[Treatment with endoprosthesis of the pathology of the descending thoracic artery]. / Tratamiento con endoprótesis de la patología de aorta torácica descendente.

Surgery and medical treatment have been classically accepted as the therapy of choice in some diseases of the thoracic aorta. Recently, treatment with endoprosthesis has emerged as a useful technique in the pathology of the descending thoracic aorta. The type of endoprosthesis, indications and experimental and clinical results are discussed.

[Cystic adventitial disease: importance of computed tomography in the diagnostic and therapeutic management]. / Kyste adventiciel: intérêt du scanner dans la stratégie diagnostique et thérapeutique.

PURPOSE: Popliteal artery entrapment and adventitial cystic disease are the main causes of claudication in young patients. Adventitial cystic disease is a rare vascular pathology mostly affecting the popliteal artery but other localisations have been reported. Diagnosis and therapeutic management of adventitial cystic disease and particularly percutaneous aspiration are presented. MATERIALS AND METHODS: The authors report six cases (four men and two women; mean age: 55) of CAD of the popliteal artery (n = 4) and unusual cases in the femoral artery (n = 1) and in the femoral vein (n = 1) explored by sonography, computed tomography (CT), magnetic resonance imaging (MRI) and angiography. Five patients were initially treated by CT-guided aspiration and one with endoprosthesis. RESULTS: Sonography, CT or MRI are more useful to establish the diagnosis because these techniques can directly visualize the arterial wall. All these patients but one have been treated by percutaneous method with a good functional outcome but surgical intervention was necessary for two of them because of cysts recurrence. CONCLUSION: Our experience suggests that percutaneous CT-guided aspiration is the first treatment option for small cysts but close long-term follow-up is necessary to detect recurrence.

[Diagnosis and endovascular treatment of thoracic aortic diseases]. / Diagnostic et traitement endovasculaire de la pathologie aortique thoracique.

Recent years have seen the emergence of non-invasive imaging techniques for the morphological assessment of the thoracic aorta. This evolution results in an important reduction of the role of diagnostic angiography. Simultaneously, thanks to a tremendous technologic development, endovascular treatment techniques concern nowadays some pathologic conditions of the descending aorta. A number of reports using a variety of devices have been published in the literature concerning the treatment of dissection and aortic aneurysm. Based on mid-term results, endoluminal repair with use of stent-grafts is a feasible and safe alternative to surgery with a low rate of morbidity and mortality. In type B dissections with end-organ involvement, interventional radiology can be used either to fenestrate the flap or to stent the flap in branch arteries. Proper selection of patients by non-invasive imaging is fundamental for successful endoluminal treatment. However, there is still major concern with respect to long term results of these new treatments.

[Systemic granulomatosis caused by a Dacron prosthetic ligament]. / Granulomatose systémique induite par un ligament prothétique en Dacron.

An uncommon systemic reaction mimicking sarcoidosis after ligament reconstruction is reported. Clinical and radiological outcome after surgical treatment led to the diagnosis of a a specific injury caused by the ligament reconstruction device.

[Intra-aortic covered endoprosthesis]. / Endoprothèses couvertes intra-aortiques.

Because of the risk and complications related to surgery of the aorta, the development of new, less invasive endovascular techniques has resulted in a certain enthusiasm for these new treatments on the part of physicians and industry. The insertion of aortic stents allows the treatment of almost one half of aneurysm of the infrarenal abdominal aorta and descending aorta. The results appear to demonstrate the medium-term reliability and efficacy of these new techniques with a lower morbidity-mortality rate than that of conventional surgery. However, preoperative and intraoperative imaging plays an essential role in the success of these new methods. Finally, although the medium-term results are encouraging, the long-term outcome of these new materials is unknown, which justifies close surveillance of these patients and prospective comparative studies.

Apparatus to measure adsorption of condensable solvents on technical surfaces by photothermal deflection.

This article describes an instrument for the measurement of the mirage effect as a tool to determine the molar adsorption per unit surface area Y(1) of condensable solvents in the presence of a non-condensable carrier gas. The present apparatus is a much improved version of previous prototypes developed in our laboratory and elsewhere with a higher surface bake-out temperature (150 °C rather than 40 °C), lower residual vacuum (3 Pa versus 100 Pa), greater sample surface (40 mm diameter instead of 10 mm), more powerful optical pump beam (150 W cf. 50 W), and larger saturated vapour preparation volume (4 L instead of 1 L). The new set-up also includes the in situ monitoring of the surface via a reflected HeNe laser beam for the real-time detection of the onset of condensation. Here, we give a detailed description of the various components, outline the experimental procedure, show typical results, and suggest some straightforward improvements.

Modular component separation and reperfusion of abdominal aortic aneurysm sac after endovascular repair of the abdominal aortic aneurysm: a case report.

Transluminal placement of a stent graft in patients with an abdominal aortic aneurysm is a new endovascular technique that offers a potentially less invasive and less risky alternative to open surgery. Complications after stent graft placement are not infrequent, but in most cases secondary endovascular intervention is successful. We describe a late major leak in the aneurysmal sac caused by a distal migration of the iliac limb of a bifurcated graft. This late complication was successfully treated by covered stent placement, excluding and thrombosing completely the reformed aneurysm.

Imaging of retroperitoneal ganglioneuroma.

The aim of this study was to describe the radiological appearance of retroperitoneal ganglioneuroma. We retrospectively reviewed seven cases of histologically proven retroperitoneal ganglioneuroma. Ultrasound and enhanced CT were obtained in all cases, and MRI in three cases. The masses were well-circumscribed, ranged in size from 5 x 3 x 3 to 10 x 6 x 4 cm. In three cases close relationships between the tumor mass and major blood vessels were noted, resulting in vessel displacement or surrounding, but without compression or occlusion. On ultrasound examination the tumor showed a heterogeneous solid echostructure. Non-enhanced CT showed homogeneous or mildly heterogeneous low attenuation, and a punctate calcification was seen in one case. Contrast uptake was absent (n = 1) or delayed (n = 6). Progressive but incomplete enhancement was observed in three cases. On MRI, T2-weighted images showed a high signal intensity. Dynamic studies depicted the same enhancement pattern as described on CT. Ganglioneuroma is a rare tumor which should nevertheless be included in differential diagnosis of retroperitoneal masses when presenting as a well-delimited tumor with possible tendency to surround or displace major blood vessels, low density on non-enhanced CT, and delayed progressive enhancement on CT and MRI.

Imaging features of uncommon adrenal masses with histopathologic correlation.

Uncommon adrenal masses include cystic lesions (hydatid cyst, endothelial cyst), solid lesions (hemangioma, ganglioneuroma, angiosarcoma, primary malignant melanoma), and solid fatty lesions (myelolipoma, collision tumor). Most of these lesions do not have specific imaging features. The liquid content of adrenal cysts is clearly demonstrated on ultrasonographic scans, computed tomographic scans, and magnetic resonance images. Nevertheless, the histologic type cannot be predicted except at some stages of hydatid disease in which pathognomonic features are present. The most typical imaging features of hemangioma are phleboliths and enhancement of peripheral vascular lakes. Ganglioneuroma has nonspecific radiologic features, but this diagnosis should be considered in cases with early enhancement of fine septa and progressive filling. The radiologic features of angiosarcoma and primary malignant melanoma are nonspecific. A macroscopic lipid content within an adrenal mass is theoretically characteristic of myelolipoma. This diagnosis should be made with caution, especially when the lipid content is not predominant, because of the possible association with an adenoma.

Endovascular stents in arterial injury after radiotherapy.

We evaluated preliminary success and patency of stenting for the treatment of radiation-induced arterial diseases. Thirteen stents were placed in 8 patients to treat occlusion (n = 3), aneurysm (n = 1), residual stenosis (n = 2), multiple stenoses (n = 1), and delayed restenosis after previous balloon angioplasty (n = 1). Interventional procedure was successfully performed in 8 patients for their arterial lesions after radiotherapy. Six patients underwent interventional procedure once or twice. Two patients underwent PTA 4 times. Five of these patients demonstrated primary patency with relief of clinical symptoms with a mean follow-up of 2 years (range: 8-60 months). Clinical improvement was noted in the other patients. Our results suggest that stent placement by single or multiple techniques may have immediate effect on arterial lesions caused by radiation and can be considered as a therapeutic option of choice in these cases.