Introducing Backtable Tumor Board BackTable Vascular & Interventional podcast

40:17

Bringing Prostate Artery Embolization (PAE) to the OBL setting means balancing cost efficiency, quality care, and a high procedure volume. What should you know and how can you get started? This week, host Dr. Ally Baheti explores outpatient PAE with Dr. Stephen “Andy” Vartanian, an independent interventional radiologist and medical director of PrecisionIR. --- SYNPOSIS The doctors discuss Dr. Vartanian’s unique career path and extensive experience with prostate artery embolization (PAE). They discuss his approach to the procedure, best practices, and how he was able to set himself up for success in the transition to an OBL. Dr. Vartanian shares insights into patient workup, collaboration with urologists, and his perspective on the financial and operational challenges of managing an independent practice. The doctors then touch on other outpatient procedures like uterine fibroid embolization (UFE) and genicular artery embolization (GAE) and the difficulties in patient acquisition for these treatments. This episode offers a unique look into factors to consider when optimizing your practice patterns for PAE in an OBL setting. --- TIMESTAMPS 00:00 - Introduction 05:38 - OBL Setting and PAE 10:02 - Approach to PAE, Techniques, and Tools 21:38 - Post-Procedure Care and Managing Patient Expectations 25:32 - Advice to IRs Interested in PAE 27:37 - Challenges and Strategies in Uterine Fibroid Embolization (UFE) 33:14 - Running an OBL: Insights and Experiences 36:40 - Future Plans and Business Reflections --- RESOURCES PrecisionIR: https://myprecisionir.com/…

BackTable Vascular & Interventional

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Ep. 544 Inside the RVS Update Committee (RUC) Process with Dr. Amar Rewari and Dr. Curtis Lee Anderson 36:16

7 days ago36:16

36:16

How is reimbursement decided? Have an inside look from the committee itself as we unpack exactly how a new CPT (Current Procedural Terminology) code is created, assessed, and ultimately valued for physician Medicare reimbursement. In this episode of BackTable, Dr. Sabeen Dhand is joined by radiation oncologist Dr. Amar Rewari and interventional radiologist Dr. Curtis Anderson, both of whom sit on the RVS Update Committee (RUC). --- SYNPOSIS The conversation covers who participates in the RUC, the preparation it takes to propose a new CPT code, and what it’s like to collaborate with physicians from all specialties. They discuss the confidential yet crucial role of the RUC in determining physician work and practice expenses, advocacy efforts, and the impact of healthcare policies on reimbursement. The doctors stress the importance of physician engagement—especially through member surveys—and share how providers can get involved. The guests also touch on their personal journeys and motivations within the RUC and introduce Dr. Rewari’s podcast, ‘Value Health Voices’, which focuses on healthcare policy and economics. --- TIMESTAMPS 00:00 - Introduction and Importance of Surveys 01:18 - Understanding the RVS Update Committee (RUC) 6:36 - How Does a New CPT Code Get Introduced? 09:44 - Challenges and Dynamics within the RUC 20:52 - Health Value Voices Podcast 22:51 - Transparency in Healthcare Policy 24:39 - Future of Healthcare Payments 29:00 - Getting Involved in Healthcare Policy 33:43- Final Thoughts and Call to Action --- RESOURCES Health Value Voices Podcast: https://open.spotify.com/show/0cxnf4Il3QK3cvFFKxwPWL?si=212d084a09034cf2…

BackTable Vascular & Interventional

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Ep. 543 Metastatic Colorectal Cancer: Discussion on the COLLISION Trial with Dr. Martijn Meijerink 47:58

10 days ago47:58

47:58

Is minimally invasive ablation the future of metastatic cancer care? We now have the results of the COLLISION Trial, which investigates the non-inferiority of thermal ablation compared to surgical resection. How will these findings change treatment paradigms and practice patterns around metastatic colorectal cancer? In this week’s episode of BackTable, interventional radiologist Dr. Chris Beck discusses the impact and implications of the COLLISION Trial with principal investigator Dr. Martijn Meijerink from Amsterdam UMC. --- SYNPOSIS The doctors explore the COLLISION Trial’s design, results, complication rates, and future directions. They also cover best practices for ablation techniques and the potential for interventional oncology to enter a “golden era.” Finally, Dr. Meijerink highlights the importance of standardizing intervention quality and being present in tumor boards to ensure optimal patient care. --- TIMESTAMPS 00:00 - Introduction 03:21 - Understanding Metastatic Colorectal Cancer and IR’s Role 05:18 - Introduction to the COLLISION Trial 07:40 - Radiofrequency vs Microwave Ablation and Technological Advancements 09:02 - Trial Design and Patient Eligibility 16:20 - Ablation Techniques and Approaches 22:05 - Trial Results and Analysis 30:19 - Impact on Guidelines and Practice 39:44 - Best Practices in Thermal Ablation 43:27 - Future Directions in Interventional Oncology --- RESOURCES “Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial.” (Meijerink, 2024) https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501…

BackTable Vascular & Interventional

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Ep. 542 Navigating Early Career in Interventional Radiology with Dr. Christopher Zarour and Dr. Kavi Devulapalli 58:23

14 days ago58:23

58:23

As graduating residents step into the IR job market, the big question remains: What truly makes a great first job? Dr. Subhash Gutti hosts guest Dr. Kavi Devulapalli (Image Guided Solutions of Missouri) and Dr. Christopher Zarour (Huron Valley Radiology in Ann Arbor) as they share early career advice and job search strategies. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors begin by highlighting different practice models and emphasize the significance of knowing what type of IR you are - an imager, a surgeon, or dynamic blend of both. They share their personal experiences navigating their early careers and underscore the pivotal role of establishing a robust clinical practice and taking full ownership of the patient. They also explore strategies for practice growth, including availability and network referrals. The episode ends with valuable advice on navigating the early stages of one's career, drawn from personal experiences. --- TIMESTAMPS 00:00 - Introduction 01:16 - Early Career Advice and Job Search 04:50 - Exploring the Job Market 09:46 - What Makes a Good First Job? 14:33 - Challenges in the First Job 28:27 - Strategies for Building a Clinical Practice 36:56 - Understanding the Business Side of Medicine 48:49 - Final Advice for New Graduates…

BackTable Vascular & Interventional

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Ep. 541 Treatment of Acute Portal Vein Thrombosis with Dr. Ben May 52:34

17 days ago52:34

52:34

To TIPS or not to TIPS? More than ever, younger patients are presenting with acute portal vein thrombosis (PVT) that requires intervention beyond anticoagulation alone. These patients need safe, effective options that offer long-term resolution and a good quality of life after treatment. In this episode of the BackTable Podcast, Dr. Benjamin May, Interventional Radiologist at Weill Cornell Medicine, discusses the evolving treatment landscape for acute PVT. --- SYNPOSIS Dr. May shares insights into the changing interventional approaches, highlights the utility of tools such as suction thrombectomy devices, and explains how his best practices have developed over time. He emphasizes the continued importance of anticoagulation therapy, explores the potential complications and outcomes of various interventions, and discusses how thrombus location and characteristics influence his clinical decisions. With real-world scenarios and a step-by-step walkthrough of his decision-making process, Dr. May offers a comprehensive look at modern strategies for managing acute portal vein thrombosis. --- TIMESTAMPS 00:00 - Introduction 05:46 - Diagnosing Portal Vein Thrombosis 10:52 - Management Options for Acute PVT and What is Safest? 21:09 - Choosing an Intervention Approach 26:19 - Tackling Large Bore Thrombectomy 32:37 - Learnings and Tips for Successful Thrombectomy 39:50 - Impact of Thrombus Location on Intervention Approach 45:01 - Post-Care and Follow-Up 49:46 - Final Thoughts and Encouragement --- RESOURCES “Transjugular Intrahepatic Portosystemic Shunt and Thrombectomy (TIPS-Thrombectomy) for Symptomatic Acute Noncirrhotic Portal Vein Thrombosis” (Shalvoy, 2023) https://www.jvir.org/article/S1051-0443(23)00341-X/abstract…

BackTable Vascular & Interventional

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Ep. 540 Dolor Crónico Femenino: Varices Pélvicas con Dr. Gloria Salazar 1:12:54

20 days ago1:12:54

1:12:54

En este episodio de BackTable, la radióloga intervencionista Dra. Sara Lojo Lendoiro y la Dra. Gloria Salazar discuten los desafíos y las barreras para diagnosticar y tratar el dolor pélvico crónico y las varices pélvicas en mujeres. --- SYNPOSIS Primero, abordan la ausencia de diagnóstico y el estereotipo que estigmatiza a las mujeres con problemas psiquiátricos. Dra. Salazar comparte su trayectoria personal desde Brasil hasta su posición de profesora asociada de radiología en la University of North Carolina, y su trabajo centrado en mejorar la salud de la mujer. También se habla sobre la necesidad de colaboración multidisciplinar, la investigación futura para entender mejor la fisiopatología, y cómo la educación y una mayor conciencia pueden mejorar el diagnóstico y tratamiento de estas patologías. Además, destacan la importancia de considerar el impacto económico y social de no tratar adecuadamente estas condiciones en mujeres activas y trabajadoras. --- TIMESTAMPS 00:00 - Presentación de la Dra. Gloria Salazar 06:25 - Desafíos en el Diagnóstico de la Salud de la Mujer 08:08 - Comprendiendo las Varices Pélvicas y el Dolor Pélvico Crónico 22:23 - Técnicas de Diagnóstico y Desafíos 36:19 - Evaluación del Dolor Pélvico y los Síntomas en las Piernas 41:46 - Variaciones Anatómicas y Técnicas de Diagnóstico 50:40 - La Importancia de los Equipos Multidisciplinarios 58:59 - Direcciones Futuras en la Investigación de las Venas Pélvicas 01:09:50 - Reflexiones Finales y Colaboraciones Futuras…

BackTable Vascular & Interventional

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Ep. 539 The Future of the IR-DR Relationship with Dr. Saher Sabri and Dr. Mark Lessne 1:03:59

21 days ago1:03:59

1:03:59

Is it time for interventional radiology to sever ties with diagnostic radiology and define its own future? Dr. Ally Baheti hosts Dr. Mark Lessne, interventional radiologist at Charlotte Radiology and Dr. Saher Sabri, Chief of Interventional Radiology at MedStar Health, to discuss the evolving relationship between interventional radiology (IR) and diagnostic radiology (DR). --- SYNPOSIS The doctors begin the discussion by asking a critical question: 'What defines an interventional radiologist?' They delve into the different practice patterns of IRs, exploring both the opportunities and challenges in interventional radiology forging its own path, independent of diagnostic radiology. The doctors share their thoughts on the financial implications, sustainability of the specialty, and the importance of establishing a clinical and longitudinal practice. The discussion concludes with the notion that an organic separation is likely inevitable, although the timing remains uncertain. --- TIMESTAMPS 00:00 - Introduction 03:45 - Challenges in IR Practice 12:23 - Financial Models and Sustainability 16:13 - The Role of SIR in Supporting IRs 34:29 - Defining IR Standards 35:28 - SIR’s Role 38:29 - Future of IR and DR 58:36 - Final Thoughts and Call to Action…

BackTable Vascular & Interventional

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Ep. 538 Immunotherapy and TACE in HCC Treatment with Dr. Julius Chapiro and Dr. Richard Finn 1:07:37

24 days ago1:07:37

1:07:37

There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field. --- This podcast is supported by an educational grant from Guerbet. --- SYNPOSIS The doctors highlight the importance of high quality clinical data and the pivotal studies shaping current best practices. They explore the role of the different players on the multidisciplinary team and compare the oncologic and radiologic perspectives. Additionally, they discuss the synergy between TACE and immunotherapy, the criteria for selecting appropriate treatments, and the ongoing need for research and collaboration. --- TIMESTAMPS 00:00 - Introduction 03:35 - HCC from an Oncologic Perspective 05:33 - Radiological Perspective on Liver Cancer 06:50 - Referral Patterns and Organizing a Multidisciplinary Approach 18:01 - Explaining TACE and Variations in the Procedure 27:27 - Choosing the Right Procedure for HCC 36:13 - Making a Decision on Medical Treatment Candidacy 42:23 - Importance of Data Driven HCC Treatment, Practical Insights, and Studies to Know 55:30 - Planning an Approach for a TACE Procedure 01:02:26 - Final Thoughts and Future Prospects in Liver Cancer Treatment --- RESOURCES Barcelona Staging System: https://www.ncbi.nlm.nih.gov/books/NBK569796/table/Ch3-t0001/ TRACE Trial: https://pubs.rsna.org/doi/full/10.1148/radiol.211806 PREMIERE Trial: https://www.gastrojournal.org/article/S0016-5085(16)34971-X/fulltext EMERALD-1 Trial: https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432 LEAP O12 Study: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02575-3/abstract…

BackTable Vascular & Interventional

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Ep. 537 Keeping It Lean in the OBL with Dr. Mary Costantino 1:10:43

27 days ago1:10:43

1:10:43

What is the key to running an efficient OBL? Dr. Mary Costantino, medical director of Advanced Vascular Centers, joins host Dr. Ally Baheti to share some of the key ingredients in keeping it lean in OBL. --- SYNPOSIS The doctors delve into strategies in running a cost-effective OBL while upholding clinical excellence. Dr. Costantino shares her personal insights and experiences in minimizing unnecessary costs while maintaining regulatory compliance, high-performing team, and outstanding patient care. She also underscores the importance of having a clear leadership vision and remaining at the forefront of patient care to proactively identify challenges and develop effective solutions to address them. Lastly, she shares her thoughts on navigating the challenges of balancing personal and professional responsibilities in the growing field of outpatient vascular care. --- TIMESTAMPS 00:00 - Introduction 01:46 - Expanding Practices and Partnerships 06:24 - Navigating Regulatory Requirements 12:26 - Building a Lean and Valuable Team 35:01 - Leadership 39:54 - Opportunity Cost in Practice Management 44:32 - Employee Growth and Retention Strategies 46:49 - Building and Maintaining a Successful Practice 01:06:54 - The Financial Wheel and Its Impact on Small Businesses…

BackTable Vascular & Interventional

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Ep. 536 Multidisciplinary Approaches to Renal Cancer Care with Dr. Louis Hinshaw and Dr. Jason Abel 39:36

30 days ago39:36

39:36

This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors. --- SYNPOSIS Their discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration. --- TIMESTAMPS 00:00 - Introduction 04:04 - Collaboration Between Urologists and Interventional Radiologists 05:58 - Advancements in Ablation 10:05 - Patient Selection 15:19 - Technical Considerations 26:57 - Post-Ablation Surveillance and Recurrence Management 33:19 - Conclusion…

BackTable Vascular & Interventional

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Ep. 535 Genicular Artery Embolization: Current Controversies and Insights with Dr. Sid Padia and Dr. Osman Ahmed 1:26:54

4 weeks ago1:26:54

1:26:54

Who is the ultimate candidate for GAE, which technical approach is best, and how do you set your patients up for success? Tune into this week’s episode of BackTable to hear from interventional radiologists Dr. Osman Ahmed (University of Chicago Medicine) and Dr. Siddharth Padia (UCLA Health) as they discuss everything from patient selection to follow-up care, covering pre-procedure imaging, access, embolics, technical challenges, clinical data, and the future of genicular artery embolization. --- SYNPOSIS Dr. Ahmed and Dr. Padia debate their approaches to patient selection criteria, the use of MRI and cone beam CT, permanent vs. resorbable embolic materials, how many arteries to embolize, and the relevance of pain metrics post GAE. They also delve into follow-up considerations and the potential for GAE as a long term treatment. --- TIMESTAMPS 00:00 Introduction 01:08 MRI for Patient Selection in GAE 08:53 Access Techniques: Femoral vs. Pedal 17:07 Cone Beam CT in GAE Procedures 27:20 Embolization Strategies 39:30 Challenges and Complications in Embolization 44:50 Follow-Up and Pain Metrics in Clinical Practice and Research 01:06:30 Repeat GAE Procedures: When and Why? 01:11:13 Post-Total Knee Replacement and GAE 01:21:01 Advice for IRs Looking to do GAE 01:24:32 Conclusion and Final Thoughts --- RESOURCES GENESIS Trial: https://pubmed.ncbi.nlm.nih.gov/33474601/ Landers et al Trial: https://pubmed.ncbi.nlm.nih.gov/37051829/…

BackTable Vascular & Interventional

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Ep. 534 What’s a Good Job? Looking at the Diagnostic Job Market with Dr. Ned Holman and Dr. Mike Romeo 45:38

5 weeks ago45:38

45:38

Are you thinking about pursuing a new diagnostic radiology gig? Get the download on the current job market, how to evaluate different compensation models, and what to look out for when considering your next job offer in this week’s episode of BackTable, featuring guests Dr. Ned Holman (Neuroradiologist at Alaska Imaging) and Dr. Mike Romeo (Radiologist and President of West Reading Radiology). --- SYNPOSIS The doctors begin by exploring various employment models, including private practice, academic positions, and hybrid arrangements that combine elements of both. They share valuable insights on job transparency and the significance of leveraging professional connections to gain honest, firsthand perspectives on potential employers. They also provide advice on key questions to ask during job interviews and strategies for negotiating contracts. The doctors conclude by sharing tips to help make informed decisions to ensure job satisfaction and professional growth. --- TIMESTAMPS 00:00 - Introduction 04:30 - Employment Models 06:32 - Compensation Structures 08:43 - Evaluating Job Offers 19:05 - Red Flags in Employment 27:13 - Private Equity Jobs: Pros and Cons 31:36 - Navigating Job Boards and Resources 42:03 - Final Advice for Job Seekers…

BackTable Vascular & Interventional

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Ep. 533 Physician’s Guide to Financial Literacy and Investment Strategies with Dr. Jim Dahle 1:01:25

5 weeks ago1:01:25

1:01:25

The road towards financial literacy and financial freedom does not need to be a solo, do-it-yourself, figure it out as it goes type of journey. Guest Dr. Jim Dahle (practicing emergency medicine physician and Founder of the White Coat Investor) joins host Dr. Chris Beck to help better illuminate the process of becoming financially literate and securing financial freedom for physicians and others in similar professional arenas. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Dahle begins the episode by driving home how sound and solid financial education coupled with early, prudent financial behaviors can be worth millions over a career. The doctors discuss writing investment plans, goal setting, and understanding of asset allocation to ensure long-term financial success. Dr. Dahle also delves into the Mega Backdoor Roth IRA, practical tips for handling savings and expenses, as well as how to integrate real estate into your investment portfolio. The episode concludes with helpful resources, programs, and conferences available through the White Coat Investor. --- TIMESTAMPS 00:00 - Introduction 04:30 - Savings Tips and Strategies 13:22 - Retirement Goals and Savings Targets 28:20 - Real Estate as an Investment 32:30 - Mega Backdoor Roth IRA 42:59 - Advice for New High-Income Earners 46:09 - Teaching Financial Literacy to Kids 48:15 - Addressing Physician Burnout 53:53 - Common Financial Mistakes by Doctors 58:11 - White Coat Investor Book Giveaway Program --- RESOURCES White Coat Investor: https://www.whitecoatinvestor.com BackTable VI Episode #194 - Financial Basics from the White Coat Investor with Dr. James Dahle: https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor White Coat Investor Champions Program (For Students): https://www.whitecoatinvestor.com/wci-champions/…

BackTable Vascular & Interventional

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Ep. 532 OBL Site of Service Update with Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki 40:54

6 weeks ago40:54

40:54

Navigating the intricate world of medical billing can be challenging, and knowing the steps needed to ensure fair reimbursement can be even more challenging. Guests Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki (private practice interventional radiologists) join host Dr. Ally Baheti to discuss how IRs in the OBL setting can legislatively rally behind the office-based facility concept and improve physician reimbursement in the light of developments addressed at the recent OEIS meeting. --- SYNPOSIS Dr. Wiechmann and Dr. Niedzwiecki begin the episode by defining several key-terms and processes in physician reimbursement in the outpatient setting to help orient us to the issue at hand. After explaining why and how reimbursement for more advanced procedures in the OBL setting has been lagging behind, the doctors introduce the concept of creating an office-based facility concept. This would help stabilize payments for complex procedures done in the OBL space. The episode concludes with emphasis on more physician involvement and advocacy in pushing reform forward, underscoring how a unified effort is essential for long-lasting, meaningful change. --- TIMESTAMPS 00:00 - Introduction 01:42 - Medicare Physician Fee Schedule 05:46 - Challenges with Current Reimbursement Models 11:28 - Proposing the Office-Based Facility Concept 17:58 - Legislative Efforts and Congressional Involvement 26:53 - Call to Action: How You Can Help 36:40 - Conclusion --- RESOURCES Outpatient Endovascular and Interventional Society: https://oeisweb.com…

BackTable Vascular & Interventional

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Ep. 531 Ten Commandments for Female Interventional Radiologists with Dr. Maureen Kohi 46:03

7 weeks ago46:03