Kuldeep Singh MD
@Kuldeep1926
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Director, Limb salvage surgery, Program Director. Associate Professor Zucker School of Med/ Northwell @SIUHOSPITAL
Staten Island, NY
Joined November 2015
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Pinned Tweet
Incredible story. Follow up. 450lbs to 205lbs Life literally changed for this patient. Five year follow up no recurrence no hospitalizations.
#lymphedema
#surgery
@SIUHOSPITAL
@VascularSVS
#wounds
#medtwitter
#vascular
#elephantiasis
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Another
#Endo
trick. If using Perclose and unsure of closure. Stick in 0.014 wire and put in a 4F micro access catheter and sinch down. Still allows you to take a final angio to ensure artery still open.
@VascularSVS
@AMPSymposium
@FutureVascSurgn
#medtwitter
@EVToday
#vascular
13
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289
Follow up. Still some work to be done but “leg feels 50 pounds lighter” we can help
@SIUHOSPITAL
@NorthwellHealth
#lymphedema
@VenousForum
@VascularSVS
#lymphedema
@LymphUnited
#vascular
#medtwitter
@AngioPod
@VarenyamVasc
28
19
216
Now he can dance again. Permission to post.
#lymphedema
@VascularSVS
@lymphnet
@LymphedemaAct
#VascularSurgery
.
@TLC
.
@Discovery
@NorthwellHealth
#medtwitter
25
17
205
Precision 5F dilator. Absolutely the best way to cinch down the knot when using Perclose. much lower profile then the company knot pusher. Works great in morbidly obese patients especially during perc AAA.
@VascularSVS
@NorthwellHealth
@CLI_Global
#clifighter
@AAAOutreach
9
24
157
Trick(not mine) for ipsi fem access. Anyone know who’s idea? worked nice. Contra fem occluded obese, previous Groin surgery. wire kept going into profunda. Buddy wire system
#MedTwitter
@FutureVascSurgn
@EVToday
#VascularSurgery
@AMPSymposium
@VascularOnline
@NorthwellHealth
16
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152
Fem-AT done 30 years ago still going strong. NO ASA, no statin, no follow up. Sent by PMD for eval refused duplex said “if it’s not broken I don’t want to fixed” still smokes.
#MedTwitter
#vascular
#bypass
#patency
14
9
150
ENDO trick !! If you cut a catheter and need to infuse through it use a Flow switch works with any 0.014-0.035 catheter.
@VascularSVS
@EVToday
@AMPSymposium
@ggillbti
@CLI_Global
@FutureVascSurgn
@cookvascular
@NorthwellHealth
@SIUHOSPITAL
#vascular
#MedTwitter
@AngioPod
6
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150
#endo
trick. when flossing to get retro wire into sheath wrap retro and antegrade wires around each other. No snare needed. Works every time…most of the time.
#MedTwitter
@EVToday
@VascularSVS
@FutureVascSurgn
@AMPSymposium
@_MCLIN_
#vascular
15
12
150
Old case but a trick that may help someone. Spider Filter used to retrieve embolized angioseal. I’ve Also used it retrieve broken IVUS Tip. .
#vascular
.
@CLIfighters
.
@CLI_Global
.
@VascularSVS
.
@AMPSymposium
.
@FutureVascSurgn
.
@VascularOnline
.
@Medtronic
#radiology
14
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149
Sometimes you have to be a bit more aggressive than compression alone. De-Scaling prior to compression is much more effective
@VascularSVS
@ACSInterntl
#lymphedema
@LymphUnited
@lymphnet
#MedTwitter
#surgery
12
7
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Years of suffering, told by multiple institutions that there is no solution. now wheelchair-bound. We can help
@SIUHOSPITAL
@NorthwellHealth
#lymphedema
@CombatNTDs
.
@VascularSVS
.
@_backtable
@JVascSurgCIT
#surgery
.
@Vsicon2022
17
6
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#endo
trick. How to form a Jenali loop. for those treating
#cli
patients this is a must. Has served me well throughout the years, originally learned this
@AMPSymposium
#CTO
@VascularSVS
@_MCLIN_
#MedTwitter
#vascular
@FutureVascSurgn
@EVToday
9
13
94
9 years after initial debulking procedure. Foot begining to swell➡️discomfort.
#lymphedema
@FutureVascSurgn
.
@VenousForum
#surgery
#vascular
4
5
92
Good way to end the week.
@VascularSVS
@FutureVascSurgn
#surgery
#MedTwitter
#lymphedema
@lymphnet
#elephantiasis
#legswelling
#vascular
@TheLymphieLife
@NorthwellHealth
5
3
93
2.5cm splenic AA coil. Tall patient downward facing celiac. Axillary artery access, closed with perclose. Another access option.
#MedTwitter
@VascularSVS
#endovascular
@PenVascular
14
8
92
Necrotic
#wound
end stage
#lymphedema
. Debulking/Treatment using the Singh-Cooper proctocol. excellent long term results. .
@lympholpogy
.
@LymphedemaAct
.
@VascularSVS
.
@AmCollSurgeons
.
@VeinForum
.
@VenousSymposium
.
@WOUNDSJournal
@SIUHOSPITAL
@NorthwellHealth
17
10
89
Rest pain in the heel with chronic plantar ulcer. Palpable DP no-palp PT. patient told no other treatment needed, Sent for second opinion. know your
#angiosomes
@FutureVascSurg
#Medtwitter
.
@VascularSVS
@AMPSymposium
@_MCLIN_
#vascular
@VascularOnline
#vascular
10
5
82
Common iliac artery endarterectomy with patch RP approach. Quick and Very satisfying operation.
#medtwitter
#vascular
@VascularSVS
@FutureVascSurgn
8
5
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51 F massive leg swelling, pain
#DVT
.
@PenVascular
Lightening 12 to the rescue no COI.
@FutureVascSurgn
#vascular
#MedTwitter
@VascularSVS
@VeinForum
7
14
74
Toughest debulking case yet. 25ys of wounds, infections. Sub-Q fat turned into calcified tissue had to use wire cutters to cut through and developed pseudomonas infection. Permission to post
@drvsbedi
@BrajeshKLal
@RKTvascular
#vascsctwitter
#MedTwitter
@VarenyamVasc
#lymphedema
12
9
72
47 yo F wt loss from 600 to 300lbs thigh mass getting bigger w/ cellulitis & wants to exercise but difficulty walking unable to find help.
@TheLymphieLife
@lymphnet
#lymphedema
@CombatNTDs
@TLC
@Discovery
@FutureVascSurgn
#VascularSurgery
#medtwitter
7
2
72
This device has yet to disappoint. No COI
#medtwitter
#vasctwitter
@VascularOnline
@InariMedical
#dvt
@SIUHOSPITAL
#vascular
2
14
70
0.5 to 4 blocks in 3 month. Best way to treat a claudicant have Patient write daily walking distance. Increases compliance big time. I tell them to count mailboxes.
@FutureVascSurgn
#vascular
#medtwitter
@CLIFightersBot
@AMPSymposium
@RKTvascular
@drvsbedi
@ggillbti
@VascularSVS
9
7
65
Patient consent obtained to post. 29 month follow up after bilateral LE Radical debulking.
8
4
65
#Endo
hack. Adjustable homemade snare with 0.014 wire. NEVER failed & Never removed a filter with a traditional snare. One size fits all and it’s cheap
@VascularSVS
@FutureVascSurgn
@EVToday
#medtwitter
#vascular
#filterout
#ivcfilter
#endovascular
8
5
64
Worsening wound 4th toe. Palpable PT pulse, Normal duplex and ABI why do angio ? Use your judgment.
@AMPSymposium
@thesaveclinic
@EVToday
@Mustapja
@FrankSokolovic
@DevinZarkowsky
@Aditya_Mehra02
#MedTwitter
#vascular
#endovascular
@NorthwellHealth
13
4
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One of my favorite operations, although not very common.
@tosinCanada
@VascularSVS
@VascularOnline
#tos
#vascular
#MedTwitter
#tos
8
2
62
Necrotizing infection of
#lymphedema
leg. All tissue was mush.🤞 this will be a tough one
#medtwitter
@VascularSVS
@VascularOnline
#elephantiasis
#surgery
@DevinZarkowsky
@drvsbedi
@VarenyamVasc
@LymphedemaAct
5
2
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@JayMathewsMD
On call during Hurric. Sandy bridges were closed to Staten Island. two patients with radial/ulnar artery transactions (pulling people out of flooded basements) showed up no one else could make it to the hospital except the fellow, fellow wound up doing both cases by himself.
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0
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Open aortic case # 20 for PGY 7
@iwg4life
, more coming up. Robust open vascular experience
@SIUHOSPITAL
#aorta
#MedTwitter
#fellowship
@FutureVascSurgn
@AliK73299840
2
3
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Recent TAVR, MI. groin pain w/ mass. Duplex>3cm PSA with no length, wide neck at bifurcation. EF now 20% 89 yo old lives alone. Balloon, assisted, thrombin with immediate closure and pain resolved. 2 week f/u no PSA.
@VascularSVS
@EVToday
#MedTwitter
#vascular
6
6
56
Redo aorto-biprofunda for acute aortic graft occlusion. Fogarty no pass. First time use of
@TerumoAortic
gelsoft graft. Handles well, minimal needle hole bleeding. Nice graft(No COI)
@VascularSVS
@FutureVascSurgn
#aorta
#MedTwitter
#VascularSurgery
@ggillbti
@AngioPod
#Surgery
4
4
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The “Staten Island octopus” for thoracoabdominal aneurysm repair. As we described in our .
@AngioPod
dissection podcast. .
@VascularSVS
.
@VascularEVS
@AngioPod
@ZuckerSoM
0
5
55
85 yo CHF, COPD h/o EVAR abdominal pain TYPE 1 leak 9.2CM sac < 1cm neck🤞. Emergent repair&Success with
@MedtronicAPV
cuff& endo Anchors. No COI
#MedTwitter
#aorta
#VascularSurgery
#surgery
@SIUHOSPITAL
@NorthwellHealth
@FutureVascSurgn
@HowardA28120196
9
1
54
Basilic vein transposition, a two stage operation handles so much better than a single stage. Other opinions ?
#vascular
#medtwitter
#dialysis
#surgery
.
@VascularOnline
@DevinZarkowsky
@ggillbti
@AngioPod
#avfistula
@FutureVascSurgn
@NMawlaMD
18
1
53
No one should get to the stage
@SIUHOSPITAL
@NorthwellHealth
we can help. Permission to post. Will post treatment results
#MedTwitter
#VascularSurgery
@LymphedemaAct
#elephantiasis
#surgery
@VascularSVS
#lymphedema
@FutureVascSurgn
@VascularOnline
2
7
50
Previously bedridden. The patient said “Thank you for giving me my life back” 1 week post op. It’s a privilege these patients.
@lymphnet
.
@VascularSVS
#medtwitter
#surgery
@ACSInterntl
#elephantiasis
#lymphedema
7
2
49
New concepts often met w/ hesitancy in medicine b/c we are a patient advocates. We never advocate this as primary access as explained but tweet was hijacked for other motives. Fem/radial safer but not used, all explained in the thread.
#MedTwitter
@VascularSVS
#VascularSurgery
2.5cm splenic AA coil. Tall patient downward facing celiac. Axillary artery access, closed with perclose. Another access option.
#MedTwitter
@VascularSVS
#endovascular
@PenVascular
14
8
92
9
4
48
38 yo previously healthy developed lymphatic mass 7yrs ago, decreased mobility, weight gain
#depression
for years finally found help
@SIUHOSPITAL
.
#lymphedeama
@VascularSVS
#plastics
#MedTwitter
#surgery
@TLC
@Discovery
#leg
#swelling
@lymphnet
@JVascSurg
7
1
48
Forearm basilic vein for AVF. An often overlooked option for AV access. Permission to post.
#dialysis
#vascular
#MedTwitter
@FutureVascSurgn
@VarenyamVasc
@DrAliKimya
@AngioPod
@NMawlaMD
9
1
47
Percutaneous AV fistula. Initial experience excellent. Case time 13 minute total.
#medtwitter
#vascular
@FutureVascSurgn
@VascularSVS
#pAVF
5
7
46
@Skepticscalpel
My formula= start off with a number look around if nobody gives you a dirty look that’s the answer, if you get a dirty look keep increasing it by 50 mL until you get the yes nod
4
1
45
Trick for those looking to do this surgery. Put on an eshmark first & leave it on for 10 min before surgery or overnight with careful monitoring Makes a huge difference.
#lymphedema
#vascular
#medtwitter
@VascularSVS
@FutureVascSurgn
@VarenyamVasc
@Vsicon2022
4
3
45
AVF stent Breaks in 1/2 and lands right angle to each other. w/ some wire/cath play we back in business.
#VascularSurgery
.
@EVToday
#medtwitter
#vasctwitter
.
@t_intheleadcoat
.
@FutureVascSurgn
.
@amitramjitMD
#Vascularaccess
.
@VascularOnline
.
@VenuVadlamudiMD
12
2
44
Lots of variability and subjectivity in CAT scan reads of carotid stenosis. This one was read as 50 -69%. To me it looked much worse. Duplex 310/98
#vascular
#surgery
#medtwitter
@VarenyamVasc
@AngioPod
@DrAliKimya
12
2
45
73F worsening severe pain/swelling/discoloration 2 weeks. Extensive DVT.
@InariMedical
amazing result and instant symptom improvement. No COI
@VenousSymposium
@VascularSVS
@FutureVascSurgn
#veins
#dvt
#MedTwitter
#MedStudentTwitter
@GeorgiaRooney11
@NorthwellHealth
@SIUHOSPITAL
2
5
44
Giant true radial artery aneurysm rupture. Scary stuff.
#aneurysm
#medtwitter
#surgery
.
@FutuVascSurgn
2
9
44
Interesting case. How would you treat ? Aberrant right renal takeoff, diaphragm causing compression/ thrombosis. Viable kidney.
#medtwittter
#vascular
@VascularSVS
@FutureVascSurgn
@VascularOnline
#kidney
@HofstraKidney
@MinaGuerges
@AngioPod
20
3
43
18 year old with extensive femoral DVT and worsening leg pain 3 weeks old. INARI Thrombectomy and 3 way stopcock closure technique courtesy of
@t_intheleadcoat
Worked out great. Thanks Dr. Tummala
@InariMedical
#dvt
@VeinForum
4
7
42
Permission to post. Follow up. 450lbs to 205lbs Life literally changed for this patient five year follow up no recurrence no hospitalizations.
#lymphedema
#surgery
@SIUHOSPITAL
@VascularSVS
#wounds
#medtwitter
#vascular
8
1
42
I guess no holiday weekend is complete without an ischemic limb. Vasopressor related radial/ulnar thrombosis, hand motor weakness. Fixed with Fogarty.
#medtwitter
@VascularSVS
@FutureVascSurgn
@SIUHOSPITAL
#vascular
@VascularOnline
1
1
40
@georgetolisjr
You can retire from work you can’t retire from family. No one looks back and says I wish I had spent more time at work Family first always
@DevinZarkowsky
@AngioPod
3
1
40
Stage one complete.
#Team
effort
#lymphedema
#medtwitter
#surgey
@VascularSVS
@LymphedemaAct
#elephantitis
@DevinZarkowsky
@RKTvascular
@drvsbedi
1
1
39
We are happy to announce our new 1 year Advanced Wound Care and Burn Fellowship. Vascular, burn, HBO, podiatry all in one. Must be BC/BE to apply. DM me for info.
#surgery
@VascularSVS
#medtwitter
@vsb_abs
@FutureVascSurgn
#fellowship
#burns
#wounds
#abwm
3
3
41
CEA on an active 96-year-old. lives alone TIA and a stroke within 6 months. The few nonagenarians that I have done did great. what’s the oldest patients you’ve done a CEA on ?
#MedTwitter
#carotid
#surgerytwitter
@VascularSVS
@FutureVascSurgn
@ggillbti
@drvsbedi
@RKTvascular
9
1
39
30 yo bow&arrow backfired 🤷🏽♂️. Carotid/jugular fistula & PSA.
#vascular
#carotid
#vasctwitter
#MedStudentTwitter
#MedTwitter
@FutureVascSurgn
@VascularSVS
@amitramjitMD
@MinaGuerges
@ggillbti
@FrankSokolovic
3
3
37
Blind pop access frog leg. Ambulatory rest pain/Heel ulcer. No good bypass targets identified. headed towards AKA. Don’t give up
#MedTwitter
#vascular
@AMPSymposium
@EVToday
@FutureVascSurgn
@VascularSVS
@VascularOnline
@NorthwellHealth
@edepopMD
@kmadass
7
2
38
This technique works well. Incisions should deep enough to cause release.
@VascularSVS
#vascular
#surgery
@AlanLumsdenMD
your fasciotomies look as though they could just be primarily closed, and if not I find this does allow primary closure, with less wound vac changes, less trips to OR, and no need for skin grafting
2
3
16
0
4
37
Recurrent infections, severe pain, weeping wounds rock hard skin. Suggestions ? Permission to post.
#vascular
#medtwitter
#lymphedema
#plasticsurgery
@FutureVascSurgn
@VascularOnline
@VarenyamVasc
@DevinZarkowsky
@RKTvascular
@AngioPod
8
2
36
#endo
trick -to get 6F balloon through 5F sheath. angioplasty the 5F sheath with 4 or 5mm balloon (to burst). For critics it WON’T destroy the sheath.
@VascularSVS
@EVToday
@FutureVascSurgn
@AMPSymposium
#medtwitter
#vascular
@NorthwellHealth
@VascularOnline
@ggillbti
@AngioPod
3
1
35
AV fistula with worsening hand pain and ulceration. Angio with and without fistula compression. Suggestions ? Typical oral board Scenario
#vascular
#medtwitter
@FutureVascSurgn
@VascularSVS
@avshuntindo
#dialysis
@AmBdSurg
@EVToday
19
3
34
79 yo very healthy but wound getting worse retro/antegrade PT failed. Suggestions ?
@FadiSaab17
@dandu_n
@kmadass
@t_intheleadcoat
@_MCLIN_
@VascularSVS
#cli
#vascular
22
2
34
Why do people on
#MedTwitter
get angry when somebody else posts something different or intriguing. This doc is not advocating he’s just showing how this technique is done.
#fragileegos
. Thanks for sharing
@SyedAAhmad5
3
2
33
1
5
32
Amazing talk on the “Failing
#EVAR
” by the man himself .
@farkomd
#vascular
@NorthwellHealth
@SIUHOSPITAL
3
1
34
#Timetogo
. This last drain is finally coming out, it has been draining > 250ml/day for over two months. These cases can be incredibly challenging post op.
#lymphedema
@lymphnet
@TheLymphieLife
#medtwitter
@VascularSVS
@drsandeeprpande
@VarenyamVasc
4
1
34
😬😬what is happening here ? Debilitating claudication SFA stent occlusion
#rotarex
@BDandCo
to the rescue worked great.
#MedTwitter
#vascular
@AMPSymposium
@EVToday
@FutureVascSurgn
@VascularOnline
8
2
32
70m acute DVT/pain/swelling
@InariMedical
4 passes incredible result as usual.
#MedTwitter
#vascular
#dvt
@EVToday
@FutureVascSurgn
1
8
31
Id advise deploying the stent a little higher up to cover the entire dissection flap. (anonymous artist)
@hendolat
@VEITHsymposium
@VIVAPhysicians
@LINCmeeting
@TCTMD
@AMPSymposium
13
30
214
3
0
31
Left iliac- Right fem bypass. Left groin recent infection. failed right ax-fem multiple abdominal operations, FAILED EVAR (outside institution). Tunneling was fairly easy. Rifampin soaked for what it’s worth
#surgery
#medtwitter
#vascular
@AngioPod
@VarenyamVasc
@DrAliKimya
2
0
31
70yo M. Left CEA 7yrs ago➡️ re-stenosis➡️ stent 3 years ago. Increasing velocities on duplex now 400/120. CT confirms stent restenosis. Asymptomatic no smoking on Asa, plavix, statin. SUGGESTIONS ?
#MedTwitter
#carotid
@VascularSVS
#vascular
15
1
31
Alternative to tibial stick is retro SFA/POP if you can’t back true lumen
@edepopMD
.
#MedTwitter
@AMPSymposium
@VascularSVS
@FutureVascSurgn
#vascular
@FrankSokolovic
@EVToday
2
1
30
Don’t see this too often. Enlarging Femoral vein cyst. Caused
#dvt
now Leg swelling, and pain.
#vascular
#dvt
#medtwitter
.
@FutureVascSurgn
#surgery
3
2
28
Gore
#TBE
. Easy deployment, smooth tracking especially with good fellow to assist
@DrAliKimya
.
#vascular
@
#SVSTweetChat
#medtwitter
#aorta
1
0
29
Learned a lot in this case. Fluid loss was tremendous. Rigging a suspension system was a great help. First time we Identified a large lymphatic pedicle as the source of the mass.
@VascularSVS
#plastics
#MedTwitter
#surgery
#leg
#swelling
@lymphnet
@JVascSurg
0
0
29
Aneurysms galore
@SIUHOSPITAL
. Finally No wires, no stents nothing fancy. Great job by our fellow
@iwg4life
&PGY5. Fixed with
@TerumoAortic
vascutek, nice graft (no COI)
@NorthwellHealth
@VascularSVS
@FutureVascSurgn
#aorta
#MedTwitter
#vascular
#aneurysm
@DevinZarkowsky
2
3
29
These
@PenVascular
Ruby coils are super smooth (no COI) . 3cm splenic artery aneurysm.
#medtwitter
#coils
#aneurysm
@EVToday
@FutureVascSurgn
@VascularOnline
@NorthwellHealth
other suggestions micro coils ?
3
1
28
Amazing candidates this year for the match. Book chapters, high score, publications, volunteer work…the future looks bright for
#vascular
@VascularSVS
@FutureVascSurgn
0
3
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