Brooke Spencer's guest appearances

Brooke Spencer

BackTable Vascular & Interventional

David Sacks

John Martin

David Wood

David Kim

Karen Brown

Justin Lee

David Liu

Eric Keller

Preston Smith

David Ball

Mike Watts

Chris Thomson

Susan Jackson

John Lipman

Aaron Shiloh

OwlTail

In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Brooke Spencer about management of pelvic venous disease, endovascular therapies for pelvic varices, and important considerations for treating patients with complex and chronic pain.---CHECK OUT OUR SPONSORBoston Scientific Drug Elutionhttps://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&amp;utm_medium=native&amp;utm_campaign=pi-at-us-de_portfolio-hci&amp;utm_content=n-backtable-n-backtable_site_portfolio_1_2023&amp;cid=n10012334---SHOW NOTESDr. Spencer serves as the CEO and medical director of Minimally Invasive Procedure Specialists in Denver, CO. Her patients commonly get referred from OB/GYNs for chronic pelvic pain that is refractory to laparoscopic surgery and undiagnosed. She notes that collaborative relationships with women's health specialists and pelvic pain physical therapists are necessary for adequate patient outreach. Classifying cases by the location and nature of the vessel abnormality (i.e. compressive, obstructive, varicose, reflux, congenital) allows her to think about the best treatment for each patient. Targeting proximal veins can improve back and groin pain, dyspareunia, and heavy periods. Iliac vein stenting can improve compressive symptoms 50% of the time. On the other hand, isolated labial pain is best treated by directly targeting labial varices. Perineal ultrasound is a helpful way to locate some varicosities, but Dr. Spencer prefers MRI and digital subtraction venography to get a comprehensive venous picture and correlate symptoms with imaging.Next, the doctors discuss embolization and foam sclerotherapy. Through her experience, Dr. Spencer has seen sclerotherapy work better in varices with slower outflow and coil embolization work better for varices with more rapid flow. She prefers oversized floppy coils to minimize the risk of migration. With both treatments, there can be significant insurance barriers. It is important to utilize preauthorization specialists and be aware of what the patient’s insurance will cover, in order to better frame a conversation about treatment options.After the procedure, maximal pain relief can be achieved anywhere between 3 to 6 months. During this period, it is important to counsel patients over adjunct therapies such as pelvic floor therapy, steroids, and puncture aspiration to remove trapped blood. Overall, Dr. Spencer wants IRs to keep in mind that the chronic pain population has faced many misdiagnoses and insurance barriers, so they might harbor mistrust of the healthcare system. It is crucial to acknowledge their feelings and understand their anatomy in order to manage their expectations.---RESOURCESPelvic Guru:https://pelvicguru.com/Efficacy of Endovascular Treatment for Pelvic Congestion Syndrome:https://pubmed.ncbi.nlm.nih.gov/27318059/International Pelvic Pain Society:https://www.pelvicpain.org/“The Way Out” book:https://www.amazon.com/Way-Out-Revolutionary-Scientifically-Approach/dp/059308683X

In this episode, host Dr. Ally Baheti interviews interventional radiologist Dr. Brooke Spencer about management of pelvic venous disease, endovascular therapies for pelvic varices, and important considerations for treating patients with complex and chronic pain. --- CHECK OUT OUR SPONSOR Boston Scientific Drug Elution<a href="https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&amp;utm_medium=native&amp;utm_campaign=pi-at-us-de_portfolio-hci&amp;utm_content=n-backtable-n-backtable_site_portfolio_1_2023&amp;cid=n10012334" rel="nofollow" target="_blank">https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies.html?utm_source=oth_site&amp;utm_medium=native&amp;utm_campaign=pi-at-us-de_portfolio-hci&amp;utm_content=n-backtable-n-backtable_site_portfolio_1_2023&amp;cid=n10012334</a> --- SHOW NOTES Dr. Spencer serves as the CEO and medical director of Minimally Invasive Procedure Specialists in Denver, CO. Her patients commonly get referred from OB/GYNs for chronic pelvic pain that is refractory to laparoscopic surgery and undiagnosed. She notes that collaborative relationships with women's health specialists and pelvic pain physical therapists are necessary for adequate patient outreach. Classifying cases by the location and nature of the vessel abnormality (i.e. compressive, obstructive, varicose, reflux, congenital) allows her to think about the best treatment for each patient. Targeting proximal veins can improve back and groin pain, dyspareunia, and heavy periods. Iliac vein stenting can improve compressive symptoms 50% of the time. On the other hand, isolated labial pain is best treated by directly targeting labial varices. Perineal ultrasound is a helpful way to locate some varicosities, but Dr. Spencer prefers MRI and digital subtraction venography to get a comprehensive venous picture and correlate symptoms with imaging. Next, the doctors discuss embolization and foam sclerotherapy. Through her experience, Dr. Spencer has seen sclerotherapy work better in varices with slower outflow and coil embolization work better for varices with more rapid flow. She prefers oversized floppy coils to minimize the risk of migration. With both treatments, there can be significant insurance barriers. It is important to utilize preauthorization specialists and be aware of what the patient’s insurance will cover, in order to better frame a conversation about treatment options. After the procedure, maximal pain relief can be achieved anywhere between 3 to 6 months. During this period, it is important to counsel patients over adjunct therapies such as pelvic floor therapy, steroids, and puncture aspiration to remove trapped blood. Overall, Dr. Spencer wants IRs to keep in mind that the chronic pain population has faced many misdiagnoses and insurance barriers, so they might harbor mistrust of the healthcare system. It is crucial to acknowledge their feelings and understand their anatomy in order to manage their expectations. --- RESOURCES Pelvic Guru:<a href="https://pelvicguru.com/" rel="nofollow" target="_blank">https://pelvicguru.com/</a> Efficacy of Endovascular Treatment for Pelvic Congestion Syndrome:<a href="https://pubmed.ncbi.nlm.nih.gov/27318059/" rel="nofollow" target="_blank">https://pubmed.ncbi.nlm.nih.gov/27318059/</a> International Pelvic Pain Society:<a href="https://www.pelvicpain.org/" rel="nofollow" target="_blank">https://www.pelvicpain.org/</a> “The Way Out” book:<a href="https://www.amazon.com/Way-Out-Revolutionary-Scientifically-Approach/dp/059308683X" rel="nofollow" target="_blank">https://www.amazon.com/Way-Out-Revolutionary-Scientifically-Approach/dp/059308683X</a>

Ep. 337 Management of Vulvar Varices with Dr. Brooke Spencer

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/tNgPeU﻿Dr. Brooke Spencer gets into the pearls and pitfalls of building a comprehensive vein practice, including a detailed discussion on the treatment of May-Thurner and Pelvic Congestion syndrome.

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: <a href="https://earnc.me/tNgPeU" rel="nofollow" target="_blank">https://earnc.me/tNgPeU</a> ﻿Dr. Brooke Spencer gets into the pearls and pitfalls of building a comprehensive vein practice, including a detailed discussion on the treatment of May-Thurner and Pelvic Congestion syndrome.

Ep. 33 Building a Comprehensive Vein Practice with Dr. Brooke Spencer