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Biomedical subjects

P Otal

Publications and source records attributed to P Otal.

50 records · Page 3Linked to original sources
PubMed1997

[Cystic adventitial disease: importance of computed tomography in the diagnostic and therapeutic management].

PURPOSE: Popliteal artery entrapment and adventitial cystic disease are the main causes of claudication in young patients. Adventitial cystic disease is a rare vascular pathology mostly affecting the popliteal artery but other localisations have been reported. Diagnosis and therapeutic management of adventitial cystic disease and particularly percutaneous aspiration are presented. MATERIALS AND METHODS: The authors report six cases (four men and two women; mean age: 55) of CAD of the popliteal artery (n = 4) and unusual cases in the femoral artery (n = 1) and in the femoral vein (n = 1) explored by sonography, computed tomography (CT), magnetic resonance imaging (MRI) and angiography. Five patients were initially treated by CT-guided aspiration and one with endoprosthesis. RESULTS: Sonography, CT or MRI are more useful to establish the diagnosis because these techniques can directly visualize the arterial wall. All these patients but one have been treated by percutaneous method with a good functional outcome but surgical intervention was necessary for two of them because of cysts recurrence. CONCLUSION: Our experience suggests that percutaneous CT-guided aspiration is the first treatment option for small cysts but close long-term follow-up is necessary to detect recurrence.

Adult↗
PubMed1996

[Adventitial cyst of the popliteal artery. Imaging and percutaneous treatment].

Adventitial cystic disease of the popliteal artery is a rare cause of calf claudication in young patients. A case explored by magnetic resonance imaging is reported: a water rich mass around the popliteal artery compressed the arterial lumen. Treatment consisted in CT-guided percutaneous aspiration. Good functional outcome except for severe efforts, despite persistance of cystic images was observed. Echography, computed tomography or magnetic resonance imaging are more useful to establish the diagnosis than arteriography because these techniques can directly visualize the arterial wall. Percutaneous treatment preserves the intima and can be performed in out-patients. When feasible, it could be preferred to conventional surgery.

Adult↗
PubMed1996

[Treatment with endoprosthesis of the pathology of the descending thoracic artery].

Surgery and medical treatment have been classically accepted as the therapy of choice in some diseases of the thoracic aorta. Recently, treatment with endoprosthesis has emerged as a useful technique in the pathology of the descending thoracic aorta. The type of endoprosthesis, indications and experimental and clinical results are discussed.

Aortic Dissection↗
PubMed1995

[Percutaneous treatment of popliteal aneurysms using a covered stent: preliminary clinical experience].

This report describes preliminary results with stented grafts (Cragg EndoPro) for treatment of popliteal aneurysms in 3 consecutive patients (3 men, average age 68 years, varying from 44 to 81 years old). One to 4 transluminally placed stented grafts (50 to 100 mm of length and 8 to 10 mm in diameter) were used to treat 3 popliteal aneurysms. The procedures were successful in all cases, under local anesthesia, without hameodynamic compromise or major complications. Angiography and color Doppler demonstrated patency and aneurysm exclusion, up to 9 months with these stented grafts in all cases except for one case occluded 15 days after stent insertion. Although technical success and short-term patency have been good with this technique, long-term patency is not yet known. The use of these stented grafts already appears justified in critically ill patients, but durability must be established in relation to traditional bypass surgery before it can be recommended on a wider scale.

Adult↗
PubMed1993

Anatomic changes in the abdominal cavity during intraperitoneal chemotherapy: prospective study using scintigraphic peritoneography.

Twenty-one patients undergoing either adjuvant or palliative intraperitoneal (ip) chemotherapy had repeated scintigraphic peritoneographies. Significant scintigraphic ip changes were recorded in 11 patients (52%). In patients without residual disease at the time of ip chemotherapy, the rate of ip mal-distribution reached 70%. These alterations did not correlate with clinical complications. Our study suggested that, independently of clinical assessment, scintigraphic peritoneography is a useful test for identifying patients who are no longer suitable for ip treatment, due to inadequate locoregional distribution.

Aged↗
PubMedDate not supplied

Middle mesenteric artery visualized by computed tomographic angiography.

The middle mesenteric artery, a third mesenteric artery arising from the aorta that principally feeds the transverse colon, is an extremely rare anomaly. We identified a middle mesenteric artery branching into the ileocolic artery and into the right, middle, and accessory middle colic arteries. It supplied the cecum and the entire ascending and transverse colon. This anomaly was detected with computed tomographic angiography.

Angiography, Digital Subtraction↗
PubMedDate not supplied

In vitro evaluation of a new rotational thrombectomy device: the Straub Rotarex catheter.

PURPOSE: To evaluate the efficacy of a new rotational thrombectomy device, and the procedure-related risk of particle embolization. METHODS: The experiments were performed in transparent silicone tubes. The conditions of flow were as close as possible to physiological parameters. Distal embolization was detected by a mesh of nylon filters. RESULTS: The Straub Rotarex catheter was able to remove all clots. The mean number of migrating particles larger than 1000 microm was 0.17 (+/- 0.38), the mean number of 400-1000 microm migrating particles was 1.08 (+/- 1.04). The mean intervention time was 67 (+/- 37) sec. The mean volume of collected liquid was 96.6 (+/- 24.7) ml. CONCLUSION: The in vitro results suggest that the Straub Rotarex catheter is able to remove large volumes of thrombus with a limited risk of embolization. The main limitation of our model is the absence of adhesion of the clot to the tube.

Catheterization↗
PubMedDate not supplied

Noncovered stent placement in a blunt traumatic injury of the right subclavian artery.

We report a case of scapulothoracic dissociation with right subclavian artery traumatic injury that was managed by endovascular treatment. Particular features are the use of a flexible self-expandable noncovered stent and simultaneous protection of the right common carotid artery from distal embolization by inflating a balloon catheter.

Angiography↗
PubMedDate not supplied

Imaging features of uncommon adrenal masses with histopathologic correlation.

Uncommon adrenal masses include cystic lesions (hydatid cyst, endothelial cyst), solid lesions (hemangioma, ganglioneuroma, angiosarcoma, primary malignant melanoma), and solid fatty lesions (myelolipoma, collision tumor). Most of these lesions do not have specific imaging features. The liquid content of adrenal cysts is clearly demonstrated on ultrasonographic scans, computed tomographic scans, and magnetic resonance images. Nevertheless, the histologic type cannot be predicted except at some stages of hydatid disease in which pathognomonic features are present. The most typical imaging features of hemangioma are phleboliths and enhancement of peripheral vascular lakes. Ganglioneuroma has nonspecific radiologic features, but this diagnosis should be considered in cases with early enhancement of fine septa and progressive filling. The radiologic features of angiosarcoma and primary malignant melanoma are nonspecific. A macroscopic lipid content within an adrenal mass is theoretically characteristic of myelolipoma. This diagnosis should be made with caution, especially when the lipid content is not predominant, because of the possible association with an adenoma.

Adenoma↗
PubMedDate not supplied

In vitro evaluation of the embolic risk of diagnostic and therapeutic intravascular procedures.

BACKGROUND: The purpose of the study was to evaluate the risk of distal embolisation in a silicon model during different endovascular diagnostic and therapeutic procedures. MATERIAL AND METHODS: Endovascular technics, such as guidewire and catheter advancement, metal stent placement and balloon angioplasty were compared. Clots were produced from human blood sample. The transparent silicon model was filled with saline, flow was generated by an hydraulic pump. Stenosis was created by mechanical compression. The size of the circulating particles were measured with a mesh of nylon filters. RESULTS: No loose particles were detected using guidewire, pigtail and straight catheters. Balloon inflation induced embolisation of particles ranging from 100 microns to 10 mm in length. Deployment of self expandable metallic stents did not result in particle migration but secondary angioplasty inside the stent detached particles (ranging from 400 microns to 12 mm in length). Deployment of balloon expandable stent yielded in the stretching of the clot, which became sometimes longer than the stent, resulting in the detachment of the non covered portion. CONCLUSION: The risk of distal embolisation during guide-wires and catheters manipulation is not significant. Balloon catheters and secondary angioplasty after deployment of self-expanding stents caused large particles detachment.

Angioplasty, Balloon↗
PubMedDate not supplied

[Intra-aortic covered endoprosthesis].

Because of the risk and complications related to surgery of the aorta, the development of new, less invasive endovascular techniques has resulted in a certain enthusiasm for these new treatments on the part of physicians and industry. The insertion of aortic stents allows the treatment of almost one half of aneurysm of the infrarenal abdominal aorta and descending aorta. The results appear to demonstrate the medium-term reliability and efficacy of these new techniques with a lower morbidity-mortality rate than that of conventional surgery. However, preoperative and intraoperative imaging plays an essential role in the success of these new methods. Finally, although the medium-term results are encouraging, the long-term outcome of these new materials is unknown, which justifies close surveillance of these patients and prospective comparative studies.

Aneurysm, Ruptured↗