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Biomedical subjects

J M Buffet

Publications and source records attributed to J M Buffet.

16 recordsLinked to original sources

Arteriovenous revascularization for lower limb salvage in unreconstructible arterial occlusive disease (long-term outcome).

Between February 1983 and June 1994 we attempted surgically to salvage twenty-six legs in twenty-five patients with insufficient distal run-off and severely ischemic feet; all of them had resting pain, and 23 had tissue necrosis. A saphenous venous graft was interposed between an artery of the lower extremity (femoral or popliteal) and the veins of the foot with obligatory end-to-side distal anastomosis. The patency of the venous circulation of the ischemic foot was ascertained by retrograde phlebography. Patients were followed from 3 months to 11 years (an average of 3 years and 5 months). In 19 legs (73%), surgery succeeded in preventing extensive gangrene of the foot, and allowed postponing or avoiding major amputation. The purpose of this paper is to analyze this experience, and stimulate further interest and study of the reversed microcirculation in critical ischemia.

Aged

[Comparative study of two methods of arterialization of foot veins in ischemic crisis].

Between February 1974 and December 1991, a total of 28 arterializations of the venous network of foot were performed in patients with stage IIIB or IV arteriopathies presenting disseminated femoropopliteal and more distal lesions excluding revascularization by conventional arterial shunt operations. Two groups of patients could be distinguished. The first group, of 8 patients, underwent arterialization by shunt operation with end to end fistula at the distal part of leg and return blood emptying at the dorsal surface of foot (3 cases). The procedure was successful in 50% of cases after a mean follow up of 76 months. The intervention in the second group, of 20 patients, was by end to side fistula of foot after preoperative countercurrent phlebography and the use of a material better adapted for the destruction of the valves. Results were evaluated as successful in 70% of cases at 31 month follow up. After spontaneous closure of the fistula, the collateral circulation provoked by it was sufficient to conserve the acquired benefit. No deaths or cases of cardiac overload were reported as a result of the intervention. Comparative analysis of results showed that the use of the second procedure allowed amputation to be avoided in more than 2/3rds of cases, provided relief from pain, provoked healing of necrosed areas and permitted renewal of walking. The results of this study have demonstrated that venous arterialization of the foot by this method represents an interesting alternative in the saving of a limb destined for amputation.

Aged

[Multiple decubitus ophthalmological operating table].

A new ophthalmological operating table is presented which is adapted to the most recent developments in microsurgery and for the treatment of the most difficult cases of vitreoretinal pathology. The head of the table is mobile in the sagittal plane, movements being effected under remote-control by the surgeon at a rate of 2 mm/sec. The same movement can be applied to a horseshoe shaped armrest, which is solidly attached around the headpiece and is adjustable for height. A respiratory shield can be attached during local anesthesia, and the table can be positioned in proclivity or declivity. During vitreoretinal surgery, the table enables rotation of the patient in ventral decubitus along a longitudinal axis, rotation being possible manually or electrically. Proclivity and declivity positions can be obtained by rotation on a transversal axis. These functions assist exchanges between ocular fluids and substances used for internal packing, as well as passage into the anterior chamber of foreign bodies in the vitreal cavity.

Equipment and Supplies, Hospital

[The diagnosis of isolated choroidal hemangioma (author's transl)].

The authors report clinical and laboratory data setting the diagnosis of isolated choroidal hemangioma. Main elements appear to be biomicroscopy and angiography after fluorescein and cardiogreen injection. The clinical history of two non typical cases is reported and discussed.

Adolescent

[Destruction of residual varicose collaterals by subcutaneous dilaceration with a needle].

The persistence of collaterals after a properly conducted surgical treatment of varicose veins of the lower limbs often presents a problem which is difficult to resolve. The authors put forward a simple and original method, in which a long and slightly curved triangular needle is used, without incisions, to destroy by dilaceration the collaterals whatever their degree of dilatation and their location. This technique has also been used as a first stage preceding stripping, and over a 5 year period has given results in 70 patients which are very satisfactory both from the point of view of efficacy as well as from the aesthetic point of view.

Collateral Circulation