BackTable Vascular & Interventional

What does it really take to break away from the hospital system and build your own interventional radiology practice?---This podcast is supported by:Medtronic Emprinthttps://www.medtronic.com/emprint---SYNPOSISIn this episode, host Dr. Ally Baheti interviews Dr. Kartik Kansagra and Dr. Harout Dermendjian, independent interventional radiologists from California and founders of EVS LA. They share their journey in establishing and growing an independent IR practice, discussing their training at Kaiser Sunset, the steps they took to develop their own practice, and the challenges they faced along the way. Emphasizing the importance of training, clinician communication, and balancing inpatient and outpatient services, they offer valuable insights and advice for new IR professionals considering a similar path.---TIMESTAMPS00:00 – Introduction and opening remarks01:23 – Early training and transition08:54 – Clinical vs. non-clinical IR practice differences13:05 – Achieving parity with other interventional specialties17:47 – Building insurance contracts and following up with patients24:31 – Setting boundaries and documenting clinical decisions34:32 – Final advice and closing words from the guests

Dr. Anahita Dua, a vascular surgeon at Mass General and principal investigator of the AMBITION BTK Trial, dives into the complexities of below-the-knee atherectomy. She discusses its controversial role in limb salvage and the urgent need for Level I evidence. The conversation highlights the challenges of standardizing treatments for peripheral artery disease and the significance of cohesive strategies in clinical practice. Dr. Dua also shares insights on the overrated and underrated devices in tibial interventions, emphasizing the potential of atherectomy in vessel preparation.

Dr. Wayne Olan, an Interventional Neuroradiologist and Director of Minimally Invasive Neurosurgery at George Washington University, shares invaluable insights. He discusses the historical evolution of carotid artery stenting and how modern techniques have transformed the field. Dr. Olan highlights the importance of meticulous planning and the role of antiplatelet therapy, especially for Plavix non-responders. He also explores innovations like the Contego stent system and the future of outpatient carotid stenting, emphasizing the need for continuous adaptation in medical practices.

What does it really take to bring cutting-edge vascular care to the most underserved corners of the rural South? In this episode of the BackTable Podcast, host Dr. Ally Baheti welcomes interventional cardiologist Dr. Ash Sastry and interventional radiologist Dr. Sree Nair to discuss the financial and regulatory side of providing care to underserved rural populations in North Carolina, Virginia, and Georgia. --- SYNPOSIS The doctors delve into the operations and challenges of running an office-based lab (OBL) and the potential transition to an ambulatory surgical center (ASC). This episode covers topics like certificate of need (CON) laws, reimbursement issues, and the importance of multidisciplinary collaboration. The conversation offers insights into the practical and regulatory hurdles faced in delivering high-quality vascular care in rural settings. --- TIMESTAMPS 00:00 - Introduction02:14 - Challenges in Rural Healthcare09:00 - Understanding Certificate of Need (CON) Laws11:30 - The Financial Struggles of OBLs19:58 - Advocacy and Legislative Efforts27:53 - Future Prospects and Final Thoughts

Join Dr. Premal Trivedi, Chief of IR at the University of Colorado and an expert in interventional radiology, as he dives into the complexities of managing biliary strictures. He discusses key signs that trigger clinical suspicion and the preferred role of interventional endoscopy. You'll hear about his workup process, preferred imaging techniques, and the nuances of percutaneous transhepatic cholangiography. The conversation also highlights innovative treatment strategies and the evolution of training in interventional radiology.

Dr. Oleksandra Kutsenko, Chief of Interventional Radiology at Red Rock Radiology Associates, shares her journey from training to leadership in private equity. She discusses key differences between academic and private practice environments and the challenges of navigating a multifaceted organization. Dr. Kutsenko emphasizes the importance of skill diversification and balancing clinical work with administrative tasks. She also highlights the value of early investment in one’s career and the role of AI in enhancing radiology practices.

Dr. Keerthi Prasad, an interventional radiologist from Indiana, discusses the innovative use of resorbable embolics in musculoskeletal interventions. He shares technical insights and specific embolic agents like Imipenem and Lipiodol. Clinical experiences illustrate their efficacy in treating conditions such as knee arthritis and plantar fasciitis. Dr. Prasad emphasizes the importance of partnering with outpatient labs and encourages wider accessibility to these evolving treatments that could reshape patient care.

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!