[Axillary-subclavian injuries. Apropos of 11 cases. Procedural problems]. / Les traumatismes axillo-sous-claviers. A propos de 11 observations. Problèmes tactiques.

Tactical problems raised by treatment of injuries involving the axillary-subclavicular region were studied by analysis of 11 cases treated in a Grenoble hospital since 1975. The majority of patients had multiple injuries, and it was possible to perform pre-operative angiography in all cases. Lesions involving the mobile post-vertebral segment of the subclavian artery were treated by pre-sternocleidomastoid cervicotomy through a deltopectoral approach enlarged in L. Functional prognosis was related to the frequency and severity of associated neurological lesions.

[Lateroterminal arteriovenous fistula with "safety valve" for haemodialysis (author's transl)]. / Fistule artério-veineuse latéro-terminale "avec soupape" pour hémodialyse.

We describe a new type of arteriovenous fistula for haemodialysis, aimed at controlling arterial spasms which contribute to thrombosis. A laterolateral fistula is created, and the artery is sectioned below the anastomosis. A Fogarty catheter inserted through this "safety valve" relieves the spasm without interfering with the arteriovenous shunt. Mere ligature of the distal segment of the artery transforms the fistula from terminolateral into terminoterminal.

[The respective roles of surgery and physiotherapy at the stage of intermittent claudication (author's transl)]. / Place respective de la chirurgie et de la rééducation au stade de la claudication intermittente.

The choice between rehabilitation and surgery must be made for each case after attentive consideration, and depends largely on the experience and the means of each therapeut. The proximal level represents the best field for surgery, above all in the case of instable or embolized atheroma. At medial level, both therapeutics may be discussed. At distal level, surgery is seldom indicated apart from lumbar sympathectomy. Practically, rehabilitation is most often indicated alone or associated with surgery.

[Our experience of mesenterico-caval anastomosis with prosthetic interposition (report of 30 cases) (author's transl)]. / Notre expérience des anastomoses mésentérico-caves avec interposition prothétique 30 observations.

The authors report their experience of 30 mesenterico-caval anastomoses with prosthetic interposition according to Drapanas's technic. From the point of view of the operative indications, they have never carried out a prophylactic operation. In 19 cases, the operation was carried out as an emergency for inefficacy of the medical treatment. In 11 cases, a cold operation was performed, either to prevent eventual hemorrhagic recurrence (8 cases) or for chronic ascites (3 cases). Half the patients belonged to group C with a poor surgical risk. There was only one case of post-operative thrombosis due to a technical error, and two cases of secondary thrombosis. The overall mortality was 60%. But when the patient was of group A or B the mortality was only 20%. The survivors are those in whom the operation was rapid and the blood loss minimal. To conclude, the authors the necessity of better selection of patients, and rapid operation without bleeding.

[Isotopic angiography. Method of early post-operative control in peripheral vascular surgery. Report of 200 cases (author's transl)]. / L'angiographie isotopique. Méthode de contrôle post-opératoire précoce en chirurgie vasculaire périphérique. A propos de 200 cas.

The authors report their experience of isotopic angiography as means of post-operative control in peripheral vascular surgery in 200 cases. This investigation is very simple and non-traumatic. It gives very satisfactory morphological information and a good idea of the hemodynamics of the acts carried out.

[Repair problems of infected iatrogenic lesions of the femoral trifurcation. Review of 7 cases (author's transl)]. / Problèmes posés par la réparation des lésions iatrogènes surinfectées du trépied fémoral. A propos de 7 observations.

The authors report on seven cases of infected iatrogenic lesions of the femoral trifurcation. One case was a false aneurism consecutive to a femoral vein catheterization. In 5 cases an arterial lesion followed angiography according to Seldinger. In the last case aetiology was undetermined. Local symptomatology was always associated to systemic infection. The causative germ was a pseudomonas in 3 cases an a staphylococ in 4 others. Operation was performed in emergency in all cases because of a fissure or a rupture of the artery. The authors performed: one simple arterial suture, one resection with plastic graft, one resection with venous graft and 4 resections with double vein graft. This last procedure appears useful for lesions situated at the femoral division.