POPULARITY
83 episodes with backtable
28 episodes with backtable
22 episodes with backtable
28 episodes with backtable
12 episodes with backtable
6 episodes with backtable
2 episodes with backtable
2 episodes with backtable
How will expeditionary IR adapt and advance to meet the challenges of the next generation of combat operations? In this episode of the Backtable Podcast, host Dr. Ally Baheti speaks with Air Force IR physicians Dr. John Pavlus and Dr. Jonathon Schutt about the realities of expeditionary interventional radiology (EIR) in military and disaster settings. They discuss how EIR brings damage-control and emergency IR principles to deployments, humanitarian missions, and extreme environments, where resources are limited and teamwork is essential. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:53 - Origins and Early Pushback 06:31 - Roles of Care 09:04 - Trauma vs Elective12:09 - Staffing and Training Barriers 22:17 - Future Tech: AI and Robotics 29:24 - Why It Matters in War35:00 - Teamwork Trust and 60 Minutes39:20 - Military Culture41:18 - Wrap Up and Thanks --- More about this episode The conversation explores the military's “roles of care,” from stateside hospitals to front-line deployments, and examines how limited IR staffing and siloed services present barriers to readiness. Drs. Pavlus and Schutt emphasize the importance of close integration with trauma surgery, anesthesia, and other team members, and highlight trauma-focused endovascular care and ultrasound-guided procedures that work with minimal equipment. The episode also looks at future directions for expeditionary IR, including new training models, data systems, and advances in AI and robotics that may one day enable remote intervention in combat and disaster zones. --- Resources Expeditionary Endovascular Trauma Care as a Core Capability for Future Large-Scale Conflictshttps://pubmed.ncbi.nlm.nih.gov/41894613/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How can clinics minimize toxicity and maximize outcomes in intravesical bladder cancer treatment? In this episode of BackTable Urology, host Dr. Vignesh Packiam talks with nurse practitioners Mary Dunn (UNC) and Meredith Donahue (Vanderbilt) about how advanced practice providers (APP) workflows and hands-on management are transforming care for non-muscle-invasive bladder cancer. The discussion highlights innovative strategies for symptom management, patient education, catheter techniques, and streamlined operational protocols across both established and emerging intravesical therapies. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Introduction04:25 - Non Drug Symptom Tips09:39 - Day Of Treatment Clearance14:50 - Post Treatment Triage20:36 - Treatment Fatigue Strategies24:48 - Pelvic Floor And IC Tools27:33 - Teamwork Final Pearls --- More about this episode They share individualized pharmacologic and non-pharmacologic approaches for managing lower urinary tract symptoms, such as NSAIDs, anticholinergics, beta-3 agonists, Pyridium, timed voiding, avoidance of irritants, and constipation management. The episode covers patient education resources from the Bladder Cancer Advocacy Network (BCAN), catheterization techniques tailored to patient needs, and a gravity installation method to reduce spasms. The conversation also reviews day-of-treatment clearance and triage protocols, operational considerations for new agents like Enlexo, Adstiladrin, and gemcitabine/docetaxel, as well as financial workflows that prevent drug wastage. Additional topics include managing cumulative bladder toxicity, pelvic floor PT, addressing treatment fatigue, and integrating multifactorial evaluation and exercise into patient care. --- Resources Bladder Cancer Advocacy Network (BCAN) Basic Handbook & Patient Resources https://bcan.org/bladder-cancer-basics-handbook/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What do you do when Y-90 doesn't deliver the results you expected? In this episode of the 2026 HCC Creator Weekend™, host Dr. Tyler Sandow is joined by Drs. Beau Toskich and Juan Gimenez to discuss the technical challenges and troubleshooting strategies that can make or break a Y-90 radioembolization case. Together, they explore innovative approaches like the PREDATr technique, share tips for reducing complications, and offer guidance on optimizing outcomes for patients with complex liver tumors. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction04:24 - Treatment Nonresponse Troubleshooting06:12 - Navigating Y90 Through Replaced Arteries09:09 - Mitigating Vasospasm in Embolization13:31 - What is ‘PREDATr'?21:12 - Dual Balloon Microcatheter System23:37 - Gelfoam Techniques and Application26:06 - Embolization Agents Preferences36:16 - Concerns with Cystic Artery Treatment and Biliary Stents42:15 - Prophylactic Antibiotics 44:29 - Utilizing High Lung Shunts49:28 - Wrap Up and Credits --- More about this episode The conversation begins with case-based examples of HCC radioembolization, focusing on how to assess treatment response and troubleshoot nonresponsive cases. They discuss how to interpret SPECT findings, identify missed tumor supply with cone-beam CT, and overcome obstacles such as vasospasm, extrahepatic feeders, and challenging arterial anatomy. They introduce the PREDATr technique (proximal radioembolization enabled by distal angiozone truncation) and explain how tools like gelfoam, balloons, and retrievable coils can preserve healthy liver tissue and improve microsphere delivery. The episode also addresses managing biliary stents, using antibiotic prophylaxis, and strategies for handling high lung shunts, making it a practical resource for anyone navigating the complexities of Y-90 treatment. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What happens when urologists look beyond the clinic and take on leadership in the life sciences industry? In this episode of BackTable Urology, host Dr. Raj Pruthi talks with Dr. Kelly Parsons and Dr. Pat Keegan about their journeys from academic urology to executive roles in biotech and pharma. They discuss what motivated their transitions, how physician expertise adds value in industry, and the realities of life outside of traditional clinical practice. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:36 - Choosing a Non-Clinical Path11:07 - Reactions from Mentors and Peers14:31 - What Feels Most Fulfilling18:31 - A Typical Week in Biotech26:04 - Working with Investors31:21 - Additional Degrees and MBA Debate35:31 - Is it Risky to Leave Clinical Practice?44:13 - Networking and Next Steps47:59 - Wrap Up --- More about this episode The conversation explores the day-to-day work of industry leaders, the impact of advanced degrees like MBAs, and the importance of networking for physicians considering a nonclinical path. Drs. Parsons and Keegan reflect on the challenges and rewards of leaving clinical medicine, the support and reactions from mentors and peers, and what they miss most about patient care. They also share practical advice for urologists and other specialists who are curious about new career opportunities beyond the exam room. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
When should recurrent sinus infections trigger an allergy or immune workup? In this episode of the BackTable ENT and Allergy podcast, Dr. Karen Kaufman of Kaufman Allergy, Asthma, & Immunology in Vienna, Virginia, sits down with Dr. Ashley Agan to discuss chronic sinusitis evaluation, allergy testing, immunotherapy, immune deficiency screening, and building a private practice. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:53 - Chronic Sinusitis Basics06:44 - Sinusitis Types and Polyps10:18 - Testing and Treatment Plan18:40 - When to Suspect Immunodeficiency25:44 - Allergy Testing Methods38:39 - Why Go Solo43:10 - Practice Growth, Visibility, Team Building, and Systems51:55 - ENT and Allergy Collaboration55:50 - Closing Remarks --- More about this episode Dr. Kaufman explains how to distinguish chronic sinusitis from other causes of nasal and facial symptoms, when to evaluate for allergy and immune dysfunction, and how sinusitis phenotypes influence treatment decisions. She also shares her experience launching a private practice during the pandemic and discusses strategies for practice growth through community engagement, increased visibility, and social media. --- Resources Dr. Karen Kaufman - https://kaufmanallergy.com/ Jeffery Modell Foundation 10 Warning Signs of Primary Immunodeficiency - https://www.uhhospitals.org/-/media/files/rainbow/services/allergy-and-immunology/10warningsigns.pdf --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Lower C-section rates, faster deliveries, and less physician burnout: could the OB hospitalist model deliver all three? In this episode of BackTable Women's Health, host Dr. Nicole Faulkner interviews Dr. Maliha Sayla, a board-certified OBGYN and medical director of labor and delivery at Northwestern Medicine Delnor Hospital, to explore how the OB hospitalist model is reshaping care for physicians, patients, and healthcare systems. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:27 - Why Hospitalists Matter05:33 - How Their Model Works07:15 - Managing Pushback10:18 - Measuring Better Outcomes15:58 - Drills and Emergencies19:50 - Staffing and Transition24:33 - ROI and OB-ED26:33 - Residents and Teaching30:52 - Future Flexible OB Careers34:14 - Patient Acceptance of Model36:47 - Collaboration and Lifestyle Balance40:00 - Conclusion --- More about this episode Dr. Sayla shares her journey from traditional private practice to full-time OB hospitalist work, explaining how this model reduces physician burnout by making labor and delivery a dedicated role rather than one juggled alongside clinic visits, surgeries, and administrative responsibilities. She details her institution's staffing structure, where hospitalists provide continuous labor and delivery coverage, allowing generalist OBGYNs to focus on outpatient care. Dr. Sayla highlights the benefits of having dedicated physicians available for bedside counseling, fetal monitoring, and real-time decision-making. The episode explores improvements in communication, collaboration, and patient outcomes, including lower NTSV (Nulliparous, Term, Singleton, Vertex) cesarean rates and shorter induction-to-delivery times after adopting the hospitalist model. Additionally, she discusses the hospitalist role in obstetric emergency preparedness and interdisciplinary collaboration, patient perspectives, and the potential of hospitalist programs to address OBGYN workforce shortages. --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Are new technologies and teamwork the key to better fibroid treatment? In this episode of the BackTable Podcast, Drs. Francis Kang and Neil Resnick join host Dr. Chris Beck to share how multidisciplinary treatment planning is reshaping uterine fibroid management, from patient selection and referral patterns to procedural techniques that improve outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byTriSalus Life Scienceshttps://trinavinfusion.com/ --- Timestamps00:00 - Introduction06:18 - Multidisciplinary Care of Fibroids15:45 - Treatment Decisions21:56 - Managing Asymptomatic Fibroids25:43 - Collaborative vs. Competitive Practices30:01 - UFE Procedure Approaches34:32 - Comparing Embolic Sizes and Amounts37:44 - Changes in Speed Using TriNav Catheters40:53 - Tactile Feedback at Stasis42:28 - Embolization Target Regions44:45 - Encountering and Troubleshooting Collaterals47:30 - Post-Op Pain Regiments57:28 - Wrap Up --- More about this episodeThe conversation begins with the importance of strong partnerships with OBGYN colleagues and how multidisciplinary planning leads to better outcomes for patients. They explore patient selection and education, especially for those considering surgical versus minimally invasive treatment options. Drs. Kang and Resnick compare procedural approaches, including when to use femoral versus transradial access, nerve blocks, and embolic particle selection. They also discuss strategies to achieve optimal embolization endpoints and practical tips for handling collateral vessels, avoiding non-target embolization, and managing post-procedural pain and recovery. The episode concludes with a look at newer technologies like the TriNav Catheter and its impact on embolization speed, operator confidence, and early imaging outcomes.--- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Why does up to 10% of bladder cancer pathology change on expert review, and what does that mean for your intermediate and high-risk patients? In this episode of BackTable, Dr. Bogdana Schmidt interviews urologists Dr. Kristen Scarpato and Dr. Sunil Patel to explore the complexities of diagnosis and risk assessment in non–muscle invasive bladder cancer (NMIBC). They discuss the real-world challenges of pathology interpretation, risk-group assignment, evolving diagnostic tools, and the impact these factors have on treatment decisions and patient outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps00:00 - Introduction01:02 - Risk Stratification07:22 - Upstaging to High Risk10:06 - Calculators and Patient Education15:22 - Specific Tests Use Cases18:50 - Conflicting Biomarker Results21:36 - Adjunct Tests and Counseling24:03 - Recurrence After Chemo Next Steps27:01 - Escalation Deescalation Balance32:48 - Future Research Priorities35:43 - Biology Based Risk Stratification38:03 - Clinical Pearls and Wrap Up --- More about this episodeThe conversation highlights the heterogeneity of intermediate-risk disease, the role and importance of expert pathology over-reads, and the need to accurately document the risk category for ongoing care. They discuss selective use of urinary and genomic assays and how these tests fit alongside cystoscopy and blue light endoscopy. Practical treatment approaches are reviewed, including when to use intravesical gemcitabine or BCG, managing care during BCG shortages, and balancing escalation versus de-escalation of therapy. Additional topics include strategies for long-term surveillance, upper tract imaging, rising rates of bladder cancer in younger patients, and why thorough TURBT and strong patient-provider communication remain central to optimal management. --- Resources The Memorial Studyhttps://www.mskcc.org/cancer-care/clinical-trials/19-288 The BRIDGE Studyhttps://www.nejm.org/doi/full/10.1056/NEJMoa1501035 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Robotic technology is expanding what's possible in reconstructive urology, prompting surgeons to rethink traditional approaches and consider new minimally invasive procedures. In this episode of BackTable Urology, Dr. Ziho Lee joins host Dr. George Koch to explore the rapid evolution of robotic reconstructive surgery and its expanding role in complex pelvic and retroperitoneal procedures.They discuss the the role of single-port platforms, new strategies for managing ureteral strictures and urinary diversion, and how research, training, and patient-reported outcomes are shaping the future of minimally invasive urologic care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:10 - Bridging Reconstruction and Robotics07:41 - Where Robots Help Most14:33 - Ureteral Rest16:41 - 20% Nephrectomy Rule19:04 - Single Port Indications20:55 - Ileal Ureter Tips and Tricks22:34 - Robotic Reconstruction Course28:55 - Case: VUAS Repair39:35 - Final Advice --- ResourcesUreteral Rest is Associated With Improved Outcomes in Patients Undergoing Robotic Ureteral Reconstruction of Proximal and Middle Ureteral Strictureshttps://pubmed.ncbi.nlm.nih.gov/33639184/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
The transition between residency or fellowship to clinical practice can be a big jump, especially when it comes to keeping up with new data and independently making decisions with patients. In this episode of BackTable Industry, Anish Parikh hosts medical oncologist Dr. Kate Baker shares her experience managing a broad range of patients, from solid tumors to benign and malignant hematology. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction01:29 - From Fellowship To Practice05:01 - Nuances of Oncology Practice & Keeping Up-To-Date with New Data07:47 - What Counts As Practice Changing13:51 - Information Flow Between Pharmaceuticals & Physicians17:10 - Early Career Admin Advice --- More about this episodeDr. Baker describes oncology's clinical nuances, the need to tailor discussions with patients on survival data during decision-making, and the challenge of staying current with real-time information. To maintain agility in the field, she attends disease-state specialist meetings, focusing on practice-changing evidence before considering adopting new treatments. She also emphasizes consulting colleagues via tumor boards and reaching out to experts for complicated cases when patients don't fully fit the guidelines. --- ResourcesDESTINY-Breast05https://www.nejm.org/doi/full/10.1056/NEJMoa2514661 --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes.► https://www.backtable.com/app
Will new PE guidelines redefine risk and therapy in pulmonary embolism (PE) care? In this episode of the BackTable podcast, host Dr. Michael Barraza is joined by interventional cardiologist Dr. Jay Giri and emergency physician Dr. Trevor Cummings to break down the latest changes in PE management. They discuss how multidisciplinary pulmonary embolism response teams (PERT) are implementing these guidelines at their institutions, the introduction of a more nuanced A-E risk stratification system, and the challenges of enrolling experienced centers into clinical trials as device innovation accelerates. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Inari Medicalhttps://www.inarimedical.com/flowtriever-system --- Timestamps 00:00 - Introduction 01:24 - Building a PERT Team04:59 - Trials Shaping PE Care 10:20 - Why New Guidelines Now 14:06 - New Risk Categories Explained 19:51 - Applying Guidelines Locally 23:34 - What Is C1 Risk 27:52 - New D Category Explained 30:33 - Evidence for Aggressive Therapy 33:31 - How PERT Teams Communicate 38:22 - Upcoming PE Trials Pipeline 43:42 - Program Growth and High Risk Trials 45:46 - Closing Remarks --- More about this episode The conversation highlights the growth of catheter-directed lysis and mechanical thrombectomy, the rationale and practical impact of the new Category D for incipient cardiopulmonary failure (including normotensive shock), and the incorporation of PESI, sPESI, and Hestia for risk assessment. Additional topics include decision-making for low-risk patients, lactate and biomarkers for identifying higher-risk cases, communication strategies within PERT teams, AI-enabled risk stratification, and a preview of upcoming trials (PEITHO, PRAGUE-26, PEERLESS-2, PE-TRACT, and PERSEVERE) that are set to further transform PE care. --- Resources Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/21422387/ Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: Historical Context, Current Status, and Future Directions: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/36688837/ Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/31585051/ Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolismhttps://pubmed.ncbi.nlm.nih.gov/41910345/ PEERLESS II: A Randomized Controlled Trial of Large-Bore Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolismhttps://pubmed.ncbi.nlm.nih.gov/39132600/ Rationale and design of the PE-TRACT trial: A multicenter randomized trial to evaluate catheter-directed therapy for the treatment of intermediate-risk pulmonary embolismhttps://pubmed.ncbi.nlm.nih.gov/39638275/ Reduced-Dose Intravenous Thrombolysis for Acute Intermediate–High-risk Pulmonary Embolism: Rationale and Design of the Pulmonary Embolism International THrOmbolysis (PEITHO)-3 trialhttps://pubmed.ncbi.nlm.nih.gov/34560806/ Design and rationale of the PERSEVERE study: a randomized controlled trial of large-bore mechanical thrombectomy versus the standard of care for high-risk pulmonary embolism https://pubmed.ncbi.nlm.nih.gov/41453591/ Design and rationale of PRAGUE-26: a multicentre, randomised trial of catheter-directed thrombolysis for intermediate-high risk acute pulmonary embolismhttps://pubmed.ncbi.nlm.nih.gov/40464677/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What matters most to patients with non-muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Kelly Bree, Dr. Saum Ghodoussipour, and Meredith Donahue, N.P., join host Dr. Vignesh Packiam to discuss the power of shared decision-making across the NMIBC spectrum. They explore risk-adapted treatment selection, when to escalate or de-escalate therapy, and how to navigate conversations about recurrence risk, treatment burden, quality of life, and the possibility of cystectomy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Introduction01:55 - Second Opinions and Patient Counseling06:08 - Intermediate Risk Stratification12:13 - Treatment Options for Intermediate Risk NMIBC16:20 - BCG and Alternative Treatments for High Risk NMIBC26:49 - Options for BCG-Unresponsive NMIBC31:42 - Sequencing and Cystectomy37:03 - Financial and Time Toxicity41:08 - Biomarkers and ctDNA44:04 - Future Trials and NMIBC Innovations --- More about this episode They also review emerging therapies such as ZUSDURI, the evolving role of intravesical treatments, and the promise of biomarkers and ctDNA for personalized care. The discussion covers practical strategies for patient counseling, key updates to clinical guidelines, and a preview of innovations shaping the future of NMIBC management. --- Resources Active Surveillance Versus Intravesical Bacillus Calmette-Guérin for High-grade T1 Bladder Cancer with Negative Second Transurethral Resection: The Randomized Noninferiority Phase 3 JCOG1019 Trial:https://pubmed.ncbi.nlm.nih.gov/41571573/ Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non–Muscle-Invasive Bladder Cancerhttps://ascopubs.org/doi/10.1200/JCO-25-01324 CIRCULATING TUMOR DNA AS A BIOMARKER FOR UPSTAGING AND ADVERSE PATHOLOGY IN HIGH-RISK NON–MUSCLE-INVASIVE BLADDER CANCER:https://www.auajournals.org/doi/abs/10.1097/01.JU.0001191388.74345.c9.09 Preoperative Circulating Tumor DNA Predicts Upstaging and Recurrence in High-Risk Nonmuscle-Invasive Bladder Cancer Undergoing Radical Cystectomyhttps://pubmed.ncbi.nlm.nih.gov/41843048/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How can targeted liver radiation unlock surgical or transplant options for tough hepatocellular carcinoma (HCC) cases? In this episode of BackTable 2026 HCC Creator Weekend™ host Dr. Kavi Krishnasamy is joined by interventional radiologists Dr. Beau Toskich and Dr. Chris Malone to explore how downstaging and radiation lobectomy with Y-90 are creating new surgical and transplant opportunities for patients with limited future liver remnants. They discuss Y-90's role as a “test of time” for tumor biology, strategies to prevent post-hepatectomy liver failure, and the ongoing challenge of recurrence even after R0 resection in cirrhotic livers. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction01:31 - Rad Lobectomy Goals and Case Discussion06:09 - Selective vs Lobar Dosing07:51 - PVE Versus Y9009:35 - Downstaging to Transplant13:03 - Patient Selection Factors19:22 - Radseg vs. Lobar Strategy22:12 - Percent Liver Treated Debate26:38 - Particle Density and Catheter Bias28:04 - Downstaging Evidence MERIT LT36:20 - Operating After Y9041:25 - Hypertrophy Timing and Readiness43:03 - Wrap Up --- More about this episode The discussion features a case of massive right-lobe HCC in a non-cirrhotic patient, with stepwise Y-90 dosing and selective retreatment leading to complete response and marked liver hypertrophy. The doctors compare radiation lobectomy with portal vein embolization (PVE), explore dosimetry advances from studies like DOSISPHERE and MERITS-LT, and stress the importance of careful mapping and patient selection. Additional topics include the pros and cons of different downstaging methods, functional imaging to assess risk, the impact of lab values and portal hypertension, and the practicalities of timing surgery after Y-90. --- Resources Long-Term Overall Survival After Selective Internal Radiation Therapy for Locally Advanced Hepatocellular Carcinomas: Updated Analysis of DOSISPHERE-01 Trialhttps://jnm.snmjournals.org/content/early/2024/01/10/jnumed.123.266211 Downstaging hepatocellular carcinoma before liver transplantation: A multicenter analysis of the "all-comers" protocol in the Multicenter Evaluation of Reduction in Tumor Size before Liver Transplantation (MERITS-LT) consortiumhttps://pubmed.ncbi.nlm.nih.gov/37532179/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Can you really treat prostate cancer effectively without knowing the genetics? In this episode of BackTable Urology, Dr. Evan Yu and Dr. Tanya Dorff join host Dr. Alan Tan to discuss why genetic testing is essential in personalized prostate cancer care. They discuss when and how to perform germline and somatic testing, address common barriers, and share best practices for counseling patients. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Pfizer. --- Timestamps 00:00 - Introduction02:18 - Who Gets Somatic Testing?06:43 - Patient Barriers to Testing09:00 - Genetic Testing Workflow12:28 - Treating BRCA2 Alterations24:18 - Monitoring Progression: ctDNA vs. PSA vs. Imaging29:32 - Treating mCRPC with ATM Mutations34:39 - CDK12 Classification 37:43 - Closing Takeaways --- More about this episode The doctors explore how BRCA2 and other DNA repair alterations can directly shape treatment decisions, focusing on the roles of PARP inhibitors and platinum therapy in advanced cases. The discussion highlights why both germline and somatic testing are critical for identifying actionable mutations and discuss the nuances of interpreting test results, including current limitations and emerging biomarkers. They also examine challenges such as insurance coverage, patient misconceptions, and workflow integration, as well as the movement toward truly personalized, biology-driven approaches in prostate cancer care. --- Resources Niraparib and abiraterone acetate plus prednisone for HRR-deficient metastatic castration-sensitive prostate cancer: a randomized phase 3 trial:https://pmc.ncbi.nlm.nih.gov/articles/PMC12705445/ Capivasertib plus abiraterone in PTEN-deficient metastatic hormone-sensitive prostate cancer: CAPItello-281 phase III study:https://www.annalsofoncology.org/article/S0923-7534(25)04936-1/fulltext Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer:https://www.nejm.org/doi/full/10.1056/NEJMoa1903307 ARCHES 5-year Survival with Enzalutamide Plus Androgen-deprivation Therapy in Metastatic Hormone-sensitive Prostate Cancer Patientshttps://www.sciencedirect.com/science/article/pii/S0302283825048766 First-Line Camizestrant for Emerging ESR1-Mutated Advanced Breast Cancer:https://www.nejm.org/doi/abs/10.1056/NEJMoa2502929 PROMISE Registry:https://www.prostatecancerpromise.org/ Talazoparib plus enzalutamide in men with HRR-deficient metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trial:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00683-X/abstract --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
For years, an indeterminate thyroid biopsy meant diagnostic surgery but molecular testing is now changing that reality entirely. On this episode of the BackTable ENT podcast, Dr. Ashley Agan interviews endocrinologist Dr. Erik Alexander about how molecular testing and a systematic, layered approach to thyroid nodule evaluation are reducing diagnostic surgeries and enabling more individualized patient care. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Veracytehttps://www.veracyte.com/ --- Timestamps 00:00 - Introduction02:48 - Incidence, Presentation, and Workup of Thyroid Nodules 06:26 - Hormonal Impact and Indications for FNA 10:49 - FNA workflow and Bethesda Categories 16:10 - Role of Molecular Testing for Indeterminate Nodules19:59 - Evolution of Molecular Testing and Afirma 23:51 - Basics of DNA based Testing and RNA based Testing 28:34 - Comparing DNA based and RNA Based Testing 32:10 - Utility of Molecular Testing and Sampling Techniques 35:55 - Cost Coverage and Practical Limits39:20 - Clinical Implications and Future Impact42:00 - Final Takeaways --- More about this episode Together they walk through the full evaluation pathway, including ultrasound risk stratification using the TI-RADS criteria, the role of TSH testing, and how FNA indications have shifted from biopsying every solid nodule to a more selective, risk-adapted approach. The discussion covers the Bethesda classification system and addresses why the one-third of patients landing in indeterminate categories (Bethesda III, IV, and V) have historically been the most challenging and most overtreated group. The conversation then explores molecular diagnostics as an additional layer of risk assessment, highlighting key differences between DNA-based mutation panels and RNA-based expression classifiers. Dr. Alexander also discusses practical considerations like insurance coverage, sampling technique, turnaround time, and the future potential of molecular testing to move beyond diagnosis toward individualized prognosis. --- Resources American College of Radiology: TI-Rads Guidelines https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/TI-RADS/TI-RADS-Assessment-Categories.pdf American Thyroid Association - Nodule Guidelineshttps://pmc.ncbi.nlm.nih.gov/articles/PMC4739132/ Bethesda System for Reporting Thyroid Ctyopathology https://www.ncbi.nlm.nih.gov/books/NBK278969/table/thyroid-nod-canc-eld.T.bethesda_system_f/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Can a “normal” pelvic exam mask life-altering pain? On this episode of BackTable Women's Health, host Dr. Karen Toubi interviews board-certified OBGYN Dr. Chailee Moss about why common vulvovaginal pain and skin conditions are frequently missed or dismissed as “normal” exams. Dr. Moss explores how gaps between gynecology and dermatology, limited training, and the under-recognition of non-life-threatening but highly morbid pain contribute to these diagnostic challenges, including mental health impact and even suicidality in some cases. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:56 - Why Pain Gets Missed08:58 - Building Trust With Time10:51 - Vulvodynia Workup Basics16:02 - Hormonal Vestibulodynia Clues21:21 - New Treatments On Horizon23:07 - Lichen Steroid Maintenance26:25 - Biopsy Decisions And Mimics30:30 - Multimodal Treatment Planning33:00 - Pelvic Floor PT Done Right35:55 - When To Consider Surgery37:33 - Clinical Trials Ketotifen Botox40:40 - Conclusion and Resources --- More about this episode They discuss rebuilding trust through time, attentive listening, and clear communication, along with a detailed evaluation process that includes medication review, targeted symptom questions, Q-tip mapping, vulvoscopy, cultures, and selective biopsy. The approach informs an individualized, multimodal treatment plan. Additional topics include lichen steroid counseling,differentiating mimickers like yeast and irritant dermatitis, and connecting patients to resources such as ISSWSH, ISSVD, and support groups. --- Resources Experiences of Care and Gaslighting in Patients With Vulvovaginal Disorders https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833711 ISSWSH https://www.isswsh.org/ Pudendal Hope https://www.pudendalhope.info/ Tight Lipped https://www.tightlipped.org/ The National Vulvodynia Association https://www.nva.org/ --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Are academic medical conferences falling short when it comes to preparing clinicians for the unpredictable realities of modern surgery and patient care? In this episode of BackTable Industry, co-founder Anish Parikh interviews Dr. Ruchika Talwar about the real-world challenges traditional conferences often overlook and how informal, peer-to-peer exchanges like those at Creator Weekend™ in Nashville bridge the gap. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:37 - Why Conferences Miss It06:35 - From Training to Practice08:10 - On Call Reality Check10:39 - Learning With Videos14:44 - Keeping Up With New Info16:37 - Rise and Fall of Urology Twitter19:27 - Lifelong Learning and Patients25:44 - CME and Med Ed Revolution28:30 - Closing Thoughts --- More about this episode Together, they unpack what it really takes to bring new NMIBC therapies into clinical practice, from navigating approval barriers and staffing challenges to managing workflow and operational details. Dr. Talwar shares insights on moving from training to independent practice, navigating on-call emergencies with quick learning tools like surgical videos and residency notes, and building patient-centered approaches beyond rigid guidelines. The conversation also explores how surgeons use their own "game tape" to improve, the rise and fall of online medical communities like MedTwitter, and the evolving landscape of CME and lifelong learning for today's physicians. --- Resources Hinman's Atlas of Urologic Surgeryhttps://www.clinicalkey.com/#!/browse/book/3-s2.0-C20210026651 American Urologic Association Guidelines & Video Bankhttps://www.auanet.org/guidelines-and-quality/guidelines --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes. ► https://www.backtable.com/app
When hemodialysis-dependent patients exhaust all conventional venous access options, how do IRs navigate complex central occlusions to provide a lifeline? In this episode of the BackTable Podcast, Dr. Gian Paolo Zamboni of Clínica Alemana in Santiago, Chile joins guest host Dr. Neil Jain to discuss workup protocols and advanced technical algorithms for complex central venous recanalization cases. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction03:06 - IR Practice and Referrals in Santiago07:19 - Pre-Procedure Workup15:06 - Standard Recanalization Techniques20:14 - Dual-Access Sharp Recanalization24:43 - Needle Maneuvers and Alternatives29:32 - Predilation, IVUS, and Stent Sizing37:42 - Transhepatic Technique and Indications45:45 - Tract Closure, Anticoagulation, and Follow-up50:03 - Advice and Closing Remarks --- More about this episode The physicians review the critical role of pre-procedural planning, emphasizing the necessity of thorough workup with CT venography to accurately assess remaining vascular capital. Dr. Zamboni shares how his group addresses severe central venous occlusions, outlining a structured, stepwise approach that begins with standard maneuvers and progresses to sharp recanalization techniques before opting for dual-access approaches. He outlines critical safety measures, highlighting the importance of performing intraprocedural cardiac ultrasound, pre-dilating with caution, and keeping covered stents on the shelf to prevent fatal cardiac tamponade. For patients who lack viable conventional iliofemoral and IVC access, Dr. Zamboni shares an advanced jugular-to-transhepatic strategy, walking through the steps and nuances of creating a reliable working route, optimizing inflow, and managing post-procedure anticoagulation. Finally, Dr. Zamboni offers invaluable advice for IRs on mastering foundational techniques before tackling advanced cases and building strong, collaborative relationships with referring providers. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Are traditional bladder cancer care models falling behind as new therapies flood the field and reshape the landscape? In this episode of BackTable Urology, Dr. Bogdana Schmidt talks with Dr. Amy Luckenbaugh and DNP/APP Meredith Donahue about building a co-managed intravesical therapy clinic that rethinks care for patients with non–muscle invasive bladder cancer (NMIBC). With innovative agents increasing patient volume and complexity, the team discusses adapting care models to new realities. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Why Clinic Models Need to Change Now04:03 - Overcoming Financial and J-Code Hurdles11:04 - High Volume Workflow14:10 - Pharmacy Coordination And Timing19:02 - Proactive Lower Urinary Tract SYmptom Management22:25 - Handling Difficult Catheters32:08 - Defining Clinic Success --- More about this episode The conversation covers prioritizing clinical trials, managing operational challenges such as prior authorizations and billing hurdles, and the importance of pharmacy coordination and predictable clinic workflows. Donahue describes a high-efficiency installation day model managing up to 50 patients a week with specialized staff, real-time decisions, and tailored logistics for therapies like Adstiladrin. They also discuss symptom prevention, patient triage, and clinic success measures including therapy availability, patient satisfaction, and opportunities to preserve bladder function. --- Resources Gemcitabine IDRS Drug Delivery Trialhttps://ascopubs.org/doi/10.1200/JCO.2026.44.7_suppl.635 BCG-IO Combination Trialhttps://www.astrazeneca.com/media-centre/press-releases/2026/imfinzi-approved-in-us-for-early-bladder-cancer.html --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What does it really take to run a high-volume Y-90 program that is efficient, scalable, and patient-centered? In this episode of BackTable 2026 HCC Creator Weekend™, host Dr. Zach Berman is joined by Drs. Nima Kokabi and Kirema Garcia-Reyes to break down the systems, workflows, and strategies that drive successful radioembolization centers. The conversation focuses on overcoming referral and insurance delays, implementing multidisciplinary clinics, and using tools like single-session Y-90 and routine post-treatment dosimetry to reduce treatment times and improve outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction04:46 - Multidisciplinary Model on Radioembolization08:39 - Referral Pathways and Embolization Preferences13:18 - Y-90 Follow Up and Imaging15:51 - Procedure Preparation and Involvement18:00 - Dosimetry Planning and Software ROI22:59 - Analyzing Outcomes and Quality Control26:47 - Various Ways to Expedite Treatments34:04 - Wrap Up and Credits --- More about this episode The doctors discuss the importance of robust internal systems for patient selection, integration of dosimetry planning, and standardized follow-up protocols.They share insights on procedural workflows, including best practices for dosimetry ownership and equipment setup, and highlight the growing role of post-Y-90 dosimetry as both a quality control measure and a billable service. The episode also explores the order-map-treat paradigm, the impact of multidisciplinary tumor boards and clinics, and how single-session strategies are reshaping HCC care by cutting delays, reducing costs, and enhancing the patient experience. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ready to move beyond “one-size-fits-all” for BCG-unresponsive NMIBC? In this episode of BackTable Urology, Dr. Ruchika Talwar hosts Dr. Sam Chang to discuss the evolving treatment landscape for BCG-unresponsive non-muscle invasive bladder cancer (NMIBC). They explore why BCG may fail, the science and clinical rationale behind new immunotherapies and gene therapies, practical approaches to patient selection, treatment sequencing, and surveillance, and the value of emerging biomarkers, empowering urologists to make more informed, personalized decisions in complex cases of NMIBC. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by ImmunityBiohttps://anktiva.com/ --- Timestamps 00:00 - Introduction03:48 - BCG: How it Works and Why it Fails11:13 - Pembrolizumab Role and Limits14:38 - Nadofaragene firadenovec 16:34 - Cretostimogene grenadenorepvec18:39 - BCG + Anktiva Rationale29:50 - Explaining Options to Patients33:05 - Post Treatment Surveillance37:32 - Future of Biomarkers and AI42:05 - Key Takeaways --- Resources N-803 Plus BCG Treatment for BCG-Naïve or -Unresponsive Non-Muscle Invasive Bladder Cancer: A Plain Language Reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11524197/ Safety, Tolerability, and Long-Term Clinical Outcomes of an IL-15 analogue (N-803) Admixed with Bacillus Calmette-Guérin (BCG) for the Treatment of Bladder Cancerhttps://doi.org/10.1080/2162402X.2021.1912885 IL-15 Superagonist NAI in BCG-Unresponsive Non–Muscle-Invasive Bladder Cancerhttps://evidence.nejm.org/doi/full/10.1056/EVIDoa2200167 --- More about this episode This podcast is for informational purposes only. The views and opinions expressed in this podcast are solely those of the moderator and individual guest. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Not all chronic cough, globus, or voice changes are due to reflux, so how do you distinguish laryngopharyngeal symptoms (LPS) from true laryngopharyngeal reflux disease (LPRD)? In this episode of the BackTable ENT & Allergy podcast, Dr. Ashley Agan interviews laryngologist Dr. Inna Husain about how nuanced diagnostic definitions and a careful clinical approach can improve patient outcomes and avoid both under- and overdiagnosis. Together, they discuss the differences between GERD and LPRD, review the importance of detailed patient histories, endoscopic findings, and the evolving role of biomarkers like pepsin. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:14 - LPS Versus LPR Basics06:34 - GERD Versus LPRD11:28 - Clinic Workup and Scoping18:02 - San Diego Consensus Debate24:14 - Testing Over Empiric PPIs31:45 - Managing Proven Reflux34:59 - Stroboscopy Before Surgery36:10 - Pepsin Therapies and Tests39:54 - What Counts as Abnormal Reflux44:24 - Tapering Off PPIs Safely50:12 - Long Term Plan and Dietitians55:39 - GLP One Drugs and Reflux57:34 - Menopause Rhinitis and Hormones01:00:09 - Final Pearl For ENTs --- More about this episode They outline contemporary workup strategies, including the San Diego Consensus on Bravo testing, 24-hour pH impedance, and alternatives for negative reflux testing. The conversation covers management strategies, from selective PPIs and lifestyle tailoring to emerging therapies and the impact of GLP-1 drugs, helping ENT specialists refine their approach to complex laryngopharyngeal complaints. --- Resources San Diego Consensus for LPS and LPRD:https://doi.org/10.14309/ajg.0000000000003482 Dr. Inna Husainhttps://innahusainmd.com/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How do you decide which noninvasive prenatal testing option is best for your patient, and when should you reach for single-gene NIPT? In this episode of BackTable Women's Health, host Dr. Nicole Faulkner interviews maternal-fetal medicine specialist Dr. Andrei Rebarber to break down the evolving world of prenatal genetic testing. They discuss the importance of pan-ethnic carrier screening, the clinical scenarios where single-gene NIPT is most useful, and how to navigate counseling and follow-up for a wide range of patients. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Naterahttps://www.natera.com/info/fetal-focus --- Timestamps 00:00 - Introduction04:43 - Prenatal Genetic Testing Basics07:10 - Larger Panel Screening Benefits10:49 - Defining Single-Gene NIPT14:51 - Counseling and Invasive Options18:26 - Accuracy Data and No Call Rate22:03 - Patient Acceptance of Test24:18 - When to Test and Screen26:13 - Counseling Carrier Results30:12 - In Utero Treatment 32:36 - Workflow for Generalists35:33 - How to Interpret Literature40:08 - Closing Remarks --- More about this episode Dr. Rebarber shares how witnessing in-utero transfusions for severe Rh disease inspired his career in OBGYN and maternal-fetal medicine, highlighting the importance of treating the fetus as a patient and the rapid growth of fetal therapy. The episode reviews ACOG-guided carrier screening for conditions like cystic fibrosis and hemoglobinopathies, the trend toward larger, pan-ethnic screening panels, and why carrier findings are common but true “double-carrier” couples are relatively rare. Dr. Rebarber also discusses the clinical utility of single-gene NIPT—a cell-free placental DNA test for select recessive conditions—especially when partner testing isn't possible or when patients wish to avoid invasive procedures. The conversation compares screening and diagnostic strategies, including CVS and amniocentesis, and provides practical insight into interpreting test performance and emerging research. --- Resources EXpanding Prenatal Cell Free DNA Screening Across moNogenic Disorders (EXPAND) https://clinicaltrials.gov/study/NCT06808880?tab=study --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Routine doesn't mean risk-free. What should be considered before, during, and after inferior vena cava (IVC) filter placement? In this episode of the BackTable Podcast, interventional radiologist Dr. Daniel O'Neal (Ohio State University) joins guest host Dr. Jessica Yoon to walk through the workup protocols, technical considerations, and multidisciplinary approaches required for placing and following up on IVC filters. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction02:10 - IVC Filter Basics07:37 - Workup and Contraindications12:18 - Pre-Procedural Imaging and Timing14:35 - Procedural Technique18:53 - Cavagram and Variant Anatomy23:18 - Filter Positioning and Deployment30:02 - IVC Filter Complications33:58 - Post-Placement Follow-Up39:14 - Final Thoughts and Closing Remarks --- More about this episode The physicians review the key indications for the procedure, highlighting evidence-based patient selection and emphasizing the need for interventional radiologists to critically assess the clinical workup rather than function merely as technicians. They discuss how a comprehensive pre-procedural workup relies on cross-sectional imaging to identify access obstacles and to plan for adequate filter placement in cases of variant anatomy. Dr. O'Neal also shares technical tips from the suite, including deployment mechanics, positioning considerations, and strategies for preventing common complications. The conversation concludes with the IR's ongoing responsibility to ensure a robust, multidisciplinary follow-up system with referring specialties, outlining potential strategies to ensure these devices are safely retrieved in a timely manner when no longer indicated. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Can the right dosimetry approach turn palliative Y90 into a curative therapy? In this episode of the BackTable 2026 HCC Creator Weekend™, Interventional oncologists Dr. Riad Salem, Dr. Nima Kokabi, and Dr. Zach Berman examine modern Y90 dosimetry, from the decline of body-surface-area calculations to newer strategies that tailor treatment intensity to tumor burden, liver reserve, and clinical intent. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction03:16 - MIRD and Dosing Considerations06:20 - BSA Is Dead09:26 - Early Stage Segmentectomy13:04 - Sphere Density Questions18:12 - CPN as the Goal18:41 - BCLC B Multifocal Strategy22:56 - Radiation Lobectomy Explained25:49 - Surgery and Adhesions28:59 - Advanced PVT Patients30:22 - Dosisphere and Biomarkers34:29 - Wrap Up --- More about this episode The doctors discuss how to choose how much radiation treatment to give and why “activity” (what you order) is different from “dose” (what tissue receives). The episode goes on to compare one-area calculations with more nuanced methods that distinguish tumor from healthy tissue, and explains why advanced 3D planning is often simpler after treatment than before. The discussion also covers treatment goals for various clinical scenarios, such as when to aim for complete ablation versus palliation, managing radiation lobectomy, and tailoring therapy in cases with portal vein tumor thrombus. The episode concludes with insights on how imaging informs treatment intensity and how local and systemic therapies work together in the latest Y90 approaches. --- Resources Combination treatment with transarterial chemoembolization, radiotherapy, and hyperthermia (CERT) for hepatocellular carcinoma with portal vein tumor thrombosis: Final results of a prospective phase II trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC5581058/ A global evaluation of advanced dosimetry in transarterial radioembolization of hepatocellular carcinoma with Yttrium-90: the TARGET studyhttps://pubmed.ncbi.nlm.nih.gov/35394152/ Y90 Radioembolization Significantly Prolongs Time to Progression Compared With Chemoembolization in Patients With Hepatocellular Carcinomahttps://pubmed.ncbi.nlm.nih.gov/27575820/ Long-Term Overall Survival After Selective Internal Radiation Therapy for Locally Advanced Hepatocellular Carcinomas: Updated Analysis of DOSISPHERE-01 Trialhttps://jnm.snmjournals.org/content/early/2024/01/10/jnumed.123.266211 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
How do you keep no-shows low and patient satisfaction high in an office-based overactive bladder (OAB) practice? In this episode of BackTable Urology, Dr. Michael Kennelly and Dr. Jason Kim join guest host Dr. Polina Reyblat to share practical strategies for improving efficiency, reducing cancellations, and optimizing the patient experience for OAB and urinary incontinence procedures. --- Get the BackTable app https://www.backtable.com/app --- This podcast was developed in collaboration withSociety of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) https://sufuorg.com/home.aspx --- Timestamps 00:00 - Introduction02:08 - Pre Visit Optimization05:49 - Botox Protocol11:31 - Spa-Style Comfort14:46 - Prior Auth and Medicare LCD21:25 - PTNS Workflow Challenges24:52 - Stacking Procedures27:55 - Bulking Agent Clinic Workflow36:17 - Rapid Fire Tips --- More about this episode The panel discusses streamlined Botox workflows, patient-centered approaches to anxiety and pain management, percutaneous tibial nerve stimulation (PTNS) and peripheral nerve evaluation (PNE) scheduling, office-based bulking procedures, and the evolving Medicare LCD documentation requirements. They also share tips for procedure-day planning, staffing, prior authorizations, and reducing no-shows while maintaining high-quality care. --- Resources Relaxing Environment Lowers Anxiety During Chemodenervation: a Randomized Trialhttps://journals.lww.com/fpmrs/abstract/2026/04000/relaxing_environment_lowers_anxiety_during.6.aspx --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
With such a wide range of presentations and severity, how do laryngologists approach the diagnosis and treatment of unilateral vocal fold paralysis? In this episode of the BackTable ENT and Allergy Podcast, Dr. Rebecca Howell, Laryngologist at the University of Cincinnati, joins Dr. Stephen Schoeff to discuss the evaluation and management of unilateral vocal fold paralysis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:18 - Classic Symptoms of Vocal Fold Paralysis 04:15 - Etiology and Imaging Workup08:40 - Injection Timing and Materials23:20 - Permanent Options and Framework Surgery28:41 - Arytenoid Adduction Risks and When to Add Adduction30:56 - Awake Thyroplasty Technique compared to Sedation and OR Setup35:48 - Reinnervation and Bilateral Medialization Choices42:10 - Vocal Fold Long-term Injectables51:54 - Closing Remarks --- More about this episode Dr. Howell reviews the spectrum of patient presentations and common causes, including thoracic surgery, ACDF, thyroid surgery, intubation injuries, and idiopathic cases. She explains when to pursue imaging from brainstem to chest, how to set realistic recovery expectations, and the benefits of early intervention. The episode covers office-based injection augmentation, the pros and cons of injectable materials, and treatment durability, as well as risks like calcium hydroxylapatite. Long-term care options are discussed, including framework surgery, arytenoid adduction, bilateral approaches for vocal fold atrophy, reinnervation, and patient selection considerations. --- Resources Pathophysiology of Iatrogenic and idiopathic vocal fold paralysis may be distinct - Ted Mau: https://pubmed.ncbi.nlm.nih.gov/31498451/ Vocal Fold augmentation with injectable calcium hydroxylapatite - Clark Rosen: https://pubmed.ncbi.nlm.nih.gov/15331112/ Using High-Speed Videoendoscopy to Analyze Laryngeal closure parameters during normal swallow - Rebecca Howell: https://pubmed.ncbi.nlm.nih.gov/39659169/ Arytenoid abduction for bilateral vocal fold immobility - Gayle Woodson: https://pubmed.ncbi.nlm.nih.gov/22001662/ Laryngeal Reinnervation for Unilateral Vocal Fold Paralysis - Randal Paniello : https://profiles.wustl.edu/en/publications/laryngeal-reinnervation-for-unilateral-vocal-fold-paralysis/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Osteoporosis may present after menopause, but prevention starts decades earlier. In this episode of BackTable Women's Health, Dr. Carla Gunn, guest host and OBGYN, interviews Dr. Pooja Luthra, an endocrinologist at UConn Health, about osteopenia, osteoporosis, and practical strategies for lifelong bone health. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction03:28 - Why Bone Health Matters Early05:23 - Bone as a Vital Sign08:02 - Amenorrhea and Early Screening09:51 - Calcium, Vitamin D, and Protein15:11 - Menopause Bone Biology Explained21:58 - Metabolic Diseases and Bone Risk25:58 - Early Screening Red Flags27:53 - Hormone Therapy Bone Benefits30:59 - Reading DEXA Scores33:42 - FRAX Scores35:09 - Modern Treatment Sequencing38:02 - Bisphosphonates Mechanism and Concerns41:16 - Secondary Labs and Referrals44:23 - Closing Thoughts --- More about this episode Dr. Luthra explains how peak bone mass is largely established by early adulthood, followed by accelerated loss during the perimenopausal/menopausal transition due to estrogen decline, inflammatory cytokines, altered calcium absorption, and increased bone resorption. She reviews prevention strategies, including adequate calcium, vitamin D, and protein intake, resistance training, and avoiding smoking and excess alcohol use. The discussion also covers high-risk conditions that can negatively impact bone health, including amenorrhea, premature ovarian insufficiency, hyperthyroidism, diabetes, and chronic kidney disease, along with considerations for earlier screening in these patients. Dr. Luthra walks through DEXA interpretation, including T-scores, Z-scores, trabecular bone score (TBS), and FRAX assessment. She closes the conversation by outlining treatment sequencing with anabolic agents before antiresorptives, bisphosphonate safety, alternative therapies, and secondary osteoporosis workup labs. --- Resources FRAX Tool:https://www.fraxplus.org/calculation-tool --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Discover how modern physicians are secretly swapping out old medical textbooks for Google and AI tools like Gemini to prep for your next surgery. On this episode of BackTable Industry, the hosts chat with Dr. Baxter about being eleven years out of training and how his learning focus has shifted from seeking the single “right” cutting-edge answer to optimizing patient care with available tools and resources. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 Introduction03:54 Finding Your Way as an Attending06:26 Internet Prep Habits12:28 Keeping Up in the Field21:13 IR Culture MacGyver26:44 Wrap Up Thanks --- More about this episode He describes realizing he had become a mid-career physician when younger partners began calling him for advice, despite his own imposter syndrome. They discuss how he prepares for infrequently performed or new procedures—using “phone a friend,” targeted Google searches, specific journals like Techniques in Vascular and Interventional Radiology, SIR's Digital Video Library, and AI tools such as Open Evidence —while being discerning about sources. Baxter explains overlap between specialties (e.g., double-J ureteral stents), variability between devices and when reps or formal training like cadaver labs are needed, and how IR's broad, evolving scope fosters a MacGyver-like, information-sharing culture. --- Resources Open Evidencehttps://www.openevidence.com/ Techniques in Vascular nad Interventional Radiologyhttps://www.sciencedirect.com/journal/techniques-in-vascular-and-interventional-radiology Digital Video Library of the Society of Interventional Radiology (SIR)https://www.youtube.com/c/SocietyofInterventionalRadiology --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes.► https://www.backtable.com/app
How do you build a pipeline for passionate, well-prepared interventional radiologists from day one of med school? In this episode of the BackTable Podcast, Dr. Aaron Rohr, interventional radiologist and associate professor at the University of Kansas, joins guest host Dr. Jessica Yoon to discuss how IR is accessed, taught, and experienced by medical students throughout their early education. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:49 - Finding IR: Then and Now06:54 - Challenges of Teaching IR in Core10:07 - How IR Thinks Through Problems14:40 - MAVIRIC Symposium20:09 - Engaging Teaching Models27:26 - Increasing Clinical Presence of IR30:17 - Leadership in Educational Initiatives35:57 - Reflections and Advice for Educators39:15 - Final Thoughts and Closing Remarks --- More about this episode The physicians explore ways in which the transition from traditional fellowship models to integrated IR training pathways has increased the specialty's visibility for early learners while also pointing out obstacles that continue to hinder greater integration of IR into the core medical curriculum. They discuss how IR's involvement in diverse systems and disease processes offers valuable opportunities for comprehensive clinical learning, but simultaneously makes the specialty challenging for students with structured rotations to engage within a longitudinal fashion. Dr. Rohr goes on to highlight the Mid-America Vascular and Interventional Radiology Initiative Collegium (MAVIRIC), a student-led, faculty-supervised program hosted by KUMC that aims to introduce medical students to clinical, technical, and industry-related aspects of IR. He reflects on the effectiveness of hands-on interaction with devices and physicians' demonstration of passion for their practice in piquing student interest. While acknowledging the burden of labor beyond work hours that such initiatives often demand of doctors and students alike, the physicians express their optimism for the growth of IR's presence both in the hospital ecosystem and in the medical curriculum. --- Resources MAVIRIChttps://www.maviric.org/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Pulmonary AVM may be rare, but missing them can lead to lifelong complications, especially in patients with hereditary hemorrhagic telangiectasia (HHT). How do you choose the right device and strategy to ensure long-term success with embolization? In this episode of the BackTable Podcast, host Dr. Kavi Krishnasamy is joined by Dr. Brian Funaki and Dr. Nima Kokabi to unpack the evolving treatment landscape for pulmonary arteriovenous malformations (PAVM). Through imaging breakdown, review of challenging real-world cases, and a discussion on advanced treatment strategies, the conversation tackles a key debate in pulmonary embolization: are plugs replacing coils as the new standard? --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Okamihttps://okamimedical.com/ --- Timestamps 00:00 - Introduction01:43 - Defining HHT and PAVM05:53 - Democratizing Interventions for HHT Patients08:83 - Recommendations to Embolize PAVM13:19 - Imaging Specificity and Procedural Preferences23:29 - Persistence Rates with Plugs and Coils25:59 - Lag in Utilization of Plugs29:18 - Comparison of LOBO to Alternative Vascular Plugs34:26 - Post Embolization Symptoms and Troubleshooting Methods39:04 - PAVM Cases and Treatments54:26 - Wrap Up and Credits --- More about this episode The discussion begins by defining HHT and PAVM, highlighting the risks associated with untreated PAVM and the critical need for genetic screening and multi-organ evaluation. Drs. Funaki and Kokabi review current treatment recommendations, surveillance imaging, and follow-up protocols, with special considerations for pediatric and high-risk patients. They explore practical tips for optimizing embolization performance, focusing on device selection and the evolving role of vascular plugs. By comparing different plug designs, such as wire count and pore size, and sharing lessons from challenging cases, including persistent lesions, tortuous anatomy, and pseudoaneurysm management, they provide advanced troubleshooting and decision-making strategies to achieve more durable, successful PAVM treatments. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Keeping patients on PARP inhibitors long enough to see real benefit often comes down to proactive side effect management. In this episode of BackTable Urology, Dr. Neeraj Agarwal and Dr. Arun Azad join host Dr. Alan Tan to discuss practical, evidence-based strategies for managing hematologic and GI toxicities in advanced prostate cancer patients receiving PARP inhibitors. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Pfizer. --- Timestamps 00:00 - Introduction06:17 - Managing Anemia11:12 - Side Effect Profiles19:33 - Transfusions vs ESAs26:43 - Docetaxel vs PARP Inhibitors30:27 - Side Effect Management Pearls40:18 - Team Based Monitoring52:27 - Tissue Versus Liquid01:01:24 - Genetic Counseling Workflow01:07:07 - Trial Equity and Access --- More about this episode The doctors discuss the importance of close anemia monitoring during the critical first 3 to 4 months of therapy, maintaining dose intensity, proactive antiemetic use, and the role of exercise and resistance training in combating fatigue. The conversation also covers differences in toxicity profiles between PARP agents, the value of multidisciplinary care teams, molecular advances in molecular and germline testing, and the evolving landscape of emerging therapies in prostate care. --- Resources Talazoparib plus enzalutamide in men with metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00684-1/abstract BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with metastatic castration-resistant prostate cancer (mCRPC) bearing homologous recombination-repair mutations (HRRm).https://ascopubs.org/doi/10.1200/JCO.2024.42.4_suppl.19 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Pediatric thyroid nodules are rare, but their risk of malignancy is significantly higher than in adults, raising the stakes for accurate diagnosis and multidisciplinary management. In this episode of the BackTable ENT Podcast Dr. Gopi Shah and co-host Dr. Jeff Hyzer interview Dr. Wen Jiang, pediatric otolaryngologist at Rady Children's Hospital in San Diego, for an in-depth discussion on the evaluation and management of thyroid nodules in children. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:27 - Thyroid Nodule Risks and Care Team 06:47 - Age-related Differences in Nodule Presentation and Outcomes08:50 - Initial workup 13:42 - Ultrasound Interpretation16:07 - Lymph Node Mapping and CT19:58 - Incidental Findings24:14 - Role of FNA, Molecular Testing, and Radiofrequency Ablation32:40 - Molecular Testing Results and Counseling 38:04 - Neck Dissection Strategy40:44 - Hypocalcemia Protocol Considerations44:01 - Parathyroid and Recurrent Laryngeal Nerve Dissection Tips 47:33 - Postop Care and Follow-up 51:25 - Using Radioactive Iodine and Targeted Therapy 54:55 - AI's and Ultrasound and Final Thoughts --- More about this episode Dr. Jiang highlights the key differences between pediatric and adult thyroid nodules. She describes her multidisciplinary approach including collaboration with radiology, pathology, endocrinology and nuclear medicine. The discussion reviews the initial workup for pediatric thyroid nodules and why ultrasound remains the primary diagnostic tool. She also discusses situations where CT with contrast can be helpful for surgical planning. This episode explores the growing role of reflex molecular testing in guiding management decisions and outlines the impacts of molecular testing results. Dr. Jiang shares her approach to patient counseling along with management of calcium and PTH after surgery. The conversation concludes with emerging applications of molecular diagnostics and AI models for improving thyroid ultrasound interpretation. --- Resources Dr. Jiang's Research on Pediatric Thyroid Nodule Management - https://pubmed.ncbi.nlm.nih.gov/26770219/ Bethesda System for Thyroid Cytopathology - https://pmc.ncbi.nlm.nih.gov/articles/PMC7182964/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
"The treatment of cervical cancer is definitely a team sport." Hear how recent radiation advancements are impacting gynecologic cancer care, and how to partner with your radiation oncologist to tailor therapy. This BackTable Women's Health / Tumor Board episode features hosts Dr. Mona Guo and Dr. Marcia Ciccone joined by USC radiation oncologist and brachytherapy director Dr. Andrew Lim discussing modern radiation techniques, indications for definitive/adjuvant therapy, and toxicity management in gynecologic cancers. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:39 - Modern External Beam IMRT05:47 - Planning With CT And AI08:14 - Daily Setup Imaging Workflow13:30 - Dose and Fractionation Basics18:50 - HDR Image Guided Brachy21:50 - Brachy Vs External Boost Evidence24:54 - Managing Side Effects and Menopause28:49 - Hormone Therapy Benefits30:37 - Dilators and Pelvic Rehab33:12 - Long Term Radiation Effects38:14 - Spacers and Prolapse Planning41:42 - Reirradiation and Plan Review44:05 - Palliative Radiation Choices46:50 - Gamma Knife Explained50:16 - Conclusion --- More about this episode Dr. Lim contrasts historical four-field box radiation with contemporary IMRT, CT-based planning, daily cone-beam verification, and AI-assisted contouring with dosimetrist support. They review pelvic radiation treatment timelines, emerging hypofractionation data, and the essential role of image-guided brachytherapy for cervical cancer, including outpatient workflows and improved tumor coverage with reduced bladder/rectum dose. The group covers patient counseling on expected side effects, radiation-induced menopause, fertility, sexual health, vaginal stenosis prevention with dilators/pelvic floor therapy, late effects, re-irradiation considerations, spacers, palliative regimens, and stereotactic radiosurgery/Gamma Knife for brain metastases. --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
It's comeback season! What's bringing lateral extra-articular tenodesis (LET) back to the landscape of ACL surgery? In this episode of BackTable Bone & Sports, Dr. Larry Balle joins sports orthopedic surgeon and knee specialist Dr. Kyle Borque to discuss the resurgence of lateral extra-articular tenodesis (LET) as an adjunct to ACL repair and reconstruction. They explore LET's origins as a solution for rotation instability in the era of open ACL surgery, and examine how modern arthroscopic techniques, patient selection, and surgical evidence have driven LET's renewed relevance in today's practice. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:36 - LET Origin Story14:16 - Modern LET Technique Updates23:13 - A Run-Down of the Procedure in the OR26:54 - Patient Selection for LET34:18 - Supporting LET with Published Evidence38:43 - Rehab After LET44:33 - Dismissing OA Concerns50:10 - Case Example: ACL Revision53:02 - Wrap Up --- More about this episode The Drs. highlight the anatomy considerations, technical modifications, and the evidence that supports LET's role in reducing graft failure, without changing rehab or increasing lateral OA risk. They compare LET with anterolateral ligament (ALL) reconstruction, emphasizing anatomy and technical approach. Dr. Borque details his modified technique using an iliotibial (IT) band strip fixed proximal and posterior to the lateral epicondyle of the femur. Furthermore, the doctors discuss selection factors for high-risk and revision patients, tactics to avoid overconstraint, and tips for patient counseling. They review the latest evidence, outline perioperative protocols, and address persistent myths about LET's impact on recovery and osteoarthritis. The doctors highlight a real-world case example and the actionable insights for orthopedic surgeons to optimize ACL outcomes. --- Resources Dr. Larry Ballehttps://www.linkedin.com/in/larry-balle-ii/ Dr. Kyle Borquehttps://www.drborque.com/ Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/31940222/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Why are some GJ tubes more prone to failure, and what can you actually do about it? In this episode of the BackTable Podcast, Dr. Chris Beck hosts Dr. Kevin Wong, a pediatric interventional radiologist at the University of South Alabama, to discuss the complexities of gastrojejunostomy (GJ) tube management in hospital-based IR, especially in pediatric patients. The discussion offers clinically relevant guidance on troubleshooting, device selection, and multidisciplinary approaches to enhance GJ tube care and improve patient outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:40 - Etiologies of GJ Tube Dislodgement and Placement Considerations 12:17 - Spiral Upsizing Solutions14:30 - Parent Education Playbook19:34 - Indications for GJ Conversion21:55 - Criteria for GJ Removal24:12 - Preferred Low-Profile Tube Designs27:15 - Addressing Suboptimal Angles and Guidewire Selection31:26 - Strategies to Prevent Tube Occlusion33:34 - Wish List for Industry 36:12 - Balloon Assisted Placement Techniques37:58 - Wrap Up and Credits --- More about this episode The doctors explore why GJ tubes fail and how to manage common complications, such as balloon failures, vomiting-induced dislodgement, stoma enlargement, and recurrent malfunction due to poor gastrostomy angle or architecture, often seen with surgically placed G-tubes. Dr. Wong shares prevention strategies, including parent education on balloon-volume checks and refills, sending patients home with a backup G-tube, minimizing upsizing, and addressing traction and granulation tissue (including the use of silver nitrate). He also covers approaches to clog management such as warm water, Coke, aggressive flushing, and avoiding routing medications through the G port. The episode wraps up with a discussion on device preferences (AMT G-JET versus MIC-KEY), tips for wire and catheter exchanges, and the need for industry improvements in materials and lumen design. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
A high-functioning HCC tumor board can turn complex transplant decisions into coordinated treatment plans that account for liver reserve, tumor biology, and evolving biomarkers. In this episode of the BackTable Podcast 2026 HCC Creator Weekend™, abdominal transplant surgeon Dr. Ari Cohen (Ochsner Health) and transplant hepatologist Dr. Neil Mehta (UCSF) join host Dr. Kavi Krishnasamy to map out strategies for effective multidisciplinary treatment and transplantation planning in HCC. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction00:51 - Starting a Tumor Board06:39 - Building Referral Streams09:03 - Academic and Community Practice Integration14:31 - Treatment Selection Criteria20:38 - Modern HCC Biomarkers25:24 - Role of ctDNA and Biopsy29:37 - Bridging Therapy on Transplant Waitlist32:34 - Downstaging Strategy and Risks39:25 - Final Thoughts and Closing Remarks --- More about this episode The physicians discuss what it takes to build a robust tumor board, from fostering hospital buy-in to engaging leaders across specialties and utilizing virtual formats for consistent participation. The conversation explores clinical decision-making, emphasizing the integration of AFP-L3 and DCP biomarkers alongside AFP to better understand tumor biology and predict post-transplant recurrence. Dr. Mehta and Dr. Cohen also share their patient selection criteria, discussing how bilirubin, liver disease etiology, and INR influence decisions. While radiographic guidance remains central to HCC management, they highlight the growing potential of reliable ctDNA analysis and other biomarkers. The specialists conclude by emphasizing that an integrated, communicative tumor board is the most effective way to navigate the nuances of liver reserve and HCC biology to achieve the best possible patient outcomes. --- Resources Sustained AFP-L3 or DCP expression is associated with progression risk and inferior outcomes in unresectable hepatocellular carcinoma.https://doi.org/10.1007/s10238-025-01877-8 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Male factor infertility accounts for nearly half of all infertility cases, yet male evaluation is often delayed or overlooked. In this episode of BackTable Urology, Dr. Robert Brannigan joins guest host Dr. Catherine Nam to unpack the 2024 AUA/ASRM Male Infertility Guideline update and discuss how the field is evolving beyond basic semen analysis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:12 - Rationale Behind the Updates09:37 - Concurrent Couple Evaluation15:01 - Diagnosis, Assessment and Evaluation20:33 - Y Chromosome Microdeletion Testing23:54 - Workup for Recurrent Pregnancy Loss33:57 - Pelvic MRI for EDO36:46 - MicroTESE40:15 - Future Research Directions44:09 - Closing Takeaways --- More about this episode They review updated definitions of infertility, challenges with WHO semen reference ranges, and the need for comprehensive male assessment. The discussion also covers sperm DNA fragmentation, recurrent pregnancy loss, the role of pelvic MRI for ejaculatory duct obstruction, micro-TESE for nonobstructive azoospermia, and the latest directions in male infertility research. --- Resources Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data:https://pubmed.ncbi.nlm.nih.gov/26674559/ Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guidelinehttps://www.auanet.org/guidelines-and-quality/guidelines/male-infertility Sixth edition of the World Health Organization laboratory manual of semen analysis: Updates and essential take away for busy clinicianshttps://pmc.ncbi.nlm.nih.gov/articles/PMC10929669/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
From clinic to the OR, storytelling quietly shapes every decision in clinical care. This episode of BackTable ENT & Allergy examines how narrative medicine and the stories at the heart of each patient encounter can elevate your clinical practice, enhance empathy, and deepen the doctor-patient relationship. Pediatric ENT Dr. Gopi Shah interviews Dr. Alessandra (Alessa) Colaianni, a head and neck surgical oncologist at the University of North Carolina, about the power and relevance of narrative medicine in modern surgical care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:53 - What is Narrative Medicine? 11:36 - Narrative Medicine in Clinic 17:28 - Narrative Medicine in the OR21:09 - Patient Case Presentation and Boundaries 25:05 - Writing For Reflection and the impact of AI 29:35 - Resources And Podcasts33:19 - Final Takeaways --- More about this episode Dr. Colaianni is a published writer whose work has been featured in the New York Times, New Yorker, and the New England Journal of Medicine. She describes her lifelong interest in writing and shares how earning a master's degree in the history and philosophy of science at the University of Cambridge during medical school helped her reconnect with the humanistic side of medicine. She reframes narrative medicine not as an extra task, but as an approach already woven into daily clinical work through history-taking, listening, and documentation. The conversation explores the influence of patient identity, socioeconomic context, and the “characters” in each patient's story on clinical decisions and care. Dr. Colaianni reflects on the role of storytelling in surgical training, the apprenticeship model, and how thoughtful boundaries can foster meaningful doctor-patient relationships. The episode concludes with a discussion of AI's potential impact on empathy and recommended reading for further exploration of narrative medicine. --- Resources Dr.Colaianni's published work https://www.alessandracolaianni.com Columbia University Division of Narrative Medicine https://www.mhe.cuimc.columbia.edu/division-narrative-medicine Columbia University Narrative Medicine Youtube channel https://www.youtube.com/@columbiauniversitynarrativ8472 The Nocturnists podcast https://thenocturnists.org/podcast Autobiography of a Face by Lucy Grealey https://www.amazon.com/Autobiography-Face-Lucy-Grealy The Empathy Exams by Leslie Jameson https://www.graywolfpress.org/books/empathy-exams The Collected Schizophrenias Essays by Esmé Weijun Wanghttps://www.graywolfpress.org/books/collected-schizophrenias My Own Country: A Doctor's Story by Abraham Verghese https://www.amazon.com/My-Own-Country-Doctors-Story --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
What happens when maternity care deserts stop being just a “rural problem” and start impacting your own labor and delivery unit? On this episode of BackTable Women's Health, host Dr. Nicole Faulkner interviews Dr. Yamicia Connor about the evolving “birth worker crisis.” Dr. Connor reframes the issue as a long-standing structural collapse accelerated by deliberate policy decisions, not simply sudden burnout. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:30 - Structural Collapse Explained05:41 - What Providers Can Do09:40 - Data On Care Deserts14:24 - COVID Like System Failure19:50 - Limits Of Telehealth20:57 - Think Systemwide Care23:52 - Insurance Access Shifts25:04 - Support Midlevel Workforce27:06 - Build Future Infrastructure29:39 - Burnout Is System Failure31:02 - Defunding Surveillance Risks32:51 - Stop Calling It Burnout34:35 - Conclusion --- More about this episode Dr. Connor describes how the systematic decoupling of clinical science from federal and state infrastructure has shifted legal and operational risk onto individual physicians, leading to illogical practice patterns and confusion about the standard of care, especially in settings like emergency departments. A review of the 2024 March of Dimes data showing over 35% of U.S. counties are now maternity care deserts, and JAMA-tracked data in states like Idaho, where nearly a third of OBs left between 2022 and 2024. She warns that as more rural units close, regional and academic hospitals will absorb sicker and less managed patients, straining L&D units, NICUs, staffing, and training pipelines. To address this crisis, Dr. Connor calls for system-level coordination, stronger leadership from professional societies, improved care navigation, expanded mid-level support, and enhanced telehealth infrastructure to extend obstetric expertise. --- Resources Maternity Care Deserts Across the US https://www.marchofdimes.org/maternity-care-deserts-report Change in Number of OB/GYN Physicians Practicing Obstetrics After the Dobbs Decision https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2837058 --- BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
“The athlete's job is to stay consistent with rehab and to be hungry to get back on the field. I think our job as a sports medicine team is to make sure that they're safe and that they can perform.” In this episode of BackTable MSK, guest host and sports medicine physician Dr. Larry Balle joins physical therapist/athletic trainer Andy Glidewell to discuss how “return to play” is defined and why it is often misunderstood among athletes, coaches, physicians, and rehab teams. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:25 - Return to Play from the Lens of Physical Therapy vs. Sports Medicine12:11 - Evidence-based vs. Anecdotal-based Practice for Return to Play21:18 - Is there an Appropriate Team Approach? 24:25 - Continuing Conservative Management vs. Surgical Intervention34:01 - Notes on a High-Profile Sports Medicine Case40:20 - The Influence of NIL on College Athletics42:51 - Obtaining Objective Metrics for Clearance52:38 - Influence of AI on Return to Play Algorithms 57:11 - Final Takeaways --- More about this episode They emphasize that return to play is a milestone-based rehabilitation phase requiring clear communication, collaboration, and risk management, rather than rigid timelines or just “vibes.” The conversation covers how evidence and objectivity have shaped protocols (notably ACL timelines), the role of prognostic indicators in operative vs. non-operative decisions, and practical use of functional strength and agility reassessment. They also address pressures of working with elite sport and NIL (Name, Image, Likeness) considerations. Furthermore, they expand on how AI may inform, but not replace, the humanistic and team-based components of decision making. --- Resources Dr. Larry Ballehttps://www.linkedin.com/in/larry-balle-ii/ Dr. Andy Glidewellhttps://uamshealth.com/provider/michael-a-glidewell/ The Journal of Orthopedic and Sports Physical Therapyhttps://www.jospt.org/ --- BackTable Musculoskeletal (MSK) is the go-to podcast for musculoskeletal radiologists, interventional pain specialists, and orthopedic surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Can arterial closure devices transform your OBL workflow and get patients moving sooner? In this episode of the BackTable Podcast, Dr. Mike Barraza sits down with Interventional Radiologist Dr. Dave Johnson to discuss the ins and outs of launching and running an office-based lab (OBL) in Florida. While covering startup logistics, staffing, regulatory requirements, and cost-saving strategies, the conversation centers on how the use of arterial closure devices can streamline workflow, speed post-procedure recovery, and enhance both efficiency and patient care in the OBL setting. --- Get the BackTable apphttps://www.backtable.com/app --- Terumohttps://www.terumo.com/ --- Timestamps 00:00 - Introduction01:31- Launching The OBL04:41- Logistics And Staffing07:14 - Standardizing Supplies11:57 - OBL vs. Hospital Cases15:30 - Patient Experience Benefits17:41 - Efficiency And Throughput20:49 - Closure Devices For Flow23:28 - Early Ambulation With AngioSeal26:14 - Anticoagulation Decisions28:31 - AngioSeal Access Technique30:20 - Avoiding Hostile CFA Access32:19 - Choosing SFA or Radial34:04 - Do You Need Groin Runs36:14 - Closure Device Fundamentals38:53 - Ultrasound Guided AngioSeal45:11 - Post Op Monitoring Checklist --- More about this episode Dr. Johnson explains that some procedures, such as Prostate Artery Embolization (PAE), may still require a hospital setting due to insurance coverage, patient preference, or unique clinical needs. He compares patient experiences in OBLs versus hospitals, emphasizing the advantages of privacy, convenience, and personalized communication in the OBL environment. A major challenge discussed is managing post-procedure recovery and patient throughput with limited holding beds, where femoral arterial closure devices like Angio-Seal are essential for early ambulation and efficient turnover. The discussion highlights best practices for access site selection, ultrasound guidance, and post-closure assessment, providing actionable insights for IR physicians aiming to optimize office-based procedures. --- Resources Cost Comparison of Prostatic Artery Embolization Between In-Hospital and Outpatient-Based Lab Settingshttps://pubmed.ncbi.nlm.nih.gov/39310461/ Prostate Artery Embolization: Indication, Technique and Clinical Resultshttps://pubmed.ncbi.nlm.nih.gov/29975976/ Ultrasound-guided angio-seal deploymenthttps://pubmed.ncbi.nlm.nih.gov/25735527/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
With recent updates to the Barcelona Clinic Liver Classification (BCLC), how should multidisciplinary teams adapt their treatment strategies to accommodate the newest evidence? In this episode of the BackTable Podcast 2026 HCC Creator Weekend™, Dr. Neil Mehta of UCSF and Dr. Riad Salem of Northwestern Medicine join host Dr. Tyler Sandow to explore the complexities of hepatocellular carcinoma (HCC) therapies and the practical application of the latest global algorithms in balancing standardized therapeutic algorithms with individual patient factors. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:54 - HCC Case Discussion08:05 - Guest Introductions10:37 - BCLC Committee and 2025 Update15:54 - CUSE and Tumor Board Goals17:46 - Bridging vs Curative Y9022:37 - Patient Factors in Treatment Algorithms26:41 - Liver Function and Hyperbilirubinemia Trends30:25 - HCC Treatment Decision Ownership34:36 - Radiation Segmentectomy vs Surgical Resection37:35 - BCLC B Heterogeneity41:51 - Improving HCC Risk Stratification43:48 - Final Thoughts and Closing Remarks --- More about this episode The discussion begins with an inside look at the consensus process behind the 2025 BCLC updates, highlighting the official inclusion of Y90 radioembolization as a recognized therapeutic option. The experts introduce the "CUSE" (Complexity, Uncertainty, Subjectivity, and Emotion) framework to provide a structured approach to the subjective considerations that modulate purely data-based algorithms in multidisciplinary decision-making. Dr. Salem and Dr. Mehta speak on the nuances of surgical resection versus radiation segmentectomy in a case-based discussion, highlighting how factors such as portal hypertension, patient age, and etiology of cirrhosis should influence treatment pathways. Finally, they underscore the paradigm shift toward pursuing complete pathonecrosis (CPN) as a primary curative goal, regardless of bridging status, and reiterate that success in HCC care is driven by continuous communication and collaboration between physicians and patients. --- Resources BCLC 2026 Updatehttps://doi.org/10.1016/j.jhep.2025.10.020 ---BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Are biomarkers the missing link in personalized prostate cancer care? What is the practical role of biomarkers across the prostate cancer treatment continuum? In this episode of BackTable Urology, Dr. Udit Singhal (University of Michigan) joins Dr. Ruchika Talwar (Vanderbilt University) to explore the evolving role of genomic classifiers and biomarkers in prostate cancer care. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byVeracytehttps://www.veracyte.com/decipher-prostate --- Timestamps 00:00 - Introduction04:58 - Current State10:07 - Interpreting High Risk Scores13:25 - Intermediate Risk Decisions16:18 - Imaging vs. Genomics18:26 - Advanced Disease Evidence22:02 - AI and Clinical Trials29:52 - Conclusions --- More about this episode They review commonly used assays, including Prolaris, Oncotype Dx, Decipher, and ConfirmMDx and emphasize how these tools complement traditional clinical and pathologic risk factors. The discussion highlights practical applications across the disease continuum from initial diagnosis and active surveillance to intermediate-risk management and post-prostatectomy salvage decisions. They also explore emerging AI-driven tools and ongoing trials, highlighting the importance of contextualizing biomarker data within the broader clinical picture and using it to inform, rather than dictate, patient-centered care. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
From the clinic to the camera, discover how an allergist turned social media into a patient education powerhouse. On this week's episode of the BackTable ENT & Allergy Podcast, allergist Dr. Zachary Rubin of Oak Brook Allergists joins host Dr. Basil Kahwash to discuss his path from fellowship training to becoming a widely followed social media educator and author of the New York Times bestselling book “All About Allergies”. He explains how the COVID-19 pandemic and the rapid spread of online medical misinformation inspired him to educate the public through social media, developing an authentic on-camera style and consistent brand that has expanded his reach far beyond the clinic. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:21 - Learning the Creator Playbook10:10 - Authenticity and Creating a Personal Brand16:51 - Writing for Patients and Clinicians20:41 - Balancing Clinic and Content Creation26:15 - How to Start Your Public Voice29:11 - Professional Boundaries and Handling Criticism Online36:34 - How Patients Following Your Content Impacts the Clinic43:08 - The Unexpected Doors Content Creation Can Open48:44 - Future of Public Health53:09 - Final Advice --- More about this episode The conversation explores strategies for communicating complex medical topics, such as using metaphors to improve public understanding, and the importance of professionalism, boundaries, and safety in the online space. Dr. Rubin offers advice on avoiding individualized medical advice, managing online harassment, and navigating the nonfiction publishing world. He also discusses the impact of advocacy and media engagement for both patients and healthcare professionals, showing how physicians can leverage media to make a difference well beyond their practice. --- Resources Dr. Zachary Rubinhttps://www.oakbrookallergists.com/our-team/zachary-e-rubin-md/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
From surgery to systems to access, medicine is shaped as much by barriers to care as it is by innovation and the latest techniques. In this episode of BackTable OBGYN, Dr. Kimberly Kho, a complex benign gynecologic surgeon, joins host Dr. Amy Park to discuss her work expanding access to women's healthcare, including building a surgical program in Hawaii, studying childcare as a barrier to care, and exploring the diagnosis and management of adenomyosis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction08:35 - Faculty Development in Hawaii12:26 - Childcare as Access Barrier16:20 - Survey and Trial Findings18:10 - Annie's Place Childcare Center24:23 - Childcare Barrier Example25:43 - Applying Community Solutions 27:04 - What Is Adenomyosis30:22 - Diagnosis Strategies Beyond Hysterectomy34:07 - Risk Factors and Age Myths36:03 - Fertility and Pregnancy Risks38:02 - Medical and Surgical Treatments41:20 - Uterine Sparing Procedures45:59 - Closing Thoughts --- More about this episode Dr. Kho discusses her recent transition to the University of Hawaii, where she is building a complex benign gynecology program to serve patients across the state and broader Pacific region. Her work emphasizes faculty development through mentorship, strengthening research infrastructure for generalists, fostering inter-island collaboration, and implementing surgical coaching. She then reflects on her time at Parkland, where she expanded access to minimally invasive gynecologic surgery, demonstrated by a significant reduction in open hysterectomy rates. She also shares how her team identified unmet childcare needs as a major barrier to care, leading to multiple research initiatives, a clinical trial, and ultimately the creation of a five-year, no-cost, onsite childcare center (Annie's Place) developed through hospital and community partnerships. The episode concludes with an in-depth discussion of adenomyosis, covering its pathophysiology, imaging-based diagnosis, common symptoms, and fertility implications. In the absence of formal guidelines or FDA-approved therapies, Dr. Kho reviews current management strategies, including medical therapy, uterine artery embolization (UAE), and endometrial ablation techniques. --- Resources Childcare needs as a barrier to healthcare among women in a safety-net health systemhttps://pubmed.ncbi.nlm.nih.gov/38886715/ Addressing childcare as a barrier to healthcare access through community partnerships in a large public health systemhttps://pubmed.ncbi.nlm.nih.gov/36261213/ Adenomyosis Pathophysiology, Diagnostic Advances, and Therapeutic Optionshttps://pubmed.ncbi.nlm.nih.gov/41926770/ --- BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health.Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
When a liver tumor is hard to see, the limits of conventional image guidance can become the limits of treatment. In this episode of the BackTable Podcast, Netherlands interventional oncologist Dr. Maarten (M.L.J.) Smits shares a step-by-step walkthrough of the new hepatic arteriography and C-arm CT–guided ablation (HepACAGA) technique, punctuated with a real-world case series at the end. Find out how intra-arterial contrast, cone-beam CT, and 3D needle guidance can improve tumor conspicuity, targeting accuracy, and ablation margin assessment within a single angiography suite. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:55 - Netherlands Tech Access04:31 - Origin of HepACAGA07:14 - Why Use a Catheter?11:24 - Tools and Setup13:13 - Catheters and Devices17:06 - Contrast Protocol Basics22:51 - Targeting and Needle Guidance31:09 - Patient Selection35:56 - Extra Benefits and Multimodal39:58 - Workflow and Outcomes46:14 - Evidence and Early Studies51:41 - Rethinking Size Cutoffs57:54 - HCC Case Walkthrough01:02:27 - Hard-to-See Metastasis01:06:22 - Margin Driven Reablation01:11:04 - Bleeding and Embolization01:16:05 - Renal ACAGA Expansion01:23:31 - Adoption and Next Steps --- More about this episode Dr. Smits explains the origins of HepACAGA and why catheter-based contrast delivery can meaningfully change ablation planning, particularly for small lesions, poorly visualized tumors, and cases where ultrasound or conventional CT guidance may be insufficient. He walks through the practical setup, including catheter positioning, contrast dilution, timing protocols, needle navigation, apnea/end-expiration technique, and built-in fusion for immediate ablation verification. He also describes how the angio suite environment supports multimodal treatment, including intraprocedural embolization when bleeding occurs or when additional transarterial therapy is needed. The episode also examines early outcomes from Dr. Smits' group, including a reported reduction in local recurrence from approximately 25% to 5%, with a modest increase in procedure time. Case examples include HCC, small colorectal liver metastases, margin-driven re-ablation, hemorrhage management, and extension of the ACAGA concept to renal tumors (RenACAGA). --- Resources Hepatic Arteriography and C-Arm CT-Guided Ablation (HepACAGA) to Improve Tumor Visualization, Navigation and Margin Confirmation in Percutaneous Liver Tumor Ablationhttps://pubmed.ncbi.nlm.nih.gov/37704863/ Renal Arteriography and C-arm CT-Guided Ablation (RenACAGA) for Thermal Ablation of Challenging Renal Tumorshttps://pubmed.ncbi.nlm.nih.gov/40295401/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
When Renal Cell Carcinoma (RCC) invades the veins, the stakes and the surgical challenges rise. Are you prepared? In this episode, Dr. Vidit Sharma (Mayo Clinic) joins guest host Dr. Daniel Roberson to review Renal Cell Carcinoma (RCC) with Venous Tumor Thrombus (VTT), seen in 4 to 10% of cases. They review Mayo level classification and how CT and MRI venography guide surgical planning by defining thrombus extent and IVC involvement. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:03 - What is a Venous Tumor Thrombus?12:32 - Presentation and Workup31:49 - Preoperative Considerations40:26 - Building the Dream Team46:06 - Preop Counseling and Risks51:24 - The Operation01:31:01 - Outcomes and Adjuvant Immunotherapy01:36:40 - Future Neoadjuvant Shrinkage01:39:40 - Final Takeaways --- More about this episode They also cover key management decisions, including when anticoagulation is appropriate and why embolic urgency is often overestimated. Dr. Sharma highlights the importance of experienced multidisciplinary teams, reviews surgical considerations across thrombus levels, and discusses outcomes, including risk stratification with the TeNNiS model and evolving roles for systemic therapy. --- Resources Outcomes for patients with renal tumors and venous tumor thrombushttps://www.mayoclinic.org/medical-professionals/urology/news/outcomes-for-patients-with-renal-tumors-and-venous-tumor-thrombus/mac-20570379 TeNNiS Scorehttps://www.goldjournal.net/article/S0090-4295(26)00078-6/fulltext --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Imaging, incisions, and Instagram: Dr. Ramirez on the cutting edge of endometriosis management. In this episode of BackTable OBGYN, host Dr. Mark Hoffman interviews Atlanta-based Complex Benign Gynecology (CBG/MIGS) surgeon Dr. Laura Ramirez about how her practice has shifted toward predominantly endometriosis care, driven in part by social media referrals bringing patients nationwide. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:57 - Introduction02:22 - Mentorship Mission and Career Focus06:13 - Social Media Referrals08:10 - What Is Endo Surgery and Targeted Excision13:27 - Multidisciplinary Care16:53 - Lesions and Adhesions Approach 22:20 - Imaging and Case Triage24:07 - Hysterectomy Expectations27:28 - Going Solo on Bowel Endo31:25 - Team Support and Mentors34:27- Residency Training Gaps40:39 - Call for Help Culture43:07 - Challenging Surgeries 48:10 - Noninvasive Tests and Therapy Limits51:26 - Conclusion --- More about this episode Dr. Ramirez discusses why endometriosis surgery varies by patient, pathology, and surgeon experience. She emphasizes careful symptom-based assessment, recognizing atypical lesions, and setting realistic expectations. The conversation contrasts radical peritoneal stripping with her preference for targeted excision to reduce complications, highlights multidisciplinary management for central sensitization and overlapping bowel/bladder symptoms, and covers imaging triage, robotic vs. laparoscopic approaches, collaborating with colorectal specialists, and diaphragmatic endometriosis as an ongoing surgical challenge. --- BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health.Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Vascular trauma care looks a lot different when the OR is improvised, supplies are limited, and limb salvage decisions cannot wait. On this episode of the BackTable Podcast, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Ahmad Hussain, a Southern California private-practice “hired gun” who volunteered on a WHO/UN-coordinated humanitarian mission to Gaza after an orthopedic colleague requested vascular surgeons due to widespread limb loss. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:02 - Why Volunteer In Gaza?07:41 - Logistics and Crossing Into Gaza10:45 - Hospital as Refugee Camp13:34 - First Vascular Trauma Case18:24 - Mass Casualty Triage23:20 - Kids Guiding Doctors27:09 - Evacuation Uncertainty32:03 - Would You Go Back?37:55 - How to Volunteer39:30 - Show Wrap Up and Credits --- More about this episode Dr. Hussain describes entering through the Rafah border with suitcases of medical supplies, working in a hospital functioning as a refugee camp for tens of thousands, and treating shrapnel-related vascular trauma with limited imaging (mainly ultrasound and X-ray), scarce anesthesia, and minimal surgical resources, relying heavily on skilled local medical students and residents. He recounts mass-casualty triage, the emotional impact of caring for injured children, bonding with the children who assisted the volunteers, and the dangerous, militarized evacuation via Israel with U.S. embassy assistance. He says he wants to return, but notes tightened restrictions and dwindling aid, and he recommends other organizations, noting any specialty of medical professionals should consider volunteering. --- Resources Gift of Disability Alleviation (GODA)https://indushospital.ca/appeal/gift-of-disability-alleviation-goda/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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