Tim Simpson

Nice result. What’s been your experience with HDR adjacent to bifurcations? Assume it follows more compliant limb of the CTO, much difficulty reentering into side branch?

Could well be- will keep a closer eye on it

Thanks for sharing- homework for the weekend.

I’ve found much side-branch loss comes w post dilation of main vessel. Have you found it helpful to prevent PD loss and if so, why? Seems prudent to use longer SB balloon than stent to prevent fully covering/trapping prox balloon, is that true?

Interesting work- thanks for sharing.

Incidental coronary artery calcification checking in

No stent, put her on b-blocker and Asa, FMD workup negative. No further ischemia or angina and discharged home

Congrats buddy! Yale is luck to have you… Looking forward to watching all your successes from afar

If no ischemia could let it marinate w more IIbIIIa if ischemia CatRx, image, stent. Had a recent anurrysmal RCA w huge thrombus and catrx just couldn’t clear it- used Angiojet and worked beautifully followed by 5.0 stent

Can’t make sense of the LM. I’d try an undersized MP from above, possibly w guideliner. If LM find a surgeon if not laser/dcb ramus depending on availability

Why not go b/l radial? This seems like excessive risk with minimal benefit.

Congrats @HsuePriscilla! Well deserved.

Agree- there was already faint staining, probably from flush and filling w con.

Absolutely re: ostial lesions. Had a recent mid RCA w a poorly chosen under supportive guide (you know the one) and delivered 5.5 extension down within stent to deliver post balloon. Painful and risk LSD taking extension in and out to IVUS- this would have been perfect.

Are you using a 1:1 sized guideliner and relying on reflux from guideliner injection or can you go smaller and fill contrast around guideliner?

What are the super wiggles? You add some bends proximally to get even more support?

Usually well intentioned but I’m not comfortable w it and call it out by saying “it’s going to be 20 minutes of boring question. I’ll summarize the plan at the end and happy if you want to record that part of the conversation”

2001 Toyota 4Runner w 200k miles. When it explodes I’m going to leave it on the side of the road and buy a 2010 4Runner.

100% agree!