BackTable Vascular & Interventional

Dr. Shivank Bhatia, an interventional radiologist at the University of Miami, discusses his extensive research on prostatic artery embolization (PAE). He reveals findings from his groundbreaking study involving 1,075 patients, exploring PAE's long-term efficacy and safety. Dr. Bhatia shares insights on building a successful PAE program, patient workup, and key procedural techniques. He emphasizes the impressive outcomes in urinary function and quality of life, establishing PAE as a minimalist alternative to traditional surgeries.

In this engaging discussion, medical oncologists Adam Burgoyne and Lingling Du, alongside interventional radiologists Kirema Garcia-Reyes and Zachary Berman, tackle the complexities of hepatocellular carcinoma (HCC) treatment. They explore the 'grey zone' in treatment goals, emphasizing the importance of performance status and comprehensive liver function assessments. The guests share insights on navigating advanced liver disease, the role of immunotherapy, and the critical need for multidisciplinary collaboration to optimize patient outcomes.

Dr. Ari Kramer, a general surgeon specializing in dialysis access, and Dr. Omar Davis, an interventional nephrologist, share insights on enhancing dialysis care. They discuss the advanced FLEX Vessel Prep system, emphasizing its benefits and latest clinical data. Mental health support for dialysis patients takes center stage, with a tribute to patient Fred Hill, author of "Dialysis Is Not Your Life." The doctors address advanced techniques, innovative devices, and how tailoring approaches can significantly improve patient outcomes.

Dr. Kirema Garcia-Reyes, an interventional radiologist from Mount Sinai specializing in Y90, joins Dr. Sabeen Dhand and Dr. Kevin Burns, an early adopter of histotripsy. They delve into the complexities of treating hepatocellular carcinoma (HCC) through ablation. Key insights include comparing cryoablation and microwave ablation, discussing histotripsy's noninvasive approach, and highlighting the significance of advanced imaging techniques. They also explore the future of curative therapies and the importance of patient-specific strategies in optimizing treatment outcomes.

Dr. Amy Deipolyi, an interventional radiologist and Division Chief at Charleston Area Medical Center, shares her innovative approach to deep sedation using ketamine. She discusses the challenges of scheduling anesthesia in the IR suite and how she gained support for this shift. The conversation reveals the comparative advantages of ketamine over traditional sedatives, its role in improving patient experiences, and overcoming regional healthcare hurdles. Dr. Deipolyi also offers practical insights for IR professionals looking to implement similar sedation techniques.

Join experts Jonathan Mizrah, a medical oncologist at Ochsner Health specializing in HCC treatment, Lingling Du, who focuses on HCC trials, Adam Burgoyne from UCSD discussing immunotherapy communication, and interventional radiologist Zachary Berman on an insightful exploration of advanced liver cancer treatments. They discuss the promising role of combination therapies, particularly TACE with immunotherapy, and dive into groundbreaking clinical trial results. Simplifying complex mechanisms, they emphasize the importance of personalized treatment strategies and ongoing patient care.

Dr. Gregg Alzate, a senior interventional radiologist at Sharp Healthcare, discusses his career journey and the innovative A-RAM technique he pioneered. He shares valuable insights on mastering vessel access techniques and strategies for limb salvage. Dr. Alzate reflects on the challenges of managing complex chronic total occlusions (CTOs) and the moral injuries that can affect medical professionals. He also emphasizes the significance of mentorship and staying open to new techniques in advancing patient care.

Zachary Berman and Kirema Garcia-Reyes, interventional radiologists, share their expertise on Y-90 dosimetry, stressing that it's not a one-size-fits-all approach. They discuss factors influencing dosing, such as tumor size and underlying liver function. The guests reflect on gaps in training and the evolution of dosimetry education in interventional radiology. Real-life case examples illustrate the complexities of individualized treatment plans. They also critique planning software and underscore the importance of empirical approaches to achieve optimal dosages.

Dr. Raj Narayanan, an interventional radiologist at the Miami Cancer Institute, and Dr. Sean Tutton from UC San Diego share insights on the rising role of robotics in interventional radiology. They discuss the enhanced precision and efficiency robotic systems bring to complex procedures like tumor ablations and biopsies. The conversation delves into the logistics of integrating robotics into clinical workflows and the learning curve associated with it. Both experts agree that this technology democratizes minimally invasive procedures, paving the way for more advanced skill development.

In this engaging discussion, Dr. Steven Young, a hepatologist, shares his insights on HCC diagnosis and streamlined transplant evaluations. Dr. Jonathan Mizrahi, a medical oncologist, dives into systemic therapies for HCC and building essential referral networks. Patient navigator Deondra Bonds-Adams emphasizes the crucial role of patient education and care coordination. They explore multidisciplinary approaches that improve patient outcomes, tackle barriers in scheduling, and highlight the importance of communication and collaboration in hepatocellular carcinoma care.