References of "Van Damme, Hendrik"
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See detailBilateral humeral artery aneurysm as a cause of digital ischaemia.
Marival, T.; Vandaele, S.; Van Damme, Hendrik ULg et al

in Acta Chirurgica Belgica (2008), 108(6), 750-2

Bilateral humeral artery aneurysm is a very rare condition. Simultaneous bilateral complication of these aneurysms makes it even more unusual. We present a case of a 44-year-old man with bilateral digital ... [more ▼]

Bilateral humeral artery aneurysm is a very rare condition. Simultaneous bilateral complication of these aneurysms makes it even more unusual. We present a case of a 44-year-old man with bilateral digital ischaemia as a complication of a bilateral humeral artery aneurysm. Anamnestic, clinical and per-operative findings led to several hypotheses. A venous bypass graft was done to exclude both aneurysms and to arrest the embolisation into the digital arteries. [less ▲]

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See detailAssociation of abdominal aortic aneurysm, horseshoe kidneys, and left-sided inferior vena cava: report of two cases.
Radermecker, Marc ULg; Van Damme, Hendrik ULg; Kerzmann, Arnaud ULg et al

in Journal of Vascular Surgery (2008), 47(3), 645-8

Surgery for abdominal aortic aneurysm may be challenging when rare renal or venous anomalies are present. This article reports two similar cases of aortic abdominal aneurysm associated with horseshoe ... [more ▼]

Surgery for abdominal aortic aneurysm may be challenging when rare renal or venous anomalies are present. This article reports two similar cases of aortic abdominal aneurysm associated with horseshoe kidney and left-sided inferior vena cava treated with a transperitoneal approach. Preoperative knowledge of the anatomic situation enabled appropriate aneurysm repair. Operative strategy is discussed. This report describes an uncommon venous vascular malformation complex and stresses the importance of computed tomography imaging not only in assessing the characteristics of the aneurysmal disease but also in detecting variations in pertinent vascular or parenchymal anatomy. [less ▲]

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See detailSpinal cord stimulation. New regulation of national health insurance.
Van Damme, Hendrik ULg; Suy, R.; Van den Brande, P. et al

in Acta Chirurgica Belgica (2008), 108(1), 139-41

Since January 1, 2008, the Belgian national health insurance (INAMI/RIZIV) edited a new agreement for the prolongation of the pilot-study on spinal cord stimulation for chronic critical unreconstructable ... [more ▼]

Since January 1, 2008, the Belgian national health insurance (INAMI/RIZIV) edited a new agreement for the prolongation of the pilot-study on spinal cord stimulation for chronic critical unreconstructable lower limb ischemia. After a short introduction and a summary of the results of the initial Belgian pilot study (2000-2005) on spinal cord stimulation, the official new text is now published in both languages. [less ▲]

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See detailFDG PET/CT for diagnostic arterial prosthetic graft infection : preliminary report.
NAMUR, Gauthier ULg; VAN DAMME, Hendrik ULg; BECKERS, Catherine ULg et al

in PROCEEDINGS OF XIIIth SYMPOSIUM OF THE BELGIAN SOCIETY OF NUCLEAR MEDICINE (2007, May)

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See detailDiagnosis and treatment of peripheral arterial disease: recommendations for the medical practice in Belgium.
Clement, Denis; Kolh, Philippe ULg; Motte, Serge et al

in Acta Chirurgica Belgica (2007), 107(6), 595-604

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See detailRupture d'un anevrysme iliaque externe six ans apres un bypass aorto-bifemoral.
Duysens, C.; Quaniers, Janine ULg; Van Damme, Hendrik ULg et al

in Revue Médicale de Liège (2007), 62(1), 7-10

We report the case of a patient operated on for an aorto-iliac aneurysm with an aorto-bifemoral bypass who presented a metachronous iliac aneurysm rupture, six years later, because of aneurysmal ... [more ▼]

We report the case of a patient operated on for an aorto-iliac aneurysm with an aorto-bifemoral bypass who presented a metachronous iliac aneurysm rupture, six years later, because of aneurysmal degeneration. We performed bipolar ligation of the external iliac artery and an end-to-end anastomosis of the prosthetic limb to the common femoral artery. We discuss aneurysms of the external iliac artery, characterised by their rarity, their specific morbidity and mortality. [less ▲]

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See detailAmputation in diabetic patients.
Van Damme, Hendrik ULg; Limet, Raymond ULg

in Clinics in Podiatric Medicine & Surgery (2007), 24(3), 569-82

In diabetes-related amputations, the risk of nonhealing or infection of a wound and the need for revision are increased. Medical treatment before amputation should optimize general and local conditions ... [more ▼]

In diabetes-related amputations, the risk of nonhealing or infection of a wound and the need for revision are increased. Medical treatment before amputation should optimize general and local conditions including the regression of edema, the control of infection, and the optimization of glucoregulation. A major argument for foot-sparing surgery is the poor functional recovery after major limb amputation. Diabetic patients are frail, with an increased postoperative morbidity and mortality after major amputation. Factors detrimental to functional outcome are advanced age, end-stage renal disease, dementia, and above-knee amputation. A multidisciplinary approach is required to optimize the results of diabetes-related amputations. The authors discuss medical and technical aspects that may reduce the failure of minor or major diabetes-related amputations. [less ▲]

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See detailIntra-arterial thrombolysis of thrombosed popliteal artery aneurysm. A series of six cases
Van Damme, Hendrik ULg; Trotteur, Geneviève ULg; Kerzmann, Arnaud ULg et al

in Acta Chirurgica Belgica (2006), 106(6), 679-683

Aim of the study : To evaluate the role of perioperative, catheter-guided fibrinolysis in the management of thrombosed popliteal artery aneurysms. Material : From 1990 to 2005, six patients suffering ... [more ▼]

Aim of the study : To evaluate the role of perioperative, catheter-guided fibrinolysis in the management of thrombosed popliteal artery aneurysms. Material : From 1990 to 2005, six patients suffering subacute limb ischemia, secondary to thrombosis of a popliteal artery aneurysm, benefited selective intra-arterial fibrinolysis, followed by subsequent aneurysm exclusion and bypass grafting. This represents ten percent of all popliteal aneurysms operated on in that time period and 28% of all thrombosed popliteal artery aneurysms. Results : The lytic procedure was successful in all cases, restituting patency in two (n = 3), one (n = 2) or all (n = 1) crural arteries. The venous bypass graft remained patent in all but one patient. In one patient, the graft occluded at 10 months without limb loss. This outcome compares more favorable than the result obtained with emergent surgery alone for thrombosed popliteal artery aneurysms with profound limb ischemia (eight patients, of whom one required amputation at day 5 and one lost his limb at nine months following graft thrombosis). Conclusion : Preoperative intra-arterial lytic therapy, in the setting of subacute limb ischemia caused by thrombosis of a popliteal artery aneurysm, can be considered as safe and effective. [less ▲]

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See detailRetour sur les dilatations-stenting des carotides
Van Damme, Hendrik ULg; Limet, Raymond ULg

in Revue Médicale de Liège (2006), 61(10), 697-704

Recent publications about carotid-stenting are submitted to a critical analysis. The fact that an interventional approach in asymptomatic carotid lesions generates only marginal benefit being universally ... [more ▼]

Recent publications about carotid-stenting are submitted to a critical analysis. The fact that an interventional approach in asymptomatic carotid lesions generates only marginal benefit being universally admitted, it is disturbing to see that modern series devoted to carotid artery stenting include a lot of asymptomatic patients and many symptomatic patients with a degree of stenosis well below the optimal range defined in NASCET (70 to 99%). Moreover, the degree of stenosis is often calculated from an inappropriate method that overestimates the degree of stenosis. Two objections have been made about an "hyper-selection" of the patients enrolled in the NASCET study and the production of ideal not realistic results, not attainable in community hospitals; both objections have been overruled. The rate of acute perioperative myocardial infarction is mentioned, both in NASCET and ECST, it is around 0.9% vs 7.5% in SAPPHIRE study. Moreover, carotid artery stenting with an embolic protection device has resulted in the production of infra-clinical cerebral micro-infarcts in 40% of the patients. Significantly, the independent study EVA-3S, devoted to symptomatic patients had to be stopped because of the high cerebral morbidity in the dilatation-stenting group. Carotid artery stenting of asymptomatic lesions is futile (and potentially harmful because of microinfarcts) while carotid artery stenting of symptomatic lesions generate emboli. [less ▲]

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See detailLe cas clinique du mois. Anevrisme de l'aorte thoracique fistulise dans l'oesophage
Weber, Laurence ULg; Van Damme, Hendrik ULg; Creemers, Etienne ULg et al

in Revue Médicale de Liège (2006), 61(10), 675-81

Primary aorto-oesophageal fistula, secondary to an aneurysm of the thoracic aorta, are almost fatal. In the literature, only twenty six successfully operated cases have been reported. We report the case ... [more ▼]

Primary aorto-oesophageal fistula, secondary to an aneurysm of the thoracic aorta, are almost fatal. In the literature, only twenty six successfully operated cases have been reported. We report the case of a 78-year-old man with a thoracic aortic aneurysm eroded into the mid oesophagus. Prompt diagnosis of an aorto-oesophageal fistula resulted from clinical history, CT-imaging and oesophagoscopy. The patient was successfully operated by exclusion of the thoracic aneurysm (insertion of a straight cryopreserved arterial allograft), oesophagectomy and cervical oesophagostomy and jejunostomy. The continuity of the digestive tube was later restored after preliminary aortic valve remplacement (stenosis of 0.8 cm2). This case report is the second in which a cryopreserved allograft was successfully implanted in the management of a primary aorto-oesophageal fistula. [less ▲]

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See detailLessons learnt from carotid artery trials
Van Damme, Hendrik ULg; Limet, Raymond ULg

in Acta Chirurgica Belgica (2006), 106(5), 489-499

The objective of the authors is to assess the natural history of carotid artery disease and the role of carotid intervention in preventing ipsilateral stroke. The development of endovascular techniques ... [more ▼]

The objective of the authors is to assess the natural history of carotid artery disease and the role of carotid intervention in preventing ipsilateral stroke. The development of endovascular techniques for correction of carotid artery stenoses made this less invasive technique very popular, with an inherent risk of unregulated overuse by a variety of medical specialists, who are not always well informed on the natural history of carotid artery disease. It re-opened the discussion on the value of carotid endarterectomy for stroke prophylaxis. This ongoing debate offers the opportunity to distil evidence-based guidelines for the management of extracranial carotid artery stenoses. In recent papers, some authors expressed doubts on the validity and general applicability of the results of the pivotal randomised trials of carotid endarterectomy. The excellent results in terms of operative outcome and long term stroke prevention would, according to certain comments, not be attainable in routine practice. Another criticism of carotid endarterectomy is its higher operative morbidity in terms of cranial nerve lesions and myocardial infarctions, compared to endovascular procedures. This consideration is, for some authors, the main reason to espouse carotid artery stenting as a better alternative to carotid endarterectomy. Any evidence supporting this point of view is missing. The supposed equivalence or non-inferiority of carotid artery stenting is purely speculative. The aim of this review paper is to summarize the crude data of carotid surgery trials. The authors aim to answer four questions. For which lesions is carotid endarterectomy most beneficial ? Are the results of randomised carotid surgery trials biased by the selection of patients ? Is operative morbidity, other than stroke, under-estimated ? Is carotid artery stenting safe and efficacious ? An in-depth review with a critical analysis is made of recently published and on-going trials, comparing carotid surgery with percutaneous carotid angioplasty. [less ▲]

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See detailL'ischemie intestinale chronique et la revascularisation par pontage: a propos d'un cas
Marival, T.; Van Damme, Hendrik ULg; Limet, Raymond ULg

in Revue Médicale de Liège (2006), 61(2), 71-5

Intestinal angina is a rare affection with a high morbidity-mortality rate if not diagnosed. It is characterized by abdominal pain and postprandial vomiting, weight loss and anorexia. Arteriography allows ... [more ▼]

Intestinal angina is a rare affection with a high morbidity-mortality rate if not diagnosed. It is characterized by abdominal pain and postprandial vomiting, weight loss and anorexia. Arteriography allows confirmation of the diagnosis. The following case is a typical example of its clinical presentation and surgical treatment. Different techniques of revascularisation in case of a stenosis of the main digestive arteries are discussed. [less ▲]

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See detailLe cas clinique du mois. Necrose du cuir chevelu revelatrice d'une arterite a cellules geantes (maladie de Horton)
Smitz, S. S.; HEINEN, Vincent ULg; Van Damme, Hendrik ULg

in Revue Médicale de Liège (2006), 61(1), 5-7

Scalp necrosis is an uncommon manifestation of giant cell arteritis (GCA). In this paper, we report our experience with a 78-year old woman in whom extensive scalp necrosis developed as a complication of ... [more ▼]

Scalp necrosis is an uncommon manifestation of giant cell arteritis (GCA). In this paper, we report our experience with a 78-year old woman in whom extensive scalp necrosis developed as a complication of GCA. A left frontal defect (7 X 4 cm) involving full-thickness scalp was observed. The necrosis extended deeply, involving the epicranium and the outer table of the skull. The therapeutic approach included corticotherapy, anticoagulation and wound care. Severe wound infection (osteitis, subgaleal abscess) occurred, requiring prolonged antibiotherapy. Second intention healing was obtained using a conservative approach. During the healing process, areas of neovascularization developed beneath the exposed part of the outer table and the necrotic bone underwent resorption. [less ▲]

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See detailClinical Case of the Month. Cerebrovascular Accident Related to Arterial Brachiocephalic Trunk Stenosis
Pirard, Laurence ULg; Belachew, Shibeshih ULg; Trotteur, Geneviève ULg et al

in Revue Médicale de Liège (2006), 61(7-8, Jul-Aug), 553-8

The authors report the case of a 47-year old man, admitted for syncope and left-sided motor deficit. Diagnostic investigations revealed a right middle cerebral artery embolic stroke, secondary to a ... [more ▼]

The authors report the case of a 47-year old man, admitted for syncope and left-sided motor deficit. Diagnostic investigations revealed a right middle cerebral artery embolic stroke, secondary to a critical stenosis of the arterial brachiocephalic trunk, harboring a floating thrombus. The treatment options for occlusive lesions of the brachiocephalic trunk are discussed, as well as the optimal delay between stroke and brain revascularization. [less ▲]

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See detailAnalyse des resultats des principales etudes randomisees d'endarteriectomie carotidienne pour stenose asymptomatique
Van Damme, Hendrik ULg; Limet, Raymond ULg

in Revue Médicale de Liège (2005), 60(10), 811-3

The authors analyse the ACAS (1997-93) and ACST (1993-2003) trials, comparing the best medical therapy vs endarterectomy of an asymptomatic 60 % or more stenosis of the internal carotid artery. The ACAS ... [more ▼]

The authors analyse the ACAS (1997-93) and ACST (1993-2003) trials, comparing the best medical therapy vs endarterectomy of an asymptomatic 60 % or more stenosis of the internal carotid artery. The ACAS trial does not reveal any benefit of surgery in preventing major stroke during follow-up (stroke rate 3.4% vs 6.02% in medical group, N.S.). Only by considering minor and major strokes together, a beneficial effect of carotid endarterectomy could be evidenced (5.9% stroke reduction at 5 years: 5.1% ipsilateral stroke at 5 years after surgery vs 11% stroke at 5 years under medical treatment). Indeed, following surgery, the stroke risk (ipsilateral) at 5 years attained 5,1% vs 11% following medical treatment of an asymptomatic internal carotid artery stenosis of 60-99%. The ACST trial, set up in 1993, aimed to assess the long-term result of carotid endarterectomy for asymptomatic 60-99% stenosis. Patients randomized for immediate surgery had a slightly more favorable outcome than those allocated to medical treatment. Absolute risk reduction of major stroke at 5 years was 2.5%. Overall, the benefit of operating an asymptomatic carotid artery stenosis is rather low (1% less stroke per year and less than 0.5% major stroke reduction per year). This positive result is obtained only if the operative stroke-death rate remains extremely low (<2.8%). The indication for operating asymptomatic carotid stenosis must be cautiously taken; age of the patient, degree of stenosis and surgeon's experience and results are to be considered. [less ▲]

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See detailA propos d'une analyse retrospective parue dans Lancet sur les benefices de la chirurgie des stenoses carotidiennes symptomatiques. L'importance de definir ce dont on parle
Van Damme, Hendrik ULg; Limet, Raymond ULg

in Revue Médicale de Liège (2005), 60(9), 737-40

It is important to establish clear definitions concerning carotid artery disease, a topic that recently regained widespread interest in medical literature. Therefore, we summarize a paper of Rothwell and ... [more ▼]

It is important to establish clear definitions concerning carotid artery disease, a topic that recently regained widespread interest in medical literature. Therefore, we summarize a paper of Rothwell and Barnett, recently published in the Lancet 2003 (1). In their analysis, the data of three randomized trials, comparing carotid endarterectomy to optimal medical therapy alone for a symptomatic internal carotid artery stenosis, were pooled after standardization of the measurement of the degree of stenosis and redefinition of the outcome events, to achieve comparability of the results of each trial. This analysis concerns 6092 patients with 35,000 patient-years of follow-up. Surgery offers a marginal benefit for patients with a moderate (50-69%) symptomatic carotid artery stenosis (absolute risk reduction of 4.6% for subsequent ipsilateral stroke at 5 years). Surgery is highly beneficial for patients with a symptomatic 70-99% stenosis (absolute risk reduction of 16% for ipsilateral stroke at 5 years). The benefit is uncertain for a symptomatic "near occlusion" (99% with retarded opacification of the distal internal carotid artery): absolute risk reduction of -1.7% for ipsilateral stroke at 5 years). [less ▲]

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See detailL'ischemie aigue des membres: aspects cliniques, diagnostiques et therapeutiques
Van Damme, Hendrik ULg; Limet, Raymond ULg

in Revue Médicale de Liège (2005), 60(4), 247-54

Acute lower limb ischemia, with sudden interruption of tissue perfusion, is a medico-surgical emergency. An early diagnosis is a prerequisite for optimal management. Diagnosis is mainly based on clinical ... [more ▼]

Acute lower limb ischemia, with sudden interruption of tissue perfusion, is a medico-surgical emergency. An early diagnosis is a prerequisite for optimal management. Diagnosis is mainly based on clinical data. Complementary investigations have a limited place, and should not unnecessarily delay the treatment. There are two categories of acute arterial, non-traumatic occlusion: embolism and thrombosis of an atherosclerotic vessel. The distinction between these two entities is not always evident, since ischemia can be the consequence of an arterial embolism in a diseased atherosclerotic artery. We discuss the clinical aspects and the causes of acute lower limb ischemia. The prognosis, outcome and therapeutic management are determined by the cause of the acute arterial obliteration. [less ▲]

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See detailFactors promoting rupture of abdominal aortic aneurysms
Van Damme, Hendrik ULg; Sakalihasan, Natzi ULg; Limet, Raymond ULg

in Acta Chirurgica Belgica (2005), 105(1), 1-12

The risk for rupture of an abdominal aortic aneurysm is widely believed to be related to its maximum diameter. Rupture occurs at the site of maximum wall stress, when it exceeds the tensile strength of ... [more ▼]

The risk for rupture of an abdominal aortic aneurysm is widely believed to be related to its maximum diameter. Rupture occurs at the site of maximum wall stress, when it exceeds the tensile strength of the aortic wall. Basic research confirmed that peak wall stress and aortic wall biodegradation contribute to the mechanism of aneurysm rupture. In order to highlight the role of loss in wall strength and increase in focal peak stress, the authors reviewed recent literature. The clinical relevance of these recent insights in the etiopathogenesis of aneurysm rupture is analysed. [less ▲]

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See detailLe cas clinique du mois. Revascularisation des artères fémorales à partir de l'aorte thoracique descendante après thrombose d'un pontage axillo-bifémoral
Schleich, FLorence ULg; Van Damme, Hendrik ULg; Creemers, Etienne ULg et al

in Revue Médicale de Liège (2005), 60(1), 11-7

We report the case of a patient who had lower limb revascularization by a bypass graft originating from the decending thoracic aorta, after total thrombosis of an axillobifemoral bypass graft. The latter ... [more ▼]

We report the case of a patient who had lower limb revascularization by a bypass graft originating from the decending thoracic aorta, after total thrombosis of an axillobifemoral bypass graft. The latter had been performed for surgical repair of a secondary aorto-enteric fistula. We successively discuss the three particular apects of this observation: the secondary aortodigestive fistula, the axillobifemoral bypass and the bypass between the descending thoracic aorta and the femoral arteries. [less ▲]

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See detailLe pied diabetique
Van Damme, Hendrik ULg; Limet, Raymond ULg

in Revue Médicale de Liège (2005), 60(5-6, May-Jun), 516-25

The pathophysiological mechanisms underlying a diabetic foot disease are complex and multifactorial, including neuropathy, ischemia, infection and abnormal foot biomechanics. All these factors are often ... [more ▼]

The pathophysiological mechanisms underlying a diabetic foot disease are complex and multifactorial, including neuropathy, ischemia, infection and abnormal foot biomechanics. All these factors are often intricated and source of delayed wound healing. Insight in the pathophysiology of the diabetic foot provides a comprehensive basis for a protocol of primary and secondary preventive care. Since non-enzymatic glycosilation of proteins and of connective tissue underlies structural changes in vessels, nerves and osteo-articular structures, a rigid control of blood glucose levels is of paramount importance. Early recognition of the etiology of foot lesions and prompt management of foot ulcers are essential for successful outcome. Aggressive treatment of infections, clinical assessment and correction of vascular occlusive disease (diabetic macroangiopathy), adequate wound care and appropriate off-loading (pressure relief) of the ulcer are essential steps in the treatment protocol. It is not surprising that optimal management of the diabetic foot requires a multidisciplinary approach in a Diabetic Foot Clinic, coordinating care-provisions by a team of diabetologist, infectiologist, vascular surgeon, interventional radiologist, plastic surgeon, podiatrist and specialized nurse. Applying evidence-based multidisciplinary treatment results in a 50% reduction of major lower-limb amputation in this high risk group. [less ▲]

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