Résultats à moyen terme du stenting primaire des lésions fémoro-poplitées TASC II C et D (étude STELLA (stenting long de l'artère fémorale superficielle))

Le traitement endovasculaire des lésions athéromateuses fémoro-poplitées connait un essort grandissant. Les recommandations sont en faveur d'un traitement chirurgical des lésions TASC D et TASC C chez les patients à bon pronostic chirurgical. Le succès technique du traitement endovovasculaire de lésions si sévères est bon mais très peu de données existent sur le devenir clinique des patients ainsi pris en charge. L'étude STELLA a évalué à travers une cohorte de 58 patients suivis prospectivement la validité et l'efficacité du traitement endovasculaire des lésions TASC C et D. Le maintien de l'amélioration clinique primaire et secondaire de 69% et 83% à 1 an respectivement ainsi que le faible taux de resténose (<20% à 1 an) sont en faveur d'une telle attitude thérapeutique. Le taux élevé de resténose (50%) est à contrebalancer avec leur faible impact clinique. Un suivi plus long est indispensable étant donné la proportion importante de patients en ischémie critique.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF

Brachial artery pseudoaneurysm after phlebotomy for iron overload: first case report.

International audienc

Identification of Carotid Plaques Composition through a Compact Microwave Sensor

International audienceMicrowave biosensor brings the prominent promise ofdielectric parameters detection to characterize biological tissues. Thispromise has already been materialized in multiple fields of healthcareand body parts. Yet when it comes to carotid plaque sticking to basicsimulations, and correlating that with real-time measurements isarguably much harder. Measuring and simulating carotid plaquescomprise a wide range of sub-problems, such as the heterogeneity anduniquity of each plaque, the different thicknesses, and various areasof interest. In this study, a miniaturized microwave biosensor wasproposed to perform dielectric characterizations of atheromatousplaques present in arterial tissues. The designed microwave biosensoremploys a Complementary Split Ring Resonator (CSRR) topology at2.3 GHz. Electromagnetic modeling and experimentalcharacterization have been carried out to validate the developedequivalent electrical model with very good precision and to calibrateit using other material. Atheroma measurements were achieved andcompared to data obtained by simulation and then correlated with thehistology result

Importance of Early Diagnosis and Care in Knee Dislocations Associated with Vascular Injuries

International audienceBackground: Arterial injury secondary to acute knee dislocation (KD) is a rare but devastative complication. The aim of this study is to evaluate functional sequelae and factors of poor prognosis.Methods: A retrospective monocentric series of consecutive KD with acute ischemia by popliteal artery injury was analyzed between 2005 and 2017. The main outcome was the amputation rate.Results: Sixteen dislocations were included. Nine (56%) were due to public road accidents, 5 (31%) were due to falls from height, and 2 (13%) were due to sports injuries. Dislocation had occurred in the posterior location in 8 (50%) cases. Regarding arterial injury, there were 7 (44%) ruptures, 7 (44%) dissections, and 2 (13%) isolated thromboses. Eleven (69%) KDs with vascular trauma were associated with signs of acute ischemia. Revascularization was achieved by anatomical venous bypass in 14 (88%), resection and direct anastomosis in one (6%), and isolated thrombectomy in one (6%). Median time to surgery (time between trauma and vascular repair) was 7 hours (3.25-60.92 hours). Primary revascularization was performed in 12 (75%) cases. In three cases (19%), orthopedic reduction and stabilization were performed first. In one case, (6%) three-step management with vascular shunt at first, then with knee stabilization, and finally vascular bypass was carried out. Stabilization was achieved by using an external fixator in 13 (82%) cases, by open reduction and internal fixation in one case (6%), by ligamentoplasty in one (6%), and by using a long leg cast in one (6%). Fasciotomy was required in 12 (75%) cases. Two patients had early vascular complications, and 2 had early systemic complications. Three secondary transfemoral amputations were performed. Median follow-up duration was 23 months. No secondary amputation was recorded. At the end of follow-up, functional outcomes were evaluated using the Oxford Knee Score (OKS). The median OKS was 30 versus the pretrauma median OKS of 47 (P < 0.00028). No risk factor associated with limb amputation has been highlighted.Conclusions: Analysis of these results provided indications for therapeutic management of this condition. This study shows poor functional outcomes because of severity of vascular lesion in patients with orthopedic trauma but with healthy arteries