How is genicular artery embolization reshaping our clinical approach to patients with chronic knee pain? Dr. Rachel Piechowiak and Dr. Faraz Khan, interventional radiologists at IR Centers join Dr. Don Garbett in a deep dive into the current state of Genicular Artery Embolization (GAE).

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This podcast is supported by an educational grant from Varian.

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SYNPOSIS

Dr. Piechowiak and Dr. Khan provide a deep dive on the technical nuances of GAE, covering patient selection, access strategies, and key procedural techniques. The conversation also details complex case scenarios and how to tailor catheters and embolics to navigate challenging anatomy. The doctors then share their structured approach to post-procedure follow-up, underscoring the importance of setting realistic treatment expectations with patients. The episode closes with their perspective on the future of genicular artery embolization, emphasizing the need for robust long-term outcomes data to better define the role of GAE in chronic knee pain management.

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TIMESTAMPS

00:00 - Introduction
05:54 - Patient Workup for GAE
10:42 - Setting Patient Expectations for GAE
16:24 - Procedure Approaches and Techniques
30:41 - Understanding Artery Targeting Strategies
34:56 - Approaches to Microcatheter Selection
38:18 - Choosing the Right Embolic Agents
47:43 - Managing Complications and Follow-Ups
51:23 - Challenges with Post-TKA Patients
54:16 - Future Directions

Why might the standard RECIST criteria fail to accurately track success after tumor ablation, and what should you look for instead? In the 4th installment of the 2025 NSCLC Creator Weekend™ series, hosts Drs. Scott Genshaft and Kavi Krishnasamy are joined by specialists from UCLA and USC to discuss and debate advanced treatment options for primary lung cancer.

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This podcast is supported by an educational grant from Johnson & Johnson and Varian.

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SYNPOSIS

The panel, including interventional radiologists, pulmonologists, and a radiation oncologist, discusses the intricacies of photon versus proton therapies, the physics behind radiation treatment, and the evolving landscape of ablation technologies. The conversation covers the efficacy and limitations of different treatments, patient selection criteria, and the role of newer technologies like electroporation and robotic-assisted bronchoscopy in enhancing precision and outcomes. Additionally, the panel addresses the practical challenges of intraprocedural imaging, the importance of adequate margins, and the complexities of managing local recurrences and radiation-induced toxicities.

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TIMESTAMPS

00:00 - Tumor Ablation and Recurrence Rates
12:53 - Advancements in Ablation Technologies
23:31 - Bronchoscopic Approaches in Lung Cancer Treatment
38:46 - Challenges in Radiation Dose and Delivery
49:21 - Ablation and Radiation Margins
01:07:19 - Final Thoughts

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RESOURCES

Thierry de Baere Paper on Ablation Margins https://pmc.ncbi.nlm.nih.gov/articles/PMC9815739/

Pseudoaneurysms are among the most common complications of vascular access. Here’s a refresher on how to treat them with thrombin injection featuring interventional radiologist Dr. Gabriel Werder from Radiology Associates of Florida. Alongside host Dr. Chris Beck, Dr. Werder outlines both the clinical and procedural approach to thrombin injection for pseudoaneurysms.

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SYNPOSIS

This episode covers best practices for thrombin injection procedures, including preferred needle positioning techniques, sedation protocols, ultrasound evaluation, and follow-up care. The physicians discuss recent evidence supporting needle placement at the center of the sac from an inferior approach, and share specific cases that highlight the utility of balloon-assisted thrombin injections. Dr. Werder provides a detailed walkthrough of his technique, including contralateral femoral access, balloon oversizing, and preferences for a post-procedural run-off angiogram. The episode also touches on complex pseudoaneurysms with multiple sacs and learnings from several other unique cases.

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TIMESTAMPS

00:00 - Introduction
03:53 - Thrombin Injection Procedural Overview
08:14 - Procedure Setup and Execution
16:13 - Needle Positioning and Ultrasound Evaluation
18:47 - Handling Complex Pseudoaneurysms
19:20 - Balloon Occlusion Thrombin Injection
19:59 - Case Studies and Practical Insights
26:21 - Post-Procedure Care and Follow-Up
29:17 - Final Thoughts and Reflections

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RESOURCES

Kim et al. “Optimal thrombin injection method for the treatment of femoral artery pseudoaneurysm” - https://www.jthjournal.org/article/S1538-7836(24)00048-5/fulltext

How do leading oncologists interpret the abundance of molecular tests, genomic data, and biomarkers to create a lung cancer patient’s treatment plan? In this episode of the 2025 NSCLC Creator Weekend™ series, our tumor board discusses the complexities of lung cancer treatment, including new systemic therapies, lung cancer staging, and the role of molecular diagnostics and liquid biopsies.

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This podcast is supported by an educational grant from Johnson & Johnson and Varian.

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SYNPOSIS

The panel, featuring specialists from various institutions, discusses the specifics of sequencing therapies, the impact of targeted and immunotherapies, and the nuances of treating different patient profiles, including non-smokers and those with specific genetic mutations. The conversation also touches on the integration of new staging systems, the benefits of multidisciplinary clinics, and the ongoing evolution of cancer treatment trials. The discussion aims to provide clarity on the latest advancements and future directions in managing lung cancer, emphasizing the importance of tailored treatment plans and the potential of emerging technologies.

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TIMESTAMPS

00:00 - Introduction
05:16 - Molecular Diagnostics and Liquid Biopsy
21:43 - Targeted Therapy Options
27:29 - Managing Toxicities and Treatment Strategies
33:13 - Challenges with Immunotherapy in Special Cases
34:07 - Lung Transplantation in Cancer Patients
48:38 - Multidisciplinary Clinics and Collaboration
01:06:29 - Future Directions

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RESOURCES

ADAURA Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2027071

Gomez NSCLC
https://pmc.ncbi.nlm.nih.gov/articles/PMC5143183/

Are you up to date with the latest guidelines on deep venous thrombosis (DVT) management? Dr. Steven Abramowitz, vascular surgeon at MedStar Health, joins host Dr. Chris Beck for a deep dive into emerging clinical data in DVT management, where they review the evolving indications for mechanical thrombectomy and the implications of studies like the ATTRACT trial, the CLOUT registry, and the ongoing DEFIANCE trial.

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This podcast is supported by:

Inari Medical
https://www.inarimedical.com/

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SYNPOSIS

Dr. Abramowitz reviews recent data comparing outcomes of mechanical intervention versus lytic-based therapy, outlining how each approach fits into current practice. He underscores the critical role of IVUS in determining treatment endpoints, while noting the ongoing challenge of an absent standardized definition. The conversation also offers practical insights on procedural techniques and the evolving role of anticoagulation, emphasizing the importance of close collaboration and open communication with referring physicians.

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TIMESTAMPS

00:00 - Introduction
00:45 - Overview of DVT Management
02:50 - New Guidelines for DVT Treatment
07:30 - Technical Endpoints in DVT Treatment
13:26 - Clout Registry and Its Findings
17:57 - Anticoagulation and DVT
23:05 - Defining Acute DVT Management
27:00 - Evolving Approaches to Acute DVT
28:19 - Patient Experience and Quality of Life
31:08 - Referring Providers and Data Impact
37:01 - Single Session Treatments and Stenting
41:07 - Chronic Venous Disease Management

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RESOURCES

(ATTRACT) Weinberg I, Vedantham S, Salter A, et al. Relationships between the use of pharmacomechanical catheter-directed thrombolysis, sonographic findings, and clinical outcomes in patients with acute proximal DVT: Results from the ATTRACT Multicenter Randomized Trial. Vasc Med. 2019;24(5):442-451. doi:10.1177/1358863X19862043
https://pubmed.ncbi.nlm.nih.gov/31354089/

(CLOUT) Shaikh A, Zybulewski A, Paulisin J, et al. Six-Month Outcomes of Mechanical Thrombectomy for Treating Deep Vein Thrombosis: Analysis from the 500-Patient CLOUT Registry. Cardiovasc Intervent Radiol. 2023;46(11):1571-1580. doi:10.1007/s00270-023-03509-8
https://pubmed.ncbi.nlm.nih.gov/37580422/

(DEFIANCE) Abramowitz SD, Marko X, D'Souza D, et al. Rationale and design of the DEFIANCE study: A randomized controlled trial of mechanical thrombectomy versus anticoagulation alone for iliofemoral deep vein thrombosis. Am Heart J. 2025;281:92-102. doi:10.1016/j.ahj.2024.10.016
https://pubmed.ncbi.nlm.nih.gov/39491572/

What should you know before applying to an interventional radiology residency program? Get 70 minutes of free advice in this week's episode of BackTable featuring Georgetown IR fellow Dr. Neil Jain and host Dr. Chris Beck, covering everything from building your IR resume to crushing your interviews.

SYNPOSIS

The conversation starts by covering the essential steps that medical students can take to build their resume prior to the application cycle, including involvement in the medical student sections of SIR, CIRSE, and local symposiums. Dr. Jain highlights the importance of mentorship and research, strategies for obtaining strong letters of recommendation, and effectively navigating both home and away rotations. The discussion also extends to interview preparation, program selection, signaling updates, and the rank list construction. The episode also touches on the SOAP process for unmatched applicants and the avenues to secure a match. Importantly, Dr. Jain emphasizes the significance of fit over prestige and finding a program that aligns with your values and professional goals.

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TIMESTAMPS

00:00 - Introduction
03:07 - Building Your Resume for IR
10:43 - Away Rotations and Letters of Recommendation
23:54 - Personal Statements: Importance and Tips
30:07 - Application Strategies: IR and DR Programs
41:48 - Utilizing Signaling in the Application Process
44:19 - Evaluating Programs During Interviews
49:58 - Letters of Interest and Intent
54:33 - The Interview Day Experience
01:04:47 - Building Your Rank List
01:08:56 - The SOAP Process
01:12:50 - Final Advice and Closing Remarks

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RESOURCES

2025 NRMP Match Data

https://www.nrmp.org/wp-content/uploads/2025/03/Advance_Data_Tables_2025.pdf
Society of Interventional Radiology Trainee Website
https://www.sirweb.org/in-training/

VI 372 - IR Pathways Unveiled: Matching, Training & Beyond https://www.backtable.com/shows/vi/podcasts/372/ir-pathways-unveiled-matching-training-beyond

VI 554: Optimizing the IR/DR Curriculum & Experience
https://www.backtable.com/shows/vi/podcasts/554/optimizing-the-ir-dr-curriculum-experience

With the range of interventional modalities that are available for metastatic liver tumors, when should you advocate for thermal ablation at the tumor board? In this episode of BackTable, host Dr. Sabeen Dhand welcomes back Dr. Jason Hoffman, an interventional radiologist from New York University, to discuss tools, techniques, and multidisciplinary collaboration around microwave ablation for liver metastases.

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This podcast is supported by:

Varian

https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions

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SYNPOSIS

The physicians discuss the decision-making process behind using microwave ablation for metastatic liver disease, and strategies for advocating for the technology in tumor boards. Dr. Hoffman especially emphasizes the value of educating patients about their options and using thoughtful clinical judgement as an IR. The discussion delves into the benefits and advancements in microwave ablation, including his experience with the Varian system in light of NeuWave’s discontinuation. Dr. Hoffman shares the utility of software guidance, system fusion with CT machines, temperature monitoring, and the ability to achieve a more spherical ablation zone.

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TIMESTAMPS

00:00 - Introduction
04:39 - Practice Growth
11:10 - Microwave Ablation Technology
12:43 - Multidisciplinary Approach to Liver Metastases
26:48 - Microwave Technology and Probe Placement
28:42 - Guidance Software and Technological Integration
30:40 - Planning and Intraoperative Decisions
40:28 - Future of Microwave Ablation
48:35 - Conclusion and Final Thoughts

When cancer spreads to the brain, what is the best approach: immediate local treatment or systemic immunotherapy first? Part two of the 2025 NSCLC Creator Weekend™ series focuses on a complex case involving a 75-year-old woman with a history of breast malignancy, presenting with new dyspnea and a large mass in the left lower lobe.

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This podcast is supported by an educational grant from Johnson & Johnson and Varian.

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SYNPOSIS

Our mock tumor board consists of surgeons, medical oncologists, and radiation oncologists to deliberate and determine the best treatment plan. The specialists explore diagnostic and treatment options, including neoadjuvant chemoimmunotherapy, invasive mediastinal staging, and the potential for surgical resection or radiation therapy.

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TIMESTAMPS

00:00 - Introduction
05:01 - Approach to Isolated Brain Metastasis
09:09 - Radiation Therapy Considerations
12:06 - Imaging and Follow-Up Strategies
14:39 - Resectability and Surgical Decisions
19:10 - Conclusion

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RESOURCES

PACIFIC Clinical Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1709937

When conventional revascularization fails, can deep venous arterialization offer a new lifeline to limb salvage? Dr. Lucas Ferrer Cardona, vascular surgeon at Ascension and Dr. Miguel Montero Baker, vascular surgeon and medical director at HOPE Clinical Innovation Center join host Dr. Sabeen Dhand for an insightful discussion on deep venous arterialization (DVA).

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This podcast is supported by:

RADPAD® Radiation Protection
https://www.radpad.com/

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SYNPOSIS

The doctors discuss the progression of deep venous arterialization, highlighting the benefits of open, endovascular, and hybrid approaches. They draw on their personal experiences to share key technical nuances and explore new devices such as the Aveera Boomerang device. They emphasize the critical role of patient selection, family support, and close postoperative surveillance, including weekly wound assessments and monthly ultrasound evaluations. Although currently FDA-approved for no-option chronic limb-threatening ischemia (CLTI), Dr. Baker notes that deep venous arterialization may hold promise even for patients earlier in the disease course.
The episode concludes by exploring future directions for deep venous arterialization, highlighting the ongoing need for research to advance limb preservation.

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TIMESTAMPS

00:00 - Introduction
03:15 - The Inspiration Behind Their Podcast
10:05 - Challenges and Success Stories in Vascular Surgery
10:29 - Exploring Deep Venous Arterialization (DVA)
25:16 - Hybrid Approaches and Patient Outcomes
32:06 - Evolution of Endovascular Techniques
37:33 - Patient Selection and Criteria
38:52 - Understanding the Biology of Procedures
43:57 - Exploring New Techniques and Devices
58:52 - Challenges and Considerations
01:01:51 - Final Thoughts

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RESOURCES

Hybrid superficial venous arterialization and endovascular deep venous arterialization
https://pubmed.ncbi.nlm.nih.gov/37404577/

Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia
https://www.nejm.org/doi/full/10.1056/NEJMoa2212754

As lung cancer treatments become more complex, is a collaborative tumor board more essential than ever? We’re kicking off the 2025 NSCLC Creator Weekend™ series with an in-studio panel discussion on the multidisciplinary management of lung cancer. The panel includes experts from medical oncology, thoracic surgery, radiation oncology, and interventional pulmonology from major institutions in Los Angeles.

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This podcast is supported by an educational grant from Johnson & Johnson and Varian.

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SYNPOSIS

They discuss the operation of tumor boards at their respective institutions, the impact of virtual meetings, optimal strategies for mediastinal staging, the management of early-stage lung cancer, and the emerging role of ablation therapy. The conversation dives into the complexities of treating patients with recurrence or metastatic disease, highlighting the importance of collaborative decision-making in navigating these challenging scenarios. The episode emphasizes the critical role of multidisciplinary tumor boards in providing informed, patient-centered care.

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TIMESTAMPS

00:00 - Introduction
06:59 - Role of Pulmonologists in Tumor Boards
12:08 - Importance of Tissue Diagnosis
24:52 - Lung Cancer Screening and Stigma
34:01 - Interventional Radiology and Biopsies
46:21 - Challenges with Immunotherapy and Radiation
53:44 - The Importance of Multidisciplinary Teams
54:24 - Final Thoughts

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RESOURCES

American Lung Association 2024 Data
https://www.lung.org/getmedia/12020193-7fb3-46b8-8d78-0e5d9cd8f93c/SOLC-2024.pdf

National Lung Screening Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1102873

Checkmate 816
https://www.nejm.org/doi/full/10.1056/NEJMoa2202170

PACIFIC Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1709937