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1. Insight from an Italian Delphi Consensus on EVAR feasibility outside the instruction for use: the SAFE EVAR Study

Author

Sirignano, P, Piffaretti, G, Ceruti, S, Orso, M, Picozzi, M, Ricci, G, Sirignano, A, Taurino, M, Giancarlo Accarino, M, Accrocca, F, Alba, G, Alberti, A, Alberti, V, Allevi, S, Aloisi, F, Amato, B, Amico, A, Andreoli, F, Angiletta, D, Antico, A, Antico, L, Antonello, M, Baccellieri, D, Badalamenti, G, Bafile, G, Baldi, C, Barillà, C, Barillà, D, Bartoli, S, Basile, G, Battaglia, G, Battocchio, C, Belloni, A, Bellosta, R, Benevento, D, Bernardini, G, Bertagna, G, Bertoglio, L, Bianchini Massoni, C, Bisacco, D, Bischetti, M, Boccalon, L, Bonanno, P, Bonardelli, S, Borioni, R, P Borrelli, M, Bozzani, A, M Bracale, U, Camparini, S, Canciglia, A, Canova, F, Capoccia, L, Cappelli, A, Cappiello, P, Carluccio, C, Casalino, A, Casella, F, Casilli, G, Castagno, C, Castelli, P, Castrucci, T, Cavallo, M, Cavazzini, C, Ceccanei, G, Cefalì, P, Celoria, G, Cevolani, M, Chiappa, R, Chisci, E, Comande, C, Compagna, R, Cumino, A, Cuozzo, S, Dalla Caneva, P, D'Alessio, I, D'Arrigo, G, DE Caridi, G, DE Donato, G, DE Donno, G, Desantis, C, DE Santis, F, DE Troia, A, Dezi, T, A Diaco, D, DI Domenico, R, DI Filippo, M, DI Girolamo, A, P Dionisi, C, Dinoto, E, DI Stefano, F, DI STEFANO, L, D'Oria, M, Esposito, A, Esposito, D, Ettore, L, F Fadda, G, Faggioli, G, T Fargion, A, Fazzini, S, Fermani, N, Ferrante, G, Ferrari, M, Ferraro, S, Ferrer, C, Ferretto, L, Ficarelli, I, Filippi, F, Fino, G, Forliti, E, Formiconi, M, Flora, L, Fresilli, M, Frigatti, P, Frigerio, D, Froio, A, Freyrie, A, Furgiuele, S, Gabrielli, R, Gaggiano, A, Galassi, L, Gallelli, G, Gallitto, E, Gallo, F, Galzerano, G, Gargiulo, M, Garriboli, L, G Genadiev, G, Gentile, L, Giaquinta, A, Gibello, L, Grande, R, Grassi, V, Ippoliti, A, Irsara, S, Kahlberg, A, Konstantinos, N, LA Corte, F, Lanza, G, Lauricella, A, Lazzeri, E, Lenti, M, Leopardi, M, Lepidi, S, Li Destri, A, Locatelli, F, Lomazzi, C, Lombardi, F, Lorido, A, Maggiore, C, Mansour, W, Marcucci, V, Mascia, D, Massara, M, Mastrangelo, G, Margheritini, C, Maritati, G, Martelli, E, Martinelli, O, Marzano, A, Mauri, F, Mazzacaro, D, Melloni, A, Mezzetti, R, Michelagnoli, S, Migliara, B, Migliari, M, Millarelli, M, Misuraca, M, Modugno, P, Moniaci, D, Montelione, N, Monti, A, Monzio-Compagnoni, N, Moro, M, Mortola, L, Mozzetta, G, Musilli, A, Nano, G, Occhiuto, M, M Oddi, F, Orellana, B, Orlando, P, Orrico, M, A Pacilè, M, Pagliariccio, G, Pallini, C, Palmieri, A, Palughi, M, Panagrasso, M, Panzano, C, Panzera, C, Pascucci, F, Pasqua, R, Pasquetti, L, Pasqui, E, Pecchio, A, Pecoraro, F, Peluttiero, I, F Pennetta, F, Perini, P, Piazza, M, Pini, R, Pipito, N, Pranteda, C, Praquin, B, Pratesi, C, F Porreca, C, Pulli, R, Reina, N, F Rinaldi, L, Rizzo, L, Romano, E, Ronchey, S, Ruggiero, F, Ruggiero, M, Sallustro, M, Saviane, G, Sbarigia, E, Scovazzi, P, M Segramor, V, Sena, G, Setacci, C, Setacci, F, E Setteducati, C, M Settembrini, A, Siani, A, Sica, S, Speziale, F, Squizzato, F, Stella, N, Stilo, F, Sufali, G, Tanda, E, Tinelli, G, Tomei, F, Tosti, F, Trimarchi, S, Troisi, N, Tshomba, Y, Turchino, D, Turriziani, V, Ucci, A, Veneto, V, Veraldi, G, Wiesel, P, Xodo, A, Zacà, S, Zaraca, F, Zenunaj, G, SIRIGNANO, Pasqualino, PIFFARETTI, Gabriele, CERUTI, Silvia, ORSO, Massimiliano, PICOZZI, Mario, RICCI, Giovanna, SIRIGNANO, Ascanio, TAURINO, Maurizio, Giancarlo Accarino, Maurizio, Accrocca, Federico, Alba, Giuseppe, Alberti, Antonino, Alberti, Vittorio, Allevi, Sara, Aloisi, Francesco, Amato, Bruno, Amico, Alessio, Andreoli, Francesco, Angiletta, Domenico, Antico, Antonio, Antico, Lorenzo, Antonello, Michele, Baccellieri, Domenico, Badalamenti, Giovanni, Bafile, Gennaro, Baldi, Claudio, Barillà, Chiara, Barillà, David, Bartoli, Stefano, Basile, Giusi, Battaglia, Giuseppe, Battocchio, Cesare, Belloni, Ailin, Bellosta, Raffello, Benevento, Domenico, Bernardini, Giulia, Bertagna, Giulia, Bertoglio, Luca, Bianchini Massoni, Claudio, Bisacco, Daniel, Bischetti, Michelangelo, Boccalon, Luca, Bonanno, Paolo, Bonardelli, Stefano, Borioni, Raul, P Borrelli, Maria, Bozzani, Antonio, M Bracale, Umberto, Camparini, Stefano, Canciglia, Aldo, Canova, Francesco, Capoccia, Laura, Cappelli, Alessandro, Cappiello, Pierlugi, Carluccio, Chiara, Casalino, Alfonso, Casella, Francesco, Casilli, Giulia, Castagno, Claudio, Castelli, Patrizio, Castrucci, Tommaso, Cavallo, Matteo, Cavazzini, Carlo, Ceccanei, Gianluca, Cefalì, Pietro, Celoria, Gianni, Cevolani, Mauro, Chiappa, Roberto, Chisci, Emiliano, Comande, Carlo, Compagna, Rita, Cumino, Andrea, Cuozzo, Simone, Dalla Caneva, Patrizia, D'Alessio, Ilaria, D'Arrigo, Giuseppe, DE Caridi, Giovanni, DE Donato, Gianmarco, DE Donno, Gabriele, Desantis, Claudio, DE Santis, Francesco, DE Troia, Alessandro, Dezi, Tommaso, A Diaco, Domenico, DI Domenico, Rossella, DI Filippo, Michele, DI Girolamo, Alessia, P Dionisi, Carlo, Dinoto, Ettore, DI Stefano, Francesco, DI STEFANO, Lucia, D'Oria, Mario, Esposito, Andrea, Esposito, Davide, Ettore, Ludovica, F Fadda, Gian, Faggioli, Gianluca, T Fargion, Aaron, Fazzini, Stefano, Fermani, Nicoletta, Ferrante, Giulia, Ferrari, Mauro, Ferraro, Stafanio, Ferrer, Ciro, Ferretto, Luca, Ficarelli, Ilaria, Filippi, Federico, Fino, Gianluigi, Forliti, Enzo, Formiconi, Martina, Flora, Loris, Fresilli, Mauro, Frigatti, Paolo, Frigerio, Dalmazio, Froio, Alberto, Freyrie, Antonio, Furgiuele, Sergio, Gabrielli, Roberto, Gaggiano, Andrea, Galassi, Luca, Gallelli, Giuseppe, Gallitto, Enrico, Gallo, Francesco, Galzerano, Giuseppe, Gargiulo, Mauro, Garriboli, Luca, G Genadiev, Genadi, Gentile, Lucia, Giaquinta, Alessia, Gibello, Lorenzo, Grande, Raffaele, Grassi, Viviana, Ippoliti, Arnaldo, Irsara, Sandro, Kahlberg, Andrea, Konstantinos, Nikolakopoulos, LA Corte, Francesco, Lanza, Gaetano, Lauricella, Antonio, Lazzeri, Elisa, Lenti, Massimo, Leopardi, Marco, Lepidi, Sandro, Li Destri, Andrea, Locatelli, Federica, Lomazzi, Chiara, Lombardi, Francesco, Lorido, Antonio, Maggiore, Claudia, Mansour, Wassim, Marcucci, Vittorio, Mascia, Daniele, Massara, Mafalda, Mastrangelo, Giovanni, Margheritini, Costanza, Maritati, Gabriele, Martelli, Eugenio, Martinelli, Ombretta, Marzano, Antonio, Mauri, Francesca, Mazzacaro, Daniela, Melloni, Andrea, Mezzetti, Roberto, Michelagnoli, Stefano, Migliara, Bruno, Migliari, Mattia, Millarelli, Massimiliano, Misuraca, Maria, Modugno, Pietro, Moniaci, Diego, Montelione, Nunzio, Monti, Andrea, Monzio-Compagnoni, Nicola, Moro, Mario, Mortola, Lorenzo, Mozzetta, Gaddiel, Musilli, Aldo, Nano, Giovanni, Occhiuto, Mariateresa, M Oddi, Fabio, Orellana, Bernardo, Orlando, Paola, Orrico, Matteo, A Pacilè, Maria, Pagliariccio, Gabriele, Pallini, Cristina, Palmieri, Armando, Palughi, Martina, Panagrasso, Marco, Panzano, Claudia, Panzera, Chiara, Pascucci, Francesco, Pasqua, Rocco, Pasquetti, Leonardo, Pasqui, Eduardo, Pecchio, Alberto, Pecoraro, Felice, Peluttiero, Ilaria, F Pennetta, Federico, Perini, Paolo, Piazza, Michele, Pini, Rodolfo, Pipito, Narayana, Pranteda, Chiara, Praquin, Barbara, Pratesi, Carlo, F Porreca, Carlo, Pulli, Raffaele, Reina, Nicola, F Rinaldi, Luigi, Rizzo, Luigi, Romano, Elisa, Ronchey, Sonia, Ruggiero, Federica, Ruggiero, Massimo, Sallustro, Marianna, Saviane, Gianna, Sbarigia, Enrico, Scovazzi, Paolo, M Segramor, Vittorio, Sena, Giuseppe, Setacci, Carlo, Setacci, Francesco, E Setteducati, Carmen, M Settembrini, Alberto, Siani, Andrea, Sica, Simona, Speziale, Francesco, Squizzato, Francesco, Stella, Nazzareno, Stilo, Francesco, Sufali, Gemmi, Tanda, Elisabetta, Tinelli, Giovanni, Tomei, Francesca, Tosti, Filomena, Trimarchi, Santi, Troisi, Nicola, Tshomba, Yamume, Turchino, Davide, Turriziani, Valerio, Ucci, Alessandro, Veneto, Vincenzo, Veraldi, Gianfranco, Wiesel, Paola, Xodo, Andrea, Zacà, Sergio, Zaraca, Francesco, Zenunaj, Glaudiol, Sirignano, P, Piffaretti, G, Ceruti, S, Orso, M, Picozzi, M, Ricci, G, Sirignano, A, Taurino, M, Giancarlo Accarino, M, Accrocca, F, Alba, G, Alberti, A, Alberti, V, Allevi, S, Aloisi, F, Amato, B, Amico, A, Andreoli, F, Angiletta, D, Antico, A, Antico, L, Antonello, M, Baccellieri, D, Badalamenti, G, Bafile, G, Baldi, C, Barillà, C, Barillà, D, Bartoli, S, Basile, G, Battaglia, G, Battocchio, C, Belloni, A, Bellosta, R, Benevento, D, Bernardini, G, Bertagna, G, Bertoglio, L, Bianchini Massoni, C, Bisacco, D, Bischetti, M, Boccalon, L, Bonanno, P, Bonardelli, S, Borioni, R, P Borrelli, M, Bozzani, A, M Bracale, U, Camparini, S, Canciglia, A, Canova, F, Capoccia, L, Cappelli, A, Cappiello, P, Carluccio, C, Casalino, A, Casella, F, Casilli, G, Castagno, C, Castelli, P, Castrucci, T, Cavallo, M, Cavazzini, C, Ceccanei, G, Cefalì, P, Celoria, G, Cevolani, M, Chiappa, R, Chisci, E, Comande, C, Compagna, R, Cumino, A, Cuozzo, S, Dalla Caneva, P, D'Alessio, I, D'Arrigo, G, DE Caridi, G, DE Donato, G, DE Donno, G, Desantis, C, DE Santis, F, DE Troia, A, Dezi, T, A Diaco, D, DI Domenico, R, DI Filippo, M, DI Girolamo, A, P Dionisi, C, Dinoto, E, DI Stefano, F, DI STEFANO, L, D'Oria, M, Esposito, A, Esposito, D, Ettore, L, F Fadda, G, Faggioli, G, T Fargion, A, Fazzini, S, Fermani, N, Ferrante, G, Ferrari, M, Ferraro, S, Ferrer, C, Ferretto, L, Ficarelli, I, Filippi, F, Fino, G, Forliti, E, Formiconi, M, Flora, L, Fresilli, M, Frigatti, P, Frigerio, D, Froio, A, Freyrie, A, Furgiuele, S, Gabrielli, R, Gaggiano, A, Galassi, L, Gallelli, G, Gallitto, E, Gallo, F, Galzerano, G, Gargiulo, M, Garriboli, L, G Genadiev, G, Gentile, L, Giaquinta, A, Gibello, L, Grande, R, Grassi, V, Ippoliti, A, Irsara, S, Kahlberg, A, Konstantinos, N, LA Corte, F, Lanza, G, Lauricella, A, Lazzeri, E, Lenti, M, Leopardi, M, Lepidi, S, Li Destri, A, Locatelli, F, Lomazzi, C, Lombardi, F, Lorido, A, Maggiore, C, Mansour, W, Marcucci, V, Mascia, D, Massara, M, Mastrangelo, G, Margheritini, C, Maritati, G, Martelli, E, Martinelli, O, Marzano, A, Mauri, F, Mazzacaro, D, Melloni, A, Mezzetti, R, Michelagnoli, S, Migliara, B, Migliari, M, Millarelli, M, Misuraca, M, Modugno, P, Moniaci, D, Montelione, N, Monti, A, Monzio-Compagnoni, N, Moro, M, Mortola, L, Mozzetta, G, Musilli, A, Nano, G, Occhiuto, M, M Oddi, F, Orellana, B, Orlando, P, Orrico, M, A Pacilè, M, Pagliariccio, G, Pallini, C, Palmieri, A, Palughi, M, Panagrasso, M, Panzano, C, Panzera, C, Pascucci, F, Pasqua, R, Pasquetti, L, Pasqui, E, Pecchio, A, Pecoraro, F, Peluttiero, I, F Pennetta, F, Perini, P, Piazza, M, Pini, R, Pipito, N, Pranteda, C, Praquin, B, Pratesi, C, F Porreca, C, Pulli, R, Reina, N, F Rinaldi, L, Rizzo, L, Romano, E, Ronchey, S, Ruggiero, F, Ruggiero, M, Sallustro, M, Saviane, G, Sbarigia, E, Scovazzi, P, M Segramor, V, Sena, G, Setacci, C, Setacci, F, E Setteducati, C, M Settembrini, A, Siani, A, Sica, S, Speziale, F, Squizzato, F, Stella, N, Stilo, F, Sufali, G, Tanda, E, Tinelli, G, Tomei, F, Tosti, F, Trimarchi, S, Troisi, N, Tshomba, Y, Turchino, D, Turriziani, V, Ucci, A, Veneto, V, Veraldi, G, Wiesel, P, Xodo, A, Zacà, S, Zaraca, F, Zenunaj, G, SIRIGNANO, Pasqualino, PIFFARETTI, Gabriele, CERUTI, Silvia, ORSO, Massimiliano, PICOZZI, Mario, RICCI, Giovanna, SIRIGNANO, Ascanio, TAURINO, Maurizio, Giancarlo Accarino, Maurizio, Accrocca, Federico, Alba, Giuseppe, Alberti, Antonino, Alberti, Vittorio, Allevi, Sara, Aloisi, Francesco, Amato, Bruno, Amico, Alessio, Andreoli, Francesco, Angiletta, Domenico, Antico, Antonio, Antico, Lorenzo, Antonello, Michele, Baccellieri, Domenico, Badalamenti, Giovanni, Bafile, Gennaro, Baldi, Claudio, Barillà, Chiara, Barillà, David, Bartoli, Stefano, Basile, Giusi, Battaglia, Giuseppe, Battocchio, Cesare, Belloni, Ailin, Bellosta, Raffello, Benevento, Domenico, Bernardini, Giulia, Bertagna, Giulia, Bertoglio, Luca, Bianchini Massoni, Claudio, Bisacco, Daniel, Bischetti, Michelangelo, Boccalon, Luca, Bonanno, Paolo, Bonardelli, Stefano, Borioni, Raul, P Borrelli, Maria, Bozzani, Antonio, M Bracale, Umberto, Camparini, Stefano, Canciglia, Aldo, Canova, Francesco, Capoccia, Laura, Cappelli, Alessandro, Cappiello, Pierlugi, Carluccio, Chiara, Casalino, Alfonso, Casella, Francesco, Casilli, Giulia, Castagno, Claudio, Castelli, Patrizio, Castrucci, Tommaso, Cavallo, Matteo, Cavazzini, Carlo, Ceccanei, Gianluca, Cefalì, Pietro, Celoria, Gianni, Cevolani, Mauro, Chiappa, Roberto, Chisci, Emiliano, Comande, Carlo, Compagna, Rita, Cumino, Andrea, Cuozzo, Simone, Dalla Caneva, Patrizia, D'Alessio, Ilaria, D'Arrigo, Giuseppe, DE Caridi, Giovanni, DE Donato, Gianmarco, DE Donno, Gabriele, Desantis, Claudio, DE Santis, Francesco, DE Troia, Alessandro, Dezi, Tommaso, A Diaco, Domenico, DI Domenico, Rossella, DI Filippo, Michele, DI Girolamo, Alessia, P Dionisi, Carlo, Dinoto, Ettore, DI Stefano, Francesco, DI STEFANO, Lucia, D'Oria, Mario, Esposito, Andrea, Esposito, Davide, Ettore, Ludovica, F Fadda, Gian, Faggioli, Gianluca, T Fargion, Aaron, Fazzini, Stefano, Fermani, Nicoletta, Ferrante, Giulia, Ferrari, Mauro, Ferraro, Stafanio, Ferrer, Ciro, Ferretto, Luca, Ficarelli, Ilaria, Filippi, Federico, Fino, Gianluigi, Forliti, Enzo, Formiconi, Martina, Flora, Loris, Fresilli, Mauro, Frigatti, Paolo, Frigerio, Dalmazio, Froio, Alberto, Freyrie, Antonio, Furgiuele, Sergio, Gabrielli, Roberto, Gaggiano, Andrea, Galassi, Luca, Gallelli, Giuseppe, Gallitto, Enrico, Gallo, Francesco, Galzerano, Giuseppe, Gargiulo, Mauro, Garriboli, Luca, G Genadiev, Genadi, Gentile, Lucia, Giaquinta, Alessia, Gibello, Lorenzo, Grande, Raffaele, Grassi, Viviana, Ippoliti, Arnaldo, Irsara, Sandro, Kahlberg, Andrea, Konstantinos, Nikolakopoulos, LA Corte, Francesco, Lanza, Gaetano, Lauricella, Antonio, Lazzeri, Elisa, Lenti, Massimo, Leopardi, Marco, Lepidi, Sandro, Li Destri, Andrea, Locatelli, Federica, Lomazzi, Chiara, Lombardi, Francesco, Lorido, Antonio, Maggiore, Claudia, Mansour, Wassim, Marcucci, Vittorio, Mascia, Daniele, Massara, Mafalda, Mastrangelo, Giovanni, Margheritini, Costanza, Maritati, Gabriele, Martelli, Eugenio, Martinelli, Ombretta, Marzano, Antonio, Mauri, Francesca, Mazzacaro, Daniela, Melloni, Andrea, Mezzetti, Roberto, Michelagnoli, Stefano, Migliara, Bruno, Migliari, Mattia, Millarelli, Massimiliano, Misuraca, Maria, Modugno, Pietro, Moniaci, Diego, Montelione, Nunzio, Monti, Andrea, Monzio-Compagnoni, Nicola, Moro, Mario, Mortola, Lorenzo, Mozzetta, Gaddiel, Musilli, Aldo, Nano, Giovanni, Occhiuto, Mariateresa, M Oddi, Fabio, Orellana, Bernardo, Orlando, Paola, Orrico, Matteo, A Pacilè, Maria, Pagliariccio, Gabriele, Pallini, Cristina, Palmieri, Armando, Palughi, Martina, Panagrasso, Marco, Panzano, Claudia, Panzera, Chiara, Pascucci, Francesco, Pasqua, Rocco, Pasquetti, Leonardo, Pasqui, Eduardo, Pecchio, Alberto, Pecoraro, Felice, Peluttiero, Ilaria, F Pennetta, Federico, Perini, Paolo, Piazza, Michele, Pini, Rodolfo, Pipito, Narayana, Pranteda, Chiara, Praquin, Barbara, Pratesi, Carlo, F Porreca, Carlo, Pulli, Raffaele, Reina, Nicola, F Rinaldi, Luigi, Rizzo, Luigi, Romano, Elisa, Ronchey, Sonia, Ruggiero, Federica, Ruggiero, Massimo, Sallustro, Marianna, Saviane, Gianna, Sbarigia, Enrico, Scovazzi, Paolo, M Segramor, Vittorio, Sena, Giuseppe, Setacci, Carlo, Setacci, Francesco, E Setteducati, Carmen, M Settembrini, Alberto, Siani, Andrea, Sica, Simona, Speziale, Francesco, Squizzato, Francesco, Stella, Nazzareno, Stilo, Francesco, Sufali, Gemmi, Tanda, Elisabetta, Tinelli, Giovanni, Tomei, Francesca, Tosti, Filomena, Trimarchi, Santi, Troisi, Nicola, Tshomba, Yamume, Turchino, Davide, Turriziani, Valerio, Ucci, Alessandro, Veneto, Vincenzo, Veraldi, Gianfranco, Wiesel, Paola, Xodo, Andrea, Zacà, Sergio, Zaraca, Francesco, and Zenunaj, Glaudiol

Abstract

BACKGROUND: The SAfety and FEasibility of standard EVAR outside the instruction for use (SAFE-EVAR) Study was designed to define the attitude of Italian vascular surgeons towards the use of standard endovascular repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA) outside the instruction for use (IFU) through a Delphi consensus endorsed by the Italian Society of Vascular and Endovascular Surgery (Società Italiana di Chirurgia Vascolare ed Endovascolare - SI CVE). METHODS : A questionnaire consisting of 26 statements was developed, validated by an 18-member Advisory Board, and then sent to 600 Italian vascular surgeons. The Delphi process was structured in three subsequent rounds which took place between April and June 2023. In the first two rounds, respondents could indicate one of the following five degrees of agreement: 1) strongly agree; 2) partially agree; 3) neither agree nor disagree; 4) partially disagree; 5) strongly disagree; while in the third round only three different choices were proposed: 1) agree; 2) neither agree nor disagree; 3) disagree. We considered the consensus reached when ≥70% of respondents agreed on one of the options. After the conclusion of each round, a report describing the percentage distribution of the answers was sent to all the participants. RESULTS: Two-hundred-forty-four (40.6%) Italian Vascular Surgeons agreed to participate the first round of the Delphi Consensus; the second and the third rounds of the Delphi collected 230 responders (94.3% of the first-round responders). Four statements (15.4%) reached a consensus in the first rounds. Among the 22 remaining statements, one more consensus (3.8%) was achieved in the second round. Finally, seven more statements (26.9%) reached a consensus in the simplified last round. Globally, a consensus was reached for almost half of the proposed statements (46.1%). CONCLUSIONS: The relatively low consensus rate obtained in this Delphi seems to confirm the discrepancy between Guideline

Published
2024

3. SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS

Author

BRACALE, Umberto Marcello, Porcellini, M, del Guercio, L, Carbone, F, Russo, A, Viola, D, Ficarelli, I, Bracale, GC, Bracale, UM, Porcellini, M, del Guercio, L, Carbone, F, Russo, A, Viola, D, Ficarelli, I, and Bracale, GC

Subjects
stent, subintimal angioplasty, peripheral artery disease, Settore MED/22 - Chirurgia Vascolare
Abstract

Objective: To assess the feasibility and mid-term outcome of combined subintimal recanalization and stenting for the treatment of long superficialFebruary, and then Protégé® EverFlexTM) were placed in the whole subintimal space. The number and the length of stents was dictated from the length of the intentional subintimal dissection. The site of re-entry was chosen without compromise the feasibilty of a future bypass grafting. When completion arteriogram revealed residual stenosis, a post-dilatation was performed. Results: Twenty-eight patients (90.3%) underwent successful procedures, whereas two attempts failed because of inability to pass the guidewire through SFA occlusion and one because of arterial perforation. Two of the patients with unsuccessful SFA subintimal recanalization underwent successful leg bypass and one required an above-knee amputation. Arterial stenoses proximal or distal to the recanalized segment were treated with concomitant balloon angioplasties in five (16.2%) cases. The mean ABI increased to 0.87 (range 0.62-1.0) after the procedures. All the patients with successful SFA subintimal recanalization and stenting had resolution of symptoms and healing of ischemic lesions. Twenty-three of the 28 patients (82.1%) who had successful SFA procedures were patent at a mean follow-up of 21±6 months (range 2-57 months), and overall survival was 80.7%. Conclusions: Subintimal recanalization and routine stent placement allows high technical success rates and mid-term patency rates in the management of long SFA occlusions, with no significant procedure-related complications. femoral artery (SFA) occlusions. Methods: From 2002 to 2006, 31 consecutive patients (22 male, 9 female) with severe chronic ischemia were intended to be submitted to subintimal wire placement and routine stenting of SFA. The mean age of the patients was 67.3 years (range 61-79 years). Risk factors included diabetes mellitus (n=9, 29%) and end-stage renal failure (n=4, 12.9%). Thirteen patients (41.9%) were treated for disabling intermittent claudication, seven (22.6%) were treated for rest pain and 11 (35.5%) for ischemic ulcers or gangrene. The mean ankle-brachial index (ABI) was 0.51 (range 0.28-0.72). The procedures were performed under local anesthesia and using fluoroscopic guidance for entering subintimal space with an angled 0.035’ hydrophilic guidewire (Radifocus; Terumo, Japan); in 14 (45.1%) cases of flush occlusion of SFA, the procedures were made with associated duplex guidance to direct the devices into the SFA ostium. After advancement over the wire of a 5 Fr vertebral catheter (Terumo, Japan) and re-entry into the true lumen at the distal end of the lesion, self-expandable nitinol stents (Bard® LuminexxTM until 2006

Published
2007

4. Trattamento endovascolare del piede diabetico e copertura delle lesioni trofiche

Author

BRACALE, UMBERTO MARCELLO, DEL GUERCIO, LUCA, CARBONE, FRANCESCA, Viola D, Ficarelli I, Russo A, Porcellini M, BRACALE, GIANCARLO, Pratesi C - Pulli R, Bracale, UMBERTO MARCELLO, DEL GUERCIO, Luca, Carbone, Francesca, Viola, D, Ficarelli, I, Russo, A, Porcellini, M, and Bracale, Giancarlo

Subjects
trattamento endovascolare, piede diabetico, ulcera
Published
2007

5. Paragangliomi cervicali: diagnosi e trattamento

Author

Porcellini, M, Carbone, F, Russo, A, Ficarelli, I, Bracale, GC, BRACALE, Umberto Marcello, Porcellini, M, Carbone, F, Bracale, UM, Russo, A, Ficarelli, I, and Bracale, GC

Subjects
open surgery, carotid body tumor, Settore MED/22 - Chirurgia Vascolare, carotid arteries
Published
2006

6. Indicazioni al trattamento endovascolare

Author

BRACALE, GIANCARLO, Porcellini M, DEL GUERCIO, LUCA, CARBONE, FRANCESCA, BRACALE, UMBERTO MARCELLO, Russo A, Viola D, Ficarelli I., Pratesi C - Pulli R, Bracale, Giancarlo, Porcellini, M, DEL GUERCIO, Luca, Carbone, Francesca, Bracale, UMBERTO MARCELLO, Russo, A, Viola, D, and Ficarelli, I.

Subjects
insufficienza celiaco-mesenterica
Published
2006

7. A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy

Author

Ilaria Ficarelli, Luigi Salemme, Rosario Mancusi, Eugenio Stabile, Loris Flora, Raffaele Pio Ammollo, Emilio Soreca, Daniela Viola, Paolo Sangiuolo, Enrico Cappello, Giovanni Esposito, Giovanni Cioffi, Raffaella Niola, Gennaro Vigliotti, Danilo Barbarisi, Angelo Cioppa, Umberto Bracale, Eugenio Laurenzano, Mario De Laurentis, Alfonsina M Corbisiero, Eugenio Martelli, Giancarlo Accarino, Carlo Ruotolo, Claudio Molino, Giampaolo Amabile, Gianpaolo Santini, Alessandro Luongo, Antonio D'angelo, Bruno Villari, Giuseppe Sarti, Adolfo Crinisio, Gianluca Cangiano, Pietro Landino, Claudia De Gregorio, Fernando Petrosino, Raffaele Piccolo, Davide Razzano, Michele Franzese, Stabile, E., Piccolo, R., Franzese, M., Accarino, G., Bracale, U. M., Cappello, E., Cioffi, G., Cioppa, A., Crinisio, A., Flora, L., Landino, P., Martelli, E., Mancusi, R., Niola, R., Petrosino, F., Razzano, D., Ruotolo, C., Salemme, L., Sangiuolo, P., Santini, G., Soreca, E., Vigliotti, G., Villari, B., Amabile, G., Ammollo, R. P., Barbarisi, D., Corbisiero, A. M., D'Angelo, A., Cangiano, G., De Gregorio, C., De Laurentis, M., Laurenzano, E., Ficarelli, I., Luongo, A., Molino, C., Sarti, G., Viola, D., and Esposito, G.

Subjects
medicine.medical_specialty, Cross-sectional study, medicine.medical_treatment, Ischemia, cross-sectional studies, ischemia, 030204 cardiovascular system & hematology, Rate ratio, Revascularization, COVID-19, chronic limb-threatening ischemia (CLTI), peripheral artery disease (PAD), adult, aged, aged, 80 and over, chronic disease, extremities, female, hospitalization, humans, italy, male, middle aged, peripheral arterial disease, retrospective studies, risk factors, SARS-CoV-2, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 80 and over, 030212 general & internal medicine, Peripheral artery disease (PAD), Aged, 80 and over, business.industry, Outbreak, Original Articles, medicine.disease, Amputation, Population study, Cardiology and Cardiovascular Medicine, business
Abstract

The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown ( n = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 ± 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32–0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; p < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions.

Published
2021

8. Stent-assisted detachable coil embolization of wide-necked renal artery aneurysms

Author

Ilaria Ficarelli, Donatella Narese, Gaetano Vitale, Mario De Laurentis, Felice Pecoraro, Ettore Dinoto, Umberto Bracale, Domenico Solari, Flavia Spalla, Guido Bajardi, Bracale, UMBERTO MARCELLO, Narese, Donatella, Ficarelli, Ilaria, De Laurentis, Mario, Spalla, Flavia, Dinoto, Ettore, Vitale, Gaetano, Solari, Domenico, Bajardi, Guido, Pecoraro, Felice, Bracale, U, Narese, D, Ficarelli, I, De Laurentis, M, Spalla, F, Dinoto, E, Vitale, G, Solari, D, Bajardi, G, and Pecoraro, F

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Population, Self Expandable Metallic Stents, Aged, Aneurysm, Blood Vessel Prosthesis, Embolization, Therapeutic, Humans, Middle Aged, Renal Artery, Treatment Outcome, Radiology, Nuclear Medicine and Imaging, Cardiology and Cardiovascular Medicine, 030204 cardiovascular system & hematology, Settore MED/22 - Chirurgia Vascolare, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Self-expandable metallic stent, Blood vessel prosthesis, medicine.artery, Interventional Radiology, medicine, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Embolization, Renal artery, education, Self Expandable Metallic Stent, education.field_of_study, business.industry, Stent, medicine.disease, Nephrectomy, Blood Vessel Prosthesi, cardiovascular system, Radiology, business, Human
Abstract

Renal artery aneurysms (RAAs) are rare with an estimated incidence of 0.1% in the general population, and they represent approximately 25% of all visceral aneurysms. The gold standard of treatment is open surgery, but it is associated with a high risk of nephrectomy, mortality, and morbidity. Less invasive endovascular therapies are becoming increasingly common for the treatment of RAAs. Here, we aimed to report three cases of wide-necked complex renal artery aneurysms treated endovascularly using stent-assisted coil embolization with self-expandable stent nitinol Solitaire AB and Concerto Axium coils. In addition, we describe the use of the waffle-cone technique in a case of wide-necked saccular RAA involving the renal artery bifurcation. Technical success was achieved in all three cases with no early or late complications and no recurrences.

Published
2017
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9. A multicenter prospective observational study appraising the effectiveness of the Supera stent after subintimal recanalization of femoro-popliteal artery occlusion: The SUPERSUB II study.

Author

Palena LM, Isernia G, Parlani G, Veroux P, Ficarelli I, Frascheri A, Pischedda A, Patrone L, Dionisi CP, Cianni R, Airoldi F, Landino P, Kleiban A, Filauri P, Passalacqua G, Antignani PL, De Rose E, Valls A, Biondi-Zoccai G, and Manzi M

Subjects
Humans, Prospective Studies, Male, Female, Aged, Time Factors, Middle Aged, Treatment Outcome, Aged, 80 and over, Risk Factors, Constriction, Pathologic, Popliteal Artery diagnostic imaging, Popliteal Artery physiopathology, Femoral Artery diagnostic imaging, Femoral Artery physiopathology, Vascular Patency, Stents, Peripheral Arterial Disease therapy, Peripheral Arterial Disease physiopathology, Peripheral Arterial Disease diagnostic imaging, Prosthesis Design
Abstract

Background: Complex femoropopliteal artery disease represents a challenge. The Supera stent holds the promise of improving the results of endovascular therapy for complex femoropopliteal disease., Aims: We aimed at appraising the early and long-term effectiveness of the Supera stent after successful subintimal angioplasty (SuperSUB strategy) for complex femoropopliteal lesions., Methods: We conducted a multicenter, prospective, single-arm observational study including consecutive patients at participating centers in whom Supera was implanted after successful subintimal angioplasty for complex femoropopliteal lesions., Results: A total of 92 patients were included Femoropopliteal arteries were the most common target, and lesion length was 261 ± 102 mm. Most procedures were technically demanding, with antegrade femoral access in 35 (38%) and retrograde distal access in 55 (60%). Supera stent length was 281 ± 111 mm, with 4, 5, and 6 mm devices being most commonly used: 32 (35%), 35 (38%), and 23 (25%), respectively. Technical success was achieved in 100% of subjects, as was clinical success (per subject), whereas procedural success (per subject) was obtained in 98%. At 24 months, freedom from clinically driven target lesion revascularization was 93%, whereas primary patency was 87%. When compared with a similar historical cohort, Supera stent use appeared to be associated with a reduction in resources., Conclusion: Use of Supera stent after successful subintimal recanalization of complex lower limb arterial lesions yields favorable procedural results, which are maintained over follow-up, and are associated also with a favorable resource use profile., (© 2024 Wiley Periodicals LLC.)

Published
2024
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10. Limb salvage and survival after urgent surgical treatment of popliteal artery aneurysm.

Author

Pomatto S, Faggioli G, Pini R, Ficarelli I, Pini A, Angherà C, Rocchi C, Caputo S, Vacirca A, Ruotolo C, and Gargiulo M

Subjects
Humans, Limb Salvage adverse effects, Retrospective Studies, Ischemia etiology, Popliteal Artery Aneurysm, Aneurysm surgery, Aneurysm complications, Thrombosis etiology
Abstract

Background: Popliteal artery aneurysms (PAAs) need urgent treatment in case of acute thrombosis, distal embolization, or rupture. Few data are available in the literature about the treatment results in these scenarios. The aim of the present study was to evaluate an 11-year multicenter experience in the urgent treatment of PAAs., Methods: All symptomatic PAAs surgically treated in two vascular centers between 2010 and 2021 were retrospectively analyzed. In the postoperative period periodical clinical and Duplex-Ultrasound evaluation were performed. The evaluated endpoint was the outcome of urgent PAAs treatment according to their clinical presentation. Statistical analysis was performed by Kaplan-Meier log-rank evaluation and multivariable Cox regression tests., Results: Sixty-six PAAs needed an urgent repair. Twelve (18%) patients had a PAA rupture and 54 (82%) had an acute limb ischemia (ALI) due to either distal embolization or acute thrombosis. Patients with ALI underwent bypass surgery in 51 (95%) cases, which was associated with preoperative thrombolysis in 18 (31%) cases. A primary major amputation was performed in 3 (5%) cases. The mean follow-up was 52 ± 21 months with an overall 5-year limb salvage of 83 ± 6%. Limb salvage was influenced only by the number of patent tibial arteries (pTA) [5-years limb salvage 0%, 86 ± 10%, 92 ± 8% and 100% in case of 0, 1, 2 or 3 pTA, respectively (P = .001)]. An independent association of number of pTA and limb loss was found [hazard ratio (HR): 0.14 (95% confidence interval (CI) 0.03-0.6), P = .001]. Overall 5-year survival was 71 ± 7%. Ruptured PAAs were associated with lower 5-year survival compared with the ALI group (48 ± 2% vs. 79 ± 7%, P = .001). The number of pTA (33 ± 20%, 65 ± 10%, 84 ± 10% and 80 ± 10% for 0, 1, 2 and 3 pTA, respectively, P = .001) and the thrombolysis (94 ± 6% vs. 62 ± 10%, P = .03) were associated with higher survival in patients with ALI. There was an independent association of number of pTA and long-term survival [HR 0.15 (95% CI 0.03-0.8), P = .03]., Conclusions: PAA rupture is the cause of urgent PAA treatment in almost one fifth of cases, and it is associated with lower long-term survival. ALI can benefit from thrombolysis, and long-term limb salvage and survival are associated with the number of pTA., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Published
2023
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11. Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry.

Author

Martelli E, Zamboni M, Sotgiu G, Saderi L, Federici M, Sangiorgi GM, Puci MV, Martelli AR, Messina T, Frigatti P, Borrelli MP, Ruotolo C, Ficarelli I, Rubino P, Pezzo F, Carbonari L, Angelini A, Galeazzi E, Di Pinto LC, Fiore FM, Palmieri A, Ventoruzzo G, Mazzitelli G, Ragni F, Bozzani A, Forliti E, Castagno C, Volpe P, Massara M, Moniaci D, Pagliasso E, Peretti T, Ferrari M, Troisi N, Modugno P, Maiorano M, Bracale UM, Panagrosso M, Monaco M, Giordano G, Natalicchio G, Biello A, Celoria GM, Amico A, Di Bartolo M, Martelli M, Munaó R, Razzano D, Colacchio G, Bussetti F, Lanza G, Cardini A, Di Benedetto B, De Laurentis M, Taurino M, Sirignano P, Cappiello P, Esposito A, Trimarchi S, Romagnoli S, Padricelli A, Giudice G, Crinisio A, Di Nardo G, Battaglia G, Tringale R, De Vivo S, Compagna R, Tolva VS, D'Alessio I, Curci R, Giovannetti S, D'Arrigo G, Basile G, Frigerio D, Veraldi GF, Mezzetto L, Ippoliti A, Oddi FM, and Settembrini AM

Abstract

Background: Identifying sex-related differences/variables associated with 30 day/1 year mortality in patients with chronic limb-threatening ischemia (CLTI)., Methods: Multicenter/retrospective/observational study. A database was sent to all the Italian vascular surgeries to collect all the patients operated on for CLTI in 2019. Acute lower-limb ischemia and neuropathic-diabetic foot are not included., Follow-Up: One year. Data on demographics/comorbidities, treatments/outcomes, and 30 day/1 year mortality were investigated., Results: Information on 2399 cases (69.8% men) from 36/143 (25.2%) centers. Median (IQR) age: 73 (66-80) and 79 (71-85) years for men/women, respectively ( p < 0.0001). Women were more likely to be over 75 (63.2% vs. 40.1%, p = 0.0001). More men smokers (73.7% vs. 42.2%, p < 0.0001), are on hemodialysis (10.1% vs. 6.7%, p = 0.006), affected by diabetes (61.9% vs. 52.8%, p < 0.0001), dyslipidemia (69.3% vs. 61.3%, p < 0.0001), hypertension (91.8% vs. 88.5%, p = 0.011), coronaropathy (43.9% vs. 29.4%, p < 0.0001), bronchopneumopathy (37.1% vs. 25.6%, p < 0.0001), underwent more open/hybrid surgeries (37.9% vs. 28.8%, p < 0.0001), and minor amputations (22% vs. 13.7%, p < 0.0001). More women underwent endovascular revascularizations (61.6% vs. 55.2%, p = 0.004), major amputations (9.6% vs. 6.9%, p = 0.024), and obtained limb-salvage if with limited gangrene (50.8% vs. 44.9%, p = 0.017). Age > 75 (HR = 3.63, p = 0.003) is associated with 30 day mortality. Age > 75 (HR = 2.14, p < 0.0001), nephropathy (HR = 1.54, p < 0.0001), coronaropathy (HR = 1.26, p = 0.036), and infection/necrosis of the foot (dry, HR = 1.42, p = 0.040; wet, HR = 2.04, p < 0.0001) are associated with 1 year mortality. No sex-linked difference in mortality statistics., Conclusion: Women exhibit fewer comorbidities but are struck by CLTI when over 75, a factor associated with short- and mid-term mortality, explaining why mortality does not statistically differ between the sexes.

Published
2023
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12. How the First Year of the COVID-19 Pandemic Impacted Patients' Hospital Admission and Care in the Vascular Surgery Divisions of the Southern Regions of the Italian Peninsula.

Author

Martelli E, Sotgiu G, Saderi L, Federici M, Sangiorgi G, Zamboni M, Martelli AR, Accarino G, Bianco G, Bonanno F, Bracale UM, Cappello E, Cioffi G, Colacchio G, Crinisio A, De Vivo S, Dionisi CP, Flora L, Impedovo G, Intrieri F, Iorio L, Maritati G, Modugno P, Monaco M, Natalicchio G, Palazzo V, Petrosino F, Pompeo F, Pulli R, Razzano D, Ruggieri MR, Ruotolo C, Sangiuolo P, Vigliotti G, Volpe P, Biello A, Boggia P, Boschetti M, Centritto EM, Condò F, Cucciolillo L, D'Amodio AS, De Laurentis M, Desantis C, Di Lella D, Di Nardo G, Disabato A, Ficarelli I, Gasparre A, Giordano AN, Luongo A, Massara M, Molinari V, Padricelli A, Panagrosso M, Petrone A, Pisanello S, Prunella R, Tedesco M, and Settembrini AM

Abstract

Background: To investigate the effects of the COVID-19 lockdowns on the vasculopathic population. Methods: The Divisions of Vascular Surgery of the southern Italian peninsula joined this multicenter retrospective study. Each received a 13-point questionnaire investigating the hospitalization rate of vascular patients in the first 11 months of the COVID-19 pandemic and in the preceding 11 months. Results: 27 out of 29 Centers were enrolled. April-December 2020 (7092 patients) vs. 2019 (9161 patients): post-EVAR surveillance, hospitalization for Rutherford category 3 peripheral arterial disease, and asymptomatic carotid stenosis revascularization significantly decreased (1484 (16.2%) vs. 1014 (14.3%), p = 0.0009; 1401 (15.29%) vs. 959 (13.52%), p = 0.0006; and 1558 (17.01%) vs. 934 (13.17%), p < 0.0001, respectively), while admissions for revascularization or major amputations for chronic limb-threatening ischemia and urgent revascularization for symptomatic carotid stenosis significantly increased (1204 (16.98%) vs. 1245 (13.59%), p < 0.0001; 355 (5.01%) vs. 358 (3.91%), p = 0.0007; and 153 (2.16%) vs. 140 (1.53%), p = 0.0009, respectively). Conclusions: The suspension of elective procedures during the COVID-19 pandemic caused a significant reduction in post-EVAR surveillance, and in the hospitalization of asymptomatic carotid stenosis revascularization and Rutherford 3 peripheral arterial disease. Consequentially, we observed a significant increase in admissions for urgent revascularization for symptomatic carotid stenosis, as well as for revascularization or major amputations for chronic limb-threatening ischemia.

Published
2022
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13. One Year Outcomes of an International Multicentre Prospective Cohort Study on the Gore Excluder Iliac Branch Endoprosthesis for Aorto-Iliac Aneurysms.

Author

van der Veen D, Holewijn S, Bellosta R, van Sterkenburg SMM, Heyligers JMM, Ficarelli I, Gómez Palonés FJ, Mangialardi N, Mosquera NJ, Holden A, and Reijnen MMPJ

Subjects
Aged, Aortic Aneurysm, Abdominal diagnostic imaging, Blood Vessel Prosthesis Implantation, Endoleak etiology, Endovascular Procedures adverse effects, Erectile Dysfunction etiology, Female, Humans, Iliac Aneurysm diagnostic imaging, Male, Middle Aged, Postoperative Complications, Prospective Studies, Prosthesis Failure adverse effects, Registries, Reoperation, Walking, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis adverse effects, Iliac Aneurysm surgery, Vascular Patency
Abstract

Objective: The Gore Excluder Iliac Branch Endoprosthesis (IBE) was developed to preserve perfusion in the hypogastric artery after endovascular repair of aorto-iliac aneurysms. This study reports the 12 month technical and clinical outcomes of treatment with this device., Methods: This study was a physician initiated international multicentre, prospective cohort study. The primary endpoint was primary patency of the hypogastric branch at 12 months. Secondary endpoints included technical and clinical outcomes. Patients with an indication for elective treatment with the Gore Excluder IBE were enrolled between March 2015 and August 2018. Baseline and procedural characteristics, imaging data, physical examinations and questionnaire data (Walking Impairment Questionnaire [WIQ], EuroQol-5-Dimensions [EQ5D], International Index of Erectile Function 5 [IIEF-5]) were collected through 12 month follow up., Results: One hundred patients were enrolled of which 97% were male, with a median age of 70.0 years (interquartile range [IQR] 64.5 - 75.5 years). An abdominal aortic aneurysm (AAA) above threshold for treatment was found in 42.7% and in the remaining patients the iliac artery diameter was the indication for treatment. The maximum common iliac artery (CIA) diameter on the Gore Excluder IBE treated side was 35.5 mm (IQR 30.8 - 42.0) mm. Twenty-two patients received a bilateral and seven patients had an isolated IBE. Median procedural time was 151 minutes (IQR 117 - 193 minutes) with a median hospital stay of four days (IQR 3 - 5 days). Primary patency of the IBE at 12 month follow up was 91.3%. Primary patency for patients treated inside and outside the instructions for use were 91.8% and 85.7%, respectively (p = .059). Freedom from secondary interventions was 98% and 97% at 30 days and 12 months, respectively. CIA and AAA diameters decreased significantly through 12 months. IIEF-5 and EQ5D scores remained stable through follow up. Patency of the contralateral internal iliac artery led to better IIEF-5 outcomes. WIQ scores decreased at 30 days and returned to baseline values through 12 months., Conclusion: Use of the Gore Excluder IBE for the treatment of aorto-iliac aneurysms shows a satisfactory primary patency through 12 months, with significant decrease of diameters, a low re-intervention rate, and favourable clinical outcomes., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

Published
2021
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14. A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy.

Author

Stabile E, Piccolo R, Franzese M, Accarino G, Bracale UM, Cappello E, Cioffi G, Cioppa A, Crinisio A, Flora L, Landino P, Martelli E, Mancusi R, Niola R, Petrosino F, Razzano D, Ruotolo C, Salemme L, Sangiuolo P, Santini G, Soreca E, Vigliotti G, Villari B, Amabile G, Ammollo RP, Barbarisi D, Corbisiero AM, D'angelo A, Cangiano G, De Gregorio C, De Laurentis M, Laurenzano E, Ficarelli I, Luongo A, Molino C, Sarti G, Viola D, and Esposito G

Subjects
Adult, Aged, Aged, 80 and over, Chronic Disease, Cross-Sectional Studies, Female, Humans, Ischemia physiopathology, Ischemia virology, Italy epidemiology, Male, Middle Aged, Peripheral Arterial Disease complications, Peripheral Arterial Disease virology, Retrospective Studies, Risk Factors, COVID-19 epidemiology, COVID-19 virology, Extremities physiopathology, Hospitalization statistics & numerical data, Ischemia epidemiology, SARS-CoV-2 pathogenicity
Abstract

The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown ( n = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 ± 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32-0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; p < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions.

Published
2021
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15. Stent-assisted detachable coil embolization of wide-necked renal artery aneurysms.

Author

Bracale UM, Narese D, Ficarelli I, Laurentis M, Spalla F, Dinoto E, Vitale G, Solari D, Bajardi G, and Pecoraro F

Subjects
Adult, Aged, Blood Vessel Prosthesis, Humans, Male, Middle Aged, Self Expandable Metallic Stents, Treatment Outcome, Aneurysm therapy, Embolization, Therapeutic instrumentation, Renal Artery abnormalities
Abstract

Renal artery aneurysms (RAAs) are rare with an estimated incidence of 0.1% in the general population, and they represent approximately 25% of all visceral aneurysms. The gold standard of treatment is open surgery, but it is associated with a high risk of nephrectomy, mortality, and morbidity. Less invasive endovascular therapies are becoming increasingly common for the treatment of RAAs. Here, we aimed to report three cases of wide-necked complex renal artery aneurysms treated endovascularly using stent-assisted coil embolization with self-expandable stent nitinol Solitaire AB and Concerto Axium coils. In addition, we describe the use of the waffle-cone technique in a case of wide-necked saccular RAA involving the renal artery bifurcation. Technical success was achieved in all three cases with no early or late complications and no recurrences., Competing Interests: disclosure The authors declared no conflicts of interest.

Published
2017
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