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Biomedical subjects

J Watelet

Publications and source records attributed to J Watelet.

At least 73 records · Page 4Linked to original sources

[Evaluation of digital subtraction angiography, ultrasonography and Doppler velocimetry versus conventional angiography in the femoral bifurcation].

Thirty patients were examined by 4 procedures, conventional angiography (C.A.), peripheric intravenous digital subtraction angiography (D.S.A.), ultrasonography and Doppler on femoral artery bifurcation. These arteries are divided into several sections on which findings were classified into three or five categories. There is an excellent correlation between conventional and digital angiograms. Various results of D.S.A. versus C.A. were obtained in 2% of these sections. More differences were noticed between C.A. and Doppler (7%), C.A. and ultrasonography (10%). There is a positive correlation of D.S.A. versus C.A. With Doppler and ultrasonography, arterial map is difficult to establish especially in case of many stenoses of the iliac arteries or thrombosis on femoral superficialis arteries.

Adult↗

[Inter-observer variability in the interpretation of arteriographies of the carotid arteries and lower limbs].

This study attempts to measure inter-observer variability in reading 14 carotid angiograms and 8 aortograms. 24 surgeons and radiographs with training in arterial diseases participated in the study from different hospitals. The results were analysed with the Kappa statistical method which incorporate a correction for the extend of agreement expected by chance alone, in the evaluation of the reliability of diagnostic procedures. From a topographic point of view, the interpretation of the proximal arterial segments is more reliable than the distal segments, with the exception of the aorto-iliac bifurcation and the profunda femoral arteries. Inter-observer agreement is the most important for the occlusive lesions and the identification of stenosis is of poor reliability.

Angiography↗

[Electroencephalographic surveillance during carotid endarterectomy].

Continuous EEG monitoring during 110 carotid endarterectomies showed transient or permanent abnormalities in 35 cases. In 13 cases, these abnormalities occurred during carotid clamping and led the surgeon to place a shunt in 8 cases. In 22 cases, electrical abnormalities of various types appeared outside the clamping period. Continuous EEG monitoring demonstrated that cerebral disturbances can occur at any time during the operative period. Thus, intra-operative EEG monitoring allows a better understanding of clinical signs which may be seen postoperatively.

Anesthesia, General↗

[Value of per-operative measurement of the blood flow in vascular surgery (author's transl)].

Post-operative thrombosis in vascular surgery results from either technical error of deficient arterial outflow and can be avoided by checking, during the operation, that the new circulatory conditions created are adequate. Among the most frequently used control methods arteriography occupies a prominent place but requires a sophisticated equipment to be truly reliable. Per-operative measurement of the blood flow is much simpler. It objectively assesses the haemodynamic value of the arterial reconstruction and provides useful information on the short-and medium-term patency of the vessels.

Aged↗

Occurrence and specificity of anti-B lymphocyte antibodies in renal allograft recipients.

Anti-HLA-A,B and anti-B lymphocyte antibodies were screened as part of a prospective alloimmunity monitoring study in 29 renal allograft recipients using a standard microlymphocytotoxicity test. Warm-reactive and/or cold-reactive lymphocytotoxins were directed against a panel of B lymphocytes, the donor's B lymphocytes, and the recipient's own B lymphocytes. A small proportion of patients had pretransplant antibodies, whereas about one-half of the patients had post-transplant antibodies. One-year allograft survival rates were lower among the patients with warm- and cold-reactive sera than among those with nonreactive sera or pure B cold-reactive sera. The sera of 20 patients were tested against donor B lymphocytes. The presence of donor-specific antibodies correlated closely enough with graft loss to be of predictive value. Autoantibodies appeared to have an enhancing effect in this study.

Antibody Specificity↗

[Infection of vascular sutures: a report on 26 cases (author's transl)].

The authors describe 26 cases of infection after vascular surgery, affecting a Dacron prosthesis in 13 cases and venous grafts in the other 13 patients. The site of infection was usually the region of Scarpa's triangle (15 cases) with the presence of enterobacterium in 40% of cases. The most frequently isolated germ was staphylococcus aureus (20 cases). Infection was revealed by hemorrhage in 17 patients and was evidence of breaking down of the anastomosis. Results of surgical treatment in the two groups were evaluated by using three criteria: --persistence or not of infection, --vital prognosis, --functional prognosis. Surgical treatment methods and possible contamination sources are discussed. When the operative zone is infected, the authors recommend ablation for the prostheses and conservative therapy for venous autografts. The prosthesis was left in place in 5 patients, and only one patient recovered, while two deaths occurred. In the 10 cases where ablation of the prosthesis was performed, however, the infection was cured, and in 4 patients there was revascularization in the infected area. Apart from these cases, conservative therapy was applied in 11 cases and healing occurred in all of them.

Adult↗

[Benign vascular digestive tract malformations. Review and report on two cases (author's transl)].

Benign vascular digestive tube malformations were first described in 1839. Their incidence is low, they occur mainly in the small intestine and colon, and they are of current interest because of their rare nature, the difficulty in establishing a diagnosis, and the large variety of lesion observed. They tend to be diffuse, multiple, and may be found in the rectum. Treatment is difficult, therefore, and though surgery is usually indicated, endoscopic electrocoagulation, laser beams, or embolization may be of value when used alone or as complementary therapy.

Adult↗

["Suspended" popliteal artery shunts. A report on 15 cases (author's transl)].

A "suspended" popliteal artery (S.P.A.) constitutes one of the most pejorative anatomical forms for atheromatous lesions of the lower limbs, as obliteration of the superficial femoral artery is often associated with atheromatous lesions in the tibial arteries, making them inaccessible to arterial reconstruction. Operations have been conducted on 5 cases (14 patients) over a period of 3 years. The average age of the patients was 71.6 years and the average follow-up period was 13 months. In each case operation was required to avoid amputation. Venous material was used for the shunt in 10 cases, while 5 had composite (n = 3) or prosthetic (n = 2) material. Postoperative mortality was nul, but 28% died by the end of the first year. Thrombosis occurred in 3 cases, at the 2nd, 7th, and 9th month respectively (actuarial permeability rate after 1 year: 72%), and 4 patients had high amputations (leg: 3, thigh: 1) in spite of permeability of the shunt is two cases (actuarial conservation rate of the limbs after 1 year: 67.5%). An analysis of the results of these 15 cases and those rare series reported in the published literature, enables definition of the indications for revascularization of an S.P.A.

Aged↗

[Sub-adventitial cystic degeneration of the popliteal artery. One case (author's transl)].

On the basis of a new case of sub-adventitial cystic degeneration of the popliteal artery, the authors review the characteristics of this condition. The diagnosis may be suspected on the basis of clinical and arteriographic findings in an individual in whom the arterial system is otherwise normal. The various aetiological hypotheses are recalled. Treatment in the majority of cases consists of simple excision of the cyst. Intimal changes or segmental obstruction impose the need for resection with restoration of continuity by bypass.

Cysts↗

[Polycystic liver. Report of one case and therapeutic discussion (author's transl)].

The authors report a new case of polycystic liver associated with polycystic kidney. The functional disorder due to distension of the cysts led to surgery. The impossibility of carrying out removal of the liver, owing to the diffuse character of these lesions, led the authors to choose the method described by Tien Yu Lin in 1968. This seems to be indicated in a few cases owing to the remarkable functional results.

Cysts↗