New Techniques in Hemorrhage Control

The use of interventional procedures in trauma has increased steadily over the past 10 years. With advancements in both imaging and device technology, endovascular techniques have become part of the treatment algorithm for both large and small vessel injury. Endovascular therapy in trauma involves a minimally invasive, catheter-based approach, which can be used as a temporizing measure in patients in extremis or as definitive therapy in a wide variety of diagnoses. Sheaths, catheters, and guide wires are universal instruments, regardless of procedure. Devices passed over guide wires form the basis of diagnosis and treatment. Using this technology provides many advantages to traditional open surgical therapy, namely the avoidance of large and potentially morbid incisions. Angioembolization, stent grafting, and resuscitative endovascular balloon occlusion of the aorta (REBOA) are being used with increasing frequency in trauma centers, with established algorithms, multiinstitutional trials, and more published data available, particularly for solid-organ and pelvic hemorrhage. Key words: angiography, embolization, hemorrhage, resuscitative endovascular balloon occlusion of the aorta, stent graft

New Techniques in Hemorrhage Control

The use of interventional procedures in trauma has increased steadily over the past 10 years. With advancements in both imaging and device technology, endovascular techniques have become part of the treatment algorithm for both large and small vessel injury. Endovascular therapy in trauma involves a minimally invasive, catheter-based approach, which can be used as a temporizing measure in patients in extremis or as definitive therapy in a wide variety of diagnoses. Sheaths, catheters, and guide wires are universal instruments, regardless of procedure. Devices passed over guide wires form the basis of diagnosis and treatment. Using this technology provides many advantages to traditional open surgical therapy, namely the avoidance of large and potentially morbid incisions. Angioembolization, stent grafting, and resuscitative endovascular balloon occlusion of the aorta (REBOA) are being used with increasing frequency in trauma centers, with established algorithms, multiinstitutional trials, and more published data available, particularly for solid-organ and pelvic hemorrhage. Key words: angiography, embolization, hemorrhage, resuscitative endovascular balloon occlusion of the aorta, stent graft

Rationale of Unfractionated heparin during elective Coronary Angiography

Background: Unfractionated heparin (UFH) has been conventionally used during coronary angiography (CAG). Whether to use unfractionated heparin or not, has been unanswered. Methods: Hundred patients who underwent CAG through femoral route were assessed. CAG was performed without using unfractionated heparin and embolic or thrombotic event and vascular complications were observed during and after procedure. Results: The right femoral approach was used in 92% of cases and the left in 8%. Those patients who underwent radial route were excluded. Male (65%) were exceeded the female and smoking (50%) was the major predisposing factor. There were no embolic or thrombotic event and vascular complications such as bleeding, heamatoma, pseudoaneurysm formation, A-V fistula and retroperitoneal bleeding during or after procedure. Conclusions: Routine elective CAG have shown no significant complication during or after the procedure without UFH. Key words: angiography, coronary angiography, unfractionated heparin DOI: 10.3126/jnhrc.v7i1.2278 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 42-44