Biomedical subjects

M Nonent

Publications and source records attributed to M Nonent.

28 records · Page 2Linked to original sources

PubMed1997

Successful surgical treatment of intraorbital arteriovenous malformations: case report.

OBJECTIVE AND IMPORTANCE: Cases of intraorbital arteriovenous malformations are rare, and their management presents a challenge for multidisciplinary teams. CLINICAL PRESENTATION: A 39-year-old woman developed a pulsating exophathalmos, visual loss, and ocular pain within 1 month, revealing the presence of intraorbital arteriovenous malformations. She underwent only surgical treatment. INTERVENTION: A fronto-orbital approach with removal of the orbital rim was performed. A CO2 laser facilitated all the surgical steps. CONCLUSION: Full recovery of vision and correction of the proptosis have been achieved, and postoperative magnetic resonance imaging and angiography confirmed the total removal of the malformations. The literature is reviewed regarding the management of such lesions. Surgery remains the treatment of choice. The role of embolization is discussed.

Adult↗

PubMed1997

[Pulmonary embolism and unusual deep venous thrombosis. Report of two cases].

Contrast venography is the gold standard for the diagnosis of deep vein thrombosis in the lower limb extremities, but it fails to visualize deep veins like deep femoral vein and internal iliac vein. The internal iliac can be examined with duplex scanning if the technique and the examination conditions are correct. As reported in these two cases, thrombosis of these deep veins may lead to pulmonary embolism. The first case is a young female with venous thromboembolic disease in whom internal iliac vein thrombosis was documented only at the second examination. In the second case, deep femoral vein thrombosis appeared early in a comatose young male. This thrombosis may be classified as proximal muscular vein thrombosis. These two cases emphasize the importance of a duplex scanning examination performed with rigorous technique, whose the main limitation being examination conditions.

Adult↗

PubMed1996

[Endovascular treatment of traumatic and iatrogenic intrarenal arterial lesions by microcoil embolization].

Selective embolization is the best treatment for intrarenal arterial lesions due to trauma or percutaneous procedures with non-controlled or recurrent haematuria. Three male patients, aged 20-70 (mean 49 years), were recently treated in our institution by means of arterial embolization with microcoils. Two patients presented a pseudo-aneurysm and an arterio-venous fistula secondary to percutaneous nephrolithotomy and one patient presented an isolated pseudo-aneurysm due to trauma. In the 3 cases, haematuria (associated with retroperitoneal haemhorrage in one case) was not controlled and required repeated units of blood. Embolization allowed definitive treatment of these lesions. One of our patients with a solitary functional kidney presented rapidly increasing renal failure which completely resolved after arterial embolization. We think that microcoils are the embolic agents of choice to perform endovascular treatment in this indication.

Adult↗

PubMed1995

[Pulmonary embolism and the level of thrombosis. A prospective study of 155 patients].

This study was designed to assess the risk of associated pulmonary embolism according to the level of deep venous thrombosis. From March 1992 to March 1994, 328 patients were referred to medical units for suspected deep venous thrombosis, with recent clinical signs, less than a week. Each patient underwent contrast venography and/or duplex ultrasounds of lower extremities, ventilation and perfusion lung scan within 48 hours and angiography in case of low or intermediate pulmonary embolism probability. Diagnosis of deep venous thrombosis was confirmed in 155 patients; location was distal in 41, proximal in 114; an associated pulmonary embolism was found in 66 patients (10 with distal, 56 with proximal deep venous thrombosis); odds ratio was 2.99 (95% Cl: 1.2-3.13). Significantly higher risk of associated pulmonary embolism when deep venous thrombosis involves proximal veins is confirmed, but as many as 10 out of 41 patients with distal thrombosis also had an associated embolism. Management of both distal and proximal deep venous thromboses appears identical.

Aged↗

PubMed1995

[Duodenal leiomyosarcoma. Apropos of a case].

The authors report a new case of leiomyosarcoma of the duodenum. The exoluminal growth and the volume of this tumor explain the difficulties of the imaging methods diagnostic. Computed tomography, magnetic resonance imaging and angiography were not sufficient to determine the origin of the tumor. Surgical exposure itself was not conclusive and only pathology provided the definitive diagnosis. We think that endoscopic ultrasonography should be indicated in these submucosal tumors of the duodenum to differentiate them from pancreatic neoplasms.

Aged↗

PubMed1994

[Retroperitoneal lymphocele: a rarely reported complication of abdominal aortic surgery. Apropos of a case].

The authors present a case of a retroperitoneal lymphocele following prosthetic reconstruction of the abdominal aorta followed by a discussion about the principal differential diagnosis of a retroperitoneal collection following surgery on abdominal aorta. To date, only ten cases have been reported in this post-operative; it is probably a more frequent complication; the radiologist must play a major role both in the detection and the treatment of such collections.

Aortic Aneurysm, Abdominal↗

PubMed1991

[3-dimensional reconstruction of x-ray computed tomographic views in fractures of the acetabulum].

In 21 cases of acetabulum fractures of 19 patients, the authors compare the findings given by three dimensional reconstructions of axial CT scan cuts with the plain films. The number of CT scan cuts is reasonable for each patient. Working time is about 20 to 30 minutes for the technician. In the cases of complex and displaced fractures, three dimensional imaging brings often decisive informations for the therapeutic management of these patients. Unusual views are often allowed but completely adapted to each type of fracture.

Acetabulum↗

PubMedDate not supplied

Multi-detector row computed tomography angiography: an alternative imaging method for surgical strategy in lower extremity arterial occlusive disease.

In order to show the value of CT angiography in the pretherapeutic assessment of lower leg ischemia, we studied 93 CT angiographies in 85 patients. Two groups were defined according to the level of revascularization: 52 angioscanner were made prior to suprainguinal revascularization and 41 prior to infrainguinal reconstruction. Two decision attitudes were chosen by two different physicians, a radiologist and vascular surgeon, members of the same team. The attitudes where then compared in order to evaluate the value of CT angiography. The first attitude was a pragmatic strategy based on the images as interpreted by the first physician and on the intraoperative information including surgical treatment and, if necessary, angiography. This indicates that the results of this attitude cover the performed revascularizations. The second attitude determined a virtual strategy and was chosen by the second physician a posteriori, based solely on the medical file with the same CT angiography images. These two strategies were compared in order to assess the agreement on the level of the lesion and the choice of revascularization. In 84 CT angiographies (90.3%), the analysis of the lesions and the choice of lesions to be treated were identical. In 9.6% of scans the strategies were not comparable because the lesions were interpreted differently or the scans were difficult to read. The sensitivity of CT angiography in detecting lesions and guiding the therapeutic strategy was 96% and its positive predictive value was 93%. Follow-up was reported according to the life-table method to assess the overall outcome and the results in both groups. The overall survival rate at 12 months for 85 patients was 90%. Secondary patency rates at 12 months in the group of patients who underwent a suprainguinal and infrainguinal revascularization were 98% and 71% respectively. Overall limb salvage at 12 months was 94%. In this setting, CT angiography allowed us to select adequate treatment in the majority of cases. These results obtained after a strategy based on CT angiography images are comparable with the results as published in the literature after the strategy based on conventional angiography.

Adult↗

PubMedDate not supplied

CT appearances of ossicular injuries.

Trauma of the ossicular chain is a frequent complication of temporal bone injury. Skull trauma from blows to the temporal, parietal, or occipital region (with or without fracture of the temporal bone) is the main cause of ossicular injury; other modes of injury are rare. Ossicular injury usually occurs as a dislocation, of which there are five types: incudostapedial joint separation, incudomalleolar joint separation, dislocation of the incus, dislocation of the malleoincudal complex, and stapediovestibular dislocation. Fracture of the malleus, incus, or stapes is uncommon. High-resolution computed tomography is the method of choice for evaluation of ossicular trauma. Joint separation and fracture of the stapes are seen on axial images; coronal images may aid visualization. Both axial and coronal images are needed for evaluation of a dislocated malleus or incus. Fracture of the malleus or incus is detected with axial or coronal images; reformatted images may also be useful.

Adolescent↗

PubMedDate not supplied

Early versus delayed introduction of oral vitamin K antagonists in combination with low-molecular-weight heparin in the treatment of deep vein thrombosis. a randomized clinical trial. The ANTENOX Study Group.

OBJECTIVE: To compare oral anticoagulant treatment (fluindione) started on either the 1st or the 10th day of a low-molecular-weight heparin (enoxaparin) treatment for deep vein thrombosis confirmed by venography. DESIGN: An open, multicenter, randomized study in two parallel treatment groups. INTERVENTIONS: All patients received enoxaparin, 1 mg/kg s.c. twice daily, and oral fluindione, 20 mg once daily, either beginning on day 1 or on day 10 of the enoxaparin treatment. Enoxaparin was discontinued once the international normalized ratio under fluindione was stable between 2.0 and 3.0 over 2 days. Fluindione treatment was maintained during a 3-month follow-up period. OUTCOME MEASUREMENTS: Specific examinations (venography and/or V/Q lung scanning and/or angiography) were performed only in the event of a clinically suspected recurrence of venous thromboembolism during the 3-month follow-up period. All cases were blindly assessed by an independent Reading Committee. RESULTS: A clinically suspected venous thromboembolism was confirmed by objective tests in 1 of 223 patients (group of delayed introduction of fluindione; n = 111). Equivalence was demonstrated between the two treatment schedules (p < 0.0001) for a maximal difference of 10% (90% confidence interval: -2.42 to 0.58). The mean duration of hospitalization was significantly reduced (p = 0.0001) in the group with early introduction of fluindione. The incidence of hemorrhage was comparable between the two treatment groups. CONCLUSION: Early and delayed introduction of oral anticoagulant treatment in association with subcutaneous enoxaparin in patients with deep vein thrombosis was shown to be equivalent in preventing the recurrence of venous thromboembolism. In patients with early introduction of oral anticoagulant, hospitalization was significantly reduced.

Administration, Oral↗