Thread by @MusaSharkawiMD

Here are some important interventional cardiology algorithms I've compiled over the past couple of years. The good IC/CTO operator always knows what the next step is. Major credit to @esbrilakis for many of these algorithms. Must think systematically about every PCI. 1/

Very nice algorithm on tough to wire vessels. Important techniques to know: Use of SuperCross (only use 120/they tend to straighten out), Hairpin wiring technique, deflection balloon, and probably most importantly, appropriate wire shape. 2/

A suggested algorithm on use of hemodynamic support in PCI. 3/

Algorithm on treating bifurcation lesions. 4/

Suggested algorithms on treating balloon undilatable (de novo vs ISR) and balloon uncrossable lesions. Those are important to commit to memory. 5/

Complications. In general steps 1 and 2 are to keep calm and to call for help.

How to deal with coronary perforation: Note: Should know how to use coils and fat embo in the cath lab (attached videos). 6/

Causes and management of No Reflow. It is critical to think of the most likely cause and proceed accordingly. 7/

Lastly, it is critical to know how large the stents you implanted can go up to safely. 8/

@mmamas1973 @mirvatalasnag @ziadali
@ronnieramadan @drfaher @arjunmaj @Almanfi_Cardio @dramirkaki @docsav @heartdoc45 @IzzyO_MD @ardati
@DrJayMohan @jason_wollmuth @babar_bas
@saia_francesco

Types of coronary perforations

CTO algorithms including how to tackle ambiguous proximal caps, impenetrable caps and the different dissection/re-entry strategies.

This is a very helpful algorithm by @TanveerRab et al. on how to treat patients with OHCA vis a vis coronary angiography. #CommonSense

How to treat ISR per @kevinjamescroce's algorithm. Must treat stent under-expansion which is the predominant mechanism in most.