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BackTable / VI / Podcast / Episode #549

Liquid Embolics: Practical Applications & Techniques

with Dr. Gary Siskin

Liquid embolics are a relatively new addition to the interventional radiology toolkit—how well do you understand the technical considerations that come with using these agents? Get up to speed in this episode of the BackTable Podcast where Dr. Gary Siskin, Chair of Radiology at Albany Medical Center, shares his expertise.

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Liquid Embolics: Practical Applications & Techniques with Dr. Gary Siskin on the BackTable VI Podcast
Ep 549 Liquid Embolics: Practical Applications & Techniques with Dr. Gary Siskin
00:00 / 01:04

BackTable, LLC (Producer). (2025, June 3). Ep. 549 – Liquid Embolics: Practical Applications & Techniques [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Gary Siskin discusses Liquid Embolics: Practical Applications & Techniques on the BackTable 549 Podcast

Dr. Gary Siskin

Dr. Gray Siskin is a professor and Chair of the Department of Radiology and Chief of the Division of Vascular & Interventional Radiology at Albany Med Health System in New York.

Dr. Christopher Beck discusses Liquid Embolics: Practical Applications & Techniques on the BackTable 549 Podcast

Dr. Christopher Beck

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

Synopsis

Dr. Siskin provides expert insights into the use of liquid embolic agents, including Onyx and LAVA, with a focus on their practical applications, techniques for safe and effective deployment, and the critical role they play in treating complex cases which range from peripheral and traumatic hemorrhage to portal vein embolization. He highlights the importance of understanding the viscosity and flow characteristics of various liquid embolic agents, providing expert guidance on ensuring optimal catheter positioning, case selection, and avoidance of common pitfalls. Additionally, he shares strategies for tailoring injection speed based on vessel caliber to mitigate reflux. The episode ends with final thoughts on best practices and future directions for the technology.

Timestamps

00:00 - Introduction
02:09 - Historical Perspective on Liquid Embolics
06:37 - Practical Applications and Techniques
16:14 - Handling Catheters and Reflux Concerns
22:38 - Trauma Embolization
26:53 - Visibility and Injection Techniques
29:06 - Catheter Compatibility and Vessel Size
32:53 - Best Practices and Common Mistakes
45:55 - Final Thoughts and Advice

Resources

Arslan B, Razavi MK, Siskin G, et al. The LAVA Study: A Prospective, Multicenter, Single-Arm Study of a Liquid Embolic System for Treatment of Peripheral Arterial Hemorrhage. J Vasc Interv Radiol. 2025;36(3):436-445.e2. doi:10.1016/j.jvir.2024.11.005

Onyx Liquid Embolic System:
https://europe.medtronic.com/xd-en/healthcare-professionals/products/cardiovascular/peripheral-embolization/onyx-liquid-embolic-system.html

LAVA Liquid Embolic System:
https://www.sirtex.com/us/products/lava-liquid-embolic-system/product-information/

Transcript Preview

[Dr. Gary Siskin]
I think there's a lot of enthusiasm about liquids. As people start to hear more about it, they get excited about it, but it's not easy. I think that those of us with experience may make it sound easy. Sure, you're grabbing a syringe and you're injecting it into a catheter. It's not that hard. There is nuance to it. There are different products out there with different viscosities. Some are Newtonian in nature, some are non-Newtonian in nature. They behave differently, even though they all look the same...It's really important for a new user to not only find a safe vascular bed to try this for the first time in, but also to make sure that they're appropriately educated on the technique and the nuances of the particular product that they want to use. I think that I'm not trying to scare people away from using it. I would say that this has been transformative for us, but you just need to be careful and just know the specifics about the product that you're using, the nuances of the vascular bed that you're treating, and just make sure that you're educated appropriately. I think that's the advice I would give to people.

Disclaimer: The Materials available on BackTable.com 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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