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Biomedical subjects

J J Merland

Publications and source records attributed to J J Merland.

At least 163 records · Page 9Linked to original sources
PubMed1987

Vascular malformations of the spinal cord: intrathecal perimedullary arteriovenous fistulas fed by medullary arteries.

We studied eleven patients with intrathecal extramedullary arteriovenous fistulas identified by selective angiography and myelography. The fistulas were located on the surface of the cord, fed by medullary arteries. Angiography distinguished three separate types that gave identical clinical disorders. Therapeutic results of surgery and embolization allowed specific indications to be defined for treatment of each type of fistula.

Adolescent↗
PubMed1987

[Tympanic and jugular paragangliomas. II. Angiographic, surgical and irradiation treatment. Results. Indications. Apropos of 25 cases].

Results of treatment are reviewed in 25 cases of tympanic and jugular paragangliomas treated and followed up in the Lariboisière hospital, Paris between 1978 and 1986. Therapy has been transformed by the use of embolization but its non-negligible neurologic accident risks, whatever the carotid artery territory involved, justify prior weighing of indications for its application. New surgical technics allow more extensive exeresis, but intrapetrous extension to the nerve compartment of the jugular foramen and the anterior pericarotid region still raises difficult surgical problems and appears to be the principal reason for failure of treatment. Radiotherapy is very effective and applicable for inoperable forms, as a complement to incomplete surgical removal and for recurrences.

Cerebral Angiography↗
PubMed1987

[Arteriovenous malformations in the region of the ampulla of Galen. Anatomical and clinical aspects and the course of endovascular treatment (1979-1986). Apropos of 10 cases].

Technological progress has resulted in embolization being adapted as treatment of choice for arteriovenous malformations in the region of Galen's ampulla. To ensure recovery it is essential to conduct treatment at an early stage, to adapt it to the morphologic type of malformation and to investigate possible associated thrombosis requiring anticoagulant therapy. A shunt operation may be necessary if hydrocephalus fails to regress.

Adult↗
PubMed1986

A simple propulsion-chamber-system for the 16 gauge approach.

The construction of a propulsion chamber system is simplified by separating the different elements of its functions. For injections of the propulsive fluid the coiling chamber is bypassed, leaving its contents untouched. The diameter of the coaxial system is reduced by minimizing the space between the two catheters. Consequently the puncture site becomes small (a balloon-catheter may be introduced through a 16 G catheter needle) allowing punctures proximal to lesions (e.g. puncture of the axillary a. or the carotid a.) and thus shortening the length of the coaxial catheter system. The risk of thrombus formation diminishes and renders heparinization dispensable. Control angiographies are separated from the coaxial system.

Blood Vessels↗
PubMed1986

Endovascular treatment of vertebral arteriovenous fistulas in twenty-two patients.

Twenty-two cases of vertebral arteriovenous fistulas treated by embolization are reported. Although such fistulas are usually asymptomatic they may be occasionally responsible for tinnitus. Neurologic complications are exceptional. Spontaneous fistulas have been found predominantly in the C1-C2 region (9 of 13 cases), while post-traumatic fistulas were located in the C5-C6 region and were often iatrogenic in origin (7 of 9 cases). In 17 cases embolization caused definitive closure of the fistula, while the vertebral artery remained patent. In three patients it was also necessary to close the vertebral artery in order to occlude the fistula. In two instances, endovascular management failed to obliterate the fistula. At present, endovascular treatment is the simplest and one of the least aggressive therapeutic approaches to vertebral arteriovenous fistulas.

Angioplasty, Balloon↗
PubMed1986

Vertebral hemangiomas: radiologic evaluation.

Radiologic studies of 57 solitary vertebral hemangiomas (VHs) were reviewed to find radiographic and computed tomographic (CT) criteria by which to distinguish asymptomatic lesions from those compressing the spinal cord. Six features were seen significantly more often in those compressing the cord: location between T-3 and T-9, involvement of the entire vertebral body, extension to the neural arch, an expanded cortex with indistinct margins, an irregular honeycomb pattern, and soft-tissue mass. Contrast material-enhanced CT scans and selective spinal angiograms demonstrated extension into the spinal canal. In patients with a VH and back pain of uncertain origin, the presence of three or more of these signs may indicate a potentially symptomatic VH. In such patients, spinal angiography and, in some cases, embolization, are indicated.

Adolescent↗
PubMed1986

Superselective catheterization using very flexible, formed catheters.

Superselective catheterization of even very tortuous vessels is possible, with very low risk of arterial spasm and plication of the catheter, when very flexible catheters are used. The thermoplasticity as a new additional quality of very flexible catheters offers new possibilities to guide such catheters. Thus, the catheter extremity may be curved in order to overcome difficult anatomic pathways, or a bulb-shaped dilatation of the catheter tip can be achieved in order to increase the flow-dependent guidance of the catheter.

Brain↗
PubMed1986

Endovascular treatment with isobutyl cyano acrylate in patients with arteriovenous malformation of the brain. Indications, results and complications.

Between December 1984 and May 1986 67 patients with arteriovenous malformation (AVM) of the brain have been treated with endovascular occlusion using isobutyl-cyano-acrylate at the Lariboisière Hospital. Six patients were completely cured, i.e. with complete occlusion of the malformation. In 21, reduction of the size of the AVM was obtained, permitting surgery or radiation therapy not considered possible before endovascular intervention. In 33 cases a partial cure was achieved, but additional embolization is needed. In 3 cases the treatment was interrupted. Four patients died. The overall frequency of complications was in this material around 10 per cent.

Bucrylate↗
PubMed1986

[Clinical and developmental aspects of small brain stem hematomas. Contribution of x-ray computed tomography].

In a review of 16 cases, the authors emphasize that small brainstem haemorrhages, diagnosed by CT-scan, can have a good outcome, most often spontaneously. Twelve hematomas were in the pons, four in the mesencephalon. Several clinical features were remarkable: consciousness was not or moderately impaired, focal symptoms and signs predominantly neuro-ophthalmologic were present. Involvement of the cranial nerves and long tracts occurred rarely in isolation. Arterial hypertension was the usual cause (50 p. cent); one normotensive patient with neurological disorders prior to the bleeding had an arteriovenous malformation, demonstrated angiographically. In two cases an obstructive hydrocephalus was surgically treated. Expected advances from CT-scan and magnetic resonance imaging (M.R.I.) are discussed.

Adult↗
PubMed1986

[Nonsurgical treatment of cystic lymphangioma].

Capillary lymphangiomas present of birth, and which have very little tendency to regress, must be distinguished from true cystic lymphangiomas developing after birth which are probably due to lymph blockade and are not true congenital malformations. This probably explains why the latter lesions regress either spontaneously or more rapidly after treatment with products such as Ethibloc. In the latter case, the efficacy of Ethibloc therapy appears to be equal to that of surgery without the formation of a scar and should therefore be tried initially before surgery.

Adolescent↗
PubMed1986

[Embolization of iatrogenic traumatic vascular lesions of the kidney. Apropos of 25 cases].

The authors present 25 cases of traumatic iatrogenic vascular lesions of the kidney, treated by embolization. Twenty two patients were seen for serious haemorrhagic complications: the embolization restored haemostasis in all cases. An early precocious relapse, due essentially to the use of reabsorbable embolization material, was seen in 4 patients, 2 of which were able to be reembolized, thereby definitely stopping the haemorrhage. No immediate complications were noted. 5 of the 12 patients follow-up, showed signs suggestive of infarction, strictly localized to the corresponding segmental territory embolized. The use of inflatable balloons facilitates the catheterization of segmental renal arteries and the endovascular treatment. Therapeutic angiography offers a simple, efficient, and remarkably conservative treatment of vascular iatrogenic trauma of the kidney. Angiography defines the number, site and type of vascular lesions ; the embolization assures the elective treatment.

Adolescent↗
PubMed1986

[Embolization of arteriovenous malformations using compression. Apropos of 11 cases].

External compression of both arterial feeder and venous return of an MAV allows embolization material to be stabilized into the area of the shunts. 11 patients were treated according to this method, either by an external compression method (4 cases) or by tourniquets (4 cases) or by a balloon compressing the vena cava (3 cases). The material of embolization was in all cases Isobutyl-2-Cyano-Acrylate. 5 patients were successfully operated after the procedure and 7 patients had considerable improvement after embolization, 2 of them being considered as cured.

Adolescent↗