Ep. 178 Challenging Stroke Thrombectomies with Tough Clot with Dr. Matt Gounis and Dr. Hannes Nordmeyer

Ep. 178 Challenging Stroke Thrombectomies with Tough Clot with Dr. Matt Gounis and Dr. Hannes Nordmeyer

Interventional Neuroradiologist Dr. Hannes Nordmeyer and Biomedical Engineer Dr. Matt Gounis discuss compositions of tough clots, approaches to stroke thrombectomy, and bailout stenting. --- CHECK OUT OUR SPONSOR CERENOVUS https://www.jnjmedicaldevices.com/en-US/companies/cerenovus --- SHOW NOTES In this episode, interventional neuroradiologist Dr. Hannes Nordmeyer, biomedical engineering professor Dr. Matt Gounis, and our host Dr. Michael Barraza discuss compositions of tough clots, approaches for stroke thrombectomy, and bailout stenting. Dr. Nordmeyer believes that interventionalists are still struggling to find the most effective method for pulling clots. He says that the use of double stent retrievers has shown high success rates, but it would be ideal to have one retriever that can work on its own. He describes his equipment setup for a standard large vessel occlusion. Dr. Nordmeyer notes clot location and behavior within the first two passes determines whether or not the operator should continue with the stent retrieval approach or change the approach. Dr. Gounis evaluates various devices by defining “success” as achievement of TICI 3 with the first pass. He comments on the current development of very large bore aspiration catheters, such as the 088 Millipede catheter and the Tenzing catheter. He also emphasizes that the success of the procedure relies largely on the composition of the embolus. Fibrin-rich clots are less likely to integrate with the stent retriever. We discuss Dr. Nordmeyer’s technique, which utilizes a microcatheter and the NIMBUS device to pin and retrieve the challenging clot. We also cover bailout stenting and the benefits of recanalization when clot removal is not possible. --- RESOURCES SWIFT DIRECT Trial: https://www.swift-direct.ch/the-swift-direct-trial/ Preclinical Evaluation of Millipede 088 Intracranial Aspiration Catheter: https://pubmed.ncbi.nlm.nih.gov/32606100/ The Novel Tenzing 7 Delivery Catheter Designed to Deliver Intermediate Catheters to the Face of Embolus Without Crossing: https://jnis.bmj.com/content/13/8/722 Factors Influencing Recanalization After Mechanical Thrombectomy With First-Pass Effect for Acute Ischemic Stroke: https://www.frontiersin.org/articles/10.3389/fneur.2021.628523/full NIMBUS Geometric Clot Extractor: https://www.jnjmedicaldevices.com/en-EMEA/news-events/cerenovus-launches-nimbustm-geometric-clot-extractor-remove-tough-clots

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Ep. 30 Transradial Access: Basic to Advanced with Dr. Aaron Fischman

Ep. 30 Transradial Access: Basic to Advanced with Dr. Aaron Fischman

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o72eK3 Our interventional radiologist guest Dr. Aaron Fischman gets into the details of his technique, equipment and tips/tricks for transradial access, as well as its advantages in a variety of IR interventions.

26 Kesä 201847min

Ep. 29 Interview with Interventional Initiative founders Isabel Newton and Susan Jackson

Ep. 29 Interview with Interventional Initiative founders Isabel Newton and Susan Jackson

An interview with Interventional Initiative founders Isabel Newton and Susan Jackson taking us through the journey behind the awe-inspiring Without A Scalpel documentaries, including some funny stories and more exciting things to come.

17 Kesä 201837min

Ep. 28 Advanced Enteral Access with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Ep. 28 Advanced Enteral Access with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/q7wJPr Dr. Jeffrey Chick and Dr. Ravi Srinivasa discuss what inspired them to start IRAD Lab, their advanced enteral access techniques, as well as a new technique for closing EC fistulas with laser!

7 Touko 201831min

Ep. 27 Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson

Ep. 27 Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/cGcyzt Our latest BackTable podcast on an exciting new therapy for osteoarthritis of the knee- Geniculate Artery Embolization! Our guests Dr. Ari Isaacson and Dr. Sandeep Bagla discuss their experiences and the immense potential this trans-arterial treatment has for management of people suffering from OA.

13 Huhti 201843min

Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck

Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck

Dr. Christopher Beck and Dr. Jason Iannuccilli discuss radial vs femoral access in IO procedures, including the pros and cons of both, and a very informative "how I do it" for radial access by Dr. Iannuccilli.

30 Maalis 201844min

Ep. 25 Declots and the Argon Cleaner Device with Dr. Sabeen Dhand and Dr. Chris Beck

Ep. 25 Declots and the Argon Cleaner Device with Dr. Sabeen Dhand and Dr. Chris Beck

In this episode, Dr. Sabeen Dhand joins Dr. Christopher Beck to discuss arteriovenous access declot procedure with the Argon Cleaner device. We review the routine declot procedure and the different methods to get access. Dr. Dhand explains why he starts out using the Argon Cleaner device and what his endpoint is. We discuss the nuances of the device in addition to tips and tricks for using the device with declots, including external massaging the fistula and an unsheathing trick.

20 Maalis 201813min

Ep. 24 Endoscopy for the Interventional Radiologist with Dr. Srinivasa and Dr. Chick

Ep. 24 Endoscopy for the Interventional Radiologist with Dr. Srinivasa and Dr. Chick

Jeffrey Chick and Ravi Srinivasa of University of Michigan VIR. In Episode 24 they explain the advantages of using simple to learn endoscopic techniques in gallbladder, biliary and genitourinary cases.

8 Maalis 201843min

Ep. 23 Adrenal Vein Sampling with Dr. Mike Devane

Ep. 23 Adrenal Vein Sampling with Dr. Mike Devane

The procedure that everyone gets excited about! In this week's BackTable podcast Mike Devane talks us through adrenal vein sampling technique, including equipment/imaging tips and tricks, as well as pitfalls to avoid. Whether looking to build an AVS service, or just preparing for that once in a blue moon case, you're certain to take away a few pearls!

20 Helmi 201822min

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