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Biomedical subjects

G Trotteur

Publications and source records attributed to G Trotteur.

At least 19 recordsLinked to original sources
PubMed2002

Traumatic injuries: radiological hemostatic intervention at admission.

Blunt trauma victims and selected patients with penetrating trauma are systematically investigated after resuscitation and hemodynamic stabilization with cross-sectional imaging. Computed tomography is a good predictor of the need for hemostatic arteriographic embolization, based on contrast medium extravasation observed on CT. In centers admitting polytrauma patients, the CT and angiography units should be installed together within the emergency environment. Trauma-dedicated interventional radiologists should be on call for optimal patient management. Posttraumatic retroperitoneal and pelvic bleeding is a primary indication for angiographic hemostasis, together with orthopedic fixation of pelvic bone fractures. Angiography should be carried out rapidly, before the patient decompensates for considerable blood loss. In patients with visceral bleeding, arterial embolization can obviate primary surgery or potentializes surgical intervention and contributes to changing hierarchy of injuries to be treated surgically. Failure to achieve primary hemostasis may occur according to the type of specific organ injury and coagulation and metabolic parameters of the patient. Postembolization complications are few and are usually non-life-threatening and rarely carry definitive sequelae.

Angiography↗
PubMed2000

Sedation, analgesia and anesthesia for interventional radiological procedures in adults. Part I. Survey of interventional radiological practice in Belgium.

A questionnaire was mailed to 217 interventional radiologists to evaluate current practice in analgesia and sedation in adults. Response rate was 15% (33/217). Diagnostic angiography was performed with local anesthesia in 94% to 99%; for PTA, local thrombolysis or stent placement, light sedation was added in 0.1%. Premedication was given in 43% of diagnostic angiographies and in 68% of therapeutic procedures. Radiologists consulted an anesthesiologist before administration of intravenous sedation, always in 54% of cases, occasionally in 19% and never in 27%. General anesthesia with artificial ventilation was applied in 56% of TIPS, in 70% of aortic stent grafting and in 82% of neuroradiological interventions. Intravenous sedation was applied given in 53% of percutaneous biliary drainage, in 42% of bile duct dilatation or stenting, in 40% of percutaneous nephrostomy and in 72% of ureteral balloon dilatation. Patient monitoring during an interventional procedure was always carried out by an anesthesiologist in 52% of cases. 21% of radiologists never visited the patient before a therapeutic procedure, and 36% never did so after completion of a procedure. This survey showed that high standard practice of sedation and analgesia, with the assistance of anesthesiologists, is underused by interventional radiologists in Belgium.

Adult↗
PubMed1999

Use of a balloon occlusion catheter to facilitate transarterial coil embolisation of a patent ductus arteriosus in two dogs.

Two dogs with a history of coughing and exercise intolerance were suspected to have a patent ductus arteriosus (PDA), and the presence of a type III PDA was confirmed by radiography, electrocardiography, ultrasonography and angiography. Transarterial coil embolisation was carried out by using a modified technique. An occlusion balloon catheter was inserted through a femoral vein and placed at the pulmonary side of the ductus before the embolisation coils were put in place. Both dogs remained healthy during a follow-up period of nine months.

Animals↗
PubMed1998

Arterial embolization of bone metastases: is it worthwhile?

Arterial embolization was performed in ten skeletal metastases occurring in nine patients: eight patients presented with renal cell carcinoma and one with bronchogenic carcinoma. Five metastatic lesions were located in the spine, one in the pelvis, three in the proximal humerus and one in the proximal femur. Selective arterial embolization was performed preoperatively in seven cases and as a palliative treatment in three cases. The embolic material used was polyvinyl alcohol particles, gelatin sponge and coils or a combination of these. Arterial embolization was technically successful in all patients achieving subtotal (> 90%) tumour devascularization in five metastases and a 75% devascularization in the remaining five lesions. In operative patients, median intra-operative volume of blood transfusion was 510 mL. Palliative embolization was followed by major pain relief in two cases and moderate relief in one case lasting from 7 to 26 months. Arterial embolization is an effective and safe adjunctive treatment of hypervascular bone metastases.

Adult↗
PubMed1997

Thrombolysis of occluded infrainguinal bypass grafts.

From January 1993 to December 1995, intraarterial catheter guided urokinase infusion was used as an initial approach in the management of 29 episodes of infrainguinal graft thrombosis (12 venous and 17 prosthetic grafts) in 27 patients. The infusion catheter was embedded inside the occluding clot which was infiltrated by 225.000 U urokinase from distal to proximal. Local low-dose urokinase (1.000 U/kg/hr) was continued for a mean of 39 hours. By this regimen, prompt relief of ischaemia was achieved in 69% (20/29) of cases. Complete recanalization was obtained in 79% of cases. In six cases, the graft remained totally (n = 3) or partially (n = 3) occluded. Two of these patients benefited from secondary surgery, two improved clinically by conservative treatment, and two required amputation. In the 23 successful cases, thrombolysis unmasked an underlying flow-limiting stenosis in 83% (19/23), that was subsequently corrected by percutaneous balloon angioplasty (n = 15), by surgery (n = 3), or by a combination of both (n = 4). One early rethrombosis resulted in an amputation. The immediate limb-salvage rate was 89% (26/29). Surgical intervention was avoided in 17 cases (58%). The main hospital stay was 13 days. The short-term follow-up (mean of 17 months) reveals a high early rethrombosis rate (8/23 or 35%) within one year. Four of these repeated graft failures evolved to amputation. At one year, the overall limb salvage rate dropped to 79%. Thrombolytic management of infrainguinal occluded bypass grafts gives excellent initial technical results (79%), minimizing the need for major surgical revision. It is however characterized by a high procedure-related morbidity (21%). These immediate favourable results are not longstanding. Diffuse graft disease, limited outflow and high recurrence rate of anastomotic stenoses after balloon angioplasty explain poor long-term results after thrombolysis of failed grafts.

Adult↗
PubMed1996

Evaluation of colour images printed by a thermal dye diffusion process.

Dry printing of medical images, without photochemicals, may be based on the principle of thermal dye diffusion. The Drystar (Agfa Gevaert, Mortsel, Belgium) system was evaluated in colour-coded Doppler examinations of the carotid arteries. A total of 25 consecutive patients were examined for the colour test and 37 patients for the black-and-white test. Colour and black-and-white data were available on the same view. The performances of the Drystar were tested against against laser films, matrix films and two types of glossy paper using the following criteria: grey scale, colour scale, quality of reproduction of vascular colouring, registration, endothelial layer, intraluminal echogenicity, spectral resolution, and artefacts. The overall handiness of the document was graded. A significant difference (p = 0.00005) was noted in favour of the Drystar concerning registration, grey scale, spectral resolution and vascular colouring. The global score for handiness of the colour film was 96%. Radiologists preferred the colour hard copy as compared with glossy paper prints. As in the black-and-white test, blue-base and clear-base films obtained with the Drystar were rated inferior to laser films, a double line print mode was included in the printer, giving a density of 2.3 OD.

Angiography↗
PubMed1996

A combined CT and angiography suite with a pivoting table.

In a suite with fully interactive computed tomography (CT) and C-arm fluoroscopy units, emergency and elective interventional procedures were performed successfully in 41 patients (overall time range, 40-180 minutes [mean, 80 minutes]). The table can be manually pivoted from the fixed CT position to the free-floating angiography position, in an overall working space of about 40 m(2), with room for anesthesiology and monitoring equipment and personnel.

Angiography↗
PubMed1995

Results of an exclusion technique for treatment of abdominal aortic aneurysm.

An exclusion technique for the treatment of abdominal aortic aneurysm was used in six patients considered to be at high operative risk mainly because of chronic pulmonary disease. There were no deaths or immediate major complications. Thrombosis of the aneurysm was achieved in four of the six patients. However, in three cases, repeated percutaneous embolization was required to produce thrombosis. One patient developed a secondary rupture of a persisting infrarenal sac resulting from a patent inferior mesenteric artery. This patient was successfully managed by ligature of the infrarenal portion of the abdominal aorta through a median laparotomy. This study emphasizes the limits and the risks of the exclusion technique.

Aged↗
PubMed1995

[Spiral tomodensitometry applied to interventional radiology].

Spiral CT can be applied to many interventional procedures. Rapid scanning time reduces the duration of percutaneous CT guided biopsy and examination time of polytrauma patients. 3D reconstructions are applied to the planning and follow-up of vascular interventional procedures such as embolization of aneurysms or arteriovenous fistulae, stent grafting of aortic aneurysms or dissection, percutaneous transluminal angioplasty of the renal arteries, supra-aortic or iliac arteries. TIPS, percutaneous biliary procedures and percutaneous treatment of liver tumors do largely benefit from 3D reconstructions as a planning method.

Adult↗
PubMed1993

Duplex ultrasonographic evaluation of liver transplants.

Two hundred and twenty-two duplex ultrasonographic examinations were performed on 36 liver transplants in 30 patients over a period of 5 years and 9 months. Positive sonographic findings were correlated with 13 angiographic examinations. Arterial complications included 4 thromboses, 5 stenoses, and one mycotic aneurysm. A false-negative result was obtained in 2 cases of stenosis and a false-positive result in one case of thrombosis. One portal vein thrombosis, 2 stenoses, and 2 cases of portal hypertension were diagnosed correctly. Sensitivity was 87%, specificity 95%, and accuracy 93%. Duplex Doppler was least effective in the diagnosis of hepatic artery stenosis. Five cases showed biliary complications of ischemic origin. Angiography is indicated when duplex Doppler is positive or doubtful, but also when the clinical condition is unclear.

Adult↗