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Publications (5)3.58 Total impact

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    ABSTRACT: L’adénomyose est une pathologie utérine bénigne fréquente définie par la présence d’îlots d’endomètre ectopique au sein du myomètre. Elle est asymptomatique dans un tiers des cas et dans le cas contraire, les signes cliniques restent peu spécifiques. Son diagnostic est souvent méconnu en échographie et peut être pris à tort pour un utérus polymyomateux ou un épaississement de l’endomètre avec des enjeux pronostiques et thérapeutiques différents. L’adénomyose est fréquemment associée à des lésions pelviennes hormono-dépendantes (myomes, endométriose et hyperplasie de l’endomètre). L’association avec une infertilité ou des complications obstétricales est plus rare et son implication directe reste controversée. L’imagerie a pour buts de poser le diagnostic, déterminer le degré d’extension (adénomyose focale ou diffuse, superficielle ou profonde, adénomyome) et rechercher d’éventuelles pathologies associées, en particulier l’endométriose. L’objectif de cet article est de savoir reconnaître l’adénomyose en imagerie et d’identifier les pathologies qui lui sont fréquemment associées afin de guider la prise en charge thérapeutique des patientes symptomatiques. L’échographie pelvienne est l’examen de première intention. L’hystérosonographie peut aider au diagnostic dans certains cas particuliers (faux épaississement échographique endométriale). L’IRM peut compléter l’échographie pour affirmer le diagnostic et rechercher les pathologies associées.
    Journal de Radiologie Diagnostique et Interventionnelle. 01/2013; 94(1):3–25.
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    ABSTRACT: Adenomyosis is a common benign uterine pathology that is defined by the presence of islands of ectopic endometrial tissue within the myometrium. It is asymptomatic in one third of cases, but when there are clinical signs they remain non-specific. It can often be misdiagnosed on sonography as it may be taken to be multiple uterine leiomyomata or endometrial thickening, both of which have a different prognosis and treatment. Adenomyosis is often associated with hormone-dependent pelvic lesions (myoma, endometriosis, or endometrial hyperplasia). It is less commonly connected to infertility or obstetrical complications and indeed any direct relationship remains controversial. The purpose of imaging is to make the diagnosis, to determine the extent of spread (focal or diffuse, superficial or deep adenomyosis, adenomyoma), and to check whether there is any associated disease, in particular endometriosis. The aim of this article is to provide assistance in recognising adenomyosis on imaging and to identify the pathologies that are commonly associated with it in order to guide the therapeutic management of symptomatic patients. Pelvic ultrasonography is the first line investigation. Sonohysterography can assist with diagnosis in some cases (pseudothickening of the endometrium seen on sonography). MRI may be used in addition to sonography to back up the diagnosis and to look for any associated disease.
    Diagnostic and interventional imaging. 12/2012;
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    ABSTRACT: The purpose of this study is to present an alternative technique for management of a type II endoleak associated with aneurysm sac enlargement. We report the use of a transseptal needle-sheath system for a transcatheter transcaval embolization (TTE) in a 3-staged treatment of a persistent type II endoleak after abdominal EVAR. Inferior vena cava is cannulated through a femoral venous access, and aneurysmal sac access is gained with a puncture through the walls of the 2 vessels at the site where the vein is adjacent to the aneurysm. The whole system (sheath-dilator-needle) is then advanced across the vascular walls into the aortic sac. Thus, embolization with glue is performed. The TTE using a transseptal needle-sheath system demonstrated to be feasible and effective to treat a persistent type II endoleak after failure of 2 attempts of transarterial embolization of the feeding vessels.
    Vascular and Endovascular Surgery 05/2012; 46(5):410-3. · 0.88 Impact Factor
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    ABSTRACT: To review the use of thoracic endovascular aortic repair (TEVAR) for late pseudoaneurysm formation after surgical repair of aortic coarctation. From May 2001 to May 2005, 8 patients (5 men; mean age 47.6 years, range 18-73) with a history of aortic coarctation repairs 17 to 40 years prior were referred to our institution for an anastomotic thoracic pseudoaneurysm. TEVAR was performed successfully in 7 patients; 1 died of suspected aneurysm rupture before the scheduled procedure. A carotid-subclavian bypass was performed in 3 patients. All the procedures were immediately successful. No type I endoleaks were seen on the final control angiogram, but 2 of the patients with carotid-subclavian bypasses required additional left subclavian artery embolization due to type II endoleak. One of these patients died before embolotherapy on the 5th postoperative day from presumed aneurysm rupture (14% 30-day mortality rate). Over a follow-up period ranging from 15 to 72 months (mean 37), all the false aneurysms have remained thrombosed and the mean diameter has decreased from 44 to 23 mm. No endograft-related complications have occurred, and no further interventions have so far been necessary. TEVAR is a feasible alternative treatment for patients who have already undergone surgical repair of aortic coarctation. Technical issues regarding the endovascular strategy should be discussed with a multidisciplinary team to define the correct interventional plan.
    Journal of Endovascular Therapy 11/2008; 15(5):552-7. · 2.70 Impact Factor
  • Journal De Radiologie - J RADIOL. 01/2008; 89(10):1532-1532.