Mini-tweetorial on Shockwave MOA
1\ 3 types of lithotripsy
1)Extracorporeal (ESWL) – break kidney stones from the outside
2)Intracorpoeal (ISWL) – break kidney stones from the inside
3)Intravascular (IVL) – fracture calcium in the vasculature from the inside
#ILUMIENIV
@
#HOTLINE
#ESC2023
Take home
•OCT resulted in larger MSA than angio with greater stent expansion
•OCT led to fewer major dissections, malapposition, tissue protrusion and untreated focal reference disease
•OCT reduced angiographic complications
1/18
Time for a unified physician voice. Join
@PaulTeirstein
and I who have launched . Every member will vote on every issue. There are no delegates, no representatives, no “board”, and every $ tracked. Its free and takes 15 secs to signup.
#unitedphysicians
To all the Dads, forget the sheaths, catheters, balloons, stents, clips and scaffolds for one day and enjoy time being a father. Happy Father’s Day to you all. I’m going for ice cream with my girls 😊.
This is THE event for imaging and physiology. 3 live cases (CMD, OCT guided calcification mx, Syncvision PCI) didactics, debates and more from
@StFrancis_LI
. Free! Check out the cast. Register here:
Not even the snow stopped us! Here's a recap of OPCI Fellows 2022: Imaging & Physiology Boot Camp that took place last weekend. Thanks to all of the Faculty, Fellows, and Industry that attended the event. Can't wait until next year!
This is an amazing opportunity for
#ACCFIT
. Hands on, completely practical physiology and imaging training with the masters. Even better it’s free. The only thing fellows spend is time.
@DrAllenJ
@ESHLOF
@djc795
@JWMoses
Happy Father’s Day. I’m shelfing the wires, sheaths, catheters balloons, stents, databases, analyses, submissions, revisions and all that other stuff. Today is a day to enjoy being a dad to my two angels.
Consequences to incomplete revasc in LMPCI? From EXCEL, leaving a residual jeop score >4 is BAD, and most importantly, leaving >70%DS in the Cx has a 3-fold hazard of Death/MI. So for all the provisionalists, respect the Cx!
@GreggWStone
@MinaMadanMD
We should all show our immense gratitude to
@ajaykirtane
, M Parikh,
@sahilparikhmd
for the immense amount of work they put into making this a successful
#CRFfellows2019
. These are passionate people, but I have never seen more. Also impossible without
@crfheart
logistical team!
My favorite day of the year! As much as it’s supposed to be a day to be pampered for all the things we do as fathers, it’s actually a day to reflect on how lucky we are. No
#IC
today , instead “daddy pancakes”, swimming, park, slides, and Thai for my girls. Happy Father’s Day!
1/Mini-Tweetorial on which test when.
@StFrancis_LI
@DeMatteisCVI
@crfheart
@ColumbiaCardio
This case - typical chest pain.
Strategy?
1) Stent it
2) Non-hyperemic invasive physiology
3) Hyperemic invasive physiology
4) Intravascular Imaging
5) Medical therapy
1-I don’t normally do this on twitter but here goes...
My family are dual citizens of the US and the UK. My parents, who are now elderly, CHOOSE to live in the UK because of the
#NHS
even though both their kids live in the USA and both are physicians. This week I saw exactly why
1/ COMBINE (OCT–FFR): Using OCT in DM to detect risk
FFR negative lesions, according to contemporary trial data, are very low risk for subsequent events. BUT...DM patients are a unique entity. What if we could use OCT, with its incredible resolution, to identify high risk - TCFA.
We were open about the faults on Ultreon 1.0. Credit to Abbott to come to its core users and to a redesign iteration. 2.0 is fantastic. Wait til you see the new features. Can’t wait to show you it live!
📣Exciting news for
#imagefirst
.
@StFrancis_LI
Hospital, NY was 1⃣ to experience the power of Ultreon 2.0 Software & AI for
#OCTimaging
.
“This is a game changer & brings PCI Optimization to a new level!” – Dr. Richard Shlofmitz
More to come!
Safety Info:
Every Fellow should graduate with experience in intravascular imaging and physiology but only 20% can do it independently. Complimentary registration for Fellows plus assistance with lodging! Register here . See you on March 8 and 9th.
#OPCI
#CRF
Hands on, completely practical physiology and imaging training with the masters. Due to demand we are expanding to accommodate up to 50 more fellows. Expenses covered by
@StFrancis_LI
. Apply now , there are very few spots left.
@DrAllenJ
@ESHLOF
@djc795
#CIT2019
at the annual dinner CRF-CIT Beijing
@GreggWStone
“no one exceptional is controllable.” The most inspirational and impactful words I have heard in my career as an IC.
First 3-vessel OCT imaging study publ in JACC w/long-term FU showing OCT can identify vulnerable plaques with strong discrimination. Our editorial on whether inv imaging (OCT, NIRS-IVUS, RF-IVUS) can detect VP: "Case Closed"! There are now at least 10 good studies!
@ziadalinyc
Big bro being humble. I’ll say it how it is. You pushed CT to the top of that list. You pushed the boundaries, thought outside the box, brought a new European perspective. You ignored prevailing dogma. You saved many many lives. Brilliant surgeon ALWAYS puts
#patientsfirst
.
In 2019 heart transplants were performed at a higher rate in Connecticut (19.5 per million population) than any other state in the U.S.A. For years CT residents traveled out of state seeking access to heart transplants. Now we welcome those in need from surrounding regions.
1/Let’s get cracking – DISRUPT CAD III
@deankeriakes
Disclosure: I have equity from Shockwave from when it started in 2010.
Calcium is still a pain in the cath lab. IVL is a new tech which uses acoustic pulses to fracture Coronary Ca and improve vascular compliance.
So, as the dust settles, what happens to nuclear cardiology for stable CAD? What is the value of knowing the burden of ischemia?
#CTfirst
? CMS didn’t waste time to implement the cuts to CT. Anatomy or physiology? Confused but excited to see how this will impact cardiology for CAD
While we await the results of OCT-guided PCI in the ILUMIEN-IV trial, which will be presented by
@ziadalinyc
next Sunday at
#ESCCongress
, it is a good time to review the study design and rationale, which
@EuroInterventio
published in 2021.
If you are a fellow you would be crazy to miss this. I love Bill, Rhian and Jeff but George Adams is a maniac! I would pay to have that guy teach me Endo. Sign up. It’s free, it’s on a beach in LA and George is bringing a c-arm to the beach.
Are you currently enrolled in a Fellowship Program for Advanced Cardiovascular, CHIP, Endovascular, Interventional Cardiology or Structural Heart? Submit a request to attend the
#ShockwaveIVL
Fellowship Forum led by esteemed faculty on November 3-4 to learn personally from the
4- I lived in both systems. Both have their pro’s and con’s BUT access to care should never be an issue. So...with all the taxes we pay, and all the fighting we do to keep them down, this part I’m willing to pay for.
#healthiswealth
#NHS
#Obamacare
Very reassuring real world results
@csi360
. We're "chipping" away at CAC. Follow the algorithm. I'll go through step-by-step what to use when and why
@OptimaCTO
Optimal Online 2020 4, 5, 11, 12 Nov 2020. Register at .
@ESHLOF
@jcspratt
@crfheart
@agtruesdell
1 small suggestion for safety - perform access site angio through dilator of the MP sheath. That way you aren’t committed if stick is high. If high leave the dilator and wire in and restick below. Pull high stick gear when Impella sheath goes in and it tamponades the 2F hole.
In contemporary
#PCI
, rate of post-procedure AKI was 6.5% & associated w/ worse 2-yr outcomes. Predictors of post-PCI AKI included older age, ♀️ sex, CHF,
#diabetes
, HTN,
#CKD
,
#STEMI
, radial access, hypotension, IABP use & # of stents.
#JACCINT
Dispelling the Nodular Myth that “atherectomy is the ideal tool for modifying nodular calcium," the new
@JACCJournals
pub by Dr.
@ziadalinyc
et al. shows that
#ShockwaveIVL
can safely and effectively modify nodular calcium:
ISI
"Outcomes of OCT compared with intravascular ultrasound and with angiography to guide coronary stent implantation: one-year results from the ILUMIEN III: OPTIMIZE PCI trial" by
@ziadalinyc
@MaeharaAkiko
@GreggWStone
et al.
#EAPCI
In the spirit of
#OCTober
#imagefirst
on your OCT systems under settings,under lumen profile, please turn on the following settings. It’s the only way to automatically calculate your expansion!
1/5 Today I got the news that I passed my
#echo
boards 🙏🏻 This one is very special for me, hence I’m sharing it on social media. My mother who was a brilliant cardiologist didn’t have the opportunity to pursue medical training in the U.S after she’d graduated med school in Syria.
#IC
don’t miss the boat. CT is the future of interventional cardiology, but not only for structural! Learn to read and strategize and optimize your PCI by CT, step-by-step. Finally CT from the ICs eyes.
#MLDMAX
Honestly, I didn’t have time to read through the whole revasc guidelines.
@HollandTamis
did an amazing job summarizing them at a clinically relevant level. Get with the guidelines in 20 mins!
Join United Physicians, a new coalition of physicians fighting for goals common to ALL physicians (PPE, payment for scribes/pre-authorization etc). Physician leaders are unpaid. Free, takes 30 seconds.
@EricTopol
@gabrieldane
@CMichaelGibson
@ziadalinyc
@rwyeh
@duanepinto
@mohsincMD
That’s why.
#FFRfriends
. If you SB pinch and are FFR +, undersized 0.7:1 balloon inflation rescues 92% of lesions acutely with normalization of FFr and no change at 8 months follow-up.
DEFINE PCI – 1 year
@Ajeremias
@manesh_patelMD
@jerd10
showed in DEFINEPCI that we miss angiographically INVISIBLE ischemia in ≈25% of patients. Of those 80% are focal lesions, split in 1/3s prox-, in- and distal to the stent.