drcostantino
@drcostantino1
Followers
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Following
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Advanced Vascular Centers. Interventional radiologist, love my job.
Portland, OR
Joined January 2019
Don't wanna be here?
Send us removal request.
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🙏🏼🙏🏼Thank you to everyone who has reached out, I am okay! Just bruised/concussion, got lucky!
PDX has changed. Still hopeful we can get our city back, time will tell.
I can’t tell you how much I appreciate every text and post. At the end of it all all we have is community. ❤️
48
5
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No mention of ovarian vein reflux or vascular etiology of pain. Sigh, so much work to be done.
16
12
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THIS is an ultrasound report.
Time to change the standard.
@svuinfo
@SIRspecialists
@JillSommerset
@Leni_Karr
@monteromiguel
@vascularIR
12
17
142
Pelvic congestion. How is there any debate about whether this exists? I just had a patient fight BCBS for a YEAR.
@GSalazar_MD
@MaureenKohi
@SIRspecialists
@womenirads
@theveinlady
19
9
131
Ovarian vein reflux. Fought
@UHC
for years. Seven denials. Tried to pay cash, hospital wouldn’t give her a cash price (said way too high and wouldn’t show her.) Not wealthy, just suffering.
Hardest part about complex venous disease? The insurance companies practicing medicine.
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16
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No stent without IVUS and respiratory variation images.
Looks like a tight stenosis on pullback video. GO BACK and do a spot video with deep breathing to reveal: compliance, elasticity, NOT a fixed lesion. Insp VS exp 73% variation.
@JillSommerset
@GSalazar_MD
14
14
100
What do you do after winning Best Scientific Poster at SVS?
You win People’s Choice for Best Poster.
That’s my girl!
.
@JillSommerset
@jmills1955
@farkomd
@AmputationSuck
@Watts_IR
@LessneVIR
@SDhandMD
12
5
83
@SIRspecialists
@JVIRmedia
Dr Jason Smith I don’t know you, but I LOVE you.
Why didn’t I think of this?
JVIR is killing it - so many great articles I had to break out my iPhone flashlight on early am flight. It’s that good!
@DanSzeMDPhD
11
10
81
5
4
77
Woke up with the best idea regarding how to market the speciality of IR.
We just need to get Taylor Swift to date an IR.
7
1
78
Case planning for tomorrow. 💆🏼♀️
I think it’s all or nothing.
Anyone elect fem to lateral plantar bypass?
@farkomd
@AmputationSuck
@jmills1955
21
3
76
Ran into this awesome high schooler who revealed that she wanted to go to med school. So of course I nabbed her to keep the fire lit! Once a week teaching, the future is bright!
@SIRspecialists
@womenirads
Enjoying exposing these driven high schoolers to real world medicine.
8
0
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If one thinks IR doesn’t ‘have clinic,’ one is in the dark ages.
Another clinic day down. Been doing it since 2008…
@SIRspecialists
Funny thing is the number of patients who ask me if I can be their primary care (???). Adamant no. PCP’s make the world go around!
3
6
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Left on my desk this am!!! I’m in love…
UAE 2019. Best moment of 2021. Uterine artery embolization allows moms and dads to be…to be. 🤰🏼🤱🏼
@rwolfemd
@alexkimir
@mmaneevese
@thefibroidlady
@womenirads
#fibroids
#fibroidawarenessmonth
6
7
70
THIS is a radiology report.
As a rad and an IR who is in the receiving end of reports that I order - never is it more clear that our reports need to ANSWER THE QUESTION.
@JillSommerset
has elevated this game for ultrasound.
3
6
69
Teen Pro Tip:
Want to make your teenager love you?
Step 1: Wake up early Sunday for the mother-son brunch.
Step 2: Take a photo.
6
0
66
I mean when your ultrasound looks like this…who needs a diagnostic angio?
@JillSommerset
nails it yet again.
6
4
65
Just absolutely thrilled to have this future IR (if I have anything to do with it) shadow for a few days. Rising 3rd yr med student, just got his MBA, business oriented with his ❤️in medicine. (And learning Farsi!) Steered him to GEMS
@SIRspecialists
. Love knowing rising stars!
2
0
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Awesome incoming med student reached out, then swung by to peek in on IR. We did two great cases (a success, and yes, a failure). So fun to show her the beauty of IR.
Love these young women!
@womenirads
3
2
64
Another awesome young woman (DO school!) interested in IR. Three days hanging out and learning. She’s motivated and hoping to go to SIR Annual Meeting. Cases. Real talk.
One brilliant young woman at a time…
@SIRspecialists
@womenirads
3
3
63
Orphaned foot status post spinal cord stim improved flow to foot from CLASS 4 to CLASS 1. And we can actually see the bleeding. Set for TMA.
@dougbeall
@JillSommerset
@monteromiguel
@JRUNMD
12
6
62
Headed to
@ISETNews
Wanted to dress appropriately
@JillSommerset
@AmputationSuck
@drmcumming
@Watts_IR
@SDhandMD
@AgnesSolberg
@kymbee
8
6
62
I love introducing bright college students (and high schoolers) to the cath lab. I’ve targeted my friend’s kid to be a cath lab tech. And just like that he now has two mothers designing his life 🤣
2
1
61
Who does 14 ultrasounds in one day and one intraop case plus an add on ro DVT??
@JillSommerset
does.
(Thanks
@JRUNMD
)
6
1
60
Prepping for a case. THIS is an ultrasound report.
@JillSommerset
-access
-PAT
-vein status
-wifi (academic)
-vessel characteristic
-tech thoughts
Using ultrasound how it should be used. Cheap, bedside, informative. The standards need to be changed!
9
3
59
This is an example of an ultrasound report produced by
@JillSommerset
. Tells me exactly where the lesion is, where the Doppler is obtained and captures an image of the wound.
@svuinfo
- we need to create new vascular standards.
3
8
59
Ohhhhh boy. Evening planning for tomorrows cases. Hit with a
#jillmap
.
@JillSommerset
@jmills1955
@LorenzoPatrone3
@AmputationSuck
@IR_Doctor
@Watts_IR
@SDhandMD
8
4
58
Pregnancy after UFE.
UFE 2019 for menorrhagia.
Found out today she has an 18 month old, even got to see his adorable self.
Great day!!
@drmcumming
@GokeIRDoc
@SIRspecialists
@DrLipman1
@FarajAlkassMD
@FibroidFoun
4
7
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@JAMA_current
Seriously? UAE if you don’t desire fertility but RF, HIFU, hyst excision, adenomyomectomy, wedge resection if you do?? Insane!!! Terrible to pub this. Womens Health July 2021!
@womenirads
@SIRspecialists
@thefibroidlady
@angiowoman
@MaureenKohi
@GSalazar_MD
12
7
57
For any FELLOWS in interventional radiology/interventional cardiology/vascular surgery, join
@Watts_IR
@LessneVIR
@kmadass
and me, for a fun session on practice types (academics, OBL, private practice), general practice building TOMORROW night 7pm EST.
1
26
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Who’s a new FELLOW??
@JillSommerset
is! Long overdue and well-deserved.
@vascularIR
@jmills1955
@AmputationSuck
@monteromiguel
@AdvncdVascular
We are so proud of you!!
9
1
54
Just thinking that
@AgnesSolberg
needs a special shout out for organizing Radiology women and IR women everywhere. She does k-a PAD work and hustles behind the scenes. 🙏🏼
@AgnesSolberg
for putting yourself out there.
2
5
52
Kudos to
@roblookstein
and
@SIRspecialists
for addressing the BEST-CLI head on. Data discussion, one of the few great reasons to get on zoom.
@MisraMD
@paragpatel_IR
@bretwiechmann
@SriniTummala
Love data, science and discussion.
Important paper in CLTI.
4
2
50
I now get images with notations.
THIS is what vascular ultrasound should be.
@JillSommerset
@_backtable
@monteromiguel
@vascularIR
2
2
50
Surprise!
Dx: CFV DVT, told many times ntd. painful ulcer (1 year), pain so bad can’t sleep.
Plan: IVUS +\~ stent.
Find: Very very old occ. Pencil on waist. Somehow revasced. Didn’t stent bc giving it a chance (ext to CFV)
WWTwitterDo?
Now: 50% better, cried he was so happy.
15
2
49
Then there are these cases. 🤬Could not bore through that distal sfa/cement column.
@drmcumming
@SDhandMD
@Watts_IR
@SIRRFS
@SIRspecialists
18
3
49
Awww, gift from my PhD dad, who knows all too well how old I am. Wish we had book like this in my formative years!
@womenirads
2
4
48
Headed for an amp but we got our hands on him.
@MDTVascular
@drmcumming
@SDhandMD
@AmputationSuck
@LorenzoPatrone3
@JillSommerset
12
5
48
Really, really, really proud of this cover!! Women!! Babies!!! Postpartum hemorrhage universally available…a girl can dream.
@SIRspecialists
2
12
47
When a pt with gangrene reaches out to
@JillSommerset
and she takes the call then gets him in, and reassures with PAT that he is going to be a-okay…
Thats the compassion that radiates off of Jill!
5
1
45
Itching to get back. Almost there…Appreciate every single one of you
Had to share - PPAC family; full of love and brutal honesty🤣
@AllanHoffmanMD1
Wafa and Derek, you had me at ‘hello.’
SIR-BI 2023 it’s going down.
2
0
46
Chiba needle trick works like a charm. Thanks
@drmcumming
(and
@_backtable
b/c Mike now just thinks I call to gossip and now only picks up intermittently.)
4
3
46
@paragpatel_IR
exceptional outgoing Pres of
@SIRspecialists
And now…incoming, the great Dr Alda Tam.
Approachable, kind, brilliant, our society is so lucky. Encourage membership and action. We are in solid hands.
2
3
44
When your Dad comes into town, feeds you all week, cleans your car, identifies your emergency shut off gas and water valves with labels and teaches your boys grandpa stuff, then leaves this gem in your car as a parting gift.
1
0
45
Annual mother son high school brunch, ‘cause high school = 4 years of failed attempts to get selfies with this one.
I must win this one in the end…somehow.
2
0
45
Why MRI prior to UAE? Very young woman with baaaaddd endometrial thickening found incidentally on pre-op MRI.
@thefibroidlady
@womenirads
@MaureenKohi
@GokeIRDoc
@rwolfemd
@fibroidforum
4
2
45
How badly did I want to treat this…?
Ya’ll feel me?
@LorenzoPatrone3
@brianchiong
@AmputationSuck
@drmcumming
@Watts_IR
@AgnesSolberg
15
4
44
HBD to the most beautiful, kind, smart, creative, specialty-unifying, inventor, developer, mother and limb salvager ever. I am so honored to call you a friend.
(I miss you already, and we just separated 4 hours ago!)
@JillSommerset
you have changed the world.
2
0
43
Look who’s in town! That’s a whole lotta powerhouse right here.
Watch out world…time for SIR to take ov-ah!!
1
1
43
Closure device…
If you want to be in an obl, best be prepared for this. Rare, but when it happens…
5
1
42
Very very proud of my
@JillSommerset
creating full day learning opportunities across the globe. Mexico City, Barcelona. Sessions are well intended and interesting seems high. Kudos for changing the world.
4
1
42
Interesting UAE result. 3 weeks of watery discharge and cramping. Thought was bv, but post MRI cw somehow expulsing multiple anterior and posterior fibroids en mass.
Clusters both anterior and posterior wall mostly resolved.
@thefibroidlady
@DrLipman1
@GokeIRDoc
@drmcumming
5
0
42
Was a total honor. Hope I didn’t scare the residents and fellows with a very unpredictable career! :) What fantastic hosts. Thank you
@roblookstein
SIR is in great hands with you at the helm!
Live
@MountSinaiIR
so glad to welcome
@drcostantino1
for Grand Rounds on the Independent IR Practice.
@SIRspecialists
3
2
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0
2
42
IR don’t do clinic….they say.
Just another Monday. BUT, hats off to my VS counterpart in Eugene seeing 30ish pts a day. Or for anyone seeing more than this because I certainly cannot!
@SIRspecialists
@Watts_IR
@drmcumming
@GokeIRDoc
5
2
41
Last case day of the year. Going to close this joint down, give staff a well-deserved break, while I prep for 2024. Love this mighty team.
Peace out 2023.💃🏼
1
2
41
Holy moly what a day. Snuck in 35 Jrs to teach them all things science/fluoro/ultrasound/healthcare careers. And got to see my special guy. Sllloowwwllyy warming up to photos.
Special thx to my staff and
@JillSommerset
for diving in. Gonna get these teens into healthcare!
4
3
41
Owning an OBL = entrepreneurial 🎢. Rise early on vacation while kids sleep. BUT, flexibility. Bad news ruins the day, good news keeps you going.
Never thought this would be life entering rad residency!
@drmcumming
@RWilfe
@theveinlady
@Watts_IR
@GokeIRDoc
3
1
41
Why MRI pre-UAE?
31 yo desp wants Baby 2. After Baby 1 she had a miscarriage with huge hemorrhage. Send for possible UAE.
Turns out, her pregnancy caused fibroid infarction (known to do that…)
UAE would not have helped her. Ultrasound would not determine lack of enhancement.
6
1
40
Full force in the lab today another CTO via tib only. Kissing iliacs, flush CTO =tib/rad access only. +teaching two interns the magic of IR.
@JillSommerset
#jillmap
!
@LorenzoPatrone3
@SDhandMD
@AmputationSuck
@IR_Doctor
@jmills1955
@drmcumming
@Watts_IR
@drmcumming
8
1
41
@SIRspecialists
@womenirads
@Watts_IR
@drmcumming
@IR_Doctor
@LorenzoPatrone3
@SDhandMD
and every IR I didn’t tag…
SIR EC hard at work fighting for our speciality.
Take away so far: donate to SIRPAC!!
Incredible work keeping IR alive in this healthcare environment.
@meridity1
3
4
41
One man one woman DVA in the books. With the help of MANY others
@JillSommerset
guiding the way and
@JRUNMD
‘s ‘lucky hat’
Love/hate relationship with this procedure. Glad we have an option but it’s mentally and physically challenging!
3
1
41
Who did 15 (yes you read that right) ultrasounds and participated in intraop ultrasound? Only the great
@JillSommerset
Having had a few us techs, curious: Whats an acceptable daily case load in your centers?
@vascularIR
@AmputationSuck
@SDhandMD
@AllanHoffmanMD1
or any vein ctr?
5
2
40
THIs is an ultrasound report.
iPad and an Apple pen. Step back from the automation that creates garbage-in-garbage-out.
Setting up the process takes commitment. But once it’s set up, a beautiful product for life!
@JillSommerset
@SIRspecialists
@RadiologyACR
@monteromiguel
5
3
39
We’re climbing! 3% when I entered the field and up due to great efforts on behalf of
@SIRspecialists
and the awesome ladies in this field. We work together!!
It’s
#NationalWomenPhysicianDay
Celebrating
#WomeninIR
today, and every day!!
@SIRspecialists
@SIRRFS
@SIR_ECS
#irad
1
15
59
0
1
37
Jetstream atherectomy. IVUS don’t lie!
@JillSommerset
(of course I did the tibials too).
#Woundhealing
#limbsalvage
5
4
37
Fun little video of respiratory variation of the civ. FTR didn’t stent.
@Philips
@AmputationSuck
@kathygibbons
@theveinlady
@drmcumming
@GokeIRDoc
5
3
38
Education is everything, and shapes who we become. Educational equality, nationally and abroad.
#athenian
3
7
38
Reviewing a foot perfusion talk. I have no idea what was so funny. But it’s all love all the time.
@JillSommerset
I miss you already.
5
0
38
Does anyone use a tibial cocktail for tibial access. I use my radial cocktail, because it makes sense, but curious what other Tibial Folks are doing…
@drmcumming
@SDhandMD
@farkomd
@Watts_IR
@bretwiechmann
@SDhandMD
@FadiSaab17
@jmills1955
@AmputationSuck
24
5
37
Me: What’s up fam? (To my teen boy)
Kid: ‘Your generation already ruined our environment, don’t ruin our slang’
Heat at home far worse than heat at work.
3
0
36
Pre and post. Why stop at just the PT and peroneal? AT revasc through a tiny distal access. Intraoperative us to ensure true lumen all
@of
the way up.
#jillsommerset
6
3
37
Even those of us who do a lot of ufe....still may recommend myomectomy. I believe in informed consent and patient choice. But I also believe in protecting pts from bad choices.
#workingtogether
#thankfulforgyncolleagues
3
1
37
How cool is this?
My PA’s son works in the clean room at
@WLGore
and makes Viabahns!
Thanked him for making such a beautiful stent. I think it was cool for him to see this ‘in the field.’ All employees should know how important their work is! Drives precision.
1
1
37
@RodGerardo
If you’re not working, you’re not learning. Being a proficient doctor is a huge deal. And trainees owe it to the patients who have their lives in their future hands to get in that hospital and WORK and LEARN. Otherwise, they will suck as doctors. Very simple.
4
0
36
I just spent all day talking patients out of procedures...positive us findings but not enough to get me to treat.
#The
less fun but right thing
1
1
36
We were like ‘have you ever seen an ultrasound image of atherectomy?’ Then we got curious...Jill Sommerset does the best work!
Jetstream by ultrasound.
@JillSommerset
2
4
35
One ❤️
My 17 yo won’t take photos, but I’ll take what I can get.
3
0
35
Another year of high school chem class in the lab to educate and hopefully inspire. Told the two dudes they’re wearing my lead, now they have to be IR’s.
@SIRspecialists
3
1
35
This is literally how I waited for the PAT today during a CTO case. It’s…the…moment….
Then ❤️❤️❤️❤️❤️!!! Book of love Wed
@vascularIR
(plus zoom
@in
on
@JillSommerset
earrings.)
5
0
35
Unpleasant: When you do a vein in 2013 and pts husband takes a photo. Then they find you for the other leg and show you said photo.
Aging is real.
9
1
35
This foot. Tibial access only - can’t lie flat. This result. Able to tell pod flow is now normal (PAT 92). And..we figured out how to broadcast through
@AvailMedsystems
all by ourselves!
@JillSommerset
@vascularIR
@monteromiguel
5
1
35
You want to learn from the original? The GOAT? This is your chance. Hands on training in PAT by
@JillSommerset
OR is safe, masked, distanced, and the site is beautiful (Skamania Lodge), BP will drop 30 pts here.
@JayMathewsMD
@Watts_IR
@AmputationSuck
2
2
35
Atherectomy sometimes makes me cringe and sometimes makes me 👏🏻👏🏻. Lots of good options out there but Hawk worked well here. Could feel the ‘grating’ become softer and softer.
@AmputationSuck
@drmcumming
@SDhandMD
@Watts_IR
@Medtronic
@AgnesSolberg
@GokeIRDoc
8
4
35
Thursday Book of Love! No flow, treated three levels one case. Don’t stage!! (Use PAT to know endpoint.)
LOVE Jill Days.
@LorenzoPatrone3
@jmills1955
@SDhandMD
@AmputationSuck
@womenirads
@Watts_IR
@drmcumming
@JillSommerset
4
1
33
All of the steps of a DVA, and the most fun part.
@monteromiguel
@JillSommerset
@champagnedahlin
@Watts_IR
@drmcumming
@SDhandMD
@JRUNMD
3
3
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