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/

Episoder(638)

Ep. 625 Managing Acute Arterial Thrombosis: Devices & Approaches with Dr. Shang Loh and Dr. Khanjan Nagarsheth

Ep. 625 Managing Acute Arterial Thrombosis: Devices & Approaches with Dr. Shang Loh and Dr. Khanjan Nagarsheth

The advent of newer thrombectomy devices has turned what were once hours-long surgical cutdowns into endovascular cases that last under an hour. In this episode of BackTable, host Dr. Sabeen Dhand is ...

17 Mar 45min

Ep. 624 Integrating Spinal Cord Stimulation in Vascular Disease Management for CLTI with Dr. Mary Costantino and Jill Sommerset

Ep. 624 Integrating Spinal Cord Stimulation in Vascular Disease Management for CLTI with Dr. Mary Costantino and Jill Sommerset

Chronic limb-threatening ischemia (CLTI) represents the most advanced stage of peripheral artery disease. While many patients can be treated with endovascular or surgical revascularization, a subset o...

13 Mar 41min

Ep. 623 CLTI: Lithotripsy and Endovascular Techniques for Below the Knee Interventions with Dr. Paul Foley

Ep. 623 CLTI: Lithotripsy and Endovascular Techniques for Below the Knee Interventions with Dr. Paul Foley

Below-the-knee (BTK) arterial disease remains one of the more challenging areas in vascular care, particularly in patients with chronic limb-threatening ischemia (CLTI), where heavy calcification comp...

10 Mar 43min

Ep. 622 Intratumoral Immunotherapy Injections for Melanoma with Dr. Jennifer McQuade and Dr. Rahul Sheth

Ep. 622 Intratumoral Immunotherapy Injections for Melanoma with Dr. Jennifer McQuade and Dr. Rahul Sheth

When standard-of-care checkpoint blockade fails in metastatic melanoma, how can oncologists and interventional radiologists join forces to turn around patient outcomes? In this episode of the BackTabl...

6 Mar 45min

Ep. 621 Techniques for Liver Metastases Ablation: Planning & Execution with Dr. Jonas Redmond

Ep. 621 Techniques for Liver Metastases Ablation: Planning & Execution with Dr. Jonas Redmond

With data increasingly positioning thermal ablation as a viable alternative to surgery for select liver metastases, the demands on the interventional oncologist have never been higher. Mastering the n...

3 Mar 45min

Ep. 620 Ergonomic Strategies for Radiologists: Preventing Back & Neck Pain with Dr. Keith Horton

Ep. 620 Ergonomic Strategies for Radiologists: Preventing Back & Neck Pain with Dr. Keith Horton

Better habits start now. Poor ergonomics in the angio suite lead to cumulative neck and back injuries, absenteeism, presenteeism, and even early retirement. This episode of the BackTable Podcast offer...

27 Feb 50min

Ep. 619 Clinical Insights: Managing LUTs in BPH Patients with Dr. Art Rastinehad

Ep. 619 Clinical Insights: Managing LUTs in BPH Patients with Dr. Art Rastinehad

Prostate artery embolization may be performed by interventional radiologists, but its indications are rooted in urologic evaluation. In the second installment of our 2026 PAE University Series, Dr. Ch...

24 Feb 56min

Ep. 618 How to Manage Advanced DVA Cases: Techniques & Tips with Dr. Kumar Madassery

Ep. 618 How to Manage Advanced DVA Cases: Techniques & Tips with Dr. Kumar Madassery

How do experienced operators approach the most technically demanding aspects of deep venous arterialization (DVA)? In this episode of BackTable, host Dr. Sabeen Dhand sits down with Dr. Kumar Madasser...

20 Feb 1h 9min

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