Ep. 315 Arterial Thrombectomy with Dr. Alexander Ushinsky

In a society where discussions about medical malpractice are often concealed from the public eye, this episode of BackTable shines a spotlight on the powerful documentary ‘A World of Hurt: How Medical Malpractice Fails Everyone,’ produced by Viknesh Kasthuri, a fourth-year medical student at Brown University. Released earlier this year, the film explores how the American medical malpractice system harms and disconnects patients and providers through three compelling case studies. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS We delve into Viknesh’s motivations and the process behind creating the documentary, discussing the need for improved provider education on lawsuits, effective communication with patients and legal teams, and strategies for coping mentally and emotionally throughout this intensive process. Additionally, Viknesh provides a behind-the-scenes look at documentary production, including filming during the COVID pandemic, creating environments for patients and providers to share their stories, and submitting the documentary to film festivals. --- TIMESTAMPS 00:00 - Introduction 02:40 - Inspiration Behind the Documentary 06:10 - Technical and Legal Aspects of Documentary Production 14:34 - Releasing the Documentary 17:04 - Physician and Patient Responses to Medical Errors 20:27 - Highlighting Communication Resolution Programs 23:04 - Educational Gaps in Medical Training 26:43 - Exploring Systemic Solutions to Management of Medical Errors 30:16 - Final Thoughts and Future Projects --- RESOURCES A World of Hurt Documentary: https://www.youtube.com/watch?v=09IVcL6pACU BackTable VI Ep. 77- Doctors and Litigation: The L Word, with Dr. Gita Pensa: https://www.backtable.com/shows/vi/podcasts/177/doctors-litigation-the-l-word The L Word Podcast with Dr. Gita Pensa: https://doctorsandlitigation.com/podcast-2 BackTable ENT Ep. 90- Coaching Physicians Through the Stress of Malpractice Litigation, with Dr. Gita Pensa: https://www.backtable.com/shows/ent/podcasts/90/coaching-physicians-through-the-stress-of-malpractice-litigation Michigan Model Communication and Resolution Program: https://www.uofmhealth.org/michigan-model-medical-malpractice-and-patient-safety-umhs

13 Sep 202437min

Are you interested in starting an ASC or converting your OBL into an ASC, but aren’t sure where to start? We’ve got you covered with this comprehensive overview. Attorney Jason Greis joins guest host and ASC founder Dr. Krishna Mannava to explore the operational, financial, and legal intricacies of starting an ASC. Jason is a Partner of Benesch, Friedlander, Coplan & Aronoff LLP, outside co-counsel to the Renal Physicians Association and OEIS Society, and recognized faculty member of SIR Business Institute. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Jason and Dr. Mannava discuss crucial factors such as structural modifications, financial considerations, legal requirements, Certificate of Need (CON) states, and credentialing processes. The conversation also delves into strategic partnerships with hospitals, the role of ASC management companies, and the involvement of non-physician owners. Additionally, they explain the implications of non-compete clauses, operational challenges, investment structures, and exit strategies. --- TIMESTAMPS 00:00 - Introduction 03:11 - OBL to ASC Conversion 06:08 - Financial and Regulatory Aspects 15:35 - Ownership and Investment Strategies 29:41 - Non-Competes and Legal Risks 34:21 - Specialized Legal Advice and Conclusion --- RESOURCES Vive Vascular: https://www.vivevascular.com/ SIR Business Center: https://irbc.sirweb.org/

10 Sep 202446min

What’s needed to build a successful lymphangiography practice? Dr. Bill Majdalany joins host Dr. Chris Beck to answer this question and to discuss advancements in lymphangiography over the past decade. Dr. Majdalany is the Chief and Vice Chair of Research of Interventional Radiology at University of Vermont. --- CHECK OUT OUR SPONSOR Guerbet --- SYNPOSIS The doctors provide insights on various lymphatic procedures such as thoracic duct embolization, stenting, and recanalization. They also discuss the evolving significance of lymphatic medicine in interventional radiology and its potential applications in treating conditions like ascites and variceal bleeding. The conversation underscores the interconnected nature of the lymphatic system throughout the body, emphasizing the revolutionary potential of lymphangiography in modern medicine. --- TIMESTAMPS 00:00 - Introduction 04:23 - Building a Lymphangiography Practice 08:36 - The Lymphatic Revolution 17:42 - Practical Tips and Equipment for Lymphangiography 30:09 - Advanced Interventions and Tools 48:45 - Future of Lymphatic Interventions 51:23 - Conclusion and Resources --- RESOURCES BackTable VI Podcast Episode #135 - IR Residency Pathways & Getting In! (Part 1) with Dr. Jeff Bodner and Dr. Bill Majdalany: https://www.backtable.com/shows/vi/contributors/dr-bill-majdalany Seminars in Interventional Radiology - Lymphatics: https://www.thieme-connect.com/products/ejournals/issue/10.1055/s-010-49075 Lymphatic Anatomy: https://www.techvir.com/article/S1089-2516(16)30042-7/abstract

3 Sep 202454min

What is the final frontier of interventional radiology? Dominic Tanzillo and Dr. Richard Moon believe it could be space. Dominic is a 3rd year medical student at Duke University interested in interventional radiology (IR) and space medicine, and Dr. Moon is a Professor at Duke University and an expert in hyperbaric and aerospace medicine. --- CHECK OUT OUR SPONSOR Medtronic DCB https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/drug-coated-balloons.html --- SYNPOSIS Dominic and Dr. Moon cover the potential for IR in deep space missions, focusing on the unique challenges astronauts face, such as altered blood flow, increased clotting risks, and the impacts of microgravity on the human body. The episode dives into NASA’s investments in portable medical technologies, the practicalities of emergency medical procedures in space, and the need for minimally invasive interventions. The significance of IR in diagnosing and managing vascular issues in space is discussed, as well as the broader implications for future Mars missions and long-term space travel. --- TIMESTAMPS 00:00 - Introduction 02:36 - IR in Space 20:04 - Medical Issues Astronauts Face 26:27 - Remote Surgery and Telesurgery 30:45 - Emergency Evacuations in Space 32:32 - More on Space Medicine --- RESOURCES Aerospace Medicine Association: https://www.asma.org/about-asma/careers/aerospace-medicine Translational Research Institute for Space Health: https://www.bcm.edu/academic-centers/space-medicine/translational-research-institute Space Medicine Coursera: https://www.coursera.org/learn/space-medicine-duke What Space Medicine Taught Me About Science Communication | Dominic Tanzillo | TEDxDuke: https://www.youtube.com/watch?v=PBkdvSByneM Dominic Tanzillo: https://dominictanzillo.github.io/

27 Aug 202437min

While GLP-1 agonists continue to gain popularity in the medical management of diabetes and obesity, Dr. Cliff Weiss is exploring bariatric arterial embolization (BAE) as an adjunctive therapy to help patients sustain weight loss. Dr. Weiss, the Director of IR Research at Johns Hopkins, joins the show to discuss the techniques and impacts of BAE for obesity treatment. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Weiss outlines his initial research interest in gastric embolization of the fundus to reduce ghrelin production. He began by studying the use of sclerosants for embolization but later shifted to using embolic spheres. BAE involves the targeted embolization of the left gastric artery, with or without the left gastroepiploic artery, using 300-500 micron embolic spheres. Dr. Weiss also employs a dilute mixture of spheres and a vasodilator to achieve distal arterial penetration. He describes the role of BAE in conjunction with existing surgical and pharmaceutical treatments. According to his experience, patients undergoing BAE achieve maximum weight loss 6-9 months after the procedure and can maintain this weight when they follow up in a weight management clinic. Additionally, Dr. Weiss reviews data from BAE studies, including the BEAT Obesity Trial and the recent BEATLES Trial. --- TIMESTAMPS 00:00 - Introduction 03:21 - Early Research and Development of BAE 07:39 - Potential Role of BAE in Obesity Treatment 16:03 - Procedure Details 25:28 - Post-Procedure Care and Patient Management 28:06 - Insights from the BEAT Obesity Trial 33:38 - BEATLES Trial 37:38 - Combination Therapy for Obesity --- RESOURCES BEAT Obesity Trial: https://pubs.rsna.org/doi/full/10.1148/radiol.2019182354 LC Bead/Bead Block: https://www.bostonscientific.com/en-US/products/embolization/lc-bead.html EmboSpheres: https://www.merit.com/product/embosphere-microspheres/ EMBIO Trial: https://bmjopen.bmj.com/content/13/9/e072327 BEATLES Trial: https://www.jvir.org/article/S1051-0443(23)01155-7/fulltext

20 Aug 202445min

How can physicians and industry partners collaborate effectively to enhance patient care? Dr. Adam Tanious, Assistant Professor of Vascular Surgery at the Medical University of South Carolina, joins host Dr. Aaron Fritts to explore strategies for navigating physician-industry relationships. --- SYNPOSIS The doctors share their experiences in partnering with the medical device industry. The conversation covers the benefits of industry partnerships, the challenges of avoiding conflicts of interest, and the critical role of education in preparing new physicians for these interactions. Dr. Tanious also delves into his thought-provoking TED Talk on big business in surgery, and discusses the value of business education for physicians. --- TIMESTAMPS 00:00 - Introduction 02:12 - Medicine and Business 05:01 - Business Knowledge for Physicians 15:05 - Physician-Industry Relationships 27:26 - Industry Relationships in Medical Training 33:08 - Ethical Considerations and Influence in the OR 35:00 - Leveraging Industry Resources for Better Training 43:24 - Future of Medical Technology and Collaboration --- RESOURCES Big Business and Surgery: Who Belongs in Your Operating Room?: https://youtu.be/kksVjF0fI_w?si=LADwqrbXPz3VsFm4 Quantic MBA Program: https://quantic.edu/blog/category/fields-of-study/accounting/ The price of a cup of coffee: https://vascularspecialistonline.com/the-price-of-a-cup-of-coffee/

16 Aug 202456min

The management of portal hypertension has drastically evolved over the years. What are the current best practices? And what’s coming next? Dr. Tom Leventhal and Dr. Siobahn Flanagan from University of Minnesota Medical School join us for an interdisciplinary discussion. Dr. Leventhal is an Associate Professor of Transplant Hepatology and Dr. Siobhan is an Associate Professor of Interventional Radiology. --- CHECK OUT OUR SPONSOR Cook Medical Embolization https://www.cookmedical.com/interventional-radiology/coils-home/cook-products/?utm_source=backtable&utm_medium=digital&utm_campaign=vasc_ir_p_awa_embolization_2024_amer --- SYNPOSIS The doctors discuss current collaborative approaches that are improving portal hypertension patient care, the impact of contemporary clinical practices in transplant hepatology and IR, and the imminent future of portal hypertension treatments. Dr. Leventhal also gives his insight on what could be on the horizon, touching on in-vitro organ creation, xenotransplants, and stem cells phasing out immunosuppression. --- TIMESTAMPS 00:00 - Introduction 06:10 - Managing Portal Hypertension 07:51 - Current Collaborative Practices 10:38 - Patient Referral and Management 15:25 - Initial Workup for Portal Hypertension 19:27 - Role of Biopsy in Diagnosis 24:02 - Patient Scenarios for TIPS Referral 32:04 - Ultrasound and Intracardiac Echocardiography (ICE) in TIPS 38:09 - Clinical Management 52:48 - Future of Transplant and Organ Growth

13 Aug 202458min

We are back with Part 2 of All Things Enteral Access with Dr. Peter Bream! We discuss various aspects of enteric access and management of complications with G and GJ-tubes. --- SYNPOSIS Dr. Bream provides detailed advice on troubleshooting common issues such as leaking tubes, infections, and clogs. He emphasizes the importance of a multidisciplinary approach in managing special populations, such as patients with ALS and head and neck cancer, and offers guidance for safe and effective procedures. The conversation is rich with practical tips, tricks, and valuable insights that cater to both new and experienced practitioners. --- TIMESTAMPS 00:00 - Introduction 01:47 - Special Populations 07:21 - ALS Patients 09:57 - Head and Neck Cancer Patients 14:05 - Techniques for Gastric Bypass and Altered Anatomy 18:11 - Addressing G-Tube Issues 27:16 - Converting G to GJ-Tubes 31:11 - Advanced Tips and Tricks --- RESOURCES Weighted Tip Extensions Result in Fewer Gastrojejunostomy Tube Migrations and Increase Tube Lifespan: https://www.jvir.org/article/S1051-0443(22)01243-X/abstract

9 Aug 202437min