Publications by authors named "Tristan Mirault"

Background: Scarce data are available on pharmacodynamic (PD) variability in very elderly patients receiving direct oral anticoagulants (DOACs) for atrial fibrillation (AF). Thrombodynamics-4D (TD-4D), which simultaneously assesses fibrin clot formation and thrombin generation, has not yet been tested in patients on rivaroxaban, apixaban, or dabigatran.

Objectives: To (i) evaluate TD-4D's ability to assess DOAC effect added to normal plasma; (ii) assess DOAC PD in very elderly patients with AF along with DOAC concentrations; (iii) identify factors associated with interindividual variability of DOAC PD at peak and trough levels.

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Objective: Endovascular recanalization is considered for severely symptomatic patients with post-thrombotic syndrome (PTS) to alleviate symptoms. However, data on complete recovery and its predictors remain limited. This study aimed to assess persistent PTS 6 months after venous recanalization and identify predictive factors.

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Purpose: Thromboangiitis obliterans (TAO) diagnosis is challenging, and arterial imaging plays a major role in identifying distal artery occlusions. The ultrasonic micro-flow imaging (MFI) mode aims to identify small vessels better using high frame rates and adapted filters. Our objective was to compare the digital arterial characterization performance of MFI with digital subtraction angiography (DSA).

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Visualizing the arterial tree using ultrasound, from the aorta to the small vessels, has significantly improved over time due to advances in ultrasound imaging technology. Initially limited to exploring the major vessels, ultrasound analysis has made considerable progress with enhanced image quality. While injecting microbubbles as a contrast agent partially addresses this limitation, its use is constrained by the need for intravenous injection, making the examination more complex and time-consuming.

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The new guidelines for the management of peripheral arterial and aortic diseases (PAAD) from the European Society of Cardiology and endorsed by the European Society of Vascular Medicine (ESVM), emphasize on a comprehensive and multidisciplinary approach focusing on prevention, diagnosis, treatment, and follow-up of patients with a wide range of PAAD, including lower extremity peripheral arterial disease (PAD). The aim of this summary, focusing on PAD and coordinated by the Young Academy of ESVM, is to provide young angiologists with the fundamental principles of these guidelines and to assist them in navigating their everyday clinical practice. PAD diagnosis relies on objective evaluation of flow/oxygen reduction at rest, with arterial ultrasound as the first imaging modality to confirm the presence of arterial lesions.

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Background: Vascular Ehlers-Danlos syndrome is a rare genetic disorder characterized by defective type III collagen and a high risk of arterial morbidity and mortality. Several cardiovascular drugs are used for treatment, including celiprolol, but no controlled trial in this condition has been conducted to date. We hypothesized the benefit of the addition of an angiotensin II receptor blocker.

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Background: Non-infectious aortitis encompasses various histological patterns, but their specific cardiovascular outcomes remain unclear.

Objective: To evaluate the mortality associated with non-infectious surgical thoracic aortitis.

Methods: This retrospective multicenter study included patients who underwent thoracic aortic surgery and had histological evidence of aortitis.

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Background: Historically, women have been shown to underestimate their abilities, while men often assess themselves more accurately or overestimate. This study aims to determine self-assessment accuracy during online Objective Structured Clinical Examinations (OSCEs) according to gender.

Methods: A prospective study was conducted among fourth-year medical students at Paris Cité University during faculty training OSCEs, utilizing Zoom® software for remote participation.

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Background: Neovascularisation of carotid plaques contributes to their vulnerability. Current imaging methods such as contrast-enhanced ultrasound (CEUS) usually lack the required spatial resolution and quantification capability for precise neovessels identification. We aimed at quantifying plaque vascularisation with ultrasound localization microscopy (ULM) and compared the results to histological analysis.

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Objectives: Antiphospholipid syndrome (APS) is an autoimmune disease combining the occurrence of thrombotic and/or obstetric events with the persistent presence of antiphospholipid antibodies (i.e. lupus anticoagulant (LA), anti-cardiolipin (aCL) and anti-beta-2-glycoprotein I (aβ2GPI) antibodies).

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Article Synopsis
  • A study compared the effectiveness and safety of infliximab and cyclophosphamide as induction therapies for severe Behçet's syndrome involving major vascular or CNS issues.
  • Infliximab showed a higher complete response rate (81%) compared to cyclophosphamide (56%), indicating it may be more effective.
  • Additionally, infliximab had fewer adverse events (29.6%) compared to cyclophosphamide (64%), suggesting it may also be safer for patients.
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Article Synopsis
  • - The study investigates the effectiveness of Objective Structured Clinical Examinations (OSCEs) for evaluating medical students, revealing that while in-person assessments provide depth, they also lead to inconsistencies due to varying examiner standards.
  • - Data from 900 medical students at Université Paris Cité was analyzed over multiple OSCE sessions, showing significant differences in scores based on staff who graded them, highlighting the need for a statistical method to account for this variability.
  • - The results indicate that both staff and student variances affect OSCE scores, with staff variability being notably impactful; implementing two raters for consensus grading can help enhance score reliability.
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Background: The long isoform of the Wnk1 (with-no-lysine [K] kinase 1) is a ubiquitous serine/threonine kinase, but its role in vascular smooth muscle cells (VSMCs) pathophysiology remains unknown.

Methods: AngII (angiotensin II) was infused in to induce experimental aortic aneurysm. Mice carrying an allele were cross-bred with mice carrying a floxed allele to specifically investigate the functional role of Wnk1 in VSMCs.

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Lower extremity peripheral artery disease (PAD) often results from atherosclerosis, and is highly prevalent in patients with type 2 diabetes mellitus (T2DM). Individuals with T2DM exhibit a more severe manifestation and a more distal distribution of PAD compared to those without diabetes, adding complexity to the therapeutic management of PAD in this particular patient population. Indeed, the management of PAD in patients with T2DM requires a multidisciplinary and individualized approach that addresses both the systemic effects of diabetes and the specific vascular complications of PAD.

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Sporadic venous malformations are genetic conditions primarily caused by somatic gain-of-function mutation of PIK3CA or TEK, an endothelial transmembrane receptor signaling through PIK3CA. Venous malformations are associated with pain, bleedings, thrombosis, pulmonary embolism, esthetic deformities and, in severe cases, life-threatening situations. No authorized medical treatment exists for patients with venous malformations.

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Background: Post-thrombotic syndrome (PTS) is the main long-term complication of deep vein thrombosis (DVT). Several therapies are being evaluated to prevent or to treat PTS. Identifying the patients most likely to benefit from these therapies presents a significant challenge.

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Objectives: We aimed to compare clinical spectrum and outcome between adults and children with Takayasu's arteritis (TAK) in a European population.

Methods: We made a nationwide retrospective observational study between 1988 and 2019. All adult patients met the ACR diagnostic criteria for TAK and all children met the EULAR/PRINTO/PRES criteria for paediatric TAK.

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Takayasu arteritis (TA) is associated with microvascularization of the wall of large arteries and is related to inflammation. Ultrasound localization microscopy (ULM), combining ultrafast ultrasound imaging with microbubble (MB) injection, can track the path of MBs within the arterial wall and thus provide imaging of the vasa vasorum. From the analysis of MB tracks in the common carotid arteries of patients with active TA, we report the presence of microvessels in connection with the carotid lumen (i.

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Article Synopsis
  • The study aimed to evaluate the effectiveness of the Consultation And Relational Empathy (CARE) measure for assessing medical students' empathy during Objective and Structured Clinical Examinations (OSCEs), addressing the lack of a definitive tool for this purpose.
  • Researchers analyzed the CARE measure's psychometric properties and compared scores given by examiners and standardized patients (SPs) to 129 students, finding discrepancies in their evaluations.
  • Although the CARE measure had satisfactory overall properties, the inter-rater reliability was deemed poor, suggesting that the evaluators and the type of SP significantly impact the assessment of empathy in medical education.
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The symptomatic upper extremity peripheral artery disease (sUE-PAD) is poorly studied compared with the lower extremity peripheral artery disease (LE-PAD). We aimed to describe sUE-PAD etiologies and outcomes at 2 years. From an observational survey conducted in two French tertiary hospitals, demographic characteristics, etiology, treatment, and outcomes during follow-up were collected on patients with ICD-10 I74.

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Fluoroquinolones (FQ), commonly prescribed antibiotics, may trigger aortic and carotid dissections. We report three successive cases of visceral artery dissection: one patient with celiac trunk dissection and two with dissection of the superior mesenteric artery. These events occurred up to 4 months after 7 to 14 days of FQ treatment (2 cases of ofloxacin, 1 of norfloxacin).

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Blood pressure measurement is the most widely performed clinical exam to predict mortality risk. The gold standard for its noninvasive assessment is the auscultatory method, which relies on listening to the so-called "Korotkoff sounds" in a stethoscope placed at the outlet of a pneumatic arm cuff. However, more than a century after their discovery, the origin of these sounds is still debated, which implies a number of clinical limitations.

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