John Rundback's guest appearances

John Rundback

BackTable Vascular & Interventional

OwlTail

In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback about analysis of arterial calcifications using microCT.---CHECK OUT OUR SPONSORAngioDynamics Auryon Systemhttps://www.auryon-system.com/---SHOW NOTESDr. Rundback starts by describing the basic differences between microCT and current imaging techniques. MicroCT is a non-destructive imaging method where the x-ray source is stationary but the subject is on a rotating stage. This method can create 3D imaging with a 3 to 5 micron resolution. On the other hand, in traditional CT imaging, the subject is stationary and the x-ray source rotates, which gives a 3 to 5 millimeter resolution.Then, the episode shifts to a discussion on Dr. Rundback’s recent study, in which he used microCT to evaluate the treatment effect of medial arterial calcification in below knee interventions after Auryon laser atherectomy. For this study, arteries were dissected out of cadavers with cardiac risk factors. These artery segments were then subject to different energies from the Auryon laser. MicroCT was performed before and after the procedure to analyze the degree of calcification. These trials have shown that atherectomy using the Auryon laser could increase compliance of the treated arteries. MicroCT has also helped expand knowledge about different types of calcification and how atherectomy differentially impacts them.---RESOURCESTreatment effect of medial arterial calcification in below-knee after Auryon laser atherectomy using micro-CT and histologic evaluation:https://pubmed.ncbi.nlm.nih.gov/37400346/Auryon Atherectomy Device:https://www.angiodynamics.com/product/auryon/

In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback about analysis of arterial calcifications using microCT. --- CHECK OUT OUR SPONSOR AngioDynamics Auryon System<a href="https://www.auryon-system.com/" rel="nofollow" target="_blank">https://www.auryon-system.com/</a> --- SHOW NOTES Dr. Rundback starts by describing the basic differences between microCT and current imaging techniques. MicroCT is a non-destructive imaging method where the x-ray source is stationary but the subject is on a rotating stage. This method can create 3D imaging with a 3 to 5 micron resolution. On the other hand, in traditional CT imaging, the subject is stationary and the x-ray source rotates, which gives a 3 to 5 millimeter resolution. Then, the episode shifts to a discussion on Dr. Rundback’s recent study, in which he used microCT to evaluate the treatment effect of medial arterial calcification in below knee interventions after Auryon laser atherectomy. For this study, arteries were dissected out of cadavers with cardiac risk factors. These artery segments were then subject to different energies from the Auryon laser. MicroCT was performed before and after the procedure to analyze the degree of calcification. These trials have shown that atherectomy using the Auryon laser could increase compliance of the treated arteries. MicroCT has also helped expand knowledge about different types of calcification and how atherectomy differentially impacts them. --- RESOURCES Treatment effect of medial arterial calcification in below-knee after Auryon laser atherectomy using micro-CT and histologic evaluation:<a href="https://pubmed.ncbi.nlm.nih.gov/37400346/" rel="nofollow" target="_blank">https://pubmed.ncbi.nlm.nih.gov/37400346/</a> Auryon Atherectomy Device:<a href="https://www.angiodynamics.com/product/auryon/" rel="nofollow" target="_blank">https://www.angiodynamics.com/product/auryon/</a>

Ep. 353 MicroCT for PAD: What You Need to Know with Dr. John Rundback

In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators.---CHECK OUT OUR SPONSORVeryan BioMimics 3D® Vascular Stent Systemhttps://www.veryanmed.com/usa/products/biomimics-3d-vascular-stent-system/---SHOW NOTESIn this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators.We begin by discussing peripheral arterial disease (PAD) pathophysiology, specifically in the challenging areas around the adductor canal (Hunter’s canal). Dr. Rundback describes how the femoral artery has twists and turns around this area and that it can experience compressive forces up to 15-20% during motions such as flexion of the knee. Due to this being the most dynamic location of the femoral artery, this is often where plaque rupture will happen, resulting in critical limb ischemia (CLI) and requiring urgent intervention.The two discuss how traditional rigid stents do not work well in this area due to the dynamic nature of the region and the fact that the artery is tortuous and can cause rigid stents to fracture or cause intimal hyperplasia due to turbulent flow. Drug coated balloon (DCB) angioplasty generally does not work for this region due to poor durability. They discuss the utility of the Tack device, a scaffold with minimal metal which is better suited for focal dissections. Dr. Rundback emphasizes the importance of intravascular ultrasound (IVUS) during all distal femoropopliteal cases due to the complexity of the region and patient-to-patient variation. He uses IVUS to choose which device and what size to use because measuring on angiography is not accurate in these cases.Finally, they discuss the Supera and BioMimics stents, including the indications, benefits, and ease of deployment of each. Dr. Rundback says that Supera, a woven nitinol stent, gives it the benefit of thermal memory. The difficulty with this stent is the need for aggressive vessel preparation and plaque modification, generally requiring lengthy angioplasty and possibly atherectomy. The BioMimics stent can rotate, curve, and shorten, which is optimal for this region to maintain swirling or helical blood flow rather than causing turbulent flow. The BioMimics stent is also very easy to deploy, and Dr. Rundback generally chooses this stent in locations where he can’t adequately prep the vessel.---RESOURCESBioMimics 3D stent:https://www.veryanmed.com/international/products/biomimics-3d-vascular-stent-system/Supera™ Stent:https://www.cardiovascular.abbott/int/en/hcp/products/peripheral-intervention/supera-stent-system/overview.htmlTack device:https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device

In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators. --- CHECK OUT OUR SPONSOR Veryan BioMimics 3D® Vascular Stent System<a href="https://www.veryanmed.com/usa/products/biomimics-3d-vascular-stent-system/" rel="nofollow" target="_blank">https://www.veryanmed.com/usa/products/biomimics-3d-vascular-stent-system/</a> --- SHOW NOTES In this episode, host Dr. Sabeen Dhand interviews Dr. John Rundback, interventional radiologist, about distal femoropopliteal disease, including the unique pathophysiology of this area, which stents work best at the adductor canal and the trifurcation, and tips for early operators. We begin by discussing peripheral arterial disease (PAD) pathophysiology, specifically in the challenging areas around the adductor canal (Hunter’s canal). Dr. Rundback describes how the femoral artery has twists and turns around this area and that it can experience compressive forces up to 15-20% during motions such as flexion of the knee. Due to this being the most dynamic location of the femoral artery, this is often where plaque rupture will happen, resulting in critical limb ischemia (CLI) and requiring urgent intervention. The two discuss how traditional rigid stents do not work well in this area due to the dynamic nature of the region and the fact that the artery is tortuous and can cause rigid stents to fracture or cause intimal hyperplasia due to turbulent flow. Drug coated balloon (DCB) angioplasty generally does not work for this region due to poor durability. They discuss the utility of the Tack device, a scaffold with minimal metal which is better suited for focal dissections. Dr. Rundback emphasizes the importance of intravascular ultrasound (IVUS) during all distal femoropopliteal cases due to the complexity of the region and patient-to-patient variation. He uses IVUS to choose which device and what size to use because measuring on angiography is not accurate in these cases. Finally, they discuss the Supera and BioMimics stents, including the indications, benefits, and ease of deployment of each. Dr. Rundback says that Supera, a woven nitinol stent, gives it the benefit of thermal memory. The difficulty with this stent is the need for aggressive vessel preparation and plaque modification, generally requiring lengthy angioplasty and possibly atherectomy. The BioMimics stent can rotate, curve, and shorten, which is optimal for this region to maintain swirling or helical blood flow rather than causing turbulent flow. The BioMimics stent is also very easy to deploy, and Dr. Rundback generally chooses this stent in locations where he can’t adequately prep the vessel. --- RESOURCES BioMimics 3D stent:<a href="https://www.veryanmed.com/international/products/biomimics-3d-vascular-stent-system/" rel="nofollow" target="_blank">https://www.veryanmed.com/international/products/biomimics-3d-vascular-stent-system/</a> Supera™ Stent:https://www.cardiovascular.abbott/int/en/hcp/products/peripheral-intervention/supera-stent-system/overview.html Tack device:<a href="https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device" rel="nofollow" target="_blank">https://www.usa.philips.com/healthcare/product/HCIGTDTCKESYSTM/tack-endovascular-system-dissection-repair-device</a>