Andrew MacDonald

@AustinBourgeois Surprising from a UK perspective! Do you just do arterial CT? We do dual bolus CT and don’t seem to be missing anything!

I’m a big believer that the clinically unstable patient with pelvic fractures should go to angiogram, even with no active bleeding on CT … You never know what you might find 😬😬😬 #iRad

@JeremyKimMD @SIR_ECS @SIRRFS @MountSinaiIR @bonesz Beautiful! Are you using an occlusion balloon to get it that far in, wedging it or a dilution above 1:8?

3 prostatic arteries embolized w/ glue & coils. 1 microcatheter. 1 happy patient. #PAE #BPH #irad @SIR_ECS @SIRRFS @MountSinaiIR @bonesz

@NaineshParikhMD @keithppereira 😬😂

@AndyCMacD @keithppereira unfort for me a ton of my patients are POST XRT! but i agree!

How would you handle right distal IP collateral in second image? (90gm prostate, severe LUTS prior to XRT for GGG3 PCa) (pics in comments)

@NaineshParikhMD @keithppereira Coil then only one thing to come back to! Not sure anyone would want to come back to this post radiotherapy!

@AndyCMacD @keithppereira if you treat - do you leave a coil behind to shut the door?

@NaineshParikhMD @keithppereira I’m with Keith, treat the main pa first then have a look. If lots of flow in and safe for some embolic then put some in, if dicey and refluxing easily then just coil it off. If no real residual supply in then leave it.

@keithppereira so you would treat then leave it alone?

@DrDLittle Who said you need to be a radiologist or a doctor to report imaging… 😜

“Physician assistants used imaging at higher rates than physicians, in particular CT at 6.5% of visits compared with 0.7% for doctors of medicine” We’re going to need more radiologists… jacr.org/article/S1546-…

@eliebalesh Good to see elsevier adding value…oh wait

ChatGPT authorship fail. “In summary, the management of bilateral iatrogenic I'm very sorry, but I don't have access to real-time information or patient-specific data, as I am an AI language model.” sciencedirect.com/science/articl…

@bonesz @MountSinaiIR @IcahnMountSinai @MountSinaiDMIR @SIRspecialists @GuerbetGroup @roblookstein @RSP516 @bostonsci @marklittle_IR @thegestgroup @_backtable @keithppereira @SandeepBaglaMD @AriIsaacsonMD

#TREATLive is back and better than ever! Join us on March 8 for our new monthly live case series! Up first: PAE with glue! #justglueit @MountSinaiIR @IcahnMountSinai @MountSinaiDMIR @SIRspecialists HERE: treatsymposium.com

@ABarotchi1 @doctorgrieco @BISRT_news @BSIR_News @RCRadiologists bsir.org/media/resource…

@doctorgrieco @BISRT_news @BSIR_News @RCRadiologists Absolutely unacceptable, I hope there is a strong statement from @BSIR_News to say this scope is far beyond the qualifications and expertise of a PA. A procedure is not just the manual task. Stop treating patients like a video game

🚨‼️ Reports from 2 separate IR departments with Physician assistant/associates 1. Illegal use of radiation by PA (e.g. pushing pedals whilst doing a nephrostomy.) 2. Taking opportunities from radiology doctors. @BISRT_news @BSIR_News @RCRadiologists Scope must be set.

@drmcumming @ECIOcongress @NajranPavan @Radiology_UK @BSIR_News Nice 👌

@ECIOcongress @NajranPavan @Radiology_UK @BSIR_News Coiling like that is not necessary to occlude the testicular vein. 2-3 larger diameter coils, long length (10-20cm) are all that is required. See drcumming.com/seldinger-file… for an example. Abstract from GEST drcumming.com/commentary/ges…

#ECIOtakeover @NajranPavan What is your embolic product of choice? Varicocele embolisation performed, coils vs glue? In my personal experience, glue is far quicker & cheaper vs the cost of coils! More data is required to assess long-term outcomes. #IRads @radiology_uk @BSIR_News

@ECIOcongress @NajranPavan @Radiology_UK @BSIR_News Are you using a microcatheter, if so cost neutral once add lipiodol cost no?

@Flavius_IR That said my 1st go to is my poor man’s BeBack - a 5F bern and a 0.14 halberd, 70% of the time it works every time…

#irad and #vascular surgeons in the UK, is your unit using the GoBack (or BeBack) re-entry device?

@Flavius_IR Yes, we have outback and pioneeer also -be back my pref as lower profile and more controllable throw angles, and throws from the tip rather than side

@cirsesociety @DrNeilGuptaIR @nhsuhcw Interesting! Is this part of a research study?

#CIRSEtakeover @DrNeilGuptaIR Day 2: I really enjoy collaborating with my @nhsuhcw HPB surgery colleagues to treat the most challenging of liver and pancreatic tumours intra-operatively with microwave or IRE. We introduced Nanoknife in 2018, which has expanded what we can treat.

@AustinBourgeois @agraif @IR_Doctor @keithppereira @SDhandMD @MUSCVIR @saherssabri @Watts_IR @AbhiKumar47 @DrDaveTabriz @SIRRFS Looks great is that 3 air 2 sts 1 lipiodol?

@agraif @IR_Doctor @keithppereira @SDhandMD @MUSCVIR @saherssabri @Watts_IR @AbhiKumar47 @DrDaveTabriz @SIRRFS Couple 035 interlocks to frame - undersized hydrogels 035 in the middle then final coil was an interlock. Little blob of gelfoam to plug a tiny phrenic collateral then 3:2:1 STS foam.

CARTO for bleeding gastric varies. Dual sheath, IJ approach. Super satisfying when it fills like this. #iRad

@RexRayMD @smbracewell @ajgunnmd @SIRspecialists Ask 5 IRs get 5 diff answers! That’s what’s great about IR!

@smbracewell @ajgunnmd @SIRspecialists What size of particles do you prefer to use if there is no AV shunt?

Hey #IRad, I need some advice. I have a 76F patient with 4.5cm #RCC. Cannot get surgery. Normally I cryoablate, but the blood supply looks ROBUST. I want to bland embo first. How long do you wait between embo and cryo? @ajgunnmd

@RexRayMD @smbracewell @ajgunnmd @SIRspecialists 3-500 or glue

@Flavius_IR @BSIR_News @SIRspecialists Should be fine ipsi but 175 truselect radial might reach…

#irad #vascular @BSIR_News @SIRspecialists

Large type II #endoleak from left iliolumbar. How would you approach it? 1. Femoral ipsilateral with skill? 2. Femoral ipsilateral w/ steerable sheath? 3. Left brachial? 4. Other? Poll below #irad #vascular @BSIR_News @SIRspecialists

@WAHT_IR @BSIR_News @TraineesBSIR @angiodynamics @IrChivate @IRad_doc Handy, you should post a video to BSIR!

@WAHT_IR @BSIR_News @TraineesBSIR @angiodynamics @IrChivate @IRad_doc Very nice! What’s your technique for working out of plane?

Another successful ablation case today defying the argument that you need robot AI kit for all complex ablations @BSIR_News @TraineesBSIR @angiodynamics @IrChivate @IRad_doc