28 results on '"Sbarzaglia, Paolo"'
Search Results
2. Radial access for peripheral vascular intervention: the S.M.A.R.T. RADIANZ Vascular Stent System
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Subramanian, Vinayak, primary, Sauguet, Antoine, additional, Werner, Martin, additional, Sbarzaglia, Paolo, additional, Hausegger, Klaus A., additional, Goyault, Gilles, additional, Guerra, Mercedes, additional, Deloose, Koen, additional, Kahlberg, Andrea, additional, Balestriero, Giovanni, additional, Brodmann, Marianne, additional, Binkert, Christoph, additional, Goueffic, Yann, additional, Groezinger, Gerd, additional, Schwindt, Arne, additional, Schlager, Oliver, additional, Bertoglio, Luca, additional, Adams, George, additional, Sultana, Nusrath, additional, and Coscas, Raphaël, additional
- Published
- 2023
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3. Sex-Related Outcomes in Elderly Patients Presenting With Non–ST-Segment Elevation Acute Coronary Syndrome: Insights From the Italian Elderly ACS Study
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De Carlo, Marco, Morici, Nuccia, Savonitto, Stefano, Grassia, Vincenzo, Sbarzaglia, Paolo, Tamburrini, Paola, Cavallini, Claudio, Galvani, Marcello, Ortolani, Paolo, De Servi, Stefano, and Petronio, A. Sonia
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- 2015
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4. Safety and feasibility of iliac endovascular interventions with a radial approach. Results from a multicenter study coordinated by the Italian Radial Force
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Cortese, Bernardo, Trani, Carlo, Lorenzoni, Roberto, Sbarzaglia, Paolo, Latib, Azeem, Tommasino, Antonella, Bovenzi, Francesco, Cremonesi, Alberto, Burzotta, Francesco, Pitì, Antonino, Tarantino, Fabio, and Colombo, Antonio
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- 2014
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5. The MicroStent HEAL Registry: Interim 6-Month Outcomes
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Manzi, Marco, Deloose, Koen R., Schmidt, Andrej, Scheinert, Dierk, Zeller, Thomas, Maene, Lieven, van den Heuvel, Daniel, Lansink, Wouter, Palena, Luis Mariano, Sbarzaglia, Paolo, Brodmann, Marianne, and Lichtenberg, Michael
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- 2024
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6. Endoprosthesis Disconnection, Type III Endoleak in Endurant II Prosthesis
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Bardooli, Fawaz, primary, Grattoni, Chiara, additional, Oshoala, Kareem, additional, Sbarzaglia, Paolo, additional, Mangieri, Antonio, additional, Giannini, Francesco, additional, and Colombo, Antonio, additional
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- 2019
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7. Limb salvage in diabetic patients with no-option critical limb ischemia: outcomes of a specialized center experience
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Dalla Paola, Luca, primary, Cimaglia, Paolo, additional, Carone, Anna, additional, Scavone, Giuseppe, additional, Boscarino, Giulio, additional, Bernucci, Davide, additional, Sbarzaglia, Paolo, additional, Censi, Stefano, additional, Ferrari, Roberto, additional, and Campo, Gianluca, additional
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- 2019
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8. The “Woundosome” Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia
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Patrone, Lorenzo, Pasqui, Edoardo, Conte, Michael S., Farber, Alik, Ferraresi, Roberto, Menard, Matthew, Mills, Joseph L., Rundback, John, Schneider, Peter, Ysa, August, Abhishek, Kumar, Adams, George L., Ahmad, Naseer, Ahmed, Irfan, Alexandrescu, Vlad A., Amor, Max, Alper, David, Andrassy, Martin, Attinger, Christopher, Baadh, Andy, Barakat, Hashem, Biasi, Lukla, Bisdas, Theodosios, Bhatti, Zagum, Blessing, Erwin, Bonaca, Marc P, Bonvini, Stefano, Bosiers, Michel, Bradbury, Andrew W., Beasley, Robert, Behrendt, Christian-Alexander, Brodmann, Marianne, Cabral, Gonzalo, Cancellieri, Roberto, Casini, Andrea, Chandra, Venita, Chisci, Emiliano, Chohan, Omar, Choke, Edward T.C., Chong, Patrick F.S., Clerici, Giacomo, Coscas, Raphael, Costantino, Mary, Dalla Paola, Luca, Dand, Sabeen, Davies, Robert S.M., D’Oria, Mario, Diamantopoulos, Athanasios, Debus, Sebastian, Deloose, Koen, Del Giudice, Costantino, Donato, Gianmarco de, Rubertis, Brian De, Paul De Vries, Jean, Dias, Nuno V, Diaz-Sandoval, Larry, Dick, Florian, Donas, Konstantinos, Dua, Anahita, Fanelli, Fabrizio, Fazzini, Stefano, Foteh, Mazin, Gandini, Roberto, Gargiulo, Mauro, Garriboli, Luca, Genovese, Elizabeth A., Gifford, Edward, Goueffic, Yann, Goverde, Peter, Chand Gupta, Prem, Hinchliffe, Robert, Holden, Andrew, Houlind, Kim C., Howard, Dominic PJ, Huasen, Bella, Isernia, Giacomo, Katsanos, Konstantinos, Katzen, Barry, Kolh, Philippe, Koncar, Igor, Korosoglou, Grigorios, Krishnan, Prakash, Kroencke, Thomas, Krokidis, Miltiadis, Kumarasamy, Arun, Hayes, Paul, Iida, Osamu, Alejandre Lafont, Enrique, Langhoff, Ralf, Lecis, Alexandre, Lessne, Mark, Lichaa, Hady, Lichtenberg, Michael, Lobato, Marta, Lopes, Alice, Loreni, Giorgio, Lucatelli, Pierleone, Madassery, Sreekumar, Maene, Lieven, Manzi, Marco, Maresch, Martin, Santhosh Mathews, Jay, McCaslin, James, Micari, Antonio, Michelagnoli, Stefano, Migliara, Bruno, Morgan, Robert, Morelli, Luis, Morosetti, Daniele, Mouawad, Nicolas, Moxey, Paul, Müller-Hülsbeck, Stefan, Mustapha, Jihad, Nakama, Tatsuya, Nasr, Bahaa, N’dandu, Zola, Neville, Richard, Noory, Elias, Nordanstig, Joakim, Noronen, Katariina, Mariano Palena, Luis, Parlani, Gianbattista, Patel, Ashish S., Patel, Parag, Patel, Rafiuddin, Patel, Sanjay, Pena, Costantino, Perkov, Drazen, Portou, Mark, Pratesi, Giovanni, Rammos, Christos, Reekers, Jim, Riambau, Vicente, Roy, Trisha, Rosenfield, Kenneth, Antonella Ruffino, Maria, Saab, Fadi, Saratzis, Athanasios, Sbarzaglia, Paolo, Schmidt, Andrej, Secemsky, Eric, Siah, Michael, Sillesen, Henrik, Simonte, Gioele, Sirvent, Marc, Sommerset, Jill, Steiner, Sabine, Sakr, Ahmed, Scheinert, Dierk, Shishebor, Mehdi, Spiliopoulos, Stavros, Spinelli, Alessio, Stravoulakis, Konstantinos, Taneva, Gergana, Teso, Desarom, Tessarek, Joerg, Theivacumar, Selva, Thomas, Anish, Thomas, Shannon, Thulasidasan, Narayan, Torsello, Giovanni, Tripathi, Ramesh, Troisi, Nicola, Tummala, Srini, Tummala, Venkat, Twine, Christopher, Uberoi, Raman, Ucci, Alessandro, Valenti, Domenico, van den Berg, Jos, van den Heuvel, Daniel, Van Herzeele, Isabelle, Varcoe, Ramon, Vega de Ceniga, Melina, Veith, Frank J., Venermo, Maarit, Vijaynagar, Badri, Virdee, Sanjiv, Von Stempel, Conrad, Voûte, Michiel T, Khee Yeung, Kak, Zeller, Thomas, Zayed, Hany, and Montero Baker, Miguel
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- 2024
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9. Carotid artery stenting with a new-generation double-mesh stent in three high-volume Italian centres: clinical results of a multidisciplinary approach
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Nerla, Roberto, primary, Castriota, Fausto, additional, Micari, Antonio, additional, Sbarzaglia, Paolo, additional, Secco, Gioel Gabrio, additional, Ruffino, Maria Antonella, additional, de Donato, Gianmarco, additional, Setacci, Carlo, additional, and Cremonesi, Alberto, additional
- Published
- 2016
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10. Efficacia a lungo termine della brachiterapia endocoronarica beta (32P) nel trattamento delle ristenosi intrastent ad elevato rischio. Risultati prospettici di un registro monocentrico
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Ortolani, Paolo, Marzocchi, Antonio, Gaiba, William, Neri, Stefano, Marrozzini, Cinzia, Palmerini, Tullio, Aquilina, Matteo, Corlianò, Leonardo, Lombardo, Enzo, Bunkheila, Feisal, Pini, Stefania, Sbarzaglia, Paolo, Barbieri, Enza, Branzi, Angelo, TAGLIERI, NEVIO, Ortolani, Paolo, Marzocchi, Antonio, Gaiba, William, Neri, Stefano, Marrozzini, Cinzia, Palmerini, Tullio, Aquilina, Matteo, Corlianò, Leonardo, Lombardo, Enzo, Bunkheila, Feisal, Pini, Stefania, Sbarzaglia, Paolo, Taglieri, Nevio, Barbieri, Enza, and Branzi, Angelo
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Cardiology and Cardiovascular Medicine - Abstract
BACKGROUND: The aim of the study was to evaluate, on single center prospective data, long-term angiographic and clinical results of intracoronary beta (32P) brachytherapy in "real world" patients with high-risk in-stent restenosis lesions. METHODS: Sixty-nine consecutive patients (77 lesions) with high-risk in-stent restenosis (mean lesion length 30.3 +/- 16.1 mm, pattern III-IV 57.2%, diabetes 33.3%) treated with percutaneous dilation procedures and beta-radiation therapy, underwent 7-month clinical and angiographic follow-up. RESULTS: One patient (1.4%) presented with procedural non-Q wave myocardial infarction. At a mean follow-up of 7 +/- 1.5 months, death was observed in 1 patient (1.4%) and non-Q wave myocardial infarction in 3 (4.3%) (in 2 patients, who prematurely discontinued antiplatelet therapy, caused by late coronary thrombosis). Seven-month binary angiographic restenosis occurred in 20 lesions (25.9%) (in-stent restenosis 11.6%). Target lesion and target vessel revascularization occurred in 20 (28.9%) and 21 (30.4%) patients. At follow-up only 12 (17.3%) patients presented with CCS class III-IV angina. After intracoronary beta brachytherapy angiographic restenosis occurred regardless of the vessel size, lesion length and ostial location. On the contrary a high restenosis rate was documented in obstructive lesions. CONCLUSIONS: As applied in routine clinical practice, radiation therapy is safe and effective in the treatment of high-risk in-stent restenosis. In spite of all that, total occlusion at baseline predicts late angiographic restenosis.
- Published
- 2004
11. Myocardial rupture with left ventricle to coronary sinus communication: an unusual post-infarction mechanical complication
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Perugini, Enrica, primary, Sbarzaglia, Paolo, additional, Pallotti, M Giovanna, additional, Pavesi, Pier Camillo, additional, Fattori, Rossella, additional, and Di Pasquale, Giuseppe, additional
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- 2008
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12. Long‐term clinical and angiographic outcome of patients with occlusive in‐stent restenosis treated with (32P) β‐brachytherapy
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Ortolani, Paolo, primary, Marzocchi, Antonio, additional, Aquilina, Matteo, additional, Gaiba, William, additional, Neri, Stefano, additional, Bunkheila, Feisal, additional, Lombardo, Enzo, additional, Pini, Stefania, additional, Marrozzini, Cinzia, additional, Palmerini, Tullio, additional, Taglieri, Nevio, additional, Sbarzaglia, Paolo, additional, Reggiani, Maria Letizia Bacchi, additional, Barbieri, Enza, additional, and Branzi, Angelo, additional
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- 2004
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13. Prognostic Value of Isolated Troponin I Elevation After Percutaneous Coronary Intervention.
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Cavallini, Claudio, Verdecchia, Paolo, Savonitto, Stefano, Arraiz, Gustavo, Violini, Roberto, Olivari, Zoran, Rubartelli, Paolo, De Servi, Stefano, Plebani, Mario, Steffenino, Giuseppe, Sbarzaglia, Paolo, and Ardissino, Diego
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HEART disease research ,MORTALITY risk factors ,CREATININE ,HOSPITAL patients ,ALTITUDES - Abstract
The article presents a study which tested the hypothesis that isolated cardiac troponin I (cTnI) elevations after primary percutaneous coronary intervention (PCI) are useful in predicting mortality. The study is based on a previous research on a large population of patients undergoing PCI in hospital in Italy. The methods used in data collection, statistical analyses and clinical outcomes are described. A review of other studies on the association between risk for cardiac complications and elevations in creatinine kinase-MB is discussed.
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- 2010
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14. ALTERATION OF ELASTIC PROPERTIES IN CONGENITAL/INHERITED AORTIC DISEASES:: MRI STUDY IN MARFAN SYNDROME AND BICUSPID AORTIC VALVE.
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LOVATO, LUIGI, SBARZAGLIA, PAOLO, MAGI, SILVIA, RUSSO, VINCENZO, ZANNOLI, ROMANO, and FATTORI, ROSSELLA
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MARFAN syndrome , *CONNECTIVE tissue diseases , *EXTRACELLULAR matrix , *CONNECTIVE tissues , *MAGNETIC resonance imaging , *GENETIC disorders , *PROGNOSIS - Abstract
Marfan Syndrome and Bicuspid Aortic Valve (BAV) are characterized by the congenital/inherited alteration of the fibrillin proteins of aortic wall extracellular matrix, with higher incidence of aortic dissection/rupture even without aortic dilation. Therefore, early identification and treatment of aortic involvement could improve prognosis. The purpose of this study was to evaluate aortic elastic properties of BAV and Marfan Syndrome patients to identify an index of early aortic involvement. Methods: A Magnetic Resonance Imaging (MRI) study was performed on 38 BAV patients, 20 Marfan patients and 14 healthy volunteers as a control group. A high-resolution gradient-echo sequence was applied in the axial plane at the level of pulmonary artery bifurcation to evaluate aortic distensibility. Results: Aortic distensibility was significantly different among the three groups (ANOVA, p = 0.0001) and was sensibly reduced in BAV (0.0056 ± 0.0048 versus 0.025 ± 0.006 control group) and Marfan (0.0085 ± 0.006 versus 0.025 ± 0.006 control group). Intraobserver and interobserver reproducibility for diastolic measurements were 1.2% and 0.4% respectively and for systolic measurements, they were 1.1% and 0.3% respectively. Conclusion: In BAV or Marfan Syndrome patients, MRI evaluation of abnormal distensibility may provide a reliable index of early aortic involvement, even before aortic dilation occurs. [ABSTRACT FROM AUTHOR]
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- 2006
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15. Carotid artery stenting: current role of proximal neuroprotection and technical advancements in stroke prevention
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Cremonesi, Alberto, Mussardo, Marco, Sbarzaglia, Paolo, Spagnolo, Barbara, Cavazza, Caterina, and Castriota, Fausto
- Abstract
For more than 50 years, carotid endarterectomy has been considered the gold standard therapy to prevent stroke in patients with carotid artery disease. Carotid artery stenting (CAS) has emerged in the last 15 years as minimally invasive alternative to surgery, especially in patients at high surgical risk. Recent randomized trials have challenged this concept reporting a relatively high incidence rate (4–6%) of post-CAS neurological adverse events. The aim of this study is to evaluate the current role of CAS in all-comers with advanced carotid disease, managed with mandatory proximal neuroprotection in a high-volume centre. From our database, the last 393 consecutive patients, from January 2011 to August 2013, undergoing CAS under proximal neuroprotection were analysed (mean age 72 ± 8 years). Indications included symptomatic stenoses =60% (n = 87; 22%) and asymptomatic stenoses =80% (n = 306; 78%). In an intention-to-treat approach, CAS success rate was 100%. The in-hospital all stroke/death rate was 1% (minor stroke 1%, major stroke 0%, and death 0%), and the rate of myocardial infarction was 0.3%. The minor stroke rate was 2.3% in symptomatic patients and 0.7% in asymptomatic patients. Carotid artery stenting performed in a high experience centre with the use of proximal embolic protection device is safe and has a low incidence rate of stroke.
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- 2015
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16. New imaging modalities in peripheral interventions
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Micari, Antonio, Sbarzaglia, Paolo, Meeks, M.D.M.E., Liso, Armando, Riina, Marco, Lunetto, Maria Letizia, Roscitano, Giuseppe, and Vadalà, Giuseppe
- Abstract
The aim of this article is to evaluate the feasibility and results of our peripheral revascularization where we used non-conventional intra-procedural imaging techniques. Between January 2014 and September 2014, 45 patients were imaged with CO
2 angiography and/or optical coherence tomography (OCT) or 2D perfusion imaging. The scope was to minimize the use of contrast and obtain additional information to improve the outcome. CO2 angiography was used in all patients with impaired renal function. Two-dimensional perfusion was used in all patients with critical limb ischaemia before and after revascularization to quantify angiosome blood supply improvement at wound level. Optical coherence tomography was performed in superficial femoral arteries and popliteal arteries to disclose vessel microstructure and characterize plaque structure. In all patients, the invasive imaging was feasible and safe. In those patients studied with CO2 , the creatinine serum level after procedure increased by 0.11 ± 0.05. None of the patients received dialysis. The procedural success rate was 100% and was no different from the historical sample of the cath lab. Procedural time was not significantly affected by this supplemental technique. The 2D perfusion showed an incremental blood supply at wound level and OCT provided encouraging details regarding dissections and their clinical relevance. Our early experience with supplementary imaging techniques showed safety and feasibility. The peripheral angioplasty success rate was not different from the historical sample and the reduction of the contrast media dose resulted in an encouraging outcome in terms of renal protection. Two-dimensional perfusion added objective information regarding blood supply improvement and guided re-perfusion strategy.- Published
- 2015
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17. Predictors of 32P β brachytherapy failure in patients with high-risk in-stent restenosis
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Ortolani, Paolo, Marzocchi, Antonio, Aquilina, Matteo, Gaiba, William, Bunkheila, Feisal, Neri, Stefano, Lombardo, Enzo, Marrozzini, Cinzia, Pini, Stefania, Taglieri, Nevio, Sbarzaglia, Paolo, Reggiani, Maria Letizia Bacchi, Barbieri, Enza, and Branzi, Angelo
- Subjects
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CORONARY restenosis , *RADIOTHERAPY , *THERAPEUTICS , *CLINICAL trials - Abstract
The effectiveness of coronary radiation therapy for the treatment of in-stent restenosis (ISR) has been established in several randomized clinical trials. The efficacy of this treatment in the general population is less well established.We report our experience in 118 consecutive patients with nonselected high-risk ISR who had undergone successful percutaneous coronary intervention and brachytherapy with 32P β-irradiation and who were prospectively enrolled in a quantitative angiographic and clinical follow-up protocol at 7 months after the index procedure. The aim of this study was to investigate the independent predictor of angiographic restenosis after 32P brachytherapy treatment.Of the patients, 28.8% were diabetics. The mean lesion and mean radiated lengths were, respectively, 30.1 ± 17.2 and 43.8 ± 16.9 mm. The ISR pattern was diffuse in 96% of the treated lesions; in particular, 22.1% presented an occlusive pattern and 37.1% a proliferative pattern. At follow-up angiographic, restenosis and major adverse cardiac events (MACE) rates were, respectively, 20.8% and 29.6%. The univariate predictors of angiographic restenosis were procedural geographic miss, pattern IV ISR, manual pullback maneuver of the radiation source, preprocedural lesion percentage stenosis and preprocedural lesion MLD. At logistic regression analysis, only geographic miss and pattern IV ISR were independent predictors of post intracoronary radiation therapy (IRT) angiographic restenosis.These data indicate that 7-month angiographic restenosis after 32P IRT in complex patients with ISR is not a frequent event and is predicted mainly by an occlusive lesion at baseline and by procedural geographical miss. [Copyright &y& Elsevier]
- Published
- 2004
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18. [Bioresorbable vascular scaffolds: clinical experience of the Emilia-Romagna Region, Italy]
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Alberto, Menozzi, Gianluca Calogero, Campo, Vincenzo, Guiducci, Gianni, Dall'Ara, Andrea, Santarelli, Paolo, Sbarzaglia, Marco, Balducelli, Paolo, Magnavacchi, Fabio, Sgura, Luciano, Losi, Luigi, Vignali, Gianni, Casella, Luigi, Steffanon, Fabio, Tarantino, Francesco, Saia, Menozzi, Alberto, Campo, Gianluca Calogero, Guiducci, Vincenzo, Dall'Ara, Gianni, Santarelli, Andrea, Sbarzaglia, Paolo, Balducelli, Marco, Magnavacchi, Paolo, Sgura, Fabio, Losi, Luciano, Vignali, Luigi, Casella, Gianni, Steffanon, Luigi, Tarantino, Fabio, and Saia, Francesco
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BVS ,Italy ,Tissue Scaffolds ,Absorbable Implants ,Humans ,Coronary Artery Disease ,Prosthesis Design ,Coronary Vessels ,Blood Vessel Prosthesis ,Randomized Controlled Trials as Topic ,NO - Abstract
The bioresorbable vascular scaffold (BRS) technology constitutes the new revolution of the coronary artery disease interventional treatment. Currently, three distinct types of BRSs are available but only one, the Absorb BVS, was on the market in 2013 when the Regional Commission for Medical Devices and the Cardiology and Cardiac Surgery Commission of the Emilia-Romagna Region drew up a technical and scientific essay to provide guidance for the introduction of BRS in public and affiliated health facilities. Five preferential indications were given for use: long coronary lesions (28 mm), ostial lesions (left main stem excluded), complete revascularization in patients aged50 years, diffuse disease (40 mm) or involving the mid/distal left anterior descending (LAD) branch in patients70 years, spontaneous coronary artery dissection.This survey analyzed data from all the catheterization laboratories in the Emilia-Romagna Region, merged in a unified database.In a 3-year study period, 546 BRS were implanted in 328 patients, corresponding to 1.5% of the drug-eluting stents (DES) used, with a trend towards a progressive increase over time. Initial indications were followed in 200/328 (61.0%) patients (about one third fitting more indications), mainly for treatment of long lesions in vessels2.5 mm (67%), young patients (31.5%) and mid/distal LAD (28%). In 22.6% of cases the clinical scenario was a ST-segment elevation myocardial infarction, in 39.3% a non-ST-segment elevation acute coronary syndrome. Intracoronary imaging was infrequently used (intravascular ultrasound in 24.7% of cases). In 85 patients (25.9%) a hybrid procedure (BVS/DES) was performed.BRS use has resulted lower than expected, with discrete variability among centers, but according to the initial indications of the Emilia-Romagna Region in the majority of cases. The underuse might have been due to operators' caution in their initial experience. However, the increasing trend may reveal a greater confidence in the implantation technique and the whole amount of safety and efficacy data.
- Published
- 2017
19. Predictors of 32P h brachytherapy failure in patients with high-risk in-stent restenosis
- Author
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Paolo Sbarzaglia, Cinzia Marrozzini, Paolo Ortolani, Feisal Bunkheila, Enza Barbieri, William Gaiba, Antonio Marzocchi, Matteo Aquilina, Maria Letizia Bacchi Reggiani, Stefania Pini, Enzo Lombardo, Stefano Neri, Angelo Branzi, Nevio Taglieri, Ortolani, Paolo, Marzocchi, Antonio, Aquilina, Matteo, Gaiba, William, Bunkheila, Feisal, Neri, Stefano, Lombardo, Enzo, Marrozzini, Cinzia, Pini, Stefania, Taglieri, Nevio, Sbarzaglia, Paolo, Maria Letizia Bacchi Reggiani, Barbieri, Enza, and Branzi, Angelo
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Brachytherapy ,Myocardial Infarction ,Coronary Angiography ,Lesion ,Coronary Restenosis ,Restenosis ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Radiations ,Myocardial Revascularization ,Stent ,Medicine ,Humans ,Prospective Studies ,Treatment Failure ,education ,Aged ,education.field_of_study ,business.industry ,Percutaneous coronary intervention ,medicine.disease ,Survival Analysis ,Radiation therapy ,Stenosis ,Treatment Outcome ,Cardiology ,Molecular Medicine ,Surgery ,Female ,Stents ,Radiology ,Coronary restenosi ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Phosphorus Radioisotopes ,Mace ,Follow-Up Studies - Abstract
Background The effectiveness of coronary radiation therapy for the treatment of in-stent restenosis (ISR) has been established in several randomized clinical trials. The efficacy of this treatment in the general population is less well established. Methods and materials We report our experience in 118 consecutive patients with nonselected high-risk ISR who had undergone successful percutaneous coronary intervention and brachytherapy with 32 P β-irradiation and who were prospectively enrolled in a quantitative angiographic and clinical follow-up protocol at 7 months after the index procedure. The aim of this study was to investigate the independent predictor of angiographic restenosis after 32 P brachytherapy treatment. Results Of the patients, 28.8% were diabetics. The mean lesion and mean radiated lengths were, respectively, 30.1 ± 17.2 and 43.8 ± 16.9 mm. The ISR pattern was diffuse in 96% of the treated lesions; in particular, 22.1% presented an occlusive pattern and 37.1% a proliferative pattern. At follow-up angiographic, restenosis and major adverse cardiac events (MACE) rates were, respectively, 20.8% and 29.6%. The univariate predictors of angiographic restenosis were procedural geographic miss, pattern IV ISR, manual pullback maneuver of the radiation source, preprocedural lesion percentage stenosis and preprocedural lesion MLD. At logistic regression analysis, only geographic miss and pattern IV ISR were independent predictors of post intracoronary radiation therapy (IRT) angiographic restenosis. Conclusion These data indicate that 7-month angiographic restenosis after 32 P IRT in complex patients with ISR is not a frequent event and is predicted mainly by an occlusive lesion at baseline and by procedural geographical miss.
- Published
- 2004
20. [Robotic percutaneous coronary intervention: current evidence, practical aspects and future perspectives].
- Author
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Toselli M, Nerla R, Ruggero R, Chandra K, Sbarzaglia P, Oshoala K, Margheri M, Giannini F, and Castriota F
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- Humans, Treatment Outcome, Coronary Artery Disease, Percutaneous Coronary Intervention methods, Robotic Surgical Procedures methods, Robotics methods
- Abstract
Robotic percutaneous coronary intervention (R-PCI) is an emerging technology designed to improve operator safety and procedural precision. The interventional cardiologist is able to manipulate guidewires, catheters and devices from a specific cockpit. A number of studies evaluating R-PCI have shown high procedural success rates with low complications. R-PCI advantages include the possibility to perform an accurate stent positioning, to reduce the operator radiation exposure and orthopedic injuries. However, there is a limited experience regarding R-PCI in complex anatomies, that may still require manual assistance. Moreover, the technique is limited by current incompatibility with specific materials, the lack of tactile feedback and the possibility to robotically manage only one wire/device at the same time. Globally, R-PCI is a novel approach with future interesting implications, but further investigations are necessary to overcome current limitations.
- Published
- 2021
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21. [Bioresorbable vascular scaffolds: clinical experience of the Emilia-Romagna Region, Italy].
- Author
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Menozzi A, Campo GC, Guiducci V, Dall'Ara G, Santarelli A, Sbarzaglia P, Balducelli M, Magnavacchi P, Sgura F, Losi L, Vignali L, Casella G, Steffanon L, Tarantino F, and Saia F
- Subjects
- Humans, Italy, Prosthesis Design, Randomized Controlled Trials as Topic, Absorbable Implants, Blood Vessel Prosthesis, Coronary Artery Disease surgery, Coronary Vessels surgery, Tissue Scaffolds
- Abstract
Background: The bioresorbable vascular scaffold (BRS) technology constitutes the new revolution of the coronary artery disease interventional treatment. Currently, three distinct types of BRSs are available but only one, the Absorb BVS, was on the market in 2013 when the Regional Commission for Medical Devices and the Cardiology and Cardiac Surgery Commission of the Emilia-Romagna Region drew up a technical and scientific essay to provide guidance for the introduction of BRS in public and affiliated health facilities. Five preferential indications were given for use: long coronary lesions (>28 mm), ostial lesions (left main stem excluded), complete revascularization in patients aged <50 years, diffuse disease (>40 mm) or involving the mid/distal left anterior descending (LAD) branch in patients <70 years, spontaneous coronary artery dissection., Methods: This survey analyzed data from all the catheterization laboratories in the Emilia-Romagna Region, merged in a unified database., Results: In a 3-year study period, 546 BRS were implanted in 328 patients, corresponding to 1.5% of the drug-eluting stents (DES) used, with a trend towards a progressive increase over time. Initial indications were followed in 200/328 (61.0%) patients (about one third fitting more indications), mainly for treatment of long lesions in vessels >2.5 mm (67%), young patients (31.5%) and mid/distal LAD (28%). In 22.6% of cases the clinical scenario was a ST-segment elevation myocardial infarction, in 39.3% a non-ST-segment elevation acute coronary syndrome. Intracoronary imaging was infrequently used (intravascular ultrasound in 24.7% of cases). In 85 patients (25.9%) a hybrid procedure (BVS/DES) was performed., Conclusions: BRS use has resulted lower than expected, with discrete variability among centers, but according to the initial indications of the Emilia-Romagna Region in the majority of cases. The underuse might have been due to operators' caution in their initial experience. However, the increasing trend may reveal a greater confidence in the implantation technique and the whole amount of safety and efficacy data.
- Published
- 2017
- Full Text
- View/download PDF
22. [Use of carbon dioxide as contrast agent to perform balloon angioplasty of the superficial femoral artery in a patient with severe renal impairment].
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Sbarzaglia P, Micari A, Castriota F, and Cremonesi A
- Subjects
- Aged, Angiography, Arterial Occlusive Diseases complications, Humans, Male, Renal Insufficiency, Chronic complications, Severity of Illness Index, Angioplasty, Balloon methods, Arterial Occlusive Diseases diagnostic imaging, Arterial Occlusive Diseases therapy, Carbon Dioxide, Contrast Media, Femoral Artery diagnostic imaging
- Abstract
Endovascular treatment of symptomatic atherosclerotic peripheral artery disease has gained widespread acceptance and is now recommended as the primary revascularization strategy in many clinical and interventional settings. Nevertheless, endovascular strategy finds a relative contraindication in patients affected by severe chronic kidney disease, because of nephrotoxicity of iodinated contrast medium. Carbon dioxide (CO2) angiography permits to obtain vascular angiography without the use of a iodinated contrast medium, therefore it is ideal in chronic kidney disease patients because it is not nephrotoxic and does not have appreciable medical contraindications. In this report we describe a case of percutaneous transluminal angioplasty of an occluded left superficial femoral artery using CO₂as contrast medium, because of severe chronic kidney disease (glomerular filtration rate 28 ml/min/1.73 m²). This complex procedure required double vascular access with retrograde popliteal access associated with femoral access, which was performed successfully despite a very low use of iodinated contrast medium. This case report is also the starting point for a review of literature data regarding CO2 use for peripheral intervention.
- Published
- 2015
- Full Text
- View/download PDF
23. [SICI-GISE position paper on the requirements for diagnostic and interventional procedures in patients with peripheral arterial disease].
- Author
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Cremonesi A, Setacci C, Rubino P, Stabile E, Castriota F, Reimers B, Inglese L, Berti S, Sbarzaglia P, Biamino G, and Guagliumi G
- Subjects
- Aorta surgery, Blood Vessel Prosthesis Implantation, Cardiology education, Cardiology methods, Cardiology standards, Carotid Artery Diseases surgery, Clinical Competence, Endovascular Procedures education, Endovascular Procedures standards, Humans, Leg blood supply, Patient Care Team, Peripheral Arterial Disease diagnostic imaging, Peripheral Arterial Disease therapy, Radiography, Interventional methods, Radiography, Interventional standards, Radiology, Interventional education, Referral and Consultation, Software Design, Stents, Tertiary Care Centers, Vascular Surgical Procedures education, Vascular Surgical Procedures methods, Vascular Surgical Procedures standards, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease surgery
- Abstract
Interventional procedures on peripheral vessels are the field of a novel specialty dedicated to the diagnosis and minimally invasive endovascular treatment of diseases involving the cerebral, thoracic and abdominal arteries (including renal and visceral arteries), as well as the peripheral arteries (femoro-popliteal arteries and the arteries below the knee). At present, physicians with three different types of medical training, each involving particular strengths and characteristics, specialize in endovascular treatment of patients with peripheral arterial disease: vascular surgeons, interventional radiologists and interventional cardiologists. Treatment of high-risk patients in terms of anatomical and clinical (serious comorbidities) complexity raised the need for the interventional cardiologist to face issues related to technical aspects of the procedure, multilevel pathology management and adequate indication. To achieve this goal, interventional cardiologists require particular facilities and clinical skills. The objectives of this position paper from the Italian Society of Interventional Cardiology (SICI-GISE) are (i) to define the theoretical background and practical training required to ensure that interventional cardiologists maintain high-quality standards also in the field of treatment of peripheral arterial disease, by establishing shared rules and drafting papers; (ii) to standardize the procedures of interventional cardiology operational units that treat patients with peripheral arterial disease in Italy on the basis of scientific evidence, and (iii) to establish common requirements in terms of facilities and regulations.
- Published
- 2013
- Full Text
- View/download PDF
24. [Late stent thrombosis after drug-eluting stent implantation: epidemiological, clinical and pathophysiological aspects].
- Author
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Notaristefano S, Sbarzaglia P, and Cavallini C
- Subjects
- Humans, Incidence, Time Factors, Drug-Eluting Stents, Thrombosis diagnosis, Thrombosis epidemiology, Thrombosis physiopathology, Thrombosis therapy
- Abstract
Stent thrombosis (ST) is an uncommon, but potentially catastrophic, complication of percutaneous coronary intervention, since it can be associated with acute myocardial infarction and death. The advent of drug-eluting stents (DES) has raised concerns regarding numerous reports about very-late occurrences of ST. Data from the literature seem to suggest an increased incidence of ST in patients treated with DES vs bare-metal stents after the first year from percutaneous coronary intervention (very-late ST). The magnitude of this phenomenon is quite modest in absolutely value (between 0.35% and 0.6% per year) and it does not translate into a worse hard outcome (death and myocardial infarction) for patients treated with DES vs bare-metal stents. ST is a multifactorial process, linked to many causes, each of which may play a different role in early, late or very-late ST. In the development of early ST procedural factors, antiplatelet response/compliance and lesion complexity are of primary importance; patient's risk factors, delayed endothelialization and healing of the arterial wall are involved in the late and very-late ST. Nowadays appropriate selection of DES candidates, technically accurate implantation procedures, and adequate instructions to the patient for increasing therapy compliance are the basis for the reduction of the risk of ST; the identification of more effective antiplatelet drugs and new-generation DES (i.e., bioabsorbable polymers or stents) are promising innovations for the future.
- Published
- 2008
25. Emergency balloon aortic valvuloplasty in patients with critical aortic stenosis presenting with cardiogenic shock.
- Author
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Saia F, Marzocchi A, Marrozzini C, Ortolani P, Palmerini T, Sbarzaglia P, and Branzi A
- Subjects
- Aged, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis physiopathology, Electrocardiography, Female, Humans, Male, Middle Aged, Shock, Cardiogenic diagnosis, Angioplasty, Balloon methods, Aortic Valve physiopathology, Aortic Valve Stenosis therapy, Emergencies, Shock, Cardiogenic etiology
- Abstract
This report describes 2 cases of aortic valvuloplasty performed as emergency treatment in patients with critical aortic stenosis presenting with cardiogenic shock. This procedure can be life-saving, and allows the patients to undergo further evaluation for aortic valve replacement, or other definitive treatments such as the recently developed percutaneous heart valve implantation for patients with unacceptably high surgical risk.
- Published
- 2005
26. Long-term clinical and angiographic outcome of patients with occlusive in-stent restenosis treated with (32P) beta-brachytherapy.
- Author
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Ortolani P, Marzocchi A, Aquilina M, Gaiba W, Neri S, Bunkheila F, Lombardo E, Pini S, Marrozzini C, Palmerini T, Taglieri N, Sbarzaglia P, Reggiani ML, Barbieri E, and Branzi A
- Subjects
- Aged, Beta Particles therapeutic use, Blood Vessel Prosthesis Implantation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Time Factors, Treatment Outcome, Brachytherapy methods, Coronary Angiography, Coronary Restenosis diagnostic imaging, Coronary Restenosis radiotherapy, Phosphorus Radioisotopes therapeutic use, Radiopharmaceuticals therapeutic use, Stents
- Abstract
The objective of this study was to determine the safety and efficacy of (32)P beta-brachytherapy in totally occlusive in-stent restenosis (ISR). Patients with occlusive ISR were generally excluded from the randomized clinical trials on intracoronary brachytherapy (utilizing either gamma- or beta-sources) that have shown reductions in restenosis rate and need for revascularization procedures. We analyzed short- and long-term effects of (32)P beta-brachytherapy (20 Gy) in 27 patients (28 lesions) with occlusive ISR and 84 (99 lesions) patients with nonocclusive high-risk ISR. The primary outcome measure was frequency of in-lesion angiographic binary restenosis at 7 months. Secondary endpoints were rates of major adverse cardiac events (MACE), target vessel revascularization (TVR), clinically driven TVR, and target lesion revascularization (TLR). (32)P beta-brachytherapy was feasible and safe and provided similar postprocedural angiographic results in the two clinically comparable groups. However, the 7-month binary restenosis rate was higher in the occlusive group, as were the MACE and late total occlusion rates. Multivariate logistic analysis of the overall population indicated occlusive pattern to be the only independent predictor of angiographic restenosis. In both groups, recurrent lesions most often showed a focal pattern with significant reduction of length. Although safe and effective in high-risk ISR, (32)P brachytherapy at 20 Gy does not appear to be sufficient to avoid long-term restenosis in patients with occlusive lesions. Further studies should determine the most suitable source and dosage of brachytherapy for patients with occlusive ISR., ((c) 2004 Wiley-Liss, Inc.)
- Published
- 2004
- Full Text
- View/download PDF
27. Clinical relevance of homocysteine levels in patients receiving coronary stenting for unstable angina.
- Author
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Ortolani P, Marzocchi A, Marrozzini C, Palmerini T, Aquilina M, Corlianò L, Saia F, Taglieri N, Sbarzaglia P, Bacchi Reggiani ML, and Branzi A
- Subjects
- Aged, Aged, 80 and over, Angina, Unstable mortality, Angioplasty, Balloon, Coronary, Biomarkers blood, Blood Vessel Prosthesis Implantation, C-Reactive Protein metabolism, Coronary Angiography, Coronary Artery Bypass, Coronary Stenosis metabolism, Coronary Stenosis mortality, Coronary Stenosis therapy, Female, Follow-Up Studies, Humans, Italy, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Prospective Studies, Reoperation, Stroke Volume physiology, Survival Analysis, Treatment Outcome, Angina, Unstable metabolism, Angina, Unstable therapy, Homocysteine metabolism, Stents
- Abstract
Background: We prospectively investigated whether plasma homocysteine (HCY) concentrations are related to target lesion revascularization (TLR) rates in patients with unstable angina undergoing stenting., Methods: We enrolled 196 consecutive patients with at least one successful coronary stent implantation for unstable angina., Results: The mean vessel diameter was 3.1 +/- 0.5 mm. At follow-up (17.8 +/- 7.5 months), patients with higher HCY levels (> 17 micromol/l, 4th quartile) had similar TLR rates to the rest of the sample (11.1 vs 13.2%, p = 0.90). On the other hand, high HCY levels did seem to be associated with higher total (13.3 vs 0.7%, p = 0.001) and cardiac (6.7 vs 0%, p = 0.01) mortality rates. At multivariate analysis, only target vessel diameter independently predicted TLR, while both HCY levels and target vessel size predicted late total mortality., Conclusions: At least in patients with a mean vessel diameter > 3 mm, HCY levels cannot be taken as a prognostic indicator of in-stent restenosis for patients with unstable angina. However, in spite of successful percutaneous revascularization, HCY values do seem to strongly influence late mortality.
- Published
- 2004
28. [Intracoronary beta-radiotherapy in high-risk in-stent restenosis. Prospective results of a single center registry].
- Author
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Ortolani P, Marzocchi A, Gaiba W, Neri S, Marrozzini C, Palmerini T, Aquilina M, Corlianò L, Lombardo E, Bunkheila F, Pini S, Sbarzaglia P, Taglieri N, Barbieri E, and Branzi A
- Subjects
- Aged, Angioplasty, Balloon, Coronary methods, Beta Particles therapeutic use, Female, Follow-Up Studies, Humans, Male, Middle Aged, Phosphorus Radioisotopes, Prospective Studies, Retrospective Studies, Brachytherapy methods, Coronary Restenosis radiotherapy, Stents
- Abstract
Background: The aim of the study was to evaluate, on single center prospective data, long-term angiographic and clinical results of intracoronary beta (32P) brachytherapy in "real world" patients with high-risk in-stent restenosis lesions., Methods: Sixty-nine consecutive patients (77 lesions) with high-risk in-stent restenosis (mean lesion length 30.3 +/- 16.1 mm, pattern III-IV 57.2%, diabetes 33.3%) treated with percutaneous dilation procedures and beta-radiation therapy, underwent 7-month clinical and angiographic follow-up., Results: One patient (1.4%) presented with procedural non-Q wave myocardial infarction. At a mean follow-up of 7 +/- 1.5 months, death was observed in 1 patient (1.4%) and non-Q wave myocardial infarction in 3 (4.3%) (in 2 patients, who prematurely discontinued antiplatelet therapy, caused by late coronary thrombosis). Seven-month binary angiographic restenosis occurred in 20 lesions (25.9%) (in-stent restenosis 11.6%). Target lesion and target vessel revascularization occurred in 20 (28.9%) and 21 (30.4%) patients. At follow-up only 12 (17.3%) patients presented with CCS class III-IV angina. After intracoronary beta brachytherapy angiographic restenosis occurred regardless of the vessel size, lesion length and ostial location. On the contrary a high restenosis rate was documented in obstructive lesions., Conclusions: As applied in routine clinical practice, radiation therapy is safe and effective in the treatment of high-risk in-stent restenosis. In spite of all that, total occlusion at baseline predicts late angiographic restenosis.
- Published
- 2003
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