BackTable Vascular & Interventional

BackTable
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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. -10 h

    Ep. 662 Pathways to Interventional Radiology: ESIR vs. Integrated Dr. John Cieslak

    With multiple training pathways, how can you determine which is the right choice for your career and clinical goals? In this episode of BackTable Podcast, Dr. Neil Jain sits down with interventional radiologist Dr. John Cieslak to compare the Early Specialization in Interventional Radiology (ESIR), integrated IR/DR, and independent IR routes. The conversation highlights practical differences in training structures, procedural exposure, and the key factors that influence career decisions for aspiring IRs. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:47 - Early Life and Science Roots 03:58 - Surgery to IR Pivot 05:51 - Radiology Training and ESIR Setup 08:59 - Three IR Training Pathways 11:53 - ESIR Pros Cons and Case Exposure 14:27 - Competency and Hiring Perceptions 20:12 - Job Market Academic vs Hospital 23:08 - Early Attending Surprises 26:00 - Integrated Versus ESIR 29:10 - Boosting Your Application 31:24 - Rapid Fire IR Questions 34:46 - Future Of IR 36:46 - Wrap Up And Credits --- More about this episode Dr. Cieslak shares his own journey, from early exposure to hospital science and a long academic path to switching from surgery to radiology and ultimately landing in IR. They outline the practical pros and cons of each pathway, including the flexibility and breadth of ESIR, the directness of integrated training, and the realities of re-matching and job market considerations. The discussion covers early attending challenges like building referrals and making independent decisions, the importance of multidisciplinary teamwork, and advice for residents and students interested in IR. The Drs. also discuss the evolution of IR procedures, the impact of program variability, and why persistence and exposure are vital for success in the field. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

    39 min

  2. -3 j

    Ep. 661 Practical Strategies for Advanced Embolization Techniques with Dr. Harris Chengazi

    As endovascular technologies evolve, how are IRs maximizing control while minimizing metal in modern venous embolization? In this episode of the BackTable Podcast, Dr. Harris Chengazi joins host Dr. Sabeen Dhand to discuss the clinical impact, deployment techniques, and imaging advantages of modern vascular point embolization devices, focusing on targeted venous occlusion and variceal obliteration. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Okami Medicalhttps://okamimedical.com/ --- Timestamps 00:00 - Introduction02:22 - Multidisciplinary Vascular Practice Model05:51 - Understanding Plugs in Embolization08:34 - Comparing Plugs, Coils, and Liquid Embolics13:48 - LOBO Occlusive Device16:12 - Plug Sizing and Vessel Measurement20:45 - Deliverability and Catheter Selection24:28 - Limitations of Point Embolization29:03 - PARTO Access and Technique32:46 - Other LOBO Use Cases34:33 - LOBO Deployment Mechanism36:23 - Cost Effectiveness of Embolics41:08 - Final Thoughts and Closing Remarks --- More about this episode Dr. Chengazi shares insights from incorporating vascular plugs into his embolization practice after training predominantly with coils. He highlights the features that distinguish modern devices like the LOBO from traditional plugs, including their unique nitinol weave, rapid occlusion, and predictable sizing and landing configuration. The physicians explore the utility and limitations of plugs in clinical scenarios including retrograde transvenous variceal obliteration, antegrade variceal embolization during TIPS creation, and tract embolization following percutaneous procedures. Dr. Chengazi furthermore shares specific procedural pearls for point embolization of varices, explaining how to facilitate deployment using a parallel access technique as well as how to position multi-lobed plugs across venous outflow segments to reliably treat large shunts with a single device. Finally, the physicians review the benefits of reduced imaging artifact on follow-up scans compared to traditional coil packs and liquid embolics as well as the impact of modern plug technology on healthcare costs, reinforcing the value of evidence-based device selection for optimal patient outcomes. --- Resources Kundaragi NG, et al. Measurement of Inferior Vena Cava to Shunt Distance in Deciding Access Route for Balloon-Occluded Retrograde Transvenous Obliteration Procedure: A Pilot Study. Am J Interv Radiol. 2018 Sep 19;2(16):1-9.https://dx.doi.org/10.25259/AJIR-22-2018 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

    44 min

  3. 3 juil.

    Ep. 660 Techniques & Outcomes of Portal Vein Embolization with Dr. David C. Madoff

    How is portal vein embolization (PVE) pushing the boundaries of liver tumor resectability, and what does it take to induce hypertrophy without compromising the remnant liver? In this episode of the BackTable Podcast, interventional radiologist Dr. David Madoff of Yale University joins Dr. Michael Barraza to discuss the pathophysiological rationale, technical considerations, and emerging clinical paradigms of performing PVE to augment the future liver remnant (FLR) prior to resection and reduce the risk of postoperative liver failure. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction02:14 - IO Practice and Research07:25 - PVE Indications and Adequate FLR12:55 - Referrals and Patient Selection17:27 - PVE vs. Y90 Radiation Lobectomy22:12 - Liver Venous Deprivation25:31 - Measuring FLR Function30:11 - Procedural Planning and Technique36:36 - Preferred Embolic Agents and Challenges46:58 - Ipsilateral vs. Contralateral Access50:52 - Complications, Medications, and Follow-Up55:45 - Final Thoughts and Closing Remarks --- More about this episode The physicians dissect the anatomic and oncologic benchmarks used to select PVE candidates, including FLR volumetric thresholds for normal, steatotic, and cirrhotic livers. Dr. Madoff walks through his procedural technique, detailing catheter maneuvers and embolic administration, emphasizing the importance of evaluating for anatomic variants, and explaining the benefits of using an ipsilateral approach to protect the FLR. The doctors critique ongoing debates in hepatic augmentation, assess the complementary relationship between PVE and Y90 radioembolization, and discuss the outcomes and risks associated with different embolic agents. They stress the importance of patient selection and assessment protocols that go beyond static volumetric measurements to incorporate functional parameters for better prediction of regenerative kinetics and clinical outcomes. The episode concludes with a review of postprocedural follow-up and potential complications, highlighting the importance of considering pathophysiologic dynamics of both the tumor and the anticipated liver remnant to ensure successful treatment. --- Resources DRAGON Trialhttps://www.dragontrial.com/ Three hundred and one consecutive extended right hepatectomies: Evaluation of outcome based on systematic liver volumetryhttps://doi.org/10.1097/SLA.0b013e3181b674df Portal vein embolization with N-butyl-cyanoacrylate improves liver hypertrophy compared to microparticles – A Swedish multicenter cohort studyhttps://doi.org/10.1016/j.heliyon.2023.e21210 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

    59 min

  4. 30 juin

    Ep. 659 Combination Therapy for Hepatocellular Carcinoma with Dr. Beau Toskich and Dr. Lingling Du

    How do you safely combine locoregional and systemic therapies to treat hepatocellular carcinoma (HCC) when traditional guidelines suggest your hands are tied? In this episode of the 2026 HCC Creator Weekend™, medical oncologist Dr. Lingling Du (Ochsner Health) and interventional radiologist Dr. Beau Toskich (Mayo Clinic Florida) join Dr. Tyler Sandow to break down patient selection, timing strategies, and the practical application of clinical trial outcomes when integrating Y90 radioembolization and immunotherapy in HCC management. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction01:48 - Two HCC Cases03:31 - Disease Progression on Combination Therapy07:05 - Alternatives After Immunotherapy Failure09:09 - Salvage with Ablative Y9013:41 - Mechanism of Immunotherapy15:43 - EMERALD-1 and LEAP-01220:52 - Adverse Events with Combination Therapy27:21 - Treatment Timing and Sequencing28:48 - Case: Borderline BCLC B33:48 - Case: BCLC C with Portal Vein Thrombus37:06 - Raising the Survival Tail40:11 - Final Thoughts and Closing Remarks --- More about this episode The physicians highlight how selective local treatment can achieve complete responses and salvage cases with aggressive disease. They emphasize that treatment based on anatomical and biological phenotype may yield better results than strictly adhering to rigid staging categories, while acknowledging the challenges of managing microscopic disease and unpredictable long-term tumor behavior. Dr. Du and Dr. Toskich also note that selecting the right combination regimens requires balancing aggressive tumor kinetics against the patient’s baseline liver function, pointing out that well-tolerated regimens like STRIDE are often easier to pair with Y90 than checkpoint or VEGFR inhibitors that alter tumor blood flow. While recent TACE-immunotherapy trials (EMERALD-1 and LEAP-012) may be confounded by patient heterogeneity, the physicians observe that a distinct subset of patients achieves durable, long-term remission, effectively raising the survival tail for an otherwise incurable population. Ultimately, they conclude that cross-specialty education and leaning into the expert intuition of a multidisciplinary team are essential for securing the best outcomes for patients with intermediate and advanced HCC. --- Resources Study of Durvalumab and Tremelimumab as First-line Treatment in Patients With Advanced Hepatocellular Carcinoma (HIMALAYA)https://clinicaltrials.gov/study/NCT03298451 A Study of Atezolizumab in Combination With Bevacizumab Compared With Sorafenib in Patients With Untreated Locally Advanced or Metastatic Hepatocellular Carcinoma (IMbrave150)https://clinicaltrials.gov/study/NCT03434379 Nivolumab plus ipilimumab versus lenvatinib or sorafenib as first-line treatment for unresectable hepatocellular carcinoma (CheckMate 9DW): an open-label, randomised, phase 3 trialhttps://doi.org/10.1016/S0140-6736(25)00403-9 Durvalumab with or without bevacizumab with transarterial chemoembolisation in hepatocellular carcinoma (EMERALD-1): a multiregional, randomised, double-blind, placebo-controlled, phase 3 studyhttps://doi.org/10.1016/S0140-6736(24)02551-0 Transarterial chemoembolisation combined with lenvatinib plus pembrolizumab versus dual placebo for unresectable, non-metastatic hepatocellular carcinoma (LEAP-012): a multicentre, randomised, double-blind, phase 3 studyhttps://doi.org/10.1016/S0140-6736(24)02575-3 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

    45 min

  5. 26 juin

    Ep. 658 Expeditionary Interventional Radiology: Innovations in Military Medicine with Dr. Jonathon Schutt and Dr. John Pavlus

    How will expeditionary IR adapt and advance to meet the challenges of the next generation of combat operations? In this episode of the Backtable Podcast, host Dr. Ally Baheti speaks with Air Force IR physicians Dr. John Pavlus and Dr. Jonathon Schutt about the realities of expeditionary interventional radiology (EIR) in military and disaster settings. They discuss how EIR brings damage-control and emergency IR principles to deployments, humanitarian missions, and extreme environments, where resources are limited and teamwork is essential. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:53 - Origins and Early Pushback 06:31 - Roles of Care 09:04 - Trauma vs Elective12:09 - Staffing and Training Barriers 22:17 - Future Tech: AI and Robotics 29:24 - Why It Matters in War35:00 - Teamwork Trust and 60 Minutes39:20 - Military Culture41:18 - Wrap Up and Thanks --- More about this episode The conversation explores the military’s “roles of care,” from stateside hospitals to front-line deployments, and examines how limited IR staffing and siloed services present barriers to readiness. Drs. Pavlus and Schutt emphasize the importance of close integration with trauma surgery, anesthesia, and other team members, and highlight trauma-focused endovascular care and ultrasound-guided procedures that work with minimal equipment. The episode also looks at future directions for expeditionary IR, including new training models, data systems, and advances in AI and robotics that may one day enable remote intervention in combat and disaster zones. --- Resources Expeditionary Endovascular Trauma Care as a Core Capability for Future Large-Scale Conflictshttps://pubmed.ncbi.nlm.nih.gov/41894613/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

    45 min

  6. 23 juin

    Ep. 657 Advanced Techniques in Y90 Cancer Treatment with Dr. Beau Toskich and Dr. Juan Gimenez

    What do you do when Y-90 doesn’t deliver the results you expected? In this episode of the 2026 HCC Creator Weekend™, host Dr. Tyler Sandow is joined by Drs. Beau Toskich and Juan Gimenez to discuss the technical challenges and troubleshooting strategies that can make or break a Y-90 radioembolization case. Together, they explore innovative approaches like the PREDATr technique, share tips for reducing complications, and offer guidance on optimizing outcomes for patients with complex liver tumors. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction04:24 - Treatment Nonresponse Troubleshooting06:12 - Navigating Y90 Through Replaced Arteries09:09 - Mitigating Vasospasm in Embolization13:31 - What is ‘PREDATr’?21:12 - Dual Balloon Microcatheter System23:37 - Gelfoam Techniques and Application26:06 - Embolization Agents Preferences36:16 - Concerns with Cystic Artery Treatment and Biliary Stents42:15 - Prophylactic Antibiotics 44:29 - Utilizing High Lung Shunts49:28 - Wrap Up and Credits --- More about this episode The conversation begins with case-based examples of HCC radioembolization, focusing on how to assess treatment response and troubleshoot nonresponsive cases. They discuss how to interpret SPECT findings, identify missed tumor supply with cone-beam CT, and overcome obstacles such as vasospasm, extrahepatic feeders, and challenging arterial anatomy. They introduce the PREDATr technique (proximal radioembolization enabled by distal angiozone truncation) and explain how tools like gelfoam, balloons, and retrievable coils can preserve healthy liver tissue and improve microsphere delivery. The episode also addresses managing biliary stents, using antibiotic prophylaxis, and strategies for handling high lung shunts, making it a practical resource for anyone navigating the complexities of Y-90 treatment. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

    52 min

  7. 19 juin

    Ep. 656 Advanced Practices in Uterine Fibroid Embolization with Dr. Francis Kang and Dr. Neil Resnick

    Are new technologies and teamwork the key to better fibroid treatment? In this episode of the BackTable Podcast, Drs. Francis Kang and Neil Resnick join host Dr. Chris Beck to share how multidisciplinary treatment planning is reshaping uterine fibroid management, from patient selection and referral patterns to procedural techniques that improve outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byTriSalus Life Scienceshttps://trinavinfusion.com/ --- Timestamps00:00 - Introduction06:18 - Multidisciplinary Care of Fibroids15:45 - Treatment Decisions21:56 - Managing Asymptomatic Fibroids25:43 - Collaborative vs. Competitive Practices30:01 - UFE Procedure Approaches34:32 - Comparing Embolic Sizes and Amounts37:44 - Changes in Speed Using TriNav Catheters40:53 - Tactile Feedback at Stasis42:28 - Embolization Target Regions44:45 - Encountering and Troubleshooting Collaterals47:30 - Post-Op Pain Regiments57:28 - Wrap Up --- More about this episodeThe conversation begins with the importance of strong partnerships with OBGYN colleagues and how multidisciplinary planning leads to better outcomes for patients. They explore patient selection and education, especially for those considering surgical versus minimally invasive treatment options. Drs. Kang and Resnick compare procedural approaches, including when to use femoral versus transradial access, nerve blocks, and embolic particle selection. They also discuss strategies to achieve optimal embolization endpoints and practical tips for handling collateral vessels, avoiding non-target embolization, and managing post-procedural pain and recovery. The episode concludes with a look at newer technologies like the TriNav Catheter and its impact on embolization speed, operator confidence, and early imaging outcomes.--- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app

    59 min

  8. 16 juin

    Ep. 655 Managing Large Liver Tumors: Strategies and Challenges with Dr. Beau Toskich, Dr. Chris Malone, and Dr. Tyler Sandow

    How is Y90 radioembolization rewriting the rules for managing large HCC tumors and creating new curative-intent therapeutic pathways where palliation was once deemed the only option? In this episode of the 2026 HCC Creator Weekend™, interventional radiologists Dr. Chris Malone (WashU), Dr. Tyler Sandow (Ochsner Health), and Dr. Beau Toskich (Mayo Clinic Florida) join host Dr. Zach Berman for a case-based discussion on advanced dosimetric strategies and embolization approaches for large and complex HCC lesions. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Boston Scientific. --- Timestamps 00:00 - Introduction01:59 - Case 1: Ablative Dosing to Solitary Tumor04:38 - Post-Treatment Residual Arterial Enhancement07:35 - Case 2: Tumor with Multiple Feeding Arteries10:02 - Role of Combination with Immunotherapy13:01 - Case 3: Large Caudate Tumor16:03 - Approach to Extrahepatic Arterial Supply19:14 - Case 4: Tumor Adjacent to Viscera21:32 - Does Microsphere Count Matter?24:10 - Case 5: Radioembolization in HCC Downstaging28:18 - Dosing Paradigms for Large Tumors33:06 - Case 6: Pressure-Augmented Delivery35:16 - Case 7: Multifocal Disease and Satellite Lesions37:47 - Palliative Dosimetry vs. Radiation Lobectomy40:11 - Significance of Complete Pathonecrosis43:25 - Closing Remarks --- More about this episodeThe physicians discuss systematic approaches to patient selection, the nuances of MIRD single-compartment versus multi-compartment dosing, and the critical role of precise mapping and particle dynamics in optimizing treatment for heterogeneous tumors. The panel also examines how to navigate the risks and situational challenges of delivering high radiation doses to large central and multifocal tumors. They address practical concerns such as responding to post-treatment imaging changes, managing long-term risks like biliary strictures, and ensuring the safety of treating disease near mobile viscera. The specialists highlight the power of Y90 in successful downstaging, citing evidence of its superior potential to achieve complete pathological necrosis (CPN) at explant when compared with other modalities. Ultimately, they advocate for a bold, collaborative approach within the multidisciplinary tumor board, encouraging providers to employ combination therapies and advanced technologies to optimize patient outcomes and expand the boundaries of curable HCC. --- Resources Yttrium-90 Radioembolization for the Treatment of Solitary, Unresectable HCC: The LEGACY Studyhttps://doi.org/10.1002/hep.31819 A US Study to Evaluate Transarterial Radioembolization (TARE) in Combination With Durvalumab and Bevacizumab Therapy in People With Unresectable Hepatocellular Carcinoma Amenable to TARE (EMERALD-Y90)https://clinicaltrials.gov/study/NCT06040099 TheraSphere With Durvalumab and Tremelimumab for HCC (ROWAN)https://clinicaltrials.gov/study/NCT05063565 Personalized versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (DOSISPHERE-01): a randomised, multicentre, open-label phase 2 trialhttps://doi.org/10.1016/S2468-1253(20)30290-9 Downstaging Outcomes for Hepatocellular Carcinoma: Results From the Multicenter Evaluation of Reduction in Tumor Size before Liver Transplantation (MERITS-LT) Consortiumhttps://doi.org/10.1053/j.gastro.2021.07.033 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

    45 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.

Informations

  • Création
    BackTable
  • Années d’activité
    2019 - 2026
  • Épisodes
    671
  • Classification
    Tous publics
  • Copyright
    © All rights reserved
  • Site web de l’émission
    BackTable Vascular & Interventional

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