The importance of support. A Long 150 mm RCA #CTO with a mid-segment 12-year-old stent, tough 90-degree angle of attack proximal cap, and distal cap at the bifurcation. First attempt: radial femoral approach-no pushability antegrade or retrograde-aborted. The 2nd attempt used

During the last @cvinnovations I had the pleasure to speak of DCB in ISR use,. With the ESC guidelines giving a class I indication of DES over DCB in ISR, given the solid data showing superiority, I raised the discussion that it is not a one-size-fits-all situation. Of course,

Finally!!!.I always believed contrast-induced nephropathy is just an urban myth

It was a great pleasure to be a part of @cvinnovations #CVI2025, learned a lot as usual and came back with multiple tips and tricks. Here are my top ones that I would apply in my next cases. 1- When freewiring the Rotawire in uncrossable lesions, a nice trick shared by.

Learning from the source.@SVRaoMD and the 2025 very well written ACS guidelines. #CVI2025 #CardioX

Filter entrapment with directional atherectomy. Can be daunting!. Heavily calcified SFA/Pop, crossed with Mongo and Gaia PV, 6 mm filter in place. Shockwave after IVUS followed by directional atherectomy with the Hawkone LX device. Small puff showed filled filter and could not

A wise man once said, its all about the curve you put on the wire. Diagonal wiring attempt 2 minutes didn’t work. Reshape into a new curve, didn’t have time to think 😀

Is it #HDR or not?.Prox LAD #CTO, Gaia Next III just into cap (I thought), first injection, advance Gaia but a bit much into the body (could not resist) then stopped. Second injection lighted the distal vessel. Gladius into the LAD. @realarainmd .#CardioX

A lot of work has been done on the impact of #CTO #PCI on LVEF, which I believe is largely due to reversing ischemia and hybernation in true ischemic CM patients. This is most pronounced in LAD CTO PCI patients. Our new paper @AmJCardio studies the impact of Non-LAD CTO PCI on

Complete revasc but in the legs!.3 vessel below knee CTO-completed with foot flow to heal the wounds. #CardioX

It might be subtle differences but sizing might be a bit better using IVUS. I wonder what OCT enthusiasts think.

Coronary aneurysms lack evidence in how we treat them, pooling the current literature shows surgery used more with LAD with similar mortality to CABG, while PCI has high mortality and used more in RCA. #cardioX.

Limb preservation is one of the most rewarding acts in the cath lab!.Older patient presented with worsening bilateral foot wounds, rest pain, and inability to walk for a month. Bilateral SFA long CTOs, and not a good surgical candidate. Left SFA CTO treated with reverse CART.

RT @DrBIqbal: Introducing the CRISP technique…. Coils are frequently used for therapeutic graft closure to reduce competitive flow followi….

More data to what we already know.

Finally!.Fluid restriction in heart failure is basically BULLSHIT.

5- Finally, the best data that stuck with me and probably will affect my practice. Outcomes presented by Taishi Hirai, led by @grantham_aaron. Bringing pt back after STAR at 5-7 weeks had numerically higher success rates compared with 12-14 weeks. My default was 8 weeks, and I

4-Using DCBs in #CTO #PCI is getting close to reality in the US pending some financial constraints. I always believed it is going to be a great addition in our toolbox and seems like it is picking up in Europe as well based on #EuroCTO data. Excellent talk by @GLGasparini with