Fellow boot camp- Vascular Access!
My goals in the Cath lab for a first year:
🛑Safety
🟢Access
😎Getting the RCA
In the first couple of months of your training focus on these important concepts. Understand both #RadialFirst and #SafeFemoral ..ultrasound and micro puncture!
Recent (2 weeks) PCI (OSH). Presentation ACS, CHF rLVEF. Likely mycotic. #CardioTwitter #MedTwitter #MedEd JACC Journals MyJSCAI PCRonline 🫀 European Society of Cardiology Journals #CardioEd radialfirst #TroubleShootingPCI #PCI #Bifurcation #Europeanbifurcation #safefemoral #FOAMed
#Fellowbootcamp - Vascular Access!
My goals in the Cath lab for a first year:
🛑Safety
🟢Access
😎Getting the RCA
In the first couple of months of your training focus on these important concepts. Understand both #RadialFirst and #SafeFemoral ..ultrasound and micro puncture!
#SafeFemoral Tips
🫳🏽Always palpate first (keeps ur skill)
🎥Floro hemostats at bottom 3rd fem
🔊Use ultrasound ALWAYS
💉Use micropuncture ALWAYS
🍭Sweet spot- above bi below epigast
🔎Floro micro wire up
📸Take a quick pic (optional)
💪🏽Stiff wire/glide sheath if needed
77yo 👨🏼🦳 LVEF 23%, turned down for CABG, #CHIP #SafeFemoral 6Fr IVUS guided LM PCI #DKCrush Francisco Martínez Dr Jose Saldaña Garcia
Left mammary cannulation from Right #RadialFirst is sometimes challenging but possible and effective. Would you shift to #SafeFemoral earlier or not? #CardioTwitter
You know it’s gonna be a difficult PPCI when this is how you have to get into the RCA #WexhamCardiology #SafeFemoral #PPCI #poorradialpusles
Coronary Subclavian Steal Syndrome 👇
JL3.5 catheter via right #RadialFirst coz no left radial or #SafeFemoral option
#ACCEarlyCareer #ACCFIT #CardioTwitter BCM Cardiology
For those not familiar with it, here’s a quick, easy way to maintain arterial access with use of a collagen based vascular closure device. Just re-insert a 0.018 micropuncture access wire into the sheath prior to deployment #safefemoral the
70s 👨 who had 2 bypasses. Left main occluded w 2 layers of stents. Multiple stents down bypass graft. Unable to get equipment down with #radialfist . Changed to #safefemoral long sheath and Power Ranger position with the guide. Not looking forward to next intervention…
#FellowBootCamp
#SafeFemoral Tips
🫳🏽Always palpate first (keeps ur skill)
🎥Floro hemostats at bottom 3rd fem
🔊Use ultrasound ALWAYS
💉Use micropuncture ALWAYS
🍭Sweet spot- above bi below epigast
🔎Floro micro wire up
📸Take a quick pic (optional)
💪🏽Stiff wire/glide…
87yo overweight lady w/ lateral STE. Decided to switch from #radialfirst to #safefemoral for severe tortuosity and GC kinking. Unable to advance guidewire and wanted to see why...
PCRonline 🫀 European Society of Cardiology Journals EuroIntervention jedicath աǟզǟʀ.ǟɦʍɛɖ TCTMD RadialFirstBot #cardiotwitter
Got calcium? #OCT guided RCA PCI, Single Operator #Rotapro 1.25 Burr & 3 stents implantation, such a good result! PCICaseBot Francisco Martínez Dr Jose Saldaña Garcia Diego Boroel #SafeFemoral #CHIP #InterventionalCardiology PCRonline 🫀
📌 4 signs of Ostial Stenosis during Cor Angio 👇👇
#ACCEarlyCareer #ACCFIT #CardioTwitter #ACCIC #RadialFirst #SafeFemoral #ACCFIT
Arterial loops during #radialfirst cath are not that uncommon ➡️ straighten and proceed with coronary angiogram 👇
But don’t struggle too much. There’s always the other radial artery or #safefemoral
#ACCFIT #CardioTwitter #Cardiology #MedTwitter
#NSTEMI #OCT heavy #calcified 🪨
#SafeFemoral @csi360 Hybrid #DES & #DCB PCICaseBot @APSIC PCRonline 🫀 Neisser M Hady Lichaa, MD, FACC, FSCAI, FSVM, RPVI A.Nazmi Calik MIЯVΛƬ #IC Osama Bisht Salvatore Brugaletta Dr Shariq Shamim Evandro Martins F. MD Elad Asher Dimitri Zappi, M.D. David J. Cohen, MD, MSc Matthias Götberg Lorenzo Azzalini Antonious Attallah, MD, FACC, FSCAI
When you know this case is going to be a rollercoaster ride 😂 #CardioTwitter
How many loops before you stop and go #SafeFemoral ? No wonder Umair Khalid goes left radial by default 👌
PS: this was dx only, and saved to inform folks in future not to go R-radial