BackTable Vascular & Interventional

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.

Dr. Art Rastinehad, an interventional urologist with IR training known for work in prostate artery embolization and fusion biopsy. He describes a urology-grounded consult playbook, imaging and anatomic pitfalls, strategies for large or challenging glands, and why he moved from particles to liquid embolics. The conversation also covers periprocedural workflow, recovery plans, and the future of PAE training and collaboration.

How do experienced operators approach the most technically demanding aspects of deep venous arterialization (DVA)? In this episode of BackTable, host Dr. Sabeen Dhand sits down with Dr. Kumar Madassery for a detailed discussion of procedural strategy, technical decision-making, and real-world troubleshooting in DVA. --- SYNPOSIS Dr. Madassery walks through his approach from pre-procedure planning to final scaffolding. The conversation begins with imaging review, patient selection, and anesthesia considerations, emphasizing how preparation influences technical success. They then examine venous mapping and access strategy, with specific attention to femoral and tibial disease patterns and how these anatomic variables shape crossing techniques.This episode also covers wire and catheter selection, techniques for creating the arteriovenous anastomosis, balloon sizing, valve management, and stent scaffolding. Throughout, Dr. Madassery shares practical solutions to common access challenges and highlights decision points that can determine procedural durability. The discussion closes with reflections on clinical management, operator fatigue, and the value of professional networks when navigating complex limb salvage cases. --- TIMESTAMPS 00:00 - Introduction03:08 - Pre-Procedure Imaging and Setup05:01 - Venous Access and Mapping07:27 - Anesthesia and Patient Preparation12:29 - Femoral and Tibial Disease Considerations23:17 - Crossing Techniques and Tools27:16 - Venous Access Challenges and Solutions35:54 - Creating the Anastomosis37:03 - Balloon Sizing and Scaffolding Techniques38:26 - Navigating Venous Access Challenges39:56 - Wire and Catheter Strategies42:08 - Dealing with Valves and Anastomosis44:16 - Proximal vs. Distal DVA Approaches47:01 - Scaffolding and Stent Techniques50:06 - Clinical Management and Case Fatigue01:01:10 - Networking and Seeking Advice01:05:41 - Concluding Thoughts and Future Directions

Think your medical practice is safe from hackers? Learn why humans, rather than software, are often the weakest link in patient data protection. In this episode of the BackTable Podcast, host Dr. Chris Beck delves into the critical topic of cybersecurity in healthcare with Didier Jourdain, a certified Information Systems Security Professional (CISSP). --- SYNPOSIS Didier discusses his recently approved paper, 'Cybersecurity for Interventional Radiologists: A Clinical Imperative for Protecting Patient Data and Imaging Systems,' and shares his extensive background in software and application security, penetration testing, and cybersecurity risk governance. The conversation covers key issues such as phishing, ransomware, third-party vendor risks, and the vulnerabilities of the Internet of Medical Things (IOMT). Didier emphasizes the importance of education, tabletop exercises, and comprehensive third-party risk management strategies to enhance cybersecurity resilience in both hospital systems and independent physician practices. --- TIMESTAMPS00:00 - Introduction04:03 - Cybersecurity in Healthcare: A Clinical Imperative16:07 - Mitigating Cybersecurity Risks20:23 - Password Management and Best Practices27:33 - The Role of IT in Cybersecurity31:04 - Internet of Medical Things (IoMT) Vulnerabilities39:17 - Top Cybersecurity Recommendations for Physicians

Dr. Richard Daniels, an interventional radiologist who built a consortium-style outpatient IR practice, explains his fractional long-term coverage model. He discusses expanding beyond vein work into embolizations and PAD, recruiting and training physicians and tech teams, and operational tactics for scaling outpatient services nationwide.

Dr. Constantino Peña, a vascular and interventional specialist focused on tibial and below‑the‑knee limb salvage, walks through modern strategies for treating heavily calcified tibial arteries. He discusses intravascular lithotripsy, device deliverability, sizing and technique. Short, practical takes cover combining IVL with adjuncts, workflow decisions, and what next‑gen tools clinicians want.

Have you ever wondered what it was like to be in the room when the first pelvic embolization was performed or how the TIPS procedure was pioneered? Dr. Ernie Ring, a legendary figure from UCSF and a true forefather of Interventional Radiology, joins host Dr. Peder Horner to recount the early days of the specialty. Dr. Ring shares fascinating stories from his training at Massachusetts General Hospital under Dr. Stanley Baum, where he witnessed the birth of transformative techniques using angiographic catheters to treat life-threatening bleeding. --- SYNPOSIS From improvising the use of autologous blood clot and thrombin to stop massive hemorrhages to his pivotal role in developing the TIPS procedure and specialized biliary catheters, Dr. Ring’s career is loaded with innovation. The conversation explores the "cowboy" era of IR, the evolution of essential tools like the glide wire, and the critical importance of maintaining a "high-touch" clinical practice in the face of emerging technologies like AI. Dr. Ring also reflects on his later transition into hospital leadership as Chief Medical Officer, where he applied his problem-solving mindset to institutional quality and safety. --- TIMESTAMPS 00:00 - Introduction01:58 - Upbringing from Detroit to Mass Gen 06:55 - Early IR with an Embo Case13:50 - Trailblazing Cases in IR16:17 - Penn and Innovation20:00 - Polarizing Procedures24:13 - IR Device Innovation33:00 - Dotter’s Separation from Diagnostics37:30 - Fear Finds Cowboys39:08 - AI and Robotics40:08 - Fun Hobbies

Dr. Steven Huang, an interventional oncologist at MD Anderson specializing in liver and kidney interventions, discusses building an efficient renal biopsy and ablation service. He covers referral pathways, imaging and workflow tips, and when to combine biopsy with ablation. The conversation compares cryo, microwave, and RFA, tackles challenging lesions and heat-sink management, and looks ahead to AI, robotics, and novel technologies.

Dr. John York, interventional radiologist and career U.S. Navy officer with decades of deployments and shipboard service. He shares vivid stories from combat zones, improvised procedures in resource-limited settings, leadership running expeditionary medical units, and managing the COVID crisis aboard an aircraft carrier. Short, tense clinical tales and reflections on adaptability and training.

Dr. Rajasekhara Ayyagari, an interventional radiologist who built multiple prostate artery embolization programs, walks through tough PAE scenarios. He discusses balloon occlusion microcatheters, switching from beads to glue, protecting penile flow with coils, and tactics for tortuous or crossover anatomy. Practical points on Foley timing, postprocedure care, and technique workarounds are also highlighted.