Ep. 679 Navigating Liquid Embolization Techniques: Insights & Practices with Dr. Gary Siskin and Dr. Kavi Krishnasamy

Could replacing bulky coil packs with specialized liquid embolic agents be the key to faster, more cost-effective peripheral embolizations? In this kickoff episode of the BackTable 2026 Liquid Embolics Creator Weekend™, Dr. Kavi Krishnasamy (University of Alabama at Birmingham) and Dr. Gary Siskin (Albany Med) join Dr. Tyler Sandow to break down the foundational principles, deployment approaches, and expanding clinical applications of liquid embolics in non-neurological interventions. They discuss the transition toward a "liquid-first" procedural mindset, the technical nuances of adhesive and cohesive agents, and how targeted liquid cast creation might optimize procedure times and device expenditure compared to traditional coiling. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex. --- Timestamps 00:00 - Introduction03:01 - Case 1: Rectus Sheath Bleed06:15 - Liquid Embolics: Advantages and Apprehension12:15 - Adhesive vs. Cohesive Mechanisms14:28 - LAVA Workflow and Deployment Considerations19:37 - Safe Post-Delivery Technique23:49 - Risks and Preventing Adverse Events27:06 - Case 2: Roadmap Mask for Embolic Visualization30:22 - Stuck Catheter Experiences34:01 - Glue Timing and Control37:13 - Rapid-Fire Practical Pearls41:40 - Closing Remarks --- More about this episode The panel walks through procedural protocols, detailing microcatheter selection, dead-space calculations, and injection techniques designed to prevent arterial spasm and non-target reflux. Dr. Siskin and Dr. Krishnasamy detail troubleshooting strategies including catheter extraction maneuvers to prevent device entrapment, the use of road-map masking for better embolic visualization, and the application of pushable or detachable coils as distal backstops. They review approaches in high-yield clinical scenarios such as rectus sheath hematomas, gastroduodenal artery (GDA) obliteration, and type II endoleak interventions. The episode concludes with advice for early-career operators on gaining hands-on preclinical experience, mastering multi-embolic combinations, and identifying scenarios where liquid agents should be avoided. --- Resources Treatment of Peripheral Arterial Hemorrhage with Lava LES (The LAVA Study)https://clinicaltrials.gov/study/NCT04649255 Onyx™ Liquid Embolic IDE Clinical Studyhttps://clinicaltrials.gov/study/NCT06742801 Fluidx’s GPX Embolic Device Meets Primary Endpoints in Pivotal Trialhttps://evtoday.com/news/fluidxs-gpx-embolic-device-meets-primary-endpoints-in-pivotal-trial --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app