[Can minimal arterial aggressions using non-penetrating mechanical clip suture prevent myo-intimal hyperplasia? Preliminary results].

SUBJECT:Vascular anastomosis is still associated with a significant rate of early (stenosis, thrombosis) and delayed (intimal hyperplasia) complications. Even though suture closure remains the most widespread standard procedure, many mechanical systems have been developed mostly using non penetrating clips, aiming to make the suture easier, to reduce the operating time and to reduce the scarring process of the arterial wall. We investigated the usefulness of non penetrating titanium Vascular Closure Staple (VCS) developed for peripheral blood vessels anastomosis, in a study on 20 rabbits with the small VCS system. MATERIAL AND METHODS:On 20 rabbits, 9 of the aortic sutures were done with VCS clips and 11 were done by standard closure. RESULTS:We found a significant improvement in the operating time of the closure (9 +/- 2 minutes versus 14 +/- 4 minutes), early and delayed (10 weeks) patency and the respect of the aorta diameter (0.248 +/- 0.01 centimetres versus 0.246 +/- 0.039 centimetres) and loss of surface (40.3 +/- 5.59% versus 45.6 +/- 6.34%). The main improvement is the reduced intimal hyperplasia (0.128 +/- 0.05 millimetres versus 0.198 +/- 0.032 millimetres. P=0.012). CONCLUSION:Arterial closure can be performed more rapidly with VCS clips than with suture closure, and with a marked reduced reaction of intimal hyperplasia. With those elements it is necessary to continue the experimental studies and to evaluate the VCS sutures at mean and long term.

被引量：- 发表：2001

[Management of patients with essential hypertension. Clinical recommendations and economic data. Guidelines April 2000. Recommendations of the ANAES].

被引量：- 发表：2000

[Recommendations of the University National Committee on Vascular Surgery: vascular medicine for the recruitment of university and hospital physicians].

被引量：- 发表：2000

[Placebo controlled efficacy of class 1 elastic stockings in chronic venous insufficiency of the lower limbs].

OBJECTIVE:To compare, in a 4-week clinical trial, the efficacy of class 1 Elastic Compression Stockings (pressure at the ankle 10 to 15 mmHg) to that of Placebo Stockings (pressure at the ankle 3 to 6 mmHg) in women consulting in general practice for mild, symptomatic, chronic venous insufficiency of the lower limbs. PATIENTS AND METHODS:This was a 4-week multicentre, randomised, double-blind, placebo-controlled clinical trial conducted on two parallel groups of patients presenting with mild chronic venous insufficiency grade C(1-3S) E(p) A(S1-5) according to the CEAP classification. Treatment efficacy was assessed by the following criteria: global impairment as assessed at each visit on a visual analogue scale (primary efficacy parameter), Quality of Life measured by the CIVIQ questionnaire, symptoms index (sum of individual scores for pain, limb heaviness, paresthesias, cramps and evening limb oedema), limb volume measured by volumetry, and the evolution of global impairment during the course of the trial as assessed by repeated auto-evaluations on visual analogue scales. Compliance was assessed by the number of days patients wore the stockings for at least ten hours per day. Treatment tolerability was assessed by the record of the possible adverse events. RESULTS:Three hundred and forty one patients were included in total. Statistically significant differences were observed on global score of quality of life in favour of class 1 Elastic Compression Stockings group. In the subgroup of patients with evening limb oedema at inclusion, the decrease of limb volume noted with class 1 Elastic Compression Stockings was all the more marked that evening limb oedema was more pronounced at baseline. A good compliance was observed in 76% to 80% of patients according to the treatment group. Tolerability of class 1 Elastic Compression Stockings was comparable to that of the Placebo Stockings. CONCLUSIONS:After four weeks of treatment, compression with class 1 Elastic Compression Stockings allows a statistically significant improvement of Quality of Life and a decreasing of limb oedema in patients presenting with mild chronic venous insufficiency of the lower limbs. Moreover, the tolerability of class 1 Elastic Compression Stockings was confirmed by the high level of patient compliance.

被引量：14 发表：2000

[Graduation of honorary members] [In Process Citation]

被引量：- 发表：2000