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Biomedical subjects

P Langeron

Publications and source records attributed to P Langeron.

At least 19 recordsLinked to original sources
PubMed1997

["CADASIL"].

Explore the source record for details and available documents.

Cerebral Arterial Diseases↗
PubMed1993

[From venous ligation to vena cava filter. Objectives and hazards of vena cava interruption].

Starting from the use of venous ligatures (the first measure employed), methods for the prevention of pulmonary embolism have been perfected to arrive now at the endocaval insertion of permanent or temporary filters. Both in the materials used and the techniques employed, major progress has been made and incidents and accidents (thrombosis, migration, perforation of the venous wall) have become rarer. The efficacy of classical treatment methods (anticoagulants, early mobilisation, hemodilution, etc.), the preventive value of which has long been recognized, must also be taken into account when making the decision. Specific indications for vena cava interruption procedures can be defined, but their very efficacy and the ease of insertion of filters have led to indications (on a prophylactic or adjuvant basis) which are often--and other than in special situations--dubious insofar as the prevention of embolism does not always require interruption of the vena cava and that complete freeing of the iliac veins is generally not a priority objective.

Humans↗
PubMed1992

[Lumbar sympathectomy for arteritis. A reliable and (almost) seventy year-old technique].

The old procedure of lumbar sympathectomy has long been the only chance of avoiding amputation for arteritic patients. Its field of application has shifted as reconstructive surgery and medical therapy made progress, and it is no longer the only solution and has more precise indications. Proper evaluation of its chances of success according to the individual situations allows establishing its potential and limitations. This simple procedure, entailing no risk for the future, deserves remaining among the available means for the treatment of arteritis, despite its age.

Arteritis↗
PubMed1992

[Phlegmasia caerulea dolens . Acute venous stasis and ischemic phlebothrombosis].

On the basis of the data of the literature and of 25 personal cases, the problem of phlegmasia caerulea is contemplated in its whole. Grégoire made an outstanding description of the condition in 1938; it was related to an arterial spasm, but later works showed the importance of the venous block and the secondary character of the arterial involvement. A severe form of venous thrombosis, phlegmasia caerulea dolens often occurs in elderly patients (11/25 in our series) or in persons in a poor general condition. The primary phenomenon is the occurrence, in various etiological circumstances, of an acute venous stasis giving rise to a number of phenomena, including extensive thrombosis and arterial involvement, which lead to irreversible lesions and to gangrene. Thus there is a first reversible phase of acute venous stasis with a still moderate arterial involvement, and a second phase of evolution with marketed ischemia, in which the tissular lesions can become irreversible. The necrosis results from the massive obliteration of the cutaneous venulae, not from the arterial failure. The old term of venous gangrene (Cruveilhier) points out to the mechanism and makes the practicioner aware of the extreme severity of any ischemic phlebitis, which can reach an irreversible stage within a few hours. The condition is therefore an emergency, and venous drainage must be re-established as quickly as possible in the limb, thus breaking the pathological cycle leading to irreversible lesions. In the simple venous stasis phase, a medical treatment may be attempted, but it must not be continued if it is not effective. Venous thrombectomy, a quick and safe procedure, therefore is the solution to choose either at once or after a short trial of medical treatment. Phlegmasia caerula certainly is the best indication for this procedure. If operated on time, the results are excellents: however, in very advanced cases with massive and total thrombosis of the venous system, amputation remains the only solution.

Acute Disease↗
PubMed1990

[Aneurysm of the popliteal vein].

Aneurysms of the popliteal vein are rare. They often seem to be favored by parietal dysplasia, but this is not a consistent finding. From a clinical viewpoint, the lesion is often asymptomatic. It may be detected fortuitously through the occurrence of a popliteal mass. In more severe cases, pulmonary emboli originating at the aneurysmal site will occur. As a rule, diagnosis is based on results from investigations such as phlebography and, more recently, echography which is bound to have a more important role in this field. Management must take the patient's history and background into account, depending upon which treatment will consist of either mere surveillance of asymptomatic patients, or resection possibly followed by restoration of venous circulation--placement of a caval block being restricted to very particular cases.

Aneurysm↗
PubMed1990

[Distal hyperirrigation syndrome. Clinical and physiopathological aspects].

In this retrospective study, distal hyperirrigation syndrome was identified by "irrigraphy", a functional exploration method used to define an irrigation index at various levels of the lower limbs as determined by pulse wave amplitude, heart rare and segmental resistances. In 47 lower limbs studied, there were 26 unequivocal, 14 relative and 7 "masked" hyperirrigations. The main etiology was diabetes (24 limbs), but the syndrome was also noted in cases of peripheral neuropathy and chronic venous insufficiency. There was no basic difference between unequivocal and relative hyperirrigations. Some hyperirrigation states were not apparent in irrigraphy because of arterial lesions on upstream axes. The syndrome was also observed in approximately the same number of cases in insulin-dependent and noninsulin-dependent diabetes. The clinical disorders observed were especially peripheral trophic ones, notably perforating ulcers of the foot or various ulcers. Changes in the irrigraphic profile were followed regularly in 20 limbs. The rise in distal irrigation indices was due to a drop in peripheral resistances related to an abnormal opening up of arteriovenous anastomoses. A state of spontaneous sympathectomy was thus constituted, particularly in diabetic patients. The process was similar in syndromes of neurologic origin and in venous stasis. The mechanism was local, with venous hypertension causing the opening up of arteriovenous shunts. However, microangiopathic lesions must also be taken into account, since they can cause or favor arteriovenous shunting. The opening up of arteriovenous anastomoses is in effect the element common to all syndromes of distal hyperirrigation of various origins.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Detection of acute venous thromboses using plethysmography. Possibilities and limitations].

The combined use of careful clinical examination and venous occlusion plethysmography has good diagnostic reliability. The clinical examination provides an estimated percentage "clinical probability"; in the event of negativity, complementary plethysmography enables confirmation of a negative clinical diagnosis; positive plethysmography confirms a probable clinical diagnosis or establishes the probability of thrombosis in patients with poor clinical signs. Thus false negative or false positive cases may be easily eliminated. In the remaining dubious cases complementary investigations are necessary.

Acute Disease↗
PubMed1989

[Long-term heparinotherapy in the treatment of acute venous thromboses].

This is a retrospective analytical study of the results of prolonged heparin therapy: 4 to 6 days for calf phlebitis--10 days for phlebitis reaching the level of the inguinal ligament with in both cases subcutaneous heparin injections for a further 1 to 2 months. Monitoring venography was carried out and demonstrated evidence of a lytic effect on the clot but not in all cases. In 33 cases control venography demonstrated that 2 groups of patients could be distinguished. In the first group, plethysmographic parameters were rapidly normalized (probably corresponding to lysis of the clot). In the second group, there was a slow and progressive improvement in these parameters (probably corresponding to the development of collateral circulation). The persistence of plethysmographic signs of venous stasis in certain patients constitutes an argument in favor of the maintenance of heparin therapy until an almost normal venous emptying index is established.

Acute Disease↗
PubMed1988

[Sexual function and aortoiliac reconstructive surgery].

In this study of 52 patients aged between 32 and 60 years, maintenance or restoration of sexual function during aorto-iliac surgery represented a usually non-priority but certainly desirable objective. Aspects studied were: place of crossed bypass and of endarterectomy-type of aorto-prosthesis anastomosis: end-to-end or end-to-side - routine or non-routine reimplantation of a hypogastric artery. Results in this series showed a lack of advantage from the sexual point of view for end-to-side over end-to-end surgery; hypogastric reimplantation offers a supplementary guarantee of efficacy but should not be performed routinely; crossed bypass operations are certainly interesting solutions in young patients. Endarterectomy should not be rejected as a matter of principle but with respect to sexual function its indications should be reserved for cases not requiring extensive dissection of arterial axes.

Adult↗
PubMed1988

[Early atheromatosis. Study of a series of 55 cases of arteritis of the lower limbs in young adults].

The study of 55 cases of atheromatous arteritis, representing 67.6 p. cent of the arteriopathies observed in young adults, permits to emphasize the following three points: 1) the classical risk factors of atheroma are frequently identified, but the importance of these multiple risk factors must be stressed; 2) aorto-iliac segmental forms represent a type of lesion which is rather typical of arteritis in young patients; an elective aorto-iliac involvement was noted in 56.3 p. cent of cases, beside more diffuse forms resembling the usual atheromatous forms; 3) the evolutive potential of these arteriopathies is difficult to evaluate and the type of lesion caused by arterial overload seems to be the most interesting factor to do so.

Adult↗