Discover and read the best of Twitter Threads about #Imagefirst

Most recents (9)

1/25
How would you tackle this heavily calcified LAD with calcified #nodule that was appropriately identified by intravascular imaging? #OCT
doi.org/10.1093/ehjcr/…

In this #EHJCaseReports #tweetorial we take a deep dive into the Rx of #calcified coronary lesions.
#Cardiotwitter
2/25
Calcified lesions are top of the totem pole of complex PCI
Main armamentaria are balloon-based #IVL & ablation-based (rotational/orbital) techniques, while ancillary tools eg guide extension catheters are useful too. eurointervention.pcronline.com/article/intrav…

#EHJCaseReports #tweetorial
3/25
What do you see with this non-compliant balloon in this calcified RCA?
What would you do next? Poll in next tweet! doi.org/10.1093/ehjcr/…
Read 25 tweets
1/24
A picture is worth a thousand words. This month's #EHJCaseReports tweetorial focuses on intravascular imaging in coronary intervention.

For starters, what do you see on this #OCT image of an intracoronary honeycomb🐝?

academic.oup.com/ehjcr/article/…

Poll 👇

#cardiotwitter
2/24
The intracoronary honeycomb on the image above is ⬇️

Find out the answer in #EHJCaseReports:

academic.oup.com/ehjcr/article/…
3/24
Honeycomb-like structure, a rare cause of myocardial ischaemia has multiple communicating channels divided by thin septa. Angiographically fuzzy & hazy appearance often without significant stenosis, they're best detected on high-resolution IVUS/OCT
academic.oup.com/ehjcr/article/…
Read 24 tweets
1. Today is #WorldCancerDay our analysis led by @dr_mosama & @hvanspall academic.oup.com/ehjacc/advance… with @AnaBaracCardio @islamelgendy83 @DLBHATTMD @adnanalkhouli @safinmc @dataevan studies disparities in care & outcomes of cancer pts presenting with STEMI @DrMarthaGulati @ShrillaB
2. #WorldCancerDay It builds on our work published last year led by @adityadoc1 showing pts with cancer less likely to be managed invasively, and when they are have better outcomes. academic.oup.com/eurheartj/arti… @MKIttlesonMD @ovidiogarciav @DrPeterOKane @SukhNijjer @CardioIAN
3. #WorldCancerDay The greatest incidence of AMI in cancer pts is within 30d of Ca diagnosis, many treatments can ⬆️risk aswell as shared risk factors. We sought to study whether STEMI pts with cancer are less likley to get PPCI & whether they benefit academic.oup.com/ehjacc/advance…
Read 8 tweets
So as many of you have guessed correctly this is a case of ISR 2/2 to Late acquired stent malapposition (LASM). This diagnosis wouldn't have been possible unless you #Imagefirst. But is that that simple. Let's see...
1. We used a 4.0 mm stent proximally in the initial case and then "flared" the ostium with a 4.5 mm NC
2. Here is the full IVUS run. The stent is appropriately sized to the refence segment. We didn't aggressively post dilated the positively remodeled and clot rich proximal/ostial stent but ended up with a big lumen...
Read 10 tweets
1/Week 2. How does proper identification of morphology with OCT impact treatment strategy?

Today we discuss the 1st step in the OCT-guided PCI workflow #MLDMAX: Morphology (M)

At the end, assess your morphology skills w/ a quiz.

Important Safety Info: bit.ly/2VIph7r
2/ Morphology assessment affects vessel prep which impacts stenting strategy.

In the LightLab Clinical Initiative, #OCTimaging changed physician’s angiographic assessment of lesion morphology in 48% of lesions or about 1 out of every 2 lesions.

#imagefirst
3/ When a lesion type change occurred, calcification was the predominant morphology observed in pre-PCI OCT pullback. Misdiagnosis of calcification changed vessel preparation strategy in 28% of lesions.
Read 9 tweets
1/Week 1: What is MLD MAX?

In our 1st September Tweetorial we’ll discuss #MLDMAX,the new standardized OCT-guided PCI workflow.

6 letters representing
6 steps

of the PCI goal to MAX-imize stent expansion to deliver optimal results.

Important Safety Info:bit.ly/2VIph7r
2/How does MLD MAX play a role in PCIs?

#MLDMAX is an acronym for the OCT workflow in the LightLab Clinical Initiative, a multicenter, prospective, observational study in the US to evaluate the impact of a routine workflow on physician decision-making & procedural efficiency.
3/What does #MLDMAX stand for?

M – Morphology

L – Lesion

D – Diameter

M – Medial dissection

A – Apposition

X – eXpansion

Pre-PCI OCT [MLD] --> inform your treatment strategy

Post-PCI OCT [MAX]--> optimize stent placement
Read 7 tweets
1/Welcome to our third #OCTober #Tweetorial 🎃🤓. Here we’ll talk
about how #OCTImaging can help detect the mechanisms of in-stent
restenosis (ISR) to guide treatment. #imagefirst #imagelast

Important Safety Info: abbo.tt/2GyBrZ1
2/ What causes ISR? Stent underexpansion and neointimal hyperplasia (NIH) are the two predominant mechanisms of stent failure, as cited in this expert consensus document of the European Association of PCI: bit.ly/2PdMGtt

Important Safety Info: abbo.tt/2GyBrZ1
3/Here’s how stent underexpansion and NIH are seen on angiography and OCT respectively. To spot NIH, look for a large layer of growth on top of an already fully expanded stent.

Important Safety Info: abbo.tt/2GyBrZ1
Read 7 tweets
1/Welcome to our second OCTober #Tweetorial 🎃🤓. We’ll talk about diagnosing and treating calcific plaque with #OCTImaging. #imagefirst

Important Safety Info: abbo.tt/2GyBrZ1
2/The absence of intravascular imaging may lead to underestimation of calcium and improper diagnosis, as seen in the chart below, courtesy of Richard Shlofmitz, MD. #OCTImaging #imagefirst

Important Safety Info: abbo.tt/2GyBrZ1
3/Calcific plaque is characterized as having low attenuation (light penetrates deep, can see tissue) & clear, delineated edges (appear as “islands” or “rocks”). In this image, calcific plaque is observed from 12 o’clock to 3 o’clock.
Important Safety Info: abbo.tt/2GyBrZ1
Read 12 tweets
1/Welcome to our first OCT #Tweetorial! We'll cover a few key
concepts and share a step-by-step guide on the basics of image
interpretation 🤓 #imagefirst #OCTimaging

Important Safety Info: abbo.tt/2GyBrZ1
2/First things first, what is OCT?

OCT stands for optical coherence tomography which is an imaging modality that uses near-infrared light to provide high definition images of the artery.

Important Safety Info: abbo.tt/2GyBrZ1
3/What are the basic elements of an OCT image? Here's what you see in a radial cross-sectional view:

Important Safety Info: abbo.tt/2GyBrZ1 #OCTImaging #imagefirst
Read 8 tweets

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