[Predictive value of the reactive hyperemia test as an indicator for lumbar sympathectomy].

Seventy-five patients had a lumbar sympathectomy for chronic arteritis of the lower limbs. This study was done to assess the predictive value of Hillestad's test (potential of vasodilatation) and that of the deep breath test (sympathic stimulation), realised by digital strain gauge plethysmography. Were considered a success the patients with claudication who doubled their walking distance and those with rest pain or gangrene who suffered no more or healed.

[Anatomo-clinical correlations after the treatment of iliocaval phlebitis with a 1-year follow-up].

Clinical results and anatomical findings on isotopic angiography, after a minimum follow-up period of one year, were compared in 32 patients treated for iliocaval venous thrombosis. Therapy had involved: iliofemoral thrombectomy alone (8 cases), iliocaval thrombectomy and retroperitoneal clip (10 cases), a clip alone (5 cases), fibrinolysis and heparin therapy (3 cases), heparin therapy alone (6 cases). Overall clinical results were considered as being good in 26 patients and poor in 6, whereas permeability of the main venous axis was confirmed by isotopic phlebography in only 5 cases.

[Paradoxical systemic emboli. 5 case reports].

Paradoxical systemic embolism by venous emboli in the arterial circulation can be explained by a right-left shunt. In 5 patients, the diagnosis of paradoxical emboli was definite in three cases, and suspected in two others. Venous, arterial and cardiac angiography define the anatomical criteria which alone can confirm the diagnosis.

Postoperative evaluation of in situ saphenous vein bypass with technetium-labelled albumin microspheres.

Technetium-labelled serum albumin microspheres have been used to study arteriovenous shunting in in situ saphenous vein bypasses. Their diameter (15 micron) enables the microspheres to be trapped at the capillary level, either in the limb or in the lungs, according to the extent of arteriovenous shunts. The observed shunting ranged from practically nothing to 90%.

[The use of labelled albumin microspheres in the study of arteriovenous shunting in varicosities of the lower limbs (author's transl)].

The greater proportion of oxygen in the blood circulating in veins of the lower limbs bought to attention the possibility of pre-capillary arteriovenous shunting. The intra-arteriel injection of Technetium labelled serum albumin microspheres enables one to quantify arteriovenous shunts greater than 25 microns. The authors made a comparative study of arterio-venous shunting by blood gases analysis and isotopic techniques in twenty patients.

[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.

[Evaluation of arteriovenous shunts following venous by-pass with the saphenous vein in situ. A suggested approach (author's transl)].

An isotopic method employing microspheres of serum-albumin of a mean diameter of 15 microns was used to study the problem raised by the development of arteriovenous fistulae following saphenous by-pass in situ, enabling measurement of shunt flow and qualitative evaluation of the distal bed. Shunt blood flow varies greatly from practically negligible quantities to a maximum of 90%. Comparing data from angiography during operation with these data showed a parallel between the worst angiographic appearances, the poorest scintigraphy images, and the most marked shunts.

[Assessment of cicatrisation potential in arteritic patients by means of an isotopic method employing technetium 99 m to measure cutaneous perfusion pressure (author's transl)].

Cicatrisation potential was assessed in arteritic patients by an isotopic method employing technetium 99 m to measure cutaneous perfusion pressures. Pressure threshold-values obtained showed that cicatrisation was absent when pressure was below 35 cm of water, that infectious complications developed in half of the cases with values between 35 and 65 cm, and that cicatrisation generally occurred at values above 65 cm.

Late reoperations after aorto-iliac restaurations.

(1) Late thrombosis after aorto-iliac revascularisations are infrequent when the operation is correctly performed and controlled by intra-operative angiography. (2) Reoperation after thromboendarterectomy is a difficult procedure requiring great care in the aortic approach. (3) Reoperation after thrombosis of a prosthetic graft is much easier as far as dissection is concerned, usually the upper part of the former prosthesis may be kept, which renders the procedure very much easier.

[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.