BackTable Vascular & Interventional12 Kesä 2023

Ep. 331 EVUS to IVUS: a Continuous Spectrum with Dr. Jill Sommerset and Dr. Fadi Saab

In this episode, host Dr. Ally Baheti interviews Jill Sommerset and Dr. Fadi Saab about EVUS and IVUS in peripheral arterial cases, including when to use each, how to train an interventional sonographer, and what adding ultrasound in a case can do for patient safety. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Jill Sommerset is the director of ultrasound at Advanced Vascular in Portland, OR and Hope Clinical Innovation Center in Houston, TX, and chair of the SVU annual conference. Dr. Fadi Saab is an interventional cardiologist and associate professor at Michigan State University. He begins by introducing what intravascular ultrasound (IVUS) and extravascular ultrasound (EVUS) are. EVUS is looking from the outside in, and can be used to measure vessel width, hemodynamics, and cross chronic total occlusions (CTOs). IVUS is looking from inside a vessel towards the outside of the body, and can be helpful for viewing the extent of arterial disease and discerning the exact plaque anatomy. Dr. Saab always has a specially trained interventional sonographer involved in the case and in the room for critical limb ischemia (CLI) cases. He values them not only for obtaining access, but also to provide greater safety to the patient. He considers them a core member of the team. He notes the importance of training an ultrasonographer who is good when working under pressure, can interact with multiple personality types, and most importantly, someone willing to learn, be engaged in the case, and willing to put themselves out there in this foreign environment. Jill says it took her around 4 months to feel comfortable working in the cath lab, and for other members of the team to get used to her presence during cases. She describes her work as a dance with the physician. When a wire or catheter is being exchanged, Jill is always scanning and thinking ahead, and she is always ready to check for dissections after balloon angioplasty. Most arterial cases can benefit from the addition of EVUS. Jill says the only time EVUS is not as helpful is when the CTO cap morphology shows a rock hard plaque that casts shadows on the screen. Dr. Saab says he uses EVUS for crossing CTOs, patient safety, and looking at complications. He usually introduces IVUS after he crosses a lesion to look at plaque in a more granular way and understand it’s anatomy. Jill adds that she uses IVUS to help the physician cross a CTO sometimes, but notes that it is important for the tech to hold the probe still and not move in this scenario. The two end by restating the value that EVUS and IVUS add to the procedure, especially because angiography misses a lot of plaque burden that can be seen with IVUS. They recommend finding ultrasonographers interested in working in the cath lab, and taking the responsibility as physicians to mentor them and make them feel like an invaluable member of the treatment team. --- RESOURCES CTOP Paper: https://assets.bmctoday.net/evtoday/pdfs/et0518_F5_Saab.pdf

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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

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

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

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

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

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

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

Ep. 44 TIPS Procedure Techniques: East to West Coast with Dr. Peder Horner and Dr. Peter Bream

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/2WK9kp East Coast "McBreamy" and "Western Peder" discuss their Colapinto vs. Uchida needle preference, advantages of the ICE catheter, and other great pearls and pitfalls for the TIPS Procedure. Special thanks to our sponsor RADPAD® Radiation Protection. Protect yourself and your patients during those lengthy TIPS cases.

16 Kesä 20191h

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