Discover and read the best of Twitter Threads about #iRad
Most recents (24)
PICC line 🧵 #medicine
1/
A central device (i.e in the SVC) placed via a peripheral venous access
.
#irad #vascular #MedTwitter #FOAMed #hematology #Tweetorials @nihardesai7 @MedTweetorials #Cardiology #MedEd #oncology #internalmedicine @BrownJHM #MedStudentTwitter #cardiotwitter
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A central device (i.e in the SVC) placed via a peripheral venous access
.
#irad #vascular #MedTwitter #FOAMed #hematology #Tweetorials @nihardesai7 @MedTweetorials #Cardiology #MedEd #oncology #internalmedicine @BrownJHM #MedStudentTwitter #cardiotwitter
2/
Classically placed in the arm
May be placed in the leg (eg in #pediatrics /neonates – which may then terminate in the infrarenal IVC/iliacs)
.
#criticalcare #cardiovascular
Classically placed in the arm
May be placed in the leg (eg in #pediatrics /neonates – which may then terminate in the infrarenal IVC/iliacs)
.
#criticalcare #cardiovascular
3/
Advantages:
- Lower infection rate then central lines
- Used in the outpatient setting
- Can be used for several weeks to months
- Duration of PICC lines may be from 4 weeks to 6 months
(although they have been known to be functional for more than 300 days)
Advantages:
- Lower infection rate then central lines
- Used in the outpatient setting
- Can be used for several weeks to months
- Duration of PICC lines may be from 4 weeks to 6 months
(although they have been known to be functional for more than 300 days)
Check out this starter kit on Adrenal Vein Sampling created by MSC Reserves, Alperen Elek (@ElekAlperen), Lulu Zhang, MD, and Tina Chatterje ( @tinachatterje3)! #iRad #meded #radiology #interventionalradiology #radres #iradres
PA symptoms can range from fatigue to joint pain. Keep an eye out for these signs and consider PA as a potential cause.
Discover the fascinating anatomy of the adrenal glands - small but powerful glands located above the kidneys that play a crucial role in regulating hormones and the body's response to stress.
Recently, the cumulative stresses of #iRad work reached a fever pitch, & I began itching for some adventure. I planned out a 150 mile (240 km) route from Denver into the mountains to camp. I asked around, but no one else could go, so it became my first solo #bikepacking trip.
But first! I would have to pack. And I'm a VERY slow packer for these trips. There's a LOT to put on a bike for a trip like this. Bags on the frame, handlebar, fork, seat, top top, etc. I calculated I needed to carry 2.5 L of H2O and planned to filter river water several times.
I slept restlessly the night before with thoughts of mountain lions, bears, thirst, mechanicals, and mountain rain storms battling my need for a good night's rest. I left later than expected, around 0900 am and got on the trail, a nice tailwind lifting my high spirits higher.
Follow along to learn about partial splenic artery embolization!
@albertolp2097 @DLKVIR @michaeljrepajic
#TwittIR #IR #SIR #VIR #MedTwitter #MedStudentTwitter #RadTwitter #IRad #MedEd #FOAMRad
@albertolp2097 @DLKVIR @michaeljrepajic
#TwittIR #IR #SIR #VIR #MedTwitter #MedStudentTwitter #RadTwitter #IRad #MedEd #FOAMRad
The spleen constitutes an important part of body's immune system and is highly vascular organ. Due to its location is one of the most affected organ in blunt abdominal trauma. The goal of pSAE is to decrease perfusion pressure to promote hemostasis and preserve splenic function
Splenic artery embolization (SAE) may be performed in the presence of abdominal trauma involving the spleen and non-traumatic pathologies such as hypersplenism, portal HT, and visceral aneurysms.
1/ #Tweetorial Part 2- Now its time to talk about….
CHRONIC
C-L-O-T
#VTE #DVT #Thrombectomy #Lytics #Cardiotwitter #IRAD #Medthread #Clot @CardioBot @RadialFirstBot @BotPci @EPeeps_Bot @TAVRBot @MedTweetorials @UjjwalRastogiMD @Umair2017 @Umair2017 @VenuVadlamudiMD
CHRONIC
C-L-O-T
#VTE #DVT #Thrombectomy #Lytics #Cardiotwitter #IRAD #Medthread #Clot @CardioBot @RadialFirstBot @BotPci @EPeeps_Bot @TAVRBot @MedTweetorials @UjjwalRastogiMD @Umair2017 @Umair2017 @VenuVadlamudiMD
2/ How much time does it take for #ChronicClot to START to form?
#Fellowstwitter #fellows #fellowtwitter #medtwitter #Clottwitter #VTE @MedTweetorials @CardioBot #Tweetorial #Meded @GAEscobarMD @ekgpdx @HeartOTXHeartMD @EM_RESUS @Pooh_Velagapudi @Vascupedia_com @Dr_Bowser
#Fellowstwitter #fellows #fellowtwitter #medtwitter #Clottwitter #VTE @MedTweetorials @CardioBot #Tweetorial #Meded @GAEscobarMD @ekgpdx @HeartOTXHeartMD @EM_RESUS @Pooh_Velagapudi @Vascupedia_com @Dr_Bowser
Thromboembolic disease has defined the last year for our practice. #COVID has given us the time and unfortunately the patients to refine our interventional strategies. I get asked from time to time to describe the steps involved in a basic #PE case. So here goes....(thread)
(I'll cover concepts in patient selection another time). This illustrative case is a mid 50-s male with acute onset dyspnea 3 weeks after testing positive for #COVID19. No syncope, no pertinent medical history. OSa in the low 80s on RA. HR 115. RV:LV Ratio ~1.5 #iRad (1/ )
CTA shows bilateral, predominantly lobar distribution PE. Probably a small evolving infarct in the left lower lobe. (2/ )
1/ Welcome to the first part of a #Tweetorial series on #VenousDisease.
🩸To begin how about we talk about the main player in the game- C.L.O.T. (and why you should care about it)
#Cardiotwitter #Irad #fellows #fellowtwitter #medthread #clot #medtwitter #clottwitter
🩸To begin how about we talk about the main player in the game- C.L.O.T. (and why you should care about it)
#Cardiotwitter #Irad #fellows #fellowtwitter #medthread #clot #medtwitter #clottwitter
2/ But first a question- Is there a difference between arterial and venous clot??
#Clot #cardiology #DVT #irad #VenousDisease #medthread #tweetorial #fellows @HadyLichaaMD @VladLakhter @agtruesdell @AntoniousAttall @TheNarulaSeries @t_intheleadcoat @ShariqShamimMD
#Clot #cardiology #DVT #irad #VenousDisease #medthread #tweetorial #fellows @HadyLichaaMD @VladLakhter @agtruesdell @AntoniousAttall @TheNarulaSeries @t_intheleadcoat @ShariqShamimMD
3/ All clots ARE NOT born equally! There is a difference!
1/ NAME THAT #COMPRESSIONSYNDROME
Patient with left flank pain, pelvic pain, hematuria and gonadal varices
Your only imaging modality is vascular U/S....Lets find out!
A Mohan #Tweetorial
#RPVI #cardiotwitter #irad #vascular @HadyLichaaMD @t_intheleadcoat @TheNarulaSeries
Patient with left flank pain, pelvic pain, hematuria and gonadal varices
Your only imaging modality is vascular U/S....Lets find out!
A Mohan #Tweetorial
#RPVI #cardiotwitter #irad #vascular @HadyLichaaMD @t_intheleadcoat @TheNarulaSeries
2/ What’s going on here?? First name your structures #RPVI
SMA- superior mesenteric artery
AO- Descending Aorta
Lt renal VN- left renal vein
@CHICKVIR @Jonathan_PaulMD @iRadRock @keithppereira @Vascupedia_com @DrYanLiu
SMA- superior mesenteric artery
AO- Descending Aorta
Lt renal VN- left renal vein
@CHICKVIR @Jonathan_PaulMD @iRadRock @keithppereira @Vascupedia_com @DrYanLiu
3/ Save this- transverse slice at the level of the renals! So much anatomy in such a confined space
#RPVI #cardiotwitter #IRAD #Vascular #foamed #cardioed #cardiology #ultrasound #pocus
#RPVI #cardiotwitter #IRAD #Vascular #foamed #cardioed #cardiology #ultrasound #pocus
Did you adequately numb the peritoneum for your paracentesis?
If it looks like this then yes! Yes, you did. Congratulations. Your patient thanks you (and may ask for you by name next time!)
#ultrasound #irad #MedTwitter #MedEd #POCUS
If it looks like this then yes! Yes, you did. Congratulations. Your patient thanks you (and may ask for you by name next time!)
#ultrasound #irad #MedTwitter #MedEd #POCUS
For any intra abdominal needle passage, pain crossing the skin and peritoneum (sometimes muscles too) are worst. The 25G lido needle isn't too bad, but if you try to pass a 5 French without good local anesthesia, they're going to feel it.
Paracentesis is a great procedure for learning US/needle skills. Make sure you 👀your needle tip OVERLYING the deepest, echogenic, anterior abdominal wall layer and numb, numb, numb. If that layer pushes away from you, chase it with your needle!
Kicking off multidisciplinary Research Consensus Panel (RCP) to finally investigate the ❓: what is the optimal medical therapy (OMT) following venous recan? Follow #VenousRCP throughout the day to learn more and contribute! #SIRFoundation @SIRRFS @SIR_ECS @JVIRmedia
🔴 Pathophysiology of venous thromboembolism #VTE
🟠Venous recanalization & stenting
🟡The mystery of medical therapy following recanalization
🟢Patency & outcome measures
🔵Economics & cost-effectiveness of treatment
🟣Future directions
#VenousRCP
🟠Venous recanalization & stenting
🟡The mystery of medical therapy following recanalization
🟢Patency & outcome measures
🔵Economics & cost-effectiveness of treatment
🟣Future directions
#VenousRCP
🔴 ✅#VTE affects ~100 of every 100,000 people yearly in the US
✅Incidence of VTE ⬆️⬆️ exponentially with age, especially after 40
✅#Endovascular recan is a common tx; post-tx algorithms vary widely
✅More #epidemiology info @CircAHA bit.ly/37IptZh
@Pertconsortium
✅Incidence of VTE ⬆️⬆️ exponentially with age, especially after 40
✅#Endovascular recan is a common tx; post-tx algorithms vary widely
✅More #epidemiology info @CircAHA bit.ly/37IptZh
@Pertconsortium
We are pleased to introduce the first in a series of IR Procedure “Starter Kits.” These are very basic visual overviews of common procedures designed by the RFS for IR trainees. #SIRRFS #twittIR #IRad #OncoRad #RadRes #futurerads
𝗧𝗿𝗮𝗻𝘀𝗵𝗲𝗽𝗮𝘁𝗶𝗰 𝗮𝗿𝘁𝗲𝗿𝗶𝗮𝗹 𝗰𝗵𝗲𝗺𝗼𝗲𝗺𝗯𝗼𝗹𝗶𝘇𝗮𝘁𝗶𝗼𝗻 (𝗧𝗔𝗖𝗘) is a procedure that involves intra-arterial administration of chemotherapy, followed by an embolic agent, in order to induce necrosis of liver malignancy.
TACE is used as locoregional therapy for liver malignancies, both primary and metastatic. Listed here are the indications and contraindications of TACE.
1
Sharing our invited review: Transjugular intrahepatic portosystemic shunt (TIPS) in #cirrhosis/World #Journal of #Gastroenterology. @SRajesh_IR helms 24-page colossus discussing exhaustively recent studies #livertwitter #MedTwitter #irad #GITwitter
Full: bit.ly/3ib7Frp
Sharing our invited review: Transjugular intrahepatic portosystemic shunt (TIPS) in #cirrhosis/World #Journal of #Gastroenterology. @SRajesh_IR helms 24-page colossus discussing exhaustively recent studies #livertwitter #MedTwitter #irad #GITwitter
Full: bit.ly/3ib7Frp
2
Topics we discuss include - variceal bleeding (incl ectopic), #ascites & #hydrothorax (incl chylous), #complications, new techniques, #stent size dilemma & extensive point of care algorithmic approaches in portal hypertension complications, eg: esophageal #variceal bleeding 👇
Topics we discuss include - variceal bleeding (incl ectopic), #ascites & #hydrothorax (incl chylous), #complications, new techniques, #stent size dilemma & extensive point of care algorithmic approaches in portal hypertension complications, eg: esophageal #variceal bleeding 👇
#livertwitter #irad #MedEd #MedTwitter
Large tortuous paraumbilical vein shunt in #patient with #Cirrhosis and #portalhypertension. @SRajesh_IR 👌
1/3
Large tortuous paraumbilical vein shunt in #patient with #Cirrhosis and #portalhypertension. @SRajesh_IR 👌
1/3
Post coil (CARTO) and glue, complete disappearance of shunt ✌️
#phtsig #radiology #MedStudentTwitter
2/3
#phtsig #radiology #MedStudentTwitter
2/3
#Tipss #procedure performed along with shunt occlusion, for recurrent #ascites 3/3
Complete resolution of portal hypertension complications 💯🎯
Complete resolution of portal hypertension complications 💯🎯
Orthopedic pre-op embo, transradial axillary flush arteriogram before next day reverse total shoulder arthroplasty. Catheter selection, embolic selection, outcome images to follow:
What is your preferred embolic in this case? Feel free to elaborate below! #IRad #IR #IO #OrthoIR #PalliativeIR #Embolization
(1/22) Acute PE treatment. An ever evolving landscape.
How about a #tweetorial on acute pulmonary embolism (#PE) and how to use mechanical #thombectomy with @InariMedical #FlowTriever?? Lets goooooo!
#InariFellowsEdition #IRad #IC #cardiotwitter
Pic credit @Jonathan_PaulMD
How about a #tweetorial on acute pulmonary embolism (#PE) and how to use mechanical #thombectomy with @InariMedical #FlowTriever?? Lets goooooo!
#InariFellowsEdition #IRad #IC #cardiotwitter
Pic credit @Jonathan_PaulMD
2/ From @CDCgov data one American dies of a blood clot every....? #VTE #PE @PERTConsortium #InariFellowsForum
3/ Acute #PE stats
📊100,000–180,000 PE-related deaths annually in US
📊PE is the most preventable cause of death among hospitalized patients
📊3rd leading cardiovascular cause of death after coronary disease and stroke
⏱ 1 American dies of a blood clot every 6 seconds
📊100,000–180,000 PE-related deaths annually in US
📊PE is the most preventable cause of death among hospitalized patients
📊3rd leading cardiovascular cause of death after coronary disease and stroke
⏱ 1 American dies of a blood clot every 6 seconds
#livertwitter #irad
For patients with #cirrhosis without #liver failure, we believe in early and aggressive #treatment for #portal hypertension (increased liver pressure) with #TIPS and also knockout all big parasitic #shunts (done here with a plug) 1/3
@SRajesh_IR is 💯 on it
For patients with #cirrhosis without #liver failure, we believe in early and aggressive #treatment for #portal hypertension (increased liver pressure) with #TIPS and also knockout all big parasitic #shunts (done here with a plug) 1/3
@SRajesh_IR is 💯 on it
The #satisfaction of seeing those large bunch of #bleeding and #encephalopathy source #disappear is quite nice!
#MedTwitter #Medical #medicine
#MedicalStudent #MedEd
@SIRRFS 2/3
#MedTwitter #Medical #medicine
#MedicalStudent #MedEd
@SIRRFS 2/3
In due course, we see the #spleen size reduce, as portal #hypertension comes under #control
Has anyone else noticed the dynamics of spleen post TIPS and its relevance? @keithppereira @CHICKVIR @SIRspecialists #radiology #aasld #easl #apasl
3/3
Has anyone else noticed the dynamics of spleen post TIPS and its relevance? @keithppereira @CHICKVIR @SIRspecialists #radiology #aasld #easl #apasl
3/3
#crazy Useless #patient
1/n
Middle-aged man, loves his #family, #farming, drives a cab, #happy. Son & wife at #home. Father-son relationship strong as rock. One #morning, son finds father mumbling to self. Mother says he hardly slept
Mumbling becomes angry ramblings. #Clinical
1/n
Middle-aged man, loves his #family, #farming, drives a cab, #happy. Son & wife at #home. Father-son relationship strong as rock. One #morning, son finds father mumbling to self. Mother says he hardly slept
Mumbling becomes angry ramblings. #Clinical
2/n
Has very little #breakfast. Walks excessively. Goes and lies down, only to get up and walk again. Family interactions little. Sleeps well for 2 hours from 12 to 2PM. Lunchtime. Groggy #father gets on the lunch table and defecates near plates and food. Son and mother aghast.
Has very little #breakfast. Walks excessively. Goes and lies down, only to get up and walk again. Family interactions little. Sleeps well for 2 hours from 12 to 2PM. Lunchtime. Groggy #father gets on the lunch table and defecates near plates and food. Son and mother aghast.
More power to #irad
#Bleeding #varices and plug assisted transvenous #occlusion by @SRajesh_IR
Varices dissappear (arrows)
Wonderful to see how portal vein size increases (B➡️D) after shunt occlusion. #interventional #MedTwitter #radiology #livertwitter #GITwitter
1/2
#Bleeding #varices and plug assisted transvenous #occlusion by @SRajesh_IR
Varices dissappear (arrows)
Wonderful to see how portal vein size increases (B➡️D) after shunt occlusion. #interventional #MedTwitter #radiology #livertwitter #GITwitter
1/2
Similarly, intrahepatic #portal vein caliber increases(B➡️D), making further #TIPS procedure technically more amenable. Large shunts are like blood parasites for portal vein. Shunt+varices long gone! (circled, A➡️C) #cirrhosis #MedTwitter
#hepatology #irad @SIRspecialists
2/2
#hepatology #irad @SIRspecialists
2/2
I’ve never done the #tipsfornewdocs thing…So here goes
If you’re like me, the transitions to residency and fellowship were much easier than into practice. I, like most #iRad s learned much more in the first few years in practice than all of training. Heres my summary: (thread)
If you’re like me, the transitions to residency and fellowship were much easier than into practice. I, like most #iRad s learned much more in the first few years in practice than all of training. Heres my summary: (thread)
(1/) It’s often difficult, but absolutely critical to solicit input from your colleagues, show them your cases, ask questions. Accept when your way isn’t the best. They've found success in the environment that you now work. Let their experience help your patients too #iRad
(2/) Focus on your passion: For me, taking care of cancer patients is all I’ve ever really wanted to do... Its super personal and important to me. I have found that success (referrals and good outcomes) comes easier when doing what you're most passionate about #iRad
Highlights Day 1 of #SIR20VIR, #Irad Interventional virtual meeting!
#MedTweetorial
⚫️ 1.Scientific Session
a. 🟡 Dialysis Related
b. 🟢 Others
🔴 #PAD-CLI Bootcamp
🔵 Practical Controversies in #PAE
(Long thread, use color code to jump to relevant sections)
1/
#MedTweetorial
⚫️ 1.Scientific Session
a. 🟡 Dialysis Related
b. 🟢 Others
🔴 #PAD-CLI Bootcamp
🔵 Practical Controversies in #PAE
(Long thread, use color code to jump to relevant sections)
1/
🟡 1a Dialysis related
Abstract of the year:
Are PTFE covered stents going to be standard of care to address the venous outflow stenosis in AV fistulae (AVeNEW) and AV grafts (AVeVA)?
Results from Dr Bart Dolmatch
2/
Abstract of the year:
Are PTFE covered stents going to be standard of care to address the venous outflow stenosis in AV fistulae (AVeNEW) and AV grafts (AVeVA)?
Results from Dr Bart Dolmatch
2/
🟡 1a Dialysis related
CONCERTO (COmbiNing Cutting and drug-Eluting balloon for Resistant arteriovenous fistula sTenOsis) Pilot Study showed great promise for use of the combination therapy for AVF
First Author:
Mark Wang, Singapore General Hospital
3/
CONCERTO (COmbiNing Cutting and drug-Eluting balloon for Resistant arteriovenous fistula sTenOsis) Pilot Study showed great promise for use of the combination therapy for AVF
First Author:
Mark Wang, Singapore General Hospital
3/
#LiverTwittIR #MedEd #Tweetorial
Management of post‐TIPS refractory Hepatic Encephalopathy (HE)
🟢 Definition
🟡 Prevention
🔵 Medical Rx
🔴 Endovascular approach
1/
Management of post‐TIPS refractory Hepatic Encephalopathy (HE)
🟢 Definition
🟡 Prevention
🔵 Medical Rx
🔴 Endovascular approach
1/
🟢 HE maybe:
Covert: Minimal or West haven Gr 1
Overt: West Haven Gr 2-4 which maybe episodic, recurrent (bouts within 6 mo) or persistent ( behavioral changes present with intermittent overt HE)
2/
Covert: Minimal or West haven Gr 1
Overt: West Haven Gr 2-4 which maybe episodic, recurrent (bouts within 6 mo) or persistent ( behavioral changes present with intermittent overt HE)
2/
Why does post-TIPS HE occur?
1.Shunting of blood away from liver- decreases 1st pass clearance of intestinal toxins (ammonia)
2. Upregulation of intestinal glutaminase activity- Increase ammonia production
1yr incidence 10-50%
New/ worsening 13-36%
Severe 1-3%
3/
1.Shunting of blood away from liver- decreases 1st pass clearance of intestinal toxins (ammonia)
2. Upregulation of intestinal glutaminase activity- Increase ammonia production
1yr incidence 10-50%
New/ worsening 13-36%
Severe 1-3%
3/
Siguiendo un poco la línea del famoso historiador de Medicina en @Twitter @cateterdoblej (con sus hilos impresionantes). He tomado el tiempo para hacer un Hilo en relación a la Radiología Intervencionista. #Irad
Conocéis un famoso fontanero-médico. Todos conocemos quien es Dr. Mario. Pero no muchos conocen al padre de la radiología intervencionista el #DrCharlesDotter. Quien dijo "Si un fontanero puede hacerlo con las tuberias, nosotros podemos hacerlo en los vasos sanguíneos".
El Dr. Dotter, fue el pionero de tratamientos percutáneos a nivel de arterias y otros órganos. Brillante #RADIOLOGO que realizaba procedimientos diagnósticos en el Hospital Universitario Health & Science de Oregon.
Great #DistanceMedEd about Mx of Variceal bleeding from @TedWJamesMD and thanks for this invite!
TIPS, BRTO and BATO - 🤦♀️Too many puzzling acronyms?
Lets break this down for you from #Irad perspective with a #Tweetorial
1/
TIPS, BRTO and BATO - 🤦♀️Too many puzzling acronyms?
Lets break this down for you from #Irad perspective with a #Tweetorial
1/
2/
TIPS: basic overview of variceal anatomy and flow dynamics ( will help understanding BATO and BRTO later)
Normal Liver: hepatopedal flow
Cirrhotic Liver: hepatofugal flow
TIPS: Restored hepatopedal flow
TIPS: basic overview of variceal anatomy and flow dynamics ( will help understanding BATO and BRTO later)
Normal Liver: hepatopedal flow
Cirrhotic Liver: hepatofugal flow
TIPS: Restored hepatopedal flow
3/
TIPS performed since 1982, but whats 🔥 ?
Contraindications ⬇️ with time. Why? Newer #Irad techniques
TIPS now possible in chronic Portal vein thrombosis, specially relevant as these patients not transplant eligible
High technical success, 39% underwent transplantation
TIPS performed since 1982, but whats 🔥 ?
Contraindications ⬇️ with time. Why? Newer #Irad techniques
TIPS now possible in chronic Portal vein thrombosis, specially relevant as these patients not transplant eligible
High technical success, 39% underwent transplantation
⚡️ Published @JVIRmedia ⚡️, will hopefully help #Irad #InterventionalSpecialists with patient care after #UFE
"Intraprocedural Superior Hypogastric Nerve Block (#SNHB) is safe, effective, significantly reduces pain, need for opioids and allows same-day discharge #UFE"
Thread 👇
"Intraprocedural Superior Hypogastric Nerve Block (#SNHB) is safe, effective, significantly reduces pain, need for opioids and allows same-day discharge #UFE"
Thread 👇
1/ YOU CAN DO IT! 🤜 🤛
#SNHB technique: Technical success 87% , which included operators who were not initially experienced with this procedure.
#SNHB technique: Technical success 87% , which included operators who were not initially experienced with this procedure.
