Welcome to the first episode of BackTable Tumor Board, and our first recording session at our new in-person studio! Guest host Dr. Tyler Sandow (interventional radiologist) leads a multidisciplinary discussion about patient care coordination in hepatocellular carcinoma (HCC) diagnosis and treatment, with insights from his colleagues at Ochsner Health– Dr. Steven Young (hepatologist), Dr. Jonathan Mizrahi (medical oncologist), and Deondra Bonds-Adams (patient navigator).

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This podcast is supported by an educational grant from:

AstraZeneca

https://www.astrazeneca.com/our-therapy-areas/oncology.html

With additional support from:

Boston Scientific

https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology.html

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SYNPOSIS

The team speaks on the value of having multiple specialties weigh in on treatment conversations that are tailored to each patient’s medical history and risk factors, such as underlying cirrhosis and portal hypertension. Deondra highlights the importance of assessing the patient’s understanding of their disease and the role of physician extenders and schedulers in patient education. Dr. Young discusses the value of outreach clinics and streamlining the transplant evaluation process. Finally, Dr. Mizrahi gives advice on building referral networks and establishing early contact with transplant centers.

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TIMESTAMPS

00:00 - Introduction

00:46 - Multidisciplinary Tumor Board

06:00 - Patient Experience in Treatment Pathways

10:10 - Barriers to Treatment

16:03 - Benefits of IR Clinic

19:33 - HCC Screening and Risk Factors

24:08 - Building Referral Networks

30:34 - Strategies for Effective Scheduling

35:43 - The Future of HCC Treatment

Interventional treatment for pulmonary embolism (PE) has significantly evolved in recent years, largely due to advancements in techniques, knowledge, and device technology. Dr. Zarina Sharalaya (interventional and structural cardiologist) and Dr. Ripal Gandhi (interventional radiologist) join host Dr. Chris Beck to discuss the evolving landscape of PE treatment, comparing large-bore mechanical thrombectomy with catheter-directed thrombolysis and exploring outcomes from the PEERLESS randomized control trial.

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This podcast is supported by:

Inari Medical

https://cwa.inarimedical.com/inari-learn

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SYNPOSIS

Dr. Sharalaya and Dr. Gandhi begin by covering risk stratification and treatment algorithms for their patients with PE. The doctors then go onto discuss the procedure in detail, and best practices and techniques for mechanical thrombectomy. The conversation also focuses on the PEERLESS trial, highlighting how the study showed significant benefits of mechanical thrombectomy, including faster symptom improvement, decreased ICU stay, and reduced readmission rates. Dr. Sharalaya and Dr. Gandhi conclude the episode with a series of case presentations.

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TIMESTAMPS

00:00 - Introduction

08:01 - Pulmonary Embolism Risk Stratification and Treatment Algorithms

14:49 - Procedure Overview

24:25 - Best Practices and Techniques in Thrombectomy

34:31 - Peerless Study Overview and Findings

46:50 - Gender Differences in PE Treatment

47:49 - Future of PE Treatment and Advice

51:55 - Case Presentations and Clinical Insights

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RESOURCES

2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS):

https://pubmed.ncbi.nlm.nih.gov/31504429/

PEERLESS II: A Randomized Controlled Trial of Large-Bore Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism:

https://www.jscai.org/article/S2772-9303(24)01053-6/fulltext

Large-bore Mechanical Thrombectomy Versus Catheter-directed Thrombolysis in the Management of Intermediate-risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial:

https://pubmed.ncbi.nlm.nih.gov/39470698/

Interventional radiology is unique in the way that much of what an IR’s practice looks like is extremely contingent upon their practice setting following training - whether it be community, academic, private, or hybrid. Dr. Mark Wilson joins host Dr. Donald Garbett to discuss his own journey of transitioning from a large, physician owned group to forming his own private IR practice in Spokane, Washington following a major hospital contract shift.

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This podcast is supported by:

Medtronic MVP

https://www.medtronic.com/mvp

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SYNPOSIS

Dr. Wilson shares the emotional impact of the career shift, and the technical aspects of how he was able to succeed following the change, and the details that went into creating his own private IR-only group and securing contracts with local hospitals. The doctors also spend time on the financial dynamics between DR and IR, as well as the true dollar value and impact IR brings to hospitals. The episode concludes with Dr. Wilson’s practical and thorough guide on how one can go about starting up their own IR-only private practice.

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TIMESTAMPS

00:00 - Introduction

03:02 - Forming a New IR Group

04:43 - Impact of Practice Changes

11:02 - IR’s Value to Hospitals

30:49 - Independent IR Practice Set-Up

36:38 - Conclusion

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RESOURCES

Karage, 2024. Attrition Rates in Interventional Radiology Integrated Residency Programs:

https://pubmed.ncbi.nlm.nih.gov/39586539/

It might be time to rethink your liver biopsy technique. Transfemoral transcaval core-needle liver biopsy has demonstrated key advantages over the transjugular approach and has become increasingly popular in recent years. Interventional radiologists Dr. Jacob Cynamon and Dr. Kapil Wattamwar join host Dr. Sabeen Dhand to discuss the inception and advantages of their novel approach.

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This podcast is supported by:

Reflow Medical

https://www.reflowmedical.com/

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SYNPOSIS

The doctors start with how they began using the transfemoral transcaval approach, along with the literature they published following adoption of this novel technique shortly thereafter. Dr. Cynamon and Dr. Wattamwar then go on to discuss the technique in detail, providing a thorough step-by-step and pausing to mention key considerations. The episode concludes with the doctors emphasizing the safety and efficacy of the transfemoral transcaval approach, citing specific findings and sharing exemplary cases.

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TIMESTAMPS

00:00 - Introduction

05:47 - Percutaneous vs. Transvenous Biopsies

08:56 - Evolution of Transfemoral Biopsies

12:41 - Comparing Transjugular and Transfemoral Approaches

24:52 - Pre-Procedural Imaging and Sheath Selection

29:23 - Complications and Case Studies

35:46 - Transcaval Biopsy Technique

45:00 - Conclusion

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RESOURCES

Cynamon, 2016. Transfemoral Transcaval Core-Needle Liver Biopsy: An Alternative to Transjugular Liver Biopsy:

https://pubmed.ncbi.nlm.nih.gov/26723528/

Wattamar, 2020. Transjugular versus Transfemoral Transcaval Liver Biopsy: A Single-Center Experience in 500 Cases:

https://pubmed.ncbi.nlm.nih.gov/32798119/

Wattamar, 2022. The Use of the Transfemoral Transcaval Liver Biopsy Technique for Biopsies of Hepatic Masses:

https://pubmed.ncbi.nlm.nih.gov/36182256/

Wattamar, 2022. Transcaval Creation of a Portal Vein Target for Transjugular Intrahepatic Portosystemic Shunt in a Patient with Portal Vein Thrombosis:

https://pubmed.ncbi.nlm.nih.gov/34448032/

En este episodio de BackTable, la Dra. María Luisa Die Trill conversa con la Dra. Sara

Lojo Lendoiro sobre la gestión emocional y la comunicación con los pacientes.

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SYNPOSIS

Se explora la importancia de integrar el sufrimiento como parte de la vida, la necesidad

de una formación adecuada en comunicación médico-paciente, y las estrategias para

abordar complicaciones y situaciones complejas. Además, se analizan conceptos como

la empatía, la escucha activa, y la introspección, para mejorar la relación con los

pacientes y con el resto de compañeros del hospital. Finalmente, la Dra. Trill enfatiza la

necesidad de centrarse en el bienestar del paciente y en manejar el estrés profesional

para poder ofrecer un cuidado de calidad.

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TIMESTAMPS

00:00 - Bienvenida y Comprendiendo la Psicología Oncológica

05:06 Habilidades de Comunicación en la Práctica Médica

10:19 Técnicas Prácticas de Comunicación

22:10 La Importancia de Escuchar

28:18 La Insensibilidad en la Sociedad Moderna

30:49 La Importancia de la Salud Mental en los Profesionales

34:24 La Empatía y la Conexión con los Pacientes

36:22 El Manejo del Estrés en el Personal Sanitario

48:35 El Ego y la Dinámica de Grupo en los Hospitales

52:54 Conclusión y Reflexiones Finales

En este episodio del BackTable, Dr. José Andrés Guirola Ortíz, radiólogo

intervencionista, aborda la embolización como tratamiento para las hemorroides,

mediante la técnica Emborrhoid y comparte su valoración de la embolización como

técnica de futuro.

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SYNPOSIS

En primer lugar, la Dra. Sara Lojo Lendoiro le invita a explicar qué son las hemorroides

y porqué y cuando hay que tratarlas. Además, el Dr. Guirola Ortíz analiza la historia de

las hemorroides, sus síntomas y opciones de tratamiento. También se discuten las

indicaciones, técnicas y posibles complicaciones de la embolización hemorroidal, así

como el futuro de esta técnica dentro de la radiología intervencionista.

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TIMESTAMPS

00:00 - Introducción al BackTable y Dr. Ortíz

01:56 - Entendiendo las Hemorroides: Historia y Conceptos Básicos

03:39 - Síntomas y Causas de las Hemorroides

07:36 - Opciones de Tratamiento para las Hemorroides

12:50 - Explicación de la Técnica de Embolización

19:25 - Complicaciones y Seguimiento

29:05 - Futuro de la Embolización y Conclusión

For patients with early-stage cancer, minimally invasive image-guided therapies like cryoablation can be both life-altering and life-saving. Patient Clinton Lanier, a kidney cancer survivor who underwent multiple cryoablations, sits down with host Dr. Eric Keller to share his story and raise patient-provider awareness of the positive impacts IR brings.

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This podcast was developed in collaboration with:

Interventional Initiative

https://theii.org/

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SYNPOSIS

Clinton shares his personal story of being diagnosed with a kidney tumor during a sailing trip and discovering cryoablation as a treatment option through his own research and advocacy. He discusses the effectiveness and ease of the procedure, the positive impact it has had on his quality of life, and the importance of raising awareness about cryoablation among patients and healthcare providers.

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TIMESTAMPS

00:00 - Introduction

03:56 - First Cryoablation Experience

05:20 - Patient Experience

09:12 - Cryoablation Awareness

14:44 - Conclusion

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RESOURCES

The Interventional Initiative:

https://theii.org

How can we make life-changing treatments like uterine fibroid embolization (UFE) more globally accessible? To help answer this question, Dr. Janice Newsome and Dr. Azza Naif share what they’re doing in Tanzania to make UFE a standard option in fibroid care. Dr. Newsome is a Professor at Emory University and Dr. Naif is an IR attending physician at Muhimbili University of Health and Allied Sciences (MUHAS) and a member of the first generation of Tanzanian IR trainees.

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This podcast is supported by:

Varian, a Siemens Healthineers company

https://www.varian.com/products/interventional-solutions/embolization-solutions

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SYNPOSIS

The doctors focus on patient education, overcoming cultural barriers, training of IR specialists, and the economic aspects of UFE. The discussion highlights the importance of making women’s health treatments accessible worldwide and adapting procedures to fit local resources while maintaining high standards of care.

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TIMESTAMPS

00:00 - Introduction

05:25 - Patient Care in Tanzania

16:28 - Challenges in UFE Adoption

21:38 - Equipment and Techniques for UFE

34:26 - Post-Procedure Follow-Up Care

41:16 - Cost and Accessibility of UFE

47:01 - Future Goals for Fibroid Care

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RESOURCES

BackTable VI Podcast Episode #318 - Back on the Road2IR with Dr. Janice Newsome, Dr. Judy Gichoya and Dr. Fabian Laage Gaupp:

https://www.backtable.com/shows/vi/podcasts/318/back-on-the-road2ir

BackTable VI Podcast Episode #104 - Bringing IR to East Africa: The Road2IR Story with Dr. Fabian Laage Gaupp:

https://www.backtable.com/shows/vi/podcasts/104/bringing-ir-to-east-africa-the-road2ir-story

Road2IR:

https://www.road2ir.org/

As physicians, we have the unique ability to improve the health and wellbeing of individuals in underserved communities. But even if we possess the drive and the compassion to do so, it can be difficult to know how to take meaningful steps towards addressing local healthcare disparities. In this episode of the BackTable Podcast, Dr. Lyssa Ochoa of the San Antonio Vascular and Endovascular Clinic (SAVE) shares how her clinic improves access to care for underserved patient populations, and how you can emulate her success.

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This podcast is supported by:

Philips Image Guided Therapy Solutions

https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products

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SYNPOSIS

Dr. Ochoa shares her journey from joining a large private practice to founding her own clinic focused on underserved areas in San Antonio. She discusses the importance of addressing social determinants of health, the logistics of running multiple satellite clinics, and her approach to patient care. Dr. Ochoa also emphasizes the need for community engagement and outlines her vision for improving healthcare equity in San Antonio. The conversation highlights the challenges and rewards of providing quality care in economically segregated regions, and offers insights for healthcare providers looking to make a meaningful impact.

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TIMESTAMPS

00:00 - Introduction

03:23 - Addressing Social Determinants of Health

05:20 - Innovative Approaches to Healthcare Delivery

08:46 - Challenges and Strategies in Underserved Areas

15:16 - Building Community Trust and Referrals

22:27 - Advice for New Practitioners

29:42 - Future Vision for Healthcare in San Antonio

32:07 - Resources

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DISCLAIMER

Dr. Lyssa Ochoa is a consultant for Philips and was requested to provide their services in preparing and presenting this material for Philips. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations.

500 episodes of BackTable calls for a special reunion! The original hosts—Dr. Aaron Fritts, Dr. Chris Beck, Dr. Ally Baheti, Dr. Sabeen Dhand, Dr. Mike Barraza, and producer Kieran Gannon—come together to celebrate by reminiscing about the podcast’s origins and evolution. They discuss the challenges of improving the podcast, share funny behind-the-scenes moments, and highlight their favorite episodes. The team also offers insights into how they choose topics and reflects on their experiences with both virtual and in-person recordings. Finally, they introduce the new BackTable Studio and highlight the upcoming Creator Weekends.

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SYNPOSIS

To our BackTable community, thank you for tuning in every week. We look forward to continuing to serve your vascular and interventional education needs!

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TIMESTAMPS

00:00 Introduction

01:43 The Origin Story of Backtable

06:42 From Our Side of the Microphone: Hosting Episodes

25:57 Choosing Topics and Guests

32:55 Introducing the New BackTable Studio

38:27 Favorite Episodes and Memorable Moments

44:02 The Story Behind the Backtable Theme Music

47:49 The Iconic Backtable Hoodies

51:03 Closing Thoughts and Gratitude

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RESOURCES

BackTable Special 100th Episode Interview: https://www.backtable.com/shows/vi/podcasts/special/special-100th-episode-interview-with-backtable