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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

2. Renal Perfusion During Aortic Surgery: Looking for the Ideal Substrate : Curitiba Trial Investigators

Author

Tshomba, Y., Simonini, E., Colombo, E., Ardita, V., Apruzzi, L., Rinaldi, E., Pasin, L., Cambiaghi, T., Catenaccio, B., Castellano, R., Venturini, M., Landoni, G., Nardelli, P., Leopardi, M., Espinar, E., Salvati, S., Lembo, R., Baccellieri, D., Bertoglio, L., Kahlberg, A., Bossi, S., Melissano, G., Chiesa, Roberto, Tshomba, Yamume, editor, Baccellieri, Domenico, editor, and Chiesa, Roberto, editor

Published
2019
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8. Effects of wildfires on peak discharges in watersheds

Author

Leopardi M and Scorzini Anna R

Subjects
Wildfire, Curve Number, Peak Discharge, Runoff, GIS, Forestry, SD1-669.5
Abstract

Wildfires can alter the hydrological processes in watersheds resulting in increases in peak discharge - one of the most important hydrological variables used in water resources applications. It thus follows that the standard methods used to calculate rainfall runoff should be modified in order to model the potential changes in watershed response under post-fire conditions. However, no reliable methodology for quantitatively assessing the effects of wildfires on hydrological parameters, such as curve numbers or runoff coefficients, has been identified to date. The approaches currently used are usually site-specific, mainly based on personal experience or very simple empirical strategies and then affected by a degree of uncertainty. This paper addresses issues regarding the estimation of the Soil Conservation Service Curve Number (SCS-CN or CN) and considers the case study of San Giuliano, L’Aquila (Italy), a small urban basin recently affected by a wildfire that resulted in a significant reduction in forest cover. The effects of the fire on runoff are modelled by adjusting CNs according to existing approaches from the literature in order to perform a sensitivity analysis for post-fire conditions; this allows us to examine the effects of the variability in model input parameters (estimates of post-fire CNs) upon expected peak discharges related to different return period storms. The fire effect ratio, which can be seen as a global parameter for describing alterations in the watershed response due to fire, is calculated by dividing post-fire peak discharge by pre-fire peak discharge. For the present case study, this ratio ranged between 1.1 and 2.3, indicating the urgent need for quantitative research on the effects of wildfires on the hydrological variables affecting runoff calculations.

Published
2015
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12. Renal Perfusion During Aortic Surgery: Looking for the Ideal Substrate

Author

Tshomba, Y., Simonini, E., Colombo, E., Ardita, V., Apruzzi, L., Rinaldi, E., Pasin, L., Cambiaghi, T., Catenaccio, B., Castellano, R., Venturini, M., Landoni, G., Nardelli, P., Leopardi, M., Espinar, E., Salvati, S., Lembo, R., Baccellieri, D., Bertoglio, L., Kahlberg, A., Bossi, S., Melissano, G., and Chiesa, Roberto

Published
2019

13. Thoracic aortic aneurysms

Author

Chiesa R, Marone EM, Mascia D, Leopardi M, MELISSANO G., Setacci C, Chiesa R, Cao P, Chiesa, R, Marone, Em, Mascia, D, Leopardi, M, and Melissano, G.

Published
2016

15. An anatomical review of spinal cord blood supply

Author

Germano Melissano, Luca Bertoglio, Rinaldi, E., Leopardi, M., Chiesa, Roberto, Melissano, Germano, Bertoglio, L, Rinaldi, E, Leopardi, M, and Chiesa, Roberto

Subjects
Endovascular Procedures, Aorta, Thoracic, Prosthesis Design, Aortography, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Treatment Outcome, Spinal Cord, Predictive Value of Tests, Multidetector Computed Tomography, Humans, Radiographic Image Interpretation, Computer-Assisted, Stents, Aorta, Abdominal, Anatomic Landmarks, Spinal Cord Injuries
Abstract

Knowledge of the spinal cord (SC) vascular supply is important in patients undergoing procedures that involve the thoracic and thoracoabdominal aorta. However, the SC vasculature has a complex anatomy, and teaching is often based only on anatomical sketches with highly variable accuracy; historically, this has required a "leap of faith" on the part of aortic surgeons. Fortunately, this "leap of faith" is no longer necessary given recent breakthroughs in imaging technologies and postprocessing software. Imaging methods have expanded the non-invasive diagnostic ability to determine a patient's SC vascular pattern, particularly in detecting the presence and location of the artery of Adamkiewicz. CT is the imaging modality of choice for most patients with thoracic and thoracoabdominal aortic disease, proving especially useful in the determination of feasibility and planning of endovascular treatment. Thus the data set required for analysis of SC vascular anatomy is usually already available. We have concentrated our efforts on CT angiography, which offers particularly good imaging capabilities with state-of-the-art multidetector scanners. Multidetector row helical CT provides examinations of an extensive range in the craniocaudal direction with thin collimation in a short time interval, giving excellent temporal and spatial resolution. This paper provides examples of the SC vasculature imaging quality that can be obtained with 64 row scanners and appropriate postprocessing. Knowledge of the principal anatomical features of the SC blood supply of individual patients undergoing open or endovascular thoracoabdominal procedures has several potential benefits. For open surgery, analysis of the SC vasculature could tell us the aortic region that feeds the Adamkiewicz artery and thus needs to be reimplanted. For endovascular procedures, we can determine whether the stent-graft will cover the Adamkiewicz artery, thus avoiding unnecessary coverage. CT data can also be used to stratify risk of SC ischemia and guide the selective use of spinal cord injury prevention strategies. OI Bertoglio, Luca/0000-0001-6871-2176 Knowledge of the spinal cord (SC) vascular supply is important in patients undergoing procedures that involve the thoracic and thoracoabdominal aorta. However, the SC vasculature has a complex anatomy, and teaching is often based only on anatomical sketches with highly variable accuracy; historically, this has required a "leap of faith" on the part of aortic surgeons. Fortunately, this "leap of faith" is no longer necessary given recent breakthroughs in imaging technologies and postprocessing software. Imaging methods have expanded the non-invasive diagnostic ability to determine a patient's SC vascular pattern, particularly in detecting the presence and location of the artery of Adamkiewicz. CT is the imaging modality of choice for most patients with thoracic and thoracoabdominal aortic disease, proving especially useful in the determination of feasibility and planning of endovascular treatment. Thus the data set required for analysis of SC vascular anatomy is usually already available. We have concentrated our efforts on CT angiography, which offers particularly good imaging capabilities with state-of-the-art multidetector scanners. Multidetector row helical CT provides examinations of an extensive range in the craniocaudal direction with thin collimation in a short time interval, giving excellent temporal and spatial resolution. This paper provides examples of the SC vasculature imaging quality that can be obtained with 64 row scanners and appropriate postprocessing. Knowledge of the principal anatomical features of the SC blood supply of individual patients undergoing open or endovascular thoracoabdominal procedures has several potential benefits. For open surgery, analysis of the SC vasculature could tell us the aortic region that feeds the Adamkiewicz artery and thus needs to be reimplanted. For endovascular procedures, we can determine whether the stent-graft will cover the Adamkiewicz artery, thus avoiding unnecessary coverage. CT data can also be used to stratify risk of SC ischemia and guide the selective use of spinal cord injury prevention strategies. OI Bertoglio, Luca/0000-0001-6871-2176

Published
2015

17. Clinical trials and risk-based approach: reality or Utopia?

Author

Cagnazzo, C., primary, Arizio, F., additional, Piccinni Leopardi, M., additional, Di Costanzo, A., additional, Crotto, L., additional, Matocci, R., additional, Lucarelli, A., additional, Grassi, E., additional, Saracino, V., additional, Fugazza, C., additional, Cinefra, M., additional, Marchetti, F., additional, Taverniti, C., additional, Stabile, S., additional, Monti, M., additional, and Marchesi, E., additional

Published
2017
Full Text
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18. Determination of veterinary antibiotics in biological matrices and foodstuffs by liquid chromatography

Author

MORGANTI, EMANUELE, MANDRIOLI, ROBERTO, BROCCOLI, MASSIMILIANO, GHEDINI, NADIA, RAGGI, MARIA AUGUSTA, Mercolini L., Piccinni Leopardi M., SPINELLI D., Morganti E., Mercolini L., Mandrioli R., Piccinni Leopardi M., Broccoli M., Ghedini N., and Raggi M.A.

Subjects
MACROLIDES, HUMAN HEALTH, HPLC ANALYSIS, VETERINARY, ANTIBIOTICS
Abstract

Set up of a simple, fast and cheap liquid chromatographic method to separate four macrolides and to quantify their concentrations. It was optimised evaluating mobile phase composition, column temperature and pH to provide the best resolution of these analytes. Preliminary assays are promising and the method is under validation for application to real food samples.

Published
2012

19. Unruptured Aneurysms Italian Study (UAIS) background and method

Author

Versari, P. b, Tartara, F. b, Scerrati, M. c, Caroselli, G. c, Pasquini, U. c, Ciappetta, P. d, Vailati, G. d, Occhiogrosso, M. d, Biroli, F. e, Bonaldi, G. e, Calbucci, F. f, Andreoli, A. f, Leopardi, M. f, Raff, L. f, Bollati, A. g, Gasparotti, R. g, Martellotto, N. h, Distefano, G. h, Pinna, G. i, Francaviglia, N. j, Ventura, F. k, Orazio, G. k, Cristaudo, C. k, Consoli, V. l, Nicoletti, G. l, Albanese, V. m, Ceccotti, C. n, Frattarelli, M. o, Servadei, F. o, Cremonini, A. M. o, Taborelli, A. p, Corriero, G. q, Galli, G. r, Morandini, A. r, Medina, M. s, Padovani, R. t, Farneti, M. t, Ghadirpour, R. t, DiLorenzo, N. u, Mennonna, P. v, Ammannati, F. v, Mangiafico, S. v, Celerini, M. v, Paoli, L. v, Andrioli, G. w, Zerbi, D. w, Spaziante, R. x, Pau, A. x, Stefani, F. x, Zona, G. L. x, Castellan, L. x, Cantore, G. y, Innocenzi, G. y, Galzio, R. z, Ricci, A. z, Montinaro, A. aa, Cantisani, P. aa, Arena, O. ab, Tonnarelli, G. P. ac, Gagliardi, R. ad, Benvenuti, L. ad, Tomasello, F. ae, Paterniti, S. ae, Trincia, G. af, Conti, C. af, Broggi, G. ag, Giombini, S. ag, Solero, C. L. ag, Marras, C. ag, Todaro, Ciceri, E. ag, Fornari, M. ah, DeSantis, A. ah, Cardia, Ortolina, Rodriguez, R. ai, Gaetani, P. ai, Collice, M. aj, D'Aliberti, G. aj, Talamonti, G. aaj, LaCamera, A. aj, Boccardi, E. aj, Villani, R. ak, Gaini, S. ak, Miserocchi, G. ak, Branca, V. ak, Giovanelli, M. al, Cenzato, Scotti, G. al, Merli, A. am, Piazza, P. am, Sganzerla, E. an, Profeta, G. ao, Daniele, B. ao, Monsignore, R. ao, Cioffi, F. ap, Rotondo, M. ap, Natale, DeDivitiis, E. aq, F. aq, Franco, A. ar, Apolito, R. ar, Delehaye, L. ar, Sossio, C. as, Bellotti, C. at, Car, P. G. at, Benvenuto, F. at, Scienza, R. au, Berlucchi, S. au, Pavesi, G. au, Fiore, D. au, LaSeta, F. av, Filizzolo, F. aw, Fiumara, E. aw, Tumbiolo, S. aw, Benericetti, E. ax, Sacchelli, A. ax, Arienta, C. ay, Zappoli, F. ay, Buoncristiani, P. az, Buonaguidi, R. ba, Bianchini, E. ba, Boccardo, M. bb, Valsania, V. bb, Bruzzone, L. bb, Cantini, L. R. bc, Marconi, F. bc, Parenti, G. F. bd, Liberti, G. bd, Severino, P. be, Delitala, A. bf, Cotroneo, E. bf, Gazzeri, G. bg, Fiume, D. bg, Esposito, S. bh, Agrillo, U. bi, Sidoti, C. bi, Maira, G. bj, Vignati, A. bj, Marchese, E. bj, Delfini, R. bk, Guidetti, G. bk, Bufatti, P. bl, Strabella, G. bm, D'Angelo, V. bn, Monte, Florio, F. bn, Olivieri, G. bo, Palma, L. bp, Serchi, E. bp, Fontana, R. bq, Resta, M. br, Faccani, G. bs, Musso, C. bs, Ducati, A. bt, Bradac, G. B. bt, Longatti, P. bu, Tacconi, L. bv, Skrap, M. bw, Nicassio, N. bw, Graziussi, G. bx, Migliaccio, N. bx, Puglisi, A. bx, Tomei, G. by, Bonfanti, N. by, Tabano, A. by, Bricolo, A. bz, Pasqualin, Beltramello, Colombo, F. ca, Causin, Perini, S. ca, MAIURI, FRANCESCO, BRIGANTI, FRANCESCO, Versari, P. b, Tartara, F. b, Scerrati, M. c, Caroselli, G. c, Pasquini, U. c, Ciappetta, P. d, Vailati, G. d, Occhiogrosso, M. d, Biroli, F. e, Bonaldi, G. e, Calbucci, F. f, Andreoli, A. f, Leopardi, M. f, Raff, L. f, Bollati, A. g, Gasparotti, R. g, Martellotto, N. h, Distefano, G. h, Pinna, G. i, Francaviglia, N. j, Ventura, F. k, Orazio, G. k, Cristaudo, C. k, Consoli, V. l, Nicoletti, G. l, Albanese, V. m, Ceccotti, C. n, Frattarelli, M. o, Servadei, F. o, Cremonini, A. M. o, Taborelli, A. p, Corriero, G. q, Galli, G. r, Morandini, A. r, Medina, M., Padovani, R. t, Farneti, M. t, Ghadirpour, R. t, Dilorenzo, N. u, Mennonna, P. v, Ammannati, F. v, Mangiafico, S. v, Celerini, M. v, Paoli, L. v, Andrioli, G. w, Zerbi, D. w, Spaziante, R. x, Pau, A. x, Stefani, F. x, Zona, G. L. x, Castellan, L. x, Cantore, G. y, Innocenzi, G. y, Galzio, R. z, Ricci, A. z, Montinaro, A., Aa, Cantisani, P., Aa, Arena, O., Ab, Tonnarelli, G. P., Ac, Gagliardi, R., Ad, Benvenuti, L., Ad, Tomasello, F., Ae, Paterniti, S., Ae, Trincia, G., Af, Conti, C., Af, Broggi, G., Ag, Giombini, S., Ag, Solero, C. L., Ag, Marras, C., Ag, Todaro, Ciceri, E., Ag, Fornari, M., Ah, Desantis, A., Ah, Cardia, Ortolina, Rodriguez, R., Ai, Gaetani, P., Ai, Collice, M., Aj, D'Aliberti, G., Aj, Talamonti, G., Aaj, Lacamera, A., Aj, Boccardi, E., Aj, Villani, R., Ak, Gaini, S., Ak, Miserocchi, G., Ak, Branca, V., Ak, Giovanelli, M., Al, Cenzato, Scotti, G., Al, Merli, A., Am, Piazza, P., Am, Sganzerla, E., An, Profeta, G., Ao, Daniele, B., Ao, Monsignore, R., Ao, Cioffi, F., Ap, Rotondo, M., Ap, Natale, Dedivitiis, E., Aq, Maiuri, Francesco, F., Aq, Briganti, Francesco, Franco, A., Ar, Apolito, R., Ar, Delehaye, L., Ar, Sossio, C., A, Bellotti, C., At, Car, P. G., At, Benvenuto, F., At, Scienza, R., Au, Berlucchi, S., Au, Pavesi, G., Au, Fiore, D., Au, Laseta, F., Av, Filizzolo, F., Aw, Fiumara, E., Aw, Tumbiolo, S., Aw, Benericetti, E., Ax, Sacchelli, A., Ax, Arienta, C., Ay, Zappoli, F., Ay, Buoncristiani, P., Az, Buonaguidi, R., Ba, Bianchini, E., Ba, Boccardo, M., Bb, Valsania, V., Bb, Bruzzone, L., Bb, Cantini, L. R., Bc, Marconi, F., Bc, Parenti, G. F., Bd, Liberti, G., Bd, Severino, P., Be, Delitala, A., Bf, Cotroneo, E., Bf, Gazzeri, G., Bg, Fiume, D., Bg, Esposito, S., Bh, Agrillo, U., Bi, Sidoti, C., Bi, Maira, G., Bj, Vignati, A., Bj, Marchese, E., Bj, Delfini, R., Bk, Guidetti, G., Bk, Bufatti, P., Bl, Strabella, G., Bm, D'Angelo, V., Bn, Monte, Florio, F., Bn, Olivieri, G., Bo, Palma, L., Bp, Serchi, E., Bp, Fontana, R., Bq, Resta, M., Br, Faccani, G., B, Musso, C., B, Ducati, A., Bt, Bradac, G. B., Bt, Longatti, P., Bu, Tacconi, L., Bv, Skrap, M., Bw, Nicassio, N., Bw, Graziussi, G., Bx, Migliaccio, N., Bx, Puglisi, A., Bx, Tomei, G., By, Bonfanti, N., By, Tabano, A., By, Bricolo, A., Bz, Pasqualin, Beltramello, Colombo, F., Ca, Causin, Perini, and S., Ca

Subjects
Aneurysm
Published
2006

20. Thoracoabdominal aortic aneurysms in Marfan patients

Author

Mascia, D., Leopardi, M., Baccellieri, D., Alaidroos, M., Kahlberg, A., Tshomba, Y., Melissano, G., Chiesa, R., Tshomba, Y. (ORCID:0000-0001-7304-7553), Mascia, D., Leopardi, M., Baccellieri, D., Alaidroos, M., Kahlberg, A., Tshomba, Y., Melissano, G., Chiesa, R., and Tshomba, Y. (ORCID:0000-0001-7304-7553)

Abstract

Aim: The aim if this study was to present our experience in the operative management of diseased thoracic aorta in patients with Marfan Syndrome (MFS). In the period 1993-2015 86 patients with MFS and diseased thoracic aorta were treated in our center. Methods: An open surgical treatment was performed in 63 cases and an endovascular exclusion was performed in 23 cases (including hybrid treatments). The larger part of those interventions were elective, and 21 cases were in urgent fashion. Result:. The perioperative mortality was 4.8%. At 30 postoperative day paraplegia was observed in 8.1 % of patients, renal and respiratory failure in 5.8% and 8.1%, respectively. After a mean follow-up of 13.2+3.6 years long-term survival rate was 79.1%. In the group of patients treated with open surgery we observed three cases of Carrell's patch aneurysm, which required open reintervention. In the endovascular cases we observed four cases of graft migration, two cases of aortic antegrade dissection and five cases of endoleak with significative sac growth. Conclusion: Perioperative mortality and morbidity after open and endovascular repair were acceptable in this series in patients with MFS. Because of the high risk of complications and reinterventions after TEVAR, however, we currently limited aortic stent grafting in selected patient in whom an aortic open repair is contraindicated or as bridge technique in urgent fashion.

Published
2015

21. Strategies to treat thoracic aortitis and infected aortic grafts

Author

Kahlberg, A., Melissano, G., Tshomba, Yamume, Leopardi, M., Chiesa, R., Tshomba, Y. (ORCID:0000-0001-7304-7553), Kahlberg, A., Melissano, G., Tshomba, Yamume, Leopardi, M., Chiesa, R., and Tshomba, Y. (ORCID:0000-0001-7304-7553)

Abstract

Infectious thoracic aortitis is a rare disease, especially since the incidence of syphilis and tuberculosis has dropped in western countries. However, the risk to develop an infectious aortitis and subsequent mycotic aneurysm formation is still present, particularly in case of associated endocarditis, sepsis, and in immunosuppressive disorders. Moreover, the number of surgical and endovascular thoracic aortic repairs is continuously increasing, and infective graft complications are observed more frequently. Several etiopathogenetic factors may play a role in thoracic aortic and prosthetic infections, including hematogenous seeding, local bacterial translocation, and iatrogenous contamination. Also, fistulization of the esophagus or the bronchial tree is commonly associated with these diseases, and it represents a critical event requiring a multidisciplinary management. Knowledge on underlying micro-organisms, antibiotic efficacy, risk factors, and prevention strategies has a key role in the management of this spectrum of infectious diseases involving the thoracic aorta. When the diagnosis of a mycotic aneurysm or a prosthetic graft infection is established, treatment is demanding, often including a number of surgical options. Patients are usually severely compromised by sepsis, and in most cases they are considered unfit for surgery for general clinical conditions or local concerns. Thus, results of different therapeutic strategies for infectious diseases of the thoracic aorta are still burdened with very high morbidity and mortality. In this manuscript, we review the literature regarding the main issues related to thoracic infectious aortitis and aortic graft infections, and we report our personal series of patients surgically treated at our institution for these conditions from 1993 to 2014.

Published
2015

40. Early Results of Physician Modified Fenestrated Stent Grafts for the Treatment of Thoraco-abdominal Aortic Aneurysms.

Author

Cochennec, F., Kobeiter, H., Gohel, M., Leopardi, M., Raux, M., Majewski, M., Desgranges, P., Allaire, E., and Becquemin, J.P.

Abstract

Objectives The aim was to determine whether physician modified stent grafts (PMSGs) are safe and effective for the treatment of high risk patients with thoraco-abdominal aortic aneurysms (TAAAs). Design This was a retrospective single institution study. Material Consecutive patients with TAAA undergoing endovascular repair using a PMSG between January 2012 and June 2014 were evaluated. Methods Fenestrations to preserve branch vessels were created in TX2 thoracic (Cook Medical) stent grafts. Pre- intra- and post-operative data were recorded by means of a prospectively maintained database. Results Eleven high risk patients with TAAA (type I, n = 4; type III, n = 3; type IV, n = 3; type V, n = 1) underwent fenestrated endovascular repair using PMSGs. Indications were painful aneurysm ( n = 5), >70 mm rapidly enlarging aneurysm ( n = 4), saccular aneurysm ( n = 1), and visceral patch false aneurysm after open repair of a type IV TAAA ( n = 1). In four asymptomatic patients, an additional fenestration was created for temporary selective sac perfusion and occluded 2–4 weeks later. Median duration for stent graft modifications was 2 hours (range 1–3 hours). The median number of fenestrations was three (range 2–4). One patient died during the post-operative period from colonic ischemia, giving a 9% in hospital mortality rate. Four (36%) patients presented with moderate to severe complications. One (9%) patient presented with a paraparesis that resolved completely after spinal fluid drainage. Among surviving patients, four required early endovascular re-intervention for type III endoleak ( n = 2), type Ia endoleak ( n = 1), or target vessel cannulation failure ( n = 1). The median follow up time was 6 months (range 3–20 months). During follow up, no other complications occurred and all target vessels remained patent. One patient presented with a persistent type II endoleak. Conclusion PMSGs provided acceptable short-term results and may be a management option for the treatment of TAAA in selected high risk patients. Durability concerns need to be assessed in additional studies with long-term follow up. [ABSTRACT FROM AUTHOR]

Published
2015
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44. Thoracoabdominal aortic aneurysms in Marfan patients

Author

Mascia, D., Leopardi, M., Baccellieri, D., Alaidroos, M., Kahlberg, A., Yamume Tshomba, Melissano, G., Chiesa, R., Mascia, D., Leopardi, M., Baccellieri, D., Alaidroos, M., Kahlberg, ANDREA LUITZ, Tshomba, Yamume, Melissano, Germano, and Chiesa, Roberto

Subjects
Aortic aneurysm, Endovascular procedure, Thoracic, Surgery, Cardiology and Cardiovascular Medicine, Marfan Syndrome
Abstract

Aim: The aim if this study was to present our experience in the operative management of diseased thoracic aorta in patients with Marfan Syndrome (MFS). In the period 1993-2015 86 patients with MFS and diseased thoracic aorta were treated in our center. Methods: An open surgical treatment was performed in 63 cases and an endovascular exclusion was performed in 23 cases (including hybrid treatments). The larger part of those interventions were elective, and 21 cases were in urgent fashion. Result:. The perioperative mortality was 4.8%. At 30 postoperative day paraplegia was observed in 8.1 % of patients, renal and respiratory failure in 5.8% and 8.1%, respectively. After a mean follow-up of 13.2+3.6 years long-term survival rate was 79.1%. In the group of patients treated with open surgery we observed three cases of Carrell's patch aneurysm, which required open reintervention. In the endovascular cases we observed four cases of graft migration, two cases of aortic antegrade dissection and five cases of endoleak with significative sac growth. Conclusion: Perioperative mortality and morbidity after open and endovascular repair were acceptable in this series in patients with MFS. Because of the high risk of complications and reinterventions after TEVAR, however, we currently limited aortic stent grafting in selected patient in whom an aortic open repair is contraindicated or as bridge technique in urgent fashion.

45. Unruptured Aneurysms Italian Study (UAIS) background and method

Author

Versari, P., Tartara, F., Scerrati, M., Caroselli, G., Pasquini, U., Ciappetta, P., Vailati, G., Occhiogrosso, M., Biroli, F., Bonaldi, G., Calbucci, F., Andreoli, A., Leopardi, M., Raff, L., Bollati, A., Gasparotti, R., Martellotto, N., Distefano, G., Pinna, G., Francaviglia, N., Ventura, F., Orazio, G., Cristaudo, C., Consoli, V., Nicoletti, G., Albanese, V., Ceccotti, C., Frattarelli, M., Servadei, F., Cremonini, A. M., Taborelli, A., Corriero, G., Galli, G., Morandini, A., Medina, M., Padovani, R., Farneti, M., Ghadirpour, R., Dilorenzo, N., Mennonna, P., Ammannati, F., Mangiafico, S., Celerini, M., Paoli, L., Andrioli, G., Zerbi, D., Spaziante, R., Pau, A., Stefani, F., Zona, G. L., Castellan, L., Cantore, G., Innocenzi, G., Galzio, R., Ricci, A., Montinaro, A., Cantisani, P., Arena, O., Tonnarelli, G. P., Gagliardi, R., Benvenuti, L., Tomasello, F., Paterniti, S., Trincia, G., Conti, C., Broggi, G., Giombini, S., Solero, C. L., Marras, C., Todaro, C., Ciceri, E., Fornari, M., Desantis, A., Cardia, A., Ortolina, A., Rodriguez, R., Gaetani, P., Collice, M., D Aliberti, G., Talamonti, G., Lacamera, A., Boccardi, E., Villani, R., Gaini, S., Miserocchi, G., Branca, V., Giovanelli, M., Cenzato, M., Scotti, G., Merli, A., Piazza, P., Sganzerla, E., Profeta, G., Daniele, B., Monsignore, R., Cioffi, F., Rotondo, M., Natale, M., Dedivitiis, E., Maiuri, F., Francesco BRIGANTI, Franco, A., Apolito, R., Delehaye, L., Sossio, C., Bellotti, C., Car, P. G., Benvenuto, F., Scienza, R., Berlucchi, S., Pavesi, G., Fiore, D., Laseta, F., Filizzolo, F., Fiumara, E., Tumbiolo, S., Benericetti, E., Sacchelli, A., Arienta, C., Zappoli, F., Buoncristiani, P., Buonaguidi, R., Bianchini, E., Boccardo, M., Valsania, V., Bruzzone, L., Cantini, L. R., Marconi, F., Parenti, G. F., Liberti, G., Severino, P., Delitala, A., Cotroneo, E., Gazzeri, G., Fiume, D., Esposito, S., Agrillo, U., Sidoti, C., Maira, G., Vignati, A., Marchese, E., Delfini, R., Guidetti, G., Bufatti, P., Strabella, G., D Angelo, V., Monte, V., Florio, F., Olivieri, G., Palma, L., Serchi, E., Fontana, R., Resta, M., Faccani, G., Musso, C., Ducati, A., Bradac, G. B., Longatti, P., Tacconi, L., Skrap, M., Nicassio, N., Graziussi, G., Migliaccio, N., Puglisi, A., Tomei, G., Bonfanti, N., Tabano, A., Bricolo, A., Pasqualin, A., Beltramello, A., Colombo, F., Causin, F., and Perini, S.

Subjects
Embolization, Endovascular surgical procedures, Surgery, Cerebral aneurysms, Neurology (clinical), Surgical clipping, Cerebral aneurysms, Embolization

47. Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): For how long?

Author

Silvia Ferrari, Neal Shiv Chawla, Michela Pierini, Imran S. Syed, William E. Mendanha, Emanuela Marchesi, Anna Paioli, Kumar Sankhala, Madhuri Sudan, M. Piccinni Leopardi, Prarthana Parthasarathy, Sant P. Chawla, Emanuela Palmerini, P. Picci, Palmerini, E, Chawla, N.S., Ferrari, S., Sudan, M., Picci, P., Marchesi, E., Leopardi, M. Piccinni, Syed, I., Sankhala, K.K., Parthasarathy, P., Mendanha, W.E., Pierini, M., Paioli, A., and Chawla, S.P.

Subjects
Male, Cancer Research, Lung Neoplasms, Time Factors, Receptor activator of nuclear factor κB ligand, Cohort Studies, 0302 clinical medicine, GCTB, Giant Cell Tumor of Bone, Bone Density Conservation Agents, Femoral Neoplasms, Middle Aged, Primary tumor, Rash, Radius, medicine.anatomical_structure, Denosumab, Oncology, 030220 oncology & carcinogenesis, Toxicity, Disease Progression, Bisphosphonate-Associated Osteonecrosis of the Jaw, Female, medicine.symptom, medicine.drug, Adult, Sacrum, medicine.medical_specialty, Adolescent, ONJ, Skull Neoplasms, Bone Neoplasms, Young Adult, 03 medical and health sciences, Ischium, medicine, Giant-cell tumour of the bone, Humans, Adverse effect, Aged, Retrospective Studies, Spinal Neoplasms, Lung, Dose-Response Relationship, Drug, Tibia, business.industry, medicine.disease, Surgery, Peripheral neuropathy, Giant cell, business, 030217 neurology & neurosurgery
Abstract

Background Giant-cell tumours of bone (GCTB) are RANK/RANK-ligand (RANKL) positive, aggressive and progressive osteolytic tumours. Denosumab, a RANKL inhibitor, was FDA-approved for adults and skeletally mature adolescents with unresectable GCTB or when surgical resection is likely to result in severe morbidity. Data on long-term toxicity and activity of denosumab monthly ‘GCTB-schedule’ (120 mg per 12/year, 1440 mg total dose/year) are lacking. Methods Patients with GCTB receiving denosumab, 120 mg on days 1, 8, 15, 29 and every 4 weeks thereafter, from 2006 to 2015 treated in two centres were included. Long-term toxicity was evaluated. Results Ninety-seven patients were identified. 43 patients underwent resection of the tumour with a median time on denosumab treatment of 12 months (range 6–45 months). Fifty-four patients had unresectable GCTB's (male/female 23/31, median age 35 years [range: 13–76 years], 26% presented with lung metastases, 31% had primary tumor located to the spine, 63% were relapsed after previous surgery) with a median time on denosumab of 54 months (9–115 months). In the unresectable GCTB group, tumour control and clinical benefits were observed in all patients undergoing denosumab, whereas 40% of patients discontinuing denosumab had tumour progression after a median of 8 months (range 7–15 months). Adverse events Overall, six (6%) patients developed osteonecrosis of jaw (ONJ): 1/43 (2%) in the resectable group, 5/54 (9%) in the unresectable group, with a 5-year ONJ-free survival of 92% (95% CI 84–100). Only patients with prolonged treatment experienced mild peripheral neuropathy (6/54, 11%), skin rash (5/54, 9%), hypophosphataemia (2/54, 4%) and atypical femoral fracture (2/54, 4%). Conclusions Prolonged treatment with denosumab has sustained activity in GCTB, with a mild toxicity profile. The dose-dependent toxicity observed recommends a careful and strict monitoring of patients who need prolonged treatment. Decreased dose-intensity schedules should be further explored in unresectable GCTB.

Published
2017

48. CXCR4 in human osteosarcoma malignant progression. The response of osteosarcoma cell lines to the fully human CXCR4 antibody MDX1338

Author

Serena Pollino, Elisa Bientinesi, Emanuela Palmerini, Maria Serena Benassi, Martina Piccinni-Leopardi, Alberto Righi, Enrico Lucarelli, Barbara Dozza, Laura Pazzaglia, Pollino S., Palmerini E., Dozza B., Bientinesi E., Piccinni-Leopardi M., Lucarelli E., Righi A., Benassi M.S., and Pazzaglia L.

Subjects
0301 basic medicine, lcsh:Diseases of the musculoskeletal system, Prognosi, CXCR4 antagonist, medicine.medical_treatment, Metastasi, lcsh:RC254-282, CXCR4, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Biopsy, Medicine, Chemotherapy, medicine.diagnostic_test, business.industry, Mesenchymal stem cell, Sarcoma, Biomarker, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Cancer research, Osteosarcoma, lcsh:RC925-935, business, Research Article
Abstract

Osteosarcoma (OS) is the most frequent primary malignant tumour of bone and metastases occur in 30% of cases, the 5-year survival rate is 25–30%.Although pre- and post-operative chemotherapy has improved prognosis in osteosarcoma (OS), high toxicity and natural and acquired drug-resistance are the first cause of treatment failure. The identification of new predictive and therapeutic biomarkers may increase drug sensitivity and better control localized and metastatic disease. By the evidence that CXCR4 receptor by binding its ligand CXCL12 activates downstream critical endpoints for tumour malignancy, we first studied human OS progression correlating CXCR4 expression in OS biopsy with patient clinical data. By Real-time PCR and immunoistochemistry we found that high levels of CXCR4 gene and protein expression significantly correlated with OS progression, emphasizing the role of CXCR4/CXCL12 axis in tumour prognosis. This was supported by univariate analyses that showed a higher probability of local and/or systemic relapse in OS patients with a high CXCR4 gene expression and a significant increase of metastasis risk associated with an increasing score of CXCR4 protein staining intensity. Secondarily, to study the role of CXCR4 as a target for new therapeutic strategies, we evaluated the response of OS cells to the fully human CXCR4 antibody, MDX1338. In the study we also included AMD3100, the most studied CXCR4 antagonist.In CXCR4-positive OS cells cultured in CXCL12-rich BM-MCS-CM (bone marrow-derived mesenchymal stem conditioned medium), a decrease of cell proliferation up to 30%–40% of control was seen after drug exposure. However, an increase of apoptosis was seen in p53-positive U2OS and 143B after CXCR4 inhibitor incubation, while no changes were seen in treated SAOS-2 cells which also present a different labeling profile. The role of p53 in apoptotic response to CXCR4 inhibitors was confirmed by p53 silencing in U2OS cell line. Our data suggest that the response to anti-CXCR4 agents could be influenced by the genetic background and labeling profile which induces a different cross-talk between tumour cells and environment. The delay in cell cycle progression associated with increased apoptosis could sensitize p53-positive cells to conventional therapy and in vivo preclinical experiments are on going with the aim to suggest new combined target therapies in human OS. Keywords: Sarcoma, Metastasis, CXCR4 antagonists, Prognosis, Biomarkers

Published
2019

49. Original Off-Label Endovascular Solution to Occlude False Lumen Rupture in Chronic Type B Aortic Dissection

Author

Roberto Chiesa, Luca Bertoglio, Enrico Maria Marone, Daniele Mascia, Marco Leopardi, Marone, Em, Leopardi, M, Bertoglio, L, Mascia, D, and Chiesa, R

Subjects
Male, medicine.medical_specialty, Aortography, Time Factors, Computed Tomography Angiography, medicine.medical_treatment, Aortic Rupture, Dissection (medical), 030204 cardiovascular system & hematology, Prosthesis Design, 03 medical and health sciences, Aortic aneurysm, Blood Vessel Prosthesis Implantation, 0302 clinical medicine, Aneurysm, Blood vessel prosthesis, Occlusion, Multidetector Computed Tomography, medicine, Humans, Aortic rupture, medicine.diagnostic_test, Aortic Aneurysm, Thoracic, business.industry, Endovascular Procedures, nutritional and metabolic diseases, Stent, General Medicine, Middle Aged, medicine.disease, nervous system diseases, Surgery, Blood Vessel Prosthesis, Aortic Dissection, surgical procedures, operative, Treatment Outcome, 030228 respiratory system, Chronic Disease, cardiovascular system, Stents, Radiology, Cardiology and Cardiovascular Medicine, business
Abstract

After Thoracic Endovascular Aortic Repair (TEVAR) for chronic type B aortic dissection (cTBD), the patency of the false lumen is quite common and its presence is associated with the risk of developing complications and is a predictor of death by aortic rupture. We report a case of a patient treated in emergency for the rupture of the false lumen in cTBD. He had previous TEVAR with persisting distal dissection and retrograde reperfusion of the false lumen. We performed an original endovascular treatment with graft relining and false lumen occlusion with a homemade "candy plug" obtained with 2 commercially available stent grafts.

Published
2016

50. Late retrograde migration of a left subclavian artery chimney stent-graft into the innominate artery

Author

Roberto Chiesa, Andrea Kahlberg, Giampiero Negri, Alessandro Castiglioni, Yamume Tshomba, Marco Leopardi, Domenico Baccellieri, Germano Melissano, Leopardi, M, Tshomba, Yamume, Castiglioni, A, Baccellieri, D, Kahlberg, ANDREA LUITZ, Negri, Giampiero, Melissano, Germano, and Chiesa, Roberto

Subjects
Aortic arch, Male, Time Factors, Computed Tomography Angiography, medicine.medical_treatment, Thoracic, Subclavian Artery, Aorta, Thoracic, 030204 cardiovascular system & hematology, Pseudoaneurysm, 0302 clinical medicine, Foreign-Body Migration, Nuclear Medicine and Imaging, 030212 general & internal medicine, Aorta, Brachiocephalic Trunk, Aortic isthmic rupture, Endovascular Procedures, Thrombosis, Settore MED/22 - CHIRURGIA VASCOLARE, Ostium, surgical procedures, operative, medicine.anatomical_structure, Treatment Outcome, cardiovascular system, Chimney technique, Stents, Radiology, Cardiology and Cardiovascular Medicine, Artery, Traumatic aortic rupture, Adult, Reoperation, medicine.medical_specialty, Left subclavian artery, Thoracic endovascular aortic repair, Innominate artery, Open surgery, Stent-graft migration, Aortography, Blood Vessel Prosthesis Implantation, Device Removal, Hemodynamics, Humans, Prosthesis Design, Regional Blood Flow, Blood Vessel Prosthesis, Radiology, Nuclear Medicine and Imaging, 03 medical and health sciences, medicine.artery, medicine, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, business.industry, Stent, medicine.disease, Surgery, Median sternotomy, business
Abstract

Purpose: To report an uncommon case of chimney stent-graft migration in the aortic arch. Case Report: A 29-year-old man presented with chronic left arm hyposthenia after late displacement and thrombosis of a left subclavian artery (LSA) chimney graft that migrated retrogradely into the innominate artery 2 years after deployment. The self-expanding LSA chimney was placed during a redo procedure to repair a pseudoaneurysm and type I endoleak after an index emergency thoracic endovascular aortic repair for traumatic aortic rupture 1 year earlier. The patient was successfully treated in an elective procedure via a median sternotomy, with arch aortotomy under circulatory arrest to remove the proximal end of the thrombosed chimney graft from the ostium of the innominate trunk. Three months later, a left carotid-to-subclavian bypass was performed to restore flow to the left arm. Conclusion: Migration of the proximal end of an overly long chimney graft that moved freely in the aortic arch exposed the patient to a high risk of stroke and death. Because of the high-risk situation, open repair under circulatory arrest was elected to remove the proximal end of the chimney graft, with no major complications. Purpose: To report an uncommon case of chimney stent-graft migration in the aortic arch. Case Report: A 29-year-old man presented with chronic left arm hyposthenia after late displacement and thrombosis of a left subclavian artery (LSA) chimney graft that migrated retrogradely into the innominate artery 2 years after deployment. The self-expanding LSA chimney was placed during a redo procedure to repair a pseudoaneurysm and type I endoleak after an index emergency thoracic endovascular aortic repair for traumatic aortic rupture 1 year earlier. The patient was successfully treated in an elective procedure via a median sternotomy, with arch aortotomy under circulatory arrest to remove the proximal end of the thrombosed chimney graft from the ostium of the innominate trunk. Three months later, a left carotid-to-subclavian bypass was performed to restore flow to the left arm. Conclusion: Migration of the proximal end of an overly long chimney graft that moved freely in the aortic arch exposed the patient to a high risk of stroke and death. Because of the high-risk situation, open repair under circulatory arrest was elected to remove the proximal end of the chimney graft, with no major complications.

Published
2016

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