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. 52 IVUS for Iliac Vein Compression with Dr. Mark Lessne and Dr. Mike Cumming

Ep. 52 IVUS for Iliac Vein Compression with Dr. Mark Lessne and Dr. Mike Cumming

Dr. Michael Cumming and Dr. Mark Lessne discuss the utility of Intravascular Ultrasound (IVUS) in the diagnosis and treatment of Deep Venous Disease, including patient selection, appropriate assessment of stenoses and assistance with stent placement. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ySM6hy

11 Marras 201944min

Ep. 51 Cone Beam CT Technique with Dr. Austin Bourgeois

Ep. 51 Cone Beam CT Technique with Dr. Austin Bourgeois

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zGhYib Austin Bourgeois and Dr. Christopher Beck discuss ways you can improve your Cone Beam imaging for liver directed therapy, prostate artery embolization and how it can be used to improve safety of other procedures, such as G-tube placement.

30 Loka 201944min

Ep. 50 Practicing IR in India with Dr. Deepa Shree

Ep. 50 Practicing IR in India with Dr. Deepa Shree

Dr. Deepa Shree tells us about the challenges she faced building her IR practice in Chennai, and how she is spreading awareness of the specialty and training new IRs to help serve the need throughout India.

13 Loka 201948min

Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen

Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Ucy8jI Director of IR Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care.

30 Syys 201929min

Ep. 48 IR and ENT Treatment of Epistaxis with Dr. Ashley Agan and Dr. Sabeen Dhand

Ep. 48 IR and ENT Treatment of Epistaxis with Dr. Ashley Agan and Dr. Sabeen Dhand

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xQPc7h In this episode, Dr. Ashley Agan and Dr. Sabeen Dhand join Dr. Gopi Shah to discuss IR and ENT treatment of epistaxis. We cover the differences in how epistaxis presents for ENT and IR as well as how epistaxis presents in children and older patients. Dr. Agan tells us about the types of nosebleeds that are common and the general treatment algorithm she follows. We discuss nasal packing and decongestant sprays for treatment and how to know when to take the patient to the OR. Dr. Agan talks about isolating the bleeding spot, how to use a foley for posterior nosebleeds, and SPA litigation. We discuss why ENT might consult IR for an embolization. Dr. Dhand tells us about the contraindications for embolization and the procedure for treating the epistaxis. We review the materials that should be used and why it is important to look out for artery connections and pseudoaneurysms. We discuss the pearls and pitfalls of ENT and IR treatment of epistaxis and how to avoid the risk of stroke.

30 Elo 201933min

Ep. 47 BRTO vs. PARTO and other Techniques with Dr. Luke Wilkins

Ep. 47 BRTO vs. PARTO and other Techniques with Dr. Luke Wilkins

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ZvpYnL Special Guest Dr. Luke Wilkins of University of Virginia VIR discusses BRTO and PARTO techniques for treatment of gastric variceal bleeding.

18 Elo 201941min

Ep. 46 Collaboration not Competition between IR and IC with Dr. Achal Sahai and Dr. Chris Beck

Ep. 46 Collaboration not Competition between IR and IC with Dr. Achal Sahai and Dr. Chris Beck

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/bobcIg Interventional Cardiologist (IC) Dr. Achal Sahai and Interventional Radiologist (IR) Dr. Christopher Beck discuss ways these two specialties collaborate on complex cases, share endovascular techniques, and avoid the "turf war" trap.

31 Heinä 201945min

Ep. 45 Coping with Complications with Dr. Maureen Kohi and Dr. Sandeep Bagla

Ep. 45 Coping with Complications with Dr. Maureen Kohi and Dr. Sandeep Bagla

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/uVVOw3 Dr. Maureen Kohi from UCSF Medical Center and Dr. Sandeep Bagla from Vascular Institute of Virginia discuss the challenges of dealing with procedural complications, and the importance of talking with colleagues and mentors in effective coping.

1 Heinä 201959min

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