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  1. Article ; Online: Modified upside-down technique with Gore tapered iliac limbs for isolated iliac artery aneurysms.

    Pennetta, Federico Francisco / De Santis, Francesco / Millarelli, Massimiliano / Diotallevi, Nicolò / Chiappa, Roberto

    Vascular

    2024  , Page(s) 17085381241242859

    Abstract: Purpose: To describe the off-label use of tapered iliac limbs for the treatment of isolated iliac aneurysms with proximal landing zone significantly larger than distal landing zone.: Technique: Inversion of a Gore Excluder tapered leg (W. L. Gore & ... ...

    Abstract Purpose: To describe the off-label use of tapered iliac limbs for the treatment of isolated iliac aneurysms with proximal landing zone significantly larger than distal landing zone.
    Technique: Inversion of a Gore Excluder tapered leg (W. L. Gore & Associates Inc, Flagstaff, Arizona) with a modified upside-down technique is described. The endoprosthesis, with the olive at the tip of the releasing system previously cut, is inserted in a tip-to-tip fashion into a 15 Fr introducer sheath. The graft is released inside the introducer. An 18 Fr introducer sheath is advanced up to the proximal sealing zone. Following the removal of the 18 Fr dilator, the 15 Fr introducer with the pre-released graft is inserted co-axially into the 18 Fr introducer. A pre-cut 15 Fr dilator is brought up to the endograft and used as a pusher. A pull-back maneuver of the co-axial system, countertractioning with the dilator maintained in position, allows the delivery of the endograft.
    Conclusion: This technique might offer a feasible option in case of endovascular exclusion of isolated iliac artery aneurysms with significant landing zone diameter mismatch. Extracorporeal inversion is time-saving and could be safer in terms of graft damage and infection.
    Language English
    Publishing date 2024-03-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2137151-9
    ISSN 1708-539X ; 1708-5381
    ISSN (online) 1708-539X
    ISSN 1708-5381
    DOI 10.1177/17085381241242859
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Cavoatrial junction stenting in vascular hemodialysis catheter malfunction.

    Pennetta, Federico Francisco / Millarelli, Massimiliano / De Santis, Francesco / Bandiera, Alessandra / Tozzi, Matteo / Chiappa, Roberto

    The journal of vascular access

    2024  , Page(s) 11297298241250372

    Abstract: In patients undergoing hemodialytic treatment via intravascular catheters, stenosis or occlusion of central veins is common. Despite an extensive characterization of Superior Vena Cava Syndrome (SVCS) no data is available about CavoAtrial Junction (CAJ) ... ...

    Abstract In patients undergoing hemodialytic treatment via intravascular catheters, stenosis or occlusion of central veins is common. Despite an extensive characterization of Superior Vena Cava Syndrome (SVCS) no data is available about CavoAtrial Junction (CAJ) stenosis. We report the case of two patients with a story of multiple catheter failures due to thrombosis or infection. Computed tomography (CT) showed radiological signs of CAJ stenosis confirmed at the following venography. In absence of other feasible options to place a vascular access, the two underwent stenting with Gore Viabahn VBX balloon expandable endoprosthesis (W.L. Gore & Associates, Flagstaff, AZ, USA) of the CAJ stenosis. Completion venography showed complete resolution of the stenosis in both patients. No complications occurred during the procedures. At a mean follow-up of 878 ± 559 days no signs of in-stent restenosis or recoil were found. The present cases emphasize the feasibility and safety of CAJ stenting, underlining the importance of preserving CAJ and upper veins patency in hemodialysis access.
    Language English
    Publishing date 2024-05-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2252820-9
    ISSN 1724-6032 ; 1129-7298
    ISSN (online) 1724-6032
    ISSN 1129-7298
    DOI 10.1177/11297298241250372
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: First clinical experience with the Innova versus the Protege EverFlex self-expanding bare metal stents in superficial femoral artery occlusions.

    Gabrielli, Roberto / Rosati, Maria Sofia / Chiappa, Roberto / Millarelli, Massimiliano / Marcuccio, Luigi / Siani, Andrea / Caselli, Giovanni

    The Thoracic and cardiovascular surgeon

    2015  Volume 63, Issue 2, Page(s) 158–163

    Abstract: Background: To evaluate outcomes of superficial femoral artery (SFA) stenting with Boston Scientific Innova stent system (Boston Scientific Corporation Place, Natick, Massachusetts, United States) compared with ev3 Protege stent system (Endovascular, ... ...

    Abstract Background: To evaluate outcomes of superficial femoral artery (SFA) stenting with Boston Scientific Innova stent system (Boston Scientific Corporation Place, Natick, Massachusetts, United States) compared with ev3 Protege stent system (Endovascular, Inc., Plymouth, Minnesota, United States) in terms of safety and effectiveness and to identify factors predictive of restenosis.
    Methods: From March 2012 to January 2013, 71 patients with SFA TASC (Trans Atlantic Inter-Societal Consensus)-II B and C occlusive lesions were treated by percutaneous transluminal angioplasty with stenting (30 patients in the Innova group and 41 cases in the Protege group) and were evaluated by retrospective observational data analysis. Chi-square tests for categorical data and time to event provided two-sided p values with a level of significance at 0.05 and 95% confidence intervals (CIs). Survival curves for primary patency were plotted using the Kaplan-Meier method. Univariate analysis for diabetes, hypercholesterolemia, smoking, hypertension, and critical limb ischemia was performed according to the Cox proportional hazards model.
    Result: The mean follow-up was 14 months (range 1-18 months). The occlusive lesions treated were ≤15 cm in length. The 12-month primary patency rate was significantly higher in the Protege group (81.5%; 31/38) than the Innova group (43.3%; 13/30; hazard ratio [HR] 3.0; 95% CI: 1.38-6.8; p = 0.005. The secondary patency was similar to the primary comparison data and showed a significant advantage for the Protege stent (HR 2.9; 95% CI: 1.21-6.99; p = 0.01). Univariate analysis demonstrated that diabetes and smoking were significantly related to patency failure in both groups.
    Conclusions: SFA stenting is generally a safe procedure, but the effectiveness and patency rates are significantly lower for Innova than Protege. Furthermore, preoperative diabetes and smoking continue to be associated with low primary patency rate. These preliminary data suggest that Innova stent is not the treatment of choice for SFA lesions.
    MeSH term(s) Aged ; Angioplasty, Balloon/adverse effects ; Angioplasty, Balloon/instrumentation ; Angioplasty, Balloon/mortality ; Chi-Square Distribution ; Constriction, Pathologic ; Disease-Free Survival ; Female ; Femoral Artery/physiopathology ; Humans ; Kaplan-Meier Estimate ; Male ; Metals ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/mortality ; Peripheral Arterial Disease/physiopathology ; Peripheral Arterial Disease/therapy ; Proportional Hazards Models ; Prosthesis Design ; Recurrence ; Retrospective Studies ; Risk Factors ; Stents ; Time Factors ; Treatment Outcome ; Vascular Patency
    Chemical Substances Metals
    Language English
    Publishing date 2015-03
    Publishing country Germany
    Document type Comparative Study ; Journal Article ; Observational Study
    ZDB-ID 800050-5
    ISSN 1439-1902 ; 0171-6425 ; 0946-4778 ; 0172-6137
    ISSN (online) 1439-1902
    ISSN 0171-6425 ; 0946-4778 ; 0172-6137
    DOI 10.1055/s-0034-1396898
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Multiple instances of peripheral artery emboli from occult primary small cell lung cancer.

    Gabrielli, Roberto / Rosati, Maria Sofia / Chiappa, Roberto / Vitale, Silvio / Millarelli, Massimiliano / Caselli, Giovanni

    Texas Heart Institute journal

    2008  Volume 39, Issue 3, Page(s) 420–423

    Abstract: Most peripheral artery emboli originate in the heart, and systemic neoplastic emboli are infrequently associated with bronchogenic carcinoma. To our knowledge, there have been no reports of pulmonary vein infiltration by small cell lung cancer.We ... ...

    Abstract Most peripheral artery emboli originate in the heart, and systemic neoplastic emboli are infrequently associated with bronchogenic carcinoma. To our knowledge, there have been no reports of pulmonary vein infiltration by small cell lung cancer.We describe a highly unusual case of multiple instances of peripheral embolism as the first overt sign of occult primary small cell lung cancer. Tumor emboli infiltrated the pulmonary veins of a 62-year-old man who presented first with a transient ischemic attack and then with other ischemic symptoms. The uncommonly wide distribution of tumor emboli over a short time resulted in death.Improvements in diagnostic imaging have led to the early identification of relatively isolated small cell lung cancers. This patient's case underscores the importance of transesophageal echocardiography in detecting cardiac emboli when the cause of cerebral ischemic attack is unknown or if there might be multiple instances of arterial embolism. Computed tomography also has a role in the investigation of possible sources of emboli and unrecognized, asymptomatic embolization.
    MeSH term(s) Autopsy ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal ; Embolectomy ; Embolism/diagnosis ; Embolism/etiology ; Embolism/pathology ; Embolism/surgery ; Fatal Outcome ; Humans ; Ischemia/etiology ; Ischemic Attack, Transient/etiology ; Lung Neoplasms/complications ; Lung Neoplasms/diagnosis ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Neoplasms, Unknown Primary ; Pulmonary Veins/diagnostic imaging ; Pulmonary Veins/pathology ; Small Cell Lung Carcinoma/complications ; Small Cell Lung Carcinoma/diagnosis ; Small Cell Lung Carcinoma/pathology ; Tomography, X-Ray Computed ; Treatment Outcome
    Language English
    Publishing date 2008-11-21
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 604761-0
    ISSN 1526-6702 ; 0730-2347
    ISSN (online) 1526-6702
    ISSN 0730-2347
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: First Clinical Experience with the Innova versus the Protege EverFlex Self-Expanding Bare Metal Stents in Superficial Femoral Artery Occlusions

    Gabrielli, Roberto / Rosati, Maria Sofia / Chiappa, Roberto / Millarelli, Massimiliano / Marcuccio, Luigi / Siani, Andrea / Caselli, Giovanni

    The Thoracic and Cardiovascular Surgeon

    2015  Volume 63, Issue 02, Page(s) 158–163

    Abstract: Background: To evaluate outcomes of superficial femoral artery (SFA) stenting with Boston Scientific Innova stent system (Boston Scientific Corporation Place, Natick, Massachusetts, United States) compared with ev3 Protege stent system (Endovascular, ... ...

    Abstract Background: To evaluate outcomes of superficial femoral artery (SFA) stenting with Boston Scientific Innova stent system (Boston Scientific Corporation Place, Natick, Massachusetts, United States) compared with ev3 Protege stent system (Endovascular, Inc., Plymouth, Minnesota, United States) in terms of safety and effectiveness and to identify factors predictive of restenosis.
    Methods: From March 2012 to January 2013, 71 patients with SFA TASC (Trans Atlantic Inter-Societal Consensus)-II B and C occlusive lesions were treated by percutaneous transluminal angioplasty with stenting (30 patients in the Innova group and 41 cases in the Protege group) and were evaluated by retrospective observational data analysis. Chi-square tests for categorical data and time to event provided two-sided p values with a level of significance at 0.05 and 95% confidence intervals (CIs). Survival curves for primary patency were plotted using the Kaplan-Meier method. Univariate analysis for diabetes, hypercholesterolemia, smoking, hypertension, and critical limb ischemia was performed according to the Cox proportional hazards model.
    Result: The mean follow-up was 14 months (range 1–18 months). The occlusive lesions treated were ≤15 cm in length. The 12-month primary patency rate was significantly higher in the Protege group (81.5%; 31/38) than the Innova group (43.3%; 13/30; hazard ratio [HR] 3.0; 95% CI: 1.38–6.8; p  = 0.005. The secondary patency was similar to the primary comparison data and showed a significant advantage for the Protege stent (HR 2.9; 95% CI: 1.21–6.99; p  = 0.01). Univariate analysis demonstrated that diabetes and smoking were significantly related to patency failure in both groups.
    Conclusions: SFA stenting is generally a safe procedure, but the effectiveness and patency rates are significantly lower for Innova than Protege. Furthermore, preoperative diabetes and smoking continue to be associated with low primary patency rate. These preliminary data suggest that Innova stent is not the treatment of choice for SFA lesions.
    Keywords femoropopliteal lesions ; self-expanding bare metal stent system ; endovascular interventions ; restenosis factors
    Language English
    Publishing date 2015-01-20
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 800050-5
    ISSN 1439-1902 ; 0171-6425 ; 0946-4778 ; 0172-6137
    ISSN (online) 1439-1902
    ISSN 0171-6425 ; 0946-4778 ; 0172-6137
    DOI 10.1055/s-0034-1396898
    Database Thieme publisher's database

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