Thread by @ABaliMD

As someone just getting started in IC, this talk by @jaygirimd was inspiring. #VTE/#PERT is such an exciting space with rapid development & study 🙌🏽

(Also shoutout to my mentor @GoldbergJBCTMD who’s work is displayed in Dr Giri’s slides)

My takeaways, a🧵:
(1/6)
#Fellows2023

🔹Risk stratification and patient selection is key.

🔸Risk scores may not accurately stratify younger patients

🔹Full risk assessment has to include with the bedside eval w/ imaging + lab markers as adjunctive data

🔸Be on the lookout for normotensive shock

#Fellows2023 (2/6)

🔹Patients can be sick - upfront MCS with ECMO may be the first treatment needed in tackling high risk PE

🔸Contralateral arterial access during thrombectomy in case urgent MCS is needed

🔹always start with a RHC to establish severity of disease

#Fellows2023 (3/6)

🔹If predominant abnormality is hypoxia, look for lung process (bad V/Q mismatch) or suspect PFO w/ shunting due to ⬆️RA pressure

🔸Subacute or acute on chronic is a tough scenario to improve on, may need CDT-lytics to “reset” pt back to chronic baseline

#Fellows2023 (4/6)

🔹This isn’t a “treat and street” dz: post-PE synd, CTED, #CTEPH, all are under recognized/tx, and req MDT approach (non-inv, imaging, CTS) for mgmt

🔸VTE is following the arc of tx that MI has historically (first conservative, then lytic era, now devices)

#Fellows2023 (5/6)

Refer to the 4 documents!

🔹@AHAScience 2023 CTS mgmt: doi.org/10.1161/CIR.00…

🔸@AHAScience 2019 IC tx: doi.org/10.1161/CIR.00…

🔹@PERTConsortium 2019 Dx/Tx/follow up: 10.1177/1076029619853037

🔸@escardio 2019 guidelines: doi.org/10.1093/eurhea…

#Fellows2023 @crfheart (6/6)