Episode # 3 • 17 Jan 2025
Understanding Liquid Embolization for Acute Hemorrhage
What changes about your embolization plan when a bleeding patient is coagulopathic, vasospastic, and running out of time? On this episode of the BackTable 2026 Liquid Embolics Creator Weekend, Dr. Gary Siskin (Albany Med) and Dr. Oleksandra Kutsenko (Red Rock Radiology) join Dr. Tyler Sandow to break down practical strategies for liquid embolization in acute hemorrhage, illustrated with real-world case examples from pelvic trauma to lower GI bleeding. They discuss how trauma triage, rapid decision-making, and a “liquid-first” mindset can make all the difference when the usual clotting mechanisms are unreliable.
This podcast is supported by an educational grant from Sirtex.
Timestamps
00:00 - Introduction
02:49 - Overnight Trauma Triage
04:50 - Embolic Preparation and the Liquid-First Mindset
07:04 - Case 1: Splenic Pseudoaneurysms
10:15 - Selective vs. Proximal Splenic Embolization
13:42 - Coils vs. Liquids in the Coagulopathic Patient
16:05 - Choosing LAVA 18 vs. LAVA 34
17:07 - GI Bleed Workup and Endoscopy Timing
22:14 - Case 2: Diverticular Lower GI Bleed
25:31 - The Negative Angiogram
28:49 - Technique Pearls and Pain Control
31:27 - Training Pearls for Early Operators
32:55 - Closing Remarks
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More about this episode
The conversation covers selective versus proximal embolization, hands-on tips for microcatheter preparation, dead-space calculation, and pain control, as well as troubleshooting negative angiograms and strategies for preventing non-target embolization. Drs. Siskin and Kutsenko share pearls from their experience, including how to manage vessel spasm, avoid complications, and teach these techniques to early-career operators. The episode closes with a look ahead at future directions in bleeding management as new devices and protocols continue to evolve.
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