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Biomedical subjects

J M Cormier

Publications and source records attributed to J M Cormier.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Intermittent treatment with streptokinase in arterial disease of the limbs.

Sixty-two patients with arterial disease of the lower limbs were treated with streptokinase by intermittent administration. All patients had experienced recent aggravation of their arterial disease, and 22 had thrombolysis confirmed by arteriography. In 20 cases clinical study showed repermeation--in 8 cases during the first perfusion and in 8 cases during the third perfusion. During the first perfusion the fall in fibrinogen was significantly greater in the 8 patients with thrombolysis. Further, the third perfusion corresponded to a new phase of fibrinogenolysis. These results support the possibility of the relationship between plasminemia and thrombolysis, and emphasize the limits of the classic theory of Sherry, Fletcher, and Alkjaersig. Permitting phases of repeated but limited plasminemia, the interruption method used here is a compromise between the risk of hemorrhage and the efficacy of treatment at low dosage.

Angiography↗
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[Arteritis in aged patients].

Gangrene is the usual reason for admission to a surgical unit in elderly patients with peripheral vascular disease. It is often the first sign of arterial disease occurring in a foot with satisfactory skin and may be triggered off by trauma or infection. Obstruction at various levels of the profunda femoris artery, of the main leg arteries with calcification of the media, are the usual characteristics, whether the patient is diabetic or not. This explains why reconstructive vascular surgery is rarely possible but this, nevertheless, remains the best chance for obtaining healing of trophic disorders with limited removal of the toes. No failure was observed in cases of axillo-femoral or femoro-femoral by-pass. But, as in diabetics, one may, in elderly patients with gangrene, attempt to conserve weight-bearing areas thanks to medical treatment in association in some cases with lumbar sympathectomy when the patient's general condition makes this possible. The mortality is low when patients are selected for operation and depending on the surgical technique adopted, e.g. sub-cutaneous by-pass or surgery of the origin of the profunda femoris. The mortality is less than 7 p. 100 during the first month (one death in 31 vascular operations, one death in 40 sympathectomies), but the mortality during the first 6 months exceeds 20 p. 100 due to cardiac, or cerebral complications or urinary infection. The prevention of digestive symptoms, nutritional, renal or urinary complications, and electrolyte disturbances is essential together with physiotherapy and reduction in time spent in hospital, for example, the patient may be sent home and treated by the district nurse. 135 patients with arteritis, including 48 diabetics, aged over 70 years, admitted to hospital in 1971 at the Saint-Joseph hospital, illustrate these findings. 109 patients with 114 diseased limbs, had gangrene or ischemic ulcer. Out of 80 survivors, beyond 6 months, i.e. 84 limbs, in 75 cases the weight bearing areas were preserved, in 9 cases amputation was necessary but in 8 of these it was possible to carry out amputation below the knee and walking was possible. These functional results justify attempts to maintain weight bearing areas or, at least, the knee, whatever the duration of healing or amputation of a toe or of the metatarsus; in Syme's amputation of the leg, healing requires 2 to 4 months.

Age Factors↗
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[Takayasu's disease. Exploration by intra-arterial digital angiography. 50 cases].

The long-term prognosis of Takayasu's disease depends on an elective surgical treatment which requires full and accurate assessment of the lesions. We present here a retrospective study of 50 patients explored before surgery by intra-arterial digital angiography. In 92 percent of the patients the thoraco-abdominal aorta and its branches were well documented on 2 orthogonal projections performed in one single session. The high-quality intra-arterial opacification made it possible to detect incipient parietal lesions and to evaluate the lesions of the small caliber branches and the downstream bed in case of occlusion. These advantages, and the absence of morbidity in our experience, make digital panarteriography a method of choice to evaluate Takayasu's disease.

Adolescent↗
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[Isolated dissecting aneurysm of the superior mesenteric artery. Dysplasia, a rare cause of mesenteric ischemia. Report of a case].

We report a case of successful surgical revascularization of the superior mesenteric artery in a patient presenting with intestinal ischaemia due to fibrodysplasia. This is a rare pathology, with 5 cases operated in our institution and only 16 cases reported in the literature. Angiography may show other sites of arterial dysplasia. In such cases, success depends on early surgical revascularization.

Aortic Dissection↗
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[Revascularization of the inferior mesenteric artery through an endoaortic approach. A prospective series of 51 cases].

From January 1, 1986 to December 31, 1987, 170 subrenal abdominal aortic aneurysms were operated on using a technique involving systematic revascularisation of the inferior mesenteric artery each time this was possible. The electively chosen revascularisation method was endo-aortic reimplantation which was carried out on 51 occasions out of 53 revascularisations. The post-operative mortality was zero. Post-operative angiographic examination via the arterial route was systematically performed. 5 post-operative occlusions occurred. In these patients undergoing inferior mesenteric revascularisation, there was only one single case of severe ischemic colitis which subsequently resolved. Endo-aortic reimplantation of the inferior mesenteric artery would thus appear to be the procedure of choice for the prevention of ischemic colitis when the ostium is not stenosed or occluded.

Aged↗
PubMedDate not supplied

[Reimplantation of the subclavian artery into the common carotid artery].

Since 1973, transposition of the subclavian artery into the common carotid artery has been the technique of choice to treat prevertebral occlusive subclavian lesions. However, the haemodynamic results in the vertebral artery were far from perfect, as shown by immediate post-operative ultrasonic examinations. This has been corrected by a technical modification: the subclavian artery is severed flush with the vertebral artery lying obliquely downward and medially, which is equivalent to reimplanting a "double-barrelled" vessel (the vertebral and subclavian arteries) into the common carotid artery.

Arterial Occlusive Diseases↗