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. 18 Complex LE Venous Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Ep. 18 Complex LE Venous Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Dr. Jeffrey Chick and Dr. Ravi Srinivasa discussing complex lower extremity venous interventions at University of Michigan VIR.

18 Dec 201756min

Ep. 17 Prostate Artery Embolization with Dr. Ari Isaacson and Dr. Sandeep Bagla

Ep. 17 Prostate Artery Embolization with Dr. Ari Isaacson and Dr. Sandeep Bagla

Special guests Dr. Ari Isaacson and Dr. Sandeep Bagla sharing their experiences with prostate artery embolization, including a candid discussion on practice building, equipment, and a brief intro on what to expect at the upcoming STREAM PAE course Jan 13 in Washington DC.

20 Nov 201747min

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

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