BackTable Vascular & Interventional

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/

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

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

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

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