologic perspective that aims to reduce tumor burden. Dr. Tran says the ideal candidate for ablation is a patient who has isolated disease to the anterior column of the spine. With larger lesions, Dr. Tran relies on his neurosurgical background to take an aggressive approach in treating the entire vertebra. The doctors also discuss research studies that have made ablation more widely accepted and available (all articles are linked below). --- RESOURCES OPuS One Study: https://pubmed.ncbi.nlm.nih.gov/33129427/ CAFE Study: https://www.clinicaltrials.gov/ct2/show/study/NCT00211237 Mon, 18 Oct 2021 04:00:00 -0000 full BackTable Neurosurgeon Dr. Nam Tran from Moffitt Cancer Center talks with us about RF ablation for painful spinal metastases, including patient selection and the importance of a multidisciplinary approach. Neurosurgeon Dr. Nam Tran from Moffitt Cancer Center talks with us about RF ablation for painful spinal metastases, including patient selection and the importance of a multidisciplinary approach. --- CHECK OUT OUR SPONSOR Medtronic OsteoCool https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html --- SHOW NOTES In this episode, neurosurgeon Dr. Nam Tran and our host Dr. Michael Barraza discuss minimally invasive procedures to treat both primary spine tumors and spine metastases. Dr. Tran describes the flexibility that kyphoplasty and spinal ablation can grant patients who are not suitable candidates for open surgical decompression. These minimally invasive procedures can reduce hospital stays from 4-5 days to just one night. Dr. Tran views ablation not only from a palliative pain reduction perspective, but also from an oncologic perspective that aims to reduce tumor burden. Dr. Tran says the ideal candidate for ablation is a patient who has isolated disease to the anterior column of the spine. With larger lesions, Dr. Tran relies on his neurosurgical background to take an aggressive approach in treating the entire vertebra. The doctors also discuss research studies that have made ablation more widely accepted and available (all articles are linked below). --- RESOURCES OPuS One Study: https://pubmed.ncbi.nlm.nih.gov/33129427/ CAFE Study: https://www.clinicaltrials.gov/ct2/show/study/NCT00211237 Neurosurgeon Dr. Nam Tran from Moffitt Cancer Center talks with us about RF ablation for painful spinal metastases, including patient selection and the importance of a multidisciplinary approach.


---


CHECK OUT OUR SPONSOR


Medtronic OsteoCool

https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/tumor-management/osteocool-ablation-system-rf.html


---


SHOW NOTES


In this episode, neurosurgeon Dr. Nam Tran and our host Dr. Michael Barraza discuss minimally invasive procedures to treat both primary spine tumors and spine metastases.


Dr. Tran describes the flexibility that kyphoplasty and spinal ablation can grant patients who are not suitable candidates for open surgical decompression. These minimally invasive procedures can reduce hospital stays from 4-5 days to just one night.


Dr. Tran views ablation not only from a palliative pain reduction perspective, but also from an oncologic perspective that aims to reduce tumor burden. Dr. Tran says the ideal candidate for ablation is a patient who has isolated disease to the anterior column of the spine. With larger lesions, Dr. Tran relies on his neurosurgical background to take an aggressive approach in treating the entire vertebra.


The doctors also discuss research studies that have made ablation more widely accepted and available (all articles are linked below).


---


RESOURCES


OPuS One Study: https://pubmed.ncbi.nlm.nih.gov/33129427/


CAFE Study: https://www.clinicaltrials.gov/ct2/show/study/NCT00211237

]]> 1144 Ep. 160 BRTO: Beyond the Basics with Dr. Saher Sabri Dr. Aparna Baheti talks with Dr. Saher Sabri from MedStar Georgetown University Hospital about his approach to Balloon-occluded retrograde transvenous obliteration (BRTO) for portal hypertension, including advanced tips and tricks. --- CHECK OUT OUR SPONSOR Medtronic Embolization https://www.medtronic.com/embolization --- SHOW NOTES In this episode, Dr. Saher Sabri and our host Dr. Aparna Baheti discuss PARTO, BRTO, and combined TIPS and BRTO procedures. First, they discuss differences between PARTO (Plug-Assisted Retrograde Transvenous Obliteration) and BRTO (Balloon-Occluded Retrograde Transvenous Obliteration). Dr. Sabri walks us through the steps of both, noting that it is important to study the shunt before the procedure to identify its narrowest part. He also emphasizes the need to confirm successful balloon occlusion before starting embolization. This can require minor adjustments to balloon size and positioning. To identify the endpoint for injection, Dr. Sabri tracks sclerosant movement up to the diaphragm and then down to the gastric varix. He confirms that the shunt has been obliterated and prevented from recruiting other outflows in the future. When considering combined TIPS and BRTO procedure, Dr. Sabri focuses on key indications such as bleeding gastric varices, high-risk esophageal varices, and ascites. He prefers to do the TIPS procedure first, then the BRTO, then re-measuring the gradient and deciding if more ballooning of the TIPS is needed. Finally, the doctors discuss post-procedural follow up and imaging. Dr. Sabri aims to have CT imaging within 2-4 weeks after BRTO and an ultrasound within 2 weeks after TIPS. Fri, 15 Oct 2021 04:00:00 -0000 full BackTable Dr. Aparna Baheti talks with Dr. Saher Sabri from MedStar Georgetown University Hospital about his approach to Balloon-occluded retrograde transvenous obliteration (BRTO) for portal hypertension, including advanced tips and tricks. Dr. Aparna Baheti talks with Dr. Saher Sabri from MedStar Georgetown University Hospital about his approach to Balloon-occluded retrograde transvenous obliteration (BRTO) for portal hypertension, including advanced tips and tricks. --- CHECK OUT OUR SPONSOR Medtronic Embolization https://www.medtronic.com/embolization --- SHOW NOTES In this episode, Dr. Saher Sabri and our host Dr. Aparna Baheti discuss PARTO, BRTO, and combined TIPS and BRTO procedures. First, they discuss differences between PARTO (Plug-Assisted Retrograde Transvenous Obliteration) and BRTO (Balloon-Occluded Retrograde Transvenous Obliteration). Dr. Sabri walks us through the steps of both, noting that it is important to study the shunt before the procedure to identify its narrowest part. He also emphasizes the need to confirm successful balloon occlusion before starting embolization. This can require minor adjustments to balloon size and positioning. To identify the endpoint for injection, Dr. Sabri tracks sclerosant movement up to the diaphragm and then down to the gastric varix. He confirms that the shunt has been obliterated and prevented from recruiting other outflows in the future. When considering combined TIPS and BRTO procedure, Dr. Sabri focuses on key indications such as bleeding gastric varices, high-risk esophageal varices, and ascites. He prefers to do the TIPS procedure first, then the BRTO, then re-measuring the gradient and deciding if more ballooning of the TIPS is needed. Finally, the doctors discuss post-procedural follow up and imaging. Dr. Sabri aims to have CT imaging within 2-4 weeks after BRTO and an ultrasound within 2 weeks after TIPS. Dr. Aparna Baheti talks with Dr. Saher Sabri from MedStar Georgetown University Hospital about his approach to Balloon-occluded retrograde transvenous obliteration (BRTO) for portal hypertension, including advanced tips and tricks.


---


CHECK OUT OUR SPONSOR


Medtronic Embolization

https://www.medtronic.com/embolization


---


SHOW NOTES


In this episode, Dr. Saher Sabri and our host Dr. Aparna Baheti discuss PARTO, BRTO, and combined TIPS and BRTO procedures.


First, they discuss differences between PARTO (Plug-Assisted Retrograde Transvenous Obliteration) and BRTO (Balloon-Occluded Retrograde Transvenous Obliteration). Dr. Sabri walks us through the steps of both, noting that it is important to study the shunt before the procedure to identify its narrowest part. He also emphasizes the need to confirm successful balloon occlusion before starting embolization. This can require minor adjustments to balloon size and positioning.


To identify the endpoint for injection, Dr. Sabri tracks sclerosant movement up to the diaphragm and then down to the gastric varix. He confirms that the shunt has been obliterated and prevented from recruiting other outflows in the future.


When considering combined TIPS and BRTO procedure, Dr. Sabri focuses on key indications such as bleeding gastric varices, high-risk esophageal varices, and ascites. He prefers to do the TIPS procedure first, then the BRTO, then re-measuring the gradient and deciding if more ballooning of the TIPS is needed.


Finally, the doctors discuss post-procedural follow up and imaging. Dr. Sabri aims to have CT imaging within 2-4 weeks after BRTO and an ultrasound within 2 weeks after TIPS.

]]> 3000 Ep. 159 Renal Ablation Technique and Devices with Dr. Nainesh Parikh Dr. Nainesh Parikh from Moffitt Cancer Center discusses his approach to ablation of small renal masses, including workup, technique, and device selection. He also tells us why he has the best job ever! --- CHECK OUT OUR SPONSOR Medtronic FlowMet https://www.medtronic.com/flowmet --- SHOW NOTES In this episode, Dr. Nainesh Parikh and our host Dr. Michael Barraza discuss tips for renal ablation and multispecialty care for kidney cancers. First, they delve into the decision-making process for choosing between cryoablation and microwave ablation. Dr. Parikh believes that cryoablation is relatively safe to use in lesions near the collection system; however, it can cause a large inflammatory response in surrounding tissues. On the other hand, he prefers to use microwave ablation on exophytic lesions. Both doctors share their experiences with tricky lesions near the spine and various nerves. They also discuss the usage of pre-ablation embolization lesions larger than 5 cm. Throughout the episode, the doctors emphasize the importance of constant communication with urologists, since embolization and ablation can provide significant benefits for patients who are poor surgical candidates. Collaboration can help the medical team better manage recurrences as they arise. Dr. Parikh notes that follow up care for image-guided procedures should occur around four weeks, which is sooner than the conventional urology follow up period. Finally, Dr. Parikh gives pearls of wisdom regarding the advantages of hydrodissection, pneumodissection, and CT fluoroscopy for a safer and more efficient procedure. --- RESOURCES Moffitt Cancer Center IR Page: https://moffitt.org/for-healthcare-professionals/clinical-programs-and-services/radiology-diagnostic-imaging-and-interventional-radiology-program/ Mon, 11 Oct 2021 04:00:00 -0000 full BackTable Dr. Nainesh Parikh from Moffitt Cancer Center discusses his approach to ablation of small renal masses, including workup, technique, and device selection. He also tells us why he has the best job ever! Dr. Nainesh Parikh from Moffitt Cancer Center discusses his approach to ablation of small renal masses, including workup, technique, and device selection. He also tells us why he has the best job ever! --- CHECK OUT OUR SPONSOR Medtronic FlowMet https://www.medtronic.com/flowmet --- SHOW NOTES In this episode, Dr. Nainesh Parikh and our host Dr. Michael Barraza discuss tips for renal ablation and multispecialty care for kidney cancers. First, they delve into the decision-making process for choosing between cryoablation and microwave ablation. Dr. Parikh believes that cryoablation is relatively safe to use in lesions near the collection system; however, it can cause a large inflammatory response in surrounding tissues. On the other hand, he prefers to use microwave ablation on exophytic lesions. Both doctors share their experiences with tricky lesions near the spine and various nerves. They also discuss the usage of pre-ablation embolization lesions larger than 5 cm. Throughout the episode, the doctors emphasize the importance of constant communication with urologists, since embolization and ablation can provide significant benefits for patients who are poor surgical candidates. Collaboration can help the medical team better manage recurrences as they arise. Dr. Parikh notes that follow up care for image-guided procedures should occur around four weeks, which is sooner than the conventional urology follow up period. Finally, Dr. Parikh gives pearls of wisdom regarding the advantages of hydrodissection, pneumodissection, and CT fluoroscopy for a safer and more efficient procedure. --- RESOURCES Moffitt Cancer Center IR Page: https://moffitt.org/for-healthcare-professionals/clinical-programs-and-services/radiology-diagnostic-imaging-and-interventional-radiology-program/ Dr. Nainesh Parikh from Moffitt Cancer Center discusses his approach to ablation of small renal masses, including workup, technique, and device selection. He also tells us why he has the best job ever!


---


CHECK OUT OUR SPONSOR


Medtronic FlowMet

https://www.medtronic.com/flowmet


---


SHOW NOTES


In this episode, Dr. Nainesh Parikh and our host Dr. Michael Barraza discuss tips for renal ablation and multispecialty care for kidney cancers.


First, they delve into the decision-making process for choosing between cryoablation and microwave ablation. Dr. Parikh believes that cryoablation is relatively safe to use in lesions near the collection system; however, it can cause a large inflammatory response in surrounding tissues. On the other hand, he prefers to use microwave ablation on exophytic lesions. Both doctors share their experiences with tricky lesions near the spine and various nerves. They also discuss the usage of pre-ablation embolization lesions larger than 5 cm.


Throughout the episode, the doctors emphasize the importance of constant communication with urologists, since embolization and ablation can provide significant benefits for patients who are poor surgical candidates. Collaboration can help the medical team better manage recurrences as they arise. Dr. Parikh notes that follow up care for image-guided procedures should occur around four weeks, which is sooner than the conventional urology follow up period.


Finally, Dr. Parikh gives pearls of wisdom regarding the advantages of hydrodissection, pneumodissection, and CT fluoroscopy for a safer and more efficient procedure.


---


RESOURCES


Moffitt Cancer Center IR Page:

https://moffitt.org/for-healthcare-professionals/clinical-programs-and-services/radiology-diagnostic-imaging-and-interventional-radiology-program/

]]> 3299 Ep. 158 Microwave Ablation for Liver Lesions with Dr. Driss Raissi Dr. Christopher Beck talks with Dr. Driss Raissi about his approach to Microwave Ablation of Liver Lesions, including workup, technique, and tips and tricks for a successful ablation treatment. --- CHECK OUT OUR SPONSOR Medtronic Emprint Ablation System https://www.medtronic.com/covidien/en-gb/products/ablation-systems/emprint-ablation-system.html --- SHOW NOTES In this episode, Dr. Driss Raissi and our host Dr. Chris Beck discuss the planning, technique, and follow-up considerations for microwave ablation of liver lesions. First, they talk through the process of mapping out the tumor. Dr. Raissi often attends tumor boards to contribute to the variety of treatment perspectives and gain consensus for microwave ablation from colleagues in different specialties. He also discusses the differences between cirrhotic and steatotic livers because the latter can limit the efficiency of microwave energy delivery. During the procedure, Dr. Raissi appreciates the simplicity of a one-needle device. He offers advice for maneuvering near critical organs: direct the tip of the needle towards the critical structure to gain control. Additionally, he prefers to align the long axis of the needle with the long axis of the tumor and to minimize the number of new liver punctured by overlapping ablation zones. The doctors also discuss the need to balance clean margins with preservation of liver tissue, noting that lesions in different lobes can be treated in different sessions. Finally, they cover telehealth follow-ups and MRI follow-up during the subsequent month. Throughout this episode, we refer to findings about microwave ablation from previous publications, which are linked below. --- RESOURCES Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/30676100/ Liver microwave ablation: a systematic review of various FDA-approved systems: https://pubmed.ncbi.nlm.nih.gov/30506218/ Early Outcomes with Single-antenna High-powered Percutaneous Microwave Ablation for Primary and Secondary Hepatic Malignancies: Safety, Effectiveness, and Predictors of Ablative Failure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110402/ Mon, 04 Oct 2021 04:00:00 -0000 full BackTable Dr. Christopher Beck talks with Dr. Driss Raissi about his approach to Microwave Ablation of Liver Lesions, including workup, technique, and tips and tricks for a successful ablation treatment. Dr. Christopher Beck talks with Dr. Driss Raissi about his approach to Microwave Ablation of Liver Lesions, including workup, technique, and tips and tricks for a successful ablation treatment. --- CHECK OUT OUR SPONSOR Medtronic Emprint Ablation System https://www.medtronic.com/covidien/en-gb/products/ablation-systems/emprint-ablation-system.html --- SHOW NOTES In this episode, Dr. Driss Raissi and our host Dr. Chris Beck discuss the planning, technique, and follow-up considerations for microwave ablation of liver lesions. First, they talk through the process of mapping out the tumor. Dr. Raissi often attends tumor boards to contribute to the variety of treatment perspectives and gain consensus for microwave ablation from colleagues in different specialties. He also discusses the differences between cirrhotic and steatotic livers because the latter can limit the efficiency of microwave energy delivery. During the procedure, Dr. Raissi appreciates the simplicity of a one-needle device. He offers advice for maneuvering near critical organs: direct the tip of the needle towards the critical structure to gain control. Additionally, he prefers to align the long axis of the needle with the long axis of the tumor and to minimize the number of new liver punctured by overlapping ablation zones. The doctors also discuss the need to balance clean margins with preservation of liver tissue, noting that lesions in different lobes can be treated in different sessions. Finally, they cover telehealth follow-ups and MRI follow-up during the subsequent month. Throughout this episode, we refer to findings about microwave ablation from previous publications, which are linked below. --- RESOURCES Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/30676100/ Liver microwave ablation: a systematic review of various FDA-approved systems: https://pubmed.ncbi.nlm.nih.gov/30506218/ Early Outcomes with Single-antenna High-powered Percutaneous Microwave Ablation for Primary and Secondary Hepatic Malignancies: Safety, Effectiveness, and Predictors of Ablative Failure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110402/ Dr. Christopher Beck talks with Dr. Driss Raissi about his approach to Microwave Ablation of Liver Lesions, including workup, technique, and tips and tricks for a successful ablation treatment.


---


CHECK OUT OUR SPONSOR


Medtronic Emprint Ablation System

https://www.medtronic.com/covidien/en-gb/products/ablation-systems/emprint-ablation-system.html


---


SHOW NOTES


In this episode, Dr. Driss Raissi and our host Dr. Chris Beck discuss the planning, technique, and follow-up considerations for microwave ablation of liver lesions.


First, they talk through the process of mapping out the tumor. Dr. Raissi often attends tumor boards to contribute to the variety of treatment perspectives and gain consensus for microwave ablation from colleagues in different specialties. He also discusses the differences between cirrhotic and steatotic livers because the latter can limit the efficiency of microwave energy delivery.


During the procedure, Dr. Raissi appreciates the simplicity of a one-needle device. He offers advice for maneuvering near critical organs: direct the tip of the needle towards the critical structure to gain control. Additionally, he prefers to align the long axis of the needle with the long axis of the tumor and to minimize the number of new liver punctured by overlapping ablation zones.


The doctors also discuss the need to balance clean margins with preservation of liver tissue, noting that lesions in different lobes can be treated in different sessions. Finally, they cover telehealth follow-ups and MRI follow-up during the subsequent month.


Throughout this episode, we refer to findings about microwave ablation from previous publications, which are linked below.


---


RESOURCES


Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/30676100/


Liver microwave ablation: a systematic review of various FDA-approved systems:

https://pubmed.ncbi.nlm.nih.gov/30506218/


Early Outcomes with Single-antenna High-powered Percutaneous Microwave Ablation for Primary and Secondary Hepatic Malignancies: Safety, Effectiveness, and Predictors of Ablative Failure:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110402/

]]> 3678 Ep. 157 Lung Biopsies Part II: Pleural and Parenchymal Blood Patching with Dr. Fred Lee In Part II of our Lung Biopsy Series Dr. Fred Lee and Dr. Christopher Beck discuss Pleural and Parenchymal Blood Patching to prevent Pneumothorax, including results of the recent JVIR article from Sept 2021. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/0lTQ87 --- SHOW NOTES In this episode, Dr. Fred Lee and our host Dr. Chris Beck discuss the use of parenchymal and pleural blood patches to reduce the rate of lung biopsy re-interventions. First, Dr. Lee describes why he has incorporated parenchymal blood patching at the end of most biopsies, noting that it is a straightforward procedure that only adds on a few extra minutes to the overall biopsy, and it can reduce the rate of re-intervention. Both doctors agree that minimizing the need for chest tubes can greatly improve the patient experience. Pleural blood patches are used as a salvage technique in the event of a pneumothorax. Dr. Lee walks through his process of re-inflating the lung, finishing the biopsy, and using a three-way stopcock to inject blood onto the pleural surface and along the needle track. He notes that there are other valid ways of treating intraprocedural pneumothoraces (saline, fibrin plug, etc); however, he prefers the pleural blood patch because of its liquid-to-solid clotting transition, minimal time, minimal cost, and relatively low risk. Throughout this episode, we cite data from Dr. Lee’s previous publications, which are cited below. --- RESOURCES Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies: https://www.jvir.org/article/S1051-0443(21)01202-1/fulltext CT-Guided Lung Biopsies: Pleural Blood Patching Reduces the Rate of Chest Tube Placement for Postbiopsy Pneumothorax: www.ajronline.org/doi/full/10.2214/AJR.10.6324 Pulmonary Intraparenchymal Blood Patching Decreases the Rate of Pneumothorax-Related Complications following Percutaneous CT–Guided Needle Biopsy: www.jvir.org/article/S1051-0443…6)32178-9/fulltext Tue, 28 Sep 2021 05:00:00 -0000 full BackTable In Part II of our Lung Biopsy Series Dr. Fred Lee and Dr. Christopher Beck discuss Pleural and Parenchymal Blood Patching to prevent Pneumothorax, including results of the recent JVIR article from Sept 2021. In Part II of our Lung Biopsy Series Dr. Fred Lee and Dr. Christopher Beck discuss Pleural and Parenchymal Blood Patching to prevent Pneumothorax, including results of the recent JVIR article from Sept 2021. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/0lTQ87 --- SHOW NOTES In this episode, Dr. Fred Lee and our host Dr. Chris Beck discuss the use of parenchymal and pleural blood patches to reduce the rate of lung biopsy re-interventions. First, Dr. Lee describes why he has incorporated parenchymal blood patching at the end of most biopsies, noting that it is a straightforward procedure that only adds on a few extra minutes to the overall biopsy, and it can reduce the rate of re-intervention. Both doctors agree that minimizing the need for chest tubes can greatly improve the patient experience. Pleural blood patches are used as a salvage technique in the event of a pneumothorax. Dr. Lee walks through his process of re-inflating the lung, finishing the biopsy, and using a three-way stopcock to inject blood onto the pleural surface and along the needle track. He notes that there are other valid ways of treating intraprocedural pneumothoraces (saline, fibrin plug, etc); however, he prefers the pleural blood patch because of its liquid-to-solid clotting transition, minimal time, minimal cost, and relatively low risk. Throughout this episode, we cite data from Dr. Lee’s previous publications, which are cited below. --- RESOURCES Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies: https://www.jvir.org/article/S1051-0443(21)01202-1/fulltext CT-Guided Lung Biopsies: Pleural Blood Patching Reduces the Rate of Chest Tube Placement for Postbiopsy Pneumothorax: www.ajronline.org/doi/full/10.2214/AJR.10.6324 Pulmonary Intraparenchymal Blood Patching Decreases the Rate of Pneumothorax-Related Complications following Percutaneous CT–Guided Needle Biopsy: www.jvir.org/article/S1051-0443…6)32178-9/fulltext In Part II of our Lung Biopsy Series Dr. Fred Lee and Dr. Christopher Beck discuss Pleural and Parenchymal Blood Patching to prevent Pneumothorax, including results of the recent JVIR article from Sept 2021.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/0lTQ87


---


SHOW NOTES


In this episode, Dr. Fred Lee and our host Dr. Chris Beck discuss the use of parenchymal and pleural blood patches to reduce the rate of lung biopsy re-interventions.


First, Dr. Lee describes why he has incorporated parenchymal blood patching at the end of most biopsies, noting that it is a straightforward procedure that only adds on a few extra minutes to the overall biopsy, and it can reduce the rate of re-intervention. Both doctors agree that minimizing the need for chest tubes can greatly improve the patient experience.


Pleural blood patches are used as a salvage technique in the event of a pneumothorax. Dr. Lee walks through his process of re-inflating the lung, finishing the biopsy, and using a three-way stopcock to inject blood onto the pleural surface and along the needle track. He notes that there are other valid ways of treating intraprocedural pneumothoraces (saline, fibrin plug, etc); however, he prefers the pleural blood patch because of its liquid-to-solid clotting transition, minimal time, minimal cost, and relatively low risk.


Throughout this episode, we cite data from Dr. Lee’s previous publications, which are cited below.


---


RESOURCES


Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies:

https://www.jvir.org/article/S1051-0443(21)01202-1/fulltext


CT-Guided Lung Biopsies: Pleural Blood Patching Reduces the Rate of Chest Tube Placement for Postbiopsy Pneumothorax: www.ajronline.org/doi/full/10.2214/AJR.10.6324


Pulmonary Intraparenchymal Blood Patching Decreases the Rate of Pneumothorax-Related Complications following Percutaneous CT–Guided Needle Biopsy: www.jvir.org/article/S1051-0443…6)32178-9/fulltext

]]> 2751 Ep. 156 Percutaneous Lung Biopsies Part I: The Basics and Tips/Tricks with Dr. Fred Lee We start off Part 1 of a 2 part series with Dr. Fred Lee discussing Percutaneous Lung Biopsy Technique, with tips and tricks to help your daily practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QD39HM --- SHOW NOTES In this episode, Dr. Fred Lee and our host Dr. Chris Beck discuss tips for achieving safe and successful percutaneous lung biopsies. They start by discussing the increasing popularity of core biopsy (as opposed to fine needle aspiration), since an adequate amount of specimen is needed for genetic testing and personalized medicine. Dr. Lee emphasizes that knowing the goals of lung biopsy for each individual patient helps him decide how much specimen to collect and how the specimen should be handled. Next, Dr. Lee walks through his lung biopsy technique. He outlines the difference between conventional CT and CT with fluoroscopy. While CT with fluoroscopy can be more efficient, it poses radiation risk to the patient and the physician. To minimize radiation risks, he advises IRs to intermittently tap the foot pedal and stand lateral to the CT scanner. The doctors also discuss some of the trickiest lung regions to biopsy and ways to avoid pneumothorax. Finally, Dr. Lee comments on the choice between percutaneous lung biopsies and electromagnetic navigation bronchoscopy, noting that each procedure has different advantages and risks. He encourages interventional radiologists and interventional pulmonologists to explore these options and take evidence-based approaches. Throughout this episode, we cite data from Dr. Lee’s previous publications, which are cited below. --- RESOURCES Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies: https://www.jvir.org/article/S1051-0443(21)01202-1/fulltext Mon, 27 Sep 2021 11:36:00 -0000 full BackTable We start off Part 1 of a 2 part series with Dr. Fred Lee discussing Percutaneous Lung Biopsy Technique, with tips and tricks to help your daily practice. We start off Part 1 of a 2 part series with Dr. Fred Lee discussing Percutaneous Lung Biopsy Technique, with tips and tricks to help your daily practice. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QD39HM --- SHOW NOTES In this episode, Dr. Fred Lee and our host Dr. Chris Beck discuss tips for achieving safe and successful percutaneous lung biopsies. They start by discussing the increasing popularity of core biopsy (as opposed to fine needle aspiration), since an adequate amount of specimen is needed for genetic testing and personalized medicine. Dr. Lee emphasizes that knowing the goals of lung biopsy for each individual patient helps him decide how much specimen to collect and how the specimen should be handled. Next, Dr. Lee walks through his lung biopsy technique. He outlines the difference between conventional CT and CT with fluoroscopy. While CT with fluoroscopy can be more efficient, it poses radiation risk to the patient and the physician. To minimize radiation risks, he advises IRs to intermittently tap the foot pedal and stand lateral to the CT scanner. The doctors also discuss some of the trickiest lung regions to biopsy and ways to avoid pneumothorax. Finally, Dr. Lee comments on the choice between percutaneous lung biopsies and electromagnetic navigation bronchoscopy, noting that each procedure has different advantages and risks. He encourages interventional radiologists and interventional pulmonologists to explore these options and take evidence-based approaches. Throughout this episode, we cite data from Dr. Lee’s previous publications, which are cited below. --- RESOURCES Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies: https://www.jvir.org/article/S1051-0443(21)01202-1/fulltext We start off Part 1 of a 2 part series with Dr. Fred Lee discussing Percutaneous Lung Biopsy Technique, with tips and tricks to help your daily practice.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/QD39HM


---


SHOW NOTES


In this episode, Dr. Fred Lee and our host Dr. Chris Beck discuss tips for achieving safe and successful percutaneous lung biopsies.


They start by discussing the increasing popularity of core biopsy (as opposed to fine needle aspiration), since an adequate amount of specimen is needed for genetic testing and personalized medicine. Dr. Lee emphasizes that knowing the goals of lung biopsy for each individual patient helps him decide how much specimen to collect and how the specimen should be handled.


Next, Dr. Lee walks through his lung biopsy technique. He outlines the difference between conventional CT and CT with fluoroscopy. While CT with fluoroscopy can be more efficient, it poses radiation risk to the patient and the physician. To minimize radiation risks, he advises IRs to intermittently tap the foot pedal and stand lateral to the CT scanner. The doctors also discuss some of the trickiest lung regions to biopsy and ways to avoid pneumothorax.


Finally, Dr. Lee comments on the choice between percutaneous lung biopsies and electromagnetic navigation bronchoscopy, noting that each procedure has different advantages and risks. He encourages interventional radiologists and interventional pulmonologists to explore these options and take evidence-based approaches.


Throughout this episode, we cite data from Dr. Lee’s previous publications, which are cited below.


---


RESOURCES


Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies:

https://www.jvir.org/article/S1051-0443(21)01202-1/fulltext

]]> 2965 Ep. 155 The Butterfly Story: An Interview with Dr. John Martin https://soundcloud.com/backtable/ep-155-the-butterfly-story-an-interview-with-dr-john-martin We talk with Vascular Surgeon John Martin about his entrepreneurial journey to becoming CMO of Butterfly Network, Inc., and their mission to revolutionize medical imaging and medical education. --- CHECK OUT OUR SPONSOR Medtronic AV DCB https://www.medtronic.com/avdcb --- SHOW NOTES In this installment of the BackTable Innovation Series, Dr. John Martin, Chief Medical Officer of Butterfly Network, and our host Dr. Bryan Hartley discuss Dr. Martin’s work in clinical software development, nonprofit efforts, and the revolutionary Ultrasound-on-Chip technology. Dr. Martin traces his entrepreneurial journey back to his vascular surgery fellowship years, when he developed software programs to automate risk stratification and track patient outcomes. He emphasizes that it is important to take risks and “bet on yourself” when you know that your product can bring benefits to patients and physicians. Dr. Martin also advises listeners to be open to partnerships with larger companies who can bring their ideas to fruition. This collaborative mindset brought him into the nonprofit world, where he worked with industry and government leaders to found a free cardiovascular screening initiative called Dare to CARE. In his current role at Butterfly Network, Dr. Martin aims to make bedside ultrasound care affordable and accessible to all patients across the globe. He highlights the fact that the portable Butterfly probe has been successfully employed in contexts such as medical education, the COVID response, and his own cancer diagnosis. Overall, Dr. Martin believes that ultrasound access will benefit all medical specialties and help physicians make more efficient and informed clinical decisions. --- RESOURCES The Butterfly Network: https://www.butterflynetwork.com/ Dare to CARE: http://www.daretocare.us/ Mon, 20 Sep 2021 11:13:00 -0000 full BackTable We talk with Vascular Surgeon John Martin about his entrepreneurial journey to becoming CMO of Butterfly Network, Inc., and their mission to revolutionize medical imaging and medical education. We talk with Vascular Surgeon John Martin about his entrepreneurial journey to becoming CMO of Butterfly Network, Inc., and their mission to revolutionize medical imaging and medical education. --- CHECK OUT OUR SPONSOR Medtronic AV DCB https://www.medtronic.com/avdcb --- SHOW NOTES In this installment of the BackTable Innovation Series, Dr. John Martin, Chief Medical Officer of Butterfly Network, and our host Dr. Bryan Hartley discuss Dr. Martin’s work in clinical software development, nonprofit efforts, and the revolutionary Ultrasound-on-Chip technology. Dr. Martin traces his entrepreneurial journey back to his vascular surgery fellowship years, when he developed software programs to automate risk stratification and track patient outcomes. He emphasizes that it is important to take risks and “bet on yourself” when you know that your product can bring benefits to patients and physicians. Dr. Martin also advises listeners to be open to partnerships with larger companies who can bring their ideas to fruition. This collaborative mindset brought him into the nonprofit world, where he worked with industry and government leaders to found a free cardiovascular screening initiative called Dare to CARE. In his current role at Butterfly Network, Dr. Martin aims to make bedside ultrasound care affordable and accessible to all patients across the globe. He highlights the fact that the portable Butterfly probe has been successfully employed in contexts such as medical education, the COVID response, and his own cancer diagnosis. Overall, Dr. Martin believes that ultrasound access will benefit all medical specialties and help physicians make more efficient and informed clinical decisions. --- RESOURCES The Butterfly Network: https://www.butterflynetwork.com/ Dare to CARE: http://www.daretocare.us/ We talk with Vascular Surgeon John Martin about his entrepreneurial journey to becoming CMO of Butterfly Network, Inc., and their mission to revolutionize medical imaging and medical education.


---


CHECK OUT OUR SPONSOR


Medtronic AV DCB

https://www.medtronic.com/avdcb


---


SHOW NOTES


In this installment of the BackTable Innovation Series, Dr. John Martin, Chief Medical Officer of Butterfly Network, and our host Dr. Bryan Hartley discuss Dr. Martin’s work in clinical software development, nonprofit efforts, and the revolutionary Ultrasound-on-Chip technology.


Dr. Martin traces his entrepreneurial journey back to his vascular surgery fellowship years, when he developed software programs to automate risk stratification and track patient outcomes. He emphasizes that it is important to take risks and “bet on yourself” when you know that your product can bring benefits to patients and physicians.


Dr. Martin also advises listeners to be open to partnerships with larger companies who can bring their ideas to fruition. This collaborative mindset brought him into the nonprofit world, where he worked with industry and government leaders to found a free cardiovascular screening initiative called Dare to CARE.


In his current role at Butterfly Network, Dr. Martin aims to make bedside ultrasound care affordable and accessible to all patients across the globe. He highlights the fact that the portable Butterfly probe has been successfully employed in contexts such as medical education, the COVID response, and his own cancer diagnosis. Overall, Dr. Martin believes that ultrasound access will benefit all medical specialties and help physicians make more efficient and informed clinical decisions.


---


RESOURCES


The Butterfly Network: https://www.butterflynetwork.com/


Dare to CARE: http://www.daretocare.us/

]]> 3435 no Ep. 154 Discussing the Complications Survey Results with The BackTable Team https://soundcloud.com/backtable/ep-154-discussing-the-complications-survey-results-with-the-backtable-team The BackTable hosts get together to discuss the results of the recent complications survey, including some stories from the audience as well some of their own experiences. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/beC0Z4 --- SHOW NOTES Two months ago, we invited our listeners to participate in an anonymous Complications Survey. Our goal was to encourage open and honest conversations about procedural complications and what we can learn from them. In this episode, our BackTable hosts conduct a roundtable discussion about the results of the survey and share their personal experiences with complications. The hosts start with distinguishing between complications from high-risk procedures and unexpected complications that arise in healthy individuals, noting that the latter type takes a larger toll on an IR. They emphasize the important role of case selection in minimizing complications and how each of them presents complication risks to patients during the informed consent process. Next, the hosts read through complication stories that respondents submitted. Each host also shares stories about the aftermath of their own complications and how to communicate these to patients, families, and referring doctors. Finally, we highlight an important survey finding: 76% of respondents do not think that complications are discussed enough among endovascular and interventional specialists. In the future, we hope to bring more attention to procedural complications and share advice on how we can collectively minimize risks for our patients and support each other in dealing with complications. We would like to give special thanks to all of our BackTable community members who submitted their insights on complications! If you have a show topic or guest suggestion on the subject of dealing with or preventing complications, reach out to us on our website or social media. --- RESOURCES BackTable Ep. 54: Coping with Procedure Complications: https://www.backtable.com/shows/vi/podcasts/45/coping-with-procedure-complications “Doctors and Litigation: The L Word” Podcast: https://podcasts.apple.com/us/podcast/doctors-and-litigation-the-l-word/id1469155084 Mon, 13 Sep 2021 11:23:00 -0000 full BackTable The BackTable hosts get together to discuss the results of the recent complications survey, including some stories from the audience as well some of their own experiences. The BackTable hosts get together to discuss the results of the recent complications survey, including some stories from the audience as well some of their own experiences. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/beC0Z4 --- SHOW NOTES Two months ago, we invited our listeners to participate in an anonymous Complications Survey. Our goal was to encourage open and honest conversations about procedural complications and what we can learn from them. In this episode, our BackTable hosts conduct a roundtable discussion about the results of the survey and share their personal experiences with complications. The hosts start with distinguishing between complications from high-risk procedures and unexpected complications that arise in healthy individuals, noting that the latter type takes a larger toll on an IR. They emphasize the important role of case selection in minimizing complications and how each of them presents complication risks to patients during the informed consent process. Next, the hosts read through complication stories that respondents submitted. Each host also shares stories about the aftermath of their own complications and how to communicate these to patients, families, and referring doctors. Finally, we highlight an important survey finding: 76% of respondents do not think that complications are discussed enough among endovascular and interventional specialists. In the future, we hope to bring more attention to procedural complications and share advice on how we can collectively minimize risks for our patients and support each other in dealing with complications. We would like to give special thanks to all of our BackTable community members who submitted their insights on complications! If you have a show topic or guest suggestion on the subject of dealing with or preventing complications, reach out to us on our website or social media. --- RESOURCES BackTable Ep. 54: Coping with Procedure Complications: https://www.backtable.com/shows/vi/podcasts/45/coping-with-procedure-complications “Doctors and Litigation: The L Word” Podcast: https://podcasts.apple.com/us/podcast/doctors-and-litigation-the-l-word/id1469155084 The BackTable hosts get together to discuss the results of the recent complications survey, including some stories from the audience as well some of their own experiences.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/beC0Z4


---


SHOW NOTES


Two months ago, we invited our listeners to participate in an anonymous Complications Survey. Our goal was to encourage open and honest conversations about procedural complications and what we can learn from them. In this episode, our BackTable hosts conduct a roundtable discussion about the results of the survey and share their personal experiences with complications.


The hosts start with distinguishing between complications from high-risk procedures and unexpected complications that arise in healthy individuals, noting that the latter type takes a larger toll on an IR. They emphasize the important role of case selection in minimizing complications and how each of them presents complication risks to patients during the informed consent process.


Next, the hosts read through complication stories that respondents submitted. Each host also shares stories about the aftermath of their own complications and how to communicate these to patients, families, and referring doctors.


Finally, we highlight an important survey finding: 76% of respondents do not think that complications are discussed enough among endovascular and interventional specialists. In the future, we hope to bring more attention to procedural complications and share advice on how we can collectively minimize risks for our patients and support each other in dealing with complications.


We would like to give special thanks to all of our BackTable community members who submitted their insights on complications! If you have a show topic or guest suggestion on the subject of dealing with or preventing complications, reach out to us on our website or social media.


---


RESOURCES


BackTable Ep. 54: Coping with Procedure Complications:

https://www.backtable.com/shows/vi/podcasts/45/coping-with-procedure-complications


“Doctors and Litigation: The L Word” Podcast:

https://podcasts.apple.com/us/podcast/doctors-and-litigation-the-l-word/id1469155084

]]> 2984 no Ep. 153 Mediport Placement with Dr. Chris Beck https://soundcloud.com/backtable/ep-153-mediport-placement-with-dr-chris-beck Dr. Christopher Beck and Dr. Aaron Fritts discuss the Mediport placement procedure, including differences in technique (tie-down vs snug pocket), tips and tricks, and avoiding complications. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/X2qOIH --- CHECK OUT OUR SPONSOR Medtronic VenaSeal https://www.medtronic.com/impact --- SHOW NOTES In this episode, our co-hosts Dr. Chris Beck and Dr. Aaron Fritts share their tips and techniques to make Mediport placement more efficient and comfortable for both IRs and patients. They start by discussing common reasons for port placement, noting that the majority of patients need them for chemotherapy, but they can also be helpful for patients who need access for frequent blood transfusions. As for contraindications, it is best to wait on patients who are currently experiencing active infections. Radiation burns, mastectomies, and bleeding disorders are not absolute contraindications, but these conditions can present challenges to port placement that might require extra planning. Next, they walk through a port placement procedure, giving insights to their personal preferences. Dr. Beck uses the micropuncture needle to administer lidocaine along the track that he will be tunneling, to reduce the number of sticks. Both doctors aim to create a “snug pocket” for the Mediport, which reduces to suture it into place. As for avoiding complications, they prescribe antibiotics depending on the hospital protocols and exercise caution with patients who are sensitive to arrhythmias. Finally, they discuss the satisfaction of port removal and emotional significance for patients. This episode is also available in video format on our BackTable YouTube channel (linked below). --- RESOURCES Watch the Video Podcast: https://youtu.be/PwDqG3av3eE Fri, 10 Sep 2021 12:17:00 -0000 full BackTable Dr. Christopher Beck and Dr. Aaron Fritts discuss the Mediport placement procedure, including differences in technique (tie-down vs snug pocket), tips and tricks, and avoiding complications. Dr. Christopher Beck and Dr. Aaron Fritts discuss the Mediport placement procedure, including differences in technique (tie-down vs snug pocket), tips and tricks, and avoiding complications. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/X2qOIH --- CHECK OUT OUR SPONSOR Medtronic VenaSeal https://www.medtronic.com/impact --- SHOW NOTES In this episode, our co-hosts Dr. Chris Beck and Dr. Aaron Fritts share their tips and techniques to make Mediport placement more efficient and comfortable for both IRs and patients. They start by discussing common reasons for port placement, noting that the majority of patients need them for chemotherapy, but they can also be helpful for patients who need access for frequent blood transfusions. As for contraindications, it is best to wait on patients who are currently experiencing active infections. Radiation burns, mastectomies, and bleeding disorders are not absolute contraindications, but these conditions can present challenges to port placement that might require extra planning. Next, they walk through a port placement procedure, giving insights to their personal preferences. Dr. Beck uses the micropuncture needle to administer lidocaine along the track that he will be tunneling, to reduce the number of sticks. Both doctors aim to create a “snug pocket” for the Mediport, which reduces to suture it into place. As for avoiding complications, they prescribe antibiotics depending on the hospital protocols and exercise caution with patients who are sensitive to arrhythmias. Finally, they discuss the satisfaction of port removal and emotional significance for patients. This episode is also available in video format on our BackTable YouTube channel (linked below). --- RESOURCES Watch the Video Podcast: https://youtu.be/PwDqG3av3eE Dr. Christopher Beck and Dr. Aaron Fritts discuss the Mediport placement procedure, including differences in technique (tie-down vs snug pocket), tips and tricks, and avoiding complications.


The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/X2qOIH


---


CHECK OUT OUR SPONSOR


Medtronic VenaSeal

https://www.medtronic.com/impact


---


SHOW NOTES


In this episode, our co-hosts Dr. Chris Beck and Dr. Aaron Fritts share their tips and techniques to make Mediport placement more efficient and comfortable for both IRs and patients.


They start by discussing common reasons for port placement, noting that the majority of patients need them for chemotherapy, but they can also be helpful for patients who need access for frequent blood transfusions. As for contraindications, it is best to wait on patients who are currently experiencing active infections. Radiation burns, mastectomies, and bleeding disorders are not absolute contraindications, but these conditions can present challenges to port placement that might require extra planning.


Next, they walk through a port placement procedure, giving insights to their personal preferences. Dr. Beck uses the micropuncture needle to administer lidocaine along the track that he will be tunneling, to reduce the number of sticks. Both doctors aim to create a “snug pocket” for the Mediport, which reduces to suture it into place. As for avoiding complications, they prescribe antibiotics depending on the hospital protocols and exercise caution with patients who are sensitive to arrhythmias. Finally, they discuss the satisfaction of port removal and emotional significance for patients.


This episode is also available in video format on our BackTable YouTube channel (linked below).


---


RESOURCES


Watch the Video Podcast: https://youtu.be/PwDqG3av3eE

]]> 3055 no Ep. 152 Treating Vascular Anomalies with Dr. Alex Barnacle We talk with Dr. Alex Barnacle about her approach to the workup of Vascular Anomalies, including the importance of correct nomenclature and multidisciplinary teams for accurate diagnosis and long-term success. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/f2yvd6 --- SHOW NOTES In this episode, Dr. Alex Barnacle and our host Dr. Chris Beck discuss the diagnosis and treatments of different vascular anomalies, as well as considerations in treating a pediatric population. We start by reviewing the terminology of vascular anomalies, noting that the terms can be complicated and misleading for providers and for patients. Dr. Barnacle explains categories delineated by the ISSVA (International Society for the Study of Vascular Anomalies). She emphasizes the importance of combining imaging and physical examination to correctly differentiate between capillary, venous, lymphatic, and arterial malformations. Next, Dr. Barnacle highlights the interdisciplinary nature of her joint clinics, which involve a variety of specialties (dermatologists, orthopedic surgeons, plastic surgeons, and others) and physical therapists. All play a role in diagnosing, treating, and following up with patients. When discussing sclerotherapy, we cover considerations such as sedation, sclerosing agent, two needle technique, and potential complications. Dr. Barnacle talks about managing patient and family expectations, emphasizing that large lesions may require multiple interventions. We conclude by reflecting on the current state of pediatric IR and the future growth of the field. --- RESOURCES Commentary on Electrosclerotherapy as a Novel Treatment Option for Hypertrophic Capillary Malformations: https://pubmed.ncbi.nlm.nih.gov/31574036/ ISSVA Classification for Vascular Anomalies: https://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf ISSVA website: https://www.issva.org/ Mon, 06 Sep 2021 12:00:00 -0000 full BackTable We talk with Dr. Alex Barnacle about her approach to the workup of Vascular Anomalies, including the importance of correct nomenclature and multidisciplinary teams for accurate diagnosis and long-term success. We talk with Dr. Alex Barnacle about her approach to the workup of Vascular Anomalies, including the importance of correct nomenclature and multidisciplinary teams for accurate diagnosis and long-term success. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/f2yvd6 --- SHOW NOTES In this episode, Dr. Alex Barnacle and our host Dr. Chris Beck discuss the diagnosis and treatments of different vascular anomalies, as well as considerations in treating a pediatric population. We start by reviewing the terminology of vascular anomalies, noting that the terms can be complicated and misleading for providers and for patients. Dr. Barnacle explains categories delineated by the ISSVA (International Society for the Study of Vascular Anomalies). She emphasizes the importance of combining imaging and physical examination to correctly differentiate between capillary, venous, lymphatic, and arterial malformations. Next, Dr. Barnacle highlights the interdisciplinary nature of her joint clinics, which involve a variety of specialties (dermatologists, orthopedic surgeons, plastic surgeons, and others) and physical therapists. All play a role in diagnosing, treating, and following up with patients. When discussing sclerotherapy, we cover considerations such as sedation, sclerosing agent, two needle technique, and potential complications. Dr. Barnacle talks about managing patient and family expectations, emphasizing that large lesions may require multiple interventions. We conclude by reflecting on the current state of pediatric IR and the future growth of the field. --- RESOURCES Commentary on Electrosclerotherapy as a Novel Treatment Option for Hypertrophic Capillary Malformations: https://pubmed.ncbi.nlm.nih.gov/31574036/ ISSVA Classification for Vascular Anomalies: https://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf ISSVA website: https://www.issva.org/ We talk with Dr. Alex Barnacle about her approach to the workup of Vascular Anomalies, including the importance of correct nomenclature and multidisciplinary teams for accurate diagnosis and long-term success.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/f2yvd6


---


SHOW NOTES


In this episode, Dr. Alex Barnacle and our host Dr. Chris Beck discuss the diagnosis and treatments of different vascular anomalies, as well as considerations in treating a pediatric population.


We start by reviewing the terminology of vascular anomalies, noting that the terms can be complicated and misleading for providers and for patients. Dr. Barnacle explains categories delineated by the ISSVA (International Society for the Study of Vascular Anomalies). She emphasizes the importance of combining imaging and physical examination to correctly differentiate between capillary, venous, lymphatic, and arterial malformations.


Next, Dr. Barnacle highlights the interdisciplinary nature of her joint clinics, which involve a variety of specialties (dermatologists, orthopedic surgeons, plastic surgeons, and others) and physical therapists. All play a role in diagnosing, treating, and following up with patients.


When discussing sclerotherapy, we cover considerations such as sedation, sclerosing agent, two needle technique, and potential complications. Dr. Barnacle talks about managing patient and family expectations, emphasizing that large lesions may require multiple interventions. We conclude by reflecting on the current state of pediatric IR and the future growth of the field.


---


RESOURCES


Commentary on Electrosclerotherapy as a Novel Treatment Option for Hypertrophic Capillary Malformations:

https://pubmed.ncbi.nlm.nih.gov/31574036/


ISSVA Classification for Vascular Anomalies:

https://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf


ISSVA website: https://www.issva.org/

]]> 4002 no Ep. 151 Innovation MD: An Interview with Dr. David Liu We talk with Dr. David Liu about the life cycle of innovation projects, developing ideas strategically, and his mentorship work with Creative Destruction Lab. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/F02n8o --- SHOW NOTES In this episode, Dr. David Liu and our host Dr. Bryan Hartley discuss the intersections of medicine, engineering, and business in innovation. Dr. Liu describes his background in computer science and how it helped him develop a problem-solving mindset. Within the IR space, he believes that innovation can be divided into three categories: disease management, technical refinement of procedures, and transformational technologies. Dr. Liu outlines his projects that fall into these categories, including an app for Y90 dosimetry, gesture based control for the angio suite, and collaboration through virtual reality. We also discuss how innovation and execution are processes that require diverse perspectives. Dr. Liu summarizes important business concepts such as the various stages of a company’s evolution (start up, small cap, mid cap, and large cap) and two different types of investment (accretive vs. dilutive). Bringing a product to the marketplace involves multiple milestones such as establishment of intellectual property rights, proof of concept, first in human clinical trials, and regulatory approval. Achieving these milestones helps a company “de-risk” itself and become more attractive to investors. --- RESOURCES NZ Technologies: https://nztech.ca/ Imaging Reality: https://www.imagingreality.com/ Creative Destruction Lab: https://www.creativedestructionlab.com/ Mon, 30 Aug 2021 11:10:00 -0000 full BackTable We talk with Dr. David Liu about the life cycle of innovation projects, developing ideas strategically, and his mentorship work with Creative Destruction Lab. We talk with Dr. David Liu about the life cycle of innovation projects, developing ideas strategically, and his mentorship work with Creative Destruction Lab. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/F02n8o --- SHOW NOTES In this episode, Dr. David Liu and our host Dr. Bryan Hartley discuss the intersections of medicine, engineering, and business in innovation. Dr. Liu describes his background in computer science and how it helped him develop a problem-solving mindset. Within the IR space, he believes that innovation can be divided into three categories: disease management, technical refinement of procedures, and transformational technologies. Dr. Liu outlines his projects that fall into these categories, including an app for Y90 dosimetry, gesture based control for the angio suite, and collaboration through virtual reality. We also discuss how innovation and execution are processes that require diverse perspectives. Dr. Liu summarizes important business concepts such as the various stages of a company’s evolution (start up, small cap, mid cap, and large cap) and two different types of investment (accretive vs. dilutive). Bringing a product to the marketplace involves multiple milestones such as establishment of intellectual property rights, proof of concept, first in human clinical trials, and regulatory approval. Achieving these milestones helps a company “de-risk” itself and become more attractive to investors. --- RESOURCES NZ Technologies: https://nztech.ca/ Imaging Reality: https://www.imagingreality.com/ Creative Destruction Lab: https://www.creativedestructionlab.com/ We talk with Dr. David Liu about the life cycle of innovation projects, developing ideas strategically, and his mentorship work with Creative Destruction Lab.


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/F02n8o


---


SHOW NOTES


In this episode, Dr. David Liu and our host Dr. Bryan Hartley discuss the intersections of medicine, engineering, and business in innovation.


Dr. Liu describes his background in computer science and how it helped him develop a problem-solving mindset. Within the IR space, he believes that innovation can be divided into three categories: disease management, technical refinement of procedures, and transformational technologies. Dr. Liu outlines his projects that fall into these categories, including an app for Y90 dosimetry, gesture based control for the angio suite, and collaboration through virtual reality.


We also discuss how innovation and execution are processes that require diverse perspectives. Dr. Liu summarizes important business concepts such as the various stages of a company’s evolution (start up, small cap, mid cap, and large cap) and two different types of investment (accretive vs. dilutive). Bringing a product to the marketplace involves multiple milestones such as establishment of intellectual property rights, proof of concept, first in human clinical trials, and regulatory approval. Achieving these milestones helps a company “de-risk” itself and become more attractive to investors.


---


RESOURCES


NZ Technologies: https://nztech.ca/


Imaging Reality: https://www.imagingreality.com/


Creative Destruction Lab: https://www.creativedestructionlab.com/

]]> 2889 no Edición Esp: Inclusión de la Comunidad Latina en la Conversación Endovascular con Dr. Gloria Salazar Nuestro primer episodio de Backtable en español está aquí. Las doctoras Gloria Salazar y Gina Landinez discuten COVID, las demandas médicas y endovasculres de nuestra población Iberoamericana y como convertir un ”no” en un “si". Our first episode of BackTable en Español is here! With a growing demand for outreach in the Latin American community, Drs. Gloria Salazar, MD, FSIR and Gina Landinez MD talk about COVID, growing medical needs of our Spanish speaking community, and how to find opportunity when turning a “no” to a “yes”. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Cdf5S1 --- SHOW NOTES En este episodio de BackTable, la radióloga intervencionista Dra. Gina Landinez entrevista a la Dra. Gloria Salazar, la jefa de división de radiología vascular e intervencionista de UNC Chapel Hill , sobre las desigualdades de salud en las comunidades minoritarias, su camino médico, y sus consejos para los aprendices médicos latinos. Nacida por padres chilenos, la Dra. Salazar creció en Brasil. Desde su niñez, tuvo aspiraciones de ser doctora en los Estados Unidos y por eso, tuvo la motivación para aprender inglés a una temprana edad. Como alumna médica de la Universidad Federal de Sāo Paulo, tuvo excelentes mentores quienes fomentaron una curiosidad de pesquisa en ella. Fue ahí que nació su deseo de participar en el desarrollo del campo de la medicina. La Dra. Salazar explica cómo su perspectiva sobre la salud cambió a través de sus experiencias como fellow y attending en el Hospital de Massachusetts General, donde el treinta por ciento de los pacientes eran latinos. Durante la pandemia, ella se dio cuenta que los pacientes latinos con COVID-19 enfrentaban retos únicos, como la barrera lingüística y dificultades económicas que impactan su recuperación. Ella recalca la relación entre las comunidades inmigrantes y el acceso a salud básica y describe como esta pandemia funciona como un despertar y llamada de conciencia tanto como para ella como para todos sus compañeros médicos, al enfatizar las divisiones existentes en nuestro sistema de salud. Sin embargo, cree que la competencia cultural y la colaboración internacional entre radiólogos puede mejorar las vidas de pacientes estadounidenses y latinos. Finalmente, refleja en los factores más importantes en su éxito hoy en día. Reconoce que la persistencia inculcada por sus padres desde joven le proveía la fuerza de superar los retos profesionales y personales. Adicionalmente, destaca la importancia de los buenos mentores quienes pudieron iniciar sus intereses médicos y clarificar sus caminos. Finalmente, explica el fenómeno del “síndrome impostor” y anima a los médicos en formación a creer en sí mismos. Fri, 27 Aug 2021 14:12:00 -0000 full BackTable Nuestro primer episodio de Backtable en español está aquí. Las doctoras Gloria Salazar y Gina Landinez discuten COVID, las demandas médicas y endovasculres de nuestra población Iberoamericana y como convertir un ”no” en un “si". Nuestro primer episodio de Backtable en español está aquí. Las doctoras Gloria Salazar y Gina Landinez discuten COVID, las demandas médicas y endovasculres de nuestra población Iberoamericana y como convertir un ”no” en un “si". Our first episode of BackTable en Español is here! With a growing demand for outreach in the Latin American community, Drs. Gloria Salazar, MD, FSIR and Gina Landinez MD talk about COVID, growing medical needs of our Spanish speaking community, and how to find opportunity when turning a “no” to a “yes”. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Cdf5S1 --- SHOW NOTES En este episodio de BackTable, la radióloga intervencionista Dra. Gina Landinez entrevista a la Dra. Gloria Salazar, la jefa de división de radiología vascular e intervencionista de UNC Chapel Hill , sobre las desigualdades de salud en las comunidades minoritarias, su camino médico, y sus consejos para los aprendices médicos latinos. Nacida por padres chilenos, la Dra. Salazar creció en Brasil. Desde su niñez, tuvo aspiraciones de ser doctora en los Estados Unidos y por eso, tuvo la motivación para aprender inglés a una temprana edad. Como alumna médica de la Universidad Federal de Sāo Paulo, tuvo excelentes mentores quienes fomentaron una curiosidad de pesquisa en ella. Fue ahí que nació su deseo de participar en el desarrollo del campo de la medicina. La Dra. Salazar explica cómo su perspectiva sobre la salud cambió a través de sus experiencias como fellow y attending en el Hospital de Massachusetts General, donde el treinta por ciento de los pacientes eran latinos. Durante la pandemia, ella se dio cuenta que los pacientes latinos con COVID-19 enfrentaban retos únicos, como la barrera lingüística y dificultades económicas que impactan su recuperación. Ella recalca la relación entre las comunidades inmigrantes y el acceso a salud básica y describe como esta pandemia funciona como un despertar y llamada de conciencia tanto como para ella como para todos sus compañeros médicos, al enfatizar las divisiones existentes en nuestro sistema de salud. Sin embargo, cree que la competencia cultural y la colaboración internacional entre radiólogos puede mejorar las vidas de pacientes estadounidenses y latinos. Finalmente, refleja en los factores más importantes en su éxito hoy en día. Reconoce que la persistencia inculcada por sus padres desde joven le proveía la fuerza de superar los retos profesionales y personales. Adicionalmente, destaca la importancia de los buenos mentores quienes pudieron iniciar sus intereses médicos y clarificar sus caminos. Finalmente, explica el fenómeno del “síndrome impostor” y anima a los médicos en formación a creer en sí mismos. Nuestro primer episodio de Backtable en español está aquí. Las doctoras Gloria Salazar y Gina Landinez discuten COVID, las demandas médicas y endovasculres de nuestra población Iberoamericana y como convertir un ”no” en un “si".


Our first episode of BackTable en Español is here! With a growing demand for outreach in the Latin American community, Drs. Gloria Salazar, MD, FSIR and Gina Landinez MD talk about COVID, growing medical needs of our Spanish speaking community, and how to find opportunity when turning a “no” to a “yes”.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Cdf5S1


---


SHOW NOTES


En este episodio de BackTable, la radióloga intervencionista Dra. Gina Landinez entrevista a la Dra. Gloria Salazar, la jefa de división de radiología vascular e intervencionista de UNC Chapel Hill , sobre las desigualdades de salud en las comunidades minoritarias, su camino médico, y sus consejos para los aprendices médicos latinos.


Nacida por padres chilenos, la Dra. Salazar creció en Brasil. Desde su niñez, tuvo aspiraciones de ser doctora en los Estados Unidos y por eso, tuvo la motivación para aprender inglés a una temprana edad. Como alumna médica de la Universidad Federal de Sāo Paulo, tuvo excelentes mentores quienes fomentaron una curiosidad de pesquisa en ella. Fue ahí que nació su deseo de participar en el desarrollo del campo de la medicina.


La Dra. Salazar explica cómo su perspectiva sobre la salud cambió a través de sus experiencias como fellow y attending en el Hospital de Massachusetts General, donde el treinta por ciento de los pacientes eran latinos. Durante la pandemia, ella se dio cuenta que los pacientes latinos con COVID-19 enfrentaban retos únicos, como la barrera lingüística y dificultades económicas que impactan su recuperación. Ella recalca la relación entre las comunidades inmigrantes y el acceso a salud básica y describe como esta pandemia funciona como un despertar y llamada de conciencia tanto como para ella como para todos sus compañeros médicos, al enfatizar las divisiones existentes en nuestro sistema de salud. Sin embargo, cree que la competencia cultural y la colaboración internacional entre radiólogos puede mejorar las vidas de pacientes estadounidenses y latinos.


Finalmente, refleja en los factores más importantes en su éxito hoy en día. Reconoce que la persistencia inculcada por sus padres desde joven le proveía la fuerza de superar los retos profesionales y personales. Adicionalmente, destaca la importancia de los buenos mentores quienes pudieron iniciar sus intereses médicos y clarificar sus caminos. Finalmente, explica el fenómeno del “síndrome impostor” y anima a los médicos en formación a creer en sí mismos.

]]> 2375 no Ep. 150 Overcoming Imposter Syndrome with Dr. Robert Ryu https://soundcloud.com/backtable/ep-150-overcoming-imposter-syndrome-with-dr-robert-ryu We talk with Dr. Robert Ryu about Imposter Syndrome. What is it, why is it so common in medicine, and how do we effectively deal with it? --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/MWOHi5 --- SHOW NOTES In this episode, Dr. Robert Ryu and our host Dr. Michael Barraza discuss the prevalence and implications of imposter syndrome. They open up about personal experiences with imposter syndrome and share strategies for overcoming feelings of inadequacy. Dr. Ryu distinguishes between self-examination (critically assessing the situation and figuring out if you have the resources to succeed) and imposter-like feelings (constantly questioning yourself and unwillingness to acknowledge your achievements), noting that there is a whole spectrum of thoughts and feelings in between the two terms. As a new department chair, Dr. Ryu acknowledges that he had experienced some insecurities with adjusting to the role. After learning about imposter syndrome, he has become interested in how it affects the medical community. He also emphasizes the important role of medical schools and residency programs in raising awareness of this topic to prevent burnout. The doctors wrap up the episode by discussing their personal strategies for managing self doubt. For Dr. Barraza, extensive preparation brings confidence. For Dr. Ryu, reaching out to others for support and keeping a larger goal in mind has proven to be beneficial. --- RESOURCES The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention: https://psycnet.apa.org/doiLanding?doi=10.1037%2Fh0086006 How to Deal with Imposter Syndrome (TIME article): https://time.com/5312483/how-to-deal-with-impostor-syndrome/ Mon, 23 Aug 2021 11:30:00 -0000 full BackTable We talk with Dr. Robert Ryu about Imposter Syndrome. What is it, why is it so common in medicine, and how do we effectively deal with it? We talk with Dr. Robert Ryu about Imposter Syndrome. What is it, why is it so common in medicine, and how do we effectively deal with it? --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/MWOHi5 --- SHOW NOTES In this episode, Dr. Robert Ryu and our host Dr. Michael Barraza discuss the prevalence and implications of imposter syndrome. They open up about personal experiences with imposter syndrome and share strategies for overcoming feelings of inadequacy. Dr. Ryu distinguishes between self-examination (critically assessing the situation and figuring out if you have the resources to succeed) and imposter-like feelings (constantly questioning yourself and unwillingness to acknowledge your achievements), noting that there is a whole spectrum of thoughts and feelings in between the two terms. As a new department chair, Dr. Ryu acknowledges that he had experienced some insecurities with adjusting to the role. After learning about imposter syndrome, he has become interested in how it affects the medical community. He also emphasizes the important role of medical schools and residency programs in raising awareness of this topic to prevent burnout. The doctors wrap up the episode by discussing their personal strategies for managing self doubt. For Dr. Barraza, extensive preparation brings confidence. For Dr. Ryu, reaching out to others for support and keeping a larger goal in mind has proven to be beneficial. --- RESOURCES The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention: https://psycnet.apa.org/doiLanding?doi=10.1037%2Fh0086006 How to Deal with Imposter Syndrome (TIME article): https://time.com/5312483/how-to-deal-with-impostor-syndrome/ We talk with Dr. Robert Ryu about Imposter Syndrome. What is it, why is it so common in medicine, and how do we effectively deal with it?


---


CHECK OUT OUR SPONSOR


RADPAD® Radiation Protection

https://www.radpad.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/MWOHi5


---


SHOW NOTES


In this episode, Dr. Robert Ryu and our host Dr. Michael Barraza discuss the prevalence and implications of imposter syndrome. They open up about personal experiences with imposter syndrome and share strategies for overcoming feelings of inadequacy.


Dr. Ryu distinguishes between self-examination (critically assessing the situation and figuring out if you have the resources to succeed) and imposter-like feelings (constantly questioning yourself and unwillingness to acknowledge your achievements), noting that there is a whole spectrum of thoughts and feelings in between the two terms.


As a new department chair, Dr. Ryu acknowledges that he had experienced some insecurities with adjusting to the role. After learning about imposter syndrome, he has become interested in how it affects the medical community. He also emphasizes the important role of medical schools and residency programs in raising awareness of this topic to prevent burnout.


The doctors wrap up the episode by discussing their personal strategies for managing self doubt. For Dr. Barraza, extensive preparation brings confidence. For Dr. Ryu, reaching out to others for support and keeping a larger goal in mind has proven to be beneficial.


---


RESOURCES


The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention:

https://psycnet.apa.org/doiLanding?doi=10.1037%2Fh0086006


How to Deal with Imposter Syndrome (TIME article):

https://time.com/5312483/how-to-deal-with-impostor-syndrome/

]]> 2176 no Ep. 149 Blockchain MD: Healthcare Applications with Dr. Leah Houston https://soundcloud.com/backtable/ep-149-blockchain-md-healthcare-applications-with-dr-leah-houston We talk with Dr. Leah Houston, founder of HPEC, about the healthcare applications of Blockchain Technology and Self-Sovereign Identity (SSI), including the importance of giving physicians control over their own professional digital identity. Thank you to Dr. Tim Yates for co-hosting! --- SHOW NOTES In this episode, our co-hosts Dr. Tim Yates and Dr. Aaron Fritts invite Dr. Leah Houston, founder and CEO of Humanitarian Physicians Empowerment Community (HPEC), to discuss blockchain technology and how she is applying it to healthcare. Dr. Houston describes how she was initially introduced to blockchain through investing; however, she learned more about the technology and felt compelled to seek ways to use the technology to decentralize healthcare and allow physicians to regain autonomy as well as patient trust. She describes her vision of creating self-sovereign identities (SSI) for physicians that would allow them to carry digital assets like credentials, medical documentation, and payments. From the patient’s perspective, SSI could help them easily access their medical records. HPEC is a physician-owned and physician-led company that aims to help them regain control over their practice of medicine. Dr. Houston describes the process of crowdfunding through other physicians and friends/family that has allowed her team to develop and test their product, a mobile application. She encourages any interested physician to get involved in development and/or pilot testing through the HPEC website. --- RESOURCES Humanitarian Physicians Empowerment Community (HPEC): https://www.hpec.io/ World Wide Web Consortium: https://www.w3.org/ Fri, 20 Aug 2021 11:32:00 -0000 full BackTable We talk with Dr. Leah Houston, founder of HPEC, about the healthcare applications of Blockchain Technology and Self-Sovereign Identity (SSI), including the importance of giving physicians control over their own professional digital identity. Thank you to Dr. Tim Yates for co-hosting! We talk with Dr. Leah Houston, founder of HPEC, about the healthcare applications of Blockchain Technology and Self-Sovereign Identity (SSI), including the importance of giving physicians control over their own professional digital identity. Thank you to Dr. Tim Yates for co-hosting! --- SHOW NOTES In this episode, our co-hosts Dr. Tim Yates and Dr. Aaron Fritts invite Dr. Leah Houston, founder and CEO of Humanitarian Physicians Empowerment Community (HPEC), to discuss blockchain technology and how she is applying it to healthcare. Dr. Houston describes how she was initially introduced to blockchain through investing; however, she learned more about the technology and felt compelled to seek ways to use the technology to decentralize healthcare and allow physicians to regain autonomy as well as patient trust. She describes her vision of creating self-sovereign identities (SSI) for physicians that would allow them to carry digital assets like credentials, medical documentation, and payments. From the patient’s perspective, SSI could help them easily access their medical records. HPEC is a physician-owned and physician-led company that aims to help them regain control over their practice of medicine. Dr. Houston describes the process of crowdfunding through other physicians and friends/family that has allowed her team to develop and test their product, a mobile application. She encourages any interested physician to get involved in development and/or pilot testing through the HPEC website. --- RESOURCES Humanitarian Physicians Empowerment Community (HPEC): https://www.hpec.io/ World Wide Web Consortium: https://www.w3.org/ We talk with Dr. Leah Houston, founder of HPEC, about the healthcare applications of Blockchain Technology and Self-Sovereign Identity (SSI), including the importance of giving physicians control over their own professional digital identity. Thank you to Dr. Tim Yates for co-hosting!


---


SHOW NOTES


In this episode, our co-hosts Dr. Tim Yates and Dr. Aaron Fritts invite Dr. Leah Houston, founder and CEO of Humanitarian Physicians Empowerment Community (HPEC), to discuss blockchain technology and how she is applying it to healthcare.


Dr. Houston describes how she was initially introduced to blockchain through investing; however, she learned more about the technology and felt compelled to seek ways to use the technology to decentralize healthcare and allow physicians to regain autonomy as well as patient trust. She describes her vision of creating self-sovereign identities (SSI) for physicians that would allow them to carry digital assets like credentials, medical documentation, and payments. From the patient’s perspective, SSI could help them easily access their medical records.


HPEC is a physician-owned and physician-led company that aims to help them regain control over their practice of medicine. Dr. Houston describes the process of crowdfunding through other physicians and friends/family that has allowed her team to develop and test their product, a mobile application. She encourages any interested physician to get involved in development and/or pilot testing through the HPEC website.


---


RESOURCES


Humanitarian Physicians Empowerment Community (HPEC): https://www.hpec.io/


World Wide Web Consortium: https://www.w3.org/

]]> 2879 no Ep. 148 Radial vs Femoral for Prostate Artery Embolization with Dr. Blake Parsons https://soundcloud.com/backtable/ep-148-radial-vs-femoral-for-prostate-artery-embolization-with-dr-blake-parsons We talk with Dr. Blake Parsons about his approach to Radial vs. Femoral access for Prostate Artery Embolization for BPH, including patient selection, device considerations, and practice pearls. --- SHOW NOTES In this episode, Dr. Blake Parsons and our host Dr. Chris Beck discuss access sites for prostate artery embolization, along with advice for visualizing pelvic anatomy, procedural tips, and post-operative care. We start by comparing radial and femoral access. Dr. Parsons prefers femoral access because it is faster, although both approaches share the same amount of bleeding risk. Radial access may offer more pushability and may be more appropriate for patients with tortuous iliac arteries. Additionally, we discuss the closure methods for each approach-- TR Band for radial access, and Angio-Seal for femoral access. Since pelvic anatomy varies from patient to patient, it can be challenging and time-consuming to identify the prostate artery. Dr. Parsons recommends using the obturator and pudendal arteries as landmarks. He also emphasizes that resources like lectures, meetings, papers, and courses can help IRs gain exposure and confidence in the pelvic anatomy. Finally, we talk about managing patient expectations about post-operative pain and dysuria relief. Dr. Parsons prescribes antibiotics, Medrol Dosepak, and Pyridium. The timeline for improvement in benign prostatic hyperplasia is different in each patient, but improvement can be tracked with the IPSS score at follow up appointments. --- RESOURCES STREAM Meeting: https://www.thestreammeeting.com/ Mon, 16 Aug 2021 11:56:00 -0000 full BackTable We talk with Dr. Blake Parsons about his approach to Radial vs. Femoral access for Prostate Artery Embolization for BPH, including patient selection, device considerations, and practice pearls. We talk with Dr. Blake Parsons about his approach to Radial vs. Femoral access for Prostate Artery Embolization for BPH, including patient selection, device considerations, and practice pearls. --- SHOW NOTES In this episode, Dr. Blake Parsons and our host Dr. Chris Beck discuss access sites for prostate artery embolization, along with advice for visualizing pelvic anatomy, procedural tips, and post-operative care. We start by comparing radial and femoral access. Dr. Parsons prefers femoral access because it is faster, although both approaches share the same amount of bleeding risk. Radial access may offer more pushability and may be more appropriate for patients with tortuous iliac arteries. Additionally, we discuss the closure methods for each approach-- TR Band for radial access, and Angio-Seal for femoral access. Since pelvic anatomy varies from patient to patient, it can be challenging and time-consuming to identify the prostate artery. Dr. Parsons recommends using the obturator and pudendal arteries as landmarks. He also emphasizes that resources like lectures, meetings, papers, and courses can help IRs gain exposure and confidence in the pelvic anatomy. Finally, we talk about managing patient expectations about post-operative pain and dysuria relief. Dr. Parsons prescribes antibiotics, Medrol Dosepak, and Pyridium. The timeline for improvement in benign prostatic hyperplasia is different in each patient, but improvement can be tracked with the IPSS score at follow up appointments. --- RESOURCES STREAM Meeting: https://www.thestreammeeting.com/ We talk with Dr. Blake Parsons about his approach to Radial vs. Femoral access for Prostate Artery Embolization for BPH, including patient selection, device considerations, and practice pearls.


---


SHOW NOTES


In this episode, Dr. Blake Parsons and our host Dr. Chris Beck discuss access sites for prostate artery embolization, along with advice for visualizing pelvic anatomy, procedural tips, and post-operative care.


We start by comparing radial and femoral access. Dr. Parsons prefers femoral access because it is faster, although both approaches share the same amount of bleeding risk. Radial access may offer more pushability and may be more appropriate for patients with tortuous iliac arteries. Additionally, we discuss the closure methods for each approach-- TR Band for radial access, and Angio-Seal for femoral access.


Since pelvic anatomy varies from patient to patient, it can be challenging and time-consuming to identify the prostate artery. Dr. Parsons recommends using the obturator and pudendal arteries as landmarks. He also emphasizes that resources like lectures, meetings, papers, and courses can help IRs gain exposure and confidence in the pelvic anatomy.


Finally, we talk about managing patient expectations about post-operative pain and dysuria relief. Dr. Parsons prescribes antibiotics, Medrol Dosepak, and Pyridium. The timeline for improvement in benign prostatic hyperplasia is different in each patient, but improvement can be tracked with the IPSS score at follow up appointments.


---


RESOURCES


STREAM Meeting: https://www.thestreammeeting.com/

]]> 2983 no Ep. 147 Passion Projects and Entrepreneurship with Dr. Sahil Mehta We talk with Dr. Sahil Mehta, founder of MedSchoolCoach, about how a side gig as an MCAT and med school tutor scaled up into a successful business. We also talk about the importance of passion projects of all types and sizes in preventing burnout, and avoiding "analysis paralysis" when it comes to starting a new business. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/4HTCj4 --- SHOW NOTES In this episode, physician entrepreneurs Dr. Sahil Mehta and Dr. Aaron Fritts discuss how they started their passion projects and share business operations advice for budding entrepreneurs. Dr. Mehta starts the show by telling the origin story of MedSchoolCoach, an online educational platform created to help students achieve their goals of entering medicine. MedSchoolCoach offers academic and career resources for high school, college, and medical students. While Dr. Mehta was a medical student when he originally had the idea for the company, the majority of business development occurred in his IR fellowship year. The doctors talk about how passion projects can protect against burnout and actually relieve academic and financial stress from working in clinical practice. They also emphasize how they can apply business concepts to enhance their clinical practices. For example, marketing MedSchoolCoach to consumers taught Dr. Mehta how to better market IR procedures directly to patients. Scaling up a business can present obstacles, so Dr. Mehta outlines strategies for hiring the right people, conducting market research, and making effective use of social media. He highlights the fact that motivated and talented employees can always learn specific industry knowledge. To anyone who is debating whether or not to pursue a passion project, Dr. Mehta advises them to avoid over-analysis and jump into the idea because it will always be a learning experience. --- RESOURCES MedSchoolCoach: https://www.medschoolcoach.com/ Entrepreneurship in Medicine Panel: https://www.prospectivedoctor.com/entrepreneurship-in-medicine/ Mon, 09 Aug 2021 11:24:00 -0000 full BackTable We talk with Dr. Sahil Mehta, founder of MedSchoolCoach, about how a side gig as an MCAT and med school tutor scaled up into a successful business. We also talk about the importance of passion projects of all types and sizes in preventing burnout, and avoiding "analysis paralysis" when it comes to starting a new business. We talk with Dr. Sahil Mehta, founder of MedSchoolCoach, about how a side gig as an MCAT and med school tutor scaled up into a successful business. We also talk about the importance of passion projects of all types and sizes in preventing burnout, and avoiding "analysis paralysis" when it comes to starting a new business. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/4HTCj4 --- SHOW NOTES In this episode, physician entrepreneurs Dr. Sahil Mehta and Dr. Aaron Fritts discuss how they started their passion projects and share business operations advice for budding entrepreneurs. Dr. Mehta starts the show by telling the origin story of MedSchoolCoach, an online educational platform created to help students achieve their goals of entering medicine. MedSchoolCoach offers academic and career resources for high school, college, and medical students. While Dr. Mehta was a medical student when he originally had the idea for the company, the majority of business development occurred in his IR fellowship year. The doctors talk about how passion projects can protect against burnout and actually relieve academic and financial stress from working in clinical practice. They also emphasize how they can apply business concepts to enhance their clinical practices. For example, marketing MedSchoolCoach to consumers taught Dr. Mehta how to better market IR procedures directly to patients. Scaling up a business can present obstacles, so Dr. Mehta outlines strategies for hiring the right people, conducting market research, and making effective use of social media. He highlights the fact that motivated and talented employees can always learn specific industry knowledge. To anyone who is debating whether or not to pursue a passion project, Dr. Mehta advises them to avoid over-analysis and jump into the idea because it will always be a learning experience. --- RESOURCES MedSchoolCoach: https://www.medschoolcoach.com/ Entrepreneurship in Medicine Panel: https://www.prospectivedoctor.com/entrepreneurship-in-medicine/ We talk with Dr. Sahil Mehta, founder of MedSchoolCoach, about how a side gig as an MCAT and med school tutor scaled up into a successful business. We also talk about the importance of passion projects of all types and sizes in preventing burnout, and avoiding "analysis paralysis" when it comes to starting a new business.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/4HTCj4


---


SHOW NOTES


In this episode, physician entrepreneurs Dr. Sahil Mehta and Dr. Aaron Fritts discuss how they started their passion projects and share business operations advice for budding entrepreneurs.


Dr. Mehta starts the show by telling the origin story of MedSchoolCoach, an online educational platform created to help students achieve their goals of entering medicine. MedSchoolCoach offers academic and career resources for high school, college, and medical students. While Dr. Mehta was a medical student when he originally had the idea for the company, the majority of business development occurred in his IR fellowship year.


The doctors talk about how passion projects can protect against burnout and actually relieve academic and financial stress from working in clinical practice. They also emphasize how they can apply business concepts to enhance their clinical practices. For example, marketing MedSchoolCoach to consumers taught Dr. Mehta how to better market IR procedures directly to patients.


Scaling up a business can present obstacles, so Dr. Mehta outlines strategies for hiring the right people, conducting market research, and making effective use of social media. He highlights the fact that motivated and talented employees can always learn specific industry knowledge.


To anyone who is debating whether or not to pursue a passion project, Dr. Mehta advises them to avoid over-analysis and jump into the idea because it will always be a learning experience.


---


RESOURCES


MedSchoolCoach: https://www.medschoolcoach.com/


Entrepreneurship in Medicine Panel: https://www.prospectivedoctor.com/entrepreneurship-in-medicine/

]]> 2881 no Ep. 146 Spyglass Interventions with Dr. Ravi Srinivasa and Dr. Jeff Chick https://soundcloud.com/backtable/ep-146-spyglass-interventions-with-dr-ravi-srinivasa-and-dr-jeff-chick Interventional Radiologists Dr. Jeffrey Chick and Dr. Ravi Srinivasa tell us all about the latest and greatest in Spyglass Interventions, including how and where they're being used for lithotripsy, as well as upcoming training opportunities for those interested. --- SHOW NOTES In this episode, Dr. Ravi Srinivasa, Dr. Jeff Chick, and our host Dr. Michael Barraza discuss the SpyGlass Direct Visualization System and its benefits for endoscopic procedures. The doctors begin with a short introduction to previous single-use endoscopes, noting challenges like limited flexibility and incompatibility with existing hospital infrastructure. The SpyGlass overcomes these obstacles by providing on demand irrigation, four-way flexion, recording capabilities, and its own compatible ancillary devices. Dr. Srinivasa describes his use of the Spyglass in targeted biopsies and lithotripsies. Dr. Chick emphasizes that any IR can easily access and use this device, whether they are in a private, academic, solo, or hybrid practice. The minimal setup and ideal dimensions of the SpyGlass make it adaptable to many parts of the body. Finally, the doctors discuss upcoming educational content from Boston Scientific that will help IRs learn how to use the device and adapt it to their practices. --- RESOURCES Spyglass Direct Visualization System: https://www.bostonscientific.com/en-US/products/single-use-scopes/spyglass-ds-direct-visualization-system.html Mon, 02 Aug 2021 12:00:00 -0000 full BackTable Interventional Radiologists Dr. Jeffrey Chick and Dr. Ravi Srinivasa tell us all about the latest and greatest in Spyglass Interventions, including how and where they're being used for lithotripsy, as well as upcoming training opportunities for those interested. Interventional Radiologists Dr. Jeffrey Chick and Dr. Ravi Srinivasa tell us all about the latest and greatest in Spyglass Interventions, including how and where they're being used for lithotripsy, as well as upcoming training opportunities for those interested. --- SHOW NOTES In this episode, Dr. Ravi Srinivasa, Dr. Jeff Chick, and our host Dr. Michael Barraza discuss the SpyGlass Direct Visualization System and its benefits for endoscopic procedures. The doctors begin with a short introduction to previous single-use endoscopes, noting challenges like limited flexibility and incompatibility with existing hospital infrastructure. The SpyGlass overcomes these obstacles by providing on demand irrigation, four-way flexion, recording capabilities, and its own compatible ancillary devices. Dr. Srinivasa describes his use of the Spyglass in targeted biopsies and lithotripsies. Dr. Chick emphasizes that any IR can easily access and use this device, whether they are in a private, academic, solo, or hybrid practice. The minimal setup and ideal dimensions of the SpyGlass make it adaptable to many parts of the body. Finally, the doctors discuss upcoming educational content from Boston Scientific that will help IRs learn how to use the device and adapt it to their practices. --- RESOURCES Spyglass Direct Visualization System: https://www.bostonscientific.com/en-US/products/single-use-scopes/spyglass-ds-direct-visualization-system.html Interventional Radiologists Dr. Jeffrey Chick and Dr. Ravi Srinivasa tell us all about the latest and greatest in Spyglass Interventions, including how and where they're being used for lithotripsy, as well as upcoming training opportunities for those interested.


---


SHOW NOTES


In this episode, Dr. Ravi Srinivasa, Dr. Jeff Chick, and our host Dr. Michael Barraza discuss the SpyGlass Direct Visualization System and its benefits for endoscopic procedures.


The doctors begin with a short introduction to previous single-use endoscopes, noting challenges like limited flexibility and incompatibility with existing hospital infrastructure. The SpyGlass overcomes these obstacles by providing on demand irrigation, four-way flexion, recording capabilities, and its own compatible ancillary devices. Dr. Srinivasa describes his use of the Spyglass in targeted biopsies and lithotripsies.


Dr. Chick emphasizes that any IR can easily access and use this device, whether they are in a private, academic, solo, or hybrid practice. The minimal setup and ideal dimensions of the SpyGlass make it adaptable to many parts of the body. Finally, the doctors discuss upcoming educational content from Boston Scientific that will help IRs learn how to use the device and adapt it to their practices.


---


RESOURCES


Spyglass Direct Visualization System: https://www.bostonscientific.com/en-US/products/single-use-scopes/spyglass-ds-direct-visualization-system.html

]]> 1793 no Ep. 145 The History (and Future) of the STREAM conference with Dr. Isaacson and Dr. Bagla https://soundcloud.com/backtable/ep-145-the-history-and-future-of-the-stream-conference-with-dr-isaacson-and-dr-bagla We talk with STREAM meeting founders Dr. Ari Isaacson and Dr. Sandeep Bagla about its origin story, as well as what they have planned at STREAM 2021 for docs who want to learn Prostate Artery Embolization, Musculoskeletal Embolizations, and new techniques for Pain Therapy. --- SHOW NOTES In this episode, Dr. Ari Isaacson, Dr. Sandeep Bagla, and our host Dr. Michael Barraza discuss the evolution of the STREAM conference and new developments for the September 2021 meeting. Starting from 2017, the STREAM conference has attracted minimally invasive specialists seeking practical education and training. While the conference originally revolved around prostate artery embolization, it has since expanded to include topics such as genicular artery embolization, peripheral artery disease, and musculoskeletal interventions. Drs. Isaacson and Bagla highlight the wide variety of speakers, which include urologists, orthopedic surgeons, and medical malpractice lawyers. They both emphasize that this dynamic conference responds to the audience’s interests and has an overall laid-back atmosphere. This year will also be the first one to feature a case competition for students and residents. Click the link below to register for the conference and apply the BackTable promotional code! --- RESOURCES STREAM Meeting: https://www.thestreammeeting.com/ For attendings, use the code “BACKTABLE” for 50% off registration fee. For residents/fellows/students, use the code “BACKTABLETRAINEE” for 100% off registration fee. Fri, 30 Jul 2021 12:00:00 -0000 full BackTable We talk with STREAM meeting founders Dr. Ari Isaacson and Dr. Sandeep Bagla about its origin story, as well as what they have planned at STREAM 2021 for docs who want to learn Prostate Artery Embolization, Musculoskeletal Embolizations, and new techniques for Pain Therapy. We talk with STREAM meeting founders Dr. Ari Isaacson and Dr. Sandeep Bagla about its origin story, as well as what they have planned at STREAM 2021 for docs who want to learn Prostate Artery Embolization, Musculoskeletal Embolizations, and new techniques for Pain Therapy. --- SHOW NOTES In this episode, Dr. Ari Isaacson, Dr. Sandeep Bagla, and our host Dr. Michael Barraza discuss the evolution of the STREAM conference and new developments for the September 2021 meeting. Starting from 2017, the STREAM conference has attracted minimally invasive specialists seeking practical education and training. While the conference originally revolved around prostate artery embolization, it has since expanded to include topics such as genicular artery embolization, peripheral artery disease, and musculoskeletal interventions. Drs. Isaacson and Bagla highlight the wide variety of speakers, which include urologists, orthopedic surgeons, and medical malpractice lawyers. They both emphasize that this dynamic conference responds to the audience’s interests and has an overall laid-back atmosphere. This year will also be the first one to feature a case competition for students and residents. Click the link below to register for the conference and apply the BackTable promotional code! --- RESOURCES STREAM Meeting: https://www.thestreammeeting.com/ For attendings, use the code “BACKTABLE” for 50% off registration fee. For residents/fellows/students, use the code “BACKTABLETRAINEE” for 100% off registration fee. We talk with STREAM meeting founders Dr. Ari Isaacson and Dr. Sandeep Bagla about its origin story, as well as what they have planned at STREAM 2021 for docs who want to learn Prostate Artery Embolization, Musculoskeletal Embolizations, and new techniques for Pain Therapy.


---


SHOW NOTES


In this episode, Dr. Ari Isaacson, Dr. Sandeep Bagla, and our host Dr. Michael Barraza discuss the evolution of the STREAM conference and new developments for the September 2021 meeting.


Starting from 2017, the STREAM conference has attracted minimally invasive specialists seeking practical education and training. While the conference originally revolved around prostate artery embolization, it has since expanded to include topics such as genicular artery embolization, peripheral artery disease, and musculoskeletal interventions.


Drs. Isaacson and Bagla highlight the wide variety of speakers, which include urologists, orthopedic surgeons, and medical malpractice lawyers. They both emphasize that this dynamic conference responds to the audience’s interests and has an overall laid-back atmosphere. This year will also be the first one to feature a case competition for students and residents. Click the link below to register for the conference and apply the BackTable promotional code!


---


RESOURCES


STREAM Meeting: https://www.thestreammeeting.com/


For attendings, use the code “BACKTABLE” for 50% off registration fee.


For residents/fellows/students, use the code “BACKTABLETRAINEE” for 100% off registration fee.

]]> 2494 no Ep. 144 Direct Aspiration vs Co-Aspiration for Ischemic Stroke with Dr. Baxter and Dr. Tateshima https://soundcloud.com/backtable/ep-144-direct-aspiration-vs-co-aspiration-for-ischemic-stroke-with-dr-baxter-and-dr-tateshima Dr. Sabeen Dhand talks with Dr. Blaise Baxter and Dr. Satoshi Tateshima about direct aspiration vs. co-aspiration technique when treating ischemic stroke. In this first episode of a multi-part series covering treatment of ischemic stroke they discuss radial vs. femoral approach, anatomic considerations, and tips and tricks with both techniques. --- SHOW NOTES In this episode, neurointerventional specialists Drs. Blaise Baxter, Satoshi Tateshima, and Sabeen Dhand discuss anatomical considerations and procedural techniques in direct aspiration and co-aspiration for ischemic stroke treatment. The episode starts with a discussion about radial versus femoral approaches. While femoral access remains the most common method, device innovations are making brachial and radial access more available. Dr. Baxter and Dr. Tateshima describe the use of co-aspiration in their frontline techniques. However, Dr. Tateshima notes that he prefers to use direct aspiration in posterior circulation, since the vessel size may be unknown. Dr. Baxter also emphasizes that with co-aspiration, it is important to size-match the catheter with the vessel. The choice of direct aspiration vs. co-aspiration depends largely on the location of the clot. The doctors walk through different considerations for M1, M2, and M3 strokes. Additionally, they talk about studies that compare the aspiration techniques and outcome factors such as improvements in TICI and mRS scores. Finally, they speak about the rewarding nature of stroke interventions and exciting new developments in the field. --- RESOURCES ASTER Randomized Clinical Trial: https://pubmed.ncbi.nlm.nih.gov/28763550/ SAVE vs. ADAPT for Acute Stroke: https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1291-9 Mon, 26 Jul 2021 12:03:00 -0000 full BackTable Dr. Sabeen Dhand talks with Dr. Blaise Baxter and Dr. Satoshi Tateshima about direct aspiration vs. co-aspiration technique when treating ischemic stroke. In this first episode of a multi-part series covering treatment of ischemic stroke they discuss radial vs. femoral approach, anatomic considerations, and tips and tricks with both techniques. Dr. Sabeen Dhand talks with Dr. Blaise Baxter and Dr. Satoshi Tateshima about direct aspiration vs. co-aspiration technique when treating ischemic stroke. In this first episode of a multi-part series covering treatment of ischemic stroke they discuss radial vs. femoral approach, anatomic considerations, and tips and tricks with both techniques. --- SHOW NOTES In this episode, neurointerventional specialists Drs. Blaise Baxter, Satoshi Tateshima, and Sabeen Dhand discuss anatomical considerations and procedural techniques in direct aspiration and co-aspiration for ischemic stroke treatment. The episode starts with a discussion about radial versus femoral approaches. While femoral access remains the most common method, device innovations are making brachial and radial access more available. Dr. Baxter and Dr. Tateshima describe the use of co-aspiration in their frontline techniques. However, Dr. Tateshima notes that he prefers to use direct aspiration in posterior circulation, since the vessel size may be unknown. Dr. Baxter also emphasizes that with co-aspiration, it is important to size-match the catheter with the vessel. The choice of direct aspiration vs. co-aspiration depends largely on the location of the clot. The doctors walk through different considerations for M1, M2, and M3 strokes. Additionally, they talk about studies that compare the aspiration techniques and outcome factors such as improvements in TICI and mRS scores. Finally, they speak about the rewarding nature of stroke interventions and exciting new developments in the field. --- RESOURCES ASTER Randomized Clinical Trial: https://pubmed.ncbi.nlm.nih.gov/28763550/ SAVE vs. ADAPT for Acute Stroke: https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1291-9 Dr. Sabeen Dhand talks with Dr. Blaise Baxter and Dr. Satoshi Tateshima about direct aspiration vs. co-aspiration technique when treating ischemic stroke. In this first episode of a multi-part series covering treatment of ischemic stroke they discuss radial vs. femoral approach, anatomic considerations, and tips and tricks with both techniques.


---


SHOW NOTES


In this episode, neurointerventional specialists Drs. Blaise Baxter, Satoshi Tateshima, and Sabeen Dhand discuss anatomical considerations and procedural techniques in direct aspiration and co-aspiration for ischemic stroke treatment.


The episode starts with a discussion about radial versus femoral approaches. While femoral access remains the most common method, device innovations are making brachial and radial access more available. Dr. Baxter and Dr. Tateshima describe the use of co-aspiration in their frontline techniques. However, Dr. Tateshima notes that he prefers to use direct aspiration in posterior circulation, since the vessel size may be unknown. Dr. Baxter also emphasizes that with co-aspiration, it is important to size-match the catheter with the vessel.


The choice of direct aspiration vs. co-aspiration depends largely on the location of the clot. The doctors walk through different considerations for M1, M2, and M3 strokes. Additionally, they talk about studies that compare the aspiration techniques and outcome factors such as improvements in TICI and mRS scores. Finally, they speak about the rewarding nature of stroke interventions and exciting new developments in the field.


---


RESOURCES


ASTER Randomized Clinical Trial: https://pubmed.ncbi.nlm.nih.gov/28763550/


SAVE vs. ADAPT for Acute Stroke: https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1291-9

]]> 2763 no Ep. 143 Better Marketing Strategies with Dianne Keen https://soundcloud.com/backtable/ep-143-better-marketing-strategies-with-diane-keen We chat with seasoned Marketing Director Dianne Keen about the strategies that are helping doctors build sustainable practices, add service lines, and work toward patient-centered collaborative care with referring providers. Listen to learn about Dianne's "Trifecta" approach! --- SHOW NOTES In this episode, radiology marketing director Dianne Keen and our host Dr. Aaron Fritts delve into effective marketing strategies for IR practices. Throughout the episode, they emphasize the need to educate referring physicians and patients about how IR services can help them. Dianne describes her “IR Practice Growth Trifecta” as a framework for success. All three parts-- the IR, the clinic infrastructure, and the marketing talent, are essential for communicating with colleagues and patients. Dianne emphasizes the importance of finding a marketing specialist who is knowledgeable about the field of IR, and specifically, details about the procedures that they are marketing. She encourages IRs to invite marketing specialists to shadow them in the lab and the clinic to build this knowledge. To build relationships with referring doctors, it is important to identify receptive doctors in each specialty and stay in touch with them regularly. Dianne recommends focusing on the most relevant procedures to their practices, sending updates about their patients, and avoiding divisive messaging between referring doctors and their patients. Finally, we discuss marketing channels and ways to embrace new forms of patient engagement, such as social media. Overall, marketing should be well-crafted and succinct, whether it is transmitted through social media, print, or community events. --- RESOURCES Northside Radiology Associates: https://northsideradiology.com/ SIR Toolkit for “Developing Your Practice”: https://www.sirweb.org/practice-resources/toolkits/practice-development-toolkits/ Mon, 19 Jul 2021 12:00:00 -0000 full BackTable We chat with seasoned Marketing Director Dianne Keen about the strategies that are helping doctors build sustainable practices, add service lines, and work toward patient-centered collaborative care with referring providers. Listen to learn about Dianne's "Trifecta" approach! We chat with seasoned Marketing Director Dianne Keen about the strategies that are helping doctors build sustainable practices, add service lines, and work toward patient-centered collaborative care with referring providers. Listen to learn about Dianne's "Trifecta" approach! --- SHOW NOTES In this episode, radiology marketing director Dianne Keen and our host Dr. Aaron Fritts delve into effective marketing strategies for IR practices. Throughout the episode, they emphasize the need to educate referring physicians and patients about how IR services can help them. Dianne describes her “IR Practice Growth Trifecta” as a framework for success. All three parts-- the IR, the clinic infrastructure, and the marketing talent, are essential for communicating with colleagues and patients. Dianne emphasizes the importance of finding a marketing specialist who is knowledgeable about the field of IR, and specifically, details about the procedures that they are marketing. She encourages IRs to invite marketing specialists to shadow them in the lab and the clinic to build this knowledge. To build relationships with referring doctors, it is important to identify receptive doctors in each specialty and stay in touch with them regularly. Dianne recommends focusing on the most relevant procedures to their practices, sending updates about their patients, and avoiding divisive messaging between referring doctors and their patients. Finally, we discuss marketing channels and ways to embrace new forms of patient engagement, such as social media. Overall, marketing should be well-crafted and succinct, whether it is transmitted through social media, print, or community events. --- RESOURCES Northside Radiology Associates: https://northsideradiology.com/ SIR Toolkit for “Developing Your Practice”: https://www.sirweb.org/practice-resources/toolkits/practice-development-toolkits/ We chat with seasoned Marketing Director Dianne Keen about the strategies that are helping doctors build sustainable practices, add service lines, and work toward patient-centered collaborative care with referring providers. Listen to learn about Dianne's "Trifecta" approach!


---


SHOW NOTES


In this episode, radiology marketing director Dianne Keen and our host Dr. Aaron Fritts delve into effective marketing strategies for IR practices. Throughout the episode, they emphasize the need to educate referring physicians and patients about how IR services can help them.


Dianne describes her “IR Practice Growth Trifecta” as a framework for success. All three parts-- the IR, the clinic infrastructure, and the marketing talent, are essential for communicating with colleagues and patients. Dianne emphasizes the importance of finding a marketing specialist who is knowledgeable about the field of IR, and specifically, details about the procedures that they are marketing. She encourages IRs to invite marketing specialists to shadow them in the lab and the clinic to build this knowledge.


To build relationships with referring doctors, it is important to identify receptive doctors in each specialty and stay in touch with them regularly. Dianne recommends focusing on the most relevant procedures to their practices, sending updates about their patients, and avoiding divisive messaging between referring doctors and their patients.


Finally, we discuss marketing channels and ways to embrace new forms of patient engagement, such as social media. Overall, marketing should be well-crafted and succinct, whether it is transmitted through social media, print, or community events.


---


RESOURCES


Northside Radiology Associates: https://northsideradiology.com/


SIR Toolkit for “Developing Your Practice”: https://www.sirweb.org/practice-resources/toolkits/practice-development-toolkits/

]]> 2990 no Ep. 142 Type B Aortic Dissections with Dr. Frank Arko Interventional Radiologist Sabeen Dhand talks with Vascular Surgeon Frank Arko about endovascular treatment of Type B Aortic Dissections (TBAD), including patient selection, appropriate sizing, and complications to avoid. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Hv2gx0 --- SHOW NOTES In this episode, vascular surgeon Dr. Frank Arko and our host Dr. Sabeen Dhand give an overview of type B aortic dissections, which includes different methods of classifying dissections, workup and imaging, thoracic endovascular aortic repair (TEVAR), potential complications, and timeline for follow up care. Dr. Arko starts the episode by defining vocabulary terms related to aortic dissections. He describes the Stanford and DeBakey classification systems that are used to signify the location of the dissection and the method of treatment (medical management or surgical/endovascular repair). He also distinguishes between complicated/uncomplicated dissections, as well as acute/subacute/chronic dissections. When Dr. Arko discusses TEVAR, he mentions three important complications to be aware of: retrograde type A dissection, stroke, and spinal cord ischemia. He emphasizes that in the debate between optimal medical therapy and early TEVAR, more research on how to minimize these complications is needed before recommending widespread use of early TEVAR. During his walk through of the procedure, Dr. Arko also gives his insight on adjunct techniques such as PETTICOAT. Finally, the doctors discuss special considerations for patients with pleural effusion, chronic hypertension, type II thoracoabdominal aneurysms, and connective tissue disorders. --- RESOURCES INSTEAD-XL Trial- https://pubmed.ncbi.nlm.nih.gov/23922146/ Fri, 16 Jul 2021 11:15:00 -0000 full BackTable Interventional Radiologist Sabeen Dhand talks with Vascular Surgeon Frank Arko about endovascular treatment of Type B Aortic Dissections (TBAD), including patient selection, appropriate sizing, and complications to avoid. Interventional Radiologist Sabeen Dhand talks with Vascular Surgeon Frank Arko about endovascular treatment of Type B Aortic Dissections (TBAD), including patient selection, appropriate sizing, and complications to avoid. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Hv2gx0 --- SHOW NOTES In this episode, vascular surgeon Dr. Frank Arko and our host Dr. Sabeen Dhand give an overview of type B aortic dissections, which includes different methods of classifying dissections, workup and imaging, thoracic endovascular aortic repair (TEVAR), potential complications, and timeline for follow up care. Dr. Arko starts the episode by defining vocabulary terms related to aortic dissections. He describes the Stanford and DeBakey classification systems that are used to signify the location of the dissection and the method of treatment (medical management or surgical/endovascular repair). He also distinguishes between complicated/uncomplicated dissections, as well as acute/subacute/chronic dissections. When Dr. Arko discusses TEVAR, he mentions three important complications to be aware of: retrograde type A dissection, stroke, and spinal cord ischemia. He emphasizes that in the debate between optimal medical therapy and early TEVAR, more research on how to minimize these complications is needed before recommending widespread use of early TEVAR. During his walk through of the procedure, Dr. Arko also gives his insight on adjunct techniques such as PETTICOAT. Finally, the doctors discuss special considerations for patients with pleural effusion, chronic hypertension, type II thoracoabdominal aneurysms, and connective tissue disorders. --- RESOURCES INSTEAD-XL Trial- https://pubmed.ncbi.nlm.nih.gov/23922146/ Interventional Radiologist Sabeen Dhand talks with Vascular Surgeon Frank Arko about endovascular treatment of Type B Aortic Dissections (TBAD), including patient selection, appropriate sizing, and complications to avoid.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Hv2gx0


---


SHOW NOTES


In this episode, vascular surgeon Dr. Frank Arko and our host Dr. Sabeen Dhand give an overview of type B aortic dissections, which includes different methods of classifying dissections, workup and imaging, thoracic endovascular aortic repair (TEVAR), potential complications, and timeline for follow up care.


Dr. Arko starts the episode by defining vocabulary terms related to aortic dissections. He describes the Stanford and DeBakey classification systems that are used to signify the location of the dissection and the method of treatment (medical management or surgical/endovascular repair). He also distinguishes between complicated/uncomplicated dissections, as well as acute/subacute/chronic dissections.


When Dr. Arko discusses TEVAR, he mentions three important complications to be aware of: retrograde type A dissection, stroke, and spinal cord ischemia. He emphasizes that in the debate between optimal medical therapy and early TEVAR, more research on how to minimize these complications is needed before recommending widespread use of early TEVAR. During his walk through of the procedure, Dr. Arko also gives his insight on adjunct techniques such as PETTICOAT.


Finally, the doctors discuss special considerations for patients with pleural effusion, chronic hypertension, type II thoracoabdominal aneurysms, and connective tissue disorders.


---


RESOURCES


INSTEAD-XL Trial- https://pubmed.ncbi.nlm.nih.gov/23922146/

]]> 3032 no Ep. 141 DEB vs. Balloon Angioplasty Alone for Dysfunctional HD Access with Dr. Eric Therasse https://soundcloud.com/backtable/ep-141-deb-vs-balloon-angioplasty-alone-for-dysfunctional-hd-access-with-dr-eric-therasse Dr. Eric Therasse discusses the results of a randomized clinical trial demonstrating benefit of drug eluting balloon (DEB) over balloon angioplasty alone in treatment of Dysfunctional Hemodialysis Access. --- SHOW NOTES In this episode, Dr. Eric Therasse, an author of the recent JVIR article titled “Safety and Efficacy of Paclitaxel-Eluting Balloon Angioplasty for Dysfunctional Hemodialysis Access,” and our host Dr. Christopher Beck discuss the study design, outcomes, and implications for further research in the use of drug eluting balloons (DEBs) for hemodialysis access. In this study, the control group received “plain old balloon angioplasty” (POBA), while the treatment group received angioplasty with Biotronik’s Passeo 18-Lux DEB. Dr. Therasse describes the angiographic endpoints, with primary endpoint as late lumen loss (to measure the degree of restenosis), and secondary endpoints as hemodialysis access failure and mortality at 12 months. He emphasizes that the clinical endpoints of this study were more significant than the angiographic endpoints because they showed that when treating dysfunctional hemodialysis access, there is decreased incidence and severity of restenosis with DEB compared with POBA. Additionally, the doctors walk through obstacles that arose during the study, which included coordination of data collection across multiple centers, low patient enrollment rate, strict exclusion criteria, and the need for re-intervention prior to the standardized follow up date. Dr. Therasse comments on the increasing use of DEBs in clinical practices and their future cost-effectiveness. He also references other helpful articles for interested listeners (linked below). --- RESOURCES Safety and Efficacy of Paclitaxel-Eluting Balloon Angioplasty for Dysfunctional Hemodialysis Access: https://www.jvir.org/article/S1051-0443(20)30961-1/fulltext Drug-Coated Balloons for Dysfunctional Dialysis Arteriovenous Fistulas: https://www.nejm.org/doi/10.1056/NEJMoa1914617?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed The Lutonix AV Randomized Trial of Paclitaxel-Coated Balloons in Arteriovenous Fistula Stenosis: https://www.jvir.org/article/S1051-0443(19)30817-6/fulltext Mon, 12 Jul 2021 11:10:00 -0000 full BackTable Dr. Eric Therasse discusses the results of a randomized clinical trial demonstrating benefit of drug eluting balloon (DEB) over balloon angioplasty alone in treatment of Dysfunctional Hemodialysis Access. Dr. Eric Therasse discusses the results of a randomized clinical trial demonstrating benefit of drug eluting balloon (DEB) over balloon angioplasty alone in treatment of Dysfunctional Hemodialysis Access. --- SHOW NOTES In this episode, Dr. Eric Therasse, an author of the recent JVIR article titled “Safety and Efficacy of Paclitaxel-Eluting Balloon Angioplasty for Dysfunctional Hemodialysis Access,” and our host Dr. Christopher Beck discuss the study design, outcomes, and implications for further research in the use of drug eluting balloons (DEBs) for hemodialysis access. In this study, the control group received “plain old balloon angioplasty” (POBA), while the treatment group received angioplasty with Biotronik’s Passeo 18-Lux DEB. Dr. Therasse describes the angiographic endpoints, with primary endpoint as late lumen loss (to measure the degree of restenosis), and secondary endpoints as hemodialysis access failure and mortality at 12 months. He emphasizes that the clinical endpoints of this study were more significant than the angiographic endpoints because they showed that when treating dysfunctional hemodialysis access, there is decreased incidence and severity of restenosis with DEB compared with POBA. Additionally, the doctors walk through obstacles that arose during the study, which included coordination of data collection across multiple centers, low patient enrollment rate, strict exclusion criteria, and the need for re-intervention prior to the standardized follow up date. Dr. Therasse comments on the increasing use of DEBs in clinical practices and their future cost-effectiveness. He also references other helpful articles for interested listeners (linked below). --- RESOURCES Safety and Efficacy of Paclitaxel-Eluting Balloon Angioplasty for Dysfunctional Hemodialysis Access: https://www.jvir.org/article/S1051-0443(20)30961-1/fulltext Drug-Coated Balloons for Dysfunctional Dialysis Arteriovenous Fistulas: https://www.nejm.org/doi/10.1056/NEJMoa1914617?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed The Lutonix AV Randomized Trial of Paclitaxel-Coated Balloons in Arteriovenous Fistula Stenosis: https://www.jvir.org/article/S1051-0443(19)30817-6/fulltext Dr. Eric Therasse discusses the results of a randomized clinical trial demonstrating benefit of drug eluting balloon (DEB) over balloon angioplasty alone in treatment of Dysfunctional Hemodialysis Access.


---


SHOW NOTES


In this episode, Dr. Eric Therasse, an author of the recent JVIR article titled “Safety and Efficacy of Paclitaxel-Eluting Balloon Angioplasty for Dysfunctional Hemodialysis Access,” and our host Dr. Christopher Beck discuss the study design, outcomes, and implications for further research in the use of drug eluting balloons (DEBs) for hemodialysis access.


In this study, the control group received “plain old balloon angioplasty” (POBA), while the treatment group received angioplasty with Biotronik’s Passeo 18-Lux DEB. Dr. Therasse describes the angiographic endpoints, with primary endpoint as late lumen loss (to measure the degree of restenosis), and secondary endpoints as hemodialysis access failure and mortality at 12 months. He emphasizes that the clinical endpoints of this study were more significant than the angiographic endpoints because they showed that when treating dysfunctional hemodialysis access, there is decreased incidence and severity of restenosis with DEB compared with POBA.


Additionally, the doctors walk through obstacles that arose during the study, which included coordination of data collection across multiple centers, low patient enrollment rate, strict exclusion criteria, and the need for re-intervention prior to the standardized follow up date. Dr. Therasse comments on the increasing use of DEBs in clinical practices and their future cost-effectiveness. He also references other helpful articles for interested listeners (linked below).


---


RESOURCES


Safety and Efficacy of Paclitaxel-Eluting Balloon Angioplasty for Dysfunctional Hemodialysis Access: https://www.jvir.org/article/S1051-0443(20)30961-1/fulltext


Drug-Coated Balloons for Dysfunctional Dialysis Arteriovenous Fistulas: https://www.nejm.org/doi/10.1056/NEJMoa1914617?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed


The Lutonix AV Randomized Trial of Paclitaxel-Coated Balloons in Arteriovenous Fistula Stenosis: https://www.jvir.org/article/S1051-0443(19)30817-6/fulltext

]]> 3195 no Ep. 140 Starting a MedTech Company 101 with Dr. Mahmood Razavi https://soundcloud.com/backtable/ep-140-starting-a-company-101-with-dr-mahmood-razavi Bryan Hartley talks with physician entrepreneur Dr. Mahmood Razavi about the essential elements of successfully starting a medtech company, as well as pitfalls to avoid. --- SHOW NOTES In this episode, serial entrepreneur Dr. Mahmood Razavi and our host Dr. Bryan Hartley discuss factors to consider when starting a medical technology company, steps of the innovation process, and fundraising strategies. Dr. Razavi recounts his path into entrepreneurship, emphasizing the importance of finding innovative mentors. He advises listeners to go beyond merely observing other successful innovators and instead, actively engaging and asking them questions. The doctors bring up the concept of filing a provisional patent in the early stages of product development, which can allow an entrepreneur to protect their intellectual property as they seek guidance from others. A critical decision point arises when an entrepreneur must decide whether or not they should establish a new product for an existing company or establish a completely new company. If the product is a different iteration of a design that already exists it might be worthwhile to innovate within the structure of an existing company. If you are creating a completely new device class that addresses a new clinical need or disease, there could be potential to start a company. The startup process requires entrepreneurs to recruit team members and raise funds. Dr. Razavi uses equity as a recruiting tool to bring business and engineering experts into the company. He also describes various methods of funding, including venture capital and strategic partnerships and the pros and cons of each. Mon, 05 Jul 2021 12:48:00 -0000 full BackTable Bryan Hartley talks with physician entrepreneur Dr. Mahmood Razavi about the essential elements of successfully starting a medtech company, as well as pitfalls to avoid. Bryan Hartley talks with physician entrepreneur Dr. Mahmood Razavi about the essential elements of successfully starting a medtech company, as well as pitfalls to avoid. --- SHOW NOTES In this episode, serial entrepreneur Dr. Mahmood Razavi and our host Dr. Bryan Hartley discuss factors to consider when starting a medical technology company, steps of the innovation process, and fundraising strategies. Dr. Razavi recounts his path into entrepreneurship, emphasizing the importance of finding innovative mentors. He advises listeners to go beyond merely observing other successful innovators and instead, actively engaging and asking them questions. The doctors bring up the concept of filing a provisional patent in the early stages of product development, which can allow an entrepreneur to protect their intellectual property as they seek guidance from others. A critical decision point arises when an entrepreneur must decide whether or not they should establish a new product for an existing company or establish a completely new company. If the product is a different iteration of a design that already exists it might be worthwhile to innovate within the structure of an existing company. If you are creating a completely new device class that addresses a new clinical need or disease, there could be potential to start a company. The startup process requires entrepreneurs to recruit team members and raise funds. Dr. Razavi uses equity as a recruiting tool to bring business and engineering experts into the company. He also describes various methods of funding, including venture capital and strategic partnerships and the pros and cons of each. Bryan Hartley talks with physician entrepreneur Dr. Mahmood Razavi about the essential elements of successfully starting a medtech company, as well as pitfalls to avoid.


---


SHOW NOTES


In this episode, serial entrepreneur Dr. Mahmood Razavi and our host Dr. Bryan Hartley discuss factors to consider when starting a medical technology company, steps of the innovation process, and fundraising strategies.


Dr. Razavi recounts his path into entrepreneurship, emphasizing the importance of finding innovative mentors. He advises listeners to go beyond merely observing other successful innovators and instead, actively engaging and asking them questions. The doctors bring up the concept of filing a provisional patent in the early stages of product development, which can allow an entrepreneur to protect their intellectual property as they seek guidance from others.


A critical decision point arises when an entrepreneur must decide whether or not they should establish a new product for an existing company or establish a completely new company. If the product is a different iteration of a design that already exists it might be worthwhile to innovate within the structure of an existing company. If you are creating a completely new device class that addresses a new clinical need or disease, there could be potential to start a company.


The startup process requires entrepreneurs to recruit team members and raise funds. Dr. Razavi uses equity as a recruiting tool to bring business and engineering experts into the company. He also describes various methods of funding, including venture capital and strategic partnerships and the pros and cons of each.

]]> 3367 no Ep. 139 AV Fistula and Graft Maintenance with Dr. Ari Kramer https://soundcloud.com/backtable/ep-139-av-fistula-and-graft-maintenance-with-dr-ari-kramer We talk with Vascular Access Surgeon Ari Kramer about AV Fistula and Graft Maintenance in dialysis patients from creation to long-term care, as well as tips and tricks for treating stenoses. --- SHOW NOTES In this episode, vascular access surgeon Dr. Ari Kramer and our host Dr. Chris Beck discuss the creation, management, and salvage of AV fistulas and grafts. Dr. Kramer describes the referral patterns that lead dialysis patients to his practice, citing the need to coordinate dialysis care around a common surgical practice. He works closely with nephrologists and dialysis centers to ensure quality of care and streamlined patient management. During an initial workup, Dr. Kramer includes a physical assessment and an echocardiogram to establish a baseline. The doctors discuss the pros and cons of using AV fistulas versus grafts. While AV fistulas are autogenic and carry a lower risk of infection, there is a risk that these may not mature. On the other hand, AV grafts are fully matured but they carry a higher risk of infection and require a higher intervention rate. Dr. Kramer emphasizes the importance of understanding a patient’s cardiac performance and history before selecting a method of AV access. He also schedules periodic follow-up appointments to ensure that the access site reaches maturity, which is evaluated by the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines. Dr. Kramer walks us through devices and procedures for angioplasty, stent placement, and drug coated balloon placement. Finally, he addresses strategies for managing re-stenosis and considerations for patient preferences regarding surgical revision. --- RESOURCES Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline for Vascular Access: 2019 Update: https://www.ajkd.org/article/S0272-6386(19)31137-0/fulltext#secsectitle0720 American Society of Diagnostic and Interventional Nephrology (ASDIN): https://www.asdin.org/page/A2 Kidney Academy (use code “backtable21” for free access): https://www.kidneyacademy.com/ Fri, 02 Jul 2021 12:00:00 -0000 full BackTable We talk with Vascular Access Surgeon Ari Kramer about AV Fistula and Graft Maintenance in dialysis patients from creation to long-term care, as well as tips and tricks for treating stenoses. We talk with Vascular Access Surgeon Ari Kramer about AV Fistula and Graft Maintenance in dialysis patients from creation to long-term care, as well as tips and tricks for treating stenoses. --- SHOW NOTES In this episode, vascular access surgeon Dr. Ari Kramer and our host Dr. Chris Beck discuss the creation, management, and salvage of AV fistulas and grafts. Dr. Kramer describes the referral patterns that lead dialysis patients to his practice, citing the need to coordinate dialysis care around a common surgical practice. He works closely with nephrologists and dialysis centers to ensure quality of care and streamlined patient management. During an initial workup, Dr. Kramer includes a physical assessment and an echocardiogram to establish a baseline. The doctors discuss the pros and cons of using AV fistulas versus grafts. While AV fistulas are autogenic and carry a lower risk of infection, there is a risk that these may not mature. On the other hand, AV grafts are fully matured but they carry a higher risk of infection and require a higher intervention rate. Dr. Kramer emphasizes the importance of understanding a patient’s cardiac performance and history before selecting a method of AV access. He also schedules periodic follow-up appointments to ensure that the access site reaches maturity, which is evaluated by the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines. Dr. Kramer walks us through devices and procedures for angioplasty, stent placement, and drug coated balloon placement. Finally, he addresses strategies for managing re-stenosis and considerations for patient preferences regarding surgical revision. --- RESOURCES Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline for Vascular Access: 2019 Update: https://www.ajkd.org/article/S0272-6386(19)31137-0/fulltext#secsectitle0720 American Society of Diagnostic and Interventional Nephrology (ASDIN): https://www.asdin.org/page/A2 Kidney Academy (use code “backtable21” for free access): https://www.kidneyacademy.com/ We talk with Vascular Access Surgeon Ari Kramer about AV Fistula and Graft Maintenance in dialysis patients from creation to long-term care, as well as tips and tricks for treating stenoses.


---


SHOW NOTES


In this episode, vascular access surgeon Dr. Ari Kramer and our host Dr. Chris Beck discuss the creation, management, and salvage of AV fistulas and grafts.


Dr. Kramer describes the referral patterns that lead dialysis patients to his practice, citing the need to coordinate dialysis care around a common surgical practice. He works closely with nephrologists and dialysis centers to ensure quality of care and streamlined patient management. During an initial workup, Dr. Kramer includes a physical assessment and an echocardiogram to establish a baseline.


The doctors discuss the pros and cons of using AV fistulas versus grafts. While AV fistulas are autogenic and carry a lower risk of infection, there is a risk that these may not mature. On the other hand, AV grafts are fully matured but they carry a higher risk of infection and require a higher intervention rate. Dr. Kramer emphasizes the importance of understanding a patient’s cardiac performance and history before selecting a method of AV access. He also schedules periodic follow-up appointments to ensure that the access site reaches maturity, which is evaluated by the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines.


Dr. Kramer walks us through devices and procedures for angioplasty, stent placement, and drug coated balloon placement. Finally, he addresses strategies for managing re-stenosis and considerations for patient preferences regarding surgical revision.


---


RESOURCES


Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline for Vascular Access: 2019 Update: https://www.ajkd.org/article/S0272-6386(19)31137-0/fulltext#secsectitle0720


American Society of Diagnostic and Interventional Nephrology (ASDIN): https://www.asdin.org/page/A2


Kidney Academy (use code “backtable21” for free access): https://www.kidneyacademy.com/

]]> 3623 no Ep. 138 From the Angio Suite to the Podium- How to Present Your Cases at Your Best with Dr. Patrone https://soundcloud.com/backtable/ep-138-from-the-angio-suite-to-the-podium-how-to-present-your-cases-at-your-best-with-dr-patrone Dr. Sabeen Dhand talks with Dr. Lorenzo Patrone about how to be your best at giving an amazing, engaging presentation. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rN9SC1 --- SHOW NOTES In this episode, interventional radiologists Dr. Lorenzo Patrone and Dr. Sabeen Dhand discuss their best tips for creating and delivering quality presentations. Due to the highly visual nature of interventional radiology, both doctors agree that PowerPoints are a great way to communicate information to audiences. Dr. Patrone recommends learning how to fully utilize PowerPoint functionalities such as embedded videos, animations, and transitions. Specifically, looped videos can help show blood flow. Interspersing dynamic presentation features can better illustrate important points; however, overuse of these can be distracting and unprofessional. As for presentation delivery, both doctors agree that showing authentic personality can engage audiences. They advise listeners to embrace talking about complications and posing questions to the audience. Finally, they discuss considerations to keep in mind for different types of presentation formats, such as online webinars, industry-sponsored events, and debates. Overall, Dr. Patrone advises doctors to only speak on behalf of products that they truly believe in. --- RESOURCES Vascupedia: https://vascupedia.com/ Envato Presentation Templates: https://elements.envato.com/presentation-templates Fri, 25 Jun 2021 11:23:00 -0000 full BackTable Dr. Sabeen Dhand talks with Dr. Lorenzo Patrone about how to be your best at giving an amazing, engaging presentation. Dr. Sabeen Dhand talks with Dr. Lorenzo Patrone about how to be your best at giving an amazing, engaging presentation. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rN9SC1 --- SHOW NOTES In this episode, interventional radiologists Dr. Lorenzo Patrone and Dr. Sabeen Dhand discuss their best tips for creating and delivering quality presentations. Due to the highly visual nature of interventional radiology, both doctors agree that PowerPoints are a great way to communicate information to audiences. Dr. Patrone recommends learning how to fully utilize PowerPoint functionalities such as embedded videos, animations, and transitions. Specifically, looped videos can help show blood flow. Interspersing dynamic presentation features can better illustrate important points; however, overuse of these can be distracting and unprofessional. As for presentation delivery, both doctors agree that showing authentic personality can engage audiences. They advise listeners to embrace talking about complications and posing questions to the audience. Finally, they discuss considerations to keep in mind for different types of presentation formats, such as online webinars, industry-sponsored events, and debates. Overall, Dr. Patrone advises doctors to only speak on behalf of products that they truly believe in. --- RESOURCES Vascupedia: https://vascupedia.com/ Envato Presentation Templates: https://elements.envato.com/presentation-templates Dr. Sabeen Dhand talks with Dr. Lorenzo Patrone about how to be your best at giving an amazing, engaging presentation.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/rN9SC1


---


SHOW NOTES


In this episode, interventional radiologists Dr. Lorenzo Patrone and Dr. Sabeen Dhand discuss their best tips for creating and delivering quality presentations.


Due to the highly visual nature of interventional radiology, both doctors agree that PowerPoints are a great way to communicate information to audiences. Dr. Patrone recommends learning how to fully utilize PowerPoint functionalities such as embedded videos, animations, and transitions. Specifically, looped videos can help show blood flow. Interspersing dynamic presentation features can better illustrate important points; however, overuse of these can be distracting and unprofessional.


As for presentation delivery, both doctors agree that showing authentic personality can engage audiences. They advise listeners to embrace talking about complications and posing questions to the audience. Finally, they discuss considerations to keep in mind for different types of presentation formats, such as online webinars, industry-sponsored events, and debates. Overall, Dr. Patrone advises doctors to only speak on behalf of products that they truly believe in.


---


RESOURCES


Vascupedia: https://vascupedia.com/


Envato Presentation Templates: https://elements.envato.com/presentation-templates

]]> 2205 no Ep. 137 Road to Becoming a Y90 Authorized User (while in training!) with Dr. Rakesh Ahuja Dr. Rakesh Ahuja walks us through the Pathway to Becoming a Y-90 Authorized user as a Resident, as well as the standard post-training pathway. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/2JujFM --- SHOW NOTES In this episode, interventional radiologist Dr. Rakesh Ahuja and our host Dr. Michael Barraza continue the BackTable Trainee Series by discussing the meaning, benefits, and pathway for residents to become Y90 Authorized Users (AU). The doctors discuss what it means to be an AU in interventional oncology, a rapidly growing field. The major benefit of Y90 licensing is that AUs can have the freedom to independently prescribe and administer customized doses to patients. Additionally, AU status can make a physician more marketable to private practices and it can allow them to perform cases on their own schedule. AU status is transferable to different sites and states, and it does not expire. Dr. Ahuja speaks about eligibility requirements and emphasizes that trainees do not have to be board certified in radiology to start Y90 training. Supervised clinical training throughout an IR/DR residency will make most PGY-5 residents eligible to start the Authorized User training process. While this alternate pathway of Y90 Authorization can be faster than the traditional pathway (waiting until after board certification from the American Board of Radiology), it is important to work with local radiation safety officers to ensure that all eligibility and training criteria are met. --- RESOURCES US Nuclear Regulatory Commission Y90 Licensing Guidance- https://www.nrc.gov/docs/ML1920/ML19204A272.pdf Thu, 24 Jun 2021 12:00:00 -0000 full BackTable Dr. Rakesh Ahuja walks us through the Pathway to Becoming a Y-90 Authorized user as a Resident, as well as the standard post-training pathway. Dr. Rakesh Ahuja walks us through the Pathway to Becoming a Y-90 Authorized user as a Resident, as well as the standard post-training pathway. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/2JujFM --- SHOW NOTES In this episode, interventional radiologist Dr. Rakesh Ahuja and our host Dr. Michael Barraza continue the BackTable Trainee Series by discussing the meaning, benefits, and pathway for residents to become Y90 Authorized Users (AU). The doctors discuss what it means to be an AU in interventional oncology, a rapidly growing field. The major benefit of Y90 licensing is that AUs can have the freedom to independently prescribe and administer customized doses to patients. Additionally, AU status can make a physician more marketable to private practices and it can allow them to perform cases on their own schedule. AU status is transferable to different sites and states, and it does not expire. Dr. Ahuja speaks about eligibility requirements and emphasizes that trainees do not have to be board certified in radiology to start Y90 training. Supervised clinical training throughout an IR/DR residency will make most PGY-5 residents eligible to start the Authorized User training process. While this alternate pathway of Y90 Authorization can be faster than the traditional pathway (waiting until after board certification from the American Board of Radiology), it is important to work with local radiation safety officers to ensure that all eligibility and training criteria are met. --- RESOURCES US Nuclear Regulatory Commission Y90 Licensing Guidance- https://www.nrc.gov/docs/ML1920/ML19204A272.pdf Dr. Rakesh Ahuja walks us through the Pathway to Becoming a Y-90 Authorized user as a Resident, as well as the standard post-training pathway.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/2JujFM


---


SHOW NOTES


In this episode, interventional radiologist Dr. Rakesh Ahuja and our host Dr. Michael Barraza continue the BackTable Trainee Series by discussing the meaning, benefits, and pathway for residents to become Y90 Authorized Users (AU).


The doctors discuss what it means to be an AU in interventional oncology, a rapidly growing field. The major benefit of Y90 licensing is that AUs can have the freedom to independently prescribe and administer customized doses to patients. Additionally, AU status can make a physician more marketable to private practices and it can allow them to perform cases on their own schedule. AU status is transferable to different sites and states, and it does not expire.


Dr. Ahuja speaks about eligibility requirements and emphasizes that trainees do not have to be board certified in radiology to start Y90 training. Supervised clinical training throughout an IR/DR residency will make most PGY-5 residents eligible to start the Authorized User training process. While this alternate pathway of Y90 Authorization can be faster than the traditional pathway (waiting until after board certification from the American Board of Radiology), it is important to work with local radiation safety officers to ensure that all eligibility and training criteria are met.


---


RESOURCES


US Nuclear Regulatory Commission Y90 Licensing Guidance- https://www.nrc.gov/docs/ML1920/ML19204A272.pdf

]]> 1585 no Ep. 136 IR Residency Pathways and Getting In! (Part II) with Dr. Sahil Mehta and Dr. Elias Farah https://soundcloud.com/backtable/ep-136-ir-residency-pathways-and-getting-in-part-ii-with-dr-sahil-mehta-and-dr-elias-farah We chat with MedSchoolCoach Founder Dr. Sahil Mehta and 1st Year IR Resident Dr. Elias Farah about what inspired them to go into IR, and advice on getting into the specialty via the existing training pathways. --- SHOW NOTES In this episode, interventional radiologist Dr. Sahil Mehta, integrated DR/IR resident Dr. Elias Farah, and our host Dr. Aaron Fritts continue the BackTable Trainee Series by discussing how they each discovered the field of interventional radiology (IR), recent trends in the IR match process, and the importance of raising awareness of the IR specialty. With the recent shift towards integrated IR residencies, medical students now have the opportunity to experience a mix of diagnostic and interventional radiology training from PGY-2 through PGY-4, and then dedicate time to IR training during PGY-5 and PGY-6. As a recent IR applicant and now a resident, Dr. Farah walks us through his process of applying to residency. He outlines the steps that he took to prepare and the number of programs that he applied to. We also address the fact that IR has grown to be one of the most competitive specialties to match into. Dr. Mehta emphasizes that applicants’ average USMLE scores and number of publications have increased in the last few years, so it is important for applicants to demonstrate their genuine interest in the field and be prepared to speak about this during the interview. The doctors close by discussing why increased awareness of IR can benefit both providers and patients. They highlight organizations that advance this mission, including the Society of Interventional Radiology (SIR) and the Interventional Institute. --- RESOURCES Society of Interventional Radiologists (SIR) Online Education Resources: https://www.sirweb.org/learning-center/rfs-landing-page/medical-student-and-resident-educational-resources/ SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/ The Interventional Initiative: http://www.theii.org/ Beth Israel Deaconess IR Residency: https://www.bidmc.org/medical-education/medical-education-by-department/radiology/residencies-in-radiology/interventional-radiology-integrated-pathway-residency University of Florida IR Residency: https://radiology.med.jax.ufl.edu/interventional-radiology-integrated-residency/ MedSchoolCoach: https://www.medschoolcoach.com/ Wed, 23 Jun 2021 12:00:00 -0000 full BackTable We chat with MedSchoolCoach Founder Dr. Sahil Mehta and 1st Year IR Resident Dr. Elias Farah about what inspired them to go into IR, and advice on getting into the specialty via the existing training pathways. We chat with MedSchoolCoach Founder Dr. Sahil Mehta and 1st Year IR Resident Dr. Elias Farah about what inspired them to go into IR, and advice on getting into the specialty via the existing training pathways. --- SHOW NOTES In this episode, interventional radiologist Dr. Sahil Mehta, integrated DR/IR resident Dr. Elias Farah, and our host Dr. Aaron Fritts continue the BackTable Trainee Series by discussing how they each discovered the field of interventional radiology (IR), recent trends in the IR match process, and the importance of raising awareness of the IR specialty. With the recent shift towards integrated IR residencies, medical students now have the opportunity to experience a mix of diagnostic and interventional radiology training from PGY-2 through PGY-4, and then dedicate time to IR training during PGY-5 and PGY-6. As a recent IR applicant and now a resident, Dr. Farah walks us through his process of applying to residency. He outlines the steps that he took to prepare and the number of programs that he applied to. We also address the fact that IR has grown to be one of the most competitive specialties to match into. Dr. Mehta emphasizes that applicants’ average USMLE scores and number of publications have increased in the last few years, so it is important for applicants to demonstrate their genuine interest in the field and be prepared to speak about this during the interview. The doctors close by discussing why increased awareness of IR can benefit both providers and patients. They highlight organizations that advance this mission, including the Society of Interventional Radiology (SIR) and the Interventional Institute. --- RESOURCES Society of Interventional Radiologists (SIR) Online Education Resources: https://www.sirweb.org/learning-center/rfs-landing-page/medical-student-and-resident-educational-resources/ SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/ The Interventional Initiative: http://www.theii.org/ Beth Israel Deaconess IR Residency: https://www.bidmc.org/medical-education/medical-education-by-department/radiology/residencies-in-radiology/interventional-radiology-integrated-pathway-residency University of Florida IR Residency: https://radiology.med.jax.ufl.edu/interventional-radiology-integrated-residency/ MedSchoolCoach: https://www.medschoolcoach.com/ We chat with MedSchoolCoach Founder Dr. Sahil Mehta and 1st Year IR Resident Dr. Elias Farah about what inspired them to go into IR, and advice on getting into the specialty via the existing training pathways.


---


SHOW NOTES


In this episode, interventional radiologist Dr. Sahil Mehta, integrated DR/IR resident Dr. Elias Farah, and our host Dr. Aaron Fritts continue the BackTable Trainee Series by discussing how they each discovered the field of interventional radiology (IR), recent trends in the IR match process, and the importance of raising awareness of the IR specialty.


With the recent shift towards integrated IR residencies, medical students now have the opportunity to experience a mix of diagnostic and interventional radiology training from PGY-2 through PGY-4, and then dedicate time to IR training during PGY-5 and PGY-6.


As a recent IR applicant and now a resident, Dr. Farah walks us through his process of applying to residency. He outlines the steps that he took to prepare and the number of programs that he applied to. We also address the fact that IR has grown to be one of the most competitive specialties to match into. Dr. Mehta emphasizes that applicants’ average USMLE scores and number of publications have increased in the last few years, so it is important for applicants to demonstrate their genuine interest in the field and be prepared to speak about this during the interview.


The doctors close by discussing why increased awareness of IR can benefit both providers and patients. They highlight organizations that advance this mission, including the Society of Interventional Radiology (SIR) and the Interventional Institute.


---


RESOURCES


Society of Interventional Radiologists (SIR) Online Education Resources: https://www.sirweb.org/learning-center/rfs-landing-page/medical-student-and-resident-educational-resources/


SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/


The Interventional Initiative: http://www.theii.org/


Beth Israel Deaconess IR Residency: https://www.bidmc.org/medical-education/medical-education-by-department/radiology/residencies-in-radiology/interventional-radiology-integrated-pathway-residency


University of Florida IR Residency: https://radiology.med.jax.ufl.edu/interventional-radiology-integrated-residency/


MedSchoolCoach: https://www.medschoolcoach.com/

]]> 2844 no Ep. 135 IR Residency Pathways and Getting In! (Part 1) with Dr. Bill Majdalany and Dr. Jeff Bodner https://soundcloud.com/backtable/ep-135-ir-residency-pathways-and-getting-in-part-1-with-dr-bill-majdalany-and-dr-jeff-bodner We talk with IR Resident Dr. Jeff Bodner and Emory IR Program Director Dr. Bill Majdalany about the current IR training pathways and what it takes to get in these days! --- SHOW NOTES In this episode, interventional radiology (IR) program director Dr. Bill Majdalany, integrated IR resident Dr. Jeff Bodner, and our host Dr. Chris Beck continue the BackTable Trainee Series by discussing the IR residency application and interview process: different pathways to enter IR, applications that stand out, and interview day tips. As a recent residency applicant, Dr. Bodner walks us through his journey through medical school, applications, and interviews. For students interested in pursuing IR, he recommends demonstrating interest in the field by participating in medical student committees, conferences, and volunteer opportunities. He also advises fourth-year students to apply broadly to both integrated interventional radiology and diagnostic radiology programs, emphasizing that there are multiple pathways to IR. Dr. Majdalany elaborates on these pathways, describing the differences between the Early Specialization in Interventional Radiology (ESIR), the independent IR residency, and the integrated IR residency. He highlights key actions that applicants can take, which include performing well in all clerkships, taking advantage of research opportunities, and composing a personal statement that ties the whole application together. We conclude the episode by offering advice for interview days. Overall, the best practices are to maintain professionalism and come prepared with knowledge about each program. --- RESOURCES Society of Interventional Radiologists (SIR) Online Education Resources: https://www.sirweb.org/learning-center/rfs-landing-page/medical-student-and-resident-educational-resources/ SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/ Emory University IR Residency: https://med.emory.edu/departments/radiology/education/interventional-radiology-residency/index.html Tue, 22 Jun 2021 12:00:00 -0000 full BackTable We talk with IR Resident Dr. Jeff Bodner and Emory IR Program Director Dr. Bill Majdalany about the current IR training pathways and what it takes to get in these days! We talk with IR Resident Dr. Jeff Bodner and Emory IR Program Director Dr. Bill Majdalany about the current IR training pathways and what it takes to get in these days! --- SHOW NOTES In this episode, interventional radiology (IR) program director Dr. Bill Majdalany, integrated IR resident Dr. Jeff Bodner, and our host Dr. Chris Beck continue the BackTable Trainee Series by discussing the IR residency application and interview process: different pathways to enter IR, applications that stand out, and interview day tips. As a recent residency applicant, Dr. Bodner walks us through his journey through medical school, applications, and interviews. For students interested in pursuing IR, he recommends demonstrating interest in the field by participating in medical student committees, conferences, and volunteer opportunities. He also advises fourth-year students to apply broadly to both integrated interventional radiology and diagnostic radiology programs, emphasizing that there are multiple pathways to IR. Dr. Majdalany elaborates on these pathways, describing the differences between the Early Specialization in Interventional Radiology (ESIR), the independent IR residency, and the integrated IR residency. He highlights key actions that applicants can take, which include performing well in all clerkships, taking advantage of research opportunities, and composing a personal statement that ties the whole application together. We conclude the episode by offering advice for interview days. Overall, the best practices are to maintain professionalism and come prepared with knowledge about each program. --- RESOURCES Society of Interventional Radiologists (SIR) Online Education Resources: https://www.sirweb.org/learning-center/rfs-landing-page/medical-student-and-resident-educational-resources/ SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/ Emory University IR Residency: https://med.emory.edu/departments/radiology/education/interventional-radiology-residency/index.html We talk with IR Resident Dr. Jeff Bodner and Emory IR Program Director Dr. Bill Majdalany about the current IR training pathways and what it takes to get in these days!


---


SHOW NOTES


In this episode, interventional radiology (IR) program director Dr. Bill Majdalany, integrated IR resident Dr. Jeff Bodner, and our host Dr. Chris Beck continue the BackTable Trainee Series by discussing the IR residency application and interview process: different pathways to enter IR, applications that stand out, and interview day tips.


As a recent residency applicant, Dr. Bodner walks us through his journey through medical school, applications, and interviews. For students interested in pursuing IR, he recommends demonstrating interest in the field by participating in medical student committees, conferences, and volunteer opportunities. He also advises fourth-year students to apply broadly to both integrated interventional radiology and diagnostic radiology programs, emphasizing that there are multiple pathways to IR.


Dr. Majdalany elaborates on these pathways, describing the differences between the Early Specialization in Interventional Radiology (ESIR), the independent IR residency, and the integrated IR residency. He highlights key actions that applicants can take, which include performing well in all clerkships, taking advantage of research opportunities, and composing a personal statement that ties the whole application together.


We conclude the episode by offering advice for interview days. Overall, the best practices are to maintain professionalism and come prepared with knowledge about each program.


---


RESOURCES


Society of Interventional Radiologists (SIR) Online Education Resources: https://www.sirweb.org/learning-center/rfs-landing-page/medical-student-and-resident-educational-resources/


SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/


Emory University IR Residency: https://med.emory.edu/departments/radiology/education/interventional-radiology-residency/index.html

]]> 3662 no Ep. 134 How to Crush Your Interventional Radiology (IR) Rotation with Dr. Daryl Goldman https://soundcloud.com/backtable/ep-134-how-to-crush-your-interventional-radiology-ir-rotation-with-dr-daryl-goldman We talk with Dr. Daryl Goldman, an IR resident at Mount Sinai Health System, about what it takes to "crush" your Interventional Radiology Rotation as a medical student, as well as what makes for a great educational experience from the resident and attending side. --- SHOW NOTES In this episode, interventional radiology resident Dr. Daryl Goldman and our host Dr. Aaron Fritts launch our BackTable Trainee Series by talking about how medical students can perform well on IR rotations, and more broadly, how they can best position themselves to apply for an integrated IR residency. They also discuss actions that program directors can take to ensure that their rotation is effective at teaching and recruiting trainees. Dr. Goldman outlines her path to IR and offers advice to medical students for getting involved in research, networking, and away rotations. For students at sites without IR residency/fellowship programs, she suggests that they reach out to external programs for research opportunities and away rotations. Overall, she encourages interested students to learn how to be good mentees, attend conferences, and get involved with IR interest groups. Dr. Goldman says that a major goal of an IR rotation should be showing students a broad view of the specialty: workups, procedures, inpatient management, clinic time, and follow-up care. She suggests that programs provide students with graduated responsibility, didactic time, and opportunities to give presentations. The doctors advise students to use social media to get connected with their specialty networks. Specifically, they emphasize the collaborative and educational environment of the endovascular community on Twitter. --- RESOURCES BackTable’s Twitter: @_BackTable Dr. Goldman’s Twitter: @Daryl_Goldman SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/ Mt. Sinai Integrated IR Residency: https://icahn.mssm.edu/education/residencies-fellowships/list/msh-interventional-diagnostic-radiology “Five Ways to Be a Great Mentee” by Dr. Yasha Gupta: https://www.acr.org/Member-Resources/rfs/Resident-and-Fellow-News/2020MAR-Mentorship Mon, 21 Jun 2021 11:47:00 -0000 full BackTable We talk with Dr. Daryl Goldman, an IR resident at Mount Sinai Health System, about what it takes to "crush" your Interventional Radiology Rotation as a medical student, as well as what makes for a great educational experience from the resident and attending side. We talk with Dr. Daryl Goldman, an IR resident at Mount Sinai Health System, about what it takes to "crush" your Interventional Radiology Rotation as a medical student, as well as what makes for a great educational experience from the resident and attending side. --- SHOW NOTES In this episode, interventional radiology resident Dr. Daryl Goldman and our host Dr. Aaron Fritts launch our BackTable Trainee Series by talking about how medical students can perform well on IR rotations, and more broadly, how they can best position themselves to apply for an integrated IR residency. They also discuss actions that program directors can take to ensure that their rotation is effective at teaching and recruiting trainees. Dr. Goldman outlines her path to IR and offers advice to medical students for getting involved in research, networking, and away rotations. For students at sites without IR residency/fellowship programs, she suggests that they reach out to external programs for research opportunities and away rotations. Overall, she encourages interested students to learn how to be good mentees, attend conferences, and get involved with IR interest groups. Dr. Goldman says that a major goal of an IR rotation should be showing students a broad view of the specialty: workups, procedures, inpatient management, clinic time, and follow-up care. She suggests that programs provide students with graduated responsibility, didactic time, and opportunities to give presentations. The doctors advise students to use social media to get connected with their specialty networks. Specifically, they emphasize the collaborative and educational environment of the endovascular community on Twitter. --- RESOURCES BackTable’s Twitter: @_BackTable Dr. Goldman’s Twitter: @Daryl_Goldman SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/ Mt. Sinai Integrated IR Residency: https://icahn.mssm.edu/education/residencies-fellowships/list/msh-interventional-diagnostic-radiology “Five Ways to Be a Great Mentee” by Dr. Yasha Gupta: https://www.acr.org/Member-Resources/rfs/Resident-and-Fellow-News/2020MAR-Mentorship We talk with Dr. Daryl Goldman, an IR resident at Mount Sinai Health System, about what it takes to "crush" your Interventional Radiology Rotation as a medical student, as well as what makes for a great educational experience from the resident and attending side.


---


SHOW NOTES


In this episode, interventional radiology resident Dr. Daryl Goldman and our host Dr. Aaron Fritts launch our BackTable Trainee Series by talking about how medical students can perform well on IR rotations, and more broadly, how they can best position themselves to apply for an integrated IR residency. They also discuss actions that program directors can take to ensure that their rotation is effective at teaching and recruiting trainees.


Dr. Goldman outlines her path to IR and offers advice to medical students for getting involved in research, networking, and away rotations. For students at sites without IR residency/fellowship programs, she suggests that they reach out to external programs for research opportunities and away rotations. Overall, she encourages interested students to learn how to be good mentees, attend conferences, and get involved with IR interest groups.


Dr. Goldman says that a major goal of an IR rotation should be showing students a broad view of the specialty: workups, procedures, inpatient management, clinic time, and follow-up care. She suggests that programs provide students with graduated responsibility, didactic time, and opportunities to give presentations.


The doctors advise students to use social media to get connected with their specialty networks. Specifically, they emphasize the collaborative and educational environment of the endovascular community on Twitter.


---


RESOURCES


BackTable’s Twitter: @_BackTable


Dr. Goldman’s Twitter: @Daryl_Goldman


SIR Residents, Fellows, and Students (SIR RFS): http://rfs.sirweb.org/


Mt. Sinai Integrated IR Residency: https://icahn.mssm.edu/education/residencies-fellowships/list/msh-interventional-diagnostic-radiology


“Five Ways to Be a Great Mentee” by Dr. Yasha Gupta: https://www.acr.org/Member-Resources/rfs/Resident-and-Fellow-News/2020MAR-Mentorship

]]> 2469 no Ep. 133 MSOs and Value-Based Care: What You Need to Know with Dr. Chris Pittman https://soundcloud.com/backtable/ep-133-msos-and-value-based-care-what-you-need-to-know-with-dr-chris-pittman We talk with Dr. Christopher Pittman to better understand Management Services Organizations (MSOs) and what they can do for your practice. We also get the 101 on Value-Based Care payment models. --- SHOW NOTES In this episode, interventional radiologist and vein treatment expert Dr. Chris Pittman and our host Dr. Aaron Fritts discuss the structure and benefits of management services organizations (MSOs). As healthcare moves from a fee-for-service model to a fee-for-value model, MSOs have become increasingly popular. Dr. Pittman gives a brief overview of the services that these organizations can provide to independent physicians. These services can encompass billing, human resources, scheduling, contract negotiation, marketing, and any aspect of practice management outside of direct medical care. We discuss the benefits of joining an MSO, which include sharing resources within the network, offloading non-medical functions, controlling costs, learning best business practices, and ultimately, having more time and energy to deliver quality patient care. Additionally, having a network of practices allows each physician to have access to industry data and benchmark themself from operational, clinical, and patient satisfaction standpoints. Dr. Pittman advises all physicians to have due diligence when deciding to join an MSO. He emphasizes the importance of determining the amount of physician autonomy that will be retained, evaluating the organization based on outcomes of past clients, and having an attorney look over agreements. In general, he believes that the most well-run MSO’s are the ones that focus on a single specialty and have physicians on their leadership teams. --- RESOURCES Health Performance Specialists (HSP): https://www.healthperformancespecialists.com/ Fri, 18 Jun 2021 12:00:00 -0000 full BackTable We talk with Dr. Christopher Pittman to better understand Management Services Organizations (MSOs) and what they can do for your practice. We also get the 101 on Value-Based Care payment models. We talk with Dr. Christopher Pittman to better understand Management Services Organizations (MSOs) and what they can do for your practice. We also get the 101 on Value-Based Care payment models. --- SHOW NOTES In this episode, interventional radiologist and vein treatment expert Dr. Chris Pittman and our host Dr. Aaron Fritts discuss the structure and benefits of management services organizations (MSOs). As healthcare moves from a fee-for-service model to a fee-for-value model, MSOs have become increasingly popular. Dr. Pittman gives a brief overview of the services that these organizations can provide to independent physicians. These services can encompass billing, human resources, scheduling, contract negotiation, marketing, and any aspect of practice management outside of direct medical care. We discuss the benefits of joining an MSO, which include sharing resources within the network, offloading non-medical functions, controlling costs, learning best business practices, and ultimately, having more time and energy to deliver quality patient care. Additionally, having a network of practices allows each physician to have access to industry data and benchmark themself from operational, clinical, and patient satisfaction standpoints. Dr. Pittman advises all physicians to have due diligence when deciding to join an MSO. He emphasizes the importance of determining the amount of physician autonomy that will be retained, evaluating the organization based on outcomes of past clients, and having an attorney look over agreements. In general, he believes that the most well-run MSO’s are the ones that focus on a single specialty and have physicians on their leadership teams. --- RESOURCES Health Performance Specialists (HSP): https://www.healthperformancespecialists.com/ We talk with Dr. Christopher Pittman to better understand Management Services Organizations (MSOs) and what they can do for your practice. We also get the 101 on Value-Based Care payment models.


---


SHOW NOTES


In this episode, interventional radiologist and vein treatment expert Dr. Chris Pittman and our host Dr. Aaron Fritts discuss the structure and benefits of management services organizations (MSOs).


As healthcare moves from a fee-for-service model to a fee-for-value model, MSOs have become increasingly popular. Dr. Pittman gives a brief overview of the services that these organizations can provide to independent physicians. These services can encompass billing, human resources, scheduling, contract negotiation, marketing, and any aspect of practice management outside of direct medical care. We discuss the benefits of joining an MSO, which include sharing resources within the network, offloading non-medical functions, controlling costs, learning best business practices, and ultimately, having more time and energy to deliver quality patient care. Additionally, having a network of practices allows each physician to have access to industry data and benchmark themself from operational, clinical, and patient satisfaction standpoints.


Dr. Pittman advises all physicians to have due diligence when deciding to join an MSO. He emphasizes the importance of determining the amount of physician autonomy that will be retained, evaluating the organization based on outcomes of past clients, and having an attorney look over agreements. In general, he believes that the most well-run MSO’s are the ones that focus on a single specialty and have physicians on their leadership teams.


---


RESOURCES


Health Performance Specialists (HSP): https://www.healthperformancespecialists.com/

]]> 2784 no Ep. 132 Viz.AI: Improving Access to Stroke Care using AI with Dr. Chris Mansi https://soundcloud.com/backtable/ep-132-vizai-improving-access-to-stroke-care-using-ai-with-dr-chris-mansi Bryan Hartley talks with Neurosurgeon Dr. Chris Mansi about the origin story of Viz.ai, a company using Artificial Intelligence to Shorten Time to Treatment and Improve Access to Care for Stroke Patients. --- SHOW NOTES In this episode, neurosurgeon and co-founder/CEO of Viz.ai, Dr. Chris Mansi, and our host Dr. Bryan Hartley discuss the use of AI technology to detect large vessel occlusion (LVO) strokes and increase efficiency of workflow. Dr. Mansi describes his entrepreneurial journey, through the phases of idea formation, funding, growth, and expansion of his company. We start by outlining key advantages that MBA and other graduate degree programs can provide for healthcare entrepreneurs. Both doctors emphasize the value of dedicating space and time, outside of clinical practice, to innovate and test new ideas. Dr. Mansi highlights his collaboration with other disciplines, such as engineering. He also discusses takeaways from his business education-- the importance of patient-centered innovation and having flexible technology that can meet the changing needs of the market. Dr. Mansi gives an overview of Viz.ai’s origins, mission, and product offerings. The company addresses a clinical need for more consistent and efficient stroke care, and aims to move patients from stroke detection to stroke treatment more quickly. Viz.ai employs self-learning technology to provide high-quality imaging, automatic workflow triggers, and HIPAA-compliant communication channels for stroke teams to work together for the benefit of patients. We end this episode by talking about Viz.ai’s plan to expand to more disease states and medical specialties in the near future. --- RESOURCES Viz.ai Platform: https://www.viz.ai/ “Crossing the Chasm” by Geoffrey Moore: Dr. Mansi’s book recommendation for all tech entrepreneurs Mon, 14 Jun 2021 12:36:00 -0000 full BackTable Bryan Hartley talks with Neurosurgeon Dr. Chris Mansi about the origin story of Viz.ai, a company using Artificial Intelligence to Shorten Time to Treatment and Improve Access to Care for Stroke Patients. Bryan Hartley talks with Neurosurgeon Dr. Chris Mansi about the origin story of Viz.ai, a company using Artificial Intelligence to Shorten Time to Treatment and Improve Access to Care for Stroke Patients. --- SHOW NOTES In this episode, neurosurgeon and co-founder/CEO of Viz.ai, Dr. Chris Mansi, and our host Dr. Bryan Hartley discuss the use of AI technology to detect large vessel occlusion (LVO) strokes and increase efficiency of workflow. Dr. Mansi describes his entrepreneurial journey, through the phases of idea formation, funding, growth, and expansion of his company. We start by outlining key advantages that MBA and other graduate degree programs can provide for healthcare entrepreneurs. Both doctors emphasize the value of dedicating space and time, outside of clinical practice, to innovate and test new ideas. Dr. Mansi highlights his collaboration with other disciplines, such as engineering. He also discusses takeaways from his business education-- the importance of patient-centered innovation and having flexible technology that can meet the changing needs of the market. Dr. Mansi gives an overview of Viz.ai’s origins, mission, and product offerings. The company addresses a clinical need for more consistent and efficient stroke care, and aims to move patients from stroke detection to stroke treatment more quickly. Viz.ai employs self-learning technology to provide high-quality imaging, automatic workflow triggers, and HIPAA-compliant communication channels for stroke teams to work together for the benefit of patients. We end this episode by talking about Viz.ai’s plan to expand to more disease states and medical specialties in the near future. --- RESOURCES Viz.ai Platform: https://www.viz.ai/ “Crossing the Chasm” by Geoffrey Moore: Dr. Mansi’s book recommendation for all tech entrepreneurs Bryan Hartley talks with Neurosurgeon Dr. Chris Mansi about the origin story of Viz.ai, a company using Artificial Intelligence to Shorten Time to Treatment and Improve Access to Care for Stroke Patients.


---


SHOW NOTES


In this episode, neurosurgeon and co-founder/CEO of Viz.ai, Dr. Chris Mansi, and our host Dr. Bryan Hartley discuss the use of AI technology to detect large vessel occlusion (LVO) strokes and increase efficiency of workflow. Dr. Mansi describes his entrepreneurial journey, through the phases of idea formation, funding, growth, and expansion of his company.


We start by outlining key advantages that MBA and other graduate degree programs can provide for healthcare entrepreneurs. Both doctors emphasize the value of dedicating space and time, outside of clinical practice, to innovate and test new ideas. Dr. Mansi highlights his collaboration with other disciplines, such as engineering. He also discusses takeaways from his business education-- the importance of patient-centered innovation and having flexible technology that can meet the changing needs of the market.


Dr. Mansi gives an overview of Viz.ai’s origins, mission, and product offerings. The company addresses a clinical need for more consistent and efficient stroke care, and aims to move patients from stroke detection to stroke treatment more quickly. Viz.ai employs self-learning technology to provide high-quality imaging, automatic workflow triggers, and HIPAA-compliant communication channels for stroke teams to work together for the benefit of patients. We end this episode by talking about Viz.ai’s plan to expand to more disease states and medical specialties in the near future.


---


RESOURCES


Viz.ai Platform: https://www.viz.ai/


“Crossing the Chasm” by Geoffrey Moore: Dr. Mansi’s book recommendation for all tech entrepreneurs

]]> 2729 no Ep. 131 Novel Treatment of Unicameral and Aneurysmal Bone Cysts with Dr. Shankar Rajeswaran Dr. Sabeen Dhand chats with Interventional Radiologist Shankar Rajeswaran from Lurie Children's Hospital in Chicago about a novel minimally invasive treatment of unicameral and aneurysmal bone cysts. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PzYQjW --- SHOW NOTES In this episode, pediatric interventional radiologist Dr. Shankar Rajeswaran joins host Dr. Sabeen Dhand to discuss a novel minimally-invasive treatment for unicameral and aneurysmal bone cysts. Pediatric interventional radiology is a rapidly growing field, and Dr. Rajeswaran describes how it has evolved in complexity and innovation over the course of his career. Dr. Rajeswaran says that there is a significant challenge that pediatric IRs must overcome-- treating children with IR devices that were originally designed to be used in adults. As a result, he emphasizes the need for creativity and flexibility in this field. Next, we define and differentiate between unicameral and aneurysmal bone cysts. Both can be benign; however, they carry the risk of causing pain, bone fracture, and growth deformities. Dr. Rajeswaran outlines the current standard of care, which includes monitoring and curettage and bone grafting. Then, he describes a new method of treatment, which involves needle injection of doxycycline to burn the walls of the cyst and bone paste to help generate new bone. This method can be applied to unicameral bone cysts and aneurysmal bone cysts, and it leaves no scarring. He also discusses the recurrence rate for various treatment methods. Overall, Dr. Rajeswaran encourages anyone interested in pediatric IR to reach out to doctors in the field for shadowing opportunities and guidance. --- RESOURCES Society for Pediatric Interventional Radiology: https://www.spir.org/ Lurie Children’s Hospital blog article over novel treatment of bone cysts: https://www.luriechildrens.org/en/blog/interventional-radiology-cutting-edge-procedure-puts-brooklyn-back-in-the-game/ Mon, 07 Jun 2021 11:10:00 -0000 full BackTable Dr. Sabeen Dhand chats with Interventional Radiologist Shankar Rajeswaran from Lurie Children's Hospital in Chicago about a novel minimally invasive treatment of unicameral and aneurysmal bone cysts. Dr. Sabeen Dhand chats with Interventional Radiologist Shankar Rajeswaran from Lurie Children's Hospital in Chicago about a novel minimally invasive treatment of unicameral and aneurysmal bone cysts. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PzYQjW --- SHOW NOTES In this episode, pediatric interventional radiologist Dr. Shankar Rajeswaran joins host Dr. Sabeen Dhand to discuss a novel minimally-invasive treatment for unicameral and aneurysmal bone cysts. Pediatric interventional radiology is a rapidly growing field, and Dr. Rajeswaran describes how it has evolved in complexity and innovation over the course of his career. Dr. Rajeswaran says that there is a significant challenge that pediatric IRs must overcome-- treating children with IR devices that were originally designed to be used in adults. As a result, he emphasizes the need for creativity and flexibility in this field. Next, we define and differentiate between unicameral and aneurysmal bone cysts. Both can be benign; however, they carry the risk of causing pain, bone fracture, and growth deformities. Dr. Rajeswaran outlines the current standard of care, which includes monitoring and curettage and bone grafting. Then, he describes a new method of treatment, which involves needle injection of doxycycline to burn the walls of the cyst and bone paste to help generate new bone. This method can be applied to unicameral bone cysts and aneurysmal bone cysts, and it leaves no scarring. He also discusses the recurrence rate for various treatment methods. Overall, Dr. Rajeswaran encourages anyone interested in pediatric IR to reach out to doctors in the field for shadowing opportunities and guidance. --- RESOURCES Society for Pediatric Interventional Radiology: https://www.spir.org/ Lurie Children’s Hospital blog article over novel treatment of bone cysts: https://www.luriechildrens.org/en/blog/interventional-radiology-cutting-edge-procedure-puts-brooklyn-back-in-the-game/ Dr. Sabeen Dhand chats with Interventional Radiologist Shankar Rajeswaran from Lurie Children's Hospital in Chicago about a novel minimally invasive treatment of unicameral and aneurysmal bone cysts.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PzYQjW


---


SHOW NOTES


In this episode, pediatric interventional radiologist Dr. Shankar Rajeswaran joins host Dr. Sabeen Dhand to discuss a novel minimally-invasive treatment for unicameral and aneurysmal bone cysts.


Pediatric interventional radiology is a rapidly growing field, and Dr. Rajeswaran describes how it has evolved in complexity and innovation over the course of his career. Dr. Rajeswaran says that there is a significant challenge that pediatric IRs must overcome-- treating children with IR devices that were originally designed to be used in adults. As a result, he emphasizes the need for creativity and flexibility in this field.


Next, we define and differentiate between unicameral and aneurysmal bone cysts. Both can be benign; however, they carry the risk of causing pain, bone fracture, and growth deformities. Dr. Rajeswaran outlines the current standard of care, which includes monitoring and curettage and bone grafting. Then, he describes a new method of treatment, which involves needle injection of doxycycline to burn the walls of the cyst and bone paste to help generate new bone. This method can be applied to unicameral bone cysts and aneurysmal bone cysts, and it leaves no scarring. He also discusses the recurrence rate for various treatment methods.


Overall, Dr. Rajeswaran encourages anyone interested in pediatric IR to reach out to doctors in the field for shadowing opportunities and guidance.


---


RESOURCES


Society for Pediatric Interventional Radiology: https://www.spir.org/


Lurie Children’s Hospital blog article over novel treatment of bone cysts: https://www.luriechildrens.org/en/blog/interventional-radiology-cutting-edge-procedure-puts-brooklyn-back-in-the-game/

]]> 1916 no Ep. 130 Technologist Training and Retention with Alisha Hawrylack and Andrew Struchen We talk with radiologic technologists Andrew Struchen and Alisha Hawrylack about current training pathways for Vascular and Interventional Technologists, the importance of respect at work and in the lab, as well as key factors in recruiting and retaining top notch A-team technologists. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/xxskLL --- SHOW NOTES In this episode, interventional radiologic technologists Alisha Hawrylack and Andrew Struchen join Dr. Aaron Fritts to discuss the important role of IR technologists in the lab and major factors that affect their recruitment, training, and retention. To start, we discuss the current state of IR technologist training. Alisha describes two major educational pathways, structured training programs and on-the-job training. She says that while both modes of training can be effective, structured training programs are likely to provide deeper knowledge of anatomy and IR procedures. Andrew gives an overview of the yearlong IR technologist program at the University of Virginia, which offers a mix of didactic learning, clinical training, and mentorship. We also briefly outline the ARRT and RCIS certification requirements. Next, we address job satisfaction and turnover of IR technologists. We discuss increasing workload, staffing concerns, and the need to feel engaged in cases. Andrew recognizes that if these problems are not addressed, technologists will start seeking other opportunities, such as careers within industry. Alisha emphasizes that technologists at academic institutions are excited about innovative procedures and seek ways to positively contribute to outcomes. Finally, we discuss team culture and ways to cultivate respectful relationships between technologists and other clinicians. We talk about our experiences with giving team members the benefit of the doubt, learning how to work with other teammates, and resolving miscommunication. --- RESOURCES Charles J. Tegtmeyer Program of Interventional Radiology and Special Procedures at the University of Virginia Medical Center: med.virginia.edu/radiology/educat…ogist-education/ Alisha Hawrylack: ac4nf@hscmail.mcc.virginia.edu Andrew Struchen: ads6r@hscmail.mcc.virginia.edu Association of Vascular and Interventional Radiographers (AVIR): avir.org/ American Registry of Radiologic Technologists (ARRT): https://www.arrt.org/ Registered Cardiovascular Invasive Specialist (RCIS) Exam: cci-online.org/CCI/Certification…OrganizerCommon=2 Fri, 04 Jun 2021 12:00:00 -0000 full BackTable We talk with radiologic technologists Andrew Struchen and Alisha Hawrylack about current training pathways for Vascular and Interventional Technologists, the importance of respect at work and in the lab, as well as key factors in recruiting and retaining top notch A-team technologists. We talk with radiologic technologists Andrew Struchen and Alisha Hawrylack about current training pathways for Vascular and Interventional Technologists, the importance of respect at work and in the lab, as well as key factors in recruiting and retaining top notch A-team technologists. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/xxskLL --- SHOW NOTES In this episode, interventional radiologic technologists Alisha Hawrylack and Andrew Struchen join Dr. Aaron Fritts to discuss the important role of IR technologists in the lab and major factors that affect their recruitment, training, and retention. To start, we discuss the current state of IR technologist training. Alisha describes two major educational pathways, structured training programs and on-the-job training. She says that while both modes of training can be effective, structured training programs are likely to provide deeper knowledge of anatomy and IR procedures. Andrew gives an overview of the yearlong IR technologist program at the University of Virginia, which offers a mix of didactic learning, clinical training, and mentorship. We also briefly outline the ARRT and RCIS certification requirements. Next, we address job satisfaction and turnover of IR technologists. We discuss increasing workload, staffing concerns, and the need to feel engaged in cases. Andrew recognizes that if these problems are not addressed, technologists will start seeking other opportunities, such as careers within industry. Alisha emphasizes that technologists at academic institutions are excited about innovative procedures and seek ways to positively contribute to outcomes. Finally, we discuss team culture and ways to cultivate respectful relationships between technologists and other clinicians. We talk about our experiences with giving team members the benefit of the doubt, learning how to work with other teammates, and resolving miscommunication. --- RESOURCES Charles J. Tegtmeyer Program of Interventional Radiology and Special Procedures at the University of Virginia Medical Center: med.virginia.edu/radiology/educat…ogist-education/ Alisha Hawrylack: ac4nf@hscmail.mcc.virginia.edu Andrew Struchen: ads6r@hscmail.mcc.virginia.edu Association of Vascular and Interventional Radiographers (AVIR): avir.org/ American Registry of Radiologic Technologists (ARRT): https://www.arrt.org/ Registered Cardiovascular Invasive Specialist (RCIS) Exam: cci-online.org/CCI/Certification…OrganizerCommon=2 We talk with radiologic technologists Andrew Struchen and Alisha Hawrylack about current training pathways for Vascular and Interventional Technologists, the importance of respect at work and in the lab, as well as key factors in recruiting and retaining top notch A-team technologists.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/xxskLL


---


SHOW NOTES


In this episode, interventional radiologic technologists Alisha Hawrylack and Andrew Struchen join Dr. Aaron Fritts to discuss the important role of IR technologists in the lab and major factors that affect their recruitment, training, and retention.


To start, we discuss the current state of IR technologist training. Alisha describes two major educational pathways, structured training programs and on-the-job training. She says that while both modes of training can be effective, structured training programs are likely to provide deeper knowledge of anatomy and IR procedures. Andrew gives an overview of the yearlong IR technologist program at the University of Virginia, which offers a mix of didactic learning, clinical training, and mentorship. We also briefly outline the ARRT and RCIS certification requirements.


Next, we address job satisfaction and turnover of IR technologists. We discuss increasing workload, staffing concerns, and the need to feel engaged in cases. Andrew recognizes that if these problems are not addressed, technologists will start seeking other opportunities, such as careers within industry. Alisha emphasizes that technologists at academic institutions are excited about innovative procedures and seek ways to positively contribute to outcomes.


Finally, we discuss team culture and ways to cultivate respectful relationships between technologists and other clinicians. We talk about our experiences with giving team members the benefit of the doubt, learning how to work with other teammates, and resolving miscommunication.


---


RESOURCES


Charles J. Tegtmeyer Program of Interventional Radiology and Special Procedures at the University of Virginia Medical Center: med.virginia.edu/radiology/educat…ogist-education/

Alisha Hawrylack: ac4nf@hscmail.mcc.virginia.edu

Andrew Struchen: ads6r@hscmail.mcc.virginia.edu

Association of Vascular and Interventional Radiographers (AVIR): avir.org/

American Registry of Radiologic Technologists (ARRT): https://www.arrt.org/

Registered Cardiovascular Invasive Specialist (RCIS) Exam: cci-online.org/CCI/Certification…OrganizerCommon=2

]]> 3086 no Ep. 129 OBL/ASC Business Pearls with Dr. Jim Melton and Dr. Blake Parsons https://soundcloud.com/backtable/ep-129-oblasc-business-pearls-with-dr-jim-melton-and-dr-blake-parsons We talk with Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons about several key pieces to success in the Outpatient (OBL/ASC) setting, including partnerships, staffing, and case selection. --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/9keJUq --- SHOW NOTES In this episode, vascular surgeon Dr. Jim Melton and interventional radiologist Dr. Blake Parsons join our host Dr. Aaron Fritts to discuss how they set up the vision and structure of their Outpatient-Based Lab/Ambulatory Surgery Center (OBL/ASC). Dr. Melton begins by describing how he saw a need to make the surgery experience more patient-centered, which ultimately led him to co-found CardioVascular Health Clinic in 2015. He highlights the importance of staffing his clinic with talented individuals and strategies for retaining talent. Dr. Melton also describes how the practice navigates partnerships, pay structures, and expenses. Dr. Parsons shares his advice for marketing OBLs to referring physicians. This includes staying in touch with local providers, keeping them updated on their patients, and hosting educational events. He also covers their clinic’s process of updating and changing technology, which involves team meetings and potential vendor negotiation. Additionally, we cover virtual strategies for communicating with sales representatives during the COVID era. Overall, the doctors emphasize that the OBL path is risky, but it can turn out to be very rewarding for both patients and providers. --- RESOURCES CardioVascular Health Clinic- https://cvhealthclinic.com/ CardioVascular Health Clinic Twitter- @CVHealthClinic Avail Software- https://www.avail.io/ Tue, 01 Jun 2021 11:41:00 -0000 full BackTable We talk with Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons about several key pieces to success in the Outpatient (OBL/ASC) setting, including partnerships, staffing, and case selection. We talk with Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons about several key pieces to success in the Outpatient (OBL/ASC) setting, including partnerships, staffing, and case selection. --- CHECK OUT OUR SPONSORS Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/9keJUq --- SHOW NOTES In this episode, vascular surgeon Dr. Jim Melton and interventional radiologist Dr. Blake Parsons join our host Dr. Aaron Fritts to discuss how they set up the vision and structure of their Outpatient-Based Lab/Ambulatory Surgery Center (OBL/ASC). Dr. Melton begins by describing how he saw a need to make the surgery experience more patient-centered, which ultimately led him to co-found CardioVascular Health Clinic in 2015. He highlights the importance of staffing his clinic with talented individuals and strategies for retaining talent. Dr. Melton also describes how the practice navigates partnerships, pay structures, and expenses. Dr. Parsons shares his advice for marketing OBLs to referring physicians. This includes staying in touch with local providers, keeping them updated on their patients, and hosting educational events. He also covers their clinic’s process of updating and changing technology, which involves team meetings and potential vendor negotiation. Additionally, we cover virtual strategies for communicating with sales representatives during the COVID era. Overall, the doctors emphasize that the OBL path is risky, but it can turn out to be very rewarding for both patients and providers. --- RESOURCES CardioVascular Health Clinic- https://cvhealthclinic.com/ CardioVascular Health Clinic Twitter- @CVHealthClinic Avail Software- https://www.avail.io/ We talk with Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons about several key pieces to success in the Outpatient (OBL/ASC) setting, including partnerships, staffing, and case selection.


---


CHECK OUT OUR SPONSORS


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


Accountable Revenue Cycle Solutions

https://www.accountablerevcycle.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/9keJUq


---


SHOW NOTES


In this episode, vascular surgeon Dr. Jim Melton and interventional radiologist Dr. Blake Parsons join our host Dr. Aaron Fritts to discuss how they set up the vision and structure of their Outpatient-Based Lab/Ambulatory Surgery Center (OBL/ASC).


Dr. Melton begins by describing how he saw a need to make the surgery experience more patient-centered, which ultimately led him to co-found CardioVascular Health Clinic in 2015. He highlights the importance of staffing his clinic with talented individuals and strategies for retaining talent. Dr. Melton also describes how the practice navigates partnerships, pay structures, and expenses.


Dr. Parsons shares his advice for marketing OBLs to referring physicians. This includes staying in touch with local providers, keeping them updated on their patients, and hosting educational events. He also covers their clinic’s process of updating and changing technology, which involves team meetings and potential vendor negotiation. Additionally, we cover virtual strategies for communicating with sales representatives during the COVID era.


Overall, the doctors emphasize that the OBL path is risky, but it can turn out to be very rewarding for both patients and providers.


---


RESOURCES


CardioVascular Health Clinic- https://cvhealthclinic.com/

CardioVascular Health Clinic Twitter- @CVHealthClinic

Avail Software- https://www.avail.io/

]]> 2181 no Ep. 128 From Gadgeteer to the Boardroom. Device Innovation with IR and CMO Dr. Atul Gupta https://soundcloud.com/backtable/ep-128-from-gadgeteer-to-the-boardroom-device-innovation-with-ir-and-cmo-dr-atul-gupta We talk with Interventional Radiologist and Philips Chief Medical Officer Atul Gupta about his path from the interventional suite to the boardroom, and how physicians can work with device companies to innovate and make big impact changes in healthcare. --- SHOW NOTES In this episode, Dr. Bryan Hartley discusses the intersection of IR practice and medical device innovation with Dr. Atul Gupta, interventional radiologist and Chief Medical Officer of Philips’ Image-Guided Therapy division. Throughout the show, Dr. Gupta describes his path from medical student, to IR practice builder, to executive leader. Dr. Gupta describes his philosophy of innovation, which stems from the identification of real clinical needs. He explains why interventional radiologists are well-positioned to be device innovators and cross-specialty collaborators (Hint: It has to do with our curiosity and cool technology!). He recalls innovative mentors, or “gadgeteers,” who have inspired him to work on research projects during residency and onwards. As a result, Dr. Gupta’s work with Philips grew into a partnership and, eventually, a formalized role within the company. In addition to serving as a CMO, Dr. Gupta maintains his clinical skills by continuing to practice IR when he can. To close, we discuss exciting new topics that are on the horizon of image-guided therapy: augmented reality, artificial intelligence, and dielectric imaging. We also highlight tips for any physician who is wanting to get involved with device innovation, as well as any physician who is contemplating a new role. --- RESOURCES Philips Image Guided Therapy- https://www.usa.philips.com/healthcare/solutions/interventional-devices-and-therapies “The Infinite Game” by Simon Sinek A book that Dr. Hartley recommends for anyone interested in learning how to motivate their teams to achieve long-term success. Fri, 21 May 2021 11:21:00 -0000 full BackTable We talk with Interventional Radiologist and Philips Chief Medical Officer Atul Gupta about his path from the interventional suite to the boardroom, and how physicians can work with device companies to innovate and make big impact changes in healthcare. We talk with Interventional Radiologist and Philips Chief Medical Officer Atul Gupta about his path from the interventional suite to the boardroom, and how physicians can work with device companies to innovate and make big impact changes in healthcare. --- SHOW NOTES In this episode, Dr. Bryan Hartley discusses the intersection of IR practice and medical device innovation with Dr. Atul Gupta, interventional radiologist and Chief Medical Officer of Philips’ Image-Guided Therapy division. Throughout the show, Dr. Gupta describes his path from medical student, to IR practice builder, to executive leader. Dr. Gupta describes his philosophy of innovation, which stems from the identification of real clinical needs. He explains why interventional radiologists are well-positioned to be device innovators and cross-specialty collaborators (Hint: It has to do with our curiosity and cool technology!). He recalls innovative mentors, or “gadgeteers,” who have inspired him to work on research projects during residency and onwards. As a result, Dr. Gupta’s work with Philips grew into a partnership and, eventually, a formalized role within the company. In addition to serving as a CMO, Dr. Gupta maintains his clinical skills by continuing to practice IR when he can. To close, we discuss exciting new topics that are on the horizon of image-guided therapy: augmented reality, artificial intelligence, and dielectric imaging. We also highlight tips for any physician who is wanting to get involved with device innovation, as well as any physician who is contemplating a new role. --- RESOURCES Philips Image Guided Therapy- https://www.usa.philips.com/healthcare/solutions/interventional-devices-and-therapies “The Infinite Game” by Simon Sinek A book that Dr. Hartley recommends for anyone interested in learning how to motivate their teams to achieve long-term success. We talk with Interventional Radiologist and Philips Chief Medical Officer Atul Gupta about his path from the interventional suite to the boardroom, and how physicians can work with device companies to innovate and make big impact changes in healthcare.


---


SHOW NOTES


In this episode, Dr. Bryan Hartley discusses the intersection of IR practice and medical device innovation with Dr. Atul Gupta, interventional radiologist and Chief Medical Officer of Philips’ Image-Guided Therapy division. Throughout the show, Dr. Gupta describes his path from medical student, to IR practice builder, to executive leader.


Dr. Gupta describes his philosophy of innovation, which stems from the identification of real clinical needs. He explains why interventional radiologists are well-positioned to be device innovators and cross-specialty collaborators (Hint: It has to do with our curiosity and cool technology!). He recalls innovative mentors, or “gadgeteers,” who have inspired him to work on research projects during residency and onwards. As a result, Dr. Gupta’s work with Philips grew into a partnership and, eventually, a formalized role within the company. In addition to serving as a CMO, Dr. Gupta maintains his clinical skills by continuing to practice IR when he can.


To close, we discuss exciting new topics that are on the horizon of image-guided therapy: augmented reality, artificial intelligence, and dielectric imaging. We also highlight tips for any physician who is wanting to get involved with device innovation, as well as any physician who is contemplating a new role.


---


RESOURCES


Philips Image Guided Therapy- https://www.usa.philips.com/healthcare/solutions/interventional-devices-and-therapies


“The Infinite Game” by Simon Sinek

A book that Dr. Hartley recommends for anyone interested in learning how to motivate their teams to achieve long-term success.

]]> 2537 no Ep. 127 Portal Hypertension and Ascites Management with Hepatologist Dr. Parvez Mantry https://soundcloud.com/backtable/ep-127-portal-hypertension-and-ascites-management-with-hepatologist-dr-parvez-mantry Interventional Radiologist Christopher Beck talks with Hepatologist Parvez Mantry about the management of Portal Hypertension and Ascites, and the importance of multi-disciplinary collaborative care for these patients. --- SHOW NOTES In this episode, hepatologist Dr. Parvez Mantry joins our host Dr. Christopher Beck to discuss portal hypertension and ascites, two complications that arise from liver diseases and have a large effect on patients’ quality of life. Dr. Mantry starts the episode by sharing statistics on Chronic Liver Disease (CLD) and specifically highlights the burden of CLD on the U.S. population. He discusses various causes of CLD, including Hepatitis C, Alcohol Liver Disease, and Non-Alcoholic Steatohepatitis. Next, Dr. Mantry takes us through his diagnostic workup, including his physical examination, cross-sectional imaging, percutaneous and transjugular liver biopsies, and serological workup. He checks for complications such as portal hypertension, ascites, pedal edema, and hepatic encephalopathy. We also discuss the diagnosis of Hepatocellular Carcinoma (HCC). Then, we transition to strategies for managing ascites and portal hypertension through diuretics, paracentesis, Transjugular Intrahepatic Portosystemic Shunts (TIPS), liver transplantation, and a few experimental treatments that he is currently researching. Overall, Dr. Mantry advocates for close monitoring of symptoms and making treatment modifications as needed. Finally, when focusing on the patient experience, Dr. Mantry offers troubleshooting tips, especially for patients who struggle with leakage from the paracentesis site. To close, he gives insights on how physicians can best support chronically-ill patients who are awaiting transplantation. --- RESOURCES Methodist Transplant Specialists- https://www.theliverinstitutetx.com/ Information about Dr. Mantry’s transplant center and its satellite locations in the Dallas-Ft. Worth Community. American Association for the Study of Liver Diseases (AASLD) Practice Guidelines- https://www.aasld.org/publications/practice-guidelines Management of HCC- https://www.journal-of-hepatology.eu/article/S0168-8278(12)60009-9/pdf The Management of Ascites in Cirrhosis- https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1053/jhep.2003.50315 These are guidelines set by the International Ascites Club. BackTable Pdcast Ep. 123 TIPS University Freshman Year: Referrals and Pre-Op Workup- https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup Mon, 17 May 2021 11:14:00 -0000 full BackTable Interventional Radiologist Christopher Beck talks with Hepatologist Parvez Mantry about the management of Portal Hypertension and Ascites, and the importance of multi-disciplinary collaborative care for these patients. Interventional Radiologist Christopher Beck talks with Hepatologist Parvez Mantry about the management of Portal Hypertension and Ascites, and the importance of multi-disciplinary collaborative care for these patients. --- SHOW NOTES In this episode, hepatologist Dr. Parvez Mantry joins our host Dr. Christopher Beck to discuss portal hypertension and ascites, two complications that arise from liver diseases and have a large effect on patients’ quality of life. Dr. Mantry starts the episode by sharing statistics on Chronic Liver Disease (CLD) and specifically highlights the burden of CLD on the U.S. population. He discusses various causes of CLD, including Hepatitis C, Alcohol Liver Disease, and Non-Alcoholic Steatohepatitis. Next, Dr. Mantry takes us through his diagnostic workup, including his physical examination, cross-sectional imaging, percutaneous and transjugular liver biopsies, and serological workup. He checks for complications such as portal hypertension, ascites, pedal edema, and hepatic encephalopathy. We also discuss the diagnosis of Hepatocellular Carcinoma (HCC). Then, we transition to strategies for managing ascites and portal hypertension through diuretics, paracentesis, Transjugular Intrahepatic Portosystemic Shunts (TIPS), liver transplantation, and a few experimental treatments that he is currently researching. Overall, Dr. Mantry advocates for close monitoring of symptoms and making treatment modifications as needed. Finally, when focusing on the patient experience, Dr. Mantry offers troubleshooting tips, especially for patients who struggle with leakage from the paracentesis site. To close, he gives insights on how physicians can best support chronically-ill patients who are awaiting transplantation. --- RESOURCES Methodist Transplant Specialists- https://www.theliverinstitutetx.com/ Information about Dr. Mantry’s transplant center and its satellite locations in the Dallas-Ft. Worth Community. American Association for the Study of Liver Diseases (AASLD) Practice Guidelines- https://www.aasld.org/publications/practice-guidelines Management of HCC- https://www.journal-of-hepatology.eu/article/S0168-8278(12)60009-9/pdf The Management of Ascites in Cirrhosis- https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1053/jhep.2003.50315 These are guidelines set by the International Ascites Club. BackTable Pdcast Ep. 123 TIPS University Freshman Year: Referrals and Pre-Op Workup- https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup Interventional Radiologist Christopher Beck talks with Hepatologist Parvez Mantry about the management of Portal Hypertension and Ascites, and the importance of multi-disciplinary collaborative care for these patients.


---


SHOW NOTES


In this episode, hepatologist Dr. Parvez Mantry joins our host Dr. Christopher Beck to discuss portal hypertension and ascites, two complications that arise from liver diseases and have a large effect on patients’ quality of life.


Dr. Mantry starts the episode by sharing statistics on Chronic Liver Disease (CLD) and specifically highlights the burden of CLD on the U.S. population. He discusses various causes of CLD, including Hepatitis C, Alcohol Liver Disease, and Non-Alcoholic Steatohepatitis.


Next, Dr. Mantry takes us through his diagnostic workup, including his physical examination, cross-sectional imaging, percutaneous and transjugular liver biopsies, and serological workup. He checks for complications such as portal hypertension, ascites, pedal edema, and hepatic encephalopathy. We also discuss the diagnosis of Hepatocellular Carcinoma (HCC).


Then, we transition to strategies for managing ascites and portal hypertension through diuretics, paracentesis, Transjugular Intrahepatic Portosystemic Shunts (TIPS), liver

transplantation, and a few experimental treatments that he is currently researching. Overall, Dr. Mantry advocates for close monitoring of symptoms and making treatment modifications as needed.


Finally, when focusing on the patient experience, Dr. Mantry offers troubleshooting tips, especially for patients who struggle with leakage from the paracentesis site. To close, he gives insights on how physicians can best support chronically-ill patients who are awaiting transplantation.


---


RESOURCES


Methodist Transplant Specialists- https://www.theliverinstitutetx.com/

Information about Dr. Mantry’s transplant center and its satellite locations in the Dallas-Ft. Worth Community.


American Association for the Study of Liver Diseases (AASLD) Practice Guidelines- https://www.aasld.org/publications/practice-guidelines


Management of HCC- https://www.journal-of-hepatology.eu/article/S0168-8278(12)60009-9/pdf


The Management of Ascites in Cirrhosis- https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1053/jhep.2003.50315

These are guidelines set by the International Ascites Club.


BackTable Pdcast Ep. 123 TIPS University Freshman Year: Referrals and Pre-Op Workup- https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup

]]> 3095 no Ep. 126 TIPS University Senior Year: Gunsight Technique and Splenic Closure with Dr. Lynskey It's Senior Year at TIPS University with Dr. Emmett Lynskey talking us through his Gunsight technique for TIPS placement, as well as how to perform a safe closure of splenic access. Don't miss the first three parts of the series as well! --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/MThuo7 --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the final edition of TIPS University to discuss the gunsight technique and splenic closure. We begin by discussing where to start once the catheter is in the portal vein and you have access, and Dr. Lynskey shares why he likes to use a 8mm balloon for the angioplasty. We explain the details of the gunsight technique, how to line up the portal and hepatic snare, how to adjust the view, and how to get access to both veins using a 22 gauge chiba needle. We share why it is important to make sure that the cranial caudal difference between the portal and hepatic snare is not significant before you gunsight. We discuss how to work with wires to floss through the splenic vein. Dr. Lynskey tells us why he uses a microcatheter for an extra step instead of snaring the end of the wire. We review some situations where you can throw the snare up and stick it with a colapinto needle and some of the considerations for portal vein thrombosis when doing TIPS. We discuss splenic access and why it is important to set up for good closure. We explain the different options for splenic access, using a combination of coils, plugs, and gelfoam, and Dr. Lynskey shares which combinations he prefers to use for splenic closure. We review the technique to get images using fluoro and ultrasound. Fri, 14 May 2021 12:00:00 -0000 full BackTable It's Senior Year at TIPS University with Dr. Emmett Lynskey talking us through his Gunsight technique for TIPS placement, as well as how to perform a safe closure of splenic access. Don't miss the first three parts of the series as well! It's Senior Year at TIPS University with Dr. Emmett Lynskey talking us through his Gunsight technique for TIPS placement, as well as how to perform a safe closure of splenic access. Don't miss the first three parts of the series as well! --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/MThuo7 --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the final edition of TIPS University to discuss the gunsight technique and splenic closure. We begin by discussing where to start once the catheter is in the portal vein and you have access, and Dr. Lynskey shares why he likes to use a 8mm balloon for the angioplasty. We explain the details of the gunsight technique, how to line up the portal and hepatic snare, how to adjust the view, and how to get access to both veins using a 22 gauge chiba needle. We share why it is important to make sure that the cranial caudal difference between the portal and hepatic snare is not significant before you gunsight. We discuss how to work with wires to floss through the splenic vein. Dr. Lynskey tells us why he uses a microcatheter for an extra step instead of snaring the end of the wire. We review some situations where you can throw the snare up and stick it with a colapinto needle and some of the considerations for portal vein thrombosis when doing TIPS. We discuss splenic access and why it is important to set up for good closure. We explain the different options for splenic access, using a combination of coils, plugs, and gelfoam, and Dr. Lynskey shares which combinations he prefers to use for splenic closure. We review the technique to get images using fluoro and ultrasound. It's Senior Year at TIPS University with Dr. Emmett Lynskey talking us through his Gunsight technique for TIPS placement, as well as how to perform a safe closure of splenic access. Don't miss the first three parts of the series as well!


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/MThuo7


---


SHOW NOTES


In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the final edition of TIPS University to discuss the gunsight technique and splenic closure. We begin by discussing where to start once the catheter is in the portal vein and you have access, and Dr. Lynskey shares why he likes to use a 8mm balloon for the angioplasty.


We explain the details of the gunsight technique, how to line up the portal and hepatic snare, how to adjust the view, and how to get access to both veins using a 22 gauge chiba needle. We share why it is important to make sure that the cranial caudal difference between the portal and hepatic snare is not significant before you gunsight. We discuss how to work with wires to floss through the splenic vein. Dr. Lynskey tells us why he uses a microcatheter for an extra step instead of snaring the end of the wire. We review some situations where you can throw the snare up and stick it with a colapinto needle and some of the considerations for portal vein thrombosis when doing TIPS.


We discuss splenic access and why it is important to set up for good closure. We explain the different options for splenic access, using a combination of coils, plugs, and gelfoam, and Dr. Lynskey shares which combinations he prefers to use for splenic closure. We review the technique to get images using fluoro and ultrasound.

]]> 2074 no Ep. 125 TIPS University Junior Year: Advanced Techniques, ICE, and Splenic Access with Dr. Lynskey https://soundcloud.com/backtable/ep-125-tips-university-junior-year-advanced-techniques-ice-and-splenic-access-with-dr-lynskey It's Junior Year at TIPS University with Dr. Emmett Lynskey walking through advanced techniques for TIPS, including using Intracardiac Echocardiography (ICE) for placement, as well as transsplenic access for portal reconstruction. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Il3qDw --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the third edition of TIPS University to discuss intracardiac echo (ICE) and splenic access in TIPS procedures. We discuss the learning curve associated with ICE and Dr. Lynskey tells us about the early challenges he faced when learning this technique. We share why using ICE is helpful in TIPS and how to set up the procedure, depending on the type of access you want. We explain how to get a more medial throw by getting the catheter closer to the portal vein, and we discuss how to torque the needle for different throws. We discuss making throws using an ICE probe and why ICE is helpful for acutely thrombosed TIPS revisions. Dr. Lynskey tells us about some other good uses for the ICE catheter. We discuss splenic access, and we review the conditions that allow for safe splenic access. We explain how to do the ultrasound evaluation anterior to the probe. Dr. Lynskey shares why he dedicates one hand for the wire and one hand for the ultrasound, and he tells us how he picks the sheaths and wires that he uses to get splenic access. We discuss how to know that you have opened up the splenic vein. --- RESOURCES Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse Mon, 10 May 2021 11:09:00 -0000 full BackTable It's Junior Year at TIPS University with Dr. Emmett Lynskey walking through advanced techniques for TIPS, including using Intracardiac Echocardiography (ICE) for placement, as well as transsplenic access for portal reconstruction. It's Junior Year at TIPS University with Dr. Emmett Lynskey walking through advanced techniques for TIPS, including using Intracardiac Echocardiography (ICE) for placement, as well as transsplenic access for portal reconstruction. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Il3qDw --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the third edition of TIPS University to discuss intracardiac echo (ICE) and splenic access in TIPS procedures. We discuss the learning curve associated with ICE and Dr. Lynskey tells us about the early challenges he faced when learning this technique. We share why using ICE is helpful in TIPS and how to set up the procedure, depending on the type of access you want. We explain how to get a more medial throw by getting the catheter closer to the portal vein, and we discuss how to torque the needle for different throws. We discuss making throws using an ICE probe and why ICE is helpful for acutely thrombosed TIPS revisions. Dr. Lynskey tells us about some other good uses for the ICE catheter. We discuss splenic access, and we review the conditions that allow for safe splenic access. We explain how to do the ultrasound evaluation anterior to the probe. Dr. Lynskey shares why he dedicates one hand for the wire and one hand for the ultrasound, and he tells us how he picks the sheaths and wires that he uses to get splenic access. We discuss how to know that you have opened up the splenic vein. --- RESOURCES Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse It's Junior Year at TIPS University with Dr. Emmett Lynskey walking through advanced techniques for TIPS, including using Intracardiac Echocardiography (ICE) for placement, as well as transsplenic access for portal reconstruction.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Il3qDw


---


SHOW NOTES


In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the third edition of TIPS University to discuss intracardiac echo (ICE) and splenic access in TIPS procedures. We discuss the learning curve associated with ICE and Dr. Lynskey tells us about the early challenges he faced when learning this technique.


We share why using ICE is helpful in TIPS and how to set up the procedure, depending on the type of access you want. We explain how to get a more medial throw by getting the catheter closer to the portal vein, and we discuss how to torque the needle for different throws. We discuss making throws using an ICE probe and why ICE is helpful for acutely thrombosed TIPS revisions. Dr. Lynskey tells us about some other good uses for the ICE catheter.


We discuss splenic access, and we review the conditions that allow for safe splenic access. We explain how to do the ultrasound evaluation anterior to the probe. Dr. Lynskey shares why he dedicates one hand for the wire and one hand for the ultrasound, and he tells us how he picks the sheaths and wires that he uses to get splenic access. We discuss how to know that you have opened up the splenic vein.


---


RESOURCES


Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse

]]> 3505 no Ep. 124 TIPS University Sophomore Year: Basic Procedure Techniques with Dr. Emmett Lynskey It's Sophomore Year at TIPS University with Dr. Emmett Lynskey and Dr. Christopher Beck discussing basic procedure technique for Transjugular Intrahepatic Portosystemic Shunts (TIPS). --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/jfkcyQ --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the second edition of TIPS University to discuss basic TIPS procedure techniques. Dr. Lynskey starts us off by talking through the steps of getting access for a basic TIPS procedure, and he tells us how to check if there is a large difference between wedge pressure and the true portal pressure. Next, we discuss doing a puff or a run of the vein to make sure that there is no obstruction of outflow. Dr Lynskey compares new and old techniques for getting the sheath into the vein, and he explains two different methods, bare back and over the wire, for getting the needle down for the TIPS procedure. We outline what you should expect to see after doing a puff of contrast, how to locate the central portal vein, and the differences between using CO2 and contrast. Dr. Lynskey shares what factors he considers when choosing a wire for TIPS and how he uses a pigtail and a sheath to perform a dual run. We review the purpose of a dual run and discuss the details of opening the tip once the sheath is down. We then compare the final steps of the TIPS procedure based on whether or not you will embolize, and give a brief overview of embolizing using a fogarty balloon. Dr. Lynskey goes over his goal frame rate for the final run of the TIPS, and he explains how to check the flow dynamic of blood going to the liver. He tells us about follow-up care and how it changes if a patient develops encephalopathy. We end the episode by discussing the importance of counseling patients and caretakers on medications. Fri, 07 May 2021 11:06:00 -0000 full BackTable It's Sophomore Year at TIPS University with Dr. Emmett Lynskey and Dr. Christopher Beck discussing basic procedure technique for Transjugular Intrahepatic Portosystemic Shunts (TIPS). It's Sophomore Year at TIPS University with Dr. Emmett Lynskey and Dr. Christopher Beck discussing basic procedure technique for Transjugular Intrahepatic Portosystemic Shunts (TIPS). --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/jfkcyQ --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the second edition of TIPS University to discuss basic TIPS procedure techniques. Dr. Lynskey starts us off by talking through the steps of getting access for a basic TIPS procedure, and he tells us how to check if there is a large difference between wedge pressure and the true portal pressure. Next, we discuss doing a puff or a run of the vein to make sure that there is no obstruction of outflow. Dr Lynskey compares new and old techniques for getting the sheath into the vein, and he explains two different methods, bare back and over the wire, for getting the needle down for the TIPS procedure. We outline what you should expect to see after doing a puff of contrast, how to locate the central portal vein, and the differences between using CO2 and contrast. Dr. Lynskey shares what factors he considers when choosing a wire for TIPS and how he uses a pigtail and a sheath to perform a dual run. We review the purpose of a dual run and discuss the details of opening the tip once the sheath is down. We then compare the final steps of the TIPS procedure based on whether or not you will embolize, and give a brief overview of embolizing using a fogarty balloon. Dr. Lynskey goes over his goal frame rate for the final run of the TIPS, and he explains how to check the flow dynamic of blood going to the liver. He tells us about follow-up care and how it changes if a patient develops encephalopathy. We end the episode by discussing the importance of counseling patients and caretakers on medications. It's Sophomore Year at TIPS University with Dr. Emmett Lynskey and Dr. Christopher Beck discussing basic procedure technique for Transjugular Intrahepatic Portosystemic Shunts (TIPS).


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/jfkcyQ


---


SHOW NOTES


In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the second edition of TIPS University to discuss basic TIPS procedure techniques. Dr. Lynskey starts us off by talking through the steps of getting access for a basic TIPS procedure, and he tells us how to check if there is a large difference between wedge pressure and the true portal pressure.


Next, we discuss doing a puff or a run of the vein to make sure that there is no obstruction of outflow. Dr Lynskey compares new and old techniques for getting the sheath into the vein, and he explains two different methods, bare back and over the wire, for getting the needle down for the TIPS procedure. We outline what you should expect to see after doing a puff of contrast, how to locate the central portal vein, and the differences between using CO2 and contrast.


Dr. Lynskey shares what factors he considers when choosing a wire for TIPS and how he uses a pigtail and a sheath to perform a dual run. We review the purpose of a dual run and discuss the details of opening the tip once the sheath is down. We then compare the final steps of the TIPS procedure based on whether or not you will embolize, and give a brief overview of embolizing using a fogarty balloon.


Dr. Lynskey goes over his goal frame rate for the final run of the TIPS, and he explains how to check the flow dynamic of blood going to the liver. He tells us about follow-up care and how it changes if a patient develops encephalopathy. We end the episode by discussing the importance of counseling patients and caretakers on medications.

]]> 3944 no Ep. 123 TIPS University Freshman Year: Referrals and Pre-op Workup with Dr. Emmett Lynskey We start our TIPS University series with Interventional Radiologist Dr. Emmett Lynskey discussing referral sources and pre-operative workup, including the importance of patient selection and MELD score. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/GKHtWA --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the first edition of TIPS University to discuss referrals and pre-op for transjugular intrahepatic portosystemic shunts (TIPS). Dr. Lynskey begins by telling us about his fellowship at Georgetown, his current practice, and how he became interested in portal hypertension. We talk through the most common indicators for a TIPS procedure, including refractory ascites, portal vein thrombosis, and acute bleeders. Dr. Lynskey explains how patients are referred to him, and he outlines what factors he considers before determining the eligibility for TIPS. We then discuss how useful cross sectional imaging is, and we break down the Model for End-Stage Liver Disease (MELD) score. Dr. Lynskey shares the components that make up the MELD score as well as the cutoffs and thresholds for a TIPS patient. Next, we review diuretics and emphasize the importance of being honest with patients regarding expectations post-procedure. We explain how to phrase questions when working with cardiologists. Dr. Lynskey goes over what all he can determine from cross-sectional imaging prior to the procedure, and he tells us when he might consider an alternative to TIPS. We discuss which labs should be done the day of the procedure and why Dr. Lynskey gets MELD labs again just before the TIPS. Dr. Lynskey tells us about blood typing, crossmatching, and fibrinogen levels. The episode wraps with Dr. Lynskey explaining the benefits of performing a paracentesis prior to TIPS. --- RESOURCES Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse Mon, 03 May 2021 11:20:00 -0000 full BackTable We start our TIPS University series with Interventional Radiologist Dr. Emmett Lynskey discussing referral sources and pre-operative workup, including the importance of patient selection and MELD score. We start our TIPS University series with Interventional Radiologist Dr. Emmett Lynskey discussing referral sources and pre-operative workup, including the importance of patient selection and MELD score. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/GKHtWA --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the first edition of TIPS University to discuss referrals and pre-op for transjugular intrahepatic portosystemic shunts (TIPS). Dr. Lynskey begins by telling us about his fellowship at Georgetown, his current practice, and how he became interested in portal hypertension. We talk through the most common indicators for a TIPS procedure, including refractory ascites, portal vein thrombosis, and acute bleeders. Dr. Lynskey explains how patients are referred to him, and he outlines what factors he considers before determining the eligibility for TIPS. We then discuss how useful cross sectional imaging is, and we break down the Model for End-Stage Liver Disease (MELD) score. Dr. Lynskey shares the components that make up the MELD score as well as the cutoffs and thresholds for a TIPS patient. Next, we review diuretics and emphasize the importance of being honest with patients regarding expectations post-procedure. We explain how to phrase questions when working with cardiologists. Dr. Lynskey goes over what all he can determine from cross-sectional imaging prior to the procedure, and he tells us when he might consider an alternative to TIPS. We discuss which labs should be done the day of the procedure and why Dr. Lynskey gets MELD labs again just before the TIPS. Dr. Lynskey tells us about blood typing, crossmatching, and fibrinogen levels. The episode wraps with Dr. Lynskey explaining the benefits of performing a paracentesis prior to TIPS. --- RESOURCES Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse We start our TIPS University series with Interventional Radiologist Dr. Emmett Lynskey discussing referral sources and pre-operative workup, including the importance of patient selection and MELD score.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/GKHtWA


---


SHOW NOTES


In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the first edition of TIPS University to discuss referrals and pre-op for transjugular intrahepatic portosystemic shunts (TIPS). Dr. Lynskey begins by telling us about his fellowship at Georgetown, his current practice, and how he became interested in portal hypertension.


We talk through the most common indicators for a TIPS procedure, including refractory ascites, portal vein thrombosis, and acute bleeders. Dr. Lynskey explains how patients are referred to him, and he outlines what factors he considers before determining the eligibility for TIPS. We then discuss how useful cross sectional imaging is, and we break down the Model for End-Stage Liver Disease (MELD) score. Dr. Lynskey shares the components that make up the MELD score as well as the cutoffs and thresholds for a TIPS patient.


Next, we review diuretics and emphasize the importance of being honest with patients regarding expectations post-procedure. We explain how to phrase questions when working with cardiologists. Dr. Lynskey goes over what all he can determine from cross-sectional imaging prior to the procedure, and he tells us when he might consider an alternative to TIPS.


We discuss which labs should be done the day of the procedure and why Dr. Lynskey gets MELD labs again just before the TIPS. Dr. Lynskey tells us about blood typing, crossmatching, and fibrinogen levels. The episode wraps with Dr. Lynskey explaining the benefits of performing a paracentesis prior to TIPS.


---


RESOURCES


Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse

]]> 2654 no Ep. 122 History of the TIPS Procedure: An Interview with Barry Uchida https://soundcloud.com/backtable/ep-122-history-of-the-tips-procedure-an-interview-with-barry-uchida Interventional Radiologist Peder Horner talks with Barry Uchida about the early days at The Dotter Institute, with stories about working alongside Josef Rösch on developing the first TIPS sets, as well as working with other legends in the field including Charles Dotter, Fred Keller, and Julio Palmaz. Mon, 26 Apr 2021 11:08:00 -0000 full BackTable Interventional Radiologist Peder Horner talks with Barry Uchida about the early days at The Dotter Institute, with stories about working alongside Josef Rösch on developing the first TIPS sets, as well as working with other legends in the field including Charles Dotter, Fred Keller, and Julio Palmaz. Interventional Radiologist Peder Horner talks with Barry Uchida about the early days at The Dotter Institute, with stories about working alongside Josef Rösch on developing the first TIPS sets, as well as working with other legends in the field including Charles Dotter, Fred Keller, and Julio Palmaz. Interventional Radiologist Peder Horner talks with Barry Uchida about the early days at The Dotter Institute, with stories about working alongside Josef Rösch on developing the first TIPS sets, as well as working with other legends in the field including Charles Dotter, Fred Keller, and Julio Palmaz.

]]> 2939 no Ep. 121 OBL's and What You Can Do in Them with Dr. Mike Watts Interventional Radiologist Dr. Mike Watts talks with us about which procedures are being safely performed in the OBL space, and the importance of patient selection. --- CHECK OUT OUR SPONSORS Medtronic VenaSeal https://www.medtronic.com/impact Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/N4Sfrb --- SHOW NOTES In this episode, Dr. Mike Watts joins Dr. Michael Barraza to discuss Office Based Labs (OBLs). We begin by explaining what an OBL is and how OBLs are different from Ambulatory Surgery Centers (ASC’s). Dr. Watts tells us about some of the advantages of working in an OBL, including reimbursement rates, patient access, and scheduling, and we talk about how the general patient experience is different. Next, we give an overview of how to work with referring doctors at nearby hospitals and build relationships with departments outside of interventional radiology, such as oncology and urology. Dr. Watts shares the advantages of being a full-service IR group, and he tells us how he coordinates patient care between the OBL and hospitals when needed. We also discuss how to expand an OBL practice to become a full-service IR group, how to make yourself valuable within an OBL, and how to participate in ongoing clinical studies. We end the episode with Dr. Watts telling us what is on the horizon for OBLs and what he would like to see in the future. Mon, 19 Apr 2021 12:00:00 -0000 full BackTable Interventional Radiologist Dr. Mike Watts talks with us about which procedures are being safely performed in the OBL space, and the importance of patient selection. Interventional Radiologist Dr. Mike Watts talks with us about which procedures are being safely performed in the OBL space, and the importance of patient selection. --- CHECK OUT OUR SPONSORS Medtronic VenaSeal https://www.medtronic.com/impact Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/N4Sfrb --- SHOW NOTES In this episode, Dr. Mike Watts joins Dr. Michael Barraza to discuss Office Based Labs (OBLs). We begin by explaining what an OBL is and how OBLs are different from Ambulatory Surgery Centers (ASC’s). Dr. Watts tells us about some of the advantages of working in an OBL, including reimbursement rates, patient access, and scheduling, and we talk about how the general patient experience is different. Next, we give an overview of how to work with referring doctors at nearby hospitals and build relationships with departments outside of interventional radiology, such as oncology and urology. Dr. Watts shares the advantages of being a full-service IR group, and he tells us how he coordinates patient care between the OBL and hospitals when needed. We also discuss how to expand an OBL practice to become a full-service IR group, how to make yourself valuable within an OBL, and how to participate in ongoing clinical studies. We end the episode with Dr. Watts telling us what is on the horizon for OBLs and what he would like to see in the future. Interventional Radiologist Dr. Mike Watts talks with us about which procedures are being safely performed in the OBL space, and the importance of patient selection.


---


CHECK OUT OUR SPONSORS


Medtronic VenaSeal

https://www.medtronic.com/impact


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


Accountable Revenue Cycle Solutions

https://www.accountablerevcycle.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/N4Sfrb


---


SHOW NOTES


In this episode, Dr. Mike Watts joins Dr. Michael Barraza to discuss Office Based Labs (OBLs). We begin by explaining what an OBL is and how OBLs are different from Ambulatory Surgery Centers (ASC’s). Dr. Watts tells us about some of the advantages of working in an OBL, including reimbursement rates, patient access, and scheduling, and we talk about how the general patient experience is different.


Next, we give an overview of how to work with referring doctors at nearby hospitals and build relationships with departments outside of interventional radiology, such as oncology and urology. Dr. Watts shares the advantages of being a full-service IR group, and he tells us how he coordinates patient care between the OBL and hospitals when needed.


We also discuss how to expand an OBL practice to become a full-service IR group, how to make yourself valuable within an OBL, and how to participate in ongoing clinical studies. We end the episode with Dr. Watts telling us what is on the horizon for OBLs and what he would like to see in the future.

]]> 2258 no Ep. 120 Pulmonary Embolism (PE) Interventions and Response Teams with Dr. Eric Secemsky Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist Eric Secemsky about building a Pulmonary Embolism (PE) Response Team, and about the various techniques for treatment of PE used in his practice. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/8gzIHN --- SHOW NOTES In this episode, interventional cardiologist Dr. Eric Secemsky and our host Dr. Sabeen Dhand discuss pulmonary embolization and the coordination of Pulmonary Embolism Response Teams (PERTs). Dr. Secemsky starts by introducing the diagnosis of pulmonary embolisms. He explains the classification of patients into the categories of massive, submassive, and low-risk embolisms, as well as echocardiogram and CT imaging. His workup includes not only checking for clot burden, but also checking for vital sign abnormalities, evidence of right ventricle dysfunction, and neurological deficits. Then, we transition to talking about the structure, workflow, and communication technologies used in pulmonary embolism response teams. Dr. Secemsky describes his experience with building a response team and ensuring its adaptability for a variety of cases. He emphasizes the importance of multidisciplinary care and team members’ accountability for every patient. Finally, we discuss treatment of pulmonary embolism, based on how emergent a case is. Dr. Secemsky describes factors to consider when employing different treatments: clot extraction devices, thrombolytics, and anticoagulants. Additionally, we cover the topics of catheter-directed thrombolysis, mechanical thrombectomy, and surgical embolectomy. --- RESOURCES Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association- https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000707 AHA guidelines for the classification of massive, submassive, and low-risk pulmonary embolisms. PERT Consortium- https://pertconsortium.org/ Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714903/ SUNSET sPE study- https://vivaphysicians.org/news-article?id=88424 Mon, 12 Apr 2021 11:06:00 -0000 full BackTable Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist Eric Secemsky about building a Pulmonary Embolism (PE) Response Team, and about the various techniques for treatment of PE used in his practice. Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist Eric Secemsky about building a Pulmonary Embolism (PE) Response Team, and about the various techniques for treatment of PE used in his practice. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/8gzIHN --- SHOW NOTES In this episode, interventional cardiologist Dr. Eric Secemsky and our host Dr. Sabeen Dhand discuss pulmonary embolization and the coordination of Pulmonary Embolism Response Teams (PERTs). Dr. Secemsky starts by introducing the diagnosis of pulmonary embolisms. He explains the classification of patients into the categories of massive, submassive, and low-risk embolisms, as well as echocardiogram and CT imaging. His workup includes not only checking for clot burden, but also checking for vital sign abnormalities, evidence of right ventricle dysfunction, and neurological deficits. Then, we transition to talking about the structure, workflow, and communication technologies used in pulmonary embolism response teams. Dr. Secemsky describes his experience with building a response team and ensuring its adaptability for a variety of cases. He emphasizes the importance of multidisciplinary care and team members’ accountability for every patient. Finally, we discuss treatment of pulmonary embolism, based on how emergent a case is. Dr. Secemsky describes factors to consider when employing different treatments: clot extraction devices, thrombolytics, and anticoagulants. Additionally, we cover the topics of catheter-directed thrombolysis, mechanical thrombectomy, and surgical embolectomy. --- RESOURCES Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association- https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000707 AHA guidelines for the classification of massive, submassive, and low-risk pulmonary embolisms. PERT Consortium- https://pertconsortium.org/ Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714903/ SUNSET sPE study- https://vivaphysicians.org/news-article?id=88424 Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist Eric Secemsky about building a Pulmonary Embolism (PE) Response Team, and about the various techniques for treatment of PE used in his practice.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/8gzIHN


---


SHOW NOTES


In this episode, interventional cardiologist Dr. Eric Secemsky and our host Dr. Sabeen Dhand discuss pulmonary embolization and the coordination of Pulmonary Embolism Response Teams (PERTs).


Dr. Secemsky starts by introducing the diagnosis of pulmonary embolisms. He explains the classification of patients into the categories of massive, submassive, and low-risk embolisms, as well as echocardiogram and CT imaging. His workup includes not only checking for clot burden, but also checking for vital sign abnormalities, evidence of right ventricle dysfunction, and neurological deficits.


Then, we transition to talking about the structure, workflow, and communication technologies used in pulmonary embolism response teams. Dr. Secemsky describes his experience with building a response team and ensuring its adaptability for a variety of cases. He emphasizes the importance of multidisciplinary care and team members’ accountability for every patient.


Finally, we discuss treatment of pulmonary embolism, based on how emergent a case is. Dr. Secemsky describes factors to consider when employing different treatments: clot extraction devices, thrombolytics, and anticoagulants. Additionally, we cover the topics of catheter-directed thrombolysis, mechanical thrombectomy, and surgical embolectomy.


---


RESOURCES


Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association- https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000707

AHA guidelines for the classification of massive, submassive, and low-risk pulmonary embolisms.


PERT Consortium- https://pertconsortium.org/


Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714903/


SUNSET sPE study- https://vivaphysicians.org/news-article?id=88424

]]> 3092 no Ep. 119 Intravascular Ultrasound (IVUS) for Peripheral Arterial Work with Dr. Bryan Fisher Interventional Radiologist Sabeen Dhand talks with Vascular Surgeon Bryan Fisher about the benefits of using Intravascular Ultrasound (IVUS) for endovascular treatment of peripheral arterial disease (PAD), as well as the potential for other emerging imaging modalities such as Optical Coherence Tomography (OCT). --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/V3Kshz Mon, 05 Apr 2021 12:00:00 -0000 full BackTable Interventional Radiologist Sabeen Dhand talks with Vascular Surgeon Bryan Fisher about the benefits of using Intravascular Ultrasound (IVUS) for endovascular treatment of peripheral arterial disease (PAD), as well as the potential for other emerging imaging modalities such as Optical Coherence Tomography (OCT). Interventional Radiologist Sabeen Dhand talks with Vascular Surgeon Bryan Fisher about the benefits of using Intravascular Ultrasound (IVUS) for endovascular treatment of peripheral arterial disease (PAD), as well as the potential for other emerging imaging modalities such as Optical Coherence Tomography (OCT). --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/V3Kshz Interventional Radiologist Sabeen Dhand talks with Vascular Surgeon Bryan Fisher about the benefits of using Intravascular Ultrasound (IVUS) for endovascular treatment of peripheral arterial disease (PAD), as well as the potential for other emerging imaging modalities such as Optical Coherence Tomography (OCT).


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/V3Kshz

]]> 2429 no Ep. 118 Treating Acute Limb Ischemia with Dr. Donald Garbett https://soundcloud.com/backtable/ep-118-treating-acute-limb-ischemia-with-dr-donald-garbett Interventional Radiologist Dr. Donald Garbett talks with Dr. Michael Barraza about how he approaches acute limb ischemia, including different endovascular techniques for removing acute arterial clot. --- SHOW NOTES In this episode, Dr. Donald Garbett joins Dr. Michael Barraza to discuss treating acute limb ischemia. We explain when to take a hospital patient to the OR instead of angio, and Dr. Garbett tells us why he prefers establishing severity of the limb ischemia using the Rutherford classification. We discuss the circumstances of needing to have an immediate procedure, and what challenges may occur in these patients. We discuss the beginning of treating acute limb ischemia, including getting access, initial angions, and when to get an ACT. We review how to get femoral access, and we explain some cases where a different type of access is needed. We discuss which sheath size to use for diagnostics and when lysing overnight. Dr. Garbett tells us when he will lyse while treating acute limb ischemia and why he treats the underlying issue first. We review the different kinds of grafts, and we discuss what guides the approach to re-vascularizing a graft. We talk through some challenging situations that can occur when working on a graft and the dangers of the lipstick effect. We discuss how to use balloons to treat an underlying stenosis and how to deal with an unexpected intraprocedural clot. We discuss follow-up care and working with vascular surgery to coordinate care. Mon, 29 Mar 2021 11:00:00 -0000 full BackTable Interventional Radiologist Dr. Donald Garbett talks with Dr. Michael Barraza about how he approaches acute limb ischemia, including different endovascular techniques for removing acute arterial clot. Interventional Radiologist Dr. Donald Garbett talks with Dr. Michael Barraza about how he approaches acute limb ischemia, including different endovascular techniques for removing acute arterial clot. --- SHOW NOTES In this episode, Dr. Donald Garbett joins Dr. Michael Barraza to discuss treating acute limb ischemia. We explain when to take a hospital patient to the OR instead of angio, and Dr. Garbett tells us why he prefers establishing severity of the limb ischemia using the Rutherford classification. We discuss the circumstances of needing to have an immediate procedure, and what challenges may occur in these patients. We discuss the beginning of treating acute limb ischemia, including getting access, initial angions, and when to get an ACT. We review how to get femoral access, and we explain some cases where a different type of access is needed. We discuss which sheath size to use for diagnostics and when lysing overnight. Dr. Garbett tells us when he will lyse while treating acute limb ischemia and why he treats the underlying issue first. We review the different kinds of grafts, and we discuss what guides the approach to re-vascularizing a graft. We talk through some challenging situations that can occur when working on a graft and the dangers of the lipstick effect. We discuss how to use balloons to treat an underlying stenosis and how to deal with an unexpected intraprocedural clot. We discuss follow-up care and working with vascular surgery to coordinate care. Interventional Radiologist Dr. Donald Garbett talks with Dr. Michael Barraza about how he approaches acute limb ischemia, including different endovascular techniques for removing acute arterial clot.


---


SHOW NOTES


In this episode, Dr. Donald Garbett joins Dr. Michael Barraza to discuss treating acute limb ischemia. We explain when to take a hospital patient to the OR instead of angio, and Dr. Garbett tells us why he prefers establishing severity of the limb ischemia using the Rutherford classification. We discuss the circumstances of needing to have an immediate procedure, and what challenges may occur in these patients.


We discuss the beginning of treating acute limb ischemia, including getting access, initial angions, and when to get an ACT. We review how to get femoral access, and we explain some cases where a different type of access is needed. We discuss which sheath size to use for diagnostics and when lysing overnight. Dr. Garbett tells us when he will lyse while treating acute limb ischemia and why he treats the underlying issue first.


We review the different kinds of grafts, and we discuss what guides the approach to re-vascularizing a graft. We talk through some challenging situations that can occur when working on a graft and the dangers of the lipstick effect. We discuss how to use balloons to treat an underlying stenosis and how to deal with an unexpected intraprocedural clot. We discuss follow-up care and working with vascular surgery to coordinate care.

]]> 2964 no Ep. 117 Successful (and Quick!) Declots for AV Access with Dr. Neghae Mawla https://soundcloud.com/backtable/ep-117-successful-declots-for-av-access-with-dr-neghae-mawla Interventional Radiologist Christopher Beck talks with Interventional Nephrologist Neghae Mawla about how to perform successful Declot procedures for AV fistulae and grafts, including tips and tricks to make this procedure safe and efficient. --- SHOW NOTES In this episode, Dr. Neghae Mawla joins Dr. Christopher Beck and Dr. Aaron Fritts to discuss declots for AV access. We discuss what to include in a work up for a declot and how to assess the size of an aneurysm. Dr. Mawla tells us about the cases where he would not perform a declot, and he explains why he might choose to place catheter and dialyze first. We discuss how to set up the room and how to prepare for the declot procedure. Dr. Mawla shares the reasons why he does not use an IV or ultrasound in pre-op. We explain the differences between using balloon maceration vs rotational thrombectomy device for treating outflow clot. We also touch on the back bleeding technique for declots. We review the up-down technique, how to use ultrasound to your advantage, and how to avoid overlapping sheaths. We discuss clot burden and why declot procedure length may vary. We explain some different techniques for using multiple sheaths at a time, and Dr. Mawla tells us about troubleshooting during a recalcitrant stenosis. We discuss how to decide when to stent lesions and what follow-up care looks like. Dr. Beck and Dr. Fritts share some of their favorite things they have learned from Dr. Mawla about declots. Mon, 22 Mar 2021 01:12:00 -0000 full BackTable Interventional Radiologist Christopher Beck talks with Interventional Nephrologist Neghae Mawla about how to perform successful Declot procedures for AV fistulae and grafts, including tips and tricks to make this procedure safe and efficient. Interventional Radiologist Christopher Beck talks with Interventional Nephrologist Neghae Mawla about how to perform successful Declot procedures for AV fistulae and grafts, including tips and tricks to make this procedure safe and efficient. --- SHOW NOTES In this episode, Dr. Neghae Mawla joins Dr. Christopher Beck and Dr. Aaron Fritts to discuss declots for AV access. We discuss what to include in a work up for a declot and how to assess the size of an aneurysm. Dr. Mawla tells us about the cases where he would not perform a declot, and he explains why he might choose to place catheter and dialyze first. We discuss how to set up the room and how to prepare for the declot procedure. Dr. Mawla shares the reasons why he does not use an IV or ultrasound in pre-op. We explain the differences between using balloon maceration vs rotational thrombectomy device for treating outflow clot. We also touch on the back bleeding technique for declots. We review the up-down technique, how to use ultrasound to your advantage, and how to avoid overlapping sheaths. We discuss clot burden and why declot procedure length may vary. We explain some different techniques for using multiple sheaths at a time, and Dr. Mawla tells us about troubleshooting during a recalcitrant stenosis. We discuss how to decide when to stent lesions and what follow-up care looks like. Dr. Beck and Dr. Fritts share some of their favorite things they have learned from Dr. Mawla about declots. Interventional Radiologist Christopher Beck talks with Interventional Nephrologist Neghae Mawla about how to perform successful Declot procedures for AV fistulae and grafts, including tips and tricks to make this procedure safe and efficient.


---


SHOW NOTES


In this episode, Dr. Neghae Mawla joins Dr. Christopher Beck and Dr. Aaron Fritts to discuss declots for AV access. We discuss what to include in a work up for a declot and how to assess the size of an aneurysm. Dr. Mawla tells us about the cases where he would not perform a declot, and he explains why he might choose to place catheter and dialyze first.


We discuss how to set up the room and how to prepare for the declot procedure. Dr. Mawla shares the reasons why he does not use an IV or ultrasound in pre-op. We explain the differences between using balloon maceration vs rotational thrombectomy device for treating outflow clot. We also touch on the back bleeding technique for declots.


We review the up-down technique, how to use ultrasound to your advantage, and how to avoid overlapping sheaths. We discuss clot burden and why declot procedure length may vary. We explain some different techniques for using multiple sheaths at a time, and Dr. Mawla tells us about troubleshooting during a recalcitrant stenosis. We discuss how to decide when to stent lesions and what follow-up care looks like. Dr. Beck and Dr. Fritts share some of their favorite things they have learned from Dr. Mawla about declots.

]]> 3931 no Ep. 116 Evaluation & Management (E&M) Coding 101 with Dr. Ryan Trojan https://soundcloud.com/backtable/ep-116-evaluation-management-emcoding-101-with-dr-ryan-trojan Dr. Ryan Trojan gives us a 101 on Evaluation and Management (E/M) Coding, including tips and tricks for capturing inpatient notes and practice building, as well as the updates for success in 2021. --- SHOW NOTES In this episode, Dr. Ryan Trojan joins Dr. Christopher Beck to discuss Evaluation and Management (E&M) coding in IR. We discuss what a practice that uses E&M looks like and the pros of integrating E&M into a practice while IR becomes more clinical. Dr. Trojan explains why he thinks relative value units (RVUs) are worth the bit of extra time. We clear up some of the misinformation about E&M, and we discuss global billing periods. We discuss templates, Epic, and some important details about Modifier-25 for E&M. We explain medical decision making in terms of problem point, data points, and risk. We discuss the four levels of complexity and the subsets of risk. We talk through documenting history and why it is important to use straightforward language. We discuss the most typical codes used in E&M and which codes to know for specific scenarios such as physical exams, consults, and admission. Dr. Trojan tells us some of the updates to E&M in 2021 for outpatient care. We talk about how E&M is useful when building relationships with referring doctors. --- RESOURCES Dr. Trojan’s Youtube Video https://tinyurl.com/b5pvbcer Dr. Trojan’s Templates Progress Notes: https://tinyurl.com/2uzm6hua Beck Outpatient Consultation: https://tinyurl.com/uaukf7vc Beck Inpatient Consult Note: https://tinyurl.com/a7fupr67 Resident Time Phrases: https://tinyurl.com/5uvxattn Inpatient Consult: https://tinyurl.com/2vebu7rz SIR Toolkit https://tinyurl.com/3ctz27a8 E&M Coding Education https://emuniversity.com/ Financial Advising https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse Fri, 19 Mar 2021 11:00:00 -0000 full BackTable Dr. Ryan Trojan gives us a 101 on Evaluation and Management (E/M) Coding, including tips and tricks for capturing inpatient notes and practice building, as well as the updates for success in 2021. Dr. Ryan Trojan gives us a 101 on Evaluation and Management (E/M) Coding, including tips and tricks for capturing inpatient notes and practice building, as well as the updates for success in 2021. --- SHOW NOTES In this episode, Dr. Ryan Trojan joins Dr. Christopher Beck to discuss Evaluation and Management (E&M) coding in IR. We discuss what a practice that uses E&M looks like and the pros of integrating E&M into a practice while IR becomes more clinical. Dr. Trojan explains why he thinks relative value units (RVUs) are worth the bit of extra time. We clear up some of the misinformation about E&M, and we discuss global billing periods. We discuss templates, Epic, and some important details about Modifier-25 for E&M. We explain medical decision making in terms of problem point, data points, and risk. We discuss the four levels of complexity and the subsets of risk. We talk through documenting history and why it is important to use straightforward language. We discuss the most typical codes used in E&M and which codes to know for specific scenarios such as physical exams, consults, and admission. Dr. Trojan tells us some of the updates to E&M in 2021 for outpatient care. We talk about how E&M is useful when building relationships with referring doctors. --- RESOURCES Dr. Trojan’s Youtube Video https://tinyurl.com/b5pvbcer Dr. Trojan’s Templates Progress Notes: https://tinyurl.com/2uzm6hua Beck Outpatient Consultation: https://tinyurl.com/uaukf7vc Beck Inpatient Consult Note: https://tinyurl.com/a7fupr67 Resident Time Phrases: https://tinyurl.com/5uvxattn Inpatient Consult: https://tinyurl.com/2vebu7rz SIR Toolkit https://tinyurl.com/3ctz27a8 E&M Coding Education https://emuniversity.com/ Financial Advising https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse Dr. Ryan Trojan gives us a 101 on Evaluation and Management (E/M) Coding, including tips and tricks for capturing inpatient notes and practice building, as well as the updates for success in 2021.


---


SHOW NOTES


In this episode, Dr. Ryan Trojan joins Dr. Christopher Beck to discuss Evaluation and Management (E&M) coding in IR. We discuss what a practice that uses E&M looks like and the pros of integrating E&M into a practice while IR becomes more clinical. Dr. Trojan explains why he thinks relative value units (RVUs) are worth the bit of extra time. We clear up some of the misinformation about E&M, and we discuss global billing periods.


We discuss templates, Epic, and some important details about Modifier-25 for E&M. We explain medical decision making in terms of problem point, data points, and risk. We discuss the four levels of complexity and the subsets of risk. We talk through documenting history and why it is important to use straightforward language.


We discuss the most typical codes used in E&M and which codes to know for specific scenarios such as physical exams, consults, and admission. Dr. Trojan tells us some of the updates to E&M in 2021 for outpatient care. We talk about how E&M is useful when building relationships with referring doctors.


---


RESOURCES


Dr. Trojan’s Youtube Video

https://tinyurl.com/b5pvbcer


Dr. Trojan’s Templates

Progress Notes:

https://tinyurl.com/2uzm6hua


Beck Outpatient Consultation:

https://tinyurl.com/uaukf7vc


Beck Inpatient Consult Note:

https://tinyurl.com/a7fupr67


Resident Time Phrases:

https://tinyurl.com/5uvxattn


Inpatient Consult:

https://tinyurl.com/2vebu7rz


SIR Toolkit

https://tinyurl.com/3ctz27a8


E&M Coding Education

https://emuniversity.com/


Financial Advising

https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse

]]> 3900 no Ep. 115 Novel Right Heart Interventions with Dr. John Moriarty Dr. Sabeen Dhand talks with Dr. John Moriarty about how he started removing "clot in transit" from the right heart, in addition to the PE and caval procedures, and how this service line has created a great collaboration with cardiology colleagues at UCLA Health. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XRRcBv --- SHOW NOTES In this episode, Dr. John Moriarty joins Dr. Sabeen Dhand to discuss novel right heart interventions. Dr. Moriarty tells us how he started working on right heart interventions, and we describe what a clot in transit is and how often they occur. We explain how to decide when to do a right heart intervention for various types of clots, and we discuss the difference between the European and US right heart registries. We talk through some of the common devices used for right heart interventions, such as the angiovac. We compare cable work and right heart work, and we discuss how collaborating with cardiology and anesthesia can be helpful. Dr. Moriarty tells us how often he uses a transesophageal echocardiogram (TEE). We share some advice for those hoping to start performing right heart interventions and how to build confidence when starting this part of his practice. --- RESOURCES Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse Mon, 15 Mar 2021 11:00:00 -0000 full BackTable Dr. Sabeen Dhand talks with Dr. John Moriarty about how he started removing "clot in transit" from the right heart, in addition to the PE and caval procedures, and how this service line has created a great collaboration with cardiology colleagues at UCLA Health. Dr. Sabeen Dhand talks with Dr. John Moriarty about how he started removing "clot in transit" from the right heart, in addition to the PE and caval procedures, and how this service line has created a great collaboration with cardiology colleagues at UCLA Health. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XRRcBv --- SHOW NOTES In this episode, Dr. John Moriarty joins Dr. Sabeen Dhand to discuss novel right heart interventions. Dr. Moriarty tells us how he started working on right heart interventions, and we describe what a clot in transit is and how often they occur. We explain how to decide when to do a right heart intervention for various types of clots, and we discuss the difference between the European and US right heart registries. We talk through some of the common devices used for right heart interventions, such as the angiovac. We compare cable work and right heart work, and we discuss how collaborating with cardiology and anesthesia can be helpful. Dr. Moriarty tells us how often he uses a transesophageal echocardiogram (TEE). We share some advice for those hoping to start performing right heart interventions and how to build confidence when starting this part of his practice. --- RESOURCES Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse Dr. Sabeen Dhand talks with Dr. John Moriarty about how he started removing "clot in transit" from the right heart, in addition to the PE and caval procedures, and how this service line has created a great collaboration with cardiology colleagues at UCLA Health.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XRRcBv


---


SHOW NOTES


In this episode, Dr. John Moriarty joins Dr. Sabeen Dhand to discuss novel right heart interventions. Dr. Moriarty tells us how he started working on right heart interventions, and we describe what a clot in transit is and how often they occur.


We explain how to decide when to do a right heart intervention for various types of clots, and we discuss the difference between the European and US right heart registries. We talk through some of the common devices used for right heart interventions, such as the angiovac.


We compare cable work and right heart work, and we discuss how collaborating with cardiology and anesthesia can be helpful. Dr. Moriarty tells us how often he uses a transesophageal echocardiogram (TEE). We share some advice for those hoping to start performing right heart interventions and how to build confidence when starting this part of his practice.


---


RESOURCES


Edward Jones Financial Advisor Yaphet Tadesse: https://www.edwardjones.com/us-en/financial-advisor/yaphet-tadesse

]]> 1733 no Ep. 114 Origin Story of the Palmaz Stent with Dr. Julio Palmaz Dr. Julio Palmaz talks with Dr. Bryan Hartley about where he got the idea for the first commercially-available vascular stent, how he developed it working in his garage, and persevered despite repeated rejections to take it to market. Don't miss this one! --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/biTSNQ --- SHOW NOTES In this episode, Dr. Julio Palmaz joins Dr. Bryan Hartley to discuss the origin story of his invention, the Palmaz Stent. Dr. Palmaz tells us about how he got into IR and the difference between practicing in Argentina and the United States. We discuss how Dr. Palmaz became interested in innovation and how he got started in academia. Dr. Palmaz talks about what inspired him to make the stent and what angioplasty looked like before he started working on the Palmaz Stent. We discuss how he began working on a prototype out of his garage, and we explain some of the challenges he faced in trying to get balloons to test out. We talk about welding and the cross points of the stent, and Dr. Palmaz tells us about the challenges of proposing his ideas to companies. We discuss working with mentors, getting grants and investors, and approaching Johnson & Johnson. Dr. Palmaz shares some of the biggest challenges he faced during his innovation of the Palmaz Stent. He explains his newest projects and what he sees for the future of medical devices. Mon, 08 Mar 2021 11:56:00 -0000 full BackTable Dr. Julio Palmaz talks with Dr. Bryan Hartley about where he got the idea for the first commercially-available vascular stent, how he developed it working in his garage, and persevered despite repeated rejections to take it to market. Don't miss this one! Dr. Julio Palmaz talks with Dr. Bryan Hartley about where he got the idea for the first commercially-available vascular stent, how he developed it working in his garage, and persevered despite repeated rejections to take it to market. Don't miss this one! --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/biTSNQ --- SHOW NOTES In this episode, Dr. Julio Palmaz joins Dr. Bryan Hartley to discuss the origin story of his invention, the Palmaz Stent. Dr. Palmaz tells us about how he got into IR and the difference between practicing in Argentina and the United States. We discuss how Dr. Palmaz became interested in innovation and how he got started in academia. Dr. Palmaz talks about what inspired him to make the stent and what angioplasty looked like before he started working on the Palmaz Stent. We discuss how he began working on a prototype out of his garage, and we explain some of the challenges he faced in trying to get balloons to test out. We talk about welding and the cross points of the stent, and Dr. Palmaz tells us about the challenges of proposing his ideas to companies. We discuss working with mentors, getting grants and investors, and approaching Johnson & Johnson. Dr. Palmaz shares some of the biggest challenges he faced during his innovation of the Palmaz Stent. He explains his newest projects and what he sees for the future of medical devices. Dr. Julio Palmaz talks with Dr. Bryan Hartley about where he got the idea for the first commercially-available vascular stent, how he developed it working in his garage, and persevered despite repeated rejections to take it to market. Don't miss this one!


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/biTSNQ


---


SHOW NOTES


In this episode, Dr. Julio Palmaz joins Dr. Bryan Hartley to discuss the origin story of his invention, the Palmaz Stent. Dr. Palmaz tells us about how he got into IR and the difference between practicing in Argentina and the United States. We discuss how Dr. Palmaz became interested in innovation and how he got started in academia.


Dr. Palmaz talks about what inspired him to make the stent and what angioplasty looked like before he started working on the Palmaz Stent. We discuss how he began working on a prototype out of his garage, and we explain some of the challenges he faced in trying to get balloons to test out. We talk about welding and the cross points of the stent, and Dr. Palmaz tells us about the challenges of proposing his ideas to companies.


We discuss working with mentors, getting grants and investors, and approaching Johnson & Johnson. Dr. Palmaz shares some of the biggest challenges he faced during his innovation of the Palmaz Stent. He explains his newest projects and what he sees for the future of medical devices.

]]> 3893 no Ep. 113 Below-Ankle Interventions with Dr. Kumar Madassery https://soundcloud.com/backtable/ep-113-below-ankle-interventions-with-dr-kumar-madassery Dr. Sabeen Dhand and Dr. Kumar Madassery discuss the importance of below-ankle interventions in limb salvage, including patient selection, technique, and a patient-centered longitudinal care plan. --- SHOW NOTES In this episode, Dr. Kumar Madassery joins Dr. Sabeen Dhand to discuss below ankle interventions. We discuss how to approach tissue loss in patients with severe and multi-level disease in order to minimize below ankle interventions and how to optimize imaging to get a comprehensive view. We explain the tips and tricks of performing a pedal loop, and we review the techniques for retrograde access. We review how to carefully manipulate wires during a pedal loop procedure. We discuss which devices can go through the pedal loop and what qualities are important in a wire for below ankle interventions. We discuss why having lysing can lead to a successful below ankle intervention and how to know when it is appropriate to do a pedal loop. We talk about the impact social media has had on IR and give some advice for those wanting to try pedal interventions. --- RESOURCES Dr. Madassery’s Twitter: @kmadass Use code BACKTABLE for discount at ISET: https://www.iset.org/ Mon, 01 Mar 2021 13:00:00 -0000 full BackTable Dr. Sabeen Dhand and Dr. Kumar Madassery discuss the importance of below-ankle interventions in limb salvage, including patient selection, technique, and a patient-centered longitudinal care plan. Dr. Sabeen Dhand and Dr. Kumar Madassery discuss the importance of below-ankle interventions in limb salvage, including patient selection, technique, and a patient-centered longitudinal care plan. --- SHOW NOTES In this episode, Dr. Kumar Madassery joins Dr. Sabeen Dhand to discuss below ankle interventions. We discuss how to approach tissue loss in patients with severe and multi-level disease in order to minimize below ankle interventions and how to optimize imaging to get a comprehensive view. We explain the tips and tricks of performing a pedal loop, and we review the techniques for retrograde access. We review how to carefully manipulate wires during a pedal loop procedure. We discuss which devices can go through the pedal loop and what qualities are important in a wire for below ankle interventions. We discuss why having lysing can lead to a successful below ankle intervention and how to know when it is appropriate to do a pedal loop. We talk about the impact social media has had on IR and give some advice for those wanting to try pedal interventions. --- RESOURCES Dr. Madassery’s Twitter: @kmadass Use code BACKTABLE for discount at ISET: https://www.iset.org/ Dr. Sabeen Dhand and Dr. Kumar Madassery discuss the importance of below-ankle interventions in limb salvage, including patient selection, technique, and a patient-centered longitudinal care plan.


---


SHOW NOTES


In this episode, Dr. Kumar Madassery joins Dr. Sabeen Dhand to discuss below ankle interventions. We discuss how to approach tissue loss in patients with severe and multi-level disease in order to minimize below ankle interventions and how to optimize imaging to get a comprehensive view.


We explain the tips and tricks of performing a pedal loop, and we review the techniques for retrograde access. We review how to carefully manipulate wires during a pedal loop procedure. We discuss which devices can go through the pedal loop and what qualities are important in a wire for below ankle interventions.


We discuss why having lysing can lead to a successful below ankle intervention and how to know when it is appropriate to do a pedal loop. We talk about the impact social media has had on IR and give some advice for those wanting to try pedal interventions.


---


RESOURCES


Dr. Madassery’s Twitter:

@kmadass


Use code BACKTABLE for discount at ISET:

https://www.iset.org/

]]> 2805 no Ep. 112 Shooting For Big Impact Projects with Dr. Aravind Arepally https://soundcloud.com/backtable/ep-112-shooting-for-big-projects-with-dr-aravind-arepally In this special Innovation episode, Dr. Aravind Arepally tells us the stories behind what inspires him to shoot for big impact projects, how he built a startup device company with Jim Chomas, and the importance of working with people who give you energy and challenge you. --- SHOW NOTES In this episode, Dr. Aravind Arepally joins Dr. Bryan Hartley to discuss his development and innovation of medical devices. Dr. Arepally tells us how his childhood experiences influenced him to become a physician and how his mentors during fellowship inspired him to become an innovator. We discuss how a grant writing class opened up the world of research for Dr. Arepally and connected him with engineers. We talk about how important it is to have collaborative partners and why not to ignore any of the crazy ideas. Dr. Arepally shares his experience working in Germany for four months and how he started focusing on obesity and minimally invasive procedures. We discuss some of the challenges of trying to innovate while working in a private practice. We explain the origin story of Dr. Arepally’s company, SureFire and how he developed a business plan. We discuss fundraising, finding investors, and developing prototypes. Dr. Arepally tells us about his current projects, his future plans for innovation, and why he wants to focus on need based devices. Mon, 22 Feb 2021 13:00:00 -0000 full BackTable In this special Innovation episode, Dr. Aravind Arepally tells us the stories behind what inspires him to shoot for big impact projects, how he built a startup device company with Jim Chomas, and the importance of working with people who give you energy and challenge you. In this special Innovation episode, Dr. Aravind Arepally tells us the stories behind what inspires him to shoot for big impact projects, how he built a startup device company with Jim Chomas, and the importance of working with people who give you energy and challenge you. --- SHOW NOTES In this episode, Dr. Aravind Arepally joins Dr. Bryan Hartley to discuss his development and innovation of medical devices. Dr. Arepally tells us how his childhood experiences influenced him to become a physician and how his mentors during fellowship inspired him to become an innovator. We discuss how a grant writing class opened up the world of research for Dr. Arepally and connected him with engineers. We talk about how important it is to have collaborative partners and why not to ignore any of the crazy ideas. Dr. Arepally shares his experience working in Germany for four months and how he started focusing on obesity and minimally invasive procedures. We discuss some of the challenges of trying to innovate while working in a private practice. We explain the origin story of Dr. Arepally’s company, SureFire and how he developed a business plan. We discuss fundraising, finding investors, and developing prototypes. Dr. Arepally tells us about his current projects, his future plans for innovation, and why he wants to focus on need based devices. In this special Innovation episode, Dr. Aravind Arepally tells us the stories behind what inspires him to shoot for big impact projects, how he built a startup device company with Jim Chomas, and the importance of working with people who give you energy and challenge you.


---


SHOW NOTES


In this episode, Dr. Aravind Arepally joins Dr. Bryan Hartley to discuss his development and innovation of medical devices. Dr. Arepally tells us how his childhood experiences influenced him to become a physician and how his mentors during fellowship inspired him to become an innovator. We discuss how a grant writing class opened up the world of research for Dr. Arepally and connected him with engineers.


We talk about how important it is to have collaborative partners and why not to ignore any of the crazy ideas. Dr. Arepally shares his experience working in Germany for four months and how he started focusing on obesity and minimally invasive procedures. We discuss some of the challenges of trying to innovate while working in a private practice.


We explain the origin story of Dr. Arepally’s company, SureFire and how he developed a business plan. We discuss fundraising, finding investors, and developing prototypes. Dr. Arepally tells us about his current projects, his future plans for innovation, and why he wants to focus on need based devices.

]]> 3211 no Ep. 111 Underutilization of Foam Sclerotherapy with Dr. Chris Pittman We talk with Dr. Chris Pittman, founder of Vein911 and LinkedIn Foam Sclerotherapy Experts, about Foam Sclerotherapy for the treatment of superficial venous disease, including technique, patient workup, and some of the reasons why foam is underutilized. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/sKSDrX --- SHOW NOTES In this episode, Dr. Chris Pittman joins Dr. Aaron Fritts to discuss the underutilization of foam sclerotherapy. Dr. Pittman tells us about how he started his vein treatment centers and about his upcoming reality TV show. We introduce the basics of foam sclerotherapy for varicose veins and how the procedure has been developed. Dr. Pittman shares some reasons why he thinks foam sclerotherapy is not as popular in the United States. We review when to use the three types of sclerosants, hypertonic saline, sotradecol, and polidocanol as well as the difference between compounded and non-compounded sclerosants. Dr. Pittman tells us the best way to get foam sclerotherapy training. We discuss the four components for evaluating a patient who may have venous disease, and we explain how to do a hose trial and make the proper notes for insurance claims. We discuss the treatment process from when the patient arrives and some of the details of thermal ablation. We discuss the importance of an effective treatment and why there should be at least two rounds of foam treatment. We explain some of the key points to discuss with patients to manage expectations prior to treatment. We discuss the fundamentals of foam sclerotherapy, what post-procedure follow-up looks like, and how long after to wear stockings after the treatment. We explain how the shift from fee-for-service to fee-for-value has changed some of the ways treatments are done. --- RESOURCES Contact Dr. Pittman: cpittman@vein911.com Mon, 15 Feb 2021 13:00:00 -0000 full BackTable We talk with Dr. Chris Pittman, founder of Vein911 and LinkedIn Foam Sclerotherapy Experts, about Foam Sclerotherapy for the treatment of superficial venous disease, including technique, patient workup, and some of the reasons why foam is underutilized. We talk with Dr. Chris Pittman, founder of Vein911 and LinkedIn Foam Sclerotherapy Experts, about Foam Sclerotherapy for the treatment of superficial venous disease, including technique, patient workup, and some of the reasons why foam is underutilized. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/sKSDrX --- SHOW NOTES In this episode, Dr. Chris Pittman joins Dr. Aaron Fritts to discuss the underutilization of foam sclerotherapy. Dr. Pittman tells us about how he started his vein treatment centers and about his upcoming reality TV show. We introduce the basics of foam sclerotherapy for varicose veins and how the procedure has been developed. Dr. Pittman shares some reasons why he thinks foam sclerotherapy is not as popular in the United States. We review when to use the three types of sclerosants, hypertonic saline, sotradecol, and polidocanol as well as the difference between compounded and non-compounded sclerosants. Dr. Pittman tells us the best way to get foam sclerotherapy training. We discuss the four components for evaluating a patient who may have venous disease, and we explain how to do a hose trial and make the proper notes for insurance claims. We discuss the treatment process from when the patient arrives and some of the details of thermal ablation. We discuss the importance of an effective treatment and why there should be at least two rounds of foam treatment. We explain some of the key points to discuss with patients to manage expectations prior to treatment. We discuss the fundamentals of foam sclerotherapy, what post-procedure follow-up looks like, and how long after to wear stockings after the treatment. We explain how the shift from fee-for-service to fee-for-value has changed some of the ways treatments are done. --- RESOURCES Contact Dr. Pittman: cpittman@vein911.com We talk with Dr. Chris Pittman, founder of Vein911 and LinkedIn Foam Sclerotherapy Experts, about Foam Sclerotherapy for the treatment of superficial venous disease, including technique, patient workup, and some of the reasons why foam is underutilized.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/sKSDrX


---


SHOW NOTES


In this episode, Dr. Chris Pittman joins Dr. Aaron Fritts to discuss the underutilization of foam sclerotherapy. Dr. Pittman tells us about how he started his vein treatment centers and about his upcoming reality TV show. We introduce the basics of foam sclerotherapy for varicose veins and how the procedure has been developed. Dr. Pittman shares some reasons why he thinks foam sclerotherapy is not as popular in the United States.


We review when to use the three types of sclerosants, hypertonic saline, sotradecol, and polidocanol as well as the difference between compounded and non-compounded sclerosants. Dr. Pittman tells us the best way to get foam sclerotherapy training. We discuss the four components for evaluating a patient who may have venous disease, and we explain how to do a hose trial and make the proper notes for insurance claims. We discuss the treatment process from when the patient arrives and some of the details of thermal ablation.


We discuss the importance of an effective treatment and why there should be at least two rounds of foam treatment. We explain some of the key points to discuss with patients to manage expectations prior to treatment. We discuss the fundamentals of foam sclerotherapy, what post-procedure follow-up looks like, and how long after to wear stockings after the treatment. We explain how the shift from fee-for-service to fee-for-value has changed some of the ways treatments are done.


---


RESOURCES


Contact Dr. Pittman:

cpittman@vein911.com

]]> 3932 no Ep. 110 When that First Job Isn't a Good Fit with Dr. Michael Barraza https://soundcloud.com/backtable/ep-110-when-that-first-job-isnt-a-good-fit-with-dr-michael-barraza Interventional Radiologists Dr. Michael Barraza and Dr. Aaron Fritts talk about their early careers coming out of specialty training and hard lessons learned from their first jobs. --- SHOW NOTES In this episode, Dr. Michael Barraza joins Dr. Aaron Fritts to discuss his career path and what he has learned through different job experiences. We discuss how to be proactive during a job search, and Dr. Barraza tells us about his unique experience of getting a job offer while completing his radiology training. We discuss aspects of jobs that are not learned during training, such as partnership tracks and non-competes. We explain why partnership tracks may be long and what factors determine the intensity of a non-compete. We discuss how call responsibilities are different than during training and some of the advantages of working in a large group. Dr. Barraza shares his first job experience, why it was not a good fit for him, and how he learned what to look for in his next job. We discuss how to adjust a job search once you have a better idea of where you will fit in and the importance of networking and maintaining relationships with referring doctors. We give some advice to current trainees about how to continue working when you are not getting the opportunities you want and how to know when to switch jobs. Fri, 12 Feb 2021 12:36:00 -0000 full BackTable Interventional Radiologists Dr. Michael Barraza and Dr. Aaron Fritts talk about their early careers coming out of specialty training and hard lessons learned from their first jobs. Interventional Radiologists Dr. Michael Barraza and Dr. Aaron Fritts talk about their early careers coming out of specialty training and hard lessons learned from their first jobs. --- SHOW NOTES In this episode, Dr. Michael Barraza joins Dr. Aaron Fritts to discuss his career path and what he has learned through different job experiences. We discuss how to be proactive during a job search, and Dr. Barraza tells us about his unique experience of getting a job offer while completing his radiology training. We discuss aspects of jobs that are not learned during training, such as partnership tracks and non-competes. We explain why partnership tracks may be long and what factors determine the intensity of a non-compete. We discuss how call responsibilities are different than during training and some of the advantages of working in a large group. Dr. Barraza shares his first job experience, why it was not a good fit for him, and how he learned what to look for in his next job. We discuss how to adjust a job search once you have a better idea of where you will fit in and the importance of networking and maintaining relationships with referring doctors. We give some advice to current trainees about how to continue working when you are not getting the opportunities you want and how to know when to switch jobs. Interventional Radiologists Dr. Michael Barraza and Dr. Aaron Fritts talk about their early careers coming out of specialty training and hard lessons learned from their first jobs.


---


SHOW NOTES


In this episode, Dr. Michael Barraza joins Dr. Aaron Fritts to discuss his career path and what he has learned through different job experiences. We discuss how to be proactive during a job search, and Dr. Barraza tells us about his unique experience of getting a job offer while completing his radiology training.


We discuss aspects of jobs that are not learned during training, such as partnership tracks and non-competes. We explain why partnership tracks may be long and what factors determine the intensity of a non-compete. We discuss how call responsibilities are different than during training and some of the advantages of working in a large group.


Dr. Barraza shares his first job experience, why it was not a good fit for him, and how he learned what to look for in his next job. We discuss how to adjust a job search once you have a better idea of where you will fit in and the importance of networking and maintaining relationships with referring doctors. We give some advice to current trainees about how to continue working when you are not getting the opportunities you want and how to know when to switch jobs.

]]> 2228 no Ep. 109 Life in the OBL- One Year Follow Up with Dr. Tim Yates We check back in with Dr. Tim Yates one year after his transition into the OBL to discuss the pros and cons of practicing in the OBL setting. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/g0BFLd --- SHOW NOTES In this episode, Dr. Tim Yates joins Dr. Lincoln Patel again, after one year, to discuss his life in the outpatient based lab (OBL). Dr. Yates shares how his OBL practice has been going and how the COVID-19 pandemic affected the beginning of his transition. Dr. Yates gives an update on the expansion of OBL offices, and he explains the importance of building connections with other physicians and companies. We discuss how to meet partners in the community and build relationships within the market in some unique ways, and we mention how to adapt marketing methods during a pandemic. We talk about some challenges the OBL has faced while trying to grow in the endovascular and oncology world and while trying to incorporate Y90 into the practice. We discuss why having a fixed floor unit is helpful and how equipment limitations may change how the interventionist approaches some cases. We discuss the differences between working in a hospital and an OBL, and Dr. Yates shares what part of his new job has been the most fulfilling. We talk about the importance of learning to coach and manage personnel. Dr. Patel tells us about how he changed his career path and some lessons he learned along the way. We discuss which skills have been useful in the OBL setting, and we give some advice to those considering a transition to OBL. --- RESOURCES Dr. Tim Yates Interviews from February 2020: https://www.backtable.com/shows/vi/podcasts/55/transitioning-from-hospital-to-obl-practice-part-i https://www.backtable.com/shows/vi/podcasts/56/transitioning-from-hospital-to-obl-practice-part-ii ISET; use discount code: BACKTABLE https://www.iset.org/ Mon, 08 Feb 2021 12:07:00 -0000 full BackTable We check back in with Dr. Tim Yates one year after his transition into the OBL to discuss the pros and cons of practicing in the OBL setting. We check back in with Dr. Tim Yates one year after his transition into the OBL to discuss the pros and cons of practicing in the OBL setting. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/g0BFLd --- SHOW NOTES In this episode, Dr. Tim Yates joins Dr. Lincoln Patel again, after one year, to discuss his life in the outpatient based lab (OBL). Dr. Yates shares how his OBL practice has been going and how the COVID-19 pandemic affected the beginning of his transition. Dr. Yates gives an update on the expansion of OBL offices, and he explains the importance of building connections with other physicians and companies. We discuss how to meet partners in the community and build relationships within the market in some unique ways, and we mention how to adapt marketing methods during a pandemic. We talk about some challenges the OBL has faced while trying to grow in the endovascular and oncology world and while trying to incorporate Y90 into the practice. We discuss why having a fixed floor unit is helpful and how equipment limitations may change how the interventionist approaches some cases. We discuss the differences between working in a hospital and an OBL, and Dr. Yates shares what part of his new job has been the most fulfilling. We talk about the importance of learning to coach and manage personnel. Dr. Patel tells us about how he changed his career path and some lessons he learned along the way. We discuss which skills have been useful in the OBL setting, and we give some advice to those considering a transition to OBL. --- RESOURCES Dr. Tim Yates Interviews from February 2020: https://www.backtable.com/shows/vi/podcasts/55/transitioning-from-hospital-to-obl-practice-part-i https://www.backtable.com/shows/vi/podcasts/56/transitioning-from-hospital-to-obl-practice-part-ii ISET; use discount code: BACKTABLE https://www.iset.org/ We check back in with Dr. Tim Yates one year after his transition into the OBL to discuss the pros and cons of practicing in the OBL setting.


---


CHECK OUT OUR SPONSORS


RADPAD® Radiation Protection

https://www.radpad.com/


Accountable Revenue Cycle Solutions

https://www.accountablerevcycle.com/


Accountable Physician Advisors

http://www.accountablephysicianadvisors.com/


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/g0BFLd


---


SHOW NOTES


In this episode, Dr. Tim Yates joins Dr. Lincoln Patel again, after one year, to discuss his life in the outpatient based lab (OBL). Dr. Yates shares how his OBL practice has been going and how the COVID-19 pandemic affected the beginning of his transition. Dr. Yates gives an update on the expansion of OBL offices, and he explains the importance of building connections with other physicians and companies.


We discuss how to meet partners in the community and build relationships within the market in some unique ways, and we mention how to adapt marketing methods during a pandemic. We talk about some challenges the OBL has faced while trying to grow in the endovascular and oncology world and while trying to incorporate Y90 into the practice. We discuss why having a fixed floor unit is helpful and how equipment limitations may change how the interventionist approaches some cases.


We discuss the differences between working in a hospital and an OBL, and Dr. Yates shares what part of his new job has been the most fulfilling. We talk about the importance of learning to coach and manage personnel. Dr. Patel tells us about how he changed his career path and some lessons he learned along the way. We discuss which skills have been useful in the OBL setting, and we give some advice to those considering a transition to OBL.


---


RESOURCES


Dr. Tim Yates Interviews from February 2020:

https://www.backtable.com/shows/vi/podcasts/55/transitioning-from-hospital-to-obl-practice-part-i

https://www.backtable.com/shows/vi/podcasts/56/transitioning-from-hospital-to-obl-practice-part-ii


ISET; use discount code: BACKTABLE

https://www.iset.org/

]]> 3332 no Ep. 108 Adding Wound Care To Your Practice- Pros and Cons with Dr. Morrison and Dr. Tummala https://soundcloud.com/backtable/ep-108-adding-wound-care-to-your-practice-pros-and-cons-with-dr-morrison-and-dr-tummala We talk with Interventional Radiologists Dr. Robbie Morrison and Dr. Srini Tummala about the pros and cons of adding a wound care services to your endovascular practice. --- SHOW NOTES In this episode, Dr. Robbie Morrison and Dr. Srini Tummala join Dr. Aaron Fritts to discuss adding wound care to a practice. Dr. Morrison and Dr. Tummala tell us about their work and why they, as endovascular specialists, wanted to include wound care at their practice. We discuss some examples of the benefits of wound care, and Dr. Tummala shares why he thinks wound care is the future of the vascular speciality. We explain how the referral process works and how it may vary from practice to practice. We discuss why it is important to be well-rounded in wound care and how a background in IR can help with this. Dr. Morrison tells us how he collaborates with a nurse practitioner to elevate his care and we explain why it can be difficult to differentiate patients at the referral level. We discuss how to get wound care training and certification and Dr. Morrison talks about the learning curve during training. We review some of the pearls of wound care and give some advice on how to present yourself to other physicians when getting started. --- RESOURCES BackTable Podcast Episode 86: Building a PAD Practice with Dr. Srini Tumala https://www.backtable.com/shows/vi/podcasts/86/building-a-pad-practice Dr. Tummala’s Vascular Channel https://www.youtube.com/channel/UCAbrKSywIzcobBpp0FUo34w Dr. Tummala’s Twitter @srinitummala Medtronic Abre Stent https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/deep-venous/abre-venous-stent.html Mon, 01 Feb 2021 12:51:00 -0000 full BackTable We talk with Interventional Radiologists Dr. Robbie Morrison and Dr. Srini Tummala about the pros and cons of adding a wound care services to your endovascular practice. We talk with Interventional Radiologists Dr. Robbie Morrison and Dr. Srini Tummala about the pros and cons of adding a wound care services to your endovascular practice. --- SHOW NOTES In this episode, Dr. Robbie Morrison and Dr. Srini Tummala join Dr. Aaron Fritts to discuss adding wound care to a practice. Dr. Morrison and Dr. Tummala tell us about their work and why they, as endovascular specialists, wanted to include wound care at their practice. We discuss some examples of the benefits of wound care, and Dr. Tummala shares why he thinks wound care is the future of the vascular speciality. We explain how the referral process works and how it may vary from practice to practice. We discuss why it is important to be well-rounded in wound care and how a background in IR can help with this. Dr. Morrison tells us how he collaborates with a nurse practitioner to elevate his care and we explain why it can be difficult to differentiate patients at the referral level. We discuss how to get wound care training and certification and Dr. Morrison talks about the learning curve during training. We review some of the pearls of wound care and give some advice on how to present yourself to other physicians when getting started. --- RESOURCES BackTable Podcast Episode 86: Building a PAD Practice with Dr. Srini Tumala https://www.backtable.com/shows/vi/podcasts/86/building-a-pad-practice Dr. Tummala’s Vascular Channel https://www.youtube.com/channel/UCAbrKSywIzcobBpp0FUo34w Dr. Tummala’s Twitter @srinitummala Medtronic Abre Stent https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/deep-venous/abre-venous-stent.html We talk with Interventional Radiologists Dr. Robbie Morrison and Dr. Srini Tummala about the pros and cons of adding a wound care services to your endovascular practice.


---


SHOW NOTES


In this episode, Dr. Robbie Morrison and Dr. Srini Tummala join Dr. Aaron Fritts to discuss adding wound care to a practice. Dr. Morrison and Dr. Tummala tell us about their work and why they, as endovascular specialists, wanted to include wound care at their practice. We discuss some examples of the benefits of wound care, and Dr. Tummala shares why he thinks wound care is the future of the vascular speciality.


We explain how the referral process works and how it may vary from practice to practice. We discuss why it is important to be well-rounded in wound care and how a background in IR can help with this. Dr. Morrison tells us how he collaborates with a nurse practitioner to elevate his care and we explain why it can be difficult to differentiate patients at the referral level.


We discuss how to get wound care training and certification and Dr. Morrison talks about the learning curve during training. We review some of the pearls of wound care and give some advice on how to present yourself to other physicians when getting started.


---


RESOURCES


BackTable Podcast Episode 86: Building a PAD Practice with Dr. Srini Tumala

https://www.backtable.com/shows/vi/podcasts/86/building-a-pad-practice


Dr. Tummala’s Vascular Channel

https://www.youtube.com/channel/UCAbrKSywIzcobBpp0FUo34w


Dr. Tummala’s Twitter

@srinitummala


Medtronic Abre Stent

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/deep-venous/abre-venous-stent.html

]]> 2068 no Ep. 107 Management and Treatment of Pulmonary AVM's with Dr. Theresa Caridi https://soundcloud.com/backtable/ep-107-management-and-treatment-of-pulmonary-avms-with-dr-theresa-caridi Dr. Theresa Caridi, Section Chief of Interventional Radiology at UAB School of Medicine, discusses the pathophysiology and treatment of Pulmonary AVM's, as well as the importance of multidisciplinary management of patients with Hereditary Hemorrhagic Telangiectasia (HHT). --- SHOW NOTES In this episode, Dr. Theresa Caridi joins Dr. Christopher Beck to discuss management and treatment of pulmonary arterial venous malformations (AVMs). We explain what pulmonary AVMs are, why they can be dangerous, and how patients are referred to Hereditary Hemorrhagic Telangiectasia (HHT) Centers of Excellence. We discuss the clinical manifestations of HHT and why it is important to screen for HHT when diagnosing a patient with a pulmonary AVM. Dr. Caridi tells us about the imaging and how to plan treatments for different types of pulmonary AVM patients. We review the pre-procedural steps and the intricacies of using anesthesia for PAVM treatment. We discuss catheters, access sites, and how to get the images needed. Dr. Caridi shares her advice on working closely to the feeding artery and some of the challenges when using coils. We discuss what care looks like post-procedure and when to follow up patients. We talk about some of the common side effects that occur after pulmonary AVM treatment. We explain how to decide the number of lesions to treat at one time, and Dr. Caridi gives some advice for those who do not work at an HHT Center of Excellence, but want to perform this procedure. --- RESOURCES Image Guided Interventions: Expert Radiology Series (IR Textbook by Matthew A. Mauro) https://www.elsevier.com/books/image-guided-interventions/mauro/978-0-323-61204-3 https://www.amazon.com/Image-Guided-Interventions-Matthew-Mauro-FACR/dp/0323612040/ref=sr_1_1?dchild=1&keywords=Image-Guided+Interventions%3A+Expert+Radiology+Series&qid=1612320492&s=books&sr=1-1 PAVM Embolization: An Update https://www.ajronline.org/doi/10.2214/AJR.10.5230 Treated pulmonary arteriovenous malformations: patterns of persistence and associated retreatment success https://pubmed.ncbi.nlm.nih.gov/23912618/ Medtronic Peripheral Embolization Products https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/peripheral-embolization.html Mon, 25 Jan 2021 12:45:00 -0000 full BackTable Dr. Theresa Caridi, Section Chief of Interventional Radiology at UAB School of Medicine, discusses the pathophysiology and treatment of Pulmonary AVM's, as well as the importance of multidisciplinary management of patients with Hereditary Hemorrhagic Telangiectasia (HHT). Dr. Theresa Caridi, Section Chief of Interventional Radiology at UAB School of Medicine, discusses the pathophysiology and treatment of Pulmonary AVM's, as well as the importance of multidisciplinary management of patients with Hereditary Hemorrhagic Telangiectasia (HHT). --- SHOW NOTES In this episode, Dr. Theresa Caridi joins Dr. Christopher Beck to discuss management and treatment of pulmonary arterial venous malformations (AVMs). We explain what pulmonary AVMs are, why they can be dangerous, and how patients are referred to Hereditary Hemorrhagic Telangiectasia (HHT) Centers of Excellence. We discuss the clinical manifestations of HHT and why it is important to screen for HHT when diagnosing a patient with a pulmonary AVM. Dr. Caridi tells us about the imaging and how to plan treatments for different types of pulmonary AVM patients. We review the pre-procedural steps and the intricacies of using anesthesia for PAVM treatment. We discuss catheters, access sites, and how to get the images needed. Dr. Caridi shares her advice on working closely to the feeding artery and some of the challenges when using coils. We discuss what care looks like post-procedure and when to follow up patients. We talk about some of the common side effects that occur after pulmonary AVM treatment. We explain how to decide the number of lesions to treat at one time, and Dr. Caridi gives some advice for those who do not work at an HHT Center of Excellence, but want to perform this procedure. --- RESOURCES Image Guided Interventions: Expert Radiology Series (IR Textbook by Matthew A. Mauro) https://www.elsevier.com/books/image-guided-interventions/mauro/978-0-323-61204-3 https://www.amazon.com/Image-Guided-Interventions-Matthew-Mauro-FACR/dp/0323612040/ref=sr_1_1?dchild=1&keywords=Image-Guided+Interventions%3A+Expert+Radiology+Series&qid=1612320492&s=books&sr=1-1 PAVM Embolization: An Update https://www.ajronline.org/doi/10.2214/AJR.10.5230 Treated pulmonary arteriovenous malformations: patterns of persistence and associated retreatment success https://pubmed.ncbi.nlm.nih.gov/23912618/ Medtronic Peripheral Embolization Products https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/peripheral-embolization.html Dr. Theresa Caridi, Section Chief of Interventional Radiology at UAB School of Medicine, discusses the pathophysiology and treatment of Pulmonary AVM's, as well as the importance of multidisciplinary management of patients with Hereditary Hemorrhagic Telangiectasia (HHT).


---


SHOW NOTES


In this episode, Dr. Theresa Caridi joins Dr. Christopher Beck to discuss management and treatment of pulmonary arterial venous malformations (AVMs). We explain what pulmonary AVMs are, why they can be dangerous, and how patients are referred to Hereditary Hemorrhagic Telangiectasia (HHT) Centers of Excellence. We discuss the clinical manifestations of HHT and why it is important to screen for HHT when diagnosing a patient with a pulmonary AVM.


Dr. Caridi tells us about the imaging and how to plan treatments for different types of pulmonary AVM patients. We review the pre-procedural steps and the intricacies of using anesthesia for PAVM treatment. We discuss catheters, access sites, and how to get the images needed. Dr. Caridi shares her advice on working closely to the feeding artery and some of the challenges when using coils.


We discuss what care looks like post-procedure and when to follow up patients. We talk about some of the common side effects that occur after pulmonary AVM treatment. We explain how to decide the number of lesions to treat at one time, and Dr. Caridi gives some advice for those who do not work at an HHT Center of Excellence, but want to perform this procedure.


---


RESOURCES


Image Guided Interventions: Expert Radiology Series (IR Textbook by Matthew A. Mauro)

https://www.elsevier.com/books/image-guided-interventions/mauro/978-0-323-61204-3

https://www.amazon.com/Image-Guided-Interventions-Matthew-Mauro-FACR/dp/0323612040/ref=sr_1_1?dchild=1&keywords=Image-Guided+Interventions%3A+Expert+Radiology+Series&qid=1612320492&s=books&sr=1-1


PAVM Embolization: An Update

https://www.ajronline.org/doi/10.2214/AJR.10.5230


Treated pulmonary arteriovenous malformations: patterns of persistence and associated retreatment success

https://pubmed.ncbi.nlm.nih.gov/23912618/


Medtronic Peripheral Embolization Products

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/peripheral-embolization.html

]]> 3728 no Ep. 106 Treating Extraspinal Painful Bony Metastases with Dr. Steve Yevich https://soundcloud.com/backtable/ep-106-treating-extraspinal-painful-bony-metastases-with-dr-steve-yevich Dr. Steven Yevich from MD Anderson Cancer Center talks with us about his approach to Treatment and Management of Painful Extra-spinal Bony Metastases. --- SHOW NOTES In this episode, Dr. Steve Yevich joins Dr. Michael Barraza to discuss treatment of extraspinal painful bony metastases. Dr. Yevich tells us about his training in interventional oncology at Gustave Roussy Cancer Campus in Paris, and we discuss how he adjusted to identify the individual needs of the hospital when he came back to the US. We explain how to go into a case with either curative or palliative intent. Dr. Yevich shares when he would do soft tissue ablation around nerves and the location of the metastases he commonly treats. We emphasize the anatomic considerations to determine if ablation for the extraspinal bony metastases is feasible. We discuss some of the advanced techniques Dr. Yevich learned in Paris and the two types of cases that may need pre-ablation embolization. We discuss advancements in technologies and devices that have allowed for more creative solutions in IR. Mon, 18 Jan 2021 13:00:00 -0000 full BackTable Dr. Steven Yevich from MD Anderson Cancer Center talks with us about his approach to Treatment and Management of Painful Extra-spinal Bony Metastases. Dr. Steven Yevich from MD Anderson Cancer Center talks with us about his approach to Treatment and Management of Painful Extra-spinal Bony Metastases. --- SHOW NOTES In this episode, Dr. Steve Yevich joins Dr. Michael Barraza to discuss treatment of extraspinal painful bony metastases. Dr. Yevich tells us about his training in interventional oncology at Gustave Roussy Cancer Campus in Paris, and we discuss how he adjusted to identify the individual needs of the hospital when he came back to the US. We explain how to go into a case with either curative or palliative intent. Dr. Yevich shares when he would do soft tissue ablation around nerves and the location of the metastases he commonly treats. We emphasize the anatomic considerations to determine if ablation for the extraspinal bony metastases is feasible. We discuss some of the advanced techniques Dr. Yevich learned in Paris and the two types of cases that may need pre-ablation embolization. We discuss advancements in technologies and devices that have allowed for more creative solutions in IR. Dr. Steven Yevich from MD Anderson Cancer Center talks with us about his approach to Treatment and Management of Painful Extra-spinal Bony Metastases.


---


SHOW NOTES


In this episode, Dr. Steve Yevich joins Dr. Michael Barraza to discuss treatment of extraspinal painful bony metastases. Dr. Yevich tells us about his training in interventional oncology at Gustave Roussy Cancer Campus in Paris, and we discuss how he adjusted to identify the individual needs of the hospital when he came back to the US.


We explain how to go into a case with either curative or palliative intent. Dr. Yevich shares when he would do soft tissue ablation around nerves and the location of the metastases he commonly treats. We emphasize the anatomic considerations to determine if ablation for the extraspinal bony metastases is feasible.


We discuss some of the advanced techniques Dr. Yevich learned in Paris and the two types of cases that may need pre-ablation embolization. We discuss advancements in technologies and devices that have allowed for more creative solutions in IR.

]]> 1593 no Ep. 105 A Career of Innovation with Dr. Michael Dake https://soundcloud.com/backtable/ep-105-a-career-of-innovation-with-dr-michael-dake Society of Interventional Radiology (SIR) President Dr. Michael Dake tells us stories of the Aortic and Endovascular Innovations he participated in throughout various stages in his career. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/e1zsGc --- SHOW NOTES In this episode, Dr. Michael Dake joins Dr. Bryan Hartley to discuss his career of innovation as a clinician, teacher, and researcher. Dr. Dake tells us how he shifted from working in internal medicine to interventional radiology with the help of his mentors. We discuss the challenges of starting a new residency, and Dr. Dake shares how he knew he wanted to follow a different career path in vascular work. We review the different types of cases that came up from working with cardiac surgeons and other specialties outside of IR. We discuss some lessons learned from working on the clinical side and the industry side of IR. Dr. Dake explains which failures have stuck with him and touches on why relationships and collaboration are so important. We discuss his current work on a liquid embolic and how involvement in innovative opportunities has shaped Dr. Dake’s career. --- RESOURCES ISET; use discount code: BACKTABLE https://www.iset.org Mon, 11 Jan 2021 12:00:00 -0000 full BackTable Society of Interventional Radiology (SIR) President Dr. Michael Dake tells us stories of the Aortic and Endovascular Innovations he participated in throughout various stages in his career. Society of Interventional Radiology (SIR) President Dr. Michael Dake tells us stories of the Aortic and Endovascular Innovations he participated in throughout various stages in his career. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/e1zsGc --- SHOW NOTES In this episode, Dr. Michael Dake joins Dr. Bryan Hartley to discuss his career of innovation as a clinician, teacher, and researcher. Dr. Dake tells us how he shifted from working in internal medicine to interventional radiology with the help of his mentors. We discuss the challenges of starting a new residency, and Dr. Dake shares how he knew he wanted to follow a different career path in vascular work. We review the different types of cases that came up from working with cardiac surgeons and other specialties outside of IR. We discuss some lessons learned from working on the clinical side and the industry side of IR. Dr. Dake explains which failures have stuck with him and touches on why relationships and collaboration are so important. We discuss his current work on a liquid embolic and how involvement in innovative opportunities has shaped Dr. Dake’s career. --- RESOURCES ISET; use discount code: BACKTABLE https://www.iset.org Society of Interventional Radiology (SIR) President Dr. Michael Dake tells us stories of the Aortic and Endovascular Innovations he participated in throughout various stages in his career.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/e1zsGc


---


SHOW NOTES


In this episode, Dr. Michael Dake joins Dr. Bryan Hartley to discuss his career of innovation as a clinician, teacher, and researcher. Dr. Dake tells us how he shifted from working in internal medicine to interventional radiology with the help of his mentors.


We discuss the challenges of starting a new residency, and Dr. Dake shares how he knew he wanted to follow a different career path in vascular work. We review the different types of cases that came up from working with cardiac surgeons and other specialties outside of IR. We discuss some lessons learned from working on the clinical side and the industry side of IR.


Dr. Dake explains which failures have stuck with him and touches on why relationships and collaboration are so important. We discuss his current work on a liquid embolic and how involvement in innovative opportunities has shaped Dr. Dake’s career.


---


RESOURCES


ISET; use discount code: BACKTABLE

https://www.iset.org

]]> 3200 no Ep. 104 Bringing IR to East Africa: The Road2IR Story with Dr. Fabian Laage Gaupp https://soundcloud.com/backtable/episode-104-bringing-ir-to-east-africa-the-road2ir-story-with-dr-fabian-laage-gaup Dr. Fabian Laage Gaupp tells us the origin story of Road2IR.org, an initiative to build self-sustaining IR training programs in East Africa. In collaboration with Yale and Emory Departments of Radiology, Road2IR has helped establish East Africa’s first accredited IR training program in Tanzania! --- SHOW NOTES In this episode, Dr. Fabian Laage Gaupp joins Dr. Aaron Fritts to discuss his work in The Road2IR training program. We discuss the beginnings of the program and how they worked to build the first generation of interventional radiologists as well as nurses and technologists in Tanzania. We discuss the types of procedures that the program offers and how they have adapted to the needs of the communities they work with. We explain how the training measures have changed during the COVID-19 pandemic, and we examine the importance of having a certain mindset while working in this program. Dr. Laage Gaupp tells us about the sedation certificate nurses can train for and their plans for expanding the program to Rwanda. We discuss some of the challenges of shipping imaging equipment and other disposable equipment. Dr. Laage Gaupp explains why he thinks IR will gain popularity in Africa, and we talk about how to get involved in the Road2IR program. --- RESOURCES Tanzania IR Initiative, Training the First Generation of Interventional Radiologists https://www.clinicalkey.com/service/content/pdf/watermarked/1-s2.0-S1051044319306876.pdf?locale=en_US&searchIndex= Road2IR website https://www.road2ir.org/ Social Media Accounts Instagram: @road2ir Twitter: @Road2IR Facebook: https://www.facebook.com/road2IR/ Mon, 04 Jan 2021 12:58:00 -0000 full BackTable Dr. Fabian Laage Gaupp tells us the origin story of Road2IR.org, an initiative to build self-sustaining IR training programs in East Africa. In collaboration with Yale and Emory Departments of Radiology, Road2IR has helped establish East Africa’s first accredited IR training program in Tanzania! Dr. Fabian Laage Gaupp tells us the origin story of Road2IR.org, an initiative to build self-sustaining IR training programs in East Africa. In collaboration with Yale and Emory Departments of Radiology, Road2IR has helped establish East Africa’s first accredited IR training program in Tanzania! --- SHOW NOTES In this episode, Dr. Fabian Laage Gaupp joins Dr. Aaron Fritts to discuss his work in The Road2IR training program. We discuss the beginnings of the program and how they worked to build the first generation of interventional radiologists as well as nurses and technologists in Tanzania. We discuss the types of procedures that the program offers and how they have adapted to the needs of the communities they work with. We explain how the training measures have changed during the COVID-19 pandemic, and we examine the importance of having a certain mindset while working in this program. Dr. Laage Gaupp tells us about the sedation certificate nurses can train for and their plans for expanding the program to Rwanda. We discuss some of the challenges of shipping imaging equipment and other disposable equipment. Dr. Laage Gaupp explains why he thinks IR will gain popularity in Africa, and we talk about how to get involved in the Road2IR program. --- RESOURCES Tanzania IR Initiative, Training the First Generation of Interventional Radiologists https://www.clinicalkey.com/service/content/pdf/watermarked/1-s2.0-S1051044319306876.pdf?locale=en_US&searchIndex= Road2IR website https://www.road2ir.org/ Social Media Accounts Instagram: @road2ir Twitter: @Road2IR Facebook: https://www.facebook.com/road2IR/ Dr. Fabian Laage Gaupp tells us the origin story of Road2IR.org, an initiative to build self-sustaining IR training programs in East Africa. In collaboration with Yale and Emory Departments of Radiology, Road2IR has helped establish East Africa’s first accredited IR training program in Tanzania!


---


SHOW NOTES


In this episode, Dr. Fabian Laage Gaupp joins Dr. Aaron Fritts to discuss his work in The Road2IR training program. We discuss the beginnings of the program and how they worked to build the first generation of interventional radiologists as well as nurses and technologists in Tanzania. We discuss the types of procedures that the program offers and how they have adapted to the needs of the communities they work with.


We explain how the training measures have changed during the COVID-19 pandemic, and we examine the importance of having a certain mindset while working in this program. Dr. Laage Gaupp tells us about the sedation certificate nurses can train for and their plans for expanding the program to Rwanda.


We discuss some of the challenges of shipping imaging equipment and other disposable equipment. Dr. Laage Gaupp explains why he thinks IR will gain popularity in Africa, and we talk about how to get involved in the Road2IR program.


---


RESOURCES


Tanzania IR Initiative, Training the First Generation of Interventional Radiologists

https://www.clinicalkey.com/service/content/pdf/watermarked/1-s2.0-S1051044319306876.pdf?locale=en_US&searchIndex=


Road2IR website

https://www.road2ir.org/


Social Media Accounts

Instagram: @road2ir

Twitter: @Road2IR

Facebook: https://www.facebook.com/road2IR/

]]> 2431 no Special 100th Episode Tribute Interview with Dr. Mary Costantino https://soundcloud.com/backtable/special-100th-episode-tribute-interview-with-dr-mary-costantino Dr. Mary Costantino interviews the BackTable Team in honor of hitting the 100th episode mark. We had a great time telling the origin story of BackTable, reminiscing the early days of the podcast, and where we hope to go in 2021. It doesn't happen without all the amazing guests and guest hosts along the way. --- SHOW NOTES In this special episode, Dr. Mary Constantino interviews Dr. Aaron Fritts, Dr. Christopher Beck, and Dr. Michael Barraza to discuss the journey of the BackTable Podcast. Co-founder Dr. Aaron Fritts tells us why he wanted to start BackTable and how it transformed from an app to a podcast. Dr. Beck and Dr. Barraza share their experiences getting involved in the podcast. We discuss some of the early challenges they faced while trying to get started, and we explain the lessons learned from these experiences. We discuss plans to expand to ENT and urology topics as well as other plans for 2021. Dr. Fritts touches on the learning process of editing audio and creating a podcast. Dr. Fritts, Dr. Beck, and Dr. Barraza share their goals and hopes for the BackTable podcast. We discuss the work that goes on behind the scenes and the team that makes it all possible. Thu, 31 Dec 2020 13:00:00 -0000 full BackTable Dr. Mary Costantino interviews the BackTable Team in honor of hitting the 100th episode mark. We had a great time telling the origin story of BackTable, reminiscing the early days of the podcast, and where we hope to go in 2021. It doesn't happen without all the amazing guests and guest hosts along the way. Dr. Mary Costantino interviews the BackTable Team in honor of hitting the 100th episode mark. We had a great time telling the origin story of BackTable, reminiscing the early days of the podcast, and where we hope to go in 2021. It doesn't happen without all the amazing guests and guest hosts along the way. --- SHOW NOTES In this special episode, Dr. Mary Constantino interviews Dr. Aaron Fritts, Dr. Christopher Beck, and Dr. Michael Barraza to discuss the journey of the BackTable Podcast. Co-founder Dr. Aaron Fritts tells us why he wanted to start BackTable and how it transformed from an app to a podcast. Dr. Beck and Dr. Barraza share their experiences getting involved in the podcast. We discuss some of the early challenges they faced while trying to get started, and we explain the lessons learned from these experiences. We discuss plans to expand to ENT and urology topics as well as other plans for 2021. Dr. Fritts touches on the learning process of editing audio and creating a podcast. Dr. Fritts, Dr. Beck, and Dr. Barraza share their goals and hopes for the BackTable podcast. We discuss the work that goes on behind the scenes and the team that makes it all possible. Dr. Mary Costantino interviews the BackTable Team in honor of hitting the 100th episode mark. We had a great time telling the origin story of BackTable, reminiscing the early days of the podcast, and where we hope to go in 2021. It doesn't happen without all the amazing guests and guest hosts along the way.


---


SHOW NOTES


In this special episode, Dr. Mary Constantino interviews Dr. Aaron Fritts, Dr. Christopher Beck, and Dr. Michael Barraza to discuss the journey of the BackTable Podcast. Co-founder Dr. Aaron Fritts tells us why he wanted to start BackTable and how it transformed from an app to a podcast. Dr. Beck and Dr. Barraza share their experiences getting involved in the podcast.


We discuss some of the early challenges they faced while trying to get started, and we explain the lessons learned from these experiences. We discuss plans to expand to ENT and urology topics as well as other plans for 2021. Dr. Fritts touches on the learning process of editing audio and creating a podcast. Dr. Fritts, Dr. Beck, and Dr. Barraza share their goals and hopes for the BackTable podcast. We discuss the work that goes on behind the scenes and the team that makes it all possible.

]]> 3904 no Ep. 103 Getting it Right on Insurance Claims with Dr. Ezana Azene Dr. Ezana Azene M.D., Ph.D. talks with us about how he found his side gig reviewing insurance claims, and shares tips on how to avoid insurance claim denials for procedures. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/OHtkwE --- SHOW NOTES In this episode, Dr. Ezana Azene joins Dr. Christopher Beck to discuss reviewing medical cases for insurance claims. Dr. Azene tells us how often he reviews insurance claims for IR procedures, and he explains what the step-by-step process looks like once he gets a case to review. We discuss how to search for information to show a procedure was done in extenuating circumstances by looking at clinic notes and labs, in addition to previous reviews from other physicians. We review some mistakes that physicians make that could keep an insurance claim from being approved, and we discuss why documenting all previous interventions is important. We explain why it is helpful to understand the patient’s insurance policy and how citing articles and references can support an insurance claim. Dr. Azene shares how reviewing medical cases has improved his documentation, and we give some advice on how to get involved in this process. --- RESOURCES IR Quarterly article featuring Dr. Azene https://connect.sirweb.org/e-irq/participate/viewirqarticle?DocumentKey=ec2b47d8-e067-4628-a40a-ab19021ab36a Mon, 28 Dec 2020 13:00:00 -0000 full BackTable Dr. Ezana Azene M.D., Ph.D. talks with us about how he found his side gig reviewing insurance claims, and shares tips on how to avoid insurance claim denials for procedures. Dr. Ezana Azene M.D., Ph.D. talks with us about how he found his side gig reviewing insurance claims, and shares tips on how to avoid insurance claim denials for procedures. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/OHtkwE --- SHOW NOTES In this episode, Dr. Ezana Azene joins Dr. Christopher Beck to discuss reviewing medical cases for insurance claims. Dr. Azene tells us how often he reviews insurance claims for IR procedures, and he explains what the step-by-step process looks like once he gets a case to review. We discuss how to search for information to show a procedure was done in extenuating circumstances by looking at clinic notes and labs, in addition to previous reviews from other physicians. We review some mistakes that physicians make that could keep an insurance claim from being approved, and we discuss why documenting all previous interventions is important. We explain why it is helpful to understand the patient’s insurance policy and how citing articles and references can support an insurance claim. Dr. Azene shares how reviewing medical cases has improved his documentation, and we give some advice on how to get involved in this process. --- RESOURCES IR Quarterly article featuring Dr. Azene https://connect.sirweb.org/e-irq/participate/viewirqarticle?DocumentKey=ec2b47d8-e067-4628-a40a-ab19021ab36a Dr. Ezana Azene M.D., Ph.D. talks with us about how he found his side gig reviewing insurance claims, and shares tips on how to avoid insurance claim denials for procedures.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/OHtkwE


---


SHOW NOTES


In this episode, Dr. Ezana Azene joins Dr. Christopher Beck to discuss reviewing medical cases for insurance claims. Dr. Azene tells us how often he reviews insurance claims for IR procedures, and he explains what the step-by-step process looks like once he gets a case to review.


We discuss how to search for information to show a procedure was done in extenuating circumstances by looking at clinic notes and labs, in addition to previous reviews from other physicians. We review some mistakes that physicians make that could keep an insurance claim from being approved, and we discuss why documenting all previous interventions is important.


We explain why it is helpful to understand the patient’s insurance policy and how citing articles and references can support an insurance claim. Dr. Azene shares how reviewing medical cases has improved his documentation, and we give some advice on how to get involved in this process.


---


RESOURCES


IR Quarterly article featuring Dr. Azene

https://connect.sirweb.org/e-irq/participate/viewirqarticle?DocumentKey=ec2b47d8-e067-4628-a40a-ab19021ab36a

]]> 1749 no Ep. 102 Pelvic Congestion Syndrome Part II- Technique and FU with Dr. Meissner and Dr. Cumming https://soundcloud.com/backtable/ep-102-pelvic-congestion-syndrome-part-ii-technique-and-fu-with-dr-meissner-and-dr-cumming In Part 2 of their Pelvic Congestion Syndrome discussion, Dr. Mark Meissner and Dr. Michael Cumming get into their specific techniques, tips and tricks for embolization, and follow up care. --- SHOW NOTES In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss techniques for treating Pelvic Congestion Syndrome. We examine their goals for therapy and why to approach the internal iliac veins first. We discuss which catheters they use and how to approach venograms in a therapeutic way, rather than diagnostic. We share a new technique for coiling that reduces procedure time and pain for the Pelvic Congestion Syndrome patient. We discuss the challenges of embolization and why we often rely on the sclerosant when using an occlusion balloon. Dr. Meissner and Dr. Cumming tells us about the post-procedure management, why to follow-up after the first menstrual period, and why to make foam using CO2 when a patient has a history of migraines. We examine the verbiage of the name “Pelvic Congestion Syndrome” and how it leads to misconceptions about its etiology. Dr. Meissner shares his process for treating Nutcracker Syndrome, and we discuss the potential problems of renal vein stenting. Thu, 24 Dec 2020 13:00:00 -0000 full BackTable In Part 2 of their Pelvic Congestion Syndrome discussion, Dr. Mark Meissner and Dr. Michael Cumming get into their specific techniques, tips and tricks for embolization, and follow up care. In Part 2 of their Pelvic Congestion Syndrome discussion, Dr. Mark Meissner and Dr. Michael Cumming get into their specific techniques, tips and tricks for embolization, and follow up care. --- SHOW NOTES In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss techniques for treating Pelvic Congestion Syndrome. We examine their goals for therapy and why to approach the internal iliac veins first. We discuss which catheters they use and how to approach venograms in a therapeutic way, rather than diagnostic. We share a new technique for coiling that reduces procedure time and pain for the Pelvic Congestion Syndrome patient. We discuss the challenges of embolization and why we often rely on the sclerosant when using an occlusion balloon. Dr. Meissner and Dr. Cumming tells us about the post-procedure management, why to follow-up after the first menstrual period, and why to make foam using CO2 when a patient has a history of migraines. We examine the verbiage of the name “Pelvic Congestion Syndrome” and how it leads to misconceptions about its etiology. Dr. Meissner shares his process for treating Nutcracker Syndrome, and we discuss the potential problems of renal vein stenting. In Part 2 of their Pelvic Congestion Syndrome discussion, Dr. Mark Meissner and Dr. Michael Cumming get into their specific techniques, tips and tricks for embolization, and follow up care.


---


SHOW NOTES


In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss techniques for treating Pelvic Congestion Syndrome. We examine their goals for therapy and why to approach the internal iliac veins first. We discuss which catheters they use and how to approach venograms in a therapeutic way, rather than diagnostic.


We share a new technique for coiling that reduces procedure time and pain for the Pelvic Congestion Syndrome patient. We discuss the challenges of embolization and why we often rely on the sclerosant when using an occlusion balloon. Dr. Meissner and Dr. Cumming tells us about the post-procedure management, why to follow-up after the first menstrual period, and why to make foam using CO2 when a patient has a history of migraines.


We examine the verbiage of the name “Pelvic Congestion Syndrome” and how it leads to misconceptions about its etiology. Dr. Meissner shares his process for treating Nutcracker Syndrome, and we discuss the potential problems of renal vein stenting.

]]> 1886 no Ep. 101 Pelvic Congestion Syndrome Part I- Diagnosis and Planning with Dr. Meissner and Dr. Cumming https://soundcloud.com/backtable/ep-101-pelvic-congestion-syndrome-part-i-diagnosis-and-planning-with-dr-meissner-and-dr-cumming Vascular Surgeon Dr. Mark Meissner and Interventional Radiologist Dr. Michael Cumming discuss diagnosis and treatment planning for Pelvic Congestion Syndrome. This is Part 1 of 2 on Pelvic Congestion Syndrome. --- SHOW NOTES In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss Pelvic Congestion Syndrome. We discuss the pathophysiology of Pelvic Congestion Syndrome and the fundamentals of pelvic venous hypertension. Dr. Meissner and Dr. Cumming tell us how patients end up in their clinic. We discuss why it is important to distinguish primary and secondary causes of Pelvic Congestion Syndrome and the dangers of an incomplete embolization. We review some techniques for ultrasounds, why not to rely on cross-sectional imaging, and the advantages of getting a CT for the Pelvic Congestion Syndrome patient. We discuss how to adapt treatment plans for women that have never been pregnant or women that are post-menopausal. Dr. Meissner and Dr. Cumming explain how they frame their goals and expectations for each patient’s treatment process, and we examine when it is appropriate to use a multi-modality approach to treat Pelvic Congestion Syndrome. --- RESOURCES Check out our other episode featuring Dr. Michael Cumming: https://www.backtable.com/shows/vi/podcasts/52/ivus-for-iliac-vein-compression Tue, 22 Dec 2020 13:00:00 -0000 full BackTable Vascular Surgeon Dr. Mark Meissner and Interventional Radiologist Dr. Michael Cumming discuss diagnosis and treatment planning for Pelvic Congestion Syndrome. This is Part 1 of 2 on Pelvic Congestion Syndrome. Vascular Surgeon Dr. Mark Meissner and Interventional Radiologist Dr. Michael Cumming discuss diagnosis and treatment planning for Pelvic Congestion Syndrome. This is Part 1 of 2 on Pelvic Congestion Syndrome. --- SHOW NOTES In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss Pelvic Congestion Syndrome. We discuss the pathophysiology of Pelvic Congestion Syndrome and the fundamentals of pelvic venous hypertension. Dr. Meissner and Dr. Cumming tell us how patients end up in their clinic. We discuss why it is important to distinguish primary and secondary causes of Pelvic Congestion Syndrome and the dangers of an incomplete embolization. We review some techniques for ultrasounds, why not to rely on cross-sectional imaging, and the advantages of getting a CT for the Pelvic Congestion Syndrome patient. We discuss how to adapt treatment plans for women that have never been pregnant or women that are post-menopausal. Dr. Meissner and Dr. Cumming explain how they frame their goals and expectations for each patient’s treatment process, and we examine when it is appropriate to use a multi-modality approach to treat Pelvic Congestion Syndrome. --- RESOURCES Check out our other episode featuring Dr. Michael Cumming: https://www.backtable.com/shows/vi/podcasts/52/ivus-for-iliac-vein-compression Vascular Surgeon Dr. Mark Meissner and Interventional Radiologist Dr. Michael Cumming discuss diagnosis and treatment planning for Pelvic Congestion Syndrome. This is Part 1 of 2 on Pelvic Congestion Syndrome.


---


SHOW NOTES


In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss Pelvic Congestion Syndrome. We discuss the pathophysiology of Pelvic Congestion Syndrome and the fundamentals of pelvic venous hypertension. Dr. Meissner and Dr. Cumming tell us how patients end up in their clinic.


We discuss why it is important to distinguish primary and secondary causes of Pelvic Congestion Syndrome and the dangers of an incomplete embolization. We review some techniques for ultrasounds, why not to rely on cross-sectional imaging, and the advantages of getting a CT for the Pelvic Congestion Syndrome patient.


We discuss how to adapt treatment plans for women that have never been pregnant or women that are post-menopausal. Dr. Meissner and Dr. Cumming explain how they frame their goals and expectations for each patient’s treatment process, and we examine when it is appropriate to use a multi-modality approach to treat Pelvic Congestion Syndrome.


---


RESOURCES


Check out our other episode featuring Dr. Michael Cumming:

https://www.backtable.com/shows/vi/podcasts/52/ivus-for-iliac-vein-compression

]]> 1995 no Ep. 100 Why Dr. Rusty Hofmann Built an Innovative Digital Health Company Bryan Hartley talks with Lawrence "Rusty" Hofmann MD about his experiences in device and digital health innovation, including the inspiring story behind building Grand Rounds, a digital health company helping patients get better access to expert healthcare. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/hA0kx3 --- SHOW NOTES In this episode, Dr. Randy Hofmann joins Dr. Bryan Hartley to discuss his path to creating an innovative digital health company. Dr. Hofmann tells us how he became an IR and discusses his start in medical devices. We share some advice on how to get started on a new project. We discuss Dr. Hofmann’s health technology company, Grand Rounds, which offers clinical and financial guidance. Dr. Hofmann explains why he came up with the idea for a digital health company and how his experiences as a father and husband influenced his advocacy for patient education. Fri, 18 Dec 2020 13:00:00 -0000 full BackTable Bryan Hartley talks with Lawrence "Rusty" Hofmann MD about his experiences in device and digital health innovation, including the inspiring story behind building Grand Rounds, a digital health company helping patients get better access to expert healthcare. Bryan Hartley talks with Lawrence "Rusty" Hofmann MD about his experiences in device and digital health innovation, including the inspiring story behind building Grand Rounds, a digital health company helping patients get better access to expert healthcare. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/hA0kx3 --- SHOW NOTES In this episode, Dr. Randy Hofmann joins Dr. Bryan Hartley to discuss his path to creating an innovative digital health company. Dr. Hofmann tells us how he became an IR and discusses his start in medical devices. We share some advice on how to get started on a new project. We discuss Dr. Hofmann’s health technology company, Grand Rounds, which offers clinical and financial guidance. Dr. Hofmann explains why he came up with the idea for a digital health company and how his experiences as a father and husband influenced his advocacy for patient education. Bryan Hartley talks with Lawrence "Rusty" Hofmann MD about his experiences in device and digital health innovation, including the inspiring story behind building Grand Rounds, a digital health company helping patients get better access to expert healthcare.


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/hA0kx3


---


SHOW NOTES


In this episode, Dr. Randy Hofmann joins Dr. Bryan Hartley to discuss his path to creating an innovative digital health company. Dr. Hofmann tells us how he became an IR and discusses his start in medical devices. We share some advice on how to get started on a new project.


We discuss Dr. Hofmann’s health technology company, Grand Rounds, which offers clinical and financial guidance. Dr. Hofmann explains why he came up with the idea for a digital health company and how his experiences as a father and husband influenced his advocacy for patient education.

]]> 1367 no Ep. 99 Multidisciplinary Approach to Treating Spinal Metastases with Dr. Levy and Dr. Lavaf In this episode, Dr. Jason Levy and Dr. Amir Lavaf join Dr. Michael Barraza to discuss their multidisciplinary approach to treating spinal metastases. We examine the collaborative efforts between IR and radiation oncologists, and we break down the indications for treating spinal metastases. We discuss pain control and local control rates, and how doctors are working to improve them. Dr. Levy and Dr. Lavaf tell us why they are able to get better survival numbers when they approach the primary and metastatic disease at the same time. We explain how to work with tumor boards and different groups of doctors to make spinal metastases treatment easier. We discuss how to reduce risk of delayed skeletal events and radiation failure after spinal metastases treatment. We go over some of the challenges of working with the tumor board, and why it is important to develop relationships with medical oncologists and the importance of continuing systemic therapies. RESOURCES MENTIONED: BackTable Podcast Episode 68: RF Ablation Therapy for Bone Metastases https://www.backtable.com/podcast/68/rf-ablation-therapy-for-bone-metastases Mon, 14 Dec 2020 12:43:00 -0000 full BackTable In this episode, Dr. Jason Levy and Dr. Amir Lava… In this episode, Dr. Jason Levy and Dr. Amir Lavaf join Dr. Michael Barraza to discuss their multidisciplinary approach to treating spinal metastases. We examine the collaborative efforts between IR and radiation oncologists, and we break down the indications for treating spinal metastases. We discuss pain control and local control rates, and how doctors are working to improve them. Dr. Levy and Dr. Lavaf tell us why they are able to get better survival numbers when they approach the primary and metastatic disease at the same time. We explain how to work with tumor boards and different groups of doctors to make spinal metastases treatment easier. We discuss how to reduce risk of delayed skeletal events and radiation failure after spinal metastases treatment. We go over some of the challenges of working with the tumor board, and why it is important to develop relationships with medical oncologists and the importance of continuing systemic therapies. RESOURCES MENTIONED: BackTable Podcast Episode 68: RF Ablation Therapy for Bone Metastases https://www.backtable.com/podcast/68/rf-ablation-therapy-for-bone-metastases In this episode, Dr. Jason Levy and Dr. Amir Lavaf join Dr. Michael Barraza to discuss their multidisciplinary approach to treating spinal metastases. We examine the collaborative efforts between IR and radiation oncologists, and we break down the indications for treating spinal metastases. We discuss pain control and local control rates, and how doctors are working to improve them. Dr. Levy and Dr. Lavaf tell us why they are able to get better survival numbers when they approach the primary and metastatic disease at the same time. We explain how to work with tumor boards and different groups of doctors to make spinal metastases treatment easier. We discuss how to reduce risk of delayed skeletal events and radiation failure after spinal metastases treatment. We go over some of the challenges of working with the tumor board, and why it is important to develop relationships with medical oncologists and the importance of continuing systemic therapies. RESOURCES MENTIONED: BackTable Podcast Episode 68: RF Ablation Therapy for Bone Metastases https://www.backtable.com/podcast/68/rf-ablation-therapy-for-bone-metastases

]]> 1972 no Ep. 98 Using AI to Improve Stroke Care with Dr. Ameer Hassan In this episode, Dr. Ameer Hassan joins Dr. Sabeen Dhand to discuss the use of artificial intelligence (AI) to improve stroke care. We explain the hub and spoke model and how the primary stroke centers communicate in the hub. Dr. Hassan describes how the system determines which center a stroke patient will go to. We discuss how the system optimizes the transfer from spoke to hub and how comparing trends in stroke patients allowed them to speed up the process. We explain how AI is used in stroke care using decision trees and deep learning. We discuss the benefits of using AI to remove steps and sending push notifications to phones, allowing radiologists to review imaging quicker. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IhN6NW RESOURCES MENTIONED: SAGE journals; Interventional Neuroradiology https://journals.sagepub.com/doi/full/10.1177/1591019920953055 Early experience utilizing artificial intelligence shows significant reduction in transfer times and length of stay in a hub and spoke model Mon, 07 Dec 2020 13:00:00 -0000 full BackTable In this episode, Dr. Ameer Hassan joins Dr. Sabeen Dhand to discuss the use of artificial intelligence (AI) to improve stroke care. We explain the hub and spoke model and how the primary stroke centers communicate in the hub. In this episode, Dr. Ameer Hassan joins Dr. Sabeen Dhand to discuss the use of artificial intelligence (AI) to improve stroke care. We explain the hub and spoke model and how the primary stroke centers communicate in the hub. Dr. Hassan describes how the system determines which center a stroke patient will go to. We discuss how the system optimizes the transfer from spoke to hub and how comparing trends in stroke patients allowed them to speed up the process. We explain how AI is used in stroke care using decision trees and deep learning. We discuss the benefits of using AI to remove steps and sending push notifications to phones, allowing radiologists to review imaging quicker. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IhN6NW RESOURCES MENTIONED: SAGE journals; Interventional Neuroradiology https://journals.sagepub.com/doi/full/10.1177/1591019920953055 Early experience utilizing artificial intelligence shows significant reduction in transfer times and length of stay in a hub and spoke model In this episode, Dr. Ameer Hassan joins Dr. Sabeen Dhand to discuss the use of artificial intelligence (AI) to improve stroke care. We explain the hub and spoke model and how the primary stroke centers communicate in the hub. Dr. Hassan describes how the system determines which center a stroke patient will go to. We discuss how the system optimizes the transfer from spoke to hub and how comparing trends in stroke patients allowed them to speed up the process. We explain how AI is used in stroke care using decision trees and deep learning. We discuss the benefits of using AI to remove steps and sending push notifications to phones, allowing radiologists to review imaging quicker.


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IhN6NW


RESOURCES MENTIONED: SAGE journals; Interventional Neuroradiology https://journals.sagepub.com/doi/full/10.1177/1591019920953055 Early experience utilizing artificial intelligence shows significant reduction in transfer times and length of stay in a hub and spoke model

]]> 2094 no Ep. 97 Nephrostomy Tube Placement- Basic to Advanced with Dr. David Field In this episode, Dr. David Field joins Dr. Aaron Fritts to discuss nephrostomy tube placement. We talk about the most common indications for this procedure, and Dr. Field explains why he prefers the single stick technique over the double stick technique. We discuss why it is important to scan the patient with ultrasound before preparing them for the nephrostomy tube placement. We give some tips for trainees on the process of inserting the needle, and we review the dangers of over-pressurizing. We discuss how much blood in the urine is worrisome, managing anticoagulation meds, and which labs to run prior to the nephrostomy tube placement. Dr. Field tells us about using guidance software and how to properly direct the needle, once inside the patient. We discuss why you might inject air rather than contrast. We emphasize the importance of working with urology ahead of time and what post-op care looks like for different types of patients. Dr. Field gives some advice when dealing with the challenges of nephrostomy tube placement, and we give trainees some general advice on this procedure. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/r2AlYc RESOURCES MENTIONED: Nephrostomy Tube Placement Procedure https://www.backtable.com/app-procedure/nephrostomy-tube-placement Mon, 30 Nov 2020 13:00:00 -0000 full BackTable In this episode, Dr. David Field joins Dr. Aaron Fritts to discuss nephrostomy tube placement. We talk about the most common indications for this procedure, and Dr. Field explains why he prefers the single stick technique over the double stick technique. In this episode, Dr. David Field joins Dr. Aaron Fritts to discuss nephrostomy tube placement. We talk about the most common indications for this procedure, and Dr. Field explains why he prefers the single stick technique over the double stick technique. We discuss why it is important to scan the patient with ultrasound before preparing them for the nephrostomy tube placement. We give some tips for trainees on the process of inserting the needle, and we review the dangers of over-pressurizing. We discuss how much blood in the urine is worrisome, managing anticoagulation meds, and which labs to run prior to the nephrostomy tube placement. Dr. Field tells us about using guidance software and how to properly direct the needle, once inside the patient. We discuss why you might inject air rather than contrast. We emphasize the importance of working with urology ahead of time and what post-op care looks like for different types of patients. Dr. Field gives some advice when dealing with the challenges of nephrostomy tube placement, and we give trainees some general advice on this procedure. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/r2AlYc RESOURCES MENTIONED: Nephrostomy Tube Placement Procedure https://www.backtable.com/app-procedure/nephrostomy-tube-placement In this episode, Dr. David Field joins Dr. Aaron Fritts to discuss nephrostomy tube placement. We talk about the most common indications for this procedure, and Dr. Field explains why he prefers the single stick technique over the double stick technique. We discuss why it is important to scan the patient with ultrasound before preparing them for the nephrostomy tube placement. We give some tips for trainees on the process of inserting the needle, and we review the dangers of over-pressurizing. We discuss how much blood in the urine is worrisome, managing anticoagulation meds, and which labs to run prior to the nephrostomy tube placement. Dr. Field tells us about using guidance software and how to properly direct the needle, once inside the patient. We discuss why you might inject air rather than contrast. We emphasize the importance of working with urology ahead of time and what post-op care looks like for different types of patients. Dr. Field gives some advice when dealing with the challenges of nephrostomy tube placement, and we give trainees some general advice on this procedure.


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/r2AlYc


RESOURCES MENTIONED: Nephrostomy Tube Placement Procedure https://www.backtable.com/app-procedure/nephrostomy-tube-placement

]]> 2755 no Ep. 96 Building a PAE Program Alongside Urology with Dr. Matt Raynor and Dr. Ari Isaacson In this episode, Dr. Matt Raynor and Dr. Ari Isaacson join Dr. Michael Barraza to discuss their prostatic artery embolization (PAE) program. They tell us about their new book and how they worked with IR and urology to build their program. We discuss how they got started with their first patient and explain when to follow up with PAE patients. We talk about the initial challenges of starting the PAE program, and we discuss what type of patients would be good candidates for the procedure. Dr. Raynor and Dr. Isaacson give us some advice on how to make a pitch to Urology practices that treat benign prostatic hyperplasia (BPH) patients. We discuss how IR and urology departments can collaborate and how to work with physicians who are skeptical. We examine how they approach the market for this procedure and why word-of-mouth from previous patients is so important. We emphasize learning the technique of the prostatic artery embolization, but also why interventional radiologists should learn about BPH disease process in detail. RESOURCES MENTIONED: Prostatic Artery Embolization https://www.amazon.com/Prostatic-Artery-Embolization-Ari-Isaacson/dp/3030234703/ref=sr_1_1?dchild=1&keywords=prostatic+artery+embolization&qid=1606166571&sr=8-1 This is the book by Dr. Raynor and Dr. Isaacson about PAE in IR. BackTable Podcast episode 17: Prostate Artery Embolization with Dr. Ari Isaacson and Dr. Sandeep Bagla https://www.backtable.com/podcast/17/prostate-artery-embolization Check out another episode about PAE with Dr. Isaacson! Mon, 23 Nov 2020 13:00:00 -0000 full BackTable In this episode, Dr. Matt Raynor and Dr. Ari Isaacson join Dr. Michael Barraza to discuss their prostatic artery embolization (PAE) program. In this episode, Dr. Matt Raynor and Dr. Ari Isaacson join Dr. Michael Barraza to discuss their prostatic artery embolization (PAE) program. They tell us about their new book and how they worked with IR and urology to build their program. We discuss how they got started with their first patient and explain when to follow up with PAE patients. We talk about the initial challenges of starting the PAE program, and we discuss what type of patients would be good candidates for the procedure. Dr. Raynor and Dr. Isaacson give us some advice on how to make a pitch to Urology practices that treat benign prostatic hyperplasia (BPH) patients. We discuss how IR and urology departments can collaborate and how to work with physicians who are skeptical. We examine how they approach the market for this procedure and why word-of-mouth from previous patients is so important. We emphasize learning the technique of the prostatic artery embolization, but also why interventional radiologists should learn about BPH disease process in detail. RESOURCES MENTIONED: Prostatic Artery Embolization https://www.amazon.com/Prostatic-Artery-Embolization-Ari-Isaacson/dp/3030234703/ref=sr_1_1?dchild=1&keywords=prostatic+artery+embolization&qid=1606166571&sr=8-1 This is the book by Dr. Raynor and Dr. Isaacson about PAE in IR. BackTable Podcast episode 17: Prostate Artery Embolization with Dr. Ari Isaacson and Dr. Sandeep Bagla https://www.backtable.com/podcast/17/prostate-artery-embolization Check out another episode about PAE with Dr. Isaacson! In this episode, Dr. Matt Raynor and Dr. Ari Isaacson join Dr. Michael Barraza to discuss their prostatic artery embolization (PAE) program. They tell us about their new book and how they worked with IR and urology to build their program. We discuss how they got started with their first patient and explain when to follow up with PAE patients. We talk about the initial challenges of starting the PAE program, and we discuss what type of patients would be good candidates for the procedure. Dr. Raynor and Dr. Isaacson give us some advice on how to make a pitch to Urology practices that treat benign prostatic hyperplasia (BPH) patients. We discuss how IR and urology departments can collaborate and how to work with physicians who are skeptical. We examine how they approach the market for this procedure and why word-of-mouth from previous patients is so important. We emphasize learning the technique of the prostatic artery embolization, but also why interventional radiologists should learn about BPH disease process in detail. RESOURCES MENTIONED: Prostatic Artery Embolization https://www.amazon.com/Prostatic-Artery-Embolization-Ari-Isaacson/dp/3030234703/ref=sr_1_1?dchild=1&keywords=prostatic+artery+embolization&qid=1606166571&sr=8-1 This is the book by Dr. Raynor and Dr. Isaacson about PAE in IR. BackTable Podcast episode 17: Prostate Artery Embolization with Dr. Ari Isaacson and Dr. Sandeep Bagla https://www.backtable.com/podcast/17/prostate-artery-embolization Check out another episode about PAE with Dr. Isaacson!

]]> 2453 no Ep. 95 Needs Driven Innovation with Dr. Todd Brinton In this episode, Dr. Brinton tells us how he started as a biomedical engineer and why he eventually went to medical school. We discuss how important mentorship can be, and we talk about how he was able to balance residency with building a company. Dr. Brinton shares some of the biggest lessons he has learned while being an innovator, and he discusses the goals of his company, Shockwave. We talk about the importance of understanding the patient population and some of the technical challenges of creating solutions to healthcare problems. We speak about Dr. Brinton’s position as the Fellowship Director of BioDesign at Stanford, and how he worked to train the next generation of innovators. We review the importance of needs driven innovation in medicine and how to keep the patient at the center of the innovation process. We discuss the importance of having a creative, multidisciplinary team behind an invention. We share some advice for physicians wanting to get started in needs driven innovation and explain when to file for intellectual property. Dr. Brinton explains why it can be important to “fail often and fail fast.” Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/oaB26u Mon, 16 Nov 2020 13:00:00 -0000 full BackTable In this episode, Dr. Brinton tells us how he started as a biomedical engineer and why he eventually went to medical school. We discuss how important mentorship can be, and we talk about how he was able to balance residency with building a company. In this episode, Dr. Brinton tells us how he started as a biomedical engineer and why he eventually went to medical school. We discuss how important mentorship can be, and we talk about how he was able to balance residency with building a company. Dr. Brinton shares some of the biggest lessons he has learned while being an innovator, and he discusses the goals of his company, Shockwave. We talk about the importance of understanding the patient population and some of the technical challenges of creating solutions to healthcare problems. We speak about Dr. Brinton’s position as the Fellowship Director of BioDesign at Stanford, and how he worked to train the next generation of innovators. We review the importance of needs driven innovation in medicine and how to keep the patient at the center of the innovation process. We discuss the importance of having a creative, multidisciplinary team behind an invention. We share some advice for physicians wanting to get started in needs driven innovation and explain when to file for intellectual property. Dr. Brinton explains why it can be important to “fail often and fail fast.” Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/oaB26u In this episode, Dr. Brinton tells us how he started as a biomedical engineer and why he eventually went to medical school. We discuss how important mentorship can be, and we talk about how he was able to balance residency with building a company. Dr. Brinton shares some of the biggest lessons he has learned while being an innovator, and he discusses the goals of his company, Shockwave. We talk about the importance of understanding the patient population and some of the technical challenges of creating solutions to healthcare problems. We speak about Dr. Brinton’s position as the Fellowship Director of BioDesign at Stanford, and how he worked to train the next generation of innovators. We review the importance of needs driven innovation in medicine and how to keep the patient at the center of the innovation process. We discuss the importance of having a creative, multidisciplinary team behind an invention. We share some advice for physicians wanting to get started in needs driven innovation and explain when to file for intellectual property. Dr. Brinton explains why it can be important to “fail often and fail fast.”


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/oaB26u


]]> 3092 no Ep. 94 Innovation in Spine Interventions with Dr. Douglas Beall In this episode, Dr. Douglas Beall joins Dr. Michael Barraza to discuss innovation in spine interventions. Dr. Beall tells us how he got his training in spine interventions and shifted to a more clinical approach. We talk about how following patients longitudinally can help determine the true source of pain, and the benefit of implementing new methods into a practice. We discuss what the term interventional radiologist really means and the importance of diagnostic input. We discuss an example of an out of the box spine intervention that helped a patient. Dr. Beall speaks about his new book that came out earlier this year and how it is different from other textbooks and how he has been using Twitter to give tips and tricks. We talk about how this inspired Dr. Beall to re-start a fellowship training program for spine intervention. We discuss studies and trials that were done on vertebral augmentation, and we examine the relationship between the name and value of interventional radiology. We touch on some goals for AI use in spine interventions and its impact on diagnosis and treatment. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/BiMwPv RESOURCES MENTIONED: Book by Dr. Beall: Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation https://www.amazon.com/gp/product/B0856PWC7G/ref=dbs_a_def_rwt_hsch_vapi_tkin_p1_i0 Check out Dr. Beall on Twitter @dougbeall Mon, 09 Nov 2020 12:05:00 -0000 full BackTable In this episode, Dr. Douglas Beall joins Dr. Michael Barraza to discuss innovation in spine interventions. Dr. Beall tells us how he got his training in spine interventions and shifted to a more clinical approach. In this episode, Dr. Douglas Beall joins Dr. Michael Barraza to discuss innovation in spine interventions. Dr. Beall tells us how he got his training in spine interventions and shifted to a more clinical approach. We talk about how following patients longitudinally can help determine the true source of pain, and the benefit of implementing new methods into a practice. We discuss what the term interventional radiologist really means and the importance of diagnostic input. We discuss an example of an out of the box spine intervention that helped a patient. Dr. Beall speaks about his new book that came out earlier this year and how it is different from other textbooks and how he has been using Twitter to give tips and tricks. We talk about how this inspired Dr. Beall to re-start a fellowship training program for spine intervention. We discuss studies and trials that were done on vertebral augmentation, and we examine the relationship between the name and value of interventional radiology. We touch on some goals for AI use in spine interventions and its impact on diagnosis and treatment. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/BiMwPv RESOURCES MENTIONED: Book by Dr. Beall: Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation https://www.amazon.com/gp/product/B0856PWC7G/ref=dbs_a_def_rwt_hsch_vapi_tkin_p1_i0 Check out Dr. Beall on Twitter @dougbeall In this episode, Dr. Douglas Beall joins Dr. Michael Barraza to discuss innovation in spine interventions. Dr. Beall tells us how he got his training in spine interventions and shifted to a more clinical approach. We talk about how following patients longitudinally can help determine the true source of pain, and the benefit of implementing new methods into a practice. We discuss what the term interventional radiologist really means and the importance of diagnostic input. We discuss an example of an out of the box spine intervention that helped a patient. Dr. Beall speaks about his new book that came out earlier this year and how it is different from other textbooks and how he has been using Twitter to give tips and tricks. We talk about how this inspired Dr. Beall to re-start a fellowship training program for spine intervention. We discuss studies and trials that were done on vertebral augmentation, and we examine the relationship between the name and value of interventional radiology. We touch on some goals for AI use in spine interventions and its impact on diagnosis and treatment.


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/BiMwPv


RESOURCES MENTIONED: Book by Dr. Beall: Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation https://www.amazon.com/gp/product/B0856PWC7G/ref=dbs_a_def_rwt_hsch_vapi_tkin_p1_i0 Check out Dr. Beall on Twitter @dougbeall

]]> 2826 no Ep. 93 Deep Venous Arterialization for CLI with Dr. Fadi Saab https://soundcloud.com/backtable/ep-93-deep-venous-arterialization-for-cli-with-dr-fadi-saab In this episode, Dr. Fadi Saab joins Dr. Sabeen Dhand to discuss deep venous arterialization for critical limb ischemia. Dr. Saab explains how gained experience in this procedure and the changes in treatment of CLI that have occurred over the past few years. We discuss the concept of deep venous arterialization and some common patient concerns. We talk about working as a team with podiatrists and wound care specialists, who the best candidates for deep venous arterialization are, and Dr. Saab explains the term “white stop sign.” We discuss the setting of these procedures and why having the right support staff throughout the case is so important. We examine the technique and steps of the deep venous arterialization procedure, as well as potential pitfalls to avoid. Dr. Saab describes his protocol for post-procedure care, and we discuss how technology has impacted this field in recent years. RESOURCES MENTIONED: https://www.iset.org/ Use the discount code (BACKTABLE) to register for ISET. CLI Fighters Global Society https://www.cliglobalsociety.org/ Mon, 02 Nov 2020 12:47:00 -0000 full BackTable In this episode, Dr. Fadi Saab joins Dr. Sabeen D… In this episode, Dr. Fadi Saab joins Dr. Sabeen Dhand to discuss deep venous arterialization for critical limb ischemia. Dr. Saab explains how gained experience in this procedure and the changes in treatment of CLI that have occurred over the past few years. We discuss the concept of deep venous arterialization and some common patient concerns. We talk about working as a team with podiatrists and wound care specialists, who the best candidates for deep venous arterialization are, and Dr. Saab explains the term “white stop sign.” We discuss the setting of these procedures and why having the right support staff throughout the case is so important. We examine the technique and steps of the deep venous arterialization procedure, as well as potential pitfalls to avoid. Dr. Saab describes his protocol for post-procedure care, and we discuss how technology has impacted this field in recent years. RESOURCES MENTIONED: https://www.iset.org/ Use the discount code (BACKTABLE) to register for ISET. CLI Fighters Global Society https://www.cliglobalsociety.org/ In this episode, Dr. Fadi Saab joins Dr. Sabeen Dhand to discuss deep venous arterialization for critical limb ischemia. Dr. Saab explains how gained experience in this procedure and the changes in treatment of CLI that have occurred over the past few years. We discuss the concept of deep venous arterialization and some common patient concerns. We talk about working as a team with podiatrists and wound care specialists, who the best candidates for deep venous arterialization are, and Dr. Saab explains the term “white stop sign.” We discuss the setting of these procedures and why having the right support staff throughout the case is so important. We examine the technique and steps of the deep venous arterialization procedure, as well as potential pitfalls to avoid. Dr. Saab describes his protocol for post-procedure care, and we discuss how technology has impacted this field in recent years. RESOURCES MENTIONED: https://www.iset.org/ Use the discount code (BACKTABLE) to register for ISET. CLI Fighters Global Society https://www.cliglobalsociety.org/

]]> 2889 no Ep. 92 Interventional Oncology in Private Practice- Part II Approach to HCC with Dr. Justin Lee https://soundcloud.com/backtable/ep-92-interventional-oncology-in-private-practice-part-ii-approach-to-hcc-with-dr-justin-lee In this episode, Dr. Justin Lee joins Dr. Christopher Beck to discuss hepatocellular carcinoma (HCC) and interventional oncology in private practice. Dr. Lee tells us how he frames his HCC patients and works with medical oncologists for treatment plans and procedures. We talk about the importance of IR bringing cases to the tumor board, the evolution of cases involving ablation, and why Dr. Lee started moving towards radioembolization (Y90). We review how to approach HCC cases while working with medical oncologists. We examine the differences between using resin and glass for radioembolization and when they should be used. Dr. Lee shares why IR should start looking into arterial drug delivery for immunotherapies. RESOURCES MENTIONED: NEJM: Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma https://www.nejm.org/doi/10.1056/NEJMoa1915745 This paper, mentioned by Dr. Lee, discusses the third phase of an HCC trial. Wed, 28 Oct 2020 11:32:00 -0000 full BackTable In this episode, Dr. Justin Lee joins Dr. Christo… In this episode, Dr. Justin Lee joins Dr. Christopher Beck to discuss hepatocellular carcinoma (HCC) and interventional oncology in private practice. Dr. Lee tells us how he frames his HCC patients and works with medical oncologists for treatment plans and procedures. We talk about the importance of IR bringing cases to the tumor board, the evolution of cases involving ablation, and why Dr. Lee started moving towards radioembolization (Y90). We review how to approach HCC cases while working with medical oncologists. We examine the differences between using resin and glass for radioembolization and when they should be used. Dr. Lee shares why IR should start looking into arterial drug delivery for immunotherapies. RESOURCES MENTIONED: NEJM: Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma https://www.nejm.org/doi/10.1056/NEJMoa1915745 This paper, mentioned by Dr. Lee, discusses the third phase of an HCC trial. In this episode, Dr. Justin Lee joins Dr. Christopher Beck to discuss hepatocellular carcinoma (HCC) and interventional oncology in private practice. Dr. Lee tells us how he frames his HCC patients and works with medical oncologists for treatment plans and procedures. We talk about the importance of IR bringing cases to the tumor board, the evolution of cases involving ablation, and why Dr. Lee started moving towards radioembolization (Y90). We review how to approach HCC cases while working with medical oncologists. We examine the differences between using resin and glass for radioembolization and when they should be used. Dr. Lee shares why IR should start looking into arterial drug delivery for immunotherapies. RESOURCES MENTIONED: NEJM: Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma https://www.nejm.org/doi/10.1056/NEJMoa1915745 This paper, mentioned by Dr. Lee, discusses the third phase of an HCC trial.

]]> 2615 no Ep. 91 Interventional Oncology in Private Practice- Part I Practice Building with Dr. Justin Lee https://soundcloud.com/backtable/ep-91-interventional-oncology-in-private-practice-part-i-practice-building-with-dr-justin-lee In this episode, Dr. Justin Lee joins Dr. Christopher Beck to discuss interventional oncology in private practice. We talk about challenges that come with developing a private practice, the transition from academics to community hospitals, and how to be comfortable speaking the language of oncologists. Dr. Lee emphasizes why it is important to come out of a fellowship knowing the latest information in the field, and we cover some important details regarding scheduling oncology patients. We discuss ways to build physician-physician relationships when it comes to referrals and why it is important to remember that not everyone knows what an interventional radiologist is or the services they might offer. Dr. Lee mentions how he made adjustments at his private practice to maintaining a healthy conversation between diagnostic and interventional radiology. Mon, 26 Oct 2020 12:00:00 -0000 full BackTable In this episode, Dr. Justin Lee joins Dr. Christo… In this episode, Dr. Justin Lee joins Dr. Christopher Beck to discuss interventional oncology in private practice. We talk about challenges that come with developing a private practice, the transition from academics to community hospitals, and how to be comfortable speaking the language of oncologists. Dr. Lee emphasizes why it is important to come out of a fellowship knowing the latest information in the field, and we cover some important details regarding scheduling oncology patients. We discuss ways to build physician-physician relationships when it comes to referrals and why it is important to remember that not everyone knows what an interventional radiologist is or the services they might offer. Dr. Lee mentions how he made adjustments at his private practice to maintaining a healthy conversation between diagnostic and interventional radiology. In this episode, Dr. Justin Lee joins Dr. Christopher Beck to discuss interventional oncology in private practice. We talk about challenges that come with developing a private practice, the transition from academics to community hospitals, and how to be comfortable speaking the language of oncologists. Dr. Lee emphasizes why it is important to come out of a fellowship knowing the latest information in the field, and we cover some important details regarding scheduling oncology patients. We discuss ways to build physician-physician relationships when it comes to referrals and why it is important to remember that not everyone knows what an interventional radiologist is or the services they might offer. Dr. Lee mentions how he made adjustments at his private practice to maintaining a healthy conversation between diagnostic and interventional radiology.

]]> 1716 no Ep. 90 Pedal Acceleration Time for Limb Salvage with Jill Sommerset and Dr. Mary Costantino https://soundcloud.com/backtable/ep-90-pedal-acceleration-time-for-limb-salvage-with-jill-sommerset-and-dr-mary-costantino In this episode, Jill Sommerset joins Dr. Mary Costantino to discuss how she developed Pedal Acceleration Time (PAT) for limb salvage. She begins by talking about what got her into vascular ultrasound and the importance of vascular techs, especially for pre-operative planning. We discuss how she invented the pedal acceleration time technique by tracking data from foot scans. Jill speaks about PAT classifications and how they correlate to ABI (Ankle-Brachial Index) numbers. We talk through how they use pedal acceleration time on a typical day and for some different types of patients. We go over some of the limitations of PAT and some of the cases where it is extremely helpful. Jill discusses her role in the cath lab, how she is developing a platform for pedal acceleration time training, and why it is important for both the physician and vascular tech to learn about PAT. RESOURCES MENTIONED: International Symposium on Endovascular Therapy www.iset.org Use the discount code (backtable) to register for ISET. Mon, 19 Oct 2020 12:00:00 -0000 full BackTable In this episode, Jill Sommerset joins Dr. Mary Costantino to discuss how she developed Pedal Acceleration Time (PAT) for limb salvage. In this episode, Jill Sommerset joins Dr. Mary Costantino to discuss how she developed Pedal Acceleration Time (PAT) for limb salvage. She begins by talking about what got her into vascular ultrasound and the importance of vascular techs, especially for pre-operative planning. We discuss how she invented the pedal acceleration time technique by tracking data from foot scans. Jill speaks about PAT classifications and how they correlate to ABI (Ankle-Brachial Index) numbers. We talk through how they use pedal acceleration time on a typical day and for some different types of patients. We go over some of the limitations of PAT and some of the cases where it is extremely helpful. Jill discusses her role in the cath lab, how she is developing a platform for pedal acceleration time training, and why it is important for both the physician and vascular tech to learn about PAT. RESOURCES MENTIONED: International Symposium on Endovascular Therapy www.iset.org Use the discount code (backtable) to register for ISET. In this episode, Jill Sommerset joins Dr. Mary Costantino to discuss how she developed Pedal Acceleration Time (PAT) for limb salvage. She begins by talking about what got her into vascular ultrasound and the importance of vascular techs, especially for pre-operative planning. We discuss how she invented the pedal acceleration time technique by tracking data from foot scans. Jill speaks about PAT classifications and how they correlate to ABI (Ankle-Brachial Index) numbers. We talk through how they use pedal acceleration time on a typical day and for some different types of patients. We go over some of the limitations of PAT and some of the cases where it is extremely helpful. Jill discusses her role in the cath lab, how she is developing a platform for pedal acceleration time training, and why it is important for both the physician and vascular tech to learn about PAT. RESOURCES MENTIONED: International Symposium on Endovascular Therapy www.iset.org Use the discount code (backtable) to register for ISET.

]]> 3068 no Ep. 89 Online Education in Vascular Medicine: do we have the best format? with Dr. Theodosios Bisdas In this episode, Dr. Theodosios Bisdas joins Dr. Aaron Fritts to discuss online education and his e-learning platform, Vascupedia. Dr. Bisdas talks about how he started the platform and the three main parts of the website: main arena, polling station, and exhibition area. We talk about how social media has helped expand his platform to American audiences and how to collaborate with companies and medical societies to present new devices. We go over some of the main challenges of e-learning and why it is important for physicians to have time to watch webinars. Dr. Bisdas emphasizes the value of virtual learning, having forums for international conversation, and he speaks about his hopes for the future of Vascupedia. We discuss the benefits of on-demand, high quality online content and the importance of platforms created by physicians for physicians. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/jGVeCR RESOURCES MENTIONED: Vascupedia https://vascupedia.com/ This website contains the online learning platform mentioned by Dr. Bisdas. Tue, 13 Oct 2020 14:53:00 -0000 full BackTable In this episode, Dr. Theodosios Bisdas joins Dr. Aaron Fritts to discuss online education and his e-learning platform, Vascupedia. Dr. Bisdas talks about how he started the platform and the three main parts of the website: main arena, polling station, and exhibition area. In this episode, Dr. Theodosios Bisdas joins Dr. Aaron Fritts to discuss online education and his e-learning platform, Vascupedia. Dr. Bisdas talks about how he started the platform and the three main parts of the website: main arena, polling station, and exhibition area. We talk about how social media has helped expand his platform to American audiences and how to collaborate with companies and medical societies to present new devices. We go over some of the main challenges of e-learning and why it is important for physicians to have time to watch webinars. Dr. Bisdas emphasizes the value of virtual learning, having forums for international conversation, and he speaks about his hopes for the future of Vascupedia. We discuss the benefits of on-demand, high quality online content and the importance of platforms created by physicians for physicians. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/jGVeCR RESOURCES MENTIONED: Vascupedia https://vascupedia.com/ This website contains the online learning platform mentioned by Dr. Bisdas. In this episode, Dr. Theodosios Bisdas joins Dr. Aaron Fritts to discuss online education and his e-learning platform, Vascupedia. Dr. Bisdas talks about how he started the platform and the three main parts of the website: main arena, polling station, and exhibition area. We talk about how social media has helped expand his platform to American audiences and how to collaborate with companies and medical societies to present new devices. We go over some of the main challenges of e-learning and why it is important for physicians to have time to watch webinars. Dr. Bisdas emphasizes the value of virtual learning, having forums for international conversation, and he speaks about his hopes for the future of Vascupedia. We discuss the benefits of on-demand, high quality online content and the importance of platforms created by physicians for physicians.


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/jGVeCR


RESOURCES MENTIONED: Vascupedia https://vascupedia.com/ This website contains the online learning platform mentioned by Dr. Bisdas.

]]> 1784 no Ep. 88 Intro to Structural Heart Disease with Dr. Raj Narayan In this episode, Dr. Rajeev Narayan joins Dr. Achal Sahai to discuss structural heart disease and the (Transcatheter aortic valve replacement) TAVR procedure. Dr. Narayan talks us through what an average working week looks like and speaks to the importance of having a great referral network. We define structural heart disease and discuss the development of the TAVR procedure for high risk patients and how the process is different from a regular cardiac surgery. We examine what can make a patient with structural heart disease high risk and eligible for TAVR. We talk through how access has changed over the years and some of the more technical aspects of these procedures. Dr. Narayan gives some advice to trainees and emphasizes the importance of learning to face complications on your own. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/scgy25 Sat, 10 Oct 2020 12:00:00 -0000 full BackTable In this episode, Dr. Rajeev Narayan joins Dr. Achal Sahai to discuss structural heart disease and the (Transcatheter aortic valve replacement) TAVR procedure. In this episode, Dr. Rajeev Narayan joins Dr. Achal Sahai to discuss structural heart disease and the (Transcatheter aortic valve replacement) TAVR procedure. Dr. Narayan talks us through what an average working week looks like and speaks to the importance of having a great referral network. We define structural heart disease and discuss the development of the TAVR procedure for high risk patients and how the process is different from a regular cardiac surgery. We examine what can make a patient with structural heart disease high risk and eligible for TAVR. We talk through how access has changed over the years and some of the more technical aspects of these procedures. Dr. Narayan gives some advice to trainees and emphasizes the importance of learning to face complications on your own. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/scgy25 In this episode, Dr. Rajeev Narayan joins Dr. Achal Sahai to discuss structural heart disease and the (Transcatheter aortic valve replacement) TAVR procedure. Dr. Narayan talks us through what an average working week looks like and speaks to the importance of having a great referral network. We define structural heart disease and discuss the development of the TAVR procedure for high risk patients and how the process is different from a regular cardiac surgery. We examine what can make a patient with structural heart disease high risk and eligible for TAVR. We talk through how access has changed over the years and some of the more technical aspects of these procedures. Dr. Narayan gives some advice to trainees and emphasizes the importance of learning to face complications on your own.


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/scgy25

]]> 3202 no Ep. 87 Deep Dive Into Ascites with Dr. Rajeev Suri https://soundcloud.com/backtable/ep-87-deep-dive-into-ascites-with-dr-rajeev-suri In this episode, Dr. Rajeev Suri joins Dr. Christopher Beck to discuss ascites and paracentesis. Dr. Suri touches on what a potential paracentesis candidate might present with and speaks about why no lab values or blood tests are needed prior to the procedure. We discuss the basic steps for removing ascites, how to find the side with the biggest pocket, and preventing leakage by using a Z pattern. He speaks to the circumstances for using direct US guidance rather than intermittent and when, if ever, to use glue or stitches after paracentesis. We mention the benefits of utilizing the Renova Pump for fluid removal and discuss why Dr. Suri might use a vacuum container bottle rather than a wall suction. Lastly, we examine some methods for managing recurring patients in the ascites clinic. Dr. Suri also discusses how his practice has incorporated a paracentesis clinic to reduce the number of emergency room visits for ascites and how this practice has improved workflow and patient access to an interventional radiologist. RESOURCES MENTIONED: RenovaRP® Paracentesis Management System www.rethinkparas.com This website allows you to download the case study mentioned by Dr. Beck and check out other products from GI Supply. AASLD Guidelines https://www.aasld.org/publications/practice-guidelines This website includes the 2013 guidelines for ascites management. SIR Coagulation Guidelines https://www.jvir.org/article/S1051-0443(19)30407-5/pdf This pdf has recommendations for periprocedural management of thrombotic and bleeding risks in patients. Denver Shunts https://www.ajronline.org/doi/full/10.2214/AJR.12.9203 This article, mentioned by Dr. Suri, discusses the placement and management of Denver shunts for portal hypertensice ascites. Tue, 06 Oct 2020 15:11:00 -0000 full BackTable In this episode, Dr. Rajeev Suri joins Dr. Christopher Beck to discuss ascites and paracentesis. Dr. Suri touches on what a potential paracentesis candidate might present with and speaks about why no lab values or blood tests are needed prior to the procedure. In this episode, Dr. Rajeev Suri joins Dr. Christopher Beck to discuss ascites and paracentesis. Dr. Suri touches on what a potential paracentesis candidate might present with and speaks about why no lab values or blood tests are needed prior to the procedure. We discuss the basic steps for removing ascites, how to find the side with the biggest pocket, and preventing leakage by using a Z pattern. He speaks to the circumstances for using direct US guidance rather than intermittent and when, if ever, to use glue or stitches after paracentesis. We mention the benefits of utilizing the Renova Pump for fluid removal and discuss why Dr. Suri might use a vacuum container bottle rather than a wall suction. Lastly, we examine some methods for managing recurring patients in the ascites clinic. Dr. Suri also discusses how his practice has incorporated a paracentesis clinic to reduce the number of emergency room visits for ascites and how this practice has improved workflow and patient access to an interventional radiologist. RESOURCES MENTIONED: RenovaRP® Paracentesis Management System www.rethinkparas.com This website allows you to download the case study mentioned by Dr. Beck and check out other products from GI Supply. AASLD Guidelines https://www.aasld.org/publications/practice-guidelines This website includes the 2013 guidelines for ascites management. SIR Coagulation Guidelines https://www.jvir.org/article/S1051-0443(19)30407-5/pdf This pdf has recommendations for periprocedural management of thrombotic and bleeding risks in patients. Denver Shunts https://www.ajronline.org/doi/full/10.2214/AJR.12.9203 This article, mentioned by Dr. Suri, discusses the placement and management of Denver shunts for portal hypertensice ascites. In this episode, Dr. Rajeev Suri joins Dr. Christopher Beck to discuss ascites and paracentesis. Dr. Suri touches on what a potential paracentesis candidate might present with and speaks about why no lab values or blood tests are needed prior to the procedure. We discuss the basic steps for removing ascites, how to find the side with the biggest pocket, and preventing leakage by using a Z pattern. He speaks to the circumstances for using direct US guidance rather than intermittent and when, if ever, to use glue or stitches after paracentesis. We mention the benefits of utilizing the Renova Pump for fluid removal and discuss why Dr. Suri might use a vacuum container bottle rather than a wall suction. Lastly, we examine some methods for managing recurring patients in the ascites clinic. Dr. Suri also discusses how his practice has incorporated a paracentesis clinic to reduce the number of emergency room visits for ascites and how this practice has improved workflow and patient access to an interventional radiologist. RESOURCES MENTIONED: RenovaRP® Paracentesis Management System www.rethinkparas.com This website allows you to download the case study mentioned by Dr. Beck and check out other products from GI Supply. AASLD Guidelines https://www.aasld.org/publications/practice-guidelines This website includes the 2013 guidelines for ascites management. SIR Coagulation Guidelines https://www.jvir.org/article/S1051-0443(19)30407-5/pdf This pdf has recommendations for periprocedural management of thrombotic and bleeding risks in patients. Denver Shunts https://www.ajronline.org/doi/full/10.2214/AJR.12.9203 This article, mentioned by Dr. Suri, discusses the placement and management of Denver shunts for portal hypertensice ascites.

]]> 2470 no Ep. 86 Building a PAD practice with Dr. Srini Tummala https://soundcloud.com/backtable/ep-86-building-a-pad-practice-with-dr-srini-tummula Building a PAD practice with Dr. Srini Tummala by BackTable Sat, 03 Oct 2020 13:37:00 -0000 full BackTable Building a PAD practice with Dr. Srini Tummala Building a PAD practice with Dr. Srini Tummala by BackTable Building a PAD practice with Dr. Srini Tummala by BackTable

]]> 2724 no Ep. 85 Genicular Artery Embolization for OA with Dr. Jafar Golzarian https://soundcloud.com/backtable/ep-85-geniculate-artery-embolization-for-oa-with-dr-jafar-golzarian In this episode, Dr. Jafar Golzarian joins Dr. Michael Barraza to discuss genicular artery embolization for osteoarthritis. Dr. Golzarian describes how he worked and collaborated with orthopedic surgeons to offer this procedure for his patients. He also speaks about some potential underlying causes and aggravating factors for osteoarthritis. Dr. Golzarian provides useful tips on taking an academic approach to setting up trials and what makes his trials different from previous studies on genicular artery embolization. We discuss why patients with osteoarthritis can be a challenge for family practitioners and how collaboration with IR can benefit these patients. We go into the differences in the procedure for hemarthrosis and osteoarthritis. We review some ways to find the best angle to identify an arterial origin for embolization, and we discuss some of the challenges in the embolization procedure and how to adapt to different types of patients. Mon, 28 Sep 2020 12:00:00 -0000 full BackTable In this episode, Dr. Jafar Golzarian joins Dr. Mi… In this episode, Dr. Jafar Golzarian joins Dr. Michael Barraza to discuss genicular artery embolization for osteoarthritis. Dr. Golzarian describes how he worked and collaborated with orthopedic surgeons to offer this procedure for his patients. He also speaks about some potential underlying causes and aggravating factors for osteoarthritis. Dr. Golzarian provides useful tips on taking an academic approach to setting up trials and what makes his trials different from previous studies on genicular artery embolization. We discuss why patients with osteoarthritis can be a challenge for family practitioners and how collaboration with IR can benefit these patients. We go into the differences in the procedure for hemarthrosis and osteoarthritis. We review some ways to find the best angle to identify an arterial origin for embolization, and we discuss some of the challenges in the embolization procedure and how to adapt to different types of patients. In this episode, Dr. Jafar Golzarian joins Dr. Michael Barraza to discuss genicular artery embolization for osteoarthritis. Dr. Golzarian describes how he worked and collaborated with orthopedic surgeons to offer this procedure for his patients. He also speaks about some potential underlying causes and aggravating factors for osteoarthritis. Dr. Golzarian provides useful tips on taking an academic approach to setting up trials and what makes his trials different from previous studies on genicular artery embolization. We discuss why patients with osteoarthritis can be a challenge for family practitioners and how collaboration with IR can benefit these patients. We go into the differences in the procedure for hemarthrosis and osteoarthritis. We review some ways to find the best angle to identify an arterial origin for embolization, and we discuss some of the challenges in the embolization procedure and how to adapt to different types of patients.

]]> 2192 no Ep. 84 An Interview with Dr. Ernie Ring- WAIS Series https://soundcloud.com/backtable/ep-84-an-interview-with-dr-ernie-ring-wais-series Ep. 84 An Interview with Dr. Ernie Ring- WAIS Series by BackTable Tue, 22 Sep 2020 12:00:18 -0000 full BackTable Ep. 84 An Interview with Dr. Ernie Ring- WAIS Ser… Ep. 84 An Interview with Dr. Ernie Ring- WAIS Series by BackTable 2883 no Ep. 83 An Interview with Dr. David Kumpe- WAIS Series An Interview with Dr. David Kumpe- WAIS Series by BackTable Mon, 21 Sep 2020 12:11:00 -0000 full BackTable An Interview with Dr. David Kumpe- WAIS Series by BackTable An Interview with Dr. David Kumpe- WAIS Series by BackTable An Interview with Dr. David Kumpe- WAIS Series by BackTable

]]> 4139 no Ep. 82 An Interview with Dr. Dan Sze- WAIS Series https://soundcloud.com/backtable/ep-82-an-interview-with-dr-dan-sze-wais-series Ep. 82 An Interview with Dr. Dan Sze- WAIS Series by BackTable Sun, 20 Sep 2020 13:20:32 -0000 full BackTable Ep. 82 An Interview with Dr. Dan Sze- WAIS Series… Ep. 82 An Interview with Dr. Dan Sze- WAIS Series by BackTable 2288 no Ep. 81 Intra-Arterial Chemotherapy for Retinoblastoma with Dr. Eric Monroe In this episode, Dr. Eric Monroe joins Dr. Christopher Beck to discuss using intra-arterial chemotherapy (IAC) as a treatment for retinoblastoma. Dr. Monroe touches on how he has been using telemedicine during this time and the process of considering a patient for IAC. We go over the details of the intra-arterial chemotherapy procedure and we mention some challenges that may arise in dealing with equipment for pediatric patients, specifically how to have a successful procedure while maintaining a low radiation dose. Dr. Monroe speaks about post procedural care including follow-up intervals and what those visits entail. We discuss some of the common complications that can occur during intra-arterial chemotherapy. Dr. Monroe gives some advice about the mental preparation and learning curve that comes with developing skills for IAC. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RRlyP6 RESOURCES MENTIONED: A Review of the Literature for Intra-Arterial Chemotherapy used to Treat Retinoblastoma https://pubmed.ncbi.nlm.nih.gov/26886915/ This is the article mentioned by Dr. Monroe which gives an overview of retinoblastoma. Tue, 08 Sep 2020 10:59:00 -0000 full BackTable In this episode, Dr. Eric Monroe joins Dr. Christopher Beck to discuss using intra-arterial chemotherapy (IAC) as a treatment for retinoblastoma. Dr. Monroe touches on how he has been using telemedicine during this time and the process of considering a patient for IAC. In this episode, Dr. Eric Monroe joins Dr. Christopher Beck to discuss using intra-arterial chemotherapy (IAC) as a treatment for retinoblastoma. Dr. Monroe touches on how he has been using telemedicine during this time and the process of considering a patient for IAC. We go over the details of the intra-arterial chemotherapy procedure and we mention some challenges that may arise in dealing with equipment for pediatric patients, specifically how to have a successful procedure while maintaining a low radiation dose. Dr. Monroe speaks about post procedural care including follow-up intervals and what those visits entail. We discuss some of the common complications that can occur during intra-arterial chemotherapy. Dr. Monroe gives some advice about the mental preparation and learning curve that comes with developing skills for IAC. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RRlyP6 RESOURCES MENTIONED: A Review of the Literature for Intra-Arterial Chemotherapy used to Treat Retinoblastoma https://pubmed.ncbi.nlm.nih.gov/26886915/ This is the article mentioned by Dr. Monroe which gives an overview of retinoblastoma. In this episode, Dr. Eric Monroe joins Dr. Christopher Beck to discuss using intra-arterial chemotherapy (IAC) as a treatment for retinoblastoma. Dr. Monroe touches on how he has been using telemedicine during this time and the process of considering a patient for IAC. We go over the details of the intra-arterial chemotherapy procedure and we mention some challenges that may arise in dealing with equipment for pediatric patients, specifically how to have a successful procedure while maintaining a low radiation dose. Dr. Monroe speaks about post procedural care including follow-up intervals and what those visits entail. We discuss some of the common complications that can occur during intra-arterial chemotherapy. Dr. Monroe gives some advice about the mental preparation and learning curve that comes with developing skills for IAC.


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RRlyP6


RESOURCES MENTIONED: A Review of the Literature for Intra-Arterial Chemotherapy used to Treat Retinoblastoma https://pubmed.ncbi.nlm.nih.gov/26886915/ This is the article mentioned by Dr. Monroe which gives an overview of retinoblastoma.

]]> 2408 no Ep. 80 Making Ethics Matter with Dr. Eric Keller https://soundcloud.com/backtable/ep-80-making-ethics-matter-with-dr-eric-keller Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/gpvwSB In this episode, Dr. Eric Keller joins Dr. Christopher Beck to discuss medical ethics within IR. He speaks about using a bottom-up approach of applied ethics, and we examine why a combination of casuistry and virtue ethics may be helpful rather than principlism. We dig deeper into medical futility and the challenge of prospectively determining if a procedure is futile. Dr. Keller describes how to design a study that can explore medical ethics as well as methods of collecting and presenting data in an ethical way. We discuss advanced care planning, managing bias, and the role that unbounded ethicality plays in research. We talk through some benefits and drawbacks of ethics boards as well as how using decision support aides may improve informed consent and allow patients to become advocates for themselves. RESOURCES MENTIONED: Journal of the American Geriatrics Society https://onlinelibrary.wiley.com/action/doSearch?AllField=futility&SeriesKey=15325415 This website presents all the papers in the journal that are related to futility. Journal of the American Geriatrics Society (Medical Futility: Where Do We Go from Here?) https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1532-5415.1994.tb06570.x This article discusses various perspectives on medical futility. Decision Aids to Help People who are Facing Health Treatment of Screening Decisions https://www.cochrane.org/CD001431/COMMUN_decision-aids-help-people-who-are-facing-health-treatment-or-screening-decisions This article evaluates the effects of decision aids on health outcomes. Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons https://pubmed.ncbi.nlm.nih.gov/31882313/ American Geriatrics Society Feeding Tubes in Advanced Dementia Position Statements https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.12924 This article discusses feeding tubes and how to handle feeding for patients with advanced dementia. The Impact of Advance Care Planning on End of Life Care in Elderly Patients https://www.bmj.com/content/bmj/340/bmj.c1345.full.pdf This article describes a randomized controlled trial that examines advanced care planning. Does Facilitated Advance Care Planning Reduce the Costs of Care Near the End of Life? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838173/ This paper discusses the ethical conflicts in advanced care planning. Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units https://www.atsjournals.org/doi/full/10.1164/rccm.201505-0924ST This article describes how to handle treatment disagreements in the ICU. Research Ethics in IR: The Intersection Between Care and Progress https://pubmed.ncbi.nlm.nih.gov/32359529/ This paper mentions the ethical issues in collecting and presenting data. It also discusses the role IR plays in conflict of interest and bias. Understanding Bias: A Look at Conflicts of Interest in IR https://www.researchgate.net/publication/332750177_Understanding_Bias_A_Look_at_Conflicts_of_Interest_in_IR This article examines conflicts of interest and how they affect the field of IR. Reflect and Remember: The Ethics of Complications in Interventional Radiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531013/ This paper discusses the ethics behind the relationship between IR and complications. Informed Consent: Beating a Dead Horse or an Opportunity for Quality Improvement? https://www.researchgate.net/publication/338303598_Informed_Consent_Beating_a_Dead_Horse_or_an_Opportunity_for_Quality_Improvement This paper examines the ethical implications of informed consent and its complexities. Reconsidering Requests - Futility in IR https://www.jvir.org/article/S1051-0443(19)30069-7/fulltext This article discusses the ethics in challenging healthcare situations. Fri, 04 Sep 2020 11:00:00 -0000 full BackTable In this episode, Dr. Eric Keller joins Dr. Christopher Beck to discuss medical ethics within IR. He speaks about using a bottom-up approach of applied ethics, and we examine why a combination of casuistry and virtue ethics may be helpful rather than principlism. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/gpvwSB In this episode, Dr. Eric Keller joins Dr. Christopher Beck to discuss medical ethics within IR. He speaks about using a bottom-up approach of applied ethics, and we examine why a combination of casuistry and virtue ethics may be helpful rather than principlism. We dig deeper into medical futility and the challenge of prospectively determining if a procedure is futile. Dr. Keller describes how to design a study that can explore medical ethics as well as methods of collecting and presenting data in an ethical way. We discuss advanced care planning, managing bias, and the role that unbounded ethicality plays in research. We talk through some benefits and drawbacks of ethics boards as well as how using decision support aides may improve informed consent and allow patients to become advocates for themselves. RESOURCES MENTIONED: Journal of the American Geriatrics Society https://onlinelibrary.wiley.com/action/doSearch?AllField=futility&SeriesKey=15325415 This website presents all the papers in the journal that are related to futility. Journal of the American Geriatrics Society (Medical Futility: Where Do We Go from Here?) https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1532-5415.1994.tb06570.x This article discusses various perspectives on medical futility. Decision Aids to Help People who are Facing Health Treatment of Screening Decisions https://www.cochrane.org/CD001431/COMMUN_decision-aids-help-people-who-are-facing-health-treatment-or-screening-decisions This article evaluates the effects of decision aids on health outcomes. Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons https://pubmed.ncbi.nlm.nih.gov/31882313/ American Geriatrics Society Feeding Tubes in Advanced Dementia Position Statements https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.12924 This article discusses feeding tubes and how to handle feeding for patients with advanced dementia. The Impact of Advance Care Planning on End of Life Care in Elderly Patients https://www.bmj.com/content/bmj/340/bmj.c1345.full.pdf This article describes a randomized controlled trial that examines advanced care planning. Does Facilitated Advance Care Planning Reduce the Costs of Care Near the End of Life? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838173/ This paper discusses the ethical conflicts in advanced care planning. Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units https://www.atsjournals.org/doi/full/10.1164/rccm.201505-0924ST This article describes how to handle treatment disagreements in the ICU. Research Ethics in IR: The Intersection Between Care and Progress https://pubmed.ncbi.nlm.nih.gov/32359529/ This paper mentions the ethical issues in collecting and presenting data. It also discusses the role IR plays in conflict of interest and bias. Understanding Bias: A Look at Conflicts of Interest in IR https://www.researchgate.net/publication/332750177_Understanding_Bias_A_Look_at_Conflicts_of_Interest_in_IR This article examines conflicts of interest and how they affect the field of IR. Reflect and Remember: The Ethics of Complications in Interventional Radiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531013/ This paper discusses the ethics behind the relationship between IR and complications. Informed Consent: Beating a Dead Horse or an Opportunity for Quality Improvement? https://www.researchgate.net/publication/338303598_Informed_Consent_Beating_a_Dead_Horse_or_an_Opportunity_for_Quality_Improvement This paper examines the ethical implications of informed consent and its complexities. Reconsidering Requests - Futility in IR https://www.jvir.org/article/S1051-0443(19)30069-7/fulltext This article discusses the ethics in challenging healthcare situations. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/gpvwSB

In this episode, Dr. Eric Keller joins Dr. Christopher Beck to discuss medical ethics within IR. He speaks about using a bottom-up approach of applied ethics, and we examine why a combination of casuistry and virtue ethics may be helpful rather than principlism. We dig deeper into medical futility and the challenge of prospectively determining if a procedure is futile. Dr. Keller describes how to design a study that can explore medical ethics as well as methods of collecting and presenting data in an ethical way. We discuss advanced care planning, managing bias, and the role that unbounded ethicality plays in research. We talk through some benefits and drawbacks of ethics boards as well as how using decision support aides may improve informed consent and allow patients to become advocates for themselves.

RESOURCES MENTIONED: Journal of the American Geriatrics Society https://onlinelibrary.wiley.com/action/doSearch?AllField=futility&SeriesKey=15325415 This website presents all the papers in the journal that are related to futility.

Journal of the American Geriatrics Society (Medical Futility: Where Do We Go from Here?) https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1532-5415.1994.tb06570.x This article discusses various perspectives on medical futility.

Decision Aids to Help People who are Facing Health Treatment of Screening Decisions https://www.cochrane.org/CD001431/COMMUN_decision-aids-help-people-who-are-facing-health-treatment-or-screening-decisions This article evaluates the effects of decision aids on health outcomes.

Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons https://pubmed.ncbi.nlm.nih.gov/31882313/

American Geriatrics Society Feeding Tubes in Advanced Dementia Position Statements https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.12924 This article discusses feeding tubes and how to handle feeding for patients with advanced dementia.

The Impact of Advance Care Planning on End of Life Care in Elderly Patients https://www.bmj.com/content/bmj/340/bmj.c1345.full.pdf This article describes a randomized controlled trial that examines advanced care planning.

Does Facilitated Advance Care Planning Reduce the Costs of Care Near the End of Life? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838173/ This paper discusses the ethical conflicts in advanced care planning.

Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units https://www.atsjournals.org/doi/full/10.1164/rccm.201505-0924ST This article describes how to handle treatment disagreements in the ICU.

Research Ethics in IR: The Intersection Between Care and Progress https://pubmed.ncbi.nlm.nih.gov/32359529/ This paper mentions the ethical issues in collecting and presenting data. It also discusses the role IR plays in conflict of interest and bias.

Understanding Bias: A Look at Conflicts of Interest in IR https://www.researchgate.net/publication/332750177_Understanding_Bias_A_Look_at_Conflicts_of_Interest_in_IR This article examines conflicts of interest and how they affect the field of IR.

Reflect and Remember: The Ethics of Complications in Interventional Radiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531013/ This paper discusses the ethics behind the relationship between IR and complications.

Informed Consent: Beating a Dead Horse or an Opportunity for Quality Improvement? https://www.researchgate.net/publication/338303598_Informed_Consent_Beating_a_Dead_Horse_or_an_Opportunity_for_Quality_Improvement This paper examines the ethical implications of informed consent and its complexities.

Reconsidering Requests - Futility in IR https://www.jvir.org/article/S1051-0443(19)30069-7/fulltext This article discusses the ethics in challenging healthcare situations.

]]> 3440 no Ep. 79 Building a Deep Venous Program with Dr. Jeffrey Chick https://soundcloud.com/backtable/ep-79-building-a-deep-venous-program-with-dr-jeff-chick Interventional Radiologist Dr. Jeffrey Chick tells us about his deep venous practice at UW Medicine including tips on growing a collaborative, multidisciplinary venous program. Mon, 31 Aug 2020 12:12:00 -0000 full BackTable Interventional Radiologist Dr. Jeffrey Chick tells us about his deep venous practice at UW Medicine including tips on growing a collaborative, multidisciplinary venous program. Interventional Radiologist Dr. Jeffrey Chick tells us about his deep venous practice at UW Medicine including tips on growing a collaborative, multidisciplinary venous program. Interventional Radiologist Dr. Jeffrey Chick tells us about his deep venous practice at UW Medicine including tips on growing a collaborative, multidisciplinary venous program.

]]> 2164 no Ep. 78 Is Radioembolization a Future Option for Prostate Cancer Therapy? with Dr. Sam Mouli https://soundcloud.com/backtable/ep-78-is-radioembolization-a-future-option-for-prostate-cancer-therapy-with-dr-sam-mouli Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xI8Csf  Interventional Radiologists Dr. Sam Mouli from Northwestern University and Dr. Sandeep Bagla discuss new research examining Y-90 Radioembolization as a novel therapeutic option for treating prostate cancer. Mon, 24 Aug 2020 12:47:00 -0000 full BackTable Interventional Radiologists Dr. Sam Mouli from Northwestern University and Dr. Sandeep Bagla discuss new research examining Y-90 Radioembolization as a novel therapeutic option for treating prostate cancer. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xI8Csf  Interventional Radiologists Dr. Sam Mouli from Northwestern University and Dr. Sandeep Bagla discuss new research examining Y-90 Radioembolization as a novel therapeutic option for treating prostate cancer. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xI8Csf



Interventional Radiologists Dr. Sam Mouli from Northwestern University and Dr. Sandeep Bagla discuss new research examining Y-90 Radioembolization as a novel therapeutic option for treating prostate cancer.

]]> 1919 no Ep. 77 Endovascular AV Fistula Creation with Dr. Neghae Mawla In this episode, Dr. Neghae Mawla joins Dr. Chris Beck to discuss endovascular AV fistula creation. The episode begins by discussing the advantages of fistulas versus catheters and grafts and how guidelines have changed from “Fistula First” to the most appropriate type of access for the patient. Dr. Mawla explains the details of how he determines candidates for the EndoAVF using ultrasound for vein mapping. We then review patient preparation for EndoAVF including anticoagulation, antibiotics, and anesthesia. We share the two main systems for EndoAVF, Avenu Ellipsys and the WavelinQ device and discuss the similarities and differences between these two approaches for fistula creation. Dr. Mawla walks through his ultrasound-guided techniques and the need for dual venous and arterial access with the WavelinQ device. They review some potential complications with using these devices, including hematomas and uncontrolled arterial bleeds, and post-procedural management. Dr. Mawla discusses timelines for evaluating venous maturation in patients and when a fistula is typically ready for use. He explains the differences between EndoAVF and surgically created fistulas, including several advantages of endo-anastomosis. The episode ends by talking about EndoAVF education in dialysis centers and collaborating with nursing staff, clinics, and both device companies to re-educate staff and patients on differences in cannulation. Mon, 17 Aug 2020 11:50:00 -0000 full BackTable In this episode, Dr. Neghae Mawla joins Dr. Chris Beck to discuss endovascular AV fistula creation. In this episode, Dr. Neghae Mawla joins Dr. Chris Beck to discuss endovascular AV fistula creation. The episode begins by discussing the advantages of fistulas versus catheters and grafts and how guidelines have changed from “Fistula First” to the most appropriate type of access for the patient. Dr. Mawla explains the details of how he determines candidates for the EndoAVF using ultrasound for vein mapping. We then review patient preparation for EndoAVF including anticoagulation, antibiotics, and anesthesia. We share the two main systems for EndoAVF, Avenu Ellipsys and the WavelinQ device and discuss the similarities and differences between these two approaches for fistula creation. Dr. Mawla walks through his ultrasound-guided techniques and the need for dual venous and arterial access with the WavelinQ device. They review some potential complications with using these devices, including hematomas and uncontrolled arterial bleeds, and post-procedural management. Dr. Mawla discusses timelines for evaluating venous maturation in patients and when a fistula is typically ready for use. He explains the differences between EndoAVF and surgically created fistulas, including several advantages of endo-anastomosis. The episode ends by talking about EndoAVF education in dialysis centers and collaborating with nursing staff, clinics, and both device companies to re-educate staff and patients on differences in cannulation. In this episode, Dr. Neghae Mawla joins Dr. Chris Beck to discuss endovascular AV fistula creation. The episode begins by discussing the advantages of fistulas versus catheters and grafts and how guidelines have changed from “Fistula First” to the most appropriate type of access for the patient. Dr. Mawla explains the details of how he determines candidates for the EndoAVF using ultrasound for vein mapping. We then review patient preparation for EndoAVF including anticoagulation, antibiotics, and anesthesia. We share the two main systems for EndoAVF, Avenu Ellipsys and the WavelinQ device and discuss the similarities and differences between these two approaches for fistula creation. Dr. Mawla walks through his ultrasound-guided techniques and the need for dual venous and arterial access with the WavelinQ device. They review some potential complications with using these devices, including hematomas and uncontrolled arterial bleeds, and post-procedural management. Dr. Mawla discusses timelines for evaluating venous maturation in patients and when a fistula is typically ready for use. He explains the differences between EndoAVF and surgically created fistulas, including several advantages of endo-anastomosis. The episode ends by talking about EndoAVF education in dialysis centers and collaborating with nursing staff, clinics, and both device companies to re-educate staff and patients on differences in cannulation.

]]> 3632 no Ep. 76 Targeting the Tumor Microenvironment in HCC with Dr. Terence Gade https://soundcloud.com/backtable/ep-76-targeting-the-tumor-microenvironment-in-hcc-with-dr-terence-gade Interventional Radiologist Terence Gade from Penn Medicine, University of Pennsylvania Health System tells us about emerging research and therapies targeting the tumor microenvironment in Hepatocellular carcinoma (HCC). Mon, 10 Aug 2020 22:01:00 -0000 full BackTable Interventional Radiologist Terence Gade from Penn… Interventional Radiologist Terence Gade from Penn Medicine, University of Pennsylvania Health System tells us about emerging research and therapies targeting the tumor microenvironment in Hepatocellular carcinoma (HCC). Interventional Radiologist Terence Gade from Penn Medicine, University of Pennsylvania Health System tells us about emerging research and therapies targeting the tumor microenvironment in Hepatocellular carcinoma (HCC).

]]> 1737 no Ep. 75 The Role of IR in Stroke Interventions (Part 2) with Dr. David Sacks and Dr. Martin Radvany https://soundcloud.com/backtable/ep-75-the-role-of-ir-in-stroke-interventions-part-2-with-dr-david-sacks-and-dr-martin-radvany Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/07FYzi Part II of the discussion with Dr. Martin Radvany and Dr. David Sacks on the role of Interventional Radiologists in stroke interventions, including addressing training requirements and rural access to care. Tue, 04 Aug 2020 04:15:00 -0000 full BackTable Part II of the discussion with Dr. Martin Radvany and Dr. David Sacks on the role of Interventional Radiologists in stroke interventions, including addressing training requirements and rural access to care. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/07FYzi Part II of the discussion with Dr. Martin Radvany and Dr. David Sacks on the role of Interventional Radiologists in stroke interventions, including addressing training requirements and rural access to care. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/07FYzi


Part II of the discussion with Dr. Martin Radvany and Dr. David Sacks on the role of Interventional Radiologists in stroke interventions, including addressing training requirements and rural access to care.

]]> 2834 no Ep. 74 The Role of IR in Stroke Interventions (Part 1) with Dr. David Sacks and Dr. Martin Radvany https://soundcloud.com/backtable/ep-74-the-role-of-ir-in-stroke-interventions-part-1-with-dr-david-sacks-and-dr-martin-radvany Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/yS6TGL Dr. Martin Radvany and Dr. David Sacks discuss the role of Interventional Radiologists in the treatment of acute ischemic stroke, including training requirements, the multidisciplinary team approach, and ways to improve patient access to high quality care. Sun, 02 Aug 2020 12:26:00 -0000 full BackTable Dr. Martin Radvany and Dr. David Sacks discuss the role of Interventional Radiologists in the treatment of acute ischemic stroke, including training requirements, the multidisciplinary team approach, and ways to improve patient access to high quality care. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/yS6TGL Dr. Martin Radvany and Dr. David Sacks discuss the role of Interventional Radiologists in the treatment of acute ischemic stroke, including training requirements, the multidisciplinary team approach, and ways to improve patient access to high quality care. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/yS6TGL


Dr. Martin Radvany and Dr. David Sacks discuss the role of Interventional Radiologists in the treatment of acute ischemic stroke, including training requirements, the multidisciplinary team approach, and ways to improve patient access to high quality care.

]]> 3484 no Ep. 73 Iliocaval Stenting with Dr. Gerry O'Sullivan Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/TFABaN Interventional Radiologist Dr. Gerry O'Sullivan shares his experiences with Iliocaval stenting in post-thrombotic patients, including pearls and pitfalls and the "Aiming for the bottom corner" technique. Mon, 27 Jul 2020 13:13:00 -0000 full BackTable Interventional Radiologist Dr. Gerry O'Sullivan shares his experiences with Iliocaval stenting in post-thrombotic patients, including pearls and pitfalls and the "Aiming for the bottom corner" technique. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/TFABaN Interventional Radiologist Dr. Gerry O'Sullivan shares his experiences with Iliocaval stenting in post-thrombotic patients, including pearls and pitfalls and the "Aiming for the bottom corner" technique. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/TFABaN


Interventional Radiologist Dr. Gerry O'Sullivan shares his experiences with Iliocaval stenting in post-thrombotic patients, including pearls and pitfalls and the "Aiming for the bottom corner" technique.

]]> 2983 no Ep. 72 Uterine Fibroid Embolizations in the OBL with Dr. John Lipman https://soundcloud.com/backtable/ep-72-uterine-fibroid-embolizations-in-the-obl-with-dr-john-lipman John Lipman, MD discusses UFE practice building, patient workup, and embolization technique in his dedicated Women's interventional practice, Atlanta Interventional Institute. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/10vK6b Mon, 20 Jul 2020 11:41:00 -0000 full BackTable John Lipman, MD discusses UFE practice building, patient workup, and embolization technique in his dedicated Women's interventional practice, Atlanta Interventional Institute. John Lipman, MD discusses UFE practice building, patient workup, and embolization technique in his dedicated Women's interventional practice, Atlanta Interventional Institute. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/10vK6b John Lipman, MD discusses UFE practice building, patient workup, and embolization technique in his dedicated Women's interventional practice, Atlanta Interventional Institute.


---


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EARN CME


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/10vK6b

]]> 3140 no Ep. 71 Building a MedEd platform with Dr. Sarel Gaur https://soundcloud.com/backtable/ep-71-building-a-meded-platform-with-dr-sarel-gaur We talk with Interventional Radiologist Sarel Gaur about what inspired his #medEd #YouTube channel, where his topics come from, and tips for success for others. Mon, 13 Jul 2020 12:14:00 -0000 full BackTable We talk with Interventional Radiologist Sarel Gaur about what inspired his #medEd #YouTube channel, where his topics come from, and tips for success for others. We talk with Interventional Radiologist Sarel Gaur about what inspired his #medEd #YouTube channel, where his topics come from, and tips for success for others. We talk with Interventional Radiologist Sarel Gaur about what inspired his #medEd #YouTube channel, where his topics come from, and tips for success for others.

]]> 1745 no Ep. 70 CO2 Angiography with Dr. James Caridi Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/F6p0sz In this episode, Dr. James Caridi joins Dr. Christopher Beck to discuss the benefits of using CO2 for an angiography as well as some important tips for proper use. Dr. Caridi mentions some of the reasons for choosing CO2 rather than contrast, including its solubility, low viscosity, and buoyancy. He also speaks about CO2 angiography approaches for imaging difficult to access vasculature. Dr. Caridi also speaks to specific uses of CO2 angiography for use for mesenteric angiography and how CO2 angiography can improve the sensitivity for detection and localization of GI bleeds. Dr. Caridi and Dr. Beck also discuss some non-vascular uses for CO2 angiography as well as a technique for imaging with CO2 without having to give up wire access. We talk through safely preparing a delivery system and gently injecting CO2 to prevent/reduce reflux in the patient if needed. Finally, we go into some notes concerning dialysis, contrast induced nephropathy, and some instances when CO2 angiography should not be used. Resources mentioned: CO2 Angiography Society http://www.co2angio.org/index.php This website features over 100 pieces of literature related to CO2 angiography, information about the newest developments, and access to membership in the society. Dr. Jim Caridi explains CO2mmander and AngiAssist https://www.youtube.com/watch?v=MjsnHWmRZQI This video explains the portable delivery system and the gas management system. Mon, 06 Jul 2020 11:08:00 -0000 full BackTable In this episode, Dr. James Caridi joins Dr. Christopher Beck to discuss the benefits of using CO2 for an angiography as well as some important tips for proper use. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/F6p0sz In this episode, Dr. James Caridi joins Dr. Christopher Beck to discuss the benefits of using CO2 for an angiography as well as some important tips for proper use. Dr. Caridi mentions some of the reasons for choosing CO2 rather than contrast, including its solubility, low viscosity, and buoyancy. He also speaks about CO2 angiography approaches for imaging difficult to access vasculature. Dr. Caridi also speaks to specific uses of CO2 angiography for use for mesenteric angiography and how CO2 angiography can improve the sensitivity for detection and localization of GI bleeds. Dr. Caridi and Dr. Beck also discuss some non-vascular uses for CO2 angiography as well as a technique for imaging with CO2 without having to give up wire access. We talk through safely preparing a delivery system and gently injecting CO2 to prevent/reduce reflux in the patient if needed. Finally, we go into some notes concerning dialysis, contrast induced nephropathy, and some instances when CO2 angiography should not be used. Resources mentioned: CO2 Angiography Society http://www.co2angio.org/index.php This website features over 100 pieces of literature related to CO2 angiography, information about the newest developments, and access to membership in the society. Dr. Jim Caridi explains CO2mmander and AngiAssist https://www.youtube.com/watch?v=MjsnHWmRZQI This video explains the portable delivery system and the gas management system. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/F6p0sz


In this episode, Dr. James Caridi joins Dr. Christopher Beck to discuss the benefits of using CO2 for an angiography as well as some important tips for proper use. Dr. Caridi mentions some of the reasons for choosing CO2 rather than contrast, including its solubility, low viscosity, and buoyancy. He also speaks about CO2 angiography approaches for imaging difficult to access vasculature. Dr. Caridi also speaks to specific uses of CO2 angiography for use for mesenteric angiography and how CO2 angiography can improve the sensitivity for detection and localization of GI bleeds. Dr. Caridi and Dr. Beck also discuss some non-vascular uses for CO2 angiography as well as a technique for imaging with CO2 without having to give up wire access. We talk through safely preparing a delivery system and gently injecting CO2 to prevent/reduce reflux in the patient if needed. Finally, we go into some notes concerning dialysis, contrast induced nephropathy, and some instances when CO2 angiography should not be used.


Resources mentioned: CO2 Angiography Society http://www.co2angio.org/index.php This website features over 100 pieces of literature related to CO2 angiography, information about the newest developments, and access to membership in the society. Dr. Jim Caridi explains CO2mmander and AngiAssist


https://www.youtube.com/watch?v=MjsnHWmRZQI This video explains the portable delivery system and the gas management system.

]]> 3176 no Ep. 69 Retrograde Pedal Access with Dr. Jim Melton and Dr. Blake Parsons Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/wS9UCY Dr. Jim Melton and Dr. Blake Parsons discuss the benefits of retrograde pedal access in the treatment of PAD, as well as the team approach of their outpatient CardioVascular Health Clinic , which includes Vascular Surgery, Interventional Radiology, and Interventional Cardiology working together as partners for better patient care. Mon, 22 Jun 2020 12:14:00 -0000 full BackTable Dr. Jim Melton and Dr. Blake Parsons discuss the benefits of retrograde pedal access in the treatment of PAD, as well as the team approach of their outpatient CardioVascular Health Clinic , which includes Vascular Surgery, Interventional Radiology, and Interventional Cardiology working together as partners for better patient care. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/wS9UCY Dr. Jim Melton and Dr. Blake Parsons discuss the benefits of retrograde pedal access in the treatment of PAD, as well as the team approach of their outpatient CardioVascular Health Clinic , which includes Vascular Surgery, Interventional Radiology, and Interventional Cardiology working together as partners for better patient care. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/wS9UCY


Dr. Jim Melton and Dr. Blake Parsons discuss the benefits of retrograde pedal access in the treatment of PAD, as well as the team approach of their outpatient CardioVascular Health Clinic , which includes Vascular Surgery, Interventional Radiology, and Interventional Cardiology working together as partners for better patient care.

]]> 3219 no Ep. 68 RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla https://soundcloud.com/backtable/ep-68-treating-bone-metastases Dr. Jason Levy and Dr. Sandeep Bagla discuss palliative treatment of bone metastases with radiofrequency ablation, as well as recent results from the OPuS One trial. Mon, 15 Jun 2020 12:09:00 -0000 full BackTable Dr. Jason Levy and Dr. Sandeep Bagla discuss pall… Dr. Jason Levy and Dr. Sandeep Bagla discuss palliative treatment of bone metastases with radiofrequency ablation, as well as recent results from the OPuS One trial. Dr. Jason Levy and Dr. Sandeep Bagla discuss palliative treatment of bone metastases with radiofrequency ablation, as well as recent results from the OPuS One trial.

]]> 2515 no Ep. 67 Locoregional Therapies for Bridging to Transplant in HCC with Dr. Alex Kim https://soundcloud.com/backtable/ep-67-locoregional-therapies Interventional Radiologist Dr. Alex Kim and Dr. Christopher Beck discuss the utility of different locoregional liver therapies in bridging HCC patients to transplant. Mon, 08 Jun 2020 12:09:18 -0000 full BackTable Interventional Radiologist Dr. Alex Kim and Dr. C… Interventional Radiologist Dr. Alex Kim and Dr. Christopher Beck discuss the utility of different locoregional liver therapies in bridging HCC patients to transplant. 2891 no Ep. 66 Treatment of Endoleaks (Part II) with Dr. Saher Sabri and Dr. Sabeen Dhand Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IvRKl0 Dr. Sabeen Dhand and Dr. Saher Sabri discuss their various approaches to treating Type 2 Endoleaks. Tue, 02 Jun 2020 12:21:00 -0000 full BackTable Dr. Sabeen Dhand and Dr. Saher Sabri discuss their various approaches to treating Type 2 Endoleaks. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IvRKl0 Dr. Sabeen Dhand and Dr. Saher Sabri discuss their various approaches to treating Type 2 Endoleaks. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IvRKl0


Dr. Sabeen Dhand and Dr. Saher Sabri discuss their various approaches to treating Type 2 Endoleaks.

]]> 2125 no Ep. 65 Treatment of Endoleaks (Part I) with Dr. Saher Sabri and Dr. Sabeen Dhand https://soundcloud.com/backtable/ep-65-treatment-of-endoleaks Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zw5KJW Dr. Sabeen Dhand talks with Dr. Saher Sabri about diagnosis and treatment of Endoleaks after EVAR placement. This is part one of a two part series on Endoleaks. Wed, 27 May 2020 12:04:00 -0000 full BackTable Dr. Sabeen Dhand talks with Dr. Saher Sabri about diagnosis and treatment of Endoleaks after EVAR placement. This is part one of a two part series on Endoleaks. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zw5KJW Dr. Sabeen Dhand talks with Dr. Saher Sabri about diagnosis and treatment of Endoleaks after EVAR placement. This is part one of a two part series on Endoleaks. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zw5KJW


Dr. Sabeen Dhand talks with Dr. Saher Sabri about diagnosis and treatment of Endoleaks after EVAR placement. This is part one of a two part series on Endoleaks.

]]> 1825 no Ep. 64 Bridging to Transplant for HCC with Dr. Jennifer Berumen and Dr. Isabel Newton https://soundcloud.com/backtable/ep-64-bridging-to-transplant Transplant Surgeon Dr. Jennifer Berumen and Interventional Radiologist Dr. Isabel Newton discuss the treatment of HCC and the importance of multi-specialty collaboration in bridging these patients to successful liver transplantation. Special discussion was given around this HCC consortium article in Annals of Surgery: https://pubmed.ncbi.nlm.nih.gov/30870180/ Thu, 21 May 2020 12:14:04 -0000 full BackTable Transplant Surgeon Dr. Jennifer Berumen and Inter… Transplant Surgeon Dr. Jennifer Berumen and Interventional Radiologist Dr. Isabel Newton discuss the treatment of HCC and the importance of multi-specialty collaboration in bridging these patients to successful liver transplantation. Special discussion was given around this HCC consortium article in Annals of Surgery: https://pubmed.ncbi.nlm.nih.gov/30870180/ 3111 no Ep. 63 IR Identity and Turf Wars with Dr. Eric Keller https://soundcloud.com/backtable/ep-63-ir-identity-and-turf Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/48hidj Dr. Eric J. Keller from Stanford Medicine Department of Radiology provides insight from his studies on the IR Identity, as well as his research on perceived turf wars between specialties. Mon, 11 May 2020 12:45:00 -0000 full BackTable Dr. Eric J. Keller from Stanford Medicine Department of Radiology provides insight from his studies on the IR Identity, as well as his research on perceived turf wars between specialties. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/48hidj Dr. Eric J. Keller from Stanford Medicine Department of Radiology provides insight from his studies on the IR Identity, as well as his research on perceived turf wars between specialties. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/48hidj


Dr. Eric J. Keller from Stanford Medicine Department of Radiology provides insight from his studies on the IR Identity, as well as his research on perceived turf wars between specialties.

]]> 3114 no Ep. 62 Protect Yourself Before You Wreck Yourself with Dr. Mina Makary https://soundcloud.com/backtable/ep-62-protect-yourself-before Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xsBt1Y Special guest Dr. Mina Makary from The Ohio State University Wexner Medical Center discusses the need for better awareness and protection from the serious harmful effects of chronic low dose radiation, which can sometimes require change in institutional culture. An extremely important occupational health issue! Mon, 27 Apr 2020 12:13:00 -0000 full BackTable Special guest Dr. Mina Makary from The Ohio State University Wexner Medical Center discusses the need for better awareness and protection from the serious harmful effects of chronic low dose radiation, which can sometimes require change in institutional culture. An extremely important occupational health issue! Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xsBt1Y Special guest Dr. Mina Makary from The Ohio State University Wexner Medical Center discusses the need for better awareness and protection from the serious harmful effects of chronic low dose radiation, which can sometimes require change in institutional culture. An extremely important occupational health issue! Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xsBt1Y


Special guest Dr. Mina Makary from The Ohio State University Wexner Medical Center discusses the need for better awareness and protection from the serious harmful effects of chronic low dose radiation, which can sometimes require change in institutional culture. An extremely important occupational health issue!

]]> 1662 no Ep. 61 Physician Burnout with Dr. Jeff Chick and Dr. Jacob Bundy Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/nl8ZgW Dr. Jeffrey Chick and Dr. Jacob Bundy discuss the results of their recent study in April JVIR on rates and major contributors to Physician Burnout in IR, how they compare to other specialties, and how to prevent it in your own career. Mon, 13 Apr 2020 11:54:00 -0000 full BackTable Dr. Jeffrey Chick and Dr. Jacob Bundy discuss the results of their recent study in April JVIR on rates and major contributors to Physician Burnout in IR, how they compare to other specialties, and how to prevent it in your own career. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/nl8ZgW Dr. Jeffrey Chick and Dr. Jacob Bundy discuss the results of their recent study in April JVIR on rates and major contributors to Physician Burnout in IR, how they compare to other specialties, and how to prevent it in your own career. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/nl8ZgW


Dr. Jeffrey Chick and Dr. Jacob Bundy discuss the results of their recent study in April JVIR on rates and major contributors to Physician Burnout in IR, how they compare to other specialties, and how to prevent it in your own career.

]]> 2042 no Ep. 60 Building a Limb Salvage Program with Dr. Jihad Mustapha Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/08KW16 CLI fighters Sabeen Dhand and Jihad A. Mustapha discuss the essentials of building a successful Limb Salvage program, including the importance of a multidisciplinary approach, broadening skill sets such as pedal access, and meticulous patient follow up. Mon, 30 Mar 2020 12:54:00 -0000 full BackTable CLI fighters Sabeen Dhand and Jihad A. Mustapha discuss the essentials of building a successful Limb Salvage program, including the importance of a multidisciplinary approach, broadening skill sets such as pedal access, and meticulous patient follow up. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/08KW16 CLI fighters Sabeen Dhand and Jihad A. Mustapha discuss the essentials of building a successful Limb Salvage program, including the importance of a multidisciplinary approach, broadening skill sets such as pedal access, and meticulous patient follow up. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/08KW16


CLI fighters Sabeen Dhand and Jihad A. Mustapha discuss the essentials of building a successful Limb Salvage program, including the importance of a multidisciplinary approach, broadening skill sets such as pedal access, and meticulous patient follow up.

]]> 3043 no Special COVID-19 Weekend Update with UPenn IR Dr. Stephen Hunt https://soundcloud.com/backtable/special-covid-19-weekend Dr. Stephen Hunt of Penn Medicine at University of Pennsylvania Health System discusses ways in which his IR practice has changed in the setting of the COVID 19 pandemic, including case selection and lessons learned from colleagues in Singapore and China. Sat, 28 Mar 2020 15:47:02 -0000 full BackTable Dr. Stephen Hunt of Penn Medicine at University o… Dr. Stephen Hunt of Penn Medicine at University of Pennsylvania Health System discusses ways in which his IR practice has changed in the setting of the COVID 19 pandemic, including case selection and lessons learned from colleagues in Singapore and China. 2033 no Ep. 59 Endovascular Treatment of DVT with Dr. Dexter and Dr. Abramowitz https://soundcloud.com/backtable/ep-59-endovascular-treatment Vascular Surgeons David Dexter and Steven Abramowitz discuss endovascular treatment of lower extremity DVT, including patient selection and risks and benefits of catheter-directed therapy (CDT), mechanical thrombectomy, and pharmaco-mechanical thrombolysis. Tue, 24 Mar 2020 12:14:30 -0000 full BackTable Vascular Surgeons David Dexter and Steven Abramow… Vascular Surgeons David Dexter and Steven Abramowitz discuss endovascular treatment of lower extremity DVT, including patient selection and risks and benefits of catheter-directed therapy (CDT), mechanical thrombectomy, and pharmaco-mechanical thrombolysis. 3632 no Ep. 58 Endovascular Treatment of PE with Dr. Venkat Tummala and Dr. Thomas Tu https://soundcloud.com/backtable/ep-58-endovascular-treatment Interventional Cardiologist Thomas Tu, MD and Interventional Radiologist Venkat Tummala MD discuss their respective approach to the treatment of Pulmonary Embolism, including risk stratification, treatment options, and endovascular technique. Wed, 11 Mar 2020 11:26:40 -0000 full BackTable Interventional Cardiologist Thomas Tu, MD and Int… Interventional Cardiologist Thomas Tu, MD and Interventional Radiologist Venkat Tummala MD discuss their respective approach to the treatment of Pulmonary Embolism, including risk stratification, treatment options, and endovascular technique. 2785 no Ep. 57 Practicing IR in the UK with Dr. Gregory Makris https://soundcloud.com/backtable/ep-57-practicing-ir-in-the-uk Dr. Christopher Beck talks with Dr. Gregory Makris of Guy's and St. Thomas' NHS Foundation Trust in London about IR education and practice in the UK, as well as his involvement with CIRSE and the European Trainee Forum. Thu, 05 Mar 2020 04:19:42 -0000 full BackTable Dr. Christopher Beck talks with Dr. Gregory Makri… Dr. Christopher Beck talks with Dr. Gregory Makris of Guy's and St. Thomas' NHS Foundation Trust in London about IR education and practice in the UK, as well as his involvement with CIRSE and the European Trainee Forum. 2797 no Ep. 56 Transitioning from a Hospital to OBL practice (Part II) with Dr. Yates and Dr. Patel https://soundcloud.com/backtable/ep-56-transitioning-from-a In Part 2 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on marketing strategies, as well as the importance of experience and partners in an outpatient based endovascular practice. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5UxgxL Sun, 23 Feb 2020 23:16:00 -0000 full BackTable In Part 2 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on marketing strategies, as well as the importance of experience and partners in an outpatient based endovascular practice. In Part 2 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on marketing strategies, as well as the importance of experience and partners in an outpatient based endovascular practice. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5UxgxL In Part 2 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on marketing strategies, as well as the importance of experience and partners in an outpatient based endovascular practice.


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]]> 2608 no Ep. 55 Transitioning from a Hospital to OBL practice (Part I) with Dr. Yates and Dr. Patel In Part 1 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on how they made their career change decisions, as well as the advantages and disadvantages of a hospital-based vs. outpatient-based endovascular practice. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/vog6G0 Tue, 11 Feb 2020 14:11:00 -0000 full BackTable In Part 1 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on how they made their career change decisions, as well as the advantages and disadvantages of a hospital-based vs. outpatient-based endovascular practice. In Part 1 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on how they made their career change decisions, as well as the advantages and disadvantages of a hospital-based vs. outpatient-based endovascular practice. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/vog6G0 In Part 1 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on how they made their career change decisions, as well as the advantages and disadvantages of a hospital-based vs. outpatient-based endovascular practice.


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Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/vog6G0

]]> 3071 no Ep. 54 Inclusivity in IR with Dr. Barbara Hamilton and Dr. Mary Costantino https://soundcloud.com/backtable/ep-54-inclusivity-in-ir-with Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o6ecMR Dr. Barbara Hamilton and Dr. Mary Costantino, MD discuss inclusivity in IR, including the importance of mentorship and diversity in medicine. Thu, 16 Jan 2020 22:35:00 -0000 full BackTable Dr. Barbara Hamilton and Dr. Mary Costantino, MD discuss inclusivity in IR, including the importance of mentorship and diversity in medicine. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o6ecMR Dr. Barbara Hamilton and Dr. Mary Costantino, MD discuss inclusivity in IR, including the importance of mentorship and diversity in medicine. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o6ecMR


Dr. Barbara Hamilton and Dr. Mary Costantino, MD discuss inclusivity in IR, including the importance of mentorship and diversity in medicine.

]]> 1485 no Ep. 53 International Volunteer Work with Dr. Stephen Hunt https://soundcloud.com/backtable/international-volunteer-work Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Fh5LxS Dr. Stephen Hunt shares his international volunteer experiences traveling with IR4Nigeria and RAD-AID International. Get involved at www.rad-aid.org. Wed, 01 Jan 2020 13:18:00 -0000 full BackTable Dr. Stephen Hunt shares his international volunteer experiences traveling with IR4Nigeria and RAD-AID International. Get involved at www.rad-aid.org. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Fh5LxS Dr. Stephen Hunt shares his international volunteer experiences traveling with IR4Nigeria and RAD-AID International. Get involved at www.rad-aid.org. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Fh5LxS


Dr. Stephen Hunt shares his international volunteer experiences traveling with IR4Nigeria and RAD-AID International. Get involved at www.rad-aid.org.

]]> 1632 no Ep. 52 IVUS for Iliac Vein Compression with Dr. Mark Lessne and Dr. Mike Cumming Dr. Michael Cumming and Dr. Mark Lessne discuss the utility of Intravascular Ultrasound (IVUS) in the diagnosis and treatment of Deep Venous Disease, including patient selection, appropriate assessment of stenoses and assistance with stent placement. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ySM6hy Mon, 11 Nov 2019 12:53:00 -0000 full BackTable Dr. Michael Cumming and Dr. Mark Lessne discuss the utility of Intravascular Ultrasound (IVUS) in the diagnosis and treatment of Deep Venous Disease, including patient selection, appropriate assessment of stenoses and assistance with stent placement. Dr. Michael Cumming and Dr. Mark Lessne discuss the utility of Intravascular Ultrasound (IVUS) in the diagnosis and treatment of Deep Venous Disease, including patient selection, appropriate assessment of stenoses and assistance with stent placement. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ySM6hy Dr. Michael Cumming and Dr. Mark Lessne discuss the utility of Intravascular Ultrasound (IVUS) in the diagnosis and treatment of Deep Venous Disease, including patient selection, appropriate assessment of stenoses and assistance with stent placement.


Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ySM6hy


]]> 2710 no Ep. 51 Cone Beam CT Technique with Dr. Austin Bourgeois Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zGhYib Austin Bourgeois and Dr. Christopher Beck discuss ways you can improve your Cone Beam imaging for liver directed therapy, prostate artery embolization and how it can be used to improve safety of other procedures, such as G-tube placement. Wed, 30 Oct 2019 13:33:00 -0000 full BackTable Dr. Austin Bourgeois and Dr. Christopher Beck discuss ways you can improve your Cone Beam imaging for liver directed therapy, prostate artery embolization and how it can be used to improve safety of other procedures, such as G-tube placement. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zGhYib Austin Bourgeois and Dr. Christopher Beck discuss ways you can improve your Cone Beam imaging for liver directed therapy, prostate artery embolization and how it can be used to improve safety of other procedures, such as G-tube placement. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zGhYib


Austin Bourgeois and Dr. Christopher Beck discuss ways you can improve your Cone Beam imaging for liver directed therapy, prostate artery embolization and how it can be used to improve safety of other procedures, such as G-tube placement.

]]> 2646 no Ep. 50 Practicing IR in India with Dr. Deepa Shree https://soundcloud.com/backtable/ep-50-practicing-ir-in-india Dr. Deepa Shree tells us about the challenges she faced building her IR practice in Chennai, and how she is spreading awareness of the specialty and training new IRs to help serve the need throughout India. Sun, 13 Oct 2019 17:06:34 -0000 full BackTable Dr. Deepa Shree tells us about the challenges she… Dr. Deepa Shree tells us about the challenges she faced building her IR practice in Chennai, and how she is spreading awareness of the specialty and training new IRs to help serve the need throughout India. 2970 no Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen https://soundcloud.com/backtable/ep-49-collaboration-in-the Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Ucy8jI Director of IR Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care. Mon, 30 Sep 2019 19:22:00 -0000 full BackTable Director of IR Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Ucy8jI Director of IR Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Ucy8jI


Director of IR Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care.

]]> 1848 no Ep. 48 IR and ENT Treatment of Epistaxis with Dr. Ashley Agan and Dr. Sabeen Dhand https://soundcloud.com/backtable/ep-48-ir-and-ent-treatment-of Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xQPc7h In this episode, Dr. Ashley Agan and Dr. Sabeen Dhand join Dr. Gopi Shah to discuss IR and ENT treatment of epistaxis. We cover the differences in how epistaxis presents for ENT and IR as well as how epistaxis presents in children and older patients. Dr. Agan tells us about the types of nosebleeds that are common and the general treatment algorithm she follows. We discuss nasal packing and decongestant sprays for treatment and how to know when to take the patient to the OR. Dr. Agan talks about isolating the bleeding spot, how to use a foley for posterior nosebleeds, and SPA litigation. We discuss why ENT might consult IR for an embolization. Dr. Dhand tells us about the contraindications for embolization and the procedure for treating the epistaxis. We review the materials that should be used and why it is important to look out for artery connections and pseudoaneurysms. We discuss the pearls and pitfalls of ENT and IR treatment of epistaxis and how to avoid the risk of stroke. Fri, 30 Aug 2019 21:34:00 -0000 full BackTable In this episode, Dr. Ashley Agan and Dr. Sabeen Dhand join Dr. Gopi Shah to discuss IR and ENT treatment of epistaxis. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xQPc7h In this episode, Dr. Ashley Agan and Dr. Sabeen Dhand join Dr. Gopi Shah to discuss IR and ENT treatment of epistaxis. We cover the differences in how epistaxis presents for ENT and IR as well as how epistaxis presents in children and older patients. Dr. Agan tells us about the types of nosebleeds that are common and the general treatment algorithm she follows. We discuss nasal packing and decongestant sprays for treatment and how to know when to take the patient to the OR. Dr. Agan talks about isolating the bleeding spot, how to use a foley for posterior nosebleeds, and SPA litigation. We discuss why ENT might consult IR for an embolization. Dr. Dhand tells us about the contraindications for embolization and the procedure for treating the epistaxis. We review the materials that should be used and why it is important to look out for artery connections and pseudoaneurysms. We discuss the pearls and pitfalls of ENT and IR treatment of epistaxis and how to avoid the risk of stroke. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xQPc7h


In this episode, Dr. Ashley Agan and Dr. Sabeen Dhand join Dr. Gopi Shah to discuss IR and ENT treatment of epistaxis. We cover the differences in how epistaxis presents for ENT and IR as well as how epistaxis presents in children and older patients. Dr. Agan tells us about the types of nosebleeds that are common and the general treatment algorithm she follows. We discuss nasal packing and decongestant sprays for treatment and how to know when to take the patient to the OR. Dr. Agan talks about isolating the bleeding spot, how to use a foley for posterior nosebleeds, and SPA litigation. We discuss why ENT might consult IR for an embolization. Dr. Dhand tells us about the contraindications for embolization and the procedure for treating the epistaxis. We review the materials that should be used and why it is important to look out for artery connections and pseudoaneurysms. We discuss the pearls and pitfalls of ENT and IR treatment of epistaxis and how to avoid the risk of stroke.

]]> 2068 no Ep. 47 BRTO vs. PARTO and other Techniques with Dr. Luke Wilkins Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ZvpYnL Special Guest Dr. Luke Wilkins of University of Virginia VIR discusses BRTO and PARTO techniques for treatment of gastric variceal bleeding. Sun, 18 Aug 2019 18:09:00 -0000 full BackTable Special Guest Dr. Luke Wilkins of University of Virginia VIR discusses BRTO and PARTO techniques for treatment of gastric variceal bleeding. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ZvpYnL Special Guest Dr. Luke Wilkins of University of Virginia VIR discusses BRTO and PARTO techniques for treatment of gastric variceal bleeding. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ZvpYnL


Special Guest Dr. Luke Wilkins of University of Virginia VIR discusses BRTO and PARTO techniques for treatment of gastric variceal bleeding.

]]> 2525 no Ep. 46 Collaboration not Competition between IR and IC with Dr. Achal Sahai and Dr. Chris Beck Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/bobcIg Interventional Cardiologist (IC) Dr. Achal Sahai and Interventional Radiologist (IR) Dr. Christopher Beck discuss ways these two specialties collaborate on complex cases, share endovascular techniques, and avoid the "turf war" trap. Wed, 31 Jul 2019 02:26:00 -0000 full BackTable Interventional Cardiologist (IC) Dr. Achal Sahai and Interventional Radiologist (IR) Dr. Christopher Beck discuss ways these two specialties collaborate on complex cases, share endovascular techniques, and avoid the "turf war" trap. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/bobcIg Interventional Cardiologist (IC) Dr. Achal Sahai and Interventional Radiologist (IR) Dr. Christopher Beck discuss ways these two specialties collaborate on complex cases, share endovascular techniques, and avoid the "turf war" trap. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/bobcIg


Interventional Cardiologist (IC) Dr. Achal Sahai and Interventional Radiologist (IR) Dr. Christopher Beck discuss ways these two specialties collaborate on complex cases, share endovascular techniques, and avoid the "turf war" trap.

]]> 2781 no Ep. 45 Coping with Complications with Dr. Maureen Kohi and Dr. Sandeep Bagla Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/uVVOw3 Dr. Maureen Kohi from UCSF Medical Center and Dr. Sandeep Bagla from Vascular Institute of Virginia discuss the challenges of dealing with procedural complications, and the importance of talking with colleagues and mentors in effective coping. Mon, 01 Jul 2019 02:32:00 -0000 full BackTable Dr. Maureen Kohi from UCSF Medical Center and Dr. Sandeep Bagla from Vascular Institute of Virginia discuss the challenges of dealing with procedural complications, and the importance of talking with colleagues and mentors in effective coping. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/uVVOw3 Dr. Maureen Kohi from UCSF Medical Center and Dr. Sandeep Bagla from Vascular Institute of Virginia discuss the challenges of dealing with procedural complications, and the importance of talking with colleagues and mentors in effective coping. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/uVVOw3


Dr. Maureen Kohi from UCSF Medical Center and Dr. Sandeep Bagla from Vascular Institute of Virginia discuss the challenges of dealing with procedural complications, and the importance of talking with colleagues and mentors in effective coping.

]]> 3623 no Ep. 44 TIPS Procedure Techniques: East to West Coast with Dr. Peder Horner and Dr. Peter Bream Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/2WK9kp East Coast "McBreamy" and "Western Peder" discuss their Colapinto vs. Uchida needle preference, advantages of the ICE catheter, and other great pearls and pitfalls for the TIPS Procedure. Special thanks to our sponsor RADPAD® Radiation Protection. Protect yourself and your patients during those lengthy TIPS cases. Sun, 16 Jun 2019 14:52:00 -0000 full BackTable East Coast "McBreamy" and "Western Peder" discuss their Colapinto vs. Uchida needle preference, advantages of the ICE catheter, and other great pearls and pitfalls for the TIPS Procedure. Special thanks to our sponsor RADPAD® Radiation Protection. Protect yourself and your patients during those lengthy TIPS cases. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/2WK9kp East Coast "McBreamy" and "Western Peder" discuss their Colapinto vs. Uchida needle preference, advantages of the ICE catheter, and other great pearls and pitfalls for the TIPS Procedure. Special thanks to our sponsor RADPAD® Radiation Protection. Protect yourself and your patients during those lengthy TIPS cases. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/2WK9kp


East Coast "McBreamy" and "Western Peder" discuss their Colapinto vs. Uchida needle preference, advantages of the ICE catheter, and other great pearls and pitfalls for the TIPS Procedure. Special thanks to our sponsor RADPAD® Radiation Protection. Protect yourself and your patients during those lengthy TIPS cases.

]]> 3692 no Ep. 43 Managing Urosepsis with Dr. Caire and Dr. Bennett Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/rn9T7J Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett return to the BackTable Podcast to discuss their approaches to urosepsis, stent vs. nephrostomy for a variety of presentations, and the middle-of-the-night patient. Sun, 02 Jun 2019 00:09:00 -0000 full BackTable Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett return to the BackTable Podcast to discuss their approaches to urosepsis, stent vs. nephrostomy for a variety of presentations, and the middle-of-the-night patient. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/rn9T7J Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett return to the BackTable Podcast to discuss their approaches to urosepsis, stent vs. nephrostomy for a variety of presentations, and the middle-of-the-night patient. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/rn9T7J


Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett return to the BackTable Podcast to discuss their approaches to urosepsis, stent vs. nephrostomy for a variety of presentations, and the middle-of-the-night patient.

]]> 2130 no Ep. 42 Physician Contract Negotiation with Dr. Mary Costantino and Courtney Angeli Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/igMUV3 Dr. Mary Costantino and her contract lawyer Courtney Angeli discuss the essentials of physician contract negotiation: finding the right lawyer, partnerships, non-competes, and critical pitfalls to avoid. Sun, 12 May 2019 03:09:00 -0000 full BackTable Dr. Mary Costantino and her contract lawyer Courtney Angeli discuss the essentials of physician contract negotiation: finding the right lawyer, partnerships, non-competes, and critical pitfalls to avoid. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/igMUV3 Dr. Mary Costantino and her contract lawyer Courtney Angeli discuss the essentials of physician contract negotiation: finding the right lawyer, partnerships, non-competes, and critical pitfalls to avoid. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/igMUV3


Dr. Mary Costantino and her contract lawyer Courtney Angeli discuss the essentials of physician contract negotiation: finding the right lawyer, partnerships, non-competes, and critical pitfalls to avoid.

]]> 3701 no Ep. 41 IR and Urology Collaboration on Renal Masses with Dr. Caire and Dr. Bennett Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/PZalEv Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett discuss their approaches to treating renal masses, including ways in which IR and Urology collaborate, laparoscopic versus percutaneous ablation, follow-up imaging, and more. Mon, 29 Apr 2019 16:54:00 -0000 full BackTable Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett discuss their approaches to treating renal masses, including ways in which IR and Urology collaborate, laparoscopic versus percutaneous ablation, follow-up imaging, and more. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/PZalEv Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett discuss their approaches to treating renal masses, including ways in which IR and Urology collaborate, laparoscopic versus percutaneous ablation, follow-up imaging, and more. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/PZalEv


Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett discuss their approaches to treating renal masses, including ways in which IR and Urology collaborate, laparoscopic versus percutaneous ablation, follow-up imaging, and more.

]]> 2435 no Ep. 40 Treating the Difficult IV Access (DiVA) patient with Dr. Chick and Dr. Jagannathan https://soundcloud.com/backtable/ep-40-treating-the-difficult Dr. Arun Jagannathan and Dr. Jeffrey Chick discuss their approach to the Difficult IV access (DiVA) patient. Special thanks to sponsor Access Vascular Inc. for lending their booth at #SIR19ATX. Tue, 26 Mar 2019 13:25:19 -0000 full BackTable Dr. Arun Jagannathan and Dr. Jeffrey Chick discus… Dr. Arun Jagannathan and Dr. Jeffrey Chick discuss their approach to the Difficult IV access (DiVA) patient. Special thanks to sponsor Access Vascular Inc. for lending their booth at #SIR19ATX. 1109 no Ep. 39 Better Biopsies With Dr. Thor Johnson https://soundcloud.com/backtable/ep-39-better-biopsies-with-dr-thor-johnson Dr. Thor Johnson discusses his experience with the Argon BioPince biopsy needle for liver, renal and soft tissue biopsies, including tips and tricks for obtaining better biopsy samples with fewer passes. Recorded at SIR 2019 in ATX. Mon, 25 Mar 2019 18:31:31 -0000 full BackTable Dr. Thor Johnson discusses his experience with th… Dr. Thor Johnson discusses his experience with the Argon BioPince biopsy needle for liver, renal and soft tissue biopsies, including tips and tricks for obtaining better biopsy samples with fewer passes. Recorded at SIR 2019 in ATX. 725 no Ep. 38 Special guest Physician on Fire (POF) talks financial independence for physicians https://soundcloud.com/backtable/ep-38-special-guest-physician Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/GfYFHp Physician on FIRE (PoF) founder Dr. Leif Dahleen discusses financial independence for physicians. Leif created his platform to inform and inspire physicians with insightful writing after he attained financial independence and the freedom to retire early. More information at physicianonfire.com Wed, 20 Feb 2019 23:55:00 -0000 full BackTable Physician on FIRE (PoF) founder Dr. Leif Dahleen discusses financial independence for physicians. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/GfYFHp Physician on FIRE (PoF) founder Dr. Leif Dahleen discusses financial independence for physicians. Leif created his platform to inform and inspire physicians with insightful writing after he attained financial independence and the freedom to retire early. More information at physicianonfire.com Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/GfYFHp


Physician on FIRE (PoF) founder Dr. Leif Dahleen discusses financial independence for physicians. Leif created his platform to inform and inspire physicians with insightful writing after he attained financial independence and the freedom to retire early. More information at physicianonfire.com

]]> 3135 no Ep. 37 Treating PAD in the OBL with Dr. Mike Watts and Dr. Omar Saleh Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/9HpSIv Special guests Dr. Mike Watts and Dr. Omar Saleh discussing the ins and outs of treating PAD in the Outpatient Based Lab (OBL) setting. Includes great info on practice building, patient safety, and essential equipment. #irad #miips Mon, 07 Jan 2019 06:03:00 -0000 full BackTable Dr. Mike Watts and Dr. Omar Saleh discussing the ins and outs of treating PAD in the Outpatient Based Lab (OBL) setting. Includes great info on practice building, patient safety, and essential equipment. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/9HpSIv Special guests Dr. Mike Watts and Dr. Omar Saleh discussing the ins and outs of treating PAD in the Outpatient Based Lab (OBL) setting. Includes great info on practice building, patient safety, and essential equipment. #irad #miips Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/9HpSIv


Special guests Dr. Mike Watts and Dr. Omar Saleh discussing the ins and outs of treating PAD in the Outpatient Based Lab (OBL) setting. Includes great info on practice building, patient safety, and essential equipment. #irad #miips

]]> 3511 no Ep. 36 Building the UFE and OBL practice with Dr. Mary Costantino https://soundcloud.com/backtable/ep-36-building-the-ufe-and-obl Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/HRWoTs Dr. Mary Costantino tells us the story of how she built her OBL practice in Portland and discusses the advantages of performing UFE and other procedures in the outpatient setting. Wed, 19 Dec 2018 03:20:00 -0000 full BackTable Dr. Mary Costantino tells us the story of how she built her OBL practice in Portland and discusses the advantages of performing UFE and other procedures in the outpatient setting. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/HRWoTs Dr. Mary Costantino tells us the story of how she built her OBL practice in Portland and discusses the advantages of performing UFE and other procedures in the outpatient setting. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/HRWoTs


Dr. Mary Costantino tells us the story of how she built her OBL practice in Portland and discusses the advantages of performing UFE and other procedures in the outpatient setting.

]]> 3228 no Ep. 35 OTW Technique for IVC filter placement with Dr. David Mobley https://soundcloud.com/backtable/ep-35-otw-technique-for-ivc Dr. David Mobley of Columbia University VIR describes his over-the-wire technique to prevent tilting in IVC filter placement. Special thanks to our sponsor Argon Medical. Mon, 12 Nov 2018 22:22:21 -0000 full BackTable Dr. David Mobley of Columbia University VIR descr… Dr. David Mobley of Columbia University VIR describes his over-the-wire technique to prevent tilting in IVC filter placement. Special thanks to our sponsor Argon Medical. 1177 no Ep. 34 Spinal Ablation Therapies with Dr. Peder Horner https://soundcloud.com/backtable/ep-34-spinal-ablation Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/t4Ocb0 Our second podcast recorded live from Western Angiographic (WAIS) conference in Maui 2018! Dr. Sabeen Dhand interviews Dr. Peder Horner on how he built a spinal tumor ablation practice in Denver, CO, including tips/tricks on equipment and patient selection. Thu, 11 Oct 2018 18:37:00 -0000 full BackTable Dr. Sabeen Dhand interviews Dr. Peder Horner on how he built a spinal tumor ablation practice in Denver, CO, including tips/tricks on equipment and patient selection. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/t4Ocb0 Our second podcast recorded live from Western Angiographic (WAIS) conference in Maui 2018! Dr. Sabeen Dhand interviews Dr. Peder Horner on how he built a spinal tumor ablation practice in Denver, CO, including tips/tricks on equipment and patient selection. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/t4Ocb0


Our second podcast recorded live from Western Angiographic (WAIS) conference in Maui 2018! Dr. Sabeen Dhand interviews Dr. Peder Horner on how he built a spinal tumor ablation practice in Denver, CO, including tips/tricks on equipment and patient selection.

]]> 1534 no Ep. 33 Building a Comprehensive Vein Practice with Dr. Brooke Spencer https://soundcloud.com/backtable/ep-33-building-a-comprehensive Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/tNgPeU Dr. Brooke Spencer gets into the pearls and pitfalls of building a comprehensive vein practice, including a detailed discussion on the treatment of May-Thurner and Pelvic Congestion syndrome. Tue, 09 Oct 2018 23:52:00 -0000 full BackTable Dr. Brooke Spencer gets into the pearls and pitfalls of building a comprehensive vein practice, including a detailed discussion on the treatment of May-Thurner and Pelvic Congestion syndrome. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/tNgPeU Dr. Brooke Spencer gets into the pearls and pitfalls of building a comprehensive vein practice, including a detailed discussion on the treatment of May-Thurner and Pelvic Congestion syndrome. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/tNgPeU


Dr. Brooke Spencer gets into the pearls and pitfalls of building a comprehensive vein practice, including a detailed discussion on the treatment of May-Thurner and Pelvic Congestion syndrome.

]]> 2369 no Ep. 32 Building an Interventional Oncology Program with Dr. Zaetta and Dr. Stanton Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/a114SU Interventional Radiologist Dr. Julie Zaetta and Oncologist Dr. Julie Stanton discuss the essentials of building a successful Interventional Oncology program, including the importance of a multidisciplinary approach. Sat, 08 Sep 2018 19:32:00 -0000 full BackTable Interventional Radiologist Dr. Julie Zaetta and Oncologist Dr. Julie Stanton discuss the essentials of building a successful Interventional Oncology program, including the importance of a multidisciplinary approach. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/a114SU Interventional Radiologist Dr. Julie Zaetta and Oncologist Dr. Julie Stanton discuss the essentials of building a successful Interventional Oncology program, including the importance of a multidisciplinary approach. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/a114SU


Interventional Radiologist Dr. Julie Zaetta and Oncologist Dr. Julie Stanton discuss the essentials of building a successful Interventional Oncology program, including the importance of a multidisciplinary approach.

]]> 2164 no Ep. 31 Cosmetic IR and Marketing Tips with Dr. Aaron Shiloh Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RKhFhu Dr. Aaron Shiloh of PA Vascular Institute discusses his experiences adding Cosmetic IR procedures to his practice, as well as some essential online marketing strategies for IRs. Mon, 16 Jul 2018 17:47:00 -0000 full BackTable Dr. Aaron Shiloh of PA Vascular Institute discusses his experiences adding Cosmetic IR procedures to his practice, as well as some essential online marketing strategies for IRs. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RKhFhu Dr. Aaron Shiloh of PA Vascular Institute discusses his experiences adding Cosmetic IR procedures to his practice, as well as some essential online marketing strategies for IRs. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RKhFhu


Dr. Aaron Shiloh of PA Vascular Institute discusses his experiences adding Cosmetic IR procedures to his practice, as well as some essential online marketing strategies for IRs.

]]> 2445 no Ep. 30 Transradial Access: Basic to Advanced with Dr. Aaron Fischman Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o72eK3 Our interventional radiologist guest Dr. Aaron Fischman gets into the details of his technique, equipment and tips/tricks for transradial access, as well as its advantages in a variety of IR interventions. Tue, 26 Jun 2018 20:35:00 -0000 full BackTable Our interventional radiologist guest Dr. Aaron Fischman gets into the details of his technique, equipment and tips/tricks for transradial access, as well as its advantages in a variety of IR interventions. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o72eK3 Our interventional radiologist guest Dr. Aaron Fischman gets into the details of his technique, equipment and tips/tricks for transradial access, as well as its advantages in a variety of IR interventions. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o72eK3


Our interventional radiologist guest Dr. Aaron Fischman gets into the details of his technique, equipment and tips/tricks for transradial access, as well as its advantages in a variety of IR interventions.

]]> 2882 no Ep. 29 Interview with Interventional Initiative founders Isabel Newton and Susan Jackson https://soundcloud.com/backtable/ep-29-interview-with An interview with Interventional Initiative founders Isabel Newton and Susan Jackson taking us through the journey behind the awe-inspiring Without A Scalpel documentaries, including some funny stories and more exciting things to come. Sun, 17 Jun 2018 19:07:11 -0000 full BackTable An interview with Interventional Initiative found… An interview with Interventional Initiative founders Isabel Newton and Susan Jackson taking us through the journey behind the awe-inspiring Without A Scalpel documentaries, including some funny stories and more exciting things to come. 2290 no Ep. 28 Advanced Enteral Access with Dr. Jeffrey Chick and Dr. Ravi Srinivasa Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/q7wJPr Dr. Jeffrey Chick and Dr. Ravi Srinivasa discuss what inspired them to start IRAD Lab, their advanced enteral access techniques, as well as a new technique for closing EC fistulas with laser! Mon, 07 May 2018 03:19:00 -0000 full BackTable Dr. Jeffrey Chick and Dr. Ravi Srinivasa discuss what inspired them to start IRAD Lab, their advanced enteral access techniques, as well as a new technique for closing EC fistulas with laser! Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/q7wJPr Dr. Jeffrey Chick and Dr. Ravi Srinivasa discuss what inspired them to start IRAD Lab, their advanced enteral access techniques, as well as a new technique for closing EC fistulas with laser! Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/q7wJPr


Dr. Jeffrey Chick and Dr. Ravi Srinivasa discuss what inspired them to start IRAD Lab, their advanced enteral access techniques, as well as a new technique for closing EC fistulas with laser!

]]> 1964 no Ep. 27 Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/cGcyzt Our latest BackTable podcast on an exciting new therapy for osteoarthritis of the knee- Geniculate Artery Embolization! Our guests Dr. Ari Isaacson and Dr. Sandeep Bagla discuss their experiences and the immense potential this trans-arterial treatment has for management of people suffering from OA. Fri, 13 Apr 2018 03:47:00 -0000 full BackTable Our latest BackTable podcast on an exciting new therapy for osteoarthritis of the knee- Geniculate Artery Embolization! Our guests Dr. Ari Isaacson and Dr. Sandeep Bagla discuss their experiences and the immense potential this trans-arterial treatment has for management of people suffering from OA. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/cGcyzt Our latest BackTable podcast on an exciting new therapy for osteoarthritis of the knee- Geniculate Artery Embolization! Our guests Dr. Ari Isaacson and Dr. Sandeep Bagla discuss their experiences and the immense potential this trans-arterial treatment has for management of people suffering from OA. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/cGcyzt


Our latest BackTable podcast on an exciting new therapy for osteoarthritis of the knee- Geniculate Artery Embolization! Our guests Dr. Ari Isaacson and Dr. Sandeep Bagla discuss their experiences and the immense potential this trans-arterial treatment has for management of people suffering from OA.

]]> 2699 no Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck https://soundcloud.com/backtable/ep-26-radial-vs-femoral-access Dr. Christopher Beck and Dr. Jason Iannuccilli discuss radial vs femoral access in IO procedures, including the pros and cons of both, and a very informative "how I do it" for radial access by Dr. Iannuccilli. Fri, 30 Mar 2018 04:40:52 -0000 full BackTable Dr. Christopher Beck and Dr. Jason Iannuccilli di… Dr. Christopher Beck and Dr. Jason Iannuccilli discuss radial vs femoral access in IO procedures, including the pros and cons of both, and a very informative "how I do it" for radial access by Dr. Iannuccilli. 2726 no Ep. 25 Declots and the Argon Cleaner Device with Dr. Sabeen Dhand and Dr. Chris Beck https://soundcloud.com/backtable/ep-25-declots-and-the-argon In this episode, Dr. Sabeen Dhand joins Dr. Christopher Beck to discuss arteriovenous access declot procedure with the Argon Cleaner device. We review the routine declot procedure and the different methods to get access. Dr. Dhand explains why he starts out using the Argon Cleaner device and what his endpoint is. We discuss the nuances of the device in addition to tips and tricks for using the device with declots, including external massaging the fistula and an unsheathing trick. Tue, 20 Mar 2018 19:33:53 -0000 full BackTable In this episode, Dr. Sabeen Dhand joins Dr. Chris… In this episode, Dr. Sabeen Dhand joins Dr. Christopher Beck to discuss arteriovenous access declot procedure with the Argon Cleaner device. We review the routine declot procedure and the different methods to get access. Dr. Dhand explains why he starts out using the Argon Cleaner device and what his endpoint is. We discuss the nuances of the device in addition to tips and tricks for using the device with declots, including external massaging the fistula and an unsheathing trick. 811 no Ep. 24 Endoscopy for the Interventional Radiologist with Dr. Srinivasa and Dr. Chick https://soundcloud.com/backtable/episode-24-endoscopy-for-the Jeffrey Chick and Ravi Srinivasa of University of Michigan VIR. In Episode 24 they explain the advantages of using simple to learn endoscopic techniques in gallbladder, biliary and genitourinary cases. Thu, 08 Mar 2018 04:45:04 -0000 full BackTable Jeffrey Chick and Ravi Srinivasa of University of… Jeffrey Chick and Ravi Srinivasa of University of Michigan VIR. In Episode 24 they explain the advantages of using simple to learn endoscopic techniques in gallbladder, biliary and genitourinary cases. 2641 no Ep. 23 Adrenal Vein Sampling with Dr. Mike Devane https://soundcloud.com/backtable/a-how-to-on-adrenal-vein The procedure that everyone gets excited about! In this week's BackTable podcast Mike Devane talks us through adrenal vein sampling technique, including equipment/imaging tips and tricks, as well as pitfalls to avoid. Whether looking to build an AVS service, or just preparing for that once in a blue moon case, you're certain to take away a few pearls! Tue, 20 Feb 2018 19:06:38 -0000 full BackTable The procedure that everyone gets excited about! I… The procedure that everyone gets excited about! In this week's BackTable podcast Mike Devane talks us through adrenal vein sampling technique, including equipment/imaging tips and tricks, as well as pitfalls to avoid. Whether looking to build an AVS service, or just preparing for that once in a blue moon case, you're certain to take away a few pearls! 1409 no Ep. 22 Central and Upper Extremity Venous Interventions with Dr. Mark Lessne and Dr. Sabeen Dhand https://soundcloud.com/backtable/ep-22-central-and-upper Central and Upper Extremity Venous Interventions with Dr. Mark Lessne of Charlotte Radiology and Dr. Sabeen Dhand of PIH Health. In this episode our docs discuss central recanalizations, ballooning versus stents, declot techniques, and get into a ton of tips and tricks! Tue, 06 Feb 2018 05:31:04 -0000 full BackTable Central and Upper Extremity Venous Interventions … Central and Upper Extremity Venous Interventions with Dr. Mark Lessne of Charlotte Radiology and Dr. Sabeen Dhand of PIH Health. In this episode our docs discuss central recanalizations, ballooning versus stents, declot techniques, and get into a ton of tips and tricks! 3542 no Ep. 21 Vertebral Augmentation with Dr. Venu Vadlamudi and Dr. Kumar Madassery https://soundcloud.com/backtable/ep-21-vertebral-augmentation Vertebral augmentation can be accomplished through various techniques - Dr. Venu Vadlamudi and Dr. Kumar Madassery shed light on the utility of kyphoplasty versus vertebroplasty when treating compression fractures of the spine. Sun, 28 Jan 2018 16:30:40 -0000 full BackTable Vertebral augmentation can be accomplished throug… Vertebral augmentation can be accomplished through various techniques - Dr. Venu Vadlamudi and Dr. Kumar Madassery shed light on the utility of kyphoplasty versus vertebroplasty when treating compression fractures of the spine. 2332 no Ep. 20 Pressure-Directed Therapy in TACE with Dr. Justin Lee and Dr. Terence Gade https://soundcloud.com/backtable/episode-20-pressure-directed Our 20th BackTable podcast episode featuring special guests Dr. Justin Lee of Florida Interventional Specialists, and Dr. Terence Gade of Hospital of University of Pennsylvania. They discuss experiences and utility of pressure-directed, antireflux infusion for TACE treatments. Sat, 20 Jan 2018 06:40:52 -0000 full BackTable Our 20th BackTable podcast episode featuring spec… Our 20th BackTable podcast episode featuring special guests Dr. Justin Lee of Florida Interventional Specialists, and Dr. Terence Gade of Hospital of University of Pennsylvania. They discuss experiences and utility of pressure-directed, antireflux infusion for TACE treatments. 2757 no Ep. 19 Lymphatic Interventions with Dr. Chick and Dr. Srinivasa https://soundcloud.com/backtable/ep-19-lymphatic-interventions Our holiday episode featuring Dr. Jeffrey Chick and Dr. Ravi Srinivasa of University of Michigan. They sit fireside with our host J. Michael Barraza Jr. to discuss lymphatic interventions in IR. Wed, 27 Dec 2017 05:48:50 -0000 full BackTable Our holiday episode featuring Dr. Jeffrey Chick a… Our holiday episode featuring Dr. Jeffrey Chick and Dr. Ravi Srinivasa of University of Michigan. They sit fireside with our host J. Michael Barraza Jr. to discuss lymphatic interventions in IR. 2992 no Ep. 18 Complex LE Venous Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa https://soundcloud.com/backtable/complex-le-venous Dr. Jeffrey Chick and Dr. Ravi Srinivasa discussing complex lower extremity venous interventions at University of Michigan VIR. Mon, 18 Dec 2017 05:32:17 -0000 full BackTable Dr. Jeffrey Chick and Dr. Ravi Srinivasa discussi… Dr. Jeffrey Chick and Dr. Ravi Srinivasa discussing complex lower extremity venous interventions at University of Michigan VIR. 3472 no Ep. 17 Prostate Artery Embolization with Dr. Ari Isaacson and Dr. Sandeep Bagla https://soundcloud.com/backtable/ep-17-prostate-artery Special guests Dr. Ari Isaacson and Dr. Sandeep Bagla sharing their experiences with prostate artery embolization, including a candid discussion on practice building, equipment, and a brief intro on what to expect at the upcoming STREAM PAE course Jan 13 in Washington DC. Mon, 20 Nov 2017 04:46:00 -0000 full BackTable Special guests Dr. Ari Isaacson and Dr. Sandeep B… Special guests Dr. Ari Isaacson and Dr. Sandeep Bagla sharing their experiences with prostate artery embolization, including a candid discussion on practice building, equipment, and a brief intro on what to expect at the upcoming STREAM PAE course Jan 13 in Washington DC. 2891 no Ep. 16 Pressure-Directed Therapy in Y90 with Dr. Nutting and Dr. Parikh https://soundcloud.com/backtable/ep-16-pressure-directed In our first podcast on pressure directed therapy, Dr. Charles Nutting and Dr. Nainesh Parikh discuss some of the first principles of Y90 radioembolization delivery, and the potential advantages of pressure directed devices over end-hole catheters in the treatment of HCC. Sun, 05 Nov 2017 04:16:24 -0000 full BackTable In our first podcast on pressure directed therapy… In our first podcast on pressure directed therapy, Dr. Charles Nutting and Dr. Nainesh Parikh discuss some of the first principles of Y90 radioembolization delivery, and the potential advantages of pressure directed devices over end-hole catheters in the treatment of HCC. 1940 no Ep. 15 Renal Ablation Therapies with Dr. Mike Devane and Dr. Ahmed Kamel https://soundcloud.com/backtable/renal-ablations We discuss renal ablation therapies with Mike Devane MD and Ahmed Kamel MD, PhD, FSIR Wed, 01 Nov 2017 14:05:07 -0000 full BackTable We discuss renal ablation therapies with Mike Dev… We discuss renal ablation therapies with Mike Devane MD and Ahmed Kamel MD, PhD, FSIR 1990 no Ep. 14 Novel Bariatric and Pain Therapies with Dr. David Prologo https://soundcloud.com/backtable/novel-bariatric-and-pain Podcast episode 14 with J. David Prologo and J. Michael Barraza Jr. discussing Novel Bariatric and Pain Interventions. Fri, 20 Oct 2017 03:10:35 -0000 full BackTable Podcast episode 14 with J. David Prologo and J. M… Podcast episode 14 with J. David Prologo and J. Michael Barraza Jr. discussing Novel Bariatric and Pain Interventions. 1766 no Ep. 13 Neurovascular IR Part 2: Devices https://soundcloud.com/backtable/ep-13-neurovascular-ir-part-2 Our docs discuss integrating neurovascular interventions (part 2) into your IR practice with Venu Vadlamudi and Sabeen Dhand. Mon, 02 Oct 2017 04:23:49 -0000 full BackTable Our docs discuss integrating neurovascular interv… Our docs discuss integrating neurovascular interventions (part 2) into your IR practice with Venu Vadlamudi and Sabeen Dhand. 1703 no Ep. 12 Neurovascular IR (Part 1) with Sabeen Dhand and Venu Vadlamudi https://soundcloud.com/backtable/neurovascular-interventions Our docs discuss integrating neurovascular interventions (part 1) into your IR practice with Venu Vadlamudi and Sabeen Dhand. Mon, 02 Oct 2017 04:14:07 -0000 full BackTable Our docs discuss integrating neurovascular interv… Our docs discuss integrating neurovascular interventions (part 1) into your IR practice with Venu Vadlamudi and Sabeen Dhand. 2675 no Ep. 11 #filterOUT with Robert Ryu and AJ Gunn https://soundcloud.com/backtable/ivc-filter-retrievals-with On Episode 11 of the BackTable Podcast Robert Ryu and AJ Gunn discuss building a filter retrieval practice, equipment preferences, and challenging cases. Mon, 18 Sep 2017 03:17:53 -0000 full BackTable On Episode 11 of the BackTable Podcast Robert Ryu… On Episode 11 of the BackTable Podcast Robert Ryu and AJ Gunn discuss building a filter retrieval practice, equipment preferences, and challenging cases. 3154 no Ep. 10 Uterine Fibroid Embolizations with Dr. Keith Pereira and Dr. Chris Beck https://soundcloud.com/backtable/ep-10-uterine-fibroid Dr. Keith Pereira and Dr. Chris Beck discuss building their UFE practice and transradial versus transfemoral approaches. Fri, 25 Aug 2017 13:08:09 -0000 full BackTable Dr. Keith Pereira and Dr. Chris Beck discuss buil… Dr. Keith Pereira and Dr. Chris Beck discuss building their UFE practice and transradial versus transfemoral approaches. 2901 no Ep. 9 StoptheChop with Dr. Kumar Madassery and Dr. Sabeen Dhand https://soundcloud.com/backtable/ep-9-pad There are numerous modalities available to characterize and treat peripheral arterial disease (PAD). Dr. Kumar Madassery and Dr. Sabeen Dhand highlight their preferred techniques - covering imaging, atherectomy, drug coated balloons, and stenting. Wed, 16 Aug 2017 04:54:24 -0000 full BackTable There are numerous modalities available to charac… There are numerous modalities available to characterize and treat peripheral arterial disease (PAD). Dr. Kumar Madassery and Dr. Sabeen Dhand highlight their preferred techniques - covering imaging, atherectomy, drug coated balloons, and stenting. 3343 no Ep. 8 Dr. Abdulaziz AlHarbi discusses IR in Saudi Arabia https://soundcloud.com/backtable/episode-8-dr-abdulaziz-alharbi Dr. Aaron Fritts talks with Dr. Abdulaziz AlHarbi about his IR practice in the Kingdom of Saudi Arabia. Sun, 13 Aug 2017 20:29:05 -0000 full BackTable Dr. Aaron Fritts talks with Dr. Abdulaziz AlHarbi… Dr. Aaron Fritts talks with Dr. Abdulaziz AlHarbi about his IR practice in the Kingdom of Saudi Arabia. 1325 no Ep. 7 Lung Tumor Ablation with Dr. Stephen Hunt https://soundcloud.com/backtable/lung-cancer-ablation In Episode 7 we discuss Lung tumor ablation therapies with Dr. Stephen Hunt, MD, PhD, including practice building and devices. Tue, 01 Aug 2017 19:27:31 -0000 full BackTable In Episode 7 we discuss Lung tumor ablation thera… In Episode 7 we discuss Lung tumor ablation therapies with Dr. Stephen Hunt, MD, PhD, including practice building and devices. 2898 no Ep. 6 Setting up a Vein Clinic with Dr. Aaron Shiloh https://soundcloud.com/backtable/ep-6-vein-clinics-with-dr Episode 6 with Dr. Aaron Shiloh, MD FSIR discussing pearls and pitfalls of starting an outpatient vein clinic, including the importance of marketing. Wed, 19 Jul 2017 21:15:27 -0000 full BackTable Episode 6 with Dr. Aaron Shiloh, MD FSIR discussi… Episode 6 with Dr. Aaron Shiloh, MD FSIR discussing pearls and pitfalls of starting an outpatient vein clinic, including the importance of marketing. 3321 no Ep. 5 Closure Devices https://soundcloud.com/backtable/episode-5-closure-devices In Episode 5 of the BackTable podcast: Aaron Fritts MD and Chris Beck MD discuss the Angioseal and Mynx closure devices. Thu, 06 Jul 2017 03:38:19 -0000 full BackTable In Episode 5 of the BackTable podcast: Aaron Frit… In Episode 5 of the BackTable podcast: Aaron Fritts MD and Chris Beck MD discuss the Angioseal and Mynx closure devices. 1787 no Ep. 4 Amplatzer Plugs vs Coils in Splenic Trauma https://soundcloud.com/backtable/podcast-ep-4-amplatzer-plugs-vs-coils-in-splenic-trauma Dr. Bryan Hartley and Dr. Aaron Fritts discuss the pros and cons of using coils and/or vascular plugs for splenic trauma. Thu, 06 Jul 2017 01:29:04 -0000 full BackTable Dr. Bryan Hartley and Dr. Aaron Fritts discuss th… Dr. Bryan Hartley and Dr. Aaron Fritts discuss the pros and cons of using coils and/or vascular plugs for splenic trauma. 912 no Ep. 3 Tunneled Dialysis Catheters with Dr. Peter Bream and Dr. Aaron Brandis https://soundcloud.com/backtable/episode-3-tunnel-dialysis Special guests Peter Bream MD and Aaron Brandis MD discuss the pros and cons of antegrade versus retrograde tunneled dialysis catheter placement. Wed, 24 May 2017 02:19:17 -0000 full BackTable Special guests Peter Bream MD and Aaron Brandis M… Special guests Peter Bream MD and Aaron Brandis MD discuss the pros and cons of antegrade versus retrograde tunneled dialysis catheter placement. 2041 no Ep. 2 G-Tubes Two Ways with Bream and Brandis https://soundcloud.com/backtable/ep2-g-tubes-two-ways-with Special guests Peter Bream MD and Aaron Brandis MD discuss the Balloon-Assisted (BAG) and Per-oral (POG) techniques for the gastrostomy procedure. Sat, 20 May 2017 16:35:00 -0000 full BackTable Special guests Peter Bream MD and Aaron Brandis M… Special guests Peter Bream MD and Aaron Brandis MD discuss the Balloon-Assisted (BAG) and Per-oral (POG) techniques for the gastrostomy procedure. Special guests Peter Bream MD and Aaron Brandis MD discuss the Balloon-Assisted (BAG) and Per-oral (POG) techniques for the gastrostomy procedure.

]]> 2128 no Ep. 1 BM BX Devices: Jamshidi vs OnControl https://soundcloud.com/backtable/episode-1-bm-bx-devices-1 Listen to New Orleans IR Christopher Beck MD and Dallas IR Aaron Fritts MD discuss preferences in bone biopsy needles. Visit BackTable Mon, 10 Apr 2017 00:38:00 -0000 full BackTable Listen to New Orleans IR Christopher Beck MD and … Listen to New Orleans IR Christopher Beck MD and Dallas IR Aaron Fritts MD discuss preferences in bone biopsy needles. Visit BackTable Listen to New Orleans IR Christopher Beck MD and Dallas IR Aaron Fritts MD discuss preferences in bone biopsy needles.

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