[Phlebitis of the lower limbs. Which is the test of first choice today, Doppler echography? Phlebography?].
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Acute Disease↗
Biomedical subjects
M Piotin
Publications and source records attributed to M Piotin.
Endovascular treatment of a cervical paraspinal arteriovenous malformation via arterial and venous approaches.
We describe a cervical congenital paraspinal arteriovenous malformation (AVM) drained by paraspinal and epidural ectatic veins, which caused massive erosion of the C6 and C7 vertebral bodies, threatening the cervical stability and necessitating treatment. During the first session, six arterial embolizations were performed to reduce the size and the flow of the AVM. Two months later, a venous approach was used to occlude the remnant venous exit of the AVM and achieve a complete cure. All embolizations were performed using N-butylcyanoacrylate.
Angiography, Digital Subtraction↗
Delayed stroke secondary to increasing mass effect after endovascular treatment of a giant aneurysm by parent vessel occlusion.
A 47-year-old woman, who had lost vision in her left eye because of a giant left supraclinoid internal carotid artery aneurysm, was referred for endovascular treatment. Parent-vessel occlusion was performed to obtain circulatory exclusion of the aneurysm. Eight days after treatment, she became hemiparetic and dysphasic. Repeat angiography showed compression of the left middle cerebral artery by the swelling giant aneurysm. Preventive measures should be taken to avert worsening of mass effect when giant aneurysms become thrombotic.
Carotid Artery Diseases↗
[Persistent value of intra-arterial fibrinolysis 8 hours or more following central retinal artery occlusion or of its branches].
PURPOSE: To establish that intra-arterial fibrinolysis of the ophthalmic artery can still be efficient 8 hours or more after a central retinal artery occlusion. MATERIAL AND METHODS: Nine to twenty hours (average 12.5 H) after a loss of vision due to a central retinal artery occlusion or the occlusion of its branches, 7 patients were treated by intra-arterial fibrinolysis. The vision of the affected eye was limited to light perception for four patients, to hand movement at 1 meter for two patients, and to 4/10 P2 for one patient. Under radiological guidance, 300.000 IU of urokinase was injected through a microcatheter placed in the ophthalmic artery (6 patients), or in the facial artery (1 patient); in this case the angiogram showed an occlusion of the internal carotid artery and a retrograde filling of the ophthalmic artery through the facial artery. RESULTS: We did not observed any complication. The 3 patients who had a vision better than light perception recovered a vision of 10/10 P2. For the others: two patients recovered a vision of 9/10 P2 and 5/10 P2, two did not recover. CONCLUSION: Fibrinolysis of the ophthalmic artery must ideally be performed as soon as possible, but a recovery is still possible more than 8 hours after the onset of the loss of vision. The time limit is not yet defined but after 24 hours, the chance of improvement seems to be very low.
Adult↗