[Aneurysm of the abdominal aorta and horseshoe kidney. Apropos of a case and review of the literature]. / Anévrysme de l'aorte abdominale et rein en fer à cheval. A propos d'une observation et revue de la littérature.

A case report of a 75 year old man with abdominal aortic aneurysm and horseshoe kidney is presented. The diagnosis of this unusual association was made prior to surgery and the aneurysmectomy was carried out without great problems, by insertion of a dacron tube combined with reimplantation of an accessory right renal artery. There was an uneventful postoperative recovery and outcome. Previous publications are reviewed. The authors insist of the importance of CT-Scan, intravenous pyelogram and aortography to establish a complete preoperative diagnosis of this rare association with anomalous vasculature and pyeloureteral pattern. The prognosis of an aneurysm in association with a horseshoe kidney should not be worse than that of routine resection of an ordinary aneurysm.

[In loco fibrinolytic treatment of acute ischemia of the lower limbs]. / Traitement fibrinolytique in loco des ischémies aiguës des membres inférieurs.

Peripheral artery occlusion produced by thrombosis or embolus can be cured by intra-arterial low dose thrombolysis without severe hemorrhagic complications. 18 patients suffering of acute ischemia of lower limbs were treated by intra-arterial streptokinase infusion. Diagnostic angiography is performed by antegrade femoral puncture using a 5F straight catheter. The tip of the catheter is placed within the thrombus. After a bolus of 10 000 U, streptokinase is infused at the rate of 2,000 U/min. Fibrinolysis is usually achieved within 70 min with a total dose of 150,000 U. Arterial recanalization occurred in 14 patients, in 6 cases underlying stenosis was successfully treated by percutaneous transluminal angioplasty. No severe complications were encountered.

[Autologous venous graft disease. Incidence, physiopathologic aspects and therapeutic means of graft salvage]. / La maladie du greffon veineux autologue. Incidence, aspects physiopathologiques et moyens thérapeutiques de sauvetage du greffon.

From 1980 to 1985, 134 patients with severe ischemia of lower limbs benefited from surgical recovery by inversed autologous venous graft in subarticular femoropopliteal and distal femoral position. During the 5 year follow-up period, 14 grafts (9%) developed hemodynamic degradation requiring angiographic surveillance followed by surgical repair or percutaneous dilatation. A retrospective study of evolution of venous grafts implanted in the contralateral supra-articular femoropopliteal and femoro (ilio) femoral position demonstrated a lower incidence of hemodynamic degradation (5.3%). Localizations (proximal and distal anastomotic stenosis, valvular stenosis, stenotic degradation of the donor or receiving arterial segment) and physiopathologic mechanisms (progressive atheromatosis, anastomotic or valvular fibrosis, premature atheromatosis of graft) are systematically reviewed together with results of pathology. Etiopathogenic factors invoked for this affection are discussed as a function of findings, together with choice of therapy used, including surgical repair, fibrinolysis and percutaneous dilatation.

[A propos a case of intestinal duplication in an adult (author's transl)]. / A propos d'un cas de duplication intestinale chez l'adulte.

The authors report the case of a 26 year-old patient presenting with rectal hemorrhage. Roentgenograms showed the origin of this was an intestinal duplication. This congenital malformation is very rare in adults as it usually appears during childhood. Then comes an appraisal of the clinical signs, the histology, the embryology and the differential diagnosis between the isolated diverticulum of the digestive tract and the duplication.

Fibromuscular dysplasia of the superficial femoral artery: an unusual localization.

The authors describe an uncommon localization of fibromuscular dysplasia in the superficial femoral artery. The treatment consisted in surgical resection of the lesion. The follow-up showed extension of the disease. Review of the literature.

Ulnar artery false aneurysm: temporary ultrasound-guided compression closure in an unusual case.

A case of traumatic false aneurysm located in an unusual portion of the ulnar artery is presented and the clinical findings, diagnosis and treatments are considered. The authors report the first use of ultrasound-guided compression closure, as an alternative to surgical management of ulnar artery false aneurysms.

[Myocardial risk in patients undergoing carotid intervention. Medium-term follow-up]. / Risque myocardique chez le patient subissant une intervention carotidienne. Follow-up à moyen terme.

We have evaluated the cardiac risk for 212 patients who underwent internal carotid surgery (245 operations). The mean age at the time of operation was of 63 +/- 8 years. A complete pre-operative cardiac assessment was performed splitting the patients in two groups: one considered as having a coronary heart disease (CHD) and the other as "healthy heart" (HH). The peri-operative cardiac morbidity and mortality rate were low (CHD group: 16.88%; HH group: 2.22%). At a 2 years follow-up we notice 31% of cardiac problems in the CHD group (with a mortality rate of 5.7%) for 3.9% in the HH group (with a mortality rate of 3.9%). The 4 years follow-up gives similar results.

Incidence of pre-operative deep venous thrombosis in abdominal surgery.

In order to determine the incidence of pre-operative and postoperative deep venous thrombosis (DVT) in patients not receiving prophylactic anticoagulant therapy, bilateral phlebography was performed in a prospective study pre-operatively and on the 9th postoperative day, in 51 consecutive patients submitted for major abdominal surgery. The presence of a DVT before surgery was demonstrated in 15.7 per cent of the patients. This high frequency confirms objectively the rationale of starting prophylactic anticoagulant therapy before the surgical procedure. Thrombi were demonstrated postoperatively by phlebography in 54.9 per cent of the patients. Thus the true incidence of DVT induced by surgery was 39.2 per cent taking into account the 15.7 per cent pre-operative DVT rate.