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10. Femorofemoral Bypass

Author

Nazzal, Munier M. S., Hoballah, Jamal J., editor, Scott-Conner, Carol E. H., editor, and Chong, Hui Sen, editor

Published
2017
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11. Iliofemoral Bypass

Author

Nazzal, Munier M. S., Hoballah, Jamal J., editor, Scott-Conner, Carol E. H., editor, and Chong, Hui Sen, editor

Published
2017
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29. Synthèse et évaluation biologique de dérivés halogénés du Bisphénol A

Author

Doumas, M., primary, Dupuis, A., additional, Albouy-Llaty, M., additional, Venisse, N., additional, Pierre Eugene, P., additional, Munier, M., additional, Sibilia, P., additional, Rodien, P., additional, Deceuninck, Y., additional, Bichon, E., additional, Veyrand, B., additional, Marchand, P., additional, Le Bizec, B., additional, Migeot, V., additional, and Carato, P., additional

Published
2020
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37. Is color duplex surveillance of infrainguinal polytetrafluoroethylene grafts worthwhile?

Author

Hoballah, Jamal J., Nazzal, Munier M., Ryan, Stephen M., Martinasevic, Mario, Jacobovicz, Claudio, Rossley, Nancy, Blecha, Beth, Sharp, William J., Kresowik, Timothy F., and Corson, John D.

Subjects
Arterial occlusions, Graft occlusion, Vascular -- Identification and classification, Duplex ultrasonography -- Evaluation, Health
Abstract

BACKGROUND: Unlike vein bypasses, the role of duplex surveillance of infrainguinal prosthetic bypass grafts is controversial. The purpose of this study was to evaluate the adequacy of color duplex surveillance in identifying failing infrainguinal polytetrafluoroethylene (PTFE) bypass grafts and to assess its value in predicting continued bypass patency. METHOD: The surveillance data of primarily patent PTFE bypass grafts were compared with those of revised/occluded PTFE grafts. Ninety-five patients underwent 102 infrainguinal PTFE bypass grafts from January 1991 to December 1996 and were enrolled in a duplex surveillance program at 1 month postoperatively, every 3 months in the first year, every 6 months in the second year, and yearly thereafter. RESULTS: Seventy grafts remained primarily patent, 5 were revised and 27 occluded. There was no significant difference in the mean age, gender, indication for surgery, type of original procedure, or duration of follow-up between both groups. Four hundred and seven duplex surveillance data were available for analysis. Focal increase in peak systolic velocity (PSV) 3 x the adjacent segment or low flow manifested by PSV [is less than] 45 cm/see were considered abnormal. In the primarily patent group, 5 bypasses had abnormal duplex surveillance and were found to have no abnormality on angiogram and remained patent during the study period. In the revised/occluded group, duplex surveillance was abnormal in 8 bypasses. Twenty-four bypasses occluded without any predicting abnormalities on their last duplex examination, which was performed within 3 months from the occlusion in the majority of the patients. In the 27 occluded bypasses, no intervention was necessary following the occlusion in 7 grafts because of mild or no symptoms. Two patients were treated with a primary amputation and 2 had new bypasses. In 16 occluded grafts, salvage of the PTFE bypass was attempted. Ten of these grafts were patent at the end of the follow-up. The sensitivity of duplex surveillance was 25% with a positive predictive value of 61.5%. CONCLUSION: Duplex surveillance of infrainguinal PTFE bypass grafts has a low yield and is inadequate at predicting continued bypass patency. Am J Surg. 1997;174:131-135. [C] 1997 by Excerpta Medica, Inc.

Published
1997

47. Balloon tibioplasty for reduction of depressed tibial plateau fractures: Preliminary radiographic and clinical results

Author

Ollivier, M, Turati, M, Munier, M, Lunebourg, A, Argenson, J, Parratte, S, Parratte, S., TURATI, MARCO, Ollivier, M, Turati, M, Munier, M, Lunebourg, A, Argenson, J, Parratte, S, Parratte, S., and TURATI, MARCO

Abstract

Purpose: In vitro studies have shown promising results for balloon-guided inflation tibioplasty. It was our hypothesis that this technique may be safe and effective for use in depressed lateral tibial plateau fracture. Methods: We performed a prospective study of all patients suffering from a depressed lateral tibial plateau fracture, managed in our institution with inflation tibioplasty and a resorbable calcium phosphate bone substitute injection, between January 2012 and December 2013. Twenty patients, mean age 54.3 ± 12. 8 years, suffering from a depressed lateral tibial plateau fracture (Schatzker type II and III) were included. We then aimed to evaluate at a minimum follow-up of one year: (1) the rate of complications, (2) the clinical outcome (Knee Injury and Osteoarthritis Outcome (KOO) and 12-Item Short Form Health Survey (SF-12) scores); and (3) the radiographic outcome (evaluated by CT-scan). Results: No peri-operative complications occurred. In one patient, calcium phosphate substitute was found in the infrapatellar fat pad on post-operative radiography with no clinical or radiographic consequences at one year. At one year after surgery, the KOO subscores were: Pain 80 (range 64—93), other symptoms 81.3 (69–93), daily living activities 81.9 (46–99), sport 65.83 (20–100), and quality of life 67.04 (31–100). The SF-12 activity component was 40.4 (28.6—52.2) and SF-12 mental component 47.71 (28 – 67.1). The mean depressed step-off of the lateral joint decreased from 10.7 ± 4.8 mm pre-operatively to 2.7 ± 1.7 mm post-operatively (p < 0.0001). Conclusion: Our observations suggest that the use of balloon-guided inflation tibioplasty with injection of a resorbable bone substitute is safe, and results in a high rate of anatomic reduction and good clinical outcomes in patients with depressed tibial plateau fractures. Level of Evidence: Therapeutic Level IV.

Published
2016

50. A Comparative Evaluation of Femorofemoral Crossover Bypass and Iliofemoral Bypass for Unilateral Iliac Artery Occlusive Disease

Author

Claudio Jacobovicz, Mario Martinasevic, Jamal J. Hoballah, Stephen M. Ryan, John D. Corson, Chittur R. Mohan, Timothy F. Kresowik, William J. Sharp, and Munier M. Nazzal

Subjects
Male, medicine.medical_treatment, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Life Tables, 030212 general & internal medicine, Ultrasonography, Doppler, Color, Polytetrafluoroethylene, Aged, 80 and over, Gangrene, Ultrasonography, Doppler, Duplex, Incidence, Middle Aged, Femoral Artery, Survival Rate, Evaluation Studies as Topic, Anesthesia, Female, Cardiology and Cardiovascular Medicine, Adult, Reoperation, medicine.medical_specialty, Adolescent, Arterial Occlusive Diseases, Revascularization, Iliac Artery, Transplantation, Autologous, Veins, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, Blood vessel prosthesis, medicine, Humans, Vascular Patency, Derivation, Survival rate, Aged, Retrospective Studies, Leg, Chi-Square Distribution, business.industry, Perioperative, medicine.disease, Blood Vessel Prosthesis, Surgery, Transplantation, Regional Blood Flow, business, Follow-Up Studies
Abstract

The purpose of this study was to compare the results of extra-anatomic femorofemoral crossover bypass grafting to the anatomic iliofemoral bypass grafting procedure in the treatment of patients with unilateral iliac artery occlusive disease with respect to patency and limb salvage. The records of all patients with unilateral iliac artery disease who underwent revas cularization between January 1988 and December 1995 at the University of Iowa Hospitals and Clinics (UIHC) were retrospectively reviewed; 108 patients were identified and divided into two groups. Group I (n=68; male/female=44/24) was composed of all patients who underwent a femorofemoral crossover extra-anatomic bypass. All patients who underwent an iliofemoral anatomic bypass constituted group II (n=40; male/female=24/16). The mean age for group I was 60 years (range 28-87) and for group II, 54 years (range 14-86). The medical risk factors between both groups were comparable. Except for the higher incidence of gangrene in group II the indications for surgery were comparable between both groups. (continued on next page) A polytetrafluoroethylene graft was used in 88% of group I patients and in 90% of group II patients (NS). In the remaining patients, an autogenous vein conduit was used. Two patients from group I (2.9%) died in the perioperative period (NS). Graft patency was assessed by clinical evaluation, Doppler-derived ankle/brachial indices, and color duplex imaging. The cumulative primary and secondary patency rates, limb salvage, and patient survival were calculated by use of life table analysis (SE These data suggest that there is no significant difference in the long-term results between the femorofemoral crossover bypass grafts and iliofemoral grafts. Both procedures result in acceptable patency and limb salvage rates. The femorofemoral bypass is, however, more attractive, for it can be performed under local anesthesia if needed and does not involve the creation of the retroperitoneal incision necessary with the iliofemoral bypass.

Published
1998
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