BackTable Vascular & Interventional

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.---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

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.---SYNPOSISDr. 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.---TIMESTAMPS00:00 Introduction01:08 MRI for Patient Selection in GAE08:53 Access Techniques: Femoral vs. Pedal17:07 Cone Beam CT in GAE Procedures27:20 Embolization Strategies39:30 Challenges and Complications in Embolization44:50 Follow-Up and Pain Metrics in Clinical Practice and Research01:06:30 Repeat GAE Procedures: When and Why?01:11:13 Post-Total Knee Replacement and GAE01:21:01 Advice for IRs Looking to do GAE01:24:32 Conclusion and Final Thoughts---RESOURCESGENESIS Trial: https://pubmed.ncbi.nlm.nih.gov/33474601/Landers et al Trial: https://pubmed.ncbi.nlm.nih.gov/37051829/

Dr. Ned Holman, a Neuroradiologist at Alaska Imaging, and Dr. Mike Romeo, President of West Reading Radiology, dive into the intricacies of the diagnostic radiology job market. They discuss diverse employment models and the importance of job transparency. Tips on compensation structures, contract negotiation, and critical interview questions are shared. They also warn about red flags to look out for and discuss the pros and cons of private equity positions in radiology, making this an essential listen for anyone navigating their career path.

Dr. Jim Dahle, a practicing emergency physician and founder of the White Coat Investor, discusses crucial financial strategies tailored for high-income earners. He emphasizes the importance of early financial literacy, effective saving practices, and smart retirement goals. The conversation covers innovative investment tactics like the Mega Backdoor Roth IRA and incorporating real estate into portfolios. Additionally, Dr. Dahle shares advice for new graduates and highlights common financial pitfalls to avoid, ensuring a roadmap towards lasting financial success.

Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki, both interventional radiologists in Florida, tackle the complexities of physician reimbursement in outpatient settings. They expose the lag in payments for advanced procedures and advocate for an office-based facility concept to stabilize compensation. The conversation dives into the Medicare Physician Fee Schedule and emphasizes the urgent need for interventionalists to engage in advocacy and legislative efforts. Together, they call for collective action in seeking reform for fairer reimbursement practices.

Dr. Maureen Kohi, Chair of Radiology at UNC Chapel Hill, dives into her ten rules for female interventional radiologists. She emphasizes the importance of mentorship and navigating gender bias in a male-dominated field. Kohi discusses how to balance parenting and career, advocating for professional growth while prioritizing personal well-being. She shares insights on building strong relationships in the industry and encourages women to lead with confidence. This conversation is packed with pearls of wisdom applicable to all aspiring interventional radiologists!

Dr. Barry Katzen, a pioneering figure in interventional radiology, shares his remarkable journey from training during the field's inception to founding the Miami Cardiac and Vascular Institute. He discusses the early challenges and skepticism surrounding IR, highlighting the importance of innovation over complacency. Dr. Katzen emphasizes the value of patient-centered care and mentorship, urging future interventional radiologists to remain dedicated to evolving practices for better outcomes. His insights encapsulate the transformative spirit that continues to shape the field.

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.---SYNPOSISThe 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.---TIMESTAMPS00:00 - Introduction04:02 - Social Media for Interventional Radiologists08:56 - Building a Social Media Presence19:24 - Optimal Posting Strategies21:58 - Collaborations and Platforms25:27 - Conclusion

This week, Dr. Asad Baig, an interventional radiologist from Columbia University, dives into the world of microwave liver ablation. He shares innovative techniques and the importance of personalizing treatment based on patient needs. Dr. Baig discusses how real-time visualization software enhances ablation accuracy and emphasizes the critical role of teamwork in tumor boards. The conversation also covers best practices for tackling challenging tumors, ensuring patient safety, and fostering effective communication with patients throughout their care.

Dr. Clifford Weiss, the Director of the Johns Hopkins Vascular Anomalies Center, shares his expertise on hereditary hemorrhagic telangiectasia (HHT) and pulmonary AVMs. He discusses the critical role of early diagnosis and multidisciplinary teams in effective patient care. The conversation highlights evolving guidelines for intervention, the intricacies of embolization techniques, and the importance of genetic testing. Dr. Weiss also sheds light on innovative treatments and ongoing challenges in managing HHT, showcasing the impact of specialized care on patient outcomes.