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1. Comparison of ultrasound- versus fluoroscopy-guidEd femorAl access In tranS-catheter aortic valve replacement In the Era of contempoRary devices: The EASIER registry

Author

Bianchini, Emiliano, Morello, Alberto, Bellamoli, Michele, Romagnoli, Enrico, Aurigemma, Cristina, Tagliaferri, Marco, Montonati, Carolina, Dumonteil, Nicolas, Cimmino, Michele, Villa, Emmanuel, Corcione, Nicola, Bettari, Luca, Messina, Antonio, Stanzione, Alessio, Troise, Giovanni, Mor, Donata, Maggi, Antonio, Bellosta, Raffaello, Pegorer, Matteo Alberto, Zoccai, Giuseppe Biondi, Ielasi, Alfonso, Burzotta, Francesco, Trani, Carlo, Maffeo, Diego, Tchétché, Didier, Buono, Andrea, and Giordano, Arturo

Published
2024
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3. Midterm results on a new self-expandable covered stent combined with branched stent grafts: Insights from a multicenter Italian registry

Author

Angiletta, Domenico, Chiesa, Roberto, Di Marzo, Luca, Flora, Loris, Gennai, Stefano, Giudice, Rocco, Lenti, Massimo, Leone, Nicola, D’Oria, Mario, Lepidi, Sandro, Melloni, Andrea, Mezzetto, Luca, Michelagnoli, Stefano, Migliara, Bruno, Milite, Domenico, Pacini, Davide, Palazzo, Enzo, Pecchio, Alberto, Pegorer Matteo, Alberto, Perini, Paolo, Piazza, Michele, Pratesi, Giovanni, Ronchey, Sonia, Spadoni, Nicola, Tusini, Nicola, Verzini, Fabio, Bertoglio, Luca, Grandi, Alessandro, Veraldi, Gian Franco, Pulli, Raffaele, Antonello, Michele, Bonvini, Stefano, Isernia, Giacomo, Bellosta, Raffaello, Buia, Francesco, and Silingardi, Roberto

Published
2023
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4. Multicenter comparison between open conversions and semi-conversions for late endoleaks after endovascular aneurysm repair

Author

Mariani, Erica, Faggioli, GianLuca, Gallitto, Enrico, Migliari, Mattia, Gennai, Stefano, Paro, Barbara, Baggi, Paolo, Attisani, Luca, Pegorer, Matteo, Tadiello, Marco, Franchin, Marco, Bonvini, Stefano, Chisci, Emiliano, Troisi, Nicola, Fontana, Antonio, Strozzi, Francesco, Scabini, Matteo, Mosso, Federico, Paciaroni, Elisa, Tarantini, Salvatore, Leone, Michele, Masi, Giancarlo, Perini, Paolo, Gargiulo, Mauro, Silingardi, Roberto, Bonardelli, Stefano, Bellosta, Raffaello, Piffaretti, Gabriele, Michelagnoli, Stefano, Tusini, Nicola, Capelli, Patrizio, Turicchia, Giorgio Ubaldo, and Freyrie, Antonio

Published
2022
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5. Prognostic risk factors for loss of patency after femoropopliteal bailout stenting with dual-component stent: results from the TIGRIS Italian Multicenter Registry

Author

Ruffino, Maria Antonella, Fronda, Marco, Bergamasco, Laura, Natrella, Massimiliano, Fanelli, Gianluca, Bellosta, Raffaello, Pegorer, Matteo, Attisani, Luca, Ruggiero, Massimo, Malfa, Pierantonio, Patane’, Domenico, Lucatelli, Pierleone, Corona, Mario, Ricci, Carmelo, Candeloro, Laura, Ferri, Michelangelo, Varello, Sara, Gibello, Lorenzo, Veraldi, Gian Franco, Mezzetto, Luca, and Fonio, Paolo

Published
2021
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6. Covered versus bare metal kissing stents for reconstruction of the aortic bifurcation in the ILIACS registry

Author

Fontana, Federico, Piacentino, Filippo, Castelli, Patrizio, Speziali, Sara, Angiletta, Domenico, Marinazzo, Davide, Zacà, Sergio, Bellosta, Raffaello, Pegorer, Matteo, Ippoliti, Arnaldo, Pratesi, Giovanni, Citoni, Gianluca, Benedetto, Filippo, Pipitò, Narayana, Derone, Graziana, Ferri, Michelangelo, Cumino, Andrea, Suita, Roberta, Gargiulo, Mauro, Mascoli, Chiara, Sonetto, Alessia, Bracale, Umberto M., Turchino, Davide, Squizzato, Francesco, Piazza, Michele, Pulli, Raffaele, Fargion, Aaron, Piffaretti, Gabriele, Pratesi, Carlo, Grego, Franco, and Antonello, Michele

Published
2021
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8. Twenty-two Year Multicentre Experience of Late Open Conversions after Endovascular Abdominal Aneurysm Repair

Author

Mariani, Erica, Faggioli, GianLuca, Gallitto, Enrico, Migliari, Mattia, Gennai, Stefano, Paro, Barbara, Baggi, Paolo, Attisani, Luca, Pegorer, Matteo, Tasselli, Sebastiano, Wassermann, Valentina, Chisci, Emiliano, Troisi, Nicola, Fontana, Antonio, Strozzi, Francesco, Scabini, Matteo, Mosso, Federico, Gessaroli, Massimiliano, Leone, Michele, Masi, Giancarlo, Turicchia, Giorgio Ubaldo, Perini, Paolo, Gargiulo, Mauro, Silingardi, Roberto, Bonardelli, Stefano, Bellosta, Raffaello, Bonvini, Stefano, Michelagnoli, Stefano, Tusini, Nicola, Capelli, Patrizio, and Freyrie, Antonio

Published
2020
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9. Comparison of ultrasound- versus fluoroscopy-guidEd femorAl access In tranS-catheter aortic valve replacement In the Era of contempoRary devices: The EASIER registry

Author

Bianchini, Emiliano, Morello, Alberto, Bellamoli, Michele, Romagnoli, Enrico, Aurigemma, Cristina, Tagliaferri, Marco, Montonati, Carolina, Dumonteil, Nicola, Cimmino, Michele, Villa, Emmanuel, Corcione, Nicola, Bettari, Luca, Messina, Antonio, Stanzione, Alessio, Troise, Giovanni, Mor, Donata Angela, Maggi, Antonio, Bellosta, Raffaello, Pegorer, Matteo Alberto, Zoccai, Giuseppe Biondi, Ielasi, Alfonso, Burzotta, Francesco, Trani, Carlo, Maffeo, Diego, Tchétché, Didier, Buono, Andrea, Giordano, Arturo, Mor, Donata, Burzotta, Francesco (ORCID:0000-0002-6569-9401), Trani, Carlo (ORCID:0000-0001-9777-013X), Bianchini, Emiliano, Morello, Alberto, Bellamoli, Michele, Romagnoli, Enrico, Aurigemma, Cristina, Tagliaferri, Marco, Montonati, Carolina, Dumonteil, Nicola, Cimmino, Michele, Villa, Emmanuel, Corcione, Nicola, Bettari, Luca, Messina, Antonio, Stanzione, Alessio, Troise, Giovanni, Mor, Donata Angela, Maggi, Antonio, Bellosta, Raffaello, Pegorer, Matteo Alberto, Zoccai, Giuseppe Biondi, Ielasi, Alfonso, Burzotta, Francesco, Trani, Carlo, Maffeo, Diego, Tchétché, Didier, Buono, Andrea, Giordano, Arturo, Mor, Donata, Burzotta, Francesco (ORCID:0000-0002-6569-9401), and Trani, Carlo (ORCID:0000-0001-9777-013X)

Abstract

Background: Vascular complications (VCs) still represent one of the principal concerns of trans-femoral trans-catheter aortic valve replacement (TF-TAVR). New-generation devices can minimize such complications but the arterial access management is left to the operator's choice. This study aims to describe the rate of VCs in a contemporary cohort of patients undergoing TAVR with new-generation devices and to determine whether an ultrasound-guided (USG) vs. a fluoroscopy-guided (FG) femoral access management has an impact on their prevention. Methods: This is a prospective, observational, multicenter study. Consecutive patients undergoing TAVR with new-generation devices were analyzed from January 2022 to October 2022 in five tertiary care centers. Femoral accesses were managed according to the operator's preferences. All the patients underwent a pre-discharge peripheral ultrasound control. VCs and bleedings were the main endpoints of interest. Results: A total of 458 consecutive patients were enrolled (274 in the USG group and 184 in the FG group). VCs occurred in 6.5 % of the patients (5.2 % minor and 1.3 % major). There was no difference between the USG and the FG groups in terms of any VCs (7.3 % vs. 5.4 %; p = 0.4), or any VARC-3 bleedings (6.9 % vs 6 %, p = 0.9). At logistic regression analysis, the two guidance strategies did not result as predictors of VCs (odds Ratio 0.8, 95 % Confidence Interval 0.46-1.4; P = 0.4). Conclusions: In a contemporary cohort of patients undergoing TAVR with new-generation devices, the occurrence of VCs is low and mostly represented by minor VCs. USG and FG modalities did not affect the rate of VCs.

Published
2023

10. Mid-term results on a new self-expandable covered stent combined with branched stent-grafts: insights from a multicenter Italian registry

Author

Luca Bertoglio, Alessandro Grandi, Gian Franco Veraldi, Raffaele Pulli, Michele Antonello, Stefano Bonvini, Giacomo Isernia, Raffaello Bellosta, Francesco Buia, Roberto Silingardi, Angiletta Domenico, Chiesa Roberto, Di Marzo Luca, Flora Loris, Gennai Stefano, Giudice Rocco, Lenti Massimo, Leone Nicola, Lepidi Sandro, Melloni Andrea, Mezzetto Luca, Michelagnoli Stefano, Migliara Bruno, Milite Domenico, Pacini Davide, Palazzo Enzo, Pecchio Alberto, Pegorer Matteo Alberto, Perini Paolo, Piazza Michele, Pratesi Giovanni, Ronchey Sonia, Spadoni Nicola, Tusini Nicola, and Verzini Fabio

Subjects
Aorto-iliac aneurysm, Branched, Endovascular procedures, Thoracoabdominal Aortic Aneurysm, covered stent, instability, self-expandable, Covered stent, Instability, Self-expandable, Thoracoabdominal aortic aneurysm, Surgery, Cardiology and Cardiovascular Medicine
Published
2023

11. COVID-19 and limb ischemia: experience first

Author

ATTISANI, Luca, primary, BISSACCO, Daniele, additional, PUCCI, Alessandro, additional, LUONI, Giorgio, additional, LUZZANI, Luca, additional, PEGORER, Matteo A., additional, SETTEMBRINI, Alberto M., additional, WOHLAUER, Max V., additional, and BELLOSTA, Raffaello, additional

Published
2022
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13. Multicenter comparison between open conversions and semi-conversions for late endoleaks after endovascular aneurysm repair

Author

Perini, Paolo, primary, Gargiulo, Mauro, additional, Silingardi, Roberto, additional, Bonardelli, Stefano, additional, Bellosta, Raffaello, additional, Piffaretti, Gabriele, additional, Michelagnoli, Stefano, additional, Tusini, Nicola, additional, Capelli, Patrizio, additional, Turicchia, Giorgio Ubaldo, additional, Freyrie, Antonio, additional, Mariani, Erica, additional, Faggioli, GianLuca, additional, Gallitto, Enrico, additional, Migliari, Mattia, additional, Gennai, Stefano, additional, Paro, Barbara, additional, Baggi, Paolo, additional, Attisani, Luca, additional, Pegorer, Matteo, additional, Tadiello, Marco, additional, Franchin, Marco, additional, Bonvini, Stefano, additional, Chisci, Emiliano, additional, Troisi, Nicola, additional, Fontana, Antonio, additional, Strozzi, Francesco, additional, Scabini, Matteo, additional, Mosso, Federico, additional, Paciaroni, Elisa, additional, Tarantini, Salvatore, additional, Leone, Michele, additional, and Masi, Giancarlo, additional

Published
2022
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14. Multicentre comparison between open conversions and semi-conversions for late endoleaks after EVAR

Author

Perini, Paolo, Gargiulo, Mauro, Silingardi, Roberto, Bonardelli, Stefano, Bellosta, Raffaello, Piffaretti, Gabriele, Michelagnoli, Stefano, Tusini, Nicola, Capelli, Patrizio, Turicchia, Giorgio Ubaldo, Freyrie, Antonio, Mariani, Erica, Faggioli, Gianluca, Gallitto, Enrico, Migliari, Mattia, Gennai, Stefano, Paro, Barbara, Baggi, Paolo, Attisani, Luca, Pegorer, Matteo, Tadiello, Marco, Franchin, Marco, Bonvini, Stefano, Chisci, Emiliano, Troisi, Nicola, Fontana, Antonio, Strozzi, Francesco, Scabini, Matteo, Mosso, Federico, Paciaroni, Elisa, Tarantini, Salvatore, Leone, Michele, and Masi, Giancarlo

Subjects
Abdominal aortic aneurysm, EVAR explantation, Failed EVAR, Open surgical conversion, Type I endoleak, Type II endoleak
Published
2022

15. COVID-19 and acute limb ischemia: a systematic review

Author

ATTISANI, Luca, primary, PUCCI, Alessandro, additional, LUONI, Giorgio, additional, LUZZANI, Luca, additional, PEGORER, Matteo A., additional, SETTEMBRINI, Alberto M., additional, BISSACCO, Daniele, additional, WOHLAUER, Max V., additional, PIFFARETTI, Gabriele, additional, and BELLOSTA, Raffaello, additional

Published
2022
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16. Endovascular Reconstruction for Total Aorto–Iliac Occlusion

Author

Piffaretti, Gabriele, primary, Fargion, Aaron Thomas, additional, Dorigo, Walter, additional, Pulli, Raffaele, additional, Ferri, Michelangelo, additional, Antonello, Michele, additional, Bellosta, Raffaello, additional, Veraldi, Gianfranco, additional, Benedetto, Filippo, additional, Gargiulo, Mauro, additional, Pratesi, Carlo, additional, Tozzi, Matteo, additional, Franchin, Marco, additional, Fontana, Federico, additional, Piacentino, Filippo, additional, Giacomelli, Elena, additional, Speziali, Sara, additional, Esposito, Davide, additional, Angiletta, Domenico, additional, Marinazzo, Davide, additional, Zacà, Sergio, additional, Grego, Franco, additional, Piazza, Michele, additional, Squizzato, Francesco, additional, Pegorer, Matteo, additional, Attisani, Luca, additional, Ippoliti, Arnaldo, additional, Pratesi, Giovanni, additional, Citoni, Gianluca, additional, Pipitò, Narayana, additional, Derone, Graziana, additional, Cumino, Andrea, additional, Suita, Roberta, additional, Mascoli, Chiara, additional, Sonetto, Alessia, additional, Bracale, Umberto M., additional, Turchino, Davide, additional, Frigatti, Paolo, additional, Furlan, Federico, additional, Michelagnoli, Stefano, additional, Chisci, Emiliano, additional, Gudotti, Azzurra, additional, Masciello, Fabrizio, additional, Bonvini, Stefano, additional, Paini, Elisa, additional, Mezzetto, Luca, additional, and Mastrorilli, Davide, additional

Published
2021
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17. Covered versus bare metal kissing stents for reconstruction of the aortic bifurcation in the ILIACS registry

Author

Squizzato, Francesco, primary, Piazza, Michele, additional, Pulli, Raffaele, additional, Fargion, Aaron, additional, Piffaretti, Gabriele, additional, Pratesi, Carlo, additional, Grego, Franco, additional, Antonello, Michele, additional, Fontana, Federico, additional, Piacentino, Filippo, additional, Castelli, Patrizio, additional, Speziali, Sara, additional, Angiletta, Domenico, additional, Marinazzo, Davide, additional, Zacà, Sergio, additional, Bellosta, Raffaello, additional, Pegorer, Matteo, additional, Ippoliti, Arnaldo, additional, Pratesi, Giovanni, additional, Citoni, Gianluca, additional, Benedetto, Filippo, additional, Pipitò, Narayana, additional, Derone, Graziana, additional, Ferri, Michelangelo, additional, Cumino, Andrea, additional, Suita, Roberta, additional, Gargiulo, Mauro, additional, Mascoli, Chiara, additional, Sonetto, Alessia, additional, Bracale, Umberto M., additional, and Turchino, Davide, additional

Published
2021
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18. Regional Survey in Lombardy, Northern Italy, on Vascular Surgery Intervention Outcomes During The COVID-19 Pandemic

Author

Bellosta, Raffaello, primary, Piffaretti, Gabriele, additional, Bonardelli, Stefano, additional, Castelli, Patrizio, additional, Chiesa, Roberto, additional, Frigerio, Dalmazio, additional, Lanza, Gaetano, additional, Pirrelli, Stefano, additional, Rossi, Giovanni, additional, Trimarchi, Santi, additional, Briolini, Franco, additional, Cefali, Pietro, additional, Caronno, Roberto, additional, Arzini, Aldo, additional, Diaco, Domenico, additional, Baratta, Vittorio, additional, Aiello, Stefano, additional, Molinari, Alessandro C.L., additional, Giovannini, Francesca, additional, Socrate, Anna Maria, additional, Ferraris, Matteo, additional, Silvestro, Antonino, additional, Canu, Gianluca, additional, Costantini, Emidio, additional, Logaldo, Davide, additional, Romani, Federico, additional, Lista, Alfredo, additional, Busoni, Cristina, additional, Setti, Marco, additional, Mezzetti, Roberto, additional, Sala, Piergiorgio, additional, Bassi, Luca, additional, Luzzani, Luca, additional, Pegorer, Matteo A., additional, Attisani, Luca, additional, Carugati, Claudio, additional, Vescovi, Monica, additional, Trabattoni, Piero, additional, Zoli, Stefano, additional, Rignano, Andrea, additional, Magri, Clara, additional, Vandone, Pierluigi, additional, Losa, Sergio, additional, Civilini, Efrem, additional, Nano, Giovanni, additional, Mazzaccaro, Daniela, additional, Tolva, Valerio, additional, Lanza, Jessica, additional, Curci, Ruggiero, additional, Simonetti, Giovanna, additional, Lomazzi, Chiara, additional, Grassi, Viviana, additional, Bissacco, Daniele, additional, Kahlberg, Andrea, additional, Mascia, Daniele, additional, Dallatana, Raffaello, additional, Carmo, Michele, additional, Ragni, Franco, additional, Marone, Enrico M., additional, Bozzani, Antonio, additional, Tozzi, Matteo, additional, Franchin, Marco, additional, Lussardi, Gianluca, additional, Segramora, Vittorio, additional, Deleo, Gaetano, additional, Crippa, Matteo, additional, Porretta, Tiziano, additional, Viani, Marco, additional, Stegher, Silvia, additional, Foresti, Davide, additional, and Bonalumi, Giovanni, additional

Published
2021
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19. Vascular Surgery During COVID-19 Emergency in Hub Hospitals of Lombardy: Experience on 305 Patients

Author

Kahlberg, Andrea, primary, Mascia, Daniele, additional, Bellosta, Raffaello, additional, Attisani, Luca, additional, Pegorer, Matteo, additional, Socrate, Anna M., additional, Ferraris, Matteo, additional, Trabattoni, Piero, additional, Rinaldi, Enrico, additional, Melloni, Andrea, additional, Monaco, Fabrizio, additional, Melissano, Germano, additional, and Chiesa, Roberto, additional

Published
2021
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21. Major cardiovascular events in patients with Coronavirus Disease 2019: Experience of a cardiovascular department of Northern Italy

Author

Bellosta, Raffaello, primary, Pegorer, Matteo Alberto, additional, Bettari, Luca, additional, Luzzani, Luca, additional, Attisani, Luca, additional, Fossati, Alessandro, additional, Consoli, Letizia, additional, Maffeo, Diego, additional, Cuccia, Claudio, additional, Terragnoli, Paolo, additional, Bush, Ruth L., additional, and Piffaretti, Gabriele, additional

Published
2021
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22. Urgency and emergency treatments in cardiovascular surgery during the COVID pandemic: results of extremized HUB and spoke organization in northern Italy.

Author

Saccocci, Matteo, primary, ATTISANI, LUCA, additional, FERRARO, FRANCESCO, additional, fossati, alessandro, additional, Villa, Emmanuel, additional, Pegorer, Matteo, additional, Messina, Antonio, additional, Luzzani, Luca, additional, Cirillo, Marco, additional, Blasi, Stefania, additional, Mhagna, Zean, additional, Cossu, Luisa, additional, Tomba, Margherita Dalla, additional, Pirrelli, Stefano, additional, Rambaldini, Manfredo, additional, martinelli, federico, additional, briolini, franco, additional, Merlo, Maurizio, additional, mezzetti, roberto, additional, Baratta, Vittorio, additional, Sala, Piergiorgio, additional, Piffaretti, Gabriele, additional, Panisi, Paolo, additional, Benussi, Stefano, additional, Muneretto, Claudio, additional, bellosta, raffaello, additional, and Troise, Giovanni, additional

Published
2020
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23. Twenty-two Year Multicentre Experience of Late Open Conversions after Endovascular Abdominal Aneurysm Repair

Author

Perini, Paolo, primary, Gargiulo, Mauro, additional, Silingardi, Roberto, additional, Bonardelli, Stefano, additional, Bellosta, Raffaello, additional, Bonvini, Stefano, additional, Michelagnoli, Stefano, additional, Tusini, Nicola, additional, Capelli, Patrizio, additional, Freyrie, Antonio, additional, Mariani, Erica, additional, Faggioli, GianLuca, additional, Gallitto, Enrico, additional, Migliari, Mattia, additional, Gennai, Stefano, additional, Paro, Barbara, additional, Baggi, Paolo, additional, Attisani, Luca, additional, Pegorer, Matteo, additional, Tasselli, Sebastiano, additional, Wassermann, Valentina, additional, Chisci, Emiliano, additional, Troisi, Nicola, additional, Fontana, Antonio, additional, Strozzi, Francesco, additional, Scabini, Matteo, additional, Mosso, Federico, additional, Gessaroli, Massimiliano, additional, Leone, Michele, additional, Masi, Giancarlo, additional, and Turicchia, Giorgio Ubaldo, additional

Published
2020
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24. Major Cardiovascular Events in Patients with COVID-19: Experience of a Cardiovascular Department in the Lombardia Region of Northern Italy

Author

Bellosta, Raffaello, primary, Pegorer, Matteo Alberto, additional, Bettari, Luca, additional, Luzzani, Luca, additional, Attisani, Luca, additional, Fossati, Alessandro, additional, Consoli, Letizia, additional, Maffeo, Diego, additional, Cuccia, Claudio, additional, Terragnoli, Paolo, additional, Bush, Ruth L, additional, and Piffaretti, Gabriele, additional

Published
2020
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25. Outcomes Analysis of 677 Cases from the Multicenter Italian Registry on Primary Endovascular Treatment of Iliac and Aorto-Iliac Arteries Obstructive Disease (Iliacs Registry)

Author

Piffaretti, Gabriele, primary, Pratesi, Carlo, additional, Dorigo, Walter, additional, Fargion, Aaron T., additional, Speziali, Sara, additional, Pulli, Raffaele, additional, Angiletta, Domenico, additional, Marinazzo, Davide, additional, Zacà, Sergio, additional, Grego, Franco, additional, Antonello, Michele, additional, Squizzato, Francesco, additional, Bellosta, Raffaello, additional, Pegorer, Matteo, additional, Ippoliti, Arnaldo, additional, Pratesi, Giovanni, additional, Citoni, Gianluca, additional, Benedetto, Filippo, additional, Pipitò, Narayana, additional, Ferri, Michelangelo, additional, Viazzo, Andrea, additional, Nessi, Franco, additional, Ferrero, Ferruccio, additional, Cumino, Andrea, additional, Gargiulo, Mauro, additional, Stella, Andrea, additional, Mascoli, Chiara, additional, Sonetto, Alessia, additional, Bracale, Umberto M., additional, Gattuso, Andrea, additional, and Castelli, Patrizio M., additional

Published
2019
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26. Outcomes From the Multicenter Italian Registry on Primary Endovascular Treatment of Aortoiliac Occlusive Disease

Author

Piffaretti, Gabriele, primary, Fargion, Aaron Thomas, additional, Dorigo, Walter, additional, Pulli, Raffaele, additional, Gattuso, Andrea, additional, Bush, Ruth L., additional, Pratesi, Carlo, additional, Fontana, Federico, additional, Piacentino, Filippo, additional, Castelli, Patrizio, additional, Speziali, Sara, additional, Angiletta, Domenico, additional, Marinazzo, Davide, additional, Zacà, Sergio, additional, Grego, Franco, additional, Antonello, Michele, additional, Piazza, Michele, additional, Squizzato, Francesco, additional, Bellosta, Raffaello, additional, Pegorer, Matteo, additional, Ippoliti, Arnaldo, additional, Pratesi, Giovanni, additional, Citoni, Gianluca, additional, Benedetto, Filippo, additional, Pipitò, Narayana, additional, Derone, Graziana, additional, Ferri, Michelangelo, additional, Cumino, Andrea, additional, Suita, Roberta, additional, Gargiulo, Mauro, additional, Mascoli, Chiara, additional, Sonetto, Alessia, additional, Bracale, Umberto M., additional, and Turchino, Davide, additional

Published
2019
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27. Three-Dimensional Geometric Analysis of Viabahn VBX Bridging Stent Grafts in Fenestrated Endovascular Aortic Repair: A Multicenter, Retrospective Cohort Study

Author

Fouad, Fatima, Saleem, Ben R., Tielliu, Ignace F. J., Pegorer, Matteo A., Bellosta, Raffaello, Esposito, Davide, Fargion, Aaron T., Zeebregts, Clark J., de Vries, Jean-Paul P. M., and Schuurmann, Richte C. L.

Abstract

Purpose: The primary aim of this study was to assess the 3-dimensional flare geometry of the Gore Viabahn VBX balloon-expandable covered stent (BECS) after fenestrated endovascular aortic repair (FEVAR) and to determine and visualize BECS-associated complications.Methods: This multicenter retrospective study included patients who underwent FEVAR between 2018 and 2022 in 3 vascular centers participating in the VBX Expand Registry. Patients with at least one visceral artery treated with the VBX and with availability of 2 post-FEVAR computed tomography angiography (CTA) scans (follow-up [FU] 1: 0–6 months; FU2: 9–24 months) were included. The flare geometry of the VBX, including flare-to-fenestration distance, flare-to-fenestration diameter ratio, flare angle, and apposition with the target artery were assessed using a vascular workstation and dedicated CTA applied software.Results: In total, 90 VBX BECS were analyzed in 43 FEVAR patients. The median CTA FU for FU1 and FU2 was 35 days (interquartile range [IQR], 29–51 days) and 14 months (IQR, 13–15 months), respectively. The mean flare-to-fenestration distance was 5.6±2.0 mm on FU1 and remained unchanged at 5.7±2.0 mm on FU2 (p=.417). The flare-to-fenestration diameter ratio was 1.19±0.17 on FU1 and remained unchanged at 1.21±0.19 (p=.206). The mean apposition length was 18.6±5.3 mm on FU1 and remained 18.6±5.3 mm (p=.550). The flare angle was 31°±15° on FU1 and changed to 33°±16° (p=.009). On FU1, the BECS-associated complication rate was 1%, and the BECS-associated reintervention rate was 0%. On FU2, the BECS-associated complication rate was 3%, and the BECS-associated reintervention rate was 1%.Conclusions: The flare geometry of the VBX bridging stent did not change significantly during 14 months follow-up in this study. Three-dimensional geometric analysis of the flare may contribute to identify the origin of endoleaks and occlusions, but this should be confirmed in a larger study including enough patients and BECS to compare complicated and uncomplicated cases.Clinical Impact The three-dimensional flare geometry of the Gore Viabahn VBX BECS was assessed on the first and second postoperative CTA scans, and geometrical changes during this period were identified. For BECS that were diagnosed with a type 3c endoleak or occlusion, the BECS geometry was analyzed to detect geometrical components that were related to the complication. Geometric analysis of the flare may help to better detect and identify the cause of such complications.

Published
2024
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29. Endovascular Reconstruction for Total Aorto–Iliac Occlusion

Author

Piffaretti, Gabriele, Fargion, Aaron Thomas, Dorigo, Walter, Pulli, Raffaele, Ferri, Michelangelo, Antonello, Michele, Bellosta, Raffaello, Veraldi, Gianfranco, Benedetto, Filippo, Gargiulo, Mauro, Pratesi, Carlo, Tozzi, Matteo, Franchin, Marco, Fontana, Federico, Piacentino, Filippo, Giacomelli, Elena, Speziali, Sara, Esposito, Davide, Angiletta, Domenico, Marinazzo, Davide, Zacà, Sergio, Grego, Franco, Piazza, Michele, Squizzato, Francesco, Pegorer, Matteo, Attisani, Luca, Ippoliti, Arnaldo, Pratesi, Giovanni, Citoni, Gianluca, Pipitò, Narayana, Derone, Graziana, Cumino, Andrea, Suita, Roberta, Gargiulo, Mauro, Mascoli, Chiara, Sonetto, Alessia, Bracale, Umberto M., Turchino, Davide, Frigatti, Paolo, Furlan, Federico, Michelagnoli, Stefano, Chisci, Emiliano, Gudotti, Azzurra, Masciello, Fabrizio, Bonvini, Stefano, Paini, Elisa, Mezzetto, Luca, and Mastrorilli, Davide

Abstract

Objectives: To analyze outcomes following endovascular treatment of total occlusion of the infrarenal aorta and aorto–iliac bifurcation in a multicenter Italian registry.Methods: It is a multicenter, retrospective, observational cohort study. From January 2015 to December 2018, 1306 endovascular interventions for aorto–iliac occlusive disease were recorded in the vascular registry. For this analysis, only patients treated for total occlusion of the infrarenal aorta and aorto–iliac bifurcation were included. Early (<30 days) primary outcomes of interest were technical success and mortality. Late major outcomes were primary and secondary patency and freedom from conversion to open aortic surgery.Results: A total of 54 (4.1%) patients met the inclusion criteria. Total percutaneous revascularization was possible in 41 (75.9%) patients and hybrid (endo plus open) intervention in 13 (24.1%) patients. The kissing-stent-graft technique was used in 45 (83.3%) cases, covered endovascular reconstruction of the aortic bifurcation (CERAB) in 5 (9.2%), and a unibody endograft deployed in 4 (7.4%). Technical success was 98.1% (n = 53). There were no episodes of intraoperative or perioperative vessel rupture. Conversion to open surgery was not necessary, and there were no in-hospital deaths. The median patient follow-up time was 16 months (interquartrile range [IQR], 6-27). The estimated primary patency rate was 95.8% ± 0.03 (95% confidence interval [CI]: 85.5-98.9) at 1 year, 91.4% ± 0.05 (95% CI: 76.2-97.2) at 2 years, and 85 ± 0.08 (95% CI: 64.5-94.6) at 3 years. Cox regression analysis demonstrated that sex (hazard ratio [HR]: 0.96; 95% CI: 0.15-6.23, p= 0.963), extent of the occlusion (HR: 0.28; 95% CI: 0.05-1.46, p= 0.130), calcium score (HR: 1.88; 95% CI: 0.31-11.27, p= 0.490), or type of endovascular reconstruction (HR: 0.80; 95% CI: 0.13-5.15, p= 0.804) did not affect primary patency. Secondary patency was 95.5% ± 0.04 (95% CI: 78.4-99.2) at 3 years. No patients required late conversion to open surgical bypass.Conclusions: Endovascular reconstruction for total occlusion of the infrarenal aorta and aorto–iliac bifurcation was successful using a combination of percutaneous and hybrid revascularization techniques. Estimated patency rates at 3 years of follow-up are promising and are unaffected by the extent of occlusion or type of revascularization.

Published
2022
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30. COVID-19 acute respiratory distress syndrome: can iloprost have a role for the treatment?

Author

Filippini, Alida, Bnà, Claudio, Bellosta, Raffaello, Bazzani, Roberto, Luzzani, Luca, Pegorer, Matteo Alberto, Zandalasini, Matteo, Baldon, Michela, Codazzi, Manuela, and Sabatini, Tony

Abstract

Pulmonary infection of 2019-nCoV can frequently induce acute respiratory distress syndrome (ARDS) with partial pressure of arterial oxygen/fraction of inspired oxygen ratio (pO2/FiO2) of less than 300 mmHg. Moreover, it can be complicated with cardiac injury or arrhythmia, microvascular and large-vessel thrombosis. We describe a case of a patient with COVID19-ARDS and concomitant critical ischemia of the limbs. Iloprost treatment, an analogue of a prostacyclin PGI2, was started for residual left forefoot ischemia after surgical thromboembolectomy. Unexpectedly, we documented improvement of respiratory performance and lung high resolution computed tomography (HRCT) showed significant regression of the diffuse pulmonary ground-glass opacity. The hypothetical mechanism is that iloprost can enhance perfusion preferentially to well-ventilated lung regions, reduce pressures of peripheral pulmonary vessels and induce reduction of lung interstitial edema. In addition, iloprost antithrombotic effect, endothelial damage repairing and neo-angiogenesis activity could play a relevant role. [ABSTRACT FROM AUTHOR]

Published
2020
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31. Endovascular Reconstruction for Total Aorto-Iliac Occlusion

Author

Gabriele Piffaretti, Aaron Thomas Fargion, Walter Dorigo, Raffaele Pulli, Michelangelo Ferri, Michele Antonello, Raffaello Bellosta, Gianfranco Veraldi, Filippo Benedetto, Mauro Gargiulo, Carlo Pratesi, Matteo Tozzi, Marco Franchin, Federico Fontana, Filippo Piacentino, Elena Giacomelli, Sara Speziali, Davide Esposito, Domenico Angiletta, Davide Marinazzo, Sergio Zacà, Franco Grego, Michele Piazza, Francesco Squizzato, Matteo Pegorer, Luca Attisani, Arnaldo Ippoliti, Giovanni Pratesi, Gianluca Citoni, Narayana Pipitò, Graziana Derone, Andrea Cumino, Roberta Suita, Chiara Mascoli, Alessia Sonetto, Umberto M. Bracale, Davide Turchino, Paolo Frigatti, Federico Furlan, Stefano Michelagnoli, Emiliano Chisci, Azzurra Gudotti, Fabrizio Masciello, Stefano Bonvini, Elisa Paini, Luca Mezzetto, Davide Mastrorilli, Piffaretti, Gabriele, Fargion, Aaron Thoma, Dorigo, Walter, Pulli, Raffaele, Ferri, Michelangelo, Antonello, Michele, Bellosta, Raffaello, Veraldi, Gianfranco, Benedetto, Filippo, Gargiulo, Mauro, Pratesi, Carlo, Tozzi, Matteo, Franchin, Marco, Fontana, Federico, Piacentino, Filippo, Giacomelli, Elena, Speziali, Sara, Esposito, Davide, Angiletta, Domenico, Marinazzo, Davide, Zacà, Sergio, Grego, Franco, Piazza, Michele, Squizzato, Francesco, Pegorer, Matteo, Attisani, Luca, Ippoliti, Arnaldo, Pratesi, Giovanni, Citoni, Gianluca, Pipitò, Narayana, Derone, Graziana, Cumino, Andrea, Suita, Roberta, Mascoli, Chiara, Sonetto, Alessia, Bracale, Umberto M., Turchino, Davide, Frigatti, Paolo, Furlan, Federico, Michelagnoli, Stefano, Chisci, Emiliano, Gudotti, Azzurra, Masciello, Fabrizio, Bonvini, Stefano, Paini, Elisa, Mezzetto, Luca, and Mastrorilli, Davide

Subjects
Endovascular Procedures, Aortic Diseases, Arterial Occlusive Diseases, Iliac Artery, kissing-stents, Treatment Outcome, Leriche syndrome, aorto–iliac occlusion, aorto–iliac occlusive disease, total occlusion of the infrarenal aorta, Humans, Radiology, Nuclear Medicine and imaging, Surgery, Abdominal, Stents, Aorta, Abdominal, kissing-stent, Cardiology and Cardiovascular Medicine, Retrospective Studies, Vascular Patency, Aorta
Abstract

Objectives: To analyze outcomes following endovascular treatment of total occlusion of the infrarenal aorta and aorto–iliac bifurcation in a multicenter Italian registry. Methods: It is a multicenter, retrospective, observational cohort study. From January 2015 to December 2018, 1306 endovascular interventions for aorto–iliac occlusive disease were recorded in the vascular registry. For this analysis, only patients treated for total occlusion of the infrarenal aorta and aorto–iliac bifurcation were included. Early (Results: A total of 54 (4.1%) patients met the inclusion criteria. Total percutaneous revascularization was possible in 41 (75.9%) patients and hybrid (endo plus open) intervention in 13 (24.1%) patients. The kissing-stent-graft technique was used in 45 (83.3%) cases, covered endovascular reconstruction of the aortic bifurcation (CERAB) in 5 (9.2%), and a unibody endograft deployed in 4 (7.4%). Technical success was 98.1% (n = 53). There were no episodes of intraoperative or perioperative vessel rupture. Conversion to open surgery was not necessary, and there were no in-hospital deaths. The median patient follow-up time was 16 months (interquartrile range [IQR], 6-27). The estimated primary patency rate was 95.8% ± 0.03 (95% confidence interval [CI]: 85.5-98.9) at 1 year, 91.4% ± 0.05 (95% CI: 76.2-97.2) at 2 years, and 85 ± 0.08 (95% CI: 64.5-94.6) at 3 years. Cox regression analysis demonstrated that sex (hazard ratio [HR]: 0.96; 95% CI: 0.15-6.23, p = 0.963), extent of the occlusion (HR: 0.28; 95% CI: 0.05-1.46, p = 0.130), calcium score (HR: 1.88; 95% CI: 0.31-11.27, p = 0.490), or type of endovascular reconstruction (HR: 0.80; 95% CI: 0.13-5.15, p = 0.804) did not affect primary patency. Secondary patency was 95.5% ± 0.04 (95% CI: 78.4-99.2) at 3 years. No patients required late conversion to open surgical bypass. Conclusions: Endovascular reconstruction for total occlusion of the infrarenal aorta and aorto–iliac bifurcation was successful using a combination of percutaneous and hybrid revascularization techniques. Estimated patency rates at 3 years of follow-up are promising and are unaffected by the extent of occlusion or type of revascularization.

Published
2021

32. Covered versus Bare-metal Kissing Stents for the Reconstruction of the Aortic Bifurcation in the ILIACS registry

Author

Michele Antonello, Chiara Mascoli, Franco Grego, Giovanni Pratesi, Raffaello Bellosta, Matteo Pegorer, Roberta Suita, Alessia Sonetto, Umberto Bracale, Aaron Fargion, Patrizio Castelli, Sergio Zacà, Narayana Pipitò, Davide Turchino, Andrea Cumino, Sara Speziali, Michelangelo Ferri, Mauro Gargiulo, Carlo Pratesi, Davide Marinazzo, Filippo Piacentino, Francesco Squizzato, Federico Fontana, Raffaele Pulli, Graziana Derone, Domenico Angiletta, Gabriele Piffaretti, Michele Piazza, Gianluca Citoni, Arnaldo Ippoliti, Filippo Benedetto, Francesco, Squizzato, Michele, Piazza, Raffaele, Pulli, Aaron, Fargion, Gabriele, Piffaretti, Carlo, Pratesi, Franco, Grego, Michele, Antonello, Fontana, Federico, Piacentino, Filippo, Castelli, Patrizio, Speziali, Sara, Angiletta, Domenico, Marinazzo, Davide, Zacà, Sergio, Bellosta, Raffaello, Pegorer, Matteo, Ippoliti, Arnaldo, Pratesi, Giovanni, Citoni, Gianluca, Benedetto, Filippo, Pipitò, Narayana, Derone, Graziana, Ferri, Michelangelo, Cumino, Andrea, Suita, Roberta, Gargiulo, Mauro, Mascoli, Chiara, Sonetto, Alessia, Bracale, UMBERTO MARCELLO, Turchino, Davide, Squizzato F., Piazza M., Pulli R., Fargion A., Piffaretti G., Pratesi C., Grego F., Antonello M., Fontana F., Piacentino F., Castelli P., Speziali S., Angiletta D., Marinazzo D., Zaca S., Bellosta R., Pegorer M., Ippoliti A., Pratesi G., Citoni G., Benedetto F., Pipito N., Derone G., Ferri M., Cumino A., Suita R., Gargiulo M., Mascoli C., Sonetto A., Bracale U.M., and Turchino D.

Subjects
Biocompatible, Male, Registrie, Arterial Occlusive Disease, Aortic bifurcation, Endovascular procedures, Iliac artery, Peripheral artery disease, Registries, Stents, Time Factors, Constriction, Pathologic, Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Aortic Diseases, Arterial Occlusive Diseases, Female, Humans, Italy, Limb Salvage, Middle Aged, Polytetrafluoroethylene, Prosthesis Design, Retrospective Studies, Treatment Outcome, Vascular Patency, Coated Materials, Biocompatible, Iliac Artery, Self Expandable Metallic Stents, Retrospective Studie, 80 and over, Stent, Medicine, Bare metal, Constriction, surgical procedures, operative, medicine.anatomical_structure, Endovascular procedure, Cohort, medicine.symptom, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Time Factor, Covered stent, Pathologic, business.industry, Proportional hazards model, Angioplasty, Coated Materials, Critical limb ischemia, Aortic Disease, Surgery, Settore MED/22, Multicenter study, Propensity score matching, business, Balloon
Abstract

Objective: We compared the early and mid-term outcomes of polytetrafluoroethylene covered stents (CSs) vs bare metal stents (BMSs) used in the kissing conformation for the reconstruction of the aortic bifurcation in aortoiliac obstructive disease. Methods: A multicenter cohort registry (2015-2019) collected data from 1306 patients who had undergone endovascular treatment of aortoiliac arterial obstructive disease. Only patients who had received bilateral iliac kissing stents for TransAtlantic Inter-Society Consensus (TASC) class C and D lesions were included in the present analysis. The 30-day outcomes, mid-term primary patency, and limb salvage rates were compared between the CSs and BMSs in matched patient cohorts after propensity score matching. The follow-up results were analyzed using Kaplan-Meier curves. Cox proportional hazards models were used to identify the predictors of primary patency. Results: A total of 336 patients were treated with kissing stents, 201 with CSs (60%) and 135 with BMSs (40%). In the unmatched cohort, patients receiving CSs were more likely to have critical limb ischemia (41% vs 30%; P = .038), complex iliac lesions, such as TASC D (90% vs 56%; P < .01), and iliac occlusions (59% vs 44%; P < .01). After propensity score matching, 220 patients were selected (110 with CSs and 110 with BMSs), without differences in the clinical presentation (critical limb ischemia, 41% vs 33%; P = .167), or anatomic complexity (TASC D, 66% vs 60%, P = .21; iliac occlusion, 48% vs 49%, P = .89). The 30-day mortality was 0%. The early medical (unmatched, 5% vs 4%, P = 1.00; matched, 5% vs 4%, P = .75) and surgical (unmatched, 5% vs 5%, P = 1.00; matched, 5% vs 3%, P = .72) complication rates were similar between the CSs and BMSs. However, the CSs resulted in a lower risk of intraoperative iliac rupture (0% vs 3.5%; P = .013) and greater ankle-brachial index improvement (0.43 ± 0.22 vs 0.36 ± 0.24; P = .02). At 36 months, the overall primary patency (92% ± 7% vs 92% ± 8%; P = .38), secondary patency (98% ± 3% vs 98% ± 4%; P = .50), and limb salvage (93% ± 9% vs 97% ± 5%; P = .20) rates were similar. In cases of moderate to severe iliac calcification, the CSs showed better results in the matched cohort (100% vs 89% ± 9%; P = .048). On multivariate analysis, CS use (hazard ratio [HR], 1.67; P = .45) did not significantly affect primary patency, but older age (HR, 0.93; P = .03) and kissing stent diameter ≥8 mm (HR, 0.25; P = .03) were significantly associated. Conclusion: In the present multicenter study, the use of kissing stents for the treatment of the aortic bifurcation provided good early and mid-term results. CSs were preferred for more complex lesions, were protective from iliac rupture, and allowed for greater ankle-brachial index improvement. The 3-year patency rates were similar between the CSs and BMSs. However, CSs showed improved results in the case of moderate to severe calcification.

Published
2021

33. Vascular Surgery during COVID-19 Emergency in Hub Hospitals of Lombardy: Experience on 305 Patients

Author

Andrea Kahlberg, Fabrizio Monaco, Matteo Pegorer, Piero Trabattoni, Raffaello Bellosta, Luca Attisani, Germano Melissano, Enrico Rinaldi, Andrea Melloni, Anna Maria Socrate, Matteo Ferraris, Daniele Mascia, Roberto Chiesa, Kahlberg, ANDREA LUITZ, Mascia, Daniele, Bellosta, Raffaello, Attisani, Luca, Pegorer, Matteo, Maria Socrate, Anna, Ferraris, Matteo, Trabattoni, Piero, Rinaldi, Enrico, Melloni, Andrea, Monaco, Fabrizio, Melissano, GERMANO CARLO GIUSEPPE, and Chiesa, Roberto

Subjects
Acute limb ischaemia, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Limb ischaemia, Disease, 030204 cardiovascular system & hematology, 030230 surgery, Chest pain, Article, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Adverse effect, Pandemics, SARS-CoV-2, business.industry, Vascular disease, COVID-19, Outbreak, Vascular surgery, medicine.disease, Hospitals, Lombardy, Emergency medicine, Surgery, medicine.symptom, business, Cardiology and Cardiovascular Medicine
Abstract

Objective During the most aggressive phase of the COVID-19 outbreak in Italy, the Regional Authority of Lombardy identified a number of hospitals, named Hubs, chosen to serve the whole region for highly specialised cases, including vascular surgery. This study reports the experience of the four Hubs for Vascular Surgery in Lombardy and provides a comparison of in hospital mortality and major adverse events (MAEs) according to COVID-19 testing. Methods Data from all patients who were referred to the Vascular Surgery Department of Hubs from 9 March to 28 April 2020 were collected prospectively and analysed. A positive COVID-19 polymerase chain reaction swab test, or symptoms (fever > 37.5 °C, upper respiratory tract symptoms, chest pain, and contact/travel history) associated with interstitial pneumonia on chest computed tomography scan were considered diagnostic of COVID-19 disease. Patient characteristics, operative variables, and in hospital outcomes were compared according to COVID-19 testing. A multivariable model was used to identify independent predictors of in hospital death and MAEs. Results Among 305 included patients, 64 (21%) tested positive for COVID-19 (COVID group) and 241 (79%) did not (non-COVID group). COVID patients presented more frequently with acute limb ischaemia than non-COVID patients (64% vs. 23%; p

Published
2020

34. Twenty-Five Year Multicentre Experience of Explantation of Infected Abdominal Aortic Endografts.

Author

Perini P, Gargiulo M, Silingardi R, Bonardelli S, Bellosta R, Piffaretti G, Michelagnoli S, Ferrari M, Turicchia GU, Freyrie A, Fornasari A, Mariani E, Faggioli G, Spath P, Migliari M, Gennai S, Paro B, Baggi P, Attisani L, Pegorer M, Franchin M, Mauri F, Chisci E, Troisi N, Paciaroni E, and Fanelli M

Abstract

We report a multicenter experience of open conversions (OC) for aortic endograft infections (AEI). We retrospectively analyzed all patients who underwent OC for AEI after endovascular aneurysm repair (EVAR), from 1997 to 2021 in 12 Italian centers. The endpoints were as follows: mortality (30-days, in-hospital), major postoperative complications. Follow-up data included: survival, aortic-related complications, infection persistence or reoccurrence. Fifty-eight patients (mean age: 73.8 ± 6.6 years) were included. Median time from EVAR to OC was 14 months (interquartile range 7-45). Thirty-five patients (60.3%) were symptomatic at presentation. Aortic reconstruction was anatomic in 32 patients (55.2%), extra-anatomic in 26 (44.8%). Thirty-day mortality was 31% (18/58). Six additional patients died after 30 days during the same hospitalization (in-hospital mortality: 41.4%). Most common post-operative complications included respiratory failure (38.6%) and renal insufficiency (35.1%). During 28.1 ± 4 months follow-up, 4 aneurysm-related deaths were recorded. Infection re-occurred in 29.4% of the patients. Estimated survival was 50% at 1 year, and 30% at 5 years, and was significantly lower for patients who underwent extra-anatomic reconstructions (37 vs 61% at 1 year, 16 vs 45% at 5 years; log-rank P = .021). OC for AEI is associated with high early mortality. The poor mid-term survival is influenced by aortic complications and infection re-occurrence., 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
2023
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35. Guidelines on the management of abdominal aortic aneurysms: updates from the Italian Society of Vascular and Endovascular Surgery (SICVE).

Author

Pratesi C, Esposito D, Apostolou D, Attisani L, Bellosta R, Benedetto F, Blangetti I, Bonardelli S, Casini A, Fargion AT, Favaretto E, Freyrie A, Frola E, Miele V, Niola R, Novali C, Panzera C, Pegorer M, Perini P, Piffaretti G, Pini R, Robaldo A, Sartori M, Stigliano A, Taurino M, Veroux P, Verzini F, Zaninelli E, and Orso M

Subjects
Humans, Italy epidemiology, Treatment Outcome, Aortic Aneurysm, Abdominal diagnostic imaging, Aortic Aneurysm, Abdominal surgery, Aortic Rupture, Endovascular Procedures methods
Abstract

The objective of these Guidelines was to revise and update the previous 2016 Italian Guidelines on Abdominal Aortic Aneurysm Disease, in accordance with the National Guidelines System (SNLG), to guide every practitioner toward the most correct management pathway for this pathology. The methodology applied in this update was the GRADE-SIGN version methodology, following the instructions of the AGREE quality of reporting checklist as well. The first methodological step was the formulation of clinical questions structured according to the PICO (Population, Intervention, Comparison, Outcome) model according to which the Recommendations were issued. Then, systematic reviews of the Literature were carried out for each PICO question or for homogeneous groups of questions, followed by the selection of the articles and the assessment of the methodological quality for each of them using qualitative checklists. Finally, a Considered Judgment form was filled in for each clinical question, in which the features of the evidence as a whole are assessed to establish the transition from the level of evidence to the direction and strength of the recommendations. These guidelines outline the correct management of patients with abdominal aortic aneurysm in terms of screening and surveillance. Medical management and indication for surgery are discussed, as well as preoperative assessment regarding patients' background and surgical risk evaluation. Once the indication for surgery has been established, the options for traditional open and endovascular surgery are described and compared, focusing specifically on patients with ruptured abdominal aortic aneurysms as well. Finally, indications for early and late postoperative follow-up are explained. The most recent evidence in the Literature has been able to confirm and possibly modify the previous recommendations updating them, likewise to propose new recommendations on prospectively relevant topics.

Published
2022
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36. COVID-19 and acute limb ischemia: a systematic review.

Author

Attisani L, Pucci A, Luoni G, Luzzani L, Pegorer MA, Settembrini AM, Bissacco D, Wohlauer MV, Piffaretti G, and Bellosta R

Subjects
Acute Disease, Anticoagulants adverse effects, COVID-19 blood, COVID-19 mortality, Female, Humans, Ischemia blood, Ischemia mortality, Male, Middle Aged, Peripheral Arterial Disease blood, Peripheral Arterial Disease mortality, Postoperative Complications etiology, Risk Assessment, Risk Factors, Thrombophilia blood, Thrombophilia mortality, Treatment Outcome, Anticoagulants therapeutic use, Blood Coagulation drug effects, COVID-19 therapy, Ischemia surgery, Peripheral Arterial Disease surgery, Thrombophilia drug therapy, Vascular Surgical Procedures adverse effects, Vascular Surgical Procedures mortality
Abstract

Introduction: The main goal of this systematic review was to analyze the outcomes of acute limb ischemia (ALI) in patients suffering from the novel Coronavirus: COVID-19 (SARS-CoV-2)., Evidence Acquisition: A systematic review on Medline and Embase was conducted up to May 15, 2021. All papers were sorted by abstract and full text by two independent authors. Systematic reviews, commentaries, and studies that did not distinguish status of COVID-19 infection were excluded from review. Patient demographics were recorded along with modality of treatment (endovascular and/or surgical). We analyzed 30-day outcomes, including mortality. Primary outcome was to evaluate clinical characteristic of ALI in patients affected by SARS-CoV-2 in term of location of ischemia, treatment options and 30-day outcomes., Evindence Synthesis: We selected 36 articles with a total of 194 patients. Most patients were male (80%) with a median age of 60 years old. The treatment most used was thromboembolectomy (31% of all surgical interventions). A total of 32 patients (19%) were not submitted to revascularization due to critical status. The rate of technical success was low (68%), and mortality rate was high (35%)., Conclusions: This review confirms that SARS-CoV-2 is associated with a high risk of ALI. Further studies are needed to investigate the association and elucidate potential mechanisms, which may include a hypercoagulable state and hyperactivation of the immune response. Furthermore, management of ALI is not standardized and depends on patient condition and extension of the thrombosed segment. ALI in COVID-19 patients is associated with high risk of failure of revascularization and perioperative mortality.

Published
2021
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