BackTable Vascular & Interventional

Collaboration between interventional radiology and radiation oncology has enabled high-dose brachytherapy in central lung lesions that were previously untreatable. This episode of the 2025 NSCLC Creator Weekend™ series offers a deep dive into recent advancements in lung ablation and brachytherapy techniques for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Key discussion points include ablation zone sizes, confirmation methods for effective treatment, and the integration of different modalities such as microwave and cryoablation. Our tumor board panel also explores the practical and logistic challenges of implementing high-dose brachytherapy, especially for central lesions, and its role in palliative care. Despite the intricate processes and potential complications like pneumothorax, these methods show promising local control rates and provide crucial options for non-operative candidates. --- TIMESTAMPS 00:00 - Introduction and Overview of Lung Ablation07:01 - Microwave Ablation and Ground Glass Attenuation17:53 - Artificial Pneumothorax Techniques27:09 - Technical Aspects and Innovations32:35 - Bronchial Brachytherapy Techniques37:47 - Conclusion and Credits --- RESOURCES 2021 Central Lesion Studyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8186067/

Dr. Rachel Piechowiak and Dr. Faraz Khan, both interventional radiologists at IR Centers, delve into the transformative role of genicular artery embolization (GAE) for chronic knee pain. They discuss patient selection criteria, access strategies, and the intricacies of catheter techniques. Their insights on embedding realistic expectations with patients and managing post-procedure complications are invaluable. With an eye on the future, they emphasize the need for comprehensive long-term data to enhance GAE's application in pain management.

Dr. Alan Lee, a radiation oncologist from UCLA, shares insights on photon and proton therapies, explaining their practical differences and costs. Dr. Scott Oh, an interventional pulmonologist at USC, discusses innovative bronchoscopic approaches, including robotic-assisted techniques. Dr. Rob Suh from UCLA highlights the evolution of lung ablation technologies and addresses the complexities of managing complications like pneumothorax. Together, they explore patient selection criteria, the limitations of traditional RECIST criteria, and the advancements aiming to enhance lung cancer treatment outcomes.

Dr. Gabriel Werder, an interventional radiologist from Florida, shares his expertise on thrombin injection for treating pseudoaneurysms. He discusses essential procedural techniques, including optimal needle positioning and sedation protocols. The conversation highlights unique cases, balloon-assisted methods, and managing complex pseudoaneurysms. Werder also emphasizes the importance of comprehensive ultrasound assessments and tailored post-procedure care to ensure successful outcomes. Tune in for practical insights and best practices that can enhance your understanding of vascular intervention!

Dr. Karen Reckamp, a thoracic oncologist at Cedars-Sinai, and Dr. Scott Atay, a thoracic surgeon at USC, delve into the complexities of lung cancer treatment. They discuss the latest in lung cancer staging and cutting-edge systemic therapies. Key insights include the evolving role of molecular diagnostics, the importance of tailored treatment plans, and the integration of new therapies in surgical decision-making. They also explore the implications of pollution and genetic factors on non-smoker EGFR risks, highlighting a future focused on personalized cancer care.

Dr. Steven Abramowitz, a vascular surgeon and physician executive director at MedStar, discusses the latest guidelines on deep venous thrombosis (DVT) management. He delves into the implications of the ATTRACT trial and the CLOUT registry, emphasizing how mechanical thrombectomy is evolving. Abramowitz highlights key techniques like IVUS for treatment endpoint determination and the importance of collaboration with referring physicians. He also touches on the role of anticoagulation and the need for redefining DVT to improve patient outcomes.

What should you know before applying to an interventional radiology residency program? Get 70 minutes of free advice in this week's episode of BackTable featuring Georgetown IR fellow Dr. Neil Jain and host Dr. Chris Beck, covering everything from building your IR resume to crushing your interviews. SYNPOSIS The conversation starts by covering the essential steps that medical students can take to build their resume prior to the application cycle, including involvement in the medical student sections of SIR, CIRSE, and local symposiums. Dr. Jain highlights the importance of mentorship and research, strategies for obtaining strong letters of recommendation, and effectively navigating both home and away rotations. The discussion also extends to interview preparation, program selection, signaling updates, and the rank list construction. The episode also touches on the SOAP process for unmatched applicants and the avenues to secure a match. Importantly, Dr. Jain emphasizes the significance of fit over prestige and finding a program that aligns with your values and professional goals. --- TIMESTAMPS 00:00 - Introduction03:07 - Building Your Resume for IR10:43 - Away Rotations and Letters of Recommendation 23:54 - Personal Statements: Importance and Tips30:07 - Application Strategies: IR and DR Programs41:48 - Utilizing Signaling in the Application Process44:19 - Evaluating Programs During Interviews49:58 - Letters of Interest and Intent54:33 - The Interview Day Experience01:04:47 - Building Your Rank List01:08:56 - The SOAP Process01:12:50 - Final Advice and Closing Remarks --- RESOURCES 2025 NRMP Match Data https://www.nrmp.org/wp-content/uploads/2025/03/Advance_Data_Tables_2025.pdfSociety of Interventional Radiology Trainee Websitehttps://www.sirweb.org/in-training/ VI 372 - IR Pathways Unveiled: Matching, Training & Beyond https://www.backtable.com/shows/vi/podcasts/372/ir-pathways-unveiled-matching-training-beyond VI 554: Optimizing the IR/DR Curriculum & Experiencehttps://www.backtable.com/shows/vi/podcasts/554/optimizing-the-ir-dr-curriculum-experience

Dr. Jason Hoffman, an interventional radiologist at NYU Langone, dives deep into microwave ablation for liver lesions. He stresses the importance of educating patients and collaborating within multidisciplinary teams. Hoffman compares the benefits of microwave ablation to traditional methods and shares insights on patient selection and ideal lesion characteristics. The discussion also covers innovative technology from Varian and how AI could shape the future of the field. His expertise provides a compelling view on advancing interventional oncology practices.

Join Dr. Karen Reckamp, a medical oncologist focused on neoadjuvant strategies, Dr. Scott Oh, a radiation oncologist discussing local therapies, and Dr. Scott Atay, an interventional pulmonologist specializing in staging, as they tackle a complex NSCLC case. They debate the best approaches for treating isolated brain metastasis, the implications of nodal disease, and the optimal sequencing of chemoimmunotherapy and radiation. Their multidisciplinary insights shed light on the balance between surgical risks and systemic benefits in challenging cancer cases.

Dr. Miguel Montero-Baker and Dr. Lucas M Ferrer Cardona, innovative vascular surgeons, dive deep into the transformative technique of deep venous arterialization (DVA). They share personal insights on its evolution and the hybrid approaches that enhance outcomes. Discussions include the significance of patient selection and the role of family support in successful limb preservation. They also explore new devices like the Aveera Boomerang and the future of DVA, emphasizing ongoing research to refine these life-saving methods.