Ep. 216 Stick It — Glue Embo with Dr. Ziv Haskal

Ep. 216 Stick It — Glue Embo with Dr. Ziv Haskal

In this episode, host Dr. Aparna Baheti interviews interventional radiologist Dr. Ziv Haskal about the use of glue in peripheral applications. They discuss how to prepare and inject glue for portal vein embolization, type 2 endoleaks, and Dr. Haskal’s glue bullet technique. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES Dr. Ziv Haskal talks us through the use of glue in peripheral applications. He discusses how to prepare and inject glue for portal vein embolization, how to do the same for type 2 endoleaks, and also shares his glue bullet technique. Glue is only approved for neurointerventional procedures in the US, though there are many off-label uses where glue is the superior embolic. The benefit of glue is the power it gives to the operator. By manipulating the oil to glue ratio and thus the viscosity, the operator has control of how far the glue will travel when injected which makes it a very versatile liquid embolic. Dr. Haskal commonly uses glue for portal vein, bronchial, lumbar and intercostal embolizations as well as in coagulopathic patients. Dr. Haskal advises that one of the easiest places to start using glue is portal vein embolization. To prepare glue for a procedure, Dr. Haskal separates it from the rest of the back table, and always uses new gloves and a separate set of equipment. For a portal vein embolization, Dr. Haskal runs a microcatheter paraxially alongside the safety wire and makes U-turns into portal vein branches that he is targeting. For treating renal pseudoaneurysm or for finishing a coil embolization, Dr. Haskal uses the glue bullet method, which involves loading a syringe with dextrose and only a tiny amount of glue at the top of the syringe. Regarding complications of glue, Dr. Haskal says that though many fear the glue solidifying and causing the catheter to get stuck in a vessel, the likelihood of this is near zero because the glue does not harden fast enough for this to happen. The most common complication is over embolization and downstream spillage, which can be problematic in end organ supply vessels. Finally, Dr. Haskel explains his technique for when the glue starts solidifying around the catheter which creates a glue tail catheter is drawn back. --- RESOURCES Glue for Type 2 Endoleak: https://www.jvir.org/article/S1051-0443(18)30849-2/fulltext Global Embolization and Symposium Technologies (GEST): https://www.gestweb.org

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Ep. 39 Better Biopsies With Dr. Thor Johnson

Ep. 39 Better Biopsies With Dr. Thor Johnson

Dr. Thor Johnson discusses his experience with the Argon BioPince biopsy needle for liver, renal and soft tissue biopsies, including tips and tricks for obtaining better biopsy samples with fewer passes. Recorded at SIR 2019 in ATX.

25 Maalis 201912min

Ep. 38 Special guest Physician on Fire (POF) talks financial independence for physicians

Ep. 38 Special guest Physician on Fire (POF) talks financial independence for physicians

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/GfYFHp Physician on FIRE (PoF) founder Dr. Leif Dahleen discusses financial independence for physicians. Leif created his platform to inform and inspire physicians with insightful writing after he attained financial independence and the freedom to retire early. More information at physicianonfire.com

20 Helmi 201951min

Ep. 37 Treating PAD in the OBL with Dr. Mike Watts and Dr. Omar Saleh

Ep. 37 Treating PAD in the OBL with Dr. Mike Watts and Dr. Omar Saleh

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/9HpSIv Special guests Dr. Mike Watts and Dr. Omar Saleh discussing the ins and outs of treating PAD in the Outpatient Based Lab (OBL) setting. Includes great info on practice building, patient safety, and essential equipment. #irad #miips

7 Tammi 201957min

Ep. 36 Building the UFE and OBL practice with Dr. Mary Costantino

Ep. 36 Building the UFE and OBL practice with Dr. Mary Costantino

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/HRWoTs Dr. Mary Costantino tells us the story of how she built her OBL practice in Portland and discusses the advantages of performing UFE and other procedures in the outpatient setting.

19 Joulu 201852min

Ep. 35 OTW Technique for IVC filter placement with Dr. David Mobley

Ep. 35 OTW Technique for IVC filter placement with Dr. David Mobley

Dr. David Mobley of Columbia University VIR describes his over-the-wire technique to prevent tilting in IVC filter placement. Special thanks to our sponsor Argon Medical.

12 Marras 201818min

Ep. 34 Spinal Ablation Therapies with Dr. Peder Horner

Ep. 34 Spinal Ablation Therapies with Dr. Peder Horner

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/t4Ocb0 Our second podcast recorded live from Western Angiographic (WAIS) conference in Maui 2018! Dr. Sabeen Dhand interviews Dr. Peder Horner on how he built a spinal tumor ablation practice in Denver, CO, including tips/tricks on equipment and patient selection.

11 Loka 201824min

Ep. 33 Building a Comprehensive Vein Practice with Dr. Brooke Spencer

Ep. 33 Building a Comprehensive Vein Practice with Dr. Brooke Spencer

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/tNgPeU Dr. Brooke Spencer gets into the pearls and pitfalls of building a comprehensive vein practice, including a detailed discussion on the treatment of May-Thurner and Pelvic Congestion syndrome.

9 Loka 201838min

Ep. 32 Building an Interventional Oncology Program with Dr. Zaetta and Dr. Stanton

Ep. 32 Building an Interventional Oncology Program with Dr. Zaetta and Dr. Stanton

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/a114SU Interventional Radiologist Dr. Julie Zaetta and Oncologist Dr. Julie Stanton discuss the essentials of building a successful Interventional Oncology program, including the importance of a multidisciplinary approach.

8 Syys 201835min

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