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Publications (5)2.59 Total impact

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    ABSTRACT: The objective of this study was to evaluate the effectiveness of a new method of in situ thrombolysis using a porous balloon with low pressure compared with traditional in situ infusion of a fibrinolytic agent in the treatment of acute limb ischemia. Between January 2010 and December 2011, 14 patients (mean age, 67.2 years; range, 40-89 years) treated for grade II acute lower limb ischemia for fewer than 14 days were included in the study. Thromboaspiration was tried initially in all the cases. All patients benefitted from a novel method of intra-arterial thrombolysis guided with a balloon catheter (ClearWay; Atrium Medical, Hudson, NH) and using the same agent thrombolytic (Actosolv). The total amount injected, the rate of morbidity associated with the thrombolytic treatment, and the duration of hospitalization in the continuous monitoring unit were analyzed. Recanalization was obtained in 92% of cases (13 of 14). The rate of morbidity related to the procedure was 7%. The amount of fibrinolytic agent necessary was relatively low (82,000 units/cm of occluded artery). The rate of limb salvage 6 months after recanalization was of 92%. The mean duration of stay in the continuous monitoring unit was 1.1 day. Intra-arterial thrombolysis using the ClearWay balloon catheter is an effective method in the treatment of acute peripheral arterial occlusion. In the event of embolic occlusion, mainly among very old patients, it could decrease the hemorrhagic risk. A randomized study in these high-risk patients could confirm these first results.
    Annals of Vascular Surgery 08/2013; 27(6):781-4. · 0.99 Impact Factor
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    ABSTRACT: The benefits of a rehabilitation program before surgical lung cancer resection remain to be defined. The purpose of this prospective observational study was to assess the effects of rehabilitation together with the use of noninvasive ventilation (NIV) in patients who were at a high operative risk. Between January 2010 and June 2011, 20 consecutive patients (16 males, four females, mean age: 66 years [44-79]) with a clinical N0 non-small cell lung cancer were included. Eligibility criteria were predicted post-operative respiratory function (FEV1, VO2 max) below the guideline thresholds for eligibility for surgical resection and/or associated with severe co-morbidities. The protocol included a cardiorespiratory rehabilitation program and 3hours of NIV each day. Functional tests were repeated after 3weeks of therapy. Participants displayed a significant increase in their FEV1 and VO2 max, which allowed surgical resection to go ahead in all patients (lobectomy, n=15; pneumonectomy, n=3; bilobectomy, n=2). The morbidity rate was 20% (acute renal failure, n=2; pneumonia, n=1; haemothorax, n=1). The mortality rate was 5% (myocardial infarction, n=1). Further postoperative rehabilitation allowed a return at home in 19 patients after a mean hospital stay of 11 days. Pulmonary rehabilitation associated with a period of preoperative NIV allows surgery to be performed in patients who are not initially eligible for resection. An evaluation of long-term outcomes survival in comparison to non-surgical therapies is necessary.
    Revue des Maladies Respiratoires 05/2013; 30(5):414-9. · 0.50 Impact Factor
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    ABSTRACT: Introduction The benefits of a rehabilitation program before surgical lung cancer resection remain to be defined. The purpose of this prospective observational study was to assess the effects of rehabilitation together with the use of noninvasive ventilation (NIV) in patients who were at a high operative risk. Methods Between January 2010 and June 2011, 20 consecutive patients (16 males, four females, mean age: 66 years [44–79]) with a clinical N0 non-small cell lung cancer were included. Eligibility criteria were predicted post-operative respiratory function (FEV1, VO2 max) below the guideline thresholds for eligibility for surgical resection and/or associated with severe co-morbidities. The protocol included a cardiorespiratory rehabilitation program and 3 hours of NIV each day. Functional tests were repeated after 3 weeks of therapy. Results Participants displayed a significant increase in their FEV1 and VO2 max, which allowed surgical resection to go ahead in all patients (lobectomy, n = 15; pneumonectomy, n = 3; bilobectomy, n = 2). The morbidity rate was 20% (acute renal failure, n = 2; pneumonia, n = 1; haemothorax, n = 1). The mortality rate was 5% (myocardial infarction, n = 1). Further postoperative rehabilitation allowed a return at home in 19 patients after a mean hospital stay of 11 days. Conclusion Pulmonary rehabilitation associated with a period of preoperative NIV allows surgery to be performed in patients who are not initially eligible for resection. An evaluation of long-term outcomes survival in comparison to non-surgical therapies is necessary.
    Revue des Maladies Respiratoires. 05/2013; 30(5):414–419.
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    ABSTRACT: Video-assisted lobectomy procedures include a broad spectrum of operative techniques that range from complete thoracoscopic surgery to minithoracotomy with a thoracoscope serving only as a light source. We describe a modified method for thoracoscopic approach for lobectomy with thoracic muscle sparing based on a combined complete port-accessed technique with a subcostal incision. We have successfully used this technique for lobectomies in stage I lung tumors. Intercostal muscles and nerve injury preservation allied to fast track rehabilitation perioperative care allowed rapid postoperative recovery.
    Interactive Cardiovascular and Thoracic Surgery 10/2010; 11(4):383-4. · 1.11 Impact Factor
  • American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans; 05/2010