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Landolff Q, Quillot M, Picard F, Henry P, Sideris G, Bizeau O, Piot C, Jouve B, Rischner J, Mejri M, Charmasson C, Lasserre R, Pouliquen H, Joseph T, Monsegu J, Karsenty B, Martin Yuste V, Richet N, Lapeyre G, Beverelli F, Beygui F, Koning R. In-Hospital and 1-Year Clinical Results from the French Registry Using Polymer-Free Sirolimus-Eluting Stents in Acute Coronary Syndrome and Stable Coronary Artery Disease. J Interv Cardiol 2023; 2023:8907315. [PMID: 38125031 PMCID: PMC10733033 DOI: 10.1155/2023/8907315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/07/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives The aim of this postmarket clinical study was to assess the safety and efficacy of the latest generation polymer-free sirolimus-eluting stents (PF-SES) in an all-comers population comparing outcomes in stable coronary artery disease (CAD) versus acute coronary syndrome (ACS) in France. Background The efficacy and safety of the first-generation PF-SES have already been demonstrated by randomized controlled trials and "all-comers" observational studies. Methods For this all-comers observational, prospective, multicenter study, 1456 patients were recruited in 22 French centers. The primary endpoint was target lesion revascularization (TLR) rate at 12 months and secondary endpoints included major adverse cardiac events (MACE) and bleeding. Results 895 patients had stable CAD and 561 had ACS. At 12 months, 2% of patients had a TLR, with similar rates between stable CAD and ACS (1.9% vs 2.2%, p = 0.7). The overall MACE rate was 5.2% with an expected higher rate in patients with ACS as compared to those with stable CAD (7.3% vs 3.9%, p = 0.007). The overall bleeding event rate was 4.5%, with similar rates in stable CAD as compared to ACS patients (3.8% vs 5.6%, p = 0.3). Dual antiplatelet therapy (DAPT) interruptions prior to the recommended duration occurred in 41.7% of patients with no increase in MACE rates as compared to patients who did not prematurely interrupt DAPT (3.9% vs 6.1%, p = 0.073). Conclusions The latest generation PF-SES is associated with low clinical event rates in these all-comers patients. There was a high rate of prematurely terminated DAPT, without any effect on MACE at 12 months. This trial is registered with NCT03809715.
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Affiliation(s)
| | - Marine Quillot
- Department of Cardiology, Centre Hospitalier Henri Duffaut, Avignon, France
| | - Fabien Picard
- Department of Cardiology, Hôpital Cochin-Port Royal, AP-HP, Paris, France
| | - Patrick Henry
- Department of Cardiology, Hôpital Lariboisière- Fernand Widal, AP-HP, Paris, France
| | - Georgios Sideris
- Department of Cardiology, Hôpital Lariboisière- Fernand Widal, AP-HP, Paris, France
- Department of Cardiology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Olivier Bizeau
- Department of Cardiology, Centre Hospitalier Régional d'Orléans Hôpital de la source, Orléans, France
| | - Christophe Piot
- Department of Cardiology, Clinique du Millénaire, Montpellier, France
| | - Bernard Jouve
- Department of Cardiology, Centre Hospitalier d'Aix en Provence, Aix en Provence, France
| | - Jérôme Rischner
- Department of Cardiology, Hôpital Albert Schweitzer, Colmar, France
| | - Mourad Mejri
- Department of Cardiology, Centre Hospitalier de Saint-Malo, Saint-Malo, France
| | | | - Raphael Lasserre
- Department of Cardiology, Centre Hospitalier de Pau, Pau, France
| | - Hervé Pouliquen
- Department of Cardiology, CHD les Oudairies, La Roche sur Yon, France
| | - Thierry Joseph
- Department of Cardiology, Centre Hospitalier de Cornouaille, Quimper, France
| | | | - Bernard Karsenty
- Department of Cardiology, Hopital Privé Saint-Martin, Pessac, France
| | | | - Nicolas Richet
- Department of Cardiology, Centre Hospitalier de Valence, Valence, France
| | - Guy Lapeyre
- Department of Cardiology, Clinique Claude Bernard, Albi, France
| | - Fabrizio Beverelli
- Department of Cardiology, Clinique Ambroise Paré, Neuilly sur Seine, France
| | | | - René Koning
- Department of Cardiology, Clinique Saint Hilaire, Rouen, France
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Picard F, Adjedj J, Collet JP, Van Belle E, Monsegu J, Karsenty B, Dupouy P, Quillot M, Bonnet G, Gautier A, Cayla G, Benamer H. Pharmacological coronary spasm provocative testing in clinical practice: A French Coronary Atheroma and Interventional Cardiology Group (GACI) position paper. Arch Cardiovasc Dis 2023; 116:590-596. [PMID: 37891058 DOI: 10.1016/j.acvd.2023.10.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
Vasospastic angina, also described as Prinzmetal angina, was first described as a variant form of angina at rest with transient ST-segment elevation; it is common and present in many clinical scenarios, including chronic and acute coronary syndromes, sudden cardiac death, arrhythmia and syncope. However, vasospastic angina remains underdiagnosed, and provocative tests are rarely performed. The gold-standard diagnostic approach uses invasive coronary angiography to induce coronary spasm using ergonovine, methylergonovine or acetylcholine as provocative stimuli. The lack of uniform protocol decreases the use and performance of these tests, accounting for vasospastic angina underestimation. This position paper from the French Coronary Atheroma and Interventional Cardiology Group (GACI) aims to review the indications for provocative tests, the testing conditions, drug protocols and positivity criteria.
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Affiliation(s)
- Fabien Picard
- Department of Cardiology, Cochin Hospital, Hôpitaux Universitaire Paris Centre, AP-HP, 75014 Paris, France.
| | - Julien Adjedj
- Department of Cardiology, Institut Arnault-Tzanck, 06700 Saint-Laurent-du-Var, France
| | - Jean-Philippe Collet
- Sorbonne Université, ACTION Study Group, INSERM UMRS 1166, Institut de Cardiologie, AP-HP, 75013 Paris, France
| | - Eric Van Belle
- CHU Lille, Department of Cardiology, Department of Interventional Cardiology for Coronary, Valves and Structural Heart Diseases, Institut Coeur Poumon, INSERM U1011, Institut Pasteur de Lille, EGID, Université de Lille, 59000 Lille, France
| | - Jacques Monsegu
- Department of Interventional Cardiology, Institut Cardio-Vasculaire, Groupe Hospitalier Mutualiste Grenoble, 38000 Grenoble, France
| | | | - Patrick Dupouy
- Pôle Cardio-Vasculaire Interventionnel, Clinique les Fontaines, 77000 Melun, France
| | - Marine Quillot
- Department of Interventional Cardiology, Centre Hospitalier Henri-Duffaut, 84000 Avignon, France
| | - Guillaume Bonnet
- Haut-Lévêque Cardiology Hospital, Bordeaux University, 33600 Pessac, France
| | - Alexandre Gautier
- Department of Cardiology, Hôpital Bichat, AP-HP, 75018 Paris, France
| | - Guillaume Cayla
- Cardiology Department, Nîmes University Hospital, Montpellier University, 30900 Nîmes, France
| | - Hakim Benamer
- ICPS Jacques Cartier, Ramsay Générale de Santé, 91300 Massy, France; ICV-GVM La Roseraie, 93300 Aubervilliers, France; Hôpital Foch, 92150 Suresnes, France
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Landolff Q, Godin M, Canville A, Honton B, Monsegu J, Quillot M, Berland J, Koning R, Amabile N. Sodium Chloride Physiological Saline Solution Versus Water Preparations Injectable in the Use of Shockwave Intravascular Lithotripsy: A Single-Center Experience. Cardiol Res 2023; 14:149-152. [PMID: 37091886 PMCID: PMC10116940 DOI: 10.14740/cr1489] [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: 03/03/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
Background Shockwave intravascular lithotripsy (IVL) coronary system is a very useful new technology for de novo severely calcified coronary artery plaques before percutaneous coronary intervention (PCI). The device uses a semi-compliant low-pressure balloon, integrated into a sterile catheter, to deliver by vaporizing fluid an expanding bubble that generates high-pressure ultrasonic energy by waves that create multiplane longitudinal micro-macro fractures in calcified plaques, which facilitate optimal stent placement and expansion, and luminal gain. Methods The use of Shockwave IVL coronary system in our cardiac catheterization laboratory (Cath lab) at the "Clinique Saint-Hilaire" in Rouen, France, started in March 2019, with 42 procedures performed since this date: two patients in 2019, two patients in 2020, seven patients in 2021, 23 patients in 2022, and eight patients since the beginning of 2023. Results We had experienced problems at the beginning of our activity for the first 11 patients (two patients in 2019, two patients in 2020, and seven patients in 2021): after less than five pulses, the shock therapy stopped. We used initially for Shockwave IVL semi-compliant low-pressure integrated balloons a mixture of 50% contrast and 50% water preparations injectable (PPI). After changing water PPI by sodium chloride physiological saline solution, we never encountered this problem again for the following 31 patients (23 patients in 2022, and eight patients since the beginning of 2023). In fact, the proper functioning of Shockwave IVL system requires ions in balloon mixture in addition to the contrast. It is thanks to the ions contained in sodium chloride physiological saline solution that the spark necessary for shocks delivery after balloon inflation is produced. Conclusions Water PPI or sodium chloride physiological saline solution is used in angioplasty balloons in a lot of Cath labs worldwide. It is therefore essential to disseminate in the worldwide Cath lab the obligation to put in Shockwave IVL semi-compliant low-pressure integrated balloons sodium chloride physiological saline solution, rather than water PPI for optimal performance, and the importance of Shockwave Medical reporting this to interventional cardiologists.
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Affiliation(s)
- Quentin Landolff
- Department of Interventional Cardiology, Clinique Saint Hilaire, Rouen, France
- Corresponding Author: Quentin Landolff, Department of Interventional Cardiology, Clinique Saint Hilaire, Rouen, France.
| | - Matthieu Godin
- Department of Interventional Cardiology, Clinique Saint Hilaire, Rouen, France
| | - Alexandre Canville
- Department of Interventional Cardiology, Clinique Saint Hilaire, Rouen, France
| | - Benjamin Honton
- Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France
| | - Jacques Monsegu
- Department of Interventional Cardiology, Institut Cardio-Vasculaire, Groupe Hospitalier Mutualiste Grenoble, France
| | - Marine Quillot
- Department of Interventional Cardiology, Centre Hospitalier Henri Duffaut, Avignon, France
| | - Jacques Berland
- Department of Interventional Cardiology, Clinique Saint Hilaire, Rouen, France
| | - Rene Koning
- Department of Interventional Cardiology, Clinique Saint Hilaire, Rouen, France
| | - Nicolas Amabile
- Department of Interventional Cardiology, Institut Mutualiste Montsouris, Paris, France
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Aboukhoudir F, Quillot M, Rekik S, Pansieri M. [Dobutamine speckle tracking imaging for evaluation of microvascular dysfunction in a patient with exertion dyspnea]. Ann Cardiol Angeiol (Paris) 2020; 69:303-310. [PMID: 33039118 DOI: 10.1016/j.ancard.2020.09.002] [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: 04/30/2020] [Accepted: 09/03/2020] [Indexed: 11/17/2022]
Abstract
Microcirculatory dysfunction despite the absence of angiographically obvious significant coronary artery disease may potentially generate symptomatic myocardial ischemia; comprehensive assessment both noninvasive and invasive could prove to be of critical interest. We report the case of a 54-year old patient referred for an exertion dyspnea that proved to be caused by both micro and microvascular dysfunction. We present key elements for diagnosis, functional evaluation and management and demonstrate the potential role of speckle tracking imaging in that setting.
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Affiliation(s)
- F Aboukhoudir
- Service de cardiologie, centre hospitalier d'Avignon, Avignon, France; Avignon université EA4278 laboratoire de pharm écologie cardiovasculaire, Avignon, France.
| | - M Quillot
- Service de cardiologie, centre hospitalier d'Avignon, Avignon, France
| | - S Rekik
- Service de cardiologie, centre hospitalier Nord-Franche comté, Belfort, France
| | - M Pansieri
- Service de cardiologie, centre hospitalier d'Avignon, Avignon, France
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Quillot M, Lodde JP, Pegorier O, Reynaud JP, Cormerais A. [A variant of island flaps for the covering of pressure sores: the hatchet flap. Apropos of 31 cases]. ANN CHIR PLAST ESTH 1994; 39:469-72. [PMID: 7755329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The authors propose a modification of the classical design of island flaps for cover of pressure sores, applied to gluteus maximus and tensor fascia lata muscles: the hatchet flap. 31 flaps have been used including 13 gluteus maximus superior flaps for sacral pressure sores, 9 gluteal inferior flaps for ischial pressure sores and 9 tensor fascia lata flaps for trochanteric pressure sores. A small partial necrosis and two cases of sepsis were observed in this series, but did not require surgical revision. The authors emphasize the value of this modification of the classical flap design, which preserves an even better musculocutaneous capital in these patients, who are often already multi-operated. The very rapid recovery of patients supports the authors' application of hatchet flaps to the surgery of pressure sores, and suggests the extension to other musculocutaneous flaps in the future.
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Affiliation(s)
- M Quillot
- Service de Chirurgie Plastique, Centre Hospitalier de Cornouaille, Hôpital Laënnec, Quimper
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