Eric Rothstein

👍 Knuckle Wires in #CTOPCI 👏: 🔗 jacc.org/doi/abs/10.101……

@JohnInDunedin @drjohnm While I find waiting out an OMI until a patient qualifies for the OAT trial to be unpalatable, I would be willing to randomize them to lytics/no lytics in transfer to get more evidence

@JohnInDunedin @drjohnm First of all I’d like to thank you for a very thoughtful discussion… We also seem to practice in similar environments because ~50% of my patients are lysed as well and that may be the key to answering this question and I think you may have led me to a possible answer.

This is a really important paper. STEMI vs Non-STEMI thinking needs to go. It's "occlusion MI" Here is the thing though: almost all of the occlusion MI NSTEMI's can be seen on the ECG--if people could read ECGs properly Table 2 examples seem so obvious to me. Not because I am smart, but because ECG reading was a top priority at Indiana U.

@JohnInDunedin @drjohnm No arguments on selection bias and our mutual dislike of small stents, but to my original point, I can’t imagine a hypothetical RCT that I could get past an IRB that would be ethical and wouldn’t be rendered useless by crossover in the OMI+/STEMI- group… can you?

@capnintrvention @drjohnm I will personally wait until we have a bit more evidence that doing so improves outcomes (ie heart failure/mortality) rather than just having more bits of metal holding open blood vessels for an “excellent angiographic result”.

@JohnInDunedin @drjohnm I’m curious what you’d cite as your source for “OMI occurs in small vessels”. I think we both agree that more knowledge is needed, but based on how I’m interpreting the study below, I treat OMI like stemi and I think withholding pci is unethical. jem-journal.com/article/S0736-…

@capnintrvention @drjohnm The point I’m trying to make is that most OMI are not big vessels, and we shouldn’t kid ourselves that putting a 2.25mm stent in a blocked diagonal will make any medium term difference at all. But - yes - if in doubt we should have a look…

@JohnInDunedin @drjohnm Interesting position… would you let yourself be randomized to the conservative arm of this hypothetical trial if you had a “big circumflex occlusion” without STE for the sake of EBM? Perhaps I’m biased but I would leave AMA and drive to another hospital that would stent me

@drjohnm I don’t disagree, but equally need to remember that the evidence is for STEMI intervention. Not OMI intervention. Yes, big circumflex occlusions do get missed in the STEMI/non-STEMI story, but if we want to practice EBM we need the evidence!!

@stanhenkin @MayoClinicCV @SharonneHayes @RobMcbane @DrMarkCreager @GregoryPiazza4 @mnyoung1 @thaiscoutinhoCV Haha miss ya buddy, congrats on your very large brain

@capnintrvention @MayoClinicCV @SharonneHayes @RobMcbane @DrMarkCreager @GregoryPiazza4 @mnyoung1 @thaiscoutinhoCV My 8 yo probably has a better jump shot than me now...

A year after a cross-country move to @MayoClinicCV, I'm so happy to have academic appointment of Associate Professor! I can't thank all mentors and collaborators enough for their support! @SharonneHayes @RobMcbane @DrMarkCreager @GregoryPiazza4 @mnyoung1 @thaiscoutinhoCV

Should be an Olympic sport

@crfheart @mbmcentegart @JTiwanaMD @brownc_12 @A_B_Hall @BWanamakerMD @drmeghaprasad @thinkmdkane @SanjogKalra @DrDarshanDoshi @MitulPPatel1 @MountRainierNPS Absolutely phenomenal @crfheart #CompCourse24 education and training👍: content (all of it) should be mandatory (IMO) for initial Interventional Cardiology training as well as ongoing lifelong mental and technical knowledge and skills improvement 🤜🤛…

I’ve found this technique helpful when I need more support but don’t want to pull my gear

Discover how being coachable, resilient, and committed to continuous improvement on the D1 Tennis Courts helped Dr. Eric Rothstein thrive in high-pressure environments in the Cath Lab. 🌟 #Inspiration #Resilience

The importance of stupidity in scientific research

@HannahChaudryMD you’re pretty amazing! What a great story to share

Not quite @SCAI Long Beach, but not too shabby either #heliskiing #lastfrontier

@SCAI Wellbeing Task Force chairs @Allison_Dupont & @Herms2James speak about the MORAL IMPERATIVE of lead-free radiation protection at #SCAI2024.

We've had a lot of success w/ Ostial Flash-cool to see how ostial flashed stents look grossly and by OCT in our recent cadaver implants. Unanticipated benefit is that Flash increases strut density at the coronary origin-where we struggle with stent scaffold failure and recoil.