[Is percutaneous transluminal angioplasty of the femoral and popliteal arteries a justifiable procedure? A discussion in relation to 58 attempts]. / L'angioplastie transluminale percutanée (ATP) des artères fémorales et poplitées est-elle justifiée? Réflexions à propos de 58 tentatives.

Angioplasty of the femoral and popliteal arteries was attempted in 58 cases over a period of 2 years. Ideal cases for treatment by percutaneous transluminal angioplasty (PTA) are those with stenoses less than 3 cm or obliterations less than 6 cm in length where the onset was between 6 months and 2 years previously. Immediate success was obtained in 50 cases (86 patients), failures usually being observed in very advanced cases. Permeability after 2 years, by actuarial calculation, was observed in 85 p. cent of cases and there were 7 complications (12 p. cent) in the 58 patients, one of whom required urgent surgery. This method represents an alternative procedure to conventional surgical shunts in young subjects, those at high surgical risk, and those with lesions in two zones. These results illustrate the value of early diagnosis, by arteriography of the lower limbs, to detect recent lesions responding best to PTA and thus to gain time in the long and painful history of this disease.

[X-ray computed tomography in pleuropulmonary asbestos pathology]. / Apport de la tomodensitométrie dans la pathologie pleuro-pulmonaire de l'amiante.

Results of computed tomography and conventional radiology were compared during investigation of 17 patients with pleuropulmonary lesions from confirmed asbestosis. Computed tomography images appeared to provide improved data for detection and analysis of pleural plaques, particularly in the costovertebral grooves; false pleural images (associated shadows, fatty tissue) can be eliminated. The CT scan should occupy a place of choice for surveillance of subjects in contact with asbestos and presenting pleural anomalies.

[The transjugular approach to the hepatic region for the differential diagnosis of jaundice and exploration of the portal system (author's transl)]. / L'abord hépatique par voie transjugulaire dans le diagnostic des ictères et l'exploration du système porte.

The results obtained in a series of 200 patients, using the transjugular approach to the common bile duct for the differential diagnosis of cholestasis, are presented and discussed. 1. The advantages of the method are: --the simplicity of the technique and the rapidity with which it can be mastered, the negligeable investment required; --the safety in use if the only contra-indication is respected: recent acute infection of the biliary tract; --the possibility of obtaining a cholangiography and a liver needle-biopsy at the same time, even in cases with disorders of the blood. 2. The limitation of the method is the failure to visualize the CBD, which is seen in 30% of cases when the latter is not dilated by an obstruction. 3. The respective indications for either transjugular cholangiography or retrograde catheterization of the papilla can be defined. 4. A preliminary series of 37 explorations of the portal system by the transjugular approach with embolization of bleeding oesophageal varices is reported.

[The contribution of nephro-urotomography in the diagnosis of unilateral non-functioning kidney in the adult (author's transl)]. / Apport de la néphro-urotomographie au diagnostic des mutités rénales unilatérales de l'adulte

The aetiological diagnosis of a unilateral nonfunctioning kidney is achieved by angiographic or retrograde techniques. Pyelography indicates only that organ is non-functioning. 71 patients were explored by nephro-urotomography carried out using high doses of contrast medium (2 cm3/kg) with rapid injection (10cm3/sec.) and repeated tomographic sections taken during the first minute after injection. These tomographic sections, three in number, made it possible to study the three phases of the nephrogram: cortical nephrography, cortico-medullary nephrography and tubular nephrography. The aim of this study was to assess the contribution of this technique in the aetiological diagnosis of a unilateral non-functioning kidney. In the majority of cases it is possible to suspect the vascular or neoplasic origin of the non-functioning kidney. Obstructive non-functioning kidneys have two distinct nephrographic appearances. Pelvic and retroperitoneal obstructions are visualised chiefly during the phase of cortical nephrography, which shows marked parenchymatous atrophy with the presence of rounded intrarenal lacunae. By contrast, obstruction secondary to pyelo-ureteral junction syndrome results in total destruction of the parenchyma. The phenomenon of total corporeal opacification plays a major role in the visualisation of the fibrous speta which form the limits of the pseudocystic pockets. In these patients, the contribution of study of early nephrograms is less evident. Bacillary non-functioning kidneys have an analogous appearance characterised by the particular frequency of abnormal opacities, calcified ormastic. Thus the aetiological diagnosis of a unilateral nonfunctioning kidney may be obtained in the majority of cases. This permits more judicious selection of those cases requiring angiography or retrograde exploration necessary to pre-operative assessment.