Ep. 196 Building a PE Response Team with Dr. Carin Gonsalves

Ep. 196 Building a PE Response Team with Dr. Carin Gonsalves

We talk with Interventional Radiologist Dr. Carin Gonsalves about how her practice built a multidisciplinary Pulmonary Embolism (PE) Response team, including where to start, developing efficient workflows, and obtaining the equipment you need for success. --- CHECK OUT OUR SPONSOR Inari Medical https://www.inarimedical.com/ --- SHOW NOTES In this episode, hosts Dr. Michael Barraza and Dr. Aaron Fritts interview Dr. Carin Gonsalves, interventional radiologist, about building a pulmonary embolism response team (PERT) and the evolution of pulmonary embolism (PE) treatment including large bore suction thrombectomy devices and the importance of multidisciplinary effort in care of patients with PEs. Dr. Gonsalves discusses how she came to be Division Director of the PERT program at Jefferson University, and her collaborations with Geno Merli, cofounder of the PERT Consortium. Her interest in advancing PE treatment stemmed from her years of performing pulmonary arteriography and catheter directed thrombolysis before the inception of suction thrombectomy devices. She discusses the difficulty she had in obtaining these new devices, and how after 11 months of discussions, the hospital agreed to purchase the necessary equipment to enable the PE response team. She discusses how the PERT is activated when a patient presents with suspected PE. Her team is comprised of five subspecialties including IR, Pulmonary Critical Care, Vascular Surgery, Cardiothoracic Surgery, and Cardiology. She emphasizes how having a group of experts improves patient care by cutting down on critical decision time. She enjoys sharing the responsibility of evaluating treatment approaches based on the current literature and the diversity of experience in the group. Finally, we discuss advances in technology for treatment of PE. Dr. Gonsalves enjoys the ease of use and wide range of clots she can treat including acute, subacute and chronic. These devices have been game changers for PE; many patients are poor surgical candidates and have contraindications to thrombolysis. They end by discussing novel uses of these devices that Dr. Gonsalves performs including removal of clot in transit (mobile clot in the IVC, SVC, RA or RV) and vegetations on the tricuspid valve or a pacemaker lead. --- RESOURCES The PERT Consortium: https://pertconsortium.org Inari PEERLESS RCT: https://www.inarimedical.com/peerless/ Inari FlowTriever: https://www.inarimedical.com/flowtriever/ Inari ClotTriever: https://www.inarimedical.com/clottriever-int/ Inari FlowSaver: https://www.inarimedical.com/flowsaver/ AngioVac: https://www.angiovac.com

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Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen

Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Ucy8jI Director of IR Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care.

30 Sep 201929min

Ep. 48 IR and ENT Treatment of Epistaxis with Dr. Ashley Agan and Dr. Sabeen Dhand

Ep. 48 IR and ENT Treatment of Epistaxis with Dr. Ashley Agan and Dr. Sabeen Dhand

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xQPc7h In this episode, Dr. Ashley Agan and Dr. Sabeen Dhand join Dr. Gopi Shah to discuss IR and ENT treatment of epistaxis. We cover the differences in how epistaxis presents for ENT and IR as well as how epistaxis presents in children and older patients. Dr. Agan tells us about the types of nosebleeds that are common and the general treatment algorithm she follows. We discuss nasal packing and decongestant sprays for treatment and how to know when to take the patient to the OR. Dr. Agan talks about isolating the bleeding spot, how to use a foley for posterior nosebleeds, and SPA litigation. We discuss why ENT might consult IR for an embolization. Dr. Dhand tells us about the contraindications for embolization and the procedure for treating the epistaxis. We review the materials that should be used and why it is important to look out for artery connections and pseudoaneurysms. We discuss the pearls and pitfalls of ENT and IR treatment of epistaxis and how to avoid the risk of stroke.

30 Aug 201933min

Ep. 47 BRTO vs. PARTO and other Techniques with Dr. Luke Wilkins

Ep. 47 BRTO vs. PARTO and other Techniques with Dr. Luke Wilkins

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ZvpYnL Special Guest Dr. Luke Wilkins of University of Virginia VIR discusses BRTO and PARTO techniques for treatment of gastric variceal bleeding.

18 Aug 201941min

Ep. 46 Collaboration not Competition between IR and IC with Dr. Achal Sahai and Dr. Chris Beck

Ep. 46 Collaboration not Competition between IR and IC with Dr. Achal Sahai and Dr. Chris Beck

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/bobcIg Interventional Cardiologist (IC) Dr. Achal Sahai and Interventional Radiologist (IR) Dr. Christopher Beck discuss ways these two specialties collaborate on complex cases, share endovascular techniques, and avoid the "turf war" trap.

31 Juli 201945min

Ep. 45 Coping with Complications with Dr. Maureen Kohi and Dr. Sandeep Bagla

Ep. 45 Coping with Complications with Dr. Maureen Kohi and Dr. Sandeep Bagla

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/uVVOw3 Dr. Maureen Kohi from UCSF Medical Center and Dr. Sandeep Bagla from Vascular Institute of Virginia discuss the challenges of dealing with procedural complications, and the importance of talking with colleagues and mentors in effective coping.

1 Juli 201959min

Ep. 44 TIPS Procedure Techniques: East to West Coast with Dr. Peder Horner and Dr. Peter Bream

Ep. 44 TIPS Procedure Techniques: East to West Coast with Dr. Peder Horner and Dr. Peter Bream

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/2WK9kp East Coast "McBreamy" and "Western Peder" discuss their Colapinto vs. Uchida needle preference, advantages of the ICE catheter, and other great pearls and pitfalls for the TIPS Procedure. Special thanks to our sponsor RADPAD® Radiation Protection. Protect yourself and your patients during those lengthy TIPS cases.

16 Juni 20191h

Ep. 43 Managing Urosepsis with Dr. Caire and Dr. Bennett

Ep. 43 Managing Urosepsis with Dr. Caire and Dr. Bennett

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/rn9T7J Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett return to the BackTable Podcast to discuss their approaches to urosepsis, stent vs. nephrostomy for a variety of presentations, and the middle-of-the-night patient.

2 Juni 201934min

Ep. 42 Physician Contract Negotiation with Dr. Mary Costantino and Courtney Angeli

Ep. 42 Physician Contract Negotiation with Dr. Mary Costantino and Courtney Angeli

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/igMUV3 Dr. Mary Costantino and her contract lawyer Courtney Angeli discuss the essentials of physician contract negotiation: finding the right lawyer, partnerships, non-competes, and critical pitfalls to avoid.

12 Maj 20191h

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