Wysdom Radio™

Provocative Mesenteric Angiography: Safety and Efficacy in Occult GI Bleeding This episode tackles one of the most frustrating clinical challenges in Interventional Radiology: the patient with a recurrent occult GI bleed who has failed endoscopy and standard imaging. We analyze the largest retrospective cohort study to date (22 years of data) on TPA-based Provocative Mesenteric Angiography (PMA) t...

Evidence for IVUS in PAD This episode uncovers the compelling evidence behind Intravascular Ultrasound (IVUS), a technology that is revolutionizing the treatment of Peripheral Artery Disease (PAD) by fixing the fundamental flaw of traditional angiography: its "2D shadow" limitation. The Problem with Angiography: Standard X-ray imaging forces doctors to guess the size of 3D arteries from 2D picture...

IR Procedural Best Practices: Setup, Grip, and Wire Handling This episode moves beyond basic instrument knowledge to focus on the subtle physical habits and organizational tricks that distinguish expert operators from novices, aiming to maximize efficiency and safety. Air Bubble Management: We review the three techniques for removing deadly air bubbles—inversion, flicking, and the "push-pull" vacu...

IR Basics: Needles, Wires, Catheters, and Sheaths This episode provides a rapid-fire masterclass on the four foundational tools of Interventional Radiology and how to navigate the complex sizing systems that dictate their use. The Sizing Headache: We demystify the three conflicting measurement systems—Gauge, French, and Inches—that every interventionalist must juggle simultaneously. Needles (The G...

IR Procedural Skills: Pigtail Catheters and Manual Hemostasis This episode breaks down the mechanics of two foundational interventional skills—drainage catheter deployment and arterial compression—where proper technique is the only line of defense against complications. The Pigtail Mechanism: We explain how the "locking loop" secures the catheter to prevent migration and the critical deployment ru...

This fundamental episode builds your mental toolbox by outlining the three main categories of embolic agents you'll use every single day. We break down the core principles, "why," and critical safety rules for: Particulates (The "Downstream" Stuff):  Learn the difference between temporary (Gelfoam) and permanent (PVA, Embospheres) agents. When do you use each for trauma, UFE, or TACE? Coils &...

What if chronic joint pain from osteoarthritis and tendinopathy isn't just "wear and tear"? This episode explores the cutting-edge, minimally invasive world of Musculoskeletal Embolization. Discover the science behind how this procedure targets abnormal blood vessels (angiogenesis) and nerves that contribute to chronic pain. Tune in to learn about: Genicular Artery Embolization (GAE): A deep dive...

This episode is a complete introduction to IVC filters, designed for the IR trainee. We cover all the essentials you need to know from the initial consult to long-term follow-up. What you'll learn: The "Why": Why filters are not first-line therapy and are only used to prevent PE. The "When": The two absolute indications for filter placement (contraindication to anticoagulation and failure of antic...

🎙️ Wysdom Radio: BAE Insights from the Experts This episode of Morning Rounds delivers a direct line to critical research on Bronchial Artery Embolization (BAE), the life-saving procedure used to stop massive hemoptysis (coughing up blood). CF Patient Effectiveness: We analyze a long-term Stanford study on BAE in adults with Cystic Fibrosis (CF), revealing that while BAE is highly effective at sto...

🎙️ The Evolution of Cryoneurolysis: Regulatory Shifts and New Targets This episode explores Cryoneurolysis, a cutting-edge interventional radiology technique that uses extreme cold to precisely disable nerves and stop chronic pain without addictive opioids. The "Sweet Spot" of Freezing: We break down the critical science of achieving a Sunderland Grade 2 injury (axonotmesis). This requires freezin...

🎙️ Wysdom Radio: Portal Hypertension, TIPS, and RTO—Latest AASLD Guidance This episode breaks down the critical differences between the two main endovascular strategies for managing variceal bleeding in patients with portal hypertension: TIPS (Transjugular Intrahepatic Portosystemic Shunt): A procedure that acts as an internal bypass to lower the overall portal pressure. New Guidance: Covered sten...

This episode dives into the STORM PE Randomized Control Trial, which fundamentally shifts how we treat patients with intermediate high-risk Pulmonary Embolism (PE)—those who look stable but have hidden heart strain. ⚡ Key Findings Rapid Decompression: The trial compared standard anticoagulation (AC) alone to AC plus Computer-Assisted Vacuum Thrombectomy (CAVT). Superior Efficacy: CAVT was signifi...

🎙️ Wisdom Radio: Managing Parastomal Variceal Bleeding—Embolization vs. TIPS This episode dives into the high-stakes management of Parastomal Variceal Bleeding (PVB), a rare but life-threatening complication of portal hypertension, often seen in patients with significant comorbidities (like metastatic cancer) where a TIPS procedure is initially contraindicated. The Clinical Dilemma: We explore a c...

🎙️ CREST-2 Results—A Paradigm Shift in Carotid Care This episode unpacks the long-awaited results of the CREST-2 Trial, a landmark study that challenges the standard of care for treating asymptomatic carotid stenosis (narrowing of the carotid artery without recent stroke symptoms). The Big Question: Does adding invasive revascularization (Endarterectomy or Stenting) to Intensive Medical Management...