BackTable Vascular & Interventional

Exploring the use of prostatic artery embolization (PAE) in the treatment of prostate cancer. Discussing the benefits of PAE in different clinical scenarios and its potential as a last option treatment. Also, addressing the challenges and approach to prostatitis cases. Emphasizing the importance of regular follow-up and the potential utility of PAE in the treatment of prostate cancer.

Dr. Robert Lookstein, interventional radiologist, discusses the PERT approach for acute pulmonary embolisms. They cover PERT activation, risk stratification, endovascular PE interventions, and advancements in technology. They also explore challenges in diagnosis and post-procedure care.

Dr. Omar Saleh, interventional radiologist, and Dr. Syed Hussain, vascular surgeon, discuss new innovations in closure devices. They highlight the advantages of consistent closure devices, patient preferences, and introduce the CELT ACD closure device. The ease of deployment and reliability of results using CELT are discussed, along with its potential drawbacks. The doctors also cover time to ambulation/discharge, closure-site complications, good outcomes with calcified arteries, and ease of bailout options. They conclude by discussing how physicians can obtain CELT.

Dr. Alan Matsumoto, Chair of the Department of Radiology at the University of Virginia, discusses his career in interventional radiology, including his initial interest and journey into the field. He highlights the importance of uniformity and training in clinical IR, as well as the challenges faced in transitioning to independent practice. Dr. Matsumoto reflects on the experiences and differences between private practice and academia, and shares insights into transitioning from a fellow to an attending. He also discusses his path to becoming chief and chair of his department, and offers advice for upcoming interventional radiologists.

Dr. Kush Desai and Dr. Steven Abramowitz discuss iliofemoral venous stenting, including referral patterns, work-up of patients, procedural approach, best practices, and post-operative follow up. They also touch on the impact of venous disease, tools for complex crossings, stent selection, recognizing problems during procedures, and the rapid evolution of venous stenting.

Interventional radiologists discuss the spectrum of patient sedation for IR procedures, emphasizing the fluidity between local anesthesia, moderate sedation, and deep sedation. They highlight the need for trauma-informed care and comprehensive patient education. The decision for anesthesia is influenced by factors such as the procedure type, patient's condition, and provider preference. The game-changing concept of having an anesthesia team present for real-time monitoring is explored. The podcast also touches on topics like G2 tubes, lidocaine toxicity, patient-centered care, and the importance of separate roles for sedation and procedure.

In this episode, host Dr. Ally Baheti interviews vascular surgeon Dr. Steven Abramowitz and interventional radiologist Dr. Angelo Marino on managing venous stent rethrombosis with the RevCore device. Steven is the Chair of Vascular Surgery at MedStar Washington Hospital and Angelo is an Assistant Professor of Interventional Radiology at Yale School of Medicine.---CHECK OUT OUR SPONSORInari Medical RevCorehttps://www.inarimedical.com/revcore/---SHOW NOTESWe start this episode with Steven and Angelo’s experience in venous interventions and how venous stent rethrombosis presents. The doctors then tell us more about how stent failure can precipitate, inflow and landing zone considerations, and stenting location. Angelo then goes onto introduce the RevCore device.Both Steven and Angelo share their experience in using the RevCore device in venous stent rethrombosis, and their preferred access site(s) when using this tool. They also discuss specific maneuvers, troubleshooting, and other tools they use alongside the RevCore system. We conclude this episode with the doctor’s overall treatment algorithm for venous stent rethrombosis and follow-up plans.---RESOURCESInari Medical RevCore Device:https://www.inarimedical.com/revcore/

Interventional radiologists Dr. Juan Gimenez and Dr. Tyler Sandow discuss managing hepatocellular carcinoma (HCC) in this episode. They delve into topics like lobar treatment vs. radiation segmentectomy, ablation and Y-90 combination, preoperative mapping, cone-beam CT, complex cases, treatment plans, and current research pursuits. Important points include new developments in tumor markers and the role of albumin in HCC. They also touch upon combination therapies, collaboration with oncologists, and the use of segmentectomy for metastatic disease.

Dr. Bruno Odisio and Dr. Constantinos Sofocleous discuss the history and advancements in tumor ablation, emphasizing the importance of establishing larger margins for improved outcomes. They also explore the challenges in conducting comprehensive studies due to the presence of multiple ablation technology vendors. The significance of ablation margin confirmation and the use of software for optimal treatment planning is highlighted. The speakers also touch upon the background, design, and industry sponsors of a renowned liver ablation trial, as well as the challenges in assessing ablation confirmation margin.