Cyrus Hadadi, MD Profile picture
Nov 10, 2022 5 tweets 4 min read Read on X
Working with @seth_j_worley to create a reproducible, technically "easier" and systematic approach to #VeinofMarshall ethanol ablation for #EPeeps. Advance Preface sheath over CS decapolar catheter and then advance Amplatz Super Stiff to retain wire access.
Use the @MeritMedical Worley Coronary Sinus Guide Jumbo 50 cm size. The 9 Fr inner diameter is key to provide room to easily manipulate balloons, wires, inner guide catheters, etc. #VeinofMarshall is easily identified with RAO 20° cine projection.
The 5 Fr CS Vertebral shape vein selector easily advances through the 9 Fr @seth_j_worley Jumbo sheath to cannulate the #VeinofMarshall with a Boston Choice PT Floppy guidewire.
The 1.5 mm coronary balloon did not fully occlude the #VeinofMarshall as you can see, but upsizing to a 2 mm balloon did.
Fin.

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