BackTable Vascular & Interventional

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 benefits and advancements in microwave ablation, the decision-making process behind using microwave ablation for metastatic liver disease, and strategies for advocating for this 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 conversation also covers 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

As breast imaging is becoming increasingly sensitive, is cryoablation the next frontier for treating small cancers or patients who are poor surgical candidates? Learn from expert Dr. Robert Ward, associate professor and program director of the Breast Imaging Fellowship at Brown University as he provides a contemporary overview of the innovative field of breast cryoablation.

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SYNPOSIS

Dr. Ward shares his journey to becoming an expert in breast cryoablation, from his start in residency to his well-developed service line today. He details his experience enrolling patients in the FROST Trial, which is investigating the role of breast cryoablation as an alternative for surgery in patients with early stage invasive breast cancer.

The conversation also covers the intricacies of the procedure, patient selection criteria, pre- and post-procedural care, and the significance of receptor positivity and clinical markers in treatment choices. Dr. Ward talks through the challenges in needle positioning prior to ice ball formation and the possibility of treating tumors close to the skin surface given appropriate wound care. The discussion concludes with a future look at how cryoablation could change the current paradigm of breast cancer care.

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TIMESTAMPS

00:00 - Introduction
01:39 - The Rise of Breast Cryoablation
06:40 - Challenges and Considerations in Cryoablation
07:59 - Patient Referral and Evaluation Process
13:35 - Equipment and Techniques for Cryoablation
23:29 - Procedure Steps and Needle Positioning
26:11 - Post-Procedure Thawing and Patient Expectations
28:35 - Post-Procedure Care and Follow-Up
34:20 - Future of Cryoablation in Breast Cancer Treatment
38:01 - Conclusion

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RESOURCES

FROST Trial
https://clinicaltrials.gov/study/NCT01992250

Brown et al., Strategies to Optimize Success in Breast Cancer Cryoablation, Journal of Vascular and Interventional Radiology
https://pubmed.ncbi.nlm.nih.gov/41083146/

What role does thyroid artery embolization play in contemporary thyroid cancer care? Dr. Juan Camacho, an interventional radiologist from Sarasota, Florida, joins host Dr. Sabeen Dhand to discuss how this emerging technique is reshaping the management of thyroid malignancies.

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SYNPOSIS

Dr. Camacho shares his experiences establishing a multidisciplinary team at Memorial Sloan Kettering Cancer Center dedicated to the management of thyroid malignancies, highlighting the critical role of collaboration in the successful implementation of this emerging treatment. He details key procedural techniques, emphasizing the importance of recognizing anatomic variations that can influence technical success. He also examines how arterial supply and lesion location inform procedural planning and decision-making, and outlines his technical approach to thyroid artery embolization, including the use of a radial artery access, catheter selection strategies, and the application of cone-beam CT for procedural optimization. Finally, he reviews his pre- and post-procedural management strategies, including the role of beta blockers in optimizing patient outcomes.

The discussion concludes with illustrative case studies demonstrating substantial reductions in thyroid volume and symptomatic relief, notably achieved without post-procedural hypothyroidism.

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TIMESTAMPS

00:00 - Introduction
03:31 - Pioneering Thyroid Ablation at Sloan Kettering
06:53 - The Need for Thyroid Artery Embolization
25:08 - Pre-Procedural Planning
32:41 - Embolization Technique and Procedure
44:48 - Choosing the Right Catheter for the Job
45:43 - Ensuring Patient Comfort and Safety
47:09 - High-Stakes Imaging and Safety Protocols
47:55 - Innovative Techniques and Case Studies
51:02 - Post-Procedure Management and Follow-Up
56:30 - Engaging with Endocrinology and Surgeons
01:00:00 - Case Studies and Practical Applications

A patient presents to the ER with hemoptysis. When is bronchial artery embolization (BAE) the right call, and what can you do to tip the odds of procedural success in your favor? In this episode of the BackTable Podcast, interventional radiologist Dr. Alexander Lam of UCSF shares his approach to bronchial artery embolization with host Dr. Ally Baheti.
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This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
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SYNPOSIS
The conversation covers why patients are referred for this procedure, the typical causes of bronchial artery hypertrophy, and Dr. Lam's preferred techniques for embolization, including the use of glue over traditional particles. Dr. Lam emphasizes the importance of multidisciplinary collaboration, detailed pre-procedure preparations, and recognizing potential complications.
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TIMESTAMPS
00:00 - Introduction
01:45 - Patient Evaluation
04:22 - Causes of Bronchial Hypertrophy
09:03 - Procedure Setup
10:35 - Catheter Selection and Techniques
13:35 - Embolic Choices and Techniques
19:39 - Understanding Different Types of Glue
22:48 - Continuous Push Technique
24:38 - Managing Complications and Success Rates
28:14 - Postoperative Instructions and Follow-Up
29:00 - Handling Difficult Bronchial Artery Selections
34:02 - Final Thoughts