Robert A Lookstein MD, MHCDL

I ask my professional contacts and colleagues to follow this model. Please block all anonymous accounts. The tone of these accounts has become increasing aggressive and harmful. They do not deserve your attention. If you follow, you are endorsing this behavior on #medtwitter

ACVC 2026 | STORM PE: First randomized evidence for aspiration thrombectomy. At #ACVC26, STORM PE delivered a landmark message in pulmonary embolism management. 👉 The first randomized controlled trial evaluating aspiration mechanical thrombectomy versus anticoagulation alone 🧪 Study concept STORM PE addresses a long standing evidence gap: • No prior RCT comparing mechanical thrombectomy plus anticoagulation versus anticoagulation alone • First completed RCT in more than 10 years in this field ➡️ A pivotal step in defining the role of catheter based therapies in acute PE 📊 Primary efficacy outcome Primary endpoint: • Change in RV to LV ratio at 48 hours Results: • Greater reduction in RV to LV ratio in the thrombectomy group • Absolute reduction 0.52 vs 0.24 • Between group difference 0.27 • Statistically significant with P < 0.001 ➡️ Demonstrates superior early right ventricular unloading ⚙️ Procedural performance • Technical success achieved in 100 percent of cases • Median thrombectomy time approximately 25 minutes • No device related transfusion • No access site complications ➡️ High feasibility with excellent procedural safety 🛡️ Safety profile • Comparable major adverse events at 7 days • No increase in major bleeding • No device related mortality • No PE related mortality beyond 7 days ➡️ Safety profile similar to anticoagulation alone 🚶 Functional outcomes • Significant improvement in 6 minute walking distance • Greater recovery between 30 and 90 days in the thrombectomy group ➡️ Suggests meaningful clinical benefit beyond imaging endpoints 🎯 Take home message STORM PE provides: • First randomized evidence for aspiration thrombectomy • Superior early RV recovery • Comparable safety • Improved functional outcomes 👉 Mechanical thrombectomy moves from promising technology to evidence based therapy #ACVC26 #PulmonaryEmbolism #STORMPE #InterventionalCardiology #CriticalCare #Cardiology #Thrombosis #ESC #MedicalEducation

@MountSinaiIR Original Angiogram from 2023

Live @MountSinaiIR 3 year follow up of this endovascular repair of a large superior mesenteric artery aneurysm. Patient is well and is currently 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?

Live @MountSinaiIR getting ready to start 12th Annual NYC IR Med Student Symposium. Big thanks to @TherealDoctorJ for leading this effort.

Live @MountSinaiDMIR our own Vice Chair for Research Bachir Taouli MD MHA sharing his wisdom on Research Investment and Development as part of our Leadership Development Curriculum Series 👏

Live @SIRspecialists @MountSinaiIR congratulations to all the incoming FSIRs to be inducted #SIR26TORONTO and a special 🙌 to our very own alumni @vivianbishay @msran124

SIR publishes practice guidance for treatment of chronic pelvic pain - Interventional News interventionalnews.com/sir-publishes-…

One month to go until SIR 2026 Annual Scientific Meeting! Excited to join conversations that drive patient care and innovation in IR. Join me in Toronto this April! i.snoball.it/p/1W0FqWI9/t #SIR26TOR

Live @MountSinaiIR #NationalResidentsDay We have the most dedicated, brilliant, inspiring, creative, and thoughtful #IRAD residents in the world. Period. Full Stop. ✋ Very grateful to work, teach, partner, and learn with this team everyday #LFG!! @MountSinaiIR

@GillHarkanwar @MountSinaiIR 6fr FR4 guidecath

@roblookstein @MountSinaiIR R2P sheath ?

Live @MountSinaiIR 79 yr old HTN, DM, CAD, CKD duplex showed occluded right renal artery (patent/open in 2023) and left renal artery 60-99% stenosis (PSV 350 cm/sec) treated with Megatron #DES

Live @MountSinaiIR our own @DanShilo and my colleague @saherssabri commenting on the bright future for #IRAD as a comprehensive clinical specialty. From Basement to C-Suite: Interventional Radiology Poised to Consolidate Gains in 2026 theicecommunity.com/from-basement-…

@jaygirimd @JayMathewsMD @ISeropianMD @GBarnesMD @drandrewsharp @jameshorowitzmd @DrJayMohan Just submitted for peer review @jaygirimd should be able to share the results fairly soon 🤞

@JayMathewsMD @ISeropianMD @GBarnesMD @drandrewsharp @jameshorowitzmd @DrJayMohan @roblookstein Will need to wait for peer reviewed pub on that before drawing too many conclusions and considering for guideline influence. Though similar endpoints should be assessed in enrolling trials, so could be supportive

I need som help w this table All trials for MT/CDL (except FLAME and few pts in SEATLEII) were in C2-D2 pts. Yet stronger (2a) recomm for CDL/MT is in E. .. that were excluded from trials. Thougts @jaygirimd @GBarnesMD @drandrewsharp @jameshorowitzmd @DrJayMohan @roblookstein

Live @MountSinaiIR 52yr old pt ?!?! failed endo (kissing stents) and aorta-iliac bypass at OSH with intractable ischemic rest pain (told no other options)….fixed in a few hours by our expert team. Now with no pain and palpable pedal pulses.

Live @SIRspecialists The VIRTEX Registry is Live!!! The first #IRAD focused quality registry is collecting data from our member sites. This is the future of Real World Data. 🙌

Live @MountSinaiDMIR @MountSinaiIR amazing grand rounds from @MattHawkinsMD on healthcare economics…great evening with “the team” and already feeling like a member of our extended family.

Live @MountSinaiIR Publication Alert!! @SIRspecialists @SCAI @SVM_tweets @VascularSVS @PERTConsortium Reperfusion Strategies for Acute Pulmonary Embolism: Design and Ration... sciencedirect.com/science/articl…

Live @SIRspecialists #SIR26BizIR is crushing it!!! what a great showing!! This is our future…Learn the value of your practice!

A true New Yorker giving a keynote is the best. Direct. Informative. Opinionated. Strong. It’s refreshing.

Live @SIRspecialists #SIR26BizIR what a day!! Twice the number of attendees as last year. Standing room only for many of the sessions. This is our moment #IRAD