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J M Cormier

Publications and source records attributed to J M Cormier.

246 records · Page 14Linked to original sources
PubMedDate not supplied

[Multiple arterial lesions in von Recklinghausen's disease. A case].

Arterial lesions are thought to be rare in neurofibromatosis. In the case reported here full vascular exploration demonstrated diffuse lesions of the aorta, splenic artery, renal arteries, left internal carotid artery, right common iliac artery and arteries of the legs. This underlines the usefulness of thorough angiographic exploration when arterioplasty is envisaged in a patient with neurofibromatosis. Microscopic examination of an arterial biopsy specimen showed fibrodysplasia of the media associated with hyperplasia of the periarterial nerves, thus confirming that the lesions involved tissues of both mesodermal and neuroectodermal origins.

Adult↗
PubMedDate not supplied

[74 by-passes on leg arteries (author's transl)].

74 by-passes on leg arteries have been performed during these last ten years at St Joseph's hospital to cure: femoropopliteal atherosclerotic occlusive disease (67 cases), aneurisms (5 cases), post-traumatic arteriovenous fistula (1 case), popliteal thrombosis on exostosis (1 case). The indication for operation was, in almost every case, carried on a distal advanced ischemia, followed by an imminent limb loss. In four cases, there existed an acute sensory and motor ischemia. The accumulated potency rate was 58.5% at 1 year and decreased progressively afterwards: 38.20% at 3 years and 21.6% at 5 years. However, the choice of a surgical technics doesn't find its justification in a long-dated prognosis for this operation, the aim of which being limb-salvage. In this prospect, the results are hopeful: 77% of the limbs have effectively been preserved at the end of the follow-up period.

Adult↗
PubMedDate not supplied

Streptokinase after late failure of reconstructive surgery for peripheral arteriosclerosis.

After the failure of reconstructive surgery for arterial occlusions of the lower limbs, 25 patients with severe ischemia were treated with streptokinase (SK) to avoid amputation of the limbs and sometimes death, in the absence of any other possible treatment. In 16 subjects, thrombolysis, assessed by the Doppler ultrasound technique, occurred rapidly; in 12 cases, SK combined with surgery or with symptomatic medical treatment gave good results saving limbs and improving the quality of life. Three of the 16 patients died from a cerebral vascular accident which occurred before the 10th hour. Whatever the type and the number of surgical operations performed before the use of SK, the indications and the results of the treatment are governed by the condition of the vascular tree below the arterial lesions. SK seems to be justified in endarterectomy or venous grafts with severe ischemia less than two months old. For dacron by-passes, the possibility of prosthesis dissection makes SK debatable in spite of frequent lysis. In axillofemoral by-passes, the risk of embolism of the upper limbs makes the use of SK inadvisable.

Adult↗
PubMedDate not supplied

Infection complicating aortoiliac surgery.

25 cases of sepsis complicating aorto-iliac surgery have been encountered in the period 1970 to 1976 (8 cases occured in our own unit and 17 were received from elsewhere). There were 10 instances of infection following thromboendarterectomy and all 10 were treated successfully. Among the 19 patients with infected prostheses (14 primary, 5 secondary) there were 5 deaths(1 myocardial infarct, 2 septicaemia, 2 aortic haemorrhages) and 3 amputations. The treatment of choice for infected thromboendarterectomy cases is iliac exclusion coupled with either an obturator by-pass or a femoro-femoral vein graft using the perineal route. An infected prosthesis should be removed and circulation restored by means of an axillofemoral-bypass, or a femoro-femoral vein graft or a combination of the two. Occasionally an infected aorto-femoral prosthesis can be treated by removal of one limb only followed by obturator or axillo-femoral by-pass. The prophylactic value of omentopexy in aortoiliac surgery is emphasised.

Amputation, Surgical↗
PubMedDate not supplied

[Acute ischaemia of the colon. 23 cases (author's transl)].

Twenty three cases of acute ischaemia of the left side of the colon were seen between 1968 and 1978. The physiopathology is similar to that of acute ischaemia of the limbs and two major factors must be borne in mind : underlying arterial disease and a low systemic flow rate. Severe surgical forms may be associated with suggestive abdominal symptoms and signs (diffuse or localised peritonitis, febrile obstruction, abscess in the left flank) or there may be only a septicaemia, unexplained fever or diarrhoea. The diagnosis is based upon hydrop aque enema which shows characteristic appearances and is rarely a source of error. Only early diagnosis makes it possible to reduce the mortality below 50% in severe forms.

Acute Disease↗
PubMedDate not supplied

Surgical management of vertebral-basilar insufficiency.

The authors report 251 cases of lesions of the major branches of the aortic arch and the vertebral artery in 172 patients. A detailed account is given of the observed lesions (34 lesions of the innominate artery, 93 of the subclavian artery and 119 of the vertebral arteries), the techniques used and the indications for surgery. The use of the cervical approach seems to be justified in order to adapt the extent of cure to the patient's condition and accounts for the low mortality rate of 1.5%.

Adult↗
PubMedDate not supplied

[Aorto-arteriography of the lower limbs using carbon dioxide].

OBJECTIVES: Carbon dioxide is often used as a contrast medium for angiocardiography and has recently been proposed for peripheral arteriography. We therefore evaluated this method of opacification in comparison with iodine medium. METHODS: From December 1992 to February 1993, arteriographies using carbon dioxide contrast medium were performed in 13 patients (age range 57-83) with severe arteriopathies requiring revascularization: 2 aorta plus renal arteries, 2 aorta plus iliac and lower limb arteries, 9 lower limb arteries only. The intraarterial injections of carbon dioxide were delivered rapidly (< 20 sec) at a rate of 30 cm3/s (50 cm3/injection) for the aorta and 10-15 cm3/s (15-60 cm3/injection) for peripheral arteries. In 8 of the patients, control arteriographies were performed with iopamidol. RESULTS: The injections of carbon dioxide were well tolerated being painless in 12/13 patients. Digital subtraction images were satisfactory in 6, mediocre but conclusive in 5 and poor in 2. Images of distal arteries were the most difficult to interpret and images of the aorta were generally good. The low viscosity of carbon dioxide allowed the use of small 4F catheters. CONCLUSIONS: Carbon dioxide can be routinely used as a contrast medium, notably in diabetic patients, patients with renal impairment and those who are allergic to iodine based compounds.

Aged↗