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Biomedical subjects

R Courbier

Publications and source records attributed to R Courbier.

At least 73 records · Page 4Linked to original sources
PubMed1977

Detecting complications of direct arterial surgery: the role of intraoperative arteriography.

Intraoperative arteriography was carried out using a specially constructed operating table and long x-ray film changer that permitted rapid serial exposure of the arterial reconstruction and the distal arteries. During a ten-year period, this method was applied in 1,810 arterial reconstructions, with technical problems being detected in 82 (4.6%) of these patients. The incidence of problems was highest in patients undergoing endarterectomy, where 16.7% of the patients were found to have either residual debris in the cleared segment or areas of stenosis. When bypass grafts were used, technical problems were found in 2.2% of patients and included embolism or thrombosis, graft torsion in vein grafts, stenosis of the distal anastomosis, and the creation of an intimal flap. In the entire series, five patients needed reoperation in the early postoperative period. In three of these, the operative arteriograms had been initially misread.

Angiography↗
PubMed1977

[Long term results of surgical treatment for aneurysms of the abdominal aorta].

A series of 100 consecutive patients operated on for an abdominal aortic aneurysm, whether cold or as emergency, but excluding those cases with circulatory collapse, has enabled us to define the post-operative prognosis after a follow-up of a maximum of ten years. The operative mortality of 12% was due essentially to coronary and renal complications. All of the survivors, except one, were available for review. Five years after the operation 64% were still alive, and the figure was 46% at eight years. These figures confirm the indication for systematic surgical treatment as soon as an aneurysm is discovered, unless any of the contra-indications which are discussed are present. The best method of following up small aneurysms (with a diameter of less than 6 cms) discovered in elderly subjects would be by echotomography.

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PubMed1977

[Evaluation of the results of lumbar sympathectomy with functional vascular tests. Statistical study (author's transl)].

A series of 100 unselected patients operated on for lumbar sympathectomy were studied by digit plethysmography, thest of hyperemia, rheography, measurement of segmental pressure and dynamic tests, treadmill and Strandness test. Statistical analysis of data showed that isolated lesions of atheroma yield the best result. Increase in walking perimeter and in blood flow (rheographic quotient) were the only parameters showing statistical change. Forecasting of the effect of lumbar sympathectomy by the hyperemia test of Hillestad was confirmed. Other forms of disease : diffuse lesions, lesions of arteries in the legs or due to diabetes were followed by very numerous failures. Lumbar sympathectomy is justified as an isolate procedure for femoral lesions, and associated to reconstructive aorto-iliac surgery whenever the distal runoff consists only of a deep femoral artery.

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PubMed1976

[Riolan's arcade: hemodynamic importance--therapeutic deductions].

The hemodynamic significance of the arcade of Riolan has been analysed. This arterial arcade provides an anastomosis between the territories of the superior and inferior mesenteric arteries. The arcade is only clearly visible on arteriography when an obstacle is present at one of its extremities or when it is being used for revascularization of the lower limbs. The discovery during surgery or on X-ray of a dilated arcade of Riolan presents a hemodynamic problem when the continuity of a digestive artery must be reestablished. In addition, when a patient known to suffer from arteritis has to undergo surgery involving the rectosigmoid area, a preliminary arteriography is necessary: the presence of a hypertonic arcade of Riolan requires special therapy since untimely ligature of this artery would provoke lethal ishcemia of the colonic wall. Examination of the arteriogram affords the surgeon some indication of the state of the splanchnic circulation, and he can then take the necessary precautions to prevent any risk of postoperative development of necrosis of the left colon.

Angiography↗
PubMed1976

[Objective results of lumbar sympathectomy. Statistical study, based on vascular function tests].

A series of 100 unselected patients who had undergone low lumbar sympathectomy were studied using vascular function tests (digital plethysmography, hyperaemia test, rheography, measurement of segmental pressures and dynamic tests, walking tolerance on a conveyor belt, Strandness test). Statistical study of the results obtained showed that, above all, isolated lesions of atherosclerotic origin gave excellent results. Increase in walking tolerance and circulatory flow (rheographic quotient) were the only statistically valid parameters. Prediction of the effects of lumbar sympathectomy by Hillestad's hyperaemia test was confirmed. There were many failures amongst the other cases (diffuse lesions, leg artery involvement, diabetic type lesions). Lumbar sympathectomy is hence justified only in the presence of femoral lesions and in association with reconstructive aorto-iliac surgery in all cases when the distal bed consists of the deep femoral only.

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