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Biomedical subjects

E Houdart

Publications and source records attributed to E Houdart.

64 records · Page 4Linked to original sources
PubMed1993

Posttraumatic arteriovenous fistula and subclavian vein thrombosis: treatment by percutaneous arterial embolization and vein angioplasty.

A 71-year-old woman had edema and venous dilatation of her upper right limb that caused painful functional disability following a shoulder injury. Arteriograms demonstrated an arteriovenous fistula between the subclavian artery and vein associated with thrombosis of the vein at the same level. The arteriovenous fistula was found to have multiple arteriovenous communications. Because of associated distal venous thrombosis, venous drainage was retrograde through the brachial vein. The inflow arteries of the fistula were embolized and then the subclavian vein thrombosis was recanalized, dilated, and an endoluminal stent inserted. Clinical signs completely resolved.

Aged↗
PubMed1993

Endovascular treatment of external carotid-jugular fistulae in the parotid region.

A series of eight patients with large arteriovenous fistulae involving the external carotid artery and the jugular vein that were treated with the endovascular technique are reviewed. The origin of the fistula was congenital in six patients, spontaneous in one, and iatrogenic in one. All the fistulae were located in the parotid region, and single channel arteriovenous shunts were evident in all the cases. Endovascular treatment was performed with a detachable balloon. All the patients were cured, and no complications were observed. No recurrences were observed after a clinical follow-up of 6 months to 12 years (mean, 5 yr). Endovascular treatment offers the advantage of being less traumatic because it avoids facial scars and injury to the facial nerve. This is especially important in children, who most commonly have this condition. In our group, endovascular treatment is considered first in the management of external carotid-jugular fistulae.

Adolescent↗
PubMed1993

Selective endovascular treatment of 71 intracranial aneurysms with platinum coils.

Seventy-one intracranial aneurysms were treated by endovascular techniques, with the placement of minicoils inside the aneurysmal sac. Most aneurysms were manifest by hemorrhage (67 cases), and 43 of these were treated within the first 3 days after presentation. At the 1-year follow-up examination, the outcome was scored as good in 84.5% of cases, but the morbidity and mortality rates were 4.2% and 11.3%, respectively. Twenty-nine aneurysms in the anterior circulation and 42 in the posterior circulation were treated. In this series, 23 patients were classified as Hunt and Hess neurological Grade I, 27 as Grade II, 12 as Grade III, nine as Grade IV, and none as Grade V. Thirty-three aneurysms were less than 10 mm in diameter, 28 were 10 to 25 mm, and 10 were larger than 25 mm. The preliminary results from this study appear to justify the emergency treatment of aneurysms by this approach. Aneurysms in the posterior circulation are particularly well suited for this type of surgery.

Adult↗
PubMed1992

[Contribution of therapeutic angiography in the management of tumors of the base of the skull].

Embolization of tumors of the skull base plays an important role in the treatment of these often complex lesions. Endovascular techniques provide important information concerning the circle of willis and facilitate surgery by reducing blood loss. The coordination of the different steps of embolization and neurosurgical treatment necessitate a preliminary multidisciplinary discussion of each case. Different procedures are possible: Arterial embolization of the branches of the internal and external carotid arteries, definitive or temporary champing of the internal carotid, and, most recently, embolization by direct injection.

Carotid Artery, External↗
PubMed1987

Combined aortic, mitral and tricuspid surgery: results in 78 patients.

Between 1968 and 1984, 78 patients (mean age 43, range 14 to 65 years) underwent combined aortic, mitral and tricuspid surgery (22 triple valve replacements, 56 aortic valve replacements with tricuspid conservative surgery and mitral valve replacement (N = 48), or commissuroplasty (N = 8). Pre-operative consequences of valvular disease (mainly mixed valve disease) were severe as assessed by functional class (72 pts in III or IV NYHA), cardiomegaly (CTR: 62 +/- 6%), increase of mean pulmonary arterial and wedge pressures (respectively 30 +/- 12 and 19 +/- 6 mmHg) decrease in cardiac index (2.1 +/- 0.5 l min-1 m-2), LV dilatation (LV end diastolic volume: 184 +/- 86 ml m-2) and impairment of LV systolic function (LV ejection fraction: 50 +/- 12%). Operative mortality rate was 11.5%. The 69 survivors were all followed up, for a mean of 56 months (2 to 207). 16 late deaths occurred. Actuarial survival rate at 10 years was 58.4%, and greatly influenced by pre-operative NYHA class. Linearized rates of thromboembolic events, valve thrombosis and haemorrhage were respectively 6.4, 1.5 and 1.2% pt-1 yr-1. Those of infective endocarditis, periprosthetic leak, reoperation and valve failure were 0.6, 3.3 and 4.9% pt-1 yr-1 respectively. At 9 years, 42% of the patients were in NYHA class I or II and free from complications.

Adolescent↗
PubMedDate not supplied

Balloon-assisted coil embolization for large-necked renal artery aneurysms.

An aneurysm of the right renal artery was discovered in a patient suffering from cerebral arterial angiodysplasia and arterial hypertension. The aneurysm was large necked, which made selective endovascular treatment very difficult. To perform the embolization of the aneurysm, a balloon remodelling technique was used. This prevented migration of coils within the arterial lumen.

Aged↗
PubMedDate not supplied

Percutaneous transvenous embolization through the thrombosed sinus in transverse sinus dural fistula.

Each of two patients presented with a dural arteriovenous fistula involving the transverse sinus. The sinus was thrombosed proximal and distal to the dural arteriovenous fistula with the venous drainage being retrograde through cortical veins. An ipsilateral percutaneous transjugular approach was used in both cases and allowed recanalization of the thrombosed sinus and embolization of the dural arteriovenous fistula with coils. Complete cure was achieved in one patient and 95% reduction in arteriovenous shunting including elimination of the cortical venous reflux in the other. This technique avoided surgical exposure of the sinus.

Aged↗
PubMedDate not supplied

[Treatment of 315 intracranial aneurysms using electrically controlled detachable coils].

The purpose of this study was to evaluate the results of 315 intracranial saccular aneurysms in 290 patients selectively treated with GDC in a single Center. One hundred and fifty eight patients were treated at the acute phase of the sub-arachnoid hemorrhage (SHA), sixty patients were treated more than three weeks after the SHA, seventy two patients were treated for unruptured aneurysms. We found at three months post-embolization good clinical results in 88,6%, a moderate disability in 3,4%, a severe disability in 2,7%, a 5,2% mortality. The complete aneurysm occlusion rate was 80,6% on the immediate control angiogram. Smaller the aneurysms, better were the anatomical results. The GDC treatment appears as an alternative treatment of surgery for the ruptured aneurysms at the acute-phase of SHA.

Adolescent↗