Top Tweets for #CardiotwitterCase
What do you think has happened here 🤔
An educational rota burr entrapment case. When a burr is stuck, we pull on the burr. If that doesn’t work, then we think of complex manoeuvres: cutting the burr, removing Teflon sheath, guide extensions, parallel wiring/ballooning and ping pong guides etc… But we often forget the simple stuff. The 0.014 tip of rotawire is larger than 0.009 shaft that contains the burr. This prevents distal vessel injury but can help retrieve a stuck burr. If wire is intact, bring wire back to burr, but this can only be done with brake defeat on (this is often forgotten!!!). Once the tip is at the burr, just pull! Works in many cases of stuck burr. Here a case of LAD rotablation. Unrecognised calcific distal LMS disease, led to burr advancement and entrapment. Tugging the burr didn’t help. So brake defeat on and then pull the rota wire. Burr came out. Then rewired with new rotawire and used same burr to finish the job.
#Cardiology #cardiotwitter #PCI #complexPCI #rotablation #complications
@Can_CTO @CtoEuro @SanjogKalra @DrBillLombardi @DrDarshanDoshi @KambisMashayek1 @RinfretStephane @KovacicMihajlo @AgostoniPF @mornei2011 @swissCTO @A_B_Hall @SmithElliotjs @YbarraLuiz @dautov_MD @ammozid @MohamadAlmutawa @BElbarouni @jcspratt @tomkaier @AnjaKsnes @RajaHatem @LAzzaliniMD @jedicath @Laserrman @FaroucJaffer @MohanedEgred @stefan_harb @BostonEdney @AHRavandi @DrIHHashmi1 @ogoktekin @OpolskiMP @K_DeSilva @KVM83 @FaurieBenjamin1 @MichaelMegalyMD @ignamatsant @agtruesdell @ziadalinyc @rickytiago @sharmaine0206 @aspergian1 @realarainmd @MauroCarlino3 @yassersadeknhi @MdM_Ochiai @SarahFairley7 @mbmcentegart
Thrombolysed ant STEMI in young patient. Re-infarction. Occluded diag and LAD. Prox LAD tubular narrowing. IVUS shows extensive SCAD with IMH into diag across ostium and back to near ostial LAD. Luminal wire position LAD and diag.
🚨 87yo👵iwSTEMI-RCA TIMI 0
➤ ASA+Heparin+Cangrelor
➤ @penumbrainc CAT RX: thrombus extracted
➤ 2 DES implanted
➤ Moves arm, and here’s the angio📸
➤ BP 160/80 mmHg, HR 80, no chest pain
What now? Inflate a🎈, then (next thread)?
#CardioTwitter @PCRonline @ESC_Journals
Seeing this, you'll realize that I had a long day yesterday 😃😂🤡
Stuck rota burr and a perf in a post CABG CTO patient.
Guidzilla+trapping ballon facilitated evacuation of the stuck burr (pic in comments)
@AGIKinterv @PCRonline @CMichaelGibson @ateap0tist @Obisht @vlad_sok
Thanks for the votes
🎯 We need to clarify if Os LAD/LM are involved or not (most of the time yes)
🎯 Having multi modality imaging including CTCA and OCT helps.
🎯 Decided to nail Os but with AI using the co-registration feature
LAD- Dg 1-1-1 bifurcation lesion. Provisional approach. Guiding the procedure with OCT is awesome. @pemarlor08 @jorgeachv @AntonioGomezM21 @iotaegui @@shci_sec @PCRonline @lydiarocap
@jtsaxon @JMonteroMD Great thread Dr Saxon. In @EuroInterventio we were lucky that some colleagues shared a similar case https://t.co/FPgHYkQIjh @PCRonline #CardiotwitterCase #TAVR #TAVI
Combination of IVL- @ShockwaveIVL and OPNC @sis_medical are often used as complementary tools for better outcome. IVL modifies the thick calcified plaque, OPNC compresses the plaque resulting in optimal outcome. @OPCILive @PCRonline @CtoEuro @MLCTOAcademy @incathlab
Did you know that neoatherosclerosis (in the context of in-stent restenosis (ISR)) can suffer dissection, just like any native coronary artery, when 🎈dilatation is performed?
Find out more in this #CardioTwitterCase shared by @LAzzaliniMD & @RezMasoomi & selected by @aayshacader for publication on PCRonline:
🔗https://t.co/p0idLFRA9h
#cardiotwitter #cardioX #CardioEd #interventionalcardiology
Losing a stent in the LM... ;( @PCRonline @MusaSharkawiMD @djc795 @DavidLBrownMD @timir_paul @ShariqShamimMD @jl35wilsonMD @KardiologieHH @AGIKinterv @MGol_MD @sulimov_dmitry @ateap0tist
How nervous would you be after this first shot of the left system in an inferior STEMI 😟
See how we tackled it. @DrZafarullahBr1 @ZafrullahDr #CardioTwitter
#CardioTwitterCase
@ABH_IC_Fellows
@cardionerdsjc
@SCAI
@mirvatalasnag @Abi_sood @AKassier
@Lcathlab
@secardiologia
@indiancathtech
@PCRonline
Radial, unprotected LM bifurcation with Occluded RCA. Extremely obese. Started with provisional into LCX, 4mm stent. Ivus LAD showed plaque shift. Converted to Culottes with 4mm LAD. Kissing balloon then POT with 5mm balloon. Final IVUS. #CardioTwitter
#CardioTwitterCase
@ABH_IC_Fellows @zulfiqarqutrio1 @ZafrullahDr
@cardionerdsjc
@SCAI @Abi_sood @AKassier
@LCathlab
@indiancathtech
@PCRonline
Smallest LAA that I have closed. 5 mm Ostial and 10mm wide body. Accommodated a 20mm Watchman. #CardioTwitter
#CardioTwitterCase
@ABH_IC_Fellows
@cardionerdsjc
@SCAI @Abi_sood @AKassier
@Lcathlab
@secardiologia
@njohncamm
@indiancathtech
@PCRonline
Would you defer LAA closure again? Patient received 3 months of Warfarin maintaining INR of 3 and baby aspirin, after initial TEE which aborted the closer.
Decided to close without pre LAA Angio. #CardioTwitter
#CardioTwitterCase
@ABH_IC_Fellows
@cardionerdsjc
@SCAI
@mirvatalasnag @Abi_sood @AKassier
@Lcathlab
@secardiologia
@njohncamm
@indiancathtech
@PCRonline
@echotalk
@EchoCases
@Echocardioblog
@echo_stepbystep
@EchofirstB
@The_echo_lady
@BhaskarEchoVA
@ottoecho
@echofirstb
@echo_stepbystep
Awaiting commercial #CoronaryDCB in the US!
Meanwhile, an option for #2LayerISR
@kerrigjl @chadialraies @KateKearney4 @RhianEDavies1 @DrDamluji @leahmraj @HashimHayder @samitshahmd @HashimKhan_1 @SahoorKhan @Pooh_Velagapudi @mirvatalasnag @BaoGTran @brownc_12 @essadii
Referral for “stent-ectomy”:: gooseneck snare 🎣 removal of prior stent, calcium 🪨 modification with IVL⚡️, re-stent with IVUS 👁️ guidance 👍…
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