Treatment of stage II chronic arterial disease of the lower limbs with the serotonergic antagonist naftidrofuryl: results after 6 months of a controlled, multicenter study.

A study was carried out in patients with intermittent claudication (Fontaine's stage II). The atheromatous origin of the disease was confirmed and localized by angiography or Doppler. One hundred eight-three patients were selected initially (day -30) with a pain-free walking distance on a treadmill (at a speed of 3 km/h and a slope of 10%) ranging from 150 to 300 m.

[Aneurysm of the pancreaticoduodenal arteries and stenosis of the celiac trunk. Apropos of a case].

The authors describe the different imaging techniques and their interest. They discuss their etiology. The association with stenosis of the coeliac axis incites to think at a hemodynamic theory.

[Digestive hemorrhage caused by seromuscular erosion of the wall of a section of the small intestine at the level of an aortic prosthesis implanted 5 years earlier].

A new paraprosthetic enteric fistula case between the small bowel and the body of a Dacron aortobifemoral prosthesis is presented. That complication happened five years after the initial reconstruction and the fistula does not interest an anastomotic site. A process is rare (22 published cases); if symptomatology is often less important than complete fistulas, surgical therapy must be aggressive to be effective.

[Post-partum development of a mesenteric venous infarct and portal thrombosis in a young woman taking an oral contraceptive (author's transl)].

A 19-year-old girl developed a total venous infarct of the small intestine secondary to extensive portal thrombosis, on the 21st post-partum day. She had started to take an oral contraceptive on the 9th post-partum day, and the association of these two factors appears to have played a major role in the physiopathology of this accident. Diagnosis is difficult and often delayed in this affection, which can only be suspected as a function of the previous medical history.

Experimental study of sensitization to catecholamines after lumbar sympathectomy.

In a first time, the authors have shown a real supersensitivity to the action of catecholamines after lumbar sympathectomy in dog. Then, they have established a protocol which can be applied to the exploration of those phenomena in arteritic patients. Same doses of epinephrine and norepinephrine (which correspond to a slight hypercatecholamine blood level under stress) are injected intravenously, comparatively before and after lumbar sympathectomy.

[Isotopic criteria for the assessment of the effects of lumbar sympathectomy (author's transl)].

The authors present a work intended to assess the effects of lumbar sympathectomy using radioactive microspheres. These contain 99mTe and are injected into the femoral artery. The distribution of radioactivity is then measured at the lower limb with a gamma camera linked to a computer.

[Experimental study of the sensitivity to catecholamines after lumbar sympathectomy (author's transl)].

To determine sensitivity to catecholamines after lumbar sympathectomy the authors first tested it in dogs : there was an increase in reactions to catecholamine beyond doubt after bilateral lumbar sympathectomy. In patients with arteritis they recorded, on a segment of the lower limb, a rheographic tracing with simultaneous modifications of the arterial blood pressure and electrocardiogram. These were studied after injection of adrenalin or noradrenalin in a dose of 5 to 7.

[Electron microscopic studies of lumbar sympathetic chains resected for arteritis of the lower limbs (author's transl)].

Eighteen lumbar sympathetic chains resected for lower limb arteritis are examined on electron microscopy. A comparative study of the nature of lesions is done for diabetics and non-diabetics. Development of vascular lesions, clearly accelerated in the diabetic does not coincide with neurological lesions.