Ep. 549 Liquid Embolics: Practical Applications and Techniques with Dr. Gary Siskin

BackTable Vascular & Interventional

Liquid embolics are a relatively new addition to the interventional radiology toolkit—how well do you understand the technical considerations that come with using these agents? Get up to speed in this episode of the BackTable Podcast where Dr. Gary Siskin, Chair of Radiology at Albany Medical Center, shares his expertise.

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This podcast is supported by:

Sirtex
https://www.sirtex.com/us/

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SYNPOSIS

Dr. Siskin provides expert insights into the use of liquid embolic agents, including Onyx and LAVA, with a focus on their practical applications, techniques for safe and effective deployment, and the critical role they play in treating complex cases which range from peripheral and traumatic hemorrhage to portal vein embolization. He highlights the importance of understanding the viscosity and flow characteristics of various liquid embolic agents, providing expert guidance on ensuring optimal catheter positioning, case selection, and avoidance of common pitfalls. Additionally, he shares strategies for tailoring injection speed based on vessel caliber to mitigate reflux. The episode ends with final thoughts on best practices and future directions for the technology.

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TIMESTAMPS

00:00 - Introduction
02:09 - Historical Perspective on Liquid Embolics
06:37 - Practical Applications and Techniques
16:14 - Handling Catheters and Reflux Concerns
22:38 - Trauma Embolization
26:53 - Visibility and Injection Techniques
29:06 - Catheter Compatibility and Vessel Size
32:53 - Best Practices and Common Mistakes
45:55 - Final Thoughts and Advice

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RESOURCES

Arslan B, Razavi MK, Siskin G, et al. The LAVA Study: A Prospective, Multicenter, Single-Arm Study of a Liquid Embolic System for Treatment of Peripheral Arterial Hemorrhage. J Vasc Interv Radiol. 2025;36(3):436-445.e2. doi:10.1016/j.jvir.2024.11.005

Onyx Liquid Embolic System:
https://europe.medtronic.com/xd-en/healthcare-professionals/products/cardiovascular/peripheral-embolization/onyx-liquid-embolic-system.html

LAVA Liquid Embolic System:
https://www.sirtex.com/us/products/lava-liquid-embolic-system/product-information/