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1. 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, Resch, 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, Tambyraja, 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, Raphael, C, Clair, D, Dawson, D, Arnaoutakis, D, Bockler, 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, Alvarez-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, Duppers, P, Holt, P, Helmio, 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, Horer, T, Bisdas, T, Vasudevan, T, Lattmann, T, Wyss, T, Maldonado, T, Pfammatter, T, Kolbel, T, Jakimowicz, T, Donati, T, Tracci, M, Bracale, U, Tolva, V, Riambau, V, Palazzo, V, Makaloski, V, Von Allmen, R, Dorigo, W, Mansour, W, Van den Eynde, W, Tinelli G., D'Oria M., Sica S., Mani K., Rancic Z., Resch T. A., Beccia F., Azizzadeh A., Da Volta Ferreira M. M., Gargiulo M., Lepidi S., Tshomba Y., Oderich G. S., Haulon S., Beck A. W., Hertault A., Savlania A., Froio A., Giaquinta A., Zimmermann A., Psyllas A., Wanhainen A., Marchetti A. A., Queiroz A. B., Kahlberg A., Reyes-Valdivia A., Schanzer A., Tambyraja A., Freyrie A., Lorido A., Millon A., Ippoliti A., Abai B., Mees B., Reutersberg B., Maurel B., Michel B., Wahlgren C. M., Cavazzini C., Setacci C., Lee C. J., Ferrer C., Bicknell C., Raphael C., Clair D., Dawson D. L., Arnaoutakis D. J., Bockler D., Kotelis D., Mujagic E., Chisci E., Cieri E., Gallitto E., Marone E. M., Ducasse E., Verzini F., Pecoraro F., Serracino-Inglott F., Benedetto F., Speziale F., Stilo F., Alvarez-Marcos F., Pagliariccio G., Piffaretti G., Lanza G., Philipp G., Geenberg G., Jung G., Melissano G., Veraldi G. F., Parlani G., Faggioli G., de Donato G., Simonte G., Colacchio G., De Caridi G., Pratesi G., Spinella G., Torsello G., Leong Tan G. W., Magee G. A., Verhagen H., Andrew H., Koleilat I., Ohman J. W., de Vries J. P. P. M., Budtz-Lilly J., Black J., Eldrup-Jorgensen J., Hockley J., Bath J., Sobocinski J., van Herwaarden J. A., Reinhard K., Orion K. C., 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. G., Czerny M., Orrico M., Eagleton M. J., Smeds M. R., Taurino M., Wohlauer M., Sharafuddin M. J., Anna-Leonie M., Reijnen M., Antonello M., Piazza M., Settembre N., Mouawad N. J., Tsilimparis N., Dias N., Martinelli O., Frigatti P., Sirignano P., Chong P., Bevis P., DiMuzio P., Henke P., Duppers P., Holt P., Helmio P., Vriens P., Pulli R., Bellosta R., Micheli R., Veeraswamy R., Cuff R., Chiappa R., Gattuso R., Pini R., Dalman R. L., Milner R., Scali S. T., Bahia S., Laukontaus S., Trimarchi S., Fernandez-Alonso S., Deglise S., Bellmunt-Montoya S., Hofer S., Yusuf S. W., Ronchey S., Bartoli S., Bonvini S., Camparini S., Fazzini S., Pirrelli S., Horer T., Bisdas T., Vasudevan T., Lattmann T., Wyss T. R., Maldonado T., Pfammatter T., Kolbel T., Jakimowicz T., Donati T., Tracci M., Bracale U. M., Tolva V. S., Riambau V., Palazzo V., Makaloski V., Von Allmen R. S., Dorigo W., Mansour W., Van den Eynde W., Tinelli, G, D'Oria, M, Sica, S, Mani, K, Rancic, Z, Resch, 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, Tambyraja, 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, Raphael, C, Clair, D, Dawson, D, Arnaoutakis, D, Bockler, 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, Alvarez-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, Duppers, P, Holt, P, Helmio, 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, Horer, T, Bisdas, T, Vasudevan, T, Lattmann, T, Wyss, T, Maldonado, T, Pfammatter, T, Kolbel, T, Jakimowicz, T, Donati, T, Tracci, M, Bracale, U, Tolva, V, Riambau, V, Palazzo, V, Makaloski, V, Von Allmen, R, Dorigo, W, Mansour, W, Van den Eynde, W, Tinelli G., D'Oria M., Sica S., Mani K., Rancic Z., Resch T. A., Beccia F., Azizzadeh A., Da Volta Ferreira M. M., Gargiulo M., Lepidi S., Tshomba Y., Oderich G. S., Haulon S., Beck A. W., Hertault A., Savlania A., Froio A., Giaquinta A., Zimmermann A., Psyllas A., Wanhainen A., Marchetti A. A., Queiroz A. B., Kahlberg A., Reyes-Valdivia A., Schanzer A., Tambyraja A., Freyrie A., Lorido A., Millon A., Ippoliti A., Abai B., Mees B., Reutersberg B., Maurel B., Michel B., Wahlgren C. M., Cavazzini C., Setacci C., Lee C. J., Ferrer C., Bicknell C., Raphael C., Clair D., Dawson D. L., Arnaoutakis D. J., Bockler D., Kotelis D., Mujagic E., Chisci E., Cieri E., Gallitto E., Marone E. M., Ducasse E., Verzini F., Pecoraro F., Serracino-Inglott F., Benedetto F., Speziale F., Stilo F., Alvarez-Marcos F., Pagliariccio G., Piffaretti G., Lanza G., Philipp G., Geenberg G., Jung G., Melissano G., Veraldi G. F., Parlani G., Faggioli G., de Donato G., Simonte G., Colacchio G., De Caridi G., Pratesi G., Spinella G., Torsello G., Leong Tan G. W., Magee G. A., Verhagen H., Andrew H., Koleilat I., Ohman J. W., de Vries J. P. P. M., Budtz-Lilly J., Black J., Eldrup-Jorgensen J., Hockley J., Bath J., Sobocinski J., van Herwaarden J. A., Reinhard K., Orion K. C., 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. G., Czerny M., Orrico M., Eagleton M. J., Smeds M. R., Taurino M., Wohlauer M., Sharafuddin M. J., Anna-Leonie M., Reijnen M., Antonello M., Piazza M., Settembre N., Mouawad N. J., Tsilimparis N., Dias N., Martinelli O., Frigatti P., Sirignano P., Chong P., Bevis P., DiMuzio P., Henke P., Duppers P., Holt P., Helmio P., Vriens P., Pulli R., Bellosta R., Micheli R., Veeraswamy R., Cuff R., Chiappa R., Gattuso R., Pini R., Dalman R. L., Milner R., Scali S. T., Bahia S., Laukontaus S., Trimarchi S., Fernandez-Alonso S., Deglise S., Bellmunt-Montoya S., Hofer S., Yusuf S. W., Ronchey S., Bartoli S., Bonvini S., Camparini S., Fazzini S., Pirrelli S., Horer T., Bisdas T., Vasudevan T., Lattmann T., Wyss T. R., Maldonado T., Pfammatter T., Kolbel T., Jakimowicz T., Donati T., Tracci M., Bracale U. M., Tolva V. S., Riambau V., Palazzo V., Makaloski V., Von Allmen R. S., Dorigo W., Mansour W., and Van den Eynde W.

Abstract

Objective: Management of follow-up protocols after endovascular aortic repair (EVAR) varies significantly between centers and is not standardized according to 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. Of 27 final statements, 15 (55.6%) were classified as grade I, whereas 12 (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 the current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues.

Published
2024

2. 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 (Società Italiana di Chirurgia Vascolare ed Endovascolare - SI CVE). 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 Guideline

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. Preliminary Results of aMulticenter Experience With NELLIX System for Endovascular Aneurysm Sealing. Italian Research Nellix-Endoprosthesis-IRENE Investigators Frigatti P, Angiletta D, Bellandi G, Marconi M, Galzerano G, Garriboli L, Grossi R, Iannello AM, La Barbera A, Martinelli O, Novali C, Pulli R, Setacci C, Speziale F, Talarico F, TaurinoM

Author

IRENE Investigators Frigatti, P, Angiletta, D, Bellandi, G, Marconi, M, Galzerano, G, Garriboli, L, Grossi, R, Iannello, Am, La Barbera, A, Martinelli, O, Novali, C, Pulli, R, Setacci, C, Speziale, F, Talarico, F, Taurino, M, Gossetti, B, Ferri, M, Ippoliti, A, Verzini, Fabio, and Silingardi, R.

Published
2016

8. POSTOPERATIVE ARTERIAL INFECTION: EPIDEMIOLOGY, BACTERIOLOGY AND PATHOGENESIS

Author

CHIESA , ROBERTO, MELISSANO, GERMANO, Castellano R, Astore D, Frigerio S, Garriboli L, Gesu GP, Anzuini A, Piccolo G, Sirchia G, Scalamogna M., Branchereau A, Jacobs M, Chiesa, Roberto, Melissano, Germano, Castellano, R, Astore, D, Frigerio, S, Garriboli, L, Gesu, Gp, Anzuini, A, Piccolo, G, Sirchia, G, and Scalamogna, M.

Published
2001

9. Postoperative arterial infection:epidemiology, bacteriology, and pathogenesis

Author

Chiesa R, Castellano R, Astore D, Frigerio S, Garriboli L, Gesu GP, Anzuini A, Piccolo G, Sirchia G, Scalamogna M., MELISSANO , GERMANO, Branchereau A, Jacobs M, Chiesa, R, Melissano, Germano, Castellano, R, Astore, D, Frigerio, S, Garriboli, L, Gesu, Gp, Anzuini, A, Piccolo, G, Sirchia, G, and Scalamogna, M.

Published
2001

10. Coartazioni aortiche

Author

Setacci C, MELISSANO , GERMANO, Astore D, TSHOMBA, YAMUME, Garriboli L, Palasciano G, Setacci F., CHIESA , ROBERTO, Benedetti-Valentini F, Setacci, C, Melissano, Germano, Astore, D, Tshomba, Yamume, Garriboli, L, Palasciano, G, Setacci, F., and Chiesa, Roberto

Published
2001

15. Vascular prosthetic graft infection : Epidemiology, bacteriology, pathogenesis and treatment

Author

Chiesa, R, Astore, D, Frigerio, S, Garriboli, L, Piccolo, G, Castellano, R, Scalamogna, M, Odero, A, Pirrelli, S, Biasi, G, Mingazzini, P, Biglioli, P, Polvani, G, Guarino, A, Agrifoglio, G, Tori, A, Spina, G, Spina, G., BIASI, GIORGIO MARIA, MINGAZZINI, PAOLO, Chiesa, R, Astore, D, Frigerio, S, Garriboli, L, Piccolo, G, Castellano, R, Scalamogna, M, Odero, A, Pirrelli, S, Biasi, G, Mingazzini, P, Biglioli, P, Polvani, G, Guarino, A, Agrifoglio, G, Tori, A, Spina, G, Spina, G., BIASI, GIORGIO MARIA, and MINGAZZINI, PAOLO

Abstract

Vascular prosthetic graft infection remains a major surgical challenge. Prevention of risk factors and antibiotic therapy can reduce, but not eradicate it. Management of infected vascular grafts depends on several factors, including the location of the infected prosthesis, the extent of infection, and the underlying micro-organism. Classic treatment consists of extra-anatomic bypass grafting. The disappointing results due to the high mortality and amputation rate have kindled interest in alternàtive approaches, such as in situ reconstruction with antibiotic-bonded prostheses, autogenous veins or arterial allografts. Purpose: We focused on the treatment of aortic graft infection by means of both fresh and cryopreserved arterial allograft. Here, the experience of the Italian Collaborative Vascular Homograft Group is reported. Methods: Between March 1994 and December 2000 seventy-nine patients with aortic graft infection were treated. The results of 68 patients are analysed. Eleven patients were treated with fresh, and 5l with cryopreserved homograft. Emergency surgical procedures were performedinl2 patients (17%).Aortoenteric fistula was diagnosed in 22 patients. The mean interval between the first procedure and the insertion of a homograft for patients with infected aortic graft was 3 years (range 1-15). The mean duration of follow-up was 30 months (range 1-68). Clinical and duplex scanning evaluaiion were routinely performed. Computed tomography (CT), magnetic resonance (MR), or arteriography were performed on the basis of duplex scanning results. Results: The analysis was performed on 68 cases for which there were sufficient reliable data. Eleven deaths occurred during the early postoperative period (3Odays), a mortality rate of l6%.There were also seventeen late deaths, a mortality ràte of 25%-. Eleven patients had graft occlusion ; six cases were successfully treated with thrombectomy. In three caies leg amputation was necessary. The results of fresh and cryopr

Published
2002

16. Vascular prosthetic Graft Infection: Epidemiology, Bacteriology, Pathogenesis and Treatment

Author

Chiesa, R., primary, Astore, D., additional, Frigerio, S., additional, Garriboli, L., additional, Piccolo, G., additional, Castellano, R., additional, Scalamogna, M., additional, Odero, A., additional, Pirrelli, S., additional, Biasi, G., additional, Mingazzini, P., additional, Biglioli, P., additional, Polvani, G., additional, Guarino, A., additional, Agrifoglio, G., additional, Tori, A., additional, and Spina, G., additional

Published
2002
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17. Vascular prosthetic Graft Infection: Epidemiology, Bacteriology, Pathogenesis and Treatment

Author

G. Piccolo, Roberto Chiesa, M. Scalamogna, A Tori, R. Castellano, Attilio Odero, S. Pirrelli, Paolo Biglioli, G. Spina, G Polvani, L Garriboli, Sillia Frigerio, Domenico Astore, Anna Guarino, G. Agrifoglio, Biasi G, P. Mingazzini, Chiesa, R, Astore, D, Frigerio, S, Garriboli, L, Piccolo, G, Castellano, R, Scalamogna, M, Odero, A, Pirrelli, S, Biasi, G, Mingazzini, P, Biglioli, P, Polvani, G, Guarino, A, Agrifoglio, G, Tori, A, Spina, G, Chiesa, Roberto, Mingazzini, R, Biglioli, R, and Spina, G.

Subjects
Graft Rejection, Male, Reoperation, medicine.medical_specialty, Prosthesis-Related Infections, medicine.medical_treatment, Gram-Positive Bacteria, Risk Assessment, Prosthesis, Blood Vessel Prosthesis Implantation, Pharmacotherapy, Blood vessel prosthesis, Gram-Negative Bacteria, prosthetic graft infection, MED/22 - CHIRURGIA VASCOLARE, medicine, cryopreserved arterial allograft, Humans, Transplantation, Homologous, Prosthesis-Related Infection, blood vessel prosthesi, Cryopreservation, Vascular disease, business.industry, Incidence, Graft Survival, Bacterial Infections, General Medicine, Prognosis, medicine.disease, Prosthesis-related infection, Combined Modality Therapy, Anti-Bacterial Agents, Blood Vessel Prosthesis, Surgery, Transplantation, Treatment Outcome, surgical procedures, operative, Amputation, artreries, cryopreservation, Drug Therapy, Combination, Female, Complication, business
Abstract

Vascular prosthetic graft infection remains a major surgical challenge. Prevention of risk factors and antibiotic therapy can reduce, but not eradicate it. Management of infected vascular grafts depends on several factors, including the location of the infected prosthesis, the extent of infection, and the underlying micro-organism. Classic treatment consists of extra-anatomic bypass grafting. The disappointing results due to the high mortality and amputation rate have kindled interest in alternàtive approaches, such as in situ reconstruction with antibiotic-bonded prostheses, autogenous veins or arterial allografts. Purpose: We focused on the treatment of aortic graft infection by means of both fresh and cryopreserved arterial allograft. Here, the experience of the Italian Collaborative Vascular Homograft Group is reported. Methods: Between March 1994 and December 2000 seventy-nine patients with aortic graft infection were treated. The results of 68 patients are analysed. Eleven patients were treated with fresh, and 5l with cryopreserved homograft. Emergency surgical procedures were performedinl2 patients (17%).Aortoenteric fistula was diagnosed in 22 patients. The mean interval between the first procedure and the insertion of a homograft for patients with infected aortic graft was 3 years (range 1-15). The mean duration of follow-up was 30 months (range 1-68). Clinical and duplex scanning evaluaiion were routinely performed. Computed tomography (CT), magnetic resonance (MR), or arteriography were performed on the basis of duplex scanning results. Results: The analysis was performed on 68 cases for which there were sufficient reliable data. Eleven deaths occurred during the early postoperative period (3Odays), a mortality rate of l6%.There were also seventeen late deaths, a mortality ràte of 25%-. Eleven patients had graft occlusion ; six cases were successfully treated with thrombectomy. In three caies leg amputation was necessary. The results of fresh and cryopreserved homografts were compared. No significant difference of early postoperative mortality, late mortality, homograft-related mortality, graft failure were observed. The presence of aortoenteric fistula is a negative predicting factor of perioperative early mortality, which causes a rapid decline in the survival curve. Thirty-six months after surgery the actuarial survival of the patients was 57% and the actuarial patency of the allograft was 4l%. Conclusion: No significant difference in terms of clinical outcome was observed when using fresh, rather than cryopreserved homografts. The only factor that significantly influenced the survival rate appeared to be the aorto-enteric fistula.

Published
2002

18. The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia.

Author

Patrone L, Pasqui E, Conte MS, Farber A, Ferraresi R, Menard M, Mills JL, Rundback J, Schneider P, Ysa A, Abhishek K, Adams GL, Ahmad N, Ahmed I, Alexandrescu VA, Amor M, Alper D, Andrassy M, Attinger C, Baadh A, Barakat H, Biasi L, Bisdas T, Bhatti Z, Blessing E, Bonaca MP, Bonvini S, Bosiers M, Bradbury AW, Beasley R, Behrendt CA, Brodmann M, Cabral G, Cancellieri R, Casini A, Chandra V, Chisci E, Chohan O, Choke ETC, Chong PFS, Clerici G, Coscas R, Costantino M, Dalla Paola L, Dand S, Davies RSM, D'Oria M, Diamantopoulos A, Debus S, Deloose K, Del Giudice C, Donato G, Rubertis B, Paul De Vries J, Dias NV, Diaz-Sandoval L, Dick F, Donas K, Dua A, Fanelli F, Fazzini S, Foteh M, Gandini R, Gargiulo M, Garriboli L, Genovese EA, Gifford E, Goueffic Y, Goverde P, Chand Gupta P, Hinchliffe R, Holden A, Houlind KC, Howard DP, Huasen B, Isernia G, Katsanos K, Katzen B, Kolh P, Koncar I, Korosoglou G, Krishnan P, Kroencke T, Krokidis M, Kumarasamy A, Hayes P, Iida O, Alejandre Lafont E, Langhoff R, Lecis A, Lessne M, Lichaa H, Lichtenberg M, Lobato M, Lopes A, Loreni G, Lucatelli P, Madassery S, Maene L, Manzi M, Maresch M, Santhosh Mathews J, McCaslin J, Micari A, Michelagnoli S, Migliara B, Morgan R, Morelli L, Morosetti D, Mouawad N, Moxey P, Müller-Hülsbeck S, Mustapha J, Nakama T, Nasr B, N'dandu Z, Neville R, Noory E, Nordanstig J, Noronen K, Mariano Palena L, Parlani G, Patel AS, Patel P, Patel R, Patel S, Pena C, Perkov D, Portou M, Pratesi G, Rammos C, Reekers J, Riambau V, Roy T, Rosenfield K, Antonella Ruffino M, Saab F, Saratzis A, Sbarzaglia P, Schmidt A, Secemsky E, Siah M, Sillesen H, Simonte G, Sirvent M, Sommerset J, Steiner S, Sakr A, Scheinert D, Shishebor M, Spiliopoulos S, Spinelli A, Stravoulakis K, Taneva G, Teso D, Tessarek J, Theivacumar S, Thomas A, Thomas S, Thulasidasan N, Torsello G, Tripathi R, Troisi N, Tummala S, Tummala V, Twine C, Uberoi R, Ucci A, Valenti D, van den Berg J, van den Heuvel D, Van Herzeele I, Varcoe R, Vega de Ceniga M, Veith FJ, Venermo M, Vijaynagar B, Virdee S, Von Stempel C, Voûte MT, Khee Yeung K, Zeller T, Zayed H, and Montero Baker M

Abstract

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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19. Open vascular surgery training in the endovascular era: 5-year experience with cadaver laboratory.

Author

Garriboli L, Chisci E, Antonello M, Parlani G, Civilini E, Maritati G, and Troisi N

Subjects
Adult, Cadaver, Clinical Competence, Curriculum, Education, Medical, Graduate, Humans, Vascular Surgical Procedures education, Internship and Residency
Abstract

Background: Vascular cadaver laboratory (CAD LAB) courses included vascular exposure techniques and simulations of open procedures. Aim of the study was to demonstrate the benefit of cadaver laboratory (CAD LAB) courses to improve trainees' experience in open surgical vascular procedures., Methods: Between 2014 and 2020, 162 vascular surgeons or medical trainees (mean age 28 years) participated in vascular CAD LAB courses in Italy and France. Outcomes were measured using the Linkert survey, performed pre- and postcourse to evaluate self-efficacy/confidence, surgical experience, and resident perception of the course with a range score from 0 to 5 for each point. Anatomical knowledge improvement was measured using a questionnaire with multiple answers pre- and postcourse. The course was considered to have yielded a positive result if the postcourse Linkert Survey Score increased by ≥2 points, or in the case of an increase of at least 30% above the baseline value of the multiple questionnaires., Results: Postcourse questionnaires were positive for all outcomes evaluated. Participants' perception of the usefulness of the CAD LAB evaluation was 4.8 out of 5. For the vascular CAD LAB, participant anatomical knowledge improved overall from an average of 55% to 93% (P<0.001), and self-efficacy/confidence improved from 2.3 to 4.5 out of 5 (P<0.001). Regarding the different operative procedures, the greatest self-efficacy/confidence improvement was recorded in carotid endarterectomy and aortic procedures (+50% and +66% respectively; P<0.001). The city location (Italy vs. France) did not affect the results., Conclusions: CAD LAB courses were shown to be effective in increasing participants' self-efficacy, confidence, and anatomical knowledge in open vascular surgical procedures.

Published
2022
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20. Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric "ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)".

Author

D'Oria M, Galeazzi E, Veraldi GF, Garriboli L, Saccà S, Farneti F, Mezzetto L, Mastrorilli D, and Lepidi S

Subjects
Aged, Aged, 80 and over, Angiography, Endoleak epidemiology, Female, Humans, Italy epidemiology, Male, Postoperative Complications epidemiology, Prosthesis Design, Registries, Retrospective Studies, Aorta, Abdominal anatomy & histology, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation methods, Endovascular Procedures methods
Abstract

Background: The aim of the study was to evaluate the short-term and mid-term technical and clinical outcomes of the Bolton Treo endograft in subjects with abdominal aortic aneurysm (AAA) requiring endovascular aortic repair (EVAR) and assess if presence of hostile proximal neck would represent a risk factor for increased failure rates., Methods: A retrospective review of all consecutive patients who had undergone elective or non-elective EVAR with the Bolton Treo endograft at 5 institutions located in the North-East of Italy (January 2016-December 2020) was performed. The main exposure variable for this study was presence of hostile (HAN) or friendly (FAN) aortic neck., Results: A total of 137 consecutive patients were treated with the Bolton Treo endograft at participating institutions; of these 63 (46%) presented HAN while 74 (54%) had FAN. At baseline, no significant differences were observed in the distribution of demographics and comorbidities between study groups. Two type Ia endoleaks (EL) were detected at completion angiography, all in patients with HAN but none in patients with FAN (3% vs. 0%, P = 0.04), but no type III EL were identified in the whole cohort. The median duration of follow-up in the study cohort was 30 months (IQR 22-34 months) and was similar between study groups (P = 0.87). At 3-years, survival estimates were 89% and 91% (P= 0.82) in patients with HAN and FAN, respectively. At three years, patients with HAN had significantly lower freedom from type IA endoleak as compared with patients with FAN (87% vs. 94%, P= 0.02). No significant differences were found between study groups in the three-year estimates of freedom from reinterventions (80% vs. 86%, P= 0.28). Using cox proportional hazards, presence of type II EL (HR 3.15, 95%CI 1.18-8.5, P= 0.02) and presence of type IA EL (HR 4.22, 95%CI 1.39-12.85, P= 0.01) were found as independent predictors for reinterventions in univariate analysis, although they were no longer significant in the multivariate model. Freedom from sac increase >5mm at three years were not significantly different between study groups (92% vs 91%, P= 0.95)., Conclusions: Within a contemporary multicentric real-world experience, EVAR with the Bolton Treo endograft shows a satisfactory safety profile in the immediate postoperative phase and acceptable outcomes during mid-term follow-up. Presence of HAN is correlated with development of type Ia EL (either early following stent-graft implantation or late after EVAR) which, in turn, may represent a significant factor leading to reinterventions., (Copyright © 2021. Published by Elsevier Inc.)

Published
2022
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21. Early and midterm outcomes following open surgical conversion after failed endovascular aneurysm repair from the "Italian North-easT RegIstry of surgical Conversion AfTer Evar" (INTRICATE).

Author

Xodo A, D'Oria M, Squizzato F, Antonello M, Grego F, Bonvini S, Milite D, Frigatti P, Cognolato D, Veraldi GF, Perkmann R, Garriboli L, Jannello AM, and Lepidi S

Subjects
Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal mortality, Conversion to Open Surgery statistics & numerical data, Endoleak etiology, Endovascular Procedures instrumentation, Endovascular Procedures statistics & numerical data, Female, Follow-Up Studies, Hospital Mortality, Humans, Italy epidemiology, Male, Registries statistics & numerical data, Retrospective Studies, Risk Assessment statistics & numerical data, Risk Factors, Stents adverse effects, Survival Rate, Treatment Outcome, Aortic Aneurysm, Abdominal surgery, Conversion to Open Surgery adverse effects, Endoleak epidemiology, Endovascular Procedures adverse effects
Abstract

Objective: To report the early and mid-term outcomes following open surgical conversion (OSC) after failed endovascular aortic repair (EVAR) using data from a multicentric registry., Methods: A retrospective study was carried out on consecutive patients undergoing OSC after failed EVAR at eight tertiary vascular units from the same geographic area in the North-East of Italy, from April 2005 to November 2019. Study endpoints included early and follow-up outcomes., Results: A total of 144 consecutive patients were included in the study. Endoleaks were the most common indication for OSC (50.7%), with endograft infection (24.6%) and occlusion (21.9%) being the second most prevalent causes. The overall rate of 30-day all-cause mortality was 13.9% (n = 20); 32 patients (22.2%) experienced at least one major complication. Mean length of stay was 13 ± 12.7 days. On multivariate logistic regression, age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.01-1-19; P = .02), renal clamping time (OR, 1.07; 95% CI, 1.02-1.13; P = .01), and suprarenal/celiac clamping (OR, 6.66; 95% CI, 1.81-27.1; P = .005) were identified as independent predictors of perioperative major complications. Age was the only factor associated with perioperative mortality at 30 days. Renal clamping time >25 minutes had sensitivity of 65% and specificity of 70% in predicting the occurring of major adverse events (area under the curve, 0.72; 95% CI, 0.61-0.82). At 5 years, estimated survival was significantly lower for patients treated due to aortic rupture/dissection (28%; 95% CI, 13%-61%), compared with patients in whom the indication for treatment was endoleak (54%; 95% CI, 40%-73%), infection (53%; 95% CI, 30%-94%), or thrombosis (82%; 95% CI, 62%-100%; P = .0019). Five-year survival rates were significantly lower in patients who received emergent treatment (28%; 95% CI, 14%-55%) as compared with those who were treated in an urgent (67%; 95% CI, 48%-93%) or elective setting (57%; 95% CI, 43%-76%; P = .00026). Subjects who received suprarenal/celiac (54%; 95% CI, 36%-82%) or suprarenal (46%; 95% CI, 34%-62%) aortic cross-clamping had lower survival rates at 5 years than those whose aortic-cross clamp site was infrarenal (76%; 95% CI, 59%-97%; P = .041). Using multivariate Cox proportional hazard, older age and emergency setting were independently associated with higher risk for overall 5-year mortality., Conclusions: OSC after failed EVAR was associated with relatively high rates of early morbidity and mortality, particularly for emergency setting surgery. Endoleaks with secondary sac expansion were the main indication for OSC, and suprarenal aortic cross-clamping was frequently required. Endograft infection and emergent treatment remained associated with poorer short- and long-term survival., (Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2022
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22. Acute mesenteric ischemia as late complication of previous endovascular treatment in young woman. Case report and review of the literature.

Author

Tamellini P, Miccoli T, Recchia A, Pruner G, Garriboli L, and Jannello AM

Subjects
Adult, Chronic Disease, Female, Humans, Ischemia etiology, Mesenteric Artery, Superior diagnostic imaging, Mesenteric Artery, Superior surgery, Retrospective Studies, Stents adverse effects, Time Factors, Treatment Outcome, Mesenteric Ischemia diagnostic imaging, Mesenteric Ischemia etiology, Mesenteric Ischemia surgery, Mesenteric Vascular Occlusion diagnostic imaging, Mesenteric Vascular Occlusion etiology, Mesenteric Vascular Occlusion surgery
Abstract

Background: Acute mesenteric ischemia (AMI) represents a severe complication of chronic mesenteric ischemia (CMI) which is a disorder caused by severe stenosis or occlusion of mesenteric arterial supply. If untreated, patients could face mesenteric infarction and death., Case Report: A 41-year-old female smoker and drug abuser, previously treated with angioplasty and stenting of the superior mesenteric artery (SMA) for CMI four years before, was admitted to our institution suffering from acute abdominal pain due to complete occlusion of the stent. After a few hours of thrombolytic therapy, she experienced sudden worsening of clinical conditions, including AMI, due to complete rethrombosis of the SMA. Thereafter, she underwent urgent thrombectomy and a subsequent retrograde 6 mm prosthetic aorto-mesenteric bypass graft. The patient reported complete relief of symptoms afterwards. A CT scan at 1-month follow-up showed primary patency of the bypass in the absence of clinical recurrence., Discussion: In cases of CMI, treatment options include surgical, endovascular or hybrid approaches. Endovascular therapy, based on percutaneous angioplasty with or without stenting, seems to be effective, although it can have worse midterm and long-term results., Conclusion: In patients already treated with an endovascular revascularization of the SMA or celiac trunk (CT), open surgical repair through a single retrograde aorto-mesenteric prosthetic bypass in cases of acute mesenteric ischemia, seems to offer a valid and safe approach in order to prevent bowel infarction., Key Words: Acute mesenteric ischemia Angioplasty, Bypass, stent,Thrombolysis.

Published
2021

23. Hybrid Laparoscopic and Endovascular Treatment for Median Arcuate Ligament Syndrome: Case Report and Review of Literature.

Author

Garriboli L, Miccoli T, Damoli I, Rossini R, Sartori CA, Ruffo G, and Jannello AM

Subjects
Adult, Constriction, Pathologic, Humans, Male, Median Arcuate Ligament Syndrome diagnostic imaging, Median Arcuate Ligament Syndrome physiopathology, Mesenteric Ischemia diagnostic imaging, Mesenteric Ischemia physiopathology, Mesenteric Vascular Occlusion diagnostic imaging, Mesenteric Vascular Occlusion physiopathology, Stents, Treatment Outcome, Vascular Patency, Angioplasty, Balloon instrumentation, Celiac Artery diagnostic imaging, Celiac Artery physiopathology, Laparoscopy, Median Arcuate Ligament Syndrome therapy, Mesenteric Ischemia therapy, Mesenteric Vascular Occlusion therapy
Abstract

Median arcuate ligament syndrome is a rare cause of chronic gastrointestinal ischemia caused by compression of median arcuate ligament on the celiac trunk. A 38-year-old male presented at our institution with unspecific crampy abdominal pain. After several diagnostic examinations, he firstly underwent arcuate ligament resection by laparoscopic approach and 2 months later, he underwent percutaneous transluminal angioplasty with stenting of the stenotic vessel. Postoperatory and follow-up controls showed regular patency of the artery with complete relief of abdominal symptoms. We propose a review of the literature on this uncommon condition, describing different surgical approaches., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Published
2020
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24. PTA and Stenting of Femoropopliteal Trunk With Cordis Smartflex Stent System: A Single-Center Experience.

Author

Garriboli L, Miccoli T, Pruner G, and Jannello AM

Subjects
Aged, Aged, 80 and over, Angioplasty adverse effects, Female, Humans, Intermittent Claudication diagnostic imaging, Intermittent Claudication physiopathology, Ischemia diagnostic imaging, Ischemia physiopathology, Italy, Male, Middle Aged, Peripheral Arterial Disease diagnostic imaging, Peripheral Arterial Disease physiopathology, Recurrence, Time Factors, Treatment Outcome, Vascular Patency, Angioplasty instrumentation, Femoral Artery diagnostic imaging, Femoral Artery physiopathology, Intermittent Claudication therapy, Ischemia therapy, Peripheral Arterial Disease therapy, Popliteal Artery diagnostic imaging, Popliteal Artery physiopathology, Stents
Abstract

Introduction: The aim of this study is to describe our experience in the treatment of femoropopliteal occlusive disease with percutaneous transluminal angioplasty (PTA) followed by stenting with S.M.A.R.T. Flex vascular stent system., Materials and Methods: From June 2014 to October 2018, 80 patients were treated at our Institution for intermittent claudication, critical, or acute limb ischemia due to total occlusion or long diffused lesions of the femoropopliteal segment. Main study end points are primary patency, target lesion revascularization, and stent fractures; secondary end points are major amputation rate, procedure-related bleeding, incidence of intrastent restenosis, and primary assisted patency after reintervention., Results: Mean follow-up time was 21 months (range 2-48 months). Primary patency rate was 80% (64 patients of 80), with mean covered lesion length of 8.2 cm. The deployment of a single stent was obtained for 57 (89%) patients, with a mean stent length of 9.86 cm. Of 80 patients, 2 (2.5%) had early stent occlusion within first 48 hours after the procedure, while 4 (5%) of 80 patients experienced stent occlusion within first 6 months. Of 80 patients, 6 (7.5%) had an intrastent restenosis detected at duplex ultrasound with a primary-assisted patency after simple re-PTA procedures of 83.3% at 12 months., Discussion: In the literature, primary patency after PTA and stenting of the femoropopliteal trunk seems to be related to several variables, such as number of stents used, specific stent length, diameters, type and length of lesions, type of pathology (if acute or chronic), and number of preoperatory patent below-the-knee vessels. In this study, we try to analyze each single factor in order to understand their role in predisposing specific stent restenosis., Conclusions: S.M.A.R.T. Flex vascular stent system has shown good results in terms of primary patency in the treatment of calcified lesions both at SFA and at popliteal level. However, in our experience, stent patency seems to be significantly poorer in patients presenting with acute limb ischemia associated with chronic atherosclerotic disease as well as for lesions located in the mid-distal part of the popliteal artery and both when number of stents increases or number of runoff vessel decreases.

Published
2020
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25. Carotid Artery Stenting Without Embolic Protection Device: A Single-Center Experience.

Author

Garriboli L, Pruner G, Miccoli T, Recchia A, Tamellini P, and Jannello AM

Subjects
Aged, Angioplasty, Balloon adverse effects, Angioplasty, Balloon mortality, Asymptomatic Diseases, Carotid Stenosis diagnostic imaging, Carotid Stenosis mortality, Carotid Stenosis physiopathology, Female, Humans, Male, Myocardial Infarction etiology, Retrospective Studies, Risk Assessment, Risk Factors, Stroke etiology, Time Factors, Treatment Outcome, Angioplasty, Balloon instrumentation, Carotid Artery, Internal diagnostic imaging, Carotid Artery, Internal physiopathology, Carotid Stenosis therapy, Stents
Abstract

Purpose: To evaluate the safety and efficacy of carotid artery stenting (CAS) performed without an embolic protection device (EPD) in a selected group of asymptomatic patients with primary internal carotid artery (ICA) stenosis or restenosis after carotid endarterectomy (CEA)., Materials and Methods: Between May 2015 and May 2018, 77 patients (mean age 77 years; 60 men) underwent CAS without any embolic protection device. Forty-seven (61%) patients had primary ICA stenosis and were excluded from CEA because of high surgical risk; the other 30 (39%) patients had post-CEA restenosis (n=26) or a distal ICA flap after eversion CEA (n=4). The mean ICA stenosis was 82%. All procedures were performed from a femoral artery access. Pre- and/or postdilation were used in 64 patients. The primary outcome was the incidence of major complications (death, stroke, or myocardial infarction) during the procedure and within 30 days; the secondary outcome was the incidence of restenosis in follow-up., Results: No relevant bradycardia was encountered during CAS. The combined rate of stroke, death, or myocardial infarction at 30 days was 1.3%. The single stroke patient recovered fully after 2 months. Over a follow-up that ranged to 3 years (mean 24±18 months), no further neurological events were recorded. One (1.3%) patient had a >70% restenosis after 6 months; the lesion was dilated, successfully restoring the lumen contour., Conclusion: In our series, endovascular treatment of carotid stenosis without the use of protection devices in patients with primary stenosis or postsurgical restenosis can achieve satisfactory safety and efficacy outcomes. The choice of performing CAS without using EPDs should follow a tailored approach based on the appropriate patient anatomy and specific clinical parameters to minimize neurological complications.

Published
2019
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26. Non-anastomotic aneurysmal degeneration of great saphenous vein graft A case report and review of the literature.

Author

Tamellini P, Recchia A, Garriboli L, Miccoli T, Pruner G, and Jannello AM

Subjects
Acute Disease, Aged, Humans, Male, Aneurysm diagnosis, Aneurysm surgery, Ischemia diagnosis, Ischemia surgery, Leg blood supply, Postoperative Complications diagnosis, Postoperative Complications surgery, Saphenous Vein transplantation
Abstract

Introduction: True aneurysmal degeneration of autogenous vein grafts is unusual, despite their widespread use as arterial substitutes. We report a case of acute lower leg ischemia due to thrombosis of a non-anastomotic venous aneurysm., Case Report: A 71-year old man presented at Emergency Unit at our Institution with left lower limb acute ischemia. The patient had 9 years before undergone left below the knee femoro-popliteal bypass with in situ autologous great saphenous vein (GSV) graft. Doppler ultrasound exam revealed patency of the entire conduit, and subtotal acute thrombosis of a saccular aneurysm of the vein 2 cm before the distal anastomosis of the graft. Aneurysmectomy and distal thrombo- embolectomy with Fogarty catheter of below the knee popliteal artery and tibio-peroneal trunk was performed. Vein graft continuity was restored by a termino-terminal anastomosis., Discussion: Arterialized autologous veins are at risk of degenerative changes because of histological differences with arteries, but the cause of true aneurysmal degeneration of these grafts is still unknown. The mean time from graft implantation to clinical manifestation of the aneurysm is 7 years and the management of venous graft aneurysms should be subjected to the same criteria as other aneurysms. The first choice in detecting vein graft aneurysms is Duplex ultrasonography and the type of surgical intervention depends on the cause, type and extension of aneurysmal dilatation., Conclusions: Aneurysmal degeneration of deep lower extremity vein conduits implanted for vascular reconstruction has been rarely reported, but when detected they can lead to graft thrombosis, distal embolization, acute rupture, or skin ulceration. Therefore, Doppler ultrasound guided surveillance of GSV grafts should be mandatory and long time from vein graft creation to onset of aneurysms makes long-term graft surveillance even more imperative., Key Words: Acute Leg Ischemia, Great Saphenous Vein, Graft; Aneurysm, Thrombosis.

Published
2019

27. Uncovered Chimney Stent Graft for Renal Arteries With the Nellix Endovascular Aneurysm Sealing Technique.

Author

Garriboli L and Jannello AM

Subjects
Aged, 80 and over, Aorta, Abdominal diagnostic imaging, Aortic Aneurysm, Abdominal diagnostic imaging, Aortography methods, Computed Tomography Angiography, Humans, Male, Middle Aged, Prosthesis Design, Renal Artery diagnostic imaging, Treatment Outcome, Aorta, Abdominal surgery, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation instrumentation, Endovascular Procedures instrumentation, Renal Artery surgery, Stents
Abstract

Purpose: To describe the application of uncovered chimney stent grafts with the Nellix endovascular aneurysm sealing technique (ChEVAS) for juxtarenal abdominal aortic aneurysms (JAAAs)., Case Report: Two patients with JAAA and multiple comorbidities were considered unfit for open surgery and were selected for an endovascular approach. Fenestrated and branched endografts were too expensive, and a chimney endovascular approach was considered inappropriate for the relatively high incidence of proximal type I endoleak and graft migration. ChEVAS was performed successfully with the novel addition of uncovered chimney stents to further reduce costs and possibly improve target vessel patency. JAAA exclusion and visceral vessel patency was confirmed at 18-month follow-up., Conclusion: ChEVAS with bare chimney stents is technically less complex, potentially reduces access complications and procedural costs, and may improve long-term patency compared to alternative techniques. Results at 18 months seem promising, but strict follow-up is necessary as the long-term durability is unknown.

Published
2018
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