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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,... show more

Rodrigo V. Wainstein, MD, PhD

2,113 subscribers

18,789 次观看 • 2 年前 •via X (Twitter)

健康养生科学技术

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8 条评论

Rodrigo V. Wainstein, MD, PhD 的头像

Rodrigo V. Wainstein, MD, PhD2 年前

Agree that non coaxial GC position may be a potential cause to this complication. But in this case the aortic dissection was probably caused by agressive pre dil of a ostial LM calcified nodule that was pushed against the aortic wall as you can see in the video below

Jeffrey Wilson, MD 的头像

Jeffrey Wilson, MD2 年前

@agtruesdell @mmamas1973 @mirvatalasnag @evandrofilhobr @Hragy @DrAmirKaki @LAzzaliniMD @DKarmpaliotis @aspergian1 @djc795 @Babar_Basir @KateKearney4 @SrihariNaiduMD @sbrugaletta @KPujdak @TheNarulaSeries @DrJayMohan @KambisMashayek1 Be obsessive about guide position/coaxiality. I often use a GEC that is advanced over a 🎈 shaft after deflation into the LM DES especially if coaxial guide engagement is difficult. But would do nothing here except stop injecting and get serial CTAs. Result looks amazing.

Alex Truesdell 的头像

Alex Truesdell2 年前

@mmamas1973 @mirvatalasnag @evandrofilhobr @Hragy @DrAmirKaki @LAzzaliniMD @DKarmpaliotis @aspergian1 @djc795 @jl35wilsonMD @Babar_Basir @KateKearney4 @SrihariNaiduMD @sbrugaletta @KPujdak @TheNarulaSeries @DrJayMohan @KambisMashayek1 👍”Never Walk Into a [Cath Lab] You [and Your Patient] Can’t Walk Out Of” (“Ronin” Movie paraphrased):

MIЯVΛƬ #IC 的头像

MIЯVΛƬ #IC2 年前

@agtruesdell @mmamas1973 @evandrofilhobr @Hragy @DrAmirKaki @LAzzaliniMD @DKarmpaliotis @aspergian1 @djc795 @jl35wilsonMD @Babar_Basir @KateKearney4 @SrihariNaiduMD @sbrugaletta @KPujdak @TheNarulaSeries @DrJayMohan @KambisMashayek1 #TipForFIT Complications happen: -Key is to recognize & treat them -Ask for help..2 pair of hands can be useful when patients crash & it makes you a better operator not worse

Jack Hall 的头像

Jack Hall2 年前

@agtruesdell @mmamas1973 @mirvatalasnag @evandrofilhobr @Hragy @DrAmirKaki @LAzzaliniMD @DKarmpaliotis @djc795 @jl35wilsonMD @Babar_Basir @KateKearney4 @SrihariNaiduMD @sbrugaletta @KPujdak @TheNarulaSeries @DrJayMohan @KambisMashayek1 Thank you for sharing. Great result on the lesion. The only thing I can add is the simple law of physics: for every action there is sn equal but opposite reaction. For FITs, when withdrawing large bulky devices (large NC balloons, ShockWave, etc) you have to pull harder.

Lorenzo Azzalini 的头像

Lorenzo Azzalini2 年前

@agtruesdell @mmamas1973 @mirvatalasnag @evandrofilhobr @Hragy @DrAmirKaki @DKarmpaliotis @aspergian1 @djc795 @jl35wilsonMD @Babar_Basir @KateKearney4 @SrihariNaiduMD @sbrugaletta @KPujdak @TheNarulaSeries @DrJayMohan @KambisMashayek1 Come

Pramod V Menon 的头像

Pramod V Menon2 年前

@agtruesdell @mmamas1973 @mirvatalasnag @evandrofilhobr @Hragy @DrAmirKaki @LAzzaliniMD @DKarmpaliotis @aspergian1 @djc795 @jl35wilsonMD @Babar_Basir @KateKearney4 @SrihariNaiduMD @sbrugaletta @KPujdak @TheNarulaSeries @DrJayMohan @KambisMashayek1 Stent the LM into aorta….should tack it up…Shit happens man…I realized after 20 years….we do our best to keep shit FROM happening…but sometimes we can’t help it….if you do enough cath/pci…it’s inevitable….dont kill yourself over it…

Hany Ragy 的头像

Hany Ragy2 年前

@agtruesdell @mmamas1973 @mirvatalasnag @evandrofilhobr @DrAmirKaki @LAzzaliniMD @DKarmpaliotis @aspergian1 @djc795 @jl35wilsonMD @Babar_Basir @KateKearney4 @SrihariNaiduMD @sbrugaletta @KPujdak @TheNarulaSeries @DrJayMohan @KambisMashayek1 How do you follow up this case?

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Abad khan,MD/DM

20,414 次观看 • 2 年前

✨ The Linnemeier Award launched their careers. Now it could launch yours. Recognizing emerging investigators under 40, this prestigious award has elevated some of today’s most influential voices in #interventionalcardiology. If you're committed to research, innovation, and academic excellence, this is your moment. Step into the spotlight at #TCT2025. Apply today! #CardioX #CardioTwitter #CardioEd #CardioResearch David Kandzari Robert W. Yeh Farouc Jaffer MD PhD Dan Burkhoff MD PhD David J. Cohen, MD, MSc George Dangas, MD, MACC, MSCAI Juan F. Granada Marty Leon Dr Roxana Mehran Sahil A. Parikh, MD Jeffrey Popma Tricia Rawh MIЯVΛƬ #IC ༄ ｡° TCT Conference TCTMD jedicath աǟզǟʀ.ǟɦʍɛɖ إبراهيم الحربي Ibrahim Alharbi Hooman Bakhshi Chirag Bavishi MD, MPH Aaysha Cader Angel Caldera 𝔻𝕣 ℕ𝕚𝕤𝕙𝕚𝕥𝕙 ℂ𝕙𝕒𝕟𝕕𝕣𝕒 Julio Farjat Pasos Prof. Hector M. Garcia-Garcia Ahmed Ghoneem, MD MSc Stefan Harb Priya R. Kothapalli, MD, FACC, FSCAI Evandro Martins F. MD Oscar Mendiz Neisser M Srihari S. Naidu, MD Krutarth Pandya Anila & Lakshmi Rao, DO Michael Savage Dr Shariq Shamim Muhammad Shuaib Abid Alessandro Sticchi

✨ The Linnemeier Award launched their careers. Now it could launch yours. Recognizing emerging investigators under 40, this prestigious award has elevated some of today’s most influential voices in #interventionalcardiology. If you're committed to research, innovation, and academic excellence, this is your moment. Step into the spotlight at #TCT2025. Apply today! #CardioX #CardioTwitter #CardioEd #CardioResearch David Kandzari Robert W. Yeh Farouc Jaffer MD PhD Dan Burkhoff MD PhD David J. Cohen, MD, MSc George Dangas, MD, MACC, MSCAI Juan F. Granada Marty Leon Dr Roxana Mehran Sahil A. Parikh, MD Jeffrey Popma Tricia Rawh MIЯVΛƬ #IC ༄ ｡° TCT Conference TCTMD jedicath աǟզǟʀ.ǟɦʍɛɖ إبراهيم الحربي Ibrahim Alharbi Hooman Bakhshi Chirag Bavishi MD, MPH Aaysha Cader Angel Caldera 𝔻𝕣 ℕ𝕚𝕤𝕙𝕚𝕥𝕙 ℂ𝕙𝕒𝕟𝕕𝕣𝕒 Julio Farjat Pasos Prof. Hector M. Garcia-Garcia Ahmed Ghoneem, MD MSc Stefan Harb Priya R. Kothapalli, MD, FACC, FSCAI Evandro Martins F. MD Oscar Mendiz Neisser M Srihari S. Naidu, MD Krutarth Pandya Anila & Lakshmi Rao, DO Michael Savage Dr Shariq Shamim Muhammad Shuaib Abid Alessandro Sticchi

Cardiovascular Research Foundation

12,323 次观看 • 1 年前

#HDR #investment Few months post CABG patient presented with severe crippling angina. SVG to RCA gone. Cath outside. Discussed in office & hospital with patient & family (Drs) #HDR times 3 followed by PTCA achieved a small lumen. Would you stent or relook in few weeks? Salman Arain Lorenzo Azzalini Evandro Martins F. MD Neisser M Hany Ragy Stefan Harb

#HDR #investment Few months post CABG patient presented with severe crippling angina. SVG to RCA gone. Cath outside. Discussed in office & hospital with patient & family (Drs) #HDR times 3 followed by PTCA achieved a small lumen. Would you stent or relook in few weeks? Salman Arain Lorenzo Azzalini Evandro Martins F. MD Neisser M Hany Ragy Stefan Harb

jedicath աǟզǟʀ.ǟɦʍɛɖ

12,166 次观看 • 6 个月前

Hydraulic Exchange Technique: super useful in complex PCI/CTO work. Quick way to get a microcatheter off a short wire without a 300cm wire, trapper, or trapping balloon. Connect an indeflator to the microcatheter, pressurize to 20 atm (it drops constantly, so keep bumping it back up), and just open the Touhy and microcatheter will come out right away. The hydraulic force pushes the catheter back on its own while keeping the wire in position. I don’t do it over a hydrophilic wire as it can jump forward and cause a tip perforation. I use a workhorse wire. Video below Credit to J Aaron Grantham JAG for teaching me such valuable skills! TCTME+ Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Amr Mohsen, MD Aref BinAbdulhak MD MSc Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Mohammed Al-Hijji Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi scottiejj12 Dr Alo, DO, FACC

Hydraulic Exchange Technique: super useful in complex PCI/CTO work. Quick way to get a microcatheter off a short wire without a 300cm wire, trapper, or trapping balloon. Connect an indeflator to the microcatheter, pressurize to 20 atm (it drops constantly, so keep bumping it back up), and just open the Touhy and microcatheter will come out right away. The hydraulic force pushes the catheter back on its own while keeping the wire in position. I don’t do it over a hydrophilic wire as it can jump forward and cause a tip perforation. I use a workhorse wire. Video below Credit to J Aaron Grantham JAG for teaching me such valuable skills! TCTME+ Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Amr Mohsen, MD Aref BinAbdulhak MD MSc Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Mohammed Al-Hijji Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi scottiejj12 Dr Alo, DO, FACC

Anas T. Noman

24,566 次观看 • 6 天前

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, an effective bailout technique. • Small 0.5 cm groin incision • Subcutaneous fat harvested using forceps into small bowl • Fat mixed with saline • Loaded into a 2 cc syringe • Using a microcatheter (Turnpike/Finecross/Export, etc.), to inject fat into the perf site. • Final angiography confirmed complete seal. Join us at TCTME+ in Sep 2026. Will have a lot of great #CHIP and complications discussions. J Aaron Grantham JAG Dany Jacob Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Aref BinAbdulhak MD MSc Amr Mohsen, MD Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Karim Al-Azizi, MD Adam Greenbaum Mohammed Al-Hijji Emory University Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas TCTME+ Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi

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, an effective bailout technique. • Small 0.5 cm groin incision • Subcutaneous fat harvested using forceps into small bowl • Fat mixed with saline • Loaded into a 2 cc syringe • Using a microcatheter (Turnpike/Finecross/Export, etc.), to inject fat into the perf site. • Final angiography confirmed complete seal. Join us at TCTME+ in Sep 2026. Will have a lot of great #CHIP and complications discussions. J Aaron Grantham JAG Dany Jacob Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Aref BinAbdulhak MD MSc Amr Mohsen, MD Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Karim Al-Azizi, MD Adam Greenbaum Mohammed Al-Hijji Emory University Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas TCTME+ Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi

Anas T. Noman

28,151 次观看 • 2 个月前

Learn from my pitfalls: Severe iliofemoral tortuosity during a MitraClip case. Right iliac: the guide wouldn’t cross over Bayliss wire then Amplatz Super Stiff. Tried the left side instead, very tortuous too. 24F DrySeal went through fine, but the guide still wouldn’t follow. Went back to the right, swapped for a Lunderquist wire. Left the DrySeal sitting in the left iliac/IVC to help straighten things out. Right before pushing the guide through, pulled the DrySeal back to the left iliac and it finally advanced. Lesson: in tortuous vessels before you think about switching to the other side, don’t stop at one stiff wire. Escalate: Bayliss, Amplatz Super Stiff, Safari, Lunderquist, Meier. The theory of a contralateral sheath straightening the IVC might be helpful too. Another idea is to put a 28 F dry-seal then advance the mitraclip through it? Curious to hear how others have handled similar tortuosity? TCTME+ Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Amr Mohsen, MD Aref BinAbdulhak MD MSc Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Mohammed Al-Hijji Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi scottiejj12 Dr Alo, DO, FACC

Learn from my pitfalls: Severe iliofemoral tortuosity during a MitraClip case. Right iliac: the guide wouldn’t cross over Bayliss wire then Amplatz Super Stiff. Tried the left side instead, very tortuous too. 24F DrySeal went through fine, but the guide still wouldn’t follow. Went back to the right, swapped for a Lunderquist wire. Left the DrySeal sitting in the left iliac/IVC to help straighten things out. Right before pushing the guide through, pulled the DrySeal back to the left iliac and it finally advanced. Lesson: in tortuous vessels before you think about switching to the other side, don’t stop at one stiff wire. Escalate: Bayliss, Amplatz Super Stiff, Safari, Lunderquist, Meier. The theory of a contralateral sheath straightening the IVC might be helpful too. Another idea is to put a 28 F dry-seal then advance the mitraclip through it? Curious to hear how others have handled similar tortuosity? TCTME+ Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Amr Mohsen, MD Aref BinAbdulhak MD MSc Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Mohammed Al-Hijji Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi scottiejj12 Dr Alo, DO, FACC

Anas T. Noman

13,168 次观看 • 9 天前

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 ༄ ｡°

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 次观看 • 1 年前

#NYValves2024 exceeded all expectations! A heartfelt thank you to our attendees, supporters, program directors, and faculty for making this first meeting a remarkable success. 🙏✨ See you next year at #NYValves2025! 🚀 #CardioX #CardioTwitter #CardioEd #CardioResearch Anita Asgar vinayak bapat Dan Burkhoff MD PhD David J. Cohen, MD, MSc megan coylewright md mph Sam Dawkins Neil Fam Isaac George MD Juan F. Granada Adam Greenbaum RTHahnMD Azeem Latib Jonathon Leipsic Marty Leon Michael Mack, MD Dr Roxana Mehran thomas modine Dr. Devi G Nair Tamim Nazif Mark Reisman MD Rahul Sharma Dr. Nicolas M Van Mieghem Univ.-Prof. Dr. Ralph Stephan von Bardeleben Dee Dee Wang MD John Webb Pradeep Yadav MIЯVΛƬ #IC ༄ ｡° Tricia Rawh

#NYValves2024 exceeded all expectations! A heartfelt thank you to our attendees, supporters, program directors, and faculty for making this first meeting a remarkable success. 🙏✨ See you next year at #NYValves2025! 🚀 #CardioX #CardioTwitter #CardioEd #CardioResearch Anita Asgar vinayak bapat Dan Burkhoff MD PhD David J. Cohen, MD, MSc megan coylewright md mph Sam Dawkins Neil Fam Isaac George MD Juan F. Granada Adam Greenbaum RTHahnMD Azeem Latib Jonathon Leipsic Marty Leon Michael Mack, MD Dr Roxana Mehran thomas modine Dr. Devi G Nair Tamim Nazif Mark Reisman MD Rahul Sharma Dr. Nicolas M Van Mieghem Univ.-Prof. Dr. Ralph Stephan von Bardeleben Dee Dee Wang MD John Webb Pradeep Yadav MIЯVΛƬ #IC ༄ ｡° Tricia Rawh

Cardiovascular Research Foundation

41,259 次观看 • 2 年前