BackTable Cardiology

Radial roots, peripheral reach! Radial-to-peripheral access is the focus of this week’s episode featuring Dr. Shailendra Singh. This week hits key radial-to-peripheral topics: ⚡️Left vs right radial ⚡️Pedal access in CTO cases ⚡️Radial spasm ​​⚡️Case selection for radial-to-peripheral beginners Tune in: na2.hubs.ly/H04mcrM0 This podcast is supported by Terumo. #CV29 #radial #interventionalcardiology

Dr. Roxana Mehran explains that prior to the CHAMPION PHOENIX trial, the PLATO trial helped shape the P2Y12 inhibitor landscape by comparing the use of Ticagrelor versus Clopidogrel in patients with acute coronary syndrome. Before Cangrelor came along, Clopidogrel was widely used for platelet inhibition. Cangrelor is an intravenous, fast acting, reversible P2Y12 inhibitor with platelet function returning to normal within about an hour after stopping the infusion, whereas clopidogrel has a slower onset and causes irreversible platelet inhibition, with recovery dependent on new platelet generation over several days. Watch the full episode: youtube.com/watch?v=zCPIVL… This podcast is supported by Chiesi. #Cangrelor #AntiplateletTherapy #AcuteCoronarySyndrome #ClinicalTrial #InterventionalCardiology #CV22

What factors go into choosing the right calcium modification strategy? Dr. Yousif Ahmad and Dr. Robert Riley discuss how identifying the right treatment is essential to optimizing patient outcomes. When a calcified nodule is present, it often shifts Dr. Ahmad’s approach beyond a noncompliant balloon toward dedicated plaque modification. He emphasizes that almost all atherectomy is influenced by wire bias and that there are limited ways to overcome it. In very tight lesions, he finds that augmenting with Intravascular Lithotripsy (IVL) or selecting stronger stents with higher radial force can reduce recoil and improve expansion. Dr. Riley highlights the growing interest in IVL followed by drug-coated balloon (DCB) angioplasty as a safe and effective “stent-less” strategy for heavily calcified coronary artery disease. He reflects on the management of non flow limiting dissections after DCB, which often does not require further intervention. #CV25 Watch the full episode here: youtu.be/3Ou0HCS87bU?si… This podcast is supported by Shockwave. #CalciumModification #WireBias #Stent #InterventionalCardiology #CV25

TAPAS… A great way to start a Spanish meal and a great way to start the conversation about thrombectomy! In this episode of BackTable Cardiology, Dr. Sameh Sayfo and Dr. Andrew Goldsweig discuss manual as well as mechanical thrombectomy, practical adoption considerations, and step-by-step STEMI workflows. They break down how the data from the TOTAL, TASTE and TAPAS clinical trials reshaped guidelines, why routine aspiration fell to a Class III recommendation, and where thrombectomy still fits in modern PCI. If you treat STEMI, this episode delivers practical workflow insights, real world decision making, and the evidence you need to navigate thrombus management today. Listen here: na2.hubs.ly/H04bYGP0 This podcast is supported by Chiesi. #CoronaryThrombectomy #InterventionalCardiology #Cardiovascular #CV28

Reverse, reverse! Dr. Hady Lichaa asks Dr. Hayder Hashim about the opposite situation - switching from an oral P2Y12 inhibitor to IV Cangrelor often in the perioperative stage. While many surgeons wait about five days for Ticagrelor washout, Dr. Hashim’s approach of waiting roughly two half-lives before starting cangrelor reflects a practical bridging strategy. With Prasugrel or Clopidogrel, Dr. Hashim discusses waiting until day three due to their longer-lasting platelet effects. After stopping Cangrelor, platelet function typically returns to baseline within about 60 minutes, allowing rapid reversibility. Dr. Hashim also touches on Activated Clotting Time (ACT) considerations in the setting of Heparin and P2Y12 inhibition, emphasizing that goal ranges may vary based on individual clinical scenarios. Watch the full episode here: youtu.be/KhK2SI9vZN8?si… This campaign is supported by an educational grant from Chiesi. #CV19 #AcuteCoronarySyndrome #ACS #AntiplateletTherapy #DAPT #MyocardialInfarction #STEMI #InterventionalCardiology

Let’s take a closer look at the imaging used for evaluating calcified lesions. Drs. Yousif Ahmad and Robert Riley explain that while many calcium algorithms exist, imaging remains central to decision-making. Angiography provides valuable insight, and when an imaging catheter is used first, it helps determine whether intravascular lithotripsy (IVL) or another calcium modification strategy is appropriate, particularly in complex lesions where multiple imaging runs may be needed. Severely occluded or uncrossable lesions are often treated with atherectomy rather than balloon angioplasty alone. A near 360-degree arc of calcium typically warrants dedicated calcium modification, while focal calcium may respond well to balloon angioplasty. The presence of nodular calcium further pushes consideration toward plaque modification strategies. Watch the full episode here: youtu.be/3Ou0HCS87bU?si… This podcast is supported by Shockwave. #CalciumModification #Atherectomy #Imaging #InterventionalCardiology #CV25

Let’s start the conversation about radiation and orthopedic risks for interventional surgeons - it’s time to rethink how we protect the next generation! ⚠️🩻 In this episode of BackTable Cardiology, Dr. Hady Lichaa and Dr. Bob Foster of @RAMPARTic unpack the long-term orthopedic and radiation hazards facing interventional cardiology teams as well as the data from recent randomized clinical trials and the Society for Cardiovascular Angiography and Interventions (SCAI). Tune in to learn why radiation and orthopedic safety is not just a cardiology issue, but a conversation every interventional specialty needs to have. Listen here: na2.hubs.ly/H041JK50 #RadiationProtection #InterventionalCardiology #Cardiovascular #CV27

Dr. Hady Lichaa asks Dr. Hayder Hashim to discuss how to transition from IV Cangrelor to oral anti-platelet drugs like Ticagrelor. Cangrelor provides immediate platelet inhibition when given as an IV bolus (30 mcg/kg) followed by an infusion (4 mcg/kg/min). Prasugrel is taken once a day, and is highly potent but has three contraindications: age over 75, weight under 60 kg, and history of cerebrovascular accident (CVA) or transient ischemic attack (TIA). In an emergent STEMI setting, a patient's complete medical history may not be attainable so Dr. Hashim discusses his preference for ticagrelor in his own practice, which allows for smooth transition without a gap in platelet inhibition. If transitioning to Prasugrel or Clopidogrel, the oral loading dose must be given only after the Cangrelor infusion is stopped. Watch the full episode here: youtu.be/KhK2SI9vZN8?si… This campaign is supported by an educational grant from Chiesi. #CV19 #AcuteCoronarySyndrome #ACS #AntiplateletTherapy #DAPT #MyocardialInfarction #STEMI #InterventionalCardiology

On this week’s episode of BackTable Cardiology, Dr. Sameh Sayfo speaks with Dr. Eric Secemsky about the evolving role of renal denervation in resistant hypertension. They cover catheter-based devices like Medtronic’s Symplicity Spyral, emerging combined hepatic and renal denervation data, and potential metabolic benefits for diabetic patients. The future of renal denervation is growing, from developing advanced hypertension centers to specialized fellowships! Listen here: na2.hubs.ly/H03VK4S0 #RenalDenervation #Hypertension #InterventionalCardiology #Cardiovascular #CV26

Picture this clinical scenario: an intubated patient presents with acute coronary syndrome (ACS) and needs urgent Percutaneous Coronary Intervention (PCI). However, oral P2Y12 inhibitors may have unreliable absorption, even if administered via orogastric tube. In this context, Dr. Hayder Hashim explains the benefits of Cangrelor. Cangrelor, due to its intravenous administration, provides immediate, predictable platelet inhibition and is unaffected by opioids that can reduce the bioavailability of oral P2Y12 inhibitors. Its rapid onset makes it especially valuable in critically ill patients, where consistent antiplatelet effect is essential. Dr. Hashim also points out how Cangrelor may contribute to fewer readmissions, which indicates its cost-effectiveness. Watch the full episode here: youtu.be/KhK2SI9vZN8?si… This campaign is supported by an educational grant from Chiesi. #CV19 #AcuteCoronarySyndrome #ACS #AntiplateletTherapy #DAPT #MyocardialInfarction #STEMI #InterventionalCardiology

How do imaging, intravascular lithotripsy, and equipment selection come together to effectively target coronary calcium? 🎯Join interventional cardiologists Dr. Robert Riley (@perc_surgeon) and Dr. Yousif Ahmad on this week's BackTable episode as they overview ideal lesions for intravascular lithotripsy, trade techniques for modifying calcium, and review key clinical data including findings from Short-CUT and VICTORY trials. This podcast is sponsored by Shockwave Medical. Link: na2.hubs.ly/H03Mhmn0 #PCI #IVL #stent #atherectomy #stickthestent #cardiology #CV25

What can’t Cangrelor do? Drs. Hady Lichaa and Hayder Hashim discuss its role across the Acute Coronary Syndrome (ACS) spectrum. In patients with STEMI, Cangrelor is used during percutaneous coronary intervention (PCI) for rapid platelet inhibition. In NSTEMI patients awaiting catheterization, aspirin and heparin are initiated, with Cangrelor added if proceeding with PCI. Cangrelor’s lower bleeding risk makes it a useful option, but it can cause transient dyspnea that may resemble chronic Ticagrelor use. As Dr. Hashim notes, sometimes the best “lytic” is the patient’s own blood, optimized with heparin and cangrelor for improved local results. Watch the full episode here: youtu.be/KhK2SI9vZN8?si… This campaign is supported by an educational grant from Chiesi. #CV19 #AcuteCoronarySyndrome #ACS #AntiplateletTherapy #DAPT #MyocardialInfarction #STEMI #InterventionalCardiology

According to recent surveys, about 60-70% of physicians who wear lead have orthopedic injuries…Ouch, that hurts! 🦴🩻 In this episode of BackTable Cardiology, Dr. Sameh Sayfo hosts Dr. Sahil Parikh to unpack the hidden occupational hazards of interventional cardiology, from radiation exposure to the orthopedic risks of wearing lead day after day. Tune in to learn more about making meaningful changes for physician safety: na2.hubs.ly/H03BkdH0 #OccupationalHazard #OrthopedicInjuries #InterventionalCardiology #Cardiovascular #CV24

The use of antiplatelet therapies often requires a delicate balance between bleeding and clotting. Drs. Hady Lichaa and Hayder Hashim discuss how the pharmacokinetics of some of the most commonly used antiplatelet drugs, such as Clopidogrel, Prasugrel and Ticagrelor play into their use. Dr. Hashim explains how cases of Acute Coronary Syndrome (ACS), unstable angina and myocardial infarction tend to involve simpler lesions and thus procedures are completed quicker than cases which involve calcium modification. When Dr. Lichaa inquires about GP2b3a (Glycoprotein IIb/IIIa) inhibitors, Dr. Hashim highlights their use when there are large thrombus burdens or if there is no re-flow or slower flow during procedures. GP2b3a (Glycoprotein IIb/IIIa) inhibitors are used with caution due to their bleeding risks and prolonged effect, but P2Y12 inhibitors such as IV Cangrelor, have a faster wash-out period. Watch the full episode here: youtu.be/KhK2SI9vZN8?si… This campaign is supported by an educational grant from Chiesi. #CV19 #AcuteCoronarySyndrome #ACS #AntiplateletTherapy #DAPT #MyocardialInfarction #STEMI #InterventionalCardiology

In this episode, Dr. Sameh Sayfo hosts UK experts Drs. Mohammad Alkhalil and Abhishek Kumar to discuss coronary DEBs. Tune in to learn about lesion preparation, imaging and drug-coated balloons: na2.hubs.ly/H03rWVT0 #DrugElutingBalloon #DEB #InterventionalCardiology #CV23

IV #cangrelor offers rapid on, rapid off P2Y12 #platelet inhibition that sidesteps oral absorption delays. Join interventional cardiologist @Drroxmehran for a deep dive of cangrelor in the modern interventional cardiology arena: 💉 na2.hubs.ly/H03jn3j0 #cathlab #PCI #CV22

New Year, new insights on Heart Failure with Preserved Ejection Fraction (HFpEF) in the latest episode of BackTable Cardiology! Dr. Jessica Huston provides a plethora of guidance on navigating management of HFpEF. Regardless of your level of training, this episode highlights the most current information you need to stay up to date on HFpEF. #HeartFailureWithPreservedEjectionFraction #HFpEF #CV21 Listen here: na2.hubs.ly/H0388JL0

In the latest episode of BackTable Cardiology, Dr. Sameh Sayfo hosts Dr. Mohamad Alkhouli to discuss how an MBA, systems thinking, and global collaboration can drive healthcare innovation. 🔗Listen here: na2.hubs.ly/H0313GV0 #Innovation #MBA #InterventionalCardiology #CV20

Your primary #PCI case is done …but your oral P2Y12 inhibitor hasn’t reached maximum platelet inhibition 🤔 Dr. Hayder Hashim shares antiplatelet use in #ACS: This podcast is supported by a Chiesi educational grant. na2.hubs.ly/H02X8qY0 #ticagrelor #cathlab #cangrelor #CV19

From sternotomy to software, robotic cardiac surgery brings minimally invasive treatment to well-traveled cardiology conditions. Join Dr. Amber Edwards and host @HadyLichaaMD for all things robotic cards: na2.hubs.ly/H02RsHD0 #Afib #TECAB #MIDCAB #DAPT #roboticsurgery #CV18