Russell Reeves

Will any leaders at @SocietyAbdRad meeting this week have the guts to propose ending f/u MRCP until death for tiny IPMNs? We now know 50% of normal patients have these. End the madness. @VChernyakMD @YashantAswani @aartirad @AwanRad @LetDdiceFlyHigh @Jeanne_Horowitz @bodyradgal

The use of the word “redemonstrated” in a radiology report is associated with higher odds that the imaging study or its prior comparison study was inappropriate/unindicated/low-value/redundant.

This Rad always starts his Impressions with comparison studies. Randy's Pro Tip: Don't do this.

Percutaneous Deep Venous Arterialization: some steps. 🔵⏩️🔴

I'm heading to SIR this April in Toronto! Looking forward to advancing my knowledge for patients suffering from PAD and carotid disease. i.snoball.it/p/MQbVQXyi/t #SIR26TOR

Healthcare will make you feel like you're taking crazy pills: Precertification obtained for standard of care procedure. Patient has 45 min outpatient procedure. Hospital bills patients insurance $304,713.97 --> roughly $6,700 per MINUTE of procedure time. Itemization is opaque and makes it impossible to understand cost. Insurance arbitrarily reimburses $16,318.46 for the hospital portion but decides NOT TO PAY THE PHYSICIAN PORTION. No reason given, no mechanism to appeal. @mcuban @MattHawkinsMD @RichDuszak @SandeepBaglaMD

IVC Filter Recalled Due to Injury Risk: doximity.com/newsfeed/33bff…: doximity.com/newsfeed/33bff…

On a population basis, there are very few interventional radiologists. This effect is only magnified in rural areas like upstate NY! We need more IR doctors. x.com/i/grok/share/u…

Pelvic Venous Disease affects millions of women worldwide and can lead to debilitating pain. IR can provide an effective minimally-invasive treatment option with faster recovery times compared to surgery. #PelvicVenousDisease #InterventionalRadiology #WomensHealth

Millions suffer from hemorrhoids—IR has a solution. Learn how Hemorrhoidal Artery Embolization treats bleeding hemorrhoids and restores quality of life. #SIR #SIRRFS #InterventionalRadiology #HAE

EMBOLIZE Trial randomized controlled trial in CPP (chronic pelvic pain) is happening. Send any potential subjects to assess! @SIRspecialists @VIVAPhysicians

@moisturizedRN Not only is this not recommended by guidelines because it is so low utility, it is just plain wasteful. Do not recommend.

ER nurse here! Unfortunately, there is no regular screening for pancreatic cancer for the general population. An endoscopic ultrasound, MRI/MRCP, and specific blood tests are done. However, they won’t perform those tests unless you’re high risk or showing these symptoms

How can a doctor make money as a clinician without having any ownership of facilities or ancillary services? Professional fees - where doctors get paid a centrally set rate for seeing patients and doing procedures. Call coverage - where doctors get paid for taking ER and inpatient consults. That’s about it. Now what about hospitals? Facility fees - the facility, be it an ambulatory surgery center or hospital, gets paid substantially more for procedures than the physician does. Ancillary revenue - labs, imaging, and therapies all generate revenue for hospitals. 340B, tax exemption, GME, local and state subsidies - these are all extra revenue streams for large hospitals that are unavailable to doctors. Now if doctors want to own, they can buy into surgery centers and ancillary services, but then they must navigate stark and certificate of need laws. They can drop Medicare to open their own hospital, cutting themselves off from other revenue streams. It’s easy to see how physicians are being locked out of capital and revenue streams. This is by design.

@ChengaziMD What forceps are those?

Malpositioned double J deployed too prox with distal pig in ureter, unable to visualize UO retrograde - used an omniflush to pull catheter back, then chomp chomp for extraction

Good to know, have had patients where doac can be prohibitively expensive… this is huge

@dougbeall What SI screw did you use?

Follow up to this case, Sacroplasty was performed with 10 cc of cement on each side plus screw spanning the gapped left sided sacral alar fracture. Patient is doing much better and I will see him at two weeks then at eight weeks follow up. osteoporosis treatment is underway

@CHICKVIR Everything done in the outside so no details are available and haven't seen the patient myself yet. Most unfortunate part is that the patient is very young, so they are likely going to have troubles with long term patency no matter what we do.

@RadDoc24 Challenging case, @RadDoc24. What was that original stent placed? And how long ago? Multiple approaches, but would favor stent placement alongside the existing stent or extra anatomic bypass (likely best option). Trans-interstice is possible, but with less longterm patency.

Wondering how MedX would manage this unfortunate ESRD patient with a RUE fistula and jailed BCV due to stents extending into the RIJ. Extra anatomic bypass??? Any other options? @CHICKVIR

@smbracewell @CHICKVIR What do you do? Stent through the interstices? The frayed ends have me a little paranoid

@RadDoc24 @CHICKVIR I think you can fix that. Jeff @CHICKVIR has published several studies show how to fenestrate these. I’ve done it.

@Marri_VIR Which part is US guided? Assuming you can't see that collection through the stomach (or can you??). Also, do you just pull your access out and leave a hole in the front of the stomach?

Pancreatic WON collection, poor window fr EUS drain #Irad Percut. US guided trans-gastric drain follwd by fluoro guided cystogastrostomy stent placement fr internal drainage Trans-gastric: early external drain removal, ⬇️risk of cutaneous fistula ->Happy patient😃 #ISVIR #SIRRFS