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350 results on '"Zannoli, Romano"'

1. Passive Aortic Counterpulsation to Reduce Pressure Pulse During Aortic Prosthesis Insertion and Reduce Endoleaks Formation: A Preliminary In Silico Investigation.

Author

Corazza, Ivan, Olivieri, Michela, Casadei, Lorenzo, Rossi, Pier Luca, and Zannoli, Romano

Subjects
INTRA-aortic balloon counterpulsation, CARDIOVASCULAR system, SYSTOLIC blood pressure, OPERATIVE surgery, PROSTHETICS
Abstract

Over 10% of patients undergoing aortic endograft implantation experience endoleaks within a few years. In the case of type 1a endoleaks, a crack forms between the aorta and the prosthesis collar, allowing blood to pass. This blood fills the aneurysmal sac and can lead to its rupture. None of the strategies, such as prostheses with barbs and hooks or ad hoc pharmacological therapies, can prevent the phenomenon. An alternative approach is to reduce diameter oscillations due to pulsating pressure to improve the endoprosthesis adhesion to the internal vessel walls during the initial post-implantation phases. To reach this objective, we propose to use a passive intra-aortic balloon pump (PIABP) inserted and then maintained inside the vessel immediately after the surgical procedure. We tested our hypothesis in a mechanical mock of the cardiovascular system. A silicon aorta with physiological behavior was created for this purpose. The PIABP was inflated to increasing pressures between systolic and diastolic values (120/80 mmHg). For each aorta and each condition, the variations in aortic diameter between systole and diastole, and the pressure variations, were measured. For the normal aorta, with a PIABP pressure of 110 mmHg, the variations in diameter were reduced by 38%. Assuming an endoprosthesis with a diameter of 30 mm (oversized by 5% compared to the diastolic diameter), the time the oscillations are higher than 30 mm is also reduced by 36%. The results are positive and suggest the usefulness of a biomechanical approach to the problem of type 1a endoleaks. Further in silico and clinical trials are necessary to validate the method. [ABSTRACT FROM AUTHOR]

Published
2024
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9. BIOMECHANICAL OPTIMIZATION OF CO2 ANGIOGRAPHY.

Author

ZANNOLI, ROMANO, CORAZZA, IVAN, NERI, LUCA, CASADEI, LORENZO, and MONTI, LUCA

Subjects
*CARBON dioxide injection, *ANGIOGRAPHY, *THREE-dimensional imaging, *CONE beam computed tomography, *CONTRAST media
Abstract

Carbon dioxide (CO2) angiography represents an important technique to overcome most clinical problems related to the use of iodine contrast medium. The recent technologic advancements in the fields of gas injection and image reconstructions made CO2 angiography a very efficient method for clinical evaluation of peripheral cardiovascular system. Despite that, some challenges are still open and a better knowledge of the biomechanical behavior of CO2 and its interactions with blood flowing into the vessels is necessary to optimize this technology and to expand its field of application. This paper presents a quick overview about biomechanical behavior of carbon dioxide during injection, suggesting possible optimization tricks to make CO2 angiography procedures more effective to improve imaging and reduce the patients' radiological dose. Particular attention has been also paid to 3D imaging techniques, which can certainly be opened to the use of carbon dioxide. [ABSTRACT FROM AUTHOR]

Published
2023
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30. Understanding the basic concepts of CO2 angiography.

Author

Zannoli, Romano, Bianchini, David, Rossi, Pier Luca, Caridi, James G., and Corazz, Ivan

Subjects
*ANGIOGRAPHY, *RADIOLOGY, *CARBON dioxide, *ALGORITHMS, *MEDICAL physics
Abstract

The diagnostic quality of carbon dioxide angiography depends both on optimal setting of radiological aspects (X-ray emission and image post-processing) and on the mechanical behavior of the injected gas bubbles. The gas behavior differs in large cavities (d > 12 mm), medium sized vessels (d > 6 mm), and small diameter vessels (d < 6 mm): to optimize the result the operator has to adapt his action to the physical rules governing the phenomenon in the particular situation. In most cases, it is impossible to fill a vessel completely with gas, and to obtain an adequate angiogram, the gas volume and injection pressure must be properly selected, patient's position must be adjusted and radiological image optimization algorithms, like Digital Subtraction Angiography (DSA) and stacking, must be applied. In this optimization process, the cultural and practical intervention of a medical physicist is fundamental. Obtaining a good quality CO2 angiogram is not only a matter of medical operator experience or radiological system performance, but involves matching a wide knowledge of medical physics to particular pathophysiological conditions and to unusual measurement tests. Most medical physicists are used to dealing mainly with radiological problems, and other physical aspects are considered beyond their interest. In CO2 angiography, non-radiological aspects strongly interfere with radiological issues and an optimal result can only be obtained by tackling the two simultaneously. [ABSTRACT FROM AUTHOR]

Published
2016
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31. Dynamic planar myocardial perfusion imaging in patients with one-vessel disease with intracoronary injection of technetium 99m teboroxime during papaverine-induced coronary hyperemia

Author

Tartagni, Flavio, Fallani, Francesco, Corbelli, Claudio, Monetti, Nino, Piovaccari, Giancarlo, Marzocchi, Antonio, Zannoli, Romano, Branzi, Angelo, Magnani, Bruno, Heo, Jaekyeong, and Iskandrian, Abdulmassih S.

Subjects
Regional blood flow -- Measurement, Papaverine -- Physiological aspects, Arteries -- Stenosis, Health
Published
1996

38. Internal low energy atrial cardioversion: efficacy and safety in older patients with chronic atrial fibrillation

Author

Boriani, Giuseppe, Biffi, Mauro, Magagnoli, Giorgia, Zannoli, Romano, and Branzi, Angelo

Subjects
Electric countershock -- Research, Atrial fibrillation -- Care and treatment, Cardiovascular research -- Analysis, Aged patients -- Care and treatment, Health, Seniors
Abstract

This article evaluates the safety and effectiveness of internal low-energy atrial cardioversion, a new technique that delivers intracardiac shocks using transvenous catheters, for patients with chronic atrial fibrillation. Findings indicate that this is a safe and effective procedure for restoring normal sinus rhythm in young and old patients with atrial fibrillation.

Published
2001

45. Automated carbon dioxide digital angiography for lower-limb arterial disease evaluation: safety assessment and comparison with standard iodinated contrast media angiography

Author

Scalise, Filippo, Novelli, Eugenio, Auguadro, Carla, Casali, Valentina, Manfredi, Mariella, ZANNOLI, ROMANO, Scalise, Filippo, Novelli, Eugenio, Auguadro, Carla, Casali, Valentina, Manfredi, Mariella, and Zannoli, Romano

Subjects
RISK, ARTERIOGRAPHY, Male, Comparative Effectiveness Research, Iodine Compounds, VENA CAVOGRAPHY, Angiography, Digital Subtraction, Contrast Media, AORTIC-ANEURYSM REPAIR, Arteries, Carbon Dioxide, Peripheral Arterial Disease, SUBTRACTION-ANGIOGRAPHY, KIDNEY, ENHANCEMENT, Injections, Intra-Arterial, Lower Extremity, Dimensional Measurement Accuracy, EXPERIENCE, Feasibility Studies, Humans, Female, CO2 ANGIOGRAPHY, AGENT, Aged
Abstract

Carbon dioxide (CO2) has been validated as a contrast agent in a large series of studies. A particular advantages of CO2 over iodinated contrast medium (ICM) is the absence of nephrotoxicity and allergic reactions. One of the limitations of CO2 angiography is the difficulty of CO2 manual injection due to its compressibility. The manual gas injection does not permit optimal control of the gas output. Development of an automated CO2 injector has overcome these problems.This study compares the feasibility, safety, and diagnostic accuracy of automated CO2 digital subtraction angiography (DSA) in comparison with ICM-DSA in the evaluation of critical limb ischemic (CLI) patients.We performed DSA with both CO2 and ICM on 40 consecutive CLI patients and directly compared the two techniques. Sixteen females and 24 males participated in the study (mean age, 71.7 years). We assessed the diagnostic accuracy of CO2 in identifying arterial stenosis in the lower limb, with ICM-DSA used as the gold standard.The overall diagnostic accuracy of CO2-DSA was 96.9% (sensitivity, 99.0%; specificity, 96.1%; positive predictive value, 91.1%; negative predictive value, 99.6%). Tolerable minor symptoms occurred in 3 patients. No allergic reactions or significant decline in renal function were observed in patients receiving the CO2 injection.Carbon dioxide DSA is a valuable and safe alternative to traditional ICM-DSA for evaluating CLI patients. This modality should be considered as the standard choice for CLI patients undergoing angiographic evaluation who are known to have renal insufficiency or contrast allergy.

Published
2015

48. Proceedings of ICMMB2014

Author

Zannoli, Romano, Corazza, Ivan, and Stagni, Rita

Subjects
FIS/07 Fisica applicata (a beni culturali, ambientali, biologia e medicina), ING-INF/06 Bioingegneria elettronica e informatica, MED/34 Medicina fisica e riabilitativa, biomechanics, mechanics, medicine, biology, modeling, Proceedings ICMMB, BIO/11 Biologia molecolare, MAT/08 Analisi numerica, MED/33 Malattie apparato locomotore, MED/36 Diagnostica per immagini e radioterapia, ING-IND/34 Bioingegneria industriale, MED/11 Malattie dell'apparato cardiovascolare
Published
2014
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49. DOSE EVALUATION IN INTERVENTIONAL RADIOLOGY EMPLOYING NUMERICAL MODELS

Author

Gualdrini Gianfranco, Venturi Giovanna, Ferrari Paolo, ROSSI, PIER LUCA, MARISELLI, MATTEO, ZANNOLI, ROMANO, NOLAN HERTEL, Gualdrini Gianfranco, Venturi Giovanna, Ferrari Paolo, Rossi PL, Mariselli Matteo, and Zannoli Romano

Abstract

Interventional radiology, among guided RX procedures, is a methodology characterized by high level of doses, both for the patient and for the medical staff. The aim of the present study is to estimate the dose associated to coronary angiography procedures by means of numerical models (simplified and anthropomorphic) and MCNP Monte Carlo code. Numerical estimates were supported by measurement performed with a Dose Area Product meter that is commonly employed in such kind of studies. In the present work the main considerations and the preliminary results are presented.

Published
2008

50. Dose Optimization in Cardiovascular Interventional Radiology

Author

Zannoli, Romano, Bianchini, David <1983>, Zannoli, Romano, and Bianchini, David <1983>

Abstract

The thesis treat the patient dose optimization in Carbon Dioxide Angiography and dose reduction with the using of Clarity Philips in EP procedures. Carbon dioxide angiography is based on the visualization (i.e., the radiographic contrast) of gas bubbles injected in blood vessels. By using an experimental X-ray bench, it has been measured the energy response of a flat panel detector (Varian CB4030) and, with a dedicated phantom and a software simulation, the image contrast of vessels injected with Iodine and CO2. The results show that the contrast generated by carbon dioxide is about one fourth of that obtained with iodine, demonstrating that CO2 angiography should use different radiological settings with respect to iodine angiography. In particular, a kVp increase have a lower reduction of CNR with carbon dioxide than with iodinated CM, suggesting possible technological improvements in fluoroscopy protocols. The aim of the second work has been to evaluate the patient dose comparison between before and after the introduction of the Philips Clarity system upgrade. The retrospective study has been made on 561 procedures of pacemaker (PM) and implantable cardioverter defibrillator (ICD) implantations (134 pre, 192 post), and 235 procedures of radio frequency ablation (RFA) procedures (91 pre, 144 post). The pre and post sets are compared over clinical details in order to define an average patient for each intervention type. Each procedure has been studied over single irradiation event collected in the Structure Dose Report (SDR). The Dose-Area Product (PkA) cumulative quantities is not normal distributed over a single procedure type, so a log-normal hypothesis has been made. The results shows a significant reduction of the for the PkA equal to 54% over all the procedures. The total fluoroscopy time didn’t change appreciably and this shows in first instance that that the subjective image quality didn't change too.

Published
2016

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