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Loffroy R, Falvo N, Guillen K, Galland C, Baudot X, Demaistre E, Fréchier L, Ledan F, Midulla M, Chevallier O. Single-Session Percutaneous Mechanical Thrombectomy Using the Aspirex ®S Device Plus Stenting for Acute Iliofemoral Deep Vein Thrombosis: Safety, Efficacy, and Mid-Term Outcomes. Diagnostics (Basel) 2020; 10:diagnostics10080544. [PMID: 32751767 PMCID: PMC7459539 DOI: 10.3390/diagnostics10080544] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/09/2020] [Accepted: 07/29/2020] [Indexed: 02/05/2023] Open
Abstract
To assess the safety, efficacy and mid-term outcomes of single-session percutaneous mechanical thrombectomy (PMT) for acute symptomatic iliofemoral deep vein thrombosis (DVT) using the Aspirex®S device. Retrospective review of 30 patients (women, 23; mean age, 45.5 ± 19.9 years; range, 17-76) who underwent PMT with the 10-French Aspirex®S device (Straub Medical AG, Wangs, Switzerland) for acute DVT between December 2015 and March 2019. Procedures were performed by popliteal (n = 22) or jugular (n = 7) approach, or both (n = 1). Mean time from diagnosis to PMT was 5.5 ± 4.6 days (range, 2-11). Successful thrombus removal and venous patency restoration were achieved in all patients (100%). Fluid removal was 307.8 ± 66.1 mL (range, 190-410). Additional venous stenting rate was 100%. Mean procedural time was 107.3 ± 33.9 min (range, 70-180). No major complication occurred. The patient's postprocedural course was uneventful in all cases, with hospital discharge within 2 days in 83.3%. Early in-stent rethrombosis occurred within 1 week in 3 patients, successfully managed by endovascular approach. Secondary stent patency rate was 86.7% at a mean follow-up of 22.3 ± 14.2 months (range, 6-48), as assessed by Duplex ultrasound. Single-session of PMT using the Aspirex®S device is a safe and effective therapeutic option in patients presenting with acute symptomatic iliofemoral DVT.
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Affiliation(s)
- Romaric Loffroy
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (K.G.); (M.M.); (O.C.)
- Department of Radiology, Section of Vascular Medicine and Phlebology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (N.F.); (C.G.); (X.B.); (L.F.); (F.L.)
- Correspondence: ; Tel.: +33-380-293-677
| | - Nicolas Falvo
- Department of Radiology, Section of Vascular Medicine and Phlebology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (N.F.); (C.G.); (X.B.); (L.F.); (F.L.)
| | - Kévin Guillen
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (K.G.); (M.M.); (O.C.)
| | - Christophe Galland
- Department of Radiology, Section of Vascular Medicine and Phlebology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (N.F.); (C.G.); (X.B.); (L.F.); (F.L.)
| | - Xavier Baudot
- Department of Radiology, Section of Vascular Medicine and Phlebology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (N.F.); (C.G.); (X.B.); (L.F.); (F.L.)
| | - Emmanuel Demaistre
- Department of Biology, Section of Biological Haemostasis and Thrombosis Treatment, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France;
| | - Léo Fréchier
- Department of Radiology, Section of Vascular Medicine and Phlebology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (N.F.); (C.G.); (X.B.); (L.F.); (F.L.)
| | - Frédérik Ledan
- Department of Radiology, Section of Vascular Medicine and Phlebology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (N.F.); (C.G.); (X.B.); (L.F.); (F.L.)
| | - Marco Midulla
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (K.G.); (M.M.); (O.C.)
| | - Olivier Chevallier
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (K.G.); (M.M.); (O.C.)
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Guillen K, Falvo N, Nakai M, Chevallier O, Aho-Glélé S, Galland C, Demaistre E, Pescatori L, Samson M, Audia S, Bonnotte B, Midulla M, Loffroy R. Endovascular stenting for chronic femoro-iliac venous obstructive disease: Clinical efficacy and short-term outcomes. Diagn Interv Imaging 2020; 101:15-23. [DOI: 10.1016/j.diii.2019.03.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/27/2019] [Accepted: 03/29/2019] [Indexed: 10/26/2022]
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Brémont J, Maillet T, Putot A, Lalu-Fraisse A, Demaistre E, Terriat B, Camus A, Giroud M, Martin L, Steinmetz E, Manckoundia P. Isolated Cerebellar Ischemic Strokes Revealing Giant Cell Arteritis in an Elderly Adult. J Am Geriatr Soc 2016; 64:e117-e118. [PMID: 27564985 DOI: 10.1111/jgs.14418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Julie Brémont
- Department of Geriatric Rehabilitation, University Hospital, Champmaillot Hospital, Dijon, France
| | - Thibault Maillet
- Department of Geriatric Rehabilitation, University Hospital, Champmaillot Hospital, Dijon, France
| | - Alain Putot
- Department of Geriatric Rehabilitation, University Hospital, Champmaillot Hospital, Dijon, France
| | - Adeline Lalu-Fraisse
- Department of Geriatric Rehabilitation, University Hospital, Champmaillot Hospital, Dijon, France
| | - Emmanuel Demaistre
- Department of Biological Hematology, University Hospital, François Mitterrand Hospital, Dijon, France
| | - Béatrice Terriat
- Department of Angiology, University Hospital, François Mitterrand Hospital, Dijon, France
| | - Agnès Camus
- Department of Geriatric Rehabilitation, University Hospital, Champmaillot Hospital, Dijon, France
| | - Maurice Giroud
- Department of Neurology, University Hospital, François Mitterrand Hospital, Dijon, France
| | - Laurent Martin
- Department of Anatomopathology, University Hospital, François Mitterrand Hospital, Dijon, France
| | - Eric Steinmetz
- Department of Cardiovascular Surgery, University Hospital, François Mitterrand Hospital, Dijon, France
| | - Patrick Manckoundia
- Department of Geriatric Rehabilitation, University Hospital, Champmaillot Hospital, Dijon, France.,Institut National de la Santé et de la Recherche Médicale/U1093 Cognition Action Plasticity, University of Burgundy Franche Comté, Dijon, France
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Falcoz MT, Falvo N, Aho-Glélé S, Demaistre E, Galland C, Favelier S, Pottecher P, Chevallier O, Bonnotte B, Audia S, Samson M, Terriat B, Midulla M, Loffroy R. Endovascular stent placement for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions: a single-center study of safety, efficacy and quality-of-life improvement. Quant Imaging Med Surg 2016; 6:342-352. [PMID: 27709070 DOI: 10.21037/qims.2016.07.07] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 11/06/2022]
Abstract
BACKGROUND Post-thrombotic syndrome (PTS) is a frequent complication of deep vein thrombosis (DVT) despite adequate treatment. Venous angioplasty and stent placement has been progressively used to restore and maintain venous patency in PTS patients. This study reports our single-center experience with the use of endovascular treatment for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions. METHODS A prospective mono-centric observational cohort study of PTS patients with chronic symptomatic ilio-femoral venous obstructive lesions referred for endovascular treatment was conducted from March 2012 to April 2016. Procedure consisted in recanalization, pre-dilation and self-expandable stenting of stenotic or occluded iliac and/or femoral veins. Severity of PTS, quality-of-life and treatment outcomes were assessed using Villalta scale and Chronic Venous Insufficiency Questionnaire (CIVIQ-20) at baseline and 3 months after the procedure. Imaging follow-up was based on duplex ultrasound (US) and computed tomography (CT). RESULTS Twenty-one patients (11 females, 10 males; median age, 41 years; range, 32-60) were included. Recanalization and stenting was successfully accomplished in all prime procedures, 4 patients benefitted from an additional procedure. Immediate technical success rate was 96% considering 25 procedures, performed without any complications. Median follow-up was 18 months (range, 6-30 months) with a 90.5% stent patency rate. Villalta score significantly decreased from baseline compared with 3 months after the procedure [14 (range, 11-22) and 5 (range, 1-10), respectively, P<0.0001], showing a significant decrease in the severity of PTS. CIVIQ-20 score significantly decreased from baseline compared with 3 months after stenting [48.5 (range, 39-73) and 26.5 (range, 21-45), respectively, P<0.0001] thus showing a significant improvement of quality-of-life. Post-procedural CIVIQ-20 score was significantly associated with Villalta score (95% CI, 1.53-2.95; P<0.0001). CONCLUSIONS Our results confirm the high clinical success rate and safety of endovascular PTS treatment and highlight the significant impact of stenting on the quality of life of patients with chronic symptomatic ilio-femoral venous obstructive lesions.
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Affiliation(s)
- Marie-Tiphaine Falcoz
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Nicolas Falvo
- Department of Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Serge Aho-Glélé
- Department of Epidemiology, Statistics and Clinical Research, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Emmanuel Demaistre
- Department of Biological Haemostasis and Thrombosis Treatment, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Christophe Galland
- Department of Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Sylvain Favelier
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Pierre Pottecher
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Bernard Bonnotte
- Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Sylvain Audia
- Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Béatrice Terriat
- Department of Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Marco Midulla
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex, France
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Antier N, Quenot JP, Doise JM, Noel R, Demaistre E, Devilliers H. Mechanisms and etiologies of thrombocytopenia in the intensive care unit: impact of extensive investigations. Ann Intensive Care 2014; 4:24. [PMID: 25593741 PMCID: PMC4273722 DOI: 10.1186/s13613-014-0024-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 07/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thrombocytopenia is common in the intensive care unit. Potential mechanisms and etiologies behind this phenomenon are multiple and often entangled. We assessed the effect of a systematic approach, using routinely available tests, on the proportion of patients in whom the mechanism (primary objective) and etiology (secondary objective) of thrombocytopenia in a mixed intensive care unit (ICU) could be identified. METHODS Before-and-after study of all patients with thrombocytopenia was used. 'Before' group had no intervention. New standard operating procedures for thrombocytopenia management were introduced. In the 'After' group, bone marrow aspiration; determination of fibrinogen dosage, prothrombin time, factor V, D-dimers; assay of fibrin monomers, ferritin, triglycerides, lactic acid dehydrogenase, aspartate transaminase, alanine aminotransferase, vitamin B12, folates, reticulocytes, haptoglobin, and bilirubin were performed. RESULTS In the Before group (n = 20), the mechanism (central, peripheral, or mixed) was identified in 10 % versus 83% in After group (n = 23) (p < 0.001) (48% peripheral, 35% mixed). Before intervention, ≥1 etiology was identified in 15% versus 95.7% in the After group (p < 0.001). CONCLUSIONS Systematic and extensive investigation using routine tests highlights the mechanisms and etiology of thrombocytopenia in most cases.
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Affiliation(s)
- Nadiejda Antier
- Service de réanimation polyvalente, Centre Hospitalier, Chalon sur Saone 71321, France
| | - Jean-Pierre Quenot
- Service de réanimation médicale, Centre Hospitalier Universitaire Le Bocage, 14, Rue Gaffarel, Dijon 21079, France
| | - Jean-Marc Doise
- Service de réanimation polyvalente, Centre Hospitalier, Chalon sur Saone 71321, France
| | - Robin Noel
- Service de réanimation polyvalente, Centre Hospitalier, Chalon sur Saone 71321, France
| | - Emmanuel Demaistre
- Laboratoire d'hémostase, Centre Hospitalier Universitaire Le Bocage, Dijon 21079, France
| | - Hervé Devilliers
- Service de médecine interne, Centre Hospitalier Universitaire Hôpital Général, Dijon 21079, France ; CIC-EC CHU de Dijon (INSERM CIE1), Dijon 21000, France
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Mouriès-Martin S, Bach B, Leguy-Seguin V, Berthier S, Bonnotte B, Samson M, Volot F, Demaistre E, Lorcerie B. Traitement par facteurs de coagulation dans l’hémophilie acquise : effets secondaires. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.224] [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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Bonnet C, Denis C, Ben Signor C, Couillault G, Demaistre E, Falcon-Eicher S, Huet F, Wolf JE. 311 Nonbacterial thrombotic (Libman-Sacks) endocarditis with mitral regurgitation in catastrophic antiphospholipid syndrome (a case study). Archives of Cardiovascular Diseases Supplements 2011. [DOI: 10.1016/s1878-6480(11)70313-5] [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: 10/18/2022]
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