Episodios
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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.
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This podcast is supported by:
GE Healthcare Allia Image Guided Systems
https://www.gehealthcare.com/products/interventional-image-guided-systems/allia
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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.
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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
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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 -
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.
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RADPAD® Radiation Protection
https://www.radpad.com/
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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.
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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 -
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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.
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This podcast is supported by:
Philips Image Guided Therapy Solutions
https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products
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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.
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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
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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/ -
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.
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This podcast is supported by an educational grant from:
Varian, a Siemens Healthineers company
https://www.varian.com/
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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.
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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
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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/ -
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.
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This podcast was developed in collaboration with:
Interventional Initiative
https://theii.org/
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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.
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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
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RESOURCES
The Interventional Initiative:
https://theii.org/
The Cholangiocarcinoma Foundation:
https://cholangiocarcinoma.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.
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This podcast was developed in collaboration with:
Interventional Initiative
https://theii.org/
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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.
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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
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RESOURCES
Dr. Brooke Spencer, MD, FSIR Practice:
https://mipscenter.com/about-us/dr-e-brooke-spencer-md-fsir/
The Interventional Initiative:
https://theii.org/ -
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.
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This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
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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.
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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
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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 -
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.
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This podcast was developed in collaboration with:
Interventional Initiative
https://theii.org/
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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.
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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
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RESOURCES
Dr. Charles Nutting Denver Practice:
https://www.drnutting.com/
Say Yes to Hope Cancer Support Group:
https://www.sayyestohope.org/ -
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.
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This podcast is supported by:
Merit Embolotherapy
https://www.merit.com/solutions/embolotherapy/
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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.
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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
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RESOURCES
List of Publications by Dr. James B. Spies (PubMed):
https://pubmed.ncbi.nlm.nih.gov/?sort=jour&term=Spies+JB&cauthor_id=24436560 -
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.
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This podcast is supported by:
PearsonRavitz
https://pearsonravitz.com/backtable
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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.
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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
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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 -
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.
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This podcast is supported by an educational grant from:
Medtronic
https://www.medtronic.com/en-us/index.html
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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.\
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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
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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 -
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.
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This podcast is supported by:
Accountable Physician Advisors
http://www.accountablephysicianadvisors.com/
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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.
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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 -
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.
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This podcast is supported by:S
Accountable Physician Advisors
http://www.accountablephysicianadvisors.com/
Reflow Medical
https://www.reflowmedical.com/
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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).
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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
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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 -
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.
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This podcast is supported by an educational grant from:
Variant
https://www.varian.com/
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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.
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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
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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#:~:text=A%20total%20of%2093%20patients,RFA%20in%20treating%20small%20HCC.
Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial:
https://jgo.amegroups.org/article/view/26929/html#:~:text=to%2080%20years.-,There%20were%20no%20statistically%20significant%20differences%20between%20both%20groups%20regarding,HCC%20ablation%20(Table%202).
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/ -
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.
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This podcast is supported by:
Reflow Medical
https://www.reflowmedical.com/
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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.
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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
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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/ -
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.
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CHECK OUT OUR SPONSOR
Medtronic ClosureFast
https://www.medtronic.com/closurefast6f
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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.
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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
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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/ -
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.
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CHECK OUT OUR SPONSOR
Merit Embolotherapy
https://www.merit.com/solutions/embolotherapy/
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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.
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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
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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/ -
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.
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This podcast is supported by an educational grant from:
Guerbet
https://www.guerbet-us.com
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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.
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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
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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/ -
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.
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CHECK OUT OUR SPONSOR
Imperative Care
https://imperativecare.com/vascular/
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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.
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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
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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 -
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.
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CHECK OUT OUR SPONSOR
RADPAD® Radiation Protection
https://www.radpad.com/
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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.
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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
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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 - Mostrar más
