Intravascular Ultrasound Guidance to Minimize the use of Iodine Contrast in Percutaneous Coronary Intervention: The MOZART Randomized Controlled Trial
Identifieur interne : 000145 ( Main/Exploration ); précédent : 000144; suivant : 000146Intravascular Ultrasound Guidance to Minimize the use of Iodine Contrast in Percutaneous Coronary Intervention: The MOZART Randomized Controlled Trial
Auteurs : José Mariani [Brésil] ; Cristiano Guedes [Brésil] ; Paulo Soares [Brésil] ; Silvio Zalc [Brésil] ; Carlos M. Campos [Brésil, Pays-Bas] ; Augusto C. Lopes [États-Unis] ; André G. Spadaro [Brésil] ; Marco A. Perin [Brésil] ; Antonio Esteves Filho [Brésil] ; Celso K. Takimura [Brésil] ; Expedito Ribeiro [Brésil] ; Roberto Kalil-Filho [Brésil] ; Elazer R. Edelman [États-Unis] ; Patrick W. Serruys [Pays-Bas, Royaume-Uni] ; Pedro A. Lemos [Brésil]Source :
- JACC. Cardiovascular interventions [ 1936-8798 ] ; 2014.
English descriptors
- KwdEn :
- Acute Kidney Injury (blood), Acute Kidney Injury (chemically induced), Acute Kidney Injury (diagnosis), Acute Kidney Injury (prevention & control), Aged, Biomarkers (blood), Contrast Media (adverse effects), Coronary Angiography (adverse effects), Coronary Artery Disease (radiography), Coronary Artery Disease (therapy), Coronary Artery Disease (ultrasonography), Creatinine (blood), Female, Humans, Iohexol (adverse effects), Iohexol (analogs & derivatives), Male, Middle Aged, Percutaneous Coronary Intervention (adverse effects), Percutaneous Coronary Intervention (methods), Risk Factors, Time Factors, Treatment Outcome, Triiodobenzoic Acids (adverse effects), Ultrasonography, Interventional.
- MESH :
- chemical , adverse effects : Contrast Media, Iohexol, Triiodobenzoic Acids.
- chemical , analogs & derivatives : Iohexol.
- chemical , blood : Biomarkers, Creatinine.
- adverse effects : Coronary Angiography, Percutaneous Coronary Intervention.
- blood : Acute Kidney Injury.
- chemically induced : Acute Kidney Injury.
- diagnosis : Acute Kidney Injury.
- methods : Percutaneous Coronary Intervention.
- prevention & control : Acute Kidney Injury.
- radiography : Coronary Artery Disease.
- therapy : Coronary Artery Disease.
- ultrasonography : Coronary Artery Disease.
- Aged, Female, Humans, Male, Middle Aged, Risk Factors, Time Factors, Treatment Outcome, Ultrasonography, Interventional.
Abstract
To evaluate the impact of IVUS guidance on the final volume of contrast agent utilized in patients undergoing PCI.
To date, few approaches have been described to reduce the final dose of contrast agent in percutaneous coronary interventions (PCI). We hypothesized that intravascular ultrasound (IVUS) might serve as an alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of iodine contrast.
A total of 83 patients were randomized to I) angiography-guided PCI or II) IVUS-guided PCI, both groups treated according to a pre-defined meticulous procedural strategy. The primary endpoint was the total volume contrast agent used during PCI. Patients were followed clinically for an average of 4 months.
The median total volume of contrast was 64.5 ml (interquartile range [IQR] 42.8 – 97.0 ml; minimum 19 ml; maximum 170 ml) in angiography-guided group vs. 20.0 ml (IQR 12.5 – 30.0 ml; minimum 3 ml; maximum 54 ml) in IVUS-guided group (p<0.001). Similarly, the median volume of contrast / creatinine clearance ratio was significantly lower among patients treated with IVUS-guided PCI (1.0 [IQR 0.6 – 1.9] vs. 0.4 [IQR 0.2 – 0.6] respectively; p<0.001). In-hospital and 4-month outcomes were not different between patients randomized to angiography-guided and IVUS-guided PCI.
Thoughtful and extensive utilization of IVUS as the primary imaging tool to guide PCI is safe, and markedly reduces the volume of iodine contrast, compared to angiography-alone guidance. The use of IVUS should be considered for patients at high risk for contrast-induced acute kidney injury or volume overload undergoing coronary angioplasty.
Url:
DOI: 10.1016/j.jcin.2014.05.024
PubMed: 25326742
PubMed Central: 4637944
Affiliations:
- Brésil, Pays-Bas, Royaume-Uni, États-Unis
- Angleterre, Grand Londres, Hollande-Méridionale, État de São Paulo
- Londres, Rotterdam, São Paulo
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Lemos</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25326742</idno><idno type="pmc">4637944</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637944</idno><idno type="RBID">PMC:4637944</idno><idno type="doi">10.1016/j.jcin.2014.05.024</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000648</idno><idno type="wicri:Area/Pmc/Curation">000648</idno><idno type="wicri:Area/Pmc/Checkpoint">000123</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">000028</idno><idno type="wicri:Area/PubMed/Curation">000028</idno><idno type="wicri:Area/PubMed/Checkpoint">000034</idno><idno type="wicri:Area/Ncbi/Merge">000756</idno><idno type="wicri:Area/Ncbi/Curation">000756</idno><idno type="wicri:Area/Ncbi/Checkpoint">000756</idno><idno type="wicri:doubleKey">1936-8798:2014:Mariani J:intravascular:ultrasound:guidance</idno><idno type="wicri:Area/Main/Merge">000145</idno><idno type="wicri:Area/Main/Curation">000145</idno><idno type="wicri:Area/Main/Exploration">000145</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Intravascular Ultrasound Guidance to Minimize the use of Iodine Contrast in Percutaneous Coronary Intervention: The MOZART Randomized Controlled Trial</title><author><name sortKey="Mariani, Jose" sort="Mariani, Jose" uniqKey="Mariani J" first="José" last="Mariani">José Mariani</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Guedes, Cristiano" sort="Guedes, Cristiano" uniqKey="Guedes C" first="Cristiano" last="Guedes">Cristiano Guedes</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Soares, Paulo" sort="Soares, Paulo" uniqKey="Soares P" first="Paulo" last="Soares">Paulo Soares</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Zalc, Silvio" sort="Zalc, Silvio" uniqKey="Zalc S" first="Silvio" last="Zalc">Silvio Zalc</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Campos, Carlos M" sort="Campos, Carlos M" uniqKey="Campos C" first="Carlos M." last="Campos">Carlos M. Campos</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A2">Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Thoraxcenter, Erasmus Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Lopes, Augusto C" sort="Lopes, Augusto C" uniqKey="Lopes A" first="Augusto C." last="Lopes">Augusto C. Lopes</name><affiliation wicri:level="1"><nlm:aff id="A3">Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA</wicri:regionArea><wicri:noRegion>MA</wicri:noRegion></affiliation></author><author><name sortKey="Spadaro, Andre G" sort="Spadaro, Andre G" uniqKey="Spadaro A" first="André G." last="Spadaro">André G. Spadaro</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Perin, Marco A" sort="Perin, Marco A" uniqKey="Perin M" first="Marco A." last="Perin">Marco A. Perin</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Filho, Antonio Esteves" sort="Filho, Antonio Esteves" uniqKey="Filho A" first="Antonio Esteves" last="Filho">Antonio Esteves Filho</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Takimura, Celso K" sort="Takimura, Celso K" uniqKey="Takimura C" first="Celso K." last="Takimura">Celso K. Takimura</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Ribeiro, Expedito" sort="Ribeiro, Expedito" uniqKey="Ribeiro E" first="Expedito" last="Ribeiro">Expedito Ribeiro</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Kalil Filho, Roberto" sort="Kalil Filho, Roberto" uniqKey="Kalil Filho R" first="Roberto" last="Kalil-Filho">Roberto Kalil-Filho</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Edelman, Elazer R" sort="Edelman, Elazer R" uniqKey="Edelman E" first="Elazer R." last="Edelman">Elazer R. Edelman</name><affiliation wicri:level="1"><nlm:aff id="A3">Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA</wicri:regionArea><wicri:noRegion>MA</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A4">Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA</wicri:regionArea><wicri:noRegion>MA</wicri:noRegion></affiliation></author><author><name sortKey="Serruys, Patrick W" sort="Serruys, Patrick W" uniqKey="Serruys P" first="Patrick W." last="Serruys">Patrick W. Serruys</name><affiliation wicri:level="3"><nlm:aff id="A2">Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Thoraxcenter, Erasmus Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A5">Imperial College London, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Imperial College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Lemos, Pedro A" sort="Lemos, Pedro A" uniqKey="Lemos P" first="Pedro A." last="Lemos">Pedro A. Lemos</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author></analytic><series><title level="j">JACC. Cardiovascular interventions</title><idno type="ISSN">1936-8798</idno><idno type="e-ISSN">1876-7605</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute Kidney Injury (blood)</term><term>Acute Kidney Injury (chemically induced)</term><term>Acute Kidney Injury (diagnosis)</term><term>Acute Kidney Injury (prevention & control)</term><term>Aged</term><term>Biomarkers (blood)</term><term>Contrast Media (adverse effects)</term><term>Coronary Angiography (adverse effects)</term><term>Coronary Artery Disease (radiography)</term><term>Coronary Artery Disease (therapy)</term><term>Coronary Artery Disease (ultrasonography)</term><term>Creatinine (blood)</term><term>Female</term><term>Humans</term><term>Iohexol (adverse effects)</term><term>Iohexol (analogs & derivatives)</term><term>Male</term><term>Middle Aged</term><term>Percutaneous Coronary Intervention (adverse effects)</term><term>Percutaneous Coronary Intervention (methods)</term><term>Risk Factors</term><term>Time Factors</term><term>Treatment Outcome</term><term>Triiodobenzoic Acids (adverse effects)</term><term>Ultrasonography, Interventional</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Contrast Media</term><term>Iohexol</term><term>Triiodobenzoic Acids</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Iohexol</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Biomarkers</term><term>Creatinine</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Coronary Angiography</term><term>Percutaneous Coronary Intervention</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Acute Kidney Injury</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Acute Kidney Injury</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Acute Kidney Injury</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Percutaneous Coronary Intervention</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Acute Kidney Injury</term></keywords><keywords scheme="MESH" qualifier="radiography" xml:lang="en"><term>Coronary Artery Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronary Artery Disease</term></keywords><keywords scheme="MESH" qualifier="ultrasonography" xml:lang="en"><term>Coronary Artery Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Risk Factors</term><term>Time Factors</term><term>Treatment Outcome</term><term>Ultrasonography, Interventional</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To evaluate the impact of IVUS guidance on the final volume of contrast agent utilized in patients undergoing PCI.</p></sec><sec id="S2"><title>Background</title><p id="P2">To date, few approaches have been described to reduce the final dose of contrast agent in percutaneous coronary interventions (PCI). We hypothesized that intravascular ultrasound (IVUS) might serve as an alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of iodine contrast.</p></sec><sec id="S3"><title>Methods</title><p id="P3">A total of 83 patients were randomized to I) angiography-guided PCI or II) IVUS-guided PCI, both groups treated according to a pre-defined meticulous procedural strategy. The primary endpoint was the total volume contrast agent used during PCI. Patients were followed clinically for an average of 4 months.</p></sec><sec id="S4"><title>Results</title><p id="P4">The median total volume of contrast was 64.5 ml (interquartile range [IQR] 42.8 – 97.0 ml; minimum 19 ml; maximum 170 ml) in angiography-guided group vs. 20.0 ml (IQR 12.5 – 30.0 ml; minimum 3 ml; maximum 54 ml) in IVUS-guided group (p<0.001). Similarly, the median volume of contrast / creatinine clearance ratio was significantly lower among patients treated with IVUS-guided PCI (1.0 [IQR 0.6 – 1.9] vs. 0.4 [IQR 0.2 – 0.6] respectively; p<0.001). In-hospital and 4-month outcomes were not different between patients randomized to angiography-guided and IVUS-guided PCI.</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">Thoughtful and extensive utilization of IVUS as the primary imaging tool to guide PCI is safe, and markedly reduces the volume of iodine contrast, compared to angiography-alone guidance. The use of IVUS should be considered for patients at high risk for contrast-induced acute kidney injury or volume overload undergoing coronary angioplasty.</p></sec></div></front></TEI><affiliations><list><country><li>Brésil</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Hollande-Méridionale</li><li>État de São Paulo</li></region><settlement><li>Londres</li><li>Rotterdam</li><li>São Paulo</li></settlement></list><tree><country name="Brésil"><region name="État de São Paulo"><name sortKey="Mariani, Jose" sort="Mariani, Jose" uniqKey="Mariani J" first="José" last="Mariani">José Mariani</name></region><name sortKey="Campos, Carlos M" sort="Campos, Carlos M" uniqKey="Campos C" first="Carlos M." last="Campos">Carlos M. Campos</name><name sortKey="Filho, Antonio Esteves" sort="Filho, Antonio Esteves" uniqKey="Filho A" first="Antonio Esteves" last="Filho">Antonio Esteves Filho</name><name sortKey="Guedes, Cristiano" sort="Guedes, Cristiano" uniqKey="Guedes C" first="Cristiano" last="Guedes">Cristiano Guedes</name><name sortKey="Kalil Filho, Roberto" sort="Kalil Filho, Roberto" uniqKey="Kalil Filho R" first="Roberto" last="Kalil-Filho">Roberto Kalil-Filho</name><name sortKey="Lemos, Pedro A" sort="Lemos, Pedro A" uniqKey="Lemos P" first="Pedro A." last="Lemos">Pedro A. Lemos</name><name sortKey="Perin, Marco A" sort="Perin, Marco A" uniqKey="Perin M" first="Marco A." last="Perin">Marco A. Perin</name><name sortKey="Ribeiro, Expedito" sort="Ribeiro, Expedito" uniqKey="Ribeiro E" first="Expedito" last="Ribeiro">Expedito Ribeiro</name><name sortKey="Soares, Paulo" sort="Soares, Paulo" uniqKey="Soares P" first="Paulo" last="Soares">Paulo Soares</name><name sortKey="Spadaro, Andre G" sort="Spadaro, Andre G" uniqKey="Spadaro A" first="André G." last="Spadaro">André G. Spadaro</name><name sortKey="Takimura, Celso K" sort="Takimura, Celso K" uniqKey="Takimura C" first="Celso K." last="Takimura">Celso K. Takimura</name><name sortKey="Zalc, Silvio" sort="Zalc, Silvio" uniqKey="Zalc S" first="Silvio" last="Zalc">Silvio Zalc</name></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Campos, Carlos M" sort="Campos, Carlos M" uniqKey="Campos C" first="Carlos M." last="Campos">Carlos M. Campos</name></region><name sortKey="Serruys, Patrick W" sort="Serruys, Patrick W" uniqKey="Serruys P" first="Patrick W." last="Serruys">Patrick W. Serruys</name></country><country name="États-Unis"><noRegion><name sortKey="Lopes, Augusto C" sort="Lopes, Augusto C" uniqKey="Lopes A" first="Augusto C." last="Lopes">Augusto C. Lopes</name></noRegion><name sortKey="Edelman, Elazer R" sort="Edelman, Elazer R" uniqKey="Edelman E" first="Elazer R." last="Edelman">Elazer R. Edelman</name><name sortKey="Edelman, Elazer R" sort="Edelman, Elazer R" uniqKey="Edelman E" first="Elazer R." last="Edelman">Elazer R. Edelman</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Serruys, Patrick W" sort="Serruys, Patrick W" uniqKey="Serruys P" first="Patrick W." last="Serruys">Patrick W. Serruys</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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