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Article ; Online: Fenestrated Endograft Eclipse After Spinal Surgery.

Feroldi, Francesca Maria / Gallitto, Enrico

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

2023 Volume 66, Issue 4, Page(s) 549

Language	English
Publishing date	2023-07-29
Publishing country	England
Document type	Journal Article
ZDB-ID	1225869-6
ISSN	1532-2165 ; 1078-5884
ISSN (online)	1532-2165
ISSN	1078-5884
DOI	10.1016/j.ejvs.2023.07.046
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Zs.A 2283: 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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Article ; Online: Stent Graft Induced Thoracic Aortic Rupture After 10 Years.

Spath, Paolo / Gallitto, Enrico

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

2022 Volume 64, Issue 1, Page(s) 48

MeSH term(s)	Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Aortic Rupture ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Humans ; Stents ; Treatment Outcome
Language	English
Publishing date	2022-02-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1225869-6
ISSN	1532-2165 ; 1078-5884
ISSN (online)	1532-2165
ISSN	1078-5884
DOI	10.1016/j.ejvs.2022.02.008
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Zs.A 2283: 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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Article ; Online: Aortic Tortuosity Due to Late Migration of Multibranched Endograft.

Mirandola, Veronica / Gallitto, Enrico

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

2022 Volume 64, Issue 4, Page(s) 338

MeSH term(s)	Humans ; Stents ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation/adverse effects ; Prosthesis Design ; Treatment Outcome ; Endovascular Procedures/adverse effects ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/surgery
Language	English
Publishing date	2022-07-16
Publishing country	England
Document type	Journal Article
ZDB-ID	1225869-6
ISSN	1532-2165 ; 1078-5884
ISSN (online)	1532-2165
ISSN	1078-5884
DOI	10.1016/j.ejvs.2022.07.011
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Zs.A 2283: 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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Article ; Online: Medical and interventional outcome of dissection of the cervical arteries. Systematic review and meta-analysis.

Pini, Rodolfo / Faggioli, Gianluca / Lodato, Marcello / Campana, Federica / Vacirca, Andrea / Gallitto, Enrico / Gargiulo, Mauro

Journal of vascular surgery

2024

Abstract: Introduction: The management of cervical artery dissections (CAD) is poorly standardized given the scarce number of prospective studies comparing medical and interventional approach to CAD. The aim of the present study is to perform a systematic review ... ...

Abstract	Introduction: The management of cervical artery dissections (CAD) is poorly standardized given the scarce number of prospective studies comparing medical and interventional approach to CAD. The aim of the present study is to perform a systematic review and meta-analysis of studies on the treatments of CAD. Methods: Systematic review and meta-analysis - pre-registered on PROSPERO (CRD42022297512) and performed according to the PRISMA guidelines searching in three different databases (PubMed, Embase and Cochrane Database) - of studies on medical or interventional approach to the CAD. Only prospective studies were selected in order to reduce the risk of bias for the primary meta-analysis. Secondarily retrospective studies were also included. The aim was to assess the rate of stroke and of stroke/death/bleeding (major or intracranial) by Der Simonian-Laird weights of random effects model. Results: After screening 456 articles, 6 prospective and 22 retrospective studies were identified. Two randomized controlled trials and 5 retrospective studies comparing antiplatelet (APT) vs. oral anticoagulant therapy (OAC) for CAD were identified, as well as 4 prospective and 17 retrospective single-arm studies evaluating stenting for CAD. In the meta-analysis of RCTs comparing APT vs OAC, 444 patients were considered and a borderline significant association was identified in terms of stroke/death in APT vs OAC groups (OR 5.6; 95% CI: 0.94-33.38, P=.06, I
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2024.04.036
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Article ; Online: Iliac "paving & cracking" technique for transcatheter aortic valve implantation.

Gallitto, Enrico / Palmerini, Tullio / Saia, Francesco / Gargiulo, Mauro

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

2022 Volume 100, Issue 3, Page(s) 464–470

Abstract: Challenging femoral/iliac access (CA) can lead to vascular complications which can hamper the clinical benefit of transfemoral (TF) transcatheter aortic valve implantation (TAVI). In this sense, iliac artery rupture is a severe complication associated ... ...

Abstract	Challenging femoral/iliac access (CA) can lead to vascular complications which can hamper the clinical benefit of transfemoral (TF) transcatheter aortic valve implantation (TAVI). In this sense, iliac artery rupture is a severe complication associated with significant morbidity and mortality. We report a case of TF-TAVI managed with the "paving and cracking technique" to overcome CA.
MeSH term(s)	Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/complications ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Femoral Artery/diagnostic imaging ; Humans ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/methods ; Treatment Outcome
Language	English
Publishing date	2022-07-28
Publishing country	United States
Document type	Case Reports
ZDB-ID	1459995-8
ISSN	1522-726X ; 1522-1946
ISSN (online)	1522-726X
ISSN	1522-1946
DOI	10.1002/ccd.30344
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Zs.A 1226: Show issues

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Article ; Online: The mid-term results of the Carotid Asymptomatic Stenosis (CARAS) observational study.

Pini, Rodolfo / Faggioli, Gianluca / Rocchi, Cristina / Fronterrè, Sara / Lodato, Marcello / Vacirca, Andrea / Gallitto, Enrico / Gargiulo, Mauro

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2024 Volume 33, Issue 2, Page(s) 107508

Abstract: Introduction: Carotid endarterectomy (CEA) in patients with asymptomatic carotid stenosis (ACAS) remains a subject of debate. Current recommendations are based on randomized trials conducted over 20 years ago and improvements in medical therapies may ... ...

Abstract	Introduction: Carotid endarterectomy (CEA) in patients with asymptomatic carotid stenosis (ACAS) remains a subject of debate. Current recommendations are based on randomized trials conducted over 20 years ago and improvements in medical therapies may have reduced the risk of cerebral ischemic events (CIE). This study presents a mid-term analysis of results from an ongoing prospective observational study of ACAS patients to assess their CIE risk in a real-world setting. Methods: This is a prospective observational cohort study of patients with ACAS >60 % (NASCET criteria) identified in a single duplex ultrasonography (DUS) vascular laboratory (trial registered: NCT04825080). Patients were not considered for CEA due to their short life expectancy (<3 year) or absence of signs of plaque vulnerability (ulceration, ipoechogenic core). Patient enrollment started in January 2019 and ended in March 2020 with a targeted sample size of 300 patients.A 5-year follow-up was scheduled. Clinical characteristics, risk factors, and medical therapies were documented, and, when necessary, the best medical therapy (BMT), involving antiplatelet agents, blood pressure control, and statins, was recommended during clinical visits. The primary endpoint was to asses CIEs (including strokes, transient ischemic attacks, amaurosis-fugax) ipsilateral to ACAS along with plaque progression rate and patients survival. Follow-up involved annual clinical visit and carotid DUS examination, complemented by telephone interviews at six-month intervals. Results: The study included 307 patients, with an average age of 80 ± 7 years, of whom 55 % were male. Contralateral stenosis exceeding 60 % was present in 61 (20 %) patients. Seventy-seven percent of patients were on BMT. At a mean follow-up of 41±9 months, 7 ispilateral strokes and 9 TIAs occurred, resulting in 14 CIEs (2 patients experienced both TIA and stroke). According to Kaplan-Meier analysis, the 4-year CIE rate was 6±2 %, with an annual CIE rate of 1.5 %. Fifty-eight (19 %) patients had a stenosis progression which was associated with a higher 4-year estimated CIE rate compared to patients with stable plaque (10.3 % vs 3.2 %, P=.01). Similarly, a contralateral carotid stenosis >60 % was associated with a higher 4-year estimated CIE rate: 11.7 % vs 2.9 %, P=.002. These factors were independently associated with high risk for CIE at the multivariate COX analysis: Hazard Ratio (HR): 3.2; 95 % Confidence Interval: 1.1-9.2 and HR: 3.6; 95 % CI: 1.2-10.5. Conclusion: The mid-term results of this prospective study suggest that the incidence of CIE in ACAS patients should not be underestimated, with plaque progression and contralateral stenosis serving as primary predictors of CIEs.
MeSH term(s)	Humans ; Male ; Aged ; Aged, 80 and over ; Female ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/therapy ; Constriction, Pathologic/complications ; Prospective Studies ; Cohort Studies ; Disease Progression ; Stroke/etiology ; Stroke/complications ; Endarterectomy, Carotid/adverse effects ; Risk Factors ; Ischemic Attack, Transient/diagnostic imaging ; Ischemic Attack, Transient/epidemiology ; Ischemic Attack, Transient/etiology ; Treatment Outcome
Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2023.107508
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Zs.A 3519: Show issues

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Article ; Online: Type II endoleaks after fenestrated/branched endografting for juxtarenal and pararenal aortic aneurysms.

Gallitto, Enrico / Faggioli, Gian Luca / Campana, Federica / Feroldi, Francesca Maria / Cappiello, Antonio / Caputo, Stefania / Pini, Rodolfo / Gargiulo, Mauro

Journal of vascular surgery

2024

Abstract: Objective: Persistent type II endoleaks (pEL2s) are not uncommon after endovascular aneurysm repair and their impact on long-term outcomes is well-documented. However, their occurrence and natural history after fenestrated/branched endografting (F/B- ... ...

Abstract	Objective: Persistent type II endoleaks (pEL2s) are not uncommon after endovascular aneurysm repair and their impact on long-term outcomes is well-documented. However, their occurrence and natural history after fenestrated/branched endografting (F/B-EVAR) for juxtarenal and pararenal aneurysms (J/P-AAAs) have been scarcely investigated. Aim of this study was to report incidence, risk factors, and natural history of pEL2 after F/B-EVAR in J/P-AAAs. Methods: Between 2016 and 2022, all J/P-AAAs undergoing F/B-EVAR were prospectively collected and retrospectively analyzed. EL2 were assessed at the completion angiography, at 30 days and after 6 months as primary outcomes. Preoperative risk factors for pEL2, follow-up survival, freedom from reinterventions (FFR) and aneurysm shrinkage (≥5 mm) were considered as secondary outcomes. Results: Of 132 patients, there were 88 (67%) JAAAs and 44 (33%) PAAAs. Seventeen EL2 (13%) were detected at the completion angiography and 36 (27%) at 30-day computed tomography angiography. The mean follow-up was 28 ± 23 months. Eleven (31%) EL2 sealed spontaneously within 6 months and three new cases were detected, for an overall of 28 pEL2/107 patients (26%) with available radiological follow-up of ≥6 months. Preoperative antiplatelet therapy (odds ratio, 4.7; 95% confidence interval [CI[, 1-22.1; P = .05), aneurysm thrombus volume of ≤40% and six or more patent aneurysm afferent vessels (odds ratio, 7.2; 95% CI, 1.8-29.1; P = .005) were independent risk factors for pEL2. The estimated 3-year survival was 80%, with no difference between cases with and without pEL2 (78% vs 85%; P = .08). The estimated 3-year FFR was 86%, with no difference between cases with and without pEL2 (81% vs 87%; P = .41). Four cases (3%) of EL2-related reinterventions were performed. In 65 cases (49%), aneurysm shrinkage was detected. pEL2 was an independent risk factor for absence of aneurysm shrinkage during follow-up (hazard ratio, 3.2; 95% CI, 1.2-8.3; P = .014). Patients without shrinkage had lower follow-up survival (64% vs 86% at 3-year; P = .009) and FFR (74% vs 90% at 3 years; P = .014) than patients with shrinkage. Conclusions: PEL2 is not infrequent (26%) after F/B-EVAR for J/P-AAAs and is correlated with preoperative antiplatelet therapy, aneurysm thrombus volume of ≤40%, and six or more patent sac afferent vessels. Patients with pEL2 have a diminished aneurysm shrinkage, which is correlated with lower follow-up survival and FFR compared with patients with aneurysm shrinkage.
Language	English
Publishing date	2024-01-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2024.01.197
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Article ; Online: Impact of iliac access in elective and non-elective endovascular repair of abdominal aortic aneurysm.

Spath, Paolo / Campana, Federica / Gallitto, Enrico / Pini, Rodolfo / Mascoli, Chiara / Sufali, Gemmi / Caputo, Stefania / Sonetto, Alessia / Faggioli, Gianluca / Gargiulo, Mauro

The Journal of cardiovascular surgery

2024

Abstract: Endovascular aortic repair (EVAR) is nowadays the establishment treatment for patients with abdominal aortic aneurysm (AAA) both in elective and urgent setting. Despite the large applicability and satisfactory results, the presence of hostile iliac ... ...

Abstract	Endovascular aortic repair (EVAR) is nowadays the establishment treatment for patients with abdominal aortic aneurysm (AAA) both in elective and urgent setting. Despite the large applicability and satisfactory results, the presence of hostile iliac anatomy affects both technical and clinical success. This narrative review aimed to report the impact of iliac access and related adjunctive procedures in patients undergoing EVAR in elective and non-elective setting. Hostile iliac access can be defined in presence of narrowed, tortuous, calcified, or occluded iliac arteries. These iliac characteristics can be graded by the anatomic severity grade score to quantitatively assess anatomic complexity before undergoing treatment. Literature shows that iliac hostility has an impact on device navigability, insertion and perioperative and postoperative results. Overall, it has been correlated to higher rate of access issues, representing up to 30% of the first published EVAR experience. Recent innovations with low-profile endografts have reduced large-bore sheaths related issues. However, iliac-related complications still represent an issue, and several adjunctive endovascular and surgical strategies are nowadays available to overcome these complications during EVAR. In urgent settings iliac hostility can significantly impact on particular time sensitive procedures. Moreover, in case of severe hostility patients might be written off for EVAR repair might be inapplicable, exposing to higher mortality/morbidity risk in this urgent/emergent setting. In conclusion, an accurate anatomical evaluation of iliac arteries during preoperative planning, materials availability, and skilled preparation to face iliac-related issues are crucial to address these challenges.
Language	English
Publishing date	2024-04-18
Publishing country	Italy
Document type	Journal Article
ZDB-ID	80143-4
ISSN	1827-191X ; 0021-9509
ISSN (online)	1827-191X
ISSN	0021-9509
DOI	10.23736/S0021-9509.24.12987-4
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Zs.A 469: Show issues

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Article ; Online: Pre-emptive False Lumen Embolization to Prevent Persistent Type II Endoleak in Fenestrated-Branched Endovascular Repair of Post-Dissection Thoracoabdominal Aortic Aneurysms.

Gallitto, Enrico / Faggioli, Gianluca / Poliseno, Carmine / Cappiello, Antonio / Pini, Rodolfo / Vacirca, Andrea / Logiacco, Antonino / Gargiulo, Mauro

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

2024 , Page(s) 15266028241246656

Abstract: Purpose: The purpose was to describe a technique to promote false lumen (FL) thrombosis in post-dissection thoracoabdominal aortic aneurysms (PD-TAAAs) managed by fenestrated/branched endografting (F/B-EVAR).: Technique: A 5/6Fr-90 cm length sheath ... ...

Abstract	Purpose: The purpose was to describe a technique to promote false lumen (FL) thrombosis in post-dissection thoracoabdominal aortic aneurysms (PD-TAAAs) managed by fenestrated/branched endografting (F/B-EVAR). Technique: A 5/6Fr-90 cm length sheath is advanced from the true lumen (TL) to FL through the most distal entry tear of the infrarenal aorta or iliac arteries. It is parked in the most cranial portion of the FL in the thoracic aorta. Aortic endografts are deployed in the TL excluding all the para-visceral/distal entry tears and target visceral vessels bridging stenting is performed. A selective FL angiography is performed through the 5/6Fr sheath to detect the origin of all segmentary arteries. Embolization of FL is performed from above to below by M-reye pushable coils, obtaining the packaging of FL. After completion angiography, the 5/6Fr sheath is retrieved in external iliac artery and molding ballooning of the distal segment of the aortic/iliac endograft is performed. Between 2019 and 2023, this technique was applied in 11cases with a median number of 73 (interquartile range [IQR=12) coils. Out of 8 (72%) patients with available radiological follow-up at 1 year, 7 exhibited complete FL thrombosis. Conclusions: The FL coiling in PD-TAAAs managed by F/B-EVAR is feasible, safe, and effective to promote the complete FL thrombosis. Clinical impact: Preemptive false lumen embolization is a feasible, safe, and effective technique for preventing persistent type II endoleaks after fenestrated-branched endovascular repair of post-dissection thoracoabdominal aortic aneurysms. This technique may be routinely recommended to promote FL thrombosis and aortic remodeling after FB-EVAR in PD-TAAAs, thereby reducing the incidence of reinterventions during follow-up.
Language	English
Publishing date	2024-04-24
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	10.1177/15266028241246656
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Zs.A 4547: Show issues

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Article ; Online: Morphological and Clinical Predictors of Early/Follow-up Failure of the Endovascular Infrarenal Abdominal Aneurysm Repair With Currently Available Endografts.

Gallitto, Enrico / Faggioli, Gianluca / Mascoli, Chiara / Goretti, Martina / Pini, Rodolfo / Logiacco, Antonino / Rocchi, Cristina / Feroldi, Francesca / Caputo, Stefania / Gargiulo, Mauro

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

2023 , Page(s) 15266028231158312

Abstract: Purpose: To report outcomes of endovascular repair (EVAR) of infrarenal abdominal aortic aneurysms (AAAs) with currently-available endografts and identify predictors of technical/clinical failure.: Materials and methods: Patients undergoing EVAR ... ...

Abstract	Purpose: To report outcomes of endovascular repair (EVAR) of infrarenal abdominal aortic aneurysms (AAAs) with currently-available endografts and identify predictors of technical/clinical failure. Materials and methods: Patients undergoing EVAR between 2012 and 2020 were prospectively collected and retrospectively analyzed. Technical success (TS: no type I-III endoleaks, renal/hypogastric arteries loss, iliac leg occlusion, conversion to open repair and mortality within 24 postoperative hour), proximal neck-related TS (nr-TS: no proximal type I endoleaks, unplanned renal arteries coverage), and 30-day mortality were assessed as early outcomes. Proximal type I endoleak (ELIa), survival and freedom from reinterventions (FFRs) were assessed during follow-up. Uni/multivariate analysis and Cox-regression were used to identified factors associated with early and follow-up outcomes; FFR and survival were assessed by Kaplan-Meier analysis. Results: A total of 710 were included. Technical success and nr-TS were 692 (98%) and 700 (99%), respectively. The presence of ≥2 hostile anatomical infrarenal neck characteristics was associated with technical failure (odds ratio [OR]: 2.4; 95% confidence interval [CI]: 1.3-4.1; p: 0.007). Infrarenal neck angle >90° (OR: 2.88; 95% CI: 9.6-50.3; p: 0.004), barrel shape (OR: 2.33; 95% CI: 11.1-100.3; p: 0.02) or presence of ≥2 hostile anatomical infrarenal neck characteristics (OR: 2.16; 95% CI: 2.5-5.3; p: 0.03) were independent risk factors for neck-related technical failures. Six (0.8%) patients died within 30 postoperative days. Chronic obstructive pulmonary disease (OR: 16; 95% CI: 1.1-218.3; p: 0.04) and urgent repair (OR: 15; 95% CI: 1.8-119.6; p: 0.01) were independent risk factors for 30-day mortality. The mean follow-up was 53±13 months. There were 12 (1.7%) ELIa during follow-up. Infrarenal neck length <15 mm (hazard ratio [HR]: 2.8; 95% CI: 1.9-9.6; p: 0.005), diameter >28 mm (HR: 2.7; 95% CI: 1.6-9.5; p: 0.006), angle ≥90° (HR: 2.7; 95% CI: 8.3-50.1; p: 0.007), and persistent type II endoleak (HR: 2.9; 95% CI: 1.6-10.1; p: 0.004) were independent risk factors for ELIa. Freedom from reintervention was 91% at 5 years. The ELIa was an independent risk factor for reinterventions during follow-up (HR: 29.5; 95% CI: 1.4-1.6; p<0.001). Survival was 74% at 5 years with 2 cases (0.3%) of late aortic-related mortality. Peripheral arterial occlusive disease (HR: 1.9; 95% CI: 1.4-3.65; p: 0.03), aneurysm diameter ≥65 mm (HR: 2.2; 95% CI: 1.4-3.26; p<0.001), and infrarenal neck length <15 mm (HR: 1.7; 95% CI: 1.2-2.35; p: 0.04) were independent risk factors for mortality during follow-up. Conclusion: Endovascular repair with currently-available endografts has high TS and low 30-day mortality. Survival and FFRs were satisfactory at mid-term. Pre/postoperative risk factors for technical and clinical failure were identified and they should be considered in EVAR indication and postoperative management to reduce complications and improve mid-term outcome. Clinical impact: Pre and postoperative risk factors for technical and clinical EVAR failure can be identified and they should be considered in EVAR indication and postoperative management to reduce complications and improve mid-term outcome.
Language	English
Publishing date	2023-03-04
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	10.1177/15266028231158312
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