Podcasts about vascular

New minimally invasive treatments for arthritis and chronic joint pain are giving some patients options beyond medications, injections and more invasive surgery. Vascular surgeon Dr. Daniel Nathanson explains Genicular Artery Embolization (GAE), MSK embolization and how image-guided vascular techniques are being used to target inflammation and pain. Dr. John Phillips and I welcome Dr. Daniel Nathanson of the San Francisco Vein & Vascular Institute in San Francisco, California, for a fascinating look at how tools traditionally associated with vascular intervention are expanding into the treatment of musculoskeletal pain. Dr. Nathanson is a board-certified vascular and endovascular surgeon who specializes in minimally invasive, image-guided treatments. His work includes Genicular Artery Embolization (GAE) for knee osteoarthritis as well as musculoskeletal or MSK embolization for chronic pain involving areas such as the shoulder, hip and other joints. So how does embolization help arthritis pain? Rather than replacing a joint, these procedures use a tiny catheter to reach abnormal blood vessels associated with inflammation. The goal is to reduce that inflammatory blood flow and, in appropriately selected patients, reduce pain and improve function. For knee osteoarthritis, GAE is being explored as a minimally invasive option for patients who continue to have pain despite conservative treatment and are looking for alternatives to knee replacement. We also explore how this concept is moving beyond the knee. Dr. Nathanson discusses emerging applications of MSK embolization for chronic joint and tendon pain involving the shoulder, hand and wrist, hip, knee, Achilles tendon, plantar fascia and more. If you are dealing with osteoarthritis, chronic knee pain or persistent joint pain, this conversation will help you understand where these newer minimally invasive treatments may fit, who may be a candidate, and why vascular specialists are becoming part of a rapidly evolving area of arthritis care. Learn more about Dr. Daniel Nathanson and San Francisco Vein & Vascular Institute: San Francisco, California Search: San Francisco Vein & Vascular Institute / Dr. Daniel Nathanson Need help with Peripheral Artery Disease or another opinion before an amputation? Call the Global PAD Association Leg Saver Hotline: 1-833-PAD-LEGS Find PAD clinical trials and research opportunities: PADTrials.org Join The Great Circulation Challenge Help us walk the 60,000 miles of the human circulatory system together. SIGN UP: www.TheGreatCirculationChallenge.org Subscribe to @TheWayToMyHeart for more conversations on new treatments, vascular disease, circulation, PAD, limb salvage and medical innovation. Please LIKE, COMMENT, SUBSCRIBE & SHARE. If you know someone living with arthritis or chronic joint pain who is looking for treatment options, send them this conversation. #Arthritis #Osteoarthritis #KneePain #GenicularArteryEmbolization #GAE #MSKEmbolization #ArthritisTreatment #JointPain #MinimallyInvasive #KneeArthritis #ChronicPain #VascularSurgery #DrDanielNathanson #MedicalInnovation

This week we review the use of right axillary artery access for aortic valvuloplasty in infants. Why would this approach potentially offer advantages versus the more traditional femoral or even carotid approach? What are the particular dangers of this approach? How should the interventionist pick the approach when planning an aortic valvuloplasty in an infant with valvar aortic stenosis? We speak with Dr. Jameel Al-Ata of King Faisal Specialist Hospital in Jeddah, Saudi Arabia this week. DOI: 10.1007/s00246-025-03991-6

Dr. Edson Lucas Colomé, Cirurgião Vascular e Dr. Murilo Moraes, Especialista em Diagnóstico Vascular, participaram do programa Arauto Saúde para falar sobre cirurgias vasculares, lipedema e diagnósticos.

Dr. Edson Lucas Colomé, Cirurgião Vascular e Dr. Murilo Moraes, Especialista em Diagnóstico Vascular, participaram do programa Arauto Saúde para falar sobre cirurgias vasculares, lipedema e diagnósticos.

Marcelo Agra, médico vascular, participou do programa Direto ao Ponto para falar sobre a campanha Agosto Azul e Vermelho, que reforça a importância da prevenção e dos cuidados com a saúde vascular.

Marcelo Agra, médico vascular, participou do programa Direto ao Ponto para falar sobre a campanha Agosto Azul e Vermelho, que reforça a importância da prevenção e dos cuidados com a saúde vascular.

Commentary by Dr. Alena Shantsila.

Dr. Maya Patel and Dr. Tetyana Gorbachova explore key vascular variants of the upper and lower extremities that radiologists may encounter on routine musculoskeletal imaging, highlighting how to recognize them and understand their clinical significance. They discuss the surgical implications of variants such as the persistent median artery, corona mortis, persistent sciatic artery, and aberrant anterior tibial artery, emphasizing how accurate identification can help prevent serious complications including neuropathy, hemorrhage, limb ischemia, and amputation. Charting Variant Vascular Pathways in Musculoskeletal Imaging: Clinical and Surgical Implications. Patel et al. RadioGraphics 2026; 46(3):e250073. 

Comparing Marfan Syndrome, Loeys-Dietz Syndrome, and Vascular EDS   Guest: Juan Bowen, M.D. Host: Paul Friedman, M.D.   Marfan syndrome, Loeys-Dietz syndrome, and vascular Ehlers-Danlos syndrome are clinical problems seen in an aortic clinic. Thoracic aortic aneurysm is a common feature, but the three conditions differ in the severity of aortic and arterial disease and in the types of extracardiac problems that require management. Making an accurate diagnosis is an essential first step in their successful management.   Topics Discussed: What mutations cause Marfan syndrome, Loeys-Dietz syndrome, and the vascular Ehlers-Danlos syndrome? What is the natural history of these three conditions? How is aortic and vascular disease managed in these three conditions? What are the non-cardiac problems most often encountered in these three conditions?   Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode.   Podcast episode transcript found here.   Recorded on: 17-February-2026

How is AI reshaping the way radiology residents study, dictate reports, and summarize clinical courses? BackTable co-founder Anish Parikh catches up with Dr. Sunny Murthy, a PGY-2/R1 integrated interventional radiology (IR) resident at the University of Virginia (UVA). --- Get the BackTable apphttps://www.backtable.com/app --- More about this episode Dr. Murthy outlines the lecture structure (morning didactics, noon case-based sessions) and a curriculum shift toward on-demand video learning via Modality, alongside books, Radiopaedia, and targeted journal use. They discuss conference learning at SIR, the role of podcasts like BackTable, and balancing information overload. AI comes up in both clinical workflows (Epic-generated hospital-course summaries that can be wrong) and education (Claude/Notion for organizing study), with debate about limiting AI for trainees versus preparing for future practice. The resident explains learning procedures across multiple devices, relying on techs, industry training and exhibit halls, and notes receiving a resident teaching award while emphasizing the need for better IR exposure and simulation-based training content. --- Resources Fundamentals of Body CThttps://www.us.elsevierhealth.com/fundamentals-of-body-ct-9780323608329.html Journal of Vascular and Interventional Radiologyhttps://www.jvir.org/ CardioVascular and Interventional Radiologyhttps://www.cvironline.org/ --- 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

La prevención de enfermedades neurológicas, incluyendo el ictus y demencias como el Alzheimer, depende fundamentalmente del control de factores de riesgo vascular que son completamente modificables. Según la doctora Obdulia Lozano, vocal de la Sociedad Española de Neurología, el 90% de los ictus se deben a estos factores, sin embargo, existe una preocupante falta de hábito preventivo en España: 4 de cada 10 personas nunca controlan su tensión arterial y los jóvenes de 18 a 34 años son quienes más descuidan estas revisiones. Por ello, los expertos recomiendan realizarse analíticas de sangre anuales y controles periódicos de tensión a partir de los 30 o 35 años para detectar "enemigos silenciosos" como la hipertensión o la hipercolesterolemia antes de que den la cara de forma trágica o irreversible. Además del control médico, el autocuidado cerebral implica adoptar un estilo de vida saludable que incluya una dieta equilibrada, evitar tóxicos como el alcohol y el tabaco, y realizar al menos 150 minutos de ejercicio físico aeróbico a la semana.

En este episodio nos adentramos en una de las estructuras más fascinantes y peor simplificadas del sistema nervioso: el tálamo. Durante años se nos ha enseñado como una gran “estación de relevo sensitiva”, pero esa metáfora se queda corta. El tálamo no solo transmite información hacia la corteza: la filtra, la organiza, la modula y participa en el estado funcional en el que esa información llega al cerebro consciente. A lo largo del episodio recorremos su historia, su lugar dentro del diencéfalo, sus principales núcleos y su papel en sensibilidad, visión, audición, movimiento, memoria, atención, cognición y conciencia. Pero el episodio no se queda en la anatomía clásica. Entramos también en la neurofisiología moderna del tálamo: entradas drivers y modulators, núcleos de primer orden y de orden superior, bucles cortico-tálamo-corticales, modos de disparo tónico y en ráfaga. Finalmente, aterrizamos todo en clínica: ictus talámicos, dolor central, afasia talámica, negligencia, alteraciones cognitivas, trastornos del movimiento, arteria de Percheron, mesocircuito de Schiff y la idea central del episodio: el tálamo enferma como nodo, no como simple estación. Referencias del episodio: 1. Atallah, O., Almealawy, Y. F., Alabide, A. S., Farooq, M., Sanker, V., Alrubaye, S. N., Darwazeh, R., Awuah, W. A., Abdul-Rahman, T., Muthana, A., Saleh, A., Wellington, J., & Badary, A. (2024). Navigating the clinical landscape of artery of Percheron infarction: A systematic review. eNeurologicalSci, 37, 100521. https://doi.org/10.1016/j.ensci.2024.100521 (https://pubmed.ncbi.nlm.nih.gov/39257866/). 2. Biesbroek, J. M., Verhagen, M. G., van der Stigchel, S., & Biessels, G. J. (2024). When the central integrator disintegrates: A review of the role of the thalamus in cognition and dementia. Alzheimer's & dementia : the journal of the Alzheimer's Association, 20(3), 2209–2222. https://doi.org/10.1002/alz.13563 (https://pmc.ncbi.nlm.nih.gov/articles/PMC10984498/). 3. Bolkan, S. S., Stujenske, J. M., Parnaudeau, S., Spellman, T. J., Rauffenbart, C., Abbas, A. I., Harris, A. Z., Gordon, J. A., & Kellendonk, C. (2017). Thalamic projections sustain prefrontal activity during working memory maintenance. Nature neuroscience, 20(7), 987–996. https://doi.org/10.1038/nn.4568 (https://pubmed.ncbi.nlm.nih.gov/28481349/). 4. Cacciatore, M., Magnani, F. G., Barbadoro, F., Ippoliti, C., Stanziano, M., Clementi, L., Nigri, A., Nanetti, L., Marino, S., La Porta, F., Lucca, L. F., Prada, F., & Leonardi, M. (2025). Thalamus and consciousness: a systematic review on thalamic nuclei associated with consciousness. Frontiers in neurology, 16, 1509668. https://doi.org/10.3389/fneur.2025.1509668 (https://pmc.ncbi.nlm.nih.gov/articles/PMC12241866/). 5. Cao, T., He, S., Wang, L., Chai, X., He, Q., Liu, D., Wang, D., Wang, N., He, J., Wang, S., Yang, Y., Zhao, J., & Tan, H. (2024). Clinical neuromodulatory effects of deep brain stimulation in disorder of consciousness: A literature review. CNS neuroscience & therapeutics, 30(6), e14559. https://doi.org/10.1111/cns.14559 (https://pubmed.ncbi.nlm.nih.gov/38115730/). 6. Fritsch, M., Rangus, I., & Nolte, C. H. (2022). Thalamic Aphasia: a Review. Current neurology and neuroscience reports, 22(12), 855–865. https://doi.org/10.1007/s11910-022-01242-2 (https://pmc.ncbi.nlm.nih.gov/articles/PMC9750901/). 7. Gupta, N., & Pandey, S. (2018). Post-Thalamic Stroke Movement Disorders: A Systematic Review. European neurology, 79(5-6), 303–314. https://doi.org/10.1159/000490070 (https://pubmed.ncbi.nlm.nih.gov/29870983/). 8. Marcuse, L. V., Langan, M., Hof, P. R., Panov, F., Saez, I., Jimenez-Shahed, J., Figee, M., Mayberg, H., Yoo, J. Y., Ghatan, S., Balchandani, P., & Fields, M. C. (2025). The thalamus: Structure, function, and neurotherapeutics. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 22(2), e00550. https://doi.org/10.1016/j.neurot.2025.e00550 (https://pubmed.ncbi.nlm.nih.gov/39956708/). 9. Mitchell A. S. (2015). The mediodorsal thalamus as a higher order thalamic relay nucleus important for learning and decision-making. Neuroscience and biobehavioral reviews, 54, 76–88. https://doi.org/10.1016/j.neubiorev.2015.03.001 (http://pubmed.ncbi.nlm.nih.gov/25757689/). 10. Schiff N. D. (2010). Recovery of consciousness after brain injury: a mesocircuit hypothesis. Trends in neurosciences, 33(1), 1–9. https://doi.org/10.1016/j.tins.2009.11.002 (https://pubmed.ncbi.nlm.nih.gov/19954851/). 11. Schmahmann J. D. (2003). Vascular syndromes of the thalamus. Stroke, 34(9), 2264–2278. https://doi.org/10.1161/01.STR.0000087786.38997.9E (https://pubmed.ncbi.nlm.nih.gov/12933968/). 12. Schmitt, L. I., Wimmer, R. D., Nakajima, M., Happ, M., Mofakham, S., & Halassa, M. M. (2017). Thalamic amplification of cortical connectivity sustains attentional control. Nature, 545(7653), 219–223. https://doi.org/10.1038/nature22073 (https://pubmed.ncbi.nlm.nih.gov/28467827/). 13. Sherman, S. M., & Guillery, R. W. (1998). On the actions that one nerve cell can have on another: distinguishing "drivers" from "modulators". Proceedings of the National Academy of Sciences of the United States of America, 95(12), 7121–7126. https://doi.org/10.1073/pnas.95.12.7121 (https://pubmed.ncbi.nlm.nih.gov/9618549/). 14. Sherman S. M. (2016). Thalamus plays a central role in ongoing cortical functioning. Nature neuroscience, 19(4), 533–541. https://doi.org/10.1038/nn.4269 (https://pubmed.ncbi.nlm.nih.gov/27021938/). 15. Steriade M. (2005). Sleep, epilepsy and thalamic reticular inhibitory neurons. Trends in neurosciences, 28(6), 317–324. https://doi.org/10.1016/j.tins.2005.03.007 (http://pubmed.ncbi.nlm.nih.gov/15927688/). 16. Whyte, C. J., Redinbaugh, M. J., Shine, J. M., & Saalmann, Y. B. (2024). Thalamic contributions to the state and contents of consciousness. Neuron, 112(10), 1611–1625. https://doi.org/10.1016/j.neuron.2024.04.019 (https://pubmed.ncbi.nlm.nih.gov/38754373/).

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Gayatri Devi is a nationally recognized neurologist specializing in memory disorders, including Alzheimer's disease and related dementias. In this episode, Gayatri explains how to think about dementia as a spectrum—including Alzheimer's disease, vascular dementia, Lewy body dementia, and mixed presentations—while exploring the evolving biology of amyloid, tau, and neuroinflammation and why brain pathology does not always correlate with symptoms. She discusses her approach to detecting subtle cognitive decline in high-functioning individuals, the role of biomarkers and APOE4 testing in asymptomatic patients, the benefits and risks of anti-amyloid therapies such as lecanemab and donanemab, and strategies for minimizing treatment-related complications. Gayatri also examines why some patients may stabilize or even improve with individualized care, the overlap among different dementia syndromes, and the relationship between menopause, estrogen, and cognition—including her concept of menopause-related cognitive impairment. Finally, she discusses how advances in early detection, AI-assisted monitoring, targeted therapies, and precision medicine are reshaping the future of dementia care. We discuss: Gayatri's training and clinical focus, why dementia is a spectrum disease, and how personalized treatment is changing Alzheimer's care [3:45]; How Alzheimer's disease fits within the broader spectrum of dementia: diagnosis, biomarkers, and early pathophysiology [7:15]; The emerging role of neuroinflammation and viral infections in Alzheimer's disease [13:30]; Gayatri's comprehensive approach to evaluating cognitive decline in high-functioning patients [17:45]; Why forgetting names is usually normal and when word-finding problems become concerning [29:00]; Why women are at higher risk for Alzheimer's disease and how menopause influences cognition [33:45]; The promise and limitations of blood-based biomarkers for diagnosing Alzheimer's disease [40:15]; When preclinical Alzheimer's screening is appropriate and how to interpret positive biomarker results [45:00]; Case study: early Alzheimer's prevention in a highly-functional woman in her 50s with two copies of APOE4 [47:15]; Anti-amyloid therapies: balancing clinical benefit with ARIA risk using slow titration [51:45]; The aducanumab controversy, why it was discontinued, and why Gayatri would still choose it [1:00:00]; How anti-amyloid therapies cause ARIA, strategies for detecting and managing these complications, and how future therapies may improve safety and accessibility [1:03:30]; Two patient examples of exceptional responses to anti-amyloid therapy [1:12:30]; A multimodal approach to Alzheimer's treatment: combination therapy, MRI-guided TMS, GLP-1 receptor agonists, and more [1:15:00]; Vascular dementia, Lewy body dementia, and the overlap with Alzheimer's disease [1:21:00]; Lewy body dementia and Parkinson's disease: distinguishing two alpha-synuclein disorders [1:26:45]; Risk factors for Lewy body dementia and what remains unknown [1:36:15]; Treating menopause-related cognitive impairment: hormone therapy, brain rehabilitation, and balancing breast cancer risk [1:38:45]; How biomarkers changed Gayatri's perspective on the potential for Alzheimer's patients to improve [1:47:15]; The future of Alzheimer's care: AI, precision medicine, and personalized treatment [1:49:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

If you love facilitating workshops and trainings, but you know there's something more you want to say, this episode is for you.My guest is Corrin McCloskey, a healthcare executive, speaker, writer, and facilitator who has made the leap from being a fabulous facilitator into a true thought leader. Corrin joined us in Thought Leader Academy in January 2025, and in the year and a half since then, she has spoken at multiple national conferences, published writing in her field, and continued building momentum around her message: healthcare needs more human-centered, connected, and courageous leadership.This conversation is part of our Expert Trap series because Corrin's story is such a powerful example of what happens when you move beyond simply teaching helpful content and start naming what's missing in the conversation.We talk about:How Corrin shifted from facilitating strategic planning and leadership workshops to speaking on bigger stagesWhy thought leadership is less about having all the answers and more about sharing a clear perspectiveThe role of writing in expanding your ideas beyond a single talkHow to keep putting your work out there, even when it doesn't feel perfectWhat Corrin learned from both deeply affirming audience feedback and a painful experience of harassment after a speaking engagementWhy having a support system matters when you're using your voice more publiclyWhat I love about Corrin's journey is that she didn't abandon facilitation. She built on it. She took the skills she already had, added her lived experience and perspective, and stepped into a bigger conversation.That's the real invitation of thought leadership: to stop hiding behind expertise alone and start using your voice for the change you want to see.About Our Guest: Corrin McCloskey is a healthcare executive, executive coach, and national speaker focused on leadership, culture, and change management in healthcare. She serves as Vice President of Heart & Vascular and Oncology Services at Tanner Health, where she leads strategy, growth, and service line development. Passionate about helping leaders build trust and navigate complexity, Corrin frequently speaks on physician leadership, organizational culture, and leading change in healthcare. Over the past year, she has expanded her national speaking presence and contributed thought leadership focused on creating healthier, more sustainable healthcare systems.About Us: The Speaking Your Brand podcast is hosted by Carol Cox. At Speaking Your Brand, we help women entrepreneurs and professionals clarify their brand message and story, create their signature talks, and develop their thought leadership platforms. Our mission is to get more women in positions of influence and power because it's through women's stories, voices, and visibility that we challenge the status quo and change existing systems. Check out our coaching programs at https://www.speakingyourbrand.com. Links:Show notes at https://www.speakingyourbrand.com/480/ Corrin's website: https://corrinmccloskey.com/ Watch Corrin deliver her signature talk on our live show: https://www.youtube.com/live/rhDAdGR44-g?si=MulG_sPQ0-MmpLK4 Discover your Speaker Archetype by taking our free quiz at https://www.speakingyourbrand.com/quiz/Enroll in our Thought Leader Academy: https://www.speakingyourbrand.com/academy/ Connect on LinkedIn:Carol Cox = https://www.linkedin.com/in/carolcoxCorrin McCloskey (guest) = https://www.linkedin.com/in/corrinmccloskey/ Related Podcast Episodes:Episode 478: The Expert Trap: Why Great Speakers Don't Become Thought LeadersEpisode 391: Claiming Your Identity as a Speaker and Thought Leader

Join us for happy hour! In our new episode of The AJP-Heart and Circ Podcast, Associate Editor Dr. Amanda LeBlanc (University of Louisville) hosts a casual, witty, and engaging conversation with co-authors Dr. Camilla Wenceslau (University of South Carolina), Dr. Pooneh Bagher (University of Nebraska Medical Center), Dr. Brant Isakson (University of Virginia), Dr. Thomas Jepps (University of Copenhagen), and Dr. Aaron Trask (Nationwide Children's Hospital). The topic at hand for this lively group? The latest must-read Guidelines in Cardiovascular Research article by McCarthy et al. on evaluating endothelial function in vascular tissue. Listen now…you'll laugh a little and learn a lot.   Cameron G. McCarthy, Christian Aalkjær, Pooneh Bagher, Andreas M. Beyer, Ebbe Boedtkjer, Gisele F. Bomfim, Jerome W. Breslin, Ana M. Briones, Jorge A. Castorena-Gonzalez, Tiago J. Costa, Zhiyu Dai, Ana P. Davel, Scott Earley, Julie K. Freed, Christopher Garland, Brant E. Isakson, Thomas A. Jepps, Joanna Kalucka, Boris Lavanderos, Ayako Makino, Charles E. Norton, Steven S. Segal, Wenbin Tan, Aaron J. Trask, Calum Wilson, Scott D. Zawieja, and Camilla F. Wenceslau Guidelines for evaluating endothelial function in vascular tissue Am J Physiol Heart Circ Physiol, published May 1, 2026. DOI: 10.1152/ajpheart.00656.2025

A patient with a dying leg won't drive 20 miles for care. In Devin Zarkowsky's town, that's not a hypothetical. Vascular surgeon Devin Zarkowsky runs a solo office-based practice in a San Diego County town where peripheral arterial disease patients had nowhere local to go, and Jason McKittrick is the executive director of the Office-Based Facility Association. They discuss the KevinMD article "Why local care matters for peripheral arterial disease." You will hear how the Medicare physician fee schedule pays hospitals for big-ticket equipment but pays solo doctors out of the same bundled rate they use to cover staff and wire and drapes, why a four-figure atherectomy or Shockwave catheter swallows a week of revenue when there is no separate reimbursement, and why Congress is finally looking at fixing it after years of small fixes that did not close the gap. You will hear what local care actually means when a patient cannot drive and the limb cannot wait. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

A conversation with Dr. John Wong Find the video of this conversation at https://youtu.be/52HSuhvggRA

With Tom De Potter, Cardiovascular Research Center Aalst, Aalst - Belgium, Stefan Simovic, Faculty of Medical Sciences, University of Kragujevac, Kragujevac - Serbia and Micaela Ebert, Heart Center - University Hospital Dresden, Dresden - Germany. In this podcast, we explore the latest clinical consensus statement on vascular access and closure management for electrophysiological interventions, highlighting best practices to improve procedural safety and patient outcomes in 2025.

7/1/2026 | Vascular

7/1/2026 | Vascular

This episode features Dr Lois Rajcan, an Infusion Therapy and Vascular Access Standards of Practice 10th edition committee member, discussing best practices, standards, and organizational strategies for safe port access. Learn about the importance of competency, evidence-based practices, and patient-centered care in vascular access management.

¡Bienvenidos y bienvenidas a SINNNapsis!En este capítulo conversaremos con el Dr. Edgar Nathal Vera, neurocirujano vascular, adscrito al Servicio de Neurocirugía del Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez" (INNN), Director Médico del Instituto y profesor titular del Programa de Alta Especialidad en Neurocirugía Vascular, sobre las malformaciones arteriovenosas cerebrales (MAV). Estas credenciales coinciden con su trayectoria académica y asistencial pública.Las malformaciones arteriovenosas cerebrales son conexiones anormales entre arterias y venas que alteran el flujo sanguíneo normal del cerebro. Aunque pueden permanecer asintomáticas, representan una de las principales causas de hemorragia cerebral en pacientes jóvenes. En este episodio exploraremos su historia natural, los factores que aumentan el riesgo de ruptura, la controversia en torno al estudio ARUBA y cómo actualmente se individualiza la decisión entre observar o tratar una MAV mediante microcirugía, embolización, radiocirugía o estrategias multimodales.Visítanos en todas nuestras redes sociales.Aclaración: El contenido de este podcast tiene la finalidad de brindar información científica dirigida a un público con formación profesional en áreas de la salud. Los temas aquí presentados no pueden (ni pretenden) reemplazar la relación que usted tenga con su profesional sanitario; no se deberán considerar como un consejo médico, ni tienen tal finalidad. Los casos clínicos discutidos no corresponden a ningún paciente real que haya sido atendido por los conductores o el INNN; han sido elaborados exclusivamente con fines didácticos y de divulgación de la ciencia.

CORE RESOURCES: Rutherford's Vascular and Endovascular Therapy 10th Edition, Chapters 88, 89, 91, and 94 Atlas of Vascular Surgery and Endovascular Therapy 2nd Edition, Chapter 9 ADDITIONAL RESOURCES: Audible Bleeding Episodes Holding Pressure - Carotid Endarterectomy: https://www.audiblebleeding.com/2024/02/27/holding-pressure-carotid-endarterectomy/ Holding Pressure Case Prep - Endovascular Basics: https://www.audiblebleeding.com/2023/04/23/holding-pressure-case-prep-endovascular-basics/ Videos TCAR Technical Video: https://jnis.bmj.com/content/14/8/842 Articles Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease:  https://www.jvascsurg.org/article/S0741-5214%2821%2900893-4/fulltext Technical aspects of transcarotid artery revascularization using the ENROUTE transcarotid neuroprotection and stent system: https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2816%2931862-6 Referenced Studies ROADSTER-1 https://pubmed.ncbi.nlm.nih.gov/30611582/ ROADSTER-2 https://pubmed.ncbi.nlm.nih.gov/32811386/ https://pubmed.ncbi.nlm.nih.gov/35381327/ TCAR Surveillance Project https://jamanetwork.com/journals/jama/fullarticle/2757579?utm_source=openevidence&utm_medium=referral https://pubmed.ncbi.nlm.nih.gov/36172943/   OUTLINE:   CAROTID ARTERY DISEASE 1. Pathophysiology/etiology Carotid artery disease is primarily driven by atherosclerotic plaque deposition.  Risk factors: hypertension, hyperlipidemia, diabetes, smoking, and advanced age. Nonatherosclerotic etiologies: fibromuscular dysplasia, carotid dissection, vasculitic disease, carotid webs, and trauma. When the endothelium is damaged, monocytes migrate to the site and differentiate into macrophages that take up oxidized LDL particles to become foam cells. Meanwhile, an inflammatory response occurs where activated platelets release thromboxane A2, platelet derived growth factor, and inflammatory cytokines that promote further platelet aggregation and vascular inflammation. Smooth muscle cells migrate and proliferate, forming the structural framework of the atheroma.  Within the lesion, necrotic debris and lipid accumulate, creating a vulnerable plaque. Plaque rupture exposes this material to the bloodstream, serving as a nidus for thrombus formation which can lead to ischemic events. Carotid bifurcation is particularly prone to plaque formation due to turbulent blood flow. Embolization of plaque from this area can result in TIA or ischemic stroke.  2. Presentation Patients are often asymptomatic and stenosis is incidentally found on imaging.  Symptomatic patients present with neurologic symptoms including unilateral motor and sensory loss, aphasia (difficulty finding words), dysarthria (difficulty speaking), amaurosis fugax (temporary monocular vision loss due to embolus to the ophthalmic artery), transient ischemic attacks Physical exam findings may be notable for auscultation of a carotid bruit. Patients may also have evidence of retinal artery embolization on fundoscopic examination (Hollenhorst plaque) or asymptomatic cerebral infarction.  3. Diagnosis USPTF recommends against screening for asymptomatic carotid artery stenosis.  In patients with no risk factors, SVS recommends against screening for asymptomatic carotid artery stenosis. However, they do recommend screening for asymptomatic clinically significant carotid bifurcation in certain groups of patients with multiple risk factors.  These risk factors include patients with clinically significant peripheral vascular disease, patients 65 and older with history of CAD, smoking, hypercholesterolemia, and patients prior to coronary artery bypass.  Relevant findings on physical exam or imaging findings may warrant screening, but screening is not recommended for the presence of neck bruit alone without other risk factors, as this finding has a low sensitivity and specificity for detecting clinically significant carotid artery stenosis.  Carotid duplex ultrasound: first-line imaging modality for both screening and initial evaluation of stenosis, noninvasive, low-cost CTA: rapid, high-resolution, three-dimensional imaging of vascular anatomy, risk of contrast and radiation exposure MRA: high-quality, three-dimensional imaging without radiation or contrast, expensive with longer acquisition time, can overestimate stenosis in severe disease DSA/angiography: gold standard, expensive, invasive, not generally recommended for routine diagnostic evaluation or screening 4. Classification Carotid artery stenosis is classified by degree of luminal narrowing. NASCET method: standard in current practice. Compares the minimal residual lumen at the point of greatest stenosis to the diameter of the normal distal internal carotid artery.  Classification of stenosis: Mild: 70 bpm, and ACT >250 seconds to optimize cerebral perfusion and minimize thrombotic risk. Clamp the carotid artery just proximal to the arterial sheath to establish active flow reversal.  Flow controller settings: Low setting High setting Flow-stop button: allows for temporary cessation of flow (used when we inject contrast).  Confirm flow reversal via two different ways:  The first way is to stop flow to the venous return sheath with the stopcock, clearing the line with hep saline injection, and then opening the stopcock and seeing the blood returning to the controller in a reverse fashion. The second way is to perform an angiogram with a small amount of contrast injection while holding the flow-stop button. Using the angio we want to make sure that contrast is flowing retrograde in the cervical ICA thereby confirming flow reversal.    Carotid artery stenting, balloon angioplasty, and completion angiogram At this point, a standard carotid angioplasty and stenting procedure is performed. ENROUTE transcarotid Neuroprotection System device:  inner diameter of 8F and an outer diameter of 10F Has its own carotid artery stent system but is also compatible with all FDA-approved carotid stents.  Final angiogram is performed to confirm stent position, vessel patency, and absence of complications including vasospasm at the distal end of the stent and filling defects from protrusion of atheromatous material through the stent    Cessation of flow reversal and sheath removal Allow the flow reversal to run for a few minutes after the final balloon angioplasty to clear any debris.  Antegrade flow is restored by releasing the carotid clamp and closing the stopcocks on the neuroprotection system.  The patient is auto-transfused the blood from the flow line back to the venous system.  As the arterial access system is removed and the puncture site is closed with the U-stitch.  IV protamine is administered to reverse the heparin. Standard closure is performed at the incision site. Meanwhile, hemostasis is achieved after removal of the femoral vein sheath with brief manual compression.  Postop care/complications Postop care All patients after a TCAR should be monitored in the ICU setting for 24 hours, as an embolic stroke, hypotension with or without bradycardia, or hypertension can occur.  Should a TIA or stroke be observed, a carotid duplex scan and CT angiogram should be immediately obtained to assess the stent site and the presence of an embolic or thrombotic filling defect, dissection, or occlusion.  Dual antiplatelet therapy: continue for 45 days to 12 months Aspirin and statin therapy: continued indefinitely Surveillance duplex imaging: 4 weeks, 6 months, and 12 months, and annually thereafter. Postop complications Hematoma Stroke Myocardial infarction Cerebral hyperperfusion syndrome Sudden and excessive increase in cerebral blood flow to previously hypoperfused brain tissue is met with vasculature that cannot constrict appropriately from chronic vasodilation Leads to breakthrough hyperperfusion. This results in cerebral edema, intracerebral hemorrhage, and neurological symptoms.  Cranial nerve injury Hypoglossal nerve (CN XII) injury: ipsilateral tongue deviation. It is the most commonly injured cranial nerve.  Vagus nerve (CN X) injury: hoarseness and possible vocal cord paralysis.  Glossopharyngeal nerve (CN IX) injury: soft palate dysfunction.  Recurrent laryngeal nerve injury: voice hoarseness and inability to cough as it innervates all of the voice box muscles except for the cricothyroid muscle Marginal mandibular nerve injury: ipsilateral lip droop, injury is rare in TCAR.  Stent restenosis Pseudoaneurysm Access site infection

Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Sonal's 18th Season starts up and Episode 4 features Newsworthy updates on the month's fraud, waste, and abuse cases. Sonal's Trusty Tip and compliance recommendations focus on documentation requirements for noninvasive vascular studies.Spark inspires us all to reflect on all things fear based on the inspirational words of Jack Canfield.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Paint The Medical Picture Podcast now on:Spotify:⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3X⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id153044217⁠7⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Amazon Music: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcas⁠t⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Find Paint The Medical Picture Podcast on YouTube:⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7A⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Find Sonal on LinkedIn:⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/sonapate/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠And checkout the website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://paintthemedicalpicturepodcast.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠PaintTheMedicalPicturePodcast@gmail.com

Vascular access is the lifeline for people on dialysis. Today we'll cover the different types, how doctors determine the best option, what the surgery and recovery involve, and more! Today we're joined by Dr. Vandana Dua Niyyar, and kidney warrior Brittany Dickerson to discuss vascular access–an important topic that will hopefully help you all listening feel more informed and confident in your care.  In today's episode we heard from:  Vandana Dua Niyyar is Professor of Medicine in the Division of Nephrology and has received the Clinical Distinction of Master Physician at Emory University. Dr. Niyyar is passionate about promoting multidisciplinary collaboration in research and education in the field of vascular access; with the ultimate goal of optimizing access care and processes for dialysis patients. She currently serves as Immediate Past President of the American Society of Diagnostic and Interventional Nephrology (ASDIN). Dr. Niyyar has been recognized for her exemplary clinical and service achievements through various awards including ASDIN Distinguished Service Award in 2019, Emory Nanette Wenger Service Award in 2019, ASN Mid-Career Distinguished Clinical Service Award in 2020, ANIO Clinical Excellence Award in 2021, Emory DOM Outstanding Quality Achievement Award in 2022 and and ASDIN Gerald Beathard Award in recognition of her teaching excellence, scholarly activity, and clinical excellence in 2024. Brittany Dickerson- I am a dedicated mother, motivational speaker, and compassionate life coach living with Polycystic Kidney Disease (PKD). I use my kidney failure battle to educate and help others regarding kidney disease and transplantation. My personal journey has fueled my passion for helping others navigate life's challenges with courage and grace. Through partnership with the National Kidney Foundation, I have had the opportunity to mentor others and to be a guest for the National Kidney Foundation Podcast channel. My dedication to kidney awareness has led me to pursue becoming a National Kidney Foundation Advocate. I use my voice to spread my powerful message of perseverance and hope. My goal is to continue making an impact on individuals facing adversity, offering guidance, support, and being a shining example of strength in the face of hardship.   Additional Resources Vascular Access Guidelines   Do you have comments, questions, or suggestions? Email us at NKFpodcast@kidney.org. Also, make sure to rate and review us wherever you listen to podcasts.  

Rachel Ludwig, Partner, DLA Piper, speaks with John Saran, Partner, Holland & Knight, Regan Parker, CEO, Association for Responsible Healthcare Investment, and Robbie Allen, CEO, U.S. Heart & Vascular, about the latest legal and regulatory developments related to corporate ownership of health care providers. They discuss the recent evolution of these laws and regulations at the state level, recurring trends, unintended consequences, and what the industry is doing to build trust and help shape the legal and regulatory landscape. From AHLA's Business Law and Governance Practice Group.Watch this episode: https://www.youtube.com/watch?v=Z9LWJzUczjkLearn more about AHLA's Business Law and Governance Practice Group: https://www.americanhealthlaw.org/practice-groups/practice-groups/business-law-and-governance Essential Legal Updates, Now in AudioAHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Comprehensive members. Get all your health law news from the major media outlets on this podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.Stay At the Forefront of Health Legal EducationLearn more about AHLA and the educational resources available to the health law community at https://www.americanhealthlaw.org/. 

This episode is brought to you by The Primal Skincare. Vascular surgeon Dr. Lily Johnston breaks down the definitive science of heart attack prevention and evaluates how modern diet and lifestyle choices directly accelerate or mitigate your cardiovascular risk. We explore the complex biological mechanisms underlying plaque formation and arterial rupture, moving beyond outdated dogmas to examine the real drivers of vascular disease: chronic inflammation, metabolic dysfunction, and the direct effects of insulin and glucose on your endothelial lining. Whether you are navigating the nuances of cholesterol management or looking for the most accurate diagnostic testing, this episode provides an authoritative, evidence-based roadmap to optimize your heart health and protect your arteries.In This Episode, We Reveal:The Pathophysiology of Plaque: How arterial plaque forms, why it ruptures, and the crucial clinical distinction between volatile soft plaque and stable calcified plaque.The Metabolic Drivers: The profound impact of chronic glucose and insulin elevation on arterial degradation.Advanced Diagnostics: Why standard lipid panels fail to show the whole picture, and how advanced imaging tools can detect early-stage disease.The Cholesterol Matrix: A scientific contextualization of LDL, the complexities of HDL, and whether elevated markers are a true risk factor on low-carbohydrate diets.Dietary Realities: A medical critique of common foods, the cardiovascular impact of processed ingredients, and the evidence supporting the Mediterranean diet.Scientific Resources & Dr. Johnston's Work:Dr. Lily Johnston (YouTube): https://www.youtube.com/@lilyjohnstonmdCleerly Health: https://cleerlyhealth.com/CardioRisk Ultrasound Testing: https://cardiorisk.com/HeartFlow CT Analysis: https://www.heartflow.com/

What if one of the most popular non-surgical procedures in aesthetic medicine is also one of the most misunderstood?In this episode of Plastic Surgery Uncensored, Dr. Rady Rahban takes an in-depth look at liquid rhinoplasty—a procedure that has surged in popularity thanks to its promise of immediate results, minimal downtime, and the ability to alter the appearance of the nose without surgery.But beneath the appeal lies a far more complex reality.Dr. Rahban breaks down what liquid rhinoplasty actually is, the anatomical principles that make it effective in certain situations, and why it is often being used to address concerns it was never designed to correct. He explains which patients may benefit from strategically placed filler, why others are poor candidates, and how an incomplete understanding of nasal anatomy can lead to devastating consequences.This conversation goes far beyond social media transformations and before-and-after photos. It explores the limitations of filler, the importance of proper patient selection, and the potentially catastrophic complications that can occur when injections are performed in one of the most anatomically complex regions of the face—including vascular occlusion, tissue necrosis, and even blindness.If you've ever considered a liquid rhinoplasty, been told filler can "fix" your nose, or want to understand the difference between temporary camouflage and true structural correction, this episode is essential listening.Topics covered include:• What liquid rhinoplasty actually is• How filler can improve select nasal contour irregularities• Who may be an appropriate candidate• Why some noses should never be treated with filler• The limitations of non-surgical nose reshaping• Vascular occlusion and tissue necrosis explained• The rare but devastating risk of blindness• Why nasal anatomy matters• Liquid rhinoplasty vs. surgical rhinoplasty• When surgery is the more appropriate solutionThis is a thoughtful, evidence-based discussion about one of aesthetic medicine's most controversial procedures—and the information every patient should understand before allowing anyone to inject their nose.✨ If you enjoyed this episode of Plastic Surgery Uncensored:✔️ Subscribe on Apple Podcasts, Spotify, or wherever you listen.✔️ Rate & Review—your feedback helps more people find us.✔️ Follow Dr. Rady Rahban across all platforms for daily insights, behind-the-scenes, and patient education:Instagram: @drradyrahbanTikTok: @radyrahbanMDYouTube: @Rady RahbanFacebook: @Rady Rahban✔️ Share this episode with someone considering plastic surgery—the right knowledge can save a life.

A 25-year-old pregnant woman presents with a 1-day history of progressive pain and swelling. The foot is cold, pulseless and neurologic function is deteriorating by the hour. Imaging shows a massive iliofemoral DVT. Now both the limb and the pregnancy are threatened. Do you anticoagulate, thrombolyse or operate? Join us as we break down the management and decision making behind this rare but devastating case.Hosts:·      Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center·      Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center·      Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center·      Lucio Flores, Vascular surgery, Brookdale Hospital Medical CenterLearning objectives:-       Recognize the clinical presentation and pathophysiology of phlegmasia cerulea dolens-       Describe how pregnancy affects decision making in patients with phlegmasia and venous thromboembolic disease-       Discuss the goals of treatment for patients with DVT's and identify when operative intervention is indicated-       Describe the sequelae of DVT's and how this relates to post thrombotic syndrome-       Review the indications, risks, and limitations of anticoagulation, catheter-directed thrombolysis, thrombectomy, and fasciotomy in the management of DVT and phlegmasia.-       Explain the role of IVUS in managing venous thromboembolic disease and May Thurner syndromeReferences:-       Vedantham, S., Goldhaber, S. Z., Julian, J. A., Kahn, S. R., Jaff, M. R., Cohen, D. J., Magnuson, E., Razavi, M. K., Comerota, A. J., Gornik, H. L., Murphy, T. P., Lewis, L., Duncan, J. R., Nieters, P., Derfler, M. C., Filion, M., Gu, C.-S., Kee, S., Schneider, J., … Kearon, C. (2017). Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis. New England Journal of Medicine, 377(23), 2240–2252. https://doi.org/10.1056/NEJMoa1615066-       Gomes, M. S., Guimarães, M., & Montenegro, N. (2019). Thrombolysis in pregnancy: A literature review. Journal of Maternal-Fetal & Neonatal Medicine, 32(14), 2418–2428. https://doi.org/10.1080/14767058.2018.1438402-       Mangla, A., & Hamad, H. (2023). May-Thurner syndrome. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554377/-       Bates, S. M., Rajasekhar, A., Middeldorp, S., McLintock, C., Rodger, M. A., James, A. H., et al. (2018). American Society of Hematology 2018 guidelines for management of venous thromboembolism: Venous thromboembolism in the context of pregnancy. Blood Advances, 2(22), 3317–3359. https://doi.org/10.1182/bloodadvances.2018024802-       Kahn, S. R., Comerota, A. J., Cushman, M., Evans, N. S., Ginsberg, J. S., Goldenberg, N. A., et al. (2014). The postthrombotic syndrome: Evidence-based prevention, diagnosis, and treatment strategies. Circulation, 130(18), 1636–1661. https://doi.org/10.1161/CIR.0000000000000130 https://pubmed.ncbi.nlm.nih.gov/25246013/Sponsor URL: https://www.goremedical.com/If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Could mushrooms hold the secret to better gut health, lower cholesterol, and can they protect your brain? Today, Professor Robin May, a leading microbiologist and the UK Government's Chief Scientific Officer, explores why our interest in mushrooms has exploded. He explains why they are not just another vegetable but could hold the key to better gut health, brain health, immune health, and lower cholesterol. By the end of the episode, you'll know which health claims about mushrooms are real, which are exaggerated and where the science is just too early to trust. You'll have a solid understanding of what mushrooms are really doing inside our bodies and how to unlock the secret health powers they hold. Should mushrooms become a regular part of your weekly shop rather than an occasional side dish? And if fungi have evolved alongside humans for millions of years, what else might they reveal about the future of nutrition and health?

6/2/2026 | Vascular

6/2/2026 | Vascular

6/2/2026 | Vascular

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast with Brit Long (@long_brit), we cover how to evaluate and manage acute limb ischemia. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play Send us Fan Mail

Send us Fan MailWe're joined by Jim's wife for this one.  We cover a bit of ground and have some laughs.Big WhackMoney back guaranteeIncenseRIP Wolves and WildVictoire'MN sports futilityDystopianFacial recognitionSchlitzYungblud concert reviewThe opposite of David Lee RothMark's Green Day connectionSongs of the Week:Vascular--PierreLove Removal Machine--The CultHappy Birthday Mark!#NewtsAppleValleyMNTheAscertainers@gmail.comPierre - "Vascular"The Cult - Love Removal Machine HD - YouTubeYUNGBLUD - Hello Heaven, Hello (Official Music Video) - YouTube (the good part starts at 2:50)Dillinger Four - Doublewhiskeycokenoice  (You be the judge--did Green Day rip them off?)

Medicine isn't what it used to be—not for the people practicing it. Independent physicians are becoming the exception, not the norm, as more doctors move into hospital systems, corporate groups, and academic networks. At the same time, the pipeline of specialists isn't keeping pace with growing patient needs, particularly in complex fields like vascular surgery, where workforce models show demand is set to outstrip supply in the years ahead. The result is a profession being pulled in two directions at once: toward consolidation on one hand, and rising clinical demand on the other.In that kind of environment, what does it really mean to make a major career move—and how do you weigh opportunity, stability, and personal priorities when the ground beneath the profession is shifting?That question sits at the heart of the latest episode of I Don't Care. Host Dr. Kevin Stevenson sits down with vascular surgeon Dr. Bradley Trinidad to unpack the realities behind a major geographic and professional transition. Their conversation explores how evolving medical technology, shifting employment models, and personal values intersect to shape modern physician careers.Key takeaways from the episode…Family can outweigh career momentum: Dr. Trinidad left a high-volume, successful practice to prioritize proximity to family and improve quality of life.Alignment is everything in hospital employment: Success depends on shared goals between physician and institution, especially in a system where most doctors are now employed.The future of vascular surgery is less invasive—and more complex: Advances in endovascular techniques are reducing the need for open surgery while increasing the need for specialized expertise.Dr. Bradley Trinidad is a board-certified vascular surgeon with expertise in both complex open and advanced endovascular procedures. He serves as Director of Vascular and Endovascular Surgery at Ascension Providence in Waco, Texas, where he leads program development and the delivery of high-acuity vascular care. He previously founded and led the vascular division at Northwest Texas Hospital and now contributes to surgical education as a Clinical Assistant Professor at Texas Tech University Health Sciences Center.

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

It's PodQuiz Monday! Test your knowledge from a recent episode with a quick set of audio flashcards designed to reinforce what you learned. These mini-reviews are a great way to study on the go, and they give you a taste of what it's like inside Study Sesh, my audio study tool for busy nursing students. If you need a brush-up on vascular assessments before you do this podquiz, I've got you covered in episode ENCORE! #274: Introduction to Vascular Assessment.

Every other week I republish one of my most popular or impactful episodes from my backlog of over 450 episodes. This week I'm highlighting Episode 274, which walks you through how to perform a vascular assessment. ___________________ ⁠Full Transcript⁠- Read the article "Performing a Vascular Assessment" and view references ⁠Nursing School Survival Blueprint⁠ - Nursing school gets easier when you have a system. This free Blueprint walks you through the key shifts that separate struggling students from thriving ones — download it and start applying them this week.

Dr. Clint Sliker breaks down the critical imaging findings of cardiac and non-thoracic vascular trauma, highlighting how these rare but life-threatening injuries appear on CT. He shares practical insights to help radiologists recognize subtle signs, choose the right protocols, and maintain a high index of suspicion in high-stakes trauma cases. Imaging of Cardiac and NonaorticThoracic Vascular Trauma. Costenbader and Beheshtian et al. RadioGraphics 2026; 46(2):e250097. 

Your arteries may be older than you are--here's how we find out. Credit available for this activity expires: 5/8/27 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/episode-3-carotid-ultrasound-seeing-vascular-age-2026a1000een?ecd=bdc_podcast_libsyn_mscpedu

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

CardioNerds (Drs. Natalie Marrero, Shivani Reddy, and Rebecca S. Steinberg), discuss the role of SGLT2i in cancer therapy-related cardiac dysfunction (CTRCD) with Dr. Manu Murali Mysore. This episode was produced as part of the CardioNerds Academy curriculum by House Taussig under the guidance of House Chief, Dr. Natalie Marrero, and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Summary: Cancer therapy-related cardiac dysfunction (CTRCD) spans a spectrum from subclinical biomarker elevation to overt heart failure, with risk amplified by preexisting cardiovascular disease, diabetes, hypertension, obesity, and exposure to therapies, such as anthracyclines, HER2-targeted therapies, or radiation. This episode explores the emerging and promising role of SGLT2 inhibitors as a cardioprotective adjunct in cardio-oncology — examining mechanisms, clinical evidence, ongoing trials, and critical knowledge gaps — while affirming that guideline-directed medical therapy remains the cornerstone of prevention and treatment. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Cardio-Oncology PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls CTRCD is a spectrum — catch it early. CTRCD ranges from subclinical injury detected by imaging and biomarkers to overt heart failure. Early identification in high-risk patients (preexisting CVD, diabetes, HTN, obesity, anthracycline/HER2/radiation exposure) is essential, and early initiation of guideline-directed medical therapy — including ACE inhibitors/ARBs/ARNIs, mineralocorticoid receptor antagonists, and beta-blockers — remains the backbone of prevention and treatment to preserve LVEF and allow safe continuation of cancer therapy. SGLT2 inhibitors are a promising new pillar of cardioprotection in cardio-oncology. They act through a unique combination of mechanisms: renal effects, metabolic reprogramming of the myocardium, anti-inflammatory and antioxidant pathways, and vascular fibrosis modulation — making them a compelling complement to standard therapies rather than a replacement. Early clinical data is encouraging but not yet definitive. The 2024 EMPACARD-PILOT trial demonstrated preserved LVEF and reduced CTRCD in higher-risk patients with diabetes or kidney disease. Ongoing trials — EMPACT and PROTECT — are actively exploring SGLT2 inhibitors for primary prevention during anthracycline and HER2-targeted therapy. SGLT2 inhibitors are NOT yet indicated for ICI-related myocarditis. Immune checkpoint inhibitor (ICI)-related myocarditis is mechanistically immune-driven. While SGLT2 inhibitors have theoretically anti-inflammatory benefits, there is currently no clinical evidence to support their use in this specific setting. The use of SGLT2 inhibitors should be guided by patient risk, existing indications, and ongoing research. Large prospective trials, clarity on timing and patient selection, long-term safety data, and deeper mechanistic understanding in humans remain the most urgent gaps in the field before broader adoption can be recommended. References Theofilis P, Vlachakis PK, Oikonomou E, et al. Cancer therapy-related cardiac dysfunction: A review of current trends in epidemiology, diagnosis, and treatment. Biomedicines. 2024;12(12):2914. doi:10.3390/biomedicines12122914. https://pubmed.ncbi.nlm.nih.gov/39767820/ Lyon AR, Dent S, Stanway S, et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society. Eur J Heart Fail. 2020;22(11):1945-1960. doi:10.1002/ejhf.1920. https://pmc.ncbi.nlm.nih.gov/articles/PMC8019326/ Li X, Li Y, Zhang T, et al. Role of cardioprotective agents on chemotherapy-induced heart failure: A systematic review and network meta-analysis of randomized controlled trials. Pharmacol Res. 2020;151(104577):104577. doi:10.1016/j.phrs.2019.104577. https://pubmed.ncbi.nlm.nih.gov/31790821/ Lee YH, Lim S, Davies MJ. Cardiometabolic and renal benefits of sodium-glucose cotransporter 2 inhibitors. Nat Rev Endocrinol. 2025;21(12):783-798. doi:10.1038/s41574-025-01170-4. https://pubmed.ncbi.nlm.nih.gov/40935880/ Dabour MS, George MY, Daniel MR, Blaes AH, Zordoky BN. The cardioprotective and anticancer effects of SGLT2 inhibitors: JACC: CardioOncology state-of-the-art review. JACC CardioOncol. 2024;6(2):159-182. doi:10.1016/j.jaccao.2024.01.007. https://pubmed.ncbi.nlm.nih.gov/38774006/ Armillotta M, Angeli F, Paolisso P, et al. Cardiovascular therapeutic targets of sodium-glucose co-transporter 2 (SGLT2) inhibitors beyond heart failure. Pharmacol Ther. 2025;270(108861):108861. doi:10.1016/j.pharmthera.2025.10886. https://pubmed.ncbi.nlm.nih.gov/40245989/ Góes-Santos BR, Castro PC, Girardi ACC, Antunes-Correa LM, Davel AP. Vascular effects of SGLT2 inhibitors: evidence and mechanisms. Am J Physiol Cell Physiol. 2025;329(4):C1150-C1160. doi:10.1152/ajpcell.00569.2025. https://pubmed.ncbi.nlm.nih.gov/40908107/ Daniele AJ, Gregorietti V, Costa D, López-Fernández T. Use of EMPAgliflozin in the prevention of CARDiotoxicity: the EMPACARD – PILOT trial. CardioOncology. 2024;10(1):58. doi:10.1186/s40959-024-00260-y. https://pubmed.ncbi.nlm.nih.gov/39237985/ Clinicaltrials.gov. Clinicaltrials.gov. Accessed April 16, 2026. https://clinicaltrials.gov/study/NCT05271162 Greco A, Quagliariello V, Rizzo G, et al. SGLT2i Dapagliflozin in primary prevention of chemotherapy induced cardiotoxicity in breast cancer patients treated with neo-adjuvant anthracycline-based chemotherapy +/- trastuzumab: rationale and design of the multicenter PROTECT trial. CardioOncology. 2025;11(1):79. doi:10.1186/s40959-025-00368-9. https://pmc.ncbi.nlm.nih.gov/articles/PMC12400668/ Key Guideline Reference: Lyon AR, López-Fernández T, Couch LS, et al. 2022 ESC guidelines on cardio-oncology developed in collaboration with the European hematology association (EHA), the European society for therapeutic radiology and oncology (ESTRO) and the international cardio-oncology society (IC-OS). Eur Heart J Cardiovasc Imaging. 2022;23(10):e333-e465. doi:10.1093/ehjci/jeac106. https://pubmed.ncbi.nlm.nih.gov/36017575/ Be sure to check out the corresponding review article on the cardioprotective role of SGLT2 inhibitors in CTRCD that will be published in US Cardiology Review, the official journal of CardioNerds. Additionally, please reference CardioNerds Cardio-Oncology Episodes 261 and 274 for related content.

As interventional radiology cements its position as a primary clinical responder for acute arterial hemorrhage, what if you could achieve rapid and durable arterial occlusion with a single, highly deliverable device? In this episode of the BackTable Podcast, Dr. Alex Villalobos (UNC), Dr. Nima Kokabi (UNC), and Dr. Brian Funaki (UChicago) join host Dr. Kavi Krishnasamy to explore the shifting paradigms of arterial embolization in a case-based discussion highlighting modern vascular plug technologies.--- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Okami Medicalhttps://okamimedical.com/ --- Timestamps 00:00 - Introduction01:24 - Trauma Activation Workflow06:42 - Empiric Arterial Embolization Indications10:40 - Embolic Agent Preferences and Value Analysis17:18 - Embolics on the Shelf19:32 - LOBO Plug Use Cases20:58 - Case 1: Abdominal Wall Hematoma23:54 - LOBO Advantages, Cost, and Microcatheter Compatibility26:33 - Alternative Access Approaches30:31 - LOBO Sizing and Trackability35:26 - Pusher Wire Features38:20 - Delivery Catheter Requirements43:41 - Case 2: Retroperitoneal Bleed45:15 - LOBO Deployment Technique49:41 - Case 3: Splenic Trauma53:51 - Occlusion Time and Adjunct Embolics57:07 - Closing Remarks --- More about this episode The panel begins by discussing the range of embolic options and combinations at their disposal, sharing their preferences and treatment algorithms in various clinical scenarios. In particular, they emphasize the need for tools that provide immediate, predictable occlusion without the technical burden and cost of needing to deploy multiple embolic agents. The physicians go on to focus on Okami Medical's LOBO vascular plug as a primary solution for rapid vessel occlusion, highlighting the micro-pore architecture and unique deliverability through microcatheters that make it advantageous for precise positioning and reliable embolization. Exploring its use in cases including rectus sheath hematomas, retroperitoneal bleeding, and splenic trauma, the physicians detail the technical nuances of sizing and positioning the LOBO as well as the long-term advantages of its artifact-free design. This episode ultimately underscores a growing preference for streamlined arterial embolization workflows that prioritize rapid stasis and clinical predictability while leveraging the strengths of a multimodal embolic toolkit.

Jacob Soucy (@JacobWSoucy) hosts an inside look at a timely and thought-provoking editorial published in The Vascular Specialist, the official news magazine of the Society for Vascular Surgery.   In this episode, we explore the evolving conversation around surgical call and compensation through the lens of the editorial "A Call for Call Pay." The discussion challenges the traditional framing of call as simply part of the job and instead examines it as a measurable burden of availability that carries legal, financial, and personal implications. This conversation highlights why the valuation of call may represent one of the defining structural issues in modern vascular surgery practice.   Jacob speaks with Dr. Malachi G. Sheahan III about the motivation behind the piece, how hospital systems value call, what the true cost of call coverage is, and what the future may hold if the current model remains unchanged.   Show Guest Dr. Malachi G. Sheahan III is Professor and Chair of Surgery at Louisiana State University Health Sciences Center and Chief of the Division of Vascular Surgery. He previously served as Program Director for both the fellowship and integrated residency in vascular surgery at LSU. Nationally, Dr. Sheahan serves as Secretary of the Society for Vascular Surgery and as Chief Medical Editor of The Vascular Specialist. With more than two decades in academic surgery, he is a recognized leader in vascular education, workforce policy, and advocacy within the specialty.   Resources and Social Media X (Twitter): @lsuvascular   Read the editorial: "A Call for Call Pay" – The Vascular Specialist   Special thanks to Dr. Malachi G. Sheahan III for sharing his time and insight and for his ongoing contributions to vascular surgery.   Follow us @audiblebleeding for updates on upcoming episodes and new research features. Learn more about us at audiblebleeding/about and share your feedback through our listener survey.   *Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.

Contributor: Travis Barlock, MD Educational Pearls: What is an internal jugular catheter (IJ) and when do we use it? IJs are catheters that can be placed in either the left or the right internal jugular vein to provide central venous catheter (CVC) access. CVCs can be placed in other locations other than the internal jugular vein (i.e. subclavian vein or femoral veins). IJs are used when the patient may require long-term venous access or have to receive hyperosmolar solutions (such as solutions with high glucose content for parenteral nutrition); solutions with extreme pHs (9); or vesicant drugs (drugs that can cause tissue necrosis with extravasation). They are not to be confused with EJs (external jugular vein catheters) which can be placed in difficult to peripherally catheterize patients. EJs function similarly to a peripheral IV. The advantage of IJs is their location in larger veins brings them closer to direct access to the heart (i.e. the right internal jugular vein will provide immediate/quicker access to the right atrium to the heart.) What are concerns of using a right internal jugular catheter versus one in the left? The right internal jugular vein provides quick access to the heart via the right atrium, making it ideal in critically ill patients who may require vasopressor support. However it is also the site commonly used for additional cannulation procedures such as hemodialysis, pulmonary artery pressure measurements, extracorporeal membrane oxygenation (ECMO) and transvenous pacemaker placement. These procedures are not uncommon in critically ill patients who also required a CVC for initial hemodynamic support via vasopressors. Gharaibeh et al. found that patients who received a right IJ and hemodialysis had a higher need for re-insertion of the hemodialysis catheter (40% compared to 2.6% in the left IJ group). Furthermore, it was found that with a right IJ, hemodialysis catheters had to be exchanged by a guidewire in 23% of those with a right IJ as opposed to 0.9% in the left IJ group (a guidewire exchange is often considered a salvage technique to try and maintain access). Big Takeaway? If you are able to obtain an IJ on the right, you can likely obtain one on the left, and if considering longitudinal care for your patient, consider obtaining an IJ on the left to allow for future critical access in the right IJ. References Gharaibeh KA, Abdelhafez MO, Guedze KEB, Siddiqi H, Hamadah AM, Verceles AC. Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications. Journal of Critical Care. 2025;87:155011. doi:10.1016/j.jcrc.2024.155011 Gallieni M, Pittiruti M, Biffi R. Vascular access in oncology patients. CA: A Cancer Journal for Clinicians. 2008;58(6):323-346. doi:10.3322/CA.2008.0015 Summarized by Dan Orbidan, OMS2 | Edited by Dan Orbidan & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

With the single-stick technique proving to be an effective addition to the venous line placement toolkit, what is stopping IRs from venturing beyond the traditional dual-incision approach? In this episode of the BackTable Podcast, pediatric interventional radiologist Dr. Kevin Wong of USA Health joins host Dr. Ally Baheti to review the single-stick technique for central venous access, a method widely utilized in pediatric practice. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:35 - Origins of Single-Stick Access03:10 - Setup and Bending the Needle07:17 - Tunneling to the IJ10:06 - Line Positioning and Measurement14:45 - Wire Handling Considerations18:55 - Clinical Advantages of Single-Stick Access21:27 - Femoral Single-Stick Tips23:41 - Common Mistakes and Pitfalls27:39 - Needle-Free Lidocaine Administration30:48 - Closing Remarks --- More about this episode Delving into the origins, technical nuances, and clinical advantages, the physicians explore how the single-stick technique can reduce the risk of infection and minimize interference with other lines and tubing to improve patient care. The discussion provides a detailed technical breakdown of the procedure, offering a masterclass on navigating the curves up the neck as well as the equipment selection and sizing necessary to facilitate the process. With the aid of visual slides and demonstrations, Dr. Wong steps us through the specifics of bending the access needle, maneuvering tools to adapt to anatomical configurations, and handling ultrasound movement to confirm and maintain a safe trajectory throughout the procedure. The conversation emphasizes the tactile “feel” and attention to forces acting on the wire that are required to appropriately position the catheter.Recognizing the logistical constraints that make it challenging for attendings to regularly adopt alternative procedural techniques, this episode serves as an accessible primer for clinicians looking to broaden their options for venous access with this effective, patient-centric technique.

Shot Targets Clogged Arteries Blocked arteries are not the main cause of heart attacks. Unstable plaque driven by oxidation, inflammation, and high insulin is. In this episode, Ben explains the 5 key drivers of arterial damage: Oxidized LDL Endothelial inflammation Low nitric oxide High triglycerides Chronically elevated insulin He shares a simple 60-second vascular support shot designed to: Support nitric oxide Lower insulin spikes Reduce inflammation Protect LDL from oxidation Key ingredients include beetroot or lemon, apple cider vinegar, ginger or turmeric, and high polyphenol fresh pressed olive oil. Small daily habits shape long-term heart health. Precision over panic.