18 results on '"Torsello, Giovanni Federico"'
Search Results
2. Outcomes of bridging stent grafts in fenestrated and branched endovascular aortic repair
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Torsello, Giovanni Federico, Beropoulis, Efthymios, Munaò, Roberta, Trimarchi, Santi, Torsello, Giovanni B., and Austermann, Martin
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- 2020
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3. Late outcomes of different hypogastric stent grafts in aortoiliac endografting with iliac branch device: Results from the pELVIS Registry
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Austermann, Martin, Inchingolo, Mirjam, Bisdas, Theodosios, Torsello, Giovanni, Pratesi, Giovanni, Barbante, Matteo, Cao, Piergiorgio, Ferrer, Ciro, Pratesi, Carlo, Fargion, Aaron, Masciello, Fabrizio, Kölbel, Tilo, Tsilimparis, Nikolaos, Haulon, Stephan, Branzan, Daniela, Schmidt, Andrej, Scheinert, Dirk, Verzini, Fabio, Parlani, Gianbattista, Varetto, Gianfranco, Gibello, Lorenzo, Boero, Michele, Torsello, Giovanni Federico, Donas, Konstantinos P., and Simonte, Gioele
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- 2020
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4. Radiation doses for endovascular aortic repairs performed on mobile and fixed C-arm fluoroscopes and procedure phase-specific radiation distribution
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Schaefers, Johannes Frederik, Wunderle, Kevin, Usai, Marco Virgilio, Torsello, Giovanni Federico, and Panuccio, Giuseppe
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- 2018
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5. Editor's Choice – RANDOMisation Screening for Drug coated or Drug Eluting Device Randomised Trials Among Patients Undergoing Endovascular FemorOPopliteal Procedures (RANDOM-STOP study)
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Stavroulakis, Konstantinos, primary, Katsogridakis, Emmanuel, additional, Torsello, Giovanni, additional, Zayed, Hany, additional, van Herzeele, Isabelle, additional, Coscas, Raphael, additional, Nasr, Bahaa, additional, Gonzalez, Teresa Martin, additional, Troisi, Nicola, additional, Saratzis, Athanasios, additional, Bohnert, Ambre, additional, Martin-Gonzalez, Teresa, additional, Torsello, Giovanni B., additional, Wichmann, Katrin, additional, Cardona, Yamel Gloria, additional, Stavroulakis, Christiane, additional, Stavroulakis, Konstantinos, additional, Tsilimparis, Nikolaos, additional, Konstantinou, Nikolaos, additional, Croo, Alexander, additional, Jacobs, Karen, additional, Pecceu, Stefanie, additional, Van Langenhove, Karen, additional, Mercier, Lucie, additional, Simonte, Gioele, additional, Terpin, Andrea Maria, additional, Isernia, Giacomo, additional, Furlan, Federico, additional, Frigatti, Paolo, additional, Canovaro, Francesco, additional, Torri, Lorenzo, additional, D'Oria, Mario, additional, Lepidi, Sandro, additional, Magalhães, Tiago, additional, Pedro, Luís Mendes, additional, Marone, Enrico Maria, additional, Marazzi, Giulia, additional, Rinaldi, Luigi Federico, additional, Thulasidasan, Narayanan, additional, Benton, Lily, additional, Gregory, Mark, additional, Asciutto, Giuseppe, additional, Korosoglou, Grigorios, additional, and Torsello, Giovanni Federico, additional
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- 2023
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6. Evaluation of Different Registration Algorithms to Reduce Motion Artifacts in CT-Thermography (CTT).
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Kostyrko, Bogdan, Rubarth, Kerstin, Althoff, Christian, Zibell, Miriam, Neizert, Christina Ann, Poch, Franz, Torsello, Giovanni Federico, Gebauer, Bernhard, Lehmann, Kai, Niehues, Stefan Markus, Mews, Jürgen, Diekhoff, Torsten, and Pohlan, Julian
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COMPUTED tomography ,RECORDING & registration ,ALGORITHMS ,THERMOGRAPHY - Abstract
Computed tomography (CT)-based Thermography (CTT) is currently being investigated as a non-invasive temperature monitoring method during ablation procedures. Since multiple CT scans with defined time intervals were acquired during this procedure, interscan motion artifacts can occur between the images, so registration is required. The aim of this study was to investigate different registration algorithms and their combinations for minimizing inter-scan motion artifacts during thermal ablation. Four CTT datasets were acquired using microwave ablation (MWA) of normal liver tissue performed in an in vivo porcine model. During each ablation, spectral CT volume scans were sequentially acquired. Based on initial reconstructions, rigid or elastic registration, or a combination of these, were carried out and rated by 15 radiologists. Friedman's test was used to compare rating results in reader assessments and revealed significant differences for the ablation probe movement rating only (p = 0.006; range, 5.3–6.6 points). Regarding this parameter, readers assessed rigid registration as inferior to other registrations. Quantitative analysis of ablation probe movement yielded a significantly decreased distance for combined registration as compared with unregistered data. In this study, registration was found to have the greatest influence on ablation probe movement, with connected registration being superior to only one registration process. [ABSTRACT FROM AUTHOR]
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- 2023
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7. A meta-analysis of safety and efficacy of endovascular aneurysm repair in aneurysm patients with severe angulated infrarenal neck
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Bernardini, Giulia, primary, Litterscheid, Sarah, additional, Torsello, Giovanni Battista, additional, Torsello, Giovanni Federico, additional, Beropoulis, Efthymios, additional, and Özdemir-van Brunschot, Denise, additional
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- 2022
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8. Combining Transarterial Radioembolization (TARE) and CT-Guided High-Dose-Rate Interstitial Brachytherapy (CT-HDRBT): A Retrospective Analysis of Advanced Primary and Secondary Liver Tumor Treatment
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Fleckenstein, Florian Nima, Roesel, Maximilian Julius, Krajewska, Maja, Auer, Timo Alexander, Collettini, Federico, Maleitzke, Tazio, B��ning, Georg, Torsello, Giovanni Federico, Fehrenbach, Uli, and Gebauer, Bernhard
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Minimal Invasive ,Oncology ,Interventional Radiology ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,SIRT ,Ablation ,Locoregional therapy ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit ,RC254-282 ,Article - Abstract
Purpose: Treatment of patients with primary and secondary liver tumors remains challenging. This study analyzes the efficacy and safety of transarterial radioembolization (TARE) combined with CT-guided high-dose-rate interstitial brachytherapy (CT-HDRBT) for the treatment of primary and secondary liver tumors. Patients and Methods: A total of 77 patients (30 female) with various liver malignancies were treated. Primary endpoints were median overall survival (OS) and time to untreatable progression (TTUP). Additionally, subgroup analyses were performed in consideration of diagnosis and procedure sequence. Median OS and TTUP prediction were estimated using Kaplan-Meier analysis and hazard ratios (HR) were calculated using a multivariate Cox proportional hazard model. Results: A total of 115 CT-HDRBT and 96 TARE procedures were performed with Purpose: Treatment of patients with primary and secondary liver tumors remains challenging. This study analyzes the efficacy and safety of transarterial radioembolization (TARE) combined with CT-guided high-dose-rate interstitial brachytherapy (CT-HDRBT) for the treatment of primary and secondary liver tumors. Patients and methods: A total of 77 patients (30 female) with various liver malignancies were treated. Primary endpoints were median overall survival (OS) and time to untreatable progression (TTUP). Additionally, subgroup analyses were performed in consideration of diagnosis and procedure sequence. Median OS and TTUP prediction were estimated using Kaplan-Meier analysis and hazard ratios (HR) were calculated using a multivariate Cox proportional hazard model. Results: A total of 115 CT-HDRBT and 96 TARE procedures were performed with no significant complications recorded. Median OS and TTUP were 29.8 (95% CI 18.1-41.4) and 23.8 (95% CI 9.6-37.9) months. Median OS for hepatocellular carcinoma (HCC)-, cholangiocarcinoma carcinoma (CCA) and colorectal cancer (CRC) patients was 29.8, 29.6 and 34.4 months. Patients starting with TARE had a median OS of 26.0 (95% CI 14.5-37.5) compared to 33.7 (95% CI 21.6-45.8) months for patients starting with CT-HDRBT. Hazard ratio of 1.094 per month was shown for patients starting with CT-HDRBT. Conclusion: Combining TARE and CT-HDRBT is effective and safe for the treatment of advanced stage primary and secondary liver tumors. Our data indicate that early TARE during the disease progression may have a positive effect on survival.no significant complications recorded. Median OS and TTUP were 29.8 (95% CI 18.1-41.4) and 23.8 (95% CI 9.6-37.9) months. Median OS for hepatocellular carcinoma (HCC)-, cholangiocarcinoma carcinoma (CCA) and colorectal cancer (CRC) patients was 29.8, 29.6 and 34.4 months. Patients starting with TARE had a median OS of 26.0 (95% CI 14.5-37.5) compared to 33.7 (95% CI 21.6-45.8) months for patients starting with CT-HDRBT. Hazard ratio of 1.094 per month was shown for patients starting with CT-HDRBT. Conclusion: Combining TARE and CT-HDRBT is effective and safe for the treatment of advanced stage primary and secondary liver tumors. Our data indicate that early TARE during the disease progression may have a positive effect on survival.
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- 2021
9. A Meta Analysis of Safety and Efficacy of EVAR in Aneurysm Patients with Angulated and Hyperangulated Necks
- Author
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Bernardini, Giulia, primary, Litterscheid, Sarah, additional, Torsello, Giovanni Battista, additional, Torsello, Giovanni Federico, additional, Beropoulis, Efthimios, additional, and Özdemir-van Brunschot, Denise, additional
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- 2022
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10. The PROTAGORAS study to evaluate the performance of the Endurant stent graft for patients with pararenal pathologic processes treated by the chimney/snorkel endovascular technique
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Donas, Konstantinos P., Torsello, Giovanni B., Piccoli, Gianluca, Pitoulias, Georgios A., Torsello, Giovanni Federico, Bisdas, Theodosios, Austermann, Martin, and Gasparini, Daniele
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- 2016
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11. Neue Stent-Graft-Designs in der Behandlung von thorakalen, thorakoabdominellen und abdominellen Aortenaneurysmen
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Torsello, Giovanni Federico
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bridging stent ,TEVAR ,FEVAR ,EVAR ,BEVAR ,aortic aneurysm ,biomechanics ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit - Abstract
Die endovaskuläre Versorgung von Aortenaneurysmen hat sich in den letzten zwei Dekaden zunehmend als Therapie der ersten Wahl durchgesetzt. Offen operative Verfahren kommen gegenwärtig vor allem dann zum Einsatz, wenn die Patientenanatomie eine angemessene endovaskuläre Therapie einschränkt. Neue Stent-Graft-Designs sollen die endovaskuläre Therapie in diesen Fällen verbessern oder ermöglichen. Im Fall von thorakalen Aortenaneurysmen sind die Hauptlimitationen einerseits die Morphologie der Zugangsgefäße und andererseits die Angulation des Aortenbogens. Die Therapie von thorakoabdominellen und juxtarenalen Aortenaneurysmen ist durch die Erhaltung der viszerorenalen Perfusion charakterisiert. Da Niedrigprofil-Endoprothesen aufgrund von Alterationen in Material und Design deutlich flexibler und dünner hergestellt werden können, bestand lange die Frage, ob sie aus diesem Grund langfristig häufiger Stentfrakturen oder Graftdefekte aufweisen. Daher adressierte Originalarbeit 1 insbesondere die dauerhafte Haltbarkeit dieser Prothesen. 44 Patient*innen wurden mittels einer Niedrigprofil-Prothese (Zenith Thoracic Alpha) behandelt und für mindestens fünf Jahre nachuntersucht. Mit einer Migrationsrate von 4,5 %, keinen Stentfrakturen und einer Typ III-Endoleckrate von 2,3 % konnte erstmals gezeigt werden, dass thorakale Niedrigprofil-Prothesen auch langfristig Aortenpathologien ausschalten können, ohne dass die Haltbarkeit der Prothesen darunter leidet. Eine weitere Limitation von thorakalen Aortenprothesen ist die erschwerte Adaptation an die Krümmung des Aortenbogens. Eine Ursache für Migration und Typ I-Endoleckagen ist das unvollständige Anliegen der Prothese an die kleine Aortenkurvatur, die einem hervorstehenden Vogelschnabel ähnelt und daher als „Bird-Beak“ bezeichnet wird. Originalarbeit 2 untersuchte die Ergebnisse ein neues Stent-Graft-Design, dass eine Nachkrümmung in situ ermöglicht. 127 Patient*innen wurden in 20 Zentren mittels dieses Stent-Grafts behandelt. In 50,4 % der Fälle wurde die Nachkrümmung angewandt, mit dem Resultat, dass kein einziger Fall von Migration oder eines Typ I-Endolecks auftrat. Ein weiterer Vorteil des neuen Stent-Graft-Designs ist der zweistufige Entfaltungsmechanismus der Prothese während der Implantation, welche eine Repositionierung des Stent-Grafts und somit eine optimale Positionierung erlaubt. Dieser Mechanismus wurde in 62,3 % der Fälle angewendet. Thorakoabdominelle Aortenaneurysmen werden seit mehr als zehn Jahren mittels fenestrierten oder gebranchten Prothesen versorgt. Dabei werden die viszeralen und renalen Arterien mittels Stent-Grafts mit den Aortenprothesen verbunden. Bis heute ist kein Stent-Graft für diese Indikation zugelassen. Die heute im Einsatz befindlichen Stent-Grafts sind lediglich für die Therapie von peripheren arteriellen Pathologien zugelassen. Hier stehen allerdings andere Eigenschaften für den klinischen Erfolg im Vordergrund als für den Einsatz als Überbrückungsstents. Originalarbeit 3 untersuchte daher dezidiert die biomechanischen Eigenschaften eines neuen Stent-Grafts. Nach Implantation von 50 VBX Stent-Grafts in Fenestrationen wurden Stentfrakturen mittels CT und Projektionsradiographie ausgeschlossen. Eine Dichtigkeitsprüfung erbrachte keine Hinweise auf Risse im Graftmaterial. Zug- und Scherkrafttests ergaben supraphysiologische Haltbarkeit mit Stentversagen bei 11,3-31 N bzw. 3,31-6,91 N. Ein klinischer Vergleich der verschiedenen, auf dem Markt erhältlichen Stent-Grafts ist aufgrund der sehr verschiedenen Aortenpathologien und Gefäßmorphologien nur sehr eingeschränkt möglich. Daher ist ein klinischer Vergleich zwischen den verschiedenen Überbrückungsstents mit Einschränkungen behaftet. In Originalarbeit 4 wurde das neue Stent-Graft-Design des VBX mit einer als Überbrückungsstent etablierten Endoprothese in vitro verglichen. Je 20 VBX Stent-Grafts und Advanta V12 Endoprothesen wurden untersucht. Nach Implantation und Anmodellierung in die Fenestrationen fanden sich keine Unterschiede in der Frakturrate. Im Zugkrafttest war der Unterschied zwischen VBX und Advanta V12 lediglich in den 6 mm Stent-Grafts statistisch signifikant (27,1 N vs. 16,6 N, p = 0,008). In den 8 mm Stent-Grafts betrugen die erforderlichen Zugkräfte 20,1 N für VBX und 15,8 N für Advanta V12. Im Scherkrafttest waren höhere Kräfte erforderlich, um die Advanta V12 Endoprothesen zu dislozieren. In der Therapie mittels fenestrierten Prothesen werden auch andere Stent-Grafts eingesetzt. In der Literatur beschrieben ist bspw. die BeGraft Endoprothese. Eine völlig neue Endoprothese ist der BeGraft Plus. In Originalarbeit 5 wurde daher ein Vergleich dieser beiden Stent-Graft-Modelle vorgenommen. Um eine Vergleichbarkeit mit der o. g. Originalarbeit 4 herzustellen, wurde ein identisches Studiendesign eingesetzt. Während allenfalls morphologische Veränderungen nach Implantation und Anmodellierung zu verzeichnen waren, zeigten sich deutliche Unterschiede in den biomechanischen Eigenschaften der beiden Stent-Grafts. Die BeGraft Plus Endoprothesen erforderten signifikant größere Kräfte sowohl im Zugkraft- (6 mm: 17,1-30,4 N, p = 0,006 sowie 8 mm: 11,3 N vs. 21,8 N, p < 0,001), als auch im Scherkrafttest (6 mm: 10,5 N vs. 15,28 N, p = 0,016 sowie 8 mm: 15,23 N vs. 20,72 N, p = 0,017). Klinische Ergebnisse zu diesem neuen Endoprothesen-Design stehen noch aus. Originalarbeit 6 berichtet erstmals über die klinischen Ergebnisse des VBX Stent-Grafts als Überbrückungsstent. 50 Patient*innen wurden nach Implantation von fenestrierten oder gebranchten Aortenprothesen in diese retrospektive, monozentrische Studie eingeschlossen. Insgesamt wurden in 198 Zielgefäße 145 solcher Stent-Grafts implantiert. Die technische Erfolgs- (98,6 % für alle Überbrückungsstents) und Reinterventionsrate (2,8 % für die VBX Stent-Grafts) waren im Vergleich mit den aus der Literatur bekannten Daten vielversprechend. Im Fall von juxtarenalen Aneurysmen kommt neben der Implantation von fenestrierten Prothesen auch der Einsatz von „Chimney“-Grafts infrage. Insbesondere in der dringlichen oder notfälligen Therapie von juxtarenalen Aneurysmen wird die Implantation von „Chimney“-Grafts angewendet, da hier nicht gewartet werden kann, bis eine maßgeschneiderte Prothese hergestellt und geliefert ist. Allerdings gibt es eine große Bandbreite an möglichen Kombinationen von Aortenprothesen und Stent-Grafts für die Nieren- und Viszeralarterien. Klinisch ideal wäre ein Stent-Graft, der sowohl möglichst kleine „Gutter“-Flächen erzeugt und genug Aufstellkraft besitzt, um langfristig offen zu bleiben. In Originalarbeit 7 wurden drei verschiedene Stent-Graft-Designs (Advanta V12 vs. VBX vs. BeGraft Plus) in Kombination mit einer Aortenprothese in einem Silikonmodell miteinander verglichen. Während die „Gutter“-Flächen beim bewährten Advanta V12 Stentgraft am kleinsten waren (4,46 ± 0,3 mm2; VBX: 4,12 ± 0,4 mm2, p = 0,251; BeGraft Plus: 4,12 ± 0,3 mm2, p = 0,749), wies der VBX Stent-Graft die geringste Stenosierung auf (4,16 ± 0,4 mm, Advanta V12: 3,77 ± 0,3 mm; BeGraft Plus: 3,74 ± 0,3 mm, p = 0,013). Zusammenfassend zeigen die vorgelegten Arbeiten, dass mit der Weiterentwicklung von neuen Stent-Graft-Designs auch anspruchsvolle Aortenpathologien behandelt werden können. Im Fall der thorakalen Aortenprothesen konnten erstmals wichtige Evidenzlücken bezüglich der Zugangs- und Aortenbogenpathologien sowie des dauerhaften klinischen Erfolgs geschlossen werden. Im Bereich der Therapie von thorakoabdominellen Aortenpathologien wurden neue Stent-Graft-Designs erstmalig klinisch evaluiert – und womöglich noch bedeutsamer – experimentell über die gesamte Bandbreite der aktuell eingesetzten Stent-Grafts miteinander vergleichbar untersucht. Die vorgelegten Ergebnisse können dazu dienen, in Zukunft einen für diese Indikation dedizierten Stent-Graft zu identifizieren oder ggf. zu entwickeln.
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- 2021
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12. One-Year Results From the SURPASS Observational Registry of the CTAG Stent-Graft With the Active Control System
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Torsello, Giovanni Federico, Argyriou, Angeliki, Stavroulakis, Konstantinos, Bosiers, Michel J., Austermann, Martin, Torsello, Giovanni B., Torsello, Giovanni Federico, Argyriou, Angeliki, Stavroulakis, Konstantinos, Bosiers, Michel J., Austermann, Martin, and Torsello, Giovanni B.
- Abstract
Purpose: To report the outcomes from the observational SURPASS registry, which was created to assess the performance of the Conformable TAG (CTAG) stent-graft with the Active Control System (ACS) in patients undergoing thoracic endovascular aortic repair (TEVAR) in a real-world setting. Materials and Methods: The SURPASS registry (ClinicalTrials.gov; identifier NCT03286400) was an observational, prospective, single-arm, post-market, international study that enrolled patients undergoing TEVAR using the CTAG with ACS for both acute and chronic thoracic aortic disease between October 2017 and July 2018. The CTAG with ACS features 2-stage deployment of the stent-graft and an optional angulation mechanism that modifies only the proximal end of the stent-graft. During the observation period, 127 patients (mean age 67.1±12.1 years, range 27-86; 92 men) were enrolled and treated for an array of aortic pathologies, including chronic and acute lesions and 4 ruptured descending thoracic aneurysms. The primary outcome of this study was technical success; secondary outcomes were clinical success and major adverse events at 30 days and 12 months. The numbers of 2-stage device deployments and applications of the angulation mechanism were recorded, along with the reasons for use. Results: Technical success of the TEVAR was 97.6% owing to unintentional partial coverage of supra-aortic branches in 3 cases (the vessels were patent on imaging). The stent-graft was repositioned at its intermediate diameter in 79 patients (62.2%), and the angulation feature was applied in 64 cases (50.4%), mainly to improve proximal wall apposition and orthogonality in the aorta. The desired effect was achieved in 60 cases (93.8%). There was no device compression, bird-beak configuration, fracture, or graft occlusion. The 30-day and 12-month clinical success rates were 97.6% and 92.9%, respectively. There were 3 aorta-related deaths at 30 days and a further 3 at 12 months. Fatalities were due to a retrog, On behalf of the SURPASS Registry Collaborators.
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- 2020
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13. Successful aspiration thrombectomy in a patient with submassive, intermediate-risk pulmonary embolism following COVID-19 pneumonia
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Pohlan, Julian, primary, Kamel, Sarah Nadine, additional, Torsello, Giovanni Federico, additional, Zickler, Daniel, additional, Kruse, Jan Matthias, additional, Eckardt, Kai-Uwe, additional, and Gebauer, Bernard, additional
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- 2020
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14. Late outcomes of different hypogastric stent grafts in aortoiliac endografting with iliac branch device: Results from the pELVIS Registry
- Author
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Verzini, Fabio, primary, Parlani, Gianbattista, additional, Varetto, Gianfranco, additional, Gibello, Lorenzo, additional, Boero, Michele, additional, Torsello, Giovanni Federico, additional, Donas, Konstantinos P., additional, Simonte, Gioele, additional, Austermann, Martin, additional, Inchingolo, Mirjam, additional, Bisdas, Theodosios, additional, Torsello, Giovanni, additional, Pratesi, Giovanni, additional, Barbante, Matteo, additional, Cao, Piergiorgio, additional, Ferrer, Ciro, additional, Pratesi, Carlo, additional, Fargion, Aaron, additional, Masciello, Fabrizio, additional, Kölbel, Tilo, additional, Tsilimparis, Nikolaos, additional, Haulon, Stephan, additional, Branzan, Daniela, additional, Schmidt, Andrej, additional, and Scheinert, Dirk, additional
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- 2020
- Full Text
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15. TAA 10. The Impact of Aortic Remodeling on the Performance of Bridging Stents After Branched Endovascular Aortic Repair
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Fazzini, Stefano, primary, Torsello, Giovanni Federico, additional, Austermann, Martin, additional, and Torsello, Giovanni, additional
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- 2019
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16. Computer-aided endovascular aortic repair using fully automated two- and three-dimensional fusion imaging
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Panuccio, Giuseppe, primary, Torsello, Giovanni Federico, additional, Pfister, Markus, additional, Bisdas, Theodosios, additional, Bosiers, Michel J., additional, Torsello, Giovanni, additional, and Austermann, Martin, additional
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- 2016
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17. SS3. The PROTAGORAS Study to Evaluate the Performance of the Endurant Stent Graft for Patients With Pararenal Pathologies Treated by the Chimney/Snorkel Endovascular Technique
- Author
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Donas, Konstantinos P., primary, Torsello, Giovanni, additional, Piccoli, Gianluca, additional, Pitoulias, Georgios A., additional, Torsello, Giovanni Federico, additional, Bisdas, Theodosios, additional, Austermann, Martin J., additional, and Gasparini, Daniele, additional
- Published
- 2015
- Full Text
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18. Combining Transarterial Radioembolization (TARE) and CT-Guided High-Dose-Rate Interstitial Brachytherapy (CT-HDRBT): A Retrospective Analysis of Advanced Primary and Secondary Liver Tumor Treatment.
- Author
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Fleckenstein, Florian Nima, Roesel, Maximilian Julius, Krajewska, Maja, Auer, Timo Alexander, Collettini, Federico, Maleitzke, Tazio, Böning, Georg, Torsello, Giovanni Federico, Fehrenbach, Uli, and Gebauer, Bernhard
- Subjects
DRUG efficacy ,DISEASE progression ,LIVER tumors ,CONFIDENCE intervals ,RADIOEMBOLIZATION ,CHOLANGIOCARCINOMA ,RETROSPECTIVE studies ,TREATMENT effectiveness ,COLORECTAL cancer ,SURVIVAL analysis (Biometry) ,KAPLAN-Meier estimator ,DESCRIPTIVE statistics ,RADIOISOTOPE brachytherapy ,COMBINED modality therapy ,PATIENT safety ,PROPORTIONAL hazards models ,HEPATOCELLULAR carcinoma - Abstract
Simple Summary: Clinical management of advanced stages of primary and secondary liver tumors remains challenging. Combining different treatment approaches to create the most effective therapy for patients is, however, often necessary. With this study we aim to analyze the efficacy and safety of a combined intrahepatic treatment of transarterial radioembolization and CT-guided high-dose-rate interstitial brachytherapy. Our study showed that patients not responding to systemic chemotherapy or suffering from tumor relapse after surgical resection might benefit from a combined minimal-invasive treatment. Purpose: Treatment of patients with primary and secondary liver tumors remains challenging. This study analyzes the efficacy and safety of transarterial radioembolization (TARE) combined with CT-guided high-dose-rate interstitial brachytherapy (CT-HDRBT) for the treatment of primary and secondary liver tumors. Patients and Methods: A total of 77 patients (30 female) with various liver malignancies were treated. Primary endpoints were median overall survival (OS) and time to untreatable progression (TTUP). Additionally, subgroup analyses were performed in consideration of diagnosis and procedure sequence. Median OS and TTUP prediction were estimated using Kaplan–Meier analysis and hazard ratios (HR) were calculated using a multivariate Cox proportional hazard model. Results: A total of 115 CT-HDRBT and 96 TARE procedures were performed with no significant complications recorded. Median OS and TTUP were 29.8 (95% CI 18.1–41.4) and 23.8 (95% CI 9.6–37.9) months. Median OS for hepatocellular carcinoma (HCC)-, cholangiocarcinoma carcinoma (CCA) and colorectal cancer (CRC) patients was 29.8, 29.6 and 34.4 months. Patients starting with TARE had a median OS of 26.0 (95% CI 14.5–37.5) compared to 33.7 (95% CI 21.6–45.8) months for patients starting with CT-HDRBT. Hazard ratio of 1.094 per month was shown for patients starting with CT-HDRBT. Conclusion: Combining TARE and CT-HDRBT is effective and safe for the treatment of advanced stage primary and secondary liver tumors. Our data indicate that early TARE during the disease progression may have a positive effect on survival. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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