Hélène Wattez | Université de Lille (original) (raw)

Papers by Hélène Wattez

Research paper thumbnail of Case report - Thoracic oncologic Primary pulmonary myoepithelial carcinoma

Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial ca... more Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial carcinoma belongs to this group. Since it was first described in 1998, we have identified only seven actual cases reported in the literature so far. We describe the case of a nonsmoker 60-year-old Caucasian female, who was referred to our institution for the treatment of three peripheral nodules. Her medical history revealed that a wedge resection, for pulmonary myoepithelial carcinoma, was performed in another center 15 months previously. After resection of the current nodules, the histological findings showed three myoepithelial carcinomas of the lung. There was no vascular or lymphatic invasion. The hilar and mediastinal lymph nodes were negatives. The patient is doing well without any sign of recurrence. Herein we shall discuss the case of a primary pulmonary myoepithelial carcinoma in a female and propose a brief review of the literature.  2011 Published by European Association for C...

Research paper thumbnail of Outcomes of endovascular aneurysm repair performed in abdominal aortic aneurysms with large infrarenal necks

Journal of Vascular Surgery, 2017

Objective: The aim of this study was to evaluate midterm clinical and morphologic outcomes after ... more Objective: The aim of this study was to evaluate midterm clinical and morphologic outcomes after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) with large ($28 mm) infrarenal neck. Methods: From 2009 to 2012, we prospectively collected and retrospectively analyzed clinical, morphologic, and intraoperative and postoperative data of patients undergoing EVAR for wide-neck AAA at three European vascular surgery units. All patients had computed tomography angiography follow-up of $24 months. The early end points were technical success and proximal type I endoleak at 30 days. The midterm end points were type Ia endoleak, freedom from reintervention (FFR), survival, AAA-related mortality, and infrarenal and suprarenal aortic diameter progression. The aortic diameters were measured on three-dimensional workstation center lumen line reconstructions, 1 cm below the lowest renal artery, at the level of the renal arteries, at the superior mesenteric artery, and at the celiac trunk. Preoperative and 24-month aortic diameters were compared by paired t-test. Survival and FFR were evaluated by Kaplan-Meier analysis. Results: During the study period, 118 patients (74 6 8 years) were enrolled. The mean aneurysm diameter was 61 6 10 mm. Suprarenal and infrarenal fixation endografts were implanted in 102 (86%) and 16 (14%) patients, respectively. The mean main body oversizing was 17% 6 9%. Technical success rate was 98% (three type Ia endoleaks at 30 days). The mean follow-up was 38 6 12 months. Fourteen type Ia endoleaks (12%) were detected during follow-up. Survival at 3 years and 5 years was 89% and 70%, respectively. Four deaths (3.4%) were type Ia endoleak related. FFR at 1 year, 3 years, and 5 years was 96%, 83%, and 82%, respectively. Eight reinterventions (7%) were proximal neck related. All infrarenal and suprarenal aortic diameters increased at 24 months. The mean increase was 11% for the lowest renal artery (29.1 6 1.1 mm preoperatively vs 32.3 6 4.5 mm at 24 months; P < .001), 3% to 5% at the level of the renal arteries, and <3% for the superior mesenteric artery and the celiac trunk. Neck length <15 mm (P ¼ .032), stainless steel endograft (P ¼ .003), and type Ia endoleak at 24 months (P ¼ .001) were associated with infrarenal neck enlargement on multivariate logistic regression. Conclusions: EVAR performed in AAAs with large necks is associated with a significant infrarenal aortic neck enlargement at 24 months as well as with a high risk of proximal type I endoleak and proximal neck-related reinterventions. In this subgroup of patients, main body oversizing >15% and suprarenal sealing should be considered.

Research paper thumbnail of Mid-term Results of Femoro-popliteal Stenting among Patients Presenting Early Atheromatous Lesions of the Lower Extremities

Annals of Vascular Surgery, 2017

presenting more severe lesions than those treated by endovascular route with comparable results a... more presenting more severe lesions than those treated by endovascular route with comparable results at one year. The benefits expected in terms of long-term patency of aorto-bi-femoral bypass compared to stenting justify proposing robot-assisted surgery in younger patients, while keeping a mini-invasive attitude.

Research paper thumbnail of Results of celiac trunk stenting during fenestrated or branched aortic endografting

Journal of Vascular Surgery, 2016

Background: Endovascular repair of aortic aneurysms involving the visceral segment of the aorta o... more Background: Endovascular repair of aortic aneurysms involving the visceral segment of the aorta often requires placement of a covered bridging stent in the celiac axis (CA). The median arcuate ligament (MAL) is a fibrous arch that unites the diaphragmatic crura on either side of the aortic hiatus. The ligament may compress and distort the celiac artery and result in difficult cannulation, or stenosis and occlusion of the vessel. This study evaluated the influence of the MAL compression on the technical success and the patency of the celiac artery after branched and fenestrated endovascular aortic repair. Methods: We retrospectively analyzed a cohort of consecutive patients treated electively for complex aneurysms with branched and fenestrated endovascular aortic repair between January 2007 and April 2014. All data were collected prospectively. Analysis of preoperative computed tomography angiography on a three-dimensional workstation determined the presence of MAL compression. Patency of the CA bridging stent was assessed during follow-up by computed tomography angiography and duplex ultrasound evaluation. Statistical analysis was performed to compare the outcomes of patients with MAL (MALþ) and without MAL (MAL-) compression. Results: Of 315 patients treated for aortic disease involving the visceral segment during the study period, 113 had endografts designed with a branch (n ¼ 57) or fenestration (n ¼ 56) for the CA. In 45 patients (39.8%), asymptomatic compression of the CA by the MAL was depicted (MALþ). Complex endovascular techniques were required in this group to access the CA in 16 (14.2%) patients (vs none in the MAL-group; P ¼ .003), which lead to a failed bridging stent implantation in seven patients (6.2%). Increased operative time and dose area product were observed in the MALþ group, but this did not reach statistical significance. In the MALþ group, no thrombosis of the CA bridging stents were observed during follow-up; an external compression of the CA bridging stent was depicted in six patients but without hemodynamic effect on duplex ultrasound imaging. In the MAL-group, one CA bridging stent occlusion occurred owing to an embolus from a cardiac source. Conclusions: MAL compression is associated with good celiac trunk bridging stent patency during follow-up, but with a higher rate of technical difficulties and failed bridging stent implantation during the procedure.

Research paper thumbnail of FT21. Results of Celiac Trunk Stenting During Fenestrated or Branched Aortic Endografting

Journal of Vascular Surgery, 2016

Research paper thumbnail of Bronchopericardial Fistula After a Pulmonary Resection

The Annals of Thoracic Surgery, 2013

Research paper thumbnail of Evolution of the management of the aneurysms of the duodeno-pancreatic arcade

Annals of Vascular Surgery, 2017

hypertension in five cases, a degradation of the renal function in five cases, and a systematic D... more hypertension in five cases, a degradation of the renal function in five cases, and a systematic Doppler in 16 cases. All the patients were evaluated by ultrasound and MRI before arteriography. Peroperative measurement of pressure was systematic. Post-angioplasty monitoring was biological, hemodynamic and by ultrasound. Results: The treatment was carried out by a femoral transcutaneous approach with 13 ipsilateral punctures and 13 contralateral punctures. The average degree of stenosis was 70% [60-80%]. The stenoses were observed between three months (10 cases) and 28 months after transplantation. One case of immediate arterial thrombosis was observed (3.8%). Sixteen angioplasties were carried out for ostial lesions, 10 procedures were carried out for truncal lesions and one angioplasty was done for branch lesions. The procedure was a simple angioplasty in 16 cases and associated with stenting in 11 cases. Recurrence was observed in two cases (7.6%). The lesions were re-dilated and stented in one case with active stents. A dissection without stenosis was observed in three cases. Two migrations of stent were seen. The immediate improvement or a stabilization of the renal function was observed in most patients. In all the cases revealed by hypertension (HBP), one could note an improvement of the blood pressure or a reduction in the number of drugs required to treat the HBP. The one-year death rate and the return in dialysis were 3.8% and 15.3%, respectively. Conclusion: The angioplasty of the renal arteries of transplanted kidneys is reliable but the rate of dissections or thromboses remains high. Angioplasty allows an improvement of the lifespan of the renal graft.

Research paper thumbnail of FT10. Mid-term Outcomes of EVAR Performed in AAA With Large Infrarenal Necks

Journal of Vascular Surgery, 2015

Objectives: This study compared outcomes of an iliacbranched device (IBD) and the sandwich techni... more Objectives: This study compared outcomes of an iliacbranched device (IBD) and the sandwich technique (ST) for preservation of hypogastric flow in the setting of aortoiliac aneurysm repair. Methods: Between 2010 and 2014, patients of two high-volume vascular centers referred for elective repair of abdominal aortic aneurysms (AAAs) involving iliac bifurcation or isolated common iliac artery (CIA) aneurysms underwent IBD placement or ST. Clinical and anatomic data, operative intervention, and outcomes were collected prospectively and analyzed retrospectively. Results: Thirty-seven patients underwent 40 procedures: 20 IBD and 20 ST, with placement of aortic endograft in 28 patients (70%). Technical success rate were comparable in both groups (95% vs 100%, P ¼ 1). Three external iliac artery (EIA) limbs and one internal iliac artery (IIA) stent thrombosed in the ST group. Early and late patency rates were not statistically different in the IBD group (100% and 94.7%) and in the ST group (90% and 80%; P > .05). There was no statistical difference between both groups regarding endoleaks onset (P ¼ .2). One patient suffered of transient buttock claudication after branched device IIA stent thrombosis. Reintervention rates were comparable in both groups (P ¼ .1). Both techniques permitted comparable aneurysm sac shrinkage (P ¼ .7). No rupture, colonic ischemia, or arterial access complication was noticed. Conclusions: In this retrospective study, IBD and ST provided similar outcomes for aortoiliac aneurysm treatment with hypogastric preservation. The sandwich technique represents a reliable alternative to IBD when the latter is not feasible, making patients more eligible for endovascular treatment. Further larger cohort studies are warranted to confirm these encouraging results.

Research paper thumbnail of Predictive Role of the Rate of preoperative C-reactive Protein in Limb Salvage and Postoperative Restenosis After Tibial Arteries Angioplasty

Annals of Vascular Surgery, 2015

Research paper thumbnail of FT10. Mid-term Outcomes of EVAR Performed in AAA With Large Infrarenal Necks

Journal of Vascular Surgery, 2015

Research paper thumbnail of Comparison of Short- and Mid-Term Follow-Up Between Standard and Fenestrated Endografts

Annals of Vascular Surgery, 2013

This study compared early and mid-term results of endovascular treatment for abdominal aortic ane... more This study compared early and mid-term results of endovascular treatment for abdominal aortic aneurysms (AAAs) and pararenal aneurysms (PRAs). Using data from a prospective database, patients treated with endografts for AAA and PRA between January 2007 and December 2009 were analyzed. In both groups, mortality, endoleak rates, evolution of renal function, reintervention rate at 30 days and at mid-term follow-up, and aneurysmal sac evolution at 1 year were compared. In total, 379 patients were included: 264 treated for AAA and 115 for PRA. Median follow-up was 24 months (range 12-46 months) in both groups. Risk factors and medical history were comparable in both groups, except for chronic renal failure (higher in the PRA group; P = 0.003). The mortality rates at 30 days were 1% and 3% in the AAA and APR groups, respectively (P = 0.10). During follow-up, the mortality rates were 11.1% and 12.8% in the AAA and PRA groups, respectively (P = 0.72). The reoperation rates at 30 days were 8% and 10% in the AAA and PRA groups, respectively (P = 0.72). During follow-up, the reoperation rates were 9.2% and 9.9% in the AAA and PRA groups, respectively (P = 0.85). At 1 year, retraction of the aneurysmal sac was diagnosed in 48% of the patients in the AAA group and in 56% of the patients in the PRA group (P = 0.41). The incidence rates of new postoperative cases of renal insufficiency were 19.3% and 8.1% in the AAA and PRA groups, respectively (P = 0.008). At 30 days, the endoleak rates were 27.5% and 12.7% in the AAA and PRA groups, respectively (P = 0.001). At 1 year, the endoleak rates were 19.4% and 7.3% in the AAA and PRA groups, respectively (P = 0.007). When type II endoleaks were excluded, the endoleak rates were comparable in both groups (P = 0.5). At 1 year, in both groups, a retraction of the aneurysmal sac was significantly correlated to the absence of endoleak (P = 0.001). Early and mid-term results of AAA treatment with standard endografts and PRA treatment with fenestrated endografts are comparable.

Research paper thumbnail of Compressive Pancreaticoduodenal Artery Aneurysm Associated With Celiac Artery Stenosis

Annals of Vascular Surgery, 2013

Peripancreatic artery aneurysms are a rare condition, representing &amp;amp;amp;amp;amp;amp;a... more Peripancreatic artery aneurysms are a rare condition, representing &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2% of all splanchnic artery aneurysms, and have been significantly related to celiac axis stenosis. While they are most often asymptomatic, those aneurysms have a strong tendency to rupture (52% rupture rate at the initial presentation) and, in this case, the outcome is often dramatic. Given that reports of this disease are rare, appropriate guidelines are difficult to formulate and different treatment strategies have been proposed. Endovascular management seems to be efficient in the large majority of most recent reports, but open surgery still remains necessary for complex cases, especially when associated with celiac axis stenosis. We report a new occurrence of a symptomatic compressive aneurysm related to common bile duct compression that we treated using a hybrid procedure.

Research paper thumbnail of Primary pulmonary myoepithelial carcinoma

Interactive CardioVascular and Thoracic Surgery, 2011

Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial ca... more Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial carcinoma belongs to this group. Since it was first described in 1998, we have identified only seven actual cases reported in the literature so far. We describe the case of a nonsmoker 60-year-old Caucasian female, who was referred to our institution for the treatment of three peripheral nodules. Her medical history revealed that a wedge resection, for pulmonary myoepithelial carcinoma, was performed in another center 15 months previously. After resection of the current nodules, the histological findings showed three myoepithelial carcinomas of the lung. There was no vascular or lymphatic invasion. The hilar and mediastinal lymph nodes were negatives. The patient is doing well without any sign of recurrence. Herein we shall discuss the case of a primary pulmonary myoepithelial carcinoma in a female and propose a brief review of the literature.

Research paper thumbnail of Bronchopericardial Fistula After a Pulmonary Resection

The Annals of Thoracic Surgery, Mar 1, 2013

A 70-year-old patient with vascular comorbidities underwent a middle lobectomy with mediastinal l... more A 70-year-old patient with vascular comorbidities underwent a middle lobectomy with mediastinal lymphadenectomy for a squamous carcinoma classified pT1N0M0. The postoperative course was uneventful, and the patient was discharged on postoperative day 8 with a perfectly clear chest radiograph.

Research paper thumbnail of Case report - Thoracic oncologic Primary pulmonary myoepithelial carcinoma

Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial ca... more Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial carcinoma belongs to this group. Since it was first described in 1998, we have identified only seven actual cases reported in the literature so far. We describe the case of a nonsmoker 60-year-old Caucasian female, who was referred to our institution for the treatment of three peripheral nodules. Her medical history revealed that a wedge resection, for pulmonary myoepithelial carcinoma, was performed in another center 15 months previously. After resection of the current nodules, the histological findings showed three myoepithelial carcinomas of the lung. There was no vascular or lymphatic invasion. The hilar and mediastinal lymph nodes were negatives. The patient is doing well without any sign of recurrence. Herein we shall discuss the case of a primary pulmonary myoepithelial carcinoma in a female and propose a brief review of the literature.  2011 Published by European Association for C...

Research paper thumbnail of Outcomes of endovascular aneurysm repair performed in abdominal aortic aneurysms with large infrarenal necks

Journal of Vascular Surgery, 2017

Objective: The aim of this study was to evaluate midterm clinical and morphologic outcomes after ... more Objective: The aim of this study was to evaluate midterm clinical and morphologic outcomes after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) with large ($28 mm) infrarenal neck. Methods: From 2009 to 2012, we prospectively collected and retrospectively analyzed clinical, morphologic, and intraoperative and postoperative data of patients undergoing EVAR for wide-neck AAA at three European vascular surgery units. All patients had computed tomography angiography follow-up of $24 months. The early end points were technical success and proximal type I endoleak at 30 days. The midterm end points were type Ia endoleak, freedom from reintervention (FFR), survival, AAA-related mortality, and infrarenal and suprarenal aortic diameter progression. The aortic diameters were measured on three-dimensional workstation center lumen line reconstructions, 1 cm below the lowest renal artery, at the level of the renal arteries, at the superior mesenteric artery, and at the celiac trunk. Preoperative and 24-month aortic diameters were compared by paired t-test. Survival and FFR were evaluated by Kaplan-Meier analysis. Results: During the study period, 118 patients (74 6 8 years) were enrolled. The mean aneurysm diameter was 61 6 10 mm. Suprarenal and infrarenal fixation endografts were implanted in 102 (86%) and 16 (14%) patients, respectively. The mean main body oversizing was 17% 6 9%. Technical success rate was 98% (three type Ia endoleaks at 30 days). The mean follow-up was 38 6 12 months. Fourteen type Ia endoleaks (12%) were detected during follow-up. Survival at 3 years and 5 years was 89% and 70%, respectively. Four deaths (3.4%) were type Ia endoleak related. FFR at 1 year, 3 years, and 5 years was 96%, 83%, and 82%, respectively. Eight reinterventions (7%) were proximal neck related. All infrarenal and suprarenal aortic diameters increased at 24 months. The mean increase was 11% for the lowest renal artery (29.1 6 1.1 mm preoperatively vs 32.3 6 4.5 mm at 24 months; P < .001), 3% to 5% at the level of the renal arteries, and <3% for the superior mesenteric artery and the celiac trunk. Neck length <15 mm (P ¼ .032), stainless steel endograft (P ¼ .003), and type Ia endoleak at 24 months (P ¼ .001) were associated with infrarenal neck enlargement on multivariate logistic regression. Conclusions: EVAR performed in AAAs with large necks is associated with a significant infrarenal aortic neck enlargement at 24 months as well as with a high risk of proximal type I endoleak and proximal neck-related reinterventions. In this subgroup of patients, main body oversizing >15% and suprarenal sealing should be considered.

Research paper thumbnail of Mid-term Results of Femoro-popliteal Stenting among Patients Presenting Early Atheromatous Lesions of the Lower Extremities

Annals of Vascular Surgery, 2017

presenting more severe lesions than those treated by endovascular route with comparable results a... more presenting more severe lesions than those treated by endovascular route with comparable results at one year. The benefits expected in terms of long-term patency of aorto-bi-femoral bypass compared to stenting justify proposing robot-assisted surgery in younger patients, while keeping a mini-invasive attitude.

Research paper thumbnail of Results of celiac trunk stenting during fenestrated or branched aortic endografting

Journal of Vascular Surgery, 2016

Background: Endovascular repair of aortic aneurysms involving the visceral segment of the aorta o... more Background: Endovascular repair of aortic aneurysms involving the visceral segment of the aorta often requires placement of a covered bridging stent in the celiac axis (CA). The median arcuate ligament (MAL) is a fibrous arch that unites the diaphragmatic crura on either side of the aortic hiatus. The ligament may compress and distort the celiac artery and result in difficult cannulation, or stenosis and occlusion of the vessel. This study evaluated the influence of the MAL compression on the technical success and the patency of the celiac artery after branched and fenestrated endovascular aortic repair. Methods: We retrospectively analyzed a cohort of consecutive patients treated electively for complex aneurysms with branched and fenestrated endovascular aortic repair between January 2007 and April 2014. All data were collected prospectively. Analysis of preoperative computed tomography angiography on a three-dimensional workstation determined the presence of MAL compression. Patency of the CA bridging stent was assessed during follow-up by computed tomography angiography and duplex ultrasound evaluation. Statistical analysis was performed to compare the outcomes of patients with MAL (MALþ) and without MAL (MAL-) compression. Results: Of 315 patients treated for aortic disease involving the visceral segment during the study period, 113 had endografts designed with a branch (n ¼ 57) or fenestration (n ¼ 56) for the CA. In 45 patients (39.8%), asymptomatic compression of the CA by the MAL was depicted (MALþ). Complex endovascular techniques were required in this group to access the CA in 16 (14.2%) patients (vs none in the MAL-group; P ¼ .003), which lead to a failed bridging stent implantation in seven patients (6.2%). Increased operative time and dose area product were observed in the MALþ group, but this did not reach statistical significance. In the MALþ group, no thrombosis of the CA bridging stents were observed during follow-up; an external compression of the CA bridging stent was depicted in six patients but without hemodynamic effect on duplex ultrasound imaging. In the MAL-group, one CA bridging stent occlusion occurred owing to an embolus from a cardiac source. Conclusions: MAL compression is associated with good celiac trunk bridging stent patency during follow-up, but with a higher rate of technical difficulties and failed bridging stent implantation during the procedure.

Research paper thumbnail of FT21. Results of Celiac Trunk Stenting During Fenestrated or Branched Aortic Endografting

Journal of Vascular Surgery, 2016

Research paper thumbnail of Bronchopericardial Fistula After a Pulmonary Resection

The Annals of Thoracic Surgery, 2013

Research paper thumbnail of Evolution of the management of the aneurysms of the duodeno-pancreatic arcade

Annals of Vascular Surgery, 2017

hypertension in five cases, a degradation of the renal function in five cases, and a systematic D... more hypertension in five cases, a degradation of the renal function in five cases, and a systematic Doppler in 16 cases. All the patients were evaluated by ultrasound and MRI before arteriography. Peroperative measurement of pressure was systematic. Post-angioplasty monitoring was biological, hemodynamic and by ultrasound. Results: The treatment was carried out by a femoral transcutaneous approach with 13 ipsilateral punctures and 13 contralateral punctures. The average degree of stenosis was 70% [60-80%]. The stenoses were observed between three months (10 cases) and 28 months after transplantation. One case of immediate arterial thrombosis was observed (3.8%). Sixteen angioplasties were carried out for ostial lesions, 10 procedures were carried out for truncal lesions and one angioplasty was done for branch lesions. The procedure was a simple angioplasty in 16 cases and associated with stenting in 11 cases. Recurrence was observed in two cases (7.6%). The lesions were re-dilated and stented in one case with active stents. A dissection without stenosis was observed in three cases. Two migrations of stent were seen. The immediate improvement or a stabilization of the renal function was observed in most patients. In all the cases revealed by hypertension (HBP), one could note an improvement of the blood pressure or a reduction in the number of drugs required to treat the HBP. The one-year death rate and the return in dialysis were 3.8% and 15.3%, respectively. Conclusion: The angioplasty of the renal arteries of transplanted kidneys is reliable but the rate of dissections or thromboses remains high. Angioplasty allows an improvement of the lifespan of the renal graft.

Research paper thumbnail of FT10. Mid-term Outcomes of EVAR Performed in AAA With Large Infrarenal Necks

Journal of Vascular Surgery, 2015

Objectives: This study compared outcomes of an iliacbranched device (IBD) and the sandwich techni... more Objectives: This study compared outcomes of an iliacbranched device (IBD) and the sandwich technique (ST) for preservation of hypogastric flow in the setting of aortoiliac aneurysm repair. Methods: Between 2010 and 2014, patients of two high-volume vascular centers referred for elective repair of abdominal aortic aneurysms (AAAs) involving iliac bifurcation or isolated common iliac artery (CIA) aneurysms underwent IBD placement or ST. Clinical and anatomic data, operative intervention, and outcomes were collected prospectively and analyzed retrospectively. Results: Thirty-seven patients underwent 40 procedures: 20 IBD and 20 ST, with placement of aortic endograft in 28 patients (70%). Technical success rate were comparable in both groups (95% vs 100%, P ¼ 1). Three external iliac artery (EIA) limbs and one internal iliac artery (IIA) stent thrombosed in the ST group. Early and late patency rates were not statistically different in the IBD group (100% and 94.7%) and in the ST group (90% and 80%; P > .05). There was no statistical difference between both groups regarding endoleaks onset (P ¼ .2). One patient suffered of transient buttock claudication after branched device IIA stent thrombosis. Reintervention rates were comparable in both groups (P ¼ .1). Both techniques permitted comparable aneurysm sac shrinkage (P ¼ .7). No rupture, colonic ischemia, or arterial access complication was noticed. Conclusions: In this retrospective study, IBD and ST provided similar outcomes for aortoiliac aneurysm treatment with hypogastric preservation. The sandwich technique represents a reliable alternative to IBD when the latter is not feasible, making patients more eligible for endovascular treatment. Further larger cohort studies are warranted to confirm these encouraging results.

Research paper thumbnail of Predictive Role of the Rate of preoperative C-reactive Protein in Limb Salvage and Postoperative Restenosis After Tibial Arteries Angioplasty

Annals of Vascular Surgery, 2015

Research paper thumbnail of FT10. Mid-term Outcomes of EVAR Performed in AAA With Large Infrarenal Necks

Journal of Vascular Surgery, 2015

Research paper thumbnail of Comparison of Short- and Mid-Term Follow-Up Between Standard and Fenestrated Endografts

Annals of Vascular Surgery, 2013

This study compared early and mid-term results of endovascular treatment for abdominal aortic ane... more This study compared early and mid-term results of endovascular treatment for abdominal aortic aneurysms (AAAs) and pararenal aneurysms (PRAs). Using data from a prospective database, patients treated with endografts for AAA and PRA between January 2007 and December 2009 were analyzed. In both groups, mortality, endoleak rates, evolution of renal function, reintervention rate at 30 days and at mid-term follow-up, and aneurysmal sac evolution at 1 year were compared. In total, 379 patients were included: 264 treated for AAA and 115 for PRA. Median follow-up was 24 months (range 12-46 months) in both groups. Risk factors and medical history were comparable in both groups, except for chronic renal failure (higher in the PRA group; P = 0.003). The mortality rates at 30 days were 1% and 3% in the AAA and APR groups, respectively (P = 0.10). During follow-up, the mortality rates were 11.1% and 12.8% in the AAA and PRA groups, respectively (P = 0.72). The reoperation rates at 30 days were 8% and 10% in the AAA and PRA groups, respectively (P = 0.72). During follow-up, the reoperation rates were 9.2% and 9.9% in the AAA and PRA groups, respectively (P = 0.85). At 1 year, retraction of the aneurysmal sac was diagnosed in 48% of the patients in the AAA group and in 56% of the patients in the PRA group (P = 0.41). The incidence rates of new postoperative cases of renal insufficiency were 19.3% and 8.1% in the AAA and PRA groups, respectively (P = 0.008). At 30 days, the endoleak rates were 27.5% and 12.7% in the AAA and PRA groups, respectively (P = 0.001). At 1 year, the endoleak rates were 19.4% and 7.3% in the AAA and PRA groups, respectively (P = 0.007). When type II endoleaks were excluded, the endoleak rates were comparable in both groups (P = 0.5). At 1 year, in both groups, a retraction of the aneurysmal sac was significantly correlated to the absence of endoleak (P = 0.001). Early and mid-term results of AAA treatment with standard endografts and PRA treatment with fenestrated endografts are comparable.

Research paper thumbnail of Compressive Pancreaticoduodenal Artery Aneurysm Associated With Celiac Artery Stenosis

Annals of Vascular Surgery, 2013

Peripancreatic artery aneurysms are a rare condition, representing &amp;amp;amp;amp;amp;amp;a... more Peripancreatic artery aneurysms are a rare condition, representing &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2% of all splanchnic artery aneurysms, and have been significantly related to celiac axis stenosis. While they are most often asymptomatic, those aneurysms have a strong tendency to rupture (52% rupture rate at the initial presentation) and, in this case, the outcome is often dramatic. Given that reports of this disease are rare, appropriate guidelines are difficult to formulate and different treatment strategies have been proposed. Endovascular management seems to be efficient in the large majority of most recent reports, but open surgery still remains necessary for complex cases, especially when associated with celiac axis stenosis. We report a new occurrence of a symptomatic compressive aneurysm related to common bile duct compression that we treated using a hybrid procedure.

Research paper thumbnail of Primary pulmonary myoepithelial carcinoma

Interactive CardioVascular and Thoracic Surgery, 2011

Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial ca... more Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial carcinoma belongs to this group. Since it was first described in 1998, we have identified only seven actual cases reported in the literature so far. We describe the case of a nonsmoker 60-year-old Caucasian female, who was referred to our institution for the treatment of three peripheral nodules. Her medical history revealed that a wedge resection, for pulmonary myoepithelial carcinoma, was performed in another center 15 months previously. After resection of the current nodules, the histological findings showed three myoepithelial carcinomas of the lung. There was no vascular or lymphatic invasion. The hilar and mediastinal lymph nodes were negatives. The patient is doing well without any sign of recurrence. Herein we shall discuss the case of a primary pulmonary myoepithelial carcinoma in a female and propose a brief review of the literature.

Research paper thumbnail of Bronchopericardial Fistula After a Pulmonary Resection

The Annals of Thoracic Surgery, Mar 1, 2013

A 70-year-old patient with vascular comorbidities underwent a middle lobectomy with mediastinal l... more A 70-year-old patient with vascular comorbidities underwent a middle lobectomy with mediastinal lymphadenectomy for a squamous carcinoma classified pT1N0M0. The postoperative course was uneventful, and the patient was discharged on postoperative day 8 with a perfectly clear chest radiograph.