How can you keep them down on the farm once they've seen Paris?
I'll never go back, did one in about 15 seconds yesterday afternoon, 
something highly appreciated by my tech at 4:30 PM on a Friday- we have 
never failed to thrombose one with thrombin, the only two problems we have 
ever had were in what came to be recognized as infected pseudoaneurysms and 
it works even in patients on Plavix- ultrasound guided compression was our 
previous method (we published two papers on it), but it could take an hour 
of tech (often two techs) and machine time, it was exhausting for the techs 
and painful (required narcotics and benzodiazepines) for the patients, and 
failed in about a fourth to a third of patients- furthermore, I don't think 
we ever succeeded in a patient taking Plavix and virtually all coronary 
stent patients are now on Plavix and more for at least a month- perhaps 
most important is the response of the techs when I did the first one: "Can 
we order a gallon of the thrombin?"- they'd all revolt if we went back-
ultrasound guided thrombin injection is better treatment and is much less 
resource intensive
Joe

At 12:15 AM 9/9/2005 -0400, you wrote:
>      I know this subject has been kicked around a lot, but we recently 
> got a new Medical Director who says that thrombin injection is not the 
> standard of care. He wants us to go back to compression of 
> pseudoaneurysms. My technical director asked me to see if I could get 
> some comments on this issue from other vascular labs. I would greatly 
> appreciate the group's input. Also was there a poll on compression vs 
> injection? If so, how can I access it. Many thanks!
>
>                                                        Fraternally,
>
>                                                        James M. Russell, RVT
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Joseph R. Schneider, MD, PhD
Professor, Vascular Surgery
Associate Director, Northwestern General Surgery Residency
Northwestern University Medical School

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