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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