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Biomedical subjects

M Maraval

Publications and source records attributed to M Maraval.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

Fractures of the clavicle and injuries of the sub-clavian artery. Report of 10 cases.

During four years, the authors have observed ten lesions of the sub-clavian artery associated with a fracture of the clavicle. The clinical picture in one case out of two was that of an acute ischemia of the upper limb. The surgical repair has been performed in 8 cases. The thoracic approach was necessary three times. The clavicle was resected in most cases. The prognosis of these lesions depends on the rapidity of their recognition, and of their treatment, and on the fact whether the brachial plexus is involved or not

Accidents, Traffic↗
PubMedDate not supplied

[Chances of avoiding amputation in an arteritis patient with gangrene].

During the period 1970-1974, restorative surgery was carried out 324 times in patients with gangrene or severe ischaemia caused by arteritis of the lower limbs. In 67 percent of the cases major excision surgery, such as amputation at the thigh or of the whole leg, was avoided and the support was retained. In 61 cases (19 percent) amputation was necessary either immediately or within a few weeks or months. Death occurred in 47 patients (14 percent) either in the operative period or in the 3 following years.

Amputation, Surgical↗
PubMedDate not supplied

[Left predominance of varices: myth or reality?].

The study of 843 legs operated for major varices shows that they are equally distributed between the two lower limbs (48.6% on the right, 51.4% on the left). There is little sex-determined variation in this distribution (410 women - 184 men), the main difference being that found in men: +4.6% on the left. Other studies carried out in Europe come to much the same conclusion. Two of these studies do, however, note a much clearer predominance of left-leg varices in men (+10%). For some studies, the lack of information about the type of varices being considered has proved troublesome (for example the many isolated telangiectasis and varices) and means that it is impossible to come to any exact conclusion. Clinical quantification is therefore desirable: at least it takes into account the diameter of the varices studied.

Adolescent↗
PubMedDate not supplied

[Post-stripping telangiectasis].

These telangiectasia appear between one and six months after the operation, especially in cases of capillary fragility. The most common localizations are the antero-internal and external sides of the thighs and knees. Unnecessary strippings, of continent saphenous veins, are the most frequent cause of these. Their prevention consists of the least possible traumatising stripping, using a fine stripper, a very rigorous post-operative support, and the wearing of light varicose stockings or tights for between one and three months. The treatment using microsclerosis, often delicate, should not be undertaken before six months.

Female↗
PubMedDate not supplied

"Redo" surgery for late aorto-femoral graft occlusive failures.

Experience of late failures of Dacron aortofemoral grafts is presented; about 70 cases observed during the past eight years on whom 105 subsequent operations were performed. One third of these patients were first operated upon by another surgical team. During the same period, 850 patients were submitted to reconstructive surgery of the abdominal aorta and iliac arteries either for atherosclerotic or for aneurysmal disease. It appears that conservative procedures like thrombectomy of the occluded limb are often insufficient, impossible, inappropriate or dangerous, even after restoration of a good deep femoral outflow. On the other hand, aggressive restoration of limbflow is generally necessary, with other various and ingenious direct or indirect reconstructive techniques for restitution of a good inflow and outflow. These techniques are usually successful (85%) and gain time against the major etiology of these late failures viz the development of atherosclerotic disease.

Aged↗
PubMedDate not supplied

[Axillary-femoral by passes. Technic. Complications. Results (92 patients) (author's transl)].

Between January 1970 and October 1977, 95 operations of revascularisation of 124 lower limbs were carried out using the axillary artery in 92 patients. 84 patients had very severe ischemia, acute or chronic, which threatened the survival of the limb. In all, direct surgery was too dangerous (77 cases) or impossible owing to local or regional problems (7 cases). The results gave a mortality during the first two months of 13% in which infective complications of the technic accounted for 3.5%. The latter were frequent (12%) but a certain number of them could have been prevented (6%). 55 patients (65%) had a good result at two months (weight-bearing conserved) whilst 20%, i.e. 18 patients were amputated, of which five had a permeable by pass which permitted conservation of the knee. We observed the highest percentage of deaths (3/8 i.e. 37%) in bilateral emergency revascularisations for acute ischemia. We observed a very low percentage of early thrombosis (4%) in axillary bifemoral by pass performed for chronic ischemia. The operation is of great value when no other direct surgical technic is possible and only in these cases. 8 patients underwent an axillary by pass to treat infective complications of aorto-iliac surgery. 4 early deaths showed the severity of this complication (50%). Tactical aspects are discussed briefly.

Aged↗
PubMedDate not supplied

Carotid artery surgery in patients over 70 years of age.

Between 1965 and 1979, 934 patients underwent 1,057 operations for extracranial carotid stenosis at this institute, and over a recent 30-month period 463 patients underwent 511 operations of this type. This number is equal to the total of operations performed during the years 1965-1976. The increase in the frequency of carotid artery surgery has been more marked in patients of over 70 years. The percentage of elderly patients has increased from 17.5% to 27% in the recent period. In the latter group of 511 operations, results were good in 93.17% of cases, while there was a mortality rate of 1.95% (1% of which were directly related to the surgery), in 1.95% the neurologic condition deteriorated and in 3.13% there was no change. In the first period the mortality rate for patients over 70 years of age was 7.69%. In the second it was 3.27% (1.63% of which were due to non-neurologic causes), 4.09% deteriorated, in 2.18% there was no change and good results were obtained in 90.46%.

Aged↗
PubMedDate not supplied

[Therapeutic problems posed by various angiodysplasias].

The clinical and anatomical aspects of the angiodysplasias are multiple and numerous classifications have been proposed. After review of a more simple classification put forward by Natali and Merland based on the contribution of superselective arteriography, consideration is given to a therapeutic approach for each angiodysplasia. Whereas for a long time the only therapeutic alternatives have been between surgery and no surgery, improved arteriographic understanding of these lesions has now permitted improved treatment, by surgery or by embolization or by the combination of the two methods. Finally the fields of the pure arterial dysplasias and the rares phacomatoses are considered, with a therapeutic scheme in each case.

Adult↗
PubMedDate not supplied

[Intermittent compression of the subclavian vein].

The pathology of the cervico-thoracic channel is now well understood. Intermittent venous compression in the costo-clavicular space by the subclavian muscle can lead to acute occlusion of the venous trunk. It is important to make an early diagnosis of such compression before the stage of occlusive phlebitis. Clinical examination and dynamic phlebography allow the diagnosis to be made. Resection of the first rib is the ideal treatment. The mode of approach to the first rib is debatable since it seems that when venous symptomatology is dominant, the axillary method of Roos is not the best approach. A combined sub- and supra-clavicular approach permits a wide decompression of the vein and a more complete excision of the rib.

Adult↗