I very much like your style and thorough and clear explanation. Thank you for your effort and great illustrations. Id like to clarify a few moments though, if i may. Anterior and posterior aspects of ribs are supplied by anterior ICA and posterior ICA respectively - anterior IC arteries originate from IT artery - the upper two originate from supreme TA (1st branch of axillary artery) - anterior ICA are much smaller than posterior ICA - each ICS has two anterior ICA (one running above and one below each rib) - posterior ICA run in the costal groove and leave it around AAL after that the course and position varies significantly The mantra "along cefalad/superior edge..." is itrelevant in anterior approaches And yes, ive done it once in a remote location on an unstable patient with tamponad on D5 post PPM implantation as the wire perforated RV, only with analgesic doses of Ketamine....
I think I missed the part where you say first that patient is comfortable using a short, acting general, aesthetic, such as propofol. After all of my invasive experiences , nobody is planting a hollow harp into one of my internal organs while I am aware and alert.
I very much like your style and thorough and clear explanation. Thank you for your effort and great illustrations.
Id like to clarify a few moments though, if i may.
Anterior and posterior aspects of ribs are supplied by anterior ICA and posterior ICA respectively
- anterior IC arteries originate from IT artery
- the upper two originate from supreme TA (1st branch of axillary artery)
- anterior ICA are much smaller than posterior ICA
- each ICS has two anterior ICA (one running above and one below each rib)
- posterior ICA run in the costal groove and leave it around AAL after that the course and position varies significantly
The mantra "along cefalad/superior edge..." is itrelevant in anterior approaches
And yes, ive done it once in a remote location on an unstable patient with tamponad on D5 post PPM implantation as the wire perforated RV, only with analgesic doses of Ketamine....
I think I missed the part where you say first that patient is comfortable using a short, acting general, aesthetic, such as propofol. After all of my invasive experiences , nobody is planting a hollow harp into one of my internal organs while I am aware and alert.