📇 Rhumatologue · ST HERBLAIN · (44) · Hospitalier

M ROMAIN BOURCIER

Pourquoi vous devez consulter ce praticien

4 raisons identifiées

Plateau technique de référence
Centre hospitalier universitaire (CHU) — équipements et expertise pointus pour les cas complexes
Auteur de référence en rhumatologie
31 articles scientifiques publiés — un praticien à la pointe de la recherche
Encadrant universitaire
Forme la prochaine génération de rhumatologues (2 thèses dirigées)
Délais de RDV courts dans la région
129.9 rhumatos / 100 000 hab. — département bien doté

Rhumatologue

📍 ST HERBLAIN (44)HospitalierRPPS 10100407187

Enseignement

9ans d'exercice (thèse 2017)

📊 Reconnaissance scientifique : 36/100📝 239 articles publiés🇫🇷 Publications académiques françaises (8)🎓 2 thèses dirigées

✨ Génération du profil synthétique IA en cours…

Données ANS publiques (Licence Ouverte 2.0) · Enrichissements MonRhumato 100 % opt-in · Toute personne référencée peut demander la suppression ou la rectification.

Top publications · les plus citées

Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size

The New England journal of medicine · 2024

📚 214 citations🎯 RCR 52.83Top 0% NIH🩺 Clinique

Aspirin versus aggressive antiplatelet therapy for acute carotid stenting plus thrombectomy in tandem occlusions: ETIS Registry results

Journal of neurointerventional surgery · 2023

📚 24 citations🎯 RCR 3.44Top 13% NIH🩺 Clinique

Lire l'abstract Crossref ↓

Background Patients treated with acute carotid stenting (CAS) may have higher odds of a favorable outcome than those treated without CAS during thrombectomy in tandem occlusions. Antiplatelet therapy is associated with CAS to avoid stent thrombosis, which occurs in around 20% of patients and negatively impacts outcomes. In this study we compared two antiplatelet strategies in tandem occlusion strokes treated with CAS and intracranial thrombectomy in clinical practice. Methods The Endovascular Treatment in Ischemic Stroke Registry is an ongoing prospective observational study involving 21 comprehensive stroke centers performing thrombectomy in France. We analyzed patients with atherosclerotic tandem occlusions treated with acute CAS and intracranial thrombectomy who received at least one antiplatelet agent. Aggressive antiplatelet therapy included oral or intravenous glycoprotein (GP) IIb/IIIa or P2Y12 inhibitors. The primary outcome was cervical carotid artery patency at day 1 imaging follow-up. Results Among the 187 included patients, 124 (66.3%) received aspirin alone and 63 (33.7%) received aggressive antiplatelet therapy. There was no significant difference regarding safety outcomes, especially in symptomatic intracerebral hemorrhage, parenchymal hematoma, and procedural complications. There was a significantly higher rate of carotid stent patency at day 1 in the aggressive antiplatelet therapy group (81.7% vs 97.1%, aOR 17.49, 95% CI 1.10 to 277.2, p=0.042). Odds of favorable functional outcome (90-day modified Rankin Scale score 0–2) were similar between the groups (OR 3.04, 95% CI 0.64 to 14.25, p=0.158). Conclusions In tandem occlusions treated with CAS plus thrombectomy, an aggressive antiplatelet regimen was associated with an increased rate of carotid stent patency at day 1 without safety concerns. Randomized trials are warranted to confirm these findings.

Poor clinical outcome despite successful basilar occlusion recanalization in the early time window: incidence and predictors

Journal of neurointerventional surgery · 2023

📚 19 citations🎯 RCR 2.54Top 20% NIH

Lire l'abstract Crossref ↓

Background Endovascular treatment (EVT) for basilar artery occlusions (BAO) is associated with a higher rate of futile recanalization compared with anterior circulation procedures. We aimed to identify the incidence and predictors of poor clinical outcome despite successful reperfusion in current clinical practice. Methods We used data from the ETIS (Endovascular Treatment in Ischemic Stroke) registry, a prospective multicenter observational registry of stroke treated with EVT in France. Patients undergoing EVT for acute BAO from January 2014 to May 2019 successfully treated within 8 hours from onset were included. Predictors of 90-day poor outcome (modified Rankin Scale (mRS) 4–6) were researched within patients with successful (modified Thrombolysis In Cerebral Infarction (mTICI 2b-3)) and excellent (mTICI 2c-3) reperfusion. Results Among 242 patients treated within 8 hours, successful reperfusion was achieved in 195 (80.5%) and excellent reperfusion in 120 (49.5%). Poor outcome was observed in 107 (54.8%) and 60 (50%) patients, respectively. In patients with successful early reperfusion, age, higher initial National Institutes of Health Stroke Scale (NIHSS) score, lower posterior circulation Alberta Stroke Programme Early CT Score (pc-ASPECTS), and absence of prior intravenous thrombolysis were independent predictors of poor outcome. The only treatment factor with an independent predictive value was first-pass mTICI 2b-3 reperfusion (adjusted OR 0.13, 95% CI 0.05 to 0.37, p<0.001). In patients with excellent early reperfusion, independent predictors were age, initial NIHSS score, first-pass mTICI 2c-3 reperfusion, and hemorrhagic transformation on post-interventional imaging. Conclusions Early successful reperfusion with EVT occurred in 80.5% of patients, and the only treatment-related factor predictive of clinical outcome was first pass mTICI 2b-3 reperfusion. Further research is warranted to identify the optimal techniques and devices associated with first pass reperfusion in the posterior circulation.

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M ROMAIN BOURCIER

Pourquoi vous devez consulter ce praticien

Thèses universitaires

Direction de thèses

Activité de recherche & publications

Publications académiques en France

Lieu de consultation

Tarifs & secteur de conventionnement

Prendre rendez-vous & contact

Top publications · les plus citées

Publications scientifiques (31) — classées par pathologie

Transversal17

Épidémiologie & registres5

Essai clinique4

IA en rhumatologie2

Pharmacovigilance2

Revue / méta-analyse2

Économie santé1

Recommandations1

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