Georges El Hachem’s Post

Elderly gentleman referred to our CathLab for worsening angina over the past couple of months, on maximal anti-ischemic medication. Did CA which showed severe calcific unprotected LM disease, with proximal and mid- LAD involvement. On top of that, RCA was diffusely diseased. Decided on scheduled LM-LAD rotational atherectomy. LVEF was normal. 7 Fr femoral access, there was difficulty in wiring the LAD due to the severe calcification, finally managed with a Pilot 200, which was further advanced only with MC support. We then proceded to the rotablation procedure- multiple rotablation runs on the whole diseased segment (rotafloppy/1.5mm burr). There was particular need to activate the burr from within the guide itself, because of the ostial LM lesion. From here on, everything was straight- forward, proceded to aggressive predilation using NC/ cutting balloons, followed by implantation of 4xDES. Good final result, and there were no periprocedural complications. This procedure was one of the three cases which marked the beginning of the rotablation program in our Center. Special and sincere thank you to our Proctor, Dr. Ayman Elkahlout and his invaluable insights which helped us manage these difficult cases. #Rotablation #rotapro #PCI #leftmain #crackingthecalcium #CHIP #DES #NC #cuttingballoon

Prepare well to achieve success 👌 51 years gentleman, with positive family Hx. (His seven brothers died with CAD at the same age)….. Presented with anterior STEMI and received thrombolytic at a remote hospital with successful reperfusion then referred for PCI… CA showed critical LM bifurcation stenosis and the pt was refferred to us after he refused to do CABG…. We decided to: 1. PCI IVUS guided with minimal contrast 2. Circulatory support with low dose of norepinephrine due to Borderline BP (no available MCS device) 3. Mini crush for LM bifurcation to reduce steps and time of LM occlusion by balloons and stents…… 4. Radial 7F approach for better rehabilitation afterwards Our plan succeeded very well and the patient did very well, discharged after one day with no pain nor HF symptoms…… Planned and done as usual with my CHIP journey companion Dr. Aly Tohamy 🫶 #CHIP_Assiut #bostonScientific #IVUS

Direct endoscopic necrsoectomy - large chunks of necrotic materials removed form pancreatic necrotic cavity (WOPN), a life saving procedure in patient of sepsis due to infected WOPN. #pancreas #advanceGIendoscopy

"Tackling post-EVAR complications? Session IV: Complex Aortic Aneurysm Management: From Post-EVAR Complications to Innovative Repair Strategies This session delves into the complexities of managing aortic aneurysm post-EVAR. Learn about innovative strategies that address complications and improve repair outcomes in the most challenging cases. 👉 Secure your spot to enhance your expertise! 🔗 Register here: https://lnkd.in/dckGuSaK #VascularArt2024 #EarlyBird #CME #MedicalWorkshop #VascularEducation"

SVC obstruction is a rare complication of hemodialysis catheter. Here, we demonstrate peripheral IVUS images of SVC obstruction, pre- and post stenting. #SVCobstruction #IVUS

Myocardial changes especially Desmin May be an important marker to determine timing of operation for restrictive VSD. https://lnkd.in/ds3wMyv3

The study evaluated the test-retest reliability of the 10-Meter Walk Test (10MWT) and Timed Up and Go (#TUG) in indoor and outdoor environments for patients in the acute phase post-total hip arthroplasty (#THA). Conducted with 35 inpatients on the second postoperative day, results showed excellent reliability for both tests in both environments, with higher gait speeds recorded outdoors. The findings indicate that both 10MWT and TUG are reliable in assessing early post-THA recovery, with minor variability noted outdoors. | https://ow.ly/K4Af50TZjOs

Endoscopic Radial Artery Harvesting for TCRAT-CABG Procedure I’m pleased to share a recent case involving a 56-year-old patient with a BSA of 2.15 (BMI 34.1). We successfully performed total arterial revascularization using the left internal mammary artery (LIMA), right internal mammary artery (RIMA), and radial artery. The LIMA and RIMA were harvested through a left anterior thoracotomy, while the radial artery was harvested using an endoscopic technique. The resulting graft configurations were: • Aorta to Radial artery to RCA • LIMA to LAD • LIMA to T-shunt to RIMA to D1 to RIMA to OM This approach highlights the advancements in minimally invasive techniques and their impact on patient outcomes. #TCRAT #CABG #ERAH #MinimallyInvasive

SFA Revascularization 55 YOM , Hx of pelvic trauma 5 years ago and gradual claudication then after... weak pulses at femoral sites. Angiogram shoewd total cutoff at SFA origin on both sides. this session was full revascularization of Lt sided SFA using crossing technique via long sheath, LIMA diagnostic Catheter and PTA balloon 6*20. internal non flow limitting disection flaps are seen that would resolve within days and of course impressive effects of medical treatment. patient is sceduled next week for revascularization of RT SIDED SFA.

Male patient, 87 years hold, asymptomatic with 70% stenosis and moderate calcification. A carotid angioplasty was performed with femoral approach, distal protection and deployed a 07x40 CGuard EPS stent and post dilation with a 06x20 balloon. Patient discharged in the second day of the procedure without cognitive or motor functions abnormalities. #Inspiremd #CGuardEPS #Strokeprevention #embolicprotection #MedNeurovascular_Solutions