Thrilled to announce that I've secured a $3.3M NIH R01 grant! Our cutting-edge MRI methods will pinpoint who benefits from bypass vs. endo and tailor device selection. Thanks to
@JuditCsore
,
@AlanLumsdenMD
and everyone who made this possible!
I have spent 16 years as a
@UofT
student. Engineering, med school, phd and now finished
@UofTVascular
residency! I have finally accomplished a life long goal of becoming a surgeon scientist and NOW the learning really begins!
Officially my first day as a vascular surgeon-scientist
@DeBakeyCVedu
@HMethodistCV
(and this is my first office ever)! So grateful to start my career in such a historic and innovative centre!
#ILookLikeASurgeon
First mothers’ day came a little late! Meet Ryan Roy le Nobel, born May 15, 2023 at a whopping 8 lb 7 ounces! I guess everything really is bigger in Texas!
It’s official! My Katz Investigator plaque was installed in the Houston Methodist Research Institute yesterday! So grateful for this $1 mill endowment for peripheral artery disease research!
@AlanLumsdenMD
@DeBakeyCVedu
Every angioplasty causes dissections. We are happy w luminal gain and dismiss vessel wall damage. Can vessel prep help? Our early histologic results of orbital atherectomy is encouraging but bottom line: we need more histologic data!
@DeBakeyCVedu
So honoured to be named a Jerold B. Katz Investigator
@HMethodistCV
! This $1M Endowment ($50K/year + $500k cash) will support advanced imaging research to save limbs & lives! Thanks to
@AlanLumsdenMD
for support and mentorship. Can't wait to get started!
Tonight was a true highlight in my career. Feel so fortunate to be a Katz investigator
@HMAIChief
@DeBakeyCVedu
. I came from Toronto to Houston for this endowment, enabling groundbreaking vascular MRI and PAD device research. This is just the beginning!
@AlanLumsdenMD
T-8 days until
@Royal_College
exam (finally!!). Not sure how much of this is sinking in but at least I’ll have a collection of beautiful notes at the end of this!
Wrapped up my first day in OR as an attending with
@AlanLumsdenMD
@DeBakeyCVedu
@HMethodistCV
! Inari thrombectomy for phlegmasia and SMA pseudoaneurysm intervention with beautiful fusion imaging. This is only the beginning!
I hear this ALL the time from young, talented, and bright female medical students. Our field is missing out! I’m so happy to say that this medical student has decided to apply for vascular surgery after her rotation w us ( w Dr Werneck
@UofTVascular
). Mentorship matters!
When you inflate a balloon in BTK lesions - what do you *actually* do to the vessel wall? Does vessel prep and other devices help? Check out our publication on how we do device testing with advanced imaging and histology to find out!
@AlanLumsdenMD
@DeBakeyCVedu
Last case
@Sunnybrook
, open AAA (supraceliac clamp, renal implant x2) w my mentor
@AndrewDueckMD
who inspired me to become a vascular surgeon in this OR 10 years ago! Thank you to our nurses for supporting me along the way! Great way to end an amazing chapter of my life.
Officially a fellow of
@Royal_College
!!! Thanks to
@UofTVascular
@TL_Forbes
and all my mentors for helping me through this process. So grateful and proud to finally have FRCSC next to my name!!
Tomatoes are flying at me already, but can't argue w the histo! So far not much diff w IVL for BTK - recoil and dissections similar to POBA. Looks like debulking really matters for optimal results. The study continues!
@AlanLumsdenMD
@monteromiguel
@DeBakeyCVedu
Looking forward to giving a TED talk at this weekend retreat with
@RiceUniversity
Bioengineering
@MethodistHosp
scientists!
Why are doctors failing in the treatment of chronic limb threatening ischemia, and what can engineers do about it?
How often do we cross subintimally? We don't know! This vessel was crossed intraluminal and then into subintimal plane - we go in/out but can't see on angio. Poor result after 3 min inflation - is subintimal PVI truly equivalent to intraluminal?
@monteromiguel
@AlanLumsdenMD
This came in the mail today! For other graduates - "The Buck Stops Here" is an interesting panel discussion about becoming a vascular surgery attending:
@DeBakeyCVedu
. Any other recommendations for resources about transitioning to practice?
PAD is very heterogeneous, and we need better imaging to personalize treatments and improve outcomes. A snapshot of our histologic validation (and a very engaged mentor
@AlanLumsdenMD
who supports this work every step of the way!).
#CLIfighters
#surgeonscientist
@DeBakeyCVedu
Vasc limb preservation is a hard job w ++failure. This pt w art/ven wound was told amputation was the only option. With vasc + wound care he now has no pain, walks, lives a full life. Then I remember, being a vasc limb preservation specialist is truly the best job in the world!
Honored and grateful to be a recipient of the 2023 AHA Transformational Project award for 300k! Thank you so much for your unwavering support
@AlanLumsdenMD
and thanks to HMH CV and HMRI
@DeBakeyCVedu
@HMAIChief
. We will be hiring a post doc with the funds - come join us!
We all talk about the importance of IVUS sizing but HOW do you size? Cross section? IEL to IEL? “Effective” diameter? Are you sizing up? Are you consistent? Our paper explores vessel sizing
@AmputationSuck
@EricSecemskyMD
@AlanLumsdenMD
Excited to have received a $800k CIHR project grant w my supervisor G Wright
@Sunnybrook
to further develop our peripheral artery MRI techniques! Looking forward to working with our excellent team (T Forbes
@UofTVascular
@AndrewDueckMD
).
I was using 7T MRI for PAD plaque imaging, but now here
@HMethodistCV
I get to image with their 9.4T! Histologic detail without having to section the lesions. Enables PAD device testing to understand which devices are best suited for specific types of lesions.
#PrecisionMedicine
Last day with our graduating chief. Tarundeep Singh ended with an epic 11 cm open AAA/EVAR explant with the amazing
@AlanLumsdenMD
! What a spectacular final case for a spectacular graduating resident.
Interested in advanced imaging for below the knee arteries? Join one of our upcoming events (virtual and in person)! I'll discuss how MRI provides a new understanding of BTK lesion composition and why it matters for device selection.
#seeinginthedark
Finished late evening experiments with a fantastic team! Do vessel prep devices actually work in BTK lesions? We are finding out with a rigorous study involving advanced MRI plaque characterization, and histologic validation!
#personalizedmedicine
#translationalscience
Such an honor to present for
@AnahitaDua
and the PAD group
@MassGenBrigham
. Wonderful to see their multidisciplinary, innovative approaches and passion for limb preservation. Also got to see the etherdome OR where anesthesia first used and surgery began!
With a heavy heart, I just canceled my trip to
@VascularSVS
. Covid cases are rising exponentially in Houston and we are doing our part to keep each other safe. Hope to be there next year and will take part in the virtual experience until then!
Some hard, uncrossable lesions are invisible on imaging but high risk for endo failure - min calcium but ++ rock-hard dense collagen. We can use our MRI-histo method to differentiate these lesions and tailor CLTI tx.
@AlanLumsdenMD
@DeBakeyCVedu
This pic shows how the future of vascular surgery is so beautifully diverse. We are slowly becoming a specialty that reflects the patients we serve! The future of vascular surgery is bright!
@DeBakeyCVedu
High resolution imaging of the leg is feasible with clinical 7T MRI scanner! Calcium blooming w CTA obscures the lumen and lacks the soft tissue contrast for plaque characterization.
#SeeingInTheDark
#PAD
#Imaging
Wound care may not be glamorous, but it is an essential part of what we do as vascular surgeons! Good wound care changes lives. This is a quick video on how to apply a cellular tissue product and vacuum dressing.
@DeBakeyCVedu
@AlanLumsdenMD
Thank you
#ESVS2022
judges for scoring my fast track presentation today, and giving me the opportunity to present at a plenary session on 9/22! Can’t wait!
Thanks
@DeBakeyCVedu
for capturing this pic of me speaking at bootcamp! Very lucky to have your talented team (as opposed to my poorly lit live-tweeting pictures)! The stern expression is just because I take limb preservation very seriously :)!
Back to work after maternity leave! 💼🔬 Missing my little one, but stunning SEM images of paclitaxel on calcified PAD lesions offer a mesmerizing remedy.
@AlanLumsdenMD
Today
#GoogleDoodle
honours Dr. Jennie Trout, the first woman to become a licensed medical doctor in Canada (1875) and a champion for women in medicine.
#ILookLikeASurgeon
Honoured to take our newly minted PGY1 Jennifer Klopfenstein through her very first OR
@DeBakeyCVedu
w chief resident-extraordinaire
@rossgmcfall
! Welcome! We are so excited to have you join our team!
Looking forward to presenting our early work on using MRI to evaluate DVT clot characteristics to inform patient selection for Catheter directed tx. A new and exciting direction for our lab!
@VenousForum
@DeBakeyCVedu
@AlanLumsdenMD
Ryan sporting his star mitts and red, white, and blue wishing you and your family a happy July 4! He is the first and only US citizen in the Roy-le Nobel family!
Hot off the press! Our experience with vasc device design & development (bench, cadaver, imaging, CFD + more!). Robust device testing is essential to ensure txs are safe, effective and we understand the mechanism of action!
@AlanLumsdenMD
@monteromiguel
I was discouraged to go into vasc surg in med school if I “ever wanted to get married or be a mom one day”. There are many role models that show you can do both! I encourage talented women to consider surgery but find it is so difficult to counteract persistent stereotypes!
What barriers do female medical students face when considering surgery?
A new survey shows that female students receive significantly more discouragement based on gender, age, & family considerations than males.
#VisualAbstract
Busy weekend on call. With Covid seeing more DVT/PE. How to know who will benefit from CDT? We are developing MRI protocols to characterize clot and understand which patients will benefit most (like this PE patient who had a great result!)
It’s official - we moved to the USA! Completed the first leg of our 3 day road trip to Houston. Already missing our family, friends, babies, zorro and even local baristas and stores.
I have never lived outside of…
It's that time of year again! I first watched
@AlanLumsdenMD
@DeBakeyCVedu
address on YouTube and was so inspired I had to get on this rocket ship. Very grateful to now be a part of this "100-year start up" dedicated to innovation and improving the standard of CV care.
Unnecessary procedures in asymptomatic/claud are not justified. CLTI is more challenging w ~20% limb loss. High-risk pts require rigorous research. Though there may be some bias, this critique raises valid concerns paucity of evidence for PAD devices.
#Manels
are a problem. Mentors like
@TL_Forbes
are part of the solution. He steadfastly supports women in vascular surgery at all stages of their careers!
@UofTVascular
has become a more inclusive program under his leadership and I hope other organizations follow his example.
Last but not least, our graduating chief
@pghaddad
! No surprise that the whole dept comes out to commemorate their time w him. Wonderful clinician/innovator/surgeon/girl-dad/and all around great guy. You are so loved
@DeBakeyCVedu
@AlanLumsdenMD
and we’ll miss you!
@BavareMd
Thanks for the opportunity to talk about our work on PAD plaque characterization and device selection! Advanced imaging is key to personalized care.
@ISEVSonline
@AlanLumsdenMD
Prepping for
@vsb_abs
oral board exams. Missing our
@UofTVascular
Sunday school prep sessions with
@TL_Forbes
during our chief year! But at least still have this:
Convocation ceremony for PhD. So grateful for
@UofTSurgery
@UofTVascular
surgeon scientist training program which supported me to pursue this degree during my residency!
Great article by
@AuroraPryor
on factors influencing surgical specialty selection. Our gender biases reflected in specialties we recommend to men vs. women. 50% of surgeons said cardiovascular was for men only! Thoughts
@drnikkistamp
?
via
@medscape
Celebrating w our lab with high tea at Kiran’s restaurant! NIH R01 app submitted and welcoming our new post doc Judit Csore from Hungary! Very proud of the work we have submitted and excited for the year ahead!
@AlanLumsdenMD
@DeBakeyCVedu
Thrilled to visit
@AnahitaDua
and the incredible team at the MGH PAD center! Looking forward to diving deep into discussions on groundbreaking innovations in peripheral artery disease imaging and devices!
#PAD
#VascularSurgery
@AlanLumsdenMD
@AmputationSuck
delivers an engaging talk on “eureka” moments using IVUS for BTK interventions. When basing on Angio: we are under sizing, we have no idea when we are in the Subintimal plane, “30% residual stenosis” is grossly underestimated and IVUS changes your management!
Learn more about our research on new advanced imaging tools to personalize your PAD interventions. PAD lesions are heterogeneous and a “one-size-fits-all” strategy is failing them.
@DeBakeyCVedu
@AlanLumsdenMD
@monteromiguel
Calling South Asian Folks: Join us for an evening of delicious food, and important conversations about diabetes, CV and mental health. Let's break stigma and empower our community to prioritize health. Bring your aunties and uncles along for a night of learning and connection!
DUS showed long calcified AT total occlusion, but lesion easily crossed! Ghost lumens exist w patent channels to foot that we can't see, not even on angio. 7T MRI = ghost lumens, plaque, DVTs + nerves in detail we've never seen before. Lets understand PVD better!
@AlanLumsdenMD
Capping off my last day in Halifax in the OR w Dr. Casey. Thank you for a wonderful experience and incredible open and endo aortic cases! I have been converted, retroperitoneal exposure for open AAA is the way to go (in most cases)!
One view is no view! VIDIO trial updates on importance of IVUS vs venography. But when sizing stents, important to do DYNAMIC imaging - IVUS with and without Valsalva maneuvers, take deep breaths, position etc to make sure the stenosis is real
#philipseliitevascularsummit
Shout out and a huge thank you to
@MethodistHosp
@DeBakeyCVedu
super star residents. I feel so fortunate to work with all of you incl.
@MujeebZubair
(more of you need to be on Twitter tho!!)
Wow what a way to welcome new members!
@SouthernVasc
presents each new member and gives them ribbons so that others will know who they are to welcome them. Haven’t seen that at other societies yet.
@AlanLumsdenMD
- need to get application in for next year!
Happy 1st bday Ryan! At the
@VascularSVS
VRIC meeting today and so excited for your special day. Being a mom has brought new perspective to my work, being a surgeon-scientist hones my problem solving, curiosity and innovation as a mom.