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J P Joris

Publications and source records attributed to J P Joris.

10 recordsLinked to original sources
PubMed2005

Practice variability in the management of subrenal arterial stenoses in seven Belgian hospitals.

This multicentre retrospective study describes the variation of therapeutic options, treatment outcomes and costs for treating subrenal arterial stenoses as observed in daily practice in 1997-99 in seven Belgian hospitals. Data were obtained from clinical record review and from the sickness fund claims database, and included preoperative functional state, presence of acute ischaemia, diabetes and polyvascular disease, state of the lower-leg run-off arteries, anatomical site and type of lesion, type of treatment, result at 30 days and up to 4 years. A total of 442 episodes were studied, but most analyses dealt with a subgroup of 240 lesions in the common iliac up to the superficial femoral artery. The proportion of surgical treatments (as compared to an endovascular or mixed approach) varied from 15% to 81% between the hospitals. In univariate patency analysis, relapse or failure rates at 4 years ranged from 5% for the common iliac artery to 35% for the superficial femoral artery. Polyvascular disease, a poor run-off, multiple stenoses and chronic occlusion were significant risk factors; age and diabetes were not. In the multivariate (stratified Cox regression) analysis, only a location in the superficial femoral artery and a poor preoperative clinical stage were significant risk factors, but type of therapeutic approach was not. The total average cost of treatment was 5,300 Euros, of which 15% was contributed by the patient. Surgery was associated with longer stays (median at 12 days) than endovascular treatments (median 2 days), and was 1.9 times more expensive. In conclusion, the results of the present study suggest that a multidisciplinary approach, orienting the patient to the most appropriate therapeutic pathway, could increase both the quality and the cost-effectiveness of the care.

Adult↗
PubMed1996

[Late diagnosis of a traumatic pseudo-aneurysm of the subclavian artery].

The authors report a rare case of subclavian pseudoaneurysm diagnosed six months after a left clavicular fracture. The leading symptoms were pain and claudication in the left arm related to peripheral embolization. The essential diagnosis was made by selective arteriography followed by arterio-CT. Peripheral embolization or brachial nerve compression are the most common presentations of subclavian pseudoaneurysms. To avoid such late complications, the authors emphasize the importance of the initial vascular examination of the shoulder after blunt trauma with or without clavicular fracture. Surgery is imperative and the use of autologous vein graft is the method of choice.

Adult↗
PubMed1993

[Infected urachal cyst].

There is a wide variety of pathologies associated with the presence of urachal remnants. We describe a case of infected urachal cyst in a young adult male, with classical symptoms of dysuria, lower abdominal pain, and fever. Ultrasound, cystography and CT are described, ultrasound being often the modality of choice. Differential diagnosis of acute abdominal and pelvic pain or a midline lower abdominal mass at this age should include infection of an urachal remnant.

Adult↗
PubMed1991

[Wegener's granulomatosis: breast localization].

The case of a 37-year-old patient with a history of Wegener's granulomatosis presenting with a right painless breast mass is reported. Breast mammography and sonography were poorly contributive and the inflammatory nature of the lesion was established by fine needle biopsy.

Adult↗
PubMed1990

[Endobronchial lipoma: a potential CT diagnosis].

Bronchial lipomas are rare and benign neoplasms. Computed tomography can provide a powerful adjunct to conventional modalities in determining the nature of an endobronchial lesion. The reflex vasoconstriction can also be nicely depicted.

Bronchial Neoplasms↗
PubMedDate not supplied

Acute renal failure requiring haemodialysis after high doses percutaneous acetic acid injection for hepatocellular carcinoma.

Recently, ultrasound-guided percutaneous acetic acid injection has been proposed in the treatment of hepatocellular carcinoma as an alternative to percutaneous ethanol injection. We report the case of severe renal failure requiring haemodialysis which occurred in a patient with 4 cm hepatocellular carcinoma treated adequately by high dose percutaneous acetic acid injection. The risk of such a serious side effect, likely related to a direct toxic effect of acetic acid, should be of concern when considering percutaneous treatment of hepatocellular carcinoma. Acute renal failure has been reported as a complication of acetic acid poisoning, but to our knowledge, we report here the first case of acute renal failure following high dose percutaneous acetic acid injection.

Acetic Acid↗
PubMedDate not supplied

Practice variability in the management of infrarenal arterial stenoses in seven Belgian hospitals.

This multicentre retrospective study describes the variation of therapeutic options, treatment outcomes and costs for treating infrarenal arterial stenoses as observed in daily practice in 1997-99 in seven Belgian hospitals. Data were obtained from clinical record review and from the sickness fund claims database, and included preoperative functional state, presence of acute ischaemia, diabetes and polyvascular disease, state of the lower-leg run-off arteries, anatomical site and type of lesion, type of treatment, result at 30 days and up to 4 years. A total of 442 episodes were studied, but most analyses dealt with a subgroup of 240 lesions in the common iliac up to the superficial femoral artery. The proportion of surgical treatments (as compared to an endovascular or mixed approach) varied from 15% to 81% between the hospitals. In univariate survival analysis, relapse or failure rates at 4 years ranged from 5% for the common iliac artery to 35% for the superficial femoral artery. Polyvascular disease, a poor run-off, multiple stenoses and chronic occlusion were significant risk factors; age and diabetes were not. In the multivariate (stratified Cox regression) analysis, only a location in the superficial femoral artery and a poor preoperative clinical stage were significant risk factors, but type of therapeutic approach was not. The total average cost of treatment was 5300 Euro, of which 15% was contributed by the patient. Surgery was associated with longer stays (median at 12 days) than endovascular treatments (median 2 d), and was 1.9 times more expensive. In conclusion, the results of the present study suggest that a multidisciplinary approach, orienting the patient to the most appropriate therapeutic pathway could increase both the quality and the cost-effectiveness of the care. In many clinical situations, the endovascular approach appears to offer similar long-term results as surgery, but at a substantially lower cost, both for the patient and for society, especially when performed in a (semi-)ambulatory radiology setting.

Aged↗