@JohnInDunedin@drjohnm While I find waiting out an OMI until a patient qualifies for the OAT trial to be unpalatable, I would be willing to randomize them to lytics/no lytics in transfer to get more evidence
@JohnInDunedin@drjohnm First of all I’d like to thank you for a very thoughtful discussion… We also seem to practice in similar environments because ~50% of my patients are lysed as well and that may be the key to answering this question and I think you may have led me to a possible answer.
@JohnInDunedin@drjohnm No arguments on selection bias and our mutual dislike of small stents, but to my original point, I can’t imagine a hypothetical RCT that I could get past an IRB that would be ethical and wouldn’t be rendered useless by crossover in the OMI+/STEMI- group… can you?
@JohnInDunedin@drjohnm I’m curious what you’d cite as your source for “OMI occurs in small vessels”. I think we both agree that more knowledge is needed, but based on how I’m interpreting the study below, I treat OMI like stemi and I think withholding pci is unethical.
https://t.co/WjcnvJLdbY
@JohnInDunedin@drjohnm Interesting position… would you let yourself be randomized to the conservative arm of this hypothetical trial if you had a “big circumflex occlusion” without STE for the sake of EBM? Perhaps I’m biased but I would leave AMA and drive to another hospital that would stent me
📑💡Case describing initial experience w impromptu coaxial trapping of guide extension catheters within the left main coronary artery using the dual access rapid trap (DART) technique. #PCI#LeftMain#InterventionalCardiology
➡️https://t.co/SDE3kM4C4D
@capnintrvention @jason_wollmuth
Discover how being coachable, resilient, and committed to continuous improvement on the D1 Tennis Courts helped Dr. Eric Rothstein thrive in high-pressure environments in the Cath Lab.
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We've had a lot of success w/ Ostial Flash-cool to see how ostial flashed stents look grossly and by OCT in our recent cadaver implants. Unanticipated benefit is that Flash increases strut density at the coronary origin-where we struggle with stent scaffold failure and recoil.