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Biomedical subjects

F Gigou

Publications and source records attributed to F Gigou.

48 records · Page 3Linked to original sources
PubMed1981

[Partial occlusion of the inferior vena cava by clips. Indications and results about 95 cases (author's transl)].

Vena cava clips were applied in 95 patients between October 1975 and October 1979, without mortality directly related to the surgical intervention. One patients died early after operation due to an associated thoracic aorta aneurysm. The 10 deaths occurring at a later stage were not related to the insertion of the clips or its consequences. One patient developed a pulmonary embolism during operation, as a result of a concomitant juxtarenal thrombectomy. Postoperative extension of a femoropopliteal thrombosis or bilateralization of an iliac phlebitis was observed in 31 p.cent (30 out of 95) of cases. Permeability of the inferior vena cava was confirmed in 32 patients, 65 p. cent of the clips remained patent. Lower limb venous sequelae, related to the insertion of the clip or its consequences, were noted in 34 p.cent (24 of 69) but caused little inconvenience. Severe venous disorders, due to the thrombo-embolic disease, were always present before the insertion of the clips. Postoperative morbidity was low, the clip causing extension of previously existing venous thrombosis, without significant distal sequelae. The absence of recurrence of pulmonary embolism demonstrates the efficacy of this method. The employ of a caval filter to preserve improved permeability of the inferior vena cava (IVC) is discussed.

Adolescent↗
PubMed1979

Use of biological glue in acute aortic dissection. Preliminary clinical results with a new surgical technique.

Use of a biological glue (GRF) is common in certain fields such as hepatic or renal surgery, but its use in vascular surgery, especially in acute aortic dissection, has not yet been reported. Our experience has demonstrated many advantages: The glue is very simple and safe to use. The aortic tissues are firmly reinforced and the sutures tighten immediately. The proximal aortic stump is anatomically reconstructed, and generally the aortic valve can be preserved and coronary reimplantation avoided. The preoperative and postoperative bleeding rates are low and the postoperative course generally is simple. The risk of maintenance or recurrence of the dissection process is reduced. Consequently, the hospital mortality rate can be reduced to about 10 percent and the long-term survival rate greatly improved.

Adult↗
PubMed1979

[Surgery of acute aortic dissection by use of a biological glue. Experimental study (author's transl)].

The improvement in surgical technic in the treatment of dissecting aneurysm of the aorta should permit a reduction in mortality and secondary complications. With this object, an attempt to stick together the two parts of the aneurysm with biological glue, was submitted to an experimental study. The operative protocol included on the one hand, creation of a dissecting aneurysm in the thorax of the dog, and secondly, repair of the latter with biological glue of variable composition. 27 dogs were thus operated on : -- 4 dissections were treated by simple suture (control group); -- in 23 cases, the two parts of the dissecting aneurysm were stuck together with gelatin-resorcin glue which was polymerised either by formaldehyde alone, or by a mixture of glutaraldehyde-glycerinaldehyde or by a mixture formaldehyde-glutaraldehyde. The best results of adhesiveness and tissue tolerance were obtained with the latter mixture.

Acute Disease↗
PubMed1978

[Congenital arteriovenous fistula of the broad ligament. 1 case].

Following a case report of a congenital arterio-venous fistula of the broad ligament, the authors set out the different types of vascular malformation seen in the pelvic region and they attempt to define the place of treatment. The treatment of these lesions involves embolisation of the vascular pedicle and an attempt at surgical excision, alone or one after another.

Adnexa Uteri↗
PubMed1977

[Gelatin resorcin formaldehyde glue in vascular surgery (author's transl)].

The use of this biological glue appeared to us to be of particular interest in the surgical treatment of dissecting aneurysms of the aorta. An experimental investigation revealed its hemostatic and adhesive properties, and demonstrated its merit when used as material in vascular embolization.

Aortic Dissection↗
PubMedDate not supplied

[Critical ischemia of the leg. A technique for distal anastomosis in a a small caliber artery].

CRITICAL ISCHEMIA OF THE LOWER LIMBS: This type of lesion, which spontaneously progresses to gangrene and amputation, is encountered more and more frequently. Emergency endoluminal revascularization or bypass surgery is required. When conventional endoluminal techniques cannot be used, a distal graft using the autologous saphenous vein is a promising alternative to achieve patent vascularization and salvage the limb. IF VENOUS MATERIAL IS NOT AVAILABLE: Usable venous material is not always available due to varicosities, thrombus formation, small size or previous surgery (stripping, coronary surgery, prior revascularization procedure); rates reported range from 20 to 40%. For such patients, other veins (external saphenous, arm veins, superficial femoral veins) may be useful but are not always appropriate for distal repair. Different prostheses might also be used but again do not always provide improved permeability. Most teams however use a polytetrafluoroethylene stent for revascularization of the distal leg. Different technical improvements favor success of prosthetic bypasses, but when used below the knee, flow remains less satisfactory than with venous bypasses. VEIN CUFFS: This procedure is a common adjuvant technique positioning a venous cuff between the recipient artery and the prosthesis. The cuff avoids the direct contact between the prosthesis and the fragile artery that is often difficult to suture. RESULTS: Several series have demonstrated that the rate of success of vein cuff procedures remains lower than venous bypass procedures, but also that flow is better than with simple femorotibial prostheses. PATHOGENIC HYPOTHESES: The reduction of the neo-intimal hyperplasia observed in experimental models is insufficient to explain entirely the observed in vivo benefit. The fact that the suture is easier to make is one possible reason. Indeed the rate of failure of simple prosthetic bypass surgery is high in the immediate postoperative period. These cases of thrombosis result from technical insufficiencies and are undoubtedly overcome by the use of the venous cuff.

Angiography↗
PubMedDate not supplied

[Arteritis in aged patients].

Gangrene is the usual reason for admission to a surgical unit in elderly patients with peripheral vascular disease. It is often the first sign of arterial disease occurring in a foot with satisfactory skin and may be triggered off by trauma or infection. Obstruction at various levels of the profunda femoris artery, of the main leg arteries with calcification of the media, are the usual characteristics, whether the patient is diabetic or not. This explains why reconstructive vascular surgery is rarely possible but this, nevertheless, remains the best chance for obtaining healing of trophic disorders with limited removal of the toes. No failure was observed in cases of axillo-femoral or femoro-femoral by-pass. But, as in diabetics, one may, in elderly patients with gangrene, attempt to conserve weight-bearing areas thanks to medical treatment in association in some cases with lumbar sympathectomy when the patient's general condition makes this possible. The mortality is low when patients are selected for operation and depending on the surgical technique adopted, e.g. sub-cutaneous by-pass or surgery of the origin of the profunda femoris. The mortality is less than 7 p. 100 during the first month (one death in 31 vascular operations, one death in 40 sympathectomies), but the mortality during the first 6 months exceeds 20 p. 100 due to cardiac, or cerebral complications or urinary infection. The prevention of digestive symptoms, nutritional, renal or urinary complications, and electrolyte disturbances is essential together with physiotherapy and reduction in time spent in hospital, for example, the patient may be sent home and treated by the district nurse. 135 patients with arteritis, including 48 diabetics, aged over 70 years, admitted to hospital in 1971 at the Saint-Joseph hospital, illustrate these findings. 109 patients with 114 diseased limbs, had gangrene or ischemic ulcer. Out of 80 survivors, beyond 6 months, i.e. 84 limbs, in 75 cases the weight bearing areas were preserved, in 9 cases amputation was necessary but in 8 of these it was possible to carry out amputation below the knee and walking was possible. These functional results justify attempts to maintain weight bearing areas or, at least, the knee, whatever the duration of healing or amputation of a toe or of the metatarsus; in Syme's amputation of the leg, healing requires 2 to 4 months.

Age Factors↗
PubMedDate not supplied

[Isolated dissecting aneurysm of the superior mesenteric artery. Dysplasia, a rare cause of mesenteric ischemia. Report of a case].

We report a case of successful surgical revascularization of the superior mesenteric artery in a patient presenting with intestinal ischaemia due to fibrodysplasia. This is a rare pathology, with 5 cases operated in our institution and only 16 cases reported in the literature. Angiography may show other sites of arterial dysplasia. In such cases, success depends on early surgical revascularization.

Aortic Dissection↗
PubMedDate not supplied

Results of thrombolysis in the treatment of arterial ischemia of the limbs according to mode of administration.

After reviewing the principles, results and complications of thrombolytic therapy with "classical" agents (Streptokinase and Urokinase) used via intravenous, intraarterial route, or intraoperatively, and with more "modern" agents (APSAC, scuPA, tPA), we discuss the future of thrombolysis in the treatment of arterial ischemia of the limbs. Several items need to be clarified: --indication of thrombolysis among other treatments, mainly surgery, of arterial ischemia depends on the clinical staging of ischemia, its causes and the site of arterial obstruction; --method of delivery of the thrombolytic agent must provide the highest local concentration and the lowest systemic side effects; --efficacy of each thrombolytic agent must be analyzed when used in peripheral arterial ischemia, but also in other diseases such as myocardial infarction.

Fibrinolytic Agents↗