Laparoscopic aortic surgery: Techniques and results.

Objective: This review describes and evaluates the results of laparoscopic aortic surgery.

Methods: We describe the different laparoscopic techniques used to treat aortic disease, including (1) total laparoscopic aortic surgery (TLS), (2) laparoscopy-assisted procedures including hand-assisted laparoscopic surgery (HALS), and (3) robot-assisted laparoscopic surgery, with their current indications. Results of these techniques are analyzed in a systematic review of the clinical series published between 1998 and 2008, each containing >10 patients with complete information concerning operative time, clamping time, conversion rate, length of hospital stay, morbidity, and mortality.

The VenaTech LP permanent caval filter: effectiveness and safety in the prevention of pulmonary embolism--a European multicenter study.

Purpose: To evaluate (i) the appropriateness, safety, and patient outcomes after placement of the VenaTech LP caval filter and (ii) the success of filter insertion through various venous access routes.

Materials And Methods: An open multicenter prospective observational study was conducted in 12 European centers, including an initial part limited to four centers. Patients with common indications were eligible for inclusion after approval by an independent ethics committee.

Results in a consecutive series of 83 surgical corrections of symptomatic stenotic kinking of the internal carotid artery.

Background: Although there is a growing body of evidence to document the safety and efficacy of operative treatment of carotid stenosis, surgical indications for elongation and kinking of the internal carotid artery remain controversial. The goal of this study was to evaluate the efficacy of surgical correction of internal carotid artery kinking in patients with persistent hemispheric symptoms despite antiplatelet therapy.

Methods: A consecutive series of 81 patients (mean age, 64 years) underwent 83 surgical procedures to correct kinking of the internal carotid artery either by shortening and reimplanting the vessel on the common carotid artery, inserting a bypass graft, or transposing the vessel onto the external carotid artery.

Long-term results of a multicenter randomized study on direct versus crossover bypass for unilateral iliac artery occlusive disease.

Objective: To compare late patency after direct and crossover bypass in good-risk patients with unilateral iliac occlusive disease not amenable to angioplasty.

Methods: Between May 1986 and March 1991, 143 patients with unilateral iliac artery occlusive disease and disabling claudication were randomized into two surgical treatment groups, ie, crossover bypass (n = 74) or direct bypass (n = 69). The size of the patient population was calculated to allow detection of a possible 20% difference in patency in favor of direct bypass with a one-sided alpha risk of 0.

Surgical revascularization of renal artery after complicated or failed percutaneous transluminal renal angioplasty.

Purpose: The purpose of this study was to evaluate the feasibility and effectiveness of surgical reconstruction of the renal artery after complicated or failed percutaneous transluminal renal angioplasty (PTRA).

Methods: This was a retrospective study of 45 consecutive patients who were referred to our centers for surgical renal artery reconstruction after 52 complicated or failed PTRA procedures performed between 1980 and 2003. There were 27 women and 18 men, with a median patient age of 28 years (25th percentile, 13.

InterGard silver bifurcated graft: features and results of a multicenter clinical study.

Objectives: Recent research in vascular surgery has focused on development of infection-resistant prosthetic grafts. This article describes the results of a multicenter study to evaluate safety, patency, and infection rates after implantation of the InterGard Silver bifurcated polyester graft coated with collagen and silver.

Methods: Between October 2000 and February 2002, 289 consecutive patients were implanted with a collagen and silver acetate-coated polyester bifurcated graft at 16 French vascular surgery centers.

Long-duration temporary vena cava filter: a prospective 104-case multicenter study.

Background: Nonpermanent caval filters are placed in critical thromboembolic situations in which anticoagulation therapy is transiently contraindicated, ineffective, or the source of complications. The purpose of this study was to assess the safety and effectiveness of a second-generation long-duration temporary caval filter in these situations and compare its utility with that of other temporary filters.

Methods: This prospective study, including patients who underwent temporary caval filtration with the Tempofilter II, was conducted in nine European centers.

Total laparoscopic aortic repair for occlusive and aneurysmal disease: first 95 cases.

Objectives: To analyze the outcome of our preliminary experience with total laparoscopic aortic repair in patients with occlusive or aneurysmal disease.

Material And Methods: From September 2002 to April 2005, we performed 95 consecutive total laparoscopic aortic repair procedures including 72 for aortic occlusive disease (group A) and 23 for abdominal aortic aneurysm (group B).

Results: In group A, mean operating time was 216+/-50 min with a mean clamp time of 57+/-21 min and surgical conversion was required in two cases (2.

Stent-graft repair for thoracic aortic disease: results of an independent nationwide study in France from 1999 to 2001.

Background: The purpose of this study was to assess the overall short-term outcome of stent-graft repair for thoracic aortic disease in France between June 1999 and May 2001.

Methods: This retrospective study was designed by the French National Health Insurance Fund for Salaried Workers. To ensure objectivity, data were retrieved at each center and checked by a team of medical advisors.

Endoluminal angioplasty of the popliteal artery. Review of 54 consecutive patients.

Aim: To determine the results of endoluminal angioplasty for occlusive or stenotic lesions of the popliteal artery.

Methods: Retrospective study of symptomatic patients having popliteal occlusive lesions treated by endoluminal balloon angioplasty. All patients underwent systematic preoperative and postoperative color duplex scan and preoperative angiography.

Totally laparoscopic aortic repair: a new device for direct transperitoneal approach.

On the basis of our experience with more than 71 cases of totally laparoscopic aortic surgery by the retrocolic approach, we have developed a new technique by a simple transperitoneal approach. The purpose of this report is to describe that technique and the novel laparoscopic bowel retractor used to ensure stable exposure of the aorta.

[Treatment for carotid stenosis: surgery, the reference].

THE CONTROVERSY: The indications for carotid revascularisation are clearly codified, but the surgical treatment is debatable. The angioplasty initially proposed for non-atheromatous stenosis or for high surgical risk patients is used by some as first-line therapy, although no benefit/risk ratio in its favour has been demonstrated. ARE THERE ANY BENEFITS WITH SURGICAL TREATMENT?: The efficacy of surgery in the treatment of atheromatous carotid stenosis has been demonstrated.

Use of abdominal aortic endovascular prostheses in France from 1999 to 2001.

Background: Since the introduction of endovascular repair (EVR) for infrarenal abdominal aortic aneurysm (AAA), clinical evaluation has been under way in many countries throughout the world. The main purpose of this retrospective study was to determine outcome of EVR with aortic endovascular prostheses (AEPs) and to evaluate the extent to which French practitioners have complied with regulatory and clinical guidelines for the use of these trial devices.

Methods: This retrospective study was conducted by the French National Health Insurance Fund for Salaried Workers.

Modalities of surveillance after carotid endarterectomy: impact of surgical technique.

The purpose of this study was to assess the need for follow-up duplex scan (DS) 1 year after carotid endarterectomy (CE) performed with prosthetic patching and intraoperative completion arteriography. Between April 1994 and December 2000, a total of 605 CE procedures with prosthetic patch closure and intraoperative completion arteriography were performed in 540 patients. All patients underwent DS at 4 days and then yearly after the procedure.

Carotid bypass with polytetrafluoroethylene grafts: a study of 110 consecutive patients.

Background: Carotid endarterectomy (CEA) is the standard treatment for atherosclerotic lesions involving the carotid bifurcation. However, CEA can be challenging under some conditions. We describe the technique and outcome of prosthetic carotid bypass grafting (PCB) with polytetrafluoroethylene (PTFE) grafts as an elective alternative to CEA.

Endovascular repair of abdominal aortic aneurysm: one-year results of the French AneuRx trial.

The purpose of this prospective study was to evaluate the results of abdominal aortic aneurysm (AAA) repair using the Medtronic AneuRx endovascular stent graft. Forty-seven patients presenting with asymptomatic AAA were recruited in 17 French vascular centers. The mean age of these patients was 72.

Closure of carotid bifurcation endarterectomy using a polyurethane patch. A multicentre prospective study with 252 patients.

Background: In order to evaluate the results of carotid endarterectomy with closure using a polyurethane patch, a multicentre prospective study of 252 patients (263 interventions) undergoing this operation was performed between November 1996 and August 2001.

Methods: One hundred and seventy-one men and 81 women with a mean age of 70 years were studied. Fifty-five percent of the patients had neurological symptoms.

[Iliac venous leiomyosarcoma revealed by cruralgia: a case report].

The iliac venous leimyosarcoma is rare, usually malignant, and often occurs with oedema or phlebitis. We report one case of iliac venous leiomyosarcoma revealed by cruralgia. A 69 years old patient, presented with a left cruralgia which had been developing for three months and which happened after an insignificant trauma.

Infected aneurysms of neck and limb arteries: a retrospective multicenter study.

Infected aneurysms (IA) of neck and limb arteries are uncommon. This report describes the results of a retrospective study undertaken by the University Association for Surgical Research (AURC) to evaluate etiology, bacteriology, location, diagnostic features, and therapeutic methods associated with IA. A total of 58 IA in 52 patients were reviewed.

Optimization of the resistance of arterial allografts to infection: comparative study with synthetic prostheses.

Arterial allografts can be used for in situ treatment of prosthetic graft infection. The purpose of this in vitro study was to compare the resistance of allografts and synthetic prostheses to infection by five strains of bacteria and to study antibiotic treatments designed to reduce allograft infection. Fresh and cryopreserved allografts were compared with synthetic prostheses made of various biomaterials including PTFE, plain Dacron, gelatine-sealed Dacron, and gelatine-sealed, rifampicine-bonded Dacron.

Do internal iliac arteries contribute to vascularization of the descending colon during abdominal aortic aneurysm surgery? An intraoperative hemodynamic study.

The inferior mesenteric artery (IMA) is the nutrient artery for the descending colon. Colon ischemia after repair of abdominal aortic aneurysm (AAA) can be prevented by routine or elective revascularization of the IMA. In case of occlusion of the IMA, revascularization of the internal iliac artery (IIA) has been recommended but its effectiveness has never been documented.

Emergency interruption of the inferior vena cava: a debatable issue.

In spite of improvements in the diagnosis and treatment of thromboembolic disease, pulmonary embolism continues to be a major cause of morbidity and mortality. Anticoagulation remains the preferred therapy for deep venous thrombosis; however, this form of treatment is either ineffective or contraindicated for some patients. For these patients, partial interruption of the inferior vena cava via percutaneous filter placement has become the procedure of choice to protect against fatal pulmonary embolism.