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Publications (81)
Objective
The benefit of aneurysm sac coil embolisation (ASCE) during endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA) remains unclear. This prospective randomised two centre study (SCOPE 1: Sac COil embolisation for Prevention of Endoleak) compared the outcomes of standard EVAR in patients with AAA at high risk of type II endol...
Objective
The chimney technique (ChEVAR) allows for proximal landing zone extension for endovascular repair of complex aortic aneurysms. The aim of the present study was to assess ChEVAR national outcomes in French university hospital centres.
Methods
All centres were contacted and entered data into a computerised online database on a voluntary ba...
Objectives:
Common femoral artery (CFA) stenting appears as a promising alternative treatment to the open surgery for de novo CFA stenosis. Whereas, the stenting of lesions just located at the CFA is simple, stenting of CFA bifurcation lesions is more complex and outcomes are still matter to debate. The aim of this study was to describe and to com...
Purpose:
To assess if aortic 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT) could play a role in predicting complications after endovascular aneurysm repair (EVAR).
Materials and methods:
This study involved 2 cohorts of men with abdominal aortic aneurysm treated by EVAR: those who underwent a PE...
Background:
Cellular treatments using mesenchymal stem cells (MSCs) cultured in 3D conditions constitute a solution to the classical surgery in treating abdominal aortic aneurysm (AAA). The recurrent question is: how this type of biotherapy changes the mechanical behavior of artery?
Methods:
Experiments measurements based on xenograft rat model...
This study investigated the efficiency of a cellular therapy with mesenchymal stem cells (MSCs) cultured in an hyaluronic acid-based hydrogel on growth of abdominal aortic aneurysms (AAA) obtained in the rat xenograft model. The experimental model was devoted to create an AAA at D14 after grafting of a decellularized abdominal aorta obtained from g...
Purpose:
The aim of this retrospective study was to examine the impact of graft oversizing on gutter area and stent compression in chimney graft (CG) for complex abdominal aortic aneurysms (CAAA) repair. The influence of stent graft oversizing on type Ia endoleaks and bridging stent occlusion rates were also examined.
Methods:
Preoperative and p...
Objectives:
Arteriovenous malformations (AVMs) are complex vascular lesions. Surgical excision is the treatment of choice, but is often not achievable. Embolo-sclerotherapy alone is associated with high recurrence rates. This study tested the hypothesis that seeding hydrogel conditioned bone marrow derived mesenchymatous stem cells (BM-MSCs) in an...
Objectives
The TECCO (Traitement des Lésions Athéromateuses de l’Artère Fémorale Commune par Technique Endovasculaire Versus Chirurgie Ouverte [Endovascular Versus Open Repair of the Common Femoral Artery]) trial is a randomized comparison of safety and efficacy of stenting versus open surgery for de novo common femoral artery (CFA) stenosis.
Back...
The purpose of this study was to evaluate the diameter and thickness-related variations in mechanical properties of degraded arterial wall. To this end, ring tests were performed on thirty-one samples from the rat xenograft model of abdominal aortic aneurysm (AAA) and failure properties were determined. An inverse finite element method was then emp...
Q fever is a worldwide zoonosis caused by an intracellular bacillus named Coxiella Burnetii and is a rare cause of vascular infections. We report a case of abdominal aortic aneurysm infected by Coxiella Burnetii with bilateral paravertebral abscesses and contigous spondylodiskitis treated by open repair using a cryopreserved allograft and long term...
Report an initial experience with percutaneous angioplasty (PTA) in de novo stenotic lesions of the common femoral artery (CFA).
Retrospective analysis for 34 consecutive patients. Follow-up consisted in clinical evaluation and duplex-scan ultrasound (CDU) 1, 6, and 12 months after the procedure.
Symptoms were claudication in 16 patients (47%), cri...
To evaluate the safety and success of target vessel cannulation in the visceral aortic segment using the Magellan robotic catheter system (RCS) during complex endovascular aortic procedures.
Robotic navigation was attempted for access to 37 target vessels in 15 patients (14 men; mean age 75±10 years) during 16 fenestrated and/or branched stent-graf...
In this work, we study the mechanical properties of abdominal aortic aneurysms (AAAs) treated by cell therapy. Based on the xenograft model in rats, we analyze the effects of the injection of bone marrow mesenchymal stem cells (MSCs) on the stiffness of the arterial wall. Uniaxial tests performed on control, treated and untreated samples, have led...
Background:
Proximal aortic control by endovascular balloon occlusion (EBO) is an alternative to conventional aortic cross-clamping (CAC) in hemodynamically unstable patients presenting with a ruptured abdominal aortic aneurysm (rAAA). The aim of this study was to evaluate the potential clinical benefit of EBO over CAC.
Methods:
Data from 72 pat...
Objective:
Inflammation plays a critical role in the development of abdominal aortic aneurysms (AAAs). Because stromal cell-derived factor 1 (SDF-1) is known for its ability to attract inflammatory cells, we investigated whether SDF-1/chemokine (C-X-C motif) receptor 4 (CXCR4) axis is expressed in aneurysmal aortic wall and plays a role in AAA phy...
Endovascular aortic repair (EVAR) has been applied to abdominal aortic aneurysm (AAA) to decrease and prevent morbidity and mortality due to open surgery. However, this therapeutic approach may lead to complications such as occurrence of endoleaks which may result in rupture of the aneurysm. Decisions for complementary treatment after EVAR to preve...
Regenerative medicine to substitute conventional surgery or an endovascular stent constitutes currently a challenge to treat abdominal aneurysm artery (AAA). The present paper addresses the following question: Can a cellular therapy from mesenchymal stem cells reestablish the mechanical properties of damaged abdominal aorta? For that, the xenograft...
Fenestrated and branched endovascular devices are increasingly used for complex aortic diseases, and despite the challenging nature of these procedures, early experiences from pioneering centers have been encouraging. The objectives of this retrospective study were to report our experience of intraoperative adverse events (IOAEs) during fenestrated...
Background:
Loss of the endothelium and its replacement by a thick thrombus are structural features of human abdominal aortic aneurysms (AAAs). In AAAs, the relationship between aortic diameter expansion, the presence of thrombus, and the lack of endothelial cells (ECs) remains unexplored. We hypothesized that reendothelialization by cell therapy...
Objective:
Hybrid interventions combining debranching of supra-aortic branch vessels with stent grafting of the aortic arch have become an attractive alternative to open repair for aortic arch pathologies. However, results in patients with dissections of the aortic arch remain unclear. We present our experience with hybrid aortic arch repair for a...
A novel approach that preserved most mesenchymal stem cell (MSC) characteristics was developed using MSC encapsulation in a hydrogel based on hyaluronic acid (HA). An optimized HA-hydrogel composition, whose characteristics were assessed by scanning electron microscopy and viscoelastic property analyses, as well as the more favorable MSC seeding de...
Objectives:
The singularity of the ascending aorta regarding mechanisms driving aneurysm formation requires the development of specific animal models. We investigated if adventitial elastase application results in ascending aorta aneurysms in rats.
Methods:
Adult Lewis rats (n = 26) were anesthetized, their ascending aortas measured by transthor...
Abdominal aortic aneurysms (AAAs) expand as a consequence of extracellular matrix destruction, and vascular smooth muscle cell (VSMC) depletion. Transforming growth factor (TGF)-beta 1 overexpression stabilizes expanding AAAs in rat. Cyclosporine A (CsA) promotes tissue accumulation and induces TGF -beta1 and, could thereby exert beneficial effects...
Evolution of stentgraft and vascular imaging technologies allows endovascular treatment (ET) of juxta-renal aneurysms (JRA). However, endoleaks rates and implants stability are not well documented. The aim of this study was to report the incidence and the perioperative treatment of the endoleaks occurring during ET for JRA.
Between January 2000 and...
A 50-year-old male patient was admitted for a symptomatic aneurysm of the external jugular vein. Thrombosis of the aneurysm was treated by oral anticoagulant but recurrence of neck swelling and thrombosis occurred 1 year after oral anticoagulant was discontinued. No other vascular anomalies were detected, and blood tests were normal. Surgical resec...
A stochastic mechanical model using the membrane theory was used to simulate the in vivo mechanical behaviour of abdominal aortic aneurysms (AAAs) in order to compute the wall stresses after stabilisation by gene therapy. For that, both length and diameter of AAAs rats were measured during their expansion. Four groups of animals, control and treate...
Objectifs : Evaluer la faisabilité de l'imagerie volumique ultrasonore des anévrysmes de l'aorte abdominale (AAA) natifs ou traités par endoprothèse dans le but clinique d'améliorer leur suivi. Mise au point d'un prototype de quantification volumique. Matériels et Méthodes : Les acquisitions volumiques d'AAA natifs ou traités par endoprothèse ont é...
Aneurysm of the abdominal aorta (AAA) is a particular, specifically localized form of atherothrombosis, providing a unique human model of this disease. The pathogenesis of AAA is characterized by a breakdown of the extracellular matrix due to an excessive proteolytic activity, leading to potential arterial wall rupture. The roles of matrix metallop...
Aneurysmal involvement of the iliac bifurcation increases the level of difficulty during surgery for abdominal aortic aneurysm (AAA) repair, potentially increasing the risk of early postoperative complications. Three previous randomized trials comparing endovascular aneurysm repair (EVAR) and open repair (OR) for AAAs showed that EVAR is associated...
Introduction: Endovascular cell therapy using catheter-based delivery of Vascular Smooth Muscle Cells (VSMCs) has been shown to stabilize diameter of expanding Abdominal Aortic Aneurysms (AAAs) in rat. Mesenchymal Stem Cells (MSCs) are able to differentiate into VSMCs after stimulation by Platelet Derived Growth Factor-BB (PDGF-BB). Our goal was to...
The aim of this paper is to illustrate the application of a stochastic approach to estimate the human common carotid arterial pressure. The analysis took into account the possible random uncertainties of the problem inputs such as geometric information and mechanical model parameters so that it is called a probabilistic parametric approach. Based o...
Background
The majority of ascending aortic aneurysms cannot be related to any specific etiology and should be qualified as idiopathic. The incidence of this disease is increasing in the population of the developed countries but its pathobiology is poorly understood.
Aim
This article is reviewing the publications concerning the pathobiology of idi...
The majority of ascending aortic aneurysms cannot be related to any specific etiology and should be qualified as idiopathic. The incidence of this disease is increasing in the population of the developed countries but its pathobiology is poorly understood.
This article is reviewing the publications concerning the pathobiology of idiopathic ascendin...
Few reports of aortoiliac aneurysms infected by Campylobacter fetus are available. We report five cases and review previous reports, with a view to describing the clinical pattern, treatment options, and outcome of this infection.
During a 10-year period, 21 patients were diagnosed with C fetus infection in the Department of Clinical Microbiology,...
To review, in the era of endovascular abdominal aortic repair (EVAR), the clinical spectrum of colonic ischemia (CI) following abdominal aortic aneurysm (AAA) repair and to assess the rate, overall mortality, and associated factors of occurrence.
Between 1995 and 2005, 1174 patients with infrarenal AAA were treated either by open surgery (n = 682)...
To prospectively evaluate in rats whether magnetic cell labeling can be used to noninvasively assess the technical success of endovascular cell therapy for abdominal aortic aneurysms (AAAs).
The study was approved by an institutional animal care and use committee. Vascular smooth muscle cells (VSMCs) labeled with iron oxide nanoparticles were seede...
The long-term benefit of venous bypass has been clearly demonstrated, but procedure feasibility is contingent upon availability of a suitable vein. In this study, we evaluated the outcome of venous bypasses performed by the first author using veins presenting dilatations that were selectively reinforced with a short prosthesis. The purpose was to a...
Differentiated Thyroid carcinoma : Importance of the "Extension-Thyroglobulin" classification to guide the man- agement and the long-tem survey. Objectives- Differentiated thyroid carcinoma (CTD) are not always well operated and/or followed. One of the reasons is the lack of reliable and easy-to-use classification that points out the risks of poor...
The study addresses mechanisms driving the formation of ascending aortic aneurysms by comparing the maximal dilatation area with the transition area immediately adjacent to the normal aortic tissue left in place during surgical repair.
Aortic wall specimens were taken from the maximal dilatation area and transition area in 10 patients undergoing su...
The majority of ascending aortic aneurysms cannot be related to any specific etiology and should be qualified as idiopathic. The pathobiology of ascending aortic aneurysms remains incompletely understood. Data from direct study are still scarce and often limited because of patient heterogenicity. Currently available information suggests that destru...
The prevalence of peripheral arterial disease (PAD) in patients with end-stage renal disease (ESRD) is high, with an annual risk of amputation estimated at 13%, and indications for limb revascularization in patients combining ESRD with stage IV PAD (foot gangrene) are still controversial. This case-controlled study compared survival, limb salvage,...
About 4000 people are diagnosed with thyroid carcinoma each year in France and as many as one in three adult patients have thyroid nodules on sonography. Nine in ten cases are differentiated (DTC). DTC may recur in the neck or metastasize very late, and final outcomes should therefore only be assessed after at least 20 years of follow-up. The goals...
The cell response to transforming growth factor-beta1 (TGF-beta1), a multipotent cytokine with healing potential, varies according to tissue context. We have evaluated the ability of TGF-beta1 overexpression by endovascular gene therapy to stabilize abdominal aortic aneurysms (AAAs) already injured by inflammation and proteolysis.
Active TGF-beta1...
To perform a quantitative analysis of anionic maghemite nanoparticle-labeled cells in vitro and determine the effect of labeling on signal intensity at magnetic resonance (MR) imaging.
The study was approved by the institutional animal care and use committee at Hôpital Bichat. In vitro cell proliferation, iron content per cell, and MR signal intens...
More than a decade after the first clinical attempts, two large randomized studies have proven that endovascular aortic aneurysm repair (EVAR) provides immediate advantages over open repair. In the long run, however, a relatively high number of reinterventions is necessary to improve the long-term efficacy of EVAR, which may outweigh the early bene...
Objective: To answer the following questions: 1) is it necessary to excise and suture the dilatations before wrapping? 2) are the wrapped segments at risk of hyperplasia or stenosis? 3) are the non-wrapped areas at risk of dilatation and rupture? Methods: Infrainguinal revascularization was performed in 12 patients (10 males, two females), aged 33-...
Objective: To answer the following questions: 1) is it necessary to excise and suture the dilatations before wrapping? 2) are the wrapped segments at risk of hyperplasia or stenosis? 3) are the non-wrapped areas at risk of dilatation and rupture? Methods: Infrainguinal revascularization was performed in 12 patients (10 males, two females), aged 33-...
In patients with long unilateral iliofemoral occlusive disease unfit for percutaneous transluminal angioplasty (PTA), most surgeons would choose some type of prosthetic bypass (aortounifemoral, iliofemoral or cross over). All these bypasses would provide excellent early results, but some may not be sufficient in patients with a good life expectancy...
In patients with long unilateral iliofemoral occlusive disease unfit for percutaneous transluminal angioplasty (PTA), most surgeons would choose some type of prosthetic bypass (aortounifemoral, iliofemoral or cross over). All these bypasses would provide excellent early results, but some may not be sufficient in patients with a good life expectancy...
To investigate the efficiency of endovascular smooth muscle cell (VSMC) seeding in promoting healing and stability in already-developed aneurysms obtained by matrix metalloproteases (MMPs)-driven injury.
VSMCs are instrumental in arterial healing after injury and are in decreased number in arterial aneurysms. This cellular deficiency may account fo...
To assess the clinical relevance of gadolinium-enhanced MR angiography (Gd-MRA) as the first-line angiographic examination for planning lower limb revascularization in patients at high risk of complications after contrast arteriography (CA).
Forty-five consecutive patients at high risk of post-CA complications because of chronic renal insufficiency...
Background:
Identification of molecular factors involved in artery wall stabilization after extracellular matrix injury elicited by inflammation and proteolysis has a major role in the development of new therapies for atherosclerosis. A study from our group demonstrated that endovascular seeding of vascular smooth muscle cells (VSMCs) promotes hea...
Intraoperative and postoperative arterial ruptures associated with 657 iliac artery balloon dilatation procedures in our department from 1981 to 2000 were prospectively collected and retrospectively analyzed. Our results showed that failure to exercise basic safety principles and the presence of heavily calcified plaque are the major predictors of...
Diabetes complicated by diabetic neuropathy is a risk factor initiating chronic foot ulceration, which may lead to amputation (1).
We postulated that a form of functional cutaneous microangiopathy is associated with diabetic neuropathy, and we assessed the cutaneous vasoreactivity reserve (CVR) using laser-Doppler flowmetry.
We investigated 42 pa...
Background: Identification of molecular factors involved in artery wall stabilization after extracellular matrix injury elicited by inflammation and proteolysis has a major role in the development of new therapies for atherosclerosis. A study from our group demonstrated that endovascular seeding of vascular smooth muscle cells (VSMCs) promotes heal...
Inflammation and elastinolysis are observed in the media of abdominal aortic aneurysms (AAAs) where vascular smooth muscle cell (VSMC) density is decreased. In contrast, elastin and VSMCs are preserved in the noninflammatory media of stenotic atherosclerotic lesions. We have tested the hypothesis that VSMCs exert a protective effect against inflamm...
To report a case of endograft disintegration misinterpreted as a type II endoleak.
An 86-year-old man underwent successful Vanguard stent-graft implantation for a 49-mm abdominal aortic aneurysm. At 1 month, a distal type I endoleak was repaired, but another endoleak thought to arise from the lumbar or inferior mesenteric arteries remained. Multipl...
Purpose
To report a case of endograft disintegration misinterpreted as a type II endoleak.
Case Report
An 86-year-old man underwent successful Vanguard stent-graft implantation for a 49-mm abdominal aortic aneurysm. At 1 month, a distal type I endoleak was repaired, but another endoleak thought to arise from the lumbar or inferior mesenteric arter...
Arteries and veins respond to injury by a healing process that includes the development of a neointima. This response to injury is implicated as the primary cause of failure after arterial reconstruction. Because it is an integrator and transmitter of blood flow variations, inflammation, and growth stimuli, the endothelium is a potent regulator of...
Most of the indications for cardiovascular operation and many of its complications are in large part due to advanced atherosclerosis. The pathogenesis of atherosclerosis involves inflammatory infiltration of the vessel wall, cellular proliferation, fibrous plaque formation, and ultimately plaque rupture and occlusive thrombosis. Many of these event...
Arteries and veins respond to injury by a healing process that includes the development of a neointima. This response to injury is implicated as the primary cause of failure after arterial reconstruction. Because it is an integrator and transmitter of blood flow variations, inflammation, and growth stimuli, the endothelium is a potent regulator of...
The extracellular matrix maintains vascular structure and stability and helps to regulate arterial wall cell homeostasis.
In response to injury, as well as during ontogeny, arteries modify their mass by qualitative and quantitative changes of the
extracellular matrix. A class of proteolytic enzymes, the matrix metalloproteinases (MMPs), contribute...