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Biomedical subjects

G Vandenbosch

Publications and source records attributed to G Vandenbosch.

At least 19 recordsLinked to original sources
PubMed1989

Deep dorsal vein arterialisation in vascular impotence.

A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre-operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections. Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow-up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno-venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed.

Adult↗
PubMed1988

Opacification of the glans penis during cavernosography.

Cavernosography and cavernometry were performed in 150 impotent patients and 10 normal potent volunteers. Opacification of the glans penis was noted in 5 normal volunteers, while among the impotent patients it was noted in 53 per cent of those with venous leakage and in 36 per cent of those without leakage. We believe that opacification of the glans during cavernosography must be regarded as a normal variant rather than as a sign of pathological shunts between the glans and the corpora cavernosa.

Adult↗
PubMed1988

[Transluminal percutaneous angioplasty by thermal lasers. 20 cases of peripheral artery occlusion].

The authors report their experience of laser thermal angioplasty in a series of 20 patients. An argon laser with a 1.5 or 2.0 millimeter diameter metalcapped optical fiber (Hot Tip Trimedyne Inc.) was used; the laser probe was pushed to the occlusion point; after a channel was produced through the obliteration, a conventional percutaneous balloon angioplasty was performed. The indications were: 4 primitive iliac occlusions, 15 femoral/popliteal occlusions and 1 subclavian obliteration. The immediate results were as follows (table I): 75% overall recanalization (50% at the iliac level, 87% at the femoral/popliteal level and failure at the subclavian level); 5 notable complications were observed (2 limb ischaemia, 2 voluminous inguinal haematoma and 1 aortic cross perforation) without clinical sequelae. The short term follow-up (1 to 8 months) of the successfully treated patients (table II) shows 100% permeability at the iliac level and 77% at the femoral/popliteal level. We conclude that laser thermal angioplasty is a very attractive method in the treatment of primitive iliac and femoral/popliteal occlusions. The well-defined indications must form the subject of a closely discussion between the angiologist, the vascular surgeon and the interventional radiologist.

Angioplasty, Balloon↗
PubMed1988

[Evaluation of the permeability of aortocoronary bypass by digital angiography].

Evaluation of coronary artery bypass graft patency by intra-arterial digital subtraction angiography was performed in 201 patients. A first group of 150 asymptomatic patients was systematically evaluated for post-operative screening 8.5 days after surgery as an immediate check on surgical results. Grafts were found occluded in 2.3%. A second group of 51 patients complaining of recurrent angina was studied 10 months (range 2 months to 9 years) after operation. Angiography revealed that 90% of grafts were patent but 8 grafts stenoses were diagnosed. In both groups, opacification of the run-off was achieved in 83%, but the quality of opacification was very low.

Adult↗
PubMed1987

The effect of papaverine on arterial and venous hemodynamics of erection.

The aim of this study was to establish how much of the erectogenic effect of papaverine is due to arterial dilatation and how much to venous obstruction during artificial erection. Three consecutive cavernosographies were done on each of 10 psychogenic impotent patients: a baseline run without papaverine; a run with papaverine (60 mg. intracavernously) after occlusion of arterial supply to the corpora cavernosa with balloon catheters inflated at the origin of the hypogastric arteries; and a third run after restoring arterial blood supply to the corpora. The measured flow rates indicated that during cavernosography in papaverine-induced erection, the major effect of papaverine is to increase the resistance to venous outflow from the corpora cavernosa.

Adult↗
PubMed1987

Comparison of iohexol and ioxaglate for intravenous digital subtraction angiography of the neck and head.

Two hundred patients undergoing intravenous digital subtraction angiography of the cerebral circulation were examined on a random basis with either iohexol 350 mg I/mL or ioxaglate 320 mg I/mL. The two low osmotic media provided equally satisfactory image quality and diagnostic possibilities. No significant differences were found in incidence and severity of adverse reactions.

Carotid Arteries↗
PubMed1986

Impotence: evaluation with cavernosography.

Many patients with organic impotence do not have abnormalities of the penile arterial system. To determine the function of the venous system in erection, cavernosography was performed in 187 impotent men during artificial induction of erection with monitoring of intracavernous pressure and inflow. To evaluate the mechanism of active erection, 69 patients also received intracavernous injections of papaverine. Venous leakage was found in 88 patients. In these patients, a higher than normal rate of flow of diluted, heparinized contrast medium was required to initiate and maintain erection. Opacification of the prostatic plexus also occurred during erection in these patients. In all patients who received papaverine, the flow rates required to initiate and maintain erection decreased. The authors conclude that cavernosography and cavernometry are essential in the work-up of impotence and that papaverine may be helpful in elucidating the active mechanism of erection.

Adolescent↗
PubMed1986

Subclavian vein thrombosis: a frequent complication of subclavian vein cannulation for hemodialysis.

Subclavian vein cannulation was suggested as a temporary vascular access for hemodialysis since one of its advantages was considered to be no damage to blood vessels. As we observed six patients with symptomatic subclavian vein thrombosis among 148 patients having received subclavian vein cannulation for hemodialysis, we systematically performed subclavian venogram in 42 asymptomatic patients selected on the basis of a history of previous subclavian vein cannulation. Venograms were performed 15.7 +/- 8.9 months after the removal of the last catheter. Eight patients (19%) had complete thrombosis or severe stenosis of the subclavian vein while six patients (14%) had minimal luminal defects. Considering together the 48 patients, the group with thrombosis or severe stenosis (group 1, n = 14) was compared with the group with minimal defects or normal venograms (group 2, n = 34). In group 1, as compared with group 2, there were more female (64% vs 32%, p = 0.02), more cannulations per vein (1.87 +/- 0.35 vs 1.32 +/- 0.08, p less than 0.05) and more cumulative days of cannulation per vein (35.1 +/- 7.9 vs 24.4 +/- 1.1, p less than 0.001). No difference between the two groups was seen for the number of catheter infections, the number of catheters with poor flow or obstruction, the coagulation screening of the patients or the time-length between the removal of the last catheter and the venogram study. Two of the initially asymptomatic patients developed later on clinical problems related to the subclavian vein thrombosis. We conclude that the subclavian vein cannulation leads to significant damages of the vessels, excluding a whole arm, for future vascular access in some patients.

Catheterization↗
PubMed1986

[Venous exploration of impotence of vascular origin].

Vascular origin accounts for more than 25% of cases of disturbances of erection. Venous pathology may explain the majority of erectile dysfunctions in patients with normal arterial anatomy. We have performed cavernography in 115 patients with monitoring of intracavernous pressure. Nocturnal plethysmography was recorded in all cases to prove the organic etiology of the erectile dysfunction. Cavernography was realized after puncture of both corpora cavernosa by two microcatheters (19-21 G). The intracavernous pressure was recorded through 1 of them and the contrast medium infused through the other. The contrast medium is infused at a rate of 80-120 ml/min. until the penis appears erect. The simultaneous recording of the intracavernous pressure then showed a rapid increase of the pressure curve followed by a stabilization at greater than or equal to 90 mHg. The flow to maintain the erection reach 1/3 of the flow needed to induce the erection. The venous leak is characterized by the absence of erection, no increase in intracavernous pressure and a rapid opacification of the vein. Artificial erection induced in impotent men allows to classify patients with vascular organic impotence into three categories: those with pure arterial insufficiency, those with pure venous leak, and patients with both.

Adolescent↗