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Biomedical subjects

J J Merland

Publications and source records attributed to J J Merland.

At least 271 records · Page 15Linked to original sources
PubMed1975

[Functional anatomy of the superfical temporal blood vessels].

Functional study on superficial temporal vessels. These vessels appear to have a board territory on--the horizontal part of the scalp--the superior lateral face--the anterior and superior half of the external ear The terminal part of these vessels and the rich anastomotic system is particularly studied. This system passes the middle line; the anastomoses are in the fascia superficilialis. Secondly there is a sub-dermal plexual formation which is in a parallel direction to the vessels. Practical consequences can be found--in neuro-surgery--in plastic-surgery--and in the new surgery of cutaneous transfer with micro-anastomoses of the vessels.

Arteries↗
PubMedDate not supplied

MR imaging of head and neck vascular malformations.

Between 1980 and 1990, 150 patients with cervicofacial vascular malformations were studied at the authors' institution with computed tomography, plain radiography, and angiography. Since 1989, 34 of these patients have also undergone magnetic resonance (MR) imaging. Capillary-venous hemangiomas seem to be the best indication for the adjunctive use of MR imaging. The venous pouches, characteristic of this type of lesion, cause elevated signal intensity, well seen on the T2-weighted images. Excellent fat and muscle differentiation with MR imaging allows appreciation of the depth of extension of these lesions and their delimitation from normal tissue. Arteriovenous malformations (AVMs) are characterized by serpentine signal voids, indicative of the high flow rate of these lesions. Delimitation of the AVM nidus in the midst of the afferent and efferent dilated vessels is often difficult. Study of immature angiomas with MR imaging should be restricted to lesions in specific locations (eg, orbital, laryngeal). Lymphatic malformations showed either tissular or cystic signal intensity changes. MR imaging does not replace other studies but represents an important complementary study for the delineation and diagnosis of deep extensions of vascular malformations, allowing better planning of therapy.

Arteriovenous Malformations↗
PubMedDate not supplied

Phase-contrast MR angiography of vascular malformations of the spinal cord at 0.5 T.

Preliminary experience with phase-contrast magnetic resonance (MR) angiography at 0.5 T applied in 12 cases of vascular malformations of the spinal cord is reported. There were six intramedullary arteriovenous malformations (AVMs), four perimedullary fistulas, and two dural arteriovenous fistulas with perimedullary drainage, all proved with x-ray angiography. The small size of the vessels and their location within a bony structure presented a technical challenge. Serpentine vascular signal patterns were identified within the spinal canal in all cases, showing good correlation with the x-ray angiographic pattern. Relative to spin-echo images, MR angiograms allowed better visualization of the venous drainage. The nidus of intramedullary AVMs was more difficult to recognize. The ability to manipulate the velocity-encoding value allows better characterization of flow speed. The results underline the two dimensions of the phase-contrast technique, which provides both anatomic images and dynamic information about vascular malformations. MR angiography does not replace selective x-ray angiography, which is indispensable for therapeutic strategy (endovascular procedure or surgery), but it can be considered a valuable alternative to x-ray angiography during follow-up.

Adult↗
PubMedDate not supplied

Balloon-assisted coil embolization for large-necked renal artery aneurysms.

An aneurysm of the right renal artery was discovered in a patient suffering from cerebral arterial angiodysplasia and arterial hypertension. The aneurysm was large necked, which made selective endovascular treatment very difficult. To perform the embolization of the aneurysm, a balloon remodelling technique was used. This prevented migration of coils within the arterial lumen.

Aged↗
PubMedDate not supplied

Endovascular treatment of arteriovenous fistulas arising from branches of the subclavian artery.

PURPOSE: The goal of this study was to evaluate the role of endovascular techniques in the treatment of arteriovenous fistulas (AVFs) in the subclavian region. PATIENTS AND METHODS: Since 1984 six patients with AVFs arising from branches of the subclavian artery have been treated. All AVFs were of iatrogenic origin (five venous punctures and one pacemaker insertion). Two patients had cardiac insufficiency, three had a bruit, and one had upper extremity venous hypertension. Angiographically, four of the AVFs were located on the thyrocervical trunk and two were on the internal mammary artery. RESULTS: All fistulas were treated by means of endovascular occlusion with a detachable balloon, with full resolution of symptoms. One AVF recurred after a balloon deflated prematurely. The patient was treated again and was subsequently cured. No other complications were associated with treatment. CONCLUSION: Endovascular balloon occlusion of AVFs in the subclavian region is a simple, effective, and safe method that eliminates the need for surgery. It should be the method of choice for treatment of these lesions.

Arteriovenous Fistula↗
PubMedDate not supplied

[Uterine fibroids embolization: results about 454 cases].

OBJECTIVE: To determine the effectiveness of uterine arterial embolization (UAE) as primary treatment in the management of symptomatic leiomyomas. PATIENTS AND METHOD: UAE was performed on 454 patients (age range: 21-68) with menorrhagia, bulk-related symptoms or both, due to leiomyomas. The effectiveness of this therapy in the control of symptoms and reduction of uterine and leiomyoma volume was measured by clinical and imaging controls at 3, 6 and 9 months after the procedure. RESULTS: Four hundred and thirty-three patients were evaluated, and 42 failures were observed (9.6%). Six months after the procedure, 391 patients were symptom-free. Follow-up ultrasonic examination showed an average reduction of 55% in dominant myoma volume at 6 months, 70% at 1 year. Twenty-seven women became pregnant (30 pregnancies). Complications related to procedure, and requiring surgery, occurred in three cases. Principal complications are amenorrhoea and fibroid sloughs. Severe complications are rarely found. DISCUSSION AND CONCLUSION: UAE is an efficient therapy in the management of symptomatic myomas and proves to be a valid alternative to surgical procedure. The future of this mini-invasive and conservative technique appears to be a very promising one.

Adult↗
PubMedDate not supplied

Aneurysms of spinal arteries associated with intramedullary arteriovenous malformations. I. Angiographic and clinical aspects.

PURPOSE: To evaluate the nature of aneurysms of the spinal arteries, their relative frequency, and the risks associated with these lesions. METHODS: We retrospectively reviewed the spinal angiographic studies of 186 patients with spinal cord vascular malformations--70 intramedullary AVMs, 44 extra (peri) medullary AV fistulas, and 72 dural AV fistulas. RESULTS: Fifteen spinal artery aneurysms (SAs) in 14 out of 70 patients (20%) with an intramedullary AVM were discovered. No SAs were observed in the other types of spinal vascular malformations. The intramedullary AVMs with SAs were cervical in seven cases and thoracic in the other seven cases (one of the thoracic had two SAs). Fourteen SAs were located on a major feeding vessel to the associated intramedullary AVM (10 on the anterior spinal artery and four on a posterior spinal artery and only one SA was located remote from the AVM feeding vessels. This remote aneurysm was located on the intercostal artery feeding a vertebral angioma in a patient with metameric angiomatosis. Subarachnoid hemorrhage occurred in all cases of SA. The presence of a SA carried a statistically significant (P less than .05) increase in the risk of bleeding. CONCLUSIONS: Although increased blood flow seems to be an important factor in formation of these SAs associated with intramedullary AVMs, the role of a developmental vascular anomaly must be stressed: metameric angiomatosis was found in six out of the 14 patients (43%).

Adolescent↗