BackTable Vascular & Interventional

Dr. Ali Golshan discusses treating superficial venous disease, SOLVEIN device, FDA approval, and advice for medical entrepreneurs. Topics include diagnostic techniques, treatment options, and insights into the entrepreneurial journey.

Dr. Venkatesh Krishnasamy, an interventional radiologist and Director of Interventional Oncology, shares techniques for challenging lung biopsies, emphasizes the importance of multidisciplinary tumor boards, mentorship, and continued learning. Topics include handling complications, needle position verification, blood patching vs. plug technique, post-procedure protocols, advanced techniques, and encouragement for trainees.

Dr. Alexander Vezeridis discusses advanced biliary interventions, including stone retrieval procedures using Spyglass cholangioscopy and laser lithotripsy. He emphasizes the importance of continuous learning, collaboration with other specialties, and optimizing patient outcomes. The podcast covers innovative techniques like endobiliary ablation, laser treatment for biliary obstructions, and future innovations in managing benign and malignant biliary diseases.

Dr. Noor Ahmad, an interventional radiologist, shares insights on complex IVC filter retrievals. He discusses preoperative evaluation, retrieval techniques using devices like CloverSnare and ClavaClear laser sheath, and the importance of collaboration for challenging cases. The episode emphasizes patient monitoring, preparation, and post-retrieval care in handling complex IVC filter retrieval procedures.

Dr. Sameh Sayfo, interventional cardiologist, shares insights on R2P interventions, benefits of radial access over femoral, advancements in laser atherectomy, and post-op care. Tips on procedure planning, device selection, and adopting flexible approaches for better outcomes.

Dr. Steven Smith discusses venous orthostatic flow dysfunction connecting to multisystem disorders. Topics include POTS physiology, pelvic vein treatment, symptom constellations, patient selection, and advocating for patients. Emphasis on interdisciplinary collaboration and the need for research in vascular interventions.

Dr. Jafar Golzarian shares insights on transitioning from academia to private OBL practice, emphasizing independence, patient-centric approach, embolization procedures, and collaborating with industry partners. He provides practical advice on marketing, finding business partners, staffing, and offers guidance for new practitioners.

Elie Toubiana, CEO of ScribeMD.ai, discusses AI scribes in healthcare with Dr. Aditya Bagrodia. They cover benefits like reducing physician burnout, enhancing patient interactions, and AI's adaptability. Also, they talk about legal, cost, and ethical considerations of AI in medical documentation.

In this episode of the Back Table MSK podcast, Dr. Jacob Fleming and Dr. Douglas Beall dive into the intricacies of sacroplasty, including considerations for selecting cement volume, efficacy of small versus large needles, and biomechanics of the pelvis.---CHECK OUT OUR SPONSORStryker Interventional Spinehttps://www.strykerivs.com---SYNPOSISThe doctors review evidence from the SAKOS trial on pain relief and highlight the complexities of billing. They also emphasize proactive treatments for aging populations suffering from fractures and the need for more training and propagation of sacroplasty techniques. Listeners are encouraged to stay informed about new educational opportunities and advancements in sacroplasty through ongoing updates and courses.---TIMESTAMPS00:00 - Introduction02:33 - Expanding Sacroplasty Training and Curriculum04:50 - Walkthrough of Sacroplasty Technique10:36 - Mechanical Stabilization and Cement Volume21:41 - Choosing Hardware and Needle Size27:37 - Industry-Sponsored Trials and Bias32:47 - Navigating Billing and Reimbursement38:05 - Closing Thoughts on Sacroplasty and Osteoporotic Fractures---RESOURCESBackTable VI Ep. 51- Sacroplasty: Principles & New Data in the Treatment of Sacral Insufficiency Fractures:https://www.backtable.com/shows/msk/podcasts/51/sacroplasty-i-principles-new-data-in-the-treatment-of-sacral-insufficiency-fracturesSeattle Science Foundation Annual Image Guided Interventional Spine Procedures Course:https://ssf.cloud-cme.com/course/courseoverview?P=5&EID=1149Dr. Doug Beall’s Twitter: @dougbeallVertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation:https://www.amazon.com/Vertebral-Augmentation-Comprehensive-Vertebroplasty-Kyphoplasty/dp/1684200156An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall, 2023):https://www.jvir.org/article/S1051-0443(23)00356-1/fulltext

Dr. Jacob Fleming and Dr. Douglas Beall discuss the challenges and advancements in treating sacral insufficiency fractures (SIF), the importance of real-world data in evaluating treatment efficacy, and the need to increase awareness of sacral fractures and sacroplasty.---CHECK OUT OUR SPONSORStryker Interventional Spinehttps://www.strykerivs.com---SYNPOSISDr. Beall emphasizes the underrecognition and undertreatment of sacral insufficiency fractures, pointing out the high mortality and chronic pain rates associated with non-treatment. He urges providers to consider this diagnosis, especially if the patient is describing symptoms of pain with position changes with standing, sitting, and laying, has pubic rami fractures, or reports a history of pelvic radiation. Even with imaging, the diagnosis can remain elusive, since it is not commonly recognized on x-ray and may not show obvious cortical disruption on CT or MRI.We also review the current literature on sacroplasty efficacy in lowering patient-reported pain scores and adverse events associated with treatment versus conservative management. Dr. Beall speaks about the importance of real-world data collection in the form of patient registries and the insight that these resulting studies have on applications of sacroplasty in specific patient populations.---TIMESTAMPS00:00 - Introduction03:01 - Sacral Fractures and Sacroplasty15:17 - Treatment Options for Sacral Fractures17:34 - Consequences of Untreated Sacral Fractures28:32 - Sacroplasty Registry and Current Research38:08 - Imaging Modalities: CT vs. Fluoroscopy40:49 - Complications of Sacroplasty: Extravasation43:21 - Bone Quality and Fracture Healing45:42 - Growing Awareness of Sacral Fractures and Treatment Options---RESOURCESSpontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly (Lourie, 1982):https://pubmed.ncbi.nlm.nih.gov/7097924/Percutaneous cementoplasty for pelvic bone metastasis (Marcy, 2000):https://pubmed.ncbi.nlm.nih.gov/11094996/Safety and Efficacy of Sacroplasty for Sacral Fractures: A Systematic Review and Meta-Analysis (Chandra et al, 2019):https://pubmed.ncbi.nlm.nih.gov/31587952/Percutaneous sacroplasty for osteoporotic sacral insufficiency fractures: a prospective, multicenter, observational pilot study (Frey et al, 2008):https://pubmed.ncbi.nlm.nih.gov/17981097/Sacroplasty: A Ten-Year Analysis of Prospective Patients Treated with Percutaneous Sacroplasty: Literature Review and Technical Considerations (Frey et al, 2017):https://pubmed.ncbi.nlm.nih.gov/29149151/Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation (Beall, 2020):https://www.thieme-connect.de/products/ebooks/book/10.1055/b000000226An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall et al, 2023):https://pubmed.ncbi.nlm.nih.gov/37207812/Clinical Effect of Balloon Kyphoplasty in Elderly Patients with Multiple Osteoporotic Vertebral Fracture (Liu et al, 2019):​https://journals.lww.com/njcp/fulltext/2019/22030/clinical_effect_of_balloon_kyphoplasty_in_elderly.1.aspx