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Biomedical subjects

R Limet

Publications and source records attributed to R Limet.

At least 163 records · Page 9Linked to original sources
PubMed1996

[Infrarenal aneurysm: traditional surgery].

Abdominal aortic aneurysm surgery has been widely performed for more than forty years. Indications, contraindications, mortality-morbidity are clearly known. Surgical results are grossly reproducible whatever the centre. This classical technique of graft inclusion is superior to recent endovascular technique in terms of practicability and reproducibility. Classical technique seems safer for prevention of secondary aneurysms, for simultaneous treatment of abdominal non vascular lesions, for assessment and cure of associated renovascular abnormalities, and for avoiding distal emboli and colorectal ischemia.

Aortic Aneurysm, Abdominal↗
PubMed1996

[Positron emission tomography in the evaluation of intrathoracic lymphatic extension of non-small cell bronchial cancer. A preliminary study of 30 patients].

Current methods for evaluating the mediastinum include chest radiography, computed tomography (CT) or magnetic resonance (MR) imaging and mediastinoscopy. Despite advances in morphologic imaging, some lung cancer patients are found to have unresectable disease at surgery. In contrast to CT scan or MR imaging, which depend primarily on anatomic and morphological criteria, positron emission tomography (PET) with 18fluorodeoxyglucose (FDG) depends mainly of the metabolic characteristics of a tissue for the diagnosis of disease. We perform a prospective study to compare FDG-PET and CT of the thorax in the presurgical assessment of the mediastinum in patients with newly diagnosed non-small cell lung cancer. Thirty patients have been included. CT and PET-scans were interpreted separately and results were compared to surgical staging during thoracotomy. In assessing mediastinal involvement, CT scan had a sensitivity of 56% and a specificity of 64%. For diagnosis mediastinal nodal disease, FDG-PET was 87% sensitive and 78% specific. Its positive predictive value was 82%, and the negative value was 83%. In conclusion, our preliminary results show that FDG-PET appears more accurate than CT in staging of mediastinal non-small cell lung cancer.

Adult↗
PubMed1995

Proximal migration of vena caval filters: report of two cases with operative retrieval.

Operative retrieval of two proximally migrated vena caval filters was performed in two patients, ages 42 and 45 years, respectively. In the first patient the filter was encrusted in the right ventricle, and in the second one the filter was found in the pulmonary artery. Both filters were retrieved under cardiopulmonary bypass via an incision in the right atrium and the pulmonary artery, respectively. These two observations underscore the risk of increased unwarranted indications and consequent higher complication rates of vena caval filters.

Adult↗
PubMed1995

Results of an exclusion technique for treatment of abdominal aortic aneurysm.

An exclusion technique for the treatment of abdominal aortic aneurysm was used in six patients considered to be at high operative risk mainly because of chronic pulmonary disease. There were no deaths or immediate major complications. Thrombosis of the aneurysm was achieved in four of the six patients. However, in three cases, repeated percutaneous embolization was required to produce thrombosis. One patient developed a secondary rupture of a persisting infrarenal sac resulting from a patent inferior mesenteric artery. This patient was successfully managed by ligature of the infrarenal portion of the abdominal aorta through a median laparotomy. This study emphasizes the limits and the risks of the exclusion technique.

Aged↗
PubMed1995

Successful abdominal aortic aneurysm resection in long-term survivors of cardiac transplantation.

With the improvement of survival rates following cardiac transplantation, the probability of recipients developing extracardiac disease is increased. Three cases are reported of abdominal aortic aneurysm successfully operated on in cardiac allograft recipients 1 to 4 years after transplantation. Indications for transplantation were valvular, idiopathic and ischaemic cardiomyopathy. Post-transplant hypertension and hyperlipidaemia may have played a role in the rapid growth of the aneurysms. Cardiac function and the incidence of graft atherosclerosis were assessed before surgery by coronary angiography. All three patients were discharged from hospital. Abdominal aortic aneurysm resection may be a safe procedure in cardiac transplant patients. In view of the rapid increase in the size of the aneurysms in transplanted patients, careful screening should be performed during follow-up.

Aortic Aneurysm, Abdominal↗
PubMed1995

Valve replacement for acute left heart endocarditis.

Between January 1982 and June 1993, 66 patients (48 men and 18 women of mean (range) age 50 (21-77) years) underwent valve replacement for acute infective endocarditis. There were 45 aortic valve and 17 mitral valve infections. Four patients had bivalvular involvement. Fifty-three patients suffered from native valve endocarditis, with underlying valvular lesions documented for 31 patients. Staphylococci and Streptococci spp. were responsible for 68% of infection, and 20% of blood and valve cultures were negative. Refractory congestive heart failure was the leading surgical indication in 86% of patients. The mean follow-up period was 44 months. The perioperative mortality rate was 6%. Actuarial survival rates were 88.5% at 1 year and 83% at 3 years. No early recurrence of infection was noted. Six patients (9%) needed reoperation. Satisfactory results confirm that early surgical management should be considered in patients with complicated infective endocarditis.

Acute Disease↗
PubMed1995

Aneurysms of the abdominal aorta: familial and genetic aspects in three hundred thirteen pedigrees.

PURPOSE: Familial clustering of abdominal aortic aneurysm was first noticed in 1977. METHODS: Through questionnaire and phone inquiry, familial data on 324 probands with abdominal aortic aneurysms allowed the establishment of 313 multigenerational pedigrees including 39 with multiple affected patients. RESULTS: There were 276 sporadic cases (264 men, 12 women); 81 cases belonged to multiplex pedigrees (76 men; 5 women). We compared familial and sporadic male cases; the ages at diagnosis were 64.1 +/- 7.9 years and 66.0 +/- 7.3 years (p < 0.05), respectively, the ages at rupture were 65.4 +/- 6.6 years and 75.2 +/- 8.6 years (p < 0.001), and the rupture rate was 32.4% and 8.7% (p < 0.001). Survival curves were computed. Relative risk for male siblings of a male patient was 18. We performed a segregation analysis with the mixed model, the most likely explanation for occurrence of abdominal aortic aneurysm in our families was a single gene effect showing dominant inheritance. The frequency of the morbid allele was 1:250, and its age-related penetrance was not higher than 0.4. CONCLUSION: This analysis indicates the preeminence of genetic factors on multifactorial/environmental effects of the pathogenesis of abdominal aortic aneurysm.

Adult↗
PubMed1995

Isolated atherosclerotic aneurysms of the iliac arteries.

Atherosclerotic aneurysms limited to the iliac arteries are rare and entail a high risk of rupture. To evaluate the efficacy of prophylactic surgery, we retrospectively studied 15 patients (13 men and two women; mean age 69 years) treated for isolated iliac aneurysms in the Department of Cardiovascular Surgery at the University Hospital of Liège over a period of 18 years. They had a total of 25 aneurysms (20 common iliac and five internal iliac). Six patients were treated electively and nine on an emergency basis for rupture. Five of the emergency patients (33%) died in the early postoperative period (< 30 days); in each case the aneurysm had ruptured and an emergency operation was performed (55.5% mortality in the ruptured iliac aneurysm group). On the other hand, all patients treated electively survived. Our study is comparable to other recent series in the literature, which also reported a high incidence of rupture and death in emergency operations. Prophylactic elective surgery is recommended for iliac aneurysms.

Aged↗
PubMed1995

The impact of renal revascularisation on renal dysfunction.

AIM: To determine the value of kidney revascularisation in patients with impaired renal function and correctable renal artery stenosis, the authors reviewed their surgical experience from 1978 to 1990. PATIENTS AND METHODS: The study population included 23 patients with ischaemic nephropathy whose preoperative baseline creatinine level exceeded 20 mg/l (range 21-65 mg/l). This represents 20% of all patients operated on for renal artery disease during the same time interval. Preoperative risk profile, operative mortality, impact on hypertension and on renal function, and late survival were analysed. Renal function response to kidney revascularisation was defined as favourable (20% or more reduction of serum creatinine), moderate (stabilised serum creatinine values) or bad (further deterioration of renal function). All patients had atherosclerotic renal artery disease, involving a solitary kidney in five, both kidneys in 15 and one of the two kidneys in three patients. Hypertension was present in 74%. Revascularisation was unilateral in 10, bilateral in nine and associated with controlateral nephrectomy in four patients. RESULTS: Four patients died postoperatively (three myocardial infarctions, one stroke). Four patients needed postoperative short-term dialysis. After operation, renal function improved in 13, stabilised in six and deteriorated in four patients (of whom two died). Follow-up among the survivors averaged 46 months. The mean serum creatinine value at last follow-up visit was 26.2 mg/l, a decrease of 7.7 mg/l compared to preoperative values (p < 0.05). Overall, 69% of azotemic patients submitted to renal revascularisation manifested a favourable response (45% improved and 24% stabilised). Three patients required long-term dialysis. The 5-year survival rate was 48%. CONCLUSION: These data suggest that kidney revascularisation in patients with ischaemic nephropathy can restore or stabilise renal function, preventing evolution and end-stage renal disease and dialysis dependency.

Chronic Disease↗