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Biomedical subjects

P Raymond-Martimbeau

Publications and source records attributed to P Raymond-Martimbeau.

5 recordsLinked to original sources

The Bulletin of the North American Society of Phlebology. Insurance Advisory Committee Report.

The treatment of varicose veins as taught within the specialty of phlebology consists of the best combinations of sclerotherapy and surgery after a thorough evaluation by physical examination and Doppler ultrasound, as well as other techniques. Although patients can experience some relief of symptoms by external compression hosiery, only treatment that closes up leaky valves will stop the progression of disease. Sclerotherapy is a safe, well-accepted, non-investigational, highly effective method to treat abnormally enlarged veins. Surgical procedures may be necessary to supplement sclerotherapy in certain anatomic sites. Varicose veins cause patients to experience pain, lose time from work, and can ultimately lead to permanent disability. Our healthcare system must provide the most high quality cost effective care for these patients. By keeping costs down as compared with full-scale surgical procedures, the approach of sclerotherapy or sclerotherapy with outpatient surgery, performed by properly trained physicians, provides a means to accomplish this. Medical necessity criteria allow exclusion of payments for patients seeking treatment purely for cosmetic needs.

Cardiology

[Endovascular echography].

The author reports data obtained by endoluminal pre and post-therapeutical ultrasound imaging of the wall architecture and lumen morphology of the arteries and varicose veins. In these studies, 20 and 25 MHz probes were used. These probes were covered with a 1 to 1.6 mm diameter flexible catheter and were introduced into the lumen of the vessels. Then, the probe was mechanically oriented in order to give, in cross-sectional section and real time, 360 degrees 2D images. The anatomical elements of the vessel wall and lumen, visualized with this technique, were described. The intima and adventitia appeared as echogenic structures while the media appeared as a non echogenic structure. The characteristics of endoluminal reactions such as atheromatous plaque, stenosis, thrombogenic and sclerogenic reactions were described. In conclusion, endovascular ultrasound imaging shows, accurate images of the morphology and dynamics of the arterial and venous vessel lumen and wall. This new technology can be used helpfully before, during and after vessel medical or surgical treatment.

Blood Vessels

Two different techniques for sclerosing the incompetent saphenofemoral junction: a comparative study.

A study comparing two methods of sclerosing the saphenofemoral junction (SFJ) that included 2186 patients was conducted. In the first method, injections were made below the junction with digital pressure applied at the SFJ, with the patient in a sitting position. In the second, injections were made below the junction with digital pressure at the SFJ and below the injection site, with the patient in a standing position. The results indicated that higher saphenous sequestration with the patient in a standing position is a valuable sclerotherapy technique.

Adult

[Intravenous ultrasonography].

The author used in vivo endovenous ultrasonography to study the architecture and dynamics of varicose veins of the lower limbs. In this study, segments of the great saphenous vein were examined, before and after sclerosing injections, using a miniaturised 20 mHz ultrasound probe. This probe incorporated in a 1.6 mm diameter flexible catheter was inserted into the varicose vein. The probe was then pivoted mechanically in order to obtain, in transverse section and in real time, 360 degree two-dimensional venous images. The anatomical structures of the wall, lumen and venous valves were visualised. The layers of the vein wall, the intima and adventitia, were seen to be echogenic structures while the media was an anechogenic zone. The spread between valve cusps, endoluminal diameter and the thickness of the layers of the vein wall were measured. It is concluded that endovenous ultrasonography provides precise images of the morphology and dynamics of valves, lumen and vein wall. This new technique is useful before, during and after the treatment of venous diseases by sclerosing injections or surgery.

Humans

[Sclerotherapy of the internal saphenous vein in the standing and sitting position. A comparative study].

A study was undertaken to compare two methods of sclerosing injection of the sapheno-femoral junction (SFJ). The study involved a sample of 2186 patients. In the first method, with the patient in sitting position, injections were administered below the junction with digital compression applied directly to the SFJ. In the second method, with the patient in standing position, injections were administered below the junction with digital compression applied directly to the junction as well as below the injection site. Results showed that sequestration of the proximal saphenous segment with the patient in standing position is a valid technique for the treatment by sclerosing injections of incompetence of the long saphenous.

Adult