[Shaving of popliteal artery secondary to a knee arthroscopy]. / Cas clinique. Lésion iatrogène de l'artère poplitée lors d'une arthroscopie du genou.

Popliteal artery lesions are rare complications of knee surgery and may have significant sequelae depending on the length of time it takes to diagnose this type of vascular injury. We present two case reports of popliteal artery following meniscus resection by shaving.

Les cas de lésions iatrogènes de l'artère poplitée liées à la chirurgie orthopédique du genou sont des complications rares, qui peuvent entraîner des séquelles importantes en cas de retard dans le diagnostic de ce type d'atteintes vasculaires. Nous vous présentons deux cas particuliers de plaie de l'artère poplitée à la suite d'une résection des ménisques lors d'une arthroscopie.

May-Thurner syndrome will be completed?

BACKGROUND: The May-Thurner syndrome is a deep venous thrombosis of the left iliofemoral vein due to a compression by the right primitive iliac artery. Some authors suggested that this syndrome could be associated with genetics factors predisposing to thrombophilia. OBJECTIVES: The aim of this article is to assess if the May-Thurner syndrome could be associated with inherited thombophilia particularly the factor V mutation. PATIENTS/METHODS: We exposed three cases of May-Thurner syndrome, all were positive for the presence of factor V Leiden. CONCLUSION: Some olds syndromes can be revisited and explained by molecular research. In this case, the May-Thurner syndrome could be associated with inherited thrombophilia. This finding could explain the pathology but also open new treatments or guidelines for the management this kind of pathology.

Infection of an abdominal aortic stent graft with suprarenal attachment.

Stent grafting for treatment of abdominal aortic aneurysm can lead to infectious complications. The purpose of this report is to describe a case involving a patient with an aortobiliac stent graft, a horseshoe kidney, and coronary artery disease who presented suprarenal aortic infection requiring removal of the stent graft and in situ reconstruction using an arterial homograft. The discussion deals with management of infected vascular material and reconstruction techniques.

The cuff leak test to predict failure of tracheal extubation for laryngeal edema.

OBJECTIVE: Laryngeal edema secondary to endotracheal intubation may require early re-intubation. Prior to extubation the absence of leak around an endotracheal tube may predict laryngeal edema after extubation. We evaluated the usefulness of a quantitative assessment of such a leak to identify the patients who will require early re-intubation for laryngeal edema. METHODS: This prospective study included 76 patients with endotracheal intubation for more than 12 h. The leak, in percent, was defined as the difference between expired tidal volume measured just before extubation, in volume-controlled mode, with the cuff inflated and then deflated. The best cut-off value to predict the need for re-intubation for significant laryngeal edema was determined and the patients were divided into two groups, according to this cut-off value. RESULTS: Eight of the 76 patients (11%) needed re-intubation for laryngeal edema. Patients requiring re-intubation had a smaller leak than the other patients [9 (3-18) vs 35 (13-53)%, p<0.01]. The best cut-off value for gas leak was 15.5%. The high leak group included 51 patients, of whom only two patients (3%) required re-intubation. The low leak group included 25 patients, among whom six patients (24%) required re-intubation ( p<0.01). The sensitivity of this test was 75%, the specificity 72.1%, the positive predictive value 25%, the negative predictive value 96.1% and the percent of correct classification 72.4%. CONCLUSIONS: A gas leak around the endotracheal tube greater than 15.5% can be used as a screening test to limit the risk of re-intubation for laryngeal edema.