Ep. 400 Intra-Arterial Approaches in Tumor Therapy: Overcoming the Blood-Brain Barrier with Dr. Piotr Walczak and Dr. Prakash Ambady

Ep. 400 Intra-Arterial Approaches in Tumor Therapy: Overcoming the Blood-Brain Barrier with Dr. Piotr Walczak and Dr. Prakash Ambady

In this episode of the Backtable Podcast, guest host Dr. Paul Bhogal, a consultant interventional neuroradiologist at Royal London Hospital in the UK, and guests Dr. Piotr Walczak and Dr. Prakash Ambady discuss the potential of intra-arterial treatments combined with blood brain barrier (BBB) manipulation in treating various neurological conditions and tumors. The trio of doctors discuss methods such as the use of hyperosmolar mannitol and focused ultrasound to breach the BBB and deliver drugs directly to the brain tissue. Dr. Walczak and Dr. Ambady also highlight their individual research areas, including therapies involving cell delivery and engineered cells. The conversation also covers potential risks and new perspectives in comparison to current techniques such as whole-brain radiation. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 05:44 - Challenges of Treating Glioblastoma Multiforme 12:52 - Understanding the Blood Brain Barrier 18:30 - Strategies to Negate the Blood Brain Barrier 20:52 - Blood Brain Barrier Disruption Using Intra-Arterial Mannitol 26:35 - Infusion Rates and Magnetic Resonance Guidance 33:47 - Role of Radiolabel Studies in Drug Delivery 36:31 - Future of Therapeutic Agents Design 47:54 - Potential of Focused Ultrasound in Drug Delivery 56:10 - Exploring the Use of Cells in Drug Delivery 58:44 - Future of Intra-Arterial Interventions --- RESOURCES Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma: https://pubmed.ncbi.nlm.nih.gov/15758009/ Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-year analysis of the EORTC-NCIC trial: https://pubmed.ncbi.nlm.nih.gov/19269895/ REMOVAL OF RIGHT CEREBRAL HEMISPHERE FOR CERTAIN TUMORS WITH HEMIPLEGIA - PRELIMINARY REPORT: https://jamanetwork.com/journals/jama/article-abstract/254927 Real-Time MRI Guidance for Reproducible Hyperosmolar Opening of the Blood-Brain Barrier in Mice: https://www.researchgate.net/publication/328537972_Real-Time_MRI_Guidance_for_Reproducible_Hyperosmolar_Opening_of_the_Blood-Brain_Barrier_in_Mice Dr. Piotr Walczak ResearchGate Profile: https://www.researchgate.net/profile/Piotr-Walczak-6 Dr. Prakash Ambday ResearchGate Profile: https://www.researchgate.net/profile/Prakash-Ambady Maculopathy Associated With Osmotic Blood- Brain Barrier Disruption and Chemotherapy in Patients With Primary CNS Lymphoma: https://pubmed.ncbi.nlm.nih.gov/32484895/ PET imaging of intra-arterial 89 Zr bevacizumab in mice with and without osmotic opening of the blood-brain barrier: distinct advantage of intra-arterial delivery: 10.2967/jnumed.118.218792 Safety of intra-arterial chemotherapy with or without osmotic blood–brain barrier disruption for the treatment of patients with brain tumors: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307096/ Delivery of chemotherapeutics across the blood-brain barrier: challenges and advances: https://pubmed.ncbi.nlm.nih.gov/25307218/

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Special COVID-19 Weekend Update with UPenn IR Dr. Stephen Hunt

Special COVID-19 Weekend Update with UPenn IR Dr. Stephen Hunt

Dr. Stephen Hunt of Penn Medicine at University of Pennsylvania Health System discusses ways in which his IR practice has changed in the setting of the COVID 19 pandemic, including case selection and lessons learned from colleagues in Singapore and China.

28 Maalis 202032min

Ep. 59 Endovascular Treatment of DVT with Dr. Dexter and Dr. Abramowitz

Ep. 59 Endovascular Treatment of DVT with Dr. Dexter and Dr. Abramowitz

Vascular Surgeons David Dexter and Steven Abramowitz discuss endovascular treatment of lower extremity DVT, including patient selection and risks and benefits of catheter-directed therapy (CDT), mechanical thrombectomy, and pharmaco-mechanical thrombolysis.

24 Maalis 202059min

Ep. 58 Endovascular Treatment of PE with Dr. Venkat Tummala and Dr. Thomas Tu

Ep. 58 Endovascular Treatment of PE with Dr. Venkat Tummala and Dr. Thomas Tu

Interventional Cardiologist Thomas Tu, MD and Interventional Radiologist Venkat Tummala MD discuss their respective approach to the treatment of Pulmonary Embolism, including risk stratification, treatment options, and endovascular technique.

11 Maalis 202045min

Ep. 57 Practicing IR in the UK with Dr. Gregory Makris

Ep. 57 Practicing IR in the UK with Dr. Gregory Makris

Dr. Christopher Beck talks with Dr. Gregory Makris of Guy's and St. Thomas' NHS Foundation Trust in London about IR education and practice in the UK, as well as his involvement with CIRSE and the European Trainee Forum.

5 Maalis 202045min

Ep. 56 Transitioning from a Hospital to OBL practice (Part II) with Dr. Yates and Dr. Patel

Ep. 56 Transitioning from a Hospital to OBL practice (Part II) with Dr. Yates and Dr. Patel

In Part 2 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on marketing strategies, as well as the importance of experience and partners in an outpatient based endovascular practice. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5UxgxL

23 Helmi 202043min

Ep. 55 Transitioning from a Hospital to OBL practice (Part I) with Dr. Yates and Dr.  Patel

Ep. 55 Transitioning from a Hospital to OBL practice (Part I) with Dr. Yates and Dr. Patel

In Part 1 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on how they made their career change decisions, as well as the advantages and disadvantages of a hospital-based vs. outpatient-based endovascular practice. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/vog6G0

11 Helmi 202051min

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

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