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Article: Current Debates in the Management of Visceral Artery Aneurysms: Where the Guidelines Collide.

Marone, Enrico Maria / Rinaldi, Luigi Federico

2023 Volume 12, Issue 9

Abstract: On one hand, the main difficulties in establishing a wide, evidence-based consensus about the best approach to visceral artery aneurysms (VAAs) and pseudoaneurysms (VAPAs) are the paucity of data, due to their rarity in the general population, and the ... ...

Abstract	On one hand, the main difficulties in establishing a wide, evidence-based consensus about the best approach to visceral artery aneurysms (VAAs) and pseudoaneurysms (VAPAs) are the paucity of data, due to their rarity in the general population, and the extreme heterogeneity of this group of diseases, which encompasses different aneurysm types, with different degrees of rupture risks according to their anatomical locations [...].
Language	English
Publishing date	2023-05-04
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12093267
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Endovascular and Open Surgical Treatment of Ruptured Splenic Artery Aneurysms: A Case Report and a Systematic Literature Review.

Rinaldi, Luigi Federico / Brioschi, Chiara / Marone, Enrico Maria

Journal of clinical medicine

2023 Volume 12, Issue 18

Abstract: Background: Ruptured splenic artery aneurysms (r-SAA), although rare, are burdened by high morbidity and mortality, even despite emergent surgical repair. It is suggested that endovascular treatment can achieve reduction in peri-operative death and ... ...

Abstract	Background: Ruptured splenic artery aneurysms (r-SAA), although rare, are burdened by high morbidity and mortality, even despite emergent surgical repair. It is suggested that endovascular treatment can achieve reduction in peri-operative death and complication rates, as in other vascular diseases, but evidence of such benefits is still lacking in this particular setting. We report a case of an r-SAA treated by trans-arterial embolization and then converted to open surgery for persistent bleeding, and we provide a systematic review of current results of open and endovascular repair of r-SAAs. Materials and methods: A 50-year-old male presenting in shock for a giant r-SAA underwent emergent coil embolization and recovered hemodynamic stability. On the following day, he underwent laparotomy for evacuation of the huge intraperitoneal hematoma, but residual bleeding was noted from the splenic artery, which was ligated after coil removal, and a splenectomy was performed. A systematic literature review of the reported mortality and complications of r-SAA undergoing open (OSR) or endovascular (EVT) treatment was performed using the main search databases. All primary examples of research published since 1990 were included regardless of sample size. The main outcome measures were mortality and reinterventions. Secondary outcomes were post-operative complications. Results: We selected 129 studies reporting on 350 patients-185 treated with OSR and 165 with EVT. Hemodynamically unstable patients and ruptures during pregnancy were more frequently treated with open repair. Overall, there were 37 deaths (mortality: 10.6%)-24 in the OSR group and 13 in the EVTr group (mortality: 12.9% and 7.8% respectively, Conclusions: Current results of r-SAA treatment show equipoise terms of morbidity and mortality between open and endovascular repair; however, in case of hemodynamic instability and rupture during pregnancy, open surgery might still be safer. Moreover, endovascular repair is still burdened by a significantly higher rate of reinterventions, mostly with conversions to open surgery.
Language	English
Publishing date	2023-09-20
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12186085
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Article ; Online: Current Debates in the Management of Visceral Artery Aneurysms

Enrico Maria Marone / Luigi Federico Rinaldi

Journal of Clinical Medicine, Vol 12, Iss 3267, p

Where the Guidelines Collide

2023 Volume 3267

Abstract	On one hand, the main difficulties in establishing a wide, evidence-based consensus about the best approach to visceral artery aneurysms (VAAs) and pseudoaneurysms (VAPAs) are the paucity of data, due to their rarity in the general population, and the extreme heterogeneity of this group of diseases, which encompasses different aneurysm types, with different degrees of rupture risks according to their anatomical locations [.]
Keywords	n/a ; Medicine ; R
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Endovascular and Open Surgical Treatment of Ruptured Splenic Artery Aneurysms

Luigi Federico Rinaldi / Chiara Brioschi / Enrico Maria Marone

Journal of Clinical Medicine, Vol 12, Iss 6085, p

A Case Report and a Systematic Literature Review

2023 Volume 6085

Abstract	Background: Ruptured splenic artery aneurysms (r-SAA), although rare, are burdened by high morbidity and mortality, even despite emergent surgical repair. It is suggested that endovascular treatment can achieve reduction in peri-operative death and complication rates, as in other vascular diseases, but evidence of such benefits is still lacking in this particular setting. We report a case of an r-SAA treated by trans-arterial embolization and then converted to open surgery for persistent bleeding, and we provide a systematic review of current results of open and endovascular repair of r-SAAs. Materials and Methods: A 50-year-old male presenting in shock for a giant r-SAA underwent emergent coil embolization and recovered hemodynamic stability. On the following day, he underwent laparotomy for evacuation of the huge intraperitoneal hematoma, but residual bleeding was noted from the splenic artery, which was ligated after coil removal, and a splenectomy was performed. A systematic literature review of the reported mortality and complications of r-SAA undergoing open (OSR) or endovascular (EVT) treatment was performed using the main search databases. All primary examples of research published since 1990 were included regardless of sample size. The main outcome measures were mortality and reinterventions. Secondary outcomes were post-operative complications. Results: We selected 129 studies reporting on 350 patients—185 treated with OSR and 165 with EVT. Hemodynamically unstable patients and ruptures during pregnancy were more frequently treated with open repair. Overall, there were 37 deaths (mortality: 10.6%)—24 in the OSR group and 13 in the EVTr group (mortality: 12.9% and 7.8% respectively, p -value: 0.84). There were 37 reinterventions after failed or complicated endovascular repair —6 treated with endovascular re-embolization and 31 with laparotomy and splenectomy (22.4%); there were 3 (1.6%) reinterventions after open repair. Overall complication rates were 7.3% in the EVT group ( n : 12) and 4.2% in the OSR ...
Keywords	ruptured splenic aneurysms ; splenic artery aneurysms and pseudoaneurysms ; visceral aneurysms ; splanchnic aneurysms ; transarterial artery embolization ; splenectomy ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Five-Year Outcomes of Endovascular Aortic Repair With the TREO Abdominal Endograft.

Marone, Enrico Maria / Marazzi, Giulia / Brioschi, Chiara / Rinaldi, Luigi Federico

Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists

2023 , Page(s) 15266028231170161

Abstract: Purpose: Newer generation abdominal endografts, including Treo (Terumo Aortic, Sunrise, Florida), have shown optimal safety and effectiveness in treating abdominal aortic aneurysms (AAAs), even with hostile anatomy over the short- and mid-term. The ... ...

Abstract	Purpose: Newer generation abdominal endografts, including Treo (Terumo Aortic, Sunrise, Florida), have shown optimal safety and effectiveness in treating abdominal aortic aneurysms (AAAs), even with hostile anatomy over the short- and mid-term. The durability of such results, however, is still a controversial issue, due to the paucity of long-term data. Our aim is to show the long-term outcomes of endovascular aortic repair of both standard and hostile AAAs with the Treo endograft on a cohort of patients treated between 2016 and 2017. Methods: We analyzed the postoperative follow-up of 37 consecutive patients who have undergone endovascular aortic repair (EVAR) with the Treo Endograft between 2016 and 2017, whose baseline clinical conditions, operative data, and short-term outcomes had been published in 2018. All patients were followed up by computed tomography angiography (CTA) at 6 and 12 months and 5 years postoperatively. Primary endpoints were aortic-related mortality, type I-III endoleak (EL), and reintervention rate. Secondary endpoints were the rates of type II ELs and aneurysm sac regression. Results: Of 37 patients, 27 had at least one criterion of anatomic hostility and 11 were performed outside the device-specific instructions for use (IFU). In the perioperative period, we observed 100% technical success, with no perioperative mortality. Over a mean follow-up of 5.5 years (66 months), 3 patients (8.1%) were lost to follow-up and 3 (8.1%) died of non-aortic causes (overall survival: 91.9%). One type IA EL of an AAA with a hostile neck (but within the IFU) and a type III EL of an AAA with standard anatomy were observed and treated by endovascular relining (overall reintervention rate: 5.5%). Four type II ELs were associated with aneurysm sac stability over time and are still under surveillance. Mean aneurysm shrinkage was 11.25±8.30 mm. Conclusion: The optimal results of the Treo Endograft in terms of complication and reintervention rates reported over the mid-term by the current literature (ITA-ENDOBOOT registry) are maintained on the long term, both in case of hostile and friendly aortic anatomy, with a satisfactory shrinkage rate of the aneurysm sac. Clinical impact: The innovative characteristics of Treo and its short-term results are well-known and reported. The present case series contributes to the scientific validation of a new-generation abdominal aortic endograft over the long-term, focusing especially on its performance in treating AAAs with hostile anatomy. Its 5-years outcomes confirm the optimal results already reported over the short- and mid-term.
Language	English
Publishing date	2023-04-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2006618-1
ISSN	1545-1550 ; 1526-6028
ISSN (online)	1545-1550
ISSN	1526-6028
DOI	10.1177/15266028231170161
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Zs.A 4547: Show issues

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Article ; Online: Reply. Use of low-molecular-weight heparin in COVID-19 patients.

Marone, Enrico Maria / Rinaldi, LuigiFederico

2020

Keywords	covid19
Language	English
Publishing country	it
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Endovascular-First Approach for Symptomatic Carotid Artery Stenosis in a COVID-19 Positive Patient: Expected and Unexpected Advantages.

Rinaldi, Luigi Federico / Brioschi, Chiara / Marazzi, Giulia / Pallini, Maura / Marone, Enrico Maria

Annals of vascular surgery

2022 Volume 83, Page(s) e1–e2

MeSH term(s)	COVID-19 ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/surgery ; Endarterectomy, Carotid ; Humans ; Stents ; Stroke ; Treatment Outcome
Language	English
Publishing date	2022-03-03
Publishing country	Netherlands
Document type	Letter
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.01.018
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Zs.A 2882: Show issues

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Article ; Online: Endovascular Treatment of a Ruptured Pararenal Abdominal Aortic Aneurysm in a Patient With Coronavirus Disease-2019: Suggestions and Case Report.

Rinaldi, Luigi Federico / Marazzi, Giulia / Marone, Enrico Maria

Annals of vascular surgery

2020 Volume 66, Page(s) 18–23

Abstract: The aim of this report is to discuss emergent repair for complex aortic diseases in patients affected by novel coronavirus pneumonia (coronavirus disease-2019 [COVID-19]), describing a case of ruptured pararenal aortic aneurysm. An eighty-year-old man ... ...

Abstract	The aim of this report is to discuss emergent repair for complex aortic diseases in patients affected by novel coronavirus pneumonia (coronavirus disease-2019 [COVID-19]), describing a case of ruptured pararenal aortic aneurysm. An eighty-year-old man with COVID-19 was admitted for ruptured aneurysm of the pararenal aorta and hemorrhagic shock. Endovascular repair was chosen, and a proximal extension of the previous abdominal endograft was performed with parallel stents in the right renal artery and the superior mesenteric artery. Endovascular treatment and early anticoagulation are the key for success for vascular emergencies in patients with COVID-19, despite the risk of late endoleak.
MeSH term(s)	Aged, 80 and over ; Aortic Aneurysm, Abdominal/surgery ; Aortic Aneurysm, Abdominal/virology ; Aortic Rupture/surgery ; Aortic Rupture/virology ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Endovascular Procedures ; Humans ; Male ; Pandemics ; Pneumonia, Viral/complications ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-15
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2020.05.011
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 2882: Show issues

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Article ; Online: Mini-Surgical Access Prevents Local Complications and Reduces Costs in Endovascular Aortic Repair.

Marone, Enrico Maria / Brioschi, Chiara / Pallini, Maura / Marazzi, Giulia / Chierico, Simona / Rinaldi, Luigi Federico

Annals of vascular surgery

2022 Volume 86, Page(s) 111–116

Abstract: Background: This study aims to propose a minimally invasive surgical approach to the common femoral artery in endovascular aortic repair and assess its value by a single-center retrospective study including 118 patients.: Methods: Between 2017 and ... ...

Abstract	Background: This study aims to propose a minimally invasive surgical approach to the common femoral artery in endovascular aortic repair and assess its value by a single-center retrospective study including 118 patients. Methods: Between 2017 and 2022, all patients receiving endovascular treatment for thoracic and abdominal aortic aneurysms in our center had the anterior wall of the common femoral artery exposed, through a 2-3 cm transverse groin incision, instead of a complete surgical cutdown. We access the artery with a purse-string suture, held tight with a tourniquet. After procedure completion, we tie the purse-string closing the arteriotomy. We retrospectively analyzed the cohort of all consecutive patients treated with endovascular aortic repair in this period and recorded primary and assisted technical success, operative time, in-hospital length of stay, access failure, and access-related complications, comparing the results with the current literature. Results: All procedures were successful, with no perioperative mortality. Primary technical success was achieved in 116 patients; 2 required adjunctive procedures. No access failure or access-related complications (thrombosis, groin hematoma, lymphocele, wound dehiscence, or infection) occurred. Two accesses required conversion to complete femoral artery exposure and endarterectomy. Operatory time and length of in-hospital stay were comparable to the outcomes of the major studies reporting on percutaneous access, saving the costs of the closure devices. Conclusions: Minimally invasive surgical access is safe and feasible for endovascular aortic procedures. Compared to the costs of percutaneous access found in literature, it is cost-effective. It can be chosen whenever the percutaneous approach is not feasible or at a high risk of complications.
MeSH term(s)	Humans ; Retrospective Studies ; Treatment Outcome ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/surgery ; Aortic Aneurysm, Abdominal/etiology ; Endovascular Procedures ; Femoral Artery/diagnostic imaging ; Femoral Artery/surgery ; Blood Vessel Prosthesis Implantation
Language	English
Publishing date	2022-06-15
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.05.014
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Zs.A 2882: Show issues

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Article ; Online: Parallel graft techniques for urgent complex aortic diseases: Mid-term results of 12 cases.

Rinaldi, Luigi F / Chierico, Simona / Marazzi, Giulia / Marone, Enrico Maria

Vascular

2020 Volume 28, Issue 6, Page(s) 675–682

Abstract: Objectives: Open repair is still the first choice for thoraco-abdominal and para-renal aortic aneurysms, but surgical treatment is burdened by significant morbidity and mortality, especially in urgent setting. Endovascular treatment by fenestrated or ... ...

Abstract	Objectives: Open repair is still the first choice for thoraco-abdominal and para-renal aortic aneurysms, but surgical treatment is burdened by significant morbidity and mortality, especially in urgent setting. Endovascular treatment by fenestrated or branched endografts is feasible and safe; but in urgent/emergent settings, custom-made endografts are hardly available in due time, and the repair with standard multibranched devices is still debated in cases with complex anatomy. Parallel grafting, on the other hand, which exploits covered stents to preserve patency of the visceral vessels, has been shown as a valuable option and can be performed in urgency, though some concerns still remain regarding its durability and complications. The purpose of this case series is to review the outcomes of all consecutive cases of complex aortic diseases treated with this technique in emergent/urgent setting. Materials and methods: All cases of endovascular aortic repair of thoraco-abdominal and para-thoraco-abdominal performed in urgency or emergency from 2016 to June 2019 were retrospectively reviewed, recording clinical records, operative technique, primary technical success, and long-term outcomes. Each patient was followed-up by computed tomography angiography three months after the procedure and yearly thereafter. Results: Twenty consecutive patients (median age: 68, range: 47-89, male/female ratio: 16:4) affected by para-thoraco-abdominal (12) or thoraco-abdominal (8) were treated in urgent or emergent setting by chimney and/or periscope technique. A total number of 37 visceral vessels were stented (29 renal arteries, 1 polar artery of the kidney, 3 superior mesenteric arteries, and 4 coeliac trunks). Primary technical success was 100%, with one perioperative death. One patient died on post-operative month III for unrelated cause. Two type II endoleaks were detected at the first post-operative imaging studies and were managed conservatively. One type IB endoleak was treated by endovascular repair with a custom-made endograft (overall re-intervention rate: 5%). Over a median 22 months follow-up (range: 4-40, interquartile range: 12 months), all stentgrafts were patent. Conclusion: Parallel graft is a feasible and safe option that should be considered in urgent and emergent treatment of para-thoraco-abdominal and thoraco-abdominal, when fenestrated and branched endografts cannot be used.
MeSH term(s)	Aged ; Aged, 80 and over ; Aneurysm, Dissecting/diagnostic imaging ; Aneurysm, Dissecting/mortality ; Aneurysm, Dissecting/surgery ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/mortality ; Aortic Aneurysm, Abdominal/surgery ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/mortality ; Aortic Aneurysm, Thoracic/surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/instrumentation ; Blood Vessel Prosthesis Implantation/mortality ; Endoleak/etiology ; Endoleak/therapy ; Endovascular Procedures/adverse effects ; Endovascular Procedures/instrumentation ; Endovascular Procedures/mortality ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Stents ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2020-05-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2137151-9
ISSN	1708-539X ; 1708-5381
ISSN (online)	1708-539X
ISSN	1708-5381
DOI	10.1177/1708538120923189
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Zs.A 4277: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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