Said Ashraf MD, FACC, FSCAI

▶️Interventional & Structural Cardiologist @AtlantiCareNJ ⏮ ⚒ #RadialFirst #CHIP #IVUS #MCS #TAVR #PERT |Views My Own|🍉

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

Halloween Haunt: Male 60s with chest pain for 1 hour, EKG with STE in AVR & wide spread depressions. Hemodynamically stable ➡️ CCL ➡️ here’s what angio showed. After the second Left cors shot became acutely 🤢, hemodynamics collapsed hypotension + respiratory failure.
What would you do next?

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@KHERA_MD @MountSinaiHeart @PradeepYadavMD @mirusmed @GilbertTangMD @MountSinaiNYC @SCAI @ACCinTouch @DoctorKini @LucySafi @AmithoodaMD @ccclivecases Congrats to you and your team!

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@jedicath @Uqayyum123 @aspergian1 @drAliyor @Hragy @realarainmd @TWilsonMD @cardiojaydoc02 @skat_ct @ignamatsant The 2/10 who don’t will end up being more successful

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@Uqayyum123 @jedicath @aspergian1 @drAliyor @Hragy @realarainmd @TWilsonMD @cardiojaydoc02 @skat_ct @ignamatsant I’ll usually pair the IVUS with FFr in these scenarios, and take data sets from angio+ffr+IVUS to help decide treatment. I think this patient will be ok with medical therapy alone.

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

Great result and display of escalation of technique to optimize the result. Were you happy with the end result of Lm-LAD? Infrequently, there is no answer to these nodules despite the utilization of all the tools. Lucky for you the LM-LCx is already stented so you could use a DCB there! Great that we are no longer living in a time compelled to put another layer of stent in that LCx.

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@mirvatalasnag @AnkurKalraMD @SrihariNaiduMD @biljana_parapid @avolgman @RakanINazer @ihtanboga @KardiologieHH @Pooh_Velagapudi @omendiz "Math tells us of the three saddest love stories:
Of parallel lines, who were never meant to meet.
Of tangent lines, who were together once then parted forever. And of asymptotes, who could only get closer and closer, but never could be together."

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

Great meeting last night in #Philadelphia on CTO/CHiP led by @AhmedAlOgaili - excellent cases & conversations by faculty & fellows from around the region. @Drbankacardio #cardiotwitter @scai

[mandeep singh @mandeep_mayo]

10/ My last and most important message

It isn't just your hard work that built your interventional career- it's also the sacrifice, blood and sweat of those who love you

[Ashish K. Jha @ashishkjha]

Gene Braunwald died at 96.

In a normal world, this would be front page of the NYT and WSJ.

The father of modern cardiology.

Fled the Holocaust as a boy

Went on to save millions of lives

The most important clinician-scholar of the last 50 years. We should all know his name

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

Nice demonstration! Many nuances to this, back in the day were leaving the sheath it but have not done so for a few years now. Angle of entry (more parallel to the skin), anterior puncture, less movement/trauma during peel away, placing 3-4 gauze to keep angle 120-140 degrees all helpful. Sometimes, they just bleed! Subcu epi/lido injection, bone wax, pressure dressings, and mattress sutures all helpful.

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

Excited to attend #SCAI2026 in Montréal this week! Looking forward to a week of cutting-edge science.
I’ll be presenting on Drug-Coated Balloons (DCB) & Lipid Lowering Therapy, paneling Cardiogenic Shock Team case exchange and a live case from Oman! — come join the conversations! 🎈💉
Registration is still open—don't miss out on the best in #InterventionalCardiology. See you there!

[SCAI @SCAI]

Are you ready?! Stenty can’t wait to welcome you to #SCAI2026 next week—bringing you cutting-edge science, live cases, and the latest innovations in #InterventionalCardiology. Have you built your schedule?

Explore the program ➡️ https://t.co/Cp2jslPYHo

Register ➡️ https://t.co/z5iwU1PtJP

#AdventuresOfStenty #CardioX #SCAIHatDay

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

I learned from @homam_heartdoc to create a small incision with scalpel after removing the micro puncture sheath and pushing a hemostat down to the arteriotomy site overriding the 0.035” J wire, so as to create a clear track & get subcu tissue out of the way. Much smoother deployment, can’t recall last time I had any problems with Perclose and I use it a lot.

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@LloydKlein10 @Hragy know a lot of surgeons who operate on active chest pain and stemi on ekg loaded with ticagrelor and asa a few hours earlier?

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

3AM STEMI, female in 70s with chest pain for 5 hrs. When you see this angio, you know you’re not goin back to sleep
😁

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

In any case! I don’t think this will be a durable result. My understanding & experience with these types of resistant nodules has taught me that they continue growing & despite aggressive modification they return to haunt. had a case where it protruded right through the stent strut exactly 1 year later. Time will tell with this one. Curious to hear your Thoughts?

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@drmssm I landed it at the ostium, Ivus showed relatively disease free 2-3mm zone in the LAD area.

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@realarainmd CP, +EKG changes, +DAPT loaded, prox LAD with large area of myocardium in jeopardy. Hemodynamics stable. Didnt know Lvef at the time of decision making. +experience in dealing with these helps

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@OneMoreDrPatel

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

Have been in these scenarios before. EKG with stemi and active chest pain, a couple of angios showing transient recanalization, stop and bring back later or send to CTS, only for vessel to close again & come back to the lab after cardiac arrest in shock. With active chest pain and EKG shows STEMI with large area of myocardium at risk loaded with DAPT - pci first.

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@EdmondOwen8 Perhaps. I think in modern era the rate of stemis going for cabg are <2%. Did have a discussion with the surgeon midway through the case, had OA not modified the plaque ,
Wouldve probably sent to surgery; patient was loaded with aspirin and ticagrelor before the procedure started

[Said Ashraf MD, FACC, FSCAI @SaidAshrafMD]

@Uqayyum123 evolving ekg changes in a vessel that’s closed and then recanalizing