Ep. 289 Treating Clot in Transit with Dr. Rehan Quadri

Ep. 289 Treating Clot in Transit with Dr. Rehan Quadri

In this episode, host Dr. Michael Barraza interviews Dr. Rehan Quadri, interventional radiologist, about the definition, indications and techniques for treating clot in transit. We begin by defining and describing when to treat clot in transit. Traditionally, the definition is the washing machine mobile clot in the right atrium (RA) or right ventricle (RV). In these situations, the next place for the clot to travel is the pulmonary artery (PA). Mortality in these cases can reach as high as 30%, which is why these cases are considered emergencies. There is another category of clot in transit where a clot is partially adhered to a vessel wall, catheter, or heart valve. They are most commonly diagnosed via an echocardiogram, or found incidentally on a CT angiogram. They commonly present as catheter malfunction with symptoms resembling SVC syndrome. Dr. Quadri explains his usual method for retrieving clot in transit, though he notes each case is complex and different depending on the etiology and the overall status of the patient. In general, unless there is a massive PE, he treats the clot in transit before the PE. He always ensures with the preoperative echocardiogram that there is no interatrial shunt or patent foramen ovale (PFO). At the beginning of the case he checks PA and RA pressures. He uses a 24 French Inari Flowtriever with FLEX technology, which helps with tough angles. He uses ICE guidance in all clot in transit cases. To help with orientation when using the ICE catheter, he recommends pointing it anteriorly while entering the RA, then using the Eustachian ridge, an echogenic line in the RA, to confirm you are in the RA and indicating that you should see the tricuspid valve as you advance. He uses the FlowSaver device, and always has 2 units of blood in the room just in case. At the end of the case, he remeasures the PA pressures, then injects through the Inari sheath to verify that there is no residual before finally doing a pulmonary arteriogram. He sends all the clots to pathology, and has seen that the morphology is usually mixed, with some organized fibrin in addition to acute thrombus.

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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

Ep. 31 Cosmetic IR and Marketing Tips with Dr. Aaron Shiloh

Ep. 31 Cosmetic IR and Marketing Tips with Dr. Aaron Shiloh

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RKhFhu Dr. Aaron Shiloh of PA Vascular Institute discusses his experiences adding Cosmetic IR procedures to his practice, as well as some essential online marketing strategies for IRs.

16 Heinä 201839min

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

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