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Biomedical subjects

H Rousseau

Publications and source records attributed to H Rousseau.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Narrow cervical canal and lumbar canal. Frequency of the association, role of hyperostosis].

The authors undertook a retrospective study involving 47 records of patients hospitalised for cervical myelopathy as the main clinical feature (n = 17) or symptomatic narrow lumbar canal (n = 30). Nine of these patients had clinical signs of both cervical myelopathy and of narrow lumbar canal, 10 of the 17 patients with a cervical myelopathy had lumbar stenosis as shown by midline sagittal tomography and/or CT scan, 9 of the 30 patients hospitalised for symptomatic narrow lumbar canal had cervical stenosis as shown by midline sagittal tomography, 13 of these 19 patients with both cervical and lumbar stenosis had enveloping vertebral hyperostosis.

Cervical Vertebrae↗
PubMed1991

[Different methods of percutaneous desobstruction of peripheral arteries].

Chronic arterial occlusion of the iliac and femoro-popliteal vessels has been considered, until recently, to be a contraindication to percutaneous transluminal angioplasty. However, recent advances in radiological and catheterisation equipment and the introduction of new methods of recanalisation (laser, mechanical devices) have increased the therapeutic possibilities. The immediate and long-term results of iliac recanalisation are usually excellent with conventional angioplasty methods. The success rate of recanalisation of the femoro-popliteal segments is about 80% irrespective of the method used, the failure rate increasing with the length of the occlusion. However, the long-term patency rate is poor, about 50%. These methods of percutaneous recanalisation are technically difficult and require special training and sophisticated equipment. The indications should be carefully evaluated in a pluridisciplinary manner taking into account the potential clinical benefits, the technical difficulties, the risks and other therapeutic possibilities.

Angioplasty, Balloon↗
PubMed1991

[Self-expanding endoprostheses. Applications in iliac and femoro-popliteal arteries].

Vascular endoprosthesis are aimed at optimizing the results of angioplasty. They are metallic cylinders, most often meshed, laid against the wall of the vessel and progressively incorporated into the intima by endothelial coverage. Experimental studies show that this incorporation occurs within a few weeks. The prosthesis are either self-expanding or mounted on a dilatation balloon. Their aim is to restore a good-quality caliber by smoothing the parietal irregularities that were frequently encountered after dilatation. They are a true parietal prop, inserted into the arterial lumen through a percutaneous approach. The middle-term results of iliac and femoropopliteal implants are very encouraging, and they suggest that this technique may be a very useful complement to transluminal angioplasty in cases of poor results or recurrence. The insertion of an endoprosthesis also allows to extend the indications of transluminal angioplasty to cases that had been regarded as hardly favorable so far: long, irregular stenosis, iliac obliteration, etc.

Blood Vessel Prosthesis↗
PubMed1990

Use of Gianturco self-expandable stents in the tracheobronchial tree.

Gianturco self-expandable stents were used successfully in the management of 5 patients with tracheobronchial pathology. Placement was performed under endoscopic and fluoroscopic guidance. None of the patients has experienced complications secondary to the stent placement, and in all of them the clinical problems resolved satisfactorily. Longer follow-up is required to determine the place of tracheobronchial stenting in patients with respiratory compromise.

Aged↗
PubMed1990

Use of the Wallstent endourethral prosthesis in the treatment of recurrent urethral strictures.

Urethral strictures recur in about 30% of the cases irrespective of treatment. We describe a new urethral stent, originally developed in our institution for vascular use after transluminal angioplasty. We have previously tested the biocompatibility and tolerance in the normal urethra of dogs in a study with a 1-year follow-up undertaken in 1986. The stent has a braided structure, made of fine stainless steel wires and is self-expanding when released from a special endoscopic instrument. Since November 1987, we have implanted the stent in 25 men (mean age 54 years), after a previous urethrotomy had been performed. Eighteen were evaluated. Results are good, morbidity and complications occasional. This new technique has a considerable future in treating recurrent urethral stricture.

Adult↗
PubMed1990

Treatment of iliac artery stenoses with the Wallstent endoprosthesis.

Sixteen symptomatic iliac artery stenoses and three occlusions in 16 patients were treated by the percutaneous implantation of Wallstent endoprostheses (Medinvent SA, Lausanne, Switzerland). The endoprosthesis consists of stainless steel monofilaments braided into a self-expanding cylinder. The indications for placement were restenosis after angioplasty (10 cases), failed arterial dilations (eight cases), and restenosis after endarterectomy (one case). The prostheses used had a mean diameter of 8 mm (range, 6-10 mm) and were placed in the external iliac (14 cases) and common iliac (five cases) arteries. The 16 stenoses were greater than 80%, and the three occlusions were longer than 7 cm. Mean length of the lesions treated was 7 cm (range, 4-14 cm). Three of the arteries thrombosed after treatment, one 2 days later and two in the month after implantation of the stent. On clinical and angiographic follow-up (mean, 16 months; range, 1-24 months) no symptoms or stenoses reappeared in the remaining 16 cases. Our experience in these cases suggests that implantation of a Wallstent endovascular prosthesis is a valuable technique for the treatment of external and common iliac artery stenoses.

Adult↗
PubMed1990

["Wallstent" intra-urethral prosthesis in recurrent urethral stenosis].

Urethral strictures recur in about 30% of the cases whatever might be the treatment. We describe a new urethral stent, originally developed in our Institution for vascular use after transluminal angioplasty. Since january 1986, we previously have controlled the biocompatibility and tolerance into the normal urethra of dogs with a one year of follow-up. The stent has a braided structure, made of fine stainless steel wires and is self-expanding when released from a special endoscopic instrument. From november 1987, we have implanted the stent into 11 males (mean age 54 years), after a previous urethrotomy has been performed. In two patients a second stent has been implanted for incomplete result. Now with a mean follow-up of 12 months all patients recovered normal micturation, only two complained of slight stress incontinence.

Adult↗
PubMed1990

[Long-term results of transluminal angioplasty in the treatment of stenosis of the renal artery].

MATERIALS AND METHODS. A multicenter study was undertaken to determine the long-term results of renal angioplasty. Five teams with considerable experience in the procedure replied to a computerized questionnaire concerning transluminal angioplasty (TLA) performed with immediate success from 1979 to 1985 and followed up regularly (minimum of four years). The main purpose of the study was to assess the long-term results, both anatomical results and clinical, of renal TLA. Consideration was given to anatomical of average quality and their possible correlation with long-term results, in an attempt to foresee and even prevent restenosis. The main points of the study are given in figure 1. Two hundred and forty-seven renal TLA performed in 210 patients were included (insofar as clinical and radiologic follow-up was adequate, with a minimum of one control angiography beyond six months). Patients who had immediate failure (dilatation not possible or ineffective dilatation) were excluded from the analysis of long-term results. Likewise, TLA of the renal artery of grafted kidneys were not included in this study. The histogram of patients ages shows a clear predominance of subjects 60 to 65 years of age, with extremes ranging from 10 to 80 years (mean 53 years). TLA were done mainly by the femoral route according to a technique using a balloon catheter positioned on a previously inserted guide at the level of the stenosis. The examination was performed under local anesthesia. Balloon size was determined according to the diameter of the renal artery upstream from the stenosis and that of the contralateral renal artery. A balloon of the same or slightly larger caliber was used. The indication of angioplasty was determined after multidisciplinary discussion according to two main criteria: First, treatment of hypertension presumed to be in relation with a stenosis of the renal artery (renovascular hypertension). Secondly, conservation of the nephrotic capacities of a patient with a renal stenosis possibly associated with arterial hypertension, in relation with a bilateral stenosis of the renal arteries or with a unilateral stenosis affecting a functionally or anatomically single kidney. In this latter case, the purpose of TLA was to avoid development toward thrombosis of the renal artery and worsening of renal insufficiency. RESULTS. Two hundred and forty-seven TLA in 210 patients were included in the study. Nineteen patients (9%) had bilateral TLA. The lesions treated are indicated in figure 3. These were most often simple atheromatous and truncal lesions of the renal artery (73%) which were significant (greater than 50%) in 99% of cases. TLA was indicated in 77% of cases for treatment of arterial hypertension presumed to be renovascular. In 23% of cases, treatment of the stenosis was intended to conserve, especially, kidney vascularization, i.e., an indication of nephrotic protection. There were 9.7% immediate failures...

Acute Kidney Injury↗
PubMed1990

[Wallstent endourethral prosthesis in recurrent urethral stenoses].

Urethral strictures recur in about 30% of the cases irrespective of treatment. We describe a new urethral stent, originally developed in our institution for vascular use after transluminal angioplasty. We have previously controlled the biocompatibility and tolerance in the normal urethra of dogs in a study with a one year follow-up that was undertaken in 1986. The stent has a braided structure, made of fine stainless steel wires and is self-expanding when released from a special endoscopic instrument. Since November 1987, we have implanted the stent in 11 men (mean age 54 years), after a previous urethrotomy had been performed. In two patients a second stent was implanted for incomplete result. Now with a mean follow-up of 12 months all patients are continent, and only two patients have complained of slight stress incontinence.

Adult↗
PubMed1989

[Diagnosis of diseases of the urinary tract].

Radiological exploration of the urinary tract has become highly sophisticated. The information provided by the new imaging techniques is extremely accurate and useful in the diagnosis and pretherapeutic assessment of most urinary tract diseases. Interventional radiology has given radiologists an important role in the treatment of some types of pathology. The authors describe the value of modern imaging and its different aspects in each of the principal branches of urinary tract pathology, viz.: tumours, obstructions, infections, vascular and prostatic diseases.

Humans↗
PubMed1989

Self-expanding endovascular stent in experimental atherosclerosis. Work in progress.

To investigate the physiologic and histologic responses induced by the self-expanding endovascular prosthesis, rabbits subjected to a combination of high-cholesterol diet and intravascular trauma underwent stent implantation. The results were compared with those obtained with the placement of stents in the healthy aortas of rabbits. Stents in healthy aortic tissue led to stent intimalization, previously reported in canine studies. For stents placed in animals subjected to a high-cholesterol diet but no intimal trauma, it was found that the stent was not the source of atherogenesis. Stents placed in atheromatous plaque were found to radially compress plaque with time and to stimulate for formation of a fibrotic crust. The results suggest that the self-expanding stent protects against progressive encroachment of the vessel lumen by atherosclerotic tissue.

Animals↗
PubMed1989

[Interventional radiology and vascular pathology].

Percutaneous transluminal angioplasty (PTA) has been an important step in the therapy of arterial diseases. Nowadays, it opens the way to new techniques which main goals are to improve the PTA results and to enlarge the indications. This article review these new techniques. The principles, the therapeutic possibilities, the advantages and the inconvenience of each are evaluated, based upon the personal experience of the authors, the bibliography of current literature and the proceedings of a meeting organized on this topic (Toulouse, February 1988). All these procedures are encouraging and let foresee new possible therapy in vascular pathology.

Angioplasty, Balloon↗
PubMed1989

[Usefulness of a percutaneous endoprosthesis in the treatment of renal artery stenoses].

In approximately 10 p. 100 of the cases stenosis of the renal artery cannot be satisfactorily dilated by percutaneous transluminal angioplasty (PTA), and about 10 p. 100 of the patients successfully dilated have short-term restenosis. The excellent results obtained experimentally and clinically with the implantation of percutaneous intravascular stents have prompted us to use this material in the renal arteries. Stents were implanted in 10 patients who were followed up for periods of 1 to 16 months. Eight of them had restenosis after PTA; five of these stenoses were due to atheroma, 2 to fibromuscular dysplasia and 1 to Takayasu's disease. Two patients were implanted from the start owing to the insufficient results of PTA. Seven patients had severe arterial hypertension most probably of renovascular origin. Three patients had hypertension associated with moderate renal failure. Implantation was performed after a previous PTA. Adjuvant treatments and monitoring were the same in every case with, in particular, radiological control examination after one and six months. The implantations themselves were uneventful, and immediate control showed almost perfect anatomical restoration in all patients. On subsequent controls, arterial patency was preserved in all but one case. All patients showed significant clinical improvement. These results are most encouraging. They suggest that intravascular stents constitute an interesting solution when PTA is insufficient in the treatment of renal artery stenosis.

Adult↗
PubMed1989

[Application of auto-expansible endoprostheses to arteries of the legs].

An endovascular support inserted percutaneously, may represent an attractive solution to prevent early obstructions and recurrent stenoses after angioplasty (ATP). 23 iliac lesions and 40 femoro-popliteal lesions, symptomatic in 55 patients, were treated with endoprostheses of the Wallstent type. For the iliac implantations, it concerned in one case a recurrence after endarterectomy, 13 cases of recurrent stenoses after ATP and 9 cases of immediate failure of the angioplasty. The mean length of the lesions under treatment was 8 cm (extreme values between 4 and 14 cm). For the femoro-opoliteal arteries, the implants concerned lesions ranging between 3 and 7 cm, in 75 p. cent of the cases, and lesions exceeding 7 cm in 25 p. cent of the cases. Three iliac thromboses and six femoro-popliteal thromboses were reported at the beginning of this study; on the contrary, no thrombosis is present in the last 18 patients treated with oral anticoagulants. The rate of recurrent stenosis is low (none at the iliac level and 10 p. cent at the femoro-popliteal level); in all other cases an excellent clinical result was obtained with a mean follow-up of 18 months.

Adult↗