Nathan Ertel MD

@patrickppatten @IR_Doctor @SIRspecialists @SIRRFS @AustinBourgeois @keithppereira @ajgunnmd @CHICKVIR @AgnesSolberg @LessneVIR @kmadass @IRadColorado Don’t fix a pig.

@IR_Doctor @SIRspecialists @SIRRFS @AustinBourgeois @keithppereira @ajgunnmd @CHICKVIR @AgnesSolberg @LessneVIR @kmadass @IRadColorado Looks like a case of IJ snare, trim, and tuck, though I know some who would just remove and replace due to subclavian placement. Thoughts on one vs the other?

Hospitalist calls: "Hey Peder, we have this pt from out of state, and his port is too long. Can you please take a look at him and help?" Me: "Sure, the rad probably just over-called the tip position a bit." Then I look at the CXR myself. ... Scout in #iRad: 🙃

@carin_gonsalves @SIRspecialists @womenirads @RonaldWinokurMD @JeffersonRads From my personal collection- a gift from Jack Roehm!

For all those trainees out there, what’s the name of this filter?⁦@SIRspecialists⁩ ⁦@womenirads⁩ ⁦@RonaldWinokurMD⁩ ⁦⁦@JeffersonRads⁩

@DrAnnieKLim @uab_ir Yes.

@keithppereira @uab_ir @SIRRFS @SIRspecialists Not that crazy. It was in the sheets between the pts back and the table, waiting to poke an unwitting soul. Fortunately, the needle was covered. Things can get pretty chaotic in a truama bay.

@NathanErtel @uab_ir @SIRRFS @SIRspecialists WHAT? was this inside???

Always check your scout image. Trauma pt came to IR with a bonus hiding sharp... #iRad #TwittIR @uab_ir @SIRRFS @SIRspecialists #FOAMIR #SafetyFirst

A #IRad trick i learnt on #TwittIR from @NathanErtel and @ajgunnmd ...with a little twist!😋

Fenestrated hepatic artery. I thought I was seeing things, but proved it by doing a loop-de-loop with my microcatheter. #SIRRFS #iRad @JVIRmedia @uab_ir @uabRadResidents @uabmedicine

After 7 fantastic years at UAB, I am happy to announce that I will be joining a fine group of Interventional Radiologists at Quantum Radiology in Atlanta. Many thanks to those who have helped me develop my skills and career here at UAB!

Breast cancer presenting as massive hemorrhage. Embolized with @bostonsci Embozene particles via radial artery access. #SIRRFS #JVIRMedia #WithoutAScalpel #irad #Cancer @BreastImaging @BCCare

Work event...

@AvaStarMD @LessneVIR @UABVascular @SIRspecialists @SIRRFS @JVIRmedia @uab_ir @ahmed_kamel_ir @ajgunnmd @parkhurst42 @amdevane @rakeshkvarma Not “an” 8mm stent- 4of them!!

@LessneVIR @NathanErtel @UABVascular @SIRspecialists @SIRRFS @JVIRmedia @uab_ir @ahmed_kamel_ir @ajgunnmd @parkhurst42 @amdevane @rakeshkvarma Leg vein stent?

Pt presented to ED with CP, SOB. CXR shows embolized venous stent from OSH. Retrieved with 3 snares, 4 forceps, OR on standby, @UABVascular help, 26F sheath, extra IR. Immediate symptom relief @SIRspecialists @SIRRFS @JVIRmedia #withoutascalpel #MIIPS #venous #embolize @uab_ir

@AvaStarMD @UABVascular @SIRspecialists @SIRRFS @JVIRmedia @uab_ir @ahmed_kamel_ir @ajgunnmd @LessneVIR @parkhurst42 @amdevane @rakeshkvarma It was initially placed in a leg vein- along with 3 others. Not so tiny- 8 mm x 4 cm or so (before I smashed it).

@NathanErtel @UABVascular @SIRspecialists @SIRRFS @JVIRmedia @uab_ir @ahmed_kamel_ir @ajgunnmd @LessneVIR @parkhurst42 @amdevane @rakeshkvarma Where did they originally place this tiny stent?

@DrCaughron_IR @UABVascular @SIRspecialists @SIRRFS @JVIRmedia @uab_ir @ahmed_kamel_ir @ajgunnmd @LessneVIR @parkhurst42 @amdevane @rakeshkvarma Yes, that was a possibility, but would not likely have improved the symptom of sob, or chest pain- no guarantee that stent retrieval would either...

@NathanErtel @UABVascular @SIRspecialists @SIRRFS @JVIRmedia @uab_ir @ahmed_kamel_ir @ajgunnmd @LessneVIR @parkhurst42 @amdevane @rakeshkvarma Consider just ballooning it into place in the PA?

Thanks @AWBeckMD and @ahmed_kamel_ir

Endoscopic biliary stent failure. Percutenous retrieval with snare, Glidewire through stent, and retraction. The Glidewire provides guidance when they don't pull out easily #SIRRFS #withoutascalpel #iRad #JVIRmedia #MIIPS #Cancer #TwittIR @SIRspecialists

@Anuj_MalhotraMD @SIRspecialists Yes. The pancreas, celiac artery branches, and gallbladder were all in close proximity. I studied my CT images very carefully.

@NathanErtel @SIRspecialists Any fear of going through pancreas or bowel?

Percutaneous Meso-caval shunt creation via trans-splenic access. Bleeding varices, portal system 100% thromboses, TIPS failed, couldn't recanalize portal, had to completely bypass. #iRad #IR #SIRRFS #withoutascalpel #MIIPS #cirrhosis @sirspecialists #JVIRMedia

@mms62786 @SIRspecialists Completely fluoroscopically. I considered ICE. It may have been useful- I’m using it on another case shortly!

@NathanErtel @SIRspecialists Boss. Done completely fluoroscopically? Or used ICE as well?

@mcbreamy @SIRspecialists Well that’s a silly question- of course I did!!

@NathanErtel @SIRspecialists Did you wear your Fez during the procedure?

The portal had been thrombosed chronically- not intraprocedurally.