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Biomedical subjects

C Laurian

Publications and source records attributed to C Laurian.

At least 109 records · Page 6Linked to original sources
PubMed1985

[Subungual glomus tumor. Apropos of a case].

Glomus tumors are rare, though not exceptional. They are considered by some authors as hyperplasia of a normal neuromyo-arterial glomus, by others as a benign tumoral proliferation. Most of them combine the three histological types initially described by Masson. i.e. solid, angiomatous and muco-hyaline. Subungual glomus tumors are more often seen in middle-aged subjects than in children. Although often belatedly diagnosed, they have characteristic symptoms, notably paroxysmal, acute pain provoked by cold or by minimal traumas: the Raynaud's phenomenon is inconstant and localized to the tip of the affected finger. When clinical and standard radiological examinations are normal, arteriography may be useful to confirm the diagnosis and locate the lesion. The main differential diagnoses before arteriography are post-traumatic neuroma and subungual melanoma. Surgical treatment is straightforward, but pain may recur post-operatively; it may be due to incomplete excision, development of a new tumor, presence of other tumors or cicatricial neuroma.

Adult↗
PubMed1985

Extradural and hourglass cervical neurinomas: the vertebral artery problem.

Eleven cases of cervical neurinomas with an extradural component were operated on with control of the vertebral artery as the first step of the surgical procedure. The lateral anterior approach was used first in each case with excellent results. In the case of hourglass tumors (seven cases), a complementary posterior approach was performed to remove the intradural portion. Primary control of the vertebral artery in cases of extradural or hourglass neurinoma is a logical and safe procedure in the attempt to achieve complete and bloodless tumor removal.

Adult↗
PubMed1985

[Value of arteriography in the exploration of subungual glomus tumors. Apropos of a case].

Difficulties in the diagnosis of subungual glomus tumors are increased when clinical examination and standard radiographic images are normal. In these cases arteriography is a useful procedure, opacification in the arterial phase of a small vascular lake confirming the diagnosis and localizing the lesion. A case is described that illustrates the interest of this examination, although it is indispensable only in patients with glomus tumors of atypical clinical expression or when symptoms recur after excision.

Adult↗
PubMed1985

[Limitations and results of revascularization of the lower extremities of diabetics].

Both the possibility and prognosis of procedures for revascularization of lower limbs are still the subject of discussion. In 1976, Tingaud et al. emphasized the deceptive nature of femorotibial bypass operations, whereas more recently, the inverse position was taken by Logerfo who considered that therapy should be identical for diabetic and non-diabetic arterial diseases. As a function of experience gained in the Hospital Saint-Joseph with vascular surgery in diabetics, results of revascularization in diabetics were compared with those in non-diabetic patients (the possible influence of the type of diabetes-particularly whether insulin-dependent or not- could not be assessed because of the variable use of insulin apart from precise cases).

Diabetic Angiopathies↗
PubMed1984

[Revascularization of the distal vertebral artery (3d segment). Indications in the treatment of vertebrobasilar insufficiency].

This article reviews 11 cases of distal revascularization of the extracranial vertebral artery above C2. Revascularization was indicated in 7 cases of extensive atheromatous stenotic or occlusive lesions, 3 cases of dissecting aneurysm, and one case of cervical malformation of the vertebral artery. The procedure of choice was a venous graft - in the C1/C2 space in 10 cases and above C1 in the eleventh. Doppler tests, ultrasound and arteriography demonstrated the patency of all the bypasses, and this was confirmed, 6 months to 3 years postoperatively, by Doppler and ultrasound. No neurological anomalies were observed either during the postoperative course or subsequently. The satisfactory results obtained would seem to justify extension of indications to include the treatment of atheromatous lesions of the supra-aortic trunks, and also adjacent vascular tumors (vertebral bone tumors, or complex cervical malformations of the vertebral artery).

Adult↗
PubMed1984

[Peroperative embolization of arteriovenous malformations arising from the vertebral artery].

Surgical exposure of the vertebral artery above C2 may be used in very selected cases to embolize medullary or cerebral arterio-venous malformations. 3 cases are reported which were treated by this technique. It allows to use a catheter of sufficient diameter for solid emboles, when balloon catheter cannot be used because IBC seems too hazardous (2 cases). This intra-operative technique may also be indicated when standard embolization is impossible for technical reasons : tortuosity, occlusion (1 case).

Adult↗
PubMed1984

[Aneurysmal disease. Results of treatment].

Immediate and long-term results in the principal sites involved: abdominal aorta, and iliac, femoral and popliteal arteries, are explored successively, and are compared with the principal results reported in the literature. Multiple localizations in the aorta are discussed with respect to the problems they raise, in the light of the personal experiences of the authors.

Aneurysm↗
PubMed1984

[165 bilateral atherosclerotic carotid occlusive lesions. Surgical and secondary risk].

Operative treatment was applied in 139 patients with hemodynamically significant bilateral stenosis of the carotid arteries due to atherosclerosis. Three groups could be distinguished: group I--stenosis greater than 75% on one side and between 50 and 75% on the other side; group II--stenosis greater than 75% on both sides; group III--obstruction on one side and stenosis greater than 50% on the other side. The risk of clamping did not appear abnormally high, while the peroperative neurologic risk was slightly enhanced due to the possibility of accidents in the region which lies contralateral to that of the operated side, or in the region of the brain stem. The risk in the group III patients did not appear to be increased. Immediate and secondary neurologic prognosis is mainly a function of the presence of multiple peculiar lesions, and also of the presence or absence of parenchymatous ischemic lesions. Preventive surgery on narrowed, stenotic, progressive lesions, detected by ultrasound imaging systematically repeated every 6 months, diminishes the incidence of onset of neurologic complications.

Adult↗
PubMed1984

[Axillo-femoral bypass using PTFE. Early and secondary results. 104 patients].

Between 1977 and 1981, 104 patients underwent 115 axillo-femoral bypass operations (AFB). All the indications were based upon limb salvage. Ninety-nine unilateral bypasses and only 8 axillo-bi-femoral procedures were performed. Prolongation of revascularisation by femoro-popliteal bypass was necessary in 10 cases, in 1 or 2 stages. Secondary bilateralisation of an unilateral bypass was required in only 6 cases because of the development of gangrene of the other limb. The postoperative mortality was 6% (5 patients) in the gangrene group and was 33% (6 patients) in the acute ischaemia group. Study of the cumulative permeability of bypasses until the time of their first thrombosis showed that 62% were permeable at 1 year and 44% at 4 years. Thrombectomy was followed by a percentage permeability of 10%. Weight bearing was still possible by 75% of limbs after 5 years. In conclusion to this study: axillo-femoral bypass remains reserved for salvage of the limb; extension of implantations to the distal and/or pathological artery remains legitimate; PTFE seems the most suitable material at present; the development of a thrombosis in the first 18 months should be treated by thrombectomy in order to decrease the number of amputations.

Adult↗
PubMed1983

[Anastomosis of the low popliteal and leg arteries without clamping].

Using an Esmarch's bandage and a lower thigh tourniquet makes it possible to suppress flow and backflow in arteries below the knees. Distal anastomosis without proximal and distal clamps can then be performed on arteries with pathological wall but with adequate residual lumen. The elective indication is bypass on partially calcified arteries of the leg.

Arteries↗
PubMed1983

[Complications of angiography, punctures, and catheterizations in the framework of iatrogenic arteriopathies].

The complications of angiography, arterial puncture and catheterisation in the context of iatrogenic arterial disease are extremely variable and they are related to the condition of the artery (healthy or pathological), the site of puncture and the type of catheterisation; their clinical manifestations and prognosis are therefore wide ranging. Three types of complications can be distinguished by their high incidence: --complications of the Seldinger method comprising 110 cases between 1967 and 1980; --complications of high translumbar aortography, including one rare complication which should be underlined because of the severity of the prognosis: septic rupture in two observations; --complications of angioplastic dilatation which are now well-recognised. Their character allows precise determination of the indications of this type of therapeutic angiographic procedure: from December 1979 to March 1982, 6 complications observed out of a total of 114 angioplasty performed. The relatively high incidence of iatrogenic complications explains the necessity of early diagnosis, ensuring a good surgical result.

Angiography↗
PubMed1983

[4-year clinical experience with gelatin-resorcinol-formol glue in acute dissections of the ascending aorta].

The gelatine-resorcine-formol glue (GRF) was used to reinforce the tissues of 25 patients operated for acute dissection of the ascending aorta, between January 1977 and September 1980. The results were compared with those of a control group of 25 patients operated between 1970 and 1976 by "classical techniques". There were no significant differences between the two groups as regards age, anatomical and preoperative clinical states. The ascending aorta was replaced in all patients; the aortic valve was replaced three times (12 p. 100) in the GRF group and twelve times (48 p. 100) in the control group: the coronary arteries were bypassed or reimplanted in 20 p. 100 of patients in both groups. The average peroperative blood loss was 5,800 ml in the control group and 2,100 ml in the GRF group (p less than 0,01). There were four peroperative deaths (16 p. 100) in the control group and no peroperative deaths in the GRF group. Postoperative complications (renal failure, cerebral ischemia, persistent peripheral ischemia or infection) were much more common in the control group. They were responsible for eight hospital deaths in the control group and two hospital deaths in the GRF group (p less than 0,01). Therefore, global hospital mortality was reduced from 48 p. 100 (control group) to 8 p. 100 (GRF group) (p less than 0,01). Two late deaths occurred in the control group, but there were none in the GRF one, all survivors being in good clinical condition. Sixteen patients in the GRF group underwent 19 angiographic controls, 2 to 36 months after surgery. These investigations showed two moderate aortic regurgitations (8 p. 100), three persistent dissections of the descending aorta but a stable, good quality repair in the other patients. In conclusion, the use of GRF glue significantly reduced: 1) the number of aortic valve replacements, 2) per- and postoperative blood loss, 3) the incidence and severity of postoperative complications. The long-term survival rate (4 years) has improved from 40 to 91 p. 100.

Acute Disease↗