IVUS versus NO IVUS. HR = 0.44

Other P2Y12 inhibitors versus Clopidogrel. HR = ~0.82

CURE trial: HR 0.80

In 2025, with the evidence accumulated so far, shouldn’t a deliberate choice of an operator NOT to use IVI to guide PCI shock us as much as a decision NOT to use DAPT?

The magnitude of the benefit of using intravascular imaging to guide PCI in a calcified LAD in ACS is

The magnitude of the benefit of using a second anti-platelet in PCI following ACS is:

Now, read back the thread and replace the following terms: DAPT ➡️ Imaging, Clopidogrel ➡️ IVUS and Ticagrelor ➡️OCT. Would your answers change?

Do you think the operator was negligent for not using DAPT after ACS PCI in a calcified LAD?

Do you believe that the decision of the operator for not using Clopidogrel or Ticagrelor contributed directly to the stent thrombosis?

Stent thrombosis 1 week after LAD PCI. Initial presentation with ACS. Calcified vessel. Turned down for CABG. The operator decided not to use DAPT as he didn’t believe in the data, despite RCTs clearing showing reduction in MACE and guidelines recommending it.

Simple and effective. Microbubble contrast use has the potential to change our perception of coronary Doppler as a noisy and unreliable tool. Follow this thread from @RahulBahl3 and read our paper.

🆕Can AI Capture and Quantify Clinical Expertise?🤖💡 The authors present a futuristic view of the application of #AI by capturing the experts’ gestalt to better inform #decision-making. Read more from #JSCAI's AI Special Issue📚 ➡️ https://t.co/A1zvARtHKE @DanielChamie

AI will have deeper impact in medicine when tools can capture clinical expertise. Our preliminary work on imaging for PCI guidance at @MyJSCAI @DanielChamie @dansbandeira @mshunshin @ProfDFrancis @AlexandraLansky @RahulBahl3 @ImperialNHLI @Yale https://t.co/9LpJPo88lV

One of the many upcoming collaborative publications between @ImperialNHLI and @Yale. If you are worried about injecting contrast or doing OCT during a suspected SCAD case, or in the presence of a stent edge dissection, you should read this paper.

🆕New Study Alert! 🚨 Can Contrast Injections Cause or Propagate Coronary Injuries? Findings from a prospective, single-arm, multicenter study presented at #TCT2024💥 Read now: ➡️ https://t.co/EgbVY4JnNb @DanielChamie @RicardoPetraco @mshunshin @twj1974 @RahulBahl3 @rallamee

Coronary physiology: why, when and how? A 2024 practical update. Honoured to have joined @JEscaned and @wfearonmd on this @MyJSCAI review. https://t.co/PiXogUmmis

Amazing to see the agreement between this work and what we found on https://t.co/fearHNHrwh

When we initially proposed it (@jerd10 @DrShaiSen @SukhNijjer and @JEscaned) some said we were wrong, nuts or dodgy. Resting physiology in the lab was “not a state to be achieved reliably”. Now it appears that (surprise!) nothing is more stable than resting flow!

It’s amazing to see an old concept being demonstrated with new tools. Coronary auto regulation has been shown in animals and humans with Doppler and PET. Now thermodilution! This forms the basis of serial lesion assesssment in the Cathlab with iFR and resting indices. 🧵

Another ORBITA team award ⭐️