Cassra Arbabi,MD,FSVS,RPVI-Assistant Professor of Surgery,Division of Vascular Surgery
@CedarsSinai
. Regional Director of
@AorticTrauma
Foundation Tweets=My own
@kiswanson
@twittersecurity
needs to block this account for blatant spread of misinformation. This person is straight up telling lies, anyone who’s worked in an ICU knows patients on a vent are often awake and often write messages to communicate with physicians, nursing and family. SMH
Hey
#VascTwitter
a quick poll of the audience…when doing a
#CEA
, how do you get control and occlude the ICA, CCA and ECA? Vessel loops Potts technique or clamps? If clamps what kind for each vessel?
#VascularSurgery
@DrAliAzizzadeh
#CLTI
pt was told no other options and needed BKA…treated w BK pop to AT w rGSV, tunneled interosseous. Palpable DP in foot, TMA healed.
#limbsalvage
#vascular
#surgery
Acute limb ischemia w popliteal/TPT occlusion after
#TEVAR
, look what came out w the Fogarty😳. I’ll give you a clue, its not a huge piece intima from the leg. Anyone seen this before? Credit to our fellow
@DonnaBahroloomi
for fishing it out 💪🏻
@FutureVascSurgn
#vascular
#surgery
Fractured stent inside saphenous vein bypass now floating in a 6cm pseudo. Im thinking its not the best idea to place a large metal object inside a delicate vein conduit🤔Pt told me she had all this work done because her legs got tired after walking 3 miles
#firstdonoharm
#MedEd
25M w post prandial abd pain,wt loss,& CT evidence of
#MALS
. Dx confirmed w celiac plex blk(temp relief of symptoms)Tx w open median arcuate lig release,truly the best way to release every fiber,stay right on the aorta. Symptoms gone!
#VascTwitter
@SallySchonefeld
@NavyashGupta
53M p/w
#MRSA
MV endocarditis,CVA & acute limb ischemia 2/2 septic emboli. Diagnosed and taken to OR based on physical exam. One of the largest (intact) clots I’ve seen,nearly 3ft! Note the large cardiac vegetations on the left
#Vascular
#surgery
#MedTwitter
@SallySchonefeld
Young male, stab wound to R neck (Zone 2) with hard signs of vascular injury. Thru n thru the distal CCA, repaired with interposition vein bypass using ipsilateral internal jugular. Neuro intact postop. Great case!
#trauma
#vascular
#surgery
#casesduringCOVID
@aamirshah_csmc
@kipsDS2010
There’s no such thing as “cardiac clearance” for any case, emergent or elective. What we are asking for is cardiac “risk stratification” and we as surgeons make the decision along with the patient/family to proceed with whatever intervention based on the overall risk/benefit
Octogenarian w chronic mesenteric ischemia p/w post prandial abd pain,food fear,wt loss->tx w SMA balloon expandable stent graft. Symptoms resolved by next meal. One of the most gratifying&life changing operations IMO
#LoveMyJob
#vascular
#surgery
#MedStudentTwitter
@LiliSadri
@primal_body
@BradleyMartyn
This is the problem with social media. This is not new news. Its a fairly common thing been happening forever. Hypertrophic obstructive cardiomyopathy. A genetic condition, young athletes “drop dead” during practice. It’s due to a heart arrhythmia. Bronny thankfully survived
Trauma, dragged by a car several blocks w arm stuck in the window. P/w cold pulseless LUE 2/2 transection of L axillary artery, severe motor deficits (BP injury), tx w emergent placement of stent graft via brachial artery cut down
#trauma
#surgery
#vasctwitter
#MedTwitter
#MedEd
Small AAA and L CIAA and 4+cm R CIAA, anatomy not suitable for IBE. Treated w good old fashioned coil and cover using
@penumbrainc
coils and
@WLGore
Excluder limb. Pt doing great in fu no symptoms whatsoever and no bridges burned for future repair. WWYD?
#vasctwitter
#MedEd
Symptomatic carotid (vision loss), CTA & Duplex read as occluded ICA (axial cuts w possible tiny channel of flow)->confirmatory angio with string sign and slow antegrade filling of ICA. Taken for CEA->ruptured ulcerated plaque removed. Pt did very well.
#vascular
@LiliSadri
Im honored to be a part of The
@AorticTrauma
Foundation,& so excited to continue contributing to our mission! If youre on the west coast and would like to join the cause,DM and we can discuss how your institution can start enrolling in our international multicenter
#BTAI
registry
55M w cirrhosis, had Type A repair (root/ascending) years ago at OSH. Now presenting w chest/back pain and this CT. What would you do?
#vasctwitter
#aortaed
#MedEd
Honored to be selected as one of the
#Superdoctors
Southern California Rising Stars Edition 2023 👨🏻⚕️🩺 Its a privilege and a pleasure taking care of patients with
#vascular
disease and I want to thank
@CedarsSinai
and
@VascularSurgCS
for the opportunity to do so 🙏🏻
Octogenarian w history of Head&Neck cancer s/p surgery+radiation, presented w high grade
#carotid
stenosis. Absolutely no reason to subject him to extra risk of
#stroke
by doing TFCAS when
#TCAR
is safer/better option. The data is strong and plentiful
@CMSGov
#vascular
#surgery
When ultrasound guided thrombin injection goes wrong.😳Curious to hear from
#irad
and
#vasctwitter
, what’s your approach to treatment of femoral pseudoaneurysms?When is it safe to proceed w thrombin injections and when do you proceed w
#surgery
?
@FutureVascSurgn
@NavyashGupta
ESRD on HD via RUE AVG…Severe central (Innominate vein) stenosis tx w DCB,recurrent stenosis the short term. I never like to leave a stent but in this case was necessary&worked very well.
@FutureVascSurgn
note the difference of collaterals pre/post tx
#vasctwitter
#irad
#MedEd
Ulcerated
#carotid
plaque with intraluminal thrombus. 50% lesion on duplex and CTA. Symptomatic,sent home 2x from OSH after TIA. Seen in clinic and booked right away for CEA. % of stenosis is not the only important finding, eval plaque morphology as well.
#callvascular
#MedEd
58M w bad DM,
#CLTI
(toe ulcers x 6mo) failed multiple endo interventions.Tx w Pop-PT rGSV bypass.Wound still not healing. Repeat angio 2mo later w very poor outflow/small vessel dz, including chr occluded AT/DP. Able to PTA PT/plantar& recan AT/DP. Cant get much better than this
Endovascular treatment of a popliteal artery aneurysm. In a patient with no vein, and 3v runoff, what’s the better approach…endo with viabahn or exclusion and bypass w PTFE?
#vascular
#surgery
@LiliSadri
Young F w BMI >60, Mitral valve endocarditis embolized to left common femoral bifurcation. Note the difference between thrombus and valvular vegetations. Also good reason why open 🔪 is the only way to get this out
#vascular
#surgery
#SoMe4Surgery
@LiliSadri
@FutureVascSurgn
Thoracic aortic PAU treated w TEVAR.
#vascTwitter
what’s your criteria for repair in an asymptomatic patient? Size? Growth rate? Ugliness factor?
#thinkAorta
#AortaEd
Acute IVC/BL iliofem
#DVT
. Has non retrievable IVCF for 30+ yrs. Not on AC. Treated w both flowtriever+clottriever, followed by kissing stents, massive clot burden removed. Doing well several months post op. Tiny chronic residual clot in IVCF, now on AC.
#vascular
@kevinsealsmd
@CaitlinWHicks
@nytimes
@VascularSVS
@JudithLin4
Non medical friend texted me this today…agree there is rampant spread of unnecessary/ harmful tx of PAD.Although from this article sounds like this pt had“festering wounds”which sounds like CLTI and weve all had that pt that required multiple interventions & still ended up w amp
Excellent paper, should be referenced/ followed by anyone who diagnoses/treats pts w PAD….this isnt “see lesion, treat lesion” this is “see patient, thoroughly assess clinical problem, treat patient accordingly making sure benefits outweigh risks”
Wanted to share a pretty incredible story. 87F seen as consult for thrombosed LEIA, CFA/PFA/SFA/L>RFem-fem bypass. Impressive CT scan. Initially treated w heparin. And next day pain resolved. up walking by day 2 w/o claudication, DC on day 3 on Eliquis. Elected to forgo surgery..
@scotter
I was a general surgery resident not too long ago...I always treated everyone (students, residents, nurses, etc) with kindness and respect. Most of my fellow residents were similar. Yes there are some bad apples out there, but the culture has changed a lot...don’t generalize plz
@Priceman33
@docpark
😂 Dying field? U must be confusing us with someone else. Where are you getting your info? Probably one of the most needed specialties in the health care system.
Hey
#vasctwitter
, when doing a femoral endarterectomy and ipsilateral iliac stent, which do you do first? (More details/comments on your approach welcomed)
#vascular
#surgery
Anyone seen pressors have this profound an effect? 88yo in ICU on 2 max pressors,w acute pop occl,no flow below the knee.This is completion angio after Penumbra. I was convinced everything was trashed & leg was toast.After pressors weaned,foot turned pink& now normal exam.
ECMO pt w hemorrhagic shock, bleeding fr SFA. BMI 40, post OHT on immunosuppression. Severely edematous LE. Had existing 8F sheath in the contralateral groin (IABP). High risk for wound complications w open, perfect set up for endo intervention.
#vasctwitter
#surgery
#MedEd
The spotlight🌟 is on our
#VascularSurgery
program! Under
@DrAliAzizzadeh
leadership, the program has been recognized for innovative treatments, research and education. Check out our Dept of
#Surgery
#sutures
2020 spring edition here 👉🏻
88F p/wCVA wR hemiparesis.CTA showing ~99% stenosis.Tx w L CEA w patch angioplasty,intraop EEG. One of the most elegant operations IMO!How do you do your CEAs?Patch v Eversion?Routine v Selective Shunt?EEG v awake v TCD?
#vasctwitter
#vascular
#surgery
@DonaldBaril
@DanielMilesMD
@MujeebZubair
Don’t forget 3,979 vascular surgery educational YouTube videos…congratulations Mujeeb! One of the most competitive fellowships and what an amazing career so far! You will shine bright my friend 😊
(Throwback) 58M w chronic mesenteric ischemia & L CIA stent occlusion,malnutrition+weight loss+disabling claudication. S/P failed attempt SMA stent. Tx w aorto-L EIA bypass w 14x7mm Dacron,Retrograde jump graft to SMA w 6mm ePTFE
#vascularsurgery
#casesduringCOVID
@NavyashGupta