Severe Thoracic Aorta Stenosis After Endovascular Treatment of Blunt Thoracic Aortic Injury

International audienceTen months after thoracic endovascular treatment of blunt thoracic aortic injury, a 15-year-old woman was admitted for chest pain, headache, and lower limbs weakness. Emergent computed tomography showed almost occlusive stenosis at the distal junction between the thoracic stent graft and the native thoracic due to clot formation inside the graft. She subsequently presented a pulmonary edema with concurrent anuria. Emergent angioplasty and stenting using nitinol bare stent was successfully performed. Blood pressure gradient between radial and femoral arteries decreased from 100 mm Hg to 25 mm Hg. Peripheral hypoperfusion signs progressively resolved and kidney function normalized. The patient was discharged 12 days later. Subcutaneous curative anticoagulation during 1 month associated with single antiplatelet therapy was administered. After a 2-month follow-up, the patient was asymptomatic and control CT scan showed a patent stent graft and a patent distal bare stent

sj-docx-1-jet-10.1177_15266028231169172 – Supplemental material for Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk

Supplemental material, sj-docx-1-jet-10.1177_15266028231169172 for Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk by Aurélien Hostalrich, Jean Porterie, Thibaut Boisroux, Bertrand Marcheix, Jean Baptiste Ricco and Xavier Chaufour in Journal of Endovascular Therapy</p

sj-tiff-4-jet-10.1177_15266028231169172 – Supplemental material for Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk

Supplemental material, sj-tiff-4-jet-10.1177_15266028231169172 for Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk by Aurélien Hostalrich, Jean Porterie, Thibaut Boisroux, Bertrand Marcheix, Jean Baptiste Ricco and Xavier Chaufour in Journal of Endovascular Therapy</p

sj-tif-3-jet-10.1177_15266028231169172 – Supplemental material for Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk

Supplemental material, sj-tif-3-jet-10.1177_15266028231169172 for Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk by Aurélien Hostalrich, Jean Porterie, Thibaut Boisroux, Bertrand Marcheix, Jean Baptiste Ricco and Xavier Chaufour in Journal of Endovascular Therapy</p

sj-tif-2-jet-10.1177_15266028231169172 – Supplemental material for Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk

Supplemental material, sj-tif-2-jet-10.1177_15266028231169172 for Outcomes of Secondary Endovascular Aortic Repair After Frozen Elephant Trunk by Aurélien Hostalrich, Jean Porterie, Thibaut Boisroux, Bertrand Marcheix, Jean Baptiste Ricco and Xavier Chaufour in Journal of Endovascular Therapy</p

Boot camp approach to surgical residency preparation: feedback from a French university hospital

International audienceAbstract Introduction The transition from medical student to surgical resident is not a simple one. The aim of this study was to report the experience of a university hospital in the organization of the induction course for future surgical residents and the contribution of a video support in the learning of the suture. Material and method We were able to study two consecutive years of students (October 2020 and 2021). Concerning the practical and technical workshops (learning suture) we carried out a comparative study between two groups of students. A group that had video support for learning suture (video group) and a group without video (control group). The evaluation of the suture was performed in a blinded manner by two supervising surgeons. The other practical workshop was drain fixation; the students did not have a video for this workshop. A comparative study was also performed for the drain fixation workshop between the two groups (video group and control group). A program of theoretical courses was also set up. This program is established according to the different future functions of the residents by integrating medico-legal notions and teamwork. Satisfaction questionnaires were given to the students and the answers were given two months after taking up their duties in the hospital (6 questions with Likert scale and 4 free questions). Results The cohort consisted of 58 students (29 each in 2020 and 29 in 2021). Comparative analyses of the evaluation of the suture workshops showed better performance in the video group compared with the group without video. The comparison of these two groups did not show significant differences in the drain fixation workshop. The theoretical teaching was broken down according to the students' future tasks and each speaker was a specialist in his or her field of expertise. The results of the questionnaires showed a desire on the part of the students to increase the time spent on practical workshops and theoretical forensic teaching. Conclusion We were able to show through these two years of a program that we were able to offer a surgical resident preparation course. In addition, we have highlighted the contribution of a video support in the learning curve of the suture

Additional file 1 of Boot camp approach to surgical residency preparation: feedback from a French university hospital

Additional file 1

Late Outcomes of Carotid Artery Stenting for Radiation Therapy-Induced Carotid Stenosis

International audiencePurpose: Carotid artery stenting (CAS) appears as a promising alternative treatment to carotid endarterectomy for radiation therapy (RT)-induced carotid stenosis. However, this is based on a poor level of evidence studies (small sample size, primarily single institution reports, few long-term data). The purpose of this study was to report the long-term outcomes of a multicentric series of CAS for RT-induced stenosis. Methods: All CAS for RT-induced stenosis performed in 11 French academic institutions from 2005 to 2017 were collected in this retrospective study. Patient demographics, clinical risk factors, elapsed time from RT, clinical presentation and imaging parameters of carotid stenosis were preoperatively gathered. Long-term outcomes were determined by clinical follow-up and duplex ultrasound. The primary endpoint was the occurrence of cerebrovascular events during follow-up. Secondary endpoints included perioperative morbidity and mortality rate, long-term mortality rate, primary patency, and target lesion revascularization. Results: One hundred and twenty-one CAS procedures were performed in 112 patients. The mean interval between irradiation and CAS was 15 ± 12 years. In 31.4% of cases, the lesion was symptomatic. Mean follow-up was 42.5 ± 32.6 months (range 1–141 months). The mortality rate at 5 years was 23%. The neurologic event-free survival and the in-stent restenosis rates at 5 years were 87.8% and 38.9%, respectively. Diabetes mellitus (p=0.02) and single postoperative antiplatelet therapy (p=0.001) were found to be significant predictors of in-stent restenosis. Freedom from target lesion revascularization was 91.9% at 5 years. Conclusion: This study showed that CAS is an effective option for RT-induced stenosis in patients not favorable to carotid endarterectomy. The CAS was associated with a low rate of neurological events and reinterventions at long-term follow-up