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Mougin J, Schwein A, Postiglione TJ, Guihaire J, Fabre D, Haulon S. Management of the False Lumen in Post Type A Aortic Dissection Arch Aneurysms Treated With Branched Endografts. J Endovasc Ther 2023:15266028221149912. [PMID: 36632664 DOI: 10.1177/15266028221149912] [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] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The treatment of chronic postdissection aneurysms of the aortic arch is a challenge. This study aims to describe false lumen management after aortic arch endovascular repair of post-type A dissection aneurysms treated with a branched endograft. METHODS In this single-center retrospective observational study, all consecutive patients undergoing endovascular treatment of aneurysmal degeneration of chronic type A aortic dissections following open repair were enrolled. The primary endpoint was maximal aortic diameter evolution measured on computed tomography angiography (CTA) performed during follow-up. Secondary endpoints included procedural success, aortic re intervention, and remodeling during follow-up. RESULTS Between January 2017 and June 2020, 22 patients underwent endovascular branched arch repair for post type A dissection aneurysms. Technical success was 100%. Thirteen patients (59%) had dissection involvement of at least 1 supra-aortic vessel. Midterm follow-up CTA was performed for 20 patients, 23.1 (±13.3) months after the procedure. Maximal aortic diameter at the level of the repair was decreasing in 13 (65%) patients, increasing in 2 (10%) patients, and no change was observed in 5 (25%) patients. During follow-up, 7 patients (35%) required aortic reintervention. Thoracic candy plugs were implanted for distal false lumen occlusion in 15 patients and associated with a high rate of complete remodeling (6/15 patients, 40%). CONCLUSION Arch branch endografting of aneurysmal evolution of a post type A dissection aortic arch is a safe and feasible option in experienced hands. Candy plug use in favorable anatomies seems to be associated with accelerated remodeling of the aorta. CLINICAL IMPACT There are currently no recommendations on dissected supra- aortic vessels management and the use of thoracic aorta false lumen occlusion devices during endovascular repair of chronic post dissection aneurysm of the aortic arch with branched endografts. Based on our clinical experience reported in the current manuscript, we propose a treatment algorithm for the management of the false lumen in this setting.
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Affiliation(s)
- J Mougin
- Aortic Center, Department of Cardiac and Vascular Surgery, Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, INSERM UMR_S 999, Université Paris-Saclay, Paris, France
| | - A Schwein
- Service de Chirurgie Vasculaire, CHU Strasbourg, Strasbourg, France
| | | | - J Guihaire
- Aortic Center, Department of Cardiac and Vascular Surgery, Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, INSERM UMR_S 999, Université Paris-Saclay, Paris, France
| | - D Fabre
- Aortic Center, Department of Cardiac and Vascular Surgery, Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, INSERM UMR_S 999, Université Paris-Saclay, Paris, France
| | - S Haulon
- Aortic Center, Department of Cardiac and Vascular Surgery, Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, INSERM UMR_S 999, Université Paris-Saclay, Paris, France
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Mesnard T, Patterson BO, Azzaoui R, Pruvot L, Haulon S, Sobocinski J. Iliac branch device to treat type IB endoleak with a brachial access or an "up-and-over" transfemoral technique. J Vasc Surg 2022; 76:1537-1547.e2. [PMID: 35760243 DOI: 10.1016/j.jvs.2022.06.025] [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: 03/04/2022] [Revised: 06/12/2022] [Accepted: 06/19/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to review the results of secondary IBD (iliac branch device) implantation in patients with type IB endoleak after prior fenestrated and/or branched or infrarenal endovascular aortic repair (F/B-EVAR or EVAR), using either brachial access or an "up-and-over" transfemoral technique. METHODS A retrospective single centre analysis was conducted between Jan 2016 and Oct 2021 including consecutive patients that underwent IBD to correct a type IB endoleak after prior EVAR or F/B-EVAR. Groups were defined by arterial access which was either brachial (group 1) or transfemoral (group 2). All IBD implanted were manufactured by Cook Medical (INC, Bloomington, IN, USA). Demographics, anatomical features, technical success, and 30-day major adverse events (MAE) were recorded according to the current SVS standards. Survival curves according to Kaplan-Meier were calculated. Branch instability was a composite endpoint of any IIA branch-related complication or reintervention indicated to treat endoleak, kink, disconnection, stenosis, occlusion or rupture. RESULTS Overall, 28 patients (93% male, median age 74 years) receiving 32 IBDs were included, with 14 patients in each group. Prior endovascular aortic repairs were 23 EVAR and 5 F/B-EVAR, with time from initial repair being 58 months [48, 70]. Median pre-IBD maximal aneurysm diameter was 63.5 mm [59.0, 78.0]. Patients' baseline characteristics were similar in both groups except for pulmonary status. All procedures were performed in a hybrid operative room. Median total operating time, fluoroscopy time and dose area product were 120 min [86, 167], 23 min [15, 32] and 54 Gy.cm2 [40, 62], respectively. Total operating time was shorter in group 2 (p=0.006). Technical success rate was 100% and no early death reported. One 30-day MAE occurred including a medically treated colonic ischemia (group 2). Aortic-related secondary interventions were required in 7 patients (5 in group 1 and 2 in group 2) including 3 surgical explantations. Median follow-up was 31 months [24, 42] and 6 months [3, 10] in group 1 and 2, respectively. In group 1, 2-year freedom from aortic-related secondary intervention and IIA branch instability were 84.6% [67.1-100] and 92.3% [78.9-100], respectively. In group 2, 6-month freedom from aortic-related secondary intervention and IIA branch instability were 87.5% [67.3-100] and 91.7% [77.3-100], respectively. CONCLUSION The secondary implantation of IBD to correct distal type I endoleak of previous aortic stent-graft is safe with a high technical success rate. The "up-and-over" technique could be considered as an alternative to the brachial access in patients with suitable anatomy.
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Affiliation(s)
- T Mesnard
- Service de chirurgie vasculaire, Centre de l'Aorte, CHU Lille, France; Univ. Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - B O Patterson
- Department of Vascular Surgery, University Hospital Southampton, United Kingdom
| | - R Azzaoui
- Service de chirurgie vasculaire, Centre de l'Aorte, CHU Lille, France
| | - L Pruvot
- Service de chirurgie vasculaire, Centre de l'Aorte, CHU Lille, France
| | - S Haulon
- Service de chirurgie vasculaire, Centre de l'Aorte, Hôpital Marie-Lannelongue, Le Plessis Robinson
| | - J Sobocinski
- Service de chirurgie vasculaire, Centre de l'Aorte, CHU Lille, France; Univ. Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France.
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Adam C, Fabre D, Mougin J, Zins M, Azarine A, Ardon R, d’Assignies G, Haulon S. Pre-surgical and Post-surgical Aortic Aneurysm Maximum Diameter Measurement: Full Automation by Artificial Intelligence. J Vasc Surg 2022. [DOI: 10.1016/j.jvs.2021.11.045] [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: 11/27/2022]
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Karelis A, Haulon S, Sonesson B, Adam D, Kölbel T, Oderich G, Cieri E, Mesnard T, Verhoeven E, Dias N, Marqués P, Tenorio E, Claridge M, Casali F, Tsilimparis N, Sobocinski J, Katsargyris A. Multicentre Outcomes of Redo Fenestrated/Branched Endovascular Aneurysm Repair to Rescue Failed Fenestrated Endografts. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.10.009] [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: 11/30/2022]
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Charbonneau P, Kölbel T, Rohlffs F, Eilenberg W, Planche O, Bechstein M, Ristl R, Greenhalgh R, Haulon S. Silent Brain Infarction After Endovascular Arch Procedures: Preliminary Results from the STEP Registry. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Loftus I, Haulon S, Boyle J. NICE Abdominal Aortic Aneurysm Guidelines Finally Published: How Will They Influence Aortic Practice in the UK and Beyond? Eur J Vasc Endovasc Surg 2020; 59:697-698. [DOI: 10.1016/j.ejvs.2020.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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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Monnet P, Zehou O, Khemri M, Hirsch G, Rakotonarivo L, Jankovic M, Thomas E, Fromentin I, Haulon S, Henry O, Bouillanne O, Motamed G, Schwald-Adam N, David JP, Mezière A, Picou Y, Schonheit C, Jannic A, Gautier MS, Lestang P, Plaquet JL, Charpentier C, Ostojic A, Wolkenstein P, Duong TA. Prise en charge des tumeurs cutanées par télédermatologie : quel parcours de soins dans une filière gériatrique ? Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.244] [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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Clough R, Barillà D, Delsart P, Ledieu G, Spear R, Crichton S, Mounier Vehier C, Peacock J, Sobocinski J, Haulon S. Long-term Survival and Risk Analysis in 136 Consecutive Patients With Type B Aortic Dissection Presenting to a Single Centre Over an 11 Year Period. J Vasc Surg 2019. [DOI: 10.1016/j.jvs.2019.04.453] [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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Hascoët S, Karsenty C, Tortigue M, Watkins A, Riou J, Boet A, Houyel L, Tahhan N, Fabre D, Haulon S, Brenot P, Petit J. A modified procedure for percutaneous pulmonary valve implantation of the Edwards SAPIEN 3 transcatheter heart valve. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hirsch G, Thomas E, Fromentin I, Haulon S, Henry O, Bouillanne O, Motamed G, Schwald-Adam N, David JP, Hua C, Zehou O, Thion P, Chosidow O, Wolkenstein P, Duong TA. TELDERM : télé-expertise en dermatologie : évolution sur 21 mois dans un établissement gériatrique. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.388] [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: 11/28/2022]
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Moussa MD, Lamer A, Mass G, Louvel P, Lecaitel S, Hertault A, Gantois G, Leroy G, Ait-Ouarab S, Brandt C, Kipnis E, Sobocinski J, Tavernier B, Haulon S, Robin E. P2662Prognostic value of postoperative high-sensitivity troponin among patients undergoing fenestrated and/or branched endovascular aortic aneurysm repair. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2662] [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)
- M D Moussa
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - A Lamer
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - G Mass
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - P Louvel
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - S Lecaitel
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - A Hertault
- Cardiology Hospital of Lille, Vascular Surgery Department, Lille, France
| | - G Gantois
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - G Leroy
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - S Ait-Ouarab
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - C Brandt
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - E Kipnis
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - J Sobocinski
- Cardiology Hospital of Lille, Vascular Surgery Department, Lille, France
| | - B Tavernier
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
| | - S Haulon
- Cardiology Hospital of Lille, Vascular Surgery Department, Lille, France
| | - E Robin
- Cardiology Hospital of Lille, Anesthesia and Cardiovascular Intensive Care Unit, Lille, France
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Clough RE, Spear R, Van Calster K, Hertault A, Azzaoui R, Sobocinski J, Fabre D, Haulon S. Case series of aortic arch disease treated with branched stent-grafts. Br J Surg 2018; 105:358-365. [DOI: 10.1002/bjs.10681] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/15/2017] [Accepted: 07/20/2017] [Indexed: 01/16/2023]
Abstract
Abstract
Background
Surgical repair of aortic arch pathology is complex and associated with significant morbidity and mortality. Alternative approaches have been developed to reduce these risks, including the use of thoracic stent-grafts with fenestrations or in combination with bypass procedures to maintain supra-aortic trunk blood flow. Branched stent-grafts are a novel approach to treat aortic arch pathology.
Methods
Consecutive patients with aortic arch disease presenting to a single university hospital vascular centre were considered for branched stent-graft repair (October 2010 to January 2017). Patients were assessed in a multidisciplinary setting including a cardiologist, cardiac surgeon and vascular surgeon. All patients were considered prohibitively high risk for standard open surgical repair. The study used reporting standards for endovascular aortic repair and PROCESS (Preferred Reporting of Case Series in Surgery) guidelines.
Results
Some 30 patients (25 men) underwent attempted branch stent-graft repair. Mean age was 68 (range 37–84) years. Eighteen patients had chronic aortic dissection, 11 patients had an aneurysm and one had a penetrating ulcer. Fourteen patients had disease in aortic arch zone 0, six in zone 1 and ten in zone 2. Twenty-five patients had undergone previous aortic surgery and 24 required surgical revascularization of the left subclavian artery. Technical success was achieved in 27 of 30 patients. Four patients had an endoleak (type Ia, 1; type II, 3). The in-hospital mortality rate was three of 30. Mean length of follow-up was 12·0 (range 1·0–67·8) months, during which time 12 patients required an aortic-related reintervention.
Conclusion
Repair of aortic arch pathology using branched stent-grafting appears feasible. Before widespread adoption of this technology, further studies are required to standardize the technique and identify which patients are most likely to benefit.
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Affiliation(s)
- R. E. Clough
- Aortic Centre, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille Cedex, France
| | - R. Spear
- Aortic Centre, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille Cedex, France
| | - K. Van Calster
- Aortic Centre, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille Cedex, France
| | - A. Hertault
- Aortic Centre, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille Cedex, France
| | - R. Azzaoui
- Aortic Centre, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille Cedex, France
| | - J. Sobocinski
- Aortic Centre, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille Cedex, France
| | - D. Fabre
- Department of Aortic and Vascular Surgery, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - S. Haulon
- Aortic Centre, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille Cedex, France
- Department of Aortic and Vascular Surgery, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
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Tinelli G, Hertault A, Martin Gonzalez T, Spear R, Azzaoui R, Sobocinski J, Clough RE, Haulon S. Evaluation of a new imaging software for aortic endograft planning. Eur Rev Med Pharmacol Sci 2017; 21:2717-2724. [PMID: 28678313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate a new 3D Workstation workflow (EVAR Assist, Advantage Windows, GE Healthcare, Chalfont, UK) (EA-AW) designed to simplify complex EVAR planning. PATIENTS AND METHODS All pre-operative computed tomography (CT) scans of patients who underwent repair at our institution of a complex aortic aneurysm using fenestrated endovascular repair (f-EVAR) between January and September 2014, were reviewed. For each patient, imaging analysis (12 measures: aortic diameters and length and "clock position" of visceral artery) was performed on two different workstations: Aquarius (TeraRecon, San Mateo, CA, USA) and EA-AW. According to a standardized protocol, three endovascular surgeons experienced in aortic endograft planning, performed image analyses and data collection independently. We analyzed an internal assessment between observers (on the Aquarius 3DWS) and an external assessment comparing these results with the planning center (PC) data used to custom the fenestrated endograft of the patients enrolled in this study. Finally, we compared both 3DWS data to determine the accuracy and the reproducibility. A p-value < .05 was considered as statistically significant. Complete agreement between operators was defined as 1.0. RESULTS Intra- and inter-observer variability (interclass correlation coefficients - ICC: 0.81-.091) was very low and confirmed the reliability of our planners. The ICC comparison between EA-AW and Aquarius was excellent (> 0.8 for both), thus confirming the reproducibility and reliability of the new EA-AW application. Aortic and iliac necks diameters and lengths were similarly reported with both workstations. In our study, the mean difference in distance and orientation evaluation of target vessels evaluated by the two workstations was marginal and has no impact on clinical practice in term of device manufacturing. CONCLUSIONS We showed that complex EVAR planning can be performed with this new dedicated 3D workstation workflow with a good reproducibility.
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Affiliation(s)
- G Tinelli
- UOC di Chirurgia Vascolare, Polo CardioVascolare e Toracico, Fondazione Universitaria Policlinico A. Gemelli, Roma, Italy.
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de Souza L, Oderich G, Farber M, Haulon S, Banga P, Pereira A, Gloviczki P, Textor S, Jia F. Comparison of Renal Outcomes in Patients Treated by Zenith® Fenestrated and Zenith® Abdominal Aortic Aneurysm Stent grafts in US Prospective Pivotal Trials. J Vasc Surg 2017. [DOI: 10.1016/j.jvs.2017.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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de Souza LR, Oderich GS, Farber MA, Haulon S, Banga PV, Pereira AH, Gloviczki P, Textor SC, Jia F. Editor's Choice - Comparison of Renal Outcomes in Patients Treated by Zenith ® Fenestrated and Zenith ® Abdominal Aortic Aneurysm Stent grafts in US Prospective Pivotal Trials. Eur J Vasc Endovasc Surg 2017; 53:648-655. [PMID: 28285957 DOI: 10.1016/j.ejvs.2017.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 02/03/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE/BACKGROUND Fenestrated endovascular repair (FEVAR) has been used to treat complex abdominal aortic aneurysms (AAAs). The risk of renal function deterioration compared with infrarenal endovascular aortic repair (EVAR) has not been determined. METHODS Patients with preserved renal function (estimated glomerular filtration rate [eGFR] > 45 mL/minute) enrolled in two prospective, non-randomised studies evaluating Zenith fenestrated and AAA stent grafts were matched (1:2) by propensity scores for age, sex, hypertension, diabetes, and pre-operative eGFR. Sixty-seven patients were treated by FEVAR and 134 matched controls treated by EVAR. Mean follow-up was 30 ± 20 months. Outcomes included acute kidney injury (AKI) defined by RIFLE and changes in serum creatinine (sCr), eGFR, and chronic kidney disease (CKD) staging up to 5 years. RESULTS AKI at 1 month was similar between groups, with > 25% decline in eGFR observed in 5% of FEVAR and 9% of EVAR patients (p = .39). There were no significant differences in > 25% decline in eGFR at 2 years (FEVAR 20% vs. EVAR 20%; p > .99) or 5 years (FEVAR 27% vs. EVAR 50%; p = .50). Progression to stage IV-V CKD was similar at 2 years (FEVAR 2% vs. EVAR 3%; p > .99) and 5 years (FEVAR 7% vs. EVAR 8%; p > .99), with similar sCr and eGFR up to 5 years. During follow-up, there were more renal artery stenosis/occlusions (15/67 [22%] vs. 3/134 [2%]; p < .001) and renal related re-interventions (12/67 [18%] vs. 4/134 [3%]; p < .001) in patients treated by FEVAR. Rate of progression to renal failure requiring dialysis was low and identical in both groups (1.5% vs. 1.5%; p > .99). CONCLUSION Aortic repair with FEVAR and EVAR was associated with similar rates of renal function deterioration in patients with preserved pre-operative renal function. Renal related re-interventions were higher following FEVAR, although net changes in renal function were similar in both groups.
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Affiliation(s)
- L R de Souza
- Advanced Endovascular Aortic Research Program, Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA; Surgery PhD Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - G S Oderich
- Advanced Endovascular Aortic Research Program, Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA.
| | - M A Farber
- Division of Vascular Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - S Haulon
- Aortic Center, CHRU Lille, France
| | - P V Banga
- Advanced Endovascular Aortic Research Program, Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA; Department of Vascular Surgery, Semmelweis University, Budapest, Hungary
| | - A H Pereira
- Surgery PhD Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - P Gloviczki
- Advanced Endovascular Aortic Research Program, Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - S C Textor
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - F Jia
- Cook Research Incorporated, West Lafayette, IN, USA
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Riambau V, Böckler D, Brunkwall J, Cao P, Chiesa R, Coppi G, Czerny M, Fraedrich G, Haulon S, Jacobs M, Lachat M, Moll F, Setacci C, Taylor P, Thompson M, Trimarchi S, Verhagen H, Verhoeven E, ESVS Guidelines Committee, Kolh P, de Borst G, Chakfé N, Debus E, Hinchliffe R, Kakkos S, Koncar I, Lindholt J, Vega de Ceniga M, Vermassen F, Verzini F, Document Reviewers, Kolh P, Black J, Busund R, Björck M, Dake M, Dick F, Eggebrecht H, Evangelista A, Grabenwöger M, Milner R, Naylor A, Ricco JB, Rousseau H, Schmidli J. Editor's Choice – Management of Descending Thoracic Aorta Diseases. Eur J Vasc Endovasc Surg 2017; 53:4-52. [DOI: 10.1016/j.ejvs.2016.06.005] [Citation(s) in RCA: 598] [Impact Index Per Article: 85.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Raybaud G, Lambert M, Douillard C, Dessein A, Morell-Dubois S, Guillou M, Haulon S, Hatron PY. Thrombose artérielle aiguë dans un contexte d’hyperhomocystéinémie : à propos d’un cas et revue de la littérature. Rev Med Interne 2016; 37:849-853. [DOI: 10.1016/j.revmed.2016.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 06/03/2016] [Accepted: 10/06/2016] [Indexed: 11/29/2022]
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Martin-Gonzalez T, Mastracci T, Carrell T, Constantinou J, Dias N, Katsargyris A, Modarai B, Resch T, Verhoeven E, Haulon S. Mid-term Outcomes of Renal Branches Versus Renal Fenestrations for Thoraco-abdominal Aneurysm Repair. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.07.062] [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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Maurel B, Lounes Y, Amako M, Fabre D, Hertault A, Sobocinski J, Spear R, Azzaoui R, Mastracci T, Haulon S. Changes in Renal Anatomy after Fenestrated Endovascular Aneurysm Repair. Eur J Vasc Endovasc Surg 2016. [DOI: 10.1016/j.ejvs.2016.07.041] [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: 11/15/2022]
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Clough RE, Haulon S. Commentary on 'Morphological Differences in the Aorto-iliac Segment in AAA Patients of Caucasian and Asian Origin'. Eur J Vasc Endovasc Surg 2016; 51:790. [PMID: 27150799 DOI: 10.1016/j.ejvs.2016.03.014] [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] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/13/2016] [Indexed: 10/22/2022]
Affiliation(s)
- R E Clough
- Aortic Centre, Hôpital Cardiologique, CHRU Lille, France; National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, UK.
| | - S Haulon
- Aortic Centre, Hôpital Cardiologique, CHRU Lille, France
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Mastracci T, Carrell T, Constantinou J, Dias N, Martin-Gonzalez T, Katsargyris A, Modarai B, Resch T, Verhoeven E, Burnell M, Haulon S. Effect of Branch Stent Choice on Branch-related Outcomes in Complex Aortic Repair. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.03.005] [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: 11/24/2022]
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Mastracci T, Carrell T, Constantinou J, Dias N, Martin-Gonzalez T, Katsargyris A, Modarai B, Resch T, Verhoeven E, Burnell M, Haulon S. Editor's Choice – Effect of Branch Stent Choice on Branch-related Outcomes in Complex Aortic Repair. Eur J Vasc Endovasc Surg 2016; 51:536-42. [DOI: 10.1016/j.ejvs.2015.12.046] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/29/2015] [Indexed: 11/29/2022]
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Spear R, Haulon S, Ohki T, Tsilimparis N, Kanaoka Y, Milne C, Debus S, Takizawa R, Kölbel T. Subsequent Results for Arch Aneurysm Repair with Inner Branched Endografts. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Maurel B, Haulon S. Re: ‘The Impact of Early Pelvic and Lower Limb Reperfusion and Attentive Peri-operative Management on the Incidence of Spinal Cord Ischemia During Thoraco-abdominal Aortic Aneurysm Endovascular Repair’. Eur J Vasc Endovasc Surg 2016; 51:316. [DOI: 10.1016/j.ejvs.2015.10.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022]
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Spear R, Sobocinski J, Settembre N, Tyrrell MR, Malikov S, Maurel B, Haulon S. Early Experience of Endovascular Repair of Post-dissection Aneurysms Involving the Thoraco-abdominal Aorta and the Arch. Eur J Vasc Endovasc Surg 2015; 51:488-97. [PMID: 26680449 DOI: 10.1016/j.ejvs.2015.10.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [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: 05/13/2015] [Accepted: 10/18/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Outcomes are reported in management of post-dissection aneurysms involving the aortic arch and/or thoraco-abdominal segment (TAAA) treated with fenestrated and branched (complex) endografts. METHODS This report includes all patients with chronic post-dissection aneurysms >55 mm in diameter, deemed unfit for open surgery, treated using complex endografts between October 2011 and March 2015. When appropriate, staged management strategies including left subclavian artery revascularization, thoracic endografting, dissection flap fenestration or tear enlargement, and other endovascular procedures were performed at least 3 weeks prior to definitive complex endovascular repair. The following outcome data were collected prospectively at discharge, 12 months and annually thereafter: technical success, endoleaks, target vessel patency, false lumen patency, aneurysm diameter, major and minor complications, re-interventions, and mortality. RESULTS The cohort comprised 23 patients with a median age of 65 years. Staged procedures were performed in 14 patients (61%). Seven patients with dissections involving the arch were treated with inner branched endografts, and 16 TAAA patients were treated with fenestrated or branched endografts. The technical success rate was 71% following arch repair and 100% following TAAA repair. During early follow up, one of the arch group patients died and one in the TAAA group suffered spinal cord ischemia. The median follow up was 12 months (range 3-48), during which time one patient died of causes unrelated to aneurysm or treatment. Two early re-interventions were performed in the arch group to correct access vessel complications and there were a further two late re-interventions in the TAAA group to treat endoleaks. All target vessels (n = 72) remained patent. CONCLUSIONS This experience indicates that complex endovascular repair of post-dissection aneurysms is a viable alternative to open repair in patients deemed unfit for open surgery. There are insufficient data to allow comparison with the outcome of open surgery in anatomically similar, but fit, patients.
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Affiliation(s)
- R Spear
- Aortic Center, Hôpital Cardiologique, CHRU Lille, France
| | - J Sobocinski
- Aortic Center, Hôpital Cardiologique, CHRU Lille, France
| | | | | | | | - B Maurel
- Aortic Center, Hôpital Cardiologique, CHRU Lille, France
| | - S Haulon
- Aortic Center, Hôpital Cardiologique, CHRU Lille, France.
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Hertault A, Haulon S. Part One: For the Motion. Branched/Fenestrated EVAR Procedures are Better than Snorkels, Chimneys, or Periscopes in the Treatment of Most Thoracoabdominal and Juxtarenal Aneurysms. Eur J Vasc Endovasc Surg 2015; 50:551-7. [PMID: 26602952 DOI: 10.1016/j.ejvs.2015.07.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A Hertault
- Aortic Centre, CHRU de Lille, INSERM U1008, Université Lille Nord de France, Lille, 59037, France
| | - S Haulon
- Aortic Centre, CHRU de Lille, INSERM U1008, Université Lille Nord de France, Lille, 59037, France.
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Martin-Gonzalez T, Pinçon C, Maurel B, Hertault A, Sobocinski J, Spear R, Le Roux M, Azzaoui R, Mastracci T, Haulon S. Renal Outcomes Following Fenestrated and Branched Endografting. Eur J Vasc Endovasc Surg 2015; 50:420-30. [DOI: 10.1016/j.ejvs.2015.04.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 04/08/2015] [Indexed: 11/30/2022]
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Martin-Gonzalez T, Pinçon C, Maurel B, Hertault A, Sobocinski J, Spear R, Le Roux M, Azzaoui R, Mastracci T, Haulon S. Renal Outcomes Following Fenestrated and Branched Endografting. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.08.076] [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: 10/23/2022]
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Haulon S, Ohki T, Spear R, Tsilimparis N, Maeda K, Debus S, Kanaoka Y, Koelbel T. Arch Aneurysm Repair with Branched Endografts. Eur J Vasc Endovasc Surg 2015. [DOI: 10.1016/j.ejvs.2015.06.042] [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: 10/23/2022]
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Desgranges P, Kobeiter H, Katsahian S, Bouffi M, Gouny P, Favre JP, Alsac J, Sobocinski J, Julia P, Alimi Y, Steinmetz E, Haulon S, Alric P, Canaud L, Castier Y, Jean-Baptiste E, Hassen-Khodja R, Lermusiaux P, Feugier P, Destrieux-Garnier L, Charles-Nelson A, Marzelle J, Majewski M, Bourmaud A, Becquemin JP. ECAR (Endovasculaire ou Chirurgie dans les Anévrysmes aorto-iliaques Rompus): A French Randomized Controlled Trial of Endovascular Versus Open Surgical Repair of Ruptured Aorto-iliac Aneurysms. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.07.061] [Citation(s) in RCA: 2] [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: 11/29/2022]
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Desgranges P, Kobeiter H, Katsahian S, Bouffi M, Gouny P, Favre JP, Alsac J, Sobocinski J, Julia P, Alimi Y, Steinmetz E, Haulon S, Alric P, Canaud L, Castier Y, Jean-Baptiste E, Hassen-Khodja R, Lermusiaux P, Feugier P, Destrieux-Garnier L, Charles-Nelson A, Marzelle J, Majewski M, Bourmaud A, Becquemin JP. Editor's Choice – ECAR (Endovasculaire ou Chirurgie dans les Anévrysmes aorto-iliaques Rompus): A French Randomized Controlled Trial of Endovascular Versus Open Surgical Repair of Ruptured Aorto-iliac Aneurysms. Eur J Vasc Endovasc Surg 2015; 50:303-10. [DOI: 10.1016/j.ejvs.2015.03.028] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 03/12/2015] [Indexed: 12/15/2022]
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Martin-Gonzalez T, Mastracci T, Carrell T, Constantinou J, Dias N, Katsargyris A, Modarai B, Resch T, Verhoeven E, Haulon S. Mid-term Outcomes of Renal Branches versus Renal Fenestrations for Complex Aneurysm Repair. Eur J Vasc Endovasc Surg 2015. [DOI: 10.1016/j.ejvs.2015.06.041] [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: 12/01/2022]
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de Souza L, Oderich G, Textor S, Farber M, Haulon S, Banga P, Gloviczki P, Jia F. Comparison of Renal Outcomes in Matched Cohorts Treated by Zenith® Fenestrated and Zenith® AAA Stent Grafts in US Prospective Pivotal Trials. Eur J Vasc Endovasc Surg 2015. [DOI: 10.1016/j.ejvs.2015.06.029] [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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Verhoeven EL, Katsargyris A, Haulon S. Response to "Re: The Awakening of Alice". Eur J Vasc Endovasc Surg 2015; 50:826-7. [PMID: 26143099 DOI: 10.1016/j.ejvs.2015.06.005] [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] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 06/05/2015] [Indexed: 10/23/2022]
Affiliation(s)
- E L Verhoeven
- Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nürnberg, Germany.
| | - A Katsargyris
- Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nürnberg, Germany
| | - S Haulon
- Department of Vascular Surgery, Aortic Centre, CHRU Lille, France
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Hertault A, Maurel B, Midulla M, Bordier C, Desponds L, Saeed Kilani M, Sobocinski J, Haulon S. Minimizing Radiation Exposure During Endovascular Procedures: Basic Knowledge, Literature Review, and Reporting Standards. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hertault A, Maurel B, Pontana F, Martin-Gonzalez T, Spear R, Sobocinski J, Sediri I, Gautier C, Azzaoui R, Rémy-Jardin M, Haulon S. Benefits of Completion 3D Angiography Associated with Contrast Enhanced Ultrasound to Assess Technical Success after EVAR. Eur J Vasc Endovasc Surg 2015; 49:541-8. [DOI: 10.1016/j.ejvs.2015.01.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 01/19/2015] [Indexed: 01/11/2023]
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De Paoli F, Eeckhoute J, Copin C, Vanhoutte J, Duhem C, Derudas B, Dubois-Chevalier J, Colin S, Zawadzki C, Jude B, Haulon S, Lefebvre P, Staels B, Chinetti-Gbaguidi G. The neuron-derived orphan receptor 1 (NOR1) is induced upon human alternative macrophage polarization and stimulates the expression of markers of the M2 phenotype. Atherosclerosis 2015; 241:18-26. [PMID: 25941992 DOI: 10.1016/j.atherosclerosis.2015.04.798] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 04/08/2015] [Accepted: 04/22/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Atherosclerosis is an inflammatory disease in which macrophages play a crucial role. Macrophages are present in different phenotypes, with at the extremes of the spectrum the classical M1 pro-inflammatory and the alternative M2 anti-inflammatory macrophages. The neuron-derived orphan receptor 1 (NOR1), together with Nur77 and Nurr1, are members of the NR4A orphan nuclear receptor family, expressed in human atherosclerotic lesion macrophages. However, the role of NOR1 in human macrophages has not been studied yet. OBJECTIVES To determine the expression and the functions of NOR1 in human alternative macrophages. METHODS AND RESULTS In vitro IL-4 polarization of primary monocytes into alternative M2 macrophages enhances NOR1 expression in human but not in mouse macrophages. Moreover, NOR1 expression is most abundant in CD68+MR+ alternative macrophage-enriched areas of human atherosclerotic plaques in vivo. Silencing NOR1 in human alternative macrophages decreases the expression of several M2 markers such as the Mannose Receptor (MR), Interleukin-1 Receptor antagonist (IL-1Ra), CD200 Receptor (CD200R), coagulation factor XIII A1 polypeptide (F13A1), Interleukin 10 (IL-10) and the Peroxisome Proliferator-Activated Receptor (PPAR)γ. Bioinformatical analysis identified F13A1, IL-1Ra, IL-10 and the Matrix Metalloproteinase-9 (MMP9) as potential target genes of NOR1 in human alternative macrophages. Moreover, expression and enzymatic activity of MMP9 are induced by silencing and repressed by NOR1 overexpression in M2 macrophages. CONCLUSIONS These data identify NOR1 as a transcription factor induced during alternative differentiation of human macrophages and demonstrate that NOR1 modifies the alternative macrophage phenotype.
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Affiliation(s)
- F De Paoli
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - J Eeckhoute
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - C Copin
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - J Vanhoutte
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - C Duhem
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - B Derudas
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - J Dubois-Chevalier
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - S Colin
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - C Zawadzki
- Université Lille 2, F-59000 Lille, France; Centre Hospitalier Régional Universitaire de Lille, France
| | - B Jude
- Université Lille 2, F-59000 Lille, France; Centre Hospitalier Régional Universitaire de Lille, France
| | - S Haulon
- Centre Hospitalier Régional Universitaire de Lille, France
| | - P Lefebvre
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - B Staels
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France.
| | - G Chinetti-Gbaguidi
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France; INSERM, U 1081, Institute for Research on Cancer and Aging of Nice (IRCAN), "Aging and Diabetes" team, France; University of Nice-Sophia Antipolis, Nice, France; Clinical Chemistry Laboratory, University Hospital, Nice, France
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Verhoeven E, Katsargyris A, Haulon S. Caveat Emptor: Lessons Learned from the Endovascular Treatment of Complex Aortic Pathologies. Eur J Vasc Endovasc Surg 2015; 49:363-5. [DOI: 10.1016/j.ejvs.2014.12.001] [Citation(s) in RCA: 6] [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] [Received: 12/01/2014] [Accepted: 12/01/2014] [Indexed: 11/25/2022]
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Maurel B, Sobocinski J, Spear R, Azzaoui R, Koussa M, Prat A, Tyrrell MR, Hertault A, Haulon S. Current and future perspectives in the repair of aneurysms involving the aortic arch. J Cardiovasc Surg (Torino) 2015; 56:197-215. [PMID: 25644831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The repair of aneurysms involving the aortic arch is technically and physiologically demanding. Historically, these aneurysms have been treated using open surgical techniques that require cardiopulmonary bypass and deep hypothermic circulatory arrest. Many patients have been deemed "untreatable" and among those selected for surgery there are reported risks of death in 2% to 16.5% and stroke rates ranging from 2% to 18%. "Hybrid arch repair" combines one of a number of open surgical procedures (to secure a proximal landing zone for an endograft) with subsequent or immediate placement of an endograft in the arch and descending aorta. Although this concept is described as "minimally invasive" because it avoids aortic cross-clamping and hypothermic circulatory arrest, the morbidity and mortality rates remain considerable (mortality 0% to 15%, stroke 0% to 11%). Ongoing development of endograft technology has enabled total endovascular repair of complex aortic aneurysms involving the visceral segment, using fenestrated and branched endografts. Encouraging early results in this anatomy have inspired extension of the concept to include the aortic arch and great vessels. These strategies can be considered in patients generally at high-risk for the conventional procedures. However, the endeavour is at an early stage of its development and the arch poses unique challenges including the potential for stroke, angulation of the arch and the great vessel ostia to the arch, extremely high volume flow, three-dimensional pulsation and rotation with the cardiac cycle and the proximity of the aortic valve and coronary arteries.
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Affiliation(s)
- B Maurel
- Vascular and Cardiac Surgery, Aortic Centre, Hôpital Cardiologique, CHRU de Lille, France -
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Maurel B, Delclaux N, Sobocinski J, Hertault A, Martin-Gonzalez T, Moussa M, Spear R, Le Roux M, Azzaoui R, Tyrrell M, Haulon S. The Impact of Early Pelvic and Lower Limb Reperfusion and Attentive Peri-operative Management on the Incidence of Spinal Cord Ischemia During Thoracoabdominal Aortic Aneurysm Endovascular Repair. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.01.011] [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: 12/01/2022]
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Chinetti-Gbaguidi G, Copin C, Derudas B, Vanhoutte J, Zawadzki C, Jude B, Haulon S, Pattou F, Marx N, Staels B. The coronary artery disease-associated gene C6ORF105 is expressed in human macrophages under the transcriptional control of PPARγ. FEBS Lett 2015; 589:461-6. [PMID: 25595457 DOI: 10.1016/j.febslet.2015.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/17/2014] [Accepted: 01/02/2015] [Indexed: 11/27/2022]
Abstract
Coronary artery disease (CAD) is a major cause of morbidity and mortality. Mutations in C6ORF105, associated with decreased gene expression, positively correlate with the risk of CAD in Chinese populations. Moreover, the C6ORF105-encoded protein may play a role in coagulation. Here, we report that C6ORF105 gene expression is lower in circulating mononuclear cells from obese diabetic than lean subjects. Moreover, C6ORF105 is expressed in human macrophages and atherosclerotic lesions, where its expression positively correlates with expression of the transcription factor Peroxisome Proliferator-Activated Receptor (PPAR)γ. Activation of PPARγ increases, in a PPARγ-dependent manner, the expression of C6ORF105 in human macrophages and atherosclerotic lesions.
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Affiliation(s)
- G Chinetti-Gbaguidi
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - C Copin
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - B Derudas
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - J Vanhoutte
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - C Zawadzki
- Université Lille 2, F-59000 Lille, France; Centre Hospitalier Régional Universitaire de Lille, France
| | - B Jude
- Université Lille 2, F-59000 Lille, France; Centre Hospitalier Régional Universitaire de Lille, France
| | - S Haulon
- Centre Hospitalier Régional Universitaire de Lille, France
| | - F Pattou
- Université Lille 2, F-59000 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France; Centre Hospitalier Régional Universitaire de Lille, France; Department of Endocrine Surgery, University Hospital, F-59000 Lille, France
| | - N Marx
- Department of Internal Medicine I, University Hospital Aachen, D-52074 Aachen, Germany
| | - B Staels
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France.
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Delloye M, Maurel B, Spear R, Hertault A, Azzaoui R, Tyrrell M, Sobocinski J, Haulon S. Aortic Rupture During a Staged Endovascular Repair of a Thoracoabdominal Aneurysm. EJVES Short Rep 2015. [DOI: 10.1016/j.ejvssr.2015.07.002] [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: 11/24/2022] Open
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43
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Martin Gonzalez T, Maurel B, Sobocinski J, Le Roux M, Azzaoui R, Tyrrell M, Haulon S. Management and fate of renal arteries during endovascular pararenal and thoracoabdominal aneurysm repair. INT ANGIOL 2014; 33:499-510. [PMID: 24945919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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44
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Barillà D, Sobocinski J, Stilo F, Maurel B, Spinelli F, Haulon S. Juxtarenal aortic aneurysm with hostile neck anatomy: midterm results of minilaparotomy versus f-EVAR. INT ANGIOL 2014; 33:466-473. [PMID: 25294289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this study was to compare the results of complex aneurysm (hostile neck anatomies) repair in high-risk patients with two minimally invasive techniques, fenestrated endografting (f-EVAR where EVAR stands for endovascular aneurysm repair) and minilaparotomy. METHODS All high-risk patients (N.=50, group 1) with hostile neck abdominal aortic aneurysms (AAAs) operated in the vascular surgery department of the "Policlinico Universitario G. Martino" of Messina (Italy) during a 5-year period (January 2006-December 2010) were cross-matched with 50 similar patients (group 2) treated in the Vascular Surgery Department of the "Hopital Cardiologique" University of Lille (France) with similar anatomies, comorbidities and risk factors. The patients in group 1 underwent open minilaparotomy surgery, and the patients in group 2 were treated with f-EVAR. The aim of our study was to compare perioperative complications, survival and reintervention rates. RESULTS Perioperative cardiac complications occurred in 5 patients (10%) in group 1, and 1 patient (2%) in group 2 (P<0.092). Renal impairment not requiring permanent hemodialysis was significantly higher in group 1 (14% vs. 2% P<0.027), as well as respiratory complications (32% vs. 2% P<0.0001). Five patients (10%) in group 1 underwent reintervention vs. 4 patients in group 2 (P<0.7268). There was no statistically significant difference for survival rates at 30 days (92% in group 1 and 96% in group 2; P=0.399); at six months (90% vs. 96%; P=0.239); at one year (90% vs. 96%; P=0.239); and at two years (84% vs. 94%; P=0.110). However, we observed statistically significant differences in survival rates at three years (74% vs. 94%; P<0.006); at four years (70% vs. 86%; P<0.005); and at five years (65% vs. 68%; P<0.003). CONCLUSION Our results showed that both techniques are effective in the treatment of AAA with hostile neck in high-risk patients. Although operative mortality rate was not statistically different, f-EVAR showed better results in terms of early complications and late survival.
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Affiliation(s)
- D Barillà
- Vascular Surgery, Policlinico Universitario G. Martino, Messina, Italy -
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45
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Gonzalez T, Maurel B, Sobocinski J, Hertault A, Pinçon C, Spear R, Le Roux M, Azzaoui R, Haulon S. Renal Outcomes Following Fenestrated and Branched Endografting. Eur J Vasc Endovasc Surg 2014. [DOI: 10.1016/j.ejvs.2014.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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46
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Sobocinski J, Spear R, Tyrrell MR, Maurel B, Martin Gonzalez T, Hertault A, Midulla M, Azzaoui R, Haulon S. Chronic dissection - indications for treatment with branched and fenestrated stent-grafts. J Cardiovasc Surg (Torino) 2014; 55:505-517. [PMID: 24975737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The treatment of chronic aortic dissection is a major challenge for the vascular surgeon. Close imaging follow-up after the acute episode frequently identifies dilation of untreated aortic segments. Aortic dissection often extends to both the supra-aortic trunks and to the visceral aorta. The poor medical condition that often characterizes these patients may preclude extensive open surgical repair. Recent advances in endovascular techniques provide a valid alternative to open surgery. These complex lesions can now be managed using thoracic branched and fenestrated endografts. However, clinical data are scarce and only 3 small series from 3 high-volume aortic centers are currently available. Careful anatomical study on 3D workstations is mandatory to select patients that are candidates for complex endovascular exclusion; a specific focus on the available working space within the true lumen, extension to the arch and/or the visceral/renal arteries, and false lumen perfusion of visceral vessels is required. An excellent understanding of those anatomic details demands high-quality preoperative CTA. Intraoperative advanced imaging applications are a major adjunct in the achievement of technical success.
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Affiliation(s)
- J Sobocinski
- Aortic Centre, Hôpital Cardiologique CHRU Lille, France -
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47
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Guillou M, Bianchini A, Hertault A, D'Elia P, Pottrain N, Sobocinski J, Maurel B, Azzaoui R, Tyrrell M, Haulon S. A new score to predict post operative complications after endovascular treatment of thoraco abdominal aortic aneurysms. Acta Chir Belg 2014; 114:250-255. [PMID: 26021420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The endovascular treatment of thoraco abdominal aortic aneurysms (TAAA) is a minimally invasive solution. However, patient selection remains a major problem. We have analysed our experience to identify the risk factors for post-operative morbidity and mortality and to construct a scoring system to identify those patients likely to benefit from this treatment. METHODS We have analysed a consecutive cohort of patients treated electively for TAAA using endovascular techniques between 2006 and October 2012. All data were collected prospectively. The risk factors associated with spinal cord ischemia (SCI), the need for post-operative dialysis and 30 day mortality were determined using multivariate statistical techniques and a logistic regression model including all variables that were significant on univariate analysis (p < 0.05). A predictive score was calculated using a Received Operating Characteristic (ROC) curve, defining best specificity and sensibility. RESULTS We analysed the data from 123 patients (median age 70 years). The 30 day mortality rate was 8% (10 patients). The SCI rate was 6% (7 patients). One patient (1%) required long-term dialysis after the aortic procedure. The cumulative early mortality, SCI and permanent dialysis rate was 14% (17 patients). In multivariate analysis, adverse outcome was associated with advanced age (OR = 1.110 ; p = 0.022), and Crawford type I or II or III (OR = 9.292 ; p = 0.002) as compared with Crawford type IV. Pre-operative beta blocker (BB) treatment was a protective factor (OR = 0.099 ; p = 0.005). A predictive score was then constructed : Score = -10.060 + 0.104x(A) +2.229x(B) -2.315x(C) (A = patient age ; B = 1 if TAAA Crawford type 1, 2 or 3, 0 if TAAA type 4 ; C = 1 if on-going BB treatment (30 days pre-surgery minimum), 0 if none). Its sensitivity and specificity were 88% and 89% respectively. CONCLUSIONS We propose a simple predictive scoring system. This tool is useful in predicting the most feared complications after endovascular TAAA repair and has potential use in the identification and counselling of vulnerable patients being considered for surgery. More data are needed to refine the prediction of individual operative risks.
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Affiliation(s)
- M Guillou
- Vascular Surgery, Hôpital Cardiologique, CHRU de Lille, France
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Rosset E, Ben Ahmed S, Galvaing G, Favre J, Sessa C, Lermusiaux P, Hassen-Khodja R, Coggia M, Haulon S, Rinckenbach S, Enon B, Feugier P, Steinmetz E, Becquemin J. Hybrid Treatment of Thoracic, Thoracoabdominal, and Abdominal Aortic Aneurysms: A Multicenter Retrospective Study. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2014.03.247] [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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49
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Maurel B, Hertault A, Sobocinski J, Le Roux M, Gonzalez TM, Azzaoui R, Saeed Kilani M, Midulla M, Haulon S. Techniques to reduce radiation and contrast volume during EVAR. J Cardiovasc Surg (Torino) 2014; 55:123-131. [PMID: 24796905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
There is a large variability observed in the literature regarding radiation exposure and contrast volume injection during endovascular aortic repair (EVAR). Reducing both in order to decrease their respective toxicities must be a priority for the endovascular therapist. Radiation dose reduction requires a strict application of the "as low as reasonably achievable" principles. Firstly, all X-ray system settings should be defaulted to low dose, and fluoroscopic time reduced as much as possible. Digital subtraction angiography runs should be replaced by recorded fluoroscopy runs when possible. Magnification should be avoided, whereas collimation should be systematic to minimize scatter radiation and focus only on the area of interest. Advanced imaging modes can also contribute to dose reduction. For instance, image fusion can facilitate endovascular navigation, and allow table and C-arm positioning without fluoroscopy. In our experience, routine use of image fusion during EVAR significantly reduces both radiation exposure and contrast volumes during complex EVAR. To make these imaging modes useable in real life settings, the X-ray system should be fully controlled by the operator from table side. Reducing iodinated contrast volume, while maintaining image quality, can also be achieved through the use of automated contrast injectors. Additionally, alternative contrast agents, like carbon dioxide (CO2) and gadolinium, have also been evaluated and can be used in specific cases. Contrast-enhanced ultrasound and intravascular ultrasonography are currently developed as potential alternatives to both iodinated contrast use and X-ray during EVAR. Lastly, specific education and training of operators in radiation protection are essential.
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Affiliation(s)
- B Maurel
- Departments of Vascular Surgery Hôpital Cardiologique, CHRU Lille, France -
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50
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Rosset E, Ben Ahmed S, Galvaing G, Favre JP, Sessa C, Lermusiaux P, Hassen-Khodja R, Coggia M, Haulon S, Rinckenbach S, Enon B, Feugier P, Steinmetz E, Becquemin JP. Editor's choice--hybrid treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms: a multicenter retrospective study. Eur J Vasc Endovasc Surg 2014; 47:470-8. [PMID: 24656593 DOI: 10.1016/j.ejvs.2014.02.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aim of this study was to assess the results of hybrid techniques for the treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms based on multicenter results and the various series regarding hybrid procedures reported in the literature. METHODS The results of 76 hybrid procedures performed in 19 French university hospital centers between November 2001 and October 2011 were collected. There were 50 men and 26 women, mean age 68.2 (35-86) years. All patients were considered at high risk (ASA≥3) for conventional surgery. Aneurysms involved the thoracic, abdominal, and thoracoabdominal aorta in five, 14, and 57 cases respectively. There were 11 emergent repairs. The revascularization of four visceral arteries was performed in 38 cases. Between one and three visceral arteries were revascularized in the other cases. Visceral artery debranching and stent graft deployment were performed in a one-stage procedure in 53 cases and in a two-stage procedure in 23 cases. RESULTS There were 26 (34.2%) postoperative deaths. Nine of the survivors developed paraplegia, of which one resolved completely. Bowel ischemia occurred in 13 cases (17.1%), and one patient was treated by a superior mesenteric artery bypass. Four patients required long-term hemodialysis. Postoperative computed tomography scan showed a type II endoleak in two patients. CONCLUSIONS Morbidity and mortality in this study were greater than previously reported. Candidates for hybrid aortic repair should be carefully selected.
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