Micah Girotti

Husband, father, Baltimore vascular surgeon @VSA_LLC by way of @MedicineUVA, @UMichSurgery, & @NMCardioVasc

[Micah Girotti @micahfungin]

@GAEscobarMD @UHVascular @canuc_57 Reminds me of the institutional variation in ABF vs AFB….i think it’s about 50/50 on that one

[Micah Girotti @micahfungin]

@AustinBourgeois Nice result!

[Micah Girotti @micahfungin]

@jmills1955 Beautiful sanctuary

[Micah Girotti @micahfungin]

@drcostantino1 @jmills1955 @monteromiguel @AmputationSuck @Watts_IR @SDhandMD @Flendovasc Had a similar situation a few years ago with a patent stented SFA in a BKA which stenosed and they developed a wound for several months. Angioplasty to maintain patency healed it quickly. Lots of distal stump collaterals. I’m not sure how long this SFA will stay open though.

[Micah Girotti @micahfungin]

@canuc_57 @farkomd Theoretically yes. Unless total emergency though we have 3 of the 8 that we transfer to at night and on weekends. We have a backup system that gets used if 2 operative emergencies occur simultaneously.

[Micah Girotti @micahfungin]

@Kniery_Bird @ProleneQueen No. However - years after BKA in pts who have maintained SFA patency, then had progressive SFA disease with wide open PFA, and formed arterial ulcers on their stump, have healed their wounds with SFA plasty alone. I’ve seen 2 in about 10 years.

[Real Doc Speaks @realdocspeaks]

This is the truth. There are so many useless people in a health system.

I was part of an eight-physician group with a great manager and employees.

We had no employees that had a vague job description.

Everyone was focused on the needs of the patient.

We provided the services and hours that our patients needed.

[Micah Girotti @micahfungin]

@DHidlayVIR @MPrinceMD I’ve tried this a few times and every time the physician on the other end says they’re “not allowed to give out that information” - so frustrating.

[Micah Girotti @micahfungin]

@kush_r_desai @VarenyamVasc @robshahverdyan Completely agree with all above - my main question is if the presence of pacer wires themselves changes your algorithm compared to the same clinical central venous disease from old catheter scarring, TOS, or whatever.

[Micah Girotti @micahfungin]

@DevinZarkowsky @AmputationSuck @kmadass @ReneLizola @DrLizGenovese @jmills1955 @farkomd @roblookstein Could see it both ways—perf in the middle of a long CTO likely completely benign. Vs, I had to do calf fasciotomies on a case done elsewhere - SFA/pop was widely patent down to a flush TPT occlusion which was perfed by wire during an angio earlier in the day. Pulsatile pinhole…

[Micah Girotti @micahfungin]

@AmputationSuck @DevinZarkowsky @kmadass @ReneLizola @DrLizGenovese @jmills1955 @farkomd @roblookstein I’m sure they happen often subclinically. This was at time of bypass 24 hrs after attempted crossing of pop occlusion w appearance similar to original pic with back end of floppy. Small intracompartment hematoma. It’s not benign.

[Micah Girotti @micahfungin]

@farkomd That was one of a couple questions that seemed more “advertisements” for particular pieces of literature than anything related to actual practice/MOC value.

[Micah Girotti @micahfungin]

@Dr_Sudi @SiemensHealth @BeckersHR @OEISociety Is this available online to listen to? I’d be very interested.

[Micah Girotti @micahfungin]

@NAngle007 @farkomd Same - rarely. Did first one in a couple years last week for B CIA aneurysms with occluded hypos. IMA —>middle sacral—>hypos and large lumbars

[Micah Girotti @micahfungin]

@farkomd Supervised eating program?

[Micah Girotti @micahfungin]

@farkomd @NavyashGupta @MeganTracci Have seen 3 in last 6 years, 1 each of CFA, PFA, and SFA, all related to blunt handlebar trauma, two acute, one remote. Left the PFA alone.