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Biomedical subjects

F Joffre

Publications and source records attributed to F Joffre.

At least 127 records · Page 7Linked to original sources
PubMed1985

[Atypical compression of the humeral axial artery treated by surgical arteriolysis].

A 28-year-old man with atypical humeral artery compression presented clinical signs and results of Doppler tests suggestive of a cervicothoracic outlet syndrome: dysesthesie disorders and pain in left upper limb on active abduction. Murmurs over the vascular pathways were not elicited on clinical examination. Pulses were palpable in the upper limbs at rest but were abolished during abduction and external rotation. Data were confirmed by velocimetric studies, and dynamic arteriography showed absence of compression at the cervicothoracic outlet but its presence at the humeral head level. Axillohumeral surgical exploration provided evidence of compression of the nerve-vessel bundle, which was stretched within its sheath over the head of humerus. Incision of the fibrous sheath and freeing of the artery restored distal vascular pulsatility during abduction movements. This clinical pseudosyndrome of the cervicothoracic outlet appears to result from a rare cause of compression situated distal to this anatomic zone, and to respond to simple treatment.

Adult↗
PubMed1985

[Indications and results of combined urokinase-lys plasminogen in acute ischemic pathology of the legs].

Low dose urokinase-lys plasminogen was used to treat 10 patients with acute ischemia of lower limbs. Preliminary results are reported and indications defined, the combination producing effective relief and being very well tolerated biologically and clinically. All patients presented clear signs of ischemia provoking a short term risk for the limb. Direct femoral puncture arteriography of the ischemic limb was an essential pretreatment investigation. A thin catheter left in contact with the thrombus allowed localized fibrinolysis to be performed. Follow up arteriography examinations assessed clinicopathologic results, while biologic surveillance of principal coagulation parameters showed a lack of significant alterations during treatment. Ischemic signs were totally relieved in 7 cases, with arterial repermeabilization allowing recuperation of one (3 cases) or both (2 cases) distal pulses. Persistence of a popliteal thrombus in one case required a fogarty after a direct approach and the limb was saved. Two patients had to be amputated because of delayed treatment. These encouraging results suggest that this procedure of local thrombolysis be reserved for popliteal or infra-popliteal occlusions accompanied by sensory-motor signs and of recent (less than 72 hours) onset. Follow up for 8 months is insufficient but has shown the absence of deterioration, but this is obviously a function of the natural course of the underlying atheromatous disease.

Acute Disease↗
PubMed1984

[A comparative study of percutaneous transluminal angioplasty of the iliac and femoropopliteal arteries in arterial disease of the lower extremities].

The authors compared the anatomo-radiologic data from a series of 100 consecutive percutaneous transluminal angioplasties (PTA), as well as the immediate and long-term results as a function of the level of the lesion--iliac or femoropopliteal. Proximal to the thigh, there were 57 PTAs, 36 of the common iliac and 21 of the external iliac. In the lower thigh, there were 43 PTAs, 9 of the upper part of the popliteal artery and 34 of the external femoral artery. Percutaneous transluminal angioplasty of the common iliac lesion was dominant in patients under 60 years of age (p less than 0.05). At the iliac level, 89% of the patients had severe claudication; at the femoropopliteal level, 39% had trophic problems. The "dominant" or "accessory" character of the lesion did not modify the indication for the procedure, regardless of the level. Segmental thrombosis accounted for 44.2% of the femoropopliteal PTA indications, compared with 7% at the iliac level (p less than 0.04). The failure rate was less at the iliac than at the femoropopliteal level. Follow-up was available for 86.6% of the patients for an average of 22 months. The systolic indices at the thigh after iliac PTA and at the ankle after femoropopliteal PTA were significantly increased (p less than 0.01). At the femoropopliteal level, 74% of the patients were totally asymptomatic. There was one failure (3.8%); amputation at thigh level was carried out 12 months after the PTA. At the iliac level, improvement was observed in 91% of the patients and 70% became asymptomatic. The overall success rate (clinical patency and improvement) was 92% +/- 0.09%, based on the life-table method.

Aged↗
PubMed1984

[Percutaneous transluminal angioplasty in chronic arteriopathies of the lower limbs. Immediate anatomo-radiological results and functional outcome].

The immediate anatomo-radiological results and functional outcome of a continuous series of 100 percutaneous transluminal angioplasties (PTA) in patients with chronic obliterative arterial disease of the lower limbs are reported. In 8 out of 10 cases, the patients had no previous surgical history. The iliac axis was more commonly affected than the infracrural arteries (57% compared to 43%). The indication of choice was the Leriche stage II (73%). The arterial lesion was responsible for the ischaemic pathology in 2 out of 3 cases. There was a higher incidence of preocclusive lesions (46%) than thromboses to be recanalised (23%) or significant stenoses (23%). The anatomo-radiological results were satisfactory in 80% of cases: a normal calibre was restored in 31% and stenosis was reduced to non-significant levels in 49% of cases. The morbidity associated with this technique was 7%: inability to dilate or thrombosis of the vessel. In 7 cases, failure was due to inability to pass the catheter across the stenotic lesion. Complementary surgical treatment was carried out on "accessory" arterial lesions in 33 cases; 32 sympathectomies for distal lower limb lesions and I femoro-popliteal bypass after iliac PTA. A total of 86.6% of PTA were followed up for an average of 22 months; 72% were totally asymptomatic; 21 were classified as stage II with improvement of their walking limits. The 3 year success rate was 0.92 +/- 0.1. Arterial surgery was necessary in 5.6% of cases for persistent severe intermittent claudication.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

[Pelvic lipomatosis: value of x-ray computed tomography. Apropos of a case].

Pelvic lipomatosis is characterised by an excessive amount of adipose tissue in the pelvis. Although there are usually few clinical symptoms, the radiological changes are characteristic: pear-shaped bladder, straightened and displaced rectosigmoid junction. However, these changes are not specific and some workers advise histological confirmation with or without surgical exploration. The authors describe a case illustrating the diagnostic value of computerised axial tomography, as has previously been reported. This investigation seems to give reliable results in the diagnosis of pelvic tumours, especially those of adipose tissue.

Aged↗
PubMed1984

[Role of echotomography in the diagnosis of renal masses. Comparative study with computerized tomography, arteriography and anatomopathological studies (100 cases)].

The authors have selected a series of 100 recent cases of solid and fluid-filled tumors, all of which were explored by nephro-urotomography and ultrasound. These two procedures constituted the basis of the examination. In case of doubt, they had recourse to CT scans. They consider that arteriography is likely to become exceptional.

Angiography↗
PubMed1983

Radiologic features of a metastatic carcinoma to the ureter.

2 cases of metastasis to the ureter from carcinoma of the stomach are presented. The clinical and radiologic features are reviewed. Metastasis to the ureter is rare. A plea for vigorous evaluation and early detection of this entity is made.

Adenocarcinoma↗
PubMed1982

[Angioplasty of the arteries of the extremities. Early and mid-term results (up to 3 years) in 492 cases].

Results of iliac, femoral and/or iliac artery percutaneous transluminal angioplasty (P.T.A.) in 492 cases are presented, and the latest technical improvements in the procedure reviewed. Short and medium-term results in iliac artery stenoses were excellent (98 and 96% respectively), obstructions in this region not being treated. The advantage of P.T.A. over surgery is the lack of exposure of patients to the risk of circulatory insufficiency. Very good results were obtained in stenosis of the distal femoral artery, the method being much less effective in cases of long thrombosis. The essential indications are all types of stenosis of limb arteries, while contraindications can be summarized as iliac artery obstructions (because of possible severe retroperitoneal hematomas) and massive atheromatous calcifications. Aortic and graft stenoses are particular indications. Complications are mainly hematomas and thromboses, but these can be reduced in incidence by increasing experience of radiologists in the use of P.T.A. and by improved selection of patients. Progress will also depend on improved control of anticoagulant and thrombolytic treatments. The question is raised as to the need to treat early claudication due to femoral artery stenosis following detection by the Doppler effect test. The essential argument in favor of P.T.A. is the simplicity and safety of the method to the compared reconstructive surgery, a method involving too high a risk.

Aged↗
PubMed1982

[Treatment of renal artery stenosis by percutaneous intraluminal angioplasty].

New therapeutic possibilities can be considered by the introduction of techniques for dilatation of arterial stenoses. Percutaneous intraluminal angioplasty of a stenosed renal artery is a simple procedure carrying few risks, and arterial permeability can be achieved in 90% cases. Recovery or improved control of hypertension can be obtained in the majority of cases, and renal parenchyma vascularization maintained. Though evaluation of long-term results is not yet possible, P.T.A. appears to be a very seductive therapeutic method.

Angioplasty, Balloon↗