Fawaz Bardooli, MD

Thanks for the votes 🎯 We need to clarify if Os LAD/LM are involved or not (most of the time yes) 🎯 Having multi modality imaging including CTCA and OCT helps. 🎯 Decided to nail Os but with AI using the co-registration feature

@Hragy الفرق الجميل ان تُحب ما تعمل ، و هذا الشي اللي بيخفف علينا اي تعب… 👍

في المستشفي من الصبح، معي ٣ مرضي حالاتهم حرجة اتمني لهم الشفاء، عملنا ليس به اجازات، مش عارف لو مكانش فيه اهلوية يسلوني علي تويتر كنت هستحمل الضغط ده ازاي في سني.

@Nasser_Ghattar @Obisht Given the distance between tip and camera. wire get out of the monorail segment. In fact OCT would have acquired the images of mid/ prox LAD even if not reposition. But OCT will come out of guide separate from wire. The danger comes if operator pushed OCT further Well noticed 👍

During OCT guided PCI , something wrong was about to happen !!!

🧵 CAHP score in OHCA — why accurate data matters 1/
A new study from Qatar 🇶🇦 Heart Hospital looks at the CAHP score in OHCA.
Key message: its value depends on how accurate the data are 👇 journals.lww.com/hrtv/fulltext/…

@JEscaned @NievesGonzalo1 I think we all will be validating with the FFR for the first few cases . Congrats @NievesGonzalo1 @JEscaned

@Tesslagra @NishithChandra Well done

First-in-human concept: « Access site plaque modification »  Rotational Atherectomy in the Radial Artery : ROTA-RADIAL linkedin.com/posts/claudiu-…

@Hragy @jedicath @aymanka Love the example ☺️

Few weeks ago I had a patient with CTO LAD , he was penniless and desperate and had CTO LAD/huge D1 , it worked incredibly well, exactly like the boy goalie’s incredible save! @jedicath @Aymanka

@KhalidFAlhabib Interesting and very happy to cooperate from Bahrain

صحيح 👍 د. يحى .. أنا الباحث الرئيسي Principal Investigator لدراسه على مستوى السعوديه ودول الخليج العربي وسنقوم بإذن الله بتحديد مدى انتشاره خاصة في المرضى المصابين بالجلطات.. ستبدأ الدراسه Gulf Lp(a) registry خلال الأشهر القادمه بإذن الله.

A new study from Qatar’s HH highlights the metabolic burden in de novo HF: • 1 in 10 newly diagnosed w DM 
• 1 in 3 had unrecognized dysglycemia
• ~50% with prediabetes → DM in 26 months @DrMarthaGulati @SJGreene_md @GULFHeartAssoc @Hragy frontiersin.org/journals/clini…

GulfPCR 2025 in live case from Mohammed bin Khalifa centre 🇧🇭 🎯 importance of CT pre PCI planning 🎯 IVUS to guide decision in PCI 🎯 SBS LM provisional PCI 🎯 post PCI optimization guided by IVUS @aayshacader @Hragy @mirvatalasnag @KhalidAlSaidiMD @Dr_Almubarak @DrHaithamAmin

LIVE Educational Case: Provisional left main stenting after lesion preparartion guided by IVUS Learn from replay📺pcronline.com/Cases-resource… Operators: @DrShereen_ @FBardooli Procedural Analyst: @GoranEBC Key moments 🟣33:05–43:28 : Lesion preparation - IVL 🟣51:20–54:28 : Left main - LAD stenting 🟣24:00–31:20, 43:42–50:40, 58:20–1:01:50, 1:10:27–1:17:20 : IVUS at each step This case has been editorialised by @MartineGilard #GulfPCR #interventionalcardiology #imagefirst #cardioed

@jaygirimd @JACCJournals Thank you @jaygirimd for the nice summary.I don’t see how would this new category help direct management more. As the simple low risk (will be treated medically) while unstable high risk will go for invasive procedure. And we are still in the grey zone in the mid left for PERT !

3a/ This is a major change in risk categorization compared to prior AHA and ESC reccs. Writing group felt granularity needed to capture current evidence & options for treatment. Greg Piazza will explain the development process in upcoming @JACCJournals editorial.

🧵 1/ First ever AHA/ACC/multi-society guidelines re: diagnosis & management of acute PE released today! 2 year effort with 38 authors from 10 specialties. Link attached & summary in this thread: jacc.org/doi/10.1016/j.…

Credits for sharing to Dr. Abdulrahman Nassiri 💐👌🤝 100 concise pearls from the 2026 AHA/ACC Guideline for Acute PE 🫀 Acute PE – 100 Pearls 1️⃣ PE risk stratification is mandatory before therapy. 2️⃣ New AHA/ACC Acute PE Clinical Categories A–E introduced. 3️⃣ Category A = incidental, asymptomatic PE. 4️⃣ Category B = symptomatic, low severity score. 5️⃣ Category C = elevated severity score ± RV strain. 6️⃣ Category D = incipient cardiopulmonary failure. 7️⃣ Category E = cardiopulmonary failure. 8️⃣ Use validated clinical probability tools. 9️⃣ Wells score remains practical. 🔟 Revised Geneva score validated. 1️⃣1️⃣ PERC rule avoids unnecessary imaging in very low-risk. 1️⃣2️⃣ Always assess pretest probability before imaging. 1️⃣3️⃣ Age-adjusted D-dimer recommended. 1️⃣4️⃣ Threshold = age ×10 μg/L (FEU). 1️⃣5️⃣ <2% failure acceptable for PE exclusion. 1️⃣6️⃣ YEARS algorithm reduces imaging burden. 1️⃣7️⃣ D-dimer strategies unsafe if already anticoagulated. 1️⃣8️⃣ Pregnancy-adapted YEARS supported. 1️⃣9️⃣ Avoid over-testing in low probability patients. 2️⃣0️⃣ CTPA is first-line imaging. 2️⃣1️⃣ Positive CTPA confirms PE. 2️⃣2️⃣ High-probability V/Q is diagnostic. 2️⃣3️⃣ Prefer CTPA over planar V/Q. 2️⃣4️⃣ V/Q SPECT better than planar V/Q. 2️⃣5️⃣ Echo cannot rule in or rule out PE. 2️⃣6️⃣ RV/LV ratio should be reported numerically. 2️⃣7️⃣ RV/LV ≥1 suggests RV strain. 2️⃣8️⃣ TAPSE <1.6 cm abnormal. 2️⃣9️⃣ McConnell’s sign indicates RV dysfunction. 3️⃣0️⃣ Report chronic thromboembolic signs on CT. 3️⃣1️⃣ LMWH preferred over UFH initially. 3️⃣2️⃣ DOACs preferred over VKAs. 3️⃣3️⃣ DOACs reduce major bleeding. 3️⃣4️⃣ Extended anticoagulation if unprovoked PE. 3️⃣5️⃣ Treat first episode ≥3–6 months minimum. 3️⃣6️⃣ Persistent risk → continue beyond 6 months. 3️⃣7️⃣ Evaluate bleeding risk regularly. 3️⃣8️⃣ IVC filters not routine. 3️⃣9️⃣ Use IVC filter only if anticoagulation contraindicated. 4️⃣0️⃣ Remove IVC filter when safe. 4️⃣1️⃣ Category A patients can be discharged. 4️⃣2️⃣ Category B often early discharge. 4️⃣3️⃣ Category C requires hospitalization. 4️⃣4️⃣ Category D needs close monitoring. 4️⃣5️⃣ Category E needs aggressive intervention. 4️⃣6️⃣ Persistent hypotension defines high risk. 4️⃣7️⃣ Use biomarkers for risk stratification. 4️⃣8️⃣ Troponin elevation signals myocardial injury. 4️⃣9️⃣ BNP elevation suggests RV strain. 5️⃣0️⃣ PE Response Teams (PERT) recommended. 5️⃣1️⃣ Systemic thrombolysis for high-risk PE. 5️⃣2️⃣ Consider advanced therapy in D1–D2. 5️⃣3️⃣ Catheter-directed thrombolysis reasonable. 5️⃣4️⃣ Mechanical thrombectomy evolving option. 5️⃣5️⃣ Surgical embolectomy when indicated. 5️⃣6️⃣ ECMO for refractory shock. 5️⃣7️⃣ Avoid routine thrombolysis in low-risk PE. 5️⃣8️⃣ Evaluate for contraindications before lytics. 5️⃣9️⃣ Monitor for intracranial hemorrhage risk. 6️⃣0️⃣ Early recognition saves mortality. 6️⃣1️⃣ Assess hemodynamics continuously. 6️⃣2️⃣ Monitor oxygenation closely. 6️⃣3️⃣ HFNC or NIV may be required. 6️⃣4️⃣ Mechanical ventilation cautiously. 6️⃣5️⃣ Avoid aggressive fluid overload. 6️⃣6️⃣ Use vasopressors if hypotension. 6️⃣7️⃣ Norepinephrine preferred. 6️⃣8️⃣ Reassess category over time. 6️⃣9️⃣ Clinical status can evolve rapidly. 7️⃣0️⃣ Repeat imaging only if clinically indicated. 7️⃣1️⃣ Ask about dyspnea at every follow-up visit. 7️⃣2️⃣ Screen for CTEPD at least 1 year. 7️⃣3️⃣ Persistent symptoms need evaluation. 7️⃣4️⃣ Chronic RV strain needs specialist input. 7️⃣5️⃣ Exercise intolerance must be addressed. 7️⃣6️⃣ Educate patients about recurrence risk. 7️⃣7️⃣ Travel guidance important. 7️⃣8️⃣ Activity resumption individualized. 7️⃣9️⃣ Avoid routine thrombophilia testing acutely. 8️⃣0️⃣ APS alters anticoagulation choice. 8️⃣1️⃣ Cancer-associated PE requires special planning. 8️⃣2️⃣ Pregnancy PE requires low-dose protocols. 8️⃣3️⃣ Avoid over-radiation in pregnancy. 8️⃣4️⃣ Avoid under-treatment of high-risk PE. 8️⃣5️⃣ Document RV strain in report. 8️⃣6️⃣ Quantify clot burden cautiously. 8️⃣7️⃣ Clot burden alone not treatment determinant. 8️⃣8️⃣ Clinical severity score essential. 8️⃣9️⃣ Hemodynamics trump imaging. 9️⃣0️⃣ Biomarkers add prognostic

Complex multivessel disease: CT- and IVUS-guided complex bifurcation PCI - #EuroPCR LIVE educational case 📺pcronline.com/Cases-resource… (via your free My PCR account) Opearators: @NievesGonzalo1, @JEscaned Procedural analyst: @FBardooli Watch this replay, chapterised by @MartineGilard, to optimise your learning experience: Key moments 🟣17:50-19:40 - Cx bifurcation PCI with provisional stenting 🟣20:40-24:13 - CT analysis 🟣26:03-44:44 - CT/angio co-registration 🟣1:02:57-1:08:39 - Dual microcatheter liner for diagonal wiring after LAD stenting 🟣1:17:53-1:20:31 - Post-procedural analysis #interventionalcardiology #CardioEd

@XavierPrida @Babar_Basir Well said ✅

One thing is certain- any team with @Babar_Basir as a member/player is better, stronger, faster, and more graceful. Beneficence defined with "patient-dom" made good.

@Hragy @nolanjimradial @SVRaoMD @mmamas1973 @mirvatalasnag Good to know, but I am not fan of it 🫣

@nolanjimradial @SVRaoMD @mmamas1973 @mirvatalasnag Your thoughts on #dtra ?

2019 Ferdinand Kiemeneij Came to Cairo where I learned distal radial access from him. After he left I considered but found no real personal need for distal radial access for me, but was good to meet again, to learn something new,and since then using US guidance and more left side

@Hragy @AAbbot52838 @PCRonline @Shoaib9702 @mmamas1973 @mirvatalasnag @ANazmiCalik @CuissetDr @RHAAttar @w_jyg @KardiologieHH @Zill_cardio @adil_jabri @yaqoub_lina @Zayer_h @SripalBangalore @Dr_ShazaAlalawi @aayshacader @ShariqShamimMD @rallamee @sbrugaletta @NievesGonzalo1 @MohanedEgred @MogneeA Agree 💯 %

@AAbbot52838 @FBardooli @PCRonline @Shoaib9702 @mmamas1973 @mirvatalasnag @ANazmiCalik @CuissetDr @RHAAttar @w_jyg @KardiologieHH @Zill_cardio @adil_jabri @yaqoub_lina @Zayer_h @SripalBangalore @Dr_ShazaAlalawi @aayshacader @ShariqShamimMD @rallamee @sbrugaletta @NievesGonzalo1 @MohanedEgred @MogneeA The answer is no- because the data of COMPLETE almost had no CTO patients

70 years active lady AWMI last month PPCI to LAD. disease RCA. What would you do to RCA. Pt is Asymptomatic @shoaib9702 @mmamas1973 @PCRonline @mirvatalasnag @ANazmiCalik @CuissetDr @Hragy @RHAAttar @w_jyg @KardiologieHH @Zill_cardio @adil_jabri @yaqoub_lina @Zayer_h

@realarainmd @Shoaib9702 @mmamas1973 @PCRonline @mirvatalasnag @ANazmiCalik @CuissetDr @Hragy @RHAAttar @w_jyg @KardiologieHH @Zill_cardio @adil_jabri @yaqoub_lina @Zayer_h @SripalBangalore @Dr_ShazaAlalawi @aayshacader @ShariqShamimMD @rallamee @sbrugaletta @NievesGonzalo1 @MohanedEgred @MogneeA Still more to learn despite all DATA !!

Interesting dilemma, Fawaz. I can see the case for both strategies: complete revascularization vs. deferral guided by FFR (like you did). As @mirvatalasnag notes, plaque erosion often involves multiple coronaries, so OCT to assess the “state of the endothelium” may be helpful. BTW, I may have also gone the deferred route, but using cardiac PET as per our routine.

I completely understand PCI supporter✅ Imagine this lady come to visit me 2 months back with angina pain, I fix her LAD as it is tighter and correspond to RWMA on Echo, then I have the RCA as it is 👆. Stable angina symptoms medical VS PCI using contemporary data @BaoGTran.

@BaoGTran @Shoaib9702 @mmamas1973 @PCRonline @mirvatalasnag @ANazmiCalik @CuissetDr @Hragy @RHAAttar @w_jyg @KardiologieHH @Zill_cardio @adil_jabri @yaqoub_lina @Zayer_h @SripalBangalore @Dr_ShazaAlalawi @aayshacader @ShariqShamimMD @rallamee @sbrugaletta @NievesGonzalo1 @MohanedEgred @MogneeA Point well taken .

@FBardooli @Shoaib9702 @mmamas1973 @PCRonline @mirvatalasnag @ANazmiCalik @CuissetDr @Hragy @RHAAttar @w_jyg @KardiologieHH @Zill_cardio @adil_jabri @yaqoub_lina @Zayer_h @SripalBangalore @Dr_ShazaAlalawi @aayshacader @ShariqShamimMD @rallamee @sbrugaletta @NievesGonzalo1 @MohanedEgred @MogneeA With a history of MI, based on available data she is at high risk for having recurrent event in nonculprit vessel regardless of ischemia or not. I would offer a complete revasc.