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Biomedical subjects

F Thaveau

Publications and source records attributed to F Thaveau.

7 recordsLinked to original sources

[An atypical discipline: surgery in bullfighting. Two case reports].

Many bullfighters had been seriously injured, even sometimes killed during the fight in the bullring (around 300 deaths since the beginning of the 20th century). There is no comparison between bullfight's traumas and civil or war traumas, so only specialized medicine doctors and surgeons can be involved for practising. Surgery of bullfighting is a single speciality. The bullfight's surgeon in safekeeping will operate immediately in the bullfight place's infirmary and will aim at reducing the deep effect of horn injury. In this work, authors point out the bullfight pathology's complexity and its surgical treatment by presenting two original cases.

Animals↗

[Vascular graft prosthesis].

Performed since the 1950s, vascular grafting has opened modern era of vascular surgery. Autologous venous grafts are of first choice for revascularisation of small arteries. Synthetic grafts are mainly modelled using microporous polytetrafluoroethylene or terephtalate polyethylene. These prosthesis are mainly used for revascularization of medium and large size arteries.

Blood Vessel Prosthesis↗

Influence of the textile structure on the degradation of explanted aortic endoprostheses.

OBJECTIVES: To investigate mechanisms of textile failure in explanted human aortic endoprostheses. MATERIALS AND METHODS: Endoprostheses (n31) underwent optical and scanning electron microscopy, filament dynamometry, and saturation index measurement. RESULTS: The macroscopic lesions observed in the Stentor and Vanguard devices were holes at the extremities of the stents and slipping of the warp yarns at the level of sutures or of the longitudinal seams. The macroscopic lesions observed in AneurX endoprostheses were holes, slipping of the warp yarns and ruptures of the ligatures. The macroscopic lesions observed in the two Talent endoprostheses were sections of fibers at the level of the suture holes and few areas lesions of wear, with sometimes holes at the contact of the stent extremities. Stentor, Vanguard and AneurX all demonstrated low saturation indexes of the fabric (44-59%) with an important anisotropy. Whereas the Talent endograft demonstrated a high index of saturation (124-131%) with a low anisotropy. We did not demonstrate significant polymer degradation in any of the endoprostheses. CONCLUSIONS: It is essential to take into account the saturation index to optimally choose a woven textile for the construction of an endoprosthesis since this property of the textile may contribute to explain the macroscopic lesions observed. We did not observe significant polymer degradation by filament dynamometry but further studies are needed to confirm these data.

Aortic Aneurysm, Abdominal↗

Mechanisms of rupture of knitted polyester vascular prostheses: an in vitro analysis of virgin prostheses.

OBJECTIVES: Previous explant retrieval studies have shown ruptures occurring on the remeshing line and the guide line of two types of warp-knitted grafts. The aim of our study was to characterize the mechanisms these ruptures. MATERIALS AND METHODS: We performed an in vitro study of the mechanical and chemical characteristics of virgin prostheses. We studied 2 virgin polyester warp-knitted grafts models: the Cooley Double Velour and the Microvel Double Velour constructed by Meadox (USA), using the following techniques: characterization and de-knitting of the textile structure, circumferential tensile strength, filament dynamometry, critical dissolution time of the filaments and scanning electron microscopy. RESULTS: Both prostheses were constructed in the same way but the texturized yarns of the Cooley graft included twice as many filaments (54) than the Microvel (27). There was more adsorbed tension in the Cooley structure than in the Microvel. The circumferential tensile strength test demonstrated that the Cooley graft always ruptured on the remeshing line and the Microvel graft always ruptured at the interface between the remeshing line and the standard line. Filament dynamometry demonstrated a heterogeneous behavior of the filaments inside the yarns, mainly at the remeshing line of the Cooley graft (27.1 cN/tex +/- 11.5% versus 26.1 cN/tex +/- 2.2% for the guide line and 28 cN/tex +/- 6.7% for the standard knit). Critical dissolution time of the filaments was significantly lower for the Microvel grafts (2.5 sec versus 17.2 sec for the Cooley). CONCLUSIONS: Rupture of knitted polyester prostheses are probably an underestimated phenomenon. They may occur at specific areas of the graft. Further studies are required to determine whether all grafts of this type are at risk.

Blood Vessel Prosthesis↗

Sealing of polyester prostheses with autologous fibrin glue and bone marrow.

The purpose of this study was to develop a sealing technique for polyester prosthetic grafts able to promote healing and reduce intimal hyperplasia. The porcine experimental model was aortoiliac bypass with a 6-mm diameter knitted polyester prosthetic graft implanted for 14 and 90 days. Animals were divided into three groups according to sealing technique as follows: pre-clotting with blood (group I, n = 12), sealing with autologous fibrin glue (group II, n = 14), and sealing with autologous fibrin glue and bone marrow cells (group III, n = 16). Feasibility and quality of sealing were evaluated by scanning electron microscopy prior to implantation and by assessment of blood loss. After removal, prostheses were cut into three segments comprising the proximal anastomosis, midsection, and distal anastomosis. Pieces were fixed, embedded in paraffin, and serially sectioned for histologic study. Histological study focused on the degree of stenosis and hyperplasia of the neointima of each prosthesis. The results of this short-term study indicate that sealing of polyester vascular prosthetic grafts with autologous fibrin glue and bone marrow cells is effective in reducing intimal hyperplasia. However further study will be needed to assess long-term healing.

Animals↗

[Paraplegia secondary to surgery of the abdominal aorta].

We report the case of an 84 year-old man who suffered of paraplegia after surgery of an abdominal aortic aneurysm. The neurologic status did not improve during 5 years of follow-up. This complication is rare in light of the review of the literature. It is more frequent after emergency (1.4%) and redux (19%) surgery than after elective surgery (1.1%). Its mechanisms are anatomic (occlusion of the Adamkievitz artery and of the pelvic collateral arteries) and hemodynamic mechanisms (thromboembolism, low systemic tension, long supra-renal clamping). Since pre-operative aortography to detect anatomic variations is not realistic, its only prevention remains maintenance of intra-operative hemodynamic, systemic heparinization, and preservation of the pelvic collateral circulation.

Aged↗