References of "Desiron, Quentin"
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See detailLe cas clinique du mois. Les endofuites, une complication specifique du traitement endovasculaire des pathologies aortiques.
BRULS, Samuel ULg; CREEMERS, Etienne ULg; TROTTEUR, Geneviève ULg et al

in Revue Médicale de Liège (2011), 66(11), 559-63

Endoleaks represent the most common complication of endovascular aortic aneurysm repair. With the increasing use of endovascular techniques for aortic aneurysm repair, the prevalence of endoleaks has ... [more ▼]

Endoleaks represent the most common complication of endovascular aortic aneurysm repair. With the increasing use of endovascular techniques for aortic aneurysm repair, the prevalence of endoleaks has risen. While maintaining pressurization of the aneurysm sac, endoleaks expose to persistent risks of an evolution towards rupture. Long-term surveillance with imaging studies is necessary to reduce the incidence of these specific complications that may require intervention. The objective of this article is to draw the attention to the possible occurrence of these complications and to report the elements of diagnosis and treatment. [less ▲]

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See detailBispectral Index profile during carotid cross clamping
Bonhomme, Vincent ULg; Desiron, Quentin ULg; Lemineur, Thierry et al

in Journal of Neurosurgical Anesthesiology (2007), 19(1), 49-55

This study aimed at investigating the Bispectral Index (BIS) profile during carotid cross clamping (CXC). The study involved a pilot group of 10 patients undergoing routine carotid endarterectomy with ... [more ▼]

This study aimed at investigating the Bispectral Index (BIS) profile during carotid cross clamping (CXC). The study involved a pilot group of 10 patients undergoing routine carotid endarterectomy with shunt insertion under total intravenous anesthesia, and a study group of 26 additional patients. In all patients, rates of propofol and remifentanil providing a steady-state level of hypnosis (BIS: 40-60) were maintained constant throughout a recording period ranging from 3 minutes before CXC to shunt insertion. BIS was recorded throughout this period and the internal carotid backflow observed at the time of shunt insertion was graded as good, moderate, or poor. In addition, A-Line Autoregressive Index (AAI) and processed electroencephalogram (EEG) parameters were recorded in patients of the study group. All parameters were averaged over I minute before CXC, at CXC, 1, 2, and 3 minutes after CXC, and at shunt insertion. Statistical analysis was performed using X 2, Friedman, and Spearman correlation tests. For technical reasons, reliable AAI, BIS monitor-derived, and other processed EEG data were obtained in 24, 25, and 18 patients of the study group, respectively. During the first 3 minutes after CXC, BIS increased over 60 [68.8 (6.1)] in 47%, decreased below 40 [34.9 (4.4)] in 25%, and remained in the 40 to 60 range in 28% of all recruited patients. A BIS increase was more frequently observed in patients with moderate or poor than in those with good internal carotid backflow (78, 67, and 29%, respectively). It was significantly correlated to an increase in AAI and EEG amplitude, a decrease in EEG suppression ratio, and a shorter time between induction of anesthesia and CXC. A BIS decrease was significantly correlated to an increase in suppression ratio and a longer time between induction and CXC. In conclusion, during CXC under a constant level of intravenous anesthesia, BIS may increase, decrease, or remain unchanged. The paradoxical BIS increase could be related to borderline ischemia, a change in brain anesthetic agent concentration, or a change in the nociceptive-antinociceptive balance associated with a CXC-elicited painful stimulation. Caution should be used when interpreting BIS value during CXC. [less ▲]

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See detailPotential benefits of laparoscopic aorto-bifemoral bypass surgery
Rouers, Anthony; MEURISSE, Nicolas; LAVIGNE, Jean-Paul ULg et al

in Acta Chirurgica Belgica (2005), 105(6), 610-615

Background: This series aims to prove the positive impact of laparoscopic approach in aortofemoral bypass grafting. Methods : It concerns a retrospective non randomized study comparing 58 consecutive ... [more ▼]

Background: This series aims to prove the positive impact of laparoscopic approach in aortofemoral bypass grafting. Methods : It concerns a retrospective non randomized study comparing 58 consecutive patients treated with laparoscopic procedure (n = 30) and with a standard open procedure (n = 28) in a single center. The different operating times, the complications and the follow-up of these two groups are compared Results : The demographics and angiographic data of the two groups were comparable. Operating time was longer in the laparoscopic group. However, we noticed a significant shorter hospitalisation stay (p < 0.0001) after the laparoscopic procedure with a mean 5.1 days. There was no significant difference of morbidity. Conclusion : We suggest that the trans-peritoneal approach is the best way in laparoscopic procedure in term of exposure and ergonomics. Laparoscopic aortofemoral bypass grafting is feasible, safe and effective. Shortening of operating time is observed as surgeon's experience grows. [less ▲]

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See detailSequential successful surgical management of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm. Case reports.
Detry, Olivier ULg; Defraigne, Jean-Olivier ULg; Desiron, Quentin ULg et al

in Vascular Surgery (1997), 31

The coexistence of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm is a rare event whose management is controversial. Theoretically, the correction of a significant stenosis ... [more ▼]

The coexistence of extracranial internal carotid stenosis and ipsilateral intracranial aneurysm is a rare event whose management is controversial. Theoretically, the correction of a significant stenosis of the extracranial internal carotid may lead to an increase in the downstream pressure in the intracranial carotid, and may consequently increase the risk of rupture of the ipsilateral aneurysm. Moreover, dramatic increase of blood pressure is not uncommon after carotid endarterectomy, and may promote aneurysmal rupture. Intracranial surgical correction of a hypoperfused aneurysm down to extracranial carotid stenosis should carry an increased risk of inadequate cerebral flow during procedure, and unspecific postoperative stimulation of platelets aggregation and coagulation may complete obstruction of a subtotal carotid stenosis. We report the cases of two patients successfully treated by a two-stage surgical procedure. In a first step, the intracerebral aneurysms were controlled and electively excluded by clipping. In a second step, carotid endarteriectomies were performed some days later without any neurological complications. Postoperative recoveries were uneventful and six months after these surgical procedures, clinical examination of both patients did not reveal any worsening of the preoperative neurological status. [less ▲]

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See detailComparison of results of carotid artery surgery after either direct closure or use of a vein patch.
Desiron, Quentin ULg; Detry, Olivier ULg; Van Damme, Hendrik ULg et al

in Cardiovascular Surgery (1997), 5(3), 295-303

In order to assess the benefit of vein patching versus direct closure after carotid endarterectomy, a series of 2271 carotid operations were analysed retrospectively. Apart from 114 procedures consisting ... [more ▼]

In order to assess the benefit of vein patching versus direct closure after carotid endarterectomy, a series of 2271 carotid operations were analysed retrospectively. Apart from 114 procedures consisting of saphenous vein bypass (n = 29) and eversion endarterectomy (n = 85), 2157 open endarterectomies were performed. They were closed either directly (n = 837) or using a vein patch (n = 1320). The combined mortality-major neurological morbidity rate was 1.7%, i.e. 1% mortality (0.2% neurological) and 0.7% permanent neurological morbidity (0.5% ipsilateral to the operated artery). Early symptomatic internal carotid thrombosis was documented in six cases (four following direct closure and two after vein patching). A total of 827 carotid arteries were followed up by duplex scanning on an annual basis (244 direct closure and 583 vein patching). The mean follow-up was 44 months; 69 months for direct closure and 35 months for vein patching. In direct closure, there were 21 stenoses (9%) and 10 occult thromboses (4%); in vein patching carotids, there were 17 stenoses (3%), nine thromboses (1.8%) [corrected] and six pseudoaneurysms (1%). Annual incidence of poor results was 2.4% in direct closure, and 0.87% in vein patching. The only other factor responsible for a significant difference was gender (3.4% in women versus 2.1% in men). In this retrospective study, vein patching appears to be beneficial for the prevention of acute postoperative thrombosis and late stenosis or thrombosis. [less ▲]

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See detailKinking of the Internal Carotid Artery: Clinical Significance and Surgical Management
Van Damme, Hendrik ULg; Gillain, Daniel ULg; Desiron, Quentin ULg et al

in Acta Chirurgica Belgica (1996), 96(1), 15-22

The authors report on 62 surgical corrections for kinking of the internal carotid artery during a 13-year period (1980-1993). This represents 2.8% of all carotid operative procedures (n = 2188) in the ... [more ▼]

The authors report on 62 surgical corrections for kinking of the internal carotid artery during a 13-year period (1980-1993). This represents 2.8% of all carotid operative procedures (n = 2188) in the same period. It always concerned a significant (< 60 degrees) angulation of a redundant internal carotid artery, that in all but 3 cases was associated with atherosclerotic involvement of the carotid bifurcation. The indication to surgery included transient hemispheric or ocular ischaemia in 25.5% of cases, a regressive neurologic deficit in 8%, a minor stroke in 3%, a stroke in evolution in 11%, and non-lateralized cerebral ischaemia in 21%. In 19 patients (31%) it concerned an asymptomatic high degree stenosis. The surgical technique consisted in carotid transposition-reimplantation after eversion endarterectomy in 37 cases, in posterior transverse plication with patch angioplasty in 20 cases, and in segmental excision with venous interposition graft in 5 cases. There was one postoperative death. The morbidity include one ipsilateral non-fatal stroke and 3 transient ischaemic attacks. A complete long-term follow-up (mean duration 3.4 years) is available for 57 patients. The late incidence of stroke is 1.5% per year. The 5-year survival attains 67%. These long-term results are comparable to the outcome of standard endarterectomy in the same institution. The authors discuss the indication, techniques, and outcome of surgical correction of kinked internal carotid artery. They recommend a shortening procedure, often associated with endarterectomy for severely kinked vessels (angulation 60 degrees or less), symptomatic or not. [less ▲]

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See detailCarotid Surgery in Octogenarians: Is It Worthwhile?
VAN DAMME, Hendrik ULg; Lacroix; Desiron, Quentin ULg et al

in Acta Chirurgica Belgica (1996), 96(2), 71-7

Controversy surrounds the role of carotid endarterectomy in octogenarians. Although the prognosis of severe degree carotid stenosis is more ominous in the elderly, operative risk seems more important in ... [more ▼]

Controversy surrounds the role of carotid endarterectomy in octogenarians. Although the prognosis of severe degree carotid stenosis is more ominous in the elderly, operative risk seems more important in the aged. To evaluate the presumed detrimental effect of advanced age on the mortality-morbidity of carotid endarterectomy, the authors reviewed their common experience with carotid surgery in patients aged 80 years or more. From 1980 to 1994, 129 octogenarians were operated on for occlusive carotid artery disease in two university hospitals. The data for these patients, 80 years of age and older (group 1) are compared to these for a large middle age group (less than 80 years) (group 2) operated by the same surgeons during that period. The baseline characteristics of both groups were similar, except for smoking, diabetes and previous myocardial revascularization, more prevalent in the younger age group. In the elderly group prophylactic surgery for asymptomatic stenosis was done in 36%, versus 40% of the middle aged patients, and for stroke in evolution in 8% versus 4% (p < 0.05). The perioperative stroke rate was 0.8% in the group older than 80 years, compared to 1.2% for non octogenarians (NS). The operative mortality was similar for both age groups (2.3 and 1.5 respectively). The long-term results gave a similar outlook for both age groups. The 5-year stroke-free rate reached 89% for group 1 versus 91% for group 2. The 5-year survival rate, however, was less for the elderly patients (47% versus 77%, mean follow-up periods of 30 and 49 months). These results suggest that carotid endarterectomy can be safely done in elderly patients, with a similar risk/benefit ratio as for the younger patients. Advanced age, by itself, is not to be considered as contraindication to carotid surgery. [less ▲]

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See detailSaphenous vein patch (SVP) is superior to direct closure (DC) for long-term patency of carotid endarterectomy (CEA)
Desiron, Quentin ULg; Detry, Olivier ULg; Sakalihasan, Natzi ULg et al

in Cardiovascular Surgery (1995, September), 3(Suppl. 1), 44

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See detailIsolated Atherosclerotic Aneurysms of the Iliac Arteries
Desiron, Quentin ULg; Detry, Olivier ULg; Sakalihasan, Natzi ULg et al

in Annals of Vascular Surgery (1995), 9(Suppl), 62-6

Atherosclerotic aneurysms limited to the iliac arteries are rare and entail a high risk of rupture. To evaluate the efficacy of prophylactic surgery, we retrospectively studied 15 patients (13 men and two ... [more ▼]

Atherosclerotic aneurysms limited to the iliac arteries are rare and entail a high risk of rupture. To evaluate the efficacy of prophylactic surgery, we retrospectively studied 15 patients (13 men and two women; mean age 69 years) treated for isolated iliac aneurysms in the Department of Cardiovascular Surgery at the University Hospital of Liege over a period of 18 years. They had a total of 25 aneurysms (20 common iliac and five internal iliac). Six patients were treated electively and nine on an emergency basis for rupture. Five of the emergency patients (33%) died in the early postoperative period (< 30 days); in each case the aneurysm had ruptured and an emergency operation was performed (55.5% mortality in the ruptured iliac aneurysm group). On the other hand, all patients treated electively survived. Our study is comparable to other recent series in the literature, which also reported a high incidence of rupture and death in emergency operations. Prophylactic elective surgery is recommended for iliac aneurysms. [less ▲]

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See detailRôle de la chirurgie carotidienne dans la prévention de l'infarctus cérébral
Limet, Raymond ULg; DESIRON, Quentin ULg; DETRY, Olivier et al

in Bulletin et Mémoires de l'Académie Royale de Médecine de Belgique (1994), 149(5-7), 299-305306-7

A significant part of transient or permanent cerebral ischemic attacks (CIA) are due to arterio-arterial emboli issued from carotid plaques. Surgery for carotid disobstruction aims to take out emboligenic ... [more ▼]

A significant part of transient or permanent cerebral ischemic attacks (CIA) are due to arterio-arterial emboli issued from carotid plaques. Surgery for carotid disobstruction aims to take out emboligenic plaques by endarterectomy (associated to angioplasty or not). The adversaries of surgical treatment sustain two main assertions: 1. carotid stenoses are not very dangerous, because the definitive thromboses they create are easily compensated by the development of collaterals, so that the risk for stroke is low. 2. this low and late risk of spontaneous carotid thrombosis is not greater than the immediate one following carotid surgery. Those objections have been encountered in randomized North American studies (Nascet [less ▲]

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