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Biomedical subjects

M C Riché

Publications and source records attributed to M C Riché.

At least 19 recordsLinked to original sources
PubMed1998

Therapeutic approach to arteriovenous malformations of the tongue.

Arteriovenous malformations (AVM) are developmental errors with a high complication rate because they are hemodynamically active. The aim of our study is to evaluate management of the rare subgroup of tongue AVM. From 1982 to 1994, 25 patients with AVM of the tongue presented to our department. All patients were discussed in our multidisciplinary staff consultation and were treated by embolization, surgery, or were followed-up clinically with no intervention. Thirteen patients were asymptomatic in a hemodynamically quiescent phase and did not require any kind of intervention. The 12 others underwent embolization procedures following which 6 became stable, 2 had complementary surgery, 1 was lost to follow-up, 1 had two minor bleeding episodes without the need for hospitalization, and 2 were improved. Arteriovenous malformations of the tongue must be followed clinically and treated only if they become active. Permanent embolization with a polymerizing liquid administered through supra-selective catheterization or by direct puncture of the malformation is recommended.

Adolescent↗
PubMed1995

[Disabling calf pain in the context of venous angiodysplasia: Contribution of dynamic exploration].

We report the case of a 25-year old woman presenting with disabling pain of the left calf, associated with lower left limb angiodysplasia. Dynamic testing (duplex scan and phlebography) showed a popliteal vein ectasia, with reflux into an incompetent lesser saphenous vein: the venous drainage of this ectasia was an embryonic femoropopliteal vein going to the profunda femoris vein. As long as patency and competence of deep veins and of the superficial femoral vein were confirmed by dynamic testing with compressions, curative surgery was considered: en-bloc resection of lesser saphenous vein and of embryonic femoropopliteal vein combined with lateral suture of the popliteal vein. One-year follow-up confirms the absence of recurrent symptoms. Dynamic testing allows safe surgical therapy of persisting embryonic abnormalities associated with incompetent veins, in cases where such testing clearly demonstrates that a sufficient venous drainage of the affected limb will be provided after surgery.

Adult↗
PubMed1994

Vertebral arteriovenous fistulas: a study of 49 cases and review of the literature.

The experience is reported with 50 vertebral fistulas treated by the authors in a joint radiological and surgical team. Of the 28 fistulas that were traumatic, 18 occurred after incidental iatrogenic puncture, and 22 were spontaneous, of which four presented in patients displaying angiographic features of fibromuscular dysplasia. Eleven patients were operated on and 33 had endovascular treatment. In nine patients who were either symptom-free or in poor health, no treatment was advised. The fistula was occluded in 38 (93%) of the treated patients, and the vertebral artery patency was preserved in 32 (78%). A total of 224 published cases were reviewed: 152 were traumatic, most after a penetrating injury; 72 were spontaneous, with three age peaks (at 7, 26 and 52 years). Treatment has evolved considerably and endovascular occlusion is now the treatment of choice, surgery being reserved for specific indications.

Adolescent↗
PubMed1992

[Superficial venous malformations].

Mature vascular malformations of the venous compartment are haemodynamically inactive and persist throughout the patient's life. They have no systemic repercussions, except in patients with disorders of coagulation (e.g. disseminated intravascular coagulation), but they have local, cosmetic and functional repercussions. Percutaneous embolization, notably with Ethibloc, has modified their prognosis favourably. This simple and effective procedure is mainly used for superficial venous malformations of the face.

Angiomatosis↗
PubMed1992

[Lymphangioma].

The term lymphangioma applies to two types of vascular malformations with very different prognoses: cystic lymphangioma, a benign and easy to treat condition, and tissue lymphangioma, a deeply infiltrating lesion the course of which is sprinkled with complications which may be severe in some locations. Therapeutic sclerosis of cystic pouches with ethibloc gives excellent results and must be performed prior to any surgical treatment, but it is ineffective in tissue lymphangioma which requires a difficult and often maiming treatment. Both types of lymphangioma may coexist, each one following a different course.

Child↗
PubMed1992

Endovascular treatment of vertebral arteriovenous fistula.

The clinical and angiographic features of 46 vertebral arteriovenous fistulas (AVFs) seen during a 12-year period (45 patients) were reviewed. Fourteen patients were asymptomatic, with vertebral AVF discovered at routine clinical examination. Specific symptoms at presentation in the other patients were tinnitus (n = 21), vertigo (n = 6), neurologic deficit (n = 3), and pain (n = 2). Of the 46 AVFs, 19 (41%) were caused by trauma and 27 (59%) were spontaneous. The fistula was found at C-1 to C-2 in 21 (46%) cases, at C-2 to C-5 in five (11%), and below C-5 in 20 (44%). Thirty-four patients (35 vertebral AVFs) were treated with the endovascular technique. Embolization was performed with latex balloons filled with contrast medium in most cases. Endovascular therapy resulted in complete occlusion in 32 cases (91%) and partial occlusion in three (9%). The vertebral artery could not be preserved in three patients. Endovascular balloon treatment of vertebral AVFs is effective in occluding the shunt, avoids general anesthesia and surgical intervention, and results in minimal morbidity. Endovascular therapy is the treatment of choice for vertebral AVF.

Adolescent↗
PubMed1991

[Pseudo-Kaposi syndromes of vascular origin].

Pseudo-Kaposi's Sarcoma with vascular disease concern mainly acroangiodermatitis described by Mali--(with chronic venous insufficiency)--, arteriovenous malformations with angiodermatitis described by Stewart and Bluefarb, and pseudo-Kaposi's Sarcoma occurring after placement of arteriovenous shunt for hemodialysis. Search for relation ships between classical Kaposi's Sarcoma and new AIDS Kaposi's Sarcoma explains new interest devoted to Pseudo-Kaposi's Sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Persistant carotido-hypoglossal artery associated with atherosclerotic stenosis treated by venous bypass.

A 66 year-old woman presented with a tight but asymptomatic atheromatous stenosis in a persistant carotido-hypoglossal artery. Stenosis was documented by ultrasound Doppler tomography whereas the embryologic anomaly was disclosed by digital angiography. A successful venous bypass was done. Based on this case report, the diagnostic and therapeutic problems raised by such anomalies are discussed.

Blood Vessel Prosthesis↗
PubMed1985

Port-wine stains.

Explore the source record for details and available documents.

Arteriovenous Malformations↗
PubMed1985

[Angiographic and surgical control of the vertebral and carotid pedicles supplying giant paraganglioma of the skull base and neck].

Results obtained after excision of large jugular paragangliomas are largely conditioned by the possibility of control of the different vascular pedicles, and existing possibilities are discussed in relation to 6 briefly presented cases. The internal carotid artery can either be occluded radiologically by balloon catheter and then embolized if the artery is surrounded by a tumor, or controlled surgically if the artery is in contact with the tumor only and provides only a small proportion of its vascular supply. Whenever internal carotid artery occlusion is envisaged a clamping test by balloon under local anaesthesia is carried out initially. The vertebral artery pedicles are interrupted during surgical approach to the artery above the atlas. The value of a 2 or even 3 stage operation for excision of very large tumors with posterior fossa extension is discussed.

Adult↗
PubMed1982

Arteriovenous malformations (AVM) of the spinal cord in children. A review of 38 cases.

The cases of 38 children with AVM seen at the Lariboisière Hospital since 1962 are reviewed. The clinical picture was often of sudden onset with impairment of motor function and/or subarachnoid hemorrhage. The diagnosis was usually made by myelography, but spinal arteriography is the key examination, since it confirms the diagnosis and is essential to determine the exact location of the angioma: whether it is extramedullary, intramedullary, or mixed. Angiotomography and angiomyelography with magnification are necessary to determine if the lesion is median, compact, and if it has long sulco-commissural arteries, details which have an important bearing on the prognosis. Operation should be performed as soon as possible after its feasibility has been demonstrated angiographically. But embolization with new materials has also been effective, either associated with operation or as an alternative.

Adolescent↗