----- Original Message -----
Sent: Saturday, September 10, 2005 9:02
AM
Subject: Re: A real oldie: thrombin
injection vs. compression for pseudoaneurysm
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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