BackTable Vascular & Interventional

In this episode, Dr. Mark Little shares his insights about genicular artery embolization (GAE), implications for patients with knee osteoarthritis, possible applications in other MSK interventions, and the importance of research for advancing the field. Dr. Little is a consultant diagnostic and interventional radiologist at Berkshire Imaging and Visiting Professor at the University of Reading in England.

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Varian, a Siemens Healthineers company

https://www.siemens-healthineers.com/

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SYNPOSIS

The doctors also discuss challenges and considerations in patient selection, particularly concerning patients with comorbid peripheral arterial disease, and they further emphasize the need for high-quality research and collaboration within the IR community to continue improving MSK embolization practices.

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TIMESTAMPS

00:00 - Introduction

12:28 - Genicular Artery Embolization

24:30 - GENESIS 1 and 2 Studies

41:04 - Future of MSK Embolization

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RESOURCES

BackTable VI Episode 27 - Geniculate Artery Embolization for Osteoarthritis with Dr. Sandeep Bagla and Dr. Ari Isaacson:

https://www.backtable.com/shows/vi/podcasts/27/geniculate-artery-embolization-for-osteoarthritis

BackTable VI Episode 85 - Genicular Artery Embolization for OA with Dr. Jafar Golzarian:

https://www.backtable.com/shows/vi/podcasts/85/genicular-artery-embolization-for-oa

GEST MSK Annual Meeting:

https://thegestgroup.com/annual-msk-meeting/

GENESIS 1 - Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis:

https://pubmed.ncbi.nlm.nih.gov/33474601/

GENESIS 2 - Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial:

https://pubmed.ncbi.nlm.nih.gov/37337060/

Dr. Little Genicular Artery Anatomy Paper - Cadaveric and Angiographic Anatomical Considerations in the Genicular Arterial System: Implications for Genicular Artery Embolisation in Patients with Knee Osteoarthritis:

https://pubmed.ncbi.nlm.nih.gov/34657976/

Dr. Sid Padia’s Knee OA Research (UCLA) - Genicular Artery Embolization for the Treatment of Symptomatic Knee Osteoarthritis:

https://pubmed.ncbi.nlm.nih.gov/34703964/

Dr. Lars Lönn from Copenhagen Trial - Genicular Artery Embolization as Pain Treatment of Knee Osteoarthritis (GETKO):

https://classic.clinicaltrials.gov/ct2/show/NCT05360329

Dr. Anna Martinez from Spain Shoulder Study - Mid-Term Results of Transcatheter Arterial Embolization for Adhesive Capsulitis Resistant to Conservative Treatment:

https://pubmed.ncbi.nlm.nih.gov/33135118/

Dr. Anna Martinez from Spain Shoulder Study - Clinical Outcomes of Transcatheter Arterial Embolization for Secondary Stiff Shoulder:

https://pubmed.ncbi.nlm.nih.gov/33478903/

En este episodio de nuestro podcast, Dra. Anna Alguersuari Cabiscol, una radióloga intervencionista que dejó su especialidad hace cuatro años, comparte su experiencia personal sobre los desafíos relacionados con la salud mental dentro de la profesión médica.

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SYNPOSIS

Expone cómo la insatisfacción profesional, el síndrome del impostor y la falta de bienestar mental la llevaron a tomar la decisión drástica de abandonar el intervencionismo. A través de su relato, se discute la relevancia de crear un entorno positivo en el trabajo, invertir en el bienestar mental, y la importancia de enfrentar y superar el estigma asociado con estos temas en el ámbito médico. El episodio también aborda la necesidad de cambiar la percepción del éxito y cómo el apoyo de la comunidad médica y científica es fundamental para mejorar la situación actual.

Finalmente, se destaca el rol crucial de los mentores en todas las etapas de la carrera médica para fomentar un equilibrio entre competencia y confianza, así como promover un entorno laboral saludable y respetuoso.

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TIMESTAMPS

00:00 - Bienvenido al podcast

07:16 - Redefiniendo el éxito

10:20 - Los cuatro pilares de una vida y un trabajo significativos

28:36 - Crecimiento personal y la importancia de la tutoría

32:22 - Pensamientos finales

In this episode, Dr. Jason Hoffmann shares his harrowing personal experience as a patient with massive portal vein thrombosis - recounting the onset of his symptoms, the subsequent diagnosis, treatment, and recovery, all occurring while he was on-call for his own hospital. Dr. Hoffmann is an interventional radiologist and educator at NYU Langone Health.

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Reflow Medical

https://www.reflowmedical.com/

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SYNPOSIS

Reflecting on how this experience impacted his approach to medicine and patient care, Dr. Hoffmann discusses the importance of empathy, patient education, and building trust. Additionally, he touches upon his personal and family medical history, and how these events have influenced his medical practice and perspective on patient care.

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TIMESTAMPS

00:00 - Introduction

05:55 - Dr. Hoffmann’s IR Practice and Passions

09:23 - Physician’s Experience as a Patient

22:47 - New Perspective on Patient Care

28:53 - Closing Thoughts

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RESOURCES

Combating the Health Risks of Sedentary Behavior in the Contemporary Radiology Reading Room:

https://pubmed.ncbi.nlm.nih.gov/27057784/

En este episodio de BackTable la Dra. Maite Velázquez, hemodinamista del Hospital 12 de Octubre de Madrid, aborda el creciente porcentaje de mujeres que ingresan en el campo de la medicina y, en comparación, el escaso porcentaje de mujeres entre los profesionales que trabajan en entornos con radiación ocupacional, como la radiología vascular intervencionista, hemodinámica o cirugía vascular. Además, se analizan los desafíos existentes alrededor del embarazo de estas profesionales, legislación existente y qué medidas protectoras existen en España y Europa, así como los riesgos reales de radiación para el feto basados en evidencia científica.

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SYNPOSIS

La Dra. Velázquez disipa mitos, enfatiza la seguridad existente a la hora de mantener la actividad profesional durante el embarazo con las protecciones adecuadas y destaca la brecha de género y el impacto de la escasez de relevo generacional en estas especialidades. La conversación tiene como objetivo informar y reflejar la evidencia científica existente en cuanto al manejo del embarazo mientras se trabaja en ambientes expuestos a la radiación ionizante.

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TIMESTAMPS

00:00 - Introducción

03:11 - Exposición a la radiación durante el embarazo

07:33 – Evidencia científica y legislación

20:19 - Abordar el impacto profesional del embarazo

26:56 - Combatir conceptos erróneos y promover prácticas seguras

34:59 - Comentarios finales

In this episode, Dr. Amit Srivastava discusses the transformation of peripheral interventional practices through radial access techniques, emphasizing reduced complication rates, the extensive range of devices now available, and the option for same-day discharge.

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Terumo Interventional Systems

https://terumois.com/education

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SYNPOSIS

Through a series of real-world examples and discussion on the R2P registry, the doctors illustrate the high success rates and low complications of the transradial approach, debunking common misconceptions, and highlighting the significance of team collaboration in executing these procedures efficiently. Additionally, the conversation covers the evolution of devices suited for R2P, including longer length wires, catheters, and novel training methods like immersive virtual reality courses designed to educate and inspire practitioners to adopt radial access in their endovascular practices.

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TIMESTAMPS

00:00 - Introduction

02:19 - Current Role of Radial Access in Peripheral Interventions

15:08 - Future of Radial Access

21:11 - The R2P Registry

28:44 - Educational Opportunities and Community Support

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RESOURCES

TERUMO Transradial Training & Education:

https://www.terumois.com/education-training/healthcare-provider-education-programs/transradial-courses.html

BT Episode 342 - Radial Access for PAD with Dr. Rami Tadros:

https://www.backtable.com/shows/vi/podcasts/342/radial-access-for-pad

Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study:

https://pubmed.ncbi.nlm.nih.gov/22858390/

Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions (RPI Study):

https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext

In this episode, Dr. Nicole Lamparello discusses the strides and challenges in achieving gender equity in interventional radiology (IR), sharing insights from her research on gender disparities in IR, and revealing how women currently comprise a significantly low percentage of the IR workforce compared to men despite equal numbers of male and female medical students. Dr. Lamparello is an interventional radiologist and serves as the Program Director for Weill Cornell Medicine’s Integrated IR Residency in New York City.

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RADPAD® Radiation Protection

https://www.radpad.com/

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SYNPOSIS

The doctors cover the importance of workplace culture with flexibility for family and maternity needs, mentorship, visibility of female leaders in IR, and strategies for attracting more women to the field. The conversation also touches on the impact of diverse IR professionals on patient outcomes, and how outsourcing personal tasks can help maintain work-life balance. The necessity of early exposure to IR for medical students and addressing specific hurdles for women in IR, such as work-life balance, radiation exposure fears, and lack of female role models are also explored.

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TIMESTAMPS

00:00 - Introduction

05:40 - Addressing Gender Disparity in IR

13:48 - Importance of Physician Workforce Diversity

18:31 - Challenges and Solutions for Gender Equity in IR

25:28 - Work-Life Balance

38:40 - Concluding Thoughts

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RESOURCES

The Gender Gap in Interventional Radiology: Barriers, Opportunities, and the Role of the Integrated IR Residency:

https://pubmed.ncbi.nlm.nih.gov/36870809/

The IR Trainee Workforce 10 Years after Becoming a Primary Medical Specialty:

https://www.jvir.org/article/S1051-0443(23)00651-6/fulltext

Lack of exposure and perceived occupational hazards as barriers to entry into IR for women: a survey of 143 female medical students:

https://www.jvir.org/article/S1051-0443(16)31526-3/fulltext

Untapped Resources: Attaining Equitable Representation for Women in IR:

https://www.jvir.org/article/S1051-0443(18)31645-2/fulltext

Gender and racial diversity among plenary session speakers at the Society of Abdominal Radiology Annual Meetings: a five-year assessment:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226100/

Bridging the Gender Gap in the Society of IR: A Benchmark Study:

https://www.jvir.org/article/S1051-0443(18)31492-1/pdf

In this episode, Dr. Aron Chary provides an in-depth look into endovascular and minimally invasive treatments for pain management, specifically focusing on cryoneurolysis. He shares his experience of implementing the technology for both benign and malignant conditions in an independent private practice setting.

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Boston Scientific Visual ICE Cryoablation System

https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html

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SYNPOSIS

The discussion covers various aspects, including collaboration with Boston Scientific for the VISUAL ICE cryoablation system, Dr. Chary’s personal journey from academics at Emory to private practice in Memphis, the effectiveness of cryoneurolysis in different areas such as genicular nerve and palliative care, and the operational dynamics between hospital and outpatient settings. The doctors delve into the procedural specifics, patient response, and outcomes with cryoneurolysis, including Dr. Chary’s efforts to navigate insurance and reimbursement challenges.

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TIMESTAMPS

00:00 - Introduction

07:04 - Evolution of Pain Intervention Techniques

11:08 - Building a Pain Intervention Service

16:16 - Versatility of Cryoablation in Pain Management

23:54 - Expectations and the Future of Pain Management Research

31:41 - Cryoneurolysis Insights and Patient Management

42:10 - Techniques in Celiac Cryoneurolysis

52:33 - Pain Management in the Outpatient Setting

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RESOURCES

Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol:

https://www.jvir.org/article/S1051-0443(20)30349-3/abstract

BT VI Episode 199 - Advanced Minimally Invasive Pain Interventions with Dr. David Prologo:

https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions

BT VI Episode 433 - Kyphoplasty Evolution: Steering Toward Targeted Therapy with Dr. David Prologo:

https://www.backtable.com/shows/vi/podcasts/433/kyphoplasty-evolution-steering-toward-targeted-therapy

Boston Scientific, VISUAL ICE:

https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html

In this episode, Dr. David Guez discusses the advancements in contrast enhanced ultrasound, its application in detecting endoleaks, and his journey of learning and applying this modality from residency to his current practice.

Dr. Guez emphasizes ultrasound’s utility in lesion characterization, endoleak monitoring, and sparing patients from more invasive diagnostic procedures. The doctors delve into the specifics of using ultrasound contrast agents, particularly LUMASON and its intravascular utility for real-time monitoring of disease states with superior resolution compared to CT or MRI. Dr. Guez also discusses the potential for contrast enhanced ultrasound in interventional radiology, including diagnosing vascular lesions and augmenting tumor treatments. The conversation highlights the technique’s advantages, its high sensitivity for endoleaks, and potential areas for future research and application. The episode underscores the underutilized potential of contrast enhanced ultrasound in both diagnostic and interventional radiology settings.

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Reflow Medical

https://www.reflowmedical.com/

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SHOW NOTES

00:00 - Introduction

03:54 - Exploring the Basics of Contrast Enhanced Ultrasound

06:49 - Clinical Applications and Advantages of Contrast Enhanced Ultrasound

09:15 - Contrast Enhanced Ultrasound in Action: Diagnosing Endoleaks

23:52 - Future of Contrast Enhanced Ultrasound in Interventional Radiology

27:02 - Closing Thoughts

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RESOURCES

Bracco LUMASON:

https://lumason.com/

Nontraditional Uses of US Contrast Agents in Abdominal Imaging and Intervention:

https://pubs.rsna.org/doi/full/10.1148/rg.220016

Book written by Andrej Lyshchik, MD, PhD (Thomas Jefferson) - Specialty Imaging: Fundamentals of CEUS:

https://www.amazon.com/Specialty-Imaging-Fundamentals-Andrej-Lyshchik/dp/0323625649

Contrast-enhanced Ultrasound Identifies Patent Feeding Vessels in Transarterial Chemoembolization Patients With Residual Tumor Vascularity:

https://pubmed.ncbi.nlm.nih.gov/32890324/

Contrast-enhanced ultrasound (CEUS) versus computed tomography angiography (CTA) in detection of endoleaks in post-EVAR patients. Are delayed type II endoleaks being missed? A systematic review and meta-analysis:

https://pubmed.ncbi.nlm.nih.gov/26191109/

In this episode, guest host Dr. Krishna Mannava interviews Dr. Bob Tahara about the significant multilevel impacts, ripple effects, and fallout of cyberattacks on the healthcare industry, specifically covering the recent cyberattack that targeted major clearinghouse, Change Healthcare.

Dr. Tahara is a vascular surgeon practicing in rural northwest Pennsylvania and President of Outpatient Endovascular Interventional Society (OEIS). Dr. Tahara shares his experiences as a solo vascular surgeon in rural Pennsylvania, highlighting the complexities of modern billing systems, the advantages of hiring a quality billing company, and the challenges posed by the consolidation of clearinghouses. The conversation also delves into the alarming ransomware attack on Change Healthcare, where 6 terabytes of patient data were compromised. This incident exposed vulnerabilities across the healthcare sector, from payment processes to electronic medical and prescription records. The doctors underscore the importance of cybersecurity preparedness, diversification of clearinghouses, and the role of physicians in advocating for more secure and efficient healthcare systems. They also touch on personal hobbies like Kendo to manage stress.

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Reflow Medical

https://www.reflowmedical.com/

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SHOW NOTES

00:00 - Introduction

02:02 - Cyberattack on Change Healthcare: An Overview

06:37 - Impact of the Cyberattack on Healthcare Practices

09:50 - Understanding Clearinghouses in Healthcare Billing

14:30 - Fallout from the Cyber Attack: A Personal Account

16:40 - Navigating the Aftermath: Strategies and Solutions

22:54 - Value of Medical Records and Cybersecurity Measures

29:18 - Action Items and Advocacy for Physicians

35:00 - OEIS 2024 Meeting and Final Thoughts

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RESOURCES

OEIS Annual Meeting Schedule 2024:

https://oeisweb.com/wp-content/uploads/2024/04/2024-AM-attendee-brochure-v4-FINAL-proof-lowres.pdf

BackTable Episode 349 - Cybersecurity for Physicians with Jason Newton, Esq:

https://www.backtable.com/shows/vi/podcasts/349/cybersecurity-for-physicians

In this episode, Dr. Omar Saleh and Dr. Mike Watts discuss the challenging aspects of vascular interventions in the OBL setting, focusing on ‘oh $#!%’ moments and how to address various complications. Both Dr. Saleh and Dr. Watts are vascular and interventional radiologist, practicing in Southern California and New Jersey, respectively.

The doctors share specific, challenging cases they’ve encountered, including device malfunctions and unexpected outcomes during procedures. Additionally, Dr. Saleh and Dr. Watts discuss the advantages of having hybrid OBL and hospital practices, the importance of being prepared for complications by having the right tools and strategies at hand, and interdisciplinary collaboration. The conversation also touches on the value of certain devices and techniques in managing complications effectively and ensuring patient safety.

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RADPAD® Radiation Protection

https://www.radpad.com/

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SHOW NOTES

00:00 - Introduction

04:53 - Creative Solutions for Complex Vascular Cases

16:47 - Hybrid Practice: Balancing OBL and Hospital Work

21:39 - The Pros and Cons of Hybrid OBL-Hospital Practices

30:34 - Navigating Complex Medical Procedures

35:09 - Importance of Preparedness and Resourcefulness in Medical Emergencies

44:38 - Advice for Handling Complicated Medical Cases

49:26 - Concluding Thoughts and Looking Ahead to Future Conferences

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RESOURCES

BackTable VI Episode 384 - New Innovations in Closure Devices with Dr. Omar Saleh and Dr. Syed Hussain:

https://www.backtable.com/shows/vi/podcasts/384/new-innovations-in-closure-devices

BackTable VI Episode 121 - Office-Based Labs (OBLs) & What You Can Do in Them with Dr. Mike Watts:

https://www.backtable.com/shows/vi/podcasts/121/office-based-labs-obls-what-you-can-do-in-them

BackTable VI Episode 37 - Treating PAD in the OBL with Dr. Mike Watts and Dr. Omar Saleh:

https://www.backtable.com/shows/vi/podcasts/37/treating-pad-in-the-obl