Sanjay Kunapuli MD FACC

Interventional cardiologist, endovascular specialist, CLOT WARRIOR . Angel investor, Options, crypto : ALL OPINIONS ARE SOLELY MINE

[Michael | Hypermarkets @itsmichaelluu]

When $SPY pulls back I like these 5 levels most (explaination):

1. $720–$722 → (probability 75%)
- Almost guaranteed first test, it's the nearest broken resistance

2. $697–$700 → (probability 50%)
- Round number + prior base makes it a high-probability magnet

3. $675–$680 → (probability 35%)
- Only if macro data deteriorates and 200MA gets tagged

4. $650–$655 → (probability 20%)
- Requires a true risk-off panic, not just a garden dip

5. $630–$640 → (probability 10%)
- Black swan territory, Fed error or credit event needed

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the $SPY option contract I'd add on this dip for 200%-500%

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@AustinBourgeois @SDhandMD @t_intheleadcoat @keithppereira @TheRealDoctorOs @_backtable @ChengaziMD @DonGarbettMD @DaveJohnsonMD @Samarth_IRadoc @Doc_Rock_MD @AustinBourgeois - excellent presentation. 6 Fr Pig sans wire with a 20cc syringe c contrast works most of the time - watch out for the RV pap muscles, esp in the more dilated RV

[Davide Capodanno @DFCapodanno]

Finally, a sham-controlled CTO PCI trial—and it delivers. ORBITA-CTO: small (n=50), but rigor where it matters—blinding, placebo control, symptom-level data. CTO PCI improves angina beyond placebo, with a clear reduction in episodes and more angina-free days. Not prognosis, not hard endpoints, but real symptom benefit—properly measured. #acc26
https://t.co/UgoJVoX87H

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@AlphaBetaAnil Anil- this problem is pervasive in academia- while constantly shunning communal practice, often times preaching from ivory Towers, talking about equality while their actions often times counter everything that they preach

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@krisvancleave @carlquintanilla @krisvancleave- total mess @ Hobby today. We stood in line for 21/2 hrs, missed our flight . Finally able to get on after 6 hrs. Terrible for families with kids and elderly

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@AustinBourgeois This is a technique that I used to do in the past. Worked but multiple sticks . Now I just go up and over.

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@Hragy I started left TRA , switched to right TRA, tried/used DTRA, but then stopped- I still think left TRA is something all operators need to mean- esp if venturing into radial

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@AustinBourgeois Left side of thrombus, especially in the left upper lobe or in a distal left main has always been problematic, but my go to is a T 24 curve

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@realarainmd @MichaelMegalyMD Excellent case. @realarainmd I’ve used #HDR in venous cases and it gets the job done . Thanks for spreading #HDR

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@jtsaxon @djc795 Last year, we had 2 IC Job Openings in our group. We interviewed a total of 20 fellows, 19 of them who wanted to practice SHD- only one wanted to practice IC. Even better one of the candidates stood us up and never showed up to the interview.

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@mcuban @mcuban - why not have a two tier system: a government supported mini Medicare type which gives everyone from 18 to 65 -4 preventative MD visits/yr,and 2 visits to the ER covered, and anything more can be bought through HSA

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@realarainmd @realarainmd thanks for the excellent tutorial. What’s your experience with OPN a balloons for vessels with just an arc of calcium? (one quadrant)?

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@DeepValueBagger Nicely said - Home run - wait for it , hit it out of the park . Always appreciate your posts

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@realarainmd Nice case. Completely agree DCB are changing the landscape. In my practice, I have shifted too DCB for mid/distal LAD lesions- not burning any bridges to CAB

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@jedicath As senior cardiac surgeons are retiring, it’s becoming increasingly difficult to find cardiac surgeons that have adequate volume and as a result outcomes for suffering. Obviously big centers still have higher volumes, but the issue is much more prevalent.

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@jedicath CABG volumes ↘️,#cases/surgeon⬇️🙃graft failure rate ↗️

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@AndrewJSauer @AndrewJSauer -so well written and so true. The biggest flex is to have no debt. It makes a big difference in how we approach our work and also the choices we make. Financial freedom is priceless. I call it financial nirvana.

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@jedicath It’s unfortunate that in 2025 with all the evidence of image guided PCI, imaging is still utilized- I see this everyday . 🤷🤦

[Elon Musk @elonmusk]

The rocket came back from space at hypersonic speed and then hovered at a precise position

[Sanjay Kunapuli MD FACC @HoustonHrtDoc]

@realarainmd @Laserrman Excellent tutorial. Thank you @realarainmd , @Laserrman