BackTable Vascular & Interventional

Dr. Zachary Berman, an interventional radiologist at UC San Diego, offers insights into pressure-enabled drug delivery for liver cancers. He explains how manipulating blood flow in tumors can optimize drug delivery, showcasing the innovative TriNav catheter's design. The discussion delves into real-world applications, including case studies of complex tumors like neuroendocrine lesions and segmental HCC. Additionally, they cover advancements in pressure-directed embolotherapy and the exciting potential future developments in enhancing treatment effectiveness.

Join interventional cardiologist Dr. Jay Mathews, with 20 years of experience in endovascular innovation, and vascular surgeon Dr. Michael Siah, Director of Limb Salvage at UT Southwestern, as they delve into cutting-edge vessel preparation techniques. They discuss advancements like bioresorbable scaffolds and the pivotal role of imaging in assessing critical limb ischemia. Listeners will learn about specialty tools like intravascular lithotripsy and the balance of treatment efficacy against device costs. Exciting emerging technologies promise to reshape their practices!

What are the key elements of a robust interventional radiology practice, and how can IRs effectively demonstrate their value to hospitals? Guest, Dr. Harris Chengazi, interventional radiologist at Great Lakes Medical Imaging, joins host Dr. Sabeen Dhand to explore the core strategies behind developing a successful and sustainable clinical IR practice. --- This podcast is supported by: RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS Dr. Chengazi reflects on formative experiences from the early stages of his career, highlighting the importance of joining a group that shares your vision for a clinical interventional radiology (IR) practice. He underscores the unique value IR offers hospitals—particularly through longitudinal patient care, which not only enhances reimbursement opportunities but also strengthens interdisciplinary collaboration and drives outpatient referrals.He shares insights on balancing complex cases with essential procedures, while underscoring the importance of clear communication and articulating IR’s value to hospital leadership. He also highlights the critical need for physicians to understand the business side of medicine—including coding, billing, and reimbursement—in order to effectively advocate for the specialty. He concludes the episode with a compelling message on the importance of taking ownership of both our patients and the future of our profession. --- TIMESTAMPS00:00 - Introduction and Overview01:55 - Building a Private Practice05:22 - Challenges and Successes24:58 - The Value of Complex Cases in Medical Practice27:00 - Improving Hospital Efficiency Through IR Services29:18 - Involvement of IR in Hospital Administration31:26 - Building a Successful IR Practice36:14 -The Financial Dynamics of IR and DR Practices41:14 -The Essential Role of IR in Hospital Operations

Dr. Tyler Sandow and Dr. Zach Berman, both interventional radiologists, dive into the complexities of treating metastatic diseases with Y90. They discuss the types of metastases they handle and how Y90 can alleviate tumor-related pain. Key topics include the differences between liver-dominant and liver-only conditions, advanced dosing techniques, and the significance of mutation status in treatment. They also share compelling case studies to highlight the decision-making process for various treatment strategies, ensuring improved patient outcomes.

Dr. John Smirniotopoulos, an interventional radiologist at MedStar Health, discusses groundbreaking biliary endoscopy techniques for gallstone management. He shares insights from his early experiences with cholangioscopy and highlights the importance of selecting the right equipment. The conversation delves into effective patient management, the collaboration between radiologists and surgeons, and innovative strategies to overcome technical challenges. Dr. Smirniotopoulos also emphasizes the significance of billing and coding knowledge in clinical practice.

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.