The role of biomechanics in the assessment of carotid atherosclerosis severity: a numerical approach

Numerical fluid biomechanics has been proved to be an efficient tool for understanding vascular diseases including atherosclerosis. There are many evidences that atherosclerosis plaque formation and rupture are associated with blood flow behavior. In fact, zones of low wall shear stress are vivid areas of proliferation of atherosclerosis, and in particular, in the carotid artery. In this paper a model is presented for investigating how the presence of the plaque influences the distribution of the wall shear stress. In complement to a first approach with rigid walls, an FSI model is developed as well to simulate the coupling between the blood flow and the carotid artery deformation. The results show that the presence of the plaque causes an attenuation of the WSS in the after-plaque region as well as the emergence of recirculation areas

Realization of Conductive Wells for Rear Side Electrical Contact of Integrated Solar Cell

AbstractThe so-called integrated solar cell (i-Cell) consists of several small area sub-cells manufactured by bonding monocrystalline Si (mono-Si) thin foils (20-60μm) ontocost effective insulating substrates on which local conductive wells have been previously integrated. In this paper, we report on the realization of deep recrystallized conductive wells acting as the rear side electrical contact of each sub-cell. These conductive wells have been produced by screen-printing of a thick aluminum (Al) layer followed by a fast-firing process for the formation of the back electrode of each sub-cell. The i-Cell delivers a high voltage and a low current, which reduces the resistive losses in the interconnections of i-cells and modules. The influence of firing temperature profile on the depths and electrical properties of conductive wells are investigated. The feasibility of i-Cell realized on these deep recrystallized conductive wells has been demonstrated. The preliminary results, obtained from 156x156 mm2 i-Cell on which four sub-cells are connected in series, show an efficiency over 16%, with a short circuit current of 2.1 A and an open circuit voltage of 2.5V

Una combinación nueva en Erica (Ericaceae).

[EN] A new nomenclatural status and combination is proposed for Erica cinerea var. numidica. New data about the morphology, chorology and ecology of this taxon are given.[ES] Una combinación nueva en Erica (Ericaceae).- Se propone un nuevo estatus y combinación nomenclatural para Erica cinerea var. numidica. Se aportan nuevos datos sobre la morfología, corología y ecología de este taxón.This work has been supported by “Ajuts a grups de recerca consolidats: 2005SGR00344 and 2009SGR0439, Generalitat de Catalunya” and "Proyectos Intramurales de Incorporación del CSIC: 2009930I161".Peer reviewe

The complementary roles of dynamic contrast-enhanced MRI and 18F-fluorodeoxyglucose PET/CT for imaging of carotid atherosclerosis

Inflammation and neovascularization in vulnerable atherosclerotic plaques are key features for severe clinical events. Dynamic contrast-enhanced (DCE) MRI and FDG PET are two noninvasive imaging techniques capable of quantifying plaque neovascularization and inflammatory infiltrate, respectively. However, their mutual role in defining plaque vulnerability and their possible overlap has not been thoroughly investigated. We studied the relationship between DCE-MRI and [supersript 18]F-FDG PET data from the carotid arteries of 40 subjects with coronary heart disease (CHD) or CHD risk equivalent, as a substudy of the dal-PLAQUE trial (NCT00655473)

Optimal management of asymptomatic carotid stenosis in 2021: the jury is still out. An International, multispecialty, expert review and position statement

Objectives: The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement is to reconcile the conflicting views on the topic. Materials and methods: A literature review was performed with a focus on data from recent studies. Results: Several clinical and imaging high-risk features have been identified that are associated with an increased long-term ipsilateral ischemic stroke risk in patients with ACS. Such high-risk clinical/imaging features include intraplaque hemorrhage, impaired cerebrovascular reserve, carotid plaque echolucency/ulceration/ neovascularization, a lipid-rich necrotic core, a thin or ruptured fibrous cap, silent brain infarction, a contralateral transient ischemic attack/stroke episode, male patients <75 years and microembolic signals on transcranial Doppler. There is growing evidence that 80-99% ACS indicate a higher stroke risk than 50-79% stenoses. Conclusions: Although aggressive risk factor control and BMT should be implemented in all ACS patients, several high-risk features that may increase the risk of a future cerebrovascular event are now documented. Consequently, some guidelines recommend a prophylactic carotid intervention in high-risk patients to prevent future cerebrovascular events. Until the results of the much-anticipated randomized controlled trials emerge, the jury is still out regarding the optimal management of ACS patients

Optimal Management of Asymptomatic Carotid Stenosis in 2021:The Jury is Still Out. An International, Multispecialty, Expert Review and Position Statement

Objectives: The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement is to reconcile the conflicting views on the topic. Materials and methods: A literature review was performed with a focus on data from recent studies. Results: Several clinical and imaging high-risk features have been identified that are associated with an increased long-term ipsilateral ischemic stroke risk in patients with ACS. Such high-risk clinical/imaging features include intraplaque hemorrhage, impaired cerebrovascular reserve, carotid plaque echolucency/ulceration/ neovascularization, a lipid-rich necrotic core, a thin or ruptured fibrous cap, silent brain infarction, a contralateral transient ischemic attack/stroke episode, male patients < 75 years and microembolic signals on transcranial Doppler. There is growing evidence that 80–99% ACS indicate a higher stroke risk than 50–79% stenoses. Conclusions: Although aggressive risk factor control and BMT should be implemented in all ACS patients, several high-risk features that may increase the risk of a future cerebrovascular event are now documented. Consequently, some guidelines recommend a prophylactic carotid intervention in high-risk patients to prevent future cerebrovascular events. Until the results of the much-anticipated randomized controlled trials emerge, the jury is still out regarding the optimal management of ACS patients

Morphological and functional imaging of the atherosclerotic plaque

La compréhension des mécanismes précis conduisant à la formation d'une plaque d'athérosclérose et à sa déstabilisation provoquant infarctus du myocarde ou accident vasculaire cérébral est fondamentale pour l'amélioration de la prévention, du dépistage et du traitement. Notre travail de thèse a porté sur l'analyse et le développement des modalités d'imagerie de la plaque d'athérosclérose afin d'améliorer notre capacité à suivre in vivo l'évolution de cette maladie. Nous proposons, après une introduction sur l'athérosclérose et la notion de plaque vulnérable, une revue des modèles animaux d'athérosclérose et l'intérêt du suivi en imagerie par résonance magnétique. Différentes modalités permettent le suivi en imagerie de la plaque d'athérosclérose. En pratique clinique, l'Imagerie par Résonance Magnétique (IRM) haute résolution est reconnue comme étant une modalité fiable et reproductible de caractérisation morphologique de la plaque carotidienne. Nous démontrons que l'injection de Gadolinium utilisée classiquement pour visualiser la lumière des vaisseaux permet également de préciser la caractérisation de la plaque carotidienne en donnant des informations sur la néovascularisation, la matrice extracellulaire et son statut inflammatoire. La caractérisation fonctionnelle de la plaque peut également être appréciée par l'injection de particules de fer en IRM ou par l'injection de radio-traceur comme le 18Ffluorodesoxyglucose en Tomographie par Emission de Positron (TEP). Le couplage de l'IRM et de la TEP de développement récent nous a permis de montrer une plus grande sensibilité de signal en TEP qu'en IRM avec particules de fer pour détecter les changements inflammatoires observés dans des plaques d'athérome d'aorte de lapin. Les applications actuelles de l'imagerie de l'athérosclérose sont nombreuses permettant de juger de l'efficacité thérapeutique d'un médicament ou d'identifier les patients à plus haut risque d'évènement cardiovasculaireA better understanding of mechanisms leading to the formation of an atherosclerotic plaque and its destabilization causing myocardial infarction or stroke is fundamental to improve prevention, detection and treatment. Our work focused on development of imaging modalities of atherosclerotic plaque in order to improve our ability to monitor in vivo the progression of this disease. We propose, after an introduction to the concept of atherosclerosis and vulnerable plaque, a review of existing animal models of atherosclerosis and the interest of monitoring with magnetic resonance imaging. Different methods allow imaging of atherosclerotic plaque. In clinical practice, Magnetic Resonance Imaging (MRI) is recognized as a reliable and reproducible tool for morphological characterization of carotid plaque. We demonstrate that Gadolinium conventionally used to visualize the lumen of the vessels also allows a characterization of carotid plaque with information on neovascularization, extracellular matrix and inflammatory status. The functional characterization of the atherosclerotic plaque can be assessed with iron particles in MRI or with radiotracer such as 18Ffluorodeoxyglucose in positron emission tomography (PET). Combined PET-MR systems allowed us to show a better sensitivity of PET signal than USPIO-MR signal to detect early inflammatory changes in atherosclerotic plaque of rabbit aorta. We also provide some current clinical applications of atherosclerosis imaging (drug efficacy or identification of high risk patients

Angioplastie transluminale de l'artère fémorale commune et de sa bifurcation (résultats à court terme)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Les résultats à court et long terme des pontages aortobifémoraux pour maladie occlusive sont-ils TASC dépendants ?

LYON1-BU Santé (693882101) / SudocSudocFranceF

Athérosclérose carotidienne symptomatique (évolution de l'instabilité de la plaque selon le délai de l'accident cérébral)

LYON1-BU Santé (693882101) / SudocSudocFranceF