Episode 84: Adrenal vein sampling

On this episode of the Kinked Wire, Ian J. Wilson, MD and J. Dana Dunleavy, MD, discuss building practices and establishing relationships in rural communities.Highlights of the discussion:Rural IR is advanced IR. Dr. Wilson says a quiet day of bread-and-butter cases can turn into a complex GI bleed embolization at 4:30. In a rural hospital, "You're it."Collaboration drives care. Strong relationships with urologists, GI specialists, and primary care physicians let IRs offer PAE, nephrostomy tubes, stents, and cryoablation locally. This keeps patients from traveling to distant centers.An IR clinic builds referrals. Seeing patients before and after procedures earns trust. Educational events for the ED and hospitalists, such as one on vertebral compression fractures, open new referral pipelines.The need is growing. Teleradiology and AI-assisted imaging find more disease, but treatment resources in underserved areas haven't kept pace. The episode notes that other specialties may fill the gap if IR doesn't."Live where you want, work where you're needed." Long-term contract models, such as one week a month, let IRs serve rural hospitals without relocating. This suits new graduates and experienced physicians easing toward semi-retirement.Independent IR is a real path. Wilson describes working as an independent contractor and covers the business, contracting, and tax skills it takes.Keep learning after fellowship. PAE didn't exist during his training. His advice is to build microcatheter skills and spend time with high-volume operators.Support the show

Articles"Drug-Eluting Stents versus Drug-Coated Balloons Plus Bare-Metal Stents for the Treatment of Femoropopliteal Artery Lesions: 2-Year Outcomes from the TALENT Study" (Full article)"Transarterial Embolization for Pediatric Pelvic Fracture Hemorrhage: A National Trauma Data Bank Analysis (2013–2023)""Preserving the Injured Kidney: A Retrospective Comparative Cohort Study of Contemporary Management Strategies at a Level 1 Trauma Center""Therapy Outcomes and Healthcare Resource Utilization in Computer-Assisted Vacuum Thrombectomy versus Open Embolectomy: The THRIVE Study"HostMarie Hamel, the Warren Alpert Medical School of Brown UniversityAudio EditorAndrew Sasser, University of Miami Leonard M. Miller School of MedicineAbstract ReadersAprupa Alahari, Rowan-Virtua School of Osteopathic MedicineArna Choksi, Rutgers NJMSEmily Christner, Drexel University College of MedicineManasa Mula, Drexel University College of Medicine Support the show

What current legislative priorities will affect IR?In the first part of this episode, SIR and SIR Foundation Treasurer C. Matthew Hawkins, MD, MBA, FSIR, speaks with Roger Tomihama, MD, MBA, FSIR, chair of SIR’s Government Affairs Committee, and Chris Eastlee, SIR’s senior manager for government relations, about the value of coalition advocacy and why IR-specific education for lawmakers is so crucial.This week, learn more about the legislative and regulatory priorities affecting interventional radiology, particularly physician reimbursement, prior authorization, and the importance of sustained advocacy.Support the show

What's it like to be an IR advocate in Washington?In this two-parter, SIR Treasurer C. Matthew Hawkins, MD, MBA, FSIR, speaks with Roger T. Tomihama, MD, MBA, FSIR, chair of SIR’s Government Affairs Committee, and Chris Eastlee, SIR’s senior manager for government relations, about federal advocacy for interventional radiology. Learn about the Alliance for Specialty Medicine, SIR’s role in the alliance, and how a Capitol Hill visit works.Stay tuned for part two: what upcoming legislative priorities will affect IRs?Support the show

ArticlesMedical Therapies for Vascular Anomalies: What Interventional Radiologists Need to Know (Read)Short-Term and Long-Term Changes in Renal Function Following Percutaneous Cryoablation: A Comparison of Endophytic Versus Exophytic Renal Tumors (Read)Ablative Radioembolization Dosing Thresholds for Glass Microspheres Predictive of Complete Imaging Response and Survival in Patients with Hepatocellular Carcinomas Larger than 4 cm: A Multi-institution Retrospective Analysis (Read)Safety and Impact on Sustainability of Reduced Protective Equipment inUltrasound-Guided Paracentesis: A Retrospective Cohort Study (Read)Socioeconomic Factors Impacting Survival in Patients With Hepatocellular Carcinoma Treated With Locoregional Therapies: A Single-Center Study (Read)Trends in the Concentration of Interventional Radiology Work amongRadiologists in the United States: Analysis of Medicare Claims Data, 2008–2023 (Read)HostMarie Hamel, the Warren Alpert Medical School of Brown UniversityAudio EditorAndrew Sasser, University of Miami Leonard M. Miller School of MedicineAbstract ReadersBryant Nelson, Edward Via College of Osteopathic Medicine Carolinas CampusMushira Khan, Alfaisal UniversityEmily Eng, University at Buffalo Jacobs School of MedicineClaire Kung, Albany Medical CollegeSamuel Wang, Washington University School of Medicine in St LouisDaniel Shen, Case Western Reserve University School of MedicineSupport the show

In this episode of the Kinked Wire, Anh-Tho Nguyen interviews Alexa Levey, MD, about her advice for dealing with pain management as an IR, and what the future looks like in IR pain management.This episode was published during September 2026, in part to acknowledge Pain Management Month. To learn more about how IR can be used to treat pain, visit our patient center.Support the show

2026 Women in IR Champion Sue E. Hanks, MD, FSIR, reflects on her career in interventional radiology, sharing insights on leadership, trauma care, mentorship and the value of building collaborative, data-driven teams. Joined by colleagues M. Victoria Marx, MD, FSIR, Shellie C. Josephs, MD, FSIR, and Alda L. Tam, MD, MBA, FSIR, she discusses the importance of hands-on training, cross-specialty collaboration, networking and creating supportive spaces where physicians can learn from both successes and challenges.Support the show

ArticlesIN.PACT AV Access Post-Approval Study of a Paclitaxel Drug-Coated Balloon for the Treatment of Dysfunctional Arteriovenous Dialysis Circuits (Read)Cost-Effectiveness Analysis of Resection, Ablation and Radiation Segmentectomy for Solitary Hepatocellular Carcinoma ≤3 centimeters from a U.S. Payor’s Perspective (Read)Clinical Criteria for Improved Outcomes in Patients Who Undergo Percutaneous CT-Guided Pudendal Nerve Cryoablation: A Retrospective Analysis (Read)HostMarie Hamel, the Warren Alpert Medical School of Brown UniversityAudio EditorAndrew Sasser, University of Miami Leonard M. Miller School of MedicineAbstract ReadersRajit Agarwal, Drexel University College of MedicineAddison Liu, Icahn School of MedicineDaniel Shen, Case Western Reserve University School of MedicineSupport the show

In this episode, James B. Spies, MD, MPH, FSIR, speaks with Moaz Choudhary, MD, about the highlights of his career, and how to deal with the highs and lows of managing IR teams. Support the show

In this episode of the Kinked Wire podcast, Parveer Kaur and Lei Yu, MD, discuss how Dr. Yu has seen an increase in the number of adrenal vein sampling procedures she does in Omaha. She also dives into why her methodical approach works for her, and her patients. Support the show