1
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Bentounes NK, Le Hingrat Q, Planquette B, Darnige L, Khider L, Sanchez O, Smadja DM, Mauge L, Lê MP, Mirault T, Gendron N. [Human immunodeficiency virus and venous thromboembolism: Role of direct oral anticoagulants]. Rev Med Interne 2023; 44:181-189. [PMID: 36878744 DOI: 10.1016/j.revmed.2023.01.006] [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: 10/17/2022] [Revised: 12/16/2022] [Accepted: 01/08/2023] [Indexed: 03/07/2023]
Abstract
Nowadays, thanks to highly active antiretroviral therapy (HAART), human immunodeficiency virus (HIV) infection is transforming into a chronic disease. The life expectancy of people living with HIV (PWH) has increased, as well as their risk of developing several co-morbidities, in particular cardiovascular diseases. In addition, the incidence of venous thromboembolism (VTE) is increased in PWH with a 2 to 10 times higher incidence when compared to the general population. Over the last decade, direct oral anticoagulants (DOACs) have been widely used in the treatment and prevention of VTE and non-valvular atrial fibrillation. DOACs are characterized by a rapid onset of activity, a predictable response and a relatively wide therapeutic window. Nevertheless, drug interactions exist between HAART and DOACs, exposing PWH to a theoretically increased bleeding or thrombotic risk. DOACs are substrates of the transport protein P-glycoprotein and/or of isoforms of cytochromes P450 pathway, which can be affected by some antiretroviral drugs. Limited guidelines are available to assist physicians with the complexity of those drug-drug interactions. The aim of this paper is to provide an updated review on the evidence of the high risk of VTE in PWH and the place of DOAC therapy in this population.
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Affiliation(s)
- N K Bentounes
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 20, rue Leblanc, 75015 Paris, France
| | - Q Le Hingrat
- Inserm, UMR 1137 IAME, Virology dDepartment, Université Paris Cité, Hôpital Bichat-Claude-Bernard, AP-HP, 75018 Paris, France
| | - B Planquette
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France
| | - L Darnige
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 20, rue Leblanc, 75015 Paris, France
| | - L Khider
- Vascular medicine department, AP-HP Centre Université Paris Cité, 75015 Paris, France
| | - O Sanchez
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France
| | - D M Smadja
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 20, rue Leblanc, 75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France
| | - L Mauge
- PARCC Inserm U970, Hematology Department, Université Paris Cité, AP-HP Centre Université Paris Cité, 75015 Paris, France
| | - M P Lê
- Inserm, Laboratoire de Pharmacologie, Université Paris Cité, UMRS 1144, Hôpital Bichat Claude-Bernard, AP-HP, 75018 Paris, France
| | - T Mirault
- PARCC Inserm U970, Hematology Department, Université Paris Cité, AP-HP Centre Université Paris Cité, 75015 Paris, France; Inserm U970, Université Paris Cité, PARCC, Paris, France
| | - N Gendron
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 20, rue Leblanc, 75015 Paris, France.
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Kubiak T, Sitruk J, Mortelette H, Durivage A, Mohamedi N, Détriché G, Khider L, Messas E, Mirault T, Goudot G. Place of the Advanced Practice Registered Nurse (APRN) within the vascular team: A qualitative study of vascular medicine physicians and nurses caring for patients with Peripheral Artery Disease (PAD). Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.300] [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: 01/01/2023]
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3
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Wang L, Oehmichen B, Pariente B, Mohamedi N, Cheng C, Détriché G, Galloula A, Khider L, Lillo Le Louet A, Messas E, Amar L, Goudot G, Mirault T. Fluoroquinolone use preceding medium-size artery dissection: A case series. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.217] [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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4
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Le Jeune S, Sadoudi S, Charue D, Abid S, Helley D, Bihan H, Baudry C, Lelong H, Mirault T, Vicaut E, Dhôte R, Mourad J, Boulanger C, Blanc-Brude O. Hémolyse intravasculaire de bas grade associée aux complications neurologiques du diabète de type 2 : résultats de l’étude multicentrique DIABELYSE. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.100] [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: 12/12/2022]
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5
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Adham S, Legrand A, Bruno RM, Billon C, Dalens V, Boutouyrie P, Mazzella JM, Gueguen S, Frank M, Mirault T, Jeunemaitre X. Assessment of arterial damage in vascular Ehlers-Danlos syndrome: a retrospective multicentric cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1981] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Vascular Ehlers-Danlos syndrome (vEDS) is a rare inherited connective tissue disorder due to pathogenic variants in the COL3A1 gene, leading to medium-size artery (MSA) dissection, aneurysm, and rupture with a poor prognosis. Conversely, aortic lesions are rarer and less investigated.
Purpose
To describe the association between the distribution of MSA and aortic lesions and the type of COL3A1 variants in a multicentric cohort of vEDS patients.
Methods
Analysis of the 330 vEDS adult patients from the French RaDiCO SEDVASC registry. At the time of the study, 87% were alive, 60.3% were index cases and 60.0% females. Median age at molecular diagnosis was 36 years (IQR 24.3–46.8). COL3A1 variants were identified using NGS and/or Sanger sequencing and classified according to their functional consequences: 80.6% dominant-negative (DN) and 19.4% leading to haplo-insufficiency (HI). Computed tomography angiography (CTA) was systematically performed during the initial work-up of patients. Carotid mechanics was also assessed by echotracking in a subgroup of 133 patients.
Results
Arterial lesion history was reported in 82.4% of the patients (N=272), with 227/272 patients (83.5%) having MSA lesions alone, 9 (3.3%) aortic lesions alone and 36 (13.2%) both. DN variant was associated with higher prevalence of arterial lesions than HI variant (P 0.044), especially on supra-aortic trunks and renal arteries (P 0.018 and P 0.0003 respectively). Importantly, the higher prevalence of aortic lesions observed in HI patients with arterial lesions versus DN patients (P 0.027) was not significantly different when adjusted for age (P 0.559). Carotid Young's modulus was lower in DN than HI patients (P 0.014), in association with the higher incidence of MSA lesions in this genotype group.
Conclusion
The prevalence of aortic lesions is not influenced by the COL3A1 genotype when adjusted for age. vEDS patients with DN variants have a higher frequency of MSA lesions especially in supra-aortic trunks which is associated with a lower carotid stiffness, suggesting a need for an optimal care for this subgroup of patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): French National Research Agency under the specific programme “Investments for the Future”, cohort grant-agreement ANR-l0-COHO-03-01
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Affiliation(s)
- S Adham
- CHU Montpellier, Hôpital Saint Eloi, Vascular Medicine , Montpellier , France
| | - A Legrand
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - R M Bruno
- Paris Cardiovascular Research Center (PARCC), AP-HP, Unité de Pharmacologie, Hôpital Européen Georges Pompidou , Paris , France
| | - C Billon
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - V Dalens
- Centre Hospitalier Universitaire de Québec-Université Laval, Hôpital Saint-François d'Assise, Division de Médecine Interne, Département de Médecine , Quebec , Canada
| | - P Boutouyrie
- Paris Cardiovascular Research Center (PARCC), AP-HP, Unité de Pharmacologie, Hôpital Européen Georges Pompidou , Paris , France
| | - J M Mazzella
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - S Gueguen
- Sorbonne Université, Inserm, RaDiCo, French National Program on “Rare Disease Cohorts”, Hôpital Armand Trousseau , Paris , France
| | - M Frank
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - T Mirault
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - X Jeunemaitre
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
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Mazzella JM, Oehmichen B, Billon C, Nicolas S, Lahlou-Laforet K, Frank M, Jeunemaitre X, Mirault T. Celiprolol to prevent arterial events in patients with vascular Ehlers-Danlos and neither symptomatic nor silent arterial event. A retrospective cohort study from the French national reference center. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1941] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Vascular Ehlers-Danlos syndrome (vEDS) is a rare inherited connective tissue disorder, leading to mainly arterial complications, caused by COL3A1 pathogenic variations. Ong et al. (Lancet 2010) showed that the introduction of celiprolol significantly reduced arterial events in a predominantly symptomatic population on arterial level. We reported the benefit of full dose of Celiprolol in longitudinal study to prevent arterial events in Frank et al. (JACC 2019). To our knowledge, there is no data regarding the benefit of celiprolol in patients without any arterial event.
Purpose
The aim of this study was to assess the occurrence of arterial events during follow-up in vEDS patients without arterial event.
Methods
All patients – probands and relatives – with a pathogenic variation in COL3A1 diagnosed at the Referral Centre for Rare Vascular Diseases since 2001 and at least one arterial tree assessment were included. We then focused on vEDS patients without any arterial event. We retrospectively analyzed the duration of follow-up, the occurrence of arterial events during follow-up, and the introduction and dose of celiprolol, especially at the time of occurrence of an arterial event.
Results
Among the 230 patients included, 144 (63%) had at least one symptomatic arterial event, 44 (19%) had only silent arterial event and 67 (29%) had no arterial event at the first arterial tree assessment event. Patients with no arterial event were significantly younger at this visit compared with the two other groups with a median age of 23 vs. 38 and 39 years (silent and symptomatic) (p<0.05). Patients with no arterial event were more frequently relatives (73%) than probands (27%) (p<10–3). Celiprolol was introduced in 48 (72%) of the 67 patients with no arterial event after positive genetic diagnosis disclosure or during one of the outpatient visit. During follow-up, 22 patients had a first arterial event at a median age of 29 years: 16 (33%) were receiving celiprolol and 6 (32%) were not. But the median follow-up duration was 4 years for the 48 treated patients vs. 2 years for the 19 untreated patients (p=0.03).
Conclusions
Genetic testing of the relatives of probands with vEDS remains of utmost importance as one quarter presented with symptomatic arterial event and one fifth had silent arterial event at initial arterial tree assessment. For patients with no arterial event, those without celiprolol have a similar incidence of arterial events than those with celiprolol, however their follow-up duration was twice shorter suggesting a higher incidence rate or arterial event in the absence of celiprolol.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J M Mazzella
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - B Oehmichen
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - C Billon
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - S Nicolas
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - K Lahlou-Laforet
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - M Frank
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - X Jeunemaitre
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
| | - T Mirault
- Université Paris Cité, hôpital européen Georges-Pompidou APHP, INSERM U970, National reference center for Rare Vascular Diseases , Paris , France
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Guedon A, De Freminville JB, Mirault T, Mohamedi N, Rance B, Fournier N, Paul JL, Messas E, Goudot G. Elevated Lipoprotein(a) levels increase Major Adverse Limb Event. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1980] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
High lipoprotein(a) levels are involved in the development of cardiovascular events, as particularly in myocardial infarction, stroke, and peripheral artery disease. Studies assessing prognostic values of lipoprotein(a) levels on the lower limbs are lacking.
Purpose
The aim of our study was to look after a relationship between the lipoprotein(a) level and the incidence of major adverse limb events (MALE) defined as major amputation, peripheral artery endovascular revascularization or peripheral artery bypass.
Methods
We included 16,513 patients with lipoprotein(a) measurements from our clinical information system. Normal lipoprotein(a) level was under 50 mg/dL and we defined: high lipoprotein(a) level as a lipoprotein(a) level between 50 mg/dL and 134 mg/dL and very high lipoprotein(a) level as a lipoprotein(a) levels over 134 mg/dL, i.e the 95th percentile in this cohort. Accelerated Failure Time models were used to assess the relationship between the lipoprotein(a) level and the incidence of MALE retrieved from the patient's electronic record during a median (interquartile range) follow-up of 3.74 (1.07; 7.30) years after the lipoprotein(a) measurement. MALE was defined as the occurrence of one of the following during follow-up: aortofemoral bypass surgery, limb bypass surgery, percutaneous transluminal angioplasty revascularization of the iliac, or infrainguinal arteries; or major amputation above the forefoot. Secondary outcomes included individual components of the primary
Results
Median lipoprotein(a) level was 24 mg/dL (10; 60), with 70.3%; 24.7%; and 5.0% within normal; high and very high lipoprotein(a) level respectively. The 1-year MALE incidence was 2.2% [95% CI: 1.96; 2.51]; 2.60% [95% CI: 2.09; 3.10] and 4.54% [95% CI: 3.08; 5.98] among the normal, high and very high lipoprotein(a) level patients respectively. High and very high lipoprotein(a) levels were independently associated with an increased risk of MALE (adjusted Accelerated Failure Time Exponential Estimate) 0.43 [95% CI: 0.24; 0.78], p=0.01 and 0.17 [95% CI: 0.07; 0.40], p<0.001, respectively.
Conclusion
In this large cohort of unselected real-world hospital inpatients, higher lipoprotein(a) levels were independently associated with an increased risk of MALE. Though, lipoprotein(a) measurement shall be taken into account not only to refine the cardiovascular risk but also the lower limb risk of revascularization or amputation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Guedon
- European Hospital Georges Pompidou , Paris , France
| | | | - T Mirault
- European Hospital Georges Pompidou , Paris , France
| | - N Mohamedi
- European Hospital Georges Pompidou , Paris , France
| | - B Rance
- European Hospital Georges Pompidou , Paris , France
| | - N Fournier
- European Hospital Georges Pompidou , Paris , France
| | - J L Paul
- European Hospital Georges Pompidou , Paris , France
| | - E Messas
- European Hospital Georges Pompidou , Paris , France
| | - G Goudot
- European Hospital Georges Pompidou , Paris , France
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Kubiak T, Sitruk J, Khider L, Durivage A, Mortelette H, Mohamedi N, Detriche G, Messas E, Mirault T, Goudot G. Place of the Advanced Practice Registered Nurse within the vascular team: a qualitative study of vascular medicine physicians and nurses caring for patients with peripheral artery disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2751] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Advanced Practice Registered Nurses (APRNs) treat and diagnose diseases, counsel the public about health problems, manage chronic diseases, and participate in continuing education. In the cardiovascular field, Peripheral Arterial Disease (PAD), one of the manifestations of atherosclerotic cardiovascular disease, is archetypal in combining multiple cardiovascular risk factors (hypertension, hyperlipidemia, diabetes mellitus smoking). Vascular medicine faces the challenge of improving their care and quality of life, but some goals cannot be achieved with all patients. Patients with PAD should benefit from APRN care, but to date there is little published on the place of APRN in vascular medicine worldwide, and none in France.
Objective
It appeared important to us to assess the perception of their role by physicians and nurses in vascular medicine. As the status of APRN in France has only been enacted by law in 2018, we aim to investigate physicians and nurses working with patients suffering from PAD, to gather their opinions and draw the cooperation outlines these practitioners could have with an APRN.
Methods
Multicentre exploratory qualitative study by semi-directive interview conducted until data saturation and thematic analysis carried out with healthcare practitioners taking care of patients with PAD: 10 physicians working either in private practice setting or hospital setting or both, and 8 nurses in a vascular unit for hopsitalised patients.
Results
Three main themes emerged from responders' verbatims: a specific organization of vascular medicine with its inherent challenges, particularly regarding patients with PAD (specific psychosocial profile of patients, lack of therapeutic education, time, knowledge of non-specialist physicians, tedious follow-up outside hospitals, complex care trajectory, and lack of medical-surgical collaboration). Second, a role for APRN, particularly in consultation as part of patient follow-up, with expected benefits for the patient and the care team. The APRN is wanted to fill part of this gap. The expected benefits include a smoother care pathway and increased capacity for cardiovascular education and prevention, especially during consultations. Third, there are certain pitfalls that need to be clarified to integrate these new practitioners into the vascular teams already in place. In particular, the need to inform the vascular medicine teams about this new profession, and the indispensable presence of the conditions necessary for the development of a relationship of trust.
Conclusion
APRN could be the missing link in a Vascular team by creating a continuum in the care of patients with PAD, ensuring clinical assessment, nursing supervision, adverse event screening, and renewing drug prescriptions with the necessary adjustments, while ensuring an essential part of therapeutic education personalized to each PAD patient.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Kubiak
- European Hospital Georges Pompidou , Paris , France
| | - J Sitruk
- European Hospital Georges Pompidou , Paris , France
| | - L Khider
- European Hospital Georges Pompidou , Paris , France
| | - A Durivage
- Sherbrooke University , Sherbrooke , Canada
| | - H Mortelette
- European Hospital Georges Pompidou , Paris , France
| | - N Mohamedi
- European Hospital Georges Pompidou , Paris , France
| | - G Detriche
- European Hospital Georges Pompidou , Paris , France
| | - E Messas
- European Hospital Georges Pompidou , Paris , France
| | - T Mirault
- European Hospital Georges Pompidou , Paris , France
| | - G Goudot
- European Hospital Georges Pompidou , Paris , France
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Goudot G, Jimenez A, Mohamedi N, Sitruk J, Khider L, Mortelette H, Tanter M, Messas E, Pernot M, Mirault T. Evaluation of Takayasu's arteritis activity by ultrasound localization microscopy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1964] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Use of sulphur hexafluoride microbubbles (MB) with ultrasound can provide arterial wall enhancement. The use of ultrafast imaging with MB super-localization offers the possibility of ultrasound localization microscopy (ULM) and thus a visualization of in vivo carotid vasa vasorum. We aim to perform in vivo Vasa vasorum imaging in the carotid wall in Takayasu's arteritis and to provide a correlation with the disease's activity.
Methods
Patients with Takayasu arteritis were consecutively included in the national referral centre. Assessment of activity was performed by NIH activity index, with measurement of biological inflammation, morphological evaluation by computed tomography (CT) angiography, and 18-fluorodeoxyglucose CT scan. Ultrafast ultrasound imaging was performed with a 7 MHz central frequency linear probe. A dedicated contrast imaging sequence (plane waves with 8 angles, frame rate 500 Hz, voltage 8 V, duration of 8 s), coupled with the intravenous injection of sulphur hexafluoride MB allow us to store the raw radio frequency data of the MB passage. After a pre-processing step to accumulate frames properly including a frames selection and a movement correction, the MB were localized then tracked, allowing reconstruction of the vasa vasorum. The inflammation was quantified through MB tracked and normalized for inter acquisition comparison.
Results
16 patients were included. 5 patients (median age 35.8 [24.5–46.0] years, 3 women) had active disease and 11 patients (37.2 [31.7–47.3] years, 9 women) had quiescent disease. The passage of MB allowed the visualisation of microvessels within the arterial wall for active cases. The number of MB detected per second in the wall was 118 [80–169] for active cases vs. 13 [10–15] for quiescent cases (p=0.0005).
Conclusion
ULM allows visualization of microvessels within the carotid wall, with significantly greater MB passage in active Takayasu arteritis. ULM provides for the first time a precise visualization in vivo of the vasa vasorum and gives access to quantification of the vascularity of the arterial wall.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Société française de cardiologie
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Affiliation(s)
- G Goudot
- European Hospital Georges Pompidou, Vascular medicine , Paris , France
| | - A Jimenez
- Inserm, Physics for medicine, U1273 INSERM , Paris , France
| | - N Mohamedi
- European Hospital Georges Pompidou, Vascular medicine , Paris , France
| | - J Sitruk
- European Hospital Georges Pompidou, Vascular medicine , Paris , France
| | - L Khider
- European Hospital Georges Pompidou, Vascular medicine , Paris , France
| | - H Mortelette
- European Hospital Georges Pompidou, Vascular medicine , Paris , France
| | - M Tanter
- Inserm, Physics for medicine, U1273 INSERM , Paris , France
| | - E Messas
- European Hospital Georges Pompidou, Vascular medicine , Paris , France
| | - M Pernot
- Inserm, Physics for medicine, U1273 INSERM , Paris , France
| | - T Mirault
- European Hospital Georges Pompidou, Vascular medicine , Paris , France
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Mirouse A, Deltour S, Leclerc D, Pouchelon C, Comarmond C, Kahn J, Benhamou Y, Mirault T, Mekinian A, Lambert M, Cacoub P, Biard L, Saadoun D. Accidents cérébraux ischémiques au cours de la maladie de Takayasu. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.322] [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: 11/25/2022]
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Guédon A, Delarue A, Mohamedi N, Roffé A, Khider L, Gendron N, Goudot G, Détriché G, Chocron R, Oudard S, Smadja D, Mirault T, Messas E. Relationship between kalemia and intensive care unit admission or death in hospitalized COVID-19 patients: A cohort study. JMV-Journal de Médecine Vasculaire 2022; 47:3-10. [PMID: 35393089 PMCID: PMC8557982 DOI: 10.1016/j.jdmv.2021.10.006] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/21/2021] [Indexed: 01/08/2023]
Abstract
Background Methods Results Conclusion
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12
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Luu M, Vabres P, Devilliers H, Loffroy R, Phan A, Martin L, Morice-Picard F, Petit F, Willems M, Bessis D, Jacquemont ML, Maruani A, Chiaverini C, Mirault T, Clayton-Smith J, Carpentier M, Fleck C, Maurer A, Yousfi M, Parker VER, Semple RK, Bardou M, Faivre L. Safety and efficacy of low-dose PI3K inhibitor taselisib in adult patients with CLOVES and Klippel-Trenaunay syndrome (KTS): the TOTEM trial, a phase 1/2 multicenter, open-label, single-arm study. Genet Med 2021; 23:2433-2442. [PMID: 34385668 PMCID: PMC8631579 DOI: 10.1038/s41436-021-01290-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE PIK3CA pathogenic variants in the PIK3CA-related overgrowth spectrum (PROS) activate phosphoinositide 3-kinase signaling, providing a rationale for targeted therapy, but no drug has proven efficacy and safety in this population. Our aim was to establish the six-month tolerability and efficacy of low-dose taselisib, a selective class I PI3K inhibitor, in PROS patients. METHODS Patients over 16 years with PROS and PIK3CA pathogenic variants were included in a phase IB/IIA multicenter, open-label single-arm trial (six patients at 1 mg/day of taselisib, then 24 at 2 mg/day). The primary outcome was the occurrence of dose limiting toxicity (DLT). Efficacy outcomes were the relative changes after treatment of (1) tissue volume at affected and unaffected sites, both clinically and on imaging; (2) cutaneous vascular outcomes when relevant; (3) biologic parameters; (4) quality of life; and (5) patient-reported outcomes. RESULTS Among 19 enrolled patients, 2 experienced a DLT (enteritis and pachymeningitis) leading to early trial termination (17 treated, 10 completed the study). No serious adverse reaction occurred in the 1 mg cohort (n = 6). No significant reduction in affected tissue volume was observed (mean -4.2%; p = 0.81; SD 14.01). Thirteen (76.4%) participants reported clinical improvement (pain reduction, chronic bleeding resolution, functional improvement). CONCLUSION Despite functional improvement, the safety profile of low-dose taselisib precludes its long-term use.
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Affiliation(s)
- M Luu
- Centre d'Investigation Clinique-module plurithématique, CHU, Dijon, France.
- INSERM CIC1432, UBFC, Dijon, France.
| | - P Vabres
- Centre référence MAGEC, Dijon, France
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU, Dijon, France
| | - H Devilliers
- INSERM CIC1432, UBFC, Dijon, France
- Centre d'Investigation Clinique-module épidémiologie clinique, CHU, Dijon, France
| | - R Loffroy
- Radiologie Interventionnelle, CHU, Dijon, France
| | - A Phan
- Dermatologie Pédiatrique, HFME, Lyon, France
| | - L Martin
- Centre référence MAGEC, CHU, Angers, France
| | | | - F Petit
- Centre de référence Anomalies du Développement et Syndromes Malformatifs, CHU, Lille, France
| | - M Willems
- Centre de référence Anomalies du Développement et Syndromes Malformatifs, Montpellier, France
| | - D Bessis
- Service de Dermatologie, CHU, Montpellier, France
| | - M L Jacquemont
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU La Réunion, Saint-Pierre, France
| | - A Maruani
- Centre référence MAGEC, CHU, Tours, France
| | | | - T Mirault
- Centre de référence maladies vasculaires rares, Hôpital européen Georges-Pompidou, AP-HP, Paris, France
- INSERM U970 PARCC, Université de Paris, Paris, France
| | - J Clayton-Smith
- Clinical Genetics and Manchester Centre for Genomic Medicine, NHS and Manchester University, Manchester, UK
| | - M Carpentier
- Délégation à la Recherche Clinique et de l'Innovation, CHU, Dijon, France
| | - C Fleck
- Délégation à la Recherche Clinique et de l'Innovation, CHU, Dijon, France
| | - A Maurer
- Centre d'Investigation Clinique-module plurithématique, CHU, Dijon, France
- INSERM CIC1432, UBFC, Dijon, France
| | - M Yousfi
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU, Dijon, France
| | | | - R K Semple
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - M Bardou
- Centre d'Investigation Clinique-module plurithématique, CHU, Dijon, France
- INSERM CIC1432, UBFC, Dijon, France
| | - L Faivre
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU, Dijon, France
- INSERM UMR1231 GAD, Génétique des Anomalies du Développement, Université Bourgogne Franche-Comté, Dijon, France
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Goudot G, Sitruk J, Jimenez A, Khider L, Julia P, Alsac JM, El Batti S, Bruneval P, Amemyia K, Pedreira O, Calvet D, Tanter M, Mirault T, Pernot M, Messas E. Carotid plaque vulnerability assessed by combined shear wave elastography and ultrafast doppler compared to histology: the UF-plaque study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1995] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
New biomarkers are needed to assess the vulnerability of carotid plaque to guide carotid surgery decision. Ultrafast Ultrasound Imaging (UUI) provides an estimation of plaque stiffness by Shear Wave Elastography (SWE) and the quantification of wall shear stress (WSS) by ultrafast Doppler. We aimed at evaluating the plaque stiffness and WSS applied on the plaque as potential biomarkers of plaque vulnerability.
Methods
Patients were referred for carotid endarterectomy because of symptomatic or asymptomatic carotid stenosis. Their plaques were evaluated by UUI within 48 hours before surgery. For each plaque, WSS and SWE were obtained on a longitudinal view at the stenosis. After endarterectomy, gross analysis and histology were performed on each removed plaque.
Results
46 plaques with SWE data and 29 with WSS data were analysed. Histological analysis revealed 29 vulnerable and 17 stable plaques. Analysis of the Gray Scale Median by B mode, mean and standard deviation of stiffness by SWE were not helpful in identifying vulnerable plaques. Figure 1 presents the SWE acquisition on one plaque (A) and the distribution of plaque's stiffness average over all plaques showing the 4 ranges of stiffness (B). SWE analysis revealed that the percentage of stiffness range of [3–5] m/s was significantly increased in vulnerable plaques (p=0.048) (Figure 2A). WSS alone showed no significant difference between stable and vulnerable plaques regardless of which segment of the plaque was analysed. A multiparametric score using maximal WSS at the peak of the plaque associated with SWE texture analysis parameters was created by a stepwise analysis, leading to a score with a sensitivity of 80% and a specificity of 78%. The ROC curve of this score found an AUC of 0.85 (Figure 2B).
Conclusions
Multiparameter scoring including plaque stiffness and flow analysis using ultrafast ultrasound imaging allows an effective identification of histologically vulnerable carotid plaques.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Fédération Française de cardiologieSociété Française de Cardiologie Figure 1Figure 2
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Affiliation(s)
- G Goudot
- European Hospital Georges Pompidou, Vascular Medicine, Paris, France
| | - J Sitruk
- European Hospital Georges Pompidou, Vascular Medicine, Paris, France
| | - A Jimenez
- Inserm, Physics for Medicine, U1273 INSERM, Paris, France
| | - L Khider
- European Hospital Georges Pompidou, Vascular Medicine, Paris, France
| | - P Julia
- Hopital Europeen Georges Pompidou - University Paris Descartes, Vascular Surgery Department, Paris, France
| | - J M Alsac
- Hopital Europeen Georges Pompidou - University Paris Descartes, Vascular Surgery Department, Paris, France
| | - S El Batti
- Hopital Europeen Georges Pompidou - University Paris Descartes, Vascular Surgery Department, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou - University Paris Descartes, Pathology Department, Paris, France
| | - K Amemyia
- Hopital Europeen Georges Pompidou - University Paris Descartes, Pathology Department, Paris, France
| | - O Pedreira
- Inserm, Physics for Medicine, U1273 INSERM, Paris, France
| | - D Calvet
- Inserm, Physics for Medicine, U1273 INSERM, Paris, France
| | - M Tanter
- Inserm, Physics for Medicine, U1273 INSERM, Paris, France
| | - T Mirault
- European Hospital Georges Pompidou, Vascular Medicine, Paris, France
| | - M Pernot
- Inserm, Physics for Medicine, U1273 INSERM, Paris, France
| | - E Messas
- European Hospital Georges Pompidou, Vascular Medicine, Paris, France
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Goudot G, Sitruk J, Jimenez A, Khider L, Tanter M, Pedreira O, Bruneval P, Julia P, El Batti S, Alsac J, Calvet D, Mirault T, Pernot M, Messas E. Carotid plaque vulnerability assessed by Shear Wave elastography and ultrafast Doppler compared to histology: The UF-plaque study. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.085] [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: 10/21/2022]
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15
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Mohamedi N, Mirault T, Durivage A, Di Primio M, Khider L, Detriche G, El Batti S, Sapoval M, Messas E, Goudot G. Ergotism with acute limb ischemia, provoked by HIV protease inhibitors interaction with ergotamine, rescued by multisite transluminal balloon angioplasty. J Med Vasc 2021; 46:13-21. [PMID: 33546816 DOI: 10.1016/j.jdmv.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/29/2020] [Indexed: 11/17/2022]
Abstract
Acute limb ischemia induced by arterial vasospasm remains an exceptional situation, favoured by the use of arterial vasoconstrictors. The risk of these substances is largely underestimated in the general population, especially with the co-administration of strong cytochrome inhibitors like human immunodeficiency virus (HIV) protease inhibitors. A 33-year-old woman, who used to take dihydroergotamine for orthostatic hypotension, was prescribed a post-exposure HIV prophylaxis including lopinavir and ritonavir. One day later, she presented an acute bilateral limb ischemia with a sudden pain in both calves, initially while walking and then at rest with bilateral ischemic toes. Angiography confirmed diffuse arterial vasospasm of the lower limb arteries. A first-line therapy with isosorbide dinitrate and amlodipine was ineffective, with rapid clinical worsening. A combination of intra-arterial injections and intra-venous infusions of vasodilators, transluminal balloon angioplasty and bilateral 4-Compartment fasciotomies permitted rapid improvement and finally resulted in both lower limbs rescue. This case and literature review illustrate ergotism due to ergotamine overdose after taking HIV protease inhibitors. It also demonstrates the benefit of an interventional procedure besides medical therapy with vasodilators in severe arterial vasospasm. All along the lower limb arterial tree, transluminal balloon angioplasty restored the blood flow, without vasospasm recurrence. CONCLUSION: In case of ergotism with acute lower limbs ischemia, combining medical vasodilator therapy with interventional procedure can restore the arterial blood flow, thus allowing to save lower limbs.
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Affiliation(s)
- N Mohamedi
- Vascular medicine, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - T Mirault
- Vascular medicine, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - A Durivage
- Vascular medicine, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - M Di Primio
- Interventional radiology department, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - L Khider
- Vascular medicine, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - G Detriche
- Vascular medicine, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - S El Batti
- Vascular surgery department, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - M Sapoval
- Interventional radiology department, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - E Messas
- Vascular medicine, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - G Goudot
- Vascular medicine, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France.
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16
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Diehl JL, Peron N, Chocron R, Debuc B, Guerot E, Hauw-Berlemont C, Hermann B, Augy JL, Younan R, Novara A, Langlais J, Khider L, Gendron N, Goudot G, Fagon JF, Mirault T, Smadja DM. Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study. Ann Intensive Care 2020; 10:95. [PMID: 32676824 PMCID: PMC7364286 DOI: 10.1186/s13613-020-00716-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022] Open
Abstract
Rationale COVID-19 ARDS could differ from typical forms of the syndrome. Objective Pulmonary microvascular injury and thrombosis are increasingly reported as constitutive features of COVID-19 respiratory failure. Our aim was to study pulmonary mechanics and gas exchanges in COVID-2019 ARDS patients studied early after initiating protective invasive mechanical ventilation, seeking after corresponding pathophysiological and biological characteristics. Methods Between March 22 and March 30, 2020 respiratory mechanics, gas exchanges, circulating endothelial cells (CEC) as markers of endothelial damage, and D-dimers were studied in 22 moderate-to-severe COVID-19 ARDS patients, 1 [1–4] day after intubation (median [IQR]). Measurements and main results Thirteen moderate and 9 severe COVID-19 ARDS patients were studied after initiation of high PEEP protective mechanical ventilation. We observed moderately decreased respiratory system compliance: 39.5 [33.1–44.7] mL/cmH2O and end-expiratory lung volume: 2100 [1721–2434] mL. Gas exchanges were characterized by hypercapnia 55 [44–62] mmHg, high physiological dead-space (VD/VT): 75 [69–85.5] % and ventilatory ratio (VR): 2.9 [2.2–3.4]. VD/VT and VR were significantly correlated: r2 = 0.24, p = 0.014. No pulmonary embolism was suspected at the time of measurements. CECs and D-dimers were elevated as compared to normal values: 24 [12–46] cells per mL and 1483 [999–2217] ng/mL, respectively. Conclusions We observed early in the course of COVID-19 ARDS high VD/VT in association with biological markers of endothelial damage and thrombosis. High VD/VT can be explained by high PEEP settings and added instrumental dead space, with a possible associated role of COVID-19-triggered pulmonary microvascular endothelial damage and microthrombotic process.
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Affiliation(s)
- J-L Diehl
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, 75006, Paris, France. .,Intensive Care Unit and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, 20 Rue Leblanc, 75015, Paris, France.
| | - N Peron
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - R Chocron
- Université de Paris, PARCC, INSERM, 75015, Paris, France.,Emergency Department, AP-HP, Georges Pompidou European Hospital, 75015, Paris, France
| | - B Debuc
- Plastic Surgery Department, AP-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - E Guerot
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - C Hauw-Berlemont
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - B Hermann
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - J L Augy
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - R Younan
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - A Novara
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - J Langlais
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - L Khider
- Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - N Gendron
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, 75006, Paris, France.,Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, 75015, Paris, France
| | - G Goudot
- Emergency Department, AP-HP, Georges Pompidou European Hospital, 75015, Paris, France
| | - J-F Fagon
- Intensive Care Unit, AH-HP, Georges Pompidou European Hospital, Université de Paris, 75015, Paris, France
| | - T Mirault
- Université de Paris, PARCC, INSERM, 75015, Paris, France.,Vascular Medicine Department, AP-HP, Georges Pompidou European Hospital, 75015, Paris, France
| | - D M Smadja
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, 75006, Paris, France.,Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, 75015, Paris, France
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17
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Vautier M, Dupont A, De Boysson H, Comarmond C, Mirault T, Mekinian A, Lambert M, Ferfar Y, Aouba A, Cacoub P, Resche-Rigon M, Saadoun D. SAT0244 PROGNOSIS OF LARGE VESSEL INVOLVEMENT IN LARGE VESSEL VASCULITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5252] [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: 11/03/2022]
Abstract
Background:Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are the two main forms of large vessels vasculitis (LVV). Vessel inflammation leads to aneurysms, wall thickening, stenosis, and, in some cases, complete occlusion of the artery. Due to the wide variation in the course of LVV, predicting outcome is challenging. To our knowledge, data regarding prognosis factors of LVI in LVV patients and comparison of outcome of LVI in GCA and TAK are lacking. An early identification of patients with higher mortality could help to prevent deaths and vascular complications.Objectives:To assess prognosis factors and outcome of large vessel involvement (LVI) in large vessels vasculitis (LVV) patients.Methods:Retrospective multicenter study of characteristics and outcomes of 417 patients with LVI including 299 Takayasu arteritis (TAK) and 118 Giant cell arteritis (GCA-LVI) were analyzed. Logistic regression analysis assessed prognosis factors in LVV patients. Outcome of LVI among TAK and GCA-LVI patients (ischemic complications, aneurysms complications, relapses and revascularization) were assessed.Results:In multivariable analysis, stroke/transient ischemic attack [HR: 3.63 (1.46 - 9.04), p=0.006] was independently associated with vascular complications in LVV. The 10-years aneurysm free survival was significantly lower [67% (48 – 93) vs 89% (84 – 95), p=0.02] in GCA-LVI compare to TAK patients. The 5-years relapse free survival was significantly lower [47% (37 – 60) vs 69% (63 – 75), p<0.001,] in GCA-LVI compare to TAK patients. The 10-years revascularization free survival was significantly lower [55% (48 – 64) vs 76% (59 – 99), p<0.001] in TAK compare to GCA-LVI patients. After a median follow-up of 5 years, 16 (5.4%) TAK and 7 (5.9%) GCA-LVI patients died, mainly of aneurysm (26%) and ischemic complications (26%).Conclusion:This large nationwide cohort of LVI provided prognosis factors of vascular complications in LVV patients. TAK and GCA-LVI have different long-term outcome in term of aneurysm development, relapse and revascularization.Disclosure of Interests:None declared
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Khider L, Soudet S, Laneelle D, Boge G, Bura-Rivière A, Constans J, Dadon M, Desmurs-Clavel H, Diard A, Elias A, Emmerich J, Galanaud JP, Giordana P, Gracia S, Hamade A, Jurus C, Le Hello C, Long A, Michon-Pasturel U, Mirault T, Miserey G, Perez-Martin A, Pernod G, Quere I, Sprynger M, Stephan D, Wahl D, Zuily S, Mahe G, Sevestre MA. Proposal of the French Society of Vascular Medicine for the prevention, diagnosis and treatment of venous thromboembolic disease in outpatients with COVID-19. J Med Vasc 2020; 45:210-213. [PMID: 32571561 PMCID: PMC7183940 DOI: 10.1016/j.jdmv.2020.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 01/08/2023]
Affiliation(s)
- L Khider
- Vascular Medicine department, Georges-Pompidou European Hospital, Paris University, AP-HP, 75015 Paris, France
| | - S Soudet
- Vascular Medicine department, University Hospital Amiens Picardie, 80000 Amiens, France
| | - D Laneelle
- Vascular Medicine department, University Hospital of Caen-Normandie, 14000 Caen, France
| | - G Boge
- Vascular Medicine unit, Department of Internal Medicine, Montpellier University Hospital, 34000 Montpellier cedex 5, France
| | - A Bura-Rivière
- Vascular Medicine department, CHU of Rangueil, 31059 Toulouse cedex 9, France
| | - J Constans
- Vascular Medicine department, Saint-André Hospital, 33075 Bordeaux cedex, France
| | - M Dadon
- Vascular Medicine department, Paris Saint-Joseph Hospital Group, 75014 Paris, France
| | - H Desmurs-Clavel
- Internal Medicine department, Hospital Edouard-Herriot, 69003 Lyon, France
| | - A Diard
- Vascular Medicine office, 33550 Langoiran, France
| | - A Elias
- Vascular Medicine department, Sainte-Musse Hospital Center, 83100 Toulon, France
| | - J Emmerich
- Vascular Medicine department, Paris Saint-Joseph Hospital Group, 75014 Paris, France; Paris Descartes University, Paris, France
| | - J-P Galanaud
- Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, M4N 3M5 Toronto, ON, Canada
| | - P Giordana
- Vascular Medicine office, 06000 Nice, France
| | - S Gracia
- Vascular Medicine office, 17138 Puilboreau, France
| | - A Hamade
- Vascular Medicine unit, Emile-Muller Hospital, 68070 Mulhouse cedex 01, France
| | - C Jurus
- Vascular Medicine department, Tonkin Clinic, 69100 Villeurbanne, France
| | - C Le Hello
- Vascular Medicine department, University Hospital of Saint-Étienne, 42000 Saint-Étienne, France
| | - A Long
- Vascular Medicine department, Edouard-Herriot Hospital, 69003 Lyon, France
| | - U Michon-Pasturel
- Vascular Medicine department, Paris Saint-Joseph Hospital Group, 75014 Paris, France; Paris Descartes University, Paris, France
| | - T Mirault
- Vascular Medicine department, Georges-Pompidou European Hospital, Paris University, AP-HP, 75015 Paris, France
| | - G Miserey
- Vascular Medicine office, 78120 Rambouillet, France
| | - A Perez-Martin
- Vascular Medicine department, University hospital of Nîmes, 30000 Nîmes, France
| | - G Pernod
- Vascular Medicine department, Grenoble-Alpes University Hospital, 38000 Grenoble, France
| | - I Quere
- Vascular Medicine unit, Department of Internal Medicine, Montpellier University Hospital, 34000 Montpellier cedex 5, France
| | - M Sprynger
- Department of Cardiology, University Hospital of Liège, 4000 Liège, Belgium
| | - D Stephan
- Hypertension and Vascular Medicine department, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - D Wahl
- Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy, 54000 Nancy, France
| | - S Zuily
- Vascular Medicine departement, University hospital of Rennes, 35000 Rennes, France
| | - G Mahe
- Vascular Medicine departement, University hospital of Rennes, 35000 Rennes, France
| | - M A Sevestre
- Vascular Medicine department, University Hospital Amiens Picardie, 80000 Amiens, France.
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Vautier M, Dupont A, De Boysson H, Comarmond C, Mirault T, Mekinian A, Lambert M, Ferfar Y, Aouba A, Cacoub P, Resche-Rigon M, Saadoun D. Vascularite des gros vaisseaux : facteurs pronostics et comparaison de l’évolution à long terme de l’artérite gigantocellulaire et de la maladie de Takayasu. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.110] [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: 10/25/2022]
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20
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Goudot G, Khider L, Pedreira O, Poree JM, Julia P, Alsac JM, Mirault T, Pernot M, Messas E. 3041Wall shear stress measurement by ultrafast vector flow imaging for atherosclerotic carotid stenosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/13/2022] Open
Abstract
Abstract
Background
Carotid plaque vulnerability assessment is an important factor in guiding the decision to treat significant carotid stenosis. Ultrafast Ultrasound Imaging (UF) offers the possibility of evaluating local flow velocities over an entire 2D image, allowing access to velocity measurements in contact with the arterial wall and to measure the wall shear stress (WSS).
Purpose
To evaluate the feasibility of WSS measurement in a prospective series of patients with carotid stenosis.
Methods
A 7.5 MHz linear probe of an Aixplorer scanner was used. UF acquisitions had 3 tilted plane waves transmits (−10; 0; 10°) and an effective frame rate of 5000Hz. We evaluated the flow velocity in 5 areas of the carotid wall: common carotid artery (1), plaque ascent (2), plaque peak (3), plaque descent (4), internal carotid artery (5) (Figure). WSS was computed with the vector field speed using the following formula, WSS=μ·δn·v with v the blood velocity, n the normal vector to the vessel wall and μ, the blood viscosity, calculated from the hematocrit value for each patient. WSS measurement method was first validated using a laminar flow phantom and known viscosity. And then, 33 patients were then prospectively evaluated, with a median carotid stenosis degree of 80% [75–85].
Results
Significant correlation was found between in vitro measurement and the theoretical WSS values (R2=0.95; p<0.001).In patients,the maximum WSS value over the cardiac cycle follows the shape of the plaque with an increase during the ascend, reaching its maximum value of 3.57 Pa [2.47–4.45] at the peak of the plaque, and a fall after passing the peak (0.99 Pa [0.8–1.32]) lower than the WSS values in the non-stenotic areas (1.55 Pa [1.13–1.90] for the common carotid artery) (Table).
Table 1 Wall's area Wall shear stress (Pa) Min Max Delta 1. Common carotid artery 0.14 [0.05–0.27] 1.55 [1.13–1.90] 0.73 [0.55–0.96] 2. Plaque's ascent 0.39 [0.24–0.59] 2.63 [1.89–3.28] 1.20 [0.89–1.79] 3. Plaque's peak 0.60 [0.32–0.89] 3.57 [2.47–4.45] 1.78 [1.44–2.46] 4. Plaque's descent 0.16 [0.13–0.22] 0.99 [0.80–1.32] 0.52 [0.34–0.73] 5. Internal carotid artery 0.17 [0.13–0.35] 1.37 [1.04–1.75] 0.72 [0.50–0.87] Results are median [25th–75th percentile].
Figure 1
Conclusion
UF provide reliable WSS values. High WSS was present at the peak of the plaque, whereas lowest WSS values were found at the post-stenotic zone. WSS evaluation may help to better characterize the carotid plaque vulnerability.
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Affiliation(s)
- G Goudot
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - L Khider
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - O Pedreira
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - J M Poree
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - P Julia
- European Hospital Georges Pompidou, APHP, Paris Descartes University - USPC, INSERM U970 PARCC, Paris, France
| | - J M Alsac
- European Hospital Georges Pompidou, APHP, Paris Descartes University - USPC, INSERM U970 PARCC, Paris, France
| | - T Mirault
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - M Pernot
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - E Messas
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
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21
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Khider L, Goudot G, Del Giudice C, Mirault T, Bruneval P, Galloula A, Amemiya K, Vion M, Remond M, Tanter M, Pernot M, Messas E. P2765Efficacy of venous recanalization by noninvasive pulsed cavitational ultrasound therapy on swine model of acute deep venous thrombosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1082] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Post thrombotic syndrome is a frequent complication of deep venous thrombosis and is associated with high morbidity and hospitalization. Treatments currently available are invasive, involve use of endovenous procedures with stents and balloons, and frequently require general anesthesia. Pulsed cavitational ultrasound therapy (PCUT) emerged recently as a new technique to destroy remotely soft tissue. We recently demonstrated that PCUT was able to recanalize non-invasively in in vitro model of acute venous thrombosis (human blood clot).
Purpose
We aim to test the safety and efficacy of venous recanalization by noninvasive PCUT in vivo swine model of acute venous thrombosis.
Methods
All the experiments were performed on White large X Landrace swine. We induced an acute femoral deep venous thrombosis by using occlusive balloons introduced from jugular and popliteal vein combined with local injection of 50 IU of human thrombin. A 3 cm length occlusive thrombosis was obtained after 2 hours. Swines were divided in three groups: one with PCUT without follow-up (n=11), one with PCUT and follow-up at 14 days (n=8), and a control group also followed for 14 days (n=5). Acutely and during the follow up all swines received curative anticoagulation. To achieve PCUT, a 2.25 MHz transducer centered by a linear probe was used and cavitation was obtained in the center of the vein (Figure). After manual determination of thrombus location, a robotic arm was used to automatically move the transducer along the thrombus. Effectiveness of recanalization was evaluated by echo-Doppler and phlebography. Safety was assessed by Doppler ultrasound of the insonified area (artery, veins and surrounding tissue) and by histological analysis (local femoral vein and artery and lungs for pulmonary embolism).
Results
Among the 24 swines, we obtained 22 occlusive venous thromboses and 2 partial. The median length of the thrombus was 26±4.4 mm with vein diameter of 8.5±1.6 mm. Acutely, thrombosis recanalization was systematically obtained among the 19 swine with PCUT with median treatment duration of 33 minutes with residual diameter of 2.9±0.9 mm. No extravasation of contrast material or hematoma was observed after the therapy. After a 14-day follow-up, 75% of recanalisation remain permeable vs. 0% of vein permeable in the no therapy group (p=0.008). Residual diameter was 2.6±1.2 mm, which correspond to 50% of the venous diameter. No vein or artery damage and no embolism or pulmonary infarction was observed in all pigs.
Figure 1
Conclusion
We have demonstrated in vivo the safety and the efficacy of PCUT for non-invasive venous recanalization, persistent after 2 weeks.
Acknowledgement/Funding
French society of cardiology
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Affiliation(s)
- L Khider
- European Hospital Georges Pompidou, Paris, France
| | - G Goudot
- European Hospital Georges Pompidou, Paris, France
| | | | - T Mirault
- European Hospital Georges Pompidou, Paris, France
| | - P Bruneval
- European Hospital Georges Pompidou, Paris, France
| | - A Galloula
- European Hospital Georges Pompidou, Paris, France
| | - K Amemiya
- European Hospital Georges Pompidou, Paris, France
| | - M Vion
- Cardiawave, Paris, France
| | | | - M Tanter
- Waves and Acoustics Laboratory Institute Langevin, Paris, France
| | - M Pernot
- Waves and Acoustics Laboratory Institute Langevin, Paris, France
| | - E Messas
- European Hospital Georges Pompidou, Paris, France
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Detriche G, Zhang Y, Esposito B, Rea D, Messas E, Mirault T, Ait Oufella H. P3110Tyrosine kinase inhibitor nilotinib increases atherosclerosis burden in ApoE knock-out mice. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0185] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In 2001, imatinib, the 1st generation tyrosine kinase inhibitor (TKI), dramatically improved the treatment and survival of the patients with chronic myeloid leukemia (CML). However, the emergence of imatinib-resistant patients led to the development of 2nd generation TKIs. Nilotinib demonstrated increased efficacy to control CML disease over imatinib and is now recommended as first-line therapy. But arterial occlusive adverse events (AOE) occurs in patients treated with nilotinib and not with imatinib. Mechanisms leading to AOE with nilotinib is not well understood. AOE are dominated by ischemic heart disease and lower extremity arterial disease. Moreover, we demonstrated that CML patients with cardiovascular risk factors are at high risk to rapidly develop AOE with nilotinib.
Purpose
To evaluate the impact of nilotinib in a pre-clinical model of atherosclerosis.
Methods
ApoE Knock-Out mice (8-week-old) were treated with either placebo (N=10), imatinib (IMA) 200mg/kg/day (N=10) or nilotinib (NILO) 100mg/kg/day (N=10) by daily feeding and a high-fat diet for 12 weeks. Heart and aorta were harvested after sacrifice, for histology staining and immunochemistry. Splenocytes were cultured from collected spleens, and Interleukin (IL) 12p70 and IL10 measured by ELISA.
Results
Mice treated with nilotinib showed an increase of atherosclerotic plaque size at the aortic sinus level: 462.1x103 μm2 vs. 344.4x103 μm2 with imatinib or 394.9x103 μm2 with placebo (p<0.05) and at the thoracoabdominal aorta level (p<0.05). Plaques had greater infiltration of macrophages: 33.0±3.4% with nilotinib vs. 7.3±1.3% with imatinib and 12.6±1.1% with placebo (p<0.001) and a larger necrotic nucleus 33.0±3.4% with nilotinib vs. 7.3±1.3% with imatinib or 12.6±1.1% with placebo (p<0.001). Nilotinib modulated the systemic immune response by increasing IL-12p70 and by decreasing IL-10 production by splenocytes after stimulation by LPS-IFNγ whereas IL10 increase was observed with imatinib.
Plaque size (aortic sinus)
Conclusion
Nilotinib has a pro-atherogenic effect in a pre-clinical model of atherosclerosis and increases the monocyte/macrophage pro-inflammatory response. Further experiments are required to identify pathways activated by nilotinib.
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Affiliation(s)
- G Detriche
- European Hospital Georges Pompidou, Vascular medicine department, Paris Descartes university, Sorbone Paris Cité, APHP, Paris, France
| | - Y Zhang
- Paris Cardiovascular Research Center (PARCC), INSERM UMR-S970, Paris, France
| | - B Esposito
- Paris Cardiovascular Research Center (PARCC), INSERM UMR-S970, Paris, France
| | - D Rea
- Hopital Saint-Louis, Hematology department, Paris, France
| | - E Messas
- European Hospital Georges Pompidou, Vascular medicine department, Paris Descartes university, Sorbone Paris Cité, APHP, Paris, France
| | - T Mirault
- European Hospital Georges Pompidou, Vascular medicine department, Paris Descartes university, Sorbone Paris Cité, APHP, Paris, France
| | - H Ait Oufella
- Paris Cardiovascular Research Center (PARCC), INSERM UMR-S970, Paris, France
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Goudot G, Mirault T, Cheng C, Gruest M, Amoah J, Pedreira O, Khider L, Pernot M, Messas E. P1823Aortic walls elastic properties assessment with ultrafast ultrasound imaging in case of bicuspid aortic valve. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0575] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Magnetic resonance imaging allows evaluation of aortic stiffness by the maximum rate of systolic distension (MRSD) a new prognosis factor of aortic dilatation in patients with bicuspid aortic valve (BAV). MRSD requires a continuous monitoring of the aortic diameter during the cardiac cycle, not accessible to conventional echocardiography contrary to ultrafast ultrasound imaging (UF).
Purpose
To develop specific aortic sequences in ultrafast ultrasound imaging (UF) to provide access to the aortic MRSD
Methods
Tissue Doppler allowed a precise estimation of the movement of each wall and the fine variation of the aortic diameter. To automatically track the anterior and posterior aortic walls during the cardiac cycle, we developed in the laboratory a specific interface (Figure). MRSD was the maximum of the derivative of the diameter chande over time. To assess this new technique, 24 patients (10 BAV patients and 14 controls, mean age 45.8 vs. 40.7 years, p=0.464, respectively) were consecutively included at a reference center for BAV. The ascending aorta was evaluated at the sinus of Valsalva, the tubular aorta and the aortic arch with a phased array probe (Supersonic Imagine) and dedicated sequences at 2000 frames/s.
Results
The lab-made interface allowed to track the aortic diameter and to calculate the MRSD from the UF acquisitions for each patient. We found lower MRSD at the sinus of Valsalva in case of BAV in accordance with previously demonstrated higher stiffness at this segment by our team (Table).
Table 1. UF Aortic parameters for BAV patients and controls BAV patients Controls p (Mann Whitney) Sinus of Valsalva Diameter (mm) 26.2 [22.4–32.5] 27.09 [23.5–29.5] 0.796 MRSD (s–1) 1.05 [0.73–1.19] 1.51 [1.28–1.99] 0.023 Tubular ascending aorta Diameter 31.4 [29.4–32.2] 28.9 [22.6–31.5] 0.328 MRSD 0.94 [0.59–1.27] 1.09 [0.87–1.41] 0.353 Aortic arch Diameter 24.2 [23.7–24.8] 24.2 [18.9–24.5] 0.673 MRSD 0.57 [0.35–1.07] 0.85 [0.76–1.02] 0.257 Results are median [25th–75th percentile].
Figure 1
Conclusion
UF allows evaluation of aortic stiffness by MRSD using dedicated sequence and interface. As echocardiography, UF is easily accessible and therefore deserves attention from cardiologists taking care of BAV patients to evaluate the segmental aortic remodeling associated with BAV.
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Affiliation(s)
- G Goudot
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - T Mirault
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - C Cheng
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - M Gruest
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - J Amoah
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - O Pedreira
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - L Khider
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - M Pernot
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - E Messas
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
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Goudot G, Pedreira O, Khider L, Mirault T, Alsac J, Julia P, Pernot M, Messas E. Clinical evaluation of wall shear stress by ultrafast vector flow imaging in carotid atherosclerotic stenosis. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.04.054] [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: 10/26/2022]
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25
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Goudot G, Khider L, Del Giudice C, Mirault T, Vion M, Galloula A, Bruneval P, Pernot M, Messas E. Robotic assisted thrombotripsy allows high accurate venous recanalization in a porcine model of femoral venous thrombosis. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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26
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Zarka S, Mirault T, Frank M, Cheng C, Besnainou R, Abouth S, Rossi A, Goudot G, Jeunemaitre X, Messas E, Messas E. Mitral valve phenotype in vascular Ehlers Danlos syndrome. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.144] [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: 10/27/2022]
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Goudot G, Mirault T, Zarka S, Rossi A, Albuisson J, Mazella JM, Pernot M, Messas E. P731Carotid elastic properties impairment in case of Bicuspid aortic valve: myth or reality? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p731] [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: 11/12/2022] Open
Affiliation(s)
- G Goudot
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - T Mirault
- European Hospital Georges Pompidou, APHP, Paris Descartes University - USPC, INSERM U970 PARCC, Paris, France
| | - S Zarka
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - A Rossi
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - J Albuisson
- European Hospital Georges Pompidou, APHP, Paris Descartes University - USPC, INSERM U970 PARCC, Paris, France
| | - J M Mazella
- European Hospital Georges Pompidou, Vascular medicine, Paris, France
| | - M Pernot
- Institut Langevin, INSERM U979, ESPCI Paris, PSL University, Paris, France
| | - E Messas
- European Hospital Georges Pompidou, APHP, Paris Descartes University - USPC, INSERM U970 PARCC, Paris, France
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Albuisson J, Gabay I, Goudot G, Mazzella JM, Loeys B, Rossi A, Mirault T, Durst R, Gilon D, Messas E. P2599The Notch pathway regulatory protein MIB1 is a novel gene for nonsyndromic bicuspid aortic valve. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2599] [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: 11/14/2022] Open
Affiliation(s)
- J Albuisson
- European Hospital Georges Pompidou, Department of Genetics, Centre de Référence des Maladies Vasculaires Rares, Paris, France
| | - I Gabay
- Hadassah-Hebrew University, Cardiology Division, Jerusalem, Israel
| | - G Goudot
- European Hospital Georges Pompidou, Vascular Medicine, Paris, France
| | - J M Mazzella
- European Hospital Georges Pompidou, Department of Genetics, Centre de Référence des Maladies Vasculaires Rares, Paris, France
| | - B Loeys
- University of Antwerp, Center of Medical Genetics, Faculty of Medicine and Health Sciences, Antwerp, Belgium
| | - A Rossi
- European Hospital Georges Pompidou, APHP, Paris Descartes University - USPC, INSERM U970 PARCC, Paris, France
| | - T Mirault
- European Hospital Georges Pompidou, Vascular Medicine, Paris, France
| | - R Durst
- Hadassah-Hebrew University, Cardiology Division, Jerusalem, Israel
| | - D Gilon
- Hadassah-Hebrew University, Cardiology Division, Jerusalem, Israel
| | - E Messas
- European Hospital Georges Pompidou, Vascular Medicine, Paris, France
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Delahaye M, Goudot G, Galloula A, Zarka S, Guillet M, Jeunemaitre X, Sapoval M, Messas E, Mirault T. P747Characteristics of upper limb arterial involvement in thromboangeiitis obliterans patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p747] [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: 11/13/2022] Open
Affiliation(s)
- M Delahaye
- AP-HP - European Hospital Georges Pompidou, Vascular Medicine Service, Paris Descartes University, Paris, France
| | - G Goudot
- AP-HP - European Hospital Georges Pompidou, Vascular Medicine Service, Paris Descartes University, Paris, France
| | - A Galloula
- AP-HP - European Hospital Georges Pompidou, Vascular Medicine Service, Paris Descartes University, Paris, France
| | - S Zarka
- AP-HP - European Hospital Georges Pompidou, Vascular Medicine Service, Paris Descartes University, Paris, France
| | - M Guillet
- AP-HP - European Hospital Georges Pompidou, Vascular Medicine Service, Paris Descartes University, Paris, France
| | - X Jeunemaitre
- AP-HP - European Hospital Georges Pompidou, Cardiovascular Genetic Unit, Paris Descartes University, Paris, France
| | - M Sapoval
- European Hospital Georges Pompidou, Interventional Radiology, Paris, France
| | - E Messas
- AP-HP - European Hospital Georges Pompidou, Vascular Medicine Service, Paris Descartes University, Paris, France
| | - T Mirault
- AP-HP - European Hospital Georges Pompidou, Vascular Medicine Service, Paris Descartes University, Paris, France
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Del Giudice C, Van Den Heuvel D, Wille J, Mirault T, Messas E, Ferraresi R, Kum S, Sapoval M. Correction to: Percutaneous Deep Venous Arterialization for Severe Critical Limb Ischemia in Patients With No Option of Revascularization: Early Experience From Two European Centers. Cardiovasc Intervent Radiol 2018; 41:1810. [PMID: 30062443 DOI: 10.1007/s00270-018-2047-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The fifth author's name was incorrectly published as "M. Messas". The correct name is "E. Messas". The original article has been corrected.
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Affiliation(s)
- C Del Giudice
- Vascular and Oncological Interventional Radiology, Hôpital Européen Georges-Pompidou, Université Paris Descartes Paris Cité Sorbonne, 20 Rue Leblanc, 75015, Paris, France.
| | - D Van Den Heuvel
- Department of Interventional Radiology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - J Wille
- Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, The Netherlands
| | - T Mirault
- Department of Vascular Medicine, Hôpital Européen Georges Pompidou, Université Paris Descartes Paris Cité Sorbonne, 20 Rue Leblanc, 75015, Paris, France
| | - E Messas
- Department of Vascular Medicine, Hôpital Européen Georges Pompidou, Université Paris Descartes Paris Cité Sorbonne, 20 Rue Leblanc, 75015, Paris, France
| | - R Ferraresi
- Peripheral Interventional Unit, Humanitas Gavazzeni, Bergamo, Italy
| | - S Kum
- Vascular Service, Department of Surgery, Changi General Hospital, Changi, Singapore
| | - M Sapoval
- Vascular and Oncological Interventional Radiology, Hôpital Européen Georges-Pompidou, Université Paris Descartes Paris Cité Sorbonne, 20 Rue Leblanc, 75015, Paris, France
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Papadacci C, Mirault T, Dizier B, Tanter M, Messas E, Pernot M. Non-invasive Evaluation of Aortic Stiffness Dependence with Aortic Blood Pressure and Internal Radius by Shear Wave Elastography and Ultrafast Imaging. Ing Rech Biomed 2018. [DOI: 10.1016/j.irbm.2017.12.001] [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: 11/28/2022]
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32
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Goudot G, Mirault T, Baudrie V, Ferreira I, Tanter M, Jeunemaitre X, Pernot M, Messas E. Evaluation of non-invasive arterial stiffening by aortic pulse wave velocity recording with ultrafast ultrasound imaging in a mouse model of vascular Ehlers-Danlos syndrome. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.193] [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: 11/29/2022]
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33
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Goudot G, Mirault T, Arnal B, Boisson-Vidal C, Le Bonniec B, Gaussem P, Galloula A, Tanter M, Messas E, Pernot M. Pulsed cavitational therapy using high-frequency ultrasound for the treatment of deep vein thrombosis in an in vitro model of human blood clot. ACTA ACUST UNITED AC 2017; 62:9282-9294. [DOI: 10.1088/1361-6560/aa9506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mirault T, Delahaye M, Suduca M, Mortelette H, Courtois M, Galloula A, Goudot G, Messas E. P5187Efficacy and potency of revascularisation in patients with thromboangiitis obliterans (Buerger disease). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Goudot G, Mirault T, Rossi A, Albuisson J, Zarka S, Achouh P, Jeunemaitre X, Pernot M, Messas E. P5167Influence of the Sievers type and aortic valvular dysfunction on the bicuspid aortic valve associated aortopathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5167] [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: 11/14/2022] Open
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36
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Goudot G, Mirault T, Baudrie V, Ferreira I, Tanter M, Jeunemaitre X, Pernot M, Messas E. 5951Insight in vascular fragility induced by collagen structural change using ultrafast ultrasound imaging in a col3a1 knock-in gly183arg mutation mouse model mimicking vascular Ehlers-Danlos syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5951] [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: 11/14/2022] Open
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37
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Mirault T, Delahaye M, Jannez S, Pessin S, Gourjault M, Mehraik I, Esnault V, Bourges D, Formela D, Bourgeois F, Pronesti L, Messas E. P2500Walking improvement for patients with intermittent claudication: success of a short 25 days supervised exercise program. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2500] [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: 11/13/2022] Open
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Goudot G, Del Giudice C, Pellerin O, Courtois MC, Galloula A, Messas E, Mirault T, Sapoval M. [Recanalization procedure of the common femoral vein following iatrogenic femoral chronic occlusion: 3 cases]. J Med Vasc 2017; 42:237-243. [PMID: 28705343 DOI: 10.1016/j.jdmv.2017.05.002] [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] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
Common femoral vein occlusion (CFVO) is frequently found in patients with chronic venous insufficiency. The iatrogenic form, secondary to either central catheter or surgery, is very rare but highly symptomatic. Classical compression therapy barely improves the clinical status of these patients, making them suitable candidates for an interventional procedure for venous recanalization. METHODS We report here three consecutive cases of iatrogenic CFVO referred to our outpatient clinic because the disease had an impact on daily life activities. We detail the recanalization procedure, the Doppler control and the short-term outcome. RESULTS In each case, endovascular recanalization required rigid material (rigid guide or Colapinto needle) to cross the fibrous adhesions before angioplasty could be performed with stenting. The procedure required two attempts in each case, underlining its complexity, but eventually enabled effective recanalization. No major complication occurred per- or post-procedure. One month later, a duplex Doppler control confirmed the permeability of the common femoral vein. The patients had experienced rapid and significant symptom improvement. CONCLUSION Patients suffering from severe chronic venous insufficiency caused by iatrogenic CFVO can benefit from endovascular recanalization. Although these procedures may be complex due to the extensive fibrosis at the Scarpa and require specialized equipment, no major complications were observed. Patency of the recanalization persisted at least one month after the procedure. Symptom relief was good.
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Affiliation(s)
- G Goudot
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France; Inserm U970, PARCC, université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France
| | - C Del Giudice
- Service de radiologie interventionnelle vasculaire et oncologique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - O Pellerin
- Service de radiologie interventionnelle vasculaire et oncologique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - M C Courtois
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - A Galloula
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - E Messas
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France; Inserm U970, PARCC, université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France
| | - T Mirault
- Service de médecine vasculaire, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France; Inserm U970, PARCC, université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France
| | - M Sapoval
- Service de radiologie interventionnelle vasculaire et oncologique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
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Senet P, Blas-Chatelain C, Levy P, Manea E, Peschanski M, Mirault T, Stankovic-Stojanovic K, Debure C, Debbache K, Girot R, Bureau JM, Bachmeyer C, Baldeschi C, Galacteros F, Lionnet F, Gellen-Dautremer J. Factors predictive of leg-ulcer healing in sickle cell disease: a multicentre, prospective cohort study. Br J Dermatol 2017; 177:206-211. [DOI: 10.1111/bjd.15241] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2016] [Indexed: 01/01/2023]
Affiliation(s)
- P. Senet
- Service de Dermatologie; Hôpital Tenon; Assistance Publique-Hôpitaux de Paris (APHP); 4 Rue de la Chine Paris CEDEX 20 75970 France
| | - C. Blas-Chatelain
- Service de Rééducation Vasculaire; Hôpital Corentin-Celton; APHP; 4 Parvis Corentin-Celton, BP 66 Issy-les-Moulineaux CEDEX 92133 France
| | - P. Levy
- Service de Santé Publique; Hôpital Tenon; APHP; Université Pierre et Marie Curie and Institut National de la Santé et de la Recherche Médicale; UMR-S 1136; Paris France
| | - E.M. Manea
- Unité des Maladies Génétiques du Globule Rouge; Service de Médecine Interne; Centre de Référence de la Drépanocytose; Hôpital Henri-Mondor; APHP and Université Paris-Est Créteil; Créteil France
| | - M. Peschanski
- Inserm/UEVE UMR 861, I-Stem, AFM; Génopôle Campus 1 Évry France
| | - T. Mirault
- Service de Rééducation Vasculaire; Hôpital Corentin-Celton; APHP; 4 Parvis Corentin-Celton, BP 66 Issy-les-Moulineaux CEDEX 92133 France
| | - K. Stankovic-Stojanovic
- Service de Médecine Interne; Centre de Référence de la Drépanocytose; Hôpital Tenon; APHP and Université Pierre et Marie Curie; Paris France
| | - C. Debure
- Service de Rééducation Vasculaire; Hôpital Corentin-Celton; APHP; 4 Parvis Corentin-Celton, BP 66 Issy-les-Moulineaux CEDEX 92133 France
| | - K. Debbache
- Unité des Maladies Génétiques du Globule Rouge; Service de Médecine Interne; Centre de Référence de la Drépanocytose; Hôpital Henri-Mondor; APHP and Université Paris-Est Créteil; Créteil France
| | - R. Girot
- Service de Médecine Interne; Centre de Référence de la Drépanocytose; Hôpital Tenon; APHP and Université Pierre et Marie Curie; Paris France
| | - J.-M. Bureau
- Service de Rééducation Vasculaire; Hôpital Corentin-Celton; APHP; 4 Parvis Corentin-Celton, BP 66 Issy-les-Moulineaux CEDEX 92133 France
| | - C. Bachmeyer
- Service de Médecine Interne; Centre de Référence de la Drépanocytose; Hôpital Tenon; APHP and Université Pierre et Marie Curie; Paris France
| | - C. Baldeschi
- Inserm/UEVE UMR 861, I-Stem, AFM; Génopôle Campus 1 Évry France
| | - F. Galacteros
- Unité des Maladies Génétiques du Globule Rouge; Service de Médecine Interne; Centre de Référence de la Drépanocytose; Hôpital Henri-Mondor; APHP and Université Paris-Est Créteil; Créteil France
| | - F. Lionnet
- Service de Médecine Interne; Centre de Référence de la Drépanocytose; Hôpital Tenon; APHP and Université Pierre et Marie Curie; Paris France
| | - J. Gellen-Dautremer
- Service de Médecine Interne et Maladies Infectieuses; Centre Hospitalier Universitaire Poitires; 86021 Poitiers France
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Gillard M, Maillard H, Senet P, Cuny JF, Sin C, Mahé E, Lok C, Anuset D, Bernard P, Goujon E, Journet-Tollhupp J, Mirault T, Develter T, Dabouz F, Modiano P. Comorbidités et pathologies associées au Pyoderma gangrenosum : une étude rétrospective multicentrique de 126 cas. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Takayasu arteritis is a chronic inflammatory vasculitis of unknown origin affecting large vessels, predominantly the aorta and its main branches. Vessel inflammation leads to wall thickening, fibrosis, and stenosis. The lesions are often asymptomatic leading to limb numbness, transient ischemic attack, cardiovascular event and renovascular hypertension. Treatment is based on corticosteroids, immunosuppressant and biologics if necessary. Endovascular treatment and open-surgery can be useful for end-organ ischemia relief.
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Affiliation(s)
- T Mirault
- Pôle cardiovasculaire rénal et métabolique, service de médecine vasculaire, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris Ouest, université Paris Descartes, AP-HP, 20, rue Leblanc, 75015 Paris, France; Centre national de référence des maladies vasculaires rares, hôpital européen Georges-Pompidou, 75015 Paris, France; Inserm U970 PARCC, université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France.
| | - E Messas
- Pôle cardiovasculaire rénal et métabolique, service de médecine vasculaire, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris Ouest, université Paris Descartes, AP-HP, 20, rue Leblanc, 75015 Paris, France; Centre national de référence des maladies vasculaires rares, hôpital européen Georges-Pompidou, 75015 Paris, France; Inserm U970 PARCC, université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France
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Senet P, Blas Chatelain C, Levy P, Manea E, Peschanski M, Mirault T, Stojanovic KS, Debure C, Galactéros F, Girot R, Bureau J, Bachmeyer C, Lavollée LO, Lionnet F, Dautremer JG. Pronostic de cicatrisation et de récidive des ulcères drépanocytaires : étude multicentrique prospective française. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.115] [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: 10/22/2022]
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Comarmond C, Mirault T, Mekinian A, Lambert M, Ferar Y, Kahn J, Benhamou Y, Marie I, Chiche L, Hachulla E, Cacoub P, Saadoun D. Manifestations neurologiques au cours de l’artérite de Takayasu. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.255] [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: 10/22/2022]
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Comarmond C, Mirault T, Biard L, Nizard J, Lambert M, Wechsler B, Hachulla E, Chiche L, Koskas F, Gaudric J, Cluzel P, Messas E, Resche-Rigon M, Piette JC, Cacoub P, Saadoun D. Takayasu Arteritis and Pregnancy. Arthritis Rheumatol 2015; 67:3262-9. [DOI: 10.1002/art.39335] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/13/2015] [Indexed: 01/26/2023]
Affiliation(s)
- C. Comarmond
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
| | - T. Mirault
- AP-HP, Hôpital Européen Georges-Pompidou, INSERM UMR970, PARCC, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux Universitaires Paris Ouest, and Université Paris Descartes, Paris 5, Sorbonne Paris Cité; Paris France
| | - L. Biard
- AP-HP, SBIM, Hôpital Saint-Louis and Université Paris Diderot, Paris 7, INSERM, CRESS UMR-S 1153; Paris France
| | - J. Nizard
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Sorbonne Universités, Université Pierre et Marie Curie, Paris 6, CNRS UMR 7222, INSERM U1150; Paris France
| | - M. Lambert
- Hôpital Claude Huriez, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre Hospitalier Régional Universitaire de Lille, and Université de Lille 2; Lille France
| | - B. Wechsler
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
| | - E. Hachulla
- Hôpital Claude Huriez, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre Hospitalier Régional Universitaire de Lille, and Université de Lille 2; Lille France
| | - L. Chiche
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6; Paris France
| | - F. Koskas
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6; Paris France
| | - J. Gaudric
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6; Paris France
| | - P. Cluzel
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6, INSERM-CNRS-LIB; Paris France
| | - E. Messas
- AP-HP, Hôpital Européen Georges-Pompidou, INSERM UMR970, PARCC, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux Universitaires Paris Ouest, and Université Paris Descartes, Paris 5, Sorbonne Paris Cité; Paris France
| | - M. Resche-Rigon
- AP-HP, SBIM, Hôpital Saint-Louis and Université Paris Diderot, Paris 7, INSERM, CRESS UMR-S 1153; Paris France
| | - J. C. Piette
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
| | - P. Cacoub
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
| | - D. Saadoun
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
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Courtois MC, Sapoval M, Del Giudice C, Ducloux R, Mirault T, Messas E. [Distal revascularization in diabetic patients with chronic limb ischemia]. ACTA ACUST UNITED AC 2015; 40:24-36. [PMID: 25596672 DOI: 10.1016/j.jmv.2014.12.007] [Citation(s) in RCA: 7] [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: 06/11/2014] [Accepted: 12/04/2014] [Indexed: 12/01/2022]
Abstract
Diabetes mellitus is an independent risk factor for peripheral artery disease. Life expectancy is 41 months for diabetic patients with an ischemic ulcer. The characteristics of diabetic arteriopathy make its treatment more difficult than in non-diabetic patients. Few data are available about the surgical treatment of arteriopathy in diabetic patients (including angioplasty or bypass), especially in case of distal arteriopathy. The choice of the procedure depends on multiple factors such as the disease localization, its extent, distal blood flow and vascular disease-related surgical risk. The principal aim of revascularisation is to restore direct flow to the foot in order to ensure wound healing and limb salvage. With percutaneous endoluminal angioplasty, limb salvage can be achieved in more than 80% of patients at 1-3 years. The percutaneous procedure is less invasive than open surgery, there are fewer complications, and morbidity and mortality rates are reduced; moreover, a second procedure remains possible in the future. With bypass surgery, the rate of limb salvage exceeds 80% at five years. Nevertheless, peri-operative mortality reaches 3% and arterial anatomy, patient-related risks factors or venous graft availability may be limitations. New endovascular techniques especially designed for the distal arteries of the lower limbs enable very distal revascularization with morbidity and mortality rates lower than with surgery.
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Affiliation(s)
- M-C Courtois
- Unité de médecine vasculaire, service de médecine vasculaire, université Paris-Descartes, hôpital européen George-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - M Sapoval
- Service de radiologie interventionnelle vasculaire et oncologique, université Paris-Descartes, hôpital européen George-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - C Del Giudice
- Service de radiologie interventionnelle vasculaire et oncologique, université Paris-Descartes, hôpital européen George-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - R Ducloux
- Service de diabétologie, université Paris-Descartes, hôpital européen George-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - T Mirault
- Service de réadaptation vasculaire, université Paris-Descartes, hôpital Corentin-Celton, 4, parvis Corentin-Celton, 92130 Issy-les-Moulineaux, France
| | - E Messas
- Unité de médecine vasculaire, service de médecine vasculaire, université Paris-Descartes, hôpital européen George-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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Rea D, Mirault T, Raffoux E, Boissel N, Andreoli AL, Rousselot P, Dombret H, Messas E. Usefulness of the 2012 European CVD risk assessment model to identify patients at high risk of cardiovascular events during nilotinib therapy in chronic myeloid leukemia. Leukemia 2014; 29:1206-9. [DOI: 10.1038/leu.2014.342] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Comarmond C, Mirault T, Lambert M, Kahn J, Mekinian A, Marie I, Karras A, Fain O, Messas E, Cacoub P, Saadoun D. Accidents vasculaires cérébraux dans une cohorte française de 231 patients ayant une artérite de Takayasu. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.116] [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: 10/24/2022]
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Comarmond C, Mirault T, Lambert M, Kahn J, Mekinian A, Marie I, Karras A, Fain O, Messas E, Cacoub P, Saadoun D. Facteurs de risque associés aux complications ischémiques majeures dans l’artérite de Takayasu : cohorte française multicentrique de 231 patients. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.069] [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: 10/24/2022]
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Mekinian A, Mirault T, Lambert M, Sibilia J, Hie M, Comarmond C, Messas E, Berthier S, Neel A, Hamidou M, Cohen P, Marie I, Lavigne C, Amoura Z, Guillevin L, Godeau B, Fain O, Cacoub P, Saadoun D. AB0568 Biologics in Takayasu Arteritis: Preliminary Data from the French Registry. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Comarmond C, Mirault T, Cluzel P, Koskas F, Chiche L, Gaudric J, Messas E, Cacoub P, Saadoun D. FRI0459 Characteristics and Long-Term Outcome of 122 Patients with Takayasu Arteritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5926] [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: 11/04/2022]
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