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C Gosselin

Publications and source records attributed to C Gosselin.

76 records · Page 5Linked to original sources
PubMedDate not supplied

New frontiers of vascular grafting.

Vascular grafting can be a very rewarding surgical technique: following surgery, most patients will maintain their autonomy and, in many cases, will be able to return to work. Should small diameter calibre substitutes be required, the autologous saphenous vein is the gold standard. If not available, the expanded PTFE is probably the best choice. For medium and large diameters, the polyesters (Dacron) are recommended provided they have a structure adapted to the needs of patients. However, progress in the last few years is not related to improvements in the grafts themselves. The only breakthrough has come with the success of graft seeding. This is the reason why other approaches have been proposed to restore or improve blood flow in atherosclerotic arteries: medication, sympathectomy, dilatation, laser endarterectomy, stent and spinal cord stimulation. All those approaches have more and more precise indications: they can supplement vascular grafting.

Arterial Occlusive Diseases↗
PubMedDate not supplied

[On preclotting of woven Dacron vascular prostheses (author's transl)].

The role and the clinical value of common protocols of preclotting for a woven Dacron vascular prosthesis have been investigated. A comparative study of blood loss was carried out for Standard Woven De Bakey protheses inserted in a specially constructed extracorporeal blood circuit with canine models. The system detected transport of blood across the wall of the prostheses. These measurements were supplemented by gravimetric assessment of blood clot density and scanning electronmicroscopy examination of the internal surfaces of the prostheses. The pre-operative protocols investigated included : absence of pre-treatment, precoagulation with anticoagulant-free blood and various techniques using heparinized blood subsequent to an initial blood contact (modified method of Sauvage). The effect of using heparinized animals was also investigated. Leakages in unclotted prostheses could be reduced almost five fold by any precoagulation technique. Heparinization did not cause a significant increase in leakage and considerably improved the quality of the newly deposited blood product lining on the prostheses which consisted almost entirely of fibrin and eliminated any embolization.

Animals↗
PubMedDate not supplied

[Glutaraldehyde - fixed human umbilical cord vein as a small diameter arterial substitute. Experimentation on the monkey].

Autologous saphenous veins, the preferred substitute material for aorto-coronary, femoro-popliteal and femoro-tibial by-pass, are usable in only 70% of individuals in need of such procedures. The development of small diameter substitute arteries is therefore essential to broaden the pool of patients who could benefit from this class of cardiovascular surgery. Existing substitutes, however, present major difficulties and have had limited success. In this laboratory, an attempt has been made to develop a vessel of 3 millimetres or less in diameter derived from human umbilical cord processed in glutaraldehyde. This substitute can be stored in 45% ethanol or dessicated by critical point drying. This device had been implanted as a segment of abdominal aorta in eight primates (Macaca fascicularis). Preliminary results are disappointing. The indicate that retention of a patency for more than a year post-implantation is difficultly achievable and that connective tissue hyperplasia leading to occlusion at the anastomoses is a major problem. Similar but larger diameter by-passes in the order of 6-8 millimetres should be investigated in greater detail, in order to better establish the "in-vivo" behavior of this class of tissue prosthesis. This would address the more fundamental issues pertaining to the clinical usefulness of fixed biological tissue by-pass devices.

Animals↗