Ep. 361 Intra-Arterial and Percutaneous Treatment of Giant Hepatic Hemangiomas with Dr. Jafar Golzarian

Ep. 361 Intra-Arterial and Percutaneous Treatment of Giant Hepatic Hemangiomas with Dr. Jafar Golzarian

In this episode, our host Michael Barazza interviews Dr. Jafar Golzarian, interventional radiologist at the University of Minnesota, about intra-arterial and percutaneous treatment of giant hepatic hemangiomas. --- SHOW NOTES We start this episode off by highlighting the Global Embolization Symposium and Technologies (GEST) initiative that Jafar co-founded in 2007. Over time, GEST has evolved into a highly acclaimed conference, drawing an international audience of thousands of participants for its webinars. We then dive into cutting edge treatments of liver hemangiomas. Jafar discussed how he was introduced to a novel approach in 2014 when one of his friends, Dr. Shahram Akhlaghpoor, sent him a paper with his results from using transarterial bleomycin-lipiodol embolization (B/LE) to treat symptomatic giant hepatic hemangiomas. Another friend of Jafar’s shared an inventive approach in shifting perspectives to view hepatic hemangiomas as low-grade venous malformations and using percutaneous injections for treatment. Then, Jafar discusses the specifics of his approach to hepatic hemangiomas and how he usually only treats hemangiomas that are large, cause pain and discomfort, or exert pressure on vital structures such as the portal vein or bile duct. Jafar notes that the patient demographic that presents with hemangiomas are typically women aged 30 to 50, and they can be self-referred or referred by hepatobiliary surgeons. In regards to treatment, Jafar prefers either 30, 45, or 60 units of bleomycin, favoring the latter for hemangiomas exceeding 10 cm. He prefers percutaneous access if feasible, but he resorts to chemoembolization in cases when insurance coverage presents issues. Minor post-treatment symptoms post-treatment include abdominal pain and occasional nausea, with extremely rare compilations being pulmonary fibrosis or allergic reactions to the bleomycin. Jafar notes that imaging at 1, 3, and 6 months post-treatment guides assessment of treatment effectiveness of, with substantial change best evaluated at the 6-month mark. Jafar’s treatment has garnered high patient satisfaction, with very few patients requiring return for further therapy after the 6 months. He notes that when surgeons are shown the before and after imaging of the treatment of hemangiomas, they become big advocates of these procedures. --- RESOURCES Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma: https://pubmed.ncbi.nlm.nih.gov/29922860/

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Ep. 41 IR and Urology Collaboration on Renal Masses with Dr. Caire and Dr. Bennett

Ep. 41 IR and Urology Collaboration on Renal Masses with Dr. Caire and Dr. Bennett

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/PZalEv Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett discuss their approaches to treating renal masses, including ways in which IR and Urology collaborate, laparoscopic versus percutaneous ablation, follow-up imaging, and more.

29 Huhti 201939min

Ep. 40 Treating the Difficult IV Access (DiVA) patient with Dr. Chick and Dr. Jagannathan

Ep. 40 Treating the Difficult IV Access (DiVA) patient with Dr. Chick and Dr. Jagannathan

Dr. Arun Jagannathan and Dr. Jeffrey Chick discuss their approach to the Difficult IV access (DiVA) patient. Special thanks to sponsor Access Vascular Inc. for lending their booth at #SIR19ATX.

26 Maalis 201917min

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

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