Nishan Deshpande’s Post

76 years-old male patient with history of arterial hypertension and chronic atrial fibrillation. Severe intermittent claudication (Rutherford 3) of the right lower limb (walking impairment-90 meters). Angiography revealed severe stenosis of mid SFA, moderate stenosis of popliteal artery, occlusion of all BTK vessels, occlusion of dorsalis pedis and the plantar arteries were patent. Strategy: Antegrade US-guided puncture of right CFA and 6 Fr sheath placement. Failed attempt of antegrade recanalization of the tibial-peroneal trunk (TPT) with the support of a Rubicon 18 catheter and a V-18 guidewire. Retrograde US-guided puncture of the distal posterior tibial artery (PTA) and successfull crossing of the occlusion with the support of a Rubicon 18 catheter and a V-18 guidewire. Rendez-vous technique in the popliteal artery. BAT technique because of imposibillity to cross the occlusion with a 3.0 mm x 150 mm balloon from antegrade access. Angioplasty of PTA with 3.0 mm and 3.5 mm x 150 mm balloons and TPT with a 4.0 mm x 80 mm balloon. Angioplasty of SFA with a 6.0 mm x 150 mm DCB. Spasm is observed at the retrograde puncture site in the last picture of the foot (the wire is still there). #cli #clti #clifighters #limbsalvage #peripheralarterydisease #vascularnews #endovascular #medicine #hospital

Let's talk DVT treatment! When it comes to tackling deep vein thrombosis (DVT), we've got three main goals in mind: Prevent the clot from growing larger. Stop the clot from breaking free and causing trouble in the lungs. Lower the risk of another DVT episode. So, what are your options? Here's the lowdown: Blood Thinners: These heroes, also known as anticoagulants, work to keep blood clots in check, reducing the chances of them getting bigger. From pills to injections, there's a variety to choose from. Your healthcare provider will help find the perfect fit for you. Remember, consistency is key! Clot Busters (Thrombolytics): Reserved for serious cases, these potent drugs break down clots swiftly. Administered directly into the clot via a catheter, they're a last resort due to their risk of causing bleeding. Filters: When blood thinners aren't an option, a filter placed in the vena cava can intercept rogue clots, preventing them from reaching the lungs and causing mayhem. Support Stockings (Compression Stockings): These nifty knee socks are like a hug for your legs, preventing blood from pooling and reducing swelling. Wear them during the day to keep your legs feeling light and limber. Remember, your journey to managing DVT is unique, and with the right treatment plan, you're on track to conquer it! If you are searching for minimally invasive vein treatment and vascular treatment, please call our office at 858 550 0330. #DeepVeinThrombosis #DVTAwareness #BloodClots #vistaveinspecialists #sandiegoveinspecialists #sandiego #venousdisease #veinclinic #sandiegoveinclinic #lajollavein #dvtwarrior #dvtawareness #DVTTreatment #BloodClotAwareness

Performing an ambulatory phlebectomy procedure. Ambulatory phlebectomy is a minimally invasive method for removing varicose veins. Through tiny incisions varicose veins are removed in sections, leaving you with smoother, healthier-looking legs. Although the ambulatory phlebectomy procedure is minimally invasive, and most patients feel very little, if any discomfort, the procedure can make some people feel anxious. To reduce any anxiety or discomfort you may have during varicose veins removal, at Milford Vascular Institute, we have made the PRO-NOX™ nitrous oxide and oxygen analgesia system available to any patients who request to use it. Join the thousands of satisfied patients who have regained confidence in their legs and are now enjoying life to the fullest, thanks to varicose vein removal at Milford Vascular Institute. To learn more about varicose vein treatment, visit: https://lnkd.in/e4PeiRDJ #GotVeins #VeinClinicMilfordCT #LegVeinSurgeryNewHavenCT #VeinSpecialistsNewHavenCT #VaricoseVeinSurgeryNewHavenCT #VaricoseVeinsSurgeryNewHavenCT #VaricoseVeinRemovalNewHavenCT #VaricoseVeinDoctorNewHavenCT #VaricoseVeinTreatmentNewHavenCT #VaricoseVeinTreatmentMilfordCT #VeinTreatmentNewHavenConnecticut

cherry eye Hypertrophy, inflammation, and prolapse of the gland of the nictitating membrane. Common in young dogs and certain breeds (eg, Beagle, Boston Terrier, Bulldog, Cocker Spaniel, Lhasa Apso, and Pekingese) Indication ~ KCS ~swelling Treatment The gland should be replaced and anchored with sutures to the orbital rim, periorbital fascia, or nictitans cartilage, or covered with adjacent conjunctival mucosa (envelope or pocket techniques) Dacryocystitis ( inflammation of Lacrimal sac) caused by obstruction of the nasolacrimal sac and proximal nasolacrimal duct by inflammatory debris, foreign bodies, or masses pressing on the duct. Epiphora. Secondary conjunctivitis refractory to treatment . Treatment. ~Antimicrobials. ( topical plus systemic) ~Anti inflammatory medication. in case of irreversible damage, surgical construction of new pathway. ~(Conjuctivorhinostomy or Conjuctivoralostomy)

Successful Laser Fenestrated EVAR Procedure: An 80-year-old patient with a 7.5cm juxtarenal abdominal aortic aneurysm, discovered during a negative metastatic workup for gastric adenocarcinoma. Unfit for open aortic repair due to poor nutritional status, we opted for laser fenestrated EVAR, stenting the suprarenal aorta and fenestrating renal arteries bilaterally. Post-op, patient discharged in 48hrs, with normal renal function and palpable pedal pulses. And at follow up, a CT scan showing effective aneurysm treatment with no endoleak and patent renal stents.

Multifunctional electroactive bio-adhesive for robustly-integrated wound therapy and postoperative wound-status warning and assessment https://lnkd.in/grrYSXtc

angiogram ll diabetic foot

ChitoHeal Gel is a hydrogel based on N-Acetyl-D-Glucosamine which provides a moist healing environment to assist and enhance the natural process of healing wounds. It increases angiogenesis, promotes tissue regeneration, and reduces the risk of scarring. Furthermore, its antimicrobial nature avoids secondary infections. It is highly biocompatible, can fill irregularly shaped wounds, and remains on the site of application for a prolonged time.   Intended use: ·      I & II-degree burn and Sunburn ·      Surgical wounds ·      I & II-degree diabetic foot ulcer & bed sore ·      Traumatic wounds, abrasion, cuts and scratches ·      Wounds in EB patients (Epidermolysis bullosa- Butterfly Children) ·       Prevent bed sore by forming a secondary skin

Symptomatic #ATBAD with completely occluded superior mesenteric artery and right renal artery, 53 male with abdominal and chest pain.The CT scan revealed a complex Type B aortic dissection with a true lumen collapse. Laboratory tests revealed elevated lactate levels and elevated renal function. Urgent Percutaneous TEVAR using the #Medtronic Thoracic stent was performed. Here, the strategy was first needed to canulate the true lumen.IVUS and angiograms performed intraoperatively confirmed the true lumen.An intraoperative angiogram showed good results, so I did not use dissection stents or any other escalation at this point. Postoperative CT showed well-perfused SMA and Right Renal Artery. The patient is discharged for Follow Up.

74 years-old male patient with history of former smoker and dyslipidemia. CLTI (Rutherford 5). Rest pain and ulcer on left first toe. Angiography revealed severe stenosis of left CFA, severe stenosis of profunda femoral artery, occlusion of the SFA, severe stenosis of popliteal artery, occlusion of both tibial arteries, severe stenosis of TP trunk and the dorsalis pedis artery is reconstituted by collateral circulation through a large anterior malleolar branch of the peroneal artery. Strategy: Retrograde puncture of right CFA and 6 Fr-45 cm sheath placement in the left EIA with up and over technique. Failed first attempt of antegrade recanalization of SFA with the support of a Rubicon 18 and a Command 18 guidewire. Retrograde puncture of distal SFA and failed attempt of retrograde recanalization of SFA with the support of a Rubicon 18 and a Command 18 guidewire. Multiple failed attempts of recanalization after CART and reverse CART techniques. Successfull retrograde recanalization after parallel balloon technique and rendez vous technique. Pre-dilatation of the fem-pop segment with a 7 mm x 120 mm balloon. 6.5 mm x 200 mm Supera stent placement in the fem-pop segment and placement of two 7 mm x 120 mm self-expandable stents in the proximal and mid portions of the SFA. Left CFA angioplasty with a 7 mm x 40 mm balloon. TP trunk angioplasty with a 4 mm x 80 mm balloon. Good flow to the foot and complete resolution of rest pain.  #clti #cli #limbsalvage #peripheralarterydisease #endovascular #clifighters #diabeticfoot #vascularnews #hospital #medicine