Prashant Wankhade

Cardiologist

[Prashant Wankhade @prw0706]

@Hragy LM looks clean. As the patient is not willing for CABG, may plan ostial LAD stenting, preferably under IVUS guidance. RCA looks borderline, OMT.

[Prashant Wankhade @prw0706]

@DrRajeshG1 @ShariqShamimMD @mmamas1973 @abadkhan2002 Distal flow is good. I would prefer stress test to look if the territory is truely schemic. And above all this must be there since the CABG done, so is angina there since CABG or new onset?

[Prashant Wankhade @prw0706]

@jedicath @realarainmd @rickytiago @LAzzaliniMD @saraceciliamtz @mornei2011 @evandrofilhobr @dautov_MD @GLGasparini @agtruesdell Nice work. Can you please share the IVUS images/videos of CTO cap puncture. Thanks.

[Prashant Wankhade @prw0706]

@bhushanshah007 @DrRajeshG1 @cardiodoc1988 @ankitbusy @swatigar @JoySanyal74 Dr. Bhushan, kindly enlighten us.

[Prashant Wankhade @prw0706]

@radcliffeCARDIO https://t.co/AScTvBLikN

[Prashant Wankhade @prw0706]

@radcliffeCARDIO https://t.co/xA0NyS3tUM

[Prashant Wankhade @prw0706]

Anybody would like to use this technique for placement of aorto-ostial coronary stent, using goose-neck snare?

Other techniques available are,
1. Angiographic assisted
2. Sepal wire technique
3. Szabo technique
4. Ostial Pro stent positioning system

[Prashant Wankhade @prw0706]

@DrRajeshG1 Your posts are academic feast for all. When everyone is flashing their heroics especially in interventions, you are bringing out basics. People like you keeps the olden art of medicine alive. Keep it up.👍

[Prashant Wankhade @prw0706]

@DrRajeshG1 Yeah, once demonstrated clot with effusion in pericardium in MI patient, any thoughts behind LV angio?

[Prashant Wankhade @prw0706]

@DrWhyWho @djc795 @DrRajeshG1 @mmamas1973 How to know the duration of MI? Is it broadly since the onset of pain? Many a times, it’s a stuttering MI with onset of pain more than 72 hours and artery might be occluded 24 hours back. Or is it based on ECG changes (evolved MI)?

[Prashant Wankhade @prw0706]

@mmamas1973 @DrWhyWho @djc795 @DrRajeshG1 How to know the duration of MI? Is it broadly since the onset of pain? Many a times, it’s a stuttering MI with onset of pain more than 72 hours and artery might be occluded 24 hours back. Or is it based on ECG changes (evolved MI)?

[Prashant Wankhade @prw0706]

@DrRajeshG1 Would like to prefer in following sequence,
1. DEB at LAD and Diagonal
2. DEB at LAD only
3. Stent down from the septal ±POBA to Diagonal
4. OMT
5. Last, Bifurcation strategy (DK Crush) with a stent with good expansion capacity in LAD (few 2.5 mm stent can be expanded upto 4mm)

[Prashant Wankhade @prw0706]

@drvishalg @Obisht @ABH_IC_Fellows @Ascension_MI @DrZafarullahBr1 @Abi_sood @CathLabDigest @birbath62 I think we can use this technique to exchange unstable or inadequate supporting guide catheters (in the middle of procedure) in coronaries also. Eg. exchanging JR guide with AR.

[Prashant Wankhade @prw0706]

@DrDungTranHMU @Obisht Congratulations for the save. A query. How to keep the cut balloon stable over the stent while crossing till the coronary? Won’t it slip from the stent while crossing?

[Prashant Wankhade @prw0706]

@GabashaMD Sepal wire technique: As the wire doesn't take 90° bend from the ostium, the actual ostium is located a few millimeters away from the curvature of the wire from the guide to the aortic wall.

[Prashant Wankhade @prw0706]

Anybody would like to use this technique for placement of aorto-ostial coronary stent, using goose-neck snare?

Other techniques available are,
1. Angiographic assisted
2. Sepal wire technique
3. Szabo technique
4. Ostial Pro stent positioning system

[Prashant Wankhade @prw0706]

@cardiopandey @KPujdak @DrRajeshG1 @DrIHHashmi1 @DrAnkushG @jedicath @mmamas1973 Could have left procedure at this stage (post predilatation), good TIMI III flow, no visual significant narrowing, diffuse disease, and visual thrombus. Medical management with GP IIb/IIIa and anticoagulant should be enough.

[Prashant Wankhade @prw0706]

@DrRajeshG1 Short axis views from mid to apex can give better idea.

[Prashant Wankhade @prw0706]

@Sujathavip @mmamas1973 @aayshacader @ShrillaB @sabeedak1 @DrAnkushG @davidson_deepak @RameshDaggubati CABG will take care of both LAD and huge Ramus, so a better option in long term. Else DK crush with first stent at LAD ostium, crush and then second stent from LM to Ramus, leading to single layer of stent across the LCx ostium. Cullote will lead to double layer across LCx.

[Prashant Wankhade @prw0706]

@LKoliastasis @qdehempt Try this one👇🏼

https://t.co/IabzaLoY5y

[Prashant Wankhade @prw0706]

Anybody would like to use this technique for placement of aorto-ostial coronary stent, using goose-neck snare?

Other techniques available are,
1. Angiographic assisted
2. Sepal wire technique
3. Szabo technique
4. Ostial Pro stent positioning system

[Prashant Wankhade @prw0706]

What usually happens is, a famous celebrity gets a heart attack/cardiac arrest at a young age which results in mass fear and everyone worries about the heart and then commits themselves to a healthy lifestyle . Forget celebrities, they have dietitians, gym trainers, etc, etc.

[Prashant Wankhade @prw0706]

Notice the highlighted age of the patients, these are not celebrities but common people like us.
This is a list of patients who were treated for cardiac events/heart attacks at our heart center in the last few weeks, and this list is from just one heart center!