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Biomedical subjects

C Delcour

Publications and source records attributed to C Delcour.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Iatrogenic femoral pseudo-aneurysm and arteriovenous fistula. Non-surgical treatment].

Pseudoaneurysm and arteriovenous fistulae are classical but unusual complications of femoral catheterism. The use of large diameter catheters, heparinotherapy and fibrinolysis constitute risk factors. These local complications are becoming more frequent resulting from an increase in interventional techniques. Therefore, a non invasive management of these lesions becomes necessary. A simple manual percutaneous compression of the puncture site was successful as treatment of 3 arteriovenous fistulae and 4 of 7 pseudoaneurysms. That is the reason why the authors consider that this technique constitutes a good alternative of the surgical treatment.

Aneurysm↗
PubMed1991

[Male impotence. Radiologic venous evaluation].

Vascular lesions are one of the most frequent causes of organic impotence. Dysfunction of the penile veno-occlusive mechanism is studied by cavernography-cavernometry. The major criterion of venous leakage is the maintenance flow which remains less than 25 ml/min after intracavernous injection of papaverine (60 mg). In the erect state cavernography can demonstrate the abnormal venous drainage.

Erectile Dysfunction↗
PubMed1991

[Cavernometry-cavernography].

The penile venous outflow is studied by cavernometry-cavernography associated with intrapenile injection of vasoactive drugs. This method allows the detection of patients with cavernovenous leak.

Erectile Dysfunction↗
PubMed1990

Bronchiolar morphology after systemic arterial interruption.

To assess ischemic lesions as a factor in obliterative bronchiolitis after lung transplantation, the authors severed the left bronchial arteries of 15 dogs, together with the left stem bronchus, the latter being immediately reanostomosed. They examined the bronchioles at weekly interfals up to three and a half months. On the week chosen each dog was anesthetized, totally heparinized, and exsanguino-perfused with saline. Just after heart arrest, the thoracic aorta was injected with a barium solution until this white medium appeared in the bronchial arteries. The heart-lung blocs were excised en bloc, submitted to soft-tissue x ray, fixed, and then sliced to 1 cm. Corresponding right and left 5-mm-thick samples of these slices were prepared for contact microradiography followed by histologic 5-to-20-micron-thick, stained, correlated specimens. For two weeks the left bronchial arteries remained empty, but there was no necrosis or edema. Between two and four weeks barium solution appeared in the bronchial arteries, and the bronchiolar epithelium had become multistratified. Later the left bronchiangiogram became similar to the right, but there were more folds of the mucosa and a little submucosal fibrosis. These studies provide proof that no significant ischemic lesions occurred during repermeation of the bronchiolar vascular bed. Ischemia, if existent, is not a significant factor in obliterative bronchiolitis.

Anastomosis, Surgical↗
PubMed1990

[MRI of acute myocardial infarction with injection of Gd-DOTA (15 patients)].

We studied 15 patients 4 to 8 days after myocardial infarction by using ECG gated MR before and after administration of 0.2 mmol/kg Gd-DOTA. The diagnosis in each patient was confirmed by electrocardiographic criteria, elevated levels of fractionated creatine kinase (CK) isoenzyme, thallium scintigraphy, ventriculography and coronarography. T1-weighted, spin-echo images, were obtained before and immediately after injection of Gd-DOTA and were repeated 15 min later. The site of infarction was visualised in 10 patients as an area of high signal intensity after the injection of Gd-DOTA. Contrast between normal and infarcted myocardium was greatest 15 min after injection. Three patients were excluded because of failure to acquire adequate MR studies. In 2 other patients, the infarct were not detected. Before injection of Gd-DOTA, only 2 infarcts were detected. These results suggest that Gd-DOTA can improve MR visualisation and detection of acute myocardial infarction.

Adult↗
PubMed1990

[Percutaneous transluminal coronary angioplasty: short- and long-term results].

We reviewed the results of percutaneous transluminal coronary angioplasty (PTCA) in 200 consecutive patients from January 1988 to January 1989. The mean age was 55.8 years. Twenty-two per cent had unstable angina, 66% had stable angina and the other 12% had atypical chest pain or were asymptomatic after a myocardial infarction. Five percent had left ventricular function less than 45%. The angioplasty procedure was angiographically successful in 184 patients (92%). There was no significant difference in success rate in the different vessels or indications. Coronary bypass surgery was required in 3% of patients as an emergency procedure; myocardial infarction occurred in 2% less than 24 hours after the procedure. There has been no in-hospital death. The recurrence rate of ischemic symptoms was 26.5%. Considering lesions treatment, the procedure was successful in 71% of the 200 patients over a long-term follow-up period.

Adult↗
PubMed1989

Central venous access for haemodialysis using the Hickman catheter.

One hundred and seven Hickman catheters for haemodialysis were inserted in 90 end-stage chronic renal failure patients, and were used for 1-448 days (median 45 days). Sixty-nine per cent of the patients were treated without any problem for 1-165 days (median 34 days). Clinically evident complications occurred in 44 catheters inserted in 28 patients, and included outflow obstruction (16.8% of the catheters) and thrombosis (13.1% of the catheters). However, many episodes of clotting or insufficient flow could be corrected by simple manoeuvres. Other less frequent complications were recorded: sepsis, mainly in patients with increased risk factors (4.1% of the catheters), laceration of the catheter (3.7%) and occasional cases of jugular-vein phlebitis, transient palsy of a vocal cord, haematoma of the wound, and bleeding of the cutaneous orifice. No clinical sign of subclavian or innominate-vein thrombosis was observed. Nevertheless, a prospective study conducted in 50 asymptomatic patients demonstrated a 12% rate of anomalies of the venous system, although two-thirds of these alterations were mild and had no consequence. When the present series is compared to the results obtained with currently available percutaneous haemodialysis catheters, it is concluded that the Hickman catheter is a safe, comfortable and efficient vascular access device.

Catheterization, Central Venous↗
PubMed1989

Deep dorsal vein arterialisation in vascular impotence.

A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre-operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections. Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow-up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno-venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed.

Adult↗
PubMed1989

[Laser assisted angioplasty].

Percutaneous laser thermal angioplasty with a hot tip fiber was used in 26 patients to recanalize 20 femoropopliteal occlusions, 5 iliac thromboses and one occlusion of the left subclavian artery. Initial angiographic success was achieved in 85% for the femoropopliteal lesions and in 60% for the iliac occlusions. Eight complications did occur, but none necessitated emergency bypass surgery.

Aged↗
PubMed1989

[Iatrogenic femoral pseudo-aneurysm. Analysis of the causes, diagnosis and treatment. Study of 12,248 arterial catheterizations].

Pseudoaneurysm is a classical but unusual complication of femoral catheterism. 22 cases are reviewed: 19 occurred after coronarography, 2 after peripheral percutaneous angioplasty and only one after a renal diagnostic arteriography. In all cases, the diagnosis of the pseudoaneurysm was established by I.V. D.S.A. 2 different medical teams are distinguished: the first using small catheters (4 and 5 F), the second using larger catheters (7 and 8 F) which are more aggressive. Two factors allow to avoid this complication: the diameter of the catheter and a correct compression dressing. The treatment of this complication, usually surgical, consisted in a simple manual percutaneous compression in 3 patients.

Aneurysm↗
PubMed1989

Intravenous digital subtraction angiography. A criteria of brain death.

The absence of cerebral blood flow is the best criteria of cerebral death. Intravenous digital subtraction angiography (DSA) was performed in 110 patients with clinical signs of brain death. In 105 cases DSA, confirmed the stop of the intracranial circulation. In the other 5 cases, repeated examination a few hours later demonstrated arrested cerebral circulation. Organs transplantations were performed in 30 cases. DAS represents a relatively non invasive and quick to perform method to demonstrate brain death.

Adolescent↗
PubMed1988

Techniques for performing cavernosometry and cavernosography.

We have performed cavernosography and cavernosometry in more than 400 impotent patients and in 10 normal volunteers. In patients without abnormal venous leakage, intracavernosal infusion at a flow rate of 80-140 ml/min produces a complete rigid erection with an intracavernous pressure greater than 90 mm Hg; 25-50 ml/min is necessary to maintain the erection. Abnormal venous leakage is characterized by the absence of erection without a significant increase in intracavernous pressure under the maximum standardized perfusion rate of 140 ml/min. Cavernosography provides good morphologic studies of the cavernous bodies and the penile venous network, but must always be associated with flow rate measurement and intracavernous pressure monitoring for reliable assessment of venous leakage.

Adolescent↗
PubMed1988

Opacification of the glans penis during cavernosography.

Cavernosography and cavernometry were performed in 150 impotent patients and 10 normal potent volunteers. Opacification of the glans penis was noted in 5 normal volunteers, while among the impotent patients it was noted in 53 per cent of those with venous leakage and in 36 per cent of those without leakage. We believe that opacification of the glans during cavernosography must be regarded as a normal variant rather than as a sign of pathological shunts between the glans and the corpora cavernosa.

Adult↗