BackTable Vascular & Interventional

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.

Dr. Gary Siskin, Chair of Radiology at Albany Medical Center and an expert in liquid embolic agents, shares valuable insights into their practical applications. He discusses techniques for the effective use of Onyx and LAVA in complex cases, especially in trauma care. Key topics include managing catheter positioning and preventing reflux with tailored injection speeds. Siskin emphasizes the importance of understanding viscosity differences and minimizing complications during procedures, making it a must-listen for interventional radiologists seeking to enhance their skills.

Dr. Joshua Kuban, an interventional radiologist at MD Anderson Cancer Center, discusses the significant impacts of NeuWave's discontinuation of its microwave tumor ablation technology. He reflects on how NeuWave reshaped interventional oncology and held over 50% of the microwave market. The conversation explores strategies for adapting to alternative technologies and highlights the evolving landscape of ablation confirmation and emerging robotic technologies. Kuban emphasizes the importance of collaboration and innovation for the future of interventional radiology.

Dr. Sunandana Chandra, a medical oncologist and director of melanoma care at Northwestern, joins Dr. Riad Salem, an interventional oncologist specializing in metastatic melanoma treatments. They discuss the evolution of melanoma management, highlighting innovative approaches like immunotherapy and intratumoral oncolytic viruses. The conversation dives into key clinical trials, including IGNYTE-3, and best practices for administering therapies. Their collaborative approach showcases the importance of multidisciplinary teams in enhancing patient-centered care and improving outcomes in advanced melanoma.

Dr. Quinn Meisinger, the Program Director at UCSD, shares insights on the evolution of interventional radiology training. He discusses the shift from traditional fellowships to integrated residency programs, emphasizing the importance of mentorship. The transition to real-world practice reveals the need for adaptability and a supportive community. Dr. Meisinger also highlights the changing dynamics in the job market and the evolving roles of Advanced Practice Providers in interventional radiology, showcasing the potential for growth and collaboration in this field.