Lessons

    1. What are the indications for just a routine BRTO?

    2. In general, which patients are good candidates for TIPS and BRTO?

    3. How do you use the MELD score and preprocedure imaging for BRTO compared to TIPS?

    4. For a BRTO do you use moderate sedation or general anesthesia and what are your go-to access tools?

    5. What do you look for in terms of collaterals and shunts and what is going to change your treatment plan?

    6. What's your recipe for making your sclerosant and do you leave coils?

    7. What do you do for follow up for BRTO patients?

    8. Any pearls or pitfalls from more challenging cases?

    9. CME/CE Reflection: Module I

    1. Can you walk through how you do a routine BRTO?

    2. Can you walk through how you do a routine PARTO?

    3. How far into the shunt do you want your embolic catheter to be?

    4. How do you mix your STS plus gel foam concoction, and what is a reproducible fluoroscopic endpoint?

    5. Do you do this single session and leave coils behind?

    6. In what patient presentation would you start with BRTO with TIPS?

    7. Do you do the TIPS first in all of your combined cases?

    8. Is there ever a situation where you put a TIPS in and have them come back for the BRTO?

    9. Can you walk me through a situation where you've had to get access through the spleen for embolization?

    10. What is your setup for trans-splenic access?

    11. Would you do a BRTO on someone who you know could not get TIPS?

    12. How did you raise awareness around this new procedure to your referring doctors before they were familiar?

    13. CME/CE Reflection: Module II

    1. Why do we need to care about portal vein recanalization?

    2. What does the workup look like for a patient needing portal vein recanalization?

    3. Once you have the patient on the table, where do you start?

    4. Can you describe your technique for accessing through the spleen?

    5. Talk us through challenging access

    6. How much time do you spend probing and trying to locate the portal vein?

    7. Are there any troubleshooting techniques for starting out and hitting that snare easier?

    8. Talk to us about things to be careful about with your wire, and any other pitfalls

    9. What advantage is there to embolizing varices and what will it do to the portal system flow?

    10. What do you do when it's time to close your access at the spleen?

    11. What is your portal vein recanalization post-care and follow up regimen for the patient?

    12. What are some helpful resources for someone who's looking to get into complex portal vein recanalization?

    13. CME/CE Reflection: Module III
  • 35 lessons
  • 1.5 hours of content
  • Earn up to 3 CME/CE credits