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Alexandrescu VA, Van Overmeire L, Makrygiannis G, Azdad K, Popitiu M, Paquet S, Poppe L, Nodit M. Clinical Implications of Diabetic Peripheral Neuropathy in Primary Infrapopliteal Angioplasty Approach for Neuro-Ischemic Foot Wounds. J Endovasc Ther 2023; 30:920-930. [PMID: 35786131 DOI: 10.1177/15266028221106312] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To assess the clinical effects of diabetic peripheral neuropathy (DPN) in patients with chronic limb-threatening ischemia (CLTI) treated by primary infrapopliteal angioplasty for neuro-ischemic Rutherford 5, foot wounds. MATERIALS AND METHODS Over a 10-year period (2009-2019), a series of 304 diabetic ischemic limbs adding or not evincible neuropathic affectation were treated by primary infrapopliteal angioplasty and their files were retrospectively reviewed. Mean length of treated arterial lesions was 6.1 cm (range 1-22 cm). Inferior limb vibration perception threshold diagnostic was performed for comparing and scoring detectable DPN in all studied diabetic patients (classed from 0 to 10 points). There were 19% limbs with normal (0-1 points) perception (group 1), 55% others with "mild" and "moderate" (2-6 points) neuropathic impairment (group 2), and 26% limbs showing "severe" (7-10 points) DPN (group 3). RESULTS Primary infrapopliteal angioplasty succeeded in 89% cases in group 1, in 82% in group 2, and in 68% of limbs in group 3. This latest group assembled the heaviest neuropathic affectation and arterial calcifications and proved the lowest clinical benefit at 36 months: 35% (95% confidence interval [CI]=22% to 48%) of primary patency, 36% (95% CI=22% to 50%) wound healing, and 54% (95% CI=39% to 69%) limb preservation rates. A comparison between groups 1 vs 3 and 2 vs 3 of primary patency (p=0.014 and p=0.043), tissue healing (p=0.049 and p=0.01), and limb salvage (p=0.006 and p=0.023) proved significant, yet without statistical weight for group 1 vs 2 (p>0.05). Overall survival was not significantly affected between groups (p=0.34). CONCLUSION The presence of severe DPN may jeopardize the results of infrapopliteal angioplasty in terms of patency, tissue cicatrization, and limb preservation, yet without significance on survival of these patients. When present, DPN requires appropriate stratification as specific indicator in CLTI treatment.
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Affiliation(s)
- Vlad Adrian Alexandrescu
- Department of Thoracic and Vascular Surgery, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
| | - Lionel Van Overmeire
- Department of Nephrology and Internal Medicine, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
| | - Georgios Makrygiannis
- Department of Thoracic and Vascular Surgery, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
| | - Khalid Azdad
- Department of Radiology, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
| | - Mircea Popitiu
- Department of Vascular Surgery and Reconstructive Microsurgery, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Séverine Paquet
- Department of Thoracic and Vascular Surgery, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
| | - Laura Poppe
- Department of Thoracic and Vascular Surgery, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
| | - Mihaela Nodit
- Department of Geriatric Care and Internal Medicine, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
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Courtois A, Makrygiannis G, Cheramy-Bien JP, Purnelle A, Pirotte B, Dogne JM, Hanson J, Defraigne JO, Drion P, Sakalihasan N. Therapeutic Applications of Prostaglandins and Thromboxane A2 Inhibitors in Abdominal Aortic Aneurysms. Curr Drug Targets 2019; 19:1247-1255. [PMID: 29284385 DOI: 10.2174/1389450119666171227224314] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 08/07/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Abdominal aortic aneurysm (AAA) is one of the leading causes of death in western countries. Surgery is still, at the present time, the sole treatment that has however a significant mortality and cost rate. Many pharmacological agents are under investigation aiming to reduce growth and prevent AAA rupture. These drugs target different pathological pathways and, notably, the excessive production of prostanoids by cyclooxygenases (COX). Intra-aneurysmal thrombus plays an adverse key role in the progression of AAA, platelets being a primary source of prostanoids as thromboxane A2. OBJECTIVE In this review, we summarize studies targeting prostanoids production and down-stream pathways in cardiovascular diseases, and more specifically in AAA. RESULTS AND CONCLUSION Various inhibitors of COX or antagonists of prostanoids receptors have been investigated in AAA animal models with conflicting results. In human AAA, only a few number of studies focused on anti-platelet therapy mostly using acetylsalicylic acid (aspirin, ASA), a COX1 inhibitor. Finally, we report preliminary promising results of a model of AAA in rats receiving a thromboxane A2 inhibitor, BM-573 that induced a reduction of aneurysmal growth.
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Affiliation(s)
- Audrey Courtois
- Surgical Research Center, GIGA-Cardiovascular Unit, University of Liege, Liege, Belgium.,Department of Cardiovascular and Thoracic Surgery, University Hospital of Liege, Liege, Belgium
| | - Georgios Makrygiannis
- Surgical Research Center, GIGA-Cardiovascular Unit, University of Liege, Liege, Belgium.,Department of Cardiovascular and Thoracic Surgery, University Hospital of Liege, Liege, Belgium
| | - Jean-Paul Cheramy-Bien
- Surgical Research Center, GIGA-Cardiovascular Unit, University of Liege, Liege, Belgium.,Department of Cardiovascular and Thoracic Surgery, University Hospital of Liege, Liege, Belgium
| | - Audrey Purnelle
- Surgical Research Center, GIGA-Cardiovascular Unit, University of Liege, Liege, Belgium
| | - Bernard Pirotte
- Laboratory of Pharmaceutical Chemistry, Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
| | - Jean Michel Dogne
- Trombosis and Hemostasis center (NTHC) - Narilis, University of Namur, Namur, Belgium
| | - Julien Hanson
- Laboratory of Pharmaceutical Chemistry, Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium.,Laboratory of Molecular Pharmacology, GIGAMolecular Biology of Diseases, University of Liege, Liege, Belgium
| | - Jean-Olivier Defraigne
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Liege, Liege, Belgium
| | - Pierre Drion
- Experimental Surgery Unit, CREDEC, GIGA-R, University of Liege, Liege, Belgium
| | - Natzi Sakalihasan
- Surgical Research Center, GIGA-Cardiovascular Unit, University of Liege, Liege, Belgium.,Department of Cardiovascular and Thoracic Surgery, University Hospital of Liege, Liege, Belgium
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Courtois A, Makrygiannis G, El Hachemi M, Hultgren R, Allaire E, Namur G, Hustinx R, Defraigne JO, Sakalihasan N. Positron Emission Tomography/Computed Tomography Predicts and Detects Complications After Endovascular Repair of Abdominal Aortic Aneurysms. J Endovasc Ther 2019; 26:520-528. [PMID: 31074323 DOI: 10.1177/1526602819849088] [Citation(s) in RCA: 9] [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] [Indexed: 12/26/2022]
Abstract
Purpose: To assess if aortic 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT) could play a role in predicting complications after endovascular aneurysm repair (EVAR). Materials and Methods: This study involved 2 cohorts of men with abdominal aortic aneurysm treated by EVAR: those who underwent a PET/CT scan before EVAR (n=17) and those who had a PET/CT during follow-up (n=34). Uptake of FDG was measured as the standardized uptake value (SUV). D-dimer, a marker of fibrinolysis, was measured in blood drawn concomitantly with the PET/CT. Results: A significant uptake of FDG in the aneurysm wall was detected by PET/CT before EVAR in 6 of 17 patients. During the first year after EVAR, type II endoleaks developed in 5 of these FDG+ patients vs 3 of 11 FDG- patients (p=0.04). Two of the FDG+ patients had continued sac growth and required conversion to open repair. A significant association between sac growth rate, SUV, and the presence of endoleak was found in the 34 patients who underwent PET/CT after EVAR. Finally, D-dimer was significantly increased in patients with both endoleak and positive PET/CT in the post-EVAR group. Conclusion: This study suggests that the presence of FDG uptake in the aortic wall might be a useful tool to predict patients at high risk of developing post-EVAR complications.
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Affiliation(s)
- Audrey Courtois
- 1 Surgical Research Center, GIGA-Cardiovascular Science Unit, University of Liège, Department of Cardiovascular and Thoracic Surgery, CHU Liège, University of Liège, Belgium
| | - Georgios Makrygiannis
- 1 Surgical Research Center, GIGA-Cardiovascular Science Unit, University of Liège, Department of Cardiovascular and Thoracic Surgery, CHU Liège, University of Liège, Belgium
| | | | - Rebecka Hultgren
- 3 Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Eric Allaire
- 4 Vascular Surgery, Clinique Geoffroy Saint Hilaire, Paris, France
| | | | - Roland Hustinx
- 6 Department of Nuclear Medicine, CHU Liège, University of Liège, Belgium
| | - Jean-Olivier Defraigne
- 7 Department of Cardiovascular and Thoracic Surgery, CHU Liège, University of Liège, Belgium
| | - Natzi Sakalihasan
- 7 Department of Cardiovascular and Thoracic Surgery, CHU Liège, University of Liège, Belgium
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Makrygiannis G, Mourmoura E, Spanos K, Roussas N, Kuivaniemi H, Sakalihasan N, Tsezou A, Giannoukas A. Risk Factor Assessment in a Greek Cohort of Patients With Large Abdominal Aortic Aneurysms. Angiology 2018; 70:35-40. [PMID: 29739236 DOI: 10.1177/0003319718774474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 12/30/2022]
Abstract
Environmental and genetic risk factors contribute to the etiology of abdominal aortic aneurysms (AAAs). Matrix metalloproteinases (MMPs) have been associated with the pathophysiology of AAAs. A prospective, nonrandomized case-control study was undertaken to investigate the risk factors for large AAAs (≥5.5 cm) among 175 male Greek AAA patients and to compare the results with a cohort of 166 male controls free from any aortic dilatation, as confirmed by ultrasonography from an existing AAA screening program in the same region. We also assessed the potential association between 2 functional single nucleotide polymorphisms in the genes MMP9 (-1561C/T; rs3918242) and MMP13 (-77A/G; rs2252070), and the presence of large AAAs. Multiple logistic regression analysis revealed AAA family history ( P = .028), hypercholesterolemia ( P < .001), and current smoking ( P < .001) as AAA risk factors. Statistical difference was reached in genotype ( P = .047) and allele ( P = .037) frequencies for rs2252070, but the results did not remain significant after correction for multiple testing. No significant differences in genotype or allele frequencies for rs3918242 were detected. In summary, AAA family history, hypercholesterolemia, and current smoking were found to be risk factors for large AAAs.
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Affiliation(s)
- Georgios Makrygiannis
- 1 Department of Vascular Surgery, University Hospital of Larissa, Greece.,2 Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, Liège, Belgium
| | - Evanthia Mourmoura
- 3 Department of Cytogenetics and Molecular Genetics, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | - Nikolaos Roussas
- 1 Department of Vascular Surgery, University Hospital of Larissa, Greece
| | - Helena Kuivaniemi
- 4 Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Natzi Sakalihasan
- 2 Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, Liège, Belgium
| | - Aspasia Tsezou
- 3 Department of Cytogenetics and Molecular Genetics, Faculty of Medicine, University of Thessaly, Larissa, Greece.,5 Department of Biology, University of Thessaly, Faculty of Medicine, Larissa, Greece
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Affiliation(s)
| | - I Sian
- The Royal Devon and Exeter Hospital, Exeter, UK
| | - O Giasin
- Department of Ophthalmology, Ynysmaerdy, Pontyclun, UK
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Makrygiannis G, Labalue P, Erpicum M, Schlitz M, Seidel L, El Hachemi M, Gangolf M, Albert A, Defraigne JO, Lindholt JS, Sakalihasan N. Extending Abdominal Aortic Aneurysm Detection to Older Age Groups: Preliminary Results from the Liège Screening Programme. Ann Vasc Surg 2016; 36:55-63. [DOI: 10.1016/j.avsg.2016.02.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 11/01/2015] [Accepted: 02/17/2016] [Indexed: 12/28/2022]
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Makrygiannis G, Loeys B, Defraigne JO, Sakalihasan N. Cervical artery dissections and type A aortic dissection in a family with a novel missense COL3A1 mutation of vascular type Ehlers-Danlos syndrome. Eur J Med Genet 2015; 58:634-6. [PMID: 26497932 DOI: 10.1016/j.ejmg.2015.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 08/25/2015] [Revised: 09/24/2015] [Accepted: 10/18/2015] [Indexed: 10/22/2022]
Abstract
Cervical artery dissection (CeAD) is a rare condition. One of the causes is the vascular type of Ehlers-Danlos syndrome (vEDS). A novel missense mutation in COL3A1 was found in a young patient with CeAD as the single manifestation of vEDS. This is a heterozygous c.953G > A mutation in exon 14, disrupting the normal Gly-X-Y repeats of type III procollagen, by converting glycine to aspartic acid.
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Affiliation(s)
- Georgios Makrygiannis
- Department of Cardiovascular Surgery, University Hospital of Liège, Liège, Belgium; Department of Surgery, Surgical Research Center (CREDEC), GIGA Cardiovascular Sciences, University of Liège, Liège, Belgium.
| | - Bart Loeys
- Center for Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Jean-Olivier Defraigne
- Department of Cardiovascular Surgery, University Hospital of Liège, Liège, Belgium; Department of Surgery, Surgical Research Center (CREDEC), GIGA Cardiovascular Sciences, University of Liège, Liège, Belgium
| | - Natzi Sakalihasan
- Department of Cardiovascular Surgery, University Hospital of Liège, Liège, Belgium; Department of Surgery, Surgical Research Center (CREDEC), GIGA Cardiovascular Sciences, University of Liège, Liège, Belgium
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Makrygiannis G, Courtois A, Drion P, Defraigne JO, Kuivaniemi H, Sakalihasan N. Sex Differences in Abdominal Aortic Aneurysm: The Role of Sex Hormones. Ann Vasc Surg 2014; 28:1946-58. [DOI: 10.1016/j.avsg.2014.07.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/21/2014] [Accepted: 07/27/2014] [Indexed: 01/16/2023]
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Rinaldi S, Cleveland R, Norat T, Biessy C, Rohrmann S, Linseisen J, Boeing H, Pischon T, Panico S, Agnoli C, Palli D, Tumino R, Vineis P, Peeters PHM, van Gils CH, Bueno-de-Mesquita BH, Vrieling A, Allen NE, Roddam A, Bingham S, Khaw KT, Manjer J, Borgquist S, Dumeaux V, Torhild Gram I, Lund E, Trichopoulou A, Makrygiannis G, Benetou V, Molina E, Donate Suárez I, Barricarte Gurrea A, Gonzalez CA, Tormo MJ, Altzibar JM, Olsen A, Tjonneland A, Grønbaek H, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC, Morois S, Slimani N, Boffetta P, Jenab M, Riboli E, Kaaks R. Serum levels of IGF-I, IGFBP-3 and colorectal cancer risk: results from the EPIC cohort, plus a meta-analysis of prospective studies. Int J Cancer 2010; 126:1702-15. [PMID: 19810099 DOI: 10.1002/ijc.24927] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Several prospective studies have shown a moderate positive association between increasing circulating insulin-like growth factor-I (IGF-I) levels and colorectal cancer risk. However, the associations were often statistically nonsignificant, and the relationship of cancer risk with IGF-I's major binding protein, IGFBP-3, showed major discrepancies between studies. We investigated the association of colorectal cancer risk with serum IGF-I, total and intact IGFBP-3, in a case-control study nested within the EPIC cohort (1,121 cases of colorectal cancer and 1,121 matched controls). Conditional logistic regression was used to adjust for possible confounders. Our present study results were combined in a meta-analysis with those from 9 previous prospective studies to examine the overall evidence for a relationship of prediagnostic serum IGF-I with colorectal cancer risk. In the EPIC study, serum concentrations of IGF-I and IGFBP-3 showed no associations with risk of colorectal cancer overall. Only in subgroup analyses did our study show moderate positive associations of IGF-I levels with risk, either among younger participants only (and only for colon cancer) or among participants whose milk intakes were in the lowest tertile of the population distribution (RR for an increase of 100 ng/ml = 1.43 [95% CI = 1.13-1.93]). Nevertheless, in the meta-analysis a modest positive association remained between serum IGF-I and colorectal cancer risk overall (RR = 1.07 [1.01-1.14] for 1 standard deviation increase in IGF-I). Overall, data from our present study and previous prospective studies combined indicate a relatively modest association of colorectal cancer risk with serum IGF-I.
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Affiliation(s)
- Sabina Rinaldi
- International Agency for Research on Cancer, Lyon, France
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Suzuki R, Allen NE, Appleby PN, Key TJ, Dossus L, Tjønneland A, Føns Johnsen N, Overvad K, Sacerdote C, Palli D, Krogh V, Tumino R, Rohrmann S, Linseisen J, Boeing H, Trichopoulou A, Makrygiannis G, Misirli G, Bueno-de-Mesquita HB, May AM, Díaz MJT, Sánchez MJ, Barricarte Gurrea A, Rodríguez Suárez L, Buckland G, Larrañaga N, Bingham S, Khaw KT, Rinaldi S, Slimani N, Jenab M, Riboli E, Kaaks R. Lifestyle factors and serum androgens among 636 middle aged men from seven countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control 2009. [DOI: 10.1007/s10552-009-9349-4] [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: 10/20/2022]
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Suzuki R, Allen NE, Appleby PN, Key TJ, Dossus L, Tjønneland A, Føns Johnsen N, Overvad K, Sacerdote C, Palli D, Krogh V, Tumino R, Rohrmann S, Linseisen J, Boeing H, Trichopoulou A, Makrygiannis G, Misirli G, Bueno-de-Mesquita HB, May AM, Díaz MJT, Sánchez MJ, Barricarte Gurrea A, Rodríguez Suárez L, Buckland G, Larrañaga N, Bingham S, Khaw KT, Rinaldi S, Slimani N, Jenab M, Riboli E, Kaaks R. Lifestyle factors and serum androgens among 636 middle aged men from seven countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control 2009; 20:811-21. [DOI: 10.1007/s10552-009-9326-y] [Citation(s) in RCA: 22] [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] [Received: 08/22/2008] [Accepted: 02/24/2009] [Indexed: 10/21/2022]
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