Ep. 328 Adrenal Vein Sampling with Dr, Fritz Angle

In this episode, Dr. Nicole Lamparello discusses the strides and challenges in achieving gender equity in interventional radiology (IR), sharing insights from her research on gender disparities in IR, and revealing how women currently comprise a significantly low percentage of the IR workforce compared to men despite equal numbers of male and female medical students. Dr. Lamparello is an interventional radiologist and serves as the Program Director for Weill Cornell Medicine’s Integrated IR Residency in New York City. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors cover the importance of workplace culture with flexibility for family and maternity needs, mentorship, visibility of female leaders in IR, and strategies for attracting more women to the field. The conversation also touches on the impact of diverse IR professionals on patient outcomes, and how outsourcing personal tasks can help maintain work-life balance. The necessity of early exposure to IR for medical students and addressing specific hurdles for women in IR, such as work-life balance, radiation exposure fears, and lack of female role models are also explored. --- TIMESTAMPS 00:00 - Introduction 05:40 - Addressing Gender Disparity in IR 13:48 - Importance of Physician Workforce Diversity 18:31 - Challenges and Solutions for Gender Equity in IR 25:28 - Work-Life Balance 38:40 - Concluding Thoughts --- RESOURCES The Gender Gap in Interventional Radiology: Barriers, Opportunities, and the Role of the Integrated IR Residency: https://pubmed.ncbi.nlm.nih.gov/36870809/ The IR Trainee Workforce 10 Years after Becoming a Primary Medical Specialty: https://www.jvir.org/article/S1051-0443(23)00651-6/fulltext Lack of exposure and perceived occupational hazards as barriers to entry into IR for women: a survey of 143 female medical students: https://www.jvir.org/article/S1051-0443(16)31526-3/fulltext Untapped Resources: Attaining Equitable Representation for Women in IR: https://www.jvir.org/article/S1051-0443(18)31645-2/fulltext Gender and racial diversity among plenary session speakers at the Society of Abdominal Radiology Annual Meetings: a five-year assessment: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226100/ Bridging the Gender Gap in the Society of IR: A Benchmark Study: https://www.jvir.org/article/S1051-0443(18)31492-1/pdf

3 Mai 202442min

In this episode, Dr. Aron Chary provides an in-depth look into endovascular and minimally invasive treatments for pain management, specifically focusing on cryoneurolysis. He shares his experience of implementing the technology for both benign and malignant conditions in an independent private practice setting. --- CHECK OUT OUR SPONSOR Boston Scientific Visual ICE Cryoablation System https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html --- SYNPOSIS The discussion covers various aspects, including collaboration with Boston Scientific for the VISUAL ICE cryoablation system, Dr. Chary’s personal journey from academics at Emory to private practice in Memphis, the effectiveness of cryoneurolysis in different areas such as genicular nerve and palliative care, and the operational dynamics between hospital and outpatient settings. The doctors delve into the procedural specifics, patient response, and outcomes with cryoneurolysis, including Dr. Chary’s efforts to navigate insurance and reimbursement challenges. --- TIMESTAMPS 00:00 - Introduction 07:04 - Evolution of Pain Intervention Techniques 11:08 - Building a Pain Intervention Service 16:16 - Versatility of Cryoablation in Pain Management 23:54 - Expectations and the Future of Pain Management Research 31:41 - Cryoneurolysis Insights and Patient Management 42:10 - Techniques in Celiac Cryoneurolysis 52:33 - Pain Management in the Outpatient Setting --- RESOURCES Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol: https://www.jvir.org/article/S1051-0443(20)30349-3/abstract BT VI Episode 199 - Advanced Minimally Invasive Pain Interventions with Dr. David Prologo: https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions BT VI Episode 433 - Kyphoplasty Evolution: Steering Toward Targeted Therapy with Dr. David Prologo: https://www.backtable.com/shows/vi/podcasts/433/kyphoplasty-evolution-steering-toward-targeted-therapy Boston Scientific, VISUAL ICE: https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html

30 Apr 202457min

In this episode, Dr. David Guez discusses the advancements in contrast enhanced ultrasound, its application in detecting endoleaks, and his journey of learning and applying this modality from residency to his current practice. Dr. Guez emphasizes ultrasound’s utility in lesion characterization, endoleak monitoring, and sparing patients from more invasive diagnostic procedures. The doctors delve into the specifics of using ultrasound contrast agents, particularly LUMASON and its intravascular utility for real-time monitoring of disease states with superior resolution compared to CT or MRI. Dr. Guez also discusses the potential for contrast enhanced ultrasound in interventional radiology, including diagnosing vascular lesions and augmenting tumor treatments. The conversation highlights the technique’s advantages, its high sensitivity for endoleaks, and potential areas for future research and application. The episode underscores the underutilized potential of contrast enhanced ultrasound in both diagnostic and interventional radiology settings. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:54 - Exploring the Basics of Contrast Enhanced Ultrasound 06:49 - Clinical Applications and Advantages of Contrast Enhanced Ultrasound 09:15 - Contrast Enhanced Ultrasound in Action: Diagnosing Endoleaks 23:52 - Future of Contrast Enhanced Ultrasound in Interventional Radiology 27:02 - Closing Thoughts --- RESOURCES Bracco LUMASON: https://lumason.com/ Nontraditional Uses of US Contrast Agents in Abdominal Imaging and Intervention: https://pubs.rsna.org/doi/full/10.1148/rg.220016 Book written by Andrej Lyshchik, MD, PhD (Thomas Jefferson) - Specialty Imaging: Fundamentals of CEUS: https://www.amazon.com/Specialty-Imaging-Fundamentals-Andrej-Lyshchik/dp/0323625649 Contrast-enhanced Ultrasound Identifies Patent Feeding Vessels in Transarterial Chemoembolization Patients With Residual Tumor Vascularity: https://pubmed.ncbi.nlm.nih.gov/32890324/ Contrast-enhanced ultrasound (CEUS) versus computed tomography angiography (CTA) in detection of endoleaks in post-EVAR patients. Are delayed type II endoleaks being missed? A systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/26191109/

26 Apr 202431min

In this episode, guest host Dr. Krishna Mannava interviews Dr. Bob Tahara about the significant multilevel impacts, ripple effects, and fallout of cyberattacks on the healthcare industry, specifically covering the recent cyberattack that targeted major clearinghouse, Change Healthcare. Dr. Tahara is a vascular surgeon practicing in rural northwest Pennsylvania and President of Outpatient Endovascular Interventional Society (OEIS). Dr. Tahara shares his experiences as a solo vascular surgeon in rural Pennsylvania, highlighting the complexities of modern billing systems, the advantages of hiring a quality billing company, and the challenges posed by the consolidation of clearinghouses. The conversation also delves into the alarming ransomware attack on Change Healthcare, where 6 terabytes of patient data were compromised. This incident exposed vulnerabilities across the healthcare sector, from payment processes to electronic medical and prescription records. The doctors underscore the importance of cybersecurity preparedness, diversification of clearinghouses, and the role of physicians in advocating for more secure and efficient healthcare systems. They also touch on personal hobbies like Kendo to manage stress. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 02:02 - Cyberattack on Change Healthcare: An Overview 06:37 - Impact of the Cyberattack on Healthcare Practices 09:50 - Understanding Clearinghouses in Healthcare Billing 14:30 - Fallout from the Cyber Attack: A Personal Account 16:40 - Navigating the Aftermath: Strategies and Solutions 22:54 - Value of Medical Records and Cybersecurity Measures 29:18 - Action Items and Advocacy for Physicians 35:00 - OEIS 2024 Meeting and Final Thoughts --- RESOURCES OEIS Annual Meeting Schedule 2024: https://oeisweb.com/wp-content/uploads/2024/04/2024-AM-attendee-brochure-v4-FINAL-proof-lowres.pdf BackTable Episode 349 - Cybersecurity for Physicians with Jason Newton, Esq: https://www.backtable.com/shows/vi/podcasts/349/cybersecurity-for-physicians

25 Apr 202441min

In this episode, Dr. Omar Saleh and Dr. Mike Watts discuss the challenging aspects of vascular interventions in the OBL setting, focusing on ‘oh $#!%’ moments and how to address various complications. Both Dr. Saleh and Dr. Watts are vascular and interventional radiologist, practicing in Southern California and New Jersey, respectively. The doctors share specific, challenging cases they’ve encountered, including device malfunctions and unexpected outcomes during procedures. Additionally, Dr. Saleh and Dr. Watts discuss the advantages of having hybrid OBL and hospital practices, the importance of being prepared for complications by having the right tools and strategies at hand, and interdisciplinary collaboration. The conversation also touches on the value of certain devices and techniques in managing complications effectively and ensuring patient safety. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 04:53 - Creative Solutions for Complex Vascular Cases 16:47 - Hybrid Practice: Balancing OBL and Hospital Work 21:39 - The Pros and Cons of Hybrid OBL-Hospital Practices 30:34 - Navigating Complex Medical Procedures 35:09 - Importance of Preparedness and Resourcefulness in Medical Emergencies 44:38 - Advice for Handling Complicated Medical Cases 49:26 - Concluding Thoughts and Looking Ahead to Future Conferences --- RESOURCES BackTable VI Episode 384 - New Innovations in Closure Devices with Dr. Omar Saleh and Dr. Syed Hussain: https://www.backtable.com/shows/vi/podcasts/384/new-innovations-in-closure-devices BackTable VI Episode 121 - Office-Based Labs (OBLs) & What You Can Do in Them with Dr. Mike Watts: https://www.backtable.com/shows/vi/podcasts/121/office-based-labs-obls-what-you-can-do-in-them BackTable VI Episode 37 - Treating PAD in the OBL with Dr. Mike Watts and Dr. Omar Saleh: https://www.backtable.com/shows/vi/podcasts/37/treating-pad-in-the-obl

23 Apr 202453min

In this episode, host Dr. Bryan Hartley takes us on a deep dive into the origin story and mission of Pulmera, a medtech company dedicated to transforming the field of bronchoscopic lung cancer diagnosis by retrofitting existing fluoroscopy machines into cone beam CT-like scanners. Dr. Hartley is a vascular and interventional radiologist and co-founded Pulmera, alongside interventional pulmonologist Dr. Harmeet Bedi at Stanford. Pulmera is developing a novel approach to enhance physicians’ ability to diagnose lung nodules accurately through innovative technology. Dr. Hartley shares insights into the challenges of existing diagnostic methods, the inspiration behind Pulmera, and the technology’s potential to combine the best of 3D imaging and endoscopy techniques. Dr. Hartley discusses the benefits for both patients and physicians, such as improved diagnostic yields and patient outcomes, and introduces an investment opportunity for the BackTable community to be part of this revolutionary project. The episode also explores the broader implications of this technology across various medical specialties beyond pulmonology. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES 00:00 - Introduction 02:18 - Personal Journey: From Vanderbilt to Stanford Biodesign 06:11 - Pulmera’s Mission: Enhancing Diagnostic Accuracy in Lung Biopsies 15:02 - Introducing a Game-Changing Technology for Bronchoscopic Procedures 22:09 - Challenges and Breakthroughs in Portable CT Imaging 27:44 - Economic Impact of Enhanced Diagnostic Procedures 29:48 - Building a Team and Securing Funding for Innovation 31:30 - Understanding Investment Opportunities and Equity Financing --- RESOURCES Dr. Bryan Hartley’s email: bryan.hartley@pulmera.com Dr. Bryan Hartley’s cell: 423-432-0612 Pulmera: http://www.pulmera.com/ Stanford Biodesign Fellowship: https://biodesign.stanford.edu/programs/fellowships/innovation-fellowships.html BackTable Innovation Episode #1 - Needs Driven Innovation with Dr. Todd Brinton (Stanford BioDesign): https://www.backtable.com/shows/innovation/podcasts/1/needs-driven-innovation BackTable Innovation Episode #30 - Host Stories with Dr. Bryan Hartley and Dr. Eric Gantwerker (Stanford BioDesign): https://www.backtable.com/shows/innovation/podcasts/30/host-stories BackTable VI Episode #422 - Pathology 101: Solid Advice for Percutaneous Biopsies with Dr. Andrew Sholl: https://www.backtable.com/shows/vi/podcasts/422/pathology-101-solid-advice-for-percutaneous-biopsies

19 Apr 202434min

In this episode, Dr. Jos van den Berg discusses the benefits of joining the Critical Limb Ischemia (CLI) Global Society, including discounts on Amputation Prevention Symposium (AMP) meetings, access to a specialized journal, and participation in Multidisciplinary CLI Network (MCLIN) discussion boards. Dr. van den Berg is an interventional radiologist at University of Bern in Switzerland and Europe Office Chairman and Member of Board of Directors for CLI Global Society. Dr. van den Berg also serves as a reviewer and editorial board member of multiple high-impact scientific journals. With members across the globe, the CLI Global Society emphasizes a multidisciplinary approach to combat CLI, aiming to prevent amputation and death through education, patient advocacy, and awareness about CLI. Dr. van den Berg also sheds light on the complexity of CLI management in Europe due to varied reimbursement systems among countries and the society’s efforts to tackle these challenges. The episode also touches on the society’s future goals, including expanding its global presence and continuing to offer extensive resources and networking opportunities to its members. --- CHECK OUT OUR SPONSORS BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 02:08 - Meet Our Guest: Dr. Jos van den Berg 05:42 - Deep Dive into CLI Global Society 07:53 - Exploring the Impact and Initiatives of CLI Global Society 14:42 - Challenges and Differences of CLI Management in Europe 21:08 - Innovations and Future Endeavors in CLI Treatment 23:45 - Closing Thoughts and the Importance of Membership --- RESOURCES CLI Global Society: https://www.cliglobalsociety.org/ Multidisciplinary CLI Network (MCLIN) Global CLI LIVE Meeting (every 2nd Friday of the month, 7am EST): https://www.cliglobalsociety.org/education/mclin/#myaccount AMP CLI Meeting: https://www.hmpglobalevents.com/amptheclimeeting

17 Apr 202427min

In this episode, Dr. Blake Parsons talks through the role of spinal cord stimulation in treating vascular issues and diabetic neuropathy. He also discusses the growing presence of vascular specialists in clinics, the transition from procedural work to clinical involvement, and the significance of building a strong patient-doctor relationship. The doctors highlight the effectiveness of Nevro 10 kHz therapy in providing long-term pain relief and sensory improvements for patients struggling with painful diabetic neuropathy, even after conventional treatments fail. Additionally, they touch upon reimbursement updates, the rise of outpatient care, and the future of spinal cord stimulation - emphasizing its potential beyond just pain relief to include improvements in patients’ overall quality of life, reducing risks related to diabetic foot wounds, and incidental falls. The need for a multidisciplinary approach in treating vascular and neuropathic conditions is also discussed, along with the role of interventional radiologists in managing these complex cases. --- CHECK OUT OUR SPONSOR Nevro HFX Spinal Cord Stimulator https://www.hfxforpdn.com --- SHOW NOTES 00:00 - Introduction 06:00 - Demystifying Spinal Cord Stimulation for Pain Management 17:11 - Optimizing Patient Care: Trials, Techniques, and Insurance 26:03 - Leveraging Telehealth and Support Teams for Patient Success 30:22 - Challenges and Solutions in Managing Peripheral Neuropathy 35:19 - Collaboration and Referral Dynamics in Vascular and Interventional Radiology 39:19 - Exploring the Future of Neuropathy Treatment and Quality of Life Improvements 43:46 - Addressing the Challenges of Permanent Implant Procedures 48:46 - Role of Technology and AI in Patient Management 56:31 - Concluding Thoughts on Neuropathy Treatment and Practice Dynamics --- RESOURCES Nevro 10 kHz Therapy: https://nevro.com/English/en/providers/HFX-Advanced-Therapies/default.aspx Effect of High-frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy: A Randomized Clinical Trial (JAMA Neurology RCT 2021): https://pubmed.ncbi.nlm.nih.gov/33818600/ Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial (SENZA-PDN RCT 2023): https://pubmed.ncbi.nlm.nih.gov/37536514/ Electrical spinal-cord stimulation for painful diabetic peripheral neuropathy (Lancet RCT 1996): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)02467-1/abstract

16 Apr 202459min