• BackTable Vascular & Interventional

  • By: BackTable
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BackTable Vascular & Interventional

By: BackTable
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  • Summary

  • The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Listen on BackTable.com or on the streaming platform of your choice. You can also visit www.BackTable.com to browse our open access, physician-catered knowledge center for all things vascular and interventional; now featuring practice tools, procedure walkthroughs, and expert guidance on more than 40 endovascular procedures.
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Episodes
  • Ep. 514 Deep Sedation in IR: Intro to Ketamine with Dr. Amy Deipolyi

    Ep. 514 Deep Sedation in IR: Intro to Ketamine with Dr. Amy Deipolyi
    Feb 4 2025
    When deep sedation is required, it can be challenging to implement due to the difficulty of scheduling dedicated anesthesia coverage in the IR suite. Dr. Amy Deipolyi (interventional radiologist and Division Chief at Charleston Area Medical Center, WY) joins host Dr. Ally Baheti to explain an alternative approach to deep sedation through the use of ketamine. --- This podcast is supported by: Medtronic Abre Stent https://www.medtronic.com/en-us/healthcare-professionals/products/cardiovascular/deep-venous-stents/abre-venous-self-expanding-stent-system.html --- SYNPOSIS Dr. Deipolyi begins by sharing how she built a dedicated, academic IR program at a level 1 trauma center in West Virginia. The doctors then discuss the advantages of ketamine for deep sedation in the IR suite, and how Dr. Deipolyi gained administrative approval and implemented the change to achieve an alternative approach to deep sedation for interventional procedures. The discussion also includes how ketamine compares to traditional agents such as fentanyl and Versed. The episode concludes with Dr. Deipolyi’s practical advice to fellow IR’s interested in providing their patients deep sedation via ketamine and her ongoing and future research and outreach efforts. --- TIMESTAMPS 00:00 - Introduction 02:04 - Dr. Deipolyi’s Practice 14:32 - Overcoming Hurdles and Gaining Support 20:12 - Application and Patient Experiences 26:01 - Future of Deep Sedation in IR 28:55 - Conclusion
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    33 mins
  • Ep. 513 Combination Therapy and Clinical trials for Advanced HCC: What They Really Mean

    Ep. 513 Combination Therapy and Clinical trials for Advanced HCC: What They Really Mean
    Jan 31 2025
    In the past five years, the use of immunotherapeutic agents for advanced cancers has emerged as a promising alternative to tyrosine kinase inhibitors and chemotherapy, making it an exciting time to be practicing oncology. In this episode, Dr. Tyler Sandow interviews oncology experts about the landscape of advanced hepatocellular carcinoma (HCC) and the current state of immunotherapy treatments. He is joined by medical oncologists Dr. Jonathan Mizrah, Dr. Lingling Du, and Dr. Adam Burgoyne, as well as interventional oncologist Dr. Zachary Berman. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125737 --- This podcast is supported by an educational grant from: AstraZeneca https://www.astrazeneca.com/our-therapy-areas/oncology.html With additional support from: Boston Scientific https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology.html --- SYNPOSIS Drs. Burgoyne and Mizrahi provide a primer on immunotherapy and explain how they communicate the principles of this treatment to their patients. Dr. Du discusses the Imbrave clinical trial and how recent studies have shown improved overall survival when immunotherapeutic agents are used, especially when multiple agents targeting various pathways are employed. When choosing between different regimens, the doctors consider factors such as the patient's underlying liver function, symptom burden, and prior treatments. Importantly, the doctors also discuss contraindications to immunotherapy, including a history of organ transplant, autoimmune disease, and poor performance status—all of which put patients at high risk for deterioration with this treatment. The treatment of patients with poor liver function remains controversial, as underlying cirrhosis may prevent the recovery of liver function. Dr. Berman outlines recent clinical trials studying the effects of transarterial chemoembolization (TACE) combined with immunotherapy. Finally, the doctors discuss the future of HCC treatment and the benefits of continued innovation in both interventional and medical oncology. --- TIMESTAMPS 00:00 - Introduction to Immunotherapy 04:32 - Notable Clinical Trials 13:39 - HCC Etiology and Immunotherapy Outcomes 18:43 - Contraindications for Immunotherapy 23:05 - Adverse Effects from Treatment 25:14 - Combination Therapy 36:22 - Considerations for Immunotherapy Dosing 40:26 - The Future of HCC Treatment --- RESOURCES Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma, IMbrave150 Trial (Finn et al, 2020): https://pubmed.ncbi.nlm.nih.gov/32402160/ Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma, HIMALAYA Trial (Abou-Alfa et al, 2022): https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100070 Nivolumab versus sorafenib in advanced hepatocellular carcinoma (CheckMate 459): a randomised, multicentre, open-label, phase 3 trial (Yau, 2022): https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00604-5/abstract Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): First results from CheckMate 9DW (Galle, 2024): https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA4008 Randomized Phase 3 LEAP-012 Study: Transarterial Chemoembolization With or Without Lenvatinib Plus Pembrolizumab for Intermediate-Stage Hepatocellular Carcinoma Not Amenable to Curative Treatment (Llovet, 2022): https://pubmed.ncbi.nlm.nih.gov/35119481/ Find this episode on BackTable.com for more resources.
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    48 mins
  • Ep. 512 The "Alzate Maneuver”: Flipping Retrograde Access with Dr. Gregg Alzate

    Ep. 512 The "Alzate Maneuver”: Flipping Retrograde Access with Dr. Gregg Alzate
    Jan 28 2025
    Proximity to innovation often gives rise to further innovation. This trend is especially true in interventional radiology. Dr. Gregg Alzate (interventional radiologist in San Diego, California) joins host Dr. Ally Baheti to share his career pearls for early and mid-career IRs, and how he came to pioneer the Alzate Retrograde Antegrade Maneuver (A-RAM). --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Alzate starts by sharing his early influences, including his time with interventional radiology giant Dr. Harold Coons. The doctors also cover the importance of proper vessel access techniques, innovative approaches to limb salvage, and how to address complex chronic total occlusions (CTOs). Dr. Alzate then goes on to give us a thorough walkthrough of the A-RAM. The episode concludes with Dr. Alzate’s closing thoughts on being open to adopt new techniques, the impact of strong mentorship, and importance for consuming and sharing knowledge. --- TIMESTAMPS 00:00 - Introduction 03:05 - Dr. Alzate’s Journey 25:52 - A-RAM Technique 34:26 - CTO’s and Heavy Calcium 40:16 - Moral Injury in Medical Practice 43:35 - Honoring Dr. Harold Coons 46:23 - Closing Thoughts and Reflections --- RESOURCES Ohki, Takao et al. “Long-term results of the Japanese multicenter Viabahn trial of heparin bonded endovascular stent grafts for long and complex lesions in the superficial femoral artery.” Journal of vascular surgery vol. 74,6 (2021): 1958-1967.e2. https://www.jvascsurg.org/article/S0741-5214(21)01011-9/fulltext Kedora, John et al. “Randomized comparison of percutaneous Viabahn stent grafts vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral arterial occlusive disease.” Journal of vascular surgeryvol. 45,1 (2007): 10-6; discussion 16. https://www.jvascsurg.org/article/S0741-5214(06)01612-0/fulltext
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    50 mins

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