Ep. 564 Pressure-Enabled Drug Delivery in HCC & Metastatic Liver Lesions with Dr. Zach Berman

Ep. 564 Pressure-Enabled Drug Delivery in HCC & Metastatic Liver Lesions with Dr. Zach Berman

Can you manipulate blood flow in the tumor microenvironment to optimize drug delivery? In this episode of the BackTable Podcast, interventional oncologist Dr. Zachary Berman (UC San Diego) joins host Dr. Christopher Beck to discuss real-world applications of pressure-enabled drug delivery in locoregional liver-directed therapies like TACE and Y90.---This podcast is supported by:TriSalus Life Scienceshttp://trinavinfusion.com/---SYNPOSISThe conversation begins with an overview of the tumor microvascular environment, focusing on the abnormal nature of the new vessels that feed tumors. They then discuss the genesis of pressure-enabled drug delivery and the theory behind its efficacy. Dr. Berman explains the TriNav catheter’s micro-valve design, its anti-reflux properties, and how these features enhance tumor drug delivery. He walks through his own procedure technique, comparing and contrasting it to standard embolization, and details the utility of pressure-enabled drug delivery in lobar radioembolization and larger tumors. They also explore the benefits of both balloon occlusion and microvalve catheters.Real-world cases—including neuroendocrine tumors, segmental HCC, and more—illustrate the thought process around when to use specialized technologies. The episode wraps up with a discussion of the future implications for this technology in other pathologies, cost considerations, and the potential for enhancing drug delivery with innovative approaches.---TIMESTAMPS00:00 - Introduction01:39 - The Tumor Microenvironment06:59 - Pressure-Enabled Drug Delivery Explained09:37 - Technical Aspects of Pressure-Enabled Catheters21:48 - Case 1: Grade 3 Neuroendocrine Tumor34:06 - Case 2: Hepatocellular Carcinoma with Tumor and Vein36:01 - Case 3: TACE for Segmental HCC in Decompensated Cirrhosis38:58 - Case 4: Large Heterogenous Cholangiocarcinoma40:40 - Case 5: Lobar Neuroendocrine Tumor42:38 - Case 6: Segmental HCC with Central Necrosis47:52 - Best Practices and Technical Considerations57:52 - Future Directions in Pressure-Directed Embolotherapy59:48 - Conclusion and Final Thoughts---RESOURCESJVIR 2024 Jaroch et al.:https://pubmed.ncbi.nlm.nih.gov/38969336/

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Ep. 470 Updated Guidance on Paclitaxel-Coated Devices with Dr. Sahil Parikh and Dr. John Park

Ep. 470 Updated Guidance on Paclitaxel-Coated Devices with Dr. Sahil Parikh and Dr. John Park

The use of drug-coated balloons (DCBs) for peripheral arterial disease has been controversial in the past. However, new data and updated FDA guidance have helped these devices regain popularity. In th...

6 Elo 202446min

Ep. 469 Price Transparency in Healthcare with Dr. Keith Smith

Ep. 469 Price Transparency in Healthcare with Dr. Keith Smith

Creating an ambulatory surgery center (ASC) with transparent, affordable pricing is possible and can go a long way in protecting our patients’ health, pockets, and futures. Dr. Keith Smith, founder of...

2 Elo 202438min

Ep. 468 Advancements in Laser Atherectomy with Dr. On Topaz

Ep. 468 Advancements in Laser Atherectomy with Dr. On Topaz

How has Laser Atherectomy advanced over the years to treat patients with coronary and peripheral artery disease? Dr. On Topaz, renowned specialist in laser atherectomy, answers exactly that and much m...

30 Heinä 20241h 7min

Ep. 467 Independent IR Practice in Rural America with Dr. Frederick D. Johnson

Ep. 467 Independent IR Practice in Rural America with Dr. Frederick D. Johnson

Bringing more interventional radiology to rural America would benefit many patients who currently do not have access to minimally invasive, image guided medicine. In today's episode, Dr. Frederick Joh...

26 Heinä 202449min

Ep. 466 Exploring IR in Australia with Dr. Chris Rogan

Ep. 466 Exploring IR in Australia with Dr. Chris Rogan

Ever wonder what it’s like to practice interventional radiology down under? Dr. Chris Rogan joins us on the BackTable Podcast this week to tell us about his IR practice in Australia, with special emph...

23 Heinä 202437min

Ep. 465 Innovations in Superficial Venous Disease Treatment with Dr. Ali Golshan

Ep. 465 Innovations in Superficial Venous Disease Treatment with Dr. Ali Golshan

Superficial venous disease can pose significant management challenges, particularly after patients have exhausted conservative and invasive therapies. This week, our host, Dr. Sabeen Dhand, interviews...

19 Heinä 202437min

Ep. 464 Minimizing Complications for Challenging Lung Biopsies with Dr. Venkatesh Krishnasamy

Ep. 464 Minimizing Complications for Challenging Lung Biopsies with Dr. Venkatesh Krishnasamy

Dr. Venkatesh Krishnasamy shares techniques and specific cases for challenging lung biopsies, his insights on mentorship, importance of multidisciplinary tumor boards, and the evolution of lung biopsy...

16 Heinä 202440min

Ep. 463 Stone Retrieval and Other Advanced Biliary Interventions with Dr. Alexander Vezeridis

Ep. 463 Stone Retrieval and Other Advanced Biliary Interventions with Dr. Alexander Vezeridis

In this episode, Dr. Alexander Vezeridis discusses advanced biliary interventions; covering stone removal procedures, technical success rates, and practical tips for using Spyglass cholangioscopy, las...

12 Heinä 202453min

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