BackTable Vascular & Interventional

Dr. Cliff Weiss, the Director of IR Research at Johns Hopkins, dives into the promising realm of bariatric arterial embolization (BAE) for obesity treatment. He discusses how BAE can enhance weight loss efforts alongside surgical and pharmaceutical options. Highlighting his research on ghrelin's effect on hunger, Dr. Weiss explains the technique involves targeted embolization using specific spheres. He shares findings from notable trials, revealing that patients often achieve significant weight loss around six to nine months post-procedure, reshaping obesity management strategies.

Dr. Adam Tanious, an Assistant Professor of Vascular Surgery at the Medical University of South Carolina, shares insights on enhancing physician and industry collaborations. He discusses the balance between patient care and industry influences, emphasizing ethics and possible conflicts of interest. The conversation also highlights the necessity of business education for doctors and advocates for transparent communication in these partnerships. Additionally, Dr. Tanious reflects on his impactful TED Talk regarding the integration of big business in surgery.

Dr. Thomas Leventhal, an Associate Professor of Transplant Hepatology, and Dr. Siobhan Flanagan, an Associate Professor of Interventional Radiology, discuss the collaborative evolution in managing portal hypertension. They emphasize the significance of teamwork in complex liver conditions, particularly through TIPS procedures. Insights into current best practices, including patient assessment and biopsy challenges, are shared. Looking ahead, they explore groundbreaking advancements like stem cells and lab-grown organs, which could transform transplant outcomes and reduce immunosuppression.

Dr. Peter Bream, a medical expert specializing in enteral access, shares invaluable insights on managing complications with G and GJ-tubes. He discusses the unique challenges faced by ALS and head and neck cancer patients, stressing a multidisciplinary approach for optimal care. Listeners will learn practical troubleshooting tips for issues like leaks and clogs. The conversation also covers advanced techniques and strategies to enhance the safety and effectiveness of enteral procedures, making it a must-listen for both new and seasoned practitioners.

Dr. Peter Bream, a former Professor at UNC and now an interventional radiologist, dives deep into enteral access techniques. He discusses a variety of tubes like NG and G-tubes and innovative methods such as Balloon-Assisted Gastrostomy. The conversation also covers handling complications and ensuring patient comfort during procedures. Bream shares personal experiences, safety measures, and the importance of post-procedure care, making this a fascinating resource for both medical professionals and curious listeners.

Dr. Sahil Parikh, an interventional cardiologist from NYC, and Dr. John Park, a vascular surgeon in Omaha, discuss the evolving landscape of drug-coated balloons (DCBs) for peripheral artery disease. They unpack the historical controversies around Paclitaxel-coated devices and the recent FDA guidance that has renewed interest in their use. The doctors share insights on patient selection, treatment algorithms, and the impact of DCBs on claudication symptoms. They emphasize the balance between effective patient care and healthcare costs, advocating for confidence in DCB implementation.

Dr. Keith Smith, founder of Oklahoma Surgery Center and the Free Market Medical Association, discusses his revolutionary approach to healthcare pricing. He outlines the journey of establishing transparent, affordable healthcare, overcoming regulatory challenges and insurance complexities. Dr. Smith shares insights on the rise of self-funding in healthcare and the value of the Free Market Medical Association in connecting consumers and providers. He emphasizes the need for price transparency to enhance patient care and plans for expanding this model beyond Oklahoma.

Dr. On Topaz, a distinguished interventional cardiologist and professor at Duke University, dives into the evolution of laser atherectomy. He contrasts traditional Excimer lasers with groundbreaking Auryon technology, highlighting advances in treating complex vascular conditions. The discussion includes thrombus management best practices and innovative techniques for improved patient outcomes. Dr. Topaz also shares insights from the latest research studies and hints at future developments in laser applications across various medical fields.

Dr. Frederick D. Johnson, an interventional radiologist in Thomasville, Georgia, shares his unique insights on establishing a successful rural IR practice. He discusses the challenges of recruitment and maintaining case diversity in a remote setting. Dr. Johnson highlights the benefits of the Professional Service Agreement model, which allows for autonomy while collaborating with local hospitals. The conversation also touches on the joys of small-town living and the importance of building strong community relationships in healthcare.

Ever wonder what it’s like to practice interventional radiology down under? Dr. Chris Rogan joins us on the BackTable Podcast this week to tell us about his IR practice in Australia, with special emphasis on healthcare system and interventional practice model differences between our two countries.---SYNPOSISWe cover a wide range of topics, including the differences in IR training pathways between Australia and the U.S., the impact of healthcare models on IR practice, and the cooperation between public and private healthcare. We also highlight the urgent need for more IR specialists in Australia. Additionally, the doctors explore the challenges of public awareness, interdisciplinary and global collaboration, and the ongoing efforts by the Interventional Radiology Society of Australasia (IRSA) to promote IR through public outreach and educational strategies.---TIMESTAMPS00:00 - Introduction04:08 - Australia vs. US Healthcare Systems08:21 - Compensation and Career Mobility16:52 - IR Public Awareness and Marketing25:56 - Global Collaboration and Conferences30:53 - Travel Tips for Australia---RESOURCESDr. Chris Rogan’s practice:https://drrogan.com/Interventional Radiology Society of Australasia (IRSA):https://irsa.com.au/IRSA 2024 Annual Meeting:https://irsa.com.au/education-events/irsa-annual-scientific-meeting-2024/