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Dérimay F, Aminian A, Lattuca B, Souteyrand G, Maillard L, Alvain S, Cayla G, Motreff P, Bochaton T, Hayek A, Rioufol G, Finet G. Erratum to "One year results of Coronary bifurcation revascularization with the re-POT provisional sequential technique. The CABRIOLET registry" [Int J Cardiol. 2024 Feb 15;397:131632.]. Int J Cardiol 2024; 407:132045. [PMID: 38691903 DOI: 10.1016/j.ijcard.2024.132045] [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] [Indexed: 05/03/2024]
Affiliation(s)
- François Dérimay
- Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1060, CarMeN laboratory, Université de Lyon, Lyon, France.
| | - Adel Aminian
- Cardiology Department, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Benoit Lattuca
- ACTION Study Group, Cardiology Department, Centre Hospitalier Universitaire de Nimes, Nimes, France
| | - Géraud Souteyrand
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Sean Alvain
- Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
| | - Guillaume Cayla
- ACTION Study Group, Cardiology Department, Centre Hospitalier Universitaire de Nimes, Nimes, France
| | - Pascal Motreff
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Thomas Bochaton
- INSERM U1060, CarMeN laboratory, Université de Lyon, Lyon, France; Department of Intensive Cardiac Care, Cardiovascular Hospital, Hospices Civils de Lyon, Bron, France
| | - Ahmad Hayek
- INSERM U1060, CarMeN laboratory, Université de Lyon, Lyon, France; Department of Intensive Cardiac Care, Cardiovascular Hospital, Hospices Civils de Lyon, Bron, France
| | - Gilles Rioufol
- Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1060, CarMeN laboratory, Université de Lyon, Lyon, France
| | - Gérard Finet
- Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1060, CarMeN laboratory, Université de Lyon, Lyon, France
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Dérimay F, Aminian A, Lattuca B, Souteyrand G, Maillard L, Alvain S, Cayla G, Motreff P, Bochaton T, Hayek A, Rioufol G, Finet G. One year results of coronary bifurcation revascularization with the re-POT provisional sequential technique. The CABRIOLET registry. Int J Cardiol 2024; 397:131632. [PMID: 38048882 DOI: 10.1016/j.ijcard.2023.131632] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/18/2023] [Accepted: 11/30/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Re-POT (proximal optimization technique (POT)) is a simple provisional sequential technique for percutaneous coronary bifurcation revascularization with better arterial geometry respect compared to classical techniques. Re-POT has demonstrated excellent mechanical and short-term clinical results. The multicenter CABRIOLET registry (NCT03550196) evaluate the long-term clinical benefit of the re-POT sequence in non-selected patients. METHODS All consecutive patients presenting a coronary bifurcation lesion for which provisional stenting was indicated were included in 5 european centers. Re-POT strategy was systematically attempted. The primary endpoint was target lesion failure (TLF), comprising cardiac death, myocardial infarction, stent thrombosis and target lesion revascularization (TLR) at 12 months' follow-up. The secondary endpoints were the individual components of the primary endpoint, all-cause death, target vessel failure (TVF) and target vessel revascularization (TVR). Complex bifurcation was defined as Medina 0.1.1 or 1.1.1. RESULTS A total of 500 patients aged 67.7 ± 11.7 years, 78.4% male, were included from 2015 to 2019, 174 of whom (34.8%) were considered having complex bifurcation lesions. Bifurcations involved the left main in 35.2% of cases. The full re-POT sequence was systematically performed in all cases. At 1 year, TLF was 2.0% (1.7% in complex vs. 2.1% in non-complex bifurcation; p = NS), and TLR was 1.6%, (1.1% vs. 1.8% respectively; p = NS). TVF and TVR rates were 3.2% and 2.8%. On multivariate analysis, only multivessel disease was predictive of TLF at 1 year (OR = 1.66 (1.09-2.53), p = 0.02). CONCLUSIONS In this large prospective all-comer registry, provisional stenting with re-POT technique appeared safe and effective at 1 year, without anatomical bifurcation restriction.
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Affiliation(s)
- François Dérimay
- Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1060, CarMeN Laboratory, Université de Lyon, Lyon, France.
| | - Adel Aminian
- Cardiology Department, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Benoit Lattuca
- ACTION Study Group, Cardiology Department, Centre Hospitalier Universitaire de Nimes, Nimes, France
| | - Géraud Souteyrand
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Sean Alvain
- Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
| | - Guillaume Cayla
- ACTION Study Group, Cardiology Department, Centre Hospitalier Universitaire de Nimes, Nimes, France
| | - Pascal Motreff
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Thomas Bochaton
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Lyon, France; Department of Intensive Cardiac Care, Cardiovascular Hospital, Hospices Civils de Lyon, Bron, France
| | - Ahmad Hayek
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Lyon, France; Department of Intensive Cardiac Care, Cardiovascular Hospital, Hospices Civils de Lyon, Bron, France
| | - Gilles Rioufol
- Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1060, CarMeN Laboratory, Université de Lyon, Lyon, France
| | - Gérard Finet
- Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1060, CarMeN Laboratory, Université de Lyon, Lyon, France
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Lansky AJ, Xu B, Baumbach A, Kelbæk H, van Royen N, Zheng M, Knaapen P, Slagboom T, Johnson TW, Vlachojannis GJ, Arkenbout KE, Holmvang L, Janssens L, Brugaletta S, Naber CK, Schmitz T, Anderson R, Rittger H, Berti S, Barbato E, Toth GG, Maillard L, Valina CM, Buszman PE, Thiele H, Schächinger V, Wijns W. Targeted therapy with a localised abluminal groove, low-dose sirolimus-eluting, biodegradable-polymer coronary stent - five-year results of the TARGET All Comers randomised clinical trial. EUROINTERVENTION 2023; 19:e844-e855. [PMID: 37860860 PMCID: PMC10687649 DOI: 10.4244/eij-d-23-00409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND In the prospective, multicentre, randomised TARGET All Comers study, percutaneous coronary intervention (PCI) with the FIREHAWK biodegradable-polymer sirolimus-eluting stent (BP-SES) was non-inferior to the durable-polymer everolimus-eluting stent (DP-EES) for the primary endpoint of target lesion failure (TLF) at 12 months. AIMS We aimed to report the final study outcomes at 5 years. METHODS Patients referred for PCI were randomised to receive either a BP-SES or DP-EES in a 1:1 ratio in 10 European countries. Randomisation was stratified by centre and ST-elevation myocardial infarction (STEMI) presentation, and clinical follow-up extended to 5 years. The primary endpoint was TLF (composite of cardiac death, target vessel myocardial infarction [MI], or ischaemia-driven target lesion revascularisation). Secondary endpoints included patient-oriented composite events (POCE; composite of all-cause death, all MI, or any revascularisation and its components). RESULTS From December 2015 to October 2016, 1,653 patients were randomly assigned to the BP-SES or DP-EES groups, of which 93.8% completed 5-year clinical follow-up or were deceased. At 5 years, TLF occurred in 17.1% of the BP-SES group and in 16.3% of the DP-EES group (p=0.68). POCE occurred in 34.0% of the BP-SES group and 32.7% of the DP-EES group (p=0.58). Revascularisation was the most common POCE, occurring in 19.3% of patients receiving BP-SES and 19.2% receiving DP-EES, of which less than one-third was ischaemia-driven target lesion-related. In the landmark analysis, there were no differences in the rates of TLF and POCE between groups from 1 to 5 years, and these results were consistent across all subgroups. CONCLUSIONS In an all-comers population requiring stent implantation for myocardial ischaemia, the BP-SES was non-inferior to the DP-EES for the primary endpoint of TLF at 12 months, and results were sustained at 5 years, confirming the long-term safety and efficacy of the FIREHAWK BP-SES.
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Affiliation(s)
- Alexandra J Lansky
- Yale Cardiovascular Research Group, Yale School of Medicine, New Haven, CT, USA
| | - Bo Xu
- Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Andreas Baumbach
- Barts Heart Centre and Queen Mary University of London, London, United Kingdom
| | - Henning Kelbæk
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Niels van Royen
- Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands
| | - Ming Zheng
- Shanghai MicroPort Medical (Group) Co., Ltd. Shanghai, China
| | - Paul Knaapen
- Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands
| | - Ton Slagboom
- Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Thomas W Johnson
- Bristol Heart Institute, University of Bristol, and University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | | | | | - Lene Holmvang
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Luc Janssens
- Heart Centre, Imeldaziekenhuis, Bonheiden, Belgium
| | - Salvatore Brugaletta
- Cardiovascular Institute, Hospital Clínic de Barcelona, and Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Christoph K Naber
- Contilia Heart and Vascular Center, Elisabeth Krankenhaus Essen, Essen, Germany
| | - Thomas Schmitz
- Contilia Heart and Vascular Center, Elisabeth Krankenhaus Essen, Essen, Germany
| | - Richard Anderson
- Cardiology Department, University Hospital of Wales, Cardiff, United Kingdom
| | | | - Sergio Berti
- UOC Cardiologia Diagnostica e Interventistica, Ospedale del Cuore, Fondazione C.N.R. Regione Toscana G. Monasterio, Massa, Italy
| | - Emanuele Barbato
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Gabor G Toth
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Luc Maillard
- Service de Cardiologie, Clinique Axium, Aix-en-Provence, France
| | - Christian M Valina
- Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Paweł E Buszman
- American Heart of Poland, Katowice, Poland
- Department of Epidemiology and Biostatistics, Medical School of Silesia, Katowice, Poland
| | - Holger Thiele
- Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Volker Schächinger
- Medizinische Klinik I, Herz-Thorax Zentrum, Klinikum Fulda, Fulda, Germany
| | - William Wijns
- The Lambe Institute for Translational Medicine and CURAM, University of Galway, and Saolta University Health Care Group, University Hospital Galway, Galway, Ireland
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Aminfar F, Rubimbura V, Maillard L, Noble S, Rangé G, Belle L, Derimay F, Bellemain-Appaix A, Al Karaky A, Morelle JF, Sideris G, Motreff P, Muller O, Adjedj J. The POT-PUFF sign: an angiographic mark of stent malapposition during proximal optimisation. EUROINTERVENTION 2023; 18:1456-1457. [PMID: 36876867 PMCID: PMC10111119 DOI: 10.4244/eij-d-22-00861] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/23/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Farhang Aminfar
- Department of Cardiology, CHUV, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Luc Maillard
- Department of Cardiology, GCS ES Axium Rambot, Aix-en-Provence, France
| | - Stéphane Noble
- Department of Cardiology, Geneva University Hospital, Geneva, Switzerland
| | - Grégoire Rangé
- Department of Cardiology, Chartres Hospital, Chartres, France
| | - Loic Belle
- Department of Cardiology, Annecy Hospital, Annecy, France
| | - Francois Derimay
- Invasive Cardiology Department, Cardiovascular Louis Pradel Hospital, Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| | - Anne Bellemain-Appaix
- Department of Cardiology, Centre Hôpitalier d'Antibes Juan-les-Pins, Antibes, France
| | - Alexis Al Karaky
- Department of Cardiology, Fréjus Saint-Raphael Hospital, Fréjus, France
| | | | - Georgios Sideris
- Department of Cardiology, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Pascal Motreff
- Department of Cardiology, Hôpital Lariboisière, Paris, France
| | - Olivier Muller
- Department of Cardiology, CHUV, Lausanne University Hospital, Lausanne, Switzerland
| | - Julien Adjedj
- Department of Cardiology, Institut Arnault Tzanck, Saint-Laurent-du-Var, France
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Andersen BK, Sejr-Hansen M, Westra J, Campo G, Efterkhari A, Tu S, Escaned J, Koltowski L, Stähli BE, Erglis A, Jaruševičius G, Žiubrytė G, Råmunddal T, Liu T, Wijns W, Landmesser U, Maillard L, Matsuo H, Christiansen EH, Holm NR. Quantitative flow ratio versus fractional flow reserve for guiding percutaneous coronary intervention: design and rationale of the randomised FAVOR III Europe Japan trial. EUROINTERVENTION 2023; 18:e1358-e1364. [PMID: 36648404 PMCID: PMC10068862 DOI: 10.4244/eij-d-21-00214] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 10/28/2022] [Indexed: 01/18/2023]
Abstract
Quantitative flow ratio (QFR) is a computation of fractional flow reserve (FFR) based on invasive coronary angiographic images. Calculating QFR is less invasive than measuring FFR and may be associated with lower costs. Current evidence supports the call for an adequately powered randomised comparison of QFR and FFR for the evaluation of intermediate coronary stenosis. The aim of the FAVOR III Europe Japan trial is to investigate if a QFR-based diagnostic strategy yields a non-inferior 12-month clinical outcome compared with a standard FFR-guided strategy in the evaluation of patients with intermediary coronary stenosis. FAVOR III Europe Japan is an investigator-initiated, randomised, clinical outcome, non-inferiority trial scheduled to randomise 2,000 patients with either 1) stable angina pectoris and intermediate coronary stenosis, or 2) indications for functional assessment of at least 1 non-culprit lesion after acute myocardial infarction. Up to 40 international centres will randomise patients to either a QFR-based or a standard FFR-based diagnostic strategy. The primary endpoint of major adverse cardiovascular events is a composite of all-cause mortality, any myocardial infarction, and any unplanned coronary revascularisation at 12 months. QFR could emerge as an adenosine- and wire-free alternative to FFR, making the functional evaluation of intermediary coronary stenosis less invasive and more cost-effective.
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Affiliation(s)
| | | | - Jelmer Westra
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - Gianluca Campo
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Ferrara, Italy and Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Italy
| | - Ashkan Efterkhari
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Shengxian Tu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Javier Escaned
- Hospital Clinico San Carlos IdISSC, Complutense University of Madrid, Madrid, Spain
| | - Lukasz Koltowski
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Barbara E Stähli
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland
| | - Andrejs Erglis
- Department of Cardiology, Riga Stradiņš University, Riga, Latvia
| | - Gediminas Jaruševičius
- Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Kaunas, Lithuania and Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Greta Žiubrytė
- Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Kaunas, Lithuania and Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Truls Råmunddal
- Department of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Tommy Liu
- Department of Cardiology, HagaZiekenhuis, The Hague, the Netherlands
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway, Ireland
| | - Ulf Landmesser
- Department of Cardiology (CBF), Charite - Universitätsmedizin Berlin, Berlin, Germany
| | - Luc Maillard
- GCS ES Axium Rambot, Clinique Axium, Aix-en-Provence, France
| | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
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Hayek A, Dargaud Y, Maillard L, Finet G, Bochaton T, Rioufol G, Dérimay F. Thrombus burden management during primary coronary bifurcation intervention: a new experimental bench model. Cardiol J 2023; 31:24-31. [PMID: 36896636 PMCID: PMC10919574 DOI: 10.5603/cj.a2023.0015] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Management of thrombus burden during primary percutaneous coronary intervention (pPCI) is a key-point, given the high risk of stent malapposition and/or thrombus embolization. These issues are especially important if pPCI involves a coronary bifurcation. Herein, a new experimental bifurcation bench model to analyze thrombus burden behavior was developed. METHODS On a fractal left main bifurcation bench model, we generated standardized thrombus with human blood and tissue factor. Three provisional pPCI strategies were compared (n = 10/group): 1) balloon-expandable stent (BES), 2) BES completed by proximal optimizing technique (POT), and 3) nitinol self-apposing stent (SAS). The embolized distal thrombus after stent implantation was weighed. Stent apposition and thrombus trapped by the stent were quantified on 2D-OCT. To analyze final stent apposition, a new OCT acquisition was performed after pharmacological thrombolysis. RESULTS Trapped thrombus was significantly greater with isolated BES than SAS or BES+POT (18.8 ± 5.8% vs. 10.3 ± 3.3% and 6.2 ± 2.1%, respectively; p < 0.05), and greater with SAS than BES+POT (p < 0.05). Isolated BES and SAS tended show less embolized thrombus than BES+POT (5.93 ± 4.32 mg and 5.05 ± 4.56 mg vs. 7.01 ± 4.32 mg, respectively; p = NS). Conversely, SAS and BES+POT ensured perfect final global apposition (0.4 ± 0.6% and 1.3 ± 1.3%, respectively, p = NS) compared to isolated BES (74.0 ± 7.6%, p < 0.05). CONCLUSIONS This first experimental bench model of pPCI in a bifurcation quantified thrombus trapping and embolization. BES provided the best thrombus trapping, while SAS and BES+POT achieved better final stent apposition. These factors should be taken into account in selecting revascularization strategy.
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Affiliation(s)
- Ahmad Hayek
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude Bernard University and INSERM Unit 1060 CARMEN, Lyon, France
| | - Yassim Dargaud
- Unité d'Hémostase Clinique, Hôpital Cardiologique Louis Pradel, CRTH de Lyon, CHU de Lyon, France
| | | | - Gerard Finet
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude Bernard University and INSERM Unit 1060 CARMEN, Lyon, France
| | - Thomas Bochaton
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude Bernard University and INSERM Unit 1060 CARMEN, Lyon, France
| | - Gilles Rioufol
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude Bernard University and INSERM Unit 1060 CARMEN, Lyon, France
| | - François Dérimay
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude Bernard University and INSERM Unit 1060 CARMEN, Lyon, France.
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Maillard L, Vochelet F, Peycher P, Ayari A, Barra N, Billé J, Joly P, Silvestri M, Sevilla J, Tavildari A. How short can we reduce DAPT for HBR patients? MAPT after COBRA PzF™ NanoCoated Coronary Stent implantation. 200 patients at 1 year. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.033] [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: 12/31/2022]
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Landolff Q, Lefèvre T, Fajadet J, Sainsous J, Lhermusier T, Elhadad S, Tarragano F, Ranc S, Ghostine S, Cayla G, Marco F, Garot P, Maillard L, Motreff P, Delarche N, De Labriolle A, Pansieri M, Morelle JF, Cazaux P, Moulichon ME, Chopat P, Angoulvant D, Bataille V, Le Breton H, Koning R. Five-year clinical outcomes using the bioresorbable vascular scaffold: Insights from the FRANCE ABSORB registry. Arch Cardiovasc Dis 2022; 115:505-513. [PMID: 36123284 DOI: 10.1016/j.acvd.2022.05.008] [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: 01/18/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Randomized trials comparing the first-generation absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, CA, USA) with a drug-eluting stent showed a moderate but significant increase in the rate of 3-year major adverse cardiac events and scaffold thrombosis, followed by a decrease in adverse events after 3 years. AIM The objective of this study was to assess the 5-year outcomes of patients treated with at least one absorb BVS and included in the FRANCE ABSORB registry. METHODS All patients treated in France with an absorb BVS were prospectively included in a large nationwide multicentre registry. The primary efficacy outcome was the occurrence of 5-year major adverse cardiac events. Secondary efficacy outcomes were the rates of 5-year target vessel revascularization and definite/probable scaffold thrombosis. RESULTS Between September 2014 and April 2016, 2,070 patients were included in 86 centres (mean age 55±11 years; 80% men; 49% with acute coronary syndrome). The rates of 1-, 3- and 5-year major adverse cardiac events were 3.9%, 9.4% and 12.1%, respectively (including cardiac death in 2.5% and target vessel revascularization in 10.4%). By multivariable analysis, diabetes, oral anticoagulation, the use of multiple Absorb BVSs and the use of a 2.5mm diameter absorb BVS were associated with 5-year major adverse cardiac events. The rates of 1-, 3- and 5-year definite/probable scaffold thrombosis were 1.5%, 3.1% and 3.6%, respectively. By multivariable analysis, older age, diabetes, anticoagulation at discharge and the use of a 2.5mm diameter absorb BVS were associated with 5-year scaffold thrombosis. CONCLUSIONS Absorb BVS implantation was associated with low rates of 1-year major adverse cardiac events, which increased significantly at 3-year follow-up. There was a clear decrease in the rates of scaffold thrombosis and major adverse cardiac events after 3 years.
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Affiliation(s)
| | - Thierry Lefèvre
- Institut cardiovasculaire Paris Sud, Ramsay-Générale de Santé, hôpital privé Jacques-Cartier, 91300 Massy, France
| | | | | | | | - Simon Elhadad
- Centre hospitalier de Marne-la-Vallée, 77600 Jossigny, France
| | | | - Sylvain Ranc
- Centre hospitalier Saint-Joseph Saint-Luc, 69007 Lyon, France
| | - Saïd Ghostine
- Hôpital Marie-Lannelongue (groupe hospitalier Paris Saint-Joseph), 92350 Le Plessis-Robinson, France
| | | | | | - Philippe Garot
- Hôpital privé Claude-Galien, 91480 Quincy-sous-Sénart, France
| | | | | | | | | | | | | | - Pierre Cazaux
- Centre hospitalier de Bretagne Sud Site de Scorff, 56322 Lorient, France
| | | | - Patrick Chopat
- Centre hospitalier territorial, hôpital Gaston-Bourret, 98800 Nouméa, Nouvelle-Calédonie, France
| | | | - Vincent Bataille
- ADIMEP, université Paul-Sabatier, Toulouse III, 31400 Toulouse, France
| | | | - René Koning
- Clinique Saint-Hilaire, 76000 Rouen, France.
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Aminfar F, Honton B, Meyer P, Mariottini C, Durand P, Haessler M, Vareille P, Wijns W, Maillard L, Adjedj J. Quantitative Flow Ratio Analysis by Paramedical Compared With Medical Users. J Invasive Cardiol 2022; 34:E281-E285. [PMID: 35302947] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES We aimed to validate whether quantitative flow ratio (QFR) analysis could be performed by both medical and paramedical certified users. Therefore, we compared QFR values with conventional guidewire-based fractional flow reserve (FFR) as the reference using core laboratory analysis. QFR allows FFR calculation based on the coronary angiogram. QFR analysis requires certified users with dedicated training and skills. However, the ability of medical and paramedical users to correctly analyze QFR remains unknown. METHODS In a prospective, single-center study, we included all consecutive patients with stable coronary artery disease and indicated physiological assessment. QFR was performed and analyzed by 1 medical and 2 paramedical QFR users who were unaware of conventional pressure-guidewire FFR measurements. RESULTS We included 67 consecutive patients and 100 lesions for assessment with QFR and FFR. Pearson's correlation coefficient of QFR performed by paramedical users compared with medical users was 0.89 (range, 0.83-0.92). A Bland-Altman analysis showed no significant bias (-0.0008). Receiver-operator characteristic curves were generated to compare the ability to predict an FFR value above or below 0.80 with QFR performed by paramedical vs medical users. When comparing FFR with QFR performed by paramedical and medical users, the values for area under the curve were 0.964 and 0.970, respectively. Intraclass correlation was 0.884. CONCLUSION Our study showed a noticeable correlation between QFR analysis performed by QFR-certified paramedical and medical users, as compared with FFR. These data suggest that QFR analysis could be performed by certified paramedicals in order to reduce physician workload without impacting the quality of the obtained results.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Julien Adjedj
- Department of Cardiology, Arnault Tzanck Institute, Saint Laurent du Var, France.
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10
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Adrian-Lancelle M, Moreau D, Trinh-Duc A, Rozier PA, Darré M, Vanier E, Cournol M, Maillard L, Delonglée V. Analyse de la satisfaction des usagers du Samu 47 (Lot-et-Garonne) sur leur prise en charge dans le cadre de l’aide médicale urgente (AMU). Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectif : Évaluer la satisfaction des usagers du Samu 47 à la suite de leur appel dans le cadre de l’aide médicale urgente.
Matériel et méthodes : Étude de cohorte observationnelle, monocentrique, prospective, menée entre le 25 août et le 13 septembre 2020 par un même opérateur, à partir d’un questionnaire téléphonique. Le critère de jugement principal était le niveau de satisfaction générale des requérants après leur appel. Les critères secondaires étaient le ressenti du délai de décroché ARM (assistant de régulation médicale) et médical, le niveau de satisfaction de la prise en charge ARM et médicale, le ressenti du délai d’arrivée des effecteurs envoyés, le niveau de satisfaction de leur prise en charge, la mise en application du conseil formulé par le médecin régulateur et la suggestion d’axes d’amélioration.
Résultats : Parmi les 596 requérants inclus, 419 (70 %) étaient « très satisfaits », 132 (22 %) « assez satisfaits », 25 (4 %) « peu satisfaits » et 20 (3 %) « pas du tout satisfaits ». Les analyses univariées montraient que cela était lié à l’entretien avec l’ARM et le médecin régulateur, à la prise en charge des secours, à certaines attentes, à la suite donnée à l’appel, au délai ressenti d’arrivée des secours et au délai ressenti de décroché. L’analyse multivariée révélait que les éléments liés à l’insatisfaction étaient l’attente « faire venir les secours » (RC : 5,71, IC 95 % : 2,56–13,01), le fait de recevoir un conseil à l’issue de l’appel (RC : 9,28, IC 95 % : 4,15–21,96) et le délai ressenti de décroché de l’appel jugé « long » (RC : 3,64, IC 95 % : 1,06–10,75).
Conclusion : Les usagers sont globalement satisfaits à la suite de leur appel au Samu 47.
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Cutlip DE, Jauhar R, Meraj P, Garratt KN, Novack V, Novack L, Maillard L, Erglis A, Stoler R, Barakat M, Silber S. Five year clinical outcomes of the COBRA Polyzene F NanoCoated Coronary Stent System. Cardiovascular Revascularization Medicine 2022; 41:76-80. [DOI: 10.1016/j.carrev.2021.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/28/2021] [Accepted: 12/27/2021] [Indexed: 11/26/2022]
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12
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Lipiecki J, Brunel P, Dibie A, Morelle J, Abdellauoi M, Levy R, Carrié D, Karsenty B, Robin C, Berland J, Maillard L, Pankert M, Depoli F, Delarche N, Boiffard E, Champagne S, Piot C, Morel O, Chapon P, Garot P. Biofreedom France registry: A prospective evaluation of clinical outcomes in real-world patients treated by coronary angioplasty with Biolimus A9 polymer-free Biofreedom stents. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.012] [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: 11/26/2022]
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13
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Hussain Y, Wijns W, Xu B, Kelbæk H, Knaapen P, Zheng M, Slagboom T, Johnson T, Smits P, Arkenbout K, Holmvang L, Janssens L, Ochala A, Brugaletta S, Schmitz T, Anderson RA, Rittger H, Berti S, Barbato E, Toth G, Maillard L, Valina C, Buszman P, Thiele H, Schachinger V, Baumbach A, Lansky A. TCT-489 Three-Year Outcomes of Patients Treated With the Firehawk Stent Versus XIENCE Stent on the Basis of Diabetes Status: Subgroup Analysis of the TARGET All Comers Trial. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1342] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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Cuenin L, Honton B, Aminfar F, Meyer P, Mariottini C, Haessler M, Vareille P, Wijns W, Maillard L, Adjedj J. Head to head comparison of quantitative flow ratio using 4-French and 6-French catheters versus fractional flow reserve. Catheter Cardiovasc Interv 2021; 99:746-753. [PMID: 34468076 DOI: 10.1002/ccd.29933] [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: 05/25/2021] [Revised: 07/20/2021] [Accepted: 08/21/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To validate QFR using 4-F diagnostic catheters compared to using 6-F guiding catheters, with conventional guidewire-based FFR as the reference standard, using independent core laboratory analysis. BACKGROUND Quantitative Flow Ratio (QFR) allows Fractional Flow Reserve (FFR) calculation based on the coronary angiogram, using 5- or 6-French (F) catheters. However, the use of 4-F diagnostic catheters to perform coronary angiography is currently routine in some centers. METHODS We included all consecutive patients with stable coronary artery disease and indicated for physiological assessment. QFR was performed using a 4-F diagnostic catheter, then QFR was performed using a 6-F guiding catheter while conventional FFR was measured using a pressure guidewire. Angiograms were sent to two separate core laboratories. RESULTS One hundred lesions in 67 consecutive patients with QFR performed using 4-F and 6-F catheters, and with conventional FFR, were included. Pearson's correlation coefficient was for QFR 4-F vs. FFR 0.91 [0.87-0.94], for QFR 6-F vs. FFR 0.90 [0.86-0.94], and for QFR 4-F vs. QFR 6-F 0.93 [0.90-0.95]. Receiver-operator characteristic curves (ROC) comparing the ability to predict an FFR value above or below 0.80 with QFR 4-F and 6-F were generated. The area under the ROC curve (AUC) vs. FFR was 0.972 [0.95-0.99] for QFR 4-F and 0.970 [0.94-0.99] for QFR 6-F. CONCLUSIONS Our study demonstrated the feasibility of performing QFR analysis from angiograms obtained by 4-F catheters, and showed a good correlation with QFR performed using 6-F catheters as well as with conventional FFR performed using a pressure guidewire.
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Affiliation(s)
- Léo Cuenin
- Department of Cardiology, Arnault Tzanck Institute, Saint Laurent du Var, France
| | - Benjamin Honton
- Department of Cardiology, Clinique Pasteur, Toulouse, France
| | - Farhang Aminfar
- Department of Cardiology, CHU Vaudois, Lausanne, Switzerland
| | - Pierre Meyer
- Department of Cardiology, Arnault Tzanck Institute, Saint Laurent du Var, France
| | - Claude Mariottini
- Department of Cardiology, Arnault Tzanck Institute, Saint Laurent du Var, France
| | - Maelle Haessler
- Department of Cardiology, Clinique Axium, Aix en Provence, France.,Department of Cardiology, Clinique Saint Joseph, Marseille, France
| | | | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group, Galway, Ireland
| | - Luc Maillard
- Department of Cardiology, Clinique Axium, Aix en Provence, France.,Department of Cardiology, Clinique Saint Joseph, Marseille, France
| | - Julien Adjedj
- Department of Cardiology, Arnault Tzanck Institute, Saint Laurent du Var, France
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15
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Eberli FR, Stoll HP, Urban P, Morice MC, Brunel P, Maillard L, Lipiecki J, Cook S, Berland J, Hovasse T, Carrie D, Schütte D, Slama SS, Garot P. Polymer-free Biolimus-A9 coated thin strut stents for patients at high bleeding risk 1-year results from the LEADERS FREE III study. Catheter Cardiovasc Interv 2021; 99:593-600. [PMID: 34241947 PMCID: PMC9544800 DOI: 10.1002/ccd.29869] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/14/2021] [Accepted: 07/01/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND In patients at high bleeding risk (HBR), the LEADERS FREE (LF) trial established the safety and efficacy of a polymer-free drug coated (Biolimus-A9) stainless steel stent (SS-DCS) with 30 days of dual antiplatelet treatment (DAPT). In LEADERS FREE III, we studied a new cobalt-chromium thin-strut stent (CoCr-DCS) in HBR patients. METHODS The CoCr-DCS shares all of the design features of the SS-DCS but has a CoCr stent platform with strut thickness of 84-88 μm. The primary safety endpoint was a composite of cardiac death, myocardial infarction (MI), and definite/probable stent thrombosis. The primary efficacy endpoint was clinically indicated target lesion revascularization. Outcomes were compared to those of LF (non-inferiority to SS-DCS for safety and superiority to SS-BMS for efficacy). Additional propensity-matched comparisons were performed to account for baseline differences. RESULTS We recruited 401 HBR patients using identical criteria to the LF trial. At 1 year, the primary safety endpoint was reached by 31/401 (8.0%) of patients treated with the CoCr-DCS versus 35/401 (8.9%) for the propensity-matched cohort (HR: 0.89, [0.55-1.44], p < 0.001 for non-inferiority, 0.62 for superiority). The efficacy endpoint was reached by 16/401 (4.2%) of CoCr-DCS patients versus 41/401 (10.6%) in the propensity-matched cohort (HR: 0.4 [0.2:0.7]) (p = 0.007 for superiority). There was no statistical difference between CoCr-DCS and SS-DCS in terms of efficacy (HR: 1.46 [0.68-3.15], p = 0.33). CONCLUSIONS The new thin-strut CoCr-DCS proved non-inferior to the SS-DCS for safety, and superior to the BMS for efficacy in HBR patients treated with 30 days of DAPT.
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Affiliation(s)
- Franz R Eberli
- Cardiology Department, Triemli Hospital, Zurich, Switzerland
| | - Hans-Peter Stoll
- Clinical Research, Biosensors Clinical Research, Morges, Switzerland
| | - Philip Urban
- Cardiovascular European Research Center (CERC), Massy, France
| | | | - Philippe Brunel
- Interventional Cardiology Unit, Clinique de Fontaine, Dijon, France
| | - Luc Maillard
- Department of Cardiology, GCS ES Axium-Rambot, Aix-en-Provence, France
| | - Janus Lipiecki
- Department of Cardiology, Pole Sante Republique, Clermont Ferrand, France
| | - Stephane Cook
- Department of Cardiology, University Hospital Fribourg, Fribourg, Switzerland
| | - Jacques Berland
- Department of Cardiology, Clinique Saint Hilaire, Rouen, France
| | - Thomas Hovasse
- Department of Cardiology, Institut Cardiovasculaire Paris-Sud (ICPS), Ramsay-Santé, Hôpital Jacques Cartier, Massy, France
| | - Didier Carrie
- Cardiology Department, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Diana Schütte
- Clinical Research, Biosensors Clinical Research, Morges, Switzerland
| | | | - Philippe Garot
- Ramsay-Santé, Hôpital Claude Galien, Institut Cardiovasculaire Paris-Sud (ICPS), Quincy, France
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16
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Pagnoni M, Meier D, Candreva A, Maillard L, Adjedj J, Collet C, Mahendiran T, Cook S, Mujcinovic A, Dupré M, Rubimbura V, Roguelov C, Eeckhout E, De Bruyne B, Muller O, Fournier S. Future culprit detection based on angiography-derived FFR. Catheter Cardiovasc Interv 2021; 98:E388-E394. [PMID: 33913606 DOI: 10.1002/ccd.29736] [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: 02/10/2021] [Revised: 03/23/2021] [Accepted: 04/12/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES We sought to characterize the hemodynamic impact of mild coronary artery disease (CAD) using quantitative flow ratio (QFR, an angiography-derived fractional flow reserve [FFR]) in a population of patients with only non-significant CAD at baseline that subsequently experienced a myocardial infarction (MI). BACKGROUND The discriminatory value of FFR in patients with mild CAD remains imperfect. METHODS We retrospectively included patients who underwent invasive coronary angiography for an MI, in whom another angiogram had been performed within the previous 5 years. Three-dimensional quantitative coronary angiography, QFR, and lesion length analysis were conducted on lesions responsible for the MI (future culprit lesions, [FCL]) as well as on control lesions (non-culprit lesions, [NCL]). RESULTS Eighty-three FCL and 117 NCL were analyzed in 83 patients: FCL were more severe (median % diameter of stenosis [DS] 39.1% [29.8; 45.7] vs. 29.8% [25.0; 37.2], p < .001), had lower QFR values (0.94 [0.86; 0.98] vs. 0.98 [0.96; 1.00], p < .001) and tended to be longer (15.2 mm [10.0; 27.3] vs. 12.7 mm [9.3; 22.4], p = .070) than NCL. In lesions with an interval < 2 years between baseline angiography and MI, the difference in QFR was more pronounced compared to the lesions with a longer interval (FCL: 0.92 [0.85; 0.97] vs. NCL: 0.98 [0.94; 1.00], p < .001 and FCL: 0.96 [0.88; 1.00] vs. NCL: 0.98 [0.96;1.00], p = .006 respectively) CONCLUSION: Mild coronary stenoses that are subsequently responsible for an MI (FCL) exhibit a higher DS and lower QFR years before the event. Furthermore, FCL with a lower QFR at baseline appear to lead earlier to MI.
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Affiliation(s)
- Mattia Pagnoni
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - David Meier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Luc Maillard
- Department of Cardiology, GCS ES Axium Rambot, Aix en Provence, France
| | - Julien Adjedj
- Department of Cardiology, Arnault Tzank Institute, Saint Laurent Du Var, France
| | - Carlos Collet
- Cardiovascular Center, OLV Ziekenhuis, Aalst, Belgium
| | - Thabo Mahendiran
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Cook
- Department of Cardiology, HFR Fribourg, Fribourg, Switzerland
| | - Alma Mujcinovic
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Marion Dupré
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Vladimir Rubimbura
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Christan Roguelov
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Eric Eeckhout
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Bernard De Bruyne
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.,Cardiovascular Center, OLV Ziekenhuis, Aalst, Belgium
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.,Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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17
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Fanget F, Demarchi MS, Maillard L, Lintis A, Decaussin M, Lifante JC. Medullary thyroid cancer outcomes in patients with undetectable versus normalized postoperative calcitonin levels. Br J Surg 2021; 108:1064-1071. [PMID: 33899100 DOI: 10.1093/bjs/znab106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/27/2021] [Indexed: 11/14/2022]
Abstract
BACKGROUND Calcitonin (Ct) is a sensitive diagnostic biomarker and one of the most important prognostic factors in medullary thyroid cancer (MTC). This study aimed to evaluate progression-free survival and recurrence rates of MTC associated with undetectable compared with normalized serum Ct levels after surgery. METHODS This retrospective observational study included patients operated for MTC at the Digestive and Endocrine Surgery Department of Lyon Sud Hospital Centre between 2000 and 2019. Clinical and pathological factors were correlated with postoperative Ct concentrations. Undetectable and normalized Ct concentrations were defined as below 2 pg/ml and 2-10 pg/ml respectively. RESULTS Overall, 176 patients were treated for MTC, and 127 were considered biochemically cured after surgery. Of these, 24 and 103 had normalized and undetectable Ct concentrations respectively. Patients with Ct level normalization had a 25 per cent risk of disease recurrence, compared with 3 per cent in patients with undetectable Ct levels after surgery. The presence of metastasis in two or more compartments was predictive of failure to achieve undetectable Ct concentrations after surgery and an increased risk of recurrence. CONCLUSION Among patients with biochemically cured MTC, those with undetectable or normalized Ct concentrations after surgery had different risks of recurrence. Simply assessing postoperative Ct normalization can be falsely reassuring, and long-term follow-up is needed.
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Affiliation(s)
- F Fanget
- Department of General, Digestive and Endocrine surgery, Lyon Sud Hospital Centre, Pierre Bénite, France
| | - M S Demarchi
- Department of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - L Maillard
- Department of General, Digestive and Endocrine surgery, Lyon Sud Hospital Centre, Pierre Bénite, France
| | - A Lintis
- Department of General, Digestive and Endocrine surgery, Lyon Sud Hospital Centre, Pierre Bénite, France
| | - M Decaussin
- Department of Pathology, Hospices Civils de Lyon, Lyon, France
| | - J C Lifante
- Department of General, Digestive and Endocrine surgery, Lyon Sud Hospital Centre, Pierre Bénite, France.,Health Services and Performance Research Laboratory (EA 7425 HESPER), Université Claude Bernard, Lyon, France
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18
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Colleran R, Joner M, Cutlip D, Urban P, Maeng M, Jauhar R, Barakat M, Michel JM, Mehran R, Kirtane AJ, Maillard L, Kastrati A, Byrne RA. Design and rationale of a randomized trial of COBRA PzF stenting to REDUCE duration of triple therapy (COBRA-REDUCE). Cardiovasc Revasc Med 2021; 34:17-24. [PMID: 33608239 DOI: 10.1016/j.carrev.2021.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/04/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND/PURPOSE A coronary stent with thromboresistant and pro-healing properties such as the polymer polyzene F-coated (COBRA PzF) stent might safely allow for a very short duration of triple therapy in patients taking oral anticoagulation (OAC) who undergo coronary stenting. METHODS The COBRA-REDUCE trial is a prospective, multinational, randomized, open-label, assessor-blinded trial. A total of 996 patients at high bleeding risk because of requirement for OAC (with a vitamin K antagonist or non-vitamin K antagonist for any indication) will be randomized at sites in the United States and Europe to treatment with the COBRA-PzF stent followed by very short duration (14 days) DAPT or a Food and Drug Administration (FDA)-approved new generation drug-eluting stent followed by guideline-recommended DAPT duration (3 or 6 months). Two co-primary endpoints will be tested at 6 months: a bleeding co-primary endpoint (bleeding academic research consortium [BARC] ≥2 bleeding beyond 14 days or after hospital discharge, whichever is later [superiority hypothesis]) and a thrombo-embolic co-primary endpoint (the composite of all-cause death, myocardial infarction, definite/probable stent thrombosis or ischaemic stroke [non-inferiority hypothesis]). The trial is registered at clinicaltrials.gov (NCT02594501). CONCLUSION The COBRA-REDUCE trial will determine whether coronary stenting with the COBRA PzF stent followed by 14 days of clopidogrel will reduce bleeding without increasing thrombo-embolic events compared with FDA-approved DES followed by 3-6 months clopidogrel in patients taking OAC and aspirin.
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Affiliation(s)
- Róisín Colleran
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Michael Joner
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Donald Cutlip
- Cardiology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Philip Urban
- La Tour Hospital, Geneva, Switzerland; CERC (Cardiovascular European Research Center), Massy, France
| | | | - Rajiv Jauhar
- North Shore University Hospital, Manhasset New York, NY, USA
| | | | - Jonathan M Michel
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Ajay J Kirtane
- Department of Medicine, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, NY, United States of America; Cardiovascular Research Foundation, New York, NY, United States of America
| | - Luc Maillard
- GCS-ES Axium-Rambot, Clinique Axium, Aix en Provence, France
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany.
| | - Robert A Byrne
- Cardiovascular Research Institute Dublin, Mater Private Hospital, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons University of Medicine and Health Sciences, Dublin, Ireland.
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19
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Chichareon P, Modolo R, Kerkmeijer L, Tomaniak M, Kogame N, Takahashi K, Chang CC, Komiyama H, Moccetti T, Talwar S, Colombo A, Maillard L, Barlis P, Wykrzykowska J, Piek JJ, Garg S, Hamm C, Steg PG, Jüni P, Valgimigli M, Windecker S, Onuma Y, Mehran R, Serruys PW. Association of Sex With Outcomes in Patients Undergoing Percutaneous Coronary Intervention: A Subgroup Analysis of the GLOBAL LEADERS Randomized Clinical Trial. JAMA Cardiol 2021; 5:21-29. [PMID: 31693078 DOI: 10.1001/jamacardio.2019.4296] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [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] [Indexed: 01/10/2023]
Abstract
Importance Women experience worse ischemic and bleeding outcomes after percutaneous coronary intervention (PCI). Objectives To assess the association of sex with patient outcomes at 2 years after contemporary PCI and with the efficacy and safety of 2 antiplatelet strategies. Design, Setting, and Participants This study is a prespecified subgroup analysis of the investigator-initiated, prospective, randomized GLOBAL LEADERS study evaluating 2 strategies of antiplatelet therapy after PCI in an unselected population including 130 secondary/tertiary care hospitals in different countries. The main study enrolled 15 991 unselected patients undergoing PCI between July 2013 and November 2015. Patients had an outpatient clinic visit at 30 days and 3, 6, 12, 18, and 24 months after the index procedure. Data were analyzed between January 1, 2019, and March 31, 2019. Interventions Eligible patients were randomized to either the experimental or reference antiplatelet strategy. Experimental strategy consisted of 1 month of dual antiplatelet therapy (DAPT) followed by 23 months of ticagrelor monotherapy, while the reference strategy comprised of 12 months of DAPT followed by 12 months of aspirin monotherapy. Main Outcomes and Measures The primary efficacy end point was the composite of all-cause mortality and new Q-wave myocardial infarction at 2 years. The secondary safety end point was Bleeding Academic Research Consortium type 3 or 5 bleeding. Results Of the 15 968 patients included in this study, 3714 (23.3%) were women. The risk of the primary end point at 2 years was similar between women and men (adjusted hazard ratio [HR], 1.00; 95% CI, 0.83-1.20). Compared with men, women had higher risk of Bleeding Academic Research Consortium type 3 or 5 bleeding (adjusted HR, 1.32; 95% CI, 1.04-1.67) and hemorrhagic stroke at 2 years (adjusted HR, 4.76; 95% CI, 1.92-11.81). At 2 years, there was no between-sex difference in the efficacy and safety of the 2 antiplatelet strategies. At 1 year, compared with DAPT, ticagrelor monotherapy was associated with a lower risk of bleeding in men (HR, 0.72; 95% CI, 0.53-0.98) but not in women (HR, 1.23; 95% CI, 0.80-1.89; P for interaction = .045). Conclusions and Relevance Compared with men, women experienced a higher risk of bleeding and hemorrhagic stroke after PCI. The effect of 2 antiplatelet strategies on death and Q-wave myocardial infarction following PCI did not differ between the sexes at 2 years. Trial Registration ClinicalTrials.gov identifier: NCT01813435.
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Affiliation(s)
- Ply Chichareon
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Rodrigo Modolo
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Cardiology Division, Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | - Laura Kerkmeijer
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Mariusz Tomaniak
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands.,First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Norihiro Kogame
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Kuniaki Takahashi
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Chun-Chin Chang
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands
| | - Hidenori Komiyama
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Tiziano Moccetti
- Department of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Suneel Talwar
- Royal Bournemouth and Christchurch National Health Services Trust, Bournemouth, England
| | - Antonio Colombo
- Division of Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy
| | | | - Peter Barlis
- St Vincent's and Northern Hospitals, Melbourne Medical School, The University of Melbourne, Victoria, Australia
| | - Joanna Wykrzykowska
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jan J Piek
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Scot Garg
- East Lancashire Hospitals National Health Services Trust, Blackburn, Lancashire, England
| | - Christian Hamm
- Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim, Germany
| | - Philippe Gabriel Steg
- French Alliance for Cardiovascular Trials; Hôpital Bichat, AP-HP; Université Paris-Diderot; INSERM U-1148; Paris, France.,Royal Brompton Hospital, Imperial College, London, England
| | - Peter Jüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Canada
| | - Marco Valgimigli
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Yoshinobu Onuma
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands.,Cardialysis Clinical Trials Management and Core Laboratories, Westblaak 98, Rotterdam, the Netherlands
| | - Roxana Mehran
- Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Patrick W Serruys
- National Heart and Lung Institute, Imperial College London, London, England
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Maillard L, de Labriolle A, Brasselet C, Faurie B, Durel N, de Poli F, Bosle S, Madiot H, Berland J, Belle L. Evaluation of the safety and efficacy of the Cobra PzF NanoCoated coronary stent in routine, consecutive, prospective, and high-risk patients: The e-Cobra study. Catheter Cardiovasc Interv 2020; 98:45-54. [PMID: 32548891 DOI: 10.1002/ccd.29065] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 08/25/2019] [Revised: 05/02/2020] [Accepted: 05/24/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND The Cobra PzF coronary stent is cobalt chromium with flat thin struts, nano-coated with Polyzene-F that enhance rapid reendothelialization and reduce the risk of stent thrombosis and restenosis. It is designed to overcome shortfalls of BMS and DES in patients requiring short DAPT duration. AIMS To report procedural and 1-year clinical outcomes following Cobra PzF stent implantation in routine practice PCI. METHODS e-Cobra registry is a multicenter prospective study to evaluate Cobra PzF stent in routine practice in patients deemed appropriate for short DAPT after PCI. The primary endpoint was MACE rate at 12 months (Cardiac death, MI, TLR). The secondary endpoint was definite stent thrombosis at 12 months. RESULTS Among 940 patients (72% men, 72.8 ± 13.4 years) with multiple co-morbidities, 47% had acute coronary syndromes, and 62% were defined as high bleeding risk. A total of 1,229 lesions were treated with 1,314 stents. 36% of patients had lesion type B2 or C classification. Angiographic success was achieved in all cases. One-year follow-up was available for 97% of patients. The primary endpoint occurred in 9.0% of patients, including cardiac death 3.7%, MI 4.8%, and TLR 4.3%. Definite stent thrombosis occurred in six out of 915 (0.7%). CONCLUSION The Cobra PzF stent was safe and effective in routine practice patients and seems feasible in situations when short DAPT or Mono Antiplatelet Therapy (MAPT) is needed. One-year follow-up was associated with satisfactory clinical outcomes and validate previously reported data.
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Affiliation(s)
| | | | | | - Benjamin Faurie
- Institut Cardiovasculaire, Groupe Hospitalier Mutualiste, Grenoble, France
| | | | | | - Sébastien Bosle
- Center Hospitalier de Brive de la Gaillarde, Brive de la Gaillarde, France
| | - Hend Madiot
- Center Hospitalier Annecy Genevois, Metz-Tessy, France
| | | | - Loic Belle
- Center Hospitalier Annecy Genevois, Metz-Tessy, France
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21
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Forthoffer N, Brissart H, Tyvaert L, Maillard L. Long-term cognitive outcomes in patient with epilepsy. Rev Neurol (Paris) 2020; 176:448-455. [PMID: 32414533 DOI: 10.1016/j.neurol.2020.04.012] [Citation(s) in RCA: 3] [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: 09/26/2019] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Abstract
In contrast to short-term cognitive outcomes, long-term cognitive outcomes (over 5 years) has been scarcely assessed so far. Yet, predicting long-term outcomes at any time point of the epilepsy, from initial diagnosis, to medically intractability is very important for therapeutic decision-making, patient information, and orientation. Assessing long-term cognitive outcomes in patients with epilepsy would ideally require longitudinal studies and a comparison with a healthy controls group. This issue has been addressed extensively, but with controversial results. However, there is a general consensus about the fact that cognitive outcome is not the same in all groups of patients with epilepsy. Possible prognostic factors include age at onset, duration of epilepsy, syndrome and etiology, seizure outcome and therapeutics. The multiplicity of factors makes it very difficult to assess their relative weight in individuals. Although long-term cognitive outcome studies are scarce, this issue has been specifically studied in newly diagnosed epilepsies and in focal drug-resistant epilepsies. In the first clinical setting, i.e. newly diagnosed epilepsy, it appears that cognitive deficits are already present at epilepsy onset in a significant proportion of patients but seem to remain stable over time. In focal drug-resistant epilepsies, cognitive deficits (mainly verbal memory) were generally shown to remain stable provided that seizures were controlled either by medication or by surgery. Beyond the possible correlation between seizure and cognitive outcome, no causal link however has been demonstrated between these two important outcomes.
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Affiliation(s)
- N Forthoffer
- Service de Neurologie, Centre Hospitalier Universitaire de Nancy, Nancy, France; LNCA, UMR 7364, CNRS, Université de Strasbourg, 67000 Strasbourg, France.
| | - H Brissart
- Service de Neurologie, Centre Hospitalier Universitaire de Nancy, Nancy, France; CRAN, UMR 7039, CNRS, université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - L Tyvaert
- Service de Neurologie, Centre Hospitalier Universitaire de Nancy, Nancy, France; CRAN, UMR 7039, CNRS, université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - L Maillard
- Service de Neurologie, Centre Hospitalier Universitaire de Nancy, Nancy, France; CRAN, UMR 7039, CNRS, université de Lorraine, Vandoeuvre-lès-Nancy, France
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22
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Aatti Y, Schwan R, Maillard L, El-Age W, Hingray C. Enquête sur le niveau de connaissances et sur les perceptions des crises non épileptiques psychogènes des psychiatres exerçant en France. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2015.09.251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
L’objectif de cette étude est de déterminer le niveau de connaissances générales et des perceptions sur les crises non épileptiques psychogènes (CNEP) des psychiatres et internes de psychiatrie exerçant en France. L’objectif secondaire est d’étudier la relation entre les connaissances et les perceptions des CNEP et le fait d’avoir bénéficié d’une formation ou d’avoir une expérience de suivi de patients présentant des CNEP. Dans cette enquête, les psychiatres ont été invités par courriel, à répondre à un questionnaire mis en ligne sur internet. Le questionnaire portait sur les connaissances générales des CNEP, puis les perceptions des CNEP étaient recueillies avec le Brief Illness Perception Questionnaire (Brief-IPQ). L’enquête a permis de recueillir les réponses de 1242 participants, et 963 réponses étaient exploitables. L’étude indique que trois quarts des psychiatres exerçant en France (75 %) n’ont jamais bénéficié de formation sur les CNEP, et 42 % des psychiatres n’ont jamais suivi de patients souffrant de CNEP. Les résultats révèlent que d’une manière générale les psychiatres considèrent les CNEP comme une maladie chronique, avec un retentissement important sur la qualité de vie. Ils admettent une compréhension limitée de cette pathologie même s’ils ont conscience de l’importance des traumatismes psychiques dans la survenue des CNEP. La terminologie et la classification de ces troubles sont peu connues des psychiatres et les liens avec la personnalité histrionique sont massivement surévalués. Le fait d’avoir bénéficié d’une formation sur les CNEP permet une nette amélioration du niveau de connaissances et une adaptation des perceptions. Les CNEP restent assez méconnues par les psychiatres français et certaines de leurs perceptions sont particulièrement erronées. Une formation spécifique semble indispensable pour une meilleure compréhension des CNEP.
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G Toth G, Lansky A, Baumbach A, Kelbæk H, van Royen N, Holmvang L, Janssens L, Brugaletta S, Barbato E, Maillard L, Kiemeneij F, Naber CK, Pucher F, Laursen PN, Ameloot K, Robles C, Milkas A, Sevilla J, Jensen C, Wijns W. Validation of the all-comers design: Results of the TARGET-AC substudy. Am Heart J 2020; 221:148-154. [PMID: 31924299 DOI: 10.1016/j.ahj.2019.10.019] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Results of clinical trials are often criticized by low inclusion rate and potential sampling bias in patient recruitment. The aim of this validation registry is to evaluate how far an all-comers design in the context of clinical research can ensure the representation of the true all-comers population. METHODS This validation registry is a prospective international multicentre registry, conducted at 10 out of the total 21 centers, participating in TARGET-AC (registered under NCT02520180). During a predefined four-week period data were recorded prospectively on all PCIs performed in the participating centers, whether or not patients were enrolled in TARGET-AC. Data were collected on patient demographics, angiographic lesion- and procedural characteristics. For patients who were not enrolled in the study, operators were asked to declare the reason for not enrolling the patient, using a single-choice questionnaire. RESULTS A total of 131 patients were enrolled in the TARGET-AC study during the investigated period (ER group), standing as 20% (range 4% and 54%) of all eligible cases per protocol. In the ER group more patients presented with stable angina (61% vs. 43%, respectively; P < .001). Whereas ST-elevation infarction was less common (5% vs. 26%, respectively; P < .001), there was no difference in non-ST elevation acute coronary syndrome (32% vs. 27%, respectively; P = .248). Risk factors and comorbidities did not show any difference between the ER and the non-enrolled (NER) groups, except for greater rate of significant valvular disease in the NER group (12% vs 19%, respectively; P = .037). The NER group presented more thrombotic stenoses than the ER group (20% vs 12%, respectively; P = .040). No difference was found in any other investigated angiographic parameters, like target vessels, bifurcation lesion, severe calcification or chronic total occlusions. Admission during regular working hours and availability of study nurse were associated with markedly higher recruitment rate. CONCLUSION Results suggest that TARGET AC was outbalanced for stable patients over primary PCIs as compared to real world. However in terms of risk factors and comorbidities the trial managed to represent the collective of real world clinical practice. Fairly representative cases were included at an average inclusion-to-eligible rate of 20%.
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Affiliation(s)
- Gabor G Toth
- Department of Cardiology, University Heart Center Graz, Medical University of Graz, Austria
| | - Alexandra Lansky
- Yale University School of Medicine, New Haven, CT, USA; Barts Heart Center, London and Queen Mary University of London, London, UK
| | - Andreas Baumbach
- Yale University School of Medicine, New Haven, CT, USA; Barts Heart Center, London and Queen Mary University of London, London, UK
| | - Henning Kelbæk
- Department of Cardiology, Roskilde University Hospital, Roskilde, Denmark
| | - Niels van Royen
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Lene Holmvang
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Luc Janssens
- Heart Center, Imelda Ziekenhuis, Bonheiden, Belgium
| | | | - Emanuele Barbato
- Cardiovascular Research Center Aalst, OLV Hospital, Aalst, Belgium; Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Luc Maillard
- Department of Cardiology, GCS ES Axium Rambot, France
| | | | | | - Felix Pucher
- Department of Cardiology, University Heart Center Graz, Medical University of Graz, Austria
| | - Peter Nørkjær Laursen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Koen Ameloot
- Heart Center, Imelda Ziekenhuis, Bonheiden, Belgium
| | - Carlos Robles
- Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
| | | | - Jose Sevilla
- Department of Cardiology, GCS ES Axium Rambot, France
| | - Christoph Jensen
- Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus, Essen, Germany
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group, Ireland.
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24
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Dérimay F, Rioufol G, Aminian A, Maillard L, Finet G. Toward a sequential provisional coronary bifurcation stenting technique. From kissing balloon to re-POT sequence. Arch Cardiovasc Dis 2020; 113:199-208. [PMID: 32008946 DOI: 10.1016/j.acvd.2019.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 09/23/2019] [Revised: 10/31/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022]
Abstract
The specific anatomy of coronary bifurcations makes them prime sites of atherogenesis and complicates revascularization. Account must be taken of the systematic difference in diameter between the 3 constituent vessels so as to minimize final side-branch ostium obstruction and maintain the law of conservation of flow, while respecting the bifurcation angles. Kissing balloon inflation (KBI) was long recommended, but never clearly demonstrated clinical benefit in single-stent provisional stenting. The detrimental proximal overstretch induced by simultaneous inflation of balloons, observed clinically and confirmed experimentally, probably explains this inefficacy. Advances in knowledge of bifurcation pathophysiology and experimental bench studies gradually led to the development of a new purely sequential technique, re-POT, without balloon juxtaposition, comprising 3 successive steps: (1) initial "proximal optimization technique" (POT), (2) side-branch opening, and (3) final POT. In contrast to KBI, re-POT has been progressively assessed from bench to first clinical study. The aim of the present review is to present the pathophysiological specificities of coronary bifurcations, and some explanations for the failure of KBI which led to the development of a new purely sequential coronary bifurcation provisional stenting strategy, based on re-POT.
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Affiliation(s)
- François Dérimay
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, INSERM Unit 1060 CARMEN, Lyon, France.
| | - Gilles Rioufol
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, INSERM Unit 1060 CARMEN, Lyon, France
| | - Adel Aminian
- Cardiology Department, CHU Charleroi, Charleroi, Belgium
| | | | - Gérard Finet
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, INSERM Unit 1060 CARMEN, Lyon, France
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25
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Maillard L, Corseaux D, Altié A, Ung A, Courageot J, Barakat M, Teiger E, Van Belle E. Time Course of Reendothelialization with Polyzene-F Nanocoated Cobra PzF™ Coronary Stent on Rabbit Iliac Arteries. Cardiovasc Revasc Med 2019; 21:195-199. [PMID: 31727585 DOI: 10.1016/j.carrev.2019.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 07/10/2019] [Revised: 09/04/2019] [Accepted: 11/04/2019] [Indexed: 01/23/2023]
Abstract
PURPOSE Evaluation of reendothelialization with a new thin struts cobalt chromium alloy stent coated with a nano-layer of Polyzene™-F (PzF) in a rabbit iliac artery model. METHODS Fifteen stented external rabbit iliac arteries were harvested at Day 7 for electron microscopy analysis following Cobra PzF stents implantation to assess reendothelialization and compare to historical data. Ten additional rabbits were used to assess time course of reendothelialization at 3 and 5 days. RESULTS At Day 7, almost complete coverage of endothelial cells was observed with a coverage of 99.54 ± 0.25% of the stented area. No thrombus area was noted. At Day 3, more than half of examined pieces was reendothelialized and reached 78.30 ± 3.7% at Day 5 (p < .01 between each group). All stents were well expanded against the arterial wall and no struts were mal-apposed. CONCLUSIONS Reendothelialization was rapid and complete at Day 7. This is the fastest reendothelization process after stenting in this model. No stent occlusion was observed.
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Affiliation(s)
- Luc Maillard
- Department of Cardiology, GCS ES Axium Rambot, Aix en Provence, France.
| | - Delphine Corseaux
- Department of EA2693, Université Lille Nord de France, Lille, France
| | - Alexandre Altié
- Department of Service Commun de Microscopie Electronique, Faculté de Médecine La Timone, Marseille, France
| | - Alexandre Ung
- Department of EA2693, Université Lille Nord de France, Lille, France
| | - Joël Courageot
- Department of Service Commun de Microscopie Electronique, Faculté de Médecine La Timone, Marseille, France
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26
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Briguori C, Tamburino C, Jessurun GAJ, Meyer-Geßner M, Reczuch K, Cortese B, Maillard L, Anthonio RL, La Manna A, Morice MC, Bouchez D, Balland A, Huynh VP, Baumbach A. Prospective evaluation of drug eluting self-apposing stent for the treatment of unprotected left main coronary artery disease: 1-year results of the TRUNC study. Catheter Cardiovasc Interv 2019; 96:E142-E148. [PMID: 31696618 DOI: 10.1002/ccd.28584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/06/2019] [Revised: 09/26/2019] [Accepted: 10/26/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To assess long-term safety and efficacy of the Xposition S self-apposing stent in the treatment of unprotected left main coronary artery (ULMCA) disease. BACKGROUND Percutaneous intervention with stents has emerged as a valid alternative to surgical revascularization to treat ULMCA disease. Conventional balloon-expandable stents face technical challenges, particularly in large left main diameter requiring extensive optimization and side branch access in distal bifurcation. Xposition S allows for optimal apposition, bridging diameter differences, and allows expansion to vessel diameters up to 6.0 mm. METHODS Between June 2016 and July 2017, 205 patients were enrolled in this international, prospective, multicenter registry. Patients with SYNTAX score ≥ 33 or recent STEMI were excluded. IVUS during procedure was performed in a prespecified subgroup of 50 patients. The primary clinical endpoint was 12 months Target lesion failure (TLF) and the primary efficacy endpoint was angiographic success. RESULTS Distal left main bifurcation was involved in 92.7%, treated with provisional approach in most cases (79.4%). TLF rate at 12 months was 8.3%, which was defined as a composite of cardiac death (2.0%), target-vessel MI (2.9%), and TLR (5.4%). Most revascularizations occurred at SB ostium. IVUS analysis demonstrated optimal stent apposition with only one reported malapposition and promising poststenting minimal stent area measures. CONCLUSIONS The TRUNC study confirms that Xposition S self-apposing stent is a valid and feasible option for the treatment of ULMCA disease. Such results were reached without the systematic need of stent optimisation techniques, focusing mainly on lesion treatment.
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Affiliation(s)
| | | | | | | | - Krzysztof Reczuch
- Medical University of Wrocław, Wroclaw, Poland.,Military Hospital, Wroclaw, Poland
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Maillard L, Vochelet F, Peycher P, Ayari A, Barra N, Billé J, Joly P, Silvestri M, Sévilla J, Tavildari A. MAPT (Mono Antiplatelet Therapy) as Regular Regimen After COBRA PzF™ NanoCoated Coronary Stent (NCS) Implantation. Cardiovasc Revasc Med 2019; 21:785-789. [PMID: 31780418 DOI: 10.1016/j.carrev.2019.10.007] [Citation(s) in RCA: 9] [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: 07/10/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
AIMS To report procedural and 1-year outcomes following COBRA PzF NCS implantation in a routine daily setting with high bleeding risk (HBR) patients treated with clopidogrel as mono antiplatelet therapy (MAPT). METHODS This is a prospective, consecutive, observational study in HBR patients who underwent PCI with COBRA PzF NCS and treated with clopidogrel alone at discharge. The primary endpoint was definite stent thrombosis at one month. The secondary endpoint was MACE (Cardiac Death, myocardial infarction (MI), target lesion revascularization (TLR)) at 12 months. RESULTS From October 2015 to December 2018, 77 patients with 120 lesions were enrolled and treated. Mean age was 78.7 ± 8.89 years, 58.5% men and 18.2% had ACS. Patients included had a minimum of 2.0 inclusion LEADERS FREE criteria. Angiographic success was achieved in all cases. The primary endpoint occurred in 0%, no stent thrombosis was occurred. MACE at 12-months (available for 52 patients) was 3.8% including cardiac death 0%, MI 0% and TLR 3.8%. No severe bleeding events (BARC3-5) or stroke or late stent thrombosis were noted. CONCLUSION Clopidogrel as MAPT after COBRA PzF NCS implantation in HBR patients is feasible and an attractive option. One-year follow-up was associated with excellent clinical outcomes and should be confirmed with large randomised study. CONDENSED ABSTRACT This is prospective registry of high bleeding risk patients treated with the COBRA PzF NCS and MAPT at discharge. The primary end point demonstrated no stent thrombosis. The rate of major cardiac adverse events (a composite of cardiovascular death, myocardial infarction and target lesion revascularisation) at 1 year was 3.8%. No severe bleeding events, stroke or late stent thrombosis were noted. One-year follow-up was associated with good clinical outcomes and compared favorably with current devices.
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Affiliation(s)
- Luc Maillard
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France.
| | - François Vochelet
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
| | - Patrick Peycher
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
| | - Anis Ayari
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
| | - Nicolas Barra
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
| | - Jacques Billé
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
| | - Patrick Joly
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
| | - Marc Silvestri
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
| | - José Sévilla
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
| | - Alain Tavildari
- Service de Cardiologie, GCS ES Axium Rambot, 21, Avenue Alfred Capus, 13 090 Aix en Provence, France
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28
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Saito Y, Wijns W, Baumbach A, Xu B, Kelbæk H, van Royen N, Zheng M, Knaapen P, Slagboom T, Johnson T, Vlachojannis G, Holmvang L, Janssens L, Ochala A, Brugaletta S, Anderson R, Rittger H, Berti S, Barbato E, Toth G, Maillard L, Valina C, Buszman P, Thiele H, Lansky A. TCT-287 Impact of Eligibility Criteria on Clinical Outcomes of Firehawk and XIENCE Coronary Drug-Eluting Stent in an All-Comers Randomized Trial. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.361] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Tamburino C, Carlo B, Jessurun GA, Meyer-Gessner M, Reczuch K, Cortese B, Maillard L, Anthonio RL, La Manna A, Morice MC, Baumbach A, Huynh VP. TCT-389 Prospective Evaluation of the Drug-Eluting Self-Apposing Stent for the Treatment of Unprotected Left Main Coronary Artery Disease: 2-Year Results of the TRUNC Study. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.478] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Xu B, Saito Y, Baumbach A, Kelbæk H, van Royen N, Zheng M, Morel MA, Knaapen P, Slagboom T, Johnson TW, Vlachojannis G, Arkenbout KE, Holmvang L, Janssens L, Ochala A, Brugaletta S, Naber CK, Anderson R, Rittger H, Berti S, Barbato E, Toth GG, Maillard L, Valina C, Buszman P, Thiele H, Schächinger V, Lansky A, Wijns W. 2-Year Clinical Outcomes of an Abluminal Groove–Filled Biodegradable-Polymer Sirolimus-Eluting Stent Compared With a Durable-Polymer Everolimus-Eluting Stent. JACC Cardiovasc Interv 2019; 12:1679-1687. [DOI: 10.1016/j.jcin.2019.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 01/23/2023]
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Koessler L, Jacques C, Jonas J, Maillard L, Rossion B. The cortical sources of face selective N170: A simultaneous multi-scale EEG study. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.05.015] [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: 11/16/2022] Open
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Aron O, Krieg J, Jonas J, Maillard L, Colnat-Coulbois S. Connectivité effective et troubles de langage induits pas la stimulation cérébrale. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.05.021] [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: 11/16/2022] Open
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Volfart A, Yan X, Maillard L, Rossion B, Jonas J. Intracerebral electrical stimulation of the right anterior fusiform gyrus elicits a transient face-specific impairment in recognizing famous people. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.05.014] [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: 11/26/2022] Open
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Brissart H, Forthoffer N, Maillard L. Attention disorders in adults with epilepsy. Determinants and therapeutic strategies. Rev Neurol (Paris) 2019; 175:135-140. [PMID: 30826090 DOI: 10.1016/j.neurol.2019.01.394] [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: 09/03/2018] [Revised: 12/07/2018] [Accepted: 01/04/2019] [Indexed: 11/08/2022]
Abstract
Cognitive consequences in epilepsy are often described in the following domains: verbal memory, language, executive functions, and attention. Attention is involved in all cognitive activities, and attention disorders (AD) are reported in patients with various neurological diseases. This paper proposes to define the concept of AD and its assessment, to consider their determinants in epilepsy and potential therapies (drug or not). ADs are reported in new onset epilepsy, generalized epilepsy of presumed genetic origin, and in focal epilepsy. In focal epilepsy, alertness and divided attention impairment are observed and seem to improve after successful curative surgery. Additional studies are needed to assess the prevalence and nature of AD related to status epilepticus. In the field of therapeutic strategies, anti-epileptic drugs show an impact on AD. Effects of antidepressive drug therapy are not reported, as well as psychotherapy. Cognitive rehabilitation on AD is a promising therapeutic intervention but specific studies are needed to assess its efficacy.
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Affiliation(s)
- H Brissart
- Epileptology unit, neurology department, Nancy hospital, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France; UMR 7039, CNRS, université de Lorraine, 54500 Nancy, France; Reference, Center for rare Epilepsies, Nancy hospital, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
| | - N Forthoffer
- Epileptology unit, neurology department, Nancy hospital, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France; Reference, Center for rare Epilepsies, Nancy hospital, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - L Maillard
- Epileptology unit, neurology department, Nancy hospital, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France; UMR 7039, CNRS, université de Lorraine, 54500 Nancy, France; Reference, Center for rare Epilepsies, Nancy hospital, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
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Cayla G, Koning R, Fajadet J, Sainsous J, Carrié D, Elhadad S, Tarragano F, Lefévre T, Ranc S, Ghostine S, Garot P, Marco F, Maillard L, Motreff P, Le Breton H. Percutaneous coronary interventions with the Absorb Bioresorbable vascular scaffold in real life: 1-year results from the FRANCE ABSORB registry. Arch Cardiovasc Dis 2019; 112:113-123. [PMID: 30630761 DOI: 10.1016/j.acvd.2018.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/03/2018] [Revised: 07/13/2018] [Accepted: 09/06/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Several randomized studies have shown that bioresorbable vascular scaffold (BVS) technology is associated with an increased risk of stent thrombosis. AIM This study aimed to assess the rates of adverse outcomes at 1 year in patients treated with the Absorb BVS (Abbott Vascular, Santa Clara, CA, USA), using data from a large nationwide prospective multicentre registry (FRANCE ABSORB). METHODS All patients receiving the Absorb BVS in France were included prospectively in the study. Predilatation, optimal sizing and postdilatation were recommended systematically. The primary endpoint was a composite of cardiovascular death, myocardial infarction and target lesion revascularization at 1 year. Secondary endpoints were scaffold thrombosis and target vessel revascularization at 1 year. RESULTS A total of 2072 patients at 86 centres were included: mean age 55±11 years; 80% men. The indication was acute coronary syndrome (ACS) in 49% of cases. Predilatation and postdilatation were done in 93% and 83% of lesions, respectively. At 1 year, the primary endpoint occurred in 3.9% of patients, the rate of scaffold thrombosis was 1.5% and the rate of target vessel revascularization was 3.3%. In a multivariable analysis, diabetes and total Absorb BVS length>30mm were independently associated with the occurrence of the primary endpoint, whereas oral anticoagulation and total Absorb BVS length>30mm were independently associated with occurrence of scaffold thrombosis. CONCLUSIONS The Absorb BVS was implanted in a relatively young population, half of whom had ACS. Predilatation and postdilatation rates were high, and 1-year outcomes were acceptable.
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Affiliation(s)
- Guillaume Cayla
- Service de cardiologie, hôpital universitaire Carémeau, université de Montpellier, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes, France.
| | | | | | | | - Didier Carrié
- Hôpital Rangueuil, CHU de Toulouse, 31400 Toulouse, France
| | - Simon Elhadad
- Centre hospitalier de Marne-la-Vallée, 77600 Jossigny, France
| | | | - Thierry Lefévre
- Hôpital privé Jacques-Cartier, Institut Cardiovasculaire Paris-Sud, Ramsay-Générale de Santé, 91300 Massy, France
| | - Sylvain Ranc
- Centre hospitalier Saint-Joseph et Saint-Luc, 69007 Lyon, France
| | - Said Ghostine
- Centre chirurgical Marie-Lannelongue, 92350 Le Plessis Robinson, France
| | - Philippe Garot
- Hôpital privé Claude-Galien, Institut Cardiovasculaire Paris-Sud, Ramsay-Générale de Santé, 91480 Quincy, France
| | | | - Luc Maillard
- GCS-ES Axium-Rambot, clinique Axium, 13100 Aix-en-Provence, France
| | | | - Hervé Le Breton
- Service de cardiologie et maladies vasculaires, CIC-IT 804, hôpital Pontchaillou, CHU de Rennes, 35033 Rennes, France; Inserm U1099, laboratoire de traitement du signal et de l'image, université de Rennes 1, 35000 Rennes, France
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Derimay F, Maillard L, Rioufol G, Souteyrand G, Aminian A, Guérin P, Finet G. Sequential techniques of provisional stenting in coronary bifurcation with the Xposition S™ self-apposing nitinol stent. A comparative bench study. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.051] [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: 11/16/2022]
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Lansky A, Wijns W, Xu B, Kelbæk H, van Royen N, Zheng M, Morel MA, Knaapen P, Slagboom T, Johnson TW, Vlachojannis G, Arkenbout KE, Holmvang L, Janssens L, Ochala A, Brugaletta S, Naber CK, Anderson R, Rittger H, Berti S, Barbato E, Toth GG, Maillard L, Valina C, Buszman P, Thiele H, Schächinger V, Baumbach A. Targeted therapy with a localised abluminal groove, low-dose sirolimus-eluting, biodegradable polymer coronary stent (TARGET All Comers): a multicentre, open-label, randomised non-inferiority trial. Lancet 2018; 392:1117-1126. [PMID: 30190206 DOI: 10.1016/s0140-6736(18)31649-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [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] [Received: 06/30/2018] [Revised: 07/11/2018] [Accepted: 07/13/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND The FIREHAWK is a drug-eluting stent with a fully biodegradable sirolimus-containing polymer coating localised to recessed abluminal grooves on the stent surface. We investigated clinical outcomes with this targeted, low-dose, biodegradable polymer, sirolimus-eluting stent compared with XIENCE durable polymer, everolimus-eluting stents in an all-comers population. METHODS The TARGET All Comers study was a prospective, multicentre, open-label randomised non-inferiority trial done at 21 centres in ten European countries. Patients with symptomatic or asymptomatic coronary artery disease and objective evidence of myocardial ischaemia who qualified for percutaneous coronary intervention were randomised 1:1 to undergo implantation of a FIREHAWK or XIENCE. Randomisation was web-based, with random block allocation and stratification by centre and ST elevation myocardial infarction. Outcome assessors were masked to treatment allocation, but treating physicians and patients were not. The primary endpoint was target lesion failure at 12 months, a composite of cardiac death, target vessel myocardial infarction, or ischaemia-driven target lesion revascularisation. The control event rate for XIENCE was assumed to be 7%, the non-inferiority margin was 3.5%, and the primary analysis was in the intention-to-treat population, censoring patients who did not have either an event before 365 days or contact beyond 365 days. Late lumen loss was the primary endpoint of an angiographic substudy designed to investigate the non-inferiority of the FIREHAWK compared with the XIENCE stent. This trial is registered with ClinicalTrials.gov, number NCT02520180. FINDINGS From Dec 17, 2015, to Oct 14, 2016, 1653 patients were randomly assigned to implantation of the FIREHAWK (n=823) or XIENCE (n=830). 65 patients in the FIREHAWK group and 66 in the XIENCE group had insufficient follow-up data and were excluded from the analyses. At 12 months, target lesion failure occurred in 46 (6·1%) of 758 patients in the FIREHAWK group and in 45 (5·9%) of 764 patients in the XIENCE group (difference 0·2%, 90% CI -1·9 to 2·2, pnon-inferiority=0·004, 95% CI -2·2 to 2·6, psuperiority=0·88). There were no differences in ischaemia-driven revascularisation or stent thrombosis rates at 12 months. 176 patients were included in the angiographic substudy, in which in-stent late lumen loss was 0·17 mm (SD 0·48) in the FIREHAWK group and 0·11 mm (0·52) in the XIENCE group (p=0·48), with an absolute difference of 0·05 mm (95% CI -0·09 to 0·18, pnon-inferiority=0·024). INTERPRETATION In a broad all-comers population of patients requiring stent implantation for myocardial ischaemia, the FIREHAWK was non-inferior to the XIENCE as assessed with the primary endpoint of target lesion failure at 12 months and in-stent late lumen loss at 13 months. The FIREHAWK is a safe and effective alternative stent to treat patients with ischaemic coronary artery disease in clinical practice. FUNDING Shanghai Microport Medical.
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Affiliation(s)
- Alexandra Lansky
- Yale University School of Medicine, New Haven, CT, USA; Barts Heart Centre, London and Queen Mary University of London, London, UK.
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group, University College Hospital Galway, Galway, Ireland
| | - Bo Xu
- Fu Wai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Henning Kelbæk
- Department of Cardiology, Roskilde University Hospital, Roskilde, Denmark
| | - Niels van Royen
- Department of Cardiology, VU University Medical Centre, Amsterdam, Netherlands
| | - Ming Zheng
- Shanghai MicroPort Medical (Group), Shanghai, China
| | | | - Paul Knaapen
- Department of Cardiology, VU University Medical Centre, Amsterdam, Netherlands
| | - Ton Slagboom
- Amsterdam Department of Interventional Cardiolody, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Thomas W Johnson
- Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | | | - Lene Holmvang
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Luc Janssens
- Heart Centre, Imelda Ziekenhuis, Bonheiden, Belgium
| | - Andrzej Ochala
- Department of Invasive Cardiology, Silesian Medical University, Katowice, Poland
| | - Salvatore Brugaletta
- Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Christoph K Naber
- Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus, Essen, Germany
| | - Richard Anderson
- Department of Cardiology, University Hospital of Wales, Cardiff, UK
| | - Harald Rittger
- Medizinische Klinik I, Klinikum Fürth, University of Erlangen, Fürth, Germany
| | - Sergio Berti
- UOC Cardiologia Diagnostica ed Interventistica, Fondazione CNR Reg Toscana G Monasterio, Ospedale del Cuore, Massa, Italy
| | - Emanuele Barbato
- Cardiovascular Research Centre Aalst, OLV Hospital, Aalst, Belgium; Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy
| | - Gabor G Toth
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Luc Maillard
- Service de Cardiologie, Clinique Axium, Aix-en-Provence, France
| | - Christian Valina
- Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | | | | | - Volker Schächinger
- Medizinische Klinik I, Herz-Thorax Zentrum, Klinikum Fulda, Fulda, Germany
| | - Andreas Baumbach
- Yale University School of Medicine, New Haven, CT, USA; Barts Heart Centre, London and Queen Mary University of London, London, UK
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Maillard L, Faurie B, Bosle S, Piot C, Paemelaere JM, Delarche N, Berland J. TCT-472 ACS versus non ACS. A pre defined sub study analysis of e-Cobra. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1644] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Derimay F, Maillard L, Rioufol G, Souteyrand G, Aminian A, Guerin P, Finet G. TCT-468 Sequential techniques of provisional stenting in coronary bifurcation with the Xposition S™ self-apposing nitinol stent. A comparative bench study. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1640] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dérimay F, Finet G, Souteyrand G, Maillard L, Aminian A, Lattuca B, Cayla G, Cellier G, Motreff P, Rioufol G. Benefit of a new provisional stenting strategy, the re-proximal optimisation technique: the rePOT clinical study. EUROINTERVENTION 2018; 14:e325-e332. [PMID: 29553940 DOI: 10.4244/eij-d-17-00941] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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] [Indexed: 01/17/2023]
Abstract
AIMS A new coronary bifurcation provisional stenting technique without kissing balloon, rePOT, associating the proximal optimisation technique (POT), side branch inflation and final POT, showed excellent mechanical results in a bench test. The present study sought to use optical coherence tomography (OCT) to quantify the mechanical results of rePOT in vivo in a large patient sample with complex coronary bifurcations. METHODS AND RESULTS A total of 106 patients with coronary bifurcations were included in a multicentre prospective registry (left main, 40.6%; true Medina bifurcation, 39.6%). Three OCT runs were performed, at baseline, just after stent implantation and after the complete rePOT sequence, quantifying global malapposition, side branch obstruction (SBO), and various geometric arterial criteria. RePOT was completed systematically. RePOT significantly reduced global strut malapposition from 18.9±13.4% just after stent implantation to 3.2±3.9% (p<0.05), residual SBO from 44.3±12.9% to 17.0±14.3% (p<0.05), and ellipticity index from 1.19±0.11 to 1.13±0.12 (p<0.05). Exhaustive six-month follow-up found only one mother-vessel target lesion revascularisation. CONCLUSIONS This clinical study of a large sample of complex coronary bifurcations with OCT analysis showed the benefit of the rePOT sequence in provisional stenting, replicating in vivo the excellent in vitro geometric results previously reported, and confirming ease of implementation and medium-term safety.
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Affiliation(s)
- François Dérimay
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude Bernard University and INSERM Unit 1060 CARMEN, Lyon, France
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Didier R, Morice MC, Barragan P, Noryani AAL, Noor HA, Majwal T, Hovasse T, Castellant P, Schneeberger M, Maillard L, Bressolette E, Wojcik J, Delarche N, Blanchard D, Jouve B, Ormezzano O, Paganelli F, Levy G, Sainsous J, Carrie D, Furber A, Berlan J, Darremont O, Le Breton H, Lyuycx-Bore A, Gommeaux A, Cassat C, Kermarrec A, Cazaux P, Druelles P, Dauphin R, Armengaud J, Dupouy P, Champagnac D, Ohlmann P, Ben Amer H, Kiss RG, Ungi I, Gilard M. 6- Versus 24-Month Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents in Patients Nonresistant to Aspirin: Final Results of the ITALIC Trial (Is There a Life for DES After Discontinuation of Clopidogrel). JACC Cardiovasc Interv 2018. [PMID: 28641840 DOI: 10.1016/j.jcin.2017.03.049] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study was to test the hypothesis that 6-month dual antiplatelet therapy (DAPT) is noninferior to 24-month DAPT in aspirin-sensitive patients. BACKGROUND The ITALIC (Is There a Life for DES After Discontinuation of Clopidogrel) trial showed that rates of bleeding and thrombotic events at 1 year were much the same with 6 versus 12 months of DAPT after percutaneous coronary intervention with second-generation drug-eluting stents. In this report, 2-year follow-up is presented. METHODS In a multicenter randomized study, patients with confirmed nonresistance to aspirin undergoing drug-eluting stent implantation were allocated to 6 or 24 months of DAPT. The primary endpoint was a composite of death, myocardial infarction, urgent target vessel revascularization, stroke, and major bleeding at 12 months post-percutaneous coronary intervention. The secondary endpoints comprised the same composite endpoint at 24 months and each individual component. RESULTS Overall, 2,031 patients from 70 centers were screened; 926 were randomized to 6-month and 924 to 24-month DAPT. Noninferiority was demonstrated for 6- versus 12-month DAPT, with an absolute risk difference of 0.11% (95% confidence interval: -1.04% to 1.26%; p = 0.0002). At 2 years, the composite endpoint was unchanged, at 3.5% for 6 months and 3.7% for 24 months (p = 0.79), and rates of myocardial infarction (1.3% vs. 1.0%; p = 0.51), stroke (0.6% vs. 0.8%; p = 0.77), and target vessel revascularization (1.0% vs. 0.3%; p = 0.09) were likewise similar. There was a trend toward higher mortality with longer DAPT (2.2% vs. 1.2%; p = 0.11). Four patients (0.4%) in the 24-month group and none in the 6-month group had major bleeding. CONCLUSIONS Two-year outcomes in the ITALIC trial confirmed the 1-year results and showed that patients receiving 6-month DAPT after percutaneous coronary intervention with second-generation drug-eluting stent have similar outcomes to those receiving 24-month DAPT.
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Affiliation(s)
- Romain Didier
- Department of Cardiology Brest University, Brest, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Irme Ungi
- SZTE Szent-Györgyi Albert, Szeged, Hungary
| | - Martine Gilard
- Department of Cardiology Brest University, Brest, France.
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Lemesle G, Laine M, Pankert M, Puymirat E, Cuisset T, Boueri Z, Maillard L, Armero S, Cayla G, Bali L, Motreff P, Peyre JP, Paganelli F, Kerbaul F, Roch A, Michelet P, Baumstarck K, Bonello L. Early versus delayed invasive strategy for intermediate- and high-risk acute coronary syndromes managed without P2Y 12 receptor inhibitor pretreatment: Design and rationale of the EARLY randomized trial. Clin Cardiol 2018; 41:5-12. [PMID: 29356001 DOI: 10.1002/clc.22852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 09/19/2017] [Revised: 11/13/2017] [Accepted: 11/15/2017] [Indexed: 01/23/2023] Open
Abstract
According to recent literature, pretreatment with a P2Y12 ADP receptor antagonist before coronary angiography appears no longer suitable in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) due to an unfavorable risk-benefit ratio. Optimal delay of the invasive strategy in this specific context is unknown. We hypothesize that without P2Y12 ADP receptor antagonist pretreatment, a very early invasive strategy may be beneficial. The EARLY trial (Early or Delayed Revascularization for Intermediate- and High-Risk Non-ST-Segment Elevation Acute Coronary Syndromes?) is a prospective, multicenter, randomized, controlled, open-label, 2-parallel-group study that plans to enroll 740 patients. Patients are eligible if the diagnosis of intermediate- or high-risk NSTE-ACS is made and an invasive strategy intended. Patients are randomized in a 1:1 ratio. In the control group, a delayed strategy is adopted, with the coronary angiography taking place between 12 and 72 hours after randomization. In the experimental group, a very early invasive strategy is performed within 2 hours. A loading dose of a P2Y12 ADP receptor antagonist is given at the time of intervention in both groups. Recruitment began in September 2016 (n = 558 patients as of October 2017). The primary endpoint is the composite of cardiovascular death and recurrent ischemic events at 1 month. The EARLY trial aims to demonstrate the superiority of a very early invasive strategy compared with a delayed strategy in intermediate- and high-risk NSTE-ACS patients managed without P2Y12 ADP receptor antagonist pretreatment.
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Affiliation(s)
- Gilles Lemesle
- USIC et Centre Hémodynamique, Institut Cœur Poumon, Centre Hospitalier Régional et Universitaire de Lille; Faculté de Médecine de l'Université de Lille; Institut Pasteur de Lille, Unité INSERM UMR 1011; and FACT (French Alliance for Cardiovascular Trials), Lille, F-59000, France
| | - Marc Laine
- Aix-Marseille Université, AP-HM, Unité INSERM 1076, Unité de Soins Intensifs Cardiologiques, Department of Cardiology, Hôpital Nord, Marseille, France.,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France
| | - Mathieu Pankert
- Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France.,Department of Cardiology, Centre Hospitalier Henri Duffaut, Avignon, France
| | - Etienne Puymirat
- Département de Cardiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris Descartes, INSERM U-970, Paris, France
| | - Thomas Cuisset
- Aix-Marseille Université, AP-HM, Unité INSERM 1062, Unité de Soins Intensifs Cardiologiques, Department of Cardiology, Hôpital Nord, Marseille, France
| | - Ziad Boueri
- Department of Cardiology, Centre Hospitalier de Bastia, France
| | - Luc Maillard
- Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France.,Department of Cardiology, Clinique Axium, Aix-en-Provence, France
| | - Sébastien Armero
- Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France.,Department of Cardiology, Hôpital Européen, Marseille, France
| | - Guillaume Cayla
- Department of Cardiology, Centre Hospitalier Universitaire de Nîmes, Université de Montpellier, Nîmes, France
| | - Laurent Bali
- Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France.,Department of Cardiology, Centre Hospitalier de Cannes, France
| | - Pascal Motreff
- Department of Cardiology, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Jean-Pascal Peyre
- Department of Cardiology, Hôpital Privé Beauregard, Marseille, France
| | - Franck Paganelli
- Aix-Marseille Université, AP-HM, Unité INSERM 1076, Unité de Soins Intensifs Cardiologiques, Department of Cardiology, Hôpital Nord, Marseille, France
| | - François Kerbaul
- Pole RUSH, Assistance-Publique Hôpitaux de Marseille, Marseille, France
| | - Antoine Roch
- Emergency Department, Hôpital Nord, Marseille, France
| | | | - Karine Baumstarck
- Unité d'Aide Méthodologique à la Recherche Clinique, EA 3279, Laboratoire de Santé Publique, Aix-Marseille Université, Marseille, France
| | - Laurent Bonello
- Aix-Marseille Université, AP-HM, Unité INSERM 1076, Unité de Soins Intensifs Cardiologiques, Department of Cardiology, Hôpital Nord, Marseille, France.,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France
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Verger A, Lagarde S, Maillard L, Bartolomei F, Guedj E. Brain molecular imaging in pharmacoresistant focal epilepsy: Current practice and perspectives. Rev Neurol (Paris) 2018; 174:16-27. [DOI: 10.1016/j.neurol.2017.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
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Carrié D, Menown I, Oldroyd K, Copt S, Talwar S, Maillard L, Morice MC, Teik LS, Lang I, Urban P. Safety and Efficacy of Polymer-Free Biolimus A9–Coated Versus Bare-Metal Stents in Orally Anticoagulated Patients. JACC Cardiovasc Interv 2017; 10:1633-1642. [DOI: 10.1016/j.jcin.2017.05.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/27/2017] [Accepted: 05/18/2017] [Indexed: 10/19/2022]
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Maupas E, Lipiecki J, Levy R, Faurie B, Karsenty B, Moulichon ME, Brunelle F, Maillard L, de Poli F, Lefèvre T. Safety and efficacy outcomes of 3rd generation DES in an all-comer population of patients undergoing PCI: 12-month and 24-month results of the e-Biomatrix French registry. Catheter Cardiovasc Interv 2017; 90:890-897. [PMID: 28544186 PMCID: PMC5724651 DOI: 10.1002/ccd.27081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/14/2017] [Accepted: 03/25/2017] [Indexed: 12/02/2022]
Abstract
Objectives The French Ebiomatrix registry aimed to confirm the results of the Leaders trial in an all‐comer population in France. Background The Leaders trial showed the Biolimus‐eluting‐sent (BES) to be equivalent to the Cypher stent in terms of safety and efficacy at 1 year and superior regarding stent thrombosis after 1 year. Methods BES recipients were enrolled in 42 French centers with up to 24‐month clinical follow up. Results 2365 patients were included. Mean age: 65.7 ±11.2 years, 76.1% males, 31.8% had diabetes, 36.5% ACS (28.7% non‐ST‐elevation MI and 7.8% with ST‐elevation MI). 1.7 ± 1.0 stents/patient were implanted and procedural success was 99.5%. 12‐month follow‐up was completed in 94.3% patients and 24 months in 91.4%. MACCE rates at 12 and 24 months were 5.8% and 9% (all cause‐death 1.5% and 2.2%; stent thrombosis definite/probable 0.4% and 0.6%), respectively. MACCE were not significantly higher in diabetic patients compared with non‐diabetics but cardiac death was higher (1.6% vs. 0.6%, P = 0.01 at 1 year and 1.9% vs. 0.6, P = 0.005 at 2 years) as was stent thrombosis (0.9% vs. 0.2%, P = 0.009 and 1.2 vs. 0.3% P = 0.008). Compared with non‐ACS patients, MACCE was significantly higher in the ACS subgroup (7.5% vs. 4.8%, P = 0.001 at 1 year and 10.3% vs.8.1%, P = 0.07 at 2 years). Conclusion In this large real‐world registry, the BES with biodegradable polymer showed excellent acute and mid‐term outcomes with a 5.8% and 9% rate of MACCE at one and 2 years and a very low rate of stent thrombosis between 1 and 2 years (0.2%), thus demonstrating the replicability of the LEADERS trial in a registry population. © 2017 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Thierry Lefèvre
- Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France
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Hingray C, Donne C, Cohn A, Maillard L, Schwan R, Montel S, El-Hage W. Link between psychogenic nonepileptic seizures and complex PTSD: A pilot study. European Journal of Trauma & Dissociation 2017. [DOI: 10.1016/j.ejtd.2017.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cam SL, Ranta R, Caune V, Korats G, Koessler L, Maillard L, Louis-Dorr V. SEEG dipole source localization based on an empirical Bayesian approach taking into account forward model uncertainties. Neuroimage 2017; 153:1-15. [PMID: 28323161 DOI: 10.1016/j.neuroimage.2017.03.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 07/01/2016] [Revised: 01/18/2017] [Accepted: 03/14/2017] [Indexed: 11/24/2022] Open
Abstract
Electromagnetic brain source localization consists in the inversion of a forward model based on a limited number of potential measurements. A wide range of methods has been developed to regularize this severely ill-posed problem and to reduce the solution space, imposing spatial smoothness, anatomical constraint or sparsity of the activated source map. This last criteria, based on physiological assumptions stating that in some particular events (e.g., epileptic spikes, evoked potential) few focal area of the brain are simultaneously actives, has gained more and more interest. Bayesian approaches have the ability to provide sparse solutions under adequate parametrization, and bring a convenient framework for the introduction of priors in the form of probabilistic density functions. However the quality of the forward model is rarely questioned while this parameter has undoubtedly a great influence on the solution. Its construction suffers from numerous approximation and uncertainties, even when using realistic numerical models. In addition, it often encodes a coarse sampling of the continuous solution space due to the computational burden its inversion implies. In this work we propose an empirical Bayesian approach to take into account the uncertainties of the forward model by allowing constrained variations around a prior physical model, in the particular context of SEEG measurements. We demonstrate on simulations that the method enhance the accuracy of the source time-course estimation as well as the sparsity of the resulting source map. Results on real signals prove the applicability of the method in real contexts.
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Affiliation(s)
- S Le Cam
- Université de Lorraine, CRAN, UMR 7039, 54500 Vandœuvre-lès-Nancy, France; CNRS, CRAN, UMR, 7039, France.
| | - R Ranta
- Université de Lorraine, CRAN, UMR 7039, 54500 Vandœuvre-lès-Nancy, France; CNRS, CRAN, UMR, 7039, France
| | - V Caune
- Université de Lorraine, CRAN, UMR 7039, 54500 Vandœuvre-lès-Nancy, France; CNRS, CRAN, UMR, 7039, France
| | - G Korats
- Université de Lorraine, CRAN, UMR 7039, 54500 Vandœuvre-lès-Nancy, France; CNRS, CRAN, UMR, 7039, France; Ventspils University College, 101 Inzenieruiela, LV-3601 Ventspils, Latvia
| | - L Koessler
- Université de Lorraine, CRAN, UMR 7039, 54500 Vandœuvre-lès-Nancy, France; CNRS, CRAN, UMR, 7039, France
| | - L Maillard
- Université de Lorraine, CRAN, UMR 7039, 54500 Vandœuvre-lès-Nancy, France; CNRS, CRAN, UMR, 7039, France; CHU Nancy, Neurology Department, 54000 Nancy, France
| | - V Louis-Dorr
- Université de Lorraine, CRAN, UMR 7039, 54500 Vandœuvre-lès-Nancy, France; CNRS, CRAN, UMR, 7039, France
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Garot P, Morice MC, Tresukosol D, Pocock SJ, Meredith IT, Abizaid A, Carrié D, Naber C, Iñiguez A, Talwar S, Menown IB, Christiansen EH, Gregson J, Copt S, Hovasse T, Lurz P, Maillard L, Krackhardt F, Ong P, Byrne J, Redwood S, Windhövel U, Greene S, Stoll HP, Urban P, Urban P, Morice MC, Abizaid A, Meredith IT, Pocock SJ, Carrié D, Naber C, Greene S, Stoll HP. 2-Year Outcomes of High Bleeding Risk Patients After Polymer-Free Drug-Coated Stents. J Am Coll Cardiol 2017; 69:162-171. [DOI: 10.1016/j.jacc.2016.10.009] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 10/06/2016] [Accepted: 10/07/2016] [Indexed: 10/20/2022]
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Ratini R, Maillard L, Belle L, Berland J, de Labriolle A. Evaluation of the safety and efficacy of the Cobra PzF NanoCoated Coronary Stent (NCS) in 1 000 all-comers, consecutive, prospective, high risk patients: the e-Cobra Registry. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30080-0] [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: 10/19/2022]
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Carrié D, Alexander Menown IB, Oldroyd K, samuel copt, Talwar S, Maillard L, Morice MC, Lim ST, Lang I, Urban P. TCT-54 LEADERS FREE OAC : Biolimus A9 coated versus bare metal stents in patients requiring oral anticoagulation. A pre-specified subgroup analysis of the LEADERS FREE trial. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.200] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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