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Claudinot A, Douane F, Morla O, Perret C, Neveu M, Thouveny F, Bouvier A, Hureaux J, Le Guen A, Jouan J, Heautot JF, Larralde A, Cerasuolo D, Bergot E, Fohlen A, Pelage JP. Pulmonary Artery Embolization in the Management of Hemoptysis Related to Lung Tumors. J Pers Med 2023; 13:1597. [PMID: 38003912 PMCID: PMC10672290 DOI: 10.3390/jpm13111597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/04/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: Bronchial artery embolization has been shown to be effective in the management of neoplastic hemoptysis. However, knowledge of pulmonary artery embolization is lacking. The aim of this study was to evaluate the safety and efficacy of pulmonary artery embolization in patients presenting with hemoptysis related to lung tumors. (2) Methods: This retrospective study reviewed all consecutive patients with cancer and at least one episode of hemoptysis that required pulmonary artery embolization from December 2008 to December 2020. The endpoints of the study were technical success, clinical success, recurrence of hemoptysis and complications. (3) Results: A total of 92 patients were treated with pulmonary artery embolization (63.1 years ± 9.9; 70 men). Most patients had stage III or IV advanced disease. Pulmonary artery embolization was technically successful in 82 (89%) patients and clinically successful in 77 (84%) patients. Recurrence occurred in 49% of patients. Infectious complications occurred in 15 patients (16%). The 30-day mortality rate was 31%. At 3 years, the survival rate was 3.6%. Tumor size, tumor cavitation and necrosis and pulmonary artery pseudoaneurysm were significantly associated with recurrence and higher mortality. (4) Conclusions: Pulmonary artery embolization is an effective treatment to initially control hemoptysis in patients with lung carcinoma, but the recurrence rate remains high and overall survival remains poor.
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Affiliation(s)
- Amandine Claudinot
- Department of Radiology, CHU de Caen, 14000 Caen, France; (A.F.); (J.-P.P.)
| | - Frédéric Douane
- Department of Radiology, CHU de Nantes, 44000 Nantes, France; (F.D.); (O.M.); (C.P.); (M.N.)
| | - Olivier Morla
- Department of Radiology, CHU de Nantes, 44000 Nantes, France; (F.D.); (O.M.); (C.P.); (M.N.)
| | - Christophe Perret
- Department of Radiology, CHU de Nantes, 44000 Nantes, France; (F.D.); (O.M.); (C.P.); (M.N.)
| | - Marine Neveu
- Department of Radiology, CHU de Nantes, 44000 Nantes, France; (F.D.); (O.M.); (C.P.); (M.N.)
| | - Francine Thouveny
- Department of Radiology, CHU d’Angers, 49933 Angers, France; (F.T.); (A.B.); (J.H.)
| | - Antoine Bouvier
- Department of Radiology, CHU d’Angers, 49933 Angers, France; (F.T.); (A.B.); (J.H.)
| | - José Hureaux
- Department of Radiology, CHU d’Angers, 49933 Angers, France; (F.T.); (A.B.); (J.H.)
| | - Arnaud Le Guen
- Department of Radiology, Centre Hospitalier Bretagne Atlantique, 56000 Vannes, France; (A.L.G.); (J.J.)
| | - Jérémy Jouan
- Department of Radiology, Centre Hospitalier Bretagne Atlantique, 56000 Vannes, France; (A.L.G.); (J.J.)
| | | | - Antoine Larralde
- Department of Radiology, CHU de Rennes, 35000 Rennes, France; (J.-F.H.); (A.L.)
| | - Damiano Cerasuolo
- Department of Biostatistics and Clinical Research, CHU de Caen, 14000 Caen, France
| | - Emmanuel Bergot
- Department of Pulmonology and Respiratory Disease, CHU de Caen, 14000 Caen, France;
| | - Audrey Fohlen
- Department of Radiology, CHU de Caen, 14000 Caen, France; (A.F.); (J.-P.P.)
- Normandy University, UNICAEN, CEA, CNRS, ISTCT-CERVOxy, 14000 Caen, France
| | - Jean-Pierre Pelage
- Department of Radiology, CHU de Caen, 14000 Caen, France; (A.F.); (J.-P.P.)
- Normandy University, UNICAEN, CEA, CNRS, ISTCT-CERVOxy, 14000 Caen, France
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Guillen K, Thony F, Del Giudice C, Goyault G, David A, Douane F, Le Bras Y, Monnin-Bares V, Heautot JF, Rousseau H, Martinelli T, Thouveny F, Barral PA, Le Pennec V, Chabrot P, Rogopoulos A, Aho-Glélé LS, Sapoval M, Rodière M, Chevallier O, Falvo N, Loffroy R. Patient-Reported Outcomes of Endovascular Treatment of Post-Thrombotic Syndrome: Ancillary Study of a French Cohort. Diagnostics (Basel) 2023; 13:2357. [PMID: 37510101 PMCID: PMC10378457 DOI: 10.3390/diagnostics13142357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Excellent outcomes of angioplasty/stenting for the post-thrombotic syndrome (PTS) have been reported, notably regarding objective criteria in the vast French SFICV cohort. Differences may exist between patient-reported and objective outcomes. We investigated this possibility by using validated scales because significative correlations are discordant in the literature between patency and patient-reported characteristics. Patient-reported outcomes seem to be a more consistent tool than radiologic patency for the diagnosis and follow-up of patients displaying PTS. We retrospectively reviewed the Villalta scale and 20-item ChronIc Venous dIsease quality-of-life Questionnaire (CIVIQ-20) scores recorded after endovascular stenting for PTS at 14 centres in France in 2009-2019. We also collected patency rates, pre-operative post-thrombotic lesion severity, and the extent of stenting. We performed multivariate analyses to identify factors independently associated with improvements in each of the two scores. The 539 patients, including 324 women and 235 men, had a mean age of 44.7 years. The mean Villalta scale improvement was 7.0 ± 4.7 (p < 0.0001) and correlated with the thrombosis sequelae grade and time from thrombosis to stenting. The CIVIQ-20 score was available for 298 patients; the mean improvement was 19.2 ± 14.8 (p < 0.0001) and correlated with bilateral stenting, single thrombosis recurrence, and single stented segment. The objective gains demonstrated in earlier work after stenting were accompanied by patient-reported improvements. The factors associated with these improvements differed between the Villalta scale and the CIVIQ-20 score. These results proved that clinical follow-up with validated scores is gainful in patients treated for PTS thanks to a mini-invasive procedure.
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Affiliation(s)
- Kévin Guillen
- Department of Interventional Radiology, CHU Dijon, 21000 Dijon, France
| | - Frédéric Thony
- Department of Interventional Radiology, CHU Grenoble, 38000 Grenoble, France
| | - Costantino Del Giudice
- Interventional Radiology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014 Paris, France
| | - Gilles Goyault
- Department of Vascular and Oncological Interventional Radiology, Institut Cardiovasculaire de Strasbourg (ICS), Clinique Rhena, 67000 Strasbourg, France
| | - Arthur David
- Department of Interventional Radiology, CHU Nantes, 44000 Nantes, France
| | - Frédéric Douane
- Department of Interventional Radiology, CHU Nantes, 44000 Nantes, France
| | - Yann Le Bras
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France
| | - Valérie Monnin-Bares
- Department of Imaging and Interventional Radiology, Montpellier University Hospital (CHU), 34000 Montpellier, France
| | | | - Hervé Rousseau
- Cardiac Imaging Centre, Toulouse University Hospital, 31000 Toulouse, France
| | - Thomas Martinelli
- Department of Medical Imaging and Radiology, Valence Hospital, 179 bd Maréchal Juin, 26953 Valence, France
| | | | - Pierre-Antoine Barral
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, 13000 Marseille, France
| | - Vincent Le Pennec
- Department of Interventional and Diagnostic Imaging, University Hospital of Caen, Avenue de la Côte de Nacre, 14033 Caen, France
| | - Pascal Chabrot
- Department of Vascular Radiology, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Place Henri Dunant, 63000 Clermont-Ferrand, France
| | - André Rogopoulos
- Department of Radiology, Institut Arnault Tzanck, 06700 Saint-Laurent du Var, France
| | - Ludwig Serge Aho-Glélé
- Department of Epidemiology, Statistics and Clinical Research, Hôpital Universitaire François-Mitterrand, 21079 Dijon, France
| | - Marc Sapoval
- Vascular and Oncological Interventional Radiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Mathieu Rodière
- Department of Interventional Radiology, CHU Grenoble, 38000 Grenoble, France
| | | | - Nicolas Falvo
- Department of Interventional Radiology, CHU Dijon, 21000 Dijon, France
| | - Romaric Loffroy
- Department of Interventional Radiology, CHU Dijon, 21000 Dijon, France
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Espitia O, Douane F, Hersant J, Abbadie F, Sobocinski J, Heautot JF, Miossec A, Lapébie FX, Hartung O. Predictive Factors of Stent Patency in Iliofemoral Venous Diseases in a Multicentre Cohort Study. Eur J Vasc Endovasc Surg 2023; 65:564-572. [PMID: 36642400 DOI: 10.1016/j.ejvs.2023.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 12/13/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE This study assessed primary stent patency predictive factors in three groups of patients with history of lower limb (LL) vein thrombosis: non-thrombotic iliac vein lesion (NIVL), acute deep vein thrombosis (aDVT), and post-thrombotic syndrome (PTS). METHODS Consecutive patients from January 2014 to December 2020 with history of LL vein stenting from seven hospitals were included. All patients received an iliac or common femoral venous stent and had at least a six month follow up available with stent imaging. Anticoagulant and antiplatelet therapy strategies employed after venous stenting are reported and compared between groups. RESULTS This study included 377 patients: 134 NIVL, 55 aDVT, and 188 PTS. Primary patency was statistically significantly higher in the NIVL group (99.3%) compared with the PTS group (68.6%) (p < .001) and the aDVT group (83.6%) (p = .002). PTS patients received a statistically significantly greater number of stents (p < .001) and had more stents below the inguinal ligament (p < .001). Median follow up was 28.8 months (IQR 16, 47). Discontinuation of antiplatelet therapy at the last assessment was 83.6% for NIVL, 100% for aDVT, and 95.7% for the PTS group (p < .001). Discontinuation of anticoagulation therapy at the last assessment was 93.2% for NIVL, 25.0% for aDVT, and 70.3% for the PTS group (p < .001). The only predictor of worse primary patency in the aDVT group was long term anticoagulation before stenting. CONCLUSION Patients with NIVL have better primary patency after venous stenting than patients with venous thrombotic disorders. Long term anticoagulation before stenting was the only factor associated with poorer primary patency in patients with aDVT.
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Affiliation(s)
- Olivier Espitia
- Nantes Université, CHU Nantes, Department of Internal and Vascular Medicine, Nantes, France.
| | - Frédéric Douane
- Nantes Université, CHU Nantes, Department of Radiology, Nantes, France
| | | | | | | | | | - Annaïg Miossec
- Nantes Université, CHU Nantes, Department of Internal and Vascular Medicine, Nantes, France
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Trochu T, Desfriches-Doria N, Grillot N, Feuillet F, Lair D, Liberge R, Douane F, Dumont R, David A. Safety of High-Frequency Jet Ventilation During Image-Guided Thermal Ablation Procedures. Cardiovasc Intervent Radiol 2023; 46:360-368. [PMID: 36658374 DOI: 10.1007/s00270-023-03358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023]
Abstract
RATIONALE AND OBJECTIVE Percutaneous thermal ablative technique is a common radiological procedure for malignant lesions treatment. Controlled assisted ventilation during general anesthesia is the usual mode of ventilation, but high-frequency jet ventilation (HFJV) can be a helpful alternative for the operator. The objective was to evaluate the safety of HFJV during thermal ablation procedures. MATERIALS AND METHODS This monocentric prospective analysis included adult patients undergoing percutaneous thermal ablation procedures for abdominal tumor performed under HFJV. Procedures with a transpulmonary path were excluded. The primary outcome was the incidence of respiratory complications. Secondary outcomes included gas exchange modifications (hypercapnia, hypoxemia, pulmonary atelectasis) and the incidence of barotrauma. RESULTS Sixty patients were included during the study period. The mean duration time was 88 min. All procedures went according to the protocol and there was no respiratory complication. There was no barotrauma event. Three patients had an exhaled capnia above 45 mmHg at the end of the procedure which normalized within 10 min of conventional ventilation. CONCLUSION HFJV during thermal ablation procedures is safe regarding gas exchange and barotrauma. This technique could be an interesting alternative to conventional ventilation during image-guided thermal ablation procedures. Clinical Trials database This study was registered in Clinical Trials database (NCT04209608).
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Affiliation(s)
- Théophane Trochu
- Department of Radiology, Nantes University Hospital, 1, place Alexis Ricordeau, 44093, Nantes, France.
| | - Nathalie Desfriches-Doria
- Pôle d'Anesthésie Réanimation Chirurgicale, CHU Nantes, Université de Nantes, Hôtel-Dieu, 1, place Alexis Ricordeau, 44093, Nantes, France
| | - Nicolas Grillot
- Pôle d'Anesthésie Réanimation Chirurgicale, CHU Nantes, Université de Nantes, Hôtel-Dieu, 1, place Alexis Ricordeau, 44093, Nantes, France
| | - Fanny Feuillet
- SPHERE U1246, DRCI, Plateforme de Méthodologie et de Biostatistique, INSERM, CHU Nantes & Nantes Université, Université de Tours, 1, place Alexis Ricordeau, 44093, Nantes, France
| | - David Lair
- Research and Innovation Department, CHU Nantes, Nantes Université, 53, Chaussée de la Madeleine, 44000, Nantes, France
| | - Renan Liberge
- Department of Radiology, Nantes University Hospital, 1, place Alexis Ricordeau, 44093, Nantes, France
| | - Frédéric Douane
- Department of Radiology, Nantes University Hospital, 1, place Alexis Ricordeau, 44093, Nantes, France
| | - Romain Dumont
- Pôle d'Anesthésie Réanimation Chirurgicale, CHU Nantes, Université de Nantes, Hôtel-Dieu, 1, place Alexis Ricordeau, 44093, Nantes, France
| | - Arthur David
- Department of Radiology, Nantes University Hospital, 1, place Alexis Ricordeau, 44093, Nantes, France
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Garret C, Douillard M, David A, Péré M, Quenehervé L, Legros L, Archambeaud I, Douane F, Lerhun M, Regenet N, Gournay J, Coron E, Frampas E, Reignier J. Infected pancreatic necrosis complicating severe acute pancreatitis in critically ill patients: predicting catheter drainage failure and need for necrosectomy. Ann Intensive Care 2022; 12:71. [PMID: 35916981 PMCID: PMC9346045 DOI: 10.1186/s13613-022-01039-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/25/2022] [Indexed: 11/27/2022] Open
Abstract
Background Recent guidelines advocate a step-up approach for managing suspected infected pancreatic necrosis (IPN) during acute pancreatitis. Nearly half the patients require secondary necrosectomy after catheter drainage. Our primary objective was to assess the external validity of a previously reported nomogram for catheter drainage, based on four predictors of failure. Our secondary objectives were to identify other potential predictors of catheter-drainage failure. We retrospectively studied consecutive patients admitted to the intensive care units (ICUs) of three university hospitals in France between 2012 and 2016, for severe acute pancreatitis with suspected IPN requiring catheter drainage. We assessed drainage success and failure rates in 72 patients, with success defined as survival without subsequent necrosectomy and failure as death and/or subsequent necrosectomy required by inadequate improvement. We plotted the receiver operating characteristics (ROC) curve for the nomogram and computed the area under the curve (AUROC). Results Catheter drainage alone was successful in 32 (44.4%) patients. The nomogram predicted catheter-drainage failure with an AUROC of 0.71. By multivariate analysis, catheter-drainage failure was independently associated with a higher body mass index [odds ratio (OR), 1.12; 95% confidence interval (95% CI), 1.00–1.24; P = 0.048], heterogeneous collection (OR, 16.7; 95% CI, 1.83–152.46; P = 0.01), and respiratory failure onset within 24 h before catheter drainage (OR, 18.34; 95% CI, 2.18–154.3; P = 0.007). Conclusion Over half the patients required necrosectomy after failed catheter drainage. Newly identified predictors of catheter-drainage failure were heterogeneous collection and respiratory failure. Adding these predictors to the nomogram might help to identify patients at high risk of catheter-drainage failure. ClinicalTrials.gov number: NCT03234166. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-022-01039-z.
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Affiliation(s)
- Charlotte Garret
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France.
| | - Marion Douillard
- Institut des Maladies de L'Appareil Digestif, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Arthur David
- Radiologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Morgane Péré
- Plateforme de Méthodologie et Biostatistique, Direction de la Recherche, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Lucille Quenehervé
- Service d'Hépatogastroentérologie, Centre Hospitalier Universitaire de Brest, 29200, Brest, France
| | - Ludivine Legros
- Service d'Hépatogastroentérologie, Centre Hospitalier Universitaire de Rennes, 35203, Rennes, France
| | - Isabelle Archambeaud
- Institut des Maladies de L'Appareil Digestif, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Frédéric Douane
- Radiologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Marc Lerhun
- Institut des Maladies de L'Appareil Digestif, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Nicolas Regenet
- Institut des Maladies de L'Appareil Digestif, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Jerome Gournay
- Institut des Maladies de L'Appareil Digestif, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Emmanuel Coron
- Institut des Maladies de L'Appareil Digestif, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Eric Frampas
- Radiologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Jean Reignier
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
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Quénéhervé L, Imbert A, Douane F, Archambeaud I, Gournay J, Coron E. Iatrogenic bilhemia after transjugular portal stent placement. Clin Res Hepatol Gastroenterol 2021; 45:101597. [PMID: 33639360 DOI: 10.1016/j.clinre.2020.101597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Lucille Quénéhervé
- Institut des Maladies de l'Appareil Digestif, IMAD, University Hospital of Nantes, Nantes, France
| | - Astrid Imbert
- Institut des Maladies de l'Appareil Digestif, IMAD, University Hospital of Nantes, Nantes, France
| | - Frédéric Douane
- Radiology Department, University Hospital of Nantes, Nantes, France
| | - Isabelle Archambeaud
- Institut des Maladies de l'Appareil Digestif, IMAD, University Hospital of Nantes, Nantes, France
| | - Jérôme Gournay
- Institut des Maladies de l'Appareil Digestif, IMAD, University Hospital of Nantes, Nantes, France
| | - Emmanuel Coron
- Institut des Maladies de l'Appareil Digestif, IMAD, University Hospital of Nantes, Nantes, France.
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Gilbert A, Thubert T, Dochez V, Riteau AS, Ducloyer M, Ragot P, Frampas E, Douane F, David A. Angiographic findings and outcomes after embolization of patients with suspected postabortion uterine arteriovenous fistula. J Gynecol Obstet Hum Reprod 2020; 50:102033. [PMID: 33301980 DOI: 10.1016/j.jogoh.2020.102033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this study is to assess the angiographic incidence of uterine arteriovenous fistula (UAVF) in women referred for a high ultrasonographic suspicion in a postabortion setting and to evaluate the safety, efficacy and impact on further fertility of uterine artery embolization (UAE) in this indication. MATERIALS AND METHODS A monocentric retrospective study of 31patients managed by uterine artery embolization for suspected UAVF after spontaneous or induced first trimester abortion. The diagnosis of UAVF was confirmed when an early venous drainage was identified on the angiogram. Technical success was defined as complete exclusion of the vascular lesion. Clinical success was defined as the absence of bleeding during the clinical follow-up and during the surgery in case of hysteroscopic resection. Information about further fertility was gathered by phone calls to the patients. RESULTS The mean age of the patients was 30.8 (±6.0) years. The diagnosis of UAVF was angiographically confirmed in 6 patients (19.4 %). Angiographic findings of retained product of conception (RPOC) with varying degrees of vascularity were observed in remaining patients. The technical success rate of UAE was 100 %, mostly through a proximal and bilateral embolization using a resorbable agent (27/31 patients, 87.1 %). The clinical success rate of UAE was 100 % in the group treated by a single UAE. We did not notice any bleeding during the surgery in the group of patients who needed a further hysteroscopic resection. 14 patients led at least one subsequent pregnancy to term without any difficulty. CONCLUSION UAVF is a rare condition. We supposed it may constitute the ultimate stage in the natural history of the retained products of conception with "marked vascularity". UAE seems to be an effective and safe first-line treatment.
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Affiliation(s)
- Alizé Gilbert
- Department of Radiology, Nantes University Hospital, 9 Quai Moncousu, 44093, Nantes, France
| | - Thibault Thubert
- Department of Obstetrics and Gynecology, Nantes University Hospital, 38 Boulevard Jean Monnet, 44000, Nantes, France
| | - Vincent Dochez
- Department of Obstetrics and Gynecology, Nantes University Hospital, 38 Boulevard Jean Monnet, 44000, Nantes, France
| | - Anne-Sophie Riteau
- Department of Obstetrics and Gynecology, Jules Verne Medical Center, 2 - 4 Route de Paris, 44300, Nantes, France
| | - Mathilde Ducloyer
- Department of Radiology, Nantes University Hospital, 9 Quai Moncousu, 44093, Nantes, France
| | - Paul Ragot
- Department of Obstetrics and Gynecology, Nantes University Hospital, 38 Boulevard Jean Monnet, 44000, Nantes, France
| | - Eric Frampas
- Department of Radiology, Nantes University Hospital, 9 Quai Moncousu, 44093, Nantes, France
| | - Frédéric Douane
- Department of Radiology, Nantes University Hospital, 9 Quai Moncousu, 44093, Nantes, France
| | - Arthur David
- Department of Radiology, Nantes University Hospital, 9 Quai Moncousu, 44093, Nantes, France.
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Garret C, Canet E, Corvec S, Boutoille D, Péron M, Archambeaud I, Le Thuaut A, Lascarrou JB, Douane F, Lerhun M, Regenet N, Coron E, Reignier J. Impact of prior antibiotics on infected pancreatic necrosis microbiology in ICU patients: a retrospective cohort study. Ann Intensive Care 2020; 10:82. [PMID: 32542577 PMCID: PMC7295875 DOI: 10.1186/s13613-020-00698-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
Background Recent guidelines advise against prophylactic antibiotics in patients with necrotizing pancreatitis, advocating instead a step-up drainage and necrosectomy strategy with antibiotics as dictated by microbiological findings. However, prompt antibiotic therapy is recommended in patients with sepsis or septic shock, a possible presentation of infected pancreatic necrosis (IPN). Consequently, in many critically ill patients with IPN, pancreatic samples are collected only after broad-spectrum antibiotic therapy initiation. Whether this prior antibiotic exposure alters the microbiological findings is unknown. The main objective was to determine whether prior antibiotic exposure sterilized the samples collected during procedures for suspected IPN in patients admitted to the intensive care unit (ICU) for acute pancreatitis with suspected IPN. We retrospectively studied 56 consecutive ICU patients admitted with suspected IPN. We collected details on the microbiological samples and antimicrobials used. A definite diagnosis of IPN was given when bacteria were identified in pancreatic samples. Results In all, 137 pancreatic samples were collected, including 91 (66.4%) after antibiotic therapy initiation. IPN was confirmed in 48 (86%) patients. The proportion of positive samples was 74 (81.3%) in antibiotic-exposed patients and 32/46 (69.5%) in unexposed patients (p = 0.58). Of the 74 positive samples from exposed patients, 62 (84%) had organisms susceptible to the antibiotics used. One-third of samples contained more than one organism. Among patients with IPN, 37.5% had positive blood cultures. Multidrug- or extensively drug-resistant bacteria were identified at some point in half the patients. Enterobacter cloacae complex was more frequent in the exposed group (p = 0.02), as were Gram-negative anaerobic bacteria (p = 0.03). Conclusion Antibiotic exposure before sampling did not seem to affect culture positivity of pancreatic samples to confirm IPN, but may affect microbiological findings. Our results suggest that, in patients with sepsis and suspected IPN, antibiotics should be started immediately and pancreatic samples obtained as soon as possible thereafter. In other situations, antibiotics can be withheld until the microbiological results of pancreatic samples are available, to ensure accurate targeting of the spectrum to bacterial susceptibility patterns. ClinicalTrials.gov number NCT03253861
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Affiliation(s)
- Charlotte Garret
- Service de Médecine Intensive et Réanimation, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France.
| | - Emmanuel Canet
- Service de Médecine Intensive et Réanimation, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Stéphane Corvec
- Service de Bactériologie-Hygiène Hospitalière, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | | | - Matthieu Péron
- Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Isabelle Archambeaud
- Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Aurélie Le Thuaut
- Institut des Maladies de l'appareil Digestif, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Jean-Baptiste Lascarrou
- Service de Médecine Intensive et Réanimation, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Frédéric Douane
- Département de Biostatistiques, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Marc Lerhun
- Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Nicolas Regenet
- Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Emmanuel Coron
- Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Jean Reignier
- Service de Médecine Intensive et Réanimation, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
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David A, Frampas E, Douane F, Perret C, Leaute F, Cantarovich D, Karam G, Branchereau J. Management of vascular and nonvascular complications following pancreas transplantation with interventional radiology. Diagn Interv Imaging 2020; 101:629-638. [PMID: 32089482 DOI: 10.1016/j.diii.2020.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 12/23/2022]
Abstract
Pancreas transplantation exposes to high rates of complications, either vascular (thrombosis, stenosis, pseudoaneurysm, arteriovenous fistula) or nonvascular (fluid collection, graft rejection). With advances in percutaneous and endovascular techniques, interventional radiologists are increasingly involved in the management of these complications. In this article, we review the anatomical considerations relevant to pancreas transplantation, the techniques used for image-guided interventions for vascular and nonvascular complications, and the expected outcomes of these interventions.
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Affiliation(s)
- A David
- Department of Radiology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France.
| | - E Frampas
- Department of Radiology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France
| | - F Douane
- Department of Radiology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France
| | - C Perret
- Department of Radiology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France
| | - F Leaute
- Department of Radiology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France
| | - D Cantarovich
- Department of Nephrology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France
| | - G Karam
- Department of Urology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France
| | - J Branchereau
- Department of Urology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France
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10
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David A, Metairie S, Perret C, Schnee M, Archambeaud I, Frampas E, Douane F. Minilaparotomy-assisted transmesenteric approach for portal vein recanalization and transjugular intrahepatic portosystemic shunt in a non-cirrhotic patient with portal cavernoma. Diagn Interv Imaging 2020; 101:417-419. [PMID: 31899148 DOI: 10.1016/j.diii.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/29/2019] [Accepted: 12/09/2019] [Indexed: 02/07/2023]
Affiliation(s)
- A David
- Department of Radiology, Nantes University Hospital and University of Medicine of Nantes, 1, place Alexis Ricordeau, 44093 Nantes, France.
| | - S Metairie
- Department of Abdominal Surgery, Nantes University Hospital and University of Medicine of Nantes, 44093 Nantes, France
| | - C Perret
- Department of Radiology, Nantes University Hospital and University of Medicine of Nantes, 1, place Alexis Ricordeau, 44093 Nantes, France
| | - M Schnee
- Department of Gastroenterology, Centre Hospitalier Départemental de Vendée, Les Oudairies, 85000 La Roche-Sur-Yon, France
| | - I Archambeaud
- Department of Gastroenterology, Nantes University Hospital and University of Medicine of Nantes, 44093 Nantes, France
| | - E Frampas
- Department of Radiology, Nantes University Hospital and University of Medicine of Nantes, 1, place Alexis Ricordeau, 44093 Nantes, France
| | - F Douane
- Department of Radiology, Nantes University Hospital and University of Medicine of Nantes, 1, place Alexis Ricordeau, 44093 Nantes, France
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David A, Liberge R, Meyer J, Morla O, Leaute F, Archambeaud I, Gournay J, Trewick D, Frampas E, Perret C, Douane F. Ultrasonographic guidance for portal vein access during transjugular intrahepatic portosystemic shunt (TIPS) placement. Diagn Interv Imaging 2019; 100:445-453. [DOI: 10.1016/j.diii.2019.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/08/2019] [Accepted: 01/16/2019] [Indexed: 02/07/2023]
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12
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David A, Meyer J, Archambeaud I, Frampas É, Perret C, Douane F. Endovascular Closure of a Large Congenital Extrahepatic Portosystemic Shunt (Abernethy Malformation) Using Vena Cava Filter and AMPLATZER Vascular Plugs. J Vasc Interv Radiol 2019; 29:1631-1633. [PMID: 30368322 DOI: 10.1016/j.jvir.2018.05.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/18/2018] [Accepted: 05/24/2018] [Indexed: 12/01/2022] Open
Affiliation(s)
- Arthur David
- Service de Radiologie Centrale, Centre Hospitalier Universitaire de Nantes, 1, Place Alexis Ricordeau, Nantes 44093, France
| | - Jérémy Meyer
- Service de Radiologie Centrale, Centre Hospitalier Universitaire de Nantes, 1, Place Alexis Ricordeau, Nantes 44093, France
| | - Isabelle Archambeaud
- Service d'Hépatologie et de Gastroentérologie, Centre Hospitalier Universitaire de Nantes, 1, Place Alexis Ricordeau, Nantes 44093, France
| | - Éric Frampas
- Service de Radiologie Centrale, Centre Hospitalier Universitaire de Nantes, 1, Place Alexis Ricordeau, Nantes 44093, France
| | - Christophe Perret
- Service de Radiologie Centrale, Centre Hospitalier Universitaire de Nantes, 1, Place Alexis Ricordeau, Nantes 44093, France
| | - Frédéric Douane
- Service de Radiologie Centrale, Centre Hospitalier Universitaire de Nantes, 1, Place Alexis Ricordeau, Nantes 44093, France
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Moreau F, Blanchard C, Perret C, Flet L, Douane F, Frampas E, Mirallie E, Croyal M, Aguesse A, Krempf M, Prieur X, Pichelin M, Cariou B, Le May C. In vivo evidence for transintestinal cholesterol efflux in patients with complete common bile duct obstruction. J Clin Lipidol 2018; 13:213-217.e1. [PMID: 30342919 DOI: 10.1016/j.jacl.2018.09.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/27/2018] [Accepted: 09/15/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Beyond the hepatobiliary pathway, studies have demonstrated that direct transintestinal cholesterol efflux (TICE) of plasma-derived cholesterol may contribute to reverse cholesterol transport. The clinical evidence of TICE in human remains challenged because of the difficulty to discriminate the hepatobiliary and transintestinal routes in vivo. OBJECTIVE To provide the first proof of concept that TICE exists in vivo in humans by demonstrating that plasma labeled cholesterol can be excreted in the feces of patients with complete bile duct obstruction. METHODS Plasma, bile, and fecal cholesterol excretion was measured by mass spectrometry 24, 48, and 72 hours after intravenous injection of D7-cholesterol in two patients presenting cholangiocarcinomas with a total obstruction of their primary bile duct. RESULTS No trace of bile acids was detected in the feces of the two patients. Despite this, a significant amount of plasma D7-cholesterol was quantified in the feces of the two patients 48 hours and 72 hours after the intravenous injection. CONCLUSION Our data bring a direct proof that TICE is an active pathway in humans.
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Affiliation(s)
- François Moreau
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France
| | - Claire Blanchard
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France; Service de Clinique de Chirurgie Digestive et Endocrinienne, CHU de Nantes, France
| | | | | | | | - Eric Frampas
- Department of Radiology, CHU Nantes, Nantes, France
| | - Eric Mirallie
- Service de Clinique de Chirurgie Digestive et Endocrinienne, CHU de Nantes, France
| | - Mikael Croyal
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Nantes, France; CRNHO, West Human Nutrition Research Center, CHU, Nantes, France
| | - Audrey Aguesse
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Nantes, France; CRNHO, West Human Nutrition Research Center, CHU, Nantes, France
| | - Michel Krempf
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Nantes, France; CRNHO, West Human Nutrition Research Center, CHU, Nantes, France
| | - Xavier Prieur
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France
| | - Matthieu Pichelin
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France; L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Bertrand Cariou
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France; L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Cédric Le May
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France.
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Chapelle N, Matysiak-Budnik T, Douane F, Metairie S, Rougier P, Touchefeu Y. Hepatic arterial infusion in the management of colorectal cancer liver metastasis: Current and future perspectives. Dig Liver Dis 2018; 50:220-225. [PMID: 29290599 DOI: 10.1016/j.dld.2017.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 12/04/2017] [Accepted: 12/06/2017] [Indexed: 12/11/2022]
Abstract
The technique of hepatic arterial infusion (HAI) for the treatment of liver metastases from colorectal cancer has been developed over more than 30 years. Although the indications and protocols for this technique have evolved with time, HAI is not routinely performed in clinical practice. Studies have been heterogeneous, with different regimens of intra-arterial drugs, associated or not with systemic chemotherapy, and with unconvincing outcomes. Technical difficulties for catheter placement have limited the implementation of this method in routine practice. The aim of this review is to present recent studies, highlighting technical improvements and promising combinations of oxaliplatin-based HAI with systemic treatments. HAI is being investigated in both the metastatic setting - in the first line and beyond - and in the adjuvant setting, and we will discuss its potential place in current and future patient management.
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Affiliation(s)
- Nicolas Chapelle
- University of Nantes, Nantes, France; Nantes University Hospital, Hôtel-Dieu, Digestive Disease Institute, Gastro-Enterology, Hepatology and Digestive Oncology Unit, France.
| | - Tamara Matysiak-Budnik
- University of Nantes, Nantes, France; Nantes University Hospital, Hôtel-Dieu, Digestive Disease Institute, Gastro-Enterology, Hepatology and Digestive Oncology Unit, France
| | | | | | - Philippe Rougier
- Nantes University Hospital, Hôtel-Dieu, Digestive Disease Institute, Gastro-Enterology, Hepatology and Digestive Oncology Unit, France
| | - Yann Touchefeu
- Nantes University Hospital, Hôtel-Dieu, Digestive Disease Institute, Gastro-Enterology, Hepatology and Digestive Oncology Unit, France
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Garret C, Péron M, Reignier J, Le Thuaut A, Lascarrou JB, Douane F, Lerhun M, Archambeaud I, Brulé N, Bretonnière C, Zambon O, Nicolet L, Regenet N, Guitton C, Coron E. Risk factors and outcomes of infected pancreatic necrosis: Retrospective cohort of 148 patients admitted to the ICU for acute pancreatitis. United European Gastroenterol J 2018; 6:910-918. [PMID: 30023069 DOI: 10.1177/2050640618764049] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/10/2018] [Indexed: 12/18/2022] Open
Abstract
Objective The primary objective of this article is to identify risk factors for infected pancreatic necrosis (IPN) in patients admitted to the intensive care unit (ICU) for severe acute pancreatitis. We also described outcomes of IPN. Background Acute pancreatitis is common and associated with multiple, potentially life-threatening complications. Over the last decade, minimally invasive procedures have been developed to treat IPN. Methods We retrospectively studied consecutive patients admitted for severe acute pancreatitis to the ICUs of the Nantes University Hospital in France, between 2012 and 2015. Logistic regression was used to evaluate potential associations linking IPN to baseline patient characteristics and outcomes. Results Of the 148 included patients, 26 (17.6%) died. IPN developed in 62 (43%) patients and consistently required radiological, endoscopic, and/or surgical intervention. By multivariate analysis, factors associated with IPN were number of organ failure (OF) (for ≥ 3: OR, 28.67 (6.23-131.96), p < 0.001) and portosplenomesenteric venous thrombosis (OR, 8.16 (3.06-21.76)). Conclusion IPN occurred in nearly half our ICU patients with acute pancreatitis and consistently required interventional therapy. Number of OFs and portosplenomesenteric venous thrombosis were significantly associated with IPN. Early management of OF may reduce IPN incidence, and management of portosplenomesenteric venous thrombosis should be investigated.
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Affiliation(s)
- Charlotte Garret
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Matthieu Péron
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Jean Reignier
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | | | - Jean-Baptiste Lascarrou
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Frédéric Douane
- Radiologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Marc Lerhun
- Institut des Maladies de l'Appareil Digestif, F-44093, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Isabelle Archambeaud
- Institut des Maladies de l'Appareil Digestif, F-44093, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Noëlle Brulé
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Cédric Bretonnière
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Olivier Zambon
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Laurent Nicolet
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Nicolas Regenet
- Institut des Maladies de l'Appareil Digestif, F-44093, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Christophe Guitton
- Médecine Intensive Réanimation, Centre Hospitalier du Mans, Le Mans, Pays de la Loire, France
| | - Emmanuel Coron
- Institut des Maladies de l'Appareil Digestif, F-44093, Centre Hospitalier Universitaire de Nantes, Nantes, France
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Moreau F, Blanchard C, Perret C, Flet L, Douane F, Frampas E, Aguesse A, Ouguerram K, Krempf M, Prieur X, Pichelin M, Miraillé E, Cariou B, Le May C. Plasma cholesterol is excreted in the feces of patients with complete common bile duct obstruction : In vivo evidence for TICE pathway in humans. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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17
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David A, Liberge R, Perret C, Frampas E, Douane F. CT-guided direct percutaneous treatment of a ruptured pulmonary artery pseudoaneurysm using N-butyl cyanoacrylate. Diagn Interv Imaging 2017; 98:903-904. [PMID: 28733139 DOI: 10.1016/j.diii.2017.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 06/23/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Affiliation(s)
- A David
- Department of Radiology, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
| | - R Liberge
- Department of Radiology, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
| | - C Perret
- Department of Radiology, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
| | - E Frampas
- Department of Radiology, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
| | - F Douane
- Department of Radiology, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
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18
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Frenard C, Planade O, Lot A, Bourreille A, Douane F, Barbarot S. Livedo systématisé : une complication de la chimioembolisation. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Lim A, Le Sourd S, Senellart H, Luet D, Douane F, Perret C, Bouvier A, Métairie S, Cauchin E, Philippe R, Tamara MB, Touchefeu Y. P-289 Hepatic arterial infusion chemotherapy for unresectable liver metastases of colorectal cancer: a multicenter retrospective study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Kauffmann C, Douane F, Therasse E, Lessard S, Elkouri S, Gilbert P, Beaudoin N, Pfister M, Blair JF, Soulez G. Source of Errors and Accuracy of a Two-Dimensional/Three-Dimensional Fusion Road Map for Endovascular Aneurysm Repair of Abdominal Aortic Aneurysm. J Vasc Interv Radiol 2015; 26:544-51. [DOI: 10.1016/j.jvir.2014.12.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 12/09/2014] [Accepted: 12/11/2014] [Indexed: 10/23/2022] Open
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