Publications by authors named "Axel Bartoli"

Myocardial tissue characterization is fundamental in diagnosing, treating, and managing various cardiac diseases. In recent years, cardiac computed tomography (CCT) emerged as a valuable alternative to cardiac magnetic resonance (CMR) for myocardial tissue characterization, with the possibility to detect myocardial scar and quantify the extracellular volume fraction in a single CT study with the advantage of combined coronary arteries evaluation, shorter scanning time, and less susceptibility to device artifacts compared to CMR. However, CCT is typically affected by a lower contrast-to-noise ratio and potentially increased radiation exposure.

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Surgical repair of abdominal aortic aneurism (AAA) with horseshoe kidney (HK) is challenging because of several accessory renal arteries (RAs), variable in number, branches, and vascular territories, with subsequent variable renal damage. The identification of RAs and vascular territories could contribute to surgical planning. We developed a semiautomatic presurgical computed tomography angiography (CTA)-based model to measure the renal volume of each RA, validated on postsurgical CTA in patients with HK treated for AAA.

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Article Synopsis
  • - The study aimed to evaluate a software designed for tracking oncological CT scans in the Radiology department using data from 37 cancer patients.
  • - Findings showed no major differences between the software's assessments and traditional PACS reports regarding tumor responses, though some discrepancies were noted in a few cases related to lesion evaluations.
  • - The conclusion suggests that this specialized software could enhance efficiency and diminish human errors in interpreting follow-up CT scans for cancer patients.
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Background: The aim of this study (EPIDIAB) was to assess the relationship between epicardial adipose tissue (EAT) and the micro and macrovascular complications (MVC) of type 2 diabetes (T2D).

Methods: EPIDIAB is a post hoc analysis from the AngioSafe T2D study, which is a multicentric study aimed at determining the safety of antihyperglycemic drugs on retina and including patients with T2D screened for diabetic retinopathy (DR) (n = 7200) and deeply phenotyped for MVC. Patients included who had undergone cardiac CT for CAC (Coronary Artery Calcium) scoring after inclusion (n = 1253) were tested with a validated deep learning segmentation pipeline for EAT volume quantification.

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  • Chronic myocardial inflammation can lead to serious heart issues like arrhythmias and dilated cardiomyopathy, and cardiovascular magnetic resonance (CMR) is a key tool for detecting this inflammation non-invasively.* -
  • A retrospective study involving 88 patients suspected of chronic myocarditis indicated that certain CMR mapping parameters could help predict negative outcomes, with models showing good to very good predictive performance.* -
  • The findings suggest that analyzing the extent of myocardial damage through CMR parameters can enhance risk assessment in patients suffering from chronic myocarditis.*
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To assess the ability of the aortic aneurysm volume (AAV), aneurysmal lumen volume (ALV), and aneurysmal thrombus volume (ATV) to predict the need for aortic reintervention when using the maximal aortic diameter as a reference. This monocentric retrospective study included 31 consecutive patients who underwent successful thoracic endovascular aortic repair (TEVAR) to treat an atheromatous thoracic aortic aneurysm. All patients underwent clinical and computed tomography angiography (CTA) for 3 years after TEVAR.

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  • Some patients with metastatic melanoma (a type of skin cancer) don't get better from usual treatments. Scientists are looking at personalized medicine, which means tailoring treatment to the patient’s specific cancer.
  • In a study, 26 patients who found specific genetic changes in their cancer received personalized treatments, with some seeing good results.
  • The study showed that using advanced testing followed by targeted therapy might help patients whose melanoma didn't respond to regular treatments.
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Background The extent of left ventricular (LV) trabeculation and its relationship with cardiovascular (CV) risk factors is unclear. Purpose To apply automated segmentation to UK Biobank cardiac MRI scans to () assess the association between individual characteristics and CV risk factors and trabeculated LV mass (LVM) and () establish normal reference ranges in a selected group of healthy UK Biobank participants. Materials and Methods In this cross-sectional secondary analysis, prospectively collected data from the UK Biobank (2006 to 2010) were retrospectively analyzed.

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Late ischaemic consequences of type A aortic dissection are rare. We present a 6-year late complication of type A aortic dissection treated by Bentall surgery in a 41-year-old patient. The patient presented with several episodes of lipothymia associated with hypertensive attacks with anisotension, cervicalgia, hemicranial headache, abdominal pain and lower limb slipping initially on exertion and later at rest.

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Purpose: The aim of this comparative study was to evaluate the increased aortic diameter of the distal aorta after implementing the STABILISE technique in complicated type B aortic dissection (AD).

Design: This is a comparative monocentric retrospective study.

Materials And Methods: All patients who underwent an STABILISE procedure for complicated AD between 2018 and 2020 were included and compared with a historic cohort treated with thoracic endovascular aortic repair (TEVAR) alone.

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Background: Recent advanced in radiomics analysis could help to identify breast cancer among benign mammary masses. The aim was to create a radiomics signature using breast DCE-MRI extracted features to classify tumors and to compare the performances with the BI-RADS classification.

Material And Methods: From September 2017 to December 2019 images, exams and records from consecutive patients with mammary masses on breast DCE-MRI and available histology from one center were retrospectively reviewed (79 patients, 97 masses).

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Coronary artery disease (CAD) screening is usually performed before transcatheter aortic valve implantation (TAVI) by invasive coronary angiography (ICA). Computed coronary tomography angiography (CCTA) has shown good diagnostic performance for CAD screening in patients with a low probability of CAD and is systematically performed before TAVI. CCTA could be an efficient alternative to ICA for CAD screening before TAVI.

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  • Heart failure (HF) and arrhythmia-related complications significantly impact patients with nonischemic dilated cardiomyopathy (NIDCM), and this study investigates the prognostic value of cardiovascular magnetic resonance (CMR) imaging metrics like T1 and extracellular volume (ECV) for predicting these events.
  • Analyzing 225 NIDCM patients over two years, the study found 26% experienced major adverse cardiovascular events (MACE), with a notable association between increased ECV and HF-related events, while higher T1 Z-scores and ECV values correlated with arrhythmia-related events.
  • The study concluded that specific cutoffs for ECV and T1 Z-scores can be important independent predictors of both
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Desmoid tumors (DT) are rare benign tumors with a local invasion potential and recurrence. It is characterized on histology by an abnormal fibroblastic proliferation in a collagenous stroma, in variable proportions leading to heterogeneity of the lesion signal on magnetic resonance imaging (MRI). Current guidelines propose watchful waiting but in case of progression or symptoms, cryotherapy may be a therapeutic option in its extra-abdominal form.

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In this study, we report our local experience of type A aortic dissections in patients with cerebral malperfusion treated with carotid stenting before or after aortic surgery, and present a systematic literature review on these patients treated either with carotid stenting (CS) before or after aortic surgery (AS) or with aortic and carotid surgery alone (ACS). We report on patients treated in our center with carotid stenting for brain hemodynamic injury of carotid origin caused by type A dissection since 2018, and a systematic review was conducted in PubMed for articles published from 1990 to 2021. Out of 5307 articles, 19 articles could be included with a total of 80 patients analyzed: 9 from our center, 29 patients from case reports, and 51 patients from two retrospective cohorts.

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Background: Spinal cord ischemia is a major complication of treatment for descending thoracic aorta (DTA) disease. Our objectives were (1) to describe the value of angiographic cone-beam CT (angio-CBCT) and 3D road-mapping to visualize the Adamkiewicz artery (AA) and its feeding artery and (2) to evaluate the impact of AA localization on the patient surgical strategy.

Methods: Between 2018 and 2020, all patients referred to our institution for a surgical DTA disorder underwent a dedicated AA evaluation by angio-CBCT.

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(1) Background: The vascular type of Ehlers-Danlos syndrome (vEDS) is a rare genetic connective tissue disorder caused by pathogenic variants in the COL3A1 gene that result in arterial and organ fragility and premature death. We present five cases of vEDS that highlight the diagnosis and treatment challenges encountered by clinicians with these patients. (2) Case presentations: we present the cases of five patients with vascular complications of vEDS who were successfully managed using endovascular interventions or hybrid techniques at our institution from 2005 to 2022.

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Article Synopsis
  • Chronic hemorrhoidal disease affects millions globally, leading to symptoms like rectal bleeding and impacting quality of life; pain is less common but can occur with complications.
  • Treatment typically includes lifestyle changes, medications, and nonsurgical options like infrared photocoagulation, while surgical options such as hemorrhoidectomy are standard for severe cases.
  • A new method called hemorrhoid embolization offers an effective alternative, involving minimal risks and a same-day procedure with positive results in symptom improvement and technical success rates.
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Purpose: Acute mesenteric ischemia (AMI) is frequently diagnosed late, leading to a poor prognosis. Our aims were to identify predictive factors of delayed diagnosis and to analyze the outcomes of patients with AMI admitted in emergency units.

Methods: All the patients with AMI (2015-2020), in two Emergency units, were retrospectively included.

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Background: SARS-CoV-2 infection can impair diaphragm function at the acute phase but the frequency of diaphragm dysfunction after recovery from COVID-19 remains unknown.

Materials And Methods: This study was carried out on patients reporting persistent respiratory symptoms 3-4 months after severe COVID-19 pneumonia. The included patients were selected from a medical consultation designed to screen for recovery after acute infection.

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Background: To develop a deep-learning (DL) pipeline that allowed an automated segmentation of epicardial adipose tissue (EAT) from low-dose computed tomography (LDCT) and investigate the link between EAT and COVID-19 clinical outcomes. Methods: This monocentric retrospective study included 353 patients: 95 for training, 20 for testing, and 238 for prognosis evaluation. EAT segmentation was obtained after thresholding on a manually segmented pericardial volume.

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  • Developed a deep learning (DL) pipeline for quantifying COVID-19 lung lesions using low-dose CT scans and evaluated its prognostic significance.
  • The study analyzed data from 144 patients for training and 30 for testing, comparing automated segmentations of lung lesions to manual ones.
  • Results showed the DL model provided more consistent and accurate lesion detection than human observers, enhancing prognostic accuracy for identifying high-risk patients.
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