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المؤلفون: Nicla Settembre, Lucie Salomon du Mont, Stéphane Avril, Simon Rinckenbach, Fanny Lorandon, Eric Steinmetz
المصدر: Annals of Vascular Surgery. 79:279-289
مصطلحات موضوعية: Male, Patient-Specific Modeling, Time Factors, Computed Tomography Angiography, Aortic Rupture, Computed tomography, Aortography, Risk Assessment, Stress (mechanics), Imaging, Three-Dimensional, Predictive Value of Tests, Risk Factors, Humans, Medicine, Intraluminal thrombus, In patient, Rupture risk, Thrombus, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Hemodynamics, Models, Cardiovascular, Biomechanics, Thrombosis, General Medicine, Middle Aged, Prognosis, medicine.disease, Abdominal aortic aneurysm, Biomechanical Phenomena, Radiographic Image Interpretation, Computer-Assisted, Surgery, Stress, Mechanical, Cardiology and Cardiovascular Medicine, business, Nuclear medicine, Aortic Aneurysm, Abdominal
الوصف: Objectives A biomechanical approach to the rupture risk of an abdominal aortic aneurysm (AAA) could be a solution to ensure a personalized estimate of this risk. It is still difficult to know in what conditions, the assumptions made by biomechanics, are valid. The objective of this work was to determine the individual biomechanical rupture threshold and to assess the correlation between their rupture sites and the locations of their maximum stress comparing two computed tomography scan (CT) before and at time of rupture. Materials and Methods We included 5 patients who had undergone two CT; one within the last 6 months period before rupture and a second CT scan just before the surgical procedure for the rupture. All DICOM data, both pre- and rupture, were processed following the same following steps: generation of a 3D geometry of the AAA, meshing and computational stress analysis using the finite element method. We used two different modelling scenarios to study the distribution of the stresses, a “wall” model without intraluminal thrombus (ILT) and a “thrombus” model with ILT. Results The average time between the pre-rupture and rupture CT scans was 44 days (22-97). The median of the maximum stresses applied to the wall between the pre-rupture and rupture states were 0.817 MPa (0.555-1.295) and 1.160 MPa (0.633-1.625) for the "wall" model; and 0.365 MPa (0.291-0.753) and 0.390 MPa (0.343-0.819) for the "thrombus" model. There was an agreement between the site of rupture and the location of maximum stress for only one patient, who was the only patient without ILT. Conclusion We observed a large variability of stress values at rupture sites between patients. The rupture threshold strongly varied between individuals depending on the intraluminal thrombus. The site of rupture did not correlate with the maximum stress except for one patient.
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المؤلفون: Virginie Dufrost, Thomas Foret, Véronique Regnault, Jeremy Lagrange, Patricia Costa, Denis Wahl, Patrick Lacolley, Stéphane Zuily, Cécile Lakomy, Lucie Salomon du Mont
المصدر: Rheumatology. 61:2993-2998
مصطلحات موضوعية: Lupus anticoagulant, biology, business.industry, Thrombosis, Neutrophil extracellular traps, Antiphospholipid Syndrome, medicine.disease, Extracellular Traps, Cross-Sectional Studies, Rheumatology, Antiphospholipid syndrome, Immunology, Antithrombotic, medicine, biology.protein, Humans, Pharmacology (medical), Antibody, Activated protein C resistance, business, Protein C, Activated Protein C Resistance, medicine.drug
الوصف: Objectives In APS, precise evaluation of thrombotic risk is a major challenge. Different players, such as activated protein C (APC) resistance or neutrophil extracellular traps (NETs) contribute to the risk of thrombosis. Nevertheless, no study has investigated the interaction between these actors. The main objective of this study was to investigate the relation between NETs and APC resistance. Methods We designed a cross-sectional study including APS/antiphospholipid antibodies (aPL) patients and patients with autoimmune diseases (AID). We performed thrombin generation tests without and with APC to determine APC resistance. To evaluate circulating NETs, we measured plasma levels of MPO-DNA complexes and cell-free DNA with ELISA. Results We recruited 117 patients with definite APS/aPL or AID. We found a positive correlation between NETs and APC resistance, in APS patients and specifically in patients with high thrombotic risk, displaying LA or positivity of all three aPL tests (triple+), or anti-domain I IgG (aDI+). All these patient subgroups had increased NETs concentrations and APC resistance. As the risk profile for thrombosis increased, the relationship between NETs and APC resistance was stronger. Conclusion We have shown that NETs participate in the hypercoagulable state of APS patients by contributing to APC resistance, in particular in high-risk patients. In these most at-risk patients, a targeted action on NETs could reduce APC resistance and constitute a new therapeutic approach in the treatment of APS patients in addition to antithrombotic therapy.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ee262f4ef4bd0a1e4e1d3a0876ffbd9e
https://doi.org/10.1093/rheumatology/keab853 -
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المؤلفون: Eugenio Rosset, Fabien Thaveau, Eric Allaire, Réda Hassen-Khodja, Yann Gouëffic, Jean-Marc Alsac, Thierry Reix, Béatrice Guyomarch, Bahaa Nasr, Nellie Della Schiava, Lucie Salomon du Mont, Eric Ducasse, Jean-Pierre Favre, Raphael Soler
المصدر: Annals of Vascular Surgery. 64:2-10
مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Constriction, Pathologic, Femoral artery, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, law.invention, Lesion, Peripheral Arterial Disease, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Restenosis, law, medicine.artery, medicine, Clinical endpoint, Humans, Prospective Studies, Prospective cohort study, Vascular Patency, Aged, business.industry, Endovascular Procedures, General Medicine, Middle Aged, medicine.disease, Thrombosis, Surgery, Femoral Artery, Stenosis, Treatment Outcome, Female, Stents, France, medicine.symptom, Cardiology and Cardiovascular Medicine, business
الوصف: Background Common femoral artery (CFA) stenting appears as a promising alternative treatment to the open surgery for de novo CFA stenosis. The stenting of lesions just located at the CFA is simple, whereas stenting of CFA bifurcation lesions is more complex, and outcomes are still matter of debate. The aim of this study was to describe and to compare clinical outcomes of techniques used to treat simple over complex lesions for the stenting of CFA lesions. Materials/Methods From the French randomized controlled trial, TECCO, a total of 54 patients underwent stenting intervention and were enrolled in this study. Patients were excluded if they had CFA thrombosis, restenosis, and nonatheromatous lesions. Patients were classified by simple and complex lesions based on the type of lesion. The primary end point was the primary sustained clinical improvement. Results Eighteen patients were included in the simple lesion group, and 36 patients, in the complex lesion group. Baseline characteristics of patients were comparable between the 2 groups. The technical success was 100% in the simple lesion group and 91.7% in the complex lesion group. There was no significant difference between the 2 groups, regarding the primary sustained clinical improvement. The primary patency rates at 24 months for simple and complex lesion groups were 86.3% and 79%, respectively (P = 0.66). Freedom from target lesion revascularization was of 93.3% and 82% in the simple and complex lesion group, respectively (P = 0.34). Conclusions The stenting technique for CFA bifurcation lesions is a safe and effective technique. More trials with a large number of patients are needed to define the optimal stenting technique.
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المؤلفون: Patrick Lacolley, Thomas Foret, Virginie Dufrost, Denis Wahl, Véronique Regnault, Stéphane Zuily, Patricia Costa, Lucie Salomon du Mont, Benjamin Lefevre
المساهمون: Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Adaptation, mesure et évaluation en santé. Approches interdisciplinaires (APEMAC), Université de Lorraine (UL), REGNAULT, Véronique, Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO)
المصدر: Current Rheumatology Reports
Current Rheumatology Reports, Current Medicine Group, 2021, 23 (8), ⟨10.1007/s11926-021-01029-3⟩
Current Rheumatology Reports, Current Medicine Group, 2021, 23 (8), pp.65. ⟨10.1007/s11926-021-01029-3⟩مصطلحات موضوعية: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Disease, 030204 cardiovascular system & hematology, Severity of Illness Index, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, immune system diseases, Internal medicine, Severity of illness, medicine, Humans, neoplasms, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, Lupus anticoagulant, biology, business.industry, SARS-CoV-2, Antiphospholipid Syndrome (S Zuily, Section Editor), Antiphospholipid antibodies, COVID-19, Fibrinogen, Thrombosis, medicine.disease, Isotype, 3. Good health, Immunoglobulin A, [SDV] Life Sciences [q-bio], C-Reactive Protein, Immunoglobulin M, beta 2-Glycoprotein I, Antibodies, Anticardiolipin, Immunoglobulin G, Lupus Coagulation Inhibitor, biology.protein, Antibodies, Antiphospholipid, Antibody, business, Cohort study
الوصف: International audience; Purpose of review: COVID-19 patients have a procoagulant state with a high prevalence of thrombotic events. The hypothesis of an involvement of antiphospholipid antibodies (aPL) has been suggested by several reports. Here, we reviewed 48 studies investigating aPL in COVID-19 patients.Recent findings: Prevalence of Lupus Anticoagulant (LA) ranged from 35% to 92% in ICU patients. Anti-cardiolipin (aCL) IgG and IgM were found in up to 52% and up to 40% of patients respectively. Anti-β2-glycoprotein I (aβ2-GPI) IgG and IgM were found in up to 39% and up to 34% of patients respectively. Between 1% and 12% of patients had a triple positive aPL profile. There was a high prevalence of aβ2-GPI and aCL IgA isotype. Two cohort studies found few persistent LA but more persistent solid phase assay aPL over time. aPL determination and their potential role is a real challenge for the treatment of this disease.
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المؤلفون: Adrien Kaladji, Wilfried Bertho, Anaïs Debucquois, Olivier Hartung, Lucie Salomon du Mont, Simon Rinckenbach
المساهمون: Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Marseille, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Jonchère, Laurent
المصدر: Journal of Vascular Surgery: Venous and Lymphatic Disorders
Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2021, 9 (6), pp.1504-1509. ⟨10.1016/j.jvsv.2021.03.003⟩
Journal of Vascular Surgery: Venous and Lymphatic Disorders, Elsevier Inc., 2021, ⟨10.1016/j.jvsv.2021.03.003⟩مصطلحات موضوعية: Adult, Male, Renal Nutcracker Syndrome, medicine.medical_specialty, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Pelvic congestion syndrome, Inferior vena cava, Veins, 03 medical and health sciences, Nutcracker syndrome, Left gonadal vein transposition, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine, Back pain, Humans, 030212 general & internal medicine, Vein, Gonads, Aged, Retrospective Studies, business.industry, Pelvic pain, Middle Aged, medicine.disease, Thrombosis, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Surgery, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Treatment Outcome, medicine.vein, Female, medicine.symptom, Gonadal vein, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures
الوصف: International audience; OBJECTIVE: Nutcracker syndrome can cause disabling chronic pain requiring surgical intervention. At present, data describing a straightforward management approach are lacking. Transposition of the left gonadal vein is one of the surgical therapeutic alternatives. The aim of the present study was to describe our clinical results with gonadal vein transposition. METHODS: All 11 patients from three centers who had undergone left gonadal vein transposition for nutcracker syndrome from 2016 to 2019 were retrospectively included. The surgical cases were mainly selected according to the morphologic criteria of the left gonadal vein. The diameter and length dictated the type of approach (laparotomy or retroperitoneal) and the transposition level. A minimally invasive retroperitoneal approach was preferred. Pain was assessed using a numeric rating scale. RESULTS: We included 11 patients (10 women) with a median age of 35 years (range, 25-69). Preoperative computed tomography angiography showed anterior nutcracker syndrome in 10 patients (91%). All 11 patients had experienced lower back and/or pelvic pain, which was associated with pelvic congestion syndrome in 6 patients (55%) and hematuria in 5 patients (45%). The median preoperative numeric rating scale score for pain was 7.0 (range, 3.5-10.0) and 6.0 (range, 3.5-8.0) for lower back pain and pelvic pain, respectively. At the level of the iliac vein crossing (external or common), the median diameter of the left gonadal vein was 7.87 mm (range, 6.45-11.28). The left gonadal vein was transposed to the inferior vena cava in one case (9%), the left external iliac vein in five (45%), and the left common iliac vein in five cases (45%). The median in-hospital stay was 4 days (range, 2-20 days). Two early complications (18%) requiring surgical revision occurred: one of active bleeding and one hematoma. The median follow-up was 15 months (range, 6-44 months). The median postoperative pain score was 1.0 (range, 0.0-4.0) and 0.0 (range, 0.0-6.0) for lower back and pelvic pain, respectively. Incisional and/or neuropathic pain was noted, with a median score of 3.5 (range, 1.0-6.0) in seven patients (64%). Two late complications (18%) were observed: one case of thrombosis and one case of anastomotic stenosis. The hematuria had disappeared in all patients who had presented with it initially. CONCLUSIONS: Left gonadal vein transposition can be proposed as a first approach if the diameter of the left gonadal vein is sufficient to perform the anastomosis. It is an easily achievable, minimally invasive alternative that achieves satisfactory results without the use of foreign material.
وصف الملف: application/pdf
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المؤلفون: Eric Ducasse, Jean-Marc Alsac, Eugenio Rosset, Bahaa Nasr, Yann Gouëffic, Thierry Reix, Nellie Della Schiava, Jean-Pierre Favre, Béatrice Guyomarch, Eric Allaire, Fabien Thaveau, Raphael Soler, Réda Hassen-Khodja, Lucie Salomon du Mont
المصدر: JACC. Cardiovascular interventions. 10(13)
مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Femoral artery, Constriction, Pathologic, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Restenosis, Interquartile range, medicine.artery, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Vascular Patency, Aged, Peripheral Vascular Diseases, business.industry, Mortality rate, Endovascular Procedures, Perioperative, Length of Stay, Middle Aged, medicine.disease, Thrombosis, Surgery, Femoral Artery, Stenosis, Treatment Outcome, Female, Stents, France, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures
الوصف: The TECCO (Traitement des Lésions Athéromateuses de l'Artère Fémorale Commune par Technique Endovasculaire Versus Chirurgie Ouverte [Endovascular Versus Open Repair of the Common Femoral Artery]) trial is a randomized comparison of safety and efficacy of stenting versus open surgery for de novo common femoral artery (CFA) stenosis.Surgery for CFA lesions is considered effective and durable. Despite the widespread use of endovascular repair for infrainguinal disease, the value of this procedure for such lesions is uncertain.From February 23, 2011, to September 5, 2013, a total of 117 patients with de novo atherosclerotic lesions of the CFA were randomly assigned to undergo surgery (n = 61) or stenting (n = 56). The main exclusion criteria were asymptomatic disease, restenosis, and thrombosis of the CFA. The primary outcome was the morbidity and mortality rate within 30 days. This includes any general complications or local complications that caused or prolonged hospitalization and/or re-intervention, lymphorrhea of more than 3 days, and post-operative paresthesia that required drugs. The median duration of follow-up was 2 years (interquartile range [IQR]: 19.8 to 24.9 years).Primary outcome events occurred in 16 of 61 patients (26%) in the surgery group and 7 of 56 patients (12.5%) in the stenting group (odds ratio: 2.5; 95% confidence interval: 0.9 to 6.6; p = 0.05). The mean duration of hospitalization was significantly lower in the stenting group (3.2 ± 2.9 days vs. 6.3 ± 3 days; p 0.0001). At 24 months, the sustained clinical improvement, the primary patency rate, and the target lesion and extremity revascularization rates were not different in the 2 groups.In patients with de novo atherosclerotic lesions of the CFA, the perioperative morbidity and mortality rate was significantly lower among patients who underwent endovascular therapy by stenting compared with surgery, whereas clinical, morphological, and hemodynamic outcomes were comparable at mid-term. (Traitement des Lésions Athéromateuses de l'Artère Fémorale Commune par Technique Endovasculaire Versus Chirurgie Ouverte [Endovascular Versus Open Repair of the Common Femoral Artery] [TECCO]; NCT01353651).
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