Yale Cancer Center: Liver Cancer Program
- Schneider AM, Thomas E, Ayyagari R, Grossman M, Kakoyannis A:Memory Modulation and the Stria Terminalis.Soc. Neurosci. Abstr. 22:442.15, 1996.
- Wheeler M, Ayyagari R, Wheeler G, Weiss R:Regulation of Cyclic Nucleotides in theUrinary Tract.J. Smooth Muscle Res. 41:1-21, 2005.
- Gaur S, Friese J, Sadow C, Ayyagari R, Binkert C, Schenker M, Kulke M, Baum R: Hepatic Arterial Chemoembolization Using Drug-Eluting Beads in Gastrointestinal Neuroendocrine Tumor Metastatic to the Liver.Cardiovasc. Intervent. Radiol. 34:566-572, 2011.
Chapters, Books, and Reviews:
- Ayyagari R, Pollak J, White R. Varicocele Embolization.Book chapter in Embolization: Principles and Clinical Applications, eds. Guimaraes M, Lencioni R, and Siskin G, Lippincott Williams & Wilkins, Philadelphia, PA, 2015.
Case Reports, Technical Notes, Letters:
- Courtney M and Ayyagari R: Idiopathic Chylopericardium Treated by Percutaneous Thoracic Duct Embolization After Failed Surgical Thoracic Duct Ligation. Pediatr. Radiol. 45:927-930, 2015.
- Ayyagari R, Yeh C, Arici M, Mojibian H, Reiner E, Pollak S: Image-Guided Transvesicular Drainage of Pelvic Fluid Collections: A Safe and Effective Alternative Approach. J. Vasc. Interv. Radiol. 27:689-693, 2016.
Extensive Research Description
Much of my training as an interventional radiologist, and my subspecialized work during my first few years in practice, was in the field of interventional oncology. The field’s dominant focus worldwide for the past few decades has been primarily on liver oncology. A massive body of investigation and innovation has led to the development of the “loco-regional” paradigm of liver cancer therapy, a cadre of diagnostic and therapeutic procedures that broadly encompasses transarterial chemo- and radioembolization, percutaneous ablation, and several related procedures and therapies. This treatment paradigm has led to truly revolutionary advances in the management of primary and metastatic liver tumors. The first publication I was involved with demonstrated safety and efficacy of drug-eluting bead chemoembolization for the treatment of metastatic neuroendocrine liver lesions.
But my original training was in Urology, and as my career continues to unfold, I find myself gravitating progressively towards the practice of, and more importantly the advancement of, cutting-edge urologic interventions. After taking over Dr. Robert White’s active varicocele embolization practice when he retired, I was invited to run a workshop on varicocele embolization with Dr. Jeff Pollak at the international Society of Interventional Radiology meeting two years in a row. My work spawned an invitation to write a chapter on varicocele embolization in a prominent IR textbook. I then first-authored a study describing a novel technique of placing drainage catheters through the bladder to treat pelvic fluid collections. I was honored with an invitation to speak about such advances in urologic interventions at the National Medical Association annual meeting.
However my career really began to take shape after the advent of prostatic arterial embolization for the treatment of benign prostatic hyperplasia. An idea derided by many at first, I determined to become a leader in the development of this procedure and began performing it three years ago. My first case was a resounding success, and within a couple of years I was able to nurture that single referral into perhaps one of the largest prostate embolization practices in the country. As I collected my outcomes data, seeing first-hand how well the body tolerates prostate gland embolization and the success we can have with transarterial prostatic treatments prompted me to re-examine the loco-regional treatment paradigm for liver cancer. I realized that we are on the verge of another revolution in medicine: the development of the loco-regional treatment paradigm for prostate cancer.
Moving forward, I plan to shape my career as an academic interventional radiologist around the development of minimally invasive treatments for benign and malignant prostatic disease. I teamed with others in our department to develop MRI-guided prostate biopsy and tumor ablation, and I hope to begin investigating arterial embolization as a treatment for prostate cancer. I joined forces with a multidisciplinary group organized by Yale urologists Dr. Preston Sprenkle and Dr. Peter Schulam, Director of the Yale Cancer Center and Smilow Cancer Hospital, to help lead the effort to transform Yale into a world-class center for comprehensive and revolutionary prostate disease treatment.