Episodios

  • Ep. 464 Minimizing Complications for Challenging Lung Biopsies with Dr. Venkatesh Krishnasamy

    Ep. 464 Minimizing Complications for Challenging Lung Biopsies with Dr. Venkatesh Krishnasamy
    Jul 16 2024
    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
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    41 m
  • Ep. 463 Stone Retrieval and Other Advanced Biliary Interventions with Dr. Alexander Vezeridis

    Ep. 463 Stone Retrieval and Other Advanced Biliary Interventions with Dr. Alexander Vezeridis
    Jul 12 2024
    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
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    54 m
  • Ep. 462 IVC Filter Retrieval: Tips and Technique with Dr. Noor Ahmad

    Ep. 462 IVC Filter Retrieval: Tips and Technique with Dr. Noor Ahmad
    Jul 9 2024
    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 ClavaClear 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
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    46 m
  • Ep. 461 Advanced Radial to Peripheral Interventions with Dr. Sameh Sayfo

    Ep. 461 Advanced Radial to Peripheral Interventions with Dr. Sameh Sayfo
    Jul 2 2024
    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
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    58 m
  • Ep. 460 What is POTS and Orthostatic Flow Syndrome? with Dr. Steven Smith

    Ep. 460 What is POTS and Orthostatic Flow Syndrome? with Dr. Steven Smith
    Jun 28 2024
    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
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    46 m
  • Ep. 459 Transitioning from Academia to Private OBL Practice with Dr. Jafar Golzarian

    Ep. 459 Transitioning from Academia to Private OBL Practice with Dr. Jafar Golzarian
    Jun 25 2024
    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
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    49 m
  • Ep. 458 AI Scribes: Enhancing Patient and Physician Interaction with Elie Toubiana

    Ep. 458 AI Scribes: Enhancing Patient and Physician Interaction with Elie Toubiana
    Jun 21 2024
    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/
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    45 m
  • Ep. 457 Sacroplasty II: Technique, Pearls, and Training Opportunities with Dr. Doug Beall

    Ep. 457 Sacroplasty II: Technique, Pearls, and Training Opportunities with Dr. Doug Beall
    Jun 20 2024
    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
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    41 m