Ep. 572 How to Perform Mesocaval Shunts: Techniques & Outcomes with Dr. Omar Chohan and Dr. Harris Chengazi

Ep. 572 How to Perform Mesocaval Shunts: Techniques & Outcomes with Dr. Omar Chohan and Dr. Harris Chengazi

Before the advent of TIPS, mesocaval shunts were considered a less popular option for managing portal hypertension. But today, could they serve as a lifeline when no other choices remain? This week on BackTable, Drs. Omar Chohan and Harris Chengazi (Great Lakes Medical Imaging) join host Dr. Chris Beck to discuss the evolving role of endovascular mesocaval shunts, covering patient selection, clinical decision-making, and technical pearls. --- SYNPOSIS In this episode, the hosts delve into the specialized procedure of meso-caval shunts, focusing on its applications for patients with portal hypertension who have no other viable options. This discussion includes detailed case studies, such as one involving a woman with autoimmune hepatitis and another with pancreatic cancer, showcasing the practical challenges and innovative solutions in creating these shunts. In each case, they detail the rationale for patient selection, difficult anatomy, procedural steps, and resolution of symptoms like recurrent ascites and variceal bleeding. The episode emphasizes the importance of pre-procedure planning, collaboration, and precise imaging, utilizing advanced tools like the 4D CT scanner. The conversation also highlights the compassionate motivation behind these complex procedures, aimed at improving patients' quality of life. --- TIMESTAMPS 00:00 - Introduction 03:07 - Historical Context and Indications06:49 - Case 1: Patient with Refractory Ascites34:00 - Case 2: Recurrent GI Bleeding41:16 - Case 3: TIPS Consult - Pancreatic Cancer and Duodenal Varices47:44 - Lessons, Pearls, and Tips56:13 - Final Thoughts --- RESOURCES A Case Series of Dr. Chengazi's Mesocaval Shunts on X:https://x.com/chengazimd/status/1966337167879438571 Episode 573 Portal Hypertension Treatment Strategies:https://www.backtable.com/shows/vi/podcasts/473/portal-hypertension-treatment-strategies-ir-hepatology-perspectives TIPS University Freshman Year:https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup TIPS University Sophomore Year:https://www.backtable.com/shows/vi/podcasts/124/tips-university-sophomore-year-basic-procedure-technique TIPS University Junior Year:https://www.backtable.com/shows/vi/podcasts/125/tips-university-junior-year-advanced-techniques-ice-splenic-access TIPS University Senior Year:https://www.backtable.com/shows/vi/podcasts/126/tips-university-senior-year-gunsight-technique-splenic-closure

Episoder(641)

Ep. 628 Techniques for Managing Biliary Drain Complications with Dr. Ahsun Riaz

Ep. 628 Techniques for Managing Biliary Drain Complications with Dr. Ahsun Riaz

Patients and IRs alike dread the persistent cycles of malfunction and repeated procedures that often accompany biliary drains. What can you do to keep patients off the doorstep of reintervention? In t...

27 Mar 47min

Ep. 627 Radial Access for Peripheral Interventions: Techniques & Considerations with Dr. Shailendra Singh

Ep. 627 Radial Access for Peripheral Interventions: Techniques & Considerations with Dr. Shailendra Singh

Radial roots, peripheral reach! Radial to peripheral (R2P) access is the focus of this week’s episode with interventional cardiologist Dr. Shailendra Singh (Pennsylvania’s Lehigh Valley Heart and Vasc...

24 Mar 1h 7min

Ep. 626 Single Stick Vascular Access: Techniques & Benefits Explained with Dr. Kevin Wong

Ep. 626 Single Stick Vascular Access: Techniques & Benefits Explained with Dr. Kevin Wong

With the single-stick technique proving to be an effective addition to the venous line placement toolkit, what is stopping IRs from venturing beyond the traditional dual-incision approach? In this epi...

20 Mar 33min

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

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