Tom Wilson

Interventional Cardiologist, CTO-PCI, CHIP, Peripheral vascular disease, acute PE. Views & opinions are my own.

[Tom Wilson @TWilsonMD]

@gbiondizoccai Depends on vessel size. Some distal RCAs are 2.25-2.5 and others are 3.0+. 3.0+ I’ll take a short DES. <2.5-2.75 I’ll take a DCB.

[Tom Wilson @TWilsonMD]

@SripalBangalore @Hragy @ShariqShamimMD @realarainmd @jl35wilsonMD @evandrofilhobr @MarekRadomski71 @drAliyor @ziadalinyc @SarahFairley7 @agtruesdell @Allison_Dupont 2.5 Wolverine was used prior to DCB here.

[Tom Wilson @TWilsonMD]

@Hragy @ShariqShamimMD @SripalBangalore @realarainmd @jl35wilsonMD @evandrofilhobr @MarekRadomski71 @drAliyor @ziadalinyc @SarahFairley7 @agtruesdell @Allison_Dupont F/u on 65 runner w prolonged run times. PCCTA demonstrated critical prox-mLAD disease. I found—LAD CTO w/ mod diffuse distal LAD Dz. DCB, dissection. Leave it or stent it?

[Tom Wilson @TWilsonMD]

@realarainmd @Hragy @ShariqShamimMD @SripalBangalore @jl35wilsonMD @evandrofilhobr @MarekRadomski71 @drAliyor @ziadalinyc @SarahFairley7 @agtruesdell @Allison_Dupont Pre-IVUS no hematoma. Thank you excellent points.

[Tom Wilson @TWilsonMD]

@evandrofilhobr @Hragy @ShariqShamimMD @SripalBangalore @realarainmd @jl35wilsonMD @MarekRadomski71 @drAliyor @ziadalinyc @SarahFairley7 @agtruesdell @Allison_Dupont Sure hope so! Non US docs have far more experience w/ dissections. We have the medical-legal component to consider too, which is unfortunate.

[Tom Wilson @TWilsonMD]

If there’s a dissection no known benefit to gp2b3a. Nothing in the guidelines to recommend using. Patient was already on p2y12-. I don’t see the need for more aggressive antiplatelet therapy. He went home 5-6h after the case. Doing great. Please comment on your rationale for aggrastat/integrilin.

[Tom Wilson @TWilsonMD]

@nyalborgesmd @Hragy @ShariqShamimMD @SripalBangalore @realarainmd @jl35wilsonMD @evandrofilhobr @MarekRadomski71 @drAliyor @ziadalinyc @SarahFairley7 @agtruesdell @Allison_Dupont I left it alone. Relook angio or not? Relook CCTA?

[Tom Wilson @TWilsonMD]

@SarahFairley7 @Hragy @ShariqShamimMD @SripalBangalore @realarainmd @jl35wilsonMD @evandrofilhobr @MarekRadomski71 @drAliyor @ziadalinyc @agtruesdell @Allison_Dupont Thank you. The patient is doing great.

[Tom Wilson @TWilsonMD]

@drAliyor @Hragy @ShariqShamimMD @SripalBangalore @realarainmd @jl35wilsonMD @evandrofilhobr @MarekRadomski71 @ziadalinyc @SarahFairley7 @agtruesdell @Allison_Dupont DCB and left it alone. Save the LIMA.

[Tom Wilson @TWilsonMD]

You know—boss—we have same day visits available for patients who need urgent attention! MOST patients do not need urgent attention. Hospitals can’t do this. Private, independent physicians can! Hospital systems limit how many patients cardiologists see! It’s not the physician’s fault 99% of the time. https://t.co/yLA3VtZiVf

[Tom Wilson @TWilsonMD]

@baramink Most likely atherosclerosis in my view. 38 male smoker? Or female?

[Tom Wilson @TWilsonMD]

@realarainmd @MichaelMegalyMD @ihtanboga @divaka_perera @SaadEzad @hollymorgs @AishSinha1 @BCIS_uk @SripalBangalore @Hragy @mirvatalasnag @stefan_harb Let ‘em breeeeaaaaathhhee

[Tom Wilson @TWilsonMD]

Obviously. There are some excellent 80 year olds. Most are not, ridden by polypharmacy. Ask your pts: “would you prefer to continue this medication or stop it with the chance you may have a slightly higher risk of heart attack and stroke?” You will be surprised. We obsess over mortality. Most patients don’t.

[Tom Wilson @TWilsonMD]

@drAliyor @esbrilakis @gbiondizoccai @sbrugaletta @Obisht @realarainmd @ShariqShamimMD @ziadalinyc @SarahFairley7 @Sher_Intervent Frustrating when this happens despite the use of longer balloons, slow inflations. Cutter is the answer! Works great for this problem—agree.

[Tom Wilson @TWilsonMD]

@ColletCarlos @ziadalinyc @Hragy @jl35wilsonMD @djc795 @evandrofilhobr @DrJayMohan what happens when you have a radiologist read a PCCTA? This report is incomplete in so many ways. Name some that bother you. “HIGH GRADE MODERATE MODERATE STENOSIS” 🤔

[Tom Wilson @TWilsonMD]

@beachlife227 @rookisaacman No there aren’t. And there aren’t many 757s left flying. Find one for me. Preferably 2.

[Tom Wilson @TWilsonMD]

@beachlife227 @rookisaacman Very few 25-year-old captains on commercial aircraft. I’m guessing none on the majors. ATP minimum age is 21 for a F.O., Age 23 for captain. Would be surprised if >1% of commercial aircraft (passenger flights) are piloted by captains <25 years old.

[Tom Wilson @TWilsonMD]

@DrRajeshG1 Stop, pigtail.

[Tom Wilson @TWilsonMD]

@DrJayMohan @rwyeh @crfheart @TCTConference @JJMT_CircRest Useless device.