Episode # 3 • 17 Jan 2025
Navigating Liquid Embolization Techniques: Insights & Practices
Could replacing bulky coil packs with specialized liquid embolic agents be the key to faster, more cost-effective peripheral embolizations? In this kickoff episode of the BackTable 2026 Liquid Embolics Creator Weekend™, Dr. Kavi Krishnasamy (University of Alabama at Birmingham) and Dr. Gary Siskin (Albany Med) join Dr. Tyler Sandow to break down the foundational principles, deployment approaches, and expanding clinical applications of liquid embolics in non-neurological interventions. They discuss the transition toward a "liquid-first" procedural mindset, the technical nuances of adhesive and cohesive agents, and how targeted liquid cast creation might optimize procedure times and device expenditure compared to traditional coiling.
This podcast is supported by an educational grant from Sirtex.
Timestamps
00:00 - Introduction
03:01 - Case 1: Rectus Sheath Bleed
06:15 - Liquid Embolics: Advantages and Apprehension
12:15 - Adhesive vs. Cohesive Mechanisms
14:28 - LAVA Workflow and Deployment Considerations
19:37 - Safe Post-Delivery Technique
23:49 - Risks and Preventing Adverse Events
27:06 - Case 2: Roadmap Mask for Embolic Visualization
30:22 - Stuck Catheter Experiences
34:01 - Glue Timing and Control
37:13 - Rapid-Fire Practical Pearls
41:40 - Closing Remarks
Resources
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More about this episode
The panel walks through procedural protocols, detailing microcatheter selection, dead-space calculations, and injection techniques designed to prevent arterial spasm and non-target reflux. Dr. Siskin and Dr. Krishnasamy detail troubleshooting strategies including catheter extraction maneuvers to prevent device entrapment, the use of road-map masking for better embolic visualization, and the application of pushable or detachable coils as distal backstops. They review approaches in high-yield clinical scenarios such as rectus sheath hematomas, gastroduodenal artery (GDA) obliteration, and type II endoleak interventions. The episode concludes with advice for early-career operators on gaining hands-on preclinical experience, mastering multi-embolic combinations, and identifying scenarios where liquid agents should be avoided.
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