Alfredo Páez Carpio
@apaezcarpio
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MD, PhD, EDIR, EBIR l Radiologist interested in IR, education and science @UofTMedIm @RadioGraphics
Toronto, ON, Canada
Joined November 2020
Es un ABSOLUTO HONOR recibir este reconocimiento de la Asociación de Radiólogos del Sur (filial de @SERAM_RX ) MUCHAS GRACIAS Para un andaluz emigrao este es un techo profesional, porque nosotros... NO HABLAMOS UN MAL CASTELLANO, SINO UN PERFECTO ANDALÚ #OrgulloAndaluz
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Este trabajo evalúa la seguridad y eficacia de la QETA con microesferas radiopacas cargadas con doxorrubicina (rDEB-TACE) en pacientes con carcinoma hepatocelular (CHC). @SERVEISoc Descúbrelo en este enlace: https://t.co/LRWn1DUoAc English version: https://t.co/4DoiepgWqf
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10/ Restoring flow means restoring function. TCVO management defines the future of venous IR—from access salvage to true vascular reconstruction. Read the full @RadioGraphics review: https://t.co/UheAcdtOtU
@RadG_Editor @cookyscan1 @teachplaygrub
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9/ 🧠 Teaching Points TCVO is progressive—treat early. Recanalization + stenting = functional restoration. IVUS defines success. Technique must match cause. Durability = structured follow-up.
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8/ Outcomes matter: ✅ Technical success >95% ✅ Primary patency 90% at 12 mo ✅ Reintervention ≈9% Complications <5% Structured follow-up = durability: CT/MR at 1, 3, 6, 12 mo → yearly; DAPT × 4–6 wks.
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7/ Complications: recognize early, manage fast. ⚠️ Venous rupture → balloon tamponade or covered stent ⚠️ Migration → avoid undersizing ⚠️ Hemopericardium → drain promptly IVUS + gradual ballooning = prevention Success = vigilance.
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6/ Stent reconstruction strategy: – Single SVC: short segment – Unilateral BCV–SVC: one inflow – Kissing stents: bilateral occlusion Use self-expanding venous stents (Abre, Venovo). IVUS defines landing zones and prevents migration.
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5/ Endovascular recanalization step-by-step: 1️⃣ Dual access (brachial/jugular ± femoral) 2️⃣ Blunt or sharp crossing, IVUS confirmation 3️⃣ Mechanical thrombectomy + angioplasty 4️⃣ Stent reconstruction (kissing or single) Goal: durable, symmetric inline flow.
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4/ Imaging defines the roadmap. ✅ CT venography: extent, chronicity, collaterals ✅ DS venography: confirm functional obstruction ✅ MRV: option for renal impairment Always map the azygos system & internal thoracic/vertebral pathways before crossing.
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3/ Causes of TCVO: 🩸 Malignant (≈90%) – lung CA, lymphoma, thymic tumors 🩺 Benign – catheters, pacers, dialysis, radiation Symptoms: facial plethora, UE swelling, dyspnea Collateral pathways often mask early disease—act before access is lost.
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2/ Thoracic central vein obstruction (TCVO) is not rare—it’s just underrecognized. This isn’t only about dialysis or SVC syndrome. It’s a progressive venous disease where functional restoration, not patency alone, defines success.
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1/ Thoracic central vein obstruction (TCVO) is no longer a niche problem—it’s a growing IR frontier. This international @RadioGraphics review reframes TCVO as a progressive, reconstructable venous disease, not a complication. @RadG_Editor @cookyscan1 @teachplaygrub
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A los padres, familiares y amigos de la pequeña Sandra Peña: mi más sentido pésame. Ni me quiero, ni me puedo imaginar por lo que estaréis pasando. Ojalá encontréis en lo más profundo de vuestro corazón el coraje y la fuerza necesaria para intentar ayudar a que no vuelva a
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Este inmenso reconocimiento a la lucha de todos los venezolanos es un impulso para concluir nuestra tarea: conquistar la Libertad. Estamos en el umbral de la victoria y hoy más que nunca contamos con el Presidente Trump, el pueblo de los Estados Unidos, los pueblos de América
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In the past year, #NobelPeacePrize laureate Maria Corina Machado has been forced to live in hiding. Despite serious threats against her life she has remained in the country, a choice that has inspired millions of people. When authoritarians seize power, it is crucial to
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Pablo Iglesias ha comparado a María Corina Machado con Hitler. Menuda rata miserable. Qué basura de tío.
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Thrilled to share that today I successfully defended my PhD at @UniBarcelona @hospitalclinic Muy feliz de compartir que hoy defendí con éxito mi doctorado en @UniBarcelona @hospitalclinic Agradecido con @KHellenMW @fermgmez @isabelclinic @Ivanvollmert por todo el apoyo
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How time really flies! Serving as Editor of @RadioGraphics has been most meaningful roles of my career.Grateful for our fantabulous authors, reviewers,editors,staff-together,we’ve grown in scope, reach, and impact. Here’s to what’s next! @RSNA @RadG_Editor
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A method for planning liver tumor radioembolization WITHOUT the 99mTc-MAA scan! All you need is the CT. #RadAdv @RSNA @OxfordJournals
Contrast enhanced CT-derived hypervascular-tumor-to-perfused volume ratio may offer a non-invasive alternative to 99mTc-MAA for lung shunt fraction estimation in hepatic transarterial radioembolization @RSNA #RadAdv @OxfordJournals @SusannaLeeRad
https://t.co/Gshm4yy97k
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