Rex Ray

@shamitsdesai I think an even bigger issue is the turn over. Every month new dialysis techs, and they are still learning how to palpate the fistula, let alone use ultrasound guidance. If you can’t retain employees, then you cannot teach them advanced skills.

HD nurses not being trained in ultrasound guidance is peak laziness, inefficiency, and healthcare waste. Prob 50+ annual fistulas in the lab for “pulling clots” bc the access nurses have no clue where their needle is.

Used #RevCore to clean out a troublesome central occluded stent. Put up some discs as embolic protection. These stents were occluded for years, the results speak for themselves. #IRad

Double aortic arch! 🌈 🌈 #IRad #VariantAnatomy

Double the vessel, double the clot! Prone, Popliteal access, #ClotTriever. Wired up each side sequentially, and pulled out those dark, sticky clots. #DVT #IRad

@_AzizAhmad_ @SIRRFS @SIRspecialists That’s crazy!! I think I missed that in class, lol.

@RexRayMD @SIRRFS @SIRspecialists New to me! Here is a post about it.

Excuse me Dr. Kaufman, what did you use to embolize the Varicocele!?!? #IRad

@drmcumming @SIRspecialists Neat case, I’ve never seen this before.

Venous insufficiency US shows an arterial structure "inside" the GSV. Diagnosis? @SIRspecialists

@theblanketdog @haydenpanettier @ZacharyQuinto @MasiOka Haha I was thinking the same thing!!

Why is everyone freaking out over an eclipse? It's like you've never seen an episode of Heroes @haydenpanettier @ZacharyQuinto @MasiOka

@aburnett_PharmD Thank you, I’m glad y’all enjoyed my silly stories. We have to fight VTE from all sides, so it was fun and meaningful to share the rural interventional side of the battle!

Central occlusion on a fistula arm, with horrible breast swelling from collaterals. Sharp recan success with #Gunsight technique. A very excellent skill to have in your back pocket!! #IRad

@mahmoudali_md @CHICKVIR @Watts_IR @SIRspecialists Yes agree! It’s a useful technique

@RexRayMD @CHICKVIR @Watts_IR @SIRspecialists The other thing I always do is pass a Cobra 2 catheter up and over and do a run from the other common iliac. Also confirms positioning in a good way

INARI clottriever bold for chronic DVT in May turner pt. Worked well for prepping before ABRE stent @CHICKVIR @Watts_IR @SIRspecialists

@mahmoudali_md @CHICKVIR @Watts_IR @SIRspecialists Yeah, the bifurcation is always hard to see clearly on DSA, and fluoro underestimates compression. IVUS adds so much accuracy to the whole process.

@RexRayMD @CHICKVIR @Watts_IR @SIRspecialists Also I measure the size of stent, and mark the bifurcation using IVUS.

Acute, occlusive #DVT cleaned out with #ClotTriever. There was a compression defect at the iliac origin. Brought her back a few days later with #IVUS, confirmed the compression, and stented with #Abre. It felt weird to put a 12mm in the iliac, but she was petite! #IRAD

Forget the biloma… are those FRENCH FRIES? Is it possible to eat French Fries whole!?!? #Radiology

@RajWellnessMD @InariMedical That’s beautiful.

The images tell the story. Courtesy of one of my partners Travis Healy, MD @InariMedical

@CHICKVIR @InariMedical @davidsshin @FredBertinoMD @UWRadiology @UofWa_IR @EVToday @VIVAPhysicians @SIRRFS @keithppereira @medravi @JBundyRad @DaveJohnsonMD @t_intheleadcoat @Thomas_TuMD @AbhiKumar47 @prat_shuk @RadDrDuke That is a TON of clot! You should be proud this is a bad situation that you turned into a great outcome

Inferior vena cava (IVC) filter-associated caval and bilateral iliocaval thrombosis treated in a single session with #FlowTriever and #ClotTriever. #IRAD @InariMedical @davidsshin @FredBertinoMD @UWRadiology @UofWa_IR @EVToday @VIVAPhysicians @SIRRFS

So much structural protein in this #DVT, it’s insane!! Removed with #ClotTriever after angioplasty with 8mm balloon. Super difficult to recanalize… you can see why! #IRad

@rkryu @SDhandMD @TherealDoctorJ @kmadass @radtrivedi @TLHM_MD @Watts_IR 100% agree. Ptx is easy to fix, but surprise massive hemoptysis is horrendous. I feel like it happens 0.5% of cases, and there is never anesthesia available for endobronchial blocker. I just resuscitate until hemostasis achieved. Horrible risk and stress not conveyed by rVUs.

Look at this big booger I pulled out of the IVC!! Is this even considered a thrombus anymore? #IRad Removed with ClotTriever XL