As endovascular technologies evolve, how are IRs maximizing control while minimizing metal in modern venous embolization? In this episode of the BackTable Podcast, Dr. Harris Chengazi joins host Dr. Sabeen Dhand to discuss the clinical impact, deployment techniques, and imaging advantages of modern vascular point embolization devices, focusing on targeted venous occlusion and variceal obliteration.

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This podcast is supported by

Okami Medical
https://okamimedical.com/

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Timestamps

00:00 - Introduction
02:22 - Multidisciplinary Vascular Practice Model
05:51 - Understanding Plugs in Embolization
08:34 - Comparing Plugs, Coils, and Liquid Embolics
13:48 - LOBO Occlusive Device
16:12 - Plug Sizing and Vessel Measurement
20:45 - Deliverability and Catheter Selection
24:28 - Limitations of Point Embolization
29:03 - PARTO Access and Technique
32:46 - Other LOBO Use Cases
34:33 - LOBO Deployment Mechanism
36:23 - Cost Effectiveness of Embolics
41:08 - Final Thoughts and Closing Remarks

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More about this episode

Dr. Chengazi shares insights from incorporating vascular plugs into his embolization practice after training predominantly with coils. He highlights the features that distinguish modern devices like the LOBO from traditional plugs, including their unique nitinol weave, rapid occlusion, and predictable sizing and landing configuration. The physicians explore the utility and limitations of plugs in clinical scenarios including retrograde transvenous variceal obliteration, antegrade variceal embolization during TIPS creation, and tract embolization following percutaneous procedures. Dr. Chengazi furthermore shares specific procedural pearls for point embolization of varices, explaining how to facilitate deployment using a parallel access technique as well as how to position multi-lobed plugs across venous outflow segments to reliably treat large shunts with a single device. Finally, the physicians review the benefits of reduced imaging artifact on follow-up scans compared to traditional coil packs and liquid embolics as well as the impact of modern plug technology on healthcare costs, reinforcing the value of evidence-based device selection for optimal patient outcomes.

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Resources

Kundaragi NG, et al. Measurement of Inferior Vena Cava to Shunt Distance in Deciding Access Route for Balloon-Occluded Retrograde Transvenous Obliteration Procedure: A Pilot Study. Am J Interv Radiol. 2018 Sep 19;2(16):1-9.
https://dx.doi.org/10.25259/AJIR-22-2018

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BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

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