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Biomedical subjects

M Hoehne

Publications and source records attributed to M Hoehne.

8 recordsLinked to original sources
PubMed1986

[Arterial complications following surgery or sclerotherapy of varices].

Surgical treatment of varicose veins occasionally can be followed by severe limb ischemia either after surgery or sclerotherapy. We report here two cases with the clinical features and the therapeutic strategy. The first case concerned a woman operated by venous stripping. A post-operative acute ischemia occurred and was treated by femoro-femoral bypass and lumbar sympathectomy. However this procedure did not avoid persistent chronic ischemia, sciatica paralysis and equinus ankle blockage. A secondary arterial procedure associated with intensive physiotherapy and ankle arthrodesis led to a poor functional result, partly because of an irreversible algodystrophia. The second case concerned a woman treated by sclerotherapy. An injection of the drug in the retro-malleolar area was immediately followed by an acute foot ischemia. Heparin, xylocaine and sodium nitroprusside perfusion avoided a foot amputation, however osteoporosis and algodystrophia occurred. A sympathectomy was necessary two years later. These dramatic complications although unusual, may occur even with experienced physicians. Therefore a great attention is always necessary during these simple procedures. In case of acute ischemia, early diagnosis and aggressive treatment are necessary, but prevention remains more secure.

Arterial Occlusive Diseases↗
PubMed1986

[Nonatheromatous degenerative aneurysm of the popliteal artery in a young adult female].

A degenerative non atheromatous popliteal aneurysm was observed in a 32 year old woman. At microscopical examination of the aneurysmal shell, the internal elastic-lamina and the muscular fibers of the media appeared to be replaced by a thick acellular collagen layer. No other arterial abnormality was found on a complete arteriography and the etiological screening failed. Therefore the aneurysm was classified as an arterial dysplasia. As far as we know, only two similar cases were previously reported in the literature. The true nature of these lesions remain unknown.

Adult↗
PubMed1985

[Severe ischemia caused by femoro-popliteal thrombosis. Endarterectomy using a pneumatic oscillator].

Autologous saphenous vein bypass is the best treatment for severe ischemia with femoro-popliteal thrombosis. But in over 20% of cases a vein is not available. Patency rates after prosthetic grafts are low. Therefore we have tested femoro-popliteal endarterectomy with the Hall arterial oscillator. This instrument is composed of loops (size: 5-12 mm) and of a pneumatic oscillator. All the length of the artery has to be exposed. The endarterectomy is started with a spatula and is then performed with the oscillating loops. Three arteriotomies are usually necessary to remove the total core. After the arterial vacuity has been checked, the distal intima is tacked down and the arteriotomies are closed with or without a venous patch angioplasty. Thirteen patients have been operated on. All of them were high risk patients. They were submitted to surgery for rest pain, distal gangrene or acute ischemia. During the post-operative period, one death and 4 thromboses occurred, the latter leading to major amputation with two subsequent deaths. Early results of the 8 other patients were good. Mean follow-up was ten months. Limb salvage was achieved in 7 patients out of 8,6 of them with patent artery and 1 with an occluded artery. Run off was an essential condition for patency. The best results were achieved when distal arteries were patent. But some success occurred in spite of a poor run off. This technic is an useful and money saving alternative for severe ischemia associated with femoro-popliteal thrombosis when autologous vein is not available.

Aged↗
PubMed1983

[True and false radiation arteritis].

Radiation therapy seldom induces large arteries injuries. When it occurs, their consequences are serious and their treatment is difficult. In six patients, arterial disease followed radiotherapy with cutaneous and subcutaneous fibrosis. Three were located on the carotid arteries and three in the aorto-iliac vessels. In four cases, radiation was the main causal factor; in one case it was one of the contributive factors; in the last case it was nothing else than an association. In all cases, surgical treatment was difficult because the cutaneous, subcutaneous and periarterial fibrosis. Radiation effects induced risks of cutaneous unhealing, anastomotic rupture and arterial infection. The carotid arterial stenosis were cured in one patient by two gore-tex bypass from the aorta to the carotid arteries and in the two others by three venous bypass from the common carotid arteries to the internal carotid arteries. The aorto-iliac obliterations were treated by different methods: one by-pass from the thoracic aorta to the deep femoral arteries, one aorto-bifemoral bifurcation and one medical treatment in a patient with poor condition. All patients have good results several years after treatment.

Aged↗
PubMed1983

[Evaluation of the extension of iliac or iliocaval phlebitis. Value of tomodensitometry].

Before operating on a case of iliac or ilio-caval phlebitis with or without pulmonary embolism, three questions need to be asked about the condition of the inferior vena cava: is it involved? is there a local cause? where is the superior pole of the thrombus in relation to the renal veins? The study of 10 cases of recent phlebitis benefitting from phlebography and C.T. scan reveals the value of this investigation. In 7 cases the condition of the lumen of the inferior vena cava was defined and in the 3 cases in which it was thrombosed, the position of the thrombus in relation to the renal veins was visualised. In 2 cases, the inferior vena cava was laminated by an extrinsic compression which was defined by the C.T. In only one case was the vena cava not seen, due to the presence of a large collateral channel. The indications for C.T. scan should remain selective: cases where direct ilio-cavography is impossible and where descending cavography is undesirable or impossible.

Humans↗
PubMed1983

[Persistence of an embryonic hypoglossal artery. Apropos of a case].

Persistence of an embryonic hypoglossal artery, discovered during exploration of an atheromatous carotid artery stenosis, is a rarely observed anomaly that results from an embryologic slip during closure of basilo-carotid communications. Encephalic protection must be ensured during treatment of such lesions, and the establishment of a shunt during operation has to be considered.

Arteriosclerosis↗