Alexandria CVIR

After 53 years in operation, Alexandria Radiology has merged with Fairfax Radiology Centers. The IR section of AAR is now part of FRC. We are excited to continue providing world class care to our patients under the larger umbrella of FRC.

New data on real-world safety of catheter interventions for PE using the Ekos catheter lysis system, led by @drksterling and @GregoryPiazza4 489 patients who underwent CDT on clinical grounds utilising whatever protocol the site felt appropriate.

@drcostantino1 probably pass on vertebral augmentation.......

Back pain x 4 months. I know what I’m going to do, but curious re others opinions: Kypho? Open stabilization?

Anyone read this yet? #OBL nytimes.com/2023/07/15/hea…

@roblookstein Amazing idea. This was very elegant and bought the patient some time. Surgical options likely way more morbid. However, at some point the distal uncovered diseased segment is going to be a problem and then I’m not sure what you can do.

Three stage procedure. 1. Embolize 2 branches at their origin to promote collaterals in the mesenteric arcades 2. 2 weeks later embolize two more branches at their origin to promote more collaterals 3. 2 weeks later place self expanding stent graft Currently at home asymptomatic

Live @MountSinaiIR 25mm superior mesenteric artery aneurysm in a 34 yr old vEDS pt (existing coils from a previous ruptured splenic artery aneurysm) what to do? How to manage?

@SDhandMD @rkryu @kmadass @kush_r_desai @LessneVIR @keithppereira @Watts_IR @t_intheleadcoat @SriniTummala @ABrandisMD @omarsaleh66 @DonGarbettMD @_backtable @drcostantino1 Never even took out the snare…….

Option w/ 1 wk dwell time for perioperative prophy 5 mins fluoro failed w/ snare, quick snag w/ forceps Impressive to see 🪝 in such short dwell times Remember the old times when we spent a lot longer before busting out those forceps?! @rkryu @kmadass @kush_r_desai #GTFO

Post RPLND. Chylous ascites. Glue through micro puncture access. 5:1 ratio. @Penn_IR @SIRspecialists

@Muhammed_Karamm @Nass_the_gr8 Some have claimed that, especially in lipid dominant and hence poorly vascular AML, you get more shrinkage with ethanol.

@Nass_the_gr8 Nice one 🤝🏻 But i have a question We usually use microspheres , when or why i should use ethanol ? What precautions to use with ethanol in this kind of procedure?

Transcatheter arterial #embolization is the first line treatment for AMLs. This case was done trans-radial using ethanol/lipiodol mix (1:1 ratio) injected through an #Occlusafe microballoon catheter. #Irad

Depends on flow rate@and how slushy you want the mixture. We were going to do just ethanol and lipiodol but I was doing the case with one of the other guys just switching over form particles. He felt more comfortable@with a thicker mixture.

Massive but slowly bleeding AML. Love liquid Embolics for this. Lipiodol, ethanol, Gelfoam and contrast. #IRAD Now you see it, now you don’t.

@drafoxter @Vapourologist Glycopyrrolate for carotid stents as well……googled the spelling😀

@Vapourologist Kind of curious to know why someone would load Ondansetron and Dex. Assuming patient had a high Apfel score? I have never used Glycopirolate before or however that is spelled in English.

I drew up half these drugs, the trainee the other. One of us isn’t leaving the anaesthetic room alive

After treating three ultramarathoners who had developed colorectal cancer in recent years, Inova's Dr. Timothy Cannon had a suspicion whether this could be more than a coincidence. More on a study of 100 endurance athletes inovanewsroom.org/expert-comment… #ColorectalCancerAwarenessMonth

@farkomd VBX (goretex not Dacron 😜) or coronary DES…… but we need a trial to validate what many are now using first line

Some more medicines? Some metal? Or Dacron? My #MedTwitter #IRAD #IC #Vascular

It was GU week this week. AVM/AVF with 3 feeders. Two largest embolized with #Embold. Glue for the smallest branch. Now you see it now you don’t!

@DrShannonThomas @SIRRFS @SIR_ECS @VA_Int_Oncology @PenVascular Erased the original tweet by mistake. Inflammatory/ruptured SMA branch aneurysm and pain.

@DrShannonThomas @SIRRFS @SIR_ECS Correct! Coiled the aneurysm and the inflow/outflow with Penumbra Ruby, POD and Packing coils. @VA_Int_Oncology @VenuVadlamudiMD @PenVascular

@SohailCmd @SIRspecialists @AASLDtweets @SIRRFS Amazing the patient was alive with that much active bleeding. 💪

Brisk bleed from EV - quick TIPS ⁦@SIRspecialists⁩ ⁦@AASLDtweets⁩ ⁦@SIRRFS⁩

@DrDukesVIR @SIRspecialists @SIR_ECS @SIRRFS @FutureVascSurgn @VascularSVS @STS_CTsurgery @ACCinTouch @trevorlewis_md @mms62786 @DrFLoya @keithppereira @thefibroidlady @amitramjitMD @kmadass @IR_Doctor @behnam_tehrani @katecarrato Elegant coil mass!

Dear @SIRspecialists, @SIR_ECS, @SIRRFS, #twitir, @FutureVascSurgn, @VascularSVS, @STS_CTsurgery, @ACCinTouch and anyone else who currently or aspires to access groins, Respect the 👑☠️. #variants Sincerely, @DrDukesVIR

@mazsig @mohamma27915214 @BrettHyattIR @SIRspecialists @SIR_ECS @SIRRFS @cirsesociety @InariMedical @VenousForum This opens a great discussion. We would not have done this case unless the patient presented with phlegmasia. We wait until the patient can be anticoagulated to perform thrombectomy. Our concern is rethrombosis as recurrence off anticoagulation in the acute setting is high.

Great vid showing clot removal. Pt presented with symptomatic acute DVT extending from pop to iliac, unable to be anticoagulated due to recent hemorrhagic stroke. 30 mins later all thrombus is removed from leg. Temporary IVC filter was also placed. #TwittIR #DVT #VTE #IRad

#STROKE Predictive score using early venous filling #EVF, time, glycemia and ASPECTS score demonstrates good performance (AUC >0.8) for #sICH prediction after mechanical thrombectomy #THRACE TRIAL ahajrnls.org/3b0rvYj @KerlerouxB @marco_pasi85 @gboulouis

SO, THE NEPHROSTOMY TUBE IS DRAINING JUST FINE AND THE PATIENT FEELS WELL BUT THE URINE CULTURES ARE POSITIVE AND WE WANT THE TUBE CHANGED ASAP FOR SOURCE CONTROL