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Papers by rené anxionnat

Pierre-Frédéric Villard started a one year full time CNRS delegation in September 2014 in the Har... more Pierre-Frédéric Villard started a one year full time CNRS delegation in September 2014 in the Harvard Biorobotics Laboratory. 9. Dissemination 9.1. Promoting Scientific Activities 9.1.1. Scientific events selection 9.1.1.1. Organizing committee membership M.-O. Berger was chair of the French conference on pattern recognition RFIA 2014. 9.1.1.2. Conference program committee membership • M.-O. Berger was member of the program committee of the following conferences: International

Annals of Neurology, 2020

Whether the time from intravenous thrombolysis (IVT) to endovascular treatment (EVT) in patients ... more Whether the time from intravenous thrombolysis (IVT) to endovascular treatment (EVT) in patients with acute ischemic stroke has an effect on the functional outcome is unknown.

Journal of NeuroInterventional Surgery, 2020

BackgroundTo date, the choice of optimal anesthetic management during endovascular therapy (EVT) ... more BackgroundTo date, the choice of optimal anesthetic management during endovascular therapy (EVT) of acute ischemic stroke patients remains subject to debate. We aimed to compare functional outcomes and complication rates of EVT according to the first-line anesthetic management in two comprehensive stroke centers: local anesthesia (LA) versus general anesthesia (GA).MethodsRetrospective analysis of prospectively collected databases, identifying all consecutive EVT for strokes in the anterior circulation performed between January 1, 2018 and December 31, 2018 in two EVT-capable stroke centers. One center performed EVT under LA in the first intention, while the other center systematically used GA. Using propensity score analysis, the two groups underwent 1:1 matching, then procedural metrics, complications, and clinical outcomes were compared. Good outcome was defined as 90 days modified Rankin Scale (mRS) ≤2, and successful recanalization as modified Thrombolysis In Cerebral Ischemia ...

Background: Chronic encapsulated intracerebral hematomas (CEIHs) are a rare, late complication of... more Background: Chronic encapsulated intracerebral hematomas (CEIHs) are a rare, late complication of radiosurgery for intracranial AVM. We present 5 cases treated mostly by surgical excision and review the literature. Methods: Patients (age 39, 42, 36, 31, 62) presented with headache, paresthesia, hemiparesis or were asymptomatic. CEIHs presented 10 to 13 years (median 12 years) post radiosurgery. Three patients had demonstrated early radiation induced changes post radiosurgery. Angiographic cure, assessed with DSA, was present in all cases except 1 case with a small nidus remnant. MRI demonstrated mixed lesions with a solid enhancing part, organized hematoma and extensive surrounding edema while three cases had also a cystic component. Results: Excision of the CEIHs with complete or partial removal of the capsule was perfomed in 4 patients and resulted in marked clinical improvement. On patient was managed conservatively with administration of steroids as surgery was judged excessivel...

Journal of the American Heart Association, 2019

Background The association between time to reperfusion and clinical outcome is well known in ante... more Background The association between time to reperfusion and clinical outcome is well known in anterior circulation strokes, whereas the impact of main time metrics remains unknown in posterior circulation strokes. We investigated the clinical effect of different time intervals from symptom onset to reperfusion on the 90‐day clinical outcome in acute ischemic stroke patients with basilar artery occlusion, and especially in the subset population presenting a low stroke volume on baseline diffusion‐weighted imaging. Methods and Results We studied patients included in the prospective, multicenter, observational ETIS (Endovascular Treatment in Ischemic Stroke) registry who had had basal artery occlusion and had achieved successful reperfusion (modified Thrombolysis In Cerebral Infarction 2b‐3). Three time intervals (onset to reperfusion, onset to imaging, and imaging to reperfusion) were considered in all patients and separately in patients with pc‐ ASPECTS (posterior‐circulation Alberta ...

JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA, 2018

Objectives: Symptomatic intracranial atheromatous disease has an unfavorable prognosis. The endov... more Objectives: Symptomatic intracranial atheromatous disease has an unfavorable prognosis. The endovascular treatment with percutaneous transluminal angioplasty (PTA) stent assisted must be held in accordance with the efficacy, safety, complications and the risk of restenosis in the long term. Materials and methods: A study conducted between 1996 and 2008, includes 28 patients with 30 cases of stenosis located in the internal carotid artery (11), basilar artery (14) and vertebral artery (5). All cases were symptomatic even under anticoagulation treatment and the stenosis grade > 60% (average 83.5%). Results: There was a significant reduction in the degree of stenosis (less than 50%), with an average residual stenosis of 36.8%. There were two complications, with reperfusion bruising (6.6%). In the long term monitoring, we found a single case of restenosis and no patient had a transient or permanent ischemic stroke. Conclusion: The treatment of intracranial stenosis with stentassisted...

Frontiers in Neurology, 2019

Conclusion: Emergent stenting of the cervical carotid lesion with antithrombotic agents in conjun... more Conclusion: Emergent stenting of the cervical carotid lesion with antithrombotic agents in conjunction to thrombectomy appears to be the best treatment strategy for acute ischemic strokes with tandem lesions. These findings will be further investigated in the ongoing randomized controlled TITAN trial.

Stroke, 2018

Background and Purpose— Although successful reperfusion is usually defined as a modified Thrombol... more Background and Purpose— Although successful reperfusion is usually defined as a modified Thrombolysis in Cerebral Infarction (mTICI) 2B or 3 at the end of the procedure, studies have shown that mTICI 2B patients had poorer functional outcomes than TICI 3 patients. An mTICI 2C category has been recently introduced for patients with near-complete perfusion except for slow flow in a few distal cortical vessels or presence of small distal cortical emboli after mechanical thrombectomy. The purpose of this study was to evaluate the difference in functional outcome between patients achieving successful reperfusion (ie, mTICI 2B, mTICI 2C, and TICI 3 scores). Methods— Ancillary study from the ASTER (Contact Aspiration Versus Stent Retriever for Successful Revascularization) prospective multicenter blinded end point trial. Reperfusion results are reported as the mTICI score, including the mTICI 2C grade. Primary outcome was the percentage of patients with favorable outcome defined as a 90-da...

The Lancet. Neurology, 2018

Evidence regarding whether imaging can be used effectively to select patients for endovascular th... more Evidence regarding whether imaging can be used effectively to select patients for endovascular thrombectomy (EVT) is scarce. We aimed to investigate the association between baseline imaging features and safety and efficacy of EVT in acute ischaemic stroke caused by anterior large-vessel occlusion. In this meta-analysis of individual patient-level data, the HERMES collaboration identified in PubMed seven randomised trials in endovascular stroke that compared EVT with standard medical therapy, published between Jan 1, 2010, and Oct 31, 2017. Only trials that required vessel imaging to identify patients with proximal anterior circulation ischaemic stroke and that used predominantly stent retrievers or second-generation neurothrombectomy devices in the EVT group were included. Risk of bias was assessed with the Cochrane handbook methodology. Central investigators, masked to clinical information other than stroke side, categorised baseline imaging features of ischaemic change with the Al...

Journal of Neuroradiology, 2017

ère sous-section : (Bactériologie-virologie ; hygiène hospitalière) Professeur Alain LOZNIEWSKI-P... more ère sous-section : (Bactériologie-virologie ; hygiène hospitalière) Professeur Alain LOZNIEWSKI-Professeure Evelyne SCHVOERER 2 ème sous-section : (Parasitologie et Mycologie) Professeure Marie MACHOUART 3 ème sous-section : (Maladies infectieuses ; maladies tropicales) Professeur Thierry MAY-Professeure Céline PULCINI-Professeur Christian RABAUD 46 ème Section : SANTÉ PUBLIQUE, ENVIRONNEMENT ET SOCIÉTÉ 1 ère sous-section : (Épidémiologie, économie de la santé et prévention) Professeur François ALLA-Professeur Francis GUILLEMIN-Professeur Denis ZMIROU-NAVIER 3 ème sous-section : (Médecine légale et droit de la santé) Professeur Henry COUDANE 4 ème sous-section : (Biostatistiques, informatique médicale et technologies de communication) Professeure Eliane ALBUISSON-Professeur Nicolas JAY 47 ème Section : CANCÉROLOGIE, GÉNÉTIQUE, HÉMATOLOGIE, IMMUNOLOGIE 1 ère sous-section : (Hématologie ; transfusion) Professeur Pierre FEUGIER 2 ème sous-section : (Cancérologie ; radiothérapie

Medical Image Analysis, 2017

Endovascular interventions can benet from interactive simulation in their training phase but also... more Endovascular interventions can benet from interactive simulation in their training phase but also during pre-operative and intra-operative phases if simulation scenarios are based on patient data. A key feature in this context is the ability to extract, from patient images, models of blood vessels that impede neither the realism nor the performance of simulation. This paper addresses both the segmentation and reconstruction of the vasculature from 3D Rotational Angiography data, and adapted to simulation: An original tracking algorithm is proposed to segment the vessel tree while ltering points extracted at the vessel surface in the vicinity of each point on the centerline; then an automatic procedure is described to reconstruct each local unstructured point set as a skeletonbased implicit surface (blobby model). The output of successively applying both algorithms is a new model of vasculature as a tree of local implicit models. The segmentation algorithm is compared with Multiple Hypothesis Testing (MHT) algorithm [17] on patient data, showing its greater ability to track blood vessels. The reconstruction algorithm is evaluated on both synthetic and patient data and demonstrate its ability to t points with a subvoxel precision. Various tests are also reported where our model is used to simulate catheter navigation in interventional neuroradiology. An excellent realism, and much lower computational costs are reported when compared to triangular mesh surface models.

Journal of Neuroradiology, 2010

tridimensionnel et expert de l'artère carotide interne, qui constitue le danger majeur de ce geste.

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Bulletin de l'Académie nationale de médecine, 2009

First developed in the 1960s, interventional neuroradiology has vastly improved the management of... more First developed in the 1960s, interventional neuroradiology has vastly improved the management of patients with vascular diseases of the brain and spine, including vascular malformations and stroke. Gradually replacing open-skull neurosurgical approaches, endovascular occlusion of ruptured intracranial aneurysms has improved the post-bleed prognosis. With the increasing number of fortuitously discovered aneurysms, international randomized studies are being organized to determine whether preventive treatment is better than abstention. A wide range of therapeutic strategies are available for brain arteriovenous malformations, including hyperselective embolization, open-skull surgery, radiosurgery, and abstention. The choice depends on multiple parameters, including symptoms, clinical status, the angioarchitecture of the malformation, and the patient's psychology and wishes (...).

Neuroimaging clinics of North America, 2006

Aneurysm diagnosis has evolved considerably over the last years. Technological advances have brou... more Aneurysm diagnosis has evolved considerably over the last years. Technological advances have brought CT angiography and MR angiography to the forefront of ruptured and nonruptured intracranial aneurysm diagnosis. This article highlights current diagnostic modalities for intracranial aneurysms.

AJNR. American journal of neuroradiology

Controversy still surrounds the question of when and how to manage cases of subarachnoid hemorrha... more Controversy still surrounds the question of when and how to manage cases of subarachnoid hemorrhage of Hunt and Hess grade IV and V aneurysms. Several authors are in favor of surgical treatment, reporting improved clinical outcomes and lower mortality rates. Considering that endovascular procedures are currently being increasingly used to treat aneurysms, we investigated their use in the management of subarachnoid bleeding in a retrospective review of 80 patients. Eighty patients were admitted to our hospital between October 1992 and October 1998 with subarachnoid hemorrhage of Hunt and Hess grade IV and V aneurysms. Patients received standard resuscitation treatment, nimodipine to prevent vasospasm, CSF shunt when necessary, and selective occlusion with Guglielmi detachable coil. They were subsequently followed up for at least 1 year. Aneurysm occlusion was monitored with MR angiography and/or angiography at 6 months and at 1 year. Of the 80 patients, 42 (52.5%) did well (Glasgow O...

Radiology, 2012

Note: This copy is for your personal non-commercial use only. To order presentation-ready copies ... more Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights.

Lecture Notes in Computer Science, 2004

Various medical treatments require an accurate determination of the shape of a considered anatomi... more Various medical treatments require an accurate determination of the shape of a considered anatomic structure. The shape is often recovered from several delineations performed on a two-dimensional gold standard imagery. Using true 3D imagery is attractive to supplement this gold standard. However, before using 3D modalities in clinical routine, it must be proved that these modalities are well suited to the delineation task. We propose in this paper a methodology for validating a new imaging modality with respect to a reference imagery.

Medical Imaging 2001: Image Processing, 2001

An automated algorithm for frameless registration of intra-cranial 3D X-ray angiograms (3DXA) to ... more An automated algorithm for frameless registration of intra-cranial 3D X-ray angiograms (3DXA) to Magnetic Resonance (MR) images is described and evaluated. The registration procedure starts with the manual designation of a pre-defined anatomical point in both modalities. Then, the registration is performed through an iterative process that alternatively estimates the rotation and translation using an original correlation optimization scheme. The evaluation procedure implied comparisons with both manual (11 cases) and stereotactic frame based (9 cases) registration. The results encompass that manual registration is not a viable method of reference for registering such volumes whereas stereotactic frame (or equivalent means) is acceptable for validation purpose. A maximum error of 4 mm was measured for our automated algorithm while variations of up to 5 mm were considered on the initial point location. Convergence time was below 1 minute while an average time of 30 minutes was required to perform manual registration. This validation procedure demonstrates a good precision for the automated algorithm when compared to a stereotactic frame based matching. Such an algorithm could make the intra-cranial pathology assessment more reliable, enable frameless radiotherapy planning of AVMs in 3D, ease biopsy planning in neurosurgery or be helpful for educational purpose.