A Bonafé

Université de Montpellier 1, Montpelhièr, Languedoc-Roussillon, France

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Publications (249)362.31 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Incomplete occlusion and recanalization of large and wide-neck brain aneurysms treated by endovascular therapy remains a challenge. We present preliminary clinical and angiographic results of an experimentally optimized Surpass flow diverter for treatment of intracranial aneurysms in a prospective, multicenter, nonrandomized, single-arm study.
    AJNR. American journal of neuroradiology. 08/2014;
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    ABSTRACT: WEBCAST is a European study dedicated to the evaluation of the feasibility, safety, and efficacy of endovascular treatment with WEB of intracranial aneurysms.
    Journal of neurointerventional surgery 07/2014; 6 Suppl 1:A51. · 1.38 Impact Factor
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    ABSTRACT: The present study follows an experimental work based on the characterization of the biomechanical behavior of the aneurysmal wall and a numerical study where a significant difference in term of volume variation between ruptured and unruptured aneurysm was observed in a specific case. Our study was designed to highlight by means of numeric simulations the correlation between aneurysm sac pulsatility and the risk of rupture through the mechanical properties of the wall.
    AJNR. American journal of neuroradiology. 05/2014;
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    ABSTRACT: Background and Purpose—We report on workflow and process-based performance measures and their effect on clinical outcome in Solitaire FR Thrombectomy for Acute Revascularization (STAR), a multicenter, prospective, single-arm study of Solitaire FR thrombectomy in large vessel anterior circulation stroke patients. Methods—Two hundred two patients were enrolled across 14 centers in Europe, Canada, and Australia. The following time intervals were measured: stroke onset to hospital arrival, hospital arrival to baseline imaging, baseline imaging to groin puncture, groin puncture to first stent deployment, and first stent deployment to reperfusion. Effects of time of day, general anesthesia use, and multimodal imaging on workflow were evaluated. Patient characteristics and workflow processes associated with prolonged interval times and good clinical outcome (90-day modified Rankin score, 0–2) were analyzed. Results—Median times were onset of stroke to hospital arrival, 123 minutes (interquartile range, 163 minutes); hospital arrival to thrombolysis in cerebral infarction (TICI) 2b/3 or final digital subtraction angiography, 133 minutes (interquartile range, 99 minutes); and baseline imaging to groin puncture, 86 minutes (interquartile range, 24 minutes). Time from baseline imaging to puncture was prolonged in patients receiving intravenous tissue-type plasminogen activator (32-minute mean delay) and when magnetic resonance–based imaging at baseline was used (18-minute mean delay). Extracranial carotid disease delayed puncture to first stent deployment time on average by 25 minutes. For each 1-hour increase in stroke onset to final digital subtraction angiography (or TICI 2b/3) time, odds of good clinical outcome decreased by 38%. Conclusions—Interval times in the STAR study reflect current intra-arterial therapy for patients with acute ischemic stroke. Improving workflow metrics can further improve clinical outcome. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01327989. http://strokeblog.strokeahajournal.org/2014/05/factors-that-delayed-treatment-in-star.html
    Stroke 05/2014; STROKEAHA.114.005050 Published online before print May 15, 2014, doi: 10.1161/ STROKEAHA.114.005050. · 6.16 Impact Factor
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    ABSTRACT: The goal of aneurysm treatment is occlusion of an aneurysm without morbidity or mortality. Using well-established, traditional endovascular techniques, this is generally achievable with a high level of safety and efficacy. These techniques involve either constructive treatment of the aneurysm (coils with or without an intravascular stent) or deconstruction (coil occlusion) of the aneurysm and the parent artery. While established as safe and efficacious, the constructive treatment of large and giant aneurysms with coils has typically been associated with relatively lower rates of complete occlusion and higher rates of recurrence. Parent artery deconstruction, though immediately efficacious in achieving complete and durable occlusion, does require occlusion of a major intracranial blood vessel and is associated with risk of stroke. Flow diversion represents a new technology that can be used to constructively treat large and giant aneurysms. Once excluded successfully, the vessel reconstruction and aneurysm occlusion appears durable. The ability to definitively reconstruct cerebral blood vessels is an attractive approach to these large and giant complex aneurysms and allows the treatment of some aneurysms which were previously not amenable to other therapies. By comparison, conventional coiling techniques have traditionally been used for endovascular treatment of large aneurysms. Large and giant aneurysms that are amenable to either flow diversion or traditional endovascular treatment will be randomized to either therapy with FDA (or appropriate regulatory body) approved devices. The trial is currently enrolling and results of the data are pending the completion of enrollment and follow-up. This paper details the trial design of the LARGE trial, a blinded, prospective randomized trial of large anterior circulation aneurysms amenable to either traditional endovascular treatments using coils or reconstruction with flow diverters.
    American Journal of Neuroradiology 05/2014; · 3.17 Impact Factor
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    ABSTRACT: Endovascular treatment of intracranial aneurysms can be technically difficult when the neck is wide. The Solitaire AB stent, the only fully retrieved stent, assists in the coiling of wide-neck intracranial aneurysms. To evaluate the mid-term angiographic follow-up of wide-necked aneurysms treated with the Solitaire AB stent. SOLARE is a consecutive, prospective study conducted in 7 European centers. A core laboratory evaluated the postoperative and mid-term (6 month ± 15 days) angiographic results by using the Raymond classification Scale. "Recanalization" was defined as worsening, and "progressive thrombosis" was defined as improvement on the Raymond scale. The mean width of the aneurysm sac was 7.5 mm, and the mean diameter of the aneurysm neck was 4.7 mm. Angiographic mid-term follow-up was obtained in 55 of 65 aneurysms (85.9%). Complete occlusion was achieved in 33 aneurysms (60%); neck remnant was seen in 16 aneurysms (29.1%) and aneurysm remnant in 6 aneurysms (10.9%). Of 55 aneurysms, recanalization was observed in 8 aneurysms (14.5%), and progressive thrombosis was observed in 17 aneurysms (30.9%). No bleeding or rebleeding was observed during the follow-up period. Stent-assisted coiling of wide-necked intracranial aneurysms is safe and effective with the Solitaire AB stent at 6-month follow-up. Angiographic results improve with time due to progressive thrombosis of the aneurysm.
    Neurosurgery 05/2014; · 2.53 Impact Factor
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    ABSTRACT: Hemidystonia is usually 'secondary' to structural lesions within the cortico-striato-pallido-thalamic or the cerebello-thalamo-cortical loops. Globus pallidus internus Deep Brain Stimulation (GPi DBS) is a validated technique in the treatment of primary dystonia and still under assessment for secondary dystonia. Results of DBS in hemidystonia are limited and heterogeneous. Further knowledge concerning motor network organization after focal brain lesions might contribute to the understanding of this mitigated response to DBS and to the refinement of DBS indications and techniques in secondary dystonia. This study aimed to identify movement-related functional magnetic resonance imaging (fMRI) activation patterns in a group of hemidystonic patients in comparison to healthy controls (HC). Further analysis assessed recruitment pattern in different patient subgroups defined according to clinical and radiological criteria relevant to GPi DBS eligibility (hyperkinetic/hypokinetic and prepallidal/postpallidal). Eleven patients and nine HC underwent fMRI with a block-design alternating active and rest conditions. The motor paradigm consisted of self-paced elbow flexion-extension movements. The main results were as follows: single-subject studies revealed several activation patterns involving motor-related network regions; both ipsilesional and contralesional hemispheres showed abnormal patterns of activity; compared with HC, hemidystonic patients showed decreased brain activity in ipsilesional thalamus, pallidal and temporal areas during affected arm task execution; 'hypokinetic' subgroup was commonly related to widespread bilateral overactivity. This study provides additional arguments for case-by-case assessment of DBS surgery indication and target selection in hemidystonia. Single-lead approach might be unable to modulate a highly disorganized network activity in certain patients with this clinical syndrome.
    Brain Imaging and Behavior 04/2014; · 2.67 Impact Factor
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    ABSTRACT: Carotid cavernous sinus fistulas are a potentially severe pathology. Their basic standard treatment is an occlusion of the CCF performed by retrograde venous catheterization via the inferior petrous sinus. When the inferior petrous sinuses are occluded, other alternative venous routes are possible with various subsequent difficulties and risks. We report an original and safe method for endovascular treatment using submandibular puncture of the facial vein. We report 4 cases of patients with severe unilateral carotid cavernous sinus fistula associated with the occlusion of both inferior petrous sinuses. A submandibular surgical puncture of the ipsilateral inferior facial vein permitted the catheterization of the fistula. Complete occlusion of carotid cavernous sinus fistula was obtained by using a combination of microcoils and Onyx™. When inferior petrous sinuses are occluded, endovascular treatment of carotid cavernous sinus fistulas is more difficult. After reviewing the other treatment options reported in the literature and their respective advantages and adverse effects, we describe an original technique based on the surgical puncture of the ipsilateral facial vein. The occlusion of the fistula is then obtained by using a combination of microcoils and Onyx™. When the inferior petrous sinuses are occluded, an endovascular treatment for a carotid cavernous sinus fistula can be performed using an original and secure method. This method relies on a simple surgical puncture of the facial vein in the submandibular region, which then permits a retrograde catheterization of the carotid cavernous sinus fistula with no significant risk.
    Neurochirurgie 04/2014; · 0.32 Impact Factor
  • Journal of Neuroradiology 03/2014; · 1.24 Impact Factor
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    ABSTRACT: In the present study, we performed biometric characterization of the temporomandibular joints (TMJs) of clinically normal subjects. Fifty-one healthy volunteers underwent high-resolution computerized tomography examination of the TMJs in the position of maximal intercuspidation according to a standardized protocol. Frontal and sagittal reconstructions were then performed to obtain measurements and indexes in three planes of space. Correlations are observed with age, gender, amplitude of mouth opening and presence of dental abrasion. The lateral stability index reflects the degree of mobility of the temporo-discal compartment of the joint. The coverage index reflects how much the mandibular condyle is inserted into the articular fossa and may be related to the risk of occurrence and severity of regressive remodeling phenomena. This study supports the interest in examining morphological aspects of the TMJ and performing intra-articular measurements. The biometric examination of the TMJ has important applications in the domain of TMJ pathology.
    Anatomia Clinica 03/2014; · 0.93 Impact Factor
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    ABSTRACT: Age and stroke severity are inversely correlated with the odds of favorable outcome after ischemic stroke. A previously proposed score for Stroke Prognostication Using Age and NIHSS Stroke Scale (SPAN) indicated that SPAN-100-positive patients (ie, age + NIHSS score = 100 or more) do not benefit from IV-tPA. If this finding holds true for endovascular therapy, this score can impact patient selection for such interventions. This study investigated whether a score combining age and NIHSS score can improve patients' selection for endovascular stroke therapy. The SPAN index was calculated for patients in the prospective Solitaire FR Thrombectomy for Acute Revascularization study: an international single-arm multicenter cohort for anterior circulation stroke treatment by using the Solitaire FR. The proportion with favorable outcome (90-day mRS score ≤2) was compared between SPAN-100-positive versus-negative patients. Of the 202 patients enrolled, 196 had baseline NIHSS scores. Fifteen (7.7%) patients were SPAN-100-positive. There was no difference in the rate of successful reperfusion (Thrombolysis In Cerebral Infarction 2b or 3) between SPAN-100-positive versus -negative groups (93.3% versus 82.8%, respectively; P = .3). Stroke SPAN-100-positive patients had a significantly lower proportion of favorable clinical outcomes (26.7% versus 60.8% in SPAN-100-negative, P = .01). In a multivariable analysis, SPAN-100-positive status was associated with lower odds of favorable outcome (OR, 0.3; 95% CI, 0.1-0.9; P = .04). A higher baseline Alberta Stroke Program Early CT Score and a short onset to revascularization time also predicted favorable outcome in the multivariable analysis. A significantly lower proportion of patients with a positive SPAN-100 achieved favorable outcome in this cohort. SPAN-100 was an independent predictor of favorable outcome after adjusting for time to treatment and the extent of preintervention tissue damage according to the Alberta Stroke Program Early CT Score.
    American Journal of Neuroradiology 02/2014; · 3.17 Impact Factor
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    ABSTRACT: The prognosis for ischemic stroke due to acute basilar artery occlusion is very poor: Early recanalization remains the main factor that can improve outcomes. The baseline extent of brain stem ischemic damage can also influence outcomes. We evaluated the validity of an easy-to-use DWI score to predict clinical outcome in patients with acute basilar artery occlusion treated by mechanical thrombectomy. We analyzed the baseline clinical and DWI parameters of 31 patients with acute basilar artery occlusion, treated within 24 hours of symptom onset by using a Solitaire FR device. The DWI score of the brain stem was assessed with a 12-point semiquantitative score that separately considered each side of the medulla, pons, and midbrain. Clinical outcome was assessed at 180 days by using the mRS. According to receiver operating characteristic analyses, the cutoff score determined the optimal positive predictive value for outcome. The Spearman rank correlation coefficient assessed the correlation between the DWI brain stem score and baseline characteristics. Successful recanalization (Thrombolysis in Cerebral Infarction 3-2b) was achieved in 23 patients (74%). A favorable outcome (mRS ≤ 2) was observed in 11 patients (35%). An optimal DWI brain stem score of <3 predicted a favorable outcome. The probability of a very poor outcome (mRS ≥ 5) if the DWI brain stem score was ≥5 reached 80% (positive predictive value) and 100% if this score was ≥6. Interobserver reliability of the DWI brain stem score was excellent, with an intraclass correlation coefficient of 0.97 (95% CI, 0.96-0.99). The DWI brain stem score was significantly associated with baseline tetraplegia (P = .001) and coma (P = .005). In patients with acute basilar artery occlusion treated by mechanical thrombectomy, the baseline DWI brain lesion score seems to predict clinical outcome.
    American Journal of Neuroradiology 02/2014; · 3.17 Impact Factor
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    ABSTRACT: 1) study cochlea size variability among age and degree of deafness; 2) calculate the length of the cochlear implant electrode needed to obtain the optimal final insertion depth angle of 270°. A total of 241 patients (482 ears) that underwent high resolution computed tomography (HRCT) of the ear in our Institution between 2003 and 2008 were included to collect temporal bone data, and were divided in 3 groups: 97 (194 ears) patients with bilateral severe or profound sensorineural hearing loss (Group A), 70 patients (140 ears) with bilateral moderate sensorineural hearing loss (Group B), 74 patients (148 ears) without sensorineural or mixed hearing loss (Group C). In each of the 3 groups, 5 subgroups were identified with the following age criteria: 1) subgroup 1: subjects ≤5 years old; 2) subgroup 2: subjects 6-10 years old; 3) subgroup 3: patients 11-15 years old; 4) subgroup 4: patients 16-20 years old; 5) subgroup 5: subjects >; 20 years old. The length of the cochlea, height of the cochlea, basal turn lumen diameter (BTLD) and volume of the cochlea were measured. The Mann-Whitney test was used to assess the alternative hypothesis that a statistically significant difference in size exists between the different groups and subgroups. The following equation was adopted to calculate the length of a straight electrode which follows the outer wall of the scala tympani required to obtain the ideal insertion depth angle of 270°( LIC ): [Formula: see text] . We found that the cochlea is completely developed and has reached adult size at birth. The degree of deafness does not affect the length or volume of the cochlea, while it can affect the height and BTLD. To assist the surgeon to calculate the ideal insertion depth angle of 270° in order to preserve residual hearing, it is useful to propose a straight electrode with 3 landmarks on the array (the first at 16.635 mm from the tip, the second at 17.987 mm and the third at 19.34 mm).
    Acta otorhinolaryngologica Italica: organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale 02/2014; 34(1):42-49. · 0.79 Impact Factor
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    ABSTRACT: The ability of polymer-modified coils to promote stable aneurysm occlusion after endovascular treatment is not well-documented. Angiographic aneurysm recurrence is widely used as a surrogate for treatment failure, but studies documenting the correlation of angiographic recurrence with clinical failure are limited. This trial compares the effectiveness of Matrix(2) polyglycolic/polylactic acid biopolymer-modified coils with bare metal coils and correlates the angiographic findings with clinical failure (ie, target aneurysm recurrence), a composite end point that includes any incident of posttreatment aneurysm rupture, retreatment, or unexplained death. This was a multicenter randomized noninferiority trial with blinded end point adjudication. We enrolled 626 patients, divided between Matrix(2) and bare metal coil groups. The primary outcome was target aneurysm recurrence at 12 ± 3 months. At 455 days, at least 1 target aneurysm recurrence event had occurred in 14.6% of patients treated with bare metal coils and 13.3% of Matrix(2) (P = .76, log-rank test) patients; 92.8% of target aneurysm recurrence events were re-interventions for aneurysms that had not bled after treatment, and 5.8% of target aneurysm recurrence events resulted from hemorrhage or rehemorrhage, with or without retreatment. Symptomatic re-intervention occurred in only 4 (0.6%) patients. At 455 days, 95.8% of patients with unruptured aneurysms and 90.4% of those with ruptured aneurysms were independent (mRS ≤ 2). Target aneurysm recurrence was associated with incomplete initial angiographic aneurysm obliteration, presentation with rupture, and a larger aneurysmal dome and neck size. Tested Matrix(2) coils were not inferior to bare metal coils. Endovascular coiling of intracranial aneurysms was safe, and the rate of technical success was high. Target aneurysm recurrence is a promising clinical outcome measure that correlates well with established angiographic measurements.
    American Journal of Neuroradiology 01/2014; · 3.17 Impact Factor
  • Journal of Neuroradiology. 01/2014; 41(1):2.
  • Journal of Neuroradiology. 01/2014; 41(1):18.
  • Journal of Neuroradiology. 01/2014; 41(1):4.
  • Journal of Neuroradiology. 01/2014; 41(1):18–19.
  • Journal of Neuroradiology. 01/2014; 41(1):13–14.
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    ABSTRACT: Introduction Les fistules durales du sinus caverneux représentent une pathologie potentiellement sévère. Leur traitement de référence est l’occlusion du sinus caverneux fistuleux obtenue par cathétérisme veineux rétrograde via le sinus pétreux inférieur. En cas d’occlusion de celui-ci, d’autres accès veineux sont possibles, avec des difficultés et des risques variables. Nous rapportons une méthode originale et sûre de traitement endovasculaire, nécessitant une ponction sous-mandibulaire de la veine faciale. Cas cliniques Il s’agit de 4 patients porteurs d’une forme sévère de fistule durale du sinus caverneux associée à une occlusion des 2 sinus pétreux inférieurs. Une ponction chirurgicale sous-mandibulaire de la veine faciale homolatérale a permis le cathétérisme du sinus caverneux fistuleux. L’occlusion complète de la fistule a été obtenue en combinant l’utilisation de microcoïls et d’Onyx™. Discussion Quand les sinus pétreux inférieurs sont occlus, le traitement endovasculaire des fistules durales du sinus caverneux est plus difficile. Après avoir passé en revue les différentes méthodes rapportées précédemment, nous présentons une technique originale basée sur une ponction chirurgicale de la veine faciale homolatérale. L’occlusion de la fistule est ensuite obtenue par l’usage combiné de microcoïls et d’Onyx™. Conclusion En cas d’occlusion des sinus pétreux inférieurs, le traitement endovasculaire des fistules durales du sinus caverneux peut être réalisé grâce à une méthode originale et sûre, basée sur un abord chirurgical simple de la veine faciale dans la région sous-mandibulaire, qui permet le cathétérisme rétrograde du sinus caverneux fistuleux.
    Neurochirurgie. 01/2014;

Publication Stats

1k Citations
362.31 Total Impact Points


  • 2013–2014
    • Université de Montpellier 1
      • Faculté de Pharmacie
      Montpelhièr, Languedoc-Roussillon, France
    • Imperial College Healthcare NHS Trust
      Londinium, England, United Kingdom
  • 2000–2013
    • Centre Hospitalier Universitaire de Montpellier
      Montpelhièr, Languedoc-Roussillon, France
  • 2012
    • Centre Hospitalier Universitaire de Bordeaux
      Burdeos, Aquitaine, France
  • 2009–2012
    • Centre Hospitalier Universitaire de Dijon
      • Department of Neurology
      Dijon, Bourgogne, France
  • 2011
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France
  • 2002–2008
    • Centre Hospitalier Universitaire de Reims
      Rheims, Champagne-Ardenne, France
  • 2006
    • Université Montpellier 2 Sciences et Techniques
      Montpelhièr, Languedoc-Roussillon, France
  • 2005
    • Hôpital Charles-Nicolle
      Tunis-Ville, Tūnis, Tunisia
    • Université Libre de Bruxelles
      Bruxelles, Brussels Capital Region, Belgium
    • Assistance Publique Hôpitaux de Marseille
      • Service de neurochirurgie infantile
      Marseille, Provence-Alpes-Cote d'Azur, France
    • invivo-AFDIAR
      United States
    • Centre Hospitalier Universitaire d'Angers
      Angers, Pays de la Loire, France
  • 1978–2001
    • Centre Hospitalier Universitaire de Toulouse
      • Département d’Urologie
      Tolosa de Llenguadoc, Midi-Pyrénées, France