BackTable Vascular & Interventional

Dr. Zach Berman, an interventional radiologist from UC San Diego, and Dr. Tyler Sandow from Ochsner Health share their expertise on Y90 dose optimization strategies for liver cancer. They discuss the delicate balance of targeting tumors while preserving healthy liver tissue. The doctors delve into real-world cases, analyzing lab values that affect treatment decisions, strategies for managing portal vein invasion, and the complexities of large tumors. Their insights highlight the importance of a multidisciplinary approach to maximize patient outcomes.

Dr. Blaise Baxter, an interventional radiologist from Sutter Health who has developed stroke programs in developing regions, joins Dr. James Milburn from the Ochsner Clinic, known for his role in a large telestroke network. They dive into cutting-edge advancements in stroke thrombectomy, discussing the impactful HERMES and BAOCHE trials that reveal better patient outcomes with endovascular thrombectomy. The duo also highlights the evolving role of imaging in neurointervention and emphasizes the power of rehabilitation in recovery, calling for innovative training in the field.

Dr. Matt Hawkins, an interventional radiologist and a councilor for the Society of Interventional Radiology (SIR), shares insights into financial strategies for interventional radiologists. He discusses the importance of proving their worth by exploring physician reimbursement models and the intricacies of hospital reimbursement structures. Hawkins emphasizes moving beyond traditional metrics to showcase the economic impact of IR, particularly in trauma and cancer care, while advocating for improved documentation and coding practices.

Join interventional oncologists Dr. Nima Kokabi, an expert in Y90 treatment strategies, and Dr. Tyler Sandow as they dive into the nuances of radiation segmentectomy. They uncover the curative potential of Y90 compared to traditional methods, emphasizing the importance of achieving complete pathological necrosis for better survival rates. The duo discusses personalized approaches for treating metastatic liver cancers, explores complex case studies, and examines the critical role of advanced imaging and dosimetry in enhancing patient outcomes.

Join interventional oncologists Drs. Tyler Sandow and Nima Kokabi as they dive into the fascinating world of single-session Y90 treatments for liver tumors. They discuss the latest insights on patient selection and the workflow involved in this innovative approach, highlighting its cost-effectiveness and safety profile. The doctors share practical tips for optimizing treatment and tackling challenges in the procedure. They even delve into real cases, exploring strategies that can enhance patient outcomes, including the potential for combined therapies.

Dr. Nicole Lamparello, an Assistant Professor of Clinical Radiology at Weill Cornell Medicine, and Dr. Gregg Khodorov, a PGY-5 resident with an MBA at Thomas Jefferson University, delve into optimizing interventional radiology residency programs. They discuss effective surgical year rotations and emphasize the importance of early IR exposure. The duo also tackles the dynamics of consult services, balancing diagnostic and interventional skills, and the need for practical, real-world training. Their insights aim to enhance resident experiences and improve patient care.

Join interventional oncologists Dr. Tyler Sandow and Dr. Nima Kokabi as they dive deep into the intricacies of Y90 procedures. They tackle lung shunt fraction calculations, comparing SPECT CT with planar imaging for optimal dosing. Their discussion covers the nuances of various dosimetry models like BSA and voxel-based approaches. The duo also addresses high lung shunt management and the integration of advanced therapies such as TACE and SBRT, rounding it off with a compelling case study on individualized dosimetry planning for liver tumors.

Join interventional oncologists Dr. Tyler Sandow from Ochsner Health and Dr. Nima Kokabi from UNC Chapel Hill as they delve into the intricacies of Y90 treatment planning. They discuss optimizing therapy through multidisciplinary tumor boards and collaboration between academic and private practices. The episode highlights their preferred dosimetry tools and imaging techniques like cone beam CT. Additionally, they explore the challenges of coordinating care and navigating insurance hurdles for liver cancer patients, emphasizing the need for meticulous planning and patient care.

Dr. Waqaar Diwan, an interventional radiologist, shares his experience transitioning to building his own independent IR practice after sudden ownership changes. He discusses navigating challenges like securing hospital contracts and managing a small team. Dr. Diwan emphasizes the importance of trust-building for referrals and the differences between independent and combined practices. He also highlights leveraging networks for business development and adapting to patient care logistics, all essential for a successful independent practice.

In this engaging discussion, Dr. Alex Wallace, an interventional radiologist at Mayo Clinic, and Lisa Rotellini-Coltvet, a physician assistant, share their expertise on the groundbreaking percutaneous transesophageal gastrostomy (PTEG). They delve into patient selection criteria, emphasizing its importance for those who can't undergo traditional methods. The duo also highlights the substantial impact of PTEG on quality of life, detailing successful case studies and stressing the need for thorough education for patients and healthcare staff to ensure optimal outcomes.