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Biomedical subjects

A Raynaud

Publications and source records attributed to A Raynaud.

At least 73 records · Page 4Linked to original sources
PubMed1987

Local thrombolysis in peripheral arteries and bypass grafts.

Sixty-two patients hospitalized for recent angiographically documented arterial occlusion in the legs (46 femoropopliteal arteries and 16 grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a No. 4F or No. 5F catheter. This therapy combined a continuous urokinase (UK) infusion of 1000 U/kg/hr and a lysyl plasminogen (LYS-PLG) infusion of 15 mukat every 30 minutes. Angiographically confirmed lysis was obtained in 77% of the cases. Five percent of the patients had major and 8% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK and LYS-PLG is as effective as streptokinase but produces lower systemic fibrinolysis. However, local fibrinolysis remains a potentially hazardous procedure (10% suffered major complications) and must only be applied to patients with severe ischemia and little or no possibility of surgical intervention.

Adult↗
PubMed1986

Acute peripheral arterial and graft occlusion: treatment with selective infusion of urokinase and lysyl plasminogen.

Thirty-five patients hospitalized for recent angiographically documented arterial occlusion in the legs (27 femoropopliteal arteries and eight grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a 4- or 5-F catheter. This therapy combined a continuous urokinase (UK) infusion of 1,000 U/kg/hour and a lysyl plasminogen (LYS-PLG) infusion of 15 microkatals every 30 minutes. Angiographically confirmed lysis was obtained in 85% of the cases. Only 3% of the patients had major and 6% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK-LYS-PLG is as effective as streptokinase. Its excellent tolerance makes it a good alternative in the treatment of acute ischemia in the lower limbs.

Adult↗
PubMed1986

Percutaneous transluminal angioplasty of renal transplant arterial stenoses.

Renal artery stenosis is a relatively frequent occurrence after renal transplantation. Forty-three hypertensive patients with such a stenosis underwent percutaneous transluminal angioplasty (PTA). The procedure was successful in 35 patients (81%). One month after a primary successful PTA, 74% of patients were improved. Restenosis occurred in seven patients. It was diagnosed in all seven before the fifth post-PTA month. In six patients, repeat PTA was attempted and was successful. One year after successful PTA, 67% of the patients were improved. No complication causing loss of renal parenchyma or needing surgery occurred. PTA is the procedure of choice for relief of transplant renal artery stenosis in patients with hypertension refractory to medical treatment or decline in renal function. It is effective and appears safer than surgery.

Adult↗
PubMed1985

[Value of rapid acquisition cadences synchronized with the electrocardiogram for the diagnosis of pulmonary embolism by digital subtraction angiography].

Pulmonary digital subtraction angiography was performed in 130 patients referred with possible pulmonary emboli. Findings were interpreted as a function of apparatus used (acquisition cadence, size of matrix, ECG synchronization) and of site of injection (peripheral or central). It now appears possible to diagnose pulmonary embolism with satisfactory reliability in 80 to 85% of cases. This examination is safe (absence of selective catheterization of pulmonary artery), and it could become a standard emergency diagnostic procedure for pulmonary embolic disease.

Angiography↗
PubMed1985

[Combined study of carotid bifurcations using intravenous computed angiography and Doppler ultrasound in lower-limb arteritis].

Carotid artery bifurcations were studied in 18 patients with arteritis, by Doppler ultrasound imaging and intravenous computed angiography. Both techniques are reliable examinations for detection of stenosed carotid artery lesions. Combining the two is increasingly used as a reliable means of exploration of stenosis of the carotid artery bifurcations. They therefore reduce the need for the more invasive conventional arteriography.

Adult↗
PubMed1985

[Quantification of left ventricular function by subtraction intravenous angiography].

Digitised intravenous angiography (Diva), initially applied to the study of the aorta and great vessels, has benefited from technical advances, especially the possibility of recording 25 frames per second, which now allows studies of the heart itself. 22 subjects underwent angiography with digitised subtraction after injection of 50 ml of sodium diatrizoate and meglumine in the right atrium and selective left ventriculography in the same catheter session. The end diastolic and systolic indices and global ejection fractions were measured independently for each technique by Chapman's method by two observers. The model of digitised angiography used was a CGR Divas prototype functioning in the pulsed graphic mode at 25 images per second. The results showed that the Diva method gave reproducible values of the end diastolic index (101 +/- 29.8 and 104.5 +/- 30.7: r = 0.98), of the end systolic index (43.2 +/- 32.9 and 44.6 +/- 32.5; r = 0.98), and of the ejection fraction (62.5 +/- 17.16 p. 100 and 62.17 +/- 15.7 p. 100; r = 0.96). There was a close correlation between the results of Diva and selective ventriculography (end diastolic index: 97.8 +/- 21.1 and 101.6 +/- 10.3; r = 0.87; end systolic index: 38.82 +/- 24.8 and 43.9 +/- 21.17; r = 0.95; ejection fraction: 62.12 +/- 16.27 and 57.29 +/- 15.53; r = 0.95). There was a significant underestimation of the end systolic index using Diva (0.01 less than p less than 0.02). The originality of the pulsed graphic method is the totally digitised character of the data.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Value of numeric intravenous angiography in the study of coarctations of the thoracic aorta].

The investigation of isthmic coarctation of the aorta comprises radiological opacification usually by a retrograde arterial approach. Digitised intravenous angiography (DIVA) is a new way of carrying out this task by a relatively simple and non-invasive technique. We investigated 32 patients with this method and now present our results: the investigation was performed for suspected coarctation in 22 cases and for postoperative assessment in 10 cases. The equipment used was characterised by a variable rate of acquisition from 1 to 3 images per second with a 512 X 512 matrix. The investigation consisted in an intravenous injection of 50 to 100 ml of contrast, usually via a peripheral vein (87.5 p. 100). Overall, DIVA demonstrated the coarctation or the appearances of the site of operation in 97 p. 100 of cases. This high success rate was related to the study population: young cooperative patients capable of maintaining apnoea and remaining still during the procedure. In the 21 patients referred for suspected coarctation (excluding the only failure of the series), the diagnosis was confirmed and the site of coarctation accurately located. The degree of stenosis was assessed subjectively: appearances of the site of coarctation, importance of the collateral circulation. In addition, a videodensitometric study, i.e. a study of the variations of the patterns of grey with respect to time, was carried out in 4 patients; in severe coarctation, a delay of about 4 seconds in the opacification of the zone distal to the stenosis was observed. This analysis is still at the experimental stage, but it may eventually allow reliable quantification of the degree of stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Determination of the ejection fraction of the left ventricle by videodensitometric analysis of digital angiography. Preliminary results].

Digitalisation enables angiocardiography to be performed by a peripheral intravenous injection. Computer-assisted analysis of the date widens the possibilities of quantification. The authors have developed a videodensitometric method of studying the left ventricular ejection fraction. The research was performed on an experimental model and the technique validated in a series of 10 patients. The experimental model consisted of a series of balloons which, when inflated with contrast medium assumed an allipsoid shape resembling a left ventricle. The balloons were blown up in two stages with an automatic injector to simulate systole and diastole. The images were recorded in the same way as during ventriculography. Videodensitometric measurements showed 3 to 5% variations from the true values. The method was then applied to the calculation of the left ventricular ejection fraction in 10 patients: left ventricular function was also quantified by geometrical methods (Dodge) from the same angiogrammes and the 2 sets of results were then compared. The correlation coefficient between the two methods was 0.97, so validating the new technique. Videodensitometry opens up new perspectives in the study of left ventricular function. On the other hand it can be used to monitor the ejection fraction in severely ill or recently operated patients, and, on the other hand the principle of videodensitometry eliminates the geometrical approximations inherent in the classical methods of angiographic analysis and would therefore seem to be more suitable for the study of pathological left ventricules (aneurysm...). Finally, the technique of videodensitometry represents a new step towards the measurement of true volumes and flow rates.

Absorptiometry, Photon↗
PubMed1985

[Results of in situ arterial thrombolysis by the combination of urokinase and lysyl plasminogen in acute arterial occlusive diseases of the lower limbs].

35 patients with acute arterial occlusions [27] and graft thromboses [8], responsible for severe and recent ischemia, were treated by fibrinolytic therapy (Urokinase: 1 000 units/kg/hour, and Lys Plasminogen). These drugs were delivered at the site of occlusions using a 5 French catheter. Angiographically, initial success was obtained in 30 patients (85%) and a significant clinical benefit persisted 5 months later, in 20 patients (57%). 4 distal embolisms during the treatment were noted, and one woman died a few hours after the withdrawal of an axillary catheter of a cerebellar infarction. Only two minor (6%) and one severe (3%) groin hematoma were encountered. No patient had at any moment a fibrinogen concentration lower than 1 g/l. Thus, the thrombolytic treatment used in the study appears as effective as locally administered Streptokinase but better tolerated.

Acute Disease↗
PubMed1984

Improved diagnosis of unilateral renal artery lesions after captopril administration.

Captopril was administered (1 mg/kg of body weight) to 37 unselected hypertensive patients undergoing bilateral renal vein catheterization to determine its safety and efficacy in diagnosing hypertension related to unilateral renal artery lesions. In the 18 patients who had a unilateral renal artery lesion demonstrated by angiography, the ratio of plasma renin activity of the involved to uninvolved renal vein rose significantly after administration of captopril, whether or not patients were taking antihypertensive medication. This postcaptopril ratio differentiated cases of unilateral lesions from cases of bilateral lesions or absence of lesions without any overlap. The test was well tolerated despite occasional large drops in blood pressure. These data show that converting enzyme inhibition increases the diagnostic accuracy of renal vein catheterization by increasing the difference between the amount of plasma renin secreted by the two kidneys in cases of unilateral renal artery lesions.

Adult↗