PubMed Health⌕ Search

Biomedical subjects

Y Alimi

Publications and source records attributed to Y Alimi.

23 records · Page 2Linked to original sources
PubMed1993

[Prevalence of gastrocnemius vein insufficiency using color-coded Doppler ultrasound (modifications of the therapeutic strategy)].

The importance of morphologic and dynamic lesions of the gastrocnemius vein is underestimated. Color-coded Duplex scanning was performed in 483 patients with varicosities and 869 legs with some venous abnormalities were discovered. Two types of lesion on gastrocnemius veins were founded: incompetence and dilatation usually located on the medial gastrocnemius vein. In 29.34% of the limbs, a medial gastrocnemius vein incompetence was present and a dilatation in 15.42%. Medial gastrocnemius vein incompetence was associated with a mid calf gastrocnemius communicating vein incompetence in 25%. Physiopathological hypothesis could be drawn of our observations. Gastrocnemius veins when incompetent should be ligated flush to the popliteal vein. The high prevalence of gastrocnemius vein should be considered in the management of varicose veins and color-coded Duplex scanning routinely performed before surgery.

Adult↗
PubMed1992

Fibromuscular disease of the renal artery: a new histopathologic classification.

To evaluate the relationship between clinical, radiologic, and histopathologic features in various types of renal artery fibromuscular disease, the records of 37 patients operated upon for a total of 44 lesions of the renal artery (30 unilateral and seven bilateral) were retrospectively reviewed. Of these, 36 had hypertension associated with stenosis or aneurysm of the trunk or branches of the renal artery; one had aneurysm of the renal artery without hypertension. The histopathologic study included 38 arterial segments retrieved from 33 patients and underscored the difficulties in using topographic criteria to classify lesions. While all arterial aneurysms were associated with involvement of the media, more than one layer of the artery was involved in 65.7% of cases. Topographic forms, such as the perimedial type, were difficult to classify. Based on the study results, it appears essential to distinguish patients with fibrosis and smooth muscular hyperplasia (type I: 19 patients, 23 arteries) from patients with isolated fibrosis (type II: 14 patients, 15 arteries). In group II, preoperative hypertension was more long-standing (p less than 0.04), more lesions were extended distally (p less than 0.05), and the probability of recovery from hypertension at 52 months follow-up was lower. We have distinguished two different evolutive stages of fibromuscular disease of the renal artery, one characterized by fibrosis with smooth muscle hyperplasia and the second, associated with more severe prognosis, characterized by isolated fibrosis.

Anastomosis, Surgical↗
PubMed1992

[False anastomotic iliac aneurysms. How to detect them?].

We report about 5 iliac anastomotic false aneurysms that occurred in 4 patients 8 to 21 years (average 15.5 years) after aortoiliac prosthetic reconstruction. The diagnosis was not established at once because of atypical clinical signs, in spite of the constant presence of an abdominal pulsating mass. All patients were operated by portal excision and graft replacement. One patient, who had presented with a hypovolemic collapse due to an acute rupture, died. The incidence of iliac false aneurysms after aortoiliac reconstructions is underestimated because the clinical surveillance is not reliable. The analysis of the explorations that were proposed led to prefer computed tomography to ultrasonography and angiography. The period of occurrence of iliac false aneurysms ranges between 6 to 10 years in average after the first operation. We therefore propose to perform a systematic follow-up CT examination on the 5th postoperative year, then every 5 years, and to operate the iliac false aneurysms as soon as their diagnosis is made.

Aged↗
PubMed1990

Occlusive disease of the renal arteries and chronic renal failure: the limits of reconstructive surgery.

In order to investigate the value of renal revascularization in patients with chronic renal failure and associated occlusive lesions of the renal arteries, the long-term results of 48 revascularizations in 43 patients operated upon between January 1980 and May 1988 were analyzed. There were 36 men and 7 women whose mean age was 61.8 years (range 36 to 79 years). The diagnosis of kidney failure was based on serum creatinine levels greater than 120 micromoles/L on two consecutive determinations. Patients were divided into four groups: Group I (23 patients) had a creatininemia between 120 and 200 mumoles/L, Group II (16 patients) between 200 and 350 mumoles/L, Group III (2 patients) between 350 and 800 mumoles/L and Group IV (2 patients) who had chronic renal failure requiring hemodialysis. Hypertension was found in 37 patients. Renal artery restoration was unilateral in 38 patients, 12 of whom had a solitary kidney. Restoration was bilateral in five patients. In 24 patients, renal artery surgery was associated with reconstruction of the infrarenal aorta. Three patients undergoing associated aortic procedures (7%) died after surgery. Thirty-nine patients were followed for a mean of 35.1 months; one patient was lost to follow-up. Improvement or stabilization of renal function was noted in 24 patients (62%). Deterioration was found in 15 patients (38%), six of whom presently required chronic hemodialysis. In Groups I and II, 69.5% of patients stabilized or improved their kidney function. Renal function worsened in all patients in Groups III and IV. We conclude that restorative renal surgery can improve renal function in patients whose preoperative serum creatinine levels are less than 350 mumoles/L. In this population of patients, associated aortic restoration should be performed only when absolutely necessary.

Adult↗