BackTable / VI / Podcast / Episode #604

Mythbusters: Provocative Mesenteric Angiography for GI Bleeds

with Dr. Sabeen Dhand and Dr. Michael Barraza

A negative angiogram in a patient with recurrent lower GI bleeding often calls for provocative angiography. In this episode of the BackTable Podcast, IR hosts Mike Barraza and Sabeen Dhand team up to talk tools, techniques, and tPA dosing for safe and effective treatment of lower GI bleeds with provocative mesenteric angiography.

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Mythbusters: Provocative Mesenteric Angiography for GI Bleeds with Dr. Sabeen Dhand and Dr. Michael Barraza on the BackTable VI Podcast

Ep 604 Mythbusters: Provocative Mesenteric Angiography for GI Bleeds with Dr. Sabeen Dhand and Dr. Michael Barraza

00:00 / 01:04

BackTable, LLC (Producer). (2026, January 6). Ep. 604 – Mythbusters: Provocative Mesenteric Angiography for GI Bleeds [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Michael Barraza

Dr. Michael Barraza is a practicing interventional radiologist (and all around great guy) with Radiology Associates in Baton Rouge, LA.

Dr. Sabeen Dhand

Dr. Sabeen Dhand is a practicing interventional radiologist with PIH Health in Los Angeles.

Synopsis

Dr. Dhand describes the utility of provocative angiography in recurrent lower GI bleed patients with negative CTA and angiography, addressing common myths and concerns that may contribute to its underutilization. The conversation covers detailed procedure steps for both targeted and untargeted angiography, including access sites, dosing of tPA, and angiographic technique. Dr. Dhand emphasizes the importance of gradual increases in tPA dosage in 2 mg increments, and clear communication with care teams and the patient about the nature of the procedure. He also emphasizes the effectiveness and safety of this procedure by sharing real-world cases.

Timestamps

00:00 - Introduction
02:04 - Provocative Angiography for Lower GI Bleeds
04:09 - Detailed Protocol for Provocative Angiography
11:13 - Technical Details and Best Practices
20:07 - Challenges in GI Bleeding Studies
22:40 - Selective Embolization Techniques
27:44 - Handling Negative Angiograms
32:56 - Real-World Case Studies
35:15 - Final Thoughts

Resources

Thiry et al. Provocative Mesenteric Angiography: Outcomes and Standardized Protocol for Management of Recurrent Lower Gastrointestinal Hemorrhage
https://pubmed.ncbi.nlm.nih.gov/34506023/

The Materials available on BackTable 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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