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Medicine, Health Care and Philosophy - Can transfusions of blood plasma slow down ageing or even rejuvenate people? Recent preclinical studies and experimental tests inspired by the technique known... 相似文献
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Optional statement Percutaneous endovascular interventions for peripheral arterial disease are indicated in carefully selected patients with
favorable anatomy and associated clinical symptoms. Although endovascular therapy appears to be hemodynamically equivalent
to other modalities in isolated iliac disease, this does not appear to be the case for infrainguinal disease, particularly
when the disease is diffuse and extensive. Such disease in these beds can often be treated surgically, although there is an
increasing role for percutaneous therapies, particularly in patients at higher surgical risk. Catheter-based therapy should
be considered an integral part of comprehensive medical therapy in patients with lower extremity peripheral arterial disease.
Embarking on an endovascular approach to therapy should involve a frank physician-patient discussion of the risks, benefits,
and durability of the proposed procedure tailored to anatomic locale and patient-specific factors. 相似文献
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Management of large bore arterial access sites often represents a challenge during interventional procedures, and usually requires prolonged manual compression, though suture-mediated closure techniques have been described. We report our experience in using the Mynx vascular closure device to close a 14 French femoral arteriotomy in two patients undergoing percutaneous balloon aortic valvuloplasty. 相似文献
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Suzanne J. Baron MD Robert W. Yeh MD Ignacio Cruz‐Gonzalez MD Josephine L. Healy MBS Eugene Pomerantsev MD PhD Joseph Garasic MD Douglas Drachman MD Kenneth Rosenfield MD Ik‐Kyung Jang MD PhD 《Catheterization and cardiovascular interventions》2008,72(1):116-120
Objectives: This study aimed to evaluate the efficacy and safety of argatroban during percutaneous interventions for peripheral arterial disease (PAD). Background: Endovascular interventions are commonly used in patients with peripheral arterial disease. Heparin is routinely administered during these procedures, but cannot be used in patients with a history of heparin‐induced thrombocytopenia (HIT). Argatroban is an approved direct thrombin inhibitor for treatment of patients with HIT. There are currently few data on the efficacy and safety of argatroban during endovascular interventions for PAD. Methods: Patients who underwent endovascular interventions for PAD on argatroban between 2002 and 2005 were identified from out database. Efficacy was evaluated using a composite of death, urgent revascularization, and amputation, while safety was assessed by TIMI major bleeding during the index hospitalization. Results: A total of 48 patients undergoing lower extremity revascularization on argatroban were identified. Thirty two of these patients (67%) had antibody‐confirmed HIT and the other 16 (33%) had suspected HIT. A mean dose of argatroban was 173.5 ± 143 μg/kg bolus, followed by a 10.7 ± 9.64 μg/kg/min infusion during the procedure. Twelve patients (25%) met the composite end point (two deaths, one urgent revascularization, nine amputations because of progressive peripheral arterial disease). TIMI major bleeding occurred in three (6%) patients. Conclusion: In patients with confirmed or suspected HIT undergoing endovascular intervention for PAD, argatroban appears to be effective and safe. A larger study is warranted to confirm these findings from a single center. © 2008 Wiley‐Liss, Inc. 相似文献
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Garasic MD 《The Hastings Center report》2012,42(4):1p followiing 48
I feel the urge to express my solidarity with Alberto Giubilini and Francesca Minerva, the authors of the much‐discussed article “After‐Birth Abortion: Why Should the Baby Live?” that appeared in the Journal of Medical Ethics in February. Both their argument and, more sadly, they themselves suffered a violent attack by people who obviously do not consider freedom of expression an important value. Censorship does not fit well with the mission of scholarship—particularly when the scholarship depends on a method of speculation and hypothetical argument, as in the case of philosophy and bioethics—and the level of hatred and extremism expressed about the article seem out of proportion. Having said this, though, I want to consider why publishing the article was nonetheless inappropriate. 相似文献
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Sharad V Shetty Christopher J Kwolek Joseph M Garasic 《Catheterization and cardiovascular interventions》2007,69(7):1050-1052
Accidental insertion of an arterial sheath is an uncommon but potentially serious complication of jugular venous catheterization. When the subclavian artery is inadvertently cannulated, sheath removal can be complicated by significant hemorrhage due to its incompressible location. We report a case of inadvertent insertion of an 8 French sheath into the subclavian artery, which was successfully removed and the puncture site sealed with a collagen-based vascular closure device (Angio-Seal STS Plus). This averted an otherwise emergent open surgical procedure to remove the sheath and repair the subclavian artery in a high-risk patient. 相似文献