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Image-guided minimally invasive treatment of cT1b renal cell carcinoma: A comparative matched-pair analysis of percutaneous tumor ablation and 3D image-guided robotic-assisted partial nephrectomy (UroCCR 80). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01062-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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2
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L’élastographie par résonance magnétique dans l’évaluation de la fibrose interstitielle en transplantation rénale : résultats d’une étude prospective. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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3
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Embolization in pelvic venous disorders using ethylene vinyl alcohol copolymer (Onyx®) and Aetoxysclerol: a prospective evaluation of safety and long-term efficacy. Eur Radiol 2022; 32:4679-4686. [PMID: 35137302 DOI: 10.1007/s00330-022-08567-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To prospectively evaluate the safety and efficacy of embolization using ethylene vinyl alcohol copolymer (Onyx®) and Aetoxysclerol for treatment of pelvic venous disorders (PeVD). METHODS This prospective study was approved by the institutional ethics review board. Ten clinical parameters were retained for evaluation of PeVD (pelvic pain, dyspareunia, post-coital pain, menstruation pain, lower limbs pain, difficulty walking, aesthetic discomfort, impact on daily working life, psychological impact and impact on daily life), measured on a visual analogue scale (VAS) between 0 and 10, and a global score out of 100 was noted before embolization, after 3 months during the imaging follow-up, and at the end of follow-up by phone call. The main criterion was clinical efficacy of embolization defined by an impairment score < 40/100 and a 50% decrease in overall score. Complications were recorded. Visualization of Onyx® on MRI 3 months after embolization was noted. RESULTS Between July 2017 and May 2019, 73 consecutive women (mean age ± SD [range]: 41 ± 11 years [25-77]) treated by embolization with Onyx® and Aetoxysclerol were included. The median follow-up was 28 months [Q1-Q3: 24.0-29.2] (range: 18.1-34.5). The median initial VAS impairment score was 39/100 [29.75-48.50] (12-58). Clinical efficacy was obtained for 70 patients (70/73, 95.9%), and the median VAS impairment score at the end of follow-up was significantly lower at 3 [0.00-7.25] (0-73) (p < 0.0001). Four minor complications occurred. Onyx® was visualized on DIXON sequence of MRI for all patients. CONCLUSION Embolization using Onyx® and Aetoxysclerol for PeVD is safe and effective. KEY POINTS • Embolization using Onyx® and Aetoxysclerol for pelvic venous disorders is safe and effective. • Imaging follow-up is facilitated by visualization of Onyx® on MRI DIXON sequences.
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4
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Faisabilité des néphrectomies partielles robot-assistées de rattrapage après échec de traitement ablatif (Étude UROCCR–62). Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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5
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[Comprehensive review of 3D printing use in medicine: Comparison with practical applications in urology]. Prog Urol 2021; 31:762-771. [PMID: 34154961 DOI: 10.1016/j.purol.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/17/2021] [Accepted: 04/02/2021] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Over the past few years, 3D printing has evolved rapidly. This has resulted in an increasing number of scientific publications reporting on the medical use of 3D printing. These applications can range from patient information, preoperative planning, education, or 3D printing of patient-specific surgical implants. The objective of this review was to give an overview of the different applications in urology and other disciplines based on a selection of publications. METHODS In the current narrative review the Medline database was searched to identify all the related reports discussing the use of 3D printing in the medical field and more specifically in Urology. 3D printing applications were categorized so they could be searched more thoroughly within the Medline database. RESULTS Three-dimensional printing can help improve pre-operative patient information, anatomy and medical trainee education. The 3D printed models may assist the surgeon in preoperative planning or become patient-specific surgical simulation models. In urology, kidney cancer surgery is the most concerned by 3D printing-related publications, for preoperative planning, but also for surgical simulation and surgical training. CONCLUSION 3D printing has already proven useful in many medical applications, including urology, for patient information, education, pre-operative planning and surgical simulation. All areas of urology are involved and represented in the literature. Larger randomized controlled studies will certainly allow 3D printing to benefit patients in routine clinical practice.
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6
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Three-dimensional printing technology to create a high-fidelity ureteroscopy simulator: Development and evaluation. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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7
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Feasibility of salvage robotic partial nephrectomy after ablative treatment failure (UroCCR-62 study). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00944-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Percutaneous ablation versus surgical resection for local recurrence following partial nephrectomy for renal cell cancer: A propensity score analysis (REPART Study – UroCCR 71). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00942-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Utilisation de la technologie d’impression 3D pour créer un simulateur haute-fidélité d’urétéroscopie : développement et évaluation. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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10
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Trucs et astuces pour une néphrectomie partielle robot-assistée guidée par l’image. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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11
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Caractéristiques radiologiques des lésions rénales au cours de la sclérose tubéreuse de Bourneville : impact du traitement par inhibiteur de mTOR. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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MRI associated factors of clinical efficacy of embolization in patients with pelvic venous insufficiency. Diagn Interv Imaging 2020; 101:667-676. [PMID: 32713758 DOI: 10.1016/j.diii.2020.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to identify anatomical findings at magnetic resonance imaging (MRI) associated with successful percutaneous embolization in women with pelvic venous insufficiency (PVI). MATERIAL AND METHODS Between 2008 and 2018, 168 consecutive women (mean age, 39±9 [SD] years; range: 21-69 years) who underwent percutaneous embolization for PVI confirmed by MRI and phlebography were included. Clinical efficacy of embolization was evaluated by patients' opinion or visual analogue scale. Associated factors of success of embolization were searched by comparing MRI findings in women with successful embolization with those in women with failed embolization using univariate analyses. RESULTS The mean follow-up was 36±29 (SD) months (range: 12-138 months). Clinical efficacy of embolization was obtained in 126/168 women (75%), complete symptom improvement in 33/168 women (20%) and significant partial improvement in 92/168 women (55%). No symptom improvement and symptoms exacerbation were observed in 17/168 (10%) and 2/168 (1%) women, respectively. At univariate analysis, right ovarian vein diameter≤7mm and vulvar varicosities were associated with successful embolization (P=0.04 and P=0.01, respectively) and left ovarian vein diameter≤7mm was associated with a complete improvement of symptoms (P=0.03). At multivariate analysis, a small right ovarian vein diameter was the single MRI variable associated with clinical efficacy of embolization (P=0.04). CONCLUSION Small ovarian vein diameters on MRI are associated with best clinical efficacy of percutaneous embolization in PVI. Right ovarian vein diameter>7mm should warrant further phlebography to exclude venous insufficiency.
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Clinic Versus Ambulatory Blood Pressure in Resistant Hypertension: Impact of Antihypertensive Medication Nonadherence. Hypertension 2019; 74:1096-1103. [DOI: 10.1161/hypertensionaha.119.13520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinic-ambulatory blood pressure (BP) difference is influenced by patients- and device-related factors and inadequate clinic-BP measurement. We investigated whether nonadherence to antihypertensive medications may also influence this difference in a post hoc analysis of the DENERHTN trial (Renal Denervation for Hypertension). We pooled the data of 77 out of 106 evaluable patients with apparent resistant hypertension who received a standardized antihypertensive treatment and had both ambulatory BP and drug-screening results available at baseline after 1 month of standardized triple therapy and at 6 months on a median of 5 antihypertensive drugs. After drug assay samplings on study visits, patients took their antihypertensive treatment under supervision immediately after the start of the ambulatory BP recording, and supine clinic BP was measured 24 hours post-dosing; both allowed to calculate the clinic minus daytime ambulatory systolic BP (SBP) difference (clinic-SBP–day-SBP). A total of 29 (37.7%) were found nonadherent to medications at baseline and 38 (49.4%) at 6 months. At baseline, the mean clinic-SBP–day-SBP difference in the nonadherent group was 12.7 mm Hg (95% CI, 7.8–17.7 mm Hg,
P
<0.001). In contrast, clinic SBP was almost identical to day-SBP in the adherent group (clinic-SBP–day-SBP difference, 0.1 mm Hg; 95% CI, −3.3 to 3.5 mm Hg;
P
=0.947). Similar observations were made at 6 months. Using receiver operating characteristics curves, we found that a 6 mm Hg cutoff of clinic-SBP–day-SBP difference had 67% sensitivity and 69% specificity to predict nonadherence to the triple therapy at baseline. In conclusion, a large clinic-SBP–day-SBP difference may help discriminating between adherence and nonadherence to treatment in patients with resistant hypertension.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01570777.
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Page kidney after radiofrequency ablation of renal tumor: Successful management with percutaneous drainage. Diagn Interv Imaging 2019; 100:721-723. [PMID: 31405820 DOI: 10.1016/j.diii.2019.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/12/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
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Dose-Ranging and Cohort-Expansion Study of Monalizumab (IPH2201) in Patients with Advanced Gynecologic Malignancies: A Trial of the Canadian Cancer Trials Group (CCTG): IND221. Clin Cancer Res 2019; 25:6052-6060. [PMID: 31308062 DOI: 10.1158/1078-0432.ccr-19-0298] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/20/2019] [Accepted: 07/02/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Monalizumab binds CD94/NKG2A, preventing HLA-E inhibition of tumor lymphocytes. A dose-ranging/cohort expansion trial of monalizumab for recurrent gynecologic malignancies was conducted to determine the recommended phase II dose (RP2D) and to explore clinical activity, pharmacokinetics, pharmacodynamics, safety, and immunogenicity. PATIENTS AND METHODS Participants (and part 2 expansion cohorts) included (i) platinum-sensitive ovarian, (ii) platinum-resistant ovarian, (iii) squamous cervical (CX), and (iv) epithelial endometrial (END) carcinomas. Part 1 assessed monalizumab at 1, 4, or 10 mg/kg every 2 weeks. In part 2, ≥4 patients/cohort underwent pre- and on-treatment tumor biopsies. Preset criteria determined cohort expansion. RESULTS A total of 58 participants were evaluable. The RP2D was 10 mg/kg i.v. every 2 weeks. Dose proportionality and 100% NKG2A saturation were observed. Related adverse events were mild: headache, abdominal pain, fatigue, nausea, and vomiting. Grade 3 related adverse events were nausea (1), vomiting (1), dehydration (1), fatigue (2), anorexia (1), dyspnea (1), and proctitis (1). Dose-limiting toxicities were not observed. Hematologic and biochemical changes were mild and not dose related. Best response was SD: part 1, 7 of 18 (39%) [3.4 months (1.4-5.5)], and part 2, 7 of 39 (18%) [1.7 months (CX) to 14.8 months (END)]. Neither a predictive biomarker for SD nor evidence of pharmacodynamic effects was identified. There was a trend to significance between a reduction in lymphocyte HLA-E total score and pharmacodynamics. CONCLUSIONS Monalizumab 10 mg/kg i.v. every 2 week is well tolerated in patients with pretreated gynecologic cancers. Short-term disease stabilization was observed. Future studies should assess combinations with other agents, including immunotherapeutics.
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Néphrectomie partielle robotique pour tumeur rénale assistée par modélisation 3D : série prospective de 100 cas et analyse comparative avec le registre national de néphrectomie partielle robot-assistée RoPaN (UroCCR study no 51). Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Proximal embolization of splenic artery in acute trauma: Comparison between Penumbra occlusion device versus coils or Amplatzer vascular plug. Diagn Interv Imaging 2018; 99:801-808. [PMID: 29910169 DOI: 10.1016/j.diii.2018.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 04/14/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare intervention duration and fluoroscopy time for proximal embolization of splenic arteries in acute trauma using the Penumbra occlusion device (POD®), coils or Amplatzer™ vascular plug (AVP). MATERIAL AND METHODS A total of 29 patients with splenic injury without vascular injury who were treated by proximal splenic artery embolization using POD® (n=12), coils (n=9) or AVP (n=8) were retrospectively included. There were 25 men and 4 women with a median age of 34 years (range: 10-69 years). To overcome bias in treatment choice, a propensity score was used using inverse probability weighting. Intervention duration and fluoroscopy time, treatment success and complications were compared. RESULTS The median intervention duration was significantly shorter using POD® (30min) or AVP (47min) than using coils (60min) (P=0.0001 and 0.004, respectively). The median fluoroscopy time was significantly lower using POD® (11.5min) than using coils (23.6min) (P=0.0076) or AVP (16.5min) (P=0.049). The primary efficacy rate was 100% with POD® and AVP and 89% with coils (P=0.586). Six complications occurred with a mean follow-up of 12 months for POD®, 32 months for coils and 40 months for AVP, consisting in 2 abscesses treated by anti-biotherapy with POD®, one abscess with AVP, 2 material migrations with coils and 1 coil dismantled without consequence. CONCLUSION POD® and AVP allow proximal embolization of splenic artery in acute trauma with shorter intervention duration by comparison with conventional metallic coils with similar technical success. POD® allows a shorter fluoroscopy time than coils or AVP.
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Erratum to “In vivo percutaneous microwave ablation in kidneys: Correlation with ex vivo data and ablation work” [Diagn. Interv. Imaging 99 (1) (2018) 3–8]. Diagn Interv Imaging 2018; 99:185. [DOI: 10.1016/j.diii.2018.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
SummaryDD are now recognized as a valuable tool to screen patients suspected of deep venous thrombosis or pulmonary embolism before carrying out a gold standard radiologic examination. The newest methods available claim to be able to ascertain the absence of thrombosis, but they have yet to prove their efficiency. We compared the performances of 3 reference ELISA methods (D-DI Asserachrom™ Stago, D-dimer Enzygnost™ Behring and Dimertest GOLD EIA™ Agen), 5 recent rapid methods (VIDAS D-Dimer™ bioMérieux, Instant IA™ Stago, Simplired™ Agen, Nycocard D-dimer™ Nycomed and Accuclot D-Dimer™ Sigma Diagnostics) and two routine latex methods (Dimertest™ American Diagnostica and FDP-Slidex™ bioMérieux) in 100 patients. One of the rapid quantitative methods was demonstrated to have a level of efficiency comparable to that of ELISA methods. Finally, the cost and efficiency of different strategies were evaluated, the association of a routine latex method with the VIDAS D-Dimer™ bioMérieux being proven to be the most efficient.
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Embolization for persistent type IA endoleaks after chimney endovascular aneurysm repair with Onyx®. Diagn Interv Imaging 2017; 98:849-855. [DOI: 10.1016/j.diii.2017.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 04/19/2017] [Accepted: 04/22/2017] [Indexed: 11/30/2022]
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21
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Des varices acquises précoces chez une adolescente. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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22
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Néphrectomie totale élargie gauche avec clampage latéral de veine cave et curage ganglionnaire par voie mini-invasive robot-assistée. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Technique de dévascularisation tumorale anatomique guidée par l’image : illustration sur un cas d’héminéphrectomie robotique. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mise en place de modélisations 3D pour guidage chirurgical peropératoire d’une néphrectomie partielle robot-assistée : une série initiale de 10 cas. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Valeur ajoutée de l’IRM de prostate avant première série de biopsies : étude MRI-FIRST. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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In vivo percutaneous microwave ablation in kidneys: Correlation with ex vivo data and ablation work. Diagn Interv Imaging 2017; 99:3-8. [PMID: 29066127 DOI: 10.1016/j.diii.2017.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/29/2017] [Accepted: 09/13/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE To compare diameters of in vivo microwave ablation (MWA) performed in swine kidneys with ex vivo diameters, and to correlate with ablation work (AW), a new metric reflecting total energy delivered. MATERIAL AND METHODS Eighteen in vivo MWA were performed in 6 swine kidneys successively using one or two antennas (MicroThermX®). Ablation consisted in delivering power (45-120W) for 5-15minutes. Ex vivo diameters were provided by the vendors and obtained on bovine liver tissue. AW was defined as the sum of (power)*(time)*(number of antennas) for all phases of an ablation (in kJoules). Kidneys were removed laparoscopically immediately after ablation. After sacrifice, ablations zones were evaluated macroscopically, and maximum diameters of the zones were recorded. Wilcoxon sum rank test and Pearson's correlation were used for comparisons. RESULTS For a single antenna (n=12), the in vivo diameters ranged from 12 to 35mm, and 15-49mm for 2 antennas (n=6). The in vivo diameters remained shorter than ex vivo diameters by 8.6%±30.1 on 1 antenna and 11.7%±26.5 on 2 antennas (P=0.31 and 0.44, respectively). AW ranged from 13.5 to 108kJ. Diameters increased linearly with AW both with 1 and 2 antennas, but only moderate correlations were observed (r=0.43 [95% confidence interval: -0.19; 0.81], P=0.16; and 0.57 [-0.44; 0.95], P=0.24, respectively). CONCLUSION Although diameters after in vivo renal MWA increased linearly with AW, the moderate correlation and wide standard deviations observed may justify a careful imaging monitoring during treatment delivery and settings adaptation, if needed, for optimal ablation.
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Percutaneous image-guided biopsies of small renal tumors: Current practice and perspectives. Diagn Interv Imaging 2017; 98:589-599. [DOI: 10.1016/j.diii.2017.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 07/19/2017] [Accepted: 07/24/2017] [Indexed: 12/30/2022]
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Percutaneous cryoablation of symptomatic venous malformations as a second-line therapeutic option: a five-year single institution experience. Eur Radiol 2017; 27:5015-5023. [PMID: 28677056 DOI: 10.1007/s00330-017-4892-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 04/17/2017] [Accepted: 05/11/2017] [Indexed: 01/20/2023]
Abstract
PURPOSE To report the mid-term outcomes of percutaneous cryoablation (PCA) performed as second-line therapeutic option of venous malformations (VM). MATERIAL AND METHODS From 2011 to 2015, PCA was offered in 24 patients (mean age: 31 years, range: 12-64) as second-line treatment for recurrence of symptoms after sclerotherapy and when resection was not possible (due to lesion location or previous failure) or refused by the patient. Adverse effects were recorded, disease-free survival (DFS) and local tissue control (LTC) rates were calculated based on symptoms and volume evolution. RESULTS Mean follow-up was 18.7 months (6-48). Nine (37.5%, 9/24) adverse effects occurred and three (12.5%, 3/24) were severe. Mean pain assessed by visual analog scale (VAS) was 41.7 mm (0-80) before treatment and 20.3 mm (0-80) (p=0.01) after. Mean volume decreased significantly after treatment from 22.4 cm3 (0.9-146) to 8.35 cm3 (0-81.3) (p<0.001). Pain recurred in nine patients and size of one lesion increased. The DFS and LTC rates were 54% [95%CI: 22.94-77.27] and 93.33% [61.26-99.03] at 24 months, respectively. Only VM volume >10 cm3 was associated with a higher risk of local recurrence (p=0.05). CONCLUSION PCA as second-line treatment appears to be safe and effective for local control of VM according to mid-term results. KEY POINTS • Percutaneous cryoablation of venous malformations appeared well tolerated. • Size of venous malformations decreased significantly after percutaneous cryoablation (p<0.001). • Pain decreased significantly after percutaneous cryoablation of venous malformations (p=0.01).
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Added value of pre-biopsy prostate multiparametric MRI in biopsy-naïve patients: Preliminary results of the MRI-FIRST trial. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/s1569-9056(17)30558-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Safety and efficacy of embolization using Onyx ® of persistent type II endoleaks after abdominal endovascular aneurysm repair. Diagn Interv Imaging 2017; 98:491-497. [PMID: 28196614 DOI: 10.1016/j.diii.2017.01.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/03/2017] [Accepted: 01/09/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To retrospectively evaluate the safety and efficacy of embolization of persistent type II endoleaks occurring after abdominal endovascular aneurysm repair (EVAR) using ethylene vinyl alcohol copolymer (Onyx®). MATERIAL AND METHODS Between 2008 and 2016, 28 consecutives patients (25 men, 3 women) with a mean age of 75.3years±9 (SD) (range: 59-90years) were treated for 29 persistent type II endoleaks with increasing aneurysm size>5mm occurring after EVAR. A total of 35 embolization procedures were performed using Onyx®, via a transarterial route (n=25) or direct puncture (n=10), with or without additional metallic coils. The endpoints were to evaluate the clinical efficacy, corresponding to the stabilization or decrease of aneurism size, and the technical efficacy, corresponding to the ability to complete the embolization. RESULTS No severe complications were observed during and after embolization. The primary and secondary clinical efficacies were 75% (21/28) and 96.4% (27/28), respectively. Overall primary technical efficacy rate was 58.6% (17/29), greater for transarterial technique (72.8%) than for direct puncture (14.3%) (P=0.01). Secondary technical efficacy was 72.4% (21/29), with no differences between transarterial (81.8%) and direct puncture (42.8%) (P=0.06). CONCLUSION Embolization with Onyx® of type II endoleaks after EVAR appears a safe and effective procedure.
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Proximal Occlusion of Medium-Sized Vessels with the Penumbra Occlusion Device: A Study of Safety and Efficacy. Cardiovasc Intervent Radiol 2016; 40:210-215. [PMID: 27921152 DOI: 10.1007/s00270-016-1480-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 09/27/2016] [Indexed: 01/21/2023]
Abstract
PURPOSE To retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD). MATERIALS AND METHODS From October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10-86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up. RESULTS To produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess. CONCLUSION The POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.
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Dose ranging study of monalizumab (IPH2201) in patients with gynecologic malignancies: A trial of the Canadian Cancer Trials Group (CCTG): IND221. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32889-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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L’IRM multiparamétrique dans l’évaluation des cancers de prostate localement avancés, corrélation avec les pièces d’anatomopathologie. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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34
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Planification préopératoire avec modélisation 3D pour néphrectomie partielle complexe robot-assistée bilatérale sous clampage super-sélectif. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Tumorectomie rénale robot-assistée : la nature kystique d’une lésion, même de gros volume, n’est pas incompatible avec la voie d’abord laparoscopique. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Néphrectomie partielle vs ablation percutanée dans le traitement de tumeurs rénales en indication impérative. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Modélisation 3D et chirurgie guidée par l’image : un premier pas vers la réalité augmentée chirurgicale appliquée à la néphrectomie partielle robot-assistée. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tumorectomie laparoscopique robot-assistée de rattrapage sur rein unique après double échec de cryothérapie : apport du principe de chirurgie guidée par modélisation 3D et du repérage échographique peropératoire. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Adherence to Antihypertensive Treatment and the Blood Pressure–Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial. Circulation 2016; 134:847-57. [DOI: 10.1161/circulationaha.116.022922] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/29/2016] [Indexed: 12/20/2022]
Abstract
Background:
The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure–lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report the influence of adherence to antihypertensive treatment on blood pressure control.
Methods:
One hundred six patients with hypertension resistant to 4 weeks of treatment with indapamide 1.5 mg/d, ramipril 10 mg/d (or irbesartan 300 mg/d), and amlodipine 10 mg/d were randomly assigned to renal denervation plus standardized stepped-care antihypertensive treatment, or the same antihypertensive treatment alone. For standardized stepped-care antihypertensive treatment, spironolactone 25 mg/d, bisoprolol 10 mg/d, prazosin 5 mg/d, and rilmenidine 1 mg/d were sequentially added at monthly visits if home blood pressure was ≥135/85 mm Hg after randomization. We assessed adherence to antihypertensive treatment at 6 months by drug screening in urine/plasma samples from 85 patients.
Results:
The numbers of fully adherent (20/40 versus 21/45), partially nonadherent (13/40 versus 20/45), or completely nonadherent patients (7/40 versus 4/45) to antihypertensive treatment were not different in the renal denervation and the control groups, respectively (
P
=0.3605). The difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the 2 groups was –6.7 mm Hg (
P
=0.0461) in fully adherent and –7.8 mm Hg (
P
=0.0996) in nonadherent (partially nonadherent plus completely nonadherent) patients. The between-patient variability of daytime ambulatory systolic blood pressure was greater for nonadherent than for fully adherent patients.
Conclusions:
In the DENERHTN trial, the prevalence of nonadherence to antihypertensive drugs at 6 months was high (≈50%) but not different in the renal denervation and control groups. Regardless of adherence to treatment, renal denervation plus standardized stepped-care antihypertensive treatment resulted in a greater decrease in blood pressure than standardized stepped-care antihypertensive treatment alone.
Clinical Trial Registration:
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01570777.
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Embolization of type I endoleak occurring after EVAR with or without chimney technique: a single center study for safety and technical efficiency at short term. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Embolization of renal arteries before transplantation in patients with polycystic kidney disease: a single institution long-term experience. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Safety and short-term efficacy of embolization of type II endoleak. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Néphrectomie partielle laparoscopique robot assistée : réalisation de tumorectomies multiples sous clampages supra-sélectifs. Prog Urol 2015; 25:861-2. [DOI: 10.1016/j.purol.2015.08.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
UNLABELLED Tubulocystic renal cell carcinoma (TC-RCC) is a recently identified renal malignancy. While approximately 100 cases of TC-RCC have been reported in the pathology literature, imaging features have not yet been clearly described. The purpose of this review is to describe the main radiologic features of this rare sub-type of RCC on ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), based jointly on the literature and findings from a multi-institutional retrospective HIPAA-compliant review of pathology and imaging databases. Using a combination of sonographic and CT/MRI features, diagnosis of TC-RCC appeared to be strongly suggested in many cases. KEY POINTS • Tubulocystic renal cell carcinoma is a new entity with typical imaging features • Diagnosis of tubulocystic renal cell carcinoma can be suggested preoperatively by imaging • Cystic renal lesions with high echogenicity may correspond to tubulocystic carcinoma.
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Embolization of renal arteries before transplantation in patients with polycystic kidney disease: a single institution long-term experience. Eur Radiol 2015; 25:3263-71. [PMID: 25981217 DOI: 10.1007/s00330-015-3730-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/17/2015] [Accepted: 03/20/2015] [Indexed: 01/23/2023]
Abstract
PURPOSE We aimed to retrospectively assess the long-term safety and efficacy of embolization of renal arteries (ERA) in patients with polycystic kidney disease (PKD) before renal transplantation. MATERIAL AND METHODS Between January 2008 and November 2013, 82 ERA procedures were performed on 76 kidneys in 73 patients (mean age 53 years, range: 34-72). All patients had terminal-stage PKD and were under dialysis and on the renal transplant waiting list with a temporary contraindication due to excessive renal volume. RESULTS ERA was considered successful in 89.5% (68/76) of embolized kidneys, meaning that the temporary contraindication for transplantation could be withdrawn for 65 patients (on average 5.6 months, range: 2.8-24.3, after ERA). Mean volume reduction was 40 (range: 2-69) at 3 months and 59% (35-86) thereafter (both p < 0.001). Post-embolization syndrome occurred after 15 of 82 procedures (18.3%). The severe complication rate was 4.9%. Forty-three (67.7%) transplantations were successfully conducted after ERA, with a mean follow-up of 26.2 months (range: 1.8-59.5), and the estimated 5-year graft survival rate was 95.3% [95% CI: 82.7-98.8]. CONCLUSIONS ERA is a safe and effective alternative to nephrectomy before renal transplantation in patients with PKD. KEY POINTS • Embolization of non-functioning polycystic kidneys allowed transplantation in 89.5% of cases. • Technical failure rate was 7.9% after embolization, irrespective of the technique used. • Post-embolization syndrome occurred after 18.3% of the procedures. • A low rate of severe complications (4.9%) was observed after renal embolization.
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Multiparametric magnetic resonance imaging for the differentiation of low and high grade clear cell renal carcinoma. Eur Radiol 2014; 25:24-31. [PMID: 25117747 DOI: 10.1007/s00330-014-3380-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 07/10/2014] [Accepted: 07/29/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE To retrospectively evaluate the ability of magnetic resonance (MR) imaging to differentiate low from high Fuhrman grade renal cell carcinoma (RCC). MATERIALS AND METHODS MR images from 80 consecutive pathologically proven RCC (57 clear cell, 16 papillary and 7 chromophobe) were evaluated. Double-echo chemical shift, dynamic contrast-enhanced T1- and T2-weighted images and apparent diffusion coefficient (ADC) maps were reviewed independently. Signal intensity index (SII), tumour-to-spleen SI ratio (TSR), ADC ratio, wash-in (WiI) and wash-out indices (WoI) between different phases were calculated and compared to pathological grade and size. The Fuhrman scoring system was used. Low grade (score ≤ 2) and high grade (score ≥ 3) tumours were compared using univariate and multivariate analyses. RESULTS No associations between grade and imaging factors were found for papillary and chromophobe RCCs. For clear cell RCCs, there was a significant association between the grade and parenchymal WiI (WiI2) (P = 0.02) or ADCr (P = 0.03). A significant association between tumour grade and size (P = 0.01), WiI2 (P = 0.02) and ADCr (P = 0.05) remained in multivariate analysis. CONCLUSIONS Multiparametric MRI can be used to accurately differentiate low Fuhrman grade clear cell RCC from high grade. High Fuhrman grade (≥ 3) RCCs were larger, had lower parenchymal wash-in indices and lower ADC ratios than low grade. KEY POINTS • Fuhrman grade of clear cell RCC can be differentiated with multiparametric MR imaging. • Fuhrman grade significantly differed for size, parenchymal wash-in index and ADC ratio. • No significant associations were found for papillary and chromophobe renal cell carcinoma.
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Long-term results of preventive embolization of renal angiomyolipomas: evaluation of predictive factors of volume decrease. Eur Radiol 2014; 24:1785-93. [PMID: 24889998 DOI: 10.1007/s00330-014-3244-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/29/2014] [Accepted: 05/14/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate the efficacy of selective arterial embolization (SAE) of angiomyolipomas based on the percentage volume reduction after embolization and to identify predictive factors of volume decrease. METHODS Patients receiving prophylactic SAE of renal angiomyolipomas were included retrospectively over 3 years. The volume change after SAE and haemorrhagic or surgical events were recorded. Initial tumour volume, percentage tumour fat content, mean tumour density, embolic agent used, number of angiomyolipomas and tuberous sclerosis disease were evaluated as predictive factors of volume decrease. RESULTS A total of 19 patients with 39 angiomyolipomas were included with median follow-up of 28 months (interquartile range 21-37 months). All treatments were technically successful (92% primary and 8% secondary). No distal bleeding or any increase in size or surgical nephrectomy after SAE was recorded. Mean volume reduction was 72% (±24%). Volumes before SAE (R(2) = 0.276; p = 0.001), percentage fat content (R(2) = 0.612; p < 0.0001) and mean angiomyolipoma density (R(2) = 0.536; p < 0.0001) were identified as predictive factors of volume decrease. In multivariate regression, only percentage fat content influenced volume decreases. CONCLUSIONS SAE is an efficient treatment for angiomyolipoma devascularisation and volume reduction. A significant reduction of volume is modulated by the initial volume and tissue composition of the tumour. KEY POINTS • Selective arterial embolization is effective for angiomyolipoma devascularisation and volume reduction • Volume reduction depends of initial volume and tissue composition of the tumour • Selective arterial embolization is a low radiation treatment.
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Evaluation of the efficacy of endovascular treatment of pelvic congestion syndrome. Diagn Interv Imaging 2014; 95:301-6. [DOI: 10.1016/j.diii.2013.09.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours. Eur Radiol 2014; 24:1068-80. [PMID: 24557052 DOI: 10.1007/s00330-014-3107-z] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 01/21/2014] [Accepted: 01/24/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To retrospectively evaluate the ability of multiparametric magnetic resonance (MR) imaging to differentiate renal tumours. METHODS MR images from 100 consecutive pathologically proven solid renal tumours without macroscopic fat [57 clear cell, 16 papillary and 7 chromophobe renal cell carcinomas (RCCs), 16 oncocytomas and 4 minimal fat angiomyolipomas (AMLs)] between 2009 and 2012 were evaluated. Two radiologists blinded to pathology results independently reviewed double-echo chemical shift, dynamic contrast-enhanced T1- and T2-weighted images and apparent diffusion coefficient (ADC) maps. Signal intensity index (SII), tumour-to-spleen SI ratio (TSR), ADC ratio, wash-in (WiI) and wash-out indices (WoI) between different phases were calculated. RESULTS There were significant differences between papillary RCCs and other renal tumours for arterial WiI (P < 0.001), initial WoI (P = 0.006) and ADC ratio (P < 0.001); between chromophobe RCCs and oncocytomas for TSR (P = 0.02), parenchymal WiI (P = 0.03), late WiI (P = 0.02), initial WoI (P = 0.03) and late WoI (P = 0.04); and between clear cell RCCs and oncocytomas for SII (P = 0.01) and parenchymal WiI (P = 0.01). Papillary RCCs were distinguished from other tumours (sensitivity 37.5 %, specificity 100 %) and oncocytomas from chromophobe RCCs (sensitivity 25 %, specificity 100 %) and clear cell RCCs (sensitivity 100 %, specificity 94.2 %). CONCLUSION MR imaging provides criteria able to accurately distinguish papillary RCCs from other tumours and oncocytomas from chromophobe and clear cell RCCs. KEY POINTS • Multiparametric MR parameters accurately distinguish papillary RCCs with high specificity (100 %). • Oncocytomas can be distinguished from chromophobe RCCs with high specificity (100 %). • Oncocytomas can be distinguished from clear cell RCCs with high specificity (94.2 %). • In oncocytomatosis, imaging follow-up with such parameters analysis could be promoted.
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Double-blind randomized pilot trial evaluating the efficacy of oral propranolol on infantile haemangiomas in infants < 4 months of age. Br J Dermatol 2014; 169:181-3. [PMID: 23301692 DOI: 10.1111/bjd.12217] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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