Dr. Helena Lima

Life, work, weekends—embrace the challenges each day brings.

Today, after 3,125 days of rehab, I stood up from my couch by myself for the first time! Eight and a half years of work went into this moment, and every second was worth it. I feel so blessed to have this continued progress, and I’ll never take this ability for granted!

Starting the day in the OR, grateful for the trust my patients place in me. Every procedure is a blend of science, precision, and artistry. ✨🩺

Halloween was a blast! 🎃 This is the livery of Edward the Black Prince. He’s an actual historical figure in my Time Travel novel Soul Scepter. Amazon recommended the costume to me based on things I had been researching 😂 #SoulScepter #BlackPrince #TimeTravel #HistoricalFiction

@Siddmann I also really like China. What lasting impressions did this trip to China leave on you?

Wrapped up a whirlwind trip of China. Blown away by the hospitality of Chinese peeps. Proud owner of a personal “Panda with a white coat” courtesy Prof Zeng Rui from the busy West China hospital Chengdu, China #epeeps

🚨 BREAKING — CREST-2 Changes the Game in Asymptomatic Carotid Stenosis A landmark NEJM paper (Nov 2025) delivers the most rigorous evidence to date on how to manage ≥70% asymptomatic carotid stenosis — and the results will ignite global discussion. 🔥🧠 🔍 What CREST-2 found Across 2 parallel randomized trials, comparing intensive medical therapy (IMT) vs. Carotid Stenting or Carotid Endarterectomy (CEA): 🩺 1️⃣ Stenting Trial Primary outcome at 4 years: IMT alone: 6.0% Stenting + IMT: 2.8% ➡️ 53% relative risk reduction NNT ≈ 31 More peri-procedural events with stenting (1.3% vs 0%), but much fewer long-term ipsilateral strokes. 🔧 2️⃣ Endarterectomy Trial Primary outcome at 4 years: IMT alone: 5.3% CEA + IMT: 3.7% ❌ Non-significant difference (P=0.24) Trend favors CEA but underpowered to prove superiority. ⭐ Strengths of CREST-2 💪 Rigorous design: Two parallel RCTs, observer-blinded primary outcome adjudication. 🌍 Large, multinational cohort: 2,485 patients across 155 centers. 📈 Excellent risk-factor control: IMT arm achieved LDL <70 mg/dL and SBP <130 mmHg in the majority (Figure 1, pages 6–7). 🧠 High-fidelity event capture: Stroke adjudicated with MRI preferred (82%), improving sensitivity vs. prior studies. 🔬 Modern therapies included: PCSK9 inhibitors, updated BP targets, structured lifestyle intervention. ⚠️ Limitations to consider 🧪 Operators were high-volume, certified experts — results may not generalize to all centers. ⌛ Outcome affected by evolving medical therapy: Improved BP, LDL, diabetes & obesity treatments may reduce incremental benefit of revascularization. 🧭 No evaluation of transcarotid revascularization (TCAR): Now widely used but not incorporated. 🔍 Periprocedural risk remains: Especially for stenting (1.3%) and CEA (1.5%). 📉 Borderline tipping-point analyses: A few additional or removed events could shift significance — especially for stenting. 🧩 Some post-procedure strokes may not be carotid-related, limiting causal inference. 🧩 Take-home message For asymptomatic ≥70% carotid stenosis: Stenting + IMT → significant reduction in 4-year stroke risk, despite a small procedural risk. CEA + IMT → trend to benefit, but not significant. Intensive medical therapy performed exceptionally well — far better outcomes than historical controls. The debate isn’t over — but CREST-2 redefines the landscape. Stroke prevention will never be the same. 🔄🧠✨

PHOTON COUNTING CT AND A NEW CONCEPT OF NORMAL CORONARY ARTERIES For more than 2 decades we have been performing Cardiac CT with constant improvements in all parameters (spatial, temporal and contrast resolution). The improvements were progressive in certain fields and steep in other (e.g.: the introduction of Dual Source CT that completely changed the range of temporal resolution achievable basically overnight and still is the most important source of flexibility in Cardiac CT scanning after almost 20 years). Spatial resolution instead was improved in a slow and progressive way until the test EID CT generations that achieved a spatial resolution of 250 microns. This allowed us to assess a coronary artery tree and define it as normal when no apprentice changes were visibile up to that value. But we know that the normal thickness of coronary artery walls is quite below that threshold. It is more in the range of 80-200 microns. Therefore, the very early changes in coronary artery wall thickness could not be picked up by EID CT technology. With the introduction of PCCT we can constantly achieve 100 microns spatial resolution which means that we work extol in range in which coronary artery disease starts. It also means that we don't see any thickening of the the coronary artery walls we have a much higher specificity and reliability. This concept is a transformative one because it allows us to shift earlier and earlier the beginning of atherosclerosis in our patients and think even more precisely in terms of cardiovascular prevention and monitoring. Movie: example of normal coronary artery tree with PCCT. A new era is coming into practice and it is the age of Photon Counting CT which pushes this boundaries further away. PCCT is a NEW Imaging Modality. PCCT is changing the game, the field, the language, the priorities and in the end it will change the entire infrastructure of diagnostic medicine. PS: note that PCCT images have to be reduced in resolution when uploaded in social media. #CardiacImaging #MedicalInnovation #StentAssessment #Radiology #PCCT #photoncounting #QuantumHD #CT #computedtomography #yesCCT #coronaryarterydisease #ischemia #naeotomalpha #Peak #Pro #Prime #speed #cardiac #highresolution #siemenshealthinners #CardiacCT #PhotonCountingCT #MedicalImaging #HeartHealth #CardiovascularInnovation #Radiology #AIInMedicine

@DrRumberger A perfect match, Lol

Cheese

This is an old ad from the 50s to get warn kids from doing dangerous activities Wait until you see the kid "fall" from the ledge 😂 The doctor probably prescribed him a pack of cigarettes

@banks_AZ @HeartOTXHeartMD @gretchemaben What a stunning view! Where is this?

@HeartOTXHeartMD @gretchemaben

I'm asking those who love the outdoors to post a picture. A picture that YOU took. Just a pic. No description. The goal is to regain peace and harmony without negativity. Please copy the text, put a picture on YOUR page, and let's look at these beautiful pictures. Here’s mine:

Fantastic @American_Heart scientific statement on best practice for coronary physiological assessment. If you're going to do it, do it correctly. @SripalBangalore @HollandTamis @ACCinTouch ahajournals.org/doi/10.1161/CI…

Please welcome our newly elected Board of Directors who began their roles on November 1st! We are looking forward to an exciting two years with them. The full Board roster can be viewed online, please visit this link: surgicaloutcomesclub.com/board-of-direc…

Well this just happened ! Promoted to Associate Professor of Surgery @UMontreal @CRCHUM Thank you to those who supported my application @TL_Forbes, Dr Arya & Dr Harris

A great day at the office.

🔥Hot of the press - Our Lancet Seminar in Peripartum cardiomyopathy‼️ #PPCM sciencedirect.com/science/articl… @ShelleyZieroth @hvanspall @GiuseppeGalati_ @Herzmedizin_de @ehj_ed @EJHFEiC @DGK_org @DavidDuncker @HenrikeHillmann @DrMarthaGulati @mvaduganathan @slumberbell

🫀 Insightful #AHA25 session led by @docHJ @AHAScience, diving into real-world coronary artery disease cases & clinical decision-making 💡 His dedication to teaching and mentoring future cardiologists continues to inspire! 💙 @utmbhealth #Cardiotwitter

How do you avoid insurance premiums following the same path as college tuition ? When the money is easily available , consumers often shop less, not more. Once colleges realized this, prices skyrocketed. Why wouldn’t the same thing happen with insurance premiums and deductibles ? @SenBillCassidy

A 🔥 @AtriumHealth @advocatehealth #cardioonc symposium led by @JaiSingh_MD @amar_parikh! A 🤯 feat of balancing #cardioonc, cancer, & ♥️ disease in a forum that engages EVERYONE in cardiology, not just our tribe. Excited to see this 🚀 🙏 for letting us be a part of this!!

Great to meet such a great cardio-onc group during the regional Cardio-onc symposium on current paradigms in CV care of cancer patients and survivors #cardiotwitter #CardioOnc

🫀 Proud of this collaboration led by @jmayour: AI-enhanced infant #ECGs can accurately detect #critical #congenital #heart #disease (CCHD). This low-cost tool could complement pulse oximetry screening, reduce late diagnoses, & improve care globally. 👉 doi.org/10.1016/j.jace… #AI #Cardiology #Pediatrics #CongenitalHeartDisease #DigitalHealth #MedTech #AIinHealthcare @JACCJournals @AHAScience @MayoClinicCV @BostonChildrens @DrMarthaGulati @PRodriguezMD @RBP0612 @ggvela @RobertHPass

Great tech transfer session @CedarsSinai on #commercialization of #inventions. Featured @Jeff_golden1, @OphirKlein and Nirdesh Gupta. I spoke on #exomers— #ncRNA drugs bioinspired by #EV cargo.