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/

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Ep. 548 Winding Down Neuwave: Impact on Interventional Radiology with Dr. Joshua Kuban

Ep. 548 Winding Down Neuwave: Impact on Interventional Radiology with Dr. Joshua Kuban

It’s official — NeuWave is exiting the market. In this episode, Dr. Christopher Beck hosts a conversation with Dr. Josh Kuban, an interventional radiologist at MD Anderson Cancer Center, to discuss th...

30 Maj 202531min

Ep. 547 Intratumoral Oncolytic Treatments for Metastatic Melanoma: A Multidisciplinary Approach with Dr. Riad Salem and Dr. Sunandana Chandra

Ep. 547 Intratumoral Oncolytic Treatments for Metastatic Melanoma: A Multidisciplinary Approach with Dr. Riad Salem and Dr. Sunandana Chandra

Making strides against melanoma: how can medical oncologists and interventional oncologists join forces to deliver smarter, patient-centered care? In this episode of BackTable, Dr. Tyler Sandow,hosts ...

27 Maj 202554min

Ep. 546 IR Practice Development: Residency to Real-World with Dr. Quinn Meisinger

Ep. 546 IR Practice Development: Residency to Real-World with Dr. Quinn Meisinger

23 Maj 20251h 1min

Ep. 545 Outpatient PAE- Tips and Tricks from a High Volume Operator with Dr. Stephen "Andy" Vartanian

Ep. 545 Outpatient PAE- Tips and Tricks from a High Volume Operator with Dr. Stephen "Andy" Vartanian

Bringing Prostate Artery Embolization (PAE) to the OBL setting means balancing cost efficiency, quality care, and a high procedure volume. What should you know and how can you get started? This week, ...

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Ep. 544 Inside the RVS Update Committee (RUC) Process with Dr. Amar Rewari and Dr. Curtis Lee Anderson

Ep. 544 Inside the RVS Update Committee (RUC) Process with Dr. Amar Rewari and Dr. Curtis Lee Anderson

How is reimbursement decided? Have an inside look from the committee itself as we unpack exactly how a new CPT (Current Procedural Terminology) code is created, assessed, and ultimately valued for phy...

16 Maj 202536min

Ep. 543 Metastatic Colorectal Cancer: Discussion on the COLLISION Trial with Dr. Martijn Meijerink

Ep. 543 Metastatic Colorectal Cancer: Discussion on the COLLISION Trial with Dr. Martijn Meijerink

Is minimally invasive ablation the future of metastatic cancer care? We now have the results of the COLLISION Trial, which investigates the non-inferiority of thermal ablation compared to surgical res...

13 Maj 202547min

Ep. 542 Navigating Early Career in Interventional Radiology with Dr. Christopher Zarour and Dr. Kavi Devulapalli

Ep. 542 Navigating Early Career in Interventional Radiology with Dr. Christopher Zarour and Dr. Kavi Devulapalli

As graduating residents step into the IR job market, the big question remains: What truly makes a great first job? Dr. Subhash Gutti hosts guest Dr. Kavi Devulapalli (Image Guided Solutions of Missour...

9 Maj 202558min

Ep. 541 Treatment of Acute Portal Vein Thrombosis with Dr. Ben May

Ep. 541 Treatment of Acute Portal Vein Thrombosis with Dr. Ben May

To TIPS or not to TIPS? More than ever, younger patients are presenting with acute portal vein thrombosis (PVT) that requires intervention beyond anticoagulation alone. These patients need safe, effec...

6 Maj 202552min

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