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Biomedical subjects

A Clermont

Publications and source records attributed to A Clermont.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Contribution of digital venous angiography to the evaluation of arterial hypertension. Cost evaluation].

Concerning 100 intravenous digital subtraction angiographies (IV DSA) performed for the study of arterial hypertension, the results are discussed according to two different achievements: diagnostic and economic. One hundred patients have been examined after the intravenous (IV) injection of contrast material, seventy times in peripheral and thirty times in central venous system. Out of 94 examinations that could be interpreted, 10 revealed stenosis of renal arteries higher than 50 per cent, one revealed fibromuscular dysplasia. IV DSA generally permits the correct study of renal arteries and compared to conventional angiography it gives only a small number of false negative results. However, the reliable study of intrarenal vascularisation can be obtained only by renal arteriography. The renal arteriography remains therefore necessary: when renal IV DSA gives insufficient data; to estimate the degree of stenosis in fibro-muscular dysplasia; to evaluate intrarenal vascularisation before renovascular surgery or angioplasty. To estimate the economic validity of renal IV DSA for the study of arterial hypertension, we have investigated: the actual cost of the examination for a department of radiology, compared with the cost of conventional examination; on the other hand, the influence of this examination on the duration of hospitalisation for evaluation of arterial hypertension. According to our investigation, this examination allows the average reduction of expenses for 180 F per patient with arterial hypertension, and shortens the time of hospitalisation for about one day. Owing to this diagnostic and economic contribution, renal IV DSA is becoming the first examination to be done for the evaluation of renovascular hypertension.

Angiography↗
PubMed1985

[Late post-traumatic hemoptysis caused by hypervascularization in the area of pulmonary hematomas. Apropos of a case].

The authors report a case of hemoptysis occurring after closed chest trauma complicated by spontaneously regressive parenchymatous hematomas. Bronchial arteriography showed systemic hypervascularisation with shunt in the territory of a hematoma which had regressed spontaneously several months previously. The authors mention the rarity of this aetiology and emphasise the value of bronchial arteriography and of embolisation.

Adult↗
PubMed1984

[Angiography in bypass grafts of the left anterior descending coronary artery with the left internal mammary artery. Apropos of 100 control examinations with a maximum follow-up of 6 years and 8 months].

Ninety three patients underwent 100 angiographic control studies of a left internal mammary artery bypass of the left anterior descending artery. The controls were carried out between 11 days and 6 years 8 months after surgery. Seven patients underwent two control studies. The patients were divided into three groups:--60 early control angiographic studies (before 2 years);--16 late control angiographic studies (between 2 and 5 years);--24 very late systematic control angiographic studies (after 5 years). The patency rate of the arterial grafts was 99%. From the anatomical point of view, the arterial walls of the internal mammary artery appeared smooth and regular except in one case. There was no cases of bypass graft disease. The ratio of the diameters of the internal mammary and left anterior descending arteries was greater than or equal to 1 in 93% of cases. The adaptation of the diameter of the internal mammary artery to that of the left anterior descending artery is an early phenomenon as shown by statistical and repeat control studies. The number of remaining collateral vessels does not appear to have an effect on the diameter of the internal mammary artery. Stenosis at the site of anastomosis was observed in 16% of cases. This seemed to be favoured when the angle subtended by the two vessels reached 90 degrees. The haemodynamic changes of the coronary circulation (competition of flow, competition of flow in the distal vessels, reflux in the internal mammary graft) were comparable to those observed in aorto-coronary saphenous vein bypass.

Adult↗
PubMed1983

Non-iatrogenic trauma of the coronary arteries and myocardium: contribution of angiography--report of six cases and literature review.

Six patients with coronary and myocardial trauma had selective coronary arteriography and left ventriculography. Of these, three patients with penetrating cardiac trauma presented with an occlusion of one coronary artery, including one fistula. Of three patients with blunt chest trauma, normal coronary arteries were observed in one patient, and obstruction of one artery in another; repeat coronary arteriography showed resolution of the previous obstruction in one patient. A review of the last 15 years of experience summarizes 38 angiography reports after coronary artery trauma. An analysis of the angiographic aspect of coronary artery damage is considered as an aid to understanding the traumatic lesion, its causes and its manifestations under the conditions of total or partial parietal damage of the artery, or parietal integrity.

Adult↗
PubMed1982

[Resection of left ventricular aneurysm for clinical heart failure. Long-term results and prognostic factors (author's transl)].

Between 1970 and 1980, 46 resections of left ventricular aneurysm were carried out in patients with clinical evidence of heart failure but without associated septal perforation or severe mitral regurgitation. Aortocoronary bypass was simultaneously performed in 28% of the cases. The mean post-operative follow-up was 67 months. The early (1 mont) post-operative mortality rate was 15.2%. The actuarial survival rate (taking into account the early post-operative mortality rate) was 52.4% at 5 years and 32.9% at 10 years. Most early and late deaths were of cardiac origin. Among long-term survivors, 48.5% had no post-operative heart failure and 67% had no residual angina pectoris. In a statistical analysis of the factors involved in overall post-operative survival, no significant influence could be found for sex and age (within the limits of the study), risk factors associated with atheroma, duration of the myocardial necrosis responsible for the aneurysm, location of the aneurysm, time taken for the post-infarction heart failure to develop, presence of pre-operative angina on ECG, number of coronary arteries stenosed, extent of the aneurysm as determined by cineventriculography, cardiac index, left ventricular end-systolic pressure and associated aortocoronary bypass. In contrast, a significant prognostic value was demonstrated for the ejection fraction of the contractile area of the left ventricle (p less than 0.02), the maximal cardiac dysfunction observed prior to surgery (P less than 0.02), the presence of pre-operative dysrhythmias (P less than 0.1) and the quality of cardiac performance recovered immediately after the operation (P less than 0.001).

Age Factors↗
PubMed1982

Post-traumatic-shock lung: postmortem microangiographic and pathologic correlation.

In post-traumatic-shock lung, increased pulmonary vascular resistance and pulmonary hypertension are prominent features. The explanation for them was sought by postmortem microangiography of the lungs of 17 patients dying of respiratory failure after trauma. The 10 patients with thoracic injury died earlier (1-8 days). Extravasation of contrast material due to alveolar capillary rupture was present in all but one specimen and occupied 20% of the sampled area. Pulmonary artery thrombi lay proximal to these extravasations. Hypovascular areas due to infection and hemorrhagic alveolitis were found in all patients and involved 40% of the surface area. The small pulmonary arteries were poorly filled and contained many microthrombi. Some patients had hematomas, cavities, and areas of interstitial edema occupying about 5% of the lung area and associated with compressed or occluded vessels. Several mechanisms including pulmonary trauma may be responsible for the antemortem rupture and obstruction of small blood vessels. In the post-traumatic-shock lung, small artery occlusion and compression are associated with pulmonary hemorrhage, infarction, and infection and are important contributors to perfusion abnormalities and respiratory failure.

Adolescent↗
PubMed1982

[Hydatid cyst of the heart diagnosed with bidimensional echography. Apropos of a case].

A hydatid cyst of the left ventricular posterior wall was diagnosed by 2D echocardiography in a 36 year old North African patient presenting with exertional dyspnoea and atypical chest pain. Clinical examination was negative but the surface ECG showed inverted T-waves in the infero-lateral leads. Postero-anterior and lateral chest X rays were initially interpreted as normal but 2D echocardiography immediately revealed a cystic cardiac tumour which very probably was hydatid, given the patient's origin. Thorough investigation showed no other localisations and hydatid serology was also negative. Left ventricular and selective coronary angiography were performed to determine the vascular relationships of the cyst: ablation was carried out under cardiopulmonary bypass and pathological examination confirmed the diagnosis of hydatid disease.

Adult↗
PubMed1981

[Stenosis of the left main coronary artery. Results of aorto-coronary by-pass in 67 patients (author's transl)].

Between 1970 and 1978 sixty-seven patients with > 50% stenosis of the left main coronary artery underwent aorto-coronary by-pass operation. The mean follow-up period was 54.7 months. Early and late post-operative mortality rates amounted to 3% and 9.2% respectively. Severe global alteration of left cineventriculography was the primary factor of survival (p < 0.01). The actuarial survival rates were 90.3% at 5 years and 84.5% at 9 years. All survivors had control ECGs. Late myocardial necrosis was rare (0.6 per 100 patient-years). 60.3% of the patients remained free from angina. Deterioration of the results mainly occured during the first 2 years but continued at a slower pace beyond the 8th year. Recurrence of angina was significantly less frequent in patients with isolated left main stenosis (p < 0.05) and when local conditions were not unfavourable to derivative surgery (p. < 0.01). On the other hand, the patient's age, sex, type of angina, history of previous infarction, number of risk factors and number of by-passes (the latter excluding possibly incomplete revascularisation) has no influence on the functional prognosis. Thirty-two patients had control, usually routine coronary arteriography 13.7 months on average after surgery. Overall patency was found in 85.9% and abnormal grafts in 16.7% of the cases. The main benefits of aorto-coronary by-pass, therefore, were a reduction in the spontaneous mortality rate of patients with left main coronary disease and a pronounced functional improvement.

Adult↗
PubMed1979

[Role of intra-aortic balloon pumping in coronary surgery for stenosis of the left common coronary trunk].

Surgical treatment for stenosis of the left main coronary artery is associated with a high risk related to particular vulnerability to acute myocardial ischaemia during the period of induction of anaesthesia. Eight cases of stenosis of the left main coronary artery undergoing surgery with preoperative insertion of an intra-aortic counter-pressure balloon are reported here. The results - eight successes - as opposed to four failures seen prior to the use of this technique and in similar cases, leads the authors to suggest stenoses of the left main coronary artery as a further criterion indicating the need for routine preoperative intra-aortic counter-pressure

Aged↗
PubMed1977

[The radioimmunological assay of fibrinogen breakdown products with E antigen during postoperative venous thromboses. Study in 46 cases of arthroplasty for osteoarthrosis of the hip (author's transl)].

Twenty six patients (without thrombosis) had a normal 125I-fibrinogen test, among whom 15 had a normal phlebography; 18 patients (with thrombosis) had a positive 125I-fibrinogen test among whom 11 had a positive phlebography. There was a discrepancy between phlebography and 125I-fibrinogen test in 2 patients. In patients with thrombosis, there is a significantly increase of FgE levels for several days after the intervention. However the measurement of FgE is not a reliable test (4% of false positive and 38% of false negative); but it is always elevated in femoral and popliteal thrombosis.

Adult↗
PubMed1977

[Arterial vascularization of the os coxae].

Study of the arterial vascularization of the coxal bone by microangiographic methods. Nutritive and periosteal blood-vessels come from Iliaca interna and Iliaca externa arteries. The ilium is vascularized by the Ilio-lumbalis artery which is a nutritive blood vessel. A eriosteal vascularization also exists. Ischium and pubis have a periosteal vascularization. Blood vessels are oriented toward the sus-acetabulum area where many anastomoses exist.

Angiography↗