Ep. 395 Radial to Peripheral Tools and Technique with Dr. Sameh Sayfo
12/22/23 • 43 min
In this episode of the Back Table Podcast, host Dr. Aaron Fritts and Dr. Sameh Sayfo discuss radial to peripheral interventions, also known as R2P. Dr. Sayfo is an interventional cardiologist and the program director of the endovascular fellowship at Baylor Heart Hospital in Plano, Texas.
Dr. Sayfo points out the need for research data on the financial impact of these interventions on patients. Dr. Amit P. Amin’s work in 2017, 2018 and 2021 is highlighted for its valuable contribution in this area, specifically in the radial to coronary world. The conversation then veers into the possibilities for radial to peripheral interventions in the coming years. There’s a discussion about the potential financial impact on the healthcare system, and how radial to peripheral interventions may yield a lower length of stay and more same day discharges, which can serve as motivators for more practitioners to adopt this technology. The episode also highlights training, patient selection, complications, bailout techniques and post-procedure care related to radial to peripheral interventions.
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CHECK OUT OUR SPONSORS
Surmodics Sublime Radial Access Platform
https://sublimeradial.com/
Reflow Medical
https://www.reflowmedical.com/
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SHOW NOTES
00:00 - Introduction
04:40 - Discussion on Radial to Peripheral
15:52 - Addressing Hesitations about Radial Approach
25:24 - Crossing Complex Lesions: Challenges and Solutions
28:50 - Need for Research and Equipment Advancement
33:43 - Importance of Landmark Study in Radial to Peripheral
35:23 - Complications to Avoid and Bailout Techniques
40:53 - The Radial Movement and Future Prospects
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RESOURCES
From Femoral to Radial Approach in Coronary Intervention:
https://pubmed.ncbi.nlm.nih.gov/27401210/
Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial:
https://pubmed.ncbi.nlm.nih.gov/34167675/
Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions:
https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext
Distal Versus Proximal Radial Artery Access for Cardiac Catheterization and Intervention: Design and Rationale of the DIPRA Trial:
https://pubmed.ncbi.nlm.nih.gov/33926835/
Costs associated with transradial access and same-day discharge after percutaneous coronary intervention: a systematic review and meta-analysis:
https://pubmed.ncbi.nlm.nih.gov/34258909/
The Value of Transradial: Impact on Patient Satisfaction and Health Care Economics:
https://pubmed.ncbi.nlm.nih.gov/31733737/
Transradial Access for High-Risk Percutaneous Coronary Intervention: Implications of the Risk-Treatment Paradox:
https://pubmed.ncbi.nlm.nih.gov/34253050/
Cost of coronary syndrome treated with percutaneous coronary intervention and 30-day unplanned readmission in the United States:
https://pubmed.ncbi.nlm.nih.gov/31876371/
Terumo Radial Sheath:
https://www.terumois.com/products/access/glidesheath-slender-introducer-sheath.html
Cordis Radial Sheath:
https://cordis.com/na/products/access/cardiology/rain-sheath-transradial-thin-walled-introducer
Surmodic Radial Sheath:
https://www.surmodics.com/
In this episode of the Back Table Podcast, host Dr. Aaron Fritts and Dr. Sameh Sayfo discuss radial to peripheral interventions, also known as R2P. Dr. Sayfo is an interventional cardiologist and the program director of the endovascular fellowship at Baylor Heart Hospital in Plano, Texas.
Dr. Sayfo points out the need for research data on the financial impact of these interventions on patients. Dr. Amit P. Amin’s work in 2017, 2018 and 2021 is highlighted for its valuable contribution in this area, specifically in the radial to coronary world. The conversation then veers into the possibilities for radial to peripheral interventions in the coming years. There’s a discussion about the potential financial impact on the healthcare system, and how radial to peripheral interventions may yield a lower length of stay and more same day discharges, which can serve as motivators for more practitioners to adopt this technology. The episode also highlights training, patient selection, complications, bailout techniques and post-procedure care related to radial to peripheral interventions.
---
CHECK OUT OUR SPONSORS
Surmodics Sublime Radial Access Platform
https://sublimeradial.com/
Reflow Medical
https://www.reflowmedical.com/
---
SHOW NOTES
00:00 - Introduction
04:40 - Discussion on Radial to Peripheral
15:52 - Addressing Hesitations about Radial Approach
25:24 - Crossing Complex Lesions: Challenges and Solutions
28:50 - Need for Research and Equipment Advancement
33:43 - Importance of Landmark Study in Radial to Peripheral
35:23 - Complications to Avoid and Bailout Techniques
40:53 - The Radial Movement and Future Prospects
---
RESOURCES
From Femoral to Radial Approach in Coronary Intervention:
https://pubmed.ncbi.nlm.nih.gov/27401210/
Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial:
https://pubmed.ncbi.nlm.nih.gov/34167675/
Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions:
https://www.jscai.org/article/S2772-9303(23)00813-X/fulltext
Distal Versus Proximal Radial Artery Access for Cardiac Catheterization and Intervention: Design and Rationale of the DIPRA Trial:
https://pubmed.ncbi.nlm.nih.gov/33926835/
Costs associated with transradial access and same-day discharge after percutaneous coronary intervention: a systematic review and meta-analysis:
https://pubmed.ncbi.nlm.nih.gov/34258909/
The Value of Transradial: Impact on Patient Satisfaction and Health Care Economics:
https://pubmed.ncbi.nlm.nih.gov/31733737/
Transradial Access for High-Risk Percutaneous Coronary Intervention: Implications of the Risk-Treatment Paradox:
https://pubmed.ncbi.nlm.nih.gov/34253050/
Cost of coronary syndrome treated with percutaneous coronary intervention and 30-day unplanned readmission in the United States:
https://pubmed.ncbi.nlm.nih.gov/31876371/
Terumo Radial Sheath:
https://www.terumois.com/products/access/glidesheath-slender-introducer-sheath.html
Cordis Radial Sheath:
https://cordis.com/na/products/access/cardiology/rain-sheath-transradial-thin-walled-introducer
Surmodic Radial Sheath:
https://www.surmodics.com/
Previous Episode
Ep. 394 Cryoneurolysis Pearls and Pitfalls with Dr. Alexa Levey
In this episode of the BackTable Podcast, host Dr. Jacob Fleming and Dr. Alexa Levey have an in-depth discussion about the current uses and potential future applications of cryoneurolysis in interventional radiology. Dr. Levey is an interventional radiologist at the Memorial Hermann Health System in Houston, TX.
The doctors discuss how cryoneurolysis differs from radiofrequency (RF) ablation, highlighting the increased precision and gentleness to surrounding tissues. Dr. Levey describes the specifics of stellate ganglion procedures and cryoneurolysis techniques. They delve into the importance of research and collaboration in advancing the field, as well as the necessity of being patient-centered. They also address the need for financial discussions in medicine and the prospect for cryoneurolysis as desmoid tumor treatments. Additionally, Dr. Levey shares her journey in building a career as a female in a male-dominated space and emphasizes the importance of physician availability to patients and colleagues.
---
CHECK OUT OUR SPONSOR
Boston Scientific Visual ICE Cryoablation System
https://www.bostonscientific.com/en-US/products/cryoablation/visual-ice.html
---
SHOW NOTES
00:00 - Introduction to RF Ablation and Cryoneurolysis
03:20 - Dr. Alexa Levey’s Journey and Inspiration
07:00 - Building a Pain Practice
14:03 - Advantages of Cryoneurolysis over RF
21:09 - Patient Selection and Planning for Cryoneurolysis
32:02 - Understanding Patient’s Condition and Treatment Options
36:21 - Role of Stellate Ganglion Procedures in PTSD and Anxiety Management
37:48 - Challenges and Impact of Long COVID
41:34 - The Future of Cryoneurolysis in Medical Practice
54:55 - Future of Cryo Treatment in Medical Practice
---
RESOURCES
Safety and Effectiveness of Stellate Ganglion Cryoablation in Complex Regional Pain Syndrome:
https://doi.org/10.1016/j.jvir.2023.09.030
Treating phantom limb pain: cryoablation of the posterior tibial nerve:
https://pubmed.ncbi.nlm.nih.gov/35801126/
Stellate Ganglion Block for Psychiatric Disorders: A Systematic Review of the Clinical Research Landscape:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664306/
The Efficacy of the Stellate Ganglion Block as a Treatment Modality for Posttraumatic Stress Disorder Among Active Duty Combat Veterans: A Pilot Program Evaluation:
https://pubmed.ncbi.nlm.nih.gov/33242072/
Stellate Ganglion Block in the Treatment of Post-traumatic Stress Disorder: A Review of Historical and Recent Literature:
https://pubmed.ncbi.nlm.nih.gov/27739175/
Stellate ganglion block reduces symptoms of Long COVID: A case series:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8653406/
Stellate Ganglion Block Relieves Long COVID-19 Symptoms in 86% of Patients: A Retrospective Cohort Study:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498998/
Next Episode
Ep. 396 How I Perform a Port Removal with Dr. Chris Beck
In this episode of the BackTable Podcast, hosts Dr. Aaron Fritts and Dr. Chris Beck discuss their Mediport removal workflows and the common challenges of a port removal procedure.
Often seen as a significant milestone for cancer patients who have completed their treatment, successful Mediport removal requires a thorough understanding of the catheter and reservoir removal processes. This discussion covers tips and tricks for removing Mediports with minimal discomfort to the patient, effective anesthesia, careful dissection, and appropriate closure procedures. The hosts also emphasize the importance of preparing for unexpected scenarios such as catheter fractures or infection, and they outline strategies to effectively handle these complications.
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CHECK OUT OUR SPONSOR
RADPAD® Radiation Protection
https://www.radpad.com/
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SHOW NOTES
00:00 - Introduction
03:06 - Overview of Mediport Removal
13:25 - Mediport Removal Procedure
20:59 - Procedural Challenges and Complications
22:12 - Infected Ports
30:17 - Stuck Ports
33:14 - Fractured Ports
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