BackTable Vascular & Interventional

In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ramsey Al-Hakim about the inception and journey of Auxetics, a med-tech company innovating in the vein stent market. Dr. Al-Hakim is the co-founder of Auxetics and the Section Chief of the Division of Interventional Radiology at Scripps Hospital in San Diego, CA.Dr. Al-Hakim covers the initial challenges of understanding the market and securing capital, the clinical significance of addressing stent-adjacent stenosis, and the process of developing a stent with a negative Poisson effect to counteract it. Dr. Al-Hakim highlights Auxetics' approach to combining cutting-edge interventional technologies with world-class imaging tools for enhanced procedural efficiency in venous interventions. The company’s progress through benchtop work, animal testing, and plans for first-in-human studies outside the U.S., aiming for commercialization within the next four to five years, is also outlined. Contributions from key figures in the vascular community and the role of mentorship and perseverance in navigating the complexities of medical device innovation are discussed as well.---CHECK OUT OUR SPONSORSVarian, a Siemens Healthineers companyhttps://www.siemens-healthineers.com/Reflow Medicalhttps://www.reflowmedical.com/---SHOW NOTES00:00 - Introduction03:11 - The Market and Problem Solving12:13 - Journey of Creating a Stent22:28 - Birth of Auxetics26:53 - Learning Process and Support from the University29:16 - Building the Dream Team33:01 - Starting a Company36:42 - Challenges and Triumphs of Fundraising37:44 - Current Status and Future Plans45:32 - Importance of Community and Mentorship---RESOURCESAuxetics:https://www.auxeticsinc.comIn-stent restenosis and stent compression following stenting for chronic iliofemoral venous obstruction:https://pubmed.ncbi.nlm.nih.gov/34174500/Venous Stenosis Animal Model Utilizing Endovenous Radiofrequency Ablation:https://pubmed.ncbi.nlm.nih.gov/30717966/The Messy Middle: Finding Your Way Through the Hardest and Most Crucial Part of Any Bold Venture:https://www.amazon.com/Messy-Middle-Finding-Through-Hardest/dp/0735218072

Dr. Dean Ferrera, interventional cardiologist, discusses acute limb ischemia treatment emphasizing interdisciplinary collaboration, clot nature understanding, thrombectomy systems, and complications management. He highlights the importance of continued learning and mentorship for managing these complex conditions.

Dr. John Qiao discusses the challenges and journey of starting RadioClash for cancer treatment, the future of electroporation therapy, and balancing clinical practice with entrepreneurship. The episode covers his entrepreneurial ventures in medical technology and the potential of electroporation for cancer treatment. It also highlights his innovative approach in developing a medical device and managing professional and personal life.

Dr. Andrew Sholl discusses percutaneous biopsies, stressing the importance of clinical history and sample quality. Tips for differentiating malignancies, using biopsy devices effectively, and collaboration between radiologists & pathologists for better outcomes are highlighted.

Topics include various biliary interventions techniques, managing dilated systems and obstructions, biopsy techniques for malignant strictures, handling benign strictures, use of internal stents, and managing bleeding complications in biliary procedures

Dr. Chohan and Dr. Chengazi discuss dialysis fistula declot procedures, emphasizing problem-solving, pre-procedure ultrasound, technique refinement, and closure techniques. They share insights on treatment of anastomosis stenosis and wire management risks. Listeners are invited to share their experiences with a 'bottle-cap' hemostasis trick.

A radiologist shares his personal journey of being diagnosed with a large saddle embolus and treated by his friend. The episode discusses the impact on his practice, changes in patient approach, and advice for clinicians. Topics include diagnosis, treatment, recovery, practice impact, and final thoughts.

In this episode, host Dr. Sabeen Dhand interviews Dr. Charles Bailey about Limb Alert, a hospital protocol devised to expedite the diagnosis and treatment of patients presenting with acute limb ischemia. Dr. Bailey is a vascular surgeon and the Director of Peripheral Artery Disease (PAD) and Limb Salvage at the University of South Florida.Dr. Bailey explains how the Limb Alert program standardizes the care pathway, rapidly alerts necessary personnel, initiates labs, and prepares the Penumbra Lightning Bolt 7 System for endovascular thrombectomy. The incorporated protocol significantly streamlines patient management, resulting in encouraging survival rates. Dr. Bailey further emphasizes the necessity for modern endovascular trials in acute limb ischemia and proposes a multicenter randomized trial to provide evidence for endovascular treatment.---CHECK OUT OUR SPONSORPenumbra Lightning Flashhttps://www.penumbrainc.com/products/lightning-flash/---SHOW NOTES00:00 - Introduction02:43 - Dr. Bailey’s Journey to Florida and His Practice06:43 - Importance of Timely Intervention in Acute Limb Ischemia21:29 - Role of Debulking in Acute Limb Ischemia28:20 - Tips and Tricks for Successful Outcomes31:17 - Impact of the Limb Alert Program41:19 - Future of Acute Limb Ischemia Treatment47:40 - The Need for New Randomized Trials---RESOURCESAcute Limb Ischemia: An Update on Diagnosis and Management:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723825/Safety and efficacy of mechanical aspiration thrombectomy at 30 days for patients with lower extremity acute limb ischemia - STRIDE Study:https://www.jvascsurg.org/article/S0741-5214(23)02196-1/fulltext

In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Thomas Sullivan about the findings from a recent survey exploring the reasons behind professional job changes among interventional radiologists. Dr. Sullivan is the Assistant Program Director of Diagnostic and Integrated Interventional Radiology Residency programs at Wake Forest University.Dr. Sullivan highlights the importance of mentorship during residency and notes the huge impact of geography and financial compensation in determining job satisfaction and longevity in a role. He also discusses some surprising insights about trainee expectations of future practice settings, the need for a variety in practice caseload, and the desire for about 80% of clinical time to be spent on dedicated IR activities. The conversation also delves into the challenges of equipping residents for rural practice and the potential value of developing a procedural radiology curriculum. Dr. Sullivan anticipates that the survey results will help improve and adapt training paradigms to better align with the evolving landscape of interventional radiology practice.---CHECK OUT OUR SPONSORRADPAD® Radiation Protectionhttps://www.radpad.com/---SHOW NOTES00:00 - Introduction02:50 - Discussion on IR Training and Practice04:51 - Survey Discussion and Key Findings16:47 - Importance of Diagnostic Skills in IR19:01 - Deciding Factors for First Job After Training21:04 - Need for Medical Services in Rural Settings25:23 - Role of Mentorship in Job Seeking28:21 - Importance of Networking in Career Development32:37 - Future of IR Training and Practice38:23 - Role of BackTable in IR Training---RESOURCESSIR 2024 Monday Session (3:27 PM - 3:36 PM MT): Trainee perceptions of current IR workforce: Are we setting our residents up for failure? With Dr. Thomas Sullivan:https://www.sirmeeting.org/fsPopup.asp?PresentationID=1348792&mode=presInfo

Dr. Charles Nutting, interventional radiologist, discusses prostatic artery embolization (PAE) in the outpatient-based lab (OBL), emphasizing the importance of learning PAE in a hospital setting before transitioning to the OBL. They also discuss the advantages of using radiopaque beads in PAE and the potential impact of the 2023 AUA Guidelines. The podcast covers procedure techniques, patient selection, and benefits of the OBL environment over the hospital.