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V Scavée

Publications and source records attributed to V Scavée.

11 recordsLinked to original sources
PubMed2006

Carotid endarterectomy with internal carotid artery segmental resection, temporary shunt and vein patch angioplasty: early and mid-term results.

AIM: The authors report an alternative procedure to carotid endarterectomy with internal carotid artery (ICA) segmental resection and end-to-end anastomosis associated with temporary shunt and venous patch angioplasty. DESIGN: prospective cohort study. METHODS: Between May 1995 and December 2004, 192 patients underwent 200 primary CEAs for significant ICA stenosis. There were 131 men and 61 women with a mean age of 72.4+/-8.4 years. The indications for CEA were asymptomatic lesions in 51.5%, transient ischemic attack in 27.5% and stroke in 21%. RESULTS: The combined early morbidity and mortality rate was 2%. Two patients died, one due to fatal intracerebral hemorrhage and the second patient died of acute mesenteric ischemia. Neurological complications occurred in 2 patients, including 1 TIA and 1 nondisabling cerebrovascular accident. Non-neurological complications occurred in 26 patients (13.5%). Seventeen patients (8.8%) developed hypertension, 3 neck hematomas (1.5%) required surgical evacuation, 1 patient had reversible supraventricular arrhythmia (0.5%) and 1 patient had pneumonia (0.5%). Furthermore, 1 asymptomatic carotid occlusion was identified (0.5%) and 3 patients suffered permanent cranial nerve injury (1.5%). Mean follow-up was 45.7 months and there were 41 late deaths (21.8%). Survival rates at 1 and 5 years were 96.7+/-1.2% and 73.58+/-4.2%, respectively. CONCLUSIONS: CEA with ICA shortening and reanastomosis is a safe and reliable procedure without any increase in morbidity or mortality.

Aged↗
PubMed2005

Transilluminated powered phlebectomy. Mid-term clinical experience.

AIM: Transilluminated powered phlebectomy (TIPP) was first described in 1996 by Sptiz et al. and was designed to allow minimally invasive surgical treatment of varicose veins (VV). We report our updated experience with TIPP technique. METHODS: Between January 2001 and February 2004, 84 patients underwent treatment by TIPP technique for primary symptomatic VV. Saphenofemoral junction with complete stripping of the great saphenous vein was performed in all patients. Incompetent perforating veins was ligated and prominent VV were ablated with TIPP technique. RESULTS: Mean age of patients was 50.6 years (range 29-79 years) and most of patients were women (73%). The major varicose vein risk factors were standing position and parity. Heaviness (62%), pain (57%) and unsightly veins (30%) were the most common indications for surgery. The mean number of surgical incisions was 6 (range 3-10), the average operative time was 59 min (range 30-100 min) and the mean cosmetic score (out of 10) at 6 weeks was 8 (range 2-10). The mean pain score (out of 10) was at 2 days, 7 days and 6 weeks was 5, 3 and 0, respectively. All the complications were documented. CONCLUSIONS: The TIPP technique is safe without any adverse events, presents advantages and inconvenient which are discussed in this paper.

Adult↗
PubMed2003

Hook phlebectomy versus transilluminated powered phlebectomy for varicose vein surgery: early results.

OBJECTIVES: to compare Transilluminated Powered Phlebectomy (TIPP) (TriVex System) with Muller's hook phlebectomy. MATERIALS AND METHODS: between January and April 2001, 40 patients (group 1) undergoing TIPP were non-randomly compared to 40 patients undergoing Muller's hook phlebectomy (group 2) in the course of conventional vein stripping and perforator ligation. All patients had at least C2 CEAP disease. RESULTS: hospital stay averaged 2 days (range 1-3 days; median 2 days) and was similar for the two groups. TIPP took significantly longer (56+/-12 vs 45+/-10 min, p<0.001) but was associated with significantly fewer incisions (6 [2-8] vs 8 [4-21], p<0.001). The mean pain score (out of 10) at 2 and 7 days and 6 weeks was 5, 2 and zero after TIPP and 4, 2 and zero after hook phlebectomy. The incidence of postoperative haematoma formation was significantly higher after TIPP (45 vs 25%, p=0.06), especially in the calf region (25 vs 2.5%,p =0.003). CONCLUSION: TIPP was slower (although speed increased with practice) associated with more haematoma (although this reduced with practice) and fewer incisions. In other respects (pain, cosmetic satisfaction, other complications, residual varices) it was not significantly different from hook phlebectomy. Greater clinical experience with the technique and randomized studies are required to determine whether TIPP is a valuable addition to our armamentarium.

Adult↗
PubMed2001

Six hundred consecutive carotid endarterectomies with temporary shunt and vein patch angioplasty: early and long-term results.

PURPOSE: This retrospective study evaluates the long-term clinical outcome and the survival of 600 consecutive carotid endarterectomies performed with a temporary shunt. All arteriotomies were closed by vein patch angioplasty. MATERIALS AND METHODS: Between November 1989 and November 1998, 600 isolated carotid endarterectomies (CEA) were performed in 540 patients by a uniform surgical technique at the University Clinic of Mont-Godinne. An intraluminal shunt and patch closure were systematically used. The mean age was 68 yr (ranging from 41 to 91 yr), 400 patients were men. The risk factors included hypertension in 73%, smoking history in 60%, coronary artery disease in 51% and hyperlipidemia in 35%. The indications were asymptomatic stenosis in 47%, transient ischemic attack in 40%, vertebrobasilar symptoms in 7% and stroke in 6%. EARLY RESULTS: The combined 30-day stroke and death rate was 0.9%. There were four deaths. The stroke and TIAs rates were 0.2% and 1.5% respectively. The incidence of early carotid occlusion was 0.5%. Cranial or cervical nerve dysfunction was identified in 6.3%. LATE RESULTS: The median follow-up was 49 months with a range of 2-124 months. Cumulative survival rates at 5 and 10 yr were 92+/-1% and 89+/-2% respectively. Thirty-two patients died during long-term follow-up; the death was stroke-related in only three patients. CONCLUSION: Carotid endarterectomy using an intraluminal shunt and vein patch closure is a safe and effective procedure associated with low morbidity and mortality rates at short and long-term follow-up.

Adult↗
PubMedDate not supplied

Pseudoaneurysm of the internal carotid artery: treatment with a covered stent.

Dissection of the cervical segment of the internal carotid artery may occur spontaneously or after trauma. We report the management of a 53-year-old right-handed man with progressive dizziness and neck pain 6 weeks after a motor vehicle collision. The clinical and neurologic examinations were normal. The CT scan led to the diagnosis of a pseudoaneurysm of the right internal carotid artery near the skull base. We successfully treated this post-traumatic lesion with a covered stent. The patient underwent the endovascular procedure under general anesthesia and transcranial Doppler monitoring. No neurologic event was observed. Obliteration of the pseudoaneurysm with preservation of the carotid artery was achieved. The patient was discharged from the hospital 72 hr later with no complications. Clinical and imaging follow-up at 6 months was unremarkable.

Aneurysm, False↗
PubMedDate not supplied

Beating heart surgery using the Octopus tissue stabilizers: initial experience including triple vessel disease and high-risk patients.

OBJECTIVE: The aim of this study was to evaluate initial results in beating heart coronary artery bypass grafting performed on patients with multivessel disease, using suction-based tissue stabilizers. METHODS: Forty patients (mean age 65.5 years, range 39-83) underwent beating heart coronary bypass by median sternotomy, with the use of the Octopus 1 (n = 27) and Octopus 2 (n = 13) devices. Twenty patients had unstable angina, four had pulmonary oedema, and four required preoperative intra-aortic balloon counterpulsation. Five interventions were repeat procedures. Mean ejection fraction was 54.4%(range 20-82%). Eighteen patients had triple-vessel disease, 18 patients had double-vessel disease and > 50% left main stem stenosis was present in six patients (isolated or in association). The average number of distal anastomoses was 2.5 (range 1-5, total 101). A mean of 1.5 (range 1-3) anastomoses was achieved with arterial grafts (45 mammary and 12 gastroepiploic arteries). RESULTS: Immediate graft patency was evaluated by Doppler flowmeter and five anastomoses were successfully corrected, based on an occlusion pattern. The perioperative myocardial infarction rate was zero. Transient episodes of supraventricular arrhythmias were detected in 19 patients. The administration of dobutamine at an inotropic concentration > 5 gamma-1 kg-1 min-1 was required in one patient. There were two in-hospital deaths (one non-cardiac-related). Overall survival and cardiac event-free rate at 20 months were 92.4% +/- 4.2% and 81.8% +/- 11.6%, respectively. CONCLUSIONS: Satisfactory results can be achieved in multivessel disease high-risk patients with beating heart coronary bypass surgery.

Adult↗
PubMedDate not supplied

Transilluminated powered mini-phlebectomy: early clinical experience.

We report our preliminary experience with a new surgical endoscopic technique, the Transilluminated Powered Phlebectomy (TriVex System, Smith + Nephew) to remove varicose veins. TriVex System combined an irrigated illuminator device and a powered vein resector. There were 15 patients with a mean age of 50 years, nine were women and six were men. We evaluated prospectively the safety, efficacy and clinical benefits of this new surgical device.

Adult↗