Top Tweets for #TipForFit
Complications of large bore access include AV fistula..this was a particularly large one filling the RA/RV
#TipForFIT
1️⃣ Learn to recognize (pain & palpable thrill are a tip off)
2️⃣ Bailout techniques including coiling & covered stent sizing
3️⃣ OAC / DAPT management are key decisions
📕Reference https://t.co/AVl2iw9iW0
More @TCT_ME_
@SrihariNaiduMD @DrOwayed @HadyLichaaMD @JayMathewsMD @bkolskk
This is an excellent demonstration
#TipForFit
°Recognize complications
°Learn how to bail yourself out of them
Not sure if this qualifies for a wide neck #PSA but balloon assisted thrombin injection can save a 🔪
When do you consider it?
@farkomd @JayMathewsMD @kmadass @LessneVIR @CraigMWalkerMD @SDhandMD @keithppereira @limbsalvagedr @roblookstein @saherssabri @docTPlive
#RadialFirst Saga
#TipForFIT
⚙️Don’t underestimate pain..it’s not always spasm
⚙️Don’t go blind..fluoro is there for a reason
⚙️Acrobats are unnecessary
⚙️Learn bailout
Now what❓
@DocSavageTJU @SVRaoMD @nolanjimradial @mmamas1973 @drsonyaburgess @lismendez @cardiojaydoc02 @IndahSP_MD @DrAlsubei
#TipForFIT #FridayFinale
Life will challenge you..don’t be reactionary.. Pause & think (ask for advice)
You will need to make difficult decisions.. Pause & think (don’t let others make them for you)
Invest in friendships & collaborations.. they can be lifelong or can be severed prematurely.. Pause & think (don’t let your emotions get the better of you)
#TCT2024 Plugging in another selfie w upcoming stars who will join us @TCT_ME_ .. it is key that the next generation become part of the innovation process early on
#TipForFIT ❗️
Abstracts ⏩️manuscripts which last forever as your legacy
Podium time is finite & quickly forgotten
So make it count..hope yours makes it into @JACCJournals gentlemen 🤩 @Justine_Turco
@AlkashkariWail @drptca @kfaraidy @mmamas1973
@mmamas1973 @fischman_david @aymanka Dude where’s our selfie 😁
Here are my day #TCT2024 pics..I feel more productive than you in that sense 🤩@ShrillaB @drsonyaburgess @aayshacader @AdelTash @dr_nouf81 @drptca @djc795
Minimalism
#TipForFIT : prepare for the worst
1. Maintain wire in aSB
2. Access the femoral safely w a small sheath better than a rushed access if patient crashes
3. Co-axial engagement (or change to an appropriately sized guide before u start)
@DocSavageTJU @nachiketjpatel @mmamas1973 @djc795 @SVRaoMD @SandeepNathanMD @sis_medical #TipForFIT
-It’s not about delivering the stent..it’s about expanding it
-Prepare the lesion well cuz it makes your life easier down the line
-For ISR, use imaging to diagnose it: under-expanded stents don’t need another stent..they need better expansion
@GEICC3 @agtruesdell @mmamas1973 @evandrofilhobr @Hragy @DrAmirKaki @LAzzaliniMD @DKarmpaliotis @aspergian1 @djc795 @jl35wilsonMD @Babar_Basir @KateKearney4 @SrihariNaiduMD @sbrugaletta @KPujdak @TheNarulaSeries @DrJayMohan @KambisMashayek1 #TipForFIT
Complications happen:
-Key is to recognize & treat them
-Ask for help..2 pair of hands can be useful when patients crash & it makes you a better operator not worse
56F w multiple ASCVD RF
CP ⏩️ +ETT
Cath done for risk stratification prior to Hajj ⏩️ microvascular dysfunction
❓Recommendations
❓What’s the role of ETT in such cases
❓Would #YesCCT be the next step or invasive angio
On a side note: #TipForFIT minimal panning is preferred so set up the shot accordingly @Tesslagra @aspergian1
@nadia_sutton @sbrugaletta @HennesseyBreda @Dralkutshan @AlkashkariWail @O_Azizy_MD @Sultanotb @purviparwani @ChamsiPash
@riyaz_doc @abadkhan2002 @care4urheart2 @DrRajeshG1 @mmamas1973 @mailtarun07 @Biswaji83036474 @SareenSaab #TipForFIT - Key is prevention/anticipation:
1. Notice if pressure is dampening
2. Notice if it feels like your catheter is getting shorter
3. If in doubt pan up & see
4. Consider keeping a wire while torquing in a tortuous segment
@GilbertTangMD @M_Pompeu_Sa_MD @BaselRamlawiMD @PPibarot @TCTMD @djc795 @azeemlatib @dr_benoy_n_shah @Drroxmehran @didier_tchetche @KHERA_MD @TAVRBot #TCT2022
Congrats
@M_Pompeu_Sa_MD et al
💭Was dimensionless AR index used to quantify leak?
💭Simultaneous publication?
#EchoFirst #TipForFit @JGrapsa @hahn_rt @VDelgadoGarcia
(diastolic blood pressure - left ventricular end-diastolic pressure]/systolic blood pressure) × 100
@w_jyg @RadialFirstBot @BotPci @mornei2011 @evandrofilhobr @MGtberg @HadyLichaaMD @alaa_gabi @ANazmiCalik @Izanagi_no_mi_ @KPujdak @nyalborgesmd @Obisht @dimitri_zappi @APSIC6 Very educational case
#TipForFIT
-Recognition is the first step
-If🎈 tamponade fails, consider covered stent
-If suitable for coiling, then find delivery equipment
Article by @drnvanmieghem et al
@AHAScience
https://t.co/CMVGSTGaCh
@mornei2011 @LCathlab @foroepic @foroic @Obisht @AlcantaraCardio @brown_rye @jorgeachv @jsenior64 #TipForFIT
Study previous angiograms
Look at multiple orthogonal views
Ask for help
@DrRefai_Cardio #TipForFIT
..Tension on the wire helps avoid this loop in the Ao
..Tension ≠ Pull the wire ⚖️
@NosairMohamed Most r self limiting. Negotiate it gently & complete procedure..will seal by the end of the case
If the arm is swollen, elevate it & apply cold compression..usually sufficient
#TipForFIT
-don’t force a catheter
-listen to pt; pain is a sign (not always spasm)
-dilute contrast
@Dr_ShazaAlalawi Wow..nicely managed
#TipForFIT
-Keep an eye on the whole system during PCI ie guide catheter to wire tip
-Tacking up the entry point is critical in Ostial/Proximal dissections
@mirvatalasnag @AlexAchimMD @gabor_gt @stefan_harb @evandrofilhobr @mmamas1973 @dr_benoy_n_shah @MarcMadalin @w_jyg @skat_ct @drandrewsharp @DrNataliaP @kaschenke @jdinaus @PCRonline @Hragy #TipforFIT
Ostial CX is the grave of interventional cardiology
@mirvatalasnag @AlexAchimMD @gabor_gt @stefan_harb @evandrofilhobr @mmamas1973 @dr_benoy_n_shah @MarcMadalin @w_jyg @skat_ct @drandrewsharp @DrNataliaP @kaschenke @jdinaus @PCRonline @Hragy #TipforFit
If you see fluoroscopic calcium in both branches of LM please use upfront plaque modification preferably with expert operator on the table
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