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Biomedical subjects

A Le Baleur

Publications and source records attributed to A Le Baleur.

16 recordsLinked to original sources
PubMed1985

[Urologic manifestations of aortocaval fistulas].

The authors report two cases of aortocaval fistula, resulting from the rupture of an abdominal aneurysm, and revealed by lumbar pains and hematuria. In both cases, the left kidney was mute, and was possibly responsible for the hematuria.

Aged↗
PubMed1984

[Peroperative sclerosis].

Complete, rapid destruction of the insufficient surface network as a one-stage procedure constitutes the best method for prevention of trophic disorders and especially pigmentation. Marked, rapid regression is obtained when these have unfortunately become installed. Combined surgery and multiple peroperative injections of a sclerosant allows the exclusive use of a gently acting sclerosant, 66% glucose solution, which is particularly well tolerated.

Animals↗
PubMed1984

[66% glucose, a safe sclerosant. Experimental study].

Although accidents due to the intra-arterial injection of detergent sclerosant are very rarely observed, they are dramatic in their effects and often result in amputations, a risk accepted with difficulty for a treatment with a functional aim. To avoid these incidents, which may occur even when treatment is applied by the most experienced surgeons, the authors have used 66% glucose solution without accident since 1948. To confirm efficacy of the method, an experimental study compared 66% glucose (66 G) with a very commonly used product, 1% sodium tetradecyl sulfate (STD), in the rabbit. Except when enormous doses of 66 G are employed, the only effect noted was eosinophilic necrosis of the vessel wall without clinical symptoms, whereas doses eight times lower of STD produced an irreversible ischemia from obliterating endarteritis of the branches of the vascular tree injected. The 66% glucose solution appears to be a very safe, gently acting sclerosant, and the product of choice for peri- and post-operative sclerosis, particularly in regions where accidental arterial puncture is anatomically possible.

Animals↗
PubMedDate not supplied

[Saphenectomy in patients over 65. Indications and results].

For 779 patients who underwent varicose vein surgery at Bicêtre, between 1981 and 1984, there were 61 elderly patients between 65 and 74 years and 15 "old age" patients over 75 years. Only one severe complication occurred. Almost all patients who were operated upon were satisfied or very satisfied to see that the functional discomfort had disappeared, the trophic disorders had regressed, the superficial phlebitis or hemorrhages had not recurred and the ulcer were healed. Statistics are in favor of a surgical treatment of varicose veins or phlebitis sequellae with severe degeneration of the superficial venous network, as soon as they become uncomfortable, because of the increased life expectancy, in Europe at this time. But, because of the tremendous progress of anesthesia techniques, it seems permissible to offer this surgical procedure to those who have passed the age previously considered as reasonable and are quite disabled.

Aged↗
PubMedDate not supplied

[Product of choice for maintenance sclerosis: 66% glucose solution].

The use of a 66% hypertonic glucose saline solution provides absolute security in sclerosant treatment. It has no side effects and does not provoke any allergic reactions and it produces a good quality sclerosis without pigmentation or thrombus. The injection can sometimes be painful, so it should be made very slowly. Its effectiveness is good, although less than that of sodium tetradecyl sulphate. Intra-arterial injection in animals dose not cause gangrene of the limb. Extravascular injection does not cause necrosis.

Glucose↗
PubMedDate not supplied

[Peroperative multi-sclerosis using 66% glucose. Treatment of choice and best prevention of pigmentations of venous origin].

The complete and rapid destruction, at the one time, of the incompetent surface venous network is the best form of prevention of trophic changes, in particular pigmentation and leads to a marked and rapid regression of these lesions when they are already present. The combined method, associating surgery and peri-operative multi-sclerosis, allows the use of a gentle sclerosant, 66% glucose, which is particularly well tolerated.

Glucose↗
PubMedDate not supplied

[Veins and rheumatism].

Stasis and venous hypertension clash with static and arthritic disorders. These conditions do not add to the risks: they multiply them (Layani). If an orthopeadic operation is considered, the venous disorder should be treated first, as completely and as soon as possible, in order to lessen the risk of thrombo-embolism and to improve the trophicity of the skin. The patient must, however, be made aware from the outset of the indispensable rules of hygiene in case of irremediable after effects or accompanying obesity. If these points are observed the rheumatological treatment will produce the best of results.

Foot Deformities, Acquired↗
PubMedDate not supplied

Reinterventions for primary varices.

Out of more than 6,000 patients operated for varices since 1949, in private practice, 281 had already been operated on once before. In 230 of these cases, the first operation performed elsewhere had been incorrect or incomplete: partial stripping, a badly performed excision of the saphenofemoral-junction, neglect of gross perforants, neglect of the saphena parva which was partly or wholly responsible for 96% of the recurrences. Moreover, a partial operation, even if correct, does not check the development of a disorder which is often bilateral (89%) and which often affects the four saphenous veins (59%). 51 had been operated by myself, hoping that they would not have to come back; 29 cases in which 2/3 of the long saphenous vein was stripped and with crossectomy of the short saphenous vein until 1964, and 22 cases of complete stripping after 1965. 49 short saphenae had been causal in the first group but we noted 14 popliteal recurrences in the second. A mistaken anatomical abnormality, sixteen perforants but more particularly 30 regrown internal saphenofemoral junctions were noted in these two groups. It is difficult to give reasons for them. Finally the post-operative phlebological follow-up is often irregular or neglected. Re-operations are difficult but, with the aid of a phlebographical control, they give good results, except for deteriorations of the deep tract necessitating certain static hygiene. The best guarantees of a satisfying and lasting result are a complete and correct initial treatment of the main varices, and regular phlebological check-up.

Humans↗
PubMedDate not supplied

[Varicose recurrence: opinion of a team].

Relapse, or the continuation of the development of varicose disorder, seems to us to be common after sclerosis when there is a manifest insufficiency of the saphenous valves. Relapse following surgical operation is rare : 0.4 p. cent in our files. Most often it follows initial surgery which has been too limited, or else faulty. However, one out of every thousand of our patients has relapsed, and there has been no possible valid explanation of the venous redevelopment, whose factors are analysed.

Female↗
PubMedDate not supplied

[Limitation of surgical indications in postoperative recurrence of varicose veins].

Varicose disorders develop further after sclerotherapy when there is clear saphenous valvular incompetence, or when the surgical operation has been too limited, or faulty. Further surgery in these cases is simple and not dangerous, and clearly brings the same results as complete initial surgery. But about 1% of the patients undergoing correct and complete surgery relapse without there being any valid explanation for the venous redevelopment whose causes we have analysed. Their cure is difficult, is more dangerous, and less satisfactory results are obtained, partly because the surface area is harder to work with. In developed forms, there is no less need of the cure, combined with rigorous checks for the sclerosis of all residual veins and the treatment of associated disfiguration by the phlebologist and general practitioner. It's only in this way that we can hope for more or less satisfactory stability in these forms.

Humans↗
PubMedDate not supplied

[Sports and veins].

General harmonious exercise, walking and swimming in moderate measure are beneficial for all forms of venous insufficiency. Running, however and violent sport or competition may worsen the condition, especially where the deep veins are involved in the sequellae to phlebitis or congenital malformation. An exact evaluation and precise discussion of the inter-relationship between sport and vein disorders as well as a discussion of the various therapeutic possibilities represent indispensable elements of the first consultation.

Humans↗