Search

Your search keyword '"Costargent, A"' showing total 141 results
Start Over Author "Costargent, A"
141 results on '"Costargent, A"'

4. Meta‐analysis of individual‐patient data from EVAR‐1, DREAM, OVER and ACE trials comparing outcomes of endovascular or open repair for abdominal aortic aneurysm over 5 years

Author

Powell, J. T., Sweeting, M. J., Ulug, P., Blankensteijn, J. D., Lederle, F. A., Becquemin, J.‐P., Greenhalgh, R. M., Greenhalgh, R. M., Beard, J. D., Buxton, M. J., Brown, L. C., Harris, P. L., Powell, J. T., Rose, J. D. G., Russell, I. T., Sculpher, M. J., Thompson, S. G., Lilford, R.J., Bell, P. R. F., Greenhalgh, R. M., Whitaker, S.C., Poole‐Wilson, the late P.A., Ruckley, C. V., Campbell, W. B., Dean, M. R. E., Ruttley, M. S. T., Coles, E. C., Powell, J. T., Halliday, A., Gibbs, S. J., Brown, L. C., Epstein, D., Sculpher, M. J., Thompson, S. G., Hannon, R. J., Johnston, L., Bradbury, A. W., Henderson, M. J., Parvin, S. D., Shepherd, D. F. C., Greenhalgh, R. M., Mitchell, A. W., Edwards, P. R., Abbott, G. T., Higman, D. J., Vohra, A., Ashley, S., Robottom, C., Wyatt, M. G., Rose, J. D. G., Byrne, D., Edwards, R., Leiberman, D. P., McCarter, D. H., Taylor, P. R., Reidy, J. F., Wilkinson, A. R., Ettles, D. F., Clason, A. E., Leen, G. L. S., Wilson, N. V., Downes, M., Walker, S. R., Lavelle, J. M., Gough, M. J., McPherson, S., Scott, D. J. A., Kessell, D. O., Naylor, R., Sayers, R., Fishwick, N. G., Harris, P. L., Gould, D. A., Walker, M. G., Chalmers, N. C., Garnham, A., Collins, M. A., Beard, J. D., Gaines, P. A., Ashour, M. Y., Uberoi, R., Braithwaite, B., Whitaker, S. C., Davies, J. N., Travis, S., Hamilton, G., Platts, A., Shandall, A., Sullivan, B. A., Sobeh, M., Matson, M., Fox, A. D., Orme, R., Yusef, W., Doyle, T., Horrocks, M., Hardman, J., Blair, P. H. B., Ellis, P. K., Morris, G., Odurny, A., Vohra, R., Duddy, M., Thompson, M., Loosemore, T. M. L., Belli, A. M., Morgan, R., Adiseshiah, M., Brookes, J. A. S., McCollum, C. N., Ashleigh, R., Aukett, M., Baker, S., Barbe, E., Batson, N., Bell, J., Blundell, J., Boardley, D., Boyes, S., Brown, O., Bryce, J., Carmichael, M., Chance, T., Coleman, J., Cosgrove, C., Curran, G., Dennison, T., Devine, C., Dewhirst, N., Errington, B., Farrell, H., Fisher, C., Fulford, P., Gough, M., Graham, C., Hooper, R., Horne, G., Horrocks, L., Hughes, B., Hutchings, T., Ireland, M., Judge, C., Kelly, L., Kemp, J., Kite, A., Kivela, M., Lapworth, M., Lee, C., Linekar, L., Mahmood, A., March, L., Martin, J., Matharu, N., McGuigen, K., Morris‐Vincent, P., Murray, S., Murtagh, A., Owen, G., Ramoutar, V., Rippin, C., Rowley, J., Sinclair, J., Spencer, S., Taylor, V., Tomlinson, C., Ward, S., Wealleans, V., West, J., White, K., Williams, J., Wilson, L., Grobbee, D. E., Blankensteijn, J. D., Bak, A. A. A., Buth, J., Pattynama, P. M., Verhoeven, E. L. G., van Voorthuisen, A. E., Blankensteijn, J. D., Balm, R., Buth, J., Cuypers, P. W. M., Grobbee, D. E., Prinssen, M., van Sambeek, M. R. H. M., Verhoeven, E. L. G., Baas, A. F., Hunink, M. G., van Engelshoven, J. M., Jacobs, M. J. H. M., de Mol, B. A. J. M., van Bockel, J. H., Balm, R., Reekers, J., Tielbeek, X., Verhoeven, E. L. G., Wisselink, W., Boekema, N., Heuveling, L. M., Sikking, I., Prinssen, M., Balm, R., Blankensteijn, J. D., Buth, J., Cuypers, P. W. M., van Sambeek, M. R. H. M., Verhoeven, E. L. G., de Bruin, J. L., Baas, A. F., Blankensteijn, J. D., Prinssen, M., Buth, J., Tielbeek, A.V., Blankensteijn, J. D., Balm, R., Reekers, J. A., van Sambeek, M. R. H. M., Pattynama, P., Verhoeven, E. L. G., Prins, T., van der Ham, A. C., van der Velden, J. J. I. M., van Sterkenburg, S. M. M., ten Haken, G. B., Bruijninckx, C. M. A., van Overhagen, H., Tutein Nolthenius, R. P., Hendriksz, T. R., Teijink, J. A. W., Odink, H. F., de Smet, A. A. E. A., Vroegindeweij, D., van Loenhout, R. M. M., Rutten, M. J., Hamming, J. F., Lampmann, L. E. H., Bender, M. H. M., Pasmans, H., Vahl, A. C., de Vries, C., Mackaay, A. J. C., van Dortmont, L. M. C., van der Vliet, A. J., Schultze Kool, L. J., Boomsma, J. H. B., van Dop, H. R., de Mol van Otterloo, J. C. A., de Rooij, T. P. W., Smits, T. M., Yilmaz, E. N., Wisselink, W., van den Berg, F. G., Visser, M. J. T., van der Linden, E., Schurink, G. W. H., de Haan, M., Smeets, H. J., Stabel, P., van Elst, F., Poniewierski, J., Vermassen, F. E. G., Lederle, F. A., Freischlag, J. A., Kohler, T. R., Latts, E., Matsumura, J., Padberg, F. T., Jr, Kyriakides, T. C., Swanson, K. M., Guarino, P., Peduzzi, P., Antonelli, M., Cushing, C., Davis, E., Durant, L., Joyner, S., Kossack, the late A., Kyriakides, T. C., LeGwin, Mary, McBride, V., OʼConnor, T., Poulton, J., Stratton, the late S., Zellner, S., Snodgrass, A. J., Thornton, J., Swanson, K. M., Haakenson, C. M., Stroupe, K.T., Jonk, Y., Hallett, J. W., Hertzer, N., Towne, J., Katz, D. A., Karrison, T., Matts, J. P., Marottoli, R., Kasl, S., Mehta, R., Feldman, R., Farrell, W., Allore, H., Perry, E., Niederman, J., Randall, F., Zeman, M., Beckwith, the late D., OʼLeary, T. J., Huang, G. D., Latts, E., Bader, M., Ketteler, E. R., Kingsley, D. D., Marek, J. M., Massen, R. J., Matteson, B. D., Pitcher, J. D., Langsfeld, M., Corson, J. D., Goff, J. M., Jr, Kasirajan, K., Paap, C., Robertson, D. C., Salam, A., Veeraswamy, R., Milner, R., Kasirajan, K., Guidot, J., Lal, B. K., Busuttil, S. J., Lilly, M. P., Braganza, M., Ellis, K., Patterson, M. A., Jordan, W. D., Whitley, D., Taylor, S., Passman, M., Kerns, D., Inman, C., Poirier, J., Ebaugh, J., Raffetto, J., Chew, D., Lathi, S., Owens, C., Hickson, K., Dosluoglu, H. H., Eschberger, K., Kibbe, M. R., Baraniewski, H. M., Matsumura, J., Endo, M., Busman, A., Meadows, W., Evans, M., Giglia, J. S., El Sayed, H., Reed, A. B., Ruf, M., Ross, S., Jean‐Claude, J. M., Pinault, G., Kang, P., White, N., Eiseman, M., Jones, the late R., Timaran, C. H., Modrall, J. G., Welborn, M. B., III, Lopez, J., Nguyen, T., Chacko, J. K. Y., Granke, K., Vouyouka, A. G., Olgren, E., Chand, P., Allende, B., Ranella, M., Yales, C., Whitehill, T. A., Krupski, the late W. C., Nehler, M. R., Johnson, S. P., Jones, D. N., Strecker, P., Bhola, M. A., Shortell, C. K., Gray, J. L., Lawson, J. H., McCann, R., Sebastian, M.W., Kistler Tetterton, J., Blackwell, C., Prinzo, P. A., Lee, N., Padberg, F. T., Jr, Cerveira, J. J., Lal, B. K., Zickler, R. W., Hauck, K. A., Berceli, S. A., Lee, W. A., Ozaki, C. K., Nelson, P. R., Irwin, A. S., Baum, R., Aulivola, B., Rodriguez, H., Littooy, F. N., Greisler, H., OʼSullivan, M. T., Kougias, P., Lin, P. H., Bush, R. L., Guinn, G., Bechara, C., Cagiannos, C., Pisimisis, G., Barshes, N., Pillack, S., Guillory, B., Cikrit, D., Lalka, S. G., Lemmon, G., Nachreiner, R., Rusomaroff, M., OʼBrien, E., Cullen, J. J., Hoballah, J., Sharp, W. J., McCandless, J. L., Beach, V., Minion, D., Schwarcz, T. H., Kimbrough, J., Ashe, L., Rockich, A., Warner‐Carpenter, J., Moursi, M., Eidt, J. F., Brock, S., Bianchi, C., Bishop, V., Gordon, I. L., Fujitani, R., Kubaska, S. M., III, Behdad, M., Azadegan, R., Ma Agas, C., Zalecki, K., Hoch, J. R., Carr, S. C., Acher, C., Schwarze, M., Tefera, G., Mell, M., Dunlap, B., Rieder, J., Stuart, J. M., Weiman, D. S., Abul‐Khoudoud, O., Garrett, H. E., Walsh, S. M., Wilson, K. L., Seabrook, G. R., Cambria, R. A., Brown, K. R., Lewis, B. D., Framberg, S., Kallio, C., Barke, R. A., Santilli, S. M., dʼAudiffret, A. C., Oberle, N., Proebstle, C., Johnson, L. L., Jacobowitz, G. R., Cayne, N., Rockman, C., Adelman, M., Gagne, P., Nalbandian, M., Caropolo, L. J., Pipinos, I. I., Johanning, J., Lynch, T., DeSpiegelaere, H., Purviance, G., Zhou, W., Dalman, R., Lee, J. T., Safadi, B., Coogan, S. M., Wren, S. M., Bahmani, D. D., Maples, D., Thunen, S., Golden, M. A., Mitchell, M. E., Fairman, R., Reinhardt, S., Wilson, M. A., Tzeng, E., Muluk, S., Peterson, N. M., Foster, M., Edwards, J., Moneta, G. L., Landry, G., Taylor, L., Yeager, R., Cannady, E., Treiman, G., Hatton‐Ward, S., Salabsky, the late B., Kansal, N., Owens, E., Estes, M., Forbes, B. A., Sobotta, C., Rapp, J. H., Reilly, L. M., Perez, S. L., Yan, K., Sarkar, R., Dwyer, S. S., Perez, S., Chong, K., Kohler, T. R., Hatsukami, T. S., Glickerman, D. G., Sobel, M., Burdick, T. S., Pedersen, K., Cleary, P., Back, M., Bandyk, D., Johnson, B., Shames, M., Reinhard, R. L., Thomas, S. C., Hunter, G. C., Leon, L. R., Jr, Westerband, A., Guerra, R. J., Riveros, M., Mills, J. L., Sr, Hughes, J. D., Escalante, A. M., Psalms, S. B., Day, N. N., Macsata, R., Sidawy, A., Weiswasser, J., Arora, S., Jasper, B. J., Dardik, A., Gahtan, V., Muhs, B. E., Sumpio, B. E., Gusberg, R. J., Spector, M., Pollak, J., Aruny, J., Kelly, E. L., Wong, J., Vasilas, P., Joncas, C., Gelabert, H. A., DeVirgillio, C., Rigberg, D. A., Cole, L., Becquemin, J.‐P., Marzelle, J., Becquemin, J.‐P., Sapoval, M., Becquemin, J.‐P., Favre, J.‐P., Watelet, J., Lermusiaux, P., Sapoval, M., Lepage, E., Hemery, F., Dolbeau, G., Hawajry, N., Cunin, P., Harris, P., Stockx, L., Chatellier, G., Mialhe, C., Fiessinger, J.‐N., Pagny, L., Kobeiter, H., Boissier, C., Lacroix, P., Ledru, F., Pinot, J.‐J., Deux, J.‐F., Tzvetkov, B., Duvaldestin, P., Watelet, J., Jourdain, C., David, V., Enouf, D., Ady, N., Krimi, A., Boudjema, N., Jousset, Y., Enon, B., Blin, V., Picquet, J., LʼHoste, P., Thouveny, F., Borie, H., Kowarski, S., Pernes, J.‐M., Auguste, M., Becquemin, J.‐P., Desgranges, P., Allaire, E., Marzelle, J., Kobeiter, H., Meaulle, P.‐Y., Chaix, D., Juliae, P., Fabiani, J. N., Chevalier, P., Combes, M., Seguin, A., Belhomme, D., Sapoval, M., Baque, J., Pellerin, O., Favre, J. P., Barral, X., Veyret, C., Watelet, J., Peillon, C., Plissonier, D., Thomas, P., Clavier, E., Lermusiaux, P., Martinez, R., Bleuet, F., C, Dupreix, Verhoye, J. P., Langanay, T., Heautot, J. F., Koussa, M., Haulon, S., Halna, P., Destrieux, L., Lions, C., Wiloteaux, S., Beregi, J. P., Bergeron, P., Pinot, J.‐J., Patra, P., Costargent, A., Chaillou, P., DʼAlicourt, A., Goueffic, Y., Cheysson, E., Parrot, A., Garance, P., Demon, A., Tyazi, A., Pillet, J.‐C., Lescalie, F., Tilly, G., Steinmetz, E., Favier, C., Brenot, R., Krause, D., Cercueil, J. P., Vahdat, O., Sauer, M., Soula, P., Querian, A., Garcia, O., Levade, M., Colombier, D., Cardon, J.‐M., Joyeux, A., Borrelly, P., Dogas, G., Magnan, P.‐É., Branchereau, A., Bartoli, J.‐M., Hassen‐Khodja, R., Batt, M., Planchard, P.‐F., Bouillanne, P.‐J., Haudebourg, P., Bayne, J., Gouny, P., Badra, A., Braesco, J., Nonent, M., Lucas, A., Cardon, A., Kerdiles, Y., Rolland, Y., Kassab, M., Brillu, C., Goubault, F., Tailboux, L., Darrieux, H., Briand, O., Maillard, J.‐C., Varty, K., and Cousins, C.

Published
2017
Full Text
View/download PDF

9. Vers une armée 4.0 ?

Author

Dominique Costargent

Subjects
General Medicine
Abstract

Le developpement des robots a des fins militaires est une realite avec les progres technologiques et l’apport croissant de l’intelligence artificielle. Il est necessaire de ne pas rater cette evolution vers une armee 4.0. Une reflexion s’impose pour la France si elle ne veut pas se retrouver marginalisee avec cette realite operationnelle.

Published
2018

12. Bare Metal Versus Paclitaxel-Eluting Stents for Long Femoropopliteal Lesions: Prospective Cohorts Comparison Using a Propensity Score–Matched Analysis

Author

Alain Costargent, Béatrice Guyomarch, Adrien Kaladji, Jean-Michel Davaine, Philippe Chaillou, Yann Gouëffic, Thibaut Quillard, and Pierre-Alexandre Vent

Subjects
Male, Bare-metal stent, Time Factors, medicine.medical_treatment, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Popliteal Artery, Prospective Studies, Registries, 030212 general & internal medicine, Prospective cohort study, Aged, 80 and over, Drug-Eluting Stents, General Medicine, Middle Aged, Vitamin K antagonist, Intention to Treat Analysis, Femoral Artery, Treatment Outcome, Metals, Inclusion and exclusion criteria, Female, Stents, France, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Paclitaxel, medicine.drug_class, Matched-Pair Analysis, Urology, Prosthesis Design, Disease-Free Survival, Peripheral Arterial Disease, 03 medical and health sciences, Angioplasty, medicine, Humans, Propensity Score, Vascular Patency, Aged, Proportional Hazards Models, Chi-Square Distribution, Intention-to-treat analysis, business.industry, Stent, Cardiovascular Agents, Surgery, Logistic Models, Multivariate Analysis, Propensity score matching, business, Angioplasty, Balloon
Abstract

The study aims to compare outcomes of primary stenting of long femoropopliteal (FP) lesions with bare metal stent (BMS) versus paclitaxel eluting stent (PES).In a single centre study, we established 2 consecutive and prospective cohorts with TASC C/D FP de novo lesions. The inclusion and exclusion criteria were similar. Bare metal stent (LifeStentIn total, 110 limbs were treated (STELLA: n = 62; STELLA PTX: n = 48). We noted some difference between both cohorts regarding type 2 diabetes (P = 0.05), vitamin K antagonist use (P = 0.05), and angiotensin II receptor blocker use (P = 0.002). More stents were implanted in the STELLA PTX cohort (P 0.0013). At 12 months, in univariate analysis, freedom from target lesion revascularization (TLR) was higher in the STELLA cohort (P = 0.005). No differences were found between both cohorts in terms of primary sustained clinical improvement (P = 0.25), primary patency (P = 0.07), and survival (P = 0.79). With the propensity score, no difference was observed in terms of primary sustained clinical improvement (P = 0.79), freedom from TLR (P = 0.59), and primary patency (P = 0.69). With Cox logistic regression, the number of implanted stents influenced the primary sustained clinical improvement, the freedom from TLR, and the primary patency.Paclitaxel-eluting stents do not seem to provide benefits in terms of clinical and morphological outcomes for TASC C/D lesions compared to BMS.

Published
2017

16. Impact of Vascular Calcifications on Long Femoropopliteal Stenting Outcomes

Author

Aurore Danvin, Béatrice Guyomarch, Yann Gouëffic, Thibaut Quillard, Alain Costargent, Philippe Chaillou, Pierre-Alexandre Vent, Adrien Kaladji, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre hospitalier universitaire de Nantes (CHU Nantes), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Physiopathologie des Adaptations Nutritionnelles (PhAN), Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Jonchère, Laurent

Subjects
Time Factors, Multivariate analysis, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, Computed Tomography Angiography, retrospective study, 030204 cardiovascular system & hematology, computer assisted tomography, 0302 clinical medicine, Recurrence, Risk Factors, Popliteal Artery, Registries, 030212 general & internal medicine, Computed tomography angiography, Aged, 80 and over, stent thrombosis, clinical article, medicine.diagnostic_test, Endovascular Procedures, risk assessment, Drug-Eluting Stents, General Medicine, Middle Aged, Thrombosis, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Femoral Artery, preoperative evaluation, aged, female, Quartile, priority journal, risk factor, Radiographic Image Interpretation, Computer-Assisted, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Radiology, Cardiology and Cardiovascular Medicine, cardiovascular risk, medicine.medical_specialty, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Prosthesis Design, Article, Peripheral Arterial Disease, 03 medical and health sciences, male, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Hounsfield scale, medicine, Humans, human, Vascular Calcification, outcome assessment, blood vessel calcification, Proportional Hazards Models, Retrospective Studies, [SDV.IB] Life Sciences [q-bio]/Bioengineering, femoropopliteal bypass, Chi-Square Distribution, business.industry, Proportional hazards model, Retrospective cohort study, medicine.disease, image processing, Multivariate Analysis, treatment outcome, Feasibility Studies, target lesion revascularization, Surgery, business, Chi-squared distribution, peripheral occlusive artery disease
Abstract

International audience; Background: Vascular calcifications (VCs) may be a prognostic factor for outcome after endovascular treatment of peripheral arterial disease (PAD). Semiquantitative analysis with X-ray imaging is the main limiting factor for assessing VCs. The aim of the present study was to find a correlation between the amount of VC with computed tomography (CT) scan quantification and midterm results of endovascular treatment of Trans-Atlantic Inter-Society Consensus C/D femoropopliteal (FP) lesions. Methods: Patients belonging to 2 previously published registries (STELLA and STELLA PTX) and who underwent a preoperative CT scan were retrospectively included in the study. VC quantification was performed with a dedicated workstation (EndoSize, Therenva) on the basis of Hounsfield units (HU). The VC percentage was calculated as the ratio between VC volume and the volume of the region of interest. For the analysis, patients were divided into 3 groups according to VC percentage, from lowest to highest: group 1 (G1) included the first quartile of VCs, group 2 (G2) included the second and third quartiles, and group 3 (G3) included the fourth quartile. Risk of in-stent thrombosis was analysed using a multivariate model. Results: Thirty-nine patients were included (10 in G1, 19 in G2, and 10 in G3), and mean follow-up duration was 24 ± 14.6 months. Patients in G1 and G3 had, respectively, a VC rate of 20% (severe VC). In G2, VC was considered to be intermediate. There was no statistical difference in the cardiovascular risk factors and preoperative medication. A significant difference was found for the healthy FP diameter between G1 (4.6 ± 0.8 mm) and G3 (6.8 ± 0.8 mm, P < 0.0001) and between G2 (5.2 ± 1 mm) and G3 (P < 0.0001). The rate of drug-eluting stents was similar in all groups. There was no difference between groups concerning the rate of in-stent restenosis, target lesion revascularization, and target extremity revascularization. There was a higher rate of in-stent thrombosis for G1 versus G2 (P = 0.037), and no difference was noted between G1 versus G3 (P = 0.86) or G2 versus G3 (P = 0.12). G3 was associated with early stent thrombosis (

Published
2018

17. Drug-eluting balloon: What do you need to know?

Author

Alain Costargent, Nicolas Bague, Adrien Kaladji, Yann Gouëffic, Philippe Chaillou, and Pierre-Alexandre Vent

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, Hematology, Drug eluting balloon, business
Abstract

Les techniques endovasculaires ont revolutionne la prise en charge de l’arteriopathie obliterante des membres inferieurs (AOMI) en permettant une amelioration clinique et une diminution de la morbidite et la mortalite perioperatoire. Au cours du suivi, le maintien de la permeabilite est un facteur primordial. Actuellement, le principal parametre limitant la permeabilite a moyen terme est la survenue d’une restenose. Apres le constat d’echec des traitements systemiques ou des nombreux materiels de type atherectomie dans la prevention et le traitement de la restenose, les dispositifs a elution medicamenteuse, dits « actifs » (ballon et stent) semblent montrer les resultats les plus encourageants.A l’heure actuelle, l’engouement semble se porter plutot sur le ballon actif. Pour permettre d’apprehender tous les aspects de ce type de dispositif, nous presentons dans cet article les principes d’action du ballon actif, les differentes caracteristiques techniques, son mode d’utilisation et les resultats actuels dans la prevention et le traitement de la restenose apres traitement endovasculaire de l’AOMI.

Published
2015

18. Comparison of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease with Flat-Panel Detectors on Mobile C-arm versus Fixed Systems

Author

Marie Guillou, Philippe Chaillou, Pierre-Alexandre Vent, Alain Costargent, Blandine Maurel, Yann Gouëffic, Hatem Necib, Adrien Kaladji, Centre hospitalier universitaire de Nantes (CHU Nantes), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Nuclear Oncology (CRCINA-ÉQUIPE 13), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Operating Rooms, arteriography, medicine.medical_treatment, image display, 030204 cardiovascular system & hematology, Radiography, Interventional, Endovascular aneurysm repair, Effective dose (radiation), 030218 nuclear medicine & medical imaging, endovascular aneurysm repair, 0302 clinical medicine, Fluoroscopy, image quality, Prospective Studies, Prospective cohort study, chronic total occlusion, operating room personnel, 2. Zero hunger, medicine.diagnostic_test, Endovascular Procedures, stenosis, Angiography, General Medicine, Equipment Design, Radiation Exposure, 3. Good health, aged, priority journal, Lower Extremity, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Radiology, Cardiology and Cardiovascular Medicine, radiation dose, medicine.medical_specialty, health care personnel, nurse, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, intention to treat analysis, Radiation Dosage, Article, 03 medical and health sciences, Peripheral Arterial Disease, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Occupational Exposure, medicine, Humans, controlled study, artery thrombosis, human, Retrospective Studies, Intention-to-treat analysis, business.industry, radiation dose reduction, Retrospective cohort study, Nurse anesthetist, major clinical study, body mass, signal noise ratio, endovascular surgery, Personnel, Hospital, lower limb, Surgery, business, Body mass index, business.employer, peripheral occlusive artery disease
Abstract

International audience; Background: Flat-panel detectors on mobile C-arm (MC-arm) systems are currently challenging fixed C-arm (FC-arm) systems used in hybrid operating rooms. MC-arm systems offer an alternative to FC-arm systems in the endovascular treatment of peripheral arterial disease (PAD) but their efficiency has not been evaluated comparatively. Methods: Two series of patients undergoing arteriography with intention to treat were included. Each series consisted of 2 nonrandomized groups: an MC-arm group and an FC-arm group. Series 1 evaluated exposure to the patient (MC-arm, n = 113; FC-arm, n = 206) while series 2 evaluated exposure to patients and also health care personnel (MC-arm, n = 24; FC-arm, n = 76). The primary end points for evaluating exposure were air kerma (AK, in mGy) for patients and effective dose for health care personnel (in μSv). Results: After adjustment for the effect of body mass index (analysis of covariance test), AK was found to be lower in the MC-arm group than in the FC-arm group (124.1 ± 142 vs. 173.3 ± 248.7, P = 0.025). There was no difference between the groups with regard to effective dose recorded for senior surgeons or for operating room nurses. However, a higher effective dose was recorded by the MC-arm group external dosimeter for the trainee resident and for nurse anesthetists. Conclusions: In endovascular treatment of lower limb PAD, use of an FC-arm system is associated with more radiation exposure to the patient than an MC-arm system. However, this type of imaging system does not appear to affect exposure to health care personnel. © 2017 Elsevier Inc.

Published
2017

19. The FREEDOM Study: A Pilot Study Examining the Feasibility and Safety of Early Walking following Femoral Manual Compression after Endovascular Interventions Using 5F Sheath-Compatible Devices

Author

Alain Costargent, Nicolas Bague, Yann Gouëffic, Philippe Chaillou, Adrien Kaladji, Pierre-Alexandre Vent, Béatrice Guyomarch, and Thibaut Quillard

Subjects
Male, medicine.medical_specialty, Arterial disease, Pilot Projects, Femoral artery, Punctures, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, law.invention, 03 medical and health sciences, Peripheral Arterial Disease, 0302 clinical medicine, Aneurysm, Quality of life, Randomized controlled trial, law, medicine.artery, Clinical endpoint, Pressure, Medicine, Humans, Early Ambulation, Aged, Aged, 80 and over, business.industry, Endovascular Procedures, General Medicine, Middle Aged, medicine.disease, Compression (physics), Hemostasis, Surgical, Surgery, Femoral Artery, Endovascular interventions, Quality of Life, Feasibility Studies, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background Increasing prevalence of peripheral arterial disease (PAD) burning and pressure to reduce costs and promote patient empowerment make outpatient endovascular procedures an attractive alternative to conventional hospitalization. For outpatient peripheral endovascular procedures, femoral manual compression could replace the use of arterial closure devices for small-bore punctures. Presently, safety and feasibility evidence for femoral manual compression is still lacking. FREEDOM is a pilot study designed to demonstrate the feasibility and safety of early walking after femoral manual puncture point compression following a therapeutic endovascular procedure for PAD. Methods From May to August 2015, all patients requiring endovascular treatment for PAD were prospectively screened. Those patients that received therapeutic endovascular procedures involving retrograde femoral punctures with a 5F sheath were included. Manual compression and pressure dressing of the femoral puncture points was applied. The primary end point was defined as the walking ability 5 hr after index procedure (H5), which was assessed by a walk test. Results In total, 129 consecutive patients were screened, and 30 patients met the study criteria. The mean age was 66 ± 11 years. The mean duration of the procedure and of the manual compression was 63 ± 24 min and 12.8 ± 4 min, respectively. At 5 hr following the procedure, 97% of the patients were able to walk 100 m. Two patients failed to walk due to cardiac arrhythmia and to a false aneurysm at the femoral puncture site. No further complications were observed at 1 month, and quality of life assessed by EQ-5D test was significantly increased compare to baseline (72.3 vs. 60.4; P = 0.001). Conclusions This pilot study demonstrated the benefits of manual compression to close arterial punctures over procedures using 5F shealth-compatible endovascular devices. A sufficiently powered randomized controlled trial is needed to further characterize the potential benefits of manual compression following use of low-profile devices.

Published
2017

20. Management of ambulatory (day case) endovascular procedures for peripheral arterial disease

Author

Flora Gouaillier-Vulcain, Philippe Chaillou, Alexandra Hauguel, Alain Costargent, Yann Gouëffic, B. Maurel, and Nicolas Bague

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, Punctures, 030204 cardiovascular system & hematology, Revascularization, Risk Assessment, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Peripheral Arterial Disease, 0302 clinical medicine, Hematoma, Risk Factors, Catheterization, Peripheral, medicine, Humans, Aged, business.industry, Incidence (epidemiology), General surgery, Patient Selection, Endovascular Procedures, General Medicine, Perioperative, Critical limb ischemia, Middle Aged, medicine.disease, Treatment Outcome, Ambulatory Surgical Procedures, Ambulatory, Retreatment, Surgery, Female, Stents, medicine.symptom, Cardiology and Cardiovascular Medicine, Risk assessment, business
Abstract

Introduction Thanks to exceptional improvements in technological developments and vascular teams' expertise, endovascular repair of peripheral arterial disease (PAD) has drastically increased these past decades. Incidence of PAD rising, pressure to reduce costs and patient's empowerment make outpatient endovascular procedures for PAD an attractive alternative to conventional hospitalization. This review describes outpatient endovascular procedures for PAD in the literature. Evidence acquisition We used PRISMA guidelines and Medline to conduct this systematic review. 448 relevant articles were found. Twelve articles, all published after year 2000 were included and reviewed by two independent investigators. Evidence synthesis Among 12 selected articles, 10762 outpatient endovascular procedures were performed and 3883 procedures were realized for arterial lower limb revascularization. Average age was 65.2. Major exclusion criteria were social isolation (no available accompanying adult for the first 24 hours, no available communication system) and high-risk patients (ASA 4 and above). During the perioperative period, no death was noted. Major hematoma rate was 0% to 3%, minor hematoma rate went from 1.6% to 20%. Conversion to in-patient status for overnight observation occurred in 0% to 16% in ten real life studies and was mostly due to complications at puncture site. Reintervention over the first month occurred in 0% to 4%. Readmission in the first month after being discharged occurred in 0% to 3.2%. Diabetes and critical limb ischemia were not related to higher complication rate. Conclusions This review indicates that outpatient endovascular procedures for PAD are safe and efficient. Guidelines are necessary to enforce patients' selection and insure high quality perioperative care.

Published
2017

25. Enquête rétrospective sur les résultats de l’immunothérapie spécifique d’allergènes chez 205 chiens atopiques en Aquitaine, France (1989–2001)

Author

S.-E. Viaud, D.-N. Carlotti, F. Costargent, C. Gribeauval, and J. Ganiayre

Subjects
Gynecology, medicine.medical_specialty, business.industry, Medicine, Small Animals, business
Abstract

Resume De nombreuses etudes ouvertes rapportent des resultats favorables de l’immunotherapie specifique d’allergenes, qui est consideree comme le seul traitement etiologique de la dermatite atopique canine (DAC). Cet article presente une enquete retrospective ouverte sur des resultats d’immunotherapie specifique evalues par les proprietaires, en correlation avec les dossiers medicaux dans la mesure du possible, chez 205 chiens atopiques stricts qui ont recu ce traitement pendant au moins un an en Aquitaine, France. Les extraits allergeniques ont ete selectionnes en fonction des resultats d’intradermoreactions (IDR). Des resultats excellents (absence de prurit et de lesions), satisfaisants (signes de prurit et lesions rares), assez mauvais (prurit et lesions frequents) et mauvais (prurit tres frequent et lesions nombreuses) ont ete rapportes par les proprietaires dans 23,4 %, 39,5 % 27,8 % et 9,3 % des cas respectivement. Le sexe, la race et l’âge au debut du traitement n’ont pas eu d’influence sur les resultats du traitement. Les resultats ont ete significativement meilleurs lorsque les proprietaires ont realise eux-memes les injections. L’immunotherapie realisee avec un seul allergene a ete significativement meilleure que celle realisee avec deux, trois et quatre allergenes, globalement. L’immunotherapie comportant des extraits de moisissures a ete significativement moins efficace. Une immunotherapie de duree egale ou superieure a trois ans etait associee a un meilleur resultat. Les resultats de l’immunotherapie effectuee seule sont apparus meilleurs que lorsqu’elle etait associee a d’autres traitements, notamment des corticoides systemiques.

Published
2013

26. Long-Term Outcomes of Common Femoral Artery Stenting

Author

Alain Costargent, Yann Gouëffic, Bahaa Nasr, Pierre-Alexandre Vent, Philippe Chaillou, Adrien Kaladji, and Thibault Quillard

Subjects
Male, Time Factors, medicine.medical_treatment, Pilot Projects, Femoral artery, Constriction, Pathologic, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, 0302 clinical medicine, Restenosis, Recurrence, Risk Factors, 030212 general & internal medicine, Prospective Studies, Registries, Prospective cohort study, Arthrography, Ultrasonography, Doppler, Duplex, Endovascular Procedures, General Medicine, Middle Aged, Prosthesis Failure, Femoral Artery, Treatment Outcome, Retreatment, Female, Hip Joint, Stents, Radiology, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Revascularization, 03 medical and health sciences, Peripheral Arterial Disease, medicine.artery, medicine, Deep Femoral Artery, Humans, cardiovascular diseases, Vascular Patency, Aged, business.industry, Stent, Critical limb ischemia, medicine.disease, Surgery, business, Claudication
Abstract

Background The purpose of this study was to report the 5-year outcome relative to endovascular repair of the common femoral artery (CFA) for occlusive disease. Methods Thirty-six consecutive patients (40 limbs) underwent stenting for CFA lesions. Patients were followed up systematically within a prospectively maintained database over 5 years. Follow-up included clinical examination, duplex scan, and biplane X-ray at 1, 6, 12 months and yearly thereafter. Results Indications for endovascular repair of the CFA included 25 patients (70%) for claudication and 11 patients (30%) for critical limb ischemia. Mean follow-up was 64 months. Two patients were lost to follow-up. The mortality rate at 5 years was 38%. At 3 and 5 years, primary sustained clinical improvements were 77% and 73%, respectively. In-stent restenosis rate was 28%. The significant predictors of in-stent restenosis were deep femoral artery stenting (P = 0.0007) and type III lesions (P = 0.014). Freedom from target lesion revascularization and target extremity revascularization were 79% and 73%, respectively. One stent fracture was noted at the first year follow-up without clinical consequence, and no other stent fracture was noted during the remainder of the study. Conclusions Endovascular repair of the CFA and its bifurcation seems to provide sustained clinical and morphological long-term results. Fear of stent fracture and local complications due to hip mobility are no longer relevant.

Published
2016

27. The role for DCBs in the treatment of ISR

Author

Nicolas, Bague, Bahaa, Nasr, Philippe, Chaillou, Alain, Costargent, Flora, Gouailler-Vulcain, and Yann, Goueffic

Subjects
Hyperplasia, Time Factors, Endovascular Procedures, Cardiovascular Agents, Constriction, Pathologic, Femoral Artery, Peripheral Arterial Disease, Treatment Outcome, Coated Materials, Biocompatible, Recurrence, Risk Factors, Neointima, Retreatment, Humans, Popliteal Artery, Stents, Angioplasty, Balloon, Vascular Access Devices
Abstract

Currently, endovascular therapy is the standard of care for peripheral artery disease. The main issue of these techniques is restenosis which is a complex mechanism associating elastic recoil, constrictive remodelling and intimal hyperplasia. More and more evidence show that drug-coating balloon (DCB) is a promising device to prevent and to treat restenosis. Herein we have reviewed the role for DCB's in the treatment of in-stent restenosis (ISR).Currently, few studies are available regarding DCB use for femoropopliteal (FP) ISR treatment. In different studies evaluating DCB for treatment of FP ISR the freedom from target lesion revascularization rate at one year are range from 87% to 92.1%. In comparison to other devices used for treatment of FP ISR such as atherectomy, cutting balloon, standard angioplasty, DCB seems to show better results in terms of freedom from TLR and primary patency. Other devices such as drug-eluting stent, brachytherapy, covered stent show also good results for FP ISR.Majority of assessed data on FP ISR treated with DCB derived from uncontrolled study or historical comparisons. Only one randomized, controlled study compared DCB versus standard angioplasty. The FAIR trial showed better results in favour of DCB in terms of freedom from TLR at 12 months (90.8%).Drug coating balloon could be the first choice of devices for the treatment of FP ISR, because of its efficacy, its ease of use in comparison with more complex and less efficient devices.

Published
2016

28. One-year Clinical Outcome after Primary Stenting for Trans-Atlantic Inter-Society Consensus (TASC) C and D Femoropopliteal Lesions (The STELLA 'STEnting Long de L'Artère fémorale superficielle' Cohort)

Author

Alain Costargent, Jean-Michel Davaine, Gilles Lambert, Yann Gouëffic, P. Patra, Béatrice Guyomarch, L. Azéma, and P. Chaillou

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Consensus Development Conferences as Topic, Femoropopliteal, Arterial Occlusive Diseases, Prosthesis Design, Restenosis, Blood vessel prosthesis, Angioplasty, medicine, Stent, Humans, Popliteal Artery, Prospective Studies, Prospective cohort study, Societies, Medical, Aged, Medicine(all), Leg, Peripheral artery disease, business.industry, Endovascular Procedures, Angiography, medicine.disease, Intermittent claudication, Surgery, Blood Vessel Prosthesis, Femoral Artery, Critical ischaemia, Treatment Outcome, TASC C and D, Female, Stents, Radiology, France, medicine.symptom, Cardiology and Cardiovascular Medicine, Claudication, business, Mace, Follow-Up Studies
Abstract

Objective The study aims to evaluate the safety and the efficacy of primary stenting for Trans-Atlantic Inter-Society Consensus Document II on Management of Peripheral Arterial Disease (TASC) C and D femoropopliteal lesions. Design Prospective cohort study. Methods Patients with TASC C and D de novo femoropopliteal lesions were treated with the same endovascular technique by implanting a primary nitinol self-expanding stent (LifeStent ® , Bard Peripheral Vascular, Tempe, AZ, USA). Patients were included in a single-centre registry and prospectively followed up. The primary end point was primary sustained clinical improvement after 12 months. Secondary end points were secondary sustained clinical improvement, primary and secondary patency rates, freedom from target lesion revascularisation (TLR), freedom from target extremity revascularisation (TER) and stent fracture rate. Results We enrolled 58 patients (62 limbs) suffering from either claudication (40.3%) or critical limb ischaemia (59.7%). Lesions were either TASC C (62.9%) or TASC D (37.1%). Median length of the treated segment was 220 ± 160 mm. The mean number of stents was 2.2. Mean follow-up was 17 months, with one patient lost to follow-up. At 1 year, the primary end point was 68.6% while secondary sustained clinical improvement was 82.6%. Freedom from TLR and TER rates were 81.1% and 96.3%. Primary and secondary patencies were 66% and 80.9%. One-year primary and secondary sustained clinical improvement rates were 76.7% ± 7.2 for TASC C and 46.3% ± 11.1 for TASC D ( p = 0.03) and 87.6% ± 5.9 for TASC C and 67.3% ± 11.3 for TASC D ( p = 0.09), respectively. The ankle–brachial pressure index increased from 0.58 to 0.94 ( p = 0.001) at 1 year and the incidence of in-stent restenosis (ISR) was 19.3%. Stent fracture and disconnection rate was 17.7%. Conclusions Primary stenting of TASC C and D lesions appears to be safe and efficient given the high-sustained clinical improvement and the low rate of ISR observed in our study. Endovascular treatment of such long and severe lesions exposes to high rate of stent fractures, which should not be a concern given their low clinical impact.

Published
2012
Full Text
View/download PDF

29. Influence à long terme du type de fixation supra- ou infra-rénale sur la dilatation du collet proximal et la migration après EVAR

Author

Philippe Bizouarn, L. Azéma, Alain Costargent, Philippe Patra, David Pintoux, Philippe Chaillou, and Yann Gouëffic

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, Electrical and Electronic Engineering, business, Atomic and Molecular Physics, and Optics
Abstract

Objectifs Nous avons evalue l’influence des systemes de fixation proximale de l’endoprothese sur la dilatation du collet proximal de l’anevrisme en inter et en sous-renal apres traitement endovasculaire d’un anevrisme de l’aorte abdominale (EVAR). Des facteurs predictifs cliniques et anatomiques de dilatation du collet et de migration proximale de l’endoprothese ont ete recherches. Materiel et methodes A partir d’un registre prospectif et monocentrique, 58 dossiers de malades avec un suivi complet minimum de 3 ans ont ete analyses apres traitement par endoprothese avec fixation supra-renale (FSR : 33 Talent) ou avec fixation infra-renale (FIR : 25 AneuRx). Les deux groupes etaient compares en terme de dilatation du collet inter-renal (D1 : diametre entre les deux arteres renales), sous-renal (D2 : diametre 7 mm sous l’artere renale la plus basse) et de complication specifique (migration proximale, endofuite). Le diametre mesure sur le dernier controle tomodensitometrique etait compare au diametre post- operatoire. La dilatation du collet etait definie par une augmentation du diametre superieure a 3 mm et la migration proximale par un deplacement caudal de l’endoprothese superieur ou egal a 10 mm. Des facteurs predictifs de migration proximale ou de dilatation du collet ont ete recherches (anatomie du collet, anatomie de l’anevrisme, pourcentage de surdimensionnement de l’endoprothese, facteurs demographiques). Resultats Les deux groupes etaient comparables en termes de caracteristiques demographiques et anatomiques de l’anevrisme en pre-operatoire. Le recul moyen etait superieur dans le groupe AneuRx® (62 ± 17 mois vs 53 ± 13 mois, p = 0,045) et le pourcentage de surdimensionnement de l’endoprothese etait superieur dans le groupe Talent® (18 ± 6% vs 13 ± 5%, p

Published
2011

36. State-of-the-art treatment of common femoral artery disease

Author

Nasr, B., Kaladji, A., Vent, P. A., Chaillou, P., Costargent, A., Patra, P., Thibaut Quillard, and Goueffic, Y.

Subjects
Femoral Artery, Radiography, Blood Vessel Prosthesis Implantation, Peripheral Arterial Disease, Treatment Outcome, Angioplasty, Humans, Stents, Constriction, Pathologic, Endarterectomy
Abstract

Atherosclerotic common femoral artery (CFA) disease is a well-known and frequent cause of symptomatic peripheral artery disease (PAD). Not so long ago, surgical treatment was considered the gold standard and the main treatment option. Therapeutic advances have, however, provided a wide and suitable armamentarium. These advances concern medical treatment and the direct treatment of lesions by open surgery or endovascular treatment. The aim of this manuscript was to summarize therapeutic updates and to describe the current endovascular and open surgical procedures used to treat common femoral artery disease.

Published
2015

37. Différentes approches du plexus brachial dans la région cervicale

Author

C. Pham Dang, A. Costargent, P. Chaillou, and P. Patra

Subjects
Anesthesiology and Pain Medicine, Text mining, business.industry, Anesthesia, medicine.medical_treatment, Nerve block, medicine, General Medicine, business, Brachial plexus, Electric stimulation
Published
2006

38. Thrombose de la veine cave inférieure par thrombophlébite de la veine ovarienne droite

Author

O. Marret, P. Chaillou, A. Costargent, G Meurette, F Léauté, and P. Patra

Subjects
medicine.medical_specialty, Percutaneous, business.industry, Pelvic pain, medicine.disease, Thrombophlebitis, Inferior vena cava, Surgery, Pulmonary embolism, Embolism, medicine.vein, Right ovarian vein, cardiovascular system, medicine, cardiovascular diseases, Floating thrombus, medicine.symptom, business
Abstract

A 39-years-old woman was admitted with pelvic pain and fever occurring one month after a caesarean. An echography-doppler and an abdominal tomodensitometry were performed. Thrombophlebitis of the right ovarian vein was diagnosed with extension of a floating thrombus into the inferior vena cava. We decided to perform a surgical thrombectomy due to a pulmonary embolism which occurred while the patient was under heparin and antibiotic treatment. A temporary percutaneous caval filter was successfully used in the peri-operative period, preventing a second embolism. This observation focuses on a rare pathology occurring in young women and emphasises the safe use and removal of a temporary percutaneous caval filter in the peri-operative period.

Published
2003

41. Long-term Results of Common Femoral Artery Stenting

Author

Alain Costargent, Thibault Quillard, Pierre-Alexandre Vent, Bahaa Nasr, Philippe Chaillou, Adrien Kaladji, and Yann Gouëffic

Subjects
medicine.medical_specialty, business.industry, General Medicine, Long term results, Femoral artery, 030204 cardiovascular system & hematology, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.artery, Medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business
Published
2017

42. Bare metal stent versus paclitaxel eluting stent for intermediate length femoropopliteal arterial lesions (BATTLE trial): study protocol for a randomized controlled trial

Author

Béatrice Guyomarch, Adrien Kaladji, Carine Montagne, Simon Gestin, Philippe Patra, Yann Gouëffic, Valéry-Pierre Riche, Alain Costargent, Philippe Chaillou, Pierre Alexandre Vent, and Damien Fairier

Subjects
Target lesion, Bare-metal stent, medicine.medical_specialty, Percutaneous, Time Factors, Paclitaxel, medicine.medical_treatment, Superficial femoral artery, Medicine (miscellaneous), Constriction, Pathologic, Prosthesis Design, law.invention, chemistry.chemical_compound, Study Protocol, Peripheral Arterial Disease, Randomized controlled trial, Restenosis, Clinical Protocols, law, Recurrence, medicine, Humans, Pharmacology (medical), Popliteal Artery, cardiovascular diseases, Drug eluting stent, Prospective Studies, business.industry, Endovascular Procedures, Stent, Cardiovascular Agents, Drug-Eluting Stents, medicine.disease, equipment and supplies, Surgery, Femoral Artery, surgical procedures, operative, Treatment Outcome, chemistry, Drug-eluting stent, Metals, Research Design, Stents, Radiology, France, business, Switzerland, Bare metal stent
Abstract

Currently, endovascular treatment is indicated to treat femoropopliteal lesions ≤15 cm. However, the Achilles’ heel of femoropopliteal endovascular repair remains restenosis. Paclitaxel eluting stents have shown promising results to prevent restenosis in femoropopliteal lesions compared to percutaneous transluminal angioplasty. A recently released prospective registry using a newer generation of self-expandable nitinol stents (Misago®; Terumo Corp., Tokyo, Japan) supports primary bare metal stenting as a first-line treatment for femoropopliteal lesions. To date, no studies have been designed to compare bare metal stents to paclitaxel eluting stents for the treatment of femoropoliteal lesions. The BATTLE trial was designed to compare paclitaxel eluting stents (Zilver® PTX®) and a last generation bare self-expandable nitinol stents (Misago® RX, Terumo Corp., Tokyo, Japan) in the treatment of intermediate length femoropopliteal lesions (≤14 cm). A prospective, randomized (1:1), controlled, multicentric and international study has been designed. One hundred and eighty-six patients fulfilling the inclusion criteria will be randomized to one of the two assessments of endovascular repair to treat de novo femoropopliteal lesions ≤14 cm in symptomatic patients (Rutherford 2 to 5): bare stent group and paclitaxel eluting stent group. The primary endpoint is freedom from in-stent restenosis at 1 year defined by a peak systolic velocity index >2.4 (restenosis of >50%) at the target lesion and assessed by duplex scan. Our main objective is to demonstrate the clinical superiority of primary stenting using Zilver® PTX® stent system versus bare metal self-expandable stenting in the treatment of femoropopliteal lesions in patients with symptomatic peripheral arterial disease. This is the first randomized and controlled study to compare the efficacy of bare metal stents and paclitaxel eluting stents for the treatment of femoropopliteal lesions. It may clarify the indication of stent choice for femoropopliteal lesions of intermediate length. Clinicaltrials.gov identifier: NCT02004951 . 3 December 2013.

Published
2014

43. Infected Aneurysms of Neck and Limb Arteries: A Retrospective Multicenter Study

Author

Jean-Christophe Pillet, Philippe Patra, Yann Gouëffic, Jean-Baptiste Ricco, Alain Costargent, and Philippe Chaillou

Subjects
Adult, Carotid Artery Diseases, Male, medicine.medical_specialty, Adolescent, Aneurysm, Risk Factors, medicine.artery, medicine, Humans, Endocarditis, Aged, Aged, 80 and over, Leg, business.industry, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Surgery, Survival Rate, medicine.anatomical_structure, Bacteremia, Arm, Etiology, Female, Internal carotid artery, Cardiology and Cardiovascular Medicine, business, Aneurysm, Infected, Carotid Artery, Internal, Abdominal surgery, Artery
Abstract

Infected aneurysms (IA) of neck and limb arteries are uncommon. This report describes the results of a retrospective study undertaken by the University Association for Surgical Research (AURC) to evaluate etiology, bacteriology, location, diagnostic features, and therapeutic methods associated with IA. A total of 58 IA in 52 patients were reviewed. The lesion was located in a lower extremity artery in 47 patients (81%), internal carotid artery in 7 (12%), and upper extremity artery in 4 (6%). Eleven patients had multilocular aneurysm (21%). Symptoms of local infection were observed in 43 patients (82.6%). Rupture or splitting was the presenting manifestation in 13 patients (25%). Primary IA following bacteremia or septicemia without endocarditis was the most common type of IA observed in 34 patients (65.3%). Twelve patients (23%) presented mycotic IA secondary to bacterial endocarditis. In the remaining six patients (11.5%), IA resulted from direct contamination or spreading from a contiguous infection site. Surgical treatment included ligation of the artery without reconstruction in 19 patients and exclusion bypass in 33 patients. The duration of antibiotic treatment ranged from 15 days to 3 months. No recurrence of aneurysm was observed but three patients developed bypass infection. Primary IA was associated with high mortality due to severe septicemia.

Published
2001

44. Clinical and economic evaluation of ambulatory endovascular treatment of peripheral arterial occlusive lesions

Author

Alain Costargent, Gaël Grimandi, Marie-Pierre Chaillet, Philippe Patra, Jean-Michel Davaine, Philippe Chaillou, Béatrice Guyomarch, L. Azéma, Yann Gouëffic, and Bénédicte Albert

Subjects
Adult, Male, medicine.medical_specialty, Percutaneous, Time Factors, medicine.medical_treatment, Cost-Benefit Analysis, Risk Assessment, Peripheral Arterial Disease, Hematoma, Cost Savings, Risk Factors, medicine, Ambulatory Care, Humans, Prospective Studies, Prospective cohort study, Vascular Patency, Aged, Aged, 80 and over, business.industry, Endovascular Procedures, Stent, General Medicine, Perioperative, Health Care Costs, Recovery of Function, Length of Stay, Middle Aged, medicine.disease, Surgery, Hospitalization, Treatment Outcome, Lower Extremity, Ambulatory, Feasibility Studies, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Complication, Claudication, business
Abstract

Background Ambulatory management of patients is an alternative to conventional hospitalization. In this study we evaluate the results of a prospective cohort study of patients receiving ambulatory endovascular treatment for peripheral arterial lesions. Methods From June 2008 to October 2010, ambulatory management was proposed for endovascular treatment of peripheral arterial lesions. An arterial closure device (Angio-Seal®; St. Jude Medical) was used. For ambulatory treatment, patients were prohibited from driving a vehicle at discharge, had to be accompanied the first night after the procedure, had to live

Published
2013

48. Long-term influence of suprarenal or infrarenal fixation on proximal neck dilatation and stentgraft migration after EVAR

Author

Yann Gouëffic, Alain Costargent, Philippe Bizouarn, Philippe Chaillou, David Pintoux, Philippe Patra, and L. Azéma

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Kaplan-Meier Estimate, Prosthesis Design, Aortography, Risk Assessment, Aortic aneurysm, Fixation (surgical), Blood Vessel Prosthesis Implantation, Aneurysm, Foreign-Body Migration, Blood vessel prosthesis, Risk Factors, medicine.artery, medicine, Humans, Registries, Renal artery, Aged, Retrospective Studies, Aged, 80 and over, Chi-Square Distribution, business.industry, Endovascular Procedures, Stent, General Medicine, Middle Aged, medicine.disease, Surgery, Blood Vessel Prosthesis, Treatment Outcome, Female, Stents, France, Cardiology and Cardiovascular Medicine, Complication, business, Tomography, X-Ray Computed, Abdominal surgery, Aortic Aneurysm, Abdominal, Dilatation, Pathologic
Abstract

Background We evaluated the influence of the proximal fixation systems of stentgrafts on proximal inter-renal or infrarenal aneurysm neck dilatation after endovascular repair of abdominal aortic aneurysms. Anatomic and clinical predictive factors of neck dilatation and stentgraft proximal migration were searched for. Material and Methods Taking account of a prospective and monocenter register, 58 patients’ files, with a complete minimum 3-year follow-up, were analyzed after treatment with stentgrafts with a suprarenal fixation (SRF: 33 Talent) or an infrarenal fixation (IRF: 25 AneuRx). Both groups were compared in terms of inter-renal neck dilatation (D1: diameter between the two renal arteries), infrarenal neck dilatation (D2: 7-mm diameter under the lowest renal artery), and specific complication (proximal migration, endoleak). The diameter measured on the last control computed tomography scan was compared with the postoperative diameter. Neck dilatation was defined by a diameter increase exceeding 3 mm and by the proximal migration due to a caudal displacement of the stentgraft ≥10 mm. Predictive factors of proximal migration or neck dilatation were searched for (anatomy of the neck, aneurysm anatomy, stent graft oversize percentage, demographic factors). Results Preoperatively, both groups were comparable in terms of anatomic and demographic characteristics of the aneurysm. Mean follow-up was longer in the AneuRx group (62 ± 17 months vs. 53 ± 13 months, p = 0.045) and the percentage of stent graft oversize was greater in the Talent group (18 ± 6% vs. 13 ± 5%, p −4 ). Freedom from a dilatation exceeding 3 mm in D1 and D2 did not bring any significant difference between the two groups. In each group, the remodeling of the aneurysmal sac (AneuRx median = −4 mm, Talent median = −5 mm, p > 0.05) was only moderately related to proximal neck remodeling. A small angulation of the neck and a smaller neck were the only predictive factors of neck dilatation found respectively in D1 ( p = 0.007) and in D2 ( p = 0.022). Stent graft proximal migration was more frequent in the AneuRx group ( p = 0.031) and was more frequent with large aneurysms ( p = 0.029). Conclusion In the long term, the absence of proximal stent graft fixation system on the dilatation of the aneurysm proximal neck enhances proximal migration. Conversely, the inter-renal or infrarenal proximal neck dilatation does not depend on the type of proximal fixation but on anatomic factors and on the natural evolution of the aneurysmal disease.

Published
2009

49. False aneurysm of a brachial artery in a very premature newborn

Author

Michel Pannier, A. Costargent, Pierre Perrot, and Franck Duteille

Subjects
Male, medicine.medical_specialty, Brachial Artery, Anastomosis, Functional disorder, Resection, Catheterization, Right brachial artery, Aneurysm, medicine.artery, medicine, Humans, cardiovascular diseases, Brachial artery, Ultrasonography, business.industry, Anastomosis, Surgical, Infant, Newborn, nutritional and metabolic diseases, medicine.disease, Surgery, Premature newborn, cardiovascular system, Amenorrhea, medicine.symptom, business, Aneurysm, False, Infant, Premature
Abstract

The authors reported a case of false aneurysm in the lower third of the right brachial artery in a premature newborn (25 weeks of amenorrhea) subsequent to puncture performed 48 hours before. The treatment was surgical: resection of the false aneurysm and anastomosis (Monobrin 11-0 sutures) to restore the continuity of the brachial artery. After 6 months of follow-up, the course is favorable, with improvement in healing and absence of any functional disorder of the arm.

Published
2008

50. [Hemoperitoneum due to rupture of an omental arterial aneurysm]

Author

N, Bettini, Y, Goueffic, O, Marret, M-F, Heymann, A, Costargent, Ph, Patra, and Ph, Chaillou

Subjects
Hemoperitoneum, Humans, Female, Aneurysm, Ruptured, Omentum, Aged
Abstract

We report a case of spontaneous hemoperitoneum due to rupture of an omental arterial aneurysm. This source of bleeding is unusual (2 cases published); the diagnosis was made preoperatively by doppler ultrasound and CT scan with IV contrast. Omental resection was performed and histological analysis confirmed the diagnosis. A literature review of the rare cases of hemoperitoneum due to rupture of a digestive arterial aneurysm is done.

Published
2008

Catalog

Books, media, physical & digital resources
See catalog results