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Sharing my old video about ‘step by step what not to do during rota’ #cardiotwitter ROTAMONSTER Salman Arain Ankur Phatarpekar Abad khan,MD/DM Mamas A. Mamas IMO wire should be distal most for stability and one should give burr sufficient contact time with calcium. There is a difference between crossing...

13,933 просмотров • 1 месяц назад •via X (Twitter)

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An educational rota burr entrapment case. When a burr is stuck, we pull on the burr. If that doesn’t work, then we think of complex manoeuvres: cutting the burr, removing Teflon sheath, guide extensions, parallel wiring/ballooning and ping pong guides etc… But we often forget the simple stuff. The 0.014 tip of rotawire is larger than 0.009 shaft that contains the burr. This prevents distal vessel injury but can help retrieve a stuck burr. If wire is intact, bring wire back to burr, but this can only be done with brake defeat on (this is often forgotten!!!). Once the tip is at the burr, just pull! Works in many cases of stuck burr. Here a case of LAD rotablation. Unrecognised calcific distal LMS disease, led to burr advancement and entrapment. Tugging the burr didn’t help. So brake defeat on and then pull the rota wire. Burr came out. Then rewired with new rotawire and used same burr to finish the job. #Cardiology #cardiotwitter #PCI #complexPCI #rotablation #complications CanCTO EuroCTOClub Sanjog Kalra Dr. Bill Lombardi Darshan Doshi, MD, MS Kambis Mashayekhi Stéphane Rinfret, MD SM Mihajlo Kovacic 🫀📕/🔋🕹️ Pierfrancesco Agostoni Neisser M Gregor Leibundgut Allison Hall Elliot Smith Luiz Fernando Ybarra Rustem Dautov Abdul Mozid Mohammad Almutawa Basem Elbarouni jcspratt Tom Kaier Anja Øksnes Raja Hatem Lorenzo Azzalini jedicath աǟզǟʀ.ǟɦʍɛɖ Tsutomu Fujita MD Farouc Jaffer MD PhD Mohaned Egred Stefan Harb Edney Boston-Griffiths Amir Ravandi Dr Imran Hanif Hashmi Omer Goktekin MD Maksymilian Opolski Kalpa De Silva Kalaivani Mahadevan Faurie Benjamin Michael Megaly Ignacio J. Amat Alex Truesdell Ziad Ali Ricardo Santiago sharmainethiru Jack Hall Salman Arain Mauro Carlino yasser sadek Masahiko Ochiai MD, FACC Sarah Fairley Margaret McEntegart

Bilal Iqbal

11,353 просмотров • 1 год назад

Can you identify an oculogyric crisis? @ChristosGanos and colleagues teach us about the intriguing possibility that the rolling eyes we frequently see after administration of a drug, may be localized to a brain lesion network associated with a brain dopaminergic transcriptomic signature. Read about it in a new paper Brain. Key Points: - Oculogyric crises what are they? Acute episodes sustained, typically upward, conjugate deviation of the eyes. - Common cause? Acute D2-dopamine receptor blockade by a drug. - The authors used data from 14 previously reported cases of lesion-induced oculogyric crises and employed' lesion network mapping' to search for shared connections. - What was the common network? Basal ganglia, thalamic, brainstem nuclei and cerebellum. - A look at the gene expression profiles showed spatial overlap specifically with the gene coding for dopamine receptor type 2 (DRD2). - The very cool part: spatial overlap with DRD2 and DRD3 gene expression seemed to be 'specific to brain lesions associated with oculogyric crises when contrasted to lesions that led to other movement disorders.' My take: I love the use of multiple modalities to chase down a common neural network for oculogyric crises. We should keep in mind that these were cases associated with brain lesions, and as we all contribute by reporting more cases and sharing their MRI scans we will likely further refine our understanding of the network. For clinicians when you see this, look down that medication list for the 'dopamine blocker' as your first step in diagnosis. This video by Elan Louis provides a nice illustration of oculogyric crisis to help you to identify them in your practice. #Parkinsons #oculogyric

Michael Okun

15,398 просмотров • 2 лет назад