Totally laparoscopic aortic repair: A new device for direct transperitoneal approach

On the basis of our experience with more than 71 cases of totally laparoscopic aortic surgery by the retrocolic approach, we have developed a new technique by a simple transperitoneal approach. The purpose of this report is to describe that technique and the novel laparoscopic bowel retractor used to ensure stable exposure of the aorta

IRES-based Vector Coexpressing FGF2 and Cyr61 Provides Synergistic and Safe Therapeutics of Lower Limb Ischemia

Due to the lack of an adequate conventional therapy against lower limb ischemia, gene transfer for therapeutic angiogenesis is seen as an attractive alternative. However, the possibility of side effects, due to the expression of large amounts of angiogenic factors, justifies the design of devices that express synergistic molecules in low controlled doses. We have developed an internal ribosome entry site (IRES)–based bicistronic vector expressing two angiogenic molecules, fibroblast growth factor 2 (FGF2), and Cyr61. Through electrotransfer into the ApoE−/− mice hindlimb ischemic muscle model, we show that the IRES-based vector gives more stable expression than either monocistronic plasmid. Furthermore, laser Doppler analysis, arteriography, and immunochemistry clearly show that the bicistronic vector promotes a more abundant and functional revascularization than the monocistronic vectors, despite the fact that the bicistronic system produces 5–10 times less of each angiogenic molecule. Furthermore, although the monocistronic Cyr61 vector accelerates B16 melanoma growth in mice, the bicistronic vector is devoid of such side effects. Our results show an active cooperation of FGF2 and Cyr61 in therapeutic angiogenesis of hindlimb ischemia, and validate the use of IRES-based bicistronic vectors for the coexpression of controlled low doses of therapeutic molecules, providing perspectives for a safer gene therapy of lower limb ischemia

Anévrysmes juxtarénaux, suprarénaux et thoracoabdominaux de type IV (étude comparative des résulats du traitement chirurgical conventionnel)

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Traumatismes vasculaires du membre pelvien associé à une lésion ostéo-articulaire

Il s agit d étudier les modalités et les résultats de la prise en charge des traumatismes vasculaires du membre pelvien associés à une lésion orthopédique par mécanisme de contusion chez 35 patients. Le suivi moyen est de 43 mois. 35 pontages artériels et 5 pontages veineux ont été réalisés associés à 24 fixations externes, 10 ostéosynthèses, 7 immobilisations par attelles. Lors de délabrement cutané peu important, le taux d amputations est de 18,5%. Huit greffes de peau et un lambeau pédiculé ont permis la cicatrisation définitive. Lors de délabrement cutané important le taux d amputations est de 50%. Cinq greffes de peau et 3 lambeaux libres ont permis la cicatrisation définitive. L appui a été obtenu dans tous les cas avec un résultat neurologique satisfaisant. Un taux de sauvetage fonctionnel satisfaisant peut être obtenu d autant que la prise en charge est précoce et multidisciplinaire. Le pronostic est dominé par l étendue des lésions des parties mollesTOULOUSE3-BU Santé-Centrale (315552105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Internal ribosome entry site-based vectors for combined gene therapy.

peer reviewedGene therapy appears as a promising strategy to treat incurable diseases. In particular, combined gene therapy has shown improved therapeutic efficiency. Internal ribosome entry sites (IRESs), RNA elements naturally present in the 5' untranslated regions of a few mRNAs, constitute a powerful tool to co-express several genes of interest. IRESs are translational enhancers allowing the translational machinery to start protein synthesis by internal initiation. This feature allowed the design of multi-cistronic vectors expressing several genes from a single mRNA. IRESs exhibit tissue specificity, and drive translation in stress conditions when the global cell translation is blocked, which renders them useful for gene transfer in hypoxic conditions occurring in ischemic diseases and cancer. IRES-based viral and non viral vectors have been used successfully in preclinical and clinical assays of combined gene therapy and resulted in therapeutic benefits for various pathologies including cancers, cardiovascular diseases and degenerative diseases

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