34 results on '"Rousseau, H"'
Search Results
2. Evaluation of aortic parameters by 4d flow MRI in patients with Marfan syndrome and related syndromes.
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Vignaud-Marighetto, P., Guitarte, A., Bajanca, F., Acar, P., Moreno, R., Rousseau, H., Dulac, Y., and Karsenty, C.
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Predicting aortic root dilation and the risk of aortic dissection in Marfan syndrome remains challenging. Established predictive factors primarily include aortic diameter and younger age. However, a more comprehensive understanding of aortic hemodynamic alterations in this population is warranted. 4D magnetic resonance imaging (MRI) offers a non-irradiating approach for assessing hemodynamic parameters. This study aimed to assess aortic parameters using 4D flow MRI in young patients diagnosed with Marfan syndrome. We prospectively included patients over 12 years old from the "CHU de Toulouse Centre de Référence Marfan" cohort. They underwent MRI with 4D flow sequences and an aortic angiography sequence without contrast agent administration. Pulse wave velocity (PWV) and wall shear stress (WSS) were quantified using Circle CVI software. Since February 2023, we included 13 patients without history of aortic events, all treated with beta-blockers, with a median age of 18 years old (range: 15 to 39). MRI imaging was successfully conducted in all cases. The addition of 4D flow acquisitions extended the examination time by 15 to 25 min and the post-processing time by 5 to 10 min. The median aortic diameter was 35 mm (range: 32 to 48) and Z-score ranged from +1.2 to +6.1. Both PWV and WSS were quantifiable across all cases: the median PWV measured 5.5 m/s (range: 2.2 to 13.5), while the median WSS was 0.104 Pa (range: 0.074 to 1.590). No correlations were observed between age, body surface area, or aortic diameter with either PWV or WSS (Fig. 1). A non-invasive, non-irradiating, free-breathing assessment of aortic hemodynamics using 4D flow MRI sequences is feasible in both adolescent and adult patients with Marfan syndrome, albeit with some challenges. However, further studies with larger patient cohorts, comparison with control groups, and long-term follow-up are necessary to determine if this method could serve as a prognostic marker. [ABSTRACT FROM AUTHOR] more...
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- 2024
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3. OD155 - Multicentric comparative study of dose indexes using an "in vivo" optical fiber detection system.
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Popotte, C., Devic, C., Munier, M., Moreno, R., Rousseau, H., Perlongo, S., Pilleul, F., and Paul, D.
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- 2021
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4. Estimation de l'âge foetal par étude scanographique de la pars basilaris de l'os occipital.
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Minier, M., Dedouit, F., Mokrane, F.-T., Adalian, P., Leonetti, G., Rougé, D., Rousseau, H., and Telmon, N.
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- 2012
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5. The Importance of Imaging Assessment Before Endovascular Repair of Thoracic Aorta.
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Rousseau, H., Chabbert, V., Maracher, M.A., El Aassar, O., Auriol, J., Massabuau, P., and Moreno, R.
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ENDOVASCULAR surgery ,MEDICAL imaging systems ,THORACIC aneurysms ,TOMOGRAPHY ,ANGIOGRAPHY ,SURGICAL stents ,CLINICAL indications ,CROSS-sectional imaging - Abstract
Abstract: Indications for and experience with placement of endovascular stent grafts in the thoracic aorta are still evolving. Recent advances in imaging technologies have drastically boosted the role of pre-procedural imaging. The accepted diagnostic gold standard, digital subtraction angiography, is now being challenged by the state-of-the-art computed tomography angiography (CTA), magnetic resonance angiography (MRA) and trans-oesophageal echocardiography (TEE). Among these, technological advancements of multidetector computed tomography (MDCT) have propelled it to being the default modality used, optimising the balance between spatial and temporal resolutions and invasiveness. MDCT angiography allows the comprehensive evaluation of thoracic lesions in terms of morphological features and extent, presence of thrombus, relationship with adjacent structures and branches as well as signs of impending or acute rupture, and is routinely used in these settings. In this article, we review the current state-of-the-art radiological imaging for thoracic endovascular aneurysm repair (TEVAR), especially focusing on the role of MDCT angiography. After analysing the technical aspects for optimised imaging protocols for thoracic aortic diseases, we discuss pre-procedural determinants of candidacy, and how to formulate interventional plans based on cross-sectional imaging. [Copyright &y& Elsevier] more...
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- 2009
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6. Conditions techniques d’utilisation de la tomodensitométrie à rayons X en pathologie cardiaque.
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Dehaene, J.-L., Rousseau, H., and Chabbert, V.
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Copyright of Archives of Cardiovascular Diseases Supplements is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...
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- 2009
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7. Aorto-enteric Fistula After Endovascular Abdominal Aortic Aneurysm Repair: Case Report and Review.
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Chenu, C., Marcheix, B., Barcelo, C., and Rousseau, H.
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ENDOVASCULAR surgery ,ABDOMINAL surgery ,ABDOMINAL aortic aneurysms ,ARTERIOVENOUS fistula ,SURGICAL complications ,ABDOMINAL aorta ,HOMOGRAFTS ,MEDICAL publishing ,CRYOPRESERVATION of organs, tissues, etc. - Abstract
Abstract: Objective: To report a case and to review previous publications regarding the rare complication of aorto-enteric fistula following endovascular aortic aneurysm repair. Methods: We report the case of a stent-graft infection secondary to an aorto-enteric fistula 14 months after uncomplicated endovascular treatment of an infra-renal aortic aneurysm. Results: The surgical treatment involved the removal of the infected graft and in situ aortic replacement by cryopreserved allograft. There have been no major complications noted during the 2-month follow-up after surgery. Conclusions: An aortojejunal fistula is a possible long-term complication of endovascular treatment of abdominal aortic aneurysm. An explantation of the infected graft and aortic replacement by a cryopreserved allograft is a valuable surgical treatment. [Copyright &y& Elsevier] more...
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- 2009
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8. 1119 Optimisation of renal cryotherapy by temporary occlusion of arterial inflow. An animal study
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Auriol, J., Combelle, S., Mazerolles, C., Rousseau, H., and Malavaud, B.A.
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- 2012
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9. Acute traumatic aortic rupture: A comparison of surgical and stent-graft repair.
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Rousseau, H., Dambrin, C., Marcheix, B., Richeux, L., Mazerolles, M., Cron, C., Watkinson, A., Mugniot, A., Soula, P., Chabbert, V., Canevet, G., Roux, D., Massabuau, P., Meites, G., Tran Van, T., and Otal, P. more...
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AORTIC rupture ,SURGICAL stents ,HEART injuries ,AORTA surgery ,PARAPLEGIA ,VASCULAR grafts ,THERAPEUTICS - Abstract
Objective: The study’s objective was to comparatively evaluate surgery and stent-graft repair of acute or subacute traumatic aortic rupture. Methods: A total of 76 patients (14–76 years old; mean, 37 years; male/female ratio, 63/11) with a traumatic aortic injury were admitted to our hospital between 1981 and 2003. Six patients died within 1 to 9 days of another associated severe traumatic lesion. The 70 remaining patients were divided according to the type of rupture repair. In group 1, 35 patients were treated surgically: 28 with immediate repair and 7 with delayed repair (average time interval 66 days, 5–257 days). In group 2, 29 patients were treated with stent grafting of the aortic isthmus. In group 3, 6 patients with minor aortic lesions were treated medically with a close follow-up. Results: In the 28 patients treated surgically in the emergency department, the mortality and paraplegia rates were 21% and 7%, respectively. No death or paraplegia was observed in the group with delayed surgical repair. With stent grafting, complete exclusion of the pseudoaneurysmal sac was observed in all patients. Except for 1 iliac rupture treated during the same procedure, there was no major morbidity or mortality during the mean follow-up of 46 months (13–90 months). No major complication was observed in group 3. Conclusions: In stable rupture of the aorta, initial conservative treatment is safe and allows management of the major associated lesions. Stent grafting of the aortic isthmus is a valuable therapeutic alternative to surgical repair, especially in patients considered high risk for conventional thoracotomy. [ABSTRACT FROM AUTHOR] more...
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- 2005
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10. Stent-Graft Repair of Thoracic Aortic Aneurysms.
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Rousseau, H., Bolduc, J.P., Dambrin, C., Marcheix, B., Canevet, G., and Otal, P.
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SURGICAL stents ,AORTIC aneurysms ,MORTALITY ,VASCULAR diseases - Abstract
Endovascular treatment of aortic disease has emerged as an alternative mode of treatment that is particularly attractive for patients with severe comorbidities who would not be ideal candidates for open surgery. Actually, short-term morbidity and mortality rates, of large series, compare favorably with those from surgery, and stent-graft placement is proving to be a safe, minimally invasive, and effective treatment for thoracic aortic diseases. However, although endoluminal interventions are minimally invasive, they are associated with complications, as are surgical methods. In this article, indications, technical aspects, and results of endovascular TAA repairs will be reviewed. We will also examine the advantages and limitations of stent-graft treatment. Finally, we will discuss the management of complications following aortic stent-graft implantation. We intentionally do not cover the topic of thoracic dissection, as it is being covered in another article in this volume. [Copyright &y& Elsevier] more...
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- 2005
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11. Traitement des complications vasculaires des dissections aortiques.
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Fournial, G., Rousseau, H., Chabbert, V., Mugniot, A., Fusari, M., Biglioli, P., Rouge, P., and Roux, D.
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SCANNING systems ,THERAPEUTICS ,SYMPTOMS ,PATIENTS - Abstract
Copyright of EMC-Chirurgie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...
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- 2004
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12. Inherited venous anomalies of the lower limbs.
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Lefebvre, D., Elias, A., Léger, P., Marson, F., Chabert, V., Rousseau, H., and Boccalon, H.
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DIAGNOSTIC imaging ,VEIN diseases ,MAGNETIC resonance imaging ,THERAPEUTICS - Abstract
Copyright of EMC-Radiologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...
- Published
- 2004
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13. 48 Reference flow and role of medical physicist in the validation of 4D flow MRI protocols.
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Puiseux, T., Sewonu, A., Meyrignac, O., Nicoud, F., Rousseau, H., Mendez, S., and Moreno, R.
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Introduction Magnetic resonance imaging (MRI) applied to 4D hemodynamics conditions assessment is increasingly used in clinical routine to detect and treat cardiovascular diseases [1,2]. Although applications are obvious and the power of new technologies (deep learning) respond effectively to this demand (Arterys), the quality of the results remains highly dependent on the parameters of the acquisition MRI sequence [3]. The need to limit the examination time leads to then degrade the sequence parameters, which leads to a loss of control over the quality of the speed measurements. So far, no quality assurance program has been able to assess the quality of 4D flow measurements. In this work, we propose a 'reference' flow intended to estimate deviations with the 4D Flow measurements obtained by MRI. Methods An experimental device composed by an MRI-compatible pump, flow and pressure sensors and a 3D printed phantom, materializes reference flow. Since flow conditions and geometry are well controlled, 4D flow is correctly modeled by computational fluid dynamics (CFD). The measurements obtained by MRI on the experimental model are compared to modeling. The deviations obtained are evaluated on all the points of the flow for velocity components. Results Difference between the reference flow (CFD) and idealized 4D Flow MRI sequence (Siemens Avanto, 1.5T, voxel 2 × 2 × 2 mm, 35 phases, 45 min of acquisition) is 0.96% for velocity magnitude measurements. Differences with clinical less accurate sequence (voxel >3 mm, short acquisition time, parallel imaging) are very diverse and can exceed 20% if the sequence parameters are not controlled. Conclusions Clinical use of 4D Flow MRI sequences must benefit from a quality assurance program initiated by the head of radiology department and the manufacturer. The great variability of acquisitions and devices (brands, models, field) requires that a reference system for quality control be defined and that the implication of the medical physicist in the protocol validation process is established. The proposed reference system is a tool to achieve this goal. [ABSTRACT FROM AUTHOR] more...
- Published
- 2018
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14. Pathways to care in early psychosis
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Cougnard, A., Kalmi, E., Desage, A., Misdrahi, D., Abalan, F., Brun-Rousseau, H., and Verdoux, H.
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- 2003
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15. 215 - Relation between alkaline phosphatase and coronary artery calcification in subjects free of cardiovascular disease.
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Panh, L., Rousseau, H., Petermann, A., Taraszkiewicz, D., Bongard, V., Lairez, O., Ruidavets, J.B., and Ferrières, J.
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- 2017
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16. P37. Design of a geometric distortion characterization method in 3D MRI: Stereotactic application.
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Sewonu, A., Meyrignac, O., Carbillet, F., Rousseau, H., and Moreno, R.
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Introduction Magnetic Resonance Imaging (MRI) is increasingly being used for purposes of radiosurgery and radiotherapy planning [1] . Indeed, it is the most powerful technique for morphological and functional brain exploration. However, MR images are inherently subjected to geometric distortions because of hardware design limitations that result in failure such as inhomogeneity of the static magnetic field and non-linearity of the gradients fields [2,3] . Consequently, measuring and correcting these distortions is a major issue in clinical routine. In this study, we present the design and setup of a distortions measurement method 3D MRI and its use in the frame of stereotactic application. Materials and method The method is based on a 3D-printed phantom made up with 3621 control points (CP). CPs are 5 mm-diameter spheres that are equidistantly positioned following a cylindrical configuration (170 × 170 × 170 mm). The CPs positions ( XYZ ref ) are yielded by the computer-aided design and used as ground-truth. Principle: The points positions are measured from 3D MRI scans of the phantom ( XYZ irm ) . Distortions are assessed as the difference between the ground-truth positions and MRI-based measurements ( δ = XYZ ref - XYZ irm ) . Data analysis An analysis algorithm was developed in MATLAB in order to extract the CPs positions. It mainly relies on structure detection based on voxels’ connectivity. Eventually, CPs positions are provided by the barycenters of the detected structures. Validation: The algorithm was validated through a numerical simulation approach. A varying amplitude [2 mm-18 mm] deformation field was applied to a numerically modeled volume containing the control points. Accuracy was assessed by comparing measurements from the numerical data with the applied deformations. Clinical application: Our method was applied in the frame of stereotactic MRI-based radiotherapy treatment planning (brain exam, Siemens Avanto 1.5T, brain array coil) using dedicated 3D sequences (Inversion/Recovery 3D gradient echo, TR/TE/TI = 1940/2.95/1100 ms, voxel = 1 × 1 × 1 mm 3 ). Data were acquired with and without using the distortion correction option provided by the manufacturer. Maximum tolerated distortion is ±1 mm. Results As a result for the validation experiment, the algorithm’s accuracy was higher than 97%. Clinical routine measurement with the 3D stereotactic MRI sequence are: without correction − 1.41 mm < δ < 0.38 mm ; with correction − 1.1 mm < δ < 0.32 mm . Conclusion Since the control points are not filled with liquid material, our method’s phantom is more likely to be time-stable unlike some previously published methods [4,5] . Besides, it enables a highly accurate distortions measurement. It is suited for quality assurance purposes and helps optimizing clinical practice. Further works involve the assessment of the method’s robustness to noise and reproducibility as well. In addition, we are developing a module for the correction of MR images subsequently to the distortion characterization. [ABSTRACT FROM AUTHOR] more...
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- 2016
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17. La pratique de la télémédecine par les médecins internistes français en 2019.
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Firn, S., Galland, J., Rousseau, H., Andres, E., Salles, N., Disdier, P., Azzi, J., Baumann, C., and de Korwin, J.-D.
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TELEMEDICINE , *PHYSICIANS , *MEDICAL care surveys , *QUESTIONNAIRES - Abstract
La télémédecine se développe en France depuis 2018. L'objectif de cette enquête était d'évaluer les connaissances, attitudes, pratiques et formation des médecins internistes concernant la télémédecine. L'étude observationnelle descriptive nationale réalisée entre juillet et octobre 2019, via un auto-questionnaire en ligne auprès des membres de la Société Nationale Française de Médecine Interne et de l'Amicale des Jeunes Internistes, comportait une analyse descriptive et comparative par sous-groupes d'âge. L'analyse des 309 réponses des médecins qualifiés en médecine interne ou exerçant dans un service de médecine interne (61,8 %) et des internes de médecine interne (38,2 %) a montré que 34,6 % avaient des notions ou une bonne connaissance de la réglementation de la télémédecine. Pour respectivement 62,1 %, 72,5 % et 74,1 %, elle pouvait améliorer la prise en charge des patients, l'accès aux soins, et les échanges entre internistes et autres médecins. Les principaux freins à sa pratique étaient l'absence de face-à-face avec le patient (57,3 %) et les dysfonctionnements informatiques (55 %). Seuls 23,3 % la pratiquaient, dont 88,9 % de téléexpertise. Des actes de télémédecine étaient pratiqués de façon informelle (téléphone et email) dans 70,8 % des cas. Les médecins de plus de 50 ans connaissaient mieux la réglementation et pratiquaient plus la télémédecine officielle. Au total, 54 % souhaitaient pratiquer la télémédecine, et 72,8 % s'y former. Les attitudes envers la télémédecine étaient positives, mais peu d'internistes la connaissaient et la pratiquaient de façon formelle, justifiant une formation adaptée. Telemedicine has been developing in France since 2018. The objective of this survey was to assess the knowledge, attitudes, practices and training of internal physicians regarding telemedicine. A national descriptive observational study carried out between July and October 2019, via an online self-questionnaire with members of the National Society of Internal Medicine and the Association of Young Internists, included a descriptive and comparative analysis by subgroups of age. Analysis of 309 responses from physicians qualified in internal medicine or practicing in an internal medicine service (61,8%) and residents in internal medicine (38%) showed that 34.6% had notions or a good knowledge of regulation of telemedicine. For 62,1%, 72.5% and 74.1% respectively, it could improve patient care, access to care and exchanges between internists and other doctors. The main obstacles to this practice were the absence of face-to-face with the patient (57.3%) and computer dysfunctions (55%). Only 23.3% practiced it, including 88.9% tele-expertise. Telemedicine was performed informally (telephone and email) in 70.8% of the cases. Doctors over the age of 50 were better acquainted with the regulations and more practiced official telemedicine. In total, 54% wanted to practice telemedicine and 72.8% wanted to train there. Attitudes towards telemedicine were positive, but few internists knew about it and practiced it formally, warranting appropriate training. [ABSTRACT FROM AUTHOR] more...
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- 2021
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18. 36 Medical Physicist and Radiologists, a winning team: Definition of a new biomarker for the assessment of small aortic aneurysm rapid growth risk.
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Moreno, R., Meyrignac, O., Zadro, C., Sewonu, A., Bartoli, J.M, Rousseau, H., Piquet, P., and Bal, L.
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Introduction Abdominal Aortic Aneurysm (AAA) is a common pathology which treatment decision is mostly made upon measurement of maximal diameter, despite known limitations. Thanks to the collaboration between Medical Physicist and Radiologist, this study aimed to identify new biomarkers based on computational fluid dynamics (CFD) analysis to predict AAAs rapid growth risk. Methods In our multi-centric and prospective study, we included 78 patients with an AAA from September 2012 to June 2014. Patients underwent two CT examinations separated by a one-year interval to assess aneurysms growth. Fifty patients underwent CFD analysis thanks to the Medical Physicist expertise. Based on a 10 ml threshold of total volume growth, we classified patients into slow and rapid growth groups. Aneurysms initial morphological and functional parameters were analyzed including: maximal diameter and surface, thrombus and lumen volumes, maximal wall pressure and wall shear stress (WSS). Results There was a significant difference between the two groups regarding aneurysm lumen volume (P = 0.0051) and mean WSS variation (P = 0.0240) unlike maximal diameter (P = 0.71). We found significant correlation of aneurysm volume growth with lumen volume and reduction of the mean WSS variation value (respectively R = 0.47, P = 0.0015 and R = −0.42, P = 0.0062) and total aneurysm volume growth. Combining these parameters, we computed an AAAs growth-predicting model, which featured better area under ROC than the only measurement of maximal diameter (0.78 vs 0.52, P = 0.0031). Depending on the threshold, our model yields either excellent sensitivity (95.00% [IC95% 75.1, 99.9]) or specificity (90.00% [IC95% 73.5, 97.9]). Conclusions Tight collaboration between Medical Physicist and Radiologists allowed to find a promising biomarker based on CFD which provides better information than maximal diameter to assess rapid AAAs volume growth risk. [ABSTRACT FROM AUTHOR] more...
- Published
- 2018
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19. 49 Performance Assessment of Magnetic Resonance Imaging (MRI) pelvimetry using ex vivo anatomic pieces and a 3D-printed geometric-distortion phantom.
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Sewonu, A., Meyrignac, O., Gervais, L., Rousseau, H., and Moreno, R.
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Introduction Feto-maternal morbidity and mortality increase with prolonged labor which can be related with fetalpelvic disproportion. Pelvimetric imaging is useful for assessing the eligibility of vaginal delivery in patients suspected of having disproportion [1]. Commonly performed using Computed Tomography (CT), pelvimetry is being increasingly done in MRI in order to tackle issues of ionizing-radiation exposure and take advantage of the rich contrast provided in MRI [2]. Nonetheless, MR images can be subjected to geometric distortions because of hardware design limitations [3]. Such distortions may impair MRIpelvimetric measurements. In this study, we assessed the accuracy of MRI-pelvimetry compared with CTpelvimetry using ex-vivo pelvises and a 3D-printed geometric-distortion phantom. Method We scanned ten ex-vivo pelvises on a CT scanner (Siemens Sensation) using the implemented clinical low-dose (LD-CT) and high-dose (HD-CT) pelvimetry protocol. MRI was performed on four 1.5T MRI scanners (Siemens Avanto, GE Signa, Philips Achieva, Toshiba Elan). Pelvises were scanned in sagittal and oblique axial using T1-, T2-weighted FSE and T1-weighted SPGR sequences. A trained radiologist performed pelvimetry measurements. Pelvic inlet and outlet anteroposterior diameters were measured using sagittal images. Pelvic inlet and outlet transverse diameters were measured using oblique axial images. For data analysis, MRI measurements were compared with CT using Bland-Altman plots and discrepancy analysis. MRI measurements were also analyzed for inter-scanner variability. Geometric distortion (GD) measurement: we used a custom previously-published methodology which relies on a 3D-printed phantom made up of 3621 control points which are 5 mm-diameter spheres equally spaced within a cylinder (diameter = length = 170 mm) [4]. GD images were acquired on the Siemens Avanto MR unit with and without the manufacturer's correction that is available but commonly unused by clinical teams. Results The discrepancy between LD-CT and HD-CT measurements was up to 10%. The discrepancy between MRI and LD-CT was up to 11%. As for MRI and HD-CT, the discrepancy was up to 7%. MRI inter-scanner variation was up to 8%. As for geometric distortions, measurements were −1.4 mm < δ < 0.4 mm without correction and −0.9 mm < δ 0.3 mm with correction. Conclusion For pelvimetry purposes, our preliminary results show that MRI is as much accurate as high-dose CT and outperforms low-dose CT. We also show that geometric distortions can be minimized in MR images by using the implemented corrections. Hence MRI pelvimetry appears as an excellent alternative to CT pelvimetry in an endeavor to reduce fetuses exposure to ionizing radiation. Upcoming works in this study include assessment of interobserver reproducibility with the intervention of a second radiologist and geometric distortion measurement on the three remaining MRI scanners. [ABSTRACT FROM AUTHOR] more...
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- 2018
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20. Randomized Comparison of Strategies for Type B Aortic Dissection: The INvestigation of STEent Grafts in Aortic Dissection (INSTEAD) Trial.
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Nienaber, C.A., Rousseau, H., and Eggebrecht, H.
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- 2010
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21. Response to ‘Magnetic Resonance Imaging for Aortic Dissection’.
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Rousseau, H., Chabbert, V., Maracher, M.A., El Aassar, O., Auriol, J., Massabuau, P., and Moreno, R.
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- 2010
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22. 21 - Prospects of numerical modeling in the monitoring of aortic diseases.
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Moreno, R., Sewonu, A., Meyrignac, O., Krid, O., and Rousseau, H.
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- 2015
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23. Endovascular Repair of Type B Aortic Dissection: Long-term Results of the Randomized Investigation of Stent Grafts in Aortic Dissection Trial.
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Nienaber, C.A., Kische, S., and Rousseau, H.
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- 2014
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24. Results of endovascular repair of the thoracic aorta with the Talent Thoracic stent graft: the Talent Thoracic Retrospective Registry.
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Fattori, R., Nienaber, C.A., and Rousseau, H.
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- 2007
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25. Indication of endovascular stent grafts for traumatic rupture of the thoracic aorta
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Meites, G., Conil, C., Rousseau, H., Chabbert, V., Cron, C., Dambrin, C., Samii, K., and Virenque, C.
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AORTA , *ENDOVASCULAR surgery , *BLOOD circulation , *MORTALITY - Abstract
Objective. – The usual treatment of traumatic aortic rupture (TAR) is surgical. This invasive technique necessitating thoracotomy and ECC is associated with a mortality rate of more than 20% and a paraplegia risk of about 10%. New minimally-invasive techniques (aortic stent-grafting) are emerging as less risky alternatives to surgery. We report our experience in the percutaneous treatment of TAR with stent-graft via a surgical femoral cut-down.Patients and methods. – Between 1996 and 2002, 23 patients (16–65-year-old, mean 36 years) were treated by thoracic stent-grafting. An informed consent was obtained for every patients. Thirteen patients had an acute or sub-acute TAR (1–8 months, mean 5 months) and five patients had chronic TAR (13–24 years, mean 17 years). The technique was done under general anaesthesia and each patient received a preoperative blood-pressure reduction treatment. During the procedure, anticoagulation (heparin) was given and hypotension was induced when the stent-graft was deployed. Direct positioning control was obtained by means of TEE.Results. – Eighty percent of patients were extubed immediately after the procedure. Bleeding was <150 ml. The primary success rate was 100% with one minor type 2 endoleak that was spontaneously resolved after 2 months. There was no case of mortality or paraplegia. There were three minor complications (17%), two haematomas at the arteriotomy site and one inflammatory syndrome characterised by slight fever, raised biological markers but with negative blood culture.Conclusion. – Percutaneous aortic stent-grafting for TAR is a minimally-invasive technique, which constitute an interesting alternative to surgery. It only necessitates a femoral surgical cut-down compared to the thoracotomy and ECC associated with surgery. The complication rate is low and no mortality or major complication was encountered in our patients. Eventually, the long-term follow-up will allow a widening of indications. [Copyright &y& Elsevier] more...
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- 2004
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26. Microbiological epidemiology of preservation fluids in transplanted kidney: a nationwide retrospective observational study.
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Corbel, A., Ladrière, M., Le Berre, N., Durin, L., Rousseau, H., Frimat, L., Thilly, N., and Pulcini, C.
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DRUG infusion pumps , *KIDNEY transplantation , *SCIENTIFIC observation , *INTESTINAL perforation , *STAPHYLOCOCCUS , *EPIDEMIOLOGY , *BK virus - Abstract
Kidney transplant recipients are at high-risk for donor-derived infections in the early post-transplant period. Transplant preservation fluid (PF) samples are collected for microbiological analysis. In case of positive PF cultures, the risk for the recipient is unknown and there is no consensus for prescribing prophylactic antibiotics. This nationwide observational study aimed to determine the epidemiology of bacterial and fungal agents in kidney transplant PF cultures and identify risk factors associated with positive PF cultures. We performed a retrospective observational study on the following data collected from a national database between October 2015 and December 2016: characteristics of donor, recipient, transplantation, infection in donor and PF microbiological data. Of 4487 kidney transplant procedures, including 725 (16.2%, 725/4487) from living donors, 20.5% had positive PF cultures (living donors: 1.8%, 13/725; deceased donors: 24.1%, 907/3762). Polymicrobial contamination was found in 59.9% (485/810) of positive PF cultures. Coagulase-negative staphylococci (65.8%, 533/810) and Enterobacteriaceae (28.0%, 227/810) were the most common microorganisms. Factors associated with an increased risk of positive PF cultures in multivariable analysis were (for deceased-donor kidney transplants): intestinal perforation during procurement (OR 4.4, 95% CI 2.1–9.1), multiorgan procurement (OR 1.4, 95% CI 1.1–1.7) and en bloc transplantation (OR 2.5, 95% CI 1.3–4.9). Use of perfusion pump and donor antibiotic therapy were associated with a lower risk of positive PF cultures (OR 0.4, 95% CI 0.3–0.5 and OR 0.6, 95% CI 0.5–0.7, respectively). In conclusion, 24% of deceased-donor PF cultures were positive, and PF contamination during procurement seemed to be the major cause. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
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27. Early liver metastases in resectable periampullary cancer: Incidence and risk factors.
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Guerard, A.S., Ayav, A., Busby, H., Lafitte, M., Rousseau, H., and Laurent, V.
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LIVER metastasis , *PANCREATICODUODENECTOMY , *LOGISTIC regression analysis , *COMPUTED tomography , *MULTIVARIATE analysis , *MAGNETIC resonance imaging , *ADENOCARCINOMA , *CANCER relapse , *COMBINED modality therapy , *LIVER tumors , *LUNG tumors , *PANCREATIC tumors , *DUODENAL tumors , *PERITONEUM tumors , *DISEASE incidence , *RETROSPECTIVE studies - Abstract
Purpose: The aim of the present study was to estimate the incidence of very early hepatic metastases (HMs) (<6 months) and their imaging patterns after cephalic duodenopancreatectomy (CDP) for periampullary carcinoma (excluding duodenal carcinoma) and to identify their associated risk factors.Methods: From January 2003 to June 2016, all patients who underwent surgical treatment for periampullary carcinoma by CDP at our institution and with adequate pre- and postoperative CT scans were included. Univariate and multivariate logistic regressions were performed to determine factors associated with very early HM and recurrence.Results: Of the 132 patients included retrospectively, 27 (20.5%) patients developed HMs. The mean time to diagnosis of HM was 103.9±55.2days. HMs were multiple in 81.4% of cases and bilobar in 59.3% of cases; their mean maximum size was 16.7±12.7mm. In univariate logistic analysis, lymphovascular emboli were significantly associated with HM (p=0.02). No independent risk factors for HM were found in multivariate analysis. In multivariate logistic analysis, two independent risk factors were identified for the occurrence of early recurrence: tumor size >23mm on preoperative CT scan (OR: 3.3; 95% CI: [1.2-9.3]; p=0.02) and tumor differentiation (poor vs. good: OR 15.5; 95 CI [1.5-158.3]; moderate vs. good: OR: 17.1; 95% CI: [1.9-154.4]; p=0.04).Conclusions: Nearly one in five patients developed HM after CDP within 6 months with a highly consistent pattern. A thorough preoperative assessment, combining CT scan and MRI with a delay of less than three weeks before surgery, appears essential. A routine systematic postoperative CT scan at 8 weeks is also required prior to initiating adjuvant chemotherapy. The type of surgical intervention does not seem to be a risk factor, although the risk of HM occurrence appears to be related to the lymphovascular invasion of the tumor and maybe its degree of differentiation, elements not assessable by imaging. [ABSTRACT FROM AUTHOR] more...- Published
- 2017
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28. Old hearts for modern investigations: CT and MR for archaeological human hearts remains.
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Mokrane, F.Z., Colleter, R., Duchesne, S., Gerard, P., Savall, F., Crubezy, E., Guilbeau-Frugier, C., Moreno, R., Sewonu, A., Rousseau, H., Telmon, N., and Dedouit, F.
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CARDIOGRAPHIC tomography , *CARDIAC imaging , *CARDIAC magnetic resonance imaging , *HYPERTROPHIC cardiomyopathy , *AUTOPSY , *LIPIDS , *ANTHROPOMETRY , *COMPUTED tomography , *FORENSIC pathology , *HEART , *CARDIAC hypertrophy , *HISTORY , *MAGNETIC resonance imaging , *MYOCARDIUM , *DILATED cardiomyopathy - Abstract
Introduction: Among 800 burials dated between the 15th and 18th centuries and found in the center of Rennes (Brittany, France), a collection of five heart-shaped lead urns was discovered. This material was studied using classical methods (external study, autopsy and histology), and also modern imaging like computed tomography (CT), magnetic resonance (MR) before and after coronary opacification. The aim of this manuscript is to describe different steps of ancient soft tissues study, especially using imaging techniques.Methods: The study gathered various specialists: anthropologists, archeologists, forensic pathologists, radiologists, pathologic physicians, and physicists. Imaging techniques were performed, before and after coronary opacification. Finally, hearts were autopsied and different histological samples were analyzed.Results: Only heart n°2 was too damaged to be studied. Heart n°3 was considered as normal using all investigation techniques. The study of Hearts n°s 4 and 5 revealed dilated cardiomyopathy while Heart n°1 showed important signs of diffuse hypertrophic cardiomyopathy. Different fibro lipid plaques were identified using imaging techniques, and were confirmed by histology.Conclusions: The study of archeological soft tissues using modern imaging is possible if the material is well-preserved. This type of research can uncover principal findings, allowing scientists to establish diseases of ancient times. [ABSTRACT FROM AUTHOR] more...- Published
- 2016
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29. Un seul scanner thoracique permet de dépister l'insuffisance coronarienne et l'ostéoporose.
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Laroche, M., Ferrieres, L., Ferrieres, J., Rousseau, H., and Degboé, Y.
- Abstract
De nombreuses études épidémiologiques montrent une relation entre Ostéoporose et Maladies cardio-vasculaires. Les malades ayant des fractures ostéoporotiques font plus d'accidents vasculaires cérébraux (AVC) et d'infarctus que les malades non ostéoporotiques et les malades ayant une artériopathie ou une insuffisance coronarienne ont plus de risque d'avoir des fractures par fragilité osseuse [1]. Le scanner thoracique permet d'évaluer les calcifications coronariennes par la mesure du score d'Agatson; Ce score prédit le risque d'infarctus du myocarde. Lors d'une précédente étude présentée à ce même congrès nous avions montré, sur les coupes tomodensitométriques utilisées pour déterminer le score d'Agatson, que nous pouvions déterminer sur la vertèbre T6, la densité minérale osseuse (DMO), par un logiciel adapté. Nous avions montré que cette DMO était significativement plus basse chez les malades ayant un score d'Agatson pathologique que chez les malades dont ce score était égal à zéro. L'objectif de ce travail est d'évaluer si la mesure tomodensitométrique de DMO vertébrale thoracique est corrélée à la mesure de DMO par DXA, méthode de référence.. Nous avons analysé de façon prospective, 20 malades ayant bénéficié d'un bilan de dépistage des maladies cardiovasculaires, comprenant un examen tomodensitométrique thoracique pour évaluation du score d'Agatson. Nous avons mesuré la DMO de la vertèbre T6 par tomodensitométrie, et la DMO au rachis et à la hanche par DXA sur un appareil Lunar Prodigy. La mesure de DMO en scanner a fait l'objet d'une double lecture. La corrélation entre les valeurs de DMO en DXA et de DMO en scanner a été évaluée par le coefficient de corrélation de Spearman. Ces 20 patients, 10 femmes, 10 hommes, étaient âgés en moyenne de 65 ans (50–75). Leur DMO moyenne en T6, évaluée par scanner était de 141 ± 100 unités Hounsfield. Les coefficients de variation intra et inter-observateurs des mesures d'évaluation de la DMO en T6 par scanner étaient de 3 et 4 %. Leur T-score moyen, était de + 0,2 ± 0,15 DS en L2-L4 et de −0,8 ± 0,2 DS à la hanche totale. La corrélation DMO L2-L4 mesurée par DXA et DMO T6 évaluée par scanner était de r = 0,95 (p < 0,0001), La corrélation DMO hanche totale, DMO T6 est de r = 0,65 (p = 0,005). Les données épidémiologiques démontrant l'association entre maladies cardio-vasculaires et ostéoporose devraient impliquer que tout malade ostéoporotique ait un dépistage cardiovasculaire et que tout malade cardio-vasculaire devrait bénéficier d'une ostéodensitométrie. Le scanner thoracique peut permettre, par évaluation des calcifications coronariennes et par mesure "opportuniste" de la DMO vertébrale thoracique, très fortement corrélée à la mesure de DMO lombaire par DXA, de dépister ces deux affections. Le scanner thoracique permet de dépister le risque coronarien par évaluation des calcifications coronariennes (score d'Agatson) et potentiellement aussi le risque d'ostéoporose par évaluation tomodensitométrique de la DMO vertébrale thoracique. [ABSTRACT FROM AUTHOR] more...
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- 2021
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30. Is it useful to repeat an adrenal venous sampling in patients with primary hyperaldosteronism?
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Bouhanick, B., Delchier, M.-C., Fauvel, J., Rousseau, H., Amar, J., and Chamontin, B.
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VENOUS valves , *HYPERALDOSTERONISM , *CATHETERIZATION , *CEREBRAL dominance , *HYPERPLASIA , *HYDROCORTISONE , *VENA cava inferior , *PATIENTS - Abstract
Abstract: Adrenal venous sampling (AVS) is a challenging technical procedure and few patients had AVS procedure twice. Aim: To evaluate the reproducibility of the AVS, why AVS were repeated and the conclusions drawn from them. Patients and methods: From 1997–2012, 12 patients underwent two AVS. A cortisol level in the adrenal vein greater than or equal to 1.1 to inferior vena cava defined a successful catheterization and a lateralization of secretion corresponded to an aldosterone-to-cortisol vein ratio greater than or equal to 2 between the one side to another. Results: The same side of lateralization of secretion was found in 75% of them. The second AVS were due to technical failure (n =4), unproven lateralization (n =2), a lateralization opposite to the main nodule and ipsilateral to hyperplasia (n =4) on first AVS. For two patients, as the CT was normal, AVS was required again. The second AVS was successful in all patients, including those with an initial technical failure but only patient with technical failure underwent surgery, as BP and kaliemia were controlled. Lateralization on the side of hyperplasia or opposite to the biggest nodule was confirmed in two of four cases. Conclusion: When AVS is unsuccessful for technical reasons, it is worth doing it again but after being sure that surgery is still possibly indicated. [Copyright &y& Elsevier] more...
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- 2014
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31. Embolisation transhépatique percutanée d’un pseudoanévrisme post-traumatique de l’artère hépatique
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Marcheix, B., Dambrin, C., Cron, C., Sledzianowski, J.F., Aguirre, J., Suc, B., Cerene, A., and Rousseau, H.
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Résumé: Les pseudoanévrismes de l’artère hépatique sont des complications rares des traumatismes fermés de l’abdomen. Un pseudoanévrisme post-traumatique de l’artère hépatique a été découvert chez un patient de 18 ans ayant des douleurs abdominales récurrentes plusieurs mois après le traumatisme. Ce pseudoanévrisme a été traité avec succès par combinaison d’un traitement endovasculaire classique et d’une embolisation percutanée transhépatique. [Copyright &y& Elsevier] more...
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- 2004
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32. Study of agreement of aortic, radial and femoral blood pressures during aortic endografting.
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Ruiz, S., Minville, V., Asehnoune, K., Conil, C., Georges, B., Rousseau, H., Fourcade, O., and Conil, J.-M.
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FEMUR physiology , *BLOOD pressure , *GENERAL anesthesia , *HYPOTENSION , *HEMODYNAMICS , *AORTA - Abstract
Abstract: Purpose: To estimate the agreement between radial or femoral, and ascending aortic invasive blood pressure values. Patients and methods: Prospective study on 32 patients who underwent an aortic endografting under general anesthesia. After deploying the prosthesis under controlled hypotension, a catheter was introduced in the aorta to measure the staged systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures, in particular at the level of ascending aorta and femoral artery. Results: No differences were observed between SAP, DAP or MAP measured in the aorta versus femoral or radial arteries. A better agreement was observed between the aortic and femoral MAP (bias of 1mmHg, limits of agreement between: –8.8mmHg and +10.8mmHg) than between the aortic and the radial MAP (bias of 1.7mmHg, limits of agreement between: –14.1mmHg and +17.5mmHg). The comparison between radial and femoral MAP was not satisfying (bias of –4.7mmHg and limits of agreement between –19.1mmHg and +9.7mmHg). Conclusion: The femoral MAP is more accurate to predict value of the aortic MAP than the radial MAP in a hypotensive setting. The clinician should be aware of these discrepancies in conditions of hemodynamic impairment to optimize the treatment. [Copyright &y& Elsevier] more...
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- 2013
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33. 1018-147 Comparison of retrospectively electrocardiogram-gated, multislice spiral computed tomography and selective coronary angiography in the analysis of stent permeability after left main or ostial coronary artery angioplasty.
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Maupas, E, Carrié, D, Elbaz, M, Bennaceur, M, Rousseau, H, Joffre, F, and Puel, J
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ELECTROCARDIOGRAPHY , *SPIRAL computed tomography , *CORONARY angiography , *SURGICAL stents , *ATHEROSCLEROTIC plaque - Published
- 2004
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34. 2P-0547 Comparison of retrospectively ECG-gated, multislice spiral computed tomography (MSCT) and selective coronary angiography in the analysis of stent permeability after left main or ostial coronary artery angioplasty
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Maupas, E., Elbaz, M., Puel, J., Chabbert, V., Benaceur, M., Rousseau, H., Joffre, F., and Carri, D.
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- 2003
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