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And call me fail, but clarity has come in handy in every game I've ever played, both for me and my team.
In my experience playing this may not be the best start to a Twitch build, but no Twitch has held it's own against me.
The idea behind here is to buy...
1. Vampiric Scepter
2. Boots of Swiftness
3. Youmuu's Ghostblade
4. Madred's Bloodrazor
5. Banshee's Veil
6. The Bloodthirster
7. Infinity Edge
I generally try to buy the items in this order, but I often will change the order if necassary. I.e. If you face a bunch of tanks, it could become necassary to shoot for Madred's Bloodrazor.
While it's a given, you can't be too careless, or you're gonna regret it quickly.
It's best as a twitch to quickly max out expunge and your ult as it's what allows you to get the most kills. A fed Twitch is something to be feared! This build works well with the new twitch as well, as Youmuu's Ghostblade is a great way to counter the atk speed loss from your ult.
With the new ult I found it best not to focus on atk speed as much as focusing on increasing damage. Lifesteal can also play a major role in this game. I've walked at someone hitting harder than me, only to win cause I was gaining half his hits back in health.
This build has emphasis on power, and intelligence.
You may find at first this build is a bit tricky, but I find that it works as long as you don't get careless, or reckless.