Podcasts about catheters

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Hani Shennib, a Clinical Professor of Vascular and Cardiothoracic Surgery at the University of Arizona College of Medicine, Phoenix, USA, about catheters as a language. Chapters 00:00 Intro 02:48 UK Thoracic Forum 06:11 JANS 1, Detecting AF Using Watch 07:44 JANS 2, End-to-End Anastomotic Stapler 09:24 JANS 3, Improving Patient Selection NSCLC 12:05 JANS 4, 5-Year Women Outcomes TAVR vs SAVR 13:30 Video 1, MVR Tips & Tricks 14:43 Video 2, Ruptured SVA w Hemi-Yacoub Remodeling 16:32 Video 3, Modified Inclusion, Autograft in a Vest 18:04 Dr. Shennib, Catheters as a Language 48:25 Upcoming Events 48:52 Career Center They explore the importance of making catheters a language by learning, speaking, and practicing it daily. They also discuss how cardiac surgeons have lost the role of “gatekeepers,” with cardiologists now controlling more of the decision-making process. Dr. Shennib emphasizes the need for surgeons to be involved in decision-making from diagnosis to treatment and highlights the significance of patient-centered decision-making and the human aspect of these choices. They also compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), examining which procedure is more appropriate in different circumstances. Furthermore, they explore the reasons behind the shrinking cardiac specialty and discuss how to save it. Finally, they discuss the future of cardiac surgery.   Joel also highlights recent JANS articles on a randomized controlled trial on the enhanced detection and prompt diagnosis of atrial fibrillation using an Apple watch, the results of a human cadaver study on a novel aortic end-to-end anastomotic stapler device, improving patient selection for minimally invasive lobectomy or stereotactic ablative radiotherapy based on clinical characteristics, and a systematic review and meta-analysis on the five-year outcomes of transcatheter versus surgical aortic valve replacement in women.  In addition, Joel explores tips and tricks for mitral valve repair from a Brussels experience, treatment of ruptured sinus valsalva aneurysm with hemi-Yacoub remodeling technique, and a Ross procedure with modified inclusion technique. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Enhanced Detection and Prompt Diagnosis of Atrial Fibrillation Using Apple Watch: A Randomized Controlled Trial  2.) A Novel Aortic End-to-End Anastomotic Stapler Device—Results of a Human Cadaver Study  3.) Stage I Non-Small Cell Lung Cancer: Improving Patient Selection for Minimally Invasive Lobectomy or Stereotactic Ablative Radiotherapy Based on Clinical Characteristics  4.) Five-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Women: A Systematic Review and Meta-Analysis   CTSNet Content Mentioned  1.) Mitral Valve Repair—Tips and Tricks From Brussels Experience: 2025 London Core Review Cardiothoracic Surgery Course   2.) Treatment of Ruptured Sinus Valsalva Aneurysm With Hemi-Yacoub Remodeling Technique   3.) Ross Procedure With Modified Inclusion Technique: An Autograft in a Vest  Other Items Mentioned  1.) Instructional Video Competition   2.) Career Center   3.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

A nurse-led female external catheter trial proved hugely successful at one trust by almost eradicating incontinence-related dermatitis on two wards.In the latest episode of the Nursing Standard podcast, continence nurse Elinor Howcroft discusses what inspired her to start the trial and the positive impact it had on staff and patients.Ms Howcroft also shares tips and insights into how nurses can roll out similar innovations at their own workplace that can lead to changes in practice and policy.Follow the Nursing Standard podcast on Apple Podcasts, Spotify, Acast or wherever you get your podcasts.For more episodes of the Nursing Standard podcast, visit rcni.com/podcast Hosted on Acast. See acast.com/privacy for more information.

A nurse-led female external catheter trial proved hugely successful at one trust by almost eradicating incontinence-related dermatitis on two wards.In the latest episode of the Nursing Standard podcast, continence nurse Elinor Howcroft discusses what inspired her to start the trial and the positive impact it had on staff and patients.Ms Howcroft also shares tips and insights into how nurses can roll out similar innovations at their own workplace that can lead to changes in practice and policy.Follow the Nursing Standard podcast on Apple Podcasts, Spotify, Acast or wherever you get your podcasts.For more episodes of the Nursing Standard podcast, visit rcni.com/podcast Hosted on Acast. See acast.com/privacy for more information.

Monday - Jim wants to sell his Mustang and Jack tries Pho. We also talk about Friendsgiving, travel scams, communal dining, rock stars retiring, and sleep divorce. Brandon Kravitz on the Magic struggles, the Orlando Pride and UCF lose, parody in the NFL and Thanksgiving sides. Plus, JCS News, JCS Trivia & You Heard it Here First.

Monday - Jim wants to sell his Mustang and Jack tries Pho. We also talk about Friendsgiving, travel scams, communal dining, rock stars retiring, and sleep divorce. Brandon Kravitz on the Magic struggles, the Orlando Pride and UCF lose, parody in the NFL and Thanksgiving sides. Plus, JCS News, JCS Trivia & You Heard it Here First. See omnystudio.com/listener for privacy information.

No one is more excited than Dylan to announce the return of Santa Cinema. We begin giving away spots on the guest list but there will be plenty of chances to get in over the next month. Pepper has a very weird idea that he thinks will revolutionize road trips. Not many people think it's a smart invention. We wrap up the week with the rights and the wrongs.

(00:00-37:30) Stadium Buddies. Josh Schertz and Robby Avila in-studio at 9. Late night for Martin at the 2Fox. Tied for the longest World Series game ever. Quite the night for Shohei. Audio of Freeman's walk-off homer in the 18th. Recreational catheters. Fun Blues game last night to talk about. Short audio from Jim Montgomery. Fan took a tumble from the upper section at the Blues game last night. Matt's on the line with a question about extra innings in the post season. Is a CFP game going to be decided by a two-point conversion contest. The phone call vetting process. The Legend of Columbia is up next with a question about steak. Story time from The Legend. He's writing a book.(37:38-50:42) Jackson still has some eligibility left. It's been a while so let's check in with Pestus. Pestus has questions about the end of the year party. Soon-to-be bed mate. Pestus his regrets his Cardinal prediction and isn't happy with the Blues. The Lisa Ann/TMA backstory.(50:52-1:03:25) Brodie Hermann in-studio talking that stellar World Series game last night. Hall of Famers at the same high school. What's going on in the world of wrestling? Five hours of grapplin'. Brodie has MIzzou football takes too.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

September 5, 2025 In this episode, Scott, Mark, Ray, and special guest Dr. John Lin delve into the nuances of coding and billing for steerable vacuum-assisted catheters used in large stone removal. They clarify the differences between DISS (Direct In-Scope Suction) and FANS (Flexible and Navigable Sheaths), explain the use of HCPCS code C9761, and discuss what it means for facilities, surgery centers, and urologists.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

In this episode, Brett, Phil and Martin discuss a recent paper from Freya Bull and colleagues, who undertook a modelling exercise to determine what factors determine the colonisation process for long and short-term urinary catheters. It turns out that different factors are in play here and that strategies for CAUTI prevention miht be different for each. You can read the paper here: Bull F, Tavaddod S, Bommer N, Perry M, Brackley CA, Allen RJ. Different factors control long-term versus short-term outcomes for bacterial colonisation of a urinary catheter. Nat Commun 2025;16(1):3940. https://doi.org/10.1038/s41467-025-59161-y.  Brett's group's previous work on short-term catheters is here: Fasugba O, Cheng AC, Gregory V, Graves N, Koerner J, Collignon P, et al. Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. Lancet Infect Dis 2019;19(6):611-9. https://doi.org/10.1016/S1473-3099(18)30736-9. 

In this episode, Brett, Phil and Martin discuss a recent paper from Freya Bull and colleagues, who undertook a modelling exercise to determine what factors determine the colonisation process for long and short-term urinary catheters. It turns out that different factors are in play here and that strategies for CAUTI prevention miht be different for each. You can read the paper here: Bull F, Tavaddod S, Bommer N, Perry M, Brackley CA, Allen RJ. Different factors control long-term versus short-term outcomes for bacterial colonisation of a urinary catheter. Nat Commun 2025;16(1):3940. https://doi.org/10.1038/s41467-025-59161-y.  Brett's group's previous work on short-term catheters is here: Fasugba O, Cheng AC, Gregory V, Graves N, Koerner J, Collignon P, et al. Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. Lancet Infect Dis 2019;19(6):611-9. https://doi.org/10.1016/S1473-3099(18)30736-9. 

August 15, 2025 In this episode, Scott, Mark, Ray, and special guest Dr. John Lin dive deep into Medicare's upcoming Wiser Program—set to begin in 2026—which brings prior authorization to traditional Medicare for select urology services. Learn which states are impacted, what procedures are targeted, and what steps urologists need to take to prepare. The team also discusses the growing use of steerable ureteral catheters and how facilities can (or can't) use code C9761 for reimbursement. Get practical advice on documentation, appeal strategies, and how to advocate for your practice in this evolving regulatory landscape.NCDsSacral Modulation NCDIncontinence NCDImpotence NCDPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptp

Edie Perkins was a 46-year-old elite runner and cyclist when a catastrophic accident left her paralyzed from the chest down—just as she was entering menopause. In this candid conversation, Edie reveals how her hormonal changes intersected with her spinal cord injury recovery, leaving her with misdiagnosed UTIs, sheet-soaking night sweats she blamed on her injury, declining bone density, and a huge struggle to sort through her challenges and get quality care. Yet, through all of it, Edie continues to race (finishing second place in the handcycle division of this year's Boston Marathon), ski, and live an active life. We talk about it all and more this week. Edie Perkins served as Executive Director of the Kelly Brush Foundation from 2021 to 2025. She previously spent over twenty years managing businesses and developing curriculum products for Pre-K-12 schools. In 2017, Edie was struck by a driver while riding her bike and suffered a spinal cord injury (SCI). She is now paralyzed from the chest down. Always an athlete and active in the running and cycling communities, she sought out support after her injury and is now a competitive handcyclist and finished second at the 2025 Boston Marathon. She is thrilled to bring together her professional background, passion for sports, and new experience living with an SCI to help others thrive.Resources:The Kelly Brush FoundationGet 25% off all courses through the end of June 2025! Purchase a Feisty On-Demand Course: learning.feisty.co Subscribe to the Feisty 40+ newsletter: https://feistymedia.ac-page.com/feisty-40-sign-up-page Follow Us on Instagram:Feisty Menopause: @feistymenopause Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099 Support our Partners:Hettas: Use code FEISTY20 for 20% off at https://hettas.com/ Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/ Nutrisense: Go to nutrisense.io/hitplay and use code: HITPLAY to get 30% off Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ This podcast uses the following third-party services for analysis: Spotify Ad Analytics - https://www.spotify.com/us/legal/ad-analytics-privacy-policy/Podcorn - https://podcorn.com/privacyPodscribe - https://podscribe.com/privacy

Dosimetry University is now in session! First up—how do you plan your Y90 treatments and what can you do in the planning phase to maximize efficacy? Find out in Part I of BackTable's Dosimetry University series featuring interventional oncologists Dr. Nima Kokabi from the University of North Carolina Chapel Hill and Dr. Tyler Sandow from Ochsner Health. This episode is hosted by Dr. Kavi Krishnasamy and recorded live in the BackTable studio. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Sponsor This podcast is supported by: Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The doctors first discuss the structure of their Y90 service lines, including the impact of multidisciplinary tumor boards and clinics on time to treatment for liver cancer patients. They then talk through their technical preferences—whether to use glass or resin, preferred dosimetry guidelines and apps, and the dosimetry softwares that they use in treatment planning. The doctors also discuss the utility of the T2N ratio, advanced imaging like cone beam CT, and angiographic targeting software—emphasizing how these tools can help achieve the delicate balance of preserving normal tissue while treating as much tumor as possible. This episode also highlights the importance of collaboration between academic and private practices to optimize patient care and treatment outcomes. --- TIMESTAMPS 00:00 - Introduction and Overview02:21 - Multidisciplinary Clinics and Tumor Boards13:12 - Dosimetry Guidelines and Practices27:46 - Nuances in Tumor Dosage and Segmentectomy32:00 - Angiographic Targeting Software33:18 - Cone Beam CT Techniques48:33 - Anesthesia, Access, and Catheters

Check out the TIES Sales Showdown at www.tx.ag/TIESVisit The Sales Lab at https://thesaleslab.org and check out all our guests' recommended readings at https://thesaleslab.org/reading-listTo listen to The Sales Lab Podcast on your favorite apps, visit https://thesaleslab.simplecast.com/ and select your preferred method of listening.Connect with us on Facebook at https://www.facebook.com/saleslabpodcastConnect with us on Linkedin at https://www.linkedin.com/company/thesaleslabSubscribe to The Sales Lab channel on YouTube at  https://www.youtube.com/channel/UCp703YWbD3-KO73NXUTBI-Q 

Get ready for a wild episode! Bob is back in person, joining Ryan and our good friend Mark Cain for a classic Friday night BS session. We dive deep into fishing, swap some hilariously "Terrible" hunting stories from the past, and break down a ridiculous hunting gadget that will leave you absolutely speechless. You won't want to miss this one!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow us on YouTube!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Belly Up Guide Service⁠⁠⁠⁠Steele Game Safari's⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The Outlaw Ways Facebook⁠⁠⁠⁠⁠⁠The Airborne Angler⁠⁠⁠⁠⁠⁠Michigan Operation Freedom Outdoors⁠⁠⁠⁠⁠⁠⁠SE Michigan Bowhunters FaceBook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SE Michigan Bowhunters Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Michigan Report All Poaching⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Michigan DNR App⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠We are a Hunting, Fishing & Just general Outdoors Podcast based out of Michigan that likes to have a lot of fun, Talk tactics and tell our Terrible Stories from the field or on the water.We talk about:Hunting:Whitetail Deer, Turkey, Waterfowl, Small Game, Elk, MooseFishing:Northern Pike, Musky, Smallmouth Bass, Largemouth Bass, Walleye, Salmon, Trout, Sturgeon, PanFish, Ice Fishing, Great Lake Fishing to Small River Fishing.We couldn't be more excited to partner up with our friends at Wes Point Shores Resort. The place that Ryan & Bob have been going to since they were 5 years old! Follow the links below to check them out and be sure to mention the show and save 10% off your bill!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Wes Point Shores FaceBook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Wes Point Shores Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠WesPointShores.Com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠MI DNR Musky Survey⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠O'Wacky Tool Starter Kit⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Fishing Complete Inc⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Use Code: TERRIBLE & Save 20%!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The Terrible Outdoorsman Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Tik Tok⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Send us a textThis Episode has EVERYTHING!It's got:Tinnitus!Defective Q-Tips!Disgusting ear detritus!Paul gets real!Back surgery is scary!Pain meds are fun!Red heads are weird!Catheters aren't fun!You really want to pass the catheter test!Paul Nightingale!Screws, rods, and holes!Tooth in eye disease!Seeing eye tooth!Paul gets frustrated!"You're a 52-year-old man!"Dave needs to listen to Paul more often!Pushed buttons!Boiled rabbits!Meghan "I'm inauthentic asf" Markle's new crappy show!Ghoulish disaster tourists!Paul goes with the flow, day by day!Nihilism vs realism!Agoraphobia!Dead Paul!Gay humpback whale orgy!Dead body mile high club!Toronto plane crash miracle!Episode Links (In Order):Video showing Dave's surgery!Dave's experience with opioids episode!Tooth in yer eyeball!Meghan Markle steals Mallorca's Coat of Arms!Humpback Whale Porno!Couple forced to sit beside corpse on long haul flight!Music Credit!Music Graciously Supplied By: https://audionautix.com/  Visit Our Patreon! Email Us Here: Disturbinglypragmatic@gmail.comWhere To Find Us!: Disturbingly Pragmatic Link Tree!

Send us a textToday on Being An Engineer, we have the pleasure of hosting Steve Maxson, a distinguished figure in the medical device industry with over two decades of experience in extrusion technology and medical device manufacturing. As the owner of Maxson InSight Services, Steve offers technical solutions and consulting services, specializing in medical extruders and turnkey systems. In his role at US Extruders, he leads innovation and business development, focusing on crafting robust, customized extruders for diverse applications. Additionally, Steve is the host of the Med-Ex Podcast, where he interviews global experts in medical device contract manufacturing, sharing valuable insights into extrusion technologies, materials, processes, and broader industry trends. He also plays a pivotal role in organizing the Medical Processing Panel events, bringing together thought leaders in MedTech to discuss advancements in catheter manufacturing, silicone processing, thermoplastic processing, and more.About Being An Engineer The Being An Engineer podcast is a repository for industry knowledge and a tool through which engineers learn about and connect with relevant companies, technologies, people resources, and opportunities. We feature successful mechanical engineers and interview engineers who are passionate about their work and who made a great impact on the engineering community. The Being An Engineer podcast is brought to you by Pipeline Design & Engineering. Pipeline partners with medical & other device engineering teams who need turnkey equipment such as cycle test machines, custom test fixtures, automation equipment, assembly jigs, inspection stations and more. You can find us on the web at www.teampipeline.us

Do patients in labor need continuous bladder drainage? We will review the literature comparing intermittent to continuous drainage. Next, we venture into the art and science of manual rotation for persistent posterior fetal presentations, a skillful maneuver that might just hold the key to lowering cesarean rates. Drawing from comprehensive reviews and trials, including the TURN-OUT trial and studies from UCSF, we debate the efficacy and applicability of manual rotation in various clinical settings. From ultrasound-guided techniques to hands-on learning, gain a nuanced understanding of how this practice might enhance delivery outcomes and reduce interventions. Finally, we learn about Cesarean Scar Disorder, a relatively new diagnosis with important clinical ramifications. 00:00:10 Urinary Catheterization in Labor Management00:16:10 Manual Rotation of the OP Fetus00:49:32 Effectiveness of Labor Positioning Techniques00:58:03 Cesarean Scar DisorderFollow us on Instagram @thinkingaboutobgyn.

Get ahead with VETAHEAD and join Dr. Proença on 15 minutes of ZooMed (exotic animal medicine) content. Ever struggled with placing IV catheters in rabbits? Dr. Proença is here to make your life easier! She breaks down a fascinating study comparing cephalic, lateral saphenous, and marginal ear veins for IV catheter placement in rabbits. Discover which site has the highest success rate, the most common complications (spoiler: no major ones!), and why sedation is your best friend when working with these delicate patients. From practical tips to new insights, this episode is packed with everything you need to perfect your rabbit care game! Click here to get your VETAHEAD E-Magazine!⁠⁠⁠⁠⁠⁠⁠⁠ ⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠Click here to receive a VETAHEAD Gift!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Do you want to access more ZooMed (exotics) knowledge directly from specialists? Come with us and #jointhemovement #nospeciesleftbehind ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Head to VETAHEAD Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our VETAHEAD Community⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow @the_vetahead on Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Subscribe to @vetahead channel on YouTube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow @vetahead on Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow @vetahead on TikTok

If you work in acute care, you are working with catheters. If you are in home health, you may be dealing with the hospital consequences of those catheters. In today's episode, Dr. Christina Prevett talks about catheters. She goes into types, complications and pelvic floor considerations.

Dr. Christina Prevett // #GeriOnICE // www.ptonice.com  In today's episode of the PT on ICE Daily Show, join Modern Management of the Older Adult division leader Christina Prevett explores the essential aspects of catheter use in geriatric care. She discusses the considerations that clinicians should keep in mind regarding catheter placement, pelvic health implications, and current guidelines surrounding catheterization. Christina also teases an upcoming virtual ICE session that will provide a deeper dive into these topics, emphasizing the importance of understanding catheterization in the context of geriatric pelvic health. Take a listen to learn how to better serve this population of patients & athletes, or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.

In this bonus episode, join EMJ host Dr Hannah Moir as she speaks with our two health and wellbeing experts, Dr Sula Windgassen and Kiera McGarrity, who provide their expertise and personal experiences of using intermittent catheters. The experts address the emotional impact of intermittent catheter use and provide solutions and practical tools to support and improve patient wellbeing and advance the standard of care.   This is episode one of a three-part series: Confident Living with Intermittent Catheterisation.  This podcast was initiated and funded by Convatec. The views and opinions expressed in this podcast are those of the individual speakers and do not necessarily reflect those of Convatec or EMJ. 

In this episode, we discuss four tips for placing and using catheters for induction of labor. Then we revisit the issue of small for gestational age versus fetal growth restriction. We also discuss the most common mistake made in calculating due dates and how this can have a negative impact on pregnancies. Finally, we discuss the history of postpartum depression and the literature and stories of Kate Chopin and Sylvia Plath. 00:00:35 Four Tips for Cervical Catheter Placement00:23:00 SGA vs FGR00:28:55 Correcting Due Dates Prevents Mistakes00:46:10 History of Postpartum Depression, Chopin and PlathFollow us on Instagram @thinkingaboutobgyn.

From the gridiron to the hardwood, athletes have been known to cross the line and commit crimes. Join the BTC as we dive into the shocking stories of athletes who traded in their jerseys for handcuffs.You can check out the Vocal Fries Podcast here!Research links below! Oxygen - "O.C. Millionaire Medical Innovator Fatal Victim of His Girlfriend and Her Secret Lover"ABC News - "Convicted killers in millionaire's love triangle murder case maintain innocence"CBS News - "Murder in the O.C.: Nov. 4 case update"ABC News - "Woman Convicted in Millionaire's Love Triangle Murder"FOX Sports - "Ex-NFL player gets life for murder"Yahoo! Entertainment - "Rich & Shameless: What Did former NFL Linebacker Eric Naposki Do?"People - "Inside the Murder of a California Millionaire - at the Hands of His Girlfriend and an Ex-NFL Linebacker"The Orange County Register - "McLaughlin murder case timeline"Crime Library - "Football Player and the Millionaire: Deadly Love Triangle"Hydroplane History - "David 'Salt' Walther"Historic Racing - "David Walther"Motorsport - "1973 Indy 500 Start, Salt Walther & 11 Others Crash"NBC Sports - "'A race we would all like to forget': 50 years later, 1973 Indy 500 is grim, haunting memory"Ed Justice Jr. - "Salt Walther's 1973 Indy Race Car"BANG Shigt - "Indy 500 History Video: the Incredible Salt Walther Wreck During the Ill-Fated 1973 Indy 500"

Dr. Wood joins the show to discuss his groundbreaking new invention aimed at reducing unnecessary C-sections. The conversation explores the evolving trends in epidural use, the importance of patient autonomy, and effective coaching during labor. Dr. Wood elaborates on the issues surrounding 'failure to progress' and introduces his innovative catheter designed to mitigate common complications associated with Foley catheters during labor. This informative episode sheds light on improving maternal and infant health outcomes and offers insights into the future of obstetric care.   Epidurals: Trends and Practices Coaching During Labor Failure to Progress: Understanding the Issue The Role of the Foley Catheter Innovative Catheter Design Addressing Failure to Progress Managing Foley Catheters: Challenges and Solutions Discussing Pitocin: Usage and Misconceptions Innovative Medical Device: Development and Challenges Crowdfunding for Medical Innovation   Help Dr. Wood Prevent The Primary Section | C-section Reduction Project (Powered by Donorbox)   About Dr. Wood: Dr. Douglas Wood is a highly accomplished Obstetrician and Gynecologist with over 24 years of solo practice experience, managing and delivering more than 9,500 pregnancies. He serves as a Laborist and Hospitalist at UPMC, OBHG, and VeloSource, bringing a wealth of clinical expertise to these roles. Dr. Wood is also a product developer and patent holder, contributing to advancements in the field of obstetrics by reducing the US c-section rate. He holds academic appointments as OB/GYN Clinical Faculty at several institutions, including Baptist Health-UAMS Medical Education Program and New York Institute of Technology College of Osteopathic Medicine. A decorated military veteran, he was deployed to Saudi Arabia and Kuwait with the Arkansas Army National Guard, where he served as a Lieutenant Colonel. Dr. Wood is board-certified in OB/GYN and has been recognized for his excellence in teaching with the NYIT Outstanding Preceptor Award in 2021.   SOCIAL MEDIA: Connect with HeHe on IG  Connect with HeHe on YouTube. BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone! LINKS MENTIONED: Thank you to EISCO for the quality of their models. We'd like to give recognition to hBARSCI.  hBARSCI is the distributor that helped supply us with the model.  For any potential customers, hBARSCI Help Dr. Wood Prevent The Primary Section | C-section Reduction Project (Powered by Donorbox)      

On this episode, Sean and Nick are treated to a very special guest with a resume that is as varied and diverse as any guest we've ever had. And we are also joined by Darren's lovely wife Kim. We discuss many topics, including Darren working with Johnny Depp and driving stunt vehicles on the set of Transformers! Somehow after all of that excitement, we take a downward spiral and Nick's balls become the lead topic. SMH

In this exclusive Live Podcast Event, we dive into pulmonary artery catheters (PACs), a critical tool in the management of critically ill patients. Often regarded as a cornerstone in the monitoring of hemodynamics, PACs provide invaluable insights into the heart's function and the pulmonary circulation's state. We will unpack the principles behind how they measure key physiological parameters such as pulmonary artery pressure, cardiac output, and mixed venous oxygen saturation. These metrics are vital for diagnosing and managing conditions like heart failure, shock, and pulmonary hypertension.Featuring leading Critical Care Expert Nicole Kupchik, MN, RN, CCNS, CCRN-CMC, PCCN, CEO - Nicole Kupchik Consulting, this episode brings you the latest research and technological advancements related to pulmonary artery catheters. Whether you're a CVICU nurse seeking to deepen your understanding of hemodynamic monitoring or simply curious about the science behind the use case of PACs, this episode offers comprehensive insights into the use of pulmonary artery catheters in critical care.Giveaway! You could WIN a copy of Nicole's Book “Critical Care Survival Guide” (a $100 value!) in our social media giveaway! Find us on Instagram @crnaschoolprepacademy. We're running the contest May 8th through 10th so don't miss out! Get a FREE Copy of the Slides Used in this Presentation! Click Here: https://mailchi.mp/kupchikconsulting/cspa-pulmonary-artery-catheter FREE! 8 Steps to Becoming a CRNA: https://www.cspaedu.com/3m9jgffpLearn How to Ace Your CCRN®, PCCN®, CMC® or CSC® Certification Exams with Nicole Kupchik: Click HereGet access to planning tools, interview preparation opportunities, valuable CRNA Faculty guidance, and mapped-out courses that have been proven to accelerate your CRNA success! Become a member of CRNA School Prep Academy: https://cspaedu.com/joinGet CRNA School insights sent straight to your inbox! Join the CSPA email list: https://www.cspaedu.com/podcast-emailJoin the Free Facebook Community here! https://www.facebook.com/groups/crnaschoolprepacademyfreeBook a mock interview, resume or personal statement critique, transcript review and more: www.teachrn.com

A little Q+A to start your week. Let's chat new borns, cleaning schedules, catheters during childbirth, where to shop for baby clothes, setting boundaries to spend less time on our phones, and car seat safety.

Lisa Alvarado is joined by her very good friend Ron and they shoot the sh*t! Literally! Lisa, Ron and Sarah discuss everything from poop samples to vasectomies. What's your favorite doctor story? As Ron says if it's going to kill you, you might as well make it funny. #comedytalk #crowdworkcomedy #findthefunny #comedianslife #LisaAlvaradoComedian #Comedy #Standup #funnyvideos #tiktok #mattrifecomedy #tignataro #comedypodcast --- Send in a voice message: https://podcasters.spotify.com/pod/show/lisaalvarado/message

Preventing accidental dislodgement of tubes, drains, and catheters by AORNJournal

Interview with Simon L. Thomsen, MD, and Bodil S. Rasmussen, MD, PhD, authors of Safety and Efficacy of Midline vs Peripherally Inserted Central Catheters Among Adults Receiving IV Therapy: A Randomized Clinical Trial. Hosted by JAMA Associate Editor Angel N. Desai, MD, MPH. Related Content: Safety and Efficacy of Midline vs Peripherally Inserted Central Catheters Among Adults Receiving IV Therapy

(3:13) - Aided by AI, New Catheter Design Prevents Bacterial InfectionsThis episode was brought to you by Mouser, our favorite place to get electronics parts for any project, whether it be a hobby at home or a prototype for work. Click HERE to learn more about the type of medical devices that can benefit the most from additive manufacturing!

Using indwelling urinary catheters during general surgery by AORNJournal

Welcome to Season 2 of the Med-Ex Podcast! In our opening episode, we explore the fascinating world of robotic-assisted catheters and endoscopes with our esteemed guest, Joe Bogusky, a Staff Mechanical Engineer at Intuitive Surgical, the pioneer of robotic-assisted surgery.In this episode, Steve and Joe discuss the unique capabilities of ION's ultra thin and flexible robotic catheter, the ongoing shift from reusable to single-use, steerable, robotic endoscopes, and more.Intuitive Surgical has been leading the way in innovative surgical technology for over two decades, revolutionizing patient care with its robotic-assisted systems. The company's trailblazing spirit is evident in its ION platform, a robotic-assisted bronchoscope designed for biopsies in hard-to-reach areas of the lung.For more information, visit www.intuitive.comHost/ Producer: Steve Maxson | Innovation & Business Development Manager | US ExtrudersGuest: Joe Bogusky | Staff Mechanical Engineer | Intuitive SurgicalAnnouncer: Bill Kramer | President | US ExtrudersEditor/ Original Music: Eric Adair | Marketing Manager | US ExtrudersFor video episodes visit www.us-extruders.com/podcasts

Horus for the Holiday's, Catheters & Green Screen EffectsSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this second instalment Ashani Couchman (Urologist) and Brandon Szilagyi go on to discuss the effects of living with a stoma on relationships. Brandon shares his experiences of managing a Mitrofanoff stoma, the life situations he has tended to avoid, and the impact this had had on his friendships and relationships from childhood through to adulthood. Registration for ICS 2023 Toronto is now open at www.ics.org/2023/register The ICS annual meeting is the must-attend, multidisciplinary event for clinical and research scientists interested in: Urology Urogynaecology Female and functional urology Gynaecology Bowel dysfunction Neurourology Pure and applied science Physiotherapy Nursing Geriatrics The ICS 2023 Toronto conference fosters collaboration between all disciplines involved in continence care.

Ashani Couchman (Urologist) talks to Brandon Szilagyi about growing up with catheters and the challenges and triumphs experienced along the way. in this inspiring podcast, Brandon, who was born with bladder exstrophy and lives with a Mitrofanoff stoma, relates the childhood challenges he faced as well as sharing insights into what better support looks like for teenagers and young adults. Registration for ICS 2023 Toronto is now open at www.ics.org/2023/register The ICS annual meeting is the must-attend, multidisciplinary event for clinical and research scientists interested in: Urology Urogynaecology Female and functional urology Gynaecology Bowel dysfunction Neurourology Pure and applied science Physiotherapy Nursing Geriatrics The ICS 2023 Toronto conference fosters collaboration between all disciplines involved in continence care.

On this episode of Not Today Pal, Rob brings a ton of stories to the table. Apparently, he walked in on someone in the bathroom, his friend has a kink for catheters, and he claims hot sauce isn't always the best. He also tries to find out how much money the Booth Boys would need to do OnlyFans. Jamie brings the balanced, calmness to the show with her sage advice on meditation and chilling out in this week's Sweet and Sour segment. Also in this episode, we play Rob's favorite trivia game. Hope you enjoy it as much as he does!https://www.instagram.com/jamielynnsigler/https://www.instagram.com/nottodaypalshow/https://store.ymhstudios.com/

CathVision this week announced the FDA clearance of its PVI Analyzer and Signal Complexity algorithms for facilitating electrogram interpretation. The regulatory nod makes these artificial intelligence-based tools available to physicians. Fast Five hosts Sean Whooley and Danielle Kirsh explain what the algorithms are used for and what sets them apart from traditional EP recording systems. AngioDynamics received FDA breakthrough designation for its AngioVac system. The designation includes proposed indications for the use of AngioVac in the non-surgical removal of vegetation from the right heart. Find out what the company plans to do with the breakthrough nod and what executives see for the future of AngioVac. Tivic Health is planning to begin its vagus nerve stimulation trial after receiving Institutional Review Board (IRB) approval. Whooley shares details of the study, what the IRB approval means for Tivic and what the company hopes to achieve in the study. New data from a two-year trial of Nevro's spinal cord stimulation trial demonstrated durable pain relief and significant improvements in health-related quality of life. Learn some of the data points from the study and what doctors think about the results of the trial in today's episode. Medtronic's Mahurkar hemodialysis catheters are facing their third Class I recall. More than a million Mahurkar catheters have been recalled since July 2022. Whooley and Kirsh share the issue in this recall and how many devices are affected. Check out the show notes for links to the stories we discussed today at MassDevice.com/podcast.

In this episode, host Alyssa Watson, DVM, talks with Rebecca Walton, DVM, DACVECC, about her recent Clinician's Brief article, “Top 5 Complications of Indwelling Urinary Catheters.” Dr. Walton reviews some good options for where urinary catheters should be placed. She then expands on several of the potential complications—including kinking, hematuria, and the dreaded bladder rupture.Resource:https://www.cliniciansbrief.com/article/indwelling-urinary-catheters-complications-collection-obstructionContact us:Podcast@briefmedia.comWhere to find us:Youtube.com/@clinicians_briefCliniciansbrief.com/podcastsFacebook.com/cliniciansbriefTwitter: @cliniciansbriefInstagram: @clinicians.briefThe Team:Alyssa Watson, DVM - HostAlexis Ussery - Producer & Multimedia Specialist

Our best friend Christ makes his first apperance on the cast! He was almost too much to handle.

Endovascular 101 Authors: Sebouh Bazikian - MS4 at Keck School of Medicine of University of Southern California Sukgu Han - Associate Professor of Surgery at the University of Southern California. Co-director of Comprehensive Aortic Center at Keck Hospital of USC. Program Director of the Integrated Vascular Surgery Residency and Vascular Fellowship Editor: Yasong Yu Reviewers: Matt Chia and Kirthi Bellamkonda   Core Resources: Rutherford's Vascular and Endovascular Therapy 10th Edition Chapter#26-28 Additional Resources: Relevant Audible Bleeding episodes Holding Pressure Case Prep - AKA/BKA Journal Review in Vascular Surgery: Introduction to Endovascular Surgery – A Prime Peter A. Schneider, MD and Endovascular Skills - history, personal techniques and updates in the 4th Edition Closure devices:  Angioseal Mynx Proglide Endovascular procedures are minimally invasive techniques used to treat conditions affecting blood vessels, such as aneurysms, stenosis, or occlusions, by accessing the affected vessels through an incision in a peripheral artery and using imaging guidance to navigate catheters and devices through the blood vessels to the treatment site.  Endovascular procedures can be broken down into 4 key steps Establishing arterial access Navigating to target treatment zone or vessel Treating the lesion Closure Basic definition of wire, sheaths, and catheters Wires are thin, flexible metal devices used to navigate through blood vessels and to guide other devices, such as catheters or sheaths, to the target location. They are measured in thousands of an inch A 0.018 wire is 0.018 inch in diameter There are two categories of wires: Flexible and support Flexible wires are soft and hydrophilic. They are considered the “workhorses” because they are useful for navigating through vessels. A common type of wire is called the Glidewire which is  slippery and useful in traveling across tortuous vascular anatomy. Support wire are generally a lot stiffer and not hydrophilic. For that reason they are used to deliver and deploy devices A common type of support wire is called the Lunderquist which is used for the deployment of stent grafts in endovascular aortic repair Catheters are flexible hollow tubes used in conjunction with wires to navigate vascular anatomy Various characteristics include the degree and shape of the taper, the lengths, and the stiffness. They are inserted inside the sheath  Sheaths are hollow tubes of various diameters that are inserted into a blood vessel to provide a pathway for catheters or wires.  They have a one way valve to prevent backflow of arterial blood and a side port that permits aspiration and administration of fluids.  They also come with a dedicated dilator which is used to fill the lumen of the sheath and allows the surgeon to insert the sheath safely into the vessel.  If the wire is the rail and the catheter is the train, the sheath is the ground. Sheaths and catheters sizing Both are measured in French 1 French equals 0.33 mm. French size divided by 3 equals the approximate diameter in millimeters.  Another way to think about Fr is roughly the circumference in mm. Divide by 3 instead of 3.14 to get the diameter Sheaths are defined by their inner diameter (ID) Catheters are defined by their outer diameter (OD) This is because catheters go inside the sheath, so the size of a catheter must be smaller or equal to the size of the sheath for it to fit inside.For example, a 5 Fr sheath can accommodate 5 Fr catheter/devices Of note, the hole in the artery will roughly be 2-4Fr larger than the sheath size. This is important when considering the type of closure that will be used at the end of the procedure.  Step One: Establishing Arterial Access Preop preparation:  During physical exam, make sure there's a palpable femoral pulse to rule out iliofemoral disease Review the CT if available for high femoral bifurcation or presence of vessel disease  Patient positioning on the angio table, depends on the access site of choice. Typical position (for retrograde femoral artery access) is supine, arms tucked.   Alternative access sites (ie. radial, brachial, carotid) may require arms to be out and prepped.   How do you choose arterial access, location? Depends on location of lesion you are trying to treat and complexity of the path from the access site Size of the access vessel and device size must be considered when deciding on the access site The most common is retrograde femoral artery access When would other access points be used? Radial artery, brachial, antegrade femoral access. The goal, target location, and path complexity defines the access point. Arterial puncture Femoral access: Look for pulsatile vessel on the US (vein is medial, artery is lateral; “venous penis”) Usually access at the level of femoral head for common femoral artery Seldinger technique is  used to establish access to a vessel or cavity using needle, wire, catheters, and sheath. E.g. using the micropuncture kit: contralateral arterial CFA access with s 21 gauge needle .018” guidewire is passed through the needle Needle is removed and a short 4 or 5 Fr microcatheter with an inner dilator is passed over the guidewire The dilator and guidewire are removed leaving the catheter in place to maintain access Bigger wire is inserted through the catheter, which is then removed over the wire A sheath is inserted over the wire The overall purpose is to start with smaller arterial puncture and exchange to larger size to minimize complication should the access fail Often, percutaneous closure devices are preloaded at this step.  We will discuss this later.   Step Two:  Navigating to treatment zone or vessel With sheath in place, a guidewire is inserted into the vessel under fluoroscopic guidance. Continuous fluoroscopy is taken with the C-arm during key steps to visualize wire movement The C-arm can be portable or built into the room X rays are emitted from the X-ray generator below the patient And the subsequent image is generated from the image intensifier above the patient Radiation safety:  wear protective gear which is made of lead. In addition, use the tableside lead shield whenever possible minimize use of continuous fluoroscopy whenever possible limit use of magnification, and digital subtraction angiography keep the image intensifier as close to the patient as possible to minimize scattering The C-arm can rotate around the patient to get optimal viewing of the vessels Frequently used terminology: 30 degrees RAO which stands for right anterior oblique, describing the  relationship of image intensifier to the patient Common projections used for lower extremity angiograms Iliacs: 20-30 degrees contralateral anterior oblique Femoralsl: 20-30 degrees ipsilateral anterior oblique Trifurcation and tibials: anatomic anterior-posterior or 20 degrees ipsilateral anterior oblique with feet in neutral supine position Thoracic aorta/distal aortic arch: 30~45 degree LAO Renals: AP maximizing image quality by limiting patient movement and with breath holding and collimating Contrast  Two types of contrasts: Iodinated contrast vs carbon dioxide Iodinated contrast has better resolution but patients can have allergic reactions and are at risk of contrast induced renal injury. Therefore, CO2 is preferred for patients with compromised renal function in which an image is created by transiently displacing blood. The downside is that it has lower image resolution than iodinated contrast, and rare but potentially serious complications of air locking.  Power injection vs manual injection When using power injection, you have control over pressure, the amount of contrast, timing, and rate or rise of injection. It allows for rapid filling of large arteries at high flow rates. Manual injection is more efficient for small vessels since you can control dilution and volume Types of Wires Characteristics: wire tip, stiffness, diameter, and length Guide wires To assist in catheter placement, navigate different arteries, cross lesions, and deliver devices.  The most common sizes used in vascular surgery  Large .035” - generally used for the aorta and iliac. Small .014”/.018” - used for smaller branches like the SFA Length: from 120 to 360cm Based on distance from access site to the lesion Long enough to reach target lesions and beyond (inside pt) and deliver catheters (outside pt) but not too long that it's falling off the table and slowing down exchange Flexible vs stiff/support wires How do you decide which wire to use? Typically, you start with flexible wire inside an angle tip catheter to navigate to the target vessel.  Once you reached and crossed the target vessel, the wire is exchanged to a stiff/support wire, which allows you to deliver common brands and models used that every medical student should know and the settings they are used in? Example answer: Glidewire (Tumero): a floppy wire with a  hydrophilic coating which is useful for navigating stenosis and tortuous vessels and is used in a variety of different vessels. Lunderquist (Cook): it is very stiff and used for endovascular repairs of AAAs Rosen wire: support wire with a J tip with intermediate stiffness. Less stiff than Lunderquist. Used to catheterize visceral and renal arteries. Bentson: starter wire, that's short in length with a very long floppy tip that prevents vessel trauma. Types of Catheters  Main purpose of the catheters Allows to approach the target vessel based on the shape of the catheter Allows wire exchange from flexible to stiff Sizes are based on Fr (4-5) 5 Fr are the most common. Microcatheters are for embolizations (2.5Fr) Nonselective (Angiographic catheter) Common types are omni flush, pigtail, and straight They have multiple side holes along the tip so they can inject high volume of contrast into large blood vessels like the aorta Selective catheters/Guide (shape) catheters Have an end hole only with no side holes so they can cannulate specific branch vessels A variety of lengths and shapes depending on the curvature and tortuosity of the pathway to the target vessel. Catheter with specific shapes can align your vector (the force you are exerting by pushing the wire forward at the access site) to the stenotic lesion. Type of catheter that can be used to cross to the contralateral side at the aortic bifurcation – generally the omni.  Types of sheaths Size range: 4-26Fr (larger available for endografts) Size is decided by the device you have to deliver to the target lesion Length is based on the support required from the procedure. The distance from the access site to the target site determines the length of the sheath required.  Common lengths range from 5 to 110cm What are some of the common sheaths used and for which procedure? For endovascular aortic repairs, Dryseal sheaths range from 12Fr ~ 26Fr with lengths of 33cm to 65cm. For visceral and renal artery intervention, Ansil or Raabi sheaths range from 5Fr to 9Fr, with lengths of 45cm to 90cm. For lower extermity work, Ansil, Raabi, Balkin sheaths ranging from 4Fr to 7Fr with lengths of 45cm to 110cm. Steerable sheaths can actively articulate the shape of the sheath, allow you to navigate and treat more challenging anatomy. Step Three: Treating the lesion The lesion has to be crossed with wire and catheters before treating the lesion. They may require the need to exchange sheath Stent and balloon sizing is measured by diameter in millimeters x length in centimeters Balloons Generally need to exchange wire to stiff support wire through the catheter, then the catheter is exchanged over the wire with the balloon mounted catheter Balloons have a wide variety of diameters and lengths Nominal vs Burst pressures Nominal: pressure is where the balloon will inflate to the labeled diameter Burst: pressure where 99.9% of tested balloons ruptured Typically you inflate to nominal but can go higher depending on the type of lesion Compliant balloon vs a semi-compliant vs non-compliant balloon Most of the time, we use a compliant balloon, but in certain situations where we need high pressure dilation, we use non-compliant balloon.  This has to do with the nature of the lesion and risk of vessel rupture. Additional features  Cutting balloons have microblades on the wall. So the idea is to perform control rupture of calcified atherosclerotic lesions, so that the expansion happens more evenly. Drug coated balloons are coated with paclitaxel to reduce the risk of neo-intimal hyperplasia  So, it is sometimes used in peripheral cases where the surgeons feel that the lesions are more prone to developing neo-intimal hyperplasia or areas that have restenosed.  Stents small mesh-like device made of metal that is used to prop open a blocked or narrow blood vessel. It is inserted through a catheter and deployed at the site of the blockage to improve blood flow and reduce the risk of future blockages.  balloon expandable vs self-expanding stents Balloon expandable Better radial force at the time of deployment More accurate deployment Mounted on balloons, so it is more difficult to track them across tight stenosis. May cause damage to the surrounding tissue due to balloon inflation. Self-expanding Usually more flexible in tortuous vessels More resistant to kinking  Higher risk of migration or dislodgement during deployment Post-dilation is often needed covered stents vs bare metal stents Covered stents Covered by PTFE, polyurethane, or silicone May be more resistant to in-stent restenosis, compared to bare metal stents. useful in ruptured vessel EVAR/TEVAR/FEVAR devices are essentially fancy covered stents.   Step Four: Closure Hole in the artery is outer diameter of the sheath, and is bigger than the sheath size since sheath is measured by inner diameter Manual compression Direct pressure with fingertips Enough pressure without bleeding, but not too much that it cuts off circulation No peeking! Timing depends on sheath size, coagulation status, and vessel health. Closure devices Extravascular plug Angio-seal: sandwiches the arteriotomy with a biodegradable anchor and collagen sponge. https://www.youtube.com/watch?v=XhgAs2SxNjA Mynx: utilized a small balloon to create temporary hemostasis within the artery and covers the outside with a polyethylene glycol sealant. https://www.youtube.com/watch?v=_kcJM1lnQo8 Suture-based Sometimes placed at beginning of the case for large bore access Proglide: https://www.youtube.com/watch?v=Wol22SlEpxE Complications What are the most common complications that you experience and how do you mitigate them? Access site Hematoma, pseudoaneruysm, AV fistula, occlusion,  infection Navigation related Dissection, perforation, thromboembolism Systemic Contrast induced AKI  —----------------------------------------------------------------------------------------------------------------------- Please share your feedback through our Listener Survey! Follow us on Twitter @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and #jointheconversation.

In this panel episode recorded at SIR 2023, Drs. Stephen Hunt, Chuck Martin, and Gaurav Gadodia update us on current applications and future directions of augmented reality in interventional radiology. --- CHECK OUT OUR SPONSOR Medtronic Ellipsys Vascular Access System https://www.medtronic.com/ellipsys --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/voyqG5 --- SHOW NOTES Dr. Hunt explains the differences between virtual reality (VR), augmented reality (AR), and mixed reality (MR) since there is increasing levels of overlap between virtual and real worlds with each category . He notes that all three are being explored in surgical fields, especially orthopedics and neurosurgery. Within IR, augmented reality can be used to adjust images and subtract out respiratory motion, making biopsies and ablations safer and more effective. Dr. Hunt became interested in AR when his PIGI Lab at the University of Pennsylvania needed 3D models to access liver tumors in experimental mice. Additionally, AR is a useful tool for planning difficult procedures and teaching interventional procedures to trainees across the globe. Dr. Martin speaks about the intersection of medicine and industry. He directs research studies for Mediview, a company focused on bringing AR into medical imaging. Dr. Martin speaks about the important role that industry plays in commercializing an invention and getting it into operators' hands. As larger companies enter the AR space, accessibility and user interfaces will improve. Additionally, the shift towards AR product development can guide future FDA regulations. Dr. Gadodia's engineering background made him excited to enter the AR space as resident at the Cleveland Clinic. He highlights applications of AR in the non-academic setting. Using a headset could increase procedural efficiency and access to care. Finally, we discuss major shifts in industry and medicine that favor the increasing use of AR, such as industry's need for clinician input in product development, the multitude of startups working on the same issues, and the overarching goal of patient safety. --- RESOURCES Ep. 7- Lung Tumor Ablation with Dr. Stephen Hunt: https://www.backtable.com/shows/vi/podcasts/7/lung-tumor-ablation Ep. 53- International IR Volunteer Work with Dr. Stephen Hunt: https://www.backtable.com/shows/vi/podcasts/53/international-ir-volunteer-work Mediview: https://mediview.com/ Microsoft HoloLens: https://www.microsoft.com/en-us/hololens Penn Image-Guided Interventions (PIGI) Lab: https://www.med.upenn.edu/pigilab/

They are. I don't talk about them the whole time, but it want it on the record.

In this episode, Antonia and Andrew discuss the February 15, 2023 issue of JBJS, along with an added dose of entertainment and pop culture. Listen at the gym, on your commute, or whenever your case is on hold! Link: JBJS website: https://jbjs.org/issue.php Sponsor: This episode is brought to you by JBJS Clinical Classroom.

The plan to pay people to dial down their electricity use, the bacteria eating plastic in the ocean, and why antidepressants make it harder for users to enjoy themselves. Like this podcast? Please help us by supporting the Naked Scientists