Backtable Cardiology

Introducing Backtable Cardiology

Ep. 1 Large Bore Access: Tools, Techniques, and Tips with Dr. Jason Wollmuth

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

Ep. 2 Cardiogenic Shock Management: Latest Strategies and Innovations with Dr. Amir Kaki

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

Ep. 3 Navigating Coronary Tortuosity in Complex Interventions with Dr. Alex Truesdell

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

Ep. 4 Techniques for Effective Vessel Prep with Dr. Jay Mathews and Dr. Michael Siah

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