{"id":49895119,"date":"2024-10-18T14:07:58","date_gmt":"2024-10-18T12:07:58","guid":{"rendered":"https:\/\/www.chu-poitiers.fr\/?p=49895119"},"modified":"2024-10-18T14:08:00","modified_gmt":"2024-10-18T12:08:00","slug":"developpement-de-la-technique-shockwave-en-chirurgie-vasculaire","status":"publish","type":"post","link":"https:\/\/www.chu-poitiers.fr\/en\/developpement-de-la-technique-shockwave-en-chirurgie-vasculaire\/","title":{"rendered":"D\u00e9veloppement de la technique Shockwave en chirurgie vasculaire"},"content":{"rendered":"\n<p>Le Shockwave est un dispositif m\u00e9dical permettant de r\u00e9tablir la circulation sanguine dans une art\u00e8re bouch\u00e9e ou r\u00e9tr\u00e9cie en raison de la pr\u00e9sence de plaques d\u2019ath\u00e9rome calcifi\u00e9es. Il s\u2019agit d\u2019un ballonnet qui va \u00eatre positionn\u00e9 dans l\u2019art\u00e8re, en passant par l\u2019int\u00e9rieur des vaisseaux gr\u00e2ce \u00e0 un guidage radiologique, sans laisser de cicatrice. Ce ballonnet contient des \u00e9metteurs d\u2019ondes sonores capables de fragmenter le calcium situ\u00e9 dans la paroi art\u00e9rielle. On appelle cela la \u00ab lithotrithie intra-vasculaire \u00bb. Cette technique est d\u00e9j\u00e0 utilis\u00e9e par les urologues pour casser les calculs r\u00e9naux calcifi\u00e9s et par les cardiologues pour traiter les art\u00e8res coronaires au cours des coronarographies.<\/p>\n<p>\u00ab\u00a0<em>Nous positionnons le Shockwave \u00e0 l\u2019int\u00e9rieur de l\u2019art\u00e8re calcifi\u00e9e, puis nous envoyons des ondes sonores qui vont fragiliser et fragmenter uniquement le calcium. Ce calcium va rester inclus dans les diff\u00e9rentes couches de la paroi art\u00e9rielle ; il ne part pas dans la circulation. Cela permet \u00ab d\u2019assouplir \u00bb la paroi de l\u2019art\u00e8re, qui va se r\u00e9-ouvrir, afin que le sang circule de nouveau correctement. Nous compl\u00e9tons parfois le traitement par l\u2019utilisation d\u2019un stent ou d\u2019un ballon actif, mais ce n\u2019est pas syst\u00e9matique. Dans certains cas, nous utilisons cette technique pour \u00e9viter de mettre un stent, cela d\u00e9pend des indications chirurgicales et de la localisation des l\u00e9sions art\u00e9rielles \u00bb. <\/em>Le ballon actif est un ballon d\u2019angioplastie dont la paroi est recouverte d\u2019un produit antimitotique qui limite la division cellulaire et \u00e9vite que l\u2019art\u00e8re se r\u00e9tr\u00e9cisse de nouveau. Le stent, qui ressemble \u00e0 un petit ressort, permet d\u2019\u00e9carter les parois de l\u2019art\u00e8re pour la maintenir ouverte. \u00ab\u00a0<em>Tous les patients ne sont pas \u00e9ligibles \u00e0 cette technique, cela d\u00e9pend de la localisation des calcifications et du diam\u00e8tre de l\u2019art\u00e8re, les patients sont bien s\u00e9lectionn\u00e9s.\u00a0L\u2019avantage de cette proc\u00e9dure est de pouvoir fragmenter uniquement le calcium sans endommager les tissus sains<\/em>\u00a0<em>de la paroi art\u00e9rielle <\/em>\u00bb.<\/p>\n<p>Coordinatrice du projet de d\u00e9veloppement de la proc\u00e9dure Shockwave au sein du service de chirurgie vasculaire, le Dr Ana\u00efs Peran a effectu\u00e9 plusieurs interventions de ce type depuis le mois d\u2019ao\u00fbt 2024. Les autres chirurgiens vasculaires du service en ont \u00e9galement r\u00e9alis\u00e9. Ils ont \u00e9t\u00e9 form\u00e9s et accompagn\u00e9s lors des premi\u00e8res interventions par un expert de la soci\u00e9t\u00e9 Shockwave qui commercialise le dispositif. <em>\u00ab La courbe d\u2019apprentissage est rapide, car le dispositif est relativement simple d\u2019utilisation pour nous. Il y a bien s\u00fbr des \u00e9tapes \u00e0 respecter et il faut \u00eatre capable de bien s\u00e9lectionner les cas, mais la proc\u00e9dure chirurgicale ressemble \u00e0 ce que nous avons l\u2019habitude de faire au quotidien \u00bb.<\/em> La mise en \u0153uvre de cette proc\u00e9dure a \u00e9t\u00e9 financ\u00e9e par le budget d\u00e9di\u00e9 aux innovations du CHU de Poitiers.<\/p>\n\n\n\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2024\/10\/SHOCKWAVE-1-web-1.jpg\"><img decoding=\"async\" width=\"900\" height=\"600\" data-id=\"49896154\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2024\/10\/SHOCKWAVE-1-web-1.jpg\" alt=\"\" class=\"wp-image-49896154\"\/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2024\/10\/SHOCKWAVE-8-web.jpg\"><img decoding=\"async\" width=\"900\" height=\"600\" data-id=\"49896148\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2024\/10\/SHOCKWAVE-8-web.jpg\" alt=\"\" class=\"wp-image-49896148\"\/><\/a><\/figure>\n<\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Le CHU de Poitiers fait partie des premiers \u00e9tablissements fran\u00e7ais \u00e0 utiliser le dispositif Shockwave en chirurgie vasculaire pour traiter les l\u00e9sions\u2026","protected":false},"author":1,"featured_media":49896133,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[96],"tags":[],"class_list":["post-49895119","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-non-classifiee"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>D\u00e9veloppement de la technique Shockwave en chirurgie vasculaire - Site du CHU de Poitiers<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.chu-poitiers.fr\/developpement-de-la-technique-shockwave-en-chirurgie-vasculaire\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"D\u00e9veloppement de la technique Shockwave en chirurgie vasculaire - Site du CHU de Poitiers\" \/>\n<meta property=\"og:description\" content=\"Le CHU de Poitiers fait partie des premiers \u00e9tablissements fran\u00e7ais \u00e0 utiliser le dispositif Shockwave en chirurgie vasculaire pour traiter les l\u00e9sions art\u00e9rielles calcifi\u00e9es. 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