Ep. 328 Adrenal Vein Sampling with Dr, Fritz Angle

Dr. Fabian Laage Gaupp tells us the origin story of Road2IR.org, an initiative to build self-sustaining IR training programs in East Africa. In collaboration with Yale and Emory Departments of Radiology, Road2IR has helped establish East Africa’s first accredited IR training program in Tanzania! --- SHOW NOTES In this episode, Dr. Fabian Laage Gaupp joins Dr. Aaron Fritts to discuss his work in The Road2IR training program. We discuss the beginnings of the program and how they worked to build the first generation of interventional radiologists as well as nurses and technologists in Tanzania. We discuss the types of procedures that the program offers and how they have adapted to the needs of the communities they work with. We explain how the training measures have changed during the COVID-19 pandemic, and we examine the importance of having a certain mindset while working in this program. Dr. Laage Gaupp tells us about the sedation certificate nurses can train for and their plans for expanding the program to Rwanda. We discuss some of the challenges of shipping imaging equipment and other disposable equipment. Dr. Laage Gaupp explains why he thinks IR will gain popularity in Africa, and we talk about how to get involved in the Road2IR program. --- RESOURCES Tanzania IR Initiative, Training the First Generation of Interventional Radiologists https://www.clinicalkey.com/service/content/pdf/watermarked/1-s2.0-S1051044319306876.pdf?locale=en_US&searchIndex= Road2IR website https://www.road2ir.org/ Social Media Accounts Instagram: @road2ir Twitter: @Road2IR Facebook: https://www.facebook.com/road2IR/

4 Jan 202139min

Dr. Mary Costantino interviews the BackTable Team in honor of hitting the 100th episode mark. We had a great time telling the origin story of BackTable, reminiscing the early days of the podcast, and where we hope to go in 2021. It doesn't happen without all the amazing guests and guest hosts along the way. --- SHOW NOTES In this special episode, Dr. Mary Constantino interviews Dr. Aaron Fritts, Dr. Christopher Beck, and Dr. Michael Barraza to discuss the journey of the BackTable Podcast. Co-founder Dr. Aaron Fritts tells us why he wanted to start BackTable and how it transformed from an app to a podcast. Dr. Beck and Dr. Barraza share their experiences getting involved in the podcast. We discuss some of the early challenges they faced while trying to get started, and we explain the lessons learned from these experiences. We discuss plans to expand to ENT and urology topics as well as other plans for 2021. Dr. Fritts touches on the learning process of editing audio and creating a podcast. Dr. Fritts, Dr. Beck, and Dr. Barraza share their goals and hopes for the BackTable podcast. We discuss the work that goes on behind the scenes and the team that makes it all possible.

31 Dec 20201h 4min

Dr. Ezana Azene M.D., Ph.D. talks with us about how he found his side gig reviewing insurance claims, and shares tips on how to avoid insurance claim denials for procedures. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/OHtkwE --- SHOW NOTES In this episode, Dr. Ezana Azene joins Dr. Christopher Beck to discuss reviewing medical cases for insurance claims. Dr. Azene tells us how often he reviews insurance claims for IR procedures, and he explains what the step-by-step process looks like once he gets a case to review. We discuss how to search for information to show a procedure was done in extenuating circumstances by looking at clinic notes and labs, in addition to previous reviews from other physicians. We review some mistakes that physicians make that could keep an insurance claim from being approved, and we discuss why documenting all previous interventions is important. We explain why it is helpful to understand the patient’s insurance policy and how citing articles and references can support an insurance claim. Dr. Azene shares how reviewing medical cases has improved his documentation, and we give some advice on how to get involved in this process. --- RESOURCES IR Quarterly article featuring Dr. Azene https://connect.sirweb.org/e-irq/participate/viewirqarticle?DocumentKey=ec2b47d8-e067-4628-a40a-ab19021ab36a

28 Dec 202029min

In Part 2 of their Pelvic Congestion Syndrome discussion, Dr. Mark Meissner and Dr. Michael Cumming get into their specific techniques, tips and tricks for embolization, and follow up care. --- SHOW NOTES In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss techniques for treating Pelvic Congestion Syndrome. We examine their goals for therapy and why to approach the internal iliac veins first. We discuss which catheters they use and how to approach venograms in a therapeutic way, rather than diagnostic. We share a new technique for coiling that reduces procedure time and pain for the Pelvic Congestion Syndrome patient. We discuss the challenges of embolization and why we often rely on the sclerosant when using an occlusion balloon. Dr. Meissner and Dr. Cumming tells us about the post-procedure management, why to follow-up after the first menstrual period, and why to make foam using CO2 when a patient has a history of migraines. We examine the verbiage of the name “Pelvic Congestion Syndrome” and how it leads to misconceptions about its etiology. Dr. Meissner shares his process for treating Nutcracker Syndrome, and we discuss the potential problems of renal vein stenting.

24 Dec 202030min

Vascular Surgeon Dr. Mark Meissner and Interventional Radiologist Dr. Michael Cumming discuss diagnosis and treatment planning for Pelvic Congestion Syndrome. This is Part 1 of 2 on Pelvic Congestion Syndrome. --- SHOW NOTES In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss Pelvic Congestion Syndrome. We discuss the pathophysiology of Pelvic Congestion Syndrome and the fundamentals of pelvic venous hypertension. Dr. Meissner and Dr. Cumming tell us how patients end up in their clinic. We discuss why it is important to distinguish primary and secondary causes of Pelvic Congestion Syndrome and the dangers of an incomplete embolization. We review some techniques for ultrasounds, why not to rely on cross-sectional imaging, and the advantages of getting a CT for the Pelvic Congestion Syndrome patient. We discuss how to adapt treatment plans for women that have never been pregnant or women that are post-menopausal. Dr. Meissner and Dr. Cumming explain how they frame their goals and expectations for each patient’s treatment process, and we examine when it is appropriate to use a multi-modality approach to treat Pelvic Congestion Syndrome. --- RESOURCES Check out our other episode featuring Dr. Michael Cumming: https://www.backtable.com/shows/vi/podcasts/52/ivus-for-iliac-vein-compression

22 Dec 202032min

Bryan Hartley talks with Lawrence "Rusty" Hofmann MD about his experiences in device and digital health innovation, including the inspiring story behind building Grand Rounds, a digital health company helping patients get better access to expert healthcare. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/hA0kx3 --- SHOW NOTES In this episode, Dr. Randy Hofmann joins Dr. Bryan Hartley to discuss his path to creating an innovative digital health company. Dr. Hofmann tells us how he became an IR and discusses his start in medical devices. We share some advice on how to get started on a new project. We discuss Dr. Hofmann’s health technology company, Grand Rounds, which offers clinical and financial guidance. Dr. Hofmann explains why he came up with the idea for a digital health company and how his experiences as a father and husband influenced his advocacy for patient education.

18 Dec 202021min

In this episode, Dr. Jason Levy and Dr. Amir Lavaf join Dr. Michael Barraza to discuss their multidisciplinary approach to treating spinal metastases. We examine the collaborative efforts between IR and radiation oncologists, and we break down the indications for treating spinal metastases. We discuss pain control and local control rates, and how doctors are working to improve them. Dr. Levy and Dr. Lavaf tell us why they are able to get better survival numbers when they approach the primary and metastatic disease at the same time. We explain how to work with tumor boards and different groups of doctors to make spinal metastases treatment easier. We discuss how to reduce risk of delayed skeletal events and radiation failure after spinal metastases treatment. We go over some of the challenges of working with the tumor board, and why it is important to develop relationships with medical oncologists and the importance of continuing systemic therapies. RESOURCES MENTIONED: BackTable Podcast Episode 68: RF Ablation Therapy for Bone Metastases https://www.backtable.com/podcast/68/rf-ablation-therapy-for-bone-metastases

14 Dec 202031min

In this episode, Dr. Ameer Hassan joins Dr. Sabeen Dhand to discuss the use of artificial intelligence (AI) to improve stroke care. We explain the hub and spoke model and how the primary stroke centers communicate in the hub. Dr. Hassan describes how the system determines which center a stroke patient will go to. We discuss how the system optimizes the transfer from spoke to hub and how comparing trends in stroke patients allowed them to speed up the process. We explain how AI is used in stroke care using decision trees and deep learning. We discuss the benefits of using AI to remove steps and sending push notifications to phones, allowing radiologists to review imaging quicker. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IhN6NW RESOURCES MENTIONED: SAGE journals; Interventional Neuroradiology https://journals.sagepub.com/doi/full/10.1177/1591019920953055 Early experience utilizing artificial intelligence shows significant reduction in transfer times and length of stay in a hub and spoke model

7 Dec 202033min