50 results on '"Olivier Pellerin"'
Search Results
2. Ruptured pulmonary artery pseudoaneurysm treated with stent graft: case report and literature review
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Valère Barrot, Olivier Pellerin, Guillaume Reverdito, Marc Sapoval, and Tom Boeken
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Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Abstract
Background Hemoptysis is a severe condition, associated with a high mortality rate from asphyxiation. Less than 5% of cases come from the pulmonary arterial circulation and large pseudoaneurysm are rarely treatable by stent graft. Case presentation We present the case of a 74-year-old man who suffered from a new onset of hemoptysis despite a prior bronchial artery embolization. He underwent a rescue endovascular stent graft placement for a massive hemoptysis caused by a ruptured proximal pulmonary artery pseudoaneurysm. A short review of similar situations is provided. Conclusion Salvage endovascular stent graft placement for a massive hemoptysis caused by a ruptured proximal pulmonary artery pseudoaneurysm is a viable salvage technique for life-threatening hemoptysis.
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- 2022
3. Prostatic Artery Embolization Allows to Maintain Full Sexual Activity in Patients Suffering from Bothersome Lower Urinary Tracts Symptoms related to Benign Prostatic Hyperplasia
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Marc Sapoval, Olivier Pellerin, Gregory Amouyal, Nicolas Thiounn, Carol Dean, Ludovica Marzano, Costantino Del Giudice, Charles Dariane, and Helena Pereira
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medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Urology ,Retrospective cohort study ,Orgasm ,Prostatic artery embolization ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Sexual desire ,0302 clinical medicine ,medicine.anatomical_structure ,Sexual dysfunction ,Prostate ,Medicine ,Radiology, Nuclear Medicine and imaging ,Risk factor ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Sexual function ,media_common - Abstract
The effect of prostate artery embolization (PAE) on male sexual function is currently the subject of debate in the literature. The main purpose of this study was to define changes in all domains of sexual activity after PAE, using the international index of erectile function score (IIEF-15). A single-center retrospective study was conducted on 129 patients (mean age of 65.5 ± 7 years), who underwent PAE from February 2014 to January 2017 for symptomatic benign prostatic hyperplasia (BPH). Fifty consecutive patients fulfilling the inclusion criteria were evaluated before and after PAE follow-up using the IIEF-15, IPSS, prostate volume (PV) and cardiovascular risk factor and BPH drugs. The IIEF-15 domains analyzed were: erectile function (EF) ejaculation and orgasm (Ej/O), sexual desire (SD), intercourse satisfaction (IS) and overall satisfaction (OS). A paired sample t test or Wilcoxon signed-rank test was used to compare IIEF-15 between baseline and follow-up. The study showed nonsignificant change in IIEF-15 total score (58.0 ± 13.8 SD; p = 0.71) and the five domains (EF 24.5 ± 7.0 SD, p = 0.82; EJ/O 8.2 ± 2.3 SD, p = 0.50; SD 7.2 ± 2.7 SD, p = 0.57; IS 10.3 ± 3.0 SD, p = 0.77; OS 8.2 ± 2.7 SD; p = 0.11) after PAE. We also found a significant improvement in IPSS score after PAE. Based on the IIEF-15 questionnaire, PAE was showed to allow good urinary symptoms results and no deterioration in sexual function.
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- 2020
4. Does Bead Size Affect Patient Outcome in Irinotecan-Loaded Beads Chemoembolization Plus Systemic Chemotherapy Regimens for Liver-Dominant Colorectal Cancer? Results of an Observational Study
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Marc Sapoval, Nadia Moussa, Olivier Pellerin, Carole Déan, Abdellahi Abed, Simon Pernot, Tom Boeken, and Julien Taieb
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Adult ,Male ,medicine.medical_specialty ,Liver tumor ,Colorectal cancer ,Irinotecan ,Gastroenterology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Chemoembolization, Therapeutic ,Aged ,Aged, 80 and over ,Systemic chemotherapy ,business.industry ,Liver Neoplasms ,Significant difference ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Treatment Outcome ,Toxicity ,Female ,Observational study ,Topoisomerase I Inhibitors ,Colorectal Neoplasms ,Cardiology and Cardiovascular Medicine ,business ,Progressive disease ,medicine.drug - Abstract
We investigated the clinical effects of bead size in irinotecan-loaded beads chemoembolization (DEBIRI) used for treating liver-dominant colorectal cancer. Between March 2009 and January 2018, all consecutive patients with colorectal cancer liver metastases referred for DEBIRI at our tertiary center were included in an observational study. Patients were treated exclusively with either 100-mg irinotecan-loaded DC beads of 70–150 μm (small bead group or SB) or 100–300 μm (large bead group or LB) in diameter, in addition to systemic therapy. Liver tumor response rate at 3 months, liver and overall progression-free survival (PFS) and overall survival were estimated. In total, 84 patients with liver-dominant progressive disease underwent 232 DEBIRI sessions. Fifty-four patients were treated in the SB group and 30 patients in the LB group. Liver progression-free rates at 3 months were 86.7% for the LB group and 79.6% for the SB group (NS). Median liver-PFS and overall PFS were, respectively, 7.15 months and 7.15 months for the LB group and 7.65 and 7.55 months for the SB group (NS). Median overall survival was 13.04 months for the LB group and 15.59 months for the SB group (p = 0.04). Specific treatment grade 3 + 4 toxicity occurrence was 5 (17%) in the LB group and 20 (37%) in the SB group. No significant difference in patient outcome was observed between DEBIRI bead sizes of 70–150 μm and 100–300 μm. A trend toward higher treatment-specific toxicity was observed with the smaller beads.
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- 2020
5. Short-term Safety and Quality of Life Outcomes Following Radioembolization in Primary and Secondary Liver Tumours: a Multi-centre Analysis of 200 Patients in France
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Cirt-Fr Principal Investigators, Jean-Pierre Pelage, Charles Mastier, Valérie Vilgrain, Christian Sengel, Maxime Ronot, Michel Greget, Lambros Tselikas, Bruno Sangro, Bora Peynircioglu, Nathalie Kaufmann, José Ignacio Bilbao, María Urdániz, Thomas Helmberger, Dirk Arnold, Olivier Pellerin, Geert Maleux, Antoine Bouvier, Niklaus Schaefer, Romaric Loffroy, CIRT-FR Principal Investigators, Piana, G., Frandon, J., Tasu, J.P., and Kobeiter, H.
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Male ,SIR-Spheres ,Yttrium-90 ,Cardiac & Cardiovascular Systems ,Tare weight ,medicine.medical_treatment ,0302 clinical medicine ,MICROSPHERES ,Quality of life ,HEPATOCELLULAR-CARCINOMA ,Yttrium Radioisotopes ,SIRT ,Reimbursement ,Incidence ,Liver Neoplasms ,Radiology, Nuclear Medicine & Medical Imaging ,Neoplasms, Second Primary ,Embolization, Therapeutic ,EORTC ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,Female ,TRIAL ,France ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Transarterial radioembolization ,SIR-spheres ,03 medical and health sciences ,Carcinoma, Hepatocellular/diagnosis ,Carcinoma, Hepatocellular/epidemiology ,Carcinoma, Hepatocellular/therapy ,Embolization, Therapeutic/methods ,France/epidemiology ,Humans ,Liver Neoplasms/diagnosis ,Liver Neoplasms/epidemiology ,Liver Neoplasms/therapy ,Neoplasms, Second Primary/diagnosis ,Neoplasms, Second Primary/epidemiology ,Neoplasms, Second Primary/therapy ,Quality of Life ,Yttrium Radioisotopes/therapeutic use ,Interim analysis ,Radioembolization ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Clinical Investigation ,Adverse effect ,Science & Technology ,INTERNAL RADIATION-THERAPY ,business.industry ,SORAFENIB ,Cardiovascular System & Cardiology ,Observational study ,business - Abstract
Purpose Radioembolization has emerged as a treatment modality for patients with primary and secondary liver tumours. This observational study CIRT-FR (CIRSE Registry for SIR-Spheres Therapy in France) aims to evaluate real-life clinical practice on all patients treated with transarterial radioembolization (TARE) using SIR-Spheres yttrium-90 resin microspheres in France. In this interim analysis, safety and quality of life data are presented. Final results of the study, including secondary effectiveness outcomes, will be published later. Overall, CIRT-FR is aiming to support French authorities in the decision making on reimbursement considerations for this treatment. Methods Data on patients enrolled in CIRT-FR from August 2017 to October 2019 were analysed. The interim analysis describes clinical practice, baseline characteristics, safety (adverse events according to CTCTAE 4.03) and quality of life (according to EORTC QLQ C30 and HCC module) aspects after TARE. Results This cohort included 200 patients with hepatocellular carcinoma (114), metastatic colorectal cancer (mCRC; 38) and intrahepatic cholangiocarcinoma (33) amongst others (15). TARE was predominantly assigned as a palliative treatment (79%). 12% of patients experienced at least one adverse event in the 30 days following treatment; 30-day mortality was 1%. Overall, global health score remained stable between baseline (66.7%), treatment (62.5%) and the first follow-up (66.7%). Conclusion This interim analysis demonstrates that data regarding safety and quality of life generated by randomised-controlled trials is reflected when assessing the real-world application of TARE. Trial Registration Clinical Trials.gov NCT03256994.
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- 2020
6. Contrast-Enhanced Ultrasonography for the Early Evaluation of Prostate Artery Embolization
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Marc Sapoval, Nadia Moussa, Carole Déan, Maxime Barat, Olivier Pellerin, C. Del Giudice, Tom Boeken, Alessandro Di Gaeta, and Nicolas Thioun
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Male ,medicine.medical_specialty ,animal structures ,Prostatic Hyperplasia ,Contrast Media ,Symptoms score ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Prostate ,Artery embolization ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Aged ,Ultrasonography ,Aged, 80 and over ,Reproducibility ,business.industry ,Ultrasound ,Reproducibility of Results ,Middle Aged ,Embolization, Therapeutic ,medicine.anatomical_structure ,Semiquantitative Method ,Treatment Outcome ,Quartile ,Quality of Life ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
To prospectively evaluate the feasibility and reproducibility of the semiquantitative measurement of the unenhanced area of the prostate by trans-abdominal contrast-enhanced ultrasound (CEUS) performed immediately after prostate artery embolization (PAE) as a prognostic factor of success.Thirty-nine patients with PAE were prospectively included. They all underwent pre- and post-PAE trans-abdominal prostate CEUS. Two readers independently evaluated the pre- and post-PAE unenhanced area using a semiquantitative method: unenhanced areas were measured on 3 different slices (basis, middle, and apex) and reported to the whole prostate area. The mean of the three measures was reported semiquantitatively in classes of ten percent and quartiles. We evaluated correlation with clinical success, at 3 months after PAE, defined as a 25% reduction in the International Prostatic Symptoms Score and a Quality of life 3.Twenty-three patients who had bilateral PAE were analyzed. Pre-PAE trans-abdominal prostate CEUS showed visible early and marked enhancement of the entire prostate in all patients. After PAE, all patients had a semiquantitatively measured unenhanced area 25%. The semiquantitative measurement was found to be highly reproducible, with an interclass correlation 0.8. No correlation was found between the area of unenhanced tissue and clinical success evaluated at 3 months.Trans-abdominal prostate CEUS performed early after PAE provides reproducible results and is a valuable tool to evaluate unenhanced areas of the prostate.3, local non random sample.
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- 2020
7. The CIREL Cohort : a prospective controlled registry studying the real-life use of irinotecan-loaded chemoembolisation in colorectal cancer liver metastases : interim analysis
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Elias Brountzos, Hans Prenen, Thomas Helmberger, Riccardo Inchingolo, Stavros Spiliopoulos, Riccardo Manfredi, Maria José Sousa, Belarmino Gonçalves, Zoltán Bánsághi, Philippe L. Pereira, Geert Maleux, Roberto Iezzi, Nathalie Kaufmann, Javier J. Echevarria-Uraga, Olivier Pellerin, Michele Nardella, Dirk Arnold, Thierry de Baere, Francesca Carchesio, Bleranda Zeka, Julien Taieb, Bruno Sangro, and F.M. Gómez
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Male ,Cardiac & Cardiovascular Systems ,DEBIRI ,Colorectal cancer ,EUROPEAN-ORGANIZATION ,MULTICENTER ,Salvage therapy ,THERAPY ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Clinical endpoint ,Medicine ,Prospective Studies ,Registries ,Neoplasm Metastasis ,HEPATIC METASTASES ,TRANS-ARTERIAL CHEMOEMBOLIZATION ,Radiology, Nuclear Medicine & Medical Imaging ,Liver Neoplasms ,CHEMOTHERAPY ,Microspheres ,DRUG-ELUTING BEADS ,030220 oncology & carcinogenesis ,Cohort ,Female ,Cardiology and Cardiovascular Medicine ,Colorectal Neoplasms ,Life Sciences & Biomedicine ,medicine.drug ,medicine.medical_specialty ,TRANSARTERIAL CHEMOEMBOLIZATION ,BEVACIZUMAB ,Irinotecan ,03 medical and health sciences ,Internal medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Clinical Investigation ,Chemoembolization, Therapeutic ,Adverse effect ,Aged ,Chemoembolisation ,Computer. Automation ,TACE ,Science & Technology ,business.industry ,Interim analysis ,medicine.disease ,Drug-eluting microspheres ,Cardiovascular System & Cardiology ,Quality of Life ,Observational study ,Human medicine ,Topoisomerase I Inhibitors ,business - Abstract
Purpose Transarterial chemoembolisation (TACE) using irinotecan-eluting beads is an additional treatment option for colorectal cancer liver metastases (CRLM) patients that are not eligible for curative treatment approaches. This interim analysis focuses on feasibility of the planned statistical analysis regarding data distribution and completeness, treatment intention, safety and health-related quality of life (HRQOL) of the first 50 patients prospectively enrolled in the CIrse REgistry for LifePearl™ microspheres (CIREL), an observational multicentre study conducted across Europe. Methods In total, 50 patients ≥ 18 years diagnosed with CRLM and decided to be treated with irinotecan-eluting LifePearl™ microspheres TACE (LP-irinotecan TACE) by a multidisciplinary tumour board. There were no further inclusion or exclusion criteria. The primary endpoint is the categorisation of treatment intention, and secondary endpoints presented in this interim analysis are safety, treatment considerations and HRQOL. Results LP-irinotecan TACE was conducted in 42% of patients as salvage therapy, 20% as an intensification treatment, 16% as a first-line treatment, 14% a consolidation treatment and 8% combination treatment with ablation with curative intent. Grade 3 and 4 adverse events were reported by 4% of patients during procedure and by 10% within 30 days. While 38% reported a worse, 62% reported a stable or better global health score, and 54% of patients with worse global health score were treated as salvage therapy patients. Conclusion This interim analysis confirms in a prospective analysis the feasibility of the study, with an acceptable toxicity profile. More patients reported a stable or improved HRQOL than deterioration. Deterioration of HRQOL was seen especially in salvage therapy patients. Trial Registration NCT03086096.
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- 2020
8. Variants of Patterns of Intra- and Extra-prostatic Arterial Distribution of the Prostatic Artery Applied to Prostatic Artery Embolization: Proposal of a Classification
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Gregory Amouyal, Nicolas Thiounn, Carole Déan, Costantino Del Giudice, Olivier Pellerin, and Marc Sapoval
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Prostatic Hyperplasia ,Rectum ,Radiology, Interventional ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Lower Urinary Tract Symptoms ,Prostate ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Aged ,Retrospective Studies ,business.industry ,Angiography, Digital Subtraction ,Arteries ,Middle Aged ,Hyperplasia ,medicine.disease ,Embolization, Therapeutic ,Prostatic artery embolization ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Concomitant ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Penis ,Artery - Abstract
The development of prostatic artery embolization has led to better understand the complex male pelvic arterial anatomy. To the best of our knowledge, there is still no precise description of the distribution of the branches of the prostatic artery (PA) after its origin. In this study, the patterns of prostatic feeders near to and into the prostate were analyzed, and a classification was proposed. This study is based on angiograms of 101 consecutive male patients, mean age 70, who underwent PAE between December 2013 and June 2016, to treat symptomatic benign prostatic hyperplasia. The proposed classification is derived from the analysis of 143 solitary PAs from 199 hemipelves (72%). Pattern A was defined as an artery feeding only the prostate, patterns B and C as a PA with a concomitant large supply to the penis (pattern B) or to the rectum (pattern C). A pattern A was found in 89/143 (62%), a pattern B in 16/143 (12%) and pattern C in 38/143 (26%). Protection of a penile/rectal supply was never required in pattern A, while it was performed in 14/16 (87%) of pattern B, and in 7/38 (18%) of pattern C PAs. The PErFecTED technique could be performed in 51%, 50 and 55% of cases in pattern A to C. This study proposes a new classification of intra-/extra-prostatic arterial distribution of the PA that could be helpful to prevent complications of PAE. Further prospective angiographic investigations are necessary to confirm its clinical value.
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- 2018
9. Hepatic Intra-arterial Delivery of a 'Trojan-horses' Gene Therapy: A Pilot Study on Rabbit VX2 Hepatic Tumor Model
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Marc Sapoval, Carole Déan, Tchao Méachi, Philippe Beaune, Isabelle de Waziers, Olivier Pellerin, and Ikram Amara
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Liver tumor ,Cyclophosphamide ,Genetic enhancement ,Pilot Projects ,Gene delivery ,Pharmacology ,030218 nuclear medicine & medical imaging ,Metastasis ,03 medical and health sciences ,Liver Neoplasms, Experimental ,0302 clinical medicine ,medicine ,Animals ,Radiology, Nuclear Medicine and imaging ,Antineoplastic Agents, Alkylating ,business.industry ,Bystander Effect ,Genetic Therapy ,Suicide gene ,medicine.disease ,Disease Models, Animal ,Injections, Intra-Arterial ,030220 oncology & carcinogenesis ,Feasibility Studies ,Tumor necrosis factor alpha ,Rabbits ,Cardiology and Cardiovascular Medicine ,Liver cancer ,business ,medicine.drug - Abstract
Gene-directed enzyme prodrug therapy (GDEPT) is a “Trojan-horses” suicide gene therapy that consists of tumor-targeted gene delivery (vectorized by mesenchymal stem cells MSCs) encoding an enzyme that converts a harmless prodrug into cytotoxic metabolites in situ. Then, cytotoxic metabolites passively diffuse in the neighboring tumor cells and kill them (bystander effect). The goal of our study was to assess the feasibility and efficacy of intra-arterial administration of MSCs transduced with an optimized gene (MSC-CYP2B6TM-RED) followed by intravenous administration of cyclophosphamide (CPA) into the VX2 rabbit liver tumor. Nine rabbits with a VX2 liver tumor were randomly assigned into three groups: Control group A (one rabbit) free of any treatment; Control group B (two rabbits) receiving intravenous injection of cyclophosphamide at day 3 and CPA at day 14; and Group C (six rabbits) receiving the GDEPT treatment, consisting of successive intra-arterial injection of transduced-MSCs at days 0 (n = 6) and 11 (n = 3), followed by injection of CPA at days 3 (n = 6) and 14 (n = 3). The tumor response was assessed by ultrasound scan every 7 days and histopathological analysis at sacrifice (D25). There was a significant difference in the tumor volume between control groups (A + B) and group C at D7: 38/19 cm3 (p = 0.024); D11: 51/20 cm3 (p = 0.024), and D25: 121/37 cm3 (p = 0.048). Tumor necrosis was significantly greater and metastatic spread was lower for rabbits who received GDEPT (78% of total tumor surface) than for control animals (A + B) (22% of total tumor surface (p = 0.006). Intra-arterial delivery of transduced-MSCs is feasible and, after CPA injection, resulted in 78% tumor necrosis (p = 0.006) and less metastasis in a VX2 liver tumor model.
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- 2017
10. Cirse Quality Assurance Document and Standards for Classification of Complications: The Cirse Classification System
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Ralf-Thorsten Hoffmann, Philippe L. Pereira, Olivier Pellerin, Christoph A. Binkert, Antonín Krajina, and Dimitrios K. Filippiadis
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medicine.medical_specialty ,Quality Assurance, Health Care ,Radiology, Interventional ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Health care ,medicine ,Humans ,media_common.cataloged_instance ,Radiology, Nuclear Medicine and imaging ,European union ,Grading (education) ,Societies, Medical ,Reimbursement ,media_common ,medicine.diagnostic_test ,business.industry ,Interventional radiology ,Guideline ,medicine.disease ,Europe ,030220 oncology & carcinogenesis ,Radiology ,Medical emergency ,Outcome data ,Cardiology and Cardiovascular Medicine ,business ,Quality assurance - Abstract
Interventional radiology provides a wide variety of vascular, nonvascular, musculoskeletal, and oncologic minimally invasive techniques aimed at therapy or palliation of a broad spectrum of pathologic conditions. Outcome data for these techniques are globally evaluated by hospitals, insurance companies, and government agencies targeting in a high-quality health care policy, including reimbursement strategies. To analyze effectively the outcome of a technique, accurate reporting of complications is necessary. Throughout the literature, numerous classification systems for complications grading and classification have been reported. Until now, there has been no method for uniform reporting of complications both in terms of definition and grading. The purpose of this CIRSE guideline is to provide a classification system of complications based on combining outcome and severity of sequelae. The ultimate challenge will be the adoption of this system by practitioners in different countries and health economies within the European Union and beyond.
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- 2017
11. Mid-Term Results of Superior Rectal Artery and Coils for Hemorrhoidal Embolization with Particles Bleeding
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Nadia Moussa, L Pechmajou, C. Del Giudice, Helena Pereira, Olivier Pellerin, D Bouda, Nadia Fathallah, B Bonnet, Marc Sapoval, V. de Parades, Carole Déan, and A Abed
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Mid term results ,Hemorrhoids ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Superior rectal artery ,Major complication ,Embolization ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Rectum ,Interventional radiology ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Surgery ,Treatment Outcome ,Feasibility Studies ,Female ,Cardiology and Cardiovascular Medicine ,business ,Gastrointestinal Hemorrhage - Abstract
To compare safety and clinical outcomes of embolization of the superior rectal arteries in patients with hemorrhoidal bleeding using particles and coils versus coils only. We retrospectively reviewed data for patients undergoing embolization for chronic hemorrhoidal bleeding from January 2014 to April 2017. Embolization was performed with coils alone or with particles and coils. Clinical scores (Paris bleeding severity score, Goligher classification and quality of life score) were obtained, and embolization was performed with microparticles (300–500 μm) followed by fibered pushable coils. Clinical success was defined as an improvement of > 2 points in the Paris bleeding severity score, without complications. Outcomes were compared between the two groups in a matched-pairs analysis (1:1 scenario), with patients embolized with particles and coils as the study group and patients embolized with coils alone as the control. We treated 45 consecutive patients. After matched-pairs analysis, the final study population was 38 patients (19 study group and 19 controls). Clinical success did not differ significantly between the two populations: 63% for control group and 68% for the study group (p = 0.790). The median change in clinical score was − 3 [− 6; − 1] for the control group and − 3 [− 4; − 1] for the study group (p = 0.187). Grade 1 complications were reported in 15% of patients, with no major complications. Embolization was feasible, with a technical success of 100% and no major complications. Clinical success was obtained in 66% in patients with no difference when using combined embolization with particles and coils versus coils only.
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- 2019
12. New European Regulation for Medical Devices: What Is Changing?
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Marc Sapoval, Patrice Prognon, Olivier Pellerin, Judith Pineau, Gilles Chatellier, Carole Déan, Nicolas Martelli, Déborah Eskenazy, Groupe de Recherche et d'Accueil en Droit et Economie de la Santé (GRADES), and Université Paris-Saclay
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Medical device ,Legislation, Medical ,020205 medical informatics ,business.industry ,02 engineering and technology ,Radiology, Interventional ,Europe ,03 medical and health sciences ,0302 clinical medicine ,[SHS.DROIT]Humanities and Social Sciences/Law ,Risk analysis (engineering) ,Equipment and Supplies ,Clinical investigation ,Daily practice ,0202 electrical engineering, electronic engineering, information engineering ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,ComputingMilieux_MISCELLANEOUS - Abstract
The Medical Devices Regulation (MDR) 2017/745/EU will fully apply from May 2020. Interventional radiologists use medical devices on a daily basis and so must be aware of the impact that this new regulation will have on their daily practice. In this paper, we describe the major transformation that the MDR brings to the medical devices sector, with a focus on clinical evaluations and clinical investigations. This regulation significantly tightens controls to ensure that devices are safe and effective. In addition, equivalence to already existing devices, which allowed an accelerated access to the market, will now be possible only in some cases. Furthermore, post-marketing clinical follow-up is extended under the MDR and is required for all devices. These new requirements will probably lead to a dramatic increase in the number of clinical investigations and also to a delay in the availability of certain devices on the market. In the coming years, interventional radiologists are likely to be affected by these changes in their daily practice, in terms of medical device availability and/or in terms of increased involvement in clinical investigations.
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- 2019
13. Chemoembolization of HCC: Time for Technical Standardization, or Is It Too Late?
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Olivier Pellerin, Boris Guiu, Tom Boeken, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Université de Montpellier (UM)
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medicine.medical_specialty ,Carcinoma, Hepatocellular ,Standardization ,business.industry ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,Liver Neoplasms ,MEDLINE ,[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,030220 oncology & carcinogenesis ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Chemoembolization, Therapeutic ,Cardiology and Cardiovascular Medicine ,business ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience
- Published
- 2019
14. Four-Year Impact of Voiding and Storage Symptoms in Patients with Benign Prostatic Hyperplasia Treated with Prostatic Artery Embolization
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Marc Sapoval, Helena Pereira, Olivier Pellerin, Nicolas Thiounn, Carole Déan, Yen-Ting Lin, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université de Paris (UP), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), CCSD, Accord Elsevier, Université Paris Cité (UPCité), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
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Male ,medicine.medical_specialty ,Time Factors ,[SDV]Life Sciences [q-bio] ,Urology ,Prostatic Hyperplasia ,urologic and male genital diseases ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Lower Urinary Tract Symptoms ,Prostate ,Statistical significance ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Recovery of Function ,Hyperplasia ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Prostatic artery embolization ,[SDV] Life Sciences [q-bio] ,Urodynamics ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Quality of Life ,Population study ,Cardiology and Cardiovascular Medicine ,business - Abstract
PURPOSE To study the subscore improvement in International Prostate Symptom Scores (IPSS) after prostatic artery embolization (PAE). MATERIALS AND METHODS A single-center retrospective study was carried out with follow-up from December 2013 to July 2019 in 37 consecutive patients (66.0 ± 8.8 years old) who underwent PAE, comparing resultant scores before and after PAE. IPSS were divided into storage (IPSS-s) subscores and voiding (IPSS-v) subscores. The changes between IPSS-s and IPSS-v at 1, 3, 6, and 12 months' follow-up as well as the last follow-up were compared with baseline scores. The changes in percentages of IPSS-s and IPSS-v and the changes in average IPSS-s-to-total IPSS ratios (IPSS-s/IPSS-t) and IPSS-v-to-IPSS-t ratios (IPSS-v/IPSS-t) were also analyzed. RESULTS In the study population, consisting of 37 patients, IPSS-t significantly decreased from 16.5 ± 7.2 at baseline to 8.3 ± 5.7 at the last follow-up (4 years later) (P < .0001). Additionally, the changes in IPSS-v symptoms were greater than the changes in IPSS-s symptoms at 1, 3, 6, and 12 months' follow-up, reaching a statistical significance at 6 months with a decrease of 72.9% ± 42.4% for IPSS-v and a decrease of 50.1% ± 52.2% for IPSS-s (P = .009). CONCLUSIONS PAE can successfully reduce both IPSS-s and IPSS-v with predominant IPSS-v reduction. The improvements in both subscores were sustained for up to 4 years of follow-up.
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- 2019
15. Safety and Efficacy of Occlusion of Large Extra-Prostatic Anastomoses During Prostatic Artery Embolization for Symptomatic BPH
- Author
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Olivier Pellerin, Carole Déan, Helena Pereira, Gregory Amouyal, Costantino Del Giudice, Marc Sapoval, Pierre Chague, and Nicolas Thiounn
- Subjects
Male ,medicine.medical_specialty ,animal structures ,medicine.medical_treatment ,Prostatic Hyperplasia ,Anastomosis ,030218 nuclear medicine & medical imaging ,Arteriovenous Malformations ,03 medical and health sciences ,0302 clinical medicine ,Lower Urinary Tract Symptoms ,Lower urinary tract symptoms ,Prostate ,Occlusion ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Embolization ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Angiography ,Interventional radiology ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Prostatic artery embolization ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
During PAE, preembolization angiography of the prostatic artery can show large extra-prostatic shunts, at high risk, if embolized, of rectal or penile necrosis. We report our experience with 11 consecutive patients who underwent protective embolization of large extra-prostatic shunts before successful PAE.We treated 11 consecutive male patients (mean age 67 years), part of a series of 55 consecutive male patients referred for PAE to treat LUTS due to BPH, between December 2013 and January 2015. The procedure involved the exclusion of an extra-prostatic shunt originating from the PA, prior to complete bilateral PAE. We compared the safety and efficacy of the 11 shunt exclusions followed by embolization of the PA to the other 44 basic PAE. Clinical success was defined as a decrease of 25 % or eight points of IPSS, QoL 3 or a one-point decrease, and a Qmax improvement of 25 % or 2.5 mL/s.We had a 100 % rate of occlusion of the anastomosis. Bilateral embolization of the PA was performed in all patients with no additional time of procedure (p = 0.18), but a significant increase of dose area product (p = 0.03). Distal (PErFecTED) embolization was possible in 64 %. There was no worsening of erectile dysfunction, no rectal or penile necrosis, no immediate or late other clinical complications. Clinical success was 91 % (mean follow-up: 3.5 months), compared to 78 % for the entire PAE group.PAE using the protection technique in case of large extra-prostatic shunts is as safe and effective as basic procedures and does not induce any additional time of procedure.
- Published
- 2016
16. Repeat Prostatic Artery Embolization
- Author
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Olivier Pellerin, Costantino Del Giudice, Nadia Moussa, Alberto Kenny, Marc Sapoval, and Carole Déan
- Subjects
Male ,medicine.medical_specialty ,animal structures ,medicine.medical_treatment ,Technical success ,Prostatic Hyperplasia ,Revascularization ,Lower Urinary Tract Symptoms ,medicine ,Retrospective analysis ,Humans ,Radiology, Nuclear Medicine and imaging ,Treatment Failure ,Embolization ,Collateral vessels ,Aged ,Retrospective Studies ,business.industry ,Prostate ,Mean age ,Arteries ,Middle Aged ,Embolization, Therapeutic ,Prostatic artery embolization ,Surgery ,medicine.anatomical_structure ,Retreatment ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
This is a single-center retrospective analysis of 3 patients (mean age, 61 y ± 8.6) who underwent repeat prostatic artery (PA) embolization (PAE; rPAE) because of clinical failure after PAE. Revascularization of the central gland through a recanalized PA was the most frequent pattern observed (5 of 7; 71.4%), followed by revascularization through penile collateral vessels (2 of 7; 28.6%). Technical success during rPAE was achieved in 5 hemiprostates (83.3%). Clinical success at 6 months after rPAE was achieved in 2 of 3 patients (66.6%). Implications of these findings could be valuable to those performing PAE.
- Published
- 2020
17. Emborrhoid: A New Concept for the Treatment of Hemorrhoids with Arterial Embolization: The First 14 Cases
- Author
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Jean-Michel Bartoli, V. de Parades, Marc Sapoval, Vincent Vidal, Farouk Tradi, G. Louis, Olivier Pellerin, and Y. Sielezneff
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Arterial Embolization ,Rectum ,Embolization procedure ,medicine.disease ,Inferior mesenteric artery ,Arterial occlusion ,Surgery ,Hemorrhoids ,medicine.anatomical_structure ,medicine.artery ,Angiography ,medicine ,Radiology, Nuclear Medicine and imaging ,Embolization ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
The ‘emborrhoid’ technique consists of the embolization of the hemorrhoidal arteries. The endovascular arterial occlusion is performed using coils placed in the terminal branches of the superior rectal arteries. The emborrhoid technique has been modeled after elective transanal Doppler-guided hemorrhoidal artery ligation which has been shown to be effective in hemorrhoidal disease. We report the first 14 cases of our experience with emborrhoid technique. Fourteen patients with disabling chronic rectal bleeding were treated using the emborrhoid technique (3 women, 11 men). The stage of the hemorrhoidal disease was II (10 patients), III (3), and IV (1). This treatment was decided by a multidisciplinary team (proctologist, visceral surgeon, and radiologist). Seven patients underwent previous proctological surgery. Ten patients had coagulation disorders (anticoagulants or cirrhosis). Superior rectal arteries were embolized with pushable microcoils (0.018). Technical success of the embolization procedure was 100 %. Clinical success at 1 month was 72 % (10/14). Of the 4 patients who experienced rebleeding, two underwent additional embolization of the posterior rectal arteries with success. No pain or ischemic complications were observed in 13 patients. One patient experienced a temporary painful and edematous, perianal reaction. Our case studies suggest that coil embolization of the superior rectal arteries is technically feasible, safe and well tolerated. Additional studies are needed to evaluate the efficacy of this new ‘emborrhoid’ technique in the management of hemorrhoidal disease.
- Published
- 2014
18. Comparison of Two Endovascular Steerable Robotic Catheters for Percutaneous Robot-Assisted Fibroid Embolization
- Author
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C. Leré-Déan, M. Nouri Neville, Olivier Pellerin, C. Del Giudice, Marc Sapoval, Gregory Amouyal, and Isabelle Fitton
- Subjects
medicine.medical_specialty ,Percutaneous ,Catheters ,Uterine fibroids ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Medicine ,Fluoroscopy ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Prospective Studies ,medicine.diagnostic_test ,Leiomyoma ,business.industry ,Ultrasound ,Robotics ,Middle Aged ,medicine.disease ,Internal iliac artery ,Embolization, Therapeutic ,Catheter ,Treatment Outcome ,Dose area product ,Uterine Neoplasms ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
To compare outcomes of percutaneous robot-assisted uterine fibroid embolization (UFE) using two different endovascular robotic catheters. Twenty-one patients with a symptomatic uterine fibroid were prospectively enrolled in a single-center study to be treated with a percutaneous robot-assisted embolization using the Magellan system. Fourteen patients were treated using a first generation steerable robotic catheter, version 1.0 (group 1), and seven were treated using the new version 1.1 (group 2). Demographic, pathologic, and procedural variables were recorded. Dose Area Product (DAP) and physician equivalent doses were registered for each procedure. Procedural related complications and clinical midterm outcomes were also evaluated. Successful robot-assisted UFE was obtained in eight patients (57.1%) in group 1 and 7 patients (100%) in group 2 (p = 0.01). A successful robot-assisted catheterization of the internal iliac artery anterior branch was performed in all patients of both groups. Median selective target vessel catheterization time was 21.0 ± 12.8 vs 13.4 ± 7 min (p = 0.04) and total fluoroscopy time was 30.3 ± 11.2 vs 19.3 ± 5.9 min, respectively, in group 1 and 2. Mean DAP decreased from 18472.6 ± 15622 to 5469.1 ± 4461.0 cGy·cm2 (p = 0.04). All patients obtained a symptoms relief at 6 months follow-up. Robot-assisted uterine fibroid embolization is safe and effective. New version of steerable robotic catheter allows performing a faster procedure without related adverse events compared to old version.
- Published
- 2017
19. Eligibility for Renal Denervation: Anatomical Classification and Results in Essential Resistant Hypertension
- Author
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Pierre-François Plouin, Masato Yamaguchi, Marc Sapoval, Takuya Okada, Olivier Pellerin, Sébastien Savard, Koji Sugimoto, Michel Azizi, Matthieu Monge, Emmanuel Curis, Michael Frank, and Guillaume Bobrie
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Radiofrequency ablation ,Iohexol ,Drug Resistance ,Resistant hypertension ,Contrast Media ,urologic and male genital diseases ,law.invention ,Young Adult ,Renal Artery ,law ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Renal artery ,Aged ,Aged, 80 and over ,Observer Variation ,Denervation ,business.industry ,Ultrasound ,Reproducibility of Results ,Middle Aged ,Radiographic Image Enhancement ,Hypertension ,Female ,Radiology ,Essential Hypertension ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business - Abstract
To classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).The RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA20 mm in length or main RA4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).Bilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.Of RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification provides the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future.
- Published
- 2014
20. Management of Painful Pelvic Bone Metastasis of Renal Cell Carcinoma Using Embolization, Radio-frequency Ablation, and Cementoplasty: A Prospective Evaluation of Efficacy and Safety
- Author
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Stéphane Oudard, Claire Vulser, Jacques Medioni, Marc Sapoval, Olivier Pellerin, and Carole Déan
- Subjects
Adult ,Male ,medicine.medical_specialty ,Radio Waves ,Visual analogue scale ,Narcotic ,medicine.medical_treatment ,Bone Neoplasms ,Pelvic Pain ,Quality of life ,Renal cell carcinoma ,Surveys and Questionnaires ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Registries ,Embolization ,Pelvic Bones ,Carcinoma, Renal Cell ,Aged ,Pain Measurement ,Cementoplasty ,business.industry ,Bone metastasis ,Middle Aged ,medicine.disease ,Brief Pain Inventory Questionnaire ,Combined Modality Therapy ,Embolization, Therapeutic ,Kidney Neoplasms ,Surgery ,Catheter Ablation ,Quality of Life ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
To measure the impact on pain relief and patient quality of life using embolization radio-frequency ablation and cementoplasty (ERC) for local combination therapeutic management of painful pelvic bone metastasis of renal cell carcinoma (RCC). This prospective monocentric registry was approved by our Local Institutional Review Board. Between January 2008 and January 2013, all consecutive patients who fully met the inclusion criteria were enrolled in the ERC-procedure prospective registry. They were assigned to follow-up at discharge and again at 1 and 6 months. Efficacy was evaluated using a pain visual analog scale (VAS), and narcotic consumption and quality of life were assessed using the Brief Pain Inventory questionnaire. Fifty-two patients were enrolled, among whom 58 lesions were treated. Technical success was obtained in all procedures. The median VAS score decreased from 7 ± 1.4 (ranges 5–10) at baseline to 3 ± 1.5 (ranges 0–6) at discharge, 2 ± 1.5 (ranges 0–5) at 1 month (p
- Published
- 2013
21. Embolization of Life-Threatening Arterial Rupture in Patients with Vascular Ehlers–Danlos Syndrome
- Author
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Marc Sapoval, Georgios Angelopoulos, Takuya Okada, Emmanuel Messas, Marie-Fazia Boughenou, Jean-Yves Pagny, Olivier Pellerin, Michael Frank, and Massimiliano Di Primio
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Contrast Media ,Transarterial embolization ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Vascular Diseases ,Embolization ,Arterial rupture ,Retrospective Studies ,Rupture, Spontaneous ,medicine.diagnostic_test ,business.industry ,Arteries ,medicine.disease ,Embolization, Therapeutic ,Surgery ,Treatment Outcome ,Ehlers–Danlos syndrome ,Angiography ,Referral center ,Ehlers-Danlos Syndrome ,Female ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business - Abstract
To evaluate the safety and efficacy of transarterial embolization of life-threatening arterial rupture in patients with vascular Ehlers-Danlos syndrome (vEDS) in a single tertiary referral center.We retrospectively analyzed transarterial embolization for vEDS performed at our institution from 2000 to 2012. The indication of embolization was spontaneous arterial rupture or pseudoaneurysm with acute bleeding. All interventions used a percutaneous approach through a 5F or less introducer sheath. Embolic agents were microcoils and glue in 3 procedures, glue alone in 2, and microcoils alone in 2.Five consecutive vEDS patients were treated by 7 embolization procedures (4 women, mean age 29.8 years). All procedures were successfully performed. Two patients required a second procedure for newly arterial lesions at a different site from the first procedure. Four of the five patients were still alive after a mean follow-up of 19.4 (range 1-74.7) months. One patient died of multiple organ failure 2 days after procedure. Minor procedural complications were observed in 3 procedures (43 %), all directly managed during the same session. Remote arterial lesions occurred after 3 procedures (43 %); one underwent a second embolization, and the other 2 were observed conservatively. Puncture site complication was observed in only one procedure (14 %).Embolization for vEDS is a safe and effective method to manage life-threatening arterial rupture.
- Published
- 2013
22. Successful Retrieval of 29 ALN Inferior Vena Cava Filters at a Mean of 25.6 Months after Placement
- Author
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Massimiliano Di Primio, Marc Sapoval, Olivier Sanchez, Olivier Pellerin, and Guy Meyer
- Subjects
Adult ,Male ,medicine.medical_specialty ,Vena Cava Filters ,Ivc filter ,Risk Assessment ,Inferior vena cava ,Postoperative Complications ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Longitudinal Studies ,Aluminum Compounds ,Device Removal ,Aged ,Aged, 80 and over ,business.industry ,Incidence ,Filter retrieval ,Equipment Design ,Middle Aged ,medicine.disease ,Surgery ,Pulmonary embolism ,Equipment Failure Analysis ,Treatment Outcome ,medicine.vein ,Filter (video) ,Female ,France ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Purpose To prospectively evaluate the outcomes of ALN inferior vena cava (IVC) filter extractions after long-term implantation (ie,>1 y). Materials and Methods Between November 2004 and January 2011, 503 retrievable ALN IVC filters were implanted, but only 188 (37%) were addressed for removal. Because it was suspected that a subset of patients had not been referred for IVC filter retrievals, between November 2008 and January 2011, all patients who still had an ALN filter that had been implanted at least 1 year previously were systematically recalled. For those patients, the relative benefits and risks of filter removal were evaluated by a multidisciplinary conference. If deemed necessary by the conference, filter removals were performed. The endpoints were the feasibility and safety of filter retrieval, which were based on an evaluation of the success rates, pre- and postprocedure complications, and dosimetric assessments. Results Twenty-nine patients still retained their filters at least 1 year following implantation. The mean interval between implantation and retrieval was 25.6 months (range, 14.8–40.8 mo), and extractions were performed on eight patients who had received a filter at least 2 years earlier. The longest dwell time was 40 months. All filters were extracted successfully without complications. Conclusions Optional ALN filter retrievals can be performed safely after more than 1 year following implantation.
- Published
- 2013
23. Quantitative and Volumetric European Association for the Study of the Liver and Response Evaluation Criteria in Solid Tumors Measurements: Feasibility of a Semiautomated Software Method to Assess Tumor Response after Transcatheter Arterial Chemoembolization
- Author
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Nikhil Bhagat, Pramod Rao, MingDe Lin, Jean Francois H. Geschwind, Olivier Pellerin, Roberto Ardon, Benoit Mory, Diane K. Reyes, and Romaric Loffroy
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Image quality ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Clinical trial ,Response Evaluation Criteria in Solid Tumors ,Hepatocellular carcinoma ,Carcinoma ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Cardiology and Cardiovascular Medicine ,Prospective cohort study ,Transcatheter arterial chemoembolization ,business - Abstract
Purpose To show that hepatic tumor volume and enhancement pattern measurements can be obtained in a time-efficient and reproducible manner on a voxel-by-voxel basis to provide a true three-dimensional (3D) volumetric assessment. Materials and Methods Magnetic resonance (MR) imaging data obtained from 20 patients recruited for a single-institution prospective study were retrospectively evaluated. All patients had a diagnosis of hepatocellular carcinoma (HCC) and underwent drug-eluting beads (DEB) transcatheter arterial chemoembolization for the first time. All patients had undergone contrast-enhanced MR imaging before and after DEB transcatheter arterial chemoembolization; poor image quality excluded 3 patients, resulting in a final count of 17 patients. Volumetric RECIST (vRECIST) and quantitative EASL (qEASL) were measured, and segmentation and processing times were recorded. Results There were 34 scans analyzed. The time for semiautomatic segmentation was 65 seconds±33 (range, 40–200 seconds). vRECIST and qEASL of each tumor were computed Conclusions Semiautomatic quantitative tumor enhancement (qEASL) and volume (vRECIST) assessment is feasible in a workflow-efficient time frame. Clinical correlation is necessary, but vRECIST and qEASL could become part of the assessment of intraarterial therapy for interventional radiologists.
- Published
- 2012
24. Bilateral Arterial Embolization of the Prostate Through a Single Prostatic Artery: A Case Series
- Author
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Costantino Del Giudice, Olivier Pellerin, Marc Sapoval, Carole Déan, Gregory Amouyal, and Nicolas Thiounn
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Prostatic Hyperplasia ,Rectum ,Anastomosis ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Prostate ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Aged ,Aged, 80 and over ,business.industry ,Arterial Embolization ,Ultrasound ,Angiography, Digital Subtraction ,Arteries ,Middle Aged ,Embolization, Therapeutic ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Penis ,Artery - Abstract
Peri-prostatic shunts are frequent during PAE, carrying the risk of non-target embolization of penis/corpus cavernosum or rectum but also the potential advantage to irrigate the contralateral lobe. Sometimes, bilateral embolization is impossible, carrying the risk of limited clinical success. The possibility to reach contralateral prostatic territory from the ipsilateral prostatic artery (PA) and embolize it via peri/intra-prostatic anastomoses could be of interest in this situation. We describe a series of three consecutive patients (among 89 consecutive patients treated by PAE for symptomatic BPH) who underwent successful embolization of both prostatic lobes through catheterization of a PA on only one side. All patients had clinical success after a mean follow-up of 3.3 months. Dosimetry of these three procedures indicates that there may be radiation dose savings.
- Published
- 2016
25. Doxorubicin-Loaded 70-150 μm Microspheres for Liver-Dominant Metastatic Breast Cancer: Results and Outcomes of a Pilot Study
- Author
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Carole Déan, Jacques Medioni, Yen-Ting Lin, Gregory Amouyal, Marc Sapoval, and Olivier Pellerin
- Subjects
Oncology ,Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Breast Neoplasms ,Pilot Projects ,Disease-Free Survival ,030218 nuclear medicine & medical imaging ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Liver neoplasm ,Prospective Studies ,Chemoembolization, Therapeutic ,Adverse effect ,Survival rate ,Aged ,Chemotherapy ,Antibiotics, Antineoplastic ,business.industry ,Liver Neoplasms ,Common Terminology Criteria for Adverse Events ,Middle Aged ,medicine.disease ,Metastatic breast cancer ,Microspheres ,Treatment Outcome ,Doxorubicin ,030220 oncology & carcinogenesis ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Patients with breast cancer liver metastasis have a poor prognosis. Local therapy for liver metastasis increases survival. The purpose of this pilot prospective study was to evaluate the efficacy and safety of doxorubicin drug-eluting beads chemoembolization for liver-dominant breast cancer metastasis (LdBM) refractory to chemotherapy. All patients with LdBM refractory to of two or more lines of systemic chemotherapy were screened. Two chemoembolizations at 1-month intervals were scheduled for each patient. Tumor responses were evaluated by MRI every 3 months until progression or death. Adverse events were recorded according to the Common Terminology Criteria for Adverse Events (CTCAE version 4.02) 1 month after each chemoembolization. All patients were free from systemic treatment until progression. Patients with hormone-positive receptors and/or HER-positive disease status continued their targeted therapy. Out of 23 patients enrolled (mean age: 57.5 ± 11.5 years), 17 completed two chemoembolizations and six underwent only one because of severe adverse events. At 3-month follow-up, the disease control rate was 83 %. The median progression-free survival from the first chemoembolization was 8 months, and the median overall survival was 17 months. Nineteen patients remained free from any systemic chemotherapy for a mean of 209 ± 92 days until progression. Eight grade 3 (asthenia n = 3, anemia n = 2, thrombocythemia n = 2, liver toxicity n = 1) (Rev 1 Comment 1) occurred after the first procedure. No patient died directly due to the procedure. While chemoembolization with doxorubicin eluding beads for refractory LdBM leads to an 83 % disease control rate, it also causes severe side effects that need to be adequately managed.
- Published
- 2016
26. Early and Late Retrieval of the ALN Removable Vena Cava Filter: Results from a Multicenter Study
- Author
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C. Lions, L. Novelli, Marc Sapoval, Jean-Paul Beregi, Olivier Pellerin, and Fabrice-Guy Barral
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Vena Cava Filters ,Percutaneous ,Vena cava ,Vena Cava, Inferior ,Radiography, Interventional ,Risk Assessment ,Inferior vena cava ,Jugular vein ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Device Removal ,Aged ,Retrospective Studies ,Aged, 80 and over ,Venous Thrombosis ,Equipment Safety ,business.industry ,Ultrasound ,Equipment Design ,Middle Aged ,medicine.disease ,Surgery ,Pulmonary embolism ,Treatment Outcome ,Multicenter study ,medicine.vein ,Filter (video) ,cardiovascular system ,Feasibility Studies ,Female ,Radiology ,Pulmonary Embolism ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Retrieval of removable inferior vena cava (IVC) filters in selected patients is widely practiced. The purpose of this multicenter study was to evaluate the feasibility and results of percutaneous removal of the ALN removable filter in a large patient cohort. Between November 2003 and June 2006, 123 consecutive patients were referred for percutaneous extraction of the ALN filter at three centers. The ALN filter is a removable filter that can be implanted through a femoral/jugular vein approach and extracted by the jugular vein approach. Filter removal was attempted after an implantation period of 93 +/- 15 days (range, 6-722 days) through the right internal jugular vein approach using the dedicated extraction kit after control inferior vena cavography. Following filter removal, vena cavograms were obtained in all patients. Successful extraction was achieved in all but one case. Among these successful retrievals, additional manipulation using a femoral approach was needed when the apex of the filter was close to the IVC wall in two patients. No immediate IVC complications were observed according to the postimplantation cavography. Neither technical nor clinical differences between early and late filter retrieval were noticed. Our data confirm the safety of ALN filter retrieval up to 722 days after implantation. In infrequent cases, additional endovenous filter manipulation is needed to facilitate extraction.
- Published
- 2008
27. Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study
- Author
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Helena Pereira, Olivier Pellerin, Marc Sapoval, Lin Yen-Ting, Nicolas Thiounn, Gregory Amouyal, Gilles Chatellier, Costantino Del Giudice, and Carole Déan
- Subjects
Retrograde ejaculation ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,030232 urology & nephrology ,Prostatic Hyperplasia ,Single Center ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Lower Urinary Tract Symptoms ,Lower urinary tract symptoms ,Prostate ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,Arteries ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Prostatic artery embolization ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Prostate surgery ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Prostatic artery embolization (PAE) has been performed for a few years, but there is no report on PAE using the PErFecTED technique outside from the team that initiated this approach. This single-center retrospective open label study reports our experience and clinical results on patients suffering from symptomatic BPH, who underwent PAE aiming at using the PErFecTED technique. We treated 32 consecutive patients, mean age 65 (52–84 years old) between December 2013 and January 2015. Patients were referred for PAE after failure of medical treatment and refusal or contra-indication to surgery. They were treated using the PErFecTED technique, when feasible, with 300–500 µm calibrated microspheres (two-night hospital stay or outpatient procedure). Follow-up was performed at 3, 6, and 12 months. We had a 100 % immediate technical success of embolization (68 % of feasibility of the PErFecTED technique) with no immediate complications. After a mean follow-up of 7.7 months, we observed a 78 % rate of clinical success. Mean IPSS decreased from 15.3 to 4.2 (p = .03), mean QoL from 5.4 to 2 (p = .03), mean Qmax increased from 9.2 to 19.2 (p = .25), mean prostatic volume decreased from 91 to 62 (p = .009) mL. There was no retrograde ejaculation and no major complication. PAE using the PErFecTED technique is a safe and efficient technique to treat bothersome LUTS related to BPH. It is of interest to note that the PErFecTED technique cannot be performed in some cases for anatomical reasons.
- Published
- 2015
28. Intra-vesical Prostatic Protrusion (IPP) Can Be Reduced by Prostatic Artery Embolization
- Author
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Marc Sapoval, Nicolas Thiounn, Helena Pereira, Gregory Amouyal, Carole Déan, Costantino Del Giudice, Yen-Ting Lin, and Olivier Pellerin
- Subjects
Male ,medicine.medical_specialty ,animal structures ,030232 urology & nephrology ,Urology ,Prostatic Hyperplasia ,030218 nuclear medicine & medical imaging ,Microsphere ,03 medical and health sciences ,Bladder outlet obstruction ,0302 clinical medicine ,Lower Urinary Tract Symptoms ,Prostate ,Lower urinary tract symptoms ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Aged ,business.industry ,Arteries ,Organ Size ,Hyperplasia ,medicine.disease ,Embolization, Therapeutic ,Magnetic Resonance Imaging ,Prostatic artery embolization ,medicine.anatomical_structure ,Cardiology and Cardiovascular Medicine ,business ,Complication - Abstract
Prostate artery embolization (PAE) is a new approach to improve lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia. PAE results in global reduction of prostate volume (PV). There are no data available on the efficacy of PAE in reducing intra-vesical prostatic protrusion (IPP), an anatomic feature that is clinically related with bladder outlet obstruction and LUTS. To assess the results of PAE in patients with significant IPP due to median lobe hyperplasia and to compare the IPSS decrease and IPP change. Prospective analysis of 18 consecutive patients with significant IPP (>5 mm) related to median lobe hyperplasia undergoing PAE using 30–500-μm-calibrated trisacryl microspheres. We measured IPP on sagittal T2-weighted images before and 3 months after PAE. IPSS and clinical results were also evaluated at 3 months. PAE resulted in significant IPP reduction (1.57 cm ± 0.55 before PAE and 1.30 cm ± 0.46 after PAE, p = 0.0005) (Fig. 1) with no complication. IPSS, quality of life (QoL), total prostate-specific antigen (PSA) level, and PV showed significant reduction after PAE, and maximum urinary flow rate (Q max) showed significant increase after PAE. No significant change of International Index of Erectile Function (IIEF) for clinical evaluation after PAE. A significant correlation was found between the IPP change and the IPSS change (r = 0.636, p = 0.0045). Patients had significant IPP reduction as well as significant symptomatic improvement after PAE, and these improvements were positively correlated.
- Published
- 2015
29. Arterial Embolization of Hemorrhoids: Reply
- Author
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Vincent Vidal, Marc Sapoval, and Olivier Pellerin
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Arterial Embolization ,Ultrasound ,Rectum ,medicine.disease ,Embolization, Therapeutic ,Hemorrhoids ,Radiography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2015
30. Commentary: drug-coated balloon angioplasty to improve carotid stenting outcomes after postendarterectomy restenosis: fad or an answer to the problem of recurrent restenosis?
- Author
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Costantino Del Giudice, Roberto Gandini, Marc Sapoval, and Olivier Pellerin
- Subjects
Male ,medicine.medical_specialty ,Drug coated balloon ,Paclitaxel ,medicine.medical_treatment ,Carotid endarterectomy ,Restenosis ,Coated Materials, Biocompatible ,Internal medicine ,Angioplasty ,Carotid artery disease ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Carotid Stenosis ,Neointimal hyperplasia ,Endarterectomy, Carotid ,business.industry ,Cardiovascular Agents ,medicine.disease ,Cardiology ,Surgery ,Female ,Radiology ,Carotid stenting ,In stent restenosis ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon ,Vascular Access Devices - Published
- 2015
31. The CIRSE Retrievable IVC Filter Registry: Retrieval Success Rates in Practice
- Author
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M.A. de Gregorio, Olivier Pellerin, David Valenti, Michael J. Lee, Uri Rimon, and J. Minocha
- Subjects
Male ,medicine.medical_specialty ,Access route ,Vena Cava Filters ,business.industry ,Ivc filter ,Mean age ,Vena Cava, Inferior ,Data entry ,Middle Aged ,Surgery ,Filter (video) ,Current practice ,Median filter ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Female ,Major complication ,Registries ,Cardiology and Cardiovascular Medicine ,business ,Device Removal - Abstract
CIRSE established a registry of retrievable filter use with the primary aim of determining the success of IVC Filter retrieval and associated complications. Secondary endpoints included filter indications, imaging strategies before retrieval, filter dwell times, and anticoagulation status. A web-based electronic registry was hosted between 01/12/2010 and 30/06/2012. Data entry occurred at the date of IVC filter retrieval and included items such as filter type, indication for filter insertion, access route, dwell time, retrieval success, complications, reasons for failed retrieval, and anticoagulation status. 671 filter retrievals were entered (male:female 333:295, mean age 55, median 57). Retrieval data were not entered in 43/671 leaving 628 patients for analysis. The 4 commonest retrievable filters used were the Celect in 182 patients, the OPTEASE in 161, ALN in 120, and Gunther Tulip in 98. Filters were inserted for absolute indications 40 %, relative indications in 31 %, and prophylactic in 24 %, with 5 % missing. Mean filter dwell time was 90 days. Filters were successfully retrieved in 576/628 patients (92 %). The mean dwell time for successful retrievals was 85 days versus 145 days for unsuccessful retrievals (p = 0.001). Major complications occurred in 2 patients (0.03 %). In summary, the CIRSE retrievable filter registry demonstrates a retrieval rate of 92 % across a range of filter types, with a low major complication rate, reflecting current practice. There is an increase in trend of retrievable filter use for relative and prophylactic indications.
- Published
- 2014
32. Doxorubicin-loaded Dc-beads M1™ for liver-dominant metastatic breast cancer: phase 2 trial results and patients outcomes
- Author
-
Marc Sapoval, Olivier Pellerin, C. del giudicce, and Gregory Amouyal
- Subjects
Oncology ,medicine.medical_specialty ,Breast cancer ,business.industry ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Doxorubicin ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Metastatic breast cancer ,medicine.drug - Published
- 2016
33. Proof of concept of a gene directed enzyme prodrug therapy with intra-arterial delivery of mesenchymal stem cells in a rabbit VX2 tumor hepatic model
- Author
-
Marc Sapoval, P Beaune, I Amara, I de Waziers, and Olivier Pellerin
- Subjects
chemistry.chemical_classification ,business.industry ,Mesenchymal stem cell ,Rabbit (nuclear engineering) ,Prodrug ,Enzyme ,chemistry ,Cancer research ,Intra arterial ,Vx2 tumor ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Gene - Published
- 2017
34. Microvascular plug: a new embolic material for hepatic arterial skeletonization
- Author
-
Jafar Golzarian, Olivier Pellerin, Carole Déan, Simon Pernot, Geert Maleux, and Marc Sapoval
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Antineoplastic Agents ,Pilot Projects ,Skeletonization ,law.invention ,Port (medical) ,Hepatic Artery ,law ,medicine.artery ,Occlusion ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Prospective Studies ,Spark plug ,Aged ,Retrospective Studies ,business.industry ,Liver Neoplasms ,Middle Aged ,Arterial occlusion ,Embolization, Therapeutic ,medicine.anatomical_structure ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Right gastric artery ,Artery - Abstract
Arterial skeletonization before radioembolization or hepatic artery port catheter placement for chemotherapy is a crucial step to prevent side effects. Coils are commonly used as an embolic material for hepatoenteric arterial occlusion. Herein is reported for the first time the clinical use of a new detachable microvascular plug (MVP) suitable for occlusion of 1–3 mm diameter vessels. The MVP allows vessel embolization even in challenging anatomy such as the right gastric artery. Furthermore, immediate and stable vessel occlusion was observed in our pilot study of 16 MVP placements.
- Published
- 2013
35. DC-Beads M1™ loaded with Irinotecan combined with systemic chemotherapy for pretreated liver dominant metastatic colorectal cancer: procedure and patients outcomes
- Author
-
Marc Sapoval, C. del giudicce, Olivier Pellerin, and Gregory Amouyal
- Subjects
Irinotecan ,Oncology ,medicine.medical_specialty ,Colorectal cancer ,Systemic chemotherapy ,business.industry ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,medicine.drug - Published
- 2016
36. Effect of a Retrievable Inferior Vena Cava Filter Plus Anticoagulation vs Anticoagulation Alone on Risk of Recurrent Pulmonary Embolism: A Randomized Clinical Trial
- Author
-
Silvy Laporte, Olivier Pellerin, and Patrick Mismetti
- Subjects
medicine.medical_specialty ,business.industry ,Inferior vena cava filter ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,Surgery ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Recurrent pulmonary embolism ,Cardiology and Cardiovascular Medicine ,business - Abstract
Patrick Mismetti, MD, PhD; Silvy Laporte, MS, PhD; Olivier Pellerin, MD, MSc; Pierre-Vladimir Ennezat, MD, PhD; Francis Couturaud, MD, PhD; Antoine Elias, MD, PhD; Nicolas Falvo, MD; Nicolas Meneveau, MD, PhD; Isabelle Quere, MD, PhD; Pierre-Marie Roy, MD, PhD; Olivier Sanchez, MD, PhD; Jeannot Schmidt, MD, PhD; Christophe Seinturier, MD; Marie-Antoinette Sevestre, MD; Jean-Paul Beregi, MD, PhD; Bernard Tardy, MD, PhD; Philippe Lacroix, MD; Emilie Presles, MSc; Alain Leizorovicz, MD; Herve Decousus, MD; Fabrice-Guy Barral, MD; GuyMeyer, MD; for the PREPIC2 Study Group
- Published
- 2016
37. Erratum to: Intra-vesical Prostatic Protrusion (IPP) Can Be Reduced by Prostatic Artery Embolization
- Author
-
Helena Pereira, Olivier Pellerin, Marc Sapoval, Carole Déan, Costantino Del Giudice, Nicolas Thiounn, Gregory Amouyal, and Yen-Ting Lin
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Text mining ,business.industry ,Ultrasound ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Prostatic artery embolization ,030218 nuclear medicine & medical imaging - Published
- 2015
38. Postpartum hemorrhage treated with gelfoam slurry embolization using the superselective technique: immediate results and 1-month MRI follow-up
- Author
-
Marc Sapoval, Bertrand Louail, Olivier Pellerin, Fabrice Lecuru, Anne-Sophie Bats, Laure Fournier, Bernard Beyssen, Gabrielle Pinot de Villechenon, Ana Palomera-Ricco, Massimiliano Di Primio, and Jean-Yves Pagny
- Subjects
Adult ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Radiology, Interventional ,Risk Assessment ,Magnetic resonance angiography ,Cohort Studies ,Young Adult ,Uterine artery embolization ,Pregnancy ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Uterine artery ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Postpartum Hemorrhage ,Angiography ,Magnetic resonance imaging ,Uterine Artery Embolization ,medicine.disease ,Gelatin Sponge, Absorbable ,Surgery ,Uterine rupture ,Contrast medium ,Uterine Artery ,Treatment Outcome ,Female ,Radiology ,France ,Cardiology and Cardiovascular Medicine ,business ,Magnetic Resonance Angiography ,Follow-Up Studies - Abstract
To evaluate the efficacy and safety of superselective embolization of the uterine arteries in a postpartum hemorrhage. Between November 2004 and January 2011, a total of 44 consecutive women (median ± standard deviation age 34 ± 3 years, range 23–41 years) were referred to our institution for postpartum intractable hemorrhage management. All patients were embolized with a microcatheter that was placed deep into the uterine arteries upstream of the cervical arteries. The embolic agent was a mixture of contrast medium and 5 × 5 × 5 cm pieces of gelfoam (Gelita-Spon) modified into a gelatin emulsion as follows: rapid mixing through a three-way stopcock with two 2.5-ml syringes. A 1-ml syringe was used for injection. One month after embolization, all patients underwent magnetic resonance imaging and clinical examination. Technical and clinical success was obtained in all cases. Thirty-five patients experienced bleeding related to poor retraction of the uterus, 7 patients because of a tear of the cervix and 2 because of a vaginal hematoma. Pre- and postembolization red blood cell transfusions were (mean ± standard deviation [SD]) 6 ± 1.2 (range 3–8) U and 2 ± 0.7 (range 2–4) U, respectively. One-month magnetic resonance imaging follow-up revealed no sign of ischemic myometrium or necrosis, and no instances of uterine rupture and no pelvic vein thrombosis. Incidental findings included two small intramyometrial hematic collections. All uterine arteries were patent via magnetic resonance angiography. Seventeen patients had concomitant fibroids, all of which appeared hypovascular. This technique permits good, safe clinical results with no marked damage to the uterine arteries or the uterus itself.
- Published
- 2011
39. Quelles sténoses faut-il dilater ?
- Author
-
Marc Sapoval, Olivier Pellerin, T. Carreres, J Y Pagny, Pierre-François Plouin, D. Krajickova, Bernard Beyssen, A. Boronat, and Michel Azizi
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2014
40. Uterine artery embolization for leiomyomata: Optimization of the radiation dose to the patient using a flat-panel detector angiographic suite
- Author
-
Olivier Pellerin, Ghizlaine Rahmoune, Isabelle Fitton, Nicolas Houdoux, J.L. Rehel, Bernard Aubert, Marc Sapoval, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), and Institut de Radioprotection et de Sûreté Nucléaire (IRSN)
- Subjects
artery catheterization ,radiation detector ,thermoluminescence dosimetry ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,radiation exposure ,Radiography, Interventional ,Flat panel detector ,030218 nuclear medicine & medical imaging ,Cohort Studies ,0302 clinical medicine ,Uterine artery embolization ,Medicine ,Fluoroscopy ,angiography ,Embolization ,Prospective Studies ,Radiation ,medicine.diagnostic_test ,Leiomyoma ,Interventional ,Ultrasound ,Statistics ,article ,uterine artery embolization ,clinical trial ,Middle Aged ,3. Good health ,fluoroscopy ,female ,Treatment Outcome ,priority journal ,030220 oncology & carcinogenesis ,Uterine Neoplasms ,Radiology ,Cardiology and Cardiovascular Medicine ,radiation dose ,prospective study ,Adult ,medicine.medical_specialty ,Radiation Dosage ,Risk Assessment ,Statistics, Nonparametric ,Dose-Response Relationship ,03 medical and health sciences ,Radiation Protection ,Dosimetry ,Humans ,Radiology, Nuclear Medicine and imaging ,controlled study ,Nonparametric ,human ,Radiation Injuries ,Radiometry ,Automatic exposure control ,automation ,controlled clinical trial ,business.industry ,Dose-Response Relationship, Radiation ,uterus myoma ,major clinical study ,Radiography ,Angiography ,business ,Nuclear medicine ,Follow-Up Studies - Abstract
cited By 17; The purpose of this study was to assess the ability of low-dose/low-frame fluoroscopy/angiography with a flat-panel detector angiographic suite to reduce the dose delivered to patients during uterine fibroid embolization (UFE). A two-step prospective dosimetric study was conducted, with a flat-panel detector angiography suite (Siemens Axiom Artis) integrating automatic exposure control (AEC), during 20 consecutive UFEs. Patient dosimetry was performed using calibrated thermoluminescent dosimeters placed on the lower posterior pelvis skin. The first step (10 patients; group A) consisted in UFE (bilateral embolization, calibrated microspheres) performed using the following parameters: standard fluoroscopy (15 pulses/s) and angiography (3 frames/s). The second step (next consecutive 10 patients; group B) used low-dose/low-frame fluoroscopy (7.5 pulses/s for catheterization and 3 pulses/s for embolization) and angiography (1 frame/s). We also recorded the total dose-area product (DAP) delivered to the patient and the fluoroscopy time as reported by the manufacturer's dosimetry report. The mean peak skin dose decreased from 2.4 ± 1.3 to 0.4 ± 0.3 Gy (P = 0.001) for groups A and B, respectively. The DAP values decreased from 43,113 ± 27,207 μGy m2 for group A to 9,515 ± 4,520 μGy m2 for group B (P = 0.003). The dose to ovaries and uterus decreased from 378 ± 238 mGy (group A) to 83 ± 41 mGy (group B) and from 388 ± 246 mGy (group A) to 85 ± 39 mGy (group B), respectively. Effective doses decreased from 112 ± 71 mSv (group A) to 24 ± 12 mSv (group B) (P = 0.003). In conclusion, the use of low-dose/low-frame fluoroscopy/angiography, based on a good understanding of the AEC system and also on the technique during uterine fibroid embolization, allows a significant decrease in the dose exposure to the patient. © 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
- Published
- 2010
41. Spontaneous renal artery dissection: long-term outcomes after endovascular stent placement
- Author
-
Marc Sapoval, Bernard Beyssen, Patrick Rossignol, Christian Jacquot, Pierre-François Plouin, Olivier Pellerin, Alain Raynaud, and Philippe Garçon
- Subjects
Adult ,medicine.medical_specialty ,Renal function ,Renal Artery Obstruction ,Aneurysm ,Restenosis ,Blood vessel prosthesis ,medicine.artery ,Occlusion ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Longitudinal Studies ,Renal artery ,Aged ,medicine.diagnostic_test ,business.industry ,Digital subtraction angiography ,Middle Aged ,medicine.disease ,Surgery ,Blood Vessel Prosthesis ,Aortic Dissection ,Blood pressure ,Treatment Outcome ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business - Abstract
Purpose To report long-term clinical and morphologic results after stent placement for spontaneous renal artery dissection (SRAD). Materials and Methods Between 1991 and 2006, 16 consecutive patients (13 men; mean age, 42 y ± 12) presented with SRAD in 17 arteries. All patients had uncontrolled hypertension at the time of presentation. Nine patients had lower back pain, 10 had progressive renal insufficiency, and three had both. All patients underwent renal angiography and stent implantation. They were followed up clinically and with renal imaging. Results Baseline blood pressure and plasma creatinine levels were 176/107 mm Hg and 142 μmol/L, respectively. Successful renal artery recanalization and stent implantation were achieved in all patients. After a mean follow-up of 8.6 years ± 3.4, mean blood pressure was 118/78 mm Hg, with Seven patients were taking no antihypertensive medication, with five and four patients taking single or double antihypertensive agents, respectively. The most recent follow-up showed that plasma creatinine levels were normal, and imaging of the renal arteries showed no sign of restenosis or occlusion in all patients. Conclusions Stent implantation for symptomatic SRAD is an effective treatment in the long term and represents a safe alternative to surgery.
- Published
- 2008
42. Embolization of the internal iliac artery: cost-effectiveness of two different techniques
- Author
-
Luigi Novelli, Olivier Pellerin, Patrice Prognon, Yanis Kandounakis, Thibaud Caruba, Judith Pineau, and Marc Sapoval
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cost effectiveness ,Common iliac aneurysm ,medicine.medical_treatment ,Contrast Media ,Radiography, Interventional ,Endovascular aneurysm repair ,Blood Vessel Prosthesis Implantation ,medicine.artery ,Triiodobenzoic Acids ,Occlusion ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Iliac Aneurysm ,Embolization ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chi-Square Distribution ,business.industry ,Middle Aged ,medicine.disease ,Internal iliac artery ,Embolization, Therapeutic ,Abdominal aortic aneurysm ,Surgery ,Treatment Outcome ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business ,Aortic Aneurysm, Abdominal - Abstract
The purpose of this study was to compare the cost-effectiveness of coils versus the Amplatzer Vascular Plug (AVP) for occlusion of the internal iliac artery (IAA). Between 2002 and January 2006, 13 patients (mean age 73 +/- 13 years) were referred for stent-grafting of abdominal aortic aneurysm (n = 6); type I distal endoleak (n = 3), isolated iliac aneurysm (n = 3), or rupture of a common iliac aneurysm (n = 1). In all patients, extension of the stent-graft was needed because the distal neck was absent. Two different techniques were used to occlude the IIA: AVP in seven patients (group A) and coil embolization in six patients (group C). Immediate results and direct material costs were assessed retrospectively. Immediate success was achieved in all patients, and simultaneous stent-grafting was successfully performed in two of six patients in group C versus five of seven patients in group A. In all group A patients, a single AVP was sufficient to achieve occlusion of the IIA, accounting for a mean cost of 485 euros, whereas in group C patients, an average of 7 +/- 3 coils were used, accounting for a mean cost of 1,745 euros. Mean average cost savings using the AVP was 1,239 euros. When IIA occlusion is needed, the AVP allows a single-step procedure at significant cost savings.
- Published
- 2008
43. Abstract No LB11: 70-150 μm doxorubicin-eluting beads for intra-arterial therapy of liver cancer: first in-vivo study
- Author
-
Sahar Mirpour, Romaric Loffroy, J.H. Geschwind, Pramod Rao, Eleni Liapi, Ali Gholamrezanezhad, and Olivier Pellerin
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Pharmacology ,medicine.disease ,Doxorubicin-Eluting Beads ,In vivo ,Internal medicine ,medicine ,Intra arterial ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Liver cancer - Published
- 2012
44. Optional vena cava filter placement and 3 months retrievability: results of the PREPIC 2 randomized multicenter trial
- Author
-
M. Midulla, Fabrice-Guy Barral, Patrick Mismetti, Olivier Pellerin, O. Sanchez, G. Meyer, and M. Sapoval
- Subjects
medicine.medical_specialty ,Vena cava ,business.industry ,Inferior vena cava ,Surgery ,Food and drug administration ,medicine.vein ,Multicenter trial ,Medicine ,Radiology, Nuclear Medicine and imaging ,User Facility ,Statistical analysis ,Complication rate ,Cardiology and Cardiovascular Medicine ,business ,Complication - Abstract
Purpose: We aimed to compare the safety of permanent (pIVC) and potentially retrievable (rIVC) inferior vena cava filters by reviewing the U.S. Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. We hypothesize that self-reported complication rates respectively associated with rIVC and pIVC filters are equivalent. Materials and Methods: The MAUDE database was reviewed from January 1, 2009 to December 31, 2012. Product class search criteria were “filter, intravascular, cardiovascular.”. The total number of complications per year and complication type/rates were recorded for pIVC and rIVC devices. Binomial test was used for statistical analysis with rejection of the null hypothesis at po0.05. Results: 1,606 reported adverse events (AE) involving 1,057 IVC filters were identified. 1,394 (86.8%) AEs involved rIVC and 212 (13.2%) involved pIVC (po0.0001). The number and percentage of each specific AE was higher in rIVC compared to pIVC (see table). The most commonly reported AE varied depending on filter brand: fracture (27.1%) for Bard (Bard Peripheral Vascular, Tempe, AZ) devices, IVC penetration(29.9%) for Celect (Cook Medical, Bloomington, IN), placement difficulties for Optease (Cordis Endovascular, Warren, NJ) (30.8%) and Gunther Tulip (Cook Medical, Bloomington, IN) (45%). Conclusion: MAUDE database review reveals statistically significantly higher complication rate associated with rIVC compared to pIVC filters. Among rIVC filters prevalence of each specific complication varied widely among brands. This study suggests that optional filters are inferior to permanent devices in terms of self-reported, deviceassociated complications.
- Published
- 2014
45. Irinotecan drug eluted beads as a closure treatment for controlled liver colorectal cancer metastases after more than 2 systemic chemotherapy regiments
- Author
-
Olivier Pellerin, S. Pernot, Julien Taieb, P. Rougier, and M. Sapoval
- Subjects
Oncology ,Drug ,medicine.medical_specialty ,Colorectal cancer ,Systemic chemotherapy ,business.industry ,media_common.quotation_subject ,medicine.disease ,Surgery ,Irinotecan ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Closure (psychology) ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug ,media_common - Published
- 2014
46. Spontaneous Dissection of the Renal Arteries: A Misdiagnosed But Not Infrequent Disease!
- Author
-
Marc Sapoval, Olivier Pellerin, Alain Raynaud, and Bernard Beyssen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Infarction ,Disease ,Fibromuscular dysplasia ,Kidney ,Diagnosis, Differential ,medicine ,Fibromuscular Dysplasia ,Humans ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,business.industry ,Angiography ,Spontaneous dissection ,Aneurysm dissecting ,medicine.disease ,Surgery ,Aortic Dissection ,medicine.anatomical_structure ,Kidney Diseases ,Differential diagnosis ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon - Published
- 2009
47. Abstract No. 33: Dynamic first-pass area-detector perfusion CT for the evaluation of perfusion changes following intra-arterial therapy in the liver VX2 model
- Author
-
Jean Francois H. Geschwind, Olivier Pellerin, Ali Gholamrezanezhad, Eleni Liapi, Sahar Mirpour, and Pramod Rao
- Subjects
medicine.medical_specialty ,Pathology ,Chemokine ,Necrosis ,biology ,Cell adhesion molecule ,Angiogenesis ,business.industry ,Perfusion scanning ,HIF1A ,Parenchyma ,medicine ,biology.protein ,Radiology, Nuclear Medicine and imaging ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Perfusion - Abstract
between 2 groups were selected. Results: At D7, bland SAP did not cause necrosis and only 68 genes were deregulated. Among them, 10 genes related to angiogenesis. VEGF was not different vs control. Dox-SAP caused parenchyma necrosis at D7 (presence on 92% of the tissue sections), which was progressively resorbed between M1 (31%) and M3 (0%) and replaced by an inflammatory reaction and a fibrotic remodeling tissue after the microspheres emptied, finally resulting in regenerated liver. In parallel, the overall number of modulated genes and the number of angiogenesis-related genes decreased from D7 to M1 and M3 (resp. 770, 257 and 46 modulated genes by Dox-SAP; and among them 71, 34 and 6 modulated related to angiogenesis). VEGF decreased at D7 and M1. The angiogenesis related-genes did not included VEGF and HIF1A but were interleukins and chemokines which mark an inflammatory reaction, and collagen molecules, metallopeptidases, growth factors, and adhesion molecules which orchestrate the tissue remodeling. Conclusion: Angiogenesis following chemoembolization in normal liver, associated to the inflammatory response and tissue remodeling, participates to the healing phase replacing the necrosis induced by Dox. This repair angiogenesis must be distinguished from tumoral angiogenesis.
- Published
- 2012
48. Abstract No. 241: Volumetric RECIST: an improved way to assess tumor response after transcatheter arterial chemoembolization (TACE)
- Author
-
Olivier Pellerin, Nikhil Bhagat, Pramod Rao, Romaric Loffroy, Benoit Mory, Diane K. Reyes, MingDe Lin, Roberto Ardon, and Jean Francois H. Geschwind
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Cardiology and Cardiovascular Medicine ,Transcatheter arterial chemoembolization ,Tumor response ,business - Published
- 2012
49. Abstract No. 373: Tumor enhancement changes obersved by dual-phase cone beam CT (DPCBCT) before and immediately after glass microsphere Y90 radioembolization
- Author
-
Wenbo Shao, MingDe Lin, Jean Francois H. Geschwind, Olivier Pellerin, and Nikhil Bhagat
- Subjects
Glass microsphere ,Tumor enhancement ,business.industry ,Phase (matter) ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Cone beam ct ,Biomedical engineering - Published
- 2012
50. Abstract No. 242: Quantitative EASL: an improved way to assess tumor response after transcatheter arterial chemoembolization (TACE)
- Author
-
MingDe Lin, Nikhil Bhagat, Pramod Rao, Olivier Pellerin, Romaric Loffroy, Jean Francois H. Geschwind, Roberto Ardon, Benoit Mory, and Diane K. Reyes
- Subjects
medicine.medical_specialty ,business.industry ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Transcatheter arterial chemoembolization ,Tumor response - Published
- 2012
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