In this episode, Joshua Krieger interviews two interventional radiologists, Dr. Erica Knavel Koepsel and Dr. Cliff Weiss, and they sit down to explore how an Interventional MRI Suite moves the clinician from x-ray–based "seeing" to radiation-free "treating." Their conversation highlights relief from the hidden orthopedic and radiation burdens on staff and patients, the real-time precision that surpasses fusion techniques, and the new frontier these advances open for tackling the most complex IR cases.

Dr. John Kaufman explores prevailing perceptions around IVC filter utilization with Dr. Sarah White and Dr. Sebouh Gueyikian. They examine the operational and system-level challenges that impact follow up and retrieval, and they highlight proven strategies that support effective retrieval programs. Recent studies reaffirm the safety and real-world value of IVC filters when used appropriately. Through open dialogue, they aim to reinforce confidence in established, consistent filter technologies and to share actionable approaches that help teams optimize retrieval, follow up, and long-term patient outcomes in real world settings.

As embolization tools continue to expand, operators are increasingly adopting hybrid approaches that combine coils with liquid and other embolic agents. In this episode, Dr. Raj Ramaswamy, Dr. Nevin de Korompay, and Dr. Seetharam Chadalavada, interventional radiologists from diverse practice settings discuss how embolization has evolved in their practices and how they approach tool selection on a case‑by‑case basis. Through real‑world examples and shared experiences, the panel highlights clinical reasoning, evolving practice patterns, and differing perspectives on where embolization is headed—grounded in practical, everyday cases rather than device‑driven debate.

During this session Dr. Daniel Yung-Ho Sze dives deep into conversation with Dr. Amy Deipolyi about how she expanded the role of ketamine sedation in everyday IR practice, focusing on how ketamine fills the growing gap between traditional fentanyl and midazolam sedation and general anesthesia. The talk reviews why ketamine is uniquely suited to IR by offering reliable dissociative sedation with hemodynamic stability and preserved airway reflexes, while addressing the practical barriers of privileging, nursing scope of practice, and institutional policy. Results from a randomized trial are presented alongside real-world workflow, dosing, contraindications, and patient experience. The session concludes by outlining how ketamine can safely expand access, reduce anesthesia bottlenecks, and keep IR teams in control when it is administered within clear safety and governance frameworks.

¿Cómo están las nuevas tecnologías y la planificación cuidadosa transformando los resultados en las intervenciones biliares percutáneas? En este episodio de la serie de pódcast Cook@ SIR, el Profesor Mariano Giménez, reconocido experto en intervenciones mínimamente invasivas y biliares, comparte su amplia experiencia en procedimientos biliares percutáneos. Habla sobre la evolución tecnológica, incluyendo catéteres hidrofílicos y técnicas avanzadas de imagen, y destaca la importancia de una planificación cuidadosa y la selección de materiales. El Profesor Giménez resalta el valor de la formación mediante simulación y explora innovaciones futuras como los catéteres inteligentes y la inteligencia artificial. La conversación ofrece perspectivas valiosas para optimizar los resultados en los pacientes y los avances continuos en la intervención biliar.

How can better awareness and open conversations transform the lives of women with fibroids? Dr. John Lipman and Ms Black USA 2025, Elizabeth Perry, dive deep into the challenges women—especially women of color—face with uterine fibroids, and they discuss the minimally invasive, non-surgical treatment option called uterine fibroid embolization (UFE). Elizabeth shares her powerful personal journey, from years of debilitating symptomsand repeated surgeries to restored health and advocacy, highlighting the importance of patient education, provider accountability, and community support. Together, they call for greater awareness, honest dialogue, and access to non-surgical options like UFE. They urge both patients and healthcare professionals to change the surgery-only narrative and empower women with all of the fibroid treatment options to allow them to make the most informed decision about their health.

How has the evolution of portal vein recanalization with TIPS (PVR-TIPS) changed the outlook for patients with chronic portal vein occlusion and portal hypertension? Dr. Siobhan Flanagan is joined by Dr. Steven Sauk and Dr. Nassir Rostambeigi to explore the expanding clinical impact of PVR-TIPS, from transforming "impossible" TIPS cases into viable procedures to improving transplant candidacy and quality of life.

The panel dives into technical approaches, patient selection, and the importance of multidisciplinary teamwork, with a special focus on challenging disease states like cirrhosis, chronic pancreatitis, and non-cirrhotic portal vein thrombosis. Candid stories of complications, lessons learned, and practical pearls round out this honest conversation about the risks and rewards of complex portal venous interventions.

How do you go from anxious first presentations to confidently speaking at national scientific meetings in interventional radiology? Dr. Parag Patel is joined by Dr. Jason Wong and Dr. Kaila Redifer Tremblay to share candid stories, practical strategies, and lessons learned from their own journeys to the podium. The panel discusses overcoming imposter syndrome, tailoring talks for different audiences, the value of preparation and mentorship, and the importance of starting local and building your network through society involvement and committee work.

What does it take to bring innovative embolization procedures like prostate artery embolization (PAE) and genicular artery embolization (GAE) into the outpatient setting? Dr. Kavi Devulapalli and Dr. Jerry Niedzwiecki share their experiences pioneering these treatments in office-based labs (OBLs), highlighting the clinical benefits, patient selection strategies, and workflow efficiencies that come with outpatient care. The conversation dives into real-world challenges, including reimbursement hurdles and the importance of advocacy and data collection through societies like OEIS. Gain practical insights on responsible practice, collaboration, and how building robust clinical evidence is key to advancing the field and securing patient access.

How is interventional MRI (iMRI) changing the landscape for precision cancer care and complex procedures? Joshua Krieger of Cook Medical and Dr. Kavi Krishnasamy, Head of Interventional Oncology at UAB, discuss the launch of a new Interventional MRI Suite developed in partnership with Siemens Healthineers. They explore the clinical advantages of real-time, radiation-free imaging, the rapid learning curve for CT-trained physicians, and the potential to treat small or difficult-to-reach lesions that were previously inaccessible. They highlight workflow innovations, training considerations, and how this technology is poised to expand the interventional radiology toolkit, offering new hope for patients and new possibilities for practitioners.