Percutaneous transluminal angioplasty of the vertebral and subclavian arteries. An angiographic-velocimetry comparison.
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Biomedical subjects
Publications and source records attributed to A Tournade.
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The authors report experience of intravascular angioplasty of atheromatous ostial strictures of the vertebral artery in 24 patients. After reviewing the technique, they outline the indications provided through Doppler velocimetric data. The results seem to be encouraging as symptoms disappeared completely in 21 patients.
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The arteries and veins of the cerebellopontine angle have been injected with a contrast medium permitting a precise anatomical reconnaissance of their topography and relations. These specimens have been explored by CT in order to define the opacified vessels and to differentiate them from the adjacent nervous tissue. Thus in CT it is possible to locate the cerebellar arteries, the petrous and medullo-pontine veins and the nerves of the cerebello-pontine angle. This study describes the normal appearance of the flocculus from the arteries and veins. Moreover it should contribute to the definition of the criteria of reliability of a CT diagnosis and its limits in the cerebello-pontine angle.
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The authors describe a case of an arterio venous malformation of the tela choroidea of the third ventricle which was feeding by the postero medial choroidal artery and draining by the internal cerebral vein. This A-V malformation was microsurgically excluded in sitting position by an occipital interhemispheric, transtentorial and transversal transcallosal approach without any postsurgical clinical signs. An anatomical study of this region shows an easy recognition of the choroidal postero medial artery by the regular presence of an arterial loop which concavity is crossed by the terminal segment of the basilar vein of Rosenthal. The knowledge of the occipital internal veins drained in the callosal posterior vein to form a common trunk, the cuneo limbic vein drained itself into the vein of Galen is important to know. This venous system is to preserve at the time of retraction of the occipital lobe to not give rise to infarction and therefore hemianopsia. At least the transverse section of the posterior part of corpus callosum permits a good approach of the roof of the third ventricle and is clinically very harmless if the protection of the cuneo limbic vein is assumed.
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The venous drainage of the craniocervical junction is made up of jugular veins and particularly the vertebral veins and their anastomoses. The anterior and posterior condylar veins join to form the plexus of the vertebral vein, the supply functions of which can be modified by the presence of the mastoid anastomotic emissary veins which increase the possibilities of drainage at that level.
Venous anastomoses at the base of the brain are represented by the anterior and posterior communicating veins. The anterior communicating vein anastomoses with the anterior communicating vein anastomoses with the anterior cerebral veins. The posterior communicating veins join the basal veins through the interpenduncular veins. The functional value of these venous anastomoses is less important than that of the arterial polygon of Willis. This anastomotic function depends on anatomical constancy and on the calibre of these transverse veins. Under certain pathological conditions the variations of intracranial pressure result in contralateral venous drainage through these anterior and posterior anastomotic veins.
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