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Sat, 19 Oct 2002 11:23:51 -0700 (PDT)

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Rowley, you are talking about totally different procedures for totally different situations. looking at different anatomy. coronary arteries vs aorta.  didn't say angio procedure isn't risky, but not comparable.  IR vs cardiology,  emergent vs elective (mostly)
stephanie stafford 

 Rowley Cottingham <rowley@rowleys-host.compulink.co.uk> wrote:Your mileage obviously varies, but I have seen deaths from angiography
such as dissections of the left main stem during coronary procedures. I
agree it provides outstanding views of the vasculature, but it does
remain a procedure with mortality and morbidity.

-----Original Message-----
From: trauma-list-admin@trauma.org [mailto:trauma-list-admin@trauma.org]
On Behalf Of SJASMD@aol.com
Sent: 17 October 2002 13:12
To: trauma-list@trauma.org
Subject: Re: CT versus angio (they're not mutually exclusive)

Dr Rowley
Please spare the nonsense about dangerous angiography.
This procedure, is highly safe has almost no complications and provides
outstanding resolution of the vasculature. 
In thousands of angiograms, i have not seen any deaths or major
complications from the procedure, I have seen numerous patients who have
died because they did not get an angiogram in a timely fashion.

With regard to repeating the chest film. 
No one has ever shown that followup chest films have any utility...they
indicate indecisiveness or failure to hold in proper regard prior
images.

By the way, if your machine is "whoshing" too much, get a modern unit
that is highly reliable and runctional.

sal Sclafani

In a message dated Fri, 11 Oct 2002 06:12 +0100 (BST),
rowley@rowleys-host.compulink.co.uk writes:

> 
> 
>
> 
> No, I am specifically excluding angiography for that very reason. You 
> need to start with a high index of suspicion, do all the
> standard things, and then interpret your chest radiograph accordingly.
Then you need to keep evaluating the patient. All 
> technology can go wrong, be poorly performed and difficult to
interpret. Far better and quicker to repeat the plain film than spend 
> an hour mucking around in a CT scanner. The major time thieves in a CT
scanner are no longer the machine grinding through every 
> slice but the equipment that gets taken with the patient, readjusted
as the table gets whooshed in and out and generally bleeps 
> and complains at every available opportunity. 
> 
> Angiography can be more dangerous (although some of the pumps used on 
> CT seem to be pretty powerful and must cause just as
> high pressure surges) but DSA is still the definitive 
> investigation. 
> 
> Best wishes,
> 
> 
> Rowley Cottingham
> 
> rowley@cix.co.uk
> http://www.emergencyunit.com
> 
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit: 
> http://www.trauma.org/traumalist.html

sal

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<P>&nbsp;
<P>Rowley, you are talking about totally different procedures for totally different situations.&nbsp;looking at different anatomy. coronary arteries vs aorta.&nbsp; didn't say angio procedure isn't risky, but not&nbsp;comparable.&nbsp; IR vs cardiology,&nbsp;&nbsp;emergent vs elective (mostly)
<P>stephanie stafford&nbsp;
<P>&nbsp;
<P>&nbsp;<B><I>Rowley Cottingham &lt;rowley@rowleys-host.compulink.co.uk&gt;</I></B> wrote:
<BLOCKQUOTE style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid">Your mileage obviously varies, but I have seen deaths from angiography<BR>such as dissections of the left main stem during coronary procedures. I<BR>agree it provides outstanding views of the vasculature, but it does<BR>remain a procedure with mortality and morbidity.<BR><BR>-----Original Message-----<BR>From: trauma-list-admin@trauma.org [mailto:trauma-list-admin@trauma.org]<BR>On Behalf Of SJASMD@aol.com<BR>Sent: 17 October 2002 13:12<BR>To: trauma-list@trauma.org<BR>Subject: Re: CT versus angio (they're not mutually exclusive)<BR><BR><BR>Dr Rowley<BR>Please spare the nonsense about dangerous angiography.<BR>This procedure, is highly safe has almost no complications and provides<BR>outstanding resolution of the vasculature. <BR>In thousands of angiograms, i have not seen any deaths or major<BR>complications from the procedure, I have seen numerous patients who have<BR>died because they did not get an angiogram in a timely fashion.<BR><BR>With regard to repeating the chest film. <BR>No one has ever shown that followup chest films have any utility...they<BR>indicate indecisiveness or failure to hold in proper regard prior<BR>images.<BR><BR>By the way, if your machine is "whoshing" too much, get a modern unit<BR>that is highly reliable and runctional.<BR><BR>sal Sclafani<BR><BR>In a message dated Fri, 11 Oct 2002 06:12 +0100 (BST),<BR>rowley@rowleys-host.compulink.co.uk writes:<BR><BR>&gt; <BR>&gt; <BR>&gt;<BR>&gt; <BR>&gt; No, I am specifically excluding angiography for that very reason. You <BR>&gt; need to start with a high index of suspicion, do all the<BR>&gt; standard things, and then interpret your chest radiograph accordingly.<BR>Then you need to keep evaluating the patient. All <BR>&gt; technology can go wrong, be poorly performed and difficult to<BR>interpret. Far better and quicker to repeat the plain film than spend <BR>&gt; an hour mucking around in a CT scanner. The major time thieves in a CT<BR>scanner are no longer the machine grinding through every <BR>&gt; slice but the equipment that gets taken with the patient, readjusted<BR>as the table gets whooshed in and out and generally bleeps <BR>&gt; and complains at every available opportunity. <BR>&gt; <BR>&gt; Angiography can be more dangerous (although some of the pumps used on <BR>&gt; CT seem to be pretty powerful and must cause just as<BR>&gt; high pressure surges) but DSA is still the definitive <BR>&gt; investigation. <BR>&gt; <BR>&gt; Best wishes,<BR>&gt; <BR>&gt; <BR>&gt; Rowley Cottingham<BR>&gt; <BR>&gt; rowley@cix.co.uk<BR>&gt; http://www.emergencyunit.com<BR>&gt; <BR>&gt; --<BR>&gt; trauma-list : TRAUMA.ORG<BR>&gt; To change your settings or unsubscribe visit: <BR>&gt; http://www.trauma.org/traumalist.html<BR><BR>sal<BR><BR>--<BR>trauma-list : TRAUMA.ORG<BR>To change your settings or unsubscribe visit:<BR>http://www.trauma.org/traumalist.html<BR><BR><BR>--<BR>trauma-list : TRAUMA.ORG<BR>To change your settings or unsubscribe visit:<BR>http://www.trauma.org/traumalist.html</BLOCKQUOTE><p><br><hr size=1>Do you Yahoo!?<br>
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