706 results on '"Piscione, Federico"'
Search Results
702. Endovascular treatment of right-sided subclavian artery aneurysm in a congenitally malformed aortic arch.
- Author
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Iannelli G, Di Tommaso L, Monaco M, and Piscione F
- Subjects
- Adult, Angiography, Digital Subtraction, Female, Humans, Intracranial Aneurysm diagnostic imaging, Stents, Aorta, Thoracic abnormalities, Blood Vessel Prosthesis Implantation, Intracranial Aneurysm surgery, Subclavian Artery diagnostic imaging
- Published
- 2005
- Full Text
- View/download PDF
703. Role of beta2 adrenergic receptors in human atherosclerotic coronary arteries.
- Author
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Barbato E, Piscione F, Bartunek J, Galasso G, Cirillo P, De Luca G, Iaccarino G, De Bruyne B, Chiariello M, and Wijns W
- Subjects
- Acetylcholine pharmacology, Adrenergic beta-2 Receptor Agonists, Adrenergic beta-2 Receptor Antagonists, Albuterol pharmacology, Constriction, Pathologic physiopathology, Coronary Angiography, Coronary Artery Disease metabolism, Coronary Vessels metabolism, Endothelium, Vascular physiopathology, Female, Hemodynamics, Humans, Infusions, Intra-Arterial, Male, Middle Aged, Nitric Oxide Synthase antagonists & inhibitors, Nitro Compounds pharmacology, Phentolamine pharmacology, Vasoconstrictor Agents pharmacology, Vasodilator Agents pharmacology, omega-N-Methylarginine pharmacology, Coronary Artery Disease physiopathology, Coronary Vessels physiopathology, Receptors, Adrenergic, beta-2 physiology
- Abstract
Background: Adrenergic regulation of coronary vasomotion is balanced between alpha1-adrenergic-mediated (alpha1-AR) constriction and beta2-adrenergic-mediated (beta2-AR) relaxation. This study aimed at assessing the role of beta2-ARs in normal, mildly atherosclerotic, and stenotic human coronary arteries., Methods and Results: During intracoronary (IC) infusion of increasing doses of the beta2-AR agonist salbutamol (0.15, 0.3, and 0.6 mug/min) and the endothelial vasodilator acetylcholine (1, 3, and 10 microg/min), we measured (1) changes in lumen diameter (LD) by quantitative coronary angiography in 34 normal, 55 mildly atherosclerotic, and 42 stenotic coronary artery segments and (2) changes in average peak velocity (APV) and coronary blood flow (CBF) with the use of Doppler flow wire in 11 normal, 10 mildly atherosclerotic, and 11 stenotic coronary arteries. In 6 of 11 stenotic coronary arteries, the protocol was repeated after an IC bolus (12 microg/kg) of the alpha-adrenergic blocker phentolamine. In 6 of 11 normal coronary arteries, the protocol was repeated after an IC infusion (60 micromol/min) of N(G)-monomethyl-L-arginine (L-NMMA), a nitric oxide inhibitor. Neither salbutamol IC infusion nor acetylcholine significantly changed heart rate or blood pressure, whereas L-NMMA slightly increased blood pressure. In normal coronary arteries, salbutamol increased LD (LD max %: 11+/-2, P<0.05), APV (APV max %: 53+/-17, P<0.05), and CBF (CBF max %: 57+/-17, P<0.05), whereas L-NMMA caused a blunted APV (APV max %: 27+/-6, P<0.05) and CBF (CBF max %: 29+/-6, P<0.05) response to salbutamol. In mildly atherosclerotic coronary arteries, the salbutamol increase in LD (LD max %: 10+/-2, P<0.05), APV (APV max %: 33+/-12, P<0.05), and CBF (CBF max %: 37+/-12, P<0.05) was preserved. In stenotic coronary arteries, salbutamol induced a paradoxical reduction in LD (LD max %: -6+/-2, P<0.05), APV (APV max %: -15+/-9, P<0.05), and CBF (CBF max %: -15+/-6, P<0.05), which was no longer observed after phentolamine. Acetylcholine increased LD (LD max %: 14+/-3, P<0.05), APV (APV max %: 61+/-20, P<0.05), and CBF (CBF max %: 67+/-19, P<0.05) in normal coronary arteries. In mildly atherosclerotic coronary arteries, acetylcholine induced a significant reduction in LD (LD max %: -15+/-2, P<0.05) and no changes in APV (APV max %: -6+/-13, P=NS) and CBF (CBF max %: -10+/-13, P=NS). In stenotic coronary arteries, acetylcholine significantly reduced LD (LD max %: -15+/-3, P<0.05), APV (APV max %: -15+/-9, P<0.05), and CBF (CBF max %: -15+/-6, P<0.05)., Conclusions: In severely atherosclerotic coronary arteries, beta2-adrenergic vasodilatation is impaired, and this might contribute to alter the vasomotor balance, further precipitating myocardial ischemia during sympathetic activation.
- Published
- 2005
- Full Text
- View/download PDF
704. Thoracic aortic emergencies: impact of endovascular surgery.
- Author
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Iannelli G, Piscione F, Di Tommaso L, Monaco M, Chiariello M, and Spampinato N
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Dissection diagnostic imaging, Aorta, Thoracic diagnostic imaging, Aortic Aneurysm, Thoracic diagnostic imaging, Aortic Rupture diagnostic imaging, Aortography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications diagnostic imaging, Postoperative Complications mortality, Rupture, Spontaneous, Survival Rate, Wounds, Nonpenetrating diagnostic imaging, Aortic Dissection surgery, Angioplasty, Balloon, Aorta, Thoracic injuries, Aortic Aneurysm, Thoracic surgery, Aortic Rupture surgery, Blood Vessel Prosthesis Implantation, Emergencies, Stents, Wounds, Nonpenetrating surgery
- Abstract
Background: Conventional surgery for thoracic aortic emergencies, such as contained or free rupture of thoracic aortic aneurysms, acute type B dissections, and traumatic rupture of the thoracic aorta, is frequently associated with a high rate of mortality and morbidity. To obviate this risk, endovascular surgery is considered to be a valid alternative procedure., Methods: From March 2001 to July 2002, 15 of 22 patients with acute thoracic aortic syndromes were submitted to endovascular surgery: 3 patients (20%) for traumatic rupture, 4 patients (26.7%) for contained or free rupture of thoracic aortic aneurysm, and 8 patients (53.3%) for acute type B dissection evolving to rupture. Computed tomographic scan was diagnostic in all patients. The stent grafts were introduced through the femoral artery., Results: In the endovascular group there were no perioperative deaths or open conversions. The intraoperative angiography and computed tomographic scan performed on discharge showed no significant endoleaks and successful sealing of the aortic dissection. Average intensive care unit and hospital stay was 1.7 +/- 0.8 and 5.9 +/- 3.0 days. Follow-up ranged between 4 and 23 months and included clinical examinations and serial computed tomographic scan at 3, 6, and 12 months, and every 6 months thereafter. One 84-year-old patient with thoracic aortic aneurysm died of pneumonia 78 days after endovascular surgery. Only one type 1 endoleak was noted in the first patient with traumatic rupture, 3 months after the procedure., Conclusions: Endovascular surgery is a safe technique, showing encouraging early and midterm results and allowing for prompt treatment of associated lesions in complex multitrauma patients.
- Published
- 2004
- Full Text
- View/download PDF
705. [Morphologic and functional abnormalities of the cardiovascular system in patients with hepatic cirrhosis].
- Author
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Piscione F, Manganiello V, Viola O, and Chiariello M
- Subjects
- Blood Circulation physiology, Blood Volume, Diastole physiology, Disease Progression, Exercise physiology, Heart Diseases drug therapy, Heart Diseases pathology, Humans, Hypertension, Portal drug therapy, Hypertension, Portal physiopathology, Hypertension, Pulmonary drug therapy, Hypertension, Pulmonary etiology, Hypertension, Pulmonary physiopathology, Liver Cirrhosis complications, Liver Cirrhosis drug therapy, Myocardial Contraction, Prognosis, Receptors, Adrenergic, beta physiology, Regional Blood Flow, Syndrome, Vascular Resistance, Heart Diseases physiopathology, Liver Cirrhosis physiopathology
- Abstract
During liver cirrhosis many important changes occur in the cardiovascular system and these abnormalities appear more evident as portal hypertension and liver dysfunction progress. The cirrhotic heart develops a series of structural and functional abnormalities consisting in diastolic dysfunction and reduced myocardial reactivity during exercise, likely due to a diminished myocardial beta-adrenergic receptor function. Nevertheless, the peculiarity of the cardiovascular involvement during liver cirrhosis is represented by a progressive development of a hyperdynamic circulation that seems to be due to portal hypertension rather than to liver insufficiency. In fact, it has been hypothesized that this syndrome raise from the venous portal bed and is primarily determined by an increase in blood volume that leads to an enhanced cardiac output. Later, as liver cirrhosis progresses, new important pathogenetic elements occur and lead to a reduction in peripheral vascular resistances and to the full clinical expression of hyperdynamic circulation. The pathogenesis of hyperdynamic circulation is very interesting for scientific research because of the complex and still in part unknown origin. In addition, this syndrome has an important clinical meaning for its severely adverse prognostic value and it represents the pathogenetic background for a number of severe complications of advanced liver cirrhosis.
- Published
- 2003
706. Immediate and long-term outcome of recanalization of chronic total coronary occlusions.
- Author
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Piscione F, Galasso G, Maione AG, Pisani A, Golino P, Leosco D, Indolfi C, and Chiariello M
- Subjects
- Aged, Chronic Disease, Constriction, Pathologic therapy, Coronary Disease pathology, Coronary Restenosis therapy, Female, Humans, Male, Middle Aged, Recurrence, Retrospective Studies, Time Factors, Treatment Outcome, Angioplasty, Balloon, Coronary adverse effects, Angioplasty, Balloon, Coronary methods, Coronary Disease therapy
- Abstract
Eighty-three consecutive patients with 85 coronary total occlusions undergoing coronary angioplasty were retrospectively studied. Patients were divided into two groups according to the occlusion age that was < 30 days (subacute total occlusion [STO]: 25 patients; range 1-30 days) or > 30 days (chronic total occlusion [CTO]: 58 patients; range 3-144 months). All procedures were carried out using a hydrophilic guidewire. Clinical success, consisting of crossing the lesion, balloon dilatation, stent deployment without complications, was 96% in STO and 81% in CTO. Multiple stepwise logistic regression analysis identified a family history of coronary artery disease (CAD), left anterior descending and right coronary artery occlusions as independent predictors of a successful procedure. No major events occurred during or immediately after the angioplasty. After a mean follow-up of 24 +/- 2 months, no difference was found in survival or freedom from myocardial infarction or target vessel revascularization among the STO and CTO patients. Successful recanalization by using a hydrophilic guidewire was achieved in a high percentage of chronic total occlusions with a low incidence of complications and a satisfactory late clinical outcome. Family history of CAD and occlusion of left anterior descending or right coronary arteries are independent predictors of procedural success.
- Published
- 2002
- Full Text
- View/download PDF
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