Ep. 327 Building a Pain Interventions Service Line with Dr. Stephen Hunt
BackTable Vascular & Interventional29 Touko 2023

Ep. 327 Building a Pain Interventions Service Line with Dr. Stephen Hunt

In this episode, host Dr. Michael Barraza interviews Dr. Stephen Hunt about building a pain practice, including his nerve ablation technique, how to obtain referrals, and why it is one of the most rewarding procedures that he does. --- SHOW NOTES We begin by discussing what caused Dr. Hunt to start building a pain service. He was treating many patients with lung cancer, and he saw so many patients toward the end of their life. What they wanted was to reduce their suffering due to pain. He saw what was being offered for them, which was opioids, but this caused them to be disconnected from their families at such an important time in their life. He knew he could offer nerve blocks and ablation, so he began educating himself. As he learned about different blocks, he adapted them to create his own technique. Pretty soon, word got out that he was doing this, and he started getting referrals from oncologists. Soon after this, thoracic surgeons and breast surgeons began referring to him for post-thoracotomy and post-mastectomy pain. Next, radiation oncologists referred their patients with radiation necrosis of the ribs, and orthopedic surgeons referred patients to him for pain from musculoskeletal metastases. For his technique, he often starts with a test block using bupivacaine and triamcinolone, which prolongs the effect of the bupivacaine and provides relief for around two weeks. For the ablation, he does the block in the same way, waits 15 minutes, and then injects ethanol to ablate the nerve. Some tips he has learned for celiac ablation are to ablate the retrocrural splanchnic nerves, because they feed into the celiac, and you will get a better result. Other areas he commonly ablates are intercostal nerves. For these, to avoid devastating paralysis from damage to the spinal cord, he always orients his needle lateral and stays at least two inches away from the spine. He advises those new in pain interventions to remember your anatomy. In radiology, we learn it all, and if you remember these nerves, you will be able to help a lot of people with their pain and decrease their suffering, making an enormous impact on someone’s quality of life. --- RESOURCES PIGI Lab: https://www.med.upenn.edu/pigilab/ Twitter: @PigiLab @md_rogue

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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

Ep. 22 Central and Upper Extremity Venous Interventions with Dr. Mark Lessne and Dr. Sabeen Dhand

Ep. 22 Central and Upper Extremity Venous Interventions with Dr. Mark Lessne and Dr. Sabeen Dhand

Central and Upper Extremity Venous Interventions with Dr. Mark Lessne of Charlotte Radiology and Dr. Sabeen Dhand of PIH Health. In this episode our docs discuss central recanalizations, ballooning versus stents, declot techniques, and get into a ton of tips and tricks!

6 Helmi 201858min

Ep. 21 Vertebral Augmentation with Dr. Venu Vadlamudi and Dr. Kumar Madassery

Ep. 21 Vertebral Augmentation with Dr. Venu Vadlamudi and Dr. Kumar Madassery

Vertebral augmentation can be accomplished through various techniques - Dr. Venu Vadlamudi and Dr. Kumar Madassery shed light on the utility of kyphoplasty versus vertebroplasty when treating compression fractures of the spine.

28 Tammi 201837min

Ep. 20 Pressure-Directed Therapy in TACE with Dr. Justin Lee and Dr. Terence Gade

Ep. 20 Pressure-Directed Therapy in TACE with Dr. Justin Lee and Dr. Terence Gade

Our 20th BackTable podcast episode featuring special guests Dr. Justin Lee of Florida Interventional Specialists, and Dr. Terence Gade of Hospital of University of Pennsylvania. They discuss experiences and utility of pressure-directed, antireflux infusion for TACE treatments.

20 Tammi 201844min

Ep. 19 Lymphatic Interventions with Dr. Chick and Dr. Srinivasa

Ep. 19 Lymphatic Interventions with Dr. Chick and Dr. Srinivasa

Our holiday episode featuring Dr. Jeffrey Chick and Dr. Ravi Srinivasa of University of Michigan. They sit fireside with our host J. Michael Barraza Jr. to discuss lymphatic interventions in IR.

27 Joulu 201748min

Ep. 18 Complex LE Venous Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Ep. 18 Complex LE Venous Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Dr. Jeffrey Chick and Dr. Ravi Srinivasa discussing complex lower extremity venous interventions at University of Michigan VIR.

18 Joulu 201756min

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