Biomedical subjects

Y Juilliere

Publications and source records attributed to Y Juilliere.

23 records · Page 2Linked to original sources

PubMed1988

Early and late assessment of stenosis geometry after coronary arterial stenting.

Early and late modifications of stenosis geometry after stenting of coronary arteries were assessed. Morphologic changes were evaluated by quantitative coronary angiography (automated edge-detection) and theoretical pressure drop across the dilated and stented stenosis was calculated from the Poiseuille formula, with turbulent resistances assuming a coronary blood flow of 1 or 3 ml/s. Eleven patients (ages 41 to 69 years, mean 55) were studied before and after angioplasty, and immediately after stent implantation. The stented coronary artery was the left anterior descending artery in 9 patients and the left circumflex in 2. Following stent implantation, an additional increase in minimal luminal cross-sectional area of the dilated vessel was observed, suggesting that the self-expanding stainless-steel endoprosthesis used had a dilating function in addition to its stenting role. Repeat angiography in 6 patients 3 months after stent implantation showed a decrease in the minimal luminal cross-sectional area without a significant change in theoretic pressure decrease. This slight reduction in vessel caliber had no hemodynamically significant repercussions. Thus, stenting of coronary arteries following dilatation is a potentially valuable technique for preventing both abrupt closure and late reduction in lumen diameter.

Adult↗

PubMed1988

Normalization of coronary flow reserve by percutaneous transluminal coronary angioplasty.

Fifteen patients undergoing routine follow-up angiography 5 months after successful percutaneous transluminal coronary angioplasty (PTCA) without angina and with normal exercise thallium scintigraphy were selected for analysis. The coronary flow reserves of these patients were compared with those of 24 patients with angiographically normal coronary arteries to establish whether PTCA can restore to normal the coronary flow reserve of patients with chronic coronary artery disease. The quantitative cineangiographic changes and the concomitant alterations in coronary flow reserve as an immediate result of the PTCA and the subsequent changes 5 months later are described. Coronary flow reserve was measured with digital subtraction cineangiography. PTCA resulted in an increase in minimal obstruction area (mean +/- standard deviation) from 0.8 +/- 0.3 to 3.4 +/- 0.7 mm2 and in coronary flow reserve from 1.0 +/- 0.3 to 2.5 +/- 0.6. Five months later a further substantial and significant (p less than 0.05) late increase in obstruction area (3.8 +/- 0.9 mm2) and flow reserve (3.6 +/- 0.5) had occurred. In 11 of 15 patients coronary flow reserve was restored to normal. Changes in stenosis geometry are likely to be 1 of the major determinants of this late normalization of coronary flow reserve.

Adult↗

PubMed1988

Sustained improvement in myocardial perfusion four to six years after PTCA in patients with a satisfactory angiographic result, six months after the procedure.

Of 46 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) from April 1980 to August 1982 and who had a satisfactory angiographic result six months later, one died of cancer and 41 had a detailed evaluation with exercise single-photon emission computed tomography (SPECT, 40 patients) or repeat coronary angiography (one patient), 48-78 months after the procedure. During follow-up, two patients had recurrent angina due to progression of coronary artery disease requiring a second PTCA procedure of another coronary artery; one of them later had a limited myocardial infarction in an area supplied by the vessel initially dilated. At follow-up, only one patient had definite angina. All but one patient had a negative exercise test. Myocardial perfusion during exercise in the PTCA-related area, assessed by SPECT, was normal in 90% of the patients and showed a limited defect due to reversible ischaemia in the remaining four (10%). It is concluded that patients with a less than 50% stenosis six months after PTCA show sustained improvement in their functional status and myocardial perfusion, four to six years after the procedure suggesting continued patency of the coronary artery.

Adult↗

PubMed1987

Placebo-controlled study of oral enoximone in congestive heart failure with initial and final intravenous hemodynamic evaluation.

Seventeen patients with stable congestive heart failure (class II and III New York Heart Association) received intravenous and oral enoximone in a 2-part study. Hemodynamic data were first obtained after intravenous administration of 0.75 mg/kg of enoximone; data were again obtained after 12 weeks of therapy with either oral enoximone (150 mg 3 times daily) or placebo. The efficacy and safety of oral enoximone were also studied in a 12-week, double-blind randomized format. In the intravenous study, enoximone was delivered over 5 minutes and hemodynamic data were measured for up to 12 hours after. Cardiac index increased 2.76 +/- 0.63 to 3.42 +/- 0.72 liters/min/m2), pulmonary wedge pressure decreased (19.5 +/- 8.8 to 14.6 +/- 8.0 mm Hg) as did mean arterial blood pressure (101 +/- 14.8 to 85 +/- 13.7 mm Hg) and systemic vascular resistance (1,880 +/- 573 to 1,254 +/- 383 dynes s cm-5). Heart rate increased slightly (82 +/- 17 to 86 +/- 14 beats/min). All these changes were maximal 1 to 2 hours after infusion and lasted 8 hours at least. Patients were then randomized double-blind to oral treatment. Baseline values showed that the 7 patients who received placebo had more severe CHF. Therefore, comparison might be biased. Patient overall assessment showed a continuous benefit in both groups. Ejection fraction improved from 30.1 +/- 6.8% to 33.9 +/- 9.9% in the enoximone group while it remained unchanged with placebo (23.4 +/- 6.5% to 23.4 +/- 1.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

PubMed1985

[Adrenal metastases of bronchial cancer: value of x-ray computed tomography].

Up until now, adrenal metastases from bronchial cancer have always been an autopsy diagnosis with a frequency as high as 45%. These metastases can now be diagnosed by means of computed tomography of the adrenal glands and most of the recent studies report an incidence of 10 to 15% of adrenal metastases independently of the histological type of bronchial cancer. The authors stress the need to perform this examination in the context of pre-treatment staging and for the follow-up of bronchial cancer. The outcome of these adrenal metastases is still poorly understood, but prospective studies could provide more information concerning their prognostic significance. In cases of operable bronchial carcinoma with an isolated adrenal metastasis, it is important to be able to detect this lesion which may be able to be excised prior to the thoracic surgery.

Adrenal Gland Neoplasms↗