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Gerasimenko A, Mignot C, Naggara O, Coulet F, Ekram S, Heide S, Sorato C, Mazowiecki M, Perrin L, Colas C, Cusin V, Caux F, Dardenne A, El Chehadeh S, Verloes A, Maurey H, Afenjar A, Petit F, Barete S, Boespflug-Tanguy O, Bourrat E, Capri Y, Ciorna V, Deb W, Doummar D, Perrier A, Guédon A, Houdart E, Isidor B, Jacquemont ML, Buffet C, Mercier S, Passemard S, Riquet A, Ruaud L, Schaefer E, Heron D, Bisdorff A, Benusiglio PR. Cerebral dural arteriovenous fistulas in patients with PTEN-related hamartoma tumor syndrome. Clin Genet 2024. [PMID: 38424388 DOI: 10.1111/cge.14515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
Central nervous system (CNS) dural arteriovenous fistulas (DAVF) have been reported in PTEN-related hamartoma tumor syndrome (PHTS). However, PHTS-associated DAVF remain an underexplored field of the PHTS clinical landscape. Here, we studied cases with a PTEN pathogenic variant identified between 2007 and 2020 in our laboratory (n = 58), and for whom brain imaging was available. Two patients had DAVF (2/58, 3.4%), both presenting at advanced stages: a 34-year-old man with a left lateral sinus DAVF at immediate risk of hemorrhage, and a 21-year-old woman with acute intracranial hypertension due to a torcular DAVF. Interestingly, not all patients had 3D TOF/MRA, the optimal sequences to detect DAVF. Early diagnosis of DAVF can be lifesaving, and is easier to treat compared to developed, proliferative, or complex lesions. As a result, one should consider brain MRI with 3D TOF/MRA in PHTS patients at genetic diagnosis, with subsequent surveillance on a case-by-case basis.
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Affiliation(s)
- Anna Gerasimenko
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Hôpital la Pitié Salpêtrière, Paris, France
- APHP.Sorbonne Université, GH Pitié Salpêtrière et Trousseau, Service de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Cyril Mignot
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Hôpital la Pitié Salpêtrière, Paris, France
- APHP.Sorbonne Université, GH Pitié Salpêtrière et Trousseau, Service de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Olivier Naggara
- Université Paris Cité, INSERM UMR 1266 IMA-BRAIN, GHU Paris, Service de Neuroradiologie, Paris, France
- APHP.Université Paris Cité, Institut Imagine, INSERM U1000, Hôpital Necker - Enfants Malades, Service de Radiologie Pédiatrique UMR 1163, Paris, France
- APHP.Université Paris Cité, Centre Français pour les AVC Pédiatriques, INSERM U894, Paris, France
| | - Florence Coulet
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France
- Département de Génétique Médicale, APHP.Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Samar Ekram
- Department of Medical Genetics, College of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Solveig Heide
- APHP.Sorbonne Université, GH Pitié Salpêtrière et Trousseau, Service de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Clarisse Sorato
- APHP.Sorbonne Université, GH Pitié Salpêtrière et Trousseau, Service de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Maxime Mazowiecki
- APHP.Sorbonne Université, GH Pitié Salpêtrière et Trousseau, Service de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Laurence Perrin
- APHP.Université Paris Cité, Hôpital Robert-Debré, Service de Génétique, Paris, France
| | - Chrystelle Colas
- Université Paris Sciences Lettres, Institut Curie, Service de Génétique, Paris, France
| | - Veronica Cusin
- Département de Génétique Médicale, APHP.Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Frédéric Caux
- GH Paris Seine-Saint-Denis, INSERM UMR1125, Service de Dermatologie, Bobigny, France
| | - Antoine Dardenne
- APHP.Sorbonne Université, Hôpital Saint-Antoine, Oncologie Gigestive, Paris, France
| | - Salima El Chehadeh
- Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Institut de Génétique Médicale d'Alsace (IGMA), Service de Génétique Médicale, Strasbourg, France
| | - Alain Verloes
- APHP.Université Paris Cité, Hôpital Robert-Debré, Service de Génétique, Paris, France
- INSERM U1141, Hôpital Robert-Debré, Paris, France
| | - Hélène Maurey
- Hôpitaux Universitaires Paris Saclay, Hôpital Bicêtre, Centre National de Référence pour les Maladies Rares du Cerveau et de la Moelle Épinière, Service de Neurologie Pédiatrique, Le Kremlin Bicêtre, France
| | - Alexandra Afenjar
- Groupe d'Étude Interdisciplinaire pour les Malformations Vasculaires, Hôpitaux Lariboisière, Bichat, Saint-Joseph, Clinique Alma, Paris, France
| | - Florence Petit
- APHP.Sorbonne Université, GH Trousseau, Département de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Stéphane Barete
- Université de Lille, ULR7364 RADEME, CHU Lille, Clinique de Génétique, Guy Fontaine, Lille, France
| | - Odile Boespflug-Tanguy
- APHP.Sorbonne Université, GH Pitié-Salpêtrière, Service de Dermatologie, Paris, France
- APHP.Université Paris Cité, Hôpital Robert Debré, Service de Neuropédiatrie, Paris, France
| | | | - Yline Capri
- APHP.Université Paris Cité, Hôpital Robert-Debré, Service de Génétique, Paris, France
| | - Viorica Ciorna
- Hôpital-Saint Louis, CRMR MAGEC Nord St Louis, Service de Dermatologie, Paris, France
| | - Wallid Deb
- CHR Metz-Thionville, Service de Génétique, Metz, France
| | - Diane Doummar
- CHU Nantes, Service de Génétique Médicale, Nantes, France
| | - Alexandre Perrier
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France
- Département de Génétique Médicale, APHP.Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Alexis Guédon
- APHP.Sorbonne Université, CHU Armand Trousseau, Service de Neuropédiatrie-Pathologie du développement, Centre de Référence Maladies Rares Neurogénétiques, Paris, France
| | - Emmanuel Houdart
- APHP.Sorbonne Université, CHU Armand Trousseau, Service de Neuropédiatrie-Pathologie du développement, Centre de Référence Maladies Rares Neurogénétiques, Paris, France
| | | | - Marie-Line Jacquemont
- APHP.Université Paris Cité, Service de Neuroradiologie Diagnostique et Interventionnelle, CHU Lariboisière, Paris, France
| | - Camille Buffet
- Service de Génétique Médicale, CHU Ste-Justine, Montréal, Canada
| | | | - Sandrine Passemard
- APHP.Sorbonne Université, Service de pathologies Thyroïdiennes et Tumorales Endocrines, Hôpital La Pitié-Salpêtrière, Paris, France
| | - Audrey Riquet
- APHP.Université Paris Cité, Inserm UMR 1141, NeuroDiderotFrance, Hôpital Robert Debré, Service de Neurologie Pédiatrique, DMU INOV-RDB, Paris, France
| | - Lyse Ruaud
- APHP.Université Paris Cité, Hôpital Robert-Debré, Service de Génétique, Paris, France
- INSERM U1141, Hôpital Robert-Debré, Paris, France
| | - Elise Schaefer
- Département de Neurologie Pédiatrique, GHICL, Hôpital Saint Vincent de Paul, Lille, France
| | - Delphine Heron
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Hôpital la Pitié Salpêtrière, Paris, France
- APHP.Sorbonne Université, GH Pitié Salpêtrière et Trousseau, Service de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Annouk Bisdorff
- APHP.Sorbonne Université, CHU Armand Trousseau, Service de Neuropédiatrie-Pathologie du développement, Centre de Référence Maladies Rares Neurogénétiques, Paris, France
- CHU de Strasbourg, Service de Génétique Médicale, IGMA, Strasbourg, France
| | - Patrick R Benusiglio
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France
- Département de Génétique Médicale, APHP.Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
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Dabala E, Guédon A, Ficheux G, Béal L, Moxham B, Plaisant O. Homologies of spinal ascending nociceptive pathways between rats and macaques: can we transpose to human? A review and analysis of the literature. Surg Radiol Anat 2023; 45:1443-1460. [PMID: 37507602 DOI: 10.1007/s00276-023-03212-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE Due to the difficulty of using neural tracers in humans, knowledge of the nociceptive system's anatomy is mainly derived from studies in animals and mainly in rats. The aim of this study was to investigate the morphological differences of the ascending spinal nociceptive pathways between the rat and the macaque monkey; in order to evaluate the variability of this anatomy during phylogenesis, and thus to know if the anatomical description of these pathways can be transposed from the rat to the human. METHODS A review and analysis of the literature were performed. The criteria used for comparison were: origins, pathways, their terminations in target structures, and projections from target structures of ascending spinal nociceptive pathways. The monkey was used as an intermediate species for comparison because of the lack of data in humans. The hypothesis of transposition of anatomy between rat and human was considered rejected if differences were found between rat and monkey. RESULTS An anatomical difference in termination was found for the spino-annular or spino-periaqueductal grey (spino-PAG) pathway and transposition of its anatomy from rat to human was rejected. No difference was found in other pathways and the transposition of their anatomy from rat to human was therefore, not rejected. CONCLUSION This work highlights the conservation of most of the ascending spinal nociceptive pathways' anatomy between rat and monkey. Thus, the possibility for a transposition of their anatomy between rat and human is not rejected.
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Affiliation(s)
- Eric Dabala
- Department of Anatomy, Université Catholique de Lille, Lille, France.
- Université Paris Cité, Paris, France.
| | - Alexis Guédon
- Université Paris Cité, Paris, France
- Department of Interventional Neuroradiology, INSERM UMR_S 1140, Lariboisière Hospital, AP-HP Nord, Paris, France
| | - Guillaume Ficheux
- Department of Anatomy, Université Catholique de Lille, Lille, France
| | - Louis Béal
- Department of Anatomy, Université Catholique de Lille, Lille, France
| | - Bernard Moxham
- Cardiff School of Biosciences, Cardiff University, Cardiff, CF10 3AX, UK
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Guetarni Z, Bernard R, Boulouis G, Labeyrie MA, Biondi A, Velasco S, Saliou G, Bartolini B, Daumas-Duport B, Bourcier R, Janot K, Herbreteau D, Michelozzi C, Premat K, Redjem H, Escalard S, Bricout N, Thouant P, Arteaga C, Pierot L, Tahon F, Boubagra K, Ikka L, Chabert E, Lenck S, Guédon A, Consoli A, Saleme S, Forestier G, Di Maria F, Ferré JC, Anxionnat R, Eugene F, Kerleroux B, Dargazanli C, Sourour NA, Clarençon F, Shotar E. Longitudinal radiological follow-up of individual level non-ischemic cerebral enhancing lesions following endovascular aneurysm treatment. J Neurointerv Surg 2023:jnis-2023-020060. [PMID: 37770183 DOI: 10.1136/jnis-2023-020060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/07/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Non-ischemic cerebral enhancing (NICE) lesions following aneurysm endovascular therapy are exceptionally rare, with unknown longitudinal evolution. OBJECTIVE To evaluate the radiological behavior of individual NICE lesions over time. METHODS Patients included in a retrospective national multicentric inception cohort were analyzed. NICE lesions were defined, using MRI, as delayed onset punctate, nodular, or annular foci enhancements with peri-lesion edema, distributed in the vascular territory of the aneurysm treatment, with no other confounding disease. Lesion burden and the longitudinal behavior of individual lesions were assessed. RESULTS Twenty-two patients were included, with a median initial lesion burden of 36 (IQR 17-54) on the first MRI scan. Of the 22 patients with at least one follow-up MRI scan, 16 (73%) had new lesions occurring mainly within the first 200 weeks after the date of the procedure. The median number of new lesions per MRI was 6 (IQR 2-16). Among the same 22 patients, 7 (32%) had recurrent lesions. The median persistent enhancement of a NICE lesion was 13 weeks (IQR 6-30). No factor was predictive of early regression of enhancement activity with lesion regression kinetics mainly being patient-dependent. CONCLUSIONS The behavior of individual NICE lesions was found to be highly variable with an overall patient-dependent regression velocity.
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Affiliation(s)
- Zakaria Guetarni
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Remy Bernard
- Department of Neurosurgical Anesthesiology and Intensive Care, Pitié-Salpêtrière Hospital, Paris, France
| | - Grégoire Boulouis
- Department of Interventional Neuroradiology, CHU de Tours, Tours, France
| | | | - Alessandra Biondi
- Department of Interventional Neuroradiology, Besançon University Hospital, Besancon, France
| | - Stéphane Velasco
- Department of Interventional Neuroradiology, CHU de Poitiers, Poitiers, France
| | - Guillaume Saliou
- Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Bruno Bartolini
- Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Benjamin Daumas-Duport
- Department of Interventional Neuroradiology, University Hospital of Nantes, Nantes, France
| | - Romain Bourcier
- Department of Interventional Neuroradiology, University Hospital of Nantes, Nantes, France
| | - Kevin Janot
- Department of Interventional Neuroradiology, CHU de Tours, Tours, France
| | - Denis Herbreteau
- Department of Interventional Neuroradiology, CHU de Tours, Tours, France
| | - Caterina Michelozzi
- Department of Interventional Neuroradiology, Michallon Hospital, La Tronche, France
| | - Kevin Premat
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Hocine Redjem
- Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France
| | - Simon Escalard
- Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France
| | - Nicolas Bricout
- Department of interventional Neuroradiology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Pierre Thouant
- Department of Neuroradiology, F Mitterand Hospital, Dijon, France
| | - Charles Arteaga
- Radiology Department, Hôpital d'Instruction des Armées Sainte-Anne Bibliothèque, Toulon, Provence-Alpes-Côte d'Azu, France
| | - Laurent Pierot
- Department of Interventional Neuroradiology, University Hospital Reims, Reims, France
| | - Florence Tahon
- Department of Neuroradiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Kamel Boubagra
- Department of Neuroradiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Leon Ikka
- Department of Interventional Neuroradiology, Bicetre Hospital, Le Kremlin Bicetre, France
| | - Emmanuel Chabert
- Department of Neuroradiology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Stephanie Lenck
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Alexis Guédon
- Department of Interventional Neuroradiology, Hopital Lariboisiere, Paris, France
| | - Arturo Consoli
- Diagnostic and Therapeutic Neuroradiology Department, Hopital Foch, Suresnes, Île-de-France, France
| | - Suzana Saleme
- Department of Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Géraud Forestier
- Department of Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Federico Di Maria
- Diagnostic and Therapeutic Neuroradiology Department, Hopital Foch, Suresnes, Île-de-France, France
| | | | - René Anxionnat
- Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, Lorraine, France
| | - Francois Eugene
- Department of Neuroradiology, University Hospital of Rennes, Rennes, France
| | - Basile Kerleroux
- Department of Interventional Neuroradiology, Saint Anne Hospital Centre, Paris, France
| | - Cyril Dargazanli
- Department of Neuroradiology, University Hospital Centre Montpellier, Montpellier, Occitanie, France
| | - Nader-Antoine Sourour
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Frédéric Clarençon
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Eimad Shotar
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
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Guédon A, Checkouri T, Fantoni M, Civelli V, Labeyrie MA, Saint-Maurice JP, Vallée F, Houdart E. Blood Flow Velocity: a Decision Tool for Stenting Indication in Venous Pulsatile Tinnitus. Clin Neuroradiol 2023; 33:729-737. [PMID: 36856788 DOI: 10.1007/s00062-023-01268-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 01/24/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND AND PURPOSE Lateral sinus stenosis is the most common cause of venous pulsatile tinnitus (VPT). Stenting is an effective treatment after demonstration of a trans-stenotic pressure gradient; however, pressure measurement has many technical limitations. In 2018, a study showed that a combined approach with intravascular velocity measurement could be effective in identifying most appropriate candidates for stenting. The aim of the present study was to evaluate a new strategy using this biomarker for the indication of stenting even without a significant pressure gradient. MATERIAL AND METHODS Consecutive patients with disabling VPT were included from 2016 to 2019 and analyzed retrospectively. Intrasinusal pressures were measured and blood flow velocities (with a dual-sensor guidewire) were used for the indication of stenting independent of the pressure gradient. We evaluated the clinical outcome after stenting based on this new biomarker. RESULTS A total of 41 patients were treated according to this strategy. At last follow-up (mean = 30.2 months), 32/33 patients (97%) treated by stenting showed complete resolution or a significant decrease in VPT intensity. The use of velocity as the threshold for indicating stenting identified 8 patients (24%) missed by the pressure gradient. Their clinical outcome after stenting was excellent and no complications occurred. CONCLUSION Measurement of sinus blood flow velocity provides a hemodynamic explanation of disease and may be a better tool than pressure gradient for the indication of stenting in VPT.
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Affiliation(s)
- Alexis Guédon
- Department of Neuroradiology, AP-HP, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France.
- School of Medicine, Université Paris Cité, 75006, Paris, France.
- Inserm, UMR_S 1140, Université Paris Cité, 75006, Paris, France.
| | - Thomas Checkouri
- Department of Neuroradiology, AP-HP, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Matteo Fantoni
- Department of Neuroradiology, AP-HP, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Vittorio Civelli
- Department of Neuroradiology, AP-HP, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Marc-Antoine Labeyrie
- Department of Neuroradiology, AP-HP, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Jean-Pierre Saint-Maurice
- Department of Neuroradiology, AP-HP, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Fabrice Vallée
- Department of Anesthesiology and Critical Care, AP-HP, Lariboisière Hospital, 75010, Paris, France
- Inserm, UMR_S 942, Université Paris Cité, 75006, Paris, France
- LMS Polytechnique and M3DISIM, Inria, Paris-Saclay University, CEA, Palaiseau, France
| | - Emmanuel Houdart
- Department of Neuroradiology, AP-HP, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
- School of Medicine, Université Paris Cité, 75006, Paris, France
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Janot K, Charbonnier G, Marnat G, Sporns P, Burel J, Papagiannaki C, Forestier G, Hak JF, Agripnidis T, Bolognini F, Lebedinsky PA, Ifergan H, Bibi R, Herbreteau D, Adeniran Bankole ND, Biondi A, Barreau X, Guédon A, Shotar E, Clarençon F, Kerleroux B, Boulouis G, Bala F, Rouchaud A. Persistent flow inside the Woven EndoBridge at angiographic follow-up: A multicenter study. Interv Neuroradiol 2023:15910199231185805. [PMID: 37403459 DOI: 10.1177/15910199231185805] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The occurrence of persistent intra-device filling (BOSS 1, using the Bicêtre Occlusion Scale Score (BOSS)) in aneurysms treated with a Woven Endobridge (WEB) device is infrequent based on angiographic follow-up. To date, three monocentric case series were published studying BOSS 1 cases. Through a multicenter retrospective study, we aimed to report the incidence, and risk factors of intra-WEB persistent filling. METHODS We reached out to European academic centers that treat patients using WEB devices and requested de-identified data of patients treated with a WEB device and underwent angiographic follow-up, at least 3 months after embolization, to assess the BOSS 1 occlusion score. We compared baseline characteristics, treatment modalities, and aneurysm data of the included BOSS 1 patients with those of a control group consisting of non-BOSS 1 patients (n = 116) who had an available angiographic follow-up. Univariable and multivariable models were employed for analysis. RESULTS Among the pooled sample of 591 aneurysms treated with WEB, the rate of persistent flow (BOSS 1) at angiographic follow-up was 5.2% (n = 31 out of 591), performed after an average of 8.7 ± 6.3 months. In the multivariable-adjusted analysis, dual antiplatelet therapy in the postoperative period (adjusted odds ratio [aOR] 4.3 [95% CI 1.3-14.2]), and WEB undersizing (aOR 10.8 [95% CI 2.9-40]) were independently associated with a BOSS 1 persistent flow result. CONCLUSION Persistent blood flow within the WEB device during angiographic follow-up (BOSS 1) is an uncommon occurrence. Our findings indicate that post-procedural dual antiplatelet therapy and undersizing of the WEB device are independently associated with the presence of BOSS 1 at follow-up.
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Affiliation(s)
- Kevin Janot
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Guillaume Charbonnier
- Interventional Neuroradiology Department, University Hospital of Besançon, Besançon, France
| | - Gaultier Marnat
- Diagnostic and Interventional Neuroradiology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Peter Sporns
- Interventional Neuroradiology Department, University Hospital of Basel, Basel, Switzerland
- Interventional Neuroradiology Department, University Medical Center of Hamburg-Eppendorf, Hamburg, Germany
| | - Julien Burel
- Interventional Neuroradiology Department, University Hospital of Rouen, Rouen, France
| | | | - Geraud Forestier
- Interventional Neuroradiology Department, University Hospital of Limoges, Limoges, France
| | - Jean-Francois Hak
- Interventional Neuroradiology Department, University Hospital of Marseille, Marseille, France
| | - Thibault Agripnidis
- Interventional Neuroradiology Department, University Hospital of Marseille, Marseille, France
| | | | | | - Heloise Ifergan
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Richard Bibi
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Denis Herbreteau
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | | | - Alessandra Biondi
- Interventional Neuroradiology Department, University Hospital of Besançon, Besançon, France
| | - Xavier Barreau
- Diagnostic and Interventional Neuroradiology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Alexis Guédon
- Interventional Neuroradiology Department, Lariboisière Hospital, Paris, France
| | - Eimad Shotar
- Neuroradiology Department, Pitié Salpêtrière Hospital, Paris, France
| | | | - Basile Kerleroux
- Interventional Neuroradiology Department, Saint Anne Hospital, Paris, France
| | - Grégoire Boulouis
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Fouzi Bala
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Aymeric Rouchaud
- Interventional Neuroradiology Department, University Hospital of Limoges, Limoges, France
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Henderson D, Bichoutar I, Moxham B, Faidherbe V, Plaisant O, Guédon A. Descriptive and functional anatomy of the Heschl Gyrus: historical review, manual labelling and current perspectives. Surg Radiol Anat 2023; 45:337-350. [PMID: 36859607 DOI: 10.1007/s00276-023-03114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 02/16/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE The Heschl Gyrus (HG), which includes the Primary Auditory Cortex (PAC), lies on the upper surface of the superior temporal gyrus (T1). It has been the subject of growing interest in the fields of neuroscience over the past decade. Given the considerable interhemispheric and interindividual variability of its morphology, manual labelling remains the gold standard for its radio-anatomical study. The aim of this study was to revisit the original work of Richard L. Heschl, to provide a broad overview of the available anatomical knowledge and to propose a manually labelled 3D digital model. METHODS We reviewed existing works on the HG, from Heschl's original publication of 1878, Dejerine neuroanatomical atlas of 1895 to the most recent digital atlases (Julich-Brain Cytoarchitectonic Atlas, the Human Connectome Project). Our segmentation work was based on data from the BigBrain Project and used the MRIcron 2019 software. RESULTS The original publication by Heschl has been translated into French and English. We propose a correspondence of previous nomenclatures with the most recent ones, including the Terminologia Neuroanatomica. Finally, despite the notable anatomical variability of the HG, clear and coherent segmentation criteria allowed us to generate a 3D digital model of the HG. DISCUSSION AND CONCLUSION Heschl's work is still relevant and could impulse further anatomical and functional studies. The segmentation criteria could serve as a reference for manual labelling of the HG. Furthermore, a thorough, and historically based understanding of the morphological, microstructural and functional characteristics of the HG could be useful for manual segmentation.
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Affiliation(s)
| | - Ihsane Bichoutar
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich, Jülich, Germany
| | - Bernard Moxham
- Cardiff School of Biosciences, Cardiff University, Cardiff, Wales, UK
- Trans-European Anatomical Pedagogic Research Group (TEPARG), Barcelona, Spain
| | | | - Odile Plaisant
- Université Paris Cité, F-75006, Paris, France
- Trans-European Anatomical Pedagogic Research Group (TEPARG), Barcelona, Spain
| | - Alexis Guédon
- Université Paris Cité, F-75006, Paris, France.
- Trans-European Anatomical Pedagogic Research Group (TEPARG), Barcelona, Spain.
- Department of Interventional Neuroradiology, AP-HP Nord, Lariboisière Hospital, 2 rue Ambroise Paré, 75010, Paris, France.
- Université Paris Cité, Inserm, UMR_S 1140, Innovative Therapies in Haemostasis, F-75006, Paris, France.
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7
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Guédon A, Eliezer M, Houdart E. Venous Pulsatile Tinnitus: Turbulence or Dehiscence? : A New Endovascular Treatment of a Dehiscent Diploic Vein. Clin Neuroradiol 2022; 32:1131-1134. [PMID: 35391550 DOI: 10.1007/s00062-022-01159-w] [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: 12/24/2021] [Accepted: 03/07/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Alexis Guédon
- Department of Neuroradiology, Lariboisière Hospital, 2 rue Ambroise Paré, Paris, France. .,University of Paris Cité, Paris, France. .,INSERM UMR_S 1140, University of Paris Cité, Paris, France.
| | - Michael Eliezer
- Department of Neuroradiology, Lariboisière Hospital, 2 rue Ambroise Paré, Paris, France
| | - Emmanuel Houdart
- Department of Neuroradiology, Lariboisière Hospital, 2 rue Ambroise Paré, Paris, France.,University of Paris Cité, Paris, France
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8
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Lognon P, Gariel F, Marnat G, Darcourt J, Constant Dit Beaufils P, Burel J, Shotar E, Hak JF, Fauché C, Kerleroux B, Guédon A, Ognard J, Forestier G, Pop R, Paya C, Veyrières JB, Sporns P, Girot JB, Zannoni R, Zhu F, Crespy A, L'Allinec V, Mihoc D, Rouchaud A, Gentric JC, Ben Hassen W, Raynaud N, Testud B, Clarençon F, Kaczmarek B, Bourcier R, Bellanger G, Boulouis G, Janot K. Prospective assessment of aneurysmal rupture risk scores in patients with subarachnoid hemorrhage: a multicentric cohort. Neuroradiology 2022; 64:2363-2371. [PMID: 35695927 DOI: 10.1007/s00234-022-02987-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/20/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE The natural evolution of unruptured intracranial aneurysms (UIA) is indeed difficult to predict at the individual level. OBJECTIVE In a large prospective multicentric European cohort, we aimed to evaluate whether the PHASES, UCAS, and ELPASS scores in patients with aneurysmal subarachnoid hemorrhage would have predicted a high risk of aneurysmal rupture or growth. METHODS Academic centers treating patients with intracranial aneurysms were invited to prospectively collect de-identified data from all patients admitted at their institution for a subarachnoid hemorrhage-related to intracranial aneurysmal rupture between January 1 and March 31, 2021 through a trainee-led research collaborative network. Each responding center was provided with an electronic case record form (CRF) which collected all the elements of the PHASES, ELAPSS, and UCAS scores. RESULTS A total of 319 patients with aneurysmal subarachnoid hemorrhage were included at 17 centers during a 3-month period. One hundred eighty-three aneurysms (57%) were less than 7 mm. The majority of aneurysms were located on the anterior communicating artery (n = 131, 41%). One hundred eighty-four patients (57%), 103 patients (32%), and 58 (18%) were classified as having a low risk of rupture or growth, according to the PHASES, UCAS, and ELAPSS scores, respectively. CONCLUSION In a prospective study of European patients with aneurysmal subarachnoid hemorrhage, we showed that 3 common risk-assessment tools designed for patients with unruptured intracranial aneurysms would have not identified most patients to be at high or intermediate risk for rupture, questioning their use for decision-making in the setting of unruptured aneurysms.
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Affiliation(s)
- P Lognon
- University Hospital of Tours, Tours, France
| | - F Gariel
- University Hospital of Bordeaux, Bordeaux, France
| | - G Marnat
- University Hospital of Bordeaux, Bordeaux, France
| | - J Darcourt
- University Hospital of Toulouse, Toulouse, France
| | - P Constant Dit Beaufils
- L'institut du Thorax, University of Nantes, INSERM, CNRS, Nantes, France.,University Hospital of Nantes, Nantes, France
| | - J Burel
- University Hospital of Rouen, Rouen, France
| | - E Shotar
- Pitié Salpêtrière Hospital, Paris, France
| | - J F Hak
- University Hospital of Marseille, Marseille, France
| | - C Fauché
- University Hospital of Poitiers, Poitiers, France
| | | | - A Guédon
- Lariboisière Hospital, Paris, France
| | - J Ognard
- University Hospital of Brest, Brest, France
| | - G Forestier
- University Hospital of Limoges, Limoges, France
| | - R Pop
- University Hospital of Strasbourg, Strasbourg, France
| | - C Paya
- University Hospital of Saint-Pierre, Saint-Pierre, La Réunion, France
| | - J B Veyrières
- University Hospital of Saint-Pierre, Saint-Pierre, La Réunion, France
| | - P Sporns
- University Hospital of Basel, Basel, Switzerland.,University Medical Center of Hamburg-Eppendorf, Hamburg, Germany
| | - J B Girot
- University Hospital of Angers, Angers, France
| | - R Zannoni
- University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F Zhu
- University Hospital of Nancy, Nancy, France
| | - A Crespy
- University Hospital of Tours, Tours, France
| | - V L'Allinec
- University Hospital of Angers, Angers, France
| | - D Mihoc
- University Hospital of Strasbourg, Strasbourg, France
| | - A Rouchaud
- University Hospital of Limoges, Limoges, France
| | | | | | - N Raynaud
- University Hospital of Poitiers, Poitiers, France
| | - B Testud
- University Hospital of Marseille, Marseille, France
| | | | | | - R Bourcier
- L'institut du Thorax, University of Nantes, INSERM, CNRS, Nantes, France.,University Hospital of Nantes, Nantes, France
| | - G Bellanger
- University Hospital of Toulouse, Toulouse, France
| | - G Boulouis
- University Hospital of Tours, Tours, France
| | - Kevin Janot
- University Hospital of Tours, Tours, France.
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9
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Détriché G, Guédon A, Mohamedi N, Sellami O, Cheng C, Galloula A, Goudot G, Khider L, Mortelette H, Sitruk J, Gendron N, Sapoval M, Julia P, Smadja DM, Mirault T, Messas E. Women Specific Characteristics and 1-Year Outcome Among Patients Hospitalized for Peripheral Artery Disease: A Monocentric Cohort Analysis in a Tertiary Center. Front Cardiovasc Med 2022; 9:824466. [PMID: 35198617 PMCID: PMC8858944 DOI: 10.3389/fcvm.2022.824466] [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: 11/29/2021] [Accepted: 01/17/2022] [Indexed: 12/24/2022] Open
Abstract
Although women have lower age-standardized cardiovascular disease incidence, prevalence, and death-related rates than men, there are also reports indicating that women with cardiovascular disease receive less care, fewer investigations, and have poorer outcomes after a coronary event. The aims of this study were to compare the characteristics of men and women hospitalized for peripheral artery disease (PAD), their cardiovascular and limb outcomes, and their 1-year mortality. The study is a prospective registry collecting data about all consecutive patients hospitalized for PAD within the vascular department of the tertiary center Georges-Pompidou European Hospital (Paris, France). Patients were required to have one of three inclusion criteria: previous revascularization of the lower limb or any lower limb artery occlusion due to an atherosclerotic vascular disease or hemodynamic evidence of PAD. Exclusion criteria were patients with lower extremity arterial occlusion due to another cause. All patients were followed-up for at least 12 months after the initial hospitalization. Among the 235 patients included, there were 61 women (26%), older than men with a median age of 75.6 and 68.3 years, respectively. Main cardiovascular risk factors and comorbidities were similar for men and women except more former or current smokers [145 (83.4%) vs. 33 (54.1%)] and more history of coronary heart disease [42 (24.1%) vs. 7 (11.5%)] in men. Most patients [138 (58.8%)] had critical limb ischemia and 97 (41.3%) had claudication, with no difference for sex. After discharge, 218 patients received an antithrombotic therapy (93.2%), 195 a lipid-lowering drug (83.3%), 185 an angiotensin converting enzyme inhibitor or angiotensin-receptor blocker (78.9%), similarly between sex. At 1-year, overall mortality, major adverse cardiovascular events, major adverse limb events did not differ with 23 (13.2%), 11 (6.3%) and 32 (18.4%) in men, and 8 (13.1%), 3 (4.9%), 15 (24.6%) in women, respectively, despite the difference in age. Overall mortality, cardiovascular outcomes, limb revascularization or amputation did not differ between men and women, 1-year after hospitalization for PAD although the latter were older, less smoker and had less coronary artery disease. Due to the small size of this cohort, larger studies and future research are needed to better understand sex-specific mechanisms in the pathophysiology and natural history of PAD.
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Affiliation(s)
- Grégoire Détriché
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- *Correspondence: Grégoire Détriché
| | - Alexis Guédon
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Nassim Mohamedi
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Olfa Sellami
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Charles Cheng
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Alexandre Galloula
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Guillaume Goudot
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
| | - Lina Khider
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
| | - Hélène Mortelette
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Jonas Sitruk
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Nicolas Gendron
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- Hematology Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Marc Sapoval
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
- Interventional Radiology Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Universit de Paris (APHP-CUP), Paris, France
| | - Pierre Julia
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
- Vascular Surgery Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - David M. Smadja
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- Hematology Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Tristan Mirault
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
| | - Emmanuel Messas
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
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10
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Aubertin M, Jourdaine C, Thépenier C, Labeyrie MA, Civelli V, Saint-Maurice JP, Guédon A, Houdart E. Results of watchful waiting of unruptured intracranial aneurysms in a Western patient population: a single-center cohort. J Neurointerv Surg 2021; 14:1102-1106. [PMID: 34740987 DOI: 10.1136/neurintsurg-2021-018151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/25/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND The natural history of unruptured intracranial aneurysms (UIAs) in Western populations is still debated, especially for those <7 mm. Reporting data of a large single-center cohort managed with watchful waiting is therefore interesting. METHODS From January 2011 to June 2019, 662 UIAs were followed up by yearly MR angiography. Morphologically stable UIAs were managed conservatively while unstable UIAs were offered treatment. The patients' clinical and radiological data were analyzed retrospectively. RESULTS UIAs were ≤4 mm in 60%, 4.1-7.0 mm in 33%, and >7 mm in 7%. They were located on the anterior circulation in 90% of cases. The mean follow-up duration was 51.32 months for a total of 2831 aneurysm-years. During follow-up, 37 UIAs (5.5%) were treated because of an increase in size, and 8 UIAs were treated because of patient decision. Three aneurysms ruptured during follow-up for an annual risk of rupture of 0.1% (95% CI 0% to 0.24%). No risk factors for rupture were identified. The three ruptured cases made an excellent recovery. During follow-up, annual mortality from unrelated causes was 0.8% (95% CI 0.51% to 1.18%). CONCLUSIONS This single-center cohort evaluated our watchful waiting policy applied in two-thirds of all incidental UIAs. Morphological change of UIAs during follow-up led to treatment in 5.5% of cases. With such a management paradigm, we found a low rupture rate in these selected UIAs and the mortality was unrelated to aneurysms.
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Affiliation(s)
- Mathilde Aubertin
- Department of Neuroradiology, AP-HP, Hôpital Lariboisière, Paris, France
| | - Clément Jourdaine
- Department of Neuroradiology, AP-HP, Hôpital Lariboisière, Paris, France
| | - Cédric Thépenier
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France.,Department of Experimental Neuropathology, Institut Pasteur, Paris, France
| | | | - Vittorio Civelli
- Department of Neuroradiology, AP-HP, Hôpital Lariboisière, Paris, France
| | | | - Alexis Guédon
- Department of Neuroradiology, AP-HP, Hôpital Lariboisière, Paris, France.,School of Medicine, Université de Paris, F-75006 Paris, France
| | - Emmanuel Houdart
- Department of Neuroradiology, AP-HP, Hôpital Lariboisière, Paris, France.,School of Medicine, Université de Paris, F-75006 Paris, France
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11
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Cortese J, Eliezer M, Guédon A, Houdart E. Pulsatile Tinnitus Due to Stenosis of the Marginal Sinus: Diagnosis and Endovascular Treatment. AJNR Am J Neuroradiol 2021; 42:2194-2198. [PMID: 34711551 DOI: 10.3174/ajnr.a7325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND PURPOSE Venous pulsatile tinnitus is a disabling condition mainly caused by a stenosis of the lateral sinus. Here, we aimed to report a novel cause of venous pulsatile tinnitus, stenosis of the marginal sinus. MATERIALS AND METHODS We retrospectively analyzed patients with isolated venous pulsatile tinnitus for which the suspected cause was a stenosis of the marginal sinus, treated or not, between January 2017 and December 2020. Patient charts and imaging were systematically reviewed. All patients underwent noncontrast temporal bone CT and MR imaging. RESULTS Eight patients (7 women; median age, 36 years) were included. Six patients (75%) were overweight, and 1 patient had idiopathic intracranial hypertension. All patients presented with a typical venous pulsatile tinnitus. The stenosis of the marginal sinus was detected using oblique reconstructions on postcontrast 3D MR imaging. There was no other pathologic finding except ipsilateral stenosis of the lateral sinus in 3 patients. Four patients underwent endovascular therapy with placement of a stent in the marginal sinus, leading to complete resolution of the pulsatile tinnitus for all of them. No complication occurred. Of note, the symptoms of intracranial hypertension also regressed after stent placement in that patient. CONCLUSIONS Marginal sinus stenosis is a novel cause of venous pulsatile tinnitus, which can be easily detected on MR imaging. Marginal sinus stent placement is safe and efficient. We hypothesized that the marginal sinus stenosis pathophysiology is similar to that of lateral sinus stenosis, which is a common and well-known cause of venous pulsatile tinnitus, explaining the similar clinical presentation and endovascular management.
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Affiliation(s)
- J Cortese
- From the Department of Interventional and Diagnostic Neuroradiology, Lariboisière University Hospital, University de Paris, Paris, France
| | - M Eliezer
- From the Department of Interventional and Diagnostic Neuroradiology, Lariboisière University Hospital, University de Paris, Paris, France
| | - A Guédon
- From the Department of Interventional and Diagnostic Neuroradiology, Lariboisière University Hospital, University de Paris, Paris, France
| | - E Houdart
- From the Department of Interventional and Diagnostic Neuroradiology, Lariboisière University Hospital, University de Paris, Paris, France
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12
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Guédon A, Elhorany M, Labeyrie MA, Civelli V, Saint-Maurice JP, Houdart E. Transarterial embolization of dural arteriovenous fistulas of the lateral sinuses with stent-assisted sinus protection. J Neurointerv Surg 2021; 14:962-967. [PMID: 34645703 DOI: 10.1136/neurintsurg-2021-018176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/03/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND The balloon-assisted sinus protection technique has been described as a sinus-preserving technique during transarterial embolization (TAE) of dural arteriovenous fistulas (DAVFs). However, some serious complications of this technique have been documented. OBJECTIVE To describe our preliminary experience with a new technique called stent-assisted sinus protection (SSP). METHODS We performed a retrospective analysis of seven consecutive patients with type I or IIa DAVFs of the lateral sinus treated by TAE with a closed-cell stent temporarily deployed in the sinus. RESULTS Of the seven patients, four had type I DAVF, and three had type IIa DAVF. The patency of all involved sinuses and their tributaries (including the inferior anastomotic vein and the superior petrosal sinus) was preserved. At the end of the procedure, all stents were successfully retrieved with embolic particles trapped in their meshes. No procedural complications were noted. Clinical follow-up was satisfactory, with complete resolution or significant reduction of pulsatile tinnitus. CONCLUSIONS SSP appears to be feasible and probably safe. However, larger studies are needed to confirm these preliminary results.
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Affiliation(s)
- Alexis Guédon
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, Paris, France .,INSERM UMR_S 1140, University of Paris, Paris, France.,University of Paris, Paris, France
| | - Mahmoud Elhorany
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, Paris, France.,Department of Neurology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Vittorio Civelli
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, Paris, France
| | | | - Emmanuel Houdart
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, Paris, France.,University of Paris, Paris, France
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13
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Shotar E, Labeyrie MA, Biondi A, Velasco S, Saliou G, Boulouis G, Daumas-Duport B, Bourcier R, Janot K, Herbreteau D, Michelozzi C, Premat K, Redjem H, Bricout N, Thouant P, Arteaga C, Pierot L, Tahon F, Boubagra K, Ikka L, Chabert E, Lenck S, Guédon A, Consoli A, Saleme S, di Maria F, Ferré JC, Eugene F, Anxionnat R, Marnat G, Guetarni Z, Sourour NA, Dormont D, Clarençon F. Non-ischemic cerebral enhancing lesions after intracranial aneurysm endovascular repair: a retrospective French national registry. J Neurointerv Surg 2021; 14:925-930. [PMID: 34544825 DOI: 10.1136/neurintsurg-2021-017992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/30/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Non-ischemic cerebral enhancing (NICE) lesions are exceptionally rare following aneurysm endovascular therapy (EVT). OBJECTIVE To investigate the presenting features and longitudinal follow-up of patients with NICE lesions following aneurysm EVT. METHODS Patients included in a retrospective national multicentre inception cohort were analysed. NICE lesions were defined, using MRI, as delayed onset punctate, nodular or annular foci enhancements with peri-lesion edema, distributed in the vascular territory of the aneurysm EVT, with no other confounding disease. RESULTS From a pool of 58 815 aneurysm endovascular treatment procedures during the study sampling period (2006-2019), 21/37 centres identified 31 patients with 32 aneurysms of the anterior circulation who developed NICE lesions (mean age 45±10 years). Mean delay to diagnosis was 5±9 months, with onset occurring a month or less after the index EVT procedure in 10 out of 31 patients (32%). NICE lesions were symptomatic at time of onset in 23 of 31 patients (74%). After a mean follow-up of 25±26 months, 25 patients (81%) were asymptomatic or minimally symptomatic without disability (modified Rankin Scale (mRS) score 0-1) at last follow-up while 4 (13%) presented with mild disability (mRS score 2). Clinical follow-up data were unavailable for two patients. Follow-up MRI (available in 27 patients; mean time interval after onset of 22±22 months) demonstrated persistent enhancement in 71% of cases. CONCLUSIONS The clinical spectrum of NICE lesions following aneurysm EVT therapy spans a wide range of neurological symptoms. Clinical course is most commonly benign, although persistent long-term enhancement is frequent.
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Affiliation(s)
- Eimad Shotar
- Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France
| | | | - Alessandra Biondi
- Department of Neuroradiology and Endovascular Therapy, Besançon University Hospital, Besancon, France
| | - Stéphane Velasco
- Interventional Neuroradiology Department, Poitiers University Hospital, Poitiers, France
| | - Guillaume Saliou
- Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland.,Faculty of Medicine, UNIL, Lausanne, Switzerland
| | - Grégoire Boulouis
- Department of Interventional Neuroradiology, Bretonneau Hospital, Tours, France.,Interventional Neuroradiology Department, Sainte Anne Hospital, Paris, France
| | | | | | - Kevin Janot
- Department of Interventional Neuroradiology, Bretonneau Hospital, Tours, France
| | - Denis Herbreteau
- Department of Interventional Neuroradiology, Bretonneau Hospital, Tours, France
| | | | - Kevin Premat
- Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France
| | - Hocine Redjem
- Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France
| | - Nicolas Bricout
- Department of interventional Neuroradiology, Centre Hospitalier Regional Universitaire de Lille, Lille, France
| | - Pierre Thouant
- Department of Neuroradiology, F Mitterand Hospital, Dijon, France
| | - Charles Arteaga
- Hôpital d'Instruction des Armées Sainte-Anne Bibliothèque, Toulon, Provence-Alpes-Côte d'Azu, France
| | - Laurent Pierot
- Department of Radiology, University Hospital Reims, Reims, France
| | - Florence Tahon
- Neuroradiology Department, Grenoble University Hospital, Grenoble, France
| | - Kamel Boubagra
- Neuroradiology Department, Grenoble University Hospital, Grenoble, France
| | - Leon Ikka
- Department of Interventional Neuroradiology, Kremlin Bicetre University Hospital, Kremlin Bicetre, France
| | - Emmanuel Chabert
- Department of Neuroradiology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Stéphanie Lenck
- Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France
| | - Alexis Guédon
- Department of Interventional Neuroradiology, Lariboisière Hospital, Paris, France.,Department of Diagnostic and Therapeutic Neuroradiology, Foch Hospital, Suresnes, France
| | - Arturo Consoli
- Department of Diagnostic and Therapeutic Neuroradiology, Foch Hospital, Suresnes, France
| | - Suzana Saleme
- Department of Interventional Neuroradiology, CHU Limoges, Limoges, France
| | - Federico di Maria
- Department of Diagnostic and Therapeutic Neuroradiology, Foch Hospital, Suresnes, France
| | | | - Francois Eugene
- Department of Neuroradiology, University Hospital of Rennes, Rennes, France
| | - René Anxionnat
- Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, Lorraine, France.,Université de Lorraine, Faculté de Médecine, Vandœuvre-lès-Nancy, Lorraine, France
| | - Gaultier Marnat
- Department of Interventional and Diagnostic Neuroradiology, Bordeaux University Hospital, Bordeaux, France
| | - Zakaria Guetarni
- Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France
| | | | - Didier Dormont
- Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France.,Sorbonne Université, Paris, France
| | - Frédéric Clarençon
- Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France.,Sorbonne Université, Paris, France
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14
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Serrano F, Guédon A, Saint-Maurice JP, Labeyrie MA, Civelli V, Eliezer M, Houdart E. Endovascular treatment of infectious intracranial aneurysms complicating infective endocarditis: a series of 31 patients with 55 aneurysms. Neuroradiology 2021; 64:353-360. [PMID: 34459945 DOI: 10.1007/s00234-021-02798-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/25/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Endovascular treatment (EVT) has become a major option in management of infectious intracranial aneurysms (IIAs) complicating infective endocarditis. We report a retrospective, single-center series of consecutive patients with IIAs treated by EVT. METHODS Patients were included from January 2009 to July 2020. IIAs were diagnosed on DSA. Each patient underwent a neurological assessment before and after EVT and was followed up by imaging within 15 days of EVT. Safety was assessed on the evolution of NIHSS score. A minor stroke was defined as a worsening of NIHSS < 4 points. Efficacy was defined as the absence of hemorrhagic event during cardiac surgery and the exclusion of the IIA on control imaging. RESULTS Sixty-two IIAs (30 ruptured) were diagnosed in 31 patients. Fifty-six IIAs were diagnosed on the first DSA and 6 on the early control exploration. EVT was achieved in 55 IIAs by parent artery occlusion with glue in 52 distal IIAs and coils in 3 proximal IIAs. IIAs were located in 90.9% of cases on a fourth-division branch of a cerebral artery. The neurological examination remained unchanged in 29 patients (93.5%), and 2 patients suffered minor stroke. EVT was performed before cardiac surgery in 20/22 patients. All treated IIAs were excluded on follow-up imaging. No hemorrhage was observed during cardiac surgery or in the aftermath. Seven (11.3%) unruptured IIAs were not embolized. CONCLUSION EVT of IIAs by occlusion of the parent artery is effective in preventing rupture and carries no significant neurological risk.
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Affiliation(s)
- Fabiola Serrano
- Department of Neuroradiology, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Alexis Guédon
- Department of Neuroradiology, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France. .,University of Paris, Paris, France.
| | | | - Marc-Antoine Labeyrie
- Department of Neuroradiology, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Vittorio Civelli
- Department of Neuroradiology, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Michael Eliezer
- Department of Neuroradiology, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France
| | - Emmanuel Houdart
- Department of Neuroradiology, Lariboisière Hospital, 2, rue Ambroise Paré, 75010, Paris, France.,University of Paris, Paris, France
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15
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Guédon A, Labeyrie MA, Civelli V, Saint-Maurice JP, Houdart E. Navigability of a long sheath in the lateral dural sinuses facilitated by the pilot balloon technique: technical note. Neuroradiology 2021; 63:2149-2151. [PMID: 34338802 DOI: 10.1007/s00234-021-02776-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
Dural sinus stenting is an increasingly recognized intervention for the treatment of lateral sinus stenosis. This procedure can be challenging in tortuous anatomy and in the presence of intraluminal septa because of poor trackability and crossability of long sheath commonly used for stenting. We report a technique using a pilot angioplasty balloon positioned at the distal end of the long sheath that improves its navigability in dural sinuses and facilitated the intervention.
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Affiliation(s)
- Alexis Guédon
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, 2, rue Ambroise Paré, 75010, Paris, France. .,INSERM, UMR_S 1140, University of Paris, Paris, France.
| | - Marc-Antoine Labeyrie
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, 2, rue Ambroise Paré, 75010, Paris, France
| | - Vittorio Civelli
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, 2, rue Ambroise Paré, 75010, Paris, France
| | - Jean-Pierre Saint-Maurice
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, 2, rue Ambroise Paré, 75010, Paris, France
| | - Emmanuel Houdart
- Department of Neuroradiology, Lariboisière Hospital, AP-HP, 2, rue Ambroise Paré, 75010, Paris, France.,University of Paris, Paris, France
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16
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Guédon A, Saint-Maurice JP, Thépenier C, Labeyrie MA, Civelli V, Sissy CE, Eliezer M, Aymard A, Guichard JP, Houdart E. Results of transvenous embolization of intracranial dural arteriovenous fistula: a consecutive series of 136 patients with 142 fistulas. J Neurosurg 2021:1-9. [PMID: 34049278 DOI: 10.3171/2020.10.jns203604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/12/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Intracranial dural arteriovenous fistula (DAVF) is mainly treated with an endovascular approach. Two major treatment advances include transvenous embolization (TVE) with coils in 1989 and, more recently, transarterial embolization with Onyx. The aim of this study was to present a large monocentric series of patients with DAVF treated with TVE. This series reports more than 20 years of experience and describes the evolution of the medical management of these patients, as well as current indications for this treatment at the authors' center. METHODS Consecutive patients treated for intracranial DAVFs with TVE from 1995 to 2018 were included. Clinical and imaging data were systematically collected. Univariate and multivariate analyses were performed to identify factors that were significantly associated with adverse clinical course or complications. RESULTS In this study of 136 patients with 142 DAVFs treated with TVE, the occlusion rate was 90%. The median length of follow-up was 11 months. The rate of permanent complications was 5.1%, and the procedure-related mortality rate was 1.5%. Procedure-related mortality was associated with extension of thrombosis that was observed early in our experience. The introduction of a postoperative anticoagulation regimen has drastically decreased the occurrence of this complication. Other minor complications included cochleovestibular syndrome after embolization of lateral sinus DAVF and oculomotor nerve damage after embolization of cavernous sinus DAVF. CONCLUSIONS TVE allows efficient occlusion of DAVF. It remains a valid option for DAVF located on a sinus that does not participate in normal venous drainage of the brain.
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Affiliation(s)
- Alexis Guédon
- 1Department of Neuroradiology, Hôpital Lariboisière, AP-HP, Paris.,2University of Paris.,4INSERM UMR_S 1140, University of Paris, France
| | | | - Cédric Thépenier
- 3Department of Experimental Neuropathology, Institut Pasteur, Paris, and French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge; and
| | | | - Vittorio Civelli
- 1Department of Neuroradiology, Hôpital Lariboisière, AP-HP, Paris
| | | | - Michael Eliezer
- 1Department of Neuroradiology, Hôpital Lariboisière, AP-HP, Paris
| | - Armand Aymard
- 1Department of Neuroradiology, Hôpital Lariboisière, AP-HP, Paris
| | | | - Emmanuel Houdart
- 1Department of Neuroradiology, Hôpital Lariboisière, AP-HP, Paris.,2University of Paris
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17
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Cagnazzo F, Piotin M, Escalard S, Maier B, Ribo M, Requena M, Pop R, Hasiu A, Gasparotti R, Mardighian D, Piano M, Cervo A, Eker OF, Durous V, Sourour NA, Elhorany M, Zini A, Simonetti L, Marcheselli S, Paolo NN, Houdart E, Guédon A, Ligot N, Mine B, Consoli A, Lapergue B, Cordona Portela P, Urra X, Rodriguez A, Bolognini F, Lebedinsky PA, Pasco-Papon A, Godard S, Marnat G, Sibon I, Limbucci N, Nencini P, Nappini S, Saia V, Caldiera V, Romano D, Frauenfelder G, Gallesio I, Gola G, Menozzi R, Genovese A, Terrana A, Giorgianni A, Cappellari M, Augelli R, Invernizzi P, Pavia M, Lafe E, Cavallini A, Giossi A, Besana M, Valvassori L, Macera A, Castellan L, Salsano G, Di Caterino F, Biondi A, Arquizan C, Lebreuche J, Galvano G, Cannella A, Cosottini M, Lazzarotti G, Guizzardi G, Stecco A, Tassi R, Bracco S, Bianchini E, Micieli C, Pascarella R, Napoli M, Causin F, Desal H, Cotton F, Costalat V. European Multicenter Study of ET-COVID-19. Stroke 2020; 52:31-39. [PMID: 33222617 DOI: 10.1161/strokeaha.120.031514] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Acute ischemic stroke and large vessel occlusion can be concurrent with the coronavirus disease 2019 (COVID-19) infection. Outcomes after mechanical thrombectomy (MT) for large vessel occlusion in patients with COVID-19 are substantially unknown. Our aim was to study early outcomes after MT in patients with COVID-19. METHODS Multicenter, European, cohort study involving 34 stroke centers in France, Italy, Spain, and Belgium. Data were collected between March 1, 2020 and May 5, 2020. Consecutive laboratory-confirmed COVID-19 cases with large vessel occlusion, who were treated with MT, were included. Primary investigated outcome: 30-day mortality. SECONDARY OUTCOMES early neurological improvement (National Institutes of Health Stroke Scale improvement ≥8 points or 24 hours National Institutes of Health Stroke Scale 0-1), successful reperfusion (modified Thrombolysis in Cerebral Infarction grade ≥2b), and symptomatic intracranial hemorrhage. RESULTS We evaluated 93 patients with COVID-19 with large vessel occlusion who underwent MT (median age, 71 years [interquartile range, 59-79]; 63 men [67.7%]). Median pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score were 17 (interquartile range, 11-21) and 8 (interquartile range, 7-9), respectively. Anterior circulation acute ischemic stroke represented 93.5% of cases. The rate modified Thrombolysis in Cerebral Infarction 2b to 3 was 79.6% (74 patients [95% CI, 71.3-87.8]). Thirty-day mortality was 29% (27 patients [95% CI, 20-39.4]). Early neurological improvement was 19.5% (17 patients [95% CI, 11.8-29.5]), and symptomatic intracranial hemorrhage was 5.4% (5 patients [95% CI, 1.7-12.1]). Patients who died at 30 days exhibited significantly lower lymphocyte count, higher levels of aspartate, and LDH (lactate dehydrogenase). After adjustment for age, initial National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and successful reperfusion, these biological markers remained associated with increased odds of 30-day mortality (adjusted odds ratio of 2.70 [95% CI, 1.21-5.98] per SD-log decrease in lymphocyte count, 2.66 [95% CI, 1.22-5.77] per SD-log increase in aspartate, and 4.30 [95% CI, 1.43-12.91] per SD-log increase in LDH). CONCLUSIONS The 29% rate of 30-day mortality after MT among patients with COVID-19 is not negligible. Abnormalities of lymphocyte count, LDH and aspartate may depict a patient's profiles with poorer outcomes after MT. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT04406090.
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Affiliation(s)
- Federico Cagnazzo
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France (F. Cagnazzo, V. Costalat)
| | - Michel Piotin
- Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France (M. Piotin, S.E., B. Maier)
| | - Simon Escalard
- Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France (M. Piotin, S.E., B. Maier)
| | - Benjamin Maier
- Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France (M. Piotin, S.E., B. Maier)
| | - Marc Ribo
- Stroke Unit, Neurology, Hospital Vall d'Hebron, Barcelona, Catalonia, Spain (M. Ribo, M. Requena)
| | - Manuel Requena
- Stroke Unit, Neurology, Hospital Vall d'Hebron, Barcelona, Catalonia, Spain (M. Ribo, M. Requena)
| | - Raoul Pop
- Department of Interventional Neuroradiology, Strasbourg University Hospitals (R.P., A.H.)
| | - Anca Hasiu
- Department of Interventional Neuroradiology, Strasbourg University Hospitals (R.P., A.H.)
| | - Roberto Gasparotti
- Neuroradiology and Stroke Units, Spedali Civili, Brescia, Italy (R.G., D.M.)
| | - Dikran Mardighian
- Neuroradiology and Stroke Units, Spedali Civili, Brescia, Italy (R.G., D.M.)
| | - Mariangela Piano
- Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (M. Piano, A. Cervo)
| | - Amedeo Cervo
- Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (M. Piano, A. Cervo)
| | - Omer Faruk Eker
- Department of Diagnostic and Interventional Neuroradiology, Hospices Civils, Lyon, France (O.F.E., V.D., F. Cotton)
| | - Vincent Durous
- Department of Diagnostic and Interventional Neuroradiology, Hospices Civils, Lyon, France (O.F.E., V.D., F. Cotton)
| | - Nader-Antoine Sourour
- Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France (N.-A.S., M.E.)
| | - Mahmoud Elhorany
- Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France (N.-A.S., M.E.)
| | - Andrea Zini
- Department of Neurology and Stroke Center (A.Z.), IRCCS Istituto di Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy
| | - Luigi Simonetti
- Neuroradiology Unit (L.S.), IRCCS Istituto di Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy
| | - Simona Marcheselli
- Neurologia d'Urgenza e Stroke Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (S.M., N.N.P.)
| | - Nuzzi Nunzio Paolo
- Neurologia d'Urgenza e Stroke Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (S.M., N.N.P.)
| | - Emmanuel Houdart
- Department of Neurology, Hôpital Lariboisière, University of Paris, France (E.H., A. Guédon)
| | - Alexis Guédon
- Department of Neurology, Hôpital Lariboisière, University of Paris, France (E.H., A. Guédon)
| | - Noémie Ligot
- Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium (N. Ligot, B. Mine)
| | - Benjamin Mine
- Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium (N. Ligot, B. Mine)
| | - Arturo Consoli
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, France (A. Consoli, B.L.)
| | - Bertrand Lapergue
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, France (A. Consoli, B.L.)
| | | | - Xabier Urra
- Comprehensive Stroke Unit, Hospital Clínic de Barcelona, Catalonia, Spain (X.U., A.R.)
| | - Alejandro Rodriguez
- Comprehensive Stroke Unit, Hospital Clínic de Barcelona, Catalonia, Spain (X.U., A.R.)
| | - Federico Bolognini
- Interventional Neuroradiology Department, CHRU Colmar, France (F.B., P.A.L.)
| | | | - Anne Pasco-Papon
- Department of Radiology, University Hospital of Angers, France (A.P.-P.)
| | - Sophie Godard
- Department of Neurology, Angers University Hospital, France (S.G.)
| | - Gaultier Marnat
- Interventional Neuroradiology Department, CHRU Bordeaux, France (G.M.)
| | - Igor Sibon
- Stroke Unit, Department of Neurology, Bordeaux University, CHRU Bordeaux; France (I.S.)
| | - Nicola Limbucci
- Department of Interventional Neuroradiology, University of Florence, Italy (N. Limbucci, S.N.)
| | - Patrizia Nencini
- Stroke Unit, Ospedale Careggi-University Hospital, Firenze, Italy (P.N.)
| | - Sergio Nappini
- Department of Interventional Neuroradiology, University of Florence, Italy (N. Limbucci, S.N.)
| | - Valentina Saia
- Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure (V.S., V. Caldiera)
| | - Valentina Caldiera
- Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure (V.S., V. Caldiera)
| | - Daniele Romano
- Department of Neuroradiology, "San Giovanni di Dio e Ruggi d'Aragona" Hospital, Salerno, Italy (D.R., G.F.)
| | - Giulia Frauenfelder
- Department of Neuroradiology, "San Giovanni di Dio e Ruggi d'Aragona" Hospital, Salerno, Italy (D.R., G.F.)
| | - Ivan Gallesio
- Department of Radiology, Azienda ospedaliera "SS Antonio e Biagio e C. Arrigo", Alessandria, Italy (I.G., G. Gola)
| | - Giuliano Gola
- Department of Radiology, Azienda ospedaliera "SS Antonio e Biagio e C. Arrigo", Alessandria, Italy (I.G., G. Gola)
| | - Roberto Menozzi
- Headache Centre, Department of Medicine and Surgery, Parma, Italy (R.M., A. Genovese)
| | - Antonio Genovese
- Headache Centre, Department of Medicine and Surgery, Parma, Italy (R.M., A. Genovese)
| | - Alberto Terrana
- Department of Neuroradiology, ASST Sette Laghi, University of Insubria, Varese, Italy (A.T., A. Giorgianni)
| | - Andrea Giorgianni
- Department of Neuroradiology, ASST Sette Laghi, University of Insubria, Varese, Italy (A.T., A. Giorgianni)
| | - Manuel Cappellari
- Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy (M.C., R.A.)
| | - Raffaele Augelli
- Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy (M.C., R.A.)
| | - Paolo Invernizzi
- Neuroradiology and Neurology Units, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy (P.I., M. Pavia)
| | - Marco Pavia
- Neuroradiology and Neurology Units, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy (P.I., M. Pavia)
| | - Elvis Lafe
- Radiology, Diagnostic and Interventional Neuroradiology Unit, Policlinico IRCCS San Matteo, Pavia, Italy (E.L.)
| | - Anna Cavallini
- Cerebrovascular Department, IRCCS Mondino Foundation, Pavia, Italy (A. Cavallini)
| | - Alessia Giossi
- SC Neurologia, Dipartimento Interaziendale Neuroscienze, Cremona, Italy (A. Giossi, M.B.)
| | - Michele Besana
- SC Neurologia, Dipartimento Interaziendale Neuroscienze, Cremona, Italy (A. Giossi, M.B.)
| | - Luca Valvassori
- Department of Neuroradiology, ASST Monza, Italy (L.V., A.M.)
| | - Antonio Macera
- Department of Neuroradiology, ASST Monza, Italy (L.V., A.M.)
| | - Lucio Castellan
- RCCS Ospedale Policlinico San Martino, Genova, Italia (L.C., G.S.)
| | | | - Fortunato Di Caterino
- Department of Neuroradiology and Endovascular Therapy, Besancon, France (F.D.C., A.B.)
| | - Alessandra Biondi
- Department of Neuroradiology and Endovascular Therapy, Besancon, France (F.D.C., A.B.)
| | - Caroline Arquizan
- Department of Neurology, Hôpital Gui de Chauliac, Montpellier, France (C.A.)
| | - Julien Lebreuche
- Department of Biostatistics, University of Lille, CHU Lille, EA 2694-Santé Publique: Épidémiologie et Qualité des Soins, France (J.L.)
| | | | - Alfio Cannella
- ARNAS Garibaldi, Catania, Italy (G. Galvano, A. Cannella)
| | - Mirco Cosottini
- Neuroradiology Unit, Ospedale Cisanello, Pisa, Italy (M.C., G.L.)
| | - Guido Lazzarotti
- Neuroradiology Unit, Ospedale Cisanello, Pisa, Italy (M.C., G.L.)
| | | | | | - Rossana Tassi
- Interventional Neuroradiology and Stroke Units, Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy (R.T., S.B.)
| | - Sandra Bracco
- Interventional Neuroradiology and Stroke Units, Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy (R.T., S.B.)
| | - Elena Bianchini
- Neuroradiology Unit, ASST West Milan, Legnano Hospital (E.B., C.M.)
| | - Camilla Micieli
- Neuroradiology Unit, ASST West Milan, Legnano Hospital (E.B., C.M.)
| | - Rosario Pascarella
- Neuroradiology Unit, IRCCS Santa Maria Nuova, Hospital Reggio Emilia (R.P. M.N.)
| | - Manuela Napoli
- Neuroradiology Unit, IRCCS Santa Maria Nuova, Hospital Reggio Emilia (R.P. M.N.)
| | - Francesco Causin
- Interventional Neuroradiology Unit and Stroke Unit, Padova, Italy (F. Causin)
| | - Hubert Desal
- Service de Neuroradiologie Diagnostique et Interventionnelle du CHU de Nantes, France (H.D.)
| | - François Cotton
- Department of Diagnostic and Interventional Neuroradiology, Hospices Civils, Lyon, France (O.F.E., V.D., F. Cotton)
| | - Vincent Costalat
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France (F. Cagnazzo, V. Costalat)
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18
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Guédon A, Thépenier C, Shotar E, Gabrieli J, Mathon B, Premat K, Lenck S, Degos V, Sourour N, Clarençon F. Predictive score for complete occlusion of intracranial aneurysms treated by flow-diverter stents using machine learning. J Neurointerv Surg 2020; 13:341-346. [PMID: 33219150 DOI: 10.1136/neurintsurg-2020-016748] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Complete occlusion of an intracranial aneurysm (IA) after the deployment of a flow-diverter stent is currently unpredictable. The aim of this study was to develop a predictive occlusion score based on pretreatment clinical and angiographic criteria. METHODS Consecutive patients with ≥6 months follow-up were included from 2008 to 2019 and retrospectively analyzed. Each IA was evaluated using the Raymond-Roy occlusion classification (RROC) and dichotomized as occluded (A) or residual (B/C); 80% of patients were randomly assigned to the training sample. Feature selection and binary outcome prediction relied on logistic regression and threshold maximizing class separation selected by a CART tree algorithm. The feature selection was addressed by a genetic algorithm selected from the 30 pretreatment available variables. RESULTS The study included 146 patients with 154 IAs. Feature selection yielded a combination of six variables with a good cross-validated accuracy on the test sample, a combination we labeled DIANES score (IA diameter, indication, parent artery diameter ratio, neck ratio, side-branch artery, and sex). A score of more than -6 maximized the ability to predict RROC=A with sensitivity of 87% (95% CI 79% to 95%) and specificity of 82% (95% CI 64% to 96%) in the training sample. Accuracy was 86% (95% CI 79% to 94%). In the test sample, sensitivity and specificity were 89% (95% CI 77% to 98%) and 60% (95% CI 33% to 86%), respectively. Accuracy was 81% (95% CI 69% to 91%). CONCLUSION A score was developed as a grading scale for prediction of the final occlusion status of IAs treated with a flow-diverter stent.
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Affiliation(s)
- Alexis Guédon
- Biosurgical Research Lab (Carpentier Foundation), European Georges-Pompidou Hospital, INSERM UMR_S 1140, University of Paris, Paris, France.,Department of Anatomy, University of Paris, Paris, France
| | - Cédric Thépenier
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France.,Department of Experimental Neuropathology, Institut Pasteur, Paris, France
| | - Eimad Shotar
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Joseph Gabrieli
- Department of Neuroradiology, University of Padova Faculty of Medicine and Surgery, Padova, Veneto, Italy
| | - Bertrand Mathon
- Department of Neurosurgery, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Sorbonne University, Paris, Île-de-France, France
| | - Kévin Premat
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Sorbonne University, Paris, Île-de-France, France
| | - Stéphanie Lenck
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Vincent Degos
- Sorbonne University, Paris, Île-de-France, France.,Department of Neuro-anesthesiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Nader Sourour
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Frédéric Clarençon
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France .,Sorbonne University, Paris, Île-de-France, France
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19
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Ganon S, Guédon A, Cassier S, Atlan M. Contribution of thermal imaging in determining the depth of pediatric acute burns. Burns 2020; 46:1091-1099. [DOI: 10.1016/j.burns.2019.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/20/2019] [Accepted: 11/23/2019] [Indexed: 12/17/2022]
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20
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Hajdu SD, Pittet V, Puccinelli F, Ben Hassen W, Ben Maacha M, Blanc R, Bracco S, Broocks G, Bartolini B, Casseri T, Clarençon F, Naggara O, Eugène F, Ferré JC, Guédon A, Houdart E, Krings T, Lehmann P, Limbucci N, Machi P, Macho J, Mandruzzato N, Nappini S, Nawka MT, Nicholson P, Marto JP, Pereira V, Correia MA, Pinho-E-Melo T, Nuno Ramos J, Raz E, Ferreira P, Reis J, Shapiro M, Shotar E, van Horn N, Piotin M, Saliou G. Acute Stroke Management During the COVID-19 Pandemic: Does Confinement Impact Eligibility for Endovascular Therapy? Stroke 2020; 51:2593-2596. [PMID: 32716828 PMCID: PMC7340133 DOI: 10.1161/strokeaha.120.030794] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organization recommended measures to mitigate the outbreak such as social distancing and confinement. Since these measures have been put in place, anecdotal reports describe a decrease in the number of endovascular therapy (EVT) treatments for acute ischemic stroke due to large vessel occlusion. The purpose of our study was to determine the effect on EVT for patients with acute ischemic stroke during the COVID-19 confinement. In this retrospective, observational study, data were collected from November 1, 2019, to April 15, 2020, at 17 stroke centers in countries where confinement measures have been in place since March 2020 for the COVID-19 pandemic (Switzerland, Italy, France, Spain, Portugal, Germany, Canada, and United States). This study included 1600 patients treated by EVT for acute ischemic stroke. Date of EVT and symptom onset-to-groin puncture time were collected. Mean number of EVTs performed per hospital per 2-week interval and mean stroke onset-to-groin puncture time were calculated before confinement measures and after confinement measures. Distributions (non-normal) between the 2 groups (before COVID-19 confinement versus after COVID-19 confinement) were compared using 2-sample Wilcoxon rank-sum test. The results show a significant decrease in mean number of EVTs performed per hospital per 2-week interval between before COVID-19 confinement (9.0 [95% CI, 7.8-10.1]) and after COVID-19 confinement (6.1 [95% CI, 4.5-7.7]), (P<0.001). In addition, there is a significant increase in mean stroke onset-to-groin puncture time (P<0.001), between before COVID-19 confinement (300.3 minutes [95% CI, 285.3-315.4]) and after COVID-19 confinement (354.5 minutes [95% CI, 316.2-392.7]). Our preliminary analysis indicates a 32% reduction in EVT procedures and an estimated 54-minute increase in symptom onset-to-groin puncture time after confinement measures for COVID-19 pandemic were put into place.
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Affiliation(s)
- Steven D Hajdu
- Department of Interventional and Diagnostic Radiology, Lausanne University Hospital, Switzerland (S.D.H., F.P., B.B., G.S.)
| | - Valerie Pittet
- Center for Primary Care and Public Health, University of Lausanne, Switzerland (V.P.)
| | - Francesco Puccinelli
- Department of Interventional and Diagnostic Radiology, Lausanne University Hospital, Switzerland (S.D.H., F.P., B.B., G.S.)
| | - Wagih Ben Hassen
- Department of Neuroradiology, Sainte Anne Hospital, Paris, France (W.B.H., O.N.)
| | - Malek Ben Maacha
- Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France (M.B.M., R.B., M.P.)
| | - Raphaël Blanc
- Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France (M.B.M., R.B., M.P.)
| | - Sandra Bracco
- Unit of Neuroimaging and Neurointervention, University Hospital of Siena, Italy (S.B., T.C.)
| | - Gabriel Broocks
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany (G.B., M.T.N., N.v.H.)
| | - Bruno Bartolini
- Department of Interventional and Diagnostic Radiology, Lausanne University Hospital, Switzerland (S.D.H., F.P., B.B., G.S.)
| | - Tommaso Casseri
- Unit of Neuroimaging and Neurointervention, University Hospital of Siena, Italy (S.B., T.C.)
| | - Frederic Clarençon
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France (F.C., E.S.)
| | - Olivier Naggara
- Department of Neuroradiology, Sainte Anne Hospital, Paris, France (W.B.H., O.N.)
| | - François Eugène
- Department of Neuroradiology, Centre Hospitalier Universitaire de Rennes, Rennes, France (F.E., J.-C.F.)
| | - Jean-Christophe Ferré
- Department of Neuroradiology, Centre Hospitalier Universitaire de Rennes, Rennes, France (F.E., J.-C.F.)
| | - Alexis Guédon
- Department of Neuroradiology, Lariboisière Hospital, Paris, France (A.G., E.H.)
| | - Emmanuel Houdart
- Department of Neuroradiology, Lariboisière Hospital, Paris, France (A.G., E.H.)
| | - Timo Krings
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Canada (T.K., P.N., V.P.)
| | - Pierre Lehmann
- Department of Neuroradiology, Marseille Hospital, France (P.L.)
| | - Nicola Limbucci
- Department of Interventional Neuroradiology, Careggi University Hospital, Florence, Italy (N.L., S.N.)
| | - Paolo Machi
- Service of diagnostic and interventional neuroradiology, Geneva University Hospital, Switzerland (P.M., N.M.)
| | - Juan Macho
- Radiology Department, Hospital Clinic, Barcelona, Spain (J.M.)
| | - Nicolo Mandruzzato
- Service of diagnostic and interventional neuroradiology, Geneva University Hospital, Switzerland (P.M., N.M.)
| | - Sergio Nappini
- Department of Interventional Neuroradiology, Careggi University Hospital, Florence, Italy (N.L., S.N.)
| | | | - Patrick Nicholson
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany (G.B., M.T.N., N.v.H.).,Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Canada (T.K., P.N., V.P.)
| | - João Pedro Marto
- Departments of Neurology and Neuroradiology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (J.P.M., J.N.R.)
| | - Vitor Pereira
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Canada (T.K., P.N., V.P.)
| | - Manuel A Correia
- Departments of Neurology and Neuroradiology, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal (M.A.C., T.P.-e.-M.)
| | - Teresa Pinho-E-Melo
- Departments of Neurology and Neuroradiology, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal (M.A.C., T.P.-e.-M.)
| | - João Nuno Ramos
- Departments of Neurology and Neuroradiology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (J.P.M., J.N.R.)
| | - Eytan Raz
- NYU Langone Health, New York (E.R., M.S.)
| | - Patrícia Ferreira
- Stroke Unit and Department of Neuroradiology, Hospital São José, Centro Hospitalar Lisboa Central, Lisbon, Portugal (P.F., J.R.)
| | - João Reis
- Stroke Unit and Department of Neuroradiology, Hospital São José, Centro Hospitalar Lisboa Central, Lisbon, Portugal (P.F., J.R.)
| | | | - Eimad Shotar
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France (F.C., E.S.)
| | - Noel van Horn
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany (G.B., M.T.N., N.v.H.)
| | - Michel Piotin
- Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France (M.B.M., R.B., M.P.)
| | - Guillaume Saliou
- Department of Interventional and Diagnostic Radiology, Lausanne University Hospital, Switzerland (S.D.H., F.P., B.B., G.S.)
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21
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Kerleroux B, Fabacher T, Bricout N, Moïse M, Testud B, Vingadassalom S, Ifergan H, Janot K, Consoli A, Ben Hassen W, Shotar E, Ognard J, Charbonnier G, L'Allinec V, Guédon A, Bolognini F, Marnat G, Forestier G, Rouchaud A, Pop R, Raynaud N, Zhu F, Cortese J, Chalumeau V, Berge J, Escalard S, Boulouis G. Mechanical Thrombectomy for Acute Ischemic Stroke Amid the COVID-19 Outbreak: Decreased Activity, and Increased Care Delays. Stroke 2020; 51:2012-2017. [PMID: 32432994 DOI: 10.1161/strokeaha.120.030373] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The efficiency of prehospital care chain response and the adequacy of hospital resources are challenged amid the coronavirus disease 2019 (COVID-19) outbreak, with suspected consequences for patients with ischemic stroke eligible for mechanical thrombectomy (MT). METHODS We conducted a prospective national-level data collection of patients treated with MT, ranging 45 days across epidemic containment measures instatement, and of patients treated during the same calendar period in 2019. The primary end point was the variation of patients receiving MT during the epidemic period. Secondary end points included care delays between onset, imaging, and groin puncture. To analyze the primary end point, we used a Poisson regression model. We then analyzed the correlation between the number of MTs and the number of COVID-19 cases hospitalizations, using the Pearson correlation coefficient (compared with the null value). RESULTS A total of 1513 patients were included at 32 centers, in all French administrative regions. There was a 21% significant decrease (0.79; [95%CI, 0.76-0.82]; P<0.001) in MT case volumes during the epidemic period, and a significant increase in delays between imaging and groin puncture, overall (mean 144.9±SD 86.8 minutes versus 126.2±70.9; P<0.001 in 2019) and in transferred patients (mean 182.6±SD 82.0 minutes versus 153.25±67; P<0.001). After the instatement of strict epidemic mitigation measures, there was a significant negative correlation between the number of hospitalizations for COVID and the number of MT cases (R2 -0.51; P=0.04). Patients treated during the COVID outbreak were less likely to receive intravenous thrombolysis and to have unwitnessed strokes (both P<0.05). CONCLUSIONS Our study showed a significant decrease in patients treated with MTs during the first stages of the COVID epidemic in France and alarming indicators of lengthened care delays. These findings prompt immediate consideration of local and regional stroke networks preparedness in the varying contexts of COVID-19 pandemic evolution.
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Affiliation(s)
- Basile Kerleroux
- Neuroradiology Department, CH Sainte-Anne, Paris, France (B.K., W.B.H., G.B.)
| | | | - Nicolas Bricout
- Interventional Neuroradiology Department, CHRU Lille, France (N.B., M.M.)
| | - Martin Moïse
- Interventional Neuroradiology Department, CHRU Lille, France (N.B., M.M.)
| | - Benoit Testud
- Interventional Neuroradiology Department, CHRU Marseille La Timone, France (B.T., S.V.)
| | - Sivadji Vingadassalom
- Interventional Neuroradiology Department, CHRU Marseille La Timone, France (B.T., S.V.)
| | - Héloïse Ifergan
- Interventional Neuroradiology Department, CHRU Tours, France (H.I., K.J.)
| | - Kévin Janot
- Interventional Neuroradiology Department, CHRU Tours, France (H.I., K.J.)
| | - Arturo Consoli
- Interventional Neuroradiology Department, CH Foch, France (A.C.)
| | - Wagih Ben Hassen
- Neuroradiology Department, CH Sainte-Anne, Paris, France (B.K., W.B.H., G.B.)
| | - Eimad Shotar
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France (E.S.)
| | - Julien Ognard
- Interventional Neuroradiology Department, CHRU Brest, France (J.O.)
| | | | | | - Alexis Guédon
- Department of Neuroradiology, Lariboisière Hospital, Paris, France (A.G.)
| | | | - Gaultier Marnat
- Interventional Neuroradiology Department, CHRU Bordeaux, France (G.M., J.B.)
| | - Géraud Forestier
- Interventional Neuroradiology Department, CHU Limoges, France (G.F., A.R.)
| | - Aymeric Rouchaud
- Interventional Neuroradiology Department, CHU Limoges, France (G.F., A.R.)
| | - Raoul Pop
- Interventional Neuroradiology Department, CHRU Strasbourg, France (R.P.)
| | - Nicolas Raynaud
- Interventional Neuroradiology Department, CHRU Poitiers, France (N.R.)
| | - François Zhu
- Interventional Neuroradiology Department, CHRU Nancy, France (F.Z.)
| | - Jonathan Cortese
- Interventional Neuroradiology Department, Kremlin Bicêtre Hospital, Bicêtre, France (J.C., V.C.)
| | - Vanessa Chalumeau
- Interventional Neuroradiology Department, Kremlin Bicêtre Hospital, Bicêtre, France (J.C., V.C.)
| | - Jérome Berge
- Interventional Neuroradiology Department, CHRU Bordeaux, France (G.M., J.B.)
| | - Simon Escalard
- Interventional Neuroradiology Department, Fondation Rothschild, Paris, France (S.E.)
| | - Grégoire Boulouis
- Neuroradiology Department, CH Sainte-Anne, Paris, France (B.K., W.B.H., G.B.)
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22
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Guédon A, Labeyrie MA, Civelli V, Fantoni M, Aymard A, Jean B, Saint-Maurice JP, Houdart E. Le traitement par voie veineuse des fistules artérioveineuses durales intracrâniennes : cohorte de Lariboisière. J Neuroradiol 2020. [DOI: 10.1016/j.neurad.2020.01.009] [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: 10/24/2022]
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23
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Guédon A, Thiebaut JB, Benichi S, Mikol J, Moxham B, Plaisant O. Dejerine-Roussy syndrome: Historical cases. Neurology 2019; 93:624-629. [PMID: 31570637 DOI: 10.1212/wnl.0000000000008209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/05/2019] [Indexed: 11/15/2022] Open
Abstract
On June 7, 1906, Jules Dejerine (1849-1917) and Gustave Roussy (1874-1948) presented to the Société de Neurologie de Paris the first description of the thalamic syndrome with serial-section microscopic images. They also provided the first account of central poststroke pain (CPSP). They suggested that pain is one of the primary symptoms of the syndrome, although one of their own patients ("Hud") did not have pain. Several contemporary studies have highlighted the involvement of the anterior part of the pulvinar (PuA) in patients with CPSP of thalamic origin. Two historical observations (cases Jos and Hud) are reviewed here using the Morel nuclei staining atlas (2007). Dejerine and Roussy proposed the "irritative theory" to explain CPSP of thalamic origin and, in line with the most recent literature, they invoked the involvement of the PuA. When matching images for the Jos and Hud cases with the Morel atlas, it appears that the lesions involved what Dejerine then termed the noyau externe; that is, the ventral posterolateral nucleus and the PuA. In the Jos case, the lesion extended medially to what Dejerine termed the noyau médian de Luys; that is, the central medial-parafascicular nuclei, whereas in the Hud case the lesion extended more inferiorly. From the finding in the Hud case, one can hypothesize that impairment of the PuA alone does not assure pain. The work of Dejerine and Roussy, based on clinico-anatomical correlations, remains relevant to this day.
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Affiliation(s)
- Alexis Guédon
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Jean-Baptiste Thiebaut
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Sandro Benichi
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Jacqueline Mikol
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Bernard Moxham
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France
| | - Odile Plaisant
- From ANCRE, URDIA EA 4465 (A.G., S.B., O.P.), Department of Anatomy, School of Medicine, Paris Descartes University, University of Paris; Department of Neuroradiology (A.G.), Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Research Center (A.G.), Laboratory of Biosurgical Research-Alain Carpentier Foundation, Hôpital Européen Georges-Pompidou (HEGP), INSERM UMR_S 1140; Trans-European Anatomical Pedagogic Research Group (TEPARG) (A.G., B.M., O.P.); Department of Neurosurgery-Pain Centre (J.-B.T.), Fondation Rothschild; Dupuytren Museum-Dejerine Foundation (J.M.), Paris, France; Cardiff School of Biosciences (B.M.), Cardiff University, Wales, UK; Epilepsy Unit and Pain Centre (O.P.), Pitié-Salpêtrière Hospital, AP-HP, Paris; and Qualipsy EE 1901 (O.P.), Université de Tours, France.
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24
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Guédon A, Condette-Auliac S, Consoli A, Di Maria F, Coskun O, Rodesch G. Primary conus medullaris arteriovenous shunt and secondary lumbo-sacral epidural arteriovenous fistula: One malformation can hide another. J Neuroradiol 2019; 48:16-20. [PMID: 31323304 DOI: 10.1016/j.neurad.2019.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 11/24/2022]
Abstract
We report an anatomical-based association between conus medullaris pial arteriovenous shunt that drain caudally towards the lumbosacral area with very delayed onset of an acquired lumbar epidural shunt, draining secondarily towards intradural veins and responsible for a venous congestive myelopathy with identical clinical symptoms. These patients require close clinical and imaging follow-ups in order to propose adequate treatments before onset of irreversible neurological deficits. MRA should include the lumbo-sacral area in its field of view.
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Affiliation(s)
- Alexis Guédon
- Department of diagnostic and therapeutic neuroradiology, hopital Foch, Suresnes, Hauts-de-Seine, France.
| | - Stéphanie Condette-Auliac
- Department of diagnostic and therapeutic neuroradiology, hopital Foch, Suresnes, Hauts-de-Seine, France.
| | - Arturo Consoli
- Department of diagnostic and therapeutic neuroradiology, hopital Foch, Suresnes, Hauts-de-Seine, France.
| | - Federico Di Maria
- Department of diagnostic and therapeutic neuroradiology, hopital Foch, Suresnes, Hauts-de-Seine, France.
| | - Oguzhan Coskun
- Department of diagnostic and therapeutic neuroradiology, hopital Foch, Suresnes, Hauts-de-Seine, France.
| | - Georges Rodesch
- Department of diagnostic and therapeutic neuroradiology, hopital Foch, Suresnes, Hauts-de-Seine, France.
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25
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Wade R, Plaisant O, Guédon A, Diop AD, Ndiaye A, Manyacka P, Gaye M, Ba S, Ndiaye A, Dia A. Morphology of the lateral fossa of the brain (sylvian valley): anatomo-radiological aspects and surgical application. Surg Radiol Anat 2019; 41:639-655. [PMID: 30955058 DOI: 10.1007/s00276-019-02228-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/20/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The knowledge acquired on the lateral fossa of the brain (LFB) is heterogeneous and incomplete. Our goal was to provide a morphological description of the LFB and analyze the impact of these descriptions on the surgical approach of the region. METHODS The morphology of LFB was studied on 40 cerebral hemispheres of 20 right-handed subjects aged 18-55 years with an MRI of 1.5 T. The anatomo-radiological identification of the two section levels preceded the description of the shapes of the LFB. From these landmarks, the forms presented by the LFB were identified and described on each of the transverse, sagittal and frontal planes. The comparison of the proportion of shapes made it possible to identify the typical shapes at each section level and on each section plane. RESULTS The average age of the subjects was 33 years with extremes of 19 and 54 years including 7 women and 13 right-handed men. According to the plane and the level of section, 6 typical morphologies of the LFB have been described, 2 of which were identical. The forms did not vary according to the cerebral hemisphere or the sex of the subject. The set of typical morphologies made it possible to determine a reference subject called NSK which presented the greatest number of typical morphological characteristics. CONCLUSION Knowledge of LFB anatomical imaging is of paramount importance in the pre-surgical evaluation of pathologies in this region. The reference subject will be used for our future biometric and three-dimensional manual reconstruction work in this region.
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Affiliation(s)
- Racky Wade
- Laboratory of Anatomy and Organogenesis, Faculty of Medicine, Pharmacy and Stomatology, Cheikh Anta Diop University, Post Box 5885, 10700, Dakar, Senegal. .,Research Unit for the Development of Anatomy and Imaging (URDIA) EA 4465, Department of Numerical, Surgical, Radiological and Experimental Anatomy, Paris Descartes-Sorbonne Paris Cité University, Paris, France.
| | - Odile Plaisant
- Research Unit for the Development of Anatomy and Imaging (URDIA) EA 4465, Department of Numerical, Surgical, Radiological and Experimental Anatomy, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Alexis Guédon
- Research Unit for the Development of Anatomy and Imaging (URDIA) EA 4465, Department of Numerical, Surgical, Radiological and Experimental Anatomy, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Abdoulaye Dione Diop
- Diagnostic and Medical Imaging Center, Fann National University Hospital Center, Dakar, Senegal
| | - Aïnina Ndiaye
- Laboratory of Anatomy and Organogenesis, Faculty of Medicine, Pharmacy and Stomatology, Cheikh Anta Diop University, Post Box 5885, 10700, Dakar, Senegal
| | - Philippe Manyacka
- Laboratory of Anatomy and Organogenesis, UFR 2S, Gaston Berger University, Saint-Louis, Senegal
| | - Magaye Gaye
- Laboratory of Anatomy and Organogenesis, Faculty of Medicine, Pharmacy and Stomatology, Cheikh Anta Diop University, Post Box 5885, 10700, Dakar, Senegal
| | - Sokhna Ba
- Diagnostic and Medical Imaging Center, Fann National University Hospital Center, Dakar, Senegal
| | - Abdoulaye Ndiaye
- Laboratory of Anatomy and Organogenesis, Faculty of Medicine, Pharmacy and Stomatology, Cheikh Anta Diop University, Post Box 5885, 10700, Dakar, Senegal
| | - Abdarahmane Dia
- Laboratory of Anatomy and Organogenesis, Faculty of Medicine, Pharmacy and Stomatology, Cheikh Anta Diop University, Post Box 5885, 10700, Dakar, Senegal
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Pariente A, Guédon A, Alamowitch S, Thietart S, Carrat F, Delorme S, Capron J, Cacciatore C, Soussan M, Dellal A, Fain O, Mekinian A. Ischemic stroke in giant-cell arteritis: French retrospective study. J Autoimmun 2019; 99:48-51. [PMID: 30737054 DOI: 10.1016/j.jaut.2019.01.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/25/2019] [Accepted: 01/26/2019] [Indexed: 12/13/2022]
Abstract
Acute cerebrovascular ischemic events are a rare and severe complication of giant cell arteritis (GCA). We aimed to determine the prevalence of GCA-related stroke, the overall survival and the relapse-free survival in patients with GCA. A multicentric retrospective analysis was performed on 129 patients with GCA diagnosed between September 2010 and October 2018 in two University Hospitals. Among 129 GCA patients, 18 (16%) presented an acute ischemic cerebrovascular event. Patients with stroke were older (83 [67-96] years versus 76 [58-96]; p = 0.014) and more frequently males (61% versus 30%; p = 0.014) than those without stroke. The frequency of anterior ischemic optic neuropathy was higher in patients with stroke (n = 6, 33%) than patients without stroke (n = 12, 11%)(p = 0.02). Overall survival was significantly decreased in GCA patients with stroke (4.4 months), comparatively to patients without stroke (221.7 months; log rank test = 0.006). The 3-years relapse-free survival was decreased in patients with stroke (8.42 versus78.0 months; log rank = 0.0001), as well as the time with sustained remission (78 versus 139 months; log rank test = 0.0004). This study shows the prevalence and risk factors of ischemic stroke in GCA.
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Affiliation(s)
- Aaron Pariente
- Service de Médecine Interne-DHU i2B, Hôpital Saint-Antoine, APHP, 75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France
| | - Alexis Guédon
- Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France
| | - Sonia Alamowitch
- Service de Neurologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, F-75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France
| | - Sara Thietart
- Service de Médecine Interne-DHU i2B, Hôpital Saint-Antoine, APHP, 75012, Paris, France; Service de Médecine Interne-DHU i2B, Hôpital Saint-Antoine, APHP, 75012, Paris, France
| | - Fabrice Carrat
- Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France
| | - Stephen Delorme
- Service de Neurologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, F-75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France
| | - Jean Capron
- Service de Neurologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, F-75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France
| | - Carlotta Cacciatore
- Service de Médecine Interne-DHU i2B, Hôpital Saint-Antoine, APHP, 75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France
| | - Michael Soussan
- Service de Médecine nucléaire, Hôpital Avicenne, AP¨HP, Université Paris 13, Bobigny, France
| | - Azeddine Dellal
- Service de Rhumatologie, Hôpital Montfermeil, Montfermeil, France
| | - Olivier Fain
- Service de Médecine Interne-DHU i2B, Hôpital Saint-Antoine, APHP, 75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France
| | - Arsene Mekinian
- Service de Médecine Interne-DHU i2B, Hôpital Saint-Antoine, APHP, 75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France.
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Edjlali M, Guédon A, Ben Hassen W, Boulouis G, Benzakoun J, Rodriguez-Régent C, Trystram D, Nataf F, Meder JF, Turski P, Oppenheim C, Naggara O. Circumferential Thick Enhancement at Vessel Wall MRI Has High Specificity for Intracranial Aneurysm Instability. Radiology 2018; 289:181-187. [PMID: 29969070 DOI: 10.1148/radiol.2018172879] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To identify wall enhancement patterns on vessel wall MRI that discriminate between stable and unstable unruptured intracranial aneurysm (UIA). Materials and Methods Patients were included from November 2012 through January 2016. Vessel wall MR images were acquired at 3 T in patients with stable (incidental and nonchanging over 6 months) or unstable (symptomatic or changing over 6 months) UIA. Each aneurysm was evaluated by using a four-grade classification of enhancement: 0, none; 1, focal; 2, thin circumferential; and 3, thick (>1 mm) circumferential. Inter- and intrareader agreement for the presence and the grade of enhancement were assessed by using κ statistics and 95% confidence interval (CI). The sensitivity, specificity, and negative and positive predictive values of each enhancement grade for differentiating stable from unstable aneurysms was compared. Results The study included 263 patients with 333 aneurysms. Inter- and intrareader agreement was excellent for both the presence of enhancement (κ values, 0.82 [95% CI: 0.67, 0.99] and 0.87 [95% CI: 0.7, 1.0], respectively) and enhancement grade (κ = 0.92 [95% CI: 0.87, 0.95]). In unruptured aneurysms (n = 307), grade 3 enhancement exhibited the highest specificity (84.4%; 233 of 276; 95% CI: 80.1%, 88.7%; P = .02) and negative predictive value (94.3%; 233 of 247) for differentiating between stable and unstable lesions. There was a significant association between grade 3 enhancement and aneurysm instability (P < .0001). Conclusion In patients with intracranial aneurysm, a thick (>1 mm) circumferential pattern of wall enhancement demonstrated the highest specificity for differentiating between stable and unstable aneurysms. © RSNA, 2018.
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Affiliation(s)
- Myriam Edjlali
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Alexis Guédon
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Wagih Ben Hassen
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Grégoire Boulouis
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Joseph Benzakoun
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Christine Rodriguez-Régent
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Denis Trystram
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - François Nataf
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Jean-Francois Meder
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Patrick Turski
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Catherine Oppenheim
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
| | - Olivier Naggara
- From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabanis, 75674 Paris Cedex 14, France; and Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wis (P.T.)
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Guédon A, Shotar E, Thepenier C, Gabrieli J, Rolla-Bigliani C, Nouet A, Degos V, Sourour N, Clarençon F. Facteurs prédictifs d’occlusion anévrismale après pose d’un stent à diversion de flux. J Neuroradiol 2018. [DOI: 10.1016/j.neurad.2017.12.007] [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: 11/28/2022]
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Guédon A, Blauwblomme T, Boulouis G, Jousset C, Meyer P, Kossorotof M, Bourgeois M, Puget S, Zerah M, Oppenheim C, Meder JF, Boddaert N, Brunelle F, Sainte-Rose C, Naggara O. Predictors of Outcome in Patients with Pediatric Intracerebral Hemorrhage: Development and Validation of a Modified Score. Radiology 2018; 286:651-658. [DOI: 10.1148/radiol.2017170152] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Splenectomy is part of the therapeutic arsenal for benign or malignant hematological disorders that constitute the main indication for elective splenectomy. With the development of minimally invasive approaches, and in particular, laparoscopy, as well as the advent of monoclonal antibody therapy, the indications and the outcomes of splenectomy for hematologic disease have changed in recent years. Nonetheless, splenectomy has its place in hemoglobinopathies and hemolytic diseases, improves thrombocytopenia in refractory immune thrombocytopenic purpura, can reverse sequelae linked to voluminous splenomegaly secondary to myelofibrosis, or can be used for diagnostic purposes or for splenomegaly in lymphoproliferative syndromes.
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Affiliation(s)
- S Bonnet
- Service de chirurgie digestive, hépatobiliaire et endocrinienne, hôpital Cochin, université Paris Descartes, AP-HP, 75014 Paris, France
| | - A Guédon
- Service de chirurgie digestive, hépatobiliaire et endocrinienne, hôpital Cochin, université Paris Descartes, AP-HP, 75014 Paris, France
| | - J-A Ribeil
- Université Paris Descartes, 75005 Paris, France; Département de biothérapie, hôpital universitaire Necker-Enfants-Malades, AP-HP, 75015 Paris, France
| | - F Suarez
- Université Paris Descartes, 75005 Paris, France; Service d'hématologie adulte, hôpital universitaire Necker-Enfants-Malades, AP-HP, Paris, France
| | - J Tamburini
- Service d'hématologie clinique, hôpital Cochin, AP-HP, 75014 Paris, France; Université Paris Descartes, 75005 Paris, France
| | - S Gaujoux
- Service de chirurgie digestive, hépatobiliaire et endocrinienne, hôpital Cochin, université Paris Descartes, AP-HP, 75014 Paris, France; Université Paris Descartes, 75005 Paris, France.
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Thedrez A, Sjouke B, Passard M, Prampart-Fauvet S, Guédon A, Croyal M, Dallinga-Thie G, Peter J, Blom D, Ciccarese M, Cefalù AB, Pisciotta L, Santos RD, Averna M, Raal F, Pintus P, Cossu M, Hovingh K, Lambert G. Proprotein Convertase Subtilisin Kexin Type 9 Inhibition for Autosomal Recessive Hypercholesterolemia-Brief Report. Arterioscler Thromb Vasc Biol 2016; 36:1647-50. [PMID: 27079874 DOI: 10.1161/atvbaha.116.307493] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 12/21/2015] [Accepted: 03/31/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors lower low-density lipoprotein (LDL) cholesterol in the vast majority of patients with autosomal dominant familial hypercholesterolemia. Will PCSK9 inhibition with monoclonal antibodies, in particular alirocumab, be of therapeutic value for patients with autosomal recessive hypercholesterolemia (ARH)? APPROACH AND RESULTS Primary lymphocytes were obtained from 28 genetically characterized ARH patients and 11 controls. ARH lymphocytes treated with mevastatin were incubated with increasing doses of recombinant PCSK9 with or without saturating concentrations of alirocumab. Cell surface LDL receptor expression measured by flow cytometry and confocal microscopy was higher in ARH than in control lymphocytes. PCSK9 significantly reduced LDL receptor expression in ARH lymphocytes albeit to a lower extent than in control lymphocytes (25% versus 76%, respectively), an effect reversed by alirocumab. Fluorescent LDL cellular uptake, also measured by flow cytometry, was reduced in ARH lymphocytes compared with control lymphocytes. PCSK9 significantly lowered LDL cellular uptake in ARH lymphocytes, on average by 18%, compared with a 46% reduction observed in control lymphocytes, an effect also reversed by alirocumab. Overall, the effects of recombinant PCSK9, and hence of alirocumab, on LDL receptor expression and function were significantly less pronounced in ARH than in control cells. CONCLUSIONS PCSK9 inhibition with alirocumab on top of statin treatment has the potential to lower LDL cholesterol in some autosomal recessive hypercholesterolemia patients.
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Affiliation(s)
- Aurélie Thedrez
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Barbara Sjouke
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Maxime Passard
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Simon Prampart-Fauvet
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Alexis Guédon
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Mikael Croyal
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Geesje Dallinga-Thie
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Jorge Peter
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Dirk Blom
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Milco Ciccarese
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Angelo B Cefalù
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Livia Pisciotta
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Raul D Santos
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Maurizio Averna
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Frederick Raal
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Paolo Pintus
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Maria Cossu
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Kees Hovingh
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
| | - Gilles Lambert
- From the Inra UMR 1280, Université de Nantes, Faculté de Médecine, Nantes, France (A.T., M.P., S.P.-F., A.G., M.C., G.L.); Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands (B.S., G.D.-T., J.P., K.H.); Lipidology Division of Internal Medicine, University of Cape Town, Cape Town, South Africa (D.B.); Dipartimiento di Nefrologia Dialisi e Trapianto, SS Annunziata Hospital, Sassari, Italy (M.C., M.C.); University of Palermo, School of Medicine, Palermo, Italy (A.B.C., M.A.); University of Genoa, Genoa, Italy (L.P.); Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medica School Hospital, Sao Paulo, Brazil (R.D.S.); Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.R.); Dipartimento di Medicina Interna, Brotzu Hospital, Cagliari, Italy (P.P.); Inserm UMR 1188, Sainte Clotilde, France (G.L.); Université de la Réunion, Faculté de Médecine, Saint Denis de la Réunion, France (G.L.); and CHU de la Réunion, Saint-Denis de la Réunion, France (G.L.)
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Shotar E, Guédon A, Sourour N, Di Maria F, Gabrieli J, Nouet A, Chiras J, Clarençon F. Superficial middle cerebral vein connection to the cavernous sinus is not infrequent in brain arteriovenous malformations: an argument against their congenital origin? Neuroradiology 2016; 58:687-95. [DOI: 10.1007/s00234-016-1679-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 03/16/2016] [Indexed: 12/12/2022]
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Guédon A, Shotar E, Sourour N, Di Maria F, Gabrieli J, Nouet A, Chiras J, Clarençon F. Connexion de la veine cérébrale moyenne superficielle au sinus caverneux dans les MAVc : un argument pour leur origine congénitale ? J Neuroradiol 2016. [DOI: 10.1016/j.neurad.2016.01.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Guédon A, Clarençon F, Di Maria F, Rosso C, Biondi A, Gabrieli J, Rojas P, Chiras J, Sourour N. Very late ischemic complications in flow-diverter stents: a retrospective analysis of a single-center series. J Neurosurg 2016; 125:929-935. [PMID: 26824382 DOI: 10.3171/2015.10.jns15703] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors evaluate the rate and discuss the pathomechanisms of very late (≥ 4-month) ischemic complications after flow-diverter stent (FDS) placement for intracranial aneurysms. METHODS The authors retrospectively reviewed the clinical data of the patients treated at Pitié-Salpêtrière Hospital between January 2010 and September 2014, who underwent FDS placement for intracranial aneurysm. The patients received dual-antiplatelet therapy (clopidogrel and aspirin) 5 days before and 3-6 months after the procedure and then aspirin alone for 6-9 months. An ischemic complication was defined as a sudden focal neurological deficit documented on diffusion-weighted images. RESULTS Eighty-six consecutive patients were included. Three (3.5%) patients treated with the Pipeline embolization device experienced a delayed acute ischemic stroke (2 cases of perforator/side-wall branch infarction and 1 case of thromboembolic stroke) with an average delay of 384 days (4 months, 20 months, and 13 months, respectively). The aneurysm locations were the left superior cerebellar artery, the right anterior choroid artery, and the left internal carotid artery (paraclinoid segment), respectively. The complications occurred after the patients had completed the antiaggregation protocol, except for Patient 1, who was receiving aspirin alone because of a spontaneous hematoma. At the acute phase, no in-stent thromboses were found on digital subtraction angiography. In Patient 2, the treated anterior choroid artery was occluded 20 months after the procedure. In Patient 3, a focal stenosis (approximately 40%) of the distal aspect of the FDS, probably caused by intimal hyperplasia, was seen. CONCLUSIONS Very late ischemic complications after FDS treatment were observed in 3.5% of the cases in the authors' series, some of which occurred as late as more than 1 year after placement.
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Affiliation(s)
| | - Frédéric Clarençon
- Departments of 1 Interventional Neuroradiology.,Paris VI University, Pierre et Marie Curie, Paris; and
| | | | - Charlotte Rosso
- Vascular Neurology, and.,Paris VI University, Pierre et Marie Curie, Paris; and
| | - Alessandra Biondi
- Department of Neuroradiology and Endovascular Therapy, Jean Minjoz University Hospital, Franche Comté University School of Medecine, Besançon, France
| | - Joseph Gabrieli
- Departments of 1 Interventional Neuroradiology.,Paris VI University, Pierre et Marie Curie, Paris; and
| | | | - Jacques Chiras
- Departments of 1 Interventional Neuroradiology.,Paris VI University, Pierre et Marie Curie, Paris; and
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van Ooij P, Guédon A, Poelma C, Schneiders J, Rutten MCM, Marquering HA, Majoie CB, VanBavel E, Nederveen AJ. Complex flow patterns in a real-size intracranial aneurysm phantom: phase contrast MRI compared with particle image velocimetry and computational fluid dynamics. NMR Biomed 2012; 25:14-26. [PMID: 21480417 DOI: 10.1002/nbm.1706] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Revised: 01/27/2011] [Accepted: 02/12/2011] [Indexed: 05/30/2023]
Abstract
The aim of this study was to validate the flow patterns measured by high-resolution, time-resolved, three-dimensional phase contrast MRI in a real-size intracranial aneurysm phantom. Retrospectively gated three-dimensional phase contrast MRI was performed in an intracranial aneurysm phantom at a resolution of 0.2 × 0.2 × 0.3 mm(3) in a solenoid rat coil. Both steady and pulsatile flows were applied. The phase contrast MRI measurements were compared with particle image velocimetry measurements and computational fluid dynamics simulations. A quantitative comparison was performed by calculating the differences between the magnitude of the velocity vectors and angles between the velocity vectors in corresponding voxels. Qualitative analysis of the results was executed by visual inspection and comparison of the flow patterns. The root-mean-square errors of the velocity magnitude in the comparison between phase contrast MRI and computational fluid dynamics were 5% and 4% of the maximum phase contrast MRI velocity, and the medians of the angle distribution between corresponding velocity vectors were 16° and 14° for the steady and pulsatile measurements, respectively. In the phase contrast MRI and particle image velocimetry comparison, the root-mean-square errors were 12% and 10% of the maximum phase contrast MRI velocity, and the medians of the angle distribution between corresponding velocity vectors were 19° and 15° for the steady and pulsatile measurements, respectively. Good agreement was found in the qualitative comparison of flow patterns between the phase contrast MRI measurements and both particle image velocimetry measurements and computational fluid dynamics simulations. High-resolution, time-resolved, three-dimensional phase contrast MRI can accurately measure complex flow patterns in an intracranial aneurysm phantom.
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Affiliation(s)
- P van Ooij
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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Van Wymelbeke V, Guédon A, Maniere D, Manckoundia P, Pfitzenmeyer P. A 6-month follow-up of nutritional status in institutionalized patients with Alzheimer's disease. J Nutr Health Aging 2004; 8:505-8. [PMID: 15543424] [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: 05/01/2023]
Abstract
OBJECTIVE A follow up of nutritional status in institutionalized patients with Alzheimer's disease. DESIGN Observational study. SETTING Specialized unit for patients with Alzheimer's disease in Dijon hospital, France. SUBJECTS Fourteen women, aged 72-92 years. ASSESSMENTS On admission of patients to the specialized unit for dementia, body weight, body mass index, arm muscle circumference (AMC) and triceps skin fold (TSF) were measured. Serum concentrations of albumin, prealbumin, homocysteine, orosomucoide, calcium, folates, vitamins B12 and B6 and C-reactive protein were recorded. The same clinical and biological measurements were repeated at day 30, 90 and 180. RESULTS Both mean weight and mean BMI increased throughout the study with significant differences between day 0 and day 90, and day 180 (p<0.01). The weight gain was associated with a significant increase in AMC and TSF (p<0.01 and p<0.001, respectively). There was no significant difference for values of both mean serum levels of albumin and prealbumin between day 0 and day 180. Whatever the period, serum concentrations of folates and vitamin B12 were in the normal range, while mean levels of vitamin B6 were lower than the normal range; For all these values, there was no significant difference between day 0, 30, 90, 180. Mean levels of C-reactive protein and orosomucoide and lymphocyte counts were in the normal range both at admission and day 180. No significant difference was noted between value of homocysteine at admission and at day 180. CONCLUSION In this special care unit, the patients with Alzheimer's disease who take part in daily activities and particularly preparation of the meal don't lose weight. It is certain that future studies recording food intake and energy expenditure are necessary to explain the benefits in the nutritional status observed in patients showing dementia when they are institutionalized in a special unit.
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Affiliation(s)
- V Van Wymelbeke
- Centre Hopitalier Universitaire de Dijon, Centre de Gerontologie-Hôspital Champmaillot, 2 rue Jules Violle, 21000 Dijon.
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