Dr. Christopher Beck

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.

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. In part 2 of this article, interventional nephrologist Dr. Neghae Mawla walks through the remaining steps of the declot procedure including arterial sheath placement (inflow), polish, closure, and follow-up.

Initial steps of arteriovenous fistula and graft declot procedure including pre-op workup, obtaining access, and treating outflow lesions.

Interventional nephrologist Dr. Neghae Mawla discusses using the WavelinQ and Ellipsys devices for EndoAVF creation. The discussion covers pre-procedure preparation, WavelinQ and Ellipsys for EndoAVF creation procedure, post-procedure care, potential complications, learning curves, and the future of EndoAVF. WavelinQ and Ellipsys are devices that can help with endovascular AV fistula creation and anastomosis.

Long-lasting vascular access for dialysis can be achieved via the creation of an arteriovenous fistula using an endovascular approach. However, not every patient is a good candidate for percutaneous endoAVF creation. Interventional nephrologist Dr. Neghae Mawla discusses types of vascular access for dialysis, collabora

Locoregional treatments for HCC, the UNOS 6-month wait period for liver transplantation, and methods and markers for HCC prognostication.

Evaluating HCC patients, multi-specialty collaboration, and locoregional therapies for both transplant and non-transplant candidates.

Endovascular DVT treatment of acute and chronic DVT has become increasingly more important to help prevent chronic post-thrombotic syndrome. Learn the risks and benefits of endovascular DVT therapies, using Inari ClotTriever, optimal procedure endpoint, and post DVT procedure care.

Patient selection and DVT evaluation with clinical scoring, IVUS, and history assessment; how to choose the appropriate DVT therapy.

Endovascular approaches for fibroid treatment have gained traction as increasing evidence supports its use in most patient populations. In episode 10 of the BackTable podcast, Dr. Keith Pereira and Dr. Chris Beck discuss marketing strategies and ways to increase referrals when building a UFE practice.

Transradial access (TRA) has been shown to improve discharge and recovery times when compared to transfemoral access, though complications may arise. TRA expert Dr. Aaron Fischman discusses complications related to radial access as well as ways to circumvent these problems in episode 30 of the BackTable podcast.