137 results on '"A, Branchereau"'
Search Results
2. Short- and Long-Term Outcomes Following Biological Pericardium Patches Versus Prosthetic Patches for Carotid Endarterectomy: A Retrospective Bicentric Study
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Léonore, Freycon-Tardy, Elsa, Faure, David, Peyre-Costa, Ludovic, Canaud, Pascal, Branchereau, Charles Henri, Marty-Ané, Pierre, Alric, and Eric, Picard
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- 2021
- Full Text
- View/download PDF
3. Single Centre Experience in Open and Endovascular Treatment of Renal Artery Aneurysms
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Tom Le Corvec, Ottavia Borghese, Hubert Desal, Julien Branchereau, L. Brisard, Romain Bourcier, Georges Karam, Thomas Laurin, Philippe Chaillou, and Blandine Maurel
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Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Anastomosis ,law.invention ,Blood Vessel Prosthesis Implantation ,Postoperative Complications ,Renal Artery ,Aneurysm ,law ,medicine.artery ,medicine ,Humans ,Embolization ,Renal artery ,Aged ,Retrospective Studies ,Endovascular coiling ,business.industry ,Endovascular Procedures ,General Medicine ,Middle Aged ,Vascular surgery ,medicine.disease ,Intensive care unit ,Surgery ,Bowel obstruction ,Treatment Outcome ,Female ,France ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background : The true incidence and natural history of renal artery aneurysm (RAA) remain unclear and still exists controversy over indication for treatment. Several techniques of conventional surgical reconstructions are described in literature, and more recently endovascular therapies have been reported with satisfying results and lower complication rate. This paper aims to investigate the outcomes of both endovascular and open repair of RAA achieved in a single institution involving 3 medical teams (urology, vascular surgery and neuroradiology). Material and Methods : We conducted a single-centre retrospective observational study about all patients surgically or endovascularly treated for RAA over a 15-year period. Pre-operative, procedural and post-operative data at the early, mid- and long-term follow-up were collected and analysed, focusing on operative technique used for repair and related outcomes. Results : A total of 27 patients (n = 17 (63%) women, mean age 58 ± 13.2, n = 26 saccular RAA) were included. Mean aneurysm was size was 18.8 ± 6.3 mm. Most diagnosis were accidental. Symptomatic RAA showed with macroscopic haematuria (n = 3, 25.9%), unstable hypertension (n = 2; 7%), chronic lumbar pain (n = 1, 3.7%) and renal infarct (n = 1, 3.7%). Conventional surgery (ex-vivo repair, aneurysmorraphy, aneurysm resection and end-to-end anastomosis) was performed in 14 (51.8%) cases and endovascular coiling embolization in 13 (48.2%). Mean hospital length of stay was 5.4 ± 3.6 days. Intensive Care Unit stay was needed only in the surgically treated patients (mean 1.1 ± 1.2 days). During the early follow-up, morbidity rate was 7/14 in surgically treated patients vs. 1/13 in endovascular group; it included bleeding, retroperitoneal hematoma, arterial thrombosis and bowel obstruction. The discharge imaging showed complete aneurysm exclusion and renal artery patency in all cases. At a mean follow-up of 39 ± 42 months, 3 patients (11%) were lost to follow up and 2 (7.4 %) died from unrelated cause. None of these patients required dialysis but a statistically significant (P = 0.09) decrease in GFR was noted between the preoperative period and last follow-up control. RAA repair neither showed blood pressure control improvement nor reduced the need for anti-hypertensive drug use. Conclusion : Open or endovascular techniques are both safe and efficient to treat RAA. Even though, surgical management is burdened with higher morbidity rate, the operative technique should be selected according to anatomical features, diameters and location of RRA; and the number of renal branches involved. Further larger studies are needed to define the feasibility and safety for a wider application of the endovascular approach.
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- 2022
4. Short and long term results of biological pericardial patches and prosthetic patches used for carotid endarterectomy with patch angioplasty: A retrospective bicentric study
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Freycon-Tardy, Léonore, primary, Faure, Elsa, additional, Branchereau, Pascal, additional, Picard, Eric, additional, Peyre-Costa, David, additional, Canaud, Ludovic, additional, Marty-Ane, Charles-Henri, additional, and Alric, Pierre, additional
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- 2022
- Full Text
- View/download PDF
5. Short- and Long-Term Outcomes Following Biological Pericardium Patches Versus Prosthetic Patches for Carotid Endarterectomy: A Retrospective Bicentric Study
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Branchereau Pascal, Marty-Ané Charles Henri, Faure Elsa, Alric Pierre, Peyre-Costa David, Picard Eric, Canaud Ludovic, Freycon-Tardy Léonore, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
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Carotid Artery Diseases ,Male ,Time Factors ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Carotid endarterectomy ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Restenosis ,Recurrence ,Risk Factors ,Interquartile range ,Stroke ,ComputingMilieux_MISCELLANEOUS ,Aged, 80 and over ,Endarterectomy, Carotid ,Univariate analysis ,General Medicine ,Middle Aged ,3. Good health ,Treatment Outcome ,Heterografts ,Female ,France ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Pericardium ,medicine.medical_specialty ,Prosthesis-Related Infections ,Postoperative Hemorrhage ,Risk Assessment ,Asymptomatic ,Blood Vessel Prosthesis Implantation ,03 medical and health sciences ,Angioplasty ,medicine ,Animals ,Humans ,Aged ,Retrospective Studies ,business.industry ,Ultrasonography, Doppler ,medicine.disease ,Blood Vessel Prosthesis ,Surgery ,Stenosis ,Cattle ,business - Abstract
Background Currently, there are various types of patches available on the market for carotid endarterectomy (CEA) with enlargement angioplasty, prosthetic, and biological patches including bovine pericardial patches. Despite the increasing use of these biological patches, there are little data in the literature comparing the results of these 2 types of patch. The purpose of this study is to compare the short- and long-term results of bovine pericardium patches (BPPs) with prosthetic patches (PPs) in carotid thromboendarterectomy. Methods This study presents a retrospective analysis of all CEAs performed at Montpellier and Nimes University Hospitals (France) in 2014 and 2015. Patients who underwent eversion were excluded. Preoperative, peroperative, and postoperative clinical and Doppler ultrasound results were collected and analyzed. The primary end point was the comparison of the restenosis rate between the BPP and the PP group. Secondary end points were the analysis of restenosis risk factors (type of patch, gender, renal failure, smoking, diabetes, arterial hypertension, dyslipidemia, and redo surgery were analyzed); the comparison of morbidity–mortality and infection between the BPP and the PP group and the comparison of morbidity–mortality between symptomatic and asymptomatic stenosis. Results In total, 342 CEAs were performed: 168 (49%) with BPP and 174 (51%) with PP. Median follow-up was 30 months (interquartile range = 24). The stroke rate at day 30 was 3.22% and mortality at day 30 was 1.86%. There was no significant difference between groups concerning anyone of the variables of interest. At the end of follow-up, the restenosis rate >50% was 7.31% (6.45% for the BPP group vs. 8.22% for the PP group, P = 0.55). The severe restenosis rate (>70%) was 4.65% (5.16% for the BPP group vs. 4.11% for the PP group, P = 0.79). The univariate analysis identified renal failure (odds ratio = 2.69) as the main risk factor. The postoperative infection rate was 1.17% (0.59% for the BPP group vs. 1.75% for the PP group, P = 0.62). Conclusions The rates of stroke and postoperative death, bleeding, infection, and restenosis are comparable between BPPs and PPs in our study. The use of prosthetic or biological patches seems to deliver comparable outcomes. Further studies on larger samples are required.
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- 2021
6. Short and long term results of biological pericardial patches and prosthetic patches used for carotid endarterectomy with patch angioplasty: A retrospective bicentric study
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Léonore Freycon-Tardy, Elsa Faure, Pascal Branchereau, Eric Picard, David Peyre-Costa, Ludovic Canaud, Charles-Henri Marty-Ane, and Pierre Alric
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Surgery ,General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
7. Short and long term comparison of biological pericardial and prosthetic patches for carotid endarterectomy with angioplasty: a bicentric retrospective study
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Freycon-Tardy, Léonore, primary, Faure, Elsa, additional, Peyre-Costa, David, additional, Canaud, Ludovic, additional, Branchereau, Pascal, additional, Marty-Ane, Charles-Henri, additional, Alric, Pierre, additional, and Picard, Eric, additional
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- 2020
- Full Text
- View/download PDF
8. Extra-Anatomical Revascularization of the Adamkiewicz Artery Using the Internal Mammary Artery: Preliminary Anatomical Study
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Alain Branchereau, Jean-Michel Bartoli, Pierre Champsaur, Serguei Malikov, and Pierre-Edouard Magnan
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Pilot Projects ,Revascularization ,Thoracic Arteries ,Cadaver ,medicine.artery ,medicine ,Humans ,Mammary Arteries ,Spinal cord injury ,Aged ,Aorta ,Spinal Cord Ischemia ,business.industry ,Dissection ,Anastomosis, Surgical ,General Medicine ,medicine.disease ,Spinal cord ,Surgery ,medicine.anatomical_structure ,Spinal Cord ,Feasibility Studies ,Female ,Radiology ,Intercostal space ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures ,Intercostal arteries - Abstract
Ischemic spinal cord injury remains a major complication of both open and endovascular repairs of extensive lesions of the thoracic or thoracoabdominial aorta. Patients undergoing endovascular treatment cannot benefit from direct revascularization of the Adamkiewicz artery (AA). Primary revascularization of the intercostal artery (ICA) giving rise to the AA using the internal mammary artery (IMA) could ensure uninterrupted flow in the AA even if the origin of the feeding ICA was obstructed. The purpose of this study was to assess the anatomical feasibility of revascularization of the ICA giving rise to the AA using the IMA. Twenty-four dissections were carried out on 12 cadavers (eight men, four women) with a mean age of 76 at the time of death. Preparation consisted of intra-arterial injection of polymethylsiloxane (Rhodorsil®, Rhodia, France). For each IMA, the following parameters were determined: diameter in relation to the ICA in the paravertebral region before division, length, and level of the intercostal space in which direct anastomosis was possible. Dissection showed that the mean diameter at the end of the IMA was 1.8 mm (range 1.2-2.4). The mean diameter of the ICA in the paravertebral region was compatible with that of the IMA, i.e., 1.6 mm (range 0.9-2.5). The mean length of the IMA was 185 mm (range 165-230). The lowest intercostal space available in the paravertebral region for direct anastomosis between the IMA and ICA was the seventh space in one case, the eighth in 12, the ninth in eight, and the tenth in three. The findings of this preliminary study document the feasibility of using the IMA to revascularize the ICA in the paravertebral region. This technique could provide a means of preserving spinal cord vascularization during endovascular treatment of thoracic or thoracoabdominal aortic lesions.
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- 2009
9. Epiploic bypass flap: a new method of limb salvage. Anatomic basis and clinical application
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Rossana Bussani, Pierre Champsaur, Alain Branchereau, Sergueï Malikov, Nicla Settembre, Pierre-Edouard Magnan, Settembre, N1, Malikov, S, Branchereau, A, Champsaur, P, Bussani, Rossana, and Magnan, P. E.
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Free flap ,Gastroepiploic Artery ,Anastomosis ,Revascularization ,Free Tissue Flaps ,Transplantation, Autologous ,Ischemia ,anatomical preparations ,Cadaver ,Medicine ,Humans ,education ,Aged, 80 and over ,education.field_of_study ,Leg ,business.industry ,General Medicine ,Critical limb ischemia ,medicine.disease ,Limb Salvage ,Thrombosis ,Surgery ,Treatment Outcome ,Amputation ,Feasibility Studies ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures - Abstract
Background The incidence of critical limb ischemia increases with the aging of the population. Two-thirds of patients with critical limb ischemia present with trophic disorders. Revascularization decreases the rate of amputation. Infected wounds with exposure of the tendons, bones, or points of articulation cannot heal in spite of bridging and local debridement. Surgery associated with a distal venous bypass or recanalization and a free flap makes it possible to cover major tissue loss and offers a hemodynamic advantage by increasing the flow of the bypass, thanks to the vascular bed added by the flap. It is a complex surgery because of the multiplicity of anastomoses on the same arterial axis, with a risk of thrombosis and complications related to the venous autograft. To mitigate these disadvantages, we propose a new surgical method based on the use of a single anatomic unit, the epiploic bypass flap (BF), based on the gastroepiploic artery (GEA) as the inflow for a bypass and a free flap. The objective of this work was to analyze the anatomic feasibility of an epiploic BF and to determine its limits. Methods One hundred anatomic preparations were conducted with a measure of the internal and external diameters and the lengths of GEA and its branches and a radiograph after injection of a radiopaque product. A first clinical application was carried out. Results According to the data, our study confirms the anatomic feasibility of a BF. The average available length of GEA is 245 mm (range: 210–280 mm). The average proximal diameter is 3 mm, and the distal diameter is 1.5 mm. The most distal epiploic branch that feeds the bypass is approximately 180 mm (range: 161–195 mm) of the origin of the GEA. The anatomic unit based on the GEA provides an arterial graft that is relatively long and a large flap that is both malleable and resistant to infection. Conclusions Epiploic BF is a surgical technique that allows for distal revascularization and a simultaneous cover of the limb extremity. This technique can be useful in patients requiring a distal revascularization associated with a cutaneous cover.
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- 2013
10. From Diafoirus to Professor Nimbus
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Alain Branchereau
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Research design ,medicine.medical_specialty ,business.industry ,Treatment outcome ,General Medicine ,Evidence-based medicine ,Medicine ,Surgery ,Medical physics ,Cardiology and Cardiovascular Medicine ,business ,Drug industry ,Meta-Analysis as Topic ,Abdominal surgery ,Drama - Published
- 2006
11. The Bypass Flap: An Innovative Technique of Distal Revascularization—Anatomical Study and Clinical Application
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Pierre Edouard Magnan, Sergueï Malikov, Pierre Champsaur, Dominique Casanova, and Alain Branchereau
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,Free flap ,Dissection (medical) ,Anastomosis ,Revascularization ,Surgical Flaps ,medicine.artery ,Cadaver ,medicine ,Humans ,Aged ,Leg ,Thoracodorsal artery ,business.industry ,Dissection ,Subscapular artery ,Arteries ,General Medicine ,medicine.disease ,Thrombosis ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures - Abstract
Combined surgery for placement of a distal venous bypass and a free flap enables successful treatment of tissue loss caused by ischemia. This complex surgery has limited indications. The multiple anastomoses on the same arterial axis increase the risk of thrombosis and a certain number of venous grafts are likely to undergo mid-term deterioration. Because of these difficulties, we propose a new concept: the bypass flap (BF), which is based on the harvesting of an arterial axis to provide an arterial graft and a free flap supplied by a collateral branch of the graft. The aim of the anatomic part of this study was to evaluate the length and diameter of the arterial graft and its tissue branch and to study the feasibility of the BF. Thirty-two anatomic preparations were made by intraarterial injection of Rhodosil in 16 cadavers. The arterial graft included the subscapular artery and the thoracodorsal artery. The flap consisted of the anterior serrate muscle supplied by the branch of that graft. The distribution, length, and diameter of the arteries were examined. The mean length of the arterial graft line maintaining diameter above 2 mm was 12.5 cm (8.5-15.5). Three clinical applications of the BF based on the thoracodorsal artery axis were performed on three patients with tissue loss caused by severe ischemia of the lower limb. No occlusion of the BF occurred and healing of the tissue loss was achieved after 4, 7, and 10 months, respectively. This technique has the advantage of decreasing vascular distal resistance, which may contribute to improvement of vessel reconstruction patency. It is simpler because the anastomoses are fewer and it presents the advantage of requiring only autologous arterial material of an appropriate diameter.
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- 2004
12. Ruptured Aneurysm of the Infrarenal Abdominal Aorta: Impact of Age and Postoperative Complications on Mortality
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Henri Mary, Charles Marty-Ané, Pierre Alric, Pascal Colson, Frédérique Ryckwaert, Marie-Christine Picot, and Pascal Branchereau
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Male ,medicine.medical_specialty ,Aortic Rupture ,medicine.medical_treatment ,Revascularization ,Sepsis ,Blood Vessel Prosthesis Implantation ,Postoperative Complications ,Aneurysm ,Clinical Protocols ,Cause of Death ,Humans ,Medicine ,Risk factor ,Contraindication ,Aged ,Aged, 80 and over ,business.industry ,Age Factors ,General Medicine ,Middle Aged ,medicine.disease ,Abdominal aortic aneurysm ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business ,Aortic Aneurysm, Abdominal ,Abdominal surgery ,Autotransfusion - Abstract
Between 1985 and 2000, a total of 871 patients underwent surgical treatment for infrarenal abdominal aortic aneurysm (AAA), including 98 (11.2%) presenting with ruptured abdominal aortic aneurysms (RAAA). An optimized operative protocol was used to treat 77 RAAA starting in January 1989. The main features of the optimized protocol are routine use of intraoperative autotransfusion, revascularization by aortoaortic bypass, absence of systemic heparinization, and use of a collagen-impregnated prosthesis. Intraoperative mortality (IOM) was 3.8%. Postoperative mortality at 1 month (POM1) was 25.9% and postoperative mortality at 3 months (POM3) was 33.7%. Heart failure (p < 0.001), hemodynamic shock (p < 0.001), and hemorrhage (p = 0.04) were the only complications correlated with POM1. Pneumonia (p = 0.01) and sepsis (p = 0.01) were the only complications correlated with POM3. Isolated acute renal insufficiency was not a significant risk factor for postoperative mortality. Using a cutoff of 75 years, there was a significant age-related difference (p = 0.025) for POM1 but not for IOM and POM3. The findings of this study show that optimizing the operative protocol decreases mortality related to RAAA. The main predictor of POM1 was hemodynamic status while the main predictor of POM3 was infection. Isolated acute renal insufficiency was not a risk factor for mortality. Age should not be considered a contraindication for operative treatment.
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- 2003
13. Extraanatomical Revascularization of the Artery of Adamkiewicz: Anatomical Study
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Eugenio Rosset, Sergueï Malikov, Gérard Glanddier, Jean-Pierre Ribal, Pierre-Edouard Magnan, Mathieu Poirier, Jean-Michel Bartoli, Pierre Champsaur, Alain Branchereau, and Nikolaos Paraskevas
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Male ,Models, Anatomic ,medicine.medical_specialty ,medicine.medical_treatment ,Intercostal Muscles ,Revascularization ,Thoracic Arteries ,medicine.artery ,medicine ,Humans ,Early Ambulation ,Vertebral Artery ,Aged ,Aged, 80 and over ,Thoracodorsal artery ,Aortic Aneurysm, Thoracic ,Lateral thoracic artery ,Spinal Cord Ischemia ,business.industry ,Anastomosis, Surgical ,Arteries ,General Medicine ,Middle Aged ,Spinal cord ,Surgery ,Aortic Dissection ,Treatment Outcome ,medicine.anatomical_structure ,Cervical Vertebrae ,Disease Progression ,Female ,Artery of Adamkiewicz ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures ,Intercostal arteries ,Thoracic wall ,Aortic Aneurysm, Abdominal ,Artery - Abstract
Spinal cord ischemia is a major cause of complications after operative and endovascular treatment of descending thoracic or thoracoabdominal aortic aneurysms. Prior revascularization of the intercostal artery (IA) giving rise to the artery of Adamkiewicz (AA) using an artery of the thoracic wall would preserve circulation in the AA and allow obstruction of the IA at its origin. The purpose of this study was to determine the feasibility of revascularization of the IA giving rise to the AA using three thoracic wall arteries, i.e., lateral thoracic artery, thoracodorsal artery, and descending scapular artery. A total of 16 specimens from 8 cadavers (6 men and 2 women) were prepared. The length and diameter of the thoracic wall arteries were measured to ascertain the feasibility of revascularization of the IA giving rise to the AA. In addition, 12 preoperative spinal cord arteriograms were studied. We found that revascularization of the IA giving rise to the AA using thoracic wall arteries is feasible. This technique could be used to prevent spinal cord complications after treatment of descending thoracic or thoracoabdominal aortic aneurysms.
- Published
- 2002
14. Modalities of Preoperative Imaging of the Internal Carotid Artery Used in France
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Emmanuel Corbillon, Agnes Lepoutre, J. G. Kretz, Alain Branchereau, and Anne Long
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Diagnostic Imaging ,medicine.medical_specialty ,medicine.medical_treatment ,Magnetic resonance angiography ,medicine.artery ,medicine ,Humans ,Carotid Stenosis ,cardiovascular diseases ,Practice Patterns, Physicians' ,Inverse correlation ,Endarterectomy ,Computed tomography angiography ,Endarterectomy, Carotid ,medicine.diagnostic_test ,business.industry ,Ultrasonography, Doppler ,General Medicine ,Angiography ,cardiovascular system ,Surgery ,France ,Radiology ,Internal carotid artery ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Carotid Artery, Internal ,Magnetic Resonance Angiography ,Preoperative imaging ,Abdominal surgery - Abstract
A survey of the 382 members of the Société de Chirurgie Vasculaire de Langue Française was conducted to determine preferred imaging techniques for preoperative assessment of the proximal internal carotid artery. A total of 180 questionnaires were returned concerning 9390 carotid stenoses treated in the year 2000. Doppler ultrasound (DUS), angiography, magnetic resonance angiography (MRA), and computed tomography angiography (CTA) were routinely used in 99%, 51.5%, 4%, and 3% of cases. Usual work-up methods involved DUS and angiography in 64% of cases, DUS and MRA in 7%, and DUS and CTA in 4% of cases. Indications for endarterectomy were based on DUS and angiography findings in 69% of cases, on DUS and MRA findings in 14%, on DUS and CTA findings in 9%, and on DUS findings alone in 8%. In-house access to CTA or MRA was more frequent at state-run institutions (p = 0.00001). Indication of endarterectomy based on DUS and MRA was more common at institutions equipped with technical facilities for MRA (21% vs. 8%; p = 0.001). An inverse correlation was observed between the number of carotid artery procedures performed and use of DUS and angiography work-up. The number of carotid endarterectomies without angiography is increasing in France. Preoperative DUS is still routinely used. Combined DUS and MRA is the preferred work-up for endarterectomy without angiography. Lack of access to MRA is still a limiting factor. Further study will be needed to evaluate the benefits and risks of endarterectomy without angiography.
- Published
- 2002
15. Results of Lower Limb Revascularization from the Descending Thoracic Aorta
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Eugenio Rosset, Alain Branchereau, Jean-Pierre Mathieu, Pierre-Edouard Magnan, Bertrand Ede, and Andrea Ascoli Marchetti
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leg ,medicine.medical_specialty ,thoracic ,medicine.medical_treatment ,Ischemia ,Aorta, Thoracic ,reoperation ,ischemia ,Revascularization ,Settore MED/22 - Chirurgia Vascolare ,male ,vascular ,medicine.artery ,middle aged ,Medicine ,Thoracic aorta ,graft occlusion ,humans ,Tomography ,x-ray computed ,business.industry ,adult ,Abdominal aorta ,Graft Occlusion, Vascular ,Retrospective cohort study ,General Medicine ,medicine.disease ,follow-up studies ,Surgery ,retrospective studies ,aorta ,aged ,female ,Amputation ,Tomography, x-ray computed ,aorta, thoracic ,blood vessel prosthesis implantation ,graft occlusion, vascular ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Paraplegia ,Abdominal surgery - Abstract
The aim of this retrospective study was to substantiate our results of lower limb revascularizations from the descending thoracic aorta. From November 1984 to November 1994, we used bypass grafting from the descending thoracic aorta to revascularize 69 lower limbs in 36 patients, 34 men and 2 women, whose mean age was 61.8 years. Patients were divided into two groups. Group I (primary indications) included 10 patients who had not had any prior lower limb arterial reconstruction. Group II (secondary indications) consisted of 26 patients who had had a prior arterial reconstruction that was either occluded or complicated. There were three early graft occlusions, all of them successfully treated. Complete flaccid, paraplegia occurred in one patient. Five patients presented with one or several late graft occlusions. Two patients had to undergo below-knee amputation, bilateral in one patient. Routine late control of the repair was performed by CT scanning, at a mean interval of 50.8 months. The good results recorded for bypasses revascularizing lower limbs from the descending thoracic aorta make this technique a satisfactory alternative when the abdominal aorta cannot be used.
- Published
- 2000
16. Value of Angioscopy for Intraoperative Assessment of Carotid Endarterectomy
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Eugenio Rosset, Bertrand Ede, Alain Branchereau, and Pierre-Edouard Magnan
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Angioscopy ,Carotid endarterectomy ,Asymptomatic ,Monitoring, Intraoperative ,medicine.artery ,Humans ,Medicine ,Carotid Stenosis ,Prospective Studies ,Venous bypass ,Common carotid artery ,Stroke ,Aged ,Endarterectomy ,Aged, 80 and over ,Endarterectomy, Carotid ,medicine.diagnostic_test ,business.industry ,Angiography ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Stenosis ,Feasibility Studies ,Female ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
From March 1992 to November 1993 we used angioscopy and arteriography for intraoperative assessment of 103 carotid endarterectomies in 96 patients. The indication for surgery was asymptomatic stenosis in 55 cases and neurologic and/or ocular symptoms in 48. Intraoperative angioscopy and arteriography were performed to allow comparison of findings. Intraoperative angioscopic images were normal in 67 cases and abnormal in 36. The defect was an intimal flap in 26 cases, detachment of the distal plaque in seven cases, and an intimal wedge in five cases. In two cases both detachment and a wedge were observed. The defect was not considered severe enough to warrant revision in 31 cases and was corrected in five cases by either vein bypass (n = 1) or revision of the endarterectomy (n = 4). In the latter four cases repeat angioscopy showed normal findings. Arteriographic and angioscopic findings were compared in 102 cases. In the 71 cases in which angioscopic findings were normal, arteriography revealed a major abnormality in three cases: kinking in one and stenosis40% in two. Kinking was treated by attachment of the common carotid artery and stenosis by venous bypass. In the 31 cases in which angioscopy revealed defects not considered to warrant revision, arteriography revealed stenosis40% in three cases treated by either prosthetic bypass (n = 2) or revision of the endarterectomy (n = 1). The false negative rate for angioscopy was 5.9% and concordance between the two methods was 94.1%. The combined mortality-morbidity rate was 1.9% (one stroke and one death). Postoperative evaluation of anatomic findings by arteriography or Doppler ultrasonography revealed asymptomatic internal carotid occlusion in one and internal carotid stenosis30% in four cases. Angioscopy is a simple, low-cost method in intraoperative control that can be used either as an adjunct to arteriography or as an alternative if arteriography cannot be performed.
- Published
- 1995
17. In Vitro Antistaphylococcal Activity of Collagen-Sealed Dacron Vascular Pros theses Bonded With Rifampin, Vancomycin, or Amikacin
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Didier Raoult, Philippe Seyral, Alain Branchereau, and Pierre-Edouard Magnan
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Staphylococcus aureus ,medicine.medical_specialty ,Time Factors ,Surface Properties ,medicine.drug_class ,medicine.medical_treatment ,Antibiotics ,Prosthesis Design ,Prosthesis ,Drug Delivery Systems ,Animal model ,Vancomycin ,Immersion ,medicine ,Amikacin ,Saline ,Polyethylene Terephthalates ,business.industry ,Grafting procedure ,General Medicine ,In vitro ,Blood Vessel Prosthesis ,Surgery ,Collagen ,Rifampin ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
The goals of this study were to evaluate the in vitro antistaphylococcal activity of vascular Dacron prostheses to which a type I collagen and an antibiotic had been bonded. Collagen was fixed to the prosthesis either by an original grafting procedure or by impregnation. The antibiotics used included rifampin, vancomycin, and amikacin. They were bonded to the prosthesis either at the same time as the collagen or by soaking the prosthesis in an antibiotic solution at the beginning of the experiment. Each prosthesis was sliced into 6 mm diameter circles and preserved in a solution of saline and albumin, which was changed every day. Three disks were retrieved from each prosthesis at the beginning of the experiment and then every 24 hours; these were placed in gelose smeared with Staphylococcus aureus. The diameter of the inhibition area of each disk was measured at 24 hours. The initial inhibition area (So), the time at which the inhibition area was equal to 50% of So, and the time at which the activity was nil were used to characterize the activity of the prostheses and to calculate a beta coefficient of decreasing activity. The prostheses bonded with vancomycin or amikacin did not show adequate activity. Those bonded with rifampin were effective for at least 4 days. When rifampin was grafted to the prosthesis, the So was 278.6 mm2, 50% of So was reached within 10.4 days, the duration of effective activity was 25.7 days, and the beta coefficient was 0.067. The two prostheses soaked in rifampin had a significantly more rapid decrease (beta = 0.19 and 0.56) and a shorter duration of effective activity (12.4 and 4.5 days). Both collagen-coated prostheses, whether impregnated or soaked with rifampin, have a sufficient duration of activity to be tested in an animal model.
- Published
- 1994
18. Dacron Patch/Tube Graft: A Preliminary Study
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Luigia Manes, Jean-Pierre Mathieu, and Alain Branchereau
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Adult ,Male ,medicine.medical_specialty ,Anastomosis ,Prosthesis Design ,Blood vessel prosthesis ,medicine.artery ,Humans ,Medicine ,Prosthesis design ,In patient ,Tube (fluid conveyance) ,Aorta ,Aged ,Polyethylene Terephthalates ,business.industry ,Dacron patch ,General Medicine ,Middle Aged ,Blood Vessel Prosthesis ,Surgery ,surgical procedures, operative ,cardiovascular system ,Female ,Cardiology and Cardiovascular Medicine ,business ,Abdominal surgery - Abstract
A Dacron patch/tube graft was developed specifically to avoid technical complications associated with lateral aortic anastomoses of medium-diameter grafts. This new prosthetic device has now been used in 15 patients without complications. It seems to be particularly useful in patients with thick-walled aortas.
- Published
- 1993
19. Hemodynamic Vertebrobasilar Insufficiency Caused by Multiple Arterial Lesions: Results of Surgical Treatment
- Author
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Pierre Edouard Magnan, Pierre Grama, Alain Branchereau, Hugo Espinoza, and Eugenio Rosset
- Subjects
Adult ,Male ,medicine.medical_specialty ,Vertebral artery ,Cerebral arteries ,Hemodynamics ,Arterial Occlusive Diseases ,Asymptomatic ,Postoperative Complications ,Risk Factors ,medicine.artery ,Internal medicine ,Vertebrobasilar Insufficiency ,medicine ,Humans ,Myocardial infarction ,Vertebrobasilar insufficiency ,Aged ,Aged, 80 and over ,Cerebral Revascularization ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Cerebrovascular Disorders ,Cardiology ,Female ,medicine.symptom ,Operative risk ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Abdominal surgery - Abstract
From 1982 to 1990, 111 of 1013 patients undergoing cerebral artery reconstruction presented with signs of vertebrobasilar insufficiency associated with hemodynamically significant lesions of at least three cerebral arteries. There were 71 men and 40 women whose mean age was 70.3 ± 8.4 years. Forty patients also had hemispheric symptoms, whereas three had ophthalmic symptoms as well. A total of 191 arteries were reconstructed in 139 procedures. During the first 30 postoperative days there were nine deaths (8.1%) attributable to four neurologic events — one myocardial infarction, two hemorrhages, and one acute kidney failure. There were 18 complications including seven neurologic events (four reversible and three irreversible), one myocardial infarction, and 10 reversible local complications. Mortality and morbidity were not affected if one (87 cases) or several (52 cases) cerebral arteries were reconstructed. Of 179 arteries for which follow-up arteriograms were obtained, two (1%) were found to be occluded. Mean follow-up was 41.2+27.7 months. Four patients were lost to follow-up, and 28 died: five of cerebrovascular causes in the 21 who died of cardiovascular causes and seven secondary to noncardiovascular events. Actuarial 5-year survival and patency rates were 63.3±10.9% and 97.3±2.8%, respectively. Functional results were evaluated in 98 patients. At the last follow-up visit 73 were asymptomatic, 13 were improved (80% good results), 5 were unchanged, and 7 were worse. Mortality and morbidity rates were superior to that for isolated carotid or vertebral artery surgery performed during the same period. Functional results of combined vertebral and carotid artery surgery are good, but the operative risk is higher in this group of patients than for either type of surgery alone.
- Published
- 1993
20. Secondary procedures after infrarenal abdominal aortic aneurysms endovascular repair with second-generation endografts
- Author
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Jean Noel Albertini, Alain Branchereau, Gabrielle Sarlon, Gilles Lerussi, Pierre-Edouard Magnan, Roch Giorgi, Michel A. Bartoli, and Benjamin Thevenin
- Subjects
Male ,Reoperation ,medicine.medical_specialty ,Prosthesis-Related Infections ,Time Factors ,Endoleak ,Aortic Rupture ,Population ,Kaplan-Meier Estimate ,Prosthesis Design ,Aortography ,Risk Assessment ,Aortic aneurysm ,Blood Vessel Prosthesis Implantation ,Aneurysm ,Blood vessel prosthesis ,Risk Factors ,medicine ,Humans ,education ,Survival rate ,Aged ,Retrospective Studies ,education.field_of_study ,Chi-Square Distribution ,business.industry ,Endovascular Procedures ,General Medicine ,medicine.disease ,Abdominal aortic aneurysm ,Surgery ,Blood Vessel Prosthesis ,Prosthesis Failure ,Stenosis ,Logistic Models ,Treatment Outcome ,Female ,Stents ,Radiology ,France ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Abdominal surgery ,Aortic Aneurysm, Abdominal - Abstract
Background To study the incidence, the types, and the results of secondary procedures performed after endovascular treatment of infrarenal abdominal aortic aneurysm (AAA). To compare the population of patients who underwent secondary procedure (P2) with the population of those who did not require it. Material and Methods Between 1998 and 2008, this study included all the patients electively treated for AAA with stentgrafts that were still available on the market on January 1, 2009. Data were prospectively collected and retrospectively analyzed. The postoperative follow-up included at least a systematic computed tomography scan at 6, 12, 18, and 24 months and then every year. P2 were defined as any additionnal procedures performed to treat aneurysm related complications after initial stentgraft implantation. Results We studied 162 patients with a mean 40 ± 31 months’ follow-up. In 32 patients (19.7%), there were 46 P2, 3 of them were surgical conversion and 1 with endovascular conversion. Thirty-nine P2 were scheduled, and seven were performed in emergency. Nine patients underwent more than one P2. P2 was indicated for type II endoleak in 17 cases, 13 of them with a diameter increase; for type I endoleak in 10 cases; for AAA rupture in 3 cases; for occlusion or stentgraft stenosis in 13 cases; and for 1 type III endoleak, 1 endotension, and 1 femoro-femoral crossover bypass infection. Two ruptures occurred in patients who had undergone P2. The immediate technical success was 89.1%. At 30 days, morbidity was 10.9%, and there was no mortality. Survival rates at 3 and 5 years were respectively 85.2% and 71.9% in patients with secondary procedure and 70.6% and 47.5% in the others ( p = 0.046). Conclusions In patients treated for AAA with second generation stentgrafts, in the long term, secondary procedure rate was 19.7%. Survival rate for patients who underwent a secondary procedure was better, which was probably related to the fact that they were younger at the time of stentgraft implantation. Large AAA diameter was a secondary-procedure risk factor.
- Published
- 2010
21. Simultaneous Reconstruction of Infrarenal Abdominal Aorta and Renal Arteries
- Author
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Eugenio Rosset, Hugo Espinoza, Michele Castro, Pierre-Edouard Magnan, and Alain Branchereau
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Arterial Occlusive Diseases ,Endarterectomy ,Kidney ,Postoperative Complications ,Renal Artery ,Aneurysm ,Actuarial Analysis ,medicine.artery ,medicine ,Fibromuscular Dysplasia ,Humans ,Aorta, Abdominal ,Renal artery ,Vein ,Aged ,business.industry ,Anastomosis, Surgical ,Abdominal aorta ,General Medicine ,Middle Aged ,medicine.disease ,Autotransplantation ,Nephrectomy ,Aortic Aneurysm ,Blood Vessel Prosthesis ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Dysplasia ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Abdominal surgery - Abstract
From 1980 to 1990, 48 (4.7%) of 1,002 patients underwent elective aortic reconstruction and simultaneous renal artery reconstruction. Forty-five men and three women (mean age: 66.5 years) had 59 renal artery lesions (51 stenoses, six occlusions, one dysplasia, and one aneurysm) associated with 20 infrarenal aortic aneurysms and 28 aortoiliac occlusive lesions. One nephrectomy and 58 renal artery reconstructions were performed (35 prosthetic bypasses, 11 vein bypasses, six direct reimplantations, five transaortic endarterectomies, and one resection of an intrahilar aneurysm followed by autotransplantation). Operation was always indicated for the aortic lesions. Indication for renal artery repair was hypertension in 33 cases (17 associated with renal insufficiency) and one with isolated renal insufficiency. In the remaining 14 cases, surgery was deemed preventive. One patient died (2%). There were 12 nonfatal complications two of which were kidney failures requiring chronic extrarenal epuration. Routine follow-up arteriograms showed four postoperative renal artery occlusions. Mean follow-up was 35.8 months. Four patients were lost to follow-up; 10 died secondarily. Five year survival was 72.1 +/- 19.1%. Secondary patency of renal artery reconstruction was 89.5 +/- 9.4% at five years. Late results were favorable in 45% of patients with hypertension and in 39% of patients with renal insufficiency. Mortality in simultaneous aortic and renal artery reconstruction is not superior to that of isolated infrarenal aortic surgery.
- Published
- 1992
22. Bypass flap reconstruction, a novel technique for distal revascularization: outcome of first 10 clinical cases
- Author
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Raouf Ayari, Sergueï Malikov, Alain Branchereau, Nicolas Valerio, Pierre Champsaur, Pierre-Edouard Magnan, Mauri Lepäntalo, and Dominique Casanova
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Critical Illness ,Free flap ,Anastomosis ,Revascularization ,Transplantation, Autologous ,Amputation, Surgical ,Surgical Flaps ,Ischemia ,medicine.artery ,Medicine ,Humans ,Saphenous Vein ,Vascular Patency ,Aged ,Peroneal Artery ,business.industry ,Soft tissue ,Thrombosis ,Ultrasonography, Doppler ,General Medicine ,Arteries ,Length of Stay ,Middle Aged ,Limb Salvage ,Surgery ,Transplantation ,Radiography ,Posterior tibial artery ,Treatment Outcome ,Amputation ,Lower Extremity ,Feasibility Studies ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures - Abstract
Combined distal venous bypass grafting and free flap transfer can achieve successful treatment of soft tissue defects due to advanced leg ischemia. However, this combined approach is a complex technique involving multiple anastomoses on the same arterial axis with an increased risk of thrombosis. To reduce this risk, we have proposed a new bypass-flap (BF) reconstruction technique using an arterial graft and a free flap supplied by a collateral branch of the graft. The purpose of this report is to document the outcome in the first 10 patients treated using the BF reconstruction technique. From 2002 to 2004, a total of 10 patients with a mean age of 67 years (range 55-78) were treated using a BF. All patients presented critical ischemia with soft tissue defects resulting in exposure of tendons and muscles on the foot or ankle. Distal anastomosis was made between the distal branch of the BF and the pedal artery in five cases, the posterior tibial artery or plantar artery in four cases, and the peroneal artery in one case. In six cases proximal anastomosis was performed between the leg artery and arterial autograft. In the remaining four cases proximal anastomosis required extension of the bypass using a venous graft. The mean duration of hospitalization was 25 days. During the postoperative period, one patient died due to stercoral peritonitis and one patient required major amputation due to unrelenting sepsis. Bypass occlusion was not observed. Mean follow-up was 24 months (range 14-36). No patient was lost to follow-up and no patient died after the first 30 postoperative days. Follow-up examinations including clinical assessment and Doppler ultrasound imaging were performed at 3 months and every 6 months thereafter. Findings demonstrated bypass patency and healing of the covered defect in all cases. Outcome in this initial series demonstrates the clinical feasibility of the new BF reconstruction technique, which allows revascularization and coverage of tissue defects using a one-piece anatomic unit.
- Published
- 2009
23. Descending Thoracic Aorta as an Inflow Source for Late Occlusive Failures Following Aortoiliac Reconstruction
- Author
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Pierre Edouard Magnan, Philippe Rudondy, Jean Reboul, Alain Branchereau, and Hugo Espinoza
- Subjects
Male ,Reoperation ,medicine.medical_specialty ,medicine.medical_treatment ,Embolectomy ,Aorta, Thoracic ,Arterial Occlusive Diseases ,Femoral artery ,Anastomosis ,Iliac Artery ,Postoperative Complications ,Aneurysm ,Blood vessel prosthesis ,medicine.artery ,Angioplasty ,Methods ,medicine ,Humans ,Thoracic aorta ,Aged ,Leg ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Blood Vessel Prosthesis ,Surgery ,Femoral Artery ,Radiography ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Abdominal surgery - Abstract
From November 1984 to March 1990, 10 descending thoracic aorta-to-femoral artery bypass procedures were performed after failure of one or several aortoiliofemoral reconstructions. All patients were men, mean age 60 years. Indications included noninfected false aneurysm of an infrarenal end-to-side aortoprosthetic anastomosis in one case; one occlusion of an axillofemoral bypass; degradation of an aortobifemoral prosthetic graft; two occlusions of aortofemoral bypass; and five occlusions of aortobiiliac or aortobifemoral bypasses. Eight bifurcated grafts, one aortoprosthetic tube graft, and one aortopopliteal tube graft were inserted. One patient died 23 days postoperatively of multiple organ failure. Three patients underwent a successful secondary lower limb reconstruction procedure (prosthetic limb thrombectomy, embolectomy, femoral bifurcation angioplasty in one case each). Mean survival time was 14 months (range 3–48 months). Two patients were lost to follow-up, and one died of myocardial infarction six months postoperatively with a patent bypass. Graft thrombosis occurred in two patients. One was treated by thrombectomy at five months, the other was treated by in-situ thrombolysis at 15 months. Both of these patients had patent grafts at 12 and 21 months, respectively. The four other patients had patent grafts at 48 months. Primary patency was 55.5% (5/9 survivors) and secondary patency was 100% (9/9). This is a relatively simple method for constructing an extraanatomic aortofemoral or aortobifemoral bypass in late failures of aortoiliofemoral reconstructive surgery without having to re-enter the abdomen.
- Published
- 1991
24. Acute carotid artery thrombosis: description of 12 surgically treated cases
- Author
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Henri Mary, Jean-Philippe Berthet, Charles-Henri Marty-Ané, Reuben Veerapen, Pierre Alric, Pascal Branchereau, and Eric Picard
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Consciousness ,medicine.medical_treatment ,Infarction ,Contrast Media ,Revascularization ,Radiography, Interventional ,Blood Vessel Prosthesis Implantation ,Patient Admission ,medicine.artery ,Carotid artery disease ,Cause of Death ,medicine ,Humans ,Carotid Artery Thrombosis ,Stroke ,Endarterectomy ,Aged ,Retrospective Studies ,Thrombectomy ,Aged, 80 and over ,Endarterectomy, Carotid ,Ultrasonography, Doppler, Duplex ,business.industry ,Angiography ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Middle cerebral artery ,Female ,Internal carotid artery ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Carotid Artery, Internal ,Follow-Up Studies - Abstract
The morbidity and mortality of stroke secondary to acute internal carotid artery thrombosis range from 40 to 69% and from 15 to 55%, respectively, after purely medical treatment. This report describes a series of 12 patients who underwent urgent surgical treatment for primary acute carotid artery thrombosis between January 1999 and December 2002. Upon admission, all patients had severe neurologic deficits contralateral to carotid artery thrombosis. One patient experienced ongoing changes in the level of consciousness. The interval between the onset of symptoms and admission was less than 6 hr in all cases. Initial work-up in all patients included a brain computed tomographic scan with contrast injection and carotid duplex scan. The operative procedure consisted of carotid thomboemdarterectomy after shunt placement with prosthetic patch closure. Intraoperative angiography was performed in all cases. Following treatment, we observed deterioration of neurologic status leading to death in one case; improvement with partial regression of initial neurologic deficit in two cases, including one patient who died from causes unrelated to carotid artery disease; and full neurologic recovery in nine cases. The delay to revascularization was longer than 6 hr in both patients who died. These data support surgical intervention for carotid artery thrombosis in selected patients without major disturbances of consciousness or hemorrhagic infarction, provided that the delay to revascularization is less than 6 hr.
- Published
- 2005
25. Epiploic Bypass Flap: A New Method of Limb Salvage. Anatomic Basis and Clinical Application
- Author
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Settembre, Nicla, primary, Malikov, Serguei, additional, Branchereau, Alain, additional, Champsaur, Pierre, additional, Bussani, Rossana, additional, and Magnan, Pierre-Edouard, additional
- Published
- 2014
- Full Text
- View/download PDF
26. Endovascular treatment of anastomotic false aneurysms of the abdominal aorta
- Author
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P E, Magnan, J N, Albertini, J M, Bartoli, B, Ede, N, Valerio, G, Moulin, and A, Branchereau
- Subjects
medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Aortic aneurysm ,Blood Vessel Prosthesis Implantation ,Aneurysm ,Laparotomy ,medicine.artery ,medicine ,Humans ,Aged ,business.industry ,Abdominal aorta ,Anastomosis, Surgical ,Stent ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Common iliac artery ,Abdominal aortic aneurysm ,Surgery ,Blood Vessel Prosthesis ,Stents ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Aneurysm, False ,Abdominal surgery ,Aortic Aneurysm, Abdominal ,Follow-Up Studies - Abstract
Conventional surgical treatment of anastomotic false abdominal aortic aneurysms (AFAA) is technically difficult. Morbidity-mortality rates are higher than those for surgery of infrarenal abdominal aortic aneurysm (AAA). Endovascular management without laparotomy or aortic clamping represents an attractive alternative. The purpose of this study was to determine the immediate and middle-term outcome of endovascular management of AFAA. Between 1998 and 2001, 10 patients were treated for AFAA by placement of an endograft. The initial procedure was aortobifemoral bypass for occlusive artery disease in eight cases and resection and grafting for AAA in two cases. Mean age was 70 years. Seven patients were classified ASA 3 or 4. Three patients presented cardiac insufficiency with left ventricular ejection fraction
- Published
- 2003
27. Video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis: results in 102 cases
- Author
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Henri Mary, Pascal Branchereau, Charles Mary-Ané, Jean-Philippe Berthet, Pierre Alric, and Philippe Léger
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Thoracoscopic sympathectomy ,Patient satisfaction ,Postoperative Complications ,medicine ,Humans ,Hyperhidrosis ,Video assisted ,Sympathectomy ,Child ,Cervical Plexus ,Retrospective Studies ,Thoracic Nerves ,business.industry ,Thoracic Surgery, Video-Assisted ,Palmar hyperhidrosis ,Retrospective cohort study ,General Medicine ,Length of Stay ,Middle Aged ,Surgery ,Treatment Outcome ,Cardiothoracic surgery ,Patient Satisfaction ,Anesthesia ,Female ,Cardiology and Cardiovascular Medicine ,business ,Abdominal surgery ,Follow-Up Studies - Abstract
The purpose of this retrospective study was to evaluate the immediate and long-term outcome of video-assisted thoracoscopic sympathectomy for idiopathic palmar hyperhidrosis. Between January 1996 and December 2000, a total of 67 patients underwent 102 sympathectomy procedures with excision of the sympathetic chain between the second and fourth sympathetic ganglion. The mean duration of hospitalization was 1.7 +/- 0.6 days. Five patients were lost to follow-up. Mean duration of follow-up for the 96 sympathectomy procedures in the remaining 62 patients was 38 +/- 6.3 months. Patient outcome showed that video-assisted thoracoscopic sympathectomy is the treatment of choice for idiopathic palmar hyperhidrosis. Long-term patient satisfaction is excellent.
- Published
- 2002
28. Compromised hemodynamics associated with multipedicular lesions of cerebral arteries
- Author
-
Bertrand Ede, Nicolas Valerio, Eugenio Rosset, Alain Branchereau, and Jacques Pasquier
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Cerebral arteries ,Hemodynamics ,Revascularization ,Brain Ischemia ,Diagnosis, Differential ,medicine.artery ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Dominance, Cerebral ,Subclavian artery ,Aged ,Aged, 80 and over ,Tomography, Emission-Computed, Single-Photon ,Cerebral Revascularization ,business.industry ,Brain ,General Medicine ,Middle Aged ,Cerebral blood flow ,Regional Blood Flow ,Cardiology ,Surgery ,Female ,Radiology ,Cerebral Arterial Diseases ,Cardiology and Cardiovascular Medicine ,Acetazolamide ,business ,Abdominal surgery ,medicine.drug ,Circle of Willis - Abstract
The purpose of this study was to demonstrate that severe multipedicular lesions involving supraaortic trunks cause compromised cerebral hemodynamics with nonhemispheric symptoms (NHS) that can be relieved by surgical treatment. A total of 11 patients were prospectively included in the study. Regional cerebral blood flow (rCBF) and cerebral blood flow reactivity (CBFR) were measured by acetazolamide single photon emission computed tomoscintigraphy scans (SPECT) before and after surgery. Seven patients presented with isolated NHS and four presented with NHS associated with hemispheric symptoms. Lesions consisted of either high-grade (>75%) bilateral carotid artery stenosis associated with vertebral or subclavian artery lesions or high-grade (>75%) bilateral vertebral or subclavian artery stenosis associated with medium-grade (>50%) carotid lesions. All patients presented with a functional circle of Willis with no significant intracranial arterial lesions and no corticosubcortical atrophy. A total of 15 procedures were performed for revascularization of 19 arteries. The cumulative morbidity/mortality rate was nil. All revascularizations were patent on postoperative controls. Results from this study show that multipedicular lesions lead to hemodynamic changes affecting hemispheric and vertebrobasilar territories. Surgical treatment can improve or normalize cerebral hemodynamic abnormalities and relieve NHS.
- Published
- 2001
29. Surgical exposure of superior sulcus lung tumors with vascular involvement
- Author
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Henri Mary, Pascal Branchereau, Pierre Alric, Charles Marty-Ané, Philippe Léger, and Jean-Philippe Berthet
- Subjects
Adult ,Male ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Subclavian Artery ,Subclavian Vein ,Pneumonectomy ,Blood Vessel Prosthesis Implantation ,Actuarial Analysis ,medicine.artery ,medicine ,Humans ,Neoplasm Invasiveness ,Respiratory system ,Subclavian artery ,Aged ,Brachiocephalic Veins ,Lung ,business.industry ,Dissection ,Anastomosis, Surgical ,General Medicine ,Sulcus ,Middle Aged ,Vascular Neoplasms ,Surgery ,Tumor recurrence ,Survival Rate ,medicine.anatomical_structure ,Female ,Cardiology and Cardiovascular Medicine ,business ,Abdominal surgery - Abstract
Choice of exposure route for surgical excision of superior sulcus lung tumors depends on involvement at the thoracic inlet. From December 1985 to September 1999, we performed surgical treatment of superior sulcus tumors in 42 patients, including 22 with vascular involvement. Various exposure techniques were used, including a novel technique combining transverse supraclavicular cervicotomy and posterolateral thoracotomy in 11 cases, anterior transclavicular cervicothoracotomy in 7 cases, isolated posterolateral thoracotomy in 3 cases, and cervicosternotomy in 1 case. Vascular procedures consisted of subadventitial dissection of the subclavian artery in 5 patients, arterial resection-anastomosis in 7, and prosthetic bypass in 10. Postoperative mortality was 11.9% in the overall series of 42 patients (n = 5) and 9% (n = 2) in the subgroup of patients with vascular involvement. During follow-up, 13 patients died of tumor recurrence and 1 patient died of respiratory insufficiency. Actuarial 5-year survival was 22.7 +/- 17.5% overall and 18 +/- 17.9% in the subgroup of patients with vascular involvement. This study indicates that the combined exposure route with transverse supraclavicular cervicotomy and posterolateral thoracotomy was useful for treatment of superior sulcus lung tumors requiring lobectomy and pneumonectomy.
- Published
- 2001
30. Endovascular treatment of occlusive lesions in the distal aorta: mid-term results in a series of 31 consecutive patients
- Author
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Eugenio Rosset, Pierre-Edouard Magnan, Mathieu Poirier, Sergueï Malikov, Bertrand Ede, Alain Branchereau, and Nicolas Valerio
- Subjects
Adult ,Male ,medicine.medical_specialty ,Aortography ,Arteriosclerosis ,medicine.medical_treatment ,Aortic Diseases ,Arterial Occlusive Diseases ,Balloon ,Lesion ,Ischemia ,medicine.artery ,Angioplasty ,medicine ,Humans ,Aorta, Abdominal ,Aged ,Aged, 80 and over ,Aorta ,Leg ,medicine.diagnostic_test ,business.industry ,General Medicine ,Intermittent Claudication ,Middle Aged ,Common iliac artery ,Intermittent claudication ,Surgery ,Treatment Outcome ,Female ,Stents ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon ,Abdominal surgery ,Follow-Up Studies - Abstract
The purpose of this study was to evaluate the early and mid-term results of endovascular treatment of occlusive lesions in the distal aorta in a consecutive series of patients. Between February 1996 and March 1999, a total of 31 patients underwent transluminal procedures for treatment of occlusive atherosclerotic lesions located at the lower end of the aorta. Thirty patients presented with intermittent claudication and one had critical ischemia. Manifestations were bilateral in 26 cases and unilateral in 5. The lesion was confined to the lower aorta in 3 patients and extended to the common iliac arteries in 19, with predominant proximal lesions of the common iliac artery occurring in 9 patients. Fourteen patients had concurrent infracrural occlusive lesions. All patients underwent exclusive endovascular treatment without any associated open surgical procedure. The three patients with isolated aortic lesions were treated by angioplasty, followed by stent placement in two cases. The 19 patients with aortobiiliac lesions were treated by bilateral common iliac artery angioplasty according to the "kissing-balloon" technique; 7 of these patients also underwent aortic angioplasty. In these 19 patients, aortic stenting was performed in 3 cases and bilateral iliac stenting in 10 cases, including 3 in association with aortic stenting. The nine patients with a proximal lesion of the common iliac arteries were treated by angioplasty, followed by bilateral stenting in three cases and unilateral stenting in three cases. The findings of this study show that the mid-term anatomical and functional results of endovascular treatment for atherosclerotic lesions of the distal aorta are satisfactory. We recommend it as the initial treatment modality.
- Published
- 2001
31. Surgery for asymptomatic carotid stenosis: a study of three patient subgroups
- Author
-
Eugenio Rosset, Alain Branchereau, Bertrand Ede, Jean-Pierre Mathieu, and Pierre-Edouard Magnan
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Group ii ,Patient subgroups ,Asymptomatic ,Life Expectancy ,Postoperative Complications ,Actuarial Analysis ,Risk Factors ,medicine ,Humans ,In patient ,Carotid Stenosis ,Stroke ,Aged ,Endarterectomy, Carotid ,business.industry ,General Medicine ,medicine.disease ,Intracranial Arteriosclerosis ,Surgery ,Stenosis ,Cerebrovascular Disorders ,medicine.anatomical_structure ,Case-Control Studies ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Abdominal surgery ,Artery ,Follow-Up Studies - Abstract
The purpose of this retrospective study was to determine whether patients who undergo prophylactic surgery for asymptomatic carotid stenosis represent a single homogeneous population. Of the 805 carotid reconstructions performed between January 1984 and December 1992, a total of 357 were for asymptomatic atherosclerotic stenosis in 312 patients (227 men, 85 women) with a mean age of 69.6 years. Patients were divided into three groups. Group I included 141 patients (161 procedures) who presented no neurologic manifestations. Group II included 49 patients (55 procedures) who underwent carotid reconstruction before or at the same time as another cardiovascular procedure. Group III included 122 patients (141 procedures) who presented nonhemispheric manifestations. Patients in group III had a significantly higher number of obstructive lesions in brain arteries (p0.01). Seven patients died within the first 30 postoperative days, including three who underwent combined single-stage procedures. Nine patients presented nonfatal stroke, including three who progressively recovered. The cumulative death-stroke rate (CDSR) was 5.12% overall, 3.54% in group I, 12.24% in group II, and 4.09% in group III. The difference between groups I and II was statistically significant (p0.05). Taking into account only deaths related to carotid surgery and stroke with permanent disability, the CDSR was 2. 83% in group I and 3.25% in group III. Follow-up ranged from 24 to 132 months (mean: 66.2) with a total of 11 patients being lost from follow-up. Actuarial 5-year survival was 81.99 +/- 7.13% in group I, 70.65 +/- 13.72% in group II, and 68.51 +/- 8.93% in group III. Differences between group I and both groups II (p0.01) and III (p0.05) were statistically significant. Overall 5-year patency was 95.59 +/- 2.28%. Stroke occurred during follow-up in 13 patients. The probability of stroke-free survival was 95.29 +/- 3.76% in group I, 91.03 +/- 8.52% in group II, and 89.09 +/- 6.39% in group III. The difference between groups I and III was statistically significant (p0.05). Patients with asymptomatic carotid lesions can be divided into different prognostic groups. Life expectancy is shorter for patients with multiple artery disease. Long-term stroke risk is higher in patients with nonhemispheric neurological manifestations.
- Published
- 1998
32. Effects of cryopreservation on the viscoelastic properties of human arteries
- Author
-
Pierre-Edouard Magnan, P. H. Rolland, Eugenio Rosset, Régis Rieu, A. Friggi, Jean-François Pellissier, Gisèle Novakovitch, and Alain Branchereau
- Subjects
Adult ,Carotid Artery, Common ,Diastole ,Modulus ,Blood Pressure ,Cryopreservation ,medicine.artery ,medicine ,Humans ,Common carotid artery ,Pulse ,business.industry ,Viscosity ,Models, Cardiovascular ,Stiffness ,General Medicine ,Anatomy ,Elastic artery ,Elasticity ,Compliance (physiology) ,Femoral Artery ,Blood pressure ,Microscopy, Electron, Scanning ,Surgery ,Vascular Resistance ,Stress, Mechanical ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Biomedical engineering - Abstract
The purpose of this study was to use our newly developed mock circulation loop to determine the effects of cryopreservation on the common carotid artery (CCA) and the superficial femoral artery (SFA). Fourteen healthy arteries (7 CCA and 7 SFA) harvested from multiple organ donors between the ages of 18 and 35 years were tested before and after cryopreservation at -140 degrees C using dimethyl sulfoxide and the vapor phase of liquid nitrogen. Mean storage time was 4.2 months. The mock pulse rate was 60 beats/min and the following four systolic/diastolic pressures settings were used: 50/110, 80/140, 110/170, and 140/200 mm Hg. Simultaneous measurements of intra-arterial pressure and external arterial diameter were made using an intra-arterial pressure sensor and external piezoelectric sensors. Measured data were used to calculate pulsatility, volumetric compliance, stiffness, midwall radial arterial stress, Young's modulus, and the incremental modulus. After SFA cryopreservation, no significant changes were observed. Conversely, CCA cryopreservation led to a significant decrease in compliance and pulsatility and a significant increase in stiffness. Young's modulus, the incremental modulus, and midwall radial arterial stress did not change significantly. A clearcut decrease in hysteresis was observed after cryopreservation in the CCA. No evidence of structural changes was detected on light and scanning electron microscopy. Baseline findings in this study were consistent with classification of the CCA as an elastic artery and the SFA as a muscular artery. Cryopreservation had no effect on the viscoelastic properties of muscular arteries (SFA). Cryopreservation affected only values related to the cylindrical shape of the elastic arteries (CCA). It had no effect on values related to wall structure.
- Published
- 1996
33. Secondary Procedures After Infrarenal Abdominal Aortic Aneurysms Endovascular Repair With Second-Generation Endografts
- Author
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Bartoli, Michel A., primary, Thevenin, Benjamin, additional, Sarlon, Gabrielle, additional, Giorgi, Roch, additional, Albertini, Jean Noël, additional, Lerussi, Gilles, additional, Branchereau, Alain, additional, and Magnan, Pierre-Edouard, additional
- Published
- 2012
- Full Text
- View/download PDF
34. Internal carotid artery surgery: ten-year results
- Author
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Thierry Caus, Eugenio Rosset, François Prima, Pierre-Edouard Magnan, and Alain Branchereau
- Subjects
Adult ,Carotid Artery Diseases ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Arterial Occlusive Diseases ,Asymptomatic ,Veins ,Postoperative Complications ,Restenosis ,Recurrence ,Risk Factors ,medicine.artery ,Occlusion ,medicine ,Methods ,Humans ,Stroke ,Endarterectomy ,Aged ,Retrospective Studies ,Aged, 80 and over ,Endarterectomy, Carotid ,business.industry ,Mortality rate ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Blood Vessel Prosthesis ,Survival Rate ,Cerebrovascular Disorders ,Anesthesia ,Female ,Internal carotid artery ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Carotid Artery, Internal ,Abdominal surgery ,Follow-Up Studies - Abstract
The twofold purpose of this study was to compare the immediate results of surgery for lesions of the internal carotid artery in two series of patients operated on at 10-year intervals and to assess long-term results in the earliest series. Series I comprised 242 reconstructions in 220 patients (160 men and 60 women, mean age 64.4 years) performed between 1980 and 1982. Seventy patients (35%) were asymptomatic, 113 had monocular or hemispheric symptoms, and 30 had nonhemispheric symptoms. Contrast arteriograms revealed internal carotid artery stenosis of 70% in 119 (49.2%). Reconstruction was achieved by endarterectomy in 164 cases (67.8%), by vein graft in 75 cases (31%), and by other methods in 3 cases (1.2%). Postoperative mortality was 5% (11/110). Nonfatal postoperative stroke occurred in 1.8% (4/220) and transient ischemic attack in 0.5% (1 patient). All reconstructions were patent on postoperative control. The combined mortality/morbidity rate in patients in series II operated on between 1990 and 1991 was significantly lower, that is, 2.4% (4/170) vs. 6.8% (15/220) (p < 0.05). In series I, 11 patients (5%) were lost to follow-up and 124 were still alive at the beginning of the tenth postoperative year. Cumulative survival was 79 ± 5.6% at 5 years and 60.9 ± 6.7% at 10 years. The causes of late death were stroke in 7 cases, cardiovascular disease in 30 cases; cancer in 16 cases, and other causes in 20 cases. The patency rate, including occlusion and restenosis, was 95.3 ± 3% at 5 years and 90.1 ± 4.6% at 10 years. Neurologio events occurred during follow-up in 32 patients, including ipsilateral stroke in 13 cases and contralateral stroke in 5 cases. The stroke-free rate was 89 ± 4.3% at 5 years and 84.8 ± 5.2% at 10 years.
- Published
- 1993
35. Extra-Anatomical Revascularization of the Adamkiewicz Artery Using the Internal Mammary Artery: Preliminary Anatomical Study
- Author
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Malikov, Serguei, primary, Magnan, Pierre-Edouard, additional, Branchereau, Alain, additional, Bartoli, Jean-Michel, additional, and Champsaur, Pierre, additional
- Published
- 2009
- Full Text
- View/download PDF
36. Bypass Flap Reconstruction, A Novel Technique for Distal Revascularization: Outcome of First 10 Clinical Cases
- Author
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Malikov, Serguei, primary, Magnan, Pierre-Edouard, additional, Casanova, Dominique, additional, Lepantalo, Mauri, additional, Valerio, Nicolas, additional, Ayari, Raouf, additional, Champsaur, Pierre, additional, and Branchereau, Alain, additional
- Published
- 2009
- Full Text
- View/download PDF
37. From Diafoirus to Professor Nimbus
- Author
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Branchereau, Alain, primary
- Published
- 2006
- Full Text
- View/download PDF
38. Combined mortality and morbidity of direct surgical treatment of abdominal aortic aneurysm
- Author
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Louis Scotti, Jean-Christian Colavolpe, Alain Branchereau, and Jacques Nazet
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary artery disease ,Postoperative Complications ,Risk Factors ,medicine.artery ,Laparotomy ,medicine ,Humans ,Myocardial infarction ,Aorta, Abdominal ,Aged ,Intraoperative Care ,business.industry ,Abdominal aorta ,Age Factors ,General Medicine ,Perioperative ,Middle Aged ,medicine.disease ,Abdominal aortic aneurysm ,Surgery ,Aortic Aneurysm ,Amputation ,Cardiovascular Diseases ,Female ,Cardiology and Cardiovascular Medicine ,business ,Respiratory Insufficiency ,Vascular Surgical Procedures ,Abdominal surgery - Abstract
Two hundred aneurysms of the abdominal aorta were treated surgically from 1980 to 1987 by the same surgeon. There were 187 men and 13 women whose mean age was 66.1 years. Nine patients were 80-years-old or more. Eighty-seven percent of patients had preoperative risk factors, 30% of which were coronary artery disease. The operative approach was through a transverse laparotomy in 188 patients compared to 11 midline incisions and one lumbotomy. An aortoaortic tube was inserted in 87 patients, a bifurcated prosthesis in 99, and a tube bypass in 14. Five patients (2.5%) died within the 30 day perioperative period. Death was due to colonic necrosis, right heart chamber thrombosis, renal failure after repeat operation for acute lower limb ischemia, and myocardial infarction associated with renal and respiratory failure. The morbidity rate was 15.7% (31 patients) and included seven neurologic accidents, four respiratory complications, five ischemic events of the lower limbs requiring reoperation and one amputation, four cardiac complications, two renal failures, one reversible colonic ischemia, one revision for incomplete hemostasis, one phlebitis, one sliding syndrome, and five minor infections or cutaneous complications. Mean duration of hospital stay was 10.9 days. These results confirm that direct operation on aortic aneurysms can be performed in patients from all age groups and even with associated diseases. A rapid, simple technique based on a transverse approach, minimal dissection and insertion of aortoaortic tubes, whenever feasible, appears to reduce combined mortality-morbidity.
- Published
- 1990
39. Acute Carotid Artery Thrombosis: Description of 12 Surgically Treated Cases
- Author
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Berthet, Jean-Philippe, primary, Marty-Ané, Charles-Henri, additional, Picard, Eric, additional, Branchereau, Pascal, additional, Mary, Henri, additional, Veerapen, Reuben, additional, and Alric, Pierre, additional
- Published
- 2005
- Full Text
- View/download PDF
40. The Bypass Flap: An Innovative Technique of Distal Revascularization—Anatomical Study and Clinical Application
- Author
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Malikov, Serguei, primary, Casanova, Dominique, additional, Champsaur, Pierre, additional, Magnan, Pierre Edouard, additional, and Branchereau, Alain, additional
- Published
- 2004
- Full Text
- View/download PDF
41. Endovascular Treatment of Anastomotic False Aneurysms of the Abdominal Aorta
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Magnan, P.E., primary, Albertini, J.N., additional, Bartoli, J.M., additional, Valerio, N., additional, Moulin, G., additional, and Branchereau, A., additional
- Published
- 2003
- Full Text
- View/download PDF
42. Ruptured Aneurysm of the Infrarenal Abdominal Aorta: Impact of Age and Postoperative Complications on Mortality
- Author
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Alric, Pierre, primary, Ryckwaert, Frédérique, additional, Picot, Marie-Christine, additional, Branchereau, Pascal, additional, Colson, Pascal, additional, Mary, Henri, additional, and Marty-Ané, Charles, additional
- Published
- 2003
- Full Text
- View/download PDF
43. Video-assisted Thoracoscopic Sympathectomy for Palmar Hyperhidrosis: Results in 102 Cases
- Author
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Alric, Pierre, primary, Branchereau, Pascal, additional, Berthet, Jean-Philippe, additional, Léger, Philippe, additional, Mary, Henri, additional, and Mary-Ané, Charles, additional
- Published
- 2002
- Full Text
- View/download PDF
44. Extraanatomical Revascularization of the Artery of Adamkiewicz: Anatomical Study
- Author
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Malikov, Serguei, primary, Rosset, Eugenio, additional, Paraskevas, Nikolaos, additional, Magnan, Pierre-Edouard, additional, Poirier, Mathieu, additional, Bartoli, Jean-Michel, additional, Champsaur, Pierre, additional, Ribal, Jean-Pierre, additional, Glanddier, Gérard, additional, and Branchereau, Alain, additional
- Published
- 2002
- Full Text
- View/download PDF
45. Modalities of Preoperative Imaging of the Internal Carotid Artery Used in France
- Author
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Long, Anne, primary, Lepoutre, Agnès, additional, Corbillon, Emmanuel, additional, Branchereau, Alain, additional, and Kretz, Jean-Georges, additional
- Published
- 2002
- Full Text
- View/download PDF
46. Endovascular Treatment of Occlusive Lesions in the Distal Aorta: Mid-term Results in a Series of 31 Consecutive Patients
- Author
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Rosset, Eugenio, primary, Malikov, Serguei, additional, Magnan, Pierre-Edouard, additional, Poirier, Mathieu, additional, Valerio, Nicolas, additional, Ede, Bertrand, additional, and Branchereau, Alain, additional
- Published
- 2001
- Full Text
- View/download PDF
47. Surgical Exposure of Superior Sulcus Lung Tumors with Vascular Involvement
- Author
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Branchereau, Pascal, primary, Alric, Pierre, additional, Berthet, Jean-Philippe, additional, Léger, Philippe, additional, Mary, Henri, additional, and Marty-Ané, Charles, additional
- Published
- 2001
- Full Text
- View/download PDF
48. Compromised Hemodynamics Associated with Multipedicular Lesions of Cerebral Arteries
- Author
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Valerio, Nicolas, primary, Rosset, Eugénio, additional, Ede, Bertrand, additional, Pasquier, Jacques, additional, and Branchereau, Alain, additional
- Published
- 2001
- Full Text
- View/download PDF
49. Results of Lower Limb Revascularization from the Descending Thoracic Aorta
- Author
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Magnan, Pierre-Edouard, primary, Ede, Bertrand, additional, Marchetti, Andrea Ascoli, additional, Rosset, Eugénio, additional, Mathieu, Jean-Pierre, additional, and Branchereau, Alain, additional
- Published
- 2000
- Full Text
- View/download PDF
50. Surgery for Asymptomatic Carotid Stenosis: A Study of Three Patient Subgroups
- Author
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Branchereau, Alain, primary, Ede, Bertrand, additional, Magnan, Pierre-Edouard, additional, Rosset, Eugénio, additional, and Mathieu, Jean-Pierre, additional
- Published
- 1998
- Full Text
- View/download PDF
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