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M C Riche

Publications and source records attributed to M C Riche.

At least 19 recordsLinked to original sources
PubMed1993

Percutaneous embolization with Ethibloc of lymphatic cystic malformations with a review of the experience in 70 patients.

Cystic lymphatic malformations (CLM) are superficial vascular hemodynamically inactive malformations of the lymphatic compartment. We propose a new approach which uses a sclerosing agent as an alternative to surgical resection. In the past nine years we treated 70 patients with CLM. Fifty-five percent were younger than five years of age with a male preponderance and most (80%) of the CLM were located in the maxillofacial region. They usually presented with functional impairment from the mass effect; others had infections, bleeding, or inflammation. The CLM were injected under fluoroscopic control with a sclerosing agent, Ethibloc, which dries up the pockets and reduces the mass. On follow-up the results were good in 62%, unchanged in 5%, and continued progression in 20%. Fifteen percent underwent surgery failures (24%) occurred in mixed forms of cystic and cellular lymphangiomas. Complications were minors. Percutaneous embolization is useful for CLM, with minimal risk, absence of scar, and it avoids surgery. It should be the first line of treatment for these lesions.

Adult↗
PubMed1993

[Treatment of diabetic arteriopathy. Importance of transluminal angioplasty].

Results are reported of a retrospective analysis of transluminal angioplasty (TLA) interventions in 20 diabetic patients, 16 men and 4 women, mean age 56 years (range 32 to 82 years), with 24 dilated lesions, 16 patients having insulin-dependent diabetes. In 12 cases the lesions were at the intermittent claudication stage, trophic lesions being present in 8 cases. Stenotic lesions were iliac (12 cases), superficial femoral (2 cases), popliteal (6 cases) and tibial (4 cases). One patient developed an acute occlusion following popliteal-anterior tibial recanalization, the only direct complication of the angioplasty. Angiography showed immediate satisfactory results in 22 of the 24 dilated lesions. Functional and hemodynamic improvement was a constant finding in patients with intermittent claudication, trophic lesions being healed in 4 cases (50%) the other patient showing either no change or requiring an unavoidable amputation (2 cases). These overall findings suggest that at the intermittent claudication stage no differences exist in the results of TLA when compared with a non diabetic population; inversely, in the presence of trophic disorders, the local conditions (distal bed, infection, gangrene) interfere considerably in the course of the dilatation. Transluminal angioplasty should therefore be carried out as early as possible in diabetics; arteriography should be performed as soon as even minimal claudication appears and, a fortiori, even at the onset of a trophic lesion.

Adult↗
PubMed1992

[Cystic lymphatic malformations of the head and neck. Role of interventional radiology].

Cystic lymphatic malformations are hemodynamically inactive vascular malformations of the lymphatic compartment. Over a 9 years period, 52 patients with superficial cystic lymphatic malformations of the head and neck underwent embolization by direct injections of Ethibloc (Ethicon, Ethnon Laboratories, Neuilly/France) under fluoroscopic control. Results were graded as excellent or good in 57% of patients after embolization alone. Treatment was completed by surgery in 19% of patients. Embolization was considered a failure in 24% (12 patients), although 10 of these patients showed regression of the cystic component after embolization. This safe, efficacious percutaneous technique has emerged as the first treatment to be considered for cystic lymphatic malformations.

Child, Preschool↗
PubMed1992

[Hemangiomas and superficial vascular malformations: classification].

Superficial vascular malformations of the face, trunk and limbs are better known today, and they can be divided up into simple and complex vascular malformations. Simple vascular malformations may form five major categories: immature hemangiomas of infants, port-wine stains, capillarovenous angiodysplasias, and arteriovenous fistulae and malformations. Complex angiodysplasias are systematized (Sturge-Weber and Bonnet-Dechaume-Blanc syndromes, Cobb's metameric angiomatosis, Klippel-Trenaunay and Parkes Weber's syndromes) or disseminated (Weber-Osler-Rendu disease and blue rubber-bleb nevus syndrome). Various modalities of treatment may be contemplated, according to the type of malformations, and an interdisciplinary consultation is essential to decide whether a watch-and-wait policy, a physical method (laser), embolization, fibrosing injections, vascular, maxillofacial or plastic surgery, or a successive combination of various techniques should be resorted to.

Angiodysplasia↗
PubMed1992

[Exploration strategy for superficial vascular malformations].

Transillumination of cystic lymphangiomas, MRI of venous vascular malformations, pulsed Doppler and arteriography of arteriovenous malformations, echo-Doppler and radiomeasurement of malformations in the lower limbs are key examinations in the exploration strategy for superficial vascular malformations.

Adult↗
PubMed1991

Femoral infarction following intraarterial chemotherapy for osteosarcoma of the leg: a possible pitfall in magnetic resonance imaging.

Bone infarction of the distal femur is reported in two patients with osteosarcoma of the leg (1 tibia, 1 fibula) treated by preoperative chemotherapy including intraarterial chemotherapy (IAC) by Cis-platinum. Both patients were examined by magnetic resonance imaging before chemotherapy and again prior to limb salvage surgery. The location of these lesions in the distal femur must suggest bone infarction especially if the tumor has decreased in size under treatment.

Adult↗
PubMed1991

[Superficial vascular (arterial and venous) malformations: clinical aspects and complementary tests].

A simple and precise classification has been established during a ten-year international cooperation. There are two major groups: hemangiomas, always regressive; and vascular malformations, which never regress; they grow, throughout life, to varying degrees. Management of vascular malformations has been clearly defined. Capillary malformations do not require examination, unless they are associated with other anomalies, such as hypertrophic underlying bone, or the leptomeningeal vascular anomaly of the Sturge-Weber syndrome. Venous type malformations are diffuse, and consist of entirely anomalous channels, with low flow. CT scan and MRI clearly demonstrate the extent of tissue involvement in venous malformations; for these slow-flow malformations the evaluation is performed without resorting to invasive diagnostic techniques: phlebography is rarely performed, and arteriography is unnecessary. Arteriovenous malformations are dangerous high-flow vascular malformations, leading to skin ischemic necrosis, and congestive cardiac failure. Arteriography shows enlarged tortuous arteries, with arteriovenous shunting, and early venous drainage. CT scan and MRI show the deep components of the lesions. Doppler ultrasound evaluation is used to follow the course of the disease.

Arteriovenous Malformations↗
PubMed1990

Pelvic arteriovenous fistulas: therapeutic strategy in five cases.

Pelvic arteriovenous fistulas are rare. They may be defined as arteriovenous communications developing in the pelvis from the internal iliac artery, the origin of its posterior trunk or branches of its anterior trunk. Congenital arteriovenous malformations, more common in women, and posttraumatic arteriovenous fistulas are the two main etiological forms. Diagnostic problems include appreciation of visceral extension in arteriovenous malformations and precise localization of fistulas especially when they affect the internal iliac artery itself. Therapy is aimed at complete closure of arteriovenous communications using interventional radiologic methods or surgery. Although indications are difficult to assess, complete, one-stage therapy is preferable due to surgical difficulties following failed or incomplete radiological or surgical attempts.

Adult↗
PubMed1990

Management of alarming hemangiomas in infancy: a review of 25 cases.

During the past 10 years, 25 infants with alarming hemangiomas--lesions that impaired important functions and were life threatening, especially when there was visceral involvement--have been treated. A vascular mark was present at birth in 68% of these infants. Visceral hemangiomas were associated with bulky cervicocephalic hemangiomas or with small hemangiomas scattered over the body. Among the 25 infants, 12 had laryngeal hemangiomas, 3 had hepatic hemangiomas, and 1 had gastrointestinal hemangiomatosis. Ocular sequelae, malocclusion, and cutaneous distortion were the most important functional problems. Corticosteroid treatment was used for 23 of 25 infants with alarming hemangiomas. There was a varied treatment response: total failure (30% of the patients); excellent, dramatic, rapid improvement (30% of the patients); and moderate, doubtful response, with the natural course of the disease remaining unaltered (40% of the infants). Arterial embolization, used in 6 infants, gave inconstant results. Cardiac failure, frequently associated with large cutaneous hemangiomas and always seen with hepatic multinodular hemangiomas, required digitalization. In some cases arterial embolization reduced the increased cardiac output. Liver hemangiomas had a high mortality; all 3 infants with hepatic involvement died.

Adrenal Cortex Hormones↗
PubMed1988

[Study of the circle of Willis with digital angiography. Contribution to the detection of high-risk carotid clamping].

Radiological studies of Willis' circle morphology are mainly performed in search of intracerebral aneurysms, and for this purpose digital imaging has not superseded conventional radiology. In contrast, conventional imaging does not seem to have given satisfactory results in the functional study of this substitute vascular network, and it is in this field that digital angiography is of particular value. Between January, 1985 and June, 1986, we performed 300 digital angiographies of the supra-aortic vessels in patients with carotid artery stenosis. Each exploration included a stage of investigation for intracranial substitute vessels by compression of the carotid artery on the side of the lesion. Substitute vessels were found to be adequate in 93 p. 100 of the cases. The test showed that there was no alternative blood flow in 3.7 p. 100 of the cases, which made it imperative to use brain protection measures during clamping of the carotid artery. The substitute network was found to be insufficient in 1 p. 100 of the cases, and the method failed in 2.4 p. 100.

Carotid Arteries↗
PubMed1988

Direct arteriovenous fistula of the external carotid artery: treatment with detachable balloon.

Direct arteriovenous fistulas originating from the terminal branches of the external carotid artery constitute a rare form of facial vascular disorders. They are usually well tolerated and do not grow. Surgical removal or ligation of the fistula may be hazardous to the facial nerve or lead to aesthetic insult. Based on our experience in five cases treated successfully with detachable balloons, we propose this technique as an alternative to surgery.

Adult↗
PubMed1988

MR imaging of spinal cord arteriovenous malformations at 0.5 T: study of 34 cases.

Thirty-four patients with angiographically proved arteriovenous malformations of the spinal cord were studied between May 1986 and July 1987. Examinations were performed on a CGR 5000 Magniscan 0.5-T scanner with a surface coil in all cases, and multislices in both T1- and T2-weighted sequences were obtained in sagittal and axial planes. The results showed that MR can accurately diagnose all cases of intramedullary arteriovenous malformations, since transverse images were able to precisely locate the nidus within the spinal cord. Other types of spinal cord arteriovenous malformations were also studied (perimedullary fistulae and dural arteriovenous fistula), and the findings confirmed the value of MR in the characterization of these lesions as well.

Adult↗
PubMed1987

Long term follow-up of 43 pure dural arteriovenous fistulae (AVF) of the lateral sinus.

Forty-three patients with arterio-venous fistulae of the dura of the transverse sinus with a complaint of tinnitus are reviewed, with a follow-up of 12 months to 11 years. 34 patients were embolized, 2 treated surgically, and 7 were untreated. Embolization appears to have been beneficial. The frequently benign nature of this abnormality must be emphasized, and serious psychological study of the patient must be made before deciding on therapy.

Adolescent↗