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Biomedical subjects

J M Cormier

Publications and source records attributed to J M Cormier.

At least 91 records · Page 5Linked to original sources
PubMed1987

[Preoperative assessment of clamping in carotid artery surgery and adaptation of the operative technic].

A retrospective study of 150 consecutive patients undergoing revascularization of internal carotid artery for atheromatous lesion of carotid bifurcation, included analysis of collaterals being compressed by common carotid artery simulating clamping. Two exploratory procedures had been applied routinely: global suprasigmoid digital subtraction angiography and Doppler velocimetry. Two groups of patients could be defined: clamping without risk (95.4%) and clamping at risk (4.6%). For the group of clamping at risk a surgical strategy is proposed allowing clamping without shunt by bypass between subclavian and internal carotid arteries of by bypass between common and internal carotid arteries because of the external carotid artery collaterals left untouched. A shunt is only necessary when the latter artery is occluded. Results of this series of patients explored in this way and operated upon confirmed these data: no clamping accident in the 1st group, one transient ischemic accident in the 2nd.

Adult↗
PubMed1987

[Intersubclavian bypass. Technic. Indications. Remote results].

Between 1974 and 1984, 34 patients were treated by inter-subclavian bypass operation for occlusive lesions of proximal subclavian artery or brachiocephalic trunk. Patients treated in this way were those in whom other methods were inapplicable. Results showed it to be a valid procedure: absence of morbidity or mortality related to the operation itself (one postoperative death from myocardial infarction); excellent early and late permeability if the need for absence of parietal or stenosing lesions in the arteries of origin and supply is respected. Doppler ultrasound imaging showed satisfactory hemodynamic results.

Adult↗
PubMed1987

Hypothenar hammer syndrome: seventeen cases with long-term follow-up.

Hypothenar hammer syndrome is a rare and often incorrectly diagnosed form of secondary Raynaud's phenomenon in workers who use their hand as a hammer. We report 17 documented cases with long-term follow-up after diagnosis made on the basis of arteriography. Clinical findings include male sex, unilaterality, sudden onset, and severe Raynaud's phenomenon. Angiography indicated that the 17 patients had either ulnar thrombosis or ulnar aneurysm; most of them also had embolic occlusions of the digital arteries. Main pathologic findings were thrombosis on the intima and fibrosis in the media. We adopted a surgical procedure consisting of resection with end-to-end reconstruction for patent aneurysms to avoid downstream emboli and more conservative treatment when the ulnar artery was thrombosed. No patient required digital amputation and all except one improved and were able to live and work normally with only a moderate disability, consisting of Raynaud's phenomenon during the cold season only.

Adult↗
PubMed1986

[Hemorrhagic vascular complications of pelvic fractures . The role of embolization. 9 cases].

Emergency haemostatic embolization of the branches of the hypogastric artery was performed within 24 hours in 9 patients with fracture of the pelvis and major progressive retroperitoneal haematoma. Eight to 48 units of blood had been transfused. The patient in the worst condition (48 units of blood) died of respiratory failure and myocardial incompetence 2 hours after embolization. In the remaining 8 patients, embolization was effective without any immediate or delayed complication of the angiographic procedure. The usefulness of emergency angiographic exploration and the possible applications of endovascular haemostasis are discussed.

Adolescent↗
PubMed1986

[Revascularization of the renal arteries by endoaneurysmal approach in aneurysms of the infrarenal aorta].

Four patients needing revascularization of multiple renal arteries issues from an aneurysm of the infra-renal aorta were treated by a method derived from Crawford's procedure used for the thoracic and thoraco-abdominal aortic segments, i.e. direct reimplantation of the arteries by the endoaneurysmal route. Whatever the caliber of the revascularized renal artery and the number of renal arteries, control angiography was satisfactory in all 4 patients.

Aorta, Abdominal↗
PubMed1986

Aorto-femoral bypass with polytetrafluoroethylene prostheses: preliminary results in 363 cases.

From October 1977 to October 1982, 363 unilateral aorto-femoral bypasses using polytetrafluoroethylene (PTFE) prostheses were performed for predominantly unilateral aorto-iliac disease. The distal anastomosis was extended into the deep femoral artery in 57% of the patients. The postoperative mortality was 0.5%. The actuarial patency rate after 6 years was 87% in patients with claudication and 77% in those with critical ischemia. No false aneurysm developed. Thrombosis of the prosthesis was due to progression of distal disease, intimal hyperplasia and postural extrinsic compression. The latter seems to be characteristic of PTFE prostheses and can be treated by thrombectomy. In 21 cases a cross-over femoro-femoral bypass was done during the follow-up period because of contralateral progression of disease.

Adult↗
PubMed1986

Persistant carotido-hypoglossal artery associated with atherosclerotic stenosis treated by venous bypass.

A 66 year-old woman presented with a tight but asymptomatic atheromatous stenosis in a persistant carotido-hypoglossal artery. Stenosis was documented by ultrasound Doppler tomography whereas the embryologic anomaly was disclosed by digital angiography. A successful venous bypass was done. Based on this case report, the diagnostic and therapeutic problems raised by such anomalies are discussed.

Blood Vessel Prosthesis↗
PubMed1986

[Interruption of the vena cava inferior. A comparative study of the Adams de Weese clip and the Kimray Greenfield filter].

Efficacy of two methods for interruption of inferior vena cava was compared after insertion of 95 Adams de Weese clips by the sub or trans-peritoneal route and of 72 Greenfield filters usually by a jugular approach. Introducing Greenfield's filter to produce caval interruption did not require modification of operative indications. In contrast, it allowed caval blockade to be performed in more elderly patients, generally in a poorer condition, at the price of higher mortality, due more to the clinical circumstances of the interruption rather than the caval blockade itself. Postoperative follow up showed fewer caval thromboses after Greenfield's filter (15%) than after the pericaval clip (35%).

Adult↗
PubMed1986

[Venous thrombectomy and caval interruptions].

Authors study the role of surgical treatment in the venous thrombo-embolic disease. At the moment, venous thrombectomy can be performed only in post-operative unilateral iliac thrombosis as well as in juxtarenal vena cava thrombosis (so as to enable a sub-nephric cava interruption) and finally to ilio-cava thrombosis. Vena cava interruptions can be performed either through a peri-cava clip, or by an intra-cava filter (the most efficient appears to be the K.R. Greenfield filter). Various advantages are thus studied. Vena cava interruptions are then discussed, according to clinical and angiographic data.

Filtration↗
PubMed1986

Colonic ischemia after aorto-iliac surgery.

Post-operative colonic ischemia represents a major complication of aorto-iliac surgery. The cause is a low output with a variable combination of a systemic low output and loco-regional low output secondary to atherosclerotic or surgical lesions of the inferior mesenteric artery. The pre-operative angiographic work-up, evaluation of the colonic ischemic risk, per-operatively, revascularization of the inferior mesenteric artery, preservation of the hypogastric flow, control of stable systemic hemodynamics, have significantly diminished the incidence of severe colonic ischemia while systematic colonoscopy at the slightest evocative symptom has permitted an effective treatment. The mortality is therefore greatly reduced. When the colonic ischemia is part of an acute circulatory failure, it is only one factor among other visceral ischemias, and it is the same for pelvic ischemias. In these 2 eventualities, the prognosis remains latent.

Aorta, Abdominal↗
PubMed1985

[Popliteal artery entrapment. Contribution of ultrasonography].

Ultrasounds contribute significantly to the diagnosis of popliteal artery entrapment. The haemodynamic data obtained by Doppler's velocimetry and the parietal and morphological data obtained by ultrasonography make it possible to proceed beyond a diagnosis of "presumption" based on clinical and arteriographic findings and to reach directly a positive diagnosis of entrapment, even in cases with arterial obstruction. Between December, 1979 and December, 1983, 12 cases of popliteal artery entrapment (5 of type I, 1 of type II and 6 of type III) were diagnosed by ultrasonic methods in 8 patients. In each of these patients the data thus obtained concerning the diagnosis, the type of lesion and the arterial complications were fully confirmed by a subsequent arteriography and at surgery.

Adult↗
PubMed1985

Surface healing and histologic maturation of patent polytetrafluoroethylene grafts implanted in patients for up to 60 months.

Histologic, transmission, and scanning electron microscopic observations were made of 26 biopsy specimens from patent polytetrafluoroethylene grafts that had been implanted as arterial bypasses for up to 60 months. The results showed the rarity of host connective tissue ingrowth, the absence of neovascularization, and the limited neointimal proliferation. The defect of staining for factor VIII-related antigen by immunohistochemistry confirmed the absence of true endothelial cells at a distance from the anastomoses. Under electron microscopy the thin neointimal layer consisted mainly of fibrin, platelets, blood cells, and cellular debris. Even in prostheses implanted for the longest periods, mature collagen and elastin were not found. Tubular microfibrils (9- to 12-nm thick) could be observed. The source of such microfibrils, probably glycoproteins, remains under investigation.

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↗