S. Vignes

Hôpital Européen Georges-Pompidou (Hôpitaux Universitaires Paris-Ouest), Lutetia Parisorum, Île-de-France, France

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Publications (170)182.48 Total impact

  • M. Arrault, S. Vignes
    Journal des Maladies Vasculaires 03/2015; 40(2). DOI:10.1016/j.jmv.2014.12.144 · 0.24 Impact Factor
  • S. Vignes, P. Trévidic
    Journal des Maladies Vasculaires 03/2015; 40(2). DOI:10.1016/j.jmv.2014.12.146 · 0.24 Impact Factor
  • S. Vignes
    Journal des Maladies Vasculaires 03/2015; 40(2). DOI:10.1016/j.jmv.2014.12.074 · 0.24 Impact Factor
  • Journal des Maladies Vasculaires 03/2015; 40(2):119. DOI:10.1016/j.jmv.2014.12.025 · 0.24 Impact Factor
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    ABSTRACT: Abstract Objective: To analyze upper-limb lymphedema characteristics of renal transplant recipients taking sirolimus, an mTOR inhibitor. Method: Cross-sectional study of sirolimus-treated upper-limb lymphedema patients (01/2009-12/2013). Results: Three men and two women, whose mean age at transplantation was 60 (range: 49-76) years, were included. Sirolimus (1-2.5 mg/day) had been taken for 27.5±21 (range: 7-58) months before left (n=4) or right (n=1), whole limb (n=4), or hand and forearm (n=1) upper-limb lymphedema onset, always ipsilateral to the functional arteriovenous fistula. Ultrasonography or fistulography excluded venous thrombosis in all patients. At the time lymphedema appeared, all five arteriovenous fistulas were functional. Mean upper-limb lymphedema volume, calculated with the truncated-cone formula, was 774±162 [range: 594-1035] mL, (i.e. 44%±11% [range: 36%-64%] excess volume compared to the contralateral limb. One patient also had ipsilateral breast lymphedema. The three lymphoscintigraphies obtained showed total absence of ipsilateral axillary-region tracer uptake. Sirolimus was maintained in all cases. Upper-limb lymphedema treatment included low-stretch bandages (n=4) and elastic sleeve (20-36 mm Hg) (n=5) without fistula complications. Two patients had their fistulas closed without any impact on lymphedema volume. Conclusion: Sirolimus may be implicated in large-volume upper-limb lymphedema in kidney-transplant recipients, ipsilateral to the arteriovenous fistula, and requires compression-based therapy.
    Lymphatic Research and Biology 08/2014; 12(3). DOI:10.1089/lrb.2014.0005 · 1.66 Impact Factor
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    ABSTRACT: Objectif Le traitement du lymphœdème repose sur la thérapie décongestive qui associe une phase initiale de traitement décongestif intensif (TDI) suivie d’un traitement d’entretien. L’objectif de l’étude POLIT était de décrire l’efficacité et la tolérance des traitements pendant la phase initiale et six mois après la phase de TDI. Méthodes Étude d’observation prospective multicentrique de patients présentant un lymphœdème unilatéral de membre. Objectif principal Évaluer la variation de volume du lymphœdème entre l’inclusion, la fin du TDI et après six mois de traitement d’entretien. Objectifs secondaires Évaluer la fréquence des lourdeurs handicapantes de membre et la tolérance des traitements ; déterminer des facteurs prédictifs de la variation de volume. Résultats Trois cent six patients présentant un lymphœdème du membre supérieur/inférieur (n = 184/122) ont été inclus. Pendant le TDI, la réduction médiane du volume du lymphœdème était de 31,0 % (41,7–19,9) suivie d’une réaugmentation de volume médian de 16,5 % (5,9–42,3) après six mois de traitement d’entretien. Un TDI antérieur était le seul facteur prédictif de cette réponse. Parmi les patients, 75,5 % rapportaient des lourdeurs de membre à l’inclusion contre 42,3 % à la fin du TDI et 62,6 % à la fin du suivi. Pendant le TDI, rougeurs de peau et marques de compression étaient fréquentes (10,5 et 8,2 % des patients), les lésions de frottement nécessitant l’arrêt du traitement étaient rares (1,4 %). Conclusions Le TDI diminue le volume du lymphœdème et les lourdeurs handicapantes de membre. Ce bénéfice s’atténue lors des six premiers mois du traitement d’entretien. L’amélioration du traitement d’entretien est indispensable à la persistance à long terme du bénéfice du TDI.
    Journal des Maladies Vasculaires 07/2014; DOI:10.1016/j.jmv.2014.05.004 · 0.24 Impact Factor
  • La Revue de Médecine Interne 06/2014; 35(6):403–404. DOI:10.1016/j.revmed.2013.08.016 · 1.32 Impact Factor
  • Journal des Maladies Vasculaires 03/2014; 39(2):124-125. DOI:10.1016/j.jmv.2013.12.034 · 0.24 Impact Factor
  • S Vignes
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    ABSTRACT: Two questions arise when considering the treatment of varicose veins and the development of lymphedema: can the treatment cause lymphedema? Can it worsen it? Primary lymphedema is rarely associated with varicose veins except in the lymphedema-distichiasis syndrome. Data available in the literature is essentially based on surgical treatment. Stripping on a normal limb may induce chronic lymphedema in almost 0.1% of cases. The risk of lymphedema after stripping in patients with previous pelvic surgery including lymph node excision and/or radiotherapy remains unknown. In patients with lower limb lymphedema wearing strong elastic compression stockings, stripping provides little clinical improvement and can worsen volume. The main objective is also to avoid venous complications. Lymphatic lesions related to stripping can be evaluated by lymphography or lymphoscintigraphy. New techniques for treating varicose veins (sclerotherapy, endovenous laser treatment, radiofrequency ablation) seem to induce fewer lymphatic complications. Further studies are required to confirm these results. Indications for treatment should be unquestionable and patients must be alerted to the potential risk of lymphedema or its worsening.
    Journal des Maladies Vasculaires 12/2013; · 0.24 Impact Factor
  • La Revue de Médecine Interne 09/2013; · 1.32 Impact Factor
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    ABSTRACT: Upper-limb lymphedema (ULL) occurs in 15%-20% of women after breast-cancer treatment. Its intensive therapy relies on complete (complex) decongestive physiotherapy (CDP), whose duration is not well-established. Determine optimal intensive-phase CDP duration for lymphedema-volume reduction and factors predicting its success, with the hope of halving it from 11 to 4days. All patients with ULL (08/2011-06/2012) after breast-cancer treatment referred to our Department of Lymphology in a rehabilitation facility for 11days of CDP were eligible. Lymphedema volume was calculated using the truncated-cone formula. Volume reduction considered clinically relevant after 4days was defined as ≥75% of the total reduction obtained after 11days. We included 129 women (mean age: 64 (range: 42-88) years). Mean (sd) lymphedema volume was 907 (558) ml at CDP onset, decreased to 712 (428) ml after 4days (vs. onset, P<.0001) and 606 (341) ml after 11days (vs. 4, P<.0001), corresponding to 33% total lymphedema-volume reduction. For all patients, 4days of CDP achieved 63% (sd 40%) of that total reduction, with ≥75% for 50 (39%) patients. Surgery-to-lymphedema-onset interval >2years was the only factor significantly associated with 4days achieving ≥75% of the total lymphedema-volume reduction. Intensive phase CDP for 11days obtained significantly more volume reduction of breast cancer-related ULL than 4.
    Gynecologic Oncology 07/2013; 131(1). DOI:10.1016/j.ygyno.2013.07.101 · 3.69 Impact Factor
  • S Vignes
    Annales de Dermatologie et de Vénéréologie 06/2013; 140(6-7):483-4. DOI:10.1016/j.annder.2013.04.098 · 0.67 Impact Factor
  • La Revue de Médecine Interne 03/2013; 34(5). DOI:10.1016/j.revmed.2013.02.024 · 1.32 Impact Factor
  • S Vignes
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 03/2013; 45(5). DOI:10.1016/j.ejvs.2013.01.035 · 3.07 Impact Factor
  • Source
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    ABSTRACT: The quality standards of the French Society of vascular medicine for the ultrasonographic assessment of vascular malformations are based on the two following requirements Technical know-how: mastering the use of ultrasound devices and the method of examination. Medical know-how: ability to adapt the methods and scope of the examination to its clinical indication and purpose, and to rationally analyze and interpret its results. Aims of the quality standards To describe an optimal method of examination in relation to the clinical question and hypothesis. To achieve consistent practice, methods, glossary, and reporting. To provide good practice reference points, and promote a high-quality process. Items of the quality standards The three levels of examination; their clinical indications and goals. The reference standard examination (level 2), its variants according to clinical needs. The minimal content of the examination report; the letter to the referring physician (synthesis, conclusion and proposal for further investigation and/or therapeutic management). Commented glossary (anatomy, hemodynamics, semiology). Technical bases. Settings and use of ultrasound devices. Here, we discuss the methods of using ultrasonography for the assessment of peripheral vascular malformations and tumors.
    Journal des Maladies Vasculaires 02/2013; 38(1):29–42. DOI:10.1016/j.jmv.2012.11.005 · 0.24 Impact Factor
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    ABSTRACT: THE QUALITY STANDARDS OF THE FRENCH SOCIETY OF VASCULAR MEDICINE FOR THE ULTRASONOGRAPHIC ASSESSMENT OF VASCULAR MALFORMATIONS ARE BASED ON THE TWO FOLLOWING REQUIREMENTS: Technical know-how: mastering the use of ultrasound devices and the method of examination. Medical know-how: ability to adapt the methods and scope of the examination to its clinical indication and purpose, and to rationally analyze and interpret its results. AIMS OF THE QUALITY STANDARDS: To describe an optimal method of examination in relation to the clinical question and hypothesis. To achieve consistent practice, methods, glossary, and reporting. To provide good practice reference points, and promote a high-quality process. ITEMS OF THE QUALITY STANDARDS: The three levels of examination; their clinical indications and goals. The reference standard examination (level 2), its variants according to clinical needs. The minimal content of the examination report; the letter to the referring physician (synthesis, conclusion and proposal for further investigation and/or therapeutic management). Commented glossary (anatomy, hemodynamics, semiology). Technical bases. Settings and use of ultrasound devices. Here, we discuss the methods of using ultrasonography for the assessment of peripheral vascular malformations and tumors.
    Journal des Maladies Vasculaires 01/2013; · 0.24 Impact Factor
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    ABSTRACT: OBJECTIVE: This study aims to assess potential complications of autologous lymph-node transplantation (ALNT) to treat limb lymphoedema. DESIGN: Prospective, observational study. METHOD: All limb-lymphoedema patients, followed up in a single lymphology department, who decided to undergo ALNT (January 2004-June 2012) independently of our medical team, were included. RESULTS: Among the 26 patients (22 females, four males) included, 14 had secondary upper-limb lymphoedema after breast-cancer treatment and seven had secondary and five primary lower-limb lymphoedema. Median (interquartile range, IQR) ages at primary lower-limb lymphoedema and secondary lymphoedema onset were 18.5 (13-30) and 47.4 (35-58) years, respectively. Median body mass index (BMI) was 25.9 (22.9-29.3) kg m(-2). For all patients, median pre-surgery lymphoedema duration was 37 (24-90) months. Thirty-four ALNs were transplanted into the 26 patients, combined with liposuction in four lower-limb-lymphoedema patients. Ten (38%) patients developed 15 complications: six, chronic lymphoedema (four upper limb, two lower limb), defined as ≥2-cm difference versus the contralateral side, in the limb on the donor lymph-node-site territory, persisting for a median of 40 months post-ALNT; four, post-surgical lymphocoeles; one testicular hydrocoele requiring surgery; and four with persistent donor-site pain. Median (IQR) pre- and post-surgical lymphoedema volumes, calculated using the formula for a truncated cone, were, respectively, 1023 (633-1375) ml (median: 3 (1-6) months) and 1058 (666-1506) ml (median: 40 (14-72) months; P = 0.73). CONCLUSION: ALNT may engender severe, chronic complications, particularly persistent iatrogenic lymphoedema. Further investigations are required to evaluate and clearly determine its indications.
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 01/2013; 45(5). DOI:10.1016/j.ejvs.2012.11.026 · 3.07 Impact Factor
  • S. Vignes
    [Show abstract] [Hide abstract]
    ABSTRACT: Two questions arise when considering the treatment of varicose veins and the development of lymphedema: can the treatment cause lymphedema? Can it worsen it? Primary lymphedema is rarely associated with varicose veins except in the lymphedema-distichiasis syndrome. Data available in the literature is essentially based on surgical treatment. Stripping on a normal limb may induce chronic lymphedema in almost 0.1% of cases. The risk of lymphedema after stripping in patients with previous pelvic surgery including lymph node excision and/or radiotherapy remains unknown. In patients with lower limb lymphedema wearing strong elastic compression stockings, stripping provides little clinical improvement and can worsen volume. The main objective is also to avoid venous complications. Lymphatic lesions related to stripping can be evaluated by lymphography or lymphoscintigraphy. New techniques for treating varicose veins (sclerotherapy, endovenous laser treatment, radiofrequency ablation) seem to induce fewer lymphatic complications. Further studies are required to confirm these results. Indications for treatment should be unquestionable and patients must be alerted to the potential risk of lymphedema or its worsening.
    Journal des Maladies Vasculaires 01/2013; DOI:10.1016/j.jmv.2013.11.003 · 0.24 Impact Factor
  • S. Vignes
    Journal des Maladies Vasculaires 09/2012; 37(5):254. DOI:10.1016/j.jmv.2012.07.043 · 0.24 Impact Factor
  • Journal des Maladies Vasculaires 09/2012; 37(5):263. DOI:10.1016/j.jmv.2012.07.061 · 0.24 Impact Factor

Publication Stats

639 Citations
182.48 Total Impact Points

Institutions

  • 2011–2013
    • Hôpital Européen Georges-Pompidou (Hôpitaux Universitaires Paris-Ouest)
      • Service de Médecine Interne
      Lutetia Parisorum, Île-de-France, France
  • 2010
    • Groupe Hospitalier Saint Vincent
      Strasburg, Alsace, France
  • 1996–2010
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      • Service de Médecine Interne 1
      Lutetia Parisorum, Île-de-France, France