Justin M. Simmons

@drkeithsiau @AixEndo Call vascular surgery.

Unusual finding in the duodenum via @AixEndo. What would you do?

@AnnieWaldman @Propublica dropped 3 articles highlighting #overuse of #PAD procedures today, and they are alarming. If this isn’t a call to action, I don’t know what is. #WeCanDoBetter @VascularSVS @ACCinTouch @SIRspecialists @OEISociety @CMSGov propublica.org/article/resear…

@farkomd 100%!

Do you have vein envy?

Congrats, @AKimballMD, on receiving the Mitch & Karen Padnos Innovation Award! “Thoracoabdominal aortic aneurysms are highly morbid and often fatal. FEVAR has been paradigm-changing. Headed out to expand knowledge, foster relationships, and learn regulatory processes.”

@MrBeast Sounds peaceful. Kids would miss me though although they are HUGE fans of yours so I’d get major dad points.

Would you spend 100 days in this room with a random stranger for $500,000? (Door is unlocked, if one of you leave before day 100 you both lose)

@farkomd I was thinking the same thing about mine actually … been one of those call weekends.

How was your weekend? I think this room should charge me a 3 night stay

@MedIssacDom ER ——-> Vascular Surgery

What field/specialty did you believe you’d go into at the beginning of the medical school and what did you end up going into? For me: Sports Medicine —> OB/GYN #Match2023 #medtwitter

"Every surgeon carries within himself a small cemetery, where from time to time he goes to pray - a place of bitterness and regret, where he must look for an explanation for his failures." - Rene Leriche, 1879-1955.

@sulaiman_shamsi Id likely try for the PTA to get a blush from in-line flow

Post ATA recanalization for patient with heel ulcer Will you push more or you will stop at this stage ? #criticallimb #vascular #ampuationfight

@LeonardoRandial @farkomd @limbsalvagedr @jmills1955 @monteromiguel @GAEscobarMD @DevinZarkowsky @docpark @AmputationSuck @Aortatico Ive done endarts with local/MAC. If he’s ambulatory then endart may be best. What makes him high surgical risk? Native groin?

88 y/o man, foot rest pain and ulcer, W/ LVEF 25% and cardiac re-sync. High surgical risk, what are mu options? @farkomd @limbsalvagedr @jmills1955 @monteromiguel @GAEscobarMD @DevinZarkowsky @docpark @AmputationSuck @Aortatico @

@naviyd Whats it look like from antegrade approach? Curious about the history because as pointed out those tibials are amazing. Likely best served with bypass if candidate.

How to cross a completely flush P3 occlusion with side branches via pedal access? (Yes, those are 🔫 bullet fragments) #CLIfighters

@farkomd On the graft like a signature on a line

I think I’m going to label my pictures in the future. Supra SMA xclamp with anastomosis at renals. Should label be next to graft or on graft? #AortaEd

@aksyksvsclb I always go until I get a visible wound blush preferably via direct in-line flow. Usually select out each tibial (if patent) and shoot so there is no ambiguity.

Here is the patient with uninfected wound w rest pain. there was %90-%99 prox SFA, %100 anterior tibial and %100 posterior tibial lesions. Foot was supplied by peroneal artery via the strong collaterals. Should i wait or go for tibial arteries in the same sesion?

@mattsmeds Used one until the hospital got rid of it. Instead I now have two separate apps for hospital and providers to use, one app for the office answering service, and my cell number 🤦🏼‍♂️

Am I old because I still use a pager? Who’s still with me in #VascularSurgery? Do you use pagers?

After some delay on my end I am now officially an active member of SVS. Woohoo! #societyofvascularsurgery

Apparently I’m running specials on SMA thrombectomies this call weekend. 2 down and I know the 3rd is lurking somewhere. #vascularsurgery #theyalwayscomeinthrees

@FadiSaab17 @kmadass @SDhandMD @keithppereira @dandu_n @shadihalabi4 @MacAnsari @drmcumming @BobTahara @bretwiechmann @AmputationSuck I would be concerned about integrity of suture line. Early graft thrombosis would have me worried about an infectious process or poor outflow. I suspect the hood of the graft would come up to that PSA. Infectious process could disrupt the suture line causing the PSA.

CLI challenge of the day, post surgical incidental finding, bypass 6 months ago occluded. Rest pain, no pain at the groin #CLIFighters @kmadass @SDhandMD @keithppereira @dandu_n @shadihalabi4 @MacAnsari @drmcumming @BobTahara @bretwiechmann @AmputationSuck

@FadiSaab17 Please tell me it’s not one of mine that occluded 🤞🏻

This is a live clip of the pseudo, the neck around the 5 location

@mcuban Thanks for the post Mr. Cuban. Let’s not forget about those of us who are DOs and went through the same gauntlet as our allopathic counterparts.

I want to share what I think about MDs. I love each and everyone that busted their ass, borrowed too much money, sacrificed more than we can ever quantify, in hopes of helping their patients. Medicine is an imprecise science. The uncertainties far outnumber the absolutes.

@sewveindoc @EmergencyDocs ABSOLUTELY!!!

Attention ED providers. When working up patients with arterial occlusive disease/ischemia of the lower extremities, please stop ordering, unilateral CT angiogram of the extremity. Please order CTA of the aorta with bilateral runoff. #comprehensivevascularcare @EmergencyDocs