ABOUT THIS EPISODE
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
Instylla
https://instylla.com/embrace/
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Timestamps
00:00 - Introduction
02:23 - Liquid Embolic Use in Practice
04:46 - Case 1: Renal Mass
07:51 - Delivery Technique and Target Vessel Size
13:08 - Device Setup and Catheter Compatibility
21:57 - Case 2: Multifocal HCC
27:44 - Case 3: Large Renal Tumor
40:21 - Randomized Trial Outcomes
43:28 - Case 4: HCC Near the Gallbladder
49:39 - Case 5: Pelvic Tumor and Femoral Metastases
55:30 - Lessons from Early Use and Case Selection
1:01:37 - Case 6: Breast Cancer Liver Metastasis
1:05:23 - 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.
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Resources
Instylla HES Hypervascular Tumor Pivotal Study (NCT04523350)
https://clinicaltrials.gov/study/NCT04523350
Abi-Jaoudeh N, et al. Multicenter Randomized Trial Evaluating the Safety and Effectiveness of the Instylla Hydrogel Embolic System for Vascular Occlusion of Hypervascular Tumors. J Vasc Interv Radiol. 2026
https://doi.org/10.1016/j.jvir.2026.108946
Ganguli S, Lareau R, et al. A Water-Based Liquid Embolic: Evaluation of its Safety and Efficacy in a Rabbit Kidney Model. J Vasc Interv Radiol. 2021
https://doi.org/10.1016/j.jvir.2021.02.018
HALT: Embrace Hydrogel Embolic System Study of Embolization in Peripheral Arterial Bleeds (NCT05364502)
https://clinicaltrials.gov/study/NCT05364502
Kim GH, et al. Effectiveness and Safety of Transarterial Radioembolization Following Inferior Phrenic Artery Glue Embolization for Flow Redistribution in Hepatocellular Carcinoma. J Vasc Interv Radiol. 2026
https://doi.org/10.1016/j.jvir.2026.108784
Dr. Resmi Charalel, Montefiore Einstein
https://doctors.montefioreeinstein.org/providers/1558653980/resmi-charalel
Dr. Milan Patel, MD Anderson Cancer Center
https://faculty.mdanderson.org/profiles/milan_patel.html
Dr. Kavi Krishnasamy, BackTable contributor page
https://backtable.com/shows/vi/contributors/dr-venkatesh-krishnasamy
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BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists.
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