Backtable Cardiology

From clot to clear flow, minimally invasive aspiration devices are PAVE-ing the way for safer treatment of endocarditis and cardiac masses. In this BackTable Cardiology episode, host Dr. Hady Lichaa sits down with Dr. Abdallah El Sabbagh to discuss percutaneous continuous-flow aspiration for right- and select left-sided endocarditis and cardiac masses. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Angiodynamicshttps://9zfaiv.short.gy/cardiovascular-backtable --- Timestamps 00:00 - Introduction03:43 - Lessons in Fibroelastoma 12:01 - Imaging Workup14:24 - Transesophageal Echocardiography (TEE) vs Intracardiac Echocardiography (ICE)17:52 - AngioVac System Components20:33 - Access Strategy, Sheath Size and Flow Rates23:41 - Adjunct Tools and Retrieval Options31:35 - Using Continuous Aspiration47:16 - Percutaneous AngioVac Vegetation Extraction (PAVE) Trial 53:17 - Future Devices Wishlist --- More about this episode Dr. El Sabbagh provides guidance on removing papillary fibroelastomas, emphasizing matching technique to mass characteristics and combining tools such as continuous aspiration with electrosurgical snaring to address adherent stalks. Their conversation covers patient selection for off-label endocarditis intervention, including intravenous drug use and Cardiac Implantable Electronic Device (CIED) lead infections, use of aspiration as definitive therapy, and imaging/workflow preferences. Dr. El Sabbagh details the AngioVac system, access strategies, adjunct devices, mitigating complications, and registry outcomes. He touches on the need for prospective studies, including the Percutaneous AngioVac Vegetation Extraction (PAVE) clinical trial. To finish the conversation, Drs. Lichaa and El Sabbagh look ahead to building future devices and provide advice on creating multidisciplinary programs as well as training pathways. --- Resources Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Dr. Abdallah El Sabbagh’s Provider Profilehttps://www.mayoclinic.org/biographies/el-sabbagh-abdallah-m-d/bio-20466764 Percutaneous AngioVac Vegetation Extraction (PAVE) to Remove Right Heart Vegetations in Patients With Infective Endocarditis - PAVE Clinical Trialhttps://clinicaltrials.gov/study/NCT07282002 --- BackTable Cardiology is the go-to podcast for interventional cardiologists, cardiac surgeons, and other healthcare professionals that manage cardiovascular conditions. 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

Below-the-knee (BTK) arterial disease remains one of the more challenging areas in vascular care, particularly in patients with chronic limb-threatening ischemia (CLTI), where heavy calcification complicates endovascular treatment. As new calcium-modifying technologies emerge, an important question remains: what evidence supports their use in BTK interventions? In this episode of BackTable Vascular & Interventional, host Dr. Sabeen Dhand speaks with vascular surgeon Dr. Paul Foley of Doylestown Health about the Disrupt BTK II clinical trial from Shockwave Medical, which evaluates the performance of peripheral intravascular lithotripsy (IVL) in heavily calcified BTK disease. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Shockwave Medicalhttps://shockwavemedical.com/ --- Timestamps 00:00 - Introduction08:20 - Evolution of Below-the-Knee Treatments11:10 - Differences in BTK Calcification13:13 - Imaging and Technology in BTK Interventions15:18 - Disrupt BTK II Trial Data and Results23:17 - Introduction to the Javelin Device26:39 - Technique Considerations with Javelin28:36 - Comparing Javelin and E831:17 - Future Directions for Lithotripsy Technology35:30 - Skepticism Around IVL in BTK Disease38:47 - Final Thoughts --- More about this episode Dr. Foley begins by outlining his training and the evolution of his vascular surgery practice, setting the stage for a broader discussion on how BTK interventions have changed over the past decade. The conversation explores shifts in access strategies, procedural approaches, and the unique characteristics of calcification encountered in CLTI. Because BTK calcium differs from calcification seen elsewhere in the peripheral vasculature, imaging and device selection play a particularly important role when planning IVL-based therapies. Dr. Foley reviews the design and outcomes of the Disrupt BTK II trial, where devices such as the Shockwave M5+ and S4 catheters were used to modify calcified plaque, demonstrating encouraging safety and performance signals. The discussion then turns to emerging technologies, including Shockwave’s Javelin catheter, designed to deliver focused pressure waves to fracture dense calcium within peripheral arteries. Dr. Foley describes how the device fits into BTK workflows, including technique considerations and its use alongside adjunctive therapies such as balloon angioplasty. The episode also addresses the ongoing skepticism surrounding IVL in BTK disease, emphasizing the need for careful patient selection, procedural precision, and continued multidisciplinary collaboration as the field works to refine treatment strategies and improve outcomes for patients with peripheral artery disease (PAD). --- Resources Disrupt BTK II Trialhttps://www.jvascsurg.org/article/S0741-5214(24)02063-9/fulltext --- BackTable Cardiology is the go-to podcast for interventional cardiologists, cardiac surgeons, and other healthcare professionals that manage cardiovascular conditions. 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

Small vessels can have a major impact. Are you missing the hidden culprit of chest pain? In this episode of BackTable Cardiology, host Dr. Hady Lichaa welcomes Yale Interventional Cardiologist Dr. Samit Shah to discuss Coronary Microvascular Dysfunction (CMD) and Angina with No Obstructive Coronary Arteries (ANOCA). Their discussion demonstrates how coronary function testing turns a historically vague diagnosis into actionable phenotyping that can dramatically improve treatment efficacy and patient symptoms. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:53 - Coronary Microvascular Dysfunction (CMD) Overview10:55 - Cath Lab Workflow Tips19:28 - Structural CMD: Discordant CFR and IMR Values26:59 - Vasospastic Phenotypes28:28 - Chest Pain Case: Syncope and Arrest Risk33:31 - Treatment and ACh Testing39:10 - Mixed Physiology Pharmacotherapy49:45 - Myocardial Bridge Workup55:19 - Workflow, Reimbursement, and Future Therapies58:11 - Closing and Signoff --- More about this episode Dr. Shah breaks down clinical presentations and cath lab findings of epicardial vasospasm, microvascular spasm, and endothelial dysfunction, outlining how phenotype and physiology influence treatment. He explains how to perform both Coronary Flow Reserve (CFR) and Index of Microcirculatory Resistance (IMR) testing, incorporating examples of interpretation of abnormal values. The physicians discuss COVADIS criteria for vasospastic angina, vasospasm and cardiac arrest considerations, and myocardial bridges in LAD-PCI. The episode covers door-to-discharge care for CMD: identification of phenotype via patient case walk-throughs, practical cath lab workflow, and recommendations for tailored pharmacotherapy. --- Resources Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Dr. Samit Shah’s Provider Profile https://medicine.yale.edu/profile/samit-shah/ COVADIS Criteria for vasospastic anginahttps://covadis.online/definitions/ A doppler flow probe for canine main left coronary arterieshttps://journals.physiology.org/doi/abs/10.1152/jappl.1974.37.2.256?journalCode=jappl ChaMP-CMD: A Phenotype-Blinded, Randomized Controlled, Cross-Over Trialhttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066680 Presence and Relevance of Myocardial Bridge in LAD-PCI of CTO and Non-CTO Lesions https://pubmed.ncbi.nlm.nih.gov/38340105/ DEFINE GPS Trialhttps://clinicaltrials.gov/study/NCT04451044 --- BackTable Cardiology is the go-to podcast for interventional cardiologists, cardiac surgeons, and other healthcare professionals that manage cardiovascular conditions. 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

Summary This week, the coronary sinus isn’t the only thing getting reduced! Dr. Jai Khatri and Dr. Ziad Ali join this BackTable Brief to share strategies for reducing enrollment barriers for the COSIRA II coronary sinus reducer trial. They discuss refractory angina, emerging evidence for microvascular angina, and strategies to help patients achieve stable medical therapy and avoid resetting trial eligibility. TIMESTAMPS 00:00 - Introduction 01:46 - Maintaining Patients Eligibility 04:20 - Treadmill Test Reproducibility 07:16 - Patient Stories And Outcomes 11:39 - CTO vs. COSIRA-II Trial Candidacy 16:57 - Microvascular Angina: Evidence and Outlook CHECK OUT THE FULL EPISODE COSIRA II: Managing Refractory Angina in Clinical Practice https://www.backtable.com/shows/cardiology/podcasts/14/cosira-ii-refractory-angina-challenges-treatment-strategies RESOURCES COSIRA-II Trialhttps://clinicaltrials.gov/study/NCT05102019

Coronary sinus reducers: the hourglass-shaped stents that might be able to take patients back to angina-free times. In this BackTable Cardiology Brief, Dr. Jai Khatri and Dr. Ziad Ali discuss patient selection, treatment algorithms, and recent, clinical-trial backed technology for treating diffuse, multi-vessel atherosclerotic disease. They emphasize staged PCI, careful counseling, and setting realistic expectations when angiographic success doesn’t translate to symptom relief. Notably, the episode introduces the coronary sinus reducer, tracing the stent’s roots back to the Beck procedure of the 1950s. Drs. Jai and Khatri review the stent’s mechanism in the coronary sinus and review key coronary sinus reducer trials: COSIRA and COSIRA-II. The delve into COSIRA-II’s design, inclusion criteria, and best practices and recommendations for enrolling patients. --- Timestamps 00:00 - Introduction 00:59 - Diffuse Disease Challenges 02:42 - Patient Communication: Setting Expectations 05:06 - Treatment Algorithms: PCI vs CABG 07:22 - When PCI Fails Symptoms 08:35 - Coronary Sinus Reducers 10:52 - COSIRA Evidence 12:01 - COSIRA II Design 13:13 - Why Sham Control Matters 14:30 - Reducer Procedure Walkthrough 16:54 - Risks And Safety 18:41 - Enrollment And Criteria 20:11 - Wrap Up And Credits --- Check out the full episode COSIRA II: Managing Refractory Angina in Clinical Practice https://www.backtable.com/shows/cardiology/podcasts/14/cosira-ii-refractory-angina-challenges-treatment-strategies --- Resources COSIRA-II Trial https://clinicaltrials.gov/study/NCT05102019

Clean lumen club! This week, BackTable meets you at the carotid bifurcation to discuss all things carotid angioplasty and stenting. Interventional neuroradiologist and cerebrovascular surgeon Dr. Adnan Siddiqui, Vice Chairman of the University of Buffalo’s Department of Neurosurgery, joins host Dr. Sameh Sayfo to discuss the evolution and current state of carotid disease treatment. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Terumohttps://www.terumois.com/ --- Timestamps 00:00 - Introduction02:48 - From Aspirin to Endarterectomy03:47 - Rise of Carotid Stenting06:46 - CREST-2 and CMS Coverage09:57 - Management of Severe Asymptomatic Carotid Stenosis 15:35 - New Stent Designs Explained17:56 - Five Tips for New Operators20:08 - Case Selection Algorithm22:04 - Learning Curve and Mentorship28:27 - What’s Next: IVL and Outpatient31:24 - Managing Complications Safely35:05 - Closing and Credits --- More about this episode Dr. Siddiqui details the history of carotid stenosis treatment, charting its path and progression from medical therapy to endarterectomy and modern stenting approaches. He includes how recent trial data and updated CMS reimbursements have influenced practice and generated recent developments such as second generation stent technology. Dr. Siddiqui shares perspectives on patient selection, operator learning curve, complication preparedness, and the importance of structured training and proctoring as technology and techniques continue to improve. The physicians close by overviewing future directions for the carotid space such as IVL and how to approach management of procedural complications. --- Resources Dr. Adnan Siddiqui provider profilehttps://www.ubns.com/physicians/dr-adnan-h-siddiqui/ Carotid Endarterectomy for Asymptomatic Carotid Stenosis: Asymptomatic Carotid Surgery Trial (ACAS)https://www.ahajournals.org/doi/10.1161/01.str.0000141706.50170.a7 Asymptomatic Carotid Surgery Trial (ACST-2)https://www.acc.org/latest-in-cardiology/clinical-trials/2021/08/25/23/24/acst2 Protected Carotid-Artery Stenting versus Endarterectomy in High-Risk Patients (SAPPHIRE trial)https://www.nejm.org/doi/full/10.1056/NEJMoa040127 Medical Management and Revascularization for Asymptomatic Carotid Stenosis (CREST-2 trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2508800 The North American Symptomatic Carotid Endarterectomy Trial (NASCET trial)https://www.ahajournals.org/doi/10.1161/01.str.30.9.1751

Understanding when to use extracorporeal membrane oxygenation (and how) can be extra complex, but knowing the intricacies of ECMO is key to using it effectively. In this episode of BackTable Cardiology, Dr. Hady Lichaa sits down with Dr. Allison Dupont to approach ECMO in a practical, clinically relevant way. They cover the fundamentals, including VV versus VA ECMO, circuit components, and key settings like flow, oxygenation, and CO2 removal. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:19 - What Is ECMO12:19 - Who Should Get ECMO16:12 - ECPR Criteria and Triage29:45 - Access Strategy32:43 - Low Flow Troubleshooting44:24 - Anticoagulation Protocols48:21 - Chugging Volume Alarms50:25 - Weaning Off ECMO55:22 - Building An ECMO Program --- More about this episode The conversation also dives into real-world application, including cannulation strategies, typical flow parameters, troubleshooting low flow, preventing limb ischemia, and managing anticoagulation. They explore advanced topics like LAVA-ECMO for valvular disease, ECPR protocols inspired by the ARREST Trial, and how to think about patient selection and “bridge” strategies. Dr. DuPont finishes with practical insights on weaning, LV unloading, bleeding management, and what it takes to successfully build an ECMO program with a multidisciplinary team.---ResourcesDr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaaDr. Allison Dupont’s Provider Profilehttps://northsidecvi.com/providers/our-cardiologists/allison-dupontAdvanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trialhttps://pubmed.ncbi.nlm.nih.gov/33197396/

Radial roots, peripheral reach! Radial to peripheral (R2P) access is the focus of this week’s episode with interventional cardiologist Dr. Shailendra Singh (Pennsylvania’s Lehigh Valley Heart and Vascular Institute) and dual hosts Hady Lichaa and Sameh Sayfo. The conversation focuses on key techniques, pre-procedure planning and imaging, and ideal case selection for those new to the R2P approach. --- This podcast is supported by: Terumohttps://www.terumois.com/ --- SYNPOSIS Dr. Singh shares how he began incorporating radial-to-peripheral procedures into his practice after fellowship and how his experience with radial coronary access translated naturally to peripheral interventions. The group reviews access strategy, including right versus left radial selection, along with techniques for preventing and managing radial spasm. They also touch on staff workflow and training when introducing R2P into the lab. The episode closes with practical insights on case selection for operators new to the approach, the role of pedal access in selected CTO cases, and strategies for safe sheath removal and hemostasis. --- TIMESTAMPS 00:00 - Introduction04:42 - Radial-to-Peripheral: Right vs Left Radial10:18 - Ultrasound and Pedal Access Applications17:10 - Ideal Cases When Starting Radial to Peripheral25:59 - Impactful Radial Success Stories29:38 - Managing Radial Spasm 35:22 - Left Radial Workflow42:00 - Shelf Setup Essentials48:43 - Renal Mesenteric Access55:37 - Safe Sheath Removal01:01:10 - Training and Courses01:04:48 - Closing Thoughts --- RESOURCES Dr. Shailendra Singh’s Provider Profile https://www.lvhn.org/doctors/shailendra-singh Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa

TAPAS, TASTE, TOTAL. These are the names of clinical trials that re-evaluated the use of manual aspiration thrombectomy in STEMI. In this episode of BackTable Cardiology, host Dr. Sameh Sayfo interviews Dr. Andrew Goldsweig, Director of Cardiovascular Clinical Research at Baystate Medical Center and Chair of the SCAI Standards and Guidelines Committee, about coronary thrombectomy in contemporary PCI. --- This podcast is supported by an educational grant from Cheisi. --- SYNPOSIS Drs. Sayfo and Goldsweig review how evidence from major trials led to a Class III recommendation against routine manual aspiration thrombectomy in STEMI, discuss methodological differences among studies and concerns about stroke reporting, and clarify how selective or bailout use may still have a role in high thrombus-burden cases. Their conversation also covers growing interest in mechanical thrombectomy technologies, the design and limitations of newer device studies, practical considerations that influence adoption, and differing operator approaches to STEMI workflows. They conclude by discussing gaps in evidence, the need for comparative data, and potential future features of next-generation coronary thrombectomy devices. --- TIMESTAMPS 00:00 - Introduction02:51 - Manual vs Mechanical Thrombectomy03:56 - TAPAS, TASTE, and TOTAL Trials10:20 - CHEETAH Trial Breakdown13:05 - Practice Patterns and Billing16:26 - Step by Step STEMI Workflow20:09 - Door to Balloon Reality22:03 - Impella First Strategy24:08 - High Thrombus Scenarios33:30 - Wishlist Catheter Features --- RESOURCES Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Andrew Goldsweig’s Provider Profilehttps://www.baystatehealth.org/providers/andrew-m-goldsweig A Prospective, Multicentre, Long-Term Cohort Study in Children, Adolescents and Adults with Seasonal Allergic Rhinitis-Design and Early Results (TAPAS)https://pubmed.ncbi.nlm.nih.gov/40283440/ Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction (TASTE)https://www.nejm.org/doi/full/10.1056/NEJMoa1308789 Randomized Trial of Primary PCI with or without Routine Manual Thrombectomy (TOTAL)https://www.nejm.org/doi/full/10.1056/NEJMoa1415098 CHEETAH Study by Penumbrahttps://www.penumbrainc.com/cheetah-study-results/

What do all image-guided interventionalists and surgeons have in common? Over time, the radiation exposure and the weight of lead begin to take a toll, often in ways no one talks about until it’s too late. In this episode of BackTable Cardiology, host Dr. Hady Lichaa sits down with Dr. Bob Foster, interventional cardiologist and Chief Medical Officer of Rampart IC, for a candid conversation about the hidden occupational risks facing today’s cath lab teams. --- SYNPOSIS Drawing on his extensive experience, he reflects on a career in complex coronary and peripheral intervention and the personal health crisis that forced him to confront the hidden dangers of operating in lead.National survey data from the Society for Cardiovascular Angiography and Interventions (SCAI) reveal a sobering trend in orthopedic injury rates, prompting a deeper look at why meaningful change has been so slow. From workflow realities and emerging clinical data to advocacy efforts, this episode explores what it will take to truly move the needle on operator safety. --- TIMESTAMPS 00:00 - Introduction01:03 - The Lack of Progression for Radiation Protection 06:37 - Rampart’s Origin Story14:24 - Evaluating the Data23:28 - Workflow & Setup Time: Lab Practicalities28:30 - Orthopedic Ergonomics33:06 - Beyond Cardiology: Other Interventional Surgery Specialties36:06 - Cost, ROI, and Legislation41:54 - Making Advanced Shielding Practical and Affordable50:46 - Protecting the Next Generation --- RESOURCES Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Dr. Bob Foster’s Provider Profilehttps://www.doximity.com/pub/robert-foster-md-5201e3aa Rampart IChttps://rampart.com

John Doe is a 45 year-old male with a past medical history of hypertension, on high doses of amlodipine, metoprolol and lisinopril presenting to his cardiologist with a blood pressure of 165/86. He asks, “If the medications are not controlling my blood pressure, what are my options?” In this episode of the BackTable Cardiology Podcast, Dr. Sameh Sayfo sits down with Dr. Eric Secemsky, an internationally recognized interventional cardiologist and vascular medicine specialist to discuss renal denervation, a minimally invasive procedure that lowers blood pressure by disrupting overactive renal sympathetic nerves. --- SYNPOSIS From its proof of concept to the clinical trials that have shaped the current landscape, Drs. Sayfo and Secemsky dive into the intricacies of renal denervation. They explore the technical aspects of catheter-based denervation devices like Medtronic's Spyral catheter and Recor's Paradise device, discussing their procedures, safety features, and troubleshooting tips. The conversation also covers the significance of building advanced hypertension centers, the latest in renal denervation innovations, and the creation of a national registry to track procedural outcomes and enhance patient care. --- TIMESTAMPS 00:00 - Introduction02:52 - Guidelines Update: Why Renal Denervation Earned a Class 2B Recommendation07:31 - Clinical Trials: What Went Wrong, What We Learned, and How Devices Improved15:08 - Medtronic Symplicity Spyral22:17 - ReCor Paradise27:30 - Covering the Main Renal Artery: Anatomic Variants and Proximal Treatment Strategy33:15 - Beyond Kidneys: Multi-Organ Denervation and Metabolic Effects40:27 - Why Institutions Should Build Hypertension Centers --- RESOURCES Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Eric Secemsky’s Provider Profilehttps://findadoc.bidmc.org/details/3519 A Controlled Trial of Renal Denervation for Resistant Hypertensionhttps://www.nejm.org/doi/full/10.1056/NEJMoa1402670 Medtronic Symplicity Spyral™ Renal Denervation Systemhttps://www.medtronic.com/en-us/healthcare-professionals/products/surgical-energy/ablation/radiofrequency-ablation/systems/symplicity-spyral-renal-denervation-system.html SPYRAL GEMINI Pilot Studyhttps://clinicaltrials.gov/study/NCT06907147 Ablation of Arteries for the Treatment of Type 2 Diabetes Mellitus and Its Comorbidities (NECTAR IV) Trial https://clinicaltrials.gov/study/NCT05369065

How do imaging, intravascular lithotripsy, and equipment selection come together to effectively target coronary calcium? In this episode of BackTable, interventional cardiologists Dr. Robert Riley (Overlake Medical Center in Bellevue, Washington) and Dr. Yousif Ahmad (UCSF) trade techniques and discuss various aspects of calcium modification in complex percutaneous coronary intervention (PCI). --- This podcast is supported by: Shockwave Medicalhttps://shockwavemedical.com/ --- SYNPOSIS The discussion begins with an overview of intravascular lithotripsy (IVL), including its mechanism of action, ideal lesion characteristics, and performance across varying calcium morphologies. The conversation then expands to comparative decision-making among atherectomy, specialty balloons, and IVL, emphasizing how intravascular imaging informs procedural planning and real-time optimization. Key clinical data are reviewed, including the Disrupt CAD I-IV series as well as findings from the Short-Cut and VICTORY trials. The episode concludes with a forward-looking discussion on emerging technologies and the ongoing challenge of treating calcified nodules, one of the most demanding substrates in coronary intervention. --- TIMESTAMPS 00:00 - Introduction04:16 - Complex PCI and Calcium Modification Tools04:43 - Intravascular Lithotripsy (IVL) Insights and Evolution12:08 - Calcium Modification Algorithms and Techniques27:24 - IVUS vs. OCT Imaging and Specialty Balloons32:12 - Challenges in Implementing New Techniques37:09 - Influential Studies in Calcium Modification40:52 - Recent Studies: Short-Cut and VICTORY53:11 - Future of Calcium Modification Technologies57:48 - Final Thoughts --- RESOURCES Dr. Robert Rileyhttps://www.scai.org/robert-f-riley-md-ms-fscai Dr. Yousif Ahmadhttps://profiles.ucsf.edu/yousif.ahmad Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysishttps://pubmed.ncbi.nlm.nih.gov/38401549/ Coronary intravascular lithotripsy for severe coronary artery calcification: The Disrupt CAD I-IV trialshttps://www.sciencedirect.com/science/article/abs/pii/S1553838924000769 Orbital Atherectomy vs. Conventional Balloon Angioplasty in Severely Calcified Coronary Arteries Prior to DES Implantation - ECLIPSEhttps://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/10/25/04/32/eclipse Shockwave Lithoplasty Compared to Cutting Balloon Treatment in Calcified Coronary Disease - A Randomized Controlled Trial (Short-Cut)https://clinicaltrials.gov/study/NCT06089135 The Value of IVL Compared To OPN Non-Compliant Balloons for Treatment of RefractorY Coronary Lesions (VICTORY) Trial (VICTORY)https://clinicaltrials.gov/study/NCT05346068

This is a friendly reminder to unclench your jaw, sit up straight, and take a deep breath before diving into the latest episode of BackTable Cardiology! Host Dr. Sameh Sayfo from Baylor Scott & White Health speaks with Dr. Sahil Parikh, a renowned interventional cardiologist from Columbia University, about the health of interventional cardiologists. They discuss the various occupational hazards interventional cardiologists may be at risk for, particularly focusing on radiation exposure and orthopedic injuries caused by wearing lead aprons. The conversation touches on the need for better education and mandatory training for upcoming cardiologists to prevent such injuries. --- SYNPOSIS As Dr. Parikh shares his personal experiences with orthopedic issues related to the extensive use of lead protection, he highlights the importance of radiation safety and advocates for incorporating advanced protective technologies in the labs. Dr. Sayfo and Dr. Parikh also discuss the significant trials presented at TCT 2025, their potential impact on clinical practice, and the importance of advocacy by societies like SCAI and the American College of Cardiology (ACC) in improving interventional cardiologists' working conditions. --- TIMESTAMPS 00:00 - Introduction01:58 - Orthopedic Issues in Interventional Cardiology04:00 - The Impact of Wearing Lead13:06 - Ergonomics and Risk Factors15:47 - Preventative Measures and Solutions23:22 - The Role of Medical Societies27:00 - Radiation Reduction Devices Overview30:57 - Barriers to Adopting Safety Technologies35:40 - Addressing Burnout in Interventional Cardiology42:06 - Highlights from TCT 2025 --- RESOURCES Dr. Sahil Parikh Provider Profile https://doctors.columbia.edu/us/ny/new-york/sahil-a-parikh-md-161-fort-washington-avenue Dr. Sameh Sayfo Provider Profile https://www.bswhealth.com/physician/sameh-sayfo Cardiovascular Research Foundation's Transcatheter Cardiovascular Therapeutics (CRF TCT) Conference 2025 - The Global Forum for Interventional Cardiology https://www.tctconference.com/ Society for Cardiovascular Angiography & Interventionshttps://www.scai.org/ American College of Cardiologyhttps://www.acc.org/

Are drug-eluting balloons (DEBs) the best way to treat in-stent restenosis? In this episode of BackTable Cardiology, host and interventional cardiologist Dr. Sameh Sayfo takes a closer look at the evolving applications of coronary DEBs with two esteemed guests from the UK, Dr. Mohammad Alkhalil and Dr. Abhishek Kumar. --- SYNPOSIS This conversation covers the history and application of DEBs in treating in-stent restenosis (ISR) and small vessel disease, the differences between paclitaxel and limus-based drugs, the importance of lesion preparation and imaging, and the future potential of DEBs in coronary interventions. Dr. Kumar elaborates on the LOVE DEB study, which is investigating the use of DEBs in large de novo vessels, while Dr. Alkhalil shares his experiences and insights on adapting DEB technology in various clinical scenarios, including bifurcation lesions and acute myocardial infarction. The episode emphasizes the current role of DEB technology while cautioning against a reckless approach to its application. --- TIMESTAMPS 00:00 - Introduction02:34 - Historical Perspective and Key Studies on DCB06:30 - Mechanisms and Imaging in In-Stent Restenosis11:39 - Comparing Paclitaxel and Limus DCBs13:24 - Choosing the Right DCB: Factors and Preferences17:23 - DCB in Complex Cases: Bifurcations and Beyond24:01 - Challenges and Adoption of DCB in Europe27:38 - The Role of Imaging in DCB Procedures30:13 - Insights from the LOVE DEB Study38:59 - Future Directions in DCB Technology --- RESOURCES Dr. Sameh Sayfo Provider Profile https://www.bswhealth.com/physician/sameh-sayfo LOVE DEB Clinical Trialhttps://clinicaltrials.gov/study/NCT05915468 The European Bifurcation Club Left Main Coronary Stent Study: A Randomized Comparison of Stepwise Provisional vs. Systematic Dual Stenting Strategies (EBC MAIN)https://pubmed.ncbi.nlm.nih.gov/34002215/

Fast acting and reversible: IV cangrelor offers rapid on, rapid off P2Y12 platelet inhibition that sidesteps oral absorption delays. In this episode of the BackTable Cardiology Podcast, host Dr. Sameh Sayfo welcomes renowned interventional cardiologist Dr. Roxana Mehran, incoming President elect of the American College of Cardiology (ACC), to discuss the emerging role of cangrelor and its implications on current cardiology practice. --- This podcast is supported by an educational grant from Cheisi. --- SYNPOSIS Dr. Mehran and Dr. Sayfo cover the history and outcomes of the CHAMPION PHOENIX trial, cangrelor’s adoption and underutilization, and the nuances of transitioning high acuity patients between IV and PO antiplatelet therapies. Dr. Mehran also addresses the role of gender in cardiovascular health and the importance of inclusive representation in clinical studies. The episode concludes with Dr. Mehran sharing her initiatives to support women and minorities in cardiology, including her work as co-founder of Women As One. --- TIMESTAMPS 00:00 - Introduction to the BackTable Podcast01:57 - Understanding Cangrelor and Its Impact02:18 - CHAMPION PHOENIX Study Insights07:02 - Challenges and Misconceptions of Cangrelor in Cardiogenic Shock and STEMI14:41 - Antiplatelet Bridging to Surgery and Gender Differences in Treatment17:39 - The SMILE Study and Real-World Applications20:49 - Advancing Women in Cardiology29:22 - Future of Interventional Cardiology32:53 - Holistic Cardiac and Vascular Health36:01 - Conclusion and Final Thoughts --- RESOURCES Dr. Roxana Mehran:https://profiles.mountsinai.org/roxana-mehran Dr. Sameh Sayfo:https://www.bswhealth.com/physician/sameh-sayfo Effect of Platelet Inhibition with Cangrelor during PCI on Ischemic Events (CHAMPION PHOENIX Trial):https://www.nejm.org/doi/full/10.1056/NEJMoa1300815 Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition – CHAMPION Platform Clinical Trialhttps://www.clinicaltrials.gov/study/NCT00385138 Intravenous Platelet Blockade with Cangrelor during PCI (CHAMPION PCI):https://www.nejm.org/doi/full/10.1056/NEJMoa0908629 Meta-Analysis of the Role of Cangrelor for Patients Undergoing Percutaneous Coronary Interventionhttps://www.sciencedirect.com/science/article/abs/pii/S0002914919300426 Timing, indications and transition patterns associated with cangrelor use in patients undergoing PCIhttps://pubmed.ncbi.nlm.nih.gov/40813532/ Women As Onehttps://womenasone.org/about/

If your New Year’s resolution involves learning more about current practice guidelines and emerging research on Heart Failure with Preserved Ejection Fraction (HFpEF), you’re in the right place! In this episode of the BackTable Cardiology Podcast, host Dr. Hady Lichaa welcomes heart failure specialist Dr. Jessica Huston to provide a practical update on managing heart failure with preserved ejection fraction (HFpEF). --- SYNPOSIS Dr. Huston and Dr. Lichaa discuss the complexity of diagnosing HFpEF, differences between HFpEF and diastolic heart failure, phenotypes within HFpEF, and treatment strategies, including the use of aldosterone blockers, SGLT-2 inhibitors, and GLP-1 agonists. Dr. Huston emphasizes the importance of phenotyping patients for accurate diagnosis and treatment, and discusses the potential of future therapies and devices. Their conversation also covers the role of inflammation, metabolic syndrome, and the challenges faced in managing fluid balance and hypertension in HFpEF patients. --- TIMESTAMPS 00:00 - Introduction02:20 - Understanding HFpEF05:23 - Phenotypes and Treatment Approaches06:29 - Metabolic Syndrome and HFpEF09:17 - Emerging Treatments and Clinical Trials11:36 - Medication Strategies and Challenges24:51 - Diuretics and Their Limitations31:35 - Advanced Diuretic Strategies35:37 - Hemodynamic Measurements and Their Implications40:02 - Coronary Disease and HFpEF42:52 - Future Directions in Heart Failure Treatment45:45 - Device Therapies and Patient Management49:39 - Concluding Thoughts and Future Prospects --- RESOURCES Dr. Jessica Huston Provider Profilehttps://healthcare.ascension.org/find-care/provider/1073874616/jessica-huston Dr. Hady Lichaa Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa The SUMMIT Trialhttps://pubmed.ncbi.nlm.nih.gov/39555826/ The TOPCAT Trialhttps://pubmed.ncbi.nlm.nih.gov/24716680/ The FINEARTS Trialhttps://pubmed.ncbi.nlm.nih.gov/39225278/ The CADENCE Trialhttps://www.clinicaltrials.gov/study/NCT04945460

Clinicians play a central role in shaping cardiovascular innovation, yet many lack a clear pathway to participate. In this episode of BackTable Cardiology, Dr. Sameh Sayfo speaks with Dr. Mohamad Alkhouli, cardiologist and Chair of Research and Innovation at the Mayo Clinic, about practical approaches for clinician involvement in healthcare innovation and strategies to address persistent gaps in cardiovascular care access. --- SYNPOSIS The discussion examines Dr. Alkhouli’s decision to pursue an MBA, the role of business and organizational training in medical leadership, and how system-level thinking informs innovation beyond device development. Broader themes include stakeholder alignment, organizational behavior, and emerging opportunities for non-device innovation within contemporary cardiovascular practice. --- TIMESTAMPS 00:00 - Introduction01:49 - The Value of an MBA for Physicians05:24 - Understanding Systems and Organizational Behavior07:31 - Navigating Innovation in MedTech13:15 - Bridging the Gap Between Physicians and Business19:44 - The Role of Professional Societies in Innovation25:32 - Future Trends in Interventional Cardiology29:58 - Global Perspectives on Innovation31:47 - Closing Remarks and Credits --- RESOURCES American College of Cardiologyhttps://www.acc.org/ Bolt Medical AcquisitionBoston Scientific Announces Agreement to Acquire Bolt Medical, Inc. Silk Road Medical AcquisitionBoston Scientific Closes Acquisition of Silk Road Medical, Inc. Dr. Mohamad Alkhouli’s Provider Profile https://www.mayoclinic.org/biographies/alkhouli-mohamad-m-d-m-b-a/bio-20465257 Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayfo

Preventing problems before they aggregate, P2Y12 inhibitor style! In this episode of the BackTable Cardiology Podcast, interventional cardiologist from MedStar Washington Hospital Center joins host Dr. Hady Lichaa for practical insights and key takeaways on antiplatelet use in the setting of acute coronary syndrome (ACS).---This podcast is supported by an educational grant from Cheisi.---SYNPOSISDr. Hashim talks through the use of intravenous antiplatelet therapies, specifically cangrelor, for managing acute coronary syndrome. Their discussion explores the pharmacokinetics, clinical advantages, and potential future applications of IV P2Y12 inhibitors. Dr. Hashim shares his wealth of experience in antiplatelet case studies and shares best practices when transitioning patients from IV to oral antiplatelet therapies. The conversation focuses on enhancing patient outcomes, minimizing complications, and lessons learned from different clinical scenarios.---TIMESTAMPS00:00 - Introduction03:31 - Intravenous Antiplatelet Therapies Overview06:01 - The Importance of IV P2Y12 Inhibitors09:15 - Guidelines and Usage of GP IIb/IIIa Inhibitors11:30 - Advantages of IV P2Y12 Inhibitors in Clinical Practice14:32 - Practical Applications and Case Studies24:42 - Cost Effectiveness, Hospital Administration, Financial Implications28:20 - Contraindications and Practical Considerations30:09 - Loading and Infusion Protocols34:58 - Bridging for Surgery39:48 - Anticoagulation and Heparin Goals48:55 - Future of IV Antiplatelet Therapy50:44 - Conclusion---RESOURCESAssociation of 2B3A inhibition with new antiplatelet regimens in the setting of acute coronary syndromes: a meta-analysis of randomized controlled trialshttps://academic.oup.com/eurheartj/article-abstract/34/suppl_1/P4861/2862796 Effect of Platelet Inhibition with Cangrelor during PCI on Ischemic Events - CHAMPION PHOENIXhttps://www.nejm.org/doi/full/10.1056/NEJMoa1300815 Morphine for treatment of cough in idiopathic pulmonary fibrosis (PACIFY COUGH): a prospective, multicentre, randomised, double-blind, placebo-controlled, two-way crossover trialhttps://pubmed.ncbi.nlm.nih.gov/38237620/ Abstract 4370674: Cangrelor Versus Oral P2Y12 Inhibitors During PCI in Cardiogenic Shock and Cardiac Arrest: A Systematic Review and Meta-analysishttps://www.ahajournals.org/doi/10.1161/circ.152.suppl_3.4370674Dr. Hayder Hashimhttps://www.medstarhealth.org/doctors/hayder-hashim-md Dr. Hady Lichaahttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa

From sternotomy to software, the booming field of robotic cardiac surgery is bringing new minimally invasive treatment approaches to well-traveled cardiology conditions. This week on the BackTable Cardiology Podcast, Dr. Amber Edwards, a distinguished cardiothoracic surgeon from Ascension St. Thomas in Nashville, shares her expertise in robotic cardiac surgery with host and Tennessee neighbor Dr. Hady Lichaa. The two physicians discuss the growth and technical advancements within robotic cardiac surgery, including the burgeoning field of hybrid revascularization. --- SYNPOSIS Dr. Edwards outlines her journey in the cardiothoracic field, sharing her experiences with pioneers of minimally invasive and robotic cardiac surgeries. The discussion explores various procedures, including totally endoscopic coronary artery bypass (TECAB), minimally invasive direct coronary artery bypass (MIDCAB), and robotic LIMA to LAD bypass. Dr. Edwards also elaborates on robotic left atrial appendage ligations, robotic mitral and aortic valve surgeries, and conversion procedures for atrial fibrillation, highlighting their technical challenges, patient selection, and potential for broader adoption. --- TIMESTAMPS 00:00 - Introduction03:33 - MIDCAB and TECAB Procedures07:11 - Preoperative Testing and Considerations09:09 - Challenges and Complexities in Robotic Surgery17:20 - Hybrid Revascularization and Antiplatelet Therapy26:02 - The Future and Adoption of Robotic Surgery30:56 - Exploring Robotic Left Atrial Appendage Ligation32:03 - The Convergent Procedure for AFib Patients40:56 - Robotic Mitral Valve Surgery: Techniques and Benefits47:11 - The Future of Robotic Cardiac Surgery50:20 - Conclusion --- RESOURCES Dr. Amber Edwardshttps://healthcare.ascension.org/find-care/provider/1699031591/amber-edwards Dr. Hady Lichaahttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa REvascularization CHoices Among Under-Represented Groups Evaluation: The RECHARGE Trial - Women (RECHARGE:W)https://clinicaltrials.gov/study/NCT06399692

Intravascular imaging can provide invaluable intel on the coronaries, with OCT supplying bright ideas and IVUS giving sound judgement. Light-based and soundwave-based, respectively, mastery of these two imaging modalities can help you streamline routine PCI cases and overcome challenging ones. In this episode of BackTable Cardiology, the esteemed Dr. Erik Rafflenbeul from Schön Klinik in Hamburg, Germany joins host Dr. Hady Lichaa from Tennessee’s Ascension St. Thomas Heart to discuss intravascular imaging techniques for percutaneous coronary interventions. --- SYNPOSIS The conversation covers a wide range of topics, including the importance and benefits of using intravascular imaging, the differences and applications of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) systems, recent intravascular clinical studies to know, and practical aspects of integrating these technologies into daily practice. Dr. Rafflenbeul emphasizes the value of proactive imaging and shares comprehensive insights for both seasoned and early-career interventional cardiologists. --- TIMESTAMPS 00:00 - Introduction03:52 - Current State of Intravascular Imaging in Germany and Europe05:26 - Importance of Intravascular Imaging in PCI09:08 - Challenges and Adoption of Intravascular Imaging13:30 - IVUS vs. OCT: Which to Choose?17:06 - Practical Insights on IVUS and OCT Systems28:50 - Pre-Procedural Measurements and Techniques30:36 - Choosing Stent Diameters32:22 - Practical Aspects of Stenting36:40 - Post-PCI Assessment and Algorithm40:35 - Recent Intravascular Imaging Studies43:07 - Case Studies and Practical Tips47:16 - Advice for Early Career Interventionalists 51:54 - Concluding Thoughts and Wisdom --- RESOURCES Dr. Hady Lichaahttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Dr. Erik Rafflenbeulhttps://www.pcronline.com/Physicians/Erik-Rafflenbeul European Association of Percutaneous Cardiovascular Interventions (EAPCI)https://www.escardio.org/Sub-specialty-communities/European-Association-of-Percutaneous-Cardiovascular-Interventions-%28EAPCI%29# Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Diseasehttps://www.jacc.org/doi/10.1016/j.jacasi.2022.12.009#:~:text=The%20OPTIVUS%20(Optimal%20IntraVascular%20Ultrasound)%2DComplex%20PCI%20study,infarction%20*%20Stroke%20*%20Any%20coronary%20revascularization Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysishttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02454-6/abstract Orbital Atherectomy vs. Conventional Balloon Angioplasty in Severely Calcified Coronary Arteries Prior to DES Implantation - ECLIPSEhttps://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/10/25/04/32/eclipse A Revised Optical Coherence Tomography–Derived Calcium Score to Predict Stent Underexpansion in Severely Calcified Lesionshttps://www.sciencedirect.com/science/article/abs/pii/S193687982401817X#:~:text=Lesions%20with%20severe%20calcium%20as,higher%20risk%20for%20stent%20underexpansion. Intravascular Imaging vs Angiography Guidance for PCI of Severely Calcified Lesions: The ECLIPSE Trialhttps://pubmed.ncbi.nlm.nih.gov/41093451/#:~:text=The%20primary%20clinical%20outcome%20was,tomographic%20guidance%20and%20IVUS%20guidance. Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents - ADAPT-DEShttps://www.acc.org/latest-in-cardiology/clinical-trials/2012/10/25/11/12/adapt-des

Transcatheter aortic valve replacement (TAVR) may be a standard cardiac procedure today, but its origin story follows an intriguing tale of courage, innovation and heart. In this episode of BackTable Cardiology, renowned cardiothoracic surgeon Dr. Michael Mack, a global leader in structural heart disease from Baylor Scott White Health, shares the history of TAVR, highlighting its origins, key clinical trials, and the eventual success of TAVR as a primary therapy. --- SYNPOSIS Dr. Michael Mack and host Dr. Sameh Sayfo discuss the early adaptations, challenges, and adoption of TAVR, detailing the collaborative efforts amongst medical professionals that led to its widespread utilization. They also explore the future of valve technology and the importance of multidisciplinary teamwork in advancing cardiovascular care. The discussion concludes with insights into emerging heart technologies and the evolving partnership between different medical specialties. --- TIMESTAMPS 00:00 - Introduction02:27 - Inception of TAVR03:01 - The Global Reach of TAVR11:10 - Placement of Aortic Transcatheter Valves (PARTNER) Trial 19:10 - Advancements in Cardiac Imaging20:35 - Mapping the Next Five Years23:20 - Strides in Aortic Insufficiency 25:16 - Collegiality in Cardiac Care --- RESOURCES How Transcatheter Aortic Valve Implantation (TAVI) Was Born: The Struggle for a New Inventionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8511628/ Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgeryhttps://www.nejm.org/doi/full/10.1056/NEJMoa1008232 Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Yearshttp://nejm.org/doi/full/10.1056/NEJMoa2307447 Dr. Michael Mack Provider Profileshttps://news.bswhealth.com/en-US/photos/michael-mack-md Dr. Sameh Sayfo Provider Profilehttps://www.bswhealth.com/physician/sameh-sayfo

When there's something strange in your vasculature, who are you going to call? Clot busters! In this episode of the BackTable Podcast, interventional cardiologist Dr. Sameh Sayfo hosts interventional radiologist Dr. Sabah Butty from Indiana University to discuss contemporary interventional approaches to pulmonary embolism (PE). --- This podcast is supported by: Angiodynamicshttps://www.angiodynamics.com/ --- SYNPOSIS Dr. Butty shares his extensive experience in managing venous thromboembolism (VTE) and pulmonary embolism, highlighting the evolution of treatment strategies over the past 15 years. The discussion covers the shift from catheter-directed thrombolysis (CDT) to large bore mechanical thrombectomy, the importance of understanding the disease process, the efficiency and effectiveness of various devices–including the Alpha Vac–and the importance of achieving both short-term and long-term efficacy. Dr. Butty also shares insights on post-procedure management and follow-up protocols for PE patients. --- TIMESTAMPS 00:00 - Introduction02:53 - Development of AMI, Stroke and VTE Management07:52 - Device Selection04:25 - The Shift in Mechanical and Medicinal Therapies 13:23 - The Alpha Vac Device16:50 - Benefits of Using Alpha Vac Device20:26 - Considerations for Blood Loss During Procedure 24:30 - End of Case Criteria for Thrombectomy28:24 - Post Procedure Follow-Up --- RESOURCES Dr. Sameh Sayfo Provider Profilehttps://www.bswhealth.com/physician/sameh-sayfo Dr. Sabah Butty Provider Profile https://iuhealth.org/find-providers/provider/sabah-d-butty-md-5216 Prospective Multicenter IDE Study of the Next-Generation Precision Aspiration Thrombectomy System for Intermediate-Risk Pulmonary Embolism: The SYMPHONY-PE Trialhttps://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.125.015815

Sham-controlled, randomized, and double-blind: the COSIRA II trial has the makings to make big waves in the management of refractory angina. This week’s episode features two interventionalists that are well-versed in coronary sinus reducers and the trials investigating them. Dr. Ziad Ali, from St. Francis Hospital and Heart Center in New York, and Dr. Jai Khatri, with Weill Cornell Medicine, join BackTable Cardiology to discuss the challenges and potential solutions in treating refractory angina in interventional cardiology. --- This podcast is supported by: Shockwave Reducerhttps://shockwavemedical.com/clinical-evidence/cosira-ii/ --- SYNPOSIS The doctors cover the current approaches to managing chronic angina before and after PCI, discuss how to differentiate ischemic heart disease from non-ischemic chest pain, and address the burdens faced by patients with complex atherosclerotic disease. A significant focus of the episode is on the role of the coronary sinus reducer, including procedure technique, risks, benefits, and its potential for treating both obstructive coronary artery disease and microvascular disease. The doctors also explore the logistics and challenges of enrolling patients in the COSIRA-II trial and speculate on the future impact of this device in clinical practice. --- TIMESTAMPS 00:00 - Introduction01:42 - Understanding Refractory Angina03:36 - Diagnostic Approaches06:32 - Medical Therapy for Angina10:29 - Complex Cases and Treatment Strategies18:00 - Coronary Sinus Reducer27:11 - Understanding the Risks and Learning Curve28:06 - The COSIRA II Trial30:27 - Tips for Patient Recruitment and Management33:05 - Handling Treadmill Tests and Patient Communication38:10 - Referral Patterns and Inter-Institutional Collaborations45:38 - Future of Coronary Sinus Reducer50:33 - Final Thoughts --- RESOURCES Dr. Ziad Alihttps://ziadalimd.com/ Dr. Jai Khatrihttps://doctors.nyp.org/jaikirshan-khatri-md/cardiology-weill-greenberg-center COSIRA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1402556 COSIRA II Trial https://clinicaltrials.gov/study/NCT05102019

Tricuspid valve repair has seen booming growth in the interventional arena in the last five years, and the trajectory is only up from here. In this episode, interventional cardiologists Dr. Joe Walsh and Dr. Aiden Raney share their wealth of insights and experiences with the latest advancements in tricuspid interventions. --- SYNPOSIS The conversation covers recent landmark trials, relevant tricuspid physiology, and hands-on experiences in the cath lab with specialty devices like TriClip and Evoque. The interventionalists discuss patient selection, including how to distinguish which patients are most likely to benefit from intervention and how to define procedural success. Dr. Walsh and Dr. Raney also highlight the educational opportunities provided by MurmurMD, a specialized social media platform for peer-to-peer learning for cardiologists and cardiac surgeons. --- TIMESTAMPS 00:00 - Introduction01:29 - Tricuspid Valve Interventions: An Overview03:55 - Understanding Tricuspid Regurgitation10:29 - Therapeutic Options for the Tricuspid Valve29:25 - Evaluating Success Rates and Patient Expectations32:27 - Right Heart Catheterization33:04 - Patient Selection Criteria34:18 - Challenges with Tricuspid Valve Procedures34:31 - Case Study: Evoke Device Size Variation35:26 - Impact of Tricuspid Annulus Rigidity37:57 - Complications and Management in Tricuspid Procedures50:00 - Financial Considerations and Reimbursement54:17 - Training and Educational Resources59:49 - Conclusion and Final Thoughts --- RESOURCES Dr. Aidan Raneyhttps://www.providence.org/doctors/interventional-cardiology/az/phoenix/aidan-raney-1962631101 Dr. Joe Walshhttps://www.saintalphonsus.org/provider/joe-walsh Coapt Study https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2018/09/21/20/12/COAPT Triluminate Study:https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 Triscend Study: https://www.nejm.org/doi/full/10.1056/NEJMoa2401918

Coronary drug-eluting balloon technology continues to evolve, but has its utilization been stunted by stenting? In this episode, Dr. Sameh Sayfo, an interventional cardiologist, hosts Dr. Ron Waksman, an internationally recognized cardiologist and scientist, to discuss advancements in coronary interventions and the age-old question of which coronary revascularization tools to use in which clinical scenarios.---SYNPOSISDr. Waksman shares his 30-year journey in the field, detailing the history and transition from traditional balloon angioplasty to drug-eluting stents, and now to drug-coated balloons. They explore the benefits and challenges of each technology, the significance of vessel preparation, and the latest trials, including the De Novo Trial led by Dr. Waksman. The conversation also touches on the importance of physician education and proper training in adopting new technologies. Additionally, Dr. Waksman provides insights into his approach to conducting interviews with notable public figures and hints at future discussions at the CRT annual meeting, potentially featuring President Biden.---TIMESTAMPS00:00 - Introduction03:40 - The History of Drug-Eluting Stents07:25 - Vessel Preparation To Ensure Good Balloon Angioplastic Technique10:36 - Bioabsorbable Scaffolds 14:57 - The AGENT IDE Randomized Clinical Trial20:16 - The Use of Paclitaxel Versus Sirolumus in Drug-Eluting Stents29:40 - Cardiovascular Research Technologies (CRT) Annual Meeting31:02 - Advice for Early Stage Colleagues---RESOURCESDr. Sameh Sayfo:https://www.bswhealth.com/physician/sameh-sayfoDr. Ron Waksmanhttps://www.medstarhealth.org/doctors/ron-waksman-mdDe Novo Trial, Drug-Coated Balloon for De Novo Coronary Artery Disease: Journal of American College of Cardiology State-of-the-Art Reviewhttps://pubmed.ncbi.nlm.nih.gov/32138967/The AGENT IDE Randomized Clinical Trial, Paclitaxel-Coated Balloon vs Uncoated Balloon for Coronary In-Stent Restenosis: The AGENT IDE Randomized Clinical Trialhttps://pubmed.ncbi.nlm.nih.gov/38460161/

PERT Consortium 2025 gives interventionalists the reins to tackle even the toughest saddle pulmonary embolisms. In this episode of the BackTable Podcast, host Dr. Aaron Fritts welcomes interventional radiologist Dr. Osman Ahmed and interventional cardiologist Dr. Jonathan Paul to discuss their experiences at the annual PERT Consortium in San Diego, and offer their perspectives on the latest developments in pulmonary embolism (PE) treatment. --- SYNPOSIS The doctors delve into advancements and trials within the PE treatment space, including new devices and clinical studies that are set to shape the future of pulmonary embolism care. The conversation highlights the value of collaboration between interventional specialties, the safety and efficacy of various PE interventions, and the growing trend of using combined therapies. They also provide updates on their ongoing innovation with Flow Medical, describing their philosophy and motivation for developing a new device for PE treatment that incorporates real-time pulmonary artery pressures, mean systolic and diastolic pressures, and a potential for AI utilization in the future. --- TIMESTAMPS 00:00 - Introduction01:23 - PERT Consortium Highlights02:11 - Emerging Clinical Trials and Innovations03:59 - Thrombectomy Devices and Market Trends12:37 - Flow Medical: Origin and Updates19:37 - Advanced Data Tracking in Cardiology20:45 - Remote Monitoring and Mobile Integration22:45 - Cardiologists’ Data-Driven Approach23:10 - Upcoming Studies and Data Insights24:10 - Interventional Radiology and Cardiology Collaboration25:07 - Access to Care and Procedure Adoption27:32 - Final Thoughts --- RESOURCES Pulmonary Embolism Response Team (PERT) Consortiumhttps://pertconsortium.org/ Flow Medicalhttps://www.flowmedical.co/ PEERLESS RCThttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.072364 RESCUE-IIhttps://www.jacc.org/doi/10.1016/j.jacadv.2025.101789 PEERLESS II https://www.jscai.org/article/S2772-9303(24)01053-6/fulltext Pulmonary Embolism - Thrombus Removal With Catheter-Directed Therapy (PE-TRACT)https://clinicaltrials.gov/study/NCT05591118 The HI-PEITHO Studyhttps://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/venous-thromboembolism-portal/pulmonary-embolism/clinical-data/hi-peitho.html PRAGUE-26https://eurointervention.pcronline.com/article/design-and-rationale-of-prague-26-a-multicentre-randomised-trial-of-catheter-directed-thrombolysis-for-intermediate-high-risk-acute-pulmonary-embolism Pulmonary Embolism - Thrombus Removal With Catheter-Directed Therapy (PE-TRACT) https://clinicaltrials.gov/study/NCT05591118 Aaron Fritts, MDhttps://www.backtable.com/shows/vi/contributors/dr-aaron-fritts Osman Ahmed, MDhttps://jointvascular.com/team/osman-ahmed-m-d-fcirse/ Jonathan Paul, MDhttps://www.uchicagomedicine.org/find-a-physician/physician/jonathan-d-paul

Real intracardiac echo cases, real-time developments! In this episode of BackTable Cardiology, host Dr. Sameh Sayfo is joined by Dr. Karim Al-Azizi, a structural interventional cardiologist at Baylor Scott & White Heart Hospital Plano. Together, they explore the evolving role of intracardiac echocardiography (ICE) through three real cases of ICE use in structural heart interventions. Join as they walk through patient profiles, imaging strategies, and clinical outcomes from ICE-guided cases. --- SYNPOSIS Dr. Al-Azizi shares his journey into the field of structural heart disease, highlighting the practical benefits and challenges of ICE and describing how it is transforming procedural guidance and patient outcomes. The episode concludes with a discussion on the Dallas PCI conference, emphasizing practical, hands-on learning for physicians. --- TIMESTAMPS 00:00 - Introduction 02:46 - Advancements in Structural Heart Procedures 05:38 - Intracardiac Echocardiography (ICE) Explained 09:27 - Practical Applications of ICE 13:53 - Learning and Training in ICE 17:22 - Comparing ICE Technologies 22:38 - Case Studies: ICE in Action 43:54 - Dallas PCI Conference and Closing Remarks --- RESOURCES Dr. Karim Al-Azizihttps://www.bswhealth.com/physician/karim-al-azizi Dr. Sameh Sayfohttps://www.bswhealth.com/physician/sameh-sayfo Baylor Scott & White Heart Hospital Planohttps://www.bswhealth.com/the-heart-hospital/locations/plano ICE Overviewhttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.031343 ICE Use in SVT and Afibhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11270097/ ICE Use in Left Atrial Appendagehttps://pmc.ncbi.nlm.nih.gov/articles/PMC12209866/

What coronary device do you reach for when a blockage won’t budge? In this episode of the BackTable Cardiology Podcast, Dr. Wissam Jaber from Emory University Hospital joins host Dr. Hady Lichaa to discuss the intricacies of coronary atherectomy, outlining the differences between rotational and orbital atherectomy, their indications, and their technical nuances.---SYNPOSISDr. Jaber shares his experiences with both rotational and orbital atherectomy, when he uses which for specific lesion subsets, potential complications, and strategies to manage them. This episode provides essential insights for cardiologists seeking to enhance their proficiency in managing calcified coronary lesions.---TIMESTAMPS00:00 - Introduction04:39 - Use of Lasers in Atherectomy07:12 - Determining Guide and Catheter Size14:24 - Laser Contrast Mix17:15 - Perforation Detection and Management25:16 - Treating the Circumflex Ostium 32:17 - Using a Guide Extension Catheter with Atherectomy Devices36:36 - Orbital Versus Rotational Atherectomy47:21 - Navigating Tortuosity in Atherectomies52:45 - Complications (Perforations, Dissections and Distal Embolizations)---RESOURCESDr. Wissam Jaberhttps://providers.emoryhealthcare.org/provider/wissam-a-jaber/777074Dr. Hady Lichaahttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa

Ballin’ on a contrast budget! In this episode of BackTable Cardiology, Dr. Evan Shlofmitz outlines how utilizing imaging and physiology get you the most bang for your buck when performing low contrast PCI for patients with renal impairment.---SYNPOSISDr. Shlofmitz, co-director of Optimize PCI (OPCI) and a leading expert in intravascular imaging and physiology from St. Francis Hospital, New York, joins Dr. Sameh Sayfo, interventional cardiologist from Baylor Scott & White The Heart Hospital. Together, they delve into the importance of low contrast PCI, strategies to prevent contrast-induced nephropathy, and the use of advanced imaging techniques to aid in low contrast procedures that are critical for patients with renal impairment. Dr. Shlofmitz shares insights into staging interventions, optimal use of contrast, and the integration of technologies like dynamic coronary roadmap and angiography-derived physiology. They also discuss the vital role of multidisciplinary collaboration, physician education, and industry support in enhancing patient outcomes by advocating for technology advancements in the cath lab. Dr. Shlofmitz highlights the Optimize PCI (OPCI) conference, which continues to advance the interventional cardiology field by providing hands-on workshops and regional courses in percutaneous cardiac procedures, imaging, access techniques, and much more.---TIMESTAMPS00:00 - Introduction to Guests 02:11 - Impaired Renal Function and Contrast Induced Nephropathy 06:55 - Contrast, GFR, and Hydration Status: Cath Lab Strategies for CKD12:24 - NCDR and Quality Metrics for CIN15:28 - Multidisciplinary Care: Bringing Nephrology on Board 18:26 - Staging Diagnostic and Intervention Procedures to Reduce Contrast20:39 - Ultra Low Contrast Diagnostic Angiogram Technique25:28 - Moderate Lesions in Ultra Low Contrast 29:36 - Technology: iFR Co-registration and Diagnostic Coronary Roadmap40:15 - Physician Champions: Advocates for Implementing New Imaging46:33 - Optimizing PCI (OPCI) Conference 50:40 - Conclusion---RESOURCESEvan Shlofmitz Provider Profilehttps://doctors.catholichealthli.org/provider/evan-scott-shlofmitz/2405486Intravascular Lithotripsy for Treatment of Severely Calcified Coronary Lesions: 1-Year Results From the Disrupt CAD III Studyhttps://www.jscai.org/article/S2772-9303(21)00001-6/fulltextSameh Sayfo Provider Profilehttps://www.bswhealth.com/physician/sameh-sayfoStatewide Initiative to Increase Intracoronary Imaging Optimization in PCI: A Report From the BMC2 Registryhttps://www.jscai.org/article/S2772-9303(25)01152-4/fulltextOptimize PCI (OPCI) - November Hands-On Workshiphttps://opci.live/event/opci-michigan-2025/Optimize PCI (OPCI) https://opci.live/

Reporting from inside the cath lab: advanced PCI techniques, cutting-edge imaging, and the future of interventional cardiology! In this episode of the BackTable Cardiology Podcast, Dr. Sameh Sayfo hosts Dr. Mirvat Alasnag, the director of research at the Cardiac Catheterization Lab at King Fahd Armed Forces Hospital in Saudi Arabia to discuss various coronary bifurcation intervention strategies, including TAP, DK Crush, and their indications.---SYNPOSISThe conversation delves into the use of drug-coated balloons (DCB), intracoronary imaging techniques like IVUS and OCT, and the importance of personalized patient care in high-risk percutaneous coronary interventions (PCIs). Additionally, Dr. Alasnag addresses the challenges and innovations in supporting women in interventional cardiology and the value of mentorship and career shadowing programs for aspiring cardiologists.---TIMESTAMPS00:00 - Introduction02:06 - Understanding Bifurcation Coronary Intervention04:00 - Strategies for Bifurcation Stenting09:55 - The Role of Drug-Coated Balloons13:08 - Importance of Intra-Coronary Imaging16:31 - Global Perspectives on Bifurcation Interventions27:57 - Advocacy for Women in Interventional Cardiology31:42 - Mentorship and Career Guidance---RESOURCESDr. Mirvat Alasnag:https://www.radcliffecardiology.com/authors/mirvat-alasnag?language_content_entity=enhttps://esc365.escardio.org/person/367232Dr. Sameh Sayfo:https://www.bswhealth.com/physician/sameh-sayfoKing Fahad Armed Forces Hospital:https://www.linkedin.com/company/king-fahad-armed-forces-hospital/?trk=public_profile_topcard_past_company&originalSubdomain=ieNew Innovations at King Fahad Armed Forces Hospital (Jeddah)https://elixirmedical.com/king-fahad-armed-forces-hospital-begins-trial-of-new-bioadaptive-angioplasty-procedure-for-heart-disease-treatment/Fundamentals of percutaneous coronary bifurcation interventions:https://pmc.ncbi.nlm.nih.gov/articles/PMC8968454/Bifurcation stenting: current strategies and new deviceshttps://heart.bmj.com/content/95/6/495.short

It’s no shock that percutaneous ventricular assist devices (pVADs) play an important role in improving cardiogenic shock outcomes (pun intended). In this episode of the BackTable Cardiology Podcast, host Dr. Sameh Sayfo interviews Dr. Babar Basir, a renowned interventional cardiologist from Michigan, about advancements and protocols in managing cardiogenic shock. --- SYNPOSIS Dr. Babar Basir details the history and development of the cardiogenic shock program initiated at Henry Ford Hospital, its national expansion, and its impact on patient outcomes. The conversation touches on the role of advanced heart failure specialists, ongoing trials like the Door to Unload trial, and the importance of small bore mechanical circulatory support devices. Dr. Babar Basir also highlights the significance of team-based approaches and the necessity of multidisciplinary care in improving survival rates for patients suffering from cardiogenic shock. --- TIMESTAMPS 00:00 - Introduction03:50 - Impella in Shock: From Last-Resort to Early Use 07:30 - National Cardiogenic Shock Initiative 14:30 - Heart Failure Readmissions 17:46 - Additional Indications for Use of Impella Device 24:10 - Future Devices and Technological Advancements in the Field27:03 - International Advancements in Shock Initiative Protocols30:28 - Using Impella CP vs Impella 5.5 38:20 - SCAI Shock Conference and Importance of Attending --- RESOURCES Dr. Sameh Sayfo:https://www.bswhealth.com/physician/sameh-sayfo Dr. Babar Basir:https://www.henryford.com/physician-directory/b/basir-mir National Cardiogenic Shock Initiativehttps://www.henryford.com/cardiogenicshock Unloading the Left Ventricle Before Reperfusion in Patients With Anterior ST-Segment-Elevation Myocardial Infarction (also known as “Door to Unload Trial”):https://pubmed.ncbi.nlm.nih.gov/30586728/ Upcoming SCAI Shock Conference September 18th-20th, 2025https://scai.org/education-and-events/events-schedule/2025-scai-shock-0

Calcium belongs in the bones, not the blood vessels! But once it’s there, how can interventional cardiologists use their skills and tools to combat it? In this episode of the BackTable Cardiology Podcast, host Dr. Hady Lichaa interviews Dr. Yader Sandoval from the Minneapolis Heart Institute about handling coronary calcification. --- SYNPOSIS Dr. Sandoval shares insights into the challenges of treating calcified coronary lesions, the importance of intravascular imaging, and his strategic approach to using technologies like intravascular lithotripsy, atherectomy, and specialty balloons. He emphasizes practical tips and tricks for interventional cardiologists to optimize procedure outcomes and tackle severe coronary calcification effectively. Their discussion overviews the latest innovations in the field, providing valuable advice for balancing advanced techniques with procedural efficiency. Dr. Sandoval also details the where, when, and how of approaching in-stent restenosis (ISR), including how to use imaging to optimize treating heavy calcifications around stents. --- TIMESTAMPS 00:00 - Introduction01:57 - Overview of Coronary Calcification08:08 - Severe Calcification Cases: Equipment and Technique21:08 - Guide Wires, Microcatheters, and Guide Extensions for Calcified Lesions31:24 - IVUS vs OCT36:21 - Atherectomy vs IVL Considerations43:32 - Calcified Nodules 51:06 - Stents and In-Stent Restenosis Management56:42 - Conclusion --- RESOURCES Dr. Yader Sandovalhttps://mplsheart.org/yader-sandoval-md Abbott Northwestern Hospital Dr. Hady Lichaahttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa SCAI Expert Consensus Statement on Management of In-Stent Restenosis and Stent Thrombosishttps://pmc.ncbi.nlm.nih.gov/articles/PMC11308135/

The toolbox for vessel preparation is rapidly expanding. Are you keeping up? In this episode, host Dr. Sabeen Dhand is joined by Dr. Jay Mathews, interventional cardiologist (Manatee Memorial Hospital) and Dr. Michael Siah, vascular surgeon (UT Southwestern), to explore the latest innovations and strategies in vessel prep. --- This podcast is supported by: Cagent Vascularhttps://cagentvascular.com/ --- SYNPOSIS The discussion opens with a look at new additions to their practice over the past few years, including bioresorbable scaffolds for below-the-knee interventions and retrievable stent technologies. Both experts emphasize the role of imaging—particularly CT angiography and IVUS—and discuss how renal disease impacts their use of contrast during diagnosis and intervention. They then walk through how they assess vessels on angiography or IVUS to decide when and where to use specialty tools. From intravascular lithotripsy for managing dense calcification to serration angioplasty, the conversation highlights how the doctors decide to use specialty balloons and devices. The episode also touches on the practical challenges of balancing device cost with treatment effectiveness. The physicians break down the latest specialty balloons and devices and touch on their own experiences with them. To close, the guests share what emerging technologies they’re most excited about and how these devices could change their day-to-day practice. Whether you’re in IR, cardiology, or vascular surgery, this episode offers a valuable roadmap to the current and future state of vessel preparation. --- TIMESTAMPS 00:00 - Introduction04:07 - New Changes in Techniques14:57 - Vessel Characteristics on Angiogram18:10 - Approaches to Above-the-Knee vs. Below-the-Knee Disease23:48 - Latest Specialty Balloons46:14 - New Devices on the Horizon50:58 - Words of Advice and Final Thoughts --- RESOURCES POINT FORCE Registry: ​https://evtoday.com/news/cagent-initiates-point-force-registry-of-serranator-pta-catheter?c4src=news

How do you navigate tortuous coronary vasculature? In this episode of BackTable Cardiology, Dr. Hady Lichaa hosts Dr. Alexander Truesdell, an interventional cardiologist with extensive experience in overcoming complex cases of vessel tortuosity. --- SYNPOSIS Beginning with Dr. Truesdell’s background and expertise, the discussion delves into best practices for evaluating and navigating tortuous anatomy both diagnostically and interventionally, the use of various wires, guides, and support techniques, and how to effectively use imaging and atherectomy tools. They also touch on practical aspects of tackling coronary tortuosity, like procedural preparation, equipment choices, and the importance of continuous learning in an evolving area of medicine. --- TIMESTAMPS 00:00 - Introduction02:07 - Approaching Cases of Extreme Tortuosity14:04 - Defining Tortuosity of the Coronary Vessels18:40 - Guide Size and Equipment Strategy in Complex PCI 35:04 - Distal Guide Extension Catheter Use and One Potential Risk 43:16 - Using Imaging Catheters 49:25 - Discussion of Avoiding Complications57:40 - Selecting Stents 01:04:00 - Guide Extension Use Through Pseudo Lesions to Decrease Ischemic Time01:11:00 - Parting Advice for New and Mid-Career Interventional Cardiologists --- RESOURCES Dr. Alexander Truesdell’s Provider Profile:https://www.virginiaheart.com/find-a-provider/physicians/alexander-g-truesdell Dr. Hady Lichaa’s Provider Profile:https://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Transradial Peripheral Vascular Intervention: Challenges and Opportunities:https://www.openaccessjournals.com/articles/transradial-peripheral-vascular-intervention-challenges-and-opportunities.html

In 2024, the DanGer Shock trial changed cardiogenic shock guidelines and affected practice patterns internationally. This episode of the BackTable Cardiology Podcast explores tips, tricks, and best practices in utilizing Impella, ECMO, and national initiatives to most effectively treat patients with cardiogenic shock. Host Dr. Sameh Sayfo interviews Dr. Amir Kaki, a noted interventional cardiologist and Director of Mechanical Circulatory Support and Complex PCI at Henry Ford St. John Hospital in Detroit. --- SYNPOSIS The discussion centers on the advances in mechanical circulatory support devices like Impella and ECMO, their history, usage criteria, and impact on patient outcomes. Dr. Kaki details the landmark Detroit Cardiogenic Shock Initiative, the challenges surrounding ECMO use, and the critical implementation of the recent DanGer-SHOCK Trial in clinical practice. After outlining the history of interventions for cardiogenic shock and the significance of recent trials within the field, he emphasizes the necessity for contemporary cardiologists to be skilled in endovascular techniques. --- TIMESTAMPS 00:00 - Introduction02:12 - National Cardiogenic Shock Initiative06:23 - Shock 2 Trial07:48 - ECLS-SHOCK Trial and ECMO15:05 - DanGer Trial22:56 - Parameters for Impella RP vs Impella CP Use in Cardiogenic Shock29:39 - Impella Considerations: Placement, Limb Ischemia, Removal 37:56 - Modern Cardiogenic Shock: Overview and Resources40:16 - Conclusion --- RESOURCES The National Cardiogenic Shock Initiative:https://www.ahajournals.org/doi/10.1161/JAHA.123.031401 DanGer Shock Trial:https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/04/05/04/44/danger-shock Large-Bore Access Site Managementhttps://assets.bmctoday.net/citoday/pdfs/cit0719_SF2_Kaki.pdf Short-Term Mechanical Circulatory Support for Cardiogenic Shockhttps://scai.org/publications/ebooks/short-term-mechanical-circulatory-support-cardiogenic-shock Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shockhttps://www.nejm.org/doi/full/10.1056/NEJMoa1208410 Extracorporeal Life Support in Infarct-Related Cardiogenic Shockhttps://www.nejm.org/doi/full/10.1056/NEJMoa2307227 Dr. Amir Kaki, MDhttps://www.heartteam.com/provider/amir-kaki-mdhttps://scai.org/about-us/scai-staff-listing/amir-kaki-md-fscai Dr. Sameh Sayfohttps://www.bswhealth.com/physician/sameh-sayfo

What are the biggest challenges in large bore access and closure? In our inaugural episode of the BackTable Cardiology Podcast, Dr. Hady Lichaa hosts Dr. Jason Wollmuth, an interventional cardiologist renowned for his expertise in large bore access techniques. --- SYNPOSIS Dr. Wollmuth shares his journey in interventional cardiology, detailing his early experiences managing complex PCI cases and CTOs. They delve into the specifics of large bore access, including preparation and imaging, access techniques, managing complications, and the use of single access for complex cases. The discussion also covers equipment preferences, handling vascular disease, mitigating limb ischemia, and alternative access strategies such as axillary and carotid approaches. Dr. Wollmuth highlights the importance of procedural practice, interdisciplinary collaboration, and continued learning from experienced colleagues. --- TIMESTAMPS 00:00 - Introduction01:46 - Large-bore Access Adoption 08:00 - Micropuncture Technique for Initial Access11:30 - Challenges of Getting Antegrade Access17:20 - Practicing Emergent Scenarios in Non Emergent Settings 22:09 - Managing Calcified or Tortuous Arteries44:00 - Limb Ischemia Mitigation54:46 - The Sideclose Technique01:01:00 - Single Access Closure Method01:09:00 - Using Axillary Access Instead of Femoral --- RESOURCES Dr. Jason Wollmuth’s Provider Profile:https://www.providence.org/doctors/interventional-cardiology/or/portland/jason-wollmuth-1164498499 Dr. Hady Lichaa’s Provider Profile:https://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa The Sideclose Technique: A Novel Method for Achieving Hemostasis With an Indwelling Impella CP:https://www.jscai.org/article/S2772-9303(24)01363-2/pdf