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Pierro A, Posa A, Iorio L, Tanzilli A, Cucciolillo L, Quinto F, Sciandra M, Iezzi R, Cilla S. Bib Sign in Proximal Descending Thoracic Aorta Rupture on CT Angiography: Presentation of a Paradigmatic Case. Case Rep Radiol 2022; 2022:6947207. [PMID: 36518096 PMCID: PMC9744601 DOI: 10.1155/2022/6947207] [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: 06/20/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 08/30/2023] Open
Abstract
Thoracic aortic rupture may present with subtle clinical and CT-angiography findings. Recognition of the imaging features of early rupture is key for timely diagnosis and treatment. This report presents a new sign of incipient proximal thoracic aortic rupture on CT-angiography.
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Affiliation(s)
- Antonio Pierro
- Radiology Department, Cardarelli Regional Hospital, Viale Luigi Montalbò, 86100 Campobasso, Italy
| | - Alessandro Posa
- Vascular Surgery and Endovascular Unit, Cardarelli Regional Hospital, Viale Luigi Montalbò, 86100 Campobasso, Italy
| | - Luca Iorio
- Department of Diagnostic Imaging, Radiation Oncology and Hematology, “A. Gemelli” University Hospital, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Alessandro Tanzilli
- Vascular Surgery and Endovascular Unit, Cardarelli Regional Hospital, Viale Luigi Montalbò, 86100 Campobasso, Italy
| | - Lucia Cucciolillo
- Department of Diagnostic Imaging, Radiation Oncology and Hematology, “A. Gemelli” University Hospital, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Fabio Quinto
- Ospedale L. Bonomo, Viale Istria, 76123 Andria, Italy
| | - Mariacarmela Sciandra
- Radiology Department, Cardarelli Regional Hospital, Viale Luigi Montalbò, 86100 Campobasso, Italy
| | - Roberto Iezzi
- Vascular Surgery and Endovascular Unit, Cardarelli Regional Hospital, Viale Luigi Montalbò, 86100 Campobasso, Italy
| | - Savino Cilla
- Medical Physics Unit, Gemelli Molise Hospital, L.go A. Gemelli, 1, 86100 Campobasso, Italy
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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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