Ep. 178 Challenging Stroke Thrombectomies with Tough Clot with Dr. Matt Gounis and Dr. Hannes Nordmeyer

Ep. 178 Challenging Stroke Thrombectomies with Tough Clot with Dr. Matt Gounis and Dr. Hannes Nordmeyer

Interventional Neuroradiologist Dr. Hannes Nordmeyer and Biomedical Engineer Dr. Matt Gounis discuss compositions of tough clots, approaches to stroke thrombectomy, and bailout stenting. --- CHECK OUT OUR SPONSOR CERENOVUS https://www.jnjmedicaldevices.com/en-US/companies/cerenovus --- SHOW NOTES In this episode, interventional neuroradiologist Dr. Hannes Nordmeyer, biomedical engineering professor Dr. Matt Gounis, and our host Dr. Michael Barraza discuss compositions of tough clots, approaches for stroke thrombectomy, and bailout stenting. Dr. Nordmeyer believes that interventionalists are still struggling to find the most effective method for pulling clots. He says that the use of double stent retrievers has shown high success rates, but it would be ideal to have one retriever that can work on its own. He describes his equipment setup for a standard large vessel occlusion. Dr. Nordmeyer notes clot location and behavior within the first two passes determines whether or not the operator should continue with the stent retrieval approach or change the approach. Dr. Gounis evaluates various devices by defining “success” as achievement of TICI 3 with the first pass. He comments on the current development of very large bore aspiration catheters, such as the 088 Millipede catheter and the Tenzing catheter. He also emphasizes that the success of the procedure relies largely on the composition of the embolus. Fibrin-rich clots are less likely to integrate with the stent retriever. We discuss Dr. Nordmeyer’s technique, which utilizes a microcatheter and the NIMBUS device to pin and retrieve the challenging clot. We also cover bailout stenting and the benefits of recanalization when clot removal is not possible. --- RESOURCES SWIFT DIRECT Trial: https://www.swift-direct.ch/the-swift-direct-trial/ Preclinical Evaluation of Millipede 088 Intracranial Aspiration Catheter: https://pubmed.ncbi.nlm.nih.gov/32606100/ The Novel Tenzing 7 Delivery Catheter Designed to Deliver Intermediate Catheters to the Face of Embolus Without Crossing: https://jnis.bmj.com/content/13/8/722 Factors Influencing Recanalization After Mechanical Thrombectomy With First-Pass Effect for Acute Ischemic Stroke: https://www.frontiersin.org/articles/10.3389/fneur.2021.628523/full NIMBUS Geometric Clot Extractor: https://www.jnjmedicaldevices.com/en-EMEA/news-events/cerenovus-launches-nimbustm-geometric-clot-extractor-remove-tough-clots

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Ep. 63 IR Identity and Turf Wars with Dr. Eric Keller

Ep. 63 IR Identity and Turf Wars with Dr. Eric Keller

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/48hidj Dr. Eric J. Keller from Stanford Medicine Department of Radiology provides insight from his studies on the IR Identity, as well as his research on perceived turf wars between specialties.

11 Maj 202050min

Ep. 62 Protect Yourself Before You Wreck Yourself with Dr. Mina Makary

Ep. 62 Protect Yourself Before You Wreck Yourself with Dr. Mina Makary

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xsBt1Y Special guest Dr. Mina Makary from The Ohio State University Wexner Medical Center discusses the need for better awareness and protection from the serious harmful effects of chronic low dose radiation, which can sometimes require change in institutional culture. An extremely important occupational health issue!

27 Apr 202026min

Ep. 61 Physician Burnout with Dr. Jeff Chick and Dr. Jacob Bundy

Ep. 61 Physician Burnout with Dr. Jeff Chick and Dr. Jacob Bundy

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/nl8ZgW Dr. Jeffrey Chick and Dr. Jacob Bundy discuss the results of their recent study in April JVIR on rates and major contributors to Physician Burnout in IR, how they compare to other specialties, and how to prevent it in your own career.

13 Apr 202033min

Ep. 60 Building a Limb Salvage Program with Dr. Jihad Mustapha

Ep. 60 Building a Limb Salvage Program with Dr. Jihad Mustapha

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/08KW16 CLI fighters Sabeen Dhand and Jihad A. Mustapha discuss the essentials of building a successful Limb Salvage program, including the importance of a multidisciplinary approach, broadening skill sets such as pedal access, and meticulous patient follow up.

30 Mars 202049min

Special COVID-19 Weekend Update with UPenn IR Dr. Stephen Hunt

Special COVID-19 Weekend Update with UPenn IR Dr. Stephen Hunt

Dr. Stephen Hunt of Penn Medicine at University of Pennsylvania Health System discusses ways in which his IR practice has changed in the setting of the COVID 19 pandemic, including case selection and lessons learned from colleagues in Singapore and China.

28 Mars 202032min

Ep. 59 Endovascular Treatment of DVT with Dr. Dexter and Dr. Abramowitz

Ep. 59 Endovascular Treatment of DVT with Dr. Dexter and Dr. Abramowitz

Vascular Surgeons David Dexter and Steven Abramowitz discuss endovascular treatment of lower extremity DVT, including patient selection and risks and benefits of catheter-directed therapy (CDT), mechanical thrombectomy, and pharmaco-mechanical thrombolysis.

24 Mars 202059min

Ep. 58 Endovascular Treatment of PE with Dr. Venkat Tummala and Dr. Thomas Tu

Ep. 58 Endovascular Treatment of PE with Dr. Venkat Tummala and Dr. Thomas Tu

Interventional Cardiologist Thomas Tu, MD and Interventional Radiologist Venkat Tummala MD discuss their respective approach to the treatment of Pulmonary Embolism, including risk stratification, treatment options, and endovascular technique.

11 Mars 202045min

Ep. 57 Practicing IR in the UK with Dr. Gregory Makris

Ep. 57 Practicing IR in the UK with Dr. Gregory Makris

Dr. Christopher Beck talks with Dr. Gregory Makris of Guy's and St. Thomas' NHS Foundation Trust in London about IR education and practice in the UK, as well as his involvement with CIRSE and the European Trainee Forum.

5 Mars 202045min

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