Ep. 572 How to Perform Mesocaval Shunts: Techniques & Outcomes with Dr. Omar Chohan and Dr. Harris Chengazi

Ep. 572 How to Perform Mesocaval Shunts: Techniques & Outcomes with Dr. Omar Chohan and Dr. Harris Chengazi

Before the advent of TIPS, mesocaval shunts were considered a less popular option for managing portal hypertension. But today, could they serve as a lifeline when no other choices remain? This week on BackTable, Drs. Omar Chohan and Harris Chengazi (Great Lakes Medical Imaging) join host Dr. Chris Beck to discuss the evolving role of endovascular mesocaval shunts, covering patient selection, clinical decision-making, and technical pearls. --- SYNPOSIS In this episode, the hosts delve into the specialized procedure of meso-caval shunts, focusing on its applications for patients with portal hypertension who have no other viable options. This discussion includes detailed case studies, such as one involving a woman with autoimmune hepatitis and another with pancreatic cancer, showcasing the practical challenges and innovative solutions in creating these shunts. In each case, they detail the rationale for patient selection, difficult anatomy, procedural steps, and resolution of symptoms like recurrent ascites and variceal bleeding. The episode emphasizes the importance of pre-procedure planning, collaboration, and precise imaging, utilizing advanced tools like the 4D CT scanner. The conversation also highlights the compassionate motivation behind these complex procedures, aimed at improving patients' quality of life. --- TIMESTAMPS 00:00 - Introduction 03:07 - Historical Context and Indications06:49 - Case 1: Patient with Refractory Ascites34:00 - Case 2: Recurrent GI Bleeding41:16 - Case 3: TIPS Consult - Pancreatic Cancer and Duodenal Varices47:44 - Lessons, Pearls, and Tips56:13 - Final Thoughts --- RESOURCES A Case Series of Dr. Chengazi's Mesocaval Shunts on X:https://x.com/chengazimd/status/1966337167879438571 Episode 573 Portal Hypertension Treatment Strategies:https://www.backtable.com/shows/vi/podcasts/473/portal-hypertension-treatment-strategies-ir-hepatology-perspectives TIPS University Freshman Year:https://www.backtable.com/shows/vi/podcasts/123/tips-university-freshman-year-referrals-pre-op-workup TIPS University Sophomore Year:https://www.backtable.com/shows/vi/podcasts/124/tips-university-sophomore-year-basic-procedure-technique TIPS University Junior Year:https://www.backtable.com/shows/vi/podcasts/125/tips-university-junior-year-advanced-techniques-ice-splenic-access TIPS University Senior Year:https://www.backtable.com/shows/vi/podcasts/126/tips-university-senior-year-gunsight-technique-splenic-closure

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Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck

Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck

Dr. Christopher Beck and Dr. Jason Iannuccilli discuss radial vs femoral access in IO procedures, including the pros and cons of both, and a very informative "how I do it" for radial access by Dr. Iannuccilli.

30 Mars 201844min

Ep. 25 Declots and the Argon Cleaner Device with Dr. Sabeen Dhand and Dr. Chris Beck

Ep. 25 Declots and the Argon Cleaner Device with Dr. Sabeen Dhand and Dr. Chris Beck

In this episode, Dr. Sabeen Dhand joins Dr. Christopher Beck to discuss arteriovenous access declot procedure with the Argon Cleaner device. We review the routine declot procedure and the different methods to get access. Dr. Dhand explains why he starts out using the Argon Cleaner device and what his endpoint is. We discuss the nuances of the device in addition to tips and tricks for using the device with declots, including external massaging the fistula and an unsheathing trick.

20 Mars 201813min

Ep. 24 Endoscopy for the Interventional Radiologist with Dr. Srinivasa and Dr. Chick

Ep. 24 Endoscopy for the Interventional Radiologist with Dr. Srinivasa and Dr. Chick

Jeffrey Chick and Ravi Srinivasa of University of Michigan VIR. In Episode 24 they explain the advantages of using simple to learn endoscopic techniques in gallbladder, biliary and genitourinary cases.

8 Mars 201843min

Ep. 23 Adrenal Vein Sampling with Dr. Mike Devane

Ep. 23 Adrenal Vein Sampling with Dr. Mike Devane

The procedure that everyone gets excited about! In this week's BackTable podcast Mike Devane talks us through adrenal vein sampling technique, including equipment/imaging tips and tricks, as well as pitfalls to avoid. Whether looking to build an AVS service, or just preparing for that once in a blue moon case, you're certain to take away a few pearls!

20 Feb 201822min

Ep. 22 Central and Upper Extremity Venous Interventions with Dr. Mark Lessne and Dr. Sabeen Dhand

Ep. 22 Central and Upper Extremity Venous Interventions with Dr. Mark Lessne and Dr. Sabeen Dhand

Central and Upper Extremity Venous Interventions with Dr. Mark Lessne of Charlotte Radiology and Dr. Sabeen Dhand of PIH Health. In this episode our docs discuss central recanalizations, ballooning versus stents, declot techniques, and get into a ton of tips and tricks!

6 Feb 201858min

Ep. 21 Vertebral Augmentation with Dr. Venu Vadlamudi and Dr. Kumar Madassery

Ep. 21 Vertebral Augmentation with Dr. Venu Vadlamudi and Dr. Kumar Madassery

Vertebral augmentation can be accomplished through various techniques - Dr. Venu Vadlamudi and Dr. Kumar Madassery shed light on the utility of kyphoplasty versus vertebroplasty when treating compression fractures of the spine.

28 Jan 201837min

Ep. 20 Pressure-Directed Therapy in TACE with Dr. Justin Lee and Dr. Terence Gade

Ep. 20 Pressure-Directed Therapy in TACE with Dr. Justin Lee and Dr. Terence Gade

Our 20th BackTable podcast episode featuring special guests Dr. Justin Lee of Florida Interventional Specialists, and Dr. Terence Gade of Hospital of University of Pennsylvania. They discuss experiences and utility of pressure-directed, antireflux infusion for TACE treatments.

20 Jan 201844min

Ep. 19 Lymphatic Interventions with Dr. Chick and Dr. Srinivasa

Ep. 19 Lymphatic Interventions with Dr. Chick and Dr. Srinivasa

Our holiday episode featuring Dr. Jeffrey Chick and Dr. Ravi Srinivasa of University of Michigan. They sit fireside with our host J. Michael Barraza Jr. to discuss lymphatic interventions in IR.

27 Dec 201748min

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