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Coronary fat embolization for late coronary perforation. I did a routine DK-crush bifurcation PCI. 6 hours later, pt is hypotensive with a large effusion. Relook angio showed diagonal tip perforation that wasnt there at the end of PCI. Prolonged balloon tamponade failed. Coils unavailable. Treated with autologous fat embolization,...

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Anas T. Noman

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28,449 Aufrufe • vor 5 Monaten •via X (Twitter)

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18 Kommentare

Profilbild von Muhammet cihat çelik
Muhammet cihat çelikvor 5 Monaten

In a similar scenario I used a different technique: I kept the distal wire position, cut a small balloon, advanced the distal balloon segment over the wire beyond the perforation site, and used it as a mechanical plug. Final angiography showed complete seal.

Profilbild von sciqst
sciqstvor 5 Monaten

Interesting case, Anas. Hypotension with a large effusion post-PCI raises concerns. Could there have been vessel dissection or microvascular obstruction that wasn't evident initially? Was intravascular imaging utilized during the procedure to assess the stent placement? If yes, what findings did it reveal? #Medicine For a deeper dive into cases like this and to generate comprehensive biomedical reviews on similar topics, explore Sci-Quest, a one-stop platform for every biomedical question you might have:

Profilbild von Girish Viswanathan
Girish Viswanathanvor 5 Monaten

@Sh_Zaynobidinov Nice one..I did one for a RCA perforation. Really did the job. Thanks for sharing

Profilbild von Abhinav Aggarwal MD,DM
Abhinav Aggarwal MD,DMvor 5 Monaten

We did a recent case similarly. We also injected the distal end of coronary wire after cutting it

Profilbild von Anas T. Noman
Anas T. Nomanvor 5 Monaten

Yes, that works too.

Profilbild von Samar Arfeen MBBS FCPS
Samar Arfeen MBBS FCPSvor 5 Monaten

Daring rescue

Profilbild von Ziad Storyteller
Ziad Storytellervor 5 Monaten

Impressive bailout technique. Autologous fat embolization is an elegant solution when conventional methods fail. I look forward to TCT ME 2026.

Profilbild von Hazim Rahbi
Hazim Rahbivor 5 Monaten

@AlkashkariWail Great save Anas

Profilbild von Jay
Jayvor 5 Monaten

Great case. Do u recommend mixing fat with contrast?

Profilbild von Anas T. Noman
Anas T. Nomanvor 5 Monaten

I didnt do it in this case. I think its helpful to do though.

Profilbild von fbalex1907
fbalex1907vor 5 Monaten

What about the risk of infection?

Profilbild von Anas T. Noman
Anas T. Nomanvor 5 Monaten

Probably similar to coils. No head to head comparison. Although if you look up the data, you might conclude that infection risk is higher with coils than fat embolism.

Profilbild von muhammadwaqas
muhammadwaqasvor 5 Monaten

great save

Profilbild von Doç. Dr. Hüseyin Katlandur
Doç. Dr. Hüseyin Katlandurvor 5 Monaten

👏🏻👏🏻👏🏻

Profilbild von Vikram Sharma MD, FACC, FSCAI, MRCP(UK), MD(Res)
Vikram Sharma MD, FACC, FSCAI, MRCP(UK), MD(Res)vor 5 Monaten

What is the advantage over using a coil ?

Profilbild von Anas T. Noman
Anas T. Nomanvor 5 Monaten

Only when you don’t have coils

Profilbild von Vikram Sharma MD, FACC, FSCAI, MRCP(UK), MD(Res)
Vikram Sharma MD, FACC, FSCAI, MRCP(UK), MD(Res)vor 5 Monaten

Absolutely

Profilbild von joseph r motolenich
joseph r motolenichvor 4 Monaten

@Almanfi_Cardio Bravo! Great medicine and happy patient!

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Deep Dive Slides #ACC2024 on SMART Trial. William Suh, MD Philippe Pibarot Amr Abbas, MD, MSc thomas modine David J. Cohen, MD, MSc Mamas A. Mamas Dipti Itchhaporia, M.D., MACC , FAHA, FESC Athena Poppas, MD FACC NL valve w/ high gradient is NOT “dysfunction”-may be high EF! BEV EchoGradient > but CathGrad < SEV! MGrad and PPM not predictive!!
2:17

Deep Dive Slides #ACC2024 on SMART Trial. William Suh, MD Philippe Pibarot Amr Abbas, MD, MSc thomas modine David J. Cohen, MD, MSc Mamas A. Mamas Dipti Itchhaporia, M.D., MACC , FAHA, FESC Athena Poppas, MD FACC NL valve w/ high gradient is NOT “dysfunction”-may be high EF! BEV EchoGradient > but CathGrad < SEV! MGrad and PPM not predictive!!

RTHahnMD

18,591 Aufrufe • vor 2 Jahren

Song 38 after a long on call weekend! Here’s my take on Titanium. Rama Ellauzi Priya R. Kothapalli, MD, FACC, FSCAI Poonam Velagapudi Alex Truesdell Ishita Vasudev, MD Paul Triston B.B.J. Smith MD MGM FSCAI @the_constant_me Akinchan Bhardwaj, MD, DM, FACC Dr. Deepak L. Bhatt MIЯVΛƬ #IC ༄ ｡° Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Pooja Swamy, MD, FACC, FSCAI Aditya Bharadwaj David J. Cohen, MD, MSc
3:32

Song 38 after a long on call weekend! Here’s my take on Titanium. Rama Ellauzi Priya R. Kothapalli, MD, FACC, FSCAI Poonam Velagapudi Alex Truesdell Ishita Vasudev, MD Paul Triston B.B.J. Smith MD MGM FSCAI @the_constant_me Akinchan Bhardwaj, MD, DM, FACC Dr. Deepak L. Bhatt MIЯVΛƬ #IC ༄ ｡° Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Pooja Swamy, MD, FACC, FSCAI Aditya Bharadwaj David J. Cohen, MD, MSc

Srihari S. Naidu, MD

70,825 Aufrufe • vor 1 Jahr

75/f Ef -15% No IMPELLA ,neither available nor pt affordable OPTIONS 1. CABG 2. PCI IABP ( how) 3. Medical therapy (As per REVIVED BCIS-2) Ankush Gupta Somalaram Venkatesh Mamas A. Mamas Hany Ragy MIЯVΛƬ #IC ༄ ｡° Amitabh Yaduvanshi MD, DM, FACC, FSCAI David J. Cohen, MD, MSc Ankur Phatarpekar Ayman Magd Osama Bisht akbar haq SREEVATSA NADIG DM FSCAI FESC
0:34

75/f Ef -15% No IMPELLA ,neither available nor pt affordable OPTIONS 1. CABG 2. PCI IABP ( how) 3. Medical therapy (As per REVIVED BCIS-2) Ankush Gupta Somalaram Venkatesh Mamas A. Mamas Hany Ragy MIЯVΛƬ #IC ༄ ｡° Amitabh Yaduvanshi MD, DM, FACC, FSCAI David J. Cohen, MD, MSc Ankur Phatarpekar Ayman Magd Osama Bisht akbar haq SREEVATSA NADIG DM FSCAI FESC

Abad khan,MD/DM

23,582 Aufrufe • vor 3 Jahren

Iatrogenic aortic dissection post ivus guided LM IVL + DKC. Hemodynamics stable and no CP post procedure. How to prevent this complication? Alex Truesdell Mamas A. Mamas MIЯVΛƬ #IC ༄ ｡° Evandro Martins F. MD Hany Ragy Amir Kaki, MD Lorenzo Azzalini DKarmpaliotis Jack Hall David J. Cohen, MD, MSc Jeffrey Wilson, MD
0:58

Iatrogenic aortic dissection post ivus guided LM IVL + DKC. Hemodynamics stable and no CP post procedure. How to prevent this complication? Alex Truesdell Mamas A. Mamas MIЯVΛƬ #IC ༄ ｡° Evandro Martins F. MD Hany Ragy Amir Kaki, MD Lorenzo Azzalini DKarmpaliotis Jack Hall David J. Cohen, MD, MSc Jeffrey Wilson, MD

Rodrigo V. Wainstein, MD, PhD

18,815 Aufrufe • vor 2 Jahren

Be among the first to discover groundbreaking science! 🔍 Dr. Wissam A Jaber previews the eagerly awaited PEERLESS trial to be revealed on Tuesday, October 29 at #TCT2024. 💡 This is your opportunity to stay ahead of the curve with innovations that could revolutionize cardiovascular care and elevate your practice. Secure your spot now: Check out the full lineup of late-breaking science and trials here 👉 #CardioX #CardioTwitter #CardioEd #CardioResearch Dan Burkhoff MD PhD David J. Cohen, MD, MSc George Dangas, MD, MACC, MSCAI Juan F. Granada Marty Leon Akiko Maehara Dr Roxana Mehran Sahil A. Parikh, MD Tricia Rawh TCT Conference jedicath աǟզǟʀ.ǟɦʍɛɖ إبراهيم الحربي Ibrahim Alharbi Abdelkader Almanfi, MD, FACC, FSCAI Hooman Bakhshi Alessandro Beneduce Nyal Borges Aaysha Cader BCaseMD Nishith Chandra Bailey Ann Richardson David L. Fischman Prof. Hector M. Garcia-Garcia Julia Grapsa Nadira Hamid Stefan Harb @AmandaLimaMD Evandro Martins F. MD Giorgio A. Medranda MD, FACC, FAHA, FSCAI Neisser M Srihari S. Naidu, MD sumonroy Michael Savage Muhammad Shuaib Abid Pooja Swamy, MD, FACC, FSCAI Ritu Thamman MD Anuradha Tunuguntla MD FACC FSCAI Poonam Velagapudi Edoardo Zancanaro MD MIЯVΛƬ #IC ༄ ｡°
1:02

Be among the first to discover groundbreaking science! 🔍 Dr. Wissam A Jaber previews the eagerly awaited PEERLESS trial to be revealed on Tuesday, October 29 at #TCT2024. 💡 This is your opportunity to stay ahead of the curve with innovations that could revolutionize cardiovascular care and elevate your practice. Secure your spot now: Check out the full lineup of late-breaking science and trials here 👉 #CardioX #CardioTwitter #CardioEd #CardioResearch Dan Burkhoff MD PhD David J. Cohen, MD, MSc George Dangas, MD, MACC, MSCAI Juan F. Granada Marty Leon Akiko Maehara Dr Roxana Mehran Sahil A. Parikh, MD Tricia Rawh TCT Conference jedicath աǟզǟʀ.ǟɦʍɛɖ إبراهيم الحربي Ibrahim Alharbi Abdelkader Almanfi, MD, FACC, FSCAI Hooman Bakhshi Alessandro Beneduce Nyal Borges Aaysha Cader BCaseMD Nishith Chandra Bailey Ann Richardson David L. Fischman Prof. Hector M. Garcia-Garcia Julia Grapsa Nadira Hamid Stefan Harb @AmandaLimaMD Evandro Martins F. MD Giorgio A. Medranda MD, FACC, FAHA, FSCAI Neisser M Srihari S. Naidu, MD sumonroy Michael Savage Muhammad Shuaib Abid Pooja Swamy, MD, FACC, FSCAI Ritu Thamman MD Anuradha Tunuguntla MD FACC FSCAI Poonam Velagapudi Edoardo Zancanaro MD MIЯVΛƬ #IC ༄ ｡°

Cardiovascular Research Foundation

12,995 Aufrufe • vor 2 Jahren

Song 107 my cover to “don’t dream it’s over” just a gorgeous song from the 80s. Hope you enjoy. Giorgio A. Medranda MD, FACC, FAHA, FSCAI Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Dr. Purvi Parwani David J. Cohen, MD, MSc Ishita Vasudev, MD Akinchan Bhardwaj, MD, DM, FACC xavier prida Alex Truesdell Sandy Hung Azka Naeem Poonam Velagapudi Allison Dupont, MD MIЯVΛƬ #IC ༄ ｡° Dr. Deepak L. Bhatt Samuel B. Governor Emily Researcher Shadi Halabi MD MPH Randy Wayne Julia Mitchell Bernard Kadosh Lisa Ryan Quentin Youmans, MD, MSc Triston B.B.J. Smith MD MGM FSCAI Maham Waheed, MD
4:05

Song 107 my cover to “don’t dream it’s over” just a gorgeous song from the 80s. Hope you enjoy. Giorgio A. Medranda MD, FACC, FAHA, FSCAI Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Dr. Purvi Parwani David J. Cohen, MD, MSc Ishita Vasudev, MD Akinchan Bhardwaj, MD, DM, FACC xavier prida Alex Truesdell Sandy Hung Azka Naeem Poonam Velagapudi Allison Dupont, MD MIЯVΛƬ #IC ༄ ｡° Dr. Deepak L. Bhatt Samuel B. Governor Emily Researcher Shadi Halabi MD MPH Randy Wayne Julia Mitchell Bernard Kadosh Lisa Ryan Quentin Youmans, MD, MSc Triston B.B.J. Smith MD MGM FSCAI Maham Waheed, MD

Srihari S. Naidu, MD

76,097 Aufrufe • vor 5 Monaten