Publications by authors named "Emmanuel De Maistre"

Introduction: The entity entitled bleeding disorder of unknown cause (BDUC) qualifies individuals displaying a mild haemorrhagic profile but normal routine coagulation tests. This study was designed to evaluate whether collagen-binding assay for von Willebrand Factor (VWF) measurement (VWF:CB) could allow to diagnose VW disease in such patients.

Methods: A large screening was conducted prospectively in two University Hospitals, using the bleeding assessment tool (BAT) recommended by the International Society of Thrombosis and Hemostasis.

View Article and Find Full Text PDF

Around 10% of patients with acute coronary syndrome are treated by vitamin K antagonists or non-vitamin K antagonist oral anticoagulants for various indications. The initial management of these patients is highly complex, and new guidelines specify that, only during percutaneous coronary intervention, a bolus of unfractionated heparin is recommended in one of the following circumstances: (1) if the patient is receiving a non-vitamin K antagonist oral anticoagulant; or (2) if the international normalized ratio is<2.5 in a patient being treated with a vitamin K antagonist.

View Article and Find Full Text PDF
Article Synopsis
  • More people are taking a type of medicine called DOAC, and sometimes they need immediate help if they bleed a lot or need surgery.
  • There are special medicines called antidotes like idarucizumab for dabigatran and andexanet alfa for other DOACs to stop the effects quickly.
  • It's important to measure how much DOAC is in a person's blood to know if they need these antidotes, but sometimes the tests can be confusing after using the antidotes, so more research is needed on how to manage this well.
View Article and Find Full Text PDF

COVID-19, caused by the SARS-CoV-2 virus, has revealed a complex interplay between inflammation and coagulation, leading to the emergence of the concept of thrombo-inflammation. This concept recognizes that COVID-19 is not solely a respiratory illness, but a systemic disease with significant vascular and hematological components. COVID-19 is associated with an unusual prothrombotic state, with intense endothelial activation leading to vasculopathy, cytokine storm, complement system activation and a hypercoagulability state (the activation of platelets and the coagulation cascade, impaired fibrinolysis).

View Article and Find Full Text PDF

Background: In case of heparin-induced thrombocytopenia (HIT), the switch to a non-heparin anticoagulant is mandatory, at a therapeutic dose. Such a treatment has limitations though, especially for patients with renal and/or hepatic failure. Candidate laboratory tests could detect the more coagulable HIT patients, for whom therapeutic anticoagulation would be the more justified.

View Article and Find Full Text PDF

Background: Women with hereditary fibrinogen disorders (HFDs) seem to be at an increased risk of adverse obstetrical outcomes, but epidemiologic data are limited.

Objectives: We aimed to determine the prevalence of pregnancy complications; the modalities and management of delivery; and the postpartum events in women with hypofibrinogenemia, dysfibrinogenemia, and hypodysfibrinogenemia.

Methods: We conducted a retrospective and prospective multicentric international study.

View Article and Find Full Text PDF
Article Synopsis
  • Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) can lead to severe bleeding and high mortality, particularly among patients requiring decompressive surgery post-COVID vaccination.
  • A study reviewed 128 CVST-VITT patients, finding that 27% underwent surgery, with a 65% in-hospital mortality rate in this group compared to 29% in non-surgical patients, highlighting factors like preoperative coma and pupillary reflex absence as key mortality predictors.
  • Despite the high mortality, around 80% of the surgical survivors were functionally independent at a 6-month follow-up, indicating some potential for recovery even after critical interventions.
View Article and Find Full Text PDF

Complicated pregnancies are nowadays a major public health concern, with possible lethality or sequelae both for the mother and the fetus. Blood coagulation disorders (including antiphospholipid syndrome, factor V Leiden mutation and antithrombin deficiency) and hypertensive gestational disorders are very well-known contributors of complicated pregnancies with poor fetal outcome, such as intrauterine growth retardation (IUGR) and fetal demise. Less commonly, vascular malformations of the placenta can also potentially lead to serious complications such as IUGR and fetal death.

View Article and Find Full Text PDF

Two main types of oral anticoagulants are available in France: vitamin K antagonists (VKA) and, more recently, direct oral anticoagulants (DOAC). The benefit−risk profile appears to be favorable for DOAC, which is as effective as VKA but safer (fewer cases of severe and cerebral bleeding). In a study in 2017, we observed that older adults did not seem to receive the same modalities of oral anticoagulants as younger individuals for various reasons.

View Article and Find Full Text PDF

Nanoparticles capable of mimicking natural tissues represent a major technological advancement in regenerative medicine. In this pilot study, the development of a new nanohybrid composed of titanate nanoribbons to mimic the extracellular matrix is reported. During the first phase, nanoribbons were synthesized by hydrothermal treatment.

View Article and Find Full Text PDF

Background: Patients treated with direct oral anticoagulants (DOACs) may require urgent procedures. Managing these patients is challenging due to different bleeding risks and may include laboratory testing, procedural delays, or haemostatic/reversal agent administration.

Objective: We evaluated management strategies and outcomes of urgent, non-haemostatic invasive procedures in patients treated with DOACs.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the treatment of cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) following adenovirus-based COVID-19 vaccinations.
  • Researchers analyzed data from 99 patients across 17 countries to assess adherence to recommended treatments, including immunomodulation and avoiding certain anticoagulants.
  • While overall adherence to these treatment guidelines did not significantly impact mortality, patients who received immunomodulation showed lower mortality rates compared to those who did not.
View Article and Find Full Text PDF

Introduction: Thrombin generation (TG) documents hypercoagulability. TG in platelet-poor plasma is exquisitely sensitive to heparins, which thus must be neutralized before testing. Heparinase and hexadimethrine bromide (polybrene) have been used for that purpose, but their effects per se on TG have been poorly studied so far.

View Article and Find Full Text PDF
Article Synopsis
  • - The study focuses on patients who developed cerebral venous sinus thrombosis (CVST) after receiving SARS-CoV-2 vaccines, specifically ChAdOx1 (Oxford-AstraZeneca) and Ad26.COV2.S (Johnson & Johnson), particularly looking at those with thrombosis with thrombocytopenia syndrome (TTS) versus those without.
  • - Data was gathered from an international registry from 81 hospitals spanning 19 countries, highlighting the clinical characteristics and mortality rates of patients with CVST in relation to their vaccination status.
  • - Of 116 postvaccination CVST patients, 67.2% had TTS, predominantly after the ChAdOx1 vaccine, with a notable percentage of female patients and
View Article and Find Full Text PDF

COVID-19 displays distinct characteristics that suggest a unique pathogenesis. The objective of this study was to compare biomarkers of coagulopathy and outcomes in COVID-19 and non-COVID-19 patients with severe pneumonia. Thirty-six non-COVID-19 and 27 COVID-19 non-immunocompromised patients with severe pneumonia were prospectively enrolled, most requiring intensive care.

View Article and Find Full Text PDF

Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) in patients on oral anticoagulants (OAC) remains a clinical conundrum. In fact, combining an OAC with dual antiplatelet therapy (triple antithrombotic therapy, TAT) increases the risk of bleeding. Clopidogrel is the only thienopyridine recommended in TAT patients.

View Article and Find Full Text PDF