Discover and read the best of Twitter Threads about #Irad

Most recents (7)

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)
(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
Read 11 tweets
Highlights Day 1 of #SIR20VIR, #Irad Interventional virtual meeting!


⚫️ 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)

🟡 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

🟡 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

Read 16 tweets
#LiverTwittIR #MedEd #Tweetorial

Management of post‐TIPS refractory Hepatic Encephalopathy (HE)

🟢 Definition
🟡 Prevention
🔵 Medical Rx
🔴 Endovascular approach

🟢 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)

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%

Read 11 tweets
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.
Read 16 tweets
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


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 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
Read 10 tweets
⚡️ 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 👇
1/ YOU CAN DO IT! 🤜 🤛

#SNHB technique: Technical success 87% , which included operators who were not initially experienced with this procedure.

97.1% of patient with #SNHB DID NOT NEED PCA pump

Of patients that needed opioids, average dose was ONLY 7.5 MME
Read 7 tweets
"What is the best Venous Access Device for my patient?"

An #InterventionalRadiology (#Irad) #Tweetorial to address a frequent clinical dilemmas for #Medtwitter and #NurseTwitter


Type of VAD:

PIV: 3-6 cm, enter and terminate in peripheral veins.

US-PIV: US to reach deep veins when superficial veins difficult to palpate, ≥8 cm

Midline catheter: 7.5-25 cm, inserted basilic/cephalic vein), terminating short of subclavian. 🚫 vesicant infusions

CVC: duration 7-14 d, direct puncture of internal jugular, subclavian, or femoral veins.

TC : diff from CVC, seperate insertion site in upper chest and venipunture in neck
⬇️ risk of infection due to cuff
👍 location for catheter care
Read 15 tweets

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