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J Drouineau

Publications and source records attributed to J Drouineau.

At least 19 recordsLinked to original sources
PubMed2005

[Emergency surgery of a large ruptured arteriovenous malformation previously treated by several embolization procedures].

A 56-year-old patient with a giant parieto-occipital left-sided arteriovenous malformation (AVM) revealed by seizure was treated by four embolization procedures. Stereotactic radiosurgery was scheduled for the residual nidus but significant intracranial hemorrhage occurred and surgical excision had to be performed. The immediate post-operative status was precarious, but the final outcome was successful. Therapeutic indications are discussed. A multidisciplinary approach for judicious patient selection is surely the key to safe overall management of AVMs.

Cerebral Angiography↗
PubMed2002

[Endovascular treatment of sinus dural fistulas using vein catheterism].

PURPOSE: We report two techniques for treatment of dural arteriovenous fistulas using femoral vein catheterism and direct surgery via the superior ophthalmic vein. We will attempt to show the advantages of these new techniques instead of using the arterial pathway, which is currently the reference procedure. SUBJECTS AND METHOD: Mrs G, 75 years old was sent by her ophthalmologist because of a suspected orbital tumor. Visual acuity: right eye: 3/10, exophthalmia, chemosis, with no thrill or murmur. The fundus examination was normal. The ultrasound exam with color Doppler imaging showed an arterialization of the superior ophthalmic vein compatible with an arteriovenous sinus dural fistula. Angio-MRI revealed a large left cavernous sinus, confirming the diagnosis. Considering the type of the fistula and the weak physical condition of the patient, we decided to attempt an endovascular embolization with coil placement, using femoral vein catheterism. Exophthalmia regressed within days. The fistula remains sealed 1 year after the procedure. Mr D, 40 years old, showed a similar clinical aspect of sinus dural fistula. We attempted an embolization with the femoral vein, which failed. We decided to embolize the cavernous sinus via the direct surgical pathway of the superior ophthalmic vein. Coils were placed and the fistula was sealed. CONCLUSION: These clinical cases show two less invasive alternatives giving better results than arterial embolization, the reference method (Brooks 1930; Spearmann 1964; Parkinson 1965), endovascular trapping, or surgery.

Adult↗
PubMed2002

[Epistaxis and hospitalization: a retrospective observational study over 4 years of 260 patients].

OBJECTIVE: Epistaxis is a frequent emergency for which guidelines and treatment are well known. Nevertheless few studies have evaluated the factors that may influence the decision for hospitalisation. Through a retrospective study we have searched to define potential factors which lead to taking such a decision. METHODS: Retrospective analysis of charts of 260 patients hospitalized for epistaxis. For each patient we have reviewed several data including, age, associated pathologies, current treatment, duration of the stay, complications, recurrences etc... RESULTS: If the severity of the bleeding is one of the major factor, socio-economic factors are also taken into account and may influence the decision to hospitalize. Age, associated pathologies (hypertension, hemopathy) and their treatment (anti-coagulant) also play a role in this decision. Furthermore an obvious strategy in the choice of the different treatment may help to reduce the length of stay and the morbidity of each treatment. CONCLUSION: We propose some modifications to our strategy to improve the management of epistaxis. This includes the use of endoscopic techniques for diagnosis and treatment.

Adolescent↗
PubMed2001

Utility of balloon-assisted Guglielmi detachable coiling in the treatment of 49 cerebral aneurysms: a retrospective, multicenter study.

BACKGROUND AND PURPOSE: The management of wide-necked aneurysms or aneurysms with a neck-to-body ratio close to 1 is a difficult challenge for the interventional radiologist because of the risk of coil migration or coil protrusion into the parent vessel. Our objective was to evaluate the efficacy and safety of balloon-assisted coiling as well as the follow-up results of occlusion for those difficult aneurysms in which conventional treatment with Guglielmi detachable coils (GDCs) had failed. METHODS: A nondetachable balloon was used in 49 procedures performed in 44 patients (35 women and nine men) who underwent GDC coiling of aneurysms. Every aneurysm had either a wide neck or a sac diameter/neck size ratio (SNR) of 1.5 or less. RESULTS: In four (8%) of the procedures, balloon placement failed, leaving a total of 45 aneurysms treated with balloon-assisted coiling. Final results consisted of total occlusion in 30 cases (67%), subtotal occlusion in 11 cases (24%), and incomplete occlusion in four cases (9%). We found a correlation between the diameter of the sac and the occlusion rate, but not between the size of the neck or the SNR and the occlusion rate. Two thromboembolic complications occurred, but neither had clinical consequences. No aneurysmal rupture was observed during treatment. Final angiographic follow-up time ranged from 3 months to 5 years (mean, 16 months). CONCLUSION: Balloon-assisted coiling is an important adjunct in the treatment of aneurysms with a wide neck or low SNR. In our experience, this technique allowed safe and efficient treatment of aneurysms when conventional GDC treatment had failed.

Adult↗
PubMed2000

[Pathological laughter after the brainstem infarction].

We report a case of 'fou rire prodromique' heralding a brainstem infarct with favorable prognosis after thrombolysis. Different clinical forms of pathological laughter, the pathophysiological mechanisms and clinico-anatomical correlations of this rare phenomenon are discussed.

Anticoagulants↗
PubMed1994

[Mammary bypass dysfunction caused by proximal stenosis of the homolateral subclavian artery: treatment by percutaneous angioplasty. Apropos of a case].

Proper function of a coronary bypass using the internal mammary artery obviously depends upon the quality of the mammary artery used and of the distal coronary system, but also the absence of any significant stenosis of the first centimetres of the homolateral subclavian artery. The authors report the case of a patient in whom angina was destabilized by dysfunction of a bypass between the left internal mammary artery and the left anterior descending coronary artery. This mammary bypass dysfunction was related not to stenosis of the bypass but to stenosis of the proximal part of the left subclavian artery. Angioplasty of this stenosis led to disappearance of anterior myocardial circulatory impairment and of angina attacks.

Aged↗
PubMed1993

[Congenital arteriovenous malformation of the internal iliac artery discovered during pregnancy].

We report a case found at the start of labour because of the presence of a "tumour praevia". Ultrasound, Doppler and tomodensitometric examination carried out after caesarean section confirmed the vascular origin of this lesion. Arteriography made it possible to decide the pattern of this arteriovenous malformation which was occurring in several branches of the left internal iliac artery. It was not possible to obliterate it completely by selective arterial embolisation, so it was removed surgically a few months later. Little is known about the complications that occur because of these arteriovenous malformations in pregnancy and during delivery. There is the theoretical risk that spontaneous rupture will occur in pregnancy but this does not justify terminating the pregnancy. It is better to carry out caesarean section because the tumour can obstruct delivery and may rupture as well as causing delay in labour. The treatment for these lesions is sometimes difficult and complex and one has to decide whether to preserve the uterus or not. Selective embolisation and pre-operative embolisation followed by surgical removal of dysplasic tissue are the therapies of choice.

Adult↗
PubMed1993

[Adamantinoma of the tibia. X-ray computed tomographic and MRI study. Apropos of a case].

Adamantinoma of the long bones in a very rare tumor that mainly affects the tibia. Its diagnosis is difficult both radiologically, as the lesion appears as a poorly specific metaphyseal lacuna with or without periosteal reaction, and histologically. Its prognosis used to be guarded because of recurrence and of possible metastatic diffusion, but it has been considerably improved by wide resection with reconstruction. On the occasion of a new case, the authors describe the appearance observed with MRI and the merits of this examination for the preoperative assessment.

Ameloblastoma↗
PubMed1992

Optimal central trapping (OPCETRA) vena caval filter: results of experimental studies.

The authors present the in vitro and in vivo results of use of a new vena caval filter, the optimal central trapping (OPCETRA) filter. The in vitro study was designed to compare the clot-trapping effectiveness of three filters: the OPCETRA, the stainless steel Greenfield, and the original Vena Tech-LGM. Standardized 3-mm, 5-mm, and 7-mm clots were captured in 66%, 100%, and 100% of cases, respectively, with the OPCETRA filter; in 34%, 82%, and 100% of cases with the Greenfield filter; and in 50%, 100%, and 100% of cases with the LGM filter. When filters were tilted 15 degrees, 100% of the 5-mm clots were trapped with the OPCETRA filter versus 50% with the Greenfield (P < 1.04 x 10(-9)) and 70% with the LGM (P < 1.78 x 10(-5)) filters. The in vivo animal study was designed to confirm ease of placement, tolerance, and effectiveness of the OPCETRA filter in sheep. Animals were separated into two groups: Group 1 underwent embolization through the femoral vein 40 days after filter implantation and were killed immediately; group 2 underwent embolization at 90 days and were killed 8 days later. In all cases pathologic analysis on the vena cava wall was performed after resection. The in vivo study demonstrated no tilting or migration with the OPCETRA filter. These encouraging results can be explained by the filter's hourglass shape, the number of arms, and the slow release of the filter at insertion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Leiomyosarcoma of the inferior vena cava. Diagnostic difficulties].

As leiomyosarcomas of the inferior vena cava are extremely infrequent, the preoperative diagnosis of such tumors is rarely established. We report two cases in which the diagnosis was suggested by modern imaging prior to surgery. Three examination techniques allo contemplating this diagnosis. Ultrasound and cavography show either an intraluminal, multilobulated, roughly hyperechogenic lacuna on one of the segments of the vena cava, without any remote thrombosis image, or a complete obstruction of the vena cava with collateral circulation and a hyperechogenic right paraaortic mass. Computed tomography demonstrates the extraluminal extension. It reveals the presence of a right lateroaortic tumor with heterogeneous tissue density, in which the vena cava is concealed. The association of an intraluminal lacuna and of a tumoral syndrome on CT is highly suggestive. These three techniques are equally essential for the assessment of this tumor, which is primarily based on vascular findings. Exeresis is always difficult and the prognosis very poor.

Aged↗
PubMed1992

[X-ray computed tomographic study of the ethmoid bone and middle meatus. III. Application to chronic infectious sinus pathology].

As nasal endoscopy, high resolution CT is a part of the chronic rhinosinusitis pre-operative assessment. It shows, thanks to a precise and anatomical study of the ethmoid and sinusal draining, the extension of the diseases and the local morphological variations which predispose to chronic diseases. The main aspects of chronic sinusitis, nasal polyposis and fungal maxillary sinus diseases are reported. The frequency of individual morphological variations and the mucosal changes due to a nasal cycle require a great care in the interpretation of the diseases.

Aspergillosis↗
PubMed1991

[X-ray computed tomographic study of the ethmoid and middle meatus. II. Radio-anatomy (axial incidence) and morphological variations].

Chronic rhinosinusitis endoscopic surgery needs an accurate evaluation of diseases and paranasal sinus anatomic variations. High resolution CT by thin section (2 mm) allow this pre-operative assessment. An anatomical study of the ethmoid air cell system is always possible in axial plane. The bidimensional CT exploration (axial and coronal plane) displays the anatomic variations of ostiomeatal unit, that have been reported to predispose sinusitis. They are nasal septal deviation, pneumatization and paradoxical curvature of the middle turbinate, pneumatization of unciform process, Haller's cells, prominent agger nasi cell and ethmoid bulla. The endoscopic endonasal surgery landmarks, the individual morphologic variations, the topographic relations to the orbit and to the brain are also well shown by CT.

Ethmoid Bone↗
PubMed1990

[Intrathoracic chondrosarcoma arising at a rib in a patient with multiple exostoses].

A case of chondrosarcoma arising from the 7th left rib in a patient with multiple exostosis disease is reported. The initial CT scan feature is a purely intrathoracic mass with a parietal and pericardial junction and calcifications within the tumor. A review of the literature about the costal chondrosarcoma and their CT scan features is done and shows the uncommon initial aspect of this case.

Adult↗
PubMed1989

[Pelvic cystic lymphangioma. Apropos of a case in an adult].

The authors report about the observation of a subperitoneal pelvic cystic lymphangioma in an adult patient: ultrasound and CT dat had yet never been described for the rare pelvic form, and are the same as with the other locations of cystic lymphangioma in adults.

Aged↗
PubMed1989

[Radiological and magnetic resonance aspects in cerebral venous angioma].

This report based on a series of 8 cases deals with the appearance of cerebral venous angiomas with computed tomography (CT), arteriography and magnetic resonance imaging (MRI). The CT data are not conclusive, and venous involvement is demonstrated by arteriography, as well as the site of involvement. Magnetic resonance imaging seems to be useful owing to the morphological information and data on flow phenomena it provides.

Adolescent↗