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. 4h ago

    Ep. 671 Managing Pulmonary Embolism: Guidelines & Clinical Decisions with Dr. Timothy Fernandes and Dr. Robert Lookstein

    Once your PERT is assembled, how do you navigate the evolving pulmonary embolism (PE) literature to improve patient outcomes at all risk levels? In this episode of the BackTable Podcast, interventional radiologist Dr. Robert Lookstein (Mount Sinai) and pulmonary critical care specialist Dr. Timothy Fernandes (UC San Diego) join host Dr. Harris Chengazi to examine the latest evidence and multidisciplinary strategies for managing acute pulmonary embolism. The discussion highlights the complexities of catheter-directed therapies in intermediate- to high-risk PE, evolving guidelines in the face of new trial data, and prioritization of improving patients’ clinical trajectories. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:57 - PERT Structure and Activation08:24 - PE Risk Stratification Tools12:02 - Patient Selection for IR Intervention15:21 - Assessing Clot Chronicity21:03 - Standardizing Workup26:38 - Managing Unstable PE28:31 - STORM-PE and HI-PEITHO Trial Data35:49 - Guidelines vs. New Evidence40:12 - Determining Therapeutic Endpoints45:05 - Upcoming Trials and Future Directions51:46 - Final Thoughts and Closing Remarks --- More about this episode The physicians explore the nuances of validated PE risk stratification tools, assessing the relationship between various PE scoring systems and the 2026 ACC/AHA classification for acute PE. They emphasize that the integration of clinical assessment, serial lab work, and patient history must take precedence over static imaging alone in guiding care. The doctors go on to review new trial data, including the improved RV-to-LV ratio and 90-day functional gains seen with mechanical thrombectomy in STORM-PE and reduced clinical deterioration observed with ultrasound-assisted catheter-directed thrombolysis in HI-PEITHO. The conversation concludes with a call for collaborative, safety-first management that focuses on the patient’s clinical status and long-term post-PE functional recovery. --- Resources 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adultshttps://doi.org/10.1161/CIR.0000000000001415 Composite Pulmonary Embolism Shock (CPES) Scorehttps://doi.org/10.1161/CIRCINTERVENTIONS.124.014088 FOCUS studyhttps://doi.org/10.1093/eurheartj/ehac206 STORM-PE trialhttps://doi.org/10.1161/CIRCULATIONAHA.125.077232 HI-PEITHO trialhttps://doi.org/10.1056/nejmoa2516567 PE-TRACT studyhttps://petractstudy.org/homepage PEERLESS II studyhttps://clinicaltrials.gov/study/NCT06055920 PERSEVERE trialhttps://clinicaltrials.gov/study/NCT06588634 --- 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

  2. Aug 18

    Ep. 670 Understanding IR Attrition: Causes & Solutions with Dr. David R. Mittelstein

    Why do nearly half of IR residents consider leaving the specialty, and what can be done to change that? On this episode of the BackTable Podcast, Dr. Neil Jain interviews Dr. David Mittelstein, an integrated IR resident at UC San Diego and co-chair of the SIR RFS Recruitment Committee, about the findings of a national SIR survey on interventional radiology resident attrition. They discuss what drives uncertainty, from lifestyle and call burden to job market fears, and highlight the program features that encourage retention, such as structured training, high case volume, and a culture of camaraderie. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction04:31 - From Biomedical Engineering to IR07:41 - Recruitment Committee Mission12:37 - Match Trends Warning Sign15:12 - Survey Design Demographics20:21 - What Factors Matter25:04 - Why Residents Consider Switching30:23 - Recommendation 1 IR Curriculum32:32 - Recommendation 2 More IR Rotation34:10 - Recommendation 3 Build Camaraderie38:30 - Advice for Residents Who Are Doubting41:00 - What’s Next for RFS Recruitment43:20 - Wrap Up --- More about this episode The conversation explores free-response themes from the survey, where 78 percent of residents cited lifestyle concerns, 31 percent pointed to job market uncertainty, and 22 percent mentioned call experience as reasons for questioning IR. Retention was linked to structured training (38 percent), high case volume and procedural experience (35 percent), and program camaraderie (18 percent). Dr. Mittelstein and Dr. Jain review three concrete recommendations to improve retention, examine early changes at programs like Georgetown, and offer practical advice to residents who may be quietly doubting their path in IR. --- Resources Episode # 554 Optimizing the IR/DR Curriculum & Experience https://www.backtable.com/shows/vi/podcasts/554/optimizing-the-ir-dr-curriculum-experience --- 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

  3. Aug 11

    Ep. 669 Advancements in Pulmonary Embolism Algorithm & Management with Dr. David Dexter and Dr. Maya Serhal

    How are new aspiration thrombectomy systems and real-time hemodynamic monitoring enabling safer, more effective pulmonary embolism treatment? On this episode of the BackTable Podcast, Dr. Ally Baheti welcomes Dr. Maya Serhal and Dr. David Dexter for a deep dive into modern pulmonary embolism (PE) management, with a focus on advances in large-bore aspiration thrombectomy. They discuss evolving PE triage algorithms, real-world procedural strategies, and the clinical impact of next-generation aspiration systems on safety, efficiency, and patient recovery. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Imperative Care https://imperativecare.com/ --- Timestamps 00:00- Introduction02:03- PE Response Workflow05:32- Symphony Device07:07- Sizing and Blood Loss10:00- Multi-Port Hemodynamics14:45- Procedure Endpoints17:01- IVUS Guided Strategy20:02- ProHelix and Lollipopping25:48- Case Studies34:12- Closing Thoughts --- More about this episode The conversation explores multidisciplinary PE response workflows, lab and imaging triggers for escalation, and technical considerations in catheter sizing, blood loss management, and real-time hemodynamic monitoring. Dr. Dexter reviews his use of intravascular ultrasound for precise clot localization, and Dr. Serhal shares practical tips for adjusting aspiration power to avoid complications. Together, they discuss procedural endpoints, mechanical assist devices for difficult clots, and present case examples demonstrating rapid improvement in hemodynamics and oxygenation. The episode emphasizes the importance of teamwork, patient selection, and ongoing innovation in optimizing PE care. --- Resources American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolismhttps://ashpublications.org/bloodadvances/article/4/19/4693/463998/American-Society-of-Hematology-2020-Guidelines-for Prospective Multicenter IDE Study of the Next-Generation Precision Aspiration Thrombectomy System for Intermediate-Risk Pulmonary Embolism: The SYMPHONY-PE Trialhttps://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.125.015815 Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PEhttps://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.126.016573--- 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

  4. Aug 4

    Ep. 668 Entrepreneurship in Medicine: Bridging Healthcare and Business with Dr. Nneka Una

    Are you building a business that can thrive without you, or just creating a job you can never leave? In this episode of BackTable Women’s Health, host Dr. Karen Toubi sits down with Dr. Nneka Una (Unachukwu), a board-certified pediatrician, founder of Ivy League Pediatrics, and creator of EntreMD, to discuss the mindset and skills needed to build a truly sustainable medical practice. The conversation explores why physician entrepreneurship is essential in today’s evolving healthcare landscape, the difference between building yourself a job and building a resilient business, and practical strategies for long-term growth. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction04:47 - From Employee to Owner05:53 - Skills That Changed Everything07:35 - The Wake Up Call10:44 - Why Doctors Resist Business15:06 - Profit as Patient Care18:20 - Job vs. Business Entity21:13 - CEO Hat and Team Systems25:14 - Exit Value and Sellability29:00 - More Profit: More Time Off30:24 - Fear Before Breakthrough35:32 - Choose Service Over Perfection39:11 - Invest in Your Potential46:26 - MEAT Week Priorities48:40 - Three-Part Daily Rhythm55:02 - Advice for Burned-Out Docs59:29 - Wrap Up --- More about this episodeDr. Una shares how doctors can overcome resistance to “business,” why every practice needs a strong business engine, and how to balance profitability with ethical, people-centered care. She explains how to shift from employee to physician-CEO, tackle imposter syndrome, and develop systems that give your practice true staying power. The discussion provides actionable advice on hiring, team management, building exit value, and creating the freedom to take more time off without sacrificing patient care or financial stability. --- ResourcesEntreMD https://entremd.com/about-us/ The Profitable Private Practice Playbook https://entremd.com/method-book/ --- 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

    Ep. 668 Entrepreneurship in Medicine: Bridging Healthcare and Business with Dr. Nneka Una

  5. Jul 31

    Ep. 667 Aortoiliac Arterial Disease Treatment with Dr. Eric Secemsky

    How do you decide between a dedicated aortic scaffold and kissing stents in complex aortoiliac bifurcations? On this episode of the BackTable Podcast, Dr. Sabeen Dhand and Dr. Eric Secemsky discuss the management of a female smoker presenting with rapidly progressive bilateral hip pain, ultimately revealed to be severe aortoiliac arterial disease. The case highlights the value of noninvasive vascular studies, CTA, and IVUS for precise diagnosis and procedural planning, as well as the nuanced decision-making process between different device options. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:56 - Patient History05:42 - CTA and Angio Findings09:30 - Strategy Access and IVUS13:17 - IVUS Sizing and Lesion Review16:38 - IVL Angioplasty Technique18:28 - Stenting and Final Result22:50 - Post-procedure Meds and Outcome24:34 - Wrap Up --- More about this episode Dr. Secemsky reviews access strategy, lesion sizing, and the use of intravascular lithotripsy to reduce rupture risk in heavily calcified arteries. The doctors explain their rationale for choosing kissing covered stents over a dedicated aortic scaffold, details the technical steps of ballooning and stenting, and discusses the transition from dual antiplatelet therapy to rivaroxaban and aspirin postprocedure. The episode concludes with key insights into device selection, procedural technique, and patient-centered decision-making for successful aortoiliac interventions. --- 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

  6. Jul 28

    Ep. 666 Dear IR Residency - Residency Reflection with Dr. Gregg Khodorov and Dr. Aesha Patel

    What do new interventional radiologists wish they had known before starting residency? On this reflective episode of BackTable, Dr. Neil Jain is joined by chief residents Dr. Aesha Patel and Dr. Gregg Khodorov as they look back on six years of IR/DR training. They share what they wish they’d known as applicants, from the growing emotional weight of complications near graduation to the essential role of co-residents, support networks, and the evolving balance between confidence and competence. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:34 - Rapid Fire Reflections07:20 - Complications and Confidence12:01 - Applicant Misconceptions16:54 - Defining a Great Program26:38 - Lessons Learned Over Time29:12 - Pearls and Hard-Won Lessons33:09 - Valuing Bread-and-Butter Cases35:24 - Complications and Empathy41:03 - Memorable Attending Phrases 43:06 - Habits for the Future47:34 - Mentorship and Craftsmanship52:42 - IR Culture and Professional Pride57:44 - The Future of IR Training01:08:34 - Closing Thoughts --- More about this episode They discuss how their definition of a “good case” has evolved, the importance of mastering bread-and-butter procedures, and the impact of habits like detailed note-taking, patient-centered communication, and taking ownership of complications. The episode highlights ideas for future training improvements and offers advice on valuing patient interactions, embracing growth, and developing sound clinical judgment under pressure. Throughout, the conversation underscores the personal and professional growth that comes from these challenges and the lasting value of camaraderie and mentorship in interventional radiology. --- Resources Perspective on the New IR Residency Selection Process: 4-year Experience at a Large, Collaborative Training Programhttps://www.sciencedirect.com/science/article/pii/S1076633221000568 Diversity in Interventional Radiology Residency Programshttps://www.sciencedirect.com/science/article/abs/pii/S1546144025002765 Implementation and Evaluation of a Comprehensive Simulation Curriculum for the IR/DR Integrated Residencyhttps://www.sciencedirect.com/science/article/abs/pii/S107663322300051X --- 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

  7. Jul 21

    Ep. 665 Advanced Strategies for Targeted Bone Biopsies with Dr. Peter C. Thurlow

    A bone biopsy can reach the target and still miss the diagnosis. In this episode of the BackTable Podcast, host Dr. Neil Jain is joined by Dr. Peter Thurlow to discuss how lesion selection, imaging review, trajectory planning, and device choice determine whether a targeted bone biopsy produces a useful sample without compromising future treatment. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byVarian https://cancercare.siemens-healthineers.com/products/interventional-oncology/musculoskeletal/omnibone --- Timestamps 00:00 - Introduction04:17 - Approaching Focal Bone Lesions06:17 - Differentiating Lesions and Pain Management13:13 - Settling on Bone Biopsy Imaging16:55 - Understanding Pre-Op Imaging from Lesion Characteristics 21:50 - Maintaining Communication Across Specialties24:21 - Which Devices To Select and Navigating Challenges32:28 - Trajectory Paths and Surgical Considerations35:30 - How to Avoid and Mitigate Biopsy Complications41:30 - Wrap Up --- More about this episode The conversation begins with a systematic approach to evaluating focal bone lesions, including the likelihood of malignancy, lesion location, number of lesions, and selection of an appropriately sized sampling device. Dr. Thurlow reviews anesthesia and pain-management strategies for both superficial and deeper osseous targets, as well as the respective roles of MRI and CT in procedural planning. For challenging lesions, he explains why needle-guidance technology may be preferable to adjusting gantry tilt and outlines how imaging findings and biopsy strategy should be tailored to lesion type, with particular attention to the difficulties associated with blastic lesions. The doctors also discuss the importance of communication with pathology, surgery, oncology, and other collaborating specialties before proceeding. Dr. Thurlow shares his preferred biopsy devices, considerations for selecting a safe trajectory, and ways to account for potential future surgical approaches. The episode concludes with practical strategies for avoiding complications, minimizing tissue injury, and obtaining an adequate diagnostic sample. --- 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

  8. Jul 17

    Ep. 664 Understanding Genicular Artery Embolization for Knee Osteoarthritis with Dr. Peter Minko

    Genicular artery embolization (GAE) continues to gain traction worldwide, but is the evidence catching up to the hype? In this episode of BackTable Bone and Sports Podcast, host Dr. Kavi Krishnasamy welcomes Dr. Peter Minko, an interventional radiologist from Düsseldorf, Germany, to discuss GAE’s evolving evidence, techniques, and international practice patterns. Dr. Minko highlights forthcoming clinical trials and emphasizes the need for high-quality research to guide patient care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:13 - The Embolization Landscape in Germany07:25 - The Basics of GAE Patient Workup 13:49 - The Unideal Patient Candidate for GAE16:55 - Measuring Outcomes Beyond Clinical Scores23:14 - Procedure Specifics: Minko’s Choice36:28 - Discussing the Future of Temporary vs. Permanent Embolics43:47 - Collateral Flow Strategy and Procedure Wrap-Up49:05 - Post-Procedure Rehab Guidelines52:00 - Repeat GAE Treatment Algorithm 58:00 - Safety and Outcomes in Post-TKA Patients01:04:11 - GAE and Associations with the Hospital Anxiety and Depression Scale (HADS)01:09:40 - Call for Better Trials and Evidence in GAE01:14:11 - Case Presentation: GAE Transpedal Access Case01:21:05 - Case Presentation: “Three Stop Shop” Anastomosis 01:27:08 - Case Presentation: AV Fistula… Due to Arthroscopy?01:32:03 - Case Presentation: Popliteal Agenesis 01:38:14 - Dr. Minko’s Perspective on the Future of MSK Embolization01:40:55 - Wrap Up --- More about this episodeThe doctors break down procedural specifics, including embolic materials, access site and catheter choices, and strategies for patient selection and contraindications. They discuss post-procedure rehabilitation, approaches to repeat GAE, and unique considerations for patients with prior total knee arthroplasty. The discussion also features interesting case presentations, explores the future of temporary versus permanent embolics, and examines the importance of robust study design in advancing MSK embolization. Dr. Minko shares his perspective on the direction of the field and the collaborative effort needed to move GAE evidence and practice forward. --- ResourcesDr. Peter Minkohttps://www.researchgate.net/profile/Peter-Minko --- 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

    Ep. 664 Understanding Genicular Artery Embolization for Knee Osteoarthritis with Dr. Peter Minko
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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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