BackTable Vascular & Interventional BackTable

En este episodio de BackTable la Dra. Maite Velázquez, hemodinamista del Hospital 12 de Octubre de Madrid, aborda el creciente porcentaje de mujeres que ingresan en el campo de la medicina y, en comparación, el escaso porcentaje de mujeres entre los profesionales que trabajan en entornos con radiación ocupacional, como la radiología vascular intervencionista, hemodinámica o cirugía vascular. Además, se analizan los desafíos existentes alrededor del embarazo de estas profesionales, legislación existente y qué medidas protectoras existen en España y Europa, así como los riesgos reales de radiación para el feto basados en evidencia científica.

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SYNPOSIS

La Dra. Velázquez disipa mitos, enfatiza la seguridad existente a la hora de mantener la actividad profesional durante el embarazo con las protecciones adecuadas y destaca la brecha de género y el impacto de la escasez de relevo generacional en estas especialidades. La conversación tiene como objetivo informar y reflejar la evidencia científica existente en cuanto al manejo del embarazo mientras se trabaja en ambientes expuestos a la radiación ionizante.

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TIMESTAMPS

00:00 - Introducción
03:11 - Exposición a la radiación durante el embarazo
07:33 – Evidencia científica y legislación
20:19 - Abordar el impacto profesional del embarazo
26:56 - Combatir conceptos erróneos y promover prácticas seguras
34:59 - Comentarios finales

In this episode, Dr. Amit Srivastava discusses the transformation of peripheral interventional practices through radial access techniques, emphasizing reduced complication rates, the extensive range of devices now available, and the option for same-day discharge.

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CHECK OUT OUR SPONSOR

Terumo R2P Misago RX
https://www.terumois.com/products/r2p-portfolio/r2p-misago2.html

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SYNPOSIS

Through a series of real-world examples and discussion on the R2P registry, the doctors illustrate the high success rates and low complications of the transradial approach, debunking common misconceptions, and highlighting the significance of team collaboration in executing these procedures efficiently. Additionally, the conversation covers the evolution of devices suited for R2P, including longer length wires, catheters, and novel training methods like immersive virtual reality courses designed to educate and inspire practitioners to adopt radial access in their endovascular practices.

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TIMESTAMPS

00:00 - Introduction
02:19 - Current Role of Radial Access in Peripheral Interventions
15:08 - Future of Radial Access
21:11 - The R2P Registry
28:44 - Educational Opportunities and Community Support

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RESOURCES

TERUMO Transradial Training & Education:
https://www.terumois.com/education-training/healthcare-provider-education-programs/transradial-courses.html

BT Episode 342 - Radial Access for PAD with Dr. Rami Tadros:
https://www.backtable.com/shows/vi/podcasts/342/radial-access-for-pad

Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study:
https://pubmed.ncbi.nlm.nih.gov/22858390/

Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions (RPI Study):
https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext

In this episode, Dr. Nicole Lamparello discusses the strides and challenges in achieving gender equity in interventional radiology (IR), sharing insights from her research on gender disparities in IR, and revealing how women currently comprise a significantly low percentage of the IR workforce compared to men despite equal numbers of male and female medical students. Dr. Lamparello is an interventional radiologist and serves as the Program Director for Weill Cornell Medicine’s Integrated IR Residency in New York City.

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RADPAD® Radiation Protection
https://www.radpad.com/

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SYNPOSIS

The doctors cover the importance of workplace culture with flexibility for family and maternity needs, mentorship, visibility of female leaders in IR, and strategies for attracting more women to the field. The conversation also touches on the impact of diverse IR professionals on patient outcomes, and how outsourcing personal tasks can help maintain work-life balance. The necessity of early exposure to IR for medical students and addressing specific hurdles for women in IR, such as work-life balance, radiation exposure fears, and lack of female role models are also explored.

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TIMESTAMPS

00:00 - Introduction
05:40 - Addressing Gender Disparity in IR
13:48 - Importance of Physician Workforce Diversity
18:31 - Challenges and Solutions for Gender Equity in IR
25:28 - Work-Life Balance
38:40 - Concluding Thoughts

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RESOURCES

The Gender Gap in Interventional Radiology: Barriers, Opportunities, and the Role of the Integrated IR Residency:
https://pubmed.ncbi.nlm.nih.gov/36870809/

The IR Trainee Workforce 10 Years after Becoming a Primary Medical Specialty:
https://www.jvir.org/article/S1051-0443(23)00651-6/fulltext

Lack of exposure and perceived occupational hazards as barriers to entry into IR for women: a survey of 143 female medical students:
https://www.jvir.org/article/S1051-0443(16)31526-3/fulltext

Untapped Resources: Attaining Equitable Representation for Women in IR:
https://www.jvir.org/article/S1051-0443(18)31645-2/fulltext

Gender and racial diversity among plenary session speakers at the Society of Abdominal Radiology Annual Meetings: a five-year assessment:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226100/

Bridging the Gender Gap in the Society of IR: A Benchmark Study:
https://www.jvir.org/article/S1051-0443(18)31492-1/pdf

In this episode, Dr. Aron Chary provides an in-depth look into endovascular and minimally invasive treatments for pain management, specifically focusing on cryoneurolysis. He shares his experience of implementing the technology for both benign and malignant conditions in an independent private practice setting.

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Boston Scientific Visual ICE Cryoablation System
https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html

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SYNPOSIS

The discussion covers various aspects, including collaboration with Boston Scientific for the VISUAL ICE cryoablation system, Dr. Chary’s personal journey from academics at Emory to private practice in Memphis, the effectiveness of cryoneurolysis in different areas such as genicular nerve and palliative care, and the operational dynamics between hospital and outpatient settings. The doctors delve into the procedural specifics, patient response, and outcomes with cryoneurolysis, including Dr. Chary’s efforts to navigate insurance and reimbursement challenges.

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TIMESTAMPS

00:00 - Introduction
07:04 - Evolution of Pain Intervention Techniques
11:08 - Building a Pain Intervention Service
16:16 - Versatility of Cryoablation in Pain Management
23:54 - Expectations and the Future of Pain Management Research
31:41 - Cryoneurolysis Insights and Patient Management
42:10 - Techniques in Celiac Cryoneurolysis
52:33 - Pain Management in the Outpatient Setting

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RESOURCES

Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol:
https://www.jvir.org/article/S1051-0443(20)30349-3/abstract

BT VI Episode 199 - Advanced Minimally Invasive Pain Interventions with Dr. David Prologo:
https://www.backtable.com/shows/vi/podcasts/199/advanced-minimally-invasive-pain-interventions

BT VI Episode 433 - Kyphoplasty Evolution: Steering Toward Targeted Therapy with Dr. David Prologo:
https://www.backtable.com/shows/vi/podcasts/433/kyphoplasty-evolution-steering-toward-targeted-therapy

Boston Scientific, VISUAL ICE:
https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html

In this episode, Dr. David Guez discusses the advancements in contrast enhanced ultrasound, its application in detecting endoleaks, and his journey of learning and applying this modality from residency to his current practice.

Dr. Guez emphasizes ultrasound’s utility in lesion characterization, endoleak monitoring, and sparing patients from more invasive diagnostic procedures. The doctors delve into the specifics of using ultrasound contrast agents, particularly LUMASON and its intravascular utility for real-time monitoring of disease states with superior resolution compared to CT or MRI. Dr. Guez also discusses the potential for contrast enhanced ultrasound in interventional radiology, including diagnosing vascular lesions and augmenting tumor treatments. The conversation highlights the technique’s advantages, its high sensitivity for endoleaks, and potential areas for future research and application. The episode underscores the underutilized potential of contrast enhanced ultrasound in both diagnostic and interventional radiology settings.

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Reflow Medical
https://www.reflowmedical.com/

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SHOW NOTES

00:00 - Introduction
03:54 - Exploring the Basics of Contrast Enhanced Ultrasound
06:49 - Clinical Applications and Advantages of Contrast Enhanced Ultrasound
09:15 - Contrast Enhanced Ultrasound in Action: Diagnosing Endoleaks
23:52 - Future of Contrast Enhanced Ultrasound in Interventional Radiology
27:02 - Closing Thoughts

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RESOURCES

Bracco LUMASON:
https://lumason.com/

Nontraditional Uses of US Contrast Agents in Abdominal Imaging and Intervention:
https://pubs.rsna.org/doi/full/10.1148/rg.220016

Book written by Andrej Lyshchik, MD, PhD (Thomas Jefferson) - Specialty Imaging: Fundamentals of CEUS:
https://www.amazon.com/Specialty-Imaging-Fundamentals-Andrej-Lyshchik/dp/0323625649

Contrast-enhanced Ultrasound Identifies Patent Feeding Vessels in Transarterial Chemoembolization Patients With Residual Tumor Vascularity:
https://pubmed.ncbi.nlm.nih.gov/32890324/

Contrast-enhanced ultrasound (CEUS) versus computed tomography angiography (CTA) in detection of endoleaks in post-EVAR patients. Are delayed type II endoleaks being missed? A systematic review and meta-analysis:
https://pubmed.ncbi.nlm.nih.gov/26191109/

In this episode, guest host Dr. Krishna Mannava interviews Dr. Bob Tahara about the significant multilevel impacts, ripple effects, and fallout of cyberattacks on the healthcare industry, specifically covering the recent cyberattack that targeted major clearinghouse, Change Healthcare.

Dr. Tahara is a vascular surgeon practicing in rural northwest Pennsylvania and President of Outpatient Endovascular Interventional Society (OEIS). Dr. Tahara shares his experiences as a solo vascular surgeon in rural Pennsylvania, highlighting the complexities of modern billing systems, the advantages of hiring a quality billing company, and the challenges posed by the consolidation of clearinghouses. The conversation also delves into the alarming ransomware attack on Change Healthcare, where 6 terabytes of patient data were compromised. This incident exposed vulnerabilities across the healthcare sector, from payment processes to electronic medical and prescription records. The doctors underscore the importance of cybersecurity preparedness, diversification of clearinghouses, and the role of physicians in advocating for more secure and efficient healthcare systems. They also touch on personal hobbies like Kendo to manage stress.

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Reflow Medical
https://www.reflowmedical.com/

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SHOW NOTES

00:00 - Introduction
02:02 - Cyberattack on Change Healthcare: An Overview
06:37 - Impact of the Cyberattack on Healthcare Practices
09:50 - Understanding Clearinghouses in Healthcare Billing
14:30 - Fallout from the Cyber Attack: A Personal Account
16:40 - Navigating the Aftermath: Strategies and Solutions
22:54 - Value of Medical Records and Cybersecurity Measures
29:18 - Action Items and Advocacy for Physicians
35:00 - OEIS 2024 Meeting and Final Thoughts

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RESOURCES

OEIS Annual Meeting Schedule 2024:
https://oeisweb.com/wp-content/uploads/2024/04/2024-AM-attendee-brochure-v4-FINAL-proof-lowres.pdf

BackTable Episode 349 - Cybersecurity for Physicians with Jason Newton, Esq:
https://www.backtable.com/shows/vi/podcasts/349/cybersecurity-for-physicians