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Oct 28 • 4 tweets • 2 min read
RCA Views;#Intervention

First keep in mind RCA Portions .

RCA appears as Letter "C" 

Proximal RCA ..R1
Middle RCA......R2
Distal RCA ..R3 

Distal RCA divides into PLV & PDA branches Image
Sequence of 3 views are used .

1.LAO Straight 30°. ( Best for Proximal Portion .R1)
RCA appears as Letter "C"

2.AP Cranial 15° with 5° - 10 LAO angulation

( Distal RCA R3 ,Bifurcation portion )

3.RAO Straight 30°.(Middle Portion .R2)

RCA appears as Letter "L"
@ACCinTouch
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More from @shoaib9702

Muhammad Shuaib Abid Profile picture
Oct 29
#Pericardiocentesis Site of Puncture;

There are 3 Options .

1.Subxiphoid
2.Parasternal
3.Apical

Factors to choose site .

•It depends on location ,type (eg circumferential)

•In situation of cardiac arrest or emergency situation ,subxiphoid is best . Image
For other situations ,Apical is safest when performed under ultrasound guidance with biopsy line function of probe.

•Choose the location with probe with biopsy line ,avoiding any parallel structure (heart,liver,lung)
Puncture Canal or Axis .

If needle has long puncture Canal /axis in effusion it is safe .

1.Subxiphoid Approach;

•Puncture is always directed towards right heart so short part of Puncture axis within effusion

•subxiphoid puncture often passes through liver.
Read 4 tweets
Muhammad Shuaib Abid Profile picture
Oct 29
#Classification of Guidewires
( very important Topic)
..........................

Guidewires have different properties ,it is classified on different parameters but most practical classification is ""Based on Lesion -Type Classification.
@PCRonline
@TCTMD
@mmamas1973
@Hragy Image
A.Based on Tip -Flexibility ( Tip -Load )

#Tip Load..Amount of force ( in grams) needed to buckle distal 1cm of Tip

1.Floppy wires (<1.5gm)
2.Intermediate wires (2-4gm)
3.Stiff wires (>4gm)
.............. ..............
B..#Based on Tip -Coating

1.Hydrophilic
2.Hydrophobic
3.No coating

....................

C..#Based on Tip -Tappering Design

1.Tapered
2.Non -Tapered

.............

D..#Based on Tip -Style

1.One Piece design
2.Two piece design
Read 16 tweets
Muhammad Shuaib Abid Profile picture
Oct 29
#GulfPCR
@PCRonline
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Muhammad Shuaib Abid Profile picture
Oct 29
#GulfPCR
@PCRonline
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Antegrade approach for CTO from cap penetration to completion

.....
Read 5 tweets
Muhammad Shuaib Abid Profile picture
Oct 28
Antegrade Approach for #CTO Lesions #Cardiotwitter

Method A..Antegrade wire Escaltation ;

It consists of advancing various guidewires in antegrade direction to cross CTO while remaining within true lumen of vessel (True to True )
@mmamas1973
@mirvatalasnag
@Hragy
@PCRonline Image
#crossing proximal cap.

Wire escaltation

Wire Gear 1

For proximal cap penetration, tapered polymer GW with low-penetration power soft-tip (Fielder family guidewires; Ashai Intecc), allowing advancement along visible or invisible microchannels, are the first choice
Wire Gear 2

~If the operator encounters difficulties in crossing the lesion, they can switch to GW with greater penetration force. When proximal cap is blunt, GW with intermediate penetration force (Gaia 2nd–3rd [Ashai Intecc] or Pilot 200 [Abbott Vascular]) are used.
Read 15 tweets

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