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Biomedical subjects

J Watelet

Publications and source records attributed to J Watelet.

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

Transluminal angioplasty of failing infrainguinal arterial by-pass grafts: initial and long-term results in 13 patients.

Thirteen stenotic infrainguinal arterial bypasses (12 venous, 1 Gore-tex graft) were treated by transluminal angioplasty, either percutaneously (10 patients) or surgically (3 patients). Eleven procedures were immediately successful (two at the proximal portions of femoropopliteal grafts, six near the distal anastomoses, and three at the distal parts of femoroinfrapopliteal grafts) and dilated stenoses are still patent with a mean duration of 24 months in all patients except 2 who died during the follow-up period. The calculated cumulative patency rate is 85% at 36 months. Two procedures were followed by immediate disruption near the distal end of an in situ saphenous bypass graft where balloon inflation was performed. These required immediate surgical repair. Dilatation of the distal ends of in situ saphenous femoropopliteal bypasses may not be as safe as in other locations.

Aged↗
PubMedDate not supplied

Allograft-induced arterial wall injury and response in normotensive and spontaneously hypertensive rats.

The role of genetically determined immune attack and blood pressure in graft rejection-induced arterial wall injury and response was assessed by studying the compliance and changes in wall structure of aortic isografts and allografts in normotensive (Wistar-Kyoto [WKY]) and hypertensive (spontaneously hypertensive [SHR]) rats. Six groups of 8-week-old rats were compared: sham-operated in both strains, isografts, and allografts between the two strains (SHR aortas grafted in WKYs, designated SWs; WKY aortas grafted in SHRs, designated WSs; isografts in SHRs, designated SSs; and isografts in WKYs, designated WWs). Each arterial graft was studied 8 weeks after transplantation for volume and compliance (pressures of 75-175 mm Hg) under basal conditions. The amounts of collagen, elastin, and nuclei in the media and intima of the walls of control and grafted aortas were quantified morphometrically. Isografts and controls had the same mechanical characteristics under basal conditions: the arterial volume and arterial compliance of hypertensive rats were lower than those of normotensive rats (p less than 0.001). Allografts had a greater initial volume (p less than 0.001) and a lower compliance (p less than 0.001) than did isografts. Allografts in SHRs (SSs) were initially dilated, whereas allografted WKYs (WWs) were not. There was intimal proliferation in hypertensive isografts (14 +/- 0.77 microns) and in both types of allografts (WS, 69 +/- 1.55 microns; SW, 44 +/- 1.81 microns); nucleus density was higher in hypertensive allografts (WS) than in normotensive allografts (SW); and collagen density was also higher in SW than in WS allografts. Allografts had decreased medial thickness and decreased smooth muscle cell density.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

[Rupture of the subclavian artery. Apropos of a case].

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.

Accidents, Traffic↗
PubMedDate not supplied

Is emergency aorto-superior mesenteric artery by-pass worthwhile?

Out of 9 superior mesenteric artery (SMA) revascularizations made in emergency, only an early direct aortic reimplantation was successful. The other cases were bypasses and their failures were due either to shock at revascularization (2 cases), or to thrombosis of a by-pass (4 cases), or to persistent ischemic lesions (2 cases). It is suggested: (1) that late mesenteric revascularization should be excluded and let place to extensive bowel resection, (2) that, in emergency, direct SMA aortic reimplantation is preferable to aorto-SMA by-pass.

Aged↗
PubMedDate not supplied

[74 by-passes on leg arteries (author's transl)].

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.

Adult↗
PubMedDate not supplied

When can revascularization be limited to the profunda femoris alone?

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.

Adult↗
PubMedDate not supplied

[Current status of reconstructive surgery of the sub-inguinal artery].

Saphenous vein bypass is the optimal operation for arterial reconstruction in the subinguinal region. There has been no demonstrated advantage to using a devalvulated saphenous vein in situ rather than an inverted dissected vein. Prosthetic bypass may be preferred over saphenous bypass with a vein < or = 4 mm if the lower anastomosis is situated on the upper popliteal artery, if the life expectancy is short or if on the contrary the downstream bed is normal. Permeability after percutaneous transluminal angioplasty does not last as long as after bypass surgery for obliterations, but the operation is less aggressive and does not compromise a subsequent procedure. The best indications are short stenoses in patients with a long walking distance in whom surgery would be excessive. Angiography or ultrasound angioscopy after a bypass procedure or endoluminal dilatation can check the technical quality of the operation and help improve permeability duration. Adjuvant treatment such as a venous patch on a prosthetic anastomosis or various drugs are highly important in improving the duration of permeability. A prospectively planned follow-up should be an integral part of arterial reconstruction surgery in order to identify subsequent stenoses and programme their treatment before occlusion occurs.

Arterial Occlusive Diseases↗