Background: Neovascularisation of carotid plaques contributes to their vulnerability. Current imaging methods such as contrast-enhanced ultrasound (CEUS) usually lack the required spatial resolution and quantification capability for precise neovessels identification. We aimed at quantifying plaque vascularisation with ultrasound localization microscopy (ULM) and compared the results to histological analysis.
View Article and Find Full Text PDFBackground: To quantify the volumetric aortic remodeling of patients with acute type B aortic dissection treated with the stent-assisted balloon-induced intimal disruption and relamination (STABILISE) technique.
Methods: All patients with acute type B aortic dissection operated with the STABILISE technique between 2014 and 2017 with preoperative, postoperative, and >12 months (follow-up) computed tomography scans were included in this study. True lumen and total aortic volume were accurately assessed in the thoracic and abdominal portions with a semiautomatic three-dimensional tool.
Objective: Due to its favorable outcome regarding late morbidity and mortality, thoracic endovascular repair (TEVAR) is becoming more popular for uncomplicated type B aortic dissection (TBAD). This study aimed to compare preemptive endovascular treatment and optimal medical treatment (OMT) and OMT alone in patients presenting uncomplicated TBAD with predictors of aortic progression.
Design: Retrospective multicenter study.
Backgroud: The learning curve and midterm results of aortoiliac occlusive disease (AIOD) revascularization by robot-assisted laparoscopic (RAL) surgery may be known.
Methods: A prospective single-center study was conducted in the vascular surgery department of Georges Pompidou European Hospital (Paris, France). Patients with AIOD treated by RAL from February 2014 to February 2019 were included.
Comput Methods Programs Biomed
February 2024
Background And Objective: Endovascular aortic aneurysm repair (EVAR) has become the standard treatment for abdominal aortic aneurysms in most centers. However, proximal sealing complications leading to endoleaks and migrations sometimes occur, particularly in unfavorable aortic anatomies and are strongly dependent on biomechanical interactions between the aortic wall and the endograft. The objective of the present work is to develop and validate a computational patient-specific model that can accurately predict these complications.
View Article and Find Full Text PDFAims: IgE type immunoglobulins and their specific effector cells, mast cells (MCs), are associated with abdominal aortic aneurysm (AAA) progression. In parallel, immunoglobulin-producing B cells, organised in tertiary lymphoid organs (TLOs) within the aortic wall, have also been linked to aneurysmal progression. We aimed at investigating the potential role and mechanism linking local MCs, TLO B cells, and IgE production in aneurysmal progression.
View Article and Find Full Text PDFBackground: The management of residual aortic dissection after initial type A repair with the Frozen elephant trunk technique remains mostly unexplored. This work aimed to evaluate endovascular second-stage surgery for patients with residual aortic dissection.
Methods: A retrospective analysis of consecutive patients that underwent Type A aortic repair with Frozen elephant trunk, followed by a second-stage endovascular procedure was done from March 2016 to December 2021.
Objective: A proximal scallop design allows aortic arch repair without complex endovascular manipulation in the aortic arch. The aim was to assess the safety and efficacy at one year of the Relay proximal scallop stent graft.
Methods: A prospective multicentre study evaluated consecutive patients treated with the Relay proximal scallop stent graft in 10 French aortic centres.
We report the case of a 70-year-old woman who presented with a ruptured infective native thoracic aortic aneurysm (INTAA), associated with spondylodiscitis and posterior mediastinitis. She underwent a staged hybrid repair: urgent thoracic endovascular aortic repair was first performed as a bridge therapy in the context of septic shock. Allograft repair using cardiopulmonary bypass was performed five days later.
View Article and Find Full Text PDFObjective: To report clinical outcomes of COVID-19 related acute aortic thrombosis (AAT).
Methods: Consecutive COVID-19 patients presenting with AAT between April 2020 and August 2021 were included retrospectively. Clinical and radiological data were prospectively collected.
Background: COVID-19 infection is associated not only with venous thromboses but also with arterial thromboses (COV-ATs) in relation with an endothelial dysfunction, a coagulopathy and rhythm disorders. The incidence, the topography, and the prognosis of COV-ATs remain poorly known. The objective of this study was to report the overall experience of the Greater Paris University Hospitals (Assistance Publique - Hopitaux de Paris, AP-HP) during the first pandemic wave of COVID-19 infection.
View Article and Find Full Text PDFAORTIC DISSECTION AFTER THE ACUTE PHASE After the acute phase, it is imperative that patients who have presented with aortic dissection can be followed clinically and morphologically. The antihypertensive medical treatment must be adapted, and the dissected aorta must be monitored by CT scans, given the risk of aneurysmal development and secondary rupture it represents. Certain predictive factors of aneurysmal progression could make it possible to offer a subgroup of patients at risk a more aggressive surgical management of their aortic dissection, using endovascular procedures currently under evaluation.
View Article and Find Full Text PDFA FILIARISATION OF THE MANAGEMENT OF AORTIC DISSECTIONS IN ÎLE DE FRANCE Creation of a dedicated Aortic network for patients with an aortic emergency in Ile de France, via the SOS AORTE program, not only improves the times of immediate care and their 30-day mortality, but also offers a specialized and multidisciplinary follow-up, dedicated to chronic aortic pathology. The multidisciplinary "Aortic team" of cardiologists, radiologists, resuscitators, cardiac and vascular surgeons optimizes the patient's chances of benefiting from the most suited treatment to the type of dissection and its complications. After the acute phase, specialized rehabilitation to stress, psychological support and patient's education about his aortic pathology, allow his resumption of activity in the best conditions.
View Article and Find Full Text PDFACUTE AORTIC DISSECTION Acute aortic dissection is the most common and dramatic of aortic emergencies. The many complications that it generates, such as rupture or malperfusion, make it a complex pathology to be managed in the context of an emergency, which requires many medical and surgical skills. Its medical management is based on the control of arterial pressure, and its surgical treatment on the replacement of the ascending aorta when damaged, or the endovascular repair of the descending thoracic aorta by aortic stentgraft.
View Article and Find Full Text PDFInt J Cardiol Congenit Heart Dis
March 2022
Background: The use of covered stents (CVS) in congenital heart disease (CHD) interventions is increasing but intrinsic properties of commercially available material remain not optimal. The Optimus-CVS™ (AndraTec GmbH, Koblenz, Germany) is a new balloon-expandable, non-premounted, Cobalt-Chromium stent with patented hybrid-cell design, innovative end-free Nano-PTFE sandwich-covering, and competitive deliverability features.
Methods And Results: Three patients with CHD received Optimus-CVS during December 2020 at our institution.
Background: For same-day discharge lower extremity arterial disease (LEAD) endovascular procedures, femoral manual compression could be an alternative to arterial closure devices. The aim of this study was to assess the security and efficacy of same-day discharge after manual compression in patients treated for LEAD endovascular revascularization with 5F sheath.
Methods: FREEDOM OP was a national multicenter, prospective, single arm study.
Ultrafast ultrasound imaging (UUI) provides an estimation of carotid plaque stiffness by shear wave elastography (SWE) and the quantification of wall shear stress (WSS) by ultrafast Doppler. We aimed to evaluate the combined criteria of plaque stiffness and WSS applied on the plaque as potential biomarkers of plaque vulnerability assessed by histology. We included patients for whom carotid endarterectomy had been decided by a multidisciplinary team.
View Article and Find Full Text PDFPurpose: Restenosis remains a limitation of endovascular angioplasty with a patency of 30% in BTK at 12 months. Several studies on drug-coated balloons have not demonstrated any improvements in terms of patency and target lesions revascularization in BTK lesions. This prospective single-centre cohort study evaluates the safety and efficacy of a new generation low-dose drug-coated balloon (DCB) with a reduced crystalline structure to treat below the knee (BTK) lesions in patients with critical limb ischemia (CLI).
View Article and Find Full Text PDFBackground: Coronavirus disease 2019 (COVID-19) has been associated with coagulation disorders, in particular high concentrations of D-dimer, and increased frequency of venous thromboembolism.
Aim: To explore the association between D-dimer at admission and in-hospital mortality in patients hospitalised for COVID-19, with or without symptomatic venous thromboembolism.
Methods: From 26 February to 20 April 2020, D-dimer concentration at admission and outcomes (in-hospital mortality and venous thromboembolism) of patients hospitalised for COVID-19 in medical wards were retrospectively analysed in a multicenter study in 24 French hospitals.
Background Coronavirus disease 2019 (COVID-19) is a respiratory disease associated with thrombotic outcomes with coagulation and endothelial disorders. Based on that, several anticoagulation guidelines have been proposed. We aimed to determine whether anticoagulation therapy modifies the risk of developing severe COVID-19.
View Article and Find Full Text PDFIEEE Trans Ultrason Ferroelectr Freq Control
June 2021
Doppler ultrasound is the premier modality to analyze blood flow dynamics in clinical practice. With conventional systems, Doppler can either provide a time-resolved quantification of the flow dynamics in sample volumes (spectral Doppler) or an average Doppler velocity/power [color flow imaging (CFI)] in a wide field of view (FOV) but with a limited frame rate. The recent development of ultrafast parallel systems made it possible to evaluate simultaneously color, power, and spectral Doppler in a wide FOV and at high-frame rates but at the expense of signal-to-noise ratio (SNR).
View Article and Find Full Text PDFObjectives: Our goal was to study the immediate outcome after an emergency frozen elephant trunk procedure with a Thoraflex™ Hybrid prosthesis (THP) in patients included in the EPI-Flex national registry and operated on in 21 French centres.
Methods: All patients operated on in France between April 2016 and April 2019 for acute aortic syndromes and who had an frozen elephant trunk procedure with a THP were included in the study. The main end point was in-hospital mortality.