Episode 87

Deep Dive Into Ascites

with Dr. Rajeev Suri and Dr. Christopher Beck

Interventional Radiologist Rajeev Suri from UT Health San Antonio tells us about his clinical approach to the high-volume ascites patient, including paracentesis technique and tips, albumin regimen, and discussing the need for TIPS in some patients.

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BackTable, LLC (Producer). (2020, October 6). Ep. 87 – Deep Dive Into Ascites [Audio podcast]. Retrieved from https://www.backtable.com/podcasts

In this Episode

Podcast Participants

Dr. Rajeev Suri is a practicing Interventional Radiologist and a professor of Radiology at UT Health San Antonio.

Host Dr. Chris Beck is a practicing interventional radiologist with Regional Radiology Group in New Orleans.

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Show Notes

In this episode, Dr. Rajeev Suri joins Dr. Christopher Beck to discuss ascites and paracentesis. Dr. Suri touches on what a potential paracentesis candidate might present with and speaks about why no lab values or blood tests are needed prior to the procedure.

We discuss the basic steps for removing ascites, how to find the side with the biggest pocket, and preventing leakage by using a Z pattern. He speaks to the circumstances for using direct US guidance rather than intermittent and when, if ever, to use glue or stitches after paracentesis.

We mention the benefits of utilizing the Renova Pump for fluid removal and discuss why Dr. Suri might use a vacuum container bottle rather than a wall suction. Lastly, we examine some methods for managing recurring patients in the ascites clinic. Dr. Suri also discusses how his practice has incorporated a paracentesis clinic to reduce the number of emergency room visits for ascites and how this practice has improved workflow and patient access to an interventional radiologist.


RESOURCES MENTIONED:

RenovaRP® Paracentesis Management System
www.rethinkparas.com
This website allows you to download the case study mentioned by Dr. Beck and check out other products from GI Supply.

AASLD Guidelines
https://www.aasld.org/publications/practice-guidelines
This website includes the 2013 guidelines for ascites management.

SIR Coagulation Guidelines
https://www.jvir.org/article/S1051-0443(19)30407-5/pdf
This pdf has recommendations for periprocedural management of thrombotic and bleeding risks in patients.

Denver Shunts
https://www.ajronline.org/doi/full/10.2214/AJR.12.9203
This article, mentioned by Dr. Suri, discusses the placement and management of Denver shunts for portal hypertensice ascites.

Disclaimer: The Materials available on the BackTable Podcast are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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