Join interventional cardiologist Dr. Jay Mathews, with 20 years of experience in endovascular innovation, and vascular surgeon Dr. Michael Siah, Director of Limb Salvage at UT Southwestern, as they delve into cutting-edge vessel preparation techniques. They discuss advancements like bioresorbable scaffolds and the pivotal role of imaging in assessing critical limb ischemia. Listeners will learn about specialty tools like intravascular lithotripsy and the balance of treatment efficacy against device costs. Exciting emerging technologies promise to reshape their practices!
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volunteer_activism ADVICE
Use Retrograde Access Early
Use retrograde access quickly if proximal cap morphology is unfavorable for true lumen crossing.
Be prepared to consider bypass surgery when endovascular crossing repeatedly fails or causes complications.
volunteer_activism ADVICE
Crossing Tips for Challenging Lesions
Use larger wires and support catheters to facilitate true lumen crossing.
Maintain a low threshold for retrograde crossing if antegrade approaches are prolonged or unsuccessful.
question_answer ANECDOTE
Michael Siah's Device Use Experience
Michael Siah has used bioresorbable scaffolds below the knee and recently tried retrievable stent technology.
He also heavily relies on the Serenator balloon and Shockwave, evolving his algorithm as new devices emerge.
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The toolbox for vessel preparation is rapidly expanding. Are you keeping up? In this episode, host Dr. Sabeen Dhand is joined by Dr. Jay Mathews, interventional cardiologist (Manatee Memorial Hospital) and Dr. Michael Siah, vascular surgeon (UT Southwestern), to explore the latest innovations and strategies in vessel prep.
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This podcast is supported by:
Cagent Vascular https://cagentvascular.com/
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SYNPOSIS
The discussion opens with a look at new additions to their practice over the past few years, including bioresorbable scaffolds for below-the-knee interventions and retrievable stent technologies. Both experts emphasize the role of imaging—particularly CT angiography and IVUS—and discuss how renal disease impacts their use of contrast during diagnosis and intervention. They then walk through how they assess vessels on angiography or IVUS to decide when and where to use specialty tools. From intravascular lithotripsy for managing dense calcification to serration angioplasty, the conversation highlights how the doctors decide to use specialty balloons and devices. The episode also touches on the practical challenges of balancing device cost with treatment effectiveness. The physicians break down the latest specialty balloons and devices and touch on their own experiences with them. To close, the guests share what emerging technologies they’re most excited about and how these devices could change their day-to-day practice. Whether you’re in IR, cardiology, or vascular surgery, this episode offers a valuable roadmap to the current and future state of vessel preparation.
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TIMESTAMPS
0:00 - Introduction 4:07 - New Changes in Techniques 14:57 - Vessel Characteristics on Angiogram 18:10 - Approaches to Above-the-Knee vs. Below-the-Knee Disease 23:48 - Latest Specialty Balloons 46:14 - New Devices on the Horizon 50:58 - Words of Advice and Final Thoughts
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RESOURCES
POINT FORCE Registry: https://evtoday.com/news/cagent-initiates-point-force-registry-of-serranator-pta-catheter?c4src=news
BackTable Vascular & Interventional