Groin complications and Management 2011
•
29 likes•14,321 views
The document discusses prevention and treatment of complications from groin punctures during cardiac procedures. It describes optimal puncture sites, common complications like hematomas, and treatments for minor oozing or more serious bleeding. Risk factors for complications include age, diabetes, obesity, and large sheath sizes. Manual compression is recommended to control bleeding, along with monitoring vital signs.
Report
Share
Report
Share
Recommended
Femoral Site Complications
This document provides information on complications that can occur after femoral access for catheterization procedures. The major complications discussed include hematoma, pseudoaneurysm, arteriovenous fistula, and arterial occlusion. For each complication, the summary describes typical physical findings and recommended nursing interventions. Studies comparing different approaches to hemostasis and sheath removal are also summarized, finding no significant difference in vascular complication rates between sandbag compression and bandage dressings.
Groin management 2013
The management and prevention of groin complications post cardiac catheterization procedures. Let's get back to the BASICS.
Vascular access in cardiac catheterization
This document discusses vascular access during cardiac catheterization. It covers various access sites including femoral, radial, brachial and ulnar arteries as well as internal jugular, subclavian and femoral veins. Potential complications of vascular access like hematoma, pseudoaneurysm, retroperitoneal hemorrhage and arteriovenous fistula are described. Risk factors, diagnosis and management of these complications are provided. Prevention strategies to avoid vascular access complications are also mentioned.
Radial access interventions pros,cons and evidense
This document discusses the history and current evidence regarding transradial catheterization. Some key points:
- Transradial catheterization began in the 1920s but became more widely used starting in the late 1980s and 1990s.
- Studies have shown that radial access reduces access site bleeding complications compared to femoral access, especially in high-risk patients. It also improves patient comfort and allows for shorter hospital stays.
- Radial access should be the preferred approach over femoral for experienced operators, according to ESC revascularization guidelines. While there is a steep learning curve, radial access can be used for all procedures including bifurcation PCI.
- Disadvantages include a longer procedural time initially and risks of radial
Coronary artery dissection
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction characterized by a non-traumatic separation of the coronary arterial wall. It most commonly affects younger women and the left anterior descending artery. SCAD results from an intimal tear or bleeding of vasa vasorum that leads to the formation of a false lumen filled with blood. This can cause the artery to narrow and restrict blood flow. SCAD is increasingly recognized and can be caused by conditions affecting connective tissue or hormonal factors during pregnancy. Angiography is used to diagnose SCAD but findings may be subtle, with long diffuse narrowing being most common. Management involves conservative treatment but revascularization may be needed for ongoing ischemia
Stent Thrombosis
Stent thrombosis is a rare but serious complication of percutaneous coronary intervention (PCI) with mortality rates between 25-40%. It is classified based on timing (acute, subacute, late, very late) and etiology (primary, secondary). Risk factors include premature discontinuation of dual antiplatelet therapy, smoking, diabetes, chronic kidney disease, acute coronary syndrome, and high platelet reactivity. Strategies to minimize stent thrombosis involve careful patient selection, optimal stent deployment, adherence to potent dual antiplatelet regimens, and treatment involving emergent thrombectomy with escalated antiplatelet therapy.
Coronary artery dissection and perforation
Coronary artery dissection and perforation are serious potential complications of percutaneous coronary intervention (PCI) that can be life-threatening. Up to 30% of conventional balloon angioplasties result in angiographically significant coronary artery dissection. Perforation occurs in 0.3-0.6% of all PCI cases. The development of devices to remove or ablate tissue has increased the risk of these complications. Types C through F dissections according to the NHLBI classification portend significant morbidity and mortality if untreated, as they can lead to total coronary occlusion without blood flow. Acute vessel closure was the most feared complication before stents but now occurs in less than 1% of elective PCI due to stenting
Vascular closure devices
Vascular closure devices were developed in the 1990s as alternatives to manual compression for achieving hemostasis after a cardiac catheterization procedure. There are two main types - passive devices that enhance clotting without achieving prompt hemostasis, and active devices that achieve hemostasis more quickly through mechanical or chemical means. Examples of active devices discussed include the Angio-Seal device which uses an absorbable anchor and collagen plug, and the Perclose device which uses an automated suturing mechanism. Studies have shown that active devices can reduce time to hemostasis, ambulation, and discharge compared to manual compression, though they may increase risks of infection and limb ischemia in some cases. Complications associated with vascular closure include bleeding
Recommended
Femoral Site Complications
This document provides information on complications that can occur after femoral access for catheterization procedures. The major complications discussed include hematoma, pseudoaneurysm, arteriovenous fistula, and arterial occlusion. For each complication, the summary describes typical physical findings and recommended nursing interventions. Studies comparing different approaches to hemostasis and sheath removal are also summarized, finding no significant difference in vascular complication rates between sandbag compression and bandage dressings.
Groin management 2013
The management and prevention of groin complications post cardiac catheterization procedures. Let's get back to the BASICS.
Vascular access in cardiac catheterization
This document discusses vascular access during cardiac catheterization. It covers various access sites including femoral, radial, brachial and ulnar arteries as well as internal jugular, subclavian and femoral veins. Potential complications of vascular access like hematoma, pseudoaneurysm, retroperitoneal hemorrhage and arteriovenous fistula are described. Risk factors, diagnosis and management of these complications are provided. Prevention strategies to avoid vascular access complications are also mentioned.
Radial access interventions pros,cons and evidense
This document discusses the history and current evidence regarding transradial catheterization. Some key points:
- Transradial catheterization began in the 1920s but became more widely used starting in the late 1980s and 1990s.
- Studies have shown that radial access reduces access site bleeding complications compared to femoral access, especially in high-risk patients. It also improves patient comfort and allows for shorter hospital stays.
- Radial access should be the preferred approach over femoral for experienced operators, according to ESC revascularization guidelines. While there is a steep learning curve, radial access can be used for all procedures including bifurcation PCI.
- Disadvantages include a longer procedural time initially and risks of radial
Coronary artery dissection
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction characterized by a non-traumatic separation of the coronary arterial wall. It most commonly affects younger women and the left anterior descending artery. SCAD results from an intimal tear or bleeding of vasa vasorum that leads to the formation of a false lumen filled with blood. This can cause the artery to narrow and restrict blood flow. SCAD is increasingly recognized and can be caused by conditions affecting connective tissue or hormonal factors during pregnancy. Angiography is used to diagnose SCAD but findings may be subtle, with long diffuse narrowing being most common. Management involves conservative treatment but revascularization may be needed for ongoing ischemia
Stent Thrombosis
Stent thrombosis is a rare but serious complication of percutaneous coronary intervention (PCI) with mortality rates between 25-40%. It is classified based on timing (acute, subacute, late, very late) and etiology (primary, secondary). Risk factors include premature discontinuation of dual antiplatelet therapy, smoking, diabetes, chronic kidney disease, acute coronary syndrome, and high platelet reactivity. Strategies to minimize stent thrombosis involve careful patient selection, optimal stent deployment, adherence to potent dual antiplatelet regimens, and treatment involving emergent thrombectomy with escalated antiplatelet therapy.
Coronary artery dissection and perforation
Coronary artery dissection and perforation are serious potential complications of percutaneous coronary intervention (PCI) that can be life-threatening. Up to 30% of conventional balloon angioplasties result in angiographically significant coronary artery dissection. Perforation occurs in 0.3-0.6% of all PCI cases. The development of devices to remove or ablate tissue has increased the risk of these complications. Types C through F dissections according to the NHLBI classification portend significant morbidity and mortality if untreated, as they can lead to total coronary occlusion without blood flow. Acute vessel closure was the most feared complication before stents but now occurs in less than 1% of elective PCI due to stenting
Vascular closure devices
Vascular closure devices were developed in the 1990s as alternatives to manual compression for achieving hemostasis after a cardiac catheterization procedure. There are two main types - passive devices that enhance clotting without achieving prompt hemostasis, and active devices that achieve hemostasis more quickly through mechanical or chemical means. Examples of active devices discussed include the Angio-Seal device which uses an absorbable anchor and collagen plug, and the Perclose device which uses an automated suturing mechanism. Studies have shown that active devices can reduce time to hemostasis, ambulation, and discharge compared to manual compression, though they may increase risks of infection and limb ischemia in some cases. Complications associated with vascular closure include bleeding
Acute aortic dissection
This document discusses acute aortic syndrome, including a case presentation of a 55-year-old female with chest pain. Key details include:
1. The patient presented with sudden onset chest pain and was found to have hypertension on examination.
2. Initial workup including ECG, labs and chest x-ray were non-diagnostic but showed a widened mediastinum.
3. Echocardiogram and CT angiogram revealed an aortic dissection involving the aortic arch and descending thoracic aorta.
4. She was referred urgently for cardiovascular surgery to treat this life-threatening condition within 24 hours of presentation.
Peripheral vascular diseases
Peripheral vascular diseases (PVD), also known as peripheral artery occlusive disease, refers to obstruction or deterioration of arteries other than those supplying the heart or brain, primarily caused by atherosclerosis. PVD presents as either chronic arterial insufficiency or acute arterial occlusion. Management involves risk factor modification, endovascular or surgical revascularization techniques, and exercise therapy. For intermittent claudication, cilostazol is an effective pharmacotherapy that improves walking distance. Acute limb ischemia requires immediate anticoagulation and revascularization to prevent limb loss.
G03 vascular injury
Vascular injuries require prompt evaluation and treatment to prevent limb loss from hemorrhage or ischemia. Physical exam and Doppler are initial steps to detect hard signs of injury warranting arteriography or surgery. Soft signs may be managed non-operatively with serial imaging. Scoring systems help determine limb salvability in mangled extremities based on injury mechanism, ischemia time, age, and hemodynamics. Revascularization generally precedes fixation to restore blood flow, though temporary shunts allow staged procedures. Close coordination between specialties optimizes limb salvage.
Closure devices
Passive closure devices such as hemostasis pads, Chito-Seal, Clo-Sur PAD, and SyvekPatch rely on accelerating the body's natural clotting process without leaving any materials in the body. Compression devices provide mechanical compression to allow hemostasis but do not shorten time to ambulation compared to manual compression. Active closure devices such as Angio-Seal, VasoSeal, and Mynx deploy plugs or sealants outside the artery, while some like Cardiva Catalyst provide temporary intravascular tamponade. Overall, closure devices aim to improve patient comfort over manual compression but have varying effects on time to hemostasis and ambulation or risks of complications.
AORTIC ARCH SURGERY
Surgical management of aortic arch pathology often requires complex techniques to protect vital organs like the brain during replacement or repair of the aortic arch. Conventional techniques used hypothermic circulatory arrest and surface cooling but had limitations. Newer techniques like antegrade and retrograde selective cerebral perfusion allow prolonged safe periods of cerebral protection with improved cooling and independent control of cerebral and systemic circulation, though they are more technically challenging. The optimal approach considers individual patient and anatomical factors to maximize benefits and reduce risks.
Aiod
This document discusses surgical bypass options for aorto-iliac occlusive disease (AIOD). It defines AIOD and describes the standard TASC classification system. The main indications for surgical intervention are claudication or chronic limb-threatening ischemia. Surgical bypass options described include aortoiliac endarterectomy, aortobifemoral bypass, femorofemoral bypass, axillofemoral bypass, and obturator bypass. Postoperative patency rates for different procedures are provided.
Cardiac cath complications
The document summarizes various potential complications that can occur during or after cardiac catheterization. The major complications discussed include death, myocardial infarction, stroke, bleeding, vascular injury, and contrast induced nephrotoxicity. Risk factors for complications include patient demographics, cardiovascular anatomy, clinical situation, and operator experience. Local vascular complications like hematoma, pseudoaneurysm, arterial thrombosis are also described. Strategies to prevent complications involve careful technique, minimizing contrast and anticoagulation.
Acute Limb Ischemia
Acute limb ischemia is a sudden decrease in blood flow to a limb that threatens viability. It requires urgent evaluation and management to determine if the limb is viable, threatened, or irreversibly damaged. Prompt diagnosis and revascularization through catheter-based thrombolysis, thrombectomy, or surgery can reduce limb loss risk. Treatment approaches depend on the severity of ischemia and limb threat.
Vascular Closure Devices
The document discusses various vascular closure devices (VCDs), including:
1. Plug-based devices like Angio-Seal, Exoseal, and MynxGrip that use anchors, plugs, or polymers to seal the puncture site.
2. Suture-mediated devices like Perclose Proglide and Prostar that deploy sutures before sheath removal to close the arteriotomy.
3. Mechanical devices like StarClose that use clips, and compressive devices like Catalyst III that use disks, to facilitate hemostasis.
While VCDs can reduce time to hemostasis and ambulation compared to manual compression, meta-
CORONARY ARTERY PERFORATION DURING PCI
This document discusses coronary artery perforation during percutaneous coronary intervention (PCI). Some key points:
- Coronary perforation can occur during or after PCI and is defined as extravasation of contrast or blood from the coronary artery. Proximal or mid vessel perforations are more severe while distal perforations often have a benign course.
- Perforations are classified based on their severity. Treatment depends on the severity and location of the perforation. Conservative measures often suffice for minor perforations while techniques like prolonged balloon inflation or stenting may be needed for more severe perforations to stop bleeding.
- Factors like the use of atherectomy or laser devices, complex lesions, small vessels, and guide
Updates in venous thromboembolism
This document discusses updates in venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). It describes the risk factors, signs, symptoms, and diagnostic testing for VTE including ultrasonography, CT pulmonary angiography (CTPA), ventilation-perfusion (V/Q) scanning, and magnetic resonance imaging (MRI). It also discusses specific considerations for diagnosing PE during pregnancy.
Venous Disorders
It is estimated that 20% of American women and 7% of American men suffer from venous disease. Venous disease results in symptoms such as aching, fatigue, swelling, and pain in the legs which can interfere with daily living.Cosmetic issues may affect quality of life.
At least 20% of patients with venous disease will develop leg ulcers. This presentation outlines the normal anatomy and physiology of venous drainage of the extremities as well as the common venous disorders such as varicose veins and deep vein thrombosis.
MICS
The document describes the history and evolution of minimally invasive cardiac surgery, including early procedures using smaller incisions rather than full sternotomy, and the development of techniques like port-access bypass which use peripheral cannulation and an endoaortic balloon to occlude the aorta and allow procedures like CABG or mitral valve surgery to be done through smaller incisions. It also covers the various approaches and techniques used for minimally invasive procedures, as well as patient selection considerations and how to harvest vessels like the LIMA through smaller incisions.
Cardiac cath complications
Presentation about the hazards and potential complications that could happen in any cardiac or peripheral catheterization procedure and how to avoid them
Ischaemic cardiomyopathy revascularisation how when and why
This document discusses ischemic cardiomyopathy and revascularization. It begins with an overview of ischemic cardiomyopathy and discusses factors that contribute to left ventricular remodeling and heart failure progression. It then reviews data from studies such as the Duke CVD Data Bank and STITCH trial on the outcomes of coronary artery bypass grafting versus medical therapy for patients with ischemic cardiomyopathy. The document discusses the role of myocardial viability and hibernation in identifying patients most likely to benefit from revascularization. It reviews various modalities for assessing myocardial viability and hibernation such as cardiac MRI, PET, and echocardiography. Overall, the document provides an overview of ischemic cardiomyopathy and the evidence regarding revascularization outcomes based on viability assessment.
Cardiac trauma
This document discusses cardiac trauma, including traumatic aortic rupture and penetrating cardiac injuries. It provides details on:
- The pathophysiology, clinical features, diagnosis and treatment options for traumatic aortic rupture, including endovascular stenting or open surgical repair.
- The indications and techniques for emergency resuscitative thoracotomy to address penetrating cardiac injuries.
- The principles of managing blunt cardiac trauma and penetrating injuries, including decompressing cardiac tamponade, repairing lacerations, and addressing injuries to the coronary arteries.
Emergency surgical access methods like left anterolateral thoracotomy or clamshell thoracotomy are described for rapidly addressing life-threatening cardiac injuries.
Chronic total occlusion
This document discusses chronic total occlusion (CTO) of coronary arteries. It defines CTO and differentiates it from functional occlusions and pseudo-occlusions. The prevalence of CTO is estimated to be around 15% based on registry data. CTOs present technical challenges for percutaneous coronary intervention (PCI) due to factors like lesion length, calcification, and tortuosity. Proper preparation is important for CTO PCI, including adequate guide support and anticoagulation. Scoring systems can help predict the difficulty of crossing a CTO. Special guidewires and techniques may be needed depending on the lesion characteristics and collateral pathways.
Techniques of Vascular acess for Cardiac Catheterization
Vascular acess, cardiac catheterization, femoral artery puncture, vascular acess route, radial artery catheterization
Long term Hemodialysis Vascular Access (AVFs and AVGs)
This document provides an overview of the history and development of vascular access for hemodialysis. It discusses:
- The early development of hemodialysis and use of arteriovenous shunts by Scribner in the 1960s.
- Research in the 2000s that showed much higher rates of AV fistula use and better patient outcomes in Europe and Japan compared to the US. This led to the "Fistula First" initiative in the US to increase AV fistula rates.
- Guidelines for vascular access including the preference for autogenous AV fistulas over prosthetic grafts when possible, with radiocephalic fistulas as the first choice.
- Common complications of AV fist
Aortic SURGERY Intro
my aortic surgery presentation in Solo as an introduction for general practitioner and cardiology resident
Cover the basic diagram of surgical procedures of aorta.
definitely not for surgeon.
Vascular complications post cardiac catherization
This document provides information and guidance for managing vascular complications that can occur after cardiac catheterization. It begins with objectives and describes the cardiac catheterization procedure and most common complication of bleeding. It then discusses specific complications like hematomas, pseudoaneurysms, retroperitoneal bleeding, arteriovenous fistulas, contrast induced nephropathy, loss of pulses, and strokes. Treatment options and steps to take for each complication are outlined. The document concludes with discussing setting up a first aid kit, providing discharge instructions, and answering questions.
Femoral site psudeoaneurysm
1. Femoral pseudoaneurysms are defects in the femoral artery wall that allow blood to leak between the layers of the arterial wall. They are usually caused by complications from catheterization procedures.
2. Ultrasound is used to diagnose femoral pseudoaneurysms by detecting swirling blood flow within a sac connected to the artery.
3. Small, asymptomatic pseudoaneurysms may be monitored, as many will close on their own. Treatment options for problematic pseudoaneurysms include ultrasound-guided compression, thrombin injection under ultrasound-guidance, or surgery.
More Related Content
What's hot
Acute aortic dissection
This document discusses acute aortic syndrome, including a case presentation of a 55-year-old female with chest pain. Key details include:
1. The patient presented with sudden onset chest pain and was found to have hypertension on examination.
2. Initial workup including ECG, labs and chest x-ray were non-diagnostic but showed a widened mediastinum.
3. Echocardiogram and CT angiogram revealed an aortic dissection involving the aortic arch and descending thoracic aorta.
4. She was referred urgently for cardiovascular surgery to treat this life-threatening condition within 24 hours of presentation.
Peripheral vascular diseases
Peripheral vascular diseases (PVD), also known as peripheral artery occlusive disease, refers to obstruction or deterioration of arteries other than those supplying the heart or brain, primarily caused by atherosclerosis. PVD presents as either chronic arterial insufficiency or acute arterial occlusion. Management involves risk factor modification, endovascular or surgical revascularization techniques, and exercise therapy. For intermittent claudication, cilostazol is an effective pharmacotherapy that improves walking distance. Acute limb ischemia requires immediate anticoagulation and revascularization to prevent limb loss.
G03 vascular injury
Vascular injuries require prompt evaluation and treatment to prevent limb loss from hemorrhage or ischemia. Physical exam and Doppler are initial steps to detect hard signs of injury warranting arteriography or surgery. Soft signs may be managed non-operatively with serial imaging. Scoring systems help determine limb salvability in mangled extremities based on injury mechanism, ischemia time, age, and hemodynamics. Revascularization generally precedes fixation to restore blood flow, though temporary shunts allow staged procedures. Close coordination between specialties optimizes limb salvage.
Closure devices
Passive closure devices such as hemostasis pads, Chito-Seal, Clo-Sur PAD, and SyvekPatch rely on accelerating the body's natural clotting process without leaving any materials in the body. Compression devices provide mechanical compression to allow hemostasis but do not shorten time to ambulation compared to manual compression. Active closure devices such as Angio-Seal, VasoSeal, and Mynx deploy plugs or sealants outside the artery, while some like Cardiva Catalyst provide temporary intravascular tamponade. Overall, closure devices aim to improve patient comfort over manual compression but have varying effects on time to hemostasis and ambulation or risks of complications.
AORTIC ARCH SURGERY
Surgical management of aortic arch pathology often requires complex techniques to protect vital organs like the brain during replacement or repair of the aortic arch. Conventional techniques used hypothermic circulatory arrest and surface cooling but had limitations. Newer techniques like antegrade and retrograde selective cerebral perfusion allow prolonged safe periods of cerebral protection with improved cooling and independent control of cerebral and systemic circulation, though they are more technically challenging. The optimal approach considers individual patient and anatomical factors to maximize benefits and reduce risks.
Aiod
This document discusses surgical bypass options for aorto-iliac occlusive disease (AIOD). It defines AIOD and describes the standard TASC classification system. The main indications for surgical intervention are claudication or chronic limb-threatening ischemia. Surgical bypass options described include aortoiliac endarterectomy, aortobifemoral bypass, femorofemoral bypass, axillofemoral bypass, and obturator bypass. Postoperative patency rates for different procedures are provided.
Cardiac cath complications
The document summarizes various potential complications that can occur during or after cardiac catheterization. The major complications discussed include death, myocardial infarction, stroke, bleeding, vascular injury, and contrast induced nephrotoxicity. Risk factors for complications include patient demographics, cardiovascular anatomy, clinical situation, and operator experience. Local vascular complications like hematoma, pseudoaneurysm, arterial thrombosis are also described. Strategies to prevent complications involve careful technique, minimizing contrast and anticoagulation.
Acute Limb Ischemia
Acute limb ischemia is a sudden decrease in blood flow to a limb that threatens viability. It requires urgent evaluation and management to determine if the limb is viable, threatened, or irreversibly damaged. Prompt diagnosis and revascularization through catheter-based thrombolysis, thrombectomy, or surgery can reduce limb loss risk. Treatment approaches depend on the severity of ischemia and limb threat.
Vascular Closure Devices
The document discusses various vascular closure devices (VCDs), including:
1. Plug-based devices like Angio-Seal, Exoseal, and MynxGrip that use anchors, plugs, or polymers to seal the puncture site.
2. Suture-mediated devices like Perclose Proglide and Prostar that deploy sutures before sheath removal to close the arteriotomy.
3. Mechanical devices like StarClose that use clips, and compressive devices like Catalyst III that use disks, to facilitate hemostasis.
While VCDs can reduce time to hemostasis and ambulation compared to manual compression, meta-
CORONARY ARTERY PERFORATION DURING PCI
This document discusses coronary artery perforation during percutaneous coronary intervention (PCI). Some key points:
- Coronary perforation can occur during or after PCI and is defined as extravasation of contrast or blood from the coronary artery. Proximal or mid vessel perforations are more severe while distal perforations often have a benign course.
- Perforations are classified based on their severity. Treatment depends on the severity and location of the perforation. Conservative measures often suffice for minor perforations while techniques like prolonged balloon inflation or stenting may be needed for more severe perforations to stop bleeding.
- Factors like the use of atherectomy or laser devices, complex lesions, small vessels, and guide
Updates in venous thromboembolism
This document discusses updates in venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). It describes the risk factors, signs, symptoms, and diagnostic testing for VTE including ultrasonography, CT pulmonary angiography (CTPA), ventilation-perfusion (V/Q) scanning, and magnetic resonance imaging (MRI). It also discusses specific considerations for diagnosing PE during pregnancy.
Venous Disorders
It is estimated that 20% of American women and 7% of American men suffer from venous disease. Venous disease results in symptoms such as aching, fatigue, swelling, and pain in the legs which can interfere with daily living.Cosmetic issues may affect quality of life.
At least 20% of patients with venous disease will develop leg ulcers. This presentation outlines the normal anatomy and physiology of venous drainage of the extremities as well as the common venous disorders such as varicose veins and deep vein thrombosis.
MICS
The document describes the history and evolution of minimally invasive cardiac surgery, including early procedures using smaller incisions rather than full sternotomy, and the development of techniques like port-access bypass which use peripheral cannulation and an endoaortic balloon to occlude the aorta and allow procedures like CABG or mitral valve surgery to be done through smaller incisions. It also covers the various approaches and techniques used for minimally invasive procedures, as well as patient selection considerations and how to harvest vessels like the LIMA through smaller incisions.
Cardiac cath complications
Presentation about the hazards and potential complications that could happen in any cardiac or peripheral catheterization procedure and how to avoid them
Ischaemic cardiomyopathy revascularisation how when and why
This document discusses ischemic cardiomyopathy and revascularization. It begins with an overview of ischemic cardiomyopathy and discusses factors that contribute to left ventricular remodeling and heart failure progression. It then reviews data from studies such as the Duke CVD Data Bank and STITCH trial on the outcomes of coronary artery bypass grafting versus medical therapy for patients with ischemic cardiomyopathy. The document discusses the role of myocardial viability and hibernation in identifying patients most likely to benefit from revascularization. It reviews various modalities for assessing myocardial viability and hibernation such as cardiac MRI, PET, and echocardiography. Overall, the document provides an overview of ischemic cardiomyopathy and the evidence regarding revascularization outcomes based on viability assessment.
Cardiac trauma
This document discusses cardiac trauma, including traumatic aortic rupture and penetrating cardiac injuries. It provides details on:
- The pathophysiology, clinical features, diagnosis and treatment options for traumatic aortic rupture, including endovascular stenting or open surgical repair.
- The indications and techniques for emergency resuscitative thoracotomy to address penetrating cardiac injuries.
- The principles of managing blunt cardiac trauma and penetrating injuries, including decompressing cardiac tamponade, repairing lacerations, and addressing injuries to the coronary arteries.
Emergency surgical access methods like left anterolateral thoracotomy or clamshell thoracotomy are described for rapidly addressing life-threatening cardiac injuries.
Chronic total occlusion
This document discusses chronic total occlusion (CTO) of coronary arteries. It defines CTO and differentiates it from functional occlusions and pseudo-occlusions. The prevalence of CTO is estimated to be around 15% based on registry data. CTOs present technical challenges for percutaneous coronary intervention (PCI) due to factors like lesion length, calcification, and tortuosity. Proper preparation is important for CTO PCI, including adequate guide support and anticoagulation. Scoring systems can help predict the difficulty of crossing a CTO. Special guidewires and techniques may be needed depending on the lesion characteristics and collateral pathways.
Techniques of Vascular acess for Cardiac Catheterization
Vascular acess, cardiac catheterization, femoral artery puncture, vascular acess route, radial artery catheterization
Long term Hemodialysis Vascular Access (AVFs and AVGs)
This document provides an overview of the history and development of vascular access for hemodialysis. It discusses:
- The early development of hemodialysis and use of arteriovenous shunts by Scribner in the 1960s.
- Research in the 2000s that showed much higher rates of AV fistula use and better patient outcomes in Europe and Japan compared to the US. This led to the "Fistula First" initiative in the US to increase AV fistula rates.
- Guidelines for vascular access including the preference for autogenous AV fistulas over prosthetic grafts when possible, with radiocephalic fistulas as the first choice.
- Common complications of AV fist
Aortic SURGERY Intro
my aortic surgery presentation in Solo as an introduction for general practitioner and cardiology resident
Cover the basic diagram of surgical procedures of aorta.
definitely not for surgeon.
What's hot (20)
Ischaemic cardiomyopathy revascularisation how when and why
Ischaemic cardiomyopathy revascularisation how when and why
Techniques of Vascular acess for Cardiac Catheterization
Techniques of Vascular acess for Cardiac Catheterization
Long term Hemodialysis Vascular Access (AVFs and AVGs)
Long term Hemodialysis Vascular Access (AVFs and AVGs)
Viewers also liked
Vascular complications post cardiac catherization
This document provides information and guidance for managing vascular complications that can occur after cardiac catheterization. It begins with objectives and describes the cardiac catheterization procedure and most common complication of bleeding. It then discusses specific complications like hematomas, pseudoaneurysms, retroperitoneal bleeding, arteriovenous fistulas, contrast induced nephropathy, loss of pulses, and strokes. Treatment options and steps to take for each complication are outlined. The document concludes with discussing setting up a first aid kit, providing discharge instructions, and answering questions.
Femoral site psudeoaneurysm
1. Femoral pseudoaneurysms are defects in the femoral artery wall that allow blood to leak between the layers of the arterial wall. They are usually caused by complications from catheterization procedures.
2. Ultrasound is used to diagnose femoral pseudoaneurysms by detecting swirling blood flow within a sac connected to the artery.
3. Small, asymptomatic pseudoaneurysms may be monitored, as many will close on their own. Treatment options for problematic pseudoaneurysms include ultrasound-guided compression, thrombin injection under ultrasound-guidance, or surgery.
Cardiac cath roles and responsibilities durning an Intra-Procedure emergency
Cardiac cath roles and responsibilities durning an Intra-Procedure emergencyCardiac Cath Lab Information
Your role and responsibility during an emergency in the cath lab. Communication is extremely important. This power point discusses how to do that. Effective teamwork and communication increases the success of resuscitation.Cardiac catheterization
a slide show from http://theblogger911.blogspot.com and http://sellerfriend.blogspot.com created by theblogger911 about Cardiac catheterization
Case of the week - superficial femoral artery pseudoaneurysm
A presentation about an interesting case that came to the Radiology Department of Sebha Medical Center.
A 16 years old male, victim of stab wound in the lower part of the back of the right thigh, and was found to have a pseudoaneurysm in the superficial femoral artery when he was examined by ultasound one month after the injury.
The presentation contains 37 slides, and is divided into the following parts :
1 - The case
2 - Pseudoaneurysms
3 - Imaging of pseudoaneurysms
4 - Treatment of pseudoaneurysms
This presentation was prepared and presented by me in cooperation with D.Mabroka Ellafi in the tutorials of the Radiology Department of Sebha Medical Center.
Cath lab
Cath lab is an examination room
Used to visualize the arteries and treat any stenosis or abnormality found.
Cardiac catheterization
Cardiac catheterization involves inserting a catheter into the heart to view coronary artery anatomy and function. A contrast agent is injected to visualize the arteries under fluoroscopy. The procedure assesses coronary artery disease and collects data on heart structures and pressures. It begins with patient preparation and sterile technique before puncturing an artery to insert the catheter for imaging coronary arteries and ventricles. The procedure provides diagnostic information and is completed when the cardiologist has the needed views, after which the patient must rest.
Kadro W 201306
A 66-year-old female presented with chest pain and underwent a coronary angiogram via the trans-radial approach. During the procedure, she developed pain and pallor in her right arm. Further investigation revealed an occlusion of the right brachial artery likely due to wire-induced dissection. Attempts at medical management were unsuccessful. Angioplasty of the right brachial artery was performed with balloon inflations to restore blood flow. Follow up showed good pulse return though the patient continued experiencing vague right arm pain. The case highlights the risks of trans-radial procedures and importance of addressing complications directly.
Aminian A - AIMRADIAL 2013 - Glidesheath slender
Aminian A - AIMRADIAL 2013 - Glidesheath slenderInternational Chair on Interventional Cardiology and Transradial Approach
Initial experience with the Glidesheath Slender for transradial coronary angiography and intervention: a feasibility study with prospective radial ultrasound follow-upLOWER GI BLEEDING
Lower gastrointestinal tract bleeding can be caused by various conditions affecting the colon and small intestine. The most common cause is diverticular disease, followed by hemorrhoids. Bleeding may present as hematochezia, melena, or occult bleeding resulting in anemia. Colonoscopy is the primary diagnostic tool for evaluating the source and managing bleeding, while other modalities like capsule endoscopy and angiography can also be used. Treatment depends on the underlying cause and may involve endoscopic therapies, medications, or surgery.
Cardio eval
This presentation is for medical risk evaluation of patients prior to undergoing surgery or any medical procedures...
PCI procedure complication
This document discusses complications that can occur during percutaneous coronary intervention (PCI) procedures. It notes that while PCI has over a 90% success rate, complications still occur in 1-5% of cases. It identifies several factors that can increase the risk of complications, such as advanced age, urgent procedures, and comorbidities like heart failure or diabetes. The document categorizes types of potential complications and discusses some in more depth, such as vascular access complications, dissections, and perforations. It also examines angiographic and technical factors that can influence complications, as well as indications for emergency cardiac surgery following PCI.
Myelogram rad 205-2011
This document provides information about myelography, a radiographic procedure used to examine the spinal cord and surrounding structures. It begins with definitions of key terms like myelogram and spinal cord anatomy. It then describes the meninges layers surrounding the spinal cord and details the standard myelography procedure, which involves injecting water-soluble contrast into the thecal sac between the L3-L5 vertebrae under fluoroscopy. Post-procedure monitoring and potential complications are also outlined.
0914
The most common cerebral vascular malformations are venous angiomas, which are usually asymptomatic. Arteriovenous malformations (AVMs) are the most common symptomatic cerebral vascular malformations, presenting most often with hemorrhage or seizures in individuals between 20-40 years of age. A vein of Galen malformation is a rare type seen in neonates presenting with high-output heart failure or older individuals with subarachnoid hemorrhage.
Staniloae C - Transradial peripheral vascular interventions
Staniloae C - Transradial peripheral vascular interventionsInternational Chair on Interventional Cardiology and Transradial Approach
The document discusses the advantages and techniques for performing peripheral vascular interventions via the transradial approach, noting that it is well-suited for interventions in the subclavian, carotid, renal and iliac arteries but current equipment limitations restrict its use for femoral and below-knee interventions; while transfemoral access remains preferable for left carotid and femoral/popliteal interventions. The radial approach reduces access site complications and allows for quicker recovery compared to femoral access.Radiation Safety In The Cath Lab
Ionizing Radiation -How is Gray different from Sievert -Deterministic & Stochastic Radiation Risks -Air Kerma-Time, Distance and Shielding Principles -Dosimetry
Rao SV - Radial hemostasis
This document discusses best practices for radial hemostasis after a transradial procedure. The goals are to minimize bleeding complications while also preventing radial artery occlusion. Key points include: applying focused manual compression using a TR-band or similar device; titrating pressure below the patient's mean arterial pressure using plethysmography; leaving compression on for at least 2 hours; and coordinating care with nursing staff as part of a standardized post-procedure protocol. Radial hemostasis is important to perform correctly in order to realize the benefits of the transradial approach.
Anaesthetic Management of a Patient with Ischaemic Heart Disease
This document discusses the anaesthetic management of patients with ischemic heart disease undergoing non-cardiac surgery. It begins by defining ischemic heart disease and outlining its various manifestations including stable angina, unstable angina, and myocardial infarction. It then discusses preoperative evaluation and risk stratification of these patients, including medical history, physical exam, ECG, stress testing, and coronary angiography. Intraoperative management focuses on minimizing myocardial ischemia through beta-blockers, tight blood pressure control, and avoidance of tachycardia or hypotension.
Diagnostic Procedures for Cardiovascular system
Cardiac catheterization is a procedure that inserts a catheter into the heart to evaluate heart function and disease. It can diagnose conditions like coronary artery disease and determine if treatments like angioplasty are needed. The catheter is inserted into an artery and guided to the heart where contrast dye is injected to image the heart and arteries. An electrocardiogram (ECG) records the heart's electrical activity through electrodes on the skin to check for issues like heart attacks or abnormal rhythms. A computed tomography (CT) scan uses x-rays to create clear pictures of the heart and assess conditions like tumors without invasive procedures.
Viewers also liked (20)
Cardiac cath roles and responsibilities durning an Intra-Procedure emergency
Cardiac cath roles and responsibilities durning an Intra-Procedure emergency
Case of the week - superficial femoral artery pseudoaneurysm
Case of the week - superficial femoral artery pseudoaneurysm
Staniloae C - Transradial peripheral vascular interventions
Staniloae C - Transradial peripheral vascular interventions
Anaesthetic Management of a Patient with Ischaemic Heart Disease
Anaesthetic Management of a Patient with Ischaemic Heart Disease
Similar to Groin complications and Management 2011
Abdominal aortic aneurysm
An aortic aneurysm is an abnormal bulging or swelling of the aorta, the main blood vessel that supplies blood to the body. The most common type is an abdominal aortic aneurysm, which occurs below the renal arteries in the abdomen. Risk factors include smoking, hypertension, and genetics. Symptoms may include abdominal or back pain. Diagnosis involves ultrasound or CT scan. Surgery is recommended for aneurysms over 5 cm to prevent rupture, which can be fatal. Surgical options include open repair or endovascular grafting through catheters to place a stent graft. Post-op care focuses on monitoring for complications like bleeding or infection.
Hemorrhage & Shock
This document provides information on hemorrhage (excessive blood loss). It defines hemorrhage and describes the natural process of clotting to stop bleeding. Causes of hemorrhage include wounds, fractures, surgery, and accidents. Stages and classifications of hemorrhage severity are presented. Signs and symptoms ranging from mild pallor to life-threatening shock are outlined. First aid treatments and nursing management of hemorrhage are discussed.
Nursing Care of Clients with Peripheral Vascular Disorders Part 3 of 3
Nursing Care of Clients with Peripheral Vascular Disorders Part 3 of 3:
Venous and Lymphatic System
PREVIEW OF EMT/EMR BLEEDING POWERPOINT TRAINING PRESENTATION
Describes the care of the patient with internal and external bleeding. Estimated teaching time 2 hours. Meets or exceeds current US DOT NHTSA 2009 requirements.
Lower Limb Vascular Trauma
This document provides an overview of lower limb vascular trauma, including:
- It accounts for 80% of all vascular trauma cases, with the lower extremities involved in two-thirds of patients.
- Presentation can include hard signs like active bleeding or soft signs like pulse deficits. Complications include thrombosis, embolization, and rupture.
- Diagnosis involves clinical examination, pulse oximetry, Doppler ultrasound, duplex ultrasound, and angiography.
- Management includes immediate hemorrhage control, volume resuscitation, operative strategies like suturing, grafting or shunting, and damage control techniques like ligation if needed. Case examples from the author's experience are also summarized.
deep vein thrombosis
Venous thromboembolism refers to blood clots forming in the veins, which can break off and travel to the lungs (pulmonary embolism). Deep vein thrombosis is a blood clot that forms deep in the leg veins and can progress upwards. Superficial vein thrombosis involves shallow leg veins near the skin surface. Risk factors include surgery, trauma, cancer, genetic conditions. Symptoms include leg pain/swelling. Diagnosis involves D-dimer testing and ultrasound imaging of leg veins. Treatment is blood thinners to prevent clot growth and embolism.
External hemorrhage
1. Major causes of external hemorrhage include penetrating trauma from high-velocity weapons, stab wounds, and blunt trauma, especially in young males.
2. External hemorrhage is classified based on the degree of blood loss and physiological symptoms, ranging from mild with minimal changes to severe with more than 40% blood loss and marked physiological depression.
3. Initial assessment of external hemorrhage focuses on recognizing and reversing life-threatening injuries, preventing ongoing blood loss, and restoring intravascular volume. Direct pressure, tourniquets, and hemostatic agents can control bleeding while intravenous fluids, blood products, and rapid mobilization of resources aim to resuscitate the patient.
Neha diwan presentation on aortic aneurysm
The document discusses aneurysms and aortic dissections. It defines an aneurysm as an abnormal dilatation of a blood vessel wall due to weakening. Aortic dissections occur when the inner layer of the aorta tears, allowing blood to surge between the layers. Risk factors include hypertension, smoking, genetics. Symptoms include chest pain. Diagnosis involves imaging tests like ultrasound, CT, or MRI. Treatment depends on location but may include open or endovascular surgery to repair or replace the damaged vessel.
Venous Disorders
Veins transport deoxygenated blood back to the heart. They have three layers and are more distensible than arteries due to less muscle and connective tissue. One-way valves in the veins, especially in the legs, allow blood to flow against gravity back to the heart. Vein disorders include thrombosis, thrombophlebitis, and varicose veins caused by altered blood flow and valve problems. Thrombophlebitis is vein inflammation from blood clots caused by stasis, vessel wall damage, and hypercoagulability. Risk factors include surgery, trauma, obesity, and oral contraceptives. Treatment involves anticoagulants, elevation, heat, and sometimes surgery to remove cl
Surgery 6th year, Tutorial (Dr. Ahmed Al-Azzawi)
The document discusses various artery emergencies including acute arterial occlusion, abdominal aortic aneurysm, and peripheral vascular injuries. Acute arterial occlusion occurs when blood flow to the leg is suddenly blocked, requiring immediate medical care to restore flow and prevent tissue death and gangrene. Symptoms include severe leg pain and skin changes. Abdominal aortic aneurysms are localized dilations of the abdominal aorta, often below renal arteries, and may cause abdominal or back pain. Peripheral vascular injuries from trauma can damage arteries and require rapid treatment to prevent limb loss.
Hemorrhage
This document provides an overview of hemorrhage (excessive bleeding) including its definition, causes, signs and symptoms, effects on the body, and first aid treatment. Hemorrhage is defined as the loss of blood from the vascular system and can be caused by wounds, fractures, surgery, accidents, or anatomical defects. Signs include pallor, faintness, and thirst. Effects depend on the amount of blood lost and can include decreased blood pressure and organ dysfunction. First aid involves applying direct pressure to the wound, elevating the limb, use of a tourniquet if needed, and seeking immediate medical help. Special types of hemorrhage from different body sites are also discussed.
Vein Disorder
Venous Disorders, varicose vein, chronic venous insufficiency, venous thrombosis, a complete presentation. pdf file
Bindhya dvt
Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. It can dislodge and travel to the lungs, causing a pulmonary embolism. Risk factors include surgery, trauma, cancer, and prolonged immobility. Symptoms may include leg pain, swelling, redness, and warmth. Diagnosis involves assessing risk factors and testing such as ultrasound, venography, MRI, or D-dimer blood test. Treatment focuses on blood thinners to prevent clot growth and embolism.
Nursing Care of Clients with Peripheral Vascular Disorders Part 2 of 3
Nursing Care of Clients with Peripheral Vascular Disorders Part 2 of 3: Arterial disorders such as Arterial occlusive disease, Arterial embolism, Arterial thrombosis, Thromboangiitis obliterans (Buerger’s disease), Aortitis, Aortoiliac disease, Aneurysms, Raynaud’s disease, and Thoracic outlet syndrome
Diseases and disorders a nursing therapeutics manual
The document provides information on abdominal aortic aneurysm (AAA). It describes AAA as a localized dilation of the arterial wall in the descending portion of the aorta. AAA is most common in men over age 50 and usually results from atherosclerosis weakening the aortic wall. Symptoms may include back or abdominal pain. Diagnosis involves imaging tests like ultrasound or CT scan. Treatment for larger AAAs is surgical repair through graft placement. Postoperative care focuses on monitoring for complications like bleeding or infection. Lifestyle changes like smoking cessation are also important to prevent expansion of small AAAs.
Venous Disorders
veinous disorders, thrombophlebitis, venous thrombosis, deep vein thrombosis, chronic venous insufficiency, varicse veins,leg ulcers
Causes and treatments of aneurysm.pdf
An aneurysm is a bulge or swelling in a blood vessel caused by weakness in the vessel wall. Most aneurysms do not cause symptoms but can rupture, leading to internal bleeding and death. The most common sites for aneurysms are the aorta and brain arteries. Treatment depends on the type and size of the aneurysm but may include surgery to repair or replace the damaged blood vessel. The main risks for developing an aneurysm are smoking, high blood pressure, obesity, and lack of exercise.
Phlebotomy
1. Blood collection technique is an important skill that is rarely formally taught but critically observed by patients.
2. It is important to be familiar with the collection equipment and avoid unnecessary errors or movements that could cause patient anxiety and negatively impact vein conditions.
3. This guide provides instructions on selecting vein sites, improving vein prominence, properly applying a tourniquet, disinfecting the site, performing the puncture, and applying pressure after to prevent bruising. Special considerations are given for collecting from children.
Varicose Veins
Varicose veins are swollen, twisted veins that are typically caused by a malfunctioning deeper vein called the saphenous vein. Doctors use ultrasound imaging to evaluate the source of varicose veins and may recommend treatment to correct the underlying issue, such as surgery to repair the saphenous vein. Surgery involves eliminating blood flow in the saphenous vein using heat energy and then removing individual varicose veins through small incisions. The procedure is performed in an office setting using local anesthesia and patients can return to light activity right away with compression stockings.
Hemorrhage And Shock
The document discusses shock, its causes, signs and symptoms, and treatment. It defines shock as inadequate tissue perfusion and lists the main types as hypovolemic, cardiogenic, obstructive, and distributive. It outlines steps to treat hemorrhagic shock, the most common cause, including stopping bleeding, elevating wounds, applying direct pressure, and using tourniquets if needed before giving fluids and assessing the patient's response.
Similar to Groin complications and Management 2011 (20)
Nursing Care of Clients with Peripheral Vascular Disorders Part 3 of 3
Nursing Care of Clients with Peripheral Vascular Disorders Part 3 of 3
PREVIEW OF EMT/EMR BLEEDING POWERPOINT TRAINING PRESENTATION
PREVIEW OF EMT/EMR BLEEDING POWERPOINT TRAINING PRESENTATION
Nursing Care of Clients with Peripheral Vascular Disorders Part 2 of 3
Nursing Care of Clients with Peripheral Vascular Disorders Part 2 of 3
Diseases and disorders a nursing therapeutics manual
Diseases and disorders a nursing therapeutics manual
Recently uploaded
Top 10 Best Ayurvedic Kidney Stone Syrups in India
we have mentioned the best 10 ayurvedic Kidney Stone Syrups. You can check all these products and choose the best one for yourself.
Top Effective Soaps for Fungal Skin Infections in India
Swisschem Dermacare has mentioned the List of The Best Antifungal Soap In India 2022. All of these soaps are trusted by various Dermatology Experts.
The Best Ayurvedic Antacid Tablets in India
Treat the symptoms of indigestion, heartburn and stomach reflux with the 10 Best Ayurvedic Antacid Tablets in India.
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...chandankumarsmartiso
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel With 100% Satisfaction
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
It includes regulation of combination products and medical devices. FDA and industry liaisons.
Top-Vitamin-Supplement-Brands-in-India List
Swisschem Dermacare provides the Top 10 Vitamin Supplement Brands in India. To know more about us give us call at our official number
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
STIs may cause PID. For the both disease, herbal medicine Fuyan Pill can be a solution.
Dehradun #ℂall #gIRLS Oyo Hotel 8107221448 #ℂall #gIRL in Dehradun
Dehradun #ℂall #gIRLS Oyo Hotel 8107221448 #ℂall #gIRL in Dehradun
share - Lions, tigers, AI and health misinformation, oh my!.pptx
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
#cALL# #gIRLS# In Dehradun ꧁❤8107221448❤꧂#cALL# #gIRLS# Service In Dehradun W...
#cALL# #gIRLS# In Dehradun ꧁❤8107221448❤꧂#cALL# #gIRLS# Service In Dehradun W...chandankumarsmartiso
#cALL# #gIRLS# In Dehradun ꧁❤8107221448❤꧂#cALL# #gIRLS# Service In Dehradun Women Seeking Service
Recently uploaded (20)
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in India
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Dehradun #ℂall #gIRLS Oyo Hotel 8107221448 #ℂall #gIRL in Dehradun
Dehradun #ℂall #gIRLS Oyo Hotel 8107221448 #ℂall #gIRL in Dehradun
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
#cALL# #gIRLS# In Dehradun ꧁❤8107221448❤꧂#cALL# #gIRLS# Service In Dehradun W...
#cALL# #gIRLS# In Dehradun ꧁❤8107221448❤꧂#cALL# #gIRLS# Service In Dehradun W...
Groin complications and Management 2011
- 1. Prevention and Treatment Of Groin Presented By Jacob Mason CIS
- 3. Angiographic anatomy The optimal puncture site for femoral artery access is 1-2 cm below the inguinal ligament.
- 4. The boney area is use to help achieve hemostasis by giving you a solid foundation to compress the femoral.
- 5. Vascular complications are a major preventable cause of morbidity and mortality from invasive cardiac procedures.
- 15. Loss of blood under the skin directly as a result of arterial/venous injury. A hematoma is more than just a ”bruise” in that it forms a lump which hardens.
- 18. Bleeding into retroperitoneal cavity
- 22. After the inferior epigastric artery the Illiac artery takes a dive.
- 24. Apply direct pressure 1-2 cm above site
- 25. Correct Compression Method Incorrect You will find pressing down with your finger tips is less fatiguing. On the obese patient, you will not be able to get enough force down to the arteriotomy.
- 27. Safety is defined as the percentage of patients with major or minor vascular complications. Minor vascular complications are hematoma greater than 10 cm, arteriovenous fistulas, or pseudo aneurysm. Major vascular complications are death due to vascular complications, vascular repair, major vascular bleeding where hemoglobin level decreases more than 3 g/dL due to bleeding at the access site or retroperitoneal bleeding, vessel occlusion, and loss of pulse. Effectiveness is defined as the percentage of patients in whom the device was deployed successfully and the femoral artery was closed.
- 37. Bifurcation of the profunda and superficial femoral artery Sheath inserted above the inferior epigastric artery
- 38. Femoral artery diameter here is less than 3 cm
- 39. A tear in the wall of the iliacs that causes blood to flow between the layers of the wall . Diseased and small right femoral artery
- 41. Hemostat placement Femoral head
- 46. Ulnar artery Is the blood vessel, with oxygenated blood, of the medial aspect of the forearm Radial artery is the main blood vessel with oxygenated blood of the lateral aspect of the forearm.
- 47. Is used to test blood supply to the hand. It is performed prior to cannulation
- 49. Both arteries are open Release ulnar with radial occluded Occlude both ulnar and radial
- 50. Diagnostic Release slowly over 15 minutes Intervention Release slowly over 20 minutes
- 51. zero tolerance Having a For bleeding
- 52. 4 x 6 resource flyer Cut out and laminate