BackTable Vascular & Interventional

Dr. Don Garbett, high-volume interventional radiologist working with urology in Austin, TX, and Dr. Art Rastinehad, interventional radiologist and urologic oncologist focused on image-guided prostate care, discuss prostate artery embolization strategies. They cover patient selection and workup. They debate access routes, catheter and wire choices, glue versus beads, managing collaterals, procedural timing, and redo strategies.

Dr. Ahsun Riaz, interventional radiologist specializing in percutaneous biliary procedures, shares practical approaches to reduce drain complications. He discusses choosing left versus right access, techniques for non-dilated systems, optimal insertion tools and positioning, strategies for flushing versus capping, and managing dislodgement, leakage, bloody output, and stent decisions.

Radial roots, peripheral reach! Radial to peripheral (R2P) access is the focus of this week’s episode with interventional cardiologist Dr. Shailendra Singh (Pennsylvania’s Lehigh Valley Heart and Vascular Institute) and dual hosts Hady Lichaa and Sameh Sayfo. The conversation focuses on key techniques, pre-procedure planning and imaging, and ideal case selection for those new to the R2P approach. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Terumo https://www.terumois.com/ --- Timestamps 00:00 - Introduction04:42 - Radial-to-Peripheral: Right vs Left Radial10:18 - Ultrasound and Pedal Access Applications17:10 - Ideal Cases When Starting Radial to Peripheral25:59 - Impactful Radial Success Stories29:38 - Managing Radial Spasm 35:22 - Left Radial Workflow42:00 - Shelf Setup Essentials48:43 - Renal Mesenteric Access55:37 - Safe Sheath Removal01:01:10 - Training and Courses01:04:48 - Closing Thoughts --- More about this episode Dr. Singh shares how he began incorporating radial-to-peripheral procedures into his practice after fellowship and how his experience with radial coronary access translated naturally to peripheral interventions. The group reviews access strategy, including right versus left radial selection, along with techniques for preventing and managing radial spasm. They also touch on staff workflow and training when introducing R2P into the lab. The episode closes with practical insights on case selection for operators new to the approach, the role of pedal access in selected CTO cases, and strategies for safe sheath removal and hemostasis. --- Resources Dr. Shailendra Singh’s Provider Profile https://www.lvhn.org/doctors/shailendra-singh Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa

Dr. Kevin Wong, a pediatric interventional radiologist and IR division chief, walks through the single-stick central venous access technique. He discusses its origins, needle bending and trajectory, wire handling and measurement tricks. Practical tips cover tunneling, femoral variations, avoiding common pitfalls, and when to choose lines and equipment.

Dr. Khanjan Nagarsheth, vascular surgeon and professor at the University of Maryland, specializes in PAD, venous disease, vascular compressions, and endovascular thrombectomy. They compare thrombectomy devices versus lysis. New device types and the Arctix flow-rest funnel get attention. Strategies for fem-pop, iliofemoral, and visceral thrombosis are outlined. Training needs and device limitations are discussed.

Jill Sommerset, vascular technologist and clinical education lead, and Dr. Mary Costantino, interventional radiologist specializing in complex peripheral artery disease, discuss spinal cord stimulation for no-option CLTI. They cover ultrasound mapping and pedal acceleration time, immediate perfusion changes during trial stimulation, practical barriers to permanent implants, comparisons to deep venous arterialization, and the need for larger studies.

Dr. Paul Foley, a vascular surgeon focused on limb preservation and below-the-knee endovascular care, discusses treating heavily calcified tibial disease. He talks about evolving access strategies, intravascular lithotripsy (IVL) and the Disrupt BTK II trial, the Javelin catheter concept and technique, and how plaque-modifying tools are changing tibial workflows.

Dr. Jennifer McQuade, a melanoma medical oncologist researching oncolytic therapies, and Dr. Rahul Sheth, an interventional radiologist skilled in image-guided tumor treatments, discuss intratumoral oncolytic injections like RP1. They cover how these agents work, trial evidence for refractory metastatic melanoma, practical delivery to visceral lesions, technique tips, imaging follow-up, and multidisciplinary implementation challenges and opportunities.

Dr. Keith Horton, an interventional radiologist and ergonomics educator, shares practical wisdom on procedural technique and workplace safety. He discusses common setup mistakes and simple fixes for posture, monitor placement, and lead fit. Short, actionable strategies for career longevity, AR and robotics to reduce strain, and institutional ergonomics programs are highlighted.

Dr. Keith Horton, interventional radiologist and ergonomics expert at Georgetown/MedStar Health, shares decades of experience improving lab setup and preventing musculoskeletal injury. He spotlights monitor and ultrasound placement, neutral posture and table height, lead fit and zero-gravity alternatives, microbreaks, and emerging tech like AR and robotics. Practical setup fixes for longer, complex procedures are emphasized.