PubMed Health⌕ Search

Biomedical subjects

V Costes

Publications and source records attributed to V Costes.

24 records · Page 2Linked to original sources
PubMed1994

Use of endovascular stents for acute aortic dissection: an experimental study.

This study was designed to evaluate the potential obliteration of an experimental aortic dissection using an intravascular stent introduced via the femoral artery. Twenty-two adult dogs were divided into four groups: in group A (n = 6) a thoracoabdominal aortic dissection was surgically created to observe the natural course of this lesion; in group B (n = 6) a nitinol coil graft was introduced into the aorta via the femoral artery; in group C (n = 3) a nitinol coil graft was introduced via the femoral artery into a dissected aorta in an attempt to obliterate the dissection; and in group D (n = 7) an expandable intraluminal vascular graft (Palmaz stent) was introduced via the femoral artery into a dissected aorta in an attempt to obliterate the dissection. Arteriographic evaluation was performed postoperatively and again 6 weeks later before the aortas were explanted. Gross and light microscopic examinations were performed on all explanted aortas. In group A dissection was achieved and a postoperative aortogram demonstrated evidence of aortic dissection in all animals. Autopsy revealed persistence of dissection with a reentry tear near the celiac axis in five animals. In group B there was incomplete expansion of the nitinol coil graft in five dogs, resulting in aortic thrombosis in one. In group C the nitinol coil graft failed to obliterate the aortic dissection in all animals and resulted in aortic thrombosis in two. In group D placement of a balloon-expandable intraluminal stent solely at entry and reentry sites resulted in only partial obliteration of the dissection (n = 3), but when the entire length of the dissected aorta was treated, the dissection was completely obliterated (n = 3).

Acute Disease↗
PubMed1994

Experimental study on demineralized bone matrix (DBM) and coral as bone graft substitutes in maxillofacial surgery.

Three different bone substitutes were implanted in a standardized nasal bone defect in 30 Wistar rats. The results were assessed at 2 months by macroscopic examination, contact radiography, and histologic analysis. Demineralized osseous implants sterilized by ethylene oxide induced bone formation in 90% of the the cases, as no heat-treated graft showed any bone formation. Coralline grafts were osteointegrated in 50% of the cases, but osteoconduction was not sufficient to achieve complete bone repair. This study implies that ethylene oxide sterilization does not impair biologic properties of demineralized grafts, but further studies on more evolved animal species are necessary before human implantation.

Animals↗
PubMed1994

[Heterogeneity of bronchial carcinoid tumors. Place of atypical forms].

Atypical carcinoid is an intermediate form between low grade malignant typical carcinoid and high grade malignant small cell carcinoma which are the two ends of the spectrum of neuroendocrine bronchopulmonary tumors. Between 1983 and 1993, twenty-three atypical carcinoids underwent surgical treatment. Histologic diagnosis of atypical carcinoid was established if the criteria proposed by Arrigoni et al, were fulfilled. Diagnosis was most frequently based on screening chest roentgenogram (56%). CT-scan findings showed a nodular peripheral mass in 65% of patients and central mass or atelectasis in 35% of patients. Four pneumonectomies, 15 lobectomies, 2 segmentectomies and 2 wedge resections were performed. Nine patients (39%) had regional nodal metastases and 4 patients (17%) had mediastinal nodal metastases (N2 disease) at the time of surgery. There were 4 death related to recurrence of the disease with distant metastasis in 3 patients (14%). Ten-year survival in atypical form was 59% contrasting with the 90% ten-year survival rate in patient with typical form operated on the same period. Because of their aggressive behavior, atypical carcinoids were comparable to well differentiated carcinoma of the lung and require an aggressive approach with lobectomy and mediastinal lymph node dissection being a minimum procedure.

Adult↗
PubMed1989

[Prognostic value of the normalization of the exercise test under medical treatment in coronary insufficiency].

The prognostic value of exercise testing was studied in 118 patients with angiographically proven chronic coronary disease, positive ET and/or a history of myocardial infarction (MI) who were followed up for 698 years (mean 5.9 years). Medical treatment was instituted step by step and controlled by repeated ET's. ET remained positive (ST depression 1 mm) in 58 cases (group I), was alternately positive and negative in 22 cases (group II) and became normal in 38 cases (group III). The mean duration of follow-up in these three groups was 5.0, 7.6 and 6.4 years respectively. Eight patients were lost sight of. Ergometric data and outcome were similar in groups II and III, but there were differences between group I (58 patients) and groups II + III (60 patients) as regards: (a) ergometric data: total workload (22,077 +/- 9,860 vs 34,856 +/- 15,552 joules), workload causing a 1 mm ST depression (13,892 +/- 9,253 vs 31,555 +/- 15,811 joules) and maximal ST depression (2.5 +/- 0.9 vs 0.9 +/- 0.8 mm); (b) outcome: cardiac deaths (12 vs 3), myocardial revascularization (19 vs 6); but there was no significant difference as regards MI (4 vs 5), heart failure (11 vs 5) and extracardiac deaths (3 vs 4). It is concluded that the persistence of a positive ET under optimal medical treatment is a major argument in favour of myocardial revascularization.

Adult↗
PubMedDate not supplied

Use of a balloon-expandable intravascular graft in the management of type B aortic dissection in an animal model.

PURPOSE: To evaluate obliteration of an experimental aortic dissection with a balloon-expandable intravascular stent. MATERIALS AND METHODS: Fourteen adult dogs were divided into two groups. In group 1 (n = 6), a thoracoabdominal aortic dissection was surgically created to observe the natural course of this lesion. In group 2 (n = 8), a balloon-expandable intraluminal vascular graft was introduced via the femoral artery in a dissected aorta to try to obliterate the dissection. Angiography was performed postoperatively and again 6 weeks later before the aortae were explanted for pathologic evaluation. RESULTS: In group 1, postoperative aortography depicted evidence of aortic dissection in all animals. Autopsy revealed persisting dissection with reentry tear near the celiac axis in five animals. In group 2, placement of a stent at only entry and reentry sites resulted in partial obliteration of the dissection (n = 3). When the entire length of dissected aorta was treated, the dissection was completely obliterated (n = 4). CONCLUSION: An aortic dissection can be obliterated with a balloon-expandable stent if the entire dissected aorta is treated.

Aortic Dissection↗