BackTable Vascular & Interventional

Latest Episodes:

Ep. 678 Medicare Audits Explained: Impact on Physicians & Practices with Jason Greis Sep 25, 2026

Show notes

What do you actually do when a Medicare audit letter lands in your inbox? On this episode of BackTable Podcast, Dr. Ally Baheti interviews healthcare attorney Jason Greis, partner at Benesch, to demystify the audit process and the rising scrutiny on interventional practices. They discuss why audits are accelerating, which procedures are under the microscope, and how enforcement economics and AI-driven review are reshaping the landscape for OBLs and ASCs.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

RADPAD® Radiation Protection
https://www.radpad.com/

---

Timestamps

00:00 - Introduction
02:32 - Audit Hotspots in Endovascular Work
05:00 - AI Oversight and Proactive Compliance
13:35 - The Alphabet Soup of Audit Types
19:16 - Responding to an Audit and the Appeals Ladder
24:48 - Employment Status, Liability and AI Downcoding
30:29 - Final Advice and Wrap Up

---

More about this episode

The conversation covers the “alphabet soup” of audit types, the five-step appeals process, and strategies for proactive compliance and documentation. The discussion walks through personal liability, employment status, the risks of algorithmic downcoding by commercial payers, and why practices must balance when to fight and when to let an audit go. The episode closes with actionable advice on protecting your practice, the dangers of putting patient data into AI tools, and why trade organizations are the first line of defense.

---

Resources

OIG: Utilization Trends and Medicare Part B Billing for Office-Based Peripheral Vascular Procedures Raise Questions About Program Integrity (OEI-01-24-00250)
https://oig.hhs.gov/reports/all/2026/utilization-trends-and-medicare-part-b-billing-for-office-based-peripheral-vascular-procedures-raise-questions-about-program-integrity/

CMS Wasteful and Inappropriate Service Reduction (WISeR) Model
https://www.cms.gov/priorities/innovation/innovation-models/wiser

CMS Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH)
https://www.cms.gov/fraud

CMS Medicare Fee-for-Service Appeals: The Five Levels
https://www.cms.gov/medicare/appeals-grievances/fee-for-service

CMS Medicare Fee-for-Service Compliance Programs (TPE, RAC, SMRC, CERT)
https://www.cms.gov/data-research/monitoring-programs/medicare-fee-service-compliance-programs

BackTable VI Ep. 478: ASC vs. OBL: Legal Insights Explained
https://www.backtable.com/shows/vi/podcasts/478/asc-vs-obl-legal-insights-explained

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 677 Pulmonary Embolism: Catheter-Based Therapy & Importance of Blood Return with Dr. Jay Giri and Dr. Julie Bulman Sep 22, 2026

Show notes

As new guidelines redefine risk stratification for pulmonary embolism (PE), emerging technologies are also changing what it means to achieve procedural success. On this episode of the BackTable Podcast, interventional radiologist Dr. Julie Bulman (BIDMC) and interventional cardiologist Dr. Jay Giri (Penn Medicine) join host Dr. Chris Beck to discuss the evolving frameworks and technologies redefining standards for catheter-directed treatment of intermediate- and high-risk PE. They discuss the role of multidisciplinary PERT teams, patient selection, the impact of new thrombectomy devices, and why autologous blood return is a growing consideration for procedural success.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

Endovascular Engineering (E2)
E2Helo.com

---

Timestamps

00:00 - Introduction
03:42 - Referral Patterns and PERT Scope
05:25 - PE Workup Essentials
07:26 - Targeted Assessment of Acuity
11:36 - Reliability of the Walk Test
14:35 - PE Treatment Pathways
19:26 - Procedural Walkthrough
24:15 - Catheter Sizing
30:05 - Adjunct Aspiration Device Features
35:09 - Blood Return Process and Safety
40:03 - Helo Study Early Results
45:09 - Determining Procedural Endpoints
50:20 - Future Trials and Technologies
53:48 - Final Thoughts and Closing Remarks

---

More about this episode

The discussion highlights how PERT teams use updated guidelines and thorough clinical evaluation to guide patient classification and treatment pathway selection. Dr. Bulman and Dr. Giri outline their criteria for choosing anticoagulation, catheter-directed lysis, or mechanical clot removal, and compare the techniques and learning curves for medium- versus large-bore thrombectomy devices. They explore the significance of autologous blood return during aspiration thrombectomy, noting how new reinfusion systems can reduce blood loss and influence procedural decision-making. Dr. Bulman also presents early Helo Thrombectomy System study data demonstrating the benefits of mechanized aspiration with minimal complications. The episode closes with a critical look at defining true functional procedural endpoints beyond pulmonary arterial pressures and offers a preview of upcoming trial data, such as HI-PEITHO and PEERLESS II, that could further advance PE management.

---

Resources

2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults
https://doi.org/10.1161/CIR.0000000000001415

Ultrasound-Facilitated, Catheter-Directed Thrombolysis in Intermediate-High Risk Pulmonary Embolism (HI-PEITHO)
https://clinicaltrials.gov/study/NCT04790370

PEERLESS II study
https://clinicaltrials.gov/study/NCT06055920

Catheter-Directed Thrombolysis in Intermediate-High–Risk Pulmonary Embolism (PRAGUE-26)
https://doi.org/10.1056/nejmoa2608012

Pulmonary Embolism International THrOmbolysis Study-3 (PEITHO-3)
https://clinicaltrials.gov/study/NCT04430569

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 676 Use of Tunneled Catheters for Ascites & Effusions Management with Dr. Marco Ertreo Sep 18, 2026

Show notes

When is it time to move from repeat drainage to a tunneled catheter for managing pleural effusions or ascites? On this episode of BackTable Podcast, Dr. Neil Jain interviews Dr. Marco Ertreo, interventional radiologist and IR residency program director at Strong Memorial Hospital, University of Rochester, about best practices for tunneled catheter management in both the chest and abdomen. They discuss the triggers for placing a tunneled catheter, patient selection, placement technique, home drainage protocols, complication management, and the unique considerations for malignant versus cirrhotic ascites.

---

Get the BackTable app
https://www.backtable.com/app

---

Timestamps

00:00 - Introduction
06:39 - Indications and Pleural Catheter Placement Technique
12:10 - Tunneling, Cuff Position and Exit Site Selection
17:42 - Home Drainage, Volume Limits and Complications
26:13 - Peritoneal Catheters, TIPS Candidacy and Catheter Choice
35:16 - Avoiding Bowel and Varices
43:42 - Key Takeaways and Closing Remarks

---

More about this episode

Dr. Ertreo shares practical details about pocket selection, access points, catheter testing, and choosing Tenckhoff catheters for abdominal cases to avoid proprietary systems. The conversation covers volume limits, complication counseling, criteria for removal, and the psychological impact of living with a long-term drain. They discuss when to consider TIPS for cirrhotic patients, the importance of early conversations with patients and referring providers, and why multidisciplinary teamwork and family support are essential for long-term success.

---

Resources

Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial
https://pubmed.ncbi.nlm.nih.gov/30037711/

Management of Malignant Pleural Effusions. An Official ATS/STS/STR Clinical Practice Guideline
https://www.atsjournals.org/doi/10.1164/rccm.201807-1415ST

Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions, Part II: Recommendations
https://pubmed.ncbi.nlm.nih.gov/31229333/

Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases (AASLD)
https://pubmed.ncbi.nlm.nih.gov/33942342/

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 675 Advancements & Challenges in GAE Practice with Dr. Amin Astani and Dr. Anish Ghodadra Sep 15, 2026

Show notes

As interest in genicular artery embolization grows, what does it actually take to build a sustainable GAE practice? On this episode of the BackTable Podcast, Dr. Kavi Krishnasamy is joined by Dr. Anish Ghodadra and Dr. Amin Astani to share their blueprint for building a successful genicular artery embolization (GAE) practice. They discuss patient selection, imaging workup, scoring tools, and procedural techniques, including access strategies, device choice, and embolic selection. The conversation also covers follow-up protocols, defining treatment success, and how to set patient expectations.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by
Varian
https://www.siemens-healthineers.com/

---

Timestamps

00:00 - Introduction
04:00 - GAE Workup and Patient Scoring
05:28 - KL Score and MRI Debate
10:15 - Patient Selection and Contraindications
15:11 - Access Strategy and Closure Techniques
19:54 - Catheters, Wires, and Embolic Choices
28:19 - Cone Beam CT Workflow
31:37 - Managing Collaterals
34:26 - Follow-Up and Repeat GAE
38:42 - Defining Success and Setting Expectations
44:25 - Technique Nuances and Flow Modulation
50:28 - Building Referral Networks
56:56 - Keeping Referrers Engaged
59:46 - Direct-to-Patient Marketing
01:04:57 - Leveraging Social Media and Reviews
01:12:42 - Tracking Leads and Insurance Coverage
01:19:47 - Final Thoughts and Next Steps

---

More about this episode

Beyond technique, the discussion dives into practical strategies for growing a GAE practice: referral pathways, engaging physical therapists and orthopedic surgeons, direct-to-patient marketing, digital outreach, and tracking outcomes. The guests share experience-driven tips on handling insurance hurdles, building relationships with referring providers, and using data to demonstrate value. The episode wraps with reflections on negative trial results, the evolving landscape of GAE, and what it takes to keep a practice thriving in a competitive environment.

---

Resources

Long-term outcomes of genicular artery embolization for knee osteoarthritis: 12-month efficacy and secondary outcomes from a randomized sham-controlled clinical trial
https://doi.org/10.1007/s00330-026-12505-8

Repeated Genicular Artery Embolization Using Permanent Microspheres for Severe Osteoarthritis and Postsurgical Pain
https://doi.org/10.1007/s00270-026-04410-w

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 674 Treatment Strategies for Acute and Chronic Limb Ischemia with Dr. Anahita Dua and Dr. Ripal Gandhi Sep 11, 2026

Show notes

How do you choose between thrombolysis, mechanical thrombectomy, or open surgery for acute limb ischemia, and what options remain when there’s no vessel to open? On this episode of the BackTable Podcast, host Dr. Chris Beck is joined by vascular surgeon Dr. Anahita Dua (Massachusetts General Hospital) and interventional radiologist Dr. Ripal Gandhi (Miami Cardiac and Vascular Institute) to explore treatment strategies across the full spectrum of limb ischemia. They discuss presentation and referral patterns, the imaging and exam findings that start the clock, single-session mechanical thrombectomy, the evolving role of lysis, procedural endpoints, and deep vein arterialization for chronic limb-threatening ischemia.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by
Stryker Peripheral Vascular
https://www.stryker.com/us/en/peripheral-vascular.html

---

Timestamps

00:00 - Introduction
02:27 - Presentation, Referral Patterns, and Imaging
06:07 - Acute Limb Ischemia: Treatment Algorithm
12:16 - Thrombectomy Device Selection
16:09 - Thrombolysis and Applications Beyond Lower Extremity
18:46 - Procedural Endpoints, Closure, and Case Selection
24:43 - Deep Vein Arterialization: Patient Selection and Planning
31:25 - DVA Technique: Imaging, Anesthesia, and Access
34:58 - Step-by-Step DVA Approach
41:56 - Surveillance and Managing Expectations
45:59 - Wound Care and Amputation Decisions
49:40 - Future Directions in PAD
52:43 - Closing Remarks

---

More about this episode

The conversation moves from acute interventions for the cold leg, where mechanical thrombectomy has become first-line and lysis is held in reserve, to the stepwise management of no-option chronic cases, including pedal access, valve disruption, and inflow for deep vein arterialization. Drs. Dua and Gandhi share practical insights on device selection, preventing distal embolization, and when to consider open embolectomy or hybrid approaches. The episode closes with a discussion of post-procedure surveillance, wound care, and the need for better measures of perfusion to improve limb salvage and patient outcomes.

---

Resources

Rutherford classification of acute and chronic limb ischemia.
https://doi.org/10.1016/S0741-5214(97)70045-4

Global vascular guidelines on the management of chronic limb-threatening ischemia. Conte, Bradbury, Kolh et al., Journal of Vascular Surgery, 2019.
https://doi.org/10.1016/j.jvs.2019.02.016

PROMISE II. Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia. Shishehbor et al., New England Journal of Medicine, 2023.
https://doi.org/10.1056/NEJMoa2212754

BackTable VI Episode 618, How to Manage Advanced DVA Cases: Techniques and Tips, with Dr. Kumar Madassery and Dr. Sabeen Dhand. https://www.backtable.com/shows/vi/podcasts/618/how-to-manage-advanced-dva-cases-techniques-tips

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 673 Y90 for Liver-Directed Cancer Treatments: The PROACTIF Study with Dr. Tyler Sandow and Dr. Ryan Hickey Sep 08, 2026

Show notes

The key to personalizing Y90 may not just be treating the tumor, but understanding how much radiation a patient can tolerate, where to deliver it, and when to safely push the dose. In this episode of the BackTable Podcast, Drs. Tyler Sandow and Ryan Hickey join host Dr. Kavi Krishnasamy to explore strategies for using Y90 in hepatocellular carcinoma and liver metastases. They combine real-world data from a study of nearly 1,000 patients with insights into methodology and the many variables that influence these procedures.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by an educational grant from Boston Scientific TheraSphere Y-90.

---

Timestamps

00:00 - Introduction
02:36 - Resection After Radioembolization
06:07 - Personal Practices Between HCC and Liver Metases
07:26 - Bridging Radiation Segmentectomy
11:22 - Understanding Portal Vein Tumor Thrombus
14:21 - Preferences in Dosimetry Software
17:57 - Liver Reserve Limits
25:11 - Microsphere Activity and Density
29:16 - Diving into PROACTIF
33:32 - RCTs and Trial Challenges
36:57 - Patient Diversity in PROACTIF
41:42 - Extrahepatic Disease
43:03 - Data Gaps and Takeaways
45:32 - Defining Personalized Dosimetry and Bridging Software
50:15 - Mixed Delivery Approaches and Dose Thresholds
01:01:36 - Response and Local Control
01:04:26 - Treating PVT Subgroups
01:09:03 - Comparison Between Dosing and Survival
01:15:03 - Differences in Patients Quality of Life After Transplantation
01:26:34 - Wrap-Up and Credits

---

More about this episode

The discussion covers radiation segmentectomy and selective delivery, the nuances of portal vein tumor thrombus levels, and how multidisciplinary collaboration differs between resection and transplant. The doctors dive into the PROACTIF study, focusing on personalized dosimetry, dose escalation, trial challenges, tumor response, and survival outcomes across disease stages. Drs. Sandow and Hickey also explain the limits of Y90, such as lung shunts, liver reserve, and treated liver volume, and highlight how decision-making and tailored techniques are essential for improving outcomes in liver cancer care.

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 672 Challenges in Biopsy Techniques for Bone Lesions with Dr. Junjian Huang and Dr. Majid Khan Sep 01, 2026

Show notes

What characteristics make bone biopsies unique in both presentation and procedure? In this episode of the BackTable Podcast, Drs. Junjian Huang and Majid Khan join host Dr. Neil Jain to break down the complexities of bone biopsy technique. They discuss key strategies for tackling difficult cases, from understanding referral patterns and pre-procedure planning to selecting the best guidance modality and anticipating complications.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

Varian OmniBone
https://cancercare.siemens-healthineers.com/products/interventional-oncology/musculoskeletal/omnibone

---

Timestamps

00:00 - Introduction
08:06 - Referrals And Pre-Procedure Planning
12:35 - Triaging and Managing Difficult Cases
17:06 - Measuring and Improving Diagnostic Yield
18:58 - Knowing Boundaries Behind Difficult Cases
22:37 - Choosing the Best Guidance Modality
26:16 - The Future with Augmented Reality
28:11 - Tough Case Scenarios and Setup
41:27 - Preventing and Managing Complications
47:49 - Technical Tips for Future IRs
51:40 - Wrap-up and Credits

---

More about this episode

The conversation covers how to triage complex cases, adjust technique for smaller or hard-to-reach lesions, and benchmark diagnostic success. Drs. Huang and Khan share their preferred imaging guidance, from CT to fluoroscopy, and explore new frontiers like augmented reality. Case scenarios highlight practical problem-solving, and the episode wraps up with technical pearls and complication-prevention tips gained from years of experience in targeted bone biopsy.

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 671 Managing Pulmonary Embolism: Guidelines & Clinical Decisions with Dr. Timothy Fernandes and Dr. Robert Lookstein Aug 25, 2026

Show notes

Once your PERT is assembled, how do you navigate the evolving pulmonary embolism (PE) literature to improve patient outcomes at all risk levels? In this episode of the BackTable Podcast, interventional radiologist Dr. Robert Lookstein (Mount Sinai) and pulmonary critical care specialist Dr. Timothy Fernandes (UC San Diego) join host Dr. Harris Chengazi to examine the latest evidence and multidisciplinary strategies for managing acute pulmonary embolism. The discussion highlights the complexities of catheter-directed therapies in intermediate- to high-risk PE, evolving guidelines in the face of new trial data, and prioritization of improving patients’ clinical trajectories.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

Penumbra

https://www.penumbrainc.com/

Timestamps

00:00 - Introduction
03:57 - PERT Structure and Activation
08:24 - PE Risk Stratification Tools
12:02 - Patient Selection for IR Intervention
15:21 - Assessing Clot Chronicity
21:03 - Standardizing Workup
26:38 - Managing Unstable PE
28:31 - STORM-PE and HI-PEITHO Trial Data
35:49 - Guidelines vs. New Evidence
40:12 - Determining Therapeutic Endpoints
45:05 - Upcoming Trials and Future Directions
51:46 - Final Thoughts and Closing Remarks

---

More about this episode

The physicians explore the nuances of validated PE risk stratification tools, assessing the relationship between various PE scoring systems and the 2026 ACC/AHA classification for acute PE. They emphasize that the integration of clinical assessment, serial lab work, and patient history must take precedence over static imaging alone in guiding care. The doctors go on to review new trial data, including the improved RV-to-LV ratio and 90-day functional gains seen with mechanical thrombectomy in STORM-PE and reduced clinical deterioration observed with ultrasound-assisted catheter-directed thrombolysis in HI-PEITHO. The conversation concludes with a call for collaborative, safety-first management that focuses on the patient’s clinical status and long-term post-PE functional recovery.

---

Resources

2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults
https://doi.org/10.1161/CIR.0000000000001415

Composite Pulmonary Embolism Shock (CPES) Score
https://doi.org/10.1161/CIRCINTERVENTIONS.124.014088

FOCUS study
https://doi.org/10.1093/eurheartj/ehac206

STORM-PE trial
https://doi.org/10.1161/CIRCULATIONAHA.125.077232

HI-PEITHO trial
https://doi.org/10.1056/nejmoa2516567

PE-TRACT study
https://petractstudy.org/homepage

PEERLESS II study
https://clinicaltrials.gov/study/NCT06055920

PERSEVERE trial
https://clinicaltrials.gov/study/NCT06588634

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 670 Understanding IR Attrition: Causes & Solutions with Dr. David R. Mittelstein Aug 18, 2026

Show notes

Why do nearly half of IR residents consider leaving the specialty, and what can be done to change that? On this episode of the BackTable Podcast, Dr. Neil Jain interviews Dr. David Mittelstein, an integrated IR resident at UC San Diego and co-chair of the SIR RFS Recruitment Committee, about the findings of a national SIR survey on interventional radiology resident attrition. They discuss what drives uncertainty, from lifestyle and call burden to job market fears, and highlight the program features that encourage retention, such as structured training, high case volume, and a culture of camaraderie.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

RADPAD® Radiation Protection
https://www.radpad.com/

---

Timestamps

00:00 - Introduction
04:31 - From Biomedical Engineering to IR
07:41 - Recruitment Committee Mission
12:37 - Match Trends Warning Sign
15:12 - Survey Design Demographics
20:21 - What Factors Matter
25:04 - Why Residents Consider Switching
30:23 - Recommendation 1 IR Curriculum
32:32 - Recommendation 2 More IR Rotation
34:10 - Recommendation 3 Build Camaraderie
38:30 - Advice for Residents Who Are Doubting
41:00 - What’s Next for RFS Recruitment
43:20 - Wrap Up

---

More about this episode

The conversation explores free-response themes from the survey, where 78 percent of residents cited lifestyle concerns, 31 percent pointed to job market uncertainty, and 22 percent mentioned call experience as reasons for questioning IR. Retention was linked to structured training (38 percent), high case volume and procedural experience (35 percent), and program camaraderie (18 percent). Dr. Mittelstein and Dr. Jain review three concrete recommendations to improve retention, examine early changes at programs like Georgetown, and offer practical advice to residents who may be quietly doubting their path in IR.

---

Resources

Episode # 554 Optimizing the IR/DR Curriculum & Experience

https://www.backtable.com/shows/vi/podcasts/554/optimizing-the-ir-dr-curriculum-experience

---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Ep. 669 Advancements in Pulmonary Embolism Algorithm & Management with Dr. David Dexter and Dr. Maya Serhal Aug 11, 2026

Show notes

How are new aspiration thrombectomy systems and real-time hemodynamic monitoring enabling safer, more effective pulmonary embolism treatment? On this episode of the BackTable Podcast, Dr. Ally Baheti welcomes Dr. Maya Serhal and Dr. David Dexter for a deep dive into modern pulmonary embolism (PE) management, with a focus on advances in large-bore aspiration thrombectomy. They discuss evolving PE triage algorithms, real-world procedural strategies, and the clinical impact of next-generation aspiration systems on safety, efficiency, and patient recovery.

---

Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

Imperative Care
https://imperativecare.com/

---

Timestamps

00:00- Introduction
02:03- PE Response Workflow
05:32- Symphony Device
07:07- Sizing and Blood Loss
10:00- Multi-Port Hemodynamics
14:45- Procedure Endpoints
17:01- IVUS Guided Strategy
20:02- ProHelix and Lollipopping
25:48- Case Studies
34:12- Closing Thoughts

---

More about this episode

The conversation explores multidisciplinary PE response workflows, lab and imaging triggers for escalation, and technical considerations in catheter sizing, blood loss management, and real-time hemodynamic monitoring. Dr. Dexter reviews his use of intravascular ultrasound for precise clot localization, and Dr. Serhal shares practical tips for adjusting aspiration power to avoid complications. Together, they discuss procedural endpoints, mechanical assist devices for difficult clots, and present case examples demonstrating rapid improvement in hemodynamics and oxygenation. The episode emphasizes the importance of teamwork, patient selection, and ongoing innovation in optimizing PE care.

---

Resources

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism
https://ashpublications.org/bloodadvances/article/4/19/4693/463998/American-Society-of-Hematology-2020-Guidelines-for

Prospective Multicenter IDE Study of the Next-Generation Precision Aspiration Thrombectomy System for Intermediate-Risk Pulmonary Embolism: The SYMPHONY-PE Trial
https://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.125.015815

Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PE
https://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.126.016573
---

BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Our TOPPODCAST Picks

Follow Us

Stay Connected

BackTable Vascular & Interventional

Related Podcasts

Links

Stay Connected