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Biomedical subjects

J J Merland

Publications and source records attributed to J J Merland.

At least 235 records · Page 13Linked to original sources

[Development of therapeutic neuroradiology (author's transl)].

While therapeutic endovascular occlusions date from as early as 1904, it is in the last 20 years that therapeutic neutroradiology has come into its own. Progress has been made in four directions. (1) Embolization has developed from the original technique involving arteriotomy, through percutaneous methods, to present-day superselective catheterization. Concurrently, the materials used have been improved: from nonmalleable muscle and Silastic balls, to malleable Spongel and dura mater, and most recently to polymerizable fluid plastic substances. The possibility of obstructing very narrow vessels extends the range of indications of embolization. (2) Balloon catheters have been developed, first with nondetachable balloons (1971), more recently with detachable ones (1974). (3) Other techniques may be used to produce a therapeutic thrombosis, e.g., endovascular electrocoagulation and thermocoagulation. (4) Foreign bodies may be extracted safely by catheterization. Further development of techniques should ensure a growing importance for therapeutic neuroradiology in the future.

Embolization, Therapeutic↗

[Therapeutic principles in angioma of the mandible: applications in relation to a clinical observation (author's transl)].

When confronted with a case of angioma of the mandible, treatment should be directed towards two main areas:--to stop blood loss. Ligature of the external carotid can be life-saving, but it does not prevent the formation of nearby anastomotic vessels which refill, more or less rapidly, the external carotid axis. Ligature make embolization impossible by femoral way. A by-pass operation to improve permeability is also dangerous if not impossible. Ligature should be reserved only for those cases in which there is an immediate threat to life. On the contrary, embolization is necessary before surgery. --to treat the angioma. As radiotherapy is not effective or is dangerous, surgical treatment is necessary; either by a conservative operation or by radical resection. All these facts are illustrated dramatically by the case reported.

Adult↗

[Indications of arteriography and of emergency embolization in gastrointestinal tract and abdominal hemorrhages (author's transl)].

A propos 24 cases of gastro-intestinal tract's embolization of which eleven were performed in emergency for bleeding, the principle indications are described and illustrated. In some cases embolization gracefully replaces the ligation by a rapid and simple procedure at the time of diagnostic arteriography, preparing with safety the operative cure. In other cases embolization alone is curative: arteriovenous fistulas, telangiectases in 'Osler-'s disease, radiotherapic bleeding lesions, inoperable cancers. This implies the presence of trained radiologic teams and a tight collaboration with intensive care, endoscopy and surgery in large medical center. In this view the existence of radio-surgical rooms is useful.

Adult↗

Narrowing and occlusion of arteries by intracranial tumors. Review of the literature and report of 25 cases.

The intracranial arterial obstructions (narrowing or occlusion) found with intracranial tumors are rarely reported. Our 25 cases and those of the literature enable us to draw a statistical view of these facts. Meningiomas and gliomas are often concerned, and they principally involve the main arteries at the base of the brain. The practical interest in such pathology concerns: the risk of a fall in blood pressure during general anesthesia which may result in occlusion of a narrowed artery; the need to estimate the pathological state of one or several arteries passing by a tumor which must be removed; and the possibility of providing an extra-intracranial arterial bypass if necessary.

Arterial Occlusive Diseases↗

The intra-arterial injection of Iskedyl for hyperselective vascular exploration.

The development of spasm with the introduction of catheters into very small calibered arteries has tended to interfere with routine superselective catheterization. To overcome this problem the vasodilating drug Iskedyl, which containes raubasine 6.25 mg and dihydroergosistine 0.3125 mg in an ampule of 2.5 ml, has been injected into the artery being manipulated. The study was conducted on 112 patients undergoing hyperselective explorations of intracranial, thoracic, abdominal and peripheral arteries of small caliber and the results have been most gratifying and encouraging.

Angiography↗