Ep. 530 Evolution of IR: A Conversation with Dr. Barry Katzen

As physicians, we have the unique ability to improve the health and wellbeing of individuals in underserved communities. But even if we possess the drive and the compassion to do so, it can be difficult to know how to take meaningful steps towards addressing local healthcare disparities. In this episode of the BackTable Podcast, Dr. Lyssa Ochoa of the San Antonio Vascular and Endovascular Clinic (SAVE) shares how her clinic improves access to care for underserved patient populations, and how you can emulate her success. --- This podcast is supported by: Philips Image Guided Therapy Solutions https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products --- SYNPOSIS Dr. Ochoa shares her journey from joining a large private practice to founding her own clinic focused on underserved areas in San Antonio. She discusses the importance of addressing social determinants of health, the logistics of running multiple satellite clinics, and her approach to patient care. Dr. Ochoa also emphasizes the need for community engagement and outlines her vision for improving healthcare equity in San Antonio. The conversation highlights the challenges and rewards of providing quality care in economically segregated regions, and offers insights for healthcare providers looking to make a meaningful impact. --- TIMESTAMPS 00:00 - Introduction 03:23 - Addressing Social Determinants of Health 05:20 - Innovative Approaches to Healthcare Delivery 08:46 - Challenges and Strategies in Underserved Areas 15:16 - Building Community Trust and Referrals 22:27 - Advice for New Practitioners 29:42 - Future Vision for Healthcare in San Antonio 32:07 - Resources -- DISCLAIMER Dr. Lyssa Ochoa is a consultant for Philips and was requested to provide their services in preparing and presenting this material for Philips. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations.

10 Joulu 202434min

500 episodes of BackTable calls for a special reunion! The original hosts—Dr. Aaron Fritts, Dr. Chris Beck, Dr. Ally Baheti, Dr. Sabeen Dhand, Dr. Mike Barraza, and producer Kieran Gannon—come together to celebrate by reminiscing about the podcast’s origins and evolution. They discuss the challenges of improving the podcast, share funny behind-the-scenes moments, and highlight their favorite episodes. The team also offers insights into how they choose topics and reflects on their experiences with both virtual and in-person recordings. Finally, they introduce the new BackTable Studio and highlight the upcoming Creator Weekends. --- SYNPOSIS To our BackTable community, thank you for tuning in every week. We look forward to continuing to serve your vascular and interventional education needs! --- TIMESTAMPS 00:00 Introduction 01:43 The Origin Story of Backtable 06:42 From Our Side of the Microphone: Hosting Episodes 25:57 Choosing Topics and Guests 32:55 Introducing the New BackTable Studio 38:27 Favorite Episodes and Memorable Moments 44:02 The Story Behind the Backtable Theme Music 47:49 The Iconic Backtable Hoodies 51:03 Closing Thoughts and Gratitude --- RESOURCES BackTable Special 100th Episode Interview: https://www.backtable.com/shows/vi/podcasts/special/special-100th-episode-interview-with-backtable

6 Joulu 202453min

IR technologists are a valuable part of the interventional team due to their technical expertise and hands-on contributions to patient and provider safety. Lake Odom, a seasoned IR tech with over 14 years of experience, sits down with host Dr. Ally Baheti to share his wisdom from his time in hospital-based and outpatient care settings. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Lake begins by describing his unconventional career path, the importance of passion in profession, and how he started his consulting businesses: IR Tech Tips and Image Guided Consultants. Lake also speaks on transitioning from the hospital to the outpatient-based lab (OBL) setting, and highlights key aspects of the tech’s role, including inventory management, patient workflow, and building efficient systems. The significance of understanding the financial intricacies within OBLs, common inefficiencies, and strategies to foster a culture of accountability and teamwork are also discussed. The episode provides valuable insights for IR technologists and other professionals seeking to improve their practices and operate at maximum potential. --- TIMESTAMPS 00:00 - Introduction 06:55 - Image Guided Consultants 12:07 - Improving Practice Efficiency 17:51 - Daily IR Tech Responsibilities 20:56 - Inventory Management and Preparedness 28:03 - Building Trust and Credibility --- RESOURCES BackTable Ep. 130- Technologist Training & Retention with Andrew Struchen and Alisha Hawrylack: https://www.backtable.com/shows/vi/podcasts/130/technologist-training-retention Image Guided Consultants: https://igsconsults.com/ IR Tech Tips Course: https://irtechtips.teachable.com/

3 Joulu 202438min

Cone Beam CT has become a cornerstone of modern interventional practice. Are you utilizing it to its fullest potential? Dr. Michael Miller joins host Dr. Chris Beck to discuss Cone Beam CT, sharing advanced techniques and clinical pearls. Dr. Miller is an interventional radiologist and Associate Professor of Radiology at Atrium Health, Wake Forest Baptist Hospital, North Carolina. --- This podcast is supported by: GE Healthcare Allia Image Guided Systems https://www.gehealthcare.com/products/interventional-image-guided-systems/allia --- SYNPOSIS Dr. Miller explains the importance of fundamental training and how fundamentals can be scaled across various procedures to improve outcomes, including vascular malformations and endoleaks. Dr. Miller then speaks to best practices that he has learned firsthand through his years of using Cone Beam CT. The doctors also touch on tips for setting up the IR suite and collaborating with anesthesia. --- TIMESTAMPS 00:00 - Introduction 07:22 - Advanced Uses of Cone Beam CT 15:04 - Setup and Best Practices 22:34 - Vascular Malformations 23:32 - Understanding Sclerosant Distribution 26:53 - Trajectory Guidance in Complex Cases 32:45 - Contrast Bolus Timing and Spin Techniques 40:16 - Advice for New Angio Suites --- RESOURCES BackTable VI Podcast Episode #51 - Cone Beam CT Techniques with Dr. Austin Bourgeois: https://www.backtable.com/shows/vi/podcasts/51/cone-beam-ct-techniques Shujaat, S., Alfadley, A., Morgan, N., Jamleh, A., Riaz, M., Aboalela, A.A., Jacobs, R., 2024. Emergence of artificial intelligence for automating cone-beam computed tomography-derived maxillary sinus imaging tasks. A systematic review. Clin Implant Dent Relat Res 26, 899–912. https://doi.org/10.1111/cid.13352 Orth, R.C., Wallace, M.J., Kuo, M.D., Technology Assessment Committee of the Society of Interventional Radiology, 2009. C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 20, S538-544. https://doi.org/10.1016/j.jvir.2009.04.026 Bapst, B., Lagadec, M., Breguet, R., Vilgrain, V., Ronot, M., 2016. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver. Cardiovasc Intervent Radiol 39, 8–20. https://doi.org/10.1007/s00270-015-1180-6 Wallace, M.J., Kuo, M.D., Glaiberman, C., Binkert, C.A., Orth, R.C., Soulez, G., Technology Assessment Committee of the Society of Interventional Radiology, 2008. Three-dimensional C-arm cone-beam CT: applications in the interventional suite. J Vasc Interv Radiol 19, 799–813. https://doi.org/10.1016/j.jvir.2008.02.018 Bm, K., Sm, T., Mj, S., 2023. Cone-Beam CT With Enhanced Needle Guidance and Augmented Fluoroscopy Overlay: Applications in Interventional Radiology. AJR. American journal of roentgenology 221. https://doi.org/10.2214/AJR.22.28712 Kwok, Y.M., Irani, F.G., Tay, K.H., Yang, C.C., Padre, C.G., Tan, B.S., 2013. Effective dose estimates for cone beam computed tomography in interventional radiology. Eur Radiol 23, 3197–3204. https://doi.org/10.1007/s00330-013-2934-7

26 Marras 202448min

Varicoceles embolization is the least invasive treatment option for varicoceles, making it the favored option for most patients and a staple in the interventional radiologist’s procedural repertoire. Dr. John Matson joins host Dr. Ally Baheti to give us an essential guide to varicocele embolization, serving as an introduction for junior IRs and refresher for the more experienced. Dr. Matson is an Assistant Professor of Interventional Radiology at University of Virginia. --- RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Mattson covers the indications, procedural setup, technique variations, and post-procedure follow-up for treating varicoceles, with specific attention to the different embolic materials used in clinical practice. He also delves into the importance of pre-procedure evaluations, imaging requirements, and managing potential complications. --- TIMESTAMPS 00:00 - Introduction 02:05 - Indications for Varicocele Embolization 06:05 - Procedure Setup and Execution 12:57 - Coil Sizing and Embolic Materials 17:36 - Managing Complications 20:25 - Post-Procedure Care and Follow-Up

22 Marras 202423min

Interested in setting up an Ambulatory Surgery Center (ASC) or Outpatient Based Lab (OBL)? Special guest Kristen Richards sits down with host Dr. Aaron Fritts to discuss the importance of establishing and tracking safety and quality metrics in the outpatient space to achieve success. Kristen is Vice President of Ambulatory Care at Cardiovascular Logistics in Chicago, IL. --- This podcast is supported by: Philips Image Guided Therapy Solutions https://www.usa.philips.com/healthcare/solutions/image-guided-therapy/all-products --- SYNPOSIS Kristen shares insights from her experience in the cardiovascular ambulatory space, highlighting the necessity of patient safety, efficient care, and the benefits of outpatient settings over hospital environments. Patient selection, infection control, staff and physician satisfaction, economic drivers, and the future outlook for cardiovascular procedures in ASCs are some of the key topics discussed. Kristen also emphasizes the need for continuous data tracking to demonstrate and improve the quality of care provided in these centers. --- TIMESTAMPS 00:00 - Introduction 06:25 - Benefits of Out-of-Hospital Care 17:47 - Financial Incentives and Ownership Models 18:17 - Technological Advancements and Cost Reduction 25:00 - Considerations for Opening an ASC 31:58 - Importance of Quality Metrics --- RESOURCES BackTable VI Podcast Episode #366 Navigating OBL & ASC Business: Pitfalls to Avoid with Teri Yates https://www.backtable.com/shows/vi/podcasts/366/navigating-obl-asc-business-pitfalls-to-avoid BackTable VI Podcast Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates https://www.backtable.com/shows/vi/podcasts/431/obl-or-asc-for-your-private-practice-how-to-decide BackTable VI Podcast Episode #431 OBL or ASC for Your Private Practice? How to Decide with Teri Yates https://www.backtable.com/shows/vi/podcasts/486/winning-the-revenue-cycle-game Outpatient Endovascular and Interventional Society (OEIS) 2025 Conference: https://oeisweb.com/ Cardiovascular Business: https://cardiovascularbusiness.com/ SCAI: https://scai.org/ --- DISCLAIMER Kristen Richards is a consultant for Philips. She has been compensated by Philips for their services in preparing and presenting this material. The opinions and clinical expertise presented herein by are specific to the featured speakers and are for informational purposes only. The results from their experiences may not be predicative for all subject, physicians or patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations.

19 Marras 202436min

Is your microwave ablation technique up to date? Dr. Ed Kim sits down with guest-host Dr. Kavi Krishnasamy to explore cutting-edge techniques in tumor ablation, with a focus on hepatocellular carcinoma (HCC) treatment with microwave. Dr. Ed Kim is the Director of Interventional Oncology and Professor of Radiology and Surgery in the Division of Vascular and Interventional Radiology at the Mount Sinai Medical Center. --- This podcast is supported by an educational grant from Varian, a Siemens Healthineers company. --- SYNPOSIS The doctors discuss microwave ablation, radiation segmentectomy, and the decision-making algorithms for choosing appropriate procedures based on lesion characteristics. Dr. Kim touches on the complexities of ablation near the diaphragm and subcapsular lesions, emphasizing the impact of practitioner skill and experience on outcomes. Recent advancements in ablation technologies, software, and device-specific versus device-agnostic applications are also highlighted, along with the importance of post-contrast scans and ultrasound skills. Dr. Kim also delves into emerging technologies such as HistoSonics, augmented reality/virtual reality, and immunotherapy synergies. The doctors underscore the need for a multidisciplinary approach for optimizing patient outcomes and pushing the field toward future innovations. --- TIMESTAMPS 00:00 - Introduction 04:28 - Standardizing Ablation Algorithms 07:51 - Suboptimal Lesion Locations 13:06 - Device Selection and Properties 22:49 - Ablation Planning Software 32:53 - Real-Time Visualization 44:48 - Biopsy and Ablation Techniques 52:14 - Future of Ablation Technology --- RESOURCES Dr. Ed Kim’s Publications: https://scholars.mssm.edu/en/persons/edward-kim ACCLAIM Trial: https://www.sio-central.org/ACCLAIM-Trial A multicenter randomized controlled trial to evaluate the efficacy of surgery versus radiofrequency ablation for small hepatocellular carcinoma (SURF trial): Analysis of overall survival: https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.4093 Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial. https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501 SIR welcomes results of COLLISION Trial, presented at the 2024 ASCO Annual Meeting: https://www.sirweb.org/media-and-pubs/media/news-release-archive/collision-trial-06032024/ HistoSonics: https://histosonics.com/

12 Marras 202459min

How do interventional oncologists fit into the bigger picture of multidisciplinary cancer care? Today we hear the patient’s perspective from Lynn Lazzaro, a liver cancer survivor who underwent multiple interventional oncology procedures prior to liver resection and eventual transplant. Lynn sits down with host Dr. Eric Keller to discuss her journey from initial diagnosis to present day. --- This podcast was developed in collaboration with: Interventional Initiative https://theii.org/ --- SYNPOSIS Lynn provides insights on the importance of patient self-advocacy, seeking second opinions, and the benefits of a multidisciplinary approach when fighting cancer. Lynn encourages patients to be informed, ask questions, and connect with mentors, while also emphasizing the important duty physicians have in humanizing patient care. Her story highlights resilience, the value of teamwork among medical specialists, and the transformative potential of minimally invasive procedures. --- TIMESTAMPS 00:00 - Introduction 02:22 - Multidisciplinary Management 06:59 - Navigating TACE and Support Systems 13:39 - Surgical Interventions and Transplant Journey 19:09 - Reflections and Advice for Patients and Clinicians 26:13 - Conclusion --- RESOURCES The Interventional Initiative: https://theii.org/ The Cholangiocarcinoma Foundation: https://cholangiocarcinoma.org/

8 Marras 202430min