[Our experience with interaxillary shunts. Apropos of 39 shunts. Technic, results, indications]. / Notre expérience sur les pontages inter-axillaires. A propos de 39 pontages. Technique, résultats, indications.

The technique used and the results obtained in 39 patients with chronic obstructive subclavian artery lesions treated by interaxillary shunts are described and the literature reviewed. The indications for this therapy appear to be well defined and to apply mainly to elderly patients, to those with evidence of return flow after carotid-subclavian bypass, and to those with upper limb ischemia from post-vertebral lesions. This type of shunt is effective, is simple to perform and possesses minimal morbidity.

[Our experience with surgery of chronic obstructive lesions of the subclavian artery. Apropos of 94 procedures. Critical analysis of our results]. / Notre expérience dans la chirurgie des lésions obstructives chroniques de l'artère sous-clavière. A propos de 94 interventions. Analyse critique de nos résultats.

Patient characteristics, types of lesion, routes of approach and techniques employed are discussed in relation to 94 cases of surgical treatment for chronic obstruction of the subclavian artery. The most frequently (60% of cases) used procedure was an extrathoracic by-pass operation, thrombo-endarterectomy being performed in 25%, réimplantations in 10%, and aortic by-pass implants in 6% of cases. Immediate and 30-day follow-up results are presented, and failures critically analyzed with regard to their relation to vascular or neurological complications, and those linked to the approach route. Conclusions to be drawn from these unsuccessful cases are exposed, as well as current tendencies in respect of indications for surgery in these lesions.

[Vascular complications of cervical ribs. Apropos of 15 cases]. / Les complications vasculaires des côtes cervicales. A propos de 15 observations.

Anatomical, etiopathogenic, clinical, and paraclinical aspects of vascular complication of cervical rib are discussed based on findings in 15 cases. Emphasis is placed on the value of newly available non-invasive functional tests, such as computerized angiography and particularly ultrasonography, which can modify surgical conduct. Operative technique is described, and indications for surgery and short- and long-term results obtained presented. Evaluation of results reported in the literature shows that they were excellent in 75 to 93% of cases, recent studies indicating an even higher rate of improvement.

[Echographic study in the exploration of supra-aortic trunks. Comparative study with doppler velocimetry and their respective roles in functional vascular explorations]. / Examen échographique dans l'exploration des troncs supra-aortiques. Etude comparée à l'examen vélocimétrique doppler et leur place respective dans les explorations fonctionnelles vasculaires.

Over the last six months, 1,311 doppler examinations of the supra-aortic trunks have been performed with confrontation doppler, ultrasound, arteriography and intra-operative examination according to the cases. We studied these cases with the following questions in mind: Does real time ultrasound of the supra-aortic trunks give more valuable information than the classical doppler examination? Is the diagnosis simplified? Is the therapeutic management altered? We are able to conclude: 1. In the case of a mildly stenotic plaque (less than 50%), the doppler examination gives an acoustic and graphic representation which is rich and not differentiated for stenoses of between 10% and 50%, which corresponds to an ultrasound plaque of 1 mm to 4-5 mm: the ultrasound supports the diagnosis. 2. However, in stenoses greater than 50%, there is good correlation between the doppler examination, ultrasound and arteriography. Ultrasound enables the exact extent of the plaque to be visualised in sagittal and transverse planes. It can diagnose aneurysmal lesions and suggest ulcerated lesions. 3. Finally, the doppler examination seems to be indispensable in cases of pre-thrombosis or fresh thrombosis of the carotid. Ultrasound can be negative at this early stage.

[Iliocaval venous thrombosis. Clinical and paraclinical aspects and therapeutic approach, apropos of 58 cases]. / Les thromboses veineuses ilio-caves. Aspects cliniques, paracliniques et approche thérapeutique à propos de 58 cas.

The authors report 58 cases of ilio-femoral and ilio-caval thrombosis and emphasise the considerable contribution of two vascular function tests: Doppler and occlusion rheoplethysmography, which now compensate for clinical deficiencies. Nevertheless, phlebography remains essential in defining management which is based upon age, general condition, and the site and type of thrombosis (floating or adherent clot). An outline therapeutic approach is suggested on the basis of these data.

[Four cases of bronchial lipoma (author's transl)]. / Le lipome bronchique. A propos de quatre observations.

The authors report four observations of bronchial lipoma. They note the rarity of this variety of benign tumor, since 69 observations have been published to date. This tumor occurs predominantly in the male, is found preferentially in a large bronchus and has several particularities of macroscopic and histologic pathology. Its histogenesis is still not well understood even though most authors subscribe to the theory of "hyperplasia-metaplasia". The treatment is essentially surgical in nature and includes three possible alternatives : endoscopic resection, single exeresis by bronchotomy or exeresis associated with resection of the parenchyma.

[Treatment of dissecting aneurysms of renal artery. Report of four cases (author's transl)]. / Le traitement des anévrismes disséquants de l'artère rénale. A propos de quatre cas.

The localized dissection of visceral arteries, renal arteries in particular, is less frequent than the extension forward the visceral arteries of aneurysms of the abdominal aorta which are well known. Reporting on four cases within their own personal experience, the authors present their commentaries and insist upon the necessity of early diagnosis which, thanks to an adapted surgical treatment, permits protection of these patients from the complications inherent in this reno-vascular pathology.

[Legal disability rates for sequelae of hepatic injuries. 75 cases (author's transl)]. / Traumatismes du foie. Réparation médico-légale des séquelles. 75 observations.

Out of 75 patients with hepatic injury, 31 sustained a rupture of the liver (group I) and 44 a linear wound (group II). The mean duration of temporary total disability (TTD) was 65 days for patients in group I and 45 days for those in group II. The rate of permanent partial disability (PPD) varied from 8 to 30% in group I and from 5 to 7% in group II. In sutured wounds TTD was 45 days on average and PPD ranged from 0 to 10%. After tissue resection for ruptured liver the corresponding figures were 65 days and 10 to 40% respectively.

[Aneurysms of the pancreaticoduodenal arteries associated with thrombosis of the coeliac artery (author's transl)]. / Anévrysme des artères pancréatico-duodénales associé a une thrombose du tronc coelique.

Aneurysms of the pancreaticoduodenal arteries are rare, but are becoming discovered relatively more frequently because of the development of modern angiography, as has been suggested by recent publications on this subject. Our work is of interest because the diagnosis was made before operation, and a complexe angiographic study permitted the most appropriate surgical treatment possible.

[Aneurysms of the superior mesenteric artery and of its branches. Report of three cases (author's transl)]. / Les anévrysmes de l'artère mésentérique supérieure et de ses branches. A propos de trois observations.

The authors report three cases of atheromatous aneurysm revealed by a complication (e.g. rupture, thrombosis, peripheral embolisation) and propose an etiological, physio-pathological, clinical and therapeutic study of aneurysms of the superior mesenteric artery. They emphasise the advantages of early diagnosis leading to arteriography, which alone permits appropriate surgical treatment.

[Indications and results of dorsal sympathectomy in vascular syndromes of the upper limb (author's transl)]. / Indications et résultats de la sympathectomie dorsale dans les syndromes vasculaires du membre supérieur.

The authors report 50 cases of dorsal sympathectomy followed up on the cardiovascular surgery unit of the Amiens University Hospital over a period of six years. The authors then formulate a number of reflexions concerning the clinical findings, the therapeutic indications, and the way of assessing the results of this operation in vascular syndromes of the upper limb. This is a plea in favour of this operation as, in most cases, no other treatment is comparable.