Ep. 334 New Balloon Technologies for CLI with Dr. Peter Soukas

Ep. 334 New Balloon Technologies for CLI with Dr. Peter Soukas

In this episode, host Dr. Aaron Fritts interviews Dr. Peter Soukas taking a deep dive into novel balloon technologies, appropriate uses below the knee, and how these new balloons are highly effective in treating patients with critical limb ischemia (CLI). Dr. Soukas explains how these new balloon technologies can minimize the risk of dissections (therefore decreasing the need for bailout stents), create effective lumen gain in concentric and eccentric calcified lesions with minimal recoil, and keep pressures low compared to legacy products. --- CHECK OUT OUR SPONSOR Cagent Vascular Serranator https://www.cagentvascular.com --- SHOW NOTES Dr. Soukas is an Interventional Cardiologist who is the Founder and Director of the Brown Vascular and Endovascular Medicine Fellowship program, serves as the Director of the Interventional PV Lab at the Lifespan Cardiovascular Institute of Brown, and an Associate Professor of Medicine at the Warren Alpert School of Medicine. We begin by discussing the treatment of CLI, particularly with new below the knee balloon angioplasty devices like the Cagent Serranator and how balloon tech has evolved over time. These new technologies allow for 1000x more force than previous balloon models through unique serration technology at significantly lesser pressures, minimizing the risk of barotrauma and iatrogenic lumen dissections, while allowing for effective luminal gain, and showing success in treating CLI even when calcified lesions are present. What’s more is that there is now a variety of serration balloon lengths available, which was definitely a huge shortcoming in prior scoring balloons with limited sizing. While IVL is the preferred option in terms of treating concentric (360°) calcified lesions, new serration balloons are cheaper and show success in treating both concentric and eccentric calcified lesions with minimal recoil. Dr. Soukas and Dr. Fritts also go on to discuss how using IVUS is critical in visualizing the size, shape, and depth of possible calcifications but also important in picking the correctly sized serration-balloon to get the job done. Dr. Soukas also explains how the serration balloon technology is easily deployable, tracks very well within vasculature, and can even be used below the ankle if needed (with some pre-dilation of the lumen) stating that if the IVUS can fit, usually so can the serration balloon. To wrap up the episode we underscore how important it is to have the right tools in our toolbox to treat patients with CLI, getting as much “red gold” down to the foot as possible to avoid loss of the limb, and a few papers our listeners can check out to learn more about serration balloons (find linked in Resources below). --- RESOURCES CagentVascular.com Prospective Study of Serration Angioplasty in the Infrapopliteal Arteries Using the Serranator Device: PRELUDE BTK Study DOI: 10.1177/15266028211059917 Standard Balloon Angioplasty Versus Serranator Serration Balloon Angioplasty for the Treatment of Below-the-Knee Artery Occlusive Disease: A Single-Center Subanalysis From the PRELUDE-BTK Prospective Study DOI: 10.1177/15266028221134891 PRELUDE Prospective Study of the Serranator Device in the Treatment of Atherosclerotic Lesions in the Superficial Femoral and Popliteal Arteries DOI: 10.1177/1526602818820787

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Ep. 54 Inclusivity in IR with Dr. Barbara Hamilton and Dr. Mary Costantino

Ep. 54 Inclusivity in IR with Dr. Barbara Hamilton and 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/o6ecMR Dr. Barbara Hamilton and Dr. Mary Costantino, MD discuss inclusivity in IR, including the importance of mentorship and diversity in medicine.

16 Tammi 202023min

Ep. 53 International Volunteer Work with Dr. Stephen Hunt

Ep. 53 International Volunteer Work with Dr. Stephen Hunt

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Fh5LxS Dr. Stephen Hunt shares his international volunteer experiences traveling with IR4Nigeria and RAD-AID International. Get involved at www.rad-aid.org.

1 Tammi 202026min

Ep. 52 IVUS for Iliac Vein Compression with Dr. Mark Lessne and Dr. Mike Cumming

Ep. 52 IVUS for Iliac Vein Compression with Dr. Mark Lessne and Dr. Mike Cumming

Dr. Michael Cumming and Dr. Mark Lessne discuss the utility of Intravascular Ultrasound (IVUS) in the diagnosis and treatment of Deep Venous Disease, including patient selection, appropriate assessment of stenoses and assistance with stent placement. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ySM6hy

11 Marras 201944min

Ep. 51 Cone Beam CT Technique with Dr. Austin Bourgeois

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

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

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

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

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

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