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Radu RA, Costalat V, Fahed R, Ghozy S, Siegler JE, Shaikh H, Khalife J, Abdalkader M, Klein P, Nguyen TN, Heit JJ, Sweid A, El Naamani K, Regenhardt RW, Diestro JDB, Cancelliere NM, Amllay A, Meyer L, Dusart A, Bellante F, Forestier G, Rouchaud A, Saleme S, Mounayer C, Fiehler J, Kühn AL, Puri AS, Dyzmann C, Kan PT, Colasurdo M, Marnat G, Berge J, Barreau X, Sibon I, Nedelcu S, Henninger N, Kyheng M, Marotta TR, Stapleton CJ, Rabinov JD, Ota T, Dofuku S, Yeo LLL, Tan BYQ, Martinez-Gutierrez JC, Salazar-Marioni S, Sheth S, Renieri L, Capirossi C, Mowla A, Tjoumakaris SI, Jabbour P, Khandelwal P, Biswas A, Clarençon F, Elhorany M, Premat K, Valente I, Pedicelli A, Pedro Filipe J, Varela R, Quintero-Consuegra M, Gonzalez NR, Möhlenbruch MA, Jesser J, Tancredi I, ter Schiphorst A, Yedavalli V, Harker P, Chervak LM, Aziz Y, Gory B, Paul Stracke C, Hecker C, Killer-Oberpfalzer M, Griessenauer CJ, Thomas AJ, Hsieh CY, Liebeskind DS, Alexandre AM, Faizy TD, Weyland C, Patel AB, Pereira VM, Lubicz B, Dmytriw AA, Guenego A. First pass effect as an independent predictor of functional outcomes in medium vessel occlusions: An analysis of an international multicenter study. Eur Stroke J 2024; 9:114-123. [PMID: 37885243 PMCID: PMC10916815 DOI: 10.1177/23969873231208276] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION First pass effect (FPE), achievement of complete recanalization (mTICI 2c/3) with a single pass, is a significant predictor of favorable outcomes for endovascular treatment (EVT) in large vessel occlusion stroke (LVO). However, data concerning the impact on functional outcomes and predictors of FPE in medium vessel occlusions (MeVO) are scarce. PATIENTS AND METHODS We conducted an international retrospective study on MeVO cases. Multivariable logistic modeling was used to establish independent predictors of FPE. Clinical and safety outcomes were compared between the two study groups (FPE vs non-FPE) using logistic regression models. Good outcome was defined as modified Rankin Scale 0-2 at 3 months. RESULTS Eight hundred thirty-six patients with a final mTICI ⩾ 2b were included in this analysis. FPE was observed in 302 patients (36.1%). In multivariable analysis, hypertension (aOR 1.55, 95% CI 1.10-2.20) and lower baseline NIHSS score (aOR 0.95, 95% CI 0.93-0.97) were independently associated with an FPE. Good outcomes were more common in the FPE versus non-FPE group (72.8% vs 52.8%), and FPE was independently associated with favorable outcome (aOR 2.20, 95% CI 1.59-3.05). 90-day mortality and intracranial hemorrhage (ICH) were significantly lower in the FPE group, 0.43 (95% CI, 0.25-0.72) and 0.55 (95% CI, 0.39-0.77), respectively. CONCLUSION Over 2/3 of patients with MeVOs and FPE in our cohort had a favorable outcome at 90 days. FPE is independently associated with favorable outcomes, it may reduce the risk of any intracranial hemorrhage, and 3-month mortality.
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Affiliation(s)
- Răzvan Alexandru Radu
- Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Vincent Costalat
- Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Robert Fahed
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, ON, Canada
| | - Sherief Ghozy
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - James E Siegler
- Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Hamza Shaikh
- Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Jane Khalife
- Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Mohamad Abdalkader
- Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA
| | - Piers Klein
- Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA
| | - Thanh N Nguyen
- Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA
| | - Jeremy J Heit
- Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA
| | - Ahmad Sweid
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Kareem El Naamani
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Robert W Regenhardt
- Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Jose Danilo Bengzon Diestro
- Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada
| | - Nicole M Cancelliere
- Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada
| | - Abdelaziz Amllay
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lukas Meyer
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Dusart
- Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium
| | - Flavio Bellante
- Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium
| | - Géraud Forestier
- University Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France
| | - Aymeric Rouchaud
- University Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France
| | - Suzana Saleme
- University Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France
| | - Charbel Mounayer
- University Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Luisa Kühn
- Department of Radiology, University of Massachusetts Memorial Hospital, Worcester, MA, USA
| | - Ajit S Puri
- Department of Radiology, University of Massachusetts Memorial Hospital, Worcester, MA, USA
| | - Christian Dyzmann
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Sana Klinik Lübeck, Lübeck, Germany
| | - Peter T Kan
- Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Marco Colasurdo
- Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Gaultier Marnat
- Interventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | - Jérôme Berge
- Interventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | - Xavier Barreau
- Interventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | - Igor Sibon
- Neurology Department, Bordeaux University Hospital, Bordeaux, France
| | - Simona Nedelcu
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Nils Henninger
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Maéva Kyheng
- Department of Biostatistics, CHU Lille, Lille, France
| | - Thomas R Marotta
- Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada
| | - Christopher J Stapleton
- Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - James D Rabinov
- Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Takahiro Ota
- Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Shogo Dofuku
- Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Leonard LL Yeo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Benjamin YQ Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Neurology, Department of Medicine, National University Hospital, Singapore
| | | | | | - Sunil Sheth
- Department of Neurology, UTHealth McGovern Medical School, Houston, TX, USA
| | - Leonardo Renieri
- Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy
| | - Carolina Capirossi
- Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy
| | - Ashkan Mowla
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | | | - Pascal Jabbour
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Priyank Khandelwal
- Department of Endovascular Neurosurgery and Neuroradiology, NJMS, Newark, NJ, USA
| | - Arundhati Biswas
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA
| | - Frédéric Clarençon
- Department of Neuroradiology, Pitié-Salpêtrière Hospital. Paris. France; GRC BioFast, Sorbonne University, Paris VI, France
| | - Mahmoud Elhorany
- Department of Neuroradiology, Pitié-Salpêtrière Hospital. Paris. France; GRC BioFast, Sorbonne University, Paris VI, France
- Neurology Department, Faculty of Medicine, Tanta University, Egypt
| | - Kevin Premat
- Department of Neuroradiology, Pitié-Salpêtrière Hospital. Paris. France; GRC BioFast, Sorbonne University, Paris VI, France
| | - Iacopo Valente
- UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italy
| | - Alessandro Pedicelli
- UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italy
| | - João Pedro Filipe
- Department of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ricardo Varela
- Department of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | | | - Nestor R Gonzalez
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Markus A Möhlenbruch
- Sektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Jessica Jesser
- Sektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Illario Tancredi
- Department of Radiology, Hôpital Civil Marie Curie, Charleroi, Belgium
| | - Adrien ter Schiphorst
- Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Vivek Yedavalli
- Division of Neuroradiology, Department of Radiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA
| | - Pablo Harker
- Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Lina M Chervak
- Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Yasmin Aziz
- Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Benjamin Gory
- Department of Interventional Neuroradiology, Nancy University Hospital, Nancy, France
| | - Christian Paul Stracke
- Department of Radiology, Interventional Neuroradiology Section, University Medical Center Münster, Münster, Germany
| | - Constantin Hecker
- Departments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria
| | - Monika Killer-Oberpfalzer
- Departments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria
| | - Christoph J Griessenauer
- Departments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria
| | - Ajith J Thomas
- Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - David S Liebeskind
- UCLA Stroke Center and Department of Neurology Department, UCLA, Los Angeles, CA, USA
| | - Andrea M Alexandre
- UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italy
| | - Tobias D Faizy
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Charlotte Weyland
- Sektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Aman B Patel
- Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Vitor Mendes Pereira
- Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada
| | - Boris Lubicz
- Department of Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium
| | - Adam A Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA
- Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada
| | - Adrien Guenego
- Department of Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium
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Adwane G, Lapergue B, Piotin M, Gory B, Blanc R, Consoli A, Rodesch G, Mazighi M, Kyheng M, Labreuche J, Pico F. Frequency and predictors of decompressive craniectomy in ischemic stroke patients treated by mechanical thrombectomy in the ETIS registry. Rev Neurol (Paris) 2024; 180:177-181. [PMID: 37863718 DOI: 10.1016/j.neurol.2023.08.014] [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] [Received: 03/23/2023] [Revised: 08/09/2023] [Accepted: 08/30/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND AND AIMS Mechanical thrombectomy (MT) for patients with acute ischemic stroke (AIS) is usually performed in a comprehensive stroke center with on-site neurosurgical expertise. The question of whether MT can be performed in a primary stroke center without a neurosurgical facility is debated. In this context, there is a need to determine the frequency, delay and predictors of neurosurgical procedures in patients treated by MT. This study aims to determine these factors. METHODS In total, 432 patients under 60years old, diagnosed with an acute ischemic stroke with a large vessel occlusion and treated by MT between January 2018 and December 2019 in six French stroke centers, were selected from the French clinical registry ETIS. Univariate and multivariate logistic regression models were used to identify predictive factors for decompressive craniectomy. RESULTS Among the 432 included patients, 43 (9.9%) patients with an anterior circulation infarct underwent decompressive craniectomy. Higher admission NIHSS (OR: 1.08 [95% CI: 1.02-1.16]), lower ASPECT (OR per 1 point of decrease 1.53 [1.31-1.79] P<0.001) and preadmission antiplatelet use (OR: 3.03 [1.31-7.01]) were independent risk factors for decompressive craniectomy. The risk of decompressive craniectomy increases to more than 30% with an ASPECT score<4, an NIHSS>16, and current antiplatelet use. CONCLUSION In this multicenter registry, 9% of acute ischemic stroke patients (<60years old) treated with MT, required decompressive craniectomy. Higher NIHSS score, lower ASPECT score, and preadmission antiplatelet use increase the risk of subsequent requirement for decompressive craniectomy.
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Affiliation(s)
- G Adwane
- Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Versailles, France; Departement of Neurology and Stroke Center, Rothschild Foundation, Paris ,Fance.
| | - B Lapergue
- Neurology Department and Stroke Center, Foch Hospital, Suresnes, France
| | - M Piotin
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France
| | - B Gory
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Nancy, France
| | - R Blanc
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France
| | - A Consoli
- Department of Diagnostic and Interventional Neuroradiology, Hopital Foch, Suresnes, France
| | - G Rodesch
- Department of Diagnostic and Interventional Neuroradiology, Hopital Foch, Suresnes, France
| | - M Mazighi
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France; Paris Denis-Diderot University, Paris, France
| | - M Kyheng
- Lille University, CHU de Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, 59000 Lille, France
| | - J Labreuche
- Lille University, CHU de Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, 59000 Lille, France
| | - F Pico
- Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Versailles, France; Versailles Saint-Quentin-en-Yvelines and Paris Saclay University, Versailles, France; INSERM, Laboratory for Vascular Translational Science (LVTS)-1148, Paris, France
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Derraz I, Moulin S, Gory B, Kyheng M, Arquizan C, Costalat V, Lapergue B. Endovascular Thrombectomy Outcomes with and without Intravenous Thrombolysis for Large Ischemic Cores Identified with CT or MRI. Radiology 2023; 309:e230440. [PMID: 37847131 DOI: 10.1148/radiol.230440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/18/2023]
Abstract
Background Whether intravenous thrombolysis (IVT) prior to endovascular thrombectomy (EVT) provides additional benefits in patients with acute ischemic stroke (AIS) and a large infarct core (LIC) remains unclear. Purpose To examine whether treatment with IVT before EVT is beneficial in patients with LIC identified with CT or MRI (Alberta Stroke Program Early CT score 0-5). Materials and Methods This retrospective study included consecutive adult patients diagnosed with AIS due to large vessel occlusion (LVO) and LIC treated with EVT who were enrolled in the ETIS (Endovascular Treatment in Ischemic Stroke) Registry in France between January 2015 and January 2022. The primary outcome measure was a favorable outcome (modified Rankin Scale [mRS] score 0-3) at 90 days. Secondary outcomes included functional independence (mRS score 0-2) at 90 days, improvement in degree of disability (ordinal shift in mRS score toward a better outcome) at 90 days, early neurologic improvement at 24 hours, and successful reperfusion (modified Thrombolysis in Cerebral Infarction score of 2b or higher). Safety outcomes included symptomatic intracerebral hemorrhage within 24 hours and mortality at 90 days. Inverse probability of treatment weighting (IPTW)-adjusted analysis was used to assess the treatment effect of IVT adjusted for baseline variables. Results Of 1408 patients (mean age, 68.3 years ± 15.4 [SD]; 789 men), 654 (46.4%) were treated with IVT prior to EVT. In the IPTW-adjusted data set, IVT plus EVT was associated with a higher rate of favorable outcome at 90 days (odds ratio [OR], 1.24 [95% CI: 1.05, 1.46]; P = .01), functional independence at 90 days (OR, 1.47 [95% CI: 1.22, 1.77]; P < .001), improvement in degree of disability at 90 days (common OR, 1.30 [95% CI: 1.13, 1.49]; P < .001), early neurologic improvement (OR, 1.26 [95% CI: 1.07, 1.49]; P = .005), and successful reperfusion (OR, 1.43 [95% CI: 1.14, 1.79]; P = .002) than EVT alone. Rates of brain hemorrhage within 24 hours and mortality at 90 days were similar between groups. Conclusion In patients with AIS due to LVO with LIC identified with CT or MRI, treatment with IVT before EVT appeared to provide a clinical benefit over EVT alone. Clinical trial registration no. NCT03776877 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Kallmes and Rabinstein in this issue.
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Affiliation(s)
- Imad Derraz
- From the Departments of Neuroradiology (I.D., V.C.) and Neurology (C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, 80 Avenue Augustin Fliche, Montpellier 34295, France; Department of Neurology, Reims University Hospital Center, Reims, France (S.M.); Department of Neuroradiology, Nancy University Hospital Center, Nancy, France (B.G.); Department of Biostatistics, University of Lille, Lille University Hospital Center, EA 2694-Public Health: Epidemiology and Quality of Care, Lille, France (M.K.); and Department of Neurology, University of Versailles Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L.)
| | - Solène Moulin
- From the Departments of Neuroradiology (I.D., V.C.) and Neurology (C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, 80 Avenue Augustin Fliche, Montpellier 34295, France; Department of Neurology, Reims University Hospital Center, Reims, France (S.M.); Department of Neuroradiology, Nancy University Hospital Center, Nancy, France (B.G.); Department of Biostatistics, University of Lille, Lille University Hospital Center, EA 2694-Public Health: Epidemiology and Quality of Care, Lille, France (M.K.); and Department of Neurology, University of Versailles Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L.)
| | - Benjamin Gory
- From the Departments of Neuroradiology (I.D., V.C.) and Neurology (C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, 80 Avenue Augustin Fliche, Montpellier 34295, France; Department of Neurology, Reims University Hospital Center, Reims, France (S.M.); Department of Neuroradiology, Nancy University Hospital Center, Nancy, France (B.G.); Department of Biostatistics, University of Lille, Lille University Hospital Center, EA 2694-Public Health: Epidemiology and Quality of Care, Lille, France (M.K.); and Department of Neurology, University of Versailles Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L.)
| | - Maéva Kyheng
- From the Departments of Neuroradiology (I.D., V.C.) and Neurology (C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, 80 Avenue Augustin Fliche, Montpellier 34295, France; Department of Neurology, Reims University Hospital Center, Reims, France (S.M.); Department of Neuroradiology, Nancy University Hospital Center, Nancy, France (B.G.); Department of Biostatistics, University of Lille, Lille University Hospital Center, EA 2694-Public Health: Epidemiology and Quality of Care, Lille, France (M.K.); and Department of Neurology, University of Versailles Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L.)
| | - Caroline Arquizan
- From the Departments of Neuroradiology (I.D., V.C.) and Neurology (C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, 80 Avenue Augustin Fliche, Montpellier 34295, France; Department of Neurology, Reims University Hospital Center, Reims, France (S.M.); Department of Neuroradiology, Nancy University Hospital Center, Nancy, France (B.G.); Department of Biostatistics, University of Lille, Lille University Hospital Center, EA 2694-Public Health: Epidemiology and Quality of Care, Lille, France (M.K.); and Department of Neurology, University of Versailles Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L.)
| | - Vincent Costalat
- From the Departments of Neuroradiology (I.D., V.C.) and Neurology (C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, 80 Avenue Augustin Fliche, Montpellier 34295, France; Department of Neurology, Reims University Hospital Center, Reims, France (S.M.); Department of Neuroradiology, Nancy University Hospital Center, Nancy, France (B.G.); Department of Biostatistics, University of Lille, Lille University Hospital Center, EA 2694-Public Health: Epidemiology and Quality of Care, Lille, France (M.K.); and Department of Neurology, University of Versailles Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L.)
| | - Bertrand Lapergue
- From the Departments of Neuroradiology (I.D., V.C.) and Neurology (C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, 80 Avenue Augustin Fliche, Montpellier 34295, France; Department of Neurology, Reims University Hospital Center, Reims, France (S.M.); Department of Neuroradiology, Nancy University Hospital Center, Nancy, France (B.G.); Department of Biostatistics, University of Lille, Lille University Hospital Center, EA 2694-Public Health: Epidemiology and Quality of Care, Lille, France (M.K.); and Department of Neurology, University of Versailles Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L.)
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Nicolas A, Aumar M, Tran LC, Tiret A, Duclaux-Loras R, Bridoux-Henno L, Campeotto F, Fabre A, Breton A, Languepin J, Kyheng M, Viala J, Coopman S, Gottrand F. Comparison of Endoscopic Dilatation and Heller's Myotomy for Treating Esophageal Achalasia in Children: A Multicenter Study. J Pediatr 2022; 251:134-139.e2. [PMID: 35853483 DOI: 10.1016/j.jpeds.2022.07.010] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the efficacy of, and complications from, the 2 main treatments for achalasia: endoscopic dilatation and surgical cardiomyotomy (Heller's myotomy). STUDY DESIGN We retrospectively collected data on children treated for achalasia over an 11-year period from 8 tertiary pediatric centers. A line of treatment was defined as performing either Heller's myotomy or 1-3 sessions of endoscopy dilatation over 3 months. Treatment success was a priori defined as clinical improvement and no need for new treatment. RESULTS Ninety-seven children (median age, 12 years; 57% boys) were included. The median time to diagnosis was 10.5 months, and the median follow-up period was 27 months. Thirty-seven children were treated by Heller's myotomy and 60 by endoscopy dilatation as the first-line treatment. After adjustment for potentially confounding factors, Heller's myotomy was significantly more successful than endoscopy dilatation (hazard ratio, 3.93 [1.74; 8.88]; P = .001), with a median survival without failure of 49 and 7 months, respectively, and with no significant difference in the occurrence of complications (35.2% for Heller's myotomy, 29.7% for endoscopy dilatation, P = .56). Hydrostatic dilatation was as successful as pneumatic dilatation (hazard ratio, 1.35 [0.56; 3.23]; P = .50). CONCLUSIONS Heller's myotomy is more successful than endoscopy dilatation, with no significant difference in the occurrence of serious complications. This raises the potential role of peroral endoscopic myotomy as an alternative treatment to Heller's myotomy.
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Affiliation(s)
- Audrey Nicolas
- Department of Pediatrics, CHU Limoges, Limoges, France; Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University Lille, Lille, France
| | - Madeleine Aumar
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University Lille, Lille, France; University Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Léa Chantal Tran
- University Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Alice Tiret
- Department of Pediatric Gastroenterology and Nutrition, Hôpital Universitaire Robert-Debré, Assistance Publique-Hôpitaux de Paris, University Paris, Paris, France
| | - Rémi Duclaux-Loras
- Department of Pediatric Gastroenterology Hepatology and Nutrition, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France
| | - Laure Bridoux-Henno
- Department of Child and Adolescent Medicine, CHU Rennes Hôpital Sud, Rennes Cedex 2, France
| | - Florence Campeotto
- Pediatric Gastroenterology Department, APHP Necker-Enfants Malades Hospital, Paris, France
| | - Alexandre Fabre
- Pediatric Multidisciplinary Pediatric APHM, Timone Enfant, Marseille, France; Aix-Marseille University, INSERM, GMGF, Marseille, France
| | - Anne Breton
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Purpan University Hospital, Toulouse, France
| | | | - Maéva Kyheng
- ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, Lille, France; Department of Biostatistics, University Lille, CHU Lille, Lille, France
| | - Jérôme Viala
- Department of Pediatric Gastroenterology and Nutrition, Hôpital Universitaire Robert-Debré, Assistance Publique-Hôpitaux de Paris, University Paris, Paris, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University Lille, Lille, France
| | - Frédéric Gottrand
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University Lille, Lille, France; University Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.
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Laventure A, Lauwers L, Nicot R, Kyheng M, Ferri J, Raoul G. Autogenous bone grafting with conventional implants vs zygomatic implants for atrophic maxillae: a retrospective study of the oral health-related quality of life. J Stomatol Oral Maxillofac Surg 2022; 123:e782-e789. [PMID: 35817319 DOI: 10.1016/j.jormas.2022.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Autogenous bone grafting (ABG)-combined or not with Le Fort I osteotomy (LFIO)-and zygomatic implants (ZI) are two reliable techniques for the fixed rehabilitation of atrophic maxillae. ZI allow a reduced treatment duration with no need to graft, immediate loading and in principle less morbidity. The aim of this retrospective study was to compare these two protocols on oral health-related quality of life (OHRQoL). We also discussed implant and prosthetic survival rates, and biological complications. MATERIAL AND METHODS All patients who benefited from ZI or ABG with conventional implants (CI) for a fixed maxillary rehabilitation, from November 2011 to April 2019, were included: 21 patients in the ABG group and 22 in the ZI group. OHRQoL was evaluated postoperatively by OHIP-14 questionnaire. RESULTS OHIP-14 median scores were respectively 6.5 (interquartile range [IQR] 2.0-13.0) and 6.0 (IQR 3.0-10.0) without significant difference (p = 0.97). Implant/prosthetic survival rates were 97.9%/100% and 97.1%/95.5%. Biological complications rates were 33.3% and 36.4% without significant difference (p = 0.83). DISCUSSION The type of surgery or prosthesis does not seem to affect final OHRQoL, implant and prosthetic survival rates or biological complications rates.
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Affiliation(s)
- Alexandre Laventure
- University of Lille, F-59000 Lille, France; Department of oral and maxillofacial surgery, Roger Salengro hospital, Lille university hospital, Boulevard du Professeur Émile Laine, F-59000 Lille, France.
| | - Ludovic Lauwers
- University of Lille, F-59000 Lille, France; Department of oral and maxillofacial surgery, Roger Salengro hospital, Lille university hospital, Boulevard du Professeur Émile Laine, F-59000 Lille, France; University of Lille, Lille university hospital, ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - Romain Nicot
- University of Lille, F-59000 Lille, France; Department of oral and maxillofacial surgery, Roger Salengro hospital, Lille university hospital, Boulevard du Professeur Émile Laine, F-59000 Lille, France; Inserm, U1008, Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Maéva Kyheng
- University of Lille, F-59000 Lille, France; University of Lille, Lille university hospital, ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France; Lille university hospital, department of biostatistics, F-59000 Lille, France
| | - Joël Ferri
- University of Lille, F-59000 Lille, France; Department of oral and maxillofacial surgery, Roger Salengro hospital, Lille university hospital, Boulevard du Professeur Émile Laine, F-59000 Lille, France; Inserm, U1008, Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Gwénaël Raoul
- University of Lille, F-59000 Lille, France; Department of oral and maxillofacial surgery, Roger Salengro hospital, Lille university hospital, Boulevard du Professeur Émile Laine, F-59000 Lille, France; Inserm, U1008, Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
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6
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Bonnin P, Constans B, Duhamel A, Kyheng M, Ducloy-Bouthors AS, Estevez MG, Tavernier B, Gaudet A. Accuracy and trending ability of finger plethysmographic cardiac output monitoring in late pregnancy. Can J Anaesth 2022; 69:1340-1348. [PMID: 35927539 DOI: 10.1007/s12630-022-02297-y] [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] [Received: 11/04/2021] [Revised: 03/22/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Individuals in late pregnancy are at risk of significant hemodynamic variations, especially during Cesarean delivery. Although non-invasive monitoring might enable the early detection of variations in cardiac output (CO), clinical validation is lacking. METHODS In a prospective, single-center study, we measured CO simultaneously with finger plethysmography and transthoracic echocardiography in 100 third-trimester pregnant individuals in the supine and left lateral decubitus (LLD) positions. RESULTS A Bland-Altman analysis revealed a mean (standard deviation) bias of 1.36 (1.04) L·min-1 in the supine position (95% limits of agreement, -0.68 to 3.4 L·min-1; percent error, 26.6%), indicating overestimation by finger plethysmography. The intra-class correlation coefficient was 0.43 (95% confidence interval [CI], 0.33 to 0.51). Regarding the changes in CO induced by the supine-to-LLD transition, the concordance rate in a four-quadrant plot was 98.3% (95% CI, 91.1 to 99.9%). CONCLUSION Our study showed a poor reliability of finger plethysmography for static measurement of CO. Nevertheless, finger plethysmography had a reasonably high concordance rate for the detection of CO changes secondary to positional changes in late-pregnant individuals. STUDY REGISTRATION DATE: www. CLINICALTRIALS gov (NCT03735043); registered 8 November 2018.
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Affiliation(s)
- Paul Bonnin
- CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France
| | - Benjamin Constans
- CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France
- Centre Hospitalier de Seclin-Carvin, Service d'Anesthésie, Seclin, France
| | - Alain Duhamel
- Université de Lille, CHU Lille, ULR 2694 METRICS- Evaluation des technologies de santé et des pratiques médicales, Lille, France
- CHU Lille, Unité de Méthodologie, Biostatistiques et Data Management, Lille, France
| | - Maéva Kyheng
- Université de Lille, CHU Lille, ULR 2694 METRICS- Evaluation des technologies de santé et des pratiques médicales, Lille, France
- CHU Lille, Unité de Méthodologie, Biostatistiques et Data Management, Lille, France
| | | | | | - Benoit Tavernier
- CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France
- Université de Lille, CHU Lille, ULR 2694 METRICS- Evaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Alexandre Gaudet
- CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France.
- Department of Intensive Care Medicine, Critical Care Centre, CHU Lille, 59000, Lille, France.
- Université de Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Lille, France.
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Carton L, Auger F, Laloux C, Durieux N, Kyheng M, Potey C, Bergeron S, Rolland B, Deguil J, Bordet R. Effects of acute ethanol and/or diazepam exposure on immediate and delayed hippocampal metabolite levels in rats anesthetized with isoflurane. Fundam Clin Pharmacol 2022; 36:687-698. [DOI: 10.1111/fcp.12764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 01/13/2022] [Accepted: 01/31/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Louise Carton
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
| | - Florent Auger
- Lille In vivo Imaging and Functional Exploration platform Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41‐UMS 2014‐PLBS Lille France
| | - Charlotte Laloux
- Lille In vivo Imaging and Functional Exploration platform Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41‐UMS 2014‐PLBS Lille France
| | - Nicolas Durieux
- Lille In vivo Imaging and Functional Exploration platform Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41‐UMS 2014‐PLBS Lille France
| | - Maéva Kyheng
- ULR 2694‐METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales Univ. Lille, CHU Lille Lille France
- Département de Biostatistiques CHU Lille Lille France
| | - Camille Potey
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
| | - Sandrine Bergeron
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon CH Le Vinatier, Hospices Civils de Lyon Bron France
- Inserm U1028, CNRS UMR5292 Université Claude Bernard Lyon 1 Bron France
| | - Julie Deguil
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
| | - Régis Bordet
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
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Vitrant É, Rolland AL, Kyheng M, Delepine J, Bardiaux L, Parent C, Baffet H, Catteau-Jonard S, Robin G. [Evaluation of the success of medical abortion by a plasma hCG control threshold]. Gynecol Obstet Fertil Senol 2022; 50:382-389. [PMID: 34774854 DOI: 10.1016/j.gofs.2021.10.013] [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] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/07/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES In France, monitoring of the success of medical abortion is recommended 2 to 3 weeks after the procedure. However, there is no clear consensus on the modalities of this monitoring. The main objective of this study is to identify a threshold of serum hCG (human chorionic gonadotropin) control for medical abortions ≤7 weeks of gestation below which success can be confirmed without recourse to pelvic ultrasound. METHODS This is a retrospective multicenter study conducted over a 14-month period. The serum hCG level, measured between the 15th and 25th day following the abortion, was compared with the results of the pelvic ultrasound performed at the follow-up visit. Ultrasound failure was defined as retention or persistent pregnancy. RESULTS Among the 624 women included, the failure rate was 22.3%, including 86.3% of retentions, 8.6% of pregnancies stopped and 5% of pregnancies progressed. Using a ROC curve, the threshold value of hCG found to exclude failure at 95% was 253 IU/l (AUC=0.9202, sensitivity=84.17%, specificity=85.95% and positive predictive value [PPV]=63%). CONCLUSIONS A serum hCG level ≤253 IU/l is sufficient to affirm the efficacy of medical abortion. However, since PPV is only 63% for this threshold, ultrasound should be reserved for women with high hCG levels.
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Affiliation(s)
- É Vitrant
- Service de gynécologie médicale, orthogénie et sexologie, CHU de Lille, University Lille, 59000 Lille, France.
| | - A-L Rolland
- Service de gynécologie médicale, orthogénie et sexologie, CHU de Lille, University Lille, 59000 Lille, France
| | - M Kyheng
- Département de biostatistique de Lille, CHU de Lille, University Lille, 59000 Lille, France
| | - J Delepine
- Service de gynécologie-obstétrique et orthogénie, centre hospitalier de Calais, 62100 Calais, France
| | - L Bardiaux
- Service de gynécologie-obstétrique et orthogénie, GH Artois-Ternois, centre hospitalier de Arras, 62000 Arras, France
| | - C Parent
- Service de gynécologie-obstétrique et orthogénie, GH Territoire de l'Artois, centre hospitalier de Lens, 62300 Lens, France
| | - H Baffet
- Service de gynécologie médicale, orthogénie et sexologie, CHU de Lille, University Lille, 59000 Lille, France
| | - S Catteau-Jonard
- Service de gynécologie médicale, orthogénie et sexologie, CHU de Lille, University Lille, 59000 Lille, France
| | - G Robin
- Service de gynécologie médicale, orthogénie et sexologie, CHU de Lille, University Lille, 59000 Lille, France
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9
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Duloquin G, Ferrigno M, Hassen WB, Kyheng M, Bricout N, Boulouis G, Seners P, Labreuche J, Turc G, Naggara O, Cordonnier C, Henon H, Pasi M. Pre-treatment lesional volume in older stroke patients treated with endovascular treatment. Int J Stroke 2022; 17:1085-1092. [PMID: 35225745 DOI: 10.1177/17474930211068657] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent studies in the general stroke population treated with endovascular treatment (EVT) reported that higher pre-treatment lesional volumes were independently associated with poor neurological outcome and functional dependence after stroke. However, it has been not evaluated in older patients. AIM We test the association between the pre-treatment lesional volume on diffusion-weighted magnetic resonance imaging and relevant outcome measures in older adults with stroke treated with EVT. METHODS We included consecutive older adults with stroke (⩾80 years old) treated with EVT in two academic comprehensive stroke centers. The association between pre-treatment lesional volume and relevant outcome measures (poor outcome (modified Rankin scale 4-6), 3-month mortality and symptomatic intracerebral hemorrhage (sICH)) was evaluated using univariate and multivariable models. RESULTS Five hundred seventy-nine patients were included (mean age: 85.6 ± 4.1, median lesional volume was 10 ml; interquartile range: 3-30 ml). Pre-treatment lesional volume was associated with poor functional outcome (adjusted odds ratio (aOR): 1.87, 95% confidence interval (CI): 1.60-2.20, for +1 logarithmic increase of lesional volume), 3-month mortality (aOR: 1.50, CI: 1.28-1.76), and sICH (aOR: 1.67, CI: 1.27-2.20). A threshold lesional volume >35 ml predicted 90% of patients with poor functional outcome and a cut-off >51 ml predicted 90% of patients dead at 3 months. CONCLUSIONS Pre-treatment lesional volume might contribute, in association with other relevant clinical features, to the selection of older stroke patients who will benefit from EVT.
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Affiliation(s)
- Gauthier Duloquin
- EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Marc Ferrigno
- University of Lille, Inserm, CHU Lille, U1172-Lille Neuroscience & Cognition (LilNCog), Lille, France
| | - Wagih Ben Hassen
- Department of Neuroradiology, Paris University, Inserm U1266, GHU Paris, Saint-Anne Hospital, Paris, France
| | - Maéva Kyheng
- Département de Biostatistiques, CHU Lille, Lille, France.,University of Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France
| | | | - Grégoire Boulouis
- Department of Neuroradiology, Paris University, Inserm U1266, GHU Paris, Saint-Anne Hospital, Paris, France
| | - Pierre Seners
- Université de Paris, Inserm U1266, GHU Paris Psychiatrie et Neurosciences (Department of Neurology), FHU NeuroVasc, Paris, France
| | | | - Guillaume Turc
- Université de Paris, Inserm U1266, GHU Paris Psychiatrie et Neurosciences (Department of Neurology), FHU NeuroVasc, Paris, France
| | - Olivier Naggara
- Department of Neuroradiology, Paris University, Inserm U1266, GHU Paris, Saint-Anne Hospital, Paris, France
| | - Charlotte Cordonnier
- University of Lille, Inserm, CHU Lille, U1172-Lille Neuroscience & Cognition (LilNCog), Lille, France
| | - Hilde Henon
- University of Lille, Inserm, CHU Lille, U1172-Lille Neuroscience & Cognition (LilNCog), Lille, France
| | - Marco Pasi
- University of Lille, Inserm, CHU Lille, U1172-Lille Neuroscience & Cognition (LilNCog), Lille, France
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Depoortere S, Lapillonne A, Sfeir R, Bonnard A, Gelas T, Panait N, Rabattu PY, Guignot A, Lamireau T, Irtan S, Habonimana E, Breton A, Fouquet V, Allal H, Elbaz F, Talon I, Ranke A, Abely M, Michel JL, Lirussi Borgnon J, Buisson P, Schmitt F, Lardy H, Petit T, Chaussy Y, Borderon C, Levard G, Cremillieux C, Tolg C, Breaud J, Jaby O, Grossos C, De Vries P, Arnould M, Pelatan C, Geiss S, Laplace C, Kyheng M, Nicolas A, Aumar M, Gottrand F. Nutritional status at age 1 year in patients born with esophageal atresia: A population-based, prospective cohort study. Front Pediatr 2022; 10:969617. [PMID: 35990006 PMCID: PMC9387303 DOI: 10.3389/fped.2022.969617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Despite recent progress in caring for patients born with esophageal atresia (EA), undernutrition and stunting remain common. Our study objective was to assess nutritional status in the first year after birth with EA and to identify factors associated with growth failure. STUDY DESIGN We conducted a population-based study of all infants born in France with EA between 2010 and 2016. Through the national EA register, we collected prenatal to 1 year follow-up data. We used body mass index and length-for-age ratio Z scores to define patients who were undernourished and stunted, respectively. Factors with P < 0.20 in univariate analyses were retained in a logistic regression model. RESULTS Among 1,154 patients born with EA, body mass index and length-for-age ratio Z scores at 1 year were available for about 61%. Among these, 15.2% were undernourished and 19% were stunted at the age of 1 year. There was no significant catch-up between ages 6 months and 1 year. Patients born preterm (41%), small for gestational age (17%), or with associated abnormalities (55%) were at higher risk of undernutrition and stunting at age 1 year (P < 0.05). Neither EA type nor surgical treatment was associated with growth failure. CONCLUSION Undernutrition and stunting are common during the first year after birth in patients born with EA. These outcomes are significantly influenced by early factors, regardless of EA type or surgical management. Identifying high-risk patient groups with EA (i.e., those born preterm, small for gestational age, and/or with associated abnormalities) may guide early nutritional support strategies.
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Affiliation(s)
- Suzanne Depoortere
- Univ. Lille, CRACMO Reference Center for Rare Esophageal Diseases, CHU Lille, INFINITE U1286, Lille, France
| | | | - Rony Sfeir
- Univ. Lille, CRACMO Reference Center for Rare Esophageal Diseases, CHU Lille, INFINITE U1286, Lille, France
| | | | | | | | | | | | | | - Sabine Irtan
- University Hospital APHP Armand Trousseau, Paris, France
| | | | - Anne Breton
- University Hospital of Toulouse, Toulouse, France
| | | | - Hossein Allal
- University Hospital of Montpellier, Montpellier, France
| | | | | | | | - Michel Abely
- University Hospital of Reims, Reims, Champagne-Ardenne, France
| | - Jean-Luc Michel
- University Hospital of La Réunion, Saint Denis de la Réunion, France
| | | | | | | | | | | | - Yann Chaussy
- University Hospital of Besançon, Besançon, France
| | - Corinne Borderon
- University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | - Cécilia Tolg
- University Hospital of Fort De France, Martinique, Fort de France, France
| | | | | | | | | | | | | | | | | | - Maéva Kyheng
- CHU Lille-Department of Biostatistics, Lille, France
| | - Audrey Nicolas
- Univ. Lille, CRACMO Reference Center for Rare Esophageal Diseases, CHU Lille, INFINITE U1286, Lille, France
| | - Madeleine Aumar
- Univ. Lille, CRACMO Reference Center for Rare Esophageal Diseases, CHU Lille, INFINITE U1286, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, CRACMO Reference Center for Rare Esophageal Diseases, CHU Lille, INFINITE U1286, Lille, France
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Marrama F, Kyheng M, Pasi M, Pierre Rutgers M, Moulin S, Diomedi M, Leys D, Cordonnier C, Hénon H, Casolla B. Early-onset delirium after spontaneous intracerebral hemorrhage. Int J Stroke 2021; 17:1030-1038. [PMID: 34875917 DOI: 10.1177/17474930211059636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/17/2022]
Abstract
OBJECTIVE This study aimed at identifying the incidence, predictors, and impact on long-term mortality and dementia of early-onset delirium in a cohort of patients with spontaneous intracerebral hemorrhage. METHODS We prospectively recruited consecutive patients in the Prognosis of InTra-Cerebral Hemorrhage (PITCH) cohort and analyzed incidence rate of early-onset delirium (i.e. during the first seven days after intracerebral hemorrhage onset) with a competing risk model. We used a multivariable Fine-Gray model to identify baseline predictors, a Cox regression model to study its impact on the long-term mortality risk, and a Fine-Gray model adjusted for pre-specified confounders to analyze its impact on new-onset dementia. RESULTS The study population consisted of 248 patients (mean age 70 years, 54% males). Early-onset delirium incidence rate was 29.8% (95% confidence interval (CI) 24.3-35.6). Multivariate analysis showed that pre-existing dementia (subhazard ratio (SHR) 2.08, 95%CI 1.32-3.32, p = 0.002), heavy alcohol intake (SHR 1.79, 95%CI 1.13-2.82, p = 0.013), and intracerebral hemorrhage lobar location (SHR 1.56, 95%CI 1.01-2.42, p = 0.049) independently predicted early-onset delirium. Median follow-up was 9.5 years. Early-onset delirium was associated with higher mortality rates during the first five years of follow-up (HR 1.52, 95%CI 1.00-2.31, p = 0.049), but did not predict new-onset dementia (SHR 1.31, 95%CI 0.60-2.87). CONCLUSION Early-onset delirium is a frequent complication after intracerebral hemorrhage; it is associated with markers of pre-existing brain vulnerability and with higher mortality risk, but not with higher dementia rates during long-term follow-up.
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Affiliation(s)
- Federico Marrama
- U1172 - LilNCog-Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France.,Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy
| | - Maéva Kyheng
- ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Univ. Lille, CHU Lille, Lille, France.,Département de Biostatistiques, CHU Lille, Lille, France
| | - Marco Pasi
- U1172 - LilNCog-Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France
| | - Matthieu Pierre Rutgers
- U1172 - LilNCog-Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France.,82432Europe Hospitals, Brussels, Belgium
| | - Solène Moulin
- U1172 - LilNCog-Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France.,Department of Neurology, CHU Reims, Reims, France
| | - Marina Diomedi
- Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy
| | - Didier Leys
- U1172 - LilNCog-Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France
| | - Charlotte Cordonnier
- U1172 - LilNCog-Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France
| | - Hilde Hénon
- U1172 - LilNCog-Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France
| | - Barbara Casolla
- U1172 - LilNCog-Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, Lille, France.,Stroke Unit, UR2CA-URRIS Neurology, CHU Pasteur 2, Nice Cote d'Azur University, Nice, France
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12
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Carton L, Niot C, Kyheng M, Petrault M, Laloux C, Potey C, Lenski M, Bordet R, Deguil J. Lack of direct involvement of a diazepam long-term treatment in the occurrence of irreversible cognitive impairment: a pre-clinical approach. Transl Psychiatry 2021; 11:612. [PMID: 34857741 PMCID: PMC8640018 DOI: 10.1038/s41398-021-01718-8] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/20/2021] [Accepted: 10/25/2021] [Indexed: 11/11/2022] Open
Abstract
Several observational studies have found a link between the long-term use of benzodiazepines and dementia, which remains controversial. Our study was designed to assess (i) whether the long-term use of benzodiazepines, at two different doses, has an irreversible effect on cognition, (ii) and whether there is an age-dependent effect. One hundred and five C57Bl/6 male mice were randomly assigned to the 15 mg/kg/day, the 30 mg/kg/day diazepam-supplemented pellets, or the control group. Each group comprised mice aged 6 or 12 months at the beginning of the experiments and treated for 16 weeks. Two sessions of behavioral assessment were conducted: after 8 weeks of treatment and after treatment completion following a 1-week wash-out period. The mid-treatment test battery included the elevated plus maze test, the Y maze spontaneous alternation test, and the open field test. The post-treatment battery was upgraded with three additional tests: the novel object recognition task, the Barnes maze test, and the touchscreen-based paired-associated learning task. At mid-treatment, working memory was impaired in the 15 mg/kg diazepam group compared to the control group (p = 0.005). No age effect was evidenced. The post-treatment assessment of cognitive functions (working memory, visual recognition memory, spatial reference learning and memory, and visuospatial memory) did not significantly differ between groups. Despite a cognitive impact during treatment, the lack of cognitive impairment after long-term treatment discontinuation suggests that benzodiazepines alone do not cause irreversible deleterious effects on cognitive functions and supports the interest of discontinuation in chronically treated patients.
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Affiliation(s)
- Louise Carton
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, 59000, Lille, France.
| | - Candice Niot
- Pharmacy Service, Arras Hospital Center, 62000 Arras, France
| | - Maéva Kyheng
- grid.410463.40000 0004 0471 8845Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, 59000 Lille, France ,grid.410463.40000 0004 0471 8845Département de Biostatistiques, CHU Lille, 59000 Lille, France
| | - Maud Petrault
- grid.410463.40000 0004 0471 8845Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, 59000 Lille, France
| | - Charlotte Laloux
- grid.410463.40000 0004 0471 8845Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UMS 2014 - PLBS, Lille In vivo Imaging and Functional Exploration, 59000 Lille, France
| | - Camille Potey
- grid.410463.40000 0004 0471 8845Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, 59000 Lille, France
| | - Marie Lenski
- grid.410463.40000 0004 0471 8845Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS – Impact de l’Environnement Chimique sur la Santé, 59000 Lille, France
| | - Régis Bordet
- grid.410463.40000 0004 0471 8845Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, 59000 Lille, France
| | - Julie Deguil
- grid.410463.40000 0004 0471 8845Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, 59000 Lille, France
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13
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Bobin A, Kyheng M, Guidez S, Gruchet-Merouze C, Richez V, Duhamel A, Karlin L, Kolb B, Tiab M, Araujo C, Meuleman N, Malfuson JV, Bourquard P, Lenain P, Perrot A, Roussel M, Jaccard A, Petillon MO, Belhadj-Merzoug K, Chretien ML, Fontan J, Rodon P, Schmitt A, Offner F, Voillat L, Cereja S, Kuhnowski F, Rigaudeau S, Decaux O, Humbrecht-Kraut C, Frayfer J, Fitoussi O, Roos-Weil D, Eisenmann JC, Dorvaux V, Voog EG, Moreau P, Avet-Loiseau H, Hulin C, Facon T, Leleu X. Carfilzomib maintenance in newly diagnosed non-transplant eligible multiple myeloma. Leukemia 2021; 36:881-884. [PMID: 34650225 DOI: 10.1038/s41375-021-01415-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Arthur Bobin
- Service d'onco-hématologie, and Inserm 1402, CHU, Poitiers, France
| | - Maéva Kyheng
- Univ., ULR 2694-METRICS, CHRU, Lille, France.,Département de Biostatistiques, CHRU, Lille, France
| | - Stéphanie Guidez
- Service d'onco-hématologie, and Inserm 1402, CHU, Poitiers, France
| | | | - Valentine Richez
- Service d'Hématologie Clinique-Greffe de Moelle, CHU, Nice, France
| | - Alain Duhamel
- Univ., ULR 2694-METRICS, CHRU, Lille, France.,Département de Biostatistiques, CHRU, Lille, France
| | | | - Brigitte Kolb
- Service d'Hématologie, Hôpital Robert Debré, CHU, Reims, France
| | - Mourad Tiab
- Service d'Hématologie, CH, La Roche sur Yon, France
| | | | - Nathalie Meuleman
- Service d'Hématologie, Institut Jules Bordet, Université Libre, Bruxelles, Belgium
| | | | | | - Pascal Lenain
- Service d'Hématologie, Centre Henri Becquerel, CNLCC, Rouen, France
| | | | | | | | | | | | | | | | | | - Anna Schmitt
- Service d'Hématologie, Institut Bergonié, Bordeaux, France
| | - Fritz Offner
- Department Clinical Hematology, University Hospital, Ghent, Belgium
| | | | | | | | | | | | | | | | | | - Damien Roos-Weil
- Service d'Hématologie, Hôpital de la Pitié Salpétrière, Paris, France
| | | | | | | | | | | | - Cyrille Hulin
- Service d'Hématologie, Hôpital Haut Leveque, CHU, Bordeaux, France
| | | | | | - Xavier Leleu
- Service d'onco-hématologie, and Inserm 1402, CHU, Poitiers, France.
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14
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Marrama F, Kyheng M, Pasi M, Rutgers M, Moulin S, Diomedi M, Leys D, Cordonnier C, Hénon H, Casolla B. Early-onset delirium after spontaneous intracerebral hemorrhage. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.117657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Kyheng M, Babykina G, Ternynck C, Devos D, Labreuche J, Duhamel A. Joint latent class model: Simulation study of model properties and application to amyotrophic lateral sclerosis disease. BMC Med Res Methodol 2021; 21:198. [PMID: 34592944 PMCID: PMC8482570 DOI: 10.1186/s12874-021-01377-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background In many clinical applications, evolution of a longitudinal marker is censored by an event occurrence, and, symmetrically, event occurrence can be influenced by the longitudinal marker evolution. In such frameworks joint modeling is of high interest. The Joint Latent Class Model (JLCM) allows to stratify the population into groups (classes) of patients that are homogeneous both with respect to the evolution of a longitudinal marker and to the occurrence of an event; this model is widely employed in real-life applications. However, the finite sample-size properties of this model remain poorly explored. Methods In the present paper, a simulation study is carried out to assess the impact of the number of individuals, of the censoring rate and of the degree of class separation on the finite sample size properties of the JLCM. A real-life application from the neurology domain is also presented. This study assesses the precision of class membership prediction and the impact of covariates omission on the model parameter estimates. Results Simulation study reveals some departures from normality of the model for survival sub-model parameters. The censoring rate and the number of individuals impact the relative bias of parameters, especially when the classes are weakly distinguished. In real-data application the observed heterogeneity on individual profiles in terms of a longitudinal marker evolution and of the event occurrence remains after adjusting to clinically relevant and available covariates; Conclusion The JLCM properties have been evaluated. We have illustrated the discovery in practice and highlights the usefulness of the joint models with latent classes in this kind of data even with pre-specified factors. We made some recommendations for the use of this model and for future research.
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Affiliation(s)
- Maéva Kyheng
- ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, Univ. Lille, CHU Lille, Lille, France. .,Département de Biostatistiques, CHU Lille, Lille, France.
| | - Génia Babykina
- ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, Univ. Lille, CHU Lille, Lille, France.,Département de Biostatistiques, CHU Lille, Lille, France
| | - Camille Ternynck
- ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, Univ. Lille, CHU Lille, Lille, France.,Département de Biostatistiques, CHU Lille, Lille, France
| | - David Devos
- Expert center for ALS, Expert center for Parkinson, Medical Pharmacology, Univ. Lille, Lille Neuroscience & Cognition, Inserm, UMR-S1172, Lille, France
| | - Julien Labreuche
- Expert center for ALS, Expert center for Parkinson, Medical Pharmacology, Univ. Lille, Lille Neuroscience & Cognition, Inserm, UMR-S1172, Lille, France
| | - Alain Duhamel
- ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, Univ. Lille, CHU Lille, Lille, France.,Département de Biostatistiques, CHU Lille, Lille, France
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16
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Letarouilly JG, Flachaire B, Labadie C, Kyheng M, Cohen N, Sellam J, Richette P, Dieude P, Claudepierre P, Fautrel B, Houvenagel E, Nguyen CD, Guyot MH, Segaud N, Marguerie L, Deprez X, Salmon JH, Baudens G, Miceli-Richard C, Gervais E, Chary-Valckenaere I, Lafforgue P, Philippe P, Loeuille D, Richez C, Tubach F, Pham T, Flipo RM. Secukinumab and ustekinumab treatment in psoriatic arthritis: results of a direct comparison. Rheumatology (Oxford) 2021; 60:2773-2782. [PMID: 33232465 DOI: 10.1093/rheumatology/keaa710] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/26/2020] [Revised: 09/19/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To evaluate the characteristics of patients (pts) with PsA treated by ustekinumab (UST) or secukinumab (SEK) and to compare real-world persistence of UST and SEK in PsA. METHODS In this retrospective, national, multicentre cohort study, pts with PsA (CASPAR criteria or diagnosis confirmed by the rheumatologist) initiating UST or SEK with a follow-up ≥6 months were included from January 2011 to April 2019. The persistence between SEK and UST was assessed after considering the potential confounding factors by using pre-specified propensity-score methods. Causes of discontinuation and tolerance were also collected. RESULTS A total of 406 pts were included: 245 with UST and 161 with SEK. The persistence rate was lower in the UST group compared with the SEK group [median persistence 9.4 vs 14.7 months; 26.4% vs 38.0% at 2 years; weighted hazard ratio (HR) = 1.42; 95% CI: 1.07, 1.92; P =0.015]. In subgroup analysis, the persistence rate of SEK associated with MTX was significantly higher than that of UST associated with MTX: HR = 2.20; 95% CI: 1.30, 3.51; P =0.001, in contrast to SEK vs UST monotherapy: HR = 1.06; 95% CI: 0.74, 1.53; P =0.75. Discontinuation due to inefficacy was reported in 91.7% (SEK) and 82.4% (UST) of pts. Discontinuation due to an adverse event was reported in 12.2% (SEK) and 7.7% (UST) of pts. CONCLUSION In this first study comparing UST and SEK, the persistence of SEK was higher than that of UST in PsA. In subgroup analysis, this difference was only found in association with MTX.
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Affiliation(s)
| | - Benoît Flachaire
- Service de Rhumatologie, Univ. Aix-Marseille, APHM, Marseille, France
| | - Céline Labadie
- Service de Rhumatologie, Université Bordeaux, CHU Bordeaux, Bordeaux, France
| | - Maéva Kyheng
- ULR 2694 - METRICS: Évaluation des Technologies de santé et Des Pratiques Médicales, Université Lille, France.,Département des Biostatistiques, CHU de Lille, Lille, France
| | - Nicolas Cohen
- Service de Rhumatologie, Univ. Aix-Marseille, APHM, Marseille, France
| | - Jérémie Sellam
- Service de Rhumatologie, APHP, Hôpital Saint Antoine, Sorbonne Université, CRSA Inserm UMRS_938, Paris, France
| | - Pascal Richette
- Service de Rhumatologie, APHP, Hôpital Lariboisière, Paris, France.,Inserm, UMR-S 1132, Bioscar, Université de Paris, Paris, France
| | - Philippe Dieude
- Service de Rhumatologie, Université de Paris, INSERM UMR1152, Groupe Hospitalier Universitaire Bichat-Claude Bernard, APHP, Paris, France
| | - Pascal Claudepierre
- Ep, iDermE, EA7379, Université Paris Est Creteil, Creteil, France.,Department of Rheumatology, Hopital Henri-Mondor, AP-HP, Creteil, France
| | - Bruno Fautrel
- Service de Rhumatologie, Hôpital Pitié, Sorbonne Université, AP-HP, Paris, France
| | - Eric Houvenagel
- Service de Rhumatologie, Institut Catholique de Lille, Hôpital Saint Philibert, Ghicl, Lomme, France
| | | | | | - Nicolas Segaud
- Service de Médecine Interne, CH Armentières, Armentières, France
| | | | - Xavier Deprez
- Service de Rhumatologie, CH Valenciennes, Valenciennes, France
| | - Jean-Hugues Salmon
- Service de Rhumatologie, Université Reims, Champagne-Ardenne, CHU Reims, Reims, France
| | - Guy Baudens
- Cabinet, Libéral de Rhumatologie, Valenciennes, France
| | | | - Elisabeth Gervais
- Service de Rhumatologie, Université de Poitiers, CHU Poitiers, Poitiers, France
| | | | - Pierre Lafforgue
- Service de Rhumatologie, Univ. Aix-Marseille, APHM, Marseille, France
| | - Peggy Philippe
- Service de Rhumatologie, Université Lille, CHU Lille, Lille, France
| | - Damien Loeuille
- Service de Rhumatologie, Université de Poitiers, CHU Poitiers, Poitiers, France
| | - Christophe Richez
- Service de Rhumatologie, Université Bordeaux, CHU Bordeaux, Bordeaux, France
| | - Florence Tubach
- Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Institut Pierre Louis d'Epidémiologie et de Santé Publique, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
| | - Thao Pham
- Service de Rhumatologie, Univ. Aix-Marseille, APHM, Marseille, France
| | - René-Marc Flipo
- Service de Rhumatologie, Université Lille, CHU Lille, Lille, France
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17
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Masheka-Cishesa O, Kyheng M, Cordonnier C, Kuchcinski G, Chochoi M, Lejeune JP, Hénon H, Casolla B. Seizures after decompressive hemicraniectomy for large middle cerebral artery territory infarcts: Incidence, associated factors, and impact on long-term outcomes. Eur J Neurol 2021; 28:2745-2755. [PMID: 33938095 DOI: 10.1111/ene.14893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/15/2020] [Revised: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Decompressive hemicraniectomy (DH) reduces mortality of large middle cerebral artery (MCA) territory infarcts. Survivors are at high risk of poststroke seizures (PSSs). This study aims to describe the incidence of PSSs, to identify associated factors, and to assess their impact on long-term outcomes. METHODS We included consecutive patients who underwent DH for large MCA infarcts from May 2005 to December 2019 at Lille University Hospital. Patients were followed up at 3 months, 1 year, and 3 years. We analysed (i) the incidence and associated factors of early onset PSSs (EPSSs) with logistic regression models; (ii) the incidence and associated factors of late onset PSSs (LPSSs) in survivors at 7 days with a univariate Cox proportional hazard regression model for interval-censored data; and (iii) the impact of PSSs (EPSSs and LPSSs) on mortality with univariate and multivariate Cox proportional hazard regression models and modified Rankin Scale at 1 and 3 years, with univariate and adjusted multivariate ordinal logistic regression analyses. RESULTS Of 248 patients (150 men, 60.5%; mean age = 50.4 ± 9.6 years), 106 (42.7%) presented PSSs (six inaugural seizures, 22 EPSSs, 78 LPSSs) during follow-up. The PSS cumulative incidence was 12.3% at 7 days, 24.9% at 3 months, 49.8% at 1 years, and 54.8% at 3 years. No predictor was significantly associated with either EPSSs or LPSSs. PSSs did not significantly impact mortality and long-term functional outcome. CONCLUSIONS The incidence of PSSs after DH is high, reaching more than 50% 3 years after stroke, but PSSs did not influence long-term mortality or functional outcome.
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Affiliation(s)
- Olivier Masheka-Cishesa
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Maéva Kyheng
- Evaluation of Health Technologies and Medical Practices, ULR 2694-METRICS, University of Lille, CHU Lille, Lille, France.,Department of Biostatistics, CHU Lille, Lille, France
| | - Charlotte Cordonnier
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Grégory Kuchcinski
- Department of Neuroradiology, University of Lille, Inserm U1172, CHU Lille, Lille, France
| | - Maxime Chochoi
- Department of Neurology, Neurophysiology Unit, CHU Lille, Lille, France
| | - Jean Paul Lejeune
- Department of Neurosurgery, University of Lille, Inserm U1189, CHU Lille, Lille, France
| | - Hilde Hénon
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Barbara Casolla
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
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18
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Zhu F, Gauberti M, Marnat G, Bourcier R, Kyheng M, Labreuche J, Sibon I, Dargazanli C, Arquizan C, Anxionnat R, Audibert G, Mazighi M, Blanc R, Lapergue B, Consoli A, Richard S, Gory B. Time from I.V. Thrombolysis to Thrombectomy and Outcome in Acute Ischemic Stroke. Ann Neurol 2020; 89:511-519. [PMID: 33274475 DOI: 10.1002/ana.25978] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Whether the time from intravenous thrombolysis (IVT) to endovascular treatment (EVT) in patients with acute ischemic stroke has an effect on the functional outcome is unknown. METHODS The Endovascular Treatment in Ischemic Stroke (ETIS) registry is an ongoing, prospective, multicenter, observational study that perform EVT in France. Data were analyzed from patients treated by IVT and EVT between October 2013 and December 2018 in 6 comprehensive stroke centers. In the primary analysis, we assessed the association of time from IVT administration to start of EVT with functional outcome (measured with the modified Rankin Scale [mRS]), by means of ordinal logistic regression. Secondary end points included angiographic and safety outcomes. RESULTS We analyzed 1,986 patients with acute ischemic stroke due to anterior circulation large vessel occlusion who underwent IVT and EVT. An increased IVT to start of EVT time was associated with a worse functional outcome at 90 days (mRS = 0-2, adjusted odds ratio [OR] per 30 minutes increase in time = 0.91, 95% confidence interval [CI] = 0.86-0.96; mRS = 0-1, adjusted OR per 30 minutes increase in time = 0.89, 95% CI = 0.84-0.94), a lower chance of modified Thrombolysis in Cerebral Infarction (mTICI) grade 2b to 3 reperfusion (adjusted OR per 30 minutes increase in time = 0.93, 95% CI = 0.87-0.98), and an increased probability of symptomatic intracerebral hemorrhage (adjusted OR per 30 minutes increase in time = 1.09, 95% CI = 0.99-1.18). INTERPRETATION These findings provide a basis for further studies to determine if the functional outcome of patients with stroke can be greatly improved by optimizing IVT to EVT times. ANN NEUROL 2021;89:511-519.
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Affiliation(s)
- François Zhu
- Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,IADI, INSERM U1254, Université de Lorraine, Nancy, France
| | - Maxime Gauberti
- Unité Mixte de Recherche-S U1237, "Physiopathology and Imaging for Neurological Disorders," Institut National de la Santé et de la Recherche Médicale, Université de Caen Normandie, Caen, France.,Department of Diagnostic Imaging and Interventional Radiology, CHU Caen Côte de Nacre, Caen, France
| | - Gaultier Marnat
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bordeaux, Bordeaux, France
| | - Romain Bourcier
- Department of Neuroradiology, University Hospital of Nantes, Nantes, France
| | - Maéva Kyheng
- CHU Lille, EA 2694, Santé Publique: épidémiologie et Qualité des Soins, University Lille, Lille, France
| | - Julien Labreuche
- CHU Lille, EA 2694, Santé Publique: épidémiologie et Qualité des Soins, University Lille, Lille, France
| | - Igor Sibon
- Department of Neurology, Stroke Center, University Hospital of Bordeaux, Bordeaux, France
| | - Cyril Dargazanli
- Department of Interventional Neuroradiology, CHRU Gui de Chauliac, Montpellier, France
| | - Caroline Arquizan
- Department of Neurology, Stroke Unit, CHRU Gui de Chauliac, Montpellier, France
| | - René Anxionnat
- Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,IADI, INSERM U1254, Université de Lorraine, Nancy, France
| | - Gérard Audibert
- Department of Anesthesiology and Surgical Intensive Care, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - Mikaël Mazighi
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France
| | - Raphaël Blanc
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France
| | - Bertrand Lapergue
- Department of Neurology, Stroke Unit, Foch Hospital, Versailles Saint-Quentin en Yvelines University, Suresnes, France
| | - Arturo Consoli
- Department of Diagnostic and Interventional Neuroradiology, Foch Hospital, Versailles Saint-Quentin en Yvelines University, Suresnes, France
| | - Sébastien Richard
- Department of Neurology, Stroke Unit, CHRU-Nancy, Université de Lorraine, Nancy, France.,INSERM U1116, CHRU-Nancy, CIC-P 1433, Nancy, France
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,IADI, INSERM U1254, Université de Lorraine, Nancy, France
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19
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Dubois M, Abi Rached H, Escande A, Dezoteux F, Darloy F, Jouin A, Kyheng M, Labreuche J, Mirabel X, Mortier L. Évaluation du traitement par radiothérapie exclusive du carcinome de Merkel au stade localisé : étude rétrospective sur 53 patients. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.113] [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: 10/22/2022]
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20
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Anadani M, Lapergue B, Blanc R, Kyheng M, Labreuche J, Machaa MB, Duhamel A, Marnat G, Saleme S, Costalat V, Bracard S, Anxionnat R, Spiotta AM, DeHavenon A, Richard S, Desal H, Mazighi M, Consoli A, Piotin M, Gory B. Admission Blood Pressure and Outcome of Endovascular Therapy: Secondary Analysis of ASTER Trial. J Stroke Cerebrovasc Dis 2020; 29:105347. [PMID: 33017755 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/05/2020] [Accepted: 09/21/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Elevated blood pressure (BP) is common among patients presenting with acute ischemic stroke due to large vessel occlusions. The literature is inconsistent regarding the association between admission BP and outcome of mechanical thrombectomy (MT). Moreover, it is unclear whether the first line thrombectomy strategy (stent retriever [SR] versus contact aspiration [CA]) modifies the relationship between BP and outcome. METHODS This is a post hoc analysis of the ASTER (Contact Aspiration Versus Stent Retriever for Successful Revascularization) randomized trial. BP was measured prior to randomization in all included patients. Co-primary outcomes included 90-day functional independence (modified Rankin Scale [mRS] 0-2) and successful revascularization (modified Treatment in Cerebral Ischemia [mTICI] 2b-3). Secondary outcomes included symptomatic intracerebral hemorrhage (sICH) and parenchymal hemorrhage (PH) within 24 hours. RESULTS A total of 381 patients were included in the present study. Mean (SD) systolic BP (SBP) and diastolic BP (DBP) were 148 (26) mm Hg and 81 (16) mm Hg, respectively. There was no association between SBP or DBP and successful revascularization or 90-day functional independence. Similarly, there was no association between admission SBP or DBP with sICH or PH. Subgroup analysis based on the first-line thrombectomy strategy revealed similar results with no heterogeneity across groups. CONCLUSION Admission BP was not associated with functional, angiographic or safety outcomes. Results were similar in both CA and CA groups.
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Affiliation(s)
- Mohnammd Anadani
- Department of Neurology, Washington University School of Medicine, St Louis, MO, United States.
| | | | - Raphael Blanc
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France.
| | - Maéva Kyheng
- Department of Biostatistics, University Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, France.
| | - Julien Labreuche
- Department of Biostatistics, University Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, France.
| | - Malek Ben Machaa
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France.
| | - Alain Duhamel
- Department of Biostatistics, University Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, France.
| | - Gautier Marnat
- Department of Neuroradiology, University Hospital of Bordeaux, France.
| | - Suzana Saleme
- Department of Interventional Neuroradiology, University Hospital of Limoges, France.
| | - Vincent Costalat
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France.
| | - Serge Bracard
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Université de Lorraine, INSERM U1254, Nancy, France.
| | - René Anxionnat
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Université de Lorraine, INSERM U1254, Nancy, France.
| | - Alejandro M Spiotta
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, United States.
| | - Adam DeHavenon
- Department of Neurology, Utah University, Salt lake, UT, United States.
| | - Sébastien Richard
- Department of Neurology, Stroke Unit, University Hospital of Nancy, Université de Lorraine, INSERM U1116, Nancy, France.
| | - Hubert Desal
- Department of Neuroradiology, Guillaume et René Laennec University Hospital, Nantes, France.
| | - Mikael Mazighi
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France.
| | - Arturo Consoli
- Department of Neuroradiology, Foch Hospital, Suresnes, France.
| | - Michel Piotin
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France.
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Université de Lorraine, INSERM U1254, Nancy, France.
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Girot JB, Richard S, Gariel F, Sibon I, Labreuche J, Kyheng M, Gory B, Dargazanli C, Maier B, Consoli A, Daumas-Duport B, Lapergue B, Bourcier R. Predictors of Unexplained Early Neurological Deterioration After Endovascular Treatment for Acute Ischemic Stroke. Stroke 2020; 51:2943-2950. [PMID: 32921260 DOI: 10.1161/strokeaha.120.029494] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Although the efficacy of endovascular treatment (EVT) in patients with anterior circulation ischemic stroke (AIS) is well documented, early neurological deterioration after EVT remains a serious issue associated with poor outcome. Besides obvious causes, such as lack of reperfusion, procedural complications, or parenchymal hemorrhage, early neurological deterioration may remain unexplained (UnEND). Our aim was to investigate predictors of UnEND after EVT in patients with AIS. METHODS Patients who underwent EVT for AIS, with an initial National Institutes of Health Stroke Scale score >5, Alberta Stroke Program Early CT Score ≥6, and included in a multicenter prospective observational registry were analyzed. Predictors of UnEND, defined as ≥4-point increase in the National Institutes of Health Stroke Scale score between baseline and day 1 after EVT, were determined via center-adjusted analyses. RESULTS Among the 1925 included in the analysis, 128 UnEND (6.6%) were recorded. In multivariate analysis, predictors of UnEND were diabetes mellitus (odds ratio [OR], 2.17 [95% CI, 1.32-3.56]), prestroke modified Rankin Scale score ≥2 (OR, 2.22 [95% CI, 1.09-4.55]), general anesthesia (OR, 2.55 [95% CI, 1.51-4.30]), admission systolic blood pressure (OR, 1.10 [95% CI, 1.01-1.20]), age (OR, 1.38 [95% CI, 1.14-1.67]), number of passes (OR, 1.16 [95% CI, 1.04-1.28]), direct admission or not to a comprehensive stroke center (OR, 0.49 [95% CI, 0.30-0.81]), and initial National Institutes of Health Stroke Scale score (OR, 0.65 [95% CI, 0.52-0.81]). CONCLUSIONS Severely impaired AIS patients with nonmodifiable factors are more likely to develop UnEND. Some modifiable predictors of UnEND such as the number of EVT passes could be the object of improvement in AIS management.
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Affiliation(s)
- Jean-Baptiste Girot
- Neuroradiology Department, Nantes University Hospital, France (J.-B.G., B.D.-D., R.B.).,Radiology Department, Angers University Hospital, France (J.-B.G.)
| | - Sébastien Richard
- Department of Neurology, Stroke Unit, CIC-P 1433, INSERM U1116 (S.R.), University Hospital of Nancy, France
| | - Florent Gariel
- Department of Neuroradiology (F.G.), Bordeaux University Hospital, France
| | - Igor Sibon
- Department of Neurology, Stroke Unit (I.S.), Bordeaux University Hospital, France
| | - Julien Labreuche
- Lille University, CHU Lille, EA 2694-Santé publique: épidémiologie et qualité des soins, France (J.L., M.K.)
| | - Maéva Kyheng
- Lille University, CHU Lille, EA 2694-Santé publique: épidémiologie et qualité des soins, France (J.L., M.K.)
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, INSERM U1254 (B.G.), University Hospital of Nancy, France
| | - Cyril Dargazanli
- Neuroradiology Department, University Hospital Güi de Chauliac, Montpellier, France (C.D.)
| | - Benjamin Maier
- Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France (B.M.)
| | - Arturo Consoli
- Department of Neurology, Stroke Center, Foch Hospital, Suresnes, France (A.C., B.L.)
| | | | - Bertrand Lapergue
- Department of Neurology, Stroke Center, Foch Hospital, Suresnes, France (A.C., B.L.)
| | - Romain Bourcier
- Neuroradiology Department, Nantes University Hospital, France (J.-B.G., B.D.-D., R.B.)
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Pasi M, Casolla B, Kyheng M, Boulouis G, Kuchcinski G, Moulin S, Labreuche J, Hénon H, Cordonnier C, Leys D. Long-term mortality in survivors of spontaneous intracerebral hemorrhage. Int J Stroke 2020; 16:448-455. [DOI: 10.1177/1747493020954946] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Factors associated with long-term mortality after spontaneous intracerebral hemorrhage (ICH) have been poorly investigated. Aim Our objective was to identify variables associated with long-term mortality in a prospective cohort of 30-day ICH survivors. Methods We prospectively included consecutive 30-day spontaneous ICH survivors. We evaluated baseline and follow-up clinical characteristics and magnetic resonance imaging (MRI) markers of chronic brain injury as variables associated with long-term mortality using univariate and multivariable Cox proportional hazard regression models. Results Of 560 patients with spontaneous ICH, 304 (54.2%) survived more than 30 days and consented for follow-up. During a median follow-up of 10 years (interquartile range: 8.0–10.5), 176 patients died. The cumulative survival rate at 10 years was 38%. In multivariable analysis, variables independently associated with long-term mortality were age (hazard ratio (HR) per 10-year increase: 1.68, 95% confidence interval (CI): 1.45–1.95), male gender (HR: 1.41, CI: 1.02–1.95), prestroke dependency (HR: 1.66, CI: 1.15–2.39), National Institutes of Health Stroke Scale score (HR per 1-point increase: 1.03, CI: 1.01–1.04), occurrence of any stroke (HR: 2.24, CI: 1.39–3.60), and dementia (HR: 1.51, CI: 1.06–2.16) during follow-up. Among MRI markers, only cerebral atrophy (HR per 1-point increase: 1.50, CI: 1.13–2.00) was independently associated with long-term mortality. Conclusions Preexisting comorbidities, clinical severity at presentation, and significant clinical event during follow-up are associated with long-term mortality. Among MRI markers of chronic brain injury, only cerebral atrophy is associated with long-term mortality.
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Affiliation(s)
- Marco Pasi
- U1172 - LilNCog - Lille Neuroscience & Cognition, University of Lille, Inserm, CHU Lille, Lille, France
| | - Barbara Casolla
- U1172 - LilNCog - Lille Neuroscience & Cognition, University of Lille, Inserm, CHU Lille, Lille, France
| | - Maéva Kyheng
- Department of Biostatics and Public Health, University of Lille, EA 2694, CHU Lille, Lille, France
| | - Grégoire Boulouis
- Department of Neuroradiology, University of Lille, Inserm U1171, CHU Lille, Lille, France
- Department of Neuroradiology, Paris-Descartes University, Inserm U894, Saint-Anne Hospital, Paris, France
| | - Grégory Kuchcinski
- Department of Neuroradiology, University of Lille, Inserm U1171, CHU Lille, Lille, France
| | - Solène Moulin
- U1172 - LilNCog - Lille Neuroscience & Cognition, University of Lille, Inserm, CHU Lille, Lille, France
| | - Julien Labreuche
- Department of Biostatics and Public Health, University of Lille, EA 2694, CHU Lille, Lille, France
| | - Hilde Hénon
- U1172 - LilNCog - Lille Neuroscience & Cognition, University of Lille, Inserm, CHU Lille, Lille, France
| | - Charlotte Cordonnier
- U1172 - LilNCog - Lille Neuroscience & Cognition, University of Lille, Inserm, CHU Lille, Lille, France
| | - Didier Leys
- U1172 - LilNCog - Lille Neuroscience & Cognition, University of Lille, Inserm, CHU Lille, Lille, France
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Casolla B, Kuchcinski G, Kyheng M, Hanafi R, Lejeune JP, Leys D, Cordonnier C, Hénon H. Infarct Volume Before Hemicraniectomy in Large Middle Cerebral Artery Infarcts Poorly Predicts Catastrophic Outcome. Stroke 2020; 51:2404-2410. [DOI: 10.1161/strokeaha.120.029920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose:
Infarct volumes predict malignant infarcts in patients undergoing decompressive hemicraniectomy (DH) for large middle cerebral artery territory infarcts. The aim of the study was to determine the optimal magnetic resonance imaging infarct volume threshold that predicts a catastrophic outcome at 1 year (modified Rankin Scale score of 5 or death).
Methods:
We included consecutive patients who underwent DH for large middle cerebral artery infarcts. We analyzed infarct volumes before DH with semi-automated methods on b1000 diffusion-weighted imaging sequences and apparent diffusion coefficient maps. We studied infarct volume thresholds for prediction of catastrophic outcomes, and analyzed sensitivity, specificity, and the area under the curve, a value ≥0.70 indicating an acceptable prediction.
Results:
Of 173 patients (109 men, 63%; median age 53 years), 42 (24.3%) had catastrophic outcomes. Magnetic resonance imaging b1000 diffusion-weighted imaging and apparent diffusion coefficient infarct volumes were associated to the occurrence of 1-year catastrophic outcome (adjusted odds ratio, 9.17 [95% CI, 2.00–42.04] and odds ratio, 4.18 [95% CI, 1.33–13.19], respectively, per 1 log increase). The optimal volume cutoff of were 211 mL on b1000 diffusion-weighted imaging and 181 mL on apparent diffusion coefficient maps. The 2 methods showed similar sensitivities and specificities and overlapping area under the curve of 0.64 (95% CI, 0.54–0.74).
Conclusions:
In patients with large middle cerebral artery infarcts, optimal magnetic resonance imaging infarct volume thresholds showed poor accuracy and low specificity to predict 1-year catastrophic outcome, with different b1000 diffusion-weighted imaging and apparent diffusion coefficient thresholds. In the setting of DH, optimal infarct volumes alone should not be used to deny DH, irrespectively of the method used.
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Affiliation(s)
- Barbara Casolla
- Department of Neurology, Stroke Unit (B.C., D.L., C.C., H.H.), University of Lille, Inserm U1172, CHU Lille, France
| | - Gregory Kuchcinski
- Department of Neuroradiology (G.K., R.H.), University of Lille, Inserm U1172, CHU Lille, France
| | - Maéva Kyheng
- University of Lille, CHU Lille, ULR 2694 - METRICS: évaluation des technologies de santé et des pratiques médicales, France (M.K.)
- CHU Lille, Département de Biostatistiques, France (M.K.)
| | - Riyad Hanafi
- Department of Neuroradiology (G.K., R.H.), University of Lille, Inserm U1172, CHU Lille, France
| | - Jean-Paul Lejeune
- Department of Neurosurgery, University of Lille, Inserm, U1189, CHU Lille, France (J.-P.L.)
| | - Didier Leys
- Department of Neurology, Stroke Unit (B.C., D.L., C.C., H.H.), University of Lille, Inserm U1172, CHU Lille, France
| | - Charlotte Cordonnier
- Department of Neurology, Stroke Unit (B.C., D.L., C.C., H.H.), University of Lille, Inserm U1172, CHU Lille, France
| | - Hilde Hénon
- Department of Neurology, Stroke Unit (B.C., D.L., C.C., H.H.), University of Lille, Inserm U1172, CHU Lille, France
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Letarouilly JG, Flachaire B, Labadie C, Cohen N, Kyheng M, Sellam J, Richette P, Dieudé P, Claudepierre P, Fautrel B, Houvenagel E, Nguyen CD, Guyot MH, Segaud N, Maury F, Marguerie L, Deprez X, Salmon JH, Baudens G, Miceli Richard C, Gervais E, Chary Valckenaere I, Lafforgue P, Loeuille D, Richez C, Pham T, Flipo RM. FRI0348 PERSISTENCE OF SECUKINUMAB AND USTEKINUMAB IN PSORIATIC ARTHRITIS: A REAL-WORLD MULTICENTRIC COHORT OF 409 PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Real-world data are missing for Ustekinumab (UST) and secukinumab (SEK) in psoriatic arthritis (PsA).Objectives:To evaluate the characteristics of the patients (pts) with PsA treated by UST or SEK and to assess real world persistence of UST and SEK in PsA.Methods:This is a retrospective, multicenter study of pts with PsA (CASPAR criteria or diagnosis confirmed by a rheumatologist) initiating UST or SEK with a follow-up ≥ 6 months from January 2011 to April 2019. The comparison of persistence between UST and SEK was analysed using a Cox model with an inverse probability of treatment weighting propensity score including 11 confounding factors. Subgroup analyses (age>65 years, gender, Body Mass Index (BMI), Charlson score>2, psoriasis, CRP>5mg/L, number (nb) of prior biotherapies, proportion of pts on maximum dose of UST or SEK, combination with methotrexate (MTX), enthesitic and axial forms of PsA) were also performed to test the heterogeneity of UST and SEK persistence. Finally, 2 sensitivity analyses were performed, first excluding the pts treated before the marketing authorization of SEK, and then excluding the pts that underwent a molecule switch. Causes of discontinuation were also collected.Results:406 pts were included: 245 with UST and 161 with SEK. At baseline before propensity score-matching, the UST group has a higher BMI (28.9 ± 6.4 kg/m2vs. 27.4 ± 6.0 kg/m2), more peripheral forms (98% vs. 90.8%), a higher nb of active smokers (27.1% vs. 19.9%), a higher frequency of psoriasis (96.3% vs. 83.2%), less MTX users (38.9% vs. 44.2%), a higher nb of pts with CRP >5mg/L (54.3% vs. 47%), a higher nb of pts naïve to biotherapies (22% vs. 13%) and a higher nb of pts with recommended dosing (97.3% vs 50.9%). The median persistence was 9.4 months and 14.7 months for UST and SEK, respectively. The persistence rate was lower in the UST group compared to the SEK group (40.9% vs. 59.1% % at 1 year; 26.4% vs. 38.0% at 2 years; weighted HR=1.42; 95% CI 1.07 to 1.92; p=0.015) (Fig 1). In subgroup analysis, combination with MTX was associated with a higher persistence rate in the patients with SEK compared to those receiving UST: 43.6% vs. 23.2% (HR=2.20; 95% CI 1.30 to 3.51; p=0.001), whereas no difference was observed in SEK and UST monotherapy: 33.8% vs 28.4%, respectively (HR=1.06; 95% CI 0.74 to 1.53; p=0.75) (Fig 2). A similar difference was found in the sensitivity analyses, with however a difference at the limit of significance for the analysis excluding pts with a molecule switch (adjusted HR=1.35; IC95% 0.96 to 1.92; p=0.085). The causes of discontinuation were due to inefficacy in 85% of cases and an adverse event in 12% of cases (19% in the SEK group and 9% in the UST group).Conclusion:In this first real-world study comparing UST and SEK persistence in PsA, the persistence of SEK was longer than that of UST. Subgroup analysis revealed this difference of persistence was restricted to patients treated in combination with MTX.Disclosure of Interests:Jean-Guillaume Letarouilly Grant/research support from: Research grant from Pfizer, Benoît Flachaire: None declared, Céline Labadie: None declared, Nicolas Cohen Speakers bureau: Novartis, Janssen, Maeva Kyheng: None declared, Jérémie SELLAM: None declared, Pascal Richette: None declared, Philippe Dieudé: None declared, Pascal Claudepierre Speakers bureau: Janssen, Novartis, Lilly, Bruno Fautrel Grant/research support from: AbbVie, Lilly, MSD, Pfizer, Consultant of: AbbVie, Biogen, BMS, Boehringer Ingelheim, Celgene, Lilly, Janssen, Medac MSD France, Nordic Pharma, Novartis, Pfizer, Roche, Sanofi Aventis, SOBI and UCB, Eric Houvenagel Speakers bureau: Janssen, Novartis, Chi Duc Nguyen: None declared, Marie-Hélène Guyot: None declared, Nicolas Segaud: None declared, Frederic Maury: None declared, Laurent Marguerie: None declared, Xavier Deprez Speakers bureau: Novartis, Janssen, Jean-Hugues Salmon Speakers bureau: Novartis, Janssen, Guy Baudens: None declared, Corinne Miceli Richard: None declared, Elisabeth Gervais Speakers bureau: Novartis, Janssen, Roche, Pfizer, BMS, Abbvie, Isabelle CHARY VALCKENAERE: None declared, Pierre Lafforgue Speakers bureau: Novartis, Janssen, Damien LOEUILLE: None declared, Christophe Richez Consultant of: Abbvie, Amgen, Mylan, Pfizer, Sandoz and UCB., Thao Pham Speakers bureau: Novartis, Janssen, Lilly, Rene-Marc Flipo Speakers bureau: Novartis, Janssen, Lilly
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Di Maria F, Kyheng M, Consoli A, Desilles JP, Gory B, Richard S, Rodesch G, Labreuche J, Girot JB, Dargazanli C, Marnat G, Lapergue B, Bourcier R. Identifying the predictors of first-pass effect and its influence on clinical outcome in the setting of endovascular thrombectomy for acute ischemic stroke: Results from a multicentric prospective registry. Int J Stroke 2020; 16:20-28. [PMID: 32380902 DOI: 10.1177/1747493020923051] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [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: 11/16/2022]
Abstract
BACKGROUND The first-pass effect, defined as a complete or near-complete recanalization after one pass (first-pass effect) of a mechanical thrombectomy device, has been related to better clinical outcome than good recanalization after more than one pass in acute ischemic stroke. We searched for predictors of first-pass effect by analyzing the results within a large prospective multicentric registry. METHODS We included patients treated by mechanical thrombectomy for isolated anterior intracranial occlusions. A multi-variate logistic regression analysis was carried out to search for predictors of first-pass effect. We also analyzed the percentage of patients with 90-day modified Rankin Scale score 0 to 2, excellent outcome (90-day modified Rankin Scale 0 to 1), 24-h NIHSS change, and 90-day all-cause mortality. RESULTS Among the 1832 patients included, clinical outcome at 90 days was significantly better in first-pass effect patients (50.6% vs. 38.9% in patients without first-pass effect), with a center-adjusted OR associated with first-pass effect of 1.74 (95%CI, 1.24 to 1.77). Older age, a lower systolic blood pressure, an MCA-M1 occlusion, higher DWI-ASPECTS at admission, mechanical thrombectomy under local anesthesia, and combined first-line device strategy were independent predictors of first-pass effect. CONCLUSIONS In this study, a strategy combining thrombectomy and thrombo-aspiration was more effective than other strategies in achieving first-pass effect. In addition, we confirm that clinical outcome was better in patients with first-pass effect compared to non-first-pass effect patients.
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Affiliation(s)
- Federico Di Maria
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, Versailles, France
| | | | - Arturo Consoli
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, Versailles, France
| | - Jean-Philippe Desilles
- Department of Interventional Neuroradiology, Fondation Ophtalmologique A. De Rothschild, Paris France
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Nancy, France.,University of Lorraine, INSERM U1254, Nancy, France
| | - Sébastien Richard
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Nancy, France.,University of Lorraine, INSERM U1254, Nancy, France
| | - Georges Rodesch
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, Versailles, France
| | | | | | - Cyril Dargazanli
- Department of Neuroradiology, Guy de Chauliac University Hospital, Montpellier, France
| | - Gaultier Marnat
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bordeaux, Bordeaux, France
| | - Bertrand Lapergue
- Department of Neurology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, Versailles, France
| | - Romain Bourcier
- 0Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nantes, Nantes, France
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Blaise AS, Baille G, Carrière N, Devos D, Dujardin K, Grolez G, Kreisler A, Kyheng M, Moreau C, Mutez E, Seguy D, Defebvre L. Safety and effectiveness of levodopa-carbidopa intestinal gel for advanced Parkinson's disease: A large single-center study. Rev Neurol (Paris) 2020; 176:268-276. [DOI: 10.1016/j.neurol.2019.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 01/15/2023]
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Roland-Billecart T, Raoul G, Kyheng M, Sciote JJ, Ferri J, Nicot R. TMJ related short-term outcomes comparing two different osteosynthesis techniques for bilateral sagittal split osteotomy. J Stomatol Oral Maxillofac Surg 2020; 122:70-76. [PMID: 32229181 DOI: 10.1016/j.jormas.2020.03.018] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 03/11/2020] [Accepted: 03/18/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Bilateral sagittal split osteotomy (BSSO) is a morpho-functional surgery and post-surgical osteosynthesis may influence temporomandibular joint (TMJ) health. Our objective was to evaluate temporomandibular disorders (TMD) and TMJ symptoms after orthognathic surgery according to the type of osteosynthesis used in a population of patients with dentofacial deformities. MATERIALS AND METHODS One hundred and eighty-three consecutive patients undergoing orthodontic and maxillofacial surgery treatment for correction of their malocclusion were recruited for a two-year period at Lille University Hospital. All patients had at least a mandibular BSSO using Epker's technique. Each patient was examined before and one year after orthognathic surgery. We compared osteosynthesis by miniplates fixed with monocortical screws (n=42) and the hybrid fixation with bicortical retro-molar screws used with miniplates (n=141). TMJ health was assessed by monitoring TMD signs and symptoms according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and scores obtained from the "Jaw Pain Function" questionnaire. RESULTS There was no significant difference in pre-operative and one year post-operative RDC/TMD assessments (p≥0.91) or JPF score (p≥0.29) between the two types of osteosynthesis. CONCLUSION There was no difference in TMJ health between the two techniques of osteosynthesis after BSSO. CLINICAL RELEVANCE In our experience the hybrid technique fixation affords many advantages and does not influence postoperative TMD compared with osteosynthesis by miniplates.
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Affiliation(s)
- T Roland-Billecart
- University Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, 59000 Lille, France.
| | - G Raoul
- University Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, 59000 Lille, France
| | - M Kyheng
- Univ Lille, CHU Lille, EA 2694-santé publique : épidémiologie et qualité des soins, 59000 Lille, France
| | - J J Sciote
- Department of orthodontics, Temple university, Philadelphia, Pa, USA
| | - J Ferri
- University Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, 59000 Lille, France
| | - R Nicot
- University Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, 59000 Lille, France
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28
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Vincent F, Spillemaeker H, Kyheng M, Belin-Vincent C, Delhaye C, Piérache A, Denimal T, Verdier B, Debry N, Moussa M, Schurtz G, Porouchani S, Cosenza A, Juthier F, Pamart T, Richardson M, Coisne A, Hertault A, Sobocinski J, Modine T, Pontana F, Duhamel A, Labreuche J, Van Belle E. Ultrasound Guidance to Reduce Vascular and Bleeding Complications of Percutaneous Transfemoral Transcatheter Aortic Valve Replacement: A Propensity Score-Matched Comparison. J Am Heart Assoc 2020; 9:e014916. [PMID: 32172643 PMCID: PMC7335526 DOI: 10.1161/jaha.119.014916] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Ultrasound (US) guidance provides the unique opportunity to control the puncture zone of the artery during transfemoral transcatheter aortic valve replacement and may decrease major vascular complications (VC) and life-threatening or major bleeding complications. This study aimed to evaluate the clinical impact of US guidance using a propensity score-matched comparison. Methods and Results US guidance was implemented as the default approach for all transfemoral transcatheter aortic valve replacement cases in our institution in June 2013. We defined 3 groups of consecutive patients according to the method of puncture (fluoroscopic/US guidance) and the use of a transcatheter heart valve. Patients in the US-guided second-generation group (Sapien XT [Edwards Lifesciences, Irvine, CA], Corevalve [Medtronic, Dublin, Ireland]) were successfully 1:1 matched with patients in the fluoroscope-guided second-generation group (n=95) with propensity score matching. In a second analysis we described the consecutive patients of the US-guided third-generation group (Evolut-R [Medtronic], Sapien 3 [Edwards Lifesciences], n=308). All vascular and bleeding complications were reduced in the US-guided second-generation group compared with the fluoroscope-guided second-generation group: VC (16.8% versus 6.3%; P=0.023); life-threatening or major bleeding (22.1% versus 6%; P=0.004); and VC related to vascular access (12.6% versus 4.2%; P=0.052). In the US-guided third-generation group the rates of major VC and life-threatening or major bleeding were 3.2% (95% CI, 1.6% to 5.9%) and 3.6% (95% CI, 1.8% to 6.3%). In the overall population (n=546), life-threatening or major bleeding was associated with a 1.7-fold increased mortality risk (P=0.02). Conclusions We demonstrated that US guidance effectively reduced VC and bleeding complications for transfemoral transcatheter aortic valve replacement and should be considered the standard puncture method. Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02628509.
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Affiliation(s)
- Flavien Vincent
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | - Hugues Spillemaeker
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | - Maéva Kyheng
- EA 2694-Santé Publique: Épidémiologie et Qualité des Soins CHU Lille University of Lille France
| | - Cassandre Belin-Vincent
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France
| | - Cédric Delhaye
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France
| | - Adeline Piérache
- EA 2694-Santé Publique: Épidémiologie et Qualité des Soins CHU Lille University of Lille France
| | - Tom Denimal
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | - Basile Verdier
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | - Nicolas Debry
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | - Mouhamed Moussa
- Anesthésie et Réanimation Cardio-Vasculaire CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | - Guillaume Schurtz
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France
| | - Sina Porouchani
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France
| | - Alessandro Cosenza
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France
| | - Francis Juthier
- Chirurgie Cardiaque CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | - Thibault Pamart
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | - Marjorie Richardson
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France
| | - Augustin Coisne
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | | | | | - Thomas Modine
- Chirurgie Cardiaque CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
| | | | - Alain Duhamel
- EA 2694-Santé Publique: Épidémiologie et Qualité des Soins CHU Lille University of Lille France
| | - Julien Labreuche
- EA 2694-Santé Publique: Épidémiologie et Qualité des Soins CHU Lille University of Lille France
| | - Eric Van Belle
- Cardiology Department of Interventional Cardiology for Coronary, Valves, and Structural Heart Diseases Institut Coeur Poumon CHU Lille Lille France.,Inserm U1011 Institut Pasteur de Lille EGID Lille France.,Université de Lille France
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Biardeau X, Lamande N, Tondut L, Peyronnet B, Verhoest G, Kyheng M, Soulie M, Game X, Fantoni JC, Marcelli F. Quality of life associated with orthotopic neobladder and ileal conduit in women: A multicentric cross-sectional study. Prog Urol 2020; 30:80-88. [PMID: 32061497 DOI: 10.1016/j.purol.2019.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/05/2019] [Revised: 10/27/2019] [Accepted: 11/28/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare quality of life and functional outcomes associated with orthotopic neobladder (ONB) and ileal conduit (IC) after anterior pelvic exenteration for bladder cancer in women, through a multicentric cross-sectional study. METHODS All women who have undergone an anterior pelvic exenteration associated with ONB or IC for a bladder cancer between January 2004 and December 2014 within the three participating university hospital centers and that were still alive in February 2016 were included. Three distinct auto-administered questionnaires were submitted to the patients: the EORTC QLQ-C30, the EORTC QLQ-BLmi30 and the SF-12. Comparison of response to these questionnaires between women with ONB and those with IC were studied with Mann-Whitney U tests, with a statistically significant P-value set at<0.05. The primary endpoint was the "global health status" sub-score extracted from the EORTC QLQ-C30 questionnaire. The secondary endpoints were the functional sub-scores and symptoms sub-scores obtained with the EORTC QLQ-C30 questionnaire as well as the sub-scores obtained with the EORTC QLQ-BLmi30 and the SF-12 questionnaires. RESULTS Forty women were included in the study (17 ONB, 23 IC). The primary endpoint was comparable between the ONB and IC women (83.3 vs. 66.7 P=0.22). Similarly, no significant statistical difference could be pointed between the ONB and IC women in terms of secondary endpoints. CONCLUSION The present study did not report any significance difference in terms of quality of life and functional outcomes between women with ONB and those with IC after pelvic exenteration for bladder cancer. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- X Biardeau
- Department of urology, CHU Lille, university Lille, Claude Huriez hospital, 59000 Lille, France.
| | - N Lamande
- Department of urology, CHU Lille, university Lille, Claude Huriez hospital, 59000 Lille, France
| | - L Tondut
- Department of urology, Rennes university hospital, 35000 Rennes, France
| | - B Peyronnet
- Department of urology, Rennes university hospital, 35000 Rennes, France
| | - G Verhoest
- Department of urology, Rennes university hospital, 35000 Rennes, France
| | - M Kyheng
- EA2694, department of biostatistics, CHU Lille, 59000 Lille, France
| | - M Soulie
- Department of urology, Toulouse university hospital, Rangueil hospital, Toulouse, France
| | - X Game
- Department of urology, Toulouse university hospital, Rangueil hospital, Toulouse, France
| | - J-C Fantoni
- Department of urology, CHU Lille, university Lille, Claude Huriez hospital, 59000 Lille, France
| | - F Marcelli
- Department of urology, CHU Lille, university Lille, Claude Huriez hospital, 59000 Lille, France
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Anadani M, Lapergue B, Piotin M, Kyheng M, Labreuche J, Richard S, Gory B. Abstract WP58: Admission Blood Pressure and Infarct Volume in Patients With Large Vessel Occlusions. Insights From the ASTER Trial. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.wp58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Higher systolic blood pressure (SBP) has been shown to be associated with worse outcome after mechanical thrombectomy. However, it is still unknown if higher admission SBP is just an epiphenomenon of higher infarct volume leading to the worse outcome or if the SBP association with the outcome is independent of infarct volume. In this study, we aimed to study the correlation between admission SBP and both admission infarct volume and 24 change in infarct volume.
Methods:
This is a post hoc analysis of the ASTER randomized trial. Cuff admission SBP was measured on presentation prior to thrombectomy. Diffusion-weighted imaging (DWI) infarct volume was measured on admission and at 24-hours post-procedure. Delta volume was measured by calculating the difference between the admission and 24-hour DWI lesions.
Results:
A total of 126 patients (mean age was 68.9 ± 14.8 years, median NIHSS was 17 (IQR, 11 to 20), 66% received tPA and 87% achieved mTICI 2b-3 at the end of the procedure) had MRI on admission and were included in this study. There was weak and not statistically significant negative correlation between admission SBP and infarct volume (R=-0.15; P=0.08). We did not find any correlation between admission SBP and 24 hours delta infarct volume. On generalized logistic regression analysis adjusting for infarct volume, SBP was associated with 90-day functional independence (modified Rankin Scale <3) (OR,0.84; 95% CI, 0.70-0.99; p=0.049).
Conclusion:
We did not find a significant correlation between infarct volume on admission and admission SBP. Moreover, the association between admission SBP and functional outcome was independent of infarct volume.
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Affiliation(s)
| | | | | | - Maéva Kyheng
- Dept of Biostatistics, Univ Lille,, FRANCE, France
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L'Allinec V, Sibon I, Mazighi M, Labreuche J, Kyheng M, Boissier E, Roy M, Gory B, Dargazanli C, Desal H, Lapergue B, Bourcier R. MT in anticoagulated patients. Neurology 2020; 94:e842-e850. [DOI: 10.1212/wnl.0000000000008873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 08/29/2019] [Indexed: 11/15/2022] Open
Abstract
Mechanical thrombectomy (MT) is one of the main treatments for acute ischemic stroke (AIS) in patients on effective anticoagulation. The use of direct oral anticoagulants (DOA) has increased, given their efficacy and safety profile compared to vitamin K antagonists (VKA). We compared procedural and clinical outcomes of MT in patients on DOA and VKA treatment before stroke onset. We analyzed 2 groups from the Endovascular Treatment in Ischemic Stroke prospective registry: patients on DOA and patients on VKA treated by MT without thrombolysis. Generalized linear mixed models including center as random effect were used to compare angiographic (rates of reperfusion at end of procedure, number of passes >2, procedural complications) and clinical (favorable and excellent outcome, 90-day all-cause mortality, and hemorrhagic complications) outcomes according to anticoagulation subgroups. Comparisons were adjusted for prespecified confounders (age, admission NIH Stroke Scale score) as well as for meaningful baseline between-group differences. Among 221 patients included, more DOA-treated patients (n = 115, 52%) achieved successful (modified Thrombolysis in Cerebral Infarction score [mTICI] 2b/3) or near complete (mTICI 2c/3) reperfusion at the procedure end than did VKA-treated patients, with an adjusted odds ratio (OR) for DOA vs VKA of 3.27 (95% confidence interval [CI], 1.40–7.65) and 2.00 (95% CI, 1.08–3.73), respectively. DOA-treated patients had a lower 90-day mortality risk with an adjusted OR of 0.47 (95% CI, 0.24–0.89) and a better excellent outcome OR of 2.40 (1.10–5.27). There was no significant between-group difference in hemorrhagic or procedural complications. The study highlights the benefits of DOA compared to VKA. Regarding mortality, excellent outcomes, and recanalization rate, DOA appears to provide a favorable setting for MT treatment in AIS.
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Drouard-de Rousiers E, Lucas L, Richard S, Consoli A, Mazighi M, Labreuche J, Kyheng M, Gory B, Dargazanli C, Arquizan C, Marnat G, Blanc R, Desal H, Bourcier R, Sibon I, Lapergue B, Piotin M, Blanc R, Redjem H, Escalard S, Desilles JP, Redjem H, Ciccio G, Smajda S, Mazighi M, Fahed R, Obadia M, Sabben C, Corabianu O, de Broucker T, Smadja D, Alamowitch S, Ille O, Manchon E, Garcia PY, Taylor G, Maacha MB, Wang A, Evrard S, Tchikviladze M, Afanasiev V, Ajili N, Sensenbrenner B, Lapergue B, Coskun O, Consoli A, Di Maria F, Rodesch G, Del Sette B, Russo R, Mizutani K, Leguen M, Gratieux J, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Nighoghossian N, Riva R, Eker O, Turjman F, Derex L, Cho TH, Mechtouff L, Lukaszewicz AC, Philippeau F, Cakmak S, Blanc-Lasserre K, Vallet AE, Marnat G, Gariel F, Barreau X, Berge J, Veunac L, Menegon P, Sibon I, Lucas L, Olindo S, Renou P, Sagnier S, Poli M, Debruxelles S, Bourcier R, Detraz L, Daumas-Duport B, Alexandre PL, Roy M, Lenoble C, L’allinec V, Girot JB, Desal H, de Gaalon S, Guillon B, Gory B, Bracard S, Anxionnat R, Braun M, Derelle AL, Tonnelet R, Liao L, Zhu F, Schmitt E, Planel S, Richard S, Humbertjean L, Mione G, Lacour JC, Bonnerot M, Riou-Comte N, Costa I, Chatelain A, Costalat V, Arquizan C, Dargazanli C, Gascou G, Lefèvre PH, Derraz I, Riquelme C, Gaillard N, et Lucas Corti IM, Francois E, Vannier S. Impact of Reperfusion for Nonagenarians Treated by Mechanical Thrombectomy. Stroke 2019; 50:3164-3169. [DOI: 10.1161/strokeaha.119.026448] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Nonagenarians represent a growing stroke population characterized by a higher frailty. Although endovascular therapy (ET) is a cornerstone of the management of acute ischemic stroke related to large vessel occlusion, the benefit of reperfusion among nonagenarians is poorly documented. We aimed to assess the impact of ET-related reperfusion on the functional outcome of reperfusion in this elderly population.
Methods—
A retrospective analysis of clinical and imaging data from all patients aged over 90 included in the ETIS (Endovascular Treatment in Ischemic Stroke) registry between October 2013 and April 2018 was performed. Association between post-ET reperfusion and favorable (modified Rankin Scale [0–2] or equal to prestroke value) and good (modified Rankin Scale [0–3] or equal to prestroke value) outcome were evaluated. Demographic and procedural predictors of functional outcome, including the first-pass effect, were evaluated. Results were adjusted for center, admission National Institutes of Health Stroke Scale, and use of intravenous thrombolysis.
Results—
Among the 124 nonagenarians treated with ET, those with successful reperfusion had the lowest 90-day modified Rankin Scale (odds ratio, 3.26; 95% CI, 1.04–10.25). Only patients with successful reperfusion after the first pass (n=53, 56.7%) had a reduced 90-day mortality (odds ratio, 0.15; 95% CI, 0.05–0.45) and an increased rate of good outcome (odds ratio, 4.55; 95% CI, 1.38–15.03). No increase in the rate of intracranial hemorrhage was observed among patients successfully reperfused.
Conclusions—
Successful reperfusion improves the functional outcome of nonagenarians who should not be excluded from ET. The first-pass effect should be considered in the procedural management of this frail population.
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Affiliation(s)
- Eve Drouard-de Rousiers
- From the Department of Neurology, Stroke Center (E.D.-d.R., B.L.), Foch Hospital, Suresnes, France
| | - Ludovic Lucas
- Department of Neurology, Stroke Unit, Bordeaux University Hospital, France (L.L.)
| | | | - Arturo Consoli
- Department of Interventional Neuroradiology (A.C), Foch Hospital, Suresnes, France
| | - Mikaël Mazighi
- Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France (M.M., R. Blanc)
| | - Julien Labreuche
- University of Lille, University Hospital of Lille, EA2694 -Santé publique: épidémiologie et qualité des soins, France (J.L., M.K.)
| | - Maéva Kyheng
- University of Lille, University Hospital of Lille, EA2694 -Santé publique: épidémiologie et qualité des soins, France (J.L., M.K.)
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, France (B.G.)
| | - Cyril Dargazanli
- Department of Interventional Neuroradiology (C.D.), CHRU Gui de Chauliac, Montpellier, France
| | - Caroline Arquizan
- Department of Neurology (C.A.), CHRU Gui de Chauliac, Montpellier, France
| | - Gaultier Marnat
- Department of Diagnostic and Interventional Neuroradiology (G.M.), University Hospital of Bordeaux, France
| | - Raphaël Blanc
- Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France (M.M., R. Blanc)
| | - Hubert Desal
- Department of Neuroradiology, University Hospital of Nantes, France (H.D., R. Bourcier)
| | - Romain Bourcier
- Department of Neuroradiology, University Hospital of Nantes, France (H.D., R. Bourcier)
| | - Igor Sibon
- Department of Neurology, Stroke Center (I.S.), University Hospital of Bordeaux, France
| | - Bertrand Lapergue
- From the Department of Neurology, Stroke Center (E.D.-d.R., B.L.), Foch Hospital, Suresnes, France
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Wallaert B, Kyheng M, Labreuche J, Stelianides S, Wemeau L, Grosbois JM. Long-term effects of pulmonary rehabilitation on daily life physical activity of patients with stage IV sarcoidosis: A randomized controlled trial. Respir Med Res 2019; 77:1-7. [PMID: 31855785 DOI: 10.1016/j.resmer.2019.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 06/29/2019] [Revised: 10/05/2019] [Accepted: 10/19/2019] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Pulmonary rehabilitation (PR) is known to improve exercise tolerance, mood, and quality of life in patients with chronic respiratory diseases. The aim of this work was to determine whether PR provides long-term benefits in increasing daily life physical activity in patients with chronic sarcoidosis. METHODS This randomized prospective study (registered ClinicalTrials.gov NCT02044939) of 38 patients with stage IV chronic sarcoidosis was performed between 2012 and 2016. Patients were assigned to participate in a 2-month PR program (n=20) or receive counseling (n=18). Assessments were performed at baseline, 2 months (end of the PR program), 6months, and 12months, and included daily life physical activity parameters (measured for 5 consecutive days), exercise tolerance, dyspnea, anxiety, depression, fatigue, and quality of life. The primary outcome was the 12-month change in time spent in activities above an estimated energy expenditure of 2.5metabolic equivalents (METs). Secondary daily life physical activity outcomes included number of steps per day, total daily energy expenditure, and total energy expenditure above 2.5METs. RESULTS The primary outcome did not differ between the two groups; mean between-group differences were -13.2min (95% confidence interval [CI]: -76.3 to 49.8) at 6 months and -18.1min (95% CI: -55.7 to 19.4) at 12months. Although PR had no effect on secondary daily life physical activity outcomes, it did significantly increase exercise tolerance at 6 and 12 months and decrease the dyspnea score at 6 months and the fatigue score at 12months. CONCLUSION This trial failed to demonstrate a beneficial effect of PR on daily life physical activity in sarcoidosis patients, suggesting that long-term behavioral programs may be necessary to complement PR.
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Affiliation(s)
- B Wallaert
- CHU Lille, Service de Pneumologie et ImmunoAllergologie, Centre de Référence constitutif des Maladies Rares, Hôpital Calmette, 59037 Lille, France; University of Lille, 59000 Lille, France.
| | - M Kyheng
- University of Lille, CHU Lille, EA 2694-Santé publique: épidémiologie et qualité des soins, Department of Biostatistics, 59000 Lille, France
| | - J Labreuche
- University of Lille, CHU Lille, EA 2694-Santé publique: épidémiologie et qualité des soins, Department of Biostatistics, 59000 Lille, France
| | - S Stelianides
- Division of Pneumology, Bichat Hospital, Paris-Diderot University, 75877, Paris, France
| | - L Wemeau
- CHU Lille, Service de Pneumologie et ImmunoAllergologie, Centre de Référence constitutif des Maladies Rares, Hôpital Calmette, 59037 Lille, France
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Roger C, Lionnet F, Kyheng M, Mattioni S, Livrozet M, Steichen O, Letavernier E, Hammoudi N, Duhamel A, Haymann J. Facteurs prédictifs de dégradation de la fonction rénale dans une population de patients drépanocytaires homozygotes adultes. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.040] [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: 12/01/2022]
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Marnat G, Barreau X, Detraz L, Bourcier R, Gory B, Sgreccia A, Gariel F, Berge J, Menegon P, Kyheng M, Labreuche J, Consoli A, Blanc R, Lapergue B. First-Line Sofia Aspiration Thrombectomy Approach within the Endovascular Treatment of Ischemic Stroke Multicentric Registry: Efficacy, Safety, and Predictive Factors of Success. AJNR Am J Neuroradiol 2019; 40:1006-1012. [PMID: 31122921 DOI: 10.3174/ajnr.a6074] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 01/09/2019] [Accepted: 04/18/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE After publications on the effectiveness of mechanical thrombectomy by stent retrievers in acute ischemic stroke with large-vessel occlusion, alternative endovascular approaches have been proposed using first-line aspiration catheters. Several devices are currently available to perform A Direct Aspiration First Pass Technique. The Sofia catheter aspiration has been widely used by interventionalists, but data are scarce about its efficacy and safety. Our aim was to report our multicenter thrombectomy experience with first-line Sofia catheter aspiration and to identify independent prognostic factors of clinical and procedural outcomes. MATERIALS AND METHODS We performed a retrospective analysis of the prospectively maintained Endovascular Treatment of Ischemic Stroke multicentric registry. Data from consecutive patients who benefited from thrombectomy with a first-line Sofia approach between January 2013 and April 2018 were studied. We excluded other first-line approaches (stent retriever or combined aspiration and stent retriever) and extracranial occlusions. Baseline characteristics, procedural data, and angiographic and clinical outcomes were analyzed. RESULTS During the study period, 296 patients were treated. Mean age and initial NIHSS score were, respectively, 69.5 years and 16. Successful reperfusion, defined by the modified TICI 2b/3, was obtained in 86.1% (n = 255; 95% CI, 81.7%-89.9%). Complete reperfusion (modified TICI 3) was obtained in 41.2% (n = 122; 95% CI, 35.5%-47.1%). A first-pass effect was achieved in 24.2% (n = 71; 95% CI, 19.4%-29.6%). A rescue stent retriever approach was required in 29.7% (n = 88; 95% CI, 24.6%-35.3%). The complication rate was 9.5% (n = 28; 95% CI, 6.4%-13.5%). Forty-three percent (n = 122; 95% CI, 37.1%-48.9%) of patients presented with a favorable 3-month outcome (mRS ≤ 2). Older age, M1-occlusion topography, and intravenous thrombolysis use prior to thrombectomy were independent predictors of the first-pass effect. CONCLUSIONS The first-line contact aspiration approach appeared safe and efficient with Sofia catheters. These devices achieved very high reperfusion rates with a low requirement for stent retriever rescue therapy, especially for M1 occlusions.
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Affiliation(s)
- G Marnat
- From the Interventional and Diagnostic Neuroradiology Department (G.M., X.B., F.G., J.B., P.M.), Bordeaux University Hospital, Bordeaux, France
| | - X Barreau
- From the Interventional and Diagnostic Neuroradiology Department (G.M., X.B., F.G., J.B., P.M.), Bordeaux University Hospital, Bordeaux, France
| | - L Detraz
- Interventional and Diagnostic Neuroradiology Department (L.D., R.B.), Nantes University Hospital, Nantes, France
| | - R Bourcier
- Interventional and Diagnostic Neuroradiology Department (L.D., R.B.), Nantes University Hospital, Nantes, France
- Interventional Neuroradiology Department (R.B.), Fondation Ophtalmologique Rothschild, Paris, France
| | - B Gory
- Department of Diagnostic and Therapeutic Neuroradiology (B.G.), University Hospital of Nancy, Nancy, France
- Institut National de la Santé et de la Recherche Médicale U1254 (B.G.), IADI F-54000, Nancy, France
| | - A Sgreccia
- Department of Radiology (A.S.), Ospedali Riuniti, Siena, Italy
| | - F Gariel
- From the Interventional and Diagnostic Neuroradiology Department (G.M., X.B., F.G., J.B., P.M.), Bordeaux University Hospital, Bordeaux, France
| | - J Berge
- From the Interventional and Diagnostic Neuroradiology Department (G.M., X.B., F.G., J.B., P.M.), Bordeaux University Hospital, Bordeaux, France
| | - P Menegon
- From the Interventional and Diagnostic Neuroradiology Department (G.M., X.B., F.G., J.B., P.M.), Bordeaux University Hospital, Bordeaux, France
| | - M Kyheng
- Université Lille (M.K., J.L.), Centre Hospitalier Universitaire Lille, Lille, France
| | - J Labreuche
- Université Lille (M.K., J.L.), Centre Hospitalier Universitaire Lille, Lille, France
| | - A Consoli
- Department of Neuroradiology (A.C.), Foch Hospital, Suresnes, France
| | - R Blanc
- From the Interventional and Diagnostic Neuroradiology Department (G.M., X.B., F.G., J.B., P.M.), Bordeaux University Hospital, Bordeaux, France
| | - B Lapergue
- Department of Neurology (B.L.), Stroke Center, Foch Hospital, Suresnes, France
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Grandfils S, Demondion D, Kyheng M, Duhamel A, Lorio E, Pattou F, Deruelle P. Impact of gestational weight gain on perinatal outcomes after a bariatric surgery. J Gynecol Obstet Hum Reprod 2019; 48:401-405. [DOI: 10.1016/j.jogoh.2019.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/03/2019] [Accepted: 03/15/2019] [Indexed: 02/04/2023]
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Vincent F, Delhaye C, Juthier F, Richardson M, Hertault A, Kyheng M, Belin C, Pierache A, Denimal T, Coisne A, Loobuyck V, Van Belle E. Point-of-care Ultrasound guidance to reduce vascular access complications in transfemoral TAVR. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.04.010] [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: 10/26/2022]
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Casolla B, Moulin S, Kyheng M, Hénon H, Labreuche J, Leys D, Bauters C, Cordonnier C. Five-Year Risk of Major Ischemic and Hemorrhagic Events After Intracerebral Hemorrhage. Stroke 2019; 50:1100-1107. [DOI: 10.1161/strokeaha.118.024449] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Barbara Casolla
- From the Univ. Lille, Inserm U1171, Degenerative and Vascular Cognitive Disorders, CHU Lille, Department of Neurology, Lille, France (B.C., S.M., H.H., D.L., C.C.)
| | - Solène Moulin
- From the Univ. Lille, Inserm U1171, Degenerative and Vascular Cognitive Disorders, CHU Lille, Department of Neurology, Lille, France (B.C., S.M., H.H., D.L., C.C.)
| | - Maéva Kyheng
- Univ. Lille, CHU Lille, EA 2694 Santé Publique: épidémiologie et Qualité des Soins, Lille, France (M.K., J.L.)
| | - Hilde Hénon
- From the Univ. Lille, Inserm U1171, Degenerative and Vascular Cognitive Disorders, CHU Lille, Department of Neurology, Lille, France (B.C., S.M., H.H., D.L., C.C.)
| | - Julien Labreuche
- Univ. Lille, CHU Lille, EA 2694 Santé Publique: épidémiologie et Qualité des Soins, Lille, France (M.K., J.L.)
| | - Didier Leys
- From the Univ. Lille, Inserm U1171, Degenerative and Vascular Cognitive Disorders, CHU Lille, Department of Neurology, Lille, France (B.C., S.M., H.H., D.L., C.C.)
| | - Christophe Bauters
- Univ. Lille, Inserm U1167, Institut Pasteur et CHU Lille, Lille, France (C.B.)
| | - Charlotte Cordonnier
- From the Univ. Lille, Inserm U1171, Degenerative and Vascular Cognitive Disorders, CHU Lille, Department of Neurology, Lille, France (B.C., S.M., H.H., D.L., C.C.)
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Ben Hamou A, Espiard S, Do Cao C, Ladsous M, Loyer C, Moerman A, Boury S, Kyheng M, Dhaenens CM, Tiffreau V, Pigny P, Lebuffe G, Caiazzo R, Aubert S, Vantyghem MC. Systematic thyroid screening in myotonic dystrophy: link between thyroid volume and insulin resistance. Orphanet J Rare Dis 2019; 14:42. [PMID: 30760283 PMCID: PMC6375124 DOI: 10.1186/s13023-019-1019-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/12/2018] [Accepted: 02/03/2019] [Indexed: 12/19/2022] Open
Abstract
Background Myotonic dystrophy (DM1), a neuromuscular disease related to DMPK gene mutations, is associated to endocrine disorders and cancer. A routine endocrine work-up, including thyroid ultrasound (US), was conducted in 115 genetically-proven DM1 patients in a neuromuscular reference center. The aim of this study was to determine the prevalence and the causes of US thyroid abnormalities in DM1. Results In the whole population (age 45.1 ± 12.2 years, 61.7% female), palpable nodules or goiters were present in 29.2%. The percentage of US goiter (thyroid volume > 18 mL) and US nodules were, respectively, 38.3 and 60.9%. Sixteen of the 115 patients had a thyroidectomy, after 22 fine-needle aspiration cytology guided by thyroid imaging reporting and data system (TIRADS) classification. Six micro- (1/6 pT3) and 3 macro-papillary thyroid carcinoma (PTCs) (2/3 intermediate risk) were diagnosed (7.9% of 115). Thyroid US led to the diagnosis of 4 multifocal and 2 unifocal (including 1 macro-PTC) non-palpable PTCs. Ultrasound thyroid volume was positively correlated to body mass index (BMI) (p = 0.015) and parity (p = 0.036), and was inversely correlated to TSH (p < 0.001) and vitamin D levels (p = 0.023). The BMI, the frequencies of glucose intolerance and PTC were significantly higher in UsGoiter versus non-UsGoiter groups. Conclusion In this systematically screened DM1 cohort, the frequency of UsGoiter, mainly associated to BMI, was about 40%, US nodules 60%, thyroidectomies 13–14%, and PTCs 8%, two-thirds of them being micro-PTCs with good prognosis. Therefore, a systematic screening remains debatable. A targeted US screening in case of clinical abnormality or high BMI seems more appropriate. Electronic supplementary material The online version of this article (10.1186/s13023-019-1019-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adrien Ben Hamou
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000, Lille, France. .,Department of Endocrinology, Diabetology and Metabolism, CHR-U Lille, 1, Rue Polonovski, 59037, Lille, France.
| | - Stéphanie Espiard
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000, Lille, France
| | - Christine Do Cao
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000, Lille, France
| | - Miriam Ladsous
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000, Lille, France
| | - Camille Loyer
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000, Lille, France
| | | | | | - Maéva Kyheng
- CHU Lille, EA 2694 - Public Health, Epidemiology and Quality of Care, F-59000, Lille, France
| | - Claire-Marie Dhaenens
- Univ Lille, Inserm, CHU Lille, UMR 837-1, Alzheimer & Tauopathies, F-59000, Lille, France
| | - Vincent Tiffreau
- CHU Lille Neuromuscular Reference Center, F-59000, Lille, France
| | - Pascal Pigny
- CHU Lille, Institute of Biochemistry and Molecular Biology - Biology Center, F-59000, Lille, France
| | | | - Robert Caiazzo
- CHU Lille, General and Endocrine Surgery, F-59000, Lille, France.,Univ Lille, Inserm, CHU Lille, UMR 1190 Translational Research in Diabetes, F-59000, Lille, France.,EGID European Genomics Institute for Diabetes, CHU Lille, F-59000, Lille, France
| | - Sébastien Aubert
- CHU Lille, Institute of Biochemistry and Molecular Biology - Pathology Center, F-59000, Lille, France
| | - Marie Christine Vantyghem
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000, Lille, France. .,CHU Lille Neuromuscular Reference Center, F-59000, Lille, France. .,Univ Lille, Inserm, CHU Lille, UMR 1190 Translational Research in Diabetes, F-59000, Lille, France. .,EGID European Genomics Institute for Diabetes, CHU Lille, F-59000, Lille, France. .,Department of Endocrinology, Diabetology and Metabolism, CHR-U Lille, 1, Rue Polonovski, 59037, Lille, France.
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El Nawar R, Lapergue B, Piotin M, Gory B, Blanc R, Consoli A, Rodesch G, Mazighi M, Bourdain F, Kyheng M, Labreuche J, Pico F, Piotin M, Blanc R, Redjem H, Escalard S, Desilles JP, Ciccio G, Smajda S, Mazighi M, Fahed R, Obadia M, Sabben C, Corabianu O, de Broucker T, Smadja D, Alamowitch S, Ille O, Manchon E, Garcia PY, Taylor G, Ben Maacha M, Bourdain F, Decroix JP, Wang A, Evrard S, Tchikviladze M, Lapergue B, Coskun O, Consoli A, Di Maria F, Rodesch G, Leguen M, Tisserand M, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Gory B, Labeyrie PE, Riva R, Turjman F, Nighoghossian N, Derex L, Cho TH, Mechtouff L, Lukaszewicz AC, Philippeau F, Cakmak S, Blanc-Lasserre K, Vallet AE. Higher Annual Operator Volume Is Associated With Better Reperfusion Rates in Stroke Patients Treated by Mechanical Thrombectomy. JACC Cardiovasc Interv 2019; 12:385-391. [DOI: 10.1016/j.jcin.2018.12.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/26/2018] [Accepted: 12/04/2018] [Indexed: 01/02/2023]
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Tetart M, Kyheng M, Wallet F, Le Rouzic O, Wallaert B, Prevotat A. Impact d’Achromobacter xylosoxidans sur la fonction ventilatoire de patients adultes atteints de mucoviscidose. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.045] [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: 10/27/2022]
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Gariel F, Lapergue B, Bourcier R, Berge J, Barreau X, Mazighi M, Kyheng M, Labreuche J, Fahed R, Blanc R, Gory B, Duhamel A, Saleme S, Costalat V, Bracard S, Desal H, Detraz L, Consoli A, Piotin M, Marnat G. Mechanical Thrombectomy Outcomes With or Without Intravenous Thrombolysis. Stroke 2018; 49:2383-2390. [DOI: 10.1161/strokeaha.118.021500] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Intravenous thrombolysis (IVT) within 4.5 hours of symptom onset is currently recommended before mechanical thrombectomy (MT). We compared functional outcome, neurological recovery, reperfusion, and adverse events according to the use or not of IVT before MT.
Methods—
This is a post hoc analysis of the ASTER trial (Contact Aspiration Versus Stent Retriever for Successful Revascularization). The primary outcome was favorable 90-day functional outcome defined as a modified Rankin Scale of ≤2. Secondary outcomes were successful reperfusion following all procedures and after the first-line procedure, number of device passes, and change in National Institutes of Health Stroke Scale score at 24 hours. Safety outcomes included 90-day mortality and any symptomatic intracerebral hemorrhage.
Results—
Three hundred eighty-one patients were included, 250 of whom received IVT before MT (IVT+MT group). There were no significant differences between IVT+MT and MT-alone groups in 90-day favorable functional outcome, in successful reperfusion rate (modified Thrombolysis In Cerebral Infarction 2b or 3), in National Institutes of Health Stroke Scale score improvement at 24 hours, or in hemorrhagic complication rate. The 90-day mortality rate in the IVT+MT group was lower than after MT alone (fully-adjusted risk ratio, 0.59; 95% CI, 0.39–0.88). In a subgroup of patients without anticoagulant medication before stroke onset, we observed in the IVT+MT group a better functional outcome (fully-adjusted risk ratio, 1.38; 95% CI, 1.02–1.89), a higher successful recanalization rate after first-line strategy (fully-adjusted risk ratio, 1.26; 95% CI, 1.05–1.50), and a lower mortality rate (fully-adjusted risk ratio, 0.58; 95% CI, 0.36–0.93).
Conclusions—
Our results show that IVT+MT patients in the ASTER trial have lower 90-day mortality compared with those receiving MT alone. In a selected population of patients without prestroke anticoagulation, we demonstrated that IVT associated with MT might improve functional outcome and recanalization while reducing mortality rates.
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Affiliation(s)
- Florent Gariel
- From the Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bordeaux, France (F.G., J.B., X.B., G.M.)
| | - Bertrand Lapergue
- Department of Stroke Center, University of Versailles and Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L., A.C.)
| | - Romain Bourcier
- Department of Diagnostic and Interventional Neuroradiology, Guillaume et René Laennec University Hospital, Nantes, France (R.B., H.D., L.D.)
| | - Jérôme Berge
- From the Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bordeaux, France (F.G., J.B., X.B., G.M.)
| | - Xavier Barreau
- From the Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bordeaux, France (F.G., J.B., X.B., G.M.)
| | - Mikael Mazighi
- Department of Diagnostic and Interventional Neuroradiology, Rothschild Foundation, Paris, France (M.M., R.F., R.B., M.P.)
| | - Maéva Kyheng
- Department of Biostatistics, University Lille, CHU Lille, EA2694-Santé Publique: Epidémiologie et Qualité des Soins, France (M.K., J.L., A.D.)
| | - Julien Labreuche
- Department of Biostatistics, University Lille, CHU Lille, EA2694-Santé Publique: Epidémiologie et Qualité des Soins, France (M.K., J.L., A.D.)
| | - Robert Fahed
- Department of Diagnostic and Interventional Neuroradiology, Rothschild Foundation, Paris, France (M.M., R.F., R.B., M.P.)
| | - Raphael Blanc
- Department of Diagnostic and Interventional Neuroradiology, Rothschild Foundation, Paris, France (M.M., R.F., R.B., M.P.)
| | | | - Alain Duhamel
- Department of Biostatistics, University Lille, CHU Lille, EA2694-Santé Publique: Epidémiologie et Qualité des Soins, France (M.K., J.L., A.D.)
| | - Suzana Saleme
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Limoges, France (S.S.)
| | - Vincent Costalat
- Department of Diagnostic and Interventional Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France (V.C.)
| | | | - Hubert Desal
- Department of Diagnostic and Interventional Neuroradiology, Guillaume et René Laennec University Hospital, Nantes, France (R.B., H.D., L.D.)
| | - Lili Detraz
- Department of Diagnostic and Interventional Neuroradiology, Guillaume et René Laennec University Hospital, Nantes, France (R.B., H.D., L.D.)
| | - Arturo Consoli
- Department of Stroke Center, University of Versailles and Saint-Quentin-en-Yvelines, Foch Hospital, Suresnes, France (B.L., A.C.)
| | - Michel Piotin
- Department of Diagnostic and Interventional Neuroradiology, Rothschild Foundation, Paris, France (M.M., R.F., R.B., M.P.)
| | - Gaultier Marnat
- From the Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bordeaux, France (F.G., J.B., X.B., G.M.)
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Di Maria F, Mazighi M, Kyheng M, Labreuche J, Rodesch G, Consoli A, Coskun O, Gory B, Lapergue B. Intravenous Thrombolysis Prior to Mechanical Thrombectomy in Acute Ischemic Stroke: Silver Bullet or Useless Bystander? J Stroke 2018; 20:385-393. [PMID: 30309233 PMCID: PMC6186914 DOI: 10.5853/jos.2018.01543] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 05/25/2018] [Accepted: 09/10/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Recent single-center series and meta-analyses suggest that mechanical thrombectomy (MT) without prior intravenous thrombolysis (IVT) might be equally effective to bridging therapy. We analyzed, within the Endovascular Treatment in Ischemic Stroke (ETIS) prospective observational registry, the angiographic and clinical outcomes after IVT+MT versus MT alone. METHODS From December 2012 to December 2016, a total of 1,507 consecutive patients with a proximal arterial occlusion of the anterior circulation were treated by MT. Of these, 975 (64.7%) received prior IVT. Immediate angiographic and clinical outcomes at 90 days (modified Rankin Scale [mRS]) were compared between the two groups while checking for propensity score, matched-propensity score and by inverse probability of treatment weighting (IPTW) propensity score method. RESULTS Favorable outcome (mRS 0 to 2) was more frequently achieved after IVT+MT (n=523, 53.6%) than after MT alone (n=222, 41.8%) with an unadjusted odds ratio (OR) for bridging therapy of 1.61 (95% confidence interval [CI], 1. 29 to 2.01). This difference remained not significant in matched-propensity score cohort (OR, 1.21; 95% CI, 0.90 to 1.63) although it remained according to adjusted propensity score (OR, 1.31; 95% CI, 1.02 to 1.68) and IPTW (OR, 1.37; 95% CI, 1.09 to 1.73) analyses. A significant difference was found in terms of excellent outcome (mRS 0 to 1) (adjusted OR, 1.63; 95% CI, 1.25 to 2.11) and successful reperfusion (adjusted OR, 1.58; 95% CI, 1.33 to 2.15). No differences in intracerebral hemorrhage or in allcause mortality within 90 days were found between groups. CONCLUSION s IVT prior to MT is associated with increased excellent outcome and successful reperfusion rates. These findings support the use of bridging therapy.
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Affiliation(s)
- Federico Di Maria
- Department of Diagnostic and Therapeutic Neuroradiology, Foch Hospital, Suresnes, France
| | - Mikael Mazighi
- Department of Interventional Neuroradiology, Fondation Ophtalmologique A. De Rothschild, DHU Neurovasc, Paris 7 Denis Diderot University, Paris, France.,University of Lille, CHU Lille, Lille, France
| | | | | | - Georges Rodesch
- Department of Diagnostic and Therapeutic Neuroradiology, Foch Hospital, Suresnes, France
| | - Arturo Consoli
- Department of Diagnostic and Therapeutic Neuroradiology, Foch Hospital, Suresnes, France
| | - Oguzhan Coskun
- Department of Diagnostic and Therapeutic Neuroradiology, Foch Hospital, Suresnes, France
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Nancy, France.,University of Lorraine, Nancy, France
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Baldacci S, Kherrouche Z, Cockenpot V, Stoven L, Copin MC, Werkmeister E, Marchand N, Kyheng M, Tulasne D, Cortot AB. MET amplification increases the metastatic spread of EGFR-mutated NSCLC. Lung Cancer 2018; 125:57-67. [PMID: 30429039 DOI: 10.1016/j.lungcan.2018.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 07/19/2018] [Revised: 09/05/2018] [Accepted: 09/10/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Five to 20% of metastatic EGFR-mutated non-small cell lung cancers (NSCLC) develop acquired resistance to EGFR tyrosine kinase inhibitors (EGFR-TKI) through MET amplification. The effects of MET amplification on tumor and patient phenotype remain unknown. METHODS We investigated,in vitro and in vivo, the impact of MET amplification on the biological properties of the HCC827 cell line, derived from an EGFR-mutated NSCLC. We further evaluated the time to new metastases after EGFR-TKI progression in EGFR-mutated NSCLC, exhibiting MET amplification or high MET overexpression. RESULTS MET amplification significantly enhanced proliferation, anchorage independent growth, anoikis resistance, migration, and induced an epithelial to mesenchymal transition. In vivo, MET amplification significantly increased the tumor growth and metastatic spread. Treatment with a MET-TKI reversed this aggressive phenotype. We found that EGFR-mutated NSCLC patients exhibiting MET amplification on a re-biopsy, performed after EGFR-TKI progression, displayed a shorter time to new metastases after EGFR-TKI progression than patients with high MET overexpression but no MET amplification. CONCLUSION MET amplification increases metastatic spread even in the context of an already pre-existing strong driver mutation such as EGFR mutation. These results prompt development of therapeutic strategies aiming at preventing emergence of MET amplification.
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Affiliation(s)
- Simon Baldacci
- Thoracic Oncology Department, CHU Lille, Siric OncoLille, F-59000, Lille, France; Univ Lille, Lille, France; Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000, Lille, France.
| | - Zoulika Kherrouche
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000, Lille, France; Institut Pasteur de Lille, France.
| | - Vincent Cockenpot
- Univ Lille, Lille, France; Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000, Lille, France; Pathology department CHRU Lille, France.
| | - Luc Stoven
- Thoracic Oncology Department, CHU Lille, Siric OncoLille, F-59000, Lille, France; Univ Lille, Lille, France; Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000, Lille, France.
| | - Marie Christine Copin
- Univ Lille, Lille, France; Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000, Lille, France; Pathology department CHRU Lille, France.
| | | | - Nathalie Marchand
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000, Lille, France.
| | | | - David Tulasne
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000, Lille, France.
| | - Alexis B Cortot
- Thoracic Oncology Department, CHU Lille, Siric OncoLille, F-59000, Lille, France; Univ Lille, Lille, France; Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000, Lille, France.
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Léonard M, Caldari D, Mas E, Lambe C, Compte A, Ley D, Peretti N, Borderon C, Marinier E, Coste ME, Lamireau T, Rubio A, Turquet A, Dubern B, Dabadie A, Gautry J, Kyheng M, Guimber D, Gottrand F. Experience of using a semi-elemental formula for home enteral nutrition in children: a french multicenter study. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2088] [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: 11/25/2022]
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Zhu F, Lapergue B, Kyheng M, Blanc R, Labreuche J, Ben Machaa M, Duhamel A, Marnat G, Saleme S, Costalat V, Bracard S, Richard S, Desal H, Mazighi M, Consoli A, Piotin M, Gory B. Similar Outcomes for Contact Aspiration and Stent Retriever Use According to the Admission Clot Burden Score in ASTER. Stroke 2018; 49:1669-1677. [PMID: 29880554 DOI: 10.1161/strokeaha.118.021120] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/09/2018] [Accepted: 05/04/2018] [Indexed: 11/16/2022]
Affiliation(s)
- François Zhu
- From the Department of Diagnostic and Therapeutic Neuroradiology (F.Z., S.B., B.G.)
| | - Bertrand Lapergue
- Stroke Unit, University Hospital of Nancy, University of Lorraine, INSERM U1254, IADI, Nancy, France; Department of Stroke Center (B.L.)
| | - Maéva Kyheng
- Department of Biostatistics, University Lille, CHU Lille, EA 2694–Santé Publique: Epidémiologie et Qualité des Soins, France (M.K., J.L., A.D.)
| | - Raphael Blanc
- Foch Hospital, Suresnes, France; Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (R.B., M.B.M., M.M., M.P.)
| | - Julien Labreuche
- Department of Biostatistics, University Lille, CHU Lille, EA 2694–Santé Publique: Epidémiologie et Qualité des Soins, France (M.K., J.L., A.D.)
| | - Malek Ben Machaa
- Foch Hospital, Suresnes, France; Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (R.B., M.B.M., M.M., M.P.)
| | - Alain Duhamel
- Department of Biostatistics, University Lille, CHU Lille, EA 2694–Santé Publique: Epidémiologie et Qualité des Soins, France (M.K., J.L., A.D.)
| | - Gautier Marnat
- Department of Neuroradiology, University Hospital of Bordeaux, France (G.M.)
| | - Suzana Saleme
- Department of Interventional Neuroradiology, University Hospital of Limoges, France (S.S.)
| | - Vincent Costalat
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France (V.C.)
| | - Serge Bracard
- From the Department of Diagnostic and Therapeutic Neuroradiology (F.Z., S.B., B.G.)
| | | | - Hubert Desal
- Department of Neuroradiology, Guillaume et René Laennec University Hospital, Nantes, France (H.D.)
| | - Mikael Mazighi
- Foch Hospital, Suresnes, France; Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (R.B., M.B.M., M.M., M.P.)
| | | | - Michel Piotin
- Foch Hospital, Suresnes, France; Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (R.B., M.B.M., M.M., M.P.)
| | - Benjamin Gory
- From the Department of Diagnostic and Therapeutic Neuroradiology (F.Z., S.B., B.G.)
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47
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Pez V, Deruelle P, Kyheng M, Boyon C, Clouqueur E, Garabedian C. [Cervical ripening and labor induction: Evaluation of single balloon catheter compared to double balloon catheter and dinoprostone insert]. ACTA ACUST UNITED AC 2018; 46:570-574. [PMID: 29903553 DOI: 10.1016/j.gofs.2018.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/16/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To compare the effectiveness of single balloon catheter with double balloon catheter and dinoprostone insert for cervical ripening and labor induction on unfavourable cervix. METHODS this is a comparative, retrospective, one-center trial. Were included singleton pregnancy in cephalic presentation. Were excluded cicatricial uterus. The outcomes were vaginal delivery rate, caesarean section rate, modification in Bishop score, time from induction to delivery, second time prostaglandin E2 resort, oxytocin administration resort, maternal or neonatal adverse events. RESULTS Were included 108 patients: 45 in single balloon catheter group, 32 in double balloon catheter group, 31 in dinoprostone insert group. Vaginal delivery rate was similar in single balloon catheter group (78 %) compared with others groups (75 % in double balloon catheter and 71 % in dinoprostone insert group respectively). Oxytocin administration resort was superior in single balloon catheter group. There was no significant difference on others outcomes. Labor induction costs were 9euros in single balloon catheter group, versus 55 and 81 euros in double balloon catheter group and dinoprostone insert group respectively. CONCLUSIONS Single balloon catheter seems just as effective as double balloon catheter and dinoprostone insert with its major asset the low cost for labor induction.
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Affiliation(s)
- V Pez
- Clinique d'obstétrique, CHU de Lille, 59000 Lille, France
| | - P Deruelle
- Clinique d'obstétrique, CHU de Lille, 59000 Lille, France; EA 4489 Environnement périnatal et croissance, Université de Lille, 59000 Lille, France
| | - M Kyheng
- Département de biostatistiques, EA 2694, Université de Lille, CHU de Lille, 59000 Lille, France
| | - C Boyon
- Clinique d'obstétrique, CHU de Lille, 59000 Lille, France
| | - E Clouqueur
- Clinique d'obstétrique, CHU de Lille, 59000 Lille, France
| | - C Garabedian
- Clinique d'obstétrique, CHU de Lille, 59000 Lille, France; EA 4489 Environnement périnatal et croissance, Université de Lille, 59000 Lille, France.
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48
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Gory B, Haussen DC, Piotin M, Steglich-Arnholm H, Holtmannspötter M, Labreuche J, Kyheng M, Taschner C, Eiden S, Nogueira RG, Papanagiotou P, Boutchakova M, Siddiqui AH, Lapergue B, Dorn F, Cognard C, Killer M, Mangiafico S, Ribo M, Psychogios MN, Spiotta AM, Labeyrie MA, Biondi A, Mazighi M, Turjman F. Impact of intravenous thrombolysis and emergent carotid stenting on reperfusion and clinical outcomes in patients with acute stroke with tandem lesion treated with thrombectomy: a collaborative pooled analysis. Eur J Neurol 2018; 25:1115-1120. [DOI: 10.1111/ene.13633] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 02/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- B. Gory
- Department of Diagnostic and Interventional Neuroradiology; INSERM U947; University Hospital of Nancy; Nancy France
| | - D. C. Haussen
- Department of Neurology; Emory University/Grady Memorial Hospital; Atlanta GA USA
| | - M. Piotin
- Department of Interventional Neuroradiology; Rothschild Foundation; Paris France
| | | | | | - J. Labreuche
- Department of Biostatistics; EA2694-Santé Publique: Epidémiologie et Qualité Des Soins; Lille University; Lille France
| | - M. Kyheng
- Department of Biostatistics; EA2694-Santé Publique: Epidémiologie et Qualité Des Soins; Lille University; Lille France
| | - C. Taschner
- Department of Neuroradiology; Medical Center-University of Freiburg; Freiburg
| | - S. Eiden
- Department of Neuroradiology; Medical Center-University of Freiburg; Freiburg
| | - R. G. Nogueira
- Department of Neurology; Emory University/Grady Memorial Hospital; Atlanta GA USA
| | - P. Papanagiotou
- Department of Diagnostic and Interventional Neuroradiology; Klinikum Bremen-Mitte/Bremen-Ost; Bremen Germany
| | - M. Boutchakova
- Department of Diagnostic and Interventional Neuroradiology; Klinikum Bremen-Mitte/Bremen-Ost; Bremen Germany
| | - A. H. Siddiqui
- Department of Neurosurgery; University at Buffalo; State University of New York; Buffalo NY USA
| | - B. Lapergue
- Department of Neurology; Stroke Center; Foch Hospital; Suresnes France
| | - F. Dorn
- Department of Neuroradiology; University Hospital of Munich; Munich Germany
| | - C. Cognard
- Department of Neuroradiology; University Hospital of Toulouse; Toulouse France
| | - M. Killer
- Department of Neuroradiology; Christian Doppler Clinic; Research Institute for Neurointervention; Paracelsus Medical University; Salzburg Austria
| | - S. Mangiafico
- Department of Interventional Neuroradiology; Careggi University Hospital; Florence Italy
| | - M. Ribo
- Department of Neurology; Hospital Vall D'Hebron; Barcelona Spain
| | - M. N. Psychogios
- Department of Neuroradiology; University Medical Center Göttingen; Göttingen Germany
| | - A. M. Spiotta
- Department of Neurosurgery; Medical University of South Carolina; Charleston SC USA
| | - M. A. Labeyrie
- Department of Interventional Neuroradiology; Lariboisière Hospital; Paris
| | - A. Biondi
- Department of Neuroradiology and Endovascular Therapeutic; University Hospital of Besançon; Besançon
| | - M. Mazighi
- Department of Interventional Neuroradiology; Rothschild Foundation; Paris France
| | - F. Turjman
- Department of Interventional Neuroradiology; Hospices Civils de Lyon; Lyon France
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49
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Escalard S, Gory B, Kyheng M, Desilles JP, Redjem H, Ciccio G, Smajda S, Labreuche J, Mazighi M, Piotin M, Blanc R, Lapergue B, Fahed R. Unknown-onset strokes with anterior circulation occlusion treated by thrombectomy after DWI-FLAIR mismatch selection. Eur J Neurol 2018; 25:732-738. [DOI: 10.1111/ene.13580] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/11/2018] [Indexed: 11/30/2022]
Affiliation(s)
- S. Escalard
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
| | - B. Gory
- Department of Interventional Neuroradiology; Hôpital Neurologique Pierre Wertheimer; Bron France
| | - M. Kyheng
- EA 2694-Santé Publique: Epidémiologie et Qualité des Soins; CHU Lille; University of Lille; Lille France
| | - J.-P. Desilles
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
- Laboratory of Vascular Translational Science; U1148 Institut National de la Santé et de la Recherche Médicale (INSERM); Paris France
| | - H. Redjem
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
| | - G. Ciccio
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
| | - S. Smajda
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
| | - J. Labreuche
- EA 2694-Santé Publique: Epidémiologie et Qualité des Soins; CHU Lille; University of Lille; Lille France
| | - M. Mazighi
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
- Laboratory of Vascular Translational Science; U1148 Institut National de la Santé et de la Recherche Médicale (INSERM); Paris France
- Paris Diderot and Sorbonne Paris Cite Universities; Paris France
- DHU NeuroVasc; Paris France
| | - M. Piotin
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
- Laboratory of Vascular Translational Science; U1148 Institut National de la Santé et de la Recherche Médicale (INSERM); Paris France
| | - R. Blanc
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
- Laboratory of Vascular Translational Science; U1148 Institut National de la Santé et de la Recherche Médicale (INSERM); Paris France
| | - B. Lapergue
- Laboratory of Vascular Translational Science; U1148 Institut National de la Santé et de la Recherche Médicale (INSERM); Paris France
- Department of Neurology; Stroke Center; Foch Hospital; University Versailles Saint-Quentin en Yvelines; Suresnes France
| | - R. Fahed
- Department of Interventional Neuroradiology; Fondation Rothschild; Paris France
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50
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Grolez G, Kyheng M, Lopes R, Moreau C, Timmerman K, Auger F, Kuchcinski G, Duhamel A, Jissendi-Tchofo P, Besson P, Laloux C, Petrault M, Devedjian JC, Pérez T, Pradat PF, Defebvre L, Bordet R, Danel-Brunaud V, Devos D. MRI of the cervical spinal cord predicts respiratory dysfunction in ALS. Sci Rep 2018; 8:1828. [PMID: 29379040 PMCID: PMC5789036 DOI: 10.1038/s41598-018-19938-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 01/10/2018] [Indexed: 01/07/2023] Open
Abstract
For patients with amyotrophic lateral sclerosis (ALS), the primary therapeutic goal is to minimize morbidity. Non-invasive ventilation improves survival. We aim to assess whether Magnetic Resonance Imaging (MRI) of the cervical spinal cord predicts the progression of respiratory disorders in ALS. Brain and spinal MRI was repeatedly performed in the SOD1G86R mouse model, in 40 patients and in healthy controls. Atrophy, iron overload, white matter diffusivity and neuronal loss were assessed. In Superoxide Dismutase-1 (SOD1) mice, iron accumulation appeared in the cervical spinal cord at symptom onset but disappeared with disease progression (after the onset of atrophy). In ALS patients, the volumes of the motor cortex and the medulla oblongata were already abnormally low at the time of diagnosis. Baseline diffusivity in the internal capsule was predictive of functional handicap. The decrease in cervical spinal cord volume from diagnosis to 3 months was predictive of the change in slow vital capacity at 12 months. MRI revealed marked abnormalities at the time of ALS diagnosis. Early atrophy of the cervical spinal cord may predict the progression of respiratory disorders, and so may be of value in patient care and as a primary endpoint in pilot neuroprotection studies.
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Affiliation(s)
- G Grolez
- Service de Neurologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center, Lille, France
| | - M Kyheng
- Département de Biostastistiques, Université de Lille, CHU de Lille, Lille, France
| | - R Lopes
- Service de Neuroradiologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France
| | - C Moreau
- Service de Neurologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center, Lille, France
| | - K Timmerman
- Service de Pharmacologie, Médicale Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France
| | - F Auger
- Plateau d'imagerie préclinique, Université de Lille, CHU de Lille, Lille, France
| | - G Kuchcinski
- Service de Neuroradiologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France
| | - A Duhamel
- Département de Biostastistiques, Université de Lille, CHU de Lille, Lille, France
| | - P Jissendi-Tchofo
- Service de Neuroradiologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France.,Department of Radiology, Neuroradiology section, Free University of Brussels, CHU Saint-Pierre, Brussels, Belgium
| | - P Besson
- Service de Neuroradiologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France
| | - C Laloux
- Service de Pharmacologie, Médicale Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France
| | - M Petrault
- Service de Pharmacologie, Médicale Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France
| | - J C Devedjian
- Service de Pharmacologie, Médicale Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France
| | - Thierry Pérez
- Service de Pneumologie, Université de Lille, CHU de Lille, Lille, France
| | - Pierre François Pradat
- Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne Universités, UPMC Univ Paris 06, Paris, France.,Département de Neurologie, Centre référent SLA, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - L Defebvre
- Service de Neurologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center, Lille, France
| | - R Bordet
- Service de Pharmacologie, Médicale Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France
| | - V Danel-Brunaud
- Service de Neurologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center, Lille, France
| | - D Devos
- Service de Neurologie, Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center, Lille, France. .,Service de Pharmacologie, Médicale Université de Lille, CHU de Lille, INSERM UMRS_1171, LICEND COEN Center Lille, Lille, France.
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