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Biomedical subjects

M C Riche

Publications and source records attributed to M C Riche.

At least 55 records · Page 3Linked to original sources

[Peroperative embolization of arteriovenous malformations arising from the vertebral artery].

Surgical exposure of the vertebral artery above C2 may be used in very selected cases to embolize medullary or cerebral arterio-venous malformations. 3 cases are reported which were treated by this technique. It allows to use a catheter of sufficient diameter for solid emboles, when balloon catheter cannot be used because IBC seems too hazardous (2 cases). This intra-operative technique may also be indicated when standard embolization is impossible for technical reasons : tortuosity, occlusion (1 case).

Adult↗

The treatment of capillary-venous malformations using a new fibrosing agent.

We present our early experience in the treatment of cutaneous capillary-venous malformations using a new fibrosing agent called Ethibloc. Superselective angiography was used to delineate the vascular anomaly and effect temporary occlusion. Whenever possible, compression of venous outflow also was used, while the sclerosing agent was injected directly into the malformation by percutaneous puncture. Sixteen patients with capillary-venous malformations have been treated with this agent since 1979. A mild local inflammatory reaction was noted in some cases; there were no instances of skin necrosis. In 10 patients, the fibrosed vascular malformation was excised, and in 6 patients, the area of vascular anomaly decompressed to such a degree that resection was unnecessary.

Adolescent↗

Vascular malformations of the mandible (intraosseous haemangiomas). The importance of preoperative embolization. A study of 9 cases.

Haemangiomas of the mandible are relatively rare arteriovenous malformations: 85 cases have been described since 1849. The severe risk of bleeding during tooth extraction or biopsy led us to describe the radiological and angiographic features of this condition. The afferent vessels are the inferior dental, the lingual, and the facial arteries. Preoperative embolization reduces the risk of bleeding at operation. Surgical treatment must assure the complete removal of the lesion. Radiotherapy and vascular ligatures are useless and dangerous.

Adolescent↗

[Hemostatic embolization. A report on 212 cases (author's transl)].

Among 1200 patients who have undergone embolization procedure in Lariboisière Hospital, 212 were treated to achieve hemostasis. The topographical repartition shows a preeminence in the cervico-cephalic area (91 cas) but also that hemorrages can now be controlled by this method in any part of the body. Regarding the type of the hemorrages, one must distinguish acute or semi-acute bleedings (52 cases) where embolization may instantaneously stop the hemorrage and spare arterial ligation. Pre-operative embolization (48 cases) allows surgeons to operate under excellent conditions in case of highly vascular lesions. Chronic bleedings (112 cases) affords great relief to the patient while often providing a life saving solution, when other therapeutic have failed.

Acute Disease↗

[Haemostatic embolization: possibilities and prospects. 190 cases (author's transl)].

Among more than 1 100 embolizations performed by one team, 190 were for haemostatic purposes. Owing to the ever increasing availability of suitable material and trained operators, no vascular territory nowadays is unaccessible to the technique. Simultaneous identification of the lesions and control of bleeding are advantages which no longer need be demonstrated. It must be noted that haemostatic embolization can and should be used in debilitated patients with acute or chronic lesions, even in the presence of disseminated intravascular coagulation.

Embolization, Therapeutic↗

Therapeutic angiography in neuroradiology. Classical data, recent advances and perspectives.

This report summarizes the extraordinary development of the neuroradiological entrance into the treatment of massive vascular malformations of the head and spine, also highly vascularized tumors, by embolization accomplished with the appropriate type of catheter and highly refined technique, in collaboration with the surgeons of neurology, ophthalmology, otolaryngology, and of the vascular system.

Adult↗

Closed-chest myocardial ischaemia in dog.

Myocardial ischaemia in dog was induced with releasable material in the distal segment of the anterior descending branch of the left coronary artery. Three releasable materials were tested: gel foam, wax microspheres (120-200 micron) and latex balloons, using different methods of introduction. The left carotid route was selected for introduction of a preformed catheter. The gel foam and wax microspheres caused transitory ischaemia, which was proximal for the foam and distal for the microspheres. The balloons made it possible to standardize the ischaemia as its localization and duration could be selected. This material therefore provided a model for stable chronic ischaemia. Nine dogs were observed by means of precordial mapping (36 electrodes) during the phase following ischaemia or for a period of 4 weeks. The results of these experiments are analysed and correlated with histological results for the post-mortem phase.

Animals↗

[C.T. scan and traumatic intracranial haematoma without clinical signs (author's transl)].

Patients having sustained head injuries were investigated by computerized axial tomography, a few hours after trauma. 24 conscious patients had large traumatic lesions: epidural haematoma, acute subdural haematoma and cerebral attrition. 12 had no focal sign and were well conscious or very slightly drowsy. 12 were slightly drowsy and/or had focal signs but these signs were very discrete in contrast with the huge lesions seen on the CT Scan. This seems to confirm that an epidural haematoma expands very early after the head injury, and, in any case, that it does exist during the free interval. From a practical view point, computerized tomography may greatly improve the treatment of patients who, other-wise, would have been operated upon in comatose state. This study is not a prospective one, it does not lead to any statistical value. But it points out the usefulness of CT Scan after severe head injury especially of conscious patients, above all if there is a skull fracture.

Adolescent↗

[Therapeutic embolization for traumatic renal haemorrhage. 11 cases (author's transl)].

Therapeutic embolization by means of autologous clots or fragments of gelatin sponge was carried out in 11 patients suffering from renal haemorrhage of traumatic origin (5 needle biopsies, 3 surgical operations, 2 external traumas, 1 penetrating wound). Arterio-venous fistulae were present in 6 cases and arterial lesions in 5. Performed with a fine catheter, embolization was highly selective for the segmental arteries involved. The clinical symptoms disappeared within less than 12 hours in three patients, within 2 to 4 days in five and within 15 days in one. In two patients haematuria was only temporarily arrested ; a second embolization could be performed in one of these, but nephrectomy was required in the other.

Adolescent↗