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J P Becquemin

Publications and source records attributed to J P Becquemin.

At least 19 recordsLinked to original sources
PubMed2005

Elective popliteal aneurysms: does venous availability has an impact on indications?

AIM: The aim of this retrospective study was to evaluate the patency and limb salvage rates after prosthetics or venous bypasses for asymptomatic or mildly symptomatic popliteal aneurysms, in order to determine if small uncomplicated aneurysms (caliber <300%) should be operated or periodically controlled when a venous conduit is not available. METHODS: During a 18 years period, 100 popliteal aneurysms, including 85 asymptomatic and 15 associated with intermittent claudication, were operated on: group I consisted of 80 venous bypasses, and group II consisted of 20 prosthetic bypasses. RESULTS: Demographics and risks factors were similar in both groups. Local complications were more frequent in group I (17% vs 10% p=NS). Early vascular complications were rare in both groups. Late arterial complications were more frequent in group II. Primary patency, assisted primary patency, and secondary patency rates at 2 years were 94.3%, 97.3% and 98.7% in group I, and 61.5%, 89% and 88.4% in group II (p<0.05). In contrast, the limbs salvage rates were not significantly different for each type of graft (98.7% vs 100% p=NS). CONCLUSIONS: Our data shows that aneurysms treated with a prosthetic graft are at higher risk of late occlusion than those operated with a vein graft. This should be taken into account when facing a small uncomplicated aneurysm without available venous conduit. The presence of a suitable vein should be checked before deciding to operate a small uncomplicated popliteal aneurysm.

Aged↗
PubMed2005

Endovascular repair for ruptured AAA: a literature review.

The reduced physiological impact of endovascular aneurysm repair (EVAR) compared with conventional open repair has been demonstrated. If this technique could be used routinely in patients with ruptured abdominal aortic aneurysm (AAA) it may reduce the high peri-operative mortality. This review of the literature identified the current experience with EVAR of ruptured AAA. Only a small number of case series with selected patients are reported. These patients were selected for their haemodynamic stability, and their suitable aneurysm morphology. The overall anatomic suitability rates for EVAR reported, suggest an applicability of 58% to 80% from an intent-to-treat experience. The average post-operative mortality rate was 24%, ranging from 9 to 45% and may reflect increasing experience and patient selection. Important lessons have been learned from these first experiences that help to define a clear position of EVAR as an additional therapeutic option for ruptured AAA.

Aneurysm, Ruptured↗
PubMed2004

Robotically assisted aorto-femoral bypass grafting: lessons learned from our initial experience.

OBJECTIVE: The da Vinci trade mark Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) is a computer-enhanced telemanipulator that may help to overcome some limitations of traditional laparoscopic instruments. This prospective study was performed to assess the safety and feasibility of robotically assisted aorto-femoral bypass grafting (AF). METHODS: Five patients undergoing elective AF were enrolled in this study. In three patients, a laparotomy of 6 cm was first performed, the aorta being exposed using an Omnitract degrees retractor. In two patients, aortic dissection was performed with laparoscopy, with the patient in a modified right lateral decubitus position. In all patients, the proximal anastomosis was attempted with the da Vinci trade mark system by a remote surgeon. The role of the assistant at the patient's side was limited to exposure, haemostasis and maintaining traction on the running sutures performed by the robot. Six weeks after the operation, all patients underwent a duplex scan of the graft. RESULTS: Mean operative time was 188 min. Robotically assisted aortic anastomoses were successfully completed in four out of five patients. In these four patients, adequate blood flow was observed within the graft with no need for conversion for haemostasis. In the fifth patient, despite an adequate laparoscopic aortic dissection, the anastomosis was impossible to perform due to external conflicts between the robotic arms. A conversion using conventional suture was successfully performed. No robot-related complications were noted. Six weeks after the operation, the duplex scans demonstrated a graft patency of 100%. CONCLUSION: Robotically assisted anastomoses are possible by their unique ability to combine conventional laparoscopic surgery with stereoscopic 3D magnification and ultra-precise suturing techniques due to the flexibility of the robotic-wristed instruments using different motion scaling of surgeon hand movements. In addition, prior training in laparoscopic aortic surgery is not necessary for surgeons to obtain the level required for suturing. Further clinical trials are needed to explore the clinical potential and value of robotically assisted AF.

Anastomosis, Surgical↗
PubMed2004

Subintimal angioplasty: feasible and durable.

OBJECTIVE: To assess prospectively the feasibility and durability of subintimal angioplasty (SA) clinically and by duplex scans every 3 months. PATIENTS AND METHODS: Within a period of 54 months, we selected 96 patients with 100 occlusions (mean length: 11.5 cm) of femoro-popliteal or tibial arteries, for SA. RESULTS: The technical success rate was 88% and seven out of 12 failures were treated by conventional surgery. Five below-the-knee amputations were performed despite a patent recanalization. The following complications occurred: arterial perforation (6), arterial thrombosis (4), extensions beyond the planned re-entry site (5), and arterial dissection (2). Primary, assisted-primary and secondary patency rates were 61, 68 and 74%, respectively at 24 months. The 24 month-limb salvage and survival rates were 78 and 85%, respectively. Duplex imaging demonstrated 10 restenosis (five symptomatic >70%, five asymptomatic 30-70%), seven occlusions (five asymptomatic, two symptomatic treated by a bypass) and one asymptomatic dilatation. CONCLUSION: In a selected group of patients SA is feasible with a high initial technical success rate. SA is a good alternative in patients who are poor candidates for bypass surgery.

Adult↗
PubMed2004

Local endovascular treatment of aortic aneurysms. From operating theater to lab bench.

Current treatment of aortic abdominal aneurysms by conventional surgery or endoprosthesis is flawed by high post-operative mortality and unpredictable durability of haemodynamic exclusion, respectively. We have developed endovascular approaches with cell and gene transfer, aimed at controlling further diameter expansion in an animal model of already-developed aneurysms in rats. Preliminary results suggest that both cell and gene endovascular therapy can be used to control expansion of aneurysms generated by inflammation and proteolytic destruction of the aortic wall.

Animals↗
PubMed2003

[Development and repair of vessels from bone marrow stem cells in the adult: from biology to clinical practice].

In addition to its role in hematopoiesis, bone marrow appears to be a reservoir of stem cells that can differentiate into components of vessel wall. Upon stimulation by factors such as tissue ischemia, bone marrow stem cells can enter into circulating blood, and incorporate into areas of vascular development. Animal models suggest that bone marrow is a cellular source for tissue repair and/or regeneration. Data from humans, and clinical trials using bone marrow stem cells for the treatment of chronic ischemia in limbs and myocardium, support the view that stem cells may represent a new tool for the treatment of ischemia.

Adult↗
PubMed2002

[Acute pancreatitis after surgical treatment of abdominal aortic aneurysm].

INTRODUCTION: Acute pancreatitis after surgical treatment of non ruptured aneurysm of abdominal aorta is a rare complication, considered to be due to pancreatic ischemia or peroperative trauma of pancreas. The aim of this study is to describe 4 new cases of this complication and to discuss its etiology. PATIENTS AND METHODS: From January 1995 to November 2000, 365 patients underwent elective surgery for a non ruptured abdominal aorta aneurysm. Four (1.1%) men, aged 66 to 79 years and operated for an aneurysm which diameter ranged from 60 to 77 mm, developed postoperative acute pancreatitis. The abdominal approach was a midline incision in 3 cases and a retroperitoneal lombotomy in one case. Superior pole of the aneurysm always adjoined or involved the right renal artery. The aortic clamping was supra-renal in 3 cases and celiac in one case. Diagnosis of acute pancreatitis was established at days 2, 4, 12, and 23 after surgery on abdominal computed tomography in 3 cases and at reoperation in one case. RESULTS: Three patients died, including 2 from early multiple organ failure and one peroperatively during surgical attempt to treat a prostheto-digestive fistula. One patient was alive and asymptomatic with a 2-years follow-up. CONCLUSION: Acute pancreatitis is a rare and serious complication after surgical treatment of abdominal aorta aneurysm. Its diagnosis is often delayed. The main etiological factor of this complication could be trauma of pancreas during supra-renal clamping through a midline incision.

Acute Disease↗
PubMed2002

Late reoperations after surgical and endovascular lower limb revascularisation.

OBJECTIVES: to evaluate the rate of late reoperations after primary lower limb revascularisation. METHODS: a prospectively collected database of 639 consecutive patients, undergoing 763 primary arterial reconstruction for lower limb occlusive disease during the five-year period 1989 through 1993, was analysed with regard to the rates and locations of late (after 30 days) re-operation. The reconstruction was supra-inguinal in 527 (69%) cases, surgical in 391 (Group IA) and endovascular in 136 (Group IB). Infra-inguinal reconstruction had been performed in 236 (31%) cases, surgical in 160 (Group IIA) and endovascular in 76 (Group IIB). The 499 men and 140 women were followed during an average of 32 (range 1-122) months. RESULTS: the 5-year cumulative reoperation rates were 25% after supra-inguinal surgery and 28% after supra-inguinal angioplasty, respectively (NS). The rates were 47% and 33% after infra-inguinal surgery and angioplasty, respectively ( p=0.04). CONCLUSION: limbs treated for occlusive arterial disease carry a high risk of late reoperation whether the initial procedure is open surgery or angioplasty. Reoperations were twice as common for infra-inguinal procedures.

Actuarial Analysis↗
PubMed2002

[Feasibility of ambulatory endovenous laser for the treatment of greater saphenous varicose veins: one-month outcome in a series of 20 outpatients].

The purpose of this feasibility study was to demonstrate that endovenous laser can be a useful alternative to conventional surgery for ambulatory treatment of advanced varicose veins. We assessed an open, non-randomized series of patients treated in one center by the same operator. The study protocol was approved by the local ethics committee. Twenty patients with stage II or III varicose veins in the Porter classification gave their informed consent to participate in the study. The patients were treated with endovenous laser by the first author in the outpatient clinic of the Henri Mondor University Hospital vascular surgery department. All procedures were conducted under local anesthesia. A 980 nm laser diode optic fiber was introduced into the vein percutaneously. Laser beams were fired from the sapheno-femoral junction to just under the genu, withdrawing the fiber 3 mm every 1.5 sec. Clinical evaluation with a quality-of-life questionnaire and duplex-scan was performed at days 3, 8 and 30 post-op. Complete occlusion and retraction of the treated vein was observed at day 3 and 30, from the point of introduction to the sapheno-femoral junction in 18 of the 20 patients. The branches of the greater saphenous vein remained patent with physiological flow in the stump which remained patent 1 to 2 cm upstream from the sapheno-femoral junction. The length of the patent stump dependend on the level of the anterior or posterior branch. There were no adverse effects related to the local anesthesia. Pain was low to mild during treatment and the days following the procedure, requiring 8 tablets of acetominophen at most. Hematomas were minimal and had completely resolved by the end of the first month. No work stoppage was required for the 14 patients with occupational activities. There were no cases of deep or superficial vein thrombosis. Complete occlusion and retraction of the varicose vein at one month suggests this treatment has a long-lasting effect. Long-term evaluation is required. Treatment of advanced varicose veins with endovenous laser can be an alternative to surgical treatment providing the advantage of outpatient ambulatory treatment.

Ambulatory Surgical Procedures↗
PubMed2001

[Endoprostheses for aneurysms of the abdominal aorta. A technical innovation, a cultural revolution].

FACTS: A revolutionary technology has totally renovated the treatment of aneurysms of the abdominal aorta. Classical "dissection-graft" procedures require a wide abdominal incision with clamping and declamping times, and often major blood loss. Perioperative mortality varies from 3% to 7% depending on the team's experience and the presence of comorbidities. Complications occur in 30% of the patients; often benign they can be quite serious. As direct consequence of the development of peripheral stents, endoprostheses can now be introduced via the femoral route through a short inguinal incision. Operative trauma is considerably reduced, greatly shortening the recovery time. Mortality is low, of around 1%, and postoperative complications are much less frequent and much less severe. There is also a 3-fold reduction in the duration of the hospital stay. PREREQUISITES: All aneurysms cannot be treated with this method. The anatomy of the aneurysm and the iliac arteries is a determining factor. The iliac vessels must be large enough and devoid of important obstruction (kinks, atheromatous plaques) in order to access the aorta. The subrenal collar must measure at least 1 cm and be free of severe calcifications or thrombi. A rigorous preoperative exploration, using CT-scan with 3D reconstruction and graduated arteriography, is necessary. The length and diameter of the prosthesis is calculated from the results and must be perfectly adapted to avoid failure. UNKNOWNS: Long-term outcome remains unknown. The endoprosthesis excluded the aneurysm from the blood stream, depressurizing the aneurysmal sac. Endoprosthetic leakage can occur in case of defective application or by reflux from lumbar or inferior mesenteric arteries or due to leakage of the endoprosthesis itself. In such cases, the aneurysm can continue to progress. This explains the need for careful follow-up with duplex Doppler and/or CT-scan in treated patients. If the treatment is incomplete, complementary procedures may be necessary, often via an endovascular route or in some cases with conversion to conventional surgery. EVALUATIONS: Improved prosthetic design and durability is an important point. Randomized studies organized in France, as well as in England and Holland and the United States, are currently assessing the contribution of this new technique and its relative role compared with conventional surgery.

Aortic Aneurysm, Abdominal↗
PubMed2001

Percutaneous transluminal angioplasty in patients with ischemic tissue necrosis is worthwhile.

PURPOSE: Ischemic tissue necrosis is usually associated with long or sequential arterial obstructions. As a result, the role of percutaneous transluminal angioplasty (PTA), which addresses only short lesions, in patients presenting with trophic changes remains questionable. The purpose of this study was to evaluate the effectiveness of PTA in diabetic and non-diabetic patients presenting with grade 4 Fontaine's classification. METHOD: Between January 1992 and December 1997, 1352 patients with aorto-iliac and/or infrainguinal occlusive diseases were admitted to our institution. Three hundred and ten patients who presented with distal gangrene (95.5%) or ischemic ulcers (4.5%) were identified. The patients consisted of 117 diabetics and 193 non-diabetics. PTA alone was performed in 26 diabetics (group 1) and in 30 non-diabetics (group 2). Their charts were retrospectively reviewed and the patients were recalled for clinical examination and non-invasive monitoring. RESULTS: Follow-up was available for all patients and ranged from 1 to 4 years. The survival rate was significantly higher in diabetic patients than in non-diabetic patients (96% vs 77% at 1 year; p<0.05 and 91% vs 66% at 3 years; p<0.05). In group 1, the primary cumulative patency rate at 1 and 3 years was 76%. In group 2, the primary cumulative patency rate at 1 and 3 years were 85% and 80%, respectively. Three patients in group 1 required a redo PTA at 4 months, resulting in an assisted primary patency rate at 1 and 3 years of 88%. In contrast, no patients in group 2 required additional PTA. In group 1, the limb salvage rate at 1 and 3 years was 84%; and in group 2, 80% and 75%, respectively. CONCLUSION: The results of PTA in both groups were encouraging. Dilation of one or two short stenoses, despite multiple distal lesions, may improve distal flow sufficiently to promote wound healing. Thus, this procedure may be recommended in selected patients suffering from ischemic tissue loss. However, during the first 6 months following PTA, diabetic patients should be followed carefully with Duplex as they are prone to early restenosis.

Aged↗
PubMed2001

Follow-up evaluation of endoluminally treated abdominal aortic aneurysms with duplex ultrasonography: validation with computed tomography.

OBJECTIVE: A growing number of patients with abdominal aortic aneurysms are currently being offered endoluminal treatment. However, the incidence of endoleaks, stenosis, and thrombosis is around 25% to 30%. As a result, a strict post procedure imaging surveillance protocol is necessary. The purpose of this study was to compare duplex ultrasonography (DU) and computed tomography (CT) for the follow-up of endoluminally treated aortic aneurysms. METHODS: A total of 89 patients were followed up with serial CT and DU at 1, 3, 6, 12, and 24 months after endoluminal treatment. Special attention was directed toward the presence of endoleaks and aneurysm diameter evolution. Preoperative CT and DU were also reviewed to assess aneurysm diameter correlation. RESULTS: With DU, 14 type I and 21 type II endoleaks were identified. In one case the DU did not visualize a type II endoleak present on CT, and CT did not confirm three type II leaks identified with DU. There was only one false positive for type I endoleak with DU. The sensitivity of DU was 96% with a specificity of 94%, when compared with CT. A linear regression analysis of the diameters obtained with DU and CT revealed a good correlation. However, variability was high, indicating poor agreement. Regarding diameter evolution, the range was identical in 45%, and the trend was similar in 73%. However, in 9% of the cases, DU showed a decrease in diameter, whereas CT showed a significant increase. CONCLUSION: DU is an accurate tool for the diagnosis of endoleaks, but is less valuable for diameter measurements, when compared with CT. Currently, DU is a useful tool, but CT remains a key part of the postoperative evaluation after endoluminal treatment of abdominal aortic aneurysms. At institutions where DU is used for follow-up, researchers should perform quality control studies to avoid potentially significant errors.

Aged↗
PubMed2001

Technical aspects and current results of carotid stenting.

PURPOSE: We reviewed our experience with carotid stenting (CS), focusing on technical evolution and results. METHODS: From September 1995 to February 2000, 77 patients with 83 internal (n = 68) and common carotid artery lesions (n = 15) were selected for CS. This patient population was categorized into three consecutive periods based on patient selection, material, and technical skills. For internal carotid artery lesions, period I included 11 patients treated by means of direct carotid puncture with balloon expandable stents; period II included 42 patients treated by means of a femoral approach with self-expandable stents; and period III included 15 patients in whom monorail system and cerebral protection devices were used. Common carotid artery lesions were treated by means of carotid puncture in five patients and by means of a femoral approach in 10 patients. In only two of the latter cases, cerebral protection devices were used. RESULTS: The overall immediate success rate, defined as successfully treated stenosis with no neurological events, was 89.7% for internal carotid artery lesions and 100% for common carotid artery lesions. All neurological events, which consisted of reversible events (4.4%), minor stroke (1.5%), and major stroke (2.9%), occurred during periods I and II. In periods I, II, and III, the rate of surgical conversion was 18%, 9.5%, and 0%, respectively, the rate of transient ischemic attack and reversible ischemic neurologic deficit was 0%, 7%, and 0%, respectively, and the rate of minor and major stroke was 0%, 7%, and 0%, respectively. All major strokes were cleared with intra-arterial thrombolysis. At discharge, the success rates defined by means of the absence of conversion and neurological events were 82% during period I, 76% during period II, and 100% during period III. The freedom from neurological deficits rates were 100%, 97.6%, and 100%, respectively. During follow-up, six significant asymptomatic restenoses were detected with duplex scanning; however, only one patient required reintervention. CONCLUSION: Technical skills and technological improvement, including low-profile balloon and catheter, cerebral protection device, and intra-arterial rescue techniques, may reduce the rate of neurological events associated with CS. Technical improvements should be given careful consideration before the initiation of randomized trials comparing CS and carotid endarterectomy.

Adult↗
PubMed2000

The underestimated advantages of iliofemoral endarterectomy.

Iliofemoral endarterectomy was invented 50 years ago, but it is seldom practiced today for two reasons. The first is that it is technically challenging and the second is that outcome in early series was poor. Our preliminary experience having been more encouraging, we have continued to perform iliofemoral endarterectomy for the past 20 years. The purpose of this retrospective study was to evaluate our results and compare them with results of alternative techniques described in recent literature. We have performed a total of 176 iliofemoral endarterectomies in patients with normal or nearly normal aortas. The procedure involved the entire network including the common iliac artery, external iliac artery, and common femoral artery in 108 cases (group I), the common iliac artery with or without the external iliac artery in 40 cases (group II), and the external iliac arteries and the common femoral artery with or without the deep femoral artery in 28 cases (group III). From our results we conclude that iliofemoral endarterectomy should be used as a first-choice modality in patients with normal or nearly normal aortas who present with iliac lesions that are either too long for balloon angioplasty or impossible to recanalize. It eliminates the risk of graft infection and false aneurysm. Restenosis can be treated by balloon angioplasty. It also saves the cost of a prosthesis.

Adult↗
PubMed2000

[Surveillance after treatment of differentiated thyroid cancers].

UNLABELLED: The prognosis of differentiated thyroid carcinoma mainly depends on the quality of the initial treatment and on early detection and management of any recurrences. STUDY AIM: The aim of this retrospective study was to assess the modalities and duration of surveillance in these patients according to an original classification based on the initial extent of the tumour. PATIENTS AND METHOD: The modalities of detection of local recurrences and metastases and the date of the latest recurrences were assessed in a series of 509 patients with a mean follow-up of 8.2 years (range: 1 to 25 years). Most patients were treated by total thyroidectomy, followed by a therapeutic dose of radioactive iodine. The other patients with a small localized carcinoma underwent partial thyroidectomy without radioactive iodine. Patients were divided into four groups on the 7th postoperative month after follow-up scintigraphy and thyroglobulin assay: group I: microcancers (n = 117), group II: cancer without lymph node involvement or metastasis and normal thyroglobulin divided into IIA, age < 45 years (n = 100) and IIB, age > 45 (n = 94), group III: cancer with lymph node involvement and normal thyroglobulin (n = 102), group IV: high-risk cancers with metastases or regional extension other than lymph node extension or thyroglobulin > 3 micrograms/L (n = 96). RESULTS: Cancer-dependent actuarial survival rates for groups I, IIA, IIB, III, IV were 100%, 100%, 96%, 100%, and 73% at 10 years and 100%, 100%, 92%, 100%, and 86% at 15 years, respectively. Local or metastatic recurrences were sometimes detected by a single follow-up examination, while the other examinations were negative: cervical palpation, thyroglobulin assay, iodine scintigraphy, chest X-rays. The latest recurrences were observed at 12 years in groups I and IIA and at 16 years in groups IIB, III, and IV with normal thyroglobulin. CONCLUSION: This study confirms the importance of weaning thyroglobulin assays and scintigraphy which must be repeated every 5 years. Cervical palpation, thyroglobulin assay without weaning, chest X-rays may also detect recurrences. Duration of follow-up must be adapted to the initial extension and subsequent course: 15 years in groups I and IIA, 20 years in groups IIB, III, and IV with normal thyroglobulin, for at least 10 years after each recurrence, and life-long in the case of progression and thyroglobulin > 3 micrograms/L. Patients must be informed about the duration of follow-up at the 7th month when the definitive classification can be established and continuity of this follow-up must be documented in a special register.

Adult↗
PubMed2000

[Surgery of the internal carotid: locoregional or general anesthesia?].

AIM OF THE STUDY: The aim of this retrospective study was to assess the advantages of regional anesthesia over general anesthesia in carotid artery surgery. PATIENTS AND METHOD: From January 1989 to December 1998, 670 patients with severe internal carotid artery stenosis were operated in the same center and were classified into two groups according to the type of anesthesia: group I, general anesthesia (n = 312) and group II, regional anesthesia (n = 358). Characteristics of the two groups were almost similar except for a higher rate of unstable heart disease in group I and bypass grafts in group II. RESULTS: A shunt was used in 16.3% of cases in group I and in 8.4% in group II. Complications resulting from the use of a shunt and intraoperative complications observed with regional anesthesia were reported. There was a conversion from regional to general anesthesia in 6 patients. Median duration of clamping was longer in group II (30 min vs 25 min). Cardiac complication rates were similar in the two groups, particularly cardiac mortality (0.6%). There were more pulmonary and miscellaneous complications in group I. Neurological complications were more frequent in group I, particularly fatal strokes (1% versus 0%). Neurological mortality and morbidity cumulative rates were 3.1% and 1.5%, respectively, not significantly different. CONCLUSION: These results, in agreement with those of the literature, confirm that carotid artery endarterectomy is associated with a low rate of neurological mortality and morbidity. Although regional anesthesia was associated with a lower rate of complications, we are not allowed to conclude to its superiority, as the present study was retrospective and the difference was not statistically significant.

Aged↗
PubMed2000

Placement of a fenestrated Palmaz stent across the renal arteries. Feasibility and outcome in an animal study.

OBJECTIVES: To investigate the feasibility of placing stents across renal arteries. Design we have studied in pigs: (i) the feasibility of accurately placing a fenestrated stent in front of one renal ostium; (ii) the short-term effects on renal arteries and function after the placement of such a fenestrated stent. MATERIALS AND METHODS: Eight fenestrated Palmaz stents were placed over pigs' renal ostia under fluoroscopy. Five weeks later, angiograms were performed and the animals were sacrificed. Proliferation of the healing tissues over the ostia was measured and analysed by microscopy. Serum creatinine was measured prior to all angiograms and at 5 weeks. RESULTS: All eight stents were correctly placed. One stent later migrated and was excluded from the study. One pig died at day 1. Gross examination confirmed the correct placement of the fenestrations in four pigs out of seven (57%). In the six remaining pigs, at 5 weeks, there was no angiographic evidence of stent misplacement and all the kidneys were fully perfused. Nine renal ostia were covered by struts and neointima with a mean area of coverage of 38+/-5% altogether. No tissue proliferation was observed over the three renal ostia located in front of the fenestration. Serum creatinine did not significantly increase at 5 weeks. CONCLUSION: Creating a fenestration in a stent for renal arteries may be worth while in order to avoid neointimal covering of the renal ostia. However, accurate placement of such a fenestrated stent remains a difficult task.

Animals↗