BackTable Vascular & Interventional

Dr. Steven Abramowitz, a vascular surgeon at MedStar Health, shares his expertise on chronic venous disease management. He discusses the importance of classification systems like CEAP and VCSS, targeted patient history, and innovative imaging strategies. Abramowitz emphasizes proactive prevention of post-thrombotic syndrome and various therapeutic options, including stenting techniques. He also delves into the significance of shared decision-making and the evolving role of adjunct therapies such as statins. Tune in for valuable insights and practical tips!

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/

In an insightful conversation, Dr. David Zielske, an interventional radiology coding expert and founder of Z Health Publishing, shares his journey to mastering coding. He highlights the critical role of accurate documentation in billing and reveals common pitfalls practitioners face. Zielske discusses upcoming key coding updates for 2026, the proper usage of modifiers, and how to avoid disastrous coding mistakes. He also emphasizes the importance of early training in coding for residents and offers essential tips for improving compliance and revenue capture.

Dr. Rusty Hofmann, an interventional radiologist and chief of industry partnerships at Stanford, shares insights on creating impactful digital education through his Wisdom platform. He discusses the importance of mobile microlearning, emphasizing bite-sized video 'pearls' for medical training. Rusty provides startup advice for entrepreneurs, highlights included health’s virtual care success with employers, and outlines how Wisdom integrates analytics to enhance professional development. He also contrasts Wisdom with other platforms and sets goals for global educational impact.

Dr. Scott Atai, a general thoracic surgeon at USC, and Dr. Scott Oh, an interventional pulmonologist, join the discussion on innovative lung cancer treatments. They explore the shift from traditional open thoracotomy to robotic and minimally invasive techniques. The duo emphasizes the importance of accurate mediastinal staging and the role of advanced bronchoscopic methods. They also share insights on managing multifocal lung cancers and preserving lung function while employing a multidisciplinary and personalized approach for long-term outcomes.

Dr. Sabeen Dhand, an interventional radiologist and procedural expert, dives into the world of provocative mesenteric angiography for GI bleeds. She uncovers the protocols for administering tPA, emphasizing careful dosing and communication with care teams. Addressing common myths, Dr. Dhand explains when to utilize provocative angiography after negative tests. With fascinating real-world case studies, she showcases the procedure's safety and efficiency, challenging misconceptions and highlighting its critical role in managing recurrent lower GI bleeding.

Dr. Scott Oh, an interventional pulmonologist, Dr. Rob Suh, a thoracic interventional radiologist, and Dr. Alan Lee, a radiation oncologist, dive into the intricacies of lung cancer treatment. They explore why combining biopsy and ablation may become standard for high-probability cases. The discussions cover sedation strategies, the pros and cons of various biopsy techniques, and groundbreaking advancements like robotic and cryo-biopsy. Their focus on personalized patient care and multidisciplinary collaboration offers valuable insights into improving thoracic oncology outcomes.

Dr. Daniel DePietro, an interventional radiologist and neuroendocrine tumor specialist at the University of Pennsylvania, discusses the complexities of managing neuroendocrine tumors. He shares insights on deciding between bland embolization, TACE, and radioembolization based on patient needs and prior treatments. The conversation also covers the importance of multidisciplinary collaboration, the role of thermal ablation for select patients, and updates on ongoing clinical trials that explore innovative liver-directed therapies.

Laurie Bouzarelos, a revenue cycle management consultant known for her expertise with physician-owned practices, dives deep into the intricacies of revenue cycle management for interventional radiology. She discusses critical topics like credentialing, medical necessity, and the No Surprises Act, emphasizing the importance of transparency in billing. Laurie also explores the impact of emerging technologies, including AI, on revenue management and highlights the significance of accurate coding and eligibility checks in optimizing practice profitability.

Dr. Emil Cohen, an interventional radiologist and computer scientist, shares insights on integrating AI into healthcare. He discusses the dual nature of AI, highlighting both its benefits in workflow optimization and the risks of potential errors like "hallucinations." Emil explores practical applications like maskless subtraction angiography and the use of structured reports for better patient outcomes. He also addresses fears about AI replacing medical professionals, reassuring listeners that AI primarily serves to enhance capabilities rather than replace them.