Ep. 413 TBAD Management: Best Practices in Aortic Dissection with Dr. Darren Klass

Ep. 413 TBAD Management: Best Practices in Aortic Dissection with Dr. Darren Klass

This week on the BackTable Podcast, Dr. Darren Klass shares his experiences in the treatment of aortic dissections. Dr. Klass is an interventional radiologist at the University of British Columbia. Dr. Klass underscores the criticality of intraoperative decision-making, the use of intravascular ultrasound (IVUS), and the importance of taking a multidisciplinary approach. The conversation further explores the nuances of treating acute complicated aortic dissections, stabilizing the intermedial flap, follow-up protocols, and the importance of raising awareness about this high risk disease. --- CHECK OUT OUR SPONSOR Cook Medical Aortic Interventions https://www.cookmedical.com/aorticbacktable --- SHOW NOTES 00:00 - Introduction 07:45 - Identifying and Treating Type B Aortic Dissections 09:35 - Role of Imaging 18:24 - Patient Journey Through Aortic Dissection Treatment 29:35 - Importance of Intravascular Ultrasound 39:01 - Petticoat Technique 47:12 - Role of Lumbar Drains 50:10 - Importance of Follow-ups --- RESOURCES Cook Medical Essential Prescribing Information: https://www.cookmedical.com/patient-resources/aortic-dissection/aortic-dissection-cook-medical-products/ Dr. Darren Klass’ ResearchGate Profile: https://www.researchgate.net/profile/Darren-Klass The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection: https://www.sts.org/sites/default/files/content/TBAD_Guideline_2022.pdf Krukenberg E. Beiträge zur Frage des Aneurysma dissecans. Beitr Patho Anat Allg Pathol. 1920; 67:329-351. (Paper that first described acute intramural hematoma from 1920): https://cir.nii.ac.jp/crid/1571698600607606272 Acute Aortic Dissection and Intramural Hematoma: A Systematic Review: https://pubmed.ncbi.nlm.nih.gov/27533160/ The PETTICOAT Technique for Complicated Acute Stanford Type B Aortic Dissection Using a Tapered Self-Expanding Nitinol Device as Distal Uncovered Stent: https://pubmed.ncbi.nlm.nih.gov/28279721/

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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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