Ep. 682 Liquid Embolization Techniques for Treating Hypervascular Tumors with Dr. Resmi Charalel and Dr. Milan Patel

How do you devascularize a hypervascular tumor when the vessels feeding it are too small to catheterize? On this episode of BackTable Podcast, Dr. Kavi Krishnasamy is joined by Dr. Resmi Charalel and Dr. Milan Patel to walk through seven real-world cases where non-adhesive hydrogel liquid embolics made the difference. They break down patient selection, case planning, and how to deploy these agents for safe, efficient devascularization when traditional approaches fall short.

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This podcast is supported by

Instyllahttps://instylla.com/embrace/

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Timestamps

00:00 - Introduction02:23 - Liquid Embolic Use in Practice04:46 - Case 1: Renal Mass07:51 - Delivery Technique and Target Vessel Size13:08 - Device Setup and Catheter Compatibility21:57 - Case 2: Multifocal HCC27:44 - Case 3: Large Renal Tumor40:21 - Randomized Trial Outcomes43:28 - Case 4: HCC Near the Gallbladder49:39 - Case 5: Pelvic Tumor and Femoral Metastases55:30 - Lessons from Early Use and Case Selection1:01:37 - Case 6: Breast Cancer Liver Metastasis1:05:23 - Closing Remarks

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More about this episode

The discussion reviews seven real-world cases, from renal and liver tumors to pelvic, bone, and breast metastases, sharing practical pearls on microcatheter selection, plug formation, controlled reflux, and navigating high-flow environments and multiple vessels. They dive into troubleshooting pitfalls like loose connections and procedural waste, the real learning curve for adopting liquid embolics, and the outcomes data that support broader adoption of these techniques. The episode closes with advice for early-career operators and a look at future directions for patients who are not candidates for other embolic therapies.