Cain

Assistant professor of Vascular & Interventional Radiology at @MUSCVIR. @yale_IR alum. Opinions are my own.

[Cain @IR_Cain]

@HardenedBeam @NiuSanford FYI: their VP of medical affairs is a Rad Onc, and there are many people in the IR space that actively push against the unproven treatment of histotripsy.

[Cain @IR_Cain]

@JuliusChapiro @MSKCancerCenter @cvironco @SIRspecialists @SIO_Central @ECIOcongress @AASLDtweets @EASLnews @ASCOPost @AACR @myESMO @RSNA @theNCI Correct me if I’m wrong, but this was the most accurate synopsis of Histotripsy data I could find:
https://t.co/MIrNMC0vqO

[Cain @IR_Cain]

@t_intheleadcoat @SIRRFS @kmadass @keithppereira @SDhandMD @IRKhalsa @IR_Doctor Loop snare around the external part of the catheter and loosely cinch it down. Ride the snare side by side the retrograde PCNU up into the collecting system. Advance the snare forward to disengage from the stent and remove the snare. Use the snare catheter for new wire access.

[Cain @IR_Cain]

@IR_Doctor @drcostantino1 Why not dominate the revenue cycle and the bicycle?

[Cain @IR_Cain]

@JuliusChapiro Great teaching case and a helpful lesson to anyone doing Y90! Also important to note that the Tc99MAA complex degrades with time, so longer delays between MAA admin and SPECT scans will lead to more free Tc artifacts and artificially elevated lung shunt fractions.

[Cain @IR_Cain]

Even more interesting when you superimpose the trend line for U.S. healthcare spending…and you can see where the money goes. Spoiler alert: it’s not to physicians, nurses, or other clinical healthcare workers.

[Julius Chapiro @JuliusChapiro]

No comment. Just take it in.

[Cain @IR_Cain]

No recurrence of bile leak after stent removal and continued postoperative improvement. Covered biliary stents can be an excellent alternative to external drains in select patient populations, particularly in centers with access to advanced GI docs for future removal.

[Cain @IR_Cain]

Postop biliary leak s/p endoscopic diversion sent to VIR for PTC. Managed with covered stent placement. Patient discharged without a drain and had stents endoscopically removed 10 weeks later with resolution of bile leak and no further issues. #IRad #interventionalradiology

[Cain @IR_Cain]

Percutaneous access was then closed with a plug and gelfoam in the trans-hepatic tract. Patient returned 10 weeks later for endoscopic removal

[Cain @IR_Cain]

While this case certainly could have been done without embolization guidance software, it was a useful adjunct to decrease the time (and radiation) spent searching for additional branches during the mapping procedure.

[Cain @IR_Cain]

Here was a nice case showing the clinical benefit of embolization guidance software to assist in finding small tumoral feeding vessels.

#irad #IR #y90 #radiology #cancer

[Cain @IR_Cain]

Embolization guidance software was extremely helpful in finding the posterior tumoral branch which was very faint on angiography due to preferential flow through the parent vessel (due to the posterior tumor branch arising at an acute angle off its parent vessel.

[Cain @IR_Cain]

@yoursimmo @grok can you verify these claims?