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Accarino G, Benenati A, Accarino G, De Vuono F, Fornino G, Galasso G, Bracale UM. Endovascular treatment of an aortocaval fistula caused by a late type II endoleak. J Vasc Surg Cases Innov Tech 2024; 10:101436. [PMID: 38435789 PMCID: PMC10907850 DOI: 10.1016/j.jvscit.2024.101436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/08/2024] [Indexed: 03/05/2024] Open
Abstract
An aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysms (AAAs) and constitute <1% of all AAAs, which increases from 2% to 6.7% in ruptured AAAs. Unlike other aortic ruptures, most ACFs are not associated with significant blood loss on admission. The traditional treatment strategy has been open surgery, which is associated with a high mortality rate. Endovascular repair has been performed; however, the results are difficult to interpret due to the low incidence of ACFs and the absence of cases reported with a long follow-up duration. We report the case of a 78-year-old man with previous endovascular aneurysm repair performed in 2015, who presented to our emergency department 6 years later with abdominal pain. A computed tomography angiography scan showed type Ia, Ib, and II endoleaks and an ACF. The endoleaks were selectively treated, and the ACF was covered with a polytetrafluoroethylene endograft inserted in the inferior vena cava. In our single-case experience with a medium-term follow-up of 24 months, our treatment was safe and effective for ACF closure, with no further signs of endoleak or graft thrombosis. We conducted a literature review of reported cases in which a covered stent graft was used for ACF treatment. Although no guidelines are currently available regarding this rare late complication after endovascular aneurysm repair, using a covered stent placed in the inferior vena cava to treat an ACF could be a viable option in selected cases.
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Affiliation(s)
- Giulio Accarino
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
- Vascular Surgery Unit, Department of Public Health, University Federico II of Naples, Naples, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Alessandra Benenati
- Vascular Surgery Unit, Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Giancarlo Accarino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Francesco De Vuono
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Giovanni Fornino
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Umberto Marcello Bracale
- Vascular Surgery Unit, Department of Public Health, University Federico II of Naples, Naples, Italy
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Turchino D, Peluso A, Accarino G, Accarino G, De Rosa C, D'Angelo A, Machi P, Mirabella D, Pecoraro F, Del Guercio L, Bracale UM, Dinoto E. A multicenter experience of three different "iliac branched" stent grafts for the treatment of aorto-iliac and/or iliac aneurysms. Ann Vasc Surg 2023:S0890-5096(23)00148-6. [PMID: 36921795 DOI: 10.1016/j.avsg.2023.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND The aim of study was to assess the safety and effectiveness of 3 different commercial iliac branch devices (IBDs): the Zenith Branch Iliac Endovascular Graft; the Gore Excluder Iliac Branch System and the E-liac Stent Graft System for the treatment of aorto-iliac or iliac aneurysms. METHODS From January 2017 to February 2020, a retrospective reviewed was conducted on a total of 96 patients. Primary endpoint was IBD instability rate at 24-months. Secondary endpoints included onset of any endoleaks, buttock claudication, IBD-related reintervention and all-death rates, post-operative acute kidney and changes in maximum diameter from baseline of the aortic aneurysmal sac. RESULTS At 24 months, the branch instability rate was similar amongst the three IBDs employed [Jotec 1/24 (4.1%), Gore 1/12 (8.3%), Cook 6/47 (12.7%), p-value = 0.502]. As well, no statistical difference in terms of branch-occlusion and branch-related endoleaks was observed. The Jotec group showed a significant decrease in maximum diameter from the baseline of the aortic aneurysmal sac when compared to the Gore group alone. No other differences were found relevant to the onset of any endoleaks, reinterventions and all-death rates. At 24-months, the Kaplan-Meier estimate of survival freedom from any branch instability was 95.8%, 91.6% and 86.8% for Jotec, Gore and Cook groups, respectively. CONCLUSIONS The use of IBDs represents a safe method for preserving patency of the IIA during treatment of aorto-iliac or iliac aneurysms providing a low rate of IBD instability.
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Affiliation(s)
- Davide Turchino
- Department of Public Health, Vascular Surgery Unit, University Federico II of Naples, Italy
| | - Antonio Peluso
- Department of Public Health, Vascular Surgery Unit, University Federico II of Naples, Italy
| | - Giancarlo Accarino
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Giulio Accarino
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Carmela De Rosa
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Antonio D'Angelo
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Pietro Machi
- Vascular Surgery Unit - AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy
| | - Domenico Mirabella
- Vascular Surgery Unit - AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy
| | - Felice Pecoraro
- Vascular Surgery Unit - AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy
| | - Luca Del Guercio
- Department of Public Health, Vascular Surgery Unit, University Federico II of Naples, Italy
| | | | - Ettore Dinoto
- Vascular Surgery Unit - AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy.
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3
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Martelli E, Sotgiu G, Saderi L, Federici M, Sangiorgi G, Zamboni M, Martelli AR, Accarino G, Bianco G, Bonanno F, Bracale UM, Cappello E, Cioffi G, Colacchio G, Crinisio A, De Vivo S, Dionisi CP, Flora L, Impedovo G, Intrieri F, Iorio L, Maritati G, Modugno P, Monaco M, Natalicchio G, Palazzo V, Petrosino F, Pompeo F, Pulli R, Razzano D, Ruggieri MR, Ruotolo C, Sangiuolo P, Vigliotti G, Volpe P, Biello A, Boggia P, Boschetti M, Centritto EM, Condò F, Cucciolillo L, D’Amodio AS, De Laurentis M, Desantis C, Di Lella D, Di Nardo G, Disabato A, Ficarelli I, Gasparre A, Giordano AN, Luongo A, Massara M, Molinari V, Padricelli A, Panagrosso M, Petrone A, Pisanello S, Prunella R, Tedesco M, Settembrini AM. How the First Year of the COVID-19 Pandemic Impacted Patients' Hospital Admission and Care in the Vascular Surgery Divisions of the Southern Regions of the Italian Peninsula. J Pers Med 2022; 12:jpm12071170. [PMID: 35887667 PMCID: PMC9316551 DOI: 10.3390/jpm12071170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/29/2022] Open
Abstract
Background: To investigate the effects of the COVID-19 lockdowns on the vasculopathic population. Methods: The Divisions of Vascular Surgery of the southern Italian peninsula joined this multicenter retrospective study. Each received a 13-point questionnaire investigating the hospitalization rate of vascular patients in the first 11 months of the COVID-19 pandemic and in the preceding 11 months. Results: 27 out of 29 Centers were enrolled. April-December 2020 (7092 patients) vs. 2019 (9161 patients): post-EVAR surveillance, hospitalization for Rutherford category 3 peripheral arterial disease, and asymptomatic carotid stenosis revascularization significantly decreased (1484 (16.2%) vs. 1014 (14.3%), p = 0.0009; 1401 (15.29%) vs. 959 (13.52%), p = 0.0006; and 1558 (17.01%) vs. 934 (13.17%), p < 0.0001, respectively), while admissions for revascularization or major amputations for chronic limb-threatening ischemia and urgent revascularization for symptomatic carotid stenosis significantly increased (1204 (16.98%) vs. 1245 (13.59%), p < 0.0001; 355 (5.01%) vs. 358 (3.91%), p = 0.0007; and 153 (2.16%) vs. 140 (1.53%), p = 0.0009, respectively). Conclusions: The suspension of elective procedures during the COVID-19 pandemic caused a significant reduction in post-EVAR surveillance, and in the hospitalization of asymptomatic carotid stenosis revascularization and Rutherford 3 peripheral arterial disease. Consequentially, we observed a significant increase in admissions for urgent revascularization for symptomatic carotid stenosis, as well as for revascularization or major amputations for chronic limb-threatening ischemia.
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Affiliation(s)
- Eugenio Martelli
- Department of General and Specialist Surgery, Sapienza University of Rome, 155 Viale del Policlinico, 00161 Rome, Italy
- Saint Camillus International University of Health Sciences, 8 Via di Sant’Alessandro, 00131 Rome, Italy
- Division of Vascular Surgery, S. Anna and S. Sebastiano Hospital, Via F. Palasciano, 81100 Caserta, Italy;
- Correspondence: (M.Z.); (E.M.); Tel.: +39-3490611365 (M.Z.); +39-3294003220 (E.M.)
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro, 07100 Sassari, Italy; (G.S.); (L.S.)
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro, 07100 Sassari, Italy; (G.S.); (L.S.)
| | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, 1 Viale Montpellier, 00133 Rome, Italy;
| | - Giuseppe Sangiorgi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 1 Viale Montpellier, 00133 Rome, Italy;
| | - Matilde Zamboni
- Division of Vascular Surgery, Saint Martin Hospital, 22 Viale Europa, 32100 Belluno, Italy
- Correspondence: (M.Z.); (E.M.); Tel.: +39-3490611365 (M.Z.); +39-3294003220 (E.M.)
| | - Allegra R. Martelli
- Medicine and Surgery School of Medicine, Campus Bio-Medico University of Rome, 21 Via À. del Portillo, 00128 Rome, Italy;
| | - Giancarlo Accarino
- San Giovanni Di Dio e Ruggi d’Aragona Hospital, Via San Leonardo s.n.c., 84125 Salerno, Italy;
| | - Giuseppe Bianco
- San Giovanni Bosco Hospital, 225 Via F. M. Briganti, 80144 Naples, Italy; (G.B.); (M.B.)
| | - Francesco Bonanno
- Madonna delle Grazie Hospital, Via Montescaglioso s.n.c., 75100 Matera, Italy;
| | - Umberto M. Bracale
- Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 Via S. Pansini, 80131 Naples, Italy; (U.M.B.); (F.C.); (M.P.); (A.P.)
| | - Enrico Cappello
- Mediterranean Neurological Institute NEUROMED, 18 Via Atinense, 80122 Naples, Italy; (E.C.); (F.P.)
| | - Giovanni Cioffi
- Pellegrini Hospital, 41 Via Portamedina alla Pignasecca, 80134 Naples, Italy; (G.C.); (S.D.V.); (A.S.D.)
| | - Giovanni Colacchio
- F. Miulli Hospital, Km. 4100 Strada Provinciale 127 Acquaviva-Santeramo, 70021 Acquaviva delle Fonti, Italy; (G.C.); (A.G.)
| | - Adolfo Crinisio
- Salus Clinic, 4 Via F. Confalonieri, 84091 Battipaglia, Italy; (A.C.); (G.D.N.)
| | - Salvatore De Vivo
- Pellegrini Hospital, 41 Via Portamedina alla Pignasecca, 80134 Naples, Italy; (G.C.); (S.D.V.); (A.S.D.)
| | | | - Loris Flora
- San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy;
| | - Giovanni Impedovo
- SS. Annunziata Hospital, 1 Via F. Bruno, 74121 Taranto, Italy; (G.I.); (S.P.); (R.P.)
| | - Francesco Intrieri
- Annunziata Hospital, 1 Via Migliori, 87100 Cosenza, Italy; (F.I.); (V.M.)
| | - Luca Iorio
- Cardarelli Hospital, 1 Via U. Petrella, 86100 Campobasso, Italy; (L.I.); (L.C.)
| | - Gabriele Maritati
- A. Perrino Hospital, Strada Statale 7 per Mesagne, 72100 Brindisi, Italy; (G.M.); (P.B.)
| | - Piero Modugno
- Gemelli Molise Hospital, Catholic University of the Sacred Heart, 1 Largo A. Gemelli, 86100 Campobasso, Italy; (P.M.); (E.M.C.)
| | - Mario Monaco
- Pineta Grande Hospital, Km. 30 Via Domitiana, 81030 Castelvolturno, Italy;
| | | | - Vincenzo Palazzo
- Casa Sollievo della Sofferenza Hospital, Viale Cappuccini s.n.c., 71013 San Giovanni Rotondo, Italy; (V.P.); (A.N.G.)
| | - Fernando Petrosino
- San Luca Hospital, 1 Via F. Cammarota, 84078 Vallo della Lucania, Italy; (F.P.); (A.L.)
| | - Francesco Pompeo
- Mediterranean Neurological Institute NEUROMED, 18 Via Atinense, 80122 Naples, Italy; (E.C.); (F.P.)
| | - Raffaele Pulli
- Polyclinic of Bari, Department of Emergency and Organs Transplantation, Aldo Moro University of Bari, 11 Piazza Giulio Cesare, 70124 Bari, Italy; (R.P.); (C.D.)
| | - Davide Razzano
- San Pio Hospital, 1 Via dell’angelo, 82100 Benevento, Italy;
| | | | - Carlo Ruotolo
- Cardarelli Hospital, 9 Via A. Cardarelli, 80131 Naples, Italy; (C.R.); (I.F.)
| | - Paolo Sangiuolo
- Monaldi Hospital, Via L. Bianchi s.n.c., 84100 Naples, Italy; (P.S.); (M.D.L.)
| | - Gennaro Vigliotti
- Del Mare Hospital, 11 Via E. Russo, 80147 Naples, Italy; (G.V.); (D.D.L.)
| | - Pietro Volpe
- Bianchi-Melacrino-Morelli Hospital, 21 Via G. Melacrino, 89124 Reggio di Calabria, Italy; (P.V.); (M.M.)
| | - Antonella Biello
- Venere Hospital, 1 Via Ospedale di Venere, 70131 Bari, Italy; (G.N.); (A.B.)
| | - Pietro Boggia
- A. Perrino Hospital, Strada Statale 7 per Mesagne, 72100 Brindisi, Italy; (G.M.); (P.B.)
| | - Michelangelo Boschetti
- San Giovanni Bosco Hospital, 225 Via F. M. Briganti, 80144 Naples, Italy; (G.B.); (M.B.)
| | - Enrico M. Centritto
- Gemelli Molise Hospital, Catholic University of the Sacred Heart, 1 Largo A. Gemelli, 86100 Campobasso, Italy; (P.M.); (E.M.C.)
| | - Flavia Condò
- Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 Via S. Pansini, 80131 Naples, Italy; (U.M.B.); (F.C.); (M.P.); (A.P.)
- San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy;
| | - Lucia Cucciolillo
- Cardarelli Hospital, 1 Via U. Petrella, 86100 Campobasso, Italy; (L.I.); (L.C.)
| | - Amodio S. D’Amodio
- Pellegrini Hospital, 41 Via Portamedina alla Pignasecca, 80134 Naples, Italy; (G.C.); (S.D.V.); (A.S.D.)
| | - Mario De Laurentis
- Monaldi Hospital, Via L. Bianchi s.n.c., 84100 Naples, Italy; (P.S.); (M.D.L.)
| | - Claudio Desantis
- Polyclinic of Bari, Department of Emergency and Organs Transplantation, Aldo Moro University of Bari, 11 Piazza Giulio Cesare, 70124 Bari, Italy; (R.P.); (C.D.)
| | - Daniela Di Lella
- Del Mare Hospital, 11 Via E. Russo, 80147 Naples, Italy; (G.V.); (D.D.L.)
| | - Giovanni Di Nardo
- Salus Clinic, 4 Via F. Confalonieri, 84091 Battipaglia, Italy; (A.C.); (G.D.N.)
| | - Angelo Disabato
- Cardinal Panico Hospital, 4 Via San Pio X, 73039 Tricase, Italy; (C.P.D.); (A.D.)
| | - Ilaria Ficarelli
- Cardarelli Hospital, 9 Via A. Cardarelli, 80131 Naples, Italy; (C.R.); (I.F.)
| | - Angelo Gasparre
- F. Miulli Hospital, Km. 4100 Strada Provinciale 127 Acquaviva-Santeramo, 70021 Acquaviva delle Fonti, Italy; (G.C.); (A.G.)
| | - Antonio N. Giordano
- Casa Sollievo della Sofferenza Hospital, Viale Cappuccini s.n.c., 71013 San Giovanni Rotondo, Italy; (V.P.); (A.N.G.)
| | - Alessandro Luongo
- San Luca Hospital, 1 Via F. Cammarota, 84078 Vallo della Lucania, Italy; (F.P.); (A.L.)
| | - Mafalda Massara
- Bianchi-Melacrino-Morelli Hospital, 21 Via G. Melacrino, 89124 Reggio di Calabria, Italy; (P.V.); (M.M.)
| | - Vincenzo Molinari
- Annunziata Hospital, 1 Via Migliori, 87100 Cosenza, Italy; (F.I.); (V.M.)
| | - Andrea Padricelli
- Division of Vascular Surgery, S. Anna and S. Sebastiano Hospital, Via F. Palasciano, 81100 Caserta, Italy;
| | - Marco Panagrosso
- Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 Via S. Pansini, 80131 Naples, Italy; (U.M.B.); (F.C.); (M.P.); (A.P.)
| | - Anna Petrone
- Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 Via S. Pansini, 80131 Naples, Italy; (U.M.B.); (F.C.); (M.P.); (A.P.)
- Del Mare Hospital, 11 Via E. Russo, 80147 Naples, Italy; (G.V.); (D.D.L.)
| | - Serena Pisanello
- SS. Annunziata Hospital, 1 Via F. Bruno, 74121 Taranto, Italy; (G.I.); (S.P.); (R.P.)
| | - Roberto Prunella
- SS. Annunziata Hospital, 1 Via F. Bruno, 74121 Taranto, Italy; (G.I.); (S.P.); (R.P.)
| | - Michele Tedesco
- Riuniti Polyclinic, 1 Viale L. Pinto, 71122 Foggia, Italy; (M.R.R.); (M.T.)
| | - Alberto M. Settembrini
- Division of Vascular Surgery, Maggiore Polyclinic Hospital Ca’ Granda IRCCS and Foundation, 28 Via F. Sforza, 20122 Milan, Italy;
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Bracale UM, Turchino D, Accarino G, Petrone A, Del Guercio L, Sodo M, Fornino G, Accarino G, Ielapi N, Serraino GF, Mastroroberto P, Provenzano M, Andreucci M, Serra R. Efficacy and Safety of Jotec E-Ventus BX Stent Graft for Iliac Branch Device Procedure: A Retrospective Clinical Study. Ann Vasc Surg 2021; 77:202-207. [PMID: 34437964 DOI: 10.1016/j.avsg.2021.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The endovascular aneurysm repair (EVAR) is a successful treatment for aorto-iliac aneurysms. The success of EVAR is enhanced by the use of devices that maintain the patency of targeted arteries namely the iliac branch device (IBD) With this study we aimed to evaluate the association between the use of Jotec E-ventus during EVAR with IBD and prognosis in patients with aorto-iliac aneurysms. METHODS This is a retrospective, multicentric study enrolling patients referred to our Vascular Surgery Units from January 2015 to January 2020. All patients underwent EVAR with IBD using Jotec E-ventus as bridging stent. Primary endpoint was the development of types I and III endoleaks. Secondary endpoint was the onset of device occlusion with loss of vascular patency. RESULTS We studied 32 patients (mean age 71.7±4.5y). Of these, 25 patients were treated with standard EVAR procedure whereas 7 were treated with isolated IBD due to extension of disease involving iliac bifurcation. Median follow-up lasted 15[IQR11-27] months. During follow-up, incidence rates for endoleaks and occlusion were 3.98(95%CI 0.48-14.41) and 1.99(95%CI 0.05-11.12) per 100 pts/year. CONCLUSIONS Jotec E-ventus during EVAR is associated with a low rate of severe complications in a small cohort of patients with aorto-iliac aneurysms.
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Affiliation(s)
| | - Davide Turchino
- Department of Public Health, University of Naples "Federico II", Naples, Italy; Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Giancarlo Accarino
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Anna Petrone
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Luca Del Guercio
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Maurizio Sodo
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Giovanni Fornino
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Giulio Accarino
- Vascular and Endovascular Surgery Unit, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Nicola Ielapi
- Department of Public Health and Infectious Disease, "Sapienza" University of Rome, Roma, Italy
| | | | - Pasquale Mastroroberto
- Department of Experimental and Clinical Medicine, University of Catanzaro, Catanzaro, Italy
| | - Michele Provenzano
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa Catanzaro, Italy
| | - Michele Andreucci
- Department of Health Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Raffaele Serra
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa Catanzaro, Italy; Interuniversity Center of Phlebolymphology (CIFL), "Magna Graecia" University, Catanzaro, Italy.
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5
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Stabile E, Piccolo R, Franzese M, Accarino G, Bracale UM, Cappello E, Cioffi G, Cioppa A, Crinisio A, Flora L, Landino P, Martelli E, Mancusi R, Niola R, Petrosino F, Razzano D, Ruotolo C, Salemme L, Sangiuolo P, Santini G, Soreca E, Vigliotti G, Villari B, Amabile G, Ammollo RP, Barbarisi D, Corbisiero AM, D’angelo A, Cangiano G, De Gregorio C, De Laurentis M, Laurenzano E, Ficarelli I, Luongo A, Molino C, Sarti G, Viola D, Esposito G. A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy. Vasc Med 2021; 26:174-179. [PMID: 33332228 PMCID: PMC8033437 DOI: 10.1177/1358863x20977678] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown (n = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 ± 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32-0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; p < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions.
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Affiliation(s)
- Eugenio Stabile
- Department of Advanced Biomedical
Sciences, Division of Cardiology, University of Naples Federico II, Naples,
Italy
| | - Raffaele Piccolo
- Department of Advanced Biomedical
Sciences, Division of Cardiology, University of Naples Federico II, Naples,
Italy
| | - Michele Franzese
- Department of Advanced Biomedical
Sciences, Division of Cardiology, University of Naples Federico II, Naples,
Italy
| | - Giancarlo Accarino
- Department of Vascular and Endovascular
Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Umberto Marcello Bracale
- Department of Public Health, Division of
Vascular Surgery, University of Naples Federico II, Naples, Italy
| | - Enrico Cappello
- Division of Vascular and Endovascular
Surgery, Mediterranea Centro Cuore, Naples, Italy
| | - Giovanni Cioffi
- Division of Vascular Surgery, Ospedale
Pellegrini, Naples, Italy
| | - Angelo Cioppa
- Division of Invasive Cardiology, Clinica
Montevergine, Mercogliano, Italy
| | - Adolfo Crinisio
- Division of Vascular and Endovascular
Surgery, Clinica Salus, Battipaglia, Italy
| | - Loris Flora
- Division of Vascular Surgery, AORN San
Giuseppe Moscati, Avellino, Italy
| | - Pietro Landino
- Department of Cardiology and Cardiac
Surgery, Casa di Cura S. Michele, Maddaloni, Italy
| | - Eugenio Martelli
- Division of Vascular and Endovascular
Surgery, AORN Sant’Anna e San Sebastiano, Caserta, Italy
| | - Rosario Mancusi
- Division of Vascular and Endovascular
Surgery, Villa dei Fiori Hospital, Acerra, Italy
| | - Raffaella Niola
- Division of Vascular and
Interventional Radiology, AORN Cardarelli, Naples, Italy
| | - Fernando Petrosino
- Division of Vascular Surgery, Presidio
Ospedaliero ‘San Luca’, Vallo della Lucania, Italy
| | - Davide Razzano
- Division of Vascular Surgery, AO San
Pio, Benevento, Italy
| | - Carlo Ruotolo
- Division of Vascular Surgery, AORN
Cardarelli, Naples, Italy
| | - Luigi Salemme
- Division of Invasive Cardiology, Clinica
Montevergine, Mercogliano, Italy
| | - Paolo Sangiuolo
- Division of Vascular Surgery, AORN
Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | | | - Emilio Soreca
- Department of Radiology, AO San Pio,
Benevento, Italy
| | | | - Bruno Villari
- Division of Cardiology, Ospedale Sacro
Cuore di Gesù, Benevento, Italy
| | - Giampaolo Amabile
- Division of Vascular and
Interventional Radiology, AORN Cardarelli, Naples, Italy
| | - Raffaele Pio Ammollo
- Department of Public Health, Division of
Vascular Surgery, University of Naples Federico II, Naples, Italy
| | - Danilo Barbarisi
- Division of Vascular Surgery, AORN San
Giuseppe Moscati, Avellino, Italy
| | | | - Antonio D’angelo
- Department of Vascular and Endovascular
Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Gianluca Cangiano
- Division of Vascular and
Interventional Radiology, AORN Cardarelli, Naples, Italy
| | - Claudia De Gregorio
- Division of Vascular and Endovascular
Surgery, Villa dei Fiori Hospital, Acerra, Italy
| | - Mario De Laurentis
- Division of Vascular Surgery, AORN
Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | | | | | - Alessandro Luongo
- Division of Vascular Surgery, Presidio
Ospedaliero ‘San Luca’, Vallo della Lucania, Italy
| | - Claudio Molino
- Division of Vascular and Endovascular
Surgery, Clinica Salus, Battipaglia, Italy
| | - Giuseppe Sarti
- Department of Radiology, Ospedale del
Mare, Naples, Italy
| | - Daniela Viola
- Division of Vascular Surgery, Ospedale
del Mare, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical
Sciences, Division of Cardiology, University of Naples Federico II, Naples,
Italy
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Reyes-Valdivia A, Kratimenos T, Ferraresi M, Sica S, Lovato L, Accarino G, Pagliaricco G, Tshomba Y, Tinelli G. A multicenter "real-world" study of the valiant NAVION stent graft. Int J Cardiol 2020; 331:63-68. [PMID: 33164839 DOI: 10.1016/j.ijcard.2020.10.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 09/23/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate early results of thoracic endovascular aortic repair (TEVAR) using the Valiant Navion™ stent graft in a "real-world" scenario. METHODS All patients who underwent TEVAR with the Valiant Navion™ endograft between November 2018 and November 2019 were included in this retrospective multicenter study (six European centers). The primary endpoints were technical success, incidence of major adverse events (MAEs), access failure, deployment failure, deployment accuracy, and rate of intraoperative endoleaks (ELs). RESULTS One hundred-sixteen patients with varying thoracic aortic diseases were included. Eighteen patients (15.5%) were treated for an off-label condition. The technical success rate was 100%, without any access or deployment failures. The proximal and distal deployment accuracy rates were 99.1% and 97.4%, respectively. There were no intraoperative MAEs, including death. Two (1.7%) type Ib ELs were detected at the first postoperative CTA, all of which were in off-label procedures and related to the short length of the sealing neck. No type III ELs were detected. The median hospitalization time was 8 days (IQR 4-12), including a median intensive care unit stay of 1 day (IQR 1-2). The in-hospital mortality rate was 4.3%. At a median follow-up time of 98 days (IQR 39-187), there were no aortic-related mortalities or new onset of endoleaks. CONCLUSION Our initial experience with the Valiant Navion™ endograft in a wide variety of aortic diseases showed safe early outcomes, especially for on-label procedures.
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Affiliation(s)
- Andrés Reyes-Valdivia
- Department of Vascular and Endovascular Surgery, Ramón y Cajal's University Hospital, 28034 Madrid, Spain
| | - Theodoros Kratimenos
- Interventional Radiology Department, Evangelismos Hospital, 10676 Athens, Greece
| | - Marco Ferraresi
- School of Vascular Surgery, University of Milan, 20122 Milan, Italy
| | - Simona Sica
- Unit of Vascular Surgery, Fondazione Policlinico Universitario Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luigi Lovato
- Cardiovascular Radiology Unit, Cardiovascular and Thoracic Department S. Orsola, Malpighi Hospital, 40138 Bologna, Italy
| | - Giancarlo Accarino
- U.O.C. di Chirurgia Vascolare ed Endovascolare, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, 84131 Salerno, Italy
| | - Gabriele Pagliaricco
- Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60020 Ancona, Italy
| | - Yamume Tshomba
- Unit of Vascular Surgery, Fondazione Policlinico Universitario Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
| | - Giovanni Tinelli
- Unit of Vascular Surgery, Fondazione Policlinico Universitario Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
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Vigliotti G, D’Alessandro A, Fornino G, Puca AE, Capparelli G, Cuofano M, Naddeo A, Brunico L, Vigliotti RC, Accarino G. Treatment of aortic aneurysms in elderly patients. BMC Geriatr 2011. [PMCID: PMC3194396 DOI: 10.1186/1471-2318-11-s1-a66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tesauro P, Accario B, Accarino G, Manduca A, Del Vecchio E. [Preliminary experiences in the use of radioisotopic angioscintigraphy in the bloodless study of peripheral vascular pathology]. Clin Ter 1984; 108:537-42. [PMID: 6327145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Accarino G, Barone L, Chieppa S, Giusti I, Nutile T, Luppino E, Visone C. [Experimental study of the hypolipidemic effect of tiadenol]. Boll Chim Farm 1979; 118:739-47. [PMID: 552256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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