Ep. 331 EVUS to IVUS: a Continuous Spectrum with Dr. Jill Sommerset and Dr. Fadi Saab

Ep. 331 EVUS to IVUS: a Continuous Spectrum with Dr. Jill Sommerset and Dr. Fadi Saab

In this episode, host Dr. Ally Baheti interviews Jill Sommerset and Dr. Fadi Saab about EVUS and IVUS in peripheral arterial cases, including when to use each, how to train an interventional sonographer, and what adding ultrasound in a case can do for patient safety. --- CHECK OUT OUR SPONSORS Philips Image Guided Therapy Devices Academy https://resource.philipseliiteacademy.com Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Jill Sommerset is the director of ultrasound at Advanced Vascular in Portland, OR and Hope Clinical Innovation Center in Houston, TX, and chair of the SVU annual conference. Dr. Fadi Saab is an interventional cardiologist and associate professor at Michigan State University. He begins by introducing what intravascular ultrasound (IVUS) and extravascular ultrasound (EVUS) are. EVUS is looking from the outside in, and can be used to measure vessel width, hemodynamics, and cross chronic total occlusions (CTOs). IVUS is looking from inside a vessel towards the outside of the body, and can be helpful for viewing the extent of arterial disease and discerning the exact plaque anatomy. Dr. Saab always has a specially trained interventional sonographer involved in the case and in the room for critical limb ischemia (CLI) cases. He values them not only for obtaining access, but also to provide greater safety to the patient. He considers them a core member of the team. He notes the importance of training an ultrasonographer who is good when working under pressure, can interact with multiple personality types, and most importantly, someone willing to learn, be engaged in the case, and willing to put themselves out there in this foreign environment. Jill says it took her around 4 months to feel comfortable working in the cath lab, and for other members of the team to get used to her presence during cases. She describes her work as a dance with the physician. When a wire or catheter is being exchanged, Jill is always scanning and thinking ahead, and she is always ready to check for dissections after balloon angioplasty. Most arterial cases can benefit from the addition of EVUS. Jill says the only time EVUS is not as helpful is when the CTO cap morphology shows a rock hard plaque that casts shadows on the screen. Dr. Saab says he uses EVUS for crossing CTOs, patient safety, and looking at complications. He usually introduces IVUS after he crosses a lesion to look at plaque in a more granular way and understand it’s anatomy. Jill adds that she uses IVUS to help the physician cross a CTO sometimes, but notes that it is important for the tech to hold the probe still and not move in this scenario. The two end by restating the value that EVUS and IVUS add to the procedure, especially because angiography misses a lot of plaque burden that can be seen with IVUS. They recommend finding ultrasonographers interested in working in the cath lab, and taking the responsibility as physicians to mentor them and make them feel like an invaluable member of the treatment team. --- RESOURCES CTOP Paper: https://assets.bmctoday.net/evtoday/pdfs/et0518_F5_Saab.pdf

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Ep. 74 The Role of IR in Stroke Interventions (Part 1) with Dr. David Sacks and Dr. Martin Radvany

Ep. 74 The Role of IR in Stroke Interventions (Part 1) with Dr. David Sacks and Dr. Martin Radvany

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/yS6TGL Dr. Martin Radvany and Dr. David Sacks discuss the role of Interventional Radiologists in the treatment of acute ischemic stroke, including training requirements, the multidisciplinary team approach, and ways to improve patient access to high quality care.

2 Aug 202057min

Ep. 73 Iliocaval Stenting with Dr. Gerry O'Sullivan

Ep. 73 Iliocaval Stenting with Dr. Gerry O'Sullivan

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/TFABaN Interventional Radiologist Dr. Gerry O'Sullivan shares his experiences with Iliocaval stenting in post-thrombotic patients, including pearls and pitfalls and the "Aiming for the bottom corner" technique.

27 Juli 202048min

Ep. 72 Uterine Fibroid Embolizations in the OBL with Dr. John Lipman

Ep. 72 Uterine Fibroid Embolizations in the OBL with Dr. John Lipman

John Lipman, MD discusses UFE practice building, patient workup, and embolization technique in his dedicated Women's interventional practice, Atlanta Interventional Institute. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/10vK6b

20 Juli 202052min

Ep. 71 Building a MedEd platform with Dr. Sarel Gaur

Ep. 71 Building a MedEd platform with Dr. Sarel Gaur

We talk with Interventional Radiologist Sarel Gaur about what inspired his #medEd #YouTube channel, where his topics come from, and tips for success for others.

13 Juli 202028min

Ep. 70 CO2 Angiography with Dr. James Caridi

Ep. 70 CO2 Angiography with Dr. James Caridi

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/F6p0sz In this episode, Dr. James Caridi joins Dr. Christopher Beck to discuss the benefits of using CO2 for an angiography as well as some important tips for proper use. Dr. Caridi mentions some of the reasons for choosing CO2 rather than contrast, including its solubility, low viscosity, and buoyancy. He also speaks about CO2 angiography approaches for imaging difficult to access vasculature. Dr. Caridi also speaks to specific uses of CO2 angiography for use for mesenteric angiography and how CO2 angiography can improve the sensitivity for detection and localization of GI bleeds. Dr. Caridi and Dr. Beck also discuss some non-vascular uses for CO2 angiography as well as a technique for imaging with CO2 without having to give up wire access. We talk through safely preparing a delivery system and gently injecting CO2 to prevent/reduce reflux in the patient if needed. Finally, we go into some notes concerning dialysis, contrast induced nephropathy, and some instances when CO2 angiography should not be used. Resources mentioned: CO2 Angiography Society http://www.co2angio.org/index.php This website features over 100 pieces of literature related to CO2 angiography, information about the newest developments, and access to membership in the society. Dr. Jim Caridi explains CO2mmander and AngiAssist https://www.youtube.com/watch?v=MjsnHWmRZQI This video explains the portable delivery system and the gas management system.

6 Juli 202051min

Ep. 69 Retrograde Pedal Access with Dr. Jim Melton and Dr. Blake Parsons

Ep. 69 Retrograde Pedal Access with Dr. Jim Melton and Dr. Blake Parsons

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/wS9UCY Dr. Jim Melton and Dr. Blake Parsons discuss the benefits of retrograde pedal access in the treatment of PAD, as well as the team approach of their outpatient CardioVascular Health Clinic , which includes Vascular Surgery, Interventional Radiology, and Interventional Cardiology working together as partners for better patient care.

22 Juni 202052min

Ep. 68 RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla

Ep. 68 RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla

Dr. Jason Levy and Dr. Sandeep Bagla discuss palliative treatment of bone metastases with radiofrequency ablation, as well as recent results from the OPuS One trial.

15 Juni 202040min

Ep. 67 Locoregional Therapies for Bridging to Transplant in HCC with Dr. Alex Kim

Ep. 67 Locoregional Therapies for Bridging to Transplant in HCC with Dr. Alex Kim

Interventional Radiologist Dr. Alex Kim and Dr. Christopher Beck discuss the utility of different locoregional liver therapies in bridging HCC patients to transplant.

8 Juni 202047min

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