PET CT could change which patients end up in the cath lab—and which ones don’t.

This episode gets into the heart tests, stents, and real-world decisions cardiologists debate every day.

The Blue Collar ICs crew sits down with interventional cardiologist Steve to break down stress PET CT versus traditional nuclear stress testing, coronary flow reserve, microvascular disease, calcium scores, coronary CTA, and the limits of testing anatomy without physiology. They also debate when a severe coronary blockage should actually be stented, where drug-coated balloons fit into PCI, and whether CT-guided PCI planning is genuinely useful or just another trend.

The conversation also goes beyond the cath lab into private practice, hospital employment, cardiology economics, EP demand, and why experience doing cases every day matters.

Topics include PET CT, stress testing, myocardial ischemia, coronary artery disease, coronary flow reserve, microvascular disease, calcium scoring, coronary CTA, PCI, stents, drug-coated balloons, interventional cardiology, private practice, and the cath lab.

Subscribe to Blue Collar ICs for straight talk from cardiologists working on the front lines—and share this episode with someone who lives in the cath lab.

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A massive clot crossing into the left atrium. A career rebuilt at 35. And the daily reality of working inside a busy cath lab.

This episode of Blue Collar ICs features James “JP” Pierce, Cath Lab Director at Lane Regional Medical Center in Zachary, Louisiana. JP shares how he went from industrial work to radiology and ultimately found his calling in the cath lab, where he’s spent 17 years taking on just about every role imaginable.

The crew also gets into the cases that make interventional cardiology unpredictable: a complex saddle pulmonary embolism with thrombus crossing into the left atrium, a severely thrombosed peripheral graft, left bundle branch pacing, drug-coated balloons, protected PCI, and the decisions operators have to make when there’s no perfect answer.

Plus, JP shares his firsthand experience seeing AeroShield in action and discusses why radiation protection, workflow, staff safety, and career longevity are becoming bigger conversations inside the cath lab.

Topics include interventional cardiology, cath lab careers, complex PCI, pulmonary embolism, thrombectomy, peripheral vascular intervention, radiation exposure, radiation protection, patient safety, medical devices, and real-world cath lab workflow.

Subscribe to Blue Collar ICs, follow the show on social media, and share this episode with someone who lives the cath lab life.

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Fem-pop Intervention in 2026 brings together three experienced interventional cardiologists for a practical discussion on today's approach to femoropopliteal (SFA and popliteal) interventions.

Dr. Bill Dixon, Dr. Brian Brown, and special guest Dr. Jason Yoho compare their real-world techniques for CTO crossing, IVUS-guided vessel preparation, atherectomy, intravascular lithotripsy (IVL), drug-coated balloons, specialty stents, and managing complex PAD and CLI patients. Rather than presenting a single "right" answer, they explain how lesion characteristics, patient anatomy, practice setting, and available technology all influence treatment decisions.

This episode is proudly sponsored by Veryan Medical and features discussion of the BioMimics 3D® Vascular Stent System, a helical stent engineered for the dynamic environment of the superficial femoral artery (SFA) and distal popliteal artery. Throughout the conversation, Dr. Jason Yoho shares his extensive clinical experience using the BioMimics 3D stent and discusses how its helical design helps accommodate the biomechanical forces of the femoropopliteal segment.

Topics covered:

• Fem-pop intervention strategies
• SFA CTO crossing techniques
• IVUS-guided treatment planning
• Atherectomy vs. IVL vs. drug-coated balloons
• Stent selection and vessel scaffolding
• Popliteal and common femoral interventions
• Managing in-stent restenosis
• Limb salvage for CLI patients
• OBL vs. hospital practice considerations

Special thanks to Veryan Medical for sponsoring this episode and supporting education in peripheral vascular intervention.

Subscribe for more real-world conversations from the front lines of interventional cardiology.

#PeripheralArteryDisease #PAD #InterventionalCardiology #Endovascular #FemPop #SFA #CLI #LimbSalvage #BlueCollarICs

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Not all vascular closure devices are created equal—and this conversation proves it. Dr. Kenneth Rosenfield joins Blue Collar ICs for an honest discussion on femoral access, radial access, carotid stenting, and what really works in the cath lab.

Fresh off receiving the TCT Lifetime Achievement Award, Dr. Kenneth Rosenfield joins Jordy Colada, Dr. Bill Dixon, Dr. Brian Brown, Todd Flor, and special guest David Gunther for an unfiltered conversation about vascular closure. The discussion covers real-world experience with femoral versus radial access, carotid artery stenting, Shockwave IVL, CELT Closure, Perclose, Angio-Seal, manual compression, large-bore access, and why operator experience still matters more than marketing.

Whether you're an interventional cardiologist, vascular specialist, cath lab professional, fellow, or simply interested in modern cardiovascular medicine, this episode delivers practical insights from physicians performing these procedures every day.

Topics include:

• Carotid stenting techniques

• NeuroGuard system

• Shockwave IVL for carotid disease

• Femoral vs radial access

• Snuffbox radial access

• Vascular closure devices compared

• CELT vs Perclose vs Angio-Seal

• Manual compression techniques

• Large bore access and Impella closure

• Cath lab workflow and efficiency

If you enjoy real conversations from physicians doing the work every day, subscribe to Blue Collar ICs, leave a review, and share this episode with your cath lab team.

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The Blue Collar ICs crew takes on one of the hottest debates in cardiology: should every PCI be guided by intracoronary imaging?

From IVUS and OCT to AI-assisted decision making, the team discusses where imaging helps, where it doesn't, and whether operator experience still matters most.

This episode opens with reflections from NCVH in New Orleans, where the team discusses the conference's impact, live case demonstrations, and the relationships that continue to shape interventional cardiology. Guest Dr. Aaron Gopal joins the conversation, sharing how training under Dr. Craig Walker and working alongside Dr. Brian Brown influenced his approach to patient care.

The discussion then shifts into a deep dive on intracoronary imaging, specifically IVUS and OCT. The panel examines how different generations of operators were trained, how imaging has evolved over time, and whether routine use truly leads to better outcomes. The debate highlights the tension between evidence-based medicine, operator experience, and industry influence.

The conversation expands into AI-assisted imaging, coronary physiology, pressure-wire assessment, and the future of PCI. The group explores whether modern technology is improving clinical decision-making or creating dependence that could weaken future physician training. As always, the discussion remains candid, practical, and grounded in real-world experience.

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In this episode of Blue Collar ICs, the conversation shifts from the cath lab to the journey that creates physicians in the first place.

From handwritten medical school applications and 36-hour call shifts to Zoom interviews, gap years, and pass/fail boards, the crew compares what medical education looked like decades ago versus today.

Joined by future physician Eva, family medicine resident Dr. Ann Marie Brown, and veteran cardiologists Dr. Bill Dixon and Dr. Brian Brown, the discussion explores how training, expectations, and physician culture have evolved across generations.

The episode dives into:

• The reality of residency work hours
• Whether today’s training is better or softer
• How difficult it’s become to get into medical school
• The rise of gap years and application pressure
• Burnout, sacrifice, and continuity of care
• Why medicine is still ultimately about passion and purpose
• 
  

It’s a candid, funny, and surprisingly personal conversation about the making of a doctor—and whether the system is preparing the next generation the right way.

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In this episode of Blue Collar ICs, the crew tackles one of the biggest questions in interventional cardiology right now:

Is Impella dead?

Following the latest trial data presented at ACC, including DTU and BSIS-3, the discussion dives deep into what the results actually mean—and what they don’t. Featuring insights from Dr. Amir Kaki and longtime industry expert Jim Schubert, the conversation explores the gap between clinical trials and real-world practice.

From bleeding complications and patient selection to high-risk PCI strategy and cardiogenic shock, this episode breaks down where Impella fits today—and where it’s headed next.

The takeaway? The data may be mixed, but the story is far from over.

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In this episode of Blue Collar ICs, the conversation goes beyond the cath lab and into the world of medical device innovation, startups, and what it really takes to bring an idea to life.

Interventional radiologist Dr. Jeffrey Hull and startup veteran Rob Williamson join the show to break down the full journey—from identifying real clinical problems to navigating patents, funding, FDA approval, and reimbursement.

The discussion dives into the realities most people never see: raising capital, surviving “near-death” moments, building the right team, and why most ideas never make it to market. Along the way, the group shares insider stories from companies like Shockwave Medical and explores what separates successful innovations from expensive failures.

If you’ve ever had an idea in the cath lab—or wondered how breakthrough devices actually happen—this episode is a must-listen.

#Cardiology #MedDevice #HealthcareInnovation #CathLab #BlueCollarICs

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In this episode of Blue Collar ICs, the crew is joined by Louise Caron, taking listeners inside a real day in the cath lab. The kind of day that doesn’t follow a script.

What starts as a joking line during the conversation quickly turns into the theme of the episode: the unpredictable decisions interventional cardiologists face every day. From borderline lesions and complex anatomy to the judgment calls that can’t be taught in a textbook, the discussion dives into how experience, instinct, and teamwork shape what actually happens at the table. Bill Dixon, Brian Brown, Todd Flohr and Louise Caron share candid stories, clinical insights, and the kind of cath-lab conversations that normally happen after the case is over.

It’s an honest look at the real-world decision-making that defines interventional cardiology—a true day in the lab.

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In this episode of Blue Collar ICs, the conversation goes beyond devices and data to tackle one of the most misunderstood parts of interventional cardiology: the physician–industry relationship.

Bill Dixon, Brian Brown, Todd Fuller, and Jordi Colada are joined by industry veterans Jessica McCormick and Reid Rucker for a candid discussion on what actually builds trust in the cath lab—and what gets reps quietly shut out. From emotional intelligence and timing to quotas, pressure, and reading the room, this episode breaks down the unwritten rules that define successful collaboration.

The group dives into the differences between pharma and device culture, common mistakes on both sides of the table, and why adding value—not selling—earns long-term credibility. Honest stories, sharp humor, and real-world lessons make this a must-listen for physicians, reps, and anyone navigating high-stakes procedural medicine. 

Blue Collar IC_s 2-4-26

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