Dr. Christopher Beck

There are a diversity of thrombectomy devices that are viable for arterial thrombectomy, including Boston Scientific AngioJet, Penumbra Indigo, AngioDynamics Auryon, and BD Rotarex. Each device has utility in different clinical scenarios. Learn more about effective arterial thrombectomy device selection.

Interventional radiologist Dr. Alexander Ushinksy details his procedural technique for arterial thrombectomy in acute limb ischemia, including patient preparation, imaging, heparinization, wire placement, and post-operative care.

IR Dr. Alexander Ushinsky shares expert advice on building a thriving peripheral vascular practice with a successful acute limb ischemia program.

Dr. Alexander Ushinsky provides an in-depth look at his protocol for working up acute limb ischemia, covering physical examination, Rutherford classification, imaging, and labs; and how these various factors influence which treatment is most appropriate for the acute limb ischemia patient.

The key to a successful needle lung biopsy procedure is proper preparation. Interventional radiologist Dr. Robert Suh shares his approach to patient prep for lung biopsy, including pain control.

Pneumothorax is a common complication during a lung biopsy procedure. Dr. Robert Suh describes two distinct methods, BioSentry plug and blood patching, to manage this complication, and considerations for each approach.

Dr. Nima Kokabi shares his approach to renal artery embolization in trauma, detailing the benefits of radial vs femoral access, the renal artery embolization devices that he prefers, and the specifics of his renal embolization procedure technique.

Renal trauma can present significant challenges for new interventional radiologists, from understanding biopsy risks and potential iatrogenic injuries, to the intricacies of imaging techniques and choosing between different treatment options. Learn more about the importance of targeted renal biopsy, the role of two-phase arterial and venous CT scans in diagnosing renal bleeds, and the nuanced decisions behind interventions such as embolization and partial nephrectomy.

Interventional radiologist Dr. Josh Kuban shares his workflow with the NeuWave microwave ablation system and provides his review of specific features, including the system interface, the ability to draw customizable margins, and the ability to upload mid-procedural scans.

Along with the speed and efficiency associated with microwave ablation, the introduction of NeuWave’s ablation confirmation software significantly modifies the microwave ablation procedure workflow, allowing the use of multi-probe techniques, and larger ablation zones.

Our medical vocabulary needs to name specific contrast agents rather than label these “iodine allergies” in order to streamline patient prep for CT scans. Dr. Ruff discusses how changing the contrast agent with steroid premedication is the most effective intervention for a known contrast allergy.

Though incorrect, the term "iodine allergy" is still used to describe contrast dye allergy, Betadine soap allergy, and even shellfish allergy. Radiologist Dr. Cullen Ruff suggests that the term "iodine allergy" should no longer be used in the medical field as patients are not allergic to the iodine itself, but rather to some other component in the contrast agent.

Blood patching began to emerge in the early 2000’s as a technique to reduce the incidence of chest tube placements subsequent to pneumothoraces, and has since been adopted in lung biopsy procedures. Blood patching is a technique in which the operator introduces the patient's own blood into the pulmonary space to promote coagulation of air passages created upon biopsy.

As an operator, two key challenges of the microwave liver ablation procedure are navigating the background liver parenchyma and determining the extent of lesion ablation possible without compromising liver function. Dr. Driss Raissi, an Interventional Radiologist at the University of Kentucky discusses how to navigate these challenges and shares his liver ablation procedure techniques in this BackTable Article.

CT guided lung biopsy can be quite challenging. There is a risk of injuring the many pulmonary and intercostal vessels, the time consuming process of sticking the nodule, and determining what patients are viable candidates. Abdominal radiologist Dr. Fred Lee discusses the techniques his practice has used to improve their CT guided lung biopsies.

The standard liver ablation zone for hepatocellular carcinoma is half a centimeter to one centimeter, but where does this standard come from? This article discusses the current liver ablation zone guidelines and explores an alternative approach.

Prostate artery embolization technique may vary depending on which arterial access site is chosen (radial vs femoral). Different PAE techniques may also be utilized to minimize off-target embolization.

Understanding the variations in prostate artery embolization anatomy is crucial for improving technical success, reducing the chance of re-vascularization and minimizing non-target embolization. The variations in origin of the prostate artery can be sorted in a classification system.

Dr. Parvez Mantry shares different methods of portal hypertension and ascites management and treatment. These complications arise from loss of liver architecture and liver synthetic dysfunction. For severe ascites, paracentesis or a transplant may be needed. Learn more!

An ascites assessment is done during a standard liver disease workup, which involves various physical exams, a detailed medical history, a serological workup, and imaging steps to help guide the final liver diagnosis.

E&M coding guidelines were updated and changed on January 1st, 2021. Interventional radiologist Dr. Ryan Trojan discusses some of the billing and coding E&M 2021 changes for outpatient work, requirements for documentation, E&M coding guidelines, E&M coding tools, and resources.

Different evaluation and management (E&M) codes are used depending on the type of work done and where it takes place, whether in the ER, ICU, or the outpatient setting. Interventional radiologist Dr. Ryan Trojan demystifies some aspects of E&M coding including global billing periods, modifier 25, and the scenarios in which these apply. He also describes some common inpatient billing codes.

Evaluation and management (E&M) coding requires documentation to capture physician-patient encounters so that physicians are reimbursed appropriately based on the level of clinical care they deliver. Interventional radiologist Dr. Ryan Trojan provides an E&M coding overview, describing reasons why IRs should be taking advantage of it and how the medical decision making component of E&M works.

Arteriovenous fistulas and grafts are dialysis access sites that can thrombose. To restore blood flow in the dialysis circuit, a declot procedure is performed to remove clots and treat any associated stenoses which may be flow-limiting. Interventional nephrologist Dr. Neghae Mawla provides tips and tricks for reducing procedure time, working with two sheaths, performing angioplasty, and using stents vs. drug coated balloons.