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Dr Tummala's Vascular Channel
United States
Приєднався 5 тра 2020
Learn about all things vascular including the latest data, techniques, and treatments related to peripheral artery disease/critical limb ischemia.
Complex Renal Artery Aneurysm Treatment
This case is an excellent example of stent assisted coil embolization of a large renal artery aneurysm. Courtesy of Mount Sinai Hospital & Cardiology NY and their team.
Переглядів: 72
Відео
CTO Crossing Tips and Tricks
Переглядів 6833 місяці тому
This video presents basics and advanced concepts and techniques for CTO crossing in patients with PAD/CLTI. Courtesy of NCVH.
Live Case: Pelvic Congestion Syndrome Treatment
Переглядів 7324 місяці тому
This live case shows how this challenging issue is treated today without surgery.
Tibial and Pedal Artery (BTK/BTA) Anatomy
Переглядів 3594 місяці тому
This video discusses tibial artery and below ankle pedal artery anatomy to help those performing peripheral artery/CLTI interventions.
BTK Interventions Toolbox & Guidewires 2024
Переглядів 3514 місяці тому
This video gives a brief overview of technique, devices, algorithms, tools and guidewires related to BTK interventions.
Live Case: Aorto-iliac Intervention with Dissection Management Discussion
Переглядів 6236 місяців тому
This live case shows an aorta-iliac intervention and a post treatment dissection. Panel discusses how to manage this challenge.
LIVE CASE: FemPop ISR, Pedal Access, and Tibial & Pedal Loop Intervention
Переглядів 6068 місяців тому
This live case highlights laser treatment for in stent restenosis (ISR). In addition, it highlights EVUS during pedal access and CTO crossing in the distal posterior tibial artery. This case also shows pedal access technique and pedal artery intervention.
Pedal Artery Anatomy
Переглядів 7118 місяців тому
This short video gives a quick overview of pedal artery anatomy including the 3 common anastomoses below the ankle.
Podcast: Atherectomy Basics By Dr. Srini Tummala
Переглядів 3279 місяців тому
This podcast is a discussion of atherectomy and vessel prep. Courtesy of Backtable VI.
CLTI: Importance of SAD vs BAD
Переглядів 37310 місяців тому
This video presents the concepts of small artery disease and big artery disease and MAC and how they affect treatment results in CLTI patients.
Bioabsorbable Technologies for BTK Interventions
Переглядів 12010 місяців тому
This video talks about the current state of bioabsorbable technology for BTK interventions.
SFA Anatomy, Stress, Stents, Data
Переглядів 46210 місяців тому
This video discusses the stress forces on the SFA segment, SFA anatomy, stent design, and data.
Complex Arterial CTO Crossing
Переглядів 926Рік тому
This video shows examples of techniques related to complex arterial CTO crossing in patients with PAD/CLTI.
Ultrasound Guided CTO Crossing
Переглядів 404Рік тому
This video shows how extravascular ultrasound (EVUS) and IVUS can help during CTO crossing and delivering therapy during peripheral arterial disease interventions.
ALI & the Role of Fasciotomy
Переглядів 225Рік тому
This presentation discusses the role of fasciotomy in the setting of acute limb ischemia therapy.
Part 1 Acute Limb Ischemia Panel Discussion
Переглядів 366Рік тому
Part 1 Acute Limb Ischemia Panel Discussion
Part 2 Acute Limb Ischemia Panel Discussion
Переглядів 203Рік тому
Part 2 Acute Limb Ischemia Panel Discussion
ALI: CDT vs Thrombectomy Devices. How do I choose?
Переглядів 1,1 тис.Рік тому
ALI: CDT vs Thrombectomy Devices. How do I choose?
Acute Limb Ischemia: Endovascular vs Surgical Management
Переглядів 1,6 тис.Рік тому
Acute Limb Ischemia: Endovascular vs Surgical Management
Live Case: Tibial & Pedal Loop Revascularization
Переглядів 1,7 тис.Рік тому
Live Case: Tibial & Pedal Loop Revascularization
DVA Basics Part 5 of 5: DVA Patient Outcomes
Переглядів 288Рік тому
DVA Basics Part 5 of 5: DVA Patient Outcomes
DVA Basics Part 4 of 5: Hybrid DVA (Deep Venous Arterialization)
Переглядів 457Рік тому
DVA Basics Part 4 of 5: Hybrid DVA (Deep Venous Arterialization)
DVA Basics Part 3 of 5: Endovascular DVA (Deep Venous Arterialization)
Переглядів 531Рік тому
DVA Basics Part 3 of 5: Endovascular DVA (Deep Venous Arterialization)
DVA Basics Part 2 of 5: Surgical DVA (Deep Venous Arterialization)
Переглядів 776Рік тому
DVA Basics Part 2 of 5: Surgical DVA (Deep Venous Arterialization)
Live Case: CFA and Distal SFA/Pop Shockwave with Pedal Access
Переглядів 964Рік тому
Live Case: CFA and Distal SFA/Pop Shockwave with Pedal Access
thanks a lot
Tank you very much for the detailed explanation
Really great job
Great demonstration
Great case Exceptional end result
Very nice case Perseverance
concise explanation alongside excellent videos and photos thank you very much
A book for peripheral artery disease? What you recommend? Tks
There are many books. Best to find one you like. You do a google search
great sir . please take some times for lecture of normal vascular anatomy (angiography) techniques tips and tricks.
As soon as possible
unlikely to stay patent.
It was to heal a wound. Most need to stay open just for healing
11:04 May I ask what is meant by "Once you put a stent you have to start counting" Counting what? Thanks
The process of intimal hyperplasia begins.
@@VascularDisease Thank-you
Amazing video sir. 😊
Thank you!
Im having severe calf pain in my right leg and numbness in my thigh while walking. I had a cath with stent placement in my LAD in my right groin in August 2022. I have had a EMG with normal results. My calf is sore all the time and bigger than the left with tightness. I have seen multiple MDs and even talked to my cardiologist in November about it. Im going to ask that they check me for this..the pain while doing simple tasks is dibilatating. Thanks for all the information
Thanks a lot sir .... This lecture helped me a lot
Glad to hear that!!!
Can u pls name the micro guidewires u hv used?
there are many; Asahi has many good ones, regalia, fielder, abbott command 14 and 18 are good, etc.
hello Doctor. May I have your File in this Presentation? Thanks in advance>
Hi Dr Tummala, the video is excellent Can you leave email address for me ? I want to discuss some cases with you
Gr8 talk.
I didn't know there were multiple kinds of Fistula. I barely got the one in my upper left arm working, after the one in my right failed to mature. I just got to 15 gage needles today. I wonder if this was even an option for me? My surgeon didn't say anything about something like this. Unless this is what he did. I might see him next week to remove my catheter. Maybe I'll ask him.
There are really so many different designs for these guidewires! So interesting to see. I really like the stent-like structure for centering the guidewire in the middle of the vessel for proper alignment, it seems very useful! Nice video!
Thank you
To stop future stent blockage, after the initial repair and stent placement; the plack needs be removed completely ( before the stent is placed.) Like going to the dentist: they remove all of the plack, before sealing the tooth with artificial enamel. Otherwise, the plack, would continue to invade the tooth, under the new enamel. Open the blockage; then, roto rooter with vacuum, the plack: don't just press it to the walls, to give area Flo. [That only leaves growing plack- and that growing plack-, is what invades the new stent(s), post placement. Save the patient, invasive bioproceedure liabilities,pain, and healing, times - by removing'all" of the arterial plack from within the vessel, before stent placement. Design a vacuum tube into, or that can be introduced in thru the original limb flow device, for this task; if no such device but exists at this time. HANI
Is considered side to side fistula which are obsulate nowadays
Agree but this is different technology with good early data
Very interesting presentation i like to ask you what about venous hypertension rate
Great question but no issues based on literature as far as I am aware
Great case! Congrats and thanks for sharing!
Thanks for watching!
Very informative, thanks
Excellent summary
Glad you liked it
I work in a production line where we make guidewires(I package them) and have always wondered exactly how they work. Thank you for uploading this!
Glad it was helpful!
Thank you so much for this information! 💛
You are so welcome!
Congratulations on the result, can you please share with us what kind of DES did you use in the second scenario? Many thanks for sharing your experience 🍻
Thank you for the question and sorry for the delay. Cook Zilver DES
👌👍
Great Case presentation!
Thank you kindly!
Thank you for your time and help.
You are welcome!
I have one question about the better tehnique for acces AV shunt,,button hole or other tehnique, tq
This is a tough question as I do not create them surgically.
Thanks for your presentation. What do you think about stenting, graft stenting. I had a case of consultation with one patient with popliteal cystic adventional disease. Patient had intermittent claudication and local sub occlusion of pop. I recommended open surgery ( I know that from literature). But my colleagues from another clinic recommended to implant stent And patient agreed: non traumatic. How fair is that? Thanks 🙏
Based on VS guidelines as you know, standard of care is surgery. Trying to angioplasty or stent these doesn’t work in my humble opinion as you don’t get good luminal gain/expansion of the stent because of the space occupying cysts in the wall. Thank you for your question.
Nice tutorial, excellent points discussed. You mentioned low pressure prolong angioplasty. Can you please specify the pressure and time here?
Yes at least 2 minutes at 4 ATM
Dear Dr Thanks for your unique video. I would like to please you answer this question. May we do make this type of fistula with Eps burning radio-frequency device instead of special off the shelf burning device? May I notice you I live in a developing country and do not enough money to buy this devices. Thanks.
I would only use the approved devices for safety reasons. It is very expensive here also
Great video. Thanks
You are welcome!
thank you
You're welcome
thanks so much this really help me,,,, i am only 37 year and i have this problem ...too bad.
Happy to help. See a vascular specialist
Did u find the cure?
excellent! for btk run whats the ipsi angle - 20-30?
I don't have an exact angle but I look for the fibula overlying the tibia slightly.
Thx for this video!
You bet!
Exactly what I was looking for, Great video ! Thank you
Great to hear! Please let others know so I can keep bringing new and fresh content to all of you.
Excellent 👍
Thank you! Cheers!
Awesome job! Thank you for this kinda of cases. Great explanations and invaluable education.
Thank you for your comments. Please spread the word :)!!!
What reentry device was used in the first case?
outback by Cordis
I work at an OBL as a nurse doing Vascular IR. Had a case last week and ran into a little hiccup that prolonged it by a quite substantial amount of time. We were doing a Right Leg Angiogram. He came back to us with a re-occlusion of his posterior tibial artery after angioplasty in late March. We were navigating the posterior tibial artery where we ran into substantial calcification and occlusion of the distal third portion. On top of a difficult lumen to get a wire through, we came across a sharp angled area of the PT that we could not get even our smallest/“floppiest” wire. Just such an acute bend. Our last resort attempt was bend the foot up to try and create a straighter angle. Now there’s only so far you can bend the ankle to straighten out the vessel. We ended up going with a pedal access but it took about 30 minutes due to the disease of the distal portion of the vessel. My question is do you have any other methods or tricks of the trade to help straighten out a vessel with the situation we ran into? We were trying to think of other ways and I figured try and reach some others for some expertise.
Sorry for the late reply. I think you did all the tricks I know.
I believe the planning was wrong here ....should hv taken a pedal access earlier after few failed attempts from below
Thanks , excellent video. So in first case u crossed sub intimal. Do you use atherectomy even in that.
I usually IVUS and then determine the safety profile to use atherectomy based on the IVUS results
Hope more basic videos for Radiology residents interested in ir
Great idea so trying to do this now. Please send me some topics you would like to learn more about.
A superb presentation and clear cut concepts. It would have taken few hours to comprehend/decipher these from books/articles. Thank you for your hardwork to make our work easier
Thank you for the kind words!
What's your surveillance for a case like this? Would you just go by clinical signs? Angio if wound healing slows down? Do you ever schedule repeat angios regardless because of the high rates of recoil and reocclusion? I'm trying to incorporate PAT in my clinical follow-up, but it's time consuming.
Yes close clinical follow up. If healing slows or stops I repeat the angiogram to reassess.