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Deepak Sudheendra,MD, RPVI, FSIR
Director of & Complex Venous Disease Program | Patient Educator | Consultant | Speaker | Blogger | Always here to help | Views my own
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Deepak Sudheendra,MD, RPVI, FSIR 15h
Agree 💯 buddy! And with venous dz incidence 5-6x that of arterial dz and more docs treating PAD than venous, there are millions that suffer needlessly. Glad to see your group is getting the word out!
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Deepak Sudheendra,MD, RPVI, FSIR 15h
👏👏👏 for featuring the work of who is very talented in vascular dz. Most rads groups don’t practice clinical IR nor do they value what IR, which can’t be outsourced, brings to the table. It’s nice to see a progressive rads group!
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Deepak Sudheendra,MD, RPVI, FSIR 17h
😂 😂😂😂😂
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Deepak Sudheendra,MD, RPVI, FSIR 20h
Pt referred by for mult bouts of thrombophlebitis. Pt has MINIMAL sxs of venous insuff & nontender varicosities. Wears stockings. US shows 7mm GSV & 5mm SSV both w/reflux < 0.5 sec. Trainees, what’s your rec & why?
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Deepak Sudheendra,MD, RPVI, FSIR 21h
20-30 mmHg is most important aspect. Brand doesn’t matter. Some fit better than others so trial & error. Takes 2-3 wks to get used to them so don’t give up easily. Stockings need to be replaced q3-4 months as they lose compression if worn daily. Knee high good for most people.
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Deepak Sudheendra,MD, RPVI, FSIR Jul 6
Replying to @Naviyd @farkomd and 11 others
Can’t do thrombectomy for chronic occlusions. IVC has been occluded for 3 yrs
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Deepak Sudheendra,MD, RPVI, FSIR Jul 6
👌Glad to hear ! Personally I think everyone on the planet should be wearing stockings. It’s really amazing how much venous dz can affect .
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Deepak Sudheendra,MD, RPVI, FSIR Jul 6
Dear , Start wearing compression stockings early in career/. Yrs of prolonged sitting/standing leads to chronic venous insufficiency. Believe me, you’ll thank me one day!
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Deepak Sudheendra,MD, RPVI, FSIR Jul 6
33 yo. I think open surgery is very morbid for cases like this. Leaning towards option 2
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Deepak Sudheendra,MD, RPVI, FSIR Jul 6
Update: Got images from stent placement. Option 1: Open stent removal w/IVC recan later. Option 2: stent IVC & crush renal stent. May get renal v thrombosis or maybe not given kidney’s ability to collateralize. Option 3: IVC stent UP TO renal stent & flow should keep open
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Deepak Sudheendra,MD, RPVI, FSIR Jul 4
Despite & other issues plaguing our country, let’s not 4get on this that US is still the land of opportunity. While more & is needed to get these opp, we have always risen to the challenge.
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Deepak Sudheendra,MD, RPVI, FSIR Jul 3
Mark thanks for your kind words! Where should I mail that $100 to? PayPal?
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Deepak Sudheendra,MD, RPVI, FSIR Jul 3
Annette lucky to have Gerry who is awesome in your community. But what if u didn't? W/bad info on web, what do u say when pt shows you tx you haven't heard of? The option of traveling for care should be up to pt not PCP but I understand that PCP also tries to protect pt.
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Deepak Sudheendra,MD, RPVI, FSIR Jul 3
2/2 #1 and #2 are the most fruitful. Where I have fallen short are those PCPs who practice in office only & don't go to hosp or attend GR. Going to their office has not been worth it. Or if they are in very small town, they say most pts won't travel far for care so why bother.
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Deepak Sudheendra,MD, RPVI, FSIR Jul 3
1/2 Mark/Gerry absolutely correct! What I have done with very good success: 1. After recan proc & 1 month f/u, I call PCPs if I don't know them to discuss successful outcome. This is in addition to letter. 2. Offer to do grand rounds at their hosp 3. Send/email literature to them
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Deepak Sudheendra,MD, RPVI, FSIR Jul 3
UPDATE: Pt spoke w/PCP who he trusts implicitly. PCP said there is no tx for other than AC & in all his yrs of practice he has never heard of anyone getting clot removed. He has many pts w/PTS & he tells them all to live with it so that’s what pt has decided to do.
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Deepak Sudheendra,MD, RPVI, FSIR Jul 3
Absolutely. I just saw pt recently so she has not been scheduled yet for procedure.
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Deepak Sudheendra,MD, RPVI, FSIR Jul 3
Couldn’t agree more...Great work Ashkan! I think every single person that goes to a wound care ctr should be eval for CVI even if they are going for arterial dz as statistically venous ulcers make up the vast majority of wounds.
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Deepak Sudheendra,MD, RPVI, FSIR Jul 2
2/2 CT shows IVC & iliac thrombosis & misplaced/migrated renal v stent that IMO led to thrombosis. How would you approach?
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Deepak Sudheendra,MD, RPVI, FSIR Jul 2
1/2 Young F h/o renal v thrombosis ? due to NCS. Renal v stent placed & varicosities developed in 2018. Pt sent to cosmetic vein Dr for sclero. This Dr sent pt back to 1st Dr suspecting IVC thrombosis.
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