Stefan Harb

enjoying new perspectives #mlcto2025 #GERMANCTO2025 #TOBI2025 #TCT2025 #EAPCI

[Stefan Harb @stefan_harb]

@realarainmd Fascinating delicate work
surgeons are doing here.

#stentectomy pushes my desire
to treat without stent.

Watching the surgeon here
may encourage us
to spend plenty of time and effort
on sufficient lesion preparation.

[Stefan Harb @stefan_harb]

@skat_ct @realarainmd Yes, we will, Carlo!

[Stefan Harb @stefan_harb]

Learn the latest of #HDR
presented by @realarainmd
in Istanbul this week!
https://t.co/QS6OArSl0t

[Stefan Harb @stefan_harb]

@ctoessentials https://t.co/6sDFozK3Hv

[Stefan Harb @stefan_harb]

@ctoessentials 2026

[Stefan Harb @stefan_harb]

@realarainmd @SripalBangalore @rajivxgulati @evandrofilhobr @Hragy @MichaelMegalyMD @TariqShafiDr @PurumittalDr @ihtanboga @DrBIqbal After reviewing the radiology article
on the anatomy of coronary veins that you posted I meditated the flow here again:
Seems like atrial contraction is pushing some dye up the SVC.

And epicardial fat is our friend
but the epicardium is the barrier
preventing tamponade

[Stefan Harb @stefan_harb]

@realarainmd @rajivxgulati @SripalBangalore @evandrofilhobr @Hragy @MichaelMegalyMD @TariqShafiDr @PurumittalDr @ihtanboga @DrBIqbal Looks like most contrast goes into myocardium of right atrial appendage from a prox branch of the RCA and to superior vena cava through av-fistula, so no catastrophe.
Just wait and see …

[Stefan Harb @stefan_harb]

@Hragy @TCT_ME_ @DrAmirKaki @mmamas1973 Wish your aunt and this patient the best possible recovery!

[Stefan Harb @stefan_harb]

https://t.co/stKywgwd6V
is a very special conference

[Stefan Harb @stefan_harb]

Watch out for this new
#CHIP #CTO conference
https://t.co/J1YeVkXVMS
created by Dirk Pretorius & Chris Zambakides
supported by @KambisMashayek1 Masahisa Yamane @OpolskiMP @AlexAchimMD @mihaicocoi @GoranEBC Irene Lang
and including an #EAPCI @SASCI
friendship session

[Stefan Harb @stefan_harb]

What we can learn from
https://t.co/stKywgwd6V

[Stefan Harb @stefan_harb]

@realarainmd @TWilsonMD @Hragy @rajivxgulati @agtruesdell @SripalBangalore @ihtanboga @jedicath @DrIHHashmi1 @abadkhan2002 @LouaiRazzouk @DocSavageTJU Have been using Acist for 20 years

it is very safe if you adjust and use it correctly
(flow, volume, pressure limit, injection button)

But I still do not use it for #HDR
Haha!

[Stefan Harb @stefan_harb]

@Hragy Amazing surgical #stentectomy
#coronaryendartherectomy

We really need to keep working enthusiastically
to develop better treatment for long lesions

#lesionpreparation #rotablation
#cuttingballoon #DCB …

[Stefan Harb @stefan_harb]

@realarainmd @TariqShafiDr @rajivxgulati @SripalBangalore @Hragy @agtruesdell @ihtanboga @DocSavageTJU @nyalborgesmd @TWilsonMD @skat_ct Fully agree
with your lesion preparation strategy, Salman,
I like longitudinal Rodin cuts!

[Stefan Harb @stefan_harb]

@realarainmd @JACCJournals IMHO, Nitro is indicated as first action
at emergency site.
Now we are very fast
getting patient to cathlab …
Sometimes too fast?

[Stefan Harb @stefan_harb]

@evandrofilhobr @RaghavG_MD @agtruesdell @Virginiaheart @InovaHealth @JACCJournals Genius approach, Evandro!
Thank you for sharing

[Stefan Harb @stefan_harb]

@realarainmd Thank you for this lesson, Salman!

I do not claim that
I fully understand PET
and will keep looking
through this thread.

I often spend time
comparing flow direction on angio
before and after #CABG

So I like your term
“moving target”
“Where is the last meadow
for blood to go?”

[Stefan Harb @stefan_harb]

@realarainmd @RizwanS48978934 @mirvatalasnag @realHamzaLodhi @Murmur_MD @VSimonAbraham @CMichaelGibson Agree Salman risk is higher in CTO PCI.

In this case surgeon has no clear information
where to best put the grafts
neither from angio
nor from CT.
Distality of vessels remains undefined.

So I would try
to antegradely open RCA …

[Stefan Harb @stefan_harb]

@RizwanS48978934 @mirvatalasnag @realHamzaLodhi @Murmur_MD @VSimonAbraham @CMichaelGibson @realarainmd I like to go back in time
when CTO of dominant RCA
was just a 99% stenosis.

Even without proven inferior ischemia
99% of interventional cardiologists
would have put a stent
and only then further explored
the diminutive LCA

[Stefan Harb @stefan_harb]

@realarainmd @Hragy Great suggestions to turn waiting-time into assets, Salman!
We have lots of reason to be thankful.

I do profane things like draw blood for ACT, wet my wires, adjust my guide position, …

And I like to talk to the patient …
…or my team.

Maybe a sip of coffee through a straw?