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Biomedical subjects

J P Saint-Maurice

Publications and source records attributed to J P Saint-Maurice.

At least 19 recordsLinked to original sources
PubMed2005

Use of mechanical extraction devices in basilar artery occlusion.

Three consecutive patients with embolic basilar artery occlusion were treated with endovascular mechanical thrombus extraction. Recanalisation was rapidly obtained in one patient, who had a good initial recovery, and in another patient who made a complete recovery. By contrast, recanalisation failed in the third patient, who made no recovery. No haemorrhagic complications were detected. This technique may have advantages over thrombolysis in both efficacy and safety.

Adult↗
PubMed2001

Carotid stenting for radiation-induced stenoses: A report of 7 cases.

BACKGROUND AND PURPOSE: Radiation-induced stenoses of the carotid artery are associated with fibrosis of the arterial layers and tissue planes that renders their surgical treatment difficult. We present our clinical experience in carotid angioplasty stenting (CAS) of patients harboring such stenoses. METHODS: Seven patients underwent transfemoral CAS of 10 radiation-induced stenoses located on either the common or the internal carotid artery. Six patients presented neurological symptoms. Four patients had undergone previous radical neck dissection, and 3 had permanent tracheostomies. Stenoses were primarily covered with a self-expandable stent before carotid dilation. RESULTS: All interventions were successful, with residual stenoses <20%. No permanent complication occurred. The mean follow-up was 8 months. Patients were symptom free at the last clinical examination, and Doppler control showed no evidence of restenosis. CONCLUSIONS: Carotid stenting appears very attractive for such "hostile neck" patients and seems a safe and efficient treatment for radiation-induced stenoses.

Aged↗
PubMed2001

Catheter modification for easier cannulation of the carotid artery during angioplasty and stenting.

PURPOSE: To present a modification of both the guiding catheter and stent delivery system to facilitate access into sharply curved supra-aortic vessels during carotid angioplasty. TECHNIQUE: Access failures during carotid interventions typically occur because either the vessel origin is acutely angled or the stenosis is located proximal to the carotid bifurcation, limiting access to the external carotid artery. We directly catheterized the left common carotid artery or brachiocephalic trunk with a guiding catheter whose tip had been curved by steam-shaping. The tip of the stent delivery system also was molded into a curve by this process so it engaged the curved part of the guiding catheter without pulling it out of the vessel. CONCLUSIONS: This simple modification can improve the success rate of carotid cannulation via the femoral approach and does not seem to increase the risk of the intervention.

Angioplasty, Balloon↗
PubMed1986

Respiratory effects of nitrous oxide during isoflurane anaesthesia in children.

Respiratory effects of nitrous oxide and isoflurane were studied in 13 children (mean age 45.6 +/- 19.3 months, mean weight 14.9 +/- 4.8 kg) during surgery under continuous extradural anaesthesia. Three different anaesthetic states were studied: isoflurane 0.5 MAC in oxygen (27 study periods), isoflurane 0.5 MAC with 50% nitrous oxide (32), isoflurane 1 MAC in oxygen (25). End-tidal carbon dioxide (PE' CO2) and isoflurane, respiratory indices (tidal volume, VT; minute ventilation, VE; mean inspiratory flow, VI; respiratory frequency f, effective inspiratory timing TI/Ttot were measured. The addition of nitrous oxide (comparison of respiratory variables obtained in 25 successive periods at (1) and (2)) produced a significant increase in PE' CO2' significant decreases in VT, VE and VI, a significant increase in f. The increase in alveolar concentration of isoflurane ((1) compared with (3) in 25 successive periods) was associated with a significant increase in PE' CO2' significant decreases in VT, VE, VI and a significant increase in f. The equipotent anaesthetic states (2) and (3) were compared in 21 successive periods. In children, the net result of substituting nitrous oxide for an equal MAC fraction of isoflurane was to produce a smaller decrease in VT responsible for a smaller decrease in VE without significant change in respiratory rate.

Anesthesia, Inhalation↗
PubMed1986

Ventilatory changes during nitrous oxide isoflurane anaesthesia in children.

The changes in ventilatory variables under nitrous oxide isoflurane anaesthesia were studied in 10 children (mean age 46 +/- 13.4 months, mean weight 16.2 +/- 2.1 kg). Measurements of flow and volume were performed by pneumotachography. PE'CO2 was measured by capnography. The following variables (VE, VT, TI/TTOT, VI, PE'CO2) were measured or calculated under three increasing inspired isoflurane concentrations (0.75%, 1.5%, 2.25%). At each level of anaesthesia, ventilatory changes during exposure to an inspired CO2 fraction of 2% were studied. The increase in the inspired concentration of isoflurane was associated with a decrease in alveolar ventilation. PE'CO2 increased significantly with increasing depth of anaesthesia. The respiratory rate was slightly increased under light nitrous oxide isoflurane anaesthesia, but no further changes were observed with increasing depth of anaesthesia, although the children were breathing a mixture of nitrous oxide and oxygen. The ventilatory response to a raised inspired CO2 is markedly decreased under light nitrous oxide isoflurane anaesthesia, and decreases significantly with increasing depth of anaesthesia. In response to a raised CO2, VE, VT and VI increase, but respiratory rate decreases or remains constant and TI/TTOT is unchanged.

Anesthesia↗
PubMed1983

[High frequency ventilation during the surgical treatment of esophageal atresia].

The preliminary results of the use of high frequency positive pressure ventilation (HFPPV) in six newborn infants presenting a type III oesophageal atresia during the thoracic stage of surgical repair are reported. HFPPV allowed correct gas exchange during the surgical procedure. In the six cases, a significant decrease in PaCO2 (p less than 0.05) was observed, whereas the effects on PaO2 were variable. The technical problems, mechanism of gas transport during HFPPV and clinical interest of HFPPV in thoracic surgery are discussed.

Blood Gas Analysis↗
PubMed1983

[Surgical ligation of patent ductus arteriosus in the very-low-birth-weight premature infant].

Three recent cases of surgical closure of ductus arteriosus in very low birth weight infants (less than 1 000 g) are reported. The indications of both surgical and pharmacological closure in very low birth weight premature infants are discussed. The necessity of an early closure of a patent ductus arteriosus is now admitted in the very premature infant, but the use of indomethacin in the first days of life is often impossible because of its side-effects. The use of adapted non-invasive monitoring devices during surgery allows a better control of anaesthesia.

Anesthesia, General↗
PubMed1983

[Pulmonary edema following generalized peritonitis in a 4-year-old child].

Following a recent case of adult-type respiratory distress syndrome in a four-year old child, the rare occurrence of this pathology in visceral paediatric surgery is recalled. The few published cases do not allow a comparison of the mortality in paediatric and adult patients. The treatment is discussed, as well as the results of pulmonary function tests performed some time after the acute pulmonary episode.

Child, Preschool↗
PubMed1981

[Measurement of PACO2 in children by capnography and mass spectrometry (author's transl)].

The present study examines the errors of measurement under working conditions using a capnograph and suggests a methodology to obtain optimal results in a given clinical situation. The authors compare the PCO2 measured with the aid of capnograph using CO2 absorption by infrared, with simultaneous measurements of PCO2 using a mass spectrometer as the reference. The observations measured included static and dynamic responses to a step variation of 5% CO2 and also the PACO2 in normal 9 to 12 year old children. The results show that the errors using a capnograph may reach 45 per cent at the highest respiratory frequencies. The influence of the dimensions of the sampling apparatus and the output of the sampling pump on the measurement of PACO2 are discussed. The static and dynamic calibration allow optimal operating conditions for the requirements of a patient in bed. (In this study children aged 9 to 12, with a respiratory frequency of less than 40/min). The errors after achieving optimal conditions is independent of respiratory frequency and always remained less than 5 per cent. A few simple rules are suggested to avoid the errors we have seen and if proper precautions are taken capnography can be considered as a good method for measuring PACO2 in children.

Breath Tests↗