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1. Insight from an Italian Delphi Consensus on EVAR feasibility outside the instruction for use: the SAFE EVAR Study

Author

Sirignano, P, Piffaretti, G, Ceruti, S, Orso, M, Picozzi, M, Ricci, G, Sirignano, A, Taurino, M, Giancarlo Accarino, M, Accrocca, F, Alba, G, Alberti, A, Alberti, V, Allevi, S, Aloisi, F, Amato, B, Amico, A, Andreoli, F, Angiletta, D, Antico, A, Antico, L, Antonello, M, Baccellieri, D, Badalamenti, G, Bafile, G, Baldi, C, Barillà, C, Barillà, D, Bartoli, S, Basile, G, Battaglia, G, Battocchio, C, Belloni, A, Bellosta, R, Benevento, D, Bernardini, G, Bertagna, G, Bertoglio, L, Bianchini Massoni, C, Bisacco, D, Bischetti, M, Boccalon, L, Bonanno, P, Bonardelli, S, Borioni, R, P Borrelli, M, Bozzani, A, M Bracale, U, Camparini, S, Canciglia, A, Canova, F, Capoccia, L, Cappelli, A, Cappiello, P, Carluccio, C, Casalino, A, Casella, F, Casilli, G, Castagno, C, Castelli, P, Castrucci, T, Cavallo, M, Cavazzini, C, Ceccanei, G, Cefalì, P, Celoria, G, Cevolani, M, Chiappa, R, Chisci, E, Comande, C, Compagna, R, Cumino, A, Cuozzo, S, Dalla Caneva, P, D'Alessio, I, D'Arrigo, G, DE Caridi, G, DE Donato, G, DE Donno, G, Desantis, C, DE Santis, F, DE Troia, A, Dezi, T, A Diaco, D, DI Domenico, R, DI Filippo, M, DI Girolamo, A, P Dionisi, C, Dinoto, E, DI Stefano, F, DI STEFANO, L, D'Oria, M, Esposito, A, Esposito, D, Ettore, L, F Fadda, G, Faggioli, G, T Fargion, A, Fazzini, S, Fermani, N, Ferrante, G, Ferrari, M, Ferraro, S, Ferrer, C, Ferretto, L, Ficarelli, I, Filippi, F, Fino, G, Forliti, E, Formiconi, M, Flora, L, Fresilli, M, Frigatti, P, Frigerio, D, Froio, A, Freyrie, A, Furgiuele, S, Gabrielli, R, Gaggiano, A, Galassi, L, Gallelli, G, Gallitto, E, Gallo, F, Galzerano, G, Gargiulo, M, Garriboli, L, G Genadiev, G, Gentile, L, Giaquinta, A, Gibello, L, Grande, R, Grassi, V, Ippoliti, A, Irsara, S, Kahlberg, A, Konstantinos, N, LA Corte, F, Lanza, G, Lauricella, A, Lazzeri, E, Lenti, M, Leopardi, M, Lepidi, S, Li Destri, A, Locatelli, F, Lomazzi, C, Lombardi, F, Lorido, A, Maggiore, C, Mansour, W, Marcucci, V, Mascia, D, Massara, M, Mastrangelo, G, Margheritini, C, Maritati, G, Martelli, E, Martinelli, O, Marzano, A, Mauri, F, Mazzacaro, D, Melloni, A, Mezzetti, R, Michelagnoli, S, Migliara, B, Migliari, M, Millarelli, M, Misuraca, M, Modugno, P, Moniaci, D, Montelione, N, Monti, A, Monzio-Compagnoni, N, Moro, M, Mortola, L, Mozzetta, G, Musilli, A, Nano, G, Occhiuto, M, M Oddi, F, Orellana, B, Orlando, P, Orrico, M, A Pacilè, M, Pagliariccio, G, Pallini, C, Palmieri, A, Palughi, M, Panagrasso, M, Panzano, C, Panzera, C, Pascucci, F, Pasqua, R, Pasquetti, L, Pasqui, E, Pecchio, A, Pecoraro, F, Peluttiero, I, F Pennetta, F, Perini, P, Piazza, M, Pini, R, Pipito, N, Pranteda, C, Praquin, B, Pratesi, C, F Porreca, C, Pulli, R, Reina, N, F Rinaldi, L, Rizzo, L, Romano, E, Ronchey, S, Ruggiero, F, Ruggiero, M, Sallustro, M, Saviane, G, Sbarigia, E, Scovazzi, P, M Segramor, V, Sena, G, Setacci, C, Setacci, F, E Setteducati, C, M Settembrini, A, Siani, A, Sica, S, Speziale, F, Squizzato, F, Stella, N, Stilo, F, Sufali, G, Tanda, E, Tinelli, G, Tomei, F, Tosti, F, Trimarchi, S, Troisi, N, Tshomba, Y, Turchino, D, Turriziani, V, Ucci, A, Veneto, V, Veraldi, G, Wiesel, P, Xodo, A, Zacà, S, Zaraca, F, Zenunaj, G, SIRIGNANO, Pasqualino, PIFFARETTI, Gabriele, CERUTI, Silvia, ORSO, Massimiliano, PICOZZI, Mario, RICCI, Giovanna, SIRIGNANO, Ascanio, TAURINO, Maurizio, Giancarlo Accarino, Maurizio, Accrocca, Federico, Alba, Giuseppe, Alberti, Antonino, Alberti, Vittorio, Allevi, Sara, Aloisi, Francesco, Amato, Bruno, Amico, Alessio, Andreoli, Francesco, Angiletta, Domenico, Antico, Antonio, Antico, Lorenzo, Antonello, Michele, Baccellieri, Domenico, Badalamenti, Giovanni, Bafile, Gennaro, Baldi, Claudio, Barillà, Chiara, Barillà, David, Bartoli, Stefano, Basile, Giusi, Battaglia, Giuseppe, Battocchio, Cesare, Belloni, Ailin, Bellosta, Raffello, Benevento, Domenico, Bernardini, Giulia, Bertagna, Giulia, Bertoglio, Luca, Bianchini Massoni, Claudio, Bisacco, Daniel, Bischetti, Michelangelo, Boccalon, Luca, Bonanno, Paolo, Bonardelli, Stefano, Borioni, Raul, P Borrelli, Maria, Bozzani, Antonio, M Bracale, Umberto, Camparini, Stefano, Canciglia, Aldo, Canova, Francesco, Capoccia, Laura, Cappelli, Alessandro, Cappiello, Pierlugi, Carluccio, Chiara, Casalino, Alfonso, Casella, Francesco, Casilli, Giulia, Castagno, Claudio, Castelli, Patrizio, Castrucci, Tommaso, Cavallo, Matteo, Cavazzini, Carlo, Ceccanei, Gianluca, Cefalì, Pietro, Celoria, Gianni, Cevolani, Mauro, Chiappa, Roberto, Chisci, Emiliano, Comande, Carlo, Compagna, Rita, Cumino, Andrea, Cuozzo, Simone, Dalla Caneva, Patrizia, D'Alessio, Ilaria, D'Arrigo, Giuseppe, DE Caridi, Giovanni, DE Donato, Gianmarco, DE Donno, Gabriele, Desantis, Claudio, DE Santis, Francesco, DE Troia, Alessandro, Dezi, Tommaso, A Diaco, Domenico, DI Domenico, Rossella, DI Filippo, Michele, DI Girolamo, Alessia, P Dionisi, Carlo, Dinoto, Ettore, DI Stefano, Francesco, DI STEFANO, Lucia, D'Oria, Mario, Esposito, Andrea, Esposito, Davide, Ettore, Ludovica, F Fadda, Gian, Faggioli, Gianluca, T Fargion, Aaron, Fazzini, Stefano, Fermani, Nicoletta, Ferrante, Giulia, Ferrari, Mauro, Ferraro, Stafanio, Ferrer, Ciro, Ferretto, Luca, Ficarelli, Ilaria, Filippi, Federico, Fino, Gianluigi, Forliti, Enzo, Formiconi, Martina, Flora, Loris, Fresilli, Mauro, Frigatti, Paolo, Frigerio, Dalmazio, Froio, Alberto, Freyrie, Antonio, Furgiuele, Sergio, Gabrielli, Roberto, Gaggiano, Andrea, Galassi, Luca, Gallelli, Giuseppe, Gallitto, Enrico, Gallo, Francesco, Galzerano, Giuseppe, Gargiulo, Mauro, Garriboli, Luca, G Genadiev, Genadi, Gentile, Lucia, Giaquinta, Alessia, Gibello, Lorenzo, Grande, Raffaele, Grassi, Viviana, Ippoliti, Arnaldo, Irsara, Sandro, Kahlberg, Andrea, Konstantinos, Nikolakopoulos, LA Corte, Francesco, Lanza, Gaetano, Lauricella, Antonio, Lazzeri, Elisa, Lenti, Massimo, Leopardi, Marco, Lepidi, Sandro, Li Destri, Andrea, Locatelli, Federica, Lomazzi, Chiara, Lombardi, Francesco, Lorido, Antonio, Maggiore, Claudia, Mansour, Wassim, Marcucci, Vittorio, Mascia, Daniele, Massara, Mafalda, Mastrangelo, Giovanni, Margheritini, Costanza, Maritati, Gabriele, Martelli, Eugenio, Martinelli, Ombretta, Marzano, Antonio, Mauri, Francesca, Mazzacaro, Daniela, Melloni, Andrea, Mezzetti, Roberto, Michelagnoli, Stefano, Migliara, Bruno, Migliari, Mattia, Millarelli, Massimiliano, Misuraca, Maria, Modugno, Pietro, Moniaci, Diego, Montelione, Nunzio, Monti, Andrea, Monzio-Compagnoni, Nicola, Moro, Mario, Mortola, Lorenzo, Mozzetta, Gaddiel, Musilli, Aldo, Nano, Giovanni, Occhiuto, Mariateresa, M Oddi, Fabio, Orellana, Bernardo, Orlando, Paola, Orrico, Matteo, A Pacilè, Maria, Pagliariccio, Gabriele, Pallini, Cristina, Palmieri, Armando, Palughi, Martina, Panagrasso, Marco, Panzano, Claudia, Panzera, Chiara, Pascucci, Francesco, Pasqua, Rocco, Pasquetti, Leonardo, Pasqui, Eduardo, Pecchio, Alberto, Pecoraro, Felice, Peluttiero, Ilaria, F Pennetta, Federico, Perini, Paolo, Piazza, Michele, Pini, Rodolfo, Pipito, Narayana, Pranteda, Chiara, Praquin, Barbara, Pratesi, Carlo, F Porreca, Carlo, Pulli, Raffaele, Reina, Nicola, F Rinaldi, Luigi, Rizzo, Luigi, Romano, Elisa, Ronchey, Sonia, Ruggiero, Federica, Ruggiero, Massimo, Sallustro, Marianna, Saviane, Gianna, Sbarigia, Enrico, Scovazzi, Paolo, M Segramor, Vittorio, Sena, Giuseppe, Setacci, Carlo, Setacci, Francesco, E Setteducati, Carmen, M Settembrini, Alberto, Siani, Andrea, Sica, Simona, Speziale, Francesco, Squizzato, Francesco, Stella, Nazzareno, Stilo, Francesco, Sufali, Gemmi, Tanda, Elisabetta, Tinelli, Giovanni, Tomei, Francesca, Tosti, Filomena, Trimarchi, Santi, Troisi, Nicola, Tshomba, Yamume, Turchino, Davide, Turriziani, Valerio, Ucci, Alessandro, Veneto, Vincenzo, Veraldi, Gianfranco, Wiesel, Paola, Xodo, Andrea, Zacà, Sergio, Zaraca, Francesco, Zenunaj, Glaudiol, Sirignano, P, Piffaretti, G, Ceruti, S, Orso, M, Picozzi, M, Ricci, G, Sirignano, A, Taurino, M, Giancarlo Accarino, M, Accrocca, F, Alba, G, Alberti, A, Alberti, V, Allevi, S, Aloisi, F, Amato, B, Amico, A, Andreoli, F, Angiletta, D, Antico, A, Antico, L, Antonello, M, Baccellieri, D, Badalamenti, G, Bafile, G, Baldi, C, Barillà, C, Barillà, D, Bartoli, S, Basile, G, Battaglia, G, Battocchio, C, Belloni, A, Bellosta, R, Benevento, D, Bernardini, G, Bertagna, G, Bertoglio, L, Bianchini Massoni, C, Bisacco, D, Bischetti, M, Boccalon, L, Bonanno, P, Bonardelli, S, Borioni, R, P Borrelli, M, Bozzani, A, M Bracale, U, Camparini, S, Canciglia, A, Canova, F, Capoccia, L, Cappelli, A, Cappiello, P, Carluccio, C, Casalino, A, Casella, F, Casilli, G, Castagno, C, Castelli, P, Castrucci, T, Cavallo, M, Cavazzini, C, Ceccanei, G, Cefalì, P, Celoria, G, Cevolani, M, Chiappa, R, Chisci, E, Comande, C, Compagna, R, Cumino, A, Cuozzo, S, Dalla Caneva, P, D'Alessio, I, D'Arrigo, G, DE Caridi, G, DE Donato, G, DE Donno, G, Desantis, C, DE Santis, F, DE Troia, A, Dezi, T, A Diaco, D, DI Domenico, R, DI Filippo, M, DI Girolamo, A, P Dionisi, C, Dinoto, E, DI Stefano, F, DI STEFANO, L, D'Oria, M, Esposito, A, Esposito, D, Ettore, L, F Fadda, G, Faggioli, G, T Fargion, A, Fazzini, S, Fermani, N, Ferrante, G, Ferrari, M, Ferraro, S, Ferrer, C, Ferretto, L, Ficarelli, I, Filippi, F, Fino, G, Forliti, E, Formiconi, M, Flora, L, Fresilli, M, Frigatti, P, Frigerio, D, Froio, A, Freyrie, A, Furgiuele, S, Gabrielli, R, Gaggiano, A, Galassi, L, Gallelli, G, Gallitto, E, Gallo, F, Galzerano, G, Gargiulo, M, Garriboli, L, G Genadiev, G, Gentile, L, Giaquinta, A, Gibello, L, Grande, R, Grassi, V, Ippoliti, A, Irsara, S, Kahlberg, A, Konstantinos, N, LA Corte, F, Lanza, G, Lauricella, A, Lazzeri, E, Lenti, M, Leopardi, M, Lepidi, S, Li Destri, A, Locatelli, F, Lomazzi, C, Lombardi, F, Lorido, A, Maggiore, C, Mansour, W, Marcucci, V, Mascia, D, Massara, M, Mastrangelo, G, Margheritini, C, Maritati, G, Martelli, E, Martinelli, O, Marzano, A, Mauri, F, Mazzacaro, D, Melloni, A, Mezzetti, R, Michelagnoli, S, Migliara, B, Migliari, M, Millarelli, M, Misuraca, M, Modugno, P, Moniaci, D, Montelione, N, Monti, A, Monzio-Compagnoni, N, Moro, M, Mortola, L, Mozzetta, G, Musilli, A, Nano, G, Occhiuto, M, M Oddi, F, Orellana, B, Orlando, P, Orrico, M, A Pacilè, M, Pagliariccio, G, Pallini, C, Palmieri, A, Palughi, M, Panagrasso, M, Panzano, C, Panzera, C, Pascucci, F, Pasqua, R, Pasquetti, L, Pasqui, E, Pecchio, A, Pecoraro, F, Peluttiero, I, F Pennetta, F, Perini, P, Piazza, M, Pini, R, Pipito, N, Pranteda, C, Praquin, B, Pratesi, C, F Porreca, C, Pulli, R, Reina, N, F Rinaldi, L, Rizzo, L, Romano, E, Ronchey, S, Ruggiero, F, Ruggiero, M, Sallustro, M, Saviane, G, Sbarigia, E, Scovazzi, P, M Segramor, V, Sena, G, Setacci, C, Setacci, F, E Setteducati, C, M Settembrini, A, Siani, A, Sica, S, Speziale, F, Squizzato, F, Stella, N, Stilo, F, Sufali, G, Tanda, E, Tinelli, G, Tomei, F, Tosti, F, Trimarchi, S, Troisi, N, Tshomba, Y, Turchino, D, Turriziani, V, Ucci, A, Veneto, V, Veraldi, G, Wiesel, P, Xodo, A, Zacà, S, Zaraca, F, Zenunaj, G, SIRIGNANO, Pasqualino, PIFFARETTI, Gabriele, CERUTI, Silvia, ORSO, Massimiliano, PICOZZI, Mario, RICCI, Giovanna, SIRIGNANO, Ascanio, TAURINO, Maurizio, Giancarlo Accarino, Maurizio, Accrocca, Federico, Alba, Giuseppe, Alberti, Antonino, Alberti, Vittorio, Allevi, Sara, Aloisi, Francesco, Amato, Bruno, Amico, Alessio, Andreoli, Francesco, Angiletta, Domenico, Antico, Antonio, Antico, Lorenzo, Antonello, Michele, Baccellieri, Domenico, Badalamenti, Giovanni, Bafile, Gennaro, Baldi, Claudio, Barillà, Chiara, Barillà, David, Bartoli, Stefano, Basile, Giusi, Battaglia, Giuseppe, Battocchio, Cesare, Belloni, Ailin, Bellosta, Raffello, Benevento, Domenico, Bernardini, Giulia, Bertagna, Giulia, Bertoglio, Luca, Bianchini Massoni, Claudio, Bisacco, Daniel, Bischetti, Michelangelo, Boccalon, Luca, Bonanno, Paolo, Bonardelli, Stefano, Borioni, Raul, P Borrelli, Maria, Bozzani, Antonio, M Bracale, Umberto, Camparini, Stefano, Canciglia, Aldo, Canova, Francesco, Capoccia, Laura, Cappelli, Alessandro, Cappiello, Pierlugi, Carluccio, Chiara, Casalino, Alfonso, Casella, Francesco, Casilli, Giulia, Castagno, Claudio, Castelli, Patrizio, Castrucci, Tommaso, Cavallo, Matteo, Cavazzini, Carlo, Ceccanei, Gianluca, Cefalì, Pietro, Celoria, Gianni, Cevolani, Mauro, Chiappa, Roberto, Chisci, Emiliano, Comande, Carlo, Compagna, Rita, Cumino, Andrea, Cuozzo, Simone, Dalla Caneva, Patrizia, D'Alessio, Ilaria, D'Arrigo, Giuseppe, DE Caridi, Giovanni, DE Donato, Gianmarco, DE Donno, Gabriele, Desantis, Claudio, DE Santis, Francesco, DE Troia, Alessandro, Dezi, Tommaso, A Diaco, Domenico, DI Domenico, Rossella, DI Filippo, Michele, DI Girolamo, Alessia, P Dionisi, Carlo, Dinoto, Ettore, DI Stefano, Francesco, DI STEFANO, Lucia, D'Oria, Mario, Esposito, Andrea, Esposito, Davide, Ettore, Ludovica, F Fadda, Gian, Faggioli, Gianluca, T Fargion, Aaron, Fazzini, Stefano, Fermani, Nicoletta, Ferrante, Giulia, Ferrari, Mauro, Ferraro, Stafanio, Ferrer, Ciro, Ferretto, Luca, Ficarelli, Ilaria, Filippi, Federico, Fino, Gianluigi, Forliti, Enzo, Formiconi, Martina, Flora, Loris, Fresilli, Mauro, Frigatti, Paolo, Frigerio, Dalmazio, Froio, Alberto, Freyrie, Antonio, Furgiuele, Sergio, Gabrielli, Roberto, Gaggiano, Andrea, Galassi, Luca, Gallelli, Giuseppe, Gallitto, Enrico, Gallo, Francesco, Galzerano, Giuseppe, Gargiulo, Mauro, Garriboli, Luca, G Genadiev, Genadi, Gentile, Lucia, Giaquinta, Alessia, Gibello, Lorenzo, Grande, Raffaele, Grassi, Viviana, Ippoliti, Arnaldo, Irsara, Sandro, Kahlberg, Andrea, Konstantinos, Nikolakopoulos, LA Corte, Francesco, Lanza, Gaetano, Lauricella, Antonio, Lazzeri, Elisa, Lenti, Massimo, Leopardi, Marco, Lepidi, Sandro, Li Destri, Andrea, Locatelli, Federica, Lomazzi, Chiara, Lombardi, Francesco, Lorido, Antonio, Maggiore, Claudia, Mansour, Wassim, Marcucci, Vittorio, Mascia, Daniele, Massara, Mafalda, Mastrangelo, Giovanni, Margheritini, Costanza, Maritati, Gabriele, Martelli, Eugenio, Martinelli, Ombretta, Marzano, Antonio, Mauri, Francesca, Mazzacaro, Daniela, Melloni, Andrea, Mezzetti, Roberto, Michelagnoli, Stefano, Migliara, Bruno, Migliari, Mattia, Millarelli, Massimiliano, Misuraca, Maria, Modugno, Pietro, Moniaci, Diego, Montelione, Nunzio, Monti, Andrea, Monzio-Compagnoni, Nicola, Moro, Mario, Mortola, Lorenzo, Mozzetta, Gaddiel, Musilli, Aldo, Nano, Giovanni, Occhiuto, Mariateresa, M Oddi, Fabio, Orellana, Bernardo, Orlando, Paola, Orrico, Matteo, A Pacilè, Maria, Pagliariccio, Gabriele, Pallini, Cristina, Palmieri, Armando, Palughi, Martina, Panagrasso, Marco, Panzano, Claudia, Panzera, Chiara, Pascucci, Francesco, Pasqua, Rocco, Pasquetti, Leonardo, Pasqui, Eduardo, Pecchio, Alberto, Pecoraro, Felice, Peluttiero, Ilaria, F Pennetta, Federico, Perini, Paolo, Piazza, Michele, Pini, Rodolfo, Pipito, Narayana, Pranteda, Chiara, Praquin, Barbara, Pratesi, Carlo, F Porreca, Carlo, Pulli, Raffaele, Reina, Nicola, F Rinaldi, Luigi, Rizzo, Luigi, Romano, Elisa, Ronchey, Sonia, Ruggiero, Federica, Ruggiero, Massimo, Sallustro, Marianna, Saviane, Gianna, Sbarigia, Enrico, Scovazzi, Paolo, M Segramor, Vittorio, Sena, Giuseppe, Setacci, Carlo, Setacci, Francesco, E Setteducati, Carmen, M Settembrini, Alberto, Siani, Andrea, Sica, Simona, Speziale, Francesco, Squizzato, Francesco, Stella, Nazzareno, Stilo, Francesco, Sufali, Gemmi, Tanda, Elisabetta, Tinelli, Giovanni, Tomei, Francesca, Tosti, Filomena, Trimarchi, Santi, Troisi, Nicola, Tshomba, Yamume, Turchino, Davide, Turriziani, Valerio, Ucci, Alessandro, Veneto, Vincenzo, Veraldi, Gianfranco, Wiesel, Paola, Xodo, Andrea, Zacà, Sergio, Zaraca, Francesco, and Zenunaj, Glaudiol

Abstract

BACKGROUND: The SAfety and FEasibility of standard EVAR outside the instruction for use (SAFE-EVAR) Study was designed to define the attitude of Italian vascular surgeons towards the use of standard endovascular repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA) outside the instruction for use (IFU) through a Delphi consensus endorsed by the Italian Society of Vascular and Endovascular Surgery (Societa Italiana di Chirurgia Vascolare ed Endovascolare - SICVE). METHODS: A questionnaire consisting of 26 statements was developed, validated by an 18 -member Advisory Board, and then sent to 600 Italian vascular surgeons. The Delphi process was structured in three subsequent rounds which took place between April and June 2023. In the first two rounds, respondents could indicate one of the following five degrees of agreement: 1) strongly agree; 2) partially agree; 3) neither agree nor disagree; 4) partially disagree; 5) strongly disagree; while in the third round only three different choices were proposed: 1) agree; 2) neither agree nor disagree; 3) disagree. We considered the consensus reached when >70% of respondents agreed on one of the options. After the conclusion of each round, a report describing the percentage distribution of the answers was sent to all the participants. RESULTS: Two -hundred -forty-four (40.6%) Italian Vascular Surgeons agreed to participate the first round of the Delphi Consensus; the second and the third rounds of the Delphi collected 230 responders (94.3% of the first -round responders). Four statements (15.4%) reached a consensus in the first rounds. Among the 22 remaining statements, one more consensus (3.8%) was achieved in the second round. Finally, seven more statements (26.9%) reached a consensus in the simplified last round. Globally, a consensus was reached for almost half of the proposed statements (46.1%). CONCLUSIONS: The relatively low consensus rate obtained in this Delphi seems to confirm the discrepancy between Guide

Published
2024

2. The Sac Evolution Imaging Follow-Up after EVAR: an international expert opinion-based Delphi consensus study

Author

Tinelli, G, D’Oria, M, Sica, S, Mani, K, Rancic, Z, Resh, T, Beccia, F, Azizzadeh, A, Da Volta Ferreira, M, Gargiulo, M, Lepidi, S, Tshomba, Y, Oderich, G, Haulon, S, Beck, A, Hertault, A, Savlania, A, Froio, A, Giaquinta, A, Zimmermann, A, Psyllas, A, Wanhainen, A, Marchetti, A, Queiroz, A, Kahlberg, A, Reyes-Valdivia, A, Schanzer, A, Edinburgh Vascular, A, Freyrie, A, Lorido, A, Millon, A, Ippoliti, A, Abai, B, Mees, B, Reutersberg, B, Maurel, B, Michel, B, Wahlgren, C, Cavazzini, C, Setacci, C, Lee, C, Ferrer, C, Bicknell, C, Raphaël, C, Clair, D, Dawson, D, Arnaoutakis, D, Böckler, D, Kotelis, D, Mujagic, E, Chisci, E, Cieri, E, Gallitto, E, Marone, E, Ducasse, E, Verzini, F, Pecoraro, F, Serracino-Inglott, F, Benedetto, F, Speziale, F, Stilo, F, Álvarez-Marcos, F, Pagliariccio, G, Piffaretti, G, Lanza, G, Philipp, G, Geenberg, G, Jung, G, Melissano, G, Veraldi, G, Parlani, G, Faggioli, G, de Donato, G, Simonte, G, Colacchio, G, De Caridi, G, Pratesi, G, Spinella, G, Torsello, G, Leong Tan, G, Magee, G, Verhagen, H, Andrew, H, Koleilat, I, Ohman, J, de Vries, J, Budtz-Lilly, J, Black, J, Eldrup-Jorgensen, J, Hockley, J, Bath, J, Sobocinski, J, van Herwaarden, J, Reinhard, K, Orion, K, Amankwah, K, Bertoglio, L, di Marzo, L, Garriboli, L, Rizzo, L, Hakimi, M, Sheahan, M, Khashram, M, Schermerhorn, M, Lescan, M, Conrad, M, Davies, M, Czerny, M, Orrico, M, Eagleton, M, Smeds, M, Taurino, M, Wohlauer, M, Sharafuddin, M, Anna-Leonie, M, Reijnen, M, Antonello, M, Piazza, M, Settembre, N, Mouawad, N, Tsilimparis, N, Dias, N, Martinelli, O, Frigatti, P, Sirignano, P, Chong, P, Bevis, P, Dimuzio, P, Henke, P, Düppers, P, Holt, P, Helmiö, P, Vriens, P, Pulli, R, Bellosta, R, Micheli, R, Veeraswamy, R, Cuff, R, Chiappa, R, Gattuso, R, Pini, R, Dalman, R, Milner, R, Scali, S, Bahia, S, Laukontaus, S, Trimarchi, S, Fernandez-Alonso, S, Deglise, S, Bellmunt-Montoya, S, Hofer, S, Yusuf, S, Ronchey, S, Bartoli, S, Bonvini, S, Camparini, S, Fazzini, S, Pirrelli, S, Hörer, T, Bisdas, T, Vasudevan, T, Lattmann, T, Wyss, T, Maldonado, T, Pfammatter, T, Kölbel, T, Jakimowicz, T, Donati, T, Tracci, M, Bracale, U, Tolva, V, Riambau, V, Palazzo, V, Makaloski, V, Regula S, V, Dorigo, W, Mansour, W, Van den Eynde, W, Tinelli, Giovanni, D’Oria, Mario, Sica, Simona, Mani, Kevin, Rancic, Zoran, Resh, Timothy Andrew, Beccia, Flavia, Azizzadeh, Ali, Da Volta Ferreira, Marcelo Martins, Gargiulo, Mauro, Lepidi, Sandro, Tshomba, Yamume, Oderich, Gustavo S., Haulon, Stephan, Beck, Adam W., Hertault, Adrien, Savlania, Ajay, Froio, Alberto, Giaquinta, Alessia, Zimmermann, Alexander, Psyllas, Anastasios, Wanhainen, Anders, Marchetti, Andrea Ascoli, Queiroz, Andre Brito, Kahlberg, Andrea, Reyes-Valdivia, Andrés, Schanzer, Andres, Edinburgh Vascular, Andrew Tambyraja, Freyrie, Antonio, Lorido, Antonio, Millon, Antoine, Ippoliti, Arnaldo, Abai, Babak, Mees, Barend, Reutersberg, Benedikt, Maurel, Blandine, Michel, Bosiers, Wahlgren, Carl Magnus, Cavazzini, Carlo, Setacci, Carlo, Lee, Cheong Jun, Ferrer, Ciro, Bicknell, Colin, Raphaël, Coscas, Clair, Daniel, Dawson, David L., Arnaoutakis, Dean J., Böckler, Dittmar, Kotelis, Drosos, Mujagic, Edin, Chisci, Emiliano, Cieri, Enrico, Gallitto, Enrico, Marone, Enrico Maria, Ducasse, Eric, Verzini, Fabio, Pecoraro, Felice, Serracino-Inglott, Ferdinand, Benedetto, Filippo, Speziale, Francesco, Stilo, Francesco, Álvarez-Marcos, Francisco, Pagliariccio, Gabriele, Piffaretti, Gabriele, Lanza, Gaetano, Philipp, Geisbüsch, Geenberg, George, Jung, Georg, Melissano, Germano, Veraldi, Gian Franco, Parlani, Gianbattista, Faggioli, Gianluca, de Donato, Gianmarco, Simonte, Gioele, Colacchio, Giovanni, De Caridi, Giovanni, Pratesi, Giovanni, Spinella, Giovanni, Torsello, Giovanni, Leong Tan, Glenn Wei, Magee, Gregory A., Verhagen, Hence, Andrew, Holden, Koleilat, Issam, Ohman, J Westley, de Vries, J. P. P. M., Budtz-Lilly, Jacob, Black, James, Eldrup-Jorgensen, Jens, Hockley, Joe, Bath, Jonathan, Sobocinski, Jonathan, van Herwaarden, Joost A., Reinhard, Kopp, Orion, Kristine C., Amankwah, Kwame, Bertoglio, Luca, di Marzo, Luca, Garriboli, Luca, Rizzo, Luigi, Hakimi, Maani, Sheahan, Malachi, Khashram, Manar, Schermerhorn, Marc, Lescan, Mario, Conrad, Mark, Davies, Mark G., Czerny, Martin, Orrico, Matteo, Eagleton, Matthew J., Smeds, Matthew R., Taurino, Maurizio, Wohlauer, Max, Sharafuddin, Mel J., Anna-Leonie, Menges, Reijnen, Michel, Antonello, Michele, Piazza, Michele, Settembre, Nicla, Mouawad, Nicolas J., Tsilimparis, Nikolaos, Dias, Nuno, Martinelli, Ombretta, Frigatti, Paolo, Sirignano, Pasqualino, Chong, Patrick, Bevis, Paul, DiMuzio, Paul, Henke, Peter, Düppers, Philip, Holt, Peter, Helmiö, Päivi, Vriens, Patrick, Pulli, Raffaele, Bellosta, Raffaello, Micheli, Raimondo, Veeraswamy, Ravi, Cuff, Robert, Chiappa, Roberto, Gattuso, Roberto, Pini, Rodolfo, Dalman, Ronald L., Milner, Ross, Scali, Salvatore T., Bahia, Sandeep, Laukontaus, Sani, Trimarchi, Santi, Fernandez-Alonso, Sebastian, Deglise, Sebastien, Bellmunt-Montoya, Sergi, Hofer, Simone, Yusuf, Syed W., Ronchey, Sonia, Bartoli, Stefano, Bonvini, Stefano, Camparini, Stefano, Fazzini, Stefano, Pirrelli, Stefano, Hörer, Tal, Bisdas, Theodosios, Vasudevan, Thodur, Lattmann, Thomas, Wyss, Thomas Rudolf, Maldonado, Thomas, Pfammatter, Thomas, Kölbel, Tilo, Jakimowicz, Tomasz, Donati, Tommaso, Tracci, Margaret, Bracale, Umberto Marcello, Tolva, Valerio Stefano, Riambau, Vincent, Palazzo, Vincenzo, Makaloski, Vladimir, Regula S, Von Allmen, Dorigo, Walter, Mansour, Wassim, Van den Eynde, Wouter, Tinelli, G, D’Oria, M, Sica, S, Mani, K, Rancic, Z, Resh, T, Beccia, F, Azizzadeh, A, Da Volta Ferreira, M, Gargiulo, M, Lepidi, S, Tshomba, Y, Oderich, G, Haulon, S, Beck, A, Hertault, A, Savlania, A, Froio, A, Giaquinta, A, Zimmermann, A, Psyllas, A, Wanhainen, A, Marchetti, A, Queiroz, A, Kahlberg, A, Reyes-Valdivia, A, Schanzer, A, Edinburgh Vascular, A, Freyrie, A, Lorido, A, Millon, A, Ippoliti, A, Abai, B, Mees, B, Reutersberg, B, Maurel, B, Michel, B, Wahlgren, C, Cavazzini, C, Setacci, C, Lee, C, Ferrer, C, Bicknell, C, Raphaël, C, Clair, D, Dawson, D, Arnaoutakis, D, Böckler, D, Kotelis, D, Mujagic, E, Chisci, E, Cieri, E, Gallitto, E, Marone, E, Ducasse, E, Verzini, F, Pecoraro, F, Serracino-Inglott, F, Benedetto, F, Speziale, F, Stilo, F, Álvarez-Marcos, F, Pagliariccio, G, Piffaretti, G, Lanza, G, Philipp, G, Geenberg, G, Jung, G, Melissano, G, Veraldi, G, Parlani, G, Faggioli, G, de Donato, G, Simonte, G, Colacchio, G, De Caridi, G, Pratesi, G, Spinella, G, Torsello, G, Leong Tan, G, Magee, G, Verhagen, H, Andrew, H, Koleilat, I, Ohman, J, de Vries, J, Budtz-Lilly, J, Black, J, Eldrup-Jorgensen, J, Hockley, J, Bath, J, Sobocinski, J, van Herwaarden, J, Reinhard, K, Orion, K, Amankwah, K, Bertoglio, L, di Marzo, L, Garriboli, L, Rizzo, L, Hakimi, M, Sheahan, M, Khashram, M, Schermerhorn, M, Lescan, M, Conrad, M, Davies, M, Czerny, M, Orrico, M, Eagleton, M, Smeds, M, Taurino, M, Wohlauer, M, Sharafuddin, M, Anna-Leonie, M, Reijnen, M, Antonello, M, Piazza, M, Settembre, N, Mouawad, N, Tsilimparis, N, Dias, N, Martinelli, O, Frigatti, P, Sirignano, P, Chong, P, Bevis, P, Dimuzio, P, Henke, P, Düppers, P, Holt, P, Helmiö, P, Vriens, P, Pulli, R, Bellosta, R, Micheli, R, Veeraswamy, R, Cuff, R, Chiappa, R, Gattuso, R, Pini, R, Dalman, R, Milner, R, Scali, S, Bahia, S, Laukontaus, S, Trimarchi, S, Fernandez-Alonso, S, Deglise, S, Bellmunt-Montoya, S, Hofer, S, Yusuf, S, Ronchey, S, Bartoli, S, Bonvini, S, Camparini, S, Fazzini, S, Pirrelli, S, Hörer, T, Bisdas, T, Vasudevan, T, Lattmann, T, Wyss, T, Maldonado, T, Pfammatter, T, Kölbel, T, Jakimowicz, T, Donati, T, Tracci, M, Bracale, U, Tolva, V, Riambau, V, Palazzo, V, Makaloski, V, Regula S, V, Dorigo, W, Mansour, W, Van den Eynde, W, Tinelli, Giovanni, D’Oria, Mario, Sica, Simona, Mani, Kevin, Rancic, Zoran, Resh, Timothy Andrew, Beccia, Flavia, Azizzadeh, Ali, Da Volta Ferreira, Marcelo Martins, Gargiulo, Mauro, Lepidi, Sandro, Tshomba, Yamume, Oderich, Gustavo S., Haulon, Stephan, Beck, Adam W., Hertault, Adrien, Savlania, Ajay, Froio, Alberto, Giaquinta, Alessia, Zimmermann, Alexander, Psyllas, Anastasios, Wanhainen, Anders, Marchetti, Andrea Ascoli, Queiroz, Andre Brito, Kahlberg, Andrea, Reyes-Valdivia, Andrés, Schanzer, Andres, Edinburgh Vascular, Andrew Tambyraja, Freyrie, Antonio, Lorido, Antonio, Millon, Antoine, Ippoliti, Arnaldo, Abai, Babak, Mees, Barend, Reutersberg, Benedikt, Maurel, Blandine, Michel, Bosiers, Wahlgren, Carl Magnus, Cavazzini, Carlo, Setacci, Carlo, Lee, Cheong Jun, Ferrer, Ciro, Bicknell, Colin, Raphaël, Coscas, Clair, Daniel, Dawson, David L., Arnaoutakis, Dean J., Böckler, Dittmar, Kotelis, Drosos, Mujagic, Edin, Chisci, Emiliano, Cieri, Enrico, Gallitto, Enrico, Marone, Enrico Maria, Ducasse, Eric, Verzini, Fabio, Pecoraro, Felice, Serracino-Inglott, Ferdinand, Benedetto, Filippo, Speziale, Francesco, Stilo, Francesco, Álvarez-Marcos, Francisco, Pagliariccio, Gabriele, Piffaretti, Gabriele, Lanza, Gaetano, Philipp, Geisbüsch, Geenberg, George, Jung, Georg, Melissano, Germano, Veraldi, Gian Franco, Parlani, Gianbattista, Faggioli, Gianluca, de Donato, Gianmarco, Simonte, Gioele, Colacchio, Giovanni, De Caridi, Giovanni, Pratesi, Giovanni, Spinella, Giovanni, Torsello, Giovanni, Leong Tan, Glenn Wei, Magee, Gregory A., Verhagen, Hence, Andrew, Holden, Koleilat, Issam, Ohman, J Westley, de Vries, J. P. P. M., Budtz-Lilly, Jacob, Black, James, Eldrup-Jorgensen, Jens, Hockley, Joe, Bath, Jonathan, Sobocinski, Jonathan, van Herwaarden, Joost A., Reinhard, Kopp, Orion, Kristine C., Amankwah, Kwame, Bertoglio, Luca, di Marzo, Luca, Garriboli, Luca, Rizzo, Luigi, Hakimi, Maani, Sheahan, Malachi, Khashram, Manar, Schermerhorn, Marc, Lescan, Mario, Conrad, Mark, Davies, Mark G., Czerny, Martin, Orrico, Matteo, Eagleton, Matthew J., Smeds, Matthew R., Taurino, Maurizio, Wohlauer, Max, Sharafuddin, Mel J., Anna-Leonie, Menges, Reijnen, Michel, Antonello, Michele, Piazza, Michele, Settembre, Nicla, Mouawad, Nicolas J., Tsilimparis, Nikolaos, Dias, Nuno, Martinelli, Ombretta, Frigatti, Paolo, Sirignano, Pasqualino, Chong, Patrick, Bevis, Paul, DiMuzio, Paul, Henke, Peter, Düppers, Philip, Holt, Peter, Helmiö, Päivi, Vriens, Patrick, Pulli, Raffaele, Bellosta, Raffaello, Micheli, Raimondo, Veeraswamy, Ravi, Cuff, Robert, Chiappa, Roberto, Gattuso, Roberto, Pini, Rodolfo, Dalman, Ronald L., Milner, Ross, Scali, Salvatore T., Bahia, Sandeep, Laukontaus, Sani, Trimarchi, Santi, Fernandez-Alonso, Sebastian, Deglise, Sebastien, Bellmunt-Montoya, Sergi, Hofer, Simone, Yusuf, Syed W., Ronchey, Sonia, Bartoli, Stefano, Bonvini, Stefano, Camparini, Stefano, Fazzini, Stefano, Pirrelli, Stefano, Hörer, Tal, Bisdas, Theodosios, Vasudevan, Thodur, Lattmann, Thomas, Wyss, Thomas Rudolf, Maldonado, Thomas, Pfammatter, Thomas, Kölbel, Tilo, Jakimowicz, Tomasz, Donati, Tommaso, Tracci, Margaret, Bracale, Umberto Marcello, Tolva, Valerio Stefano, Riambau, Vincent, Palazzo, Vincenzo, Makaloski, Vladimir, Regula S, Von Allmen, Dorigo, Walter, Mansour, Wassim, and Van den Eynde, Wouter

Abstract

Objective: Management of follow-up protocols after endovascular aortic repair (EVAR), vary significantly between centres and is not standardized according to the sac regression. By designing an international expert-based Delphi consensus, the study aimed to create recommendations on follow-up after EVAR according to sac evolution. Methods: Eight facilitators created appropriate statements regarding the study topic that were voted, using a 4-point Likert scale, by a selected panel of international experts using a three-round modified Delphi consensus process. Based on the experts' responses, only those statements reaching a Grade A (full agreement ≥75%) or B (overall agreement ≥80% and full disagreement <5%) were included in the final document. Results: One-hundred and seventy-four participants were included in the final analysis, and each voted the initial 29 statements related to the definition of sac regression (Q1-Q9), EVAR follow-up (Q10-Q14), and the assessment and role of sac regression during follow-up (Q15-Q29). At the end of the process, 2 statements (6.9%) were rejected, 9 statements (31%) received a grade B consensus strength, and 18 (62.1%) reached a grade A consensus strength. Out of twenty-seven final statements, fifteen statements (55.6%) were classified as grade I, while twelve (44.4%) were classified as grade II. Experts agreed that sac regression should be considered an important indicator of EVAR success and always be assessed during follow-up after EVAR. Conclusions: Based on the elevated strength and high consistency of this international expert-based Delphi consensus, most of the statements might guide current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues.

Published
2024

3. Preliminary six-month outcomes of LIMBSAVE (treatment of critical Limb IscheMia with infragenicular Bypass adopting in situ SAphenous VEin technique) registry

Author

Troisi, N., Blasis, G. D., Salvini, M., Michelagnoli, S., Setacci, C., Accrocca, F., Adami, D., Angelini, A., Arnuzzo, L., Ascoli Marchetti, A., Attisani, L., Bafile, G., Baldino, G., Barbanti, E., Bartoli, S., Bellosta, R., Benedetto, F., Borioni, R., Briolini, F., Busoni, C., Camparini, S., Cappiello, P., Carbonari, L., Casella, F., Celoria, G., Chisci, E., Civilini, E., Codispoti, F., Conti, B., Coppi, G., D'Amico, A., De Blasis, G., D'Elia, M., Di Domenico, R., Di Girolamo, C., Ercolini, L., Ferrari, A., Ferrari, M., Forliti, E., Frigatti, P., Frigerio, D., Frosini, P., Garriboli, L., Nicola Giordano, A., Guerrieri, W., Jannello, A., Massara, M., Merlo, M., Mezzetti, R., Miccoli, T., Milite, D., Mingazzini, P., Muncinelli, M., Nano, G., Natola, M., Novali, C., Palasciano, G., Perkmann, R., Persi, F., Petruccelli, D., Pinelli, M., Poletto, G., Porta, C., Pratesi, C., Pruner, G., Ragazzi, G., Righini, P., Scovazzi, P., Maria Settembrini, A., Siani, A., Silingardi, R., Silvestro, A., Talarico, F., Tolva, V., Trani, A., Trimarchi, S., Tshomba, Y., Vigliotti, G., Viola, D., Volpe, P., and Zani, F.

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, in situ saphenous vein, Databases, Factual, Critical Illness, Limb salvage, 030204 cardiovascular system & hematology, peripheral bypass, Peripheral Arterial Disease, 03 medical and health sciences, Standardized technique, Postoperative Complications, 0302 clinical medicine, Ischemia, Humans, Medicine, Saphenous Vein, Radiology, Nuclear Medicine and imaging, Registries, 030212 general & internal medicine, Vein, Vascular Patency, Aged, Critical limb ischemia, limb salvage, Aged, 80 and over, business.industry, Saphenous vein bypass, General Medicine, Middle Aged, Surgery, Settore MED/22, Treatment Outcome, medicine.anatomical_structure, Italy, Bypass surgery, Female, Vascular Grafting, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract

ObjectivesGuidelines recommend open bypass surgery for long occlusions of infrainguinal arteries. In situ saphenous vein bypass is a standardized technique. The aim of this study was to report preliminary six-month outcomes of a national, multicenter, observational, prospective registry based on the examination of treatment of critical Limb IscheMia with infragenicular Bypass adopting the in situ SAphenous VEin technique (LIMBSAVE).MethodsFrom January 2018 until October 2019, 428 patients from 41 centers were enrolled in the LIMBSAVE registry. Data were prospectively collected in a dedicated database, including demographics, preoperative risk factors, clinical and diagnostic preoperative assessments, intraoperative measures (including safety and effectiveness of the valvulotome during the surgical procedures), and 30-day follow-up data. Furthermore, estimated six-month outcomes according to Kaplan–Meier curves in terms of primary patency, primary assisted patency, secondary patency, and limb salvage were evaluated.ResultsPatients were predominantly male ( n = 332, 77.6%) with a mean age of 73.3 years (range 39–95). Technical success, defined as bypass pulse after use of the valvulotome, was obtained in all cases. The proximal anastomosis could be reached by the valvulotome in all cases. The mean number of valvulotome uses was 2.5 (range 1–5). No vein perforation was reported. In nine cases (2.1%), a vein lesion with intramural hemorrhage occurred. The mean length of hospital stay was 11.1 days (range 1–60). At 30-day follow-up, the overall bypass patency rate was 97.4%, and the rate of open or endo reinterventions for failing bypass was 5.4%. At six-month follow-up, the estimated primary patency, primary assisted patency, secondary patency, and limb salvage were 78.1%, 86.2%, 92.1%, and 94.7%, respectively.ConclusionsPreliminary intraprocedural outcomes of the LIMBSAVE registry show that the in situ technique with the valvulotome is safe and effective in disrupting valves and obtaining pulsatility in the saphenous vein. The complication rate related to the use of the valvulotome is low. The six-month preliminary outcomes in terms of overall patency and limb salvage are promising. Further examinations and continuous follow-up are needed to evaluate long-term outcomes.

Published
2020

4. iTalian RegIstry of doUble inner branch stent graft for arch PatHology (the TRIUmPH Registry)

Author

Ferrer, C., Cao, P., Coscarella, C., Ferri, M., Lovato, L., Camparini, S., di Marzo, L., Giudice, R., Pogany, G., de Gregorio, C., Arzedi, R., Pacini, D., Antonello, M., Dall'Antonia, A., Tshomba, Yamume, Tinelli, Giovanni, Rizza, A., Berti, S., Faggian, G., Franzese, I., Maritati, G., Tshomba Y. (ORCID:0000-0001-7304-7553), Tinelli G. (ORCID:0000-0002-2212-3226), Ferrer, C., Cao, P., Coscarella, C., Ferri, M., Lovato, L., Camparini, S., di Marzo, L., Giudice, R., Pogany, G., de Gregorio, C., Arzedi, R., Pacini, D., Antonello, M., Dall'Antonia, A., Tshomba, Yamume, Tinelli, Giovanni, Rizza, A., Berti, S., Faggian, G., Franzese, I., Maritati, G., Tshomba Y. (ORCID:0000-0001-7304-7553), and Tinelli G. (ORCID:0000-0002-2212-3226)

Abstract

Objective: The objective of this study was to assess early and midterm results after endovascular aortic arch repair using a double inner branch stent graft (DIBSG) in patients with aortic arch aneurysm or dissection unfit for open surgery. Methods: Between 2012 and 2018, there were 24 patients with aortic arch disease who were treated with a single model of a DIBSG (Terumo Aortic, Glasgow, United Kingdom) in nine Italian cardiovascular centers. We investigated technical success, mortality, occurrence of major complications, and need for reintervention in a multicenter, nonrandomized, retrospective fashion. Results: The in-hospital mortality rate was 16.7%. Cerebrovascular events occurred in 25% of patients and major strokes in 12.5%. Two patients experienced a retrograde dissection (8.3%), whereas none reported any type I or type III endoleak. During a mean follow-up of 18 months (range, 1-60 months), one patient died of a nonaortic cause and one reported a nonarch-related major stroke. No late secondary intervention was needed during the follow-up. Excluding from the analysis the first six patients treated until 2014 as part of the learning curve, in-hospital mortality, major stroke, and retrograde dissection rates were 11.1%, 11.1%, and 5.6%, respectively. Conclusions: Endovascular aortic arch repair using this model of DIBSG is feasible, and results are acceptable for a new technique in a high-risk subset of patients. Operative mortality suffers the effect of a learning curve, whereas midterm aorta-related survival is promising. Endovascular repair of aortic arch disease with a DIBSG should always be considered to give high-risk patients a chance of repair. Large-scale studies are needed to assess the long-term durability of this technique.

Published
2019

7. iTalian RegIstry of doUble inner branch stent graft for arch PatHology (the TRIUmPH Registry)

Author

Roberta Arzedi, Giovanni Tinelli, Stefano Camparini, Claudia de Gregorio, Gabriele Pogany, Michelangelo Ferri, Michele Antonello, Rocco Giudice, Piergiorgio Cao, Sergio Berti, Davide Pacini, Luca di Marzo, Yamume Tshomba, Giuseppe Faggian, Antonio Rizza, Luigi Lovato, Ciro Ferrer, Carlo Coscarella, Alberto Dall’Antonia, Gabriele Maritati, Ilaria Franzese, Ferrer C., Cao P., Coscarella C., Ferri M., Lovato L., Camparini S., di Marzo L., Giudice R., Pogany G., de Gregorio C., Arzedi R., Pacini D., Antonello M., Dall'Antonia A., Tshomba Y., Tinelli G., Rizza A., Berti S., Faggian G., Franzese I., and Maritati G.

Subjects
Aortic arch, Male, Time Factors, medicine.medical_treatment, Aorta, Thoracic, 030204 cardiovascular system & hematology, 0302 clinical medicine, Postoperative Complications, Risk Factors, 030212 general & internal medicine, Major complication, Hospital Mortality, Registries, Arch, Stroke, Aged, 80 and over, Mortality rate, Endovascular Procedures, Aortic arch aneurysm, Endovascular aortic arch repair, Middle Aged, Settore MED/22 - CHIRURGIA VASCOLARE, Dissection, Treatment Outcome, Italy, Female, Stents, Clinical Competence, Cardiology and Cardiovascular Medicine, Learning Curve, medicine.medical_specialty, Aortic Diseases, Thoracic endovascular aortic repair, Prosthesis Design, 03 medical and health sciences, Blood Vessel Prosthesis Implantation, Inner branch stent graft, Thoracic stent graft, medicine.artery, medicine, Humans, Aged, Retrospective Studies, business.industry, Surgery, Stent, medicine.disease, Blood Vessel Prosthesis, business
Abstract

Objective The objective of this study was to assess early and midterm results after endovascular aortic arch repair using a double inner branch stent graft (DIBSG) in patients with aortic arch aneurysm or dissection unfit for open surgery. Methods Between 2012 and 2018, there were 24 patients with aortic arch disease who were treated with a single model of a DIBSG (Terumo Aortic, Glasgow, United Kingdom) in nine Italian cardiovascular centers. We investigated technical success, mortality, occurrence of major complications, and need for reintervention in a multicenter, nonrandomized, retrospective fashion. Results The in-hospital mortality rate was 16.7%. Cerebrovascular events occurred in 25% of patients and major strokes in 12.5%. Two patients experienced a retrograde dissection (8.3%), whereas none reported any type I or type III endoleak. During a mean follow-up of 18 months (range, 1-60 months), one patient died of a nonaortic cause and one reported a nonarch-related major stroke. No late secondary intervention was needed during the follow-up. Excluding from the analysis the first six patients treated until 2014 as part of the learning curve, in-hospital mortality, major stroke, and retrograde dissection rates were 11.1%, 11.1%, and 5.6%, respectively. Conclusions Endovascular aortic arch repair using this model of DIBSG is feasible, and results are acceptable for a new technique in a high-risk subset of patients. Operative mortality suffers the effect of a learning curve, whereas midterm aorta-related survival is promising. Endovascular repair of aortic arch disease with a DIBSG should always be considered to give high-risk patients a chance of repair. Large-scale studies are needed to assess the long-term durability of this technique.

Published
2019

8. Spontaneous Isolated Dissection of Iliac Artery Treated with Endovascular Repair: A Case Report.

Author

Tanda E, Genadiev GG, Zappadu S, Donno G, and Camparini S

Abstract

Spontaneous isolated dissection of the iliac artery (SID-IA) is a rare pathologic condition. The predisposing factors and best treatment strategies are still being debated. We present the case of a 59-year-old male with acute right lower limb ischemia characterized by the sudden occurrence of rest pain, hypoesthesia, and paresis. Angiography showed SID-IA extending down to the femoral bifurcation. The patient had no risk factors for SID-IA; however, he survived an electrocution and had arterial hypertension at admission. Endovascular revascularization was successfully performed, with complete restoration of limb blood flow and remission of symptoms. Follow-up ultrasonography at 1 year confirmed stent patency and absence of clinical symptoms. Endovascular stenting is a good therapeutic option for symptomatic SID-IA without rupture.

Published
2021
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10. Endovascular aortic repair in patients with challenging anatomies: the EXTREME study.

Author

Sirignano P, Mansour W, Capoccia L, Cuozzo S, Camparini S, de Donato G, Mangialardi N, Ronchey S, Talarico F, Setacci C, and Speziale F

Subjects
Aortography, Blood Vessel Prosthesis, Humans, Male, Prosthesis Design, Stents, Treatment Outcome, Aortic Aneurysm, Abdominal diagnostic imaging, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis Implantation adverse effects, Endovascular Procedures
Abstract

Aims: The aim of this study was to report the 30-day technical and clinical success with endovascular repair using the ultra-low-profile Ovation stent graft in patients judged to be outside the instructions for use (IFU) for conventional endografts, while amenable to treatment within the IFU for Ovation., Methods and Results: One hundred and twenty-two patients (78.65±7.67 years; 111 male) were enrolled. Patients were evaluated as being outside the IFU for standard endografts because of the absence of a suitable proximal aortic neck in 109 cases (89.3%), of inadequate access vessels in 13 (10.7%), or both in 111 (90.9%). Mean aneurysm (abdominal aortic aneurysm [AAA]) diameter was 52.96±10.1 mm; mean aortic neck length was 7.75±6.05 mm. Technical success (98.4%) was achieved in all but two patients due to a type Ia endoleak. At completion angiography, 15 (12.3%) patients presented a type II endoleak. All patients underwent 30-day follow-up. Primary clinical success at one month was 96.8%, assisted clinical success 98.4%. There were no type I endoleaks, while 12 (9.8%) type II endoleaks were still evident, in the absence of sac expansions. Two patients (1.6%) presented an asymptomatic limb occlusion., Conclusions: Our experience suggests that, in a selected population of patients with challenging anatomy outside the IFU for conventional endografts, endovascular aneurysm repair (EVAR) using the Ovation stent graft can be performed safely with satisfactory immediate outcomes.

Published
2021
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11. Infiltrating Angiosarcoma of the Ascending, Arch and Descending Aorta Manifested as Acute Mesenteric Ischemia.

Author

Deiana G, Genadiev G, Giordano AN, Moro M, Spanu F, Urru F, and Camparini S

Abstract

Primary malignant aortic tumors are rare and aggressive. Most cases are diagnosed at advanced stages or during autopsies with a median overall survival of 8 months from diagnosis. We present the case of a 59-year-old male with angiosarcoma involving all segments of the thoracic aorta and a large floating thrombus causing acute mesenteric ischemia, which was treated successfully with embolectomy. Graft replacement of the aorta should be considered in cases of localized disease and when patients are fit for surgery. The best medical and surgical treatment remains unclear, and further studies are needed.

Published
2021
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12. Hybrid Solution for Mycotic Pseudoaneurysm of Carotid Bifurcation.

Author

Deiana G, Baule A, Georgiev GG, Moro M, Spanu F, Urru F, and Camparini S

Abstract

Mycotic pseudoaneurysms of the extracranial carotid artery are rare and need surgical treatment to prevent rupture or embolization. We treated a case of a carotid bifurcation pseudoaneurysm secondary to infection caused by Staphylococcus epidermidis . We successfully treated it using a catheter balloon to obtain carotid bifurcation's control and replacing the carotid bifurcation with a vein graft. Management involves aneurysmectomy associated with antibiotic therapy and restoration of arterial continuity., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2020 Giuseppe Deiana et al.)

Published
2020
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13. An interdisciplinary approach for laparoscopic removal of a large retroperitoneal pelvic schwannoma attached to vital vessels: A case report.

Author

Macciò A, Kotsonis P, Aste L, Voicu MA, Madeddu C, Conti C, and Camparini S

Subjects
Aged, Biopsy, Needle, Female, Follow-Up Studies, Humans, Immunohistochemistry, Interdisciplinary Communication, Lower Extremity, Musculoskeletal Pain diagnosis, Musculoskeletal Pain etiology, Neoplasm Invasiveness pathology, Neoplasm Staging, Neurilemmoma diagnostic imaging, Rare Diseases, Retroperitoneal Neoplasms diagnostic imaging, Risk Assessment, Treatment Outcome, Laparoscopy methods, Neurilemmoma diagnosis, Neurilemmoma surgery, Retroperitoneal Neoplasms diagnosis, Retroperitoneal Neoplasms surgery, Vena Cava, Inferior pathology
Abstract

Rationale: Retroperitoneal schwannomas are very rare and may grow very close to major abdominal vessels. Since the surgical approach to the retroperitoneal space may be complex due to surrounding vital organs, including major vessels, laparoscopic surgery is challenging and has only been recently adopted. Here, we report a case of laparoscopic resection of a large retroperitoneal schwannoma attached to large vital vessels., Patient Concerns: A 62-year-old woman presented with a chief complaint of pain in the lower right limb with consequent claudication, which had lasted for approximately 1 year., Diagnoses: Magnetic resonance imaging revealed a solid oval mass measuring 45 × 32 × 39 mm, located medially to the right iliopsoas muscle at the level of the intersomatic space between the 5th lumbar vertebra and the 1st sacral vertebra. This mass was inhomogeneously hypointense in T2 due to the presence of cystic areas, with intense and inhomogeneous contrast enhancement, compatible with the diagnosis of a schwannoma. The mass compressed the inferior caval vein near its bifurcation and the right common iliac vein, anteriorly dislocating the ipsilateral iliac arterial axis., Interventions: A multidisciplinary team skilled in vascular and pelvic laparoscopy was involved. The patient underwent laparoscopic surgery via an anterior transperitoneal approach with right adnexectomy and radical excision of the tumor. The surgery lasted 120 minutes without intraoperative complications. Blood loss was less than 100 mL. The histologic diagnosis was a benign Schwannoma; grade I according to World Health Organization classification., Outcomes: The postoperative course was uneventful. At the 10-month follow-up, the patient had no recurrences and was asymptomatic., Lessons: Laparoscopic removal of large retroperitoneal schwannomas, even if attached to major vital vessels, is feasible and safe when performed by experienced surgeons.

Published
2019
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14. iTalian RegIstry of doUble inner branch stent graft for arch PatHology (the TRIUmPH Registry).

Author

Ferrer C, Cao P, Coscarella C, Ferri M, Lovato L, Camparini S, and di Marzo L

Subjects
Aged, Aged, 80 and over, Aortic Diseases diagnostic imaging, Aortic Diseases mortality, Blood Vessel Prosthesis Implantation adverse effects, Blood Vessel Prosthesis Implantation mortality, Clinical Competence, Endovascular Procedures adverse effects, Endovascular Procedures mortality, Female, Hospital Mortality, Humans, Italy, Learning Curve, Male, Middle Aged, Postoperative Complications mortality, Postoperative Complications therapy, Prosthesis Design, Registries, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Aorta, Thoracic surgery, Aortic Diseases surgery, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation instrumentation, Endovascular Procedures instrumentation, Stents
Abstract

Objective: The objective of this study was to assess early and midterm results after endovascular aortic arch repair using a double inner branch stent graft (DIBSG) in patients with aortic arch aneurysm or dissection unfit for open surgery., Methods: Between 2012 and 2018, there were 24 patients with aortic arch disease who were treated with a single model of a DIBSG (Terumo Aortic, Glasgow, United Kingdom) in nine Italian cardiovascular centers. We investigated technical success, mortality, occurrence of major complications, and need for reintervention in a multicenter, nonrandomized, retrospective fashion., Results: The in-hospital mortality rate was 16.7%. Cerebrovascular events occurred in 25% of patients and major strokes in 12.5%. Two patients experienced a retrograde dissection (8.3%), whereas none reported any type I or type III endoleak. During a mean follow-up of 18 months (range, 1-60 months), one patient died of a nonaortic cause and one reported a nonarch-related major stroke. No late secondary intervention was needed during the follow-up. Excluding from the analysis the first six patients treated until 2014 as part of the learning curve, in-hospital mortality, major stroke, and retrograde dissection rates were 11.1%, 11.1%, and 5.6%, respectively., Conclusions: Endovascular aortic arch repair using this model of DIBSG is feasible, and results are acceptable for a new technique in a high-risk subset of patients. Operative mortality suffers the effect of a learning curve, whereas midterm aorta-related survival is promising. Endovascular repair of aortic arch disease with a DIBSG should always be considered to give high-risk patients a chance of repair. Large-scale studies are needed to assess the long-term durability of this technique., (Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2019
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