Ep. 126 TIPS University Senior Year: Gunsight Technique and Splenic Closure with Dr. Lynskey

Ep. 126 TIPS University Senior Year: Gunsight Technique and Splenic Closure with Dr. Lynskey

It's Senior Year at TIPS University with Dr. Emmett Lynskey talking us through his Gunsight technique for TIPS placement, as well as how to perform a safe closure of splenic access. Don't miss the first three parts of the series as well! --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/MThuo7 --- SHOW NOTES In this episode, Dr. Emmett Lynskey joins Dr. Chris Beck for the final edition of TIPS University to discuss the gunsight technique and splenic closure. We begin by discussing where to start once the catheter is in the portal vein and you have access, and Dr. Lynskey shares why he likes to use a 8mm balloon for the angioplasty. We explain the details of the gunsight technique, how to line up the portal and hepatic snare, how to adjust the view, and how to get access to both veins using a 22 gauge chiba needle. We share why it is important to make sure that the cranial caudal difference between the portal and hepatic snare is not significant before you gunsight. We discuss how to work with wires to floss through the splenic vein. Dr. Lynskey tells us why he uses a microcatheter for an extra step instead of snaring the end of the wire. We review some situations where you can throw the snare up and stick it with a colapinto needle and some of the considerations for portal vein thrombosis when doing TIPS. We discuss splenic access and why it is important to set up for good closure. We explain the different options for splenic access, using a combination of coils, plugs, and gelfoam, and Dr. Lynskey shares which combinations he prefers to use for splenic closure. We review the technique to get images using fluoro and ultrasound.

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Ep. 620 Ergonomic Strategies for Radiologists: Preventing Back & Neck Pain with Dr. Keith Horton

Ep. 620 Ergonomic Strategies for Radiologists: Preventing Back & Neck Pain with Dr. Keith Horton

Better habits start now. Poor ergonomics in the angio suite lead to cumulative neck and back injuries, absenteeism, presenteeism, and even early retirement. This episode of the BackTable Podcast offer...

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Ep. 619 Clinical Insights: Managing LUTs in BPH Patients with Dr. Art Rastinehad

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Prostate artery embolization may be performed by interventional radiologists, but its indications are rooted in urologic evaluation. In the second installment of our 2026 PAE University Series, Dr. Ch...

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Ep. 618 How to Manage Advanced DVA Cases: Techniques & Tips with Dr. Kumar Madassery

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How do experienced operators approach the most technically demanding aspects of deep venous arterialization (DVA)? In this episode of BackTable, host Dr. Sabeen Dhand sits down with Dr. Kumar Madasser...

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Ep. 617 Cybersecurity Essentials for Medical Professionals with Didier Jourdain

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Think your medical practice is safe from hackers? Learn why humans, rather than software, are often the weakest link in patient data protection. In this episode of the BackTable Podcast, host Dr. Chri...

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Ep. 616 Exploring Unique Outpatient Models in Interventional Radiology with Dr. Richard Daniels

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Ep. 615 Exploring Intravascular Lithotripsy in Below the Knee CLTI with Dr. Constantino Peña

Ep. 615 Exploring Intravascular Lithotripsy in Below the Knee CLTI with Dr. Constantino Peña

As new calcium-modifying technologies expand the repertoire of below-the-knee (BTK) arterial disease interventions, how should your treatment algorithm evolve, and what endpoints matter most? In this ...

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Ep. 614 Interventional Radiology’s Evolution: Insights from Dr. Ernest Ring

Ep. 614 Interventional Radiology’s Evolution: Insights from Dr. Ernest Ring

Have you ever wondered what it was like to be in the room when the first pelvic embolization was performed or how the TIPS procedure was pioneered? Dr. Ernie Ring, a legendary figure from UCSF and a t...

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Ep. 613 Microwave Ablation in Renal Tumors with Dr. Steven Huang

Ep. 613 Microwave Ablation in Renal Tumors with Dr. Steven Huang

You’re about to biopsy a renal lesion; should you ablate at the same time? In this episode of the BackTable Podcast, host Michael Barraza talks with Dr. Steven Huang from MD Anderson Cancer Center abo...

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