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F Lescalie

Publications and source records attributed to F Lescalie.

At least 19 recordsLinked to original sources

[Evaluation of a computer graphic representation of echo-Doppler (Echotrace) in the assessment of atherosclerosis of the legs].

The problems generally encountered in interpreting written reports of echo-Doppler examinations led us to develop a graphic software system to visualize the vascular network: Echotrace. The objective of the present work was to evaluate the reliability of Echotrace in patients with atherosclerosis of the lower limbs using arteriography as the standard for assessing sonographic findings. This prospective study was conducted in 29 consecutive patients. Nineteen strategic sites of the arterial network were investigated with duplex-scan and arteriography: lesions scores were attributed for each examination and data for a given site were compared. On the 551 sites compared, we found 26 disagreements including 23 concerning lesion quantification and 3 on localizations. There were also 21 minor disagreements with a single variation in the pathology score. The statistical comparisons could not be made on these scores so the results were compared with the arteriography data on the basis of therapeutic decision taking into account all the arterial lesions and the patient's general status. We observed a perfect agreement between the two imaging techniques in 12 patients, one disagreement which would not change the treatment in 15 patients and, in 2 patients, a disagreement which would modify treatment. This study demonstrated that graphic visualization of arterial lesions with Echotrace is a reliable, easy-to-interpret method.

Adult↗

[Vascularization of the wall of the superficial veins. Anatomic study of the vasa vasorum].

INTRODUCTION: The blood vessel wall is almost always nourished by two ways; from the blood stream itself and through the outer part of the wall by vasa vasorum. AIM OF THE STUDY: The aim of this study was to demonstrate that this kind of nutrition is also available for the venous wall and to define the distribution pattern in superficial venous walls. MATERIALS AND METHODS: 50 long saphenous veins and 20 short saphenous veins latex or barium injections, dissections with magnifying glasses and microradiographies. Topographical evaluation of the origin of vasa vasorum. RESULTS: The results showed that vasa vasorum originated from perforating arteries coming from several levels and getting a lot of anastomosis. We showed that the main sources for the long saphenous vein are the external pudendal artery and descending artery of the knee and for the short saphenous vein, the short saphenous vein artery. In thrombosis and varicose veins, the vasa were strongly altered. CONCLUSION: This study outlines the fact that superficial veins are supplied by arterial and venous vasa vasorum, and the role of vasa vasorum must be considered when questioning the pathogenesis of varicose and post thrombotic disease.

Arteriovenous Anastomosis↗

Popliteal arterial traumas: prognosis factors: multi-center prospective study apropos of 40 cases.

Forty cases of arterial popliteal traumas occurring in the course of 1992 were collected by 20 centers. The purpose of this prospective study was to evaluate a preoperative prognosis score suggested by Crolais from a retrospective study. Five clinical criteria are taken in account to establish the score: delay, degree of ischemia, contusion, general condition of the patient and wound apperture. Each of the criteria is affected by a progressive note according to the gravity. Analysis of our series confirms the seriousness of this pathology: one death, 8 major amputations and 50% of morbidity. The statistical analysis of pre-operative score and post-operative recovery confirms the existence of three groups at progressive risk: Low risk, score < 30 points. Revascularization must be done. Post-operative recovery is simple. Average risk, score is between 31 and 50 points. Revascularization must be done. Post-operative recovery is particularly simple as the delay before revascularisation will be short and systematic fasciotomies will be done. Major risk, score > 50 points. An amputation must be carried out.

Adult↗

[Paraplegia after surgery of the suprarenal aorta (26 cases reported during a national survey)].

Although their frequency is probably underestimated, medullary complications of abdominal aorta surgery are rare but serious, and may be the cause of medico-legal actions. Referral of a patient allowed the collection of 26 unpublished cases: 18 with aneurysms, including 6 ruptured lesions and 12 undergoing cold surgery, and 8 with aorto-iliac occlusion, these 26 cases representing 0.16% of abdominal aorta interventions performed during the same period. Mortality (6 cases) was due principally to neurological complications, total in 4 cases, partial in 3 and persistent in 13. Risk factors were perioperative collapse (explaining the elevated frequency in ruptured aneurysms) and the occlusion of the internal iliac arteries. Duration of clamping was not significant. No certain method of prevention could be elucidated, either by a literature review or by analysis of the personal series.

Aged↗

[Angioscopy in peripheral vascular diseases].

Angioscopy is a useful investigation in patients referred for vascular surgery. The material has been improved over the last few years to make available angioscopes with external diameters ranging from 0.55 to 3.2 mm. The angioscopes are either rigid, composed of two groups of fibre optics (image and light transmission) or orientable and more complex. Both systems may carry operating channels. The angioscopy may be performed peroperatively or percutaneously. Other essential equipment includes catheter guides, balloon catheters, counterpulsation balloons or perfusion pumps. This investigation is used for diagnostic evaluation but when used peroperatively it may also help guide therapeutic intervention. Angioscopy is complementary to ultrasonic and radiological methods of vessel imaging.

Catheterization↗

[Efficacy of intra-arterial fibrinolysis in subacute atheromatous ischemia of the lower limbs].

The study of 44 patients treated with intra-arterial fibrinolysis is reported. All these patients had an impending subacute ischemia of the lower limbs, a major complication of atheromatous disease. The criteria for patient selection were clinical, hemodynamic and radiological. The procedure of the treatment associating Urokinase, Heparin and Naphthidrofluril are defined, as well as its follow-up. The results have been evaluated according to the clinical and radiological improvement. 2 patients died when the treatment ceased and 10 were amputated, ie 27% of failures. The fibrinolytic treatment allowed identifying the patients who might quickly receive an additional treatment. In our experience, this treatment seems to improve the prognosis of impending subacute ischemia.

Adult↗

Topographic anatomy of the lumbar lateral vertebral groove. Anatomical basis of the surgical approach to extra foraminal herniated disc.

The study of numerous dissections, sections and X-rays of the lumbar spine has enabled us to clarify the connections of the lumbar spinal nerves at their emergence from the intervertebral foramen and in the lateral vertebral groove. This work naturally leads to the study of the extra foraminal herniated disc by an extra isthmian approach or to percutaneous surgery of thoracolumbar discs.

Humans↗

[Prognostic factors in vascular traumas of the popliteal region].

Injuries of the popliteal region remain a serious problem as far as the outcome is concerned. The role and the risks of revascularization have yet to be properly evaluated. It's always difficult to decide on a major amputation. A retrospective study was applied to 37 cases referred to the CHRU d'Angers, between 1976 and 1987. We were then able to establish a prognostic scale with 120 ischaemia, the contusion, the clinical context and the open wound. The scale is used before any decision and allows us to decide whether revascularization or amputation have to be performed. In this series, 2 patients (5%) eventually died; 11 (33%) underwent a major amputation and 24 (65%) were successfully revascularized. The results are analyzed in relation to the prognostic scale and the literature.

Adolescent↗

The principal artery of the psoas major muscle.

The psoas major m. has a complex arterial supply, derived from the lumbar, iliolumbar, obturator, external iliac and common femoral a. The branches arising from the external iliac a., though quite often multiple and slender, are represented in 75% of cases by a single large-caliber vessel. This principal artery of the psoas m. is probably responsible for the curves of the external iliac a. in the aged and also in certain competitive athletes.

Age Factors↗

A rare embryologic variation: carotid-anterior cerebral artery anastomosis or infraoptic course of the anterior cerebral artery.

Carotid-anterior cerebral artery anastomosis constitutes an anomaly of the anterior part of the arterial circle of the brain. The anterior cerebral a. arises a few millimeters above the emergence of the internal carotid from the cavernous sinus, at the usual level of origin of the ophthalmic a. It travels medially, beneath the optic n., and then describes a curve with a superolateral concavity to arrive at the anterior part of the optic chiasma, where it anastomoses with the anterior communicating a. This asymptomatic variant of course is often associated with other cerebral vascular anomalies, especially arterial aneurysms. On the basis of 2 new cases discovered by chance, together with a review of the literature, various hypotheses capable of explaining the embryologic origin of these anomalies are discussed.

Adult↗

Scanographic study of the calcaneus: normal anatomy and clinical applications.

To facilitate the interpretation of the scanographic findings in fractures of the calcaneus, the authors have achieved an anatomo-radiologic correlation in terms of the classical coronal, sagittal and horizontal planes. Clinically, the sagittal plane can be obtained only by reconstruction. The 2 other planes permit study of the sustentaculum tali and posterior talar surface only in different sections, without their respective relationships. The authors therefore suggest a new double-oblique view, practicable in the injured patient, with a forward tilt of 20 degrees and medial rotation of 35 degrees, perpendicular to the sinus tarsi. This serves for anatomo-radiologic correlation and shows both anatomic structures together. By itself, it provides as much information as the three classical views and appears adequate for the assessment of fractures.

Calcaneus↗

[Distal reimplantation of the extremities].

Over the last two years, 15 patients have undergone revascularization surgery to a total of 17 distal extremities at the level of or distal to the last phalangeal joint. Operations were performed by three surgeons trained in microsurgical techniques, making the series a homogeneous one. Results were analyzed using Tamai and Nakamura's scores. Determinant factors, social and economic costs and effects on occupation are emphasized. The mean success rate of 65% is influenced by the total or partial nature of the section, its localization to the thumb or long fingers and the mechanism of section. The good functional results obtained were due to distal forms of amputation, recognized despite the technical difficulties as being an indication of choice for this reimplantation surgery. All patients in this group were able to return to work, with or without adaptation, within a variable lapse of time.

Adolescent↗

[Anatomy of digital arteries].

An anatomic study was conducted on 100 specimens. Investigation of vascularization involved various techniques to avoid pitfalls inherent in each method. Injections, radiographs, microdissection, corrosion and transillumination allowed establishment of groups to describe variations in palmar, dorsal, pulpal and ungual artery distribution. Vasculo-neural relations are described and practical applications envisaged as a function of vascular anatomy.

Angiography↗