Resorbable embolics are gaining traction in musculoskeletal interventions, but what are the key technical considerations? Dr. Keerthi Prasad, interventional radiologist at the Centers for Pain Control and Vein Care joins host Dr. Ally Baheti to share practical insights when using resorbable embolics in MSK interventions.
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This podcast is supported by:
Medtronic OsteoCool
https://www.medtronic.com/en-us/healthcare-professionals/products/surgical-energy/ablation/radiofrequency-ablation/systems/osteocool-2-0-bone-tumor-ablation-system.html
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SYNPOSIS
Dr. Prasad opens the conversation with an overview of embolic agents used in MSK interventions—including Imipenem, Lipiodol, and Nexsphere-F—and shares practical insights into technique selection. He explores the nuances of working with various resorbable embolics, highlighting clinical cases from his personal experience. The discussion also highlights Dr. Prasad’s innovative approach to establishing an outpatient-based lab (OBL) focused on musculoskeletal interventions. Additionally, Dr. Prasad also offers insight into the expanding role of resorbable embolics in treating conditions such as knee arthritis, plantar fasciitis, and adhesive capsulitis. The episode ends with a call to broaden access to this evolving treatment.
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TIMESTAMPS
00:00 - Introduction
01:55 - Outpatient Embolization and MSK Procedures
04:20 - Resorbable Embolics in Joint Embolization
04:52 - Available Resorbable Embolics in the US
07:57 - Technical Insights on Using Resorbable Embolics
15:18 - Patient Outcomes and Long-Term Durability
22:24 - Future of MSK Embolization Techniques
24:05 - Exploring New Applications for Resorbable Embolics
27:30 - Innovative Procedures and Techniques
37:00 - Final Thoughts and Advice for Practitioners

What is the optimal embolization technique in GAE? In this BackTable Brief, Dr. Osman Ahmed and Dr. Sid Padia, MD discuss the embolization of abnormal vessels, debating between targeting any abnormal vessel versus only the painful side. They reference studies and papers, including the Landers 2023 paper, to explore best practices. 

They consider the use of temporary resorbable embolics compared to permanent embolics, examining safety profiles, efficacy, and potential complications. The conversation then shifts towards the size of embolic particles and endpoints for different embolization materials. They discuss specific techniques and their impacts, highlighting the reproducibility of certain methods and preparing for the future of resorbable embolics in various medical applications.

Episode Outline

00:00 - Introduction

00:13 - Embolization of Abnormal Vessels

02:34 - Permanent vs. Resorbable Embolics

06:21 - Debating Particle Size 

11:06 - Technique When Using Permanent Spheres 

12:42 - Technique When Using Resorbable Spheres 

Resources

Dr. Venkatesh, “Kavi”, Krishnasamy, MD

https://www.uab.edu/medicine/radiology/faculty/intervent-radiology/profile/krishnasamy

Dr. Osman Ahmed, MD

https://bucksbauminstitute.uchicago.edu/bio/osman-ahmed-md/

Dr. Siddarth, “Sid”, Padia, MD

https://www.uclahealth.org/providers/siddharth-padia

Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial

https://pmc.ncbi.nlm.nih.gov/articles/PMC10032233/

Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis

https://pubmed.ncbi.nlm.nih.gov/34610422/

Which imaging and treatment techniques are optimal for GAE in the OBL? In this BackTable Brief, Dr. Osman Ahmed and Dr. Sid Padia explore instrument selection and CT techniques in the OBL for genicular artery embolization (GAE). 

Dr. Ahmed and Dr. Padia discuss the importance of not compromising on patient safety, and the careful selection of their approach to treatment. They further elaborate on the use of cone beam CT for more precise treatment planning, sharing insights on catheter selection, contrast solutions, and best practices for ensuring high-quality patient care, especially in the OBL (office-based lab) setting.

Episode Outline

00:00 - Introduction 

00:53 - Discussion on Catheter Selection and Preference 

03:37 - Use of Cone Beam CT in the OBL

10:42 - Cone Beam CT Protocols and Technique: Selective or Non-Selective?

12:38 - Contrast Solutions and Techniques

Resources

Dr. Venkatesh, “Kavi”, Krishnasamy, MD

https://www.uab.edu/medicine/radiology/faculty/intervent-radiology/profile/krishnasamy 

Dr. Osman Ahmed, MD

https://bucksbauminstitute.uchicago.edu/bio/osman-ahmed-md/ 

Dr. Siddarth, “Sid”, Padia, MD

https://www.uclahealth.org/providers/siddharth-padia

When it comes to spinal oncology, no single specialty holds all the answers. In this episode of the BackTable Podcast, host Dr. Alexa Levey, an interventional radiologist from Yale School of Medicine, is joined by Dr. Mark Amsbaugh, a radiation oncologist, and Dr. Ran Lador, an orthopedic spine surgeon, both from the University of Texas McGovern Medical School. The discussion explores complexities and innovations in the multidisciplinary treatment of spinal tumors.

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SYNPOSIS

Dr. Ambsbaugh and Dr. Lador highlight their cohesive, patient-centered approach at Memorial Hermann, integrating various specialties including surgery, radiation oncology, and interventional radiology. The episode emphasizes the importance of collaborative techniques, advances in minimally invasive surgeries, the role of stereotactic radiosurgery, and the critical nature of personalized patient care in improving outcomes for patients with spinal tumors.

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TIMESTAMPS

00:00 - Introduction
01:20 - Multidisciplinary Approach to Spinal Tumors at Memorial Hermann
10:22 - Surgical Techniques and Timing for Radiation Treatments
12:25 - Approach to Collaborative Treatment Planning
25:45 - Connection Between Surgical and Radiation Oncology in Patient Care
31:08 - The Role of Vertebral Augmentation in Spinal Oncology
40:08 - Multimodal Pain Management Strategies
47:35 - Thoughts on Future Directions in Spinal Oncology and Conclusion

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RESOURCES

Dr. Mark Amsbaugh, MD
https://med.uth.edu/neurosciences/dr-mark-j-amsbaugh-md/

Dr. Ran Lador, MD
https://med.uth.edu/ortho/2022/11/02/ran-lador-md/

Dr. Alexa Levey, MD
https://medicine.yale.edu/profile/alexa-levey/

Shownotes

Who is the ideal candidate for genicular artery embolization (GAE)? In this BackTable Brief, Dr. Osman Ahmed and Dr. Sid Padia share how they work up and select GAE patients.

Dr. Padia and Dr. Ahmed discuss the challenges of patient selection in genicular artery embolization, specifically debating the necessity and utility of MRI with contrast. The discussion also explores the pros and cons of femoral vs. pedal access techniques, considering patient characteristics such as BMI and the practicality of these approaches in various clinical settings.

Episode Outline

00:00 - Introduction

00:20 - Use of MRI with Contrast in Patient Selection

04:22 - Challenges and Future Directions of MRI in GAE

07:46 - Pros and Cons of Femoral vs. Pedal Access

10:00 - Practical Considerations

Resources

Dr. Venkatesh, “Kavi”, Krishnasamy, MD

https://www.uab.edu/medicine/radiology/faculty/intervent-radiology/profile/krishnasamy 

Dr. Osman Ahmed, MD

https://bucksbauminstitute.uchicago.edu/bio/osman-ahmed-md/ 

Dr. Siddarth, “Sid”, Padia, MD

https://www.uclahealth.org/providers/siddharth-padia

Where does cryoneurolysis fit in contemporary pain management? In this episode of Backtable MSK, host Jacob Fleming is joined by Dr. Alexa Levey to discuss the role of cryoneurolysis in various pain presentations, covering indications, anatomical targets, and techniques in different clinical scenarios.

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SYNPOSIS

This episode offers practical guidance on how to take a detailed patient history, how to use cryoneurolysis for pain management, and the significance of multidisciplinary collaboration. The conversation also highlights the importance of setting proper patient expectations, understanding different types of pain, and the need for standardizing cryoneurolysis procedures through structured research and education.
Dr. Levey also shares her recent career move to Yale, her passion for research, and the challenges she faced returning to academia from private practice.

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TIMESTAMPS

00:00 - Introduction
03:49 - Discussion of Dr. Levey’s Recent Research Paper
09:35 - The Fine Details of Pain and Pain Management
18:42 - Patient Quality of Life Assessment in Regards to Pain Management
28:28 - Game Plan for Managing Neuritis
37:19 - Collaboration Between Different Specialists
40:16 - Offering Patient Education and Support
42:31 - Final Reflections and Gratitude

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RESOURCES

Dr. Alexa Levey
https://medicine.yale.edu/profile/alexa-levey/

Common Cryoneurolysis Targets in Pain Management: Indications, Critical Anatomy, and Potential Complications
https://pubmed.ncbi.nlm.nih.gov/40376212/

Paging all neuroradiologists and spine specialists interested in enhancing their vertebral nerve ablation practice. In this special ESNR edition of Backtable MSK, host Jacob Fleming welcomes neuroradiologist Dr. Luigi Manfre to discuss the intricacies of vertebral nerve ablation, focusing on patient selection, technical approaches, and emerging practice trends.

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SYNPOSIS

The physicians discuss the importance of careful diagnosis using MRI, SPECT scanning, and nerve block tests to improve treatment efficacy. Dr. Manfre emphasizes the need for strict patient selection to mitigate failures and highlights the variability in vertebral innervation between patients that can affect outcomes. The conversation also explores the nuances of conducting procedures under CT guidance and addresses challenges in treating different spinal levels, including L5 and S1. BONUS: Details on the ESNR Hands-On Spine Course held in Catania, Italy from October 16th-18th, 2025.

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TIMESTAMPS

00:00 - Introduction
02:43 - Upcoming Hands-On Spine Course
08:40 - The Rundown: Basivertebral Nerve Ablation
15:18 - Understanding Modic Changes and Their Implications
26:03 - Unique Innervation and Corresponding Challenges in Ablation
38:13 - Technical Approaches and Difficulties in BVNA
51:16 - Patient Selection and Procedure Efficacy for Ablative Procedures
01:00:29 - Conclusion and ESNR Course Information

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RESOURCES

Dr. Luigi Manfre
https://www.linkedin.com/in/luigi-manfre-20b61284/?originalSubdomain=it

European Society of Neuroradiology (ESNR)
https://www.esnr.org/

Musculoskeletal (MSK) embolization is emerging as a transformative, minimally-invasive option for various chronic pain conditions. In this week’s episode of Backtable MSK, host Dr. Jacob Fleming talks with Dr. Ahmed Farag, an interventional radiologist with expertise in MSK embolization. The conversation covers practice building, tools, and techniques.

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SYNPOSIS

Dr. Farag shares insights from his journey beginning with a career in engineering to now a career in medicine and private practice. He emphasizes how good patient outcomes, networking, and continuous learning all work synergistically as a marketing tool. He also touches upon the challenges and triumphs in practice management and the future prospects of outpatient musculoskeletal interventional radiology. This episode provides valuable advice for both veteran practitioners and trainees looking to carve their own paths in this evolving field.

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TIMESTAMPS

00:00 - Introduction
10:53 - Developing a Referral Network in Private Practice
15:54 - Discussing the Variety of MSK Embolization Procedures
19:39 - Sampling Products and Techniques for MSK Embolization
24:52 - Optimizing Relationships with Hospitals
28:05 - Advice for New IR Practitioners
33:39 - Keeping Up to Date: Training and Conferences
37:10 - Future Directions of Outpatient MSK IR
40:52 - Conclusion and Final Thoughts

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RESOURCES

Dr. Ahmed Farag
https://www.flvascular.com/about

Intradiscal ozone offers a minimally invasive approach to disc pain that can reduce inflammation and restore function. How well does it work and where does it fit in the lumbar radiculopathy treatment algorithm? In this episode of the Backtable MSK Podcast, host Jacob Fleming speaks with Dr. Alexis Kelekis about the contemporary role of intradiscal ozone and emerging innovations in interventional spine treatment.
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SYNPOSIS
Dr. Kelekis, a prominent figure in radiology and interventional pain management, shares insights from the 2025 GRIBOI meeting held in Banff, AB, Canada. Topics discussed include the development and possibility of bone augmentation polymers, intradiscal ozone therapy, and various interventional treatments for degenerative disc disease and vertebral fractures. Dr. Kelekis also touches on the need for specialized training in interventional radiology and the future of personalized medicine in pain management.
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TIMESTAMPS
00:00 - Introduction
06:40 - Ozone Treatment: Mechanism and Efficacy
13:23 - Challenges and Innovations in Spine Treatments
20:09 - Treatment Algorithm in Patients with Lower Extremity Radiculopathy
24:00 - Future Directions in Interventional Spine Treatments
30:28 - Closing Remarks
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RESOURCES
SpinaFx:
https://spinafx.com/
GRIBOI:
https://www.griboi.org/

What sets apart those who are good from those who are great? This episode of Backtable MSK features a profound discussion on leadership and legacy with Dana Dunleavy, MD, Wayne Olan, MD, and David Tilton. Dr. Olan, Director of Minimally Invasive Neurosurgery at George Washington University Medical Center, and David Tilton, a former Navy SEAL and current business and racing professional, share their unique experiences and insights surrounding perseverance in success.
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SYNPOSIS
The doctors discuss the importance of mentorship, collaboration, and cultivating a culture of growth and accountability. The conversation highlights how nurturing leaders can impact both professional and personal development, emphasizing that the best measure of success lies within the success of those you lead.
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TIMESTAMPS
00:00 - Introduction
10:50 - Learning from Those Around You
16:56 - The Value of Continuous Learning and Avoiding Complacency
31:43 - The Importance of Teamwork and Mentorship
50:07 - The Role of Failure in Success
52:45 - Closing Remarks: Support and Courage