Top Tweets for #HDRFAQS
When (if ever) is it safe to perform (or attempt) #HDR after failed AWE?
👇🏼 My response to @SripalBangalore’s very pertinent question.
#HDR #HDRFAQs #contrast1st #CTOPCI
Great case Sripal.
Brings up the important (but difficult) question: Is it ever safe to inject after the wire has failed to cross?
For me, the real question is this - has the 1st wire significantly modified the CTO architecture or not? Other than puncture the cap of course.
👉🏼 IF the architecture has been modified (deep wire position, knuckle, sharp bends, multiple repunctures) THEN inject with immense caution
👉🏼 IF the architecture is mostly unharmed (i.e. probed with no tip XT or a Gladius with gentle manipulation) THEN it is safe and perhaps even advisable to inject - to understand the CTO and/or perform #HDR.
#CTOPCI Thought for the Day
There is no going back, once you “learn to” inject INTRA plaque! 😀
(This was one of my conclusions from a recent case, but worthy of its own tweet! Haha).
#HDR #contrast1st #HDRFAQs
Here is a mini tutorial on how to prep the MC for contrast injection for #HDR. Remember: the injection is SLOW and GENTLE.
Thank you @jaygirimd for the question, and @aspergian1 for the 100% accurate answer!
#HDR #HDRFAQs #contrast1st
@aspergian1 @jedicath @DrBIqbal Thanks for step by step. Can you just expand a bit on the wire withdrawal part?Just have a little contrast flowing out into the hub while wire is still in the lumen taking up space? Wouldn’t this still leave some potential space in MC that would cause initial air injection?
@Laserrman @DaitaroK @calcbreaker @SKuramitsu0511 @tadano98 @rotamonster @OpolskiMP @jcspratt @KambisMashayek1 @LAzzaliniMD @AgostoniPF The beauty of #HDR is that even though the wire is EXTRA stent, it is still technically IP!
#HDR #HDRFAQs #contrast1st #CTOPCI
If you like this case, feel free to share with your colleagues.
Remember the hashtags: #HDR #HDRanalysis #HDRFAQs
Also, let me know if you have any questions 🤔
#CTOPCI has never been less than exciting, #HDR has made it no less than THRILLING! 😍
(Biased? Of course!😀)
@agtruesdell We have barely scratched (punctured?) the surface of this life altering technique! 😂
Apologies for the pun. It was just there for the taking.
Some other cool tags #HDR #HDRFAQs #contrast1st #HDRanalysis 🙏🏼
If you are new to #HDR, you can catch up by searching for the hashtags
#HDR - cases, discussions, tips
#contrast1st - more #HDR talk and cases
#HDRanalysis - analysis of #HDR cases from around the 🌎
#HDRFAQs - answers to your questions
Happy #HDR hunting!💧🧐
💧#HDRanalysis 🧐 Case 011
Here is a blast from the past - a case from 10/2022 before #HDR was a thing.
Let’s call it an #HDR Classic! 📽️
First the clip, then the analysis…
#HDR #contrast1st #CTOPCI #HDRFAQs
@MauroCarlino3 @WahajAmanMD @evandrofilhobr @Texan2007 @Laserrman @esbrilakis @DrBIqbal @OpolskiMP @DMemmini @dautov_MD @agtruesdell @stefan_harb @AllanaSalman @A_B_Hall @jbspadoni @CtoEuro @SCNapierkowski @PCRonline @AgostoniPF @TWilsonMD Search for #HDRanalysis for more cases! 🔍💧
Submit your own cases (or #HDR attempts) for analysis.🧐
And ask questions!
Time to get your #HDR game on!🙌🏼
#HDR, #contrast1st , #HDRFAQs, #HDRanalysis, #CTOPCI
A Stain Is Not (Just) A Stain
#HDR, #contrast1st, #HDRanalysis, #HDRFAQs, #CTOPCI
Here what we look for in a contrast microinjection stain:
- CTO penetration distance
- Width (<, =, or > than ref. vessel)
- Intensity
- Leading edge (sharp or fuzzy)
- Side branches (the best sign!)
- Persistence
- Growth with wire insertion into the MC
This is the alphabet of the language of contrast (as Dr. Carlino calls it)!
Let’s learn to speak this new language together!
In the weeks to come, I will share examples of each.
In the meantime, please ask questions and share cases.
This is a glimpse into the future of CTO PCI!
#HDR, #contrast1st, #TDADR, #CTOPCO, #HDRFAQS 👈🏼 Note the new tag. For all your Q&As. 🙏🏼
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