Salman Arain (@realarainmd) / X

Salman Arain

5,526 posts

Salman Arain

@realarainmd

Houston, TX

Joined November 2024

Pinned
Salman Arain
@realarainmd
Nov 1, 2024
The Contrast Modulation revolution is here! I made this account to spread the word and share my experiences with this exciting and often misunderstood technique. It is NOT an alternative to conventional CTO PCI - but an adjunct. Please comment, critique, share! #contrast1st #HDR
Salman Arain
@realarainmd
Feb 16, 2025
How I Talk About Left Main PCIs - And You Should Too!* 🧵 (*A suggestion of course!) This is one of the cases from my talk on MCS for high risk PCI. Case first, then the analysis. 86 year old man, unstable angina, EF 40%, turned down for CABG at OSH, transferred with IABP.
00:00
Salman Arain
@realarainmd
Jan 19, 2025
#JSBT - A Deeper Dive 🧵 Given the wide spread interest generated by #JSBT (@UTHeartVascular Style), I thought I would explain the technique in a little more detail. 👉🏼 #JSBT is a technique for protecting the SB ostium with a jailed balloon during PROVISIONAL bifurcation PCI
Salman Arain
@realarainmd
Apr 18, 2025
Ex Vivo Grenadoplasty! ( Or, what pressure does it take to rupture an NC balloon?) 👉🏼 We used an OPN indeflator to see how we could go on a 4 mm BSC NC balloon. Note the point of rupture! The NC 🎈remains intact! 🤔 But the hypotube is completely mangled. The video speaks
00:00
Salman Arain
@realarainmd
Nov 9, 2025
My Best OCT Image! 🧶 This image is ‘one in a million’ - literally, because I looked at 100s of 1000s of imaging frames this week. 😂 This shows the final appearance of an LCX treated with scoring PTCA, NC 🎈, and DCB. Analysis to follow…
Salman Arain
@realarainmd
Dec 28, 2024
💧#HDRanalysis 🧐 - Case 027 An CTO Intervention Unlike Any You Have Seen! 🧵 Here is an unusual CTO for most. The patient is a 48 year old woman with systemic sclerosis (SSc), Raynaud’s, and non-healing ulcer of the left 3rd digit. Here is the patient’s hand. More…👇🏼
Salman Arain
@realarainmd
Sep 13, 2025
How we crossed the wickedly calcified RCA shown below. We chose Option D: some other wire. But before I tell you which one, let’s talk about the challenges here. (A mini 🧵)
Salman Arain
@realarainmd
Mar 12, 2025
Left Main PCI - What’s New I had the pleasure of giving this talk at #CRT2025 on Monday. It was an honor to share the podium with gurus like @GoranEBC, @JWMoses, @TanveerRab, and @RinfretStephane. Here is a list of publications from 2024-25 that made the cut and some key
Salman Arain
@realarainmd
Jan 25, 2025
The Water Slide Phenomenon Or, how contrast microinjection allows PJWs to cross calcific coronary microchannels. PJWs are unable to cross ‘dry’ micro channels on account of friction. Delivery of contrast can facilitate wire crossing by filling surface irregularities (making
Salman Arain
@realarainmd
Sep 8, 2025
Post CABG Graft Failure Rates At One Year These are the graft failure rates by conduit and treated vessel from a paper shared by @agtruesdell earlier today. The numbers for combos listed in parentheses are small <50 Not likelihood ratios, but still food for thought!🤔
Salman Arain
@realarainmd
Oct 12, 2025
Cut, Shock, Drill - Weekend Deluxe Ed. You know the ostium is critically stenosed when contrast starts streaming from the guide SHs before it reaches the coronary! 😅 Other interesting observations: 👉🏼 Heavy Ca at the os 👉🏼 A narrowed lumen bec. of the low filling pressures
00:00
Salman Arain
@realarainmd
Jul 11, 2025
The Left Mains Of Harris County, Texas My favorite vessel to treat is the left main. It used to be the carotid, but that’s when I was a young(er) man. 😂 Here are 3 of 6(!) left mains that I encountered over my long weekend call. Three more after the jump.
00:00
00:00
00:00
Salman Arain
@realarainmd
Aug 8, 2025
The Little Things (That Spark Joy in the Lab!)🎋 Here is a video clip of a seemingly unremarkable moment - a wire crosses a stenosis. Look closer and you see it captures a fortunate series of events - a puff of contrast propels the wire, causing its tip to twist and form the
00:00
Salman Arain
@realarainmd
Jul 25, 2025
To Bypass Or Not To Bypass - Question Of The Day Here are all the LIMA conjectures combined into one… 🔑 CABG should be preferred over PCI only if ALL 5 criteria are met 👉🏼 visible LAD target 👉🏼 viable AW 👉🏼 healthy LIMA 👉🏼 stable patient 👉🏼 appropriate surgical resources