Ep. 564 Pressure-Enabled Drug Delivery in HCC & Metastatic Liver Lesions with Dr. Zach Berman

Ep. 564 Pressure-Enabled Drug Delivery in HCC & Metastatic Liver Lesions with Dr. Zach Berman

Can you manipulate blood flow in the tumor microenvironment to optimize drug delivery? In this episode of the BackTable Podcast, interventional oncologist Dr. Zachary Berman (UC San Diego) joins host Dr. Christopher Beck to discuss real-world applications of pressure-enabled drug delivery in locoregional liver-directed therapies like TACE and Y90.---This podcast is supported by:TriSalus Life Scienceshttp://trinavinfusion.com/---SYNPOSISThe conversation begins with an overview of the tumor microvascular environment, focusing on the abnormal nature of the new vessels that feed tumors. They then discuss the genesis of pressure-enabled drug delivery and the theory behind its efficacy. Dr. Berman explains the TriNav catheter’s micro-valve design, its anti-reflux properties, and how these features enhance tumor drug delivery. He walks through his own procedure technique, comparing and contrasting it to standard embolization, and details the utility of pressure-enabled drug delivery in lobar radioembolization and larger tumors. They also explore the benefits of both balloon occlusion and microvalve catheters.Real-world cases—including neuroendocrine tumors, segmental HCC, and more—illustrate the thought process around when to use specialized technologies. The episode wraps up with a discussion of the future implications for this technology in other pathologies, cost considerations, and the potential for enhancing drug delivery with innovative approaches.---TIMESTAMPS00:00 - Introduction01:39 - The Tumor Microenvironment06:59 - Pressure-Enabled Drug Delivery Explained09:37 - Technical Aspects of Pressure-Enabled Catheters21:48 - Case 1: Grade 3 Neuroendocrine Tumor34:06 - Case 2: Hepatocellular Carcinoma with Tumor and Vein36:01 - Case 3: TACE for Segmental HCC in Decompensated Cirrhosis38:58 - Case 4: Large Heterogenous Cholangiocarcinoma40:40 - Case 5: Lobar Neuroendocrine Tumor42:38 - Case 6: Segmental HCC with Central Necrosis47:52 - Best Practices and Technical Considerations57:52 - Future Directions in Pressure-Directed Embolotherapy59:48 - Conclusion and Final Thoughts---RESOURCESJVIR 2024 Jaroch et al.:https://pubmed.ncbi.nlm.nih.gov/38969336/

Avsnitt(584)

Ep. 16 Pressure-Directed Therapy in Y90 with Dr. Nutting and Dr. Parikh

Ep. 16 Pressure-Directed Therapy in Y90 with Dr. Nutting and Dr. Parikh

In our first podcast on pressure directed therapy, Dr. Charles Nutting and Dr. Nainesh Parikh discuss some of the first principles of Y90 radioembolization delivery, and the potential advantages of pressure directed devices over end-hole catheters in the treatment of HCC.

5 Nov 201731min

Ep. 15 Renal Ablation Therapies with Dr. Mike Devane and Dr. Ahmed Kamel

Ep. 15 Renal Ablation Therapies with Dr. Mike Devane and Dr. Ahmed Kamel

We discuss renal ablation therapies with Mike Devane MD and Ahmed Kamel MD, PhD, FSIR

1 Nov 201732min

Ep. 14 Novel Bariatric and Pain Therapies with Dr. David Prologo

Ep. 14 Novel Bariatric and Pain Therapies with Dr. David Prologo

Podcast episode 14 with J. David Prologo and J. Michael Barraza Jr. discussing Novel Bariatric and Pain Interventions.

20 Okt 201728min

Ep. 13 Neurovascular IR Part 2: Devices

Ep. 13 Neurovascular IR Part 2: Devices

Our docs discuss integrating neurovascular interventions (part 2) into your IR practice with Venu Vadlamudi and Sabeen Dhand.

2 Okt 201727min

Ep. 12 Neurovascular IR (Part 1) with Sabeen Dhand and Venu Vadlamudi

Ep. 12 Neurovascular IR (Part 1) with Sabeen Dhand and Venu Vadlamudi

Our docs discuss integrating neurovascular interventions (part 1) into your IR practice with Venu Vadlamudi and Sabeen Dhand.

2 Okt 201743min

Ep. 11 #filterOUT with Robert Ryu and AJ Gunn

Ep. 11 #filterOUT with Robert Ryu and AJ Gunn

On Episode 11 of the BackTable Podcast Robert Ryu and AJ Gunn discuss building a filter retrieval practice, equipment preferences, and challenging cases.

18 Sep 201751min

Ep. 10 Uterine Fibroid Embolizations with Dr. Keith Pereira and Dr. Chris Beck

Ep. 10 Uterine Fibroid Embolizations with Dr. Keith Pereira and Dr. Chris Beck

Dr. Keith Pereira and Dr. Chris Beck discuss building their UFE practice and transradial versus transfemoral approaches.

25 Aug 201747min

Ep. 9 StoptheChop with Dr. Kumar Madassery and Dr. Sabeen Dhand

Ep. 9 StoptheChop with Dr. Kumar Madassery and Dr. Sabeen Dhand

There are numerous modalities available to characterize and treat peripheral arterial disease (PAD). Dr. Kumar Madassery and Dr. Sabeen Dhand highlight their preferred techniques - covering imaging, atherectomy, drug coated balloons, and stenting.

16 Aug 201754min

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