Mona Ranade

Today, we are launching Clinical Compass (patent pending): clinicalcompass.net Think: TurboTax for clinical decision-making!!! Built especially for trainees and early-career physicians—and completely free. A system that actually executes the workflow! 👇@abhiklahiri

Bulky metastatic colorectal cancer with severe IVC compression + thrombus causing hepatic congestion and rapidly worsening symptoms. S/p venography, thrombectomy, thrombolysis, venoplasty, and IVC stenting with marked clinical improvement and significant LFT downtrend afterward.

Here is the full project analysis: mentormates.ai/projects/publi… @MiraMalavia @Stanford_IR

In this walkthrough, @MiraMalavia breaks down our study CDT for PE: Cost, Utilization, & Provider Variation in Contemporary US Commercial Claims Cohort—from how we built the cohort to what the results really mean. @medeloopai @StanfordRad @Stanford_IR youtu.be/AE2tFlHEr7E

Unc IR integrated residency has an unexpected opening for a rising R3 for a current DR or IR resident in good standing. Email caroline_carswell@med.unc.edu to apply!

You’re at the bedside. You know the guideline. But what’s step 1 → 2 → 3 right now? That’s what we’re building with clinicalcompass.net Try it + tell me what’s missing 👇

@marabi2004 Used your balloon - chain technique

@msran124 Great work

Failed SVC recan in chronic venous congestion from SCV occlusion. TEE ✔️ Sharp recan ✔️ Still no flow… What’s your next move? 👇

@marabi2004 RF wire from CFV access and VBX worked

@msran124 So if you get your sheath down below the stent then use Chiba to aim for SVC stump, the distance will be shorter

After-hours and weekend interventional radiology adverse events were associated with more serious outcomes despite similar quality-of-care assessments, likely reflecting higher patient acuity and urgency. link.springer.com/article/10.118… @CVIR_Journal @KECKSchool_USC @UWRadiology

@Kaden1818 I think the length of the catheter is the limiting factor. May not reach due to patient body habitus.

@msran124 Ever tried Liverty Tips access set for venous recans? Steerable cannula up to 75 degrees with 18G beveled hollow needle.

@marabi2004 I have run into a string of these, this other one is secondary to abandoned lead that is absolutely impossible to pierce through. Will try all the 👆 above options. Thanks for the suggestions.

@msran124 This is what I call “balloon-stent chain technique”

@marabi2004 Covered stent or bare metal? Typically i just do bare metal but given all these aggressive measures…

@msran124 Sharp recan of right BCV to get straight access to azygous knob to be able to puncture down into SVC stump

@Flavius_IR The left sided access wire / balloon terminates at the end of the stent. Exits into collaterals if I try to recan from the left. I had a 65 chiba targeting the balloon from CFV.

@msran124 Hold on, on image 3, with the balloon in the left BCV stent, isn't that wire through into IVC?

@marabi2004 I tried 65 Chiba from below, under TEE guidance, had the sheath parked at the stump of SVC but the throw was 3.4 cm and didn’t have enough push. The needle deflected away from the balloon. I tried targeting from IJ access with 21 g Chiba as well, same issue. Thinking RF wire next

@msran124 Sharp recan from right IJ access targeting the SVC stump at the cavoatrial junction… use braided sheath with long chiba (with gentle curve ) to target the stump

@FarajAlkassMD Chronic occlusion. Previous catheters. Has TX kidney now. No acute clot.

@msran124 chronic, invariably some acute element. Will start with thrombolysis TPA for a few hours then angiogram to assess if further lysis is needed. follow up with thrombectomy (debulking). Stent to follow. Btw etiology, age, ct scan??. ie. If inlumen tumor extension,off label VBX,🤷‍♂️

RHT in PE is where guidelines get blurry and decisions get hard. Our new CHEST paper offers a practical framework for real-world management. #ClinicalDecisionMaking #MedTwitter

My most noteworthy experience at SIR 2026 was to be there when Sue got her award. It meant a lot to see her get recognized. As anyone who trained at USC can attest, Sue deserves all the recognition our society has to offer. She is a true model for all - she always does her job to the highest degree and puts patient care first. I sometimes wonder is someone like me would survive in our current trainee environment. I was interested, hard working, and intellectually curious but was admittedly a bit timid procedurally during residency. The people at USC, including Mike, Vicki, Don, Ray and Ilya recognized my potential and fostered it while acknowledging where I had room for improvement - always directly and with respect. Sue trained me to the highest level, but more importantly, cared about me as a person first and foremost. My interview with her was unique- she didn’t care about the tiny details about cases I did or abstracts I presented. She tried to get to know me as a person, to see if the environment at USC was something I would be able to succeed in. And she was brutally honest about it. I left thinking “what was that?” But also with a feeling of inspiration and connectedness. As a junior attending at USC, she always kept a watchful yet distant on eye on me- giving me space to grow. She always had a 6th sense when something was bugging me or I was down, and always offered her support. To this day she visits me and my family on the east coast, sends my kids gifts and helps celebrate their milestones from afar. She truly is one of a kind. It’s people like her that make being in IR a privilege. Congrats Sue!

Trial Design 🩸 40% of patients with DVT will develop PTS (from chronic pain, leg swelling, and venous ulcers) C-TRACT randomized 225 pts with moderate-to-severe PTS and iliac vein obstruction to standard care OR standard care + endovascular therapy (iliac-vein stenting).

Goal: right care, right time, more consistency. Would love input—where do guidelines break down most in your day-to-day? Explore / share feedback: Women’s Health: womenshealth-compass.lovable.app Men’s Health: menshealth-compass.lovable.app GAE: …iculatearteryembolization.lovable.app #medEd #healthAI

A series of clinical decision tools that turn complex guidelines into intuitive, patient-specific pathways clinicians can actually use. #ClinicalDecisionMaking #DigitalHealth #MedEd #HealthTech

Launched PE Compass just last week—and the early traction + feedback has been incredible. What’s become clear fast: this isn’t just a PE problem. #MedTwitter