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Biomedical subjects

N Atallah

Publications and source records attributed to N Atallah.

34 records · Page 2Linked to original sources
PubMed1996

[Percutaneous bile drainage in neoplastic obstructive pathology of the biliary tract. Experience of the Hotel-Dieu of France in 100 drainages].

Between 1981 and 1994, a 100 biliary drainages were introduced transhepatically in 71 patients with malignant biliary disease. Eighty-six endoprosthesis were inserted, 6 internal-external drainages and 8 external drainages. Our success rate in catheterization of the stenosis was 97%. The early complication rate was 17% (12/71) most often due to hemorrhage (n = 3), infection (n = 4), duodenal perforation (n = 1), biliary leak (n = 2) and death by septic shock (n = 2). Twenty-nine patients with 39 endoprosthesis had a long-term follow-up. The most common late complication observed was occlusion (15/39, 37%) and migration (1/39, 2.5%). Specific treatment of complications was carried out in 10 of the 29 patients (35%). It is concluded that patients with inoperable malignant obstruction of the bile ducts should be offered an indwelling endoprosthesis whatever their prognosis; an occluded stent can be removed or at least bypassed in nearly all patients, thereby maintaining palliation of symptoms.

Aged↗
PubMed1994

[Aneurysm of the hepatic artery treated by embolization].

The hepatic artery aneurysm represent 16 to 20% of visceral artery aneurysms. The man of 40 years of age is often affected. This aneurysm is often asymptomatic. The rupture menace its evolution and justify the treatment. Echo-doppler-color constitute a non invasive exam of choice for diagnosis. Embolisation has a more extent indications. A case is reported of an aneurysm of the hepatic artery treated with embolisation with review of the literature.

Aged↗
PubMed1993

Time comparison of intensive care units with and without digital viewing systems.

As hospital radiology departments and intensive care units (ICUs) make plans to use or expand the usage of digital data outside of the radiology department, the need to assess the requirements of the potential recipients in the ICUs has become more important. The present operations in an ICU that uses digital viewing instead of film has been compared with a unit that does not. The difference in time between x-ray exposure and final image viewing was determined in both settings and compared. In this preliminary study, significant differences were found between the two units. The odds of having examination results actually accessed by the ordering physician in an hour or less were 9.5 times greater for the unit with digital viewing capability than for the one without it.

Coronary Care Units↗
PubMed1992

[Virilizing tumor in a woman. Management].

Androgen secreting ovarian or adrenal neoplasms represent a rare cause of hirsutism in women. Because of their small volume and episodic secretion, a number of these tumors may be difficult to diagnose and treat. The authors report a case of lipoid cell tumor of the ovary, which was only detected, because of its small volume, by catheterization of adrenal and ovarian veins. This latter procedure should be performed when strong clinical and biological suspicion is faced by the negativity of other imaging techniques.

Adrenal Rest Tumor↗
PubMed1981

Osteomas of the paranasal sinuses.

Twenty-three cases of osteoma of the paranasal sinuses are presented. Particular attention is paid to the aetiology, presentation, site of origin, pathology and management of these tumours. The natural history and prognosis are discussed together with the various methods of surgical approach. The relevant papers have been reviewed and the results compared with our series.

Adolescent↗
PubMedDate not supplied

[Percutaneous renal angioplasty. Experience of the Radiodiagnostic Service of the Hotel-Dieu of France].

OBJECTIVE: We report on a series of 42 renal artery stenosis treated with percutaneous transluminal angioplasty (PTA). MATERIALS AND METHODS: From January 1988 to June 1996, these 42 renal artery stenoses were found in 33 patients (17 males and 16 females) who had a balloon dilation (with 3 stent deployment); 9 of these lesions were bilateral and 7 on a single kidney. Initially, 32 patients had a high blood pressure and 6 a progressive renal failure. Twenty-two patients presented an atheromatous pathology, 7 a fibromuscular dysplasia. One patient had a Takayasu arteritis, and 3 others a stenosis of the renal graft artery. RESULTS: We find a complete initial success in 86% of the patients, a partial success in 14% without any catheterization failure. Global success rate of PTA is 90% at 29 months mean follow-up. A benefit of PTA regarding blood pressure was found in 84.4% of the patients. The renal function became normal in half the patients with renal insufficiency. CONCLUSION: PTA is an efficient treatment for renal artery stenosis. A satisfactory improvement of blood pressure and renal function is found in a high number of patients.

Adolescent↗
PubMedDate not supplied

[Complications of percutaneous nephrostomy. Apropos of 481 procedures: the value of puncture of the median calices].

The authors report on a series of 481 percutaneous nephrostomy procedures, and describe the complications encountered. 163 percutaneous nephrostomies for drainage and 318 percutaneous stone removals, were performed between 1985 and 1995 in the Radiology Department of Hôtel-Dieu de France Hospital under fluoroscopy. One tract was needed for PN but more than one was sometimes necessary for percutaneous stone removal. Complication rate was identical to the results reported in the literature. Complications were more frequently encountered when the upper calyx was punctured (intercostal approach), mostly pleural lesions. Puncture of the middle and inferior calyx were associated with the same rate of complications, but with different degrees of severity. Major complications (80% of cases of hemorrhage, including all arteriovenous fistulae and pseudoaneurysms) were encountered with the puncture of the lower calyx while those associated with the puncture of the middle calyx were minimal. Thus, puncture of the middle calyx is the least morbid. It is recommended by the authors, whenever possible.

Adolescent↗
PubMedDate not supplied

[Selective salpingography and transcervical tubal recanalization: technique, indications, results. Apropos of 53 proceedings].

The aim of the study is to evaluate the efficacy of selective salpingography and fallopian tube recanalization as a diagnostic and therapeutic procedure when proximal tubal obstruction is present. Fifty-three procedures were performed between January 95 and March 98 in the Radiology Department of Hôtel-Dieu de France Hospital, on 53 infertile women aged between 25 and 43 years. Unilateral or bilateral obstruction was documented on hysterosalpingogram or by laparoscopy. The technique consisted of a direct fallopian tube catheterization, under fluoroscopy using an hydrophilic guidewire. Water soluble contrast material was used. Eighty-eight tubes were evaluated (35 with bilateral and 10 with unilateral obstruction, 8 single tubes). Recanalization was possible in 52 cases (97.5%). Twenty-nine patients were followed. Thirteen pregnancies were reported (45%). This pregnancy rate is however increased to 62% if we exclude the cases where other infertility problems coexisted. No complications occurred. Selective salpingography and fallopian tube catheterization is a non invasive successful technique that is extremely useful in the diagnosis and treatment of tubal obstruction in women with infertility problems. It can be performed immediately after an hysterosalpingogram when the fallopian tubes are not opacified.

Adult↗
PubMedDate not supplied

[Stereotaxic excisional biopsy of non-palpable breast lesions by the ABBI(Advanced Breast Biopsy Instrumentation) technique. Advantages. Disadvantages. Indications. Apropos of 67 cases].

OBJECTIVES: Introduce briefly: the classification of the American College of Radiology for non palpable breast lesions; and the different techniques used for stereotactic breast biopsies. Evaluate the efficiency of the ABBI technique for non palpable breast lesions and its role in breast biopsies, on the base of 67 cases. SUBJECTS AND METHOD: Sixty-seven stereotactic excisional biopsies on dedicated prone tables were performed using the ABBI technique for 21 probably benign and 46 indeterminate non palpable breast lesions seen on mammograms. Twenty-five cases were densities, architectural distortions or radial scars, and 42 were microcalcifications. RESULTS: In our hands, the technique is 100% specific and sensitive. This high percentage of success is related to a team work between radiologists, surgeons or gynecologists. The specimen represent the whole lesion. Ductal carcinoma in situ (DCIS) and atypic ductal hyperplasia (ADH) are diagnosed with accuracy. Twelve carcinomas are found, three of them DCIS. ADH was encountered in two cases. Complications are minor, hematomas of small and moderate volume were encountered in eight cases (12%). CONCLUSION: ABBI technique replaces surgical biopsies after wire hook localisation for solitary lesion smaller than two cm in diameter; and stereotactic Tru-cut biopsies, even with vacuum aspiration, for small cluster of microcalcifications, architectural distortion and radial scar, where the percentage of failure is higher. For malignant lesions, surgery must follow, even when the margins are free.

Adult↗
PubMedDate not supplied

[An unusual cause of acute myelopathy: a dural arteriovenous fistula at the craniocervical junction].

BACKGROUND: Dural arteriovenous fistulas (DAVF) account for 10% to 15% of all intracranial arteriovenous malformations. Since the first case published by Woimant et al. in 1982, many type V DAVF, i.e. with spinal venous drainage, have been reported. Fistulas located at the craniocervical junction (CCJ) however, are exceptional and only 10 cases of CCJ fistulas associated with myelopathy have been described. CASE REPORT: The authors present a 36-year-old male patient without previous medical history, suffering from acute myelopathy. Cervical MRI showed multiple serpiginous flow-voids along the cord surface and cerebral angiography disclosed a dural fistula of the CCJ fed by the right posterior meningeal and occipital arteries. The venous drainage was directed caudally towards the perimedullary veins. Embolization through the occipital artery, using cyanoacrylate, was performed and resulted in complete cure of the malformation with rapid clinical recovery. DISCUSSION: The authors discuss the pathophysiology and clinical consequences of intracranial DAVF with myelopathy (named V, m+), that are usually identical to those of spinal dural fistulas and related to intramedullary venous hypertension. Early treatment is essential to reverse the patient's myelopathy. Embolization, if technically possible, is the preferred treatment and cyanoacrylate remains the best embolic agent. Following glue deposition, systemic high-dose steroids should be administered to prevent edema. CONCLUSION: In conclusion, this is the first case of DAVF of the foramen magnum causing myelopathy to be detected early and cured by glue embolization alone, with rapid and total clinical recovery.

Adult↗
PubMedDate not supplied

[Digital substraction angiography using gadolinium as contrast medium for patients with renal failure. A study of 15 patients].

OBJECTIVES: To study the feasibility of IA-DSA for diagnostic or interventional purposes using gadolinium (Gd) as a contrast medium (CM) for patients with poor renal function. MATERIALS AND METHODS: This study is about 15 patients with renal insufficiency (creat. > 133 micromol/l) who needed IA-DSA for diagnostic or interventional purposes. Gd was used as a CM at a dose < or = 0.4 micromol/kg and a concentration > or = 75%. Serum creatinine level was evaluated before, at 24 h and 48 h after injection of Gd. An increase of creat. > or = 44 micromol/l was considered significant. Image quality was evaluated by two specialists. RESULTS: In 14/15 (93%) patients no significant elevation of the serum creat. level was noted. The images are of good to medium quality, the diagnostic or therapeutic purpose was however reached. Image quality depends on Gd concentration; the feasibility of the exam is limited by the quantity of Gd used and its dilution. The procedure is well tolerated without side effects. CONCLUSION: Gd allows arteriograms of adequate quality for diagnostic or therapeutic purposes without renal complications at doses used until now (0.4 micromol/kg). The procedure is easy to perform but only one region or organ can be studied in one procedure considering the relatively small volume of contrast allowed.

Adolescent↗
PubMedDate not supplied

[Indications for arteriography in penetrating wounds of the lower limbs].

One hundred arteriographies were performed in emergency in 87 patients with penetrating trauma of the lower limbs caused by high- or medium-velocity projectiles (bullet or shell fragment). Thirteen patients had bilateral wounds. In 79 cases, the arteriogram was abnormal and led to surgical exploration. In 76 cases, an arterial lesion was found and treated (positive predictive value = 76/79 = 96%). In three cases, no arterial lesion was detected (3 false-positive findings). Among the 21 patients with normal arteriograms, 10 had surgical exploration because of clinical suspicion. An arterial lesion was found in 2 cases (2 false-negative findings). In the other 11 cases, the clinical and Doppler sonographic observations were normal (negative predictive value = 19/21 = 90%). The sensitivity rate was 97%, specificity 86% and accuracy 95%. In 8 cases, arteriography led to modifying the surgical procedure. These results show that preoperative arteriography, performed as an emergent examination in hemodynamically stable patients, allows avoiding surgery in some cases, and modifying the procedure in others.

Adolescent↗
PubMedDate not supplied

[Endovascular treatment of arteriovenous vertebro-vertebral fistula].

Vertebral arteriovenous fistulae are relatively rare, with limited experience in most centers. We report our experience in the treatment of a vertebral arteriovenous fistula treated by interventional method. A review of the literature is made and the etiology, presentation and treatment of this unusual lesion are discussed. The endovascular occlusion is now the treatment of choice of vertebral fistulae.

Adolescent↗