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Mathieu E, Gremen E, Finas M, Rodiere M, Ghelfi J, Joly M, Greze J, Thony F. Treatment of Chronic Calcified Endostent Venous Occlusion by Intravascular Lithotripsy. Cardiovasc Intervent Radiol 2024:10.1007/s00270-024-03710-3. [PMID: 38622305 DOI: 10.1007/s00270-024-03710-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/08/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Eliott Mathieu
- Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France.
- CHU Grenoble Alpes, Boulevard de la Chantourne, 38700, La Tronche, France.
| | - Emeric Gremen
- Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Mathieu Finas
- Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Mathieu Rodiere
- Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Julien Ghelfi
- Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Marion Joly
- Department of Vascular Medicine, Grenoble-Alpes University Hospital, Grenoble, France
| | - Jules Greze
- Department of Anaesthesia and Intensive Care, Grenoble-Alpes University Hospital, Grenoble, France
| | - Frédéric Thony
- Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France
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2
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Piliero N, Salvat M, Finas M, Curioz F, Traclet J, Ahmad K, Bertoletti L, Vautrin E, Bouvaist H, Degano B. Upfront triple therapy with parenteral prostanoid as a bridge to balloon pulmonary angioplasty in severe chronic thromboembolic pulmonary hypertension. ERJ Open Res 2024; 10:00085-2024. [PMID: 38444667 PMCID: PMC10910263 DOI: 10.1183/23120541.00085-2024] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/25/2024] [Indexed: 03/07/2024] Open
Abstract
In patients with very severe CTEPH eligible for BPA, it is possible to achieve major haemodynamic improvement with upfront triple PH therapy including epoprostenol and then to perform angioplasties https://bit.ly/3vZZvib.
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Affiliation(s)
- Nicolas Piliero
- Service de Cardiologie, CHU Grenoble Alpes, Grenoble, France
| | - Muriel Salvat
- Service de Cardiologie, CHU Grenoble Alpes, Grenoble, France
| | - Mathieu Finas
- Service de Radiologie, CHU Grenoble Alpes, Grenoble, France
| | - Florence Curioz
- Service de Cardiologie, CHU Grenoble Alpes, Grenoble, France
| | - Julie Traclet
- Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Université de Lyon, Lyon, France
| | - Kaïs Ahmad
- Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Université de Lyon, Lyon, France
| | - Laurent Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, CHU de St-Etienne, Saint-Etienne, France
- INSERM, UMR1059, Équipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
- INSERM, CIC-1408, CHU Saint-Etienne, Saint-Etienne, France
| | - Estelle Vautrin
- Service de Cardiologie, CHU Grenoble Alpes, Grenoble, France
| | - Hélène Bouvaist
- Service de Cardiologie, CHU Grenoble Alpes, Grenoble, France
| | - Bruno Degano
- INSERM U1300, Laboratoire HP2, Université Grenoble Alpes, Grenoble, France
- Service de Pneumologie, CHU Grenoble Alpes, Grenoble, France
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Belarbi A, Martin C, Finas M, Thony F, Spear R, Gaide-Chevronnay L, Rhem D, Chavanon O, Sebestyen A. [Management of Stent-graft migration with obstruction of supra-aortic vessel during an endovascular procedure for aortic isthmus rupture]. Ann Cardiol Angeiol (Paris) 2024; 73:101708. [PMID: 38000339 DOI: 10.1016/j.ancard.2023.101708] [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: 09/03/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
The endovascular approach is widely used in the management of aortic isthmic rupture. Even if it remains less invasive than conventional surgery, a life-threatening complications are possible. We report the case of a young female patient presenting a stent-graft migration during the deployment with total obstruction of the supra-aortic vessels. We describe the therapeutic management with a cerebral rescue procedure followed by a delayed surgical repair.
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Affiliation(s)
- A Belarbi
- Service de chirurgie cardiaque, Centre hospitalier universitaire Grenoble Alpes, La Tronche, France
| | - C Martin
- Service de chirurgie cardiaque, Centre hospitalier universitaire Grenoble Alpes, La Tronche, France
| | - M Finas
- Service de radiologie, Centre hospitalier universitaire Grenoble Alpes, La Tronche, France
| | - F Thony
- Service de radiologie, Centre hospitalier universitaire Grenoble Alpes, La Tronche, France
| | - R Spear
- Service de chirurgie vasculaire et endovasculaire, Centre hospitalier universitaire Grenoble Alpes, La Tronche, France
| | - L Gaide-Chevronnay
- Service d'anesthésie réanimation cardio-vasculaire et thoracique. Centre hospitalier universitaire Grenoble Alpes, La Tronche, France
| | - D Rhem
- Service d'anesthésie réanimation cardio-vasculaire et thoracique. Centre hospitalier universitaire Grenoble Alpes, La Tronche, France
| | - O Chavanon
- Service de chirurgie cardiaque, Centre hospitalier universitaire Grenoble Alpes, La Tronche, France
| | - A Sebestyen
- Service de chirurgie cardiaque, Centre hospitalier universitaire Grenoble Alpes, La Tronche, France.
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Thony F, Pernes JM, Menez C, Quesada JL, Heautot JF, Thouveny F, Monnin-Bares V, Bellier A, David A, Lablee A, Bouvier A, Vernhet-Kovacsik H, Douane F, Del Giudice C, Sapoval M, Guillen K, Loffroy R, Finas M, Rodiere M. Endovascular Thrombectomy for Acute Iliofemoral Deep Venous Thrombosis Through a Jugular Approach with a Rotational Device. Cardiovasc Intervent Radiol 2023; 46:1684-1693. [PMID: 37596417 DOI: 10.1007/s00270-023-03529-4] [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: 05/14/2023] [Accepted: 07/25/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To report the effectiveness of pharmacomechanical catheter-directed thrombolysis (PCDT) in the management of acute iliofemoral deep venous thrombosis (DVT) via the jugular vein using a slow rotation and large-tip device (SRD) in a large cohort of patients. MATERIAL AND METHODS From 2011 to 2021, 277 patients (mean age 45 years, 59.2% women) were treated in 6 centres with PCDT for ilio-fémoral DVT. PCDT was performed via the jugular vein and consisted of one session of fragmentation-fibrinolysis, aspiration and, if needed, angioplasty with stenting. The aim of PCDT was to achieve complete clearance of the venous thrombosis and to restore iliofemoral patency. Residual thrombotic load was assessed by angiography, venous patency by duplex ultrasound and clinical effectiveness by the rate of post-thrombotic syndrome (Villalta score > 4). RESULTS All patients were treated via the jugular vein using an SRD, and all but one were treated with fibrinolysis. Angioplasty with stenting was performed in 84.1% of patients. After the procedure, the residual thrombotic load at the ilio-fémoral region was < 10% in 96.1% of patients. The rate of major complications was 1.8% (n = 5), the rate of minor complications was 4% (n = 11), and one patient died from pulmonary embolism (0.4%) At a median follow-up of 24 months, primary and secondary iliofemoral patency was 89.6% and 95.8%, respectively. The rate of PTS was 13.8% at 12 months. CONCLUSION PCDT via the jugular vein using an SRD is an efficient treatment for acute iliofemoral DVT and results in high long-term venous patency and low PTS rates. Level of evidence Level 4, Case series.
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Affiliation(s)
- Frederic Thony
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France.
| | - Jean-Marc Pernes
- Cardio-Vascular and Interventional Department, Antony Private Hospital, Antony, France
| | - Caroline Menez
- University Grenoble Alpes, Department of Vascular Medicine, CHU Grenoble Alpes, Grenoble, France
| | - Jean-Louis Quesada
- University Grenoble Alpes, Clinical Investigation Center, CHU Grenoble Alpes, Grenoble, France
| | | | | | - Valerie Monnin-Bares
- Department of Imaging and Interventional Radiology, Montpellier University Hospital, Montpellier, France
| | - Alexandre Bellier
- University Grenoble Alpes, Clinical Investigation Center, CHU Grenoble Alpes, Grenoble, France
| | - Arthur David
- Department of Radiology, Nantes University Hospital, University of Medicine, Nantes, France
| | - Alexandre Lablee
- Radiology Department, University Hospital Pontchaillou, Rennes, France
| | | | - Helene Vernhet-Kovacsik
- Department of Imaging and Interventional Radiology, Montpellier University Hospital, Montpellier, France
| | - Frederic Douane
- Department of Radiology, Nantes University Hospital, University of Medicine, Nantes, France
| | | | - Marc Sapoval
- Vascular and Oncological Interventional Radiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Kevin Guillen
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, Dijon, France
| | - Romaric Loffroy
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, Dijon, France
| | - Mathieu Finas
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France
| | - Mathieu Rodiere
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France
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Finas M, Frandon J, Gremen E, Horteur C, Benassayag M, Lateur G, Pailhe R, Ferretti G, Bellier A, Ghelfi J. A Retrospective Comparison of the Efficacy of Embolization with Imipenem/Cilastatin and Microspheres in the Management of Chronic Shoulder Pain. Cardiovasc Intervent Radiol 2023:10.1007/s00270-023-03385-2. [PMID: 36826491 DOI: 10.1007/s00270-023-03385-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/31/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE To compare the efficacy of embolization with imipenem/cilastatin and microspheres in chronic shoulder pain. METHODS This retrospective study included 29 patients who underwent embolization for chronic shoulder pain between June 2017 and March 2022 with calibrated MSs from 100 to 250 µm or IMP/CS. The main objective was the clinical success evaluated by the Minimum Clinically Important Difference (MCID) at 3 months after the procedure, validated if the patient responded yes to 2 questions: (1) Is the pain less severe than before the procedure? (2) Are you satisfied with the procedure? The decrease in visual analogue pain scale scores and the safety of the procedure were evaluated. RESULTS Embolization was achieved in all patients. In the MS group, 4/15 patients (26.7%) experienced clinical success at 3 months according to MCID versus 10/14 patients (71.4%) in the IMP/CS group (p = 0.02). The mean VAS decreases were respectively - 28.6% ± 34.6 in the MS group and - 36.8% ± 27.8 in the IMP/CS group at 1 month (p = 0.50), - 29.9% ± 29.0 and - 39.6% ± 23.0 at 3 months (p = 0.33) and - 30.6% ± 32.8 and - 46.6% ± 28.4 at 6 months after the procedure (p = 0.26). Eleven patients (73.3%) in the MS group and 3 patients (21.4%) in the IMP/CS group had complications (p = 0.01). Among them, 2/15 patients (13.3%) had transient skin ischaemia in the MS group. CONCLUSION Embolization with IMP/CS may be more effective and safer than MSs in the management of chronic shoulder pain.
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Affiliation(s)
- Mathieu Finas
- University of Grenoble-Alpes, Grenoble, France.,Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Julien Frandon
- Department of Radiology, Nimes University Hospital, Nimes, France
| | - Emeric Gremen
- University of Grenoble-Alpes, Grenoble, France.,Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Clément Horteur
- University of Grenoble-Alpes, Grenoble, France.,Department of Orthopaedic Surgery, Grenoble Alpes University Hospital, Grenoble, France
| | - Michaël Benassayag
- Department of Orthopaedic Surgery, Medipôle de Savoie Hospital, Challes-les-Eaux, France
| | - Gabriel Lateur
- Department of Orthopaedic Surgery Department, Albertville Hospital, Albertville, France
| | - Régis Pailhe
- University of Grenoble-Alpes, Grenoble, France.,Department of Orthopaedic Surgery, Grenoble Alpes University Hospital, Grenoble, France
| | - Gilbert Ferretti
- University of Grenoble-Alpes, Grenoble, France.,Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Alexandre Bellier
- University of Grenoble-Alpes, Grenoble, France.,Clinical Research Department, Grenoble-Alpes University Hospital, Grenoble, France
| | - Julien Ghelfi
- University of Grenoble-Alpes, Grenoble, France. .,Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France. .,Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, University of Grenoble-Alpes, Grenoble, France.
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Sermet R, Piliero N, Guillien A, Madoun S, Doutreleau S, Salvat M, Finas M, Thony F, Vautrin E, Bouvaist H, Degano B. Pulmonary arterial compliance and exercise capacity after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension. ERJ Open Res 2022; 9:00590-2022. [PMID: 37009025 PMCID: PMC10052638 DOI: 10.1183/23120541.00590-2022] [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] [Received: 09/01/2022] [Accepted: 11/27/2022] [Indexed: 12/24/2022] Open
Abstract
ObjectiveTo determine whether changes in pulmonary vascular resistance (PVR) and changes in pulmonary artery compliance (PCa) are associated with changes in exercise capacity assessed either by changes in peak oxygen consumption (V̇O2) or by changes in 6-min walk distance (6MWD) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA).MethodsInvasive haemodynamic parameters, peak V̇O2and 6MWD were measured within 24 h, before and after BPA (interval, 3.1±2.4 months) in 34 CTEPH patients without significant cardiac and/or pulmonary comorbidities, of which 24 received at least one pulmonary hypertension-specific treatment. PCa was calculated according to the pulse pressure method: PCa=([SV/PP]/1.76+0.1), where SV is the stroke volume and PP is the pulse pressure. The resistance-compliance (RC)-time of the pulmonary circulation was calculated as the PVR and PCa product.ResultsAfter BPA, PVR decreased (562±234versus290±106 dyn.s.cm−5;p<0.001), PCa increased (0.90±0.36versus1.63±0.65 mL.mmHg−1; p<0.001) but RC-time did not change (0.325±0.069versus0.321±0.083 s; p=0.75). There were improvements in peak V̇O2(1.11±0.35versus1.30±0.33 L.min-1; p <0.001) and in 6MWD (393±119versus432±100 m; p <0.001). After adjustment for age, height, weight and gender, changes in exercise capacity, assessed either by peak V̇O2and 6MWD, were significantly associated with changes in PVR, but not with changes in PCa.ConclusionsContrary to what has been reported in CTEPH patients undergoing pulmonary endarterectomy, in CTEPH patients undergoing BPA, changes in exercise capacity was not associated with changes in pulmonary artery compliance.
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Mathieu E, Riethmuller D, Delouche A, Sicot M, Teyssier Y, Finas M, Guillaume B, Thony F, Ferretti G, Ghelfi J. Management of Symptomatic Vascularized Retained Products of Conception by Proximal Uterine Artery Embolization with Gelatin Sponge Torpedoes. J Vasc Interv Radiol 2022; 33:1313-1320. [PMID: 35868595 DOI: 10.1016/j.jvir.2022.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/02/2022] [Accepted: 07/12/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate the effectiveness and safety of temporary proximal uterine artery embolization (UAE) for the treatment of highly vascularized retained products of conception (RPOCs). MATERIALS AND METHODS This retrospective analysis included women who underwent treatment for vaginal bleeding after abortion, miscarriage, or delivery, with highly vascularized RPOCs detected by Doppler ultrasound (US) (ie, presence of an enhanced myometrial vascularity, a low resistance index of <0.5, and a peak systolic velocity of ≥0.7 m/s). A unilateral or bilateral embolization with torpedoes of gelatin foam was performed. From November 2017 to January 2021, 24 women with a median age of 30 years (interquartile range, 26.0-34.5 years) with symptomatic highly vascularized RPOCs were included. Clinical success was defined as bleeding arrest between the UAE and 1-month follow-up. Technical success was defined as the complete obstruction of at least 1 uterine artery supplying vascular abnormalities. The safety of the procedure according to the classification of the Society of Interventional Radiology and evolution of lesions on US were also reported. RESULTS Technical success was achieved in all 24 (100%) patients, with bilateral arterial embolization in 19 (79%) patients and unilateral embolization in 5 (21%) patients. Clinical success was achieved in all 24 (100%) patients. Five patients still had uterine retention at the 1-month follow-up, including 2 patients with highly vascularized RPOCs. Two patients benefited from hysteroscopy, and 3 had noninvasive management. Four minor adverse events were reported (1 patient had infectious endometritis and 3 patients had a postembolization syndrome). CONCLUSIONS Proximal UAE with torpedoes of gelatin foam is safe and effective for the management of symptomatic highly vascularized RPOCs.
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Affiliation(s)
- Eliott Mathieu
- University of Grenoble Alpes, Grenoble, France; Department of Radiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Didier Riethmuller
- University of Grenoble Alpes, Grenoble, France; Department of Obstetrics and Gynecology, Grenoble Alpes University Hospital, Grenoble, France
| | - Aurélie Delouche
- Department of Radiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Marie Sicot
- Department of Obstetrics and Gynecology, Grenoble Alpes University Hospital, Grenoble, France
| | - Yann Teyssier
- Department of Radiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Mathieu Finas
- Department of Radiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Bénédicte Guillaume
- Department of Radiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Frederic Thony
- Department of Radiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Gilbert Ferretti
- University of Grenoble Alpes, Grenoble, France; Department of Radiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Julien Ghelfi
- University of Grenoble Alpes, Grenoble, France; Department of Radiology, Grenoble Alpes University Hospital, Grenoble, France; INSERM U1209/CNRS UMR 5309, Institute for Advanced Biosciences, University of Grenoble Alpes, Grenoble, France.
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Madoun S, Piliero N, Guillien A, Salvat M, Thony F, Finas M, Augier C, Bouvaist H, Degano B. Improved ventilatory efficiency to evidence haemodynamic improvement after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension. Eur Respir J 2022; 60:13993003.00762-2022. [PMID: 35896210 DOI: 10.1183/13993003.00762-2022] [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: 04/11/2022] [Accepted: 07/07/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Simon Madoun
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Grenoble, France
| | - Nicolas Piliero
- Service de Cardiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Alicia Guillien
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,Épidemiologie environnementale appliquée à la reproduction et à la santé respiratoire, INSERM, CNRS, Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France
| | - Muriel Salvat
- Service de Cardiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Frédéric Thony
- Pole Imagerie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Mathieu Finas
- Pole Imagerie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Caroline Augier
- Service de Cardiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Hélène Bouvaist
- Service de Cardiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Bruno Degano
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France .,Université Grenoble Alpes, Grenoble, France.,Laboratoire HP2, INSERM U1042, Université Grenoble Alpes, Grenoble, France
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Piliero N, Thony F, Guillien A, Rousseau J, Finas M, Vautrin E, Degano B, Bouvaist H. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: Evaluation of haemodynamic effects, complication rates and radiation exposure over time. Arch Cardiovasc Dis 2022; 115:295-304. [DOI: 10.1016/j.acvd.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/02/2022]
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10
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Gremen E, Frandon J, Lateur G, Finas M, Rodière M, Horteur C, Benassayag M, Thony F, Pailhe R, Ghelfi J. Safety and Efficacy of Embolization with Microspheres in Chronic Refractory Inflammatory Shoulder Pain: A Pilot Monocentric Study on 15 Patients. Biomedicines 2022; 10:biomedicines10040744. [PMID: 35453492 PMCID: PMC9028229 DOI: 10.3390/biomedicines10040744] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 01/11/2022] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose: Musculoskeletal (MSK) embolization is emerging in tendinopathy treatment. The objective of this study was to assess the efficacy and safety of MSK embolization with microspheres in the treatment of chronic shoulder pain. Patients and methods: This retrospective monocentric study included patients with chronic shoulder pain resistant to 6 months or more of conventional therapies who were treated with MSK embolization between 2017 and 2021. Embolization was performed using calibrated 100–250 µm microspheres. Clinical success was defined as pain reduction, i.e., a decrease in the visual analogue scale (VAS) pain score of ≥50% at 3 months after MSK embolization as compared to baseline. Adverse events were collected. Results: Fifteen patients (11 women, 4 men) were included, with a median age of 50.3 years (IQR: 46.7–54.5). The median duration of symptoms was 26.6 months (20.6–39.8). The median VAS pain scores were 7.0 (7.0–8.0) at baseline, 6.0 (3.5–7.0) at 1 month, 5.0 (4.5–6.5) and 5.0 (3.0–7.4) at 3 months and 6 months (p = 0.002). Three patients (20%) reported clinical success at 3 months. Three patients experienced minor complications after embolization (paresthesia, n = 2; transient osteo-medullary edema, n = 1) and two patients had moderate complications (transient skin ischemia). Conclusion: MSK embolization with microspheres for treatment of refractory chronic shoulder pain showed moderate results in terms of clinical success and safety.
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Affiliation(s)
- Emeric Gremen
- Faculty of Medecine, Grenoble-Alpes University, 38043 Grenoble, France; (E.G.); (R.P.)
- Radiology Department, Grenoble Alpes University Hospital, 38043 Grenoble, France; (M.F.); (M.R.); (F.T.)
| | - Julien Frandon
- Radiology Department, Nimes University Hospital, University of Montpellier, 30900 Nimes, France;
| | - Gabriel Lateur
- Orthopaedic and Traumatology Surgery Department, Albertville Hospital, 73200 Albertville, France;
| | - Mathieu Finas
- Radiology Department, Grenoble Alpes University Hospital, 38043 Grenoble, France; (M.F.); (M.R.); (F.T.)
| | - Mathieu Rodière
- Radiology Department, Grenoble Alpes University Hospital, 38043 Grenoble, France; (M.F.); (M.R.); (F.T.)
| | - Clément Horteur
- Department of Orthopaedic Surgery, Grenoble Alpes University Hospital, 38043 Grenoble, France;
| | - Michaël Benassayag
- Orthopaedic Surgery Department, Medipôle de Savoie Hospital, 73190 Challes-les-Eaux, France;
| | - Frédéric Thony
- Radiology Department, Grenoble Alpes University Hospital, 38043 Grenoble, France; (M.F.); (M.R.); (F.T.)
| | - Régis Pailhe
- Faculty of Medecine, Grenoble-Alpes University, 38043 Grenoble, France; (E.G.); (R.P.)
- Department of Orthopaedic Surgery, Grenoble Alpes University Hospital, 38043 Grenoble, France;
| | - Julien Ghelfi
- Faculty of Medecine, Grenoble-Alpes University, 38043 Grenoble, France; (E.G.); (R.P.)
- Radiology Department, Grenoble Alpes University Hospital, 38043 Grenoble, France; (M.F.); (M.R.); (F.T.)
- Institute of Advanced Biosciences, INSERM U1209, CNRS UMR 5309, 38043 Grenoble, France
- Correspondence: ; Tel.: +33-4-76-76-89-09
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11
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Habert P, Bentatou Z, Aldebert P, Finas M, Bartoli A, Bal L, Lalande A, Rapacchi S, Guye M, Kober F, Bernard M, Jacquier A. Exercise stress CMR reveals reduced aortic distensibility and impaired right-ventricular adaptation to exercise in patients with repaired tetralogy of Fallot. PLoS One 2018; 13:e0208749. [PMID: 30596647 PMCID: PMC6312273 DOI: 10.1371/journal.pone.0208749] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 11/21/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim of our study was to evaluate the feasibility of exercise cardiac magnetic resonance (CMR) in patients with repaired tetralogy of Fallot (RTOF) and to assess right and left ventricular adaptation and aortic wall response to exercise in comparison with volunteers. METHODS 11 RTOF and 11 volunteers underwent prospective CMR at rest and during exercise. A supine bicycle ergometer was employed to reach twice the resting heart rate during continuous exercise, blood pressure and heart rate were recorded. Bi-ventricular parameters and aortic stiffness were assessed using accelerated cine sequences and flow-encoding CMR. A t-test was used to compare values between groups. A Mann Whitney test was used to compare values within groups. RESULTS In RTOF both ventricles showed an impaired contractile reserve (RVEF rest 36.2±8.3%, +1.3±3.9% increase after exercise; LVEF rest 53.8±6.1%, +5.7±6.4% increase after exercise) compared to volunteers (RVEF rest 50.5±5.0%, +10.4±7.1% increase after exercise, p = 0.039; LVEF rest 61.9±3.1%, +12.2±4.7% increase after exercise, p = 0.014). RTOF showed a reduced distensibility of the ascending aorta during exercise compared to volunteers (RTOF: 3.4±1.9 10-3.mmHg-1 vs volunteers: 5.1±1.4 10-3.mmHg-1; p = 0.027). Ascending aorta distensibility was correlated to cardiac work in the volunteers but not in RTOF. CONCLUSION RTOF showed an impaired contractile reserve for both ventricles. The exercise unmasked a reduced distensibility of the ascending aorta in RTOF, which may be an early sign of increased aortic rigidity.
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Affiliation(s)
- Paul Habert
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Radiology and Cardiovascular Imaging, La Timone Hospital, Marseille, France
- * E-mail:
| | | | - Philippe Aldebert
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Cardiology and Department of Infectious Diseases, La Timone Hospital, Marseille, France
| | | | - Axel Bartoli
- Department of Radiology and Cardiovascular Imaging, La Timone Hospital, Marseille, France
| | - Laurence Bal
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Vascular Surgery and Vascular Medicine, La Timone Hospital, Marseille, France
| | - Alain Lalande
- LE2I, UMR 6306 CNRS, University of Burgundy, Dijon, France
- MRI Department, University Hospital of Dijon, Dijon, France
| | | | - Maxime Guye
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
| | - Frank Kober
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
| | | | - Alexis Jacquier
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Radiology and Cardiovascular Imaging, La Timone Hospital, Marseille, France
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Frandon J, Bricq S, Bentatou Z, Marcadet L, Barral PA, Finas M, Fagret D, Kober F, Habib G, Bernard M, Lalande A, Miquerol L, Jacquier A. Semi-automatic detection of myocardial trabeculation using cardiovascular magnetic resonance: correlation with histology and reproducibility in a mouse model of non-compaction. J Cardiovasc Magn Reson 2018; 20:70. [PMID: 30355287 PMCID: PMC6201553 DOI: 10.1186/s12968-018-0489-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 09/05/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The definition of left ventricular (LV) non-compaction is controversial, and discriminating between normal and excessive LV trabeculation remains challenging. Our goal was to quantify LV trabeculation on cardiovascular magnetic resonance (CMR) images in a genetic mouse model of non-compaction using a dedicated semi-automatic software package and to compare our results to the histology used as a gold standard. METHODS Adult mice with ventricular non-compaction were generated by conditional trabecular deletion of Nkx2-5. Thirteen mice (5 controls, 8 Nkx2-5 mutants) were included in the study. Cine CMR series were acquired in the mid LV short axis plane (resolution 0.086 × 0.086x1mm3) (11.75 T). In a sub set of 6 mice, 5 to 7 cine CMR were acquired in LV short axis to cover the whole LV with a lower resolution (0.172 × 0.172x1mm3). We used semi-automatic software to quantify the compacted mass (Mc), the trabeculated mass (Mt) and the percentage of trabeculation (Mt/Mc) on all cine acquisitions. After CMR all hearts were sliced along the short axis and stained with eosin, and histological LV contouring was performed manually, blinded from the CMR results, and Mt, Mc and Mt/Mc were quantified. Intra and interobserver reproducibility was evaluated by computing the intra class correlation coefficient (ICC). RESULTS Whole heart acquisition showed no statistical significant difference between trabeculation measured at the basal, midventricular and apical parts of the LV. On the mid-LV cine CMR slice, the median Mt was 0.92 mg (range 0.07-2.56 mg), Mc was 12.24 mg (9.58-17.51 mg), Mt/Mc was 6.74% (0.66-17.33%). There was a strong correlation between CMR and the histology for Mt, Mc and Mt/ Mc with respectively: r2 = 0.94 (p < 0.001), r2 = 0.91 (p < 0.001), r2 = 0.83 (p < 0.001). Intra- and interobserver reproducibility was 0.97 and 0.8 for Mt; 0.98 and 0.97 for Mc; 0.96 and 0.72 for Mt/Mc, respectively and significantly more trabeculation was observed in the Mc Mutant mice than the controls. CONCLUSION The proposed semi-automatic quantification software is accurate in comparison to the histology and reproducible in evaluating Mc, Mt and Mt/ Mc on cine CMR.
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Affiliation(s)
- Julien Frandon
- Aix-Marseille University, CNRS, CRMBM, Marseille, France
- Department of Radiology, Timone University Hospital, Marseille, France
- Department of Radiology, Nîmes University Hospital, Nîmes, France
| | | | | | - Laetitia Marcadet
- CNRS UMR 7288, Developmental Biology Institute of Marseille, Aix-Marseille University, Marseille, France
| | | | - Mathieu Finas
- Aix-Marseille University, CNRS, CRMBM, Marseille, France
| | - Daniel Fagret
- INSERM, U1039, Radiopharmaceutiques Biocliniques, Université Grenoble Alpes, Grenoble, France
| | - Frank Kober
- Aix-Marseille University, CNRS, CRMBM, Marseille, France
| | - Gilbert Habib
- Department of Cardiology, APHM, la Timone Hospital, Marseille, France
| | | | - Alain Lalande
- Le2i, Université de Bourgogne Franche-Comté, Dijon, France
- Department of MRI, University Hospital Francois Mitterrand, Dijon, France
| | | | - Alexis Jacquier
- Aix-Marseille University, CNRS, CRMBM, Marseille, France
- Department of Radiology, Timone University Hospital, Marseille, France
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13
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Bentatou Z, Finas M, Habert P, Kober F, Guye M, Bricq S, Lalande A, Frandon J, Dacher JN, Dubourg B, Habib G, Caudron J, Normant S, Rapacchi S, Bernard M, Jacquier A. Distribution of left ventricular trabeculation across age and gender in 140 healthy Caucasian subjects on MR imaging. Diagn Interv Imaging 2018; 99:689-698. [PMID: 30262171 DOI: 10.1016/j.diii.2018.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/23/2018] [Revised: 08/20/2018] [Accepted: 08/29/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE The purpose of this study was to quantify the distribution of trabeculated (T) and compact (C) left ventricular (LV) myocardium masses in a healthy Caucasian population against age, gender and LV parameters, and to provide normal values for T, C and T/C. MATERIALS AND METHODS One hundred and forty healthy subjects were prospectively recruited and underwent cardiac MRI at 1.5T with a stack of short-axis cine sequences covering the entire LV. End-diastolic volume (EDV), C and T masses were quantified using a semi-automatic method. Ejection fraction (EF) and T/C ratio were computed. RESULTS We included 70 men and 70 women with a mean age of 44±14 (SD) years (range: 20-69 years). The mean EF was 63.7±6.3 (SD) % (range: 50.7-82.0%), the mean EDV was 75.9±16.2 (SD) mL/m2 (range: 36.4-112.2mL/m2), the mean C mass was 53.9±11.2 (SD) g/m2 (range: 26.5-93.4g/m2) and the mean T mass was 4.9±2.4 (SD) g/m2 (range: 1.1-11.4g/m2). The T/C ratio was 9.2±4.5% (range: 2.0-29.4%). Multivariate ANOVA test showed that the compact mass was influenced by EDV (P<0.0001), EF (P=0.001) and gender (P<0.0001), and the trabeculated mass depended on EDV (P<0.0001), gender (P=0.002) and age (P<0.0001), while the T/C ratio was only influenced by age (P=0.0003). Spearman test showed a correlation between EDV and C (r=0.60; P<0.0001),T (r=0.46; P<0.0001) and T/C ratio (r=0.26; P=0.0023).T and T/C ratio correlated with EF (r=-0.18, P=0.0373; r=-0.18, P=0.0321, respectively). CONCLUSION While the compact and trabeculated myocardium masses appear to relate separately to the cardiac function, age and gender, their ratio T/C appears to only decrease with age. Furthermore, we propose here normal values for T, C and T/C in a cohort of healthy Caucasians subjects.
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Affiliation(s)
- Z Bentatou
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille cedex 05, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France.
| | - M Finas
- Department of Radiology, CHU de Grenoble, 38043 Grenoble cedex 9, France
| | - P Habert
- Department of Cardiology, Aix-Marseille Université, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - F Kober
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille cedex 05, France
| | - M Guye
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille cedex 05, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - S Bricq
- Le2i, University de Bourgogne-Franche Comté, 21000 Dijon, France
| | - A Lalande
- Le2i, University de Bourgogne-Franche Comté, 21000 Dijon, France; MRI Department, University Hospital of Dijon, 21000 Dijon, France
| | - J Frandon
- Department of Radiology, CHU de Grenoble, 38043 Grenoble cedex 9, France
| | - J N Dacher
- Cardiac Imaging Unit, Department of Radiology, hôpital universitaire de Rouen, 76031 Rouen, France
| | - B Dubourg
- Cardiac Imaging Unit, Department of Radiology, hôpital universitaire de Rouen, 76031 Rouen, France
| | - G Habib
- Department of Cardiology, Aix-Marseille Université, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France; IRD, IHU-Méditerranée Infection, université d'Aix Marseille, MEPHI, AP-HM, 13385 Marseille cedex 05, France
| | - J Caudron
- Cardiac Imaging Unit, Department of Radiology, hôpital universitaire de Rouen, 76031 Rouen, France
| | - S Normant
- Cardiac Imaging Unit, Department of Radiology, hôpital universitaire de Rouen, 76031 Rouen, France
| | - S Rapacchi
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille cedex 05, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - M Bernard
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille cedex 05, France
| | - A Jacquier
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille cedex 05, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
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