180 results on '"J Watelet"'
Search Results
52. Percutaneous Repair of Aortic Aneurysms: A Prospective Study of Suture-Mediated Closure Devices
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P. Thomas, J.-C. Gallot, J. Watelet, Didier Plissonnier, and F. Douvrin
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Adult ,Male ,medicine.medical_specialty ,Percutaneous ,Femoral artery ,Aortic aneurysm ,Blood Vessel Prosthesis Implantation ,Suture (anatomy) ,medicine.artery ,medicine ,Humans ,Abdominal ,Prospective Studies ,Prospective cohort study ,Aged ,Medicine(all) ,Aged, 80 and over ,Aortic Aneurysm, Thoracic ,Sutures ,business.industry ,Middle Aged ,medicine.disease ,Dilatation ,Surgery ,Cardiothoracic surgery ,Needles ,Endovascular procedures ,Feasibility Studies ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Abdominal surgery ,Aortic Aneurysm, Abdominal - Abstract
Purpose To evaluate prospectively the safety and efficacy of totally percutaneous placement of abdominal and thoracic aortic endografts using the Prostar XL suture-mediated closure system. Methods From January 2002 to January 2005, we attempted to insert percutaneously all bifurcated abdominal aortic and thoracic endografts. Consecutive patients (25 men, four women), with mean age 74.9 years (range 44–84), underwent endovascular repair for 20 abdominal aortic aneurysms (AAA) and nine thoracic aortic aneurysms (repeat operation in one case). Endografts used included 21 Zenith (Cook), eight Talent (Medtronic), one AneuRx (Medtronic). For the «pre-close» technique, two Prostar XL 8F were used to close 22–24F access sites and one Prostar XL 10F to close 16F access sites. Results Procedural success was achieved in 21/29 (72.4%) patients and in 39/47 access sites (83%). Closure of 22–24F access sites with tandem 8F Prostar devices was successful in 23/29 (79.3%) cases. Closure of 16F access sites with 10F Prostar device was successful in 16/18 (88.8%) cases. There were seven peri-procedural failures requiring surgery to repair the femoral artery in three cases. Four access complications healed without intervention. Overall 25/29 (86.2%) patients had complete percutaneous repair. No late complications were detected during follow-up (median 17.5 months). Conclusions Percutaneous treatment of patients with AAA and thoracic aneurysms is feasible in most cases, with a very low risk of access-related complication, providing that the operator has sufficient practical experience of this technique.
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53. ['Suspended' popliteal artery shunts. A report on 15 cases (author's transl)]
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J, Watelet, C, Leturgie, P, Tenière, and J, Testart
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Femoral Artery ,Male ,Leg ,Postoperative Complications ,Ischemia ,Humans ,Female ,Popliteal Artery ,Saphenous Vein ,Middle Aged ,Aged - Abstract
A "suspended" popliteal artery (S.P.A.) constitutes one of the most pejorative anatomical forms for atheromatous lesions of the lower limbs, as obliteration of the superficial femoral artery is often associated with atheromatous lesions in the tibial arteries, making them inaccessible to arterial reconstruction. Operations have been conducted on 5 cases (14 patients) over a period of 3 years. The average age of the patients was 71.6 years and the average follow-up period was 13 months. In each case operation was required to avoid amputation. Venous material was used for the shunt in 10 cases, while 5 had composite (n = 3) or prosthetic (n = 2) material. Postoperative mortality was nul, but 28% died by the end of the first year. Thrombosis occurred in 3 cases, at the 2nd, 7th, and 9th month respectively (actuarial permeability rate after 1 year: 72%), and 4 patients had high amputations (leg: 3, thigh: 1) in spite of permeability of the shunt is two cases (actuarial conservation rate of the limbs after 1 year: 67.5%). An analysis of the results of these 15 cases and those rare series reported in the published literature, enables definition of the indications for revascularization of an S.P.A.
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- 1980
54. [Rupture of the subclavian artery. Apropos of a case]
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J, Watelet, J, Testart, N, Biga, P, Tenière, and J, Caillet
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Male ,Rupture ,Fractures, Bone ,Hematoma ,Accidents, Traffic ,Subclavian Artery ,Humans ,Middle Aged ,Clavicle - Abstract
The authors report a typical case of rupture of the sub-clavian artery in closed trauma of the shoulder and review the world literature. The pathology of this lesion is described and its mechanism studied, it seems to be due to an acute encounter between the artery and the scalenus anterior.
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- 1976
55. [A rare complication of vagotomy: chyloperitoneum and chylothorax (author's transl)]
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P, Teniere, J, Watelet, J G, Anagnostides, and P, Hecketzweiller
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Adult ,Male ,Humans ,Vagotomy ,Chylothorax ,Chylous Ascites ,Thoracic Duct - Published
- 1977
56. When can revascularization be limited to the profunda femoris alone?
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J, Watelet, J, Testart, P, Teniere, S, Chamoun, and G, Ducable
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Adult ,Femoral Artery ,Male ,Leg ,Postoperative Complications ,Ischemia ,Methods ,Humans ,Arterial Occlusive Diseases ,Female ,Thrombosis ,Middle Aged ,Aged - Abstract
Dealing with lower limbs arteriopathies with combined aorto iliac and superficial femoral occlusive diease and when ischemia leads to operation should an extension bypass to the popliteal or tibial artery be associated every time it is possible? The authors have investigated the results of revascularizing operation above the profunda femoris on 35 limbs (27 patients). On 19 limbs only, has the revascularization been sufficient to cure the distal ischemia. On the other 16 limbs, a second operation was necessary 7 times an extension bypass to the popliteal or tibial artery, once an above knee amputation, twic a below knee amputation. From the comparison of these results with the degree of ischemia and the arteriographic aspect of the profunda femoris, the author's conclusion is that revascularization must extent below the profunda femoris unless the profunda is in good condition and there is no rest ischemia.
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- 1978
57. [Prospective study comparing ultrasonics and digital subtraction angiography in arterial bypass of the lower limbs. Apropos of 54 cases]
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J P, Laissy, R, de Somer Leroy, L, Lardenois, J, Bernier, J, Watelet, and M, Benozio
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Adult ,Aged, 80 and over ,Leg ,Postoperative Complications ,Subtraction Technique ,Angiography ,Graft Occlusion, Vascular ,Humans ,Ultrasonics ,Prospective Studies ,Middle Aged ,Aged ,Blood Vessel Prosthesis - Published
- 1987
58. [Endoluminal angioplasty of iliac obstruction. Immediate results and cumulative patency at 2 years in 23 patients]
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E, Cormier, J P, Laissy, J, Bernier, C, Peillon, J, Watelet, J, Testart, and M, Benozio
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Adult ,Aged, 80 and over ,Male ,Time Factors ,Humans ,Arterial Occlusive Diseases ,Female ,Middle Aged ,Iliac Artery ,Angioplasty, Balloon ,Vascular Patency ,Aged - Abstract
23 patients with obstruction of one or both main iliac arteries underwent one or more transluminal angioplasties by catheterization via the obstructed vessel. 26 iliac arteries were thus reopened. The length of obstructions varied from 1 to 10 cm. The majority of the obstructions were of recent onset whilst in 6 cases the presumed date was more than 6 months previously. In all cases potency was obtained with normal follow-up angiograms in 20 cases, and a residual though not hemodynamically significant stenosis in 6 cases. All patients were followed up by Doppler and in the majority of cases by venous digital angiography, with a follow-up at the present time of 6 months to 2 years. 2 patients underwent surgery because of reobstruction occurring 2 and 13 months after dilatation. Cumulative patency is 79% in 2 years, similar to results obtained by surgery. These results show that iliac angioplasty, a simple procedure, may avoid or delay surgery, and that it should be widely used in this precise anatomical indication.
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- 1988
59. [Inter-observer variability in the interpretation of arteriographies of the carotid arteries and lower limbs]
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J P, Louvel, P, Czernichow, Y, Kervarrec, T, Robert, J, Watelet, M, Benozio, and J, Testart
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Leg ,Carotid Arteries ,Evaluation Studies as Topic ,Angiography ,Humans - Abstract
This study attempts to measure inter-observer variability in reading 14 carotid angiograms and 8 aortograms. 24 surgeons and radiographs with training in arterial diseases participated in the study from different hospitals. The results were analysed with the Kappa statistical method which incorporate a correction for the extend of agreement expected by chance alone, in the evaluation of the reliability of diagnostic procedures. From a topographic point of view, the interpretation of the proximal arterial segments is more reliable than the distal segments, with the exception of the aorto-iliac bifurcation and the profunda femoral arteries. Inter-observer agreement is the most important for the occlusive lesions and the identification of stenosis is of poor reliability.
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- 1984
60. [Extrahepatic portal hypertension from tuberculosis adenopathy and with encephalopathy (author's transl)]
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J, Testart, J, Watelet, and G, Ducable
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Portacaval Shunt, Surgical ,Hepatic Encephalopathy ,Hypertension, Portal ,Humans ,Female ,Middle Aged ,Tuberculosis, Lymph Node - Published
- 1979
61. [Not Available]
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J, Watelet
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Warfare ,Italy ,History, Modern 1601 ,France - Published
- 1986
62. [Arterial complications of surgery of the hip in arteritis]
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J, Watelet, P, Teniere, N, Riga, and J, Testart
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Male ,Arteritis ,Hip ,Thrombosis ,Middle Aged ,Iliac Artery ,Femoral Neck Fractures ,Femoral Artery ,Radiography ,Postoperative Complications ,Ischemia ,Humans ,Female ,Aged - Published
- 1976
63. [Electroencephalographic surveillance during carotid endarterectomy]
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C, Blondeau, F, Hebert, G, Ducasble, J, Watelet, J, Testart, and D, Samson-Dollfus
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Cerebrovascular Disorders ,Carotid Arteries ,Postoperative Complications ,Humans ,Electroencephalography ,Endarterectomy ,Anesthesia, General ,Intraoperative Complications ,Monitoring, Physiologic - Abstract
Continuous EEG monitoring during 110 carotid endarterectomies showed transient or permanent abnormalities in 35 cases. In 13 cases, these abnormalities occurred during carotid clamping and led the surgeon to place a shunt in 8 cases. In 22 cases, electrical abnormalities of various types appeared outside the clamping period. Continuous EEG monitoring demonstrated that cerebral disturbances can occur at any time during the operative period. Thus, intra-operative EEG monitoring allows a better understanding of clinical signs which may be seen postoperatively.
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- 1982
64. When can revascularization be limited to the isolated popliteal artery?
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J, Watelet, J M, Philippe, S, Chamoun, and J, Testart
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Humans ,Popliteal Artery ,Aged - Published
- 1983
65. [Axillary-distal bypass of the upper limb using in situ veins]
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C, Peillon, J P, Laissy, E, Calenda, J, Watelet, and J, Testart
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Ischemia ,Arm ,Methods ,Humans ,Veins - Abstract
Revascularization of ischaemic upper limbs by means of the patient's superficial veins in situ is a little known technique which has many advantages. Not only is the internal saphenous vein spared, but the technique is easily adaptable to all situations (e.g. length of the bypass, diameter of the arteries).
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- 1989
66. [Reoperations for early thromboses of femoropopliteal and tibial artery bypass. Apropos of 50 cases]
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C, Peillon, J P, Laissy, J L, Didelon, J, Watelet, and J, Testart
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Femoral Artery ,Male ,Reoperation ,Leg ,Postoperative Complications ,Time Factors ,Humans ,Female ,Popliteal Artery ,Thrombosis ,Prognosis ,Aged ,Retrospective Studies - Abstract
The mechanism of thrombosis early after subinguinal bypass and outcome after revision surgery have been rarely analyzed. Results are reported of revision surgery for early thrombosis in 50 cases (10% of subinguinal bypass operations during the same period). Initial indication in the 40 men and 9 women (mean age 66.9 +/- 1.74 (SEM) years), was severe chronic or acute ischemia in 82%. The 50 thrombosed bypasses included 40 femoropopliteal, 8 femorotibial and 2 short bypasses. The bypass was by saphenous in situ (21 times), an inversed saphenous (9 times), a mixed bypass (12 times) and a prosthesis (8 times). The distal arterial bed was evaluated as good in 50% of cases. Analysis of cause of thrombosis, of the operative procedure and of the time before surgery enabled a technical cause to be determined in 31 of the 50 cases. Corrective surgery produced 16 permeable bypasses and 34 definitive thromboses complicated by 21 amputations and a 10% mortality. Improved results were related to a venous bypass (p less than 0.05), to a time before operation of less than 24 hours (p less than 0.02) and to a good distal bed. The 1 year actuarial permeability for the 50 bypass operations was 35%. Mixed bypass procedures and technical problems during surgery appear to be the principal predisposing factors of early thrombosis. In this series, the preoperative distal pressure index and intraoperative flowmetric recordings were not reliable predictive elements.
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- 1988
67. [Gastric ruptures after resuscitation]
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G, Ducable, S, Chamoun, C, Leturgie, J, Watelet, and C, Winckler
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Stomach Rupture ,Resuscitation ,Humans ,Female ,Middle Aged ,Aged - Published
- 1978
68. ['Natural history' of arterial surgical restoration below the inguinal region]
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J, Testart, J, Watelet, C, Peillon, T, Delaunay, and J L, Bourgois
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Adult ,Male ,Leg ,Arterial Occlusive Diseases ,Endarterectomy ,Middle Aged ,Blood Vessel Prosthesis ,Femoral Artery ,Humans ,Female ,Popliteal Artery ,Angioplasty, Balloon ,Vascular Patency ,Aged - Abstract
Infra-inguinal endarterectomy and by-pass (PSI) are the oldest and more frequently done restorative arterial operations. Here are described the evolution of patients, limbs and PSI and the factors that could interfere with them from the facts gathered since 30 years in literature. Prognosis is serious.
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- 1989
69. [Benign vascular digestive tract malformations. Review and report on two cases (author's transl)]
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P, Tenière, J P, Galmiche, J, Watelet, and J, Testart
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Adult ,Intestines ,Male ,Arteriovenous Fistula ,Intestinal Neoplasms ,Angiography ,Humans ,Endoscopy ,Gastrointestinal Hemorrhage ,Hemangioma ,Aged - Abstract
Benign vascular digestive tube malformations were first described in 1839. Their incidence is low, they occur mainly in the small intestine and colon, and they are of current interest because of their rare nature, the difficulty in establishing a diagnosis, and the large variety of lesion observed. They tend to be diffuse, multiple, and may be found in the rectum. Treatment is difficult, therefore, and though surgery is usually indicated, endoscopic electrocoagulation, laser beams, or embolization may be of value when used alone or as complementary therapy.
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- 1980
70. [Hepatic encephalopathy complicating portal hypertension caused by lymph node tuberculosis]
- Author
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J, Testart, J, Watelet, and G, Ducable
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Hepatic Encephalopathy ,Hypertension, Portal ,Humans ,Female ,Middle Aged ,Tuberculosis, Lymph Node ,Esophageal and Gastric Varices ,Gastrointestinal Hemorrhage - Published
- 1978
71. [Direct puncture of pulseless arteries: a possible angiographic alternative in patients with multiple vessel disease]
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J P, Laissy, E, Cormier, J, Bernier, C, Peillon, J, Watelet, J, Testart, and M, Benozio
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Adult ,Femoral Artery ,Male ,Arteritis ,Leg ,Aortic Arch Syndromes ,Humans ,Arterial Occlusive Diseases ,Female ,Prospective Studies ,Punctures ,Middle Aged ,Aged - Published
- 1988
72. [Evaluation of digital subtraction angiography, ultrasonography and Doppler velocimetry versus conventional angiography in the femoral bifurcation]
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J P, Louvel, F, Zahaf, R, de Somer Leroy, J, Watelet, and M, Benozio
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Adult ,Femoral Artery ,Radiographic Image Enhancement ,Arteritis ,Leg ,Evaluation Studies as Topic ,Subtraction Technique ,Humans ,Middle Aged ,Rheology ,Aged ,Ultrasonography - Abstract
Thirty patients were examined by 4 procedures, conventional angiography (C.A.), peripheric intravenous digital subtraction angiography (D.S.A.), ultrasonography and Doppler on femoral artery bifurcation. These arteries are divided into several sections on which findings were classified into three or five categories. There is an excellent correlation between conventional and digital angiograms. Various results of D.S.A. versus C.A. were obtained in 2% of these sections. More differences were noticed between C.A. and Doppler (7%), C.A. and ultrasonography (10%). There is a positive correlation of D.S.A. versus C.A. With Doppler and ultrasonography, arterial map is difficult to establish especially in case of many stenoses of the iliac arteries or thrombosis on femoral superficialis arteries.
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- 1986
73. 74 by-passes on leg arteries (author's transl)
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J, Watelet, D, Janneau, P, Lagneau, and J M, Cormier
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Adult ,Male ,Leg ,Arterial Occlusive Diseases ,Thrombosis ,Arteries ,Arteriosclerosis Obliterans ,Middle Aged ,Infections ,Transplantation, Autologous ,Aneurysm ,Blood Vessel Prosthesis ,Veins ,Postoperative Complications ,Regional Blood Flow ,Methods ,Humans ,Female ,Mortality ,Follow-Up Studies ,Aged - Abstract
74 by-passes on leg arteries have been performed during these last ten years at St Joseph's hospital to cure: femoropopliteal atherosclerotic occlusive disease (67 cases), aneurisms (5 cases), post-traumatic arteriovenous fistula (1 case), popliteal thrombosis on exostosis (1 case). The indication for operation was, in almost every case, carried on a distal advanced ischemia, followed by an imminent limb loss. In four cases, there existed an acute sensory and motor ischemia. The accumulated potency rate was 58.5% at 1 year and decreased progressively afterwards: 38.20% at 3 years and 21.6% at 5 years. However, the choice of a surgical technics doesn't find its justification in a long-dated prognosis for this operation, the aim of which being limb-salvage. In this prospect, the results are hopeful: 77% of the limbs have effectively been preserved at the end of the follow-up period.
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- 1980
74. 55 arteriovenous fistulae for chronic hemodialysis in adults
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P, Teniere, D, Dubois, J, Watelet, and J, Testard
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Male ,Forearm ,Arteriovenous Shunt, Surgical ,Postoperative Complications ,Renal Dialysis ,Humans ,Kidney Failure, Chronic ,Thrombosis ,Middle Aged ,Infections ,Follow-Up Studies - Published
- 1974
75. [Traumatic chylothorax with dorsal spinal fracture. A case report (author's transl)]
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C, Leturgie, S, Chamoun, G, Ducable, J, Watelet, J, Testart, and P, Tenière
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Male ,Radiography ,Rupture ,Fractures, Bone ,Humans ,Middle Aged ,Chylothorax ,Thoracic Vertebrae ,Thoracic Duct - Abstract
We related there a traumatic chylothorax due to a thoracic vertebral fracture. It has been recognized at the 13st day, after a lost of 11 liter of lymph and a down of albuminemia by lymphography. The direct ligature has been only partly successful leaving still a tiny lymph leak during a fortnight.
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- 1979
76. [Polycystic liver. Report of one case and therapeutic discussion (author's transl)]
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P, Tenière, F, Michot, J, Testart, and J, Watelet
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Cysts ,Liver Diseases ,Drainage ,Humans ,Female ,Middle Aged ,Prognosis - Abstract
The authors report a new case of polycystic liver associated with polycystic kidney. The functional disorder due to distension of the cysts led to surgery. The impossibility of carrying out removal of the liver, owing to the diffuse character of these lesions, led the authors to choose the method described by Tien Yu Lin in 1968. This seems to be indicated in a few cases owing to the remarkable functional results.
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- 1977
77. [Infection of vascular sutures: a report on 26 cases (author's transl)]
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C, Leturgie, S, Chamoun, J, Watelet, P, Teniere, and J, Testart
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Adult ,Male ,Sutures ,Polyethylene Terephthalates ,Enterobacteriaceae Infections ,Middle Aged ,Staphylococcal Infections ,Prognosis ,Transplantation, Autologous ,Blood Vessel Prosthesis ,Veins ,Humans ,Female ,Vascular Surgical Procedures ,Aged ,Retrospective Studies - Abstract
The authors describe 26 cases of infection after vascular surgery, affecting a Dacron prosthesis in 13 cases and venous grafts in the other 13 patients. The site of infection was usually the region of Scarpa's triangle (15 cases) with the presence of enterobacterium in 40% of cases. The most frequently isolated germ was staphylococcus aureus (20 cases). Infection was revealed by hemorrhage in 17 patients and was evidence of breaking down of the anastomosis. Results of surgical treatment in the two groups were evaluated by using three criteria: --persistence or not of infection, --vital prognosis, --functional prognosis. Surgical treatment methods and possible contamination sources are discussed. When the operative zone is infected, the authors recommend ablation for the prostheses and conservative therapy for venous autografts. The prosthesis was left in place in 5 patients, and only one patient recovered, while two deaths occurred. In the 10 cases where ablation of the prosthesis was performed, however, the infection was cured, and in 4 patients there was revascularization in the infected area. Apart from these cases, conservative therapy was applied in 11 cases and healing occurred in all of them.
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- 1980
78. Axillo-femoral bypass failure secondary to axillary stenosis: ultrasound-guided percutaneous transluminal angioplasty
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J P, Laissy, J, Thiebot, C, Peillon, J, Watelet, J, Testart, and M, Benozio
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Male ,Leg ,Arteriosclerosis ,Graft Occlusion, Vascular ,Angiography, Digital Subtraction ,Middle Aged ,Iliac Artery ,Femoral Artery ,Postoperative Complications ,Ischemia ,Axillary Artery ,Humans ,Angioplasty, Balloon ,Ultrasonography - Published
- 1987
79. [Crural paralysis caused by hematoma of the psoas muscle during anticoagulant treatments. (Apropos of 2 cases)]
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P, Le Douarec, J, Watelet, P, Teniere, and G, Leroux
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Adult ,Male ,Postoperative Care ,Hematoma ,Aortic Valve Insufficiency ,Anticoagulants ,Thrombosis ,Middle Aged ,Atrial Flutter ,Muscular Diseases ,Thigh ,Heart Valve Prosthesis ,Humans ,Paralysis ,Femoral Nerve - Published
- 1973
80. Suggested standards for reports dealing with lower extremity ischemia
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J. Watelet and J. Testart
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Leg ,Ischemia ,business.industry ,Anesthesia ,Humans ,Medicine ,Surgery ,Lower extremity ischemia ,Cardiology and Cardiovascular Medicine ,business - Published
- 1988
81. Individual patient data meta-analysis of adjuvant gemcitabine-based chemotherapy for biliary tract cancer: combined analysis of the BCAT and PRODIGE-12 studies.
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Edeline J, Hirano S, Bertaut A, Konishi M, Benabdelghani M, Uesaka K, Watelet J, Ohtsuka M, Hammel P, Kaneoka Y, Joly JP, Yamamoto M, Monard L, Ambo Y, Louvet C, Ando M, Malka D, Nagino M, Phelip JM, and Ebata T
- Subjects
- Antineoplastic Combined Chemotherapy Protocols adverse effects, Bile Ducts, Intrahepatic pathology, Chemotherapy, Adjuvant, Deoxycytidine analogs & derivatives, Humans, Neoplasm Recurrence, Local drug therapy, Randomized Controlled Trials as Topic, Gemcitabine, Bile Duct Neoplasms drug therapy, Biliary Tract Neoplasms pathology
- Abstract
Background: Although gemcitabine-based chemotherapy is the standard of care for advanced biliary tract cancers (BTCs), adjuvant phase III studies (BCAT in Japan, PRODIGE 12 in France) failed to show benefit, possibly owing to fewer patients (n = 225 and n = 194) compared with the adjuvant capecitabine BILCAP trial (n = 447). We performed a combined analysis of both gemcitabine-based chemotherapy adjuvant studies., Methods: We performed individual patient data meta-analysis of all patients included in BCAT and PRODIGE 12. BCAT study randomised patients with extrahepatic cholangiocarcinoma to single-agent gemcitabine or observation. PRODIGE 12 randomised patients with all BTC subtypes to gemcitabine-oxaliplatin combination or observation. Combined analysis was performed using Kaplan-Meier curves and a Cox regression model stratified on the trial., Results: Two hundred and twelve versus 207 patients were randomised in the gemcitabine-based chemotherapy versus observation arms. Baseline characteristics were balanced between arms. The median follow-up was 5.5 years. After 258 relapse-free survival (RFS) events, there was no difference in RFS (log-rank p = 0.45; hazard ratio [HR] = 0.91 [95% confidence interval [CI] 0.71-1.16]; p = 0.46). RFS rates at five years were 40.8% (95%CI: 33.9%-47.5%) for gemcitabine-based chemotherapy versus 36.6% (95%CI: 29.8%-43.4%) for observation. After 201 deaths, there was no difference in overall survival (OS) (log-rank p = 0.83; HR = 1.03 [95%CI: 0.78-1.35]; p = 0.85). OS rates at five years were 50.5% (95%CI: 43.1%-57.4%) for gemcitabine-based chemotherapy versus 49.3% (95%CI: 41.6%-56.5%) for observation., Conclusion: With 419 patients included, this analysis did not show significant improvement in RFS and no trend in improvement in OS. Gemcitabine-based chemotherapy should not be used as an adjuvant treatment for BTC., Competing Interests: Conflict of interest statement The authors do not have conflict of interest for this subject., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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82. Gemcitabine and Oxaliplatin Chemotherapy or Surveillance in Resected Biliary Tract Cancer (PRODIGE 12-ACCORD 18-UNICANCER GI): A Randomized Phase III Study.
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Edeline J, Benabdelghani M, Bertaut A, Watelet J, Hammel P, Joly JP, Boudjema K, Fartoux L, Bouhier-Leporrier K, Jouve JL, Faroux R, Guerin-Meyer V, Kurtz JE, Assénat E, Seitz JF, Baumgaertner I, Tougeron D, de la Fouchardière C, Lombard-Bohas C, Boucher E, Stanbury T, Louvet C, Malka D, and Phelip JM
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols adverse effects, Biliary Tract Neoplasms mortality, Biliary Tract Neoplasms pathology, Chemotherapy, Adjuvant, Deoxycytidine administration & dosage, Deoxycytidine adverse effects, Female, France, Humans, Male, Middle Aged, Oxaliplatin adverse effects, Progression-Free Survival, Quality of Life, Time Factors, Gemcitabine, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biliary Tract Neoplasms drug therapy, Biliary Tract Neoplasms surgery, Biliary Tract Surgical Procedures adverse effects, Biliary Tract Surgical Procedures mortality, Deoxycytidine analogs & derivatives, Oxaliplatin administration & dosage, Watchful Waiting
- Abstract
Purpose: No standard adjuvant treatment currently is recommended in localized biliary tract cancer (BTC) after surgical resection. We aimed to assess whether gemcitabine and oxaliplatin chemotherapy (GEMOX) would increase relapse-free survival (RFS) while maintaining health-related quality of life (HRQOL) in patients who undergo resection., Patients and Methods: We performed a multicenter, open-label, randomized phase III trial in 33 centers. Patients were randomly assigned (1:1) within 3 months after R0 or R1 resection of a localized BTC to receive either GEMOX (gemcitabine 1,000 mg/m
2 on day 1 and oxaliplatin 85 mg/m2 infused on day 2 of a 2-week cycle) for 12 cycles (experimental arm A) or surveillance (standard arm B). Primary end points were RFS and HRQOL., Results: Between July 2009 and February 2014, 196 patients were included. Baseline characteristics were balanced between the two arms. After a median follow-up of 46.5 months (95% CI, 42.6 to 49.3 months), 126 RFS events and 82 deaths were recorded. There was no significant difference in RFS between the two arms (median, 30.4 months in arm A v 18.5 months in arm B; hazard ratio [HR], 0.88; 95% CI, 0.62 to 1.25; P = .48). There was no difference in time to definitive deterioration of global HRQOL (median, 31.8 months in arm A v 32.1 months in arm B; HR, 1.28; 95% CI, 0.73 to 2.26; log-rank P = .39). Overall survival was not different (median, 75.8 months in arm A v 50.8 months in arm B; HR, 1.08; 95% CI, 0.70 to 1.66; log-rank P = .74). Maximal adverse events were grade 3 in 62% (arm A) versus 18% (arm B) and grade 4 in 11% versus 3% ( P < .001)., Conclusion: There was no benefit of adjuvant GEMOX in resected BTC despite adequate tolerance and delivery of the regimen.- Published
- 2019
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83. Landscape and climatic characteristics associated with human alveolar echinococcosis in France, 1982 to 2007.
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Piarroux M, Gaudart J, Bresson-Hadni S, Bardonnet K, Faucher B, Grenouillet F, Knapp J, Dumortier J, Watelet J, Gerard A, Beytout J, Abergel A, Wallon M, Vuitton DA, and Piarroux R
- Subjects
- Animals, Case-Control Studies, Disease Outbreaks, Echinococcosis, Echinococcosis, Hepatic epidemiology, Foxes, France epidemiology, Humans, Incidence, Multivariate Analysis, Population Density, Residence Characteristics, Risk Factors, Seasons, Climate, Echinococcosis, Hepatic diagnosis, Echinococcus multilocularis isolation & purification, Geography
- Abstract
Human alveolar echinococcosis (AE) is a severe hepatic disease caused by Echinococcus multilocularis. In France, the definitive and intermediate hosts of E. multilocularis (foxes and rodents, respectively) have a broader geographical distribution than that of human AE. In this two-part study, we describe the link between AE incidence in France between 1982 and 2007 and climatic and landscape characteristics. National-level analysis demonstrated a dramatic increase in AE risk in areas with very cold winters and high annual rainfall levels. Notably, 52% (207/401) of cases resided in French communes (smallest French administrative level) with a mountain climate. The mountain climate communes displayed a 133-fold (95% CI: 95-191) increase in AE risk compared with communes in which the majority of the population resides. A case-control study performed in the most affected areas confirmed the link between AE risk and climatic factors. This arm of the study also revealed that populations residing in forest or pasture areas were at high risk of developing AE. We therefore hypothesised that snow-covered ground may facilitate predators to track their prey, thus increasing E. multilocularis biomass in foxes. Such climatic and landscape conditions could lead to an increased risk of developing AE among humans residing in nearby areas.
- Published
- 2015
- Full Text
- View/download PDF
84. Populations at risk for alveolar echinococcosis, France.
- Author
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Piarroux M, Piarroux R, Knapp J, Bardonnet K, Dumortier J, Watelet J, Gerard A, Beytout J, Abergel A, Bresson-Hadni S, and Gaudart J
- Subjects
- Adult, Albendazole therapeutic use, Animals, Anthelmintics therapeutic use, Echinococcosis, Echinococcosis, Hepatic drug therapy, Echinococcosis, Hepatic parasitology, Echinococcosis, Hepatic transmission, Echinococcus multilocularis drug effects, Female, Foxes parasitology, France epidemiology, Humans, Liver drug effects, Liver parasitology, Male, Mebendazole therapeutic use, Middle Aged, Retrospective Studies, Risk Factors, Rural Population, Socioeconomic Factors, Echinococcosis, Hepatic epidemiology, Echinococcus multilocularis physiology, Endemic Diseases, Registries
- Abstract
During 1982-2007, alveolar echinococcosis (AE) was diagnosed in 407 patients in France, a country previously known to register half of all European patients. To better define high-risk groups in France, we conducted a national registry-based study to identify areas where persons were at risk and spatial clusters of cases. We interviewed 180 AE patients about their way of life and compared responses to those of 517 controls. We found that almost all AE patients lived in 22 départements in eastern and central France (relative risk 78.63, 95% CI 52.84-117.02). Classification and regression tree analysis showed that the main risk factor was living in AE-endemic areas. There, most at-risk populations lived in rural settings (odds ratio [OR] 66.67, 95% CI 6.21-464.51 for farmers and OR 6.98, 95% CI 2.88-18.25 for other persons) or gardened in nonrural settings (OR 4.30, 95% CI 1.82-10.91). These findings can help sensitization campaigns focus on specific groups.
- Published
- 2013
- Full Text
- View/download PDF
85. Clinical features and evolution of alveolar echinococcosis in France from 1982 to 2007: results of a survey in 387 patients.
- Author
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Piarroux M, Piarroux R, Giorgi R, Knapp J, Bardonnet K, Sudre B, Watelet J, Dumortier J, Gérard A, Beytout J, Abergel A, Mantion G, Vuitton DA, and Bresson-Hadni S
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Animals, Anthelmintics therapeutic use, Benzimidazoles therapeutic use, Echinococcosis, Hepatic parasitology, Echinococcosis, Hepatic therapy, Female, France epidemiology, Humans, Incidence, Liver Transplantation, Male, Middle Aged, Prognosis, Prospective Studies, Retrospective Studies, Severity of Illness Index, Surveys and Questionnaires, Young Adult, Echinococcosis, Hepatic diagnosis, Echinococcosis, Hepatic epidemiology, Echinococcus multilocularis
- Abstract
Background & Aims: Alveolar echinococcosis (AE) is a rare disease in humans, caused by the larval stage of the fox tapeworm Echinococcus multilocularis., Methods: We present here 387 detailed AE cases diagnosed in France from 1982 to 2007 actively identified by a retrospective survey performed in 1997-1998 and prospectively thereafter., Results: Male:female ratio was 1.03 and mean age 57.8 years at time of diagnosis. Among the 362 complete files (including 347 non dead-out and 15 dead-out lesions), 73% of the patients were symptomatic at first admittance. Among them, 83% presented with clinical patterns evocative either of a digestive or a hepatic disorder. Other symptomatic patients presented with erratic clinical pictures, generally due to metastasis or extra-hepatic location of the parasite. Except for a few patients with particularly severe AE who died shortly after the diagnosis, most patients were treated using benzimidazoles. Their mortality tends to merge with that of the general French population, matched by sex, age, and calendar year. This study also highlights an unexpectedly high frequency of blood-tied family cases (13% of patients submitted to a specific questionnaire)., Conclusions: Even though the broad set of clinical features provoked by E. multilocularis makes AE a potential diagnostic trap for many physicians, our study revealed an improvement of its prognosis. However, as shown by our findings about the frequency of family cases, there is still a need for studies aimed at better describing this uncommon parasitic disease., (Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
86. [Liver and sport].
- Author
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Watelet J
- Subjects
- Acute Disease, Chronic Disease, Humans, Liver Diseases etiology, Sports
- Abstract
The liver is a vital organ and plays a central role in energy exchange, protein synthesis as well as the elimination of waste products from the body. Acute and chronic injury may disturb a variety of liver functions to different degrees. Over the last three decades, the effects of physical activity and competitive sport on the liver have been described by various investigators. These include viral hepatitis and drug-induced liver disorders. Herein, we review acute and chronic liver diseases potentially caused by sport. Team physicians, trainers and others, responsible for the health of athletes, should be familiar with the risk factors, clinical features, and consequences of liver diseases that occur in sports.
- Published
- 2008
- Full Text
- View/download PDF
87. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization.
- Author
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Blondiaux E, Miquel J, Thomas P, Laloum D, Watelet J, and Dacher JN
- Subjects
- Aortic Aneurysm, Abdominal etiology, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis Implantation, Calcinosis diagnosis, Calcinosis etiology, Calcinosis surgery, Catheterization, Peripheral adverse effects, Child, Contrast Media, Humans, Male, Tomography, Spiral Computed, Ultrasonography, Doppler, Color, Umbilical Arteries, Aortic Aneurysm, Abdominal diagnosis
- Abstract
We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment.
- Published
- 2008
- Full Text
- View/download PDF
88. Toxicity of chronic paracetamol ingestion.
- Author
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Watelet J, Laurent V, Bressenot A, Bronowicki JP, Larrey D, and Peyrin-Biroulet L
- Subjects
- Humans, Male, Middle Aged, Acetaminophen toxicity, Analgesics, Non-Narcotic toxicity, Liver Cirrhosis chemically induced
- Published
- 2007
- Full Text
- View/download PDF
89. Popliteal aneurysms.
- Author
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Watelet J
- Subjects
- Aneurysm diagnosis, Aneurysm etiology, Aneurysm physiopathology, Blood Vessel Prosthesis Implantation, History, 18th Century, History, 19th Century, History, 20th Century, Humans, Popliteal Artery pathology, Popliteal Artery physiopathology, Saphenous Vein transplantation, Treatment Outcome, Vascular Patency, Aneurysm surgery, Popliteal Artery surgery, Vascular Surgical Procedures adverse effects, Vascular Surgical Procedures history
- Published
- 2007
90. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis.
- Author
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Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP, Larrue V, Lièvre M, Leys D, Bonneville JF, Watelet J, Pruvo JP, Albucher JF, Viguier A, Piquet P, Garnier P, Viader F, Touzé E, Giroud M, Hosseini H, Pillet JC, Favrole P, Neau JP, and Ducrocq X
- Subjects
- Aged, Angioplasty, Carotid Stenosis mortality, Carotid Stenosis surgery, Female, Follow-Up Studies, Humans, Incidence, Male, Myocardial Infarction epidemiology, Risk, Stroke epidemiology, Stroke mortality, Treatment Outcome, Carotid Stenosis therapy, Endarterectomy, Carotid adverse effects, Stents adverse effects
- Abstract
Background: Carotid stenting is less invasive than endarterectomy, but it is unclear whether it is as safe in patients with symptomatic carotid-artery stenosis., Methods: We conducted a multicenter, randomized, noninferiority trial to compare stenting with endarterectomy in patients with a symptomatic carotid stenosis of at least 60%. The primary end point was the incidence of any stroke or death within 30 days after treatment., Results: The trial was stopped prematurely after the inclusion of 527 patients for reasons of both safety and futility. The 30-day incidence of any stroke or death was 3.9% after endarterectomy (95% confidence interval [CI], 2.0 to 7.2) and 9.6% after stenting (95% CI, 6.4 to 14.0); the relative risk of any stroke or death after stenting as compared with endarterectomy was 2.5 (95% CI, 1.2 to 5.1). The 30-day incidence of disabling stroke or death was 1.5% after endarterectomy (95% CI, 0.5 to 4.2) and 3.4% after stenting (95% CI, 1.7 to 6.7); the relative risk was 2.2 (95% CI, 0.7 to 7.2). At 6 months, the incidence of any stroke or death was 6.1% after endarterectomy and 11.7% after stenting (P=0.02). There were more major local complications after stenting and more systemic complications (mainly pulmonary) after endarterectomy, but the differences were not significant. Cranial-nerve injury was more common after endarterectomy than after stenting., Conclusions: In this study of patients with symptomatic carotid stenosis of 60% or more, the rates of death and stroke at 1 and 6 months were lower with endarterectomy than with stenting. (ClinicalTrials.gov number, NCT00190398 [ClinicalTrials.gov].)., (Copyright 2006 Massachusetts Medical Society.)
- Published
- 2006
- Full Text
- View/download PDF
91. Percutaneous repair of aortic aneurysms: a prospective study of suture-mediated closure devices.
- Author
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Watelet J, Gallot JC, Thomas P, Douvrin F, and Plissonnier D
- Subjects
- Adult, Aged, Aged, 80 and over, Dilatation, Feasibility Studies, Female, Humans, Male, Middle Aged, Needles, Prospective Studies, Sutures, Aortic Aneurysm, Abdominal surgery, Aortic Aneurysm, Thoracic surgery, Blood Vessel Prosthesis Implantation instrumentation
- Abstract
Purpose: To evaluate prospectively the safety and efficacy of totally percutaneous placement of abdominal and thoracic aortic endografts using the Prostar XL suture-mediated closure system., Methods: From January 2002 to January 2005, we attempted to insert percutaneously all bifurcated abdominal aortic and thoracic endografts. Consecutive patients (25 men, four women), with mean age 74.9 years (range 44-84), underwent endovascular repair for 20 abdominal aortic aneurysms (AAA) and nine thoracic aortic aneurysms (repeat operation in one case). Endografts used included 21 Zenith (Cook), eight Talent (Medtronic), one AneuRx (Medtronic). For the <
> technique, two Prostar XL 8F were used to close 22-24F access sites and one Prostar XL 10F to close 16F access sites., Results: Procedural success was achieved in 21/29 (72.4%) patients and in 39/47 access sites (83%). Closure of 22-24F access sites with tandem 8F Prostar devices was successful in 23/29 (79.3%) cases. Closure of 16F access sites with 10F Prostar device was successful in 16/18 (88.8%) cases. There were seven peri-procedural failures requiring surgery to repair the femoral artery in three cases. Four access complications healed without intervention. Overall 25/29 (86.2%) patients had complete percutaneous repair. No late complications were detected during follow-up (median 17.5 months)., Conclusions: Percutaneous treatment of patients with AAA and thoracic aneurysms is feasible in most cases, with a very low risk of access-related complication, providing that the operator has sufficient practical experience of this technique. - Published
- 2006
- Full Text
- View/download PDF
92. [Infectious or inflammatory aortitis? One case report].
- Author
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Benhamou Y, Plissonnier D, Cailleux N, Pons JL, Richard C, Watelet J, Marie I, and Lévesque H
- Subjects
- Adrenal Cortex Hormones therapeutic use, Aged, Aortic Dissection complications, Aortic Dissection diagnostic imaging, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Aortic Aneurysm, Abdominal complications, Aortic Aneurysm, Abdominal diagnostic imaging, Aortic Aneurysm, Abdominal surgery, Aortitis complications, Aortitis microbiology, Ceftriaxone administration & dosage, Ceftriaxone therapeutic use, Drug Therapy, Combination, Emergencies, Female, Follow-Up Studies, Gentamicins administration & dosage, Gentamicins therapeutic use, Humans, Ofloxacin administration & dosage, Ofloxacin therapeutic use, Pneumococcal Infections drug therapy, Streptococcus pneumoniae isolation & purification, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Aortitis drug therapy
- Abstract
Introduction: The infectious or inflammatory nature of an aortitis is difficult to assert because the microbiological results are often negative. The development of an aneurysm under treatment is rare, but requires a change in the therapeutic strategy and the etiologic diagnosis needs to be discussed again., Exegesis: We report the case of a 69-year-old woman treated by corticotherapy for an aortitis thought to be inflammatory, who required emergency surgery when a dissected aneurysm appeared. The peroperative samples were positive to Streptococcus pneumoniae using polymerase chain reaction and allowed a change of the diagnosis. The patient evolved favorably under antibiotic therapy., Conclusion: The decision to treat an aortitis by corticotherapy must be made with caution even if the microbiological tests are negative.
- Published
- 2006
- Full Text
- View/download PDF
93. [Address by the President of the congress].
- Author
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Watelet J
- Subjects
- France, Humans, Pathology, Vascular Diseases pathology
- Published
- 2006
- Full Text
- View/download PDF
94. [Hepatitis A acquired from an asymptomatic adopted child].
- Author
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Peyrin-Biroulet L, Donnais A, Barraud H, Darfeuil F, Watelet J, Hudziak H, Bronowicki JP, Bigard MA, and Chone L
- Subjects
- Acute Disease, Adult, Ethiopia, Female, Hepatitis A diagnosis, Humans, Immunoglobulin M blood, Infant, Male, Serologic Tests, Adoption, Hepatitis A transmission
- Abstract
We report the case of acute hepatitis in a 36-year-old woman that was acquired from an adopted African child with asymptomatic active infection. At present, most experts do not screen for hepatitis A. However, adoptive parents should be vaccinated against hepatitis A because of the risk of unrecognized active infection in adopted children from countries in which infection is endemic.
- Published
- 2006
- Full Text
- View/download PDF
95. [Gastrointestinal and liver disorders in athletes].
- Author
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Watelet J and Bigard MA
- Subjects
- Anemia etiology, Digestive System Physiological Phenomena, Gastrointestinal Hemorrhage, Heat Stroke, Humans, Risk Factors, Gastrointestinal Diseases etiology, Liver Diseases etiology, Sports
- Published
- 2005
- Full Text
- View/download PDF
96. Regarding "Use of abdominal aortic endovascular prostheses in France from 1999 to 2001".
- Author
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Becquemin JP, Sapoval M, Beregi JP, Favre JP, Rousseau H, and Watelet J
- Subjects
- Humans, Angioplasty statistics & numerical data, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis statistics & numerical data, Blood Vessel Prosthesis Implantation statistics & numerical data, Guideline Adherence statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data
- Published
- 2004
- Full Text
- View/download PDF
97. [Hepatotoxicity associated with herbal remedies: clinical, biological, histological data and the mechanisms involved in some typical examples].
- Author
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Peyrin-Biroulet L, Barraud H, Petit-Laurent F, Ancel D, Watelet J, Chone L, Hudziak H, Bigard MA, and Bronowicki JP
- Subjects
- Humans, Liver drug effects, Plant Preparations pharmacokinetics, Chemical and Drug Induced Liver Injury, Herbal Medicine, Liver pathology, Phytotherapy adverse effects, Plant Preparations adverse effects
- Published
- 2004
- Full Text
- View/download PDF
98. Closure of carotid bifurcation endarterectomy using a polyurethane patch. A multicentre prospective study with 252 patients.
- Author
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Melki J, Perrier G, Kerdiles Y, Piquet P, Ribal JP, Ricco JB, Plissonnier D, and Watelet J
- Subjects
- Aged, Aged, 80 and over, Carotid Stenosis surgery, Female, Humans, Male, Middle Aged, Polyurethanes therapeutic use, Prospective Studies, Endarterectomy, Carotid methods
- Abstract
Background: In order to evaluate the results of carotid endarterectomy with closure using a polyurethane patch, a multicentre prospective study of 252 patients (263 interventions) undergoing this operation was performed between November 1996 and August 2001., Methods: One hundred and seventy-one men and 81 women with a mean age of 70 years were studied. Fifty-five percent of the patients had neurological symptoms. The degree of carotid stenosis evaluated using the European carotid surgery trialist's collaborative group (ECST) criteria was greater than or equal to 70% in 95% of cases., Results: The combined mortality-morbidity operation rate (CMMR) was 2% (1 death from cerebrovascular haemorrhage on Day 3, 1 non-regressive cerebrovascular accident (CVA), 3 regressive CVAs). The patients had follow-up clinical examinations and Doppler ultrasound scans for 2 years. Fifteen patients died during follow-up, 8 of these patients died from heart-related causes and 2 patients died from CVA. Four patients presented with CVAs ipsilateral or contralateral to the endarterectomy. Two false aseptic aneurysms and 1 false septic aneurysm required further surgery. Three asymptomatic carotid occlusions occurred during follow-up. The rate of restenosis greater than 50% was 1.2% at 6 months, 2.3% at 1 year and 5.3% at 2 years., Conclusions: These results confirm the value of po-lyurethane patch closure of carotid endarterectomy.
- Published
- 2002
99. The validity of unplanned returns to the operating room as an indicator of quality of hospital care.
- Author
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Ladner J, Torre JP, Watelet J, and Czernichow P
- Subjects
- Diagnosis-Related Groups, Humans, Reoperation, Vascular Surgical Procedures standards, Postoperative Complications surgery, Quality Indicators, Health Care, Surgical Procedures, Operative standards
- Published
- 2002
- Full Text
- View/download PDF
100. Lower limb giant cell arteritis and temporal arteritis: followup of 8 cases.
- Author
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Le Hello C, Lévesque H, Jeanton M, Cailleux N, Galateau F, Peillon C, Veyssier P, Watelet J, Letellier P, Courtois H, and Maïza D
- Subjects
- Adult, Angiography, Biopsy, Female, Follow-Up Studies, Humans, Leg blood supply, Male, Middle Aged, Femoral Artery pathology, Giant Cell Arteritis pathology
- Abstract
Among 8 patients with giant cell arteritis (GCA) (6 women, 2 men) whose clinical presentations were compatible with temporal arteritis (TA), 6 were followed for 37-105 (mean 74.9) months, one died shortly after treatment onset, and the last was asymptomatic (10 mg steroids/day) when lost to followup at 29 months. All 8 patients had bilateral leg claudication of recent onset; for 6 patients, this was the first symptom. All leg angiograms showed multiple, bilateral, long and smooth stenoses, thromboses, or both. Biopsies of diseased leg arteries from 4 patients provided histological proof of GCA; another case was histologically proven post mortem. Among the 5 patients who met at least 3 American College of Rheumatology criteria of GCA or TA, 3 without histologically documented leg GCA also had biopsy proven temporal GCA (n = 1), or headaches and claudication and angiographic inflammatory arteritis of the arms (n = 2). All patients received steroids; 3 had bypasses, one with endarterectomy. Five are asymptomatic after 24-100 months of steroids (mean 50.6). Revascularization was not successful; one amputation was necessary. Large artery involvement in GCA can affect the legs. Bilateral and rapidly progressive intermittent claudication of recent onset is the most common symptom, even in the absence of headaches or the presence of a silent inflammatory syndrome. Early diagnosis allows rapid initiation of steroid therapy, which is usually able to generate a sufficiently good response to avoid vascular surgery.
- Published
- 2001
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