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There’s an Egyptian MANGO festival as well @MonicaMatsumoto @ahmed_kamel_ir @TheRealDoctorOs
That’s too bad - my interest is piqued and I must try Egyptian 🥭. Where can one taste this? Only Egypt? I better start packing
Egyptian Mangos are not available in the USA. They’re sssooo addictive they’re categorized under elicit drugs by the DOA, #DEA & #FDA @TheRealDoctorOs @MonicaMatsumoto @ahmed_kamel_ir
Are Egyptian mangoes available in the US? This is a strong statement my friend.
Haven eaten Indian subcontinent (India, Pakistan & Bangladesh), Central American (Mexican), American (USA) & Egyptian Mango……hands down #Egypt wins. @ahmed_kamel_ir
I like self expanding stents for these, but since it’s an 18-year old, I’ll start with balloons @SIRRFS @marabi2004 @thegestgroup @TheRealDoctorOs @thefibroidlady @billmajdalany @VIRkhaja
Great point. First line of therapy in BCS is antiCoagulation & if that fails, in the presence of symptoms: IR is the 2nd line. However…..PVT in the setting of Acute to subacute BCS is not uncommon and would make me treat the asymptomatic @TheRealDoctorOs @ahmed_kamel_ir @SIRRFS
What about the underlying LPV thrombosis? Any data or studies on going ahead with LHV stenting with underlying LPV thrombosis?
Thanks for tagging me. Symptoms ?…….For us to know ? Yes, agree with others: address hepatic veins + antiCoagulation way before TIPS/DIPS @ahmed_kamel_ir @TheRealDoctorOs @thegestgroup @SIRRFS @angiowoman @arslanmd
18Y/M, chronic BuddChiari with pancytopenia/hypersplenism. MHV+RHV thrombosed. Associated LEFT PORTAL VEIN THROMBOSIS. LHV Patent. Mx? role of LHV stenting? Or proceed with DIPSS? #irad @saherssabri @SRajesh_IR @Saad_VIR @keithppereira @Murthy_CS_ @SIRRFS @SIR_ECS @SIRspecialists
Yup Sclerose with 1%STS foam (llpiodol & air) and coils using 3rd gen Neuro coils that are soft. 1-part Lipiodol, 2-part 1%STS and 3-part-air foam. @TheRealDoctorOs @ahmed_kamel_ir @thefibroidlady @thegestgroup
As everyone suggested, I would embolize varices and then re-measure pressures and dilate based on gradient. For embolization, I would access the shunt thru IVC, place a 22 mm plug and pull it against the connection with IVC. Then embolize both inflows antegrade w STS foam & coils
Thanks for tagging me, Karan. Yes, sclerose with 1%STS foam (llpiodol & air) and coils using 3rd gen Neuro coils that are soft. The gradient of 5 is fine & the sclerosis & Embo May raise it but not a lot @TheRealDoctorOs @ahmed_kamel_ir @thefibroidlady @thegestgroup
58/F, CLD, CTP-B, MELD 17, upper GI bleed sec to duod varices with mesenterico-caval shunt. TIPS with 8mm. Pressure: 22 ➡️ 5mm. . Next? Embolism the varices? Dilate to 10? Wait & watch? @SIRRFS @SIR_ECS @Saad_VIR @SIRspecialists @SRajesh_IR @keithppereira @Murthy_CS_ @iRadRock
The gradient of 5 is fine & the sclerosis & Embo May raise it but not a lot @TheRealDoctorOs @ahmed_kamel_ir @thefibroidlady @thegestgroup
The TIPS pressure falling to 5...is that a concern to prevent post TIPS Hepatic dysfunction?
It was an honor and pleasure to be invited to Colombia @Columbia @TheRealDoctorOs @UUtah
Fantastic @columbiaimaging Grand Rounds today with a masterclass on all things portal HTN and gastric varices from the expert himself @Saad_VIR! @ColumbiaVIR @kavikrishVIR @noorahmadmd
Great talk today by my friend Rob Short on Percutaneous Ablation of Pulmonary Malignancies. #lungcancer #ablation @TheRealDoctorOs @ahmed_kamel_ir @UUtah @angiowoman
U of U IR is continuing our visiting lecture series with Dr. Robert Short. @Saad_VIR @dstrainmd #irad #interventionalradiology @SIRRFS
Large bore suction device ? Egg-beater (cleaner for example) ? @TheRealDoctorOs @ahmed_kamel_ir @billmajdalany
Complete DIPS occlusion+PV thrombus. Post 10mm plasty. What next? Stent extension further into MPV? #irad #MedTwitter #GITwitter @keithppereira @vascularIR @KprasMD @No_cut_surgery @SRajesh_IR @t_intheleadcoat @iRadRock @SandeepBaglaMD @Saad_VIR @AlanAlperMD @rkryu @IR_Doctor
The TIPS needs to be extended to make a smooth transition towards the cava cephalad @TheRealDoctorOs @ahmed_kamel_ir
#Buddchiari syndrome #Dipss done elsewhere 9 yrs back. Thrombosed stent. #recanalisation manual aspiration and plasty. Flow reestablished. Psv 52 cms/sec. Wait and watch or restent it? @Saad_VIR sir. Considering white thrombus.
#Buddchiari syndrome #Dipss done elsewhere 9 yrs back. Thrombosed stent. #recanalisation manual aspiration and plasty. Flow reestablished. Psv 52 cms/sec. Wait and watch or restent it? @Saad_VIR sir. Considering white thrombus.
Thanks for tagging me. See if symptoms resolve.
#Buddchiari syndrome #Dipss done elsewhere 9 yrs back. Thrombosed stent. #recanalisation manual aspiration and plasty. Flow reestablished. Psv 52 cms/sec. Wait and watch or restent it? @Saad_VIR sir. Considering white thrombus.
It’s been a great season …amen
Thanks for All the support from Dr.Minoshima (Chair of Radiology, UUtah) @UUtah for helping us establish IR lectureship starting with @aravindarepall1 Feb-28 on Y90 dosimetery and @TheRealDoctorOs today on VTE update @angiowoman @ahmed_kamel_ir
Thank you @Saad_VIR Vice Chair and IR Section Chief for revolutionizing Interventional Radiology @UofUHealth
It was a great pleasure having Oz @TheRealDoctorOs out visiting Utah-IR @UUtah @utahradiology Great teaching opportunity for our residents and great lecture on VTE @ahmed_kamel_ir @SIRRFS . Thank you @TheRealDoctorOs
Ramadan Mubarak from Salt Lake City!🏔️🌙 Was a huge privilege to give grand rounds today on DVT/PE interventions at @UofURadiology and hang out with the awesome #irad team led by @Saad_VIR @dstrainmd and co. Amazing facility! 🫀 🫁
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Who to follow
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GEST -Global Embolization Symposium & Technologies
@thegestgroup -
SIO
@SIO_Central -
UCLA IR
@uclaVIR -
PennIR
@Penn_IR -
Luke Wilkins, MD, FSIR
@LukeWilkins_UVA -
VIR at RUSH
@VIR_RUSH -
Saher Sabri
@saherssabri -
UCSF IR
@UCSF_IR -
VIR Chicago
@VIRChicago -
Theresa M. Caridi MD, FSIR
@thefibroidlady -
Michigan VIR
@UMichVIR -
Mona Ranade
@msran124 -
Riad Salem
@riadsalemIR -
NorthwesternIR
@NorthwesternIR -
Aaron Fritts
@AaronFrittsMD
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