1
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Grandjean F, Brisbois D. [Post-traumatic ileal branch pseudoaneurysm]. Rev Med Liege 2022; 77:199-201. [PMID: 35389001] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Arterial aneurysms of visceral branches are rare, even more if they occur on the superior mesenteric artery and its branches (among which ileal branches). Rupture is its major complication, thus rapid treatment is mandatory. CT angiography is the gold standard for diagnosis and therapeutic planification. Usual treatment is surgical, even though percutaneous embolization can be safely and precisely performed. Use of coils with sandwich technique is preferred.
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Affiliation(s)
- F Grandjean
- Service de Radiologie et d'Imagerie Médicale, CHC MontLégia, Liège, Belgique
| | - D Brisbois
- Service de Radiologie et d'Imagerie Médicale, CHC MontLégia, Liège, Belgique
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2
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Jamoulle JF, Brisbois D. [Lipoleiomyoma : rare tumor of the uterus]. Rev Med Liege 2020; 75:137-139. [PMID: 32157835] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Uterine lipoleiomyoma is a rare and benign pathology whose etiopathogenesis is still poorly understood. Benign cystic teratoma of the ovary constitutes its main and primordial differential diagnosis because of the different treatments. Pelvic MRI is the best imaging technique to confirm the diagnosis.
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Affiliation(s)
| | - D Brisbois
- Service d'Imagerie médicale, CHC Saint-Joseph, Liège, Belgique
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3
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Houbiers A, Brisbois D, Cornet O, Reginster P. [Symtomatic giant non-ruptured cerebral aneurysm]. Rev Med Liege 2019; 74:497-498. [PMID: 31609550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- A Houbiers
- Service d'Imagerie médicale, CHC Saint-Joseph, Liège, Belgique
| | - D Brisbois
- Service d'Imagerie médicale, CHC Saint-Joseph, Liège, Belgique
| | - O Cornet
- Service d'Imagerie médicale, CHC Saint-Joseph, Liège, Belgique
| | - P Reginster
- Service d'Imagerie médicale, CHC Saint-Joseph, Liège, Belgique
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4
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Van Kerkhoven C, El Abd K, Maton P, Brisbois D, Thimmesch M. [Image of the month. Pulmonary arteriovenous malformation: neonatal presentation of Rendu-Osler disease]. Rev Med Liege 2019; 74:173-174. [PMID: 30997964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
| | - K El Abd
- CHC Clinique de l'Espérance, Montegnée, Belgique
| | - P Maton
- CHC Clinique Saint-Vincent, Rocourt, Belgique
| | | | - M Thimmesch
- CHC Clinique de l'Espérance, Montegnée, Belgique
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5
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Thimmesch M, El Abd K, Brisbois D, Khamis J, Lewin M, Philippet P. [Hereditary hemorrhagic telangiectasia and pulmonary arteriovenous malformations in children]. Rev Med Liege 2016; 71:537-540. [PMID: 28387092] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hereditary hemorrhagic telangiectasia is a constitutional vascular dysplasia characterized by chronic epistaxis, mucocutaneous and visceral telangiectasias and arteriovenous malformations. Apart from family screenings, the disease is rarely diagnosed during the pediatric age given the late advent of typical clinical symptoms. Nevertheless, arteriovenous malformations are sometimes already present at a young age with significant morbidity risk. Therefore, it is important to establish an early diagnosis. We describe two pediatric cases of hereditary hemorrhagic telangiectasia and pulmonary arteriovenous malformations with divergent clinical presentation.
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Affiliation(s)
- M Thimmesch
- Chef de Département de Pédiatrie, CHC Clinique de l'Espérance, 4420 Montegnée, Belgique
| | - K El Abd
- Chef de Département de Pédiatrie, CHC Clinique de l'Espérance, 4420 Montegnée, Belgique
| | - D Brisbois
- CHC Clinique Saint-Joseph, 4000 Liège, Belgique
| | - J Khamis
- CHC Clinique de l'Espérance, 4420 Montegnée, Belgique
| | - M Lewin
- CHC Clinique de l'Espérance, 4420 Montegnée, Belgique
| | - P Philippet
- Chef de Département de Pédiatrie, CHC Clinique de l'Espérance, 4420 Montegnée, Belgique
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6
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Mertens R, Blampain JP, Boly J, Brisbois D, Buche M, Wispelaere5 JFD, Dorthu L, George A, Joris J, Kichouh M, Thomas T, Wantier M. Practice Variability in the Management of Subrenal Arterial Stenoses in Seven Belgian Hospitals. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2005.11679689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- R. Mertens
- Initiatives de Qualité [Quality Initiatives], Alliance Nationale des Mutualités Chrétiennes
| | - J. P. Blampain
- Sce de Chirurgie Vasculaire, Hôpital St-Joseph, Ste-Therese et IMTR, Gilly
| | - J. Boly
- Initiatives de Qualité [Quality Initiatives], Alliance Nationale des Mutualités Chrétiennes
| | - D. Brisbois
- Sce de Radiologie, Les Cliniques St-Joseph, Liège
| | - M. Buche
- Sce de Chirurgie Vasculaire, Clinique Universitaire de Mont-Godinne
| | | | - L. Dorthu
- Sce de Radiologie, Centre Hospitalier Peltzer La Tourelle, Verviers
| | - A. George
- Initiatives de Qualité [Quality Initiatives], Alliance Nationale des Mutualités Chrétiennes
| | - J.P. Joris
- Sce de Radiologie, Clinique St-Luc, Bouge
| | - M. Kichouh
- Sce de Radiologie, Clinique St-Luc, Bouge
| | - T. Thomas
- Sce de Chirurgie Vasculaire, Hôpital de Jolimont, Haine-St-Paul
| | - M. Wantier
- Initiatives de Qualité [Quality Initiatives], Alliance Nationale des Mutualités Chrétiennes
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7
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Desfontaines P, Brisbois D, Onclinx N, Daout C, Cornet O, Dieudonné L, Windhausen K, Maertens de Noordhoudt A. Rescue thrombectomy after failure of intravenous thrombolysis in acute ischemic stroke: Preliminary results of a multicenter prospective observational study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.950] [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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8
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Lubicz B, Mine B, Collignon L, Brisbois D, Duckwiler G, Strother C. WEB device for endovascular treatment of wide-neck bifurcation aneurysms. AJNR Am J Neuroradiol 2013; 34:1209-14. [PMID: 23292529 DOI: 10.3174/ajnr.a3387] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The WEB is an intrasaccular flow disrupter dedicated to EVT of IA. We report our initial experience in a series of patients treated with this device. MATERIALS AND METHODS This prospective study was approved by the authors' ethical committees. Nineteen patients with 20 unruptured wide-neck bifurcation IAs were treated by WEB placement. Technical issues, immediate posttreatment angiographic findings, and clinical and imaging follow-up at 3, 6, and 12 months were assessed. RESULTS Failure of WEB placement occurred in 1 case because of unavailability of a suitably sized device. Embolization was successful in 18 patients with 19 IAs, and it required additional stent placement and/or coiling in 3 cases at the acute phase and in 1 case at follow-up. Two patients experienced a symptomatic complication, and 16 patients had normal neurologic examination findings at discharge. Immediate anatomic outcome showed 1 complete occlusion, 13 near-complete occlusions, and 5 incomplete occlusions. At follow-up, 17 patients had normal neurologic examination findings and 1 retained a hemiparesis. Angiographic controls were obtained in all patients (mean, 6 months), and they showed stable or improved results in all except 4 cases, including 2 complete occlusions, 15 near-complete occlusions, and 2 incomplete occlusions. CONCLUSIONS In this initial series of patients, EVT of wide-neck bifurcation IAa with the WEB was feasible. Further studies are needed to evaluate the indications, safety, and efficacy of this new technique.
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Affiliation(s)
- B Lubicz
- Department of Neuroradiology, Erasme University Hospital, Brussels, Belgium.
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9
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Lucidi V, Katsanos G, Buggenhout A, Moreno C, Gustot T, Boon N, Degré D, Bourgeois N, Brisbois D, Bali MA, Demetter P, Van Laethem JL, Donckier V. [Multidisciplinary management of hepatocellular carcinoma in cirrhotic patients]. Rev Med Brux 2012; 33:229-236. [PMID: 23091926] [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: 06/01/2023]
Abstract
The treatment of hepatocellular carcinoma (HCC) in cirrhotic patients is challenging: the incidence is increasing, the cirrhosis dramatically limits the tolerance to treatment possibilities, there are many therapeutic modalities but resources are limited, namely in the context of organ shortage for transplantation. Liver transplantation (LT) is the optimal treatment as it combines the largest tumor resection possible and the correction of the underlying liver disease. Due to organ shortage however, LT is reserved for early-stages HCC. Surgical resection and radiofrequency destruction represent potentially curative options in highly selected patients. Arterial embolizations, chemo- or radio-embolizations, allow local tumor control but are not curative. These techniques could be performed before surgical resection or LT, to downstage the tumor and/or to control tumor progression while waiting for a graft. Finally, sorafenib is the only systemic treatment which has shown a survival benefit in advanced HCC. The benefit of combination of sorafenib and surgical treatments remains undetermined. The challenge in the management of HCC in cirrhotic patients is to integrate both individual (age, comorbidities, cirrhosis stage, tumor stage, specific contraindications to LT, etc.) and collective variables (expected waiting time before LT) to determine the best therapeutic option for each patient. In this process, multidisciplinarity is a key for success.
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Affiliation(s)
- V Lucidi
- Service de Chirurgie Digestive, Hôpital Erasme, Bruxelles
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10
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Joskin J, Bruls S, Brisbois D. [Bronchial artery ligation for the management of hemoptysis]. Rev Med Liege 2012; 67:21-25. [PMID: 22420099] [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: 05/31/2023]
Abstract
Hemoptysis is defined by the expectoration of blood from infra-glottal airway. Massive hemoptysis can be a life-threatening intrathoracic disease that requires urgent investigations and management. The chest radiography and the computed tomography (CT) are useful to localize the bleeding site and to identify the cause of hemoptysis. Bronchial artery embolization is the most effective nonsurgical treatment in the management of massive and recurrent hemoptysis. This article reviews the role of radiology in the diagnosis and treatment of hemoptysis.
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Affiliation(s)
- J Joskin
- Service de Radiologie, CHU de Liège, Belgique
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11
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Germanova D, Lucidi V, Buggenhout A, Boon N, Bourgeois N, Degré D, Gustot T, Moreno C, Bali M, Brisbois D, Donckier V. Liver Transplantation in Cases of Portal Vein Thrombosis in the Recipient: A Case Report and Review of the Various Options. Transplant Proc 2011; 43:3490-2. [DOI: 10.1016/j.transproceed.2011.09.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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12
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Lubicz B, Mine B, Collignon L, De Witte O, Brisbois D. O-026 Initial clinical experience with the web intrasaccular flow-diverter device for endovascular treatment of intracranial aneurysms. J Neurointerv Surg 2011. [DOI: 10.1136/neurintsurg-2011-010097.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Evrard P, Evrard AS, Gouzou M, Brisbois D, Quatresooz P, Engelen M. [Cardiac sarcoidosis: a case report]. Rev Med Liege 2008; 63:707-709. [PMID: 19180828] [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: 05/27/2023]
Abstract
Sarcoidosis is a systemic disease of unknown aetiology characterised by the formation of non caseating epithelioid cell granuloma, which can occur in virtually any organ. The involvement of the heart is an important prognostic factor in sarcoidosis. Early treatment prevents irreversible damage of the heart and seems to be associated with better prognosis.
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Affiliation(s)
- Ph Evrard
- Service de Cardiologie, CHC Saint-Joseph, Liège
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14
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Brisbois D, Raskinet B, Djekic J, Morar A, Broussaud T, Mancini I, Magotteaux P, Nchimi A. [Screening of asymptomatic coronaropathy with adenosine stress myocardial perfusion MRI: a pilot study]. JBR-BTR 2007; 90:92-6. [PMID: 17555067] [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: 05/15/2023]
Abstract
The aim of the study was to evaluate the incidence of asymptomatic coronary heart disease in patients with cardiovascular risk factors and evaluate the diagnostic value of myocardial stress perfusion magnetic resonance as screening test in these patients. We performed a retrospective analysis of 103 consecutive asymptomatic patients with at least one clinical risk factor for cardiovascular disease, who have undergone myocardial stress perfusion magnetic resonance. For respective evaluation of ischemic myocardium and infracted myocardium, magnetic resonance imaging protocol included the study of both myocardial viability by late enhancement imaging and first-pass perfusion at rest and during maximal stress (adenosine). The reference standard was catheter coronary angiography for 10 patients and clinical follow-up for 93 patients. The incidence of coronary heart disease was 22/103 (21%), including 6/103 (6%) ischemia and 16/103 (15%) infarcts. Respective sensitivity, specificity, negative and positive predictive values for myocardial stress perfusion magnetic resonance in detecting ischemic myocardium were 100, 97, 67 and 100%. Myocardial stress perfusion magnetic resonance can be regarded and further investigated as screening test for the detection of asymptomatic coronary heart disease in high-risk subjects. Prospective studies, larger study groups and cost-effectiveness analysis are needed.
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Affiliation(s)
- D Brisbois
- Medical Imaging Department, CHC, Rue de Hesbaye, 75, B-4000 Liège, Belgium.
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15
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Strul N, Vaessen S, Collard L, Ghuysen MS, Khamis J, Brisbois D, Dondelinger RF, Bonnet P, Bricteux G, Krzesinski JM. [Clinical case of the month. Nutcracker syndrome in association with a painful nephrologic disease]. Rev Med Liege 2007; 62:73-6. [PMID: 17461294] [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: 05/15/2023]
Abstract
Compression of the left renal vein between the aorta and the superior mesenteric artery causes a physiological condition, the so-called nutcracker phenomenon, but it can sometimes lead to left venous hypertension, or "nutcracker syndrome". Classical manifestations of which are an association of left flank pain, unilateral proteinuria and unilateral hematuria, without renal impairment. We report an atypical association of nutcracker syndrome with IgM nephropathy.
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Affiliation(s)
- N Strul
- Service de Pédiatrie Hospitalière, CHU Sart Tilman, Liège, Belgique
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16
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Mertens R, Blampain JR, Boly J, Brisbois D, Buche M, De Wispelaere JF, Dorthu L, George A, Joris JP, Kichouh M, Thomas T, Wantier M. Practice variability in the management of infrarenal arterial stenoses in seven Belgian hospitals. JBR-BTR 2005; 88:178-83. [PMID: 16176074] [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: 05/04/2023]
Abstract
This multicentre retrospective study describes the variation of therapeutic options, treatment outcomes and costs for treating infrarenal arterial stenoses as observed in daily practice in 1997-99 in seven Belgian hospitals. Data were obtained from clinical record review and from the sickness fund claims database, and included preoperative functional state, presence of acute ischaemia, diabetes and polyvascular disease, state of the lower-leg run-off arteries, anatomical site and type of lesion, type of treatment, result at 30 days and up to 4 years. A total of 442 episodes were studied, but most analyses dealt with a subgroup of 240 lesions in the common iliac up to the superficial femoral artery. The proportion of surgical treatments (as compared to an endovascular or mixed approach) varied from 15% to 81% between the hospitals. In univariate survival analysis, relapse or failure rates at 4 years ranged from 5% for the common iliac artery to 35% for the superficial femoral artery. Polyvascular disease, a poor run-off, multiple stenoses and chronic occlusion were significant risk factors; age and diabetes were not. In the multivariate (stratified Cox regression) analysis, only a location in the superficial femoral artery and a poor preoperative clinical stage were significant risk factors, but type of therapeutic approach was not. The total average cost of treatment was 5300 Euro, of which 15% was contributed by the patient. Surgery was associated with longer stays (median at 12 days) than endovascular treatments (median 2 d), and was 1.9 times more expensive. In conclusion, the results of the present study suggest that a multidisciplinary approach, orienting the patient to the most appropriate therapeutic pathway could increase both the quality and the cost-effectiveness of the care. In many clinical situations, the endovascular approach appears to offer similar long-term results as surgery, but at a substantially lower cost, both for the patient and for society, especially when performed in a (semi-)ambulatory radiology setting.
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Affiliation(s)
- R Mertens
- Initiatives de Qualité, Alliance Nationale des Mutualités Chrétiennes, Belgium
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17
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Mertens R, Blampain JP, Boly J, Brisbois D, Buche M, De Wispelaere JF, Dorthu L, George A, Joris JP, Kichouh M, Thomas T, Wantier M. Practice variability in the management of subrenal arterial stenoses in seven Belgian hospitals. Acta Chir Belg 2005; 105:148-55. [PMID: 15906905] [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: 05/02/2023]
Abstract
This multicentre retrospective study describes the variation of therapeutic options, treatment outcomes and costs for treating subrenal arterial stenoses as observed in daily practice in 1997-99 in seven Belgian hospitals. Data were obtained from clinical record review and from the sickness fund claims database, and included preoperative functional state, presence of acute ischaemia, diabetes and polyvascular disease, state of the lower-leg run-off arteries, anatomical site and type of lesion, type of treatment, result at 30 days and up to 4 years. A total of 442 episodes were studied, but most analyses dealt with a subgroup of 240 lesions in the common iliac up to the superficial femoral artery. The proportion of surgical treatments (as compared to an endovascular or mixed approach) varied from 15% to 81% between the hospitals. In univariate patency analysis, relapse or failure rates at 4 years ranged from 5% for the common iliac artery to 35% for the superficial femoral artery. Polyvascular disease, a poor run-off, multiple stenoses and chronic occlusion were significant risk factors; age and diabetes were not. In the multivariate (stratified Cox regression) analysis, only a location in the superficial femoral artery and a poor preoperative clinical stage were significant risk factors, but type of therapeutic approach was not. The total average cost of treatment was 5,300 Euros, of which 15% was contributed by the patient. Surgery was associated with longer stays (median at 12 days) than endovascular treatments (median 2 days), and was 1.9 times more expensive. In conclusion, the results of the present study suggest that a multidisciplinary approach, orienting the patient to the most appropriate therapeutic pathway, could increase both the quality and the cost-effectiveness of the care.
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Affiliation(s)
- R Mertens
- Initiatives de Qualité [Quality Initiatives], Alliance Nationale des Mutualités Chrétiennes, Bruxelles, Belgium.
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18
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De Bast Y, Tchana-Sato V, Brisbois D, Creemers E, Limet R. [Image of the month. Massive intramediastinal aortic rupture]. Rev Med Liege 2005; 60:135. [PMID: 15884694] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Y De Bast
- Service de Chirurgie Cardiovasculaire, CHU du Sart Tilman, 4000 Liège
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19
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Diamouangana D, Brisbois D, Creemers E, Magotteaux P, Materne R. [Stepping-table MR angiography of the upper limb arteries]. J Radiol 2003; 84:1989-90. [PMID: 14710052] [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: 04/27/2023]
Abstract
Stepping-table MR angiography of the upper limb arteries is reported in a patient with clinical and sonographic signs of ischemia. Advantages and limitations of the technique are discussed.
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Affiliation(s)
- D Diamouangana
- Service d'Imagerie Médicale, Clinique Saint-Joseph, Liège, Belgique
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20
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Nchimi A, Biquet JF, Brisbois D, Reginster P, Bouali K, Saive C, Magotteaux P. Duplex ultrasound as first-line screening test for patients suspected of renal artery stenosis: prospective evaluation in high-risk group. Eur Radiol 2003; 13:1413-9. [PMID: 12764659 DOI: 10.1007/s00330-002-1685-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2001] [Revised: 07/29/2002] [Accepted: 08/13/2002] [Indexed: 10/25/2022]
Abstract
Our objective was to assess how far the progress in ultrasound devices has increased feasibility and accuracy of Duplex ultrasound (DUS) for the diagnosis of renal artery stenosis (RAS), in a population with high prevalence of atherosclerotic renovascular lesions. Ninety-one hypertensive patients with atherosclerotic disease were prospectively evaluated by both DUS and digital subtraction angiography (DSA) of the renal arteries. Only proximal criteria (peak systolic velocity >180 mm/s or renal-to-aortic ratio >3.5) were used for the diagnosis of significant RAS (>60% narrowing). For both techniques, two readers were involved for interobserver variability study. Two hundred one arteries were demonstrated by DSA on 182 available kidneys. The prevalence of RAS among the study group was 37%. Sixteen of the 19 accessory arteries were not seen at DUS; in 8 patients, one renal artery was not seen at DUS (feasibility 91%). On the 177 arteries assessed, in comparison with DSA, DUS yielded 96, 91, and 97% mean values of accuracy, sensitivity, and specificity, respectively. Kappa for interobserver agreement was 0.95 for DUS and 0.92 for DSA. Although still unreliable for the detection of accessory arteries, DUS is in our experience an accurate and reproducible diagnostic test for RAS.
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Affiliation(s)
- A Nchimi
- Department of Medical Imaging, Les Cliniques Saint-Joseph, 52 rue d'Hesbaye, 4000 Liège, Belgium.
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21
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Nchimi A, Brisbois D, Donkers E, Biquet JF, Saive C, Jadot A, Magotteaux R. [MR aortofemorography versus DSA: prospective evaluation]. JBR-BTR 2002; 85:246-51. [PMID: 12465598] [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: 02/27/2023]
Abstract
PURPOSE To determine how far MRA of lower limbs obviates the need for pre-therapeutic DSA. MATERIALS AND METHOD Three-step 3-D gadolinium enhanced aortofemorography with a moving bed was prospectively compared to DSA in 49 consecutive patients (40 males, 9 females; age range 38-80 years; mean age 64 years). According to Leriche and Fontaine's clinical gradation of lower limb ischemia, 5 patients were graded I, 37 graded II, 4 graded III, and 3 graded IV. Two observers graded stenoses for DSA and three for MRA. Cohen's kappa statistics were used to evaluate interobserver variability using MRA, as well as to compare MRA to DSA. In addition, sensitivity, specificity, positive and negative predictive values of MRA for the assessment of stenosis superior to 80% were calculated by using DSA as a gold standard, respectively for arterial trunks above and below the level of the knees. RESULTS Overall accuracy of MRA was 92%. Comparison of DSA and MRA yielded a kappa value of 0.87 (0.95 for arterial trunks located above the level of the knees and 0.75 below). Interobserver agreement was very good. Sensitivity, specificity, positive and negative predictive values of MRA for the diagnosis of > 80% stenosis were respectively 98, 98, 85 and 99% above the level of the knees and 87, 91, 77 and 96% below the knees. CONCLUSION MRA can be considered as valuable technique for the evaluation of peripheral arterial obstructive disease, especially for stenosis located above the level of the knees.
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Affiliation(s)
- A Nchimi
- Service d'lmagerie Médicale, Les Cliniques Saint-Joseph, Liège, Belgique
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22
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Brisbois D, Plomteux O, Nchimi A, Hock D, Dupont P, Delforge M, Bastens B, Weerts J, Magotteaux P. [Value of MRCP for detection of choledocholithiasis in symptomatic patients: one-year experience with a standardized high resolution breath-hold technique]. JBR-BTR 2001; 84:258-61. [PMID: 11822367] [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: 04/17/2023]
Abstract
In our institution, MRCP is actually replacing diagnostic ERCP. This study is addressing its accuracy in the diagnosis of symptomatic choledocholithiasis. 137 MRCP were performed in patients with upper abdominal pain and biological anomalies (n = 48), pain with cholelithiasis at sonography (n = 69) or non-alcoholic acute pancreatitis (n = 20) on a 1.5 T system with high gradients using a standardized combination of breath-hold HASTE and RARE sequences. We included in our study 74 patients who underwent as second test ERCP (n = 36), peroperative cholangiography (n = 13), or extensive follow-up with laboratory tests and/or sonography (n = 25). All examinations were judged as diagnostic, discrepancies between direct cholangiography and MRCP being noted in 4 patients (5.4%). Lithiasis was misinterpreted on MRCP as bubbles in 2 patients after sphincterotomy or surgery. We had two false positive diagnoses on MRCP: in one patient peroperative cholangiography was negative and in the other one ERCP was negative. With a sensitivity and PPV of 92%, a specificity and NPV of 96% MRCP in our experience is shown as an accurate diagnostic tool for the detection of stone in the common bile duct replacing ERCP.
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Affiliation(s)
- D Brisbois
- Department of Medical Imaging, Les Cliniques Saint Joseph (CHC), Liège, Belgium
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23
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Brisbois D, Magotteaux P, Biquet JF, Reginster P, Bouali K. [Carotid endarterectomy without arteriography: only dedicated to urgent procedures?]. JBR-BTR 2000; 83:242-5. [PMID: 11201539] [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: 02/19/2023]
Abstract
Duplex examination is presently established as a safe non-invasive and accurate method of evaluating patients with extracranial cerebrovascular disease which usually provides complete information about the extent of carotid artery narrowing Arteriography, in this indication, is an invasive procedure with a total complication rate of 3-4% with 1% of permanent stroke. If it is currently accepted that in emergency conditions (ictus ingravescens, pre-occlusive plaque) or if iodinated contrast media are contraindicated, thrombendarteriectomy can be performed without arteriography it could be extended to most cases. The authors stress the criteria to increase the number of those patients, summarize the pre-requisites to achieve this goal, and comment on the future alternative position of MRA.
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Affiliation(s)
- D Brisbois
- Service de Radiologie, Les Cliniques St. Joseph, Liège, Belgium
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24
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Brisbois D, Biquet JF, Hock D, Magotteaux P. [State of the art of pancreatic cancer imaging]. Rev Med Liege 2000; 55:84-8. [PMID: 10769574] [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: 02/16/2023]
Abstract
Ultrasonography and CT-scanner remain the first choice nowadays concerning detection and preoperative work-up of pancreatic cancer. MRI offers interesting options for the detection of liver metastases, and high quality of ductal and vascular examination. Actually, while we await a larger diffusion of MR systems and radiological expertise this technique is preferentially indicated as a third-step procedure when ultrasonography and CT-scanner are normal despite a real suspicion. Otherwise, MRI permits with a single non-invasive examination a complete work-up useful to prepare palliative therapy in case of unresectable tumor.
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Affiliation(s)
- D Brisbois
- Service d'Imagerie médicale, Les Cliniques Saint-Joseph, Liège
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25
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Dondelinger RF, Ghysels MP, Brisbois D, Donkers E, Snaps FR, Saunders J, Devière J. Relevant radiological anatomy of the pig as a training model in interventional radiology. Eur Radiol 1998; 8:1254-73. [PMID: 9724449 DOI: 10.1007/s003300050545] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The use of swine for teaching purposes in medicine and surgery has largely increased in recent years. Detailed knowledge of the porcine anatomy and physiology is a prerequisite for proper use of pigs as a teaching or an experimental model in interventional radiology. A systematic study of the radiological anatomy was undertaken in more than 100 female pigs aged 6-8 weeks. All studies were performed under general anesthesia in a single session. Animals were sacrificed at the end of the study. Selective angiographies were systematically obtained in all anatomical territories. In other animals CT and MRI examinations were performed and were correlated to anatomical sections and acrylic casts of the vascular structures. Endoscopical examinations of the upper gastrointestinal tract, including retrograde opacification of the biliary and pancreatic ducts, were added in selected animals. The main angiographic aspects of the brain, head and neck, thorax, abdomen, and pelvis were recorded. Similarities and differences in comparison with human anatomy are stressed. Potential applications in interventional radiology are indicated.
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Affiliation(s)
- R F Dondelinger
- Department of Medical Imaging, University Hospital Sart Tilman, B-4000 Liège, Belgium
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26
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Detry O, Defechereux T, Honore P, Meurisse M, Defraigne JO, Sakalihassan N, Hartstein G, Venneman I, Joris J, Damas P, Thiry A, Demoulin JC, Brisbois D, Jacquet N, Limet R. [Combined liver and heart transplantation in a patient with thalassemia major]. Rev Med Liege 1997; 52:532-4. [PMID: 9381003] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- O Detry
- Service de Chirurgie Transplantation, Université de Liège
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27
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Brisbois D, Rausin L, Magotteaux P. Urethral saccular diverticulum. J Belge Radiol 1996; 79:264. [PMID: 9031539] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- D Brisbois
- Department of Medical Imaging, Centre Hospitalier St Joseph-Espérance, Liège, Belgium
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28
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Brisbois D, Magotteaux P, Bouali K, Rausin L, Lastra M. Acute abdomen. Is ultrasonography useful, essential or unnecessary? Acta Gastroenterol Belg 1996; 59:134-6. [PMID: 8903058] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Abdominal ultrasonography in acute conditions gives sometimes the definite diagnosis or at least indicates a strategy for further examinations. This technique is constantly accurate for the upper part of the abdomen, and its classical indications are dominated by cholecystitis, biliary and urinary lithiasis, pancreatic and aortic painful circumstances. However, its role has been emphasized recently, after famous publications about the usefulness of high resolution ultrasonography for appendicitis and various gut-related acute conditions. The efficacity of abdominal ultrasonography is enhanced by color-doppler and power-doppler, to characterize some inflammatory or ischemic diseases. For the pelvis, endocavitary examination is a "must" for studying uterus and adnexae. The main drawbacks of abdominal ultrasonography are well known: its physical limitations and mainly its operator-dependence.
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29
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Kovanda KJ, Brisbois D, Vivario M, Boutefeu JM. [Anatomo-clinical conference. Multiple pulmonary masses and Wegener's disease: diagnosis and treatment with anti-infective agents]. Rev Med Liege 1991; 46:382-94. [PMID: 1871468] [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] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- K J Kovanda
- Service de Médecine interne, Université de Liège
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