BackTable Vascular & Interventional

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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.

  1. 26 MIN AGO

    Ep. 616 Exploring Unique Outpatient Models in Interventional Radiology with Dr. Richard Daniels

    How can patients receive more consistent interventional radiology care amid a national shortage of IR physicians? That question led Dr. Rick Daniels to develop a new outpatient practice model centered on recruiting independent IRs to provide long-term, fractional coverage for groups in need. In this episode of the BackTable Podcast hosted by Dr. Aaron Fritts, Dr. Daniels outlines the thinking behind this approach and how it aims to expand access to IR services in outpatient settings. --- SYNPOSIS The conversation examines the evolving landscape of IR practice, including the challenges associated with transitioning between practice settings and building sustainable outpatient service lines. Dr. Daniels walks through the development of his model, with particular attention to identifying and supporting outpatient embolization opportunities. The discussion also explores the consortium-style structure for independent IRs, emphasizing long-term alignment, professional autonomy, and scalability at a national level. Operational considerations such as technology partnerships, documentation workflows, and targeted marketing strategies offer a practical look at what it takes to make this model work. --- TIMESTAMPS 00:00 - Introduction03:49 - Evolution of an Independent IR Practice05:30 - Challenges and Opportunities in Outpatient IR09:58 - Building Service Lines and Marketing Strategies18:34 - Forming a National IR Group25:21 - Balancing Business and Healthcare25:37 - Evaluating and Correcting Site Performance28:16 - Expanding Geographical Reach30:45 - Recruitment and Retention Challenges38:07 - The Importance of Tech-Doc Teams42:35 - Future Goals and Recruitment Efforts45:58 - Conclusion

    49 min

  2. 3 DAYS AGO

    Ep. 615 Exploring Intravascular Lithotripsy in Below the Knee CLTI with Dr. Constantino Peña

    As new calcium-modifying technologies expand the repertoire of below-the-knee (BTK) arterial disease interventions, how should your treatment algorithm evolve, and what endpoints matter most? In this episode of the BackTable Podcast, Dr. Constantino Peña of the Baptist Health Miami Cardiac and Vascular Institute joins Dr. Sabeen Dhand to discuss the latest advancements in BTK chronic limb-threatening ischemia (CLTI) therapies and the push to improve on current vessel preparation outcomes. --- This podcast is supported by: Shockwave Medicalhttps://shockwavemedical.com/ --- SYNPOSIS The physicians discuss the evolution of tibial arterial therapies, the challenges presented by heavily calcified lesions, and the impact of new tools, particularly the Shockwave E8 intravascular lithotripsy (IVL) device, on procedural considerations and endpoints. Dr. Peña shares his treatment algorithms and offers practical advice on selecting the right tools for each unique case. The episode closes with speculation on the future of treatment options and technologies for BTK disease, and the growing need for robust data to guide patient-specific treatment. --- TIMESTAMPS 00:00 - Introduction02:11 - Understanding Tibial Disease and Treatment Evolution07:22 - Advancements in Tibial Disease Treatment and the Role of IVL15:31 - Techniques for Effective IVL Sizing and Usage 21:28 - Challenges and Innovations in Tibial Disease Management26:48 - Innovations in Stent Technology30:43 - Combining IVL with Adjunct Therapies32:13 - Addressing Misconceptions in Tibial Treatment37:54 - Advancements in Intravascular Lithotripsy40:59 - Future of Vascular Treatments43:42 - Final Thoughts

    50 min

  3. 6 FEB

    Ep. 614 Interventional Radiology’s Evolution: Insights from Dr. Ernest Ring

    Have you ever wondered what it was like to be in the room when the first pelvic embolization was performed or how the TIPS procedure was pioneered? Dr. Ernie Ring, a legendary figure from UCSF and a true forefather of Interventional Radiology, joins host Dr. Peder Horner to recount the early days of the specialty. Dr. Ring shares fascinating stories from his training at Massachusetts General Hospital under Dr. Stanley Baum, where he witnessed the birth of transformative techniques using angiographic catheters to treat life-threatening bleeding. --- SYNPOSIS From improvising the use of autologous blood clot and thrombin to stop massive hemorrhages to his pivotal role in developing the TIPS procedure and specialized biliary catheters, Dr. Ring’s career is loaded with innovation. The conversation explores the "cowboy" era of IR, the evolution of essential tools like the glide wire, and the critical importance of maintaining a "high-touch" clinical practice in the face of emerging technologies like AI. Dr. Ring also reflects on his later transition into hospital leadership as Chief Medical Officer, where he applied his problem-solving mindset to institutional quality and safety. --- TIMESTAMPS 00:00 - Introduction01:58 - Upbringing from Detroit to Mass Gen 06:55 - Early IR with an Embo Case13:50 - Trailblazing Cases in IR16:17 - Penn and Innovation20:00 - Polarizing Procedures24:13 - IR Device Innovation33:00 - Dotter’s Separation from Diagnostics37:30 - Fear Finds Cowboys39:08 - AI and Robotics40:08 - Fun Hobbies

    50 min

  4. 3 FEB

    Ep. 613 Microwave Ablation in Renal Tumors with Dr. Steven Huang

    You’re about to biopsy a renal lesion; should you ablate at the same time? In this episode of the BackTable Podcast, host Michael Barraza talks with Dr. Steven Huang from MD Anderson Cancer Center about building an efficient and effective renal biopsy and ablation service line. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS Dr. Huang first covers referral patterns and the typical pathway that patients take to end up in his clinic. The discussion covers the types of lesions he treats, imaging requirements, and criteria for patient eligibility. He emphasizes the importance of shared decision making when deciding between active surveillance, interventional treatment, and partial nephrectomy. Dr. Huang explains his preferred procedural approach and ablation modalities, including cryo, microwave (MWA), and radiofrequency ablation (RFA). He shares his experiences with challenging cases and integrating new technologies like histotripsy and the Siemens interventional package. They also discuss the possibility of a preoperative embolization for larger lesions that could be susceptible to the heat sink effect. Both experts emphasize the importance of collaboration with urologists and ensuring patient safety and expectations. They also touch on the future of the field, discussing the use of AI and robotics. --- TIMESTAMPS 00:00 - Introduction 02:17 - Training Programs at MD Anderson03:23 - Referral Patterns for Renal Ablations07:25 - Patient Management and Virtual Consultations10:59 - Ablation Techniques and Device Selection26:44 - Challenges and Complications27:25 - Approach to Lesions Near Renal Vasculature28:02 - Patient Expectations and Urologist Collaboration33:26 - Post-Procedure Care and Patient Recovery35:30 - Managing Recurrences and Multiple RCCs47:17 - Closing Remarks

    49 min

  5. 30 JAN

    Ep. 612 Interventional Radiology in Military Medicine with Dr. John York

    What does day-to-day interventional radiology look like in the military? Here’s a firsthand account. Dr. John York, interventional radiologist at University of California San Diego with 37 years of active duty in the Navy joins host Dr. Ally Baheti to share his experiences and perspectives on being an interventional radiologist in the military. --- SYNPOSIS Dr. York recounts his path to the military and how it ultimately led him to interventional radiology. He reflects on his deployments to Afghanistan and Djibouti, highlighting the clinical complexity, operational challenges, and fulfilling aspects of delivering image-guided care in high-acuity environments. Dr. York recounts several remarkable cases from his deployments, including the management of a vertebral artery aneurysm. He underscores how strong foundational training enables creative problem-solving in resource-limited settings. Dr. York also shares his experience as senior medical officer on the USS Theodore Roosevelt during the initial COVID-19 outbreak, offering insight into the clinical, operational, and administrative challenges he faced. He highlights how adaptability and creative problem-solving are essential to managing complex cases in dynamic environments. --- TIMESTAMPS 00:00 - Introduction02:53 - Journey to Medicine: From Naval Academy to Medical School05:55 - Choosing Interventional Radiology08:11 - Military Medical Experience: Portsmouth and Beyond11:38 - First Deployment: Challenges and Adaptations14:38 - Case Studies: Trauma and Innovation in Afghanistan26:15 - A Unique Procedure in a Combat Zone28:49 - Transitioning Back to Civilian Life31:07 - Challenges in Combat Zones34:22 - Deployment in Djibouti38:25 - COVID-19 on the USS Theodore Roosevelt45:50 - Reflections on Military Service

    50 min

  6. 27 JAN

    Ep. 611 Challenges in Prostate Artery Embolization with Dr. Rajasekhara Ayyagari

    Are balloon occlusion microcatheters your new best friend for prostate artery embolization (PAE)? In this episode of BackTable, Dr. Raj Ayyagari, interventional radiologist at Boston Medical Center, joins Dr. Ally Baheti to tackle complex clinical and technical challenges in PAE. --- This podcast is supported by an educational grant from Guerbert. --- SYNPOSIS Dr. Ayyagari shares his unique journey from urology to interventional radiology and his experience building successful PAE service lines at multiple institutions. He walks through a series of challenging cases involving intraprostatic penile arteries, perivesicular collaterals, and internal pudendal collaterals used to treat bilateral hemi-prostates. The discussion highlights the role of balloon occlusion microcatheters such as the Sniper, his transition from 100–300 micron particles to glue embolization, and scenarios where coil protection is essential to prevent nontarget embolization. He also covers post-procedural management, the importance of setting expectations around suprapubic tube removal, and why thorough patient and provider counseling is critical for optimal care. --- TIMESTAMPS 00:00 - Introduction 02:14 - Building a Practice in Prostate Artery Embolization08:19 - Case Studies and Techniques in Prostate Artery Embolization23:16 - Challenges in Embolization Techniques23:47 - Step-by-Step Guide to Embolizing a Hemi Prostate25:24 - Choosing the Right Beads for Embolization29:10 - Transitioning to Liquid Embolics35:38 - Setting Patient Expectations and Pre-Procedure Evaluation40:17 - Post-Procedure Care and Medications44:06 - Conclusion and Final Thoughts

    46 min

  7. 23 JAN

    Ep. 610 Interventional Radiology in UAE: Current Practices with Dr. Jamal Alkoteesh

    Have you ever considered taking a sabbatical to practice Interventional Radiology in the Middle East? In this episode, Dr. Jamal AlKoteesh, the Chairman of Clinical Imaging at SEHA and the "Godfather of IR" in the United Arab Emirates, joins host Dr. Sabeen Dhand to discuss the rapid evolution and current state of IR in the Gulf region. --- SYNPOSIS Dr. AlKoteesh shares his journey from training in the UK to establishing the IR specialty in Abu Dhabi over the last 18 years. He details the unique practice environment in UAE government hospitals, where the lack of strict sub-specialization requires IRs to maintain a versatile skillset—handling everything from thyroid FNAs and UFE to complex neurovascular thrombectomies. The conversation highlights the significant government investment in healthcare technology, which allows physicians access to the latest tools—such as the Siemens Artis Icono with integrated RapidAI for stroke—often before they are widely available in other markets. Dr. AlKoteesh also provides a practical guide for US physicians interested in working abroad, covering the licensing timeline, tax-free income, and the high demand for Western-trained physicians. --- TIMESTAMPS 00:00 - Introduction01:39 - Building IR in UAE05:23 - UAE Healthcare System Overview07:54 - IR Residency and Staffing13:15 - Access to Latest Devices15:15 - Compensation and Lifestyle17:58 - PAIRS Conference Overview20:45 - Licensing and Relocation Guide21:39 - Liability and Language Barriers26:33 - Launching Stroke Interventions

    35 min

  8. 20 JAN

    Ep. 609 Chronic Venous Disease Diagnosis & Management Strategies with Dr. Steven Abramowitz

    BackTable Vascular & Interventional

    51 min
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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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