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Hamdidouche I, Gosse P, Cremer A, Lorthioir A, Delsart P, Courand PY, Denolle T, Halimi JM, Girerd X, Ormezzano O, Rossignol P, Pereira H, Azizi M, Amar L, Bobrie G, Monge M, Pagny JY, Sapoval M, Claisse G, Midulla M, Mounier-Vehier C, Dauphin R, Fauvel JP, Lantelme P, Rouvière O, Grenier N, Lebras Y, Trillaud H, Dourmap C, Heautot JF, Larralde A, Paillard F, Cluzel P, Rosenbaum D, Alison D, Popovic B, Zannad F, Baguet JP, Thony F, Bartoli JM, Vaïsse B, Drouineau J, Herpin D, Sosner P, Tasu JP, Velasco S, Ribstein J, Kovacsik H, Bouhanick B, Chamontin B, Rousseau H, Le Jeune S, Lopez-Sublet M, Mourad JJ, Bellmann L, Esnault V, Ferrari E, Chatellier G. Clinic Versus Ambulatory Blood Pressure in Resistant Hypertension: Impact of Antihypertensive Medication Nonadherence. Hypertension 2019; 74:1096-1103. [DOI: 10.1161/hypertensionaha.119.13520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinic-ambulatory blood pressure (BP) difference is influenced by patients- and device-related factors and inadequate clinic-BP measurement. We investigated whether nonadherence to antihypertensive medications may also influence this difference in a post hoc analysis of the DENERHTN trial (Renal Denervation for Hypertension). We pooled the data of 77 out of 106 evaluable patients with apparent resistant hypertension who received a standardized antihypertensive treatment and had both ambulatory BP and drug-screening results available at baseline after 1 month of standardized triple therapy and at 6 months on a median of 5 antihypertensive drugs. After drug assay samplings on study visits, patients took their antihypertensive treatment under supervision immediately after the start of the ambulatory BP recording, and supine clinic BP was measured 24 hours post-dosing; both allowed to calculate the clinic minus daytime ambulatory systolic BP (SBP) difference (clinic-SBP–day-SBP). A total of 29 (37.7%) were found nonadherent to medications at baseline and 38 (49.4%) at 6 months. At baseline, the mean clinic-SBP–day-SBP difference in the nonadherent group was 12.7 mm Hg (95% CI, 7.8–17.7 mm Hg,
P
<0.001). In contrast, clinic SBP was almost identical to day-SBP in the adherent group (clinic-SBP–day-SBP difference, 0.1 mm Hg; 95% CI, −3.3 to 3.5 mm Hg;
P
=0.947). Similar observations were made at 6 months. Using receiver operating characteristics curves, we found that a 6 mm Hg cutoff of clinic-SBP–day-SBP difference had 67% sensitivity and 69% specificity to predict nonadherence to the triple therapy at baseline. In conclusion, a large clinic-SBP–day-SBP difference may help discriminating between adherence and nonadherence to treatment in patients with resistant hypertension.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01570777.
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Affiliation(s)
- Idir Hamdidouche
- From the INSERM, Centre d’Investigations Cliniques- Plurithématique 1418, Paris, France (I.H., H.P., M.A.)
| | - Philippe Gosse
- ESH Hypertension excellence center, Hopital Saint André, University hospital of Bordeaux, France (P.G., A.C.)
| | | | - Aurelien Lorthioir
- AP-HP, Hypertension unit and DMU CARTE, Hôpital Européen Georges-Pompidou, Paris, France (A.L., H.P., M.A.)
| | - Pascal Delsart
- CHU Lille, Institut Cœur Poumon, Bd Pr Leclercq, France (P.D.)
| | - Pierre-Yves Courand
- Cardiology department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, France (P.-Y.C.)
- Université de Lyon, CREATIS; CNRS UMR5220; INSERM U1044; INSA-Lyon; Université Claude Bernard Lyon 1, France (P.-Y.C.)
| | - Thierry Denolle
- Hĉpital Arthur Gardiner, Centre d’Excellence en HTA Rennes- Dinard, France (T.D.)
| | - Jean-Michel Halimi
- Service de nephrologie-immunologie clinique, Hopital universitaire de Tours, et EA4245 Université Francois Rabelais, France (J.-M.H.)
| | - Xavier Girerd
- Unité de Prévention Cardio Vasculaire, Groupe Hospitalier Universitaire Pitié-Salpêtrière–Institut IE3M, Paris, France (X.G)
| | - Olivier Ormezzano
- Department of Cardiology, University Hospital and INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France (O.O.)
| | - Patrick Rossignol
- Université de Lorraine, Inserm, Centre d’Investigations Cliniques- Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France (P.R.)
| | - Helena Pereira
- From the INSERM, Centre d’Investigations Cliniques- Plurithématique 1418, Paris, France (I.H., H.P., M.A.)
- AP-HP, Hypertension unit and DMU CARTE, Hôpital Européen Georges-Pompidou, Paris, France (A.L., H.P., M.A.)
- AP-HP Clinical and Epidemiological Unit, Hopital Europeen Georges Pompidou, Paris, France (H.P.)
| | - Michel Azizi
- From the INSERM, Centre d’Investigations Cliniques- Plurithématique 1418, Paris, France (I.H., H.P., M.A.)
- AP-HP, Hypertension unit and DMU CARTE, Hôpital Européen Georges-Pompidou, Paris, France (A.L., H.P., M.A.)
- Université de Paris, Paris, France (M.A.)
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Vidal V, Hak JF, Brige P, Chopinet S, Tradi F, Bobot M, Gach P, Haffner A, Soulez G, Jacquier A, Moulin G, Bartoli JM, Guillet B. In Vivo Feasibility of Arterial Embolization with Permanent and Absorbable Suture: The FAIR-Embo Concept. Cardiovasc Intervent Radiol 2019; 42:1175-1182. [PMID: 31025052 DOI: 10.1007/s00270-019-02211-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/24/2018] [Accepted: 03/25/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Arterial embolization has been shown to be effective and safe for the management of bleeding, especially for postpartum and pelvic traumatic bleeding. We propose to evaluate the proof of concept of feasibility and effectiveness of arterial embolization with absorbable and non-absorbable sutures in a porcine model. MATERIALS AND METHODS In the acute setting (n = 1), several different arteries (mesenteric, splenic, pharyngeal, kidney) were embolized using non-absorbable sutures (NAS): Mersutures™ braided sutures (polyethylene terephthalate). In the chronic setting (n = 3), only lower pole renal arteries were embolized. On the right side, NAS was used, whereas on the left side embolization was realized with absorbable suture (AS): Vicryl® braided suture (polyglactin 910). The chronic group was followed for 3 months. The pigs received contrast-enhanced CT the day before embolization (D-1), after the embolization (D0), at 1 month and 3 months after embolization (M1 and M3); digital subtraction angiography (DSA) was done at D0 and M3 and histological analysis at M3. RESULTS All vascular targets were effectively embolized without any pre- or postoperative complications. Both DSAs and CTs at M3 showed a 100% recanalization rate for the AS embolization and a partial reversal rate for the NAS embolization. A renal hypotrophy in the embolized region was observed during both the M1 and M3 scans for both sutures (AS and NAS) with a clear hypotrophy for the NAS embolized kidney. CONCLUSION Embolization by AS and NAS (FAIR-Embo) is a feasible and effective treatment which opens up the possibility of global use of this inexpensive and widely available embolization agent.
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Affiliation(s)
- V Vidal
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France. .,LIIE, Aix Marseille Univ, Marseille, France. .,CERIMED, Aix Marseille Univ, Marseille, France.
| | - J F Hak
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France. .,LIIE, Aix Marseille Univ, Marseille, France. .,CERIMED, Aix Marseille Univ, Marseille, France.
| | - P Brige
- LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France
| | - S Chopinet
- LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France.,Department of Digestive Surgery, University Hospital Timone APHM, Marseille, France
| | - F Tradi
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France.,LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France
| | - M Bobot
- CERIMED, Aix Marseille Univ, Marseille, France.,Department of Nephrology, University Hospital Conception APHM, Marseille, France.,INSERM 1263, INRA 1260, C2VN, Aix Marseille Univ, Marseille, France
| | - P Gach
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France.,LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France
| | - A Haffner
- Department of Pathological Anatomy, University Hospital Timone APHM, Marseille, France
| | - G Soulez
- Department of Radiology, Centre Hospitalier de l'Université de Montréal, 1560 Sherbrooke East, Montreal, H2L 4M1, Canada
| | - A Jacquier
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France
| | - G Moulin
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France
| | - J M Bartoli
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France
| | - B Guillet
- CERIMED, Aix Marseille Univ, Marseille, France.,INSERM 1263, INRA 1260, C2VN, Aix Marseille Univ, Marseille, France.,Department of Radiopharmacy, APHM, Marseille, France
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3
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Fohlen A, Tasu JP, Kobeiter H, Bartoli JM, Pelage JP, Guiu B. Transarterial chemoembolization (TACE) in the management of hepatocellular carcinoma: Results of a French national survey on current practices. Diagn Interv Imaging 2018; 99:527-535. [PMID: 29609903 DOI: 10.1016/j.diii.2018.03.003] [Citation(s) in RCA: 11] [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: 01/21/2018] [Revised: 02/09/2018] [Accepted: 03/09/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE To report current practices of transarterial chemoembolization (TACE) by interventional radiologists (IR) for hepatocellular carcinoma (HCC) through a French national survey. MATERIALS AND METHODS An electronic survey was sent by e-mail to 232 IRs performing TACE in 32 private or public centers. The survey included 66 items including indications for TACE, technical aspects of TACE, other locally available treatments for HCC, follow-up imaging and general aspects of interventional radiology practices. RESULTS A total of 64 IRs (64/232; 27%) answered the survey. Each IR performed a mean of 49±45 (SD) TACE procedures per year. Marked variations in indications for TACE in HCC were observed. Six percent of IRs (4/64) treated only patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC. Antibioprophylaxis was not used by 43/64 of IRs (67%). The number of HCC nodules was considered to select conventional TACE versus drug-eluting beadsTACE (DEB-TACE) by 17/49 IRs (35%) followed by patient performance status and Child-Pugh score by 6/49 IRs (12%). Seventy-three percent of IRs (45/62) treated nodules selectively in patients with unilobar disease with cTACE. Thirty-three percent of IRs (21/64) planned systematically a second TACE session. Doxorubicin was the most frequently used drug (52/64; 81%) and 15/64 IRs (23%) used gelatine sponge as the only embolic agent. For DEB-TACE, 100-300μm beads were used by 26/49 IRs (53%) and no additional embolization was performed by 19/48 IRs (39%). Monopolar radiofrequency technique was widely available (59/63; 94%) compared to selective internal radiation therapy (37/64; 58%). Magnetic resonance imaging was used for follow-up by 13/63 IRs (20%). CONCLUSION Current practices of TACE for HCC varied widely among IRs suggesting a need for more standardized practices.
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Affiliation(s)
- A Fohlen
- Department of Interventional and Diagnostic Imaging, University Hospital of Caen, Avenue de la Côte de Nacre, Caen Cedex 14033, France; Normandie Univ, UNICAEN, CEA, CNRS, ISTCT/CERVOxy Group, 14000 Caen, France.
| | - J P Tasu
- Diagnostic, Functional and Therapeutic Imaging Department, Poitiers University Hospital, Poitiers Cedex, France
| | - H Kobeiter
- Department of Medical Imaging, AP-HP, Groupe Henri-Mondor Albert-Chenevrier, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France; University of Medicine, Université Paris 12, 94000 Créteil, France
| | - J M Bartoli
- Department of Radiology, Hôpital Timone, 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
| | - J P Pelage
- Department of Interventional and Diagnostic Imaging, University Hospital of Caen, Avenue de la Côte de Nacre, Caen Cedex 14033, France; Normandie Univ, UNICAEN, CEA, CNRS, ISTCT/CERVOxy Group, 14000 Caen, France
| | - B Guiu
- Department of Radiology, St-Eloi University Hospital-Montpellier, 80, Avenue Augustin Fliche, 34295 Montpellier, France
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Gaudry M, David B, Omnes V, Bal L, De Masi M, Bartoli JM, Piquet P. [Radiation-induced carotid stenosis: A personnalized approach]. J Med Vasc 2017; 42:263-271. [PMID: 28964385 DOI: 10.1016/j.jdmv.2017.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/25/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Surgical treatment of radio-induced carotid stenosis (RICS) is challenging and burdened by an elevated risk of local complications. Carotid artery stenting (CAS) may be a suitable alternative. The best approach is yet to be defined. We reviewed the results of both techniques following selection based on better-suitability characteristics (anatomic and clinical). METHODS We retrospectively reviewed 38 patients treated for 43 RICS from a group of 1230 patients who had carotid interventions between 2008 and 2015 (5 bilateral). Primary endpoints were morbidity and mortality at 30 days (transient ischemic attack, stroke, myocardial infarction, or death). Secondary endpoints were technical success, wound complications, cranial nerve injury (CNI), restenosis (≥50%) and recurrent symptoms. RESULTS RICS was symptomatic in 6 patients in the OR group and 3 in the CAS group. Lesions in the OR group were longer (P=0.02) and more calcified (P=0.08). Technical success rate was 100%. Cranial nerve injury rate was 14.2% (3/21). All injuries were completely resolved within several weeks. In the CAS group, technical success rate was 95% (21/22) with the one failure due to a residual stenosis exceeding 30%. Periprocedural stroke rates were 0% and 4.5% in the OR and CAS groups respectively (0/21 vs 1/22, P=0.32). There were no early deaths. Mean follow-up was 19.1 months (3-75). The restenosis rate was 9.5% (2/21) in the OR group and 9% (2/22) in the CAS group. CONCLUSION Our results do not support a preferred treatment strategy. The choice of treatment should be considered on an individual basis.
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Affiliation(s)
- M Gaudry
- Service de chirurgie vasculaire, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - B David
- Service de chirurgie vasculaire, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - V Omnes
- Service de chirurgie vasculaire, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - L Bal
- Service de chirurgie vasculaire, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - M De Masi
- Service de chirurgie vasculaire, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - J M Bartoli
- Service de radiologie, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - P Piquet
- Service de chirurgie vasculaire, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
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5
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Marcelin C, Izaaryene J, Castelli M, Barral PA, Jacquier A, Vidal V, Bartoli JM. Embolization of ovarian vein for pelvic congestion syndrome with ethylene vinyl alcohol copolymer (Onyx ®). Diagn Interv Imaging 2017. [PMID: 28647478 DOI: 10.1016/j.diii.2017.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of pelvic embolization using ethylene vinyl alcohol copolymer (Onyx®) for pelvic congestion syndrome. MATERIAL AND METHODS Between March 2012 to September 2016, 17 women (mean age, 44.7± 12.2 (SD) years; range: 34-71years) presenting with pelvic congestion syndrome were evaluated for transvenous embolization with Onyx®. Pelvic congestion syndrome was initially diagnosed by clinical examination and the results of transvaginal Doppler ultrasound and further confirmed by pelvic venography. Primary and secondary clinical efficacy was defined respectively by the resolution of the symptoms after embolization and at the end of the follow-up, irrespective to the number of embolization procedures. RESULTS Technical efficacy of embolization was 100% with no significant complications during and after embolization. After a mean follow-up time of 24.2 months (range: 6-69months) a primary and secondary clinical efficacy of 76.4% (13/17 women) and 94.1% (16/17 women) respectively were observed. Four women (23.5%) underwent a second embolization procedure with one woman requiring a third embolization procedure. These additional embolization procedures were associated with direct puncture of vulvar varices for sclerotherapy in two women. Five women (29%) had recurrent symptoms 21 months post-treatment (7-42months). CONCLUSION Pelvic embolization using ethylene vinyl alcohol copolymer (Onyx®) has a favorable clinical success for pelvic congestion syndrome.
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Affiliation(s)
- C Marcelin
- Department of Medical Imaging, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France.
| | - J Izaaryene
- Department of Medical Imaging, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - M Castelli
- Department of Medical Imaging, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - P A Barral
- Department of Medical Imaging, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - A Jacquier
- Department of Medical Imaging, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - V Vidal
- Department of Medical Imaging, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - J M Bartoli
- Department of Medical Imaging, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
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Dabadie A, Soussan J, Mancini J, Vidal V, Bartoli JM, Gorincour G, Petit P. Development and initial evaluation of a training program for peripherally inserted central catheter (PICC) placement for radiology residents and technicians. Diagn Interv Imaging 2016; 97:877-82. [PMID: 27150063 DOI: 10.1016/j.diii.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 09/28/2014] [Revised: 08/20/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The goals of this study were to develop and evaluate a joint theoretical/practical training course for radiology residents and technicians and to start a collaborative practice agreement enabling radiology technicians to perform PICC placement under the responsibility of an interventional radiologist. MATERIALS AND METHODS A joint training session based on literature evidences and international recommendations was designed. Participants were assessed before and after training, and were also asked to evaluate the program one month after completion of the training course. Practical post-training mentoring guidelines were laid down for radiologists supervising technicians. RESULTS From January to April 2014, 6 radiology residents and 12 radiology technicians from the two interventional radiology departments of the University hospitals in Marseille took part in the training program. For both residents and technicians, significant improvement was observed between pretraining and post-training assessment. The majority of participants were satisfied with the program. CONCLUSION Our experience suggests that combined theoretical and practical training in PICC placement allows improving technical skill and yields high degrees of satisfaction for both radiology residents and technicians. A collaborative practice agreement is now formally established to enable radiologists to delegate PICC placement procedures to radiology technicians.
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Affiliation(s)
- A Dabadie
- Service d'imagerie pédiatrique et prénatale, hôpital de La Timone-Enfants, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - J Soussan
- Service de radiologie et imagerie médicale, hôpital Nord, AP-HM, chemin des Bourrely, 13915 Marseille, France
| | - J Mancini
- BiosTIC, service biostatistiques et technologies de l'information et de la communication, hôpital de La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - V Vidal
- Service de radiologie adultes et neuroradiologie, AP-HM, hôpital de La Timone, 264, rue Saint-Pierre, 13385 Marseille, France
| | - J M Bartoli
- Service de radiologie adultes et neuroradiologie, AP-HM, hôpital de La Timone, 264, rue Saint-Pierre, 13385 Marseille, France
| | - G Gorincour
- Service d'imagerie pédiatrique et prénatale, hôpital de La Timone-Enfants, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - P Petit
- Service d'imagerie pédiatrique et prénatale, hôpital de La Timone-Enfants, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
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Vidal V, Sapoval M, Sielezneff Y, De Parades V, Tradi F, Louis G, Bartoli JM, Pellerin O. Emborrhoid: a new concept for the treatment of hemorrhoids with arterial embolization: the first 14 cases. Cardiovasc Intervent Radiol 2014; 38:72-8. [PMID: 25366092 DOI: 10.1007/s00270-014-1017-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 10/09/2014] [Indexed: 12/11/2022]
Abstract
PURPOSE The 'emborrhoid' technique consists of the embolization of the hemorrhoidal arteries. The endovascular arterial occlusion is performed using coils placed in the terminal branches of the superior rectal arteries. The emborrhoid technique has been modeled after elective transanal Doppler-guided hemorrhoidal artery ligation which has been shown to be effective in hemorrhoidal disease. We report the first 14 cases of our experience with emborrhoid technique. MATERIALS AND METHODS Fourteen patients with disabling chronic rectal bleeding were treated using the emborrhoid technique (3 women, 11 men). The stage of the hemorrhoidal disease was II (10 patients), III (3), and IV (1). This treatment was decided by a multidisciplinary team (proctologist, visceral surgeon, and radiologist). Seven patients underwent previous proctological surgery. Ten patients had coagulation disorders (anticoagulants or cirrhosis). Superior rectal arteries were embolized with pushable microcoils (0.018). RESULTS Technical success of the embolization procedure was 100 %. Clinical success at 1 month was 72 % (10/14). Of the 4 patients who experienced rebleeding, two underwent additional embolization of the posterior rectal arteries with success. No pain or ischemic complications were observed in 13 patients. One patient experienced a temporary painful and edematous, perianal reaction. CONCLUSION Our case studies suggest that coil embolization of the superior rectal arteries is technically feasible, safe and well tolerated. Additional studies are needed to evaluate the efficacy of this new 'emborrhoid' technique in the management of hemorrhoidal disease.
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Affiliation(s)
- V Vidal
- Department of Radiology, Hôpital de la Timone, 264 rue Saint Pierre, 13385, Marseille, Cedex 05, France,
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Sarlon-Bartoli G, Lazraq M, Bartoli MA, Lagrange G, Coudreuse JM, Jau P, Belenotti P, Bartoli JM, Viton JM, Magnan PE. [Postexercise duplex ultrasound to diagnose external iliac endofibrosis]. ACTA ACUST UNITED AC 2012; 37:150-4. [PMID: 22520050 DOI: 10.1016/j.jmv.2012.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 03/09/2012] [Indexed: 10/28/2022]
Abstract
Arterial endofibrosis is a disease of recent discovery which concerns high-performance athletes, predominantly competitive cyclists. The preferential location is the external iliac artery. The symptoms are diverse (pain, edema, paresthesia), always linked to an effort. The diagnosis may be delayed due to atypical symptoms in athletes. Complementary tests are measure of the systolic pressure index after exercise, duplex ultrasound, CT angiography, MR angiography and arteriography. We report a case of endofibrosis where late diagnosis was established with postexercise duplex ultrasound, while CT angiography and arteriography failed to reveal characteristic abnormalities.
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Affiliation(s)
- G Sarlon-Bartoli
- Service de chirurgie vasculaire, hôpital de la Timone, assistance publique hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
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9
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Muller C, Jacquier A, Varoquaux A, Cohen F, Louis G, Gaubert JY, Moulin G, Bartoli JM, Vidal V. [Urokinase in the management of occluded PICC lines]. ACTA ACUST UNITED AC 2010; 91:287-91. [PMID: 20508559 DOI: 10.1016/s0221-0363(10)70040-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine the efficacy and safety of urokinase in the management of occluded PICC lines. MATERIALS AND METHODS A total of 587 PICC lines were placed over an 11 month period. During this period, 28 PICC lines (4.8%) became occluded: 12 occluded PICC lines were successfully managed by simple flushing with normal saline while 16 PICC lines were thrombolyzed with urokinase. RESULTS After urokinase, 93.8% (15/16) of occluded PICC lines were completely patent. A single infusion of urokinase, 20,000 IU over 30 minutes, was used in all cases. No secondary occlusion or complication was noted after urokinase. CONCLUSION Urokinase is effective and safe to restore patency to occluded PICC lines. The procedure is simple, and could be performed at the bedside by nursing staff after medical prescription. It is an alternative to over the wire PICC line exchange, that could reduce the risk of complication related to manipulations, patient discomfort and cost.
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Affiliation(s)
- C Muller
- Service de Radiologie, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05.
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10
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Willoteaux S, Lions C, Duhamel A, Vernhet H, Sapoval M, Boyer L, Bartoli JM, Rousseau H, Beregi JP. [Virtual interventional radiology: evaluation of performances as a function of experience]. ACTA ACUST UNITED AC 2009; 90:37-41. [PMID: 19182712 DOI: 10.1016/s0221-0363(09)70076-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine the value of an angioplasty simulation to differentiate the users based on their level of experience. To determine the perceived usefulness of an angioplasty simulation program. MATERIALS AND METHODS Forty-six radiologists performed a renal angioplasty on a VIST simulator (Mentice Corporation, Gothenburg, Sweden); the procedure was completed by 41 radiologists. The radiologists were divided into two groups based on the level of experience. Quantitative variables analyzed included procedure duration time and fluoroscopy time. The radiologists then completed a questionnaire evaluating the simulation program. RESULTS Radiologists with more than 2 years of clinical experience (n=14) performed the procedures faster (20.4 min vs 27.4 min, p<0.01) using less fluoroscopy time (7.8 min vs 11.2 min, p<0.05) than others. Radiologists performing more than 2 procedures per month (n=14) performed the procedures faster (19.4 min vs 27.9 min, p<0.01) using less fluoroscopy time (7.4 min vs 11.3 min, p<0.05) than other (n=27). The participating radiologists indicated that the simulation was realistic. CONCLUSION Procedure duration time and duration of fluoroscopy were criteria able to differentiate the users based on their level of experience. The educational value of the simulation program was perceived as helpful by the users.
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Affiliation(s)
- S Willoteaux
- Service de Radiologie, Hôpital Larrey, CHU Angers, 4, rue Larrey, 49933 Angers Cedex 9, France.
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11
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Abstract
Imaging plays a chief role in the care and monitoring of patients in cervico-facial oncology. The radiologist must know the anatomy of different lymph nodes as well as signs of malignancy (hypertrophy, enhancement, necrosis, capsular rupture, etc.). CT is still the first-line examination because of its high reliability, its accessibility and its ability to make an assessment of the upper aero digestive ways at the same time. Ultrasound is very accuracy, and allows the realization of cytoponction, but does not provide a complete exploration of the neck. MRI does not appear to be indicated for the first intention, but the new rapid sequences (STIR, diffusion) seem interesting. The PET-CT is useful in post-therapeutic management of patients, and probably in the initial staging, but its accessibility is poor.
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Affiliation(s)
- O Monnet
- Service d'imagerie médicale adulte, Pr JM Bartoli et Pr G Moulin, Centre Hospitalier, Universitaire La Timone, 254 rue Saint Pierre, 13385 Marseille cedex 5, France.
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12
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Jacquier A, Champsaur P, Vidal V, Stein A, Monnet O, Drancourt M, Argenson JN, Raoult D, Moulin G, Bartoli JM. [CT evaluation of total HIP prosthesis infection]. ACTA ACUST UNITED AC 2005; 85:2005-12. [PMID: 15692411 DOI: 10.1016/s0221-0363(04)97773-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the ability of CT imaging to detect infectious lesions in total hip prosthesis. PATIENTS AND METHODS CT was performed in 17 cases of suspected total hip prosthesis infection. Images were reviewed to evaluate for the presence of soft tissue abscess, hip joint effusion or fistula and peri-prosthetic lucency or erosion at bone window setting. The feasibility of CT imaging is assessed with regards to metallic artifacts. RESULTS Infection was confirmed in 10 hips. A soft tissue abscess was present in 8 of these cases, in association to a joint effusion, presumably septic, in 7 cases. A fistula was identified in 8 cases. A peri-prosthetic lucency was present in 10 cases, 7 of which with infection, and erosions were noted in 4 patients, 2 of which with infection. Metallic artifacts reduced image quality but did not prevent detection of soft tissue abscesses. CONCLUSION CT is useful for detection of soft tissue abscesses in patients with infected hip prosthesis. CT is useful for surgical planning or follow-up of patients treated conservatively.
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Affiliation(s)
- A Jacquier
- Service de radiologie générale, CHU la Timone, 254 rue St Pierre, 13385 Marseille cedex 5.
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13
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Vidal V, Amabile P, Jacquier A, Pascal T, Chapon F, Rollet G, Le Corroller T, Gaubert J, Champsaur P, Moulin G, Piquet P, Bartoli JM. [Stent-graft treatment of a ruptured aortic graft: a case report]. J Radiol 2005; 86:76-8. [PMID: 15785420 DOI: 10.1016/s0221-0363(05)81325-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The authors report the clinical and imaging features of a patient with rupture of an aortoiliac graft successfully treated by endovascular approach. The endovascular treatment is easy to perform and effective. The main pitfall of this technique is the limited availability of stent-grafts.
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Affiliation(s)
- V Vidal
- Service de Radiologie Générale, Hôpital Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France
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14
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Rolland PH, Mekkaoui C, Vidal V, Berry JL, Moore JE, Moreno M, Amabile P, Bartoli JM. Compliance matching stent placement in the carotid artery of the swine promotes optimal blood flow and attenuates restenosis. Eur J Vasc Endovasc Surg 2004; 28:431-8. [PMID: 15350569 DOI: 10.1016/j.ejvs.2004.06.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES We assessed the value of a gradient-compliant stent in an animal model. METHODS Bilateral carotid arteries were stented with nitinol stents having variable-oversizing, variable-stiffness, and with (CMS, 10 animals) and without (SMART, four animals) compliance-matching endings. Angiography, hemodynamic, scanning-electron-microscopic and histological analyses were performed at 3-month. The protocol was completed in 14 among 19 swines. RESULTS Transient (1-month) exaggerated recoil, attributable to stress-induced phasic inhibition of vasorelaxation, developed at CMS endings. At mid-term, all stents were endothelialized; CMS-stents, but not SMART-stents, were incorporated into walls (one-strut-thickness). Restenosis developed outside SMART-stents (cell migration+wall-compensatory enlargement) whereas CMS-stents elicited no or focalized cell-accumulations at endings that bulged vascular walls radially outward. SMART-stents were blood-flow neutral, whereas CMS-stents favored (higher-stiffness, higher-oversizing) or opposed (lower-stiffness, less-oversizing) carotid blood flow. CONCLUSIONS Direct carotid stenting with stents having compliance-matched endings and specific requirements of stiffness and oversizing can optimize blood flow to the brain and restrict local restenosis.
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MESH Headings
- Animals
- Blood Pressure/physiology
- Blood Vessel Prosthesis Implantation
- Carotid Artery, Common/diagnostic imaging
- Carotid Artery, Common/physiopathology
- Carotid Artery, Common/surgery
- Compliance
- Endothelium, Vascular/diagnostic imaging
- Endothelium, Vascular/physiopathology
- Follow-Up Studies
- Graft Occlusion, Vascular/diagnostic imaging
- Graft Occlusion, Vascular/etiology
- Graft Occlusion, Vascular/physiopathology
- Models, Animal
- Models, Cardiovascular
- Pulsatile Flow
- Radiography
- Regional Blood Flow/physiology
- Statistics as Topic
- Stents
- Swine
- Time Factors
- Tunica Intima/diagnostic imaging
- Tunica Intima/physiopathology
- Venous Thrombosis/diagnostic imaging
- Venous Thrombosis/etiology
- Venous Thrombosis/physiopathology
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Affiliation(s)
- P H Rolland
- Laboratory of Hemodynamics and Cardiovascular Mechanics, School of Medicine, Marseille, France.
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15
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Jacquier A, Bressollette E, Laissy JP, Gaubert JY, Crochet D, Moulin G, Bartoli JM. [MR imaging and arrhythmogenic right ventricular dysplasia (ARVD)]. ACTA ACUST UNITED AC 2004; 85:721-4. [PMID: 15243371 DOI: 10.1016/s0221-0363(04)97673-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Arrhythmogenic right ventricular dysplasia (ARVD) is a cardiomyopathy of unknown etiology responsible for 20% of cases of sudden death in young adults secondary to arrhythmia. It is characterized histologically by fatty or fibro-fatty infiltration of the right ventricular myocardium. Diagnostic criteria have been proposed for diagnosing ARVD. Imaging, especially MRI, plays an important role. MR imaging must be performed using cardiac gating, and should include both cine-MR sequences for evaluation of segmental and global right ventricular function or any morphological change of the right ventricular shape, and anatomic sequences to detect fatty or fibro-fatty infiltration of the right ventricular myocardium.
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Affiliation(s)
- A Jacquier
- Service d'Imagerie Médicale, Hôpital La Timone, Marseille.
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16
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Jacquier A, Chabbert V, Vidal V, Otal P, Gaubert JY, Joffre F, Rousseau H, Bartoli JM. Comment, quand et pourquoi réaliser une imagerie de l’aorte thoracique chez l’adulte ? ACTA ACUST UNITED AC 2004; 85:854-69. [PMID: 15243361 DOI: 10.1016/s0221-0363(04)97692-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CT, MRI and transesophageal echocardiography have become the standard of reference for evaluation of the thoracic aorta. Angiography is mainly performed as a presurgical procedure. Congenital pathologies observed during adulthood include coarctation, patent ductus arteriosus, and aberrant retroesophageal subclavian arteries. Imaging plays a major role for diagnosis and management of patients with acute aortic syndromes: intramural hematoma, dissection, penetrating ulcer and nondissecting aneurysms. Cross sectional imaging of the thoracic aortic wall allows evaluation of inflammatory diseases of the aorta or aortitis.
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Affiliation(s)
- A Jacquier
- Service d'Imagerie Médicale, CHU la Timone, 254, rue Saint-Pierre, 13385 Marseille cedex 5.
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17
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Scherrer A, Bartoli JM. [Interpretation session in general radiology. Case No. 8: Cardiovascular system. Fallot tetralogy with pulmonary atresia]. J Radiol 2004; 85:444-6. [PMID: 15248331 DOI: 10.1016/s0221-0363(04)97613-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- A Scherrer
- CMC Foch, Service d'Imagerie Médicale, Suresnes
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18
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Scherrer A, Bartoli JM. [Interpretation session in general radiology. Case No. 4: Cardiovascular system. Single ventricle treated with total cavo-pulmonary anastomosis or Fontan's procedure]. J Radiol 2004; 85:433-4. [PMID: 15248325 DOI: 10.1016/s0221-0363(04)97609-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- A Scherrer
- CMC Foch, Service d'Imagerie Médicale, Suresnes
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19
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Jacquier A, Facon F, Vidal V, Pascal T, Chapon F, Dessi P, Bartoli JM, Moulin G. [Sphenoid sinusitis]. J Neuroradiol 2003; 30:211-8. [PMID: 14566188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Sphenoid sinusitis is uncommon, with an incidence of about 2.7%. Failure to diagnose and treat sphenoid sinus disease has been shown to lead to serious neurologic sequellae. Plain radiographs play a limited role in the management of sinusitis. CT scan can provide a positive diagnosis by the visualization of mucosal thickening, air-fluid level and complete opacification of the sinusal cavities. In addition, CT can provide more information about the anatomy and abnormalities of the sphenoid sinus. MRI is used in cases of suspected tumors or neurologic involvement. The most common presenting symptom is headache that arise characteristically, but rarely, from the vertex. Sphenoiditis has a high risk of severe neurologic involvement, cavernous sinus thrombosis being one of the most serious complications.
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Affiliation(s)
- A Jacquier
- Service d'Imagerie Médicale Adultes, Marseille, France
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20
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Magnan PE, Albertini JN, Bartoli JM, Ede B, Valerio N, Moulin G, Branchereau A. Endovascular Treatment of Anastomotic False Aneurysms of the Abdominal Aorta. Ann Vasc Surg 2003; 17:365-74. [PMID: 14670014 DOI: 10.1007/s10016-003-0024-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Conventional surgical treatment of anastomotic false abdominal aortic aneurysms (AFAA) is technically difficult. Morbidity-mortality rates are higher than those for surgery of infrarenal abdominal aortic aneurysm (AAA). Endovascular management without laparotomy or aortic clamping represents an attractive alternative. The purpose of this study was to determine the immediate and middle-term outcome of endovascular management of AFAA. Between 1998 and 2001, 10 patients were treated for AFAA by placement of an endograft. The initial procedure was aortobifemoral bypass for occlusive artery disease in eight cases and resection and grafting for AAA in two cases. Mean age was 70 years. Seven patients were classified ASA 3 or 4. Three patients presented cardiac insufficiency with left ventricular ejection fraction <40%. Eight patients were treated using an aortounilateral iliac artery endograft in association with crossover femorofemoral bypass (3 AneuRx, 2 Endologix, 1 Talent, 1 Zenith, 1 surgeon-made stent). Two patients were treated with an aortoaortic endograft (1 Talent, 1 surgeon-made stent). In two patients extraperitoneal exposure of the common iliac artery was required for introduction of the stent in one case and for surgical closure of the iliac artery in the other case. A total of nine patients underwent another surgical procedure in association with stenting. Four endografts were custom-made. Endograft deployment was successful in all cases. No patient died during the postoperative period. Postoperative computed tomography (CT) scan confirmed exclusion of the aneurysmal sac in all cases. The mean duration of hospitalization was 13 days (range, 5-28 days). During follow-up (mean duration, 17.7 months; range, 5-42 months), one patient died from heart-related causes. No direct or indirect endoleak was detected by CT scan follow-up and a significant reduction in AFAA diameter was noted in the eight patients with follow-up periods lasting 6 months or more. One patient developed occlusion of an aortounilateral iliac artery endograft and was treated by axillobifemoral bypass. In one patient stenosis of the distal end of an aortounilateral iliac endograft was discovered by duplex scan and successfully treated by dilatation. Endovascular treatment of AFAA is technically feasible but requires more complex procedures involving associated surgical procedures and use of custom-made endografts. The morbidity-mortality rate in this small series of high-risk patients was low. Immediate and middleterm exclusion of AFAA was good.
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Affiliation(s)
- P E Magnan
- Service de Chirurgie Vasculaire, Hôpital de la Timone, Marseille, France.
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21
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Champsaur P, Pascal T, Vidal V, Gaubert JY, Bartoli JM, Moulin G. [Radio-anatomy of the paranasal sinuses]. J Radiol 2003; 84:885-900. [PMID: 13679762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
UNLABELLED The imaging anatomy of the paranasal sinuses presents some complexity. The paranasal sinuses develop within facial and cranial bones. They communicate with one another and with the nasal cavity. Knowledge of normal anatomy is mandatory for accurate diagnosis of sinonasal pathology. The most frequent anatomical variants should be identified to decrease surgical risks. CT is the main imaging modality for the evaluation of sinonasal pathology. LEARNING OBJECTIVES to review the normal sinonasal anatomy and its frequent anatomical variants at CT imaging.
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Affiliation(s)
- P Champsaur
- Service de Radiologie et Imagerie Médicale, Hôpital de la Timone, 254 rue Saint Pierre, 13385 Marseille Cedex 5.
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22
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Moulin G, Pascal T, Jacquier A, Vidal V, Facon F, Dessi P, Bartoli JM. [Radiologic imaging of chronic sinusitis in the adult]. J Radiol 2003; 84:901-19. [PMID: 13679763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
The diagnosis of chronic sinusitis is based on clinical presentation, nasal endoscopy and CT scan. As a matter of fact, the CT scan of the paranasal sinuses is absolutely necessary to characterise the lesions, to visualise anatomic variations which are risk factors for the endoscopic surgery and to follow up treated and/or operated patients with recurrent symptoms. Nowadays, plain films of paranasal sinuses do not have any indication. MR Imaging may be indicated in selected cases of complicated sinusitis and of pseudotumors associated to sinusitis.
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Affiliation(s)
- G Moulin
- Service Central de Radiologie Adulte et Fédération d'ORL, CHU la Timone, 13385 Marseille Cedex 5.
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23
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Thuny F, Philip E, Caucino K, Ambrosi P, Jacquier A, Avierinos JF, Vailloud JM, Aguirre L, Lambert M, Bartoli JM, Habib G. [Isolated non-compaction of the left ventricle]. Arch Mal Coeur Vaiss 2003; 96:339-43. [PMID: 12741311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Isolated non compaction of the left ventricle is a rare congenital cardiomyopathy linked to an arrest of normal myocardial embryogenesis. We report two cases of isolated non compaction of the left ventricle discovered by echocardiography in 2 males of 30 and 55 years. The first had progressively worsening cardiac insufficiency, the second was being followed for an unexplained cardiomyopathy. In both cases, the diagnosis was able to be confirmed by transthoracic echocardiography, supported by MRI data. Although present from birth, this condition can become apparent at various ages and is complicated by sudden death (principal cause of mortality), severe cardiac insufficiency, or thrombo-embolic accidents. The diagnosis of left ventricular non compaction should be considered when faced with unexplained cardiac insufficiency in the adult.
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Affiliation(s)
- F Thuny
- Service de cardiologie, hôpital de la Timone, bd Jean Moulin 13005 Marseille
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24
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Levrier O, Mekkaoui C, Rolland PH, Murphy K, Cabrol P, Moulin G, Bartoli JM, Raybaud C. Efficacy and low vascular toxicity of embolization with radical versus anionic polymerization of n-butyl-2-cyanoacrylate (NBCA). An experimental study in the swine. J Neuroradiol 2003; 30:95-102. [PMID: 12717295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND AND PURPOSE To compare the efficacy and vascular toxicity of embolization with radical (NBCA+metacryloxysulpholane=CS) versus conventional anionic (NBCA alone=CA) polymerization of NBCA. MATERIALS AND METHODS Under continuous digital subtracted angiography (DSA) recordings, a 0.2 mL volume of identical glue mixtures were injected in a single-step procedure, concomitantly, in left and right (with CS and CA, respectively) renal arterial branches (RAB) and ascending pharyngeal arteries (APA) in 8 swines. Arterial histopathology and morphometry of inflammation were investigated at 2 weeks. RESULTS Complete embolization was achieved with equivalent cast homogeneity on DSA with both NBCA mixtures in RAB and APA. Inflammatory crowns in APA and RAB were significantly lower in CS - than in CA-treated sites (p<0.001). CS plug was scarcely adhesive to the vascular wall, and pulled apart from the wall by a residual thrombotic lining; in contrast with CA casts that were strongly adhesive to walls with endothelium stripping. CONCLUSIONS Anionic and radical polymerization of NBCA embolization was identical with regards to occlusion rate; whereas radical pathway of polymerization with cyanoacrylates lowered histotoxicity with a less sustained adhesiveness of casts against vascular walls.
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Affiliation(s)
- O Levrier
- Laboratoire d'Hémodynamique et de Mécanique Cardiovasculaire, Faculté de Médecine Marseille, Hôpital de La Timone, France.
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25
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Abstract
Static and dynamic pelvic IRM is nowadays part of the diagnostic work up of pelvic prolapse. It is a second line examination, diagnosis being made primarily on the basis of findings at physical pelvic examination. Advantages of MR imaging include lack of ionising radiation, simplicity, multiplanar imaging capability, and possibility to explore at the same time the three compartments and the pelvic floor. The dynamic MR Imaging can be coupled with a clinical examination at the magnet. Imaging is useful in patients in whom findings at physical examination are equivocal. Dynamic MR imaging can be useful in evaluating pelvic organ prolapse. It allows detection of hidden prolapses and assessment of muscle trophycity. Post-operatively it allows assessment of surgical results and failures or recurrences.
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Affiliation(s)
- V Juhan-Duguet
- Service d'imagerie médicale du Pr Bartoli, La Timone, rue St Pierre, 13385 Marseille, France.
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26
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Rolland PH, Bartoli JM, Piquet P, Mekkaoui C, Nott SH, Moulin G, Amabile P, Mesana T. Local delivery of NO-donor molsidomine post-PTA improves haemodynamics, wall mechanics and histomorphometry in atherosclerotic porcine SFA. Eur J Vasc Endovasc Surg 2002; 23:226-33. [PMID: 11914009 DOI: 10.1053/ejvs.2001.1556] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES we investigated the therapeutic effect of angioplasty with local drug delivery (LDD) of the wall-accumulating NO-donor molsidomine (M) in the superficial femoral arteries (SFA) of atherosclerotic swine. MATERIALS AND METHODS atherosclerotic Pietrin swines (n=14) underwent PTA-LDD-M (4 mg/2 ml) vs contralateral PTA-LDD-Placebo in the SFA using a channelled balloon angioplasty catheter. Invasive and colour Doppler energy (CDE) assessments of haemodynamics and wall mechanics were performed at 24 h (n=4) and 5 months (n=10). Immuno-histolabelling of cell proliferation and histomorphometry were serially performed in perfusion fixed SFA samples. RESULTS at 24 h, PCNA-positive nuclei revealed 33+/-14 and 12+/-3 proliferating cells/mm2 at placebo and molsidomine PTA-LDD sites, respectively (p<0.001). At 5 months, PTA-LDD-M vessels, compared with PTA-LDD-P, had increased compliance (66+/-9 vs 11+/-4 ml/mmHg) and lowered impedance (0.11+/-0.05 vs 0.45+/-0.14 mmHg/ml x min(-1)) (p<0.05). CDE revealed low, middle and high velocity peaks at 7.5, 20 and 35, and 8, 15 and 22 cm x s(-1) in systolic and diastolic flows, respectively; and PTA-LDD-M prevented emergence of restenosis-associated increases in low blood velocities (p<0.01). PTA-LDD-M inhibited restenotic intimal thickening and medial thinning which decreased mean lumenal diameter in placebo-treated (2.6+/-0.3) as compared to molsidomine-treated (3.4+/-0.3 mm) vessels (p<0.05). CONCLUSIONS in the atherosclerotic porcine SFA model, PTA-LDD with molsidomine consistently improved haemodynamic wall mechanics, lowered cell proliferation and prevented late lumen loss observed with PTA-LDD with placebo.
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Affiliation(s)
- P H Rolland
- Hemodynamics and Cardiovascular Mechanics Laboratory, School of Medicine, Hôpital La Timone, 27 Bd Jean-Moulin, 13385 Marseille Cedex 5, France
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27
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Dalmas P, Haddad O, Jacquier A, Lechevallier E, André M, Bartoli JM, Coulange C. [Arterio-ureteral fistula: diagnostic and therapeutic approach]. Prog Urol 2001; 11:1277-81. [PMID: 11859665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The diagnosis of arterio-ureteric fistula must be considered in the case of sudden onset of abundant or intermittent haematuria occurring in a particular context (history of aorto-iliac vascular surgery, prolonged ureteric stenting, ilio-pelvic radiotherapy). Emergency treatment must control bleeding. Endovascular stenting may be a useful technique, followed by reconstructive surgery with vascular bypass graft and treatment of the ureteric lesion.
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Affiliation(s)
- P Dalmas
- Service d'Urologie, Hôpital Salvator, 249, Bd. de Sainte-Marguerite, 13009 Marseille.
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Castellani P, Campan P, Bernardini D, Moulin G, Bartoli JM, Le Treut YP, Gauthier AP, Botta-Fridlund D. Is transjugular intrahepatic portosystemic shunt really deleterious for liver transplantation issue? A monocentric study on 86 liver transplanted patients. Transplant Proc 2001; 33:3468-9. [PMID: 11750484 DOI: 10.1016/s0041-1345(01)02494-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- P Castellani
- Medico-Surgical Liver Unit, Conception Hospital, Marseille, France
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29
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Albertini JN, Branchereau A, Hopkinson B, Magnan PE, Bartoli JM, Whitaker SC, Davidson I. Mortality and morbidity following endovascular repair of abdominal aortic aneurysms: analysis of two single centre experiences. Eur J Vasc Endovasc Surg 2001; 22:429-35. [PMID: 11735181 DOI: 10.1053/ejvs.2001.1501] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE to show how differences in anatomical and physiological risk factors can affect the outcome of endovascular repair of AAA by describing the experience of two centres with different selection policies. METHODS one hundred and thirty-five patients (group I) were treated at Queen's Medical Centre (Nottingham, U.K.) using 101 in-house made and 34 manufactured stent-grafts. Median diameter, length and angulation of the proximal aneurysm neck were 26 mm, 27 mm, 40 degrees, respectively. Seventy-six patients had ischaemic heart disease, 47 had left ventricular failure, median forced expiratory volume in one second (FEV1) was 83%, median creatinine was 100 micromol/l and median age was 72 years. Fifty patients (group II) were treated at Timone Hospital (Marseilles, France) using seven in-house made and 43 manufactured stent-grafts. Median diameter, length and angulation of the proximal aneurysm neck were 25 mm, 34 mm, 33 degrees, respectively. Thirteen patients had ischaemic heart disease, two had left ventricular failure, median forced expiratory volume in one second was 101%, median creatinine was 108 micromol/l and mean age was 72 years. RESULTS anatomical characteristics of the proximal neck were significantly worse in group I (p=0.02 for the three variables). Cardiac comorbidities were more frequent and mean FEV1 was lower in group I (p<0.0001 and p=0.001, respectively. Median aneurysm diameter was significantly greater in group I (65 mm) than in group II (53 mm) (p<0.001). Postoperative mortality was 9% and 0% in groups I and II respectively (p=0.03). The incidence of technical complications (groin wound complications and side branches endoleaks being excluded) was 20% and 0% in groups I and II, respectively (p=0.0006). CONCLUSION postoperative mortality and technical complication rates were significantly greater in group I than in group II, readily explained by poorer general condition and worse anatomical characteristics of the proximal neck in group I.
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Affiliation(s)
- J N Albertini
- Vascular Surgery Department, Hôpital d'Adultes Timone, 264 rue Saint-Pierre, 13385 Marseilles, France
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30
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Thomas P, Reynaud-Gaubert M, Bartoli JM, Augé A, Garbe L, Giudicelli R, Fuentes P. Exsanguinating hemoptysis revealing the absence of left pulmonary artery in an adult. Ann Thorac Surg 2001; 72:1748-50. [PMID: 11722085 DOI: 10.1016/s0003-4975(01)02611-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Isolated absence of a pulmonary artery is an exceptional cause of massive hemoptysis. We report a 35-year-old woman with agenesis of the left pulmonary artery who presented with exsanguinating hemoptysis that prompted angiography with the aim to embolize the bleeding vessels selectively. The procedure could not be completed because of the presence of an anterior spinal artery branching from the aberrant systemic-to-pulmonary circulation. The patient successfully underwent an emergent pneumonectomy.
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Affiliation(s)
- P Thomas
- Department of Thoracic Surgery, University Méditerranée (Aix-Marseille II), School of Medicine, St. Marguerite Hospital, France.
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31
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Nikol S, Armeanu S, Engelmann MG, Pelisek J, Fuchs A, Zähringer C, Bartoli JM, Mesana T, Rolland PH. Evaluation of endovascular techniques for creating a porcine femoral artery occlusion model. J Endovasc Ther 2001; 8:401-7. [PMID: 11552732 DOI: 10.1177/152660280100800409] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the optimal endovascular approach to achieve long-term occlusion of large arteries, while preserving the integrity of periarterial tissue, in an animal model of ischemia. METHODS Femoral artery occlusions were created in 16 pigs using detachable balloons, coils, or blinded stent-grafts. Feasibility, safety, primary and long-term success, and the degree of neovascularization were determined over a 6-month period by serial angiography and histological analyses. Four animals served as untreated controls. RESULTS Overall primary success for all occlusion devices was 100%. The 6-month occlusion rate using detachable balloons or coils was 33% and 0%, respectively; however, all arteries occluded with blinded stent-grafts remained obstructed to the end of the study. There was no significant difference in capillary densities and collateralization of periarterial areas when occluded arteries were compared with nonoccluded controls in the same animal. No increase in collateralization was observed following endovascular arterial occlusion. CONCLUSIONS Percutaneous insertion of blinded stent-grafts easily, safely, and reliably creates long-term arterial occlusion in pigs, which may make this a more appropriate model for studying the effects of angiogenic factors in vivo.
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Affiliation(s)
- S Nikol
- Medical Department I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany.
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32
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Mekkaoui C, Friggi A, Rolland PH, Bodard H, Piquet P, Bartoli JM, Mesana T. Simultaneous Measurements of Arterial Diameter and Blood Pressure to Determine the Arterial Compliance, Wall Mechanics and Stresses In vivo. Eur J Vasc Endovasc Surg 2001; 21:208-13. [PMID: 11352678 DOI: 10.1053/ejvs.2001.1320] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND to develop a periarterial dimensional clip-probe which, associated with endovascular pressure measurement, real-time digital signal processing/data treatment systems, enables characterisation of the basic wall mechanics in given arterial sites. DESIGN experimental study. MATERIAL a facing pair of ultrasonic crystals was incorporated in periarterial highlight probes, made of sterilisable silicone and manufactured from computer-designed stainless steel casts. The A/D converted diameter and pressure (from an endovascular micro-tip probe) signals, triggered by the ECG, were on-line processed to provide their respective profiles during an averaged cardiac cycle, and subsequently the arterial wall physics. The technique was tested in the iliac and renal arteries in eight pigs. RESULTS the technique was found to indicate adequately that arterial responses to distending blood pressure, as given by Petersons modulus and relative pulsatility, were identical in renals and iliacs. In contrast, the compliance, circumferential incremental elastic modulus and midwall circumferential stress were higher in iliacs than in renals, whereas arterial stiffness of the renals surpassed that of the iliacs. DISCUSSION the technique with sterilisable probes produces in vivo pressure-diameter relationships, arterial compliance, and wall mechanics and stresses, whatever the arterial size. The porcine iliacs and renals are elastic and viscorigid arteries, respectively.
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Affiliation(s)
- C Mekkaoui
- Hemodynamics and Cardiovascular Mechanics Laboratory, School of Medicine, 27 Bd. Jean-Moulin, 13385 Marseilles Cedex 5, France
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33
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Joffre F, Boyer L, Bartoli JM, Rousseau H. [Arteriography: chronicle of a predicted death?]. J Radiol 2001; 82:211. [PMID: 11287850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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34
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Petit P, Vivarrat-Perrin L, Champsaur P, Juhan V, Chagnaud C, Vidal V, Gaubert JY, Bartoli JM, Dessi P, Zanaret M, Moulin G. Radiological follow-up of inverted papilloma. Eur Radiol 2001; 10:1184-9. [PMID: 11003417 DOI: 10.1007/s003309900292] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to describe cross-sectional imaging features of recurrent papilloma of the nasal fossa and paranasal sinuses and to evaluate the role of MR and CT in the postoperative follow-up of this lesion. Magnetic resonance imaging and CT of ten patients who presented recurrence of inverted papilloma were reviewed and correlated to initial imaging, endoscopy, and surgical reports. Imaging patterns of recurrent inverted papilloma are identical to those of initial tumors and recurrence location is closely related to the site of the former lesion. Magnetic resonance is more efficient than CT for the diagnosis and evaluation of extensions. Magnetic resonance supplies the deficiencies of endoscopy in case of extensions to the frontal sinus or the lateral recess of the antrum, especially if mucosal hyperplasia or sinusitis is associated. Magnetic resonance imaging is the first imaging modality to perform in the follow-up after removal of inverted papilloma.
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Affiliation(s)
- P Petit
- Department of Radiology, Centre Hospitalier et Universitaire de Marseille, France
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35
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Gaubert JY, Caus T, Dahan M, Wilshire P, Moulin G, Mesana T, Bartoli JM. MRI for follow-up after surgery for thoracic aorta dissection. MAGMA 2000; 11:78-9. [PMID: 11186997 DOI: 10.1007/bf02678503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J Y Gaubert
- Department of Radiology, Timone Hospital, Marseille, France.
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36
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Millet V, Bartoli JM, Lacroze V, Raybaud C, Unal D, Girard N. Predictive significance of magnetic resonance imaging at 4 months of adjusted age in infants after a perinatal neurologic insult. Biol Neonate 2000; 73:207-19. [PMID: 9551187 DOI: 10.1159/000013979] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this prospective study was to evaluate the predictive significance of magnetic resonance imaging (MRI) performed at 4 months of corrected age in 60 neonates after a perinatal neurologic insult. Follow-up ranged from 2 to 5 years of chronological age. MRI examination was normal in 10; isolated external hydrocephalus was found in 15 infants. Twenty-three of these infants developed normally. Focal or multifocal lesions were shown in 6 infants, of whom 2 developed normally. Diffuse brain involvement was present in 29 cases as atrophy (n = 18), leukomalacia (n = 5), basal ganglia lesions (n = 3), and delayed myelination (n = 3). All but 4 infants showed neurologic impairment. MRI performed at 4 months of adjusted age is of prognostic significance in neonates who suffer a moderate or mild neurologic insult.
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Affiliation(s)
- V Millet
- Neonatal Unit, Hôpital d'Enfants, C.H.U. Timone, Marseille, France
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37
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Serratrice J, Granel B, De Roux C, Pellissier JF, Swiader L, Bartoli JM, Disdier P, Weiller PJ. "Coated aorta": a new sign of Erdheim-Chester disease. J Rheumatol 2000; 27:1550-3. [PMID: 10852289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Erdheim-Chester disease is a rare, non-Langerhans cell form of histiocytosis characterized by osteosclerosis of the metaphyseal regions of long bones, diabetes insipidus, proptosis, and retroperitoneal fibrosis. The latter usually involves the perirenal area and leads to hydronephrosis. Periaortic fibrosis is less frequent. We describe 3 unusual cases of Erdheim-Chester disease with periaortic fibrosis involving the whole aorta and leading to a "coated aorta" appearance on computed tomography scans. Faced with such a singular "coated aorta," bone scintigraphy can be very helpful when searching for Erdheim-Chester disease.
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Affiliation(s)
- J Serratrice
- Service de Médecine Interne, Hôpital de la Timone, Marseille, France
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38
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Qanadli SD, Wilshire P, Bartoli JM. [Progress in cardiovascular imaging in 1999]. J Radiol 2000; 81 Suppl 1:A26-33. [PMID: 10949790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- S D Qanadli
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal
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39
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Dieu V, Joffre F, Krause D, Bartoli JM, Lyonnet D, Veyret C, Garcier JM, Boyer L. A comparison of the efficacy and safety of ioxaglate and iobitridol in renal angioplasty. Cardiovasc Intervent Radiol 2000; 23:91-6. [PMID: 10795832 DOI: 10.1007/s002709910020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare ioxaglate and iobitridol for percutaneous transluminal renal angioplasty (PTRA) as regards thromboembolic complications, the quality of diagnosis, and renal and general safety. METHODS One hundred and eighty-nine patients were prospectively studied, 98 of whom received ioxaglate, and 91, iobitridol. Twenty-two were secondarily excluded from the evaluation of thromboembolic complications as they did not undergo PTRA. RESULTS Two hundred and two PTRAs were performed. The total volumes of contrast medium administered and the procedure durations were the same for each patient. In the ioxaglate group, four dissections (3 stents), one occlusive dissection, and two spasms occurred; in the iobitridol group, there were three dissections (all stented), one occlusive dissection (stented), and two spasms. The final angiograms showed four renal infarctions with ioxaglate (2 of which were in patients who were not anticoagulated), two with iobitridol. No significant difference was seen in the incidence of thromboembolic complications when the PTRA was performed after anticoagulation (n = 150; 3.9% vs 4%, p = 0.78); in the whole population, thromboembolic complications were more frequent in the ioxaglate group but the difference was not significant (5.7% vs 3.7%, p = 0.74). The quality of the diagnosis and the general and renal safety were the same in the two groups. CONCLUSION Regarding the clotting phenomenon, we recorded as many thromboembolic complications with ioxaglate as with iobitridol.
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Affiliation(s)
- V Dieu
- Department of Radiology, University Hospital, Clermont-Ferrand, France
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40
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Abstract
Dissection of the portal vein is a rare entity which has been rarely described during transjugular intrahepatic portosystemic shunt (TIPS) procedure. We report three cases of dissection during this procedure and their complications. One dissection was immediately treated with coaxial stents. The two others were complicated either by a thrombus or by a false aneurysm. In the first case a second parallel stent was used to treat this complication. The patient with the portal vein false aneurysm was transplanted 4 days after this diagnosis. Portal vein dissection in TIPS procedure appeared to be less rare than has been reported and must be considered as a potential cause of TIPS dysfunction.
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Affiliation(s)
- P Petit
- Service Central de Radiologie et Imagerie Médicale, Groupe Hospitalier de la Timone, Marseille, France
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41
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Rolland PH, Charifi AB, Verrier C, Bodard H, Friggi A, Piquet P, Moulin G, Bartoli JM. Hemodynamics and wall mechanics after stent placement in swine iliac arteries: comparative results from six stent designs. Radiology 1999; 213:229-46. [PMID: 10540667 DOI: 10.1148/radiology.213.1.r99oc26229] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare the hemodynamics and wall mechanics of swine iliac arteries after placement of six types of stent. MATERIALS AND METHODS Stents were placed in the iliac artery of 18 pigs (three pigs each underwent placement with one of six types of stent); 16 untreated pigs served as control animals. Iliac arterial hemodynamics and wall mechanics were measured 4 days after placement. RESULTS Four stents (Palmaz-Schatz, Cordis, Warren, NJ; and Strecker, Cragg, and Symphony, Boston Scientific/Vascular, Natick, Mass) caused decreased pulsatile flow rate in the treated and contralateral iliac arteries; one (Memotherm; Bard, Covington, Ga) caused increased flow pulsatility; and one (Wallstent; Schneider, Plymouth, Minn) had no effect. No compliance mismatching was noted for the Cragg, Symphony, and Memotherm stents, whereas a decrease in compliance was noted for the Palmaz-Schatz, Strecker, and Wallstent designs. The Palmaz-Schatz and Strecker stents caused increased arterial wall rigidity, the Symphony and Wallstent designs had no effect, and the Memotherm and Cragg stents caused decreased wall rigidity. Stents made of stiff metal yielded different early results than did stents made of the less rigid nitinol. CONCLUSION Soon after implantation, the six stent designs elicited varying changes in blood flow, arterial compliance, and arterial wall mechanics. Contralateral arterial flow also was affected.
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Affiliation(s)
- P H Rolland
- Hemodynamics and Cardiovascular Mechanics Laboratory, Faculte de Medicine, Marseille, France.
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42
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Dalmas P, Moiroud F, Daou N, Payan-Cassin H, Abignoly AM, Bartoli JM. [Congenital intraparenchymatous renal arteriovenous fistulas]. Prog Urol 1999; 9:742-6. [PMID: 10555232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The authors report a new case of congenital renal arteriovenous fistula (AVF) in a young adult, who presented with gross haematuria. The diagnosis and treatment of this rare disease required collaboration between the urologist and radiologist. The key examination is renal arteriography, allowing selective embolization of the lesion. Conventional surgery now has a usually limited place, following failure of embolization.
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Affiliation(s)
- P Dalmas
- Service d'Urologie, Hôpital d'Aix en Provence, France
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43
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Affiliation(s)
- J Serratrice
- Service de médecine interne, CHU Timone, Marseille
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44
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Vidal V, André M, Lechevallier E, Sammama D, Wilshire P, Crozier F, Pascal T, Bartoli JM. [Renal malakoplakia: prognostic aspects]. J Radiol 1999; 80:309-11. [PMID: 10327340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
We report the changes in imaging findings over a 5 year period of a patient with unilateral malakoplakia involving renal parenchyma and pelvis. The imaging findings of malakoplakia will be reviewed.
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Affiliation(s)
- V Vidal
- Service de Radiologie générale, Hôpital de la Timone, Marseille
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45
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Champsaur P, Moulin G, Chagnaud C, Giovanni A, Bartoli JM. [Radio-anatomy of the larynx]. J Radiol 1999; 80:199-208. [PMID: 10209717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Affiliation(s)
- P Champsaur
- Service Central de Radiologie, CHU La Timone, Marseille
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46
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Crozier F, Lechevallier E, Andre M, Uzan E, Samama D, Wilshire P, Vidal V, Pascal T, Bartoli JM. [Prostatic ultrasonography in routine radiological practice: a survey of 122 radiologists]. Prog Urol 1999; 9:95-100. [PMID: 10212958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE To evaluate the indications and practical modalities of prostatic ultrasonography in routine radiological practice. METHODS An anonymous questionnaire composed of 18 multiple choice questions was sent to 122 radiologists. RESULTS Among the 76 responses, 90% were men, 90% were in private practice and 94% regularly performed prostatic ultrasonography without clinical information (81%). The prostatic examination was performed by transrectal ultrasonography (60%) combined with vesical and renal ultrasonography. The indications were: urinary functional disorders (56%) and abnormal PSA (40%). Prostatic ultrasonography was considered to be useful to calculate prostatic volumes by 59% of radiologists and in the staging of prostatic cancer (81%). 80% of radiologists did not start by performing digital rectal examination. 59% of patients were informed. CONCLUSION The observed indications did not correspond to urological consensus recommendations, but ultrasonography was performed according to classical recommendations. This study could justify a more precise definition of the role of ultrasonography in prostatic disease.
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Affiliation(s)
- F Crozier
- Service de Radiologie Générale, Hôpital de la Timone, Marseille, France
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47
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Crozier F, Lechevallier E, Eghazarian C, André M, Sammama D, Wilshire P, Vidal V, Pascal P, Bartoli JM. [Retroperitoneal non-secreting paraganglioma]. J Radiol 1999; 80:150-2. [PMID: 10209712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Paraganglioma is a rare tumor arising from indifferentiated cells of the primitive neural crest. These tumors are most commonly found in the adrenal gland but other localisations are possible. We described a 60-year-old men with a right retro-peritoneal mass discovered on ultrasound examination. This tumor had an heterogeneous appearance on i.v. contrast injected CT (computed tomography) and MR (magnetic resonance) images. Plasma and urinary catecholamines were normal. This tumor was surgically removed. Immunohistochemical analyses revealed that the tumor cells were strongly positive for neurone specific enolase and chromogranin A. Histopathologic examination diagnosed a non secreting paraganglioma in the right retroperitoneum. After surgery, the patient remained asymptomatic without treatment.
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Affiliation(s)
- F Crozier
- Service de Radiologie générale, Hôpital de la Timone, Marseille
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Abstract
We evaluated the importance of vascular access in hemodialysis patients using noninvasive methods with the Transonic Systems monitor in 108 patients. Most of these patients (84%) had native vein fistulas. We found that a blood flow rate of below 500 ml/min suggested the occurrence of vascular stenosis and justified confirmation by angiography. Increased recirculation could be evaluated readily and was detected in only 10% of patients. Finally, employing the evaluation of the Kt/V index, we found a good correlation between low flux through the fistula and a low Kt/V value.
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Affiliation(s)
- D Bouchouareb
- Department of Nephrology Hemodialysis, Hopital de la Conception, Marseille, France
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