Necio Lizola MD
@ReneLizola
Followers
3,369
Following
523
Media
1,329
Statuses
3,737
🇲🇽Vascular Surgeon. University of Toronto 🇨🇦alumnus. Distal Bypass enthusiast.
Joined June 2020
Don't wanna be here?
Send us removal request.
Explore trending content on Musk Viewer
Lakers
• 140528 Tweets
Fernando Valenzuela
• 117376 Tweets
LINGORM FILL
• 82975 Tweets
期日前投票
• 82634 Tweets
#MerzAestheticsXหลิงออม
• 79158 Tweets
メニュー
• 65510 Tweets
助成金2000万円
• 64819 Tweets
非公認議員
• 61719 Tweets
Kürt
• 61066 Tweets
非公認候補の支部
• 46610 Tweets
प्रियंका गांधी
• 31907 Tweets
DONNY 4everAKapamilya
• 31650 Tweets
非公認の候補者
• 31544 Tweets
Daisuke
• 25277 Tweets
ILL BE THERE POSTER
• 18340 Tweets
党勢拡大のため
• 17273 Tweets
PRABOWO-GIBRAN KerjaFOKUS
• 15342 Tweets
SiapBEKERJA UntukRAKYAT
• 14931 Tweets
APT 100M VIEWS
• 14333 Tweets
Müsavat Dervişoğlu
• 14162 Tweets
#わたしの推し牛
• 13755 Tweets
キューティーハニー
• 12415 Tweets
気圧のせい
• 11857 Tweets
Pro-tip: as a surgeon, I've found extremely useful these silly-putty exercises a PT friend recommended.
I find my hands & fingers perform better if I manage to do them before surgery!
Anyone else's seen this? What's your hand warm-up routine?
@farkomd
@rbarbosa91
17
169
1K
Tiene trombosis venosa profunda esta paciente?
A propósito de varios casos, va un hilo🧵 al respecto de qué tan buena (o mala) es la exploración física para sospechar (o no) TVP
👇🏼
@OrlandoRPN
@morlaz_
12
192
818
Femoral 🔴artery & 🔵vein, in preparation for femoral AV fistula.
5
40
602
23yo female 👩.
In situ carotid thrombus‼️ - Lupus as a cause.
Open carotid thrombectomy 🔪🩸
Ever seen one of these? 👇🏼
@AWBeckMD
@farkomd
#CarotidEd
7
51
572
When they asked you what a Vascular Surgeon actually treats... 🤭 (including, but not limited to)
15
134
501
🔴🔵Snuffbox Arterio-Venous Fistula.
//
🔴🔵Fístula Arterio-Venosa para hemodiálisis - tabaquera anatómica.
7
35
335
8
25
241
🇲🇽In developing countries, not every patient can afford non-invasive techniques...
Open (modified) saphenectomy + perforating vein ligation + sclerotherapy
8
29
239
@thaniagal
🗨Ahí va otra vez: hay que bajarle 2 rayitas al ego. Al final, el que "decide" qué hacer con el paciente, es el paciente y su familia, tras una discusión informada. No hay "dueño" del paciente: estamos para servirle y para ayudarlo, entre todos, cada quién desde su trinchera.🤝🏼
2
3
207
How it started - How it's going.
Posterior "S" incisions heal nicely 👌🏼💯
9
14
192
4
15
181
Pelvic Congestion Syndrome, but I don't think I'd embolize this one...
Why not? 😳
@farkomd
@kmadass
@ChengaziMD
#IRAD
#IR
#VenousEd
#CallVascular
18
19
145
@gralbalanceada
Mm. No veo el afán de "decidir quién decide". Estamos todos para ayudar, no? Sin "dueños" del paciente; sin protagonismos.
2
2
133
Some days big vessels, some days small vessels.
Sometimes, both in the same day!
Vascular is *so* cool.
#CallVascular
1
9
136
Diabetic foot.
D5 ulcer - ostheomielitis/ostheolysis.
🔴This is limb salvage as well.
2
19
126
Por último, no olvidemos que hoy en día el ultrasonido doppler duplex venoso es por mucho la mejor prueba para descartar o confirmar una Trombosis Venosa Profunda (disponible, económico, sensible, específico, buenobonitoybarato).
Fin ✨️
2
10
123
Just an🎈Aortic tube graft
Un tubito aórtico (aneurisma 🎈 aórtico abdominal)
4
17
118
🟢Infected iliofemoral graft resection - 🔴fem-fem crossover bypass w/ GSV.
5
8
115
🔴Pedal bypass: day of creation ⏩️ 1 month follow-up. Parallel incisions brought no grief. Strong palpable pulse.
Notice bypass "carving" at the tunnel site.
Open surgery = alive & well
@monteromiguel
@jmills1955
5
8
110
🔵Throwback to an open thrombectomy case from a while back. Single groin incision.
It can definitely be an effective, low cost procedure in well-selected patients 🇲🇽.
#venousEd
@farkomd
@monteromiguel
@KaremHarthMD
@UkVenous
@JVSVL
10
18
101
One single, long incision for popliteal-PT bypass.
Personally, I prefer skip incisions.
This does make for a mildly quicker/less annoying case (since the vein that'll bring grief is invariably found under the skin bridge 😅)
Single Vs skip incisions: what's your preference?
19
9
102
Despite our best efforts, we couldn't close parallel incisions primarily without compromising flow through this pedal bypass, so we resorted to "pie crusting".
What's your go-to adjunct for this situation?🤔
Listen to the awesome doppler flow 🔥
@AmputationSuck
#CLTIFighters
8
9
94
Extreme vascular access creation, for the (true) no-option patient: the axillo-atrial AVF.
@robshahverdyan
@medvasctwitter
8
15
92
El primer (y más importante) dato que nos debe hacer sospechar TVP es edema *unilateral*, en cualquiera de sus presentaciones. Abajo otros datos clínicos a la EF que pueden presentarse junto con el edema, con sensibilidades, especificidades y LRs
👇🏼
2
7
94
34
7
92
It's true.
Plantar bypass can be a tough operation: less room for mistake than a less distal bypass, and many things can go wrong. Agree with need for appropriate vein & outflow.
If conditions are met, it can be quite satisfying, though.
@AmputationSuck
@jmills1955
@drcostantino1
@Juli0_lm
@farkomd
Just unfavorable anatomy…plantar bypass is a technical operation. Not sure how many folks are comfortable with it…and the vein has to be nice.
1
1
5
6
13
91
A beautiful,
#PAT
guided Limb Salvage story in 4 images
From 367 ms ⏩️ 83 ms following CFA-AT bypass
@JillSommerset
@AmputationSuck
@jmills1955
@monteromiguel
#CLTIFighters
5
11
89
Demonstrating the use of the straight, hand-held straight needle with 3-0 prolene
@rbarbosa91
7
15
89
🔵Venous TOS: compression of subclavian vein between 1st rib & clavicle
👇🏼
1
11
90
🔴18yo M, ALI (popliteal entrapment/trashed outflow). Underwent pop release + thrombectomy. Took a bit, but he's now walking and couldn't be happier! (Shared w/ permission)
🔴18 años, isquemia aguda por Atrapamiento poplíteo. Liberación + trombectomía. Feliz porque ya camina!
7
11
89
Is everybody seeing more & more distal disease, or is this just in 🇲🇽?
Yet another dorsalis pedis bypass.
11
9
84
Muchos médicos (en 🇲🇽 y en otros países) continúan mencionando diversos signos; con mayor frecuencia el de Homans. Estos son completamente * inútiles * y no apoyan el dx de TVP (y el mismo Homans lo sabía)
1
6
84
Infected distal bypass.
Has had 2 episodes of arterial bleed already.
What to do?
Pre-Op angios 👇🏼
#CLTIFighters
14
10
76
Abdominal liposarcoma infiltrating distal IVC & right CIV.
En bloc resection (onco surg)
Right iliac occluded, so we performed end-to-end iliocaval bypass with PTFE (no ringed available).
Illustration after the fashion of
@XavierBerardMD
#AortaEd
#OncoVascular
#CallVascular
4
18
81
🎈Juxtarrenal abdominal aortic aneurysm - inter-renal clamp, left renal reimplantation.
#AortaEd
0
8
79
Pop-PT bypass are just beautiful: quick, elegant, * d u r a b l e * surgery.
7
3
79
🔴 Symptomatic carotid dolicity (kinking): before Vs after correction
//
🔴 Dolicidad carotídea sintomática: corrección quirúrgica
3
15
81
The CTA//The patient
No more HTN meds, no more shortness of breath.
This is one happy 15-year-old.
#AortaEd
6
7
77
Y qué hay del Dímero D?
El dímero D, que es un producto de la degradación de la fibrina, se eleva siempre que existe * inflamación * en el cuerpo. Naturalmente, la TVP lo elevará (junto con otras 15 causas). Por esto, su principal valor es predictivo negativo (D-D nL = NO TVP)
1
6
75
10
7
72
Pues nomás recordándoles que el Aneurisma de Aorta Abdominal MATA 💣⏰️, pero en México 🇲🇽 nadie habla de eso.
3
21
67
Abdominal aortic aneurysm, 6 cm diameter. Asymptomatic. "Healthy", fit, active, independent 90yo.
Open or endo?
@VasculonR
@farkomd
@AWBeckMD
@XavierBerardMD
#AortaEd
39
8
68
🔴PTFE replacing the external iliac artery, injured while performing transplanted kidney nephrectomy.
2
2
69
🔴Femoro-dorsalis pedis bypass, 48h post-Op. Strong palpable pulse.
No incisional suffering despite parallel incisions (yet again).
While some will indeed require adjuncts (from pie crusting to second-intention closure), that's the exception rather than the rule.
#goDistal
4
4
66
Severe, unilateral varicosities & leg edema. It all started 40 years ago, after being kicked by a 🐄.
What would you like to know about the physical exam
@FutureVascSurgn
?
#VenousEd
#CallVascular
#IRAD
9
8
66