[Percutaneous transluminal angioplasty for vascular access in hemodialysis. Apropos of 53 operations]. / Angioplastie transluminale percutanée des abords vasculaires des hémodialysés. A propos de 53 interventions.

Percutaneous transluminal angioplasty as stenosis treatment in hemodialysis arterio venous fistulae. About 53 cases. Percutaneous transluminal angioplasty was used 53 times to dilate 75 stenoses in 37 hemodialysed patients. Rate success was 85% without vascular access loss. This kind of surgery is atraumatic and permits a future "opened surgery".

[The sapheno-femoral area: Anatomic study and concepts for the prevention of varicose recurrences]. / Le carrefour saphéno-fémoral: étude anatomique et concepts de prévention des récidives variqueuses.

The rate of varicose recurrences from the groin after stripping of the long saphenous vein is still high in case of ligation flush with the femoral vein. Is it due to a vascular neogenesis or to the development of pre-existing collaterals? Many authors highlighted the necessity of the femoral vein dissection, but the evaluation of the recurrence risk remains uncertain. 114 patients have been operated consecutively in 1988-1989 under local anesthesia, to perform 150 long saphenous vein strippings. At the same time as the sapheno-femoral junction ligation, a dissection of the front and lateral sides of the femoral vein was systematically carried out from 1 cm above down to 3 cm below the saphenous junction. 14 sub-fascial collaterals going directly to the junction lower angle (frequency rate = 9,3%), 41 internal tributaries of the femoral vein on the whole length of the junction (27,3%), 19 antero-internal (12,6%) and 14 antero-external (9,3%) tributaries of the superficial femoral vein below the junction, capable of draining a superficial area, were noticed in the 150 saphenofemoral areas. Several collaterals might exist on a same femoral vein. Only 86 (57,3%) sapheno-femoral junctions were "isolated", i.e. without deep collaterals. 90% of the antero-internal collaterals were located from 0 to 15 mm below the junction and their diameter was from 1,5 to 3 mm (in supine position, i.e. without any orthostatic reflux !) in 78,9% cases. All the antero-external collaterals were located from 10 to 30 mm below the junction, but they were nearly always equal or less than 1 mm wide.(ABSTRACT TRUNCATED AT 250 WORDS)

[A critical study of the penile Doppler test. Considerations apropos of a personal series of over 850 patients tested for the evaluation of impotence since 1983]. / Etude critique de l'examen Doppler pénien. Réflexions à propos d'une série personnelle de plus de 850 patients examinés pour bilan d'impuissance depuis 1983.

The penial Doppler is, in 1990, the first intention examination the most asked for when there is a suspicion of a vascular origin in an erection problem. In fact, due to the technical difficulties to carry it out, this examination presents many uncertainties in its interpretation, and can even be the source of diagnostic errors. The aim of this study is to argue in favour of a systematic intracavernous injection of 8 mg of papaverine when the penial Doppler is carried out, enabling an increase in its diagnostic value and often a therapeutic orientation straightaway.

[Arterial recanalization using the laser. A technic for the future?]. / Désobstruction artérielle par laser. Une technique d'avenir?

On the basis of two years' experience, a technique for the use of percutaneous endoluminal continuous emission Nd-YAG laser has been developed for arterial recanalisation. The effectiveness of this type of laser has been demonstrated in a large number of clots and atheromatous plaques, including calcified plaques. A balloon catheter gives a coaxial position of the fiber in center of the artery. Infusion of a blood solution containing 3 g of haemoglobin/100 ml at a rate of 20 ml/minute limits the thermal parietal lesions, improves the conditions of laser treatment and eliminates any risk of arterial perforation. No embolic debris is collected down-stream. Recanalisation of long arterial segments in amputated legs was performed prior to the human application. Ten patients have been treated with no mortality and virtually no morbidity. The narrowness of the reformed arterial lumina resulted in early re-thrombosis in the first 5 cases, requiring balloon modelling to ensure patency with a follow-up of 1 to 3 months in the 5 following patients.