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Rocca-Serra P, Gu W, Ioannidis V, Abbassi-Daloii T, Capella-Gutierrez S, Chandramouliswaran I, Splendiani A, Burdett T, Giessmann RT, Henderson D, Batista D, Emam I, Gadiya Y, Giovanni L, Willighagen E, Evelo C, Gray AJG, Gribbon P, Juty N, Welter D, Quast K, Peeters P, Plasterer T, Wood C, van der Horst E, Reilly D, van Vlijmen H, Scollen S, Lister A, Thurston M, Granell R, Sansone SA. The FAIR Cookbook - the essential resource for and by FAIR doers. Sci Data 2023; 10:292. [PMID: 37208467 PMCID: PMC10198982 DOI: 10.1038/s41597-023-02166-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/19/2023] [Indexed: 05/21/2023] Open
Abstract
The notion that data should be Findable, Accessible, Interoperable and Reusable, according to the FAIR Principles, has become a global norm for good data stewardship and a prerequisite for reproducibility. Nowadays, FAIR guides data policy actions and professional practices in the public and private sectors. Despite such global endorsements, however, the FAIR Principles are aspirational, remaining elusive at best, and intimidating at worst. To address the lack of practical guidance, and help with capability gaps, we developed the FAIR Cookbook, an open, online resource of hands-on recipes for "FAIR doers" in the Life Sciences. Created by researchers and data managers professionals in academia, (bio)pharmaceutical companies and information service industries, the FAIR Cookbook covers the key steps in a FAIRification journey, the levels and indicators of FAIRness, the maturity model, the technologies, the tools and the standards available, as well as the skills required, and the challenges to achieve and improve data FAIRness. Part of the ELIXIR ecosystem, and recommended by funders, the FAIR Cookbook is open to contributions of new recipes.
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Affiliation(s)
- Philippe Rocca-Serra
- Oxford e-Research Centre, Department of Engineering Science, University of Oxford, 7 Keble Road, OX13QG, Oxford, UK.
- AstraZeneca, Data Office, Data Science & AI unit R&D, 136 Hills Rd, Cambridge, UK.
| | - Wei Gu
- Luxembourg Centre for Systems Biomedicine, ELIXIR Luxembourg, University of Luxembourg, L-4367, Belval, Luxembourg
- Luxembourg National Data Service, 6 Avenue des Hauts-Fourneaux, Esch-sur-Alzette, Luxembourg, L-4362, Esch-sur-Alzette, Luxembourg
| | - Vassilios Ioannidis
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, 1015, Lausanne, Switzerland
| | - Tooba Abbassi-Daloii
- Department of Bioinformatics (BiGCaT), NUTRIM, FHML, Maastricht University, Maastricht, the Netherlands
| | | | - Ishwar Chandramouliswaran
- Office of Data Science Strategy, National Institutes of Health, 9000 Rockville Pike, Bethesda, Maryland, 20892, USA
| | | | - Tony Burdett
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, CB10 1SD, UK
| | - Robert T Giessmann
- Bayer AG, Business Development & Licensing & OI, Pharmaceuticals, 13342, Berlin, Germany
- Institute for Globally Distributed Open Research and Education (IGDORE), Berlin, Germany
| | - David Henderson
- Bayer AG, Business Development & Licensing & OI, Pharmaceuticals, 13342, Berlin, Germany
| | - Dominique Batista
- Oxford e-Research Centre, Department of Engineering Science, University of Oxford, 7 Keble Road, OX13QG, Oxford, UK
| | - Ibrahim Emam
- Data Science Institute, Imperial College London, William Penney Laboratory, South Kensington Campus, London, SW7 2AZ, UK
| | - Yojana Gadiya
- Fraunhofer Institute for Translational Medicine and Pharmacology and Fraunhofer Cluster of Excellence for Immune Mediated Diseases, Schnackenburgallee 114, 22525 Hamburg, and Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Lucas Giovanni
- Department of Bioinformatics (BiGCaT), NUTRIM, FHML, Maastricht University, Maastricht, the Netherlands
| | - Egon Willighagen
- Department of Bioinformatics (BiGCaT), NUTRIM, FHML, Maastricht University, Maastricht, the Netherlands
| | - Chris Evelo
- Department of Bioinformatics (BiGCaT), NUTRIM, FHML, Maastricht University, Maastricht, the Netherlands
| | - Alasdair J G Gray
- Department of Computer Science, Heriot-Watt University, Edinburgh, EH14 4AS, Scotland, UK
| | - Philip Gribbon
- Fraunhofer Institute for Translational Medicine and Pharmacology and Fraunhofer Cluster of Excellence for Immune Mediated Diseases, Schnackenburgallee 114, 22525 Hamburg, and Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Nick Juty
- The University of Manchester, Department of Computer Science, The University of Manchester, Manchester, M13 9PL, UK
| | - Danielle Welter
- Luxembourg Centre for Systems Biomedicine, ELIXIR Luxembourg, University of Luxembourg, L-4367, Belval, Luxembourg
- Luxembourg National Data Service, 6 Avenue des Hauts-Fourneaux, Esch-sur-Alzette, Luxembourg, L-4362, Esch-sur-Alzette, Luxembourg
| | - Karsten Quast
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397, Biberach an der Riss, Germany
| | - Paul Peeters
- Janssen, Turnhoutseweg 30, B-2340, Beerse, Belgium
| | - Tom Plasterer
- AstraZeneca Pharmaceuticals, 36 Gatehouse Drive, Waltham, MA, 02451, USA
| | - Colin Wood
- AstraZeneca, da Vinci Building, Melbourn Science Park, Cambridge Road, Royston, SG8 6HM, UK
| | - Eelke van der Horst
- The Hyve BV, Arthur van Schendelstraat 650, 3511 MJ, Utrecht, The Netherlands
| | - Dorothy Reilly
- Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | | | - Serena Scollen
- ELIXIR Hub, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SD, UK
| | - Allyson Lister
- Oxford e-Research Centre, Department of Engineering Science, University of Oxford, 7 Keble Road, OX13QG, Oxford, UK
| | - Milo Thurston
- Oxford e-Research Centre, Department of Engineering Science, University of Oxford, 7 Keble Road, OX13QG, Oxford, UK
| | - Ramon Granell
- Oxford e-Research Centre, Department of Engineering Science, University of Oxford, 7 Keble Road, OX13QG, Oxford, UK
| | - Susanna-Assunta Sansone
- Oxford e-Research Centre, Department of Engineering Science, University of Oxford, 7 Keble Road, OX13QG, Oxford, UK.
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Westen KH, Peeters P, Landers S, Kroon H, Delespaul P. [Daily practice of a FACT-team: results of an experience sampling study]. Tijdschr Psychiatr 2022; 64:348-352. [PMID: 35748145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Flexible assertive community treatment (FACT) teams are widespread in the Netherlands. Despite the presence of a model description and model fidelity scale, it is unclear what FACT workers actually do daily. AIM Examination of the daily activities of FACT workers on weekdays in relation to the intended activities from the theoretical FACT framework. METHOD Repeated momentary activity assessments were made among all employed staff (n = 54) of four FACT teams from three different organizations using the experience sampling method (ESM) yielding multiple reports on each workday for one week. 936 reports were analyzed with SPSS, providing a picture of the daily activities of FACT workers. RESULTS Overall, employees spent 30% of their time with clients, 30% in consultation (4% with network partners), 20% on administration and 20% in travel time and personal activities (30-30-20-20). CONCLUSION The actual time spent by FACT workers with clients does not match the expected production standards. Contact with relatives and network partners lags far behind the desired figures required for modern network-oriented care. The ESM-based results are different from actual methodologies and require careful interpretation. Applying ESM in FACT teams promises to support a quality development dialogue.
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Van Praet C, Vangeneugden J, Desender L, Randon C, Van Laecke S, Peeters P, Nagler E, Vanmassenhove J, Decaestecker K. Robot-assisted management of ureteral complications in kidney transplant patients: Case series and description of surgical techniques. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02273-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Verbist J, Peeters P, Bosiers M, Deferm H, Haenen L, Vermaercke M, Vercaeren P. Endoleaks after Endoluminal Repair of Abdominal Aortic Aneurysms : Diagnosis and Treatment. Acta Chir Belg 2020. [DOI: 10.1080/00015458.2001.12098607] [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] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - M. Bosiers
- St.-Blasius Hospital, Dendermonde, Belgium
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Lemmens G, Hendrickx H, Poppe C, Roche N, Peeters P, Vermeersch H, Rogiers X, Van Lierde K, Blondeel P. Psychosocial outcomes 3 years after facial transplantation of a blind patient. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.1410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BackgroundTo date, psychosocial outcomes after facial transplantation are promising although long-term consequences, outcome of blind patients and the impact on family members are less well investigated. The aim of this study was to examine the long-term psychosocial of a blind patient and his partner 2 and 3 years after facial transplantation.MethodsDepressive and anxiety symptoms, hopelessness, coping, resilience, illness cognitions, marital support, dyadic adjustment, family functioning and quality of life of the patient and the partner were assessed before and 2 and 3 years after transplantation. Reliable change index (RCI) was further calculated to evaluate the magnitude of change.ResultsMost psychological, marital and family scores of both the patient and the partner remained within a normative and healthy range at follow-up. Resilience (RCI: 2.5 & 3.4 respectively), affective responsiveness (RCI: −4.1 & −3.2 respectively), physical quality of life (RCI: 8.7 & 7.2 respectively) and helplessness (RCI: −2.2 & −2.9 respectively) of the patient improved at 2 and 3 years follow-up. Further, dyadic cohesion (RCI: 2.4) of the patient improved at 2 years whereas marital depth (RCI: −2.0) of the partner decreased at 3 years.ConclusionsThe results of this study point to positive long-term psychosocial outcomes of a blind patient and his partner after facial transplantation. Further, they may underscore the importance of patient selection, social support and involvement of family members in treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Teijink J, Power A, Böckler D, Peeters P, van Sterkenburg S, Bouwman L, Verhagen H, Bosiers M, Riambau V, Becquemin JP, Cuypers P, van Sambeek M. Five Year Outcomes of the Endurant Stent Graft for Endovascular Abdominal Aortic Aneurysm Repair in the ENGAGE Registry. J Vasc Surg 2019. [DOI: 10.1016/j.jvs.2019.07.003] [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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Barbosa-Silva A, Bratfalean D, Gu W, Satagopam V, Houston P, Becnel LB, Eifes S, Richard F, Tielmann A, Herzinger S, Rege K, Balling R, Peeters P, Schneider R. Presenting and sharing clinical data using the eTRIKS Standards Master Tree for tranSMART. Bioinformatics 2019; 35:1562-1565. [PMID: 30256906 PMCID: PMC6499239 DOI: 10.1093/bioinformatics/bty809] [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: 10/23/2017] [Revised: 07/30/2018] [Accepted: 09/25/2018] [Indexed: 11/13/2022] Open
Abstract
Motivation Standardization and semantic alignment have been considered one of the major challenges for data integration in clinical research. The inclusion of the CDISC SDTM clinical data standard into the tranSMART i2b2 via a guiding master ontology tree positively impacts and supports the efficacy of data sharing, visualization and exploration across datasets. Results We present here a schema for the organization of SDTM variables into the tranSMART i2b2 tree along with a script and test dataset to exemplify the mapping strategy. The eTRIKS master tree concept is demonstrated by making use of fictitious data generated for four patients, including 16 SDTM clinical domains. We describe how the usage of correct visit names and data labels can help to integrate multiple readouts per patient and avoid ETL crashes when running a tranSMART loading routine. Availability and implementation The eTRIKS Master Tree package and test datasets are publicly available at https://doi.org/10.5281/zenodo.1009098 and a functional demo installation at https://public.etriks.org/transmart/datasetExplorer/ under eTRIKS—Master Tree branch, where the discussed examples can be visualized.
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Affiliation(s)
- Adriano Barbosa-Silva
- University of Luxembourg, Luxembourg Centre for Systems Biomedicine, L-4371 Belvaux, Luxembourg.,Department of Clinical Pharmacology, Centre for Translational Bioinformatics, William Harvey Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M6BQ, UK
| | - Dorina Bratfalean
- CDISC, Clinical Data Interchange Standards Consortium and CDISC EU Foundation, Saint-Louis, Alsace, France
| | - Wei Gu
- University of Luxembourg, Luxembourg Centre for Systems Biomedicine, L-4371 Belvaux, Luxembourg
| | - Venkata Satagopam
- University of Luxembourg, Luxembourg Centre for Systems Biomedicine, L-4371 Belvaux, Luxembourg
| | - Paul Houston
- CDISC, Clinical Data Interchange Standards Consortium and CDISC EU Foundation, Saint-Louis, Alsace, France
| | - Lauren B Becnel
- CDISC, Clinical Data Interchange Standards Consortium and CDISC EU Foundation, Saint-Louis, Alsace, France
| | - Serge Eifes
- University of Luxembourg, Luxembourg Centre for Systems Biomedicine, L-4371 Belvaux, Luxembourg.,Information Technology for Translational Medicine (ITTM) S.A, Esch/Belval, Luxembourg
| | - Fabien Richard
- Centre National de la Recherche Scientifique (CNRS), Lyon, Auvergne-Rhône-Alpes, France
| | - Andreas Tielmann
- Department of Research and Bioinformatics, Merck KGaA, Darmstadt, Germany
| | - Sascha Herzinger
- University of Luxembourg, Luxembourg Centre for Systems Biomedicine, L-4371 Belvaux, Luxembourg
| | - Kavita Rege
- University of Luxembourg, Luxembourg Centre for Systems Biomedicine, L-4371 Belvaux, Luxembourg
| | - Rudi Balling
- University of Luxembourg, Luxembourg Centre for Systems Biomedicine, L-4371 Belvaux, Luxembourg
| | | | - Reinhard Schneider
- University of Luxembourg, Luxembourg Centre for Systems Biomedicine, L-4371 Belvaux, Luxembourg
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Schroe H, Holden A, Goueffic Y, Jansen S, Peeters P, Keirse K. Stellarex Drug-Coated Balloon for Treatment of Femoropopliteal Arterial–The ILLUMENATE Global Study: 12-Month Results From a Prospective, Multicenter, Single-Arm Study. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2018.05.026] [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: 10/28/2022]
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Aartsen W, Peeters P, Wagers S, Williams-Jones B. Getting Digital Assets from Public-Private Partnership Research Projects through "The Valley of Death," and Making Them Sustainable. Front Med (Lausanne) 2018; 5:65. [PMID: 29594123 PMCID: PMC5855043 DOI: 10.3389/fmed.2018.00065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 02/20/2018] [Indexed: 11/20/2022] Open
Abstract
Projects in public–private partnerships, such as the Innovative Medicines Initiative (IMI), produce data services and platforms (digital assets) to help support the use of medical research data and IT tools. Maintaining these assets beyond the funding period of a project can be a challenge. The reason for that is the need to develop a business model that integrates the perspectives of all different stakeholders involved in the project, and these digital assets might not necessarily be addressing a problem for which there is an addressable market of paying customers. In this manuscript, we review four IMI projects and the digital assets they produced as a means of illustrating the challenges in making digital assets sustainable and the lessons learned. To progress digital assets beyond proof-of-concept into widely adopted tools, there is a need for continuation of multi-stakeholder support tailored to these assets. This would be best done by implementing a structure similar to the accelerators that are in place to help transform startup businesses into growing and thriving businesses. The aim of this article is to highlight the risk of digital asset loss and to provoke discussion on the concept of developing an “accelerator” for digital assets from public–private partnership research projects to increase the chance that digital assets will be sustained and continue to add value long after a project has ended.
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Kurk S, Peeters P, Stellato R, Dorresteijn B, Jourdan M, Creemers GJ, Erdkamp F, de Jongh F, Kint P, Poppema B, Radema S, Simkens L, Tanis B, Tjin-A-Ton M, Van der Velden A, Punt C, Koopman M, May A. Impact of sarcopenia on dose limiting toxicities in metastatic colorectal cancer patients (mCRC pts) receiving palliative systemic treatment. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Debonnaire G, Verbist J, Peeters P. Dysphagia Lusoria. Indications and Surgical Approaches for Non-Aneurysmatic Aberrant Right Subclavian Artery. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2012.11680832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- G. Debonnaire
- Department of Cardiovascular and Thoracic Surgery, Imelda hospital, Bonheiden, Belgium
| | - J. Verbist
- Department of Cardiovascular and Thoracic Surgery, Imelda hospital, Bonheiden, Belgium
| | - P. Peeters
- Department of Cardiovascular and Thoracic Surgery, Imelda hospital, Bonheiden, Belgium
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Verbert A, Verbist J, Peeters P, Deferm H, Haenen L. Spontaneous Rupture of an Aneurysm of the Right Subclavian Artery as a First Presentation of Ehlers Danlos Syndrome in a 15-year Old Boy. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2013.11680947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Verbert
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
| | - J. Verbist
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
| | - P. Peeters
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
| | - H. Deferm
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
| | - L. Haenen
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
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Elens M, Verbist J, Keirse K, Van Den Eynde W, Peeters P. Which is currently the best strategy for treatment of SFA in-stent restenosis? J Cardiovasc Surg (Torino) 2014; 55:477-481. [PMID: 24941234] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Stents have been created to prevent vessel recoil after percutaneous transluminal angioplasty (PTA). Despite the evolution in stent design, intimal hyperplasia and stent fractures and the resulting in-stent restenosis (ISR) still occur. Different strategies to treat ISR have been described with variable results in patency rates in the short and the long-term. PTA only in the treatment of ISR showed high procedural success, but the mid and long-term patency rates were very disappointing. Atherectomy devices have showed same insufficient results. If stent fracture is the cause of the ISR, the fracture has to be overstent. The best two options are covered stents and drug eluting stents (DES). Drug eluting devices like DES and drug eluting balloons (DEBs) showed promising results, with patency rates up to over 90% after one year. DEBs have the advantage of leaving nothing behind. Combined treatment of ISR with atherectomy and DEB has a similar good result. Endovascular brachytherapy showed high patency rates after one year but this technique is limited due to the time-consuming nature of the procedure, complex radiation safety measurements, and staffing requirements. Overall drug-eluting devices are emerging as the best treatment of SFA ISR with patency rates over 90% after 2 years.
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Affiliation(s)
- M Elens
- Department of Cardiovascular and Thoracic Surgery Imelda Hospital, Bonheiden, Belgium -
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Baroi LG, Verbist J, Peeters P, Popa RF. Clinical and epidemiological assessment concerning hybrid revascularization techniques in the treatment of multilevel arterial occlusive disease. Rev Med Chir Soc Med Nat Iasi 2014; 118:764-771. [PMID: 25341299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED Aim of the study was to report a novel hybrid technique for multilevel arterial lesions of the lower extremities and to evaluate the clinical outcomes. In patients with multilevel arterial disease, the combined (hybrid) treatment, consisting of endovascular intervention and classical surgical intervention on the same vascular axis seems to be the most indicated treatment in order to obtain an adequate inflow and outflow. MATERIAL AND METHODS We have performed a non-randomized study during a 44-month period (January 2010 - September 2013) in a number of 94 patients treated by hybrid revascularization techniques. All the patients included in the study have been post-surgically surveyed at well established intervals (1, 3, 6, 9, 12, 24 and 36 months) by: clinical examination, laboratory tests, Duplex ultrasound, and, as needed, CT or MR Angiography. RESULTS The 6 months primary patency in each studied group (corresponding to the years of 2010, 2011 and 2012) was 58.69%, 68.42%, and 62.06%, respectively; the 12 months primary patency was 45.65%, 57.89%, and 34.48%, respectively. Clinical improvement has been noticed in 83 patients (88.29%). There have been registered 19 amputations (20.21% of the cases): 11 majors (thigh and below the knee), representing 11.7% of the total number of cases and 8 minors (toe or transmetatarsal), representing 8.51% of the total number of cases. The amputation-free survival period ranged between 7 days and 24 months, with an average of 7.66 months. CONCLUSIONS The hybrid techniques are a feasible option for the multilevel arterial disease, with favorable patency and limb salvage rates.
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Gallala S, Verbist J, Van Den Eynde W, Peeters P. Popliteal artery aneurysm: when open, when endo? J Cardiovasc Surg (Torino) 2014; 55:239-247. [PMID: 24796918] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this article was to obtain a more clear view in the management of popliteal artery aneurysms (PAAs). When do we need to treat it and how is it best treated? After going through multiple review articles and case reports concerning this matter, we came to the following conclusions. Repair of a PAA is indicated when it reaches a postero-anterior diameter of 3 cm (at higher risk for thrombosis) or becomes symptomatic (mild claudication or severe ischemic symptoms). Whether the repair is then performed in an endovascular (Endovascular repair) or open way (Open repair), depends on the personal experience and clinical evaluation of the surgeon.
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Affiliation(s)
- S Gallala
- Imeldaziekenhuis, Bonheiden, Belgium -
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Abstract
Delayed and slow graft function (DGF/SGF) in de novo kidney transplantation endanger outcomes of graft and patient, while predisposing the patient to acute rejection and lesser graft function. Causes and work-up of DGF/SGF are described in the present paper. Also, the epidemiology and pathophysiology of chronic renal failure both in kidney graft recipients and in recipients of other solid organs is discussed, especially in relation to calcineurin inhibitor (CNI) immunosuppression. An acute kidney injury event will have a greater and faster impact on impaired renal reserve in case of chronic renal failure. Major causes of acute kidney injury (AKI) of the native kidneys of solid organ recipients and of the transplanted kidney are: severe infections, acute toxic kidney injury caused by CNI treatment concomitant CYP450 3A4 inhibiting medication, toxic and infectious events inducing haemolytic uraemic syndrome, toxic rhabdomyolysis, acute interstitial nephritis, rapid IV immunoglobulin infusion and exposure to other well-known nephrotoxins, such as NSAIDs, amphotericin and aminoglycosides.
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Affiliation(s)
- P Peeters
- Renal Division, Department of Internal Medicine, University Hospital Ghent, Belgium.
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Bosiers M, Deloose K, Callaert J, Maene L, Beelen R, Keirse K, Verbist J, Peeters P. New devices for a better endovascular approach. J Cardiovasc Surg (Torino) 2013; 54:713-718. [PMID: 24126508] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The endovascular approach has known a great evolution in terms of vessel patency and treatment possibilities. Longer and more complex lesions with a difficult anatomy can be addressed by a range of endovascular tools. However, to maintain the patency of the treated lesion is the true challenge. In order to fulfill these long-term expectations, newer devices have been developed. The drug-coated balloon combines local drug uptake with no residual material after treatment. To maintain patency and prevent recoil of the arterial wall, the drug-eluting stent has been created to offer stent support with an antiproliferative drug. The main drawbacks of the drug-coated balloon and the drug-eluting stent are being addressed by the drug-eluting absorbable scaffold. The initial scaffolding support in combination with the drug release during a prolonged period, poses the same advantages while the scaffold is being metabolized over time. This continuing evolution in endovascular tools paves the way to an endovascular treatment for the majority of peripheral artery diseases.
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Affiliation(s)
- M Bosiers
- Department of Vascular Surgery AZ Sint‑Blasius, Dendermonde, Belgium -
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18
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Verbert A, Verbist J, Peeters P, Deferm H, Haenen L. Spontaneous rupture of an aneurysm of the right subclavian artery as a first presentation of Ehlers Danlos syndrome in a 15-year old boy. Acta Chir Belg 2013; 113:367-372. [PMID: 24294804] [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: 06/02/2023]
Abstract
We report a case of a spontaneous rupture of a right subclavian aneurysm in a 15 year-old patient. This ruptured aneurysm was successfully treated in an endovascular manner by placing a covered stent-graft in the right subclavian artery via right brachial access. Subsequent work-up by skin biopsy and fibroblast culture and by DNA-screening revealed the diagnosis of Ehlers Danlos type IV. Meanwhile, the patient developed twice a spontaneous pneumothorax, treated with thoracoscopic pleurodesis. This article provides a clear overview of the clinical and genetic characteristics of a case of Ehlers Danlos type IV and illustrates the importance of avoiding surgery in patients with connective tissue disease because of the high risk of perioperative complications.
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Affiliation(s)
- A Verbert
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
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Laute M, Vanholder R, Voet D, Peeters P, Cokelaere K, Deloose S, Terryn W. Safety and sample adequacy of renal transplant surveillance biopsies. Acta Clin Belg 2013; 68:161-5. [PMID: 24156213 DOI: 10.2143/acb.3246] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 11/18/2022]
Abstract
PURPOSE To report on the safety and adequacy of surveillance biopsy for detecting subclinical lesions in clinically stable renal grafts. MATERIALS AND METHODS We established an in-patient surveillance biopsy program with the elective performance of a renal transplant biopsy during the first year after renal transplantation. All biopsies in our centre were performed or supervised by the same operator. Patients were admitted to the hospital the day of biopsy and were discharged after 24h of observation. All patients were biopsied in supine position, using a 16-gauge needle with a spring-loaded gun (Bard) under real-time ultrasound guidance. Complication rates were retrospectively scored using the patients' charts and blood counts before and after biopsy. Major complications were defined as those requiring an intervention for resolution, a transfusion of blood products or an invasive procedure (angiography or surgery), and those that led to acute renal obstruction or failure, septicaemia, graft loss or death. In all other cases complications were considered minor. An adequate biopsy was defined as the presence of 7 or more glomeruli and at least one artery in the biopsy specimen. RESULTS We performed 282 surveillance biopsies in 248 patients between January 2006 and December 2011. None of the complications were major. We observed 6% minor complications (n = 17). 5.6% (n = 16) of the complications were related to bleeding, with macroscopic haematuria as the most common condition (n = 10; 3.5%), followed by pain (n = 6; 2.1%) eighter due to a perinephric hematoma (n = 5) or a subcutaneous hematoma (n = 1). The biopsies contained a median number of 9 glomeruli (range 0-39) with 70% of biopsies containing at least 7 glomeruli and one artery. CONCLUSION The procedure for taking surveillance biopsies was proven to be safe. There were no major complications and only rare minor complications. The majority of the samples were adequate for histological examination.
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Affiliation(s)
- M Laute
- Department of Nephrology, Ghent University Hospital, Belgium.
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Yildirim T, Yilmaz R, Altindal M, Turkmen E, Arici M, Altun B, Erdem Y, Guliyev O, Erkmen Uyar M, Tutal E, Bal Z, Sezer S, Erkmen Uyar M, Bal U, Bal Z, Tutal E, Say n B, Guliyev O, Erdemir B, Sezer S, O'Rourke-Potowki A, Gauge N, Penny H, Cronin A, Frame S, Goldsmith DJ, Yagan JA, Chandraker A, Velickovic Radovanovic RM, Catic Djordjevic A, Mitic B, Stefanovic N, Cvetkovic T, Serpieri N, Grosjean F, Sileno G, Torreggiani M, Esposito V, Mangione F, Abelli M, Castoldi F, Catucci D, Esposito C, Dal Canton A, Vatazin AV, Zulkarnaev AB, Borst C, Liu Y, Thoning J, Tepel M, Libetta C, Margiotta E, Borettaz I, Canevari M, Martinelli C, Lainu E, Abelli M, Meloni F, Sepe V, Dal Canton A, Miguel Costa R, Vasquez Martul E, Reboredo J, Rivera C, Simonato F, Tognarelli G, Daidola G, Gallo E, Burdese M, Cantaluppi V, Biancone L, Segoloni GP, Burdese M, Priora M, Messina M, Tamagnone M, Daidola G, Linsalata A, Lavacca A, Biancone L, Segoloni G, Zuidema W, Erdman R, van de Wetering J, Dor F, Roodnat J, Massey E, Timmerman L, IJzermans J, Weimar W, Goldsmith DJ, Sibley-Allen C, Hilton R, Moghul M, Burnapp L, Blake G, Koo TY, Park JS, Park HC, Kim GH, Lee CH, Oh IH, Kang CM, Hwang JK, Park SC, Choi BS, Chun HJ, Kim JI, Yang CW, Moon IS, Van Laecke S, Van Biesen W, Nagler EV, Taes Y, Peeters P, Vanholder R, Pruthi R, Ravanan R, Casula A, Harber M, Roderick P, Fogarty D, Cho A, Shin JH, Jang HR, Lee JE, Huh W, Kim DJK, Oh HY, Kim YG, Sancho Calabuig A, Gavela Martinez E, Kanter Berga J, Beltran Catalan S, Avila Bernabeu AI, Pallardo Mateu LM, Gonzalez E, Polanco N, Molina M, Gutierrez E, Garcia Puente L, Sevillano A, Morales E, Praga M, Andres A, Banasik M, Boratynska M, Koscielska-Kasprzak K, Bartoszek D, Myszka M, Zmonarski S, Nowakowska B, Wawrzyniak E, Halon A, Chudoba P, Klinger M, Rojas-Rivera J, Gonzalez E, Polanco N, Morales E, Andres A, Morales JM, Egido J, Praga M, Kopecky CM, Haidinger M, Kaltenecker C, Antlanger M, Marsche G, Holzer M, Kovarik J, Werzowa J, Hecking M, Saemann MD, Hwang JK, Kim JM, Koh ES, Chung BH, Park SC, Choi BS, Kim JI, Yang CW, Kim YS, Moon IS, Banasik M, Boratynska M, Koscielska-Kasprzak K, Krajewska M, Mazanowska O, Kaminska D, Bartoszek D, Zabinska M, Halon A, Malkiewicz B, Patrzalek D, Klinger M, Sulowicz J, Szostek S, Wojas-Pelc A, Ignacak E, Sulowicz W, Bellizzi V, Calella P, Cupisti A, Capitanini A, D'Alessandro C, Giannese D, Camocardi A, Conte G, Barsotti M, Bilancio G, Luciani R, Locsey L, Seres I, Kovacs D, Asztalos L, Paragh G, Wohlfahrtova M, Balaz P, Rokosny S, Wohlfahrt P, Bartonova A, Viklicky O, Kers J, Geskus RB, Meijer LJ, Bemelman F, ten Berge IJM, Florquin S, Hwang JC, Jiang MY, Lu YH, Weng SF, Testa A, Porto G, Sanguedolce M, Spoto B, Parlongo R, Pisano A, Enia G, Tripepi G, Zoccali C, Zuidema W, Mamode N, Lennerling A, Citterio F, Massey E, Van Assche K, Sterckx S, Frunza M, Jung H, Pascalev A, Johnson R, Loven C, Weimar W, Dor F, Soleymanian T, Keyvani H, Jazayeri SM, Fazeli Z, Ghamari S, Mahabadi M, Chegeni V, Najafi I, Ganji MR, Meys KME, Groothoff JW, Jager K, Schaefer F, Tonshoff B, Mota C, Cransberg K, van Stralen K, Gurluler E, Gures N, Alim A, Gurkan A, Cakir U, Berber I, Van Laecke S, Caluwe R, Nagler E, Van Biesen W, Peeters P, Van Vlem B, Vanholder R, Sulowicz J, Wojas-Pelc A, Ignacak E, Betkowska-Prokop A, Kuzniewski M, Krzanowski M, Sulowicz W, Masson I, Flamant M, Maillard N, Cavalier E, Moranne O, Alamartine E, Mariat C, Delanaye P, Canas Sole LL, Iglesias Alvarez E, Pastor MCMC, Moreno Flores FF, Abujder VV, Graterol FF, Bonet Sol JJ, Lauzurica Valdemoros RR, Yoshikawa M, Kitamura K, Nakai K, Goto S, Fujii H, Ishimura T, Takeda M, Fujisawa M, Nishi S, Prasad N, Gurjer D, Bhadauria D, Gupta A, Sharma R, Kaul A, Cybulla M, West M, Nicholls K, Torras J, Sunder-Plassmann G, Feriozzi S, Lo S, Wong PYH, Ip D, Wong CK, Chow VCC, Mo SKL, Molnar M, Ujszaszi A, Czira ME, Novak M, Mucsi I, Cruzado JM, Coelho S, Porta N, Bestard O, Melilli E, Taco O, Rivas I, Grinyo J, Pouteau LM, N'Guyen JM, Hami A, Hourmant M, Ghahramani N, Karparvar Z, Shadrou S, Ghahramani M, Fauvel JP, Hadj-Aissa A, Buron F, Morelon E, Ducher M, Heine C, Glander P, Neumayer HH, Budde K, Liefeldt L, Montero N, Webster AC, Royuela A, Zamora J, Crespo M, Pascual J, Adema AY, van Dorp WTH, Mallat MJK, de Fijter HW, Kim YS, Hong YA, Chung BH, Park CW, Yang CW, Kim YS, Choi BS, Suleymanlar G, Uzundurukan Z, Kapuagas A, Sencan I, Akdag R, Pascual J, Torio A, Mas V, Perez-Saez MJ, Mir M, Faura A, Montes-Ares O, Checa MD, Crespo M, Sawinski D, Trofe-Clark J, Sparkes T, Patel P, Goral S, Bloom R, Kim HJ, Park SJ, Kim TH, Kim YW, Kim YH, Kang SW, Abdel Halim M, Gheith O, Al-Otaibi T, Mosaad A, Awadeen W, Said T, Nair P, Nampoory MRN. Transplantation: clinical studies - A. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft123] [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: 11/14/2022] Open
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Deloose K, Lauwers K, Callaert J, Maene L, Keirse K, Verbist J, Peeters P, Bosiers M. Drug-eluting technologies in femoral artery lesions. J Cardiovasc Surg (Torino) 2013; 54:217-224. [PMID: 23558657] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The treatment of femoropopliteal lesions has known an important evolution in the last years. An important limitation of current endovascular therapy remains the occurrence of restenosis. In order to minimize restenosis rates, drug eluting technologies are evolving. The use of drug-eluting stents (DES) in coronary arteries shows beneficial results, leading to investigation of DES in femoropopliteal arteries. In this article, we give an overview of current available data on treatment with drug eluting technologies in the superficial femoral artery (SFA). This paper summarizes also the current available data of the use of drug-coated balloons (DCB) in the femoropopliteal tract. Currently, no data are available on the use of DCB in long lesions. A drug eluting bioresorbable scaffold seems to be very promising in coronary arteries. The transfer to the peripheral area is nowadays ongoing. Which technique and device for which lesion and patient requires further investigation to build up a real evidence based SFA treatment strategy.
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Affiliation(s)
- K Deloose
- Departement Vascular Surgery, A.Z. Sint‑Blasius, Dendermonde, Belgium.
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Bosiers M, Deloose K, Callaert J, Maene L, Beelen R, Keirse K, Verbist J, Peeters P, Schroë H, Lauwers G, Lansink W, Vanslembroeck K, D'archambeau O, Hendriks J, Lauwers P, Vermassen F, Randon C, Van Herzeele I, De Ryck F, De Letter J, Lanckneus M, Van Betsbrugge M, Thomas B, Deleersnijder R, Vandekerkhof J, Baeyens I, Berghmans T, Buttiens J, Van Den Brande P, Debing E, Rabbia C, Ruffino A, Tealdi D, Nano G, Stegher S, Gasparini D, Piccoli G, Coppi G, Silingardi R, Cataldi V, Paroni G, Palazzo V, Stella A, Gargiulo M, Muccini N, Nessi F, Ferrero E, Pratesi C, Fargion A, Chiesa R, Marone E, Bertoglio L, Cremonesi A, Dozza L, Galzerano G, De Donato G, Setacci C. BRAVISSIMO: 12-month results from a large scale prospective trial. J Cardiovasc Surg (Torino) 2013; 54:235-253. [PMID: 23558659] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The BRAVISSIMO study is a prospective, non-randomized, multi-center, multi-national, monitored trial, conducted at 12 hospitals in Belgium and 11 hospitals in Italy. This manuscript reports the findings up to the 12-month follow-up time point for both the TASC A&B cohort and the TASC C&D cohort. The primary endpoint of the study is primary patency at 12 months, defined as a target lesion without a hemodynamically significant stenosis on Duplex ultrasound (>50%, systolic velocity ratio no greater than 2.0) and without target lesion revascularization (TLR) within 12 months. Between July 2009 and September 2010, 190 patients with TASC A or TASC B aortoiliac lesions and 135 patients with TASC C or TASC D aortoiliac lesions were included. The demographic data were comparable for the TASC A/B cohort and the TASC C/D cohort. The number of claudicants was significantly higher in the TASC A/B cohort, The TASC C/D cohort contains more CLI patients. The primary patency rate for the total patient population was 93.1%. The primary patency rates at 12 months for the TASC A, B, C and D lesions were 94.0%, 96.5%, 91.3% and 90.2% respectively. No statistical significant difference was shown when comparing these groups. Our findings confirm that endovascular therapy, and more specifically primary stenting, is the preferred treatment for patients with TASC A, B, C and D aortoiliac lesions. We notice similar endovascular results compared to surgery, however without the invasive character of surgery.
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Affiliation(s)
- M Bosiers
- AZ Sint-Blasius, Dendermonde, Belgium.
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Bosiers M, Peeters P, Tessarek J, Deloose K, Strickler S. The Zilver® PTX® Single Arm Study: 12-month results from the TASC C/D lesion subgroup. J Cardiovasc Surg (Torino) 2013; 54:115-122. [PMID: 23296421] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of the present article was to report the 12-month results of the Zilver® PTX® Single Arm StudyTASC C/D de novo lesion subgroup. METHODS The Zilver PTX Drug-Eluting Peripheral Stent is a self-expanding nitinol stent with a polymer-free paclitaxel coating. This is a prospective, single-arm, multicentre clinical study evaluating the Zilver PTX Drug-Eluting Peripheral Stent for treating patients with symptomatic lesions in the above-the-knee femoropopliteal artery. This study enrolled 787 patients (900 lesions) with Rutherford class 2 or higher treated with the Zilver PTX stent; 135 were long de novo lesions, corresponding to TASC II Class C or D. RESULTS The 135 long lesions had a mean length of 226.1±43.6 mm. The 12-month Kaplan-Meier estimates included a 77.6% primary patency rate, an 84.7% event-free survival rate, and an 85.4% rate of freedom from target lesion revascularization (TLR). The 12-month stent fracture rate was 2.1%. CONCLUSION The primary patency rates in the analysis of the TASC C/D de novo lesion subgroup of the Zilver PTX Single Arm Study indicate that endovascular therapy outcomes with a paclitaxel eluting stent may equal those of bypass surgery. Endovascular treatment with DES may play an important role for treatment of patients who present with TASC C or D femoropopliteal lesions.
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Affiliation(s)
- M Bosiers
- Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium.
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Bosiers M, Deloose K, Callaert J, Maene L, Keirse K, Verbist J, Peeters P. Refining stent technologies for femoral interventions. J Cardiovasc Surg (Torino) 2012; 53:465-473. [PMID: 22854526] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Stents were created as a mechanical scaffold to prevent vessel recoil and luminal renarrowing after percutaneous transluminal angioplasty (PTA). In femoropopliteal arteries, indication for stent implantation remains a topic much debated on, especially in long lesion configurations. Ever since the first stents were introduced on the market, in-stent restenosis (ISR) has been an important issue. The evolution in stent design has known a major progression in the last decades from the first generation of stents, plagued with high fracture rates and low primary patency rates, to the design of newer stents to tackle these outcomes. More flexible and longer stents decreased the high fracture rates and drug-eluting stents offered a solution to the restenosis rates by local drug application. The difficult recrossibility of the lesion because of the presence of a permanent vascular scaffold is an obstacle that the drug-coated balloon (DCB) overcomes. Future perspectives in the treatment of femoropopliteal lesions are found in the bioresorbable stent implantation. The bioresorbable stent combines the advantages of a drug-eluting scaffolding stent without the remainder of a foreign object in the long-term. Further investigations in this area will eventually evolve in the creation of a superior endovascular treatment modality with high long-term patency rates and minimal detriments.
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Affiliation(s)
- M Bosiers
- Department Vascular Surgery, A.Z. Sint-Blasius, Dendermonde, Belgium.
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Debonnaire G, Verbist J, Peeters P. Dysphagia lusoria. Indications and surgical approaches for non-aneurysmatic aberrant right subclavian artery. Acta Chir Belg 2012; 112:237-239. [PMID: 22808768] [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: 06/01/2023]
Abstract
Non-aneurysmatic aberrant right subclavian artery is a rare cause of dysphagia. We report a case of a 65-year-old female patient having a symptomatic lusorian artery. We reviewed literature as for indications and operative techniques for type I lusorian arteries. Different types of surgical approaches have been reported but there is no consensus to date. We performed a minimally invasive sternotomy with right cervicotomy. This surgical approach maximized our visibility resulting in a safe dissection, resection and reinsertion of the aberrant right subclavian artery. Postoperative morbidity was low.
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Affiliation(s)
- G Debonnaire
- Department of Cardiovascular and Thoracic Surgery, Imelda hospital, Bonheiden, Belgium.
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Bosiers M, Deloose K, Callaert J, Maene L, Keirse K, Verbist J, Peeters P. In lower extremity PTAs intraluminal is better than subintimal. J Cardiovasc Surg (Torino) 2012; 53:223-227. [PMID: 22456645] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
With subintimal recanalization, a channel is deliberately created by dissecting the vessel wall in order to replace the native occluded lumen. This is opposed to intraluminal recanalization, where passage of an arterial obstructive lesion is performed by central luminal navigation. Both intraluminal and subintimal treatment has its proponents and adversaries. The appreciation of an investigator for a certain technique is commonly related to the training received and the personal experience. Yet, the intraluminal technique uses the clinically preferred route for adjunctive treatment, such as balloon angioplasty or stent deployment. A wide variety of devices designed to obtain intraluminal lesion passage is available and is currently being used in vascular centers worldwide. With intraluminal techniques, success rates of up to 95% have been reported.
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Affiliation(s)
- M Bosiers
- Department of Vascular Surgery, AZ Sint-Blasius, Dendermonde, Belgium.
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Bosiers M, Deloose K, Callaert J, Verbist J, Keirse K, Peeters P. BRAVISSIMO study: 12-month results from the TASC A/B subgroup. J Cardiovasc Surg (Torino) 2012; 53:91-99. [PMID: 22071471] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The BRAVISSIMO study is a prospective, non-randomized, multicenter, multinational, monitored trial, conducted at 12 hospitals in Belgium and 11 hospitals in Italy. This manuscript reports on the BRAVISSIMO TASC A&B iliac lesion cohort, based on data collected up to the 13-month time point. The primary endpoint of the study is primary patency at 12 months, defined as a target lesion without a hemodynamically significant stenosis on duplex ultrasound (>50%, systolic velocity ratio no greater than 2.0) and without Target Lesion Revascularization (TLR) within 12 months. METHODS Between July 2009 and February 2010, a total of 190 patients who presented with TASC A or TASC B aorto-iliac lesions were included, of which 140 patients were enrolled in Belgium and 50 in Italy. RESULTS The demographic data were comparable for the TASC A and TASC B patients groups. The number of occlusions, the average degree of stenosis, the average lesion length was significantly higher in the group of TASC B lesions, which is congruent with the TASC lesions definitions. Similarly, there were significantly more unilateral lesions in the TASC A group, compared to the TASC B group. The 12-month primary patency rate was 94.0% for TASC A lesions and 96.5% for TASC B lesions, which is not statistically significant. The 12-month primary patency rate was 92.9% in lesions treated with the Omnilink Elite stent, 97.1% in lesions treated with the Absolute Pro stent groups, and 100% in lesions treated with both stents. CONCLUSION Our findings confirm that endovascular therapy, and more specifically primary stenting, is the preferred treatment for patients with TASC A/B aortoiliac lesions. Currently, we are collecting the 12-month data for the TASC C/D subgroup in the BRAVISSIMO study. Upon release of the results from this subgroup, we will be able to compare the results from both arms of this large-scale international study.
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Affiliation(s)
- M Bosiers
- Department Vascular Surgery, A.Z. Sint-Blasius, Dendermonde, Belgium.
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Peeters P, Verbist J, Keirse K, Callaert J, Deloose K, Bosiers M. Endovascular procedures and new insights in diabetic limb salvage. J Cardiovasc Surg (Torino) 2012; 53:31-37. [PMID: 22231527] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Critical limb ischemia (CLI) is affecting an increasing number of patients, mainly due to an ageing population and the growing number of diabetics. Clinically, CLI is characterized by rest pain, non-healing foot wounds and gangrene, due to insufficient arterial blood supply. Limb preservation should be the goal in patients with diabetic foot due to tibial occlusive disease. As surgery is associated with considerable morbidity and mortality rates, endovascular therapy can offer a valuable alternative. Small-diameter below-the-knee arteries that were previously unamenable to surgical methods, can now be reached and treated. Currently, many endovascular techniques are available, from regular PTA and bare metal stents to drug-coated balloons and drug-eluting stents. In our opinion the results of endovascular therapy for below-the-knee vessels will be further improved by the continuous technical evolution and new material developments. In the light of the current evolution towards minimally invasive techniques, an increasing number of experienced centers will be able to treat the vast majority of all below-the-knee arterial pathology by endovascular means.
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Affiliation(s)
- P Peeters
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium.
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Soppe WJ, Borg H, Van Aken BB, Devilee C, Dörenkämper M, Goris M, Heijna MCR, Löffler J, Peeters P. Roll to roll fabrication of thin film silicon solar cells on nano-textured substrates. J Nanosci Nanotechnol 2011; 11:10604-10609. [PMID: 22408957 DOI: 10.1166/jnn.2011.4075] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
ECN is developing a novel fabrication process for thin film silicon solar cells on steel foil. Key features in this process are: (1) application of an insulating barrier layer which enables monolithic interconnection and texturization of the rear contact with submicron structures for light trapping; (2) Si deposition with remote, linear PECVD; (3) series interconnection by laser scribing and printing after deposition of all layers, which reduces the total number of process steps. The barrier layer is essential for the monolithic series interconnection of cells, but we show that it also enables optimum light trapping in the solar cells. We can fabricate any arbitrary sub-micron surface profile by hot embossing the barrier layer. For deposition of doped and intrinsic silicon layers we use novel remote, linear plasma sources, which are excellently suited for continuous roll-to-roll processing. We have been able to fabricate device-quality amorphous and microcrystalline silicon layers with these sources. The first nip a-Si cells were made on steel substrates with flat barrier layer and had initial efficiencies of 6.3%, showing the potential of the concept.
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Affiliation(s)
- W J Soppe
- SECN Solar Energy, PO. Box 1, 1755 ZG Petten, The Netherlands
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Clanet M, Chantraine F, Dewandre PY, Peeters P, Foidart JM, Brichant JF. [Pseudoxanthoma elasticum and obstetric epidural analgesia: report of a case]. ACTA ACUST UNITED AC 2011; 30:685-7. [PMID: 21705175 DOI: 10.1016/j.annfar.2011.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 05/18/2011] [Indexed: 11/16/2022]
Abstract
Pseudoxanthoma elasticum is a rare inherited disorder of the elastic tissue characterised by multisystem manifestations. Skin, eyes, gastro-intestinal system and cardiovascular system are the major affected systems. We describe the anaesthetic management of a parturient affected by this disease.
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Affiliation(s)
- M Clanet
- Département d'anesthésie-réanimation, CHU de Liège, CHR de Citadelle, université de Liège, 4000 Liège, Belgique
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Speeckaert R, Brochez L, Lambert J, van Geel N, Speeckaert M, Claeys L, Langlois M, Van Laer C, Peeters P, Delanghe J. The haptoglobin phenotype influences the risk of cutaneous squamous cell carcinoma in kidney transplant patients. J Eur Acad Dermatol Venereol 2011; 26:566-71. [DOI: 10.1111/j.1468-3083.2011.04112.x] [Citation(s) in RCA: 10] [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] [Indexed: 11/30/2022]
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Bosiers M, Deloose K, Callaert J, Keirse K, Verbist J, Peeters P. Drug-eluting stents below the knee. J Cardiovasc Surg (Torino) 2011; 52:231-234. [PMID: 21460773] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The fear that early thrombosis and late luminal loss due to intimal hyperplasia formation potentially leads to insufficient long-term patency rates can explain the reluctance on implanting stents in small diameter below-the-knee (BTK) arteries. Drug-eluting stent (DES) technology was developed to prevent early thrombosis and late luminal loss to potentially improve long-term patency rates. Currently, the first level 1 evidence from prospective, randomized, controlled DESTINY and ACHILLES studies indicate that the implantation of DES in short lesion lenghts in the infrapopliteal vasculature leads to favorable outcomes with high primary patency rates. This makes that primary DES placement can be recommended as treatment strategy in short BTK-lesions.
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Affiliation(s)
- M Bosiers
- Department of Vascular Surgery, A.Z. Sint-Blasius, Dendermonde, Belgium.
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Humar A, Peeters P, Abramowicz D, Humar A, Lebranchu Y, Hauser I, Jardine A, Limaye AP, Vincenti F, Punch JD, Blumberg E. Response to questions regarding the design and results of the IMPACT trial. Am J Transplant 2011; 11:177-8. [PMID: 21199360 DOI: 10.1111/j.1600-6143.2010.03370.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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34
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Bosiers M, Deloose K, Keirs K, Verbist J, Peeters P. Prevention and treatment of in-stent restenosis. J Cardiovasc Surg (Torino) 2010; 51:591-598. [PMID: 20671644] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In-stent restenosis has always been an important issue, since the launch of the first stents on the market. The occurrence of in-stent restenosis (ISR) is due to two main reasons. First, the presence of stent fractures significantly influences restenosis rates. Second, the continuous interaction between the permanently implanted artificial material and the vessel tissue, leads to physical irritation, long-term endothelial dysfunction, or chronic inflammatory reactions. In the Literature only very limited data on ISR treatment in the peripheral arteries are available. There are no peer-reviewed publications or studies with in-depth follow-up on this specific indication. The underlying reason for this probably being that currently available treatments do not yield satisfactory results. However, the continuing search for better solutions and the technological evolution lead to the introduction of the Viabahn with PROPATEN coating, DES and DCB, which may result in the first promising treatment options for ISR.
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Affiliation(s)
- M Bosiers
- Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium.
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Cammu G, de Kam PJ, De Graeve K, van den Heuvel M, Suy K, Morias K, Foubert L, Grobara P, Peeters P. Repeat dosing of rocuronium 1.2 mg kg-1 after reversal of neuromuscular block by sugammadex 4.0 mg kg-1 in anaesthetized healthy volunteers: a modelling-based pilot study. Br J Anaesth 2010; 105:487-92. [PMID: 20630888 DOI: 10.1093/bja/aeq167] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Re-intubation and re-operation may occasionally be required after neuromuscular block (NMB) reversal. This study evaluated block onset times of a second dose of rocuronium (1.2 mg kg(-1)) after sugammadex reversal of rocuronium 0.6 mg kg(-1). METHODS In this open-label study of healthy anaesthetized volunteers, subjects received rocuronium 0.6 mg kg(-1), were antagonized at 1-2 post-tetanic counts with sugammadex 4.0 mg kg(-1), and received rocuronium 1.2 mg kg(-1) at 5, 7.5, 10, 15, 20, 22.5, 25, 27.5, 30, 45, or 60 min after sugammadex. Spontaneous recovery occurred after repeat rocuronium dose. Primary endpoints were the onset time of maximal block (time to lowest T(1) value reached) and the clinical duration of block (until T(1)=25%) after repeat rocuronium dose. RESULTS Sixteen subjects were included. For subjects receiving rocuronium 1.2 mg kg(-1) 5 min after sugammadex (n=6), mean (sd) onset time (to T(1)=0) was 3.06 (0.97) min; range, 1.92-4.72 min. For repeat dose time points ≥25 min (n=5), mean onset was faster (1.73 min) than for repeat doses <25 min (3.09 min) after sugammadex. The duration of block ranged from 17.7 min (rocuronium 5 min after sugammadex) to 46 min (repeat dose at 45 min). Mean duration was 24.8 min for repeat dosing <25 min vs 38.2 min for repeat doses ≥25 min. CONCLUSIONS Rapid re-onset of NMB occurred after repeat dose of rocuronium 1.2 mg kg(-1) as early as 5 min after sugammadex in healthy volunteers. Re-onset of block took longer if second rocuronium dose was <25 min after sugammadex. The duration of action of second rocuronium dose increased with later repeat dose time points.
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Affiliation(s)
- G Cammu
- Department of Anaesthesiology and Critical Care Medicine, Onze-Lieve-Vrouw Ziekenhuis, Moorselbaan 164, 9300 Aalst, Belgium.
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Bosiers M, Callaert J, Deloose K, Verbist J, Keirse K, Peeters P. The role of carotid artery stenting for recent cerebral ischemia. J Cardiovasc Surg (Torino) 2010; 51:293-304. [PMID: 20523278] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Patients with cerebral ischemia as a result of acute cervical internal carotid artery occlusion are generally considered to have a poor prognosis. Despite maximal medical treatment, a better treatment for patients with acute ischemic stroke who present with serious neurologic symptoms on admission or continue to deteriorate neurologically due to a total occlusion, a dissection or a high-grade stenosis of the internal carotid artery is required. An effective intervention to improve their neurologic symptoms and clinical outcome has not yet been established and represents a challenging and complex problem. Treatment of acute symptomatic occlusion of the cervical internal carotid artery includes intravenous administration of thrombolytic agent, carotid endarterectomy and an interventional approach (intra-arterial administration of thrombolytic agent, transluminal angioplasty with or without stenting). The endovascular interventional approach is becoming a part of the stroke therapy armamentarium for intracranial occlusion. It may also now be considered in select patients with acute internal carotid artery occlusion. Stenting and angioplasty for acute internal carotid artery occlusion appears to be feasible, safe and may be associated with early neurological improvement. The encouraging preliminary results await confirmation from prospective, randomized studies.
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Affiliation(s)
- M Bosiers
- Department Vascular Surgery, A.Z. Sint-Blasius, Dendermonde, Belgium.
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Peeters P, Verbist J, Keirse K, Deloose K, Bosiers M. Endovascular management of acute limb ischemia. J Cardiovasc Surg (Torino) 2010; 51:329-336. [PMID: 20523282] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Acute limb ischemia (ALI) refers to a rapid worsening of limb perfusion resulting in rest pain, ischemic ulcers or gangrene. With an estimated incidence of 140 million/year, ALI is serious limb-threatening and life-threatening medical emergency demanding prompt action. Three prospective, randomized clinical trials provide data on trombolytic therapy versus surgical intervention in patients with acute lower extremity ischemia. Although they did not give us the final answer, satisfactory results are reported for percutaneous thrombolysis compared with surgery. Moreover, they suggest an important advantage of thrombolysis in acute bypass graft occlusions. Therefore, we believe thrombolytic therapy should be a part of the vascular surgeon's armamentarium to safely and successfully treat ALI patients.
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Affiliation(s)
- P Peeters
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium2 Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium.
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Humar A, Lebranchu Y, Vincenti F, Blumberg EA, Punch JD, Limaye AP, Abramowicz D, Jardine AG, Voulgari AT, Ives J, Hauser IA, Peeters P. The efficacy and safety of 200 days valganciclovir cytomegalovirus prophylaxis in high-risk kidney transplant recipients. Am J Transplant 2010; 10:1228-37. [PMID: 20353469 DOI: 10.1111/j.1600-6143.2010.03074.x] [Citation(s) in RCA: 356] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Late-onset cytomegalovirus (CMV) disease is a significant problem with a standard 3-month prophylaxis regimen. This multicentre, double-blind, randomized controlled trial compared the efficacy and safety of 200 days' versus 100 days' valganciclovir prophylaxis (900 mg once daily) in 326 high-risk (D+/R-) kidney allograft recipients. Significantly fewer patients in the 200-day group versus the 100-day group developed confirmed CMV disease up to month 12 posttransplant (16.1% vs. 36.8%; p < 0.0001). Confirmed CMV viremia was also significantly lower in the 200-day group (37.4% vs. 50.9%; p = 0.015 at month 12). There was no significant difference in the rate of biopsy-proven acute rejection between the groups (11% vs. 17%, respectively, p = 0.114). Adverse events occurred at similar rates between the groups and the majority were rated mild-to-moderate in intensity and not related to study medication. In conclusion, this study demonstrates that extending valganciclovir prophylaxis (900 mg once daily) to 200 days significantly reduces the incidence of CMV disease and viremia through to 12 months compared with 100 days' prophylaxis, without significant additional safety concerns associated with longer treatment. The number needed to treat to avoid one additional patient with CMV disease up to 12 months posttransplant is approximately 5.
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Affiliation(s)
- A Humar
- Department of Medicine, University of Alberta, Edmonton, AB, Canada.
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Abstract
Drug-induced immune thrombocytopenia (DITP) can be caused by numerous drugs. When this condition develops, platelet destruction results from binding of antibodies to normal platelets only in the presence of a sensitizing drug. A recently proposed model suggests that these drug-dependent antibodies are derived from a pool of naturally occurring antibodies with weak affinity for specific epitopes on certain platelet membrane glycoproteins. We describe here a case of DITP secondary to cotrimoxazole exposure in the immediate posttransplantation phase in a renal transplant recipient. Apart from heparin-induced thrombocytopenia, DITP posttransplantation has to the best of our knowledge never been described, perhaps because of its immune-mediated origin. Our case demonstrates that DITP can occur posttransplantation, that cotrimoxazole due to its intensive use in the transplanted population is one of the most likely causative agents and that a timely recognition and treatment might have important consequences for both graft and patient.
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Affiliation(s)
- R Caluwé
- Renal Division, Department of Internal Medicine, University Hospital Gent, Belgium
| | - S Van Laecke
- Renal Division, Department of Internal Medicine, University Hospital Gent, Belgium
| | - M-P Emonds
- Laboratory for Histocompatibility and Immunogenetics, HILA Mechelen, Belgium
| | - P Peeters
- Renal Division, Department of Internal Medicine, University Hospital Gent, Belgium
| | - R Vanholder
- Renal Division, Department of Internal Medicine, University Hospital Gent, Belgium
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Bosiers M, Deloose K, Vermassen F, Schroë H, Lauwers G, Lansinck W, Peeters P. The use of the cryoplasty technique in the treatment of infrapopliteal lesions for Critical Limb Ischemia patients in a routine hospital setting: one-year outcome of the Cryoplasty CLIMB Registry. J Cardiovasc Surg (Torino) 2010; 51:193-202. [PMID: 20354489] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM It was the objective of the Cryoplasty CLIMB to evaluate the effectiveness of the PolarCath device in a standard clinical practice in the treatment of infrapopliteal lesions in critical limb ischemia patients. METHODS Between May 2007 and July 2008, 100 patients (72 years, 67%male) with CLI were enrolled in the trial for the treatment of 100 infrapopliteal stenoses or occlusions. The mean lesion length and diameter stenosis were 54.9+/-55.8 mm and 91.3+/-8.3%. Primary endpoint was defined as 12-month primary patency based on duplex. Secondary endopoints were immediate success and 12-month limb salvage and survival rate. RESULTS Multiple cryoplasty cycles were performed in 56 cases (2.1 inflations per patient) and in 4 the use of a different size balloon was required. The immediate technical success rate was 95.0% and the stent rate was 17.0%. The 12 month primary patency, limb salvage and survival rates were 55.9+/-7.4%, 93.8+/-2.5% and 81.8+/-3.9%, respectively. Stratification for lesion length did not show significant outcome differences for lesions < or =50.0 mm and those >50.0 mm neither for primary patency (P=0.94), nor for limb salvage (P=0.32). CONCLUSION The cryoplasty technique is effective for the treatment of infrapopliteal lesions in CLI patients. The results seem to be within the range of those of conventional PTA. Especially for shorter lesion (<50.0 mm), the wide-spread use of cryoplasty is not recommended. For lesions with a minimal length of 50.0 mm, the results are encouraging.
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Affiliation(s)
- M Bosiers
- Department of Vascular Surgery, AZ St-Blasius Dendermonde, Belgium.
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41
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Verhelst R, Peeters P. In Memoriam Professor Dr. André Nevelsteen. Eur J Vasc Endovasc Surg 2010. [DOI: 10.1016/j.ejvs.2010.01.007] [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: 10/19/2022]
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Bosiers M, Deloose K, Keirse K, Verbist J, Peeters P. Are drug-eluting stents the future of SFA treatment? J Cardiovasc Surg (Torino) 2010; 51:115-119. [PMID: 20081767] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Drug-eluting stent (DES) technology was developed to prevent early thrombosis and late luminal loss to potentially improve long-term patency rates. Although favorable DES results have recently become available with the Zilver PTX and STRIDES studies, the high price of DES is a major drawback for this technology to become the golden standard for peripheral endovascular therapy in de novo femoro-popliteal (FP) lesions. Nevertheless, DES has the potential to make the difference and to establish itself as an important treatment option in patients presenting with TASC C&D FP lesions who are at high-risk for surgery and for the treatment of in-stent restenosis, where until now, no valuable treatment option has proven to be beneficial.
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Affiliation(s)
- M Bosiers
- Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium.
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Peeters P, Keirse K, Verbist J, Deloose K, Bosiers M. Are bio-absorbable stents the future of SFA treatment? J Cardiovasc Surg (Torino) 2010; 51:121-124. [PMID: 20081768] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Several limitations inherent to the implantation of a metallic device, such as the occurrence of in-stent re-stenosis, in an arterial lumen intuitively explain the interest for developing bio-absorbable stents. Two main types of bio-absorbable stents currently exist: polymer stents and metallic stents. To date, no studies with bio-absorbable stents have been conducted in the superficial femoral artery (SFA). Because of their strut thickness and lack of radial force, polymer stents are no good candidates for endovascular use. Absorbable metal stents (AMS) do have the potential to perform well for artery treatment, although current evidence from in-human coronary and infrapopliteal studies yield unsatisfactory results. Drastic technological improvements are mandatory before AMS can be considered for every day practice. Yet, it is our belief that further development of other metal and non-metal bio-absorbable stents, with or without drug-coating, may lead to the creation of the ultimate SFA stent.
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Affiliation(s)
- P Peeters
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium.
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Bosiers M, Deloose K, Peeters P. Carotid endovascular interventions: patient selection, devices, techniques and tips. Minerva Cardioangiol 2010; 58:97-111. [PMID: 20145598] [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: 05/28/2023]
Abstract
The optimal treatment of patients with asymptomatic or symptomatic carotid artery disease (CAD) has been a long-lasting debate. The choice between carotid endarterectomy (CEA), carotid artery stenting (CAS) and/or optimal medical therapy to treat patients with CAD, depends on their risk profile. Recent data from EVA-3S, SPACE randomized trials failed to demonstrate non-inferiority for CAS over CEA. However, other publications suggest that with growing experience and the development of dedicated CAS technology, CAS can be performed safely and efficiently. The success of carotid stenting does not solely depend on the operator's skills and experience, but also on the adequate selection of carotid stents and cerebral protection devices. Currently, CAS practitioners are confronted with a large number of dedicated CAS devices (stents and embolic protection devices). This wide array of products makes individual treatment strategies difficult to generalise as no single device possesses all of the optimal features to treat all types of carotid plaques and patients. This article reviews the principles of patient selection and device selection in contemporary CAS practice.
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Affiliation(s)
- M Bosiers
- Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium.
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45
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Libeer F, Peeters P, Verbist J. Treatment of a left common iliac aneurysm with endovascular Powerlink stentgraft in a patient with an occlusion of a left common iliac stent. Acta Chir Belg 2009; 109:785-7. [PMID: 20184070 DOI: 10.1080/00015458.2009.11680538] [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: 10/21/2022]
Abstract
Isolated iliac aneurysms are uncommon and account for only 2% of all abdominal aneurysms. Typically, patients presenting with this pathology are operated on surgically. In our patient, however, surgery could have been an option but the patient had undergone a laparotomy more than 50 years earlier because of a gun-shot wound, so we preferred an endovascular repair. Furthermore, regular endovascular repair with a straight tube stentgraft was impossible due to the absence of a proximal neck. Consequently, we opted for placing a bifurcated stentgraft to exclude the iliac aneurysm.
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De Keyzer K, Peeters P, Verhelst C, Dendooven A, Vonck A, Vanholder R. Autoimmune haemolytic anaemia associated with a thymoma: case report and review of the literature. Acta Clin Belg 2009; 64:447-51. [PMID: 19999396 DOI: 10.1179/acb.2009.075] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [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: 12/18/2022]
Abstract
A 67-year-old female presents with a small mass in the anterior mediastinum on chest computed tomography. A biopsy proves the mass to be a spindle-cell-type or type A thymoma. Subsequently the patient develops fever and severe Coombs-positive haemolytic anaemia. She is initially treated with oral corticosteroids. Because of persistence of the haemolysis subsequent thymectomy is performed. Haemolysis disappears almost instantly and does not return after discontinuation of the oral corticosteroids. Review of the literature reveals only 17 other cases of thymoma-associated autoimmune haemolytic anaemia.
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Affiliation(s)
- K De Keyzer
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium.
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47
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Peeters P, Vlaeyen J. 329 THE PERCEPTION THAT ANOTHER INDIVIDUAL HAS CONTROL OVER THE PAIN STIMULI ALTERS THE IMPACT OF PAIN CATASTROPHIZING ON PAIN EXPRESSION. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60332-3] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- P. Peeters
- Maastricht University, Maastricht, Netherlands
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Van Laecke S, Van Biesen W, Verbeke F, De Bacquer D, Peeters P, Vanholder R. Posttransplantation hypomagnesemia and its relation with immunosuppression as predictors of new-onset diabetes after transplantation. Am J Transplant 2009; 9:2140-9. [PMID: 19624560 DOI: 10.1111/j.1600-6143.2009.02752.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
New-onset diabetes after transplantation (NODAT) is a frequent complication and has an impact on patient and graft survival. Hypomagnesemia is common in both renal transplant recipients and in diabetics. This study examines the relationship between hypomagnesemia, NODAT and the type of immunosuppression in renal transplant recipients. We conducted a retrospective single-center analysis (2002-2008) in order to assess NODAT the first year posttransplantation as defined by American Diabetes Association criteria. Serum magnesium (Mg) levels were defined as the median of all Mg levels registered during the first month posttransplantation. Patients with NODAT (N = 75; 29.5%) versus non-NODAT had lower Mg levels (p < 0.001). Patients with an Mg level < versus > or = 1.9 mg/dL showed a faster development of NODAT (log-rank p < 0.001). Mg levels were lower in patients on calcineurin inhibitors (CNI) versus no CNI patients (p < 0.001). Mg levels, albumin, BMI, triglycerides, posttransplantation hyperglycemia, tacrolimus levels and the use of sirolimus were predictors of NODAT in the multivariate analysis. Hypomagnesemia was an independent predictor of NODAT in renal transplant recipients. We confirm that the use of CNI is associated with NODAT, but, to a large extent, this effect seems attributable to the induction of hypomagnesemia. After adjustment for Mg, sirolimus was also associated with NODAT.
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Affiliation(s)
- S Van Laecke
- Renal Division, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
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Peeters P, Keirse K, Verbist J, Deloose K, Bosiers M. Other endovascular methods of treating the diabetic foot. J Cardiovasc Surg (Torino) 2009; 50:313-321. [PMID: 19543191] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Critical limb ischemia (CLI) is an endstage manifestation of peripheral artery disease (PAD) and typically describes patients with ischemic rest pain (Rutherford Category 4), or patients with ischemic skin lesions, either ulcers or gangrene (Rutherford Category 5-6). CLI due to infrapopliteal lesions is often not a good indication for infrageniculate bypass surgery placement, due to the presence of prohibitive comorbidities, inadequate conduit, and lack of suitable distal targets for revascularization. Therefore, CLI patients due to blockage of below-the-knee arteries are in benefit of the endovascular approach. Infrapopliteal PTA became feasible with the introduction of low-profile peripheral balloon systems and the use of coronary balloons. Stent implantation, however, is generally reserved for cases with a suboptimal outcome after PTA (i.e. >50% residual stenosis, flow-limiting dissection). Because of the fear that early thrombosis and late luminal loss due to intimal hyperplasia formation will potentially lead to insufficient long-term patency rates, efforts to extend the range of endovascular approaches to CLI are presently focused on. Cryoplasty, scoring balloon angioplasty, excimer laser therapy and atherectomy using different types of atherectomy devices have been introduced. The current article provides an overview of the endovascular treatment strategies for infrapopliteal lesions in patients with CLI.
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Affiliation(s)
- P Peeters
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium.
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Peeters P, Depré G, Rickaert F, Coremans-Pelseneer J, Serruys E. Disseminated African Histoplasmosis in a White Heterosexual Male Patient with the Acquired Immune Deficiency Syndrome/Disseminierte Afrikanische Histoplasmose bei einem weißen Heterosexuellen mit AIDS. Mycoses 2009. [DOI: 10.1111/j.1439-0507.1987.tb03829.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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